Microbiological

Surgery, 2002 Aug, 132(2), 200 - 4
Tissue-engineered colon exhibits function in vivo; Grikscheit TC et al.; BACKGROUND: Postcolectomy morbidities include important changes in enterohepatic circulation, stool microbiology, and absorption . The surgical substitution of an ileal pouch for the absent colon also has a number of serious complications . We report in vivo colon replacement by tissue-engineered colon (TEC) in lieu of an ileal pouch . METHODS: End-ileostomies were created in 22 male Lewis rats . In 11 animals, side-to-side ileum-TEC anastomosis was performed 1 cm from the stoma . This group was compared with end-ileostomy alone . Serial weights were measured, and animals were harvested sequentially for assessment of histologic signs of pouchitis . Transit times, stool dry and wet weights, and serum and stool colon function markers were collected . RESULTS: Animals survived 41 days . Weight loss was more than 1.5 times greater in the end-ileostomy alone group compared with the ileum-TEC group . Transit times were significantly longer in the ileum-TEC group than the end-ileostomy alone group, with lower stool moisture content and higher total serum bile acids . Animals without TEC had statistically significant hyponatremia, elevated serum urea nitrogen, and lower stool short chain fatty acids (13.5 micromol/kg vs 84.2) with an abnormal distribution . CONCLUSIONS: TEC successfully recapitulates some major physiologic functions of native large intestine in vivo.

Curr Opin Ophthalmol, 2002 Oct, 13(5), 303 - 9
Obstruction of the lacrimal drainage system; Mandeville JT et al.; This review covers evolving concepts in lacrimal outflow obstruction . Recent studies have increased our understanding of the surgical anatomy and pathophysiology of the lacrimal drainage system through radiologic, clinical, and microbiologic techniques . While external dacryocystorhinostomy remains an important treatment for nasolacrimal duct obstruction, there have been a number of therapeutic developments worthy of review, including advances in endoscopic and transcanalicular dacryocystorhinostomy, conjunctivodacryocystorhinostomy, and the use of mitomycin C in these procedures . In addition, we summarize recent advances in minimally invasive techniques for lacrimal outflow obstruction, including balloon dacryocystoplasty, lacrimal stents, and conjunctivoplasty . Finally, the roles of probing versus irrigation, nasal endoscopy, and endoscopic dacryocystorhinostomy in children are discussed.

J Telemed Telecare, 2002, 8 Suppl 2, 14 - 7
Development of a website for clinical microbiology in Brazil; Rossi F et al.; The quality of Brazilian health services, including clinical microbiology laboratories, varies enormously . We established a Website to provide different professionals with up-to-date information and to create a virtual Brazilian microbiology community . The Website became operational in February 2000 and had 198,976 hits in the subsequent 20 months . There were 1031 user registrations in its virtual community . Different microbiology topics were discussed and three virtual training courses (representing about 300 printed pages of information) were given . The e-learning centre and the Brazilian virtual community created by this Website have facilitated distance learning, and have encouraged professional integration within Brazilian clinical microbiology.

Nurs Stand, 2001 Apr 11-17, 15(30), 50 - 4, 56, 58
A proactive approach to wound infection; Kingsley A; The management and treatment of infection is a complex and important area in tissue viability nursing . Andrew Kingsley discusses the value of microbiology to clinical practice and the importance of adopting a proactive approach to the management of infected wounds using an infection continuum and algorithm to help promote effective care.

Eur J Gynaecol Oncol, 2002, 23(4), 269 - 77
The role of colposcopy in modern gynecology; Dexeus S et al.; The purpose of this review is to demonstrate that colposcopy, introduced in 1925--which is, notably before the development of great technological advances in modern gynecology--continues to be a valid technique without essential innovations to the original method described at the beginning of the last century . Colposcopy was developed in Germany during the rise of Nazism with the Second World War being an important barrier for the spread and diffusion of the technique . Colposcopy, however, continued to progress in a few countries such as Spain, Italy, Brazil, France and Switzerland . When colposcopy was introduced in the United States during the 70s, its use was mostly restricted to specialists who were almost exclusively dedicated to cervical pathology and knowledgeable about cytopathology, anatomic pathology, and colposcopy and who were competent both in the diagnosis and treatment of cervical lesions . These circumstances were completely different from what happened in the majority of European countries where colposcopists were trained as gynecologists and their histocytological knowledge, which was focused on the lower genital tract, was somewhat more extensive than that acquired by specialists in gynecology . There are two clearly different trends in relation to the use of colposcopy with characteristic geographic distribution: countries with an Anglo-Saxon influence in which colposcopy is performed selectively, and countries with a German medical inheritance in which colposcopy is carried out routinely during a standard general gynecological consultation . However, this difference is not restrictive and by no means can it be stated that colposcopy is systematically being used by all European or Latin American gynecologists for reasons related to training in the colposcopic technique . In 1977, we introduced the concept of dynamic colposcopy with the aim of differentiating it from the descriptive immobility of the original classification of Hinselmann (1954) that had remained almost unchanged by his immediate followers . Briefly, the objective was to turn colposcopy into a diagnostic tool able to identify the pathological substrate corresponding to traditional colposcopic images . We established ten differential signs that allow us to classify an ATZ area as subsidiary or not to be biopsied . The classification system proposed in Rome (International Federation of Cervical Pathology and Colposcopy {IFCPC}, 1990) supports our original concept because by identifying major or minor changes in the original images, a diagnosis of the severity of the lesion can be established . With regard to specificity, the figures range between 48% and 10% with 96% for sensitivity . Obviously, a wide range of colposcopic specificity must be related to the expected efficacy of the method . When after biopsy of an atypical colposcopic image, only a low-grade lesion is detected, should this be considered a false positive colposcopic result? Although histopathologic findings are accepted as the "gold standard"...it is well known that a certain degree of subjectivity can be present . Inter- and intra-observer differences (when the same pathologist is reviewing the diagnosis after a certain time lapse) may be present . It has been argued that microbiopsy under colposcopic control gives rise to a wide error range and that it cannot be considered representative of the lesion . It is likely that this situation may occur when colposcopy-guided biopsy is performed by inexperienced hands or when biopsy is limited to small and insufficient sampling . A very important colposcopic sign, such as complete visual inspection of the squamocolumnar junction is frequently missed . Any lesion with boundaries in the endocervix, cannot be simply assessed by means of microbiopsies from the ectocervix unless there is no doubt regarding the severity of the lesions . Microcolpohysteroscopy (MCH) may be of great value in these cases by showing the limits of endocervical involvement . CONCLUSIONS: According to the evidence presented here, it can be concluded that "colposcopy is in good health" and that probably the popularity of this technique in the field of gynecology would increase if cytopathologists and gynecologists' tasks were limited to their own fields rather than turning them into improvised specialists for their counterpart disciplines . The coordinating role of the gynecologist as a specialist for integral women's health should continue to be defended and in this respect, colposcopy should be considered a routine technique in daily practice.

Eur Respir J, 2002 Aug, 20(2), 440 - 3
Side-effects of antituberculosis drug treatment in patients with chronic renal failure; Quantrill SJ et al.; Patients with chronic renal failure (CRF) have a high incidence of tuberculosis (TB) . Those from the Indian subcontinent are at particular risk . The frequency of side-effects associated with antituberculous treatment in a group of patients with CRF was studied . All cases of TB in patients with CRF occurring over a 13-yr period at the Manchester Royal Infirmary, from 1986-1999, were identified by diagnostic coding, microbiology records and a TB database . The case notes were then reviewed . Twenty-four cases were identified, eight predialysis and 16 requiring regular dialysis . TB occurring in the dialysis group was extrapulmonary in every case . Nineteen of 24 (79%) patients were of Indian subcontinent origin and 14 of 16 (87%) dialysis patients were non-Caucasian . Adverse effects of treatment occurred in two of eight (25%) in the predialysis group and nine of 16 (56%) of the dialysis group . These were most commonly neuropsychiatric (6), hepatic (4) and gastrointestinal (4) . Neuropsychiatric symptoms occurred exclusively in dialysis patients . In conclusion, a high incidence of side-effects from antituberculous medication, especially neuropsychiatric, hepatic and gastrointestinal, was identified in patients with chronic renal failure . Careful monitoring for side-effects is essential in this group, and consideration should be given to administering antituberculous chemoprophylaxis to all high-risk groups.

Int J Periodontics Restorative Dent, 2002 Aug, 22(4), 323 - 33
GTR treatment of intrabony defects in patients with early-onset and chronic adult periodontitis; Zucchelli G et al.; Young, systemically healthy subjects may suffer from early-onset forms of periodontitis characterized by the presence of localized deep vertical bony defects . The aim of this study was to compare the healing response after guided tissue regeneration (GTR) treatment of similar intrabony defects in patients affected by early-onset and chronic adult periodontitis . Twenty systemically healthy, nonsmoking subjects were enrolled in the study; 10 were affected by early-onset periodontitis (EOP) and 10 by chronic adult periodontitis (CAP) . In each subject, only one deep vertical bony defect (intrabony component > 4 mm, probing attachment level > or = 8 mm) was treated according to the principles of GTR therapy with titanium-reinforced e-PTFE membranes . At the time of the surgery and at the 1-year follow-up, a microbiologic test for the identification of the main periodontopathogens was performed in each of the treated sites . There was no statistically significant difference at 1 year in the amount of clinical attachment gain (P = .4), reduction of probing pocket depth (P = .3), or increase in gingival recession (P = 1.0) between EOP and CAP patients . The 1-year microbiologic results demonstrated the complete disappearance of the putative periodontopathogens from all surgically treated sites in both patient groups . The results of the study demonstrated that deep intrabony defects in patients with EOP can be successfully treated by means of GTR procedures and that the suppression of periodontopathogens under threshold values can be maintained for at least 1 year, provided that the patient is enrolled in a maintenance program consisting of recalls for professional tooth cleaning and reinforcement of self-performed oral hygiene measures at 1-month intervals.

Ned Tijdschr Tandheelkd, 2002 Aug, 109(8), 303 - 6
{Risk factors in adult periodontitis: polymorphism in the interleukin-1 gene family}; Laine ML et al.; Interleukin (IL)-1 alpha, IL-1 beta and IL-1 receptor antagonist (ra) play a major role in regulation of the inflammatory response in periodontal tissues . The aim of this study was to investigate the distribution of genetic variation in the IL-1 gene family among periodontitis patients and controls, taking into account smoking and microbiology as additional variables . There were 53 non-smoking and 52 smoking patients with severe adult periodontitis and 53 periodontal healthy controls genotyped for genetic variation in the IL-1 gene family . The presence of Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans was established by culture techniques . A higher frequency of genotype+ (IL-1A*2 + IL-1B*2 + IL-1RN*2) was found in non-smoking periodontitis patients in whom P . gingivalis and A . actinomycetemcomitans could not be detected (42.1% vs . 11.3% in controls; p = 0.0068; or 5.7, 95% ci: 1.6-19.8) . This data provide evidence that polymorphisms in genes of the IL-1 family are associated with severe adult periodontitis and may be a risk factor for severe periodontitis.

Nat Rev Mol Cell Biol, 2002 Sep, 3(9), 685 - 95
Listening in on bacteria: acyl-homoserine lactone signalling; Fuqua C et al.; Bacterial cell-to-cell signalling has emerged as a new area in microbiology . Individual bacterial cells communicate with each other and co-ordinate group activities . Although a lot of detail is known about the mechanisms of a few well-characterized bacterial communication systems, other systems have been discovered only recently . Bacterial intercellular communication has become a target for the development of new anti-virulence drugs.

Pediatr Pulmonol, 2002 Oct, 34(4), 297 - 303
Invasive mechanical ventilation for acute respiratory failure in children with cystic fibrosis: outcome analysis and case-control study; Berlinski A et al.; The outcome for cystic fibrosis (CF) patients requiring intubation and invasive mechanical ventilation (IMV) due to acute respiratory failure (ARF) has been poor . Mortality rates have been reported as high as 60-90% . However, a review of mortality in children has not been published in 20 years . Our objectives were to study outcomes in CF patients requiring IMV due to ARF between 1988-1998, compare recent outcomes with those previously reported, and identify risk factors associated with poor outcome . We additionally attempted to identify factors suggesting an increased risk of developing ARF requiring IMV . A retrospective cohort study design was used, comparing IMV survivors and nonsurvivors with a nested case-control study to identify risk factors for ARF leading to IMV . All patients cared for at our Center who required IMV for ARF between 1988-1998 were identified . Outcome, age, steroid use, forced vital capacity (FVC), forced expired volume in 1 sec (FEV(1)), microbiology, nutritional status, CF-related diabetes (CFRD), liver dysfunction, and history of major hemoptysis (HEM) or pneumothorax (PTX) were recorded . Cases were matched for gender and age with CF controls identified through a clinical database.Thirty-eight episodes of IMV due to ARF were reported in 33 patients . Three subjects underwent IMV on two or more occasions, but only the first episode was included in analysis . Older age was the only factor that was significantly associated with mortality: 9 subjects were <5 years of age (mortality, 22%), while 24 were 5-34 years old (mortality, 75%) (P = 0.013) . There was an increased risk of having an episode of ARF requiring IMV in malnourished subjects (OR = 4.2; 95% CI = 1.66-10.51) and in those with a history of HEM (OR = 6.3; 95% CI = 1.75-22.65).Infants and young children with CF requiring IMV due to ARF have a favorable prognosis, whereas those >or=5 years of age suffer significantly higher mortality . Malnutrition and a history of HEM are important risk factors for having an episode of ARF requiring IMV .

Pediatrics . 2002 Sep;110(3):e37.
Outcomes of primary image-guided drainage of parapneumonic effusions in children; Mitri RK et al.; OBJECTIVE: To assess the outcome of image-guided needle aspiration when compared with image-guided percutaneous catheter drainage in the management of parapneumonic effusions in children . METHODS: A retrospective chart review was conducted of the medical records, microbiology, and radiology reports of 67 children who presented with parapneumonic effusions and underwent primary image-guided drainage between April 1, 1995, and April 1, 2000 . RESULTS: Thirty-four patients had aspiration only, and 33 patients had pigtail catheters placed . The 2 drainage methods had similar median length of stay and complication rates . The reintervention rate in this study was 27% (18 patients) . Children who underwent primary aspiration without catheter placement had significantly higher rates of reintervention . Method of drainage, pH lower than 7.2, and loculation of the fluid collection were independent predictors of reintervention . A low glucose level was an additive predictor of reintervention when the pH was low . CONCLUSIONS: Aspiration and catheter drainage of parapneumonic effusions had similar complication rates and lengths of stay, but children who underwent primary aspiration had significantly higher reintervention rates, particularly when pH and glucose levels were low . Therefore, primary catheter placement for parapneumonic effusions should be considered in children who undergo diagnostic thoracentesis . The decision regarding tube placement could be facilitated by the on-site availability of a pH meter and a glucometer.

J Clin Microbiol, 2002 Sep, 40(9), 3350 - 7
Fast, noninvasive method for molecular detection and differentiation of Malassezia yeast species on human skin and application of the method to dandruff microbiology; Gemmer CM et al.; Malassezia fungi have been the suspected cause of dandruff for more than a century . Previously referred to as Pityrosporum ovale, Pityrosporum orbiculare, or Malassezia, these fungi are now known to consist of at least seven Malassezia species . Each species has a specific ecological niche, as well as specific biochemical and genetic characteristics . Malassezia yeasts have fastidious culture conditions and exceedingly different growth rates . Therefore, the results of surveys of Malassezia based on culture methods can be difficult to interpret . We developed a molecular technique, terminal fragment length polymorphism analysis, to more accurately survey the ecology of Malassezia yeasts without bias from culture . This technique involves fluorescent nested PCR of the intergenic transcribed spacer (ITS) ITS I and ITS II region ribosomal gene clusters . All known Malassezia species can be differentiated by unique ITS fragment lengths . We have used this technique to directly analyze scalp samples from subjects enrolled in a demographic scalp health study . Results for subjects assigned composite adherent scalp flaking scores (ASFS) <10 were compared to those for subjects assigned composite ASFS >24 . Malassezia restricta and M . globosa were found to be the predominant Malassezia species present in both groups . Importantly, we found no evidence of M . furfur in either group, indicating that M . furfur can be eliminated as the causal organism for dandruff . Both groups also showed the presence of non-Malassezia fungi . This method, particularly when it is used in combination with existing fungal ITS databases, is expected to be useful in the diagnosis of multiple other fungal infections.

Appl Environ Microbiol, 2002 Sep, 68(9), 4495 - 501
Evidence for natural horizontal transfer of the pcpB gene in the evolution of polychlorophenol-degrading sphingomonads; Tiirola MA et al.; The chlorophenol degradation pathway in Sphingobium chlorophenolicum is initiated by the pcpB gene product, pentachlorophenol-4-monooxygenase . The distribution of the gene was studied in a phylogenetically diverse group of polychlorophenol-degrading bacteria isolated from contaminated groundwater in Karkola, Finland . All the sphingomonads isolated were shown to share pcpB gene homologs with 98.9 to 100% sequence identity . The gene product was expressed when the strains were induced by 2,3,4,6-tetrachlorophenol . A comparative analysis of the 16S rDNA and pcpB gene trees suggested that a recent horizontal transfer of the pcpB gene was involved in the evolution of the catabolic pathway in the Karkola sphingomonads . The full-length Karkola pcpB gene allele had approximately 70% identity with the three pcpB genes previously sequenced from sphingomonads . It was very closely related to the environmental clones obtained from chlorophenol-enriched soil samples (M . Beaulieu, V . Becaert, L . Deschenes, and R . Villemur, Microbiol . Ecol . 40:345-355, 2000) . The gene was not present in polychlorophenol-degrading nonsphingomonads isolated from the Karkola source.

Appl Environ Microbiol, 2002 Sep, 68(9), 4307 - 14
Seasonal variation in lysogeny as depicted by prophage induction in Tampa Bay, Florida; Williamson SJ et al.; A seasonal study of the distribution of lysogenic bacteria in Tampa Bay, Florida, was conducted over a 13-month period . Biweekly water samples were collected and either were left unaltered or had the viral population reduced by filtration (pore size, 0.2 micro m) and resuspension in filtered (pore size, 0.2 micro m) water . Virus-reduced and unaltered samples were then treated by adding mitomycin C (0.5 micro g ml(-1)) to induce prophage or were left untreated . In order to test the hypothesis that prophage induction was phosphate limited, additional induction experiments were performed in the presence and absence of phosphate . Induction was assessed as an increase in viral direct counts, relative to those obtained in controls, as detected by epifluorescence microscopy . Induction of prophage was observed in 5 of 25 (20%) unaltered samples which were obtained during or after the month of February, paralleling the results from a previous seasonal study . Induction of prophage was observed in 9 of 25 (36%) of the virus-reduced samples, primarily those obtained in the winter months, which was not observed in a prior seasonal study (P . K . Cochran and J . H . Paul, Appl . Environ . Microbiol . 64:2308-2312, 1998) . Induction was noted in the months of lowest bacterial and primary production, suggesting that lysogeny was favored under conditions of poor host growth . Phosphate addition enabled prophage induction in two of nine (22%) experiments . These results indicate that prophage induction may occasionally be phosphate limited or respond to increases in phosphate concentration, suggesting that phosphate concentration may modulate the lysogenic response of natural populations.

An Esp Pediatr, 2002 Sep, 57(3), 244 - 8
{Perinatal cytomegalovirus infection in preterm infants}; Perez Paya A et al.; OBJECTIVE: To study the incidence of perinatal cytomegalovirus infection in neonates admitted to our hospital in the last three years, as well as the mode of transmission, serologic and microbiologic data, and the clinical outcome of these infants . METHODS: We performed a retrospective study by reviewing the medical records of neonates with a diagnosis of cytomegalovirus infection . RESULTS: Twenty-four neonates received this diagnosis . Of these, 21 (85 %) were premature infants with a birthweight of less than 1500 gr, representing 6 % of all neonates with this birthweight hospitalized during the study period . The percentage of transfusion and breastfeeding was high (87 % and 91 %, respectively) and consequently the route of transmission could not be identified . Nine neonates (34 %) presented associated hepatic dysfunction and three (12 %) developed severe disease requiring antiviral treatment . CONCLUSIONS: Perinatal cytomegalovirus infection is frequent in preterm infants and may be serious . It is important to detect cytomegalovirus infections and to develop preventive methods.

Nucl Med Commun, 2002 Sep, 23(9), 851 - 5
The importance of the location of fluorodeoxyglucose uptake in periprosthetic infection in painful hip prostheses; Chacko TK et al.; Ten per cent of patients with hip replacement will eventually complain of significant pain after surgery, often requiring a revision arthroplasty . The majority of these patients experience aseptic loosening rather than infection . Despite significant advances made in diagnostic imaging, distinguishing infection from aseptic loosening remains a significant challenge . Imaging using fluorodeoxyglucose (FDG) positron emission tomography (PET) has been reported to have excellent sensitivity in detecting infections associated with hip prostheses . However, in some studies, a high rate of false positive results has been reported, especially when increased tracer uptake adjacent to the prosthesis (which is not surrounded by bone) is used as the sole criterion for diagnosing infection . The objective of this investigation was to determine the optimal criteria for diagnosing periprosthetic infection, thereby avoiding false positive results in this setting . A total of 41 total hip arthroplasties from 32 patients and for whom complete clinical follow-up was available were included in this analysis . The location and intensity of FDG uptake were determined for each scan . Final diagnosis was made by microbiology, histopathology, surgical findings and clinical follow-up . Patients who did not undergo surgery were followed up to at least 9 months . Twelve patients were proven eventually to have periprosthetic infection . Images from 11 of these patients displayed increased tracer uptake along the interface between bone and prosthesis . The intensity of the increased tracer uptake varied from mild to moderate, with standardized uptake values less than 2 . In contrast, images from uninfected, loose hip prostheses revealed very intense uptake around the head or neck of the prosthesis with standardized uptake values as high as 7 . It is concluded that the intensity of increased FDG uptake is less important than the location of increased FDG uptake when FDG PET is used to diagnose periprosthetic infection in patients with hip arthroplasty . Using increased uptake as the sole criterion for diagnosing infection will result in false positive results in this setting.

Am J Obstet Gynecol, 2002 Aug, 187(2), 305 - 10; idscussion 310-1
Necrotizing fasciitis in gynecologic and obstetric patients: a surgical emergency; Gallup DG et al.; OBJECTIVE: We reviewed the cases of 23 patients who were admitted to the hospital with a primary diagnosis of histopathologically confirmed necrotizing fasciitis in the lower abdomen or pelvis . Rapid demise of a healthy postpartum women piqued our interest in trying to identify the early signs and symptoms that may lead to earlier diagnosis and treatment of this often fatal disease . STUDY DESIGN: A retrospective analysis of charts of all patients who were admitted to the gynecology and obstetrics services of our hospital systems with a diagnosis of necrotizing fasciitis for the past 14 years was performed . Age, comorbid factors, precipitating events, weight, symptoms and signs, microbiologic factors, radiographs, surgical therapy, and morbidity were correlated . RESULTS: Definitive operation was accomplished within 48 hours of the diagnosis of necrotizing fasciitis in all but 3 patients . Of the 17 patients who were not puerperal, 88% of the women were obese; 65% of the women were hypertensive, and 47% of the women were diabetic . Of the total 23 patients, 70% of the women complained of severe pain, and 35% of the women had radiographic diagnostics for necrotizing fasciitis ("gas") . Four patients had diverting colostomies, and 39% of the patients had flaps or synthetic grafts . Three patients died (mortality rate, 13%) . One patient who was puerperal died of a severe rapid septicemia; the 2 late deaths were the result of systemic candidiasis . CONCLUSION: Necrotizing fasciitis is a rapidly progressive, often lethal, infectious disease process that requires early aggressive debridement . Any patient with inordinate pain and unilateral edema in the pelvis, especially in the puerperium, should be suspected of having this disease . Radiographic studies are often diagnostic of this condition . The triad of pelvic pain, edema, and any sign of septicemia carries an extremely grave prognosis and mandates immediate surgical intervention.

Croat Med J, 2002 Aug, 43(4), 503 - 7
Public health training in Albania: long way toward a school of public health; Roshi E et al.; AIM: To assess the needs for a school of public health in Albania, where health system has been going through difficult periods of transition after the collapse of the communist regime and its "Soviet" health system in 1991 . METHOD: Review of the past and current state of public health training, as well as the evolution of the main institutions involved in public health training in Albania, in view of the recent attempts undertaken to establish a school of public health . RESULTS: Up to early 1990s, public health training in Albania involved mostly physicians and was based to a great extent on sanitary engineering approach . In the mid 1990s, the activities of the Department of Public Health of the Faculty of Medicine in Tirana focused on development of comprehensive public health training program . The aim of the current 2-year training program is to train public health specialists in a new fashion, in line with current international trends in the "new" public health . However, the size and the background of the faculty of the Department of Public Health (8 members, 7 physicians) is too limited and medically oriented . Since 1969, the Institute of Hygiene and Epidemiology (later National Institute of Public Health) has been providing short-term (1-3 months) courses for hygienists, chemists, and microbiologists working at the district level . CONCLUSION: Only the establishment of a school of public health capable to train specialists according to international standards can meet the health needs of Albania.

Infect Immun, 2002 Sep, 70(9), 4798 - 804
Decreased electroporation efficiency in Borrelia burgdorferi containing linear plasmids lp25 and lp56: impact on transformation of infectious B . burgdorferi; Lawrenz MB et al.; The presence of the linear plasmids lp25 and lp56 of Borrelia burgdorferi B31 was found to dramatically decrease the rate of transformation by electroporation with the shuttle vector pBSV2, an autonomously replicating plasmid that confers kanamycin resistance (P . E . Stewart, R . Thalken, J . L . Bono, and P . Rosa, Mol . Microbiol . 39:714-721, 2001) . B . burgdorferi B31 clones had transformation efficiencies that were either low, intermediate, or high, and this phenotype correlated with the presence or absence of lp25 and lp56 . Under the conditions utilized in this study, no transformants were detected in clones that contained both lp25 and lp56; the few kanamycin-resistant colonies isolated did not contain pBSV2, indicating that the resistance was due to mutation . Intermediate electroporation rates (10 to 200 colonies per micro g of DNA) were obtained with B31 clones that were either lp25(-) and lp56(+) or lp25(+) and lp56(-) . Clones in this group that initially contained lp25 lacked this plasmid in pBSV2 transformants, a finding consistent with selective transformation of lp25(-) variants . High transformation rates (>1,000 colonies per micro g of DNA) occurred in clones that lacked both lp25 and lp56 . Sequence analysis indicated that lp25 and lp56 contain genes that may encode restriction and/or modification systems that could result in the low transformation rates obtained with strains containing these plasmids . The previously reported correlation between lp25 and infectivity in mice, coupled with the barrier lp25 presents to transformation, may explain the difficulty in obtaining virulent transformants of B . burgdorferi.

Antimicrob Agents Chemother, 2002 Sep, 46(9), 3035 - 8
Predicting evolution by in vitro evolution requires determining evolutionary pathways; Hall BG; In an early example of DNA shuffling, Stemmer (W . P . C . Stemmer, Nature 370:389-390, 1994) demonstrated a dramatic improvement in the activity of the TEM-1 beta-lactamase toward cefotaxime as the consequence of six amino acid substitutions . It has been pointed out (B . G . Hall, FEMS Microbiol . Lett . 178:1-6, 1999; M . C . Orencia, J . S . Yoon, J . E . Ness, W . P . Stemmer, and R . C . Stevens, Nat . Struct . Biol . 8:238-242, 2001) that the power of DNA shuffling might be applied to the problem of predicting evolution in nature from in vitro evolution in the laboratory . As a predictor of natural evolutionary processes, that power may be misleading because in nature mutations almost always arise one at a time, and each advantageous mutation must be fixed into the population by an evolutionary pathway that leads from the wild type to the fully evolved sequence . Site-directed mutagenesis was used to introduce each of Stemmer's six substitutions into TEM-1, the best single mutant was chosen, and each of the remaining five substitutions was introduced . Repeated rounds of site-directed mutagenesis and selection of the best mutant were used in an attempt to construct a pathway between the wild-type TEM-1 and Stemmer's mutant with six mutations . In the present study it is shown (i) that no such pathway exists between the wild-type TEM-1 and the supereffective cefotaxime-hydrolyzing mutant that was generated by six amino acid substitutions via DNA shuffling (Stemmer, Nature 370:389-390, 1994) but that a pathway to a fourfold more efficient enzyme resulting from four of the same substitutions does exist, and (ii) that the more efficient enzyme is likely to arise in nature as the result of a single mutation in the naturally occurring TEM-52 allele.

Sex Transm Infect, 2002 Aug, 78(4), 235 - 40
Sexually acquired hepatitis; Brook MG; OBJECTIVES: To assess current knowledge of sexually transmitted viral hepatitis in relation to epidemiology, clinical presentation, management, and diagnosis with particular reference to resource-poor settings . METHOD: A search of published literature identified through Medline from 1966 to October 2001, the Cochrane Library, and reference lists taken from each article obtained . Textword and MeSH searches for hepatitis A, B, C, D, E, G, delta, GB virus, GBV-C, and TT virus were linked to searches under the textword terms sex$, prevent$, and MeSH subheadings, microbiology, complications, drug therapy, therapy, diagnosis, epidemiology, transmission, and prevention and control . CONCLUSIONS: In heterosexual relationships, hepatitis B is readily transmitted sexually and hepatitis C and D less so, with no evidence for sexual transmission of hepatitis A . Hepatitis types A-D are all transmissible sexually in male homosexual relationships under certain conditions . In resource-poor countries sexual transmission is generally only a significant route of transmission for hepatitis B.

Transpl Immunol, 2002 May, 9(2-4), 251 - 6
Xenotransplantation--how far have we come?
Cooper DK, Gollackner B, Knosalla C, Teranishi K.
The immunologic barriers to xenotransplantation are summarized and approaches to overcome them briefly reviewed . Intensive investigation is being directed to the problem of acute humoral xenograft rejection, which is the major current barrier . Although the induced antibody response appears to be prevented by combination therapy with an anti-CD154 monoclonal antibody and mycophenolate mofetil, deposition of natural anti-Gal antibody on the graft endothelial cells appears to be sufficient to lead to rejection or a state of consumptive coagulopathy . Approaches towards the induction of tolerance are described . The potential microbiologic risks and physiologic incompatibilities of pig-to-human organ transplantation are also briefly discussed.

J Gastroenterol Hepatol, 2002 Sep, 17(9), 1001 - 7
Pyogenic liver abscess: retrospective analysis of 80 cases over a 10-year period; Wong WM et al.; BACKGROUND: A total of 80 patients with pyogenic liver abscess managed at a single institution over a 10-year period were studied . METHODS: The clinical features, laboratory, imaging, and microbiologic findings, management strategy, and final outcome were studied . RESULTS: Fever and chills, leucocytosis and elevated alkaline phosphatase were the most common clinical and laboratory findings . Forty-one percent of patients were diabetic and 61% had biliary pathology . Systemic antibiotics and image-guided aspiration had a success rate of 94% . By multiple logistic regression analysis, malignancy on presentation (P = 0.011) was an independent risk factor associated with mortality . A past history of endoscopic sphincterotomy was an independent factor associated with resolution of liver abscess within 6 weeks (P = 0.03) . CONCLUSION: Pyrexia, leucocytosis, elevated alkaline phosphatase, presence of diabetes, and underlying biliary pathology are common clinical and laboratory findings in patients with pyogenic liver abscess . Malignancy was associated with a poor outcome . Previous endoscopic sphincterotomy was a good prognostic factor for early resolution .

Parasitology, 2002 Jul, 125(Pt 1), 11 - 9
Giardia lamblia disrupts tight junctional ZO-1 and increases permeability in non-transformed human small intestinal epithelial monolayers: effects of epidermal growth factor; Buret AG et al.; In order to improve our understanding of the host cell-parasite interactions in giardiasis, this study assessed the effects of Giardia lamblia on epithelial permeability and tight junctional ZO-1, determined whether epidermal growth factor (EGF) may affect Giardia-induced epithelial injury, and evaluated if EGF modulates epithelial colonization by live G . lamblia trophozoites . Permeability was assessed in assays of trans-epithelial fluxes of FITC-dextran, and ZO-1 integrity was characterized by confocal laser immunofluorescence microscopy in confluent epithelial cell monolayers . G . lamblia significantly increased paracellular permeability and disrupted tight-junctional ZO-1 of a novel non-transformed human small intestinal epithelial cell line (SCBN) . Pre-treatment with EGF prevented the development of these abnormalities and significantly inhibited attachment of live trophozoites to the enterocytes, independently of a direct microbiocidal action . These findings demonstrate that G . lamblia may cause intestinal pathophysiology by disrupting tight junctional ZO-1 and increasing epithelial permeability . Apical administration of EGF prevents these abnormalities, and reduces epithelial colonization by the live parasites.

Pediatrics . 2002 Aug;110(2 Pt 1):e21.
Acute disseminated encephalomyelitis in children; Murthy SN et al.; OBJECTIVE: To describe the epidemiologic, clinical, neuroimaging, and laboratory features; treatment; and outcome in a cohort of children with acute disseminated encephalomyelitis (ADEM) . METHODS: A 6-year retrospective chart review of children with the diagnosis of ADEM was conducted . RESULTS: Eighteen cases were identified . Sixteen patients (88%) presented in either winter or spring . Thirteen children (72%) had a recent upper respiratory tract illness . Patients presented most often with motor deficits (77%) and secondly with altered consciousness (45%) . Spinal fluid abnormalities occurred in 70% . Despite rigorous microbiologic testing, a definite microbiologic diagnosis was established only in 1 child with Epstein-Barr virus disease and probable or possible diagnoses in 3 children with Bartonella henselae, Mycoplasma pneumoniae, or rotavirus disease . Brain magnetic resonance imaging identified lesions in the cerebral cortex in 80%, in subcortical white matter in 93%, in periventricular white matter in 60%, in deep gray matter in 47%, and in brainstem in 47% of patients . Eleven patients (61%) were treated with corticosteroids, and 2 were treated with intravenous immunoglobulins . All patients survived . Three patients (17%) had long-term neurologic sequelae . CONCLUSIONS: Epidemiologic evidence from this study suggests an infectious cause for ADEM . The agent is most likely a difficult-to-diagnose winter/spring respiratory virus . Magnetic resonance imaging was the neuroimaging study of choice for establishing the diagnosis and for following the course of the disease . Prognosis for survival and outcome was excellent . Recurrent episodes of ADEM must be differentiated from multiple sclerosis.

J Trop Pediatr, 2002 Jun, 48(3), 149 - 55
Utility of clinically-directed selective screening to diagnose HIV infection in hospitalized children in Bombay, India; Karande S et al.; The increasing prevalence of HIV infection in urban India together with limited financial resources necessitates judicious HIV testing . This prospective study was undertaken to determine the utility of selective screening for HIV infection based on five clinical risk factors reported in African children . The study was conducted at the Departments of Paediatrics and Microbiology, LTMG Hospital, Bombay, India between September 1998 and 2000 . The children were enrolled after taking informed consent from their parents . The HIV seroprevalence rate was determined in children (aged 1 month to 12 years) consecutively admitted with severe malnutrition, serious pyogenic infections (pneumonia, pyogenic meningitis, septicaemia), disseminated tuberculosis, chronic diarrhoea and oral candidiasis, present either singly or in combination . Children above 18 months of age were diagnosed as being infected with HIV if they tested positive by two different HIV enzyme-linked immunosorbent assay (ELISA) tests . In children less than 18 months of age the diagnosis of HIV infection was made if they were ELISA positive and also fulfilled the WHO criteria for symptomatic HIV infection . Of a total 204 children (110 male, 94 female) screened, 24 (11.8 per cent) were diagnosed as HIV-infected . The HIV seropositive rate was highest in children having oral candidiasis (40.6 per cent), followed by chronic diarrhoea (18.2 per cent), disseminated tuberculosis (16.2 per cent), severe malnutrition (14.4 per cent), and serious pyogenic infections (11.2 per cent) . Only the presence of oral candidiasis was a significant independent risk factor for predicting HIV infection (p < 0.0001) . However, as the number of risk factors concomitantly present increased, the chances of the child being infected with HIV also increased significantly (p < 0.001) . Our study shows that clinically-directed selective screening does have a practical role in diagnosing HIV infection in a resource-poor setting.

J Nutr, 2002 Aug, 132(8 Suppl), 2345S - 2349S
Nutritional and genetic inefficiencies in one-carbon metabolism and cervical cancer risk; Ziegler RG et al.; Folate deficiency has long been postulated to play a role in the etiology of cervical cancer, the third most frequent cancer among women worldwide . In a large, multiethnic community-based case-control study of invasive cervical cancer in five U.S . areas, we assessed accepted and postulated risk factors with an in-home interview and successfully obtained blood samples, at least 6 mo after completion of cancer treatment, from 51 and 68%, respectively, of interviewed cases and controls . Cases with advanced disease (6%) and/or receiving chemotherapy (4%) were excluded, leaving 183 cases and 540 controls . Serum and red blood cell folate were measured with both microbiologic and radiobinding assays . For all four folate measures, risk was moderately, but nonsignificantly, elevated for women in the lowest quartile, compared to the highest {fully adjusted relative risks (RR), including serologic human papillomavirus (HPV)-16 status = 1.2-1.6} . However, for women in the upper three homocysteine quartiles (>6.31 micro mol/L), risk of invasive cervical cancer was substantially and significantly elevated (fully adjusted RR, including serologic HPV-16 status = 2.4-3.2; P for trend = 0.01) . This strong relationship suggests that circulating homocysteine may be 1) an especially accurate indicator of inadequate folate, 2) an integratory measure of insufficient folate in tissues or 3) a biomarker of disruption of one-carbon metabolism . The contribution of common polymorphisms in one-carbon pathway genes, as well as inadequate vitamin B-6, vitamin B-12 and/or riboflavin, to elevated homocysteine, inefficient one-carbon metabolism and increased cervical cancer risk merits further exploration.

J Cataract Refract Surg, 2002 Aug, 28(8), 1446 - 51
Corneal haze after photorefractive keratectomy for myopia: role of collagen IV mRNA typing as a predictor of haze; Winkler von Mohrenfels C et al.; PURPOSE: To develop a test based on the individual expression of collagen type IV synthesis in corneal epithelial cells to identify patients who have the potential for significant corneal haze after myopic photorefractive keratectomy (PRK) . SETTING: Department of Ophthalmology and the Institute of Microbiology, University of Regensburg, Germany . METHODS: The individual synthesis of collagen type IV alpha3 mRNA was quantitatively measured in corneal epithelial cells of 34 eye (34 patients) with myopia ranging from -1.5 to -10.0 diopters (D) by a polymerase chain reaction (PCR) test . The corneal epithelial cells were collected before the PRK procedure . Collagen type IV alpha3 mRNA levels were correlated to postoperative haze and regression at 12 months . RESULTS: In all samples, collagen type IV alpha3 mRNA was detected; the mean was 1.47 (range 0.11 to 6.42) . There was a correlation between haze and the amount of collagen type IV alpha3 mRNA; that is, eyes with haze had more collagen IV expression . In contrast, no correlation was observed between regression and the amount of collagen type IV alpha3 mRNA . CONCLUSIONS: The results show that collagen type IV alpha3 is an important factor in the development of corneal haze after PRK . Based on a quantitative PCR test, the individual collagen IV mRNA concentration in corneal epithelial cells could be measured . Further development could establish a screening test by which eyes with pronounced synthesis of collagen IV could be identified as being at high risk for haze after PRK.

Scand J Infect Dis, 2002, 34(6), 449 - 55
Antibiotic use and Escherichia coli resistance trends for quinolones and cotrimoxazole in Sweden; Farra A et al.; Resistance rates among Escherichia coli isolates for quinolones and cotrimoxazole were analysed at 12 Swedish hospitals, and compared with antibiotic use . Resistance figures for E . coli were retrieved from the diagnostic microbiology service databases for the period 1989-99, and antibiotic sales figures were obtained from the National Corporation of Swedish Pharmacies . At the 2 university teaching hospitals included, norfloxacin resistance of E . coli increased significantly (p < 0.001) from 0% to 2.7% and 2.5%, respectively . Ciprofloxacin resistance increased (p < 0.001) in parallel . Quinolone use increased until 1992; subsequently, sales have remained at a stable level . The increase in norfloxacin and ciprofloxacin resistance started relatively simultaneously in all hospitals, around 1991 . Cotrimoxazole resistance has also been increasing significantly in most hospitals, in spite of decreasing sales of cotrimoxazole and trimethoprim . Similar trends could be seen in blood isolates from the same hospitals for the period 1991-98 . Clinical laboratory data are subject to bias but surveillance over longer periods of time provides a useful method for detecting trends in increasing resistance and therefore functions as a resistance warning system.

Lijec Vjesn, 2002 May, 124(5), 140 - 5
{Gas gangrene and hyperbaric oxygenation--a lesson forgotten or never learned?}; Petri NM et al.; Gas gangrene develops in devitalized hypoxic tissue . It spreads rapidly under strong influence of enzymes produced by the causing bacteria and often results in fatal outcome . It is of utmost importance to stop toxin production as soon as possible, which is most effectively achieved by early application of hyperbaric oxygenation (HBO2), as the first measure in a "trident" (HBO2, antibiotics, surgical measures) . The paper reviews the most important data from microbiology, pathophysiology and epidemiology of gas gangrene, current clinical practice, scientific basis for application of HBO2 in the treatment of this disease, and data from the archives of the Naval Medical Institute of the Croatian Navy in Split (NMI) . At the NMI, in the period from 1982 to 2000, HBO2 was administered in the treatment of 21 patients with gas gangrene, of average age 41.6 +/- 16.3 years . The average treatment consisted of 6.8 +/- 3.8 sessions . 13 (76%) patients were cured.

Orthopade, 2002 Jun, 31(6), 551 - 5
{Diagnosis and therapy of necrotizing fasciitis}; Baer W et al.; Necrotizing fasciitis is a soft tissue infection with a lethality ranging up to 80% . Infection causes the activation of interleukin, tumor necrosis factor alpha, and gamma-interferon through a triggering mechanism . This results in a capillary thrombosis with necrosis of the fascia, cutis, and subcutis . The patient's history often reveals a triggering event in the form of a recent minimal trauma or operative procedure . In a fulminant necrotizing fasciitis, the development of sepsis with consecutive multiple-organ failure mainly determines the outcome of the disease . Diagnosis is made initially upon clinical findings with a rapid progression of the disease and confirmed later by histologic and microbiologic findings . Radical surgical debridement within the first 24 h with postoperative treatment in an intensive care unit represents the cornerstone of therapy . Between January 1992 and March 2001, we treated 15 patients with necrotizing fasciitis . Lethality was 33% . There was a significant correlation between risk factors (present in 86% of the patients) and morbidity . Diagnosis and therapy should be performed by an experienced surgeon . In this contribution, we discuss the most important criteria that lead to the diagnosis and the therapeutic consequences.

Presse Med, 2002 May 25, 31(18), 841 - 8
{Mycologic surveillance of the environment for preventive invasive aspergillosis . Proposals for standardization of the methodologies and implementation}; Gangneux JP et al.; A MAJOR RISK: The infection of immunodepressed patients by Aspergillus-type fungi increases morbidity and mortality, particularly in hematology units or during solid organ transplantation . Although present diagnostic means benefit from the progress over the last years, they remain limited and chemoprophylaxis protocols have still not demonstrated significant efficacy . THE NEED FOR RECOMMENDATIONS: Today, the handling of environmental risks is the only strategy that has proved its efficacy and usefulness . On the basis of administrative recommendations and data from the literature, a multicentric and pluri-disciplinary task force, grouping clinicians, microbiologists and hygienists, has assessed different methods and has proposed recommendations for the standardization and optimization of fungal surveillance of the environment.

Biol Cell, 2002 May, 94(2), 55 - 63
In situ ageing of fine beech roots (Fagus sylvatica) assessed by transmission electron microscopy and electron energy loss spectroscopy: description of microsites and evolution of polyphenolic substances; Watteau F et al.; Root biomass is quantitatively and qualitatively important in most ecosystems, but its contribution to the pool of organic matter in the soil is not clear . This work was designed to specify root ageing on an ultrastructural scale by transmission electron microscopy combined with microanalysis by electron energy loss spectroscopy . This approach is very suitable for studying the soil/plant interface, and for semi-quantitative analysis of the evolution of polyphenolic substances during root evolution . Three root segments were studied according to a gradient of root senescence: the apical and basal segments of the mycorrhiza and the mycorrhiza-carrier root . Each segment contained a certain proportion of senescent cells, some of which were of fungal origin, and this proportion increased as the root aged . In the three segments, the soil/plant interfaces were differentiated, and the micro-organisms observed in situ were described . Senescent root cells contained many polyphenolic substances and our results showed that these substances were, according to the root segment, differently associated with Ca, N and Si . When all these ultrastructural data are correlated with more global data, they can be usefully applied to root cell physiology, microbiology and pedology . This approach makes it possible to specify the evolution of organic matter in situ in soils whatever its origin.

Ann Biol Clin (Paris), 2002 Jul-Aug, 60(4), 468 - 70
{A case report of Cardiobacterium hominis endocarditis}; Lesimple B et al.; We here report a case of endocarditis due to Cardiobacterium hominis in a 53-year-old patient, who presented with large vegetations on the mitral valve . Good cooperation between clinicians and microbiologists and an efficient automated blood culture system were the decisive factors in establishing the diagnosis . Early and appropriate treatment prevented the septic embolisms often observed in this pathology.

Clin Infect Dis, 2002 Aug 15, 35(4), 409 - 13 Epub 2002 Jul 17.
Tuberculous peritonitis-associated mortality is high among patients waiting for the results of mycobacterial cultures of ascitic fluid samples; Chow KM et al.; We identified 60 cases of tuberculous peritonitis during the past 12 years at our health care center . Most of the patients had severe underlying medical conditions, such as cirrhosis, renal failure, diabetes mellitus, and malignancy . Abnormal chest radiograph findings, ascitic fluid lymphocytosis, and biochemical findings for exudates could only identify 33%, 37%, and 53% of the cases, respectively . On the other hand, peritoneal biopsy allowed early definitive diagnosis for 9 patients . Thirty-one patients died, 26 of whom died < or =6 weeks after their initial presentation, often before the result of mycobacterial culture was available . Only 8 patients died of advanced disease after antituberculous therapy was started . Univariate analysis showed that advanced age, underlying diagnosis, and delayed initiation of therapy were associated with higher mortality rates . Standard antituberculous chemotherapy is highly effective . However, conventional microbiologic diagnostic methods are slow and not sensitive enough for establishing a diagnosis of tuberculous peritonitis.

J Pediatr Hematol Oncol, 2002 Jun-Jul, 24(5), 360 - 3
Factitious fungus in two children with cancer receiving liposomal amphotericin; Fisher MJ et al.; Amphotericin B deoxycholate and liposomal formulations of amphotericin are often started and continued empirically, in immunocompromised hosts, based on the computed tomography findings and the patient's clinical picture . The authors describe two patients with presumed fungal pulmonary nodules, which were progressive despite prolonged treatment with liposomal amphotericin B . At subsequent biopsy, neither had evidence of active fungal disease; rather, the nodules revealed reactive changes and lipid-laden macrophages . These cases underscore the importance of establishing a microbiologic diagnosis in cases of presumed fungal infection.

Annu Rev Microbiol, 2002, 56, 703 - 41 Epub 2002 Jan 30.
Prions as protein-based genetic elements; Uptain SM et al.; Fungal prions are fascinating protein-based genetic elements . They alter cellular phenotypes through self-perpetuating changes in protein conformation and are cytoplasmically partitioned from mother cell to daughter . The four prions of Saccharomyces cerevisiae and Podospora anserina affect diverse biological processes: translational termination, nitrogen regulation, inducibility of other prions, and heterokaryon incompatibility . They share many attributes, including unusual genetic behaviors, that establish criteria to identify new prions . Indeed, other fungal traits that baffled microbiologists meet some of these criteria and might be caused by prions . Recent research has provided notable insight about how prions are induced and propagated and their many biological roles . The ability to become a prion appears to be evolutionarily conserved in two cases . {PSI(+)} provides a mechanism for genetic variation and phenotypic diversity in response to changing environments . All available evidence suggests that prions epigenetically modulate a wide variety of fundamental biological processes, and many await discovery.

Int J Med Microbiol, 2002 Jun, 292(1), 51 - 7
A pulsed-field gel electrophoresis study of Mycobacterium fortuitum in a Caribbean setting underlines high genetic diversity of the strains and excludes nosocomial outbreaks; Legrand E et al.; Among rapidly-growing opportunistic mycobacteria, organisms of the Mycobacterium fortuitum-Mycobacterium chelonae complex (M . fortuitum, M . chelonae, M . abscessus and M . peregrinum) were isolated in significantly higher numbers during the period 1993-99 from clinical samples in Guadeloupe, Martinique and French Guiana . Based on biochemical and cultural tests and PCR-restriction fragment length polymorphism (RFLP) of the hsp65 gene, 51 isolates from 47 patients were unambiguously identified as M . fortuitum . A molecular epidemiological study by pulsed-field gel electrophoresis (PFGE) using DraI and Xbal digestions of bacterial DNA revealed two clusters designated A and B; cluster A was composed of strains showing 10 bands that were isolated from 3 patients in Martinique within a 2-months period in 1999, and the cluster B was composed of 2 strains showing 9 bands from 2 patients in Martinique, also isolated within a 2-months period in 1999 . The available epidemiological and clinical information neither incriminated M . fortuitum as a cause of disease in these patients, nor showed any potential epidemiolgical links between them, except for the fact that the samples were processed in the same microbiology laboratory within a short span of time . In conclusion, isolation of M . fortuitum from non-sterile sites in patients without predisposing conditions, and in absence of repeated isolation, may be caused by contaminants or colonizers that are picked up more easily due to improvement of techniques used for mycobacterial isolation and identification.

Expert Rev Mol Diagn, 2002 Jul, 2(4), 329 - 36
Diagnostic tests for CAP: current approaches and future perspectives; Saranglao A et al.; Diagnostic testing in community-acquired pneumonia (CAP) serves three functions: firstly, to confirm the presence of CAP; secondly, to assess severity; and thirdly, to identify the causative pathogen . Available techniques are satisfactory to fulfill the first two roles but are seriously inadequate as regards the third . Accordingly, antibiotic therapy for CAP must be empirical, at least initially . This article reviews current diagnostic methods and provides suggestions for appropriate use of diagnostic tests in CAP . The shortcomings of the available methods for microbiologic diagnosis are discussed . The potential for PCR to become the much sought after 'ideal' test for microbiologic diagnosis in CAP is explored.

J Biol Chem, 2002 Oct 11, 277(41), 38001 - 12 Epub 2002 Jul 22.
Succinate secreted by Trypanosoma brucei is produced by a novel and unique glycosomal enzyme, NADH-dependent fumarate reductase; Besteiro S et al.; In all trypanosomatids, including Trypanosoma brucei, glycolysis takes place in peroxisome-like organelles called glycosomes . These are closed compartments wherein the energy and redox (NAD(+)/NADH) balances need to be maintained . We have characterized a T . brucei gene called FRDg encoding a protein 35% identical to Saccharomyces cerevisiae fumarate reductases . Microsequencing of FRDg purified from glycosome preparations, immunofluorescence, and Western blot analyses clearly identified this enzyme as a glycosomal protein that is only expressed in the procyclic form of T . brucei but is present in all the other trypanosomatids studied, i.e . Trypanosoma congolense, Crithidia fasciculata and Leishmania amazonensis . The specific inactivation of FRDg gene expression by RNA interference showed that FRDg is responsible for the NADH-dependent fumarate reductase activity detected in glycosomal fractions and that at least 60% of the succinate secreted by the T . brucei procyclic form (in the presence of d-glucose as the sole carbon source) is produced in the glycosome by FRDg . We conclude that FRDg plays a key role in the energy metabolism by participating in the maintenance of the glycosomal NAD(+)/NADH balance . We have also detected a significant pyruvate kinase activity in the cytosol of the T . brucei procyclic cells that was not observed previously . Consequently, we propose a revised model of glucose metabolism in procyclic trypanosomes that may also be valid for all other trypanosomatids except the T . brucei bloodstream form . Interestingly, H . Gest has hypothesized previously (Gest, H . (1980) FEMS Microbiol . Lett . 7, 73-77) that a soluble NADH-dependent fumarate reductase has been present in primitive organisms and evolved into the present day fumarate reductases, which are quinol-dependent . FRDg may have the characteristics of such an ancestral enzyme and is the only NADH-dependent fumarate reductase characterized to date.

Clin Lab Med, 2002 Jun, 22(2), 491 - 503
Appropriate use of clinical microbiology tests; Wilson ML; Laboratory medicine lacks the tools necessary to define appropriate test use; nonetheless, existing laboratory test characteristics, although inadequate, provide a common starting point for developing definitions of appropriate test use . As Lundberg {1}, Szczepura {15}, and van Walraven and Naylor {2} have emphasized, developing a process for defining appropriate laboratory use should receive a high priority . There is a particular need to develop methods for standardizing studies {59} . Laboratory medicine does not, however, lack the tools necessary to change test use . Although past interventions were largely ineffective, there is growing evidence that test use can be changed by use of a variety of approaches . By using the existing tools there is much that can be done to change inappropriate test use, such as minimizing redundant testing or the use of tests that have no clinical relevance . The real opportunities will come when there are scientifically and medically sound definitions of appropriate test use that can be used to change test use and improve patient care in a cost-effective way.

Cornea, 2002 Aug, 21(6), 555 - 9
The epidemiological features and laboratory results of fungal keratitis: a 10-year review at a referral eye care center in South India; Gopinathan U et al.; PURPOSE: To report the epidemiological features and laboratory results of 1,352 cases of fungal keratitis diagnosed at the L.V . Prasad Eye Institute (LVPEI) in south India . METHODS: The medical and microbiology records of 1,352 culture proven cases (1,354 eyes) of fungal keratitis diagnosed at the LVPEI between January 1991 to December 2000 was retrospectively reviewed for demographic features, risk factors, seasonal variation, and laboratory findings . RESULTS: Males (962) were affected significantly more (p< 0.0001) than females (390) . Of 1,352 patients, 853 (64.4%) were in the younger age group (16-49 years) . Ocular trauma predisposed to infection in 736 (54.4%) of 1,354 eyes . There was a higher incidence of fungal keratitis during the monsoon and winter than summer . A fungal cause was established by smears of corneal scrapings in 1,277 (95.4%) eyes . The potassium hydroxide preparation (KOH), Calcofluor white (CFW), Gram-, and Giemsa-stained smears revealed fungus in 1,219 (91.0%), 1,224 (91.4%), 1,181 (88.2%), and 1,139 (85.1%) eyes, respectively . Fusarium(506, 37.2%) and Aspergillus species (417, 30.7%) predominated the hyaline fungal spectrum (1,133) and Curvularia species (39, 2.8%) were the highest among the dematiaceous isolates (218) . CONCLUSIONS: To the best of our knowledge, this review presents the epidemiological features and laboratory results of the largest series of fungal keratitis ever reported in the literature . Keratomycosis is predominant in young adults with trauma as the major predisposing factor . With fungal keratitis being a major ophthalmologic problem in the tropical regions of the world, data available on the epidemiological features of a large series would greatly help medical practitioners at primary and secondary health care centers in the management of the disease . A simple KOH preparation of corneal scraping alone is highly beneficial in confirming the diagnosis.

Crit Care Med, 2002 Jul, 30(7), 1459 - 66
Internal and external validation of the NOSEP prediction score for nosocomial sepsis in neonates; Mahieu LM et al.; OBJECTIVE: To evaluate the performance of a scoring system (NOSEP) to predict nosocomial sepsis in neonates at the hospital where the score was developed (internal validation) and in an independent data set from other centers (external validation) . DESIGN: Multiple center prospective cohort study . SETTING: Six neonatal intensive care units from the Flanders in Belgium . PATIENTS: We analyzed two groups of patients: 62 episodes of presumed nosocomial sepsis in the internal validation cohort and 93 episodes of presumed nosocomial sepsis in a multiple center external validation cohort . INTERVENTIONS: Assessment of the predictive power of the NOSEP score 24 hrs preceding sepsis workup and the patients' basic demographic characteristics and co-morbidity was performed . Diagnosis of nosocomial sepsis and the microbiology results were registered . MAIN RESULTS: The NOSEP score's discriminative capability was very good in the internal validation (area under receiver operating characteristic curve = 0.73 +/- 0.08 {sem}) . The NOSEP score performed satisfactory in the external validation (area under receiver operating characteristic curve = 0.66 +/- 0.06) . The calibration capability in both validation sets as measured by goodness-of-fit tests (internal validation, p =.56; external validation, p =.48) was good . An improvement of the NOSEP score was obtained for the external centers by redefining the cut-off of the items of the NOSEP score (area under receiver operating characteristic curve for NOSEP-NEW-I = 0.71 +/- 0.05) or adding co-morbidity factors (area under receiver operating characteristic curve for NOSEP-NEW-II = 0.82 +/- 0.04), with good calibration performance (goodness-of-fit test, p >.50) . Finally, the fit of the NOSEP score demonstrated no significant variation across subgroups of patients . CONCLUSIONS: The predictive power of the original NOSEP score is very good in neonates at the original neonatal intensive care unit . In other neonatal intensive care units, its discriminatory performance is satisfactory but could be improved after modification of the variables in the model or adding additional variables . To use such a NOSEP score in other neonatal intensive care units, its accuracy has to be validated and adjusted if necessary.

Dis Colon Rectum, 2002 Jul, 45(7), 967 - 72
Hyperbaric oxygen ameliorates bacterial translocation in rats with mechanical intestinal obstruction; Akin ML et al.; PURPOSE: The aim of this study was to demonstrate bacterial translocation after experimentally induced intestinal obstruction as well as investigate the preventive effects of hyperbaric oxygen on obstruction-induced bacterial translocation in rats . METHODS: Forty Wistar-albino male and female rats were used . Although no procedure was done in the control group (n = 8), hyperbaric oxygen treatment under 2.5 atm absolute for 90 minutes daily was applied for two days in the hyperbaric oxygen group (n = 8) . In the sham group (n = 8), after laparotomy the small bowel was only handled gently, and tissue sampling was done 48 hours later . In the obstruction group (n = 8) the ileum was ligated by 5-0 polypropylene just 5 cm proximal to the ileocecal valve . In the obstruction and hyperbaric oxygen group (n = 8), after obstruction hyperbaric oxygen treatment was applied . Forty-eight hours after the procedures, tissue samples from small bowel, mesenteric lymph nodes, spleen, and liver were taken and 1 ml of blood from the portal vein was withdrawn . All samples were cultured for microbiologic examination . RESULTS: Hyperbaric oxygen treatment significantly reduced the endogenous bacterial overgrowth in the small intestine of normal rats . Endogenous bacteria in the small intestine were significantly increased in the obstruction group, and the presence of bacterial overgrowth was proven by bacterial presence on mesenteric lymph nodes, spleen, liver, and blood . Hyperbaric oxygen treatment significantly reduced the endogenous bacterial overgrowth in the small intestine and prevented the bacterial translocation almost completely in obstruction-induced rats . CONCLUSIONS: Intestinal obstruction causes bacterial overgrowth and translocation . Hyperbaric oxygen treatment prevents the bacterial translocation effectively.

Clin Liver Dis, 2002 May, 6(2), 421 - 54
Common diagnostic problems in pediatric liver pathology; Finegold MJ; The role of the pathologist in dealing with common problems of liver disease in children is likely to change dramatically as the molecular genetic revolution progresses . For example, microchip arrays for genes involved in bile salt synthesis and transport will pinpoint the specific mutations responsible for infantile cholestasis and similar methods will sort out infectious agents of acute and chronic hepatitis . But even as biochemistry, microbiology, and immunology laboratories already provide essential diagnostic information in such settings, informed histopathologic interpretation will continue to guide investigations of etiology and therapeutics and will remain an important medical necessity {95,96,100,102,104}.

Infect Immun, 2002 Aug, 70(8), 4523 - 33
A hag mutant of Moraxella catarrhalis strain O35E is deficient in hemagglutination, autoagglutination, and immunoglobulin D-binding activities; Pearson MM et al.; Previous studies correlated the presence of a 200-kDa protein on the surface of Moraxella catarrhalis with the ability of this organism to agglutinate human erythrocytes (M . Fitzgerald, R . Mulcahy, S . Murphy, C . Keane, D . Coakley, and T . Scott, FEMS Immunol . Med . Microbiol . 18:209-216, 1997) . In the present study, the gene encoding the 200-kDa protein (designated Hag) of M . catarrhalis strain O35E was subjected to nucleotide sequence analysis and then was inactivated by insertional mutagenesis . The isogenic hag mutant was unable to agglutinate human erythrocytes and lost its ability to autoagglutinate but was still attached at wild-type levels to several human epithelial cell lines . The hag mutation also eliminated the ability of this mutant strain to bind human immunoglobulin D . The presence of the Hag protein on the M . catarrhalis cell surface, as well as that of the UspA1 and UspA2 proteins (C . Aebi, I . Maciver, J . L . Latimer, L . D . Cope, M . K . Stevens, S . E . Thomas, G . H . McCracken, Jr., and E . J . Hansen, Infect . Immun . 65:4367-4377, 1997), was investigated by transmission electron and cryoimmunoelectron microscopy . Wild-type M . catarrhalis strain O35E possessed a dense layer of surface projections, whereas an isogenic uspA1 uspA2 hag triple mutant version of this strain did not possess any detectable surface projections . Examination of a uspA1 uspA2 double mutant that expressed the Hag protein revealed the presence of a relatively sparse layer of surface projections, similar to those seen on a uspA2 hag mutant that expressed UspA1 . In contrast, a uspA1 hag mutant that expressed UspA2 formed a very dense layer of relatively short surface projections . These results indicate that the surface-exposed Hag protein and UspA1 and UspA2 have the potential to interact both with each other and directly with host defense systems.

Eur J Med Res, 2002 Jun 28, 7(6), 292 - 4
Clinical management and evidence based treatment of chronic hepatitis C--12th European Congress of Clinical Microbiology and Infectious Diseases, Milan, Italy, 21-24 April 2002; Tossing G; As in totally 1% of the worldwide population is afflicted by hepatitis C virus with most of the 200 Mio carriers not diagnosed or treated, the clinical management of chronic hepatitis C remains an urgent demand for global health . The 12th European Congress of Clinical Microbiology and Infectious Diseases (12th ECCMID) held in Milan, Italy, from 21 to 24 April 2002, focussed on viral hepatitis in a keynote lecture as well as a session on evidence based treatment of chronic infection and various poster presentations.

Br J Biomed Sci, 2002, 59(2), 69 - 75
Effect of staff attitudes on quality in clinical microbiology services; Pitt SJ et al.; Technical quality of the work of clinical pathology laboratories is monitored regularly by both internal and external sources . Among the factors that might affect quality, laboratory staff attitudes are rarely considered . In this study, the psychological concepts of 'job satisfaction' and 'climate' are measured among microbiology biomedical scientists in the United Kingdom . A self-report questionnaire was developed and distributed (between November 1998 and February 1999) to biomedical scientists in 161 microbiology laboratories throughout the UK From 2415 questionnaires distributed, 931 replies were received--a response rate of 39% . A separate set of questions covering customer service and participation in internal and external quality assurance schemes was sent to laboratory managers . Biomedical scientists reported lower job satisfaction than did medical technologists in a previous study in the USA . Perception of climate was influenced by several demographic factors, the most important of which being the size of the laboratory . Optimal number of staff in a department was found to be less than 30 . Aggregation of climate scores from members of the same department showed that a positive laboratory climate was important for good performance in internal and external measures of technical quality . For the best service, laboratory climate must be supported by a staff perception that the department is committed to enhancing quality--a climate for laboratory quality.

Eur J Clin Microbiol Infect Dis, 2002 Jun, 21(6), 468 - 70 Epub 2002 Jun 11.
Mycobacterium tuberculosis and Mycobacterium fortuitum osteomyelitis of the foot and septic arthritis of the ankle in an immunocompetent patient; Lazzarini L et al.; Mycobacteria, both tuberculous and nontuberculous, are recognized as a cause of chronic bone and joint infection . However, the diagnosis of mycobacterial infection is easily missed because of the absence of systemic involvement . Moreover, specific microbiologic techniques are required to detect mycobacteria in clinical specimens . Infections due to uncommon pathogens such as mycobacteria are more likely to occur in the immunocompromised host . A case of septic arthritis of the ankle and osteomyelitis of the foot due to both tuberculous and nontuberculous mycobacteria in an immunocompetent host is reported here.

Ann Bot (Lond), 2002 Jun, 89(6), 783 - 9
Ectomycorrhizal symbiosis can enhance plant nutrition through improved access to discrete organic nutrient patches of high resource quality; Tibbett M et al.; It is known that roots can respond to patches of fertility; however, root proliferation is often too slow to exploit resources fully, and organic nutrient patches may be broken down and leached, immobilized or chemically fixed before they are invaded by the root system . The ability of fungal hyphae to exploit resource patches is far greater than that of roots due to their innate physiological and morphological plasticity, which allows comprehensive exploration and rapid colonization of resource patches in soils . The fungal symbionts of ectomycorrhizal plants excrete significant quantities of enzymes such as chitinases, phosphatases and proteases . These might allow the organic residue to be tapped directly for nutrients such as N and P . Pot experiments conducted with nutrient-stressed ectomycorrhizal and control willow plants showed that when high quality organic nutrient patches were added, they were colonized rapidly by the ectomycorrhizal mycelium . These established willows (0.5 m tall) were colonized by Hebeloma syrjense P . Karst . for 1 year prior to nutrient patch addition . Within days after patch addition, colour changes in the leaves of the mycorrhizal plants (reflecting improved nutrition) were apparent, and after I month the concentration of N and P in the foliage of mycorrhizal plants was significantly greater than that in non-mycorrhizal plants subject to the same nutrient addition . It seems likely that the mycorrhizal plants were able to compete effectively with the wider soil microbiota and tap directly into the high quality organic resource patch via their extra-radical mycelium . We hypothesize that ectomycorrhizal plants may reclaim some of the N and P invested in seed production by direct recycling from failed seeds in the soil . The rapid exploitation of similar discrete, transient, high-quality nutrient patches may have led to underestimations when determining the nutritional benefits of ectomycorrhizal colonization.

Mol Cell Biol, 2002 Aug, 22(15), 5593 - 605
Guanidine hydrochloride inhibits the generation of prion "seeds" but not prion protein aggregation in yeast; Ness F et al.; {PSI(+)} strains of the yeast Saccharomyces cerevisiae replicate and transmit the prion form of the Sup35p protein but can be permanently cured of this property when grown in millimolar concentrations of guanidine hydrochloride (GdnHCl) . GdnHCl treatment leads to the inhibition of the replication of the {PSI(+)} seeds necessary for continued {PSI(+)} propagation . Here we demonstrate that the rate of incorporation of newly synthesized Sup35p into the high-molecular-weight aggregates, diagnostic of {PSI(+)} strains, is proportional to the number of seeds in the cell, with seed number declining (and the levels of soluble Sup35p increasing) in the presence of GdnHCl . GdnHCl does not cause breakdown of preexisting Sup35p aggregates in {PSI(+)} cells . Transfer of GdnHCl-treated cells to GdnHCl-free medium reverses GdnHCl inhibition of {PSI(+)} seed replication and allows new prion seeds to be generated exponentially in the absence of ongoing protein synthesis . Following such release the {PSI(+)} seed numbers double every 20 to 22 min . Recent evidence (P . C . Ferreira, F . Ness, S . R . Edwards, B . S . Cox, and M . F . Tuite, Mol . Microbiol . 40:1357-1369, 2001; G . Jung and D . C . Masison, Curr . Microbiol . 43:7-10, 2001), together with data presented here, suggests that curing yeast prions by GdnHCl is a consequence of GdnHCl inhibition of the activity of molecular chaperone Hsp104, which in turn is essential for {PSI(+)} propagation . The kinetics of elimination of {PSI(+)} by coexpression of a dominant, ATPase-negative allele of HSP104 were similar to those observed for GdnHCl-induced elimination . Based on these and other data, we propose a two-cycle model for "prionization" of Sup35p in {PSI(+)} cells: cycle A is the GdnHCl-sensitive (Hsp104-dependent) replication of the prion seeds, while cycle B is a GdnHCl-insensitive (Hsp104-independent) process that converts these seeds to pelletable aggregates.

Clin Microbiol Rev, 2002 Jul, 15(3), 465 - 84
Current status of nonculture methods for diagnosis of invasive fungal infections; Yeo SF et al.; The incidence of invasive fungal infections has increased dramatically in recent decades, especially among immunocompromised patients . However, the diagnosis of these infections in a timely fashion is often very difficult . Conventional microbiologic and histopathologic approaches generally are neither sensitive nor specific, and they often do not detect invasive fungal infection until late in the course of disease . Since early diagnosis may guide appropriate treatment and prevent mortality, there has been considerable interest in developing nonculture approaches to diagnosing fungal infections . These approaches include detection of specific host immune responses to fungal antigens, detection of specific macromolecular antigens using immunologic reagents, amplification and detection of specific fungal nucleic acid sequences, and detection and quantitation of specific fungal metabolite products . This work reviews the current status and recent developments as well as problems in the design of nonculture diagnostic methods for invasive fungal infections.

Infect Dis Clin North Am, 2002 Jun, 16(2), 477 - 505, xii
Infections of intracardiac devices; Karchmer AW et al.; Intracardiac devices are increasingly used to correct hemodynamically dysfunctional valves and electrophysiologic abnormalities . These devices become infected at relatively low rates . Nevertheless, when these low rates are applied to widely used devices, significant numbers of infections result . Additionally, these infections have been associated with high degrees of morbidity and high mortality rates . This article reviews the epidemiology, microbiology, clinical presentation, and medical as well as surgical therapy of intracardiac device infections.

Sb Lek, 2001, 102(3), 433 - 41
{Conflicts regarding the Hospital for Epidemics in Olomouc 1925-1938} }; Masova H; The argument between the municipality of Olomouc and the provincial government in Brno was caused by diverse opinions, if an epidemic hospital for the large region of the North-Eastern Moravia should have been built in Olomouc . The Czechoslovak health care laws needed rehabilitation and unification of norms and conditions for building, financing and managing hospitals, as well as modernization of institutions concerning infectious diseases . The Moravian authorities quarrelling on the financial issues of the projected hospital, and later on the technical aspects of it, had to ask the Ministry of Public Health and Physical Training in Prague to unravel the problem, but without an effect . The solution was not easily achievable until the era of antibiotics and buckshee and compulsory inoculation after the World War II came . Microbiologist Professor Jan Kabelik took part in both the battles--for the new hospital in Olomouc in the pre-war period as well as for the immunization of the whole populace after the war.

Prehospital Disaster Med, 2001 Oct-Dec, 16(4), 244 - 51
Rehabilitating public health infrastructure in the post-conflict setting: epidemic prevention and preparedness in Kosovo; Brennan RJ et al.; The war in Kosovo in 1999 resulted in the displacement of up to 1.5 million persons from their homes . On the subsequent return of the refugees and internally displaced persons, one of the major challenges facing the local population and the international community, was the rehabilitation of Kosovo's public health infrastructure, which had sustained enormous damage as a result of the fighting . Of particular importance was the need to develop a system of epidemic prevention and preparedness . But no single agency had the resources or capacity to implement such a program . Therefore, a unique six-point model was developed as a collaboration between the Kosovo Institute of Public Health, the World Health Organization, and an international, non-governmental organization . Important components of the program included a major Kosovo-wide baseline health survey, the development of a province-wide public health surveillance system, rehabilitation of microbiology laboratories, and the development of a local capacity for epidemic response . While all program objectives were met, important lessons were learned concerning the planning, design, and implementation of such a project . This program represents a model that potentially could be replicated in other post-conflict or development settings.

West Indian Med J, 2002 Mar, 51(1), 25 - 7
Intestinal parasites among young children in the interior of Guyana; Lindo JF et al.; Intestinal parasites contribute greatly to morbidity in developing countries . While there have been several studies of the problem in the Caribbean, including the implementation of control programmes, this has not been done for Guyana . The aim of this study was to determine the prevalence of intestinal parasites among young children in a town located in the interior of Guyana . Eighty-five children under the age of 12 years were studied prospectively for intestinal parasites in Mahdia, Guyana . Stool samples were transported in formalin to the Department of Microbiology, The University of the West Indies, Jamaica, for analysis using the formalin-ether concentration and Ziehl-Neelsen techniques . Data on age and gender of the children were recorded on field data sheets . At least one intestinal parasite was detected in 43.5% (37/85) of the children studied and multiple parasitic infections were recorded in 21.2% (18/85) . The most common intestinal helminth parasite was hookworm (28.2%; 24/85), followed by Ascaris lumbricoides (18.8%; 16/85) and then Trichuris trichuria (14.1%; 12/85) . Among the protozoan infections Giardia lamblia was detected in 10.5% (9/85) of the study population while Entamoeba histolytica appeared rarely . All stool samples were negative for Cryptosporidium and other intestinal Coccidia . There was no predilection for gender with any of the parasites . The pattern of distribution of worms in this area of Guyana was unlike that seen in other studies . Hookworm infection was the most common among the children and a large proportion had multiple infections . The study established the occurrence and prevalence of a number of intestinal parasites in the population of Guyana . This sets the stage for the design and implementation of more detailed epidemiological studies.

J Clin Microbiol, 2002 Jul, 40(7), 2370 - 80
Characterization of an unusual Mycobacterium: a possible missing link between Mycobacterium marinum and Mycobacterium ulcerans; Chemlal K et al.; In an attempt to characterize an unusual mycobacterial isolate from a 44-year-old patient living in France, we applied phenotypic characterizations and various previously described molecular methods for the taxonomic classification of mycobacteria . The results of the investigations were compared to those obtained in a previous study with a set of temporally and geographically diverse Mycobacterium ulcerans (n = 29) and Mycobacterium marinum (n = 29) isolates (K . Chemlal, G . Huys, P.-A . Fonteyne, V . Vincent, A . G . Lopez, L . Rigouts, J . Swings, W . M . Meyers, and F . Portaels, J . Clin . Microbiol . 39:3272-3278, 2001) . The isolate, designated ITM 00-1026 (IPP 2000-372), is closely related to M . marinum according to its phenotypic properties, lipid pattern, and partial 16S rRNA sequence . Moreover, fingerprinting by amplified fragment length polymorphism (AFLP) analysis unequivocally classified this strain as a member of the species M . marinum, although it lacked two species-specific AFLP marker bands . However, PCR and restriction fragment length polymorphism analysis based on M . ulcerans-specific insertion sequence IS2404 showed the presence of this element in a low copy number in isolate ITM 00-1026 . In conclusion, the designation of this isolate as a transitional species further supports the recent claim by Stinear et al . (T . Stinear, G . Jenkin, P . D . Johnson, and J . K . Davies, J . Bacteriol . 182:6322-6330, 2000) that M . ulcerans represents a relatively recent phylogenetic derivative of M . marinum resulting from the systematic acquisition of foreign DNA fragments.

Eur J Pharm Biopharm, 2002 Jul, 54(1), 83 - 7
Long term stability of rh-Cu/Zn-superoxide dismutase (SOD)-liposomes prepared by the cross-flow injection technique following International Conference on Harmonisation (ICH)-guidelines; Vorauer-Uhl K et al.; The current market position of liposomes as drug carriers is still being discussed with regard to large scale production, product characterisation and the stability of the dispersions . In this study, long term stability of liposomal suspensions with encapsulated rh-Cu/Zn-superoxide dismutase was tested according to the International Conference on Harmonisation (ICH) recommendations . The guidelines of the ICH provide general requirements for stability testing for registration and export in particular . The Institute of Applied Microbiology has examined a process to produce large amounts of pharmaceutical-grade liposomes for the treatment of inflammatory diseases by topical application . For the evaluation of its long-term storage stability, liposomal stability and protein stability were tested under appropriate conditions . Therefore, size alterations of the vesicles, protein release and protein activity were evaluated . During the observation period, neither significant alterations of the liposomes nor any protein degradation could be detected . In the light of these findings our liposomal formulations seem to provide chemical, physical and biological stability according to the definitions of the ICH . Appropriate lipid compounds and environmental factors, in combination with an optimised process and adequate storage conditions, facilitate the production of liposome dispersions suitable as drug carriers on the market.

J Bacteriol, 2002 Jul, 184(14), 3879 - 85
Network of hydrogenase maturation in Escherichia coli: role of accessory proteins HypA and HybF; Hube M et al.; We have studied the roles of the auxiliary protein HypA and of its homolog HybF in hydrogenase maturation . A mutation in hypA leads to the nearly complete blockade of maturation solely of hydrogenase 3 whereas a lesion in hybF drastically but not totally reduces maturation and activity of isoenzymes 1 and 2 . The residual level of matured enzymes in the hybF mutant was shown to be due to the function of HypA; HybF, conversely, was responsible for a minimal residual activity of hydrogenase 3 in the mutant hypA strain . Accordingly, a hypA DeltahybF double mutant was completely blocked in the maturation process . However, the inclusion of high nickel concentrations in the medium could restore limited activity of all three hydrogenases . The results of this study and of previous work (M . Blokesch, A . Magalon, and A . Bock, J . Bacteriol . 189:2817-2822, 2001) show that the maturation of the three functional hydrogenases from Escherichia coli is intimately connected via the activity of proteins HypA and HypC and of their homologs HybF and HybG, respectively . The results also support the suggestion of Olson et al . (J . W . Olson, N . S . Mehta, and R . J . Maier, Mol . Microbiol . 39:176-182, 2001) that HypA cooperates with HypB in the insertion of nickel into the precursor of the large hydrogenase subunit . Whereas HypA is predominantly involved in the maturation of hydrogenase 3, HybF takes over its function in the maturation of isoenzymes 1 and 2.

Rinsho Byori, 2002 May, 50(5), 455 - 62
{Advances of laboratory testing for the rapid diagnosis of tuberculosis}; Ichiyama S; Rapid diagnosis and treatment are extensively important for preventing transmission of Mycobacterium tuberculosis: In 1994, The Centers for Disease Control and Prevention, CDC, has published recommendations for the rapid diagnosis in the laboratories, in which smear result should be reported within 24 h, detection and identification within 10 to 14 days, and susceptibility within 15 to 30 days . New technologies, therefore, should be implemented in the laboratory . There have been significant advances in the practice of microbiology . Nucleic acid amplification, rapid culture system, antigen detection, and ATP assay system have provided new approaches to the rapid diagnosis of tuberculosis . In the present paper, we review studies which evaluated the reliability, rapidity, and requisite diagnostic capability for each method . Furthermore, we propose an appropriate test algorithm in the clinical laboratories.

Cochrane Database Syst Rev . 2002;(2):CD000026.
Routine versus selective antifungal administration for control of fungal infections in patients with cancer; Gotzsche PC et al.; BACKGROUND: Systemic fungal infection is considered to be an important cause of morbidity and mortality in cancer patients, particularly those with neutropenia . Antifungal drugs are often given prophylactically, or to patients with persistent fever . OBJECTIVES: The objective of this review was to assess the effect of antifungal drugs in cancer patients with neutropenia . SEARCH STRATEGY: We searched the Cochrane Controlled Trials Register and MEDLINE (November 2001) and the reference lists of articles . We searched the proceedings of the ICAAC (from 1990 to 2001, General Meeting of the ASM (from 1990 to 2001), and the European Congress of Clinical Microbiology and Infectious Diseases (1995 to 2001) and contacted researchers in the field . SELECTION CRITERIA: Randomised trials of amphotericin B, fluconazole, ketoconazole, miconazole, or itraconazole compared with placebo or no treatment in cancer patients with neutropenia . DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial eligibility, methodological quality and abstracted data . MAIN RESULTS: Thirty trials involving 4094 patients were included . Prophylactic or empirical treatment with antifungals as a group had no statistically significant effect on mortality (relative risk 0.95, 95% confidence interval 0.82 to 1.11) . The relative risk was smallest for amphotericin B, 0.73 (0.52 to 1.03) (P=0.08) . In another review, three trials compared intravenous lipid soluble amphotericin B (AmBisome) with smaller doses of standard intravenous amphotericin B; the relative risk was 0.74 (0.52 to 1.07) . Taken together, these results indicate that intravenous amphotericin B might decrease mortality . In contrast, trials with fluconazole, ketoconazole, miconazole and itraconazole failed to find an effect on mortality . The incidence of invasive fungal infection decreased significantly with administration of amphotericin B (relative risk 0.39, 95% CI 0.20 to 0.76), fluconazole (0.39, 0.27 to 0.57) and itraconazole (0.51, 0.27 to 0.96), but not with miconazole or ketoconazole . REVIEWER'S CONCLUSIONS: Intravenous amphotericin B is the only antifungal agent for which there is evidence suggesting that it might reduce mortality . It should therefore be preferred when prophylactic or empirical antifungal therapy in cancer patients with neutropenia is considered indicated.

J Theor Biol, 2002 May 7, 216(1), 1 - 4
Bacteriophage T4 development in Escherichia coli is growth rate dependent; Rabinovitch A et al.; Three independent parameters (eclipse and latent periods, and rate of ripening during the rise period) are essential and sufficient to describe bacteriophage development in its bacterial host . A general model to describe the classical "one-step growth" experiment {Rabinovitch et al . (1999a) J . Bacteriol.181, 1687-1683} allowed their calculations from experimental results obtained with T4 in Escherichia coli B/r under different growth conditions {Hadas et al . (1997) Microbiology143, 179-185} . It is found that all three parameters could be described by their dependence solely on the culture doubling time tau before infection . Their functional dependence on tau, derived by a best-fit analysis, was used to calculate burst size values . The latter agree well with the experimental results . The dependence of the derived parameters on growth conditions can be used to predict phage development under other experimental manipulations .

Anaesth Intensive Care, 2002 Jun, 30(3), 364 - 6
Vancomycin reaction during spinal anaesthesia; Duffy BL; A 77-year-old female received uneventful spinal anaesthesia for a total knee replacement . Upon the advice of the microbiologists and at the request of the orthopaedic surgeon, a vancomycin infusion was commenced prior to the application of the leg tourniquet . Five minutes later, having received only 40 mg of the antibiotic dose, she became unconscious and suffered severe cardiovascular collapse, from which she was resuscitated with intravenous ephedrine and adrenaline.

J Radiol, 2002 Apr, 83(4 Pt 2), 535 - 50
{Screening and imaging guided biopsies of the breast}; Grumbach Y et al.; In cases of subclinical mammographic abnormalities, being able to determine after screening, the indications regarding the type of imaging guidance and the type of biopsy equipment . In presence of microcalcifications, stereotactic mammography, either screen-film or digital, is the modality of choice . As fine needle aspiration cytology is insufficient, it is necessary to obtain tissue specimens with at least 14 Gauge Tru-cut needle, triggered by automatic guns, or coaxial needles of 11 G or 8 G, adaptable on a vacuum aspiration system . In case of mammographic opacities or masses, the same type of sampling can be used under US guidance as long as there is a good sonographic contrast of the lesion . Fine needle puncture, well accepted, keeps all its interest for cystic lesions and for solid ones, because of the value of its multidirectionnal sampling that well trained cytopathologists can make very informative . However, in case of insufficient or discordant results, US guided microbiopsies or macrobiopsies, using newer guns, allow to obtain a histologic diagnosis equivalent to surgical biopsy . If fine needle US guided puncture can be performed in first intention, straight after ultrasonographic examination, percutaneous micro- or macrobiopsies (using US or stereotactic guidance) must be undertaken in second intention after having explained to the patient this ambulatory procedure, the eventual risks, and by insisting on the results that can be expected for a precise diagnosis.

Cornea, 2002 Jul, 21(5), 516 - 8
Severe keratomycosis secondary to Scedosporium apiospermum; Diaz-Valle D et al.; PURPOSE: To report an unusual case of severe keratomycosis caused by Scedosporium apiospermum without any known previous ocular injury, that resulted in a corneal perforation, which was treated with an emergency penetrating tectonic keratoplasty and later with phacoemulsification and astigmatic keratotomy to restore good visual function . METHODS: A 45-year-old woman with a history of multiple sclerosis presented with a severe and refractory corneal abscess in her right eye without any known prior injury . Corneal scrapings were obtained and stained for microscopic evaluation . The samples were sent for aerobic and anaerobic bacterial and fungal cultures . RESULTS: Microbiologic examination of the corneal scraping showed Scedosporium apiospermum micelle . The fungal culture was sensitive to miconazole, itraconazole and voriconazole . Partial clinical improvement was achieved with hourly topical natamycin, amphotericin B, and systemic itraconazole application, although in vitro sensitivity tests showed resistance to the topical antifungal agents used . A corneal paracentral perforation occurred despite aggressive treatment . An emergency eccentric penetrating keratoplasty was performed with satisfactory results . Subsequent phacoemulsification and astigmatic keratotomy restored a good visual function . CONCLUSION: A fungal etiology should be suspected in a progressive and refractory corneal abscess . This report highlights the utility of microbiologic investigation to perform an early and accurate diagnosis . Aggressive medical treatment and even therapeutic penetrating keratoplasty to remove infected tissue could result in the maintenance of useful visual function . In view of the poor prognosis of this specific fungus, a closer observation and early keratoplasty might be required to preserve the ocular globe.

Ann Ig, 2002 Mar-Apr, 14(2), 163 - 9
{Sexually transmitted diseases: epidemiological and social aspects}; Marin V et al.; STDs represent a major public health problem for two reasons: their serious sequelae and the facts that they facilitate transmission of HIV . This article presents WHO estimates new cases of some of curable STDs, and italian data from national reporting system (published from ISTAT and ISS) . The number of new reported cases decreases in Italy, but reported cases are not all cases . People with STDs tend not to seek treatment or to self-medicate, this behaviour is common in youths . In many cases STDs are asymptomatic in both sexes, particularly in women . Women are also much more vulnerable biologically, culturally, socioeconomically . There is also a lack of notification by physicians . Important social determinants of STDs diffusion are migration and travels . Prevention and control of STDs need collaboration between medical disciplines: gynaecology, urology, dermo-venerology, microbiology, epidemiology, public health . Contributions of nurses, laboratory technician and social workers are also required . The role of public health specialists in the prevention is strictly related to health education . Health education will promote responsible sexual behaviour and early recourse to health services by people with STDs and their sexual partners.

Am J Respir Crit Care Med, 2002 Jun 15, 165(12), 1618 - 23
Reproducibility of blind protected bronchoalveolar lavage in mechanically ventilated children; Gauvin F et al.; Blind protected bronchoalveolar lavage (BAL) could be an interesting tool in the diagnosis of ventilator-associated pneumonia in intubated children, but its reproducibility has never been evaluated . This study evaluates the reproducibility, feasibility, and safety of blind protected BAL in mechanically ventilated children . Two blind protected BAL were done, at a 2-hour interval, in 30 patients . The reproducibility of microbiologic and cytologic results was studied . A total of 60 BALs was analyzed . Bacterial growth was present in 26 of 60 BAL (43%) . Reproducibility for the presence of bacteria on quantitative cultures was excellent (concordance, 93%; kappa {kappa}, 0.86) . Concordance for the type of bacteria isolated was 86% and for the number of bacteria was 79% . Reproducibility for the presence of neutrophils containing bacteria was perfect (concordance, 100%; kappa, 1) although only a few BALs had a positive result (8/60) . Blind protected BAL was feasible in all patients and all samples were considered adequate for analysis . Complications were mostly benign and transitory except in two cases: one pneumothorax and one significant increase in intracranial pressure . Overall, blind protected BAL is a reproducible test in mechanically ventilated children, is easily feasible, and is usually well tolerated.

Trends Mol Med, 2002 Jun, 8(6), 280 - 7
Molecular diagnostics in infectious diseases and public health microbiology: cottage industry to postgenomics; Gilbert GL; Molecular methods have been used increasingly over the past ten years to improve the sensitivity and speed of diagnosis in infectious diseases . Although their routine use is still limited to the detection of pathogens that are difficult to culture in vitro,'real-time' methods, commercial kits, quantification and automation will increase potential applications . Molecular methods are now widely used for epidemiological fingerprinting of isolates of public health importance . Sequence-based identification and strain typing, together with the development of tools that can probe for thousands of markers, will allow detailed strain fingerprinting to assist in disease management and control.

Compend Contin Educ Dent, 2002 May, 23(5), 416 - 8, 421-2
Nutrition and oral infectious diseases: connections and future research; Mangan DF; A workshop on nutrition and oral infectious diseases was held November 5-7, 2000 at the Forsyth Institute, Boston, Massachusetts . The goal of the symposium was to review the current state-of-the-science with regard to nutrition and oral infectious diseases (particularly periodontitis) and then connect the disciplines of nutrition, microbiology, immunology, and clinical periodontology through a comprehensive list of recommendations for future research . The workshop featured five scientific sessions (oral infections and general health, research models, nutrition and infection, nutrition and oral infection, and nutrition, oral health, and life cycle) . An agenda with the complete list of speakers together with the recommendations can be found at A brief summary of the workshop is presented in this article.

J Clin Periodontol, 2002 May, 29(5), 400 - 10
Periodontal diseases in the child and adolescent; Oh TJ et al.; BACKGROUND: Periodontal diseases are among the most frequent diseases affecting children and adolescents . These include gingivitis, localized or generalized aggressive periodontitis (a.k.a., early onset periodontitis which includes generalized or localized prepubertal periodontitis and juvenile periodontitis) and periodontal diseases associated with systemic disorders . The best approach to managing periodontal diseases is prevention, followed by early detection and treatment . METHODS: This paper reviews the current literature concerning the most common periodontal diseases affecting children: chronic gingivitis (or dental plaque-induced gingival diseases) and early onset periodontitis (or aggressive periodontitis), including prepubertal and juvenile periodontitis . In addition, systemic diseases that affect the periodontium and oral lesions commonly found in young children are addressed . The prevalence, diagnostic characteristics, microbiology, host-related factors, and therapeutic management of each of these disease entities are thoroughly discussed.

Med Mycol, 2002 Apr, 40(2), 115 - 21
Occurrence of Malassezia spp . in the external ear canals of dogs and cats with and without otitis externa; Crespo MJ et al.; We studied the lipophilic microbiota of the external ear canals of 332 animals (264 dogs and 68 cats), with and without otitis externa, over an 11-year period from 1988 to 1999 . Malassezia pachydermatis was isolated from 62.2% and 50% of dogs with and without otitis externa, respectively, and from 41.2% and 17.6% of cats with and without otitis externa, respectively . In the group of animals studied for lipid-dependent species, these yeasts were isolated from 4.5% of dogs with otitis externa and from 23.1% and 8.9% of cats with and without otitis externa, respectively . M . sympodialis and M . furfur were isolated from cats and M . furfur and M . obtusa from dogs . Our findings show that lipid-dependent Malassezia species may contribute to the etiology of otitis externa in dogs and cats.

Transfus Clin Biol, 2002 Apr, 9(2), 144 - 51
{Biovigilance, a vigilance exercised on the utilization of products obtained from the human body}; Quaranta JF et al.; Organ transplantations and tissue/cells grafts are efficacious in many diseases . Nevertheless, beside the risk due to the technology which permits to carry out transplantations and grafts (surgery, tissue and cells collection, preservation, storage, cell expansion technics, immunosuppressive regimen,...), the microbiology risk must be controlled throughout the process leading to the transplantation or the graft . The structures, the organizations, the procedures, the information network and the controls assure the control of the risk . It is the main objective of human product vigilance . Future regulations will define the objectives of this sanitary vigilance more precisely.

An R Acad Nac Med (Madr), 2001, 118(4), 891 - 912; discussion 912-9
{Quality control in parasitology}; Vasallo Matilla F; Between 1990 and 1996 we coordinated a Quality Control (QC) Program in Parasitology directed to Public Health Institutions in Spain . Periodically, parasited specimens, mainly feces or blood, were sent to Microbiology Laboratories for identification . Each QC was accompanied by a short clinic and epidemiological information in order to help in the diagnostic approach . After the answers to the QC were received a bulletin that included the solution to the QC, comments on the several answers received and a chapter with parasitological themes related with the QC, was sent to each participating Laboratory . The bulletin was accompanied by a card that included a photograph and a short description of the organism object of the QC.

Ophthalmology, 2002 Jun, 109(6), 1123 - 9
Diagnostic yield of vitrectomy in eyes with suspected posterior segment infection or malignancy; Mruthyunjaya P et al.; PURPOSE: To determine the yield of diagnostic pars plana vitrectomy in eyes with suspected posterior segment inflammation or malignancy when clinical examination and systemic laboratory testing did not yield a specific diagnosis . DESIGN: Non-comparative interventional case series PARTICIPANTS: Eighty-seven consecutive patients (90 eyes) who underwent diagnostic pars plana vitrectomy from 1989 through 1999 . INTERVENTIONS: Vitreous samples were analyzed in a directed manner based on the preoperative clinical examination and systemic laboratory testing . MAIN OUTCOME MEASURES: Diagnosis from each test performed on the vitreous samples . RESULTS: Diagnostic vitrectomy was performed alone in 6 eyes (7%) and as part of a therapeutic procedure in the remaining 84 eyes . The diagnostic tests performed most frequently included cytopathology (83%), microbiologic culture and sensitivity (43%), polymerase chain reaction (PCR) (36%), and intraocular antibody levels for T . canis (14%) . Of these, intraocular antibody testing and PCR had the highest positive yield, 46% and 39%, respectively . Overall, directed vitreous analysis identified a specific cause in 35 eyes (39%) . Of the 65 cases in which an underlying infection was suspected preoperatively, the procedure yielded a specific diagnosis in 27 (42%) . When intraocular malignancy was considered preoperatively (71 eyes), a diagnosis of intraocular lymphoma was obtained in seven (10%) . This difference between these diagnostic yields was significant (P = 0.02, Fisher's exact test) . CONCLUSIONS: Diagnostic vitrectomy with directed vitreous fluid analysis yields a specific cause and guides subsequent therapy in a high percentage of cases . This procedure is a valuable adjunct in cases that cannot be diagnosed by less invasive methods.

J Asthma, 2002 May, 39(3), 191 - 201
Studies of sick building syndrome . IV . Mycotoxicosis; Assoulin-Daya Y et al.; There has been increasing public attention to the potential health risks of mold exposure, particularly in wet buildings . A variety of molds has been isolated from both damaged homes and businesses, including agents that secrete toxigenic materials . One area that is attracting particular notice is the relative toxigenic potential of mycotoxins . Although exposure to molds can produce significant mucosal irritation, there are very few data to suggest long-term ill effects . More importantly, there is no evidence in humans that mold exposure leads to nonmucosal pathology . In fact, many of the data on toxigenic molds are derived from animal toxicity studies, and these are based primarily, on ingestion . Although every attempt should be made to improve the quality of indoor air, including avoidance of molds, the human illnesses attributed to fungal exposure are, with the exception of invasive infections and mold allergy, relatively rare . In this review we discuss selected aspects of the microbiology of mycotoxin-producing molds and their potential role in human immunopathology with respect to wet building environments.

J Chemother, 1991 Jan, 3 Suppl 1, 245 - 6
The therapy of blastocystosis; Garavelli PL; During the period 1985-1989 I observed 35 patients of both sexes and of all ages, who were suffering from signs and symptoms of clear blastocystosis, such as prevailingly watery diarrhea, abdominal pain, nausea, tenesmus, eosinophilia and fever . 5 of them showed concomitant diseases, like Acquired Immune Deficiency Syndrome (AIDS) or AIDS Related Complex (ARC), diabetes mellitus and nephrocarcinoma . By means of the administration of metronidazole 2 g/die for 5 days on average, I obtained the disappearance of Blastocystis hominis from the stools and the absence of the clinical symptomatology in 11 patients, while in another 7 the treatment did not prevent, in the following months, the arising of one or more clinical and microbiologic relapses.

Adv Space Res, 2000, 26(12), 1901 - 9
Integrating public perspectives in sample return planning; Race MS et al.; Planning for extraterrestrial sample returns--whether from Mars or other solar system bodies--must be done in a way that integrates planetary protection concerns with the usual mission technical and scientific considerations . Understanding and addressing legitimate societal concerns about the possible risks of sample return will be a critical part of the public decision making process ahead . This paper presents the results of two studies, one with lay audiences, the other with expert microbiologists designed to gather information on attitudes and concerns about sample return risks and planetary protection . Focus group interviews with lay subjects, using generic information about Mars sample return and a preliminary environmental impact assessment, were designed to obtain an indication of how the factual content is perceived and understood by the public . A research survey of microbiologists gathered information on experts' views and attitudes about sample return, risk management approaches and space exploration risks . These findings, combined with earlier research results on risk perception, will be useful in identifying levels of concern and potential conflicts in understanding between experts and the public about sample return risks . The information will be helpful in guiding development of the environmental impact statement and also has applicability to proposals for sample return from other solar system bodies where scientific uncertainty about extraterrestrial life may persist at the time of mission planning . c2001 COSPAR Published by Elsevier Science Ltd . All rights reserved.

J Clin Microbiol, 2002 Jun, 40(6), 2278 - 81
Exposure of laboratory workers to Francisella tularensis despite a bioterrorism procedure; Shapiro DS et al.; A rapidly fatal case of pulmonary tularemia in a 43-year-old man who was transferred to a tertiary care facility is presented . The microbiology laboratory and autopsy services were not notified of the clinical suspicion of tularemia by the service caring for the patient . Despite having a laboratory bioterrorism procedure in place and adhering to established laboratory protocol, 12 microbiology laboratory employees were exposed to Francisella tularensis and the identification of the organism was delayed due to lack of notification of the laboratory of the clinical suspicion of tularemia . A total of 11 microbiology employees and two persons involved in performing the patient's autopsy received prophylactic doxycycline due to concerns of transmission . None of them developed signs or symptoms of tularemia . One microbiology laboratory employee was pregnant and declined prophylactic antibiotics . As a result of this event, the microbiology laboratory has incorporated flow charts directly into the bench procedures for several highly infectious agents that may be agents of bioterrorism . This should permit more rapid recognition of an isolate for referral to a Level B laboratory for definitive identification and should improve laboratory safety.

J Clin Microbiol, 2002 Jun, 40(6), 2207 - 12
Fatal endocarditis in a neonate caused by the dematiaceous fungus Phialemonium obovatum: case report and review of the literature; Gavin PJ et al.; Phialemonium species are grouped by most authorities among the dematiaceous fungi . Like several other darkly pigmented fungi, they appear to be an emerging cause of human disease, especially in the immunocompromised host . As numbers of immunocompromised patients increase, the trend of unusual fungi emerging as new pathogens is set to continue . Previous experience suggests that reports of rare fungal infections among selected patients often heralds the emergence of infection in a wider population of patients . We report a case of fatal endocarditis caused by Phialemonium obovatum in a premature neonate . To our knowledge this is the first documented case of native valve endocarditis due to this species, and we review the literature on invasive disease caused by the species . Unfamiliar fungal isolates are frequently misidentified or mistaken for environmental contaminants, and because of their relative rarity, data upon which to base antifungal treatment are limited . Thus, the diagnosis and treatment of unusual fungal pathogens present a significant challenge to clinicians and microbiologists alike . Early referral of such isolates to a specialist reference laboratory is advisable.

J Clin Microbiol, 2002 Jun, 40(6), 2126 - 33
Development of variable-number tandem repeat typing of Mycobacterium bovis: comparison of results with those obtained by using existing exact tandem repeats and spoligotyping; Roring S et al.; Various genetic markers have been exploited for fingerprinting the Mycobacterium tuberculosis complex (MTBC) in molecular epidemiological studies, mainly through identifying restriction fragment length polymorphisms (RFLP) . In large-scale studies, RFLP typing has practical processing and analysis limitations; therefore, attempts have been made to move towards PCR-based typing techniques . Spoligotyping (spacer oligotyping) and, more recently, variable-number tandem repeat (VNTR) typing have provided PCR-derived typing techniques . This study describes the identification and characterization of novel VNTR loci, consisting of tandem repeats in the size range of 53 to 59 bp in the MTBC, and their assessment as typing tools in 47 Mycobacterium bovis field isolates and nine MTBC strains . Spoligotyping and the previously described set of exact tandem repeats (ETRs) (R . Frothingham and W . A . Meeker-O'Connell, Microbiology 144:1189-1196, 1998) were also applied to the same panel of isolates . The allelic diversity of the individual VNTR loci was calculated, and a comparison of the novel VNTRs was made against the results obtained by spoligotyping and the existing set of ETRs . Eleven unique spoligotypes were discriminated in the panel of 47 M . bovis isolates . Greater resolution was obtained through the combination of the most-discriminating VNTRs from both sets . Considerable discrimination was achieved, with the 47 M . bovis isolates resolved into 14 unique profiles, while all nine MTBC isolates were uniquely differentiated . The novel VNTR markers described increased the discrimination possible in strain typing of M . bovis, with the added benefit of an intuitive digital nomenclature, with the allele copy number of the individual VNTRs providing a profile . VNTR typing was shown to be a valuable technique with great potential for further development and application to epidemiological tracing of tuberculosis transmissions.

Sex Transm Dis, 2002 Jun, 29(6), 353 - 9
High prevalence of Mycoplasma genitalium in the lower genitourinary tract of women attending a sexually transmitted disease clinic in Paris, France; Casin I et al.; BACKGROUND: Previous studies have suggested that Mycoplasma genitalium is associated with cervicitis and may be a cause of pelvic inflammatory disease . This study attempted to investigate further the possible role of M genitalium in genital symptoms of women attending a sexually transmitted disease (STD) clinic . GOAL: To determine the prevalence of and the association of clinical and microbiologic features with M genitalium in women presenting with genital symptoms . STUDY DESIGN: Between April 1994 and June 1996 a prospective study of 170 consecutive women with abnormal vaginal discharge, with or without urethral itching, dysuria, or pelvic pain, was conducted at the STD clinic at Saint-Louis Hospital in Paris . Information was collected on each subject's characteristics, and a clinical vulvar, vaginal, and cervical examination was performed . Cervical, vaginal, and urethral samples were obtained to identify infecting organisms . RESULTS: DNA of M genitalium was identified by polymerase chain reaction (PCR) at one or more genital sites in 65 women (38%; 95% CI, 31-46%) and was statistically more frequently detected in the vagina (39%) than in the cervix (21%) or urethra (28%) (P = 0.001 and 0.048, respectively) . PCR inhibitors were detected in 17 specimens (4%) . M genitalium was found in 6/14 (43%) positive for Chlamydia trachomatis, but no significant association between M genitalium and any demographic, clinical, or microbiologic data was noted in univariable or multivariable analysis . CONCLUSION: This study indicates that M genitalium is frequently encountered in the female genital tract and is not associated with cervicitis or any particular clinical or microbiologic data.

Med Hypotheses, 2002 Apr, 58(4), 270 - 5
Esophageal squamous metaplasia: nudging the esophageal carcinoma morphogenetic paradigm; Venter FS et al.; The concept regarding esophageal squamous metaplasia, its existence, origin and the role it plays in the etiology of esophageal carcinoma, needs some urgent attention . Explanations regarding the presence of metaplastic squamous epithelial cells on esophageal smears, from asymptomatic high-risk patients undergoing screening for esophageal carcinoma, are difficult to find . The presence of squamous metaplastic cells on smears from the esophagus collected by us since 1983, from rural Transkei populations, is a regular finding and warrants some discussion . Cellular material from the esophageal lumen is collected with a gelatine encapsulated sponge brush for cytological evaluation . Each full-length, 'blind' sampling procedure produces a mixture of single cells, sheets, small groups as well as microbiopsies . Some very well preserved and excellent examples of esophageal epithelium undergoing or in a state of squamous metaplasia are a regular find .

J Biopharm Stat, 2001 Nov, 11(4), 237 - 52
Testing microbiologic response to antiinfective medications with incomplete data; Phillips KF; Clinical trials of antiinfective medications often require estimates of the proportions of patients, n, who are free of disease-causing pathogens at the end of treatment, as well as the proportions of all pathogens that have been eradicated . Each patient is infected with several species of pathogens, but the response to study medication for some of these pathogens may be unknown because some specimens were lost or because the patient received nonstudy medication that was known to be effective against these species . This paper develops a statistical model that estimates pi for each treatment and that accounts for the unknown pathogen responses as well as overdispersion of the remaining responses due to within-patient effects . The data are modeled with the Poisson distribution for the numbers of pathogen species per patient and the beta-binomial model for pathogen eradication . The Poisson and beta-binomial parameters are estimated through maximum likelihood estimation, and the treatment difference in the pi valves and its standard error are estimated by transforming the underlying parameters . Confidence intervals based on these estimates are constructed to test the hypothesis of noninferiority of the test treatment.

Infection, 2002 Apr, 30(2), 61 - 7
Nosocomial pneumonia: a cost-of-illness analysis; Dietrich ES et al.; BACKGROUND: We investigated incremental cost of nosocomial pneumonia (NP) from the perspective of a hospital and health insurance funds . PATIENTS AND METHODS: The incremental cost was determined by calculating total costs for pneumonia patients and controls using prospective and retrospective matched-pairs analysis with 29 and 37 matched pairs, respectively . RESULTS: Compared to controls, patients who developed pneumonia had to be on artificial ventilation 5 days longer, needed markedly more intensive care with 6.55 additional days in intensive care . Excess cost per pneumonia patient amounted to DM 14,606 (95% CI: DM 5,285-23,927) from the hospital's perspective and to DM 7,988 (95% CI: DM 5,281-10,894) according to statutory insurance charges . According to the retrospective anaLysis carried out on the neurosurgical and neurological intensive care wards, pneumonia patients were ventiLated 5 days longer than patients without pneumonia, needed more intensive care over 30 days and had an additional 14.03 days of intensive care and 10.14 more days in hospital . Excess cost per patient was DM 29,610 (95% CI: DM 23,054-36,174) from the hospitals perspective and DM 18,000 (95% CI: 14,885-21,020) according to the statutory insurance criteria . CONCLUSION: The study gives insight into the structure of incremental cost caused by NP and shows that based on a conservative cost calculation the incremental cost per NP patient is higher for the hospital than for health insurance funds which indicates a significant financial deficit for the hospital . Antibiotics and microbiology together only contribute 6.8% to incremental cost . Therefore in a cost saving initiative their close relationship to length of hospitalization must be considered.

Curr Infect Dis Rep, 2002 Jun, 4(3), 217 - 224
Microbiology and Management of Sialadenitis; Bradley PJ; Acute and chronic inflammatory diseases of the major and minor salivary glands constitute the most common clinical syndrome of salivary glands . During the past decade, the use of antibiotics along with fluid hydration and electrolyte management has almost eliminated the development of fulminating acute suppurative parotitis in hospital surgical patients . Although acute bacterial and viral sialadenitis persists, the clinical challenge has changed, with more focus on the chronic inflammatory group of diseases . The pathogenesis of the chronic salivary inflammatory disease spectrum has also changed, with the interplay between sialadenitis, sialectasia, and sialolithiasis . There also exists a heterogeneous group of disorders in chronic inflammatory sialadenitis, which include the group of specific and nonspecific granulomatous diseases.

Indian J Pediatr, 2002 Apr, 69(4), 333 - 9
Infective endocarditis; Kohli V; Infective Endocarditis (IE) is a known and a well-described complication of congenital and acquired heart disease . Its onset may be related to a procedure (which is commonly dental) or to poor dental hygiene . Use of antibiotics prior to the procedure prevents IE . General awareness of dental hygiene and use of prophylactic antibiotic is as much a responsibility of the Pediatrician as it is of the Pediatric Cardiologist . This article reviews the changing epidemiology, pathophysiology, clinical manifestations, and the microbiology of IE . Duke criteria for diagnosis of IE and the role of echocardiography in diagnosis of IE are discussed . There is special emphasis on the prevention of IE.

Am J Obstet Gynecol, 2002 May, 186(5), 929 - 37
Effectiveness of inpatient and outpatient treatment strategies for women with pelvic inflammatory disease: results from the Pelvic Inflammatory Disease Evaluation and Clinical Health (PEACH) Randomized Trial; Ness RB et al.; OBJECTIVE: Pelvic inflammatory disease (PID) is a common and morbid intraperitoneal infection . Although most women with pelvic inflammatory disease are treated as outpatients, the effectiveness of this strategy remains unproven . STUDY DESIGN: We enrolled 831 women with clinical signs and symptoms of mild-to-moderate pelvic inflammatory disease into a multicenter randomized clinical trial of inpatient treatment initiated by intravenous cefoxitin and doxycycline versus outpatient treatment that consisted of a single intramuscular injection of cefoxitin and oral doxycycline . Long-term outcomes were pregnancy rate, time to pregnancy, recurrence of pelvic inflammatory disease, chronic pelvic pain, and ectopic pregnancy . RESULTS: Short-term clinical and microbiologic improvement were similar between women randomized to the inpatient and outpatient groups . After a mean follow-up period of 35 months, pregnancy rates were nearly equal (42.0% for outpatients and 41.7% for inpatients) . There were also no statistically significant differences between outpatient and inpatient groups in the outcome of time to pregnancy or in the proportion of women with pelvic inflammatory disease recurrence, chronic pelvic pain, or ectopic pregnancy . CONCLUSION: Among women with mild-to-moderate pelvic inflammatory disease, there was no difference in reproductive outcomes between women randomized to inpatient treatment and those randomized to outpatient treatment.

Rinsho Byori, 2002 Apr, 50(4), 353 - 7
{Postgraduates' training as laboratory physicians/clinical pathologists in Japan--board certification of JSLM as a mandatory requirement for chairpersons of laboratory medicine}; Kumasaka K; The educational committee of the Japanese Society of Laboratory Medicine(JSLM) proposed a revised laboratory medicine residency curriculum in 1999 and again in 2001 . The committee believes that present undergraduate clinical training is insufficient and that Japanese medical graduates need clinical training for two years after graduation . This two years training should be a precondition for further postgraduate training in laboratory medicine and should include fundamental clinical skills(communication skills, physical examination and common laboratory procedures such as Gram's stain, Wright-Giemsa stain and urinalysis) . After the two years training, the minimal training period of laboratory medicine should be three years, and should include: 1) Principles, instrumentation and techniques of each discipline including clinical chemistry, clinical hematology, clinical microbiology, clinical immunology, blood banking and other specific areas . 2) The use of laboratory information in a medical setting . 3) Interaction of the laboratory physician with laboratory staff, physicians and patients . With good on-the-job training and 24 hours on-call duties, laboratory physicians are expected to perform their tasks, including laboratory management, effectively . They should have appropriate educational background and should be well motivated . The background and duties of the laboratory physicians often reflect the institutional needs and personal philosophy of the chairperson of their department . At the moment, few senior physicians in Japan have qualifications in laboratory medicine and are unable, therefore, to provide the necessary guidance to help the laboratory physicians in their work . I therefore believe that the board certification of JSLM should be regarded as mandatory for chairpersons of laboratory medicine . Our on-call service system can enhance the training in laboratory medicine, and improve not only laboratory quality assurance but patients' care as well.

Clin J Sport Med, 2002 May, 12(3), 165 - 71
Tinea gladiatorum: Pennsylvania's experience; Kohl TD et al.; OBJECTIVE: To describe the impact of ringworm infections in high school wrestlers (tinea gladiatorum) in Pennsylvania during the 1998-1999 scholastic wrestling season . DESIGN: Retrospective 23-item mail-out survey . SETTING: Pennsylvania high schools with varsity wrestling programs in 1998-1999 . PARTICIPANTS: Athletic trainers, athletic directors, and wrestling coaches who responded to the mail-out survey . MAIN OUTCOME MEASURES: Frequency of ringworm infection during the 1998-1999 season . Methods of prevention, diagnosis, and treatment of ringworm among respondent schools . Summary of beliefs concerning transmission and the way ringworm is approached compared with other skin infections . Any associations between the methods of prevention, diagnosis, and treatment and the frequency of ringworm infections . RESULTS: Response rate was 42.4% . Of the respondent schools, 84.7% had at least one wrestler diagnosed with ringworm . Of these teams with infected wrestlers 33% had a wrestler miss a match because of the infection . A majority of schools (68.7%) have a written guideline for return after a ringworm infection . Most respondents believe ringworm is transmitted by personal contact or from contact with mats . An overwhelming majority of schools (97%) use preventive practices . Interestingly, schools that used a greater number of preventive practices had more ringworm infections (p < 0.05) . Larger teams were associated with more ringworm infections . In the respondent schools, 60% of coaches were involved in making a diagnosis of ringworm . Return decisions are made predominantly by a physician and/or the athletic trainer (79%) . CONCLUSIONS: Ringworm infections in wrestlers are a common occurrence . There is a lot of variation among schools in Pennsylvania in regard to prevention, diagnosis, treatment, guidelines, and beliefs about ringworm . More study is needed to determine risk factors, transmission patterns, microbiology patterns, and evidence-based prevention and treatment recommendations.

Infect Immun, 2002 Jun, 70(6), 2787 - 95
Mycobacterium tuberculosis genes induced during infection of human macrophages; Dubnau E et al.; We identified Mycobacterium tuberculosis genes preferentially expressed during infection of human macrophages using a promoter trap adapted for this pathogen . inhA encodes an enoyl-acyl carrier protein reductase that is required for mycolic acid biosynthesis (A . Quemard et al., Biochemistry 34:8235-8241, 1995) and is a major target for isoniazid (INH) in mycobacterial species (A . Banerjee et al., Science 263:227-230, 1994) . Since overexpression of inhA confers INH resistance in Mycobacterium smegmatis (Banerjee et al., Science 263:227-230, 1994), we designed a promoter trap based on this gene . A library of clones, containing small fragments of M . tuberculosis DNA cloned upstream of inhA in a plasmid vector, was electroporated into M . tuberculosis, and the resulting culture was used to infect the human monocytic THP-1 cell line . Selection was made for clones surviving INH treatment during infection but retaining INH sensitivity on plates . The DNA upstream of inhA was sequenced in each clone to identify the promoter driving inhA expression . Thirteen genes identified by this method were analyzed by quantitative reverse transcription-PCR (R . Manganelli et al., Mol . Microbiol . 31:715-724, 1999), and eight of them were found to be differentially expressed from cultures grown in macrophages compared with broth-grown cultures . Several of these genes are presumed to be involved in fatty acid metabolism; one potentially codes for a unique DNA binding protein, one codes for a possible potassium channel protein, and the others code for proteins of unknown function . Genes which are induced during infection are likely to be significant for survival and growth of the pathogen; our results lend support to the view that fatty acid metabolism is essential for the virulence of M . tuberculosis.

Haemophilia, 2002 May, 8(3), 211 - 6
Quality management and quality assurance in haemophilia care: a model at the Bonn haemophilia centre; Brackmann HH et al.; The severe clotting defects associated with the diagnosis of severe haemophilia A and B require a quality management and quality assurance system designed to avoid both bleeding sequelae (such as damaged joints) through early on-demand or prophylactic treatment in a home-care setting, and side-effects such as infectious diseases (hepatitis A-G and human immunodeficiency virus), allergic reactions, haemolysis and if possible inhibitor formation, by using highly purified, virus-inactivated or recombinant products in which the factor VIII and IX proteins are as natural as possible . As the intravenous injection of the required clotting factor is entrusted to the patients in home treatment, the haemophilia centre has to check treatment protocols and, when necessary, joint and muscle status . In addition, it is imperative to ensure the safety of the product, and checks must be carried out to make sure that batch numbers are recalled as soon as possible if side-effects are observed . These are the reasons for several Acts of Parliament in Germany requiring special treatments and regular checks (the Disabled Act, recommendations by the German Medical Council, the Transfusion Act) . Thus, at the haemophilia centre in Bonn we have established a special quality management and quality assurance system taking into account the great number of patients (> 800), the often considerable distance between the centre and the patient, and the aforementioned regulations and laws . Quality management involves dealing with daily practicalities such as 24-h availability of a physician, medical technologist and nurse, careful instruction of patient and family in home care, genetic counselling, regular laboratory tests (especially recovery time, half-life, inhibitors and gene defects, clinical chemistry and serology) and clinical investigations (especially joint and muscle status) . It also includes co-operation with family doctors and different departments at our university hospital (e.g . orthopaedic, microbiology), daily conferences with staff, information for nursery schools, schools, training institutions and/or the workplace in case of emergency, and cooperation with German haemophilia foundations . For quality assurance, several self-controlling systems are in place, such as distribution of concentrate, laboratory data, treatment protocols, joint and muscle status and bleeding tendencies . All these and more are double-checked and interactive, controlling data and activities with the help of EDP . Exceptional staff motivation and patient compliance are important for this quality system.

Metab Eng, 2002 Apr, 4(2), 124 - 37
Analysis of carbon metabolism in Escherichia coli strains with an inactive phosphotransferase system by (13)C labeling and NMR spectroscopy; Flores S et al.; We have developed Escherichia coli strains that internalize glucose utilizing the GalP permease instead of the phosphoenolpyruvate:carbohydrate phosphotransferase system . It has been demonstrated that a strain with these modifications (PTS(-)Glc(+)) can direct more carbon flux into the aromatic pathway than the wild-type parental strain (N . Flores et al., 1996, Nat . Biotechnol . 14, 620-623; G . Gosset et al., 1996, J . Ind . Microbiol . 17, 47-52; J . L . Baez et al., 2001, Biotechnol . Bioeng . 73, 530-535) . In this study, we have determined and compared the carbon fluxes of a wild-type strain (JM101), a PTS(-)Glc(-) strain, and two isogenic PTS(-)Glc(+) derivatives named PB12 and PB13 by combining genetic, biochemical, and NMR approaches . It was determined that in these strains a functional glk gene in the chromosome is required for rapid glucose consumption; furthermore, glucokinase-specific activities were higher than in the wild-type strain . (13)C labeling and NMR analysis allowed the determination of differences in vivo which include higher glycolytic fluxes of 93.1 and 89.2% compared with the 76.6% obtained for the wild-type E . coli . In PB12 and PB13 we found a flux through the malic enzymes of 4 and 10%, respectively, compared to zero in the wild-type strain . While flux through the Pck enzyme was absent in PB12 and PB13, in the wild type it was 7.7% . Finally, it was found that in the JM101 and PB12 strains both the oxidative and the nonoxidative branches of the pentose phosphate pathway contributed to ribose 5-phosphate synthesis, whereas in PB13 this pentose was synthesized almost exclusively through the oxidative branch . The determined carbon fluxes correlate with biochemical and genetic characterizations.

FEMS Microbiol Lett, 2002 Mar 19, 209(1), 15 - 21
Effects of porphyrins and inorganic iron on the growth of Prevotella intermedia; Leung KP et al.; We demonstrated earlier that hemin-iron-containing compounds which include hemin, human hemoglobin, bovine hemoglobin, and bovine catalase stimulate the growth of Prevotella intermedia {Leung, Subramaniam, Okamoto, Fukushima, Lai, FEMS Microbiol . Lett . 162 (1998) 227-233} . However, the contributions of tetrapyrrole porphyrin ring in these hemin-iron sources as well as inorganic iron for the growth of this organism have not been determined . The purpose of this study was to examine the effects of porphyrins, host iron-binding proteins, and various inorganic iron sources on the growth of hemin-iron depleted P . intermedia . Protoporphyrin IX and protoporphyrin IX-zinc, either in the presence or absence of supplemented ferrous or ferric iron, promoted the growth of P . intermedia at a rate that was comparable to that of the hemin control . On the other hand, neither the host iron proteins, transferrin and lactoferrin, nor the inorganic iron sources which included ferrous chloride, ferric chloride, ferric citrate, ferric nitrate, and ferric ammonium citrate at concentrations up to 200 microM stimulated the growth of hemin-iron-restricted P . intermedia . The results suggest that P . intermedia only use iron in a specific form and that the porphyrin-ring structure is essential for the growth of P . intermedia as in the case of other related organisms.

Clin Chem Lab Med, 2002 Mar, 40(3), 312 - 9
The management of clinical laboratories in Europe: a FESCC survey . Forum of the European Societies of Clinical Chemistry and Laboratory Medicine; de Kieviet W et al.; The professional duties of the specialists in clinical chemistry differ from country to country in Europe . One of the main goals of the Strategic Plan of the Forum of the European Societies of Clinical Chemistry and Laboratory Medicine (FESCC; IFCC-Europe) is to promote a high scientific and professional standard in the field of clinical chemistry and laboratory medicine in Europe . This can be stimulated by the knowledge of the local conditions in each country and by striving towards a strong and harmonised position in all the European countries . In order to enhance the knowledge of the managerial situation of the specialists in clinical chemistry in Europe, FESCC launched a survey in September 2000 . This survey provides information about the position of the specialists in clinical chemistry in the various disciplines in the medical laboratories and in hospitals, and about the advisory tasks and the managerial education during the post-graduate training in clinical chemistry . Of the 35 FESCC member countries 33 have participated in the survey (94%) . The results show a rather heterogeneous situation in Europe caused by the local historical developments, the differences in academic background and the relative numbers of private and physicians' office laboratories . Large differences exist between the European countries in the disciplines of laboratory medicine that are headed by a specialist in clinical chemistry . In the different countries the clinical chemistry laboratories are headed by specialists in clinical chemistry in between 20% and 100% of the laboratories . The haematology, immunology, microbiology, therapeutic drug monitoring, molecular biology and haemostasis laboratories and departments of blood banking are headed by specialists in clinical chemistry in between 0% and 100% of the laboratories . The responsibilities for the various managerial tasks of the specialists in clinical chemistry show no uniformity in Europe . In the majority of the countries the general management, the purchase of equipment and reagents and the education of technicians are in >90% the responsibility of the specialists in clinical chemistry . In most countries the majority of the specialists in clinical chemistry are members of the medical staff of the hospitals and have a position equivalent to the position of specialists in other medical disciplines . In some countries, however, it only holds true for the specialists with a medical background . In 79% of the countries the law regulates the profession of the specialists in clinical chemistry and in 60% of the countries the law regulates their position in the medical staff of the hospital . The advisory tasks to physicians, general practitioners and other users of laboratory tests are practised by >90% of the laboratories in 64% of the countries . Information is given directly to the patients by >90% of the laboratories in 30% of the countries . Only in a few countries laboratories give information to the public . The post-graduate training in clinical chemistry includes a managerial training in 58% of the countries, the study of information technology in 61% of the countries and an economy and/or a business administration study in 15% of the countries . In 27% of the countries no managerial education forms part of the post-graduate study in clinical chemistry . Harmonisation of the managerial aspects of the profession is one of the challenges for the European specialists in clinical chemistry . A European syllabus for post-graduate training could be helpful.

Br J Biomed Sci, 2002, 59(1), 47 - 64
Proteomics and its impact upon biomedical science; Marshall T et al.; Proteomics is the protein equivalent of genomics and is the study of gene expression at a functional level . The proteome of an organism is the protein complement of its genome . However, unlike the genome, the proteome is dynamic: it varies according to the cell type and the functional state of the cell . In addition, the proteome shows characteristic perturbations in response to disease and external stimuli . Proteomics combines state of the art analytical methods with bioinformatics . Here, we review the concept and technology of proteomics with specific reference to applications in medical microbiology, cellular pathology, clinical chemistry, haematology/immunology, pharmacology and toxicology.

Chemosphere, 2002 Feb, 46(7), 1019 - 25
The effect of chloroquine, quinacrine, and metronidazole on both soybean plants and soil microbiota; Jjemba PK; Chloroquine, quinacrine, and metronidazole are used extensively for therapeutic purposes . Substantial quantities of these compounds end up in the environment . The potential effect of these compounds on soybean and on the protozoa in soil was assessed . The growth of soybean plants was affected by increasing concentrations of the chloroquine, metronidazole, and quinacrine dihydrochloride . The plants were particularly sensitive to low concentrations of metronidazole . The number of bacteria and protozoa in soil was either unchanged or increased in the presence of chloroquine and quinacrine . However, in the presence of only 0.5 mg metronidazole g(-1) soil, the density of protozoa in the rhizosphere was reduced by a 10-fold.

Acta Otorrinolaringol Esp, 2002 Feb, 53(2), 146 - 50
{Diphtheria and Renaissance Spanish physicians}; Amoros Sebastia LI et al.; Along the history of medicine, diphtheria has been the cause of many deadly epidemics . Up to the incorporation of microbiology in medicine and the definition of diphtheria provided by Bretonneau in 1826, this disease was studied with all types of sore throut into the galenic system . Spanish physicians in Renaissance started the way to its systematisation, taking it off the rest of sore throat types, with other laryngeal diseases, as it was known later as "croup", giving it the name of "garrotillo" . They were the first to describe some important questions about this disease, as the specificity of the diphtheric pseudomembranes, the ineffective potential of salivary drops and the palsy of the soft palate.

Am J Infect Control, 2002 May, 30(3), 179 - 83
Contaminated operating room boots: the potential for infection; Agarwal M et al.; BACKGROUND: Dirty operating room boots, often contaminated with blood and other infected material, are not only a source of discontent among surgeons and other surgical personnel, but they also pose a potential risk of transmission of viral or bacterial diseases to the wearer and cleaner of the boots . METHOD: Operating room boots were examined for the presence of blood by visual inspection; the presence or absence of blood was confirmed by a specific biochemical test . Bacterial isolation and quantification from boots were performed with conventional methodology . RESULTS: In this study, a spot check revealed that 44% of all operating room boots tested were contaminated with blood and that the majority were contaminated with bacteria . Sixty-three percent of surgeons using the facility had blood-contaminated boots, and a significant number of boots belonging to other surgical personnel were also contaminated with blood and bacteria normally associated with skin microbiota or the environment . Comfort shoes with perforations on their upper surface and plastic boots commonly found in operating rooms were most heavily contaminated, whereas Wellington boots and clogs had less contamination . CONCLUSION: The present practice of manual cleaning of boots is unsatisfactory, and it is recommended that boots be washed in automatic washing machines.

Microbiology, 2002 May, 148(Pt 5), 1355 - 65
Enteropathogenic Escherichia coli translocate Tir and form an intimin-Tir intimate attachment to red blood cell membranes; Shaw RK et al.; Type III secretion allows bacteria to inject effector proteins into host cells . In enteropathogenic Escherichia coli (EPEC) the type III secreted protein, Tir, is translocated to the host-cell plasma membrane where it functions as a receptor for the bacterial adhesin intimin, leading to intimate bacterial attachment and "attaching and effacing" (A/E) lesion formation . To study EPEC type III secretion the interaction of EPEC with monolayers of red blood cells (RBCs) has been exploited and in a recent study {Shaw, R . K., Daniell, S., Ebel, F., Frankel, G . & Knutton, S . (2001 ) . Cell Microbiol 3, 213-222} it was shown that EPEC induced haemolysis of RBCs and translocation of EspD, a putative pore-forming type III secreted protein in the RBC membrane . Here it is demonstrated that EPEC are able to translocate and correctly insert Tir into the RBC membrane and produce an intimin-Tir intimate bacterial attachment, identical to that seen in A/E lesions . Following translocation Tir did not undergo any change in apparent molecular mass or become tyrosine-phosphorylated and there was no focusing of RBC cytoskeletal actin beneath intimately adherent bacteria, and no pedestal formation . This study, employing an RBC model of infection, has demonstrated that Tir translocation can be separated from host-cell-mediated Tir modifications; the data show that the EPEC type III protein translocation apparatus is sufficient to deliver and correctly insert Tir into host-cell membranes independent of eukaryotic cell functions.

Klin Monatsbl Augenheilkd, 2002 Mar, 219(3), 164 - 7
{Nocardia farcinica: life-threatening chorioiditis under systemic immunosuppression}; Schriever S et al.; BACKGROUND: Immunosuppressed patients occasionally suffer from a multifocal infection with Nocardia . It is important to distinguish Nocardia farcinica from Nocardia asteroides, because of different sensitivity against antibiotics . PATIENT AND METHODS: A 40-year-old patient with polycystic renal disease successfully underwent a kidney transplantation without complications . Immunosuppression consisted of: corticosteroids, azathioprin and ciclosporin A . Ten weeks later he developed acute choroiditis with consecutive retinal detachment and neovascular glaucoma in one eye . In addition, 14 weeks after transplantation CT scans revealed multiple cerebral abscesses . RESULTS: In the course of the disease Nocardia farcinica (N . f.) was identified by cerebral stereotactic biopsy of a cerebral lesion, histological examination of the enucleated globe and sputum culture . Histologically filamentous, eosinophilic organisms were found . Microbiology identified aerobic actinomycetes in cultures and Nocardia farcinica by PCR . Therapeutically the combination of vancomycin, ampicillin, and sulbactam was successful . CONCLUSION: In immunosuppressed patients Nocardia farcinica can become life-threatening . One of the first manifestations may be a choroiditis . Infection of the respiratory tract followed by hematogenous spread is the common way of systemic nocardiosis . Biopsy followed by identification of species by PCR is recommended because of the specific therapeutic strategies associated with each species.

Clin Diagn Lab Immunol, 2002 May, 9(3), 658 - 68
Infection of tick cells and bovine erythrocytes with one genotype of the intracellular ehrlichia Anaplasma marginale excludes infection with other genotypes; de la Fuente J et al.; Anaplasma marginale, a tick-borne rickettsial pathogen of cattle, is endemic in several areas of the United States . Many geographic isolates of A . marginale that occur in the United States are characterized by the major surface protein 1a, which varies in sequence and molecular weight due to different numbers of tandem repeats of 28 or 29 amino acids . Recent studies (G . H . Palmer, F . R . Rurangirwa, and T . F . McElwain, J . Clin . Microbiol . 39:631-635, 2001) of an A . marginale-infected herd of cattle in an area of endemicity demonstrated that multiple msp1alpha genotypes were present but that only one genotype was found per individual bovine . These findings suggested that infection of cattle with other genotypes was excluded . The present study was undertaken to confirm the phenomenon of infection exclusion of A . marginale genotypes in infected bovine erythrocytes and cultured tick cells . Two tick-transmissible isolates of A . marginale, one from Virginia and one from Oklahoma, were used for these studies . In two separate trials, cattle inoculated with equal doses of the two isolates developed infection with only one genotype . Tick cell cultures inoculated with equal doses of the two isolates became infected with only the Virginia isolate of A . marginale . When cultures were inoculated with different ratios of the Oklahoma and Virginia isolates of A . marginale, the isolate inoculated in the higher ratio became established and excluded infection with the other . When cultures with established infections of one isolate were subsequently infected with the other, only the established isolate was detected . We documented infection exclusion during initial infection in cell culture by labeling each isolate with a different fluorescent dye . After 2 days in culture, only a single isolate was detected per cell by fluorescence microscopy . Finally, when Anaplasma ovis infections were established in cultures that were subsequently inoculated with the Virginia or Oklahoma isolate of A . marginale, A . marginale infection was excluded . These studies confirm that infection exclusion occurs with A . marginale in bovine erythrocytes and tick cells, resulting in the establishment of only one genotype, and appears to be the first report of infection exclusion for Anaplasma and Ehrlichia species.

Proc Natl Acad Sci U S A, 2002 May 14, 99(10), 7039 - 44 Epub 2002 Apr 30.
Base-specific fragmentation of amplified 16S rRNA genes analyzed by mass spectrometry: a tool for rapid bacterial identification; von Wintzingerode F et al.; A rapid approach to the 16S rRNA gene (16S rDNA)-based bacterial identification has been developed that combines uracil-DNA-glycosylase (UDG)-mediated base-specific fragmentation of PCR products with matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) . 16S rDNA signature sequences were PCR-amplified from both cultured and as-yet-uncultured bacteria in the presence of dUTP instead of dTTP . These PCR products then were immobilized onto a streptavidin-coated solid support to selectively generate either sense or antisense templates . Single-stranded amplicons were subsequently treated with uracil-DNA-glycosylase to generate T-specific abasic sites and fragmented by alkaline treatment . The resulting fragment patterns were analyzed by MALDI-TOF MS . Mass signals of 16S rDNA fragments were compared with patterns calculated from published 16S rDNA sequences . MS of base-specific fragments of amplified 16S rDNA allows reliable discrimination of sequences differing by only one nucleotide . This approach is fast and has the potential for high-throughput identification as required in clinical, pharmaceutical, or environmental microbiology . In contrast to identification by MS of intact whole bacterial cells, this technique allows for the characterization of both cultured and as-yet-uncultured bacteria.

J Gastroenterol Hepatol, 2002 Apr, 17(4), 467 - 75
Escherichia coli as a cause of diarrhea; Robins-Browne RM et al.; Escherichia coli is the best-known member of the normal microbiota of the human intestine and a versatile gastrointestinal pathogen . The varieties of E . coli that cause diarrhea are classified into named pathotypes, including enterotoxigenic, enteroinvasive, enteropathogenic and enterohemorrhagic E . coli . Individual strains of each pathotype possess a distinct set of virulence-associated characteristics that determine the clinical, pathological and epidemiological features of the diseases they cause . In the present brief review, we summarize the key distinguishing features of the major pathotypes of diarrheagenic E . coli . Knowledge of the pathogenic mechanisms of these bacteria has led to the development of rational interventions for the treatment and prevention of E . coli-induced diarrhea . In addition, investigations into E . coli virulence are providing useful insights into the origins and evolution of bacterial pathogens more generally .

J Endotoxin Res, 2002, 8(1), 27 - 38
Identification of genes involved in biosynthesis of Actinobacillus pleuropneumoniae serotype 1 O-antigen and biological properties of rough mutants; Labrie J et al.; Actinobacillus pleuropneumoniae is an important pathogen of swine . Lipopolysaccharide (LPS) has been identified as the major adhesin of A . pleuropneumoniae and it is involved in adherence to porcine respiratory tract cells . We previously generated seven rough LPS mutants of A . pleuropneumoniae serotype 1 by using a mini-Tn10 transposon mutagenesis system {Rioux S, Galarneau C, Harel J et al . Isolation and characterization of mini-Tn10 lipopolysaccharide mutants of Actinobacillus pleuropneumoniae serotype 1 . Can J Microbiol 1999; 45: 1017-1026} . The purpose of the present study was to characterize these mutants in order to learn more about LPS O-antigen biosynthesis genes and their organization in A . pleuropneumoniae, and to determine the surface properties and virulence in pigs of these isogenic mutants . By mini-Tn10 insertions in rough mutants, four putative genes (ORF12, ORF16, ORF17, and ORF18) involved in O-antigen biosynthesis in A . pleuropneumoniae serotype 1 were found within a region of 18 ORFs . This region is homologous to the gene cluster of serotype-specific O-polysaccharide biosynthesis from A . actinomycetemcomitans strain Y4 (serotype b) . Two mutants showed homology to a protein with identity to glycosyltransferases (ORF12); two others had the mini-Tn10 insertion localized in genes encoding for two distinct proteins with identity to rhamnosyltransferases (ORF16 and ORF17) and three showed homology to a protein which is known to initiate polysaccharide synthesis (ORF18) . These four ORFs were also present in A . pleuropneumoniae serotypes 9 and 11 that express an O-antigen that serologically cross-reacts with serotype 1 . Evaluation of some biological properties of rough mutants seems to indicate that the absence of O-chains does not appear to have an influence on the virulence of the bacteria in pigs and on the overall surface hydrophobicity, charge and hemoglobin-binding activity, or on LAL activation . An acapsular mutant was included in the present study in order to compare the influence of O-chains and capsule polysaccharides on different cell surface properties . Our data suggest that capsular polysaccharides and not O-chains polysaccharides have a major influence on surface properties of A . pleuropneumoniae serotype 1 and its virulence in pigs.

J Clin Microbiol, 2002 May, 40(5), 1670 - 4
Testing of susceptibility of Mycobacterium tuberculosis to pyrazinamide with the nonradiometric BACTEC MGIT 960 system; Pfyffer GE et al.; The reliability of the novel BACTEC MGIT 960 pyrazinamide (PZA) kit (Becton Dickinson Microbiology Systems, Sparks, Md.) was assessed for testing of susceptibility of Mycobacterium tuberculosis to PZA . Results generated by the BACTEC MGIT 960 system (Becton Dickinson) were compared with those obtained with the BACTEC 460TB system . Extensive proficiency testing (phase I) and reproducibility testing (phase II) as well as susceptibility testing of blinded strains of M . tuberculosis from the Centers for Disease Control and Prevention (phase III) were performed prior to testing 58 strains isolated from clinical specimens (phase IV) . After resolution of discrepant results obtained by the two BACTEC methods by two other laboratories which acted as independent arbiters (phase V), overall agreement of the BACTEC MGIT 960 system with the BACTEC 460TB system for PZA testing of phase IV strains was 96.6% . Between the two systems there was no statistically significant difference in time until results were obtained, i.e., 6.8 days (BACTEC MGIT 960) versus 5.4 days (BACTEC 460TB), the latter not counting the time required for a subculture with a growth index of 200, however . The new BACTEC MGIT PZA susceptibility testing procedure works equally well for inocula prepared from liquid (MGIT) and solid (Lowenstein-Jensen) cultures . PZA MGIT medium in plastic tubes yielded results equivalent to medium dispensed in glass tubes.

Rev Sci Tech, 2002 Aug, 21(2), 317 - 34
Tuberculosis in free-ranging wildlife: detection, diagnosis and management; de Lisle GW et al.; Mycobacterium bovis is emerging as an important pathogen of free-ranging wildlife in which it is a potential source of infection for domestic animals and a threat to valuable wildlife species . This review examines the procedures for the detection, diagnosis and management of M . bovis in wildlife populations . The ante-mortem detection of M . bovis infection in wildlife is difficult, due to the common occurrence of subclinical infections and the deficiencies of the currently available diagnostic tests . Serological tests are insensitive, while tests measuring cell-mediated immune responses show promise, but have not been sufficiently developed for routine use in most species . The diagnosis of M . bovis in free-ranging wildlife relies on post-mortem examination supported by histopathology and microbiology . A feature of M . bovis infections is the variation in the appearance and distribution of lesions in the different host species . Bacterial culture remains the gold standard for diagnosis of tuberculosis, while histopathology is limited by the frequent inability to distinguish lesions caused by M . bovis from those produced by other mycobacterial species . Deoxyribonucleic acid (DNA) fingerprinting and advanced typing techniques are increasingly being used to unravel the epidemiology of mycobacterial infections, including tuberculosis in free-ranging wildlife . An understanding of the epidemiology is essential if procedures are to be developed for the management of tuberculosis in wildlife . Few management options are currently available, especially for protected wildlife . Vaccination is the subject of much research, but further developments are required before it can be used to control tuberculosis in any animals, let alone in free-ranging wildlife.

Cornea, 2002 May, 21(4), 426 - 9
Infectious post-LASIK crystalline keratopathy caused by nontuberculous mycobacteria; Alvarenga L et al.; PURPOSE: To report three cases of infectious crystalline keratopathy caused by non-tuberculous mycobacteria after LASIK surgery . METHODS: Interventional case reports and literature review . RESULTS: Infectious keratitis with clinical features of crystalline keratopathy after LASIK is described . Culture revealed Mycobacterium chelonae from the corneal scrapings of the three patients, all of whom underwent medical and surgical (debridement) treatment . CONCLUSIONS: Mycobacteria may cause infectious crystalline keratopathy after LASIK . The presence of crystalline keratopathy in patients that underwent LASIK must be considered an indicator of nontuberculous mycobacteria infection . Microbiologic work-up of a corneal specimen is required for the institution of appropriate therapy.

J Appl Microbiol, 2002, 92(5), 844 - 50
The detection and recovery of Erysipelothrix spp . in meat and abattoir samples in Western Australia; Wang Q et al.; AIMS: To investigate the occurrence of Erysipelothrix rhusiopathiae and other Erysipelothrix spp . in abattoir and meat samples in Western Australia . METHODS AND RESULTS: Samples were collected from various parts of pig and sheep carcasses, as well as different sections of slaughtering line, pen soil and effluent . Previously evaluated culture methods were applied for the isolation of Erysipelothrix spp., in conjunction with phenotypic and genotypic detection and identification procedures . Of 109 samples from the two abattoirs, 35 (32.1%) were Erysipelothrix genus-specific PCR-positive . These came from swabs of animal exterior surfaces and joints, slaughtering areas, pig pen soil and abattoir effluent . Four samples (3.7%) from sheep arthritic joints and pig abattoir effluent were also E . rhusiopathiae species-specific PCR-positive . Of 123 carcass washing samples, 12 (9.8%) were genus-specific PCR-positive, and these came from all five kinds of meat samples tested, including beef, lamb, mutton, pork and chicken . Four of them (3.3%) were also species-specific PCR-positive . A total of 25 isolates was recovered from the samples, of which seven were identified as E . rhusiopathiae, seven were consistent with E . tonsillarum, and the remaining 11 were other species of Erysipelothrix . CONCLUSIONS: Erysipelothrix spp . can still be isolated and identified from specimens of animal origin with relative ease, provided that appropriate cultural and molecular procedures are used . Clinical microbiology laboratories may need to improve their diagnostic protocols . SIGNIFICANCE AND IMPACT OF THE STUDY: This study confirms that E . rhusiopathiae and other species of Erysipelothrix continue to colonize and contaminate farmed animals and animal products . Erysipelothrix infection still poses a potential threat to the economy of the farmed animal industry, as well as being a potential human public health hazard.

Can J Microbiol, 2002 Feb, 48(2), 183 - 7
Azotobacter chroococcum does not contain sodA or its gene product Mn-superoxide dismutase; Caldwell JM et al.; Azotobacter chroococcum and Azotobacter vinelandii grown in Burk medium with 1% mannitol (BM) or in BM supplemented with 2.2 mg/mL ammonium acetate (BM+N) were found to have only iron-containing and CuZn-containing superoxide dismutase . Furthermore, genomic DNA from A . chroococcum and A . vinelandii were subjected to polymerase chain reaction analysis using sodA- and sodB-specific primers and yielded only a sodB product . These results dispute the assertion by Buchanan and Lees (Can . J . Microbiol . 26: 441-447, 1980) that A . chroococcum contains Mn-superoxide dismutase.

Antimicrob Agents Chemother, 2002 May, 46(5), 1417 - 24
High prevalence of KatG Ser315Thr substitution among isoniazid-resistant Mycobacterium tuberculosis clinical isolates from northwestern Russia, 1996 to 2001; Mokrousov I et al.; A total of 204 isoniazid (INH)-resistant strains of Mycobacterium tuberculosis isolated from different patients in the northwestern region of Russia from 1996 to 2001 were screened by a PCR-restriction fragment length polymorphism (RFLP) assay . This assay uses HapII cleavage of an amplified fragment of the katG gene to detect the transversion 315AGC-->ACC (Ser-->Thr), which is associated with INH resistance . This analysis revealed a 93.6% prevalence of the katG S315T mutation in strains from patients with both newly and previously diagnosed cases of tuberculosis (TB) . This mutation was not found in any of 57 INH-susceptible isolates included in the study . The specificity of the assay was 100%; all isolates that contained the S315T mutation were classified as resistant by a culture-based susceptibility testing method . The Beijing genotype, defined by IS6110-RFLP analysis and the spacer oligonucleotide typing (spoligotyping) method, was found in 60.3% of the INH-resistant strains studied . The katG S315T shift was more prevalent among Beijing genotype strains than among non-Beijing genotype strains: 97.8 versus 84.6%, respectively, for all isolates, including those from patients with new and previously diagnosed cases, isolated from 1999 to 2001 and 100.0 versus 86.5%, respectively, for isolates from patients with new cases isolated from 1996 to 2001 . The design of this PCR-RFLP assay allows the rapid and unambiguous identification of the katG 315ACC mutant allele . The simplicity of the assay permits its implementation into routine practice in clinical microbiology laboratories in regions with a high incidence of TB where this mutation is predominant, including northwestern Russia.

Contemp Top Lab Anim Sci, 2002 Mar, 41(2), 31 - 5
The RAG 2 mouse model for xenografted human oral squamous cell carcinoma; Reuther T et al.; Animal tumor models are still essential for the development of new medication and therapy concepts . In the field of human oral squamous cell cancer, there are few reliable xenografted tumor models available . Therefore, during a two-course experiment, we established a new xenografted tumor model of human oral squamous cell cancer . The tumor growth rates of two different tumor cell lines were compared in the inbred immunodeficient CD-17-RAG 2 mouse, NMRI-SCID mouse (scid/scid), and Swiss nude mouse (nu/nu) . The tumor cell line from a lymphnode metastasis of an oral squamous cell carcinoma (XF 354) had a faster growth rate and a more characteristic histology than did the cell line from the primary tumor of a squamous cell carcinoma of the floor of the mouth (UM-SCC-14C) . The highest tumor growth rate was observed in the RAG 2 mouse, followed by the SCID mouse . The Swiss nude mouse showed no tumor growth . The combination of the XF 354 tumor cell line and the RAG 2 mouse was most successful, with a tumor growth rate of 95% . Our animal model is very reliable and allows manipulations for as long as 30 min under anesthesia outside of microbiologic safety cabinets, where the handling of animals is much more comfortable and less time-consuming . The tumor histology was easily interpreted by using light microscopy . Steps for cell cultivation and tumor implantation are described and discussed . Therefore we strongly recommend the use of the model comprising the RAG 2 mouse with the xenografted cell line XF 354 for research in the field of human oral squamous cell carcinoma.

Chest, 2002 Apr, 121(4), 1171 - 6
Diagnosis of invasive pulmonary aspergillosis using polymerase chain reaction-based detection of aspergillus in BAL; Raad I et al.; STUDY OBJECTIVE: To assess the value of Aspergillus polymerase chain reaction (PCR) test performed on the BAL in diagnosing invasive pulmonary aspergillosis (IPA) . DESIGN: Between January 1996 and 1997, we prospectively followed up 249 cancer patients with pulmonary infiltrates suggestive of pneumonia . Bronchoscopy with fungal stains, cultures, and PCR was performed on all patients . PCR was used for the detection of Aspergillus mitochondrial and alkaline protease gene DNA . The PCR products were visualized either directly on polyacrylamide gel or after Southern transfer and probing with specific probes for mitochondrial and alkaline protease DNA . RESULTS: The 249 patients consisted of 10 patients with proven IPA (tissue invasion), 22 patients with probable IPA (microbiologic culture), 18 patients with possible IPA (consistent clinical and radiologic findings), and 199 control patients with no evidence of IPA . PCR positivity was strongly associated with all forms of IPA (p < 0.002) . The sensitivity, specificity, positive predictive value, and negative predictive value of PCR were 80%, 93%, 38%, and 99%, respectively, for proven IPA, and 64%, 93%, 52%, and 96%, respectively, for probable IPA . Southern blotting analysis did not improve the diagnostic yield of the PCR test . CONCLUSION: PCR performed on BAL is associated with high specificity and negative predictive value for IPA . The low positive predictive value could be related to the transient colonizing presence of aspergilli in the respiratory tract . The sensitivity correlates with the certainty of the diagnosis based on tissue invasion.

BMC Microbiol . 2002 Mar 01;2(1):4.
Evaluation of amplified rDNA restriction analysis (ARDRA) for the identification of cultured mycobacteria in a diagnostic laboratory; De Baere T et al.; BACKGROUND: The development of DNA amplification for the direct detection of M . tuberculosis from clinical samples has been a major goal of clinical microbiology during the last ten years . However, the limited sensitivity of most DNA amplification techniques restricts their use to smear positive samples . On the other hand, the development of automated liquid culture has increased the speed and sensitivity of cultivation of mycobacteria . We have opted to combine automated culture with rapid genotypic identification (ARDRA: amplified rDNA restriction analysis) for the detection resp . identification of all mycobacterial species at once, instead of attempting direct PCR based detection from clinical samples of M . tuberculosis only . RESULTS: During 1998-2000 a total of approx . 3500 clinical samples was screened for the presence of M . tuberculosis . Of the 151 culture positive samples, 61 were M . tuberculosis culture positive . Of the 30 smear positive samples, 26 were M . tuberculosis positive . All but three of these 151 mycobacterial isolates could be identified with ARDRA within on average 36 hours . The three isolates that could not be identified belonged to rare species not yet included in our ARDRA fingerprint library or were isolates with an aberrant pattern . CONCLUSIONS: In our hands, automated culture in combination with ARDRA provides with accurate, practically applicable, wide range identification of mycobacterial species . The existing identification library covers most species, and can be easily updated when new species are studied or described . The drawback is that ARDRA is culture-dependent, since automated culture of M . tuberculosis takes on average 16.7 days (range 6 to 29 days) . However, culture is needed after all to assess the antibiotic susceptibility of the strains.

Rev Argent Microbiol, 2002 Jan-Mar, 34(1), 29 - 38
{Electrophoretic karyotypes and genomic DNA restriction fragment analysis: their usefulness as tools in the epidemiological study of Candid parapsilosis}; Perrotta D et al.; During the past decades, several studies have reported an increase in the incidence of nosocomial candidosis . In a prospective study, performed at the Departamento de Micologia, INEI, ANLIS Dr . C . G . Malbran and the Servicio de Neonatologia and Microbiologia, Hospital de Ninos Sor Maria Ludovica, from October 1995 to December 1996, 167 patients with candidosis were detected . Candida species isolated were C . albicans (53.1%), C . parapsilosis (26.5%) and C . tropicalis (14.8%) . The aim of this work was to characterize the clinical C . parapsilosis isolates from pediatric patients hospitalized in two neonatal intensive care units from the same hospital and to evaluate the usefulness of electrophoretic karyotype (EK) and restriction endonuclease analysis of genomic DNA (REAG) using a low frequency digestion enzyme . EK of all isolates disclosed 12 banding patterns and REAG with endonuclease Sfi I showed only 5 groups . However, isolates from the control group could not be separated from the clinical isolates . The isolates within each dendogram group for EK or REAG were apparently unrelated . Our results show that EK yields better results than REAG, but that it falls short of the desired discrimination, which suggests that these techniques do not seem to be useful for studying nosocomial C . parapsilosis outbreaks.

Pharmacotherapy, 2002 Apr, 22(4), 471 - 83
Clinical efficacy and pharmacoeconomics of a continuous-infusion piperacillin-tazobactam program in a large community teaching hospital; Grant EM et al.; STUDY OBJECTIVE: To compare continuous versus intermittent administration of piperacillin-tazobactam with regard to clinical, microbiologic, and economic outcomes . DESIGN: Prospective, open-label controlled study SETTING: Community teaching hospital . PATIENTS: Ninety-eight hospitalized patients prescribed piperacillin-tazobactam . INTERVENTION: Substitutions were implemented so that 47 patients initially prescribed intermittent infusion of piperacillin-tazobactam were switched to continuous infusion of this drug combination . Dosages varied in accordance with the type of infection and each patient's renal function . Fifty-one other patients with similar demographics and types of infection received intermittent infusion with piperacillin-tazobactam . MEASUREMENTS AND MAIN RESULTS: Clinical success rates were 94% for the continuous-infusion group and 82% for the intermittent-infusion group (p=0.081) . Microbiologic success rates were 89% for the continuous-infusion group and 73% for the intermittent-infusion group (p=0.092) . Days to normalization of fever were significantly lower (p=0.012) in the continuous-infusion group (1.2 +/- 0.8 days) than in the intermittent-infusion group (2.4 +/- 1.5 days) . Level 1 and level 2 costs/patient were both reduced by continuous infusion, although the difference was statistically significant only for level 2 costs ($399.38 +/- 407.22 for continuous infusion vs $523.49 +/- 526.85 for intermittent infusion, p=0.028) . CONCLUSION: Continuous infusion of piperacillin-tazobactam provided clinical and microbiologic outcomes equivalent to those for intermittent infusion . Compared with intermittent infusion, continuous infusion significantly shortened the time to temperature normalization, while also offering a significant reduction in level 2 expenditures.

Clin Chem Lab Med, 2002 Feb, 40(2), 196 - 204
The practice of clinical chemistry in the European Union; Sanders GT et al.; The European Communities Confederation of Clinical Chemistry has been actively engaged in raising the level of clinical chemistry in the European Union . Closer contacts between the national societies for clinical chemistry have resulted in more comparable programs for postgraduate training of clinical chemists, closer similarity of contents and practice of the profession in the different countries, and the official registration of professionals . This article reviews some of the characteristics of professional organisation, practice, and regulation in the fifteen European Union countries . Many similarities appear . In half of the countries microbiology, blood-banking and transfusion medicine fall within the domain of clinical chemistry . The minimum number of years for training (university and postgraduate) is eight, but in practice this will extend to 10 or more years . Official regulation of the profession by law exists in a minority of countries . Continuing education and re-registration have not been officially instituted yet in any country, but these issues will be the next steps forward . In those countries that prepare themselves for entering the European Union, training and practice of clinical chemistry are moving towards the common standards of the European Communities Confederation of Clinical Chemistry.

Saudi Med J, 2002 Jan, 23(1), 20 - 4
Biomedical research in the Kingdom of Saudi Arabia (1982-2000); Tadmouri GO et al.; OBJECTIVE: Because of the leading position of the Kingdom of Saudi Arabia in biomedical research among the Arab States, we aimed this study at providing a detailed analysis of the development of this domain in the Kingdom . METHODS: More than 1500 queries were mainly directed to the PubMed bibliographic database . Tags, boolean operators, and wild cards were utilized . RESULTS: Most of the Saudi biomedical citations originated from the capital city of Riyadh (70%), particularly from the King Saud University (29.5%) and King Faisal Specialist Hospital (21.5%) . One of every 5 Saudi papers either describes a disease, a blood related analysis, or surgical observations . Only 0.5% of Saudi papers appear in the 200 highest impact-factor journals . CONCLUSION: A steady advancement in biomedical research is observed in the Kingdom mainly in years 1987-1996 . The absence of uniformity in writing the addresses of authors in published articles from Saudi Arabia results in misleading data about the geographical distribution of biomedical research and sometimes improper rating of the scientific institutions in the Kingdom . The most dynamic biomedical fields in the Kingdom observed in the present analysis are Hematology, Surgery, Cancer, Pharmacology, and Microbiology . The main reasons behind the small number of Saudi papers appearing in high impact-factor journals are the bias and the economics of scientific publishing . We hope that the present study will lay the foundation for more detailed investigations on the directions of biomedical research in the Kingdom and will be of great importance to better found future strategies in this important realm.

Am J Respir Crit Care Med, 2002 Apr 1, 165(7), 904 - 10
Inflammation, infection, and pulmonary function in infants and young children with cystic fibrosis; Dakin CJ et al.; Our aim was to study the effect of lower airway infection on clinical parameters, pulmonary function tests, and inflammation in clinically stable infants and young children with cystic fibrosis (CF) . To accomplish this goal, a prospective cohort of screened CF patients under 4 years of age were studied, using elective anesthesia and intubation for: passive respiratory mechanics (single breath occlusion passive deflation) and lung volumes (nitrogen washout), under neuromuscular blockade; and bronchoalveolar lavage (BAL) of 3 main bronchi for cytology, cytokine interleukin (IL)-8, and quantitative microbiology . There were 22 children studied, with a mean age of 23.2 months (6.7-44 months) . A greater relative risk of lower airway pathogens was associated with prior respiratory admission (3.60, 95% confidence interval {CI} 2.87-4.51), history of asthma (1.75, 95% CI 1.52-2.03), and chronic symptoms (1.50, 95% CI 1.23-1.83), especially wheeze (1.88, 95% CI 1.61-2.19) . Lower respiratory pathogens (> or = 10 cfu/ml BAL) were found in 14 out of 22, and greater than 10(5) cfu/ml in 8 out of 22 subjects . The level of pathogens in BAL (log10 cfu/ml) explained 78% of the variability in percent neutrophils and 34% of the variability in IL-8 levels . Pathogen level also correlated with pulmonary function tests of specific respiratory system compliance (r -0.49, p = 0.02) and functional residual capacity over total lung capacity (r 0.49, p = 0.03) . We conclude that the presence of pathogens in the lower airways correlated with levels of inflammation, respiratory system compliance, and degree of air trapping.

Pharm Res, 2002 Mar, 19(3), 217 - 26
Chemistry, manufacturing, and controls information in NDAs and ANDAs, supplements, annual reports, and other regulatory filings; Sheinin E et al.; Advice to the pharmaceutical industry regarding the chemistry, manufacturing, and controls and microbiology (sterility assurance) information to be included in regulatory submissions to the Center for Drug Evaluation and Research (CDER) can be found in the pertinent statutes, regulations, and guidances . The primary statute is the Federal Food, Drug and Cosmetic Act (the Act); applicable regulations appear in 21 CFR 312 and 314 . Neither the Act nor the regulations provide sufficient detail on the information that should be included in these submissions . Over the past 14 years CDER has issued a series of guidelines and guidances that provide specific detail related to the recommended filing mechanisms and information that CDER expects applicants to provide . Some of these guidances are applicable to original submissions and some are applicable to post-approval changes . This article will provide an overview of The Act, the pertinent regulations, and the pre- and post-approval guidances.

Int J Food Microbiol, 2002 Mar, 73(2-3), 119 - 25
Some examples of, and some problems with, the use of nonlinear logistic regression in predictive food microbiology; Ratkowsky DA; A new technique, nonlinear logistic regression, is described for modelling binomially distributed data, i.e., presence/absence data where growth is either observed or not observed, for applications in predictive food microbiology . Some examples of the successful use of this technique are presented, where the controlling factors are temperature, water activity, pH and the concentration of lactic acid, a weakly dissociating organic acid . Generally speaking, good-fitting models were obtained, as evidenced using various performance measures and goodness-of-fit statistics . As may be expected with a new statistical technique, some problems were encountered with the implementation of the modelling approach and these are discussed.

Int J Tuberc Lung Dis, 2002 Feb, 6(2), 137 - 42
Chest radiograph abnormalities associated with tuberculosis: reproducibility and yield of active cases; Graham S et al.; SETTING: Tertiary care referral centre specialising in respiratory diseases . OBJECTIVES: Chest radiography is a major screening and diagnostic tool for tuberculosis (TB) . We evaluated the reproducibility of a radiographic classification system for screening for active TB of immigration applicants to Canada . We also evaluated the validity of this classification system for detection of prevalent active TB among the screened applicants, as well as tuberculin-positive close contacts and symptomatic patients . METHODS: Reproducibility was assessed by re-reading a randomly selected 10% sample of screening chest films . Validity was estimated from the final clinical and microbiologic diagnosis of patients undergoing detailed clinical evaluation . RESULTS: Inter-reader agreement using five broad categories was moderate (kappas of 0.44-0.56), while intra-reader agreement was substantial (kappas of 0.59-0.72) . After adjustment for age and patient group, the adjusted odds of active tuberculosis, relative to normal or minor findings or granulomas, for fibronodular changes was 10.2 (95% confidence interval {CI} 3.2-33), for mass or pleural effusion it was 11.6 (95%CI 3.6-37), and for parenchymal infiltrate it was 46.1 (95%CI 18-117) . Among tuberculin-positive close contacts, the probability of active tuberculosis was more than 50% if the radiographs showed any mass, pleural disease, or parenchymal infiltrates . CONCLUSION: A simple classification of TB-related chest radiographic abnormalities into five broad categories had moderate to substantial reproducibility of readings, with reasonable validity.

Diagn Microbiol Infect Dis, 2002 Mar, 42(3), 159 - 67
Chronic hepatosplenic abscesses in Brucellosis . Clinico-therapeutic features and molecular diagnostic approach; Colmenero Jde D et al.; In order to analyze the clinical and therapeutic features of chronic hepatosplenic abscesses, and to define the diagnostic yield of new molecular techniques, we describe seven cases, four hepatic and three splenic, of this uncommon complication of Brucellosis . Onset of symptoms in all cases was insidious and the diagnostic delay considerable . Abdominal CT scan showed large, poorly defined lesions, with heterogeneous attenuation and thick central calcifications surrounded by hypointense areas . Histologically, all cases presented granulomas with central necrosis, a polymorphic infiltrate, few giant cells and peripheral fibrosis . The diagnostic yield with conventional microbiologic techniques was poor, whereas a Brucella PCR-assay of a tissue or pus sample was positive in all six cases in which it was performed . Conservative therapy with antibiotics, either alone or combined with percutaneous drainage, failed in all cases, so that in this type of lesion, the treatment of choice should be medical-surgical, in order to guarantee excision of the central calcium nucleus responsible for the persistence of the infection.

Rinsho Byori, 2002 Feb, 50(2), 126 - 30
External quality assessment scheme and laboratory accreditation in Indonesia; Timan IS et al.; The National Program on External Quality Assessment Scheme (NEQAS) in Indonesia was first started in 1979, organized by the Indonesian Ministry of Health collaborating with professional bodies . The first trial was for clinical chemistry test with 2 cycles per year, followed by the hematology NEQAS in 1986 in collaboration with WHO-Royal Post Graduate Medical School London . After that, the schemes for serology, microbiology and parasitology were also organized . Around 500-600 laboratories throughout Indonesia participated each year in these quality control schemes, 2-4 cycles per year . Samples would be sent to participants and results will be given back to each laboratory . Poor performers should participate in the workshop or training course conducted by the Central Health Laboratory to improve their results . Participation in this NEQAS is mandatory for obtaining the laboratory license, and the Ministry of Health uses these schemes as one of the means for monitoring and coordinating the performance of laboratories throughout Indonesia . There are also some other EQAS (External Quality Assessment Scheme) programs conducted by professional bodies, such as for hemostasis, clinical chemistry and serology . During the course of conducting these schemes, it could be observed that manual methods were gradually changed to the automatic methods, especially for the clinical chemistry and hematology laboratories, which counts also for improvements of their results . Since the last 6 years, the Ministry of Health also began to conduct the Accreditation System evaluation for hospitals, including the laboratory departments . There are 7 standards that were evaluated, such as the aspect of the organization, administration and management, staffing, facilities and equipment, standard operating procedures, research and developments and quality control . This accreditation program is still in progress for all public and private hospital laboratories.

Rinsho Byori, 2002 Feb, 50(2), 121 - 5
The external quality assessment schemes in Thailand; Opartkiattikul N et al.; In Thailand, the external quality assessment schemes have been organized by 2 main institutions:--The Department of Medical Science, Ministry of Public Health and The Faculty of Medical Technology, Mahidol University . Both schemes were initiated simultaneously by WHO experts in 1973 . The Department of Medical Science, Ministry of Public Health established a Unit of Laboratory Quality Standards to be responsible for external quality control for clinical laboratory services . In 1996 the unit was upgraded to become The Bureau of Laboratory Quality Standards and is responsible for The National Proficiency Testing Scheme (NPTS) . This includes hematology, clinical chemistry, clinical immunology, clinical microscopy, clinical microbiology and blood banking . Every laboratory is invited to be a member, free of charge . Now there are almost 800 out of 1300 laboratories all over Thailand participating in this NPTS . The proficiency testing samples are sent to the participants 3-4 times/year . The results of laboratory tests performed by participants are evaluated by using target values for every scheme, except clinical chemistry, which use participants' consensus . The control materials used in the clinical chemistry, hematology and immunology schemes are imported from aboard . The remaining control materials are prepared in house . The Faculty of Medical Technology, Mahidol University has organized 4 programs in The External Quality Assurance Scheme (EQAS):--clinical chemistry, clinical hormone, clinical microscopy and clinical immunology and serology . The first scheme was established in 1986 and the remaining schemes were established in 1999 . All the control materials used are prepared in house . The members of this EQAS have to pay a membership fee . The control samples are sent to the participants 4-12 times/year . The results of laboratory tests are evaluated by using participants' consensus . There are 150-460 laboratories enrolled in this EQAS . At this time, Thailand is very conscious of quality in every field, including hospitals, and internal and external quality controls are one of the recommendations of the quality standard . So both The NPTS and The EQAS mentioned above are very important for each laboratory at the moment . The author sent questionnaires to 200 laboratories asking whether they were enrolled in an external quality assessment scheme . Fifty-seven laboratories responded and over 70% of them had joined either The NPTS or The EQAS and some of them had joined both . In addition, there are 2 new programs of external quality control:--the external quality control in red cell serology and the external quality assessment of hematology laboratory which have been established recently . However, there are still some types of laboratory that have no external quality assessment programs e.g . coagulation, serology for autoimmune disease and hemoglobin typing . External quality assessment programs for these laboratories are urgently needed.

Ned Tijdschr Tandheelkd, 1997 Jan, 104(1), 21 - 3
{Dental research in the Netherlands . Citations in publications}; Beertsen W et al.; This study examines the citation frequency (via the Science Citation Index) of publications by Dutch dental scientists that have appeared in the international literature since World War II . It was found that most citations were obtained by a relatively small group of researchers, many of them working in the fields of cariology and periodontology . High scores were particularly found among scientists who had their academic training in disciplines other than dentistry . Out of 109 frequently cited papers over 25% was microbiology-oriented and most of them could be characterized as original basic dental research.

Anal Chem, 2002 Mar 15, 74(6), 1442 - 8
Biosensor for dengue virus detection: sensitive, rapid, and serotype specific; Baeumner AJ et al.; A serotype-specific RNA biosensor was developed for the rapid detection of Dengue virus (serotypes 1-4) in blood samples . After RNA amplification, the biosensor allows the rapid detection of Dengue virus RNA in only 15 min . In addition, the biosensor is portable, inexpensive, and very easy to use, making it an ideal detection system for point-of-care and field applications . The biosensor is coupled to the isothermal nucleic acid sequence-based amplification (NASBA) technique with which small amounts of virus RNA are amplified using a simple water bath . During the NASBA reaction, a generic sequence is attached to all RNA molecules as described earlier (Wu, S . J.; Lee, E . M.; Putvatana, R.; Shurtliff, R . N.; Porter, K R.; Suharyono, W.; Watt, D . M.; King, C . C.; Murphy, G . S.; Hayes, C . G.; Romano, J . W . J . Clin . Microbiol . 2001, 39, 2794-2798.) . It has been shown earlier that Dengue virus can be detected specifically using two DNA probes: a first probe hybridized with the attached generic sequence and, therefore, bound to every amplified RNA molecule; and a second probe either bound to all four Dengue virus serotypes or chosen to be specific for only one serotype . These probes were utilized in the biosensor described in this publication . For a generic Dengue virus biosensor, the second probe is complementary to a conserved region found in all Dengue serotypes . For identification of the individual Dengue virus serotypes, four serotype-specific probes were developed (Wu, S . J.; Lee, E . M.; Putvatana, R.; Shurtiff, R . N.; Porter, K . R.; Suharyono, W.; Watt, D . M.; King, C . C.; Murphy, G . S.; Hayes, C . G.; Romano, J . W . J . Clin . Microbiol . 2001, 39, 2794-2798.) . The biosensor is a membrane-based DNA/RNA hybridization system using liposome amplification . The generic DNA probe (reporter probe) is coupled to the outside of dye-encapsulating liposomes . The conserved or Dengue serotype specific probes (capture probes) are immobilized on a polyethersulfone membrane strip . Liposomes are mixed with amplified target sequence and are then applied to the membrane . The mixture is allowed to migrate along the test strip, and the liposome-target sequence complexes are immobilized in the capture zone via hybridization of the capture probe with target sequence . The amount of liposomes present in the immobilized complex is directly proportional to the amount of target sequence present in the sample and can be quantified using a portable reflectometer . The different biosensor components have been optimized with respect to sensitivity and, foremost, specificity toward the different serotypes . An excellent correlation to a laboratory-based detection system was demonstrated . Finally, the assay was tested using a limited number of clinical human serum samples . Although Dengue serotypes 1, 2 and 4 were identified correctly, serotype 3 displayed low cross-reactivity with biosensors designed for detection of serotypes 1 and 4.

J Clin Microbiol, 2002 Apr, 40(4), 1311 - 8
Detection and multigenic characterization of a herpesvirus associated with malignant catarrhal fever in white-tailed deer (Odocoileus virginianus) from Missouri; Kleiboeker SB et al.; Between 1998 and 2001, tissues from four captive white-tailed deer were observed to have histologic lesions of systemic lymphocytic vasculitis . These lesions suggested malignant catarrhal fever, although epizootic hemorrhagic disease and bluetongue were included in the differential diagnosis . Initial diagnostic efforts, including virus isolation and reverse transcription-PCR for epizootic hemorrhagic disease virus and bluetongue virus, failed to identify an etiologic agent . However, consensus primer PCR targeted to the herpesvirus DNA polymerase gene detected viral genomic DNA in each of these four cases . Nucleotide sequence analysis of the amplified product demonstrated that the detected virus was identical over the compared region to the recently described malignant catarrhal fever virus of white-tailed deer (H . Li, N . Dyer, J . Keller, and T . B . Crawford, J . Clin . Microbiol . 38:1313-1318, 2000) . Additional nucleotide sequencing of both the DNA polymerase gene and DNA packaging gene followed by phylogenetic analysis solidified this newly recognized herpesvirus as a member of the Gammaherpesvirinae and suggests that this virus, along with ovine herpesvirus 2, alcelaphine herpesvirus 1, alcelaphine herpesvirus 2 and caprine herpesvirus 2, may be part of a separate clade within this subfamily.

Cornea, 2002 Apr, 21(3), 265 - 9
In vivo confocal microscopy after herpes keratitis; Rosenberg ME et al.; PURPOSE: To describe the confocal microscopic findings, with special reference to corneal subbasal nerves, after herpes simplex virus (HSV) keratitis . METHODS: In this study, 16 HSV eyes and 14 contralateral eyes of 16 patients, diagnosed with unilateral HSV keratitis 1-12 months earlier by the presence of dendritic corneal ulceration or microbiologic confirmation, were examined by in vivo confocal microscopy for evaluation of corneal morphology . RESULTS: Herpes simplex virus eyes: In 2 eyes the surface epithelial cells appeared large, and no abnormalities were observed in the basal epithelial cells . In 2 eyes subbasal nerve fiber bundles were completely absent, in 3 eyes there was a reduced number of long nerve fiber bundles, and in 11 eyes the subbasal nerve plexus appeared normal . In 10 corneas, highly reflective dendritic structures were found at the level of the basal epithelial cells . Frequently these structures were found in the vicinity of stromal fibrosis . Areas with increased abnormal extracellular matrix were found in 11 eyes . Stromal nerves were not visualized in all corneas, but appeared normal when observed . Contralateral eyes: No abnormalities were observed in the epithelium . All corneas presented with a normal subbasal nerve plexus, but in 2 eyes dendritic particles were observed . Three corneas presented with activated keratocytes and increased amounts of abnormal extracellular matrix . CONCLUSIONS: When visualized by confocal microscopy, the subbasal nerve plexus appears relatively unaffected in cases with resolved HSV keratitis . Unidentified dendritic structures, presumably Langerhans cells, are frequently seen at the level of the basal epithelium in corneas with a history of herpetic disease.

Pathologica, 2002 Feb, 94(1), 28 - 31
PCR detection of specific Leishmania-DNA in patients with periodontal disease; Premoli-de-Percoco G et al.; This study deals with the detection of Leishmania braziliensis DNA in gingival specimens from 10 individuals who all had suffered from cutaneous leishmaniasis 5-10 years prior to the examination and all had been treated with anti-leishmaniasis drugs . This preliminary study gives an interesting contribution to the oral microbiology of this disease, with the observation that inflamed periodontal tissues can serve as a factor affecting the dispersion of Leishmania parasites in individuals who had suffered from cutaneous leishmaniasis . These finding are corroborated by the results of polymerase chain reaction (PCR) which demonstrated the presence of Leishmania DNA in tissue samples of patients with periodontal diseases.

Pathologica, 2002 Feb, 94(1), 22 - 7
Biological aspects of a Brazilian strain of Entamoeba dispar; Furst C et al.; A strain of Entamoeba dispar was characterized by clinical diagnosis, serological and electrophoretical isoenzyme analysis and by the polymorphism of a 482 bp genomic fragment analysis . The pathogenesis and virulence of this strain was investigated considering the experimental infection in hamster livers in association with the original intestinal microbiota . Liver lesions were observed in hamsters experimentally infected with trophozoites from xenic cultures, but not from the monoxenic cultures . Moreover, clones obtained from re-isolated strain Wil1R1 showed a distinct biological behavior . In fact, animals inoculated with Wil1R1ClB3 showed an intense acute inflammatory reaction with destructive focal hepatic lesions . These lesions were characterized as amebic abscesses . The association between bacteria and ameba has been fairly well studied because it affects the pathogenicity of the amebas and has important therapeutic implications . In this study, we demonstrated that E . dispar in association with the original microbiota is able to produce lesions in hamster liver in spite of its having been considered to be non-pathogenic in the hamster model . Based on these results we suggest that diagnosis of amebiasis needs to be made with more care and that clinical and therapeutical procedures need to be revised.

Forensic Sci Int, 2002 Feb 18, 125(2-3), 262 - 8
Evaluation of diagnostic tools applied in the examination of sudden unexpected deaths in infancy and early childhood; Arnestad M et al.; During the period between 1984 and 1999, 309 cases of sudden unexpected death in infancy and early childhood (0-3 years) were investigated at the Institute of Forensic Medicine in Oslo . In 73 cases, an explainable cause of death was found . In this non-sudden infant death syndrome (SIDS) group, 42 cases were due to disease, 14 to accidents, 7 to neglect/abuse and 10 cases were due to homicide . In 43 cases, there were pathological findings at the autopsy or suspect features in the history and/or circumstances, which were, however, insufficient to explain death ("borderline" SIDS) . In the remaining 193 cases, nothing of significance was detected ("pure" SIDS).The purpose of the present study was to evaluate the importance of the different diagnostic tools used in diagnosing non-SIDS and borderline SIDS cases . The definition of SIDS requires a negative history as well as a negative autopsy result . Thus, the following variables were analysed: circumstances, medical history and autopsy, which included a gross pathological investigation, histology, neuropathology, microbiology, radiology and toxicology . In diagnosing deaths due to disease, histology, neuropathology and microbiology were the most important diagnostic tools . In contrast, information about the circumstances of death and the gross pathological findings at autopsy most often revealed the cause of death in accidents and cases of neglect/abuse and homicide.Following the drop in SIDS rate in Norway after 1989, the share of pure SIDS in proportion to the total population of sudden unexpected deaths in infancy and early childhood has decreased . The increasing proportion of non-SIDS and borderline SIDS cases presents a challenge to improve the quality of the investigation in cases of sudden death in infancy and early childhood.

J Eukaryot Microbiol, 2002 Jan-Feb, 49(1), 17 - 23
Laboratory and field-based studies of abundances, small-scale patchiness, and diversity of gymnamoebae in soils of varying porosity and organic content: evidence of microbiocoenoses; Anderson OR; Soil samples (varying in granularity) from four natural sites were cultured in microcosms to determine small-scale patchiness in abundance and diversity of gymnamoebae . Eighty grams of the same thoroughly mixed soil, either moistened with distilled water (- nutrients) or supplemented with an equivalent vol . of organically enriched water (+ nutrients), were placed in covered glass jars and incubated for 14 d (25 degrees C) . Abundances (number/gram soil) were assessed in each of 3 core samples (5-10 mm apart) . Assay precision was estimated to be +/- 4% . Abundances were similar in the 3 closely-spaced samples, but occasional samples had higher abundances, probably representing localized enriched sites ("nutrient hot spots") . Diversity within the triplicate, closely spaced samples varied substantially . Mean abundance and diversity of amoebae were consistently higher in organically enriched soil and in soil of increasing granularity . Field samples collected directly from two of the sites showed similar patterns of abundance and diversity as found in the experimental studies, indicating substantial small-scale compartmentalization of soil protist communities . These data provide evidence of soil eukaryotic microbiocoenoses and indicate that soil microfauna may encounter wide variations in resources and prey communities as they migrate within small distances of several millimeters or less.

Nat Rev Immunol, 2001 Dec, 1(3), 209 - 19
Strategies for designing and optimizing new generation vaccines; Berzofsky JA et al.; Although the field of immunology developed in part from the early vaccine studies of Edward Jenner, Louis Pasteur and others, vaccine development had largely become the province of virologists and other microbiologists, because the model for classic vaccines was to isolate the pathogen and prepare a killed or attenuated pathogen vaccine . Only recently has vaccinology returned to the realm of immunology, because a new understanding of immune mechanisms has allowed translation of basic discoveries into vaccine strategies.

Enferm Infecc Microbiol Clin, 2002 Mar, 20(3), 110 - 2
{Rapid diagnosis of herpetic meningoencephalitis by PCR}; Munoz-Almagro C et al.; OBJECTIVE: To evaluate the usefulness of a rapid and simple PCR method in the diagnosis of herpetic meningoencephalitis in a pediatric population . PATIENTS AND METHODS: One hundred twenty-three cerebrospinal fluid samples from 114 pediatric patients attending the Hospital Sant Joan de Deu in Barcelona for clinical suspicion of viral meningoencephalitis or to rule out a possible herpetic etiology were evaluated . In addition to classical methods, the diagnostic technique used was PCR amplification of a highly preserved region of the DNA polymerase gene common to herpes virus 1 and 2 . All patients were administered acyclovir on admission and until the results of PCR were known . If the result was negative, withdrawal of acyclovir was considered after clinical reexamination . If the result was positive, the therapy was continued for 20 days . RESULTS: Herpes simplex DNA was detected in four patients . In all patients, clinical outcome confirmed the results of PCR, whether positive or negative . PCR results were available within 6.30 and 72 hours (mean: 18 hours).CONCLUSION: This simple and rapid PCR technique can be applied in the daily routine of the microbiology laboratory . It allows early diagnosis of herpetic meningocephalitis or, when lacking, exclusion of Herpes simplex etiology.

Am J Respir Crit Care Med, 2002 Mar 15, 165(6), 766 - 72
Hospitalized community-acquired pneumonia in the elderly: age- and sex-related patterns of care and outcome in the United States; Kaplan V et al.; Community-acquired pneumonia (CAP) is a frequent cause of hospital admission and death among elderly patients, but there is little information on age- and sex-specific incidence, patterns of care (intensive care unit admission and mechanical ventilation), resource use (length of stay and hospital costs), and outcome (mortality) . We conducted an observational cohort study of all Medicare recipients, aged 65 years or older, hospitalized in nonfederal U.S . hospitals in 1997, who met ICD-9-CM-based criteria for CAP . We identified 623,718 hospital admissions for CAP (18.3 per 1,000 population > or = 65 years), of which 26,476 (4.3%) were from nursing homes and of which 66,045 (10.6%) died . The incidence rose five-fold and mortality doubled as age increased from 65-69 to older than 90 years . Men had a higher mortality, both unadjusted (odds ratio {OR}: 1.21 {95% CI: 1.19-1.23}) and adjusted for age, location before admission, underlying comorbidity, and microbiologic etiology (OR: 1.15 {95% CI: 1.13-1.17}) . Mean hospital length of stay and costs per hospital admission were 7.6 days and $6,949 . For those admitted to the intensive care unit (22.4%) and for those receiving mechanical ventilation (7.2%), mean length of stay and costs were 11.3 days and $14,294, and 15.7 days and $23,961, respectively . Overall hospital costs were $4.4 billion (6.3% of the expenditure in the elderly for acute hospital care), of which $2.1 billion was incurred by cases managed in intensive care units . We conclude that in the hospitalized elderly, CAP is a common and frequently fatal disease that often requires intensive care unit admission and mechanical ventilation and consumes considerable health care resources . The sex differences are of concern and require further investigation.

J Clin Pathol, 2002 Mar, 55(3), 200 - 5
Workload and stress in consultant medical microbiologists and virologists: a questionnaire survey; Cartwright K et al.; AIMS: To document demography, changing workload patterns, job satisfaction, morale, and prevalence of stress and psychological morbidity among UK consultant medical microbiologists and virologists . METHOD: A questionnaire survey of all identified UK practising consultant medical microbiologists and virologists (n= 464) . RESULTS: Among 367 respondents (79%), there were 33 virologists and at least 89 single handed consultants . Over half the respondents (58%) were working a 1 : 1 or 1 : 2 on call rota during the week and a similar proportion (51%) at weekends . Of all consultants (including those working part time), 56% were working more than 48 hours weekly . Working more than 48 hours weekly, and being on call 1 : 1 or 1 : 2 at weekends, were both independently associated with increased psychological morbidity . Those on call 1 : 1 or 1 : 2 at weekends were also more likely to have low or very low morale . Female consultants were more likely to have higher stress scores . More than half of the respondents (208 of 363; 57%) were making active financial provision to retire early, and 198 of 363 (55%) did not intend to work beyond the age of 60 . CONCLUSIONS: The long hours worked by many consultant microbiologists and virologists are in breach of the European Working Time Directive and are associated with a higher degree of psychological morbidity . For most consultants, the frequency of on call commitments is demanding and job satisfaction and morale have deteriorated . Urgent action is needed, particularly to support those working more than 48 hours each week and those on call at weekends 1 : 1 or 1 : 2 . However, a major expansion of the consultant establishment cannot be achieved rapidly, and will be slowed further if early retirements become more frequent.

Ann Pharmacother, 2002 Mar, 36(3), 423 - 6
Stability of furosemide in human albumin solution; Elwell RJ et al.; OBJECTIVE: To determine the chemical stability of furosemide in human albumin solution over a 28-day period and to assess admixtures for microbiologic contamination . METHODS: Samples were prepared by mixing furosemide injectable solution and 25% human albumin solution in a 1:1 molar ratio . Six bulk containers were prepared and stored in the dark: 3 under refrigeration (approximately 4 degrees C) and 3 at room temperature (approximately 25 degrees C) . Study samples were withdrawn from each bulk solution immediately after preparation and at predetermined intervals over the subsequent 28 days . Containers were observed for color change and precipitation against a light and dark background at each sampling interval . Total furosemide concentration was determined using HPLC . Additional vials were prepared and assessed for microbiologic growth at time points corresponding with chemical stability results . RESULTS: A mean of 94.5%+/-1.33% of the initial furosemide concentration remained after 48 hours at room temperature . Under refrigeration, 100.6%+/-1.02% of the initial concentration remained at 14 days . Beyond these respective time points, <90% of the initial furosemide concentration remained . No bacterial or fungal growth was observed . CONCLUSIONS: When combined with 25% human albumin solution and stored under darkness, furosemide is chemically stable and free of microbiologic contamination for 48 hours at room temperature and 14 days under refrigeration.

Diagn Cytopathol, 2002 Mar, 26(3), 186 - 90
Atypical glandular cells of undetermined significance (AGUS): clinical considerations and cytohistologic correlation; Nasuti JF et al.; The diagnoses of atypical glandular cells of undetermined significance (AGUS) made upon evaluation of cervical/vaginal (Pap) smears is examined to ascertain salient clinical and cytologic features that may lead to better characterization of the true nature of these lesions . Prior history of squamous dysplasia, age of the patient, and the occurrence of abnormal microbiopsy tissue fragments are investigated to determine their value in the proper evaluation of AGUS specimens . Of the 86,234 Pap smears submitted to our laboratory during a period of 2 yr, 187 (0.2%) were diagnosed as AGUS . Available follow-up in 128 (69%) cases revealed 54 (42%) significant tissue proven abnormalities, the majority (55%, 30 patients) of which were diagnosed as squamous intraepithelial lesions (SIL) . Squamous dysplasia is significantly more common in women younger than 40 (15/18, 83%) and in patients with prior history of SIL (29/30, 97%) . In addition, all nine patients diagnosed with endometrial lesions on subsequent histology were older than 40 . Age, however, was not a discriminating factor in women proven to have endocervical glandular lesions . Additionally, certain tissue fragment cytomorphologic features were significantly more often observed on follow-up in specific histologic diagnostic categories . The Pap smears of patients diagnosed with SIL were noted to contain tissue fragments composed of both dysplastic squamous and benign glandular cells in 29 of 30 (97%) . The presence of two distinct populations of glandular tissue fragments (typical and atypical) was found in the Pap smears of all nine women with endometrial abnormalities and in the smears of most women subsequently diagnosed with endocervical glandular lesions (87%, 13/15) . These observations suggest that a more specific and clinically useful Pap smear interpretation other than AGUS is often possible by consideration of the patient's age and prior history along with the correct identification of the type of atypical cells observed in abnormal tissue fragments .

Ostomy Wound Manage, 2001 Mar, 47(3), 24 - 30, 32-41; quiz 42-3
Osteomyelitis in the diabetic patient: diagnosis and treatment . Part 2: Medical, surgical, and alternative treatments; Snyder RJ et al.; In the diabetic population, wound and foot infections are often mixed, containing from three to six organisms . This creates a significant problem regarding antibiotic protocols . Many of these episodes result in contiguous bone infections with subsequent erosive changes, sequestra, and involucrum . A multidisciplinary approach to treatment is often required . Studies have shown that a protocol of 6 weeks of intravenous antibiotics may be appropriate to treat osteomyelitis; however, this is controversial and often not curative . Osteomyelitis is a surgical disease; a subtle balance between medical and surgical therapy is necessary if a potentially curative outcome is to be achieved . The duration of antibiotic therapy may be shortened considerably after surgical intervention . In cases of infection mitigated by severe peripheral vascular disease, end-stage renal disease, diabetes, or other medical problems where surgery is not an option, long-term antibiotics may be used as suppressive therapy along with adjunctive local treatments . The following is the second article of a two-part series . The first paper discussed the diagnosis and microbiology of contiguous osteomyelitis in the diabetic foot . This article outlines the various medical, antibiotic, and surgical options available to the clinician . Adjunctive and alternative therapies also are discussed.

Ostomy Wound Manage, 2001 Jan, 47(1), 18 - 22, 25-30; quiz 31-2
Osteomyelitis in the diabetic patient: diagnosis and treatment . Part 1: Overview, diagnosis, and microbiology; Snyder RJ et al.; Foot ulcerations are common among people with diabetes and often lead to mixed infections that require hospitalization and create significant challenges for clinicians . Many result in contiguous bone infections . Regimens used to treat osteomyelitis often are seen as controversial . A subtle balance between medical and surgical therapy is necessary if a potentially curative outcome is to be achieved . The following article is one of a two-part series . This, the first manuscript, discusses the diagnosis and microbiology of contiguous osteomyelitis in the diabetic foot.

Vet Microbiol, 2002 Apr 22, 86(1-2), 175 - 81
Herpesviruses: balance in power and powers imbalanced; Ackermann M et al.; The first veterinary herpesvirus symposium, organized under the patronage of the European Society for Veterinary Virology (ESVV) and the Swiss Societies for Microbiology (SGM-SSM), was held at the University of Zurich, Switzerland, on 22nd and 23rd of March 2001 . The congress was divided into six sessions . The first session was dedicated to introductory lectures towards the main topics of the symposium, namely pathogenesis, immune response, and gene therapy . Session 2 was committed to new insights into herpesvirus-related gene therapy and vaccination . Specific and general aspects of the immune response against herpesviruses were presented in session 3, while session 4 was dedicated to virus replication . Session 5 was dedicated to a variety of poster presentations . Finally, session 6 revealed new insight into the pathogenesis of different herpesviruses . The present article summarizes the contributions and draws a new view of the herpesviruses . The herpesviruses have apparently found a multi-dimensionally balanced position between the powers of "cytopathogenicity" and "tumorigenicity" on one hand and "immunogenicity" and "tolerogenicity" on the other hand . As long as the different powers stay in balance, no or little clinical disease may be expected in association with herpesvirus infections . However, unbalanced actions of those powers may lead to disease.

Ann Periodontol, 2001 Dec, 6(1), 78 - 86
Oral bacteria and respiratory infection: effects on respiratory pathogen adhesion and epithelial cell proinflammatory cytokine production; Scannapieco FA et al.; Several microbiologic and epidemiologic studies have suggested an association between dental plaque, poor oral health, and respiratory diseases such as nosocomial pneumonia and chronic obstructive pulmonary disease (COPD) . A number of hypotheses are suggested to help explain how oral bacteria may participate in the pathogenesis of respiratory infection . Resident bacteria in oral secretions are likely aspirated along with respiratory pathogens and may affect the adhesion of the later organisms to the respiratory epithelium . Preliminary studies performed in our laboratory suggest that oral bacteria may modulate the adhesion of respiratory pathogens to epithelial cell lines . In addition, oral bacterial products or cytokines in oral/pharyngeal aspirates may stimulate cytokine production from respiratory epithelial cells, resulting in recruitment of inflammatory cells . The resulting inflamed epithelium may be more susceptible to respiratory infection . Further preliminary data are presented that some species of oral bacteria may induce the release of proinflammatory cytokines from epithelial cell lines to an extent similar to that seen for respiratory pathogens.

J Card Surg, 2001 Sep-Oct, 16(5), 363 - 73
Infection in xenotransplantation; Fishman JA; Advances in transplantation immunology have enhanced the possibility of xenotransplantation as a therapeutic option for end-stage organ failure . The potential spread of animal-derived pathogens to the recipient and to the general population, termed "xenosis," is a potential complication of interspecies transplantation . Recognition of such novel infections may be complicated by infections due to altered microbiologic behavior and clinical symptomatology of these organisms, particularly in the immunocompromised xenograft recipient . Particular concern exists over the activation of latent viruses, including retroviruses, from xenograft tissues . Based on experience with human allogeneic transplantation, those pathogens considered most likely to cause human disease can be excluded prospectively from herds of animals developed for organ donation . Research is needed into the activation and behavior of retroviruses and other potential pathogens in xenotransplantation . Xenotransplantation may also provide unique opportunities not only for the care of patients with organ failure, but in the therapy of individuals with chronic infections to which the xenograft may be resistant . Clinical protocols must be developed so as to enhance the safety of the recipient and of the community-at-large.

SADJ, 2001 Nov, 56(11), 544 - 5
{Advancements at the Faculty of Dentistry, now the School for Oral Health Science--an overview}; van Wyk CW; The aim of this communication is to give an overview of the contributions made by the faculty of Dentistry, now School of Oral Health Science, at scientific meetings of the SA Division of the IADR since 1970, the year that research started in the faculty . With the increase of staff from 1970 research started in the faculty . With the increase of staff from 1970 research papers increased in leaps and bounds . In 1970 one paper was presented in 1978 there were 15 and in 1980, 27 . The abstracts of 423 presentations have been published in the Journal of Dental Research - 17% of all the abstracts of all the papers read at IADR meetings . The majority of papers from this faculty concerned pathological conditions of the mouth (77 or 18.2%), followed by community-oriented research (8.3%), fluoride (8%), and microbiology and orthodontics (7.8% respectively) . Also prominent were papers on rontgenology, oral biology, pharmacology, periodontics, prosthetics, forensic dentistry, oral surgery and research on lead uptake . Epidemiology featured in 19.9% of the research papers . Of note are the number of doctorates awarded: 20 PhDs, 4 senior doctorates (DSc), 1 DEd, DSc from the University of Pretoria and an Honorary Doctorate also from Pretoria.

Nucleic Acids Res, 2002 Mar 15, 30(6), 1292 - 305
Real-time PCR in virology; Mackay IM et al.; The use of the polymerase chain reaction (PCR) in molecular diagnostics has increased to the point where it is now accepted as the gold standard for detecting nucleic acids from a number of origins and it has become an essential tool in the research laboratory . Real-time PCR has engendered wider acceptance of the PCR due to its improved rapidity, sensitivity, reproducibility and the reduced risk of carry-over contamination . There are currently five main chemistries used for the detection of PCR product during real-time PCR . These are the DNA binding fluorophores, the 5' endonuclease, adjacent linear and hairpin oligoprobes and the self-fluorescing amplicons, which are described in detail . We also discuss factors that have restricted the development of multiplex real-time PCR as well as the role of real-time PCR in quantitating nucleic acids . Both amplification hardware and the fluorogenic detection chemistries have evolved rapidly as the understanding of real-time PCR has developed and this review aims to update the scientist on the current state of the art . We describe the background, advantages and limitations of real-time PCR and we review the literature as it applies to virus detection in the routine and research laboratory in order to focus on one of the many areas in which the application of real-time PCR has provided significant methodological benefits and improved patient outcomes . However, the technology discussed has been applied to other areas of microbiology as well as studies of gene expression and genetic disease.

Clin Infect Dis, 2002 Apr 1, 34(7), 902 - 8 Epub 2002 Feb 26.
Clinical determinants for the recovery of fungal and mezlocillin-resistant pathogens from bile specimens; Ehrenstein BP et al.; We conducted a retrospective analysis of all bile specimens obtained for routine cultures from January 1995 through December 1999 at our tertiary care hospital . Results of microbiologic testing were linked to clinical parameters gathered by means of chart review . A total of 722 isolates were cultured from 345 of 454 bile specimens obtained from 288 individual patients . Prior receipt of a >7-day course of antibiotics (odds ratio {OR}, 5.7), extensive leukocytosis (leukocyte count, >20,000 cells/microL) on admission (OR, 7.8), endoscopic or percutaneous biliary manipulation during the previous 14 days (OR, 2.9), and treatment in an internal medicine ward (OR, 2.5) were independent factors significantly associated (Pless-than-or-eq, slant.05) with recovery of Candida species from bile specimens . Culture of mezlocillin-resistant bacteria from bile specimens was independently associated with the specimen having been obtained >1 week after admission (OR, 3.8), lack of history of endoscopic biliary drainage (OR, 3.2), and high serum aspartate aminotransferase levels (>72 U/L) on admission (OR, 2.6) . Prospective studies are warranted to evaluate accordingly adjusted empiric therapies for biliary infections.

J Clin Microbiol, 2002 Mar, 40(3), 1073 - 9
Genetic characterization of H1N2 influenza A viruses isolated from pigs throughout the United States; Karasin AI et al.; An H1N2 influenza A virus was isolated from a pig in the United States for the first time in 1999 (A . I . Karasin, G . A . Anderson, and C . W . Olsen, J . Clin . Microbiol . 38:2453-2456, 2000) . H1N2 viruses have been isolated subsequently from pigs in many states . Phylogenetic analyses of eight such viruses isolated from pigs in Indiana, Illinois, Minnesota, Ohio, Iowa, and North Carolina during 2000 to 2001 showed that these viruses are all of the same reassortant genotype as that of the initial H1N2 isolate from 1999.

Parazitologiia, 2001 Sep-Oct, 35(5), 406 - 28
{Some peculiarities of the relationships between parasitic copepods and their invertebrate hosts}; Marchenkov AV; According to the rule of academican E . N . Pavlovskiy, any organism of host is an environment of inhabit for a parasite (Pavlovskiy, 1934) . It was analysed, which "ecological niche" or microbiotop (= microhabitat) is occupied by this or that species of symbiotic (parasitic) copepods in organisms of different groups invertebrate-hosts . The assumption lying in a basis of the given analysis means that each group of hosts may give to cohabitants only certain variants of microbiotopes independently on the general morphological structure and life mode of hosts . Five types of microbiotops offered by various groups of hosts for symbiotic copepods are designated (Ta{symbol: see text} 2) . 1 . The body surface of benthic invertebrates as a microbiotope is characterized by conditions being little different (concerning any kind of physical and chemical influences on copepods) from those in external environment on any other substrate . Apparently a trophical dependence plays a determining role in this case . There are certain directions in a development of adaptations, which are characteristic in some extent for all water ectoparasitic crustaceans and have one functional task--to help to an ectoparasite to keep itself on a surface of host body . In the first, the maxillules and maxillipeds significantly are developed, they get a form of large claws, with which the dopepods are strongly attached on a surface of host body and have an opportunity to move on it without a danger to be washed off . In the second, the form of the body undergoes a dorso-ventral expression and expansion of prosome, forms a cephalic shield allowing to the symbiont to press itself tightly to the host body surface and to avoid the loss of host (tab . 2) . In occasions, some ectoparasites stimulate the formation of galls in skin tissues of the host, that also provides the parasite with constant conditions, without any threat to lose the host . However, this phenomenon has not a wide distribution and is observed in some groups of crustacean and echinoderm hosts . 2 . The narrow tubular cavities in the organism of host either they are a part of external environment (as in channel system of spongia) or a part of internal environment of organism (as channels of blood system or thin parts of a digestive system) have always rigidly limited sizes and form . Characteristics of all parasites occupying this microbiotopes are the strong transformations . They are expressed by the reduction of legs or any other appendages (frequently in a significant degree), loss of segmentation to some extent and in eruciform (or vermiform) form of a body (tab . 2) . This microbiotope is occupied by an ectoparasite in one case only (Spongicola uncifer from channel system of spongia) and by endoparasites in all other cases . 3 . Large cavities connected with external environment . The formations of various genesis, such as mantle cavity of molluscs, gill cavity and marsupium of crustaceans, bursal cavity of ophiuroids and branchial cavity of ascidians, concern this type of microbiotopes . All of them are characterized by the relative difference from the external environment and rather large volume (in comparison to sizes of copepods), that provides the parasites with a sufficient protection from factors of the external environment and constant source of food such as elements of host body or food's particles brought by the water flow . Morphological changes in inhabitants of the microbiotope have two directions . They practically are absent in the overwhelming majority copepods, living in the mantle of cavity of the lamellibranches . On the other hand, the inhabitants of gill cavity and marsupium of crustaceans, bursal cavities of ophiuroids and branchial cavity of ascidians are characterized by the presence of strong transformations . Usually there are expressed in a loss of segmentation to some extent, reduction of appendages and swelling of body, as in species of the genus Sphaeronella (tab . 2) . Changes are also observed in the life cycle: the tendency to reduce stages of development (development of nauplii stage, which takes place under the ovarial cover) . In this case the copepodid stages hatch from the ova . 4 . The internal cavity of organism of host . This type of microbiotopes in different groups of the hosts is represented in a various degree . We recognise it in a coelome of polychaetes, lacunar system of molluscs, mixocoel of crustaceans, coelome of echinoderms and cavity of body in ascidians . Two basic evolutionary directions are observed in copepods occupying this microbiotope . In the first case, the parasite is not exposed to transformations and keeps the initial plan of structure as in ancestral free-living forms . In the second case the parasites are exposed to strong transformations, they either live directly in cavity's liquid, or are surrounded by a cyst (as in Cucumaricolidae) . 5 . Microbiotope of the last type is most specific . The simultaneous existence in two environments--external environment (environment of the second order) and internal environment (environment of the first order) leads to the complete loss of ancestral type in a structure and level of organisation . At the same time both morphological and functional division of the parasite body into two parts produces a new formation--the ectosome and endosome . In this case we deals with the phenomenon of mesoparasitism.

Clin Microbiol Infect, 1996, 2(2), 127 - 131
Direct detection of Mycobacterium tuberculosis in respiratory samples from patients in Scandinavia by polymerase chain reaction; Tonjum T et al.; OBJECTIVE: To investigate the use of DNA amplification by the polymerase chain reaction (PCR) for the detection of Mycobacterium tuberculosis directly in human respiratory specimens . METHODS: The PCR assay employed was the Amplicor M . tuberculosis Test (Roche Diagnostics, Switzerland), which uses the 16S rDNA as the target template . Nine hundred and sixty samples from 741 patients in two clinical microbiology laboratories in Norway and Sweden were processed by routine culture analysis and PCR . RESULTS: Of the 56 specimens containing cultivatable M . tuberculosis, 49 (87.5%) were detected by PCR . Among the 904 culture-negative specimens, 897 samples were negative also by PCR and seven (0.8%) were positive by PCR . In comparison with culture, the sensitivity, specificity, and positive and negative predictive values of PCR were 91.7%, 99.6%, 94.2% and 99.4% for laboratory 1 and 80.0%, 98.7%, 76.2% and 99.0% for laboratory 2, respectively . For both laboratories combined the values were 87.5%, 99.2%, 87.5% and 99.2% . CONCLUSIONS: These results indicate that multiple (two or three) respiratory samples from each patients should be tested, to allow sufficient accuracy in detecting M . tuberculosis in the specimens . Still, the labor-intensive format of this test necessitates strong clinical indications and patient prioritization to provide a service feasible within the current limits of routine laboratories.

Clin Microbiol Infect, 1996 Aug, 2(1), 12 - 19
Switch therapy: the theory and practice of early change from parenteral to non-parenteral antibiotic administration; Hamilton-Miller JM; OBJECTIVE: The idea behind switch therapy is that antibiotic treatment should be changed from the parenteral to another suitable route (usually oral) as soon as the patient's condition allows . This option is cost-effective in terms of both acquisition costs (oral antibiotics are less expensive than their parenteral counterparts) and indirect costs, and patients may be discharged home sooner . This not only releases hospital beds but is also popular with patients and has other advantages . There are relatively few formal clinical trials, most often using oral third-generation cephalosporins and fluoroquinolones; these agents at present seem the most appropriate to use after parenteral antibiotics have been stopped (usually after 2 to 3 days) . Logistic aspects are important, and close collaboration is required between pharmacists, physicians and microbiologists . Further trials are needed in specific patient groups and with other antibiotic regimens to validate the efficacy of switch therapy.

Clin Microbiol Infect, 1995 Feb, 1(2), 134 - 138
Evaluation of the ATB 32 C system for identification of clinical yeast isolates; Bruun B et al.; OBJECTIVE: To compare the ATB 32 C system for routine identification of clinical yeast isolates in a clinical microbiology laboratory with identification carried out by conventional methods in a mycology reference laboratory . METHODS: A total of 113 strains initially isolated at our hospital and identified in the reference laboratory were returned in duplicate, under separate code numbers, to the microbiology laboratory where the ATB 32 C system was used for identification by: 1) visual assessment of turbidity at 72 h with use of identification table; 2) visual assessment at 72 h with use of ATB 32 C analytical profile index; and 3) automatic readings with the ATB reader at 48 h and 72 h with results of growth assessments transmitted to a computer and interpreted by the ATB 32 C software . RESULTS: Visual assessment plus identification table and visual assessment plus profile index provided correct identification in 98% and 91% of strains, respectively . Visual assessment was, however, sometimes difficult and required more experience than is usually available in a routine clinical microbiology laboratory . Automatic readings with computer identification plus supplementary tests correctly identified 87% and 86% after 48 h and 72 h, respectively . CONCLUSIONS: The ATB 32 C system with automatic readings and computer identification is a satisfactory system for identification of clinical yeast isolates in a routine clinical microbiology laboratory.

J Clin Pathol, 2002 Feb, 55(2), 93 - 7
Comparison of fine needle aspiration cytology and needle core biopsy in the diagnosis of radiologically detected abdominal lesions; Stewart CJ et al.; AIMS: To compare the sensitivity and specificity of percutaneous fine needle aspiration (FNA) cytology and needle core biopsy (NCB) in the diagnosis of suspected intra-abdominal tumours . METHODS: One hundred and forty one consecutive patients who underwent radiologically guided combined FNA/NCB of abdominal lesions over a four year period were reviewed . The diagnostic accuracy of both techniques and the value of rapid staining and assessment of cytological preparations were assessed . RESULTS: FNA cytology and NCB identified 111 of 129 (86%) and 104 of 129 (80.6%) malignant lesions, respectively; in combination, the sensitivity increased to 90.7% . The diagnostic specificity was 100% for both methods, although one case of phaeochromocytoma was misinterpreted as undifferentiated carcinoma on biopsy . More accurate tumour subtying was possible in two cases with FNA and four cases on NCB . The series included 12 benign lesions, of which 11 and nine were accurately identified on FNA and NCB, respectively . Two specific benign diagnoses (Budd-Chiari syndrome and hepatic infarct) were made only on biopsy . The use of rapid assessment cytology preparations ensured that appropriate samples were submitted for microbiology in three liver abscesses, and provided an accurate cytological diagnosis at the time of the procedure in 103 of 141 (73%) cases . None of the patients suffered biopsy related complications . CONCLUSIONS: FNA cytology is more sensitive and accurate than NCB in the diagnosis of abdominal lesions, and also offers more rapid diagnosis . However, the combination of these sampling techniques increases diagnostic sensitivity and occasionally provides more accurate classification of tumours and benign lesions . The techniques should be considered complementary in the investigation of abdominal lesions.

An Med Interna, 2001 Nov, 18(11), 594 - 6
{Mycotic pseudoaneurysm caused by Mycobacterium tuberculosis}; Martinez-Vazquez C et al.; Mycobacterium tuberculosis can involve any organ of the body, including the arteries . Usually the mycobacteria infects the arterial wall spreading from a contiguous foci . We report a case of tuberculous pseudoaneurysm involving the iliac artery clinically manifested as fever of unknown origin . The diagnosis relied on abdominal CT-scanning . Tuberculous etiology was confirmed postoperatively by microbiologic and microscopic study . The antituberculous therapy was early started, but the patient died three months later as a consequence of a non-infectious abdominal aortic rupture . Clinicians should consider tuberculous etiology when the diagnosis of mycotic pseudoaneurysm is being entertained.

Pediatr Res, 2002 Mar, 51(3), 296 - 303
Neutrophil CD64 expression: a sensitive diagnostic marker for late-onset nosocomial infection in very low birthweight infants; Ng PC et al.; This study aims to evaluate the diagnostic utilities of four leukocyte surface antigens-two lymphocyte antigens (CD25 and CD45RO) and two neutrophil antigens (CD11b and CD64)-for identification of late-onset nosocomial bacterial infection in preterm, very low birthweight infants, and to define the optimal cutoff value for each marker so that it may act as a reference with which future studies can be compared . Very low birthweight infants in whom infection was suspected when they were >72 h of age were eligible for the study . A full sepsis screen was performed in each episode . IL-6, C-reactive protein, and leukocyte surface antigens (CD25, CD45RO, CD11b, and CD64) were measured at 0 (at the time of sepsis evaluation), 24, and 48 h by standard biochemical methods and quantitative flow cytometric analysis . The diagnostic utilities including sensitivity, specificity, and positive and negative predictive values of each marker and combination of markers for predicting late-onset neonatal infection were determined . One hundred twenty-seven episodes of suspected clinical sepsis were investigated in 80 infants . Thirty-seven episodes were proven infection . The calculated optimal cutoff values for CD25, CD45RO, CD11b, and CD64 were 3,100, 2,900, 10,450, and 4,000 phycoerythrin-molecules bound per cell, respectively . An interim analysis of data after 68 episodes suggested that CD25 and CD45RO were poor predictors of neonatal infection with sensitivity or specificity <75% during a single measurement . Thus, these two markers were excluded from further investigation . In the final analysis, CD64 has the highest sensitivity (95-97%) and negative predictive value (97-99%) at 0 and 24 h after the onset . The addition of IL-6 or C-reactive protein (0 h) to CD64 (24 h) further enhanced the sensitivity and negative predictive value to 100%, and has the specificity and positive predictive value exceeding 88% and 80%, respectively . Neutrophil CD64 expression is a very sensitive marker for diagnosing late-onset nosocomial infection in very low birthweight infants . If further validated, the use of CD64 as an infection marker should allow early discontinuation of antibiotic treatment at 24 h without waiting for the definitive microbiologic culture results . The quantitative flow cytometric analysis applied in this study could be developed into a routine clinical test with high comparability and reproducibility across different laboratories.

Arch Pathol Lab Med, 2002 Mar, 126(3), 255 - 62
The postgenomic era: implications for the clinical laboratory; Kiechle FL et al.; OBJECTIVES: To review the advances in clinically useful molecular biological techniques and to identify their applications in clinical practice, as presented at the Tenth Annual William Beaumont Hospital DNA Symposium . DATA SOURCES: The 11 manuscripts submitted were reviewed and their major findings were compared with literature on the same topic . STUDY SELECTION: Manuscripts address creative thinking techniques applied to DNA discovery, extraction of DNA from clotted blood, the relationship of mitochondrial dysfunction in neurodegenerative disorders, and molecular methods to identify human lymphocyte antigen class I and class II loci . Two other manuscripts review current issues in molecular microbiology, including detection of hepatitis C virus and biological warfare . The last 5 manuscripts describe current issues in molecular cardiovascular disease, including assessing thrombotic risk, genomic analysis, gene therapy, and a device for aiding in cardiac angiogenesis . DATA SYNTHESIS: Novel problem-solving techniques have been used in the past and will be required in the future in DNA discovery . The extraction of DNA from clotted blood demonstrates a potential cost-effective strategy . Cybrids created from mitochondrial DNA-depleted cells and mitochondrial DNA from a platelet donor have been useful in defining the role mitochondria play in neurodegeneration . Mitochondrial depletion has been reported as a genetically inherited disorder or after human immunodeficiency virus therapy . Hepatitis C viral detection by qualitative, quantitative, or genotyping techniques is useful clinically . Preparedness for potential biological warfare is a responsibility of all clinical laboratorians . Thrombotic risk in cardiovascular disorders may be assessed by coagulation screening assays and further defined by mutation analysis for specific genes for prothrombin and factor V Leiden . Gene therapy for reducing arteriosclerotic risk has been hindered primarily by complications introduced by the vectors used to introduce the therapeutic genes . Neovascularization in cardiac muscle with occluded vessels represents a promising method for recovery of viable tissue following ischemia . CONCLUSIONS: The sequence of the human genome was reported by 2 groups in February 2001 . The postgenomic era will emphasize the use of microarrays and database software for genomic and proteomic screening in the search for useful clinical assays . The number of molecular pathologic techniques and assays will expand as additional disease-associated mutations are defined . Gene therapy and tissue engineering will represent successful therapeutic adjuncts.

Clin Microbiol Infect, 1999 May, 5(5), 253 - 255
Lack of significant cross-reactivity between Leishmania serology and mycobacteriosis in patients infected with HIV-1; Perez-Molina JA et al.; OBJECTIVE: To determine the existence of cross-reactions between Leishmania serology and mycobacteriosis in patients infected with HIV-1 . PATIENTS AND METHODS: HIV-positive individuals, with culture-proven episodes of tuberculosis or disseminated Mycobacterium avium complex (MAC) infection, were identified from the data files of our microbiology laboratory . Patients were included if leishmania serology had been performed within a period of 2 months before and 1 month after the diagnosis of mycobacterial disease . RESULTS: We identified 106 cases of tuberculosis and 38 of disseminated MAC infection with concomitant leishmania serology in HIV-infected individuals . Among them, only two cases (1.8%), both with tuberculosis and without visceral leishmaniasis, showed positive leishmania serology . The two cases are discussed . CONCLUSIONS: We conclude that, in spite of its low sensitivity, serology is a useful diagnostic tool in co-infected patients, mainly because of its high specificity and the low rate of cross-reactivity with two of the most frequent causes of fever of unknown origin in HIV-positive patients from our area.

Zhonghua Yan Ke Za Zhi, 2000 Mar, 36(2), 138 - 40
{Spectrum of mycotic keratitis in China}; Wang L et al.; OBJECTIVE: To investigate the spectrum of mycotic keratitis in China . METHODS: We scraped and evaluated 615 mycotic keratitis in microbiology laboratories of Zhengzhou (central China), Shijiazhuang (north China) and Guangzhou (south China) in the twenty-two years between Jan . 1, 1975 and Jun . 30, 1997 . RESULTS: Organisms of 18 genuses and 615 species isolated from corneal ulcers were found . Fusarium species were isolated the most frequently (65.0% in Zhengzhou, 33.3% in Shijiazhuang and 39.2% in Guangzhou), followed by Aspergillus (20.5% in Zhengzhou, 21.7% in Shijiazhuang, 30.7% in Guangzhou), Penicillium (3.6% in Zhengzhou, 11.6% in Shijiazhuang) and Curvularis (13.1% in Guangzhou) . Between Jan . 1, 1975 and Dec . 31, 1986, Aspergillus species were most commonly isolated in Guangzhou (48.5%), followed by Fusarium (27.7%) and Penicillium (14.27%) . CONCLUSIONS: Just as different regions of the world are characterized by specific endemic infections, the predominating organisms in corneal fungal infections also vary throughout the world . These regional differences in causative organisms in mycotic keratitis are clinically important because they influence the initial and more definite therapy . This study shows that Fusarium species are the most common organisms of mycotic keratitis in China.

Eur J Biochem, 2002 Feb, 269(3), 1006 - 11
In vivo activation of plasma membrane H(+)-ATPase hydrolytic activity by complex lipid-bound unsaturated fatty acids in Ustilago maydis; Hernandez A et al.; As an adaptation process to the growth retardation provoked by the presence of nonlethal concentrations of ergosterol biosynthesis inhibitors, Ustilago maydis alters the ratio of linoleic to oleic acid bound to plasma membrane complex lipids {Hernandez, A., Cooke, D.T., Lewis, M . & Clarkson, D.T . (1997) Microbiology 143, 3165-3174} . This alteration increases plasma membrane H(+)-ATPase hydrolytic activity . Activation of H(+)-ATPase by the linoleic/oleic acid proportion is noncompetitive, nonessential and only involves changes in the maximum velocity of the pump . Optimum pH, affinity to MgATP and constants for the inhibition by vanadate and erythrosin B remain unchanged . This all indicates that activation of plasma membrane H(+)-ATPase by unsaturated fatty acids differs clearly from glucose-induced activation observed in yeast . Also, it is a physiologically relevant event similar to other, as yet uncharacterized, changes in plasma membrane H(+)-ATPase hydrolytic activity observed in plants and fungi, as part of an adaptation process to different stress conditions.

Respirology, 2001 Dec, 6(4), 323 - 30
Prognostic factors in severe community-acquired pneumonia in patients without co-morbid illness; Feldman C et al.; OBJECTIVES: We wished to determine the prognostic factors and the impact of initial empirical antibiotic therapy on the outcome of severe community-acquired pneumonia in patients without underlying co-morbid illness . METHODOLOGY: This is a retrospective record review of consecutive patients with severe community-acquired pneumonia who were divided into those with and without underlying co-morbid illness . RESULTS: There were 182 patients including 112 primary (no co-morbid illness) and 70 secondary (underlying co-morbid illness) pneumonias . The overall mortality was 41.8% and there were no differences in APACHE II score or mortality when comparing cases with primary (37.5%) and secondary infections (48.6%) . The mortality was significantly higher in patients with negative microbiology . Univariate analysis identified a number of parameters and various antibiotic regimens, which appeared to be associated with a significantly poorer outcome . On multivariate analysis multilobar pulmonary consolidation, need for mechanical ventilation, inotropes and dialysis were documented to be independent predictors of mortality . Only in their absence could different antibiotic regimens be shown to have an apparent impact on outcome and further analysis suggested that the reason for these differences related predominantly to differences in the severity of the infection . CONCLUSIONS: Markers of disease severity appear to be the most important predictors of outcome in patients with severe community-acquired pneumonia.

J Wildl Dis, 2002 Jan, 38(1), 224 - 7
Bronchoscopy of cetaceans; Tsang KW et al.; Bronchoscopy is a standard diagnostic and therapeutic procedure in respiratory medicine and has been performed on many animal species . Cetaceans suffer considerable morbidity and mortality from lower respiratory tract infections, and it is very difficult to sample lower respiratory tract secretions for microbiology and other analyses . We report our experience on performing fiberoptic bronchoscopy in three bottle-nosed dolphins (Tursiops truncatus) and one false killer whale (Pseudorca crassidens), which should help other clinicians in performing bronchoscopy in cetaceans.

Chest, 2002 Feb, 121(2), 495 - 9
Role of biochemical tests in the diagnosis of large pericardial effusions; Burgess LJ et al.; STUDY OBJECTIVES: To determine the biochemical characteristics of large pericardial effusions in various disease states, and to assess their utility as diagnostic tools . SETTING: An academic university hospital in the Western Cape, South Africa . DESIGN: Consecutive, prospective case series . PATIENTS: One hundred ten hospital patients > 12 years old, who presented to the echocardiography department with large pericardial effusions, and 12 control subjects who underwent open-heart surgery (coronary artery bypass graft or aortic valve replacement) . MEASUREMENTS: Fluid was sent for examination of biochemistry, adenosine deaminase, microbiology, hematology, and cytology . The etiology of each pericardial fluid sample was established using predetermined criteria . RESULTS: The biochemistry of pericardial exudates differed significantly from pericardial transudates . Light' s criteria (whereby an exudate is defined as having one or more of the following: pleural fluid/serum protein ratio > 0.5; pleural fluid/serum lactate dehydrogenase {LDH} ratio > 0.6; and/or pleural fluid LDH level > 200 U/L) were applied to pericardial fluids and demonstrated to be the most reliable diagnostic tool for identifying pericardial exudates . The corresponding sensitivity was 98% . CONCLUSION: Although laboratory tests are a useful guideline when assessing the etiology and pathophysiology of pericardial effusions, the majority of large, clinically significant pericardial effusions result from exudative causes.

J Postgrad Med, 2001 Oct-Dec, 47(4), 240 - 3
In-vitro antimalarial activity of azithromycin against chloroquine sensitive and chloroquine resistant Plasmodium falciparum; Biswas S; BAKGROUND: The spread of drug resistance in Plasmodium falciparum has made the situation essential to look into new effective therapeutic agents like antibiotics . Azithromycin is a potential, chemotherapeutic agent which possesses antimalarial activity and favourable pharmacokinetic properties . It is an azalide microbiocide derived semi-synthetically from macrolide erythromycin . Like other antibiotics, the azalide azithromycin has ability to inhibit protein synthesis on 70S ribosomes . SETTINGS: Experimental study . SUBJECTS AND METHODS: The parasiticidal profile was studied in five chloroquine sensitive and five chloroquine resistant P . falciparum isolates obtained from various places of India . The antimalarial activity was evaluated in P . falciparum schizont maturation by short term culture for 24 hours and by exposing the parasites to the drug for 96 hours . Parasites synchronized at ring stage were put for culture with various concentrations of azithromycin dihydrate (0.01-40 micro/ml) . RESULTS: At highest concentration (40 micro/ml), parasite growth was inhibited totally in all 10 isolates . Antimalarial activity at 96 hours was greater than at 24 hours in both chloroquine sensitive and resistant parasites, which may indicate that the inhibition of parasite growth may occur at clinically achievable concentration of the drug when parasites were exposed for several asexual cycles . CONCLUSION: Azithromycin shows a potential for eventual use alone or in combination in the treatment of chloroquine sensitive and resistant P . falciparum malaria.

Hong Kong Med J, 1998 Mar, 4(1), 59 - 62
Penicillium marneffei infection and solitary pulmonary nodule; Chang KC et al.; We report on a patient infected with human immunodeficiency virus who presented with fever, a solitary pulmonary nodule, and cervical lymphadenopathy . The diagnosis of Penicillium marneffei infection was made from an excisional lymph node biopsy and a sputum culture . The microbiology, pathology, diagnosis, and treatment of the case are discussed . A high level of clinical suspicion is necessary for making an early diagnosis and improving the outcome of infection.

J Clin Microbiol, 2002 Feb, 40(2), 594 - 600
Rapid identification of Candida species by confocal Raman microspectroscopy; Maquelin K et al.; Candida species are important nosocomial pathogens associated with high mortality rates . Rapid detection and identification of Candida species can guide a clinician at an early stage to prescribe antifungal drugs or to adjust empirical therapy when resistant species are isolated . Confocal Raman microspectroscopy is highly suitable for the rapid identification of Candida species, since Raman spectra can be directly obtained from microcolonies on a solid culture medium after only 6 h of culturing . In this study, we have used a set of 42 Candida strains comprising five species that are frequently encountered in clinical microbiology to test the feasibility of the technique for the rapid identification of Candida species . The procedure was started either from a culture on Sabouraud medium or from a positive vial of an automated blood culture system . Prior to Raman measurements, strains were subcultured on Sabouraud medium for 6 h to form microcolonies . Using multivariate statistical analyses, a high prediction accuracy (97 to 100%) was obtained with the Raman method . Identification with Raman microspectroscopy may therefore be significantly faster than identification with commercial identification systems that allow various species to be identified and that often require 24 to 48 h before a reliable identification is obtained . We conclude that confocal Raman microspectroscopy offers a rapid, accurate, and easy-to-use alternative for the identification of clinically relevant Candida species.

J Clin Microbiol, 2002 Feb, 40(2), 495 - 500
Comparative evaluation of the VERSANT HCV RNA 3.0, QUANTIPLEX HCV RNA 2.0, and COBAS AMPLICOR HCV MONITOR version 2.0 Assays for quantification of hepatitis C virus RNA in serum; Germer JJ et al.; A comparison of quantitative results expressed in hepatitis C virus (HCV) international units per milliliter, obtained from the VERSANT HCV RNA 3.0 (bDNA-3.0) assay, the QUANTIPLEX HCV RNA 2.0 (bDNA-2.0) assay, and the COBAS AMPLICOR HCV MONITOR version 2.0 (HCM-2.0) test was performed . A total of 168 patient specimens submitted to the Mayo Clinic Molecular Microbiology Laboratory for HCV quantification or HCV genotyping were studied . Of the specimens tested, 97, 88, and 79% yielded quantitative results within the dynamic range of the bDNA-3.0, bDNA-2.0, and HCM-2.0 assays, respectively . Overall, there was substantial agreement between the results generated by all three assays . A total of 15 out of 29 (52%) of the specimens determined to contain viral loads of <31,746 IU/ml by the bDNA-3.0 assay were categorized as containing viral loads within the range of 31,746 to 500,000 IU/ml by the bDNA-2.0 assay . Although substantial agreement was noted between the results generated by the bDNA-2.0 and bDNA-3.0 assays, a bias toward higher viral titer by the bDNA-2.0 assay was noted (P = 0.001) . Likewise, although substantial agreement was noted between the results generated by the HCM-2.0 and bDNA-3.0 assays, a bias toward higher viral titer by the bDNA-3.0 assay was noted (P < or = 0.001) . The discrepancy between the HCM-2.0 and bDNA-3.0 results was more pronounced when viral loads were >500,000 IU/ml and resulted in statistically significant differences (P < or = 0.001) in determining whether viral loads were above or below 800,000 IU/ml of HCV RNA, the proposed threshold value for tailoring the duration of combination therapy . The expression of quantitative values in HCV international units per milliliter was a strength of both the bDNA-3.0 and HCM-2.0 assays.

Trends Microbiol, 2001 Nov, 9(11), 553 - 9
Desiccation tolerance: a simple process?
Potts M.
Water is essential for life, and thus the removal of water from a cell is a severe, often lethal stress . This is not a remarkable observation but it is one that is often taken for granted . Desiccation-tolerant cells implement structural, physiological and molecular mechanisms to survive severe water deficit . These mechanisms, and the components and pathways which facilitate them, are poorly understood . Here, recent developments are considered to illustrate the importance of desiccation, longevity and cell stasis in basic microbiology, and the relevance of the topic to the metabolic engineering of sensitive cells, including those of humans.

Proc AMIA Symp . 2001;:289-93.
Challenges in using the Arden Syntax for computer-based nosocomial infection surveillance; Jenders RA et al.; CONTEXT: Detection of outbreaks of infection in the hospital typically requires daily manual review of microbiology laboratory test results . This process is time-consuming, tedious, prone to error and may miss trends in infection . A standard formalism for procedural knowledge representation, the Arden Syntax, provides a vehicle for implementing algorithms for detecting such infections . OBJECTIVE: To design and implement a computer-based system for detection of concerning patterns of infection or antibiotic resistance . SETTING: Computer-based event monitor and central patient data repository at the Columbia-Presbyterian Medical Center (CPMC) . RESULTS: We designed a two-phase system, including initial filtering of individual patient laboratory results by Arden Syntax Medical Logic Modules (MLMs) and subsequent aggregation and analysis across patients and locations using a statistical monitor . Preliminary data for the filtration phase demonstrate a 94.8% reduction in the volume of messages that must be considered in surveillance . CONCLUSIONS: Filtering raw laboratory results using a standard formalism eases the process of aggregating data across patients and sites as well as detecting trends in infection . There is a need for augmenting such formalisms in order to enable population-based decision support.

Arch Pathol Lab Med, 2002 Feb, 126(2), 207 - 9
Pseudallescheriasis as an aggressive opportunistic infection in a bone marrow transplant recipient; Nonaka D et al.; Pseudallescheria boydii is a low-virulence fungus that is the main causative agent of posttraumatic mycetoma in a nonimmunocompromised host . Immunocompromised patients are at high risk for locally invasive or disseminated Pseudallescheria infection . However, aggressive opportunistic infections due to P boydii are reported infrequently because it morphologically resembles other fungi, especially Aspergillus species, on tissue histology; therefore, such infections are not identified and treated properly . We report a case of disseminated P boydii infection in a patient following bone marrow transplantation . The identity of the fungus was not recognized until microbiologic culture results became available . Our case illustrates the importance of recognizing this fungus as an opportunistic infection in immunocompromised patients, as well as the need for culture of biopsy material for proper identification so that appropriate therapy can be instituted.

Appl Environ Microbiol, 2002 Feb, 68(2), 933 - 7
Natural communities of novel archaea and bacteria with a string-of-pearls-like morphology: molecular analysis of the bacterial partners; Moissl C et al.; A recently discovered bacterial/archaeal association, growing in a string-of-pearls-like structure, thrives in the cold (approximately 10 degrees C) sulfidic marsh water of the Sippenauer Moor near Regensburg, Bavaria, Germany . It forms characteristic, macroscopically visible globules, the pearls, containing microcolonies of novel euryarchaeota, which are surrounded by mainly filamentous bacteria (C . Rudolph, G . Wanner, and R . Huber, Appl . Environ . Microbiol . 67:2336-2344, 2001) . Single pearls in series are connected by white threads . Here we report the first detailed molecular investigations of the taxonomic affiliation of the bacteria contributing to the strings of pearls . Phylogenetic analysis showed the dominance of a single phylotype (clone sipK4) within single pearls most closely related to Thiothrix unzii . The presence of Thiothrix sipK4 as a major constituent of single pearls and of the pearl-connecting white threads was verified by fluorescence in situ hybridization.

Annu Rev Med, 2002, 53, 133 - 47
Will the pig solve the transplantation backlog?
Cooper DK, Gollackner B, Sachs DH.
The increasing shortage of human cadaveric organs for purposes of transplantation has become the critical limiting factor in the number of transplants performed each year . Some of this deficit is being met by the use of organs or partial organs from living donors, but this source is insufficient . Xenotransplantation-the transplantation of organs between species, namely from the pig to human-could provide a solution if immunologic and other associated problems could be solved . When a pig organ is transplanted into a primate, hyperacute rejection, induced by anti-pig antibody and mediated by complement and the coagulation system, develops rapidly . This immediate problem can now be overcome, but the return or persistence of anti-pig antibody leads to a delayed form of humoral rejection, acute humoral xenograft rejection, which leads to destruction of the organ within days or weeks . We review the various approaches being investigated to overcome this barrier . Whether they will also prevent subsequent acute cellular rejection remains unknown . Brief mention is made of the potential physiologic incompatibilities between pig and human organs, as well as the microbiologic safety aspects of xenotransplantation . Finally, the question of patient and societal acceptance of xenotransplantation is discussed.

Magy Seb, 2001 Dec, 54 Suppl, 75 - 80
{Treatment options for complications in vascular surgery}; Acsady G et al.; The authors processed the patients' data of the last 10 years and present their experience in treating septic complications in the field of vascular surgery . They analyzed the therapeutic possibilities and reviewed the literature . They suggest the following treatment alternatives for the infection related complications, that they consider the best options these days: 1 . Identification of the causative agent by microbiologic methods and determination of the antibiotic susceptibility . 2 . In the cases of occluded grafts it is recommended to remove the whole graft and to apply a suction-irrigation drainage . 3 . In the cases of patent grafts: (a) If the infections starts in the immediate postoperative period it is suggested to spare the graft, open the wound, perform debridement and apply a suction-irrigation drainage . (b) Late suppurations, confined to the trunk of the graft without affecting the anastomoses, requires extensive debridement and lavage, and the graft could be left in place . (c) Anastomosis infection calls for graft removal, in situ reconstruction and suction-irrigation drainage in one setting . (d) Extraanatomic bypass is indicated when culture proves bacteria producing extraprotease enzymes because in these cases the incidence of repetitive septic bleedings are significantly higher, so in situ reconstructions are not recommended.

Clin Ther, 2001 Dec, 23(12), 1958 - 68
Comparison of once- and twice-daily clarithromycin in the treatment of adults with severe acute lower respiratory tract infections; Allin D et al.; BACKGROUND: Although the modified-release (MR) formulation of clarithromycin has demonstrated bioequivalence to the immediate-release (IR) formulation and thus can be prescribed for lower respiratory tract infections (LRTIs), a MEDLINE search from 1995 through 1998 and information on file with the manufacturer indicate that no data are available on the effectiveness of this new formulation in the treatment of severe LRTIs such as community-acquired pneumonia . OBJECTIVE: This study was designed to compare clinical success rates (percentage of patients with clinical cure or improvement) with once- and twice-daily regimens of clarithromycin in the treatment of patients with severe, acute LRTIs requiring oral antibiotic therapy . METHODS: In this multicenter, investigator-blinded, randomized, parallel-group study, adult patients with clinical evidence suggesting severe, acute LRTI were recruited from 22 general practices in the United Kingdom . Patients were randomly allocated to receive either clarithromycin 500 mg BID (IR tablets) or clarithromycin 1 g OD (two 500-mg MR tablets) for 7 to 14 days . The outcome measures were resolution of or improvement in clinical signs and symptoms (including resolution of cough), unscheduled visits for the same symptom, days to resumption of normal activities, and improvements in quality of life (assessed using the EQ-5D version of the EuroQoL questionnaire) . Clinical, microbiologic, and serologic assessments were performed before, during, and after treatment . Efficacy and safety data were analyzed on an intent-to-treat basis . RESULTS: One hundred sixty men (n = 83) and women (n = 77) between the ages of 19 and 88 years took part in the study, 78 receiving clarithromycin 500 mg BID and 82 receiving clarithromycin 1 g OD . At 4 weeks after the start of treatment, the high clinical success rates were comparable between groups: 84.6% with clarithromycin 500 mg BID and 90.2% with clarithromycin 1 g OD . No significant differences in outcome measures were noted between the 2 regimens . Both treatments were well tolerated, with taste disturbance being the most commonly reported adverse event (10.6% vs 6.1% with clarithromycin 500 mg BID and 1 g OD, respectively) . CONCLUSIONS: The 2 clarithromycin regimens were equally efficacious and well tolerated in the treatment of severe, acute LRTIs . However, caution should be exercised in applying these results to the general population, because the study excluded certain categories of patients who would normally be treated . In addition, the small sample size may have obscured clinically significant differences between the 2 regimens.

Rev Assoc Med Bras, 2001 Oct-Dec, 47(4), 302 - 10
{Colpocytology in a preventive gynecological ambulatory service}; Motta EV et al.; BACKGROUND: evaluate the results of Pap smear in women attended at a gynecology preventive ambulatory (University of Sao Paulo Medical School Clinical Hospital) . METHODS: 6821 women were submitted to a medical interview, clinical and gynecologic exam . Cervical and vaginal cytology (Pap smear) were analyzed according to the Papanicolaou method and classification . All women were grouped according to their age into three categories:under 40 years old, between 41 and 60 years and over 60 years . RESULTS: most of them, and mainly the younger ones, had been submitted to a previous Pap smear in a period shorter than 1 year (44.2%) . The majority of women recognized the usefulness of the exam and knew its interval; the group that best knew its importance and interval was the one with ages between 41 and 60 years, while most women over 60 years did not know both its importance and interval . Cytological material was considered insufficient for analysis in 15,1% and inadequate in 1.1%, and for those with adequate material results were classes I (21.7%), II (59.9%), III (2.0%), IV (0.1%) and V (0.1%) . Distribution of cervical intraepithelial neoplasia (CIN) were similar in the three groups . The main microbiologic findings was Gardnerella sp . (8,6%) and Human papillomavirus (HPV) incidence was significantly lower among women over 60 years . CONCLUSION: Cytological diagnoses of neoplastic modifications were performed in 2,2% and Gardnerella sp . was the most prevalent microbiologic agent . Distribution of HPV showed a decrease with age . Older women had lower knowledge on the importance of regular Pap smear examination.

Anal Chem, 2002 Jan 15, 74(2), 368 - 72
Electrochemically mediated electrodeposition/electropolymerization to yield a glucose microbiosensor with improved characteristics; Chen X et al.; A procedure is described that provides for electrochemically mediated deposition of enzyme and a polymer layer permselective for endogenous electroactive species . Electrodeposition was first employed for the direct immobilization of glucose oxidase to produce a uniform, thin, and compact film on a Pt electrode . Electropolymerization of phenol was then employed to form an anti-interference and protective polyphenol film within the enzyme layer . In addition, a stability-reinforcing membrane derived from (3-aminopropyl)trimethoxysilane was constructed by electrochemically assisted cross-linking . This hybrid film outside the enzyme layer contributed to the improved stability and permselectivity . The resulting glucose sensor was characterized by a short response time (<4 s), high sensitivity (1200 nA/mM x cm2), low interference from endogenous electroactive species, and working lifetime of more than 50 days.

Arch Pediatr, 2001 Dec, 8(12), 1318 - 24
{Acute diarrhea and rotavirus infection in the child: assessment of data from emergency care and and the microbiology laboratory of the Armand-Trousseau (Paris) Hospital between 1988 and 2001}; Grimprel E et al.; MATERIAL AND METHODS: Between October 1, 1988 and March 31, 2001, a longitudinal survey was conducted at the French pediatric hospital Armand-Trousseau in Paris . Following data were simultaneously collected: consultations and hospitalizations for acute diarrhea at the emergency room, and identifications of rotavirus from diarrheic stools at the laboratory . RESULTS: Acute diarrhea represented 9.3% to 11.1% of all consultations . The activity was continuous through the year with several epidemic peaks, the largest occurring during the winter months . The hospitalization rate was high and stable since 1989 (16.5% to 21%), reaching 22-26% at the winter peak . Overall, rotaviruses were identified in 22.4% of stool samples but the detection rate increased from 10% in 1989 to 31% in 1997 . Rotaviruses were isolated mainly in winter, reaching the rate of 50-70% at the peak . DISCUSSION: Despite numerous biases of methodology and the fact that data were extracted from two different sources, acute diarrhea appeared as a major epidemic phenomenon in Paris, and rotaviruses were the main pathogens identified in diarrheic infants in winter . The extent of the winter epidemic increased each year since ten years, in parallel with the increase of the global activity of the emergency room . Despite attempts to develop ambulatory care, admission rates remained high in patients with acute diarrhea and searching for care at the emergency room of our hospital, especially in winter . CONCLUSION: These preliminary data were restricted to a single pediatric hospital in Paris . They need to be extended to a national level before considering a strategy for prevention using vaccination.

Tidsskr Nor Laegeforen, 2001 Dec 10, 121(30), 3613 - 6
{Food control--between health and honest trade}; Elvbakken KT; Food control is a very old practice, part of regulations meant to safeguard order and control in the cities . The history of modern food safety control goes to the rise of local health commissions, set up to curtail the cholera epidemics in the first half of the 19th century . Modern sciences like chemistry and microbiology brought new monitoring tools, while industrial food processing in the rapidly growing late 19th century cities meant new challenges for the authorities . Food control was primarily the responsibility of local health authorities . The process of getting food control legislation in place in Norway was very long and full of conflicts . The initiative for it came from health authorities, while trade and agricultural interests resisted their push . During the 1950 and 1960s, the professional responsibility passed from physicians to veterinarians . For a long time, food control was uncontroversial and attracted little political attention . The mad cow disease crises in 1996 changed that . Because of the flagging confidence in the safety of food, questions were raised not only about the independence of the authorities, but also about government authority in general . The legislation for food control in Norway is now being revised and the administrative apparatus is overhauled.

Cornea, 2002 Jan, 21(1), 43 - 7
Treatment of acute bacterial conjunctivitis with topical netilmicin; Papa V et al.; PURPOSE: This study compares the clinical and microbiologic value of topical netilmicin with that of gentamicin in the treatment of acute bacterial conjunctivitis . METHODS: A double-blind, randomized, prospective, controlled study was performed in 209 patients . One to two drop(s) of either antibiotic was applied to the affected eye(s) four times a day for up to 10 days . Patients were examined at the time of diagnosis and after 3, 5, and 10 days . Clinical efficacy was measured as the cumulative sum score (CSS) of the key signs and symptoms of acute bacterial ocular infection . Sensitivity/resistance was evaluated using the disk diffusion method . RESULTS: Drug efficacy assessment was restricted only to patients with positive baseline culture results (n = 121) . Of the isolated organisms, 96.9% were sensitive to netilmicin, whereas only 75.0% were sensitive to gentamicin (p = 0.00001) . Netilmicin provided a broad-spectrum coverage comparable with that of ciprofloxacin, ofloxacin, and norfloxacin . Netilmicin also was more effective than gentamicin in eradicating infections (p = 0.001 at day 5 and p = 0.037 at day 10) and in ameliorating the CSS (p = 0.037 at day 3, p = 0.001 at both day 5 and day 10) . Only minor adverse events occurred in patients treated with either netilmicin or gentamicin . CONCLUSIONS: This study demonstrates that netilmicin is a safe and effective antibiotic that can be used as first-line therapy for the treatment of acute bacterial conjunctivitis.

Pediatr Infect Dis J, 2002 Jan, 21(1), 39 - 43
Neonatal Candida glabrata sepsis: clinical and laboratory features compared with other Candida species; Fairchild KD et al.; BACKGROUND: Recent studies have shown a rise in Candida glabrata infections among immunocompromised adults . In published case series of neonatal candidemia, however, the species glabrata is uncommon . We conducted a retrospective chart review to examine the epidemiology, clinical presentation and outcome of neonatal infection with C . glabrata compared with other species of Candida . METHODS: Neonatal and microbiology databases of two affiliated hospitals were searched for all cases of candidemia in neonatal intensive care unit patients with suspected sepsis from 1991 through 1998 . RESULTS: Of 58 cases of Candida sepsis, 9 (15%) were caused by C . glabrata (CG), 41 (71%) by C . albicans (CA) and 8 (14%) by C . parapsilosis (CP) . There was no change in the proportion of candidemia caused by glabrata species in the years studied . Although there was a significantly higher proportion of CG cases at 1 hospital (29% vs . 6%, P = 0.01), there was no case clustering to suggest direct nosocomial spread . Compared with other Candida species, CG occurred in infants of higher gestational age (CG 29.7 weeks, CA 26.6 weeks, CP 27.3 weeks) and birth weight (CG 1442 g, CA 931 g, CP 965 g) . Patients with CG sepsis were more likely to be receiving broad spectrum antibiotics at the time of diagnosis (CG 67%, CA 38%, CP 38%), were less likely to present with apnea and had less severe thrombocytopenia . Of 9 patients with CG sepsis, 1 had meningitis, 1 had necrotizing enterocolitis and 3 had candiduria . CONCLUSION: C . glabrata is a significant nosocomial pathogen in the neonate.

J Bacteriol, 2002 Feb, 184(3), 794 - 805
Regulation of the Streptomyces coelicolor calcium-dependent antibiotic by absA, encoding a cluster-linked two-component system; Ryding NJ et al.; The Streptomyces coelicolor absA two-component system was initially identified through analysis of mutations in the sensor kinase absA1 that caused inhibition of all four antibiotics synthesized by this strain . Previous genetic analysis had suggested that the phosphorylated form of AbsA2 acted as a negative regulator of antibiotic biosynthesis in S . coelicolor (T . B . Anderson, P . Brian, and W . C . Champness, Mol . Microbiol . 39:553-566, 2001) . Genomic sequence data subsequently provided by the Sanger Centre (Cambridge, United Kingdom) revealed that absA was located within the gene cluster for production of one of the four antibiotics, calcium-dependent antibiotic (CDA) . In this paper we have identified numerous transcriptional start sites within the CDA cluster and have shown that the original antibiotic-negative mutants used to identify absA exhibit a stronger negative regulation of promoters upstream of the proposed CDA biosynthetic genes than of promoters in the clusters responsible for production of actinorhodin and undecylprodigiosin . The same antibiotic-negative mutants also showed an increase in transcription from a promoter divergent to that of absA, upstream of a putative ABC transporter, in addition to an increase in transcription of absA itself . Interestingly, the negative regulation of the biosynthetic transcripts did not appear to be mediated by transcriptional regulation of cdaR (a gene encoding a homolog of the pathway-specific regulators of the act and red clusters) or by any other recognizable transcriptional regulator associated with the cluster . The role of absA in regulating the expression of the diverse antibiotic biosynthesis clusters in the genome is discussed in light of its location in the cda cluster.

J Am Soc Echocardiogr, 2002 Jan, 15(1), 76 - 9
A retrospective experience of right atrial and superior vena caval thrombi diagnosed by transesophageal echocardiography; Shapiro MA et al.; Central venous catheter (CVC) thrombosis and infection has become a frequent finding in immunosuppressed and chronically ill medical patients, particularly those with end-stage renal disease . Transesophageal echocardiography (TEE), as the only reliable noninvasive method of imaging the superior vena cava (SVC) is appreciated to be very useful in the evaluation of these lesions . We retrospectively review our findings of TEE for this purpose, with regard to frequency of positive findings, patient characteristics, and microbiologic findings from SVC and right atrial thrombi and vegetations associated with CVCs.

Infect Dis Clin North Am, 2001 Dec, 15(4), 1157 - 204
Principles of molecular microbiology testing methods; Wolk D et al.; Molecular testing methods have the potential to replace many conventional microbiology laboratory assays . Recent refinements in technology have resulted in more user-friendly testing platforms . These platforms are automated and have lowered risks for contamination, decreased costs, and are faster than older platforms . The success of these technologies depends on their successful application to patient care . Quality issues include appropriate specimens for analysis, performance characteristics of different analytical methods, optimal specimen processing, the effects of PCR inhibitors, and false-positive results caused by contaminating nucleic acids . Quality control guidelines for molecular microbiologic diagnostic assays are in their infancy and require further development . Additionally, the problem of "too much" sensitivity (brought on by the extreme sensitivity of these techniques coupled with the potential presence of small numbers of pathogenic organisms in asymptomatic individuals) should be considered . Potential problems when monitoring therapy (because molecular detection techniques do not generally have the ability to determine whether an organism is dead or alive) can also occur . Cost-effective test use, pathogen- or disease-targeted algorithms, and standardized methods will be necessary for the true value of these technologies to be realized . This is especially important, because, unlike traditional culture methods, most molecular microbiology methods are pathogen-specific . Clinicians familiar with the reasons why "pan-culture" (i.e., requesting all culture possibilities at once) is inadvisable should not use the same irrational approach when requesting molecular tests . The clinical usefulness of molecular testing will be maximized as targeted algorithms are developed and an understanding of molecular test ordering patterns is realized . Laboratory technicians and physicians must continue to apply and combine theories of traditional microbiology, clinical chemistry, and general medicine to the understanding and application of molecular diagnostics.

Infect Dis Clin North Am, 2001 Dec, 15(4), 1073 - 108
Gastrointestinal infections; Procop GW; Advances in public health have reduced the risk of contracting certain enteric diseases, but many remain, and new pathogens have emerged and/or recently have been discovered . The pathogenic agents are varied and consist of a variety of bacteria and select viruses and parasites . Selected use of microbiologic assays to detect these pathogens is encouraged . When tests are ordered non-judiciously, costs rapidly accrue . The age of the patient, time of year, travel history, and clinical presentation all provide clues to the etiologic agent . Microbiologic assays should be used judiciously to confirm or exclude the likely infectious agents.

Braz J Infect Dis, 2001 Oct, 5(5), 252 - 9 Epub 2003 Feb 21.
Detection of mycobacteria in the bloodstream of patients with acquired immunodeficiency syndrome in a university hospital in Brazil; Oplustil CP et al.; This study was done to determine the occurrence of mycobacteria in the bloodstreams of patients with fever and advanced AIDS in a Brazilian hospital . We also verified the capability of an automated method for recovering these bacteria . During a period of 19 months, 254 patients with AIDS were evaluated . Blood cultures were generally submitted in pairs and drawn separately . Blood cultures were processed by the BACTEC 460TB System (Becton Dickinson Microbiology Systems, Sparks, MD), using the Bactec 13A media (Becton Dickinson Microbiology Systems, Sparks, MD) . Of the 530 vials submitted, 77 (14.5%) from 41 (16%) patients were positive . Mycobacterium avium complex was recovered from 45 (58.4%) of the 77 positive vials, corresponding to 22 (53.6%) patients with positive blood cultures . The average time to detect Mycobacterium avium complex was 15 days . Mycobacterium tuberculosis was recovered from 26 (33.8%) of the 77 positive vials, corresponding to 15 (36.6%) patients with positive blood cultures, with an average detection time of 24 days . Other species of mycobacteria were recovered from 6 (7.8%) of the 77 vials, corresponding to 4 (9.8%) patients . M.avium complex was fairly prevalent (8.7%) in severely ill patients with AIDS in our hospital . M . tuberculosis was also an important (6.0%) agent of systemic bacterial infections in these patients . The rapid diagnosis of mycobacteremia was possible with the implementation of this automated technology.

Obstet Gynecol, 2002 Jan, 99(1), 18 - 22
Assessment of vulvovaginal complaints: accuracy of telephone triage and in-office diagnosis; Allen-Davis JT et al.; OBJECTIVE: To examine the agreement between telephone and office management of vulvovaginal complaints and to assess the accuracy of diagnosis of vulvovaginitis . METHODS: Prospective structured telephone nurse interviews of all patients with vulvovaginal complaints who called the Kaiser Permanente Telephone Call Center were conducted . Patients were appointed to a physician, nurse midwife, or physician's assistant for office evaluation . Both groups (nurses and practitioners) made independent diagnosis and treatment decisions . kappa coefficients were used to evaluate the interexaminer agreement between telephone nurses and practitioners, and practitioners and traditional diagnostic tests . RESULTS: A total of 485 patients underwent telephone interviews, and 253 (52%) completed the study protocol . kappa values showed poor agreement between nurses and practitioners for bacterial vaginosis (0.12), candidiasis (0.22), and trichomoniasis (-0.05) . Practitioners failed to accurately diagnose vaginitis when kappa values were analyzed . There was also poor agreement between telephone nurses and practitioners regarding the necessity of an office visit (0.14) . CONCLUSION: This prospective study challenges the notion that the telephone is an effective tool to diagnose and treat vulvovaginal complaints . Moreover, given the poor agreement between practitioners' diagnoses and microbiologic and microscopic data, further study into optimal diagnosis of vulvovaginitis is needed.

Zhonghua Fu Chan Ke Za Zhi, 2000 Aug, 35(8), 462 - 4
{Preclinical study of preimplantation genetic diagnosis in animal}; Ji Y et al.; OBJECTIVE: To perform preimplantation genetic diagnosis (PGD) in transgenic mice . METHODS: Single blastomere from murine heterozygous pre-embryo at 4 or 8-cell stage was sampled by microbiopsy for detection of the human gene delta F508 mutation of cystic fibrosis and biopsied pre-embryo was transferred to Swiss mice foster mothers . delta F508 mutation detection on the single blastomere was performed with nested polymerase chain reaction(PCR) . RESULTS: (1) Significant difference was not observed statistically for the in vitro hatching rate (n = 102), the birth rate (n = 79), birth weight and organ weight (n = 133) at 3 weeks after births between mice born from biopsied embryos and controls . (2) Thirty-two nested PCR were performed for the diagnosis of the cystic fibrosis delta F508 mutation, with 100.0% specificity and 100.0% sensitivity . CONCLUSIONS: Microbiopsy of pre-embryos with 4 or 8-cells did not alter their viability and further development . The technique of nested PCR on a single blastomere for the detection of cystic fibrosis delta F508 mutation is reliable.

Acta Virol, 2001 Jun, 45(3), 139 - 50
Transmission of arboviruses without involvement of arthropod vectors; Kuno G; Transmission of arboviruses (arthropod-borne viruses belonging to various virus families) without involvement of arthropod vectors has been documented for years, but the reports have not been reviewed systematically . The recent report of West Nile (WN) virus isolation from a hawk in mid-winter in New York (Garmendia et al., J . Clin . Microbiol . 38, 3110-3111, 2000) generated a considerable interest in this mode of arbovirus transmission . In this article, the data available worldwide are analyzed according to the factors involved in such a transmission under natural conditions, mode of infection, virus entry mechanism, administration and efficacy evaluation of vaccines, and significance in agricultural trade and public health . Analysis of numerous reports compiled for this review revealed that peroral and intranasal/aerosol transmissions are very common among arboviruses . The mechanism of virus infections in animals was most extensively studied for intranasal/aerosol infection, confirming two routes of virus spread to central nervous system (CNS), olfactory and hematogenous . To rule out the possibility of asymptomatic, cryptic infection the efficacy evaluation of candidates for vaccines against neurotropic arboviruses should include virus isolation from tissues of not only symptomatic but also of asymptomatic animals that survive intranasal virus challenge . Human activities, such as feeding livestock animals with food containing virus-contaminated meat and assembling a large number of livestock from many geographically-separated locations, have been identified as a cause of spread of some arboviral diseases . Despite numerous laboratory reports, the significance of this mode of transmission of arboviruses under natural conditions was rarely investigated, except for a few viruses important for veterinary medicine.

Zhonghua Kou Qiang Yi Xue Za Zhi, 1998 Jul, 33(4), 213 - 5
{Prevalence of subgingival microbiota in Chinese using checkerboard DNA-DNA hybridization}; Meng H et al.; OBJECTIVE: To evaluate the prevalence of subgingival taxa of periodontal healthy persons and rapidly progressive periodontitis (RPP) patients using checkerboard DNA-DNA hybridization and to find the main pathogens in RPP . METHODS: Eighty four subgingival plaque DNA samples taken from 5 healthy subjects (H) and 6 RPP patients were hybridizated with 37 bacterial probes . RESULTS: The detection frequences of 6 bacteria (E . corrodens, et al.) were greater than 90% . Suspected periodontal pathogens, e.g . A . actinomycetemcomitans seratype b, T . denticola, F . nucleatum as nucleatum, B . forsythus, P . nigrescens, W . succinogenes, C . rectus, P . micros, S . intermedius and P . gingivalis were significantly more frequently found in RPP group than in H group . The mean counts of these pathogens were significantly more elevated in RPP group than in H group . CONCLUSION: It is suggested that periodontal destruction occurrence requires the pathogens in sufficient number at the site, RPP may be resulted from several pathogens.

Hum Pathol, 2001 Dec, 32(12), 1300 - 3
Combined robotic and nonrobotic telepathology as an integral service component of a geographically dispersed laboratory network; Dunn BE et al.; To achieve real-time connectivity between its 8 hopital-based laboratories, Veterans Integrated Service Network (VISN) 12, headquartered in Chicago, IL, has implemented a hybrid dynamic store-and-forward (HDSF) telepathology network that extends across portions of 3 states . The majority of diagnostic telepathology functions are provided to the 3 hospitals (Iron Mountain, MI; Tomah, WI; and North Chicago, IL), which lack on-site pathologists and are serviced by the 4 pathologists located in Milwaukee, WI . In surgical pathology, routine primary diagnosis, frozen section diagnosis, and clinical consultation are provided with telepathology . In addition, autopsy and specialty clinical conferences are frequently performed by using telepathology . Telepathology has been applied to a variety of areas within clinical pathology as well, including protein electrophoresis, immunoelectrophoresis, peripheral blood smears, body fluids, microbiology, and distance learning . Implementation of telepathology has allowed VISN 12 to reach the goal of providing a single standard of accurate and timely pathology service, even at small sites that lack an on-site pathologist .

J Dermatol, 2001 Nov, 28(11), 599 - 601
Dermatological research in the 21st century: our fantastic future; Katz SI; During the second half of the twentieth century, dermatology came of age . Just as clinical dermatology, through new diagnostic and therapeutic modalities, matured to a point where the dermatologist could affect peoples' lives profoundly, so too did dermatological research enhance our understanding of skin diseases enormously . Dermatology should not be viewed as a scientific discipline-advances come from fundamental scientific areas such as cell and molecular biology, biochemistry, immunology, microbiology, technology, the clinical sciences and others . Thus, dermatology and skin biology live within a universe of science, only a small part of which is dermatology and skin biology, and our patients and our science are dependent on integration and interdigitation with the universe of science for future success . In this lecture I will elaborate on where I think the next 10-20 years will take us in this universe.

MMWR Morb Mortal Wkly Rep . 2001 Dec 7;50(48):1080.
Update: Unexplained deaths following knee surgery--Minnesota, 2001; Pulmonary tuberculosis in Kumasi et al.; Department of Medicine, School of Medical Sciences, University of Science & Technology, Kumasi, GhanaTo assist implementation of tuberculosis (TB) control measures, knowledge of the disease characteristics in a community is essential . This study in Kumasi, Ghana, correlates the clinical presentation, microbiology, molecular epidemiology and clinical outcome of thirty consecutively diagnosed patients with new smear-positive pulmonary TB . Several important factors that potentially promote disease transmission in the community were identified: patients had prolonged duration of productive cough prior to diagnosis (mean=4.1 months; SD=2.1); the disease was typically advanced at presentation and Ziehl-Neelson sputum smears indicated a high bacterial load (80% graded > AFB++); home accommodation was overcrowded with a mean of 3.3 other persons sleeping in the same room as the patients at night . IS6110 restriction fragment length polymorphism (RFLP) fingerprinting of 25 isolated (23 Mycobacterium tuberculosis and 2 Mycobacterium africanum) from epidemiologically unrelated cases identified 3 identical strains and 3 clusters containing 2, 4 and 8 isolates of > or =80% similarity, suggesting high rates of disease transmission . A high prevalence of primary resistance to isoniazid was found (6 out 26; 23%) but resistance to rifampicin, pyrazinamide, ethambutol, streptomycin and ciprofloxacin was not detected . Smear coversion at 2 months and final outcome of treatment with short courses chemotherapy were independent of isoniazid resistance, but the rate of treatment default was unacceptably high (37%) . High rates of disease transmission, primary isoniazid resistance and treatment default all indicate poor TB control . The use of rifampicin-containing short-course chemotherapy in this community must be accompanied by adequate resources and infrastructure to ensure very stringent treatment supervision to improve case-holding and reduce the risk of multi-drug resistance.

Rev Prat, 1998 Apr 15, 48(8), 848 - 53
{Microbiology in acute otitis media}; Bingen E; Acute otitis media is the most common bacterial infection in the child under 5 years of age and the leading reason for antibiotic prescriptions in Western countries . The choice of optimal antibiotic treatment is based essentially on microbiologic epidemiologic studies . The bacteria most often responsible for otitis belong to the commensal flora of the nasopharynx . French studies using paracentesis show that the main bacteria responsible for acute otitis media are H . influenzae, S . pneumoniae and M . catarrhalis . The epidemiology of resistance to antibiotics has recently changed, with the appearance of pneumococcal strains having reduced sensitivity to penicillin, and which have played a major role in treatment failures.

Orthopade, 2001 Nov, 30(11), 815 - 24
{Transition from malum coxae senile to the arthrosis deformans concept . A summary of the best known theories and classifications}; Rauschmann MA et al.; The disease of degenerative arthritis has been known for thousands of years . Paleopathology has provided findings of ancient degenerative alterations . Furthermore, physicians in classical antiquity described several forms of joint diseases . A challenging problem was the therapy, which was limited at that time . For centuries all joint diseases were subsumed under the term"rheumatism." In 1683 Thomas Sydenham, who suffered himself from gout, first differentiated this joint disease from the larger group of rheumatic joint diseases . Another early classification was undertaken by John Haygarth in 1779 . He differentiated gout from malum coxae senilis and the chronic rheumatic diseases . The different theories and the resulting classifications were influenced by different disciplines such as surgery, internal medicine, pathology, anatomy, neurology, microbiology, and radiology.This investigation includes the time period from the early nineteenth century until 1925 when the word "arthrosis" was first used in a medical publication . This investigation is based on research at the library of the German Museum for Orthopedic History and Science as well on the systematic search for articles in different German journals such as Zeitschrift fur Orthopddie and Fortschritte auf dem Gebiet der Rontgenstrahlen . It includes almost all important books and publications about degenerative arthritis for this time period . In the past there were many different descriptions for degenerative arthritis.The establishment of X-rays and new methods in histology and microbiology and the aspect of biomechanical theories led to a better understanding of the different diseases.The authors tried to construct new classifications without the knowledge of the causal and formal pathogenesis . This is the reason for the large number of different classifications, which had to be revised after a short period of time . This publication gives an overview about the most important articles and books which led to the classification currently in use.

Arch Hist Filoz Med, 2000, 63(3-4), 19 - 23
{Ludwik Hirszfeld (1884-1954) the Wrocław Years, 1945-1954}; Heimrath T; Beginning with an initial overview of his earlier activities as a scholar, this article is a study of the years which Ludwik Hirszfeld spent in Wroclaw and is based on published sources as well as the reminiscences of both his colleagues and of this author . Hirszfeld himself, in his described his life autobiography "History of One Life" until just after the Second World War . The years he spent in Wroclaw organizing the Medical Department, of which he was the first director from 1945-1946 were unusually active ones . Hirszfeld was also at that time founder of the Department of Medical Microbiology and later of the Institute for Immunology and Experimental Therapy of the Polish Academy of Sciences in Wroclaw . He was simultaneously involved in highly successful scientific research particularly in the area of immunopathology during pregnancy . He was a popular lecturer on this subject with a special gift for reaching his audience as well as an active participant in scientific discussions in a variety of foral forums . He had a great personal influence on the first generation of staff and students of the Medical Department in Wroclaw in the years immediately following the end to the Second World War.

Harefuah, 2001 Nov, 140(11), 1049 - 53, 1117
{The mosaic of pemphigus}; Gorshtein A et al.; Pemphigus is an autoimmune blistering disease of skin and mucous membranes . The classic types of pemphigus are pemphigus vulgaris and pemphigus foliaceus . In this review we summarize recent advancement in the etiology and the pathogenesis of pemphigus . Desmogleins--transmembrane glycoproteins involved in intracellular adhesion--were recognized as targets of pemphigus antibodies . It was found that the distribution and the expression of desmogleins can explain the difference in the localization of lesions in pemphigus vulgaris and pemphigus foliaceus . Pemphigus develops in a two-step process . The first step leads to the presence of a low titer of autoantibody, the second step results in a significant increase in the antibody titer which causes the clinical stage of the disease . Selective presentation of self peptides can explain the Major Histocompatibility Complex (MHC)--linked susceptibility to autoimmune diseases including pemphigus and rheumatoid arthritis . Peptides selective for the disease-associated molecules can be identified and used to search for microbiologic factors that can take part in the pathogenesis of pemphigus.

J Hosp Infect, 2001 Aug, 48 Suppl A, S50 - 4
Role of the clinical microbiology laboratory in infection control--a Danish perspective; Kolmos HJ; Clinical microbiology laboratories in Denmark are located in hospitals and staffed by clinical microbiologists who are clinically trained medical doctors . Each county has its own clinical microbiology unit, serving a population of 0.3-0.6 million . The responsibilities of clinical microbiology unit cover many different aspects of infection control . They include detection of outbreaks of hospital-acquired infections, screening for multi-resistant organisms, advice to clinicians about disinfection, sterilization and isolation procedures, and the rational use of antibiotics . Clinical microbiologists work closely with infection control nurses . Together they form the infection control team, which is the executive part of the local infection control committee . The infection control team is also the main body responsible for the development of guidelines, which are approved by the regional infection control committee . The local microbiology laboratories work in close contact with the National Department of Hospital Hygiene and other reference laboratories at the State Serum Institute . The present structure of infection control was established 25 years ago . The main aim at that time was to decentralize infection control and establish facilities as close to clinicians and patients as practically possible . This has solved most basic problems related to infection control, and compliance by clinicians has been fairly good . However, the present organization will not meet future requirements for standardization and documentation of quality . Currently a national standard for infection control is being prepared . It consists of a main standard defining requirements for the management system and 12 subsidiary standards defining requirements for specific areas of infection control . Adoption of the standard will undoubtedly require additional resources for infection control at a local level, and some organizational changes may also be needed . Infection control should be maintained as an integrated part of clinical microbiology.

Eur J Clin Microbiol Infect Dis, 2001 Oct, 20(10), 724 - 31
Multicenter study of a commercial, automated polymerase chain reaction system for the rapid detection of Mycobacterium tuberculosis in respiratory specimens in routine clinical practice; Bogard M et al.; A cooperative study was conducted among six laboratories to compare the performance of the Cobas Amplicor (CA) polymerase chain reaction (PCR) system (Roche Molecular Systems, USA) for the detection of Mycobacterium tuberculosis with that of microscopy and culture in routine clinical laboratory diagnosis . A total of 5,221 decontaminated respiratory specimens were tested . The use of an internal control allowed detection of PCR inhibition in 144 (2.8%) specimens . Only two culture-positive samples were CA PCR inhibitory and therefore could not be detected by PCR testing . Of the 333 culture-positive specimens, 278 (83.5%) were positive by the CA PCR . Of the 4,744 culture-negative specimens, 52 (1.1%) were positive by the CA PCR . After analysis of discrepancies, 40 of the 52 culture-negative, CA PCR-positive specimens were classified as true positive . Thus, the overall sensitivities of culture, CA PCR and microscopy were 89.3%, 85.2% and 55.5%, respectively . The overall specificity of the CA PCR was 99.7% . Five of the six centers found similar performances for the CA PCR, with sensitivities ranging from 85.7 to 90.9% . The CA PCR was more sensitive for smear-positive samples, exhibiting overall sensitivities of 96.1% and 71.7% for smear-positive and smear-negative specimens, respectively . These results indicate that the Cobas Amplicor system enables microbiology laboratories with reasonable previous experience in molecular biology testing to perform PCR and to detect Mycobacterium tuberculosis in more than 70% of specimens obtained from infected patients.

J Biol Chem, 2002 Apr 12, 277(15), 12507 - 15 Epub 2001 Dec 27.
Subdivision of the helix-turn-helix GntR family of bacterial regulators in the FadR, HutC, MocR, and YtrA subfamilies; Rigali S et al.; Haydon and Guest (Haydon, D . J, and Guest, J . R . (1991) FEMS Microbiol . Lett . 63, 291-295) first described the helix-turn-helix GntR family of bacterial regulators . They presented them as transcription factors sharing a similar N-terminal DNA-binding (d-b) domain, but they observed near-maximal divergence in the C-terminal effector-binding and oligomerization (E-b/O) domain . To elucidate this C-terminal heterogeneity, structural, phylogenetic, and functional analyses were performed on a family that now comprises about 270 members . Our comparative study first focused on the C-terminal E-b/O domains and next on DNA-binding domains and palindromic operator sequences, has classified the GntR members into four subfamilies that we called FadR, HutC, MocR, and YtrA . Among these subfamilies a degree of similarity of about 55% was observed throughout the entire sequence . Structure/function associations were highlighted although they were not absolutely stringent . The consensus sequences deduced for the DNA-binding domain were slightly different for each subfamily, suggesting that fusion between the D-b and E-b/O domains have occurred separately, with each subfamily having its own D-b domain ancestor . Moreover, the compilation of the known or predicted palindromic cis-acting elements has highlighted different operator sequences according to our subfamily subdivision . The observed C-terminal E-b/O domain heterogeneity was therefore reflected on the DNA-binding domain and on the cis-acting elements, suggesting the existence of a tight link between the three regions involved in the regulating process.

Am J Hematol, 2001 Dec, 68(4), 231 - 6
Invasive aspergillosis in haematological malignancies: clinical findings and management for intensive chemotherapy completion; Nosari A et al.; Sixty-one cases of Aspergillus infection (35 acute myeloid leukemia, 15 acute lymphoid leukemia, one myelodysplastic syndrome, two aplastic anemia, eight non-Hodgkin's lymphoma) seen in our department between January 1989 and July 1999 were studied retrospectively to evaluate the clinical characteristics, to ascertain the factors that influenced the outcome from mycotic infections, and whether early diagnosis and prolonged therapy permitted completion of scheduled intensive chemotherapy and bone marrow transplantation (BMT) without fungal recurrence . The patients were divided into three diagnostic categories: proven aspergillosis (autoptic or histologic diagnosis) n = 39, probable aspergillosis (radiological diagnosis with positive microbiology) n = 9, and possible aspergillosis (radiological diagnosis alone) n = 13 . In the same period among 675 acute leukemia patients the incidence of proven or probable aspergillosis was 7.1% . At onset of infection 92% of patients were neutropenic (< 0.5 x 10(9)/L) . The most frequent site of infection was the lung (90%); disseminated disease was present in 20 patients . Among 44 assessable patients, 12 (27%) failed to respond to early antifungal therapy and died . Thirty-two patients were cured with antifungal treatment, three of five nonneutropenic with only itraconazole, the others with amphotericin B 1 mg/Kg/day with or without itraconazole subsequently or with liposomal amphotericin, Ambisome, if renal toxicity occurred . Twenty-four of 29 neutropenic responders, all affected by acute leukemia, continued scheduled intensive chemotherapies . Pulmonary lobectomy was successfully combined with medical treatment in two cases before scheduled BMT . After infection nine patients were submitted to BMT (six allo, one marrow unrelated donor (MUD), two auto) with Ambisome or itraconazole as secondary prophylaxis without fungal relapse (follow-up: 25-99 months) . The median time from fungal infection to transplant was five months, range 3-10 . Thirteen of 29 surviving patients had leukemia relapse, but only three (23%) of these showed also fungal infection recurrence . In conclusion, a high index of suspicion and careful clinical and radiological examinations are the key to identifying infected patients early and to programming the following therapeutic steps . Above all in leukemia patients, prompt and aggressive administration of antifungal agents seems to improve the outcome of invasive fungal disease and to permit intensive chemotherapy completion and transplant .

Pediatr Infect Dis J, 2001 Dec, 20(12), 1149 - 54
Efficacy and safety of clarithromycin versus erythromycin for the treatment of pertussis: a prospective, randomized, single blind trial; Lebel MH et al.; BACKGROUND: Pertussis is still a prevalent public health problem, and antibiotic therapy may decrease disease severity and limit communicability . Erythromycin is the recommended antibiotic for treatment and prophylaxis of pertussis; however, side effects of erythromycin limit its usefulness in some patients . Clarithromycin, a newer macrolide, has good in vitro activity against Bordetella pertussis and a better side effect profile . GOALS OF THE STUDY: To compare the microbiologic and clinical efficacy and the clinical safety of a 7-day course of clarithromycin vs . a 14-day course of erythromycin in children with pertussis . DESIGN: Prospective, randomized, single blind (investigator), parallel group trial . METHODS: Children from 1 month to 16 years of age presenting with a clinically defined pertussis syndrome were eligible for the study . After obtaining informed written consent, we randomized patients to receive either clarithromycin (7.5 mg/kg/dose twice a day for 7 days) or erythromycin (13.3 mg/kg/dose three times a day for 14 days) . Nasopharyngeal cultures for B . pertussis were performed at enrollment and after end of treatment . Clinical assessments were performed at enrollment, at end of treatment and at a 1-month follow-up visit . Adverse event data were collected throughout the study . RESULTS: The clarithromycin (n = 76) and erythromycin (n = 77) groups were well-matched for age and previous pertussis immunization . Microbiologic eradication and clinical cure rates were 100% (31 of 31) for clarithromycin and 96% (22 of 23) for erythromycin . The clarithromycin group had significantly fewer adverse events {45% (34 of 76) for clarithromycin vs . 62% (48 of 77) for erythromycin; P = 0.035}, and compliance with the medication regimen was significantly higher in these patients . CONCLUSIONS: A 7-day regimen of clarithromycin and a 14-day course of erythromycin were equally effective for treatment of pertussis . Clarithromycin was better tolerated than conventional erythromycin therapy.

Pediatr Infect Dis J, 2001 Dec, 20(12), 1105 - 7
Postlicensure evaluation of the effectiveness of seven valent pneumococcal conjugate vaccine; Black SB et al.; OBJECTIVE: To evaluate the impact of the introduction and routine use of seven valent pneumococcal conjugate vaccine on the epidemiology of invasive pneumococcal disease within the Northern California Kaiser Permanente (KP) population . METHODS: Surveillance for invasive pneumococcal disease has been in place within KP since 1995 . Isolates from normally sterile sites in children are routinely sent for serotyping . Cases of invasive disease are identified through review of automated microbiology records within KP . Incidence rates of invasive disease were compared for the period before and after routine use of pneumococcal conjugate vaccine in children . RESULTS: The incidence of invasive pneumococcal disease caused by vaccine serotypes before the licensure and routine use of pneumococcal conjugate vaccine ranged between 51.52 and 98.15 cases per 100 000 person years in children <1 year of age and fell to 9.35 after introduction of vaccine . The incidence in children <2 years of age was 81.67 to 113.80 before introduction and 38.22 cases per 100 000 person years after introduction of the vaccine into the general population . These reductions in disease rates exceeded the average vaccine coverage substantially in each age group . No increase in disease incidence was observed for possibly cross-reacting serotypes or nonvaccine serotypes . CONCLUSION: The introduction and routine use of pneumococcal conjugate vaccine in our population have been associated with a substantial reduction in invasive disease incidence in children <5 years of age.

Pediatr Infect Dis J, 2001 Nov, 20(11), 1049 - 54
Safety of neonatal hepatitis B vaccine administration; Lewis E et al.; OBJECTIVE: To determine whether hepatitis B vaccination of newborns increases the incidence of fever and/or suspected sepsis . METHODS: A prospective clinical study was undertaken at the Kaiser Permanente San Francisco Medical Center involving normal full term newborns born between November 1, 1991, and April 30, 1994 . During this time 3302 infants were vaccinated within 21 days of birth with hepatitis B vaccine, and 2353 were not . Clinical and demographic data were collected from Kaiser Permanente's existing clinical information systems, and laboratory data for blood and cerebrospinal fluid (CSF) cultures were obtained from the comprehensive automated regional laboratory reporting system . RESULTS: There were no significant differences between vaccinated and unvaccinated newborns in the proportion of infants who received care for fever (0.8% vaccinated and 1.1% unvaccinated, P = 0.28), allergic reactions, seizures or other neurologic events in the first 21 days of life . Vaccinated newborns were significantly less likely to undergo microbiologic evaluation for possible sepsis . Among vaccinated newborns 4.0% had blood cultures and 1.6% had CSF cultures . Among infants who were not vaccinated 8.3% had blood cultures and 1.6% had CSF cultures (P <0.001 for both tests) . CONCLUSION: This study found no evidence that newborn hepatitis B vaccination is associated with an increase in the number of febrile episodes, sepsis evaluations or allergic or neurologic events . In addition our data did not support any increase in medical procedures attributed to receipt of hepatitis B vaccine.

Gene, 2001 Nov 28, 279(2), 127 - 35
TaCRK3 encodes a novel Theileria annulata protein kinase with motifs characteristic of the family of eukaryotic cyclin dependent kinases: a comparative analysis of its expression with TaCRK2 during the parasite life cycle; Kinnaird J et al.; The TaCRK3 gene from the bovine apicomplexan parasite Theileria annulata, encodes a 46 kDa polypeptide with strong homology to the eukaryotic family of cyclin-dependent kinases . TaCRK3 does not show significant alignment with any particular CDK group, other than the Pfmrk kinases from the related apicomplexans Plasmodium falciparum and Plasmodium yoelii . It has a putative bipartite nuclear localization signal and is located to parasite nuclei by IFAT . Protein levels are constitutive throughout differentiation of the intra-lymphocytic macroschizont . This contrasts with the expression pattern of TaCRK2 (Kinnaird et al., 1996, Mol . Microbiol., 22, 293-302) which is closely related to the eukaryotic CDK1 /2 families involved in regulation of cell cycle progression . TaCRK2 is also located to the parasite nuclei but has no nuclear localization signal and exhibits transient up-regulation in protein levels during mid-merogony . However compared to TaCRK3, it shows down-regulation near the end of merogony . We predict that TaCRK3 may have a role in regulation of gene transcription while TaCRK2 is more likely to be involved in control of parasite nuclear division.

J Child Neurol, 2001 Nov, 16(11), 858 - 62
Congenital hydranencephalic-hydrocephalic syndrome with proliferative vasculopathy: a possible relation with mitochondrial dysfunction; Castro-Gago M et al.; We report the case of a fetus aborted at gestation week 20 because of hydranencephalic-hydrocephalic syndrome . The fetus was the third pregnancy of a nonconsanguineous couple whose first child exhibited congenital hydranencephalic-hydrocephalic syndrome associated with muscle histology findings consistent with mitochondrial cytopathy and deficiency of complexes III and IV of the respiratory chain and whose second pregnancy had terminated in an elective abortion on detection of progressive hydrocephalus at gestation week 19 . The third pregnancy had a normal course according to obstetric and ultrasonography examinations performed at gestation weeks 5, 10, and 15, and negative results were obtained in standard serologic and polymerase chain reaction (PCR) tests for prenatal infections of the mother . However, the ultrasonography examination at gestation week 18 revealed hydrocephalus, in response to which the parents requested an abortion, which was performed at gestation week 20; the fetus was male and with no evident external malformations . Histopathologic studies of the brain and medulla oblongata revealed proliferative vasculopathy (glomeruloid vessels, intracytoplasmic inclusions, and microcalcifications) and intracytoplasmic inclusions in the voluntary muscle . Microbiologic and PCR tests of hepatic and spleen tissue were negative for prenatal infections . In view of the precedent of a sister with mitochondrial dysfunction, these findings raise the pos sibility that at least some cases of familial syndrome of congenital hydranencephalic-hydrocephalic syndrome with proliferative vasculopathy can be attributed to alterations in the mitochondrial respiratory chain.

Arch Immunol Ther Exp (Warsz), 1999, 47(1), 25 - 32
Koch's postulates and autoimmunity: an opposing viewpoint; Putterman C et al.; Autoimmunity is characterized as a state of abnormal specific humoral and cell-mediated responses against constituents of body tissues . One time-honored approach to explaining the pathogenesis of autoimmunity has been application of the Koch's postulates, on loan from the field of microbiology suggesting that autoantibodies and/or autoreactive T cells are the presumed "pathogens" of autoimmunity, and that passive transfer of these autoimmune factors to susceptible animals will result in the induction of the autoimmune disease . We suggest that autoimmunity is not in many cases due to the presence of factors leading to the autoimmune response in those susceptible . Instead, it is the lack of a factor which leads to the development of autoimmunity, a factor (cytokine, protein, gene, etc.) which is present in the healthy individual and normally protects in from disordered immune regulation . We propose to direct more research into therapeutic modulation of autoimmunity by administration of putative "protective factors", rather than by attempts to depress or remove autoreactive cells and antibodies from the autoimmune.

Teach Learn Med, 2001 Fall, 13(4), 253 - 7
Learning styles and perceptions of the value of various learning modalities before and after a 2nd-year course in microbiology and infectious diseases; Engleberg NC et al.; BACKGROUND: The authors' 4-week course in microbiology and infectious diseases consists of lectures, small-group sessions, interactive computer-assisted learning (CAL), and textbook readings . PURPOSE: To determine how individual learning style influenced learners' value assessment of these teaching modalities . METHODS: A Kolb Learning Style Inventory and questionnaire to assess enthusiasm for each teaching modality were administered before the course . At course end, a 2nd questionnaire assessed the perceived usefulness of each teaching modality . RESULTS: Learners with a relative preference for experiential learning rather than abstraction initially favored small groups (R2 = .06, p = .004) and CAL (R2 = .06, p = .005) . Similarly, learners with a preference for reflective observation rather than active experimentation favored lectures (R2 = .05, p = .01) . However, at course end, Kolb learning style did not predict the value assessment of any modality . CONCLUSIONS: Kolb learning style influenced the initial attractiveness but not the retrospective assessment of learning modalities; hence, quality and content superseded learning style as determinants of value after course completion.

J Appl Microbiol, 2001 Nov, 91(5), 929 - 32
The recovery of Arcobacter butzleri NCTC 12481 from various temperature treatments; Hilton CL et al.; AIMS: The aim of this study was to determine the growth and survival characteristics for Arcobacter butzleri NCTC 12481 . METHODS AND RESULTS: The temperature and pH growth ranges were 15-39 degrees C and pH 6.0-8.0, as determined using impedance microbiology . The maximum specific growth rate was 00.57 h(-1) at 30 degrees C, pH 7.0 . Arcobacter butzleri harvested from the exponential phase was more resistant to heat treatment than stationary phase cells (D55 1.1 and 0.4 min, respectively) . Fluorescent dye uptake, and the release of UV-absorbing material, increased in heat-treated cells . After 21 d storage at 4 and -20 degrees C, A . butzleri was recovered on blood agar, but not on the isolation media CAT or CCDA . CONCLUSION: Arcobacter butzleri cells from the exponential phase were less heat sensitive than those from the stationary phase . The organism was able to survive cold storage for at least 3 weeks . SIGNIFICANCE AND IMPACT OF THE STUDY: The growth and survival characteristics have been quantified thus providing a greater understanding of this newly emerging pathogen.

Intern Med J, 2001 Nov, 31(8), 462 - 9
What do physicians think about evidence-based antibiotic use in critical care? A survey of Australian intensivists and infectious disease practitioners; Sintchenko V et al.; BACKGROUND: The analysis of factors that influence prescribing decisions is increasingly important . Antibiotic use is often based on limited evidence and lack of information about clinical decision-making processes is an important obstacle to improving antibiotic utilization . AIMS: To compare the attitudes of intensive care unit practitioners (ICUP) and infectious disease practitioners (IDP) to antibiotic use and to the evidence-based information support . METHOD: A postal survey conducted between March and July 2000 of ICUP and IDP representing all States and Territories in Australia . RESULTS: One hundred and fifty-three of 224 clinicians returned the questionnaire (68.3% response rate) . In choosing an antibiotic, IDP placed significantly more weight than ICUP on the in vitro susceptibility of the pathogen (P = 0.001), antibiotic cost (P = 0.05) and possible development of antibiotic resistance (P = 0.007) . More than 95% of both groups believed that unit-specific antibiotic susceptibility of endemic pathogens was an essential factor in rational prescribing, but only 68.5% of IDP and 38.7% of ICUP use microbiology laboratory databases . When in doubt about appropriate antibiotic use, 63.8% of ICUP seek and 76.3% usually follow the advice of IDP . Both groups agree that published antibiotic guidelines are useful, but IDP were more likely to consult them . ICUP were more likely to believe that guidelines are used to control clinicians rather than to improve quality of care (P = 0.001) . A greater proportion of IDP (71.2%) than ICUP (52.5%) believed that antibiotic prescribing in their intensive care unit (ICU) was evidence based but most (91.8% and 86.9%, respectively) agreed that it should be . CONCLUSIONS: Australian clinicians have positive views about evidence-based prescribing and antibiotic guidelines . However, there are clinically significant differences in prescribing behaviour between ICUP and IDP . These may be explained by different disease spectra managed by each group or different cultures, training and/or cognitive styles . Improvements in the understanding of physicians' information and decision support needs are required to strengthen evidence-based prescribing.

J Am Diet Assoc, 2001 Nov, 101(11), 1326 - 39
Identification and classification of consumer food-handling behaviors for food safety education; Medeiros LC et al.; OBJECTIVE: To identify key behaviors associated with major food safety pathogen control factors . DESIGN: World Wide Web-based descriptive study with 4 tasks: compile a list of food-handling behaviors from the literature; use Delphi process to build consensus, rank order, and edit lists of behaviors; assess content and construct validity; and review results of Delphi process at a summit meeting of selected experts to make final recommendations for a food safety behavior list . SUBJECTS/SETTING: A convenience sample of 10 epidemiologists, 11 food microbiologists, 10 food safety educators, and 10 food safety policy makers was recruited from lists of nationally known experts . Twenty-four experts completed 4 rounds of surveys presented to them via a Web site . Six experts attended a face-to-face meeting to finalize behavior lists . Statistical analyses performed Descriptive statistics and sum of observation data were used to determine rank order and validity . RESULTS: Twenty-nine key food-handling behaviors for maintaining the safety of food and reducing the number of cases and outbreaks of foodborne illness were identified . These were rank-ordered within 5 pathogen control factors: practice personal hygiene, cook foods adequately, avoid cross-contamination, keep foods at safe temperatures, and avoid foods from unsafe sources . APPLICATIONS/CONCLUSIONS: This list of rank-ordered behaviors grouped by pathogen control factor should help dietitians and educators confidently teach food safety guidance that will be most effective in preventing illness.

An Med Interna, 2001 Sep, 18(9), 473 - 8
{Pyogenic liver abscesses of cryptogenic origin}; Alvarez Perez JA et al.; OBJECTIVE: To analyze and clarify the clinical behaviour and outcome of patients with pyogenic liver abscess of cryptogenic origin and, moreover, to observe if there are any differential characteristics in relation to those found in patients with a known pathogenesis . MATERIAL AND METHODS: Multicenter and retrospective study of two groups of patients diagnosed of pyogenic liver abscess, during a period of 13 years . Group 1: 34 cases with abscess of cryptogenic origin and Group 2: 99 patients with a known pathogenesis . Clinical, laboratory, and microbiologic data, morphology and topography of the lesions, treatment and outcome were assessed and compared in both groups . RESULTS: The duration of symptomatology was higher in Group 1 (9.4 +/- 6.5 vs 8.1 +/- 4.4 days; p = 0.05) . Although, in this category of patients, it was also observed a lower frequency of jaundice (6 vs 26%; p = 0.02) and lower level of bilirubinemia (0.9 +/- 0.9 vs 2.6 +/- 4.4 mg/dl; p = 0.05), the majority of clinical and laboratory data were similar in both groups . The rate of patients with abscesses on the left lobe (26% vs 12%; p = 0.04) was higher in Group 1 . The therapeutic modality carried out in the two groups was not significantly different, neither were hospital stay, and morbidity and mortality rates . CONCLUSIONS: The patients with pyogenic liver abscesses of cryptogenic origin present few specific clinical characteristics which facilitate the diagnosis . Besides, their outcome was no significantly different from that found in patients with abscesses of known pathogenesis.

J Public Health Manag Pract, 2001 Nov, 7(6), 60 - 6
Electronic laboratory reporting: barriers, solutions and findings; Overhage JM et al.; Electronic laboratory reporting can improve surveillance for notifiable conditions . Building on standards for message structure and content, we have implemented an electronic laboratory reporting system by building on the infrastructure created for the Indiana Network for Patient Care (INPC) . The system has proven reliable in delivering results and scalable to multiple laboratories over 36 months of use . In April 2000, the system identified over 1,000 cases of notifiable conditions from the laboratories at four different laboratories . Our experience in developing the system has highlighted the need for improved compliance with HL7 result message formats by the laboratory information systems and more structured reporting of results for tests such as microbiology including consistent use of the abnormal flag.

J Am Acad Dermatol, 2001 Dec, 45(6), 930 - 3
Hyaluronic acid skin fillers: adverse reactions and skin testing; Lowe NJ et al.; BACKGROUND: Hyaluronic acid (HA) fillers have been proposed as alternatives to other temporary skin fillers, such as bovine collagen, for treating facial skin lines and for providing lip augmentation . Several types of commercial HA fillers are now available in many countries . They include Restylane, which is produced by microbiologic engineering techniques, and Hylaform, which is HA extract derived from rooster combs . They have been approved for use in several countries, but not currently in the United States . There are no recommendations to perform pretreatment skin testing by the manufacturers . OBJECTIVE: Our purpose is to describe and comment on our experiences with Hylaform and Restylane fillers . Observation of any side effects and skin testing results were documented . METHODS: Between September 1996 and September 2000, 709 patients were treated with Hylaform and Restylane and were followed up clinically for at least 1 year . Three of these patients (0.42%) developed delayed skin reactions . Three other patients were referred for evaluation of their skin reactions from other practitioners . Five of these 6 patients agreed to skin testing of their forearms . RESULTS: In the 5 patients tested, challenge intradermal skin testing was positive in 4 patients; the reactions started approximately 8 weeks after injection . CONCLUSIONS: There was a slight incidence of delayed inflammatory skin reactions to two HA fillers . Both of these reactions occurred after the first and repeat injections . Challenge skin testing was positive in 4 of 5 tested patients.

Clin Nucl Med, 2001 Dec, 26(12), 1016 - 21
Comparison of Tc-99m methylene diphosphonate, Tc-99m human immune globulin, and Tc-99m-labeled white blood cell scintigraphy in the diabetic foot; Unal SN et al.; PURPOSE: The aims of this prospective study were to evaluate the contribution of Tc-99m methylene diphosphonate (MDP), Tc-99m human immune globulin (HIG), and Tc-99m white blood cell (WBC) to the diagnosis of osteomyelitis in the diabetic foot and to evaluate the surgical or medical therapy with Tc-99m HIG and Tc-99m WBC scans . METHODS: Twenty patients (15 men, 5 women) with suspected pedal osteomyelitis were included in the study . All patients had type II diabetics . Three- and four-phase bone scintigraphy (3P-MDP, 4P-MDP), early (e) and late (l) HIG, and WBC scans were completed within 1 week in all patients . The lesion-to-background ratios were calculated for early and late images of the feet for all scans and named as the indices . Eight weeks after the end of medical or surgical therapy, Tc-99m HIG and Tc-99m WBC scans were repeated in 10 patients . The difference in indices between 3P-MDP and 4P-MDP for osteomyelitis and indices for osteomyelitis, cellulitis, and inflammation in Tc-99m HIG and Tc-99m WBC in early and late scans were tested for significance . RESULTS: In 20 patients, 53 lesions were investigated . Among these 53 lesions were 25 sites of proved osteomyelitis, 6 sites of cellulitis, and 22 sites of inflammation confirmed by radiography, microbiologic culture, and clinical evaluation . 4P-MDP was more specific than 3P-MDP for detecting osteomyelitis (50% and 67%, respectively) . There was also a significant difference between the mean indices of 3P-MDP and 4P-MDP (P < 0.000) . The index values were increased in 4P-MDP scans . There was no significant difference between the indices of early and late Tc-99m HIG scans for inflammation, cellulitis, and osteomyelitis . Early and late Tc-99m WBC scans did not show a significant difference in differentiating osteomyelitis . However, Tc-99m WBC scans could differentiate aseptic inflammation from infection (P < 0.031) in early and late scans . There was a significant difference of index values between pre- and post-treatment Tc-99m HIG and Tc-99m WBC scans . The best combination of scans for detecting osteomyelitis was 4P-MDP with WBC scans, with an accuracy rate of 92% . CONCLUSIONS: These results show that four-phase bone scintigraphy with early Tc-99m WBC scanning is preferred for detecting osteomyelitis of the diabetic foot . To evaluate the response to therapy, Tc-99m WBC scans are the preferred method, but if this is not available, Tc-99m HIG scanning can be used.

Nippon Ishinkin Gakkai Zasshi, 2001, 42(4), 220 - 2
{A Case of central venous catheter-related infection with Malassezia sympodialis}; Kikuchi K et al.; We report a 63-year-old male with central venous catheter-related infection caused by Malassezia sympodialis after total gastrectomy for a gastric cancer . He had fever and his leukocyte counts and C-reactive protein were elevated 14 days after his operation . After his central venous hyperalimentation catheter was removed, the inflammatory signs immediately disappeared, suggesting an intravenous catheter-related infection . A yeast-like fungus was cultured in brain-heart infection semi-solid agar ten days later, and was diagnosed morphologically as Malassezia sp . This strain was identified as M . sympodialis by Tween assimilation test and was confirmed by whole-sequence of internal transcribed spacer 1 regions (ITS1) . This is the first report of catheter-related infection caused by M . sympodialis . This strain grew and was subcultured on CHROMagar Candida, potato dextrose agar and Sabouraud agar . There have been no reports of such a lipid-independent Malassezia sp . except for M . pachydermatis . The mechanism of lipid independence of this strain is undetermined and future work is needed . Malassezia sp . is receiving increased attention as an etiologic pathogen of catheter-related fungemia in clinical microbiology laboratories and infectious disease sections.

Infect Control Hosp Epidemiol, 2001 Aug, 22(8), 499 - 504
Etiology of fever and opportunities for reduction of antibiotic use in a pediatric intensive care unit; Toltzis P et al.; OBJECTIVE: To determine the cause of fever in critically ill children and to identify opportunities for reducing antibiotic use in this population . DESIGN: Prospective case series . SETTING: A tertiary-care medical-surgical pediatric intensive care unit (PICU) . PATlENTS: Children admitted to the PICU who experienced fever (axillary temperature >38.3 degrees C) . MEASUREMENTS: Consecutive children who were febrile at any point in their PICU stay were investigated over two winter seasons . Etiology of the fever was determined by physical examination and routine microbiology and radiographic tests . Three subgroups were reviewed to approximate the number of antibiotic-days that could have been reduced; namely, those with an indeterminate source, those with a documented viral infection, and those receiving a prolonged course of antibiotics . A set of standards reflecting common antibiotic use then was applied to these three patient groups . RESULTS: Of 211 subjects, the majority (83.3%) had either a definitive or suspected focus for their fever, and nearly all of these patients were judged to have an infectious etiology . The study population received a total of 2,036 antibiotic-days . Despite the high incidence of infectious causes of fever in our subjects, however, approximately 15% of total antibiotic-days could have been reduced by applying common-use standards . CONCLUSIONS: Fever in the PICU was usually of defined focus and infectious in origin . However, among febrile patients in the PICU, substantial opportunity exists for reduction of antibiotic use . Trials determining the safety of antibiotic reduction in this population should be pursued vigorously.

J Bacteriol, 2001 Dec, 183(23), 6832 - 40
Membrane-associated quinoprotein formaldehyde dehydrogenase from Methylococcus capsulatus Bath; Zahn JA et al.; A membrane-associated, dye-linked formaldehyde dehydrogenase (DL-FalDH) was isolated from the obligate methylotroph Methylococcus capsulatus Bath . The enzyme was the major formaldehyde-oxidizing enzyme in cells cultured in high (above 1 micromol of Cu per mg of cell protein) copper medium and expressing the membrane-associated methane monooxygenase . Soluble NAD(P)(+)-linked formaldehyde oxidation was the major activity in cells cultured in low-copper medium and expressing the soluble methane monooxygenase (Tate and Dalton, Microbiology 145:159-167, 1999; Vorholt et al., J . Bacteriol . 180:5351-5356, 1998) . The membrane-associated enzyme is a homotetramer with a subunit molecular mass of 49,500 Da . UV-visible absorption, electron paramagnetic resonance, and electrospray mass spectrometry suggest the redox cofactor of the DL-FalDH is pyrroloquinoline quinone (PQQ), with a PQQ-to-subunit stochiometry of approximately 1:1 . The enzyme was specific for formaldehyde, oxidizing formaldehyde to formate, and utilized the cytochrome b(559/569) complex as the physiological electron acceptor.

Arch Biochem Biophys, 2001 Nov 15, 395(2), 137 - 45
Hypochlorite- and hypobromite-mediated radical formation and its role in cell lysis; Hawkins CL et al.; Activated leukocytes generate the potent oxidants HOCl and HOBr via the formation of H(2)O(2) and the release of peroxidase enzymes (myeloperoxidase, eosinophil peroxidase) . HOCl and HOBr are potent microbiocidal agents, but excessive or misplaced production can cause tissue damage and cell lysis . In this study it is shown that HOBr induces red blood cell lysis at approximately 10-fold lower concentrations than HOCl, whereas with monocyte (THP1) and macrophage (J774) cells HOCl and HOBr induce lysis at similar concentrations . The role of radical formation during lysis has been investigated by EPR spin trapping, and it is shown that reaction of both oxidants with each cell type generates cell-derived radicals . Red blood cells exposed to nonlytic doses of HOCl generate novel nitrogen-centered radicals whose formation is GSH dependent . In contrast, HOBr gives rise to nitrogen-centered, membrane-derived protein radicals . With lytic doses of either oxidant, protein (probably hemoglobin)-derived, nitrogen-centered radicals are observed . Unlike the red blood cells, treatment of monocytes and macrophages with HOCl gives significant radical formation only under conditions where cell lysis occurs concurrently . These radicals are nitrogen-centered, cell-protein-derived species and have parameters identical to those detected with red blood cells and HOBr . Exposure of these cells to HOBr did not give detectable radicals . Overall these experiments demonstrate that HOCl and HOBr react with different selectivity with cellular targets, and that this can result in radical formation . This radical generation can precede, and may play a role in, cell lysis .

Ther Umsch, 2001 Oct, 58(10), 604 - 8
{Pleural effusion in pneumonia}; Schaberg T; Parapneumonic effusions are frequent (40%) but normally no clinical problem . If a parapneumonic effusion is seen on chest X-ray or by ultrasonic investigation, a thoracocentesis should be done whenever possible without risk . Investigations of the pleural fluid should include: aspect, pH-value, protein, glucose, microbiology (gram stain and culture, and cytology . Based on the extent of the effusion, the finding of free floating or loculated effusion and the results of pleura fluid investigation patients could be categorized in four risk groups . Very low and low risk for poor outcome is normally characterized by a small or moderately free floating effusion, clear pleural fluid and a pH > 7.2 . In these risk groups no further intervention seems to be necessary . For patients with moderate or high risk (pus, large effusion (> 1/2 hemithorax), loculated effusion, pH < 7.2 a drainage therapy is recommended . For larger parapneumonic effusions and for complicated parapneumonic free floating effusion tube drainage therapy seems to be sufficient . However, for empyema or large lobulated effusions video-assisted thoracoscopy surgery followed by local fibrinolytic treatment might produce the best results.

Arch Dermatol Res, 2001 Aug, 293(8), 414 - 9
Malassezia furfur invasiveness in a keratinocyte cell line (HaCat): effects on cytoskeleton and on adhesion molecule and cytokine expression; Baroni A et al.; The lipophilic yeast Malassezia furfur is a member of the cutaneous microbiota, also associated with several chronic diseases such as pityriasis versicolor, folliculitis, seborrhoeic dermatitis, and some forms of atopic dermatitis, psoriasis and confluent and reticulate papillomatosis . In this study we determined the immunomodulatory and invasive capacity of M . furfur in a human keratinocyte cell culture, HaCat . At a yeast cell to HaCat ratio of 30:1, M . furfur penetration was only 30% with poor phagolysosome fusion and with cytoskeleton modification . Transglutaminase I gene expression was also inhibited, supporting the hypothesis that M . furfur causes an initial break in the barrier function of the epidermis . Moreover, we demonstrated that M . furfur modulates proinflammatory and immunomodulatory cytokine synthesis by downregulating IL-1alpha and by inhibiting IL-6 and TNF-alpha and by upregulating IL-10 and TGF-beta1 . The suppressed inflammatory response induced by M . furfur may play a role in chronic disease.

Res Microbiol, 2001 Oct, 152(8), 707 - 16
Quantitative and qualitative microscale distribution of bacteria in soil; Ranjard L et al.; Soil structure represents a mosaic of microenvironments differing in their physical, chemical and biological properties . At a microscale level, such structural organisation consequently provides different habitats in which indigenous bacteria are heterogenously distributed . This review provides an overview of the methodologies useful to microbiologists for assessing spatial distribution of bacteria in soil, and quantitative and qualitative bacterial distribution for determining the preferential location of bacteria and the definition of "favourable" habitats.

Res Microbiol, 2001 Oct, 152(8), 697 - 705
The interface between microbiology and structural biology as viewed by nuclear magnetic resonance; Delepierre M et al.; Nuclear magnetic resonance (NMR) spectroscopy is one of two principal experimental techniques used in structural biology . It can be used to determine structures at atomic resolution and to investigate the dynamics of macromolecules and intermolecular interactions . We aim to give an overview of the use of modern high resolution NMR methodology in microbiology.

J Clin Microbiol, 2001 Nov, 39(11), 4026 - 31
Analysis of bacterial vaginosis-related amines in vaginal fluid by gas chromatography and mass spectrometry; Wolrath H et al.; The presence of various amines in vaginal fluid from women with malodorous vaginal discharge has been reported before . The investigations have used several techniques to identify the amines . However, an optimized quantification, together with a sensitive analysis method in connection with a diagnostic procedure for vaginal discharge, including the syndrome of bacterial vaginosis, as defined by the accepted "gold standard," has not been done before . We now report a sensitive gas chromatographic and mass spectrometric method for identifying the amines isobutylamine, phenethylamine, putrescine, cadaverine, and tyramine in vaginal fluid . We used weighted samples of vaginal fluid to obtain a correct quantification . In addition, a proper diagnosis was obtained using Gram-stained smears of the vaginal fluid that were Nugent scored according to the method of Nugent et al . (R . P . Nugent et al., J . Clin . Microbiol., 29:297-301, 1991) . We found that putrescine, cadaverine, and tyramine occurred in high concentrations in vaginal fluid from 24 women with Nugent scores between 7 and 10 . These amines either were not found or were found only in very low concentrations in vaginal fluid from women with Nugent scores of 0 to 3 . There is a strong correlation between bacterial vaginosis and the presence of putrescine, cadaverine, and tyramine in high concentrations in vaginal fluid.

J Clin Microbiol, 2001 Nov, 39(11), 3883 - 8
Luciferase reporter mycobacteriophages for detection, identification, and antibiotic susceptibility testing of Mycobacterium tuberculosis in Mexico; Banaiee N et al.; The utility of luciferase reporter mycobacteriophages (LRPs) for detection, identification, and antibiotic susceptibility testing of Mycobacterium tuberculosis was prospectively evaluated in a clinical microbiology laboratory in Mexico City, Mexico . Five hundred twenty-three consecutive sputum samples submitted to the laboratory during a 5-month period were included in this study . These specimens were cultivated in Middlebrook 7H9 (MADC), MGIT, and Lowenstein-Jensen (LJ) media . Of the 71 mycobacterial isolates recovered with any of the three media, 76% were detected with the LRPs, 97% were detected with the MGIT 960 method, and 90% were detected with LJ medium . When contaminated specimens were excluded from the analysis, the LRPs detected 92% (54 of 59) of the cultures . The median time to detection of bacteria was 7 days with both the LRPs and the MGIT 960 method . LRP detection of growth in the presence of p-nitro-alpha-acetylamino-beta-hydroxypropiophenone (NAP) was used for selective identification of M . tuberculosis complex (MTC) and compared to identification with BACTEC 460 . Using the LRP NAP test, 47 (94%) out of 50 isolates were correctly identified as tuberculosis complex . The accuracy and speed of LRP antibiotic susceptibility testing with rifampin, streptomycin, isoniazid, and ethambutol were compared to those of the BACTEC 460 method, and discrepant results were checked by the conventional proportion method . In total, 50 MTC isolates were tested . The overall agreement between the LRP and BACTEC 460 results was 98.5% . The median LRP-based susceptibility turnaround time was 2 days (range, 2 to 4 days) compared to 10.5 days (range, 7 to 16 days) by the BACTEC 460 method . Phage resistance was not detected in any of the 243 MTC isolates tested . Mycobacteriophage-based approaches to tuberculosis diagnostics can be implemented in clinical laboratories with sensitivity, specificity, and rapidity that compare favorably with those of the MGIT 960 and BACTEC 460 methods . The phages currently provide the fastest phenotypic assay for susceptibility testing.

Rev Med Chil, 2001 Aug, 129(8), 905 - 10
{Intravenous multi vitamin formulation to use in pediatric total parenteral nutrition}; Carreno P et al.; BACKGROUND: No intravenous multivitamin formulation is available at the Chilean market that fulfills the requirements of pediatric patients on total parenteral nutrition . Therefore, adult formulations must be used . AIM: To prepare a parenteral aqueous multivitamin solution, to be used in pediatric patients . MATERIAL AND METHODS: The solution was prepared, mixing vitamins according to their stability and compatibility, in a horizontal laminar flow hood . The quality control for this formulation at times zero and 30 days consisted of an organoleptic analysis, microbiologic and pyrogen controls and vitamin quantification . In addition, the effect of vitamin solution incorporation on the stability of total parenteral nutrition formulae was evaluated . The approximated production cost was calculated . RESULTS: The ampoules did not show changes on the organoleptic characteristics . No bacterial contamination or pyrogens were detected . Total parenteral nutrition solutions were not modified after the incorporation of the vitamins . The vitamin solution was stable for one month at 4 degrees C . CONCLUSIONS: The manufacture of this formulation results in significant savings, because it has a low manufacturing cost and fulfills pediatric requirements.

Biotechniques, 2001 Oct, 31(4), 856 - 8, 860
Microarray RNA quantification assay for large-scale nanosamples analysis; Dupre I et al.; We have developed a convenient and sensitive method for the quantification of RNA in samples from microbiopsies . This procedure is especially suitable for quantitating very small amounts of RNA in large-scale biological samples . This method, using a microarray-spotting facility for the study of multigenic expression, entails the hybridization of a DNA probe with RNA spotted at high density on nylon membrane . Furthermore, with this procedure, the reproducibility, sensitivity, and accuracy of the assay are notably improved as compared to current methods.

J Infect, 2001 Aug, 43(2), 104 - 10
Preparedness and response to bioterrorism; Spencer RC et al.; As we enter the 21st century the threats of biological warfare and bioterrorism (so called asymmetric threats) appear to be more real than ever before . Historical evidence suggests that biological weapons have been used, with varying degrees of success, for many centuries . Despite the international agreements to ban such weapons, namely the 1925 Geneva Protocol and the 1975 Biological and Toxin Weapons Convention, there is no effective international mechanism for challenging either the development of biological weapons or their use . Advances in technology and the rise of fundamentalist terror groups combine to present a significant threat to western democracies . A timely and definitive response to this threat will require co-operation between governments on a scale never seen before . There is a need for proper planning, good communication between various health, home office, defence and intelligence agencies and sufficient financial support for a realistic state of preparedness . The Department of Health has produced guidelines for responding to real or suspected incidents and the Public Health Laboratory Service (PHLS) has produced detailed protocols to inform the actions required by microbiologists and consultants in communicable disease control . These protocols will be published on the Department of Health and PHLS web sites .

J Bacteriol, 2001 Nov, 183(22), 6630 - 5
Escherichia coli division inhibitor MinCD blocks septation by preventing Z-ring formation; Pichoff S et al.; The min system spatially regulates division through the topological regulation of MinCD, an inhibitor of cell division . MinCD was previously shown to inhibit division by preventing assembly of the Z ring (E . Bi and J . Lutkenhaus, J . Bacteriol . 175:1118-1125, 1993); however, this was questioned in a recent report (S . S . Justice, J . Garcia-Lara, and L . I . Rothfield, Mol . Microbiol . 37:410-423, 2000) which indicated that MinCD acted after Z-ring formation and prevented the recruitment of FtsA to the Z ring . This discrepancy was due in part to alternative fixation conditions . We have therefore reinvestigated the action of MinCD and avoided fixation by using green fluorescent protein (GFP) fusions to division proteins . MinCD prevented the localization of both FtsZ-GFP and ZipA-GFP, consistent with it preventing Z-ring assembly . Consistent with a direct interaction between FtsZ and the MinCD inhibitor, we find that increased FtsZ, but not FtsA, suppresses MinCD-induced lethality . Furthermore, strains carrying various alleles of ftsZ, selected on the basis of resistance to the inhibitor SulA, displayed variable resistance to MinCD . These results are consistent with FtsZ as the target of MinCD and confirm that this inhibitor prevents Z-ring assembly.

Am J Respir Crit Care Med, 2001 Oct 1, 164(7), 1209 - 12
Inhaled corticosteroids and the treatment of lymphocytic bronchiolitis following lung transplantation; De Soyza A et al.; Airway rejection after lung transplantation is recognized histologically as lymphocytic bronchiolitis (LB) . We hypothesized that inhaled steroids could control LB and that changes in exhaled nitric oxide (eNO) would correlate with the development of LB and also have a role in monitoring response to treatment . A cohort of 120 lung transplant (LT) recipients attending for review and biopsy had eNO measurements, FEV1, lavage microbiology, and biopsy histology performed prospectively . Wilcoxon signed-rank test was used to assess the significance of changes in eNO and FEV1 . The coefficient of reproducibility of eNO measurement in stable recipients was 2.36 ppb . Fourteen developed graft dysfunction owing to isolated LB and were treated with inhaled budesonide 800 microg twice daily . They showed significant increases in eNO at diagnosis, median (range) 10.9 ppb (4.6 to 48) ppb compared with baseline, 4.33 (1.0 to 10.76), p = 0.008, and a decrease in FEV1 . After inhaled treatment, both eNO and FEV1 returned to baseline values . Seven developed acute vascular rejection (with or without LB) and were treated with oral corticosteroids; no changes in eNO occurred at diagnosis or after treatment . Serial eNO measurements provide a useful noninvasive method of identifying airway inflammation in LT recipients . Inhaled budesonide may be a useful addition to systemic immunosuppressants in controlling airway inflammation posttransplant.

Indian J Med Sci, 2001 May, 55(5), 257 - 62
Seroprevalence of HIV in Manipal; Bairy I et al.; A total of 32,406 persons were screened for HIV 1 and 2 antibodies between 1991 to 1999 by Enzyme Linked Immuno Sorbent Assay at Dept . of Microbiology, KMC, Manipal which is a rural teaching hospital . There was steady increase in seropositivity from 0.38% (1991) to 9.31% (1995) and thereafter there is decrease in the seropositivity rate to 4.15% (1999); but the number of cases screened increased from 1995 onwards . The HIV seropositivity is more in males 7.49% than in females (2.52%) . The male to female positivity ratio is 2.72:1, inspite of the total number of samples screened of either sexes being equal . The prevalence of HIV among STD Clinic attendants was 8.22% . The foci of infection can be traced to cities such as Mumbai and the main mode of transmission is through unprotected heterosexual contact . The decrease in the seropositivity rate from 1996 onwards could be due to the AIDS awareness among public due to the control programmes . More awareness and public education is needed towards healthy sexual practices to avoid fresh HIV cases.

An R Acad Nac Med (Madr), 2001, 118(2), 363 - 76; discussion 376-8
{Viral genotypes in different infective processes}; Maroto Vela C; This lecture includes three sections . Firstly, the concepts of genotype, subtype and quasi-specie are described . The appearance of virus is correlated with the evolution of the medical picture, and their resistance to antiviral agents . Secondly, the most modern genetical and molecular biology techniques, including DNA sequencing are studied . Thirdly, some examples of the investigation lines carried out at the Microbiology Department of the Granada Medicine School are explained, especially regarding to papillomavirus, hepatitis C virus, hepatitis G virus, virus associated to transfusions (TTV) and human immunodeficiency . The great transcendence that the genetical variability has to establish pathogeny and therapy control is emphasized.

Rev Hist Pharm (Paris), 1998, 46(319), 279 - 92
{Philippe Maupas : hepatitis B vaccine discoverer}; Chiron JP et al.; Philippe Maupas Day 8th February 1981, an official ceremony with all the Profession, the Tours Faculty of Pharmacy was called Philippe Maupas, Hepatitis B vaccine discoverer - Galien Prize 1981 . This communication presents the man, the scientist and the teacher . Born on 30th June 1939 in Toulon (south of France), married and the father of two children, Ph . Maupas was a man of action and an humanist . Full of enthusiasm, always available, passionate about his work, he never hesitated to brave the odds if he felt it would be of use to the community . With a pluridisciplinary training - Veterinary Doctor (1965), Pharmacist (1970), Science Doctor (1970) and Physician Doctor (1976) - he was Professor of Microbiology and Dean of the Faculty of Pharmacy of Tours . His scientific career fully illustrates his thirst for knowledge and his unflagging struggle against infectious diseases . Ph . Maupas approached his research work in a relaxed, imaginative frame of mind . Always passionate about his work and fired by spirit of Louis Pasteur, he was moved by a preoccupation of efficacy and a will of prevention in Public Health . He carried out research into both animal and human infectious diseases as well as anthropozoonosis . Ph . Maupas's most remarkable discoveries concerned the hepatitis B virus: he produced the first vaccine against hepatitis B and applied it to the prevention in man of this disease (1976); he confirmed the aetiological link between the hepatitis B and primary liver cancer.

Nord Medicinhist Arsb . 1996;:21-55.
{Periods and milestones in the history of dermatology}; Thyresson N; The history of dermatology may be divided in five periods . The first period, dominated by the humoral doctrine (humoral pathology), extends through the Antiquity, the Middle Ages, the 1600th, 1700th and the major part of the 1800th century . The second period (1775-1840) is characterized by the development of the "dermatological systems" and the third period (1840-1890) by the advances in pathology and microbiology . During the fourth period (1890-1940) dermatology develops into a discipline of medical science . A fifth period started in the middle of the 1940th when the chemotherapeutic and antibiotic drugs and later the glukocorticoids revolutionized dermatological therapy . From this time the advances in especially immunology, genetics, ultrastructural research and molecular biology have also given us a quite new understanding of the pathogenesis of skin diseases.

Uisahak, 1998, 7(1), 99 - 118
{History of the Korean medical journals (1945-1995) - principally on the basic science journals}; Hwang SI et al.; The development of Korean medical journals is summarized as the following: 1) Until the early 1960s there were not basic medical journals except Journal of the Korean Society for Microbiology (first issued in the year of 1958), so researchers of basic medical science had difficulty in publishing their articles . 2) Many of the basic medical journals made their first appearance around the mid-1960s, but the progress was not striking until the mid-1980s . 3) From the mid-1980s most of the journals rapidly developed in the aspect of quality as well as quantity . The increase in the number of issues per year and articles per an issue, and the increment of the articles written in English are remarkably found . The increase in the number of researchers, appropriate education and training, improvement of the research facilities, the growth of research fund, and increment of the international academic exchange are thought to be the main factors of such development . Besides those factors, the devotion of the editors of the journals played the important role.

Zhonghua Yi Shi Za Zhi, 1999 Apr, 29(2), 88 - 90
A brief history of antibiotic science; Dai J et al.; As the greatest achievement in the history of microbiology, the story of antibiotic is an extremely inspired chapter in its history . Like the developmental process of other sciences, antibiotic reveals a history of first accumulating experience, followed by the stage of interpretation of the phenomena as other experimental study . Meantime, there is no end to the discovery of new antibiotics . Currently, the scope and province of antibiotic research is expanding both in its profundity and coverage.

Rev Hist Sci {Paris}, 1997, 50(4), 461 - 79
{The introduction in France, between the two World Wars, of the ideas of American scientific ecology}; Acot P et al.; From the early XIXth century, studies of plant associations in relation to their different environments arose in geobotany, next to classical studies of species distribution . This trend in research was perpetuated and may explain some characteristics of the reception in France of American scientific ecology . Thus, during the interwar years, the Zurich-Montpellier school of phytosociology made possible important progress in bringing to the fore the discontinuities in vegetation . However, it hindered ecological research from the approach of plant associations dynamics, hence to ideas in systems ecology, while works on these subjects were successfully carried out at the same time in the USA . Nevertheless, several researchers (geobotanists, microbiologists or biocoenologists) worked within a conceptual framework that was in harmony with American studies on biotic communities.

Arch Hist Filoz Med, 1996, 59(1), 77 - 84
{Professor Dr Rudolf Weigl (1883-1957) and the activity of his typhus institute in Lvov between 1939 and 1944}; Waszynski E; Rudolf Weigl started his study on typhus fever still in time of the Ist World War, and developed them in 1920 as the member of Military Sanitary committee . The study has been carried out for all period of 20 years between the world Wars . As the greatest achievement of Weigl in field of microbiology there should be recognized the use for the first time a bacterial culture in a living organism, and then production of efficient typhus fever vaccine . Of great importance there was a production of vaccine for succeeding armies occupying Lvov; Soviet and German . Weigl's Institute was a harbour for numerous crowds of educated Poles, who--thanks to being employed at the institute--were protected against repressive measures from German invader . Occasionally the institut was supplying also Polish population with vaccines.

Yakushigaku Zasshi, 1995, 30(2), 75 - 90
{Historical sketch of modern pharmaceutical science and technology (Part 4) . Post World War II 50 years}; Yamakawa K; A short history of the pharmaceutical science and technology, postwar 50 years is divided into nine sections for the purpose of discussion . 1 . Japan's postwar rehabilitation, Japanese pharmaceutical industries and newly developed pharmaceutical sciences and technologies . In 1945, the Japanese pharmaceutical industry was reconstructed . Production of penicillin was carried out with the strong support of the U.S . Occupation Forces . New sciences in pharmacy (biochemistry, biopharmacy, pharmacology, microbiology, physical chemistry, etc.) were introduced in this period . 2 . Introduction age of foreign new drugs and technology (1951 to 1960s) . Japan gained independence in 1951 . Japanese pharmaceutical companies imported many new drugs and new pharmaceutical technologies from the U.S.A . and European countries in this period . Then, these companies were reconstruction rapidly . However, consequently Japanese pharmaceutical companies were formed as an imitation industry . 3 . Rapid economic growth period for pharmaceutical companies (1956 to 1970s) . In this period, many Japanese pharmaceutical companies grew rapidly at an annual rate of 15-20% over a period of 15 years, especially with regard to the production of active vitamin B1 analog drugs and some OTC (public health drugs) . Some major companies made large profits, which were used to construct research facilities . 4 . Problems for the harmful effects of medicines and its ethical responsibility . In the 1970s, many public toxic and harmful effects of medicines were caused, especially SMON's disease . In this time, many pharmaceutical companies changed to its security got development of ethical drugs . 5 . Self development of new drugs and administration of pharmaceutical rules (1970s) . During the 1970s, many pharmaceutical laws (GLP, GCP, GMP, GPMSP etc.) were enacted by the Ministry of Health and Welfare . In 1976, the Japanese Pharmaceutical Affairs Law was revised, which set forth standards regarding the efficacy and safety of ethical drugs and re-evaluation of drugs . Many facilities were built for the purpose of ensuring efficacy and safety, as shwon in Table 1 . 6 . Problems of Intellectual Property and followed the revisionist line of research and development for new ethical drugs . In 1976, Japanese pharmaceutical companies ceased to be an imitation industry, and increased research for the development of new drugs . 7 . Pharmaceutical science and technology innovation (After 1985) . Many of the pharmaceutical innovations during this period were as follows: 7.1) Technology innovation for evaluation of drug efficacy; 7.2) 1st to 3rd medical diagnostic technology innovations; 7.3) medical analytical methods and spectrometry technologies; 7.4) Computer-aided drug-design technology and drug information technology innovation; and 7.5) Drug delivery system and treatment drugs . 8 . Recent research and development of new ethical drugs in Japan (1970 to 1995) . Cephalosporine type beta-lactams (cefazolin, cefametazole, furomoxef, cefdinir), new quinolones (norfloxcin, ofloxacin, tosfloxcin), H1-Blockers (famotidine), Ca-antagonists (diltiazem, nicardipine), and other new drugs (pravastatine, taclolimus, leuprine) etc . came onto the market . 9 . International Harmonization Age and Review toward 21 century . The rapid development and globalization of the pharmaceutical market has promoted international harmonization and rationalization of pharmaceutical regulatory affairs . In 1990, the Japan Pharmaceutical Manufacturers Association published a report toward 21 century, which described practical plans.

Proc Natl Acad Sci U S A, 1990 Aug, 87(15), 5598 - 602
Method for isolation of auxotrophs in the methanogenic archaebacteria: role of the acetyl-CoA pathway of autotrophic CO2 fixation in Methanococcus maripaludis; Ladapo J et al.; A procedure was developed for the enrichment of auxotrophs in the antibiotic-insensitive archaebacterium Methanococcus . After mutagenesis with ethyl methanesulfonate, growing cells were selectively killed upon exposure to the base analogs 6-azauracil and 8-azahypoxanthine for 48 hr . Using this method, eight independent acetate autotrophs of Methanococcus maripaludis were isolated . Six of the auxotrophs had an absolute growth requirement for acetate and contained 1-16% of the wild-type levels of CO dehydrogenase . Three of these six also contained 14-29% of the wild-type levels of pyruvate oxidoreductase and 12-30% of the wild-type levels of pyruvate synthase . Two spontaneous revertants of these latter auxotrophs regained the ability to grow normally in the absence of acetate and wild-type levels of CO dehydrogenase, acetyl-CoA synthase, pyruvate oxidoreductase, and pyruvate synthase . Likewise, a spontaneous revertant of an auxotroph with reduced levels of CO dehydrogenase and wild-type levels of pyruvate oxidoreductase regained the ability to grow normally in the absence of acetate and wild-type levels of CO dehydrogenase and acetyl-CoA synthase . Two additional auxotrophs grew poorly in the absence of acetate but contained wild-type levels of CO dehydrogenase and pyruvate oxidoreductase . These results provide direct genetic evidence for the Ljungdahl-Wood pathway {Ljungdahl, L . G . (1986) Annu . Rev . Microbiol . 40, 415-450; Wood, H . G., Ragsdale, S . W . & Pezacka, E . (1986) Trends Biochem . Sci . 11, 14-18} of autotrophic acetyl-CoA biosynthesis in the methanogenic archaebacteria . Moreover, it suggests that the acetyl-CoA and pyruvate synthases may share a common protein or coenzyme component, be linked genetically, or be regulated by a common system.

Medinfo, 2001, 10(Pt 2), 951 - 5
Bioinformatics in medical practice: what is necessary for a hospital?
Burkle T, Hain T, Hossain H, Dudeck J, Domann E.
Building bioinformatic facilities for a university hospital is pretty similar to using standardized building blocks to construct a house . Starting with the intention to built a dwelling house, a factory or just a shelter the architect draws a construction plan and determines the material to be used . In general, the building is then constructed by the workmen following exactly the plan . However, for particular reasons, minor alterations may be needed to improve the construction of the building . Here we use the metaphor of constructing a "bio-informatics building" to describe the steps needed to support the daily tasks of a university hospital medical microbiology department which uses genomic methods quite extensively for pathogen identification . Today the Giessen "bioinformatics building" is not yet complete but we have been able to lay solid foundations and erect the ground floor which is functional already . Using a combination of standard tools, internet accessible genomic databases and some own software tools we can support genome sequencing from the raw sequence to pathogen identification.

Dtsch Med Wochenschr, 2001 Oct 12, 126(41), 1136 - 8
{Aphthous esophagitis as an atypical manifestation of a primary HIV-infection}; Schmassmann-Suhijar D et al.; HISTORY: A 56-year-old patient from Burkina Faso (Western Africa), living in Switzerland for 12 years, was referred to hospital because of acute onset of severe painful swallowing . He returned from a 3-week visit to his home country 4 weeks prior to admission . CLINICAL FINDINGS AND INVESTIGATIONS: Whereas clinical and radiological findings were normal, routine laboratory testing showed increased parameters of infection . Endoscopy revealed an aphthous esophagitis, suggesting a viral infection . Biopsy confirmed an active erosive esophagitis . Herpes simplex, cytomegalovirus and candida could not be detected in the biopsy specimens (immunohistochemistry, microbiology) and in serum . Both, the anti-HIV screening-test and the Western blot antibody test for HIV-1 and HIV-2 were negative on admission . Because of the persistent suspicion for an underlying HIV Infection, a combined HIV p24-antigen/ antibody-test was performed, showing an indeterminate result . Following PCR-based tests for HIV-RNA on days 5 and 12 showed 86 100 and 103 700 HIV-1 RNA copies/ml plasma, respectively, revealing the diagnosis of primary HIV-1 infection . Subsequent serological testing (WB) finally documented HIV-1 antibody seroconversion, showing indeterminate and positive results on days 5 and 19, respectively . TREATMENT AND COURSE: Within 5 days all signs of infection returned to normal and as documented by endoscopy on day 12, the esophagitis healed up spontaneously . As the patient intended to go back to his home country and the CD4 cell count was 615 x10(6)/l, no antiviral therapy was initiated . CONCLUSION: This case report is the first demonstrating an atypical symptomatic primary HIV-infection prior to seroconversion, which presented itself exclusively as an aphthous esophagitis with no symptoms of the classic acute retroviral syndrome . Therefore, each clinical suspicion of an underlying HIV-infection should be followed up carefully, even if the patient presents with unusual symptoms.

J Clin Virol, 2001 Dec, 23(1-2), 79 - 85
Comparison of a new immunochromatographic rapid test with a commercial EIA for the detection of Puumala virus specific IgM antibodies; Hujakka H et al.; BACKGROUND: Hantaviruses are associated with two human diseases: haemorrhagic fever with renal syndrome (HFRS) and Hantavirus pulmonary syndrome (HPS) . Puumala virus (PUUV), which is one of the Hantaviruses, is a causative agent of nephropathia epidemica (NE), a mild form of HFRS . OBJECTIVE: a new 5 min rapid test, POC PUUMALA (Erilab Ltd, Finland), for detecting IgM antibodies to PUUV was evaluated and compared with the commercially available Hantavirus (Puumala) IgM ELISA test (Progen, Germany) . Discrepant test results between the two tests were confirmed by a mu-capture reference EIA . STUDY DESIGN: Two hundred and thirty five serum samples, which had earlier been analyzed with the Progen IgM ELISA, were assayed with the POC PUUMALA rapid test . Five persons, without knowing the Progen IgM ELISA test results, interpreted independently the rapid test results . In addition, a panel of 48 serum samples was analyzed in parallel with the rapid test and the Progen IgM ELISA by one technician in daily routine diagnostics in a clinical microbiology laboratory . RESULTS: the agreement between the results of the five interpreters was 95%, and the congruence of the results between individual readers and commercial ELISA test varied from 93 to 96% . Diagnostic efficacy of the rapid test varied between 98 and 99% compared with 96% of the Progen IgM ELISA . The POC PUUMALA rapid test showed higher or similar sensitivity compared with the Progen IgM ELISA, whereas both the tests had similar levels of specificity . CONCLUSIONS: the analytical performance of the POC PUUMALA rapid test was found to be as good or even slightly better than the analytical performance of the Progen IgM ELISA . In addition, the rapid and straightforward procedure makes the POC PUUMALA a feasible tool for the diagnosis of the acute PUUV infection.

Chin Med J (Engl), 1999 Feb, 112(2), 107 - 11
Reversal of aberrant splicing of beta-thalassemia allele by antisense RNA in vitro and in vivo; Zeng Y et al.; OBJECTIVE: To investigate the reversal of aberrant splicing of beta-thalassemia allele (IVS-2-654 C-->T, beta 654) by antisense RNA in vitro and in vivo . METHODS: The vector expressing antisense RNA which targeted against the aberrant splice sites of beta 654 pre-mRNA was constructed in pcDNA3, and then used to repair the defective splicing of the mutant pre-mRNA in an in vitro transcription and splicing system, as well as in HeLa beta 654 cells and cultured beta 654 erythroid cells by lipid-mediated DNA-transfection method . The effect of the antisense RNA was identified by RT-PCR mediated mRNA quantitative assay as well as globin chain microbiosynthesis . RESULTS: The antisense RNA decreased the aberrant splicing product and restored the correct splicing pattern in vitro and in vivo efficiently . In the in vitro transcription and splicing system, the level of normally spliced mRNA {beta/(beta + beta*)} increased from 0.25 to 0.60 . In cultured HeLa beta 654 cells, the level of beta/(beta + beta*) increased from 0.07 to 0.43 on the 15th day after transfection . In cultured beta 654 erythroid cells, the level of mRNA {beta/(beta + beta*)} increased from 0.19 to 0.58 on the 8th day after transfection in beta 654/beta 654 erythroid cells, from 0.02 to 0.38 in beta 654/beta 41-42 erythroid cells, and from 0.45 to 0.83 in beta 654/beta A erythroid cells, respectively . Correspondingly, the ratios of globin chain (beta/alpha) biosynthesis increased from 0.16 to 0.52 on the 8th day after transfection in beta 654/beta 654 erythroid cells, 0.05 to 0.36 in beta 654/beta 41-42 erythroid cells, and 0.42 to 0.81 in beta 654/beta A erythroid cells, respectively . The splicing pattern did not show significant changes as compared to the untreated, as well as to the control antisense fragment . CONCLUSIONS: Antisense RNA transcribed from the expression vector described here could efficiently suppress the aberrant splicing pattern of beta 654 mutant mRNA and restore the correct splicing pathway in vitro and in vivo, leading to the improvement of globin chain biosynthesis in thalassemic cells . Our antisense strategy provides an alternative approach to the gene therapy of beta-thalassemia.

Am J Vet Res, 2001 Oct, 62(10), 1525 - 30
Association of 3-methyleneindolenine, a toxic metabolite of 3-methylindole, with acute interstitial pneumonia in feedlot cattle; Loneragan GH et al.; OBJECTIVE: To compare concentrations of 3-methyleneindolenine (3MEIN) in lung tissues obtained from feedlot cattle that died as a result of acute interstitial pneumonia (AIP) and cattle that died as a result of other causes and to compare blood concentrations of 3MEIN in healthy feedlot cattle and feedlot cattle with AIP . STUDY POPULATION: Blood samples and lung tissues collected from 186 cattle housed in 14 feedlots in the western United States . PROCEDURE: Samples of lung tissues were collected during routine postmortem examination and submitted for histologic, microbiologic, and toxicologic examination . Blood samples were collected from cattle with clinical manifestations of AIP and healthy penmates . Histologic diagnoses were categorized as AIP, bronchopneumonia (BP), control samples, and other disorders . Concentrations of 3MEIN were determined in lung tissues and blood samples, using an ELISA . RESULTS: Concentrations of 3MEIN in lung tissues were significantly greater in AIP and BP samples, compared with control samples . Absorbance per microgram of protein did not differ between BP and AIP samples . Blood concentrations of 3MEIN were significantly greater in cattle with AIP, compared with healthy cattle or cattle with BP . Odds of an animal with AIP being a heifer was 3.1 times greater than the odds of that animal being a steer . CONCLUSIONS AND CLINICAL RELEVANCE: Increased pulmonary production of 3MEIN may be an important etiologic factor in feedlot-associated AIP.

J Bacteriol, 2001 Nov, 183(21), 6355 - 64
TspO as a modulator of the repressor/antirepressor (PpsR/AppA) regulatory system in Rhodobacter sphaeroides 2.4.1; Zeng X et al.; The TspO outer membrane protein of Rhodobacter sphaeroides has been shown to be involved in controlling the transcription of a number of genes which encode enzymes involved in photopigment biosynthesis and the puc operon . The display of regulated genes appears identical to those genes encompassing the PpsR/AppA repressor/antirepressor regulon, although the effect of TspO is modest relative to that of PpsR/AppA . To directly address the hypothesis that TspO is effective through the PpsR/AppA system, we constructed mutant strains with mutations in both tspO and appA . In all cases, the phenotypes examined resembled those of the appA lesion by itself, leading us to conclude that TspO works through or modulates the PpsR/AppA system and acts upstream of the site of action of these regulatory proteins . In earlier publications, we had suggested that TspO is involved in the efflux of a certain intermediate(s) of the porphyrin biosynthesis pathway and that transcriptional regulation of target gene expression could be explained by the accumulation of a coactivator of AppA function . Although the data reported here do not precisely identify this coactivator, they lend support to this hypothesis . We discuss the importance of this form of gene control as the result of the recent extension of the TspO system to Sinorhizobium meliloti, as described by Davey and de Bruijn (M . E . Davey and F . J . de Bruijn, Appl . Environ . Microbiol . 66:5353-5359, 2000) . It is therefore possible that this system constitutes a more widely, although not universally, demonstrated form of gene regulation.

Pac Health Dialog, 2000 Sep, 7(2), 88 - 91
Regional training in public health surveillance: how far are we? An SPC perspective; Kiedrzynski T; "Training in applied epidemiology and public health surveillance" is one of the five strategies of Pacific Public Health Surveillance Network (PPHSN) . It aims to develop a regional pool of experts in public health surveillance and response for the Pacific Islands . In 1996, the idea of a modular training programme with field-based components, involving universities, health development agencies and professional associations came up . This programme should be accredited by a training institution . From 1998 to 2001, SPC made a first move in that direction and ran two different series of subregional training sessions in surveillance, outbreak investigation and the use of Epi Info 6 software for surveillance activities . The overall objective of these training sessions was to build a critical mass of health professionals who share a common set of tools and methods for public health surveillance . SPC can also provide attachment and hands-on field training opportunities for trainees in public health practice . A memorandum of understanding was signed between SPC and FSM in 1999 . The article suggests the areas of future FSM/SPC collaboration in public health surveillance: the accreditation of SPC courses by FSM; the addition of a microbiology component; the identification of opportunities for field training; and the evaluation and harmonisation of the training programme(s).

Cornea, 2001 Oct, 20(7), 675 - 9
Mechanisms of corneal graft rejection: the sixth annual Thygeson Lecture, presented at the Ocular Microbiology and Immunology Group meeting, October 21, 2000; Niederkorn JY; The history of corneal transplantation reaches back over 150 years . Kissam performed one of the first penetrating keratoplasties when he transplanted a pig cornea onto a human in 1838 . Only two interrupted sutures were used, and the surgery was performed without anesthesia! In retrospect, no one would be surprised to learn that the porcine corneal xenograft was rejected . Thirty years later, May transplanted rabbit corneal grafts to humans, but concluded that the failures in the first 24 attempts were the result of "imperfect technique and the inability to keep the eyes properly bandaged." The first documented report of a successful penetrating keratoplasty in a human subject was performed by Zirm in 1905 . As we enter the new millennium, corneal transplantation remains the oldest, most common, and, arguably, the most successful form of solid tissue transplantation . In the United States alone, approximately 36,000 corneal transplants are performed each year . The success rate for corneal transplants is in excess of 90% in uncomplicated cases, even though HLA tissue typing is not performed and systemic immunosuppressive drugs are not administered . In spite of this extraordinary success, immune rejection remains the leading cause of corneal graft failure . Many inferences about the immunobiology of corneal graft rejection have been based on clinical observations; however, confirmation of these hypotheses requires prospective studies under controlled settings . The prudent use of animal models has fostered analytic studies on the immunobiology of corneal allografts without the complicating and confounding effects of topical steroids that are typically used on most keratoplasty patients . Although animal models of penetrating keratoplasty have been in use for almost a half-century, until recently, progress in understanding the immune mechanisms of corneal graft rejection has been slow . However, the widespread use of rodent models of orthotopic corneal transplantation has shed new light on the pathogenesis of corneal graft rejection.

Trends Parasitol, 2001 Oct, 17(10), 499 - 500
A historic photomicrograph of a parasite (Trichomonas vaginalis); Campbell WC; Knowing that Alfred Donne was the discoverer of an important human parasite, and finding that he was also a pioneer of photomicrography, it occurred to me that his parasite might well have become a subject of his photography . It was a simple matter to confirm that this was indeed the case . The parasite he discovered was Trichomonas vaginalis; and, in collaboration with Foucault, Donne made a photomicrograph showing several protozoan parasites lying among vaginal epithelial cells . His publication of an engraved image of the photomicrograph in 1845, was a landmark in the history of photography and microbiology.

Gastroenterol Clin North Am, 2001 Sep, 30(3), 735 - 51
Escherichia coli O157:H7; Tarr PI et al.; E . coli O157:H7 can cause potentially lethal illness in hosts of all ages . These patients often are evaluated and treated by gastroenterologists . The treating physician should administer adequate hydration, usually parenterally, and avoid the use of antibiotics and antimotility agents . The physician needs to notify immediately the appropriate public health authorities of the diagnosis and to ensure that the isolate is recovered by the microbiologist and forwarded for molecular linkage analysesPublication Types:

	Review
	Review, Tutorial

Genetic Engineering, Protein, Environmental Microbiology, Microorganisms, Fermentation, Microbiology, Antibiotic, Bacterium, Genome, Bacteriology, Molecular Microbiology, Bacteria, Biotechnology, Microorganism, t, Nitrification, g, Microbes, q, Botulism, b, Microbe, r, Amino Acid, Bioremediation, E. coli, s, Vibriosis, m, Antibiotics, b, Escherichia coli, f, Streptococcal, p, Salmonella, e, Staphylococci, m, Cell cultures, p, Sewage treatment, x, Prokaryotes, s, Clostridium, b, E. coli, c, Haemophilus, g, Escherichia coli, b, Yeast, b, Aeromonades, b, Bacterial, m, Cryptococci, b, Microbial, l, Bacillus subtilis, e, Antibiotic treatment, b, Bacteria, a, Bactericidal, e, C. albicans, c, Vibriosis, e, Bacterium, e, Nitrifying, p, S. aureus, y, E. coli, Saccharomyces cerevisiae,

Scientific Publications - Work Done by Microbiology Reader Bioscreen C
Agricultural Microbiology Anaerobic Microbiology Antimicrobial Susceptibility Artificial Atmosphere Bioassay of Antibiotics Biofilm Microbiology Bioreactor Technology Biotechnology Cell Biology Clinical Microbiology Environmental Microbiology Experiments with Yeast	Fermentation Food Microbiology Functional Genomics Gene Technology Growth Media Development Growth Rate and Lag Time Industrial Microbiology Medical/Pharmaceutical Field Microbiological Assay Microbiological Research Microbiology of Cosmetics go to a specific theme...	Military Microbiology Molecular Microbiology Mutagenicity and Genotoxicity Oral Microbiology Patents Postantibiotic Studies Soil Microbiology Spore Microbiology Veterinary Microbiology Waste/Wastewater Treatment Water Microbiology Wine Microbiology

� 2005 Transgalactic Ltd (manufacturer of Bioscreen C software) | Privacy Statement | P.O. Box 1393, 00101 Helsinki, Finland, phone: +358 9 85172920, fax: +358 9 8749481, e-mail: microbiology@bionewsonline.com

Last modified: May 25, 2005