Sex Transm Dis, 2002 Jan, 29(1), 25 - 31 Pulsed-field gel electrophoresis as an epidemiologic tool for Neisseria gonorrhoeae: identification of clusters within serovars; Unemo M et al.; BACKGROUND: The increasing incidence of gonorrhea in Sweden in 1998 was due to mostly domestic cases . Among these, two core groups were identified: homosexual men with serovar IB-2 and young heterosexuals with serovar IB-3 . GOALS: To explore the genetic homogeneity/heterogeneity within the predominant serovars, IB-2 and IB-3, of Neisseria gonorrhoeae in Sweden by pulsed-field gel electrophoresis (PFGE) and to compare these results to epidemiologic information, as well as examine the genetic diversity within and between the 25 other represented serovars of N gonorrhoeae . STUDY DESIGN: By PFGE, 237 N gonorrhoeae isolates were examined, and the results were compared with epidemiologic data for the IB-2 and IB-3 isolates . RESULTS: In 79% of the domestic IB-2 cases involving homosexuals and 66% of the domestic IB-3 cases involving young heterosexuals, the isolates were genetically indistinguishable by PFGE . A high genetic diversity was identified within and between the 27 included serovars . CONCLUSIONS: Examination by means of PFGE indicated that one N gonorrhoeae clone each of the serovars IB-2 and IB-3 created the majority of the two core groups of domestic cases. J Clin Microbiol, 2002 Jan, 40(1), 281 - 3 Evaluation of a strand displacement amplification assay (BD ProbeTec-SDA) for detection of Neisseria gonorrhoeae in urine specimens; Akduman D et al.; The performance of a strand displacement amplification assay (the BDProbeTec-SDA assay) in detecting Neisseria gonorrhoeae in urine specimens was evaluated . When performed under stringent quality control conditions, the BDProbeTec-SDA assay is a sensitive, specific, and efficient method for the screening of large numbers of noninvasively obtained specimens . Because the predictive value of an assay is a function of the prevalence of the disease, culture confirmation is needed for samples with positive results from populations in which the prevalence of a disease is low or in situations in which false-positive results may have important medical, psychosocial, or medicolegal consequences. Zhonghua Fu Chan Ke Za Zhi, 2001 Sep, 36(9), 539 - 41 {Pathogens of transmitted disease in the pathogenesis of acute pelvic inflammatory disease}; Zhou B et al.; OBJECTIVE: To study the pathogenesis of pathogens of sexually transmitted disease (STD) in acute pelvic inflammatory disease (PID) . METHODS: Neisseria gonorrhoeae, chlamydia trchomatis, ureaplasma urealyticum were cutured respectively in 130 patients with acute PID . RESULTS: The pathogens of STD had been found in 55 patients . The detective rate of Neisseria gonorrhoeae was 6.9% (9/130), about half of them were mixed infection; the detective rate of chlamydia trachomatis was 4.6% (6/130), all of them were mixed infection; the positive percentage of ureaplasma urealyticum was 37.7% (49/130), one third of them were mixed infection . CONCLUSION: The pathogens of STD might cause acute PID or only play a synergetic role in it. West Indian Med J, 2001 Sep, 50(3), 198 - 202 Single dose (direct observed) azithromycin therapy for Neisseria gonorrhoeae and Chlamydia trachomatis in STD clinic attenders with genital discharge in Trinidad and Tobago; Swanston WH et al.; The purpose of this study was to determine the prevalence and to assess the efficacy of a single one gram oral dose of azithromycin under direct observed therapy of genital discharge due to Neisseria gonorrhoeae and Chlamydia trachomatis infections in STD clinic attenders in Trinidad and Tobago . All patients with genital discharge and their contacts were given one gram oral dose of azithromycin under direct supervision after collection of urethral and cervical swabs for N gonorrhoeae culture and smear and for C trachomatis antigen detection by ELISA . Clinical and microbiological evaluation was done on those who returned after 7-10 days for follow-up . Of the 735 patients who were enrolled in the study, 319 (43.4%) had N gonorrhoeae and 100 (13.6%) had C trachomatis . Only 151 (36%) of the 419 patients with a pathogenic isolate returned for clinical and microbiological assessment . The remaining 268 (64%) of the 419 patients were lost to follow-up . One hundred and forty-three patients (94.7%) had total abatement of signs and symptoms after taking azithromycin . One patient (0.65%), who had both N gonorrhoeae and C trachomatis, improved clinically with the drug . Seven patients (six with N gonorrhoeae and one with C trachomatis) failed to respond clinically to azithromycin . Microbiological eradication was achieved in 115 (100%) patients who had single infection with N gonorrhoeae and in 23 patients (96%) with C trachomatis infection . Of 12 patients with combined infections, N gonorrhoeae and C trachomatis were eradicated in 10 and 12 patients, respectively, after initial treatment . In two patients with combined infection, N gonorrhoeae continued to be isolated after treatment with azithromycin . A single one gram oral dose of azithromycin under direct supervision is useful in the treatment of uncomplicated genital infection with N gonorrhoeae and C trachomatis in STD clinic attenders in Trinidad. Res Microbiol, 2001 Nov, 152(9), 781 - 91 Expression of Neisseria gonorrhoeae cell division genes ftsZ, ftsE and minD is influenced by environmental conditions; Ramirez-Arcos S et al.; The activity of the promoter regions of the cell division genes ftsZ, ftsE, minC, minD and minE from Neisseria gonorrhoeae (Ng) was studied under different environmental conditions using lacZ translational fusions . The promoters of the minNg genes have not been previously determined and we identified promoter regions upstream of each gene (minCp, minDp and minEp) . We determined that minDp had the strongest activity . Expression of the promoter regions of ftSZ(Ng) and ftsE(Ng), which we had previously identified, as well as minD(Ng), were then studied under conditions reflecting the environment of the genitourinary tract . These conditions included anaerobiosis, presence of isoleucine or urea (3 mM and 400 mM, respectively) and acidity of pH 6 . Both beta-galactosidase expression and northern blot analysis indicated that all three genes were upregulated under anaerobiosis . The addition of isoleucine as well as media at pH 6 did not have any significant effects on the promoter activity of these genes while the presence of urea significantly decreased ftsZ(Ng) promoter activity . The expression of the minD(Ng) promoter region was analyzed during different growth phases and shown to follow the growth behavior of the culture . By contrast, the ftSZ(Ng) promoter activity continued to rise after the onset of the stationary phase . When gonococcal ftsZ promoter 1, (Pz1) was altered by site-directed mutagenesis, a significant decrease in the expression of ftsZ(Ng) was observed under both aerobic and anaerobic conditions . These data infer that gonococci regulate their cell division in response to different environments. Carbohydr Res, 2002 Jan 7, 337(1), 11 - 20 Synthesis of alpha-lactosyl-(1-->3)-L-glycero-alpha-D-manno-heptopyranoside, a partial oligosaccharide structure expressed within the lipooligosaccharide produced by Neisseria gonorrhoeae strain 15253; Ishii K et al.; The glycosyl donor, hepta-O-benzyl-beta-lactosyl trichloroacetimidate (4) was prepared by treating hepta-O-benzyl-lactose with trichloroacetonitrile in the presence of potassium carbonate . The acceptor, methyl 2-O-benzyl-4,6-O-benzylidene-7,8-dideoxy-alpha-D-manno-oct-7-enopyranoside (8) was synthesized by hydrolysis of a 3,4-butane diacetal of methyl L-glycero-alpha-D-manno-oct-enopyranoside and subsequent benzylidenation . Glycosidation of the donor 4 with the acceptor 8 in 1,4-dioxane using Me(3)SiOTf as a promoter for 1 h at room temperature gave methyl (2,3,4,6-tetra-O-benzyl-beta-D-galactopyranosyl)-(1-->4)-(2,3,6-tri-O-benzyl-alpha-D-glucopyranosyl)-(1-->3)-2-O-benzyl-4,6-O-benzylidene-7,8-dideoxy-alpha-D-manno-oct-7-enopyranoside (9) as a major product (59%) . The oct-enopyranoside moiety of the trisaccharide 9 was converted to a heptopyranoside (80%) by oxidative cleavage with OsO(4)-NaIO(4) and subsequent reduction . Hydrogenolysis of the resulting trisaccharide and subsequent acetylation gave the peracetate of alpha-lactosyl-(1-->3)-Hep . Deacetylation of the peracetate afforded the title trisaccharide. Obstet Gynecol, 2001 Dec, 98(6), 1117 - 23 Chlamydial infection and unplanned pregnancy in women with ready access to health care; Thomas AG et al.; OBJECTIVE: To apply urine-based ligase chain reaction for Chlamydia trachomatis (C . trachomatis) and Neisseria gonorrhoeae (N . gonorrhoeae) detection and standard urine-based pregnancy testing for Navy-enlisted women, and to compare the prevalence and epidemiologic correlates of these adverse reproductive outcomes . METHODS: Participants were surveyed and urine was collected for pregnancy testing using standard laboratory methods and detection of C . trachomatis and N . gonorrhoeae infection by ligase chain reaction . Self-administered surveys facilitated collection of demographics, sexual behavior, including contraceptive use, sexual partners, sexually transmitted disease, and pregnancy history . RESULTS: Among 299 of 314 participants, the prevalence of chlamydial infection was 4.7% and of pregnancy was 9.7%, with 48.3% of the pregnancies unplanned . Chlamydia trachomatis infection was univariately associated with having a new sex partner within the last 6 months, more sexual partners, single marital status, condom use, drinking until passing out or vomiting in the past 30 days (alcohol misuse), and current pregnancy . Unplanned pregnancy was univariately associated with young age, single marital status, inconsistent condom use, having a new sex partner within the last 6 months, and more recent sexual partners . Among the pregnant women, four (13.8%) were infected with C . trachomatis . CONCLUSION: The high rates of chlamydial infection and unplanned pregnancy found in this population of employed young women with ready access to health care and health education underscore the challenge of enhancing reproductive health via compliance with effective contraceptive and sexually transmitted disease prevention methods . This is a challenge that remains unmet. Proc Natl Acad Sci U S A, 2001 Dec 18, 98(26), 15276 - 81 Neisseria gonorrhoeae PilV, a type IV pilus-associated protein essential to human epithelial cell adherence; Winther-Larsen HC et al.; Type IV pili (Tfp) of Neisseria gonorrhoeae, the Gram-negative etiologic agent of gonorrhea, facilitate colonization of the human host . Tfp are assumed to play a key role in the initial adherence to human epithelial cells by virtue of the associated adhesin protein PilC . To examine the structural and functional basis for adherence in more detail, we identified potential genes encoding polypeptides sharing structural similarities to PilE (the Tfp subunit) within the N . gonorrhoeae genome sequence database . We show here that a fiber subunit-like protein, termed PilV, is essential to organelle-associated adherence but dispensable for Tfp biogenesis and other pilus-related phenotypes, including autoagglutination, competence for natural transformation, and twitching motility . The adherence defect in pilV mutants cannot be attributed to reduced levels of piliation, defects in fiber anchoring to the bacterial cell surface, or to unstable pilus expression related to organelle retraction . PilV is expressed at low levels relative to PilE and copurifies with Tfp fibers in a PilC-dependent fashion . Purified Tfp from pilV mutants contain PilC adhesin at reduced levels . Taken together, these data support a model in which PilV functions in adherence by promoting the functional display of PilC in the context of the pilus fiber. J Biol Chem, 2002 Mar 1, 277(9), 7438 - 46 Epub 2001 Dec 19. Nuclear factor-kappa B directs carcinoembryonic antigen-related cellular adhesion molecule 1 receptor expression in Neisseria gonorrhoeae-infected epithelial cells; Muenzner P et al.; The human-specific pathogen Neisseria gonorrhoeae expresses opacity-associated (Opa) protein adhesins that bind to various members of the carcinoembryonic antigen-related cellular adhesion molecule (CEACAM) family . In this study, we have analyzed the mechanism underlying N . gonorrhoeae-induced CEACAM up-regulation in epithelial cells . Epithelial cells represent the first barrier for the microbial pathogen . We therefore characterized CEACAM expression in primary human ovarian surface epithelial (HOSE) cells and found that CEACAM1-3 (L, S) and CEACAM1-4 (L, S) splice variants mediate an increased Opa(52)-dependent gonoccocal binding to HOSE cells . Up-regulation of these CEACAM molecules in HOSE cells is a direct process that takes place within 2 h postinfection and depends on close contact between microbial pathogen and HOSE cells . N . gonorrhoeae-triggered CEACAM1 up-regulation involves activation of the transcription factor nuclear factor kappaB (NF-kappaB), which translocates as a p50/p65 heterodimer into the nucleus, and an NF-kappaB-specific inhibitory peptide inhibited CEACAM1-receptor up-regulation in N . gonorrhoeae-infected HOSE cells . Bacterial lipopolysaccharides did not induce NF-kappaB and CEACAM up-regulation, which corresponds to our findings that HOSE cells do not express toll-like receptor 4 . The ability of N . gonorrhoeae to up-regulate its epithelial receptor CEACAM1 through NF-kappaB suggests an important mechanism allowing efficient bacterial colonization during the initial infection process. J Bacteriol, 2002 Jan, 184(2), 420 - 6 Point mutations in HpuB enable gonococcal HpuA deletion mutants to grow on hemoglobin; Chen CJ et al.; Neisseria gonorrhoeae ordinarily requires both HpuA and HpuB to use hemoglobin (Hb) as a source of iron for growth . Deletion of HpuA resulted in reduced Hb binding and failure of growth on Hb . We identified rare Hb-utilizing colonies (Hb(+)) from an hpuA deletion mutant of FA1090, which fell into two phenotypic classes . One class of the Hb(+) revertants required expression of both TonB and HpuB for growth on Hb, while the other class required neither TonB nor HpuB . All TonB/HpuB-dependent mutants had single amino acid alterations in HpuB, which occurred in clusters, particularly near the C terminus . The point mutations in HpuB did not restore normal Hb binding . Human serum albumin inhibited Hb-dependent growth of HpuB point mutants lacking HpuA but did not inhibit growth when expression of HpuA was restored . Thus, HpuB point mutants internalized heme in the absence of HpuA despite reduced binding of Hb . HpuA facilitated Hb binding and was important in allowing use of heme from Hb for growth. Infect Immun, 2002 Jan, 70(1), 407 - 11 Influence of the length of the lipooligosaccharide alpha chain on its sialylation in Neisseria meningitidis; Tsai CM et al.; The sialylation of lipooligosaccharide (LOS) in Neisseria meningitidis plays a role in the resistance of the organism to killing by normal human serum . The length of the alpha chain extending out from the heptose I {Hep (I)} moiety of LOS influenced sialylation of N . meningitidis LOS in vitro and in vivo . The alpha chain required a terminal Gal and a trisaccharide or longer oligosaccharide to serve as an acceptor for sialylation . The disaccharide lactose (Galbeta1-4Glc) in the alpha chain of immunotype L8 LOS could not function as an acceptor for the sialyltransferase, probably due to steric hindrance imposed by the neighboring Hep (II) with phosphorylethanolamine and another group attached. Infect Immun, 2002 Jan, 70(1), 335 - 44 Neisserial immunoglobulin A1 protease induces specific T-cell responses in humans; Tsirpouchtsidis A et al.; We have previously shown that immunoglobulin A1 (IgA1) protease, an exoenzyme of pathogenic neisseriae, can trigger the release of proinflammatory cytokines from human monocytic subpopulations . Here, we demonstrate a dose-dependent T-cell response to recombinant gonococcal IgA1 protease (strain MS11) in healthy human blood donors . This response was delayed in comparison to the immune response against tetanus toxoid . Stimulation with IgA1 protease led to the activation of CD4(+) and CD8(+) T cells, as well as CD19(+) B cells and CD56(+) NK cells, indicated by de novo expression of CD69 . Only CD4(+) T cells proliferated and stained positive for intracellular gamma interferon (IFN-gamma) . Both proliferation and IFN-gamma production were dependent on antigen presentation via major histocompatibility complex class II . Peripheral blood mononuclear cells stimulated with IgA1 protease produce IFN-gamma and tumor necrosis factor alpha but no, or very low amounts of, interleukin-10 (IL-10) or IL-4, indicating a Th1-based proinflammatory immune response . These findings support the significance of IgA1 protease as a virulence determinant of bacterial meningitis and its function as a dominant proinflammatory T-cell antigen. J Infect Dis, 2001 Dec 15, 184(12), 1538 - 47 Epub 2001 Dec 03. Analysis of the ontogeny of the murine humoral response to Neisseria meningitidis B capsular polysaccharide reveals levels of complexity relevant to vaccine development; Colino J et al.; Although purified capsular polysaccharide of Neisseria meningitidis group B (CpsB) is not immunogenic at any age, CpsB on the bacterial surface elicits antibody responses late in ontogeny . Therefore, a detailed analysis of the ontogeny of the murine anti-CpsB response to N . meningitidis could determine key parameters regarding the poor immunogenicity of CpsB . The effects of bacterial dose, hyperimmunization, age, and sex on the induction of primary and secondary anti-CpsB immunoglobulin isotype profiles were studied . It was demonstrated that the timing and repetition of immunization and of the bacterial dose have a marked differential effect on the primary induction of anti-CpsB immunoglobulin isotypes and on the ability to induce anti-CpsB antibody responses after subsequent rechallenge . It is noteworthy that the ontogeny of the response is related to the appearance of natural anti-CpsB antibodies, but this is not associated with the presence of CpsB cross-reactive antigens in the microflora. Clin Infect Dis, 2002 Jan 15, 34(2), 173 - 6 Epub 2001 Dec 07. Increased sensitivity of DNA amplification testing for the detection of pharyngeal gonorrhea in men who have sex with men; Page-Shafer K et al.; We compared ligase chain reaction (LCR) assay with standard culture for the detection of pharyngeal Neisseria gonorrhoeae infection in men who have sex with men (MSM) presenting at a sexually transmitted diseases clinic in San Francisco . Pharyngeal specimens were obtained from 200 MSM who reported performing fellatio during the previous 2 weeks . Confirmatory testing of discrepant specimens was conducted using N . gonorrhoeae pilin proteins . Prevalence of pharyngeal N . gonorrhoeae was 6% by culture or 11% by LCR . The sensitivity and specificity of LCR were 94.7% and 97.8%, respectively, compared with values of 47.4% and 100% for culture . Prevalence of pharyngeal N . gonorrhoeae infection, as determined by DNA amplification testing, was higher than that suggested by traditional culture . Results support the use of DNA amplification testing in the oropharynx . The high prevalence of pharyngeal N . gonorrhoeae infection among MSM suggests that routine screening should be considered in efforts to reduce the burden of gonorrhea in this population. J Antimicrob Chemother, 2001 Dec, 48(6), 853 - 9 Evolution in the trends of antimicrobial resistance in Neisseria gonorrhoeae isolated in Durban over a 5 year period: impact of the introduction of syndromic management; Moodley P et al.; Antimicrobial susceptibility testing was performed on isolates of Neisseria gonorrhoeae obtained from patients attending the City Health STD clinic in Durban, KwaZuluNatal, using the following drugs: penicillin, tetracycline, ciprofloxacin, ofloxacin, ceftriaxone, spectinomycin, erythromycin and azithromycin . These isolates were collected over a 6 year period from 1995 to 2000 . Four hundred and fifteen strains were tested: 61 in 1995, 198 in 1997, 98 in 1998/99 and 58 in 1999/2000 . A shift to the right is observed in the susceptibilities of N . gonorrhoeae to the currently recommended drugs in the syndromic management guidelines viz . penicillin, tetracycline, ceftriaxone, ciprofloxacin, spectinomycin and erythromycin . The prevalence of penicillinase-producing N . gonorrhoeae is currently c . 30%, whereas that of plasmid-mediated tetracycline-resistant N . gonorrhoeae is c . 50% . There is a definite association between the MICs of strains falling within the penicillin and tetracycline chromosomally resistant group, and strains exhibiting a decreased susceptibility to ciprofloxacin and ceftriaxone . The MICs of azithromycin showed a similar distribution when compared with erythromycin for 1999/2000 isolates . We postulate that the presence of efflux pumps might play a role in the increasing MICs that we observe among structurally unrelated groups of drugs . Furthermore, widespread use of these antimicrobials in the community may offer a selective advantage to the development of resistance . The implications of this are far reaching and the local susceptibility trends of N . gonorrhoeae need to be monitored constantly to direct therapy. Presse Med, 2001 Nov 3, 30(32), 1589 - 91 {Purpura fulminans and coxsackie B2 co-infection}; Fourier C et al.; INTRODUCTION: During septic shock in children, myocardial deficiency usually lasts 3 to 6 days . When prolonged, an other etiology should be looked for . OBSERVATION: A 29 month-old child presented with purpura fulminans, probably due to Neisseria meningitidis . Positivity of the serodiagnostic for coxsackie B2, performed because of persisting myocardial deficiency, evoked diagnosis of a coxsackie B2 co-infection . DISCUSSION: Abnormally prolonged myocardial deficiency during purpura fulminans must lead to the search for a congenital, metabolic or infectious cardiomyopathy. Pediatrics . 2001 Dec;108(6):E103. Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infection in pediatric private practice; Best D et al.; BACKGROUND: Universal screening of sexually active adolescents for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) has been recommended in settings in which prevalence is 2% or greater . Although believed to be above 2%, the prevalence of CT and GC infection in private practice settings has not been clearly established and may affect screening practices . OBJECTIVES: To determine CT and GC infection prevalence in 2 pediatric private practices . DESIGN: Cross-sectional study . SETTING: Two pediatric private practices in suburban North Carolina . PATIENTS: Convenience sample of patients aged 15 to 24 years who were seen from August 1998 through June 1999 . MAIN OUTCOME MEASURES: Prevalence of CT and GC infection . RESULTS: Of 1114 eligible patients, 803 (72%) completed questionnaires and provided urine specimens tested for CT and GC infection using ligase chain reaction assays . Mean age was 17.1 years (standard deviation: 1.8) . Most participants were female (63%), white (87%), and from highly educated families (64% of their mothers graduated from college) . Sexual activity was reported by 41% . Prevalence of CT infection in all participants was 0.9% (confidence interval {CI}: 0.4%-1.8%); in sexually active participants, 2.1% (CI: 0.9%-4.3%); in sexually active females, 2.7% (CI: 1.0%-5.7%); and in sexually active males, 0.9% (CI: 0.0%-5.1%) . One case of GC infection was found . CONCLUSIONS: The prevalence of CT and GC infection in this private practice population was much lower than reported in other settings . Screening recommendations may need to be reassessed if other low prevalence populations are found. Vet Microbiol, 2002 Jan 3, 84(1-2), 53 - 67 A putative iron-regulated TonB-dependent receptor of Mannheimia (Pasteurella) haemolytica A1: possible mechanism for phase variation; Graham MR et al.; A recombinant plasmid that codes for a novel iron receptor protein (Irp) of Mannheimia (Pasteurella) haemolytica A1 was isolated by the partial complementation of an Escherichia coli fur mutant . The deduced amino acid sequence of Irp exhibited characteristics typical of TonB-dependent receptors . These include: a TonB-box at the N-terminal; a 50 amino acid region homologous to the "plug" domain of the E . coli FhuA and FepA receptors; and a C-terminal TonB-dependent signature which likely functions as an outer membrane anchoring domain . Previously uncharacterized Irp homologues were detected by BLAST analysis of available databases and incomplete microbial genomes . When the irp homologues from Neisseria gonorrhoeae and N . meningitidis were cloned by PCR and expressed in E . coli, novel proteins of the predicted size (84kDa) were detected in cell lysates, demonstrating that these are functional genes . The M . haemolytica A1 irp gene undergoes phase variation at a nucleotide region which contain the sequence AAAAAAATTAAAA (7A-2T-4A) flanked by a short inverted repeat . Site-specific mutagenesis of the 7A-2T-4A sequence as well as replacement of the inverted repeats resulted in a stable construct that expressed the Irp protein without phase variation . The expression of irp in M . haemolytica A1 was regulated by iron concentrations and most likely a Fur homologue, consistent with the proposed function of Irp in iron metabolism . The irp genes may represent contingency loci that play a role in iron acquisition during infection. Sex Transm Dis, 2001 Dec, 28(12), 714 - 24 Risk-based versus alternative algorithms for antibiotic prophylaxis among women seeking early suction abortion: a cost-effectiveness simulation; Friedman HB et al.; BACKGROUND: Particularly in resource-poor settings, simple, inexpensive, and cost-effective algorithms are needed to direct antibiotic prophylaxis to prevent sequelae of infections with Chlamydia trachomatis, Neisseria gonorrhoeae, and bacterial vaginosis-associated organisms among women undergoing abortion . GOAL: To assess the prevalence of and risk factors for infections among women seeking abortion in Bali, Indonesia, and to use these data in designing a cost-effective risk-based prophylaxis algorithm . STUDY DESIGN: A cross-sectional analysis and data-based simulation of risk-based and alternative prophylaxis algorithms were performed . RESULTS: The risk-based algorithm would have provided prophylaxis to 70% (95% CI, 53-83%) of women with cervical infection, 64% (95% CI, 54-74%) of those with bacterial vaginosis, and 57% (95% CI, 42-72%) of those with trichomoniasis . For cervical infection, the algorithm was more cost effective than all others evaluated . The cost-effectiveness was acceptable for bacterial vaginosis . CONCLUSIONS: Risk-based algorithms may be cost effective in identifying women likely to benefit from preabortion prophylaxis . Prospective evaluation is needed to validate these findings. J Clin Microbiol, 2001 Dec, 39(12), 4575 - 6 Improved rate of isolation of Neisseria meningitidis by direct plating of pharyngeal swabs; Cunningham R et al.; Culturing of pharyngeal swabs for Neisseria meningitidis is an important clinical and epidemiological tool . Routine methods include direct plating onto solid medium or later plating in the laboratory . A comparison of these methods used with 490 high school students found a significantly higher carriage rate with direct plating (11.8 versus 6.1%; P < 0.001). J Clin Microbiol, 2001 Dec, 39(12), 4227 - 32 Laribacter hongkongensis gen . nov., sp . nov., a novel gram-negative bacterium isolated from a cirrhotic patient with bacteremia and empyema; Yuen KY et al.; A bacterium was isolated from the blood and empyema of a cirrhotic patient . The cells were facultatively anaerobic, nonsporulating, gram-negative, seagull shaped or spiral rods . The bacterium grows on sheep blood agar as nonhemolytic, gray colonies 1 mm in diameter after 24 h of incubation at 37 degrees C in ambient air . Growth also occurs on MacConkey agar and at 25 and 42 degrees C but not at 4, 44, and 50 degrees C . The bacterium can grow in 1 or 2% but not 3, 4, or 5% NaCl . No enhancement of growth is observed with 5% CO(2) . The organism is aflagellated and nonmotile at both 25 and 37 degrees C . It is oxidase, catalase, urease, and arginine dihydrolase positive, and it reduces nitrate . It does not ferment, oxidize, or assimilate any sugar tested . 16S rRNA gene sequencing showed that there are 91 base differences (6.2%), 112 base differences (7.7%), and 116 base differences (8.2%) between the bacterium and Microvirgula aerodenitrificans, Vogesella indigofera, and Chromobacterium species, respectively . The G+C content (mean and standard deviation) is 68.0% +/- 2.43%, and the genomic size is about 3 Mb . Based on phylogenetic affiliation, the bacterium belongs to the Neisseriaceae family of the beta-subclass of Proteobacteria . For these reasons, a new genus and species, Laribacter hongkongensis gen . nov., sp . nov., is proposed, for which HKU1 is the type strain . Further studies should be performed to ascertain the potential of this bacterium to become an emerging pathogen. Curr Infect Dis Rep, 2001 Dec, 3(6), 540 - 545 Nongonococcal and Nonchlamydial Cervicitis; Nyirjesy P; Cervicitis encompasses a variety of gynecologic conditions . Although inflammation on a Papanicolaou smear may be indicative of true cervical inflammation, establishing a diagnosis of mucopurulent cervicitis (MCP) is more clinically useful . MCP seems to be analogous to nongonococcal urethritis in men . Many cases of MCP are related to Chlamydia trachomatis infection, but the majority of cases have other potential causes . Other possible pathogens include Neisseria gonorrhoeae, Trichomonas vaginalis, Ureaplasma urealyticum, Mycoplasma genitalium, herpes simplex virus, and cytomegalovirus . Many cases may be related to cervical ectopy . MCP is a marker for endometritis, salpingitis, and adverse pregnancy outcomes . Given the current shortcomings in our understanding of this disease, an empiric approach to evaluation and treatment is suggested. Mol Microbiol, 2001 Nov, 42(3), 659 - 72 Receptor-mediated endocytosis of Neisseria gonorrhoeae into primary human urethral epithelial cells: the role of the asialoglycoprotein receptor; Harvey HA et al.; Urethral epithelial cells are invaded by Neisseria gonorrhoeae during gonococcal infection in men . To understand further the mechanisms of gonococcal entry into host cells, we used the primary human urethral epithelial cells (PHUECs) tissue culture system recently developed by our laboratory . These studies showed that human asialoglycoprotein receptor (ASGP-R) and the terminal lactosamine of lacto-N-neotetraose-expressing gonococcal lipooligosaccharide (LOS) play an important role in invasion of PHUECs . Microscopy studies showed that ASGP-R traffics to the cell surface after gonococcal challenge . Co-localization of ASGP-R with gonococci was observed . As ASGP-R-mediated endocytosis is clathrin dependent, clathrin localization in PHUECs was examined after infection . Infected PHUECs showed increased clathrin recruitment and co-localization of clathrin and gonococci . Preincubating PHUECs in 0.3 M sucrose or monodansylcadaverine (MDC), which both inhibit clathrin-coated pit formation, resulted in decreased invasion . N . gonorrhoeae strain 1291 produces a single LOS glycoform that terminates with Gal(beta1-4)GlcNac(beta1-3)Gal(beta1-4)Glc (lacto-N-neotetraose) . Invasion assays showed that strain 1291 invades significantly more than four isogenic mutants expressing truncated LOS . Sialylation of strain 1291 LOS inhibited invasion significantly . Preincubation of PHUECs in asialofetuin (ASF), an ASGP-R ligand, significantly reduced invasion . A dose-response reduction in invasion was observed in PHUECs preincubated with increasing concentrations of NaOH-deacylated 1291 LOS . These studies indicated that an interaction between lacto-N-neotetraose-terminal LOS and ASGP-R allows gonococcal entry into PHUECs. Am J Obstet Gynecol, 2001 Nov, 185(5), 1209 - 17 Randomized trial of presumptive sexually transmitted disease therapy during pregnancy in Rakai, Uganda; Gray RH et al.; OBJECTIVE: The purpose of this study was to assess presumptive sexually transmitted disease treatment on pregnancy outcome and HIV transmission . STUDY DESIGN: In a randomized trial in Rakai District, Uganda, 2070 pregnant women received presumptive sexually transmitted disease treatment 1 time during pregnancy at varying gestations, and 1963 control mothers received iron/folate and referral for syphilis . Maternal-infant sexually transmitted disease/HIV and infant outcomes were assessed . Intent-to-treat analyses estimated adjusted rate ratios and 95% confidence intervals . RESULTS: Sexually transmitted diseases were reduced: Trichomonas vaginalis (rate ratio, 0.28; 95% CI, 0.18%-0.49%), bacterial vaginosis (rate ratio, 0.78; 95% CI, 0.69-0.87), Neisseria gonorrhoeae /Chlamydia trachomatis (rate ratio, 0.43; 95% CI, 0.27-0.68), and infant ophthalmia (rate ratio, 0.37; 95% CI, 0.20-0.70) . There were reduced rates of neonatal death (rate ratio, 0.83; 95% CI, 0.71-0.97), low birth weight (rate ratio, 0.68; 95% CI, 0.53-0.86), and preterm delivery (rate ratio, 0.77; 95% CI, 0.56-1.05); but there were no effects on maternal HIV acquisition or perinatal HIV transmission . CONCLUSION: Reductions of maternal sexually transmitted disease improved pregnancy outcome but not maternal HIV acquisition or perinatal HIV transmission. Sex Transm Infect, 2001 Dec, 77(6), 423 - 6 Comparison of urine, first and second endourethral swabs for PCR based detection of genital Chlamydia trachomatis infection in male patients; Sugunendran H et al.; OBJECTIVES: To compare endourethral swabs and urine as diagnostic specimens for the detection of genital Chlamydia trachomatis infection using the polymerase chain reaction (PCR), in male patients attending a genitourinary clinic and to assess whether the first endourethral swab used solely for diagnosing gonococcal infection could be used for C trachomatis detection as well . METHODS: Two endourethral swabs were taken from 80 male patients, in whom the likelihood of genital C trachomatis infection was high . The first swab was used for microscopy and culture for Neisseria gonorrhoeae, before being used for C trachomatis detection . First voided urine specimens were collected from 61 of these patients . All three specimens were processed for C trachomatis DNA detection using the Roche Cobas Amplicor PCR . A diagnosis of genital C trachomatis infection was made if any one of the specimens tested reproducibly positive . Samples from 13 patients showing discrepant PCR results between swabs and/or urine were retested by ligase chain reaction (LCR) . RESULTS: Chlamydia trachomatis DNA was detected in 35 (43.8%) of the 80 patients . In 17 of the 35 patients (48.6%), all the genital specimens were positive . However, in 18 (51.4%) patients, one or more of the genital specimens had negative PCR results . Among the 18 patients with discrepant results, urine was found to be a more sensitive diagnostic specimen than the second urethral swab picking up 13 out of 16 positives (81.3%) as opposed to five out of 18 (27.8%) . There was no significant difference between the two swabs . Retesting by LCR, of the samples from 13 of the 18 patients with discrepant PCR results confirmed them all as true positives, although as with PCR, not all specimens in the set were concordantly positive . LCR detected all the 13 positives in urine, while there was no difference in the detection rate between the first and the second urethral swabs . CONCLUSIONS: Urine appeared to be a better diagnostic specimen than the conventional second endourethral swab for C trachomatis detection by PCR in this cohort of male patients . There was no difference between the first swab, intended primarily for N gonorrhoeae testing and the second swab intended for C trachomatis detection . This raises questions over the need for the conventional second swab for detecting C trachomatis. Acta Cardiol, 2001 Oct, 56(5), 327 - 9 Acute ST-segment elevation in Neisseria meningitis; Gach O et al.; Meningitis due to Neisseria meningitidis occurred in a young man . On admission, he was in septic shock and the electrocardiogram revealed convex upwards ST-segment elevation in inferior and lateral leads . Rapid and complete normalisation of the ECG was observed and the patient had a favourable evolution with intensive therapy.The mechanisms of the ECG abnormalities in this disease are unclear . In this patient, ST-segment elevation was probably related to severe transmural ischaemia or prolonged coronary artery spasm as suggested by increase and decrease of cardiac enzymes and transient echocardiographic wall motion abnormalities without pericarditis . However, myocarditis could not be completely ruled out. Kansenshogaku Zasshi, 2001 Oct, 75(10), 894 - 7 {A case of bacterial peritonitis caused by Neisseria gonorrhoeae}; Akahane T et al.; On January 17, 2001, a 39-year old female with sudden abdominal pain was admitted to her neighboring outpatient clinic and diagnosed as suspicious of infectious enteritis . However, on the next day (January 18, 2001) she was soon transferred to Toyoshina Red Cross Hospital with the chief complaint of severe abdominal pain, high fever, and of conspicuous leucocytosis . Laboratory data on her admission demonstrated apparent signs of inflammation and she was soon undergone an emergency operation . Neisseria gonorrhoeae was recovered from her ascetic fluid, otherwise Chlamydia EIA was negative . The antibiotic chemotherapy of minocycline (200 mg/day) was continued for the first 9 days and sulbactam/cefoperazone (2 g/day) had been administered for the first 5 days . Her symptoms were discontinued on her 10th hospital day, and she was discharged on the 14th hospital day . There have been few reported cases in Japan of bacterial peritonitis due to N . gonorrhoeae . This is, to the best of our knowledge, the first reported case of N . gonorrhoeae peritonitis in Japan. Int J Antimicrob Agents, 2001 Nov, 18(5), 437 - 40 Antimicrobial activity of BMS 284756 (T-3811) against Neisseria gonorrhoeae tested by three methods; Deshpande L et al.; The potency of BMS 284756, a novel des-F(6)-quinolone, was tested against 137 clinical isolates of Neisseria gonorrhoeae including 50 strains observed to be resistant to ciprofloxacin and other newer quinolones . The gonococci were tested using NCCLS methods (agar dilution, disk diffusion) and Etest . BMS 284756 potency versus N . gonorrhoeae was generally two- to four-fold greater than ciprofloxacin . Penicillin resistance in the absence of ciprofloxacin resistance did not affect BMS 284756 activity . However, elevated ciprofloxacin MICs were associated with higher BMS 284756 MIC results as follows (BMS 284756 MIC(50)/MIC range in mg/l): ciprofloxacin-susceptible strains (0.016 or 0.03/0.004-0.06), ciprofloxacin-intermediate strains (0.06 or 0.12/0.008-0.25) and ciprofloxacin-resistant strains (0.12 or 0.5/0.12-1) . Etest MICs were routinely lower than those produced by the reference agar dilution method, but the correlation coefficient remained acceptable (r = 0.87) . Similarly acceptable correlation was achieved with 5 microg disk zone diameters (r = 0.78), where all zones were > or = 28 mm (MIC < or = 1 mg/l) . In conclusion, BMS 284756 was very active against N . gonorrhoeae (MIC(50) 0.03 mg/l overall) including ciprofloxacin-resistant strains and could be considered as a single-dose therapeutic option for gonorrhoea. Antimicrob Agents Chemother, 2001 Dec, 45(12), 3603 - 6 Outbreak of cefozopran (penicillin, oral cephems, and aztreonam)-resistant Neisseria gonorrhoeae in Japan; Muratani T et al.; We have previously reported that the Neisseria gonorrhoeae isolates from clinical failure cases treated with cefdinir and aztreonam, beta-lactams exhibited high MICs . These resistant isolates were clearly separated from the isolates exhibiting a low level of resistance to beta-lactams as shown by the MIC distribution of cefozopran . Restriction fragment length polymorphism DNA typing revealed that the outbreak of cefozopran-resistant isolates in Kitakyushu, Japan, occurred as a result of clonal spread. Niger J Med, 2001 Apr-Jun, 10(2), 72 - 4 Antimicrobial susceptibility pattern of Neisseria gonorrhoeae isolated at the Jos University Teaching Hospital, Jos, Central Nigeria; Banwat EB et al.; Widespread, inadequate and inappropriate treatment of gonococcal infections are facilitating antibiotic resistance in Jos Nigeria . We present an antimicrobial susceptibility pattern of Neisseria gonorrhoeae strains in this study . Thirty-one strains of Neisseria gonorrhoeae were isolated by inoculating swabs onto prewarmed heated blood agar and Thayer Martins medium and incubated overnight at 35 to 37 degrees C . The isolates were then screened for antimicrobial susceptibility by the disk diffusion method . About 93.6% were susceptible to azithromycin, 90.3% to ciprofloxacin, 87.1% to ceftriaxone, 80.7% and 64.3% to erythromycin and ofloxacin respectively . Less than half were each susceptible to spectinomycin (38.7%) and gentamicin (32.8%), while 12.9% and 4.6% were susceptible to tetracycline and penicillin respectively . These findings suggest that gentamicin, tetracycline and penicillin may not be recommended in this environment for treating gonococcal infections . Azithromycin, ciprofloxacin and ceftriaxone are the suggested alternatives . Prompt diagnosis, treatment and indeed continued surveillance are hereby recommended for an effective management of gonococcal infections. Contraception, 2001 Sep, 64(3), 169 - 72 High rate of bacterial vaginosis among women with intrauterine devices in Manado, Indonesia; Joesoef MR et al.; Recent research reported that bacterial vaginosis (BV) might enhance the acquisition and transmission of HIV . BV is also associated with an increased risk of pelvic inflammatory disease, a disease also associated with intrauterine device (IUD) insertion . To measure the magnitude of this problem, we conducted a prevalence survey of BV and sexually transmitted diseases (STDs; defined as current infections with Neisseria gonorrhoeae, Chlamydia trachomatis, and/or Trichomonas vaginalis) among all patients attending a family planning clinic in Manado from May to July 1999 . BV was diagnosed by Gram stain using Nugent's criteria and vaginal trichomoniasis by wet mount or culture . Cervical infections with C . trachomatis and N . gonorrhoeae were diagnosed by DNA probe . Of 357 patients, 116 (32.5%) had BV, 83 (23.3%) had trichomoniasis, 9 (2.5%) had chlamydia, and 8 (2.2%) had gonorrhea . The prevalence of STD was similar among users of all types of contraception . However, BV was more common among IUD users (47.2%) than among non-IUD users (29.9%) . This association persisted after controlling for age, education, ever had douching, and any STD (odds ratio 2.0, 95% CI 1.1-3.8) . BV was also associated with STD (41.3% in women with STD vs . 29.4% in women without) . This association remained significant after adjusting for age, education, ever had douching, and IUD use (odds ratio 1.7, 95% CI 1.1-2.9) . Because we found that BV was associated with IUDs and that other studies reported that both BV and IUDs were associated with pelvic inflammatory disease, a Gram stain evaluation of BV may be considered prior to IUD insertion Mol Microbiol, 2001 Oct, 42(2), 293 - 307 Structural alterations in a type IV pilus subunit protein result in concurrent defects in multicellular behaviour and adherence to host tissue; Park HS et al.; The ability of bacteria to establish complex communities on surfaces is believed to require both bacterial-substratum and bacterial-bacterial interactions, and type IV pili appear to play a critical but incompletely defined role in both these processes . Using the human pathogen Neisseria gonorrhoeae, spontaneous mutants defective in bacterial self-aggregative behaviour but quantitatively unaltered in pilus fibre expression were isolated by a unique selective scheme . The mutants, carrying single amino acid substitutions within the conserved amino-terminal domain of the pilus fibre subunit, were reduced in the ability to adhere to a human epithelial cell line . Co-expression of the altered alleles in the context of a wild-type pilE gene confirmed that they were dominant negative with respect to aggregation and human cell adherence . Strains expressing two copies of the altered alleles produced twice as much purifiable pili but retained the aggregative and adherence defects . Finally, the defects in aggregative behaviour and adherence of each of the mutants were suppressed by a loss-of-function mutation in the twitching motility gene pilT . The correlations between self-aggregation and the net capacity of the microbial population to adhere efficiently demonstrates the potential significance of bacterial cell-cell interactions to colonization. Acta Trop, 2001 Dec 21, 80(3), 261 - 4 Neisseria gonorrhoeae and Chlamydia trachomatis infections in patients attending STD and family planning clinics in Bissau, Guinea-Bissau; Gomes JP et al.; Accurate clinical and laboratory data about sexually transmitted diseases (STD) prevalence in Guinea-Bissau are not available . These data are important, since HIV2 is prevalent in this country, rates of HIV1 are increasing and STDs facilitate HIV transmission . Since DNA amplification methods have demonstrated to accurately diagnose chlamydial infections and gonorrhoea, the Amplicor CT/NG PCR Assay with Internal Control of Amplification (Roche Diagnostic System, Branchburg, NJ, USA) was used to estimate the prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis genital infections in STDs and Family Planning Clinic attenders in Bissau, from March to July 1997 . Two hundred and two cervical swabs and 31 urethral swabs were examined . Two women were excluded from this study because their cervical swabs contained inhibitory substances . N . gonorrhoeae was identified in 34/200 (17%) women and in 12/31 (38.7%) men . C . trachomatis was detected in 8/200 (4%) women there were no positive C . trachomatis results among the 31 men with urethritis . One woman presented a mixed infection with both organisms . The prevalence difference between men and women was not statistically significant (P=0.6) for C . trachomatis infection, but it was significant for N . gonorrhoeae infection (P=0.01) . The prevalence rates of these infections found in this study, support the need for an urgent strategy to control STD in the region. J Med Microbiol, 2001 Nov, 50(11), 991 - 5 A comparison of multilocus sequence typing and fluorescent fragment-length polymorphism analysis genotyping of clone complex and other strains of Neisseria meningitidis; Hookey JV et al.; Five National Collection of Type Culture (NCTC) strains and 14 isolates of Neisseria meningitidis, representing 13 outbreak isolates from within the UK, were examined by multilocus sequence typing (MLST) for seven house-keeping genes . The results were compared with those of fluorescent amplified fragment-length polymorphism (FAFLP) analysis . Phylogenetic inferences were made from 3284-nucleotide lengths of sequence for the 19 isolates, by distance and parsimony methods . Two clusters of isolates were delineated . The larger, comprising eight isolates--S1, S3, Ironville, P9, ET-37 (M99-241951), P7, P10 and P60--shared 100-99.2% similarity and varied in only 40 nucleotides (approximately 1.22% variation) from the consensus sequence alignment . This cluster could be equated to the ET-37 complex because it had allelic signatures identical to MLST sequence types 11 and 50 . These eight isolates were also assigned to one group by FAFLP . The reference ET-5 complex isolate 'ET-5 (NG144/82)' and an isolate (X9) from an outbreak in the north of England were also grouped together by MLST . They shared 99.2% similarity and differed within the aroE and fumC genes by 4 and 17 nucleotides, respectively . Their MLST sequence types were 32 and 661 and, therefore, these two isolates could be equated to the ET-5 complex . They also grouped together by FAFLP . A comparison of the resources required to apply MLST to the 19 isolates examined with those needed to characterise them by FAFLP indicated that FAFLP (a fragment-based genotyping method) is more cost-effective than the partial sequencing approach, MLST. Bioorg Khim, 2000 Nov, 26(11), 817 - 24 {Inhibition of binding of activated compliment component C4b with its target}; Kozlov LV et al.; The inhibition of covalent binding of the nascent C4b fragment of the human complement component to its natural target, immunoglobulin G, was studied . To this end, an immunoenzyme system was developed . In this ELISA method, the complement was activated on the sorbed IgG molecules and the resulting nascent C4b fragment acylated IgG or interacted with a competitive inhibitor added to the system . The inhibition constants for binding of the nascent C4b to its target were determined for immunoglobulins G1, G2, G3, G4, M, and A1, as well as for ferritin, yeast mannan, capsid polysaccharides of the Neisseria meningitidis A, B, and C serotypes, diphtheria anatoxin, epinephrine, and salicylic acid . On the basis of the experimental data, the immunoglobulin role at the activation stage of the complement regulation cascade, the relationship between the antigen immunogenicity and its ability to interact with C4b, and the direct effect of a number of therapeutic agents on the complement system were discussed . Lectins of various specificities were shown to inhibit the enzymic activation of C4 by the first complement component and the subsequent C4b sorption to its target, which allowed us to suggest that some oligosaccharide fragments of the C1s and C4 molecules are spatially close to the C1s active site and to the thioester bond of C4. Sex Transm Dis, 2001 Oct, 28(10), 555 - 64 Experimental gonococcal urethritis and reinfection with homologous gonococci in male volunteers; Schmidt KA et al.; BACKGROUND: Reinfection, a common occurrence with gonorrhea, may result from a lack of protective immune response, or from the tremendous gonococcal strain variation . GOAL: A two-phase study in human volunteers tested whether experimental infection with Neisseria gonorrhoeae MS11mkC would protect against reinfection with the same organisms . STUDY DESIGN: In phase 1, an intraurethral inoculum of 57,000 piliated, transparent (opacity protein-negative {Opa-}) MS11mkC N gonorrhoeae infected 14 of 15 (93%) volunteers . The volunteers were encouraged to delay treatment for at least 5 days . In phase 2, which began 2 weeks after treatment for the initial infection, volunteers were inoculated with 7,100 piliated, Opa- MS11mkC . RESULTS: The phase 2 challenge infected 6 of 14 (43%) previously infected volunteers and 5 of 10 (50%) naive control subjects . Phase 1 volunteers who resisted reinfection were significantly more likely to have had a fourfold or greater increase in lipooligosaccharide immunoglobulin G during phase 1 than those who did not resist reinfection (P = 0.026) . CONCLUSIONS: Although infection did not provide protection from reinfection under the conditions used, the results suggest that immunity to reinfection is more complex than anticipated by the experimental design. Diagn Microbiol Infect Dis, 2001 Sep-Oct, 41(1-2), 83 - 8 Neisseria meningitidis with decreased susceptibility to penicillin: report from the SENTRY antimicrobial surveillance program, North America, 1998-99; Richter SS et al.; The purpose of this study was to estimate the prevalence of Neisseria meningitidis with decreased susceptibility to penicillin (MIC, >0.06 microg/mL) in North America (NA) . Antimicrobial susceptibility testing by Etest (AB BIODISK, Solna, Sweden) was performed on 53 invasive clinical isolates obtained from 11 SENTRY Antimicrobial Surveillance Program participants in NA (9 states, 2 provinces) during 1998-99 . All strains were markedly susceptible to ciprofloxacin (MIC(90), 0.008 microg/mL) and cefotaxime (MIC(90), < or = 0.002 microg/mL) . Only 54.7% were susceptible to trimethoprim-sulfamethoxazole (TMP/SMX) at < or = 0.5/9.5 microg/mL . One strain was resistant to rifampin (MIC, > 32 microg/mL) and 16 isolates (30.2%) were relatively resistant to penicillin with MICs ranging from 0.094 to 0.25 microg/mL . No beta-lactamase production was detected . The serogroup distribution was 40% Y, 28% B, 24% C, 2% W-135, and 6% of strains were nongroupable . The prevalence of N . meningitidis with decreased susceptibility to penicillin in NA appears higher than previous reports. J Am Chem Soc, 2001 Nov 7, 123(44), 10909 - 18 Microbial glycosyltransferases for carbohydrate synthesis: alpha-2,3-sialyltransferase from Neisseria gonorrheae; Izumi M et al.; The alpha-2,3-sialyltransferase from Neisseria gonorrheae was overproduced in E . coli for exploitation of its substrate specificity and synthetic utility . Several potential acceptor substrates were synthesized in this study, including mono- and oligosaccharides, glycolipids, and glycopeptides and their sulfate derivatives . Some CMP-sialic acid derivatives with modification at the C-5 position were also prepared for evaluation as donor substrates . It was found that the enzyme exhibits a broader acceptor substrate specificity when compared to other sialyltransferases, though the donor specificity is quite limited . Application of the enzyme to the preparative synthesis of representative sialyl glycoconjugates has been demonstrated . On the basis of this work and the work of others, this enzyme is the most versatile and synthetically useful among all sialyltransferases known to date, especially for the synthesis of sulfate-containing glycoconjugates. AIDS, 2001 Aug, 15 Suppl 4, S15 - 30 Ecological and individual level analysis of risk factors for HIV infection in four urban populations in sub-Saharan Africa with different levels of HIV infection; Auvert B et al.; OBJECTIVE: To identify factors that could explain differences in rate of spread of HIV between different regions in sub-Saharan Africa . DESIGN: Cross-sectional study . METHODS: The study took place in two cities with a relatively low HIV prevalence (Cotonou, Benin and Yaounde, Cameroon), and two cities with a high HIV prevalence (Kisumu, Kenya and Ndola, Zambia) . In each of these cities, a representative sample was taken of about 1000 men and 1000 women aged 15-49 years . Consenting men and women were interviewed about their socio-demographic background and sexual behaviour; and were tested for HIV, herpes simplex virus type 2 (HSV-2), syphilis, Chlamydia trachomatis and Neisseria gonorrhoea infection, and (women only) Trichomonas vaginalis . Analysis of risk factors for HIV infection was carried out for each city and each sex separately . Adjusted odds ratios (aOR) were obtained by multivariate logistic regression . RESULTS: The prevalence of HIV infection in sexually active men was 3.9% in Cotonou, 4.4% in Yaounde, 21.1% in Kisumu, and 25.4% in Ndola . For women, the corresponding figures were 4.0, 8.4, 31.6 and 35.1% . High-risk sexual behaviour was not more common in the high HIV prevalence cities than in the low HIV prevalence cities, but HSV-2 infection and lack of circumcision were consistently more prevalent in the high HIV prevalence cities than in the low HIV prevalence cities . In multivariate analysis, the association between HIV infection and sexual behavioural factors was variable across the four cities . Syphilis was associated with HIV infection in Ndola in men {aOR = 2.7, 95% confidence interval (CI) = 1.5-4.91 and in women (aOR = 1.7, 95% CI = 1.1-2.6) . HSV-2 infection was strongly associated with HIV infection in all four cities and in both sexes (aOR ranging between 4.4 and 8.0) . Circumcision had a strong protective effect against the acquisition of HIV by men in Kisumu (aOR = 0.25, 95% CI = 0.12-0.52) . In Ndola, no association was found between circumcision and HIV infection but sample sizes were too small to fully adjust for confounding . CONCLUSION: The strong association between HIV and HSV-2 and male circumcision, and the distribution of the risk factors, led us to conclude that differences in efficiency of HIV transmission as mediated by biological factors outweigh differences in sexual behaviour in explaining the variation in rate of spread of HIV between the four cities. Proteomics, 2001 Aug, 1(8), 975 - 86 Integrated system for high-throughput protein identification using a microfabricated device coupled to capillary electrophoresis/nanoelectrospray mass spectrometry; Li J et al.; An integrated microsystem providing rapid analyses of trace-level tryptic digests for proteomics application is presented . This modular microsystem includes an autosampler and a microfabricated device comprising a sample introduction port and an array of separation channels together with a low dead-volume facilitating the interface to nanoelectrospray mass spectrometry . Sequential injection and separation of peptide standards and tryptic digests was achieved with a throughput of up to 30 samples per hour with less than 3% sample carryover . Replicate injections of peptide mixtures indicated that reproducibility of migration time was typically better than 2.3% relative standard deviation (RSD) whereas RSD values of 3.7-11.8% were observed on peak height . Mass spectral detection of submicromolar protein digests (< 7 femtomoles/injection) was achieved using a quadrupole/time of flight instrument in less than 2 min/per sample with peak widths of 1.8-7.0 s . The analytical potential of this integrated device for the identification of gel isolated proteins from Neisseria meningitidis immunotype L3 has been demonstrated using both peptide mass-fingerprint database searching and on-line tandem mass spectrometry. Can J Microbiol, 2001 Sep, 47(9), 871 - 6 Acid stress upregulated outer membrane proteins in clinical isolates of Neisseria gonorrhoeae, but not most commensal Neisseria; Pettit RK et al.; Human immune serum recognition of outer membrane components from commensal and pathogenic Neisseria cultured under neutral and acidic conditions was investigated . Acid stress caused no detectable alterations in lipooligosaccharide migration and (or) staining, in outer membrane protein profiles, or in immune serum recognition of outer membrane components from Neisseria mucosa or Neisseria sicca . There was also no difference in the lipoologosaccharide electrophoretic pattern of acid- and neutral-grown Neisseria lactamica, but there were differences in outer membrane protein expression . The outer membrane protein alterations induced by acid stress in N . lactamica were not the same as those seen in isolates from patients with uncomplicated gonococcal infection, pelvic inflammatory disease, and disseminated gonococcal infection . Many differences were detected in the immune serum recognition of outer membrane components from acid- and neutral-cultured N . lactamica and from the clinical isolates of Neisseria gonorrhoeae, and these should be considered in vaccine design. J Clin Microbiol, 2001 Nov, 39(11), 3819 - 22 TaqMan-based detection of Trichomonas vaginalis DNA from female genital specimens; Jordan JA et al.; A double-labeled fluorescent probe was designed and evaluated for detecting Trichomonas vaginalis DNA in a 5' nuclease (TaqMan) assay . The T . vaginalis-specific probe contains a 5'-fluorescein (5'-FAM) and a 3'-rhodamine (TAMRA) derivative . Female genital secretions were collected on Amplicor (Roche Molecular, Indianapolis, Ind.) swabs and by a transport system used for Chlamydia trachomatis and/or Neisseria gonorrhoeae DNA detection by PCR . Five hundred fifty-two female genital specimens, of which 248 (45%) were vaginal specimens and 304 (55%) were introital, were tested for both T . vaginalis DNA and viable microorganisms using the 5' nuclease assay and broth culture, respectively . Of these, 304 of 552 (55%) were also evaluated by direct microscopic examination for the characteristic motile organism . After resolving discrepancies, the comparisons produced an analytical sensitivity and specificity for the TaqMan-based PCR assay of 97.8 and 97.4%, respectively . As a result, DeltaRQ values (differences in fluorescence due to probe hybridization and resulting 5'-FAM cleavage from the specific PCR product) of > or =2.0 and < or =1.5 were established for T . vaginalis-positive and -negative cutoffs, respectively . DeltaRQ values between 1.5 and 2.0 were considered indeterminate . Overall findings revealed a high level of agreement between PCR and culture for detecting T . vaginalis . Potential benefits of the 5' nuclease assay include a greater sensitivity compared to direct microscopic examination and the ease of testing large numbers of clinical specimens in a significantly shorter turnaround time compared to culture. Int J Med Microbiol, 2001 Sep, 291(4), 307 - 14 Signal transduction pathways induced by virulence factors of Neisseria gonorrhoeae; Popp A et al.; The obligate human pathogen Neisseria gonorrhoeae infects a variety of human tissues . In recent years, several host cell receptors for the major bacterial adhesins have been identified . While the knowledge of the molecular mechanism of colonisation has helped to understand special aspects of the infection, like the explicit tropism of gonococci for human tissues, the long-term consequences of engaging these receptors are still unknown . A variety of signalling pathways initiated by the activated receptors and by bacterial proteins transferred to the infected cell have been defined which include lipid second messenger, protein kinases, proteases and GTPases . These pathways control important steps of the infection, such as tight adhesion and invasion, the induction of cytokine release, and apoptosis . The detailed knowledge of bacteria-induced signalling pathways could allow the design of new therapeutic approaches which might be advantageous over the classical antibiotics therapy. Euro Surveill, 2001 May, 6(5), 86 - 90 The laboratory surveillance system of Chlamydia trachomatis and Neisseria gonorrhoeae infections in Denmark; Hoffmann S; This article presents results of surveillance of C . trachomatis and N . gonorrhoeae infection in Denmark . In 1999 and 2000, there were 291 and 309 male cases of laboratory-confirmed gonorrhoeae, whereas the number of female cases was 43 for both years . The penicillin resistance was steady, with a prevalence of 40% in 1999, whereas the prevalence of fluoroquinolone resistance increased from 0% in 1990 to 27% in 1999 . The number of laboratory-confirmed C . trachomatis infections remains around 13 000 cases per year . Men aged 20-29 years and women aged 15-24 are the most at risk. Euro Surveill, 2001 May, 6(5), 69 - 70 Europe-wide surveillance for sexually transmitted infections: a timely and appropriate intervention; Fenton K et al.; Sexually transmitted infections (STIs), including HIV, pose a significant threat to the health and wellbeing of Europeans and require concerted and sustained intervention . Over the past decade, the number of reported cases of STIs, including antimicrobial resistant Neisseria gonorrhoeae, has increased appreciably, and outbreaks of syphilis have recently been reported in many Member states of the European Union (EU) . Young people, homosexual men, and those with poor access to health care (including preventive and educational services) seem to be particularly affected, with increased travel and migration, high risk sexual behaviours, and a deterioration of public health responses to STI control (for example, partner notification) being key driving factors . Many of these demographic and behavioural trends are similar across EU states, as is the desire to develop and implement effective STI prevention and control programmes. Mol Microbiol, 2001 Oct, 42(1), 167 - 81 The Neisseria gonorrhoeae lpxLII gene encodes for a late-functioning lauroyl acyl transferase, and a null mutation within the gene has a significant effect on the induction of acute inflammatory responses; Ellis CD et al.; LPS is a fundamental constituent of the outer membrane of all Gram-negative bacteria, and the lipid A domain plays a central role in the induction of inflammatory responses . We identified genes of the Neisseria gonorrhoeae lipid A biosynthetic pathway by searching the complete gonococcal genome sequence with sequences of known enzymes from other species . The lpxLII gene was disrupted by an insertion-deletion in an attenuated aroA mutant of the gonococcal strain MS11 . Lipopolysaccharide (LPS) and lipid A analysis demonstrated that the lpxLII mutant had synthesized an altered LPS molecule lacking a single lauric fatty acid residue in the GlcN II of the lipid A backbone . LPS of the lpxLII mutant had a markedly reduced ability to induce the proinflammatory cytokines tumour necrosis factor (TNF)-alpha, interleukin (IL)-1beta, IL-6 and IL-8 from human macrophages and IL-8 from polymorphonuclear cells . This study demonstrates that the lpxLII gene in gonococci encodes for a late-functioning lauroyl acyl transferase that adds a lauric acid at position 2' in the lipid A backbone . The presence of lauric acid at such a position appears to be crucial for the induction of full inflammatory responses by N . gonorrhoeae LPS. Sex Transm Dis, 2001 Nov, 28(11), 630 - 2 Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae in Turkey among men With urethritis; Agacfidan A et al.; BACKGROUND: Chlamydia trachomatis and Neisseria gonorrhoeae are known to cause urethritis . However, only a small number of studies in Eastern European countries have investigated the causes of urethritis . GOALS: To determine the prevalence of C trachomatis and N gonorrhoeae among men with symptomatic urethritis in Istanbul, Turkey, and to determine whether contact with a commercial sex worker increased the likelihood of chlamydial infections . STUDY DESIGN: Men with a diagnosis of urethritis at the Istanbul Faculty of Medicine were screened for C trachomatis and N gonorrhoeae by Abbott's ligase chain reaction (LCR) using either urethral swabs or first-void urine . N gonorrhoeae cultures were done on a subset of these patients . RESULTS: The study enrolled 813 men . All of the men denied condom use during their previous sexual exposures . The overall prevalence of C trachomatis, as determined by LCR, was 15.7% . Only 192 patients were screened for both organisms . N gonorrhoeae prevalence was 9.4% . There was no difference in the chlamydia prevalence between men who had contact with commercial sex workers (CSWs) and men who had no such contact (15.3% versus 17.2%) . However, clients of foreign CSWs were more likely to have chlamydia than clients of registered Turkish CSWs . CONCLUSIONS: C trachomatis and N gonorrhoeae are commonly found in Turkish men with urethritis . The findings did not show more chlamydial infection among men who had contact with CSWs than among men who had no such contact . The failure to use condoms among these men must be addressed. Sex Transm Dis, 2001 Nov, 28(11), 624 - 9 A case-control study of beliefs and behaviors associated with sexually transmitted disease occurrence in Estonia; Wilson TE et al.; BACKGROUND: Epidemiologic data document rapidly increasing sexually transmitted disease (STD) rates throughout Eastern Europe . GOAL: This case-control study was designed to delineate factors contributing to the STD epidemic in Estonia . STUDY DESIGN: For this study, 189 study participants and 112 control subjects completed a behavioral questionnaire and underwent testing for Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum . RESULTS: The prevalence of STDs among the control subjects was 32% . Although the participants believed that condoms prevent STDs, only 17% reported consistent use . Methods believed to prevent transmission included washing the genitals (65%), urinating (26%), douching (35%), and using oral contraceptives (19%) . An interaction between sex and travel outside Estonia (odds ratio, 0.1; 95% CI, 0-0.7) reflects the fact that males with STDs were more likely to report travel (46% of participants and 45.5% of control subjects with STD) than were those without STD (16.1% of controls without STD) . CONCLUSIONS: STD rates are related to high-risk sexual behavior among males traveling outside of Estonia . Intervention is needed to promote understanding of disease transmission dynamics in this area, and to decrease sexual risk behavior, particularly in the context of travel. Ned Tijdschr Geneeskd, 2001 Sep 29, 145(39), 1899 - 900 {Increased Neisseria gonorrhoeae quinolone resistance in Amsterdam}; Peerbooms PG et al.; In addition to a rise in the number of cases of gonorrhoea, the susceptibility of Neisseria gonorrhoeae to antibiotics is also a cause for concern . After a period of high resistance rates to penicillin and tetracycline between 1985 and 1995, resistance rates have dropped considerably in recent years, probably due to changes in treatment regimens . However, recently we have seen an increasing number of quinolone-resistant N . gonorrhoeae isolates in Amsterdam, the Netherlands, a development that has previously been reported in other parts of the world . Some form of national resistance monitoring for gonococci is therefore urgently required to allow timely detection of changes in N . gonorrhoeae resistance. Kansenshogaku Zasshi, 2001 Sep, 75(9), 819 - 21 {Gonococcal abscess in the prepuce: a case report}; Yamada Y et al.; We reported a case of gonococcal abscess in the prepuce not accompanied with urethritis . As initial therapy fluoroquinolone was ineffective, the abscess spread to the subcutaneous tissue around the penile root . After intravenous administration of cefodizime, the clinical symptoms improved, and Neisseria gonorrhoeae was eradicated. Transplantation, 2001 Oct 15, 72(7), 1241 - 4 Postmenopausal tubo-ovarian abscess due to Pseudomonas aeruginosa in a renal transplant patient: a case report and review of the literature; El Khoury J et al.; BACKGROUND: Pseudomonas aeruginosa is an uncommon cause of infection in the female genital tract . We report a case of postmenopausal tubo-ovarian abscess (TOA) due to P . aeruginosa in a renal transplant recipient . The presentation included mild abdominal symptoms with rapid progression of peritonitis and surgical abscess drainage . This is the first such case in an organ transplant recipient described in the English literature . METHODS AND RESULTS: Published reports of 1040 cases of TOA were reviewed . The most common features were a history of sexually transmitted disease or pelvic inflammatory disease, and symptoms including abdominal pain and fever . Escherichia coli, Bacteroides spp., and Klebsiella pneumoniae were the most frequently encountered pathogens . Neisseria gonorrhoeae and Chlamydia trachomatis, which are frequently isolated from cervical cultures, are uncommonly isolated from tubo-ovarian abscesses . Forty percent of patients were treated with antibiotics alone, 18.8% with abdominal surgery, and 32% with surgery and antimicrobial therapy . CONCLUSION: This report illustrates the muted presentation and atypical microbiology of gynecologic infection in an organ transplant recipient. J Infect Dis, 2001 Nov 1, 184(9), 1216 - 9 Epub 2001 Sep 27. Features of Chlamydia trachomatis and Neisseria gonorrhoeae infection in male Army recruits; Cecil JA et al.; Non-health care-seeking male United States Army recruits were tested for Chlamydia trachomatis (n=2245) and Neisseria gonorrhoeae (n=884), using a urine ligase chain reaction test to determine prevalence and potential risk factors for infection . The prevalence of chlamydial infection was 5.3% . Black race, a new sex partner, a history of trichomonas, and the presence of symptoms were associated with chlamydial infection . The prevalence of N . gonorrhoeae infection was 0.6% . Only a reported history of or positive test for C . trachomatis was associated with gonorrheal infection . Of those testing positive for chlamydia, 14% reported symptoms versus 40% of those with gonorrhea . Younger age was not a predictor of either infection, as has been shown for women . A substantial number of male army recruits are infected with C . trachomatis, but few are infected with N . gonorrhoeae . Screening on the basis of symptoms alone would miss the majority of both infections. J Bacteriol, 2001 Nov, 183(21), 6394 - 403 Homologues of neisserial heme oxygenase in gram-negative bacteria: degradation of heme by the product of the pigA gene of Pseudomonas aeruginosa; Ratliff M et al.; The oxidative cleavage of heme to release iron is a mechanism by which some bacterial pathogens can utilize heme as an iron source . The pigA gene of Pseudomonas aeruginosa is shown to encode a heme oxygenase protein, which was identified in the genome sequence by its significant homology (37%) with HemO of Neisseria meningitidis . When the gene encoding the neisserial heme oxygenase, hemO, was replaced with pigA, we demonstrated that pigA could functionally replace hemO and allow for heme utilization by neisseriae . Furthermore, when pigA was disrupted by cassette mutagenesis in P . aeruginosa, heme utilization was defective in iron-poor media supplemented with heme . This defect could be restored both by the addition of exogenous FeSO4, indicating that the mutant did not have a defect in iron metabolism, and by in trans complementation with pigA from a plasmid with an inducible promoter . The PigA protein was purified by ion-exchange chromotography . The UV-visible spectrum of PigA reconstituted with heme showed characteristics previously reported for other bacterial and mammalian heme oxygenases . The heme-PigA complex could be converted to ferric biliverdin in the presence of ascorbate, demonstrating the need for an exogenous reductant . Acidification and high-performance liquid chromatography analysis of the ascorbate reduction products identified a major product of biliverdin IX-beta . This differs from the previously characterized heme oxygenases in which biliverdin IX-alpha is the typical product . We conclude that PigA is a heme oxygenase and may represent a class of these enzymes with novel regiospecificity. J Bacteriol, 2001 Nov, 183(21), 6253 - 64 Gonococcal MinD affects cell division in Neisseria gonorrhoeae and Escherichia coli and exhibits a novel self-interaction; Szeto J et al.; The Min proteins are involved in determining cell division sites in bacteria and have been studied extensively in rod-shaped bacteria . We have recently shown that the gram-negative coccus Neisseria gonorrhoeae contains a min operon, and the present study investigates the role of minD from this operon . A gonococcal minD insertional mutant, CJSD1, was constructed and exhibited both grossly abnormal cell division and morphology as well as altered cell viability . Western blot analysis verified the absence of MinD from N . gonorrhoeae (MinD(Ng)) in this mutant . Hence, MinD(Ng) is required for maintaining proper cell division and growth in N . gonorrhoeae . Immunoblotting of soluble and insoluble gonococcal cell fractions revealed that MinD(Ng) is both cytosolic and associated with the insoluble membrane fraction . The joint overexpression of MinC(Ng) and MinD(Ng) from a shuttle vector resulted in a significant enlargement of gonococcal cells, while cells transformed with plasmids encoding either MinC(Ng) or MinD(Ng) alone did not display noticeable morphological changes . These studies suggest that MinD(Ng) is involved in inhibiting gonococcal cell division, likely in conjunction with MinC(Ng) . The alignment of MinD sequences from various bacteria showed that the proteins are highly conserved and share several regions of identity, including a conserved ATP-binding cassette . The overexpression of MinD(Ng) in wild-type Escherichia coli led to cell filamentation, while overexpression in an E . coli minD mutant restored a wild-type morphology to the majority of cells; therefore, gonococcal MinD is functional across species . Yeast two-hybrid studies and gel-filtration and sedimentation equilibrium analyses of purified His-tagged MinD(Ng) revealed a novel MinD(Ng) self-interaction . We have also shown by yeast two-hybrid analysis that MinD from E . coli interacts with itself and with MinD(Ng) . These results indicate that MinD(Ng) is required for maintaining proper cell division and growth in N . gonorrhoeae and suggests that the self-interaction of MinD may be important for cell division site selection across species. J Leukoc Biol, 2001 Oct, 70(4), 543 - 50 Identification and comparison of residues critical for cell-adhesion activities of two neutrophil CD66 antigens, CEACAM6 and CEACAM8; Kuroki M et al.; CEACAM6 (CD66c) and CEACAM8 (CD66b) are cell-adhesion proteins on neutrophils that belong to the human carcinoembryonic antigen (CEA) family . CEACAM6 reveals homophilic adhesion and heterophilic adhesion to other CEACAM family antigens including CEACAM8, CEACAM1, and CEA, whereas CEACAM8 exhibits only heterophilic adhesion to CEACAM6 . Here, we investigated and compared structural requirements for the homophilic adhesion of CEACAM6 and heterophilic adhesion between CEACAM6 and CEACAM8 at the amino acid level by using CHO transfectants expressing their mutant and chimeric proteins . The NH(2)-terminal domain (N-domain) of CEACAM6 expressed on a CHO cell was suggested to bind the N-domain of CEACAM6 or CEACAM8 on the opposing cell . By homologue-scanning mutagenesis, we found that the locations of the sequences critical for the adhesion of CEACAM6 to itself and to CEACAM8 are overlapped and that they are highly similar but not identical to the locations of the residues previously shown to be essential for the binding of CEACAM antigens to Opa proteins of pathogenic NEISSERIAE: Our findings imply that subtle differences in the N-domain sequences determine the specificity of the CEACAM antigens on neutrophils for interaction with the same or different CEACAM antigens and the bacterial proteins. FEMS Microbiol Lett, 2001 Sep 25, 203(2), 173 - 7 Genetic analysis of conservation and variation of lipooligosaccharide expression in two L8-immunotype strains of Neisseria meningitidis; Zhu P et al.; Neisseria meningitidis strains A1 and M978 both express the lipooligosaccharide (LOS) L8 immunotype {Gu et al., J . Clin . Microbiol . 30 (1992) 2047-2053} . Under different growth conditions, strain A1 did not change its LOS profile whereas strain M978 produced variable LOS profiles on SDS-PAGE . To understand the genetic basis of LOS conservation and variation, their lgt locus encoding glycosyltransferases responsible for the biosynthesis of the alpha-chain of LOS was analyzed . Strain A1 possessed only two genes, lgtA and lgtH, at the lgt locus . The lgtA gene was inactivated due to a frameshift mutation; thus strain A1 expressed only L8 LOS . In contrast, strain M978 contained five genes lgtZ, lgtC, lgtA, lgtB and lgtE at this locus, thus it had a potential to express L1, L3,7 in addition to the L8 LOS . The data showed that strain A1 is a better reference strain for the L8 immunotype because of the stability of L8 LOS expression resulting from its unique lgt locus . In addition, these two strains had two new genetic organizations, lgtAH and lgtZCABE, compared to the reported gene organization at the lgt locus in N . meningitidis. J Cell Biol, 2001 Oct 1, 155(1), 133 - 43 Activation of ErbB2 receptor tyrosine kinase supports invasion of endothelial cells by Neisseria meningitidis; Hoffmann I et al.; ErbB2 is a receptor tyrosine kinase belonging to the family of epidermal growth factor (EGF) receptors which is generally involved in cell differentiation, proliferation, and tumor growth, and activated by heterodimerization with the other members of the family . We show here that type IV pilus-mediated adhesion of Neisseria meningitidis onto endothelial cells induces tyrosyl phosphorylation and massive recruitment of ErbB2 underneath the bacterial colonies . However, neither the phosphorylation status nor the cellular localization of the EGF receptors, ErbB3 or ErbB4, were affected in infected cells . ErbB2 phosphorylation induced by N . meningitidis provides docking sites for the kinase src and leads to its subsequent activation . Specific inhibition of either ErbB2 and/or src activity reduces bacterial internalization into endothelial cells without affecting bacteria-induced actin cytoskeleton reorganization or ErbB2 recruitment . Moreover, inhibition of both actin polymerization and the ErbB2/src pathway totally prevents bacterial entry . Altogether, our results provide new insight into ErbB2 function by bringing evidence of a bacteria-induced ErbB2 clustering leading to src kinase phosphorylation and activation . This pathway, in cooperation with the bacteria-induced reorganization of the actin cytoskeleton, is required for the efficient internalization of N . meningitidis into endothelial cells, an essential process enabling this pathogen to cross host cell barriers. J Antimicrob Chemother, 2001 Oct, 48(4), 545 - 8 Frequency of selection of fluoroquinolone-resistant mutants of Neisseria gonorrhoeae exposed to gemifloxacin and four other quinolones; Ruiz J et al.; We studied the frequency of mutation of clinical isolates of Neisseria gonorrhoeae (two nalidixic acid susceptible and two nalidixic acid resistant), and the stability of the mutants obtained, in the presence of three different concentrations of five fluoroquinolones . The frequency of mutation was low for all the quinolones . Only one N . gonorrhoeae mutant, obtained with trovafloxacin at 4 x MIC presented a stable increase in the MIC of this quinolone, not attributable to novel mutation(s), both in the gyrA and parC genes, although not showing any increase in the MIC of the other quinolones tested . In summary, gemifloxacin was the only quinolone tested for which resistant mutants were not obtained. Cell Microbiol, 2001 Oct, 3(10), 681 - 91 CEACAM is not necessary for Neisseria gonorrhoeae to adhere to and invade female genital epithelial cells; Swanson KV et al.; Neisseria gonorrhoeae has a repertoire of up to 11 opacity-associated (Opa) proteins that are adhesins . Most Opa proteins adhere to CEACAM antigens and when CEACAM molecules are present on the surface of transfected epithelial cells their binding by Opa is thought to induce invasion of these cells by gonococci . In this study, we investigated whether several malignant epithelial cell lines, normal cervical and fallopian tube epithelial cell cultures, as well as normal fallopian tube tissue express several of the CEACAM molecules, and whether gonococci use these molecules for adherence and invasion of these female genital epithelial cells . A primary cervical cell culture and metastatic cervical cell line ME180 both expressed CEACAM as shown by whole cell ELISA and flow cytometry, and increased the surface expression of total CEACAM during incubation with Opa+ gonococci . Opa+ gonococci both adhered to and invaded these cells; CEACAM-specific monoclonal antibody (MAb) partially abolished this interaction . Two primary fallopian epithelial tube cell cultures, a primary cervical cell culture and two malignant cell lines, HEC-1-B and HeLa, did not express CEACAM nor was CEACAM mRNA present . No evidence of either intracellular or secreted extracellular CEACAM was found with HEC-1-B and HeLa cells . Opa+ gonococci both adhered to and invaded CEACAM non-expressing cells; however, Opa+ gonococcal association with these non-expressing cell lines could not be inhibited with CEACAM-specific MAb . These data show that CEACAM is not always expressed on female genital epithelial cells and is not essential for gonococcal adherence and invasion . However, when CEACAM is expressed, Opa+ gonococci exploit it for the adherence to and invasion of these cells. J Microbiol Methods, 2001 Nov, 47(2), 135 - 49 Novel vaccine strategies to T-independent antigens; Lesinski GB et al.; T cell independent antigens do not require T cell help to induce an immune response, and are characterized by a lack of immunologic memory . These antigens can be divided into two classes, TI-1 or TI-2 . TI-1 antigens, such as bacterial lipopolysaccharide, are potent B-cell mitogens, capable of non-specific, polyclonal activation of B cells . In contrast, TI-2 antigens can only activate mature B cells and consist of highly repetitive structures, such as capsular polysaccharides (CPS) from bacteria . Many vaccines currently in use consist of purified capsular polysaccharides from pathogenic bacteria such as Streptococcus pneumoniae and Neisseria meningitidis . These vaccines are efficacious in immune-competent adults, however, due to their TI-2 nature, are not effective in children <2 years of age . Converting polysaccharides into T cell dependent (TD) antigens, allows children, <2, to produce an effective immune response . This review focuses on various strategies used to convert the immune response to polysaccharide antigens from TI-2 to a TD response . Conjugate vaccines, anti-idiotypic antibodies, phage display library technology and DNA vaccines are discussed. Hautarzt, 2001 Sep, 52(9), 820 - 3 {Recurrent chancriform mucous membrane ulcer in plasmacytoma with secondary IgA deficiency . Pyoderma chancriforme of the tongue}; Hegemann B et al.; A 66 year old patient presented with a nine month history of recurrent oral ulcerations involving the tongue . We diagnosed chancriform pyoderma and a previously not identified multiple myeloma with secondary immunoglobulin deficiency . Clinically and histologically we excluded a necrotizing ulcerative stomatitis as found in individuals with cellular immunodeficiency as in late-stage HIV-infection . On culture only Neisseria catarrhalis was found . Chancriform pyoderma is often associated with local bacterial infections, especially Staphylococcus aureus . The most common sites are the genitalia and periorbital region; involvement of the oral mucosa is uncommon . To the best of our knowledge, this is the fourth reported case with tongue lesions . The multiple myeloma-associated immunoglobulin deficiency might have facilitated the oral manifestations of chancriform pyoderma. J Comput Biol, 2001, 8(4), 401 - 27 Detection of recombination in DNA multiple alignments with hidden Markov models; Husmeier D et al.; Conventional phylogenetic tree estimation methods assume that all sites in a DNA multiple alignment have the same evolutionary history . This assumption is violated in data sets from certain bacteria and viruses due to recombination, a process that leads to the creation of mosaic sequences from different strains and, if undetected, causes systematic errors in phylogenetic tree estimation . In the current work, a hidden Markov model (HMM) is employed to detect recombination events in multiple alignments of DNA sequences . The emission probabilities in a given state are determined by the branching order (topology) and the branch lengths of the respective phylogenetic tree, while the transition probabilities depend on the global recombination probability . The present study improves on an earlier heuristic parameter optimization scheme and shows how the branch lengths and the recombination probability can be optimized in a maximum likelihood sense by applying the expectation maximization (EM) algorithm . The novel algorithm is tested on a synthetic benchmark problem and is found to clearly outperform the earlier heuristic approach . The paper concludes with an application of this scheme to a DNA sequence alignment of the argF gene from four Neisseria strains, where a likely recombination event is clearly detected. Clin Infect Dis, 2001 Nov 1, 33(9), 1455 - 61 Epub 2001 Sep 24. Evaluation of use of a single intravaginal swab to detect multiple sexually transmitted infections in active-duty military women; Rompalo AM et al.; The accuracy and suitability of use of a single intravaginal swab (SIS) for polymerase chain reaction detection of Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, and human papillomavirus infection was assessed in a cross-sectional study of 841 active-duty military women . The SIS, compared with standard diagnostic tests, allowed detection of more gonorrhea, more chlamydial infection, and more trichomoniasis . Sensitivity and specificity of SIS detection compared with adjudicated true-positive diagnoses were 95.8% and 97.8%, respectively, for gonorrhea, 94.6% and 99.3% for chlamydial infection, and 92.2% and 98.2% for trichomonal infection . Results with SISs were comparable to those with cervical swabs tested for human papillomavirus . Assay of clinician-collected and self-collected SISs yielded prevalences similar to those of standard diagnostic tests for all sexually transmitted infections . Therefore, the use of SISs is acceptable for the simultaneous diagnosis of multiple sexually transmitted infections and has potential for use as a self-administered diagnostic tool with widespread applicability among women. Am J Obstet Gynecol, 2001 Sep, 185(3), 629 - 32 A randomized trial that compared oral cefixime and intramuscular ceftriaxone for the treatment of gonorrhea in pregnancy; Ramus RM et al.; OBJECTIVE: The purpose of this study was to evaluate prospectively the Centers for Disease Control recommendations for the treatment of gonococcal infection in pregnancy . STUDY DESIGN: One hundred sixty-one women who were referred with probable endocervical gonorrhea underwent pretreatment endocervical, anal, and oral cultures for Neisseria gonorrhoeae . The women were randomly assigned to receive ceftriaxone 125 mg intramuscularly or cefixime 400 mg orally . Treatment was open and in a 1:1 distribution . There were 95 evaluable patients . The tests of cure cultures were performed 4 to 10 days after treatment . RESULTS: Eighty-six women (91%) had endocervical infection; 39 women (41%) had anal infection, and 11 women (12%) had pharyngeal infection . Fifty of 95 women (53%) had concomitant endocervical chlamydial infection . The overall efficacy was 91 of 95 subjects (95.8%; 95% CI, 89.6%-98.8%) . Ceftriaxone was effective in 41 of 43 cases (95%; 95% CI, 84.2%-99.4%), and cefixime was effective in 50 of 52 cases (96%; 95% CI, 86.8%-99.5%) . No significant difference was noted in the overall efficacy or by site of infection . Three of the 4 women who experienced treatment failures admitted to unprotected intercourse before their test of cure culture . CONCLUSION: Both intramuscular ceftriaxone 125 mg and oral cefixime 400 mg appear to be effective for the treatment of gonococcal infection in pregnancy. Biochemistry, 2001 Sep 25, 40(38), 11552 - 8 Crystal structure of heme oxygenase from the gram-negative pathogen Neisseria meningitidis and a comparison with mammalian heme oxygenase-1; Schuller DJ et al.; We report the crystal structure of heme oxygenase from the pathogenic bacterium Neisseria meningitidis at 1.5 A and compare and contrast it with known structures of heme oxygenase-1 from mammalian sources . Both the bacterial and mammalian enzymes share the same overall fold, with a histidine contributing a ligand to the proximal side of the heme iron and a kinked alpha-helix defining the distal pocket . The distal helix differs noticeably in both sequence and conformation, and the distal pocket of the Neisseria enzyme is substantially smaller than in the mammalian enzyme . Key glycine residues provide the flexibility for the helical kink, allow close contact of the helix backbone with the heme, and may interact directly with heme ligands. Eur J Biochem, 2001 Sep, 268(18), 4908 - 17 Solution structure of the lipoyl domain of the chimeric dihydrolipoyl dehydrogenase P64K from Neisseria meningitidis; Tozawa K et al.; The antigenic P64K protein from the pathogenic bacterium Neisseria meningitidis is found in the outer membrane of the cell, and consists of two parts: an 81-residue N-terminal region and a 482-residue C-terminal region . The amino-acid sequence of the N-terminal region is homologous with the lipoyl domains of the dihydrolipoyl acyltransferase (E2) components, and that of the C-terminal region with the dihydrolipoyl dehydrogenase (E3) components, of 2-oxo acid dehydrogenase multienzyme complexes . The two parts are separated by a long linker region, similar to the linker regions in the E2 chains of 2-oxo acid dehydrogenase complexes, and it is likely this region is conformationally flexible . A subgene encoding the P64K lipoyl domain was created and over-expressed in Escherichia coli . The product was capable of post-translational modification by the lipoate protein ligase but not aberrant modification by the biotin protein ligase of E . coli . The solution structure of the apo-domain was determined by means of heteronuclear NMR spectroscopy and found to be a flattened beta barrel composed of two four-stranded antiparallel beta sheets . The lysine residue that becomes lipoylated is in an exposed beta turn that, from a {1H}-15N heteronuclear Overhauser effect experiment, appears to enjoy substantial local motion . This structure of a lipoyl domain derived from a dihydrolipoyl dehydrogenase resembles that of lipoyl domains normally found as part of the dihydrolipoyl acyltransferase component of 2-oxo acid dehydrogenase complexes and will assist in furthering the understanding of its function in a multienzyme complex and in the membrane-bound P64K protein itself. Kansenshogaku Zasshi, 2001 Aug, 75(8), 692 - 5 {A case of sepsis by Neisseria meningitidis beginning with pneumonia during a trip abroad}; Shiraishi M et al.; A 62-year-male presented a high fever and a dry cough during a trip to Australia . He was admitted to a hospital as soon as be returned to Japan . The next day after returning to Japan, he was transferred to our hospital with septic shock and loss of consciousness . Neisseria meningitidis was cultured from his blood . N . meningitidis is rare in Japan . However its seems common, in some foreign countries . With these findings, it can be postulated that N . meningitidis might be one of the etiological agents of the imported infectious disease. Mol Microbiol, 2001 Sep, 41(5), 1199 - 210 Analysis of type I restriction modification systems in the Neisseriaceae: genetic organization and properties of the gene products; Piekarowicz A et al.; The hsd locus (host specificity of DNA) was identified in the Neisseria gonorrhoeae genome . The DNA fragment encoding this locus produced an active restriction and modification (R/M) system when cloned into Escherichia coli . This R/M system was designated NgoAV . The cloned genomic fragment (7800 bp) has the potential to encode seven open reading frames (ORFs) . Several of these ORFs had significant homology with other proteins found in the databases: ORF1, the hsdM, a methylase subunit (HsdM); ORF2, a homologue of dinD; ORF3, a homologue of hsdS; ORF4, a homologue of hsdS; and ORF5, an endonuclease subunit hsdR . The endonuclease and methylase subunits possessed strongest protein sequence homology to the EcoR124II R/M system, indicating that NgoAV belongs to the type IC R/M family . Deletion analysis showed that only ORF3 imparted the sequence specificity of the RM.NgoAV system, which recognizes an interrupted palindrome sequence (GCAN(8-)TGC) . The genetic structure of ORF3 (208 amino acids) is almost identical to the structure of the 5' truncated hsdS genes of EcoDXXI or EcoR124II R/M systems obtained by in vitro manipulation . Genomic sequence analysis allowed us to identify hsd loci with a very high homology to RM.NgoAV in two strains of Neisseria meningitidis . However, significant differences in the organization and structure of the hsdS genes in both these systems suggests that, if functional, they would possess recognition sites that differ from the gonococcus and from themselves. Infect Immun, 2001 Oct, 69(10), 6419 - 26 Soluble pilin of Neisseria gonorrhoeae interacts with human target cells and tissue; Rytkonen A et al.; Pili of Neisseria gonorrhoeae are phase-variable surface structures that mediate adherence to host target cells . Each pilus is composed of thousands of major pilus subunits, pilins, pilus-associated protein PilC, and possibly other components . Piliated and nonpiliated gonococcal clones may secrete a soluble smaller pilin (S-pilin) that is cleaved after amino acid 39 of the mature pilin protein . Here, purified S-pilin was found to migrate as a 61- to 64-kDa double band on nondenaturing gels, suggesting the formation of tetrameric S-pilin proteins with two isomeric forms . In situ studies of binding to formalin-fixed tissue sections demonstrated the binding of S-pilin to human tissue but not to tissue from mouse or rat organs, showing the presence of a human-specific receptor-binding domain within the pilin polypeptide . Pretreatment of the target tissues with proteinase K decreased gonococcal binding dramatically, whereas pretreatment with neuraminidase and meta-periodate, which cleave carbon-carbon linkages between vicinal hydroxyl groups in carbohydrates, did not affect gonococcal binding . In overlay assays, purified S-pilin bound to a band with a migration pattern and size similar to those of CD46, a cellular pilus receptor . Further, binding of N . gonorrhoeae to target cells and tissues could be blocked by both CD46 antibodies and purified S-pilin . These data argue that S-pilin interacts with a protein domain(s) of the CD46 receptor on human cells. Infect Immun, 2001 Oct, 69(10), 6336 - 47 Gonococcal genes encoding transferrin-binding proteins A and B are arranged in a bicistronic operon but are subject to differential expression; Ronpirin C et al.; Neisseria gonorrhoeae is capable of utilizing host iron-binding proteins, such as transferrin, lactoferrin, and hemoglobin, as the sole source of iron . The receptor involved in transferrin iron acquisition is composed of two distinct transferrin-binding proteins, TbpA and TbpB . The genes that encode these proteins are linked on the chromosome in the order tbpB-tbpA but are separated by an inverted repeat of unknown function . In this study, we sought to understand the transcriptional organization and regulation of the tbp genes, using a combination of lacZ transcriptional fusion analysis and reverse transcriptase PCR (RT-PCR) . First, we demonstrated that tbpB and tbpA are cotranscribed and coregulated from the common upstream promoter that precedes tbpB . Using beta-galactosidase activity as a surrogate for tbp-specific transcription, we found that tbpB-specific transcripts were more prevalent than tbpA-specific transcripts after 2 h of growth under iron stress conditions . We confirmed the results obtained by fusion analysis by using RT-PCR applied to native RNA isolated from wild-type gonococci . Three different varieties of RT-PCR were employed: relative, competitive, and real time quantitative . The results of all analyses indicated that tbpB-specific transcripts were approximately twofold more prevalent than tbpA-specific transcripts at steady state . In iron-stressed cultures, the ratio of tbpB- to tbpA-specific message was approximately 2; however, in iron-replete cultures, this ratio dropped to 1 . Using these techniques, we also quantitated the effects of iron, external pH, and presence of ligand on tbp mRNA levels. Cell Microbiol, 2001 Sep, 3(9), 611 - 22 The role of complement receptor 3 (CR3) in Neisseria gonorrhoeae infection of human cervical epithelia; Edwards JL et al.; Neisseria gonorrhoeae is an important sexually transmitted pathogen and a major cofactor in HIV-1 infection . This organism uses different mechanisms to infect male and female genital tract epithelia . Receptor-mediated endocytosis of N . gonorrhoeae is the principle mechanism of entry into male urethral epithelial cells . Infection in men leads to a pronounced inflammatory response . In contrast, N . gonorrhoeae infection in women induces ruffling of the cervical epithelia, allowing a macropinocytic mechanism of entry . Infection in women is frequently asymptomatic, suggesting suppression of the inflammatory response . N . gonorrhoeae-induced membrane ruffling and inflammation suppression are consistent with the ability of this bacterium to enter cervical epithelial cells, in vitro and in vivo, by interaction with complement receptor 3 (CR3), a receptor that does not trigger an inflammatory response . This receptor is present on cervical epithelial cells but not on male urogenital tract epithelia . N . gonorrhoeae engagement of CR3 initiates a unique mechanism of bacterial-induced membrane ruffling and internalization . These studies explain why the pathology of N . gonorrhoeae infection differs between males and females . Additionally, the observation that this receptor is present on cervical epithelia may provide insight into the pathogenesis of other sexually transmitted pathogens. J Infect Dis, 2001 Oct 1, 184(7), 922 - 5 Epub 2001 Aug 29. Cleavage of the hormone human chorionic gonadotropin, by the Type 1 IgA1 protease of Neisseria gonorrhoeae, and its implications; Senior BW et al.; The hormone human chorionic gonadotropin (hCG) serves to maintain the fetus during early pregnancy and regulate the onset of labor in late pregnancy . hCG also prevents Neisseria gonorrhoeae from developing invasive characteristics . Part of the beta subunit of hCG has an amino acid sequence similar to that of the hinge of human IgA1, which is the site of action of IgA1 proteases . This study examined the sensitivity of hCG to gonococcal IgA1 proteases, by means of autoradiography, immunoblotting, and RIA . hCG was cleaved in the beta subunit by the type 1 but not the type 2 IgA1 proteases of N . gonorrhoeae . hCG cleavage by gonococcal IgA1 proteases in vivo may increase the invasiveness of the pathogen and destroy its natural biologic activity, with major consequences for the fetus and the pregnancy. Annu Rev Microbiol, 2001, 55, 673 - 707 Antigenic variation at the infected red cell surface in malaria; Kyes S et al.; Many pathogens that either rely on an insect vector to complete their life cycle (e.g., Trypanosoma spp . and Borrelia spp.) or exist in a unique ecological niche where transmission from host to host is sporadic (e.g., Neisseria spp.) have evolved strategies to maintain infection of their mammalian hosts for long periods of time in order to ensure their survival . Because they have to survive in the face of a fully functional immune system, a common feature of many of these organisms is their development of sophisticated strategies for immune evasion . For the above organisms and for malaria parasites of the genus Plasmodium, a common theme is the ability to undergo clonal antigenic variation . In all cases, surface molecules that are important targets of the humoral immune response are encoded in the genome as multicopy, nonallelic gene families . Antigenic variation is accomplished by the successive expression of members of these gene families that show little or no immunological cross-reactivity . In the case of malaria parasites, however, some of the molecules that undergo antigenic variation are also major virulence factors, adding an additional level of complication to the host-parasite interaction . In this review, we cover the history of antigenic variation in malaria and then summarize the more recent data with particular emphasis on Plasmodium falciparum, the etiological agent of the most severe form of human malaria. Annu Rev Microbiol, 2001, 55, 561 - 90 Recombination and the population structures of bacterial pathogens; Feil EJ et al.; The population structures of bacterial species are complex and often controversial . To a large extent, this is due to uncertainty about the frequency and impact of recombination in bacteria . The existence of clones within bacterial populations, and of linkage disequilibrium between alleles at different loci, is often cited as evidence for low rates of recombination . However, clones and linkage disequilibrium are almost inevitable in species that divide by binary fission and can be present in populations where recombination is frequent . In recent years, it has become possible to directly compare rates of recombination in different species . These studies indicate that in many bacterial species, including Neisseria meningitidis, Streptococcus pneumoniae, and Staphylococcus aureus, evolutionary change at neutral (housekeeping) loci is more likely to occur by recombination than mutation and can result in the elimination of any deep-rooted phylogenetic signal . In such species, the long-term evolution of the population is dominated by recombination, but this does not occur at a sufficiently high frequency to prevent the emergence of adaptive clones, although these are relatively short-lived and rapidly diversify. Acta Obstet Gynecol Scand, 2001 Aug, 80(8), 757 - 61 Risk for anogenital cancer and other cancer among women hospitalized with gonorrhea; Johansen C et al.; BACKGROUND: We investigated the relationship between infections with Neisseria gonorrhoeae and anogenital and other cancers . METHODS: Nationwide and population based register linkage study utilizing prospectively notified information . The observed numbers of cancers among the women were compared with those expected on the basis of national incidence rates . RESULTS: In a cohort of 4440 women hospitalized for gonorrhea we observed a total of 227 cases of cervical intraepithelial neoplasia grade III (CIN III), with 103 expected (standardized incidence ratio (SIR), 2.2; 95% confidence interval (CI), 1.9-2.5) . No significantly increased risk for other anogenital cancers or cancer at other sites was seen . CONCLUSIONS: These results support the view that the observed association between gonorrheal infection and subsequent cervical preneoplasia is due mainly to surveillance bias . However, our results also indicate that women hospitalized with a N . gonorrhoeae infection will benefit from the compliance with the regular Pap smear screening programs. J Adolesc Health, 2001 Sep, 29(3 Suppl), 87 - 92 Correlation between urine and cervical specimens for the detection of cervical Chlamydia trachomatis and Neisseria gonorrhoeae using ligase chain reaction in a cohort of HIV infected and uninfected adolescents; Peralta L et al.; PURPOSE: (a) To examine the concordance between ligase chain reaction (LCR) results from urine and cervical samples for Chlamydia trachomatis and Neisseria gonorrhoeae in HIV infected and uninfected adolescent women, and (b) to examine factors that may influence the concordance of LCR results in this population . METHODS: Baseline specimens from 269 of 334 female subjects enrolled in a longitudinal study of HIV infection in adolescents were analyzed for C . trachomatis and N . gonorrhoeae using ligase chain reaction (LCR) assays in a central laboratory . Concordance was measured using kappa coefficient with permutation analyses to calculate the difference between HIV status groups . Discordant LCR results were examined for the co-infection with the other microorganism, bacterial vaginosis, or Trichomonas vaginalis . RESULTS: The prevalence of C . trachomatis detected by LCR in the HIV infected and uninfected groups was 19.3% and 12.2%, respectively (p = .16); the prevalence of N . gonorrhoeae was 7.0% and 2.4%, respectively (p = .16) . Urine LCR assay sensitivity to detect cervical C . trachomatis infection was 86% (95% CI: 68%-96%) in the HIV infected group and 100% (95% CI: 69%-100%) in the HIV uninfected group . Urine LCR assay sensitivity to detect cervical N . gonorrhoeae infection was 92% (95% CI: 62%-100%) in the HIV infected group . There were only 2 N . gonorrhoeae infections in the HIV uninfected group, and both were urine LCR positive . Differences in sensitivity between HIV infected and HIV uninfected subjects were not statistically significant . Coinfection with N . gonorrhoeae, bacterial vaginosis or Trichomonas vaginalis was not associated with the concordance of urine and cervical LCR results . CONCLUSION: The relatively high sensitivity of urine LCR testing overall suggests that urine screening may be reasonable for sexually active adolescent females with or without HIV infection in situations in which urine screening may be more acceptable than pelvic examinations. Aust N Z J Public Health, 2001 Aug, 25(4), 368 - 70 C . trachomatis and N . gonorrhoeae surveillance in New Zealand: comparison of laboratory and clinic data; McNicholas AM et al.; OBJECTIVE: To determine the extent to which clinic-based sexually transmitted infection (STI) surveillance underrepresents the number of laboratory-confirmed cases of Chlamydia trachomatis and Neisseria gonorrhoeae in the Waikato and Bay of Plenty regions of New Zealand; and to estimate incidence rates for these two infections . METHODS: Data on C . trachomatis and N . gonorrhoeae were collected from diagnostic laboratories in the study regions for the year 2000, and compared with routine clinic-based STI surveillance data . RESULTS: Most laboratory-confirmed C . trachomatis (65.5%) and N . gonorrhoeae (55.7%) infections were diagnosed by healthcare providers outside the clinic-based STI surveillance system . The estimated incidence rate for C . trachomatis was 501 per 100,000, and 50 per 100,000 for N . gonorrhoeae . CONCLUSIONS AND IMPLICATIONS: Laboratory surveillance of C . trachomatis and N . gonorrhoeae provides a more complete picture of disease burden . Given the high infection rates reported, developing a national strategy for the management of STIs should be a public health priority in New Zealand. Microbiol Mol Biol Rev, 2001 Sep, 65(3), 353 - 70, table of contents Sodium ion cycle in bacterial pathogens: evidence from cross-genome comparisons; Hase CC et al.; Analysis of the bacterial genome sequences shows that many human and animal pathogens encode primary membrane Na+ pumps, Na+-transporting dicarboxylate decarboxylases or Na+ translocating NADH:ubiquinone oxidoreductase, and a number of Na+ -dependent permeases . This indicates that these bacteria can utilize Na+ as a coupling ion instead of or in addition to the H+ cycle . This capability to use a Na+ cycle might be an important virulence factor for such pathogens as Vibrio cholerae, Neisseria meningitidis, Salmonella enterica serovar Typhi, and Yersinia pestis . In Treponema pallidum, Chlamydia trachomatis, and Chlamydia pneumoniae, the Na+ gradient may well be the only energy source for secondary transport . A survey of preliminary genome sequences of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, and Treponema denticola indicates that these oral pathogens also rely on the Na+ cycle for at least part of their energy metabolism . The possible roles of the Na+ cycling in the energy metabolism and pathogenicity of these organisms are reviewed . The recent discovery of an effective natural antibiotic, korormicin, targeted against the Na+ -translocating NADH:ubiquinone oxidoreductase, suggests a potential use of Na+ pumps as drug targets and/or vaccine candidates . The antimicrobial potential of other inhibitors of the Na+ cycle, such as monensin, Li+ and Ag+ ions, and amiloride derivatives, is discussed. Minerva Ginecol, 2000 Dec, 52(12 Suppl 1), 19 - 24 {Sexually transmitted diseases in adolescence}; De Seta F et al.; BACKGROUND: Sexually transmitted diseases (STD) have their most incidence in adolescence . We conducted an observational study on the symptomatic patients of our STD's office to evaluate epidemiological distribution, behavioral patterns and diffusion of genital infections in