Asymptomatic bacteriuria in pregnancy: epidemiological, clinical and microbiological approach

Asymptomatic urinary tract infection is a risk factor for fetal and maternal morbidity including development of pyelonephritis, premature labor and impaired intra-uterine development. In this study, 326 pregnant and 100 non-pregnant control women were screened for significant asymptomatic bacteriuria from April 8 to July 25, 1997 to gain insight into the prevalence rate, clinical characteristics of the disease and microbiological assessments of the causative agents. All the subjects were clinically identified to have no signs and symptoms of urinary tract infection (UTI). The age ranges of the study and control groups were between 15-40 years for both groups with mean of 25.1 and 25.3 years, respectively. Bacteriological screening of mid-stream urine (MSU) revealed that 24/326 (7%) and 3/100 (3%) were positive for asymptomatic bacteriuria in the study group and controls, respectively (P < 0.05). Further biochemical species identification showed that Escherichia coli was found in 11/24 (46%) followed by coagulase-negative staphylococci (CNS) in 8/24 (33%) and Citrobacter freundii in 2/24 (8%). Others found in smaller number included Staphylococcus aureus, Enterobacter cloacae and Proteus rettgeri in 1/24 (4%) each. Antimicrobial susceptibility test revealed that 10/11 (91%) of the E. coli isolates were resistant to ampicillin and amoxicillin and 10/11 (91%) of them sensitive to nitrofurantoin.

The labile iron pool in hepatocytes: prooxidant-induced increase in free iron precedes oxidative cell injury

The labile iron pool (LIP) represents the nonferritin-bound, redox-active iron that has been implicated in oxidative stress and cell injury. Here we examined whether alterations in LIP can be detected in cultured murine hepatocytes and whether increases in LIP are related to the oxidative damage inflicted by the redox cycling drug nitrofurantoin (NFT). Early changes in LIP were monitored with the metal-sensitive fluorescent probe calcein (CA), the fluorescence of which is quenched on binding to iron. Short-term exposure (<1 h) to NFT reduced the CA fluorescence signal by 30%, indicating that the amount of LIP-associated iron had increased. Prolonged exposure (2 h) to NFT caused oxidative cell injury. The addition of the cell-permeable ferrous iron chelator 2,2'-bipyridyl not only prevented the quenching of CA fluorescence but also partially protected from NFT toxicity. It is concluded that reductive stress-induced increase in LIP is an essential event that precedes oxidative cell damage in intact hepatocytes.

Isolation of nitrofurantoin-resistant mutants of nitroreductase-producing Clostridium sp. strains from the human intestinal tract

Five spontaneous nitrofurantoin-resistant mutants (one each of Clostridium leptum, Clostridium paraputrificum, two other Clostridium spp. strains from the human intestinal microflora, and Clostridium perfringens ATCC 3626) were selected by growth on a nitrofurantoin-containing medium. All of the Clostridium wild-type and mutant strains produced nitroreductase, as was shown by the conversion of 4-nitrobenzoic acid to 4-aminobenzoic acid. High-performance liquid chromatography (HPLC) analysis of the mutants during incubation with 50 microg of nitrofurantoin per ml showed the gradual disappearance of the nitrofurantoin peak. The nitrofurantoin peak also disappeared when cell-free supernatants instead of cultures of each of the resistant and wild-type bacteria were used, but it persisted if the cell-free supernatants had been inactivated by heat. At least two of the mutants converted nitrofurantoin to metabolites without antibacterial activity, as was shown by a bioassay with a nitrofurantoin-susceptible Bacillus sp. strain. Nitrofurantoin at a high concentration (50 microg/ml) continued to exert some toxicity, even on the resistant strains, as was evident from the longer lag phases. This study indicates that Clostridium strains can develop resistance to nitrofurantoin while retaining the ability to produce nitroreductase; the mutants metabolized nitrofurantoin to compounds without antibacterial activity.

An active efflux system for heavy metals in cisplatin-resistant human KB carcinoma cells

The mechanism for cisplatin resistance in cisplatin-resistant KCP-4 cells was studied. Although multidrug resistance-associated protein (MRP) was not detected in KCP-4 cells, the cells were more resistant to heavy metals than multidrug-resistant C-A120 cells that overexpressed MRP. KCP-4 cells expressed metallothionein, but it was scarcely involved in cisplatin resistance in these cells. KCP-4 cells did not express canalicular multispecific organic anion transporter (cMOAT). The glutathione (GSH) level was 4.7-fold higher in KCP-4 cells than in KB-3-1 cells. When the GSH level in KCP-4 cells was decreased by treating the cells with buthionine sulfoximine and nitrofurantoin, the accumulation of and sensitivity to cisplatin in the cells were increased. C-A120 cells were only 3.0-fold more resistant to cisplatin than KB-3-1 cells and this resistance was not affected by the increased glutathione level. The accumulation of platinum in C-A120 and KCP-4 cells was 68.5 and 20.4% of that in KB-3-1 cells, respectively, while the intracellular levels of antimony potassium tartrate in C-A120 and KCP-4 cells were 13.2 and 9.9% of that in KB-3-1 cells, respectively. The ATP-dependent efflux of antimony was enhanced in both C-A120 and KCP-4 cells. These results, taken together, suggest an efflux pump for heavy metals different from MRP and cMOAT is involved in cisplatin resistance in KCP-4 cells.

Susceptibility of different isolates of Vibrio harveyi to antibiotics

The susceptibility of six Vibrio harveyi strains to antibiotics was studied. Four strains originally isolated from diseased penaeids and two reference strains originally isolated from either sea water (ATCC 25919) or diseased Talorchestia sp. (ATCC 14126) were used in the present study. Results revealed that all three strains isolated in Taiwan exhibited resistance against nitrofurantoin, novobiocin and sulphonamide. The two reference strains and the strain isolated in Indonesia were susceptible to these three antibiotics.

Endonuclease V (nfi) mutant of Escherichia coli K-12

Endonuclease V (deoxyinosine 3' endonuclease), the product of the nfi gene, has a specificity that encompasses DNAs containing dIMP, abasic sites, base mismatches, uracil, and even untreated single-stranded DNA. To determine its importance in DNA repair pathways, nfi insertion mutants and overproducers (strains bearing nfi plasmids) were constructed. The mutants displayed a twofold increase in spontaneous mutations for several markers and an increased sensitivity to killing by bleomycin and nitrofurantoin. An nfi mutation increased both cellular resistance to and mutability by nitrous acid. This agent should generate potential cleavage sites for the enzyme by deaminating dAMP and dCMP in DNA to dIMP and dUMP, respectively. Relative to that of a wild-type strain, an nfi mutant displayed a 12- to 1,000-fold increase in the frequency of nitrite-induced mutations to streptomycin resistance, which are known to occur in A x T base pairs. An nfi mutation also enhanced the lethality caused by a combined deficiency of exonuclease III and dUTPase, which has been attributed to unrepaired abasic sites. However, neither the deficiency nor the overproduction of endonuclease V affected the growth of the single-stranded DNA phages M13 or phiX174 nor of Uracil-containing bacteriophage lambda. These results suggest that endonuclease V has a significant role in the repair of deaminated deoxyadenosine (deoxyinosine) and abasic sites in DNA, but there was no evidence for its cleavage in vivo of single-stranded or uracil-containing DNA.

Overexpression of the hslVU operon suppresses SOS-mediated inhibition of cell division in Escherichia coli

A multicopy clone was isolated which conferred resistance to the SOS inducer nitrofurantoin in an Escherichia coli lon mutant. Plasmid pHL1 was found to contain a 7-8 kbp HindIII DNA insert from a region of the chromosome at 88.5 minutes. Further characterisation of pHL1 revealed that resistance to nitrofurantoin was due to the overexpression of the hslV-hslU operon which encodes an ATP-dependent protease complex in E. coli. The overexpression of hslVU also conferred resistance to ultraviolet irradiation in the lon mutant. It is proposed that when overproduced, the HslV-HslU protease complex can degrade SulA which is an endogenous inhibitor of the essential cell division protein FtsZ. The ability of HslVU to degrade SulA in vivo suggests that Lon and HslVU may share a range of substrates. Furthermore, the suppression of lon could be used as a simple genetic test of proteolytic activity of cloned HslVU.

[Resistant antibiotic analysis of methicillin-resistant staphylococcus]

Methicillin-resistant staphylococcus aureus is one of the important patholonic bacteria which cause nosocomial infection. In order to investigate the resistant antibiotic circumstances of this organism and hence provide foundations of prevention and treatment, we determined the resistant rates of 88 staphylococcus strains for methicillin and for other 14 kinds of commonly used antibiotics, and we determined the engendering beta-lactamase. The results showed that the isolation rate of methicillin-resistant staphylococcus aureus (MRSA) was 56%; the rate of methicillin-resistant staphylococcus coagulase-negative (MRSCoN) was 47.6%; the resistance rate and the multi-resistant rate of methicillin-resistant staphylococcus (MRS) for the 14 kinds of antibiotics were higher as compared with those of methicillin-sensitive (MSSA). Among all the tested strains, MRSA was the highest to engender beta-lactamase (92.9%); Methicillin-sensitive staphylococcus coagulase-negative (MSSCoN) was the lowest (39.4%). MRS was sensitive to vancomycin and furantoin. These suggest that when treating this bacterium, we should select these two antibiotics first.

Transient reverse ventilation-perfusion mismatch in acute pulmonary nitrofurantoin reaction

A 67-yr-old woman with a history of myocardial infarct was admitted to emergency for marked dyspnea, nonproductive cough, nausea and fever. The thorax X-ray revealed a bilateral alveolar and interstitial infiltration pattern with basal accentuation. The cardiac examinations were normal. Technegas ventilation and Tc-99m-macroaggregated albumin (MAA) perfusion scans were performed to rule out pulmonary embolism. Bilateral multiple ventilation defects with normal perfusion was observed. The patient had been taking nitrofurantoin for four days for a bladder infection. Hypersensitivity to nitrofurantoin was suspected and the drug was discontinued. An antihistaminic and anxiolytic medication was started. The majority of the clinical symptoms disappeared within 24 hours. The control chest X-rays disclosed a marked improvement. Ventilation and perfusion scans obtained 48 hours after nitrofurantoin withdrawal were normal. The drug-related pulmonary reactions should be taken into account in patients on medication. Reversible ventilation defects can be the only lung-scintigraphic finding encountered in acute pulmonary nitrofurantoin reaction.

Differential effects of nitrofurans on the production/release of steroid hormones by porcine adrenocortical cells in vitro

Changes in the biogenesis of corticosteroids caused by nitrofurans were studied. The three nitrofurans used: furazolidone, furaltadone and nitrofurantoin, altered the steroid production/release by porcine adrenocortical cells in vitro during 1 h incubations. With pregnenolone as a substrate the nitrofurans inhibited aldosterone production/release. Although the nitrofurans differed in potency (nitrofurantoin > furazolidone > furaltadone) maximum inhibition occurred at 100 microM. In this concentration the nitrofurans changed also the release/production of other corticosteroids. The output of corticosterone and cortisol decreased by 50%. The production/release of deoxycortisol stayed the same. In contrast the output of progesterone and 17alpha-hydroxyprogesterone increased to more than 200% of control. The nitrofurans slightly reduced the output of androstenedione. No significant increases of the production/release of other steroids (testosterone, dehydroepiandrosterone, estradiol-17beta and estrone) by the cell suspension could be observed. The profile of the nitrofuran-induced changes lead to the conclusion that nitrofurans interfere with mitochondrial enzymes. These enzymes, presumably cytochrome P450(11,18) mediate the hydroxylation and the oxidation at C11 and C18, the final steps in the biogenesis of aldosterone, corticosterone and cortisol. The rapid and reversible fall in the output of these steroids occurs in vitro at concentrations which are below therapeutic blood concentrations seen in vivo. At higher concentrations the nitrofurans hinder the biogenesis of androgens. Thus nitrofurans can also affect steps in the steroid biogenesis located in the endoplasmatic reticulum.

Nitroaromatic betulin derivatives as redox cycling agents

We have synthesized nitroaromatic derivatives of triterpenoid betulin (lup-20(29)-ene-3 beta, 28-diol), betulin-(28)-5'-(aziridin-1-yl)-2',4'-dinitrobenzoate and betulin-(28)-5'-nitro-2'-furoate. These compounds were reduced in single-electron way by ferredoxin: NADP+ reductase and flavocytochrome b2 at rates comparable with their simple structure analogs. Besides, these compounds were substrates for DT-diaphorase. Their toxicity to bovine leukemia virus-transformed lamb fibroblast culture was partly prevented by antioxidant N,N'-diphenyl-p-phenylene diamine and desferrioxamine, indicating an involvement of oxidative stress in their cytotoxicity.

Nitrofurantoin-induced hepatic and pulmonary biochemical changes in mice fed different vitamin E doses

The hepatic and pulmonary effects of nitrofurantoin (40 mg/kg, intraperitoneally) were determined at 4 and 24 hr following its administration in mice fed for 10 weeks with a vitamin E sufficient, deficient or enriched diet. Liver glutathione (GSH) was reduced by nitrofurantoin at 4 hr but was unchanged 20 hr later. Nitrofurantoin did not affect liver glutathione peroxidase, glutathione reductase or superoxide dismutase activities. Liver catalase activities were decreased by nitrofurantoin at 4 hr. Lung GSH levels were increased whilst glutathione peroxidase activity was decreased at 4 and 24 hr. Lung glutathione reductase activity was reduced in certain groups. Nitrofurantoin did not affect lung superoxide dismutase, but catalase was decreased at 24 hr. Liver malondialdehyde levels were increased by nitrofurantoin in the vitamin E deficient group whilst lung malondialdehyde levels remained unchanged. Both liver and lung malondialdehyde levels were unaffected by vitamin E supplementation when compared to the vitamin E-sufficient group. These results suggest that nitrofurantoin (40 mg/kg) was deleterious to the liver and lung. Nitrofurantoin-induced lipid peroxidation was seen in vitamin E deficiency but an increase in dietary vitamin E content did not provide additional protection compared to the recommended daily allowance. The antioxidant activities of alpha-tocopherol and gamma-enriched tocotrienol were similar.

Inhibition kinetics of camel lens zeta-crystallin: multiple inhibition studies

The inhibition of camel lens zeta-crystallin by nitrofurantoin (NF) was uncompetitive with respect to co-factor NADPH, (Ki = 90 microM) and competitive with respect to the substrate 9,10-phenanthrenequinone (PQ), (Ki = 50 microM). Inhibition at micromolar concentrations was also observed with dicoumarol, NADP+ and cibacron blue (CB). Theorell-Yonetani double-inhibition analysis showed that NF and dicoumarol were mutually exclusive inhibitors against PQ. However, analysis of NF and NADP+ by a double-inhibition plot showed that they simultaneously bind to the enzyme molecule. These studies demonstrate that NF and dicoumarol share the same site so that both molecules are prevented from binding at the same time, while NF and NADP+ can bind simultaneously to different sites on the enzyme. Although CB was noncompetitive with respect to PQ, double inhibition analysis showed that CB and dicoumarol or NF were mutually exclusive inhibitors against PQ, implying a distinct mode of inhibition for CB.

Sensitivity of Australian isolates of Salmonella enteritidis to nitrofurantoin and furazolidone

Susceptibility of 66 and 62 Australian isolates of Salmonella enteritidis to nitrofurantoin and furazolidone, respectively, was determined. Most isolates were susceptible to both antibiotics. Cross-resistance was low among all isolates, but higher among the subset of phage type 4 isolates. These results contrast directly with those of a previous study (Rampling, A., Upson, R. and Brown, D.F.J. (1990) J. Antimicrob. Chemother., 25: 285-290). Sensitivity among Australian isolates of S. enteritidis does to some extent, support the contention that furans may have played a role in the selection and enhanced colonisation of poultry by Salmonella enteritidis in Britain. Furthermore, nitrofurantoin should not be used as a selective agent in the isolation of Salmonella enteritidis.

On the nature of the adaptive response induced by mitomycin C in Vibrio cholerae OGAWA 154 cells

The induction of an adaptive response in Vibrio cholerae OGAWA 154 cells was obtained using an alkylating agent, mitomycin C, as both stimulating and challenging agent. Cross-adaptive response was observed in V. cholerae cells when pretreated with a sublethal dose of another alkylating agent, N-methyl-N'nitro-N-nitrosoguanidine, followed by challenging treatment with mitomycin C. The dose of mitomycin C for 50% survival (D50) became almost double for mitomycin C pretreated cells and 1.5 times for N-methyl-N-'nitro-N-nitrosoguanidine pretreated cells, compared to nonpretreated cells. It was also shown that pretreatment with a sublethal dose of oxidative DNA damaging agents, viz, hydrogen peroxide or nitrofurantoin, did not show any cross-adaptive response against subsequent challenge by mitomycin C.

Differential activation of heat-shock and oxidation-specific stress genes in chemically induced oxidative stress

Post-ischaemic reperfusion increases the level of the major heat-shock (stress) protein hsp 70 and of its mRNA by transcriptional mechanisms, and activates the binding of the heat-shock factor HSF to the consensus sequence HSE. In common with CoCl2 treatment, post-ischaemic reperfusion increases the level of haem oxygenase mRNA, an indicator of oxidative stress, but CoCl2 does not seem to induce the expression of the hsp 70 gene [Tacchini, Schiaffonati, Pappalardo, Gatti and Bernelli-Zazzera (1993) Lab. Invest. 68, 465-471]. Starting from these observations, we have now studied the expression of two genes of the hsp 70 family and of other possibly related genes under conditions of oxidative stress. Three different chemicals, which cause oxidative stress by various mechanisms and induce haem oxygenase, enhance the expression of the cognate hsc 73 gene, but do not activate the inducible hsp 70 gene. Expression of the other genes that have been studied seems to vary in intensity and/or time course, in relation to the particular mechanism of action of any single agent. The pattern of induction of the early-immediate response genes c-fos and c-jun observed during oxidative stress differs from that found in post-ischaemic reperfused livers. Oxidative-stress-inducing agents do not promote the binding of HSF to its consensus sequence HSE, such as occurs in heat-shock and post-ischaemic reperfusion, and fail to activate AP-1 (activator protein 1). With the possible exception of Phorone, the oxidative stress chemically induced in rat liver activates NFkB (nuclear factor kB) and AP-2 (activator protein 2) transcription factors.

Dihydroxy-acid dehydratase, a [4Fe-4S] cluster-containing enzyme in Escherichia coli: effects of intracellular superoxide dismutase on its inactivation by oxidant stress

Dihydroxy-acid dehydratase (DHAD) has a [4Fe-4S] cluster and is reported to be facilely inactivated by oxidant stress. To directly assess the biological effects in vivo of superoxide dismutase (SOD) on the oxidant sensitivity of DHAD, we used an Escherichia coli K-12 parent strain (CGSC5073) and derived strains OB 1, OB 2, and OB 3 that lacked one of or both FeSOD and MnSOD. In the K-12 parent strain half the cellular DHAD activity was lost in 15 min at 0.8 atm oxygen, less than 10 microM aerobic nitrofurantoin, or about 5 microM aerobic paraquat (PQ) and in about 1 min at 10 microM aerobic PQ. Oxygen and metabolism were required for PQ to inactivate DHAD in cells; adding dithiothreitol to cell-free extracts did not restore DHAD activity. The Km was not appreciably changed for DHAD that was 50 and 70% inactivated in cells, respectively, by hyperbaric oxygen (HBO) and PQ, compared to cells in exponential, aerobic growth. Thus, active site oxidative impairment of individual enzyme molecules apparently was all-or-none. DHAD activity was greatly decreased when measured in extracts made from strains that lacked both SODs unless SOD was added to cell suspensions before extracts were made. DHAD was more sensitive in strains lacking both SODs than in the parent strain to inactivation by aerobic PQ and HBO. Anaerobic (compared to aerobic) growth increased DHAD specific activity by 20% or less in the parent strain and in strains OB 1 and OB 2 (lacking MnSOD and FeSOD, respectively); however, in strain OB 3 (lacking both SODs) DHAD was increased 60%. DHAD was partially inactivated by the oxidant stress of aerobic growth, but remained in a form detectable by DHAD antibody, and the ratio of active to inactive DHAD decreased greatly in cells lacking SOD. Thus, SOD helped maintain DHAD as an active holoenzyme and benefitted cells growing aerobically or when exposed to low levels of PQ.

The consequences of nitrofurantoin-induced oxidative stress in isolated rat hepatocytes: evaluation of pathobiochemical alterations

Oxidative stress was induced in isolated rat hepatocytes by incubation with nitrofurantoin in the absence and presence of the GSSG reductase inhibitor BCNU. In both cases nitrofurantoin markedly reduced glutathione but exerted cytotoxicity as measured by LDH release and loss of intracellular potassium only in BCNU pretreated cells. The onset of cytotoxicity was accompanied by an increase of lipid peroxidation. Oxidation of protein thiols, however, could not be detected in the early phase of cell damage. The cytoprotective activity of N-acetyl-cysteine > dithiothreitol = deferoxamine revealed the substantial importance of glutathione for cellular defence and the sensitivity of not yet identified thiol-dependent targets of oxidative stress.

Induction of adaptive response by nitrofurantoin against oxidative DNA damage in some bacterial cells

Pretreatment with a sublethal dose of nitrofurantoin did not give any protection to Vibrio cholerae OGAWA 154 (wild-type) cells against subsequent treatment with challenging doses of MNNG and vice versa. However, pretreatment with a sublethal dose of nitrofurantoin offered significant protection to the bacterial cells against subsequent treatment with challenging doses of H2O2 and vice versa. Further, sublethal doses of nitrofurantoin or H2O2 produced almost the same degree of protection against challenges by H2O2 or nitrofurantoin. Both the alkylating agent MNNG and the oxidative agent H2O2 induced adaptive responses in Vibrio cholerae OGAWA 154 cells against subsequent challenge by the respective agents. The experiments presented in this communication revealed that nitrofurantoin produced an adaptive response in bacterial cells against oxidative and not alkylating DNA damage.

Development of antibacterial resistance: the Dutch experience

An ongoing registration of resistance patterns of microorganisms in a large area in the Netherlands demonstrated a slow but steady increase of resistance to several antibacterials in the past ten years. For some bacteria and for some selected antimicrobial agents this increase was such that it might no longer be justifiable to choose them for empirical therapy. For Escherichia coli, resistance increased from 14% in 1982 to 28% in 1992 for co-trimoxazole and for trimethoprim and from 24% to 34% for amoxycillin. For nitrofurantoin the figures were 1.5% and 4.0%, respectively. Comparison with other areas in the Netherlands showed similar results, so it can be considered a nationwide problem which may have consequences for national antibiotic guidelines for the treatment of infections.

Nitrofurantoin: mechanism of action and implications for resistance development in common uropathogens

Nitrofurantoin is an effective urinary tract antibacterial to which no clinically significant resistance development has occurred. We have previously shown that nitrofurantoin susceptibility in bacteria correlates with the presence of bacterial nitroreductases which convert nitrofurantoin to highly reactive electrophilic intermediates. These intermediates were shown to attack bacterial ribosomal proteins non-specifically, causing complete inhibition of protein synthesis. In the present study, we confirm previous reports that low concentrations of nitrofurantoin specifically inhibit inducible enzyme synthesis in bacteria, and show that this inhibition occurs at levels equivalent to the MICs of nitrofurantoin for several bacterial species. Our previous studies had shown that nitrofurantoin at different concentrations interacts with bacterial ribosomal proteins in qualitatively the same fashion; we now report that quantitative differences are seen in the labelling observed at different nitrofurantoin concentrations and discuss these differences as they may relate to the inhibition of inducible enzyme synthesis. In addition, we have now demonstrated the existence of a novel mechanism of action for nitrofurantoin which does not require the production of reactive nitrofurantoin metabolites by bacterial reductases. The lack of clinically significant bacterial resistance development to nitrofurantoin is likely due to the combination of nitrofurantoin's multiple sites of attack and multiple mechanisms of action.

Inhibition studies on the involvement of flavoprotein reductases in menadione- and nitrofurantoin-stimulated oxyradical production by hepatic microsomes of flounder (Platichthys flesus)

Inhibitors of mammalian cytochrome P450 and P450 reductase were used to investigate the enzymes in flounder (Platichthys flesus) hepatic microsomes involved in the stimulation of NAD(P)H-dependent iron/EDTA-mediated 2-keto-4-methiolbutyric acid (KMBA) oxidation (hydroxyl radical production) by the redox cycling compounds menadione and nitrofurantoin. Inhibitors were first tested for their effects on flounder microsomal P450 and flavoprotein reductase activities. Ellipticine gave type II difference binding spectra (app. Ks 5.36 microM; delta A max 0.16 nmol-1 P450) and markedly inhibited NADPH-cytochrome c reductase, NADPH-cytochrome P450 reductase, and monooxygenase (benzo[a]pyrene metabolism) activities. 3-aminopyridine adenine dinucleotide phosphate (AADP; competitive inhibitor of P450 reductase) inhibited NADPH-cytochrome c but not NADH-cytochrome c or NADH-ferricyanide reductase activities. Alkaline phosphatase (inhibitor of rabbit P450 reductase) stimulated NADPH-cytochrome c reductase activity seven fold but had less effect on NADH-reductase activities. AADP inhibited nitrofurantoin- and menadione-stimulated KMBA oxidation by 45 and 17%, respectively, indicating the involvement of P450 reductase at least in the former. In contrast, ellipticine had relatively little effect, possibly because, unlike cytochrome c, the smaller xenobiotic molecules can access the hydrophilic binding site of P450 reductase. Alkaline phosphatase stimulated NAD(P)H-dependent basal and xenobiotic-stimulated KMBA oxidation, showing general consistency with the results for reductase activities. Overall, the studies indicate both similarities (ellipticine, AADP) and differences (alkaline phosphatase) between the flounder and rat hepatic microsomal enzyme systems.

Sustained-release dosage form of nitrofurantoin. Part 2. In vivo urinary excretion in man

The in vivo absorption of crystalline nitrofurantoin and the dosage forms of nitrofurantoin prepared with microcapsules were carried out in man by determination of urinary excretion of unchanged nitrofurantoin. The cumulative amount of drug excreted and the duration of the therapeutic urine levels were compared. The microcapsule administration showed that the peak reached during the excretion of nitrofurantoin in urine, decreased significantly when compared to the pure drug. This could be an explanation for the decrease in side-effects of nitrofurantoin such as nausea and vomiting. Experiments in male albino rats showed that the microcapsules did not produce gastric haemorrhage seen with the same doses of the pure drug.

Effects of nitrofurantoin on viability, DNA synthesis and morphology of Vibrio cholerae cells

Nitrofurantoin caused a dose dependent inhibition of growth and decrease in viability of V. cholerae cells, the 10% (D10) and 37% (D37) survival doses being 50 and 19 micrograms/ml respectively. The drug at a concentration of 60 micrograms/ml caused 86% inhibition of DNA synthesis. Both light and electron microscopic observations revealed that treatment with nitrofurantoin (60 micrograms/ml for 1 hr at 37 degrees C) led to a significant filamentation of the V. cholerae cells, ultrastructure of the cell cytoplasm, plasma membrane and cell wall however remaining unaltered from those of untreated cells. The results are discussed in relation to DNA lesions produced by and the carcinogenic potential of the drug.

Comparative studies of sheep lung and liver nitrofurantoin reductase

1. Nitrofurantoin reductase which catalyzes the bioactivation of nitrofurantoin was purified to electrophoretic homogenity from sheep liver and lung microsomes, with a yield of 15% and 35%, respectively. The specific activity of both reductases was found to be similar (140 nmol/min/mg protein). 2. The effects of nitrofurantoin and NADPH concentrations, pH, ionic strength, amount of enzyme and reaction period, on the enzyme activity were studied and the optimum conditions for maximum activity of purified liver and lung nitrofurantoin reductases were determined. 3. The enzyme concentration was found proportional with the square root of the rate of nitrofuratoin reduction up to approximately 15 micrograms protein/ml and 25 micrograms protein/ml incubation mixture for liver and lung nitrofurantoin reductases, respectively. 4. The plots of inverse of the nitrofurantoin concentration against the inverse of the square root of the velocity for the reduction of nitrofurantoin by liver and lung enzymes gave Km values as 27.78 microM and 32.25 microM, respectively. 5. The purified liver and lung enzymes were also saturated by NADPH at similar concentrations and the Km values were calculated as 29.4 microM and 35.5 microM, respectively. 6. The effects of magnesium, nickel, cadmium and copper ions on the nitrofurantoin reductase activity were examined. Magnesium ion was found to have almost no effect, whereas the other ions inhibited the activity of both liver and lung reductases.

Activity of a nitrofurazone matrix urinary catheter against catheter-associated uropathogens

Nitrofurazone-coated urinary catheter segments inhibited 51 (75%) of 70 urinary bacterial isolates from patients with indwelling catheters. Inhibition zones correlated significantly with the nitrofurazone MIC (r2 = 0.79, P = 0.0001). All strains except the Pseudomonas spp. were inhibited by < or = 64 micrograms of nitrofurazone per ml. MICs of nitrofurazone and nitrofurantoin correlated significantly (r2 = 0.93, P = 0.0001).

Induction of prophage lambda by nitrofurantoin and its modulation by butylated hydroxytoluene, sodium arsenite and alpha tocopherol

Nitrofurantoin induced prophage-lambda in E. coli K12 strain GY5027(lambda) in a dose dependent manner, the maximum induction being 10-fold the spontaneous induction level and the maximum efficiency of induction 74%. The lever extract used as a metabolizing mixture enhanced the induction level significantly. Chloramphenicol at a concentration of 20 micrograms/ml inhibited the prophage induction by nitrofurantoin, indicating that the induction required concomitant protein synthesis. Butylated hydroxytoluene(BHT) and sodium arsenite enhanced the nitrofurantoin induced prophage-lambda induction in E. coli GY 5027(lambda) cells in a dose dependent manner. The maximum modulations in induction level (I/Io) were achieved with 100 micrograms/ml BHT and 250 micrograms/ml sodium arsenite corresponding to a nitrofurantoin concentration of 15 micrograms/ml and were found significant on statistical analysis. alpha-tocopherol, however, did not produce any effect on the prophage-lambda induction by nitrofurantoin.

Induction of SOS like responses by nitrofurantoin in Vibrio cholerae el tor cells

Treatment of Vibrio cholerae el tor strain SLH22(J) with nitrofurantoin induced dose-dependent prophage 'kappa', the maximum induction being 6-fold the spontaneous induction level. UV-inactivated 'kappa' phages were Weigle reactivated, the maximum Weigle factor being 1.8 and 2.0 respectively in nitrofurantoin and UV pretreated el tor strain H218 Smr. Nitrofurantoin treatment also caused significant filamentation of the el tor strain H218 Smr and mutation of these cells from ampicillin sensitivity to ampicillin resistance. The levels of the four SOS-like responses induced by this drug were low but significant.

The ability of bacteria to synthesize a new cyclopyrophosphate correlates with their tolerance to redox-cycling drugs: on a crossroad of chemotherapy, environmental toxicology and immunobiochemical problems

Many redox-cyclers were recently shown to induce, in some bacterial species, large-scale biosynthesis of a new 2-methylbutan-1,2,3,4-tetraol-2,4-cyclopyrophosphate believed to be involved in anti-stress reactions. In the present study Mycobacterium smegmatis, Micrococcus luteus and Brevibacterium ammoniagenes were shown to begin synthesis of the new cyclopyrophosphate when cultivated in a medium containing furacilin or furadonin (widely used nitrofuran antibacterial drugs) and to maintain close to normal growth rates, whereas Staphylococcus aureus, Bacillus subtilis and Escherichia coli were inhibited by the drugs and were unable to synthesize the cyclopyrophosphate compound. Preferential binding of Mg2+ and Cd2+ with one or other phosphoryl groups of the cyclopyrophosphate, which was indicated by selective changes of 31P-NMR chemical shifts and intramolecular hydrogen bonding, is suggested as a reason for this selectivity.

No evidence of intracellular oxidative stress during ischemia-reperfusion damage in rat liver in vivo

The role of the intracellular generation of reactive oxygen species in the pathogenesis of ischemia-reperfusion damage of the liver was investigated in two in vivo rat models. Global hepatic ischemia was produced in the left and median lobes for 90 min followed by 60 min reperfusion to the total organ (model A) or only to the ischemic lobes (model B). Although both regimens caused significant rises in serum transaminases, this rise was higher in model B. In neither model was intracellular hydrogen peroxide production nor increased glutathione disulfide in bile found. The activities of various antioxidant enzymes were not affected by ischemia or ischemia-reperfusion. In conclusion, oxygen-free radicals are unlikely to be produced in the cells of rat liver during ischemia-reperfusion.

Lack of effect of trimethoprim and nitrofurantoin on colonization resistance in the vagina of monkeys

The effects of trimethoprim and nitrofurantoin, two antibiotics often used for treatment and long-term prophylaxis of urinary tract infections, on colonization resistance in the vagina of monkeys were investigated. Female monkeys were flushed intravaginally with one of the antibiotics or buffered saline or amoxicillin (controls) for six days. During or after this antibiotic administration a pyelonephritogenic Escherichia coli, strain DS17, was flushed into the vagina. A persistent colonization was obtained in two of eight trimethoprim experiments and a transient colonization in one trimethoprim and two of seven nitrofurantoin experiments. These results did not differ significantly from those of the buffer control experiments. Neither the number of anaerobic bacteria nor the composition of the anaerobic microflora was much affected by these antibiotic agents, while amoxicillin both reduced the number of anaerobic bacteria and promoted E. coli colonization. We conclude that trimethoprim and nitrofurantoin exert a limited effect on the microecology and the colonization resistance in the vagina. From an ecological aspect both drugs seem to be good choices for treatment and prophylaxis of urinary tract infections.

Identification and characterization of the enzymatic activity of zeta-crystallin from guinea pig lens. A novel NADPH:quinone oxidoreductase

zeta-Crystallin is a major protein in the lens of certain mammals. In guinea pigs it comprises 10% of the total lens protein, and it has been shown that a mutation in the zeta-crystallin gene is associated with autosomal dominant congenital cataract. As with several other lens crystallins of limited phylogenetic distribution, zeta-crystallin has been characterized as an "enzyme/crystallin" based on its ability to reduce catalytically the electron acceptor 2,6-dichlorophenolindophenol. We report here that certain naturally occurring quinones are good substrates for the enzymatic activity of zeta-crystallin. Among the various quinones tested, the orthoquinones 1,2-naphthoquinone and 9,10-phenanthrenequinone were the best substrates whereas menadione, ubiquinone, 9,10-anthraquinone, vitamins K1 and K2 were inactive as substrates. This quinone reductase activity was NADPH specific and exhibited typical Michaelis-Menten kinetics. Activity was sensitive to heat and sulfhydryl reagents but was very stable on freezing. Dicumarol (Ki = 1.3 x 10(-5) M) and nitrofurantoin (Ki = 1.4 x 10(-5) M) inhibited the activity competitively with respect to the electron acceptor, quinone. NADPH protected the enzyme against inactivation caused by heat, N-ethylmaleimide, or H2O2. Electron paramagnetic resonance spectroscopy of the reaction products showed formation of a semiquinone radical. The enzyme activity was associated with O2 consumption, generation of O2- and H2O2, and reduction of ferricytochrome c. These properties indicate that the enzyme acts through a one-electron transfer process. The substrate specificity, reaction characteristics, and physicochemical properties of zeta-crystallin demonstrate that it is an active NADPH:quinone oxidoreductase distinct from quinone reductases described previously.

The role of NADPH in the regulation of glucose-6-phosphate and 6-phosphogluconate dehydrogenases in rat adipose tissue

Previous studies examining the regulation of the synthesis of G6PDH and 6PGDH in rat liver and adipose tissue have focused on the induction of these enzymes by different diets and some hormones. In rat liver these enzymatic activities seem to be regulated by a mechanism involving changes in the NADPH requirements. In this paper we have studied the effect of changes in the flux through different NADPH-consuming pathways on G6PDH and 6PGDH levels in adipose tissue and on the NADPH/NADP ratio. The results show that: I) an increase in the consumption of NADPH, caused by the activation of either fatty acid synthesis or detoxification systems which consume NADPH, is paralleled by an increase in the levels of these enzymes; II) when the increase in consumption of NADPH is prevented, the G6PDH and 6PGDH levels do not change.

DNA damage and cell killing by nitrofurantoin in relation to its carcinogenic potential

Nitrofurantoin inhibited growth and produced loss of viability of Vibrio cholerae cells in a dose-dependent manner, the 10% (D10) and 37% (D37) survival doses being 18.0 and 5.5 micrograms/ml x hr. respectively. The drug also caused filamentation of the cells in a very significant manner. Ultraviolet absorption data and thermal chromatography through hydroxyapatite column revealed that nitrofurantoin treatment of Vibrio cholerae cells produced a maximum amount of 55% of DNA reversibly bihelical due to the formation of inter-strand cross-links. Helix-coil transition studies carried out by viscometric and also, spectrophotometric methods revealed that the nitrofurantoin-induced cross-links in Vibrio cholerae DNA, imparted to this DNA greater thermal stability than that of native DNA. The quantitative aspect and also the mode of nitrofurantoin action on DNA of Vibrio cholerae and Escherichia coli cells vis-à-vis the carcinogenic potential of the drug were discussed.

[Escherichia coli strains isolated from the urine of children with urinary tract infections and their antibiotic susceptibility. A comparative study from three centers]

We searched the susceptibility of E. coli strains isolated from urine cultures of sick children with urinary tract infections to Nitrofurantoin, Co-trimoxazole, Gentamicin, Ampicillin and Amoxillin-Clavulonic acid. In our study, we compared the results of Farabi Hospital of Black Sea Technical University Medical Faculty, Hacettepe University Medical Faculty Children Hospital and Glasgow Royal Hospital for sick children and tried to show their regional and national differences for antibiotic susceptibility.

Nitrofurantoin resistance in isolates of Salmonella enteritidis phage type 4 from poultry and humans

All 38 isolates of Salmonella enteritidis phage type (PT) 4 from chickens and 86 of 89 isolates from human patients were resistant to nitrofurantoin. Resistance to other agents was rare. Thirteen of 16 isolates of S. enteritidis other than PT4 were nitrofurantoin-resistant, and resistance to other agents was slightly more common than with isolates of PT4. Only one third of 83 isolates of other salmonella serotypes were nitrofurantoin-resistant, but resistance to other agents was more common and some isolates were multiply resistant. There was generally cross-resistance between nitrofurantoin and furazolidone although there were discrepancies with isolates that had MICs close to the breakpoint. It may be that use of nitrofurans in the poultry industry has selected for colonization and infection with S. enteritidis PT4. This could explain the prevalence of the organism in poultry and in human enteric infection in the United Kingdom.

Blood pressure elevation caused by inhibition of brain glutathione reductase

The effect of brain glutathione reductase activity on blood pressure regulation was investigated. The intravenous administration of the glutathione reductase inhibitor, nitrofurantoin (0.1-0.3 mg/rat), to seven normotensive Wistar rats caused dose-dependent rises in blood pressure and the heart rate (delta mean blood pressure 17 +/- 1 mmHg; delta heart rate 89 +/- 7 beats/min for 0.3 mg). Rats treated with 0.3 mg nitrofurantoin showed a 50% decrease in glutathione reductase activity with a twofold increase in the ratio of glutathione disulphide to reduced glutathione in the hypothalamus and brainstem, and a 1.5-fold increase in plasma noradrenaline and plasma renin activity compared with controls. These nitrofurantoin-induced effects were totally abolished by pretreatment with a sympathetic ganglion blocker (4 mg pentolinium tartrate, administered subcutaneously) except for the increased ratio of glutathione disulphide to reduced glutathione and the decreased glutathione reductase activity in the brain. These results suggest that the blood pressure elevation caused by inhibition of brain glutathione reductase activity occurs through activation of the sympathetic nervous system and the renin-angiotensin system.

Inhibition of rat liver microsomal lipid peroxidation by N-acyldehydroalanines: an in vitro comparative study

Captodative substituted olefins are radical scavengers which react with free radicals to form stabilized radical adducts. One of those compounds, N-(paramethoxyphenylacetyl)dehydroalanine (AD-5), may react and scavenge both superoxide anion (O-2) and alk-oxyl radicals (RO.), and in this way prevent the appearance of their mediated biological effects. Nitrofurantoin and tert-butyl hydroperoxide were used as model compounds to stimulate free radical production and their mediated lipid peroxidation in rat liver microsomes. In addition, lipid peroxidation was also initiated by exposure of rat liver microsomal suspensions to ionizing radiation (gamma rays). The microsomal lipid peroxidation induced by these chemicals and physical agents was inhibited by the addition of AD-5. These effects were dose-dependent in a millimolar range of concentration. In addition, AD-5 has no effect on microsomal electron transport, showing that NADPH-cytochrome P450 reductase activity was not modified. These data, together with the comparisons of the effects of AD-5 and some antioxidant molecules such as superoxide dismutase, uric acid, and mannitol, support the conclusion that inhibition of lipid peroxidation by AD-5 is the result of its free radical scavenger activity. In addition, the inhibitory effect of AD-5 on microsomal lipid peroxidation was dependent of the nature of the free radical species involved in the initiation of the process, suggesting that O-2 is scavenged more efficiently than RO.

Hyperoxia and the antimicrobial susceptibility of Escherichia coli and Pseudomonas aeruginosa

We have tested the ability of hyperoxia (98% O2-2% CO2 at 2.8 atmospheres absolute [ca. 284.6 kPa]) to enhance killing of Escherichia coli (serotype O18 or ATCC 25922) by nitrofurantoin, sulfamethoxazole, trimethoprim, gentamicin, and tobramycin. We have also looked for interactions between hyperoxia and the aminoglycosides against Pseudomonas aeruginosa ATCC 27853. Hyperoxia significantly enhanced bacteriostatic activity of nitrofurantoin and trimethoprim as measured by MIC testing. The possibility exists that these effects might be due to the method required to tests MICs under hyperoxic conditions rather than to the effect of hyperoxia itself. In addition, hyperoxia enhanced killing of bacteria by trimethoprim as measured by MBC testing. Hyperoxia decreased numbers of E. coli by 1.3 log10 and P. aeruginosa by 2.7 log10 in cation-supplemented Mueller-Hinton broth medium. The bacteriostatic effects of hyperoxia did not affect MICs of gentamicin or tobramycin. The lack of interaction between hyperoxia and gentamicin or tobramycin was confirmed by determining the number of viable bacteria remaining after 24 h of exposure to hyperoxia by using a pour plate method. We conclude that hyperoxia potentiates the antimicrobial activity of the reduction-oxidation-cycling antibiotic tested (nitrofurantoin) and of one of the antimetabolites tested (trimethoprim). Hyperoxia does not enhance the bactericidal effects of gentamicin and tobramycin, which require oxidative metabolism for transport into bacterial cells.

Nitrofurantoin: an update

Nitrofurantoin has been in clinical use for more than 35 years for the treatment of urinary tract infections (UTIs). In particular, it has been used to treat acute uncomplicated UTIs, recurrent urinary tract infections, and asymptomatic bacteriuria of pregnancy. Most recently, it has been used for both prophylaxis and treatment of nosocomial infections related to urinary tract instrumentation. Nitrofurantoin is being "rediscovered" for urinary tract infections in obstetrics and gynecology because of its continuing safety record and lack of associated R-factor resistance, compared to recently introduced antimicrobials.

[Changes in the antibacterial activity of nitrofurantoin preparations induced by peptone and hydrolysates]

The determination of the activity of the product nitrofurantoin (10 and 100 mcg) versus 324 strains of Gram-negative bacteria showed that the diameter of the inhibition zones and the MIC values on a medium with a definite composition (7SG) are considerably larger than on the Mueller-Hinton (MH) medium, in the bacto-tryptose (BT) medium. An increase with 8-12 mm phi or with 2-4 binary dilutions changes the interpretation from resistant, on the MH and BT media into sensitive on the 7SG medium. The low results recorded on the conventional media reveal the existence of an antagonism between peptone and nitrofurantoin, similar to that known for sulfamides. The authors believe that the peptone antagonism has hindered the knowledge of the activity of the nitrofurfural derivatives and the correct assessment of the bacteria sensitivity. They also consider questionable the elimination tendency of the small dosage of microtablets of nitrofurantoin (10 mcg) and sulfamide (30 mcg), since their apparent insufficiency might be due less to the inadequate contraction of substances and more to the inadequate testing media. The results plead for the use of the media with definite chemical composition sulfamide and nitrofuran antagonists free and for reconsideration of several methodologic problems: use of the media with definite chemical composition; introduction of an intermediary dosage of maximum 100 mcg/microtablet; reassessment of the sensitivity categories for sulphafurazole and nitrofurantoin.

Relation between biliary glutathione excretion and bile acid-independent bile flow

Glutathione efflux into bile of the fluorocarbon-perfused isolated rat liver was altered with eight different agents (L-buthionine-[S,R]-sulfoximine, cefamandole, sodium arsenite, phenobarbital, furosemide, nitrofurantoin, aminopyrine, and benzylamine), and correlations were established between bile flow and biliary excretion of 1) glutathione, 2) endogenous bile acids, and 3) glutathione plus bile acids. Biliary efflux of endogenous bile acids was relatively low (0.5-5 nmol.min-1.g liver-1) and was minimally affected by these agents. Biliary glutathione excretion in control livers was between 4 and 9 nmol.min-1.g-1 and in treated livers ranged from 1 to 21 nmol.min-1.g-1. For each of the various interventions, an increase or decrease in glutathione excretion was always accompanied by a change in bile flow in the same direction; however, these changes were not always directly proportional when comparisons were made between treatment groups. Nevertheless, when bile flow (microliter.min-1.g-1; ordinate) was plotted against glutathione excretion into bile for the pooled data, a significant correlation was observed that was adequately described by a straight line: y = 0.071 chi + 0.72 (r2 = 0.62, P less than 0.001). A similar function described the relation between bile flow and the sum of bile acids and glutathione in bile: y = 0.077 chi + 0.55 (r2 = 0.62, P less than 0.001). In contrast, the taurocholate- or glycocholate-induced choleresis had only minimal effects on glutathione efflux. These findings support the hypothesis that glutathione is one of the osmotic driving forces in bile acid-independent bile formation.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparative in vitro activities of six new fluoroquinolones and other oral antimicrobial agents against Campylobacter pylori

The in vitro susceptibilities of 56 clinical isolates of Campylobacter pylori to six new fluoroquinolones and other oral antimicrobial agents were determined by an agar dilution technique. Ciprofloxacin was the most active of the fluoroquinolones (MIC for 90% of strains tested [MIC90], 0.05 microgram/ml). Other fluoroquinolones had variable activities, although most isolates were moderately susceptible to fleroxacin (MIC90, 4 micrograms/ml) and lomefloxacin (MIC90, 4 micrograms/ml).

Nitrofurantoin produces oxidative stress and loss of glutathione and protein thiols in the isolated perfused rat liver

The effects of 150, 600 or 1,200 nmol/ml of nitrofurantoin on glutathione (GSH), glutathione disulfide (GSSG), protein thiols (PSH) and cell integrity were studied in the isolated perfused rat liver. Nitrofurantoin produced a dose-dependent, up to 3-fold, increase in bile flow and a marked, up to 150-fold, increase in biliary excretion of GSSG. By the conclusion of the experiment, tissue levels of GSH had fallen to 81 +/- 14, 41 +/- 10 and 16 +/- 5% of control values at the three dose levels. Tissue levels of GSSG rose from 18.3 +/- 2.3 to 45.3 +/- 8.0 nmol/g and from 20.0 +/- 6.0 to 187 +/- 47 nmol/g within 15 min at the two higher doses, but fell to initial levels by the end of the experiment. Only at the 1,200-nmol/ml dose did the tissue levels of PSH decline, to 64 +/- 14% of initial values, by the end of the experiment. Lactate dehydrogenase and transaminases were found in the perfusate only after the GSH and PSH levels had fallen. After a 60-min exposure to 1,200 nmol/ml of NFT followed by blank perfusate for 3 h, massive engorgement of the liver was noted. Microscopic examination revealed extensive interstitial edema, nuclear pyknosis, cytoplasmic shrinkage and vacuolization, and mitochondrial dense deposits. We conclude that toxic doses of nitrofurantoin can produce cellular depletion of GSH and PSH which, if not the direct cause, at least signal the loss of cell viability.

Quantitative study of natural antioxidant systems for cellular nitrofurantoin toxicity

The toxicity of nitrofurantoin was studied on human WI-38 fibroblasts: this chemical was lethal when added at concentrations higher than 5.10(-5) M in the culture medium. The protection afforded by antioxidants was then tested: alpha-tocopherol gave at 10(-4) M a light protection in contrast to ascorbic acid which even became toxic at high concentrations. We also tested catalase, superoxide dismutase and glutathione peroxidase introduced intracellularly by the microinjection technique. On a molecular basis, glutathione peroxidase was 23-times more efficient than catalase and 3000-times more than superoxide dismutase. The results also showed that a similar range of enzyme concentrations was found for the protection against high oxygen pressure. This suggests that, in the case of both oxygen and nitrofurantoin toxicity, the peroxide derivatives are the most toxic intermediates of the free radical attacks.

[Antimicrobial therapy with nitroheterocyclic compounds, for example, metronidazole and nitrofurantoin]

Nitroheterocyclic compounds, such as metronidazole and nitrofurantoin, are widely used in medical practice for the treatment of infectious diseases. Indeed, they exhibit a strong antimicrobial effect, which is directed not only against several groups of bacteria but also against certain protozoa and even worms. The nitrogroup coupled onto a heterocyclic structure, for example an imidazole, a thiazole or a furan ring, represents the proper site of effect. A priori the nitrogroup is, however, inactive. It has to be activated by microbial nitroreductases after penetration into the microbial cell. Those microorganisms which possess an anaerobic metabolism exhibit marked nitroreductase activity. The intracellularly produced intermediate products attack the chromosomal DNA of the target cell. Consequently, diverse mutations may occur. Partially, these chromosomal damages can be compensated by an SOS repair mechanism, which is under the control of the uvrB, lexA and polA genes. SOS repair-deficient mutants are much more susceptible to nitrocompounds than repair-proficient strains. Principally, the genotoxic activity of nitrocontaining compounds can also be expressed in eukaryotic cells of human or animal origin. This virtual property does not, however, prohibit clinical use, since until now no evidence of increased cancer incidence has been observed after rational therapy with nitrocompounds.