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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 treatment to scaling and root planing results in a significantly greater reduction of periodontal pocket depth and an average increase in clinical periodontal attachment level of about 0.8 mm . Gain in clinical attachment is greater in deeper pockets than in shallower pockets . Locally delivered adjunctive anti-microbial therapy is an effective means to enhance therapeutic outcomes.

Vet Res, 2004 Nov-Dec, 35(6), 661 - 9
The comparative pathogenicity of strains of eight serovars and untypable strains of Mannheimia haemolytica in experimental pneumonia of sheep; Odugbo MO et al.; The experimental induction of pneumonic pasteurellosis in groups of conventionally reared lambs by 8 serovars (A1, A2, A6, A7, A8, A9, T10, and A11) and untypable (UT) strains of Mannheimia haemolytica (Mh) were examined and compared . The groups of lambs were inoculated intratracheally with 1.4 x 10(8) +/- 0.6 x 10(8) (mean +/- SD) colony-forming units of the Mh serovars or UT isolates in the 6-hour log phase of growth . The variables measured as indicators of disease severity were clinical score, percentage lung consolidation and microbiological re-isolation . The clinical parameters for each group were computed daily for 6 days post infection and the lambs which died were necropsied while the remaining lambs were killed on day 7 pi and the extent of lung consolidation was measured . Clinically, the mean scores for the M . haemolytica serovars were A1 (6.1), A2 (18.8), A6 (0.5), A7 (17.4) and A9 (8.5) . The mean percent lung lesion scores for M . haemolytica serovars were A1 (12.5), A2 (66.3), A6 (5.0), A7 (51.3), A9 (33.8) and A11 (2.5) . The percent mean pneumonic lung lesions recorded for groups inoculated with A2, A7 and A9 were significantly (P < 0.05) higher than the extent of lung lesions in the other groups . A statistically significant correlation was observed between clinical scores and the severity of the lung lesions (r = 0.96, P < 0.01) . High titres of M . haemolytica were recovered from lung lesions, with 10 to 100 times the number of organisms inoculated being present in the lung lesions of lambs inoculated with serovars A2 and A7 . These data indicate that although M . haemolytica serovars A1, A2, A6, A7, A9 and A11 are important primary lung pathogens of lambs, serovars A2, A7, and A9 are to be regarded as highly virulent strains that have a greater predilection than the other serovars for causing pneumonia in lambs.

Rev Bras Enferm, 2004 Mar-Apr, 57(2), 152 - 6
{Items sterilized in humid heat: validation of the storage system}; das Neves ZC et al.; We aimed at identifying the period of validity of the sterilization of items by humid heat, taking into account the conditions of sterilization and storage . The validation was carried out by means of microbiological tests performed with instruments in the same load and evaluated in 0, 7, 10, 15, and 25 days . 30% of the instruments in each package were analysed and put in a Mueller Hinton solution and incubated at 37 degrees C for 72 hours . The reading was accomplished taking into consideration how dark the solution was . Out of the samples evaluated in nine loads, none showed microbiological growth . It was concluded that, although sterilization and storage conditions of the material were not fully in accordance with parameters recommended by the literature, the sterilization happened and was maintained for a period of 25 days.

Arch Neurol, 2004 Nov, 61(11), 1669 - 73
Neuromuscular disorders in severe acute respiratory syndrome; Tsai LK et al.; OBJECTIVE: To delineate and clarify neuromuscular disorders in patients with probable severe acute respiratory syndrome (SARS) . DESIGN: Case series with follow-up ranging from 3 weeks to 2 months . SETTING: National Taiwan University Hospital, Taipei . PATIENTS: We investigated 4 patients with SARS who had concomitant neuromuscular problems . A diagnosis of SARS was based on the demonstration of serum coronavirus antibodies . Clinical presentations, laboratory results, electrophysiologic findings, and follow-up conditions were determined . RESULTS: Patients developed neuromuscular problems approximately 3 weeks after the onset of SARS . Two women experienced motor-predominant peripheral nerve disorders . A man developed myopathy and a third woman experienced neuropathy and myopathy . Cerebrospinal fluid obtained from 2 patients with neuropathy disclosed normal protein content and the absence of pleocytosis and SARS coronavirus antibodies . Both patients with myopathy had elevated serum creatine kinase levels . A rapid clinical and electrophysiologic improvement was evident during follow-up examinations, with a good prognosis . CONCLUSIONS: The neuromuscular problems in patients with SARS are considered to be critical-illness polyneuropathy or myopathy, possibly coexistent . Further pathological and microbiological studies are necessary to determine the relationship between SARS coronavirus and neuromuscular problems.

Br J Nutr, 2004 Nov, 92(5), 861 - 7
Oral candidiasis and nutritional deficiencies in elderly hospitalised patients; Paillaud E et al.; The prevalence of oral candidiasis and its association with malnutrition in terms of protein-energy malnutrition and mineral and vitamin depletion were evaluated in ninety-seven hospitalised older adults aged 82.1 (SD 8.6) years . Patients underwent a complete oral examination with microbiological investigation on admission to our geriatric rehabilitation unit . Patients were assessed nutritionally by evaluation of dietary intake and measurement of anthropometric variables, serum nutritional proteins, ferritin, Zn, folate, vitamins B12 and C . The prevalence of oral candidiasis was 37% (n 36); the proportion of patients with BMI <20 kg/m(2) was 32% (n 31) . The nutritional status of the population was studied by comparing two groups defined according to the absence (group I; n 61) or presence (group II; n 36) of oral candidiasis . The two groups did not differ on the basis of BMI and mid-arm circumference . However, group II had a smaller leg circumference, lower daily energy and protein intakes, lower albumin and transthyretin levels . Patients successfully treated with fluconazole increased their intake on day 30 . The proportion of patients with hypozincaemia (<12.5 micromol/l) and vitamin C deficiency (<0.7 mg/l) was higher in group II . Treatment with antibiotics, poor oral hygiene, denture wearing, and vitamin C deficiency appeared as the most significant independent risk factors associated with oral candidiasis . The present findings show that oral candidiasis appears to be related to malnutrition and results in mucosal lesions that have a negative impact on energy intake, which may subsequently worsen nutritional status.

Minerva Ginecol, 2004 Oct, 56(5), 401 - 6
Chlamydia trachomatis prevalence in North-West Italy; Grio R et al.; AIM: Chlamydia (C.) trachomatis infection is the most common sexually transmitted disease (STD) among sexually active adolescents and young adults in Europe . The aim of this study was to determine the prevalence of C . trachomatis among sexually active women in Piedmont, Italy and the correlation between some risk factors and C . trachomatis infection . METHODS: In our study 31,419 sexually active women aged 12-55 were screened for C . trachomatis by Abbott's ligase chain reaction (LCR) using cervical swabs during the period 1997-2001 at St . Anna Obstetric-Gynecological Hospital, Turin . All the patients answered a specific questionnaire . RESULTS: In our analysis the prevalence of C . trachomatis infection was found to be 1.23%, and the average age among the infected patients was 36.98 years . Statistical analysis was performed using the chi squared test; a p<0.05 was considered significant . A correlation was found between a positive test result and the age at the first intercourse (p<0.001), the number of sexual partners in the preceding 6 months (p<0.001), the presence of symptoms (p<0.001), a low level of education (p<0.001) and an East-European and Central-Northern African citizenship (p<0.001) . No statistically significant differences were found among the contraceptive methods used, whether an hormonal or a barrier type; a marked increment of the risk was observed when no contraception was used . CONCLUSION: Frequent microbiological examinations are desirable for patients whose anamnesis shows an augmented risk of contracting sexually transmitted infections in order to avoid long term complications from misdiagnosed or asymptomatic pathologies, as often happens with C . trachomatis.

Mar Pollut Bull, 2004 Nov, 49(9-10), 752 - 60
Microbiological Indices for total coliform and E . coli bacteria in estuarine waters; Neill M; Bacterial counts for total coliforms and E . coli in estuaries are normally orders of magnitude greater at the freshwater end than at the seaward end and tidal movements and variations in freshwater flows produce continual change in the freshwater/seawater mix--this causes the bacterial counts to vary greatly throughout the estuary and the complexity creates difficulty in appraising or assessing the bacterial counts (i.e . difficulties arise when deciding if the bacterial counts for estuarine water samples are within an acceptable range--relative to their corresponding salinities) . The situation is further complicated in estuaries where sewage is discharged directly . Microbiological criteria and indices that can be used in a practical way to overcome these difficulties were developed . The procedure is summarised as follows: 1 . Primary criteria are proposed for total coliform and for E . coli bacteria in the freshwater at the head of the estuary and in full seawater at the mouth of the estuary . 2 . For estuarine or transitional waters (i.e . waters with salinity ranging from 0 per thousand to 35 per thousand), distinct criteria are calculated for each individual sample--with a separate criterion for total coliforms and for E . coli--the individual criteria are founded on the primary criteria and vary with salinity on a pro-rata or linear basis . 3 . Finally, the Microbiological Index for each result is obtained by dividing the actual bacterial count by the corresponding criterion--the acceptable Index is then equal to 1--at any salinity (i.e . where the Index is <1 then the bacterial count complies with the criterion, and where the Index is >1 then the count breaches the criterion) . The Index also indicates the extent of the compliance or non-compliance with the corresponding criteria . An example of the application of the Microbiological Index is also presented--including examples of graphs that demonstrate how microbiological data for estuarine waters can be summarised and presented.

J Vet Med Sci, 2004 Oct, 66(10), 1205 - 11
The effect of polysaccharides and carboxymethylcellulose combination to prevent intraperitoneal adhesion and abscess formation in a rat peritonitis model; Bae JS et al.; Polysaccharides isolated from fungi, Phellinus spp . is well-known material with anti-tumor and anti-inflammatory properties . We have assessed the adhesion- and abscess-reducing capacity of carboxymethylcellulose (CMC) and polysaccharides from Phellinus spp . combination in a rat peritonitis model . In 72 Sprague-Dawley rats, experimental peritonitis was induced by means of the cecal ligation and puncture model (CLP) . After 24 hr, the abdomen was reopened and the ligated cecum was resected . Peritoneal fluid samples were taken for microbiological examination . Rats were randomly assigned to 6 groups: ringer lactate solution (RL group), polysaccharides from Phellinus gilvus (PG group) and Phellinus linteus (PL group), carboxymethylcellulose (CMC group), and their combinations (PG+CMC and PL+CMC groups) . Adhesions and abscesses were noted at day 7 after CLP . RT-PCR assay for urokinase-type plasminogen activator (uPA), its cellular receptor (uPAR), and tumor necrosis factor (TNF)-alpha was performed to assess the cecal tissue . Microbiological examination showed polymicrobial bacterial peritonitis . Adhesion formation was significantly reduced in PG+CMC and PL+CMC groups (P<0.05) . The incidence of abscesses was reduced in all treated groups except the RL group (P<0.05) . uPA, uPAR, and TNF-alpha mRNA were highly expressed in the PG+CMC and PL+CMC groups, as compared to the RL group . We concluded that the combination of polysaccharides and CMC had significant adhesion- and abscess-reducing effects compared with their single treatment and the effects may act by modifying the fibrinolytic capacity of uPA, uPAR and TNF-alpha produced from activated macrophages in a rat peritonitis model.

Intensive Care Med, 2005 Jan, 31(1), 56 - 63 Epub 2004 Nov 04.
Post-ICU mortality in critically ill infected patients: an international study; Azoulay E et al.; OBJECTIVE: To determine the incidence and risk factors for post-ICU mortality in patients with infection.DESIGN AND SETTING: International observational cohort study including 28 ICUs in eight countries.PATIENTS: All 1,872 patients discharged alive from the ICU over a 1-year period were screened for infection at ICU admission and daily throughout the ICU stay . Outcomes at ICU and hospital discharge were recorded.MEASUREMENTS AND RESULTS: Post-ICU death occurred in 195 (10.4%) patients and was associated in the multivariable analysis with age, chronic respiratory failure, immunosuppression, cirrhosis, Simplified Acute Physiology Score II on the first day with infection, and LOD score at ICU discharge . Post-ICU death was more common among medical patients and patients with hospital-acquired infection or microbiologically documented infection and was less common in patients with pneumonia.CONCLUSIONS: Post-ICU death in patients with infection was within previously reported ranges in overall ICU populations . The main risk factors were patient and infection characteristics, severity at ICU admission, and persistent organ dysfunction at ICU discharge . Further interventions such as further ICU management, discharge to a step-down unit, or follow-up by intensivists on the ward should be evaluated in patients with a high risk of post-ICU mortality.

Indian J Med Sci, 2004 Oct, 58(10), 423 - 30
A prospective, randomised, double-blind study of comparative efficacy of immediate versus daily cleaning of stethoscope using 66% ethyl alcohol; Parmar RC et al.; OBJECTIVE: Studies have demonstrated frequent contamination of stethoscope and usefulness of different disinfectants . Albeit, studies on the precise mode of cleaning and frequency of cleaning are lacking . This study was carried out to determine efficacy of 66% ethyl alcohol as disinfectant, rate of recontamination without cleaning and benefits of daily versus immediate cleaning . METHODOLOGY: Prospective, randomised, double blind study of 100 stethoscopes . Four cultures were obtained: before cleaning (Group A), immediately after cleaning with 66% ethyl alcohol (Group B), at the end of 4 days without cleaning (Group C) and at the end of 4 days after cleaning once a day (Group D) . Samples were analysed using standard microbiological methods and Colony-forming unit (CFU) count and residual microorganism was computed for all the positive cultures . Medical staff was asked about the cleaning practices . Statistical analysis was carried out using 95% confidence interval and Chi-square test . RESULTS: 90% of the stethoscopes were contaminated with one or more microorganisms . Immediate cleaning and daily cleaning were associated with a significant reduction in the rate of contamination to 28% and 25% respectively . CFU count in groups B and D dropped to less than 10 in 75% and 84.7%, while the mean residual rates were 5.2% and 3.65% respectively . Groups B and D showed no statistically significant difference in terms of efficacy of disinfection . CONCLUSIONS: 66% ethyl alcohol is an effective disinfectant . The effects of immediate cleaning and cleaning once a day on residual flora on the diaphragm of stethoscope is comparable.

Eur J Prosthodont Restor Dent, 2004 Sep, 12(3), 115 - 20
Microbiological hazard analysis in dental technology laboratories; Verran J et al.; Dental technicians are trained in a range of skills involved in the fabrication of prostheses used in the mouth and facial region . Items entering the dental laboratory are essentially inert materials which have been in contact with the patient's mouth, saliva, and possibly blood . Appliances leaving the laboratory are then returned to the clinician to be tried/inserted in the patient's mouth . Relatively little attention has been paid to infection control policy within dental laboratories, perhaps due to perceived and/or actual remoteness from patients, lack of appropriate training, and lack of relevant research . More controlled studies are desirable, in order to identify any potentially hazardous procedures, and to make an assessment of risk for these procedures.

Mikrobiologiia, 2004 Jul-Aug, 73(4), 540 - 52
{The biogeochemical cycle of methane in the coastal zone and littoral of the Kandalaksha Bay of the White Sea}; Safe inoculation of blood and bone marrow for liquid culture detection of mycobacteria; International Reference Laboratory of Mycobacteriology, Statens Serum Institut, The National Institute for Prevention and Control of Infectious Diseases and Congenital Disorders, 2300 Copenhagen, DenmarkBACKGROUND: Needlestick injuries confer an unnecessary risk of occupational bloodborne infections such as human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) infections . After an accidental needlestick injury, procedures for inoculation of liquid culture media for rapid detection of Mycobacterium tuberculosis complex and other mycobacteria from blood and bone marrow specimens were reviewed . AIM: To identify a safer transfer device, which could replace the ordinary syringe in inoculation of liquid culture vials . METHODS: We identified a transfer device to transfer blood or bone marrow specimens from bedside tubes into liquid culture vials . CONCLUSION: The changed procedure will reduce the risk of needlestick accidents and be of benefit to other microbiological laboratories using the same or similar inoculation techniques.

Cytometry A, 2004 Dec, 62(2), 162 - 8
Production of precise microbiology standards using flow cytometry and freeze drying; Morgan CA et al.; BACKGROUND: Quality control standards provide a quantity of microorganisms for routine use in microbiology to demonstrate the efficacy of testing methods and culture media . Standards are normally prepared by diluting a culture of microorganisms to obtain a suspension that contains an estimated number of colony-forming units per milliliter . The variability and inaccuracy of these standards increase the potential for false results . Flow cytometry has been used extensively to prepare precise standards of Cryptosporidium and Giardia that contain exact numbers of organisms in a volume of liquid (1) . However, the same levels of accuracy have yet to be obtained for bacterial quality control standards . METHODS: A modification of a Becton Dickinson FACScalibur flow cytometer enabled 30 bacterial cells to be sorted into a single droplet, mixed with a cryoprotective solution within the droplet, and frozen in liquid nitrogen . The frozen droplets were then freeze dried for stable preservation of the viable bacterial cells . RESULTS: A freeze-dried sphere 3 mm in diameter was produced, which contained 30 microorganisms . The within-batch variation for these freeze-dried spheres was no greater than two standard deviations, and the between-batch variation was less than one standard deviation . CONCLUSIONS: Bacterial reference controls can now be produced with consistent accuracy and unparalleled precision, thus enabling harmonization across the microbiological testing industry . 2004 Wiley-Liss, Inc.

Lab Anim (NY), 2004 Nov, 33(10), 36 - 41
Microbiological monitoring in individually ventilated cage systems; Compton SR et al.; Housing rodents in IVC racks has many advantages over conventional cages but also presents unique challenges related to health monitoring . The authors review the issues to consider in design of a sentinel program using IVC systems.

Ann Med, 2004, 36(7), 504 - 17
Xenotransplantation and risks of zoonotic infections; Boneva RS et al.; The shortage of human organs and tissues for transplantation and the advances in immunology of rejection and in genetic engineering have renewed interest in xenotransplantation--the transplantation of animal organs, tissues or cells to humans . Clinical trials have involved the use of non-human primate, porcine, and bovine cells/tissues/organs . In recent years, research has focused mainly on pigs as donors (especially, pigs genetically engineered to carry some human genes) . One of the major concerns in xenotransplantation is the risk of transmission of animal pathogens, particularly viruses, to recipients and the possible adaptation of such pathogens for human-to-human transmission . Porcine endogenous retroviruses (PERVs) have been of special concern because of their ability to infect human cells and because, at present, they cannot be removed from the source animal's genome . To date, retrospective studies of humans exposed to live porcine cells/tissues have not found evidence of infection with PERV but more extensive research is needed . This article reviews infectious disease risks associated with xenotransplantation, some measures for minimizing that risk, and microbiological diagnostic methods that may be used in the follow-up of xenotransplant recipients.

Monaldi Arch Chest Dis, 2004 Apr-Jun, 61(2), 128 - 30
Difficult diagnosis of infliximab-related miliary tuberculosis; Contini S et al.; The use of Infliximab in the treatment of patients with rheumatoid diseases unresponsive to conventional therapies has been reported to be complicated by opportunistic infections . We report the case of a 56-yr old female rheumatoid arthritis patient complaining of fever and respiratory symptoms 9 months after commencing Infliximab, who received no ethiologic diagnosis for the six months before admission . Tuberculosis was suspected upon chest radiographic pictures and empirical treatment for miliary tuberculosis instated in the wake of microbiological confirmation . The case typifies the difficulties of diagnosing miliary tuberculosis in the immunocompromised as well as in the immunocompetent patient.

Pol Arch Med Wewn, 2004 May, 111(5), 589 - 92
{Early form of toxoplasmosis with accompanying enlargement of lymph nodes}; Malafiej E et al.; The paper describes a case of a 42-year-old female presented rapidly increasing enlargement of lymph nodes . Initially it was believed to be an effect of proliferous systemic changes . The diagnostic procedures did not confirm the initial diagnosis but they evoked a lot of stress of the patient as well as her psychic discomfort resulting from a number of biopsies . Serological tests carried out in the further course of the diagnostic procedure showed that the increased nodular reaction should be attributed to Toxoplasma gondii invasion, which was indicated by the presence of IgM and IgA antibodies and low avidity of IgG . The early administration of specific treatment with spiramycin led to the regression of the clinical symptoms and gradual normalization of the serological test . The case is worth attention for several reasons: 1 . it indicates that it is necessary to consider T . gondii infection in basic clinical practice, which is frequently ignored, 2 . it illustrates the effectiveness of early specific treatment, 3 . it demonstrates the importance of well selected and properly interpreted microbiological tests.

J Oral Sci, 2004 Sep, 46(3), 157 - 61
Rate of cultivable subgingival periodontopathogenic bacteria in chronic periodontitis; Salari MH et al.; Although microbiological studies have identified more than 400 bacterial species in periodontal pockets, only a limited number have been implicated as periodontal pathogens . The purpose of this study was to investigate the incidence of cultivable subgingival periodontopathogenic bacteria in chronic periodontitis . Bacterial samples were collected with sterile paper points from the deepest periodontal pockets ((5 mm) of 203 patients: 92 males and 111 females, aged 35-55 years . The samples were cultured under anaerobic and capnophilic conditions using selective and non-selective media . Isolates were characterized to species level by conventional biochemical tests and a commercial rapid test system . The isolates were Actinobacillus actinomycetemcomitans (26.8%), Porphyromonas gingivalis (21.9%), Capnocytophaga sputigena (16.7%), Eikenella corrodens (13.2%), Prevotella intermedia (10.5 %), Prevotella disiens (3.1%), Peptostreptococcus micros (2.9%), Capnocytophaga gingivalis (2.2%), Prevotella corporis (1.8%), Peptostreptococcus magnus (1.3%) and Fusobacterium nucleatum (0.4%) . No periodontopathogenic bacterial growth was observed in 14 of the samples (6.2%) . The number of samples associated with monobacterial growth and polybacterial growth were 74.9% and 18.2% respectively . It is concluded that the bacterial composition associated with a number of patients' samples is quite complex, and that some of cultivable anaerobic and capnophilic bacteria act as periodontal pathogens in chronic periodontitis.

Rev Panam Salud Publica, 2004 Sep, 16(3), 199 - 205
{Milk from human milk banks for low birthweight newborns: nutritional contents and supplementation}; Bortolozo EA et al.; OBJECTIVE: To determine the macronutrient and micronutrient contents of human milk from milk banks as well as to develop a supplement for addition to this milk that could satisfy the specific nutritional requirements of low birthweight newborns . METHOD: For the determination of macronutrients, 46 samples of pasteurized milk obtained from two milk banks were analyzed in triplicate: 26 samples of mature milk, 10 samples of foremilk and 10 samples of milk from mothers of preterm babies . Thirty of these samples (10 of each type of milk) were also analyzed for their micronutrient content . Following the determination of macronutrients and micronutrients, an easy-to-prepare supplement was developed . The supplement was made from protein hydrolysate powder and chelate minerals . RESULTS: The nutritional content varied both among the different types of milk and among the donors of the same type of milk . The levels of macronutrients and micronutrients were below the requirements for low birthweight newborns . The mean composition (and standard deviation) observed for mature milk, foremilk, and preterm milk, respectively, was as follows: fats (g/100 mL), 2.56 (+/- 0.8), 2.48 (+/- 0.91), 2.48 (+/- 0.76); lactose (g/100 mL), 8.6 (+/- 0.93), 7.05 (+/- 0.92), 6.56 (+/- 1.41); protein (g/ 100 mL), 1.07 (+/- 0.22), 1.71 (+/- 0.29), 1.72 (+/- 0.4); calories (kcal/100 mL), 61.67 (+/- 8.92), 57.36 (+/- 8.37), 55.44 (+/- 8.00); calcium (mg/100 mL), 17.88 (+/- 5.56), 22.75 (+/- 10.24), 22.03 (+/- 9.39); magnesium (mg/100 mL), 2.15 (+/- 0.39), 2.64 (+/- 0.67), 2.16 (+/- 0.26); potassium (mg/100 mL), 35.53 (+/- 7.54), 43.75 (+/- 14.32), 44.37 (+/- 12.83); sodium (mg/100 mL), 16.27 (+/- 5.92), 43.36 (+/- 11.34), 37.98 (+/- 11.34); zinc (mg/100 mL), 0.46 (+/- 0.26), 0.75 (+/- 0.25), 0.72 (+/- 0.26); and phosphorus (mg/100 mL), 9.98 (+/- 1.72), 9.31 (+/- 4.30), 8.47 (+/- 2.43) . After the addition of the supplement, the protein and mineral contents reached the levels recommended for low birthweight newborns . CONCLUSION: Based on our results obtained, the supplementation of human milk from milk banks is warranted for use with low birthweight newborns . The proposed supplement was shown to be practical and safe, and it did not interfere with the microbiological quality of human milk.

Waste Manag, 2004, 24(9), 919 - 26
Microbiological characterization of food residues for animal feeding; Sancho P et al.; A description is offered of microbiological characterization of the biodegradable fractions present in food wastes so that those fractions can be transformed in such a way that they will fulfil the specifications involved in their use as raw materials in other production areas . In this way the wastes can be converted into sub-products, hence minimizing the amount of them eventually sent to rubbish dumps . Of all the types of residues analyzed, only those obtained by separate collection from fishmongers' and greengrocers' sections of large supermarkets and small shops were valid for the objectives of the project and were subjected to a heat treatment to test whether or not this treatment was capable of reducing their microbiological content to the point of converting them into acceptable raw materials for animal feed . Residues from butchers' sections of supermarkets and small shops, and residues from restaurants were not included in the final study because of the prohibition by the European legislation in force of using any kind of meat containing wastes for feeding farm animals . In the present work we made a one-year analysis of representative samples of such wastes . We observed that after thermal treatment at a temperature of at least 65 degrees C for 20 min the nutritional and microbiological parameters remained suitable for their possible use as animal feed and that their harmlessness was ensured, with no loss of nutritional characteristics . Regarding the microbiological study of the meals which have been obtained from residues for the production of the feed and the feed itself, and in accordance with the data for nutritional composition, we consider valid and sanitarily adequate their use as animal feed with the concomitant consequent minimization of waste, which has become a priority in view of the recent legislation enacted by the European Union.

Circ J, 2004 Nov, 68(11), 1011 - 7
Environmental factors and risk of idiopathic dilated cardiomyopathy: a multi-hospital case-control study in Japan; Miura K et al.; BACKGROUND: Detailed epidemiological investigations on the relationship of environmental factors, especially occupational and microbiological factors, to the development of idiopathic dilated cardiomyopathy (IDC) are scarce . METHODS AND RESULTS: A multi-hospital case-control study was conducted in 38 hospitals throughout Japan in order to survey IDC cases and age, sex-matched outpatient controls at each hospital . Crude and adjusted odds ratios (ORs) by various environmental factors were calculated in 135 pairs of cases and controls . Univariate analyses revealed significantly increased ORs for lower education, passive smoking in the workplace, cold and/or hot workplace, symptoms of fatigue and history of bacterial infection; in contrast, decreased ORs were associated with a history of rubella and gastroduodenal diseases . Based on multivariate adjusted analyses, lower education (OR 1.96, 95% confidence interval (CI) 1.13-3.40), cold or hot workplace (OR 1.84, 95%CI 1.08-3.12) and history of measles (OR 1.78, 95%CI 1.01-3.08) exhibited a significant positive relationship with IDC risk . History of rubella (OR 0.17, 95%CI 0.06-0.52) and gastroduodenal diseases (OR 0.14, 95%CI 0.07-0.29) were inversely related to the risk . CONCLUSIONS: Some occupational and microbiological factors appear to relate independently to the development of IDC and further investigation is required to establish their respective mechanisms.

Transfus Apheresis Sci, 2004 Oct, 31(2), 155 - 63
Bacterial contamination in blood components and preventative strategies: an overview; Vasconcelos E et al.; Bacterial contamination of blood and its cellular components remains an unresolved problem in transfusion medicine and is considered to be the most common microbiological cause of transfusion associated morbidity and mortality . This is because contaminated units may contain large numbers of virulent bacteria as well as endotoxins that are considered to be fatal to the recipient . Accordingly, measures have been proposed to prevent or at least control the potential risk of transfusion associated bacteria infections . Broadly, these approaches include: bacterial avoidance; bacterial growth inhibition and bacterial load reduction by leucofiltration/viral inactivation . Unfortunately, none of the current approaches alone or in combination have received overall acceptance in terms of operational practice and safety/efficacy . Considerable effort has also been directed towards improving bacterial detection in order to provide a scientific basis for the lengthening of the shelf life of liquid stored platelets, without affecting, to a large extent their safety/efficacy . These issues have been highlighted in this overview on the current status and future trends.

J Hosp Infect, 2004 Nov, 58(3), 230 - 2
Source of bacterial shedding in laminar flow theatres; Owers KL et al.; In a previous unpublished observation, unacceptably high bacterial counts, presumably due to shedding episodes, occurred in two of 56 (3.57%) slit-air samples during arthroplasty surgery in a laminar flow operating theatre . The isolates matched those cultured from swab samples taken from the skin of one of the surgeons's foreheads on each of the two occasions . These findings occurred despite scrub staff wearing standard occlusive gowns, hats and masks with visors . In order to localize the potential source of such shedding more accurately, 20 members of theatre staff underwent anonymous microbiological swabbing from the facial areas not covered by theatre clothing, namely their foreheads, eyebrows and ears . These swabs were cultured and the growths were compared statistically . Significantly more colonies were cultured from swabs taken from the theatre staff's ears (P = 0.047, Freidman's test) compared with the other two facial areas studied . These data support the use of exhaust helmets in arthroplasty surgery, or at least mandatory coverage of the ears with theatre hats for scrub staff.

Environ Geochem Health, 2004 Jun-Sep, 26(2-3), 119 - 28
Changes of soil microbiological properties caused by land use changing from rice-wheat rotation to vegetable cultivation; Lin XG et al.; A survey was done recently in Jiaxing city of Zhejiang Province in the Yangtze River Delta to compare the differences of soil microbiological properties among paddy soils with different land use including continuous open-field vegetable cultivation (OFVC), plastic-greenhouse vegetable cultivation (PGVC) and traditional rice-wheat rotation (RWR) . The soil types included are percolating, permeable and waterlogged paddy soils . The results indicate that the microbial flora was markedly changed as the land use changed for all the three soil types . In continuous vegetable cultivation soils, especially in PGVC soils, the bacteria amounts decreased dramatically, but the fungal and actinomyce amounts increased as compared with RWR soils . The dehydrogenase activities decreased significantly in vegetable soils, especially in PGVC soils as compared with RWR soils . The microbial biomass C and the total phospholipid contents (TPL) in vegetable cultivation soil greatly decreased as compared with RWR soils . Biolog analysis indicated that the kinds of carbon sources that could be metabolized by native microbes in PGVC soils greatly decreased as compared with OFVC soils and RWR soils, revealing that microbial diversity had decreased since land use change . The activities of some soil enzymes including urease, invertase and phosphase were all lower in OFVC soils than those in RWR soils, and those in PGVC soils were the lowest . The degradation of microbiological activities in continuous vegetable cultivation soils, especially in PGVC soils, as compared with RWR soils might have been caused by soil acidification and accumulation of salts due to overuse of both organic and inorganic fertilizers in vegetable cultivation.

Aust Dent J, 2004 Sep, 49(3), 122 - 7
Microbiological evaluation of endodontic files after cleaning and steam sterilization procedures; Van Eldik DA et al.; BACKGROUND: Infection control procedures are essential for modern dental practice and they are continually evolving to meet the dental profession's high standards . The present study evaluated the efficacy of two cleaning procedures to reduce bacterial numbers on endodontic files, and evaluated the effect of biological debris on the subsequent sterilization of files . METHODS: Stainless steel and nickel-titanium (NiTi) files were examined upon removal from the manufacturer's packaging, after instrumentation in root canals of human teeth inoculated with a broth containing two anaerobic species and one facultative anaerobic species of bacteria, and after instrumentation and cleaning with either an ultrasonic bath or a thermal disinfector . For each file, the bacterial numbers were quantified using routine microbiological techniques in an anaerobic chamber . RESULTS: No bacteria were detected from files direct from their packets . The size, taper and type of file did not affect the ability of either of the cleaning procedures to reduce bacterial numbers . However, an absence of bacteria was more likely when files were cleaned in the thermal disinfector . No bacteria were detected from files that were-subjected to steam sterilization irrespective of the type of prior cleaning procedure . CONCLUSIONS: Steam sterilization eliminated all bacteria from the endodontic files irrespective of the presence of biological debris . The majority of bacteria were eliminated from endodontic files after either ultrasonic cleaning or using a thermal disinfector.

J Pharm Biomed Anal, 2004 Oct 29, 36(2), 257 - 64
Fast separation of bacitracin on monolithic silica columns; Pavli V et al.; The development of isocratic and gradient stability indicating HPLC methods for bacitracin (Bc) and bacitracin zinc (BcZn), which are complex mixture of several related polypeptides, is described . The methods are based on a new type of reversed phase (RP-18e) monolithic silicagel stationary phase . Chromatographic experimental conditions used on conventional column with microparticles were adopted and further modified to achieve efficient separation of Bc . The influence of methanol and acetonitrile in combination with phosphate buffer was thoroughly studied to separate microbiologically active components A, B1, B2, B3 and their oxidative degradation products F, H1, H2 and H3 . Chromatographic peaks of all the mentioned components were identified using compounds isolated previously by preparative HPLC . Applying isocratic or gradient approach, highly efficient separation was achieved together with drastically reduced analysis times (ca . 6 min) compared to all published HPLC methods up to date . With thus developed HPLC methods, it is possible to evaluate not only the main degradation product F, but for the first time also several other oxidative degradation products of Bc (H1, H2 and H3) . Such methods are also suitable for routine quality control and stability testing . Validation of both isocratic and gradient methods confirmed the selectivity and efficiency comparable to that on microparticulate columns, yet contrary to conventional columns with highly reduced analysis time.

J Pharm Biomed Anal, 2004 Oct 29, 36(2), 249 - 55
UV spectroscopy and reverse-phase HPLC as novel methods to determine Capreomycin of liposomal fomulations; Rossi C et al.; Capreomycin (CS) is an antitubercular drug active against several Mycobacterium strains, in particular, against M . Avium . In spite of its activity, it is considered a second line drug because it can induce severe renal and hepatic damages when administered as free drug . However, it is possible to employ drug delivery systems, such as liposomes, to reduce the toxicity of the peptide without loss of its biological activity . For this purpose, appropriately validated time and money saving analytical methods are needed for a careful capreomycin dosage . In the present paper, UV spectroscopy and a reverse-phase HPLC (RP-HPLC) were investigated as alternative methods for capreomycin quantitative analysis . These techniques were validated against the USP XXVI microbiological turbidimetric assay and the normal-phase HPLC (NP-HPLC) method reported in the British Pharmacopoeia 2003 . The results obtained showed that either UV spectrophotometry or RP-HPLC are techniques having higher accuracy and reproducibility with respect to the microbiological assay . Moreover, the RP-HPLC method provided improved performances if compared to NP-HPLC . In fact, RP-HPLC showed: (i) enhanced sensitivity and (ii) increased resolution . Thus we propose RP-HPLC and UV as valid alternative methods to the conventional procedures for capreomycin quantitative analysis.

Ned Tijdschr Geneeskd, 2004 Sep 25, 148(39), 1928 - 30
{A man from Surinam with haemorrhagic diarrhoea after long-standing schistosomiasis}; van Leerdam ME et al.; A 35-year-old man presented with a brief history of haemorrhagic diarrhoea . He had moved to The Netherlands 24 years before and had been in Surinam 12 years ago for the last time . Physical examination and routine laboratory tests revealed no abnormalities . Colonoscopy showed a striking congestion of the small blood vessels; histological examination of a sigmoid biopsy revealed Schistosoma eggs and microbiological investigation of the feces revealed ova of Schistosoma mansoni . The schistosomiasis was thus diagnosed more than 10 years after the last possible exposure to schistosomal cercariae . The patient was treated with a single dose of praziquantel.

J Environ Sci (China), 2004, 16(4), 662 - 5
Microbiological indication of municipal solid waste landfill non-stabilization; Zhou QX et al.; Accidental collapse resulted from unstable factors is an important technological problem to be solved in sanitary landfill . Microbiological degradation of organic matters in landfilled solid waste are an important unstable factor . A landfill reactor was thus manufactured and installed to examine quantitative and population dynamics of microorganisms during degradation of landfilled solid waste . It was showed that unstable landfill can be reflected and indicated by microbiological features such as rapidly decreased growth amount of microorganisms, no detection of fungi and actinomyces, and changing the dominant population into methanogenic bacteria and Acinotobacter.

Cochrane Database Syst Rev . 2004 Oct 18;(4):CD003957.
Prophylactic versus selective antibiotics for term newborn infants of mothers with risk factors for neonatal infection; Ungerer R et al.; BACKGROUND: Early onset bacterial infection is an important cause of morbidity and mortality in newborn infants . Various factors that increase the risk of neonatal infection have been identified . It is unclear whether asymptomatic newborn infants born to mothers with one or more of these risk factors should receive antibiotics prophylactically rather than selectively if only clinical or microbiological evidence of sepsis emerges . OBJECTIVES: To assess the effect of prophylactic versus selective antibiotic treatment for asymptomatic term neonates born to mothers with risk factors for neonatal infection . SEARCH STRATEGY: We used the standard methods of the Cochrane Neonatal Review Group . We searched MEDLINE (1966 - May 2004), EMBASE (1980 - May 2004), LILACS (1982 - 2003), SciELO (1997 - 2003), the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2004), and Centers for Disease Control and Prevention protocols and guidelines on the subject . SELECTION CRITERIA: Randomized controlled trials, or trials using quasi-random methods of allocation, comparing the use of prophylactic versus selective antibiotics in asymptomatic neonates born to mothers with one or more risk factors for infection . DATA COLLECTION AND ANALYSIS: We extracted the data using the standard methods of the Cochrane Neonatal Review Group, with separate evaluation of trial quality and data extraction by three reviewers and synthesis of data using relative risk and risk difference . The pre-specified primary outcomes were neonatal mortality, systemic neonatal infection, and need for admission to a neonatal intensive care unit . MAIN RESULTS: We identified two small trials undertaken in the 1970s . Both trials had methodological weaknesses . There was no evidence of an effect on any of the primary outcomes, but because the trials were underpowered, clinically important effect sizes may have been missed . REVIEWERS' CONCLUSIONS: There are insufficient data from randomized controlled trials to guide clinical practice . A large randomized controlled trial is needed in asymptomatic term infants born to mothers with risk factors for infection in their babies, which compares the effect of prophylactic versus selective antibiotics on morbidity, mortality and costs.

Rheumatology (Oxford) . 2004 Oct 19; {Epub ahead of print}
Isolated inflammatory coxitis associated with protrusio acetabuli: a new form of juvenile idiopathic arthritis?
Adib N, Owers KL, Witt JD, Owens CM, Woo P, Murray KJ.
Background . Isolated hip disease in the context of chronic childhood inflammatory arthritis is uncommon . This paper reports 14 children who presented to the rheumatology and orthopaedic departments of our hospitals with severe hip symptoms, and who continued to have primarily hip disease throughout their clinical course . Our aim was to characterize and present the relevant demographic, clinical, investigational, treatment and outcome data from the above cohort . Methods . All paediatric cases with the diagnosis of protrusio acetabuli, Otto pelvis or idiopathic chondrolysis who were seen in the past 15 yr at Great Ormond Hospital and Middlesex Hospital in London were identified and their case notes were searched retrospectively for relevant information . Results . In 11 cases, the disease progressed to involve no joints other than the contralateral hip . None were considered to have a specific subtype of juvenile idiopathic arthritis (JIA) and all tested were negative for HLA-B27 . Elevation of serum inflammatory markers was variable . Protrusio acetabuli was the predominant radiological feature . There were definite inflammatory changes on the gadolinium-enhanced magnetic resonance imaging study in all patients who had this procedure performed (seven cases) . Microbiological investigations were all consistently negative . Severe hip disease resulted in considerable ongoing symptoms and disability . Six cases were treated with disease-modifying anti-rheumatic drugs . Total hip replacement has been required in four patients to date, with major functional improvement . Conclusions . These cases represent severe and disabling primary hip disease with considerable clinical and investigational inflammatory features . Such a mode of presentation has not been described previously in the context of childhood chronic inflammatory arthritides, and may represent a separate oligoarthritis subtype of JIA.

Rocz Panstw Zakl Hig, 2004, 55(2), 165 - 9
{Assessment of the nutritional value of certain molluscs}; Lebiedzinska A et al.; The aim of this study was to determine levels of protein, fat, carbohydrates, vitamins B, as well as energy value in fish products available on domestic market . Nutrition value of the analyzed products was determined by analytical methods applying in food chemistry . Concentrations of thiamine, riboflavin, niacin and vitamin B6 were determined by microbiological methods . Considering high nutritive value, the analyzed seafood products are recommended as valuable ingredient of diet.

Acta Pol Pharm, 2004 Mar-Apr, 61(2), 107 - 11
Indole Mannich bases and their antimycobacterial effect; Malinka W et al.; 3-{(4-arylpiperazin-1-yl)methyl}lindoles (2a-h) and 3-{(4-hydroxy-4-phenylpiperazin-1-yl)methyl}indole (3) were prepared and characterized by 1H NMR and mass spectrometry . All eight compounds (2a-c, e-h and 3) tested inhibited in vitro the growth of Mycobacterium tuberculosis H37Rv in the range of 98-7% at a concentration of > or = 6.25 microg/ml . From the preliminary microbiological data it is possible to observe that a simple increasing of lipophilicity of the compounds tested to above logPcalc> or =3.8 significantly increases the potencies of their antitubercular action.

Surg Laparosc Endosc Percutan Tech, 2004 Oct, 14(5), 263 - 7
Is umbilical flora responsible for wound infection after laparoscopic surgery?
Hamzaoglu I, Baca B, Boler DE, Polat E, Ozer Y.
To our knowledge, the association of umbilical flora and infections has not been studied yet . The aim of this study was to identify the causative agents for trocar site infections and to highlight whether there is association between umbilical flora and trocar site infections . One hundred consecutive patients who had undergone laparoscopic surgery were studied . Microbiological samples were taken from the umbilicus before (group 1) and after (group 2) antisepsis with povidone-iodine . Microbiological assessment was done for wounds suspected to be infected, and the wounds with positive cultures were classified as group 3 . The incidence of wound infection was 8% . One hundred percent of the infections were associated with the extraction trocar . Eighty-nine percent of all of the infections occurred after laparoscopic cholecystectomy, whereas 11% occurred after laparoscopic appendectomy . The micro-organisms in group 3 did not belong to the skin flora, unlike the micro-organisms in groups 1 and 2, but hospital-acquired pathogens were responsible for the infections . The umbilical flora and the bile are not the source of the surgical site infections after laparoscopic surgery in our study despite the considerations in the literature.

Oral Microbiol Immunol, 2004 Dec, 19(6), 352 - 62
Use of checkerboard DNA-DNA hybridization to study complex microbial ecosystems; Socransky SS et al.; It has been difficult to conduct large scale studies of microbiologically complex ecosystems using conventional microbiological techniques . Molecular identification techniques in new probe-target formats, such as checkerboard DNA-DNA hybridization, permit enumeration of large numbers of species in very large numbers of samples . Digoxigenin-labeled whole genomic probes to 40 common subgingival species were tested in a checkerboard hydridization format . Chemifluorescent signals resulting from the hybridization reactions were quantified using a Fluorimager and used to evaluate sensitivity and specificity of the probes . Sensitivity of the DNA probes was adjusted to detect 10(4) cells . In all, 93.5% of potential cross-reactions to 80 cultivable species exhibited signals <5% of that detected for the homologous probe signal . Competitive hybridization and probes prepared by subtraction hybridization and polymerase chain reaction were effective in minimizing cross-reactions for closely related taxa . To demonstrate utility, the technique was used to evaluate 8887 subgingival plaque samples from 79 periodontally healthy and 272 chronic periodontitis subjects and 8126 samples from 166 subjects taken prior to and after periodontal therapy . Significant differences were detected for many taxa for mean counts, proportion of total sample, and percentage of sites colonized between samples from periodontally healthy and periodontitis subjects . Further, significant reductions were observed post therapy for many subgingival species including periodontal pathogens . DNA probes used in the checkerboard DNA-DNA format provide a useful tool for the enumeration of bacterial species in microbiologically complex systems.

J Clin Periodontol, 2004 Nov, 31(11), 972 - 7
The effect of periodontal treatment on the salivary bacterial load and early plaque formation; Dahan M et al.; AIM: The purpose of the present study was to investigate in periodontitis patients the relationship between the number of bacteria in the saliva and the amount of de novo plaque formation before and after treatment . METHODS: At baseline, before any treatment was provided, patients rinsed with 10 ml sterile saline . After professional tooth cleaning the patients were instructed to abolish all tooth cleaning procedures for the subsequent 24 h . After this period, the rinsing procedure was repeated and the amount of de novo plaque was assessed . Three months after the initial periodontal therapy was completed the experiment was repeated . The microbiological evaluation of the rinsing samples was carried out by means of phase contrast microscopy and anaerobic culturing . RESULTS: After treatment the amount of de novo plaque was less compared to before treatment, 0.40 and 0.65 respectively . Both before and after treatment more de novo plaque was present at sites with inflammation than at healthy sites . In order to evaluate the contribution of the numbers of salivary bacteria to the amount of de novo plaque formation an analysis was carried out for healthy sites . This analysis included only healthy sites as determined before treatment and the same sites after treatment . The results showed a significant reduction in the de novo plaque formation after treatment (0.49 before and 0.22 after treatment) . Phase contrast microscopic evaluation showed that the number of bacteria in the rinsing samples after treatment was less than before treatment . After treatment also a reduction was found in the prevalence of Prevotella intermedia, Tannerella forsythensis and Peptostreptococcus micros in the rinsing samples . CONCLUSION: The present study confirms the observation in the literature that the periodontal condition is of major importance in the rate of de novo plaque formation . In addition, the results suggest that the number of bacteria in the saliva may play a role . (c) Blackwell Munksgaard, 2004

Crit Rev Microbiol, 2004, 30(3), 145 - 72
Molecular biology and DNA microarray technology for microbial quality monitoring of water; Lemarchand K et al.; Public concern over polluted water is a major environmental issue worldwide . Microbial contamination of water arguably represents the most significant risk to human health on a global scale . An important challenge in modern water microbial quality monitoring is the rapid, specific, and sensitive detection of microbial indicators and waterborne pathogens . Presently, microbial tests are based essentially on time-consuming culture methods . Rapid microbiological analyses and detection of rare events in water systems are important challenges in water safety assessment since culture methods present serious limitations from both quantitative and qualitative points of view . To circumvent lengthy culture methods, newer enzymatic, immunological, and genetic methods are being developed as an alternative . DNA microarray technology is a new and promising tool that allows the detection of several hundred or even thousands DNA sequences simultaneously . Recent advances in sample processing and DNA microarray technologies provide new perspectives to assess microbial water quality . The aims of this review are to (1) summarize what is currently known about microbial indicators, (2) describe the most important waterborne pathogens, (3) present molecular methods used to monitor the presence of pathogens in water, and (4) show the potential of DNA microarrays in water quality monitoring.

East Afr Med J, 2004 Jul, 81(7), 353 - 7
Prevalence of pathogenic Escherichia coli and parasites in infants with diarrhoea in Kumasi, Ghana; Addy PA et al.; OBJECTIVES: To determine the relative frequencies and prevalence rates of pathogenic Escherichia coli and intestinal parasites in hospitalised infants (0-5 years) in Kumasi . DESIGN: A prospective descriptive study of screening 162 (83 males and 79 females) infants with diarrhoea and 122(64 males and 58 females) non-diarrhoeal infants controls for pathogens (E . coli and intestinal parasites) by standard microbiological methods . SETTING: Komfo Anokye Teaching Hospital and Maternal and Child Hospital, Kumasi, Ghana . RESULTS: From the 162 in the diarrhoeal group 96(59.6%) pathogens, and from the 122 in the control group, eight (6.6%) pathogens were isolated . Enteropathogenic E . coli (EPEC) was the most frequently detected pathogen, accounting for 24(14.8%) of the findings in the diarrhoeal group, five (4.1%) in the non-diarrhoeal control group . Of the 26 EPEC isolates, there were nine serotypes with the three dominant ones being 0125 (6), 0119 (5), and 026 (15) . Other agents isolated included Ascaris lumbricoides 18(11.1%) and two (1.6%), Cryptosporidium 13(8.0%) and one (0.8%) for diarrhoeal and non-diarrhoeal infants respectively . The following were detected only in diarrhoeal stools . Giardia lamblia, six (3.7%); Trichomonas hominis, three (1.9%); Trichuris trichiura one (0.6%) and hookworm, one (0.6%) . CONCLUSION: From this study, EPEC and Cryptosporidium may be considered as important diarrhoeagenic pathogens and it is hoped that provision of potable water and good sanitation may decrease diarrhoeas in infants caused by these agents.

Bone Marrow Transplant, 2004 Dec, 34(11), 955 - 62
Lenograstim after autologous peripheral blood progenitor cell transplantation: results of a double-blind, randomized trial; Schmitz N et al.; A phase III, randomized, double-blind, placebo-controlled, multi-center trial was conducted in order to compare the incidence of microbiologically defined infections occurring after high-dose chemotherapy (HDT) and ASCT in 98 patients given lenograstim (Granocyte) and 94 patients given placebo after transplantation . Hematopoietic recovery, the use of i.v . antibiotics, the numbers of red blood cell and platelet transfusions, the days spent in hospital, and the days on parenteral nutrition were also compared . The incidence of infections until neutrophil recovery was significantly less in patients who received lenograstim after HDT and ASCT as compared to patients who received placebo (66 of 98 vs 86 of 94 patients, P<0.001) . Lenograstim also significantly reduced the use of i.v . antibiotics (P<0.001) and the median duration of i.v . antibiotic treatment (8 days vs 10 days, P=0.04), improved neutrophil recovery (absolute neutrophil count >0.5 x 10(9)/l: 11 days vs 15 days, P<0.001) and reduced the number of days spent in hospital (15 days vs 17 days, P<0.001) . The administration of lenograstim after HDT and ASCT significantly reduces the incidence of microbiologically defined infections until neutrophil recovery . It also leads to less use of antibiotics and earlier discharge from hospital.

Eur J Radiol, 2004 Nov, 52(2), 170 - 4
Cavitary pulmonary tuberculosis HIV-related; Busi Rizzi E et al.; INTRODUCTION: It was usually assumed that pulmonary tuberculosis (TB) in HIV-seropositive patients represents reactivation TB, despite the radiographic appearance frequently consistent rather with a recent disease . Hence, these radiographic features were considered "atypical" . We have hypothesised that the so called "atypical" radiographic features could be due to a greater proportion of primary TB among these patients, representing the typical appearance of primary radiological pattern . MATERIAL AND METHODS: We reviewed chest imaging of 219 HIV+ patients with microbiological proven pulmonary tuberculosis, who were assessed for the presence, number, distribution of cavitations and for associated pulmonary parenchymal abnormalities, adenopathies and pleural effusion, and were classified as a primary or post-primary pattern . Results: The patients with post-primary pattern were 50%, and the rate of cavitation was 63%, not wandering off the general population . Cavities still occurred with similar proportion in groups with CD4 <200 or >200cells/mm(3) . CONCLUSION: We suggest that HIV-related pulmonary tuberculosis is typical in its radiological appearances, consistent with those of the general population, and this could be confirmed by the most recent molecular epidemiological techniques that allow to definitely classify the tuberculosis episodes as either primary or post-primary disease.

Rev Iberoam Micol, 2001 Sep, 18(3), 137 - 40
Recurrence of sporotrichosis in cats with zoonotic involvement; de-Oliveira-Nobre M et al.; The aim of this work is to describe the prevalence of the disease in the same cattery after three years, and to report a case of human sporotrichosis following a cat scratch . In May 1997, four felines presenting a cachexy state and ulcerous lesions on the head, nose and limbs were examined in a veterinary clinic in the town of Rio Grande (RS-Brazil) . Exudate and crusts were collected for microbiological diagnosis . The cat's owner returned to the clinic reporting that another eleven felines presented similar lesions . She had ulcerous lesions on her hand and ascending lymphangitis . She was conducted to medical examination where exudate and crusts from the lesions were collected and after the culture Sporothrix schenckii was isolated . After three years the same person sought veterinary assistance for seven more cats with similar lesions to the five previously described . Microbiological tests resulted again in isolation of S . schenckii . Treatment with potassium iodine was efective for the cure of human sporotrichosis, whereas for the felines it showed toxic effect . Only one showed regression of the disease while all the others presented progression of the lesions or even death . The authors call attention to the possible persistence of S . schenckii in cat populations.

Rev Iberoam Micol, 2001 Jun, 18(2), 70 - 5
{Invasive aspergillosis in Castilla y Leon and Cantabria: years 1998 and 1999.}; Lopez-Medrano R; BACKGROUND: Invasive aspergillosis (IA) is a life-threatening mycosis showing a fast clinical course, affecting immunosupressed people particularly patients suffering leukemia or following organ transplantation programs . The aim of this work is to show epidemiologycal concerns about IA in Castilla y Leon and Cantabria: the disease's incidence, the main clinical presentations, the underlaying diseases and diagnostic rules in the laboratory . PATIENTS AND METHODS: 50 cases of IA were obtained from the countries of Castilla y Leon and Cantabria in a two-years (1998-1999) retrospective study . Epidemiology, clinical and diagnostic features including the 14 main institutions were registered and accounted in a single data base . RESULTS: The majority of IA cases were recorded in major institutions possessing haematology units or organ transplantation programs . Invasive pulmonary aspergillosis was the main feature (39/50 cases) showing serious underlying diseases (25/50 cases) or following organ transplantation programs (15/50 cases) . Certain diagnosis was obtained for only ten cases of invasive pulmonary aspergillosis and eleven cases of extrapulmonary stages of IA . In a high number of cases (44/50 cases) conventional microbiological procedures (42/50 showing positive cultures) were developed . Serology investigations were undertaken in eight cases . Serological issues relying on anti-Aspergillus antibodies showed no diagnostic value . Aspergillus fumigatus was the most common species involved in IA (33/44 cases) . CONCLUSIONS: A low incidence of the disease in this country was reported: with 50 cases in 14 hospital institutions during a two-year period . We observed most cases in large hospital centres performing transplant operations . Invasive pulmonary aspergillosis was the main clinical setting in immunosupressed patients . Microbiology diagnostic issues relied on conventional methods in particularly on culture.

Mycopathologia, 2004 Jul, 158(1), 81 - 5
Diagnosis of clinical bovine mastitis by fine needle aspiration followed by staining and scanning electron microscopy in a Prototheca zopfii outbreak; da Costa EO et al.; Biopsy by fine needle aspiration together with microbiological examination and scanning electron microscopy were evaluated in diagnosis of clinical bovine mastitis in a Prototheca zopfii outbreak . Fine needle aspiration was performed in 21 mammary quarters from ten Holstein cows presenting clinical mastitis caused by P . zopfii . The algae were previously identified in the microbiological examination of milk collected from these cows . Material aspirated from these 21 mammary glands was submitted to cytological staining (Gram, Giemsa and/or Shor staining) . Fine needle aspiration enabled cytological identification of the algae in these 21 mammary glands, from which P . zopfii was isolated in the milk . Simultaneously, five mammary fragments collected by fine needle aspiration from these 21 mammary glands presenting clinical mastitis were also submitted to microbiological examination . P . zopfii was also isolated from these five fragments . Scanning electron microscopy technique also identified three of these five P zopfii strains isolated from mammary fragments collected by cytological aspiration . These results suggest that fine needle aspiration may be an alternative method for the diagnosis of clinical mastitis.

Br J Anaesth, 2005 Jan, 94(1), 39 - 45 Epub 2005 Jan.
Effect of excessive environmental heat on core temperature in critically ill patients . An observational study during the 2003 European heat wave; Stephan F et al.; BACKGROUND: The primary goal of this study was to investigate the relation between the core temperature of critically ill patients and hot ambient temperatures during a heat wave . The second goal was to evaluate the impact of such a heat wave on the number of microbiological tests ordered . METHODS: During a heat wave, from August 3 to 22, 2003, we conducted an observational study in the surgical intensive care unit (ICU) of a French hospital that had no air-conditioning at the time . The core temperature of 18 critically ill patients and 36 health-care workers was measured with a non-contact, infrared tympanic membrane thermometer . The association between the core body temperature in infected and non-infected critically ill patients and the staff members, and the ambient temperature in the ICU was analysed using linear regression . The number of microbiological tests ordered was also recorded and compared with the same period in the previous year . RESULTS: The equation of the regression line for infected critically ill patients was: core temperature=33.5+0.16 x ambient temperature (R(2)=0.53; P<0.0001) . The regression line was steeper than that for the non-infected patients (0.077; P<0.0001) . The slopes of the regression lines for non-infected and control patients were similar (P=0.20) . More blood cultures were carried out during the heat wave than at the same period during the year 2002 (4.80 blood cultures per 1000 patient-days vs 2.47 per 1000 patient-days; P=0.0006) . CONCLUSION: During a sustained high ambient temperature, hyperthermia can occur in critically ill infected patients and to a lesser extent in non-infected patients and health-care workers . The number of blood cultures requested rises substantially, leading to increased costs . Installation of air-conditioning is therefore recommended.

Br Poult Sci, 2004 Aug, 45(4), 550 - 6
Disposition kinetics of doxycycline in chickens naturally infected with Mycoplasma gallisepticum; Ismail MM et al.; 1 . The pharmacokinetic properties of doxycycline were determined in healthy chickens and chickens naturally infected with Mycoplasma gallisepticum after a single intravenous (i.v.) and oral administration of the drug at 20 mg/kg body weight . Tissue residues of the tested drug after an oral dose of 20 mg/kg given twice daily for 5 consecutive days were also estimated in diseased chickens . 2 . The plasma concentrations of doxycycline following single i.v . and oral administration were higher in healthy chickens than in diseased ones . Following i.v . injection, the elimination half-life (t1/2beta), distribution half-life and mean residence time (MRT) were longer in healthy chickens than in diseased birds . The values of total body clearance (ClB) and volume of distribution (Vdss) were larger in healthy chickens than in diseased birds . 3 . After single oral administration, the absorption half-life (tl/2ab) and the elimination half-life were longer in normal birds than in diseased ones . The maximum plasma concentration of the drug was higher in normal chickens than in diseased ones . 4 . Following repeated oral administration, the concentration of doxycycline in all tissues except muscle was higher than the corresponding concentrations in plasma . Concentrations of doxycycline in different tissues were in the following order: kidney > liver > lung > muscle . The drug was detected in liver and kidney in substantial concentrations on d 5 post administration of the last dose whereas, on d 7, its concentration in all tissues was below the lower limit of the sensitivity of the assay method used . Because of the low sensitivity of the microbiological assay method used in this study, a safe withdrawal time for doxycycline in diseased birds could not be estimated for the meanwhile.

Eur J Clin Nutr . 2004 Oct 13; {Epub ahead of print}
Folate intake estimated with an updated database and its association to blood folate and homocysteine in Korean college students; Han YH et al.; OBJECTIVE:: To measure folate content in cooked foods commonly consumed in Korea for evaluating its relation to folate nutriture of college students . DESIGN:: Folate content in 32 raw and cooked foods was measured by microbiological assay after trienzyme extraction . These values and the previously published values of 110 raw foods commonly consumed in Korea were used to update the currently available food tables to estimate dietary folate intake of 106 students based on a 3-day 24-h recall . The association of folate intake with blood folate and homocysteine concentrations was evaluated . SETTING:: Cheongju, Korea . SUBJECTS:: Healthy college students aged 18 to 27 y old (44 males and 62 females) . RESULTS:: The average folate loss in 32 foods caused by cooking was 29% . The mean daily dietary folate intakes estimated with an updated database were 406 and 305 mug in males and females, respectively . About 10% of both male and female students showed low serum folate (<6.8 nmol/l) . Folate intake was positively correlated with serum and erythrocyte folate concentrations in female students (r=0.27 and 0.29, respectively, P<0.05), and negatively correlated with serum homocysteine in male students (r=-0.41, P<0.05) . CONCLUSIONS:: Mean dietary folate intake was higher than those of previous studies since the database was updated using values obtained with trienzyme extraction . Folate intake for the general population should be re-evaluated using reliable food folate values obtained with trienzyme extraction . SPONSORSHIP:: Chungbuk National University.European Journal of Clinical Nutrition advance online publication, 13 October 2004; doi:10.1038/sj.ejcn.1602065.

Enferm Infecc Microbiol Clin, 2004 Oct, 22(8), 471 - 85
{Recommendations for the treatment of severe in-hospital pneumonia}; Jorda Marcos R et al.; INTRODUCTION: Given the sanitary repercussion of serious intrahospital pneumonia (SIP), representatives of three scientific societies (SEMICYUC; SEPAR and SEIMC) have developed during 2002 and 2003 a practical guide for its treatment . METHOD: A task force was constituted to value five clinical situations related with the treatment of SIP: 1) critical revision of the existent guidelines and groups of risk definition; 2) entry criteria in ICU for SIP; 3) SIP treatment in function of the groups of risk; 4) special situations in SIP treatment, and 5) control treatment . After the bibliographical revision drafts were developed and discussed until the elaboration of the final document . RESULTS: It is necessary the stratification of the patients according to the presence or not of risk factors in order to make an appropriate use of treatments . SIP without risk factors can be treated with monotherapy with several antibiotics . SIP with risk factors specifies therapy combined with betalactamic plus aminoglycoside . Its substitution for a quinolon is a topic debate . Infections for multiresistance microorganisms require an individualized approach that can end up including the use of topical antibiotics . In SIP without microorganism isolation the use of a score system can be of utility in the taking of decisions . Revision of the therapeutic rule after 72 hours, carrying out the necessary adjustments according to the clinical evolution and microbiological results is necessary in all cases . CONCLUSIONS: Scientific evidence in the treatment of SIP allows the development of different strategies to achieve a higher efficiency both in antibiotic handling and in the control of its evolution.

J Appl Microbiol, 2004, 97(5), 935 - 41
A flow cytometric technique for quantification and differentiation of bacteria in bulk tank milk; Holm C et al.; AIMS: The present study describes a flow cytometric technique for quantification and differentiation of bacteria in bulk tank milk according to the main cause of elevated counts . METHODS AND RESULTS: A total of 75 Danish bulk tank milk samples exceeding the grading level of 3.0 x 10(4) CFU ml(-1) were examined by both flow cytometry and traditional microbiological analyses . The correlation coefficient (r) between the two methods was 0.71 . For the differential analyses of the dominant bacterial populations four different parameters were used to give a species-characteristic pattern . The four parameters were as follows: staining with Oregon Green conjugated wheat germ agglutinin that binds to the cell wall of bacteria, staining with hexidium iodide that binds to all bacterial DNA, the flow cytometric forward scatter and the flow cytometric side scatter . Three regions in the flow cytometric plot were defined: region 1 includes bacteria mainly associated with poor hygiene, region 2 includes psychrotrophic hygiene bacteria and region 3 includes bacteria mainly related to mastitis . The ability of the flow cytometric technique to predict the main cause of elevated bacterial counts on routine samples was examined . Comparing these results with results obtained by traditional microbiological analyses for identification showed that for 81% of the samples the two techniques agreed on the main cause of an elevated bacterial count . CONCLUSIONS: The ability of the presented flow cytometric technique to enumerate and differentiate bacteria in bulk tank milk according to the main cause of elevated counts was demonstrated . SIGNIFICANCE AND IMPACT OF THE STUDY: This study described the first step in development of a technique suitable for routine analyses of bulk tank milk samples . A technique indicating the main cause of an elevated count will enable the farmer to eliminate the contamination source within a short time limit.

Probl Tuberk Bolezn Legk, 2004, (8), 30 - 5
{Ways of enhancing the effectiveness of bacterioscopic diagnosis of tuberculosis in general health care facilities in case of pilot areas of Russia}; Golyshevskaia VI et al.; The experience of researchers of the Central Research Institute of Tuberculosis, Russian Academy of Medical Sciences, in the pilot areas of Russia has made it possible to perfect approaches to improving a bacteriological diagnosis of tuberculosis in general health care facilities . A decisive role in enhancing the effectiveness of detection of patients with tuberculosis by the Ziel-Nielsen test is played by the following factors: training of laboratory personnel; provision of laboratories with high-grade equipment and reagents; introduction of the methods and techniques unified and approved by the Ministry of Health of the Russian Federation; regular supervision of jurisdictional laboratories; outside control of the quality of studies . Proper organization of examination of patients, including an effectual selection of patients to be examined, the observance of the established frequency of their examination, and provision of the required quality of a taken sample greatly affect the efficiency of a microscopic diagnosis of bacillary patients . In addition, the centralization of performed microbiological tests for tuberculosis in the most trained, certified, and licensed large laboratories exercising a centralized control of the quality of microbiological studies is optimal.

Arch Ophthalmol, 2004 Oct, 122(10), 1441 - 6
Intracorneal inlay complicated by intrastromal epithelial opacification; Alio JL et al.; OBJECTIVE: To report epithelial perilenticular opacity as a new complication of intracorneal inlay implantation for the correction of hyperopia . DESIGN: Prospective observational case series . PARTICIPANTS: Eleven eyes of 7 patients underwent intracorneal inlay implantation for the correction of hyperopia . METHODS: Intracorneal inlays were implanted onto the stromal bed by using a microkeratome cut to create an inferior hinged corneal flap . MAIN OUTCOME MEASURES: Postoperative complication occurrence of intracorneal perilenticular opacity, microbiological laboratory analysis, histopathological analysis, and confocal microscopy study . RESULTS: Of 11 implanted eyes, 5 showed diffuse perilenticular opacity of varying intensity that was unresponsive to steroid use following intracorneal inlay implantation . All patients had moderate to severe loss of best-corrected visual acuity . The inlays showed deposits at the edge and on the surface . Confocal microscopy in all eyes produced images compatible with the confocal morphologic features of epithelial cells . Explantation of inlays was performed in 5 eyes . The histopathologic study showed the presence of epithelial cells, and microbiological analysis and cultures were negative for bacteria, fungi, and mycobacteria . CONCLUSION: Epithelial perilenticular opacity is a new and serious complication in patients with intracorneal inlay implantation for the correction of hyperopia.

Mod Pathol . 2004 Oct 08; {Epub ahead of print}
Species identification of mycobacteria in paraffin-embedded tissues: frequent detection of nontuberculous mycobacteria; Schulz S et al.; Diagnosis of infections caused by mycobacteria, especially nontuberculous mycobacteria still represents a difficult task both in microbiology and pathology . The aim of this study was to determine the frequency of mycobacterial DNA detectable by PCR in formalin-fixed paraffin-embedded tissues showing suspicious granulomatous lesions . A total of 190 archival specimens were analyzed, using a nested PCR protocol, which amplifies a fragment of the mycobacterial 65-kDa heat-shock protein gene . Restriction fragment-length polymorphisms and sequencing were utilized to further analyze the obtained PCR products . Corresponding microbiological culture results were available for 41 cases . We detected mycobacterial DNA in 119 cases (63%), of which 71 (60%) were positive for Mycobacterium tuberculosis complex DNA and 41 (34%) for DNA of nontuberculous mycobacteria . Seven cases (6%) could not be subtyped for technical reasons . The largest group of nontuberculous mycobacteria comprised 29 cases (25% of the 119 positive cases), which were assigned to Mycobacterium fortuitum complex . Mycobacterium avium-intracellulare complex was detected in eight (7%) cases, Mycobacterium gordonae in three (2.5%) and Mycobacterium rhodesiae in a single case (0.8%) . All cases of Mycobacterium tuberculosis were unequivocally identified by restriction fragment-length polymorphism analysis . In contrast, sequencing provided a gain of information over restriction fragment-length polymorphism analysis in 37% of the nontuberculous mycobacteria cases (15 of 41) . Alignment studies on DNA of nontuberculous mycobacteria showed frequent sequence variations, supporting the existence of sequevars . Comparison of molecular data to available results of microbiological culture assays showed a good concordance of 83% . In conclusion, amplification and sequencing of the mycobacterial 65-kDa heat-shock protein gene is an excellent tool for species identification of mycobacteria, especially nontuberculous mycobacteria, in formalin-fixed paraffin-embedded tissues.Modern Pathology advance online publication, 8 October 2004; doi:10.1038/modpathol.3800289.

J Hosp Infect, 2004 Oct, 58(2), 155 - 8
Provision of safe potable water for immunocompromised patients in hospital; Hall J et al.; We conducted a survey of hospital drinking water provision for patients with immunocompromising conditions in 15 Trusts in the north of England . Ten trusts replied, reporting on provision of drinking water in 14 separate units . Of these, nine provided only tap water to all patients, irrespective of underlying condition . In two units, iced water, with ice from commercially available makers, was used . Five units distinguished between neutropenic and non-neutropenic patients, with the former group receiving cooled, boiled water (three units), sterile water and sterile water or carbonated water (one unit each) . No unit provided filtered water . Water in jugs was changed daily, twice daily or only when empty in seven, three and four units, respectively . On 10 units, patients were allowed to provide their own drinking water, but no unit provided written advice to patients on potable water . A survey within our own Trust revealed similar inter-unit disparity . The options for potable water provision were reviewed, taking into account: microbiological quality, organoleptic (perceived taste/smell) acceptability, cost and factors relating to staff safety and patient confidentiality {as it was possible for human immunodeficiency virus (HIV) seropositive patients on some wards to be identified because they were provided with cooled, boiled water} . It concluded that end-line commercially available water filters were the optimal way to provide drinking water to immunocompromised patients in hospital.

Clin Infect Dis, 2004 Sep 15, 39(6), 770 - 5 Epub 2004 Aug 27.
A randomized, double-blind trial of anidulafungin versus fluconazole for the treatment of esophageal candidiasis; Krause DS et al.; Anidulafungin is a novel antifungal agent of the echinocandin class . This randomized, double-blind, double-dummy study compared the efficacy and safety of intravenous anidulafungin to that of oral fluconazole in 601 patients with endoscopically and microbiologically documented esophageal candidiasis . Patients received intravenous anidulafungin (100 mg on day 1, followed by 50 mg per day) or oral fluconazole (200 mg on day 1, followed by 100 mg per day) for 7 days beyond resolution of symptoms (range, 14-21 days) . At the end of therapy, the rate of endoscopic success for anidulafungin (242 {97.2%} of 249 treated patients) was found to be statistically noninferior to that for fluconazole (252 {98.8%} of 255 treated patients; treatment difference, -1.6%; 95% confidence interval, -4.1 to 0.8) . The safety profile of anidulafungin was similar to that of fluconazole; treatment-related adverse events occurred in 9.3% and 12.0% of patients, respectively . Laboratory parameters were similar between treatment arms . Anidulafungin is as safe and effective as oral fluconazole for the treatment of esophageal candidiasis, when assessed at the completion of therapy.

Z Orthop Ihre Grenzgeb, 2004 Sep-Oct, 142(5), 571 - 6
{Usefulness of 16S rDNA polymerase-chain-reaction (PCR) in the intraoperative detection of infection in revision of failed arthroplasties}; Kordelle J et al.; AIM: In this study the accuracy of the 16S DNA polymerase chain reaction (PCR) in revision arthroplasties was compared to that of conventional bacterial culture when correlated to intraoperative histological findings . Furthermore, the influence of antibiotic treatment and different ways of collecting samples was evaluated . METHOD: In a prospective study we collected samples of tissues, aspiration fluids and swabs during revision arthroplasty surgery and examined them with PCR as well as conventional bacterial culturing methods . Also, we correlated these two methods with the histological findings of intraoperative tissue samples . Two independent examiners evaluated the samples according to the criteria of Mirra et al . Sensitivity, specificity, positive and negative prediction value and the accuracy were calculated for the molecular biological and culture methods . Three groups were defined to evaluate the influence of accompanying antibiotic treatment and the way of collecting the microbiological samples . RESULTS: Nine periprosthetic infections could be detected by PCR as well as by conventional bacterial culturing . Correlated with the 25 positive histological findings this resulted in a sensitivity of 0.36, a specificity of 1.0, a negative prediction value of 0.61, a positive prediction value of 1.0 and an accuracy of 0.68 for both methods . Swabs compared to aspiration fluids and tissues samples showed the highest sensitivity with both methods . No higher sensitivity of PCR compared to conventional bacterial culturing could be observed in patients with accompanying antibiotic treatment . CONCLUSION: Although PCR is more rapidly available for the diagnosis of periprosthetic infection, a definite advantage of this more expensive method could not be demonstrated in view of the same low sensitivity of PCR and conventional bacterial culturing.

Clin Imaging, 2004 Sep-Oct, 28(5), 340 - 3
Computed tomography findings of peritoneal tuberculosis: systematic review of seven patients diagnosed in 6 years (1996-2001); Vazquez Munoz E et al.; OBJECTIVE: The aim of this study was to describe the computed tomography (CT) findings in patients with demonstrated peritoneal tuberculosis (TB) and their concordance with the three types from the traditional classification (wet, fibrotic, and dry plastic) . METHODS: We reviewed the CT images of all patients with microbiologically proven peritoneal tuberculosis over a 6-year period (1996-2001) . RESULTS: Seven patients were included . Ascites was present in 5 patients (free ascites in 3 patients and loculated in 2) . Involvement of the mesentery was found in 5 patients, the omentum in 4, and the parietal peritoneum in 3 . Tuberculous lymphadenitis was the most common associated finding (6 patients) . Two patients had hepatic lesions . The fibrotic type was found in all the patients, and 5 patients had an association of the fibrotic and wet types . None of the patients had lesions consistent with the dry plastic type . CONCLUSION: Peritoneal tuberculosis is best described as a combination of ascites, peritoneal lesions, and lymphadenopathy, rather than the three types from the traditional classification.

Rev Esp Cardiol, 2004 Oct, 57(10), 993 - 6
{Tricuspid valve endocarditis in a nonaddicted patient without predisposing myocardiopathy}; Varona JF et al.; Right-sided endocarditis is exceptional in non-drug addict patients without previous heart disease . Few cases have been published, and its diagnosis sometimes presents a significant clinical challenge . We describe a 57-year-old patient with no history of parenteral drug addiction or vascular catheter use, who had tricuspid valve endocarditis in a morphologically normal valve . The clinical debut was characterized by acute febrile syndrome, purpura (petechia) on the legs, and oligoarthritis . This entity usually has a good prognosis and responds well to treatment, and presents certain common clinical features (persistent fever, pulmonary lesions, anemia and microscopic hematuria) that can lead the clinician to suspect the diagnosis . However, diagnosis should be based on microbiological studies (S . aureus is the organism isolated most often) and on echocardiographic findings.

Dtsch Tierarztl Wochenschr, 2004 Aug, 111(8), 317 - 20
{The epidemiology of human enterohemorrhagic Escherichia coli infections in Lower Saxony}; Dreesman J et al.; BACKGROUND: In the German federal state Lower Saxony, data on infections with enterohemorrhagic Escherichia coli (EHEC) and hemolytic uremic syndrome (HUS) are collected systematically since 1997 based on reports by physicians and laboratories . Initially the data were collected by means of a specific established surveillance system, since 2001 they are collected as part of the new infectious disease law . RESULTS: From 1997 to 2003, in Lower Saxony 880 EHEC-infections and 112 HUS-cases, 6 of whom died, were notified . This corresponds to an incidence of 1.6 EHEC-infections and 0.2 HUS-cases per 100000 person-years . No secular trend was observ-ed for the yearly number of HUS-cases, but raised numbers were observed for the years 1997 and 2002 . There were strong regional differences of the EHEC/HUS-incidence from 0.7 in the district Braunschweig to 3.5 in the district Weser-Ems . For 56% of reported EHEC-cases, serotype information was available . The most frequent serogroup was O157, accounting for 30% of cases with serotype information . Of HUS-cases with known serotype, 86% were caused by O157, 20% by O157:H- . 52% of the EHEC-cases were less than 5 years old (HUS: 77%), and 68% less than 10 years (HUS: 92%) . 23% of EHEC/HUS-cases could be identified as part of clusters with a mean number of 2.6 cases per cluster . These clusters almost exclusively affect-ed families . Though the data also contained information on possible sources or routes of infection, for none of the cases a microbiologically assured source was documented . CONCLUSIONS: The incidences of EHEC and HUS were higher in Lower-Saxony than in the whole of Germany . During the study period no significant trends concerning the number of HUS-cases or the distribution of serotypes were observed . More frequent serotyping and more complete information on sources or risks of infection should be achieved.

Dtsch Tierarztl Wochenschr, 2004 Aug, 111(8), 304 - 7
{Risk assessment of foodborne infections}; Braunig J et al.; The microbiological risk assessment during production, processing and treatment of foods illustrates an important basis for the judgement of the safety of food products . Since the mid-nineties the concept of risk analysis according to Codex Alimentarius requirements ist pursued more intensely . Risk assessment is part of the risk analysis process besides risk management and risk communication . A strict separation between risk management and assessment should lead to a systematic, scientifically based and independent process without considering economic or political constraints whereas the decision on protective measures or the acceptance of risks lies in the responsibility of the managers . Risk assessment can only be successfully implemented in an interdisciplinary approach between physicians, veterinarians, microbiologists, molecularbiologists, food technologists, epidemiologists and mathematicians . Surveillance, monitoring programs and other data collections on a variety of parameters like statistics on foodborne human cases, the prevalence of zoonotic agents in animals, the distribution of micro-organisms in the environment and in foods, the behaviour of micro-organisms during food processing and the consumption habits of consumers deliver the necessary data for risk assessors . With the aim of mathematic modelling and simulation it is possible to calculate the probability of health problems in humans after the consumption of a foodstuff contaminated with a specific pathogenic micro-organism.

Med J Malaysia, 2004 May, 59 Suppl B, 85 - 6
Sterilisation effect study on granular hydroxyapatite (HA); Saidu MF et al.; Hydroxyapatite is a calcium phosphate bioceramic that has been shown by many authors to be biocompatible with bioactive properties . It is widely accepted as the best synthetic material available for surgical use as a bone graft substitute . HA granules produced by AMREC-SIRIM from local materials underwent 5 types of sterilisation techniques with different ageing periods . Samples were tested for chemical and phase composition and microbial contamination before and after being sterilised . From the microbiological tests done, none of the unsterilised positive control yielded a positive culture . Results from X-Ray diffraction studies found that all the sterilisation techniques did not chemically degrade or structurally change the HA granules significantly.

J Am Soc Mass Spectrom, 2004 Oct, 15(10), 1444 - 54
MALDI-TOF-MS analysis of bacterial spores: wet heat-treatment as a new releasing technique for biomarkers and the influence of different experimental parameters and microbiological handling; Horneffer V et al.; Short wet heat-treatment is presented as a new technique to release high-mass biomarkers to obtain strain-specific fingerprints of intact bacterial spores by matrix-assisted laser desorption/ionization-mass spectrometry (MALDI-MS) . Wet heat-treatment was applied for several minutes (3-30) by two techniques using either a screw-cap tube submerged in a glycerol bath at 120 degrees C or an Eppendorff-tube submerged in a water bath at 100 degrees C . Both techniques turned out to be successful for releasing high-mass biomarkers . The influence of different experimental parameters and microbiological handling on the peak pattern of the released high-mass biomarkers was studied . While the sporulation medium, the applied washing procedure, and the choice of matrix crucially influenced the peak pattern, other parameters like storage conditions were found to be insignificant . A protocol of optimized experimental conditions for MALDI-MS of wet heat-treated spores is presented.

Vopr Pitan, 2004, 73(4), 21 - 4
{Use of the syrup prepared on the basis of wild-growing grasses of the Far East, in preventive maintenance of respiratory diseases and microelementoza at children}; Natural sesquiterpenoids; Instituto de Productos Naturales y Agrobiologia, CSIC, Avda . Astrof . F . Sanchez 3, 38206-La Laguna, Tenerife, Canary Islands, SpainThis review covers the isolation, structural determination, synthesis and chemical and microbiological transformations of natural sesquiterpenoids . The literature from January to December 2003 is reviewed, and 389 references are cited.

An Pediatr (Barc), 2004 Oct, 61(4), 314 - 9
{Fiberoptic bronchoscopy in childhood endobronchial tuberculosis}; Tagarro Garcia A et al.; BACKGROUND: Endobronchial tuberculosis is a classical manifestation of primary tuberculosis in childhood . Fiberoptic bronchoscopy (FB) is an ancillary diagnostic tool, but its utility and indications are not well established . OBJECTIVES: To analyze the FB performed over 11 years (1992-2003) in children with a diagnosis of tuberculosis and to review the literature . A further aim was to establish the current usefulness of FB in children with tuberculosis and propose criteria to determine the indications for FB in this population . METHODS: We report a retrospective series (n 5 16) . FB was indicated in children who showed any of the following findings in chest roentgenogram: a) persistent parenchymal consolidation; b) lymphadenopathy and consolidation; c) hyperinsufflation (emphysema); d) atelectasias, and e) airway narrowing caused by lymphadenopathies . Published series on the topic were reviewed and six studies were suitable for comparison with our own . RESULTS: Endobronchial tuberculosis was found in seven children (43 %) and extrinsic compression was found in three (18 %) . The microbiological results obtained from FB samples were not superior to those obtained from classical diagnostic methods . The sensitivity of the proposed criteria for suspicion of endobronchial tuberculosis was 71 % . Endoscopic findings justified a change in therapy in 50 % of the children (addition of corticoids or surgery) and this percentage was similar to that reported in other series . CONCLUSIONS: FB does not usually improve microbiological diagnosis of tuberculosis but can be useful when choosing the most appropriate therapy in children with suspected endobronchial tuberculosis . In some cases, computed tomography may make FB unnecessary, but in others this procedure can be therapeutic (obstruction due to caseum, atelectasias) . Establishing the indications for FB in childhood tuberculosis is difficult, but the proposed criteria may be an acceptable guide to identifying which patients could benefit most from this procedure . Not all children with endobronchial tuberculosis require corticoids.

Drugs, 2004, 64(19), 2249 - 58; discussion 2259-60
Anidulafungin; Murdoch D et al.; Anidulafungin is a novel antifungal agent which, like other echinocandins, inhibits beta-(1,3)-D-glucan synthase and disrupts fungal cell-wall synthesis . It has marked antifungal activity against a broad spectrum of Candida spp . and Aspergillus spp., including amphotericin B- and triazole-resistant strains . In clinical trials, anidulafungin has primarily been evaluated in patients with oesophageal and invasive candidiasis . Preliminary data are emerging for other indications such as invasive aspergillosis . In a large, multicentre, double-blind, double-dummy, randomised trial in patients with oesophageal candidiasis, intravenous anidulafungin 50 mg/day was as effective as oral fluconazole 100 mg/day regarding end-of-treatment rates of endoscopic cure and clinical and microbiological success . Duration of treatment was approximately 2-3 weeks, and patients in both groups received a loading dose of study drug (twice the daily maintenance dose) on day 1 . Anidulafungin is generally well tolerated . Across the dosage range 50-100 mg/day, adverse events appear not to be dose- or infusion-related . In the largest clinical trial to date, the most common treatment-related adverse events were phlebitis/thrombophlebitis, headache, nausea, vomiting and pyrexia.

J Periodontol, 2004 Aug, 75(8), 1114 - 8
Clinical and microbiological effects of topical subgingival application of hyaluronic acid gel adjunctive to scaling and root planing in the treatment of chronic periodontitis; Xu Y et al.; BACKGROUND: Hyaluronic acid (HA) has shown anti-inflammatory effects in gingivitis therapy . The potential benefits of local subgingival application of HA adjunctive to scaling and root planing (SRP) were evaluated in this study . METHODS: Twenty patients with chronic periodontitis were included in this split-mouth study . Sulcus fluid flow rate (SFFR) and sulcus bleeding index were monitored at baseline and after 1, 2, 3, 4, 5, 6, and 12 weeks; probing depth and clinical attachment level were monitored at baseline and 6 and 12 weeks . Subgingival plaque samples were also taken at these same three appointments to determine the presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythensis, and Treponema denticola . All patients were treated with full-mouth scaling and root planing (SRP); in addition, an HA gel was administered subgingivally in the test sites every week for 6 weeks . RESULTS: An improvement of all clinical variables was observed (P < 0.05) in both groups . Clinically, no difference between test and control sites could be found . No difference between test and control sites was seen in the tested microorganisms . CONCLUSIONS: No clinical or microbiological improvement was achieved by the adjunctive use of HA gel compared to SRP alone . Only SFFR was affected by the use of HA in terms of a more rapid reduction of SFFR in the test sites.

Vestn Ross Akad Med Nauk, 2004, (8), 11 - 5
{A new setup for the generation and studies of mono-disperse microbiological aerosols in medical-and-biological research}; Zhukov VA et al.; A setup for the generation and studies of mono-disperse microbiological aerosols is described in the paper . Coefficients of 3 microm aerosol deposition in the respiratory tract of mice and rats were refined by using the above setup . The probability of deposition of such particles in the trachea and lungs of mice was proven to be equal to 1.2 +/- 0.1% and 2.6 +/- 0.2%, respectively . The probability for rats was equal to 3.2 +/- 0.2 and 11.8 +/- 0.9%, respectively . The distribution of deposited aerosol particles was determined by electron microscopy.

Am J Infect Control, 2004 Oct, 32(6), 365 - 8
Nosocomial Stenotrophomonas maltophilia cross-infection: three cases in newborns; Gulcan H et al.; BACKGROUND: Increased nosocomial Stenotrophomonas maltophilia infection rates in newborns, especially in recent years, are a significant cause for concern . These cases are the second case group in the literature to have been identified as nosocomial cross-infection with S . maltophilia in neonates . OBJECTIVE: To investigate the clinical, microbiological, and epidemiologic features of the outbreak caused by S . maltophilia in the neonatal intensive care unit within a period of 7 days . METHODS: Three cases with nosocomial S . maltophilia infection considered to be the result of cross-transmission were prospectively analyzed . Arbitrarily primed polymerase chain reaction (AP-PCR) performed with M13 primer and pulsed-field gel electrophoresis (PFGE) of genomic DNA after digestion with XbaI were used to determine clonal relationship among the isolates . Results S . maltophilia was isolated from the blood cultures of all 3 patients . Molecular typing confirmed that the 3 cases were epidemiologically linked . CONCLUSIONS: Opportunistic pathogens such as S . maltophilia can lead to major problems in neonates . Molecular typing is helpful to improve effective control programs for preventing the spread of the infection.

Sante, 2004 Apr-Jun, 14(2), 81 - 4
{Spinal tuberculosis . Epidemiologic and diagnostic aspects: a study of 28 clinical observations}; N'Dri Oka D et al.; OBJECTIVE: To rapidly diagnose spinal tuberculosis in order to improve its prognosis . METHODS: A retrospective study of 28 clinical observations of patients treated in the neurosurgery department of Yopougon's University Teaching Hospital during a 7-year period (January 1994-December 2000) . The diagnosis of spinal tuberculosis was established based on clinical, radiological microbiological and histologic arguments . RESULTS: The mean age of the patients is 40 years (from 5 to 75 years of age) . The typical spondylodiscitis was the commonest form observed (22 cases) with paravertebral abcess (4 cases) . Retropharyngeal abcess was noted in two cases . One case of spondylitis was observed . In two cases, there were a spondylodiscal lesion associated with neural arch lesion . CT scan was helpful in determining the extent of the lesions whereas standard radiography was normal . CONCLUSION: The diagnosis is difficult because of the atypical form of spinal tuberculosis . These forms need differential diagnosis with spine tumors . Copyright John Libbey Eurotext 2003.

Zhonghua Yan Ke Za Zhi, 2004 Aug, 40(8), 533 - 8
{Organ culture for preservation of the cornea: human umbilical cord serum versus fetal bovine serum}; Zhao J et al.; OBJECTIVE: To evaluate the changes of porcine corneal endothelium, the morphology, histology, ultrastructure, enzymes activity and metabolism of the cornea induced by organ culture with two different media containing fetal bovine serum (FBS) or human umbilical cord serum (HCS) . METHODS: Fifty pairs of porcine corneas were preserved at 31 degrees C for 7, 14, 21, 28 days . One cornea of each pair was cultivated in medium I containing 10% FBS (group 1); the other one was stored in medium II containing 10% HCS (group 2) . Thirteen fresh porcine corneas served as controls . All stored corneas were dehydrated for 24 hours . Twelve corneas from each group were evaluated each week, including the morphology, histology and enzyme histochemical staining of the cornea . Scanning electron microscopy was performed on one cornea from each group at 14 and 28 days and compared with the fresh cornea . pH value, glucose and lactate concentration of the culture media before and after culture were examined . Microbiological evaluation was also performed . RESULTS: Endothelium evaluation did not differ statistically between the two groups of porcine corneas . The morphological endothelium study showed some alterations such as pleomorphism . After 28 days of cultivation, the mean cell losses of endothelium were 10.98% and 10.85% in medium I and medium II stored corneas, respectively . There were no statistical differences of the histology, ultrastructure and enzymes activity of corneas between the two groups . The histological study showed corneal swelling and epithelial sloughing after preservation . Scanning electron microscopy showed an intact endothelial layer in all corneas . Enzyme histochemical staining showed vigorous enzyme activity in the corneal epithelium and endothelium . Enzyme activity in stroma decreased with preservation time . Corneas showed good glucose metabolism . Incidence of contamination was 6% for storage medium . CONCLUSIONS: The corneal endothelium can maintain a good viability for 4 weeks in these two organ culture media . HCS can replace FBS in the organ culture medium.

Acta Ophthalmol Scand, 2004 Oct, 82(5), 606 - 8
An unusual pathogen causing microbial keratitis; Saeed MU et al.; INTRODUCTION: We report a rare case of Mycobacterium fortuitum affecting the corneal graft of a patient 6 years post-graft, possibly associated with contact lens use . CONCLUSIONS: This case shows the need for careful microbiological techniques when dealing with patients presenting with microbial keratitis . It must be kept in mind that unusual and slow growing organisms may also be responsible for corneal ulceration . If a slow growing organism is suspected, a microbiological diagnosis may not be forthcoming for weeks . Misidentification of the responsible pathogen may further complicate management for the clinicians . Cases such as these, which may not respond to medical therapy as expected, may prove a difficult therapeutic challenge to physicians.

J Food Prot, 2004 Sep, 67(9), 2033 - 40
Application of elements of microbiological risk assessment in the food industry via a tiered approach; van Gerwen SJ et al.; Food safety control is a matter for concern for all parts of the food supply chain, including governments that develop food safety policy, food industries that must control potential hazards, and consumers who need to keep to the intended use of the food . In the future, food safety policy may be set using the framework of risk analysis, part of which is the development of (inter)national microbiological risk assessment (MRA) studies . MRA studies increase our understanding of the impact of risk management interventions and of the relationships among subsequent parts of food supply chains with regard to the safety of the food when it reaches the consumer . Application of aspects of MRA in the development of new food concepts has potential benefits for the food industry . A tiered approach to applying MRA can best realize these benefits . The tiered MRA approach involves calculation of microbial fate for a product and process design on the basis of experimental data (e.g., monitoring data on prevalence) and predictive microbiological models . Calculations on new product formulations and novel processing technologies provide improved understanding of microbial fate beyond currently known boundaries, which enables identification of new opportunities in process design . The outcome of the tiered approach focuses on developing benchmarks of potential consumer exposure to hazards associated with new products by comparison with exposure associated with products that are already on the market and have a safe history of use . The tiered prototype is a tool to be used by experienced microbiologists as a basis for advice to product developers and can help to make safety assurance for new food concepts transparent to food inspection services.

J Food Prot, 2004 Sep, 67(9), 2016 - 23
Microbiological risk assessment in developing countries; Cahill SM et al.; Microbiological risk assessment (MRA) has been evolving at the national and international levels as a systematic and objective approach for evaluating information pertaining to microbiological hazards in foods and the risks they pose . This process has been catalyzed by international food trade requirements to base sanitary measures on sound scientific evidence and appropriate risk assessments . All countries, including developing countries, need to understand and use MRA . MRA is resource intensive, as has been demonstrated by some of the the assessments undertaken in industrialized countries . However, when used in the appropriate circumstances MRA offers many benefits . The process of undertaking MRA improves the understanding of key issues, enables an objective evaluation of risk management options, and provides a scientific justification for actions . Although the gap between developing countries and some industrialized countries is quite extensive with regard to MRA, many developing countries recognize the need to at least understand and move toward using MRA . This process requires development of infrastructure and enhancement of scientific and technical expertise while making optimal use of limited resources . International organizations, such as the Food and Agriculture Organization of the United Nations, are in a position to provide countries with guidance, training, information resources, and technical assistance to develop and/or strengthen food safety infrastructure . Enhanced cooperation and collaboration at all levels are needed for such efforts to be successful and to ensure that MRA, as a food safety tool, is available to all countries.

J Food Prot, 2004 Sep, 67(9), 1972 - 6
Food consumption data in microbiological risk assessment; Barraj LM et al.; The 1st International Conference on Microbiological Risk Assessment: Foodborne Hazards was held in July 2002 . One of the goals of that conference was to evaluate the current status and future needs and directions of the science of microbial risk assessment . This article is based in part on a talk presented at that meeting . Here, we review the types of food consumption data available for use in microbial risk assessments and address their strengths and limitations . Consumption data available range from total population summary data derived from food production statistics to detailed information, derived from national food consumption surveys, about the types and amounts of food consumed at the individual level . Although population summary data are available for most countries, detailed data are available for a limited number of countries and may only be available in summary format . Despite the relatively large amount of detailed information collected by these national surveys, information crucial to microbial risk assessments, such as the specific types of foods, the eating patterns of susceptible populations, or an individual's propensity for consuming high-risk foods (e.g., eating undercooked hamburgers, raw shellfish, or temperature-abused foods), are not collected during these surveys.

Langenbecks Arch Surg . 2004 Sep 24; {Epub ahead of print}
Development of clinical celiac disease after pancreatoduodenectomy: a potential complication of major upper abdominal surgery; Chedid AD et al.; BACKGROUND . Celiac disease is a gluten-induced disease of global malabsorption . There is a subset of patients with celiac disease who are free of major symptoms but who have typical damage to the intestinal mucosa (silent disease) . We present the case of a 50-year-old white woman with no clinical symptoms of celiac disease who developed diarrhea and weight loss 12 weeks after a pancreatoduodenectomy for ampullary cancer . METHODS . Microbiological and biochemical examination of the feces did not provide clues useful to diagnosis, and diarrhea was not affected by pancreatic enzyme replacement or administration of antiperistaltic drugs . RESULTS . Review of the pathologic specimen and blood tests were compatible with celiac disease . CONCLUSION . This clinical scenario illustrates that subclinical celiac disease may be an underdiagnosed cause of malabsorption after major upper gastrointestinal surgery and should be considered in the differential diagnosis of diarrhea after pancreatoduodenectomy.

Ig Sanita Pubbl, 2004 May-Jun, 60(3), 163 - 74
{Quality assurance of cooked food in conventional hospital food service}; De Giusti M et al.; The aim of this study was to evaluate the effectiveness of the hospital food service of the Azienda in preserving microbiological quality and temperature of cooked foods during the distribution to the different wards of the hospital . During three years, microbiological parameters and temperatures were monitored in the central kitchen before distribution (T0), in the first (T1) and in the last ward (T2) of the distribution route during a three-year period for a total of 337 analytical determinations . Temperature values before distribution improved during the study period, whereas the capacity of keeping adequate temperature values during the distribution decreased over time, in spite of the introduction of a new technology after the first year of the study . No significant deteriorations of the microbiological quality of the cooked foods were detected . The results of the study clearly indicate that an integrated approach involving new technology, work organization and personnel training is needed in preserving food quality in hospitals.

Am J Respir Crit Care Med, 2005 Jan 1, 171(1), 48 - 53 Epub 2004 Sep 24.
Procalcitonin kinetics as a prognostic marker of ventilator-associated pneumonia; Luyt CE et al.; We investigated the value of procalcitonin kinetics as a prognostic marker during ventilator-associated pneumonia (VAP) . This prospective, observational study was conducted in a medical intensive care unit in a university hospital . All consecutive patients with microbiologically proven VAP who survived 3 days after its diagnosis were included and grouped according to clinical outcome: favorable or unfavorable, defined as death, VAP recurrence, or extrapulmonary infection requiring antibiotics before Day 28 . Serum procalcitonin levels were measured on Days 1, 3, and 7 for all patients . Among the 63 patients included, 38 had unfavorable outcomes . On Day 1, they were more critically ill than patients with a favorable outcome . Serum procalcitonin levels decreased during the clinical course of VAP but were significantly higher from Day 1 to Day 7 in patients with unfavorable outcomes . Multivariate analyses retained serum procalcitonin levels on Days 1, 3, and 7 as strong predictors of unfavorable outcome . Based on these data, procalcitonin could be a prognostic marker of outcome during VAP.

J Chromatogr A, 2004 Aug 13, 1046(1-2), 293 - 6
Determination of carbonyl compounds in pool water with O-(2,3,4,5,6-pentafluorobenzyl)hydroxyamine hydrochloride and gas chromatographic-tandem mass spectrometric analysis; Gabrio T et al.; To avoid microbiological decay pool water is disinfected, a procedure which results into a lot of disinfection by-products, like carbonyl compounds, as well as a large number of others . The carbonyl compounds dissolved in pool water were derivatisized with O-(2,3,4,5,6-pentafluorobenzyl)hydroxyamine hydrochloride (PFBHA) and extracted using n-hexane . Measuring with the help of GC-electron-capture detection is hardly possible because of interferents like halogenated organics . Another method to detect the PFBHA derivates is the use of tandem mass spectrometry . Calibration ranges and precision are applicable and sufficient to determine carbonyl compounds in pool water.

Am J Phys Anthropol, 2005 Jan, 126(1), 32 - 47
Molecular identification of human tuberculosis in recent and historic bone tissue samples: The role of molecular techniques for the study of historic tuberculosis; Zink AR et al.; We describe the molecular identification of the M . tuberculosis complex DNA in bone tissue samples from recent and historic populations . In a first set, archival paraffin material from vertebral bodies of 12 recent cases with clinically/microbiologically proven tuberculosis was compared to 12 further cases without tuberculosis . While eight TB cases revealed a specific mycobacterial amplification product, none of the controls was positive . Interestingly, one case with tuberculous sepsis (Landouzy sepsis), five cases with tuberculous spread beyond the primarily affected organ (i.e., lymph node or miliar involvement), and also two of six cases with restricted pulmonary tuberculosis reacted positively in the vertebral specimens . This indicates that a molecular analysis can detect mycobacteria even in unremarkable bone tissue, proving that organ tuberculosis is present . In addition, the extent of spread is of high significance for the frequency of positive reactions . In addition, we investigated a series of vertebral samples coming from an Egyptian population of the necropolis of Thebes-West dating to approximately 1450-500 BC . In this group of 36 cases, three of five cases with typical macromorphological signs for tuberculous spondylitis, 2 of 12 cases with nonspecific alterations, and 2 of 19 cases without macroscopic pathology revealed a specific amplicon of the M . tuberculosis complex . This suggests a significant frequency of infected people in that ancient population . Finally, a fourth group of 51 long bone samples with pathological alterations coming form a southern German ossuary (between AD 1400-1800) was investigated, and 10 cases were positive for the M . tuberculosis complex . These studies of historic material clearly support the notion that tuberculous infections can be unequivocally identified by molecular techniques . The relatively high frequency of ancient bacterial DNA amplifications in unremarkable bone is well-explained by our analysis of the recent material . Our data form an important basis for the investigation of tuberculosis frequency and spread in historic periods . (c) 2004 Wiley-Liss, Inc.

Int J Antimicrob Agents, 2004 Oct, 24(4), 352 - 6
Mutant prevention concentration: a new tool for choosing treatment in nontuberculous mycobacterial infections; Rodriguez JC et al.; The mutant prevention concentration (MPC) of fluoroquinolones, linezolid, rifabutin, rifampicin and macrolides was determined in 16 nontuberculous Mycobacterium species in order to compare the incidence of resistant mutant occurrence for different antibiotics . Linezolid showed good activity against Mycobacterium gordonae and Mycobacterium kansasii . Rifabutin had a lower MPC values than rifampicin . The fluoroquinolones were more active against M . gordonae and Mycobacterium chelonae . Clarithromycin had better MPC values than azithromycin but its intracellular concentration was high . Mutant prevention concentration may help to establish a better clinico-microbiological correlation, the sub-populations of drug-resistant micro-organisms may be detected by that method . It is still important to administer correct drug doses, to use combined therapies and to find new drugs that are useful in the treatment of these infections.

Hua Xi Kou Qiang Yi Xue Za Zhi, 2004 Aug, 22(4), 290 - 2
{A comparison between the effects of periocline and yakang on the treatment of periodontitis}; Sun Y et al.; OBJECTIVE: To compare the efficacy of 2 available periodontal systems for local delivery of antibiotics . METHODS: 26 teeth with moderate to severe periodontitis (PD > or = 4 mm) from 11 patients were selected . The teeth were randomly divided into test group and control group . Periocline (2% minocycline hydrochoride ointment) was applied to the teeth in the test group, while Yakang (local metronidazole) was applied in the control group . The data including clinical indices and microbiological parameters was collected before and on the 7th, 14th day after the therapy . RESULTS: Before treatment, the mean of each clinical indices and microbiological parameters between the two groups was not different (P > 0.05) . But both groups demonstrated significant differences with control after treatment (P < 0.05), while there were no significant differences between the two test groups (P > 0.05) . CONCLUSION: Both Periocline and Yakang were effective and secure local delivery drug for treating periodontitis.

Rev Med Chil, 2004 Mar, 132(3), 325 - 30
{Characteristics of tuberculosis in patients older than 65 years in the sanitary area of Cadiz (Spain)}; Lopez-Pelayo I et al.; BACKGROUND: Tuberculosis in the elderly is an increasing public health problem . AIM: To describe the epidemiological, clinical and microbiological characteristics of tuberculosis in patients over 65 years old, as compared to younger patients . MATERIAL AND METHODS: We reviewed the case histories of tuberculosis, microbiologically diagnosed by Ziehl-Neelsen/auramine smear and Lowenstein-Jensen culture, in patients over 65 years old, in the sanitary area of Cadiz (Spain) . RESULTS: We detected 49 new cases (37 males) of tuberculosis in elderly subjects . The infection rate in this age group (16.3/100,000 inhabitants) is lower than in people younger than 65 years old (21.1/100,000 inhabitants) . The most common symptoms were cough (44.9%), fever (40.8%) and dyspnea (44.9%) . Neither of them were infected by the human immunodeficiency virus nor were parenteral drug abusers . Thirty seven percent of cases had a history of previous tuberculosis, and in 75.5% the disease location was pulmonary . The Ziehl-Neelsen/auramine smear was negative in 53.1% of the samples . CONCLUSIONS: The number of patients older than 65 years old with tuberculosis has increased in the sanitary area of Cadiz (Spain) . This group of patients shows different epidemiological and clinical characteristics than younger patients.

Rev Med Chil, 2004 Mar, 132(3), 317 - 24
{Influenza-A as etiology of fever and respiratory insufficiency in adults hospitalized during an outbreak in Chile}; Rabagliati R et al.; BACKGROUND: Influenza-A (IA) occurs every winter, is mostly observed among outpatients . AIM: To describe the clinical and epidemiological characteristics of cases that required hospital admission during an outbreak in Chile in 1999 . PATIENTS AND METHODS: Adults subjects, with Influenza A confirmed by antigen detection test, hospitalized in the clinical hospital of the "Hospital Clinico de la Universidad Catolica de Chile" between May and June, with fever or respiratory symptoms were studied . A special record was designed to register clinical, microbiological and therapeutic data . RESULTS: Fifty five cases, 26 males, aged 15 to 91 years, were studied . Eighty four percent had chronic concomitant diseases and 9.1% were immunosuppressed . Clinical findings were fever in 873%, asthenia in 83.6%, cough in 93.6%, abnormal pulmonary signs in 69%, an elevated C-reactive protein (mean value of 11.6 +/- 7.1 mg/dL) and acute respiratory insufficiency in 54.5% . Cases were isolated in cohort or individual rooms and 38.2% were admitted to intensive or intermediate care units . Amantadine was prescribed to 52 patients and was well tolerated . Thirty three percent of cases developed pneumonia . These subjects were older; had more dyspnea and respiratory insufficiency than patients without pneumonia . CONCLUSIONS: IA should be borne in mind when dealing with hospitalized adults, during epidemic outbreaks in the community . The clinical picture can resemble a serious bacterial infection . An early diagnosis allows the use of specific treatments, to decrease the risk of nosocomial spread and to avoid unnecessary use of antibiotics.

Anal Chem, 2004 Sep 1, 76(17), 5198 - 202
Surface-enhanced Raman spectroscopy for bacterial discrimination utilizing a scanning electron microscope with a Raman spectroscopy interface; Jarvis RM et al.; Surface-enhanced Raman scattering (SERS) utilizing colloidal silver has already been shown to provide a rapid means of generating "whole-organism fingerprints" for use in bacterial identification and discrimination . However, one of the main drawbacks of the technique for the analysis of microbiological samples with optical Raman microspectroscopy has been the inability to acquire pre-emptively a region of the sample matrix where both the SERS substrate and biomass are both present . In this study, we introduce a Raman interface for scanning electron microscopy (SEM) and demonstrate the application of this technology to the reproducible and targeted collection of bacterial SERS spectra . In secondary electron mode, the SEM images clearly reveal regions of the sample matrix where the sodium borohydride-reduced silver colloidal particles are present, Stokes spectra collected from these regions are rich in vibrational bands, whereas spectra taken from other areas of the sample elicit a strong fluorescence response . Replicate SERS spectra were collected from two bacterial strains and show excellent reproducibility both by visual inspection and as demonstrated by principal components analysis on the whole SERS spectra .

Fetal Pediat Pathol, 2004 Jan, 23(1), 11 - 28
Helicobacter pylori infection in pediatric population: epidemiology, pathophysiology, and therapy; Wallis-Crespo MC et al.; Helicobacter pylori, one of the most commonly encountered human pathogens, has been recognized in more than half of adults and children with chronic nonspecific gastritis, and nearly all children with peptic ulcer disease demonstrate antral infection with H . pylori . A high prevalence and early colonization of H . pylori infection in childhood was described in developing countries in contrast to developed countries . The current diagnostic methods include histology, microbiological culture, urease activity detection, polymerase chain reaction, and stool antigen detection . The infection often presents with nausea, vomiting, and epigastric pain but may remain asymptomatic . The treatment modality options are multiple; however, the association of a proton-pump inhibitor and two antibiotics for 1 or 2 weeks gives the best eradication rates . Drug resistance is a growing problem in this microorganism and new therapeutic options are currently limited.

Scand J Infect Dis, 2004, 36(8), 593 - 600
A prospective, randomized study comparing cefepime and imipenem-cilastatin in the empirical treatment of febrile neutropenia in patients treated for haematological malignancies; Cherif H et al.; A prospective, open label, randomized, multicentre study was conducted, comparing the efficacy and safety of cefepime with that of imipenem-cilastatin for the management of febrile neutropenia in patients with haematological malignancies . Furthermore, the safety of early discontinuation of antibiotic therapy in patients with fever of undetermined origin (FUO) was assessed . A total of 180 patients with 207 febrile episodes were randomized at start of fever (105 episodes for cefepime and 102 episodes for imipenem) . The 2 groups were comparable in terms of age, gender, underlying malignancy, prior transplantation, and presence of central venous catheters . All patients were neutropenic at inclusion with median absolute neutrophil count (ANC) 0.1 x 10(9)/l(range 0-1 x 10(9)/l), and ANC < or = 0.1 x 10(9)/l in 77% of included patients . The mean duration of neutropenia, with ANC < 0.5 x 10(9)/l was 6.2 d . Febrile episodes were classified as microbiologically documented infection (47%), FUO (43%), or clinically documented infection (10%) . At final evaluation 1-2 weeks after completion of antibiotic therapy, monotherapy success rates were 40% and 51% in the cefepime and imipenem-cilastatin groups respectively (p = 0.33) . The 4-week overall mortality rate was 5% . Three (2%) of the cefepime treated patients and 4 (3%) of the imipenem-cilastatin treated patients died as a result of infection . Adverse events directly related to antibiotic treatment were uncommon and did not differ between groups . Early discontinuation of antibiotic therapy in 31 patients with FUO 48 h after defervescence was not associated with an increased rate of fever relapse or mortality compared with a subgroup of 29 patients where therapy was continued.

Scand J Infect Dis, 2004, 36(9), 639 - 42
Mycoplasma pneumoniae and Legionella pneumophila in community-acquired lower respiratory tract infections among hospitalized children: diagnosis by real time PCR; Maltezou HC et al.; Mycoplasma pneumoniae and Legionella pneumophila are increasingly recognized as important agents of community-acquired lower respiratory tract infections (LRTI) . Mycoplasma pneumoniae has been also recognized as a cause of nosocomial infections . The aim of this study was to investigate the role of real time polymerase chain reaction (PCR) for the rapid diagnosis of these infections among hospitalized children with community-acquired LRTI . During 2001, 65 children were prospectively studied . Microbiological investigation consisted of capillary PCR with a LightCycler for M . pneumoniae and L . pneumophila in induced sputum or throat swab specimens, IgM enzyme immunoassay for M . pneumoniae and immunofluorescence for L . pneumophila in paired sera . Serology testing showed acute M . pneumoniae infection in 18 (27.5%) patients and L . pneumophila in 1 (1.5%) . M . pneumoniae was also detected in sputum specimen by capillary PCR in 9 (50%) serologically diagnosed cases, including 4 (22%) with non-diagnostic IgM levels in the acute phase . Capillary PCR and IgM enzyme immunoassay diagnosed together 15 (83%) M . pneumoniae cases in the acute phase . It is concluded that M . pneumoniae is an important cause of LRTI necessitating hospitalization among children in Greece . Capillary PCR in sputum may diagnose M . pneumoniae LRTI in the acute setting and direct therapy and isolation of patients.

PDA J Pharm Sci Technol, 2004 Jul-Aug, 58(4), 231 - 7
An approach for the reporting of microbiological results from water systems; Sandle T; Many statistical textbooks lend themselves readily to the analysis of physical and chemical data . This is due to the material gathered from such analyses, following, in most cases, normal distribution . Normally distributed data can be examined over time to allow the obtained profile to be studied for variation . Microbiological data rarely follows such distribution . However, such approaches can be adapted for non-normally distributed (or skewed) microbiological data . This paper applies Shewhart Control Charts to the trend analysis of microbiological data from two different pharmaceutical water systems.

PDA J Pharm Sci Technol, 2004 Jul-Aug, 58(4), 215 - 21
Comparative study of airborne viable particles assessment methods in microbiological environmental monitoring; Temprano G et al.; A comparative study was done among available assessment methods to measure airborne viable particles in controlled rooms . Active methods were compared (sieve/nozzle impactor, slit-to-agar, centrifugal, filtration, and impinger) . The comparative study was carried out by means of a two-way (factors: day and method) analysis of variance, after to logarithmical transformation of experimental results in order to fulfill the normality test of the variables . Statistically significant differences were found among the results of the five methods (P < 0.0001) . In a post hoc study, by means of Tukey's test, no differences were found among centrifugal, filtration, and impinger methods . Differences were found among all the other methods (P < 0.05) . It is concluded that centrifugal, filtration, and impinger methods (in which numerical results were higher than in the others) may be the most suitable methods for microbiological monitoring of a clean room . The mean results among the three selected active methods were compared with results on the settle plate (SP) (the passive method) . A relationship was established between results of the passive method (CFU/h/plate 90 mmo) and the results of active methods (CFU/m3 air) . By means of a lineal regression study, it was obtained a relation factor of 22.7; (95% CI: 19.7, 25.7) . This factor is only valid for values between 3 and 16 in CFU/h/plate 90 mmo, and it is put on record that the experimental study took place in a room that fulfills Class D clean room specifications (WHO standards) in microbiological terms.

CMAJ, 2004 Sep 14, 171(6), 585 - 9
A prospective cohort study of pregnancy risk factors and birth outcomes in Aboriginal women; Wenman WM et al.; BACKGROUND: Aboriginal women have been identified as having poorer pregnancy outcomes than other Canadian women, but information on risk factors and outcomes has been acquired mostly from retrospective databases . We compared prenatal risk factors and birth outcomes of First Nations and Metis women with those of other participants in a prospective study . METHODS: During the 12-month period from July 1994 to June 1995, we invited expectant mothers in all obstetric practices affiliated with a single teaching hospital in Edmonton to participate . Women were recruited at their first prenatal visit and followed through delivery . Sociodemographic and clinical data were obtained by means of a patient questionnaire, and microbiological data were collected at 3 points during gestation: in the first and second trimesters and during labour . Our primary outcomes of interest were low birth weight (birth weight less than 2500 g), prematurity (birth at less than 37 weeks' gestation) and macrosomia (birth weight greater than 4000 g) . RESULTS: Of the 2047 women consecutively enrolled, 1811 completed the study through delivery . Aboriginal women accounted for 70 (3.9%) of the subjects who completed the study (45 First Nations women and 25 Metis women) . Known risk factors for adverse pregnancy outcome were more common among Aboriginal than among non-Aboriginal women, including previous premature infant (21% v . 11%), smoking during the current pregnancy (41% v . 13%), presence of bacterial vaginosis in midgestation (33% v . 13%) and poor nutrition as measured by meal consumption . Although Aboriginal women were less likely than non-Aboriginal women to have babies of low birth weight (odds ratio {OR} 1.46, 95% confidence interval {CI} 0.52-4.15) or who were born prematurely (OR 1.45, 95% CI 0.57-3.72) and more likely to have babies with macrosomia (OR 2.04, 95% CI 1.03-4.03), these differences were lower and statistically nonsignificant after adjustment for smoking, cervicovaginal infection and income (adjusted OR for low birth weight 0.85, 95% CI 0.19-3.78; for prematurity 0.90, 95% CI 0.21-3.89; and for macrosomia 2.12, 95% CI 0.84-5.36) . INTERPRETATION: After adjustment for potential confounding factors, we found no statistically significant relation between Aboriginal status and birth outcome.

Sci Total Environ, 2004 Oct 15, 333(1-3), 249 - 66
Potential biogeochemical and ecological development of a flooded tailings impoundment at the Kristineberg Zn-Cu mine, northern Sweden; Widerlund A et al.; The potential short-term (<or= 10(2) years) and long-term (>10(2) years) biogeochemical and ecological effects of diverting stream water (pH 4.9-6.7) into a limed, flooded tailings impoundment (pH 8-12) were studied by combining geochemical and biological data . In the long-term perspective, the successional development of lakes was used as a natural analogue . Based on the vertical distribution of temperature and total dissolved solids (TDS < 0.22 microm), the impoundment can be characterised as a continuous/discontinuous cold polymictic lake, with holomictic summer circulation . A re-inoculation study indicated that the growth of autotrophic, aerobic bacteria (presumably Acidithiobacillus ferrooxidans) presently is inhibited by the high pH in the impoundment . In a short-term perspective, termination of liming and diversion of stream water into the impoundment will result in a complex interplay between physical, biogeochemical and ecological effects . A reduced vertical mixing of the approximately 2-m-deep water column, dissolution of calcite and gypsum (compounds of a sludge formed in the impoundment) and an enhanced microbiological activity are major expected effects . The dissolution of calcite may act as a pH buffer and result in metal remobilisation from the sludge . Excluding autochthonous organic matter produced in the impoundment, streamwater input of suspended matter and formation of settling flocculants are expected to result in a sediment accumulation rate of approximately 1.5 mg cm(-2) year(-1) (1.6-3.3 cm/10(2) years) . Settling allochthonous organic C (0.15-0.30 mg C cm(-2) year(-1)) may serve as an oxygen barrier and as a reservoir of organic compounds capable of driving redox reactions . In a long-term perspective, a hydroseral development into a wetland/peatland can be expected, with a bog lake, poor fen or flat bog as final stage . This development presupposes a decreasing pH when liming is terminated and stream water is diverted into the impoundment . It also assumes that the impoundment will be similar to an acidified lake, and that the succession is driven by Sphagnum colonizing the impoundment . If the hydrological conditions/water level is affected (e.g., by climatic changes or a dam failure), a terrestrialization culminating in coniferous forest on peat soil may occur.

Clin Diagn Lab Immunol, 2004 Sep, 11(5), 924 - 9
Comparison of Western immunoblotting and the C6 Lyme antibody test for laboratory detection of Lyme disease; Mogilyansky E et al.; Three commercial Lyme disease Western immunoblotting (WB) kits and the C6 Borrelia burgdorferi (Lyme) enzyme-linked immunosorbent assay (ELISA) kit were compared using two commercially available performance panels from the Centers for Disease Control and Prevention (CDC) and Boston Biomedica (BBI) . Combined, the panels consisted of 52 characterized specimens . Immunoglobulin G (IgG) sensitivity was similar for the three WB products . The BBI and Marblot WBs were more specific for IgG antibodies, while the Virablot was the most sensitive for IgM antibody . The BBI WB was 100% specific for IgM, while Marblot was 97% and Virablot was 77% specific for IgM . The C6 ELISA was found to be 100% sensitive . Four false-positive C6 results were identified in patients that had clinically and microbiologically confirmed Lyme disease but were not detected by the CDC reference methods . No one WB product showed overall superiority . The C6 ELISA shows promise as the first ELISA for Lyme disease that would not require a supplemental test such as a WB.

Eur J Dermatol, 2004 Sep-Oct, 14(5), 296 - 309
Dermatological manifestations of Lyme borreliosis; Mullegger RR; Lyme borreliosis is a multisystem infectious disease caused by the tick-transmitted spirochete Borrelia burgdorferi sensu lato . About 80% of all Lyme borreliosis cases represent skin manifestations (dermatoborrelioses) . The three characteristic dermatoborrelioses are erythema migrans, borrelial lymphocytoma, and acrodermatitis chronica atrophicans, which occur in different stages of the disease . Erythema migrans is the hallmark of early Lyme borreliosis, whereas acrodermatitis chronica atrophicans is the characteristic manifestation of late Lyme borreliosis . Several spirochetal factors (e.g . infection with different genospecies, co-infection with other tick-transmitted pathogens) as well as host factors (e.g . cytokine patterns at the site of infection) influence the course of the disease . Diagnosis in the early stage of Lyme borreliosis relies on the clinical picture, whereas serological, molecular, microbiological, and histopathological findings are important adjuncts in the diagnosis of later stages of the infection . Antibiotic treatment is necessary for all stages and manifestations of Lyme borreliosis . Doxycycline is the antibiotic of choice for most patients with dermatoborrelioses.

Int J Food Microbiol, 2004 Oct 1, 96(1), 67 - 73
Verocytotoxin-producing Escherichia coli O157 in minced beef and dairy products in Italy; Conedera G et al.; A total of 3879 samples of foodstuffs were examined for the presence of Verocytotoxin-producing Escherichia coli O157 (VTEC O157) . The survey was conducted by 9 of the 10 Italian Veterinary Public Health Laboratories . Samples were collected between May 2000 and September 2001 in 14 regions and comprised 931 minced beef specimens and 2948 dairy products (DP) with less than 60 days of ripening . The DP included 657 pasteurised and 811 unpasteurised bovine DP, 477 pasteurised and 502 unpasteurised ovine DP, and 501 water-buffalo's milk mozzarella cheese . Samples were collected at retail level, from plants processing minced beef and dairy plants and from farms directly manufacturing cheeses . All the samples were tested using a sensitive procedure based on ISO/DIS 16654:1999 (later ISO 16654:2001), which includes an immunomagnetic separation step . A preliminary inter-laboratory trial was organised with artificially contaminated samples to assess the ability of all the participating laboratories to isolate E . coli O157 by the established procedure . VTEC O157 was isolated from four (0.43%) of the minced beef samples, collected in four different regions and during different months, but was not detected in any of the dairy products . E . coli O157 VT-eae+ was isolated from one raw cow's milk cheese . This survey provided national data on the presence of VTEC O157 in foodstuffs, demonstrating a low prevalence of the organism . The survey also encouraged updating of knowledge and procedures on VTEC O157 in laboratories with official responsibility for microbiological testing of foods of animal origin .

J Contam Hydrol, 2004 Oct, 74(1-4), 133 - 44
Batch-test study on the dechlorination of 1,1,1-trichloroethane in contaminated aquifer material by zero-valent iron; Lookman R et al.; Chlorinated aliphatic hydrocarbons are common groundwater contaminants . One possible remediation option is in-situ reductive dechlorination by zero-valent iron, either by direct injection or as reactive barriers . Chlorinated ethenes (tetrachloroethene: PCE; trichloroethene: TCE) have received extensive attention in this context . However, another common groundwater pollutant, 1,1,1-trichlorethane (TCA), has attracted much less attention . We studied TCA reduction by three types of granular zero-valent irons in a series of batch experiments using polluted groundwater, with and without added aquifer material . Two types of iron were able to reduce TCA completely with no daughter product concentration increases (1,1-dichloroethane: DCA; chloroethane: CA) . One type of iron showed slower reduction, with intermediate rise of DCA and CA concentrations . When evaluating the formation of daughter products, the tests on the groundwater alone showed different results than the groundwater plus aquifer batches: DCA did not temporarily accumulate in the batches with added aquifer material, contrary to the batches without added aquifer material . 1,1-dichloroethene (DCE, also present in the groundwater as an abiotic degradation product of TCA) was also reduced slower in the batches without added aquifer material than in the batches with aquifer material . Redox potentials gradually decreased to low values in batches with aquifer material without iron, while the batches with groundwater alone maintained a constant higher redox potential . Either adsorption processes or microbiological activity in the samples could explain these phenomena . Polymerase Chain Reaction (PCR: a targeted gene probe technique) for chlorinated aliphatic compound (CAH)-degrading bacteria confirmed the presence of Dehalococcoides sp . (chloroethene-degraders) but was negative for Desulfobacterium autotrophicum (a known co-metabolic TCA degrader) . DCA reduction was rate determining: first-order half-lives of 300-350 h were observed . TCA was fully removed within hours . CA is resistant to reduction by zero-valent iron but it is known to hydrolyze easily . Since CA did not accumulate in our batches, it may have disappeared by the latter mechanism or it may not have formed as a major daughter product.

Comp Med, 2004 Aug, 54(4), 382 - 92
Efficacy of three microbiological monitoring methods in a ventilated cage rack; Compton SR et al.; The use of individually ventilated caging (IVC) to house mice presents new challenges for effective microbiological monitoring . Methods that exploit the characteristics of IVC have been developed, but to the authors' knowledge, their efficacy has not been systematically investigated . Air exhausted from the IVC rack can be monitored, using sentinels housed in cages that receive rack exhaust air as their supply air, or using filters placed on the exhaust air port . To aid laboratory animal personnel in making informed decisions about effective methods for microbiological monitoring of mice in IVC, the efficacy of air monitoring methods was compared with that of contact and soiled bedding sentinel monitoring . Mice were infected with mouse hepatitis virus (MHV), mouse parvovirus (MPV), murine rotavirus (agent of epizootic diarrhea of mice {EDIM}), Sendai virus (SV), or Helicobacter spp . All agents were detected using contact sentinels . Mouse hepatitis virus was effectively detected in air and soiled bedding sentinels, and SV was detected in air sentinels only . Mouse parvovirus and Helicobacter spp . were transmitted in soiled bedding, but the efficacy of transfer was dependent on the frequency and dilution of soiled bedding transferred . Results were similar when the IVC rack was operated under positive or negative air pressure . Filters were more effective at detecting MHV and SV than they were at detecting MPV . Exposure of sentinels or filters to exhaust air was effective at detecting several infectious agents, and use of these methods could increase the efficacy of microbiological monitoring programs, especially if used with soiled bedding sentinels . In contemporary mouse colonies, a multi-faceted approach to microbiological monitoring is recommended.

Infect Control Hosp Epidemiol, 2004 Aug, 25(8), 628 - 33
Has the epidemiology of nosocomial candidemia changed?
Puzniak L, Teutsch S, Powderly W, Polish L.
OBJECTIVE: To assess changes in the epidemiology of nosocomial candidemia in the post-fluconazole era among hospitalized patients using a case-control study design . DESIGN: Candidemia case-patients were matched 1:1 on diagnosis, age, and length of stay with control-patients . Conditional logistic regression was used to determine predictors and outcomes of candidemia . Treatment regimens and compliance with national practice guidelines were compared among case-patients . SETTING: Barnes-Jewish Hospital, a 1,278-bed, tertiary-care center affiliated with Washington University School of Medicine, St . Louis, Missouri . PARTICIPANTS: Patients admitted from January 1 to December 31, 2000 . Case-patients were identified through the hospital microbiological surveillance system and matched with control-patients . RESULTS: Predictors of candidemia included Hickman catheters (odds ratio {OR}, 9.53; 95% confidence interval {CI95}, 1.34 to 68.01), gastric acid suppressants (OR, 6.38; CI95, 2.33 to 17.43), nasogastric tubes (OR, 3.69; CI95, 1.27 to 10.78), antibiotics (OR, 1.46; CI95, 1.15 to 1.86), and admission to the intensive care unit (OR, 6.40; CI95, 2.12 to 19.31) . The crude case-fatality rate was 40% . Seventeen (15%) of the case-patients received the recommended treatment regimen according to recently published practice guidelines . CONCLUSIONS: The epidemiology of candidemia has changed little at our hospital during the past decade and remains a significant cause of mortality . Further studies on the benefits of preventive therapy will be essential to improve the outcome of this infection.

Izv Akad Nauk Ser Biol, 2004 May-Jun, (3), 375 - 84
{Changes in ecological features of soils after controlled fires in forests defoliated by the Siberian moth in the southern taiga subzone of the Yenisei Region, Siberia}; An analysis of reference laboratory (send out) testing: an 8-year experience in a large academic medical center; Department of Pathology, Massachusetts General Hospital, Boston, MA, USABACKGROUND: Utilization of outside reference laboratories for selected laboratory testing is common in the United States . However, relatively little data exist in the literature describing the scope and impact of these services . In this study, we reviewed use of reference laboratory testing at the Massachusetts General Hospital, a large urban academic medical center in Boston, Massachusetts . METHODS: A retrospective review of hospital and laboratory administrative records over an 8-year period from fiscal years (FY) 1995-2002 . RESULTS: Over the 8 years studied, reference laboratory expenses increased 4.2-fold and totaled 12.4% of the total laboratory budget in FY 2002 . Total reference laboratory test volume increased 4-fold to 68,328 tests in FY 2002 but represented only 1.06% of the total test volume in the hospital . The menu of reference laboratory tests comprised 946 tests (65.7% of the hospital test menu) compared to 494 (34.3%) of tests performed in house . The average unit cost of reference laboratory tests was essentially unchanged but was approximately 13 times greater than the average unit cost in the hospital laboratory . Much of the growth in reference laboratory cost can be attributed to the addition of new molecular, genetic, and microbiological assays . Four of the top 10 tests with the highest total cost in 2002 were molecular diagnostic tests that were recently added to the test menu . CONCLUSION: Reference laboratory testing comprises a major component of hospital clinical laboratory services . Although send out tests represent a small percentage of the total test volume, these services account for the majority of the hospital laboratory test menu and a disproportionate percentage of laboratory costs.

Cytometry, 2004 Sep, 61B(1), 40 - 4
Flow cytometry detection of Shiga toxins in the blood from children with hemolytic uremic syndrome; Tazzari PL et al.; BACKGROUND: Hemolytic uremic syndrome (HUS) is the main cause of acute renal failure in early childhood . Most cases are due to intestinal infections from Escherichia coli strains (STEC) which produce by Shiga toxin (Stxs) . Stx1 and Stx2 produced by STEC in the gut are absorbed into the circulation and, after binding on polymorphonuclear leukocytes (PMNs), are targeted to renal endothelium . The aim of the present work was the development of a method to detect Stxs bound on circulating PMNs and to diagnose STEC infections in patients with HUS . METHODS: White blood cells isolated after erythrocytic lysis were incubated with anti-Stxs mouse monoclonal antibodies in the presence of human serum to saturate Fc receptors on PMNs . After incubation with fluorescein isothiocyanate-goat anti-mouse immunoglobulin G, flow cytometric analysis was used to demonstrate the cell-bound fluorescence . RESULTS: The method was quick (3 h), sensitive (femtomoles), and capable of detecting both Stxs . The presence of Stxs was detected on PMNs from six patients with HUS: four patients had serologic or microbiological evidence of STEC infection, whereas the other two patients had no evidence of STEC infection when employing the standard diagnostic methods . CONCLUSIONS: The method described is rapid, simple, and based on commercially available reagents, and it might be more sensitive than the standard methods for diagnosis of STEC infection . It also allows the detection of Stxs in blood, a key step to monitor the pathogenesis of HUS .

G Ital Nefrol, 2004 Mar-Apr, 21(2), 156 - 64
{Clinical dialysis: new problems and new prospects}; Locatelli F et al.; The main problem nephrologists have to face today is the very high patient morbidity and mortality . A number of traditional and non-traditional risk factors have a role; among these anaemia, hypertension, dislipidemia, abnormalities in calcium-phosphate metabolism, hyperhomocysteinemia and endothelial dysfunction . An important innovation in the field of hemodialysis has been the availability of high-permeable and high-flux membranes, characterized by a high biocompatibility and ultrafiltration coefficient . The development of automatic systems to control ultrafiltration has enabled the utilisation of these membranes in the clinical setting (high-flux hemodialysis, hemofiltration, hemodiafiltration) . It is common opinion that high-flux membranes can positively influence cardiovascular instability, but this has not been confirmed by clinical trials . Although preliminary data indicated a favorable effect on the correction of anemia in patients treated with high-permeable membranes, randomized trials have not shown a significant effect . Better control of anemia could be possible by means of on-line treatments, given their higher removal of medium- and large molecules and reduced microbiological and pyrogenic contamination of the dialysate . A number of analyses showed a lower incidence of bone cysts and/or carpal tunnel syndrome in patients treated with high-flux membranes compared to low-flux ones . High-flux treatments could reduce morbidity and mortality in hemodialysis patients . However, despite its large sample size, the HEMO Study has not been capable of showing a statistically significant effect of higher dialysis dose and high-flux membranes on survival and morbidity . The MPO study has been expressively designed to do a prospective evaluation of the long-term effect of membrane permeability on clinical outcomes . These results are greatly awaited.

Eur J Nucl Med Mol Imaging . 2004 Sep 4; {Epub ahead of print}
In vitro and in vivo evaluation of {(18)F}ciprofloxacin for the imaging of bacterial infections with PET; Langer O et al.; PURPOSE . The suitability of the( 18)F-labelled fluoroquinolone antibiotic ciprofloxacin ({(18)F}ciprofloxacin) for imaging of bacterial infections with positron emission tomography (PET) was assessed in vitro and in vivo . METHODS . For the in vitro experiments, suspensions of various E . coli strains were incubated with different concentrations of {(18)F}ciprofloxacin (0.01-5.0 microg/ml) and radioactivity retention was measured in a gamma counter . For the in vivo experiments, 725 +/- 9 MBq {(18)F}ciprofloxacin was injected intravenously into four patients with microbiologically proven bacterial soft tissue infections of the lower extremities and time-radioactivity curves were recorded in infected and uninfected tissue for 5 h after tracer injection . RESULTS . Binding of {(18)F}ciprofloxacin to bacterial cells was rapid, non-saturable and readily reversible . Moreover, bacterial binding of the agent was similar in ciprofloxacin-resistant and ciprofloxacin-susceptible clinical isolates . These findings suggest that non-specific binding rather than specific binding to bacterial type II topoisomerase enzymes is the predominant mechanism of bacterial retention of the radiotracer . PET studies in the four patients with microbiologically proven bacterial soft tissue infections demonstrated locally increased radioactivity uptake in infected tissue, with peak ratios between infected and uninfected tissue ranging from 1.8 to 5.5 . Radioactivity was not retained in infected tissue and appeared to wash out with a similar elimination half-life as in uninfected tissue, suggesting that the kinetics of {(18)F}ciprofloxacin in infected tissue are governed by increased blood flow and vascular permeability due to local infection rather than by a binding process . CONCLUSION . Taken together, our results indicate that {(18)F}ciprofloxacin is not suited as a bacteria-specific infection imaging agent for PET.

Water Res, 2004 Oct, 38(17), 3809 - 19
A new approach to evaluating the toxicity and genotoxicity of disinfected drinking water; Monarca S et al.; The aim of this study was to evaluate the formation of toxic and genotoxic compounds in surface drinking waters treated with two widely used disinfectants, sodium hypochlorite (NaClO) and chlorine dioxide (ClO(2)), and a new disinfectant, peracetic acid (PAA) . For this purpose a pilot plant was set up to add these biocides continuously to pre-filtered lake water flowing into three different basins . During three seasonal experiments, short-term in vivo tests (with plant, fish and molluscs) and in vitro tests (with bacteria, yeast and human cells) were carried out to evaluate the formation of genotoxic disinfection by-products (DBPs) . Gas chromatography/mass spectrometry (GC/MS) was used to identify DBPs produced during the different treatments, microbiological analyses were performed to test the biocidal activity of the disinfectants, and chemical analyses were carried out to evaluate the quality of the water . The pilot drinking water plant under study was useful in studying the toxicity and genotoxicity of disinfected drinking water with this combined chemical/biotoxicological approach . This paper describes the setting up of the pilot plant and sets out/reports the results of the microbiological and chemical analyses.

Ann Clin Microbiol Antimicrob . 2004 Sep 6;3(1):16.
Tuberculosis presenting as immune thrombocytopenic purpura; Ozkalemkas F et al.; BACKGROUND: Although various hematologic abnormalities are seen in tuberculosis, immune thrombocytopenic purpura is a rare event . CASE PRESENTATION: We report a case of a 29 year-old male who was presented with immune thrombocytopenia-induced hemoptysis, macroscopic hematuria and generalized petechiae . The patient was found to have clinical, microbiological and radiological evidence of active pulmonary tuberculosis . The immune thrombocytopenic purpura was successfully treated with anti-tuberculous drugs combined with corticosteroids and high dose immune globulin therapy . CONCLUSION: Immune thrombocytopenic purpura can be one of the hematological manifestations of tuberculosis which has a global prevalence with increasing incidence secondary to HIV infection.

Hist Sci Med, 2004 Apr-Jun, 38(2), 147 - 55
{When the Egyptian mummies are speaking about the infections that have made them ill}; Chastel C; The microbiological study of mummies has started in 1910 when Sir M.A . Ruffer first applied the histologic methods to the study of mummified tissues and found Schistosoma haematobium ovas dated from the XXth dynasty . Up to the 1990 years, morphological methods including radiology, computed tomography, endoscopy, history, electron microscopy, and serology have been the main tools used in Paleopathology . They led to identify schistosomiasis, dracunculiasis, trichinosis, ascariasis and bone tuberculosis as the most prevalent diseases of the ancient residents of Egypt.The recent introduction of molecular methods (PCR) allowed t confirm the high prevalence of helminth diseases and tuberculosis among these populations, but also added new data exemplified by the widespread distribution of Plasmodium falciparum malaria . In addition, cases of bacterial septicemias and diphteria possibily occurred.Thousands of human and animal mummies remain to be studied with the hope to discover another pathogens responsible for viral or zoonotic infections prevalent during the pharaons' times.

Anesth Analg, 2004 Sep, 99(3), 689 - 93, table of contents
Subcutaneous tunneling of caudal catheters reduces the rate of bacterial colonization to that of lumbar epidural catheters; Bubeck J et al.; Bacterial colonization is regarded as a causative factor for septic complications of caudal catheters in children . To determine whether tunneling caudal catheters reduces the bacterial colonization rate effectively, we evaluated 506 children being treated with tunneled or untunneled caudal or untunneled lumbar epidural catheters . Four-hundred-nine children completed the study . After aseptic removal, the catheters were cultured and sent for microbiological assessment . We found a bacterial colonization rate of 29% in untunneled caudal catheters, 11% in tunneled caudal catheters, and 9% in untunneled lumbar catheters . No severe infectious complications were reported . There was no correlation between catheter retention time and bacterial colonization except for the first 24 h, during which no bacterial colonization was detected . The overall colonization rate remained constant at approximately 13% . We found a positive correlation between bacterial colonization and redness at the catheter entry site . We conclude that tunneled caudal epidural catheters can be used in children for postoperative analgesia without an increased risk of epidural infection.

J Environ Sci Health A Tox Hazard Subst Environ Eng, 2004, 39(8), 1989 - 2010
A review of the occurrence and fate of naphthenic acids in aquatic environments; Headley JV et al.; Naphthenic acids are comprised of a large collection of saturated aliphatic and alicyclic carboxylic acids found in hydrocarbon deposits (petroleum, oil sands bitumen, and crude oils) . Naphthenic acids enter surface water systems primarily through effluent discharge, but also through groundwater mixing and erosion of riverbank oil deposits . Of the possible environmental receptors (i.e., air, soil, and water), the most significant is water . Ambient levels of naphthenic acids in northern Alberta rivers in the Athabasca Oil Sands are generally below 1 mg L(-1) . However, tailings pond waters may contain as high as 110 mg L(-1) . The complexity of natural naphthenic acids in petroleum deposits poses an analytical challenge as reflected by the several techniques reported for quantitation of naphthenic acids in the environment . Although naphthenic acids are known to be persistent biomarkers used in identification of oil source maturation, little is established regarding their relative degradation pathways in aquatic environments . Published research related to the potential for microbiological degradation and adsorption to typical Athabasca Oil Sands soils reveal that naphthenic acids are likely to persist in the water column and, with prolonged exposure, accumulate in sediments . However, other than a very general knowledge of environmental persistence, the occurrence and fate of naphthenic acids has been sparsely studied . This article brings together some of those environmental persistence results, as well as detailed information regarding the origin of naphthenic acids in tailings ponds, chemistry and toxicological considerations, current analytical methods for aquatic sampling, and areas of future remediation research.

Indoor Air, 2004, 14 Suppl 7, 195 - 201
HVAC--the importance of clean intake section and dry air filter in cold climate; Hanssen SO; HVAC systems, if properly designed, installed, operated and maintained, will improve thermal conditions and air quality indoors . However, the success strongly depends on the design of the system and the quality of the components we use in our HVAC installations . Regrettably, several investigations have revealed that many HVAC installations have a lot of operational and maintenance problems, especially related to moisture, rain and snow entrainment . In short, it seems that too little attention is placed on the design of the intake section, despite the fact that there exists a large number of national and international guidelines and recommendations . This is a serious problem because the air intake is the initial component of the ventilation plant and as such the first line of defense against debris and other outdoor air pollutants . Unfortunately, the design is often an argued compromise between the architect, the civil engineer and the HVAC engineer . In the future, the technical, hygienic and microbiological feature of air intakes must be better ensured in order to avoid the air intake becoming a risk component as regards contamination and indoor air quality . Further, it seems that the magnitude of the problem is not well known, or recognized, by the building designers, engineers and professionals involved in the construction and operation of buildings . This fact needs to be addressed more seriously, because obviously there is a big difference between the idealistic architectonic design, engineering intentions and the real life situation . PRACTICAL IMPLICATIONS: Several practical recommendations for design and operation of HVAC systems are presented . Following the recommendations will result in less pollution from the HVAC-system and increased indoor environmental quality.

Klin Mikrobiol Infekc Lek, 2004 Aug, 10(4), 181 - 5
{Diagnostics of larval toxocariasis}; Forstl M et al.; PURPOSE OF THE STUDY: The paper, conceived as a retrospective study, resumes the results of our own investigations of the presence of serum IgG antibodies against Toxocara canis (as a crossover also against T . cati) in the sera of patients suspected of presenting larval toxocariasis in the region of Eastern Bohemia of the Czech Republic in the years 1997-2002 . Our aim was to determine the immunity rate of IgG, its relationship to age and sex, further the whole range of diagnoses, the frequency of demands for such an examination by physicians and the evaluation of our experience with the detection of low avidity IgG . MATERIAL AND METHODS: With a commercial diagnostic kit the ELISA method was used to detect the presence of IgG antibodies against T . canis in 2 994 sera . IgG avidity was determined in 92 positive samples with an avidity solution, which is included in the diagnostic kit and has been used in our laboratory since 2001 . RESULTS: The immunity rate of larval toxocariasis in our set was 20.4 % (612 samples) . With age this rate increases (in individual decades of life - 11.9; 8.3; 11.4; 17.9; 26.1; 29.8 and 34.2%) . Up to adolescence positive findings predominate among boys (males 0-10 years 84.2 %; 11-20 years 76 %) . In the third decade we see a dramatic change in favour of women (women 21-30 years - 74.6 %) . In absolute figures the number of positive findings stagnates in men after the age of 30 years, while among women positive findings continue to grow - yet expressed in percentages there is signifinct change in the male-female ratio (beginning with the 4th decade we find among the women 61.2; 69.7; 72.6 and 64.8 %) . Physicians' interest in the diagnosis of toxocariasis in the years 1997-2002 is confirmed by the significantly higher number of investigated samples (135; 446; 617; 422; 558; 816) . This, however, does not go hand in hand with a higher proportion of IgG positivity . IgG avidity was investigated in 92 positive samples - low avidity was confirmed in six of them (6.5 %); the appropriate case histories are not a part of the study . CONCLUSIONS: Our results tally with the data published by other departments in the Czech Republic . They confirm that the methods used have, as before, their place in the diagnostic range of microbiological laboratories.

Vestn Ross Akad Med Nauk, 2004, (6), 21 - 3
{Diagnosis and treatment of Helicobacter infections in patients with stomach ulcer associated with hemorrhage}; Lipnitskii EM et al.; Diagnosis and treatment of stomach ulcer associated with helicoid-bacterial infection and with hemorrhage are discussed in the paper . The many-year observations show that the risk of relapsing hemorrhage is high in patients with the above diagnosis . Eradication of the causative agent by using the modern therapeutic schemes cuts significantly the rate of such relapses . The most effective method of monitoring the infection and eradication results is suggested, i.e . urease test combined with microbiological diagnosis involving the method of polymerase chain reaction.

Curr Med Res Opin, 2004 Aug, 20(8), 1175 - 83
Efficacy and safety of topical ciprofloxacin/dexamethasone versus neomycin/polymyxin B/hydrocortisone for otitis externa; Roland PS et al.; OBJECTIVES: To compare the efficacy and safety of ciprofloxacin 0.3%/dexamethasone 0.1% (CIP/DEX) otic suspension with that of neomycin 0.35%/polymyxin B 10,000 IU/mL/hydrocortisone 1.0% (N/P/H) otic suspension in patients with acute otitis externa (AOE) . STUDY DESIGN: Randomized, observer-masked, parallel-group, multicenter study . Patients were randomized to 7 days treatment with either CIP/DEX 3-4 drops twice daily or N/P/H 3-4 drops three times daily . POPULATION: Patients of either sex and older than 1 year, with a clinical diagnosis of mild, moderate, or severe AOE and intact tympanic membranes were recruited to participate . OUTCOMES MEASURED: Signs and symptoms of AOE, including ear inflammation, tenderness, edema and discharge (assessed on Days 3, 8 {End-of-Therapy} and 18 {Test-of-Cure}); microbiologic eradication (presumed or documented); and frequency of adverse events . RESULTS: Patients enrolled numbered 468 . In culture-positive patients who met the inclusion criteria (N = 396), clinical cure rates at Day 18 were significantly higher with CIP/DEX than with N/P/H (90.9% vs . 83.9%; p = 0.0375), as were microbiologic eradication rates (94.7% vs . 86.0%; p = 0.0057) . In addition, the clinical response was significantly better with CIP/DEX than with N/P/H at Days 3 and 18 (p = 0.0279 and p = 0.0321, respectively), as was the reduction in ear inflammation at Day 18 (p = 0.0268) . Both preparations were well tolerated in pediatric and adult patients . CONCLUSIONS: 7 days treatment with CIP/DEX otic suspension administered twice daily is clinically and microbiologically superior to N/P/H otic suspension administered 3 times daily in the treatment of mild to severe AOE, and is equally well tolerated.

Akush Ginekol (Sofiia), 2004, 43 Suppl 1, 6 - 9
{Role of Gardnerella vaginalis in the development of sexually transmitted diseases--diagnostic criteria}; Tsvetkov K et al.; The authors analyze the results from the clinical and microbiological investigations of Gardnerella vaginalis in two female groups: 28 patients with clinical manifestations of bacterial vaginosis (BV) and a control group of 25 females without any complaints . Along with the data from the anamnesis and the gynecological examination, the following parameters have been examined: a native preparation for "clue cells", pH of vaginal content, ratio between polymorphonuclear leukocytes and epithelial cells, specimens for the diagnosis by polymerase-chain reaction (PCR) as well as cultural examination by using HBT agar (human blood two-layer Tween agar) . The authors discuss five diagnostic criteria and emphasize that the diagnosis of BV requires the presence of at least four of them . Every criterion possesses a high frequency (between 67.86 and 100 per cent) among the female patients with clinical evidence of BV.

Infect Immun, 2004 Sep, 72(9), 5106 - 14
Senescent BALB/c mice are able to develop resistance to Leishmania major infection; Ehrchen J et al.; Aging has been associated with a decline in immunocompetence and resistance to infections, partially due to dysregulated NO production by macrophages and deficits in mounting Th2 cell responses . We wondered if these alterations would reverse the immune response in experimental leishmaniasis . Bone-marrow-derived macrophages from 2- and 18-month-old (senescent) C57BL/6 or BALB/c mice showed no marked difference in leishmanicidal functions . In vivo infections of resistant C57BL/6 mice with Leishmania major revealed no difference between senescent and young mice . However, among susceptible BALB/c mice, senescent animals showed less foot-pad swelling than young mice, and 40 to 60% of them even showed healing of ulcers, reduced parasite dissemination, and a Th1 cell response . These changes were associated with a spontaneous release of interleukin-12 (IL-12) by macrophages from aged but not from young mice . Since exogenous microbial stimulation can influence immune responses during aging, we also infected senescent mice who were raised under specific-pathogen-free (SPF) conditions . They showed neither resistance nor a Th1 response, but their macrophages still spontaneously released IL-12 . A microbiological analysis showed that conventionally kept mice, but not SPF mice, had experienced infection with murine hepatitis virus (MHV), an infection associated with a Th1-like response . We conclude that for the reversal of the immune response, senescence is the premier requirement but needs to be completed by another mandatory event such as microbial stimulation . One of the age-related, but not environment-related, factors is the spontaneous release of IL-12 by macrophages, while confrontation with MHV presents an environment-related difference, with both having the potential to support a Th1 response.

Ground Water, 2004 Jul-Aug, 42(4), 568 - 75
Effects of water use on arsenic release to well water in a confined aquifer; Gotkowitz MB et al.; Field-based experiments were designed to investigate the release of naturally occurring, low to moderate (< 50 microg/L) arsenic concentrations to well water in a confined sandstone aquifer in northeastern Wisconsin . Geologic, geochemical, and hydrogeologic data collected from a 115 m2 site demonstrate that arsenic concentrations in ground water are heterogeneous at the scale of the field site, and that the distribution of arsenic in ground water correlates to solid-phase arsenic in aquifer materials . Arsenic concentrations in a test well varied from 1.8 to 22 microg/L during experiments conducted under no, low, and high pumping rates . The quality of ground water consumed from wells under typical domestic water use patterns differs from that of ground water in the aquifer because of reactions that occur within the well . Redox conditions in the well can change rapidly in response to ground water withdrawals . The well borehole is an environment conducive to microbiological growth, and biogeochemical reactions also affect borehole chemistry . While oxidation of sulfide minerals appears to release arsenic to ground water in zones within the aquifer, reduction of arsenic-bearing iron (hydr)oxides is a likely mechanism of arsenic release to water having a long residence time in the well borehole.

Water Sci Technol, 2004, 50(1), 105 - 10
The impact of the introduction of treated water on aspects of community health in a rural community in Kwazulu-Natal, South Africa; Bailey IW et al.; A project was designed by Umgeni Water (funded by the Water Research Commission of South Africa) to monitor the implementation of water reticulation in Vulindlela and evaluate the Water Supply Scheme from a community and environmental health perspective . The findings would hopefully contribute toward the development of criteria for Health Impact Assessment on Water Reticulation Projects . One objective of this study was to evaluate the usefulness of diarrhoeal disease as opposed to other health indicators for water-associated diseases . The innovative methodology followed in the study, a "stepped wedge design", compared four discrete areas of water reticulation implementation in Vulindlela over a 15-month period . Five surveys, including a baseline and four follow-ups at each household, were carried out . Analysis (microbiological, chemical) was carried out of samples from the household drinking water and from the source of the water . Each survey included health questionnaires, the respondent being the head of the household in each case . Overall, there was no direct correlation proved between water quality and diarrhoea per se . However, there was a marked decrease in diarrhoea with the introduction of the new water supply . There was definite correlation between hygiene behaviours and diarrhoea . Diarrhoea would seem to be the health impact associated with water, of choice.

Water Sci Technol, 2004, 50(1), 91 - 7
Measuring changes in water-related health and hygiene practices by developing-community households; Jagals P et al.; A population sample from a community in a developing urban area (Botshabelo), which obtains its treated water supply from a communal standpipe system, was subjected to a short Health and Hygiene Awareness and Education (HHA&E) programme to improve its practices on storing water in, and handling water from, storage containers at home . The problem was that the community's practices lead to the deterioration of the microbiological quality of the water in domestic storage containers . Measuring changes in the practices, as well as the microbiological quality of water in the containers, were the instruments used to determine whether the programme had a positive educational effect . This paper reports on selected elements of the practices measurement . Structured interviews, observations and statistical analyses assessed three variables--container hygiene, container storage and hand hygiene . Results indicated insignificant improvements in practices . This was supported by insignificant improvements in the microbiological water quality, that was still above health-safety limits . This implied that short-term "quick fix" HHA&E programmes would tend to be ineffective . Results also suggested that some negative water-hygiene habits may readily change (container hygiene and storage), while behaviour of a more personal nature, such as hand-washing, was not easily changed.

Probl Tuberk Bolezn Legk, 2004, (6), 40 - 2
{New technologies in the determination of drug susceptibility in Mycobacterium tuberculosis}; Skotnikova OI et al.; A variety of mutations in the genes rpoB, katG, inhA, ahpC, kasA was studied by using different molecular biological methods (conformational polymorphism of single-chain fragments, heteroduplex analysis, biochips) in rifampicin- and isoniazid-resistant Mycobacterium tuberculosis (MBT) strains isolated from patients with pulmonary tuberculosis . Twenty-nine mutation combinations were identified in the MBT strains . The use of biochips is the most promising method for identifying the type of mutations responsible for the simultaneous resistance to rifampicin and isoniazid . Detection of several MBT strains in one patient requires the use a combination of molecular biological and microbiological studies.

Probl Tuberk Bolezn Legk, 2004, (6), 31 - 4
{Comparative characterization of molecular and microbiological methods for controlling chemotherapy in new cases of pulmonary tuberculosis}; Larionova EE et al.; The purpose of the study was to define a role of molecular genetic techniques in the evaluation of the efficacy of short-term chemotherapy in patients with pulmonary tuberculosis . A total of 203 patients with first detected tuberculosis patients who isolated Mycobacterium tuberculosis (MBT) were examined . Microbiological methods (bacterioscopy and seeding) and polymerase chain reaction (PCR) were used to detect MBT in new cases . During chemotherapy, there was a reduction in the number of positive results of both bacterioscopy and PCR, which serves as a sign of abacillation . Following 2 months of chemotherapy, 50% of the patients with negative bacterioscopy and seeding were found to have MBT DNA . In the patients with negative bacterioscopy and seeding, the results of PCR were also negative by month 6 . In a group of patients without bacterial isolation, but with positive sputum tests for MBT DNA, the efficiency of chemotherapy was confirmed by the negative results of PCR . The latter is shown to enhance the sensitivity of bacteriological tests for MBT and to reduce the time of obtaining their results.

Chemosphere, 2004 Oct, 57(3), 207 - 13
The influence of humic acids on the phytoextraction of cadmium from soil; Evangelou MW et al.; Cadmium poses a major environmental and human health threat because of its constant release through anthropogenic activities . A need, therefore, exists for cost-effective remediation procedures . Phytoremediation, the use of plants to extract contaminants from soils and groundwater, has revealed great potential . However, it is limited by the fact that plants need time, nutrient supply and, moreover, have a limited metal uptake capacity . Synthetic chelators have shown positive effects in enhancing heavy metal extraction through phytoremediation, but they have also revealed a vast number of negative side-effects . The objective of this research was to investigate the use of humic acids as an alternative to synthetic chelators . Humic acids were applied to a cadmium-contaminated soil at various dosages, and the uptake of cadmium into Nicotiana tabacum SR-1 was determined in relation to the amounts of total and bioavailable cadmium in the soil . It was found that the theoretical bioavailability of cadmium, as determined by diethylenetriaminepentaacetic acid (DTPA) extraction, did not change, but its plant uptake was enhanced significantly, in some cases up to 65% . Humic acids added at a rate of 2 g kg(-1) soil increased the cadmium concentration in the shoots from 30.9 to 39.9 mg kg(-1) . A possible reason for this enhancement is the decrease in pH, resulting in higher cadmium availability . Another possibility taken into account is that plants may take up cadmium complexes with humic acid fragments, which result from microbiological degradation or, self-dissociation.

Crit Care, 2004 Aug, 8(4), R251 - 60 Epub 2004 Jun 15.
Brazilian Sepsis Epidemiological Study (BASES study); Silva E et al.; INTRODUCTION: Consistent data about the incidence and outcome of sepsis in Latin American intensive care units (ICUs), including Brazil, are lacking . This study was designed to verify the actual incidence density and outcome of sepsis in Brazilian ICUs . We also assessed the association between the Consensus Conference criteria and outcome METHODS: This is a multicenter observational cohort study performed in five private and public, mixed ICUs from two different regions of Brazil . We prospectively followed 1383 adult patients consecutively admitted to those ICUs from May 2001 to January 2002, until their discharge, 28th day of stay, or death . For all patients we collected the following data at ICU admission: age, gender, hospital and ICU admission diagnosis, APACHE II score, and associated underlying diseases . During the following days, we looked for systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, and septic shock criteria, as well as recording the sequential organ failure assessment score . Infection was diagnosed according to CDC criteria for nosocomial infection, and for community-acquired infection, clinical, radiological and microbiological parameters were used . RESULTS: For the whole cohort, median age was 65.2 years (49-76), median length of stay was 2 days (1-6), and the overall 28-day mortality rate was 21.8% . Considering 1383 patients, the incidence density rates for sepsis, severe sepsis and septic shock were 61.4, 35.6 and 30.0 per 1000 patient-days, respectively . The mortality rate of patients with SIRS, sepsis, severe sepsis and septic shock increased progressively from 24.3% to 34.7%, 47.3% and 52.2%, respectively . For patients with SIRS without infection the mortality rate was 11.3% . The main source of infection was lung/respiratory tract . CONCLUSION: Our preliminary data suggest that sepsis is a major public health problem in Brazilian ICUs, with an incidence density about 57 per 1000 patient-days . Moreover, there was a close association between ACCP/SCCM categories and mortality rate.

J Clin Periodontol, 2004 Sep, 31(9), 777 - 83
Microbiological shifts in intra- and extraoral habitats following mechanical periodontal therapy; Beikler T et al.; OBJECTIVES: The aim of the present study was to analyze the intra- and extraoral colonization dynamics of periodontal pathogens following supra- and subgingival debridement . MATERIAL AND METHODS: Thirty five patients with chronic periodontitis were enrolled in the study . Supra- and subgingival plaque samples, saliva, and swab samples from mucosa and extraoral sites were taken at baseline and 6 weeks, 3 months and 6 months after mechanical periodontal therapy . Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Eikenella corrodens (Ec), Tannerella forsythensis (Tf), Prevotella intermedia (Pi), Prevotella nigrescens (Pn), and Treponema denticola (Td) were identified by PCR . RESULTS: Supra- and subgingival debridement decreased the number of subgingival sites infected with the analyzed pathogens only transiently, if at all . However, the detection frequencies of Tf, Td, Ec, Pi, and Pn in the supragingival region, of Pg, Td, and Pn at the oral mucosa sites (mostly the tongue), and of all pathogens except Aa in saliva increased over the 6-month observation period . Td was the only pathogen recorded in notable quantities in the extraoral habitat (external ear canal) . CONCLUSION: The results indicate that supra- and subgingival debridement results in a dissemination of periodontal pathogens within the oral cavity.

Pesqui Odontol Bras, 2004 Apr-Jun, 18(2), 121 - 7 Epub 2004 Aug 05.
Systemic use of metronidazole in the treatment of chronic periodontitis: a pilot study using clinical, microbiological, and enzymatic evaluation; Vergani SA et al.; The aim of the present parallel, double-blind investigation was to evaluate the effect of using systemic metronidazole alone or associated to scaling and root planing on adult chronic periodontal disease, monitored at baseline, 30, 60 and 90 days . Twelve subjects were divided into three groups: the first group (Group I - 22 sites) was submitted to scaling and root planing (SRP) alone; the second group (Group II - 30 sites) received SRP and 250 mg of metronidazole (3 times a day for 10 days), and the third group (Group III - 31 sites) was treated with metronidazole alone . The clinical parameters evaluated were probing depth (PD), clinical attachment level (CAL), plaque index (PlI), gingival index (GI) and bleeding upon probing (BP) . Microbiological (BANA test) and enzymatic (Pocket Watch) tests were also performed . All three proposed treatments produced significant improvements in clinical conditions of subjects, from baseline, 30, 60 and 90-day period, except for clinical attachment level . The results obtained by microbiological and enzymatic tests did not show statistical differences among the groups for the 90-day period (r = 0.7924 and r = 0.7757, respectively) . In relation to clinical parameters, statistical differences among groups were observed only for the gingival index (p = 0.0261) between Groups I and II, and probing depth (p = 0.0124) between Group I and the others . We conclude that the use of systemic metronidazole did not produce additional effects on the microbiological conditions of these patients with chronic periodontal disease.

Pesqui Odontol Bras, 2004 Apr-Jun, 18(2), 110 - 5 Epub 2004 Aug 05.
Clinical and microbial evaluation of dental scaling associated with subgingival minocycline in chronic periodontitis subjects; Querido SM et al.; The aims of this double-blind randomized clinical trial were to evaluate the presence of periodontal pathogens and the clinical response of periodontal pockets treatment to scaling and root planing (SRP) associated with subgingival minocycline (SM) . A total of 36 subjects, 26 to 60 years old (40.7 +/- 9.1), who had been previously diagnosed with chronic periodontitis, were included in the present study . Eighteen subjects were selected for the test group (TG), who were treated with SRP plus SM (new treatment), and 18 subjects for the control group (CG) who received SRP plus vehicle (current treatment) . Two homologous sites in each subject with a probing depth (PD) > or = 6 mm were chosen . To evaluate the clinical response after treatment, PD was measured at baseline and at 90 days . Microbiological evaluation was performed to detect 7 periodontal pathogens using polymerase chain reaction at baseline, 30, and 120 days . A mean reduction in PD of 2.8 and 2.1 mm was observed in the TG and CG, respectively . At baseline, P . gingivalis was the most prevalent organism in both test (65.8%) and control (48.6%) groups . After 120 days it fell to 30.8% in TG and to 23.1% in CG . There were no statistically significant differences between the test and control groups concerning PD (p > 0.05 by Wilcoxon test) or presence of periodontal pathogens (p > 0.05 by Wilcoxon and chi-square; p > 0.01 by Signal test) . The results observed showed that the new treatment was as effective as the current treatment in reducing periodontal pathogens and PD among chronic periodontitis subjects.

Epidemiol Infect, 2004 Aug, 132(4), 737 - 43
Wading pool water contaminated with both noroviruses and astroviruses as the source of a gastroenteritis outbreak; Maunula L et al.; In July 2001, an outbreak of gastroenteritis occurred in Helsinki among children and adults after bathing in an outdoor wading pool . The epidemiological survey revealed that at least 242 persons were affected . Microbiological testing of both patient stool samples and of the pool water revealed the presence of two different gastroenteritis viruses: a norovirus (NV) and an astrovirus . Amplicon sequencing of the NV samples showed nucleotide sequence identity between the virus from patients and the water . After changing the pool water and the sand at the bottom of the pool followed by shock chlorination, no virus could be detected in the water . However, NV was continuously detected in the water outlet well as much as 8 months after the incident . Here we show how molecular methods aided in tracing the source of the epidemic and in finding the causative pathogens both in patients and in the environment.

J Environ Health, 2004 Jul-Aug, 67(1), 16 - 20, 28, 27; quiz 31-2
Cryptosporidiosis outbreak in a recreational swimming pool in Minnesota; Lim LS et al.; On May 6, 1998, the Olmsted County Public Health Department initiated an investigation into an outbreak of diarrheal illness that had occurred among people who swam frequently at a local swimming pool . Interviews of swimmers and microbiological testing of stool samples and swimming pool filter material were conducted to determine the source of the outbreak . Twenty-six of 206 swimmers interviewed had illnesses that met the case definition . The most common symptoms were diarrhea (100 percent), abdominal cramps (81 percent), and nausea (77 percent) . The median duration of symptoms was nine days . Four cases of cryptosporidiosis were confirmed by stool analysis . The outbreak was found to be associated with swimming at the pool . Public awareness-including an understanding that recreational water facilities should be avoided during diarrheal illness-and proper pool hygiene are vital in preventing cryptosporidiosis outbreaks . Health care providers also must consider testing specifically for cryptosporidiosis when a patient presents with persistent diarrhea.

Clin Infect Dis, 2004 Aug 1, 39 Suppl 2, S83 - 6
Diagnosing foot infection in diabetes; Williams DT et al.; Infection represents the presence of an inflammatory response and tissue injury due to the interaction of the host with multiplying bacteria . The disease spectrum is a consequence of the variability in these interactions . Diabetes, because of its effects on the vascular, neurological, and immune systems, can compromise the local and systemic response to infection, potentially masking the typical clinical features and hindering diagnosis . The early recognition of infection, particularly osteomyelitis, is paramount in the management of diabetic foot disease . Careful clinical appraisal remains the cornerstone of the assessment . Hematologic, biochemical, and radiological investigations are important aids in assessing the severity of infection . Microbiological assessment, particularly in more severe infection, requires good-quality samples, combined with rapid transport in an appropriate medium and effective communication with the laboratory . A focused, systematic approach to the accurate diagnosis and treatment of infection, combined with careful monitoring, ensures the maintenance of optimal management.

Parassitologia, 2004 Jun, 46(1-2), 109 - 13
{Tick borne zoonosis: selected clinical and diagnostic aspects}; Sambri V et al.; Tick-borne zoonotic infections are among the most diffuse vector borne diseases: these large group of infections is caused by different microorganisms: Babesia spp., Borrelia spp., Rickettsia spp., Ehrlichia spp., Francisella tularensis, Coxiella burnetii) and tick-borne encephalitis virus . Babesiosis is caused by the protozoa (sporozoa) Babesia microti and it is quite rare in humans in Europe . The ixodids ticks are the competent vectors . A few symptomatic cases have been reported, mainly in splenectomized patients . The laboratory diagnosis is made by the microscopic identification of the parasites within the red blood cells in blood smears . The serologic diagnosis, based mainly upon IFA and WB techniques has only an epidemiological interest . Lyme borreliosis (Lyme disease) has been recognized as the most frequent vector borne disease in mild climate areas . The etiologic agent is a spirochete, belonging to the Borrelia burgdorferi sensu lato complex: B . burgdorferi sensu stricto, B . garinii and B . afzelii . Several additional species of this geno-complex have been identified but their pathogenic capability for humans still needs to be elucidated . Lyme borreliosis is clinically divided into three different clinical stages: the early disease, the disseminated infection and the persistent infection . Individual stages are caused by the diffusion of the spirochetes to different anatomic districts of the body . The main clinical symptoms are, for each stage: the erythema chronicum migrans in the early infection, the peripheral nerves and joint involvement in disseminated diseases and the acrodermatitis chronica atrophica (ACA) with central nervous system involvement in the late disseminated infection . The microbiological diagnosis is achieved by serologic techniques (IFA, EIA, WB) and by isolation of the spirochetes (in vitro culture and DNA amplification methods) . Tick-borne relapsing fever (TBRF) is occasionally transmitted to humans by the soft ticks Ornithodorus and is caused by Borrelia spp . Different borreliae are responsible for TBRF in various geographic areas . The laboratory diagnosis is based upon the identification of spirochetes in peripheral blood by microscopic observation of Giemsa stained smears . Rickettsiosis diseases are caused worldwide by the obligate intracellular bacteria belonging to the genus Rickettsia . In the Mediterranean area the most frequently identified rickettsia is R . conorii, that causes the so called Mediterranean spotted fever . The serologic detection of a specific antibody response by IFA techniques is the most prominent tool for the diagnosis . In addition, the PCR method can be applied . Bacteria of the genus Ehrlichia are well known pathogens in veterinary medicine . Since the last decade their zoonotic capability has emerged and E . chafeensis, E . canis and the so called human granulocytic agent (HGE) have been identified in human diseases following a tick bite . The ehrlichiosis is characterized, in human, by a mild fever associated with lymphoadenopathy . The diagnosis is made on the identification of morulae (the intracytoplasmatic inclusion of the growing rickettsiae) in the white cells of peripheral blood . In addition the molecular diagnosis is also possible by PCR . Tick-borne encephalitis (TBE) is the only viral arthropod-borne encephalitis in Europe: it is caused by a flavivirus and it can also be transmitted by the ingestion of goat raw milk . The more relevant epidemiological figure is limited to the Alps, in particular to the Northern side (Austria) . Isolated cases have been reported also in Italy . TBE is a benign self-limiting illness that usually recovers without any reliquate . The laboratory diagnosis is obtained by isolating the virus in cell cultures from the CSF or blood of acute phase patients . Serology is anyway the main laboratory tool to perform this diagnosis . Complement fixation and EIA IgM are the most used methods: the latter technique is particularly sensitive in early infection.

Int J Tuberc Lung Dis, 2004 Aug, 8(8), 945 - 51
Accuracy of routine diagnosis of pulmonary tuberculosis in an area of high HIV prevalence; Apers L et al.; SETTING: Gweru Provincial Hospital, Zimbabwe . OBJECTIVES: To evaluate the accuracy of the diagnosis of pulmonary tuberculosis (PTB) in routine circumstances . DESIGN: Prospective cohort study of routinely diagnosed PTB patients between September 2000 and September 2001 . RESULTS: Of 300 patients started on treatment, 161 (53.7%) were positive on direct microscopy . Of the 139 sputum-negative patients, 51 (36.7%) were positive after concentration of specimens, an additional 30 (21.6%) were positive on culture only and 58 (19.3% of the total) were negative for all laboratory investigations . There was no difference in sex, human immunodeficiency virus (HIV) serostatus or treatment outcome between the culture-positive and culture-negative presumed PTB patients . Sputum-negative patients had an increased risk of dying during treatment (RR 2.39, P = 0.015) . CONCLUSIONS: The laboratory findings reveal that PTB could be confirmed in more than 80% of patients put on treatment in this setting . The treatment outcomes of the remainder did not differ from those in patients with microbiologically confirmed PTB . In a high HIV-prevalent area, clinicians rightly consider the results of the sputum microscopy test as only one element in the decision making process to put a patient on TB treatment.

Vet Hum Toxicol, 2004 Aug, 46(4), 199 - 205
The evolution of safety assessments for veterinary medicinal products in the European Union; Woodward K; The contents of the safety section of dossiers supporting marketing authorisation applications for veterinary medicinal products have improved markedly over the last 15-20y . This is particularly true for products intended for use in food producing animals and well exemplified in the European Union . The concept of the acceptable daily intake has been refined and in addition to toxicological safety, pharmacological and microbiological considerations are also now taken into account . All of these factors are built into the approach for the elaboration of maximum residue limits for residues of veterinary drugs in food of animal origin, and the subsequent determination of their withdrawal periods in each species . These developments have been matched by improvements in residues surveillance . More emphasis is now given to the safety of those using veterinary medicinal products, and to possible environmental effects . Consumers, users and the environment are therefore better protected from any potential harmful effects . Both industry and regulatory authorities have invested significant efforts into communicating these developments to the public . However, it is still worthwhile questioning whether more can be done to bring these achievements to a wider public audience, and thus to increase confidence in the safety of veterinary medicines by both consumers and user alike.

Environ Sci Technol, 2004 Jul 1, 38(13), 3713 - 22
Vulnerability of water distribution systems to pathogen intrusion: how effective is a disinfectant residual?
Propato M, Uber JG.
Can the spread of infectious disease through water distribution systems be halted by a disinfectant residual? This question is overdue for an answer . Regulatory agencies and water utilities have long been concerned about accidental intrusions of pathogens into distribution system pipelines (i.e., cross-connections) and are increasingly concerned about deliberate pathogen contamination . Here, a simulation framework is developed and used to assess the vulnerability of a water system to microbiological contamination . The risk of delivering contaminated water to consumers is quantified by a network water quality model that includes disinfectant decay and disinfection kinetics . The framework is applied to two example networks under a worst-case deliberate intrusion scenario . Results show that the risk of consumer exposure is affected by the residual maintenance strategy employed . The common regulation that demands a "detectable" disinfectant residual may not provide effective consumer protection against microbial contamination . A chloramine residual, instead of free chlorine, may significantly weaken this final barrier against pathogen intrusions . Moreover, the addition of a booster station at storage tanks may improve consumer protection without requiring excessive disinfectant.

J Infect Dis, 2004 Sep 1, 190(5), 935 - 45 Epub 2004 Jul 27.
Cardiac valves in patients with Whipple endocarditis: microbiological, molecular, quantitative histologic, and immunohistochemical studies of 5 patients; Lepidi H et al.; The pathological features of Whipple endocarditis, which is caused by Tropheryma whipplei, were histologically evaluated in cardiac valves from 5 patients . We used quantitative image analysis to compare the valvular fibrosis, calcifications, vegetations, inflammation, and vascularization due to Whipple endocarditis with those due to non-Whipple endocarditis and degenerative valves . We also studied the presence of T . whipplei in valves by immunohistochemical analysis, culture, and polymerase chain reaction (PCR) . In histologic analysis, Whipple endocarditis was characterized by significant fibrosis, a lack of calcifications, slight inflammation and vascularization, and vegetations of intermediate size . Inflammatory infiltrates consisted mainly of foamy macrophages and lymphocytes . We found that the detection of T . whipplei in cardiac valves, by immunohistochemical analysis, was correlated with the detection of the bacterium by culture and PCR . We report, for the first time, the immunodetection of T . whipplei in a surgically removed arterial embolus . Pathological and immunohistologic analyses may contribute to the diagnosis of Whipple endocarditis.

Resuscitation, 2004 Aug, 62(2), 199 - 207
Physico-chemical stability and sterility of previously prepared saline infusion solutions for use in out-of-hospital emergencies; Peculo Carrasco JA et al.; OBJECTIVE: The topic of this research was to determine whether out-of-hospital emergency teams could make use of previously prepared saline solutions (SS) . The objective was to discover the physical, chemical and sterility characteristics of previously prepared saline infusions stored in ambulances and ascertain how long they remained in optimum condition . METHOD: Randomised clinical trial, triple blind, where study units consisted of saline solutions prepared with an infusion system and a three-way valve . The duration of the study was 12 months . Six intervention groups were designed on the basis of time of exposure and location . Samples consisted of 672 units . Twelve microbiological cultures were made and the pH, density, viscosity and CINa concentration were determined . We compared hypotheses with four models of linear regression for the variables and a model of logistic regression for the variables . A value of P < 0.05 was considered significant . RESULTS: We obtained results from 669 saline solutions (98.82%) . Neither multivariant analysis nor ANOVA tests showed any significant association for a power greater than 99% with regard to the physical-chemical characteristics . The model of logistic regression also did not find any significant association for sterility . Colonisation was present in 1.7% of the 8,028 cultures made and more than 5 CFU per millilitre was found in only two cases . CONCLUSION: There is no evidence to suggest that recently prepared saline infusion solutions are any different from a physical-chemical and sterility point of view than those exposed for 24, 48, or 72 h . It was concluded that use can be made of previously prepared saline solutions with a guarantee their stability and sterility.

Am J Infect Control, 2004 Aug, 32(5), 296 - 300
Experimental study on the safety of a new connecting device; Trautmann M et al.; BACKGROUND: The tested device is a new connecting tool for infusion systems that has been designed to replace conventional single-use stopcocks . Because outbreaks of bloodstream infections have been observed during the use of similar connectors in the United States, we examined the microbiological safety of the connecting device after artificial contamination in the laboratory setting and during routine clinical use . METHODS: In the first part of the study, the new device was tested in 3 types of in vitro experiments . In the second part of the study, surgical intensive care patients had their entry ports capped with novel devices (n=27) or with conventional stopcocks (n=32), and samples of infusion fluids and swabs from entry ports were taken after completion of infusion periods . RESULTS: The new device did not perpetuate bacterial contaminations in spite of high artificial inocula in the in vitro experiments . Microbial contamination rates after 96 hours of infusion therapy for the novel connecting tool versus conventional stopcock groups were as follows: swabs from 3-way ports, 6/129 versus 1/111; rest fluid from infusion lines, 0/20 versus 1/22; rest fluid from infusion bottles, 2/196 versus 2/208; rest fluid from perfusor syringes, 7/180 versus 6/142 (all differences not significant) . CONCLUSION: The novel connecting device was microbiologically safe and did not increase microbial contamination rates of intravenous infusion systems.

Obstet Gynecol, 2004 Aug, 104(2), 267 - 72
Vulvovaginal symptoms in women with bacterial vaginosis; Klebanoff MA et al.; OBJECTIVE: A substantial, but highly variable, percentage of women with bacterial vaginosis are said to be asymptomatic . The purpose of this study was to estimate the prevalence of symptoms among women with bacterial vaginosis compared with women without bacterial vaginosis by direct, explicit, and detailed questioning of these women . METHODS: Women presenting for a routine health care visit at 12 health department clinics in Birmingham, Alabama, were recruited to participate in a longitudinal study of vaginal flora . At the first visit, they underwent a pelvic examination, lower genital tract microbiological evaluation, and an interview that included detailed questions regarding lower genital tract symptoms . The prevalence of symptoms among women with and without bacterial vaginosis (Gram stain score 7 or higher) was compared . RESULTS: Among 2,888 women without gonorrhea, Chlamydia, or trichomonas, 75% of women with and 82% of women without bacterial vaginosis never noted any vaginal odor in the past 6 months (P <.001) . The corresponding values were 63% and 65% for never noting vaginal "wetness" (P =.02); 58% and 57% for vaginal discharge (P =.65); 91% and 86% for irritation (P =.004); 88% and 85% for itching (P =.64); and 96% and 94% for dysuria (P =.002), respectively . Cumulatively, 58% of women with bacterial vaginosis noted odor, discharge, and/or wetness in the past 6 months compared with 57% of women without bacterial vaginosis (P =.70) . CONCLUSION: The 2 classic symptoms of bacterial vaginosis discharge and odor are each reported by a minority of women with bacterial vaginosis and are only slightly more prevalent than among women without bacterial vaginosis.

Acta Ophthalmol Scand, 2004 Aug, 82(4), 463 - 7
16S rDNA PCR analysis of infectious keratitis: a case series; Rudolph T et al.; PURPOSE: To discuss the value of polymerase chain reaction (PCR) in the management of bacterial infectious keratitis . METHODS: Corneal scrapings of four patients with severe infectious keratitis were analysed by culture and PCR of 16S ribosomal DNA (rDNA), followed by direct sequencing of the resulting amplicon . The medical history of the patients included laser-assisted in-situ keratomileusis (LASIK), penetrating keratoplasty (PKP) and trauma . RESULTS: Using PCR we were able to identify a possible pathogen in all four cases, while bacterial cultures were either negative or did not correspond to the clinical picture . The identified bacteria were a Pseudomonas species, Abiotrophia defectiva, Stenotrophomonas maltophilia and Porphyromonas gingivalis . CONCLUSIONS: Analysis of corneal scrapings by 16S rDNA PCR should be considered as a supplement to standard microbiological procedures . However, the results of this relatively new method have to be interpreted carefully.

J Dairy Sci, 2004 May, 87(5), 1132 - 42
Purification and characterization of a pregastric esterase from a hygienized kid rennet paste; Calvo MV et al.; Rennet pastes obtained by maceration of gastric tissues from suckling kids are used traditionally to produce some artisanal cheeses in Spain . Besides milk-clotting function, rennet pastes provide proteolytic activity and lipolytic system, essentially pregastric, necessary in the development of piquant flavor typical of these cheeses . A simple and reproducible procedure allows us to obtain a standardized rennet paste that posses the desired activity and is of good microbiological quality . Concomitantly, a kid pregastric esterase (KPGE) was purified to homogeneity . The purification procedure was based on an aqueous extract of hygienized rennet paste (HRP), which was chromatographed on DEAE-Sepharose Fast Flow then adsorbed on phenyl superose followed by a re-chromatography on the same column . The final enzymatic preparation, where the overall activity recovery was 3%, showed a molecular mass of 53 kDa . The highest activity was determined on p-nitrophenyl butyrate, but marked hydrolysis was also detected on beta-naphthyl caprylate . In contrast, low activity on tributyrin (substrate under emulsion form) was detected, thus confirming the esterase character of purified enzyme.

J Virol Methods, 2004 Sep 15, 120(2), 239 - 45
Mouse antibody production test: can we do without it?
Mahabir E, Jacobsen K, Brielmeier M, Peters D, Needham J, Schmidt J.
Introduction of microbiologically contaminated materials into mice can cause infections of the recipients and jeopardize experimental protocols . As such, the methods used to screen biological materials should be sensitive, reliable and suitable for routine diagnostic work . In this report, the sensitivity of the viral plaque assay, mouse antibody production test and polymerase chain reaction (PCR) for detection of MHV-A59 and MMVp, two of the most prevalent pathogenic viruses in experimental mouse facilities, was compared . Analysis of serial tenfold dilutions of virus stocks revealed that the sensitivity of the mouse antibody production test on day 28 (10(-10) dilution) was at least 10 times higher than that of the viral plaque assay (10(-9) dilution) and 10(4) times more than that of the RT-PCR (10(-6) dilution) for detection of MHV-A59 . For detection of MMVp, the PCR (10(-10) dilution) proved to be 10(6) times more sensitive than the viral plaque assay (10(-4) dilution) and the mouse antibody production test on day 28 (10(-4) dilution) which were equally sensitive . Based on the present study, it was shown that the method for diagnosis of viruses in biological materials should be employed only after the sensitivity has been determined for the viruses of interest implying that the most sensitive method needs to be determined independently for each virus.

J AOAC Int, 2004 May-Jun, 87(3), 614 - 20
Biosensor analysis of beta-lactams in milk: comparison with microbiological, immunological, and receptor-based screening methods; Gustavsson E et al.; Two recently developed surface plasmon resonance biosensor assays for detection of beta-lactams in milk were used to screen raw producer milk samples . Both assays use a beta-lactam receptor protein with carboxypeptidase activity for detection . The results of the biosensor assays were compared with those of various commercial screening tests, i.e., the Delvotest SP, Penzym S, Beta-STAR, SNAP, and Parallux . The results of the 2 biosensor assays showed good agreement with those of the other screening tests . Of 195 analyzed milk samples, the results of only 5 samples differed between the assays . Additionally, 30 milk samples with both negative and positive results in the screening assays were analyzed by liquid chromatography for identification and quantification of any beta-lactam residues . All screening tests showed 0% false-negative results with 15 incurred samples containing between 4.0 and 268 microg/kg penicillin G . The biosensor assays showed 27% positive results (false violatives) with 15 producer milk samples containing penicillin G concentrations between 0 and 3.6 microg/kg, i.e., below maximum residue limit . This figure varied between 27 and 53% for the other screening tests.

Annu Rev Phytopathol, 2004, 42, 271 - 309
Microbial dynamics and interactions in the spermosphere; Nelson EB; The spermosphere represents a short-lived, rapidly changing, and microbiologically dynamic zone of soil surrounding a germinating seed . It is analogous to the rhizosphere, being established largely by the carbon compounds released into the soil once the seed begins to hydrate . These seed exudations drive the microbial activities that take place in the spermosphere, many of which can have long-lasting impacts on plant growth and development as well as on plant health . In this review, I discuss the nature of the spermosphere habitat and the factors that give rise to its character, with emphasis on the types of microbial activities in the spermosphere that have important implications for disease development and biological disease control . This review, which represents the first comprehensive synthesis of the literature on spermosphere biology, is meant to illustrate the unique nature of the spermosphere and how studies of interactions in this habitat may serve as useful experimental models for testing hypotheses about plant-microbe associations and microbial ecology.

Biol Blood Marrow Transplant, 2004 Aug, 10(8), 561 - 8
Early central nervous system complications after reduced-intensity stem cell transplantation; Kishi Y et al.; To investigate clinical characteristics of early central nervous system (CNS) complications after reduced-intensity stem cell transplantation (RIST), we reviewed the medical records of 232 patients who had undergone RIST for hematologic diseases at our institutions between September 1999 and June 2003 . All patients had received purine analog-based preparative regimens . Stem cell sources comprised granulocyte colony-stimulating factor-mobilized blood from HLA-identical or 1 locus-mismatched related donors (n = 151), unrelated bone marrow (n = 44), or unrelated cord blood (n = 37) . Graft-versus-host disease prophylaxis incorporated cyclosporine with or without methotrexate . Diagnosis of CNS complications was based on clinical, radiologic, and microbiological findings . CNS complications occurred in 18 patients (7.8%), with a median onset of 22 days, and were infectious (n = 1), metabolic (n = 15), or cerebrovascular (n = 2) . Symptoms included seizures (n = 7), visual disturbance (n = 2), headache (n = 8), nausea (n = 8), vomiting (n = 6), impaired consciousness (n = 16), and hemiparesis (n = 3) . Complications improved promptly in 10 patients, and 8 patients died without improvement within 30 days . Multivariate analysis with logistic regression identified umbilical cord blood transplantation as a significant risk factor for early CNS complications (odds ratio, 14.5; 95% confidence interval, 3.7-56.9; P <.0001) . CNS complications are a significant problem after RIST, particularly with umbilical cord blood . Limbic encephalopathy is an unrecognized subtype of neurotoxicity after umbilical cord blood transplantation.

Clin Experiment Ophthalmol, 2004 Aug, 32(4), 424 - 8
Trimethoprim-sulphamethoxazole therapy in Nocardia keratitis; Kalavathy CM et al.; PURPOSE: To describe the clinical features, microbiological features and treatment outcome of nine patients with Nocardia keratitis treated with topical trimethoprim- sulphamethoxazole drops . METHODS: Retrospective review of nine patients with culture-proven Nocardia keratitis . RESULTS: Nine patients with Nocardia keratitis were treated with topical trimethoprim-sulphamethoxazole drops . The average duration of treatment was 25 +/- 9 days . Five of the nine patients presented with superficial ulcers with margins studded with yellowish white discrete pinhead sized infiltration; the other four patients had deep stromal infiltration . Complete healing of the ulcer was achieved in six out of the nine patients with topical trimethoprim- sulphamethoxazole alone or in combination with ciprofloxacin 0.3% eye drops . CONCLUSION: Topical application of trimethoprim-sulphamethoxazole appears to be effective therapy for superficial keratitis due to Nocardia.

Photochem Photobiol . 2004 Jun 1; {Epub ahead of print}
Photocatalytic Coatings For Environmental Applications; Allen NS et al.; A series of nano and micron particle grade anatase and rutile titanium dioxide pigments have been prepared with various densities of surface treatments, particle size and surface area . Their photocatalytic activites have been determined in a series of paint films by FTIR, chalking, colour, gloss change and weight loss following artifical weathering . The pigments have also been examined by rapid assessment methodologies using photodielectric microwave spectroscopy, 2-propanol oxidation and hydroxyl analysis . The microwave response under light and dark cycles provides an extended timescale probe of charge carrier dynamics in the pigments . Pigment particle size, surface area and properties clearly play an important role in dispersion and any polymer-pigment interactions . Photooxidation studies on several types of paint films show a clear demarcation between nano-particle and pigmentary grade titanium dioxide with the former being more active due to their greater degree of catalytic surface activity . The photosensitivity of titanium dioxide is considered to arise from localized sites on the crystal surface (i.e . acidic OH), and occupation of these sites by surface treatments inhibits photo-reduction of the pigment by ultraviolet radiation and hence the destructive oxidation of the binder is inhibited . Coatings containing 2-5% by weight alumina or alumina and silica are satisfactory for general-purpose paints . If greater resistance to weathering is desired, the pigments are coated more heavily to about 7-10% weight . The coating can consist of a combination of several materials, eg . alumina, silica, zirconia, aluminium phosphates of other metals . For example, the presence of hydrous alumina particles lowers Van der Waals forces between pigments particles by several orders of magnitude, decreasing particle-particle attractions . Hydrous aluminium oxide phases appear to improve dispersibility more effectively than most of the other hydroxides and oxides . Coated nanoparticles are shown to exhibit effective light stabilisation in various water and oil based paint media in comparison with conventional organic stabilisers . Hindered piperidine stabilisers are shown to provide no additional benefits in this regard often exhibiting strong antagonism . The use of photocatalytic titania nanoparticles in the development of self-cleaning paints and microbiological surfaces is also demonstrated in this work . In the former case surface erosion is shown to be controlled by varying the ratio of admixture of durable pigmentary grade rutile (heavily coated) and a catalytic grade anatase nanoparticle . For environmental applications in the development of coatings for destroying atmospheric pollutants such as nitrogen oxides (NOX) stable substrates are developed with photocatalytic nanoparticle grade anatase . Here porosity of the coatings through calcium carbonate doping is shown to be crucial in the control of the effective destruction of atmospheric NOX gases . For the development of microbiological substrates for the destruction of harmful bacteria effective nanoparticle anatase titania is shown to be important with hydrated high surface area particles giving the greatest activity.

Anaesthesist, 2004 Sep, 53(9), 830 - 5
{Detection and identification of the pathogenic cause of a brain abscess by molecular genetic methods}; Heininger AD et al.; Brain abscesses are life-threatening and detection and identification of the causative pathogens are crucial for substantiating the diagnosis and for selecting the optimal antibiotic regimen . In approximately 20% of the patients microbiological cultures of abscess material remain sterile . The polymerase chain reaction (PCR) provides a methodological alternative, but data about the use of broad spectrum PCR assays to detect the causative pathogens in brain abscesses are rare . We report on the case of a 65-years-old patient with a brain abscess caused by Fusobacterium spp., which was only diagnosed by broad spectrum PCR . To our knowledge this is the second report about a brain abscess, where Fusobacterium spp . was identified only by broad spectrum PCR and subsequent DNA sequencing.

Rev Med Interne, 2004 Aug, 25(8), 596 - 600
{Primary non-Hodgkin lymphoma of the liver in HIV infected patient: case-report}; Walter T et al.; INTRODUCTION: Primary liver non-Hodgkin's lymphoma, are extremely rare in HIV-infected patient . Most of them are diffuse large-cell lymphoma with B cell type . EXEGESIS: We report here the case of a 34-year-old HIV-infected patient, admitted for jaundice and fever since 15 days . Abdominal computerised tomography showed numerous hypodense lesions on all liver segments . The various biological, microbiological and morphological examinations (ultrasound, MRI with intravenous contrast agent specific for the liver) initially suggested a tumoral origin . The liver biopsy concluded to a large B-cell lymphoma . A chemotherapy (CHOP) with anti-CD20 monoclonal antibody (rituximab) was initiated without discontinuing antiretroviral therapy . CONCLUSION: This case-report does emphasize on the numerous presentations of primary liver lymphoma in HIV-Infected patient, and we illustrate the interest of MRI using a new intravenous contrast agent critical for differential diagnosis.

Shokuhin Eiseigaku Zasshi, 2004 Apr, 45(2), 76 - 80
Mechanism of the decrease of tetrodotoxin activity in modified seawater medium; Kobayashi T et al.; This study was designed to clarify the mechanism of the decrease of tetrodotoxin (TTX) toxicity during storage in a modified seawater medium (MSWM) . When TTX was added to sterilized MSWM, the toxicity of TTX in the medium markedly decreased within 1 day, as determined by a mouse bioassay . HPLC (high-performance liquid chromatography) analysis showed that the peak of TTX was reduced and new unidentified peaks were observed . Omission of the P-1 metal solution from MSWM suppressed the decrease in TTX toxicity and the disappearance of TTX . Further studies indicated that boric acid in the P-1 metal solution triggers this toxicity decrease, indicating that TTX is chemically, not microbiologically, converted to unknown compounds in MSWM.

J Med Microbiol, 2004 Aug, 53(Pt 8), 775 - 81
Ultrastructural examination of two cases of stromal microsporidial keratitis; Rauz S et al.; Two cases with chronic stromal keratitis are described in immunocompetent hosts where the diagnosis was originally thought to be herpetic or adenoviral disease . Light microscopy and ultrastructural examination of corneal tissue by electron microscopy were performed following penetrating keratoplasty (case 1) and corneal biopsy (case 2) . Specimens from both cases were analysed for viral identification by PCR . Two different species of Microsporidia were identified . Case 1 represents the fourth reported case of corneal stromal Vittaforma corneae where the spores measured 3.3 x 1.4 microm, arranged in characteristic linear groups of about four to eight . Each spore contained a diplokaryotic nucleus and a single row of ten polar tube coils . By contrast, case 2 is the first reported case of stromal keratitis caused by Trachipleistophora hominis . In this case, spores measured 4 x 2.4 microm, located typically within packets . In this species, the polar tube was arranged as a single row of about 10-13 profiles . Viral DNA could not be amplified by PCR . In conclusion, microsporidial stromal keratitis should be considered in culture-negative cases refractory to medical therapy . As microbiological culture techniques are unsuccessful, diagnosis may only be established following histopathological and ultrastructural examination of corneal tissue .

J Clin Pharm Ther, 2004 Aug, 29(4), 359 - 65
A retrospective drug utilization evaluation of vancomycin usage in paediatric patients; Hing WC et al.; OBJECTIVE: To evaluate the appropriateness of use of vancomycin in paediatric patients at KK Women's and Children's Hospital, the major paediatric hospital in Singapore to identify potential problems in prescribing practices that may necessitate intervention to optimize vancomycin usage . METHODS: A retrospective drug utilization evaluation was performed for paediatric patients who received intravenous vancomycin from 1 June 1998 to 31 June 1999 . The outcome measures were consistency of vancomycin indication with recommended guidelines, dosing regimens, microbiological data, monitoring of serum drug levels, renal function, clinical outcomes and adverse drug reactions (ADRs) . RESULTS: A total of 96 cases was available for evaluation . Sixty-two (64.6%) courses of vancomycin were consistent with guidelines for indication of therapy . Eighty-six (89.6%) of the dosing regimen were consistent . All infusion times that were recorded (56.3%) were consistent with criteria . Of the patients treated with vancomycin for more than 1 day, peak and/or trough serum vancomycin levels were ordered for 70 cases . Of the 56 cases with paired levels ordered, 46 cases had at least one level that fell outside the therapeutic range . Nineteen (19.8%) cases of ADRs were documented . Fifty-eight (60.4%) cases received concurrent nephrotoxic drugs . However, a substantial portion of vancomycin courses were apparently not prescribed for appropriate indications, and there was poor recording of vancomycin administration information and sampling time . CONCLUSION: The majority of dosing regimens of vancomycin was consistent with guideline criteria . The most evident problem was the sub-optimal use of the monitoring of vancomycin serum levels . The information derived from this study may be used as a for further study and for the development of strategies for optimize vancomycin usage.

Biotechnol Appl Biochem, 2004 Aug, 40(Pt 1), 35 - 9
Regulatory and microbiological safety issues surrounding cell and tissue-engineering products; Galbraith DN; Cell therapies and tissue-engineered products that contain living cells are potentially some of the most exciting of the novel therapeutic products currently under development . These products, however, present a number of important safety issues, particularly with respect to the transmission of human viruses . In addition, the short shelf life of these products precludes the normally extensive characterization performed on other biotherapeutic products . Careful examination of the risks and extensive testing of the raw materials have been used in place of product testing to ensure safety.

Parassitologia, 2003 Mar, 45(1), 47 - 9
Editorial introduction to the paper by A . Castellani "Researches on the Etiology of Sleeping Sickness" reprinted from the Journal of Tropical Medicine, June 1, 1903; Castelli F et al.; The paper by Professor Aldo Castellani represents the first report suggesting the causative role of Trypanosoma spp . in the pathogenesis of sleeping sickness and confirms his pivotal role in solving the etiologic dilemma of the disease . Professor Castellani also contributed to a large extent to many other important microbiological discoveries, mainly in the field of mycology, protozoology and bacteriology.

Ann Ist Super Sanita, 2004, 40(1), 117 - 40
{Microbiological risk associated with consumption of drinking water in developed countries}; Carraro E et al.; This article provides an overview of the waterborne disease (WBD) issue in developed countries (USA, Canada, UK and other European countries) . The factors involved in the epidemiology of waterborne infection are analysed (microbial, social, environmental, etc.) and the main WBD etiological agents are described with particular interest to emerging pathogens (i.e . Cryptosporidium parvum, Legionella and Calicivirus) . Microorganism characteristics related to water contamination risk are described and examples of waterborne outbreak are reported . A short account about the detection methods of these microorganisms in the water is given . In conclusion, some possible strategies to control waterborne microbiological risk in industrialised countries are discussed considering the application of the risk analysis and the HACCP system in the water production and the need of a WBD surveillance system.

J Gen Virol, 2004 Aug, 85(Pt 8), 2421 - 8
Characterization of germline porcine endogenous retroviruses from Large White pig; Scobie L et al.; Porcine endogenous retroviruses (PERV) are of concern when the microbiological safety aspects of xenotransplantation are considered . Four unique isolates of PERV B have been identified previously from a lambda library constructed from genomic DNA from a Large White pig . This study shows that none of these isolates are replication competent when transfected into permissive human or pig cells in vitro, and the removal of flanking genomic sequences does not confer a human tropic replication competent (HTRC) phenotype on these PERV proviruses . Analysis of the envelope sequences revealed that PERV B demonstrated high similarity to the envelope sequences derived from replication-competent PERV, indicating that lack of replication competence does not appear to be attributable to this region of the provirus . These data complement recent findings that HTRC PERV are recombinants between the PERV A and PERV C subgroups, and that these recombinants are not present in the germline of miniature swine . Together, these results indicate that these individual PERV B proviruses are unlikely to give rise to HTRC PERV.

J Mol Diagn, 2004 Aug, 6(3), 231 - 6
Detection of Mycobacterium tuberculosis complex in formalin-fixed, paraffin-embedded tissue specimens with necrotizing granulomatous inflammation by strand displacement amplification; Johansen IS et al.; Rapid, reliable diagnosis of tuberculosis is essential to initiate correct treatment, avoid severe complications, and prevent transmission . Conventional microbiological methods may not be an option if samples are formalin-fixed and paraffin-embedded (FFPE) for histopathological examination . With the demonstration of necrotizing granulomatous inflammation, tuberculosis becomes an important differential diagnosis, although it was not initially suspected . Following paraffin extraction, BDProbeTec ET strand displacement amplification for detection of Mycobacterium tuberculosis complex (MTC) was applied to 47 prospectively and 19 retrospectively collected FFPE samples from various sources with granulomatous inflammation and results were compared to tuberculosis notification . Of the prospective samples, 20 were from patients who were notified as having tuberculosis and the assay was positive in 18 (90%) . Specificity was 100% . For 27 of the patients with prospectively collected FFPE specimens, culture was performed on a specimen collected at a later date from the same location . Culture revealed MTC in 14 and nontuberculous mycobacteria in four . BDProbeTec ET was positive in 13 (92.8%) of the patients with positive MTC culture and negative in the remaining . The sensitivity and specificity in 19 archival samples was 40% and 100%, respectively, compared to notification data . The assay provided rapid, correct diagnosis on different sources of FFPE samples collected prospectively and therefore offers an important supplementary method for patients where tuberculosis was not initially suspected.

J Assoc Physicians India, 2003 Jun, 51, 585 - 8
Clinical profile in gelatinous bone marrow transformation; Sen R et al.; OBJECTIVE: To study the clinical spectrum associated with gelatinous bone marrow transformation (GMT) . METHODS: All subjects whose bone marrow aspiration showed pink purple material on Leishman stain underwent a detail history, clinical examination and investigation (biochemical/microbiological/radiological) . Additionally, in each subject the smear was stained with special stains of Periodic Acid Schiff and Alcian blue . RESULTS: Out of total 1498 marrows, 65 showed evidence of GMT . All of these had anaemia . The associated clinical spectra of diseases noticed were: Infection (31 cases), Nutritional deficiency (5 cases), Haematological disorders (Aplastic/toxic depression) (17 cases), Malignancies (3 cases), and Miscellaneous (9 cases) . CONCLUSION: Based on the heterogenecity of associated clinical disorders, GMT indicates severe illness and not a particular disease . GMT may be a result of bioregulatory process (which presently needs further prospective studies) that are activated in different pathologic conditions but resulting in similar lesion in the bone marrow and so till then it may be concluded that GMT is a symptom of bone marrow.

Am J Kidney Dis, 2004 Aug, 44(2), e15 - 7
Asaia bogorensis peritonitis identified by 16S ribosomal RNA sequence analysis in a patient receiving peritoneal dialysis; Snyder RW et al.; Here the authors report a case of refractory peritonitis leading to multiple hospitalizations and the loss of peritoneal dialysis access in a patient on automated peritoneal dialysis, caused by Asaia bogorensis, a bacterium not previously described as a human pathogen . This organism was identified by sequence analysis of the 16S ribosomal RNA gene . Unusual microbial agents may cause peritonitis, and molecular microbiological techniques are important tools for identifying these agents.

Rev Port Pneumol, 2003 Nov, 9(5 Suppl), 18 - 9
{VATS treated empyemas - retrospective analysis}; Cortesao N et al.; Parapneumonic pleural effusions (PPE) develop in up to 57% of patients admitted with bacterial pneumonia . Some effusions resolve with the antibiotic therapy while others evolve to complicated forms of PPE . The later group of patients need additional invasive therapy . One of the available therapeutic options, video-assisted thoracoscopic surgery (VATS), proved to be clinically more efficient when compared with other techniques . In fact some studies state that VATS should be considered first line treatment of PPE in a fibrinopurulent (stage 2) or organization stage (stage 3) . Despite general acceptance that complicated PPE in stage 2 or 3 should be drained, there are no guidelines regarding management or timing . We present a retrospective study of pleural empyemas treated with VATS in 394 patients (1992 to 2000) in the Thoracic Surgery Unit of CHC of which 310 (78%) were men and 84 (22%) women . Comorbidities were found in 63,1% of patients . The average age was 55,5 years (14-94) . Data with respect to symptoms, haematology and biochemical lab, microbiology and imaging, in 171 of these patients, were analysed . The most frequent symptom was chest pain, with or without associated complaints . Peripheral leukocytosis was present most frequently in stage 1 and 2 (with or without neutrophilia) . Anaemia was more prevalent in male patients, mainly in stage 3 . Thoracocentesis was performed in 61,4% of patients . A purulent pleural fluid was shown in 40% in stage 2 . When fluid pH was determined the value was inferior to 7,2 in more than 50% of stages 1 and 2 and 40% of stage 3 . Microbiological studies of pleural fluid were performed in 68,6% and cultures were positive in 17% . Loculated pleural fluid was evident in chest radiographs, ultrasound and computed tomographic studies, regardless of stage . VATS was the selected therapeutic technique in 394 patients . In 2,8% there was the need to convert VATS to thoracotomy . We registered 27 cases of surgery related complications and 3 deaths, all in stage 2 . Complications were most frequent in patients submitted to thoracotomy as compared to VATS (19,3% and 7,0%, respectively) . Complication rate was 3,2% in stage 2 and 15,4% stage 3 . Mean postoperative hospital stay was 8,7 days in the VATS group, 11,7 days in the patients that underwent thoracotomy, 12,8 days when VATS was converted to thoracotomy and 19,9 days with complicated surgery . Obtaining data was difficult, not only because this is a retrospective study, but also because most of the patients were referrals from other hospitals . Laboratory results point to two different types of pleural effusion: stage 1 and 2 with an active inflammatory process and stage 3 in which a chronic process is more evident . Imaging studies showed some degree of variability with regards to interpretation but results were in accordance with staging . Patients submitted to VATS showed lower rates of complications and shorter admissions . Surgical procedures, namely VATS, have been shown to safe, efficacious and associated to low complication rates . These results are similar to those reported in several studies . Additional studies are needed to establish criterion for the correct staging of PPE.

Rev Port Pneumol, 2003 Nov, IX(5 Suppl 1), 9 - 10
{Community-acquired pneumonia in a Pneumology Department}; Andre S et al.; Community-acquired pneumonia (CAP) is a frequent cause of hospital admission and its characterization is important to standardize medical procedures . The aim of this study was to evaluate the clinical, laboratorial and radiological presentation features of CAP, its microbiological diagnosis, management, clinical evolution and major complications . We aimed to studied prospectively patients admitted in our Pneumology Department between 2002 June and 2003 May with CAP diagnosis, using a special designed protocol . 23 patients (15 men and 8 women) were admitted . 43,5% were active smokers . Average stay length was 14,0+/-8,0 days . 43,5% of patients had associated pathology . Evolution of symptoms before admission was 5,4+/-2,8 days . Sputum production, thoracic pain, dyspnoea and fever were the most often presentation symptoms . 73,4% of patients was hypoxemic . The most sensitive laboratorial data were elevated white blood count, SR or PCR . About radiological presentation: bilateral involvement -9; unilateral </= 1lobe - 12, > lobe -2; pleural effusion associated -6; cavitation -4; atelectasis -1 . Bronchopneumonia pattern was the most prevalent (56,5%) . Microbiological diagnosis was attempted in 39% . Empirical antibiotic regimen was started in all patients . First choice antibiotics were: cephalosporin+macrolide - 6; amoxycillin/clavulanate -3; levofloxacin -2; macrolide -3; other regiments with macrolide -4 . Patients with tuberculosis diagnosis started four antituberculous agents (HRZE), streptomycin was addicted in two patients because of radiological evidence of cavitation . A second line antibiotic regimen was implemented in 10 patients after 10,7+/-6,7 days, being clinical unresponsiveness to therapy the major cause (6) . The most common complications were: parapneumonic pleural effusion -4; empyema -1; pneumothorax -1; necrotizing pneumonia -4 . Low diagnostic rate may be related to the fact that microbiological exams were made after antibiotics starting . Average stay length seems to be related with antibiotic duration and presence of complicated events . Radiological pattern was not correlated with the duration of hospital stay.

Braz J Med Biol Res, 2004 Jul, 37(7), 1015 - 21 Epub 2004 Jun 22.
An experimental model of mycobacterial infection under corneal flaps; Adan CB et al.; In order to develop a new experimental animal model of infection with Mycobacterium chelonae in keratomileusis, we conducted a double-blind prospective study on 24 adult male New Zealand rabbits . One eye of each rabbit was submitted to automatic lamellar keratotomy with the automatic corneal shaper under general anesthesia . Eyes were immunosuppressed by a single local injection of methyl prednisolone . Twelve animals were inoculated into the keratomileusis interface with 1 microl of 10(6) heat-inactivated bacteria (heat-inactivated inoculum controls) and 12 with 1 microl of 10(6) live bacteria . Trimethoprim drops (0.1%, w/v) were used as prophylaxis for the surgical procedure every 4 h (50 microl, qid) . Animals were examined by 2 observers under a slit lamp on the 1st, 3rd, 5th, 7th, 11th, 16th, and 23rd postoperative days . Slit lamp photographs were taken to document clinical signs . Animals were sacrificed when corneal disease was detected and corneal samples were taken for microbiological analysis . Eleven of 12 experimental rabbits developed corneal disease, and M . chelonae could be isolated from nine rabbits . Eleven of the 12 controls receiving a heat-inactivated inoculum did not develop corneal disease . M . chelonae was not isolated from any of the control rabbits receiving a heat-inactivated inoculum, or from the healthy cornea of control rabbits . Corneal infection by M . chelonae was successfully induced in rabbits submitted to keratomileusis . To our knowledge, this is the first animal model of M . chelonae infection following corneal flaps for refractive surgery to be described in the literature and can be used for the analysis of therapeutic responses.

An Otorrinolaringol Ibero Am, 2004, 31(3), 283 - 9
{Maxillary fungal sinusitis by Zygomicetos . Report of a case in an immunocompetent patient}; Pino Rivero V et al.; We report the clinical case of a 36 years old female without significant previous history who was diagnosed with an acute maxillary sinusitis with not responding to antibiotic treatment . After her admission we asked for a CT which showed an occupation in the left maxillary sinus with a calcified area inside suggesting a mycetoma . The patient was operated by Functional Endoscopy Sinusal Surgery (FESS) plus Caldwell-Luc techniques sending the obtained sample for microbiological study, that was reported as sinusal mycosis by Zygomicetos . The postsurgical evolution was satisfactory.

Environ Sci Pollut Res Int, 2004, 11(3), 147 - 51
Formation and emission of chloroanisoles as indoor pollutants; Gunschera J et al.; GOAL, SCOPE AND BACKGROUND: Complaints by residents of frame-houses about musty odour in the houses has become an increasing problem within the last years . An additional problem is that the odour is transferred to clothes and skin . The persons themselves do not recognize the smell after a while because of adaptation . Serious social problems are the result . For a long time, the smell was explained to be from mould due to construction-based humidity problems . However, in an increasing number of houses, no indications were found for elevated levels of mould growth . METHODS: Air and material samples were taken from 5 houses, which show typical musty odours, and analysed with respect to chlorophenols and chloroanisoles . Additionally, some samples were analysed for lindane and its metabolites, because lindane was commonly used together with pentachlorophenol (PCP) for wood protection . RESULTS AND DISCUSSION: Meticulous analysis resulted in the identification of chloroanisoles, mainly 2,3,4,6-tetrachloroanisole . These substances are known from corky wines and from contamination of food from pentachlorophenol (PCP) treated pallets and result from microbiological metabolic processes . Pentachlorophenol was commonly used to protect wood from fungi in Germany mainly in the later 60s and 70s . Details of these processes, as well as effective methods to identify chloroanisoles in the problem houses, are described . CONCLUSIONS: Chloroanisoles formed by metabolism of PCP have been well known to contaminate food or wine . Here, they were identified and are probably responsible for the musty odours in the frame houses . Since it is quite clear that these substances were not components of building materials used in the houses, an explanation for chloroanisole formation is proposed . Localized dampness probably favours microbial growth associated with metabolic conversion of chlorophenols to the corresponding chloroanisoles, primarily 2,3,4,6-tetrachloroanisol, which spread throughout the buildings, resulting in the observed odours . RECOMMENDATIONS AND OUTLOOK: The group of chloroanisoles has been recognized as important indoor pollutants as they possess musty odours at extremely low concentrations, e.g . for 2,4,6-trichloroanisole in a range of 5-10 ppt in air (Staples 2000) . On the basis of currently available toxicological data, exposure of the occupants to the concentrations of chloroanisoles measured is not associated with a health risk . No correlation could be observed between concentrations of chloroanisoles and PCP in house dust and indoor air . However, chloroanisoles are good indicators for possible PCP-treatment of wood in frame houses and their detection should initiate investigations on PCP contamination . Research is continuing to identify the microorganisms involved and to devise a remediation procedure for affected houses.

Di Yi Jun Yi Da Xue Xue Bao, 2004 Jul, 24(7), 733 - 5
{Comparison of serum biochemistry between specific pathogen-free and conventional aged Wistar rats}; Xiao YH et al.; OBJECTIVE: To investigate the differences in serum biochemistry between specific pathogen-free (SPF) and conventional aged Wistar rats . METHODS: Coulter-JT Analyzer was used to measure the values of serum biochemistry in the two grades of rats . RESULTS: The serum levels of alanine aminotransferase (ALT), total protein (TP), alkaline phosphatase (ALP), total cholesterol (TC), triglyceride (TG), blood urea nitrogen (BUN), creatinine, Fe, P, glucose, uric acid (UA), and low density lipoprotein (LDL) were very significantly different between male and female Wistar rats of either conventional or SPF grade (P<0.01), which also had significant difference in albumin, lactate dehydrogenase (LDH) and apolipoprotein B (ApoB) (P<0.05) . Between male aged Wistar rats of the two grades, the differences of TP, albumin, albumin/globulin (A/G) ratio, TC, TG, blood glucose, ApoA1, ApoB, UA, high-density lipoprotein (HDL), LDL, and glutamic oxalacetic transaminase (GOT) were very significant (P<0.01), with also significant differences in ALT, Fe, Mg (P<0.05) . Between the female rats of the two grades, the serum levels of ALT, TP, albumin, A/G ratio, ALP, TG, BUN, creatinine, Fe, ApoA1, APOB, HDL, LDL, and bile acids were very significantly different (P<0.01), and Mg was significantly different (P<0.05) . CONCLUSION: Different microbiological profiles affect serum biochemistry of aged Wistar rats.

Br J Haematol, 2004 Aug, 126(3), 372 - 6
Prospective evaluation of procalcitonin in adults with febrile neutropenia after haematopoietic stem cell transplantation; Ortega M et al.; Serum procalcitonin (PCT) levels have been proposed as a new discriminative marker for bacterial and fungal infections . We analysed the diagnostic relevance of PCT in febrile episodes of neutropenic adult patients after haematopoietic stem cell transplantation (HSCT) . PCT was determined prospectively in 92 febrile episodes, classified according to the final diagnosis as: neutropenic fever of unknown origin (n = 51), microbiological (n = 26) or clinical (n = 5) documented infection and non-infectious febrile episodes (n = 10) . On first day of fever, mean (+/- SD) PCT level was 0.3 ng/ml (0.2) in neutropenic fever of unknown origin, 0.5 ng/ml (0.7) in microbiologically confirmed infections, 0.2 ng/ml (0.2) in clinically documented infections and 1.7 (4.2) in non-infectious fever (P = not significant) . Five days after the antibiotic therapy was started, fever persisted in 29 neutropenic episodes (32%) . Cases that were eventually diagnosed with invasive aspergillosis had PCT values significantly higher {10.1 ng/ml (6.7)} than all remaining groups (P = 0.027; Kruskal-Wallis) . Our analysis indicates that the PCT level on first day of fever did not facilitate the differential diagnosis of neutropenic febrile episode . However, when fever persisted for more than 5 d, PCT values > or = 3 ng/ml had a high sensitivity and specificity for the diagnosis of invasive aspergillosis .

Br J Haematol, 2004 Aug, 126(3), 289 - 97
Advances in the molecular and serological diagnosis of invasive fungal infection in haemato-oncology patients; McLintock LA et al.; Current laboratory diagnostic methods for invasive fungal infection (IFI) in haemato-oncology patients are insensitive, resulting in late diagnosis and contributing to high mortality . In recent years, progress has been made in the development and evaluation of sensitive sero-diagnostic assays, including detection of genomic DNA sequences and fungal antigens, which aid in a rapid, early diagnosis of IFI . The sensitivity and specificity of the assays vary considerably between studies, highlighting the need to correlate serological results with conventional laboratory tests and clinical or radiological findings . As part of management protocols, these assays may help to confirm the diagnosis of suspected IFI; however, the impact on mortality from IFI may be greatest when they are used to screen high-risk patients . Persistently positive screening results could direct early aggressive antifungal therapy, guided further by radiological and microbiological findings combined with regular clinical review, while the excellent negative predictive value may allow treatment to be withheld in patients with antibiotic resistant neutropenic fever but no other signs of IFI . However, this pre-emptive approach requires evaluation in prospective randomized trials .

Pathologe, 2004 Sep, 25(5), 375 - 84
{Proposal for the classification of the periprosthetic membrane from loosened hip and knee endoprostheses}; Morawietz L et al.; After 10 years, loosening of total joint endoprostheses occurs in about 3 to 10 percent of all patients, requiring elaborate revision surgery . A periprosthetic membrane is routinely found between bone and loosened prosthesis . Further histomorphological examination allows determination of the etiology of the loosening process . Aim of this study is the introduction of clearly defined histopathological criteria for a standardized evaluation of the periprosthetic membrane . Based on histomorphological criteria and polarized light microscopy, four types of the periprosthetic membrane were defined: periprosthetic membrane of wear particle type (type I), periprosthetic membrane of infectious type (type II), periprosthetic membrane of combined type (type III), periprosthetic membrane of indifferent type (type IV) . Periprosthetic membranes of 268 patients were analyzed according to the defined criteria . The correlation between histopathological and microbiological diagnosis was high (89%, p<0,001), the inter-observer reproducibility was sufficient (95%) . This classification system enables a standardized diagnostic procedure and therefore is a basis for further studies concerning the etiology of and pathogenesis of prosthesis loosening.

Cornea, 2004 Aug, 23(6), 571 - 6
Pigmented plaque presentation of dematiaceous fungal keratitis: a clinicopathologic correlation; Garg P et al.; PURPOSE: To evaluate the clinical, microbiologic, and histopathologic features of dematiaceous fungal keratitis cases presenting with pigmented, raised, plaque-like infiltrate . STUDY DESIGN: Consecutive case series . METHODS: Microbiology-proven cases of fungal keratitis presenting with a pigmented infiltrate were included in the study . A detailed clinical and microbiological evaluation was performed in all cases . The lesion was removed by superficial keratectomy, and the specimen was subjected to histopathologic examination . Patients presenting with a large infiltrate had penetrating keratoplasty, and the corneal button was submitted for histopathology examination . RESULTS: We enrolled 15 cases in the study . There were 11 men and 4 women . The mean age of the patients was 48.5 years (range 27-68 years) . The patients presented to us with duration of symptoms ranging from 7 to 60 days (mean 27.6 +/- 15.6, median 30) . The visual acuity was better than 20/200 in 9 (60%) cases . The infiltrate size varied from 4.3 to 64 mm2 (mean 26.9 +/- 16.6, median 22.5) . Ten (66.7%) cases had a central infiltrate . The infiltrate was dry and raised, with brown to black pigmentation on its surface . Corneal scrapings revealed septate fungal filaments in all cases and the characteristic brown to black pigmentation of the fungal cell wall in 10 (66.7%) cases . Although there was a significant growth of dematiaceous fungi on culture in all cases, species identification could be done in 3 cases only . Examination of tissue sections revealed a carpet of pigmented fungal filaments on the corneal surface (n = 12, 92.3%) associated with mild to moderate inflammation (n = 11, 84.7%) and tissue destruction . Nine out of 11 cases that had keratectomy resolved with medical therapy . CONCLUSIONS: The pigmented plaque-like infiltrate in dematiaceous fungal keratitis consists of surface colonization of pigmented fungal filaments associated with mild to moderate inflammation and tissue destruction of the underlying corneal stroma.

Cell Tissue Bank, 2000, 1(1), 69 - 73
The effects of prolonged cryopreservation on the biomechanical properties of bone allografts: a microbiological, histological and mechanical study; Salai M et al.; Bone allografting is the most common form of allotransplantation in modern medicine . Bone banking is usually the major part of most tissue banks throughout the world . Several years ago, many standards of bone banking were set empirically, and have never been evaluated . One particular parameter or standard was outdating graft materials after 5 years of storage . This study was conducted to evaluate the effect of prolonged cryopreservation on the biomechanical properties of bone allografts and establish whether graft materials become contaminated during long-term storage.Proximal humeral bone allografts were obtained from the bone bank after 1, 3 and 5 years of -80 degrees C cryopreservation . Samples of each humeral head, i.e., cartilage, subchondral bone and spongy bone were histologically examined for inter- and intra-cellular changes . A three-point mechanical bending test was used on identical pieces of cortical bone to compare fresh and cryopreserved materials . Fresh-retrieved cortical bone using identically-sized segments, served as a control . Cultures were taken from each respective sample to determine contamination or sterility.Results of both the histological and mechanical testing showed that there were no significant, qualitative histological, or quantitative mechanical differences among the samples . All the cultures were negative . Therefore, based on this study's parameters, bone allografts can safely be used after a cryopreservation period of over 5 years and should not be discarded.

Cell Tissue Bank, 2000, 1(2), 111 - 5
Analysis of potential causes of positive microbiological cultures in tissue donors; Forsell JH et al.; The purpose of this statistical analysis is to determine what factors are the major contributors to bacterial contamination of recovered human cadaveric tissue . In this study we analyzed factors that could contribute to an increased bacterial bioburden from recovered tissues using the following independent variables: (1) the physical recovery environment; (2) recovery before or after an autopsy; (3) the length of time from death to recovery; (4) the cause of death; (5) the length of time to complete recovery; (6) the number of staff involved with the tissue recovery; and (7) the impact of organ and skin recovery on musculoskeletal contamination rates.In these analyses we used analysis of variance of main effects on data from seven tissue banks . The scale of the analysis included 1036 donors each having multiple cultures to better control for the inherent large variation in this type of data . We looked at several dependent variables . The dependent variable that was most useful was 'percent positive cultures'.The results of the combined data differed from analyzing the tissue banks individually . The differences in each tissue bank's procedures and techniques were responsible for most of the variability . Depending on how the data was organized, statistically significant increases in bioburden were seen with: (1) recoveries after autopsy; (2) location of the recovery; (3) length of time taken for a recovery; (4) size of the recovery team; and (5) the impact of organ and skin recovery on musculoskeletal contamination rates.In conclusion, statistical analysis of recovery cultures can be a powerful tool that may be used to indicate problems within any bank's recovery procedures or techniques.

Cell Tissue Bank, 2001, 2(3), 155 - 63
Further evaluation of amniotic membrane banking for transplantation in ocular surface diseases; Rama P et al.; Objective: To define the best conditions for amniotic membrane preparation, storage and banking in its use for corneal reconstruction . Methods: Amniotic membrane pieces were prepared under sterile conditions from placentas selected on the basis of donor medical and social history, serology, microbiological tests and histology . The pieces were kept at -140 degrees C but before grafting they were thawed and stored at 4 degrees C in RPMI medium, to have a preparation usable within 72 h . This procedure was validated by testing its therapeutic effectiveness in 25 patients 13 of which had corneal ulcers of various origin, 3 had sequelae of herpes simplex keratitis, 3 band keratopathy and 6 corneal stem cell deficiency due to chemical or thermal burns . Results: The preparation showed appreciable anti-inflammatory and analgesic effects . In the absence of corneal stem cell deficiency a stable re-epithelialisation was achieved in 15 out of 19 patients . When the limbus was lesioned, the amniotic membrane decreased vascularization and increased the number of corneal epithelial cells only in 1 of the 6 patients . No adverse reactions attributable to the tissue were recorded . Conclusions: A ready-to-use amniotic membrane preparation stored at 4 degrees C after cryopreservation has been tested in corneal reconstruction . Like the amniotic membrane thawed immediately before grafting, this preparation displayed full therapeutic effect in epithelial defects with stromal ulceration but without severe limbal stem cell deficiency . In two years banking activity 463 pieces of the preparation were successfully distributed to 90 Italian hospitals.

Cell Tissue Bank, 2003, 4(2-4), 163 - 8
The tissue bank at the national nuclear research institute in Mexico; Esther Martinez-Pardo M et al.; The Instituto Nacional de Investigaciones Nucleares (ININ, The National Nuclear Research Institute) received during 1997-1998 strong support of the International Atomic Energy Agency (IAEA), to establish the first and only one tissue bank (BTR ININ tissue bank) in Mexico that uses ionising radiation as sterilising agent . In that time, the BTR staff was trained in different tissue banks in several countries . Basic equipment for tissue processing donated by the IAEA was received in 1998 . In July, 1999 the Mexican Health Secretariat gave the Sanitary License No . 1062000001 to the BTR to operate as an official organ and tissue bank . In August, 2001 the ININ and the Hospital Materno Infantil (HMI-ISSEMYM) signed an agreement to collaborate in amnion processing . The hospital is responsible for donor selection, serology tests, tissue procurement and washing, since this hospital is the BTR amnion supplier . The tissues are collected by ININ weekly with complete documentation . The BTR is responsible for processing: cleaning, air drying, packaging, labelling, microbiological control and sterilisation by gamma irradiation . The sterilised tissue is kept under quarantine for 6 months to obtain the results of the donor second serology test . From March to June, 2002 the BTR has processed 347.86 units (50 cm(2) each), is say, 17,393 cm(2) . In addition, the pig skin xenograft process has been implemented and a protocol for clinical applications of it is running at the Hospital Central Sur de Alta Especialidad (PEMEX) . Also the ININ tissue bank present status and perspectives are described.

Semin Neonatol, 2004 Aug, 9(4), 347 - 53
Magnetic resonance imaging: an alternative to autopsy in neonatal death?
Huisman TA.
Magnetic resonance imaging (MRI) represents a non-invasive alternative to full autopsy in neonatal death if parents refuse classical full autopsy . MRI offers high resolution images of the entire neonate without disrupting the integrity of the child . Neonatal malformations or pathologies that are responsible for the death of the neonate can be identified . A major disadvantage of MR-autopsy is the lack of tissue sampling . Chromosomal, histological or microbiological analyses are consequently missing . MR-autopsy has proven to be especially helpful in the evaluation of the central nervous system but is limited in complex cardiac malformations . The limitations and possibilities of MR-autopsy are discussed .

Clin Infect Dis, 2004 Jul 15, 39 Suppl 1, S15 - 24
Randomized trial of cefepime monotherapy or cefepime in combination with amikacin as empirical therapy for febrile neutropenia; Tamura K et al.; A multicenter open randomized trial was conducted to compare cefepime monotherapy with cefepime/amikacin combination (dual) therapy in treating febrile neutropenic patients with hematologic disorders . Among the 189 evaluable patients, 5.8% had microbiologically and 10.6% had clinically documented infections . Excellent response was seen in 32.6% and 45.7% of monotherapy and dual therapy recipients, respectively, at day 3 (P=.065) . At day 3, patients with neutrophil counts of <500/ mu L receiving dual therapy had a better response than did those receiving monotherapy (45% vs . 27.6%; P=.024) . The same was true for patients with leukemia . Adverse events were minimal, and early death was observed in 7 patients in the dual therapy group and 5 patients in the monotherapy group . Overall, cefepime monotherapy is as effective as dual therapy for the initial treatment of febrile neutropenic patients . Further study is warranted for patients with severe neutropenia and leukemia who may benefit from dual therapy.

Z Orthop Ihre Grenzgeb, 2004 May-Jun, 142(3), 337 - 43
{Infection diagnosis after knee-TEP-implantation}; Kordelle J et al.; AIM: In this study, the accuracy of antigranulocyte scintigraphy as a diagnostic means prior to revision in infected total knee replacement was compared to that of preoperative joint aspiration and laboratory parameters . The most efficient combination of all diagnostic methods was calculated and thus a diagnostic algorithm recommended . The value of PCR was compared to commonly used techniques of microbiological culturing . METHODS: Preoperative diagnostic means for infection of 50 total knee replacements in 45 patients requiring revision surgery, were retrospectively analyzed . Inclusion criteria were the intraoperative microbiological and histological verification of infection . Sensitivity, specificity, negative and positive prediction value of C-reactive protein (CRP) and leukocytes, antigranulocyte scintigraphy with (99m)Tc-labeled antibodies, and preoperative joint aspiration were calculated . Furthermore, the accuracy of the different techniques of culturing was compared to that of the polymerase chain reaction (PCR) based on the intraoperative histological findings . Two blinded examiners evaluated specimens taken intraoperatively according to the criteria of Mirra . RESULTS: We observed a sensitivity of 1.0, a specificity of 0.82, a positive prediction value of 0.83 and a negative prediction value of 1.0 for the antigranulocyte scintigraphy . The sensitivity of preoperative joint aspiration was 0.5, the specificity 1.0, and the positive and negative prediction values were 1.0 and 0.5 . Correlated to the intraoperative histological findings the accuracy of PCR and culturing was comparable . The highest accuracy was obtained for blood culture samples . CONCLUSION: Compared to preoperative joint aspiration the antigranulocyte scintigraphy proved to be more sensitive in the diagnosis an infected knee replacement while having a high specificity . An advantage of PCR compared to the common microbiological culturing techniques was not observed.

Minerva Pediatr, 2004 Apr, 56(2), 189 - 95
Pulmonary tuberculosis in Italian children by age at presentation; Romano A et al.; AIM: To evaluate the clinical characteristics, diagnostic methods and outcome of paediatric pulmonary tuberculosis (PTB) in relation to children's ages when observed . METHODS: Children under 15, who had been admitted to the Children's Hospital with PTB were prospectively evaluated . Our sample included patients with a positive tuberculin skin test and signs or symptoms of tuberculosis (TB), including abnormal chest X-rays which suggested PTB . We collected demographic, clinical, radiographic and microbiological data from the patients, in addition to carrying out contact investigations in order to find a source case . All the patients involved in this study were subjected to anti-tuberculosis treatment . RESULTS: Sixty-two patients (44% under 5) were eligible for inclusion in our study . Children with presenting symptoms were younger than asymptomatic patients (p<0.05) . A source case was found in 38 patients out of 62 children (62%) and children under 5 were more likely to have a source case than that found with older children (p<0.05) . Ghon complex (infiltrate + adenopathy) tended to occur in young children (median age of 3.25, p<0.05) . Fourteen children (23%) had clinical specimens which tested positive for Mycobacterium tuberculosis (MT), and 20 (32%) for MT DNA according to a polymerase chain reaction (PCR) . Resistant strains to 1 or more anti-tuberculosis drugs were found in 5 children and in 4 adult sources . The patients with minimal or no radiographic change during therapy displayed symptoms for a longer period of time and were infected by a resistant strain (p<0.05) . CONCLUSION: Improvements in case detection, case management and contact investigations are necessary for controlling paediatric TB, especially in young children . Given that any diagnosis of TB in children is supported by epidemiological and clinical evidence rather than isolating MT, detection of the source case is important in selecting appropriate treatment.

Biochem Biophys Res Commun, 2004 Aug 6, 320(4), 1118 - 22
Inhibition of gene expression with double strand RNA interference in Entamoeba histolytica; Kaur G et al.; In order to inhibit gene expression in Entamoeba histolytica, we have developed a method based on expressing double strand RNA interference constructs in stable transformants . The 5' end of Eh Dia was cloned head to head with an intervening non-specific stuffer fragment in the E . histolytica expression vector pJST4 . This construct was transformed in E . histolytica HM1:IMSS trophozoites and stable transformants were selected with 20microg/ml G418 . Our results show that expression of Eh Dia was completely inhibited in these transformants . These stable transformants could be maintained indefinitely without expression of Eh Dia . This method therefore provides an effective tool to study the phenotypic changes, which occur due to inhibition of gene expression in the absence of mutants and other microbiological manipulations in this protozoan parasite.

Rev Neurol (Paris), 2004 Jul, 160(6-7), 713 - 5
{Intra-cavernous aneurysm of the internal carotid artery complicating sphenoid sinusitis}; Philippeau F et al.; INTRODUCTION: Mycotic or post-infectious aneurysm of the intra-cavernous portion of the internal carotid artery is uncommon . CASE REPORT: We report here the case of a patient who developed progressive left ophthalmoplegia, with left hemi-crania three weeks after a tooth extraction . The patient was febrile . Neuroradiological and microbiological analysis led to the diagnosis of sphenoidal and ethmoidal sinus infection with extension to the left cavernous sinus . An aneurysm of the intra-cavernous portion of the left internal carotid artery was also found . CONCLUSIONS: The risk of rupture for this kind of aneurysm is difficult to assess . Treatment always consists in prolonged and adapted antibiotic therapy . For certain patients neurosurgical or endovascular repair is necessary . We followed our patient for four Years without surgical intervention . The diameter of the aneurysm has remained stable.

Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2004 Jul, 98(1), 119 - 23
Mycetoma of the maxillary sinus: endodontic and microbiological correlations; Mensi M et al.; OBJECTIVE: The purpose was to show the capacity of zinc oxide and eugenol to affect the growth of Aspergillus fumigatus . STUDY DESIGN: An in vitro microbiological analysis was conducted on samples from infected maxillary sinuses and on 3 different endodontic sealers . RESULTS: Tests showed that zinc oxide in solution favors the growth of Aspergillus fumigatus, while eugenol inhibits this growth, even when mixed with zinc oxide powder . This inhibiting effect decreases over time . A reduced effectiveness was demonstrated over a 75-day period . CONCLUSIONS: The hypothesis is that the diminishing concentration of eugenol over time in endodontic sealers allows the zinc oxide to support growth of Aspergillus fumigatus . This is reinforced by clinical experience, where mycetoma has developed years after endodontic therapy with excess sealer in the maxillary sinus.

J Clin Microbiol, 2004 Jul, 42(7), 3353 - 5
Clinical and microbiological analysis of bloodstream infections caused by Chryseobacterium meningosepticum in nonneonatal patients; Lin PY et al.; Chryseobacterium meningosepticum bloodstream infections in 11 nonneonatal patients were reported . More than half of the infections were community acquired . PCR assays indicated that the organisms produced extended-spectrum beta-lactamases as well as metallo-beta-lactamases . Genotyping showed diverse fingerprints among the isolates . Six patients survived without appropriate antibiotic treatment . Host factors are the major determinant of the outcomes of C . meningosepticum infections.

Indian J Exp Biol, 2003 Sep, 41(9), 1012 - 22
Microbiologically influenced corrosion in petroleum product pipelines--a review; Muthukumar N et al.; Microbiologically influenced corrosion is responsible for most of the internal corrosion problems in oil transportation pipelines and storage tanks . One problematic area in treating gas lines is the occurrence of the stratification of water in the line . Under these conditions, corrosion inhibitors do not come into contact properly and oil and inhibitors undergo degradation . The role of bacteria on oil degradation, the consequences of oil degradation in fuel systems and its influence on corrosion have been explained in detail . Besides, factors influencing on degradation of oil and corrosion inhibitors have also been discussed . Mechanism of microbiologically influenced corrosion in oil pipeline has been explained . Many of the misapplication of biocides/inhibitors occur mainly because the characteristics of biocides/inhibitors are not considered before use in pipeline industry . List of biocides and monitoring programme have been collected from literature and presented.

Scand J Immunol, 2004 Jul-Aug, 60(1-2), 184 - 8
Mannan-binding lectin and RSV lower respiratory tract infection leading to hospitalization in children: a case-control study from Soweto, South Africa; Kristensen IA et al.; Respiratory syncytial virus (RSV) is the most important microbiological cause of lower respiratory tract infection (LRTI) in infants . Mannan-binding lectin (MBL) is believed to play a major protective role in the vulnerable period in infancy where the maternal antibodies have been catabolized, and the adaptive immune system has not yet matured . Mutations in the promoter region and in exon 1 of the gene-encoding MBL result in low serum levels of MBL . MBL deficiency is the most common immunodeficiency on the African Continent with frequencies of the variant alleles up to 0.29 . We investigated whether MBL deficiency has an impact on the hospitalization for LRTI caused by RSV in infants from Soweto, South Africa . The cases were ethnic black Africans identified through surveillance for RSV-LRTI at Chris Hani Baragwanath Hospital, Soweto, and the controls were sampled from four immunization clinics in the area . Fifty-five cases and 113 age- and sex-matched controls were identified . Seventy-six per cent were under 6 months of age, and 42% (n = 23) were under 3 months of age . No association was found between low levels of MBL or carriage of variant alleles and LRTI caused by RSV, odds ratio (OR) 1.00 (CI 0.99-1.03) and OR 1.24 (0.73-2.12) . We did not find support for the hypothesis that MBL deficiency leads to the hospitalization for LRTI caused by RSV.

J Postgrad Med, 2004 Apr-Jun, 50(2), 115 - 7
Abdominal mass secondary to actinomyces infection: an unusual presentation and its treatment; Sumer Y et al.; Abdominal actinomycosis may appear as an abdominal mass and/or abscess . This mass can mimic a malignant tumour . The diagnosis and management of abdominal actinomycosis will be discussed through a review of the literature and a case report from our own institution . The patient was a 17-year-old boy who presented with abdominal discomfort and a palpable right lower quadrant mass defined on CT scan . He underwent en bloc resection of the mass for a presumed diagnosis of tumour of uncertain type with intestinal involvement . The diagnosis was reversed, when histology revealed filamentous organisms consistent with actinomyces . He was treated with high dose penicillin for several weeks and was discharged from the hospital taking penicillin orally . Preoperative diagnosis of abdominal actinomycosis is difficult . An accurate diagnosis is always obtained in a histological or microbiological examination, often requiring surgical resection . Recognition is important because successful treatment requires combined surgery and prolonged penicillin treatment.

Int J Infect Dis, 2004 Jul, 8(4), 236 - 43
Plasma fibronectin as a marker of sepsis; Ruiz Martin G et al.; OBJECTIVES: To evaluate the value of plasma fibronectin (pFN) as a diagnostic marker of sepsis . SUBJECTS AND METHODS: Plasma FN was determined in patients showing sepsis-related symptoms who had blood cultures performed . These patients were assigned to one of two groups according to their clinical situation: (1) Clinical Septic Group: patients with sepsis according to American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) criteria; (2) Fever Peak Group: patients who did not fulfil sufficient ACCP/SCCM criteria for sepsis . Two additional control groups were also established: (3) Non-infectious Diseases Control Group and (4) Healthy Control Group . RESULTS: Plasma FN levels, microbiological and clinical data were compared among the different patient groups . For each group, the number of patients, median and mean pFN levels and the 95% confidence interval of the mean were: (1) n = 43, 102 mg/l, 122 mg/l (100-144); (2) n = 70, 185 mg/l, 207 mg/l (184-231); (3) n = 22, 175 mg/l, 181 mg/l (151-211); and (4) n = 22, 256 mg/l, 261 mg/l (229-292) . Bonferroni's test of multiple comparisons was able to detect a significant difference between pFN concentrations corresponding to the septic group, compared to the remaining groups (pANOVA < 0.001 ) . CONCLUSION: Plasma FN appears to act as a marker of sepsis in that patients showed diminished pFN levels . Along with other clinical and laboratory variables, the use of this marker would allow a rapid diagnosis of sepsis and limit the number of blood cultures to be processed and the number of antibiotic prescriptions, particularly when symptoms are insidious and diagnosis is doubtful . We propose further and more complex studies using a higher number of patients.

Dtsch Tierarztl Wochenschr, 2004 May, 111(5), 195 - 200
{Predictive microbiology and risk assessment}; Hildebrandt G et al.; Predictive microbiology (predictive modelling PM), in spite of its limits and short-comings, may often contribute to a reduction of the problems arising when HACCP systems are established or microbiological risk assessment is done . Having identified the agents which constitute a risk and the contamination rate and density in the raw material, the influences of production steps and storage on these microorganisms have to be examined . Finally, there should be an exposure assessment, i.e . an estimate of the contamination density in the final product at the time of consumption . Should the exposure assessment together with data from dose response assessments reveal a potential for intake of inacceptable numbers of organisms, the risk identified has to be characterized . As a consequence, risk management should result in a modification of the composition of the product and/or of the production process so that the risk does not surpass an acceptable limit . For this approach it is indispensable to have product- and process-specific information on the multiplication of pathogens prior to heat treatment, on reduction of their density by thermal treatment and on growth or dying of organisms having survived heat treatment or penetrated into the product after heat treatment as post-process contaminant . Commonly, challenge tests are conducted to provide such information . But they are time consuming and, as their results are only valid for the specific product tested and the conditions prevailing during the experiment, the have to be repeated if there is any modification of intrinsic or extrinsic factors . At least partially, the PM may replace the challenge tests . The efficiency of the models is rated particularly high if they are used already at the stage of product development when the question has to be answered whether a planned recipe or process of production are already save or have to be modified to become save.

Dtsch Tierarztl Wochenschr, 2004 May, 111(5), 188 - 92
{Quantitative microbiological analysis--impacting factors as demonstrated with the aerobic plate count}; Fries R; The real number of viable cells in a sample is generally unknown . In order to get a real reflection of the number of bacteria, impacting factors must be taken into consideration and must be kept comparable . Important preconditions for the assessment and comparison of quantitative microbiological data are: Samples should be taken and prepared under circumstances as identical as possible (stage of sampling and quality of the material), structure of the laboratory technique must be comparable (preparation of the first dilution, technique of plating, media and incubation circumstances), the personal factor must remain under control as far as possible (performance of the analyses in daily work, skills of all technicians).






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