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 o