Clin Infect Dis, 2005 Jan 15, 40(2), 260 - 4 Epub 2004 Dec 20. Comparison between LightCycler Real-Time Polymerase Chain Reaction (PCR) assay with serum and PCR-enzyme-linked immunosorbent assay with whole blood samples for the diagnosis of human brucellosis; Queipo-Ortuno MI et al.; BACKGROUND: To overcome some of the limitations of conventional microbiological techniques, polymerase chain reaction (PCR)-based assays have been proposed as a useful tool for the diagnosis of human brucellosis . METHODS: A single-blinded comparative study was undertaken that compared 2 different PCR assays: a SYBR Green I LightCycler-based Real-Time PCR assay (LC-PCR; Roche Diagnostic) with serum samples and a PCR-enzyme-linked immunosorbent assay (ELISA) with whole blood samples . Both assays amplify a 223-bp sequence of a gene that codes for the synthesis of an immunogenetic membrane protein specific for Brucella genus (BCSP31) . We analyzed the diagnostic yield of these assays with 60 samples obtained from patients with active brucellosis and 37 samples obtained from a control group composed of patients with febrile syndromes of other defined etiologies, asymptomatic subjects with past brucellosis or exposure to Brucella infection who had persistently high titers of anti-Brucella antibodies, and healthy subjects . RESULTS: The sensitivities of LC-PCR with serum samples, PCR-ELISA with whole blood samples, and blood cultures were 93.3%, 90%, and 65%, respectively . Three control samples (8.1%) had a positive PCR-ELISA result, and 2 of these samples (5.4%) also had positive LC-PCR results . The specificity and positive likelihood ratios were 94.6% and 17.3, respectively, for LC-PCR and 91.9% and 11.1, respectively, for PCR-ELISA . CONCLUSIONS: The diagnostic yield of LC-PCR with serum samples was higher than that of PCR-ELISA with whole blood samples . The speed and technical simplicity of LC-PCR in serum samples make it a useful alternative to blood cultures for patients with suspected brucellosis and negative or doubtful serological test results. Blood Purif, 2004, 22 Suppl 2, 20 - 5 Ultrapure dialysis fluid - direct and indirect benefits in dialysis therapy; Ledebo I; The fluid quality description 'ultrapure' means practically free from bacteria and endotoxin . In quantitative terms it is defined as <0.1 CFU/ml and <0.03 EU/ml . The requirements on endotoxin as well as bacteria should be fulfilled, because these two entities are not strictly correlated . Ultrapure dialysis fluid can be prepared from standard quality fluid by a single step of controlled ultrafiltration . Recent clinical studies demonstrate that the use of ultrapure dialysis fluid in hemodialysis is associated with patient benefits indicating a less inflammatory state compared to hemodialysis with standard fluid . By applying one additional step of controlled ultrafiltration, ultrapure dialysis fluid can be further purified to such high microbiological quality that it can be used for infusion . This opens up the possibility for convective therapies, hemodiafiltration and hemofiltration, for which large volumes of sterile infusion solution are needed . With optimal application of these therapies, solute removal is enhanced, qualitatively as well as quantitatively, and fluid management is facilitated through improved hemodynamic stability . Copyright (c) 2004 S . Karger AG, Basel. Anat Histol Embryol, 2005 Feb, 34(1), 27 - 33 Histology and ultrastructure of the equine lingual tonsil . I . Crypt epithelium and associated structures; Kumar P et al.; Summary The microstructural and ultrastructural features of the equine lingual tonsil were studied in five young horses . Located at the root of the tongue it presented an irregular surface with rounded elevations, numerous folds and crypts . Stratified squamous non-keratinized epithelium lining its outer surface was modified by heavy infiltration of lymphoid cells to form reticular epithelium within the crypt . The latter implies a role in initiating and maintaining immune responses to incoming infectious agents and antigens . Lamellated structures resembling Hassall's corpuscle were observed towards the outer surface epithelium . Microplicae were visible by scanning electron microscopy on the surface of both the outer and reticular epithelia . No microvillus cells resembling M cells were observed . The stratum superficiale of the reticular epithelium showed strong affinity for Soybean (SBA), Phosphocarpus tetragonolobus 1 (WBA 1), Ulex europaeus (UEA) and Griffonia simplicifolia 1 isolectin-B4 (GS1-B4) . The characteristic lectin binding patterns may be useful for embryological and microbiological investigations . Vimentin filaments were not detected consistent with absence of M cells . Mucus glandular acini in the deeper lamina propria mucosae contained glycogen, acidic, neutral and weakly sulphated mucopolysaccharides . Transmission electron microscopy revealed that the layers of the outer surface and reticular epithelia shared characteristic features except the stratum superficiale, which had nuclei of varying shapes and an abundance of cell organelles . A few mast cells with electron lucent granules and myelinated nerve fibres were localized in the deeper portion. Dev Biol (Basel), 2000, 102, 183 - 93 Reducing the risk of bacterial contamination of cellular blood components; Blajchman; Transfusion-associated septic reactions occurring during or following the transfusion of cellular blood components was one of the earliest recognised complications of allogeneic blood transfusions . The presence of bacteria in cellular blood products thus has been a problem for many decades and currently it is the most common microbiological cause of transfusion-associated morbidity and mortality . Transfusion-associated septic reactions due to contaminated platelet concentrates appear to be much more common than those due to red cell concentrates . The prevalence of contaminated cellular blood products (red cells and platelets) is approximately 1 in 2000 . However, the transfusion to a recipient of a contaminated blood product may not be associated with morbidity, because many contaminated blood product units contain only few bacteria and such transfusions may be innocuous to the recipient . In other instances, contaminated blood product units may contain large numbers of virulent bacteria and endotoxins, and their transfusion may be associated with significant morbidity and may even be lethal to the recipient . The prevalence of severe episodes of transfusion-associated sepsis has not been clearly established, but is probably of the order of 1 in 50,000 for platelet units and 1 in 500,000 for red blood cell units transfused . As a result of the increased recognition that such transfusion-associated septic episodes can occur, a variety of measures have been proposed to try to prevent and/or control the rate of contamination of blood products. Mycopathologia, 2004 Oct, 158(3), 325 - 35 Development of a method to detect and quantify Aspergillus fumigatus conidia by quantitative PCR for environmental air samples; McDevitt JJ et al.; Exposure to Aspergillus fumigatus is linked with respiratory diseases such as asthma, invasive aspergillosis, hypersensitivity pneumonitis, and allergic bronchopulmonary aspergillosis . Molecular methods using quantitative PCR (qPCR) offer advantages over culture and optical methods for estimating human exposures to microbiological agents such as fungi . We describe an assay that uses lyticase to digest A . fumigatus conidia followed by TaqMantrade mark qPCR to quantify released DNA . This method will allow analysis of airborne A . fumigatus samples collected over extended time periods and provide a more representative assessment of chronic exposure . The method was optimized for environmental samples and incorporates: single tube sample preparation to reduce sample loss, maintain simplicity, and avoid contamination; hot start amplification to reduce non-specific primer/probe annealing; and uracil-N-glycosylase to prevent carryover contamination . An A . fumigatus internal standard was developed and used to detect PCR inhibitors potentially found in air samples . The assay detected fewer than 10 A . fumigatus conidia per qPCR reaction and quantified conidia over a 4-log(10) range with high linearity (R(2) > 0.99) and low variability among replicate standards (CV=2.0%) in less than 4 h . The sensitivity and linearity of qPCR for conidia deposited on filters was equivalent to conidia calibration standards . A . fumigatus DNA from 8 isolates was consistently quantified using this method, while non-specific DNA from 14 common environmental fungi, including 6 other Aspergillus species, was not detected . This method provides a means of analyzing long term air samples collected on filters which may enable investigators to correlate airborne environmental A . fumigatus conidia concentrations with adverse health effects. Can J Microbiol, 2004 Nov, 50(11), 883 - 90 A review of conventional detection and enumeration methods for pathogenic bacteria in food; Gracias KS et al.; With continued development of novel molecular-based technologies for rapid, high-throughput detection of foodborne pathogenic bacteria, the future of conventional microbiological methods such as viable cell enumeration, selective isolation of bacteria on commercial media, and immunoassays seems tenuous . In fact, a number of unique approaches and variations on existing techniques are currently on the market or are being implemented that offer ease of use, reliability, and low cost compared with molecular tools . Approaches that enhance recovery of sublethally injured bacteria, differentiation among species using fluorogenics or chromogenics, dry plate culturing, differentiation among bacteria of interest using biochemical profiling, enumeration using impedence technology, techniques to confirm the presence of target pathogens using immunological methods, and bioluminescence applications for hygiene monitoring are summarized here and discussed in relation to their specific advantages or disadvantages when implemented in a food microbiology setting. An Pediatr (Barc), 2005 Jan, 62(1), 5 - 12 {Clinical characteristics of children hospitalized for influenza virus infection.}; Arostegi Kareaga N et al.; Background . The clinical manifestations of influenza virus are fairly nonspecific and are similar to those of other viral infections, respiratory processes due to other causes and even septic disease in neonates . Few studies have been performed of the clinical characteristics of influenza virus infection in hospitalized children . Objective . To evaluate the clinical characteristics of children hospitalized for influenza virus infection in four consecutive epidemic waves (2000-2004) . Material and methods . We retrospectively reviewed the medical records of children hospitalized for influenza A and B virus infection confirmed by cell culture and polymerase chain reaction . Age, sex, symptoms on admission, complementary investigations, diagnosis and outcome were evaluated . Results . Eighty-four children were hospitalized, of which 74 had influenza virus type AH3, five had influenza virus type AH1 and five had influenza B virus . A total of 42.8 % were aged less than 6 months . The main symptoms were fever (75 patients), cough (56 patients) and ENT involvement (53 patients) . The most frequent causes of admission were febrile syndrome (75 patients), bronchiolitis (19 patients), pneumonia (13 patients) and bronchitis (8 patients) . In 21 patients viral or bacterial coinfection was found, the most frequent of which was respiratory syncytial virus (10 patients) . Few differences were found among age groups except for pneumonia and prolonged fever (more frequent in children older than 6 months) and lymphocytosis (in children younger than 6 months) . The greatest number of complementary investigations in younger children was performed for acute febrile syndrome in neonates aged less than 6 months . Risk factors for hospitalization were found in only three children, all of whom were older than 6 months . Outcome was favorable in all children . Conclusions . Influenza virus infection in hospitalized children is most frequent in previously healthy neonates with fever and nonspecific signs and symptoms that are similar to those of other infectious processes . Specific microbiological diagnostic techniques are required for an early diagnosis . Healthy infants aged less than 24 months are most at risk for hospitalization for influenza virus infection. J Clin Periodontol, 2005 Jan, 32(1), 59 - 67 Risk determinants of periodontal disease - an analysis of the Study of Health in Pomerania (SHIP 0); Kocher T et al.; Kocher T, Schwahn C, Gesch D, Bernhardt O, John U, Meisel P, Baelum V: Risk determinants of periodontal disease - an analysis of the study of health in Pomerania (SHIP 0) . J Clin Periodontol 2004; doi: 10.1111/j.1600-051X.2004.00629.x . (c) Blackwell Munksgaard, 2004 . Abstract Background: In this study, risk determinants were determined for periodontal disease in the representative population sample (n=3146) of the Study of Health in Pomerania . Methods: After examining the net random sample (response 69%) and exclusion of edentulous cases and those with missing values, 2595 subjects remained . Using a multivariate, fully adjusted logistic regression, different definitions of "periodontally diseased/healthy" were examined as the dependent variable (extent of attachment loss (AL>/=4 mm, combined AL and tooth loss) . The independent variables used were sociodemographic factors (age, gender, income, education), medical factors (systemic diseases, drugs), behavioral factors (regular dental checkup, smoking), and oral factors (presence of supragingival calculus and plaque) . Results: The following risk determinants were found for AL: male gender, presence of supragingival plaque and calculus, smoking, low educational level . For the combination of AL and tooth loss, risk determinants were female gender, supragingival plaque, smoking, and low educational level . Consumption of antiallergic medications and regular dental checkups proved to be protective . Smoking was the most influential risk determinant . These parameters explained approximately 43-55% of the variation . Conclusion: These results concur with those of the literature . In order to explain disease status further, host-response and microbiological factors must also be examined. Acta Clin Belg, 2004 Sep-Oct, 59(5), 251 - 7 Invasive aspergillosis in critically ill patients: analysis of risk factors for acquisition and mortality; Vandewoude K et al.; OBJECTIVE: To investigate outcome in patients who develop invasive aspergillosis in the ICU, and to evaluate whether specific risk factors for the acquisition of invasive aspergillosis are associated with mortality . DESIGN: Retrospective cohort study (07/1997-12/1999) with screening of 8988 admissions . SETTING: 54-bed ICU of the 1060-bed Ghent University Hospital . PATIENTS: 38 ICU patients with invasive aspergillosis . Invasive aspergillosis was defined as proven by positive histology and tissue culture and as probable by a combination of clinical suspicion as well as microbiological and radiological data . Seventeen patients had risk factors (neutropenia, haematological malignancy, immunosuppressive therapy) . In the other 21 apparently immunocompetent patients, invasive aspergillosis was a complication following ARDS, COPD, pneumonia, acute liver failure, burns, severe bacterial infection and malnutrition . MEASUREMENTS: Population characteristics and outcome were compared for patients with and without risk factors for the acquisition of invasive aspergillosis . RESULTS: Patients with risk factors had higher APACHE II scores . No difference was found between patients with and without risk factors in in-hospital mortality (82% vs . 71%; p=0.431) . In patients with specific risk factors, the observed mortality was not different from the mortality as expected on basis of the APACHE II (p=0.940) . In patients without risk factors the observed mortality exceeded the expected mortality (p<0.001) . CONCLUSION: The incidence of invasive aspergillosis in this series is 4/1000 admissions . No difference in mortality was found between patients with and without risk factors for the acquisition of invasive aspergillosis . Yet, the prognosis of the patients without risk factors seems to alter more seriously by the development of this infection. APMIS, 2004 Dec, 112(11-12), 856 - 85 Let them fly or light them up: matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) mass spectrometry and fluorescence in situ hybridization (FISH); Schweickert B et al.; Schweickert B, Moter A, Lefmann M, Gobel UB . Let them fly or light them up: matrix-assisted laser desorption/Ionization time of flight (MALDI-TOF) mass spectrometry and fluorescence in situ hybridization (FISH) . APMIS 2004;112:856-85.This review focuses on clinical bacteriology and by and large does not cover the detection of fungi, viruses or parasites . It discusses two completely different but complementary approaches that may either supplement or replace classic culture-based bacteriology . The latter view may appear provocative in the light of the actual market penetration of molecular genetic testing in clinical bacteriology . Despite its elegance, high specificity and sensitivity, molecular genetic diagnostics has not yet reached the majority of clinical laboratories . The reasons for this are manifold: Many microbiologists and medical technologists are more familiar with classical microbiological methods than with molecular biology techniques . Culture-based methods still represent the work horse of everyday routine . The number of available FDA-approved molecular genetic tests is limited and external quality control is still under development . Finally, it appears difficult to incorporate genetic testing in the routine laboratory setting due to the limited number of samples received or the lack of appropriate resources . However, financial and time constraints, particularly in hospitals as a consequence of budget cuts and reduced length of stay, lead to a demand for significantly shorter turnaround times that cannot be met by culture-dependent diagnosis . As a consequence, smaller laboratories that do not have the technical and personal equipment required for molecular genetic amplification techniques may adopt alternative methods such as fluorescence in situ hybridization (FISH) that combines easy-to-perform molecular hybridization with microscopy, a technique familiar to every microbiologist . FISH is hence one of the technologies presented here . For large hospital or reference laboratories with a high sample volume requiring massive parallel high-throughput testing we discuss matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF) of nucleic acids, a technology that has evolved from the post-genome sequencing era, for high-throughput sequence variation analysis (1, 2). Curr Pharm Des, 2005, 11(1), 55 - 74 The delivery of probiotics and prebiotics to infants; Kullen MJ et al.; A number of studies involving the feeding of probiotics and prebiotics to infants have been published over the last decade . These studies have examined a wide range of health outcomes, including growth and safety, prophylaxis and alleviation of diarrheal disease, reduction in atopic disease, reduction in necrotizing enterocolitis, and reduction in infection of the preterm infant . In addition, these studies have described microbiological alterations observed in response to probiotic and prebiotic feeding . Collectively, the reports demonstrate that probiotics show considerable promise in addressing several health outcomes of significance to both formula-fed and breastfed infants . As quantitative and qualitative differences appear to exist between the microfloras of human-milk fed and formula-fed infants, recent innovations to infant formula have involved the inclusion of probiotics and prebiotics as a means of making the flora of the formula fed infant more similar to that of the breastfed infant . To date, only a few probiotic- and prebiotic-containing infant formulas have been marketed, but as new safety and efficacy data emerge and the regulatory climate becomes more favourable, the number of products is expected to grow. Srp Arh Celok Lek, 2001 May-Jun, 129 Suppl 1, 17 - 22 {C-reactive protein concentrations during initial (empiric) treatment of neonatal sepsis}; International pediatric sepsis consensus conference: Definitions for sepsis and organ dysfunction in pediatrics; FCCM Oregon Health & Science University, Portland, OR; Children's Medical Center of Dallas, Dallas, TX; and Children's Hospital, Boston, MAOBJECTIVE: Although general definitions of the sepsis continuum have been published for adults, no such work has been done for the pediatric population . Physiologic and laboratory variables used to define the systemic inflammatory response syndrome (SIRS) and organ dysfunction require modification for the developmental stages of children . An international panel of 20 experts in sepsis and clinical research from five countries (Canada, France, Netherlands, United Kingdom, and United States) was convened to modify the published adult consensus definitions of infection, sepsis, severe sepsis, septic shock, and organ dysfunction for children . DESIGN: Consensus conference . Methods: This document describes the issues surrounding consensus on four major questions addressed at the meeting: a) How should the pediatric age groups affected by sepsis be delineated? b) What are the specific definitions of pediatric SIRS, infection, sepsis, severe sepsis, and septic shock? c) What are the specific definitions of pediatric organ failure and the validity of pediatric organ failure scores? d) What are the appropriate study populations and study end points required to successfully conduct clinical trials in pediatric sepsis? Five subgroups first met separately and then together to evaluate the following areas: signs and symptoms of sepsis, cell markers, cytokines, microbiological data, and coagulation variables . All conference participants approved the final draft of the proceedings of the meeting . RESULTS: Conference attendees modified the current criteria used to define SIRS and sepsis in adults to incorporate pediatric physiologic variables appropriate for the following subcategories of children: newborn, neonate, infant, child, and adolescent . In addition, the SIRS definition was modified so that either criteria for fever or white blood count had to be met . We also defined various organ dysfunction categories, severe sepsis, and septic shock specifically for children . Although no firm conclusion was made regarding a single appropriate study end point, a novel nonmortality end point, organ failure-free days, was considered optimal for pediatric clinical trials given the relatively low incidence of mortality in pediatric sepsis compared with adult populations . CONCLUSION: We modified the adult SIRS criteria for children . In addition, we revised definitions of severe sepsis and septic shock for the pediatric population . Our goal is for these first-generation pediatric definitions and criteria to facilitate the performance of successful clinical studies in children with sepsis. Mycopathologia, 2004 Nov, 158(4), 415 - 8 A case of eumycetoma due to Madurella grisea in northern Brazil; Vilela R et al.; A case of mycetoma caused by the black fungus Madurella grisea in northern Brazil is reported . The lesion was located on the patient's right foot without bone involvement . Clinical samples were collected by opening the fistules with a scalp and the grains removed for microbiological and histopathological analyses . Although mycetoma caused by M . grisea has been previously reported in Brazil, this is the first time that of this fungus has been identify in this particular region of the country. Arch Soc Esp Oftalmol, 2004 Dec, 79(12), 617 - 22 {Modification of the conjuntival flora with cleaning palpebral solutions.}; Hueso Abancens JR et al.; OBJECTIVE: The aim of the present study is to evaluate the effectiveness of a solution of palpebral hygiene during the preoperative stageof cataract surgery . MATERIALS AND METHODS: We studied 286 patients divided in 5 groups . One control group that did not use the product, and the remaining 4, that used the product during 3, 4, 5 and 6 days . The design of the study was prospective, randomize and masked . We took a sample of the conjunctival fundus in the morning of the day of the surgery, before commencing treatment with eye drops . This sample was sown according to microbiological techniques and analyzed by the microbiology department . RESULTS: The best time for using palpebral hygiene solutions prior to cataract surgery is four to five days . If it is used at less than three days, it does not decrease the rate of positive cultures and if the solution is applied more than six days, microorganisms that are not part of the common conjunctival flora may appear . CONCLUSIONS: Palpebral hygiene products should not be used more than five consecutive days previous to surgery (Arch Soc Esp Oftalmol 2004; 79: 617-622). Indian J Med Sci, 2004 Dec, 58(12), 513 - 9 Prevalence of Aspergillus species in clinical samples isolated in an Indian tertiary care hospital; Xess I et al.; CONTEXT (BACKGROUND): In recent times, it has become important to determine the prevalence of different Aspergillus species in clinical samples in view of difference in antifungal susceptibility noted in some species . AIMS: To determine the species prevalence of Aspergillus isolates in various clinical samples received in the Mycology Laboratory at our institute . METHOD: Over a period of 4-years, a total of 18,731 samples were processed, and species identification carried out by standard microbiological methods . RESULTS: Four hundred and fifty six samples (2.43%) were culture positive for Aspergillus species . A.flavus (46.93%) was the most common isolate, followed by A.fumigatus (37.72%) and A.niger (15.35%) . It was observed that A.fumigatus was the predominant species isolated from blood and respiratory specimens, A.flavus was predominantly isolated from nasal polyps whereas A.niger predominated in nail specimens . Culture positivity was highest in the age group 12-65 years and in males . Sixty-nine patients (15.13%) were admitted to the intensive care unit . CONCLUSIONS: The study highlights the diverse manifestations caused by Aspergillus species in human beings and also throws light on the different species prevalent locally . The knowledge would prove useful in selecting empirical antifungal therapy and formulating prophylactic and pre-emptive strategies. J Am Dent Assoc, 2004 Nov, 135(11), 1559 - 64 Microbiological changes associated with dental prophylaxis; Goodson JM et al.; BACKGROUND: Despite the common application of dental prophylaxis as part of patient therapy, there is little reported that describes the microbiological impact of this treatment . METHODS: The authors gave 20 healthy college-aged subjects three dental prophylaxes with a fluoride-containing prophylaxis paste during a two-week period and instructed them in oral hygiene . They evaluated the microbiological composition of dental plaque samples collected before and after treatment using DNA probe analysis . They analyzed 40 representative bacterial species in seven bacterial complexes by checkerboard DNA-DNA hybridization assay techniques . RESULTS: After three dental prophylaxes, the patients' mean Gingival Index score decreased from 0.82 to 0.77, the mean Plaque Index score decreased from 0.72 to zero, and the total number of bacteria per tooth decreased to approximately one-third of the original number . The authors computed two different measures of bacterial presence . The reduction in bacterial numbers was statistically significant and occurred in many species . Bacterial proportion (DNA percentage or percentage of the bacteria per tooth) did not change significantly . Greater reductions in bacterial count occurred in species that showed high numbers before treatment . The total bacterial count decreased by approximately 72 percent of its original level before prophylaxis was initiated . CONCLUSIONS: Professional dental prophylaxis did not target any particular bacteria or bacterial groups but removed bacteria nonspecifically and in proportion to their initial numbers . CLINICAL IMPLICATIONS: Repeated dental prophylaxes effect a reduction in bacterial amount that is commensurate with the initial amount, but they do does not alter composition . This suggests that mild gingivitis may be a bacterially nonspecific effect of plaque accumulation and emphasizes the need for regular plaque removal to maintain optimal gingival health. Pathol Biol (Paris), 2005 Jan, 53(1), 9 - 14 Amplification of P1 and 16S rRNA genes by nested PCR for detection of Mycoplasma pneumoniae in paediatric patients; Nour M et al.; Mycoplasma (M.) pneumoniae is the most frequent atypical pathogen responsible for community-acquired respiratory infection in children and adults . The etiologic diagnosis of these infections still remains difficult . This is mainly due to the absence of characteristic clinical findings, and to the available detection methods (serology and culture) which are time consuming, insensitive and non-specific . To improve the detection of this infectious agent, nested polymerase chain reaction (PCR) analysis was developed . A total of 46 nasal aspirates, from children hospitalised with severe lower respiratory tract infection and in whom M . pneumoniae was suspected, were analysed for the presence of M . pneumoniae DNA by PCR . Routine microbiological investigations revealed no virus in these 46 samples . Using nested PCR, two targets were amplified: the sequences of 16S ribosomal (r) RNA gene (rDNA) and P1 adhesin gene . Evidence of M . pneumoniae infection was identified in four paediatric patients . The amplification of 16S rDNA was found to be more sensitive for the detection of M . pneumoniae . Our results suggest that amplification of the 16S rDNA by nested PCR and detection of the amplification products by visual inspection of the polyacrylamide gel should allow the rapid diagnosis of M . pneumoniae in respiratory tract infection in paediatric patients. Environ Pollut, 2005 Apr, 134(3), 525 - 34 Degradation and leaching of the herbicides metolachlor and diuron: a case study in an area of Northern Italy; Barra Caracciolo A et al.; In this work the degradation of the herbicides metolachlor, diuron, monuron and of the metabolites 2-ethyl-6-methylaniline (EMA), and 3,4-dichloroaniline (DCA) was assessed in laboratory experiments on microbiologically active and sterilized soils . Their leaching potentials were calculated, using Gustafson's equation, by determining their mobility (as K(oc)) and persistence (expressed as DT(50)) . Lysimeter experiments were also conducted to assess the actual leaching of the studied herbicides in a cereal crop tillage area vulnerable to groundwater contamination . The data obtained from the field were compared to the laboratory results . Moreover, some compounds of particular concern were searched for in the groundwater located near the experimental area in order to evaluate actual contamination and to test the reliability of the leaching potential . The GUS index, computed on data from microbiologically active soil, shows monuron as a leacher compound, EMA and DCA as non-leachers, metolachlor and diuron as transient ones . The presence of metolachlor in the groundwater monitored, even at concentrations up to 0.1 mug/l, confirms the possibility that transient compounds can be leached if microbial activity has not completely occurred in active surface soil. Med Mal Infect, 2004 Jan, 34(1), 42 - 7 {Eleven cases of leptospirosis: clinical and microbiological features}; Laurent D et al.; OBJECTIVE: The authors had for aim, to describe clinical and biological features of 11 cases of leptospirosis observed in Lorraine between 1996 and 2002, and to assess the interest of diagnostic methods . PATIENTS AND METHODS: A retrospective study was performed . The inclusion criteria was positive serological test for Leptospira . RESULTS: The contamination was mainly linked to water sports, during the summer holidays . The main symptom was fever, associated with moderate increase of aminotransferase serum level . Leptospira icterohaemorragiae was the most frequently identified serogroup . One 17-year-old male patient died after infection during water sports practice . CONCLUSION: Preventive measures should be considered for people exposed to Leptospira when practicing water sports. Swiss Med Wkly, 2004 Nov 27, 134(47-48), 700 - 4 Diagnostic significance of intrathecally produced herpes simplex and varizella-zoster virus-specific antibodies in central nervous system infections; Schultze D et al.; BACKGROUND AND OBJECTIVES: The optimal strategy for the diagnosis of herpes simplex virus (HSV) and varizella-zoster virus (VZV) disease of the central nervous system is the detection of viral DNA by polymerase chain reaction assay (PCR) in cerebrospinal fluid (CSF) and the examination of intrathecal production of specific antibodies . However, in acute neurological disease caused by either HSV or VZV, dual intrathecal synthesis of HSV-1, 2- as well as VZV-specific antibodies may be detectable and thus can hamper accurate aetiological diagnosis . This paper illustrates such equivocal findings in two case reports, investigates their frequency and discusses the possible reasons . METHODS: Consecutive CSF/serum pairs of two patients with central nervous system (CNS) disease were tested by HSV-1-, HSV-2-, and VZV-specific PCR and by different serological assays for detection of neurotropic viruses and bacteria . Additionally, the results of microbiological investigations of 1'155 CSF/serum samples were retrospectively analyzed for coincident intrathecal antibody synthesis against HSV-1, 2 and VZV . RESULTS: Although only HSV-1 and VZV-specific DNA was detectable in the CSF of two patients with encephalitis and chronic meningitis, respectively, increasing intrathecal antibody production against both virus species could be demonstrated . Retrospective analysis of 1155 CSF/serum pairs revealed 55 (4.8%) pairs with evidence for intrathecally produced antibodies against either HSV-1, 2 (30/55) or VZV (14/55) . Eleven of these 55 (20%) pairs showed intrathecal antibody-production against both virus species . CONCLUSIONS: Patients with CNS infection with HSV and VZV can be diagnosed by detecting intrathecally produced virus-specific antibodies, in addition to virus-specific PCR . However, in an appreciable proportion of patients a correct diagnosis is hampered by coincidentally detected antibodies in CSF against both virus species . Possible reasons for these equivocal findings are given. Aust J Rural Health, 2004 Dec, 12(6), 237 - 40 Invasive pneumococcal disease in the Kimberley, 1995-2001; Mak DB; OBJECTIVE: To describe the epidemiology of invasive pneumococcal disease (IPD) in the Kimberley and examine whether cases could have been prevented by vaccination . DESIGN: Prospective case series of IPD cases from 1 January 1995 to 31 December 2001 . SETTING: The Kimberley region of far north-western Australia . SUBJECTS: Seventy IPD cases in 37 men and 33 women aged 5 months to 90 years . Aboriginal people comprised 90% (63/70) of cases . MAIN OUTCOME MEASURES: Demographic, clinical and microbiological characteristics of IPD cases . Proportion of cases caused by vaccine-preventable serotypes . IPD incidence in the Kimberley . RESULTS: Pneumonia and bacteraemia were the commonest clinical presentations . Of IPD cases, 15% (children) and 67% (adults) had a risk factor for IPD . The case fatality rate was 13% . Of cases, 46% (95% confidence interval (CI) 35-58%) were caused by serotypes covered by an age-appropriate vaccine . Of the 26 cases eligible for pneumococcal vaccination, only 4 (16%) had been appropriately vaccinated . IPD incidence in Aboriginal people aged 15 years and over declined from 97.8/100,000 person years (95% CI 56.5-139.1) in 1997 to 38.1/100,000 person years (95% CI 22.5-53.9) in 2001 . CONCLUSIONS: The significant proportion of cases caused by vaccine-preventable serotypes and that was, therefore, preventable underscores the importance of pneumococcal vaccination. J Virol, 2005 Jan, 79(2), 884 - 95 Characterization and complete genome sequence of a novel coronavirus, coronavirus HKU1, from patients with pneumonia; Woo PC et al.; Despite extensive laboratory investigations in patients with respiratory tract infections, no microbiological cause can be identified in a significant proportion of patients . In the past 3 years, several novel respiratory viruses, including human metapneumovirus, severe acute respiratory syndrome (SARS) coronavirus (SARS-CoV), and human coronavirus NL63, were discovered . Here we report the discovery of another novel coronavirus, coronavirus HKU1 (CoV-HKU1), from a 71-year-old man with pneumonia who had just returned from Shenzhen, China . Quantitative reverse transcription-PCR showed that the amount of CoV-HKU1 RNA was 8.5 to 9.6 x 10(6) copies per ml in his nasopharyngeal aspirates (NPAs) during the first week of the illness and dropped progressively to undetectable levels in subsequent weeks . He developed increasing serum levels of specific antibodies against the recombinant nucleocapsid protein of CoV-HKU1, with immunoglobulin M (IgM) titers of 1:20, 1:40, and 1:80 and IgG titers of <1:1,000, 1:2,000, and 1:8,000 in the first, second and fourth weeks of the illness, respectively . Isolation of the virus by using various cell lines, mixed neuron-glia culture, and intracerebral inoculation of suckling mice was unsuccessful . The complete genome sequence of CoV-HKU1 is a 29,926-nucleotide, polyadenylated RNA, with G+C content of 32%, the lowest among all known coronaviruses with available genome sequence . Phylogenetic analysis reveals that CoV-HKU1 is a new group 2 coronavirus . Screening of 400 NPAs, negative for SARS-CoV, from patients with respiratory illness during the SARS period identified the presence of CoV-HKU1 RNA in an additional specimen, with a viral load of 1.13 x 10(6) copies per ml, from a 35-year-old woman with pneumonia . Our data support the existence of a novel group 2 coronavirus associated with pneumonia in humans. Lancet, 2004 Dec 18, 364(9452), 2196 - 203 Diagnosis of tuberculosis in South African children with a T-cell-based assay: a prospective cohort study; Liebeschuetz S et al.; BACKGROUND: Childhood tuberculosis often presents non-specifically and is a common differential diagnosis in high prevalence areas . Current diagnostic tools have poor sensitivity and cannot reliably exclude tuberculosis, so overdiagnosis is common . HIV co-infection exacerbates this problem and accounts for an increasing proportion of paediatric tuberculosis worldwide . METHODS: We assessed the usefulness of a T-cell-based rapid blood test for Mycobacterium tuberculosis infection, the enzyme-linked immunospot assay (ELISPOT), in routine clinical practice . We did a prospective blinded study of 293 African children with suspected tuberculosis in kwaZulu-Natal, a region with high HIV prevalence . Children had full clinical assessment, ELISPOT, and a tuberculin skin test . Test results were compared with final clinical and microbiological diagnoses . RESULTS: In children with tuberculosis, sensitivity of ELISPOT was 83% (95% CI 75-89, n=133), significantly higher (p<0.001) than the 63% (54-72) sensitivity of tuberculin skin test (n=116) . Sensitivity of tuberculin skin test fell significantly in children younger than 3 years (to 51%), with HIV co-infection (36%), or with malnutrition (44%) . Sensitivity of ELISPOT, which was not significantly adversely affected by these factors, was 85%, 73%, and 78%, respectively in these subgroups . In 116 children with both test results available, sensitivity of the two tests combined was 91% (85-95) . CONCLUSIONS: Diagnostic sensitivity of ELISPOT is higher than that of the skin test and is less affected by factors frequently associated with childhood tuberculosis in developing countries . Used together with the skin test, ELISPOT provides a clinically useful diagnostic sensitivity in African children with suspected tuberculosis. J Appl Microbiol, 2005, 98(1), 163 - 71 Micro-organisms and dust exposure in an Italian grain mill; Dacarro C et al.; Abstract c . dacarro, p . grisoli, g . del frate, s . villani, e . grignani and d . cottica . 2004.Aims: In order to assess possible occupational risk for workers in a grain mill, we evaluated aerial microbiological contamination in different areas of the mill and at different points of the production line . We also measured the concentration of aerodispersed dust particles . Methods and Results: An assessment of microbiological contamination levels based on a Global Index of Microbial Contamination per cubic metre (GIMC per m(3)), an Index of Mesophilic Bacterial Contamination, and an Amplification Index is proposed . The indices were obtained from total and fungal counts . The cleaning sector is the most contaminated area of the mill: the mean GIMC per m(3) was 17 213.6 . In this area, the average microbial contamination was 11.41 times higher than that in the external environment . The highest concentrations of aerodispersed dust (inhalable 2.763 mg m(-3); respirable 1.400 mg m(-3)) were found in the cleaning area . Conclusions: The proposed microbiological indices and the concentrations of aerodispersed dust particles show that the most hazardous section of the mill is the cleaning area . The large variation in the data does not depend on seasonal factors, but rather on not easily identifiable conditions of the internal environment which facilitate diffusion and/or proliferation of the micro-organisms . Significance and Impact of the Study: The proposed microbiological contamination indices and the evaluation of the concentration of dust particles allow the identification of critical positions during the production cycle so that suitable measures to prevent the aerial contamination can be taken. Clin Exp Immunol, 2005 Jan, 139(1), 2 - 10 Immunosuppression: towards a logical approach in liver transplantation; Perry I et al.; Summary Over the last two decades there has been a significant increase in the number and types of immunosuppressive agents that have been available to clinicians . The protocols for immunosuppression used in liver transplantation have been derived historically from those in renal transplantation . During the last decade there has been a shift in the use of immunosuppression, with the introduction of interleukin (IL)-2 receptor antagonists in place of anti-lymphocyte preparations, substitution of tacrolimus for cyclosporin and mycophenolate for azathioprine . The use of corticosteroids has been reduced . For a variety of reasons, these changes have not always been made on the basis of properly randomized studies . The place of newer agents, such as sirolimus and leflunomide derivatives and of the microbiological agents, is unclear . In this review, we outline briefly the mechanism of action of drugs and suggest possible approaches to the management of the liver allograft recipient, suggesting how treatment could be adjusted according to the indication for transplantation as well as the individual's comorbidities. Acta Ophthalmol Scand, 2004 Dec, 82(6), 762 - 4 Effect of voriconazole on a corneal abscess caused by fusarium; Polizzi A et al.; Abstract . Purpose: To describe a case of corneal abscess caused by Fusarium solani that did not respond to common antifungal agents . Method: Case report . Results: Twenty days after accidental contact with vegetation, a 56-year-old man presented with a corneal abscess . Corneal ulceration developed and a perforating keratoplasty was performed . After a microbiological examination, the diagnosis of F . solani infection was made . Systemic and topical amphotericin B and fluconazole were prescribed, with no results . A new abscess formed on the transplanted graft and a wound leak developed . We administered topical and systemic voriconazole . No side-effects were observed . The choroidal detachment and the surgical transplant recovered completely in 20 days . A vascular leukoma developed at the site of the transplanted corneal abscess . Conclusion: From a functional point of view, another corneal transplant will be necessary . Voriconazole was effective in treating a severe keratomycosis caused by F . solani that was resistant to other topical and systemic antifungal agents. Biomed Environ Sci, 2004 Sep, 17(3), 299 - 308 Occurrence of haloacetic acids in drinking water in certain cities of China; Zhou H et al.; OBJECTIVE: Since haloacetic acids (HAAs), which are nonvolatile and of high carcinogenic risk, are common species of chlorinated disinfection by-products(DBPs) in drinking water, and little has been known in China, it is necessary to make a survey about the kinds and levels of HAAs in drinking water of the nation . METHOD: HAAs were analyzed using gas chromatography with electron capture detector(GC/ECD) and relatively complex pretreatment process of sample was applied . Five main cities in different areas of China were chosen in the survey . RESULTS: Studies showed that the main species of HAAs in drinking water in China were DCAA and TCAA, ranging from 0.4 microg/L to 12.85 microg/L and from 0.56 microg/L to 10.98 microg/L, respectively . MBAA and DBAA were also detected in one city, ranging from 2.20 microg/L to 4.95 microg/L and 1.10 microg/L to 2.81 microg/L, respectively . Therefore, the contents of HAAs varied, usually no more than 25 microg/L . Based on the acquired data to date, it is known that the concentrations of HAAs in drinking water in China were surely under the limits of Sanitary Standard for Drinking Water Quality (China, 2001) . CONCLUSION: A wider survey of HAAs in drinking water should be conducted throughout the nation to get adequate data and information, the ultimate aim of which is to control HAAs pollution and keep the balance between microbiological safety insurance and chemical risk control, minimize the formation of DBPs and ensure the safety of water supply at the same time. Paediatr Anaesth, 2004 Dec, 14(12), 996 - 1000 Clinical signs of infection during continuous postoperative epidural analgesia in children: the value of catheter tip culture; Seth N et al.; Summary Background : Infection arising from the use of epidural catheters for postoperative analgesia is a major source of anxiety . Methods : The routine culture of epidural catheter tips were studied in 100 consecutive children aged 1 day to 15 years . Epidural catheters were inserted aseptically in accordance with an agreed protocol . The catheter site was inspected regularly and the tip sent for microbiological culture following removal . Results : Local signs of inflammation at the epidural site were seen in 16% of children, and bacteria were isolated from catheter tip culture in 32% . Positive catheter tip culture was found in 43% of children with local signs of inflammation and of the remaining children with no local signs, organisms were isolated from the catheter tip in 30% . Culture of skin swabs and catheter tips in two patients with purulent discharge at the epidural site yielded the same organism . No correlation between the number of attempts at catheter insertion and either local signs of inflammation or positive catheter tip cultures were found . Conclusions : Minor local signs of inflammation and infection are common in pediatric patients during continuous epidural infusion . Epidural catheter tips are also frequently culture positive in patients with and without local signs and who may not go on to develop further signs or symptoms of infection . Routine culture of catheter tips is unnecessary as it is not a good predictor of epidural space infection. Reprod Domest Anim, 2004 Dec, 39(6), 438 - 41 Use of powdered egg yolk vs fresh egg yolk for the cryopreservation of ovine semen; Marco-Jimenez F et al.; Egg yolk is a common additive to sperm cryopreservation diluents . Because of its animal origin, however, it also represents a potential risk of microbiological contamination in the diluent . This potential contamination can be avoided by using powdered egg yolk, instead of fresh egg yolk, as it is pasteurized . This study was conducted to determine ram sperm cryosurvival was affected by the type of egg yolk used (powdered egg yolk or fresh egg yolk) and by yolk concentration (10, 15 or 20%) in the diluent . Microbiological analyses were also performed to quantify the microbiological contamination in the diluents containing the two types of egg yolk . Sperm cryosurvival was determined by motility and morphology analyses after thawing . Motility parameters were assessed using a computer-assisted sperm analysis (CASA) system, and the percentage of sperm with a normal apical ridge was evaluated using a differential interference contrast microscope . No significant differences were observed between diluents in the percentage of sperm with normal apical ridge . However, higher percentages of total motile cells were observed for samples containing powdered egg yolk (69%) compared to samples containing fresh egg yolk (60%) . However, sperm in diluents containing fresh egg yolk, exhibited higher values for average-path velocity, straight-line velocity and beat cross frequency and lower values for amplitude of lateral head displacement (p <0.05), compared to cells in diluents containing powdered egg yolk . Microbiological contamination was similar (<200 CFU/ml) in both diluents, and no bacterial growth was observed in either, when antibiotics were added . Therefore, powdered egg yolk can be effective used in diluents for the freezing of ram semen . However, the in vivo fertility of sperm frozen in diluents containing powdered egg yolk should be tested, as some motility parameters were different for sperm treated with powdered egg yolk compared to fresh egg yolk. Enferm Infecc Microbiol Clin, 2004 Dec, 22(10), 643 - 59 {Advances in the diagnosis and treatment of acute human immunodeficiency virus type 1 (HIV-1) infection.}; Miro JM et al.; According the WHO there are about 14,000 new HIV infections a day . However, in a few cases the diagnosis will be made in the acute phase of the disease . Acute HIV infection is the period between infection with the virus and complete seroconversion, defined by a positive Western blot test . This period lasts approximately 30 days and most patients (40-90%) have mild clinical manifestations (fever, rash, pharyngitis, mucosal ulcers, among others) for 2 weeks which, because they are nonspecific, can be confused with other community-acquired infections . Microbiological diagnosis is based on the absence of serum antibodies (negative ELISA test) together with a positive HIV viral load in plasma (> 10,000 copies/ml) . Diagnosis of acute HIV infection is important for several reasons: firstly, from the epidemiological point of view, this is the period with the highest rates of HIV transmission and identification of new HIV infections reveals the growth of the epidemic and the transmission rates of resistant HIV strains, which in Spain is about 10%; secondly, from the immunopathological point of view, this period provides a unique opportunity to study the virological, immunological and genetic mechanisms that play a role in the transmission and pathogenesis of this disease; and thirdly, therapeutically, starting antiretroviral therapy during this phase could alter the natural history of the disease . However, this is a controversial issue and currently most guidelines recommend treatment only if these patients can be included in clinical trials or if they show lasting or severe clinical manifestations. Euro Surveill . 2004 Nov 01;9(11) {Epub ahead of print} Eighth International Meeting of the European Laboratory Working Group on Diphtheria and the Diphtheria Surveillance Network - June 2004 : Progress is needed to sustain control of diphtheria in European Region; De Zoysa A et al.; The Eighth International Meeting of the European Laboratory Working Group on Diphtheria (ELWGD) and the Diphtheria Surveillance Network (DIPNET) was held and co-organised with the WHO Regional Office for Europe, Copenhagen, Denmark, in June 2004 . This article provides an international updated review of progress in clinical, epidemiological and microbiological aspects of diphtheria in the European region as presented at the meeting . It highlights the need for improved immunisation coverage, surveillance and epidemiological studies to sustain control of diphtheria in European Region. Environ Pollut, 2005 Mar, 134(2), 267 - 276 Oil spill in the Rio de la Plata estuary, Argentina: 2-hydrocarbon disappearance rates in sediments and soils; Colombo JC et al.; The 6-month assessment of the oil spill impact in the Rio de la Plata described in the preceding paper {Colombo, J.C., Barreda, A., Bilos, C., Cappelletti, N., Demichelis, S., Lombardi, P., Migoya, M.C., Skorupka, C., Suarez, G., 2004 . Oil spill in the Rio de la Plata estuary, Argentina: 1 - biogeochemical assessment of waters, sediments, soils and biota . Environmental Pollution} was followed by a 13- and 42-month campaigns to evaluate the progress of hydrocarbon decay . Average sediment hydrocarbon concentrations in each sampling include high variability (85-260%) due to contrasting site conditions, but reflect a significant overall decrease after 3 years of the spill: 17+/-27, 18+/-39 to 0.54+/-1.4mugg(-1) for aliphatics; 0.44+/-0.49, 0.99+/-1.6 to 0.04+/-0.03mugg(-1) for aromatics at 6, 13 and 42 months, respectively . Average soil hydrocarbon levels are 100-1000 times higher and less variable (61-169%) than sediment values, but display a clear attenuation: 3678+/-2369, 1880+/-1141 to 6.0+/-10mugg(-1) for aliphatics and 38+/-26, 49+/-32 to 0.06+/-0.04mugg(-1) for aromatics . Hydrocarbon concentrations modeled to first-order rate equations yield average rate constants of total loss (biotic+abiotic) twice as higher in soils (k=0.18-0.19 month(-1)) relative to sediments (0.08-0.10 month(-1)) . Individual aliphatic rate constants decrease with increasing molecular weight from 0.21+/-0.07 month(-1) for isoprenoids and <n-C22 to 0.10+/-0.08 month(-1) for >n-C27, similar to hopanes (0.10+/-0.05 month(-1)) . Aromatics disappearance rates were more homogeneous with higher values for methylated relative to unsubstituted species (0.17+/-0.05 vs . 0.12+/-0.05 months(-1)) . Continued hydrocarbon inputs, either from biogenic (algal n-C15,17; vascular plant n-C27,29) or combustion related sources (fluoranthene and pyrene), appear to contribute to reduced disappearance rate . According to the different loss rates, hydrocarbons showed clear compositional changes from 6-13 to 42 months . Aliphatics disappearance rates and compositional changes support an essentially microbiologically-mediated recovery of coastal sediments to pre-spill conditions in a 3-4 year period . The lower rates and more subtle compositional changes deduced for aromatic components, suggest a stronger incidence of physical removal processes. Ann Fr Anesth Reanim, 2004 Dec, 23(12), 1185 - 8 {An unusual aetiology for septic shock: Capnocytophaga canimorsus . Is always dog man's best friend?}; Gouin P et al.; The mortality of overwhelming postsplenectomy infections (OPSI) is significant (50 to 80 percent) . Capnocytophaga canimorsus belongs to the normal oral flora of dogs and cats . It is seldom responsible for human infections, but its prognosis is bad (about 30 percent of overall mortality), especially in asplenic patients . We report a case of a splenectomized patient who suffered from communal septic shock due to C . canimorsus septicaemia . The course of events was rapidly fatal . Diagnosis and mode of contamination were determined only a few weeks after the patient's death . This late microbiological diagnosis is due to a slow growth of C . canimorsus in vitro. J Vet Diagn Invest, 2004 Nov, 16(6), 579 - 81 Diagnosis of a mixed mycoplasma infection associated with a severe outbreak of bovine pinkeye in young calves; Levisohn S et al.; Mycoplasma bovoculi and Mycoplasma bovis were both isolated from conjunctival swabs taken from young calves showing symptoms consistent with infectious bovine keratoconjunctivitis (pinkeye) . No Moraxella spp . or other nonmycoplasma bacteria were isolated in association with this severe clinical outbreak . Based on laboratory tests and clinical observations, the first phase of the disease was likely pneumonic in nature, possibly caused by bovine respiratory syncytial virus and M . bovis . In the subsequent phase of the disease course, infection with both M . bovoculi and M . bovis resulted in ocular disease . A combination of microbiological, serological, and molecular diagnosticmethods was used to elucidate the etiology of the outbreak. Pediatr Res . 2004 Dec 7; {Epub ahead of print} Increased CD11b-Density on Circulating Phagocytes as an Early Sign of Late-Onset Sepsis in Extremely Low-Birth-Weight Infants; Turunen R et al.; Late-onset hospital-acquired sepsis is common in extremely low birth-weight (<1000g) (ELBW) infants . The diagnosis is difficult since, at early stages of sepsis, routine laboratory tests are neither specific nor sensitive . In term infants with sepsis neutrophil surface expression of CD11b/CD18, a beta2-integrin, is significantly increased . Here we studied whether increased CD11b/CD18 density on blood neutrophils and monocytes serves as an early sepsis marker in ELBW infants . From 30 ELBW infants blood samples were obtained prospectively on a daily basis for 3-4 postnatal weeks, and neutrophil and monocyte CD11b/CD18 expression was determined by flow-cytometry . Patients were assigned retrospectively into 3 groups . Infection group (n = 7) comprised infants who had blood culture-positive sepsis, necrotizing enterocolitis, or both . Of the infants without clinical infection (n = 16), seven infants, matched by age, served as controls . Possible infection group comprised infants (n = 6) in whom infection was suspected but could not be confirmed microbiologically . One patient had blood culture contamination and was excluded from the analysis . In the infection group, CD11b expression gradually increased during the three days preceding sampling for blood culture (p for trend: neutrophils p = 0.006, monocytes p < 0.001) . At the day of sampling, median expression of CD11b by both neutrophils and monocytes was higher in infection group than control group (both p = 0.001) . The sensitivity and specificity were for neutrophils 1.00 and 0.56, respectively, and for monocytes, 0.86 and 0.94, respectively . Determination of CD11b/CD18 density on neutrophils and monocytes may improve diagnosis of late-onset sepsis in ELBW infants. J Clin Microbiol, 2004 Dec, 42(12), 5517 - 22 Aspergillus galactomannan enzyme immunoassay and quantitative PCR for diagnosis of invasive aspergillosis with bronchoalveolar lavage fluid; Musher B et al.; Invasive pulmonary aspergillosis (IPA) is frequent and often fatal in hematopoietic stem cell transplant patients . Diagnosis requires microbiological or histopathologic demonstration of the organism in tissues; however, cultivation of Aspergillus species from respiratory secretions has low diagnostic sensitivity . Assays to detect Aspergillus antigen or DNA in bronchoalveolar lavage (BAL) fluid could facilitate earlier diagnosis, thereby guiding optimal therapy and obviating the need for additional costly and potentially morbid diagnostic evaluation . We evaluated the performance of a galactomannan enzyme immunoassay (GM EIA; Bio-Rad) by using a range of index cutoffs to define positivity and a quantitative PCR (qPCR) assay for the detection of Aspergillus species from BAL samples of patients with proven and probable IPA (case patients; n = 49) and without IPA (control patients; n = 50) . The sensitivity of the GM EIA was 61% with an index cutoff of 1.0 and 76% with an index cutoff of 0.5; the corresponding specificities were 98 and 94%, respectively . The sensitivity and specificity of qPCR assay were 67 and 100%, respectively . The sensitivity with 22 culture-negative BAL specimens from patients with IPA was 41% for GM EIA with an index cutoff of 1.0, 59% for GM EIA with an index cutoff of 0.5, and 36% for qPCR assay . GM EIA indices and DNA quantities corresponded to BAL fungal burdens, with culture-positive samples having larger amounts of antigen and DNA compared to culture-negative samples . GM EIA and qPCR assay add to the sensitivity of BAL for diagnosing IPA in high-risk patients, with excellent specificity . Adjunctive use of these tests may reduce dependence on invasive diagnostic procedures. Med Oral Patol Oral Cir Bucal, 2004, 9 Suppl, 82 - 91; 75-82 Periodontal diseases: microbiological considerations; Liebana J et al.; The location of plaque-associated gingivitis at the gingival portion of the tooth plays an essential role in its genesis . However, at times local and other host response modifying factors also have an influence . The pathogeny of periodontitis is more complex . The microorganisms that comprise subgingival plaque are capable of acting directly on periodontal tissues or of modifying the host response, whereas the participation of the plaque per se (normal, decreased, or increased) is as decisive as the action of the bacteria themselves in the emergence of the disease . Different types of periodontitis are associated with specific microorganisms . The most periodontopathogenic are A . actinomycetemcomitans, P . gingivalis, and T . forsythensis . Periodontitis as a whole, represent the source of complications such as root caries, endoperiodontal processes and periodontal abscesses . They are associated with various illnesses such as atherosclerosis, diabetes, and respiratory infections, amongst others, as well as pathological oral halitosis . The different modalities of PCR are particularly important in the microbiological diagnosis of periodontitis, although on the negative side of things, it must be pointed out that in vitro sensitivity studies cannot be performed using this technique . First line antibiotic treatment of periodontitis includes amoxicillin/ clavulanic acid, metronidazole (associated or not with amoxicillin) and clindamycin. Med Oral Patol Oral Cir Bucal, 2004, 9 Suppl, 143 - 7; 139-43 Odontogenic infections . Complications . Systemic manifestations; Jimenez Y et al.; The term, odontogenic infection refers to an infection that originates in the tooth proper or in the tissues that closely surround it; said infection then progresses along the periodontia down to the apex, involving periapical bone and from this area, it then spreads through the bone and periosteum towards near-by or more distant structures . The relevance of this type of infection lies in that it can cause infections that compromise more distant structures (via direct spread and distant spread), for example, intracraneal, retropharyngeal and pulmonary pleural infections . Dissemination by means of the bloodstream can lead to rheumatic problems and deposits on the valves of the heart (endocarditis), etc . The conditions or factors that influence the spread of infection are dependent on the balance between patient-related conditions and microorganism-related conditions . The virulence of the affecting germs is dependent upon their quality and quantity and is one of the microbiological conditions that influences the infection . It is this virulence that promotes infectious invasion and the deleterious effects the microbe will have on the host . Patient-related conditions include certain systemic factors that determine host resistance, which may be impaired in situations such as immunodeficiency syndrome or in brittle diabetes, as well as local factors that will also exert their impact on the spread of the infection. Prev Vet Med, 2004 Dec 15, 66(1-4), 93 - 9 A cross-sectional study of epizootic lymphangitis in cart-mules in western Ethiopia; Ameni G et al.; A cross-sectional study was conducted to determine the prevalence of epizootic lymphangitis (EL) in 309 cart-mules (cart-pulling mules) in Bako and Ejaji towns, Western Ethiopia using clinical and microbiological examinations, between November 2002 and April 2003 . The overall prevalence was 21% (CI=16.6-26%) . The clinical, histological and mycological characteristics of EL in a cart-mule were similar with those in a horse . There was significant (chi2=133.5, P=0.001) association between tick infestation and EL lesions in study cart-mules . Amblyoma coherence and Boophilus genera were the ticks collected from lesions of cases of EL, and thus played a predisposing role . In conclusion, our results showed that EL has high prevalence in cart-mules in the two towns. Clin Infect Dis, 2004 Dec 15, 39(12), 1747 - 53 Epub 2004 Dec 15. Burden of infection in patients with end-stage renal disease requiring long-term dialysis; Berman SJ et al.; BACKGROUND: This study examines the spectrum of infections in a selected population of patients requiring long-term dialysis, enlarging the focus beyond infections associated with the dialysis process . METHODS: Infection data were reviewed from complete archived inpatient and outpatient dialysis records of 433 patients who were treated at a single hospital-based dialysis program and its dialysis satellites over a 9-year period, from 1 January 1992 to 31 December 2000 . RESULTS: The study period included 424,700 days of dialysis experience . A total of 2412 episodes of bacterial or fungal infections were treated in 433 patients . The infection rate was 5.7 episodes per 1000 days of dialysis . Patients received 5111 courses of antibiotics over 42,627 days of treatment, which cumulatively accounted for 10% of the total days of the study . Infections associated with hemodialysis vascular access devices comprised 20.5% of the total episodes . Infections below the knee (19.3% of infection episodes), pneumonia (13%), and other skin and soft-tissue infections (9%) were also important types and sources of infection, accounting for >42% of the total episodes . Eighty-two percent of the infections (1971 episodes) were acquired in the community . Of these, 868 (44%) required hospitalization . An additional 441 episodes were nosocomial . The profile of bacteria isolated from patients with community-acquired infections mirrored that of bacteria recovered from patients with nosocomial infections . CONCLUSION: Patients with end-stage renal disease have an enormous burden of infection . The majority of the infections are unrelated to dialysis . Frequent and long-term antibiotic use and cohorting of patients in the dialysis unit have altered the microbiological flora of such individuals, with clinical and epidemiological implications. Clin Infect Dis, 2004 Dec 1, 39(11), 1599 - 603 Epub 2004 Dec 1. Is "aseptic" loosening of the prosthetic cup after total hip replacement due to nonculturable bacterial pathogens in patients with low-grade infection? Ince A, Rupp J, Frommelt L, Katzer A, Gille J, Lohr JF. BACKGROUND: Loosening of the prosthetic cup is the limiting factor in the service life of total hip prostheses (THPs) . Despite effective culture methods, the detection of low-grade infection in patients with loose implants still presents a challenge . It is crucial to distinguish between "aseptic" loosening and loosening due to periprosthetic infection, so that appropriate treatment can be administered . We investigated whether aseptic loosening of the acetabular components of THPs is due to unrecognized infection . METHODS: From October through December 2002, a total of 24 patients with acetabular cup loosening were investigated . Only patients without clinical signs of infection and with negative results of bacteriologic culture of synovial fluid (obtained by preoperative aspiration) were included in the study . Intraoperative biopsy samples obtained from the neocapsule and synovia (e.g., the interface membrane) were examined by means of routine culture methods and by polymerase chain reaction (PCR) for detection of 16S ribosomal RNA (rRNA) . Control subjects included 9 patients undergoing primary hip arthroplasty . RESULTS: C-reactive protein levels and erythrocyte sedimentation rates were slightly elevated in the group with loosening, compared with the control group, but the difference was not statistically significant . PCR and routine culture showed no microorganisms in either group, with the exception of 1 patient in the loosening group . CONCLUSIONS: PCR for detection of 16S rRNA in tissue specimens obtained from hip joints is not superior to routine bacteriologic culture techniques for detection of low-grade infections . However, these results demonstrate that the loosening of cups in THPs do not usually result from nonculturable periprosthetic infection, if the microbiological processing is adequate. Rofo, 2004 Dec, 176(12), 1832 - 6 {Automatic injectors in magnetic resonance imaging and computed tomography: pilot study on hygienic aspects}; Buerke B et al.; PURPOSE: To evaluate hygienic conditions using automatic injectors in magnetic resonance imaging (MRI) and computed tomography (CT) during clinical routine . MATERIALS AND METHODS: The surfaces of medical devices (e . g., control console) and the palms of the technical and medical staff were microbiologically analyzed by taking imprints before and after hygienic education . In addition, the injector syringes for contrast medium (CM) and saline were checked for microbiological contamination following multiple (MRI: 14 h; CT 8 h) and single use . Furthermore, the potential of retrograde contamination from the patient along the tube was analyzed . RESULTS: A bacterial contamination with typical dermal bacteria was documented for the surfaces of the medical devices, the palms of the technical and medical staff, and the injection syringes following multiple use (MRI: 10/10 CM syringes, 6/10 saline syringes; CT: 8/10 CM syringes, 5/10 saline syringes) . Correct hand disinfection in combination with single use of syringes avoided bacterial colonization . Retrograde bacterial contamination from the patient was not observed . CONCLUSION: Regular hygienic teaching sessions for technical and medical staff in MRI and CT departments using automatic injectors should be mandatory . Furthermore, the multiple use of syringes should be avoided until investigations addressing the potential of bacterial contamination are performed. J Biochem Biophys Methods, 2004 Nov 30, 61(3), 265 - 70 Exploring permeability of Escherichia coli competence using quantum dots as fluorescent probes; Wenhua L et al.; Though people had recognized the pivotal function of CaCl(2) during DNA transformation into Escherichia coli, the mechanism of divalent Ca(2+) cation inducing E . coli competence development is still unknowable . Quantum dots (QDs), as a new fluorescent probe, being applied in biology research, had aroused great interest . We explored the penetrability of E . coli competent cells membrane using QDs and proved directly that competent cells were more permeable than that of noncompetent . The results are significant on understanding the problems of the microbiological genetics. Shokuhin Eiseigaku Zasshi, 2004 Aug, 45(4), 191 - 6 {Microbiological method for the detection of antibiotic residues in meat using mixed-mode, reverse-phase and cation-exchange cartridge}; Kusano T et al.; A microbiological method for screening of residual benzylpenicillin (PCG), oxytetracycline (OTC) and spiramycin (SPM) in meat using a single mixed mode, reversed-phase and cation-exchange cartridge was developed . A meat sample was extracted with 0.1 mol/mL pH 4.5 phosphate buffer and the extract was applied to a MCX cartridge . The cartridge was washed, and adsorbed antibiotic residues were eluted with acetonitrile for acidic fractions and acetonitrile containing 5% ammonia solution-0.1 mol/mL pH 4.5 phosphate buffer (9:1, v/v) for basic fractions . Each eluate was evaporated to dryness and the residue was dissolved in phosphate buffer to prepare test solutions for microbiological assay . When the diameter of the inhibition zone was more than 12 mm, the result was considered positive . In this method, the average recoveries of PCG at 0.05 microg/g, OTC at 0.1 microg/g and SPM at 0.2 microg/g were 70%, 92% and 84%, respectively . Tolerances of the three antibiotics were detected . All the results demonstrate that this method is simple, rapid and useful for screening of these three antibiotic residues in meat. Crit Care, 2004 Dec, 8(6), R504 - 11 Epub 2004 Dec. Perioperative factors determine outcome after surgery for severe acute pancreatitis; De Waele JJ et al.; INTRODUCTION: There is evidence that postponing surgery in critically ill patients with severe acute pancreatitis (SAP) leads to improved survival, but previous reports included patients with both sterile and infected pancreatic necrosis who were operated on for various indications and with different degrees of organ dysfunction at the moment of surgery, which might be an important bias . The objective of this study is to analyze the impact of timing of surgery and perioperative factors (severity of organ dysfunction and microbiological status of the necrosis) on mortality in intensive care unit (ICU) patients undergoing surgery for SAP . METHODS: We retrospectively (January 1994 to March 2003) analyzed patients admitted to the ICU with SAP . Of 124 patients, 56 were treated surgically; these are the subject of this analysis . We recorded demographic characteristics and predictors of mortality at admission, timing of and indications for surgery, and outcome . We also studied the microbiological status of the necrosis and organ dysfunction at the moment of surgery . RESULTS: Patients' characteristics were comparable in patients undergoing early and late surgery, and there was a trend toward a higher mortality in patients who underwent early surgery (55% versus 29%, P = 0.06) . In univariate analysis, patients who died were older, had higher organ dysfunction scores at the day of surgery, and had sterile necrosis more often; there was a trend toward earlier surgery in these patients . Logistic regression analysis showed that only age, organ dysfunction at the moment of surgery, and the presence of sterile necrosis were independent predictors of mortality . CONCLUSIONS: In this cohort of critically ill patients operated on for SAP, there was a trend toward higher mortality in patients operated on early in the course of the disease, but in multivariate analysis, only greater age, severity of organ dysfunction at the moment of surgery, and the presence of sterile necrosis, but not the timing of the surgical intervention, were independently associated with an increased risk for mortality. Infect Control Hosp Epidemiol, 2004 Nov, 25(11), 962 - 6 Concurrent summer influenza and pertussis outbreaks in a nursing home in Sydney, Australia; Ferson MJ et al.; OBJECTIVE: To report on the investigation of a summer outbreak of acute respiratory illness among residents of a Sydney nursing home . DESIGN: An epidemiologic and microbiological investigation of the resident cohort at the time of the outbreak and medical record review 5 months later . SETTING: A nursing home located in Sydney, Australia, during February to July 1999 . PATIENTS: The cohort of residents present in the nursing home at the time of the outbreak . INTERVENTIONS: Public health interventions included recommendations regarding hygiene, cohorting of residents and staff, closure to further admissions, and prompt reporting of illness; and virologic and serologic studies of residents . RESULTS: Of the 69 residents (mean age, 85.1 years), 35 fulfilled the case definition of acute respiratory illness . Influenza A infection was confirmed in 19 residents, and phylogenetic analysis of the resulting isolate, designated H3N2 A/Sydney/203/99, showed that it differed from strains isolated in eastern Australia during the same period . Serologic evidence of Bordetella infection was also found in 10 residents; however, stratified epidemiologic analysis pointed to influenza A as the cause of illness . CONCLUSIONS: The investigation revealed an unusual summer outbreak of influenza A concurrent with subclinical pertussis infection . Surveillance of acute respiratory illness in nursing homes throughout the year, rather than solely during epidemic periods, in combination with appropriate public health laboratory support, would allow initiation of a timely public health response to outbreaks of acute respiratory illness in this setting. Biodegradation, 2004 Dec, 15(6), 371 - 86 Monitored natural attenuation of chlorinated solvents: assessment of potential and limitations; Grandel S et al.; Chlorinated solvent contaminations in groundwater and soil are a widespread problem . Their remediation either by active and/or passive measures is complicated though, due to their characteristic features of long plumes and DNAPL . In this study Monitored Natural Attenuation (MNA) is evaluated regarding its applicability to remediate chlorinated solvent sites . At first a short overview of legal requirements is given, by whose means the efficiency of MNA is supposed to be demonstrated and assessed . Thereby the focus is set on the circumstances in the United States and Germany, as in the first MNA is applied as remediation option, whereas in the latter implementation and definition of MNA is under discussion . Based on criteria given by several German guidelines investigation methods and suitable parameters are discussed with the objective to evaluate their potential and limitations to demonstrate MNA at a chlorinated solvent site . Regarding the description of source location/inventory and source emission the legal requirements cannot be accomplished mainly because of missing methods . With regard to the characterization of plume migration, and evaluation of the efficiency of NA processes the combination of hydrogeochemical data and model approaches can accomplish most of the legal requirements . Applicability of microbiological and isotope methods is limited which is also reflected by evaluation of field studies, where these methods have been used at less than 10% of the sites . With regard to chlorinated solvents current German guidelines should be modified to enable the feasible application of MNA as an alternative or additional remediation option. Klin Monatsbl Augenheilkd, 2004 Nov, 221(11), 948 - 52 {Fatal orbital disorder}; Eicken J et al.; Fulminant processes of the orbit can cause considerable diagnostic difficulties with regards to the clinical, radiological and microbiological appearance . Rhino-orbito-cerebral mucormycosis is a rare but, when untreated, fatal orbital disease capable of destructive infiltration of soft tissue and bone . It occurs preferably in the ill adjusted diabetic or in the course of an immunodeficiency . The following case report describes a leukaemia patient developing a severe rhino-orbito-cerebral mucormycosis which was initially not recognised . Since untreated mucormycosis is fatal, an aggressive surgical approach with excision of the whole necrotic area is necessary even if the diagnosis cannot be confirmed with certainty. Rev Argent Microbiol, 2004 Jul-Sep, 36(3), 145 - 9 {Total bacterial count in raw milk of dairy farms that characterize the northwest zone of Santa Fe and south of Santiago del Estero}; Revelli GR et al.; A total of 6,998 raw milk samples of bulk tank, belonging to 55 dairy farms associated to the Cooperativa Tambera Nueva Alpina Ltda., were collected between the years 1993 and 2002 . The Total Mesophilic Aerobic Microorganisms Count was analyzed, obtaining a medium value of 1.2 x 10(5) +/- 2.4 x 10(5) CFU/ml that characterizes the zone . The final year of experience, observed a 97% of dairy farms evaluated with averages < or = 1.0 x 10(5) CFU/ml . Only a 3% it surpasses this limit, not being found establishments with levels over 1.5 x 10(5) CFU/ml . Relating this indicators with compositionals parameters, the most significant correlation resulted for: Total Bacterial Count vs Acidity (r = 0.292; P < 0.001) and Total Bacterial Count vs Freezing Point (r = 0.157; P < 0.001 . The microbiological quality in raw milk of dairy farms belonging to the northwest zone of Santa Fe and south of Santiago del Estero showed a significant improvement during this time. Izv Akad Nauk Ser Biol, 2004 Sep-Oct, (5), 597 - 600 {Nanobiology of the ocean}; Pulmonary and systemic bacterial co-infections in severe RSV bronchiolitis; Department of Paediatric Intensive Care and Neonatology, University Children's Hospital, Zurich, SwitzerlandIn 127 infants admitted to intensive care for RSV bronchiolitis, concomitant bacterial sepsis was a rare event . However, in the subgroup of intubated patients the incidence of bacterial pneumonia was 43.9% (95% CI 31.0-56.8%), half community acquired and half nosocomial . As clinical signs are not helpful in identifying these patients, tracheal aspirates have to be investigated microbiologically on a routine basis in order to start antibiotics in time. Burns, 2004 Dec, 30(8), 785 - 92 The role of poly(ADP-ribose) synthetase inhibition on the intestinal mucosal barrier after thermal injury; Avlan D et al.; Oxidative and nitrosative stressor agents can trigger DNA strand breakage, which then activates the nuclear enzyme poly(ADP-ribose) synthetase (PARS) . Activation of the enzyme depletes the intracellular concentration of energetic substrates such as nicotinamide adenine dinucleotide (NAD) . This process can result in cell dysfunction and cell death . PARS inhibitors have been successfully used in ischemia-reperfusion injury, inflammation and sepsis in several experimental models . In our experimental study, we investigated the role of 3-aminobeanzamide (3-AB), a non-specific PARS inhibitor, on the intestinal mucosal barrier after burn injury . Twenty-four Wistar rats were randomly divided into three groups . The sham group (n = 8) was exposed to 21 degrees C water while the burn group (n = 8) and the burn + 3-AB group (n = 9) were exposed to boiling water for 12s to produce a full thickness burn in 35-40% of total body surface area . In the burn + 3-AB group, 10mg/kg of 3-AB was given intraperitoneally 10min before thermal injury . Twenty-four hours later, tissue samples from mesenteric lymph nodes (MLN), spleen and liver were obtained under sterile conditions for microbiological analysis and ileum samples were obtained for biochemical and histopathological analysis . In burn group, the incidence of bacteria isolated from MLN and spleen was significantly higher than other groups (P < 0.05) . 3-AB pre-treatment prevented burn induced bacterial translocation and it significantly reduced burn induced intestinal injury . Tissue malondialdehyde and 3-nitrotyrozine levels were found significantly lower than that of the burn group . These data suggest that the relationship between PARS pathway and lipid peroxidation in intestinal tissue and PARS has a role in intestinal injury caused by thermal injury. Burns, 2004 Dec, 30(8), 778 - 84 The effect of N-acetylcysteine on oxidative stress in intestine and bacterial translocation after thermal injury; Ocal K et al.; Ischemia due to transient splanchnic vasoconstriction following major burns causes oxidative and/or nitrosative damage in intestinal tissue followed by reperfusion injury . Thus, burn injury leads to breakdown in the intestinal mucosal barrier which can induce bacterial translocation (BT) . As an antioxidant and anti-inflammatory agent the protective effects of N-acetylcysteine (NAC) are documented in several studies . This study was designed to determine the effect of NAC treatment on the oxidative stress in the intestine and BT after burn injury . To evaluate this, 32 Wistar rats were randomly divided into four groups as sham (n = 8), burn (n = 8), pre-burn, NAC injection (150 mgkg(-1), intraperitoneally) 15 min before thermal injury (n = 8), post-burn, NAC injection (150 mgkg(-1), intraperitoneally) 2h after thermal injury . Under anesthesia, the shaved dorsal skin of rats was exposed to boiling water for 12s to induce burn injury in a standardized manner . Twenty-four hours later, tissue samples from mesenteric lymph nodes (MLN), spleen, and liver were obtained under sterile conditions for microbiological analysis and ileum samples were harvested for biochemical analysis . In the burn group, the incidence of isolating bacteria in MLN, spleen, and liver specimens was significantly higher than other groups . NAC treatment prevented burn-induced BT in both pre- and post-burn groups . Thermal injury caused a significant decrease in glutathione (GSH) level, significant increases in malondialdehyde (MDA) and myeloperoxidase (MPO) activity at post-burn 24th hour . Treatment of rats with NAC significantly elevated the reduced GSH levels while decreasing MDA levels and MPO activity . These data suggested that NAC has a crucial cytoprotective role in intestinal mucosal barrier and preventive effects against burn injury-induced BT. Ann Ig, 2004 Jan-Apr, 16(1-2), 375 - 86 {Microbial air monitoring in operating theatre: active and passive samplings}; Pasquarella C et al.; Microbial air contamination was evaluated in 11 operating theatres using active and passive samplings . SAS (Surface Air System) air sampling was used to evaluate cfu/m3 and settle plates were used to measure the index of microbial air contamination (IMA) . Samplings were performed at the same time on three different days, at three different times (before, during and after the surgical activity) . Two points were monitored (patient area and perimeter of the operating theatre) . Moreover, the cfu/m3 were evaluated at the air inlet of the conditioner system . 74.7% of samplings performed at the air inlet and 66.7% of the samplings performed at the patient area before the beginning of the surgical activity (at rest) exceeded the 35 cfu/m3 used as threshold value . 100% of IMA values exceeded the threshold value of 5 . Using both active and passive sampling, the microbial contamination was shown to increase significantly during activity . The cfu values were higher at the patient area than at the perimeter of the operating theatre . Mean values of the cfu/m3 during activity at the patient area ranged from a minimum of 61+/-41 cfu/m3 to a maximum of 242+/-136 cfu/m3; IMA values ranged from a minimum of 19+/-10 to a maximum of 129+/-60 . 15.2% of samplings performed at the patient area using SAS and 75.8% of samplings performed using settle plates exceeded the threshold values of 180 cfu/m3 and 25 respectively, with a significant difference of the percentages . The highest values were found in the operating theatre with inadequate structural and managerial conditions . These findings confirm that the microbiological quality of air may be considered a mirror of the hygienic conditions of the operating theatre . Settle plates proved to be more sensitive in detecting the increase of microbial air contamination related to conditions that could compromise the quality of the air in operating theatres. Ann Ig, 2004 Jan-Apr, 16(1-2), 273 - 80 {Hygienic aspects of the Tiber river: presence of pathogenic protozoa and correlation with microbiological and physico-chemical parameters}; Bonadonna L et al.; An investigation on the hygienic quality of the Tiber river was conducted with the aim both to enumerate Giardia cysts and Cryptosporidium oocysts in the water and to determine possible correlations between them and bacterial indicators, pathogens and physico-chemical parameters . A low hygienic water quality was evidenced, with high counts of microorganisms . Furthermore, variable concentrations of Giardia and Cryptosporidium were observed . No correlation was found between the protozoa concentrations and that of the other microorganisms, whilst a significant correlation with redox potential and Giardia cysts was calculated. Pediatr Hematol Oncol, 2004 Sep, 21(6), 535 - 43 Analysis of 136 febrile neutropenic episodes in children with cancer: evaluation of treatment effectiveness and cost; Corapcioglu F et al.; In this study, 136 febrile neutropenic episodes were overviewed retrospectively . Factors affecting treatment success and cost were analyzed . Twenty percent of the episodes were microbiologically documented and 51 % of the bacterial isolates were gram negatives . The most commonly used empirical therapies in febrile episodes were the combination of two drugs (58.0%), monotherapy (14.8%), and antibiotics plus fluconazole (20.6 %) . In lymphoproliferative tumors duration of fever and discharge from the hospital were longer Administration of the hematopoietic growth factors shortened neither the duration of neutropenia nor fever and hospitalization . Treatment costs were higher in lymphoproliferative tumors, in bacteremia, and in episodes where glycopeptides, antifungal drugs, and hematopoietic growth factors were used . In conclusion, duration of neutropenia was a significant independent predictive factor for duration of fever In the lymphoproliferative tumors, duration of fever was longer and cost of treatment was more than in the solid tumors. Biomedica, 2004 Sep, 24(3), 318 - 23 {Development of a record-keeping strategy for improvement of information retention in microbiological processing}; Lopez JA et al.; The improvement of microbiological information processing in clinical laboratories depends on retention of information concerning who, what, when, how, and why each process was performed, the implementation of quality control procedures, and finally, its evaluation . The four objectives to be addressed are as follows: (1) to improve the collection of information concerned with microbiological processes, (2) to evaluate results of implemented strategies, (3) to offer a model data base to be used in research projects, and (4) to propose an evaluation model for comparative studies . To do this, microbiological cultures were collected from hospitalized patients from June 1997 to June 2003 . Data for the analytical matrix were obtained from lab requests, medical history and the microbiological data . Statistical analyses were performed in Epi-Info 6 . The laboratory records for 46,072 microbiological cultures were analyzed . Completion levels in data collection were compared between years 1997 and 2003 . Samples from 1997 and 2003 showed 11% and 99% of the request forms specifically requesting microbiological culture, 11% and 99% were completed in 1997 and 2003, respectively . For the same years, 9% and 85% specifically stated the time of the request . Ten percent and 68%, respectively, provided complete information . Zero and 83% respectively stated who had collected the sample . Zero and 77%, respectively, specified the time of sample collection . Forms containing all relevent microbiological data were most complete with 78% and 96%, respectively . A database with 44 variables related to microbiological processes was created . In conclusion, improvement of microbiological data processing depends not only on the method of collection and completion of recorded information, but also on constant quality control and evaluation. Nippon Ishinkin Gakkai Zasshi, 2004, 45(4), 239 - 45 {A Case of Allergic Fungal Sinusitis Caused by Bipolaris spicifera.}; Taguchi K et al.; We describe a case of allergic fungal sinusitis (AFS) caused by Bipolaris spicifera, the first case reported in Japan . A 70-year-old man was admitted to our hospital because of diplopia following bilateral nasal obstruction and discharge . Radiological studies using computed tomographic scan showed a large soft tissue mass occupying the right frontal, bilateral ethmoid and sphenoid sinuses . He underwent drainage surgery and histopathological examination of the contents of the paranasal sinuses revealed scattered fungal hyphae within "allergic mucin" . By cytological examination, these hyphae showed septation at irregular intervals, and were swollen to various sizes . Microbiological studies identified the fungus as Bipolaris spicifera . The presence of allergic mucin and scattered fungal hyphae were very important findings in making a diagnosis of AFS histopathologically, so squash cytology of the contents of the paranasal sinuses was quite useful to observe fungal elements and identify the strain in this case. Nippon Ishinkin Gakkai Zasshi, 2004, 45(4), 209 - 15 {Guidelines for the management of deep mycosis in neutropenic patients.}; Yoshida M; Invasive fungal infections (IFIs) are a major cause of morbidity and mortality in neutropenic patients with leukemia and those undergoing hematopoietic stem cell transplant (HSCT) . Two major IFIs are systemic candidiasis (including candidemia, chronic disseminated candidiasis and pneumonia) and invasive pulmonary aspergillosis . Recently, the incidence of the latter has been increasing . Three levels of diagnosis are specified in the Japanese guidelines for the diagnosis and treatment of IFIs . Proven fungal infections are diagnosed by histological/microbiological evidence of fungi at the site of infection or positive blood culture (fungemia) . Clinically documented fungal infections are diagnosed by typical radiological findings such as halo sign on chest CT plus positive serological/molecular evidence of fungi such as Aspergillus galactomannan, beta-glucan or fungal DNA . Possible fungal infections are diagnosed by typical radiological findings or positive serological/molecular evidence of fungi . For patients with high risk such as those undergoing HSCT, antifungal prophylaxis using oral antifungal agents is recommended . For possible fungal infections, empiric therapy with fluconazole (FLCZ) or amphotericin B (AMPH) is recommended . For patients with proven fungal infections or clinically documented fungal infections, targeted therapy is warranted . In case of candidemia, the best choice is FLCZ (400 mg/day) or AMPH (0.5-0.7 mg/kg/day), and for invasive pulmonary aspergillosis, a higher dose of AMPH (1.0-1.5 mg/kg/day) is indicated . Micafungin (MCFG), recently licensed in Japan, is an active agent for both Candida and Aspergillus . This drug seems useful for empiric and targeted therapy of IFIs. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 2004 Nov, 47(11), 1078 - 94 {Comparison of mycological and chemical laboratory methods for detecting mold damage in indoor environments}; Laussmann D et al.; To evaluate frequently used methods that discriminate between moldy and nonmoldy indoor environments, 45 homes with visible mold growth and 47 definitively non-infested homes, both confirmed by inspection, were investigated by microbiological and chemical analytical methods . The study was laboratory blinded in relation to the confirmed mold status of the rooms . Statistical evaluation of the results of the applied mycological methods with the Receiver Operating Characteristic (ROC) curve analysis showed that these methods (impaction, open Petri dish method, and determination of mold spores in house dust samples) performed very well in discriminating between rooms with visible mold growth and nonmoldy rooms when the sum score of the mold genera Aspergillus and Penicillium was used as an indicator . The calculated areas under the ROC curves (AUC) of the three mycological methods were: 0.992 (95% CI 0.942-0.997) for mold spores in house dust samples, 0.996 (95% CI 0.940-0.998) for the open Petri dish method, and 0.999 (95% CI 0.957-1.000) for the determination of airborne spores with the Andersen impactor, respectively . A perfect discrimination would lead to an AUC of 1 . These results were obtained with DG 18-agar as well as with malt extract agar . In contrast to the results of the mycological methods, the chemical analytical method under the same study conditions showed a distinctly lower performance in discriminating rooms according to their mold status when a sum score (concentration of eight typical MVOC) was used as an indicator . The area under the ROC curve (AUC) had a value of 0.620 (95% CI 0.509-0.723) . A completely useless test would have an AUC of 0.5 . As the lower limit of the 95% confidence interval of the area under the ROC curve is close to 0.5, the results obtained with the MVOC method do not differ from the classification results which can be obtained simply by chance . Possible methodological biases which could have lead to this interpretation are discussed. Clin Infect Dis, 2004 Nov 15, 39(10), 1493 - 9 Epub 2004 Oct 22. Rickettsioses and the international traveler; Jensenius M et al.; The rickettsioses--zoonotic bacterial infections transmitted to humans by arthropods--were for many years considered to be oddities in travel medicine . During the previous 2 decades, however, reports of >450 travel-associated cases have been published worldwide, the vast majority being murine typhus caused by Rickettsia typhi, Mediterranean spotted fever caused by Rickettsia conorii, African tick bite fever caused by Rickettsia africae, and scrub typhus caused by Orientia tsutsugamushi . Most patients present with a benign febrile illness accompanied by headache, myalgia, and cutaneous eruptions, but severe complications and fatalities are occasionally seen . Current microbiological tests include culture, polymerase chain reaction, and serological analysis, of which only the latter method is widely available . Tetracyclines are the drugs of first choice and should be prescribed whenever a case of rickettsiosis is suspected . Preventive measures rely on minimizing the risk of arthropod bites when traveling in areas of endemicity. J Dairy Sci, 2004 Dec, 87(12), 4033 - 41 Textural and sensory characteristics of whole and skimmed flavored set-type yogurt during long storage; Salvador A et al.; A study of refrigerated storage (10 degrees C for 91 d) of whole and skimmed flavored set-type yogurt was made . Comparison with storage at 20 degrees C for 21 d and 30 degrees C for 3 d (accelerated) was also carried out . Refrigerated storage yogurts were assessed by a trained panel and by a consumer panel . Trained-panel scores were correlated to instrumental data, and the acceptability data for long storage were studied using consumer criteria . In all cases, after-storage pH values barely changed over storage time, indicating that the yogurt samples did not develop much acidity under any of the storage conditions studied . The profile of the instrumental texture curves obtained corresponded to a firm gel, which broke after a plunger penetrated the sample, and the firmness values of the whole yogurt were lower than for the skimmed yogurt under all the storage conditions studied . From a microbiological point of view, the viability of the yogurts was adequate at the different storage times and temperatures studied, although those stored at 10 degrees C for long periods would not comply with some countries' minimum requirements . Logistic regression of the data from a 50-consumer sensory evaluation showed that the probability of the whole yogurt being accepted after 91 d storage at 10 degrees C was around 40%, whereas for the skimmed yogurt it was only 15%, largely because the skimmed yogurt developed certain negative attributes at an earlier stage of storage than the whole yogurt. Int J Environ Health Res, 2004 Dec, 14(6), 453 - 9 Risk and management in hospital water systems for Legionella pneumophila: a case study in Rio de Janeiro-Brazil; Ferreira AP; This article analyses the water used at hospitals in Rio de Janeiro, Brazil . The research, based on microbiological and physical-chemical aspects, suggests subsidies for normalization of hospital potable water systems and makes recommendations for standardization of operational procedures for inspection for Legionella pneumophila . A total of 16 hospitals were inspected and positive results for the presence of L . pneumophila were found at five hospitals . These hospitals were integrated in a research project aiming at the detection and quantification of this pathogen . During 10 consecutive weeks, four collections representing a total of 200 analyses were done at the five researched hospitals . In this way seven physical-chemical parameters and three microbiological parameters were observed to evaluate the quality of water in each hospital . The results showed that routine surveillance for a hospital water distribution system is fundamental for public health and must include, as a priority, monitoring of L . pneumophila . The water quality varies in accordance with the hospital water system involved . It is important and necessary to implement environmental culturing in order to minimize hospital infection, in particular, pneumonia data and also to provide the basis for disinfection of the water system. Int J Environ Health Res, 2004 Dec, 14(6), 415 - 27 Effects of mould remediation on school teachers' health; Patovirta RL et al.; The follow-up study of the health of teachers (n = 56) of three mould damage schools were done with self-administered symptom questionnaire before and 1 year after the remediation of school buildings . Technical and microbiological investigations were done parallel at the same time . In the beginning of the study symptoms of allergic rhinitis, sinusitis, conjunctivitis and fatigue were high compared to normal population and 1 year after the intervention a decrease in fatigue (OR = 0.4) and headache (OR = 0.2) was observed . An association between female gender and sinusitis was found before the remediation (OR = 8.1) . Age over 40 years was a risk factor for voice problems and more than 10 working years at the same school were associated with increased risk for conjunctivitis (OR = 8.5) and headache (OR = 5.4) . Other exposure situations such as mould problems at home and mould exposure during leisure time also have an effect on teachers' health . Significant reduction was found in symptoms of fatigue and headache after the cessation of exposure, while respiratory symptoms need much longer time to relieve after the remediation . Age, female gender, atopy, long-term exposure time and other exposure situations might be the risk factors for prolonged symptoms among mould exposed teachers. Int J Food Microbiol, 2004 Dec 15, 97(2), 171 - 8 Proximate sources of bacteria on boneless loins prepared from routinely processed and detained carcasses at a pork packing plant; Gill CO et al.; Microbiological samples were obtained by swabbing detained and routinely processed pig carcasses before and after cooling, and sides, loin portions and loin cuts at various stages of the carcass breaking process . Aerobes, coliforms and Escherichia coli were enumerated in each sample . All three groups of bacteria were more numerous on detained than on routinely processed carcasses . Both trimming and cooling reduced the numbers of E . coli but not the numbers of aerobes on detained carcasses . After cooling, the log mean number of aerobes and E . coli on detained carcasses were each about 0.5 log unit more than the log mean numbers on routinely processed carcasses, but numbers of coliforms on the two types of carcass were similar . There were small increases in the numbers of coliforms and E . coli on carcasses during their movement from the cooler to the breaking facility . The numbers of bacteria on the meat apparently did not increase during the carcass-breaking process, although bacteria were redistributed on the product . Despite that, substantial numbers of bacteria were recovered from parts that do not contact food in cleaned conveying equipment used for carcass breaking . However, those bacteria included few coliforms and no E . coli . These findings suggest that the contamination of meat with E . coli from persistent detritus in carcass breaking equipment, such as has been found to occur at beef packing plants, may be prevented when carcass-breaking equipment and facilities are dried after cleaning, and wetting of equipment during processing is avoided. Crit Rev Food Sci Nutr, 2004, 44(5), 349 - 51 A new quality parameter in tomato and tomato products: ergosterol; Kadakal C et al.; The poor precision of the "percentage of discarded fruits" and "Howard mold count" methods has increased the importance of ergosterol for the microbiological quality evaluation of tomato and tomato products . Ergosterol, a constituent of the cell wall of some important vegetable parasites, such as molds, has been recently recognized as a potential objective parameter useful for the characterization of the quality of processing tomatoes . Thus, 15 mg of ergosterol/kg total solids has been stated as an acceptability maximum limit of tomato products. Anal Chem, 2004 Nov 15, 76(22), 6609 - 17 Bacterial identification by protein mass mapping combined with an experimentally derived protein mass database; Tao L et al.; A protein mass mapping approach using mass spectrometry (MS) combined with an experimentally derived protein mass database is presented for rapid and effective identification of bacterial species . A prototype mass database from the protein extracts of nine bacterial species has been created by off-line high-performance liquid chromatography (HPLC) matrix-assisted laser desorption/ionization (MALDI) MS, in which the microbiological parameter of bacterial growth time is considered . A numerical method using a statistical weight factor algorithm is devised for matching the protein masses of an unknown bacterial sample against the database . The sum of these weight factors produces a corresponding summed weight factor score for each bacterial species listed in the database, and the database species producing the highest score represents the identity of the respective unknown bacterium . The applicability and reliability of this protein mass mapping approach has been tested with seven bacterial species in a single-blind study by both direct MALDI MS and HPLC electrospray ionization MS methods, and identification results with 100% accuracy are obtained . Our studies have demonstrated that the protein mass database can be rapidly established and readily adopted with relatively less dependency on experimental factors . Furthermore, it is shown that a number of proteins can be detected using a protein sample amount equivalent to an extract of less than 1000 cells, demonstrating that this protein mass mapping approach can potentially be highly sensitive for rapid bacterial identification. J Environ Qual, 2004 Nov-Dec, 33(6), 2357 - 66 Response of biogeochemical indicators to a drawdown and subsequent reflood; Corstanje R et al.; Temporal oscillations in hydrology are a common occurrence in wetlands and can result in alternating flooded and drained conditions in the surface soil . These oscillations in water levels can stimulate microbial activities and result in the mobilization and redistribution of significant amounts of carbon (C), nitrogen (N), and phosphorus (P) . The goal of this study was to experimentally simulate a drawdown and reflood of marsh soil from a nutrient-enriched site and a reference site of a wetland (Blue Cypress Marsh Conservation Area, Florida) . The goal was to better understand the changes in biogeochemistry and microbial activities present in these soils as a result of hydrological fluctuations . Measurements of dissolved reactive phosphorus (DRP), ammonia, and nitrate in the floodwater indicated significantly higher (alpha = 0.05) NH(4)(+) and DRP fluxes from the nutrient-enriched site; floodwaters in the cores from both sites contained significant NO(3)(-) concentrations (9.6 mg N L(-1)), which was rapidly consumed over the core incubation period (30 d) . Water level drawdown and reflooding initially stimulated the soil microbial biomass, methanogenic rates, and extracellular enzyme activities (acid phosphatase and beta-glucosidase) . The anaerobic microbial metabolic activities (CO(2)) where initially significantly (alpha = 0.05) enhanced by the reflood, resulting in roughly equivalent rates as the aerobic respiratory activities (CO(2)), presumably as a function of the high water column NO(3)(-) levels . This study illustrates that the reflood event in the hydrological cycles in a wetland can significantly stimulate the activities of hydrolytic enzymes and microbiological communities in these soils. Med Wieku Rozwoj, 2003 Jul-Sep, 7(3 Suppl 1), 203 - 9 {Relationship between cervical infections and premature rupture of membranes}; Reron A et al.; Preterm delivery is still one of the most important problems of the modern obstetrics . In our country frequency of preterm delivery is 7.2-8.4% of all deliveries . Although preterm birth is the leading cause of perinatal morbidity and mortality, the diagnosis and appropriate treatment of preterm labor remains an unresolved clinical problem . A growing body of evidence supports the view that preterm labor is a syndrome with multiple causes and the urogenital infections play a very important role in the pathogenesis of preterm birth . The study analyses relationship between results of microbiological examination of cervical smear and preterm rupture of membranes. J Int Acad Periodontol, 2004 Oct, 6(4 Suppl), 143 - 9 The microbiological case for adjunctive therapy for periodontitis; Page RC; That chronic periodontitis is an infectious disease is now firmly established, and the primary role of Porphyromonas gingivalis, Tannerella forsythensis and Treponema denticola is generally accepted . Treatment by mechanical means such as scaling and root planing or surgery generally results in significant clinical improvement but may not arrest the progress or recurrence of disease . Several studies have shown that the probability of achieving lasting stability as measured by the arrest of progressive attachment loss and bone loss by primary mechanical therapy is a function, in major part, of whether pathogenic microorganisms are still present at local subgingival sites at the completion of active therapy . The infecting bacterial species are susceptible to killing by several antibiotics including, among others, tetracycline-class drugs, amoxicillin and metronidazole as well as by local exposure to chlorhexidine . Randomized clinical trials have shown that use of systemically administered antibiotics as an adjunct to mechanical therapies significantly enhances clinical outcomes and stability . Several slow-release devices that deliver anti-microbial drugs directly into periodontal pockets have been developed and are now on the market . Use of these devices permits local delivery of long-lasting, high concentrations of doxycycline (Atridox) minocycline (Arestin), and chlorhexidine (PerioChip) directly into periodontal pockets . Although these devices differ with regard to ease of use, concentration of drug delivered and length of time high drug concentrations can be maintained, randomized clinical trials have shown that their use as an adjunctive