Microbial

Cornea, 2004 Jan, 23(1), 3 - 12
Keratitis due to a coelomycetous fungus: case reports and review of the literature; Kaliamurthy J et al.; PURPOSE: To describe a series of 7 patients with ulcerative keratitis caused by species of Colletotrichum, which are coelomycetous fungal pathogens . METHODS: The patients presented with keratitis of varying degrees of severity . Multiple scrapes from the corneal lesions of 6 of the 7 patients were used for microbiological investigations by a standard protocol . In the seventh patient, scraping was not performed due to the presence of deep infiltration and a descemetocele at presentation . All 7 patients were hospitalized and treatment was initiated with topical applications of natamycin (5%) and ciprofloxacin (0.3%) every hour and cyclopentolate (1%) drops 3 times daily . An emergency therapeutic penetrating keratoplasty was performed after 48 hours in the patient who had presented with a descemetocele and for another patient whose keratitis did not respond to 10 days of medical therapy . RESULTS: The corneal samples of all 7 patients yielded significant growth of filamentous fungi in culture . On the basis of macroscopic and microscopic characteristics, the fungal isolates were identified as Colletotrichum spp . Corneal lesions completely resolved with medical therapy alone in 5 patients . In the 2 patients who had undergone therapeutic penetrating keratoplasty, the infection was eradicated and the corneal graft remained clear even after several months of follow-up . CONCLUSION: Colletotrichum spp may be more frequent causes of keratitis than previously thought . Keratitis due to Colletotrichum spp frequently responds to medical therapy alone, although surgery may be indicated in a small proportion of patients.

An Pediatr (Barc), 2003 Nov, 59(5), 477 - 83
{Techniques and complementary techniques . Fiberoptic bronchoscopy in mechanically ventilated children}; Perez Ruiz E et al.; Fiberoptic bronchoscopy can be performed at the patient's bedside . This technique allows direct visualization of the upper and lower airways up to the segmental and subsegmental bronchi . Its most frequent indications are airway examination ot evaluate damage produced by toxins or the endotracheal tube, patency of the endotracheal tube and extubation failure . It is also used to obtain microbiological samples, facilitate intubation when difficult, aspirate airway sections or mucus plugs, perform bronchoalveolar lavage and administer drugs . With prior preparation, adequate monitoring and sedation, material according to the size of the patient and correct techniques, there are few complications . However, the procedure can produce trauma and obstruction of the airway, bronchial hemorrhage, barotrauma, loss of alveolar recruitment, bronchospasm, hypoxemia, bradycardia, and bronchopulmonary infection.

Arch Latinoam Nutr, 2003 Sep, 53(3), 282 - 6
{Microbiological and physicochemical evaluation of pasteurized nectar elaborated with tree tomato (Cyphomandra betaceae Sendth)pulp}; Moreno Alvarez MJ et al.; Tree tomato (Cyphomandra betaceae Sendth) is a species from high tropical regions . In Venezuela, it is cultivate at the Andean and Aragua state but its consumption is restricted as fruit-fresh, though it a nutritious and industrial potential due its provitamin A content . In this research four nectars were elaborated in proportion I L pulp/4 L of water (1:4) and addition of ascorbic acid (I: 0%; II: 0.5%; III: 1.0 y IV: 1.5%) . The nectars were pasteurized (60 degrees C for 30 min), tuned into amber bottle, and stored under refrigeration conditions (7.0 +/- 1.0 degrees C) . Weekly during 21 days the mesophilic bacteria, molds, yeasts, total coliforms (MPN/mL), pH, degree Brix, acidity, total carotenoids, vitamin C and total sugars were evaluated . The mesophilic bacteria content was < 200 UFC/mL for every formulation on the first day the evaluation, molds and yeasts were < 10 UFC/mL and the total coliforms (NPN/mL) < 3 until the third evaluation . No significant differences (P > 0.05) were founded on: pH . degree Brix and total sugars . Significant differences (P < 0.05) were founded in vitamin C and total carotenoids content . Sensorial analysis did not show significant differences between formulations for the smell and flavor attributes, when the color was discriminate during the evaluations . The formulation I (without acid ascorbic) had more preference due its color . In conclusion, the nectars showed useful life of 14-21 days under refrigeration condition storage due to the adequate physicochemical and microbiological quality of the product.

J Clin Pathol, 2004 Jan, 57(1), 1 - 5
Best Practice No 175 . Guidelines for virological and non-viral serological examination of specimens in routine diagnostic microbiological laboratories; Francis J et al.; Viral examination is routinely carried out in most routine diagnostic microbiology laboratories . Most often, this comprises the detection of viral antigens and antibodies, and less commonly the isolation of viruses and the detection of viral nucleic acids . However, there are no standards or guidelines available for processing these specimens in routine diagnostic laboratories or for referral to specialist virology centres or units . Clinical Pathology Accreditation (CPA) has defined standards for assessing the quality of service provided by laboratories, but these do not include the scientific and technical aspects of provision of service . The Association of Medical Microbiologists has recently published Standards for Laboratory practice in medical microbiology, which covers scientific and technical aspects of provision of microbiology service, mainly bacteriological examination of specimens in routine diagnostic microbiology laboratories . These guidelines are complementary to the CPA guidelines and aim to ensure a consistent and high quality service . This article presents guidelines for the examination of specimens for the diagnosis of viral infections.

J Colloid Interface Sci, 2004 Feb 1, 270(1), 47 - 55
Cu(II) retention on a humic substance; Alvarez-Puebla RA et al.; Humic substances (HS) are macromolecular products derived from a physical, chemical, and microbiological process called "humification." These substances play an important role in the mobility and bioavailability of nutrients and contaminants in the environment . Adsorption isotherms provide a macroscopic view of the retention phenomena . However, complementary techniques are needed in order to study the retention mechanism . The application of the classical models and some modern ones, based on humic substances chemistry, do not accurately describe these adsorption data . The aim of this paper is to model isotherms and combine adsorption data with spectroscopy and microscopy techniques to study the Cu(II) retention on a HS . The adsorption isotherms shape varies significantly with the solution pH from L-type (pH 2-6) to S-type (pH 8) . FTIR shows that, when pH is 2 the retention of Cu(II), as {Cu(H(2)O)(6)}(2+), is the preferred retention mechanism . The quantity of Cu(II) retained as {Cu(OH)(H(2)O)(6)}(+) rises, as pH increases . At pH 4, Cu(II) begins to precipitate, which is the preferred mechanism at pH 8.02 . The presence of HS has a great influence on the precipitation process of Cu(II), giving rise to amorphous precipitates . As it is shown by SEM-XRF, Cu(II) distributes heterogeneously on HS surface and accumulates on the humic phases . The presence of different anions (chloride and nitrate) slightly modifies the HS behavior as cation exchanger . When Cl(-) ions are present, part of the Cu(II) form {CuCl(4)}(2-), which is stable in solution due to its negative charge; when the anion present is NO(3)(-) the formed complex, {CuNO(3)}(+), is retained on the HS.

Srp Arh Celok Lek, 2003 Jul-Aug, 131(7-8), 285 - 9
{The cellular immune reaction in synovial fluid lymphocytes to Ureaplasma antigens in patients with Reiter's syndrome}; Pavlica L et al.; INTRODUCTION: Reiter's syndrome (RS) is an seronegative arthritis that occurs after urogenital or enteric infection which in addition with occular and/or mucocutaneous manifestations presents complete form of disease . According to previous understanding arthritis in the RS is the reactive one, which means that it is impossible to isolate its causative agent . However, there are the more and more authors suggesting that arthritis in the urogenital form of disease is caused by the infective agent in the affected joint . This suggestion is based on numerous studies on the presence of Chlamydia trachomatis and Ureaplasma urealyticum in the inflamed joint by using new diagnostic methods in molecular biology published in the recent literature {1-3} . Besides, numerous studies of the humoral and cell-mediated immune response to "triggering" bacteria in the affected joint have supported previous suggestions {4-7} . Aim of the study was to determine whether synovial fluid T-cells specifically recognize the "triggering" bacteria presumably responsible for the Reiter's syndrome . METHOD: The 3H-thymidine uptake procedure for measuring lymphocyte responses was applied to lymphocytes derived concurrently from synovial fluid (SF) and from peripheral blood (PB) {8} . Ureaplasma antigen and mitogen PHA stimulated lymphocytes in 24 RS patients (24 PB samples, 9 SF samples) and the results were compared with those found in 10 patients with rheumatoid arthritis (RA) (10 PB samples, 5 SF samples) . Preparation of ureaplasma antigen . Ureaplasma was cultured on cell-free liquid medium {9} . Sample of 8 ml was heat-inactivated for 15 minutes at 601C and permanently stirred with magnetic mixer . The sample was centrifuged at 2000 x g for 40 minutes and than deposits carefully carried to other sterile glass tubes (Corex) and recentrifuged at 9000 x g for 30 minutes . The deposit was washed 3 times in sterile 0.9% NaCl, and final sediment was resuspended in 1.2 ml sterile 0.9% NaCl . BACTERIOLOGY: Chlamydia trachomatis was isolated by cell culture using cycloheximide-treated McCoy cells {10}, while Ureaplasma urealyticum was identified according to its biochemical properties grown on cell-free liquid medium {9} . RESULTS: Proliferative response of the PB lymphocytes to stimulation by mitogen and ureaplasma antigen did not differ between RS and RA patients . Also, there was no difference in proliferative response of SF lymphocytes to mitogen stimulation between RS and RA patients (Figure 1) . However, proliferation of SF lymphocytes stimulated by ureaplasma antigen was significantly elevated in RS patients compared with the control group . This difference is statistically significant (p < 0.05) (Figure 2) . Difference in proliferative response of the PB and SF lymphocytes stimulated by the ureaplasma antigen was not found in RS patients . DISCUSSION: It was found that SF lymphocytes of RS patients showed significantly elevated proliferative response to stimulation by the ureaplasma antigen compared with SF lymphocytes of the control group . There was no difference when the lymphocytes were stimulated by the mitogen . Our findings suggest that elevated proliferative response of lymphocytes is the sign of stimulation cell-mediated immunity to antigen present in inflamed joint . Hence, the main immune response to Ureaplasma is on the cell-mediated level in the affected joint . This confirms the earlier finding reported by Ford et al . who concluded that synovial rather than peripheral blood lymphocytes indicate the microbiological cause of arthritis {11, 12} . Horowitz et al . demonstrated the correlation between clinical remission after antibiotic therapy and eradication of Ureaplasma, together with a decrease in cellular immune response synovial fluid lymphocytes to ureaplasma antigen stimulation {13} . In that study Horowitz did not find statistically significant difference of ureaplasma proliferative response between PB and SF lymphocytes in patients with RS . We obtained the same results . Than we concluded that sensibilization of immune system exist in the presence of foreign antigen in RS patients . The other authors demonstrated higher stimulation indices than the ones we found in our patients {11-15} . This difference may be the result of different preparation of antigens, in other words selection of serotype of Ureaplasma for antigen preparation different conditions of lymphocyte cultivation . We concluded that the presence of antigen, antigen-specific T cells and efficient antigen-presenting cells (CD4+ T cells) in the joint of RS patients strongly suggests that a T-cell-mediated response to bacteria has the central role in the pathogenesis of Reiter's syndrome.

Occup Environ Med . 2004 Jan;61(1):e3.
Microbiological evolution of hay and relapse in patients with farmer's lung; Roussel S et al.; BACKGROUND: Recent studies in France have shown that Absidia corymbifera and, to a lesser degree Eurotium amstelodami and Wallemia sebi, play a role in farmer's lung disease (FLD), but that Saccharopolyspora rectivirgula, classically incriminated, does not . Little is known about farmers' reactions to these fungi or the circumstances which lead to exposure . AIMS: To investigate the conditions which favour the development of these microorganisms in hay and to analyse the relation between their concentration and the risk of occurrence of FLD . METHODS: Sequential microbiological analyses of each batch of hay stored in 10 farms at risk for FLD and a serological survey of 10 farmers (five with a past history of FLD) . RESULTS: Exposure to microorganisms varied widely according to farms and periods . These microorganisms usually reached a peak in January and proliferated when harvesting conditions favoured excessive humidity in hay (rain during harvest, soil in the hay) . Three of the five FLD patients presented with FLD respiratory recurrence and positive serology for A corymbifera during the winter (2000-01), after exposure to a significantly higher amount of A corymbifera than other farmers . Similar, but less significant, results were found for E amstelodami exposure, but not with W sebi . CONCLUSIONS: Results contribute to confirming A corymbifera as a major aetiological agent of FLD in Doubs, and encourage further studies with a view to implementing preventive measures.

Int J Infect Dis, 2004 Jan, 8(1), 13 - 9
Human papillomavirus cervical infection in Guarani Indians from the rainforest of Misiones, Argentina; Tonon SA et al.; OBJECTIVE: To evaluate the prevalence of human papillomavirus (HPV) cervical infection in women from the South American Guarani Indian tribe located in the rain forest of Misiones, north-eastern Argentina; a region with a high incidence of cervical carcinoma . METHODS: A cross-sectional cytological and HPV screening of sexually active Guarani women from nine Indian settlements was conducted . Demographic data, information about sexual behavior, and gynaecological history were recorded . Fresh cervical specimens from 239 patients were collected, of which 207 were included in this study . Cytology and microbiological detection were carried out by the Papanicolaou and Gram stain methods, respectively . HPV detection and typing were analyzed by PCR and RFLP . RESULTS: Pap smears in 96% of all patients showed an inflammatory pattern . A possible etiologic agent was found in 58% of cases: 52% Trichomonas vaginalis, 35% Gardnerella vaginalis and 13% Candida sp . Seven cases had cytological changes compatible with Low Grade Intraepithelial Lesion (LGSIL), one with High Grade Intraepithelial Lesion (HGSIL) and one in situ cervical cancer . The prevalence for generic HPV infection was 64% (133/207) . Genotyping gave a 26% prevalence for HPV types 16/18, 13% for types 6/11 and 30% for other types, with nine mixed infections . CONCLUSION: This work reports for the first time the prevalence of cervical HPV infection in Guarani women . Nearly all Guarani women had some grade of cervical disease . Generic HPV infection prevalence was elevated (64%), with predominance of high risk types 16/18 . A large variety of viral types was detected, including high to intermediate risk types not found previously in the region.

Int J Infect Dis, 2004 Jan, 8(1), 5 - 12
Infectious diseases in the 21st century: old challenges and new opportunities; Waldvogel FA; Infectious diseases are the confrontation of two worlds, the microbial world and the world of human physiology . Although these two worlds are as a whole governed by the same laws of nature, they show substantial differences: the microbiological world is 1000 times older, and was initiated by the development of the archaea, the 'living organisms of the extreme': its biomass and its diversity are immense - two to three billion species or 60% of the total biomass of the planet . The number of pathogens that adapted to man, however, is extremely limited - barely 1000 . Thus, over billions of years, an evolution of the microbial world took place from 'early life', characterized by chemosynthesis, to the 'modern pathogens', and entailed a dramatic 'concentration' of life conditions and an adaptation towards a narrow range of requirements - those allowing survival in the human body . Within the last two centuries, these two slowly evolving systems, microbial life and human life, were profoundly modified in an unprecedented manner by a third player, human civilization, with its global impact on the environment through physical, chemical, societal, and climatic determinants . An appreciation of the evolution of infectious diseases in the 21st century and of the development of new diagnostic and therapeutic strategies therefore requires a full understanding of these three domains: human physiology, microbiology, and the environment.This review will put major emphasis on the environmental role of civilization on infectious diseases before considering new opportunities to combat them through novel and creative solutions.

Int J Oral Maxillofac Surg, 2004 Jan, 33(1), 105 - 7
An adult case of oral infection with Kingella kingae; Van Damme PA et al.; An exceptional case of microbiologically confirmed oral infection with Kingella kingae in an immunocompetent adult (30-year-old woman) is presented and the pathogenesis is discussed and related to known literature data.K . kingae is a rather common but yet relatively unknown commensal corroding bacterium from the oro- and nasopharynx in healthy children, which might turn into a human pathogen causing osteomyelitis, arthritis, spondylitis, endocarditis and intervertebral diskitis in young children and rarely endocarditis, septic arthritis, meningitis, epiglottitis, diskitis and bacteraemia in adults . Sofar K . kingae associated stomatitis was reported in children and a few adults, however, with concomitant herpes simplex virus infections, and without microbiological confirmation . In the described case no viral infection was found . The proven K . kingae stomatitis represents an extension of the pathogenic spectrum and suggests that the breach of the oral mucosal barrier can be caused by the bacterial pathogen itself . Whether a concomitant viral infection is necessary forK . kingae to actually invade the bloodstream remains to be considered.

Clin Nephrol, 2003 Dec, 60(6), 415 - 23
Disseminated ochroconis gallopavum infection in a renal transplant recipient: the first reported case and a review of the literature; Wang TK et al.; Ochroconis gallopavum is a potentially fatal dematiaceous fungus causing opportunistic infections in immunocompromised hosts . We report the first case of disseminated O . gallopavum infection in a 13-year-old renal transplant recipient, which involved the brain, lung and spleen . He was treated with amphotericin B, itraconazole and voriconazole, a new antifungal agent first used to treat such an infection . Besides antifungal treatment, all immunosuppressive agents were stopped and automated peritoneal dialysis was resumed . The initial infection was under control with both clinical and radiological improvements after treatment . However, the patient later acquired Acremonium spp . peritonitis; he failed to respond to high-dose amphotericin B, and finally succumbed . A total of 13 reported O . gallopavum human infections, including the one described here, are reviewed . The most common site of involvement is the brain and the crude mortality rate is up to 46% . As the disease is potentially lethal in immunocompromised hosts, empirical antifungal coverage should be considered in post-renal transplant recipients with suspected brain abscess . Early biopsy of lesion for histopathological and microbiological diagnosis would be essential in managing such cases.

Pediatr Infect Dis J, 2003 Dec, 22(12), 1075 - 8
Penicillin concentrations in sera and tonsils after intramuscular administration of benzathine penicillin G to children; Peloso UC et al.; BACKGROUND: The optimal regimen of benzathine penicillin G for secondary prevention of rheumatic fever is controversial . Data from serum pharmacokinetic studies do not fully agree on the period of protection after drug administration . Data from concentration of penicillin in tonsils may provide additional information . METHODS: To evaluate penicillin concentrations in palatine tonsils and in sera 1, 10, 14 and 21 days after intramuscular injection of benzathine penicillin G 40,000 IU/kg, 58 children between 4 and 12 years of age with chronic tonsillitis and indication for tonsillectomy were given the study drug 1, 10, 14 or 21 days before surgery . Blood and tonsil samples were obtained during surgery, and penicillin concentrations were determined microbiologically by the agar well diffusion technique . RESULTS: Mean serum penicillin concentrations 1, 10, 14 and 21 days after drug administration were, respectively, 0.080, 0.031, 0.023 and 0.014 microg/ml . Mean penicillin concentrations in tonsils at 1, 10, 14 and 21 days were 0.023, 0.010, 0.007 and 0.002 microg/g, respectively . Detectable penicillin concentration in tonsils (method sensitivity, 0.006 microg/g) was obtained in all patients on Day 1 and in 91% and 83.3% of patients on Days 10 and 14, respectively . By Day 21 this proportion was reduced to 30% . CONCLUSIONS: The results of this study suggest that penicillin values may be inadequate for prevention of rheumatic fever by Week 3 of administration in a majority of children.

Infect Immun, 2004 Jan, 72(1), 62 - 5
Mycobacterium bovis BCG vaccination as prophylaxis against Mycobacterium ulcerans osteomyelitis in Buruli ulcer disease; Portaels F et al.; Mycobacterium ulcerans disease, or Buruli ulcer (BU), causes significant morbidity in West Africa . Clinically, the disease presents in the skin as either nonulcerative or ulcerative forms and often invades bones either subjacent to the skin lesion (contiguous osteomyelitis) or remote from the skin lesion (metastatic osteomyelitis) . Osteomyelitis represents a severe form of the disease that often requires numerous surgical interventions, even amputations . Surgery is accepted as the present definitive treatment for BU . In the absence of an effective drug treatment, the need for the development of preventive and control strategies becomes paramount . No specific vaccine, however, is presently available for BU . Of 372 consecutive patients in Benin presenting with BU (confirmed by microbiological and histopathological analyses) whose Mycobacterium bovis BCG scar statuses were known, 196 children (<15 years old) and 108 adults had neonatal BCG vaccination scars . Of 196 children with BCG scars, 17 (8.7%) had osteomyelitis, while 7 of 28 children without BCG scars (25.0%) had osteomyelitis . Of 108 adults with BCG scars, 17 (15.7%) had osteomyelitis, while 14 of 40 adults without BCG scars (35.0%) had osteomyelitis . Our results show that effective BCG vaccination at birth provides significant protection against the development of M . ulcerans osteomyelitis in children and adults . Therefore, health authorities should give attention to the enhancement of neonatal BCG vaccination coverage in all countries of Africa where BU is endemic . Protection against severe forms of BU and childhood tuberculosis would likewise be improved by this intervention.

Orv Hetil, 2003 Nov 2, 144(44), 2147 - 57
{Microbiological and serological diagnostic methods to detect intrauterine and perinatal infections}; Kristof K et al.; Due to the revolutional development in sampling devices, transport media, automated equipments, microvolume probes and molecular microbiological techniques in the last decade new possibilities have become available for diagnosing microbiologically congenital infections in both the mother and the foetus and the newborn . This minireview gives an insight into the diagnostic tuls of clinical microbiology and infection serology by showing laboratory diagnostic processes of most frequent protozoal, viral and bacterial infections step-by-step . It exhibit an almost complete list of transplacental, intrauterinal and connatal infections . Attention is also focused to the complexity of the interrelationship between the clinical microbiology and infection serology data concerning the infections of the mother and her offspring.

Semin Respir Infect, 2003 Dec, 18(4), 272 - 91
Pediatric tuberculosis; Loeffler AM; Pediatric tuberculosis (TB) is different than that in adults in several ways . (1) The diagnosis of TB is more difficult in children due to non-specific or complete absence of symptoms and difficulty in confirming the diagnosis microbiologically . (2) Young children suffer more extrapulmonary and disseminated TB than adults . (3) Treatment of TB in children is challenging due to the lack of pediatric drug formulations and challenges in monitoring for toxicity . Fortunately, children generally do very well with treatment and tolerate the medications well . Treatment regimens are very similar to those used in adults . Four drug treatment should be initiated for treatment of presumed active TB if there are any risks of drug resistance in the child or adult source case (including residence or travel to an area where there is > 4% resistance to INH) . (4) Children should be TB skin tested only if they have risks for TB infection, are likely to progress to active TB, or are suspected of having active TB . Unlike adults, all children should be treated for latent TB infection if identified because the therapy is very safe in young people, they were likely to have been infected relatively recently, and they have a long time to reactivate their latent infection . (5) Young children are not contagious with active TB and acquired their disease from shared airspace with adolescents or adults with pulmonary TB or ingestion of unpasturized milk products (M . bovis).

Boll Chim Farm, 2003 Sep, 142(7), 277 - 84
Stability studies of tablets containing 5 mg of policosanol; Cabrera L et al.; The stability studies of tablets containing 5 mg of policosanol, a new cholesterol lowering drug, were conducted to predict an expiration date and to search the appearance of putative degradation products . All quality parameters such as colour, moisture content, hardness, disintegration, policosanol content and microbiological limits of the tablets were assessed . The effect of extreme treatments such as acid and basic hydrolysis, oxidative and photolytic degradation as well as thermal degradation, on the policosanol content was studied . In addition, studies under extreme conditions of storage {(40 +/- 2) degree C and (75 +/- 5)% R.H.} as well as 37, 45, 55 and 60 degrees C combined with 50, 75 and 92% R.H.) and under ambient conditions of storage for climatic zones II and IV were performed . These studies demonstrate that these tablets are a stable pharmaceutical formulation, without significant changes in their quality criteria at the stressed conditions used, so that policosanol content remains unchanged during the entire studies . The chromatographic profile of the samples after 9 months of thermal degradation shows chromatographic peaks that corresponds to the palmitate and stearate esters of octacosanoyl, triacontanoyl and hexacosanoyl, being the only degradation products observed on these studies.

Boll Chim Farm, 2003 Sep, 142(7), 274 - 6
What is the scope of bioluminiscence in pharmaceutical clean rooms monitoring?
Temprano GC, D'Aquino M.
By means of bioluminiscence ATP present in a sample can be quantified . Thus, it would be a method able to evaluate microbiological or organic matter (from vegetal or animal origin) contamination . The present work analyzes the possibility to assess--from the microbiological point of view--the air of pharmaceutical clean rooms by means of bioluminiscence, using the luminomiter HY-LITE 2 {Merck} . It is thought that the use of this methodology versus microbiological classical methods, will allow to obtain results in the working day . Classical methods demand a minimum of 72 hs incubation to read results . But the real conclusion is that with the used technology, it is not possible to evaluate microbiologically the air of pharmaceutical clean rooms.

Ann Ig, 2003 Jul-Aug, 15(4 Suppl 1), 69 - 75
{Systematic study of microbiological and parasitological quality of drinking water: the example of Cassino}; Briancesco R et al.; In order to evaluate microbial and parasitological quality of water resources located in the area of Cassino, different typologies of water were monitored during the course of 2002 . Analytical results showed that neither water sources nor chlorinated water were affected by microbial and parasitological contamination . Surface water can be used as drinking water after suitable treatment processes . The constant occurrence of parasitic protozoa in sewage shows their spreading in the environment; nevertheless their absence in groundwater and tap water suggests a good level of hygienic quality in water management.

J Environ Qual, 2003 Nov-Dec, 32(6), 2379 - 86
An integrated chemical, thermal, and microbiological approach to compost stability evaluation; Mondini C et al.; The evaluation of compost stability is of the utmost importance for the reliability of composting as a recycling strategy . To date there is no single parameter that can give a sure indication of the stability of composts from different starting materials . This paper investigates different methods of evaluating the dynamics of transformation of materials and the stability level of the end products in a composting process . The following parameters were determined on compost samples of different ages from cotton (Gossypium herbaceum L.) cardings and yard wastes: humification index (HI), degree of humification (DH), thermogravimetry (TG) microbial biomass C (B(C)), and ninhydrin-reactive N (B(NIN)) . Finally, from TG, derivative thermogravimetry (DTG) and differential scanning calorimetry (DSC) thermal stability parameters were deduced . Humification parameters in the end products (0.2 and 81% for HI and DH, respectively) showed the effective stability reached by the organic matter (OM) . Thermal analysis evidenced the presence of two main organic pools with different thermal stability . During composting a relative increase in the more stable organic pool was indicated by the variation of the thermostability index R1 from 0.41 to 0.74 . The parameter R1 was significantly correlated with both HI (r = -0.94; P < 0.05) and DH (r = 0.97; P < 0.05) . Microbial biomass content dynamics reflected the availability of readily decomposable substrates . The ratio between B(NIN) and total N in the end product was 0.96%, indicating a good stability level . The simultaneous application of different approaches, considering different properties of composting materials, provides a more complete description of the stability and quality reached by the organic materials.

J Gastroenterol, 2003, 38(11), 1049 - 52
Spraying of phenol red dye as a screening test for Helicobacter pylori infection in surgically resected stomach specimens; Mitsuhashi J et al.; BACKGROUND: Endoscopic spraying of phenol red dye and urea (phenol red test) has recently been used to assess the distribution of Helicobacter pylori in the gastric mucosa . We examined whether the phenol red test could be used to detect H . pylori in surgically resected stomachs . METHODS: A total of 82 surgically resected stomachs, obtained from 82 patients (mean age, 60.1 years; range, 33-84 years) with early gastric carcinomas were examined . Phenol red solution and urea were sprayed over the entire mucosa of each resected stomach . A color change from yellow to red was considered as a positive reaction for H . pylori . Gastric mucosal specimens taken from positively stained and negatively stained areas on the phenol red test were then examined immunohistochemically to determine the degree of H . pylori colonization . RESULTS: Diffusely positive reactions were seen in 16 resected stomachs (19%), and regionally positive reactions were seen in 36 (44%) . The other 30 stomachs (37%) showed no color change (negative reaction) . H . pylori was detected immunohistochemically significantly more frequently in positively stained than in negatively stained areas ( P << 0.0001) . Specificity, sensitivity, and predictive values for positive and negative results of the phenol red test, determined on the basis of H . pylori immunostaining, were 100%, 74.3%, 100%, and 72.7%, respectively . CONCLUSIONS: The phenol red test is a specific, relatively sensitive, rapid, easy-to-use, and repeatable method that can be used to diagnose H . pylori infection in surgically resected material . It enables pathologists as well as gastroenterologists with no microbiological expertise to easily diagnose H . pylori infection.

Probl Tuberk Bolezn Legk, 2003, (10), 44 - 7
{Microbiological and molecular genetic characterization of Mycobacterium tuberculosis strains isolated from patients with multiorgan and generalized tuberculosis}; Otten TF et al.; The paper presents the microbiological and molecular genetic characteristics of Mycobacterium tuberculosis (MBT) isolated from multiple lesion foci in 26 patients with multiorgan and generalized tuberculosis . Cultures of MBT of the family Beijing were isolated from the pathological specimens taken from 17 (65.4%) patients; those with individual genotypes were in 9 (34.6%) patients . The study indicated that cultured MBT from different types of pathological material from 25 of the 26 patients had identical spoligotypes irrespective of their clinical diagnosis . At the same time minor profile IS6110 changes might occur in the Mycobacteria of a patient during persistence . It may be concluded that multiple foci of tuberculous affliction in the patients are of unique origin and have the mechanism of development, associated with endogenous reactivation of infection.

J Infect, 2004 Jan, 48(1), 23 - 31
Severe acute respiratory syndrome in Taiwan: analysis of epidemiological characteristics in 29 cases; Jang TN et al.; OBJECTIVES: To describe the clinical characteristics and outcomes of patients with severe acute respiratory syndrome (SARS) . METHODS: Between March 28 and June 30 '2003, 29 patients with probable SARS seen at Shin Kong Wu Ho-Su Memorial Hospital, Taipei, were analysed . RESULTS: Presenting symptoms included fever (100%), cough (69.0%), chills or rigor (62.1%), and shortness of breath (41.4%) . Mean days to defervescence were 6.8+/-2.9 days, but fever recurred in 15 patients (51.7%) at 10.9+/-3.4 days . Common laboratory features included lymphopenia (72.4%), thrombocytopenia (34.5%) and elevated C-reactive protein (CRP), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST) (93.1, 62.1, 44.8%, respectively) . All patients except one had initial abnormal chest radiographs and 20 (69.0%) had radiological worsening at 7.5+/-2.6 days . Nine patients (31.0%) subsequently required mechanical ventilation with four deaths (13.8%) . Most patients with clinical deterioration responded to pulse corticosteroid therapy (14 out of 17) but six complicated with nosocomial infections . The risk factors associated with severe disease were presence of diarrhoea, high peak LDH and CRP, high AST and creatine kinase on admission and high peak values . CONCLUSIONS: Prudent corticosteroid use, vigilant microbiological surveillance and appropriate antibiotics coverage are the key to successful treatment.

Joint Bone Spine, 2003 Dec, 70(6), 489 - 95
Contribution of routine joint aspiration to the diagnosis of infection before hip revision surgery; Somme D et al.; OBJECTIVES: To define the sensitivity and specificity of routine preoperative hip aspiration for diagnosing hip prosthesis infection (HPI) and to separately analyze subgroups with and without a clinical suspicion of HPI before aspiration . METHODS: From June 1994 to June 1997, all patients scheduled for hip revision surgery underwent aspiration of the hip under image intensifier guidance . Microbiological results were compared between these preoperative specimens and the intraoperative specimens . The reason for surgery was either a clinical suspicion of HPI or pain suggesting loosening . RESULTS: The study patients had had multiple surgical procedures . HPI was suspected clinically in 39.4% of cases . Of the 109 patients who underwent aspiration, 54 had true-negative results, nine had false-negative results, and 44 had true-positive results (there were no false-positive results), yielding a sensitivity of 83% and a specificity of 100% . Diagnostic efficiency was 91.6%, positive predictive value was 100%, and negative predictive value was 85.7% . In the subset of 43 patients with a clinical suspicion of HPI, aspiration identified all the causative organisms in 60.5% of cases . Of the 66 patients with no clinical suspicion of HPI, 12 had HPI, and aspiration provided the diagnosis preoperatively in seven of these patients, radically changing their management plans . Restricting routine aspiration to patients whose prosthesis had been implanted within the last 5 years or whose erythrocyte sedimentation rate (ESR) was above 30 mm/h would not have modified our findings . CONCLUSIONS: Hip aspiration before revision surgery for pain is effective in detecting HPI, which can simulate aseptic loosening . However, this investigation may be noncontributive in patients who have had their prosthesis for more than 5 years and whose ESR is less than 30 mm/h.

Presse Med, 2003 Nov 29, 32(38), 1797 - 801
{Analysis of the factors influencing the internal reporting of nosocomial infections . A review of 108 notifications}; Penel N et al.; INTRODUCTION: Since July 26, 2001, the external reporting to the regional office of health and social affairs (Direction departementale des affaires sanitaires et sociales--Ddass) and the coordination centre (Comite de lutte contre les infections nosocomiales--Cclin) for the fight against nosocomial infections (NI) is mandatory . However, the modalities of internal reporting to the Clin are unknown . METHOD: We performed a retrospective analysis of 108 cases of NI reported over 23 months in 4 medical-surgical departments (MSD) with 14 to 35 NI reported/MSD . The distribution of the bacteria responsible was compared with that of the local epidemiological state (chi2 test) . A correlation analysis was performed between the number of NI reported in each MSD and the structural characteristics and activity index of these MSD (Spearmann's correlation test) . RESULTS: The NI were predominantly infections related to a catheter (43), lower respiratory tract (25) and infection of the site of surgery (19) . Ninety were documented biologically, among which 10 implied multi-resistant bacteria . Ninety-four NI were associated with the prescription of an antibiotic . Compared with the local epidemiological state, the NI reported generally implied multi-resistant bacteria (p=0.009) . The other microbiological data had little implication . In each of the MSD, the number of cases reported was independent of: the global activity, the number of interventions, the mean duration of hospitalisation, the number of beds, the number of clinicians, the number of new patients managed and the chemotherapy outpatient activity . Conversely, there was a strong correlation between the global consumption of antibiotics (r=0.78), and the number of the Clin members in each MSD DMC (r=0.82) . CONCLUSION: In each MSD, the internal reporting of NI relies on the discovery of multi-resistant bacteria, but above all on the implication of those involved in the fight against nosocomial infections.

Laryngoscope, 2003 Dec, 113(12), 2116 - 22
Topical ciprofloxacin/dexamethasone is superior to ciprofloxacin alone in pediatric patients with acute otitis media and otorrhea through tympanostomy tubes; Roland PS et al.; OBJECTIVE: To determine whether topical administration of a corticosteroid improves resolution of acute tympanostomy tube otorrhea when combined with topical antibiotic drops . STUDY DESIGN: Randomized, patient-masked, parallel-group, multicenter trial of topical otic ciprofloxacin/dexamethasone versus topical ciprofloxacin alone in 201 children aged 6 months to 12 years with acute otitis media with tympanostomy tubes (AOMT) of less than or equal to 3 weeks' duration and visible otorrhea . METHODS: Eligible patients were randomized to receive three drops of either ciprofloxacin 0.3%/dexamethasone 0.1% or ciprofloxacin 0.3% into the affected ear or ears twice daily for 7 days . Clinical signs and symptoms of AOMT were evaluated on days 1 (baseline), 3, 8 (end-of-therapy), and 14 (test-of-cure), and twice-daily assessments of otorrhea were recorded in patient diaries . RESULTS: The mean time to cessation of otorrhea in the microbiologically culture-positive patient population (n = 167) was significantly shorter with topical ciprofloxacin/dexamethasone than with ciprofloxacin alone (4.22 vs . 5.31 days; P =.004) . This resulted in significantly better clinical responses on days 3 and 8 (P <.0001 and P =.0499, respectively) . However, there were no significant differences between the two treatment groups in either the clinical response or the microbial eradication rate by day 14 . CONCLUSIONS: Topical otic treatment with ciprofloxacin/dexamethasone is superior to treatment with ciprofloxacin alone and results in a faster clinical resolution in children with AOMT . The contribution of the corticosteroid in achieving a 20% reduction (1.1 day) in time to cessation of otorrhea is clinically meaningful and represents an important advance over single-agent antibiotic therapy.

Int J Antimicrob Agents, 2003 Dec, 22(6), 618 - 21
Audit of an antibiotic policy and microbiological investigations for treating bacteraemia in a large teaching hospital; Mackenzie AR et al.; An audit of different approaches to guide empirical therapy in 78 cases of bacteraemia revealed poor utilisation of the antibiotic policy with resulting inadequate (P=0.005) or excessive (P<0.00001) antibiotic treatment and a trend to increased mortality . Eighty-seven percent of blood cultures were positive on Gram-stain within 24 h but streamlined therapy was still judged excessive in 27% . The results show poor utilisation of an up-to-date antibiotic policy but confirm its potential benefits and the ability of traditional culture methods to guide antibiotic therapy in a useful time-scale.

Int J Antimicrob Agents, 2003 Dec, 22(6), 594 - 600
Efficacy of human salivary mucin MUC7-derived peptide and histatin 5 in a murine model of candidiasis; Intini G et al.; MUC7 16-mer (residues 36-51 of human salivary mucin, MUC7) and histatin 5 possess potent in vitro antifungal activity . In the present study, we have evaluated the efficacy of these peptides in vivo using the experimental model of murine vulvo-vaginal candidiasis . The treatment groups included MUC7 16-mer, histatin 5, clotrimazole (all in pluronic F127 gel), and placebo (gel alone) . Mice were treated intravaginally for 7 consecutive days . At the end of the treatment, anticandidal activities were assessed by colony counts and by histological examination . All groups except clotrimazole presented positive cultures; no statistically significant differences were found in fungal burden amongst placebo and any treatment group except clotrimazole . Histopathological findings confirmed the microbiological results; all groups with the exception of clotrimazole showed variable signs of infection.

Environ Sci Technol, 2003 Nov 15, 37(22), 5127 - 34
Biogeochemical processes and microbial characteristics across groundwater-surface water boundaries of the Hanford Reach of the Columbia River; Moser DP et al.; Biogeochemical processes within riverbed hyporheic zones (HZ) can potentially impact the fate and transport of contaminants . We evaluated a modified freeze core technique for the collection of intact cobble-bed samples from the Columbia River HZ along a stretch of the Hanford Reach in Washington State and investigated microbiological and geochemical parameters of corresponding frozen and unfrozen samples . During three sampling periods (March, May, and November 2000), relatively high numbers of viable aerobic heterotrophic bacteria were recovered from both unfrozen (10(6)-10(7) cfu/g) and frozen samples (10(5)-10(6) cfu/g) . Relatively large populations of sulfate-, nitrate-, and iron-reducing bacteria were present, and significant concentrations of acid-volatile sulfide were measured in some samples, indicating that anoxic regions exist within this zone . Cr(VI), a priority groundwater pollutant on adjacent U.S . Department of Energy lands, was probably removed from solution in HZ samples by a combination of microbial activity and chemical reduction, presumably via products of anaerobic microbial metabolism . These results suggest that biogeochemical processes in the Columbia River HZ may contribute to the natural attenuation of Cr(VI) . Although freezing modestly diminished recovery of viable bacteria, freeze core techniques proved reliable for the collection of intact hyporheic sediments.

FEMS Yeast Res, 2003 Dec, 4(3), 221 - 31
Metabolic engineering of the astaxanthin-biosynthetic pathway of Xanthophyllomyces dendrorhous; Visser H et al.; This review describes the different approaches that have been used to manipulate and improve carotenoid production in Xanthophyllomyces dendrorhous . The red yeast X . dendrorhous (formerly known as Phaffia rhodozyma) is one of the microbiological production systems for natural astaxanthin . Astaxanthin is applied in food and feed industry and can be used as a nutraceutical because of its strong antioxidant properties . However, the production levels of astaxanthin in wild-type isolates are rather low . To increase the astaxanthin content in X . dendrorhous, cultivation protocols have been optimized and astaxanthin-hyperproducing mutants have been obtained by screening of classically mutagenized X . dendrorhous strains . The knowledge about the regulation of carotenogenesis in X . dendrorhous is still limited in comparison to that in other carotenogenic fungi . The X . dendrorhous carotenogenic genes have been cloned and a X . dendrorhous transformation system has been developed . These tools allowed the directed genetic modification of the astaxanthin pathway in X . dendrorhous . The crtYB gene, encoding the bifunctional enzyme phytoene synthase/lycopene cyclase, was inactivated by insertion of a vector by single and double cross-over events, indicating that it is possible to generate specific carotenoid-biosynthetic mutants . Additionally, overexpression of crtYB resulted in the accumulation of beta-carotene and echinone, which indicates that the oxygenation reactions are rate-limiting in these recombinant strains . Furthermore, overexpression of the phytoene desaturase-encoding gene (crtI) showed an increase in monocyclic carotenoids such as torulene and HDCO (3-hydroxy-3',4'-didehydro-beta,-psi-carotene-4-one) and a decrease in bicyclic carotenoids such as echinone, beta-carotene and astaxanthin.

Med Mycol, 2003 Oct, 41(5), 443 - 5
A case of sporotrichosis treated with itraconazole; Ozcan A et al.; Lymphocutaneous sporotrichosis is caused by Sporothrix schenckii, a dimorphic fungus commonly existing on decaying plants and in the soil . The fungus has a worldwide distribution but is more prevalent in temperate and tropical climates . Infection may result from traumatic inoculation of contaminated material such as soil, hay, moss, plant debris, splinters, thorns and barbs . Inoculation is also possible through some animal scratches and bites . We describe a typical case of lymphocutaneous sporotrichosis, which was confirmed by clinical, histological and microbiological features . The patient was successfully treated with 400 mg daily systemic itraconazole for 4 months.

Rinsho Byori, 2003 Oct, 51(10), 983 - 94
{The ideal curriculum for undergraduate clinical practice training in clinical laboratory medical education}; Kitajima I; A model core curriculum for medical education is proposed to serve as an essential basis of material to be mastered . The fundamental laboratory techniques specified by this curriculum are the following five items . 1 . Ability to appropriately record a 12-lead EKG . 2 . Ability to perform urinalysis . 3 . Ability to prepare and examine blood smear samples . 4 . Ability to select and preserve microbiological samples for analysis, and to perform Gram staining analysis . 5 . Ability to perform and evaluate pregnancy test . However, many other laboratory skill items are permitted in the model curriculum, as emphasized by the individual university . Therefore, reforms require appropriate changes in the educational programs for laboratory practice on the undergraduate level . In the Toyama Medical and Pharmaceutical University, all students must study compulsory fundamental laboratory technique in the first semester of the 5th year and, in addition, 6th graders in the last two months may choose an advanced clinical training course including genetic examinations . An important feature of our clinical training program is to introduce problem-based learning(PBL) tutorial education, which utilizes reversed CPC(R-CPC) . An additional elective curriculum in clinical laboratory practice will be required, providing unique training programs based on student needs, the educational principles of each university and the specialties of the instructors.

Unfallchirurg, 2003 Oct, 106(10), 865 - 8
{Foot injury as a rare cause of scendosporiosis with fetal outcome}; Pennekamp PH et al.; After an attempted suicide with a fall from a height of 5 m, a 33 year old male suffered a subarachnoidal haemorrhage, an instable fracture of the second lumbar vertebra as well as a soft-tissue decollement in the vicinity of the right heel . Despite surgical management, the comatose patient showed slow wound-healing of the heel, making revision-surgery necessary 10 days after the first treatment . Fungi were histologically recognised, and subsequent culturing identified Scedosporium apiospermum . Systemic antimycotic therapy with itraconazol (800 mg/d) was immediately initiated . Despite this, S . apiospermum was repeatedly found in wound swabs over the following 2 weeks . After 4 weeks, a radiographically verified osteomyelitis of the calcaneus was diagnosed and local debridement was once again performed . After 5 days, an MRI of the cranium suggested an abscess in the posterior horn of the left lateral ventricle . Itraconazol was altered to voriconazol (4 mg/kg body weight) . Neurosurgical opening of the abscess and subsequent culturing once again showed S . apiospermum . CT-scans performed over the following period showed an increase in lesions in the brain suggestive for numerous abscesses . At 78 days after the initial trauma, the still comatose patient died due to a massive cerebral haemorrhage . Microbiological assessment of the soil at the site of injury revealed S . apiospermum.

Nephrologie, 2003, 24(7), 347 - 50
{Inflammation markers in daily practice}; Le Roy F et al.; Cardiovascular diseases and infections remain the first mortality causes in ESRD patients . European recommendations for good clinical practice in the hemodialysis field advocate to use the inflammation markers in daily practice . These markers foretell both cardiovascular and global mortality . They also enable to detect the silent infections (parodontitis, Heliobacter pilory infection, shunt infection in PTFE), to make sure of the dialysis biocompatibility (microbiological quality of the dialysate, use of biocompatible membrane) . The C-reactive protein is the most current and used marker . Its use, combined with the procalcitonin measurement, specific marker for bacterial infection, would enable the diagnostic and therapeutic strategy improvement.

J Pediatr (Rio J), 2002 May-Jun, 78(3), 197 - 201
{Contamination of expressed human milk by mycelial fungi}; Novak FR et al.; OBJECTIVE: To characterize the genera of mycelial fungi detected in expressed human milk received at the human milk bank of Instituto Fernandes Figueira after home collection . METHODS: We studied 821 expressed human milk samples randomly obtained from flasks filled by the donors at home . The possible presence of molds, yeasts and mesophilic microorganisms was investigated . A total of 48 strains of mycelial fungi were isolated from the human milk bank samples and identified through standard laboratory techniques . RESULTS: Microbiological analysis revealed the occurrence of molds and yeasts in 43 samples (5.2%), with counts reaching 10(3) CFU/ml . The following microorganisms were identified: Aspergillus niger group (6.3%), Aspergillus sp . (4.2%), Paecilomyces sp . (12.6%), Penicillium sp . (60.4%), Rhizopus sp . (2.0%), and Syncephalastrum sp . (14.5%) . Four samples showed the presence of more than one mycelial fungus type . CONCLUSIONS: The presence of molds and yeasts in human milk manually expressed at home suggests that the hygiene conditions of the collection site may contaminate milk . Thus, when hospitalized premature babies receive the raw product, it is very important to observe the collection, storage and transport conditions in order to avoid the presence and consequences of contaminants increase.

J Pediatr (Rio J), 2000 Sep-Oct, 76(5), 357 - 60
{Effect of in-home boiling and refrigeration on bacterial load of pasteurized milk}; Morais TB et al.; OBJECTIVES: To assess the efficacy of in-home boiling of pasteurized milk in reducing the bacterial load and the ability of the refrigeration in preserving the milk after boiling.METHODS: Thirty samples of pasteurized milk bought in Sao Paulo, Brazil, were submitted to in-home boiling procedure at the laboratory . Portions of samples were taken before and after boiling, and after 2, 4, 6 and 24 hours under refrigeration for microbiological analyses . Methods used were mesophilic bacteria count, and coliforms and Escherichia coli (E.coli) enumeration.RESULTS: No sample presented mesophilic bacteria count above the Brazilian standard for pasteurized milk . E.coli was not recovered from any sample . Ten samples (33%) had coliform bacteria; of these, 3 samples (10%) were above the standard . Mesophilic bacteria count after boiling was significantly lower than before boiling . After 24 hours under refrigeration, mesophilic bacteria count was significantly higher than after boiling . No significant differences were found between the intervals of 2, 4, 6 and 24 hours under refrigeration . Samples before boiling presented significantly higher coliform bacteria . No coliform bacteria were recovered at any time after boiling.CONCLUSIONS: In-home boiling of milk reduced bacterial load, while refrigeration kept bacteria under low counts.

Med Sci Monit, 2003 Dec, 9(12), RA291 - 9
The impact of periodontal infection on systemic diseases; Amar S et al.; Systemic health is often closely linked to the state of the oral cavity: many systemic diseases and conditions have oral manifestations . Likewise, oral microbiological infections may also affect one's general health status . Indeed, animal and population-based studies now suggest that periodontal diseases may be linked with systemic diseases and conditions including cardiovascular diseases, diabetes, respiratory diseases, adverse pregnancy outcomes, and osteoporosis . Better understanding of this correlation will help both dental and medical professionals to determine the best approach to patient care . This review will focus on the current knowledge linking periodontal infections to a set of systemic diseases . While a number of interactions have been identified, additional research will be required to determine whether these associations are causal or coincidental, and to evaluate disease pathogenesis and potential therapeutic interventions . These findings place oral health in the perspective of systemic health, and they suggest that the dental and medical professions should develop even closer ties in the future.

J Clin Pathol, 2003 Dec, 56(12), 956 - 9
Mannan binding lectin in febrile adults: no correlation with microbial infection and complement activation; Tacx AN et al.; AIMS: To study the role of the mannan binding lectin (MBL) pathway of complement activation in the host defence to microbial infection in vivo, and the role of MBL in infectious mortality in non-selected patients . METHODS: A prospective observational study on 177 hospitalised medical patients with new onset fever . The presence, origin, and microbial cause of infection, the circulating MBL and complement activation product 3a (C3a), and the 28 day hospital course were determined . RESULTS: The patients had median MBL values similar to healthy blood donors: 18% of the patients and 14% of the blood donors had MBL deficiency, with values below 0.1 microg/ml . Median C3a was higher in patients with microbiologically confirmed infection than in those without, whereas there was no difference in MBL values or frequency of deficiency among patient groups with or without positive local cultures or bacteraemia . The mortality rate was 8% and the outcome groups did not differ in MBL . In febrile adults hospitalised in internal medicine wards, microbial infection induces complement activation, independently of MBL . CONCLUSIONS: The results argue against a predominant role for the MBL pathway of complement activation and a deficiency of MBL predisposing to serious and invasive microbial infection in non-selected adults.

Eur J Med Res, 2003 Nov 12, 8(11), 499 - 504
Correlation between inflammatory periodontal diseases and cardiovascular diseases; Willershausen B et al.; AIMS: Since cardiovascular diseases can exhibit a possible connection with chronic periodontal diseases, the aim of the present study was to examine the presence of periodontal impairment in patients with coronary heart diseases (CHD) . METHODS: For this purpose periodontal charts were raised for 101 patients (78 male, 23 female, mean age 61.8 +/- 10.5 years) with cardiovascular diseases; comparison was drawn between theses charts and those for a control group of 101 healthy patients (59 male, 42 female, mean age 56.6 +/- 9.9 years) . Over and above the dental diagnosis (probing depth {mm}, vitality, tooth mobility, plaque index (PI), inclination towards sulcus bleeding) each related to 6 characteristic teeth, various habitual aspects (diet, smoke and drink patterns, stress, body weight) were recorded . RESULTS: Within the CHD-group the periodontal chart revealed for all teeth examined a mean probing depth of 3.4 +/- 1.1mm, with the corresponding reading for the control group being 2.8 +/- 0.9 mm . The mean bleeding index (Van-der-Weiden) read 1.1 +/- 0.7 for the CHD-group and 0.7 +/- 0.6 for the control group . The mean plaque index reading was 1.4 +/- 0.9 for the group suffering from heart diseases and 0.7 +/- 0.8 for the control group . Comparison of these periodontal charts showed statistically significant differences (p<= 0.01), whereas mean degrees of tooth mobility did not differ in a statistically significant way . In summary, the results described hint at a correlation between an existent coronary heart disease and the presence of a periodontitis . CONCLUSION: However, also for consideration below are further influential factors, such as diet, individual life conduct, smoking habits, Body-Mass-Index or microbiological aspects.

Int Endod J, 2003 Nov, 36(11), 787 - 802
Bacterial status in root-filled teeth exposed to the oral environment by loss of restoration and fracture or caries--a histobacteriological study of treated cases; Ricucci D et al.; AIM: To describe histological and microbiological findings in teeth where root fillings had been exposed to caries and the oral environment for a prolonged period . METHODOLOGY: For inclusion in the study, only teeth with a follow-up period of 3 years or more and those that had been without proper restoration for at least a period of 3 months were considered . Some root fillings had been without restoration for several years . In all, 39 roots representing 32 teeth were examined by histology . RESULTS: The majority of the specimens were without a discernible periapical bone lesion as assessed by radiography . Osteolytic lesions were seen with five roots . Longitudinal tissue sections stained with a modified Brown/Brenn staining technique revealed presence of stainable bacteria in abundance at the canal entrance and in dentinal tubules but were absent mid-root and apically in all but two specimens . Soft tissue attached to the root tip and in apical ramifications displayed distinct inflammatory cell infiltrates, suggesting microbial exposure in 7 of the 39 roots examined . In all other specimens, inflammatory cell infiltrates were either nonexistent or sparse and then associated with extruded sealer material . CONCLUSIONS: Well-prepared and filled root canals resist bacterial penetration even upon frank and long-standing oral exposure by caries, fracture or loss of restoration.

J Agric Food Chem, 2003 Dec 3, 51(25), 7426 - 30
Use of recombinant cyprosin in the manufacture of ewe's milk cheese; Fernandez-Salguero J et al.; A recombinant cyprosin from the cardoon (Cynara cardunculus L.) was assayed and compared with calf rennet in batches of ewes' milk cheese by determining different chemical, biochemical, and microbiological parameters over 4 months of ripening . There were no differences between the two types of coagulants in most chemical parameters, a(w), and pH . Proteolysis was more marked and rapid in cheese containing recombinant cyprosin as coagulant, the soluble nitrogen content of which was significantly higher (p < 0.01) than that of the cheese obtained with animal rennet; at the end of ripening the nonprotein nitrogen of cheese produced with recombinant cyprosin was slightly higher (p > 0.05) as compared with that in cheeses obtained with animal rennet . Microbial counts in the milk used for making cheese were high in most of the groups analyzed . Despite slight differences in counts, the main microbial groups analyzed were similar in cheese produced with both types of coagulants throughout ripening.

Arzneimittelforschung, 2003, 53(10), 730 - 7
Clinical study on the dose-effect relationship of a nifuratel-nystatin combination in the treatment of vulvo-vaginal infections; Polatti F et al.; OBJECTIVE: The dose-effect relationship of nifuratel (CAS 4936-47-4) + nystatin (CAS 1400-61-9, CAS 34786-70-4) (Macmiror Complex) in topical treatment of vulvo-vaginitis was studied . METHOD: Sixty patients with Trichomoniasis and/or Candidiasis were randomized to: 1) nifuratel 125 mg/nystatin 50000 IU, 2) nifuratel 250 mg/nystatin 100000 IU, 3) nifuratel 500 mg/nystatin 200000 IU . Undistinguishable ovules were intravaginally applied qd for 10 days . The dose-effect relationship was assessed by ANCOVA . RESULT: After 5 days the microbiological cure rate occurred in 10% of patients in the least dose, in 40% in the middle dose and in 85% in the highest dose group (P = 0.000) . After 10 days of treatment, the microbiological cure rate increased to 45%, 84%, and 95%, respectively (P = 0.007) . Clinical signs and symptoms gradually disappeared in a dose- and time-dependent manner . No relapse has been observed after 10 day-follow up on 46 patients . CONCLUSION: The results confirmed a linear relationship between nifuratel + nystatin dose and effect . The least effective dose was nifuratel 250 mg + nystatin 100,000 IU once daily for 5 days and the best dose in terms of risk/benefit ratio was nifuratel 500 mg + nystatin 200,000 IU once daily for 5 days.

J Chin Med Assoc, 2003 Sep, 66(9), 523 - 7
Serum interleukin-6 level as a diagnostic test in children with sepsis; Huang SY et al.; BACKGROUND: This study was performed to determine the serum concentrations of interleukin-6 (IL-6) during the early course of bacterial infections disease in children, and to evaluate the usefulness of IL-6 as a diagnostic test alone and in combination with C-reactive protein (CRP) . METHODS: We measured serum IL-6 values in 3 groups of children on their first day of admission, from January 2001 to December 2001: group 1, patients with clinical and microbiological evidence of sepsis (n = 13); group 2, patients with clinical and chest radiographical evidence of pneumonia (n = 18); and group 3, patients with no signs of infection (control group) (n = 16) . Kruskal-Wallis tests were used to compare the difference of IL-6 values between groups and control subjects . RESULTS: IL-6 values were significantly higher in groups 1 and 2 compared with those in the control group (p < 0.001) . No significant differences were found between the groups 1 and 2 . As a diagnostic test, IL-6 (> or = 20 pg/mL) alone yielded a sensitivity of 68%, a specificity of 88%, a positive predictive value of 71%, and a negative predictive value of 58% . A combined parameter of IL-6 (> or = 20 pg/mL) and CRP (> or = 1 mg/dL) yielded a sensitivity of 94%, a specificity of 63%, a positive predictive value of 79%, and a negative predictive value of 87% . CONCLUSION: IL-6 levels increase in children with sepsis . In combination with CRP, IL-6 seems to be a valuable parameter in the early diagnosis of pediatric infections.

SADJ, 2003 Aug, 58(7), 273 - 8
Clinical, histological and microbiological study of hand-excavated carious dentine in extracted permanent teeth; Bonecker M et al.; Changes in cultivable flora in dentine samples collected before and after hand excavation were examined in association with clinical status of the cavity surface, light microscopy and scanning electron microscopy (SEM) . Thirty-five extracted permanent molar teeth with an occlusal caries lesion were excavated with hand instruments according to the atraumatic restorative treatment (ART) approach . Excavation pressure, dentine colour and consistency were recorded at the dentine-enamel junction (DEJ) prior to carious dentine removal and at the cavity floor after the final excavation; a microbiological sample of dentine was taken at both stages . Twelve restored teeth; six with positive and six with negative bacterial growth on the second sample, were selected for light microscopy and SEM . The hand-excavation removed tooth structure was soft, irreversibly damaged, dark and highly infected . Hand excavation reached dentine of increased hardness with a more normal colour to provide a sound structural base for restoration . Light and SEM examination of the cavity floor showed infected dentinal tubules in all 12 teeth examined . Linear logistic analysis showed a statistical association between light-yellow dentine on the cavity floor and an absence of bacterial growth (P = 0.006) . This short-term in vitro study showed that caries-producing bacteria remained in dentine close to the cavity floor in 26/35 teeth despite clinical observations that indicated a suitably prepared cavity floor.

Am J Infect Control, 2003 Nov, 31(7), 387 - 91
Bacterial transfer and cross-contamination potential associated with paper-towel dispensing; Harrison WA et al.; BACKGROUND: The role of hands in disease transmission is well established, and the importance of handwashing is recognized . However, the exits of paper-towel dispensers used in hand drying may be contaminated, and the functionality of handwashing equipment increasingly is being questioned . OBJECTIVES: We sought to study the transfer and cross-contamination potential between hands, towels, and dispenser exits if one or more is contaminated using bacteria representative of the skin's flora . MATERIALS AND METHOD: A generic wall-mounted paper-towel dispenser and a range of different paper towels were used . Volunteers with either clean or contaminated hands were asked to remove, using a range of protocols, towels from dispensers which themselves were either clean or contaminated . Previously clean surfaces were then microbiologically tested . RESULTS: Recoverable bacterial transfer rates from a contaminated hand to clean dispenser exits ranged from 0.01% to 0.64% depending on the bacteria used with an even higher transfer rate for clean towels . The reverse transfer (ie, from contaminated exits to clean hands) was between 12.4% and 13.1% . CONCLUSIONS: The results indicate that zig-zag transfer of bacteria between paper-towel dispensers and hands can take place if either one is contaminated . This potential should be considered in the design, construction, and use of paper-towel dispensers.

Ann Pharm Fr, 2003 Nov, 61(6), 425 - 30
{Formulation and stability study of sucred solutions for a clinical trial in neonates}; Senis-Loiseau C et al.; A randomized, double blind clinical trial have been initiated in the neonatology unit of CHRU in Lille to compare the analgesic effect of two oral solutions (25% dextrose and 30% glucose) after heel prick sampling . As part of this trial, the pharmacy was asked to perform the preparation and the randomization . In agreement with good clinical practices and good manufacturing practices, we have valided manufacturing processes, and performed microbiological tests, chromatography control and polarimetric dosage . The stability study of solutions (six months), allows preparation of only one batch in accordance with good manufacturing practice for 25% sucrose and 30% glucose . The participation of hospital pharmacist in the preparation of investigational products is becoming more and more frequent . This enhances his involvement in the quality control of clinical trials.

An Pediatr (Barc), 2003 Dec, 59(6), 535 - 40
{Short course treatment for visceral leishmaniasis with liposomal amphotericin B in immunocompetent patients}; Figueras Nadal MC et al.; INTRODUCTION: Visceral leishmaniasis is endemic in southern Europe . Traditional treatment consists of pentavalent antimonial compounds . However, treatment failures, the treatment's long duration, and toxicity have led to the introduction of new therapies, such as liposomal amphotericin B (LAB) . In this study we evaluate the safety and efficacy of LAB at a maximum dose of 4 mg/kg/day on days 1, 2, 3, 4, 5, and 10 . PATIENTS AND METHODS: A prospective, observational, open study was conducted in 13 Spanish centers . The diagnosis of visceral leishmaniasis was based on visualization of Leishmanias sp . in bone marrow aspirate or culture or positive serology together with compatible clinical symptoms . RESULTS: Thirty-two immunocompetent children aged from 7 months to 7 years were treated . All the children had rapid clinical response and bone marrow aspirate performed on day 21 was normal in the 24 patients (100 %) who underwent this procedure . In the remaining eight children efficacy was assessed by clinical response . Two relapses were observed . Cure was achieved in 18 patients (90.0 %) and in 87.5 % of the patients with microbiological confirmation of the disease . No adverse events were detected . CONCLUSIONS: A total dosage of 24 mg/kg of liposomal amphotericin B administered in 6 doses within 10 days is safe and effective for the treatment of visceral leishmaniasis and reduces the length of hospital stay.

J Appl Microbiol, 2003, 95(5), 904 - 12
Determination of aerial microbiological contamination in scholastic sports environments; Dacarro C et al.; AIMS: To assess the microbiological indoor air quality (IAQ) of high school and college gyms during physical training lessons and to evaluate the effective microbiological exposure of students . METHODS AND RESULTS: Air samples from 11 high school and college gyms of Pavia, Italy were collected . Total bacterial counts, total fungal counts and characterization of fungal taxa were determined . Air quality was evaluated using three microbiological contamination indices: the global index of microbiological contamination per m3 (GIMC per m3), the index of mesophilic bacterial contamination (IMC) and the amplification index (AI) . CONCLUSIONS: This work testifies that air contamination in indoor gyms is always superior to that of the outdoor environment . Nevertheless, students are exposed to relatively low concentrations of airborne micro-organisms . The highest values of fungal counts and GIMC per m3 (>14,661) were observed between April and October when the central heating systems were switched off . The lowest fungal counts were detected in modern buildings equipped with forced ventilation systems . From qualitative aeromycological studies, 45 fungal taxa were identified, and different potentially allergenic species were isolated . SIGNIFICANCE AND IMPACT OF THE STUDY: The standardization of air sampling methods and the correct evaluation of aeromicrobiological results allow the classification of indoor air healthiness . The proposed microbiological contamination indices together with the characterization of airborne fungal taxa are useful tools for detailed description of IAQ.

J Appl Microbiol, 2003, 95(6), 1285 - 92
A comparison of the International Standards Organisation reference method for the detection of coliforms and Escherichia coli in water with a defined substrate procedure; Niemela SI et al.; AIMS: This study investigated the use of the International Standards Organisation (ISO) procedure for the comparison of microbiological methods . Using this procedure the ISO reference procedure for the detection of coliforms and Escherichia coli in water was compared with a defined substrate method (ColilertTM) . METHODS AND RESULTS: A total of 20 laboratories from 13 European countries compared the use of Colilert/Quanti-TrayTM, a quantitative defined substrate test (DST) for the presence of coliforms and E . coli with the ISO reference procedure, which utilizes tergitol-TTC medium . Results of the study showed that DST detected significantly more coliforms and E . coli than did the reference procedure . In the case of E . coli the recoveries were also higher when using DST and the difference seen was statistically significant . The confirmation rate obtained when using the DST product suggested that no confirmation of wells positive for E . coli was necessary during routine use . CONCLUSIONS: Colilert is a suitable alternative to the ISO reference procedure for the detection of coliforms and E . coli in water . The methods used during the comparison study indicated that confirmation of all colonies/positive wells led to the most accurate information and it is recommended that for future comparison studies this should become standard practice . Confirmation of a small proportion of colonies led to misleading conclusions and should be avoided when comparing microbiological methods . SIGNIFICANCE AND IMPACT OF STUDY: It has been demonstrated that the ISO reference procedure fails to detect a significant proportion of coliforms and E . coli in drinking water . Colilert/QuantiTrayTM is a more suitable alternative.

J Appl Microbiol, 2003, 95(6), 1175 - 81
Detection of mutagenic pollution of natural environment using microbiological assays; Wegrzyn G et al.; One of the most important and serious ecological problems is mutagenic pollution of the natural environment . Therefore, detection of mutagenic compounds in samples taken from natural habitats is of special interest . Microbiological mutagenicity tests seem to be very useful tools for such detection . In this review article, a general view on the tests employing genetically modified bacterial strains designed for detection of low concentrations of mutagenic compounds is presented . Moreover, a comparison of advantages and disadvantages of selected assays, developed early on and more recently, and features of these assays are discussed . It appears that none of the currently available mutagenicity tests is perfect or optimal for all purposes . Thus, a choice for the particular assay must depend on the nature of studies and specific tasks of the experiments to be performed.

J AOAC Int, 2003 Sep-Oct, 86(5), 1089 - 94
Measurement uncertainty in microbiology; Forster LI; Testing laboratories wishing to comply with the requirements of ISO/IEC 17025:1999 need to estimate uncertainty of measurement for their quantitative methods . Many microbiological laboratories have had procedures available for monitoring variability in duplicate results generated by laboratory analysts for some time . These procedures, however, do not necessarily include all possible contributions to uncertainty in the calculations . Procedures for estimating microbiological method uncertainty, based on the Poisson distribution, have been published but, at times, the procedures can either underestimate uncertainty or require laboratories to undertake considerable experimental studies and more complex statistical calculations . This paper proposes procedures for estimating uncertainty of measurement in microbiology, whereby routine laboratory quality control data can be analyzed with simple statistical equations . The approaches used in these procedures are also applied to published data and examples, demonstrating that essentially equivalent results can be obtained with these procedures.

J AOAC Int, 2003 Sep-Oct, 86(5), 1084 - 8
Uncertainty in most probable number calculations for microbiological assays; McBride GB et al.; Microbiological assays commonly use incubations of multiple tubes in a dilution series, and microorganism concentration is read as a most probable number (MPN) in standard tables for the observed pattern of positive tubes . Published MPN tables differ, sometimes substantially, because of use of approximate MPN calculation procedures, different rounding conventions in the results, and different methods of calculating confidence or credible intervals . We conclude that the first 2 issues can now be resolved by using recently developed exact MPN calculation methods and by reporting rounding conventions in standard tables . The third issue is not amenable to complete resolution, especially if credible interval (as opposed to confidence interval) limits are desired--as we think they most often are . In that case, Bayesian statistics are called for and the analyst must provide a distribution of concentration that was presumed to be true before the assay was performed . This is mathematically combined with the assay data, resulting in a posterior concentration distribution . These distributions may then be used to quantify the uncertainty in the MPN estimate, and the best approach is to use the highest posterior density regions of these distributions . If based on diffuse prior information (positing that, prior to an assay being performed, all positive concentrations are equally likely), then established procedures might be used to calculate the limits and publish them in standard tables . In the event that this prior assumption is held to be not satisfactory, we show results for an empirical Bayes procedure, with a Poisson prior distribution, giving credible interval widths much narrower than in the other cases examined.

Anal Chem, 2003 Sep 1, 75(17), 4606 - 11
Analysis of microbial components using LC-IR; Huffman SW et al.; Characterization of bacteria is currently an important research area in the medical, military, food, and agricultural sciences . In recent years, FT-IR has found an application as a microbiological detection method and as a general research tool . When coupled with a liquid chromatographic system, a new facet of research has evolved . By utilizing the separation ability of typical liquid chromatography systems, matrix elimination is possible, therefore allowing for clean spectra of cellular components . Information about the compositional makeup of various bacteria enhances the overall understanding of biology at the cellular level, provides a quantification of the chemistry of cellular processes, and can be used as a general identification tool . Both whole cells and lysed Escherichia coli cells were investigated in the present study . The cellular components consisting of proteins, glycoproteins, phospholipids, fatty amides and acids, and genomic materials were separated, isolated, and identified by FT-IR.

Lancet, 2003 Nov 15, 362(9396), 1639 - 47
Lyme borreliosis; Stanek G et al.; Lyme borreliosis is the most common tick-transmitted disease in the northern hemisphere and is caused by spirochaetes of the Borrelia burgdorferi species complex . A complete presentation of the disease is an extremely unusual observation in which a skin lesion results from a tick bite and is followed by heart and nervous system involvement, and later on by arthritis . Late involvement of eye, nervous system, joints, and skin can also occur . The only sign that enables a reliable clinical diagnosis of Lyme borreliosis is erythema migrans . Other features of some diagnostic value are earlobe lymphocytoma, meningoradiculoneuritis (Garin-Bujadoux-Bannwarth syndrome), and acrodermatitis chronica atrophicans . The many other symptoms and signs have little diagnostic value . Microbial or serological confirmation of borrelial infection is needed for all manifestations of the disease except for typical early skin lesions . However, even erythema migrans might not be pathognomonic for Lyme borreliosis, especially in the southern part of the USA where there is no microbiological evidence for infection with the agent . Treatment with antibiotics is beneficial for all stages of Lyme borreliosis, but is most successful early in the course of the illness . Prevention relies mainly on avoiding exposure to tick bites but there is some interest in chemoprophylaxis and also in vaccine development following initial disappointments.

Trop Med Int Health, 2003 Nov, 8(11), 1030 - 4
Treatment of amoebic liver abscess with metronidazole alone or in combination with ultrasound-guided needle aspiration: a comparative, prospective and randomized study; Blessmann J et al.; Thirty-nine patients with amoebic liver abscess (ALA), admitted to the Central Hospital of Hue (Vietnam), were evaluated in a comparative, prospective and randomized study for the treatment of ALA . Adult patients with an abscess located in the right liver lobe and an abscess diameter of 6 to 10 cm were included . Bacterial abscesses were excluded by microbiological examination of abscess fluid in all patients . Nineteen patients were treated with metronidazole for 10 days alone and 20 patients were punctured under ultrasound guidance with aspiration of abscess fluid in addition to drug administration . The clinical symptoms fever, pain in right upper abdomen and liver tenderness, and the laboratory parameters erythrocyte sedimentation rate, white blood cells, haemoglobin and C-reactive protein and the abscess size were determined on the day of admission and followed during an observation period of 38 days . Improvement of liver tenderness was significantly faster in the aspiration group during the first 3 days (P < 0.001), whereas all the other parameters showed no differences between the two groups . This minor benefit is obviously not sufficient to justify routine needle aspiration and advocates drug treatment alone for uncomplicated amoebic liver abscesses with a diameter up to 10 cm located in the right liver lobe.

Health Serv J, 2003 Nov 6, 113(5880), 34 - 5
The missing link; Craig G et al.; Current TB services fail to reflect the changing epidemiology of the disease . Patients present with multiple and complex health and social problems . Services concentrate on providing a microbiological cure but ignore underlying social problems.

Acta Neurochir (Wien), 2003 Nov, 145(11), 957 - 60; discussion 960
Internal fixation for osteomyelitis of cervical spine: the issue of persistence of culture positive infection around the implants; Shad A et al.; BACKGROUND: We describe the management of osteomyelitis of the cervical spine, utilizing internal fixation with subsequent removal and culture of the implants . Four out of five patients had evidence of bacterial colonisation in close proximity to the internal fixation device . METHODS: Five consecutive patients (all female, ranging in age from 50 to 74 yrs) presenting with unstable cervical osteomyelitis were treated by surgical decompression, primary internal fixation followed by three months of intravenous antibiotics . The internal fixation was removed in 4 out of 5 cases within a year of stopping the intravenous regime . The remaining patient was deemed medically unfit for further operation . Multiple specimens from the screw sites were taken at the time of metal removal . A final course of oral antibiotics was prescribed based on the results of these specimens . FINDINGS: Four patients, who had removal of the implants, had positive cultures growing different bacteria from the primary infection, at the time of removal of the implant . None of the patients developed instability after removal of the implant . INTERPRETATION: Asymptomatic bacterial colonisation of a metallic implant has profound management implications . We recommend long-term oral antibiotic regimes after insertion of internal fixation devices in the face of infection and eventual removal of these implants and microbiological re-sampling.

Eur J Nucl Med Mol Imaging . 2003 Nov 19; {Epub ahead of print}
99mTc-Ciprofloxacin planar and tomographic imaging for the diagnosis of infection in the postoperative spine: experience in 48 patients; De Winter F et al.; The non-invasive assessment of postoperative spinal infections can pose a substantial diagnostic challenge, especially in the presence of orthopaedic devices . Whereas white blood cell scanning is of limited use in the spine, the low normal bone marrow uptake of technetium-99m ciprofloxacin combined with its claimed bacterial specificity makes it theoretically an ideal candidate for the evaluation of postoperative spinal infections . This study aimed to evaluate (99m)Tc-ciprofloxacin planar and single-photon emission tomography (SPET) imaging in relation to microbiological and clinical diagnosis in the postoperative spine . Planar imaging was performed at 1, 3 and 24 h and SPET was performed at 3 h post injection of 370 MBq (99m)Tc-ciprofloxacin . Images were scored by two independent certified nuclear medicine physicians, blinded to the final diagnosis . Within the 48 patients, there were 13 deep infections . Sensitivity, specificity and accuracy at visual scoring were respectively 54%, 71% and 67% (1 h), 62%, 77% and 73% (3 h), 42%, 91% and 77% (24 h) for planar imaging and 100%, 74% and 81% for SPET . When recently operated patients (<6 months) were excluded, the specificity of the SPET imaging rose to 81% . In conclusion, unlike white blood cell scanning, (99m)Tc-ciprofloxacin SPET is sensitive in evaluating infections in the postoperative spine . Sensitivity is much higher for SPET than for planar imaging . However, the results presented prove that its specificity is limited, especially in recently operated patients . Taking this limitation into account, we advise planar and SPET imaging at 3 h post injection and an interval of at least 6 months after surgery to minimise the likelihood of false positives.

Int J Food Microbiol, 2003 Dec 31, 89(2-3), 171 - 84
Cold adaptation of Escherichia coli: microbiological and proteomic approaches; Mihoub F et al.; The aim of this work was to use two approaches (microbiological and proteomic) to study the effect of cold adaptation (3 h at 4 degrees C) on the survival of two Escherichia coli strains, I2 and R3, following freezing at -20 degrees C for 24 h and thawing for 45 min at 37 degrees C . The effect of cold adaptation on cell survival after freezing was determined by measuring viable counts on selective (PTX) and nonselective media (TSA) . The beneficial effect of the cold treatment was more pronounced for the freezing-sensitive R3 strain: Prior to adaptation, differences between the two media were 3.5 log10 for R3 and 0.4 log10 for I2 . After adaptation, the differences were 2.5 log10 and 0.1 log10 for R3 and I2, respectively . The proteins from two cell compartments, cytoplasm and outer membrane, were separated by two-dimensional electrophoresis and identified by mass spectrometry or Edman sequencing . The adaptation resulted in changes in the expression of certain proteins . Among the principal changes to protein profiles in strain R3 following cold adaptation, we observed an over-expression of the EF-TU elongation factor in the outer membrane, and an under-expression of flagellin (FLIC) in the cytoplasm . Very few changes were observed in strain I2.

Int J Food Microbiol, 2003 Dec 31, 89(2-3), 139 - 44
Detection of Penicillium expansum by polymerase chain reaction; Marek P et al.; Penicillium expansum is a major causative agent of postharvest decay in a variety of fruits, including apples, peaches, nectarines, and cherries . It causes significant economic losses to the fruit industry and is also of potential public health significance, since it produces patulin, a mycotoxin known to cause harmful effects in animals . Rapid and specific detection of P . expansum is important for ensuring microbiological quality and safety of fruits and fruit juices . The traditional methods for identification of P . expansum are time-consuming and labor-intensive . In this study, we report a polymerase chain reaction utilizing primers based on the polygalacturonase gene of P . expansum . The PCR amplified a 404-bp DNA product from all the P . expansum isolates tested, but not in other common foodborne Penicillium species and Escherichia coli . Experiments to determine the sensitivity of the PCR indicated that it can detect the DNA equivalent from as low as 25 spores of P . expansum . The PCR could potentially be used as a rapid tool for screening fruits for the presence of P . expansum.

Transpl Int, 1992, 5 Suppl 1, S249 - 51
Evaluation of the International Society for Heart Transplantation (ISHT) grading of pulmonary rejection in 100 consecutive biopsies; Hunt J et al.; Heart-lung and lung transplantation are accepted treatments for patients with end-stage pulmonary vascular disease or parenchymal lung disease . Survival rates for heart-lung and lung transplantation are lower than those for heart transplantation alone . The 5-year actuarial survival for heart-lung transplantation has been 41% largely due to rejection and infection remaining as the limiting factors for long-term survival . A standardized nomenclature for the histological grading of pulmonary rejection was formulated by the International Society for Heart Transplantation (ISHT) in July 1990 . Infection, however, is a major problem in the histological assessment of lung recipient biopsies, potentially limiting the usefulness of such a classification . In this study, 100 consecutive transbronchial biopsies (TBBs) from lung transplant recipients were analysed, together with microbiological and serological data, in order to evaluate the proposed ISHT grading system for pulmonary rejection and the importance of concomitant infections in the histological interpretation of TBBs.

Sichuan Da Xue Xue Bao Yi Xue Ban, 2003 Oct, 34(4), 742 - 5
{A comparative study utilizing different methods for establishing an experimental periodontitis model in rats}; Wu Y et al.; OBJECTIVE: To evaluate the experimental periodontitis in rats induced by ligature plus high sugar water with and without infection of periodontopathic bacteria . METHODS: Forty SD rats (5 weeks of age) were randomly divided into a control group (N) and three experimental groups (P1, P2 and P3) . All experimental groups were given silk ligatures around the cervix of the second maxillary molars and were provided with drinking water containing 10% glucose . Group P2 was inoculated with P . gingivalis, three times; group P3 was inoculated with P . gingivalis and F . nucleatum, three times . At weeks 0, 2 and 4, microbiological and histological examinations were made; alveolar bone loss was stereoscopically measured as the distance from the cement-enamel junction to the alveolar crest . RESULTS: Microbiological examination indicated that the bacteria inoculated in groups P2 and P3 were successfully colonized and both of P . gingivalis and F . nucleatum were predominant among the bacterial colonies of the examined sites . At week 2, histological examination showed gingival erosion and alveolar bone loss in all experimental groups and periodontal pockets in groups P2 and P3 . The most serious lesions were observed in group P3 . At week 4, the periodontal destruction in all experimental groups became more severe . CONCLUSION: Ligature, high sugar water combined with mixed infection of periodontopathic bacteria can successfully induce experimental periodontitis in rats.

Biofouling, 2003 Feb, 19(1), 1 - 8
Influence of surface characteristics and microstructure on adhesion of bacterial cells onto a type 304 stainless steel; George RP et al.; A study was carried out to understand the influence of the surface characteristics/microstructure of a type 304 stainless steel on bacterial adhesion by exposing solution-annealed, sensitized and air-oxidized stainless steel specimens in a culture of Pseudomonas sp . in dilute nutrient broth . Epifluorescence microscopy of the exposed surfaces revealed that the pattern of adhesion as well as number density of bacterial cells was different depending on the metallurgical condition of the substratum . Among the specimens with different microstructures, the sensitized specimens had the highest bacterial density, followed by the solution annealed and the oxidized specimens . The same trend was shown by the total viable counts on the various surfaces, estimated by a plate count technique . The study assumes significance in the context of the widely reported observation of preferential attack of the welded region during microbiologically influenced corrosion of fabricated components.

Tidsskr Nor Laegeforen, 2003 Nov 6, 123(21), 3051 - 3
{What does accreditation of medical microbiological laboratories mean to patients?}; Asprang AF et al.; Accreditation of a medical microbiological laboratory according to the ISO 17025 standard confirms that the analyses included in the accreditation are performed with high quality . This paper gives an overview over various quality aspects of direct importance to the patient and the patient's doctor: i) the relationship between the doctor and the laboratory; ii) the selection of relevant analyses; iii) the accuracy of the results; iv) sources and estimation of uncertainty; v) stability of test results; vi) review of complaints; and vii) interpretation of test results . Special aspects of medical microbiology in relation to accreditation are mentioned.

Mol Microbiol, 2003 Nov, 50(3), 739 - 49
Lateral gene transfer: when will adolescence end?
Lawrence JG, Hendrickson H.
The scope and impact of horizontal gene transfer (HGT) in Bacteria and Archaea has grown from a topic largely ignored by the microbiological community to a hot-button issue gaining staunch supporters (on particular points of view) at a seemingly ever-increasing rate . Opinions range from HGT being a phenomenon with minor impact on overall microbial evolution and diversification to HGT being so rampant as to obfuscate any opportunities for elucidating microbial evolution - especially organismal phylogeny - from sequence comparisons . This contentious issue has been fuelled by the influx of complete genome sequences, which has allowed for a more detailed examination of this question than previously afforded . We propose that the lack of common ground upon which to formulate consensus viewpoints probably stems from the absence of answers to four critical questions . If addressed, they could clarify concepts, reject tenuous speculation and solidify a robust foundation for the integration of HGT into a framework for long-term microbial evolution, regardless of the intellectual camp in which you reside . Here, we examine these issues, why their answers shape the outcome of this debate and the progress being made to address them.

Clin Microbiol Infect, 2003 Oct, 9(10), 1068 - 72
Bacteremia due to Stomatococcus mucilaginosus in neutropenic patients in the setting of a cancer institute; Fanourgiakis P et al.; This study reviews the clinical manifestations, causes and frequency of Stomatococcus mucilaginosus bacteremia in neutropenic cancer patients . We analyzed retrospectively all clinical and microbiological records of patients with S . mucilaginosus bacteremia . The incidence was compared with that of other pathogens causing bacteremia during neutropenia for the same period . S . mucilaginosus represented 5.9% of bacteremias in our neutropenic patients . Seven patients with hematologic malignancies and one with breast cancer are described . The common clinical presentation was one of sepsis . All patients presented with damaged mucosal barriers as the probable portal of entry, from either stomatitis or enterocolitis . All patients survived.

Clin Microbiol Infect, 2003 Sep, 9(9), 919 - 23
Osteoarticular tuberculosis in a general hospital during the last decade; Ruiz G et al.; OBJECTIVE: To study clinical features of skeletal tuberculosis diagnosed in our laboratory over the last 10 years . METHODS: We carried out a retrospective observational study of 26 patients with osteoarticular tuberculosis recording clinical and microbiological data . RESULTS: Pain was the main clinical presentation . The median time from the onset of symptoms to the diagnosis was 8 months . Synovial fluid was the most common sample obtained . Bone disease and previous or concurrent pulmonary tuberculosis were the most important predisposing factors . The tuberculin test reaction was positive in 83.3% of the patients . The outcome was favorable in 69% of the patients . Weight-bearing joints were the most commonly involved sites . CONCLUSIONS: A high degree of suspicion is still needed to avoid a delayed diagnosis that might complicate the outcome.

Pediatr Infect Dis J, 2003 Nov, 22(11), 963 - 8
Procalcitonin, C-reactive protein and leukocyte count in children with lower respiratory tract infection; Prat C et al.; BACKGROUND: Lower respiratory tract infection is the most common infection leading to unnecessary antibiotic treatment in children . Etiologic diagnosis is not immediately achieved, and the pathogen remains unidentified in a large number of cases . Neither clinical nor laboratory factors allow for a rapid distinction between bacterial and viral etiology . The aim of our study was to evaluate the reliability of procalcitonin (PCT), C-reactive protein (CRP) and leukocyte count in distinguishing pneumococcal, atypical and viral lower respiratory tract infection . METHODS: PCT, CRP and leukocyte count were measured in children with microbiologically documented diagnoses of lower respiratory tract infection . The results were compared of children with pneumococcal, atypical and viral etiologies . RESULTS: PCT and CRP showed significant correlation with a bacterial etiology of lower respiratory tract infection . No significance was found for leukocyte count . Using a cutoff point of 2 ng/ml for PCT and 65 mg/l for CRP, the sensitivities and specificities for distinguishing bacterial from viral lower respiratory tract infections were 68.6 and 79.4% for PCT and 79.1 and 67.1% for CRP . The sensitivities and specificities for distinguishing pneumococcal from other etiologies were 90.3 and 74.1% for PCT and 90.3 and 60% for CRP, respectively . CONCLUSIONS: High PCT and CRP values show a significant correlation with the bacterial etiology of lower respiratory tract infection . PCT and CRP show good sensitivity for distinguishing pneumococcal from other etiologies . PCT shows higher specificity than CRP . PCT and CRP can help make decisions about antibiotic therapy in children with lower respiratory tract infections.

J Vet Sci, 2001 Aug, 2(2), 91 - 6
Effect of fever on pharmacokinetics and dosage regimen of intramuscularly administered amikacin in goats; Agrawal AK et al.; A comparative pharmacokinetic study of amikacin (10 mg/kg intramuscular) by microbiological assay method in normal and experimentally induced febrile goats revealed that the plasma drug concentrations were significantly higher in febrile condition at most of the time intervals . Various pharmacokinetic parameters like t(1/2), AUC, AUMC, MRT and Vd(area) were significantly higher whereas total body clearance (Cl(B)) was significantly lower in febrile goats as compared to normal goats . Absorption half-life (t(1/2) ka) value differed non-significantly . For maintaining mean therapeutic level of 2 mg/ml, a priming dose (D*) of 14.73+/-2.28 mg/kg, followed by maintenance dose (D(o)) of 13.95+/-2.28 mg/kg at shorter dosage interval (t) of 8 hr may be useful in case of normal goats whereas lower doses (D* of 13.58+/-1.61 mg/kg followed by D(o) of 12.65+/-1.60 mg/kg) at longer tau of 12 hr may be advised in case of febrile goats.

J Agric Food Chem, 2003 Nov 19, 51(24), 7005 - 11
Effects of yam starch films on storability and quality of fresh strawberries (Fragaria ananassa); Mali S et al.; Yam starch films, formulated with yam starch (4.00 g/100 g of solution) and glycerol (1.30 and 2.00 g/100 g of solution) in filmogenic solution, were employed as packaging to extend storage life of strawberries stored at 4 degrees C and 85% RH . The effects of yam starch films on fruits were compared to the effect of PVC (poly(vinyl chloride)) packaging . Starch and PVC films significantly reduced decay of the fruits compared to control . Compared to starch films, PVC presented the better behavior on weight and firmness retention of fruits, especially in the last 7 days of storage . Considering microbiological counts, the shelf life of control fruits was 14 days, and of all packaged samples, stored at same conditions, was 21 days . Two different formulations of yam starch film were tested and had different mechanical properties as a function of glycerol content (1.30 and 2.00 g/100 g of solution) but showed no difference when employed as strawberries packaging.

Srp Arh Celok Lek, 2003 Mar-Apr, 131(3-4), 156 - 61
{Therapeutic aspects of trichomoniasis}; Vukicevic J et al.; INTRODUCTION: Trichomoniasis is frequent, parasitic and sexually transmitted infection of genitourinary tract . It is treated by metronidazole (5-nitroimidazole), according to protocol recommended by Center for Disease Control (CDC, formerly called: Communicable Disease Center) {19} . The resistance of Trichomonas vaginalis (TV) strains to metronidazole (MND) was described in USA in 1960, and later on in many European countries {8, 9, 10, 11, 12, 13} . In these cases, due to persistent trichomonas infection, it is necessary to repeat MND treatment with moderate modification of dose and/or length of its application . Nevertheless, oncogenic and toxic effects of MND have to be taken into consideration . AIM: The aim of this study was to investigate and analyse the incidence of TV in STD and lower susceptibility of certain TV strains to MND were analyzed . METHODS: In three-year period (1999-2001) 612 patients (244 females and 368 males) suspected of STD were examined clinically and microbiologically at the Institute of Dermatovenereology in Belgrade . The patients detected for TV were treated according to CDC protocol . The affected were considered cured if there was no manifest clinical infection, and no TV verified by microbiological test . RESULTS: TV was isolated in 216 patients (35.29% of all subjects) . Trichomonas infection was found in 90 (36.88%) out of 244 tested females and in 126 (32.34%) of 368 males . Clinically manifested infection, with extensive urethral and vaginal secretion, was recorded in 161 patients, while the asymptomatic form was found in 55 subjects . This result indicates the predominance of manifested trichomonas infections (75.54% of cases) . The difference of distribution of clinical forms of trichomoniasis, in relation to sex, was not statistically significant (chi 2 = 0.854; p > 0.05) . The patients with verified trichomonas infection were treated by metronidazole according to CDC protocol . The recommended therapeutical scheme consisted of three phases proceeding in succession, in so far TV had not been eliminated by previous one . The number of cured patients, according to therapeutical phases, was shown in Table 4 . Three patients (1.39%, 2 males and 1 female) were not cured in spite of all three completed phases of therapeutical protocol . In all three cases, TV was eliminated by MND application in dose of 3 g/daily, during two days . The failure of minute MND treatment was analyzed in relation to clinical forms of the infection (manifested or asymptomatic), as well as in relation to types of infection (single- or associated infection) . The incidence of refractory trichomoniasis treated by a single metronidazole dose of 2 g was significantly higher in the group of patients with polyinfection (c2 = 18.270; p < 0.01) . There was no significant difference of resistance to a single MND dose between the groups with manifested and asymptomatic trichomoniasis (chi 2 = 0.321; p < 0.01) . DISCUSSION: The prevalence of TV in vaginal and urethral smears indicates the significant incidence of trichomoniasis in STD . TV was more frequently isolated in patients with clinically manifested infection . TV susceptibility to MND was tested in vitro in aerobic and anaerobic conditions . The resistance of strains under in vitro conditions did not correlate with refractory feature of trichomoniasis to MND application {7, 17, 18} . The success of trichomoniasis treatment depends upon multiple factors, including: a) TV susceptibility to drug, b) intravaginal redox potential, c) drug concentration in situ, d) associated microorganisms that may modify the amount of the drug available in situ {7, 18, 21} . The results of our investigation argue for the latter item, verifying that TV resistance to MND is higher in patients with polyinfection in relation to those with monoinfection (significant difference, chi 2 = 18.270; p < 0.01) . Repeated administration of low metronidazole doses may prolong the therapy of trichomonas infections, while application of high doses (over 3 g/day) may result in undesired complications . Given the well-known fact that repeated sublethal doses induce the resistance, would it be more beneficial to begin with slightly higher metronidazole dose (3 g/day) during short period of time (3-5 days)? This will be the subject of our further investigation.

J Pharm Sci, 2003 Nov, 92(11), 2145 - 51
Collagen/PLGA microparticle composites for local controlled delivery of gentamicin; Schlapp M et al.; To preserve the positive effect of collagen on tissue regeneration and to locally deliver low molecular weight compounds for an extended time period, a composite for parenteral application was devised based on a collagen sponge with gentamicin-loaded PLGA microparticles incorporated . Antibiotic liberation from the particles was sustained over 1 week by blending two PLGA polymers . Homogenous incorporation of the microspheres in the porous carrier could be realized by lyophilization of a particle suspension in the aqueous collagen preparation . Particle loss upon incubation was reduced with higher collagen concentration enabling local particle retention after application . Lower freezing rate and longer exposure of the PLGA microparticles to the acidic collagen dispersion at temperatures below the glass transition temperature resulted in an increase of the gentamicin burst . The final implant containing both nonencapsulated gentamicin and an equivalent amount incorporated in the microparticles reflected the microbiological demands and exhibited liberation of a high gentamicin dose initially and subsequently extended antibiotic liberation for about one week .

Anal Biochem, 2003 Nov 15, 322(2), 225 - 32
Cellodextrin preparation by mixed-acid hydrolysis and chromatographic separation; Zhang YH et al.; A procedure for preparation of purified cellodextrins in gram quantities was developed for use in biochemical and microbiological studies . Cellodextrins were prepared by hydrolyzing microcrystalline cellulose (Avicel) over a period of 4 to 5.5h in the presence of a mixture of 80% (v/v) concentrated hydrochloric acid ( approximately 37 wt.%) and 20% (v/v) concentrated sulfuric acid ( approximately 98 wt.%) at room temperature (22 degrees C) . Acetone precipitation, washing ion exchange, and neutralization with barium hydroxide were used to generate a solution of mixed cellodextrins substantially free of acids and salts . Yields following hydrolysis and precipitation were approximately 0.05, approximately 0.07, approximately 0.06, and approximately 0.02 g/g cellulose for cellotriose (G(3)), cellotetraose (G(4)), cellopentose (G(5)), and cellohexose (G(6)), respectively . Cellodextrins with degrees of polymerization from 3 to 11 were separated chromatographically using a 29 x 5-cm I.D . Bio-Rad AG50W-X4 column arranged in series with a 91 x 5-cm I.D . Bio-Gel P4 column . This two-column system was used to obtain cellodextrin preparations at 240 mg/day for G(3), 330 mg/day for G(4), 260 mg/day for G(5), and 130 mg/day for G(6), with purity >99% for G(3), G(4), and G(5) and >95% for G(6) . The overall procedure achieves yields comparable to the highest previously reported, employs a separation system that can readily be reused for multiple runs, and avoids use of fuming HCl.

Chir Ital, 2003 Sep-Oct, 55(5), 707 - 13
{Biologic tolerance of prolene prosthesis in inguinal hernia repair}; Brancato G et al.; The aim of this study was to evaluate the efficacy, safety and durability of a calibrated inguinal hernioplasty polypropylene prosthesis, particularly in relation to the microbiological phenomena that may set in the vicinity of the polypropylene plugs and mesh employed . Over the period from January 1994 to December 2002, 1416 operations were carried out for inguinal hernia . In 5 of these patients we conducted an immunological study to assess serum cytokine concentrations . In addition, we incubated peripheral blood mononuclear cells for 24 or 72 hours in RPMI 1640 medium added with 10% FCS, with or without 0.5 cm2 of polypropylene . We then evaluated cytokine levels in the supernatant of these cultures . It proved impossible, either in vivo or in vitro, to detect appreciable levels of IL-10 or IP-10 . Serum levels of IFN-gamma, TNF-alpha, IL-18 and IL-6 increased in the postoperative phases as compared to the preoperative period . In the study performed in vitro, in the presence of prosthetic material there was a remarkable increase in the production of TNF-alpha and INF-gamma both in basal conditions and after an appropriate mitogenic stimulus . The results of this study allow us to speculate that the use of polypropylene induces remarkable chemotactic activity in the tissues adjacent to the prosthesis . The in-vitro study data suggest that the presence of polypropylene may stimulate the immunocompetent cells of patients with prosthetic implants.

Appl Microbiol Biotechnol, 2004 May, 64(4), 593 - 8 Epub 2003 Oct 28.
Initial stages of microbiologically influenced tarnishing on titanium after 20 months of immersion in freshwater; Moreno DA et al.; This paper studies the initial stages of iridescent tarnishes on titanium heat exchanger tubes in contact with running freshwater on the river Tagus in Spain for up to 20 months . Electrochemical impedance spectroscopy (EIS), scanning electron microscopy {(SEM with energy dispersive X-ray (EDX)} and X-ray photoelectron spectroscopy (XPS) in conjunction with argon-ion sputtering were the techniques used . The EIS data indicated a capacitive behavior, showing a semicircle that was better defined as the experimental time increased, indicating a decreasing tarnishing resistance of titanium . XPS and EDX results indicated that the main elements identified were calcium, phosphorus, nitrogen, and iron . The amount of these elements was higher on the tarnished titanium specimens than on the untarnished specimens . SEM analysis showed the presence of diatoms in the iridescent tarnishes on titanium tubes .

Chir Organi Mov, 2003 Jan-Mar, 88(1), 93 - 7
Mycobacterium marinum: a case of skin granuloma complicated by tenosynovitis of the extensors; Causero A et al.; The authors report the case of a male patient who owned a tropical aquarium and who developed a M . marinum skin infection of the wrist . The clinical findings and microbiological features of the case are described, as are the difficulty in providing a prompt diagnosis, and the need for surgical treatment and the use of antibiotics to treat the infection.

J Small Anim Pract, 2003 Oct, 44(10), 449 - 55
Sterile nodular panniculitis and pansteatitis in three weimaraners; German AJ et al.; The clinical and pathological findings in three unrelated weimaraners with pyrexia and multiple subcutaneous nodules are reported . Abdominal pain was an additional feature in two of the dogs and clinical investigations revealed inflammation of subcutaneous, mesenteric and falciform fat . Histopathological findings were consistent with pansteatitis . In the third dog, lesions were apparently limited to the subcutis and, hence, a diagnosis of nodular panniculitis was made . Microbiological examination of tissues was negative in all dogs, and there was no evidence of pancreatic disease . This report thus describes a presumed sterile and idiopathic panniculitis/pansteatitis complex in weimaraner dogs . Although the aetiology is unknown, this may represent an immune-mediated disorder.

Adv Anat Pathol, 2003 Nov, 10(6), 319 - 27
Pathology of food-borne infectious diseases of the gastrointestinal tract: an update; Lamps LW; Although naturally occurring food-borne pathogens cause more than 76 million illnesses, 325,000 hospitalizations, and 5000 deaths annually in the United States, many more infections are unrecognized and unreported . In addition, mass production and distribution of food, on a global rather than a local scale, make it possible for localized instances of contamination to spread quickly to other states, provinces, and countries . Infectious organisms are often recovered by microbiological methods, but surgical pathologists may play a very valuable role in diagnosis . This review will focus on the diagnosis of food-borne infectious diseases of the gastrointestinal tract, including those that mimic other inflammatory conditions of the gut (such as ischemia or idiopathic inflammatory bowel disease); available diagnostic methods; and gastrointestinal infectious processes that pathologists should be aware of in terms of potential biologic weapons threats.

Rhinology, 2003 Sep, 41(3), 184 - 6
Liposomal amphotericin B treatment for rhinocerebral mucormycosis: how much is enough?
Handzel O, Landau Z, Halperin D.
Rhinocerebral Mucormycosis is a potentially life-threatening disease, which affects mainly immunocompromised patients . Treatment options include reversing immunosuppression, surgery and systemic and local administration of anti-fungal medication . Amphotericin B is the primary agent employed, but its use is often limited by frequent side effects . Complexing Amphotericin B with lipid structures avoids most of the negative side effects, most importantly the dose-limiting nephrotoxicity . No consensus has been reached regarding the appropriate duration, rate of administration or total dose of treatment . We present a case of a patient suffering from Rhinocerebral Mucormycosis treated by extensive surgery and Liposomal Amphotericin B . He was treated for 29 days at a rate of 3 mg/kg/d and a total dose of 5.6 gram . The dose of Liposomal Aphotericin B used in previously published articles ranged from 1.5 mg/kg/d to 5 mg/kg/d . The response to treatment may be evaluated by physical examination, microbiological cultures, radiological and pathological studies . Taking into account the considerable cost of liposomal Amphotericin B and other lipid complexed formulations, it is imperative to find out what is the appropriate treatment regime for Rhinocerebral and other mucormycosis infections.

Cleft Palate Craniofac J, 2003 Nov, 40(6), 585 - 9
Clinical and microbiological evaluation of the periodontal status of children with unilateral complete cleft lip and palate; Costa B et al.; OBJECTIVE: To compare periodontal conditions in children with and without cleft.Design: Clinical examinations and microbiological analysis of 57 selected children, including 30 with unilateral complete cleft lip and palate (experimental group) and 27 without clefts (control group) . SETTING: Hospital of Rehabilitation of Craniofacial Anomalies (HRCA) in Bauru, Sao Paulo, Brazil . PATIENTS, PARTICIPANTS: All children examined were healthy and between the ages of 5 and 6 years . RESULTS: The mean plaque index (PI) in the experimental group was higher (1.82 +/- 0.3) than in the control group (1.63 +/- 0.38), although this difference was not statistically significant . The mean gingival index (GI) in the experimental group (1.82 +/- 0.38) was found to be significantly higher (p <.05) than that of the control group (0.79 +/- 0.33) . The cleft area in the experimental group, with a mean PI of 2.04 +/- 0.58 and mean GI of 1.11 +/- 0.26, compared with the posterior area, with a mean PI of 1.74 +/- 0.37 and mean GI of 1.04 +/- 0.26, showed a statistically significant difference only in the PI . Most of the children in both experimental and control groups presented a moderate PI degree (73.33% and 81.48%, respectively) and a high prevalence of mild gingivitis (53.33% and 70.37%, respectively) . Analysis of the organisms showed that Prevotella nigrescens was detected in 16.67% of the experimental group and 11.11% of the control, whereas Porphyromonas gingivalis and Treponema denticola were not detected . CONCLUSION: Children with clefts showed greater gingival inflammation, despite the same amount of plaque and prevalence of microorganisms.

Ann Dermatol Venereol, 2003 Aug-Sep, 130(8-9 Pt 1), 783 - 6
{Subcutaneous mycosis due to Scopulariopsis brevicaulis in an aplasic patient}; Karam A et al.; INTRODUCTION: Among the filamentous fungi of the Hyphomycete class, Annellospore group, the Scopulariopsis genera presently includes 16 species considered as opportunist pathogens . We report some unusual cutaneous manifestations due to Scopulariopsis brevicaulis in an immunodepressed patient . OBSERVATION: A 67 year-old man presented with a lymphomatous form of Waldenstrom's macroglobulinemia . During chemotherapy with medullar aplasia, inflammatory cutaneous nodules appeared on the forearm and leg . Microbiological and histological examinations identified Scopulariopsis brevicaulis . The patient improved with rapid remission from aplasia using hematopoietic growth factors and treatment with itraconazole . COMMENTS: In a patient in medullar aplasia, the rapid onset of an extra-ungual cutaneous localization (forearm and leg) of a Scopulariopsis brevicaulis infection, without systemic involvement, suggests that the cutaneous inoculation occurred through scratching (from the nails) or from another cutaneous origin . Prolonged neutropenia enhanced the pathogenicity of this mycosis . The mycological and histological examinations are fundamental to confirm the diagnosis.

Indian J Med Sci, 2003 Oct, 57(10), 450 - 6
Socioeconomic burden of nosocomial infections; Yalcin AN; Nosocomial infection represents an important public health problem in developing countries as in developed ones . Economic concerns have taken on increasing importance in infection control since the mid 1970s in the USA, however there are few papers on the economics of NI in other countries . Studies on the costs of NI have used different methods, definitions and degrees of stringency when calculating indirect costs and there is therefore still uncertainty over their true economic impact on the community and on the workplace economy . Drug and especially antibiotic acquisition in addition to increased length of stay are the widely and well described parameters . Extra cost of NI include; bed, intensive care unit stay, hematological, biochemical, microbiological and radiological tests, antibiotics, other drugs, extra surgical procedures and working hours . In addition to high morbidity and mortality one of the well described parameters is the extra length of stay in the hospital . High mortality rates and economic expense which NI represents emphasizes the justification for measures of control of this entity . To estimate better the current personnel and financial resources necessary to support infection control activities and to prevent NI, it is imperative that those conducting studies of hospital epidemiology and healthcare outcomes research determine these current costs.

Enferm Infecc Microbiol Clin, 2003 Nov, 21(9), 477 - 83
{Epidemiological survey of dermatophytosis in Spain (April-June 2001)}; Monzon de la Torre A et al.; INTRODUCTION: A three-month (April-June 2001) cross-sectional study was designed to assess the epidemiological profile of dermatophytosis in Spain . METHODS: Sixty-two medical centers belonging to 14 different autonomous regions of Spain took part in the survey . A total of 491 strains were sent the Mycology Unit of the National Microbiology Center together with a form containing information on each patient . Isolates were identified by routine methods . RESULTS: The average age of the patients was 38.7 years and 55.6% were men . The most frequent dermatophytoses were tinea unguium (39.1%), tinea corporis (25.1%), tinea pedis (12.6%), and tinea capitis (11.2%) . Trichophyton rubrum (43%) was the most prevalent species . T . mentagrophytes (21.2%) and Microsporum canis (9.8%) were the second and third most common species, respectively . Tinea unguium was significantly associated with urban residence, and tinea corporis with rural residence and contact with animals . T . rubrum was related with urban dermatophytosis and T . mentagrophytes with rural cases . Tinea capitis due to T . tonsurans and T . violaceum was related with patients of North African origin . Tinea unguium was the most prevalent infection by autonomous region, except in Castilla-Leon, Asturias, Andalucia and Aragon, where tinea corporis was the most common dermatophytosis . Tinea capitis was the most frequent infection in Castilla-La Mancha and Extremadura . T . mentagrophytes was more prevalent than T . rubrum in Valencia, Castilla-La Mancha, Aragon and Murcia . CONCLUSION: This cross-sectional study shows regional differences in the clinical and microbiological features of dermatophytosis in Spain . Epidemiological surveys are an essential tool for developing strategies for infection control.

Pathol Biol (Paris), 2003 Oct, 51(8-9), 496 - 502
{Lymph-node tuberculosis in patients infected or not with HIV: general characteristics, clinical presentation, microbiological diagnosis and treatment}; Hochedez P et al.; Lymph node tuberculosis is the most frequent form of extrapulmonary tuberculosis, especially in immunocompromised patients . We have studied patients with proven lymph node tuberculosis in the Department of Infectious Diseases at Pitie-Salpetriere Hospital, Paris, between January 1997 and January 2002 . Clinical presentation, microbiological diagnosis and treatment were analyzed in 13 HIV infected and 19 non-HIV infected patients . A risk factor for tuberculosis was present in all cases (HIV infection, immigration, life in community, poverty, past history of tuberculosis and IVDU) . The median duration between the onset of symptoms and diagnosis was longer for HIV infected (2 months) compared with non-HIV infected patients (1 month) . At the time of the diagnosis, general symptoms were present in >50% of patients of both groups . In HIV infected patients, abdominal lymph node involvement was more frequent (P < 0.05) . All the non-HIV infected and 85% of HIV infected patients had peripheral adenopathies . A pulmonary tuberculosis was noted in more than half of the cases (53% non-HIV and 69% HIV patients) . Inflammatory parameters and liver function tests were frequently abnormal in both groups . Hyponatremia was more frequent in HIV patients (P < 0.05) . TB skin testing was more frequently positive and phlyctenular in non-HIV infected patients (P < 0.05) . In this study, direct examination of the needle aspirate from infected lymph nodes was rarely positive; cultures were more frequently positive after biopsy compared to needle-aspiration . The median duration of treatment was 9 months for the two groups (6-24 months) . Three HIV infected patients were infected by mycobacteria resistant to at least one antibiotic (isoniazid, 1; rifampicin, 1; isoniazid, streptomycin, etambutool, 1) . All the patients recovered.

Arch Pathol Lab Med, 2003 Nov, 127(11), 1485 - 8
Utility of Gram stain for the microbiological analysis of burn wound surfaces; Elsayed S et al.; CONTEXT: Surface swab cultures have attracted attention as a potential alternative to biopsy histology or quantitative culture methods for microbiological burn wound monitoring . To our knowledge, the utility of adding a Gram-stained slide in this context has not been evaluated previously . OBJECTIVE: To determine the degree of correlation of Gram stain with culture for the microbiological analysis of burn wound surfaces . DESIGN: Prospective laboratory analysis . SETTING: Urban health region/centralized diagnostic microbiology laboratory . PATIENTS: Burn patients hospitalized in any Calgary Health Region burn center from November 2000 to September 2001 . INTERVENTION: Gram stain plus culture of burn wound surface swab specimens obtained during routine dressing changes or based on clinical signs of infection . MAIN OUTCOME MEASURES: Degree of correlation (complete, high, partial, none), including weighted kappa statistic (kappa(w)), of Gram stain with culture based on quantitative microscopy and degree of culture growth . RESULTS: A total of 375 specimens from 50 burn patients were evaluated . Of these, 239 were negative by culture and Gram stain, 7 were positive by Gram stain only, 89 were positive by culture only, and 40 were positive by both methods . The degree of complete, high, partial, and no correlation of Gram stain with culture was 70.9% (266/375), 1.1% (4/375), 2.4% (9/375), and 25.6% (96/375), respectively . The degree of correlation for all 375 specimens, as expressed by the weighted kappa statistic, was found to be fair (kappa(w) = 0.32).Conclusion.-The Gram stain is not suitable for the microbiological analysis of burn wound surfaces.

Intensive Care Med, 2004 Feb, 30(2), 217 - 24 Epub 2003 Oct 18.
Clinical pulmonary infection score for ventilator-associated pneumonia: accuracy and inter-observer variability; Schurink CA et al.; OBJECTIVE: Although quantitative microbiological cultures of samples obtained by bronchoscopy are considered the most specific tool for diagnosing ventilator-associated pneumonia, this labor-intensive invasive technique is not widely used . The Clinical Pulmonary Infection Score (CPIS), a diagnostic algorithm that relies on easily available clinical, radiographic, and microbiological criteria, could be an attractive alternative for diagnosing ventilator-associated pneumonia . Initially, the CPIS scoring system was validated upon 40 quantitative cultures of bronchoalveolar lavage fluid from 28 patients, and only few other studies have evaluated this scoring system since then . Therefore, little is known about the accuracy of this score . DESIGN: We compared the scores of a slightly adjusted CPIS with results from quantitative cultures of bronchoalveolar lavage fluid in 99 consecutive patients with suspicion of ventilator-associated pneumonia, using growth of > or =10(4) cfu/ml in bronchoalveolar lavage fluid as a cut-off for diagnosing ventilator-associated pneumonia . In addition, the CPIS were calculated for 52 patients by two different intensivists to determine the inter-observer variability . RESULTS: Ventilator-associated pneumonia was diagnosed in 69 (69.6%) patients . When using a CPIS >5 as diagnostic cutoff, the sensitivity of the score was 83% and its specificity was 17% . The area under the Receiver Operating Characteristic curve was 0.55 . The level of agreement for prospectively measured Clinical Pulmonary Infection Score (< or =6 and >6) was poor (kappa =0.16) . CONCLUSIONS: When compared to quantitative cultures of bronchoalveolar lavage fluid, the CPIS has a low sensitivity and specificity for diagnosing ventilator-associated pneumonia with considerable inter-observer variability.

Zh Mikrobiol Epidemiol Immunobiol, 2003 Sep-Oct, (5), 93 - 6
{Current epidemiological surveillance of tuberculosis}; Petrukhina MI et al.; Some present-day specific epidemiological, microbiological and clinical features of tuberculosis are presented . A variant of the epidemiological surveillance morbidity scheme, comprising 3 blocks, viz . information, analysis and management, is proposed . In the information block the basic data necessary for epidemic analysis is listed, while the diagnostic block contains the stage-by-stage analysis of the information block data . In the block of management decisions the main directions of the tuberculosis prophylaxis interventions are listed.

Med Pregl, 2003 May-Jun, 56(5-6), 227 - 31
Correlation between clinical symptoms and diagnosis of trichomoniasis in women; Radonjic I et al.; The aim of this study was to investigate correlation between clinical symptoms and diagnosis of trichomoniasis in women . 200 women were included in the study . Swabs were taken from all patients from the posterior vaginal fornix . Each sample was examined using the following five methods: wet mount, Giemsa stain, acridine orange fluorescence stain, cultivation in Diamond medium and PCR method . Trichomoniasis was diagnosed in 27 women using any of the applied methods and 33.3% presented with typical frothy yellow-green discharge, characteristic for tichomoniasis and yellowish discharge characteristic for the third group of vaginal discharge . White discharge, characteristic for Candida infection, was found in 18.5% of patients with diagnosed trichomoniasis . Finally, 14.8% of positive patients had a normal discharge . Based on the results of our study we came to the conclusion that microbiological investigations are necessary for accurate diagnosis of trichomoniasis, as well as for revealing asymptomatic infections, in order to prevent spreading of this relatively common disease.

Respir Med, 2003 Oct, 97(10), 1134 - 42
Sequential IV/PO moxifloxacin treatment of patients with severe community-acquired pneumonia; Lode H et al.; BACKGROUND: IV/PO moxifloxacin was evaluated in the treatment of hospitalized patients with severe community-acquired pneumonia (CAP) . METHODS: Data were pooled from two prospective, randomized studies . In the multinational study, patients received 7-14 days IV/PO moxifloxacin 400 mg QD or IV/ PO amoxicillin clavulanate 1200/625 mg TID +/- IV/PO clarithromycin 500 mg BID . In the North American study, patients received 7-14 days IV/PO moxifloxacin 400 mg QD, IV/ PO alatrofloxacin/trovafloxacin 200 mg QD, or IV/PO levofloxacin 500 mg QD . The primary endpoint was clinical success at the test-to-cure visit . Severe CAP was defined according to the 1993 ATS criteria . RESULTS: In the clinically valid population, clinical success rates were 88% (167/190) for moxifloxacin- and 83% (155/186) for comparator-treated patients (95% CI = -1.9%, 12.2%) . Corresponding clinical success rates for the microbiologically valid population were 87% (59/68) and 84% (54/64), respectively (95% CI = 8.6%, 15.0%) . A switch from IV to PO therapy was made by day 5 of therapy for 73% of moxifloxacin- vs . 60% of comparator-treated patients (P < 0.01) . Clinical success rates were similar in a retrospective analysis using the revised 2001 ATS definition of severe CAP . Mortality rates were 6% (15/241) and 10% (24/238) in the moxifloxacin and comparator treatment groups, respectively . The incidence of drug-related adverse events was similar in both treatment groups . CONCLUSION: Sequential IV/PO moxifloxacin 400 mg QD is as safe and effective as other fluoroquinolones and a beta-lactam/macrolide combination for treating hospitalized patients with severe CAP.

Arzneimittelforschung, 2003, 53(9), 664 - 7
Pharmacokinetics of ciprofloxacin in healthy Mexican volunteers; Escobar Y et al.; Ciprofloxacin (CAS 85721-33-1) is a gyrase inhibitor used against a wide number of bacteria which develops a very low bacterial resistance . Its pharmacokinetics has been extensively studied using two main methods, liquid chromatography and microbiological assay . The pharmacokinetics of ciprofloxacin administered orally was evaluated in healthy Mexican volunteers after a dose of 500 mg . Ciprofloxacin was assayed from plasma by a specific HPLC method reading absorbance at 280 nm . Pharmacokinetic parameters were similar to reported values, including a previous study on Mexican healthy volunteers with the microbiological assay . AUC was 12.11 mg h/l, Cmax 2.44 mg/l, tmax 0.79 h and half-life 3.8 h . tmax was slightly shorter than those in other studies . Ciprofloxacin presented no adverse reactions and can be dosed to people with Amerindian origin in the same dose regimes as prescribed to Caucasians in order to achieve minimal inhibitory concentrations against a wide range of microbial pathogens.

FEMS Immunol Med Microbiol, 2003 Oct 24, 39(1), 81 - 6
Quantitative real-time PCR using TaqMan and SYBR Green for Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, tetQ gene and total bacteria; Maeda H et al.; Accurate quantification of bacterial species in dental plaque is needed for microbiological diagnosis of periodontal diseases . The present study was designed to assess the sensitivity, specificity and quantitativity of the real-time PCR using the GeneAmp Sequence Detection System with two fluorescence chemistries . TaqMan probe with reporter and quencher dye, and SYBR Green dye were used for sources of the fluorescence . Primers and probes were designed for Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia and total bacteria based on the nucleotide sequences of the respective 16S ribosomal RNA genes . Since spread of antibiotic resistance genes is one of the crucial problems in periodontal therapy, quantitative detection of tetQ gene, which confers resistance to tetracycline, was included in the examination . The detection of P . gingivalis, P . intermedia and A . actinomycetemcomitans was linear over a range of 10-10(7) cells (10-10(7) copies for tetQ gene), while the quantitative range for total bacteria was 10(2)-10(7) cells . Species-specific amplifications were observed for the three periodontal bacteria, and there was no significant difference between the TaqMan and SYBR Green chemistry in their specificity, quantitativity and sensitivity . The SYBR Green assay, which was simpler than TaqMan assay in its manipulations, was applied to the clinical plaque samples . The plaque samples were obtained from eight patients (eight periodontal pockets) before and 1 week after the local drug delivery of minocycline . Although the number of P . gingivalis, P . intermedia and A . actinomycetemcomitans markedly decreased after the antibiotic therapy in most cases, higher copy numbers of the tetQ gene were detectable . The real-time PCR demonstrated sufficient sensitivity, specificity and quantitativity to be a powerful tool for microbiological examination in periodontal disease, and the quantitative monitoring of antibiotic resistance gene accompanied with the antibiotic therapy should be included in the examination.

J Infect, 2003 Nov, 47(4), 317 - 21
The role of induced sputum in the diagnosis of pulmonary tuberculosis; Bell D et al.; OBJECTIVES: To determine the sensitivity of referral guidelines for induced sputum in pulmonary tuberculosis (PTB) case detection and determine the diagnostic yield of the test . METHODS: A retrospective analysis of case notes of adult patients referred for induced sputum was carried out at the North Trent Regional Department of Infection and Tropical Medicine, the Royal Hallamshire Hospital, Sheffield, UK . Clinical characteristics were noted on patients referred during a 12-month period in 2001-2002, and of all patients with positive induced sputum results from April 1998 to March 2002 . RESULTS: Over a 12-month period 114 patients were referred in our unit for induced sputum sampling . Twelve of the 114 patients had positive sputum cultures giving a positive yield for the test of 10.5% . With strict adherence to our referral guidelines, 10 of the 12 positive cases (83.3%) would have been detected . With modification to the referral guidelines, all 12 microbiologically positive cases would have been detected making the guidelines 100% sensitive in detecting microbiologically positive cases among patients referred with a clinical suspicion of PTB who are unable to self-expectorate . The positive yield for the test would have been increased to 13.2% . In the past 4 years 29 patients had positive induced sputum results . Of these, 11 patients (37.9%) had concurrent microbiological proven extra-pulmonary TB (EPTB) and 10 (34.5%) had past histories of TB infection . Seven patients had chest X-rays reported as normal . CONCLUSIONS: Induced sputum offers a relatively non-invasive investigation for patients with suspected PTB who are unable to bring up sputum . Induced sputum also offers a means of establishing a microbiological diagnosis in some cases of EPTB . An investigative algorithm is suggested.Summary . In an era of increasing drug resistant disease, establishing a microbiological diagnosis of TB is paramount . Sputum induction can be used as an alternative investigation to bronchoscopy in suspected PTB patients who are able to self-expectorate . Induced sputum is a sensitive investigation for suspected PTB patients but with a low diagnostic yield . Referral guidelines are suggested.

Infection, 2003 Oct, 31(5), 350 - 2
Safety of heart-lung machines during prolonged standby; Witschi A et al.; BACKGROUND: Coronary artery bypass surgery is increasingly performed without an extra-corporeal circuit . A heart-lung machine (HLM) is kept on standby for safety reasons, but rarely used . The tubes of the machines are currently discarded after every operation . Costs and waste would be avoided if HLMs could stay on standby for longer periods of time . We therefore investigated the sterility of intra-tube fluid over time . MATERIALS AND METHODS: Four machines were tested . The tube system was fixed and filled with priming solution . Samples of intra-tube fluid and fluid from the fluid bags were taken after 0, 12, 24, 36, 48 and 72 h . Microbiological cultures were performed by direct inoculation and membrane filtration and incubated up to 14 days . Endotoxin levels were also determined . RESULTS: Bacteria were grown from two samples only and were considered as contaminants . Endotoxin concentrations never exceeded acceptable levels . CONCLUSION: To keep HLMs on standby for 72 h is probably safe . The prolonged use of HLMs will contribute to cost and waste reduction in open heart surgery.

Chest, 2003 Oct, 124(4), 1451 - 9
Surgical treatment of pacemaker and defibrillator lead endocarditis: the impact of electrode lead extraction on outcome; del Rio A et al.; BACKGROUND: Cardiac device (CD) endocarditis is an infrequent but potentially lethal infectious complication of permanent pacemakers or implantable cardioverter-defibrillators (ICDs), and mortality rates of 30 to 35% have been reported . Medical treatment has been suggested for the treatment of CD endocarditis, but there is increasing evidence that surgical treatment is to be preferred as the best approach to achieve eradication of the infection and reduce mortality . OBJECTIVE: To evaluate the following: (1) the clinical and echocardiographic characteristics of patients with pacemaker or ICD endocarditis, (2) the outcome of this population depending on the mode of treatment (medical vs surgical treatment), and (3) the clinical, microbiological, echocardiographic, and therapeutic variables associated with patient outcome . DESIGN: Prospective cohort study . SETTING: Tertiary referral center in Barcelona, Spain . PATIENTS: All consecutive patients with infectious endocarditis (IE) admitted to the study institution between 1990 and 2001 were prospectively evaluated by a multidisciplinary treatment team, and a definite diagnosis of CD endocarditis was established when cases met pathologic or clinical criteria according to the Duke criteria . RESULTS: A total of 31 patients, 25 men and 6 women aged 61 +/- 15 years (mean +/- SD), with pacemaker or ICD endocarditis were identified among 669 consecutive patients (4.6%) with IE . During the study period, a total of 3,768 pacemakers and 460 ICDs were implanted in the study institution . In 22 cases of pacemaker endocarditis, the pacemaker was implanted in our institution, and 9 cases were referred from other institutions (incidences of endocarditis on pacemaker and ICD implanted in our institution of 0.58% and 0.65%, respectively) . Medical treatment without removal of the pacing system was initially performed on seven patients; all of them (100%) had relapses of endocarditis, and one patient died . The remaining 24 patients underwent surgical removal of the pacing system; 1 patient had one relapse, 3 patients died after surgical treatment, and the others were successfully cured with no relapses after a mean follow-up of 38 +/- 9 months . Clinical, echocardiographic, microbiological, and therapeutic variables were evaluated in association with prognosis . The only prognostic factor for failure of treatment or mortality was the absence of surgical treatment (p < 0.0001) . CONCLUSIONS: Electrode lead endocarditis occurred in < 1% of pacemaker and ICD implants . Conservative treatment without explantation of all hardware failed in all patients, and surgical treatment during antibiotic therapy was effective in eradication of infection but was associated with a 12.5% mortality . The only patient characteristic associated with treatment failure or death was the absence of surgical removal of all infected hardware . Complete extraction of the pacemaker or ICD should be considered as standard therapy for most patients with CD endocarditis.

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi, 2003 Sep, 17(5), 414 - 7
{Urethral epithelium culture by using L929 cells as trophoderm in vitro}; Zhai HF et al.; OBJECTIVE: To study the technique and method of urethral epithelium culture in vitro, so as to lay the groundwork for reconstructing a tissue engineering urethra and to provide an experimental model of urethral mucosa in physiological, pathological, toxicological and microbiological study . METHODS: The urethral mucosa from a young male New Zealand hare that had just been out of milk, was digested into single cell liquid with Dispase II and mixed enzyme, and the fibroblast were removed . After being seeded, the cells were cultured by using L929 cells as trophoderm . The medium was changed regularly and the cells were subcultured when they grew to mix together 80% to 90% . The cultured cells were analyzed with histochemistry, immunohistochemistry dyeing and flow cytometry examination . We observed the ultrastructure of cells with scanning electron microscope and transmission electron microscope . RESULTS: The primary cultured cells fused when they had been cultured for about ten days . They were the same in size like road rocks . The cultured cells were all epithelial cells without fibroblasts and were diploid cells . The cells could be subcultured 11-13 generations, and could survive 50-60 days . CONCLUSION: The urethral epithelium of young New Zealand hare can be cultured in vitro and maintain the ability to proliferate within a certain time . The study result not only sets a role in reconstructing a tissue engineering urethral mucosa, but also provides an experimental model for the research of urethral mucosa in vitro.

Mar Pollut Bull, 2003 Oct, 46(10), 1309 - 16
Toxicity comparison of biosurfactants and synthetic surfactants used in oil spill remediation to two estuarine species; Edwards KR et al.; The relative environmental toxicities of synthetic and biogenic surfactants used in oil spill remediation efforts are not well understood . Acute and chronic toxicities of three synthetic surfactants and three microbiologically produced surfactants were determined and compared in this study for the estuarine epibenthic invertebrate, Mysidopsis bahia and the inland silverside, Menidia beryllina . The toxicities of the surfactant were determined in standard laboratory static and static-renewal tests of 4-7 d duration . Results were specific to the surfactant, response parameter and test species . The LC50 values (nominal concentrations) for M . bahia ranged from 3.3 mg/l (Triton X-100) to >1000 mg/l (PES-61) and 2.5 mg/l (Triton X-100) to 413.6 mg/l (PES-61) for M . beryllina . Chronic first-effect concentrations (mg/l) for the six surfactants ranged from 2.3 to 465.0 (M . beryllina) and 1.0 to >1000.0 (M . bahia) based on reductions in growth and fecundity . Few generalizations could be made concerning the results due to their variability but M . bahia was generally the more sensitive species and the toxicities of the biosurfactants were intermediate to those of the synthetic surfactants.

Biotechnol Adv, 1994, 12(4), 669 - 77
Nucleic acid probes for the food industry; Dooley JS; Recombinant DNA technology has revolutionised microbiological analysis by providing rapid and sensitive methods for the direct detection and identification of organisms . These advances have been most successfully applied to basic research and to clinical microbiology . Continued improvements in the techniques and in assay formats have now brought them to the stage where they could be useful on an industrial scale . The use of nucleic acid techniques for the identification of bacteria of importance to the food industry is discussed with emphasis on developments in practical applications.

Biotechnol Adv, 1984, 2(2), 319 - 27
The role of microorganisms in the formation of pitch deposits in pulp and paper mills; Stranger-Johannessen M; The cause of pitch deposit formation seems still not fully understood . The work reported here demonstrates that microorganisms effect the agglomeration of emulgated resin droplets and the formation of sticky precipitates.Pitch deposits from mills consist mainly of ethanol-soluble resins . It is also the ethanol-soluble fraction of wood resins which forms stable emulsions and which is easily agglomerated by microorganisms.Pitch deposits, collected from various pulp and paper mills, were all found to contain large amounts of microorganisms . Sterile resin emulsions prepared from pitch deposits remained stable over long periods . After inoculation with microorganisms the emulsions were destabilized and the resins completely precipitated as sticky lumps.Various bacteria and fungi are capable of agglomerating the resins, but species isolated from water, pulp and slime in paper mills were usually most effective . Resins from fresh wood were precipitated at a faster rate than aged resins.Problems of pitch formation can be considerably reduced when microbial growth is kept under control in the production system . To be effective, the control measures, e.g . slimicides, must be applied at the right place and time, and in the correct concentrations . This presupposes a thorough knowledge of the plant's microbiological condition which can only be obtained by microbiological examination . Practical cases of the appropriate application of biocides in pulp and paper mill systems are discussed.

Andrologia, 2003 Oct, 35(5), 317 - 20
Aetiology of haemospermia; Papp GK et al.; There are several unknown factors which cause haemospermia . An earlier developed diagnostic scheme has been expended by novel imaging techniques and biopsy methods . A detailed case history, physical examination and microscopic analysis of the ejaculate is required . In haemo-pyospermia a complete microbiological analysis must be escalated . Noninvasive imaging techniques (ultrasound, computer tomography and magnetic resonance imaging) help in detecting calculous and malignant diseases . So far, as a precise diagnosis has not been available, urethroscopy has been performed . Malignancies (prostate, seminal vesicles) must be histologically verified by biopsies . In contempt of our efforts the practice shows a part of haemospermia remaining essential . Analysing two time periods we found prostatic calculi, chronic prostatitis and carcinoma of the prostate unequivocally as most frequent causes . Considering the rare genital malignancies we find more than 10% frequency . Notably, in our study only 2.4% of the malignancies occurred in patients under 40 years of age . Hence a detailed diagnosis is advocated in haemospermia patients over 40 years . Finally, we may state that in contempt of the applied modern imaging techniques 15% of patients with haemospermia had unknown aetiology.

Presse Med, 2003 Sep 20, 32(30), 1397 - 402
{The interest and assessment of the application of antibiotic protocols in a department of pneumology}; Ledru S et al.; OBJECTIVE: To assess whether antibiotic prescriptions in a department of pneumology are in accordance with the hospital conventions and whether documented prescriptions and probabilistic prescriptions are correctly adapted with regard to microbiological results and clinical progression of patients . METHOD: A 3-month prospective observational study was performed from november 1999 to january 2000 in a department of pneumology on all antibiotic prescriptions . The referential used for the conformity of probabilistic was the guide to pneumology antibiotic protocols regarding the most frequently encountered diseases . Treatment was considered adapted if the choice of the molecule and the dose administered were effective . Documented antibiotherapy was considered appropriate if the dose was correct and/or the micro-organisms were sensitive to at least one of the molecules administered . Probabilistic treatment was considered appropriated if progression was good without any change in the antibiotics . RESULTS: Among the 404 patients hospitalised in Pneumology, 132 (33%) received at least one antibiotherapy . There was a total of 163 treatments, 142 (87%) of which were probabilistic and 21 were documented . Seventy-two percent of the probabilistic prescriptions were in accordance with the protocols . The majority of those which did not conform (60.5%) was due to the dose rather than the choice of the antibiotic . More than three quarters of the probabilistic and documented treatments (79%) were clinically adapted . Treatment failures were more often due to a mistake in spectrum rather than an inappropriate dose . CONCLUSION: The use of antibiotics has become increasingly complex because of the need for therapeutic efficacy, limitation of the selection of microbial resistance, and the cost of treatment . Application of antibiotic protocols drawn-up by the clinicians, microbiologists and chemists concerned appears to be an efficient solution that is clearly acceptable to the various participants.

Klin Monatsbl Augenheilkd, 2003 Sep, 220(9), 634 - 7
{Flap Amputation in Mycobacterium chelonae Keratitis after Laser-in-situ Keratomileusis (LASIK)}; Kohnen T et al.; BACKGROUND: Keratitis due to Mycobacterium chelonae after laser-in-situ keratomileusis (LASIK) is a rare, but severe complication . In the following report, we present clinical findings, microbiological investigation, treatment and outcome of the first case of Mycobacterium chelonae reported in Europe . PATIENT AND METHODS: A 52-year old woman presented with atypical unilateral keratitis after LASIK . Mycobacterium chelonae keratitis was diagnosed by microbiological investigation . Interface irrigation and treatment with topical and oral antibiotics was performed . RESULTS: Despite intensive treatment, flap removal was necessary to control the infection . Best-corrected visual acuity dropped from preoperatively 1.0 to postoperatively 0.2 . CONCLUSION: The diagnosis of mycobacterial keratitis after laser-in-situ keratomileusis is often delayed due to atypical clinical appearance . Therefore consideration of atypical pathogens and rapid microbiological diagnosis is necessary to provide adequate treatment.

Appl Environ Microbiol, 2003 Oct, 69(10), 6201 - 7
Assessment of the effects of holding time and temperature on Escherichia coli densities in surface water samples; Pope ML et al.; Escherichia coli is a routinely used microbiological indicator of water quality . To determine whether holding time and storage conditions had an effect on E . coli densities in surface water, studies were conducted in three phases, encompassing 24 sites across the United States and four commonly used monitoring methods . During all three phases of the study, E . coli samples were analyzed at time 0 and at 8, 24, 30, and 48 h after sample collection . During phase 1, when 4 degrees C samples were evaluated by Colilert or by placing a membrane onto mFC medium followed by transfer to nutrient agar containing 4-methylumbelliferyl-beta-D-glucuronide (mFC/NA-MUG), three of four sites showed no significant differences throughout the 48-h study . During phase 2, five of seven sites showed no significant difference between time 0 and 24 h by membrane filtration (mFC/NA-MUG) . When evaluated by the Colilert method, five of seven sites showed no significant difference in E . coli density between time 0 and 48 h . During phase 3, 8 of 13 sites showed no significant differences in E . coli densities between time 0 and the 48-h holding time, regardless of method . Based on the results of these studies, it appears that if samples are held below 10 degrees C and are not allowed to freeze, most surface water E . coli samples analyzed by commonly used methods beyond 8 h after sample collection can generate E . coli data comparable to those generated within 8 h of sample collection . Notwithstanding this conclusion, E . coli samples collected from surface waters should always be analyzed as soon as possible.

Water Sci Technol, 2003, 48(4), 245 - 8
Effect of intermediate soil cover on municipal solid waste decomposition; Marquez-Benavides L et al.; A complex series of chemical and microbiological reactions is initiated with the burial of refuse in a sanitary landfill . At the end of each labour day, the municipal solid wastes (MSW) are covered with native soil (or an alternative material) . To investigate interaction between the intermediate cover and the MSW, five sets of columns were set up, one packed with refuse only, and four with a soil-refuse mixture (a clay loam, an organic-rich peaty soil, a well limed sandy soil and a chalky soil) . The anaerobic degradation over 6 months was followed in terms of leachate volatile fatty acids, chemical oxygen demand, pH and ammoniacal-N performance . Results suggest that the organic-rich peaty soil may accelerate the end of the acidogenic phase . Clay appeared not to have a significant effect on the anaerobic degradation process.

Water Sci Technol, 2003, 48(4), 45 - 52
The analysis of methods for measurement of methane oxidation in landfills; Nozhevnikova A et al.; Landfills and dumps are important sources of atmospheric methane . There is no generally accepted estimate of the influence of methane oxidation on landfill methane emissions . The present work aimed to analyse different methods for the investigation of methane emission and oxidation in methane-producing environments (wetlands, landfills, sludge checks), and to develop the precise procedure for the landfills . The combination of geochemical and microbiological methods to estimate and monitor the oxidation and emission of methane in landfills during different seasons is proposed . It includes the measurements, both on the surface and at different depths (up to 1 m) of landfill ground of the following parameters: (1) concentrations of methane, carbon dioxide and oxygen; (2) quantity of 13C isotope in gas samples; (3) methane-oxidation activity of landfill grounds assayed with two different methods: (a) in conditions of no moisture or substrate limitations, and (b) in conditions with a minimal deviation to in situ conditions; (4) the density of methanotrophic microbial population.

J Vet Intern Med, 2003 Sep-Oct, 17(5), 674 - 9
Hemostatic changes in dogs with naturally occurring sepsis; de Laforcade AM et al.; Sepsis is a frequent source of morbidity and mortality in critically ill patients . The goal of this case control study was to measure hemostatic changes in dogs with naturally occurring sepsis . Blood was collected within 24 hours of admission from 20 dogs that fulfilled the criteria for sepsis . Sepsis was defined as histologic or microbiological confirmation of infection and 2 or more of the following criteria: hypo- or hyperthermia, tachycardia, tachypnea, or leukopenia, leukocytosis, or > 3% bands . Culture and sensitivities were performed on appropriate samples from all septic dogs . Twenty-eight control dogs were enrolled on the basis of normal results of physical examination, CBC, serum biochemistry, and coagulation profile . Plasma samples were analyzed for prothrombin time (PT), partial thromboplastin time (PTT), fibrin(ogen) degradation products (FDP), D-dimer (DD) concentrations, antithrombin (AT) activity, and protein C (PC) activity . Data were compared between groups by chi-square or independent t-tests . PC (P < .001) and AT (P < .001) activities were significantly lower in dogs with sepsis compared to controls . Dogs with sepsis had significantly higher PT (P = .007), PTT (P = .005), D-dimer (P = .005), and FDP (P = .001) compared to controls . Platelet counts were not significantly different between groups . Ten of the 20 septic dogs (50%) died, but no association was identified between any of the measured variables and outcome . These findings are consistent with previous studies in animals with experimentally induced disease and in clinical studies of humans . On the basis of these results, further investigation of the role of AT and PC in canine sepsis is warranted.

Int J Clin Pract, 2003 Sep, 57(7), 635 - 6
An unusual cause of carpal tunnel syndrome; Hui AC et al.; Tuberculosis is an uncommon cause of carpal tunnel syndrome . We report a patient with systemic lupus erythematosus who developed hand numbness . Ultrasonic, operative and microbiological findings supported the diagnosis of median nerve compression secondary to a tuberculous abscess . The symptoms resolved with surgical excision and antituberculous chemotherapy.

Arch Latinoam Nutr, 2003 Jun, 53(2), 209 - 15
{Development of an optimized formulation of damask marmalade with low energy level using Taguchi methodology}; Villarroel M et al.; The goal of this present study was the development of an optimized formula of damask marmalade low in calories applying Taguchi methodology to improve the quality of this product . The selection of this methodology lies on the fact that in real life conditions the result of an experiment frequently depends on the influence of several variables, therefore, one expedite way to solve this problem is utilizing factorial desings . The influence of acid, thickener, sweetener and aroma additives, as well as time of cooking, and possible interactions among some of them, were studied trying to get the best combination of these factors to optimize the sensorial quality of an experimental formulation of dietetic damask marmalade . An orthogonal array L8 (2(7)) was applied in this experience, as well as level average analysis was carried out according Taguchi methodology to determine the suitable working levels of the design factors previously choiced, to achieve a desirable product quality . A sensory trained panel was utilized to analyze the marmalade samples using a composite scoring test with a descriptive acuantitative scale ranging from 1 = Bad, 5 = Good . It was demonstrated that the design factors sugar/aspartame, pectin and damask aroma had a significant effect (p < 0.05) on the sensory quality of the marmalade with 82% of contribution on the response . The optimal combination result to be: citric acid 0.2%; pectin 1%; 30 g sugar/16 mg aspartame/100 g, damask aroma 0.5 ml/100 g, time of cooking 5 minutes . Regarding chemical composition, the most important results turned out to be the decrease in carbohydrate content compaired with traditional marmalade with a reduction of 56% in coloric value and also the amount of dietary fiber greater than similar commercial products . Assays of storage stability were carried out on marmalade samples submitted to different temperatures held in plastic bags of different density . Non percetible sensorial, microbiological and chemical changes were detected after 90 days of storage under controlled conditions.

Boll Chim Farm, 2003 Jun, 142(5), 206 - 10
Synthesis and bactericidal properties of ethyl 4-sulfonamido pyrimidine 5-carboxylate derivatives; Cieplik J et al.; The paper presents synthesis of ethyl 6-methyl-4-arylamine-4-sulfonamide-2-phenyl-5-carboxypyrimidine derivatives and the results of microbiological tests of new derivatives performed on selected bacterial strains.

Mikrobiologiia, 2003 Jul-Aug, 72(4), 535 - 46
{Microbial sulfate reduction in sediments of the coastal zone and littoral of the Kandalaksha bay of the White sea}; Savvichev AS et al.; Microbiological and biogeochemical investigations of the coastal zone and the littoral of the Kandalaksha Bay of the White Sea were carried out . The material for investigations was obtained in the series of expeditions of the Institute of Microbiology, Russian Academy of Sciences, in August 1999, 2000, 2001, and in March 2003 . The studies were conducted on the littoral and in the water area of the Kandalaksha Preserve, the Moscow University Belomorsk Biological Station, and the Zoological Institute Biological Station, Russian Academy of Sciences, Sediment sampling on the littoral was carried out in the typical microlandscapes differing in the sediment properties and macrobenthos distribution . The maximal sulfate reduction rate (SRR) was shown for the shallow part of the Chemorechenskaya Bay (up to 2550 micrograms S/(dm3 day)) and in the Bab'ye More Bay (up to 3191 micrograms S/(dm3 day)) . During the winter season, at a temperature of -0.5-0.5 degrees C, the SRR in the sediments of the Kartesh Bay was 7.9-13 micrograms S/(dm3 day) . In the widest limits, the SRR values varied in the sediment cores sampled on the littoral . The minimal values (11 mu}g S/(dm3 day)) were obtained in the core samples on the silt-sandy littoral . The littoral finely dispersed sediments rich in organic matter were characterized by high SRR values (524-1413 micrograms S/(dm3 day)) . The maximal SRR values were shown for the sediments present within the stretch of decomposing macrophytes, in local pits at the lower littoral waterline, and in the mouth of a freshwater stream (51-159 mg S/(dm3 day)) . A sharp difference in the level of H2S production in the type microlandscapes was shown . The average hydrogen sulfide production in finely dispersed sediments constituted 125 mg S/(m2 day); in stormy discharge deposits, 1950 mg S/(m2 day); in depressions under stones and in silted pits, 4300 mg S/(m2 day) . A calculation made with regard to the area of microlandscapes with increased productivity shows that the daily H2S production per 1 km2 of the littoral (August) is 60.8 to 202 kg S/(km2 day), while the organic carbon consumption for sulfate reduction per 1 km2 of the littoral is 46 to 152 kg C(org)/(km2 day).

Pediatr Crit Care Med, 2003 Oct, 4(4), 437 - 43
Ventilator-associated pneumonia in intubated children: comparison of different diagnostic methods; Gauvin F et al.; OBJECTIVES: To compare different methods for diagnosis of ventilator-associated pneumonia in intubated children . DESIGN: Prospective epidemiologic study . SETTING: Pediatric intensive care unit of a tertiary care university hospital . PATIENTS: All consecutive pediatric intensive care unit patients <18 yrs of age with suspected ventilator-associated pneumonia . INTERVENTIONS: For all patients, the following diagnostic methods were compared: 1) clinical data using Centers for Disease Control criteria; 2) blind protected bronchoalveolar lavage, evaluating quantitative cultures, bacterial index of >5, Gram stain, and presence of intracellular bacteria; and 3) nonquantitative cultures of endotracheal secretions . The reference standard used was clinical judgment of three independent experts (Delphi method) who retrospectively established by consensus the presence of ventilator-associated pneumonia based on clinical, microbiological, and radiologic data . Concordance between each diagnostic method and the reference standard was evaluated by concordance percentage and kappa score . Validity was evaluated using sensitivity, specificity, positive predictive value, negative predictive value, and global value . RESULTS: A total of 30 patients were included in the study . According to the reference standard, ventilator-associated pneumonia occurred in 10 of 30 patients (33%) . Bacterial index of >5 in bronchoalveolar secretions showed the best concordance compared with the reference standard (concordance, 83%; kappa, 0.61) . Bacterial index of >5 also showed the best validity (sensitivity, 78%; specificity, 86%; positive predictive value, 70%; negative predictive value, 90%; global value, 90%) . Intracellular bacteria and Gram stain from bronchoalveolar secretions were very specific (95% and 81%, respectively) but not sensitive (30% and 50%, respectively) . Clinical criteria and endotracheal cultures were very sensitive (100% and 90%, respectively) but poorly specific (15% and 40%, respectively) . CONCLUSION: Our data show that the most reliable diagnostic method for ventilator-associated pneumonia is a bacterial index of >5, using blind protected bronchoalveolar lavage . Further studies should evaluate the validity of all these methods according to the gold standard (autopsy).

Eur J Pediatr, 2003 Dec, 162(12), 840 - 3 Epub 2003 Oct 02.
Hindsight judgement on ambiguous episodes of suspected infection in critically ill children: poor consensus amongst experts?
Fischer JE, Seifarth FG, Baenziger O, Fanconi S, Nadal D.
Few episodes of suspected infection observed in paediatric intensive care are classifiable without ambiguity by a priori defined criteria . Most require additional expert judgement . Recently, we observed a high variability in antibiotic prescription rates, not explained by the patients' clinical data or underlying diseases . We hypothesised that the disagreement of experts in adjudication of episodes of suspected infection could be one of the potential causes for this variability . During a 5-month period, we included all patients of a 19-bed multidisciplinary, tertiary, neonatal and paediatric intensive care unit, in whom infection was clinically suspected and antibiotics were prescribed ( n=183) . Three experts (two senior ICU physicians and a specialist in infectious diseases) were provided with all patient data, laboratory and microbiological findings . All experts classified episodes according to a priori defined criteria into: proven sepsis, probable sepsis (negative cultures), localised infection and no infection . Episodes of proven viral infection and incomplete data sets were excluded . Of the remaining 167 episodes, 48 were classifiable by a priori criteria ( n=28 proven sepsis, n= 20 no infection) . The three experts only achieved limited agreement beyond chance in the remaining 119 episodes (kappa = 0.32, and kappa = 0.19 amongst the ICU physicians) . The kappa is a measure of the degree of agreement beyond what would be expected by chance alone, with 0 indicating the chance result and 1 indicating perfect agreement . CONCLUSION: agreement of specialists in hindsight adjudication of episodes of suspected infection is of questionable reliability.

Cardiovasc Res, 2003 Oct 15, 60(1), 11 - 25
Myocarditis and inflammatory cardiomyopathy: microbiological and molecular biological aspects; Calabrese F et al.; Myocarditis is an inflammatory disease of the myocardium associated with cardiac dysfunction . The natural history of myocarditis is frequently characterised by the evolution in dilated cardiomyopathy . Due to its variable clinical manifestation from latent to very severe clinical forms, such as acute congestive heart failure and sudden death, its prevalence is still unknown and probably underestimated . In spite of the development of various diagnostic modalities, early and definite diagnosis of myocarditis still depends on the detection of inflammatory infiltrates in endomyocardial biopsy specimens according to the Dallas criteria . Routine application of immunohistochemistry, used for identification and characterisation of inflammatory cell populations, has now significantly increased the sensistivity of the diagnosis of inflammatory cardiomyopathy . Various molecular techniques, such as PCR, gene sequencing and real-time PCR, often applied on the same endomyocardial specimen, have become an essential part of the diagnostic armamentarium for rapid, specific and sensitive identification of infective agents . The correct application of molecular techniques will allow increasingly more information to be obtained: new epidemiology, new patient risk stratification and overall more appropriate medical treatment.

Am J Health Syst Pharm, 2003 Sep 15, 60(18), 1853 - 5
Using medium-fill simulation to establish a benchmark microbiological contamination rate for low-risk-level compounding; Trissel LA et al.; A benchmark contamination rate for prefilled syringe compounding was determined by using a medium-fill-simulation method . One thousand thirty-five 1-mL tuberculin syringes were aseptically filled with 0.9 mL of sterile soybean-casein digest medium and capped . These syringes were placed into clear nonsterile plastic bags and incubated at 35 degrees C for seven days, then inspected for cloudiness or colony formation indicative of bacterial growth . The operation was performed by two certified pharmacy technicians in an ISO Class 5 vertical-airflow biological safety cabinet in a typical inpatient pharmacy compounding area over two days . The technicians wore protective garments and gloves and followed standard procedures of preparing sterile injections . The adequacy of the methodology was verified by using four syringes that contained deliberately contaminated medium and incubating them along with 15 aseptically prepared syringes at 35 degrees C for seven days . Colony formation in the four syringes containing contaminated medium was directly observed and differentiated from the control syringes, which confirms the validity of the method . No bacterial growth was detected in any of the 1035 medium-filled syringes studied . Therefore, the contamination rate for aseptic compounding operation was less than 0.1% . Medium-fill-simulation testing of 1035 prefilled tuberculin syringes yielded no contamination . A contamination rate of less than 0.1% should be achievable and expected for this type of low-risk pharmacy preparation after pharmacies validate their own compounding operation.

Ter Arkh, 2003, 75(8), 76 - 8
{Treatment of patients with visceral candidiasis}; Makova GN et al.; AIM: To study effectiveness of antimycotic medication with flucostat in patients with visceral candidiasis . MATERIAL AND METHODS: Diagnosis of bronchopulmonary, gastrointestinal, urogenital candidiasis was verified microbiologically in 152 patients aged 20 to 78 years . Candidiasis was treated with flucostat: 50 mg and 150 mg capsules per os and solution (100-50 ml) intravenously by dropper . RESULTS: The response was achieved in 140 (92.1%) patients: cure--in 107 (70.4%), improvement--in 33 (21.7%), mycological sanation--in 125 (82.2%) patients . CONCLUSION: Cure of chronic diseases complicated by mycotic infection is not always achieved after mycotic sanation . Some symptoms of severe chronic pathology persist and require long-term symptomatic treatment.

Hua Xi Kou Qiang Yi Xue Za Zhi, 2003 Aug, 21(4), 292 - 4
{The effect of pulsed Nd:YAG laser used as an adjunct to subgingival scaling and root planning}; Wang Z et al.; OBJECTIVE: This study was to observe and compare the microbiological effects of laser therapy combined with ultrasonic subgingival scaling and root planning (SRP) versus SRP alone . METHODS: 26 contra lateral teeth were randomly assigned to the test group (laser + SRP) or the control group (SRP alone) . Subgingival microbial samples were collected, cultured and analyzed at baseline, then repeated immediately after laser treatment at week 1, week 2 and week 4 . RESULTS: Although both groups had significant increase in G+/G- ratio (P < 0.01), the changes of G+ and G- were more obvious in the test group till week 1(P < 0.05) . The total CFU of test group diminished significantly just after laser irradiation (P < 0.05) . That revealed the laser therapy followed by SRP appeared to have a stronger effect on converting the subgingival micro-ecosystem to healthy status . CONCLUSION: Laser appeared to have a stronger bactericidal action in vivo . especially on the dark-pigmented G- rods associated with periodontal disease.

Int J STD AIDS, 2003 Sep, 14(9), 630 - 1
Audit of gonorrhoea test of cure at the genitourinary medicine department in Newcastle upon Tyne, UK; Holland TM et al.; The aim of the audit was to assess the need for a microbiological test of cure for gonorrhoea when a sensitive antibiotic has been used . All cases of gonorrhoea attending our clinic in 2001 were reviewed . One hundred and seventy-three cases were diagnosed, 137 men and 36 women . Of the 126 cases where tests of cure were taken, none were positive from an infective site when a sensitive antibiotic was used . Cases of gonorrhoea from year 2000 were then analysed for test of cure . Of 125 tests of cure again none were positive . These results question the need for routine tests of cure which current national guidelines state are usually performed in UK practice . The implications of abandoning a test of cure visit are discussed.

Adv Space Res, 2003, 31(7), 1839 - 45
Expression of lux-genes as an indicator of metabolic activity of cells in model ecosystem studies; Boyandin AN et al.; Quick response to different impacts and easy measurement make the luminescent systems of luminous bacteria an object convenient for application in various fields . Cloning of gene luminescence in different organisms is currently used to study both the survival of microbial cells and the effect of different factors on their metabolic activity, including the environment . A primary test-object in estimating bacteriological contamination of water bodies, Escherichia coli, can be conveniently used as an indicator of bactericidal properties of aquatic ecosystems . The application of Escherichia coli Z905/pPHL7 (lux+) as a marker microorganism can facilitate monitoring the microbiological status of closed biocenoses, including systems with higher organisms . The investigation of various parameters of microecosystems (carbon nutrition type, concentrations of inorganic ions and toxic compounds) shows that the recombinant strain E . coli Z905/pPHL7 can be effectively used as a marker . c2003 COSPAR . Published by Elsevier Science Ltd . All rights reserved.

Rev Enferm, 2002 Apr, 25(4), 56 - 60
{Chemical disinfection . An alternative to sterilization in the treatment of cure instruments}; de Mena Mogrobejo MA et al.; Sterilization is the reference method recommended to ensure the asepsia of an instrument used to perform cures . Chemical disinfection has shown itself to be highly effective in this process for endoscope equipment without there being definitive references about its efficiency on instruments used for cures . OBJECTIVE: Evaluate the efficiency of chemical disinfection on instruments used for cures, with the reference method being sterilization . METHODS: Prospective study in which the efficiency of glutaraldehyde-phenolate is compared to sterilization on 9 sets of instruments used for cures, each one having a dissection clamp and a Kocher clamp, used in 122 cures carried out in different wards at the Leon Hospital . Their efficiency was evaluated by means of microbiological studies after cures were performed and after disinfection or sterilization occurred . RESULTS: There were no positive cultures after either the disinfection or the sterilization . The existence of positive cultures after cures was related to the type of wound treated, clean wounds were always negative while dirty wounds were frequently positive (p < 0.05) . CONCLUSION: Chemical disinfection with glutaraldehyde-phenolate is as efficient as sterilization in assuring the asepsia of instruments, while offering some clear advantages compared to sterilization since this chemical disinfection has a low cost, its use avoids the need to have duplicate instrument sets, it provides a longer life for these instruments and does not require moving instruments from their work site, thus preventing their loss.

Sci Total Environ, 2003 Oct 1, 314-316, 787 - 800
Carbon and nitrogen fluxes across the Hebridean shelf break, estimated by a 2D coupled physical-microbiological model; Proctor R et al.; A two-dimensional coupled physical-biological model is described and used to compute the annual cycle of primary production across the Hebridean shelf and slope based on information collected during the Land Ocean Interaction Study (LOIS), with the focus on data for 1995 . Calculations of modelled carbon and nitrate fluxes indicate an annual on-shelf near-surface flux of nitrate of 65 kmol N m(-1) year(-1) at the top of the slope (140 m deep) and an off-shelf near-bottom carbon flux of 23 kmol C m(-1) year(-1) . Further down the slope (at 300 m deep) the on-shelf nitrate flux increased to 126 kmol N m(-1) year(-1) and the off-shelf carbon flux increased to 41 kmol C m(-1) year(-1) . Carbon deposition to the sea floor was less than 0.4 mol C m(-2) year(-1) on the upper slope and 1.1 mol C m(-2) year(-1) lower down the slope, values which are four-fold lower than those inferred from benthic oxygen demand measurements made during the Shelf Edge Study but of similar magnitude to observations made during OMEX I.

Med Microbiol Immunol (Berl), 2004 Nov, 193(4), 219 - 26 Epub 2004 Nov.
An ospA-polymerase chain reaction/restriction fragment length polymorphism-based method for sensitive detection and reliable differentiation of all European Borrelia burgdorferi sensu lato species and OspA types; Michel H et al.; We describe a sensitive and reliable method for detection and differentiation of the five relevant European Borrelia burgdorferi sensu lato species ( B . burgdorferi sensu stricto, B . afzelii, B . garinii, B . valaisiana, and B . lusitaniae), based on a heminested ospA-PCR followed by restriction enzyme analysis . Sensitivity was one borrelia per PCR except for B . afzelii, where it was five per PCR . None of seven relapsing fever borreliae, eight Leptospira serovars or two Treponema species were amplified . Except B . garinii, each of the five B . burgdorferi s.l . species is represented by one or two characteristic restriction fragment length polymorphism (RFLP) patterns . Analysis of the heterogeneous group of B . garinii resulted in five different RFLP patterns, corresponding to the OspA types 3-7 associated with this species . In a pilot study on 529 Ixodes ricinus ticks from three different regions in Southern Germany, all species and OspA types were found except B . lusitaniae and B . garinii OspA type 7, arguing for a broad distribution of almost all OspA types . A further notable finding was the focal prevalence of OspA type 4, which has rarely been detected in ticks previously . Thus, the developed method provides a fast and simple tool for epidemiological studies on the heterogeneity of species and OspA types in Europe which has important implications for the development of vaccines and (microbiological) test systems for Europe.

Ann Hematol, 2003 Oct, 82 Suppl 2, S127 - 32 Epub 2003 Sep 09.
Diagnosis and treatment of documented infections in neutropenic patients--recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO); Buchheidt D et al.; Approximately 85% of patients with acute leukemia undergoing intensive antileukemic treatment develop infections and/or fever during neutropenic phases; in about 50% of these patients clinical, microbiological or clinical and microbiological evidence of infections can be obtained . The response rate is significantly lower in documented infections than in fever of unknown origin (FUO) . Evidence-based recommendations for diagnosis and treatment procedures are presented, reflecting study results and expert opinions.

Intensive Care Med, 2003 Oct, 29(10), 1688 - 95 Epub 2003 Sep 12.
Improved survival of critically ill cancer patients with septic shock; Larche J et al.; OBJECTIVE: To identify predictors of 30-day mortality in critically ill cancer patients with septic shock . DESIGN:Retrospective study over a 6-year period . SETTING: Twelve-bed medical intensive care unit (ICU) . PATIENTS: Eighty-eight patients (55 men, 33 women) aged 55 (43.5-63) years admitted to the ICU for septic shock . INTERVENTIONS: None . MEASUREMENTS AND MAIN RESULTS: Eighty (90.9%) patients had hematological malignancies and eight (9.1%) had solid tumors; 47 patients (53.4%) were neutropenic, 19 (21.6%) were hematopoietic stem cell transplantation (HSCT) recipients, and 27 (30.7%) were in remission . Microbiologically documented infections were found in 60 (68.2%) patients . The Simplified Acute Physiologic Score II (SAPS II) and Logistic Organ Dysfunction (LOD) scores at ICU admission were 66 (47-89) and 7 (5-10), respectively, and the LOD score on day 3 was 8 (4-10) . Sixty-eight (78.1%) patients received invasive mechanical ventilation (MV), 12 (13.6%) noninvasive MV, 22 (25%) dialysis . Thirty-day mortality was 65.5% (57/88) . By multivariable analysis, mortality was higher when time to antibiotic treatment was >2 h {odds ratio (OR), 7.05; 95% confidence interval (95% CI), 1.17-42.21} and when DLOD (day 3-day 1 LOD score/day 3 LOD score) was high (OR, 3.47; 95% CI, 1.44-8.39); mortality was lower when admission occurred between 1998 and 2000 (OR, 0.23; 95% CI, 0.05-0.98) and when initial antibiotics were adapted (OR, 0.24; 95% CI, 0.06-0.09) . CONCLUSIONS: Earlier ICU admission and antibiotic treatment of critically ill cancer patients with septic shock is associated with higher 30-day survival . The LOD score change on day 3 as compared to admission is useful for predicting survival.

Acta Pol Pharm, 2003 Mar-Apr, 60(2), 151 - 5
Photo- and radiostability of some 1,4-dihydropyridine derivatives in the solid state; Marciniec B et al.; The effect of UV (254 nm) and beta-irradiation at doses 10-100 kGy on physical and chemical properties of four 1,4-dihydropyridyne derivatives in the solid state (nifedipine, nitrendipine, felodipine and nimodipine) has been studied . It has been established that the irradiation causes the appearance of free radicals (EPR) and decomposition products (TLC, GC), a decrease in the melting point (DSC) and the content (GLC, IR) and an increase in microbiological purity . The changes appear faster under the effect of UV than by beta-irradiation and their intensity and character depend on the derivative and dose . The most sensitive to UV irradiation is nifedipine (about 300 times more sensitive than the most resistant nimodipine), while the most sensitive to beta-irradiation is felodipine (about twice as sensitive as the most resistant nitrendipine) . The results of our study indicate that 1,4-dihydropyridyne derivatives in solid state can be safely subjected to sterilization by beta-irradiation at doses < 20 kGy.

J Health Popul Nutr, 2003 Jun, 21(2), 127 - 41
More reliable data for diarrhoeal intervention programmes: rethinking on knowledge, attitude and practice studies; Antia BE et al.; The aim of this study was to propose an alternative approach to traditional knowledge, attitude and practice (KAP) studies to enhance the quality of data on which educational health programmes are based . The methodology proposed and illustrated involved a triangulation of approaches derived from linguistics, cognitive science, and medical laboratory sciences . Three diarrhoeal health talks (educational messages) as given to mothers in three primary-care facilities in Borno State (Northeast Nigeria) were subjected to a linguistics analysis . Relationships were then sought between the ontology of knowledge in the health talks as revealed by the text analysis and two other kinds of data, namely: (a) mothers' answers to a set of ecologically-sensitive reasoning questions that test how much relevant inferential knowledge the health talks allow for and (b) results of microbiological and biochemical analyses of salt-sugar rehydration solutions prepared by mothers participating in the study . The findings of the study show a relationship between contents/formatting of the health talks and the extent to which relevant inferential competence was supported or demonstrated by mothers . It was also evident that the laboratory analyses could be related either directly to the health talks or indirectly in terms of what the health talks need to emphasize on . The conclusion shows how the methodology proposed addresses shortcomings of traditional KAP studies in respect of the gap between health knowledge and practice.

Wien Med Wochenschr, 2003, 153(15-16), 329 - 31
{Microbiological diagnosis of deep respiratory tract infections from the clinical viewpoint}; Krause R; The appropriate use of the clinical microbiology laboratory for diagnosing lower respiratory tract infections is controversial . While examination of sputum does not help to determine the etiology in most patients with acute bronchitis, a recent study confirmed the sense of culturing sputum in patients with exacerbation of COPD . In patients with pneumonia, microbiological investigations include evaluation of sputum samples, antigentests and PCR tests as well as invasive methods of sampling with qualitative and quantitative cultures . However, there is no uniform recommendation for these investigations.

Circulation, 2003 Sep 9, 108 Suppl 1, II68 - 74
A new scoring system to determine thromboembolic risk after heart valve replacement; Butchart EG et al.; OBJECTIVE: To determine the most important inflammatory and hematologic predictors of thromboembolism (TE) in patients undergoing valve replacement (VR) to be used in conjunction with clinical risk factors for preoperative risk profiling . METHODS AND RESULTS: Preoperative and immediately postoperative clinical, echocardiographic, hematologic, biochemical and microbiological parameters were examined prospectively in 370 patients undergoing VR (249 AVR, 93 MVR, 28 DVR) . Mean follow-up was 4.4 years (max 6.6 years; total 1566 pt/yrs), and 96 TE events were documented (28 major and 68 minor) . INR data were collected on all patients . Laboratory values were considered elevated if they exceeded the 80th percentile of those of 70 controls with the same distribution of age and gender . IgA antibody to Chlamydia pneumoniae (CP)>or=1:64 was considered indicative of significant infection . Predictors of TE on multivariate analysis following AVR were (hazard ratios): CP infection (2.6), previous TE (2.5), raised eosinophils (2.4), cancer history (2.1), postoperative infection (2.0), hypertension (2.0), CABG x 3/4 (2.0), and diabetes (1.9) . Predictors of TE following MVR/DVR were raised mean platelet volume (4.0), raised factor VII (3.1), CP infection (2.7), previous mitral valvotomy (2.5), raised fibrinogen (2.2), and raised reticulocytes (2.0) . These risk factors were additive when present in the same patient, enabling a scoring system to be developed that accurately predicted risk of TE based on number of risk factors . CONCLUSIONS: Selected blood tests and clinical risk factors provide a scoring system that accurately predicts TE risk and may guide prosthesis choice and antithrombotic management.

Eur J Obstet Gynecol Reprod Biol, 2003 Oct 10, 110(2), 201 - 6
The function of sildenafil on female sexual pathways: a double-blind, cross-over, placebo-controlled study; Caruso S et al.; OBJECTIVES: To determine the changes, if any, on female sexual pathways using sildenafil (primary outcome), and to verify the safety of this drug (second outcome) . STUDY DESIGN: Following previous research on symptomatic women, we wanted to study the effects of sildenafil on asymptomatic women . We would like to make it clear from the outset that this study is part of an ongoing line of research and this drug, and others of its type, should be used under strict medical supervision only on symptomatic patients . A randomized double-blind cross-over, placebo-controlled study was conducted at the Family Planning Centre of the Group for Sexological Research, Department of Microbiological and Gynecological Science, School of Medicine, University of Catania, Italy . Sixty-eight healthy volunteer women aged 19-38 years, asymptomatic for sexual disorders, were enrolled . The study consisted of 4 weeks sildenafil, 2 weeks washout, and 4 weeks placebo, by two possible sequences: sildenafil 50 mg, washout, placebo; or placebo, washout, sildenafil 50 mg . Efficacy of sildenafil was assessed by the Personal Experiences Questionnaire (PEQ) based on the 5-point Likert scale . The questionnaire quantified subjective sexual aspects at baseline, during washout, after treatments, and at the follow-ups . Statistical analysis was done with the Wilcoxon's rank-sum test and Student's t-test . RESULTS: 50/68 women completed the study at the first follow-up, and 38 women reached the second follow-up . Six women withdrew because of adverse events . Sildenafil improved arousal (P<0.001), orgasm (P<0.05), and enjoyment (P<0.001) with respect to placebo . Significant differences were noted during sildenafil usage with respect to the baseline for arousal (P<0.01), orgasm (P<0.001), and sexual enjoyment (P<0.001) . The adverse events were transient and mild or moderate . CONCLUSIONS: Our study suggests that sildenafil acts on the different sexual pathways in healthy women, improving their sexual experience . This study could help to understand the physiologic and pathophysiologic aspects of female sexuality . In comparison with current psychosexual therapies, which are long-term, compliance would be improved with use of this drug . Additional studies are required to define the use of sildenafil in a clinical setting.

Lab Anim (NY), 2003 Sep, 32(8), 38 - 45
Genetically modified mouse health reporting: a need for global standardization; Martin-Caballero J et al.; The distribution of GM mice between facilities has raised new problems because of variable microbiological quality . One of the most important management issues concerns the methods of reporting laboratory animal health surveillance results . The authors evaluated the format and content of 380 health reports of mice received from 55 institutions in Europe and North America . Their results suggest that a standardized rodent health form would facilitate the management of laboratory mouse distribution and infection control.

Nat Prod Rep, 2003 Aug, 20(4), 392 - 413
Natural sesquiterpenoids; Fraga BM; This review covers the isolation, structural determination, synthesis and chemical and microbiological transformations of natural sesquiterpenoids . The literature from January to December 2002 is reviewed, and 388 references are cited.

Osiris, 2003, 18, 150 - 70
The microscopist of modern life; Mendelsohn JA; This is an essay in the history of observation of the natural and social worlds . It explores how nineteenth-century Paris became a field and object of scientific observation and how the everyday lives, and even the health, of scientists living in the city and leaving the city for the "country" modeled observations and theoretical interpretation . The story concerns the first important work in the research school of Louis Pasteur to focus on a human and urban disease, diphtheria, rather than animal and rural ones . An urban field practice emerged from characteristically Parisian forms and literary fictions of street life and public space, leisure, spectacle, and crowds . Some of these, such as transcience, were (and still are) viewed as not only characteristic of "modern life," but also the source of new practices and sensibilities in painting and literature . Microbiological studies elsewhere --such as in New York and Hamburg--were based on very different urban structures, patterns of everyday life, national cultures, and aspects of modernity.

Dtsch Med Wochenschr, 2003 Sep 5, 128(36), 1819 - 24
{Treatment of interdigital tinea pedis}; Korting HC et al.; BACKGROUND AND OBJECTIVE: Local antimycotic therapy of interdigital tinea pedis is widely accepted and efficacious . In Germany at present, the azoles and allylamines--part from the hydroxypyridone derivative ciclopiroxolamine--are the pharmacological agents applied most often . This study focuses on the efficacy of topical therapeutic options in Germany, by regarding the mycological and clinical cure rates of interdigital tinea pedis . METHODS: Only randomised, double-blind and controlled clinical trials of tinea pedis therapy were selected for the evaluation . Microbiological culture and microscopic information were indispensable criteria for the clinical diagnoses . RESULTS: The data from 40 randomised clinical trials of azoles and allylamines were included in the analysis . The comparison of azoles with the placebo revealed mycological cure rates between 60 - 91 % (placebo 10 - 67 %) and clinical cure rates between 64 - 95 % (placebo 10 - 63 %) . Placebo-controlled trials of allylamines (naftifine and terbinafine) indicated mycological cure rates between 62 - 100 % (placebo 10 - 45 %) and clinical cure rates between 66 - 86 % (placebo 4 - 44 %) . Both the azoles and the allylamines were significantly superior to the placebo . Comparative studies between azoles and allylamines occasionally indicated the significantly superior cure rates of allylamines (especially terbinafine) . The high cure rates of terbinafine could be detected after therapy duration of merely one week, whereas the azoles have to be applied for four weeks before good efficacy was reached . CONCLUSION: In several trials the allylamines--especially terbinafine--proved superior to the azoles . This may be explained by the fungicidal mode of action of the allylamines and the favourable pharmacokinetic characteristics of terbinafine, in contrast to the fungistatic mechanism of the azoles.

Environ Pollut, 2003, 126(3), 313 - 21
Bioindication of air pollution effects near a copper smelter in Brazil using mango trees and soil microbiological properties; Klumpp A et al.; A field study near the copper smelter of a large industrial complex examined air pollution effects on vegetation and soil parameters in Camacari (northeast Brazil) . Close to the smelter, soil pH-value was lower and total acidity as well as organic carbon contents were higher compared with a site far from the source and two reference sites . The acidification of top soil particularly and the drastically enhanced plant-available copper concentrations were caused by atmospheric deposition . High sulphur and copper deposition significantly reduced microbial biomass and altered functional diversity of soil microorganisms (arylsulphatase and xylanase) . Large accumulations of sulphur, arsenic and copper were detected in mango leaves (Mangifera indica) growing downwind from the smelter suggesting potential food chain-mediated risk.

Transplant Proc, 2003 Aug, 35(5), 1929 - 30
Bacterial infections after intestine and multivisceral transplantation; Loinaz C et al.; BACKGROUND: The frequency of bacterial infections (BI) in intestinal transplant (IT) patients is high with sepsis being the leading cause of death after this procedure . We herein report our experience with major BI to ascertain the incidence, microbiological and clinical factors, risk factors and outcome . MATERIALS AND METHODS: 124 patients (72 children and 52 adults) received 135 grafts: namely, 39 isolated intestine, 33 liver-intestine and 63 multivisceral . Only major BI were considered, namely, those associated with serious morbidity/mortality requiring specific therapy . Patient data were retrieved from computerized databases, flow-charts, and medical records . RESULTS: 92.7% patients showed BI . There were 327 episodes, representing 2.6 episodes/patient (2.8/patients with infection): 193 episodes of bacteremia (1.7/patient with BI) including 29.5% due to catheter related sepsis, 16.5% from abdominal source, 5.7% from respiratory origin and 4.1% from the wound . The organ locations includes 46 respiratory infections, 33 intraabdominal abscesses or infected fluid collections, 8 diffuse peritonitis, 34 wound infections and other miscellaneous sites: empyema, soft tissue infections, cholangitis em leader etc . Median time of infection was nine days after surgery (mean 22+/-3 days), with 67.7% patients having at least one BI before the end of the first month . Infection was present in 76.2% of the 63 deceased patients . An infectious episode during month 1, a clinically manifest abdominal infection and a positive intraabdominal culture had negative impacts on patient survival . CONCLUSIONS: BI are common and early complications after IT . The high rate of bacteremia, line sepsis and abdominal and respiratory infections reflect the recipient's condition, with chronic deterioration superimposed with the effects of prolonged abdominal visceral surgery.

Science, 2003 Sep 5, 301(5638), 1359 - 61
Seasonal dynamics of previously unknown fungal lineages in tundra soils; Schadt CW et al.; The finding that microbial communities are active under snow has changed the estimated global rates of biogeochemical processes beneath seasonal snow packs . We used microbiological and molecular techniques to elucidate the phylogenetic composition of undersnow microbial communities in Colorado, the United States . Here, we show that tundra soil microbial biomass reaches its annual peak under snow, and that fungi account for most of the biomass . Phylogenetic analysis of tundra soil fungi revealed a high diversity of fungi and three novel clades that constitute major new groups of fungi (divergent at the subphylum or class level) . An abundance of previously unknown fungi that are active beneath the snow substantially broadens our understanding of both the diversity and biogeochemical functioning of fungi in cold environments.

J Clin Microbiol, 2003 Sep, 41(9), 4475 - 9
Identification of oral peptostreptococcus isolates by PCR-restriction fragment length polymorphism analysis of 16S rRNA genes; Riggio MP et al.; Oral Peptostreptococcus isolates tentatively identified by conventional microbiological culture methods were identified to the species level by a combination of PCR amplification of 16S rRNA genes and restriction enzyme analysis of the amplified products . This method is a reliable and rapid alternative to conventional methods for identification of these bacterial species.

Int Dent J, 2003 Aug, 53(4), 249 - 54
The effect of Sterilex Ultra for disinfection of dental unit waterlines; Larsen T et al.; AIM: To evaluate the effect of a disinfectant agent based on hydrogen peroxide (Sterilex Ultra, Sterilex Corporation, Maryland, USA) on the microbiological water quality in dental unit waterlines (DUWL) . SETTING: Six older dental units were disinfected with Sterilex Ultra and another six units with sodium hypochlorite . The results were compared to six non-disinfected units examined during a period without patient treatment . OUTCOME MEASURE: The number of colony forming units of bacteria (cfu)/ml of water was determined according to European Standards on water quality . DESIGN: The water quality was initially determined during a six week period, and subsequently in more detail for two weeks . Finally, the effect of prolonged administration of Sterilex Ultra was investigated for six weeks . RESULTS: Instillation of Sterilex Ultra according to the recommendations of the manufacturer initially reduced the number of bacteria in DUWL to <10(2) cfu/ml . However, following daily, as well as prolonged administration of Sterilex Ultra a gradual recolonisation was observed resulting in bacterial numbers >10(4) cfu/ml in a number of units . Major differences between the number of cfu/ml in individual units were observed . CONCLUSION: Neither daily nor extended administration of Sterilex Ultra was capable of maintaining an acceptable water quality in these older dental units.

J Vet Med Sci, 2003 Aug, 65(8), 845 - 51
Age-related morphological changes in kidneys of SPF C57BL/6Cr mice maintained under controlled conditions; Yabuki A et al.; Age-related morphological changes were examined in the kidneys of inbred C57BL/6Cr mice maintained in a controlled environment . The specific pathogen free status of animals used in the present study was confirmed by microbiological monitoring . Kidneys were histologically and histometrically investigated at 3, 5, 12, 15, 24 and 27-months-old . Kidney weights did not change with age . Renal corpuscles increased in number at 24- and 27-months-old, but diameter remained constant . The percentage of renal corpuscles with a cuboidal glomerular capsule decreased at 24- and 27-months-old . Score indicating glomerular damage increased from 5- to 27-months-old . Changes to the proximal convoluted tubules were severe . Vacuolar degeneration was observed from 12-months-old . Tubular atrophy was observed at 24- and 27-months-old, with number of nuclei per unit area increasing at the same ages . Amyloidosis and scar lesions were observed at 27-months-old . Focal cell infiltration around vessels was found at 24- and 27-months-old . Electron microscopy at 27-months-old revealed expansion of the mesangial matrices and fusion of foot processes in the glomeruli . Enlarged lysosomes with lipid content were observed in the proximal convoluted tubules.

Epidemiol Infect, 2003 Aug, 131(1), 737 - 44
A norwalk-like virus waterborne community outbreak in a Swedish village during peak holiday season; Carrique-Mas J et al.; An outbreak of gastroenteritis due to Norwalk-like virus (NLV) affecting approximately 500 people occurred in a Swedish ski resort during February-March 2002 . Epidemiological investigations were performed on cohorts of schoolchildren, permanent residents and skiers visiting the area . Attack rates were respectively 39.7, 29.9 and 38.5% . Drinking un-boiled water originating from one of the three communal water systems was a significant risk factor for all groups . For schoolchildren, the risk of illness increased with increasing amount of water consumed . Nine of 12 stool samples of patients analysed tested positive for NLV . The water tested negative for indicator bacteria and results of NLV tests were inconclusive . In the absence of microbiological findings, the environmental authorities were reluctant to act based on the epidemiological analysis alone, and intervention was delayed until mid-April, following the discovery of a crack in a sewage pipe 10 m from the well.

J Med Assoc Thai, 2003 Jul, 86(7), 612 - 6
Pneumocystis carinii pneumonia in patients without HIV infection; Saksasithon S et al.; BACKGROUND: Pneumocystis carinii pneumonia (PCP) can occur in immunocompromised patients without HIV infection . Risk factors, clinical features, treatment outcomes, and factors related to mortality in these patients may be useful clinical data for physicians who care for these patients . METHOD: A retrospective study of PCP patients without HIV infection at Ramathibodi Hospital, from 1994 to 2001, was conducted . Only cases with microbiological and/or pathological proven were included . RESULTS: There were 19 patients with 42.1 per cent males and a mean age of 44.6 years . All patients had underlying immunocompromised diseases . 94.7 per cent of the cases received immunosuppressive drugs . PCP occurred at a mean duration of 26.4 months after the diagnosis and treatment of underlying diseases . Common clinical presentations of PCP were progressive dyspnea, fever, and non-productive cough . All patients had abnormal chest radiography with a majority of bilateral interstitial infiltration (63.2%) . Diagnosis of PCP was confirmed with microbiological examination from bronchoalveolar larvage (84.2%) and pathological diagnosis from transbronchial biopsy (15.8%) . Almost all of the cases (94.7%) were treated with co-trimoxazole . Ten patients (52.6%) had concomitant bacterial pneumonia or fungal pneumonitis . Overall mortality rate was 36.8 per cent . Mortality was significantly higher in patients who needed mechanical ventilation (p = 0.006) . There was a trend toward a higher mortality rate in patients with concomitant pulmonary diseases (p = 0.09) . CONCLUSIONS: PCP may complicate a variety of immunocompromised states especially autoimmune diseases and hematologic malignancy . Patients who receive corticosteroids and/or cytotoxic drugs should receive primary PCP prophylaxis . The mortality rate is high especially in severe cases that need mechanical ventilation . Intensive care and close monitoring are needed for these patients.

Org Biomol Chem, 2003 Jul 7, 1(13), 2314 - 20
Improved microbiological hydroxylation of sesquiterpenoids: semisynthesis, structural determination and biotransformation studies of cyclic sulfite eudesmane derivatives; Garcia-Granados A et al.; Two new cyclic sulfite eudesmane derivatives have been investigated . Their (R) and (S) sulfur configuration and the structural arrangement of their "A" rings have been assigned by means of their 13C and 1H NMR chemical shifts and have been confirmed by single-crystal X-ray analyses . Microbial-transformation of these epimer cyclic sulfites and their dihydroxyeudesmane precursor have been studied using the hydroxylating fungus Rhizopus nigricans . Increased biocatalysis rates and considerable differences in the biotransformation of both cyclic sulfite eudesmanes have been found . Promising 8alpha,11-dihydroxy derivatives have been isolated from the (S)-diastereomer bioconversion.

Arch Latinoam Nutr, 2003 Mar, 53(1), 74 - 83
{Chemical and sensory characterization of cakes enriched with dietary fiber and micronutrient for the elderly}; Wittig de Penna E et al.; This study presents the development of individual cakes enriched with dietary fiber (lupin and oat fiber), vitamins and minerals; as recent research has shown that the average daily dietary fibre intake of the elderly population in Chile is only 12 g . Each cake contains 4.8 g of dietary fibre and a 30% of the RDA of vitamins A, B1, B2, B6, B12, E, nicotinamide and folic acid, 40% of the RDA of vitamin D3, 15% of the RDA of calcium, 12% of the RDA of magnesium and 3% the RDA of zinc . Polydextrose and sorbitol were added to improve flavor and texture . Response Surface Methodology (RSM) was used for optimization, based on a two-variable composite design . Thirteen experimental runs were carried out, with polydextrose (1 to 40% based on flour content) and sorbitol (1 to 30% based on flour content) as independent variables . The response variable was sensory quality obtained by the Karlsruhe test . Sensory attributes of texture and overall quality showed a good fitting with high determination coefficients and were used for optimization . The optimized cake contained 11.5% polydextrose and 4.4% sorbitol (both based on flour content) . Quality of the optimized product was controlled by means of physical, chemical, microbiological and sensory analyses . Overall sensory quality was 8.18 ("very good") and good quality and nutritive value were achieved . In an acceptance test carried out with 150 adults, 100% acceptability was obtained in the hedonic scale categories "like it" and "like it very much" . A shelf life study performed with cakes packaged in polypropylene bags of 30 microns thickness indicated a shelf life of 13 days stored at room conditions (25 degrees C and 55-60% R.H.).

Bratisl Lek Listy, 2003, 104(3), 120 - 4
Contribution to laboratory diagnostics of neuroborreliosis; Huckova D et al.; BACKGROUND: Neuroborreliosis affects peripheral and central nervous system . OBJECTIVES: Point out on possibilities of laboratory diagnostics of neuroborreliosis . SUBJECTS AND METHODS: During 1997-2001 we tested 666 pair samples of CSF and serum from 661 patients with different neurological diagnosis by ELISA, Westernblot, PCR, completed by biochemical and cytological investigations . RESULTS: We confirmed intrathecal specific IgG antibodies production by AI in 14 cases (2.1%) of total 666 samples tested . From those in 7 cases there were present also IgM antibodies in CSF . We found borderline AI values in 3 cases (0.5%) and isolated intrathecal production, antibodies present only in CSF, in 1 case (0.15%) . There were normal AI values found in 25 cases (3.8%) . Specific antibody possitivity by WB method was detected only in one case . DNA positivity by PCR was detected in one CSF from 43 samples during 2 years period . CONCLUSIONS: The microbiological test results should not be used in isolation but used in correlation with the biochemical and cytologic tests and also with clinical symptoms and epidemiological data to produce an overall clinical diagnosis . (Tab . 7, Fig . 1, Ref . 21)

Infect Control Hosp Epidemiol, 2003 Aug, 24(8), 622 - 4
Rethinking sterilization practices: evidence for event-related outdating; Webster J et al.; A prospective study was conducted during a 2-year period to evaluate the effectiveness of event-related outdating . Hospital-prepared sterilized items (n = 152) were shelved in wards and every 3 months, several articles were retrieved and microbiologically tested . During the 2-year period, all of the items tested were sterile.

Pol Merkuriusz Lek, 2003 May, 14(83), 460 - 3
{Modern etio-pathogenesis and diagnosis of mycobacterioses}; Grubek-Jaworska H et al.; Over the last decades the incidence of infections with non-tuberculous mycobacteria (NTM) has increased . It has been noted in various regions of the world and it seems to concern also our country . The aim of this review is to call attention to clinical presentation and diagnostic criteria of mycobacterioses . The environmental sources of NTM, predispositions to dissemination of NTM infection and current epidemiological data on mycobacterioses are discussed . Since the accuracy of mycobacterial strain identification is most important for microbiological diagnosis of disease, it is suggested to perform it according to modern requirements, exclusively in selected, well-equipped laboratories.

Biologicals, 2003 Sep, 31(3), 181 - 5
Stability of minute virus of mice against temperature and sodium hydroxide; Boschetti N et al.; Treatment with steam and/or dilute NaOH are commonly used techniques to disinfect manufacturing vessels and tools in the pharmaceutical industry . The aim of this procedure is sanitisation and inactivation of microbiological and viral contaminants . Here we describe the inactivation of the mouse parvovirus Minute Virus of Mice (MVM) under these conditions . Parvoviruses are known to be resistant to physico-chemical treatment and one representative of this family, the human parvovirus B19, is a potential contaminant of blood plasma . We show inactivation kinetics for MVM treated with wet-heat (70, 80, 90 degrees C) and with 0.01-1 M NaOH solutions (pH >/=11.9) . Robust inactivation was only achieved at 90 degrees C for at least 10 min and in NaOH solutions of pH >/=12.8 (0.1 M NaOH) . It was observed, that aggregation of viruses might protect viral particles from inactivation by NaOH . Therefore, appropriate sample preparation of spiking material is important for accurate simulation of the naturally occurring situation . The observed stability at pH 11.8 exceeds the previously reported upper limit of pH 9 . Inactivation was due to disintegration of the viral capsid as assessed by accessibility of viral DNA for endonucleases.

Kansenshogaku Zasshi, 2003 Jul, 77(7), 493 - 8
{A diffuse outbreak of enterohemorrhagic Escherichia coli O157:H7 related to the Japanese-style pickles in Saitama, Japan}; Ozeki Y et al.; We have experienced an outbreak of enterohemorrhagic E . coli O157:H7 (Shiga-like toxin 1 & 2 producing) in child independence support facilities in the all dormitory system, in Saitama August 2001 . There were 13 patient and EHEC O157s were detected in a total of 29 specimens . As a result of epidemic inspection and microbiological investigation . We recognized that the causative food was Japanese-style pickles named "Wafu-Kimuchi" which had been sold in Saitama and Tokyo area . As the same period, several infections caused by EHEC O157 were considered the same origin in Saitama (8 patients in 5 families) . Furthermore some infections happened also in Tokyo . It was made clear this outbreak was a part of a diffuse outbreak caused by Wafu-Kimuchi . In diffuse outbreaks, it is important to grasp a common feature of the individual cases in a wide area . The exchange of epidemic information between two or more municipalities and the guess of the identity in the DNA levels of strains were the key role to the elucidation of this case.

Comp Biochem Physiol C Toxicol Pharmacol, 2003 Jul, 135C(3), 249 - 55
Effects of lactulose and lactitol on coliform bacteria and bacterial translocation in the caecum during 72-h starvation in rats; Demirogullari B et al.; Lactulose and lactitol, non-absorbable disaccharides, prevent bacterial translocation (BT) arising from the gut . In contrast, lack of food into the gut leads to coliform bacterial overgrowth and even if it does not cause BT, can induce the risk from other stimuli for BT . In this study, we tested whether lactulose and lactitol affected populations of coliform bacteria in the caecum during starvation in Sprague-Dawley rats . Three groups of rats were starved for 72 h and given oral 2 ml undiluted lactulose (670 mg/ml), 2 ml undiluted lactitol (666 mg/ml) or 2 ml physiological saline, respectively, once a day . The caecum and mesenteric lymph nodes (MLNs) were removed for microbiological and histopathological analyses . The highest degree of coliform bacterial overgrowth, BT to MLNs and histopathological damage were observed in lactulose-treated rats, followed by the group treated with lactitol . As a result of this study, both drugs, especially lactulose augmented the proliferation and translocation tendency of coliform bacteria in the caecum during 72-h starvation in rats.

Int J Food Microbiol, 2003 Oct 15, 87(1-2), 1 - 15
Estimating the probability of recontamination via the air using Monte Carlo simulations; den Aantrekker ED et al.; Recontamination of food products can cause foodborne illnesses or spoilage of foods . It is therefore useful to quantify this recontamination so that it can be incorporated in microbiological risk assessments (MRA) . This paper describes a first attempt to quantify one of the recontamination routes: via the air . Data on the number of airborne microorganisms were collected from literature and industries . The settling velocities of different microorganisms were calculated for different products by combining the data on aerial concentrations with sedimentation counts assuming that settling is under the influence of gravity only . Air movement is not explicitly considered in this study . Statistical analyses were performed to clarify the effect of different products and seasons on the number of airborne microorganisms and the settling velocity . For both bacteria and moulds, three significantly different product categories with regard to the level of airborne organisms were identified . The statistical distribution in these categories was described by a lognormal distribution . The settling velocity did not depend on the product, the season of sampling or the type of microorganism, and had a geometrical mean value of 2.7 mm/s . The statistical distribution of the settling velocity was described by a lognormal distribution as well . The probability of recontamination via the air was estimated by the product of the number of bacteria in the air, the settling velocity, and the exposed area and time of the product . For three example products, the contamination level as a result of airborne recontamination was estimated using Monte Carlo simulations . What-if scenarios were used to exemplify determination of design criteria to control a specified contamination level.

J Agric Food Chem, 2003 Aug 27, 51(18), 5315 - 8
Determination of folate concentrations in pulses by a microbiological method employing trienzyme extraction; Han JY et al.; Over the past two decades, the role of folate in human nutrition has been of much interest because of its relationship to diseases such as neural tube defects and heart disease . Since 1998, the U.S . Food and Drug Administration has mandated that cereal products be fortified with 140 microg of folic acid/100 g . It is important, therefore, to be able to determine accurately the folate concentrations in cereals and other grains to ensure proper dietary intake of folate . In this study, a microbiological method employing a trienzyme extraction procedure was applied to the analysis of folate in several starchy grain legumes (pulses) . Differences in the folate content of dry bean were observed among some market classes but not between cultivars in the same market class . Location had a significant effect on the folate content of lentil and dry pea; cultivar did not . The significant effect of market class, cultivar, and growth environment on the levels of folate in pulses is of particular importance to pulse processors and pulse breeders.

Environ Toxicol Chem, 2003 Aug, 22(8), 1743 - 54
Quantitative structure-activity relationships for oxidation reactions of organic chemicals in water; Canonica S et al.; Even in the absence of microbiological mediation, oxidation is one of the most important chemical processes contributing to the degradation of organic contaminants in the aquatic environment . The oxidants that are responsible for these reactions include hydroxyl radical, carbonate radical, organic oxyl and peroxyl radicals, peroxides, excited triplet states of organic chromophores, singlet molecular oxygen, ozone, chlorine dioxide, permanganate, and chromate . Some of these oxidants contribute to natural attenuation of organic contaminants, but many are of greater interest because of their role in engineered remediation technologies . Kinetic studies of these processes have lead to numerous quantitative structure-activity relationships (QSARs) . Many of these QSARs are simple empirical correlations to common convenient descriptor variables like Hammett constants (sigma), half-wave oxidation potentials (E1/2), energies of the highest occupied molecular orbital (E(HOMO)) or rate constants for other oxidation reactions . However, several environmentally relevant, aqueous-phase oxidation reactions have been described with QSARs based on theoretical models for electron transfer that were developed by Marcus-Hush and Rehm-Weller . This review summarizes many of the reported QSARs for aquatic oxidations of organic compounds with emphasis on the interrelation between traditional empirical models and the potential for future development of QSARs based on theoretical models.

Vopr Pitan, 2003, 72(2), 8 - 12
{Vitamins stability in fortified dairy products}; Shatniuk LN et al.; High safety of vitamins during vitaminization of dairy products has been shown . Adding of vitamins before pasteurization or sterilization of milk is guaranting its microbiological purity and doesn't change organoleptic quality of dairy products.

Ying Yong Sheng Tai Xue Bao, 2003 Apr, 14(4), 609 - 12
{Phylogenetic diversity of microbes and its perspectives in conservation biology}; Tian C et al.; Molecular phylogenetic analysis plays a very important role in the study of microbial diversity . For both cultivated and uncultivated microbes, the comparative sequence analysis of 16S rRNA enabled the investigation of phylogenetic relationships among microorganisms in a manner that was not feasible through traditional microbiological methods . As a result, there are drastic revisions in our understanding of microbiology . The phylogenetic diversity based on the comparative sequence analysis of 16S rRNA produced new insights into the biodiversity conservation . It provides a method for biodiversity judgment and a guideline for biodiversity conservation . Also, it produces the aim of conservation, which is to keep the phylogenetic information as much as possible . In this review, some characters of microbial phylogenetic diversity and the perspectives in conservation biology are outlined.

J Hosp Infect, 2003 Aug, 54(4), 279 - 87
A needleless closed system device (CLAVE) protects from intravascular catheter tip and hub colonization: a prospective randomized study; Bouza E et al.; Hub colonization and subsequent intraluminal progression due to frequent opening and manipulation of intravenous systems is the cause of many catheter-related infections (CRI) . A prospective, comparative, randomized study was performed to assess a new closed-needleless hub device (CLAVE) compared with conventional open systems (COS) . End-points were hub and skin colonization, catheter tip colonization, catheter-related bloodstream infection (CRBSI) and number of accidental needlesticks . All cultures were processed following standard semiquantitative microbiological techniques . The study involved patients who underwent heart surgery over an 11-month period in a post-surgical ICU . During the study period, 352 patients underwent major heart surgery and 1774 catheters were inserted . Overall, 865 catheters in 178 patients were allocated to the CLAVE system and 909 catheters in 174 patients to COS . The groups were similar regarding underlying conditions and risk factors for infection . Comparison of endpoint results in CLAVE and COS groups was as follows: incidence density per 1000 catheter-days of tip colonization: 59.2 versus 83.6 (P=0.003); of hub colonization: 7.56 versus 24.66 (P=0.0017); of skin colonization: 41.5 versus 58.9 (P=0.038); and of CRBSI 3.78 versus 5.89 (P=0.4) . There was one accidental needlestick and one catheter-related prosthetic endocarditis in the COS group . Multivariate analysis showed that CLAVE use was an independent protective factor for tip colonization . CLAVE offered significant protection from catheter-tip and hub colonization.

Eur J Med Res, 2003 Aug 20, 8(8), 358 - 62
Trans fatty acids (TFA): analysis, occurrence, intake and clinical relevance; Steinhart H et al.; More than one quarter of total daily calories are normally provided by fatty acids which contain at least one double bond . The usual configuration of these double bonds is the cis configuration . Trans fatty acids (TFA) are formed in technological and microbiological processes by isomerization of cis double bonds to trans double bonds . In the 1990s, there was public health concern about epidemiological studies suggesting that TFA increase the risk of coronary heart disease . High intakes of TFA may have an influence on total cholesterol and other blood parameters; but on the other hand there have been a lot of studies which have not been able to confirm these results . TFA are formed in varying amounts during the industrial hydrogenation of vegetable oils and in the first stomach of ruminants . Regular margarines contain varying contents of partially hydrogenated vegetable oils, and therefore of TFA . The main dietary TFA are the trans octadecenoic acids, which contribute to approximately 80-90 % of total TFA content in foods . The predominant isomer of milk fat is trans vaccenic acid, which is directly influenced by ruminant feeding conditions . For a reliable identification and quantification of TFA in foods and other biological matrices it is necessary to use a combination of chromatographic methods (GC-FID, GC-MS, GC-FTIR, Ag superset +-HPLC).

Biophys Chem, 2003 Jul 1, 104(3), 561 - 72
A combined mass and energy balance to provide bioindicators of soil microbiological quality; Barros N et al.; In this work, a method is proposed to quantify the efficiency of carbon utilization by soil microbes . Microcalorimetry was used to compute the heat yield (Y(Q/X)) of six soil samples collected in the Amazon . A combined mass and energy balance is developed to quantify the enthalpy of the glucose oxidation reaction (Delta(r)H(s)) and the biomass yield (Y(X/S)) from the experimental values of Y(Q/X) . Results were compared by graphical analysis to establish the kinetics of the glucose oxidation and the microbial growth reactions in terms of energy dissipation . The correlations found suggest that the measured values for Y(Q/X) and Delta(r)H(s) are biomass yield dependent . The main environmental factors affecting the kinetics of the glucose oxidation and the microbial growth reactions in soils are the initial microbial population and the percentage of nitrogen of the samples . The comparative study among the samples showed that the deforestation of the Primary forests in the Amazon to establish arable lands, affected the efficiency of the carbon utilization by soil microorganisms.

Nippon Ishinkin Gakkai Zasshi, 2003, 44(3), 197 - 201
{The current status of clinical laboratories on mycological examination}; Abe M; A questionnaire survey to determine the current status of clinical laboratories on mycological examination was performed in May 2002, and the results compared with data obtained in December 1994 . One hundred and sixty seven answers were received in this survey . The results indicated that the average number of medical technologists in a microbiological laboratory was one for every 168 hospital beds, and the number of clinical specimens examined daily by each technologist was 16 (bacterial) and 3.4 (mycological) . The rate of laboratories prepared a specialized technologist to handle mycological examinations was 10% in both surveys, and laboratories which had a system for mycological examination order were 23.4% (this survey) and 14.1% (prior) . The problems in routine mycological examination were: identification of non-sporulating filamentous fungi, 69.9%; identification of the fungi not previously encountered, 67.5%; and judgement of pathogenicity of the isolates, 66.9% . Sixty four percent of technologists desired a lecture on the subject of dermatophytes, techniques of mycological examination, dematiaceous fungi, and moniliaceous fungi other than Aspergillus . The above results indicate to establish a continuous postgraduate education system and reference center readily available to a medical technologist.

Dtsch Tierarztl Wochenschr, 2003 Jul, 110(7), 302 - 5
{Animal nutrition for veterinarians--actual cases: tulip bulbs with leaves (Tulipa gesneriana)--an unusual and high risk plant for ruminant feeding}; Wolf P et al.; 14 cattle (mainly younger ones) of a total of 50 extensively kept Galloways died within 6 weeks in late winter 2001/02 . According to the owner's report, grass growth had been rather poor; therefore, the herd was fed additionally hay as well as large amounts of tulip onions . In the microbiological examination a highly reduced hygienic quality of the roughage could be detected . In the rumen contents of two dissected young cattle parts of tulip onions were found . According to pertinent literature, tulip onions (in particular their external layers) contain variant-specific amounts of anti-nutritive substances; main active agents are tulipin (a glycoprotein), tuliposid A and B, and lectins . They may cause intensive mucosal irritation, accompanied by reduced feed digestion and body-weight gains, drooling, vomiting and diarrhea . This case report underlines risks caused by feeding of plants originally not destined as forage, if their active ingredients and effects are unknown or remain unconsidered.

Przegl Epidemiol, 2003, 57(2), 377 - 80
{Advances in microbiological diagnosis of infectious diseases}; Krzeminski Z; Development of new methods in microbiological diagnosis of infectious diseases is described . Particularly methods which are based on techniques DNA microarray, protein microarray and nanotechnology.

Przegl Epidemiol, 2003, 57(2), 369 - 76
{Methods of biological weapon threats detection}; Bartoszcze M; Detection and identification of biological weapon agents are ones of more important elements of defence against biological weapon and bio-terrorism . So, the attack agent determination creates the chance of necessary prophylactic--medical and liquidation activities undertaking on time . Different systems of biological hazards detection are known . Among others, they allow to detect the biological agents presence in the air, execute the aerosol particles analysis, and are able to generate the alarm signal (LRBSDS, JBSDS, FLAPS) . Some systems are able to detect biological agents presence, and moreover, to identify them (JPS, JBAIDS) . Luminometric method possesses many advantages, from which the versatility of its usage at different attack scenarios, is getting to stay the most important one . A lot of attention is paid to identification problems, recently . Simple technologies, adjusted to field conditions, which give initial identification result within several minutes (immuno-chromatographic tests), have been developed . These tests, based on colloidal gold may be replaced with UCP particles, what influences positively for identification sensibility and specificity . Systems allowing to execute genetic tests in field conditions (RAPID) and biosensors, thank to which bacteria and their toxins, and viruses can be identified (RAPTOR) have occurred . Huge diagnostic possibilities are created by flow cytometry . Instrumental techniques, among which the mass spectrometry pays attention, are developed . Huge hope is connected to systems working on "chips", allowing, among others, to execute significant amount of analyses simultaneously . Thank to huge expenditures, paid for biological agents identification methods development, part of them, after positive laboratory and field practical tests, shall be introduced into the microbiological practice, staying the valuable contribution of fight against bio-terrorism.

Ann Pathol, 2003 Jun, 23(3), 216 - 35
{Non tuberculous mycobacterial diseases}; Adle-Biassette H et al.; Mycobacteria species other than members of Mycobacterium tuberculosis complex are called non tuberculous mycobacteria (NTM) or "atypical" mycobacteria . To date, about 80 mycobacterial species have been described . They are usually opportunistic pathogens with variable degrees of virulence . Tuberculosis is the commonest mycobacterial disease in the world, followed by leprosy and Buruli ulcer . Before the AIDS epidemic, NTM diseases were confined to the lungs (M . kansasii, M . intracellulare and M . avium), the skin (M . marinum) or cervical lymph nodes (M . scrofulaceum) . The outbreak of AIDS epidemic has dramatically changed the epidemiology of NTM diseases . Between 25 to 50% of AIDS patients in Europe and USA are infected with NTM . NTM infections are usually disseminated in patients with profound immunodeficiency . The inflammatory response and the prognosis of NTM diseases depend on the immunological status and the NTM species . Diagnosis may be difficult, especially in AIDS patients in whom numerous diseases are often associated . Diagnostic criteria involve clinical, radiological, microbiological and pathological findings . Identification of Mycobacterium species in cultures is the gold standard . Pathological examination has several interests: it may reveal an NTM disease, it provides a more rapid assessment of the infection than cultures, and helps to evaluate the virulence of NTM species identified by cultures.

Med Dosw Mikrobiol, 2003, 55(1), 97 - 104
{Use of impedance methods for testing bactericidal activity of antiseptics}; Zareba T et al.; Standards PN-EN 1040 and EN 12054 describe test methods and minimum requirements for bactericidal activities of antiseptics . However, standard procedures are time consuming and require 48 hours of incubation . New alternative technique based on impedimetric procedure provides possibilities to reduce this time to several hours . The Bactometer (BioMerieux, Vitek System, USA) is a fully automated impedance technology system used to microbial quantitation of products . Impedance measures microbial activity by electrical methods . The aim of the study was to adaptate the impedimetric method utilising Bactometer--system to microbiological activity control of chemical antiseptics . Eight different products were utilised throughout the study . The samples for classical and alternative method were prepared in the same way as described in standards . The method of choice was dilution-neutralization method . All procedures conducted in Bactometer were verified by plate count method . The high correlation was observed between results obtained by normative methods and impedimetric measurement . All tested products meet requirements . The procedure utilising the Bactometer, provides a rapid and accurate system for the determination of bacterial content . The results of validation carried out during this study indicate, possibility to use impedimetric method alternatively to traditional methods.

Skin Pharmacol Appl Skin Physiol, 2003 Sep-Oct, 16(5), 324 - 42
EEMCO guidance for the efficacy assessment of antiperspirants and deodorants; Pierard GE et al.; Overproduction of sweat, sweaty skin and body odours are unpleasant for many social groups . Body cleansing products are designed to combat these undesirable features of skin . In addition, antiperspirant and deodorant products are more specifically used in the underarm site by a large part of the adult population . Antiperspirants are offered to control emotionally triggered sweating in the armpit . Deodorants are designed to combat malodour generated from bacteria-modified sweat . This review summarizes the physiology of eccrine, apocrine and apoeccrine sweat glands . The mechanisms of action of antiperspirants and deodorants are described as well as the factors influencing their efficacies . A series of tests using various measurement methods can be used to demonstrate the efficacy of antiperspirants . These include the gravimetric method, water evaporation quantification, electrodermal measurements, staining procedures, dye injections and cyanoacrylate skin surface strippings and casting replicas . Deodorant efficacy can be evaluated by sensory assessments performed by an expert panel . Indirect support is provided by visualization of apocrine gland excretion and collection of sweat and volatile compounds . Microbiological assessments and chromatographic analysis also provide indirect information .

J Dairy Sci, 2003 Jul, 86(7), 2283 - 7
Lysinoalanine content of formulas for enteral nutrition; Boschin G et al.; Casein and caseinates are the main ingredients of formulas for enteral nutrition . Their manufacturing procedure and the thermal treatments necessary to assure microbiological stabilization and satisfactory shelf-life of the end-products are particularly favorable for the formation of lysinoalanine (LAL), a cross-linked amino acid that is considered a useful marker of the thermal damage and reduced digestibility of proteins . The lysinoalanine content of 18 different kinds of formulas for enteral nutrition was determined by HPLC after derivatization . The liquid formulas have an average value of 528 microg/g protein LAL, ranging from 160 to 800 microg/g protein (average content of formulas for pediatric use 747 microg/g protein) . These values are rather high considering that the average value detected in UHT-treated drinkable milk is 117 microg/g protein . In principle, the preparation of caseinates and the thermal stabilization of the end products are the two steps more favorable for the formation of LAL . The fact that the five samples stabilized by an UHT-treatment have an average value of 512 microg/g protein suggests that the LAL content depends more on the quality of the starting ingredients than on the sterilization process . A better selection of the starting ingredients should improve the quality of formulas for enteral nutrition, which is very desirable when formulating foods for consumers with very high nutritional demands.

Mikrobiologiia, 2003 May-Jun, 72(3), 419 - 26
{Bacterial quantity and microbial reactivity in Tugur bay of the Okhotsk Sea}; Dziuban AN; The paper presents the results of investigation of the total abundance and the biomass of bacterioplankton, the abundance of heterotrophic bacteria, and the activity of microbiological processes involved in the carbon cycle in the water of the Bay of Tugur of the Sea of Okhotsk . In different regions of the bay, the total abundance of bacterioplankton was found to vary from 0.51 x 10(6) to 2.54 x 10(6) cells/ml; the bacterioplankton biomass, from 8.5 to 46.5 micrograms C/l; the abundance of heterotrophic bacteria, from 0.06 x 10(3) to 2.12 x 10(3) cells/ml; the bacterial assimilation of CO2, glucose, acetate, and protein hydrolysate, from 0.8 to 6.3, from 0.11 to 1.88, from 0.07 to 0.56, and from 0.01 to 0.22 mg C/(m3 day), respectively; the degradation of organic matter ranged from 28 to 221 mg C/(m3 day); and the intensity of methane oxidation, from 0.0005 to 0.17 microliter CH4/l . The spatial pattern and the functional characteristics of bacterioplankton in the Bay of Tugur were found to be dependent on the tidal dynamics.

Ann Univ Mariae Curie Sklodowska {Med}, 2002, 57(2), 392 - 8
The activity of dental caries in students of the Faculty of Stomatology examined by using microbiological and biochemical tests--Dentocult LB; Klichowska-Palonka M et al.; The aim of the study was to examine the relation between the value of Dentocult LB and numbers of DMF, DMFs and Ds in the 20-25 age group . Sixty-six randomly chosen students of the Faculty of Stomatology, Medical University of Lublin were included in the study . In all of them, their dental state was assessed by using average numbers of DMF, DMFs and Ds . In the microbiological examinations, a ready-made medium from the Dentocult LB set was used . Statistically significant, directly proportional dependence of the number of surfaces with Ds active caries and the LB number was found.

Eur Radiol, 2004 Feb, 14(2), 256 - 71 Epub 2003 Jul 24.
Pneumonia in neutropenic patients; Heussel CP et al.; Radiologists have a special role in the management of neutropenic patients . The appropriate investigational technique, frequently targeted differential diagnosis, and the special needs of these patients, need to be understood . Early detection of a focus is the major goal in febrile neutropenic patients . As pneumonia is the most common focus, chest imaging is a special radiological task . The sensitivity of chest X-ray, especially in supine position, is known to be low; therefore, the very sensitive high-resolution CT (HRCT) became gold standard in neutropenic hosts and will probably be replaced by thin-section multislice CT (MSCT) in the near future . Costs of high-resolution CT are low in comparison to antibiotics . An infiltrate needs to be localised, so that a physician can utilise this information as a guidance for invasive procedures for further microbiological work-up . The radiological characterisation of infiltrates gives a first and rapid hint to differentiate between different sorts of infectious (typical bacterial, atypical bacterial, fungal) and non-infectious aetiologies . Follow-up investigations need careful interpretation according to disease and concomitant treatment . Due to an increased incidence of fungal infiltrates even with appropriate therapy, follow-up of an infiltrate must use further parameters in addition to lesion size . Temporary exclusion of infectious involvement of the lung with high accuracy remains of special interest for clinicians.

Analyst, 2003 Jul, 128(7), 832 - 7
Pantothenic acid quantification by a stable isotope dilution assay based on liquid chromatography-tandem mass spectrometry; Rychlik M; A stable isotope dilution assay for the quantification of free and total pantothenic acid has been developed by using {13C3,15N}-pantothenic acid as the internal standard . The three-dimensional specificity of liquid chromatography-tandem mass spectrometry enabled unequivocal determination of the vitamin . Due to the very simple extraction and clean-up procedure, free pantothenic acid could be analysed within 2 h, which is much faster than by microbiological or gas chromatographic assays . For quantification of total pantothenic acid, the vitamin was liberated from its conjugates by an overnight incubation with pigeon liver pantetheinase and alkaline phosphatase . In analyses of corn flour, the intra-assay coefficient of variation was 8.5% (n = 5) and 15.3% (n = 4) for free and total pantothenic acid, respectively . When pantothenic acid was added to corn starch at a level of 6 mg kg(-1), a recovery of 97.5% was found . Application of the stable isotope dilution assay to whole egg powder, hazel nuts and corn revealed similar data compared to those listed in nutrition data bases, whereas the content in mushrooms and porcine liver determined by the newly developed assay appeared to be lower and that of cocoa higher than reported in the literature.

Berl Munch Tierarztl Wochenschr, 2003 Jul-Aug, 116(7-8), 340 - 5
{Chronic-idiopathic enteropathy in cats--a case control study}; Meneses F et al.; Aim of this study is to clinically, microbiologically and histopathologically characterize inflammatory bowel disease (IBD) in the cat . Nine cats with chronic persistent or intermitent vomitus and diarrhea were examined between 1998 and 2001 . All cats had a thuorough diagnostic workup performed . Full thickness biopsies from stomach, duodenum, jejunum, ileum and colon were surgically obtained for histopathological examination . Duodenal juice was obtained by direct aspiration for microbiologic qualitative and semiquantitative examination . Seven cats euthanized for other medical reasons were used as controls . Six cats had a lymphoplasmacytic IBD and three an eosinophilic IBD . Four cats with IBD had additional diseases diagnosed . Three cats with IBD had elevated bacterial counts . Retrospectively no correlation could be found between clinical symptoms and histopathological results . Serum TLI was not able to differentiate chronic pancreatitis and IBD . Serum folic acid and cobalamin did not correlate with the distribution of lesions in the gastrointestinal tract . Finally, no correlation was found between bacterial counts in the proximal duodenum and IBD.

Schweiz Arch Tierheilkd, 2003 Jul, 145(7), 336 - 9
{Melanosis maculosa in a calf}; Camenzind D et al.; This work describes findings in a fattened calf, which were seen in a routine slaughter . The most important findings by the meat inspector were diffuse, black spots between 2 and 70 mm in diameter . This hyperpigmentation was observed on the entire carcass as well as on the outside and inside of all internal organs . Removal of the spinal cord produced black colored liquor . Subsequent microbiological examination of the meat resulted in sterile findings . The muscle pH was 5.8 . On histological examination many macrophages containing melanin were found in the lung and liver . Based on these findings the diagnosis of Melanosis maculosa was made.

Int J Food Microbiol, 2003 Sep 1, 86(1-2), 23 - 50
Spoilage yeasts in the wine industry; Loureiro V et al.; Yeasts play a central role in the spoilage of foods and beverages, mainly those with high acidity and reduced water activity (a(w)) . A few species are capable of spoiling foods produced according to good manufacturing practices (GMPs) . These can survive and grow under stress conditions where other microorganisms are not competitive . However, many of the aspects determining yeast spoilage have yet to be clarified . This critical review uses the wine industry as a case study where serious microbiological problems are caused by yeasts . First, the limitations of the available tools to assess the presence of spoilage yeasts in foods are discussed . Next, yeasts and factors promoting their colonisation in grapes and wines are discussed from the ecological perspective, demonstrating that a deeper knowledge of vineyard and winery ecosystems is essential to establish the origin of wine spoilage yeasts, their routes of contamination, critical points of yeast infection, and of course, their control . Further, zymological indicators are discussed as important tools to assess the microbiological quality of wines, although they are rarely used by the wine industry.The concepts of the susceptibility of wine to spoilage yeasts and wine stability are addressed based on scientific knowledge and industrial practices for monitoring yeast contamination . A discussion on acceptable levels of yeasts and microbiological criteria in the wine industry is supported by data obtained from wineries, wholesalers, and the scientific literature.Finally, future directions for applied research are proposed, involving collaboration between scientists and industry to improve the quality of wine and methods for monitoring the presence of yeast.

Res Microbiol, 2003 Jul-Aug, 154(6), 393 - 8
Soil microbial activities and carbon and nitrogen fixation; Chen G et al.; Soil microbial activity that reflects microbiological processes of soil microorganisms is the potential indicator of soil quality, as plants rely on soil microorganisms to mineralize organic nutrients for growth and development . Soil microorganisms also process plant litter and residues into soil organic matter, a direct and stable reservoir of carbon and nitrogen that consists of living and dead organic materials subject to rapid biological decomposition . In natural systems, the action of soil microorganisms is a major determinant of efficient nutrient cycling . This paper reviews the current state of knowledge on the fate of soil microorganisms in terms of carbon and nitrogen fixation.

Rev Esp Cardiol, 2003 Aug, 56(8), 794 - 800
{Infective endocarditis in patients with chronic liver disease: clinical and prognostic assessment}; Perez De Isla L et al.; INTRODUCTION AND OBJECTIVES: Chronic liver disease increases the susceptibility to bacterial infections and infective endocarditis . Our aim was to determine the clinical and microbiological features and the prognosis in patients with chronic liver disease who also had infective endocarditis . PATIENTS AND METHOD: One hundred and seventy-four consecutive inpatients at our institution were recruited and followed . Thirty of them had chronic liver disease . Clinical, microbiological and echocardiographic variables were analyzed and, in some cases, histological variables were also recorded . RESULTS: Patients with chronic liver disease were younger (36 11 vs 54 18 years; p < 0.01) and had a larger proportion of intravenous drug users (73 vs 16%; p < 0.01), HIV infection (47 vs 10%; p < 0.01), right valve involvement and spleen enlargement, but heart failure appeared less often (7 vs 34%; p = 0.003) . Thirty percent of the patients with and 51% of patients without chronic liver disease underwent surgery for infective endocarditis . Total mortality among patients with and without chronic liver disease was 40% and 31%, respectively . After adjustment for age and for the incidence of congestive heart failure, chronic liver disease doubled mid-term mortality with a RR = 2.45 (p = 0.015) . CONCLUSIONS: Chronic liver disease has a significant impact on the prognosis in patients with infective endocarditis, and these patients should therefore be considered a high risk group.

Am Heart J, 2003 Aug, 146(2), 311 - 6
Risk factors for "major" embolic events in hospitalized patients with infective endocarditis; Durante Mangoni E et al.; BACKGROUND: Infective endocarditis often is complicated by embolic events after hospital admission . Identifying patients at higher risk may improve the disease outcome . This study was aimed at identifying predictors of embolic risk among the clinical and laboratory data obtained on hospital admission in patients diagnosed as having definite infective endocarditis according to the Duke criteria . METHODS: Ninety-four patients were enrolled in a prospective study . The results of hematologic, echocardiographic, and microbiological investigations were analyzed, using statistical methods as appropriate . Multivariate analysis was applied to variables significantly associated with embolism in univariate analysis . RESULTS: Forty-six percent of patients had a major embolic complication after admission . No association was found between embolism and sex, site of infection, or microorganism involved . Patients with embolism were significantly younger, had larger vegetation, and showed a significantly higher level of serum C-reactive protein and lower albumin concentrations than those without embolism . Young age, larger vegetation size, and high levels of C-reactive protein were the independent variables associated with an increased incidence of embolic events in the multivariate logistic regression analysis . CONCLUSIONS: Our data indicate that patients with infective endocarditis with young age and/or with large vegetation and/or with high serum levels of C-reactive protein are at increased risk of major embolic complications during the in-hospital course of the disease.

Arch Bronconeumol, 2003 Aug, 39(8), 373 - 5
{Stevens-Johnson syndrome associated with atypical pneumonia}; Modesto Alapont M et al.; Stevens-Johnson syndrome is characterized by generalized exanthema associated with high fever, catarrhal symptoms and mucositis . Various etiologies have been implicated, particularly numerous medications and certain agents of atypical pneumonia . Stevens-Johnson syndrome leads to death in up to 5% of cases.We describe the case of a 30-year-old woman with bilateral atypical pneumonia accompanied by severe generalized exanthema that required hospitalization in the serious burns unit of our hospital . She was diagnosed with Stevens-Johnson syndrome following atypical pneumonia caused by Mycoplasma pneumoniae with microbiological and pathological confirmation.

Cornea, 2003 Aug, 22(6), 576 - 7
Acanthamoeba as a cause of peripheral ulcerative keratitis; Moreira AT et al.; PURPOSE: To report a case of peripheral ulcerative keratitis caused by Acanthamoeba . METHODS: Case report and review of the literature . A 37-year-old woman with a history of pain and redness of the right eye with no apparent predisposing factors, on examination, revealed a peripheral ulcerative keratitis . RESULT: Microbiological investigations of the corneal infiltrate revealed Acanthamoeba cysts . CONCLUSION: All cases of peripheral ulcerative keratitis should be subjected to routine microbiological evaluation including those for Acanthamoeba.

Virus Genes, 2002 Dec, 25(3), 223 - 6
The World of Microbes 2002: scientific advances and challenges--impressions and highlights from the 12th Congress of Virology; Becker Y; Thousands of scientists participated in the World of Microbes Congress, which was organized by the International Union of the Microbiological Societies (IUMS) and took place in the Palais de Congres in Paris, France from 27 July to 1 August 2002 . The attendees were members of the IUMS divisions of Bacteriology and Applied Microbiology, Mycology, and Virology . In addition to the symposia that were organized by each division, joined plenary symposia were held, which encompassed subjects of common interest to all microbiologists . The activities at the 12th Congress of Virology's plenary lectures, symposia, and poster sessions were organized to accommodate the presentation of over 1500 presentations . These brief comments are aimed to provide a sample of only a few presentations that dealt with subjects of emerging and re-emerging virus diseases, which are of general interest.

Ann Clin Biochem, 2003 Jul, 40(Pt 4), 374 - 81
Diagnostic value of adenosine deaminase in tuberculous pleural effusion: a meta-analysis; Goto M et al.; BACKGROUND: Many studies have investigated the usefulness of adenosine deaminase activity (ADA) in pleural fluid for the early diagnosis of tuberculous pleurisy . To summarize the diagnostic characteristics of ADA we undertook a meta-analysis using a summary receiver operating characteristic (SROC) curve method . METHODS: Data sources were MEDLINE (1966-1999), the Cochrane Library and bibliographies of review and original articles . Studies were included if the absolute numbers of true positive, false negative, true negative and false positive observations were available or could be derived from the data presented; gold standards were described explicitly; and the criteria for a positive ADA result were reported . We constructed an SROC curve based on these extracted data to estimate the test characteristics . RESULTS: Forty articles were available for analysis . The gold standards used were pleural biopsy histology, microbiological examination of pleural fluid, pleural biopsy and sputum and the patient's clinical course or combinations of these . The sensitivity of ADA reported in the articles ranged from 47.1% to 100% and the specificity from 50.0% to 100% . The summary measure of test characteristics derived from the SROC curve was 92.2% for both sensitivity and specificity . CONCLUSIONS: The test performance of ADA in tuberculous pleural effusion is reasonably good . Measurement of pleural ADA is thus likely to be a useful diagnostic tool for tuberculous pleurisy.

Cardiol Clin, 2003 May, 21(2), 197 - 205
Diagnostic methods . Current best practices and guidelines for isolation of bacteria and fungi in infective endocarditis; Towns ML et al.; As the etiological character of IE changes, the microbiological tools used to confirm the diagnosis have also evolved . Here the authors have reviewed the current methods for optimal laboratory diagnosis of bacterial and fungal endocarditis using traditional growth-based technologies and offered good practice guidelines and recommendations . Newer techniques will be required to improve sensitivity of detection for known organisms and to identify emerging or as-yet unknown pathogens (see article by Lepidi et al in this issue).

Ig Sanita Pubbl, 2002 Nov-Dec, 58(6), 455 - 66
{Compulsory and additional parameters in water control}; Donia D et al.; The authors have analyzed 22 water samples from the Arno River (both river and drinking samples), as well as 11 effluent samples from an urban plant . Chemical and microbiological features of river samples were in line with the A3 class, needing treatment for drinking use (Executive Order n . 152/99); drinkable water met requirements (Presidents Decree n degrees 236/1988 and Executive Order n degrees 31/2001) . As regards chemical parameters, effluents complied with the law (Executive Order n . 152/1999) but their bacteriological figures exceeded the standards set by the Authorities due to a lack in chlorination . Enteric viruses reacted to the RT-PCR test in 5 of the samples, including a Coxsackievirus Type B2 and a Poliovirus . No association was shown between bacteriophage parameters and virus.

Arch Kriminol, 2003 May-Jun, 211(5-6), 166 - 73
{Dog saliva transmitted pathogens as etiology of fatal infections (on the topic of causal relationship)}; Bockholdt B et al.; The authors report on 4 deaths . 3 of the victims had been bitten by dogs shortly before death; in one case the victim had close contacts with a dog . In 3 of the cases death was caused by septicemia; microorganisms occurring in the saliva of dogs, but rarely causing infection could be determined in 2 of the cases . While in case 1 there was no bite injury so that transmission must have occurred by droplet infection (without trauma) or via a discrete skin lesion, case 2 showed a penetrating dog-bite injury; in both cases the spleen had been surgically removed some years before . In case 3 a causal relationship had to be assumed between a dog bite and death, although no pathogen could be identified in microbiological tests . In case 4 death was not attributable to the dog-bite injury suffered, but was due to an internal pathological cause.

J Food Prot, 2003 Jul, 66(7), 1247 - 52
Effects of spray-cooling processes on the microbiological conditions of decontaminated beef carcasses; Gill CO et al.; Spray processes for cooling decontaminated carcasses were examined at four beef packing plants . Temperature histories were collected from deep leg sites on 25 carcasses and from randomly selected sites on the surfaces of a further 25 carcasses selected at random from carcasses undergoing cooling at each plant . Carcass cooling rates were similar at all four plants . Proliferation values calculated from surface temperature histories indicated similar increases of < or = 2 log units in the numbers of pseudomonads on carcasses at all plants and increases of <0.5 and >0.5 log units in the numbers of Escherichia coli on carcasses at plants A and B and plants C and D, respectively . The numbers of aerobes recovered from carcasses after cooling were about 1 log unit larger than the numbers recovered from carcasses before cooling at plants A, B, and C but >1.5 log units larger at plant D . These increases in numbers of aerobes were in agreement with the estimated proliferations of pseudomonads . The larger increase in the number of aerobes on carcasses at plant D may be attributable to carcasses not being pasteurized at that plant, while carcasses were pasteurized at all of the other plants . The numbers of E . coli recovered from carcasses after cooling at plants B, C, and D were also in agreement with the increases calculated from surface temperature histories . However, numbers of E . coli declined by about 1 log unit during carcass cooling at plant A . This decline may have been due to death occurring during chilling for some E . coli cells that were injured rather than killed by pasteurization with sprayed hot water at plant A, whereas pasteurization with steam at plants B and C seemingly left few injured E . coli cells . The growth of bacteria on decontaminated carcasses during spray cooling at the four plants was apparently constrained by temperature alone.

Water Res, 2003 Sep, 37(15), 3689 - 96
An ATP-based method for monitoring the microbiological drinking water quality in a distribution network; Delahaye E et al.; The titration of adenosine triphosphate (ATP) by bioluminescence permits rapid evaluation of the quantity of viable micro-organisms present in a water sample . During two sampling campaigns, Societe Anonyme de Gestion des Eaux de Paris (SAGEP) tested a new extraction and titration system of bacterial ATP in the Paris drinking water distribution network . As far as the entire set of results of analyses of water in the network is concerned there is a linear relationship between log {ATP} and log(HPC-R2A/ml) . Furthermore, as regards the drinking water originating from treatment of surface waters, some of the results obtained indicate a slight change as regards the Paris network in the microbiological quality . This is certainly linked to the distance travelled from the production location as well as to a reservoir effect observed on a site . Conversely, no change is apparent with regard to waters of underground origin . Lastly, despite changes in temperature and chlorine residual, no significant influence has been observed, essentially because of the very low density of culturable bacteria.

Chemosphere, 2003 Sep, 52(9), 1373 - 9
Double trouble: health risks of accidental sewage release; Bridges O; Occupational health risks from long-term exposure to sewage are well documented {Am J . Ind . Med . 25 (1994) 59; Ann . Agric . Environ . Med . 81 (2001) 39; Am J . Ind . Med . 40 (2001) 170} . Some studies suggest an increase in the incidence of specific cancers {Am J . Ind . Med . 19 (1991) 75; J . Occup . Med . 36 (1994) 31} . There are also many reports of acute fatalities in confined spaces (sewage chambers and pipes) {H&S at Work 13 (1991), 10; FACE report: sewer worker dies when inflatable sewer plug bursts in Washington, DC, Performer, National Institute For Occupational Safety and Health, 19th July 1990} . In a residential area incidents of sudden sewage release can be regarded as double trouble because both the emergency service personnel and the local residents may be exposed to a galaxy of chemical and microbiological agents present in sewage . However, data on the effects of acute non-occupational exposure due to accidental sewage releases is still very limited . The incidents investigated here took place at two different locations in the southern part of the UK . In both incidents the symptoms experienced by those exposed were more serious than expected by the public health experts.

J Postgrad Med, 2003 Jan-Mar, 49(1), 39 - 49
Leishmaniasis in HIV infection; Paredes R et al.; Herein we review the particular aspects of leishmaniasis associated with HIV infection . The data in this review are mainly from papers identified from PubMed searches and from papers in reference lists of reviewed articles and from the authors' personal archives . Epidemiological data of HIV/Leishmania co-infection is discussed, with special focus on the influence of Highly Active Antiretroviral Therapy (HAART) on incidence of leishmaniasis and transmission modalities . Microbiological characteristics, pathogenesis, clinical presentation and specific treatment of the co-infection are also presented.

Gynecol Obstet Fertil, 2003 Jun, 31(6), 534 - 8
{Evaluation of the interest of semen culture before cryoconservation}; Levy R et al.; OBJECTIVES: French guidelines recommend screening all patients for virus infection prior to cryopreservation of their semen . In case of viral risk, the use of specific high secure CBS straws is recommended . The objective of this work was to evaluate the microbiological risk by testing all semen samples before cryopreservation . PATIENTS AND METHODS: Fifty one patients underwent a semen culture before cryopreservation . RESULTS: The fifty one patients were classed into 3 groups following semen culture results: group I: negative culture (39/51, 76.47%), group II: positive culture with microbiological contamination (7/51, 13.73%) and group III: positive culture with pathogen (5/51, 9.8%) . For 3 patients of the latter group, we tested a three-layer density gradient to eliminate bacteria before Assisted Reproductive Techniques . DISCUSSION AND CONCLUSIONS: This paper discusses the risks related to microbiological contamination and the options available in this case.

J Ultrasound Med, 2003 Jul, 22(7), 703 - 8
Color Doppler sonographically guided transthoracic needle aspiration of lung and mediastinal masses; Gorguner M et al.; OBJECTIVE: This study investigated the diagnostic value of color Doppler sonographically guided transthoracic needle aspiration in lung and mediastinal masses . METHODS: B-mode and colorDoppler sonographic images were obtained in 48 patients with mediastinal or peripheral pulmonary tumors . Color Doppler sonography was used to show the vascular structures before the transthoracic needle aspiration procedure . It was also used to locate the needle tip during the procedure by showing the twinkling sign . This maneuver was performed with motion of the inner stylet . Pathologic and microbiological examination of the aspirates was made . RESULTS: Vascular structures were detected in 37 cases on color Doppler images and in 10 cases on B-mode images . Similarly, the needle tip was observed in 39 cases on color Doppler images but in only 9 cases on B-mode images . No complications were observed except partial pneumothorax in 2 cases . The method had sensitivity of 90.0%, specificity of 87.5%, a positive predictive value of 97.2%, a negative predictive value of 63.6%, and diagnostic accuracy of 89.6% . CONCLUSIONS: Color Doppler sonographically guided transthoracic needle aspiration is a safe diagnostic method in malignant lung tumors, especially peripheral tumors, because of its ability to differentiate vascular structures within a tumor before the transthoracic needle aspiration procedure . It provides additional information about the location of the needle tip.

J Infect, 2003 Aug, 47(2), 148 - 54
Impaired blood polymorphonuclear leukocyte migration and infection risk in severe trauma; Egger G et al.; OBJECTIVES: We investigated the association of impaired blood polymorphonuclear leukocyte (PMN) migration with the incidence of bacterial infections in patients with severe trauma . METHOD: Twenty-six intensive-care patients with different injury severity scores were enrolled in a prospective study . PMN migration was measured daily using 300 microl fresh whole blood in a membrane filter assay . Migration was evaluated in an automated image analyzer that recorded numbers and distribution of the immigrant PMNs within a filter . The relevant parameter was the percentage of PMNs that migrated from the blood samples into the filters upon f-Met-Leu-Phe stimulation . RESULTS: Nine patients developed posttraumatic infections verified microbiologically . These patients showed a reduced PMN migratory capacity in comparison with the 17 patients without infections . A migrating portion of six per cent or less at least three days in succession preceded infections by one to 19 days and indicated infection in eight true positive versus three false positive cases, and 14 true negative versus one false negative case, i.e . specificity was 82.3% and sensitivity 88.8%, p=0.0008 . Trauma severity had no influence on PMN migration . CONCLUSIONS: Trauma patients with impaired PMN migration are at risk for bacterial infections . Whole-blood migration tests can define the infection risk and thus may be useful predictive markers for infections.

J Mol Biol, 2003 Jul 25, 330(5), 1153 - 64
Characterization of the pressure-induced intermediate and unfolded state of red-shifted green fluorescent protein--a static and kinetic FTIR, UV/VIS and fluorescence spectroscopy study; Herberhold H et al.; The green fluorescence proteins (GFP) are widely used as reporters in molecular and cell biology . For their use it in high-pressure microbiology and biotechnology studies, their structural properties, thermodynamic parameters and stability diagrams have to be known . We investigated the pressure stability of the red-shifted green fluorescent protein (rsGFP) using Fourier-transform infrared spectroscopy, fluorescence and UV/Vis spectroscopy . We found that rsGFP does not unfold up to approximately 9kbar at room temperature . Its unique three-dimensional structure is held responsible for the high-pressure stability . At higher temperatures, its secondary structure collapses below 9kbar (e.g . the denaturation pressure at 58 degrees C is 7.8kbar) . The analysis of the IR data shows that the pressure-denatured state contains more disordered structures at the expense of a decrease of intramolecular beta-sheets . As indicated by the large volume change of DeltaV degrees (u) approximately -250(+/-50)mlmol(-1) at 58 degrees C, this highly cooperative transition can be interpreted as a collapse of the beta-can structure of rsGFP . For comparison, the temperature-induced unfolding of rsGFP has also been studied . At high temperature (T(m)=78 degrees C), the unfolding resulted in the formation of an aggregated state . Contrary to the pressure-induced unfolding, the temperature-induced unfolding and aggregation of GFP is irreversible . From the FT-IR data, a tentative p,T-stability diagram for the secondary structure collapse of GFP has been obtained . Furthermore, changes in fluorescence and absorptivity were found which are not correlated to the secondary structural changes . The fluorescence and UV/Vis data indicate smaller conformational changes in the chromophore region at much lower pressures ( approximately 4kbar) which are probably accompanied by the penetration of water into the beta-can structure . In order to investigate also the kinetics of this initial step, pressure-jump relaxation experiments were carried out . The partial activation volumes observed indicate that the conformational changes in the chromophore region when passing the transition state are indeed rather small, thus leading to a comparably small volume change of -20 ml mol(-1) only . The use of the chromophore absorption and fluorescence band of rsGFP in using GFP as reporter for gene expression and other microbiological studies under high pressure conditions is thus limited to pressures of about 4kbar, which still exceeds the pressure range relevant for studies in vivo in micro-organisms, including piezophilic bacteria from deep-sea environments.

Z Arztl Fortbild Qualitatssich, 2003 Jun, 97(3), 227 - 32
{Quality of hygiene in endoscope reprocessing--the fundamentals of indicator-assisted quality management in gastroenterology}; Birkner BR et al.; High level disinfection and infection control in reprocessing gastrointestinal endoscopes is a critical security factor for patients in gastrointestinal health care . National and international guidelines for an adequate high quality disinfection of gastrointestinal endoscopes have been developed aiming to obtain infection control . The German Medical Association has recently published recommendations on quality assurance in gastrointestinal endoscopy including standardised procedures for disinfection and infection control . A prospective study was carried out in a large urban area in both private practices and hospitals to identify and characterise flaws and limitations in disinfection of gastrointestinal endoscopes by measuring a set of indicators of the quality of structures, processes and outcomes . Moreover, the influence of information and continuous medical education on the quality of disinfection and infection control were to be evaluated . The bacterial contamination of endoscopes after reprocessing was measured as a relevant outcome quality indicator . The results revealed substantial flaws in cleaning and disinfection procedures in gastrointestinal endoscopy under routine clinical conditions . Overall, 49 and 39 percent of all (pre- and post-interventionally, resp.) checked endoscopes were contaminated by one or more bacteria . More often failures were discovered in the optic rinse system than in the cleaning/disinfection and the final rinse and drying process . A substantial failure rate was detected in gastrointestinal endoscope reprocessing under routine conditions according to the reprocessing procedure . Compared to manual and semi-automatic cleaning and disinfection, the full automatic cleaning and disinfection machines (RDG-E) showed the best results . Though their cleaning process remains improveable, it seems advisable to prefer RDG-E-machines for disinfection and infection control in gastrointestinal endoscopy . Continuous quality control of disinfection should be obtained by introducing regular microbiological examinations of the reprocessed endoscopes . Negative microbiological controls of the contamination of endoscopes are suitable quality indicators of a quality management system aiming to improve the quality of structures, processes and outcomes in gastroenterological health care.

Environ Sci Technol, 2003 Jun 15, 37(12), 2714 - 9
Natural organic matter as reductant for chlorinated aliphatic pollutants; Kappler A et al.; Humic acids (HA) are ubiquitous redox-active compounds of natural aquatic and soil systems . Here we studied the potential of HA as reductants for chlorinated aliphatic pollutants . To avoid artifacts potentially involved when studying chemically reduced HA, we prepared electrochemically reduced soil, aquatic and synthetic HA, and anthrahydroquinone-2,6-disulfonic acid (AHQDS), a model compound for hydroquinone moieties in HA . Both reduced HA and AHQDS reduced hexachloroethane (HCE) at appreciable rates . Some reduction of HCE by HA, however, occurred even before electrochemical reduction of the humic acids . This indicates that a small fraction of reduced moieties in HA persists at oxic conditions for some time . The initial reaction followed pseudo-first-order reaction kinetics, and tetrachloroethylene was the only halogenated product . The relatively small variations in carbon-normalized rate constants, k(DOC), found indicate that despite inherent variations in concentration, accessibility, and reactivity of redox-active groups in HA of various origins their overall dechlorination activity is fairly constant . However, HCE transformation rate constants and reducing capacities of different HA did not correlate . Rate constants normalized to both carbon content and reducing capacity of HA clearly indicate that reduced functional groups in different HA exhibit different reactivities . Our results together with the fact that reduced HA can be formed by a variety of microbiological and chemical processes suggest that HA could play a significant role as reductants in the reductive transformation of subsurface contaminants and that such a process could potentially be enhanced at contaminated sites by addition of reducible natural organic matter.

Clin Microbiol Infect, 2003 May, 9(5), 406 - 11
Optimizing antibiotic therapy-the Aberdeen experience; Kumarasamy Y et al.; OBJECTIVE: To study the quality and continuity of treatment in the Acute Medicines Assessment Unit (AMAU) with regard to empirical prescription of antibiotics, mode of administration, adherence to ward antibiotic policy, as well as collection, awareness and utilization of microbiological investigations . METHODS: A prospective study over a 3-month period at the AMAU, Aberdeen Royal Infirmary (ARI), a teaching hospital in north-eastern Scotland, was performed . The study included all patients started on empirical antibiotics on admission to the AMAU and followed up until their discharge . RESULTS: Of 1303 patients admitted, 221 (17%) were started on empirical antibiotics . This was in accordance with hospital antibiotic policy in 52% of cases . Appropriate specimens were taken from 77% of patients . Culture results showed that 29% (n = 65) of the patients had clinically significant growth of organisms . Of the 65 patients with clinically significant culture results, 49% (n = 32) were on an inappropriate empirical regimen . In 55%, the medication was not changed to a more appropriate antibiotic . In 72% of the patients with a negative culture, the culture report had no obvious effect on the duration or type of antibiotic being administered . Intravenous antibiotics were used in 60% of patients . CONCLUSION: This study demonstrates a significant overuse of antibiotics, especially intravenous forms, despite a paucity of positive sepsis parameters and chest X-ray findings in these patients The duration of treatment could be shortened and an early switch policy introduced if culture results and sepsis profiles were taken into consideration, as there was a large number of unproven infections . Suggestions are made about how these improvements in prescribing could be made within the current administrative set-up of AMAUs.

Nephrol News Issues, 2003 Jun, 17(7), 25 - 6, 78
Running water: measuring water quality in a dialysis facility . Part 2; Levin R et al.; A summary of the primary points follows: The microbiological quality of the dialysis fluid represents an independent determinant of the nutritional status, in addition to known factors such as dose of dialysis and biocompatibility of the dialyzer membrane . Ultrapure dialysis fluid adds to the cost of the dialytic treatment, but improves the nutritional status in long-term hemodialysis patients . Water quality needs to be routinely monitored to ensure that the potential risk to patients from chemical and bacterial contaminants is minimized; this requires the implementation of a quality approach . The layout and design of the water room and water system are key to producing and maintaining high-quality dialysis fluid . Routine monitoring and preventive maintenance of the water system will ensure that high-quality dialysis fluid is delivered.

J Clin Microbiol, 2003 Jul, 41(7), 3206 - 11
Use of 18S rRNA gene-based PCR assay for diagnosis of acanthamoeba keratitis in non-contact lens wearers in India; Pasricha G et al.; Identification of Acanthamoeba cysts and trophozoites in ocular tissues requires considerable expertise and is often time-consuming . An 18S rRNA gene-based PCR test, highly specific for the genus Acanthamoeba, has recently been reported in the molecular diagnosis of Acanthamoeba keratitis . This PCR assay was compared with conventional microbiological tests for the diagnosis of Acanthamoeba keratitis . In a pilot study, the PCR conditions with modifications were first tested on corneal scrapings from patients with culture-proven non-contact lens-related Acanthamoeba, bacterial, and fungal keratitis . This was followed by testing of corneal scrapings from 53 consecutive cases of microbial keratitis to determine sensitivity, specificity, and predictive values of the assay . All corneal scrapings from patients with proven Acanthamoeba keratitis showed a 463-bp amplicon, while no amplicon was obtained from patients with bacterial or fungal keratitis . Some of these amplified products were sequenced and compared with EMBL database reference sequences to validate these to be of Acanthamoeba origin . Out of 53 consecutive cases of microbial keratitis included for evaluating the PCR, 10 (18.9%) cases were diagnosed as Acanthamoeba keratitis on the basis of combined results of culture, smear, and PCR of corneal scrapings . Based on culture results as the "gold standard," the sensitivity of PCR was the same as that of the smear (87.5%); however, the specificity and the positive and negative predictive values of PCR were marginally higher than the smear examination (97.8 versus 95.6%, 87.5 versus 77.8%, and 97.8 versus 97.7%) although the difference was not significant . This study confirms the efficacy of the PCR assay and is the first study to evaluate a PCR-based assay against conventional methods of diagnosis in a clinical setting.

Phytochemistry, 2003 Jul, 63(6), 663 - 8
The microbiological transformation of the diterpenes dehydroabietanol and teideadiol by Mucor plumbeus; Fraga BM et al.; The microbiological transformation of dehydroabietanol (18-hydroxy-dehydroabietane) by Mucor plumbeus led to 2alpha,18-dihydroxy-abieta-8,11,13,15-tetraene, 2alpha,15-dihydroxy-dehydroabietanol, 2alpha-hydroxy-15-methoxy-dehydroabietanol, 7beta-hydroxy-2-oxo-dehydroabietanol, 15-hydroxy-2-oxo-dehydroabietanol and 15,16-dihydroxy-2-oxo-dehydroabietanol, whilst that of teideadiol (1alpha,18-dihydroxy-dehydroabietane) gave 2alpha-hydroxy-teideadiol, 7alpha-hydroxy-teideadiol and 7beta-hydroxy-teideadiol . Thus, 2alpha- and 7beta-hydroxylation occur in both biotransformations and the 15-hydroxylation is inhibited in the biotransformation of teideadiol by the presence of a 1alpha-alcohol.

Gac Sanit, 2003 May-Jun, 17(3), 196 - 203
{Chickenpox outbreak in Herrera del Duque, Badajoz, Spain}; Valades FJ et al.; INTRODUCTION: Chickenpox is a worldwide disease with high morbidity but few complications, although complications can be sevre in immunocompromised individuals and healthy adults . The annual chickenpox rate declared to the National Notification Disease Surveillance System is approximately 5 cases per 1,000 inhabitants in Extremadura (Spain) . The aim of this study was to identify and describe the characteristics and cost of an epidemic outbreak of chickenpox in Extremadura . METHODS: Between November 2000 and March 2001, a descriptive study was performed . Cases of chickenpox were actively sought in a cohort of schoolchildren in Herrera del Duque (Badajoz) . The protocols of the Monitoring Network of the Autonomous Community of Extremadura was used for case definition . Microbiological confirmation was performed by isolation of the virus and the presence of IgM and IgG markers in serum . We analyzed the direct and indirect tangible costs as well as the intangible costs of the outbreak . RESULTS: Seventy-five cases were identified, of which 94.7% occurred in children aged between 1-9 years, mainly boys . The attack rate was 18.5 cases per 1,000 inhabitants and 68.2% occurred in children aged less than 10 years charing a home . The clinical course was benign, without hospital admissions or complications . A total of 71.6% of children aged between 3 and 8 years were susceptible . A possible temporary aggregation of cases in the school was analyzed and a relative risk of 5.01 (p < 0.0001) was obtained . The virus was isolated in the 4 vesicle samples studied and serology was positive (IgM) in the 9 serum samples studied . The total cost of the outbreak was of 927,21 e, with a mean of 12,53 e per case and 205 school days lost . CONCLUSION: A chickenpox outbreack was confirmed in Herrera del Duque, with person-to-person transmission, affecting children aged between 1 and 9 years . The high susceptibility of the pupils, the characteristics of teaching, and the meetings prior to the carnivals played a determining role in the transmission of the epidemic . The estimated cost of this outbreak was 76% less than the cost that would have been generated by single-dose vaccination of the 75 individuals who contracted the disease.

Appl Environ Microbiol, 2003 Jul, 69(7), 4205 - 13
Quantum dots as strain- and metabolism-specific microbiological labels; Kloepfer JA et al.; Biologically conjugated quantum dots (QDs) have shown great promise as multiwavelength fluorescent labels for on-chip bioassays and eukaryotic cells . However, use of these photoluminescent nanocrystals in bacteria has not previously been reported, and their large size (3 to 10 nm) makes it unclear whether they inhibit bacterial recognition of attached molecules and whether they are able to pass through bacterial cell walls . Here we describe the use of conjugated CdSe QDs for strain- and metabolism-specific microbial labeling in a wide variety of bacteria and fungi, and our analysis was geared toward using receptors for a conjugated biomolecule that are present and active on the organism's surface . While cell surface molecules, such as glycoproteins, make excellent targets for conjugated QDs, internal labeling is inconsistent and leads to large spectral shifts compared with the original fluorescence, suggesting that there is breakup or dissolution of the QDs . Transmission electron microscopy of whole mounts and thin sections confirmed that bacteria are able to extract Cd and Se from QDs in a fashion dependent upon the QD surface conjugate.

Scand J Infect Dis, 2003, 35(4), 282 - 4
Pneumonia due to Mycoplasma hominis in a healthy adult; Saez A et al.; A case of pneumonia due to Mycoplasma hominis in a healthy adult is presented . The bacterium was diagnosed by a quantitative culture method and identification to the species level by sequence analysis of 16S rRNA gene . The objective of this presentation is to bring to attention the need to search for this opportunistic pathogen . Mycoplasma may be an important cause of bacterial pneumonia without microbiological diagnosis and its incidence may be underestimated.

Ann Ig, 2003 Mar-Apr, 15(2), 147 - 57
{Environmental quality of Volturno river with toxic and genotoxic findings}; Parrella A et al.; In order to assess the environmental quality of Volturno river in Southern Italy, the Extended Biotic Index, chemical and microbiological parameters were determined in nine sampling points as provided for D . Lgs . 152/99 . Furthermore, this study reported toxicity of surface waters and pore waters from sediments and genotoxicity of pore waters to improve the definition of the ecological condition of the investigated watercourse . Results showed that toxicity and genotoxicity testing contributed to assess environmental quality and pore waters are an useful tool to combine investigations.

Mikrobiyol Bul, 2002 Jul-Oct, 36(3-4), 237 - 46
{Legionella pneumophila in thermal pools of hot springs in the central Anatolian district}; Alim A et al.; Microbiological contamination of hot spring waters is a public health problem, and hot spring waters have been thought to be a potential source of Legionella infections . In this study, 209 water samples collected from 69 thermal pools of 36 hot springs in the Central Anatolia Region were examined for the presence of Legionella spp . between September and November 2001 . The water samples were concentrated via filtration, and the filtrates were decontaminated by low-pH method . Then the samples were cultured on non-selective (Buffered Charcoal Yeast Extract Agar, BCYE) and selective (GVPC; BCYE supplemented with glycine, vancomycin, polymyxin B, cycloheximide, and MWY; BCYE supplemented with glycine, anisomycin, polymyxin B, vancomycin, bromthymol blue, bromcresole purple) media, and suspected colonies were confirmed by Legionella Latex Kit (Oxoid) and direct fluorescent antibody test . As a result, 24 out of 209 (11.5%) water samples were found positive for Legionella pneumophila, and a total 26 L . pneumophila strains were isolated from these 24 samples . Two of these isolates were found reactive with serogroup 1, 20 were reactive with serogroup 2-14 antisera in agglutination test, while 2 samples collected from the same thermal pool, have yielded 2 strains, of which one was serogroup 1 and the other was serogroup 2-14 . L . pneumophila was detected in 22.2% of hot springs (8 of 36) and 14.5% of thermal pools (10 of 69) . L . pneumophila concentrations which were detected in water samples ranged from 10 to 430 CFU/100 ml . This is the first data for the prevalence of Legionnaires' disease agent in hot spring spas in the Central Anatolia Region of Turkey . Colonization of bacterium in some spas indicates that the certain hot springs might be endemic focuses for Legionnaires' disease in our country.

Wien Med Wochenschr, 2003, 153(9-10), 202 - 7
Cost-effectiveness in diagnosis of patients with long-standing fever; Wolf H et al.; INTRODUCTION: It is difficult to make an adequate diagnosis regarding patients with fever of unknown origin (FUO) . The cases require time-consuming and costly investigations . Our study features a cost-effectiveness analysis and the development of an alternative diagnostic model . The diagnostic programmes include: serological and microbiological tests, blood laboratory test, radiological, histopathological and radionuclide tests . PATIENTS AND METHODS: For 100 hospitalized patients with fever (group A: > 38.0 degrees C for as long as 7 days; group B: > 38.3 degrees C for 3 weeks), the various results of clinical investigations were obtained, and the costs of a three-step programme for the four main diagnoses, including the diagnostic value, were evaluated . RESULTS: There was no significant difference between male and female patients, or patients < 35 vs . > 35, and < 50 vs . > 50 years . Infections were found in 46%, neoplasma and collagen-vascular disease/autoimmune disorders in 10% each, and other diseases in 20% of all patients . The third diagnostic programme was the most expensive in all four disease categories . In total, 30, 34, and 22 patients were diagnosed by the three diagnostic steps, respectively . In 14 patients no diagnosis was found . The overall cost of the three diagnostic programmes was 359, 1,996 and 3,496 EUR, respectively . CONCLUSIONS: In the majority of the cases (64%), the first and second diagnostic programmes result in a diagnosis . The investigations of the third diagnostic programme are more accurate, more expensive, and result in a diagnosis, mainly in patients of group B . Our proposed new diagnostic model would save 134, 746, and 558 EUR for each diagnostic step, respectively.

Wien Med Wochenschr, 2003, 153(9-10), 198 - 201
{Wound healing by steril fly larvas: basic mechanical, biochemical and microbiological principles}; Grassberger M et al.; Recently an old treatment for refractory wounds, the so-called "Maggot-Therapy", once again received attention in medical literature . It seems, that the biggest obstacle for a broad clinical use of fly larvae of the species Lucilia sericata in wound treatment is the lack of knowledge about the biology of these animals and the underlying mechanisms with respect to wound therapy . In this review, the known and possible mechanisms of action of Maggot-Therapy are presented and opportunities for further research are discussed.

Med Sci (Paris), 2003 Apr, 19(4), 481 - 8
{Quality control of gene therapy products: approach of the French Agency for the Safety of Health Products}; Chenivesse X et al.; Gene therapy is a new therapeutic strategy which can constitute in some diseases a true alternative or a complement to the "classical treatments" . Regarding the innovative features, the complexity and the extreme diversity of the gene therapy products (naked DNA, synthetic vectors, viral vectors, genetically modified cells), these new products presently in clinical trials have to be precisely evaluated and controlled for their medicine quality as well as their biological origin and/or their specific characteristics of genetically modified organisms . The French Agency for the Safety of Health Products engaged an in-depth scientific review concerning the control of this very heterogeneous class of potential therapeutics through the creation of a working group . The objectives of this group were to determine the testings to be performed by a national authority for each type of gene therapy products and to select the appropriate techniques or methods to be developed . Controls considered as essential are listed and include the verification of the identity, the purity, the transfer and expression efficiency as well as the microbiological and viral safety of the products . This implies the development of diverse techniques of molecular biology, cellular biology, physico-chemistry, animal testing, histology and microbiology . Finally, in order to define the basis of testings of these emerging products, the marketing of which should be effective for some of them in the next years, it appears extremely important to harmonize the quality, efficiency and safety criteria, to develop specific references and standards and to create specific guidelines for the control of gene therapy products.

J Clin Pathol, 2003 Jul, 56(7), 519 - 21
Fine needle aspiration cytology of granulomatous mastitis; Tse GM et al.; AIMS: Granulomatous mastitis (GM) is an uncommon breast lesion that mimics carcinoma . The fine needle aspiration cytological (FNAC) features of GM have rarely been discussed in the literature . These features are reported in eight histologically confirmed cases of GM . METHODS: A retrospective study was undertaken in which a diagnosis of GM had been made on histopathology, and the FNAC slides were reviewed and assessed for the presence of granulomas, necrosis, multinucleated giant cells, and inflammatory background cells . Polymerase chain reaction (PCR) for Mycobacterium tuberculosis was performed on the histological material to exclude tuberculosis . RESULTS: All cases were confirmed histologically and PCR for mycobacterial DNA was negative . In the FNACs, varying numbers of granulomas composed of epithelioid histiocytes were present in four cases . The same four cases showed giant cells of either foreign body or Langhan's type . No necrosis was noted . Six cases showed many histiocytes, some plump and others epithelioid, in the background . The number of epithelioid histiocytes corresponded to the presence of granulomas . Neutrophils were the predominant background inflammatory cells in most cases (six) . CONCLUSIONS: The cytological diagnosis of GM is difficult because the features overlap with other aetiologies, including tuberculosis . Specific features are absent . The absence of necrosis and a predominantly neutrophilic infiltrate in the background favour a diagnosis of GM . This diagnosis should also be considered when abundant epithelioid histiocytes are seen in smears, even in the absence of granulomas . However, the definitive diagnosis of GM depends on histology from fine needle biopsies and negative microbiological investigations.

Thorax, 2003 Jul, 58(7), 594 - 7
Asymptomatic carriage of Pneumocystis jiroveci in subjects undergoing bronchoscopy: a prospective study; Maskell NA et al.; BACKGROUND: The opportunistic fungus Pneumocystis jiroveci is a common cause of respiratory infection in immunocompromised patients . By contrast, pneumocystis pneumonia (PCP) occurs only rarely in immunocompetent individuals . Asymptomatic colonisation with P jiroveci has recently been described in patients who are either minimally immunosuppressed or who have underlying lung disorders such as bronchiectasis . We sought to determine the prevalence of asymptomatic colonisation by P jiroveci in a cohort of adult patients undergoing diagnostic bronchoscopy . METHODS: A prospective observational cohort study was performed in patients who required bronchoscopy and bronchoalveolar lavage (BAL) as part of their routine clinical assessment . All the samples underwent standard microbiological analysis and a Grocott methenamine silver stain was performed where clinically indicated to detect the presence of P jiroveci . Polymerase chain reaction for detection of P jiroveci specific DNA was also performed . RESULTS: Ninety three consecutive BAL fluid samples were analysed, 17 (18%) of which contained P jiroveci DNA . Of the potential predictors examined, only glucocorticoid use was significantly associated with detectable P jiroveci DNA . Eighteen patients were receiving oral glucocorticoids (equivalent to >20 mg/day prednisolone) at the time of bronchoscopy, of whom eight (44%) had detectable P jiroveci DNA . In contrast, P jiroveci was detected in only nine of 75 patients (12%) who were not receiving glucocorticoids (difference between proportions 32%, 95% CI 8 to 57; p=0.004, two tailed Fisher's exact test) . CONCLUSIONS: P jiroveci colonisation, as determined by detection of P jiroveci DNA in BAL fluid, is common in HIV negative patients with primary respiratory disorders undergoing bronchoscopy and BAL . The higher prevalence in patients receiving corticosteroids suggests that oral glucocorticoid therapy is an independent risk factor for colonisation . In contrast, underlying lung cancer or COPD did not appear to be risk factors.

Indian J Ophthalmol, 2003 Jun, 51(2), 139 - 45
Spectrum and clinical profile of post cataract surgery endophthalmitis in north India; Gupta A et al.; PURPOSE: To determine the spectrum, clinical profile and risk factors for poor visual outcome in patients of post cataract surgery endophthalmitis . METHODS: Data from 124 eyes were analysed . Various clinical and microbiological parameters were evaluated and risk factors for unfavourable outcome identified . RESULTS: The mean age of the patients was 59.50 +/- 13.75 years; 60.5% were males . The median surgery-symptom interval was 7 days (mean 15.81 +/- 24.01) and the medium symptom-presentation interval 7.5 days (mean 14.19 +/- 19.13) . Corneal infiltrates were seen in 29%, hypopyon in 62 (50%) . Smear positivity was 52.5% and culture positivity 38% . Equivocal microbiological positivity was seen in 22 (18%), bacterial 12 (10%), fungal 27 (21.5%), polymicrobial 8 (6.5%) and negative 55 (44%) . 20% eyes had total loss of vision at last follow-up . Poor visual acuity at presentation, presence of intraocular lens, shorter surgery-symptom interval, corneal and surgical wound infiltrates, loss of red reflex, microbiological positivity of the vitreous tap and systemic diabetes mellitus were significant risk factors for unfavourable outcome . CONCLUSION: Our data highlights a low culture positivity and a predominance of fungal pathogens as a cause of post cataract surgery endophthalmitis . The visual outcome in these patients is still dismal and better treatment strategies should be evolved keeping in mind the microbiological spectrum . The risk factors identified may be helpful in prognosticating the outcome in such patients.

Refuat Hapeh Vehashinayim, 2003 Apr, 20(2), 55 - 64, 82
{Fixed bridgework rehabilitation of an edentulous mandible using different implant systems for superior results--review of the literature and a case report}; Kolerman R et al.; Implant therapy, as a modality of treatment, has been reported to establish excellent long-term results for the edentulous patients and the partially dentate patients . It was first consisted on Branemark's protocol in which two-stage approach was claimed to be mandatory for the successful development of osseointegration . However, a one-stage approach was found to produce equal and predictable results . This article discusses the differences between the two systems regarding the alveolar bone response, the microbiological aspect, the peri-implant maintenance and the esthetic outcome . The advantages as well as the disadvantages of each implant system should be taken into consideration when solely used or in combination with the other . A case report demonstrating the combined use of one-stage and two-stage implant systems as was considered to be superior for the treated sites is presented.

Intensive Care Med, 2003 Aug, 29(8), 1368 - 71 Epub 2003 Jun 26.
The systemic inflammatory response syndrome (SIRS) to identify infected patients in the emergency room; Jaimes F et al.; OBJECTIVE: Evaluation of the usefulness of criteria for systemic inflammatory response syndrome (SIRS) compared with the final diagnosis of infection in patients admitted to the emergency room of two university-based hospitals . DESIGN: Longitudinal cohort study . SETTING: Hospital Universitario San Vicente de Paul and Hospital General de Medellin, Medellin, Colombia . PATIENTS . Seven hundred thirty-four patients with suspected infection as main diagnosis for admittance into the emergency room . MEASUREMENTS AND RESULTS: Sensitivity, specificity, predictive values and likelihood ratios (LR) of SIRS criteria at admission were determined using, as gold standards, the diagnosis at the time of discharge based on clinical history and evolution, and microbiological confirmation of infection . SIRS criteria were met by 503 patients (68.5%); the discharge diagnosis of infection was found in 657 (89.4%) and 276 (37%) had microbiological confirmation . SIRS criteria exhibited a sensitivity of 69%, specificity of 35%, positive predictive value (PPV) of 90%, negative predictive value (NPV) of 12% and positive LR of 1.06 . There were no differences between the two gold standards . CONCLUSIONS: The finding of two or more SIRS criteria was of little usefulness for diagnosis of infection . It is necessary to work with new criteria and probably with biological markers, in order to obtain a simple, precise and operative definition of the sepsis phenomenon.

Br Dent J, 2003 Jun 28, 194(12), 649 - 53
Antibiotic prophylaxis for patients with joint prostheses - still a dilemma for dental practitioners; Seymour RA et al.; OBJECTIVES: To provide a critical review of the current evidence that implicates dental-induced bacteraemia as a risk for joint infections in patients fitted with joint prostheses and appraise the need for antibiotic prophylaxis . DESIGN: Retrospective analysis . SETTING: Mainly hospital-based patients or subjects . OUTCOME MEASURES: The relationship between joint infections and dental treatment is equivocal at the best and there is no evidence that antibiotic prophylaxis provides such patients with any protection . RESULTS: Microbiological evidence linking dental treatment-induced bacteraemia to joint infections is weak and if an oral commensal is implicated, it is more likely to have arisen either from a spontaneous bacteraemia or from a dental infection . As a consequence of the latter, we recommended the institution of good dental health prior to joint replacement . There may be a case for providing prophylaxis to the immuno-compromised patient, but only if the immuno-suppression is associated with a neutropenia . In such circumstances, only emergency treatment should be considered until the neutropenia is resolved . Antibiotic regimens that are recommended by orthopaedic surgeons have not been evaluated in a randomised placebo-controlled study and many of the drugs are not licensed for this purpose . The evidence on cost-risk benefit seems to demonstrate that antibiotic prophylaxis with either amoxicillin or penicillin is not cost effective when compared with no prophylaxis . CONCLUSION: The case for providing antibiotic prophylaxis prior to dental treatment in patients fitted with a joint prosthesis is weak or virtually non-existent . Furthermore, the risk from providing prophylaxis is greater than the risk of a joint infection.

Medicina (Kaunas), 2003, 39(6), 542 - 9
What Bizzozero never could imagine - Helicobacter pylori today and tomorrow; Janulaityte-Gunther D et al.; With the observation of spiral organism in the stomach about one hundred years ago a long history of a bacterium started ending up in a worldwide research programs, studies and consensuses . With this bacterium rediscovered by Marshall and Warren and later named Helicobacter pylori, a milestone of research was laid nearly twenty years ago . Helicobacter pylori is now recognized as the main cause of most cases of gastritis and ulcer disease in the stomach and the duodenum . In the course of the Helicobacter pylori research, Helicobacter pylori was found to trigger neoplastic alterations on the ground of the inflammation in the stomach . At first, a large number of publications served to describe the connection between Helicobacter pylori and the low malignant B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) of the stomach . Furthermore, on the basis of numerous seroepidemiological studies, researchers succeeded in documenting the participation of H . pylori, at least as a co-factor, in the development of gastric carcinoma . From large epidemiological studies made during the last twenty years as well as from microbiological research we have learned much more about this in the beginning nameless and mysterious bacterium.

Z Rheumatol, 2003 Jun, 62(3), 294 - 5
{Lymph node tuberculosis in a patient with polymyalgic symptoms: value of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET)}; Wenger M et al.; 18F-FDG-PET studies were performed in a 60-year-old female patient with polymyalgia rheumatica resistant to prior corticosteroid treatment . PET studies showed a cervical focus, which was identified histologically and microbiologically as lymph node tuberculosis.

Intensive Care Med, 2003 Aug, 29(8), 1384 - 9 Epub 2003 Jun 20.
Usefulness of procalcitonin for diagnosing complicating sepsis in patients with cardiogenic shock; Geppert A et al.; OBJECTIVE: Patients in cardiogenic shock (CS) often present with signs of systemic inflammation that mimic infection, especially in the setting of multiple organ failure (MOF) . To clarify the usefulness of procalcitonin (PCT) for diagnosing complicating sepsis in patients with CS, especially in the presence of MOF we compared PCT concentrations in patients with CS with and without MOF to those in patients with septic shock (SS) . DESIGN AND SETTING: Retrospective analysis in the cardiovascular ICU at a university hospital . PATIENTS: 40 patients with CS, 15 patients with SS, and 11 noncritically ill patients without infection . MEASUREMENTS AND RESULTS: Infection was excluded by clinical and microbiological examination in all CS patients at the time of blood sampling . Nevertheless 35% exhibited CRP concentrations higher than 10 mg/dl and 25% PCT concentrations higher than 2 ng/ml . Median PCT concentrations were higher in CS patients than in controls but lower than in patients with SS . CS patients with MOF at the time of blood sampling exhibited higher PCT concentrations than patients without organ failure . In the pooled population of patients with CS and SS PCT had a higher area under the receiver operating characteristic curve (0.86 vs . 0.83) than CRP and a PCT concentration of 10 ng/ml or higher had greater specificity for sepsis than a PCT concentration of 2 ng/ml or higher but lower negative predictive value . CONCLUSIONS: PCT concentrations above 2 ng/ml are frequently found in CS patients with MOF and do not necessarily indicate infection . PCT was slightly better than CRP for diagnosing sepsis in our study, but a PCT concentration of 10 ng/ml or higher seems to be more appropriate for diagnosing this complication in CS patients than 2 ng/ml.

Cornea, 2003 Jul, 22(5), 405 - 8
Clinical experience with N-butyl cyanoacrylate tissue adhesive in fungal keratitis; Garg P et al.; PURPOSE: To evaluate the role of tissue adhesive in the management of corneal thinning or perforation associated with active fungal keratitis . DESIGN: Retrospective noncomparative interventional case series . METHODS: Seventy-three eyes of 73 patients with microbiologically proven keratomycosis associated with thinning or perforation participated in the study . N-Butyl cyanoacrylate tissue adhesive (medical grade) and bandage contact lens were applied in addition to topical and systemic antifungal therapy . Our outcome measures included resolution of the infiltrate and preservation of the structural integrity of the globe . RESULTS: Outcome data were available for 66 eyes . The infiltrate resolved with scar formation in 42 (63.6%) eyes . In an additional eight (12.1%) eyes, tissue adhesive maintained the structural integrity of the globe while the patients awaited penetrating keratoplasty . Sixteen (24.2%) eyes showed progressive worsening or persistence of the infiltrate after application of tissue adhesive . Twenty-five (37.8%) eyes required multiple applications of tissue adhesive . The outcome was better in cases where the infiltrate measured less than 30 mm2 at the time of presentation and application of tissue adhesive (P < 0.01) . CONCLUSION: In view of the poor outcome of penetrating keratoplasty in active fungal keratitis, N-butyl cyanoacrylate tissue adhesive is a useful modality for the management of progressive thinning or perforation associated with active fungal keratitis . However, close observation is mandatory to assess the progression of disease.

Crit Rev Food Sci Nutr, 2003, 43(3), 287 - 316
Development of hazard analysis by critical control points (HACCP) procedures to control organic chemical hazards in the agricultural production of raw food commodities; Ropkins K et al.; Hazard Analysis by Critical Control Points (HACCP) is a systematic approach to the identification, assessment, and control of hazards in the food chain . Effective HACCP requires the consideration of all chemical microbiological, and physical hazards . However, current procedures focus primarily on microbiological and physical hazards, while chemical aspects of HACCP have received relatively little attention . In this article we discuss the application of HACCP to organic chemical contaminants and the problems that are likely to be encountered in agriculture . We also present generic templates for the development of organic chemical contaminant HACCP procedures for selected raw food commodities, that is, cereal crops,raw meats, and milk.

Ann Ist Super Sanita, 2003, 39(1), 97 - 104
{Role of the Istituti Zooprofilattici Sperimentali in controlling the microbiological and toxicologic risks related to seafood}; Ferrari M et al.; The "Istituti Zooprofilattici" are an important network whose main function is the monitoring of animal health as well as food . As a result of the recent improvements in aquaculture technology interest in the safety of seafood is increasing . Therefore, the purpose of this study was to set up diagnostic methods for the detection of virus contamination, as well as the use of in vitro techniques able to identify the different toxins . The results have allowed the development of molecular biology assays which, together with the isolation in cell cultures, can detect contaminations/infections by the hepatitis A virus and the most common enteroviruses . Moreover, specific selected cell lines have led to the detection of different toxins . These laboratory methods will be used in order to control seafood safety.

J Arthroplasty, 2003 Jun, 18(4), 528 - 32
Fluordeoxyglucose positron emission tomography detection of inflammatory reactions due to polyethylene wear in total hip arthroplasty; Kisielinski K et al.; A patient experienced chronic pain 8 years after total hip arthroplasty . Radiology and bone scanning showed no signs of aseptic loosening, but fluorine-18 fluorodeoxyglucose positron-emission tomography ((18)F-FDG-PET) showed intensive glucose metabolism in the joint capsule and around the prosthesis neck . The surgical intervention revealed soft tissue reaction in this area . Histologic examination showed a granulomatous foreign body reaction against polyethylene debris particles . Infection and rheumatoid arthritis could be excluded clinically, histologically, microbiologically, and with the bone scan . Therefore, FDG-PET detected inflammatory reaction caused by polyethylene wear in total hip arthroplasty and allowed clinicians to decide on interventions, including removal of granulomatous tissue and the replacement of worn artificial joint components to prevent aseptic loosening.

Am J Clin Pathol, 2003 Jun, 119(6), 854 - 8
Diagnosis of invasive septate mold infections . A correlation of microbiological culture and histologic or cytologic examination; Tarrand JJ et al.; We correlated results of microbiologic culture and histopathologic examination for 2,891 consecutive samples from autopsy tissue, surgical or biopsy tissue, and bronchoalveolar lavage (BAL) or bronchial washing (BW) specimens . For 23 autopsy cases with suspected invasive septate mold infections by histopathologic examination, culture yielded a mold in 12 cases (52%) . For 1,683 surgical or biopsy samples, histopathologic evidence of invasive septate mold infection was present in 30 samples, 9 of which also grew mold by culture (30%); 20 additional samples grew mold in culture alone, possibly representing culture contamination . Of 1,185 BAL and BW samples, mold was evident in 28 by cytologic examination and culture, 20 by cytologic examination alone, and 68 by culture alone . These results suggest a positive concordance for culture and histologic-cytologic examination of 23%, although both methods were negative in 96% of surgical and biopsy tissue and BAL and BW samples . The septate molds cultured from these samples were Aspergillus fumigatus (19), Aspergillus flavus (15), Aspergillus terreus (13), Aspergillus niger (7), Fusarium species (3), and Scedosporium apiospermum (2) . A flavus was isolated significantly more frequently from tissue than from BAL and BW samples.

J Oral Sci, 2003 Mar, 45(1), 33 - 8
Use of aspartate aminotransferase in diagnosing periodontal disease: a comparative study of clinical and microbiological parameters; Barbosa e Silva E et al.; The objective of this study was to assess the association between the levels of enzyme aspartate aminotransferase (AST) in gingival crevicular fluid (GCF) with the BANA hydrolysis microbiological test (Perioscan) and clinical periodontal diagnostic measurements, such as bleeding on probing, plaque index, gingival index, probing depth, and attachment level in patients with chronic periodontitis using an enzymatic test (PocketWatch) . One hundred and forty-seven sites were evaluated in 22 patients with a probing depth of > or = 5 mm at selected sites . AST and BANA enzymatic tests were carried out, and clinical parameters recorded . Pearson's chi-square and Fisher's exact tests were used for statistical analysis . There was no statistical correlation between AST levels and any of the analyzed parameters . The lack of any association between the factors studied does not indicate, however, that the latter cannot be used in diagnosing the actual periodontal condition of patients and/or sites . However, more research should be carried out to evaluate the true relationship between AST and periodontal disease.

Acta Derm Venereol, 2003, 83(3), 202 - 5
Gianotti-Crosti syndrome and allergic background; Ricci G et al.; The aim of the study was to verify whether there is a relationship between Gianotti-Crosti syndrome and an allergic background in children . Twenty-nine children affected by Gianotti-Crosti syndrome were first screened for a large panel of microbiological examinations, including serological and cultural tests for viruses and bacteria . A causative agent was identified in only 10 cases (34.4%) . In five cases a diagnosis of Epstein-Barr virus infection was made on the basis of significant titres of anti-Epstein-Barr virus antibodies (IgM) associated with constitutional symptoms (fever, pharyngitis-tonsillitis) . Our data concur with several clinical studies demonstrating that Epstein-Barr virus is now the most common viral agent associated with Gianotti-Crosti syndrome . For allergic evaluation, a group of 59 age- and sex-matched children investigated for recurrent infections were used as controls . The presence of atopic dermatitis (24.1%) in those with Gianotti-Crosti syndrome was significantly higher (p < 0.005) than in the control group (6.8%) . In addition, a more common family history for atopy was 51.7% vs . 31% (p < 0.027) and the percentage of patients with total IgE greater than +2 SD for age higher than in controls (27.6% vs . 13.7%), as was the percentage of specific IgE present (31% vs . 17.2%) . These results indicate that atopy is significantly associated with Gianotti-Crosti syndrome.

Methods Cell Sci, 2002, 24(1-3), 91 - 7
Flow cytometric techniques for the detection of microorganisms; Davey HM; Flow cytometry (FCM) is a technique, which allows one to analyse cells rapidly and individually, and permits the quantitative analysis of distributions of a property or properties in a population . It therefore offers many advantages over conventional measurements for the analysis of biological cells . Historically the technique has been widely applied for the study of mammalian cells, but its use in microbiology has been more limited; this is mainly a consequence of the smaller size of microbes, which results in the smaller optical signals that can be obtained from them . Developments in light sources and optics, together with brighter, spectrally-diverse dyes have reduced this barrier over recent years and the flow cytometer is now an essential tool in many microbiological research establishments . FCM has an increasing role to play in the detection of microbes in both industrial and clinical settings . Environmental monitoring to prevent outbreaks of human diseases such as cryptosporidiosis and Legionnaires' disease and to detect acts of biowarfare or bioterrorism are all amenable to flow cytometric study . This review seeks to highlight the role of the flow cytometer in the detection of microbial cells.

Lancet, 2003 Jun 14, 361(9374), 2068 - 77
Nosocomial infections in adult intensive-care units; Vincent JL; Nosocomial infections affect about 30% of patients in intensive-care units and are associated with substantial morbidity and mortality . Several risk factors have been identified, including the use of catheters and other invasive equipment, and certain groups of patients-eg, those with trauma or burns-are recognised as being more susceptible to nosocomial infection than others . Awareness of these factors and adherence to simple preventive measures, such as adequate hand hygiene, can limit the burden of disease . Management of nosocomial infection relies on adequate and appropriate antibiotic therapy, which should be selected after discussion with infectious-disease specialists and adapted as microbiological data become available.

Health Bull (Edinb), 2000 Mar, 58(2), 102 - 11
Tuberculosis in children at the Royal Hospital for Sick Children, Glasgow . January 1995-April 1998; Bland RM et al.; BACKGROUND: The management of paediatric tuberculosis can be complicated . Since 1995, children referred to the Royal Hospital for Sick Children have been managed at a specialist tuberculosis clinic, in an attempt to standardise diagnosis, treatment and follow-up . AIMS: To review the management of paediatric tuberculosis at the Royal Hospital for Sick Children, Glasgow, from January 1995 to April 1998 . METHODS: Retrospective study using information from the management database of all children treated for tuberculosis since January 1995 . RESULTS: Seventy two children have been treated (median age 5.9 {range 2.2-9.2} years; sex male:female 40:32; 76% Caucasians): 43 for tuberculosis disease, 21 for tuberculosis infection (chemoprophylaxis) and eight as tuberculosis contacts . Sixty three per cent were identified by contact tracing eighty one per cent of Mantoux tests were documented accurately . Of those with disease, 93% had gastric washings taken, and positive microbiological confirmation was obtained in 33% . All patients with disease were commenced on the chemotherapy regimen recommended by the British Thoracic Society . 88% completed treatment . Eighty four per cent of those with disease had been notified . Treatment of those in the infection or contact groups were treated more aggressively than the British Thoracic Society guidelines, with six months of treatment with isoniazid and rifampicin . Directly observed therapy was used in 17 children (24%) . Only 53% of Indo-asian children had received BCG immunisation . CONCLUSIONS: Most children were managed according to the British Thoracic Society guidelines . A management system, with a computerised database, has facilitated both patient management and audit, and ensured the delivery of quality care.

J Am Med Dir Assoc, 2001 Nov-Dec, 2(6), 285 - 8
Sputum bacteriology in nursing home pneumonia: a retrospective study; Gauerke C et al.; INTRODUCTION: Pneumonia is the most lethal infection in nursing homes . The Infectious Disease Society of America recommends that attempts be made to obtain quality sputum to focus antibiotic therapy . This is especially important within the enclosed space of a nursing home, where constant pressure from broad spectrum, empiric antibiotics sets the stage for the emergence of resistant organisms . METHODS: We reviewed all cases of radiographic pneumonia diagnosed on-site at the Wisconsin Veterans Home, a 721-bed facility, for the recording of sputum bacteriology and 30-day mortality . RESULTS: Ninety-nine cases of radiographic pneumonia diagnosed on-site were identified over 1 year . Mortality was 10% within 30 days . Fourteen quality sputum specimens were obtained and processed microbiologically . None of the individuals who had a sputum specimen died within 30 days, probably because the ability to obtain a sputum specimen is a marker of higher functional status . DISCUSSION: Even if empiric therapy continues in the majority of cases, cultures in individual cases may alert clinicians to noncovered, resistant pathogens, and allow focused antibiotic therapy with agents like amoxicillin that might extend the usefulness of empiric, broad spectrum antibiotics . Institutions may also sum the results of sputum bacteriology to assist in the choice of empiric antibiotic therapy . Sputum bacteriology may benefit both the individual resident and the entire population of the institution.

Health Bull (Edinb), 1999 Sep, 57(5), 332 - 7
Out-patient and home-parenteral antibiotic therapy (OHPAT): evaluation of the impact of one year's experience in Tayside; Nathwani D et al.; OBJECTIVE: An out-patient and home parenteral antibiotic therapy programme for the treatment of suitable infections was developed over a four year period . This paper describes the impact of one year's experience of its implementation on various measures of outcome . DESIGN: Each patient treatment has a full integrated care pathway (ICP) and patient satisfaction questionnaire completed . The ICP documents the clinical progress of the patient and incorporates various measures of quality of care on the 101 number of patients treated from April 1998 to March 1999 are presented here . SETTING: Dundee Teaching Hospitals NHS Trust (now Tayside University Hospitals NHS Trust) . SUBJECTS: Patients with a range of infections requiring intravenous antibiotics . MAIN MEASURES: Number of patients treated with various infections, clinical and microbiological outcome, drug and vascular access complication rates, impact on drug costs and in-patient bed days, and measurement of patient satisfaction/quality of life . RESULTS: Patients were treated over a 12 month period . 51.5 per cent had skin & soft tissue infections and 22.8 per cent bone & joint sepsis . 57 per cent of patients received out-patient and 34 per cent self or carer administered home therapy . Ninety-four per cent of patients were cured or improved following treatment . Only 7.5 per cent of patients required an unscheduled admission to hospital . Twelve per cent of patients had some type of vascular device related adverse event (partly due to a faulty batch of lines) and six per cent of patients had a drug related reaction . The additional daily cost of drugs was minimal (< 12 Pounds/day) and more than 1,461 bed days have been saved across the Directorates . The patient satisfaction level was high.

Gastroenterol Nurs, 2003 May-Jun, 26(3), 110 - 4
Endoscope disinfection by ortho-phthalaldehyde in a clinical setting: an evaluation of reprocessing time and costs compared with glutaraldehyde; Hession SM; Ortho-phthalaldehyde provides high-level disinfection in 12 minutes at room temperature (20 degrees C) . To determine whether the endoscopy unit at Massachusetts General Hospital could cost-effectively increase endoscope throughput and decrease delayed procedures while maintaining biocidal efficacy with heavy use, ortho-phthalaldehyde solution (0.55% w/v) was used for high-level disinfection in place of glutaraldehyde in the unit's five automatic endoscope reprocessors . During this 38-day study, 1,839 endoscopes were processed in 1,201 cycles . Each machine ran an average of 80 disinfection cycles in each of three consecutive periods . The shorter disinfection time of ortho-phthalaldehyde (12 minutes) resulted in an average savings of 53 hours in disinfection time per study period for the five processors when compared with glutaraldehyde's 20-minute disinfection time.Ortho-phthalaldehyde costs more per gallon than glutaraldehyde ($31.03 versus $13.20) . This higher cost would be offset, however, by additional time savings resulting from the fact that compared with glutaraldehyde, ortho-phthalaldehyde is faster-acting and a mixing and activation step is not required . In addition, testing prior to each cycle verified that despite heavy use, ortho-phthalaldehyde solution remained efficacious, lasting through an average of 80 cycles, whereas glutaraldehyde only lasts for an average of 40 cycles . Test strips showed the concentration of ortho-phthalaldehyde in the reprocessors remained above the minimum effective concentration for the entire 14-day maximal reuse period . Additional microbiological efficacy testing of spent solution diluted to its minimum effective concentration demonstrated the solution remained tuberculocidal in tests with Mycobacterium bovis.

Acta Chir Orthop Traumatol Cech, 2003, 70(2), 83 - 8
{Bone grafts in hip prosthesis revisions}; Krbec M et al.; PURPOSE OF THE STUDY: We describe the collection, storage and examination of allogenic bone grafts and their use in revision hip arthroplasty, indicated because of acetabular loosening, that involved either an uncemented cup or an augmentation device with a cemented cup according to the extent and nature of acetabular defects . MATERIAL: Allogenic bone grafts, usually long bones, were collected from deceased humans within 12 hours of death . They were processed according to the standards of US tissue banks . Using ELISA, the blood of each donor was serologically examined for antibodies against selected antigens (HIV I, HIV II, syphilis, HbsAg, HCV, and p24HIV I, HTLV I and II, and HbcAg, if required) . Microbiological examination of each bone sample was also included . The samples were kept in a quarantine box until the examination results were known . When these were negative, the bones were cut, under aseptic conditions, to obtain parts (condyle, metaphysis, diaphysis, patella, etc.) weighing from 80 to 150 gr . Subsequently, another quality check, involving microbiological and histological examination, was performed . The allografts were stored at -80 degrees C . METHODS: Between October 1999 and October 2000, 67 revision total hip replacements were performed . Of these, allogenic bone grafting was used for acetabular reconstruction in 30 cases (45%) . The average amount of graft tissue per operation was 107 gr (range, 43 to 163 gr) . Eleven grafts had been harvested from the tibial condyle, nine from the trochanters, eight from the femoral condyle and two from the patella . The graft bone, ground into coarse chips, was washed with an antibiotic solution . Two techniques were used in graft implantation . 1) Impaction grafting, under pressure, of the acetabulum whose surface was free from any granulation tissue and scratched to make the bone bleed, and implantation of a cemented cup (LOR or Spotorno CLS) . 2) Filling of large defects with a bulk of allograft bone chips, using an augmentation ring, mesh or Burch-Schneider cage, and implantation of a cemented polyethylene acetabular component . Uncemented implants were used in 17 and cemented cups with an augmentation device in 13 cases . The hips were checked by X-ray at 3, 6 and 12 months and then at yearly intervals . RESULTS: In the postoperative period of 26 to 38 months, an early recurrent infection led to temporary removal of the implant in one case, one hip showed superficial infection that responded to therapy and there was one case of aseptic acetabular loosening . A recurrent dislocation led to femoral stem exchange for a modular component with a longer neck in one case . The remaining 28 cases showed good incorporation of the graft without any signs of implant migration . DISCUSSION: Segmental defects of the acetabulum can be treated by implantation of specific types of acetabular cups or by massive bone grafting . Cavitary defects can be filled with cancellous allograft bone or bioactive, artificial materials . We prefer morselized allograft bone from the tissue bank and this was used in 45% of repeat surgeries for failure of the acetabular component . An uncemented cup is more convenient, supposing sufficient primary stability can be ensured . When defects are extensive, augmentation devices and filling with graft bone are necessary . Cadaver allografts offer advantages over autologous bone because they are available at any amount and thus enable us to avoid extensive damage to the iliac crest by autologous tissue harvesting . Cadaver grafts are bones of good quality, free from degenerative or dystrophic changes because they are usually taken from young subjects . The size of 7 to 10 mm is optimal because it permits the grafts to maintain both structure and strength . The strict procedure of sample collection and examination minimizes the risk of infection transfer . The progress of graft bone ingrowth was evaluated on radiographs that showed incorporation of allograft into the surrounding bone during 3 to 6 months and no radiolucent areas at host bone-implant contact . CONCLUSIONS: Our patients showed good allogenic bone ingrowth in relation to the acetabular bed and good bone restructuring and incorporation in relation to the implant . Neither mechanical failure of implants nor graft rejection were recorded . The risk of infection transfer was low and comparable with routine blood transfusion . The necessary prerequisite for revision hip arthroplasty is a well-operating bone tissue bank.

Vector Borne Zoonotic Dis, 2002 Winter, 2(4), 255 - 63
Controlled trials of antibiotic treatment in patients with post-treatment chronic Lyme disease; Klempner MS; Some patients have persistence of profound fatigue, myalgias, arthralgias without arthritis, dysesthesia/paresthesia, and mood and memory disturbances after standard courses of antibiotic treatment for Lyme disease . This constellation of symptoms has been variously referred to as "chronic Lyme disease," "post-Lyme disease syndrome," and "post-treatment chronic Lyme disease." Persistent symptoms have been reported in patients who are seropositive for IgG antibodies against Borrelia burgdorferi as well as in patients who are seronegative . The cause or causes of persistent symptoms in these patients have not been clearly defined and are controversial . Because of the temporal association of these symptoms with infection with B . burgdorferi, some patients have been treated with prolonged courses of antibiotics . Case reports and uncontrolled trials have reported the efficacy of prolonged antibiotic therapy, often with relapse of the symptoms after discontinuation of therapy . To date, only one randomized, placebo-controlled, double-blind trial of antibiotic therapy for these patients has been published . An abstract of a second placebo-controlled trial of antibiotic therapy in a smaller cohort has also been presented . This paper will describe this patient population in detail and will review the clinical, microbiological, and selected biochemical and immunologic parameters and their responses to antibiotic treatment in the setting of a controlled trial.

Eur J Epidemiol, 2003, 18(4), 337 - 43
Tuberculous meningitis in adults in Turkey: epidemiology, diagnosis, clinic and laboratory {corrected}; Hosoglu S et al.; A retrospective study was performed to assess the epidemiology, diagnosis, clinic, and laboratory of the patients with tuberculous meningitis (TBM) in a multicentral study . The medical records of adult cases with TBM treated at 12 university hospitals throughout Turkey, between 1985 and 1998 were reviewed using a standardized protocol . The diagnosis of TMB was established with the clinical and laboratory findings and/or microbiological confirmation in cerebrospinal fluid (CSF) . The non-microbiologically confirmed cases were diagnosed with five diagnostic sub-criteria which CSF findings, radiological findings, extra-neural tuberculosis, epidemiological findings and response to antituberculous therapy . A total of 469 patients were included in this study . Majority of the patients were from Southeast Anatolia (164 patients, 35.0%) and (108 patients, 23.0%) from East Anatolia regions . There was a close contact with a tuberculous patient in 88 of 341 patients (25.8%) and with a tuberculous family member in 53 of 288 patients (18.4%) . BCG scar was positive in 161 of 392 patients (41.1%) . Tuberculin skin test was done in 233 patients and was found to be negative in 75 . Totally 115 patients died (24.5%) of whom 23 died in 24 hour after admittance . The diagnosis was confirmed with clinical findings and CSF culture and/or Ziehl-Nelson staining in 88 patients (18.8%) . Besides clinical criteria, there were three or more diagnostic sub-criteria in 252 cases (53.7%), two diagnostic sub-criteria in 99 cases (21.1%), and any diagnostic sub-criteria in 30 patients (6.4%) . Since TBM is a very critical disease, early diagnosis and treatment may reduce fatal outcome and morbidity.

Antibiot Khimioter, 2003, 48(2), 16 - 21
{Itraconazole (Orungal) in the treatment of mycotic infections in oncologic patients}; Mitrokhin SD; Clinical and microbiological activity of itraconazole (Orungal, solution for oral use, "Janssen-Cilag") for treatment of oncological patients with inhospital infections associated with candida was evaluated . The trial included 50 patients with oncological pathology of respiratory tract, as representatives of risk group for candida contamination . Two groups of patients were formed: when candida contamination was proved patients of the test group were treated by antifungal agent itraconazole (Orungal, "Janssen-Cilag") . Patients in control group were treated by fluconazole (Diflazon, "KRKA") according to standard therapy regime . When no clinical efficacy was achieved patients in both groups were treated by amphotericin B (Fungizone, "Bristol-Myers Squibb") . Clinical efficacy was demonstrated at 13 patients and microbiological efficacy (pathogen elimination) at 12 patient of 14 of itraconazole group . Clinical efficacy was demonstrated at 9 patients and microbiological efficacy at 7 of 11 patients of fluconazole group . Treatment with amphotericin B was effective at all 4 patients treated with this antibiotic, microbiological effect was demonstrated for 3 patients of the group . Frequency of side effects was significantly less in itraconazole group . The course price was also significantly lower at itraconazole group . All this data are important for elaboration of optimal pharmaco economic policy regarding inhospital infections at critical care units.

Mycoses, 2003 Jun, 46(5-6), 174 - 82
Disseminated aspergillosis due to Aspergillus flavus in an experimental model: efficacy of azole therapy; Kaliamurthy J et al.; The aim of this investigation was to create a reproducible experimental model of disseminated Aspergillus flavus aspergillosis, and to compare the relative therapeutic efficacies of itraconazole and fluconazole in this model . Temporarily immunosuppressed male Wistar rats received intravenous challenge by A . flavus conidia . Treatment was initiated 24 h later with oral itraconazole (1 mg kg-1 BW day-1), oral fluconazole (1 mg kg-1 BW day-1) or excipient only (infected-untreated rats); this was continued for 10 days . At this time, although 100% mortality had occurred among all infected-untreated rats, no mortality was noted among the control-uninfected, infected-itraconazole-treated or infected-fluconazole-treated rats . After killing, essential organs were processed for microbiological and histopathological studies . Aspergillus flavus was recovered in high colony counts from the organs of infected-untreated rats (lungs > liver > brain > kidneys), but in significantly lower colony counts, or not at all, from the organs of itraconazole-treated and fluconazole-treated rats . Histopathological alterations were pronounced in tissues of infected-untreated rats, but less so in treated rats . These data suggest that administration of itraconazole or fluconazole sufficiently early may prevent, or retard, progression of lesions in disseminated aspergillosis.

J Environ Health, 2003 Jun, 65(10), 24 - 8
The Welsh Food Microbiological Forum and the All-Wales Shopping Basket Sampling Program: a model for the surveillance of microbiological quality in ready-to-eat foods; Meldrum R et al.; In the United Kingdom, the monitoring of microbiological food quality and the prevention of foodborne disease are the responsibility of a number of different organizations . In 1993, to develop and extend ongoing local collaborations within selected local food groups in Wales (comprising local authorities and the Public Health Laboratory Service), the Welsh Office invited all local food groups in Wales to create a forum to coordinate the sampling and examination of ready-to-eat foods and the centralized collection of results for the whole of Wales . This paper describes the development, structure, and aims of the forum . It also discusses the outcomes of the first nine years of activities, describes the randomized sampling program for ready-to-eat foods that has been developed; and assesses the benefits that have resulted.

Eur Respir J, 2003 Jun, 21(6), 952 - 5
Prognostic features of residual pleural thickening in parapneumonic pleural effusions; Jimenez Castro D et al.; The objective of the study was the identification of predictive factors for the development of residual pleural thickening (RPT) in patients with parapneumonic effusion . The design of the prospective study involved investigating patients with parapneumonic pleural effusions diagnosed between March 1991 and December 2000 in the respiratory department of Hospital Ramon y Cajal (Madrid, Spain) which is a 1,500 tertiary-care hospital . The clinical and radiological characteristics and measurements of microbiological and biochemical variables in the pleural fluid taken from the patients were studied . RPT was defined in a posteroanterior chest radiograph as pleural thickening of > or = 10 mm measured at the lateral chest wall at the level of an imaginary line, tangent to the diaphragmatic dome . A total of 48 of the 348 patients studied (13.79%) were found to have RPT . Among the factors studied, only presence of pus in the pleural space, Fine classes IV and V, temperature > or = 38 degrees C and delayed resolution of pleural effusions after diagnosis (> 15 days) were independently associated with the risk of RPT . This study showed that significant residual pleural thickening was not a common complication of parapneumonic pleural effusions . There are certain risk factors for the development of residual pleural thickening . However, this complication was not associated with long-term functional repercussions in the series of patients involved in this study.

J Chemother, 2003 Apr, 15(2), 134 - 8
Diffusion of cefepime into cancellous and cortical bone tissue; Breilh D et al.; The degree of penetration of an antibiotic into the infection site is an important factor in its therapeutic efficacy, particularly in bone and joint infections . In the present study, we examined the bone tissue penetration of cefepime at a dose of 2 g, and the results were correlated to microbiological data to estimate the clinical efficacy of cefepime in bone infections . In this open-label, single-arm, noncomparative study, subjects of similar age, body weight, height and creatinine clearance who were undergoing elective total hip replacement received a single, parenteral 2 g dose of cefepime . Plasma samples were collected simultaneously with bone tissue samples 1.5 hours later, on average, and analyzed by a validated high performance liquid chromatography assay . Ten patients (7 women and 3 men; mean age, 78 years; mean body weight, 57 Kg; mean creatinine clearance, 56 mL/min) were enrolled . The mean +/- SD plasma concentration of cefepime at the time of bone removal was 72.9 +/- 24.4 microg/mL . The mean +/- SD cefepime concentrations were 73.5 +/- 16.2 microg/mL in cancellous bone tissue and 67.7 +/- 17.0 microg/mL in cortical bone tissue . The mean +/- SD ratios of cefepime concentration in bone and plasma (bone/plasma) were 1.06 +/- 0.23 for cancellous bone tissue and 0.87 +/- 0.37 for cortical bone tissue . Cefepime exhibits an excellent diffusion into bone tissue, with concentrations achieved in both cancellous and cortical bone tissue greater than the minimum concentrations required to inhibit the growth of 90% of strains (MIC90) of most of the susceptible pathogens commonly involved in bone infections.

Ultrasound Obstet Gynecol, 1994 Mar 1, 4(2), 95 - 100
Is oligohydramnios a risk factor for infection in term premature rupture of membranes?
Romero R, Gomez R, Galasso M, Salafia C, Yoon BH, Behnke E, Cotton D.
Our objective was to determine if a reduced volume of amniotic fluid is a risk factor for microbial invasion of the amniotic cavity in women with rupture of membranes at term . Transabdominal amniocentesis under ultrasound guidance was used to evaluate the microbiological state of the amniotic cavity in 53 patients with term premature rupture of membranes before vaginal examination . Amniotic fluid index was measured prior to the procedure in all cases . The prevalence of microbial invasion of the amniotic cavity was 32.1% (17/53) . Women with microbial invasion of the amniotic cavity had a significantly lower median amniotic fluid index than did women without evidence of infection (median 4.4 cm, range 1.0-8.1 vs . median 7.8 cm, range 1.3-14.4, respectively; p < 0.001) . An amniotic fluid index of < 5 cm had a sensitivity of 71% (12/17) a specificity of 89% (32/36), a positive predictive value of 75% (12/16) and a negative predictive value of 87% (32/37) in the prediction of microbial invasion of the amniotic cavity . Among women who delivered vaginally, those with an amniotic fluid index of < 5 cm had a higher rate of endometritis than those with an amniotic fluid index of >or= 5 cm (19% (3/16) vs . 0% (0/26), respectively; p < 0.05) . We conclude that women with term premature rupture of membranes and an amniotic fluid index of < 5 cm are at an increased risk for microbial invasion of the amniotic cavity and puerperal infection after a vaginal delivery .

J Clin Periodontol, 2003 Jun, 30(6), 511 - 8
Efficacy of subgingival calculus removal with Er:YAG laser compared to mechanical debridement: an in situ study; Eberhard J et al.; OBJECTIVES: The aim of the present study was to compare the effectiveness of subgingival calculus removal from periodontally involved root surfaces with an Er:YAG laser compared to hand instrumentation in situ . METHODS: The mesial and distal surfaces of 30 single-rooted teeth with untreated periodontitis were treated either by hand instrumentation (scaling and root planing (SRP)) or by Er:YAG laser irradiation with the aim of achieving a calculus-free root surface . Subgingival plaque samples were obtained before and immediately after treatment for microbiological evaluation by culture and DNA probe analysis . The teeth were extracted and the residual calculus was measured by means of digitized planimetry . The morphology of the root surface was evaluated by scanning electron microscopy, and undecalcified sections were analyzed to determine residual calculus and the extent of cementum removal following both treatments . RESULTS: Following laser irradiation, 68.4+/-14.4% of the root surface was calculus free in contrast to 93.9+/-3.7% after SRP when both treatments were performed for the same time (2:15+/-1:00 min) . If laser irradiation was allowed twice the time used for hand instrumentation, 83.3+/-5.7% of the root surface was devoid of calculus . The effectiveness of both treatments was not related to initial probing depth . The histologic evaluation showed that after SRP 73.2% of root dentin was completely denuded from cementum, while only a minimal cementum reduction was apparent after laser irradiation . Both treatment modalities resulted in a similar reduction of periodontopathogens . DISCUSSION: The present investigation could demonstrate the in vivo capability of the Er:YAG laser to remove calculus from periodontally involved root surfaces, although the effectiveness did not reach that achieved by hand instrumentation . The lack of cementum removal in contrast to SRP may qualify the laser as an alternative approach during supportive periodontal therapy.

Xenotransplantation, 2003 Jul, 10(4), 343 - 8
Methods for the exclusion of circoviruses and gammaherpesviruses from pigs; Tucker AW et al.; The use of porcine tissues is being developed as a means to alleviate the shortage of allogeneic tissues and organs available for transplantation . To reduce the possibility of a microorganism of pigs being inadvertently transferred to the recipient of the xenograft, recommendations have been published on the microbiological specifications for organ source pigs . The porcine circoviruses (PCV1 and PCV2) and porcine lymphotropic herpesviruses (PLHV1 and PLHV2) are two infectious agents of pigs which are considered to be of significance for the microbiological safety of xenotransplantation . To ensure the exclusion of these microorganisms from animals destined for use under clinical conditions, reliable breeding methodologies are required . We investigated the efficiency of established derivation procedures for the removal of PCV and PLHV . In comparison with conventionally reared pigs, caesarian and barrier derived animals showed a markedly reduced prevalence of PCVs and PLHVs . Our results indicate that the derivation of animals free of both of these microorganisms is achievable and will enhance the microbiological safety of xenotransplantation.

Int J Immunopathol Pharmacol, 1999 Jan-Apr, 12(1), 43 - 8
Sensitisation to Aspergillus fumigatus and Penicillium notatum in laboratory workers; Boscolo P et al.; Four workers in medical research laboratories, located in a basement level of a University facility equipped with a humidified air conditioning system, complained of cough and/or asthma and/or rhinitis during their normal working activities . Since exposure to toxic compounds was very low (similar to that of the outdoor environment) only microbiological monitoring was performed . Aspergillus fumigatus and Penicillium notatum were found in some laboratories . Eight laboratory workers (including the 4 symptomatic subjects) out of 26 investigated were found to be atopic . Specific IgE sensitisation to Aspergillus fumigatus was found in the 8 atopic and in the 6 non-atopic workers, while Penicililum notatum was found in 7 atopic and 4 non-atopic subjects . History, physical examination and laboratory data excluded the presence of aspergillosis or allergic bronchial aspergillosis in the sensitised subjects . Our results suggest that evaluation of immune parameters, along with monitoring of the working environment, may reduce the risk of sensitisation and/or allergic symptoms in atopic laboratory workers.

J Clin Microbiol, 2003 Jun, 41(6), 2623 - 8
Genetic diversity among clinical isolates of Acremonium strictum determined during an investigation of a fatal mycosis; Novicki TJ et al.; Primarily saprophytic in nature, fungi of the genus Acremonium are a well-documented cause of mycetoma and other focal diseases . More recently, a number of Acremonium spp . have been implicated in invasive infections in the setting of severe immunosuppression . During the course of routine microbiological studies involving a case of fatal mycosis in a nonmyeloablative hematopoietic stem cell transplant patient, we identified a greater-than-expected variation among strains previously identified as Acremonium strictum by clinical microbiologists . Using DNA sequence analysis of the ribosomal DNA intergenic transcribed spacer (ITS) regions and the D1-D2 variable domain of the 28S ribosomal DNA gene (28S), the case isolate and four other clinical isolates phenotypically identified as A . strictum were found to have <99% homology to the A . strictum type strain, CBS 346.70, at the ITS and 28S loci, while a sixth isolate phenotypically identified only as Acremonium sp . had >99% homology to the type strain at both loci . These results suggest that five out of the six clinical isolates belong to species other than A . strictum or that the A . strictum taxon is genetically diverse . Based upon these sequence data, the clinical isolates were placed into three genogroups.

Biotechnol Prog, 2003 May-Jun, 19(3), 776 - 83
Impact of low-temperature plasmas on Deinococcus radiodurans and biomolecules; Mogul R et al.; The effects of cold plasma on Deinococcus radiodurans, plasmid DNA, and model proteins were assessed using microbiological, spectrometric, and biochemical techniques . In low power O(2) plasma (approximately 25 W, approximately 45 mTorr, 90 min), D . radiodurans, a radiation-resistant bacterium, showed a 99.999% reduction in bioburden . In higher power O(2) plasma (100 W and 500 mTorr), the reduction rate increased about 10-fold and observation by atomic force microscopy showed significant damage to the cell . Damage to cellular lipids, proteins, and chromosome was indicated by losses of infrared spectroscopic peaks at 2930, 1651, 1538, and 1245 cm(-1), respectively . In vitro experiments show that O(2) plasmas induce DNA strand scissions and cross-linking as well as reduction of enzyme activity . The observed degradation and removal of biomolecules was power-dependent . Exposures to 200 W at 500 mTorr removed biomolecules to below detection limits in 60 s . Emission spectroscopy indicated that D . radiodurans cells were volatilized into CO(2), CO, N(2), and H(2)O, confirming that these plasmas were removing complex biological matter from surfaces . A CO(2) plasma was not as effective as the O(2) plasma, indicating the importance of plasma composition and the dominant role of chemical degradation . Together, these findings have implications for NASA planetary protection schemes and for the contamination of Mars.

Med Device Technol, 2003 Apr, 14(3), 18 - 21
Practical experience of microbiological validation of sterilisation; Harries J; The addition of the VDmax method provides manufacturers with a choice of three microbiological validation methods to substantiate a 25 kGy sterilisation dose . This article reports on experiences of applying these methods and suggests ways to handle difficult products.

Eur J Oral Sci, 2003 Jun, 111(3), 189 - 97
Effects of maxillary sinus floor elevation surgery on maxillary sinus physiology; Timmenga NM et al.; In a prospective study, the effects of elevation surgery of the maxillary sinus floor on maxillary sinus physiology were assessed . Seventeen consecutive patients without preoperative anamnestic, clinical and radiological signs of maxillary sinusitis underwent sinus floor elevation surgery with iliac crest bone grafts . All patients were subjected to unilateral endoscopic examination of the maxillary sinus, taking of a biopsy specimen from the sinus floor mucosa, and collection of a sinus lavage-fluid aspirate . This triad of evaluations was performed immediately preceding the elevation procedure, and 3 months (at implant insertion) and 9 months (at uncovering of implants) postoperatively . All procedures were performed under general anesthesia . Preoperatively, three out of 17 patients showed pre-existing mucosal pathology endoscopically, while the 3- and 9-month results revealed the presence of mucosal pathology in four and two patients, respectively . The 3-month microbiological evaluation showed a significant increase in cultures with bacterial growth, while the 9-month culture results were comparable to the preoperative status of the maxillary sinus . Morphologically, neither fibrosis nor an altered inflammatory response or thickening of the epithelium and lamina propria was observed postoperatively . The number of goblet cells in the epithelial layer was increased . From this study it is concluded that the effect of maxillary sinus floor elevation surgery with autogenous bone grafts does not appear to have clinical consequences in patients without signs of pre-existing maxillary sinusitis.

Br J Dermatol, 2003 May, 148(5), 954 - 63
Subclinical activation of latent cytomegalovirus (CMV) infection and anti-CMV immune response in patients with atopic dermatitis; Docke WD et al.; BACKGROUND: Microbiological infections are considered to be of pathophysiological importance in atopic dermatitis (AD) . As yet, no information is available regarding cytomegalovirus (CMV) infection in this disease . This, however, is of interest because of the high prevalence of latent infections in the general population, the frequent reactivation in inflammatory diseases, and the immunomodulating capacity of CMV . OBJECTIVES: To investigate the prevalence of latent CMV infection, the frequency of active CMV infection, and the immune response to CMV in patients with moderate to severe AD . Methods To detect active infection we analysed CMV antigen expression by peripheral blood mononuclear cells (PBMC) from 27 patients with moderate to severe AD in comparison with 53 healthy volunteers . We used three monoclonal antibodies recognizing different CMV-encoded antigens and immunocytological staining (alkaline phosphatase-antialkaline phosphatase technique) . RESULTS: Patients with AD had a higher mean frequency of CMV-positive PBMC: 2.25 per 10 000 vs . 0.74 per 10 000 in controls (P = 0.001) as well as a higher incidence of CMV antigenaemia: 29.6% vs . 7.5% (P < 0.01) . Seropositivity for anti-CMV IgG antibodies indicated subclinical activation of latent infection . Remarkably, a clearance of CMV antigenaemia was observed during anti-eczematous treatment . Significantly higher plasma levels of tumour necrosis factor-alpha, which is involved in CMV reactivation, and interleukin-12, which is crucial for an antiviral cellular immune response, were observed in AD patients in comparison with healthy volunteers . Furthermore, a significantly enhanced frequency of circulating activated HLA-DR+ T cells especially in CMV-seropositive AD patients (19.3% vs . 13.5% in seronegative AD patients vs . 10.2% in controls) suggested that the active CMV infection triggers a cellular immune response . This was also supported by a high frequency of CMV-specific interferon-gamma-producing T cells in CMV-seropositive patients with AD . CONCLUSIONS: Our data suggest that active, subclinical CMV infection is more frequent in patients with moderate to severe AD and may have immunopathophysiological relevance.

Aliment Pharmacol Ther, 2003 Jun, 17 Suppl 2, 2 - 6
Review article: diagnosis, monitoring and treatment of distal colitis; Vecchi M et al.; The diagnostic work-up of ulcerative colitis at presentation is based on the collection of clinical, microbiological, radiological, endoscopic and histologic data . Serological markers are characterized by too low a sensitivity to be commonly utilized in clinical practice . Although endoscopic and histologic features are characterized by very high sensitivity and specificity for the diagnosis of ulcerative colitis, negative stool cultures and parasites are mandatory to exclude an infectious aetiology at presentation . The treatment of choice of an acute flare-up of distal ulcerative colitis is represented by oral or topical mesalazine, or a combination of both, whereas the use of topical or systemic steroids should be restricted to patients who prove to be refractory to first-line treatments . Preliminary data suggest that the achievement of endoscopic and histologic remission after an acute flare of the disease might be associated with a prolonged remission.

Expert Opin Investig Drugs, 2003 Jun, 12(6), 1003 - 16
Current and novel therapies for Lyme disease; Pavia CS; From tick bite to treatment, Lyme disease is a serious concern for those who reside in parts of the world where this infectious disorder is endemic . It is a multi-system and sometimes multi-stage illness caused by a unique spirochetal bacterium, Borrelia burgdorferi, which reaches its human victim after being transmitted by a bite from Ixodid (deer) ticks that are found mostly in certain parts of North America and Europe . Management of Lyme disease patients is usually not problematic, especially in endemic areas, where rapid diagnosis and response to the recommended treatment regimen most often leads to a favourable outcome . Initially this review article describes briefly some of the key historical, epidemiological, microbiological and diagnostic aspects of Lyme disease . With this foundation, there follows a more in-depth coverage on the proper management of asymptomatic tick bite victims and of those suffering from authentic Lyme disease . Much of the key information related to proper therapy is based on results that have accrued from rigorously conducted clinical studies . The final part of this review then concentrates on some of the more controversial issues involving diagnosis and treatment, the availability and possible usefulness of other non-antibiotic treatment options and the prospects for more efficient antibiotic treatment regimens as well as development of a newer class of effective antibiotics, based on promising preclinical data.

Endoscopy, 2003 Jun, 35(6), 469 - 71
Improvement of the automatic endoscopic reprocessor: self-cleaning disinfecting connectors between endoscope and reprocessor; Ishino Y et al.; BACKGROUND AND STUDY AIMS: We have previously pointed out a defect of automatic endoscopic reprocessors, i . e . the contamination of the connecting part between the endoscope and the reprocessor . We evaluated a newly designed connector (MH-861; Olympus, Tokyo, Japan) with a self-cleaning and disinfection mechanism, which enabled cleaning and disinfection of both the connector itself and its interface with the suction and air/water valves during a reprocessing cycle, which was not previously possible . METHODS: Ten upper gastrointestinal endscopes were examined in the study . Swabs were taken from the suction and air/water valves for microbiological culture before and after reprocessing by the washer-disinfector . The numbers of contaminated endoscopes before and after reprocessing with the new connector were compared . RESULTS: Before the procedure there were five contaminated endoscopes and none after the procedure . When the new connector was used, the difference in cleaning and disinfection of the connecting parts was significant (P = 0.0325) . CONCLUSIONS: We conclude that the newly developed connector permits effective cleaning and disinfection by automatic reprocessors.

Int J Environ Health Res, 2003 Jun, 13 Suppl 1, S89 - 94
Providing clean water, keeping water clean: an integrated approach; Thompson T et al.; Millions of people, most of whom are children in developing countries, die of basic hygiene-related diseases every year . Interventions in hygiene, sanitation and water supply have been shown to control disease burden . Universal access to improved water sources and basic sanitation remains elusive but is an important long-term goal . Studies have shown that improving the microbiological quality of household water by on-site or point-of-use treatment and safe storage in improved vessels reduces diarrhoeal and other waterborne diseases in communities and households of developing and developed countries . The extent to which improving drinking water quality at the household level reduces diarrhoeal disease probably depends on a variety of technology-related and site-specific environmental and demographic factors that require further investigation, characterisation and analyses.

Int J Environ Health Res, 2003 Jun, 13 Suppl 1, S57 - 66
Developing an effective policy for home hygiene: a risk-based approach; Bloomfield SF et al.; Evaluation of the infection potential in the home suggests that improved hygiene practice could significantly reduce the impact of infectious diseases . Fundamental to developing infection prevention policy for the home is the need to recognise that people live in an environment where all human activities occur, including food and water hygiene, hand hygiene, and hygiene related to care of vulnerable groups . In all these situations, reducing infection risks is based on the same underlying microbiological principles . In developing countries, disposal of human and animal excreta and other waste is often also the responsibility of the family and community . Adopting a holistic approach provides the opportunity for a rational approach to home hygiene based on risk assessment . The International Scientific Forum on Home Hygiene (IFH) believes that to deliver hygiene policy with real health benefits, a risk-based approach must be developed and promoted for the home . A risk-based approach starts from the principle that pathogens are introduced continually into homes on people, food and water, pets, insects and air . Inadequate disposal of human and animal excreta serves to increase this risk . Additionally, sites where stagnant water accumulates, such as sinks, toilets and cleaning cloths can support microbial growth and become a source of infection . By assessing the frequency occurrence of pathogens and potential pathogens on hands, hand and food contact surfaces, laundry, reservoir and reservoir/disseminator sites, together with the potential for transfer in the home, the exposure risk can be assessed.

Mikrobiol Z, 2003 Jan-Apr, 65(1-2), 205 - 16
{The problem of mollicute resistance to antibiotics}; Skrypal' IH; The problem of disease agents resistance to antibiotics is a general-microbiological one, but it was considered in literature with respect to bacteria only . The problem of resistance to antibiotics of mollicutes class representatives has not been touched in generalizing literature . This work is the first attempt to analyze the data from the world literature concerning the appearance of resistance to antibiotics in mollicute species, doing the greatest harm to people, and to present information which would be of consultative value, when choosing antibiotics to treat human mycoplasmoses.

Kidney Blood Press Res, 2003, 26(2), 96 - 9
Experience with the GENIUS hemodialysis system; Fassbinder W; The late B . Tersteegen devised a clever way to combine the advantages of a closed tank hemodialysis system with the efficacy and bacteriological safety of a single-pass system . The Teerstegen equipment is now marketed as the GENIUS hemodialysis system . For each treatment, fresh dialysis fluid is prepared according to the physician's prescription by mixing sterile ingredients (electrolytes and glucose) with preheated ultrapure water . The total amount of dialysis fluid is put into a thermally insulated glass tank (volume 75 l) of the hemodialysis machine . The filling and emptying process is completely automated . An UV radiator is used for desinfection . Due to a consequent hygienic concept, the system operates with an almost sterile and usually pyrogen-free dialysis fluid . During treatment, fresh dialysis fluid is taken from the top of the system, and the used dialysate is returned to the bottom . There is a sharp interface between the fresh and used dialysis fluids because of a small difference in temperature (1 degrees C) . True volumetric ultrafiltration control is simply achieved; ultrafiltration rates between 100 and 1,000 ml/h can be selected as considered appropriate by the physician . MICROBIOLOGICAL EXAMINATION: We cultured more than 2,000 dialysate specimens to examine bacterial contamination, and found either no bacterial growth at all (in the vast majority of the cases) or less than 1 CFU/ml dialysate . CLINICAL EXPERIENCE: We have utilized the GENIUS system since 1994 . Meanwhile, more than 40,000 treatments have been performed in our center . Biochemical results of the first 19 stable hemodialysis patients (mean age 66 years, range 45-82), who had been treated with conventional hemodialysis systems for at least 6 months (range 6-157) before changing to GENIUS, were evaluated . We observed an increase of mean serum albumin concentration from 4.1 (+/-0.4 SD) g/dl to 4.8 (+/-0.3) g/dl (p < 0.01) within 6 months . Most patients reported improved well-being . Of these 19 patients, 18 preferred further treatment with the GENIUS system in comparison to conventional hemodialysis machines . CONCLUSION: The GENIUS hemodialysis system permits an individualized therapy of high quality; most patients prefer this system to conventional hemodialysis machines . Serum albumin levels increased significantly from normal to high normal values after change from conventional hemodialysis machines to GENIUS, probably due to less catabolic stress during the hemodialysis sessions .

Leuk Lymphoma, 2003 Apr, 44(4), 709 - 13
Acute myelogenous leukemia complicated by acute necrotizing ulcerative gingivitis due to Aspergillus terreus; Khoury H et al.; Infections caused by Aspergillus terreus are rare but have been associated with a poor outcome in immunocompromised patients due to frequent resistance to conventional antifungal therapy . This report describes a case of a woman who developed acute necrotizing ulcerative gingivitis (ANUG) due to A . terreus during induction chemotherapy for acute myelogenous leukemia . She initially failed to respond to treatment with amphotericin B but the infection resolved following the introduction of oral itraconazole . Opportunistic infections caused by A . terreus are an emerging problem and can be associated with a high mortality rate . Early microbiological diagnosis is critical since resistance to amphotericin B is likely and itraconazole appears to be an effective treatment for this infection.

Arch Esp Urol, 2003 Apr, 56(3), 303 - 4
{Juvenile gangrenous vasculitis of the scrotum.}; Julve Villalta E et al.; OBJECTIVE: To describe clinical and pathological findings of a new case of juvenile gangrenous vasculitis of the scrotum, a peculiar and unusual (only 7 cases, approximately, have been previously reported) type of scrotal gangrene described by Pinol in 1973 . METHODS: A 24 year-old male presented at the emergency room with a right scrotal necrotising cutaneous lesion and fever . Physical examination, complete blood count, biochemical test, roentgenographic abdominal and thoracic findings, microbiological test and biopsy were performed . RESULTS: Clinical aspects (symptoms and sings) and results of complete blood count (leukocytosis), normal ultrasound exploration and biochemical and roentgenographic abdominothoracic findings, microbiological test (negative) and biopsy (necrotising vasculitis) are compatible with juvenile gangrenous vasculitis of the scrotum . CONCLUSIONS: Juvenile gangrenous vasculitis of the scrotum is a rare entity which should be diagnosed by strict clinicopathological diagnostic criteria because treatment and prognosis are distinct of other numerous ulcerative scrotal diseases.

Schweiz Rundsch Med Prax, 2003 Apr 23, 92(17), 809 - 16
Antibiotic-associated diarrhea: therapeutic aspects and practical guidelines--an interdisciplinary approach to a common problem; Lembcke B et al.; Antibiotic-associated diarrhea (AAD) is a common complication of antibiotic treatment, most often seen in non-hospitalised patients . In principle, such diarrhea can be triggered by any antibiotic . An interdisciplinary working group discussed the different aspects of AAD in view of its gastroenterological, microbiological, paediatric, general medical and pharmaceutical implications, also in consideration of the position of patients and health insurance funds . This paper implies therapeutic aspects and practical guidelines to raise awareness of these problems also in routine situations and to enable the persons and institutions involved on the various levels of the health-care system (patients, pharmacists, family doctors, specialists and hospitals) to handle the problem of AAD more easily in a standardised way as far as diagnostics, therapy and prevention are concerned.

Am J Ind Med, 2003 Jun, 43(6), 630 - 41
Environmental risk factors and work-related lower respiratory symptoms in 80 office buildings: an exploratory analysis of NIOSH data; Mendell MJ et al.; BACKGROUND: We evaluated relationships between lower respiratory symptoms and risk factors for microbiological contamination in office buildings . METHODS: The National Institute for Occupational Safety and Health collected data from 80 office buildings during standardized indoor environmental health hazard evaluations . Present analyses included lower respiratory symptom-based outcome definitions and risk factors for potential microbiologic contamination . Multivariate logistic regression models for selected outcomes identified key risk factors . RESULTS: Adjusted odds ratios (95% confidence intervals) for "at least three of four work-related lower respiratory symptoms" were, for debris in ventilation air intake, 2.0 (1.0-3.9), and for poor drainage in air-conditioning drip pans, 2.6 (1.3-5.2) . Adjusted associations with risk factors were consistently stronger for outcomes requiring both multiple symptoms and improvement away from work, and somewhat stronger among diagnosed asthmatics . CONCLUSIONS: Moisture and debris in ventilation systems, possibly by supporting microbiologic growth, may increase adverse respiratory effects, particularly among asthmatics . Data from more representative buildings are needed to confirm these findings . Published 2003 Wiley-Liss, Inc.

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