Microbial

J Indian Med Assoc, 2002 Jun, 100(6), 372 - 5
A study on the comparison between clinical and microbiological diagnoses of sexually transmitted diseases; Haripriya V et al.; The efficacy of microbiological diagnosis in sexually transmitted diseases (STDs) has been evaluated in comparison with the clinical diagnosis . Amongst the clinical diagnoses of single STDs, syphilis, genital warts, gonorrhoea and herpes genitalis were the predominant ones . Syphilis was the most predominant infection in both the single and mixed STD infections in Chennai . Clinical diagnoses of trichomoniasis, genital chlamydiasis and genital herpes were more accurate and correlated well with laboratory investigations . On the other hand, clinical diagnoses of gonorrhoea, candidiasis and syphilis were less accurate . More over many of these cases, clinically diagnosed as single, infection, were also positive for other STDs in the laboratory investigations . Double infections were clinically diagnosed only in 7 cases as against 11 cases in microbiological tests and one triple infection diagnosed in microbiological tests was diagnosed only as single disease clinically . Therefore, the laboratory/microbiological investigations have been emphasised to have better accuracy of diagnosis of STDs.

Eur J Clin Microbiol Infect Dis, 2002 Oct, 21(10), 729 - 35 Epub 2002 Oct 03.
Clinical study of an outbreak of Legionnaire's disease in Alcoy, Southeastern Spain; Fernandez JA et al.; The aim of this study was to identify the clinical features of Legionnaires' disease, sudden outbreaks of which demand a quick and flexible clinical approach, particularly with regard to diagnosis and therapy . A prospective and comparative study based on a clinical protocol was performed during an outbreak of Legionnaires' disease in Alcoy, Spain . The outbreak was environmental in origin, linked to cooling towers . Data about epidemiological and clinical features, blood chemistry values, radiological and microbiological findings, and characteristics related to the clinical course of Legionnaires' disease were obtained for 357 patients admitted to hospital with community-acquired pneumonia (177 with Legionella pneumonia) . Patients with Legionnaires' disease were younger (mean age, 65.3+/-16.5 years) and more likely to be smokers compared with patients with other types of pneumonia (28.8% vs . 11.1%; P<0.01) . Moreover, they had not been admitted to any hospital because of pneumonia in the previous year . Patients with Legionnaires' disease had higher fever, more severe headache, and less expectoration as well as lower sodium blood levels (mean, 132.6+/-4.8 mmol/l vs . 135.7 mmol/l; P<0.01) . Radiological studies also showed that fewer patients with Legionnaires' disease had pleural effusion (9% vs . 19.4% of those with non- Legionella pneumonia) . The presence of headache, high fever, hyponatremia, scanty or null expectoration, and current cigarette smoking provides physicians with important clues for a high suspicion of Legionella pneumonia before the results of confirmatory laboratory tests are available.

Lancet, 2002 Oct 26, 360(9342), 1287 - 92
Diagnosis of adult tuberculous meningitis by use of clinical and laboratory features; Thwaites GE et al.; BACKGROUND: The diagnosis of tuberculous meningitis is difficult . Discrimination of cases from those of bacterial meningitis by clinical features alone is often impossible, and current laboratory methods remain inadequate or inaccessible in developing countries . We aimed to create a simple diagnostic aid for tuberculous meningitis in adults on the basis of clinical and basic laboratory features . METHODS: We compared the clinical and laboratory features on admission of 251 adults at an infectious disease hospital in Vietnam who satisfied diagnostic criteria for tuberculous (n=143) or bacterial (n=108) meningitis . Features independently predictive of tuberculous meningitis were modelled by multivariate logistic regression to create a diagnostic rule, and by a classification-tree method . The performance of both diagnostic aids was assessed by resubstitution and prospective test data methods . FINDINGS: Five features were predictive of a diagnosis of tuberculous meningitis: age, length of history, white-blood-cell count, total cerebrospinal fluid white-cell count, and cerebrospinal fluid neutrophil proportion . A diagnostic rule developed from these features was 97% sensitive and 91% specific by resubstitution, and 86% sensitive and 79% specific when applied prospectively to a further 42 adults with tuberculous meningitis, and 33 with bacterial meningitis . The corresponding values for the classification tree were 99% and 93% by resubstitution, and 88% and 70% with prospective test data . INTERPRETATION: This study suggests that simple clinical and laboratory data can help in the diagnosis of adults with tuberculous meningitis . Although the usefulness of the diagnostic rule will vary depending on the prevalence of tuberculosis and HIV-1 infection, we suggest it be applied to adults with meningitis and a low cerebrospinal fluid glucose, particularly in settings with limited microbiological resources.

Acta Paediatr, 2002, 91(9), 972 - 7; discussion 894-5
Treatment of children with cystic fibrosis: central, local or both?
van Koolwijk LM, Uiterwaal CS, van der Laag J, Hoekstra JH, Gulmans VA, van der Ent CK.
Owing to a lack of longitudinal studies, the effect of centralization of care on pulmonary function and survival remains unclear . Three different levels of involvement of centralized care in the treatment of paediatric cystic fibrosis patients were compared with regard to longitudinal pulmonary function and nutritional and microbiological status in a 3-y period, and the literature was reviewed on the possible advantages and disadvantages of centralized care . The study included 105 paediatric patients attending the Cystic Fibrosis Centre between January 1997 and January 2001 . Twenty-three patients were treated by local paediatricians according to the protocol of the Centre and were seen only once a year at the Centre, for an annual check-up (local care) . Forty-one patients were treated at the Centre only (centralized care) . The remaining 41 patients were treated in close cooperation between the Centre and local hospitals, with patients visiting the doctors alternately (shared care) . The mean annual changes in pulmonary function and body mass index from all patients, as well as a microbiological survey, were reviewed . No significant differences were found between the three groups for annual changes in FEV1, FVC and body mass index, nor did the review of microbial colonization show any significant differences between the groups . Because the groups in this study were relatively small, the results might have been influenced by lack of power . CONCLUSION: In this relatively small group, no differences in pulmonary function, nutritional status or microbiological colonization between the three levels of involvement of centralized care could be found . This could signify that local paediatricians have a special role in the care for patients with cystic fibrosis, in close cooperation with the specialists at the Centre.

Shock, 2002 Nov, 18(5), 476 - 80
Intestinal ischemic preconditioning protects the intestine and reduces bacterial translocation; Aksoyek S et al.; Ischemic preconditioning (IPC) was first demonstrated in the heart, but this protective effect has been also recently described in the intestine . The aim of this study was to determine the effects of intestinal ischemic preconditioning on the morphology of intestine and bacterial translocation . Twenty-four male Wistar rats weighting 250 to 300 g were randomized into three groups . A control group of rats (n = 8) were subjected laparotomy . In an ischemic group (n = 8), laparotomy was performed and the superior mesenteric artery was occluded by an atraumatic clamp for 30 min . In the preconditioned group (n = 8), before the ischemia-reperfusion (I/R) period (as in ischemic group), rats were subjected to an initial 10 min of intestinal ischemia and 10 min of reperfusion . Twenty-four hours later, to evaluate whether the I/R induced intestinal injury and bacterial translocation (BT), tissue and blood samples were collected, and liver, spleen, and mesenteric lymph node specimens were obtained under sterile conditions for microbiological analysis . Samples of ileum were removed for both biochemical and histopathological evaluation . In the I/R group, the incidence of bacteria-isolated mesenteric lymph nodes, spleen, liver, and blood was significantly higher than other groups (P < 0.05) . IPC prevented I/R-induced BT and it significantly reduced the I/R-induced intestinal injury (P < 0.05) . Increased inducible nitric oxide (NO) synthase (iNOS) expression observed on the ileal specimens of the I/R group was found to be prevented by IPC . Our data suggest IPC as a key factor that reduces BT and iNOS activation in intestinal I/R . This is the first study showing that intestinal IPC blocks the cascade of events that causes BT and intestinal injury that may lead to sepsis.

J Ind Microbiol Biotechnol, 2002 Nov, 29(5), 243 - 54
Chemical and microbiological changes in laboratory incubations of nitrate amendment "sour" produced waters from three western Canadian oil fields; Eckford RE et al.; Nitrate addition to oil field waters stops the biogenic formation of sulfide because the activities of nitrate-reducing bacteria (NRB) suppress the activities of sulfate-reducing bacteria (SRB) . In general, there are two types of NRB - the heterotrophic NRB and the chemolithotrophic NRB . Within the latter group are the nitrate-reducing, sulfide-oxidizing bacteria (NR-SOB) . To date, no study has specifically addressed the roles of these different NRB in controlling sulfide concentrations in oil field produced waters . This study used different culture media to selectively enumerate heterotrophic NRB and NR-SOB by most probable number (MPN) methods . Produced waters from three sulfide-containing western Canadian oil fields were amended with nitrate as an electron acceptor, but no exogenous electron donor was added to the serum bottle microcosms . Changes in the chemical and microbiological characteristics of the produced waters were monitored during incubation at 21 degrees C . In less than 4 days, the sulfide was removed from the waters from two of the oil fields (designated P and C), whereas nearly 27 days were required for sulfide removal from the water from the third oil field (designated N) . Nitrate addition stimulated large increases in the number of the heterotrophic NRB and NR-SOB in the waters from oil fields P and C, but only the NR-SOB were stimulated in the water from oil field N . These data suggest that stimulation of the heterotrophic NRB is required for rapid removal of sulfide from oil field-produced waters.

Sarcoidosis Vasc Diffuse Lung Dis, 2002 Oct, 19(3), 227 - 33
Sarcoidosis of the upper respiratory tract . Selected cases emphasizing diagnostic and therapeutic difficulties; Sharma OP; BACKGROUND: Sarcoidosis of the upper respiratory tract (SURT) is a frequently overlooked and inadequately treated complication of sarcoidosis . AIM: The aim of this descriptive study is to present selected cases of sarcoidosis of the upper respiratory tract depicting diagnostic and therapeutic challenges . METHODS AND RESULTS: Five selected patients who either had an unusual initial presentation or an unusual clinical course were included if they also had long follow up . The diagnosis of SURT was based on the conventional criteria including histological evidence and appropriate microbiological studies . CONCLUSION: These case studies underline problems that may arise when SURT is not recognized early and appropriate and adequate treatment is delayed.

Infect Control Hosp Epidemiol, 2002 Oct, 23(10), 615 - 9
Disruption of services in an internal medicine unit due to a nosocomial influenza outbreak; Sartor C et al.; OBJECTIVE: To describe a nosocomial influenza A outbreak, how it was managed, what impact it had on subsequent delivery of health care, and the additional charges attributable to it DESIGN: Prospective cohort study and microbiological investigation . SETTING: One internal medicine unit in an acute care, university-affiliated hospital . PARTICIPANTS: Twenty-three patients and 22 staff members from February 28 to March 6, 1999 . RESULTS: Attack rates were 41% (9 of 22) among patients and 23% (5 of 22) among staff members, with 3 of 14 cases being classified as "certain." The influenza virus isolates were typed as A/SYDNEY/5/97 (H3N2) . The index case was a patient who shared a room with the first nosocomial case . Vaccination rates for influenza virus were 43% (10 of 23) among patients and 36% (8 of 22) among staff members . The outbreak resulted in staff members' taking 14 person-days of sick leave . Furthermore, 8 scheduled admissions were postponed and all emergency admissions were suspended for 11 days . Hospital charges attributable to the influenza outbreak totaled $34,179 and the average extra charge per infected patient was $3,798 . CONCLUSIONS: Nosocomial influenza outbreaks increase charges and alter the quality of care delivered in acute care settings . Strategies for their prevention need to be evaluated in acute care settings.

Int J Environ Health Res, 2002 Sep, 12(3), 221 - 33
Deterioration of drinking water quality in the distribution system and gastrointestinal morbidity in a Russian city; Egorov A et al.; Few studies have been conducted in Russia to assess the relationship between drinking water quality and gastrointestinal (GI) infections . In the city of Cherepovets, effluent water at the treatment plant usually meets the country's hygienic standards . To provide protection against secondary water contamination in the distribution system, concentrations of total residual chlorine in effluent water are maintained#10; at levels from 1 to 2 mg x l(-1) . However, residual chlorine concentrations rapidly decline in the distribution system and rechlorination is not practiced . Some areas of the city routinely have very low residual chlorine at taps and little protection against secondary microbiological contamination of water in pipelines . A cross-sectional epidemiological study was conducted in Cherepovets to assess an association between decline in residual chlorine concentrations and risk of GI illness . This study included water quality monitoring and an extensive questionnaire survey of city residents . The results demonstrated a consistent spatial pattern of free chlorine decline in the distribution system . An interquartile range variability in free residual chlorine decline (0.22 mg x l(-1)) was associated with 1.42 (95% confidence interval (CI) = 1.05, 1.91) relative risk of self-reported gastrointestinal illness after control for socioeconomic, hygienic and demographic parameters.

J Acquir Immune Defic Syndr, 2002 Oct 1, 31(2), 183 - 7
Efficacy of caspofungin in the treatment of esophageal candidiasis resistant to fluconazole; Kartsonis N et al.; Caspofungin is a new echinocandin drug with comparable in vitro activity against azole-susceptible and -resistant isolates of that could provide a less toxic alternative to amphotericin B for the management of esophageal candidiasis with clinical or laboratory evidence of decreased susceptibility to fluconazole . The authors retrospectively analyzed its efficacy in adults with endoscopically documented esophagitis from four Phase II and III studies using two definitions of resistance to fluconazole: 1) clinically refractory infection based on failure of esophageal symptoms to improve despite at least 1 week of >or=200 mg/d of fluconazole; or 2) microbiologically resistant infection with either "susceptible dose-dependent" or "resistant" isolates based on MICs of 16 to 32 and >or=64 microg fluconazole/mL, respectively . A favorable response required resolution of all symptoms and substantial improvement in endoscopic findings . Seven of 11 patients (64%) who had been clinically refractory to fluconazole had favorable responses to caspofungin . Eleven of 14 patients (79%) whose isolates had decreased susceptibility to fluconazole had favorable responses to caspofungin, including 5 (83%) of 6 patients infected by isolates with MICs of >or=64 microg fluconazole/mL . Caspofungin appeared to be efficacious therapy for some patients with esophageal candidiasis who were clinically refractory to fluconazole or infected by with reduced susceptibility to fluconazole in vitro.

J Hosp Infect, 2002 Oct, 52(2), 77 - 80
A UK historical perspective on operating theatre ventilation; Stacey A et al.; As part of the preparation for the report of the Hospital Infection Society Working Party on Infection Control and Operating Theatres, studies published from the UK on the subject of operating theatre ventilation were reviewed . Few have convincingly demonstrated a direct relationship between the microbiological quality of operating theatre air and postoperative wound infection . Nevertheless, the findings from these studies have had a major influence on the development of official UK guidance on the design, performance and testing of ventilation in both conventional and ultraclean operating theatres .

J Appl Microbiol, 2002, 93(5), 825 - 34
Quantification of microcystin-producing cyanobacteria and E . coli in water by 5'-nuclease PCR; Foulds IV et al.; AIMS: 5'-Nuclease (real-time, quantitative) PCR methodologies were developed and applied as diagnostic tools for the detection of microcystin-producing cyanobacteria and Escherichia coli in water . METHODS AND RESULTS: PCR was used to detect regions of the lacZ gene in E . coli, and the microcystin synthetase gene in microcystin-producing cyanobacteria . In environmental water samples, natural inhibitors to PCR were effectively removed with a prefiltration step and an EDTA wash . A lower detection limit of 10 cells ml(-1) was obtained with endpoint PCR detection . 5'-Nuclease PCR was used for microbial quantification of 1 ml inoculated water samples . We were able to detect down to three copies of our target genes per sample within about 2 h (post-DNA isolation) for both E . coli and microcystin-producing cyanobacteria . CONCLUSIONS: 5'-Nuclease PCR offers a rapid and sensitive method of bacterial quantification in water samples . SIGNIFICANCE AND IMPACT OF THE STUDY: 5'-Nuclease PCR can be adopted as an effective diagnostic tool for monitoring microbiological water quality, through coliform quantification, and detection of other waterborne microbial pathogens.

ILAR J, 2002, 43(4), 244 - 58
Guidelines for the design and statistical analysis of experiments using laboratory animals; Festing MF et al.; For ethical and economic reasons, it is important to design animal experiments well, to analyze the data correctly, and to use the minimum number of animals necessary to achieve the scientific objectives---but not so few as to miss biologically important effects or require unnecessary repetition of experiments . Investigators are urged to consult a statistician at the design stage and are reminded that no experiment should ever be started without a clear idea of how the resulting data are to be analyzed . These guidelines are provided to help biomedical research workers perform their experiments efficiently and analyze their results so that they can extract all useful information from the resulting data . Among the topics discussed are the varying purposes of experiments (e.g., exploratory vs . confirmatory); the experimental unit; the necessity of recording full experimental details (e.g., species, sex, age, microbiological status, strain and source of animals, and husbandry conditions); assigning experimental units to treatments using randomization; other aspects of the experiment (e.g., timing of measurements); using formal experimental designs (e.g., completely randomized and randomized block); estimating the size of the experiment using power and sample size calculations; screening raw data for obvious errors; using the t-test or analysis of variance for parametric analysis; and effective design of graphical data.

J Clin Periodontol, 2002 Aug, 29(8), 743 - 9
Local antibiotic therapy guided by microbiological diagnosis; Mombelli A et al.; BACKGROUND: The aim of this study was to determine the distribution patterns of Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans in periodontitis patients after standard mechanical periodontal therapy, and to evaluate the effect of additional local antibiotic therapy, given to all teeth with cultural evidence of these bacteria . METHODS: 17 patients were included . 852 separate subgingival microbial samples were taken from the mesial and distal aspect of every tooth in 17 subjects at baseline . 46 of these samples, from 10 positive subjects, showed cultural evidence for P . gingivalis . 82 samples, from 5 subjects, were A . actinomycetemcomitans-positive . Three subjects showed no evidence for persistence of A . actinomycetemcomitans or P . gingivalis . In the other 14 subjects, all A . actinomycetemcomitans- or P . gingivalis-positive teeth were treated with tetracycline fibers (ACTISITE(R)) . Sub-gingival microbial samples were again taken from two sites of every tooth, 1 month after fiber removal . 89% of the initially P . gingivalis-positive sites were now negative, but 16 previously negative sites now tested positive . 77% of the initially A . actinomycetemcomitans-positive sites were now negative, but 5 previously negative sites now tested positive . The teeth with persisting P . gingivalis or A . actinomycetemcomitans were again treated with fibers . Two sites of every tooth were once more sampled after 1 month . At this time, 5 subjects still showed cultural evidence of P . gingivalis at a total of 19 sites, and 4 subjects were positive for A . actinomycetemcomitans in a total of 27 sites . These 9 patients were finally submitted to systemic antibiotic therapy (3 x 250 mg metronidazole plus 3 x 375 mg amoxicillin/d for 7 days) . Despite of all efforts, P . gingivalis was again detected 3 months later in isolated sites in 3 subjects, and A . actinomycetemcomitans could be cultivated from one single site . CONCLUSIONS: Therapy with tetracycline fibers guided by microbiological diagnosis effectively reduced P . gingivalis and A . actinomycetemcomitans locally, but was unable to completely eradicate the target organisms . Additional systemic antibiotic therapy further reduced P . gingivalis and A . actinomycetemcomitans . The observed persistence patterns suggest that reemergence of A . actinomycetemcomitans was due to recolonization, whereas the strikingly reproducible local reemergence of P . gingivalis in some sites indicated failed eradication.

J Clin Periodontol, 2002 Aug, 29(8), 724 - 35
Antibiotic resistance of subgingival species during and after antibiotic therapy; Feres M et al.; AIM: The purpose of the present investigation was to determine the percentage and identity of antibiotic-resistant species in subgingival plaque and saliva samples from chronic periodontitis patients treated by scaling and root planing followed by orally administered amoxicillin or metronidazole . METHOD: In all, 20 chronic periodontitis patients were selected for study . After clinical and microbiological monitoring, subjects were randomly assigned to receive either orally administered amoxicillin at the dosage of 500 mg, 3 times daily for 14 days or orally administered metronidazole at the dosage of 250 mg, 3 times daily for 14 days . For the antibiotic resistance determinations, subgingival plaque samples were taken from six posterior teeth at baseline, and 90 days; and from two randomly selected teeth at 3, 7 and 14 days during and after antibiotic administration . Samples were plated on enriched blood agar plates with or without either 2 micro g/mL metronidazole or 2 micro g/mL amoxicillin . Colonies were counted at 7 days . Significant differences in percentage of resistant organisms over time were determined by the Quade test . Microbial growth was washed from antibiotic-containing media and the identity of species determined using checkerboard DNA-DNA hybridization . Data were compared with those obtained in a previous study from subjects receiving SRP only or SRP followed by 14 days of orally administered doxycycline . The level of doxycycline used to determine antibiotic resistance in that study was 4 micro g/mL . RESULTS: The mean percentage of resistant isolates increased during antibiotic administration and returned to baseline levels by 90 days post therapy . The mean percentages (+/- SEM) of isolates resistant to 2 micro g/mL metronidazole were 53 +/- 9, 65 +/- 9, 79 +/- 4 and 69 +/- 7 at baseline, 3, 7 and 14 days during antibiotic administration, and 57 +/- 4, 64 +/- 5, 62 +/- 7 and 47 +/- 6 at 3, 7, 14 and 90 days after antibiotic administration . At the same time points, the percentage of resistant isolates to amoxicillin was 0.5 +/- 0.2, 22 +/- 12, 14 +/- 5 and 37 +/- 11 during, and 31 +/- 11, 8 +/- 3, 3 +/- 2 and 3 +/- 0.6 after, administration . Antibiotic-resistant isolates of resistant species detected during or after therapy were also detected prior to therapy . The most prevalent resistant species in the metronidazole-treated group were: A . naeslundii 1, S . constellatus, A . naeslundii 2, S . mitis, S . oralis, A . odontolyticus, S . sanguis, and in the amoxicillin-treated group: S . constellatus, P . nigrescens, E . saburreum, A . naeslundii 1, S . oralis, P . melaninogenica and P . intermedia . CONCLUSIONS: Systemic antibiotic administration transiently increased the percentage of resistant subgingival species, but a major component of subgingival plaque remained sensitive to the agents during their administration . Antibiotic-resistant isolates of resistant species could be detected in samples both prior to and after therapy . However, % antibiotic-resistant isolates returned to baseline levels 90 days after antibiotic administration.

J Clin Periodontol, 2002 Aug, 29(8), 710 - 23
Guided tissue regeneration in intrabony defects using an experimental bioresorbable polydioxanon (PDS) membrane . A 24-month split-mouth study; Christgau M et al.; AIM: The comparison of the clinical, radiographic, and microbiological healing results in deep intrabony defects following GTR therapy with two different bioresorbable membranes in a prospective split-mouth design . MATERIAL AND METHODS: 31 pairs of contralateral intrabony defects were randomly treated with either an experimental Polydioxanon (PDS) membrane or a Polylactic acid (PLA) matrix barrier . After 6, 12 and 24 months, healing results were assessed using clinical examinations (REC, PPD, CAL, vertical relative attachment gain V-rAG), quantitative digital subtraction radiography (amount and area of bone density changes), and microbiological analysis . RESULTS: Postoperative membrane exposures occurred in 14 PDS and 2 PLA treated sites . 6, 12 and 24 months p.o., both membranes provided a significant gain in CAL {median values: 6 months (PDS vs . PLA: 3.0 vs . 3.0 mm); 12 and 24 months (PDS vs . PLA: 4.0 vs . 4.0 mm)}, which corresponded to a V-rAG of 57.1% (PDS) vs . 62.5% (PLA) after 24 months . PDS and PLA treated sites revealed significant bone density gain 6, 12 and 24 months after surgery . 38.8% (PDS) vs . 41.8% (PLA) of the initial defect areas showed bone density gain . While the gain in bone density was significantly greater in PDS than in PLA sites, neither CAL gain nor the area of bone density changes revealed significant differences . Microbiological culture revealed similar bacterial loads in PDS and PLA sites during the first 12 months . CONCLUSION: This 24-month study indicates that the PDS and PLA membranes can provide similar favorable regeneration results in deep intrabony periodontal defects, although considerably more postoperative membrane exposures have to be expected in PDS treated sites.

Pathol Res Pract, 2002, 198(8), 553 - 8; discussion 559-61
Granulomatous Pneumocystis carinii pneumonia complicating hematopoietic cell transplantation; Gal AA et al.; Pneumocystis carinii pneunonia (PCP) is associated with a wide spectrum of clinical and histopathological presentations . While granulomatous PCP uncommonly occurs in AIDS patients, it is extremely rare in other non-AIDS immunocompromised patients . We identified three patients who developed granulomatous PCP after bone marrow or blood stem cell transplantation . In all cases, fiberoptic bronchoscopy with bronchoalveolar lavage was non-diagnostic, and an open lung biopsy was required for diagnosis . All patients were successfully treated with trimethoprim-sulfamethoxazole . The histological appearance varied from an ill-defined granulomatous pneumonia to well-formed necrotizing granulomas . The typical intraalveolar eosinophilic frothy exudate was absent . Often sparsely distributed, the organisms were detected by GMS and immunohistochemical stains for P . carinii . No other pathogens were identified by additional histochemical stains or by microbiological cultures . Awareness of this unusual granulomatous tissue response to P . carinii and initiation of specific treatment can lead to successful resolution of this potentially lethal infection.

J Cataract Refract Surg, 2002 Oct, 28(10), 1882 - 3
Aspergillus niger endophthalmitis after cataract surgery; Brar GS et al.; We report a 65-year-old diabetic woman who developed Aspergillus niger endophthalmitis after cataract surgery . She presented 9 weeks after extracapsular cataract extraction with a black growth covering the cornea and moderate echoes in the vitreous on ultrasonography . After microbiological confirmation of fungal endophthalmitis, the patient received intravitreal amphoterecin B 5 micro g, topical natamycin 5% hourly, atropine 1% 3 times, and oral antifungal therapy . The patient was told the visual prognosis and was advised to have penetrating keratoplasty and vitrectomy, which she refused.

Int J Antimicrob Agents, 2002 Sep, 20(3), 165 - 73
Ertapenem monotherapy versus combination therapy with ceftriaxone plus metronidazole for treatment of complicated intra-abdominal infections in adults; Yellin AE et al.; The efficacy and safety of intravenous (IV) ertapenem, 1 and 1.5 g once a day, for treatment of adults with complicated intra-abdominal infection were compared with those of IV ceftriaxone 2 g once a day plus IV metronidazole 500 mg every 8 h . After at least 3 days of IV therapy and satisfactory clinical response, patients could be switched to oral ciprofloxacin plus metronidazole . Fifty-nine patients were randomized to receive ertapenem 1 g and 51 to receive ertapenem 1.5 g; 55 patients were randomized to each comparator group . At the test of cure, 4-6 weeks post therapy, in the 1 g cohort, 84% (26/31) of patients treated with ertapenem and 85% (35/41) with comparator therapy had a favourable clinical and microbiological assessment . Success rates in the 1.5 g cohort were 83% (22/29) and 77% (24/31) in the ertapenem and comparator groups, respectively . Drug-related adverse events were generally similar in both treatment groups . Ertapenem 1 or 1.5 g once a day followed by optional oral therapy appeared similar to combined therapy with ceftriaxone plus metronidazole with the same optional oral switch for treatment of complicated intra-abdominal infections in adults . Although not compared directly in a randomized fashion, the efficacy and safety profiles of ertapenem 1 and 1.5 g appeared comparable . Ertapenem was generally well tolerated and had an overall safety profile similar to ceftriaxone plus metronidazole .

Int J Antimicrob Agents, 2002 Sep, 20(3), 153 - 64
A risk analysis framework for the long-term management of antibiotic resistance in food-producing animals; Salisbury JG et al.; In recent years, there has been increasing concern that the use of antibiotics in food-producing animals, particularly their long-term use for growth promotion, contributes to the emergence of antibiotic-resistant bacteria in animals . These resistant bacteria may spread from animals to humans via the food chain . They may also transfer their antibiotic-resistance genes into human pathogenic bacteria, leading to failure of antibiotic treatment for some, possibly life-threatening, human conditions . To assist regulatory decision making, the actual risk to human health from antibiotic use in animals needs to be determined (risk assessment) and the requirements for risk minimisation (risk management and risk communication) determined . We propose a novel method of risk analysis involving risk assessment for three interrelated hazards: the antibiotic (chemical agent), the antibiotic-resistant bacterium (microbiological agent) and the antibiotic-resistance gene (genetic agent) . Risk minimisation may then include control of antibiotic use and/or the reduction of the spread of bacterial infection and/or prevention of transfer of resistance determinants between bacterial populations .

Int J Food Microbiol, 2002 Nov 15, 79(1-2), 35 - 45
Preservation of fresh meat with active and modified atmosphere packaging conditions; Skandamis PN et al.; The sensory, microbiological and physicochemical attributes of fresh meat stored at 5 and 15 degrees C were affected by the combined effect of volatile compounds of oregano essential oil and modified atmosphere packaging conditions (40% CO2/30% N2/30% O2, 100% CO2, 80% CO2/20% air, vacuum pack and air) . It was found that the extension of shelf life of meat samples depended on the packaging conditions and augmented in the order: air < vacuum pack < 40% CO2/30% N2/30% O2 < 80% CO2/ 20% air < 100% CO2 . Longer shelf life was observed in samples supplemented with the volatile compounds of oregano essential oil and stored under the same packaging conditions mentioned above . The extension of shelf life may be due to the synergistic effect of volatile compounds of oregano essential oil and the modified atmosphere packaging used on the microbiological and physicochemical characteristics of meat . Indeed, both these hurdles can prolong and delay microbial growth or suppress the final counts of the spoilage microorganisms in comparison with the 'control' samples . The effect of essential oil volatile compounds was even more pronounced on the physicochemical changes of meat samples caused by microbial association . Oregano essential oil delayed glucose and lactate consumption, both indicators of meat spoilage aerobically as well as under 40% CO2/30% N2/30% O2, and 100% CO2 . Finally, changes in other metabolites such as formic acid were also observed.

Anat Rec, 2002 Nov 1, 268(3), 180 - 5
Chemical markers for bacteria in extraterrestrial samples; Fox A; Interplanetary missions to collect pristine Martian surface samples for analysis of organic molecules, and to search for evidence of life, are in the planning phases . The only extraterrestrial samples currently on Earth are lunar dust and rocks, brought back by the Apollo (U.S.) and Luna (Soviet Union) missions to the moon, and meteorites . Meteorites are contaminated when they pass through the Earth's atmosphere, and during environmental exposure on Earth . Lunar fines have been stored on Earth for over 30 years under conditions designed to avoid chemical but not microbiological contamination . It has been extremely difficult to draw firm conclusions about the origin of chemicals (including amino acids) in extraterrestrial samples . Of particular concern has been the possibility of bacterial contamination . Recent work using state-of-the-art gas chromatography tandem mass spectrometry (GC-MS/MS) has dramatically lowered the chemical background, allowing a clear demonstration that lunar fines are remarkably different from terrestrial dust in that they generally lack certain chemical markers (muramic acid and 3-hydroxy fatty acids) characteristic of Earth's bacteria . Thus, lunar dust might be used as a negative control, in conjunction with GC-MS/MS analyses, in future analytical studies of lunar dust and meteorites . Such analyses may also be important in studies designed to search for the presence of life on Mars .

Extremophiles, 2002 Oct, 6(5), 419 - 25 Epub 2002 Jun 13.
Microbial community in acidic hydrothermal waters of volcanically active White Island, New Zealand; Donachie SP et al.; We report the first description of the microbial community in a stream of acidic hydrothermal waters on volcanically active White Island, New Zealand, using both molecular and microbiological methods . alpha- and beta-Proteobacteria, green-sulfur bacteria, and uncultured Firmicutes were identified from the community DNA-based 16s rRNA gene library . The same bacterial groups and the Rhodophyte Cyanidium caldarium were represented in enrichment cultures . C . caldarium, two Firmicutes and an acidophilic alpha-Proteobacterium, Acidiphilium cryptum, were brought into pure culture . Bacteria cultured from the stream grow at pH > or =2, and the Cyanidium grows at pH 0.2.

J Agric Food Chem, 2002 Oct 23, 50(22), 6389 - 94
Insecticide formulations based on nicotine oleate stabilized by sodium caseinate; Casanova H et al.; Organic farming and new trends toward the use of safer insecticides for crop protection have created new opportunities for botanical insecticides in the pesticide market . In this study, the botanical insecticide nicotine was formulated as a dispersion (20 vol %) stabilized by sodium caseinate, with nicotine oleate solutions used as the dispersed phase . The formulation showed a phase transition on increasing the nicotine oleate concentration, being an emulsion at 7.5-8.2 wt %, a suspo-emulsion at 8.2-9.7 wt %, and a suspension at 9.7-10.8 wt % . Biological activity, apparent viscosity, dispersion time, and protein surface coverage were dependent on nicotine oleate concentration . The emulsion with 8.2 wt % nicotine oleate and the suspo-emulsion with 8.7 wt % nicotine oleate were found to be the most appropriate formulations for insecticide purposes due to their high bioactivity, low viscosity, and low dispersion time . Nicotine oleate formulations showed good creaming and microbiological stability for at least 4 months without losing their biological activity.

J Food Prot, 2002 Oct, 65(10), 1623 - 7
Effects of pulsed electric field processing and storage on the quality and stability of single-strength orange juice; Ayhan Z et al.; The effects of pulsed electric field (PEF) processing on microorganisms in orange juice and on the flavor and color of the juice during storage for 112 days at 4 and 22 degrees C were investigated . Single-strength orange juice was PEF processed at an electric field strength of 35 kV/cm for 59 micros and placed into sterilized glass bottles in a sanitary glove box . PEF-processed orange juice was microbiologically stable at 4 and 22 degrees C for 112 days . PEF processing resulted in significant increases in the hydrocarbons D-limonene, alpha-pinene, myrecene, and valencene (P < or = 0.05) but did not have any effect on octanal, decanal, ethyl butyrate, and linalool . The levels of hydrocarbon compounds did not change at 4 and 22 degrees C in 112 days . Octanal, decanal, ethyl butyrate, and linalool levels significantly decreased in 14 days at 4 degrees C and in 2 days at 22 degrees C . The decrease in these compounds did not have a significant effect on the sensory quality of the orange juice (P > or = 0.05) . The microorganisms in PEF-processed orange juice, along with the flavor and color of the juice, remained stable at 4 degrees C for 112 days.

Genome Biol . 2002 Sep 24;3(10):REPORTS4033 . Epub 2002 Sep 24.
Viruses in and out; Andrawiss M; A report on the twelfth Congress of Virology, part of 'The world of microbes', the joint meeting of the three divisions of the International Union of Microbiological Societies, Paris, France, 27 July to 1 August 2002

J AOAC Int, 2002 Sep-Oct, 85(5), 1187 - 200
AOAC International methods committee guidelines for validation of qualitative and quantitative food microbiological official methods of analysis; Feldsine P et al.; Responding to a need for a guide for conducting Official Method validation studies of microbiological methods, AOAC utilized the experience of three microbiologists who have been active in the field of method validation . In collaboration, a document was prepared which covered the following areas: terms and their definitions associated with the Official Methods program (e.g., reference methods, alternative methods, and ruggedness testing), protocols and validation requirements for qualitative methods versus those for quantitative methods, the concept of the precollaborative study, ruggedness testing, tests for significant differences, performance indicators, and the approval process . After its preparation, this document was reviewed by the members of the Methods Committee on Microbiology and Extraneous Materials and by members of the Official Methods Board . Herein is presented the approved version of that document.

Intensive Care Med, 2002 Oct, 28(10), 1440 - 6 Epub 2002 Aug 17.
Direct costs of severe sepsis in three German intensive care units based on retrospective electronic patient record analysis of resource use; Moerer O et al.; OBJECTIVE: To determine the direct costs of severe sepsis patients in German intensive care units (ICUs) . DESIGN: Retrospective electronic data analysis . SETTING: Three adult intensive care units (surgical/medical) in three university hospitals in Germany . PATIENTS: 385 patients identified by standard definitions as suffering from severe sepsis . MEASUREMENTS AND RESULTS: A bottom-up approach was used to determine the direct ICU cost on actual resource use (medication, laboratory tests, microbiological analysis, disposables, and clinical procedures) for patients with severe sepsis . To determine the total direct costs, center-specific personnel and basic bed ("hotel") costs were added to total resources consumed . Average hospital mortality of severely septic patients was 42.6% . Mean ICU length of stay (LOS) was 16.6 days . Survivors stayed on average 4 days longer than nonsurvivors . The mean direct ICU costs of care were 23,297+/-18,631 euros per patient and 1,318 euros per day . In comparison, average daily charges being paid for an ICU patient by the health care system in Germany are 851 euros (based on official statistics) . Nonsurvivors were more expensive than survivors in total direct costs (25,446 vs . 21,984 euros) and in per day direct cost (1,649 vs . 1,162 euros) . Medication makes up the largest part of the direct costs, followed by expenses for personnel . CONCLUSIONS . Patients with severe sepsis have a high ICU mortality rate and long ICU LOS and are substantially expensive to treat . Nonsurviving septic patients are more costly than survivors despite shorter ICU LOS . This is due to higher medication costs indicating increased efforts to keep patients alive.

Anal Bioanal Chem, 2002 Oct, 374(3), 421 - 6 Epub 2002 Sep 07.
Development of a laser-induced cell lysis system; Dhawan MD et al.; A novel cell lysis system was developed that is based on laser-induced disruption of bacterial and yeast cells . It will find application as a rapid, efficient and clean sample preparation step in bioanalytical detection systems . Using E . coli as our model analyte, we optimized cell lysis with respect to optimal laser wavelength, lowest energy input requirements, RNA release from the cells, and potential protein damage . The optimized system was finally applied to the lysis of four additional microorganisms . All experiments were carried out with about 2000 cells per sample or less . Initially, lysis was determined by the detection of cell survival after laser treatment using standard microbiological techniques, (i.e., cells were grown on nutrient agar plates) . Then, actual release of mRNA from the cells was proven . Wavelengths investigated ranged from 500 nm to 1550 nm . An average power of 100 mW for the lasers was shown to be sufficient to obtain cell lysis at wavelengths above 1000 nm, with optimal wavelengths between 1250 nm and 1550 nm . Since water absorbs energy at those wavelengths, it is assumed that laser exposure results in an instantaneous increase of the cell temperature, which causes rupture of the cell membrane . Second, damage to protein solutions treated under optimized laser-lysis conditions was also studied . Using a pure solution of horseradish peroxidase as a model protein, no loss in enzyme activity was observed . Thus, it was concluded that damage to intracellular proteins is unlikely . Third, RNA release was tested using an E . coli specific RNA biosensor . Release of RNA was not detected from untreated cells, but laser-treated E . coli cells displayed significant RNA release due to laser-induced cell lysis . Finally, lysis of M . luteus, B . subtilis, B . cereus, and S . cerevisiae were investigated under optimized conditions . In all cases, laser-induced lysis of the cells was confirmed by determination of cell survival . Hence, laser-induced cell lysis is an efficient procedure that can be used for sample preparation, without damage to macromolecules, in bioanalytical detection systems for microorganisms . Miniaturized lasers and miniaturized cell-lysis chambers will create a simple, field-usable cell lysis system and allow the application of laser-induced cell lysis in micro Total Analysis Systems.

Ann Hematol, 2002 Sep, 81(9), 529 - 31 Epub 2002 Aug 16.
Candida arthritis in a patient with chronic myelogenous leukemia (CML) in blastic transformation, unresponsive to fluconazole, but treated effectively with liposomal amphotericin B; Turgut B et al.; Candida arthritis is quite rare and might be caused either by direct intra-articular inoculation of Candida or secondary to hematogeneous seeding of Candida in immunocompromised hosts . Until now less than 50 cases of Candida arthritis have been reported in the literature . We report a case of Candida arthritis, which occurred in a patient with chronic myelogenous leukemia (CML) in blastic transformation . Aggressive chemotherapy and broad-spectrum antibiotics for a prolonged period for febrile neutropenia had been given to the patient . Arthritis of the left knee appeared during the recovery phase of leukopenia . Despite treatment with fluconazole, no clinical or microbiological improvement was obtained . Thus, administration of liposomal amphotericin B was started and after 3 days there was improvement . We can conclude that fluconazole might not be sufficient in some Candida arthritis cases and liposomal amphotericin B might be a good alternative in these resistant cases.

Int J Food Microbiol, 2002 Dec 15, 79(3), 175 - 81
Analysing collaborative trials for qualitative microbiological methods: accordance and concordance; Langton SD et al.; In qualitative (detection) food microbiology, the usual measures of repeatability and reproducibility are inapplicable . For such studies, we introduce two new measures: accordance for within laboratory agreement and concordance for between laboratory agreement, and discuss their properties . These measures are based on the probability of finding the same test results for identical test materials within and between laboratories, respectively . The concordance odds ratio is introduced to present their relationship . A method to test whether accordance differs from concordance is discussed.

Clin Chest Med, 2002 Sep, 23(3), 603 - 12
Radiology of pulmonary Mycobacterium avium-intracellulare complex; Levin DL; Although the radiographic appearance of pulmonary MAC infection in the immunocompetent host can be varied, there are several generalizations that can be made . The classic radiographic appearance is indistinguishable from that of pulmonary tuberculosis . The classic form is seen most commonly in males and is typically associated with other predisposing diseases, especially chronic obstructive pulmonary disease . Most patients have upper lobe disease with associated pleural thickening . Widespread disease is common, as is cavitation . Pleural effusions and adenopathy are uncommon . The Lady Windermere syndrome is a special form of pulmonary MAC seen primarily in middle-aged and elderly women . The radiographic findings are bronchiectasis and small nodules, predominately located within the middle lobe and lingula . The combination of bronchiectasis involving exclusively, or primarily, the right middle lobe and lingula is highly suggestive of pulmonary MAC, even in the face of negative sputum cultures . Pulmonary infection with MAC in the immunocompromised patient generally reflects a widespread systemic disease . As such, the radiographic appearance is highly variable . Diffuse pulmonary opacities and adenopathy are common features . Plain radiographs are frequently normal despite active pulmonary infection . Regardless of the clinical situation, pulmonary MAC infection is often omitted from the radiographic differential even when the appearance is characteristic . In general, when pulmonary abnormalities are identified that are consistent with a granulomatous infection, pulmonary MAC needs to be considered along with tuberculosis and fungal infection . Especially with pulmonary MAC, radiographic stability over several years does not exclude active disease . The radiographic appearance may be suggestive of the diagnosis of pulmonary MAC, but correlation with the clinical and microbiological data is necessary to confirm the diagnosis.

Curr Protein Pept Sci, 2002 Aug, 3(4), 467 - 84
Protein regulators of eicosanoid synthesis: role in inflammation; Homaidan FR et al.; A variety of factors contribute to the complex course of inflammation . Microbiological, immunological and toxic agents can initiate the inflammatory response by activating a variety of humoral and cellular mediators . In the early phase of inflammation, excessive amounts of cytokines and inflammatory mediators are released . These factors activate, in addition to other signaling pathways, the lipid synthesis pathways, which play a crucial role in the pathogenesis of organ dysfunction . Arachidonic acid (AA), the precursor of pro-inflammatory eicosanoids, is released from membrane phospholipids by the action of phospholipase A(2) (PLA(2)), and is metabolized to prostaglandins (PGs) and leukotrienes (LTs) by the action of cyclooxygenase (COX) and lipoxygenase (LO) enzymes, respectively . Disordered activation of PLA(2), LO and COX enzymes have been implicated in many inflammatory diseases . PLA(2) is activated by phospholipase-A(2)-activating protein (PLAP) and LO by 5-lipoxygenase-activating protein (FLAP) . The inducible form of COX-2 enzyme, which is usually not present under basal conditions, is induced in inflammation . In this article the function of these enzymes in eicosanoid synthesis, their regulation, and their implication in inflammatory disorders will be reviewed . The properties, function and regulation of the protein activators PLAP and FLAP will also be discussed.

Med Pr, 2002, 53(3), 279 - 81
{Tularemia as a potential weapon of bioterrorists}; Mierzynska D et al.; This paper addresses the issue of using airborne tularemia as a potential biological weapon of terrorists . Because of its extreme infectivity, easy dissemination and substantial pathogenic ability, it may become a dangerous biological agent . An outbreak of acute febrile illness with pneumonia, pleuritis and hilar lymphadenitis in urban healthy populations, regardless of age and gender, should suggest an action of terrorism . The presumptive diagnosis should be based on epidemiological and clinical findings as the final microbiological confirmation may take several weeks . The treatment with aminoglicosides or alternatively doxycycline and ciprofloxacin administered parenterally is recommended . In a mass casualty situation, oral doxycycline and ciprofloxacin are the preferred drugs . Vaccination is recommended only in the laboratory personnel working routinely with Francisella tularensis . Isolation and special precautions are not necessary because the illness is not transmitted from one person to another.

Bone Marrow Transplant, 2002 Oct, 30(7), 427 - 31
Continuous infusion of ceftazidime for patients with breast cancer and multiple myeloma receiving high-dose chemotherapy and peripheral blood stem cell transplantation; Egerer G et al.; This prospective study was performed to examine the safety and efficacy of a continuous infusion of ceftazidime in patients who developed febrile neutropenia after high-dose chemotherapy (HDCT) and autologous peripheral blood stem cell transplantation (PBSCT) and to determine if the underlying disease represents a risk factor for infectious complications . From September 1995 to May 2000, 55 patients with breast cancer (BC, group I, 54 females, one male) and 32 patients with multiple myeloma (MM, group II, 10 female, 22 male) were included in this study . The febrile patients received a 2 g intravenous bolus of ceftazidime, followed by a 4 g continuous infusion over 24 h using a portable infusion pump . If the fever persisted for 72 h a glycopeptide antibiotic was added . The median age was 42 years (range 22-59) in group I and 52 years (range 35-63) in group II . Thirty-five BC patients (64%) and 20 MM patients (63%) responded to the monotherapy with ceftazidime . After addition of a glycopeptide antibiotic, an additional 11 BC patients vs 10 MM patients became afebrile . The causes of fever in group I were fever of unknown origin (FUO) in 49 patients, microbiologically documented infection (MDI) in five patients, and clinically documented infection (CDI) in one patient . The causes of fever in group II were FUO in 22 patients, MDI in eight patients and CDI in two patients . Forty-one febrile episodes in BC patients (75%) and 22 episodes in the MM patients (69%) were successfully managed by out-patient treatment, resulting in a saving of an average of 20 days of inpatient care . Significantly more episodes of MDI and CDI occurred in patients with MM (P = 0.05) . The results indicate that BC and MM patients with febrile neutropenia after HDCT and PBSCT can be treated as outpatients with close monitoring to ensure safety . This approach represents a better use of health care resources.

Microbiology, 2002 Oct, 148(Pt 10), 2929 - 36
An ex vivo culture model for screening drug activity against in vivo phenotypes of Mycobacterium tuberculosis; Turner DJ et al.; Since the activity of drugs against Mycobacterium tuberculosis grown in microbiological culture can differ from their activity against bacteria present in infected tissues, compounds with optimal activity against in vivo phenotypes may be overlooked in drug-discovery programmes that rely on in vitro screens . The authors have investigated the use of an ex vivo cell-culture model to assess the action of drugs on M . tuberculosis in an environment resembling that encountered during infection . Mycobacterial viability in the ex vivo model was shown to be regulated by the cell-mediated immune system, with growth inhibited by CD4(+) T cells at an early stage of infection in BCG-vaccinated mice, and at a later stage after infection in naive mice . Screening of drugs in the ex vivo model demonstrated a window of pyrazinamide susceptibility that coincides with the onset of the T-cell-mediated immune response in naive or vaccinated mice . It is proposed that pyrazinamide acts on a population of bacteria that are exposed to an acidic environment as a result of immune activation . Clinically, administration of pyrazinamide during the initial phase of treatment reduces the risk of relapse after 6 months, suggesting that the early pyrazinamide-susceptible population may contribute to the later pool of mycobacteria that persist during prolonged chemotherapy.

Arh Hig Rada Toksikol, 2002 Jun, 53(2), 135 - 44
Commercial rodent feed as an occasional cause of morbidity and mortality in a rat breeding colony; Varnai VM et al.; In the last fifteen years there were several feed-related outbreaks of morbidity and mortality in the Institute's breeding colony of Wistar rats . The last event took place in April 1999, one month after the use of a new supply of the usual standard rodent feed . Animals did not thrive and manifested generalised oedema, hypoalbuminaemia, elevated liver enzymes, and high mortality . The effect of feed was assessed first by feeding a group of sick females during 14 days with either suspected feed (A-March) or with the earlier supply of feed (A-January) of the same producer . Then a group of healthy male rats Y59 from another breeding colony was fed either suspected feed (A-March) or feed from another producer (feed B) . Although neither chemical nor microbiological deviation in feed analysis had been detected, decreased consumption and slower body weight gain in all animals fed with feed A-March suggested an association between this batch of feed and the increased morbidity in those animals . Eventually, the entire rat colony was put down and replaced with a new breed which was given a new brand of feed.

Rhinology, 2002 Sep, 40(3), 154 - 8
Experimental sinusitis in nasally catheterised rabbits; Cetin CB et al.; AIM: The aim of the study was to create an experimental rabbit model for investigating the effects of nasal catheterization on rhinosinus mucosa, bacterial flora and observing the development of bacterial sinusitis . METHODS: Healthy adult white rabbits of either sex and with body weights of 2.5-3 kg were used . Rabbits were randomly separated into two groups; the first group was catheterized by 12 French and the second group was catheterized by 8 French catheters blindly and the non-catheterized left sides were accepted as control . Three randomly chosen rabbits from each group were examined by computerized tomography scans (CT) and sacrified in the first, second and the fourth week of the study . Microbiological and histopathological examinations were performed . RESULTS: In both study groups after the first week of nasal catheterization, opacity or air-fluid level was detected in maxillary sinuses by CT scans, which was significant in group 1 . Inflammation spread by the prolongation of nasal catheterization and rapidly development of sinusitis was observed by thicker catheters' usage . CONCLUSION: In this study, the role of nasal catheterization as a predisposing factor in the development of sinusitis and the increase of sinusitis development risk in relation with the catheterization period and the catheters' thickness was shown.

Cytometry, 2002 Oct 1, 49(2), 62 - 9
Assessment of Escherichia coli B with enhanced permeability to fluorochromes for flow cytometric assays of bacterial cell function; Herrera G et al.; BACKGROUND: Flow cytometry has become a choice methodology for microbiological research . However, functional cytometric assays in live bacteria are still limited . This is due, in part, to the cell wall impairing penetration of vital dyes in bacteria, thus imposing permeabilization procedures . These manipulations may affect cell physiology, provoke cell aggregation or lysis, and they are time-consuming . Escherichia coli B strains have been used for mutagenic assays because of an altered lipopolysaccharide that provokes increased membrane permeability . We assessed the use of these strains as possible alternatives for flow cytometric assays to avoid the permeabilization steps . METHODS: Suspensions of E . coli K-12 (strain AB1157) and E . coli B (strain WP2 uvrA/pKM101, denoted as strain IC188) were stained with several fluorochromes, including fluorescein isothiocyanate, propidium iodide, Nile Red, bis-(1,3-dibutylbarbituric acid) trimethine oxonol, hydroethidine, and dihydro-dichlorofluorescein diacetate, under basal conditions and following permeabilization, impairment of membrane potential, inhibition of dye efflux pump, and oxidative stress . Fluorescent staining of both strains was compared by epifluorescence microscopy and flow cytometry . RESULTS: The E . coli B strain IC188 exhibited more efficient staining with vital fluorochromes than the E . coli K-12 strain AB1157 and maintained a similar membrane potential . In addition, IC188 showed higher sensitivity than AB1157 to reveal oxidative stress when challenged with prooxidants . CONCLUSIONS: E . coli B strains may be useful for biochemical and toxicological studies based on flow cytometry and fluorescence microscopy .

J Clin Periodontol, 2002 Jul, 29(7), 638 - 44
Comparison of microbial cultivation and a commercial PCR based method for detection of periodontopathogenic species in subgingival plaque samples; Eick S et al.; OBJECTIVES: Microbiological laboratory procedures are involved in diagnosis and therapy control of progressive and refractory forms of periodontitis . In recent years techniques have been developed based on the detection of nucleic acids . The purpose of this study was to validate the commercially available micro-Dent(R) test which employs probes for A . actinomycetemcomitans, P . gingivalis, P . intermedia, B . forsythus and T . denticola . METHODS: 122 plaque samples obtained from periodontal pockets with various depths from 33 early onset periodontitis (EOP) patients and 15 periodontally healthy subjects were analysed by cultivation and the microDent(R) kit . RESULTS: Both cultivation and the nucleic acid based assay showed a positive correlation of pocket depth with the frequency and quantity of periodontopathogenic species . T . denticola was found only in pockets > 4 mm in EOP patients . Comparison of the two methods revealed that the microDent(R) kit identified both P . gingivalis and B . forsythus more often than did the cultivation method . Conclusions: Nucleic acid techniques should replace cultivation methods as gold standard in microbiological diagnosis of progressive periodontitis . The micro-Dent(R) kit can be recommended for microbiological laboratories analysing subgingival plaque samples.

Contracept Deliv Syst, 1984 Jan, 5(1), 29 - 45
Scanning electron microscopy of the IUD tail; Spornitz UM et al.; PIP: The surface ultrastructure of the tails of various IUDs (Multiload, Copper 7, Copper T-Device, Nova-T, FDI, Lippes Loop, and Dalkon Shield) was studied with the scanning electron microscope . The parts of the IUD tail exposed to the vaginal, cervical, and uterine milieu showed strikingly different surface characteristics . The surface ultrastructure of these 3 parts is influenced by the duration of use, nature of microbiological contaminants, pregnancy with the IUD in situ, and pelvic inflammatory disease (PID) . Duration of use and PID alter the surface ultrastructure most drastically . In comparing tails of the different IUDs, the IUDs with relatively smooth tails became less rapidly contaminated during the 1st few months of use . The surface ultrastructure of the IUD tail was formed through a coat of material which consists of cellular debris, dead bacteria, mucus, etc . The thickness of the coat was found to be largely dependent on the duration of IUD use . The thicker the coat, the more likely bacteria were found on the intrauterine part of the tail . The possible significance of these findings with respect to the development of PID is discussed . author's modified

Eur J Pediatr, 2002 Oct, 161(10), 542 - 6 Epub 2002 Aug 15.
Early events in atopy; Van Bever HP; The prevalence of allergic diseases, such as allergic asthma, allergic rhinitis and atopic dermatitis, has increased during the last decade . It is generally accepted that the increased prevalence of allergic diseases is due to a disturbed T-helper lymphocyte (T(h)) T(h1)-T(h2) balance, leading to more expression of T(h2) features . Decreased postnatal microbiological stimulation (i.e . improvements in public health, reduction in family size, increased usage of antibiotics) results in an increased possibility of ongoing postnatal T(h2) reactions . Furthermore, increased postnatal allergen exposure, especially to house dust mite, is known to facilitate the existence of T(h2) features . Therefore, identification of early markers of allergy such as increased total IgE in cord blood offers the possibility to initiate adequate primary prevention in subjects at risk . Primary prevention measures constitute merely of avoidance of early allergen contacts (foods and inhalants) and avoidance of pollution exposure (i.e . passive smoking) . At the moment, insufficient data are available concerning the preventive effect of medication on the development of allergic diseases . However, studies on the early use of cetirizine suggest that the occurrence of asthma can be prevented or delayed in young children suffering from atopic eczema . CONCLUSION: because identification of the atopic newborn is now possible, adequate early prevention can be instigated.

Life Sci Space Res, 1979, 17, 99 - 103
Microbiological flora as a function of ice depth in central Antarctica; Abyzov SS et al.; A technique has been developed for obtaining ice samples under sterile conditions for microbiological analyses as a function of ice thicknesses and with a view to clarifying the possibility of long term microbial anabiosis under permafrost conditions . For the first time microbiological studies from the surface down to 312 meters in the Vostok station region have been carried out and the distribution of microorganisms in the strata studied has been clarified . Microorganisms occur rather rarely, and their distribution is of a random character, independent of the depth of sampling . Viable microorganisms have been found in the ice horizons approximately as old as 8-13 thousand years.

Integration, 1998 Fall, (57), 10 - 2
Cure: myth or reality? Treatment; Harrington M; PIP: In this address to the 12th World AIDS Conference, Mark Harrington, an AIDS activist from the US presented his perspectives about the obstacles hindering efforts to cure AIDS . Harrington described the progress of his disease as revealed by a series of lymph node biopsies and reported that he successfully began highly active antiretroviral therapy (HAART) 11 years after he was infected . While he was grateful for his success, he expressed disgust that millions of people throughout the world do not have access to HAART . He asked whether those seeking a cure would be satisfied with a clinical or microbiological cure or would hold out for a complete genomic cure and noted that he was satisfied to live with a little provirus as long as his immune system can protect him from dying of AIDS . He then mentioned some of the additional approaches that researchers will take to try to increase the chances of a cure . Harrington expressed disagreement with researchers who urge infected individuals to go on therapy early, pointing out that periods of noncompliance could lead to drug resistance . He called for studies that would weigh the benefits and risks of early intervention and pointed out that a mistaken reliance on therapy has undermined prevention efforts . He also criticized cuts in funding for programs in developed countries and the lack of support offered by developed countries to AIDS programs in the developing countries hardest hit by the epidemic . He concluded by calling for a partnership of science and activism and for increased funding to combat HIV/AIDS .

CVI Forum, 1993 Nov, (5), 7 - 8
Immunization in Mongolia: where are the people?
Analysing attitude data through ridit schemes.
PIP: The attitudes of individuals and populations on various issues are usually assessed through sample surveys . Responses to survey questions are then scaled and combined into a meaningful whole which defines the measured attitude . The applied scales may be of nominal, ordinal, interval, or ratio nature depending upon the degree of sophistication the researcher wants to introduce into the measurement . This paper discusses methods of analysis for categorical variables of the type used in attitude and human behavior research, and recommends adoption of ridit analysis, a technique which has been successfully applied to epidemiological, clinical investigation, laboratory, and microbiological data . The ridit methodology is described after reviewing some general attitude scaling methods and problems of analysis related to them . The ridit method is then applied to a recent study conducted to assess health care service quality in North Carolina . This technique is conceptually and computationally more simple than other conventional statistical methods, and is also distribution-free . Basic requirements and limitations on its use are indicated .

Arch AIDS Res, 1992, 6(4), 221 - 46
HIV / STD interactions immunosuppression and future research development; Hafez ES et al.; PIP: Screening for HIV in China began in 1984, with the first AIDS case appearing in 1985 . 305,280 sera were tested as of 1992, of which 379 were seropositive for antibodies to HIV . Of these 379 individuals, there were 4 hemophiliacs identified in 1985, 1 homosexual male, 4 individuals returning from Africa, 365 drug addicts and 2 spouses . 68 foreigners and 1 Chinese hemophiliac from Hong Kong also tested seropositive . Concern is expressed over the psychosomatic trials of infected women who feel unable to discuss their HIV status with family members for fear of influencing their role as primary caregivers and sex partners . Without access to medical therapy and support groups, these women no doubt feel isolated . Non-directive counseling is recommended for seropositive women during pregnancy . AIDS patients have reduced natural killer cell cytotoxicity . Seminal plasma also suppresses several immune responses . The pathogenicity of HIV, however, has yet to be determined . Fatty acid metabolism and Beta-endorphin are discussed in the context of therapeutic approaches . HIV/STD interactions are finally considered with individual attention given to bacterial vaginosis, hepatitis B, Chlamydia trachomatis, Herpes Simplex virus, microbiological contaminants of the vagina bacterial vaginosis, syphilis, mycoplasmas/epididymitis, bacterial prostatitis, and IVF culture media infections .

Arch AIDS Res, 1990, 4(1-2), 115 - 35
Prevention of sexual transmission of AIDS / STD by a spermicide containing benzalkonium chloride; Mendez F et al.; PIP: Spermicides widely used in contraception such as nonoxynol-9 (N-9) and benzalkonium chloride (BK) have a preventive effect on the sexual transmission of HIV and STDs . In vitro inactivation of HIV by BK was obtained within 10 minutes of contact at 0.025%-0.08% concentration . The most active of all those tested, N-9, inactivates at 0.05% after 30 minutes . A vaginal pharmaceutical form of BK at 1.2% inactivates at 0.012% (Pasteur Institute, 1987) . HIV survived inside latex condoms but no free HIV-1 survived exposure to the interior of condoms lubricated with BK at .83% (Wainberg, 1988) . In vivo studies were carried out which quantified the preventive power against STDs in a study of 903 cases of high risk women who used a pharmaceutical preparation of BK during a period of 3-6 months . The control group was comprised of high risk women not treated with the BK spermicide . Clinical, gynecological, microbiological, and serological tests were performed every 2 months . A 41.3% reduction (P0.001) in the number of STD cases was observed; however, a consistent use was unrealistic and some positive diagnoses could be related to individual sexual practices (oral, anal) not covered by an intravaginal locally active product . BK is an effective inactivator of HIV, and as such, is a valuable new arm against AIDS . It provides protection against STDs and is safe . author's modified

Adv Contracept Deliv Syst, 1988, 4(2-3), 97 - 193
Conception control and HIV/STD infections; Arias E et al.; PIP: The basic clinical aspects of contraception, fertility regulation, family planning, and family health are described as they relate to parameters of human immunodeficiency virus (HIV), AIDS Related Complex (ARC), and sexually transmitted diseases (STD) in man . Special emphasis is placed on: the biology/pathology of HIV; microbiology/immunology of human semen; condoms/spermicides; IUDS and HIV infections; STDs; heterosexual/homosexual transmission of HIV; risk factors/cofactors and HIV; prevention of HIV; clinical manifestations and opportunistic infections; and the integration of family planning programs with STD/HIV services . Human semen contains a wide variety of cellular elements and microbiological contaminants . THe major leukocyte subpopulations in the semen include: granulocytes, monocytes/macrophages, B lymphocytes, helper and suppressor/cytotoxic T lymphocytes, and antibodies . HIV penetrates several types of cells: macrophages, antibody-producing B cells, endothelial cells of blood vessels, and non-neuronal brain cells . Sperm-specific moieties have a high potential of immunogenicity . Condoms have been recommended to HIV carriers, both to prevent sexual transmission of HIV to uninfected sexual partners and to avoid repeated contact with HIV which influences clinical outcome of AIDS . Fluctuations in sales of condoms are due to the removal of IUDs from the American market; homosexual fear of HIV infection; and the discontinuation of oral contraceptive use among older women . The FDA has authorized anti-AIDS benefits in advertising/labelling of condoms . With the use of IUDs, a local infection of susceptible cervical cells from infected semen precedes systemic spread of HIV . Multiple sex partners increase the risk of HIV/STD infections . Further complications may also involve immunopathological interactions among multiple viral infections . With copper IUDs there may be urticarial eruptions and eczematous dermatitis and such cases with exposure of subcutaneous areas of the skin are considered as cofactors for HIV infection . HIV-infected women should avoid pregnancy and be given the highest priority for family planning services .

Clin Oral Investig, 2002 Sep, 6(3), 161 - 5 Epub 2002 Aug 16.
Contamination level of alginate impressions arriving at a dental laboratory; Sofou A et al.; The contamination level of alginate impressions delivered to a large dental laboratory in Sweden was determined . One hundred and seven consecutive alginate impressions were included during 7 days . Samples were taken and transferred into sterile physiological saline and analysed microbiologically for colony-forming units (cfu) as well as nonhemolytic, alpha-hemolytic, and beta-hemolytic colonies . After sampling, the clinics were contacted and asked to fill in simple questionnaires about their routines of disinfecting impressions . The questionnaire study revealed that about half of the clinics had some kind of disinfection routine, while the others rinsed in running water only . Seventy-two percent of the impressions yielded growth of bacteria, with a median number of 1.3x10(2) cfu . Thirteen per cent of the samples yielded >10(3) cfu, with a maximum number of 3.4x10(4) cfu . The majority of isolates were non- and alpha-hemolytic bacteria . Growth was recorded in 61.3% of disinfected impressions, and the numbers of bacteria in disinfected and nondisinfected impressions were similar . These findings raise the question of whether impressions need to be disinfected or if proper handling and hygienic procedures are sufficient to block the possible route of infection.

Nephrol Dial Transplant, 2002 Oct, 17(10), 1814 - 8
Ultrapure dialysis fluid slows loss of residual renal function in new dialysis patients; Schiffl H et al.; BACKGROUND: Residual renal function is beneficial for adequacy of haemodialysis, quality of life and mortality in dialysis patients . Our prospective randomised investigation aimed to analyse the effects of the microbiological quality of dialysis fluid on the course of residual renal function after initiation of haemodialysis . METHODS: Thirty patients starting haemodialysis were randomly assigned to ultrapure or conventional dialysate . During the 24-month study period, creatinine clearance, CRP and IL-6 levels, hydration status, number of hypotensive episodes and blood pressure recordings were assessed every 6 months . RESULTS: Residual renal function declined in both groups during the study period, although there were no statistically significant differences in demographic (age, gender), renal (cause of end-stage renal disease, residual renal function, hypertension, ACE inhibitors) and treatment characteristics (Kt/V urea) at recruitment . The use of mildly contaminated (up to 300 CFU/ml) dialysate resulted in higher CRP and IL-6 levels and more pronounced loss of residual renal function . Multiple regression analysis showed that the microbiological quality of the dialysate is an independent determinant of the loss of residual renal function . CONCLUSIONS: Ultrapure dialysis fluid combined with high-flux synthetic membranes are effective components of renal replacement therapy to slow the loss of residual renal function in haemodialysis patients . These improvements of haemodialysis are desirable, but add to treatment costs.

Mikrobiologiia, 2002 Jul-Aug, 71(4), 545 - 9
{Microbiological and biochemical study of lignocompost during succession}; Volchatova IV et al.; The investigation of microbiological succession and changes in the enzymatic activity, temperature, pH, and phytotoxicity of lignin during its composting showed that the addition of a starter culture (a specially developed association of microorganisms) affects degradational succession in the compost pile . The process of composting can be monitored either microbiologically or biochemically, by measuring the activity of some enzymes . The compost is ready for use when the activity of oxidoreductases (particularly polyphenol oxidases) falls and the activity of invertase stabilizes at a certain level.

Cad Saude Publica, 2002 Sep-Oct, 18(5), 1401 - 9
{Criteria for definition of environmental contamination indicators related to solid waste from health care facilities: a proposal for evaluation}; Silva AC et al.; The objective of this study was to identify target microorganisms as indicators of environmental contamination . The study evaluates the main environmental aspects and epidemiological chain related to such agents . Microorganisms were selected through key information about microbiological characterization of health care facilities' solid waste and evaluation of risk of infection from discarded sharps . The form of evaluation proposed for criteria adopted in the selection of contamination indicators included prior submission of a structured questionnaire to a network of specialists from the Federal District of Brazil . The specialists' multidisciplinary background, including professionals from the health field and an environmental microbiologist, helped define environmental contamination indicators by consensus . Pathogens such as Mycobacterium tuberculosis and hepatitis A and B viruses were specifically identified as capable of environmental survival or resistance.

Chemosphere, 2002 Oct, 49(1), 85 - 90
Trace elements in organs and tissues of striped dolphins (Stenella coeruleoalba) from the Mediterranean sea (Southern Italy); Cardellicchio N et al.; The distribution of metals (Cd, Cu, Zn, Fe, Cr, Pb and Sn) were investigated in various tissues and organs obtained from striped dolphins (Stenella coeruleoalba) stranded along the Apulian coasts (Southern Italy) during April-July 1991 . Metals were determined by atomic absorption spectrophotometry . Metal concentrations were generally high in the liver, and low in brain and melon . Some metals showed organ-specific accumulations: copper, tin and zinc exhibited high concentrations in liver, the highest cadmium concentration was observed in kidney . Pathological, microbiological and parasitological surveys were performed on the animals . It was not possible to relate dolphin death to a specific cause, or to contaminants; however, the accumulation of metals may contribute to certain pathological alterations.

Lancet, 2002 Aug 24, 360(9333), 619 - 20
Assessment of lungs rejected for transplantation and implications for donor selection; Ware LB et al.; Present criteria for donor-lung selection exclude more than 85% of lungs . We aimed to establish if potentially suitable lungs are rejected for transplantation . We obtained 29 pairs of rejected lungs and assessed them by physiological, microbiological, and histological methods . Most donor lungs had no or mild pulmonary oedema (24/29 {83%}), intact alveolar fluid clearance (17/23 {74%}), and normal or mildly abnormal histological findings (18/29 {62%}) . When all factors were considered, including microbiological and non-lung donor factors, 12 (41%) of 29 pairs of rejected lungs would have been potentially suitable for transplantation . Our findings emphasise the urgent need for prospective scientific assessment of selection of donors for lung transplantation.

Lancet, 2002 Aug 17, 360(9332), 528 - 34
Rifapentine and isoniazid once a week versus rifampicin and isoniazid twice a week for treatment of drug-susceptible pulmonary tuberculosis in HIV-negative patients: a randomised clinical trial; Benator D et al.; BACKGROUND: Rifapentine has a long half-life in serum, which suggests a possible treatment once a week for tuberculosis . We aimed to compare rifapentine and isoniazid once a week with rifampicin and isoniazid twice a week . METHODS: We did a randomised, multicentre, open-label trial in the USA and Canada of HIV-negative people with drug-susceptible pulmonary tuberculosis who had completed 2 months of a 6-month treatment regimen . We randomly allocated patients directly observed treatment with either 600 mg rifapentine plus 900 mg isoniazid once a week or 600 mg rifampicin plus 900 mg isoniazid twice a week . Primary outcome was failure/relapse . Analysis was by intention to treat . FINDINGS: 1004 patients were enrolled (502 per treatment group) . 928 successfully completed treatment, and 803 completed the 2-year 4-month study . Crude rates of failure/relapse were 46/502 (9.2%) in those on rifapentine once a week, and 28/502 (5.6%) in those given rifampicin twice a week (relative risk 1.64, 95% CI 1.04-2.58, p=0.04) . By proportional hazards regression, five characteristics were independently associated with increased risk of failure/relapse: sputum culture positive at 2 months (hazard ratio 2.8, 95% CI 1.7-4.6); cavitation on chest radiography (3.0, 1.6-5.9); being underweight (3.0, 1.8-4.9); bilateral pulmonary involvement (1.8, 1.0-3.1); and being a non-Hispanic white person (1.8, 1.1-3.0) . Adjustment for imbalances in 2-month culture and cavitation diminished the association of treatment group with outcome (1.34; 0.83-2.18; p=0.23) . Of participants without cavitation, rates of failure/relapse were 6/210 (2.9%) in the once a week group and 6/241 (2.5%) in the twice a week group (relative risk 1.15; 95% CI 0.38-3.50; p=0.81) . Rates of adverse events and death were similar in the two treatment groups . INTERPRETATION: Rifapentine once a week is safe and effective for treatment of pulmonary tuberculosis in HIV-negative people without cavitation on chest radiography . Clinical, radiographic, and microbiological data help to identify patients with tuberculosis who are at increased risk of failure or relapse when treated with either regimen.

Z Naturforsch {C}, 2002 Jul-Aug, 57(7-8), 654 - 9
Microbial transformation of a beta- and gamma-eudesmols mixture; Maatooq GT; Beta- and gamma-eudesmols mixture was microbiologically transformed by Gibberella suabinetti ATCC 20193 . Seven different eudesmanoidal metabolites (3-9) were isolated and their structures were elucidated by the different spectroscopic techniques . These metabolites are: eudesma-4-en-11-ol-3-one (carissone), eudesma-3-en-2beta, 11-diol, eudesma-4-en-3beta,11-diol, eudesma-4(15)-en-8,11-diol, eudesma-4(15)-en-2a,11-diol (pterocarpol), 1(3)cyclo-eudesma-4(15)-en-11,12-diol and eudesma-4-en-11,15-diol.

Dtsch Med Wochenschr, 2002 Sep 20, 127(38), 1947 - 50
{Osteomyelitis of the tibial head caused by Mycobacterium haemophilium in a patient with AIDS}; Gruschke A et al.; HISTORY AND ADMISSION FINDINGS: A 53-year-old man with known HIV infection and AIDS was admitted because of painful swelling at the right knee for 6 weeks . The cause was thought to be osteomyelitis and surgical treatment was planned . INVESTIGATIONS: No causative pathogen was found at curettage and lavage of an abscess at the right medical head of the tibia, but at a subsequent operative revision acid-fast rods were seen and identified as Mycobacterium haemophilum . TREATMENT AND COURSE: A systemic antibiotic, 1 g levofloxacin daily, had been started at the initial abscess operation . 2 weeks later, because swelling of the right knee had recurred with marked local and systemic signs of infection, a second surgical intervention was performed . Afterwards, in view of the histological finding of acid-fast bacteria suggesting tubercular osteomyelitis, the patient was put on combined treatment with 300 mg/d of isoniazid, 1600 mg/d of ethambutol, 2 g/d of pyrazinamide, and 1 g of streptomycin i.m . every other day . After molecular microbiological identification of M . haemophilum the antibiotic treatment was changed to 1600 mg/d of ethambutol, 300 mg/d of rifabutin and 1 g/d of clarithromycin . The operation wound healed well . CONCLUSION: M . haemophilum infection can be lethal in immunodeficient patients if untreated . Although there is no standard treatment, this rare infectious disease responds relatively well to a modified combined tuberculostatic regimen . Special laboratory techniques to identify the specific causative pathogen are therefore of great importance.

Rev Clin Esp, 2002 Sep, 202(9), 476 - 84
{Nosocomial bacteremia in the adult patient . Study of associated costs}; Morano Amado LE et al.; OBJECTIVE: Nosocomial infection causes a prolonged hospital stay and an increase in care costs . The objective of this study was to determine the length of stay excess and costs attributable to nosocomial bacteremia . PATIENTS AND METHODS: Retrospective study of clinical records of 148 patients with nosocomial bacteremia during 1996 . A matched case-control study was performed . For matching, the following parameters were used: RDG, year of admission, age 10 years, main diagnosis and number of secondary diagnoses . Costs were determined by excess length of hospital stay and calculating alternative costs . RESULTS: Matching was obtained for 100 cases (67.5%) and cost estimation was performed . Compared with cases, non-matched cases showed differences regarding significant issues for cost, such as hospital stay ( p = 0.01), number of empirical (p = 0.001) or definitive antibiotics (p = 0.03) . The median hospital stay for cases was longer than for controls (35 vs 15.5 days, respectively; p = 0.000) . When only survivor case-control pairs were considered (n = 75), cases remained in hospital for a median of 36 vs 15 days for controls (p = 0.000) . Hospital stay days attributable to nosocomial bacteremia were 19.5 for all matched and 21 for matched survivor cases . Only 76% of cases had stay days attributable to bacteremia . Significant differences between cases and controls included: the mean total costs of admission (p = 0.000), cost of stay (p = 0.001), pharmaceutical expenses (p = 0.000), and cost of microbiological studies (p = 0.000), laboratory work-up (p = 0.001) and radiological studies (p = 0.000) . Hospital stay represented more than 60% of costs, followed by pharmaceutical expenses . Cost differences between bacteremic patients and controls, calculated in function of stay median, was 4.424 euros (p = 0.000) and 4.744 euros (p = 0.000) for alternative costs . Ten cases showed a difference that represented more than half of the total difference . CONCLUSIONS: Nosocomial bacteremia represent a stay prolongation and a significant economical burden . Hospital stay and pharmaceutical expenses accounted for the most part of the associated costs . The differences in costs obtained with both methods were small . Since not all selected cases were matched, there may be an error in the appreciation of the difference between cases and controls.

Rocz Panstw Zakl Hig, 2002, 53(2), 141 - 7
{Evaluation of qualitative properties of amaranth (Amaranthus)}; Gajewska R et al.; The work contains results of determination of protein, fat, carbohydrates, water, ash, energy value, B group vitamins (B1, B2, PP, B6) and minerals (Ca, P, Mg, Fe, Na, K, Cu, Mn, Zn, Co, Ni, Cr, Cd, Pb) in three products of amaranth . The nutrients components were determined by general approved analytical methods . Vitamins group B were determined using microbiological methods . Minerals like Ca, Mg, Fe, Na, K, Cu, Mn, Zn, Co, Ni, Cr, Cd and Pb were determined using the flame AAS method . Phosphorus was determined spectrophotometrically as phosphates with ammonium molybdate . Mean percentage content of protein, fat, caborhydrates, water and ash in products of amaranth examined (seeds, meal, expanded seeds "popping") were: 13.5-14.4; 7.1-7.6; 63.8-71.7; 3.0-12.3; 3.1-3.4 respectively; there energy value expressed in Kcal/100 g were 373-412 . Vitamins content in products of amaranth (mg/100 g) were: 0.019-0.029 thiamin; 0.100-0.143 riboflavin; 1.02-1.20 niacinamide and 0.563-0.615 pyridoxin . The levels (mg/100 g) of minerals were as follow: 204-223 Ca; 712-792 P; 8.3-9.7 Fe; 200-235 Mg; 2.9-3.1 Zn; 1.03-1.38 Cu; 3.78-4.54 Mn; 6.30-8.42 Na; 318-337 K; 0.040-0.055 Cr; 0.185-0.292 Ni and 0.045-0.051 Co . Mean contents of cadmium ranged 5-9 micrograms/100 g and lead 27-35 micrograms/100 g in examined products of amaranth.

Kidney Int, 2002 Oct, 62(4), 1447 - 53
Heat sterilization of peritoneal dialysis solutions influences ingestive behavior in non-uremic rats; Zheng ZH et al.; BACKGROUND: The appetite inhibitory effect of glucose-based peritoneal dialysis (PD) solutions may be due to glucose as such, or the hyperosmolality of the PD solution, or an effect of glucose degradation products (GDPs) formed in the PD solution during heat sterilization . This was studied in an experimental appetite model in rat . METHODS: The effect of different experimental PD solutions on ingestive behavior was investigated in non-uremic rats equipped with an implanted intraoral (i.o.) cannula through which a 1 mol/L sucrose solution was infused during tests . The amount of intake was recorded at 30 min after rats were infused intraperitoneally (IP) with 30 mL of different solutions . This method allowed an accurate and reproducible analysis of i.o . intake . The experimental PD solutions tested included (1) glucose based PD solutions with different glucose concentrations, sterilized by heat or microbiological filter, (2) glucose- and mannitol-based PD solutions with the same osmolality, sterilized by heat or microbiological filter; and (3) glucose based PD solutions, using different pH values (pH 3.0, pH 5.5 or pH 7.4) during heat sterilization . RESULTS: Following IP infusion of solutions, (1) the i.o . intake was significantly inhibited by glucose based, heat sterilized PD solutions and the degree of appetite suppression was related to the concentration of dialysate glucose in a dose-dependent way; (2) the i.o . intake was significantly less suppressed by filter sterilized than by heat sterilized glucose-based solutions; (3) the i.o . intake was significantly less following the IP infusion of glucose-based than following the mannitol-based heat sterilized solutions; however, i.o . intake did not differ between the glucose-based and mannitol-based filter sterilized solutions; and (4) furthermore, the degree of suppression of i.o . intake induced by glucose-based PD solutions was influenced by the pH value during heat sterilization . The lower the pH of the PD solution during heat sterilization, the higher the i.o . intake . CONCLUSIONS: The IP infusion of glucose-based heat-sterilized PD solutions inhibited food intake in this experimental appetite model, and the degree of suppression depended on the concentration of dialysate glucose and the pH of the solution during heat sterilization . The results suggest that GDPs formed during heat sterilization may exert a more adverse effect than glucose itself on ingestive behavior, and that a reduction of the concentration of GDPs in the PD solution using filter sterilization or a low pH value in the PD solution during heat sterilization may improve food intake.

Int J Tuberc Lung Dis, 2002 Sep, 6(9), 831 - 8
An outbreak of Legionnaires' disease in an inner city district: importance of the first 24 hours in the investigation; Jansa JM et al.; OBJECTIVE: To present the main results of the investigation of an outbreak of Legionnaire's disease that occurred in an inner city district of Barcelona between 15 October and 15 November 2000 . METHODS: Epidemiological surveys of patients and environmental investigations were initiated on the day the first five cases were notified . Water samples and smears from cooling tower trays were taken for microbiological analysis . Maps of the distribution of cases and possible contamination foci were elaborated . Incidences were calculated for each census tract . RESULTS: A total of 54 patients related to the outbreak were identified, with a case fatality rate of 5.5% . Incidence rate in the area closest to the cooling tower (6.40/1000) was significantly higher than that of the rest of the neighbourhood (2.23/1.000, RR 2.87, 95%CI 1.37-6.12, P = 0.0035) . Cultures positive for Legionella pneumophila serogroup 1, subtypes Pontiac, Philadelphia or Allentown, were obtained from eight patients . On the 39th day of the investigation it was found that the strain isolated in one of the cooling towers coincided with the serogroup, subtype and molecular profiles identified in clinical samples . CONCLUSIONS: Rapid coordination of clinicians, microbiologists, epidemiologists and environmentalists permitted the source of infection and the affected cases to be correlated within a few days.

Int J Tuberc Lung Dis, 2002 Sep, 6(9), 806 - 13
Tuberculosis in children dying with HIV-related lung disease: clinical-pathological correlations; Rennert WP et al.; SETTING: Chris Hani Baragwanath Hospital, Soweto, South Africa . OBJECTIVES: To compare post mortem histological, microbiological and biochemical findings with clinical and radiological data generated ante mortem in children infected with HIV dying from clinical lung disease . METHODS: Post mortem lung and liver biopsies were undertaken on 93 consecutive deaths in children with HIV . Specimens were processed for culture, histology and staining for M . tuberculosis, Pneumocystis carinii pneumonia (PCP) and cytomegalovirus (CMV) . Post mortem diagnoses were compared with clinical and radiological data generated during the final hospitalisation . RESULTS: Tuberculosis (TB) was diagnosed post mortem in four (4.3%) cases; a further 17 (18.2%) patients had been treated empirically for TB before death, and the remaining 72 (77.5%) patients had not been treated for TB . TB was more prevalent in children aged 1 year or older (13.4%) than in younger patients (1.4%) (P < 0.025) . Patients with PCP, CMV pneumonitis or lymphocytic interstitial pneumonitis (LIP) had the same clinical presentation or radiographic appearances as patients with TB . The only features distinguishing patients with TB were older age and ante mortem gastric aspirate cultures positive for M . tuberculosis . CONCLUSION: The diagnosis of TB in children infected with HIV remains difficult . Clinical and radiographic features are shared with other opportunistic diseases . Case identification strategies relying on clinical and radiographic findings lead to overtreatment, particularly in children younger than 1 year of age . Gastric aspirate cultures remain a reliable tool for the identification of infected patients.

J Food Prot, 2002 Sep, 65(9), 1447 - 51
Rapid and simple estimation of microbiological quality of raw milk using chromogenic Limulus amoebocyte lysate endpoint assay; Rhee MS et al.; A rapid chromogenic Limulus amoebocyte lysate (LAL) endpoint assay for the enumeration of total mesophilic microbial loads and coliforms was investigated as a means to assess the microbiological quality of raw milk . For experiment 1, raw milk samples (n = 25) were stored in a refrigerator (2 +/- 2 degrees C) and then analyzed at regular intervals (1, 5, 10, and 15 days) . For experiment 2, fresh raw milk samples (n = 50) were tested to determine the utility of the LAL assay for fresh raw milk . The sample was diluted threefold in a 96-well microtiter plate with pyrogen-free water and assayed with a chromogenic LAL kit to find a final reaction point . The LAL results were compared with standard plate counts (SPC) and coliform counts determined by conventional plating methods . The results of the LAL assay were strongly correlated to conventional SPC (r2 = 0.93; n = 100) and were highly correlated to coliforms (r2 = 0.74; n = 100) . A highly significant linear relationship (r2 = 0.82; n = 50) was also observed between the predicted SPC based on the LAL value and the actual SPC . The results of LAL testing were classified into one of seven contamination groups . The data set for SPC was effectively differentiated using the LAL technique (P < 0.01) . The chromogenic LAL assay was found to be a rapid (within 16 min) and simple (not requiring specific instruments) method for monitoring microbial levels in raw milk . This method may be successfully implemented to rapidly determine highly microbial contaminated raw milk (> 3.0 log10 CFU/ml of SPC).

Probl Tuberk, 2002, (6), 33 - 7
{Migration of CD4+ and CD8+ lymphocytes into the internal lining of tuberculous pleural empyema and tuberculous caverns during their local sanitation}; Trusov VN et al.; Cytological, immunological, and microbiological findings after sanitation of pulmonary caverns and pleural empyemas were analyzed in 13 patients: 7 with empyemas of residual pleural cavities after surgery for pulmonary tuberculosis and 6 with fibrocavernous pulmonary tuberculosis . It has been found that target sanitation of the intrapulmonary and intrapleural cavities enhances lymphocytic penetration into the internal part of the cavitary wall, infiltrating lymphocytes represent mainly CD4+ cells whose count progressively increases with successful sanitation, as appeared as a significant rise in both the so-called immunoregulatory index (CD4+/CD8+ ratios of 3.4 to 6.1) . A study of the populational composition of lymphocytes promotes an objective evaluation of the magnitude of a specific tuberculous inflammatory process in the wall of the cavity of empyemas and caverns.

Anesteziol Reanimatol, 2002 Mar-Apr, (2), 23 - 5
{Possibilities of fiber bronchoscopy in complex diagnosis and treatment of inhalation injuries of the tracheobronchial tree}; Volkov SV et al.; The treatment of patients with burn injuries of the tracheobronchial tree is a pressing problem today, because of rather high prevalence of this injury and high mortality (90%) . Clinical signs during the first 24 h do not allow evaluating the severity of the injury . Based on analysis of case histories of 24 patients, the authors sum up results of complex examinations including fibrobronchoscopy, microbiological, and histological studies . Fibrobronchoscopy precisely showed the degree and extension of airway involvement in burn injuries, while accessory microbiological and histological studies help timely predict the development of pyoseptic complications . Endoscopic methods of therapy promote a more rapid reduction of inflammation and healing of erosive ulcerative involvement of the tracheobronchial mucosa.

J Environ Health, 2002 Sep, 65(2), 29 - 36
Where we are in retail food safety, how we got to where we are, and how do we get there?
Bryan FL.
Food safety has not yet been attained . This is evident from reported foodborne-disease outbreaks, laboratory-confirmed cases of diseases that can be foodborne, estimates of foodborne illness based on surveillance data, and out-of-compliance risk factors . Several activities have had an impact on food safety, but there are limitations in the way each of those activities has been or is being conducted . The activities include foodborne-disease surveillance; food sampling and testing; swabbing and testing of utensils; inspection and enforcement of regulations; use of the Food Code; on-site hazard analyses, on-site monitoring of critical control points and prompt corrective actions; applied research and challenge testing; training of public-health and food regulatory personnel; training of food workers, supervisors, and managers; and education of the public . To attain food safety, we must use common (microbiological) sense and understand the principles of transmission of foodborne-disease etiological agents and their control . A change of attitudes and program focus is necessary.

Trop Med Int Health, 2002 Sep, 7(9), 788 - 92
Epidemiological aspects of mycetoma from a retrospective study of 264 cases in West Bengal; Maiti PK et al.; Between 1981 and 2000, 264 cases of mycetoma were diagnosed clinically and microbiologically at Calcutta School of Tropical Medicine . Retrospective analysis of the records revealed that the ratio of actinomycetomas and eumycetomas was 197 : 67; the male to female ratio was 183 : 81 . Ninety-four cases occurred in the 1980s and 170 in 1990s, with significantly more infections of Actinomadura spp . (P < 0.01) and fewer with Nocardia caviae (P < 0.01) during the last decade . Pricking was the most common injury associated with eumycetomas (P < 0.01) . A total of 196 infections were in exposed body parts and 68 in covered areas . The localization of mycetomas differed significantly (P < 0.01) according to sex, incidence of actinomycetomas or eumycetomas, and obvious history of trauma . Exposed area cases were more common among agricultural workers (P < 0.01), while covered area mycetomas were almost always actinomycetomas with a remarkably lower incidence of N . caviae, A . madurae and Madurella grisea infections . The peak age of onset was between 16 and 25 years . The delay of diagnosis for the 80th percentile of cases was around 6 years for cases caused by N . brasiliensis and Streptomyces spp.; 8 years for N . caviae and N . asteroides; and 10 years for M . grisea and Actinomadura spp . From the history of trauma in 130 patients, the 80th percentile incubation period (IP) was calculated for N . brasiliensis, N . caviae and N . asteroides as 3 years; for Actinomadura spp . 7 years and for M . grisea 9 years . The minimum IP for all organisms was around 3 months.

Nahrung, 2002 Aug, 46(4), 258 - 69
Controlling organic chemical hazards in food manufacturing: a hazard analysis critical control points (HACCP) approach; Ropkins K et al.; Hazard analysis by critical control points (HACCP) is a systematic approach to the identification, assessment and control of hazards . Effective HACCP requires the consideration of all hazards, i.e., chemical, microbiological and physical . However, to-date most 'in-place' HACCP procedures have tended to focus on the control of microbiological and physical food hazards . In general, the chemical component of HACCP procedures is either ignored or limited to applied chemicals, e.g., food additives and pesticides . In this paper we discuss the application of HACCP to a broader range of chemical hazards, using organic chemical contaminants as examples, and the problems that are likely to arise in the food manufacturing sector . Chemical HACCP procedures are likely to result in many of the advantages previously identified for microbiological HACCP procedures: more effective, efficient and economical than conventional end-point-testing methods . However, the high costs of analytical monitoring of chemical contaminants and a limited understanding of formulation and process optimisation as means of controlling chemical contamination of foods are likely to prevent chemical HACCP becoming as effective as microbiological HACCP.

J Fr Ophtalmol, 2002 Jun, 25(6), 590 - 3
{Fungal contamination detection in cornea preservation media}; Rousset A et al.; PURPOSE: Fungi can cause major complications following corneal grafting . In this study we aimed to verify the efficiency of a fungal contamination detection protocol for human corneas in preservation before clinical use . Materials and methods: The 12 most frequently found species of fungi responsible for keratitis and endophthalmitis were inoculated to preservation medium used by most French eye banks . A protocol used by several centers, including a daily visual control, was followed in order to check that it showed the presence of all microorganisms, particularly slow-growing filamentous fungi . RESULTS: Every species was detected in a time from 2 to 4 days . CONCLUSION: This microbiological contamination detection protocol of detection for human corneas in organ culture at +31 degrees C, seems to effectively detect the main agents responsible for fungal contamination.

Plant Physiol, 1997 Sep, 115(1), 299 - 309
Distribution of Folate Derivatives and Enzymes for Synthesis of 10-Formyltetrahydrofolate in Cytosolic and Mitochondrial Fractions of Pea Leaves; Chen L et al.; Leaf extracts of 14-d-old pea (Pisum sativum L . cv Homesteader) seedlings were examined for folate derivatives and for 10-formyltetrahydrofolate synthetase (SYN), 5,10-methenyltetrahydrofolate cyclohydrolase (CYC), and 5,10-methylenetetrahydrofolate dehydrogenase (DHY) activities . Microbiological and enzyme assays showed that leaf folates SYN, CYC, and DHY were predominantly cytosolic . Extracts of Percoll gradient-purified mitochondria contained less than 1% of total leaf folate and less that 1% of each enzyme activity . Fractionation of whole-leaf homogenates resulted in the copurification of DHY and CYC (subunit 38 kD) and the isolation of a SYN protein (subunit 66 kD) . Polyclonal antibodies were raised against purified cytosolic DHY-CYC (DHY-CYC-Ab) and cytosolic SYN (SYN-Ab), respectively . Immunoblots showed that DHY-CYC-Ab cross-reacted with a mitochondrial protein band (38 kD) . Two mitochondrial protein bands (subunit Mr = 40,000 and 44,000) cross-reacted with SYN-Ab . Immunoaffinity chromatography (DHY-CYC-Ab as the immobile ligand) indicated that the bulk of mitochondrial SYN activity was not associated with mitochondrial DHY or CYC . When 9-d-old etiolated pea seedlings were exposed to light for up to 3 d, the specific enzyme activities of DHY-CYC in whole-leaf extracts rose 2-fold and more DHY-CYC-Ab cross-reacting protein was detected . In contrast, the specific activity of SYN fell from 5 to 1 {mu}mol min-1 mg-1 protein and less SYN-Ab cross-reacting protein was detected . The data suggest that in pea leaves, the bulk of one-carbon-substituted tetrahydrofolates and enzymes for the generation of 10-formyltetrahydrofolate are extra-mitochondrial.

J Am Med Inform Assoc, 2002 Sep-Oct, 9(5), 500 - 8
Basic microbiologic and infection control information to reduce the potential transmission of pathogens to patients via computer hardware; Neely AN et al.; Computer technology from the management of individual patient medical records to the tracking of epidemiologic trends has become an essential part of all aspects of modern medicine . Consequently, computers, including bedside components, point-of-care testing equipment, and handheld computer devices, are increasingly present in patients' rooms . Recent articles have indicated that computer hardware, just as other medical equipment, may act as a reservoir for microorganisms and contribute to the transfer of pathogens to patients . This article presents basic microbiological concepts relative to infection, reviews the present literature concerning possible links between computer contamination and nosocomial colonizations and infections, discusses basic principles for the control of contamination, and provides guidelines for reducing the risk of transfer of microorganisms to susceptible patient populations.

Biodegradation, 2002, 13(1), 41 - 52
Assessment of soil contamination--a functional perspective; van Straalen NM; In many industrialized countries the use of land is impeded by soil pollution from a variety of sources . Decisions on clean-up, management or set-aside of contaminated land are based on various considerations, including human health risks, but ecological arguments do not have a strong position in such assessments . This paper analyses why this should be so, and what ecotoxicology and theoretical ecology can improve on the situation . It seems that soil assessment suffers from a fundamental weakness, which relates to the absence of a commonly accepted framework that may act as a reference . Soil contamination can be assessed both from a functional perspective and a structural perspective . The relationship between structure and function in ecosystems is a fundamental question of ecology which receives a lot of attention in recent literature, however, a general concept that may guide ecotoxicological assessments has not yet arisen . On the experimental side, a good deal of progress has been made in the development and standardized use of terrestrial model ecosystems (TME) . In such systems, usually consisting of intact soil columns incubated in the laboratory under conditions allowing plant growth and drainage of water, a compromise is sought between field relevance and experimental manageability . A great variety of measurements can be made on such systems, including microbiological processes and activities, but also activities of the decomposer soil fauna . I propose that these TMEs can be useful instruments in ecological soil quality assessments . In addition a "bioinformatics approach" to the analysis of data obtained in TME experiments is proposed . Soil function should be considered as a multidimensional concept and the various measurements can be considered as indicators, whose combined values define the "normal operating range" of the system . Deviations from the normal operating range indicate that the system is in a condition of stress . It is hoped that more work along this line will improve the prospects for ecological arguments in soil quality assessment.

Int J Food Microbiol, 2002 Sep 15, 78(1-2), 57 - 77
Physiological and mathematical aspects in setting criteria for decontamination of foods by physical means; Smelt JP et al.; In heat processing, microbial inactivation is traditionally described as log-linear . As a general rule, the relation between rate of inactivation and temperature is also described as a log-linear relation . The model is also sometimes applied in pressure and in pulsed electric field (PEF) processing . The model has proven its value by the excellent safety record of the last 80 years, but there are many deviations from log-linearity . This could lead to either over-processing or under-processing resulting in safety problems or, more likely, spoilage problems . As there is a need for minimal processing, accurate information of the inactivation kinetics is badly needed . To predict inactivation more precisely, models have been developed that can cope with deviations of linearity . As extremely low probabilities of survival must be predicted, extrapolation is almost always necessary . However, extrapolation is hardly possible without knowledge of the nature of nonlinearity . Therefore, knowledge of the physiology of inactivation is necessary . This paper discusses the physiology of denaturation by heat, high pressure and pulse electric field . After discussion of the physiological aspects, the various aspects of the development of inactivation models will be addressed . Both general and more specific aspects are discussed such as choice of test strains, effect of the culture conditions, conditions during processing and recovery conditions and mathematical modelling of inactivation . In addition to lethal inactivation, attention will be paid to sublethal inactivation because of its relevance to food preservation . Finally, the principles of quantitative microbiological risk assessment are briefly mentioned to show how appropriate inactivation criteria can be set.

Int J Food Microbiol, 2002 Sep 15, 78(1-2), 3 - 17
New directions in foodborne disease prevention; Schlundt J; Food safety is an important part of public health linking health to agriculture and other food production sectors . For over a century, developments in food production and new control philosophies have contributed to food safety systems in most developed countries perceived by many to be efficient in the prevention of foodborne disease . Nevertheless, a number of problems still remain dominant, one of these being the high level of foodborne microbiological diseases which seem, for some pathogens, to have increased over the last decades . Although there is an urgent need for better foodborne disease data in most countries, the paper attempts an analysis of the background to these problems using available data to illustrate the developments for some of the major foodborne pathogens . Some of the shortcomings of present food safety systems are discussed, as are new principles to improve food safety strategies . A new paradigm for the integration of research data, food-control monitoring, epidemiological investigations and disease surveillance in a renewed effort to manage and lower foodborne risk is presented . Within this paradigm, the development of an interdisciplinary approach with direct interaction between surveillance and risk analysis systems is described as a potential basis for improved foodborne disease prevention . Specific consideration is given to the situation in developing countries, suggesting a leap forward past the experience of noncollaboration between the disciplines in many developed countries . Today, food safety is one of WHO's top 11 priorities and the Organisation calls for more systematic and aggressive steps to be taken to significantly reduce the risk of microbiological foodborne diseases . Dealing with this challenge is one of the major challenges for the 21st century in regard to food safety, implying a significant redirection of food microbiology efforts in many parts of the world.

Aviakosm Ekolog Med, 2002, 36(3), 58 - 61
{A system for biomaterial handling and sample pretreatment in conditions of weightlessness}; Noskov VB et al.; To perform laboratory biochemical, immunologic and microbiological analyses and special pretreatment and stabilization of biosamples immediately on the space station, system Plasma-03 was designed and manufactured and associated procedure for sample collection and pretreatment was developed . Main elements of the system are a refrigerator/thermostat, centrifuge and returnable container, and a set of accessories and expendables . The system meets the requirements to the equipment to be employed in crew health monitoring and biochemical experiments on board the International space station.

Pharmacol Res, 2002 Aug, 46(2), 171 - 5
Selenium pretreatment prevents bacterial translocation in rat intestinal ischemia/reperfusion model; Ozturk C et al.; Protective role of selenium against free radical damage was first demonstrated in the heart and this effect was further questioned in other systems . In the present study, the effects of exogenously administered selenium on intestinal fine morphology, lipid peroxidation, and bacterial translocation (BT) in experimental intestinal ischemia/reperfusion (I/R) model were examined . Thirty-two male Wistar rats weighing 250-300 g were randomized into four groups . Sham group (n=8) underwent laparotomy only . In the I/R group (n=8), laparotomy was performed and the superior mesenteric artery was occluded using an atraumatic microvascular clamp for 30 min . In corresponding selenium-treated groups (n=8 each), sodium selenate was given 0.2 mg kg(-1)day(-1) intraperitoneally (i.p.) for 3 consecutive days, prior to surgery for either laparotomy only or with I/R . Twenty-four hours later, tissue samples from liver, spleen, and mesenteric lymph nodes were obtained under sterile conditions for microbiological analysis and further evaluation of I/R-induced intestinal injury . Ileum samples were fixed in 10% formaldehyde for histopathological evaluation . In the I/R group, the incidence of bacteria-isolated mesenteric lymph nodes, spleen, and liver was significantly higher than other groups (P<0.05) . Selenium supplementation prevented I/R-induced BT and significantly reduced the I/R-induced intestinal injury (P<0.05) . Tissue MDA levels from the ileum specimens of selenium-treated rats were significantly lower than that of the I/R group (P<0.05) . Our results provide evidence that the relationship between BT and lipid peroxidation in intestinal tissue is crucial . Selenium pretreatment reduces lipid peroxidation which contributes to the maintenance of intestinal mucosal integrity.

J Oral Pathol Med, 2002 Sep, 31(8), 468 - 72
Betel quid-associated oral lesions and oral Candida species in a female Cambodian cohort; Reichart PA et al.; BACKGROUND: Betel quid chewing (BQC) is still prevalent among elderly Cambodian women and is associated with a wide variety of oral mucosal lesions . BQC has also been associated with a reduced rate of dental caries and changes in the oral microbiological flora . METHODS: Since no studies were available on the impact of BQC on the oral carriage of Candida species, in this study oral swabs (Fungiquick, Hain Diagnostika, Germany) were taken from the tongue and palate of 48 Cambodian women with BQC habit (study group) and 13 control subjects without BQC habit (control group) to determine the spectrum of Candida species in these two groups . In addition, we investigated lesions of the oral mucosa likely to be associated with BQC habit in both study and control groups . RESULTS: The median duration of BQC was 10 years (range 10 months-30 years) . The following oral lesions were found in the study group: betel chewer's mucosa (85.4%), oral leukoplakia (8.3%), leukoedema (37.5%) and oral lichen planus (4.2%) . Oral candidiasis was seen neither in BQ-chewers nor in controls . Candida spp . were found in 70.8% of the cases (controls 69.2%) . Whilst C . albicans was isolated from 27.1% of the study cohort, C . tropicalis was the second most common isolate . One control case was colonised by C . dubliniensis--the first report of this organism from a Cambodian population . There was no significant difference in the candidal carriage rate or the Candida species isolated between the study and the control group . CONCLUSIONS: Mycological findings from the present study do not indicate that BQC has a significant effect on oral colonisation by Candida species.

Dev Biol (Basel), 2002, 108, 59 - 67
Incidence and significance of the bacterial contamination of blood components; Blajchman MA; A septic reaction occurring during or following the transfusion of cellular blood components was one of the earliest recognized complications of allogeneic blood transfusions . The presence of bacteria in blood products has been a problem for many decades and currently it is probably the most common microbiological cause of transfusion-associated morbidity and mortality . Transfusion-associated sepsis due to contaminated platelet concentrates appears to be much more common than those due to red cells . The overall prevalence of contaminated cellular blood products (red cells and platelets) is approximately one in 3000; however, the transfusion to a recipient of a contaminated blood product may not necessarily be associated with clinically evident morbidity . This is because the majority of contaminated blood product units contain only few bacteria . In other instances, contaminated units may contain large numbers of virulent bacteria as well as endotoxins, and their transfusion may be associated with significant morbidity and even be lethal to the recipient . The prevalence of severe episodes of transfusion-associated sepsis has not been clearly established, but is probably of the order of one in 50,000 per platelet unit and one in 500,000 per red cell unit transfused . As a result of the increased recognition that such transfusion-associated episodes can occur, a variety of measures have been proposed to try to prevent and/or control the risk of transfusion-associated septic reactions.

Life Sci Space Res, 1971, 9, 65 - 8
Microbiological problems of manned space flight; Spizizen J; The hazard of infectious disease in long-duration manned space flight is discussed in relation to the unique conditions of spacecraft environment . Confinement in a small, enclosed volume, special problems of waste disposal and personal hygiene, zero gravity, and high oxygen content present special features that favor transmission of micro-organisms . Alterations in microbial flora will occur and these will influence host defenses against disease . Genetic variants of micro-organisms could be induced by and selected under the unique conditions of space flight . A reduction in the variety of microbial flora could result in "microbial shock" on re-entry . The influence of environmental conditions of the spacecraft on host defenses against infection is unpredictable in the absence of investigative work . However, pre-flight assessment of immune status is recommended . A graduated pre-flight isolation period is highly recommended to permit exchange of flora, to protect astronauts from new agents, and to allow most infections to emerge.

J Postgrad Med, 2002 Apr-Jun, 48(2), 113 - 6
Correlation of fine needle aspiration cytology, smear and culture in tuberculous lymphadenitis: a prospective study; Nataraj G et al.; BACKGROUND AND AIM: Bacteriological studies are necessary to confirm the diagnosis of tuberculous lymphadenitis, as cytological appearances mimic other granulomatous lesions . The objective was to assess the diagnostic role of culture of fine needle aspiration done on clinically suspected cases of tuberculous lymphadenitis and to determine the prevalence of drug resistance in M . tuberculosis isolates . SETTING AND DESIGN: A prospective, double-blind study over a period of one year in a tertiary care hospital . MATERIAL AND METHODS: Fine needle aspiration cytology and culture were done on 250 patients with clinical suspicion of tuberculous lymphadenitis . STATISTICAL ANALYSIS: Data was statistically analysed using chi square test . Sensitivity, specificity, positive predictive and negative predictive values and likelihood ratio were also calculated . RESULT: Of the 161 cytologically or microbiologically proven cases of tuberculous lymphadenitis, cytological changes consistent with tuberculosis were observed in 133 patients, out of which mycobacteria were isolated in 102 aspirates . Mycobacteria were also isolated from 28 aspirates cytologically missed as tuberculous lymphadenitis . Of the 130-mycobacterial isolates, 5 were non-tuberculous mycobacteria . Culture positivity was significantly higher (P<0.001) than smear positivity . Drug susceptibility studies showed resistance to one or more drugs in 61% of isolated strains with maximum resistance to isoniazid (16% primary and 48% secondary) and minimum to ethambutol (4% primary and 12% secondary) . CONCLUSION: Culture for mycobacteria should be carried out on all aspirates from patients suspected with tuberculous lymphadenitis.

Acta Otolaryngol Suppl, 2002, (548), 30 - 3
Autoimmunity in sudden sensorineural hearing loss: possible role of anti-endothelial cell autoantibodies; Cadoni G et al.; In order to verify whether anti-endothelial cell autoantibodies (AECAs) can be used as serological markers of inner ear vasculitis in sudden sensorineural hearing loss (SSHL), 32 patients affected by idiopathic SSHL were investigated . All patients underwent a routine general physical examination and extensive audiovestibular, microbiological and immunological investigations . Fourteen normal subjects without a history of HL, autoimmune or metabolic disease served as controls . Detection of AECAs was performed using an indirect immunofluorescence technique . AECA-positive patients were treated with methylprednisone, while AECA-negative patients were treated with a combined regimen of steroids, plasma expander and aspirin . The average hearing recovery for 5 frequencies (0.25-4 kHz) was analyzed in each subject 1 month after treatment and every 3 months thereafter; median follow-up was 12 months (range 9-18 months) . A total of 15/32 patients (46.8%; 11/19 females, 4/13 males) were AECA-positive and thus differed significantly from the normal population in whom only 2/14 tested cases were positive (p = 0.03) . Severe hearing loss was associated with being AECA-positive in 8/11 cases . During follow-up, 25/32 patients improved their hearing and 17 of these patients were AECA-negative . The seven cases without hearing improvement were all AECA-positive . In patients with SSHL, immune-mediated vascular damage may have a pathogenetic role and AECAs may represent a serological marker of vasculitis even if they are not inner ear-specific and even if they represent an epi-phenomenon rather than the only cause of SSHL.

Bone Marrow Transplant, 2002 Sep, 30(5), 303 - 9
Early infections in adults undergoing matched related and matched unrelated/mismatched donor stem cell transplantation: a comparison of incidence; van Kraaij MG et al.; We compared the incidence of early infectious complications between matched related (MR) and matched unrelated/mismatched (MU/MM) allogeneic stem cell transplant (allo-SCT) recipients in a single centre over a 6-year period in 214 consecutive adult patients . Early infections were defined as occurring from hospital admission for SCT until discharge . One hundred and fifty-nine patients received an allograft from MR donors and 55 patients received MU/MM allo-SCT . One hundred and eight of 214 patients had 147 episodes of fever . Ninety-three episodes (63%) were due to clinically or microbiologically documented infections and 54 episodes (37%) to fever not related to infection . Patients undergoing MU/MM transplantation tended to have more documented infections compared to recipients of MR allo-SCT (P = 0.06) . Significantly more MU/MM transplant recipients had breakthrough infections with Herpes simplex virus type 1 (HSV-1, P = 0.003), and more CMV reactivation (P = 0.015) . The mortality rate in all patients during hospitalisation post-SCT was 6.3% in MR and 18.2% in MU/MM allo-SCT recipients (P = 0.009) . Early mortality was associated with infection in 70% of the patients, with a similar distribution between MR and MU/MM transplant recipients . However, MU/MM transplant recipients had significantly more early deaths due to toxic causes (P < 0.001) . We conclude that early post-transplant MU/MM transplant recipients tend to have more documented infections, and have significantly more breakthrough infections with HSV-1 and more CMV reactivation . MU/MM transplant recipients are at higher risk of early mortality, especially due to toxic causes.

Am J Ophthalmol, 2002 Sep, 134(3), 435 - 8
Colletotrichum keratitis; Fernandez V et al.; PURPOSE: To evaluate Colletotrichum keratitis and to report the risk factors and clinical course . DESIGN: Interventional case series . METHODS: In order to report the clinical course of Colletotichum keratitis, fungal keratitis cases between January 1980 and February 2001 in an institutional setting were retrospectively reviewed and 10 eyes of 9 patients with Colletotrichum keratitis were identified by positive cultures . RESULTS: Colletotrichum species were identified in 10 of 360 culture-proven fungal keratitis cases . All cases were sensitive to amphotericin B, three of the isolates showed resistance to natamycin, two isolates had intermediate sensitivity to natamycin, and one isolate was resistant to fluconazole . Natamycin 5% was used as the initial antifungal agent in eight microbiologically proven fungal keratitis cases . Two of nine patients continued the treatment with amphotericin B 0.15% after the sensitivity results were obtained . CONCLUSION: Colletotrichum is an infrequent cause of fungal keratitis . The risk factors are similar to the known fungal keratitis . Colletotrichum is resistant to natamycin in vitro; however, all our patients responded well to this treatment while resistance or intermediate sensitivity to natamycin and resistance to fluconazole was observed.

Med Hypotheses, 2002 Oct, 59(4), 373 - 7
Parkinson's: another look; Broxmeyer L; Recent studies in the Parkinson's literature have cited a tuberculosis-like germ called Nocardia as being responsible for Parkinson's disease . Kohbata seemingly cemented a relationship between Nocardia and Parkinson's by finding serologic evidence in 20 of 20 Parkinson's patients, acknowledging that blood tests for Nocardia and the mycobacteria such as tuberculosis often cross-react, as they belong to the same order of bacteria, the Actinomycetales . Besides this difficulty in differentiation, a well-used medical school textbook of microbiology, Atlas, points out that even among experts, different observers may classify the same strain of bacteria as Nocardia or Mycobacterium tuberculosis . Parkinson's: another look is a theoretical article which presents compelling, well-documented evidence for an infectious cause for Parkinson's disease on historical, epidemiological, pharmacologic, microbiological, and biochemical levels.

Int J Dermatol, 2002 Aug, 41(8), 491 - 3
Perianal actinomycetoma experience of 20 cases; Chavez G et al.; BACKGROUND: Actinomycetoma is a chronic infection resulting from aerobic Actinomycetes . The major agents are Nocardia brasiliensis, Actinomadura madurae, and Streptomyces somaliensis . The most frequent topographies are the lower and upper limbs . The prognosis of this disease is determined by several factors, such as etiologic agent, clinical topography, and depth of disease (degree of involvement, visceral, and bone affection) . The purpose of this paper was to present our experience with actinomycetoma of the perianal region . METHODS: This study comprises 20 cases of perianal actinomycetoma, all of which were clinically and microbiologically proven by direct examinations, cultures, and biopsies . Clinical responses to the two principal treatment regimes used {combination of trimethoprim-sulfamethoxazole (TMS/SMX) and diaminodiphenylsulfone (DDS) or amikacine plus TMS/SMX} are reported . RESULTS: Most of the cases were male (17/20, 85%), the mean age was 42.1 years, and the farmers predominated (90%) . The principal etiologic agent isolated was N . brasiliensis (85%) . CONCLUSIONS: Perianal actinomycetoma is a rare entity . Differential diagnosis with anal sinuses, hydroadenitis, and cutaneous tuberculosis must be made in endemic areas by performing mycologic tests and biopsies . Treatment depends on the etiologic agent involved and the patient's condition.

FEMS Microbiol Lett, 2002 Aug 27, 214(1), 39 - 43
A multiplex-PCR for the differentiation of Mycobacterium bovis and Mycobacterium tuberculosis; Shah DH et al.; A multiplex-polymerase chain reaction (PCR) assay based on one-step amplification and detection of two different mycobacterial genomic fragments was designed for differentiation of Mycobacterium bovis and Mycobacterium tuberculosis . The oligonucleotide primers were chosen from a 500-bp genomic fragment which is well conserved in M . bovis and the pncA gene (based on M . tuberculosis-specific nucleotide polymorphism, a cytosine residue at position 169), specific for M . tuberculosis . The multiplex-PCR allowed detection of a single product of 500 bp in M . bovis isolates while M . tuberculosis isolates generated a single product of 185 bp, with or without an additional product of 500 bp . None of the atypical mycobacterial isolates revealed any amplification products . The method was found to be highly specific and could detect as little as 20 pg of pure DNA . This multiplex-PCR assay, based on the 500-bp fragment and the pncA gene, may be very useful for the rapid and specific differentiation of these two closely related mycobacteria and easy to use in medical and veterinary microbiological laboratories.

Surg Today, 2002, 32(9), 849 - 52
Retroperitoneal schwannoma misdiagnosed as a psoas abscess: report of a case; Kishi Y et al.; A retroperitoneal cystic mass compressing the right psoas muscle was found incidentally by ultrasonography in a 67-year-old woman . The radiological findings and a history of costal caries led us to suspect a psoas cold abscess . Ultrasound-guided needle aspiration was done to establish the diagnosis and to drain the content, but only a small amount of sterile fluid was obtained . The patient complained of neuralgia in her right leg at the time of puncture . Under the preoperative diagnosis of a neurogenic tumor, the mass was surgically resected, and found to be filled with old blood . The solid region consisted of a proliferation of fusiform cells, leading to a diagnosis of benign schwannoma . Retroperitoneal schwannoma is often misdiagnosed as an adjacent anatomical structure . Thus, we conclude that both microbiological and cytological examination of an aspiration specimen is important when psoas abscess is considered in a differential diagnosis.

Rev Clin Esp, 2002 Aug, 202(8), 416 - 20
{Prognostic factors of mortality during the episode of pneumonia due to Pneumocystis carinii in patients with HIV infection}; Fernandez Cruz A et al.; BACKGROUND: Despite a steady decrease in its incidence, pneumonia caused by Pneumocystis carinii (PCP) are still diagnosed, and they occur frequently in patients unaware of being infected with the human immunodeficiency virus (HIV) . Since it is a disease with a high mortality risk, its early diagnosis and therapy would allow these patients to benefit from the advantages afforded Pneumocystis carinii, neumonia, infecciones oportunistas relacionadas con el sida, pronostico.by anti-retroviral therapy . PATIENTS AND METHODS: Retrospective study, in which all adult HIV infected patients with microbiologically demonstrated PCP diagnosed at two tertiary-level hospitals in our country between 1985 and 1996 were included . The clinical records of patients were used as information source . The relative risks (RR) of death were estimated by the multivariant logistic regression . RESULTS: PCP was the first AIDS indicating disease in approximately 70 % of cases . Thirteen percent of patients died during the episode . Patients aged over 45 years had a death RR during the episode of 3.15 (95 % CI from 0.8 to 12.2); patients previously diagnosed of AIDS had a death RR of 3.4 (95 % CI from 1.3 to 9), and those with an alveolar-arterial oxygen gradient (pA-aO2) > 50 mmHg, a death RR of 3 (95% CI from 1.1 to 8) . CONCLUSIONS: Factors independently related to survival to the PCP episode are age below 45 years, not to have had another AIDS indicating disease, and to have a pA-aO2 below 50 mmHg at diagnosis.

Life Sci Space Res, 1965, 3, 120 - 6
On artificial Martian conditions reproduced for microbiological research; Zhukova AI et al.; 1 . It is of interest to investigate the behaviour of the terrestrial microorganisms under artificial Martian conditions . This will help to verify the hypothesis concerning a possibility of life on this planet . 2 . An artificial climate chamber enables one to expose microbial cells to a simultaneous effect of such factors as temperature, pressure, gas composition and insolation: a) Temperature regime is maintained automatically by means of an electronic mechanical programme device . b) A sealed chamber insures a permanent gas mixture pressure equal to 0.1 atm . c)The spectral composition of light source is close to that of the sun spectrum . d)The chamber enables to expose microorganisms on membrane filters with diameter of 23 mm or in special quartz cells of the same diameter size . 3 . The preliminary experiments have shown that not all the terrestrial forms of microorganisms do survive under artificial conditions of the Martian summer.

Uisahak, 2000 Jun, 9(1), 54 - 62
{Development of National Institute of Health, Korea}; Lee JS et al.; The National Institute of Health (NIH) under the Ministry of Health and Welfare of the Korean Government was established in 1963, integrating four institutes: National Institute of Health, National Chemical Laboratories, National Laboratory of Herb Medicine and National Institute of Public Health Training . The root, however, goes down to the Bacteriology Laboratory, opened in 1912 with the function for microbiological testing and pox vaccine development, which was absorbed into the former National Institute of Health in 1948 when the government of the Republic of Korea was inaugurated . The Institute opened a satellite office, the Masan Branch in 1977, and was further expanded, adding the Divisions of AIDS and Biotechnology in 1988 . In 1996, as part of restructuring the Government organizations, Korea Food and Drug Administration (KFDA) ws founded by expanding the Toxicology Research Institute, to which all the functions of testing and certifying foods and drugs were transferred . Simultaneously, a new department, the Department of Biomedical science was organized, which currently consists of five divisions; the Divisions of Cancer Research, Degenerative Diseases, Cardiovascular Diseases, Metabolic Diseases and Genetic Diseases . In 1999, in order to provide a rapid and effective disease control, the Department of Communicable Diseases was newly founded, merging the Division of Disease Control and Prevention from the Ministry of Health and Welfare . With these steady and significant changes, the NIH, together with the training of health manpower, has become the national organization for research, prevention and control of various diseases of public health importance in Korea.

Life Sci Space Res, 1969, 7, 21 - 7
Discussion of a possible contamination of space with terrestrial life; Bucker H et al.; Theoretical considerations were made on what forces and energies affect a particle the size of a microorganism near the Earth and what conditions result for the particle . A transfer of terrestrial life to other celestial bodies seems impossible unless it is done by a spacecraft . This possibility cannot be excluded even after sterilization of the spacecraft on Earth, for in higher layers of the atmosphere the spacecraft could be contaminated again . In this case microorganisms would be subjected to a space flight where decompression is much slower initially than is the case on leaving the Earth's surface with the spacecraft . With these considerations, experiments on microorganisms were carried out in a vacuum chamber . For testing the effect of vacuum on the rate of desorption, mainly of water, measurement was made by a mass spectrometer . In the experiments the decompression rate was varied and different microbiological forms were used, namely, spores and vegetative cells of different cell wall structures . Further experiments in the ultrahigh-vacuum range are necessary and the problems involved are discussed.

Life Sci Space Res, 1969, 7, 207 - 8
Some results of radiobiological studies performed on Cosmos-110 biosatellite; Antipov VV et al.; The experiment carried out on the Cosmos 110 biosatellite is a step further in radiobiological investigations performed in outer space and differs appreciably from flight experiments conducted on board the Vostok and Voskhod spacecraft . The difference lies, firstly, in the integral dose of cosmic radiation . According to the onboard dosimeter readings, it was 12 rad at an average dose rate of 500 mrad/day during the biosatellite flight, whereas in previous biological flight experiments, as is well known, the total dose was below 80 mrad (on a five-day flight of Vostok 5) at a dose rate of 80 to 20 mrad/day . Secondly, during the biosatellite mission, cosmic radiation originated not from the primary cosmic radiation as was the case in the Vostok and Voskhod flights but mainly from the Earth's radiation belts . Thirdly, the duration of the Cosmos 110 flight was far longer than that of any previous mission: the effect of weightlessness lasted for about 22 days . The paper presents results of investigations performed on E . coli K-12 lambda lysogenic bacteria, Tradescantia microspores, dry seeds of higher plants, different Chlorella strains and an intact plant of Tradescantia paludosa . The biological effect of space flight factors was evaluated by various physiological, cytogenetic, genetic and microbiological techniques . Similar to previous experiments carried out on board the Vostok 3-6 spacecraft, tests with lysogenic bacteria revealed a statistically significant induction of moderate bacteriophage . The induction value was shown to lag behind the mission duration dependence level . This seems to be related to a change of inducibility properties of lysogenic bacteria and a reduction of the yield range of phages per bacterial cell . Other tests (duration of the latent period, formation pattern of phage components) indicated no significant differences between test and control objects (N.N . Zhukov-Verezhnikov, N.I . Rybakov, V.A . Kozlov et al.) . A study of protective properties of chemical compounds of different types in relation to the bacteriophage induction demonstrated that preparations of the aminothiolic group produced a high antimutagenic effect (V.A . Kozlov, N.I . Rybakov et al.) . A postflight cytological analysis of Tradescantia paludosa microspores indicated their changes of three types: chromosome aberrations, mitotic disturbances and disorders of growth processes in the cell . Examinations of dry seeds of wheat, barley, pine and other plants, as well as of Allium cepa bulbs, gave evidence of a diverse effect of space flight factors on both physiological processes and hereditary structures of the objects . In some cases an increased percentage of seed germination, stimulation of their growth and a significant increase of aberrations were found . An investigation of the occurrence frequency of visible mutations in reaction cell cultures of different Chlorella strains (LARG-1, LARG-3 and others) showed no significant differences between the test and control material . Some cultures taken under a more detailed study indicated a delay with which cells entered the first sporulation and a greater amount of cells that divided into a lesser than usual number of autospores . In addition, test variants of the strains showed a slightly reduced survival of Chlorella cells . The reduction appeared to be statistically significant for the LARG-3 strain only (E.N . Vaulina et al.) . A postflight examination of the appearance of the Tradescantia paludosa plant showed that it retained good turgor; its leaves were dark green and several bright flowers bloomed . No signs of its inhibition or etiolation were noted . As compared to the control, the test plant grew noticeably and the stem became crooked . Certain problems of biological indications of outer space are discussed.

Life Sci Space Res, 1969, 7, 123 - 9
Current research on regenerative systems; Shapira J et al.; Multiple studies directed toward the development of a regenerative life support system have shown that easily synthesized organic compounds and microbiological materials are potentially capable of being used as foods for long-duration space missions . Animal feeding studies have supported these views . The organic compounds presently believed to offer the greatest potential are glycerol, simple glycerol derivatives such as triacetin, and formose sugars . Laboratory studies indicate that glycerol can be synthesized from formaldehyde which in turn is obtained by the direct catalytic oxidation of methane, a by-product of the Sabatier reaction used in spacecraft atmosphere control system . Formose sugars are derived from the self-condensation of formaldehyde . Mixtures of glycerol and triacetin have been shown to be suitable as a major component of diets fed to weanling rats for prolonged periods . These compounds do not exist as stereoisomers and therefore offer advantages over the formose sugars . Hydrogenomonas eutropha is the microbiological system under investigation . An automated system for the continuous autotrophic production of Hydrogenomonas bacteria is in operation, and the nutritional requirements for growth in the system using urea as a nitrogen source are being studied . Nutritional evaluation of Hydrogenomonas bacteria has shown they are capable of supplying the total protein requirement of growing rats for prolonged periods . The potential and problems of these regenerative systems and the prospects for the accomplishment of a totally regenerative food system will be discussed.

Boll Chim Farm, 2002 May-Jun, 141(3), 223 - 9
Study of the stability of tablets containing 10 mg of policosanol as active principle; Cabrera L et al.; The stability studies of tablets containing 10 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 specification parameters such as colour, moisture content, hardness, disintegration, policosanol content and microbiological limits of the tablets were done . The effect of drastic treatments such as acid and basic hydrolysis, oxidative and photolytic degradation as well as thermolysis on such parameters was studied . In addition; studies under drastic conditions of storage (40 degrees C and 75% 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 on their quality criteria at the stressed conditions studied . The chromatographic profile of the samples after 9 months of thermal degradation shows chromatographic peaks that corresponds to the octacosanoyl, triacontanoyl and hexacosanoyl esters of palmitate and stearate, being the only degradation products observed on these studies.

Rozhl Chir, 2002 Jul, 81(7), 357 - 9
{Fournier's gangrene}; Veselsky Z et al.; The authors present their own experiences with diagnostics and treatment of men with necrotising fasciitis of the scrotum (Fournier's gangrene) . During 1995-2001 8 men were treated for the above diagnosis at the Clinic of Urology, Faculty Hospital in Hradec Kralove . Six cases were patients with diabetes type II, in one patient we found during basic examinations a large tumour of the sigmoid and one patient was 7 days after total scrotal orchiectomy (because of prostatic adenocarcinoma) . Repeated open revision under general anaesthesia was performed in all men with necessary necrectomy, testicles were intact (except a patient after orchiectomy) . The infection was spread into the hypogastric area in two patients and in one patient spontaneous rupture of bulbar urethra occurred . By a combination of antibiotic therapy and repeated necrectomies, open wound healing and wet compresses we achieved cure of infection and granulations, which made final scrotal plastic surgery possible . From microbiological point of view it was mixed aerobic and anaerobic flora.

Int Endod J, 2002 Aug, 35(8), 660 - 7
Periapical healing of endodontically treated teeth in one and two visits obturated in the presence or absence of detectable microorganisms; Peters LB et al.; AIM: The purpose of the present study is to evaluate the healing of periapical lesions of teeth with positive and negative canal cultures at the time of obturation, and to evaluate the periapical healing of teeth treated in one visit (without) or in two visits with an interappointment dressing of calcium hydroxide . METHODOLOGY: Thirty-nine patients received root-canal treatment . In the first visit, teeth were instrumented, and 18 of these teeth were filled (after microbiological sampling) with calcium hydroxide in sterile saline . The other 21 teeth were obturated with gutta-percha and AH-26 sealer after microbiological sampling . Four weeks later, the teeth with calcium hydroxide were accessed again and after microbiological sampling they were obturated with gutta-percha and AH-26 sealer . Healing of periapical radiolucency was recorded over a period up to 4.5 years . RESULTS: In both the treatment groups, the size of the periapical lesions reduced significantly during the follow-up period . Complete radiographic healing was observed in 81% of the cases in the one-visit group, and in 71% of the cases in the two-visit group . The probability of success increased continuously over time for both treatment groups . Seven out of eight cases (87.5%) that showed a positive root-canal culture at the time of obturation healed . The number of colony forming units (CFU) in six out of eight positive canals was <10(2) CFU mL(-1) . CONCLUSIONS: Within the limitations of this study, no significant differences in healing of periapical radiolucency was observed between teeth that were treated in one visit (without) and two visits with inclusion of calcium hydroxide for 4 weeks . The presence of a positive bacterial culture (CFU<10(2)) at the time of filling did not influence the outcome of treatment.

Int J STD AIDS, 2002 Aug, 13(8), 577 - 9
An audit of outpatient management of pelvic inflammatory disease; Piyadigamage A et al.; Pelvic inflammatory disease (PID) is a common condition presenting to Genitourinary Medicine clinics in the UK . It is unclear what is the best therapeutic option in the outpatient setting . A clinical audit of current standard of care in women presenting with PID was conducted . A total of 150 women were diagnosed clinically during a six-month period . Chlamydia and gonorrhoea were identified in 30% and 4% of patients respectively . The clinical and microbiological cure rates of oral doxycycline and metronidazole were assessed . In 57% of patients their symptoms resolved, but 18% had persistent signs and symptoms; 25% did not attend for follow up visit . Partner notification was discussed in 87% of patients . With a treatment failure rate of 18% we felt it appropriate to change the antibiotic regimen of PID in our department.

Scand J Gastroenterol, 2002 Jul, 37(7), 772 - 7
Carditis: all Helicobacter pylori or is there a role for gastro-oesophageal reflux?
McNamara D, Buckley M, Crotty P, Hall W, O'Sullivan M, O'Morain C.
BACKGROUND: Recent epidemiological studies have reported a threefold increase in the incidence of adenocarcinoma of the lower oesophagus and gastro-oesophageal junction (cardia) . There are conflicting reports available implicating both gastro-oesophageal reflux disease and Helicobacter pylori infection in the aetiology of carditis and cardia intestinal metaplasia, despite strong evidence to show that these two conditions are, if anything, inversely related . We aimed to determine the prevalence of carditis and cardia intestinal metaplasia in dyspeptic subjects and also their association with H . pylori infection and gastro-oesophageal reflux disease . METHOD: Histological samples from the gastric cardia were obtained from dyspeptic subjects . H . pylori status was assessed based on histological, microbiological and rapid urease testing . Gastro-oesophageal disease was diagnosed on the basis of histological evidence and/or erosive oesophagitis . Patient demographics were recorded . Cardia intestinal metaplasia (CIM), when present, was subgrouped as complete or incomplete . RESULTS: Overall, 276 subjects were enrolled; 163 (59%) had carditis and 36 (13%) CIM . H . pylori infection and gastro-oesophageal reflux disease occurred in 64 (23%) and 150 (54%), respectively . H . pylori infection was strongly associated with carditis and CIM (P<0.001 and P<0.01) . Older age and male gender were also associated with inflammation and intestinal metaplasia of the cardia . Gastro-oesophageal reflux was not associated with either entity . CONCLUSION: Carditis and CIM occur frequently . Both conditions are strongly associated with H . pylori infection, older age and male gender . There was no association with gastro-oesophageal reflux disease.

Int J Periodontics Restorative Dent, 2002 Jun, 22(3), 209 - 19
The effect of apically repositioned flap surgery on clinical parameters and the composition of the subgingival microbiota: 12-month data; Levy RM et al.; The purpose of this investigation was to examine the clinical and microbiologic effects of apically repositioned flap surgery . Eighteen patients with chronic periodontitis received initial preparation (IP) including scaling and root planing, followed at 3 months by apically repositioned flap surgery at sites with pocket depth > 4 mm . Subjects were monitored clinically and microbiologically at baseline, 3 months after IP, and at 3, 6, 9, and 12 months postsurgery . Clinical assessments of plaque accumulation, gingival redness, suppuration, bleeding on probing, pocket depth, and attachment level were made at six sites per tooth . Subgingival plaque samples were taken from the mesial aspect of each tooth, and the presence and levels of 40 subgingival taxa were determined using checkerboard DNA-DNA hybridization . Significant reductions were seen in mean pocket depth and percentage of sites exhibiting gingival redness and bleeding on probing in both sites that received IP only and in sites receiving IP followed by surgery . Mean attachment level increased significantly for both sets of sites, but the increase was greater at the surgically treated sites . The total DNA probe counts were significantly reduced at sites in both treatment groups . At surgically treated sites, 19 of 40 taxa were significantly reduced posttherapy At sites receiving IP only, 16 species were significantly reduced over time . While there were some reductions in mean counts after IP in this site group, the major reductions occurred after the surgical phase in these patients, even though these particular sites did not receive surgical therapy . The reduction in pocket depth by surgical means and the associated decrease in reservoirs of periodontal pathogens may be important in achieving sustained periodontal stability.

PDA J Pharm Sci Technol, 2002 Jul-Aug, 56(4), 206 - 19
Validation of the Scan RDI for routine microbiological analysis of process water; Costanzo SP et al.; In this report, we review the validation methods and criteria specified in the PDA Technical Report No . 33 "Evaluation, Validation, and Implementation of New Microbiological Testing Methods" against data generated on the Chemunex Scan RDI . For each parameter, we have either reported data obtained in-house or reviewed information and documentation available from the manufacturer of the system . For all specified requirements, the Scan RDI produced data that was within the specifications suggested in the PDA Technical Report or suitable information was obtained from the manufacturer . The results of the study indicate that the Scan RDI can be validated for routine use in a pharmaceutical environment and provide results equivalent to current methods, but in a much shorter time frame.

Aust Vet J, 2002 Jan-Feb, 80(1-2), 70 - 4
Assessment of organoleptic postmortem inspection techniques for bovine offal; Uzal FA et al.; OBJECTIVE: To evaluate organoleptic postmortem inspection techniques for bovine livers and kidneys . STUDY DESIGN: At Australian export abattoirs, bovine liver and kidneys are assessed and graded by qualified meat inspectors during normal operations . Over a 12-month period at a large abattoir in eastern Australia during 1997 and 1998, a sample of these organs was reassessed independently using a range of pathological and microbiological methods . Agreement between routine inspection and independent assessment was evaluated using methods of inter-rater agreement . RESULTS: A total of 944 livers and 1374 kidneys were included in the study . All of these organs had been classified during routine inspection . The authors examined 363 livers and 329 kidneys both grossly and histologically, including 36 livers and 14 kidneys that were also subjected to microbiological examination . All other organs were only examined grossly . There was only a moderate level of agreement between the routine and independent assessment methods . For livers, the percentage agreement was 80.2%, McNemar's test of symmetry 55.2 (3 degrees of freedom, P < 0.001) and kappa 0.63 . For kidneys, the percentage agreement was 67.8%, McNemar's test of symmetry 9.9 (1 df, P = 0.002) and kappa 0.35 . CONCLUSIONS: The results reinforce concerns from a number of authors about organoleptic postmortem inspection . Risk assessment methodologies offer the opportunity to modify inspection techniques in a manner that is most relevant to current public health concerns.

Transpl Immunol, 2002 May, 9(2-4), 281 - 8
Virus safety in xenotransplantation: first exploratory in vivo studies in small laboratory animals and non-human primates; Specke V et al.; For xenotransplantation, the transplantation of animal cells, tissues and organs into human recipients, to date, pigs are favored as potential donors . Beside ethical, immunological, physiological and technical problems, the microbiological safety of the xenograft has to be guaranteed . It will be possible to eliminate all of the known porcine microorgansims in the nearby future by vaccinating or specified pathogen-free breeding . Thus, the main risk will come from the porcine endogenous retroviruses (PERVs) which are present in the pig genome as proviruses of different subtypes . PERVs will therefore be transmitted, with the xenograft, to the human recipient . PERVs can infect numerous different types of human primary cells and cell lines in vitro and were shown to adapt to these cells by serial passaging on uninfected cells . Furthermore, PERVs have high homology to other retroviruses, such as feline leukemia virus (FeLV) or murine leukemia virus (MuLV), which are known to induce tumors or immunodeficiencies in the infected host . To evaluate the potential risk of a trans-species transmission of PERV in vivo, naive and immunosuppressed rats, guinea pigs and minks were inoculated with PERV and screened over a period of 3 months for an antibody reaction against PERV proteins or for the integration of proviral DNA into the genomic DNA of the host's cells . Furthermore, we inoculated three different species of non-human primates, rhesus monkey (Macaca mulatta), pig-tailed monkey (Macaca nemestrina) and baboon (Papio hamadryas) with high titers of a human-adapted PERV . To simulate a situation in xenotransplantation, the animals received a daily triple immunosuppression using cyclosporine A, methylprednisolone and RAD, a rapamycin derivative, presently under development by Novartis . None of the small laboratory animals or the non-human primates showed production of antibodies against PERV or evidence of integration of proviral DNA in blood cells or cells of several organs, 3 months after virus inoculation, despite the observation that cells of the animals used in the experiment were infectible in vitro . This apparent difference in the outcome of the in vitro and the in vivo data might be explained by an efficient elimination of the virus by the innate or adaptive immunity of the animals.

J AOAC Int, 2002 Jul-Aug, 85(4), 984 - 95
Molecular methods for identification and detection of bacterial food pathogens; Rijpens NP et al.; The polymerase chain reaction (PCR) shortens conventional microbiological methods for the detection of food pathogens either by replacing the conventional biochemical and serological identification or by its direct use on pre-enrichment media or food products . PCR allows fast and highly reliable identification of bacterial taxa, particularly phenotypically atypical bacterial strains . For reliablity, PCR primers and reaction conditions must be thoroughly optimized and evaluated, appropriate sample preparations must be developed, and a stringent laboratory protocol must be followed . Positive control systems are used to monitor possible inhibition of the reaction and negative controls are needed to monitor for contamination . The most recent developments involve messenger RNA-based (mRNA-based) detection of viable bacterial pathogens and real-time PCR quantitation of pathogens.

J AOAC Int, 2002 Jul-Aug, 85(4), 1000 - 2
Predictions for rapid methods and automation in food microbiology; Fung DY; A discussion is presented on the present status of rapid methods and automation in microbiology . Predictions are also presented for development in the following areas: viable cell counts; real-time monitoring of hygiene; polymerase chain reaction, ribotyping, and genetic tests in food laboratories; automated enzyme-linked immunosorbent assay and immunotests; rapid dipstick technology; biosensors for Hazard Analysis Critical Control Point programs; instant detection of target pathogens by computer-generated matrix; effective separation and concentration for rapid identification of target cells; microbiological alert systems in food packages; and rapid alert kits for detecting pathogens at home.

Urban Health Newsl, 1996 Mar, (28), 39 - 47
The Greater Johannesburg Healthy Foods / Markets Programme; Mathee A et al.; PIP: This article discusses the World Health Organization's (WHO) Healthy Cities Project's (HCP) Healthy Foods/Markets program in Johannesburg, South Africa, among food vendors (FVs) . Food contamination is a major contributor to illness, a compromised nutritional status and less resistance to disease, and loss of productivity . Health risk is related to the potential of food to support microbiological growth . Foods can have a high or low health risk . Food risk is related to food type, pH, method of preparation, water availability, handling, exposure temperature, and holding time . Food vending has increased in South Africa, and may employ 6-25% of the labor force . Street food is exposed to climate and temperature, unsafe water supplies and sanitation, and pests . A study conducted among 116 FVs in Johannesburg, assessed the microbiological food quality and potential risks . Formal FVs were less likely to be women and had more vending experience than informal ones . All food from informal FVs was hot, while food from formal FVs tended to be cool . 73% of formal FVs stored leftovers for sale the next day . FVs used some precautions in food preparation . 15% of street FVs, and 13% of formal FVs, had contaminated foods . Formal traders had better hygiene practices, but greater storage that would contribute to contamination . Street FVs need access to safe, ample supplies of water, sanitation, and waste disposal mechanisms . Authorities will be implementing the WHO Hazard Analysis Critical Control Point for low-cost, effective surveillance of street foods .

Urban Health Newsl, 1997 Mar, (32), 48 - 52
WRC Report No . 562/1/96 . The effect of water supply, handling and usage on water quality in relation to health indices in developing communities; South Africa . Medical Research Council; South Africa . Council for Scientific and Industrial Research; PIP: This study examined the quality of water at point of source and point of use in a South African community, and the patterns of water use for drinking and hygiene . The study correlated water quality with health indicators among 150 cases and 150 controls who were preschool children visiting a health facility for severe diarrhea . Data were obtained from interviews, observations of water and sanitation facilities, and microbiological testing of water samples . Water supplied at point of source complied with South Africa's Bureau of Standards guidelines . Contamination occurred after handling and storage . Both cases and controls experienced contamination at point of use . There was a strong association between a child's attendance at a daycare center or creche and diarrhea . The risk of diarrhea was increased with poor knowledge of food handling and hygiene, a lower level of knowledge of the causes and prevention of diarrhea, and poor kitchen hygiene . Water quality was worse at communal taps compared to "site and service" facilities . Households filled their storage cans with about 50 l of water per week . Water quality was unrelated to diarrhea prevalence . It is recommended that health promotion programs provide comprehensive information about water use, storage, and environmental hygiene . Water quality at daycare centers and at communal taps should be evaluated . The final research findings should be distributed to authorities with decision-making power for water and sanitation supplies and for health policies . The community, as well as health workers, should also be informed .

Urban Health Newsl, 1995 Sep, (26), 32 - 6
The effect of water supply, handling and usage on water quality in relation to health indices in a developing community in South Africa; Genthe B et al.; PIP: This study examined the relationship between the quality of water consumed by people in a developing community in South Africa, and health outcomes for diarrhea . Water sources included no formal water supply, communal taps used by over 100 people, outdoor taps on individual plots, and indoor taps . The aim of this 3-year study was to determine water quality at point of collection, to examine patterns of water usage, and to determine the health consequences . This was a case control study and epidemiological assessment . The sample included over 300 households . Cases included pre-school children with severe diarrhea who visited a health facility in the study area . Interviews were conducted to determine hygiene, sanitation, education, and socioeconomic information . Controls of similar age and type of water supply were obtained from neighborhoods in the study area . Findings indicate that water, based on microbiological assay, was of good quality and complied with the South African Bureau of Standards . Water was significantly more contaminated after handling and storage compared to point of source . Cases and controls had equally poor water quality after collection and storage . Control indoor cases had higher levels of E . coli . There was a strong association between diarrhea and the attendance at a day care center . Increased risk of diarrhea was associated with poor kitchen hygiene and low levels of knowledge about hygiene and diarrhea prevention . Communal tap facilities had lower water quality than private taps .

J Virol Methods, 2002 Aug, 105(1), 181 - 6
Flow cytometry assay for intracellular rabies virus detection; Bordignon J et al.; Following previous studies reporting microbiological diagnosis by flow cytometry, the possibility of using this method was examined to monitor infection of susceptible cell lines by a fixed rabies virus strain (Pasteur Virus strain-PV) or a wild rabies virus strain (WRS) . Suspensions of BHK-21 and C6 cells were infected with viruses and a time course of virus infection was established . Sequentially, at several time points, infected and control uninfected cells were fixed, permeabilized, and stained with a rabies virus-specific antibody conjugate . This was achieved by resuspending cells in a solution containing p-formaldehyde in FACS lysis fluid, which allowed the detection of intracellular virus with flourescein-coupled antibodies by flow cytometry . A Becton Dickinson FACSCalibur flow cytometer was used to analyze the percentage of cells infected and the kinetics of the infection process was determined . As early as 12 h after inoculation with both rabies virus strains, significant levels (P<0.01) of infection (from 4.7 to 7.1%) were detected by flow cytometry . The maximum level of infection was obtained at 48 h in C6 cells (88%) with both viruses . The advantages of this method for examination of intracellular virus infection are discussed.

Harefuah, 2002 May, 141 Spec No, 7 - 12, 124
{The history of biological warfare}; Cohen A et al.; Selected events in the history of biological weapons are highlighted to increase the physician's awareness of this crucial threat . The deliberate use of biological substances originated in antiquity and has pervaded the history of human wars throughout time until the 21th century . The history of biological warfare is difficult to assess because of a number of confounding factors . These include the difficulty in verification of allegation, the use of the threat of this weapon for propaganda purposes, the lack of microbiological or epidemiological data, and the incidence of natural occurring endemic or epidemic diseases during hostilities . Although it may be problematic to verify at times, the use of such weapons has not been limited to national armies or militia . Frustrated civilians, terrorists and even physicians have used biological substances to promote their interests . Today, the biological threat has become more serious . It's potency, cost-effectiveness, and the ability to manufacture and deploy it with little sophistication, or under the semblance of legitimate commercial endeavors, will ensure that biological weapons remain a constant threat to human health.

Harefuah, 2002 May, 141 Spec No, 34 - 42, 122, 121
{The spectrum of symptoms associated with biological warfare}; Yinnon AM et al.; BACKGROUND: There are hundreds of potential agents that could be used in biological warfare or bioterrorism: bacteria, viruses and toxins . There are no similarities between clinical presentations of organisms or toxins belonging to specific microbial families . Therefore, it is important for the physician, required to cope with an unusual disease or outbreak among his patients, to become familiar with the various symptoms that victims of biological warfare or bioterrorism may present . METHODS: To describe the six most common groups of symptoms expected in the above setting . The most common symptoms will be described as they appear in nature, because of a fortunate lack of experience with the majority of these agents in biological warfare . Hence, variations of these presentations may be possible . RESULTS: The six most common presentations reviewed are: 1) respiratory tract symptoms; 2) hemorrhagic fevers; 3) meningitis and encephalitis; 4) flaccid paralyses; 5) fever syndromes with rash; and 6) diarrheal syndromes . Additional presentations may be possible due to alterations made in these organisms or development of new agents and mixtures . A list is provided of features that may alert a physician of the possibility of biological warfare or bioterrorism . CONCLUSION: Knowledge of the principal clinical presentations of victims of biological warfare or bioterrorism is essential to all physicians . This knowledge may contribute to the early recognition of a cluster of patients, an epidemic, an unusual disease, or biological warfare; quick referral to the emergency department, leading to early microbiological diagnosis; and rapid notification of the Ministry of Health . All these, and the institution of appropriate measures, will ultimately contribute to the survival of individual patients and at-risk populations.

JAMA, 2002 Aug 14, 288(6), 715 - 21
Effect of daily vitamin E and multivitamin-mineral supplementation on acute respiratory tract infections in elderly persons: a randomized controlled trial; Graat JM et al.; CONTEXT: Immune response in elderly individuals has been reported to improve after micronutrient supplementation . However, efficacy trials evaluating infectious diseases as outcomes are scarce and inconclusive . OBJECTIVE: To investigate the effect of daily multivitamin-mineral and vitamin E supplementation on incidence and severity of acute respiratory tract infections in elderly individuals . DESIGN: A randomized, double blind, placebo-controlled, 2 x 2 factorial trial . SETTING AND PARTICIPANTS: A total of 652 noninstitutionalized individuals aged 60 years or older enrolled from 2 community-based sampling strategies in the Wageningen area of the Netherlands, conducted from 1998 to 2000 . At baseline, 6% of participants had suboptimal ascorbic acid and 1.3% had suboptimal alpha-tocopherol plasma concentration . INTERVENTION: Physiological doses of multivitamin-minerals, 200 mg of vitamin E, both, or placebo . MAIN OUTCOME MEASURES: Incidence and severity of self-reported acute respiratory tract infections at 15 months, as assessed by a nurse (telephone contact), home visits, and microbiological and serological testing in subsets of patients . RESULTS: During a median observation period of 441 days, 443 (68%) of 652 participants recorded 1024 respiratory tract infection episodes . The incidence rate ratio of acute respiratory tract infection for multivitamin-mineral supplementation was 0.95 (95% confidence interval, 0.75-1.15; P =.58) and for vitamin E supplementation, 1.12 (95% confidence interval, 0.88-1.25; P =.21) . Severity of infections was not influenced by multivitamin-mineral supplementation . For vitamin E vs no vitamin E, severity was worse: median (interquartile range) for illness-duration was 19 (9-37) vs 14 (6-29) days, P =.02; number of symptoms, 6 (3-8) vs 4 (3-8), P =.03; presence of fever, 36.7% vs 25.2%, P =.009; and restriction of activity, 52.3% vs 41.1%, P =.02 . CONCLUSIONS: Neither daily multivitamin-mineral supplementation at physiological dose nor 200 mg of vitamin E showed a favorable effect on incidence and severity of acute respiratory tract infections in well-nourished noninstitutionalized elderly individuals . Instead we observed adverse effects of vitamin E on illness severity.

Commun Dis Public Health, 2002 Jun, 5(2), 157 - 62
Guidelines for investigating single cases of Legionnaires' disease; Lee JV et al.; These guidelines for the investigation of single cases of legionnaires' disease have been updated from those produced in 1994 to take account of developments in microbiological and environmental diagnostic capabilities and the recognition that infection may be acquired from the patient's domestic water system . The new guidelines recommend that when a case of legionnaires' disease has been diagnosed, it should be investigated to determine whether it is part of an outbreak or cluster, work related, suspected to be a hospital acquired infection or is travel associated . If information concerning the patient's movements during the incubation period shows it to be none of these, then appropriate environmental investigations should be considered which might include the patient's domestic water system as a potential source of infection . The guidelines are designed to provide advice and information to all public health personnel involved in the control and prevention of legionnaires' disease.

J Antimicrob Chemother, 2002 Aug, 50(2), 231 - 40
Efficacy, tolerability and development of resistance in HIV-positive patients treated with fluconazole for secondary prevention of oropharyngeal candidiasis: a randomized, double-blind, placebo-controlled trial; Pagani JL et al.; Over 37 months, we conducted a prospective double-blind, randomized study in a cohort of 138 HIV-infected patients to compare the effect of two different strategies on the prevention and treatment of oropharyngeal candidiasis relapses and on the development of clinical and microbiological resistance to fluconazole . Each episode was treated with a 7 day course of fluconazole 200 mg/day, followed by secondary prophylaxis with fluconazole 150 mg once weekly matched to placebo . The duration of the double-blind phase of the study, from the day of randomization to the first primary end-point, was 347 +/- 186 days for the fluconazole group and 196 +/- 128 days for the placebo group (P < 0.001) . A total of 33 patients remained relapse-free during the course of the study . Clinical failure was observed in a total of five patients (four in the fluconazole group, one in the placebo group; P = 0.15) . Microbiological resistance was recorded in 12 patients (eight in the fluconazole group, four in the placebo group; P = 0.20) . There were no significant treatment group differences in microbiological resistance whether comparisons were made for all cases or for cases up to 1 month post-study . In the few patients who developed clinical and/or microbiological resistance, the cumulative dose of fluconazole before entry into the study was a mean value of 8.6 g (compared with 2.9 g in patients without clinical and/or microbiological resistance) . In summary, patients treated with secondary prophylaxis suffered fewer relapses of oropharyngeal candidiasis . Development of resistant candidiasis (clinical and/or microbiological) was rarely seen in either group and its incidence was not significantly different.

Srp Arh Celok Lek, 2002 Mar-Apr, 130(3-4), 95 - 9
{Brucellosis--diagnostic dilemmas--case report}; Bojic B et al.; The authors present a case of a 20-year old student from Belgrade, who was admitted to the Institute of Infectious Diseases with fever, muscle and spine pains, strong headache and malice . During the clinical examination bilateral sacroileitis was found . Serological analyses confirmed brucellosis . Epidemiological data showed that she lived in Kosovo and Metohia in 1997, where she consumed diary products from domestic animals; this might be the reason of the acquired infection . With appropriate antibiotic therapy (aminoglycoside, doxicyclin, rifampicin), symptomatic therapy and rehabilitation the disease had favourable outcome; there was no recidive . The authors point out the importance of specific microbiological examinations of patients with fever of unknown origin, especially if the patient has the symptoms that are compatible with brucellosis . In our case it was sacroileitis, as a characteristic complication . As brucellosis is endemic in some parts of our country, there is always a possibility of brucellosis in general medical practice.

Ophthalmology, 2002 Aug, 109(8), 1538 - 46
Evaluation of agent and host factors in progression of mycotic keratitis: A histologic and microbiologic study of 167 corneal buttons; Vemuganti GK et al.; PURPOSE: To evaluate the host and agent factors in the progression of mycotic keratitis through the microbiologic evaluation and histologic study of human corneal buttons obtained at the time of therapeutic keratoplasty . DESIGN: Retrospective noncomparative consecutive case series . MATERIALS: One hundred sixty-seven corneal buttons from 148 patients of microbiologically diagnosed and treated cases of mycotic keratitis who underwent therapeutic keratoplasty between January 1995 and May 1998 . METHODS: Therapeutic penetrating keratoplasty, review of microbiologic results, histopathologic and microbiologic evaluation of the corneal buttons of mycotic keratitis MAIN OUTCOME MEASURES: Histologic evaluation of the buttons for morphologic changes, degree and distribution of inflammatory cells, presence or absence of fungal filaments, and their degree and distribution within the corneal buttons . RESULTS: The diagnosis of fungal infection was made on corneal scrapings in 36 cases; whereas in 131 (78%), the fungus was grown in cultures and identified as Aspergillus in 55 (42%), Fusarium in 42 (32%), unidentified hyaline fungi in 22 (17%), dematiaceous (unidentified) in 4 (3%), and others in 8 (6%) . The mean interval between diagnosis and keratoplasty was 19 (+/-40) days . From the keratoplasty specimen, the fungus was identified at histologic examination in 127 of 167 (76%) buttons and grown by culture techniques in 76 of 115 (66%) buttons . The fungal species identified in the corneal button were Fusarium in 30 (39%); Aspergillus in 25 (33%); unidentified hyaline in 19 (25%), and others in 2 (3%) . Fungus-positive corneal buttons had early surgery (mean, 15 days) compared with fungus-negative (39 days) corneal buttons (P = 0.0005), with 93% fungus positivity in the buttons removed within 2 weeks and 42% after 2 months . In the fungus-positive buttons, there was an inverse correlation between the degree, distribution of inflammatory cells, and fungal filaments (r = -0.255, P = 0.024; r = -0.199, P = 0.027), respectively . The factors necessitating an early keratoplasty were heavy fungal load, deeper penetration of fungus, and possibly insufficient inflammation to combat infection . A granulomatous reaction was noted in the posterior stroma and around the fragmented Descemet's membrane in 23 buttons (13.8%), independent of fungal species . Inflammation was unaffected by elimination of fungus and increasing interval between diagnosis and treatment . CONCLUSIONS: Rapid progression of mycotic keratitis in the early phases is by agent factors such as heavy load and deeper penetration of the fungus, insufficient inflammatory response, and possibly relative ineffectiveness of antifungal agents . Progression in the later phase of mycotic keratitis need not necessarily be agent mediated; it could be either host-modulated, species-related, or drug resistance, thereby suggesting that ideal treatment regimens should include sensitivity-based antifungal therapy aided by in vivo monitoring of fungal filaments.

Dis Aquat Organ, 2002 Jun 21, 50(1), 19 - 27
PCR detection and PFGE DNA macrorestriction analyses of clinical isolates of Pseudomonas anguilliseptica from winter disease outbreaks in sea bream Sparus aurata; Blanco MM et al.; A PCR-based detection system for Pseudomonas anguilliseptica was evaluated . The primer combination PAF-PAR (forward primer PAF = 5'-GACCTCGCCATTA-3', reverse primer PAR = 5'-CTCAGCAGTTTTGAAAG-3') gave a unique and specific amplification product of 439 bp at an annealing temperature of 46 degrees C with all the P . anguilliseptica isolates and strains (n = 56) but no amplification products were observed with any other Pseudomonas species or phylogenetically related bacteria tested . The PCR assay had a detection limit of 170 to 200 cells per PCR tube, which was improved 8-fold when the PCR amplification product was used as a nonradioacfive probe in blotting hybridization experiments . The PCR assay allowed the specific and reliable detection of P . anguilliseptica within 8 h, compared with up to 10 d required for its isolation and further characterization by conventional microbiological approaches . Clinical isolates of P . anguilliseptica recovered from several winter disease (WD) outbreaks diagnosed in sea bream Sparus aurata in Spain and Portugal between 1996 and 2001 were characterized by pulse field-gel electrophoresis (PFGE) macrorestriction analysis . The 54 clinical isolates analyzed were included in 4 different pulsotypes . Pulsotypes B and C represented 54 and 25% of the isolates, respectively, and were responsible for most of the WD outbreaks diagnosed in Spain between 1996 and 2001 . The implication of asymptomatic infected carriers in the dissemination and spread of WD is discussed.

JAMA, 2002 Aug 7, 288(5), 604 - 10
An outbreak of food-borne illness associated with methomyl-contaminated salt; Buchholz U et al.; CONTEXT: On January 5, 1999, the California Department of Health Services was notified of the repeated occurrence (December 21, 1998, and January 2, 1999) of gastrointestinal tract illness among patrons at a Thai restaurant in central California . OBJECTIVE: To identify the source of the outbreak . DESIGN: Case-control study; microbiological and toxicological laboratory testing of samples of food, stool, and vomitus . SETTING: Thai food restaurant in central California . PARTICIPANTS: Patrons of the restaurant . A case (n = 107) was defined as dizziness, nausea, or vomiting occurring in a person who ate at the restaurant between December 20, 1998, and January 2, 1999, with onset of symptoms within 2 hours of eating . A control (n = 169) was a person who ate at the restaurant during the same period but reported no symptoms . MAIN OUTCOME MEASURES: Odds ratios (ORs) of illness associated with food exposures; ORs of shifts during which illness occurred associated with certain cooks; laboratory results . RESULTS: The median latency period was 40 minutes from beginning eating to first symptom and was 2 hours to onset of diarrhea . The median duration of symptoms was 6 hours . Twenty-six persons (24%) visited the emergency department or were treated by a physician; no person required hospitalization . Patients reported nausea (95%), dizziness (72%), abdominal cramps (58%), headache (52%), vomiting (51%), chills (48%), and diarrhea (46%) . Fifty-one cases (48%) included dizziness, lightheadedness, or a feeling of disequilibrium as the initial symptom . Illness was statistically associated with several foods and ingredients, but no single dish or ingredient explained a substantial number of cases . The analysis of food exposures included salt added by cooks, as estimated by using the amount of salt in the recipe for each dish and the amount of each dish eaten by respondents . This association was stronger with increasing levels of salt: ORs for illness among persons who consumed more than 0.42 to 0.84, more than 0.84 to 1.25, and more than 1.25 tsp of salt added to foods in the kitchen were 1.9 (95% confidence interval {CI}, 0.6-5.7), 3.0 (95% CI, 1.0-8.8), and 4.0 (95% CI, 1.3-13.5) compared with persons who consumed less than 0.42 tsp (P value for trend =.004) . Methomyl, a highly toxic carbamate pesticide, was identified in a sample of vomitus (20 ppm) and in salt taken from containers in the storeroom (mean, 5600 ppm) and the stovetop (mean, 1425 ppm) . The oral toxic dose causing illness in 50% of those exposed to methomyl was estimated to be 0.15 mg/kg of body weight (estimated range, 0.09-0.31 mg/kg of body weight) . The presence of cook A was associated with shifts during which cases of illness occurred (OR, 10.4; 95% CI, 1.2-157.4) . CONCLUSION: This outbreak of gastrointestinal illness was associated with the consumption of food seasoned with methomyl-contaminated salt . To allow rapid assessment for further investigational and control measures by health officials, physicians should report suspected outbreaks of illness to public health departments, however trivial the symptoms or cause may seem.

J Clin Microbiol, 2002 Aug, 40(8), 3100 - 3
Unique case of Helicobacter sp . osteomyelitis in an immunocompetent child diagnosed by broad-range 16S PCR; Harris KA et al.; We report the first case of Helicobacter sp . osteomyelitis in an immunocompetent child . The infection was diagnosed by broad-range 16S PCR followed by sequencing of the resulting amplicon . All other microbiological investigations proved negative . This case highlights the importance of molecular methods in the diagnosis of unsuspected etiological agents and the potential role of Helicobacter sp . in human infection.

J Periodontol, 2002 Jul, 73(7), 694 - 700
Effect of polylactide/glycolide (PLGA) membranes loaded with metronidazole on periodontal regeneration following guided tissue regeneration in dogs; Kurtis B et al.; BACKGROUND: Bioabsorbable membranes have been successfully used for guided tissue regeneration (GTR) and local delivery systems because they are biocompatible and do not require second surgery for removal . Several studies have demonstrated that metronidazole, when applied topically, produced immediate effects on microbiological and clinical parameters, most notably a reduction in probing depth and loss of attachment . The purpose of this study was to evaluate the regenerative potential of a metronidazole-loaded biodegradable (polylactide/glycolide) (PLGA) GTR membrane in dogs . METHODS: Six male adult dogs with 36 created osseous defects were enrolled . Bilateral dehiscence type defects in 5 mm diameter were created at buccal aspect of the alveolar bone in maxillary premolar teeth . After full thickness flap elevation, exposed root surfaces were thoroughly planed . In the experimental sites, PLGA membranes with or without metronidazole were fitted and placed over the defects . On the control defects only root planing was performed . Gingival flaps were replaced slightly coronal to the cemento-enamel junction . Animals were sacrificed at 60 days . The histometric analysis was evaluated with the following parameters: defect height (DH), apical extension of junctional epithelium (AEJE), new cementum height (NCH), new bone height (NBH), and new gingival connective tissue height (NCTH) . RESULTS: Postoperative clinical healing was similar in the 3 groups . There were no statistically significant differences between the 2 experimental groups in any parameters . Statistically significant differences were observed for AEJE, NCH, NBH, and NCTH in experimental groups when compared with the controls . Statistically significantly greater NCH, NBH, and NCTH were seen in the experimental groups than the controls and control defects showed longer AEJE than the experimental defects . CONCLUSIONS: These results suggest that PLGA membranes with and without metronidazole may have a beneficial effect on periodontal regeneration.

Clin Infect Dis, 2002 Aug 15, 35(4), 381 - 9 Epub 2002 Jul 19.
Once-daily, high-dose levofloxacin versus ticarcillin-clavulanate alone or followed by amoxicillin-clavulanate for complicated skin and skin-structure infections: a randomized, open-label trial; Graham DR et al.; This study tested whether levofloxacin, at a new high dose of 750 mg, was effective for the treatment of complicated skin and skin-structure infections (SSSIs) . Patients with complicated SSSIs (n=399) were randomly assigned in a ratio of 1:1 to 2 treatment arms: levofloxacin (750 mg given once per day intravenously {iv}, orally, or iv/orally) or ticarcillin-clavulanate (TC; 3.1 g given iv every 4-6 hours) followed, at the investigator's discretion, by amoxicillin-clavulanate (AC; 875 mg given orally every 12 hours) . In the clinically evaluable population, therapeutic equivalence was demonstrated between the levofloxacin and TC/AC regimens (success rates of 84.1% and 80.3%, respectively) . In the microbiologically evaluable population, the overall rate of eradication was 83.7% in the levofloxacin treatment group and 71.4% in the TC/AC treatment group (95% confidence interval, -24.3 to -0.2) . Both levofloxacin and TC/AC were well tolerated . These data demonstrate that levofloxacin (750 mg once per day) is safe and at least as effective as TC/AC for complicated SSSIs.

Dtsch Med Wochenschr, 2002 Jul 26, 127(30), 1584 - 8
{Parvovirus B19 myocarditis in a young man with previous non-bacterial meningitis}; Dux S et al.; HISTORY AND CLINICAL FINDINGS: A 22-year old man presented with fatigue, dyspnea NYHA III and presyncopes that had persisted since a non-bacterial meningitis 3 months before . INVESTIGATIONS: Transthoracic echocardiography revealed a dilated left ventricle with an ejection fraction (EF) reduced to 35-40 % due to global hypokinesia . No pericardial effusion was seen; ECG and lung function test were normal . Serological, immunological and microbiological tests as well as nested PCR analysis of blood leucocytes for detection of cardiotropic pathogens were inconclusive . In endomyocardial biopsies retrieved from the left ventricular posterolateral wall, a chronic macro-phage-rich myocarditis was shown by histopathology and, in addition, Parvovirus B19 was identified as specific pathogen by use of nested PCR analysis . TREATMENT AND COURSE: At physical rest and with ACE inhibitor therapy (2.5 mg ramipril/day), heart failure decreased steadily . Follow-up echocardiography 1 month later revealed a left ventricle that was only slightly dilated with an EF of 50 % . 3 months later, the patient was markedly more load-bearing; the EF amounted to 55-60 % . CONCLUSIONS: Parvovirus B19 should be regarded as potential pathogen in case of suspected myocarditis in adulthood . Whether the previous non-bacterial meningitis was also attributable to this specific pathogen, remains open . Of note, however, the present case report by demonstrating a localized myocardial Parvovirus B19 infection without detectable systemic infection underscores the importance of molecular tests for diagnostic accuracy in manifest organ failure.

J Nat Prod, 2002 Jul, 65(7), 1011 - 5
Chemical-microbiological synthesis of cryptomeridiol derivatives by Gliocladium roseum: semisynthesis of 11-hydroxyeudesmanolides; Garcia-Granados A et al.; Biotransformations of 4alpha- and 4beta-hydroxyeudesmane derivatives by the filamentous fungus Gliocladium roseum were achieved . Hydroxylation at C-11 was the main action of this microorganism, producing new cryptomeridiol (12 and 14) and 4-epi-cryptomeridiol derivatives (6 and 7), respectively, in good yields . The biotransformation activity of G . roseum toward 4beta-hydroxyeudesmane was focused on the isopropyl moiety, but more scattered on the 4alpha-hydroxylated derivative, acting in both the "A" and "B" rings and the isopropyl group of the molecule . Semisyntheses of 11-hydroxyeudesmanolides from the isolated 11,12-dihydroxylated metabolites were also accomplished and used in assigning the stereochemistry of hydroxylation.

Int J Med Microbiol, 2002 Jun, 291 Suppl 33, 114 - 9
Microbiological diagnosis in Lyme borreliosis; Wilske B; For the microbiological diagnosis of Lyme borreliosis, antibody detection methods are mainly used . Serological diagnosis should follow the principle of a rational stepwise diagnosis (see English Internet Version of MiQ Lyme borreliosis) . A screening assay (a sensitive ELISA differentiating IgM and IgG) is recommended as the first step . When the ELISA is reactive, it is followed by immunoblot (IgM, IgG) (second step) . The reactive diagnostic bands should be clearly identified; this is easy if recombinant antigens are used . Identification of diagnostic bands is difficult in the conventional blot and should be done by monoclonal antibodies . Progress has been made in the sensitivity of the recombinant blot using additional antigens as p58 and homologues of Osp17 . In neuroborreliosis the determination of the CSF/serum index is indicated (investigation of paired serum and CSF from the same day) . Detection of the etiological agent by culture or PCR should be performed only in specialised laboratories and is confined to specific indications . Recommended specimens are skin, other biopsies, CSF and synovial fluid . The best results are obtained from biopsies (culture and PCR) and synovial fluid (PCR).

Rev Clin Esp, 2002 Jul, 202(7), 375 - 8
{Nocardiosis in patients with HIV infection}; Santos J et al.; OBJECTIVE: To know the characteristics of nocardiosis in HIV infected patients . PATIENTS AND METHODS: Retrospective analysis of HIV infected patients with a concomitant Nocardia spp . infection in nine Andalusian hospitals . RESULTS: Eighteen cases of nocardiosis were studied . Seventeen patients were males and the mean age was 33.1 years . The risk behaviour for acquiring HIV infection was parenteral drug use in 15 patients (83.3%) and seven of them were active users when acquiring nocardiosis . The mean CD4 lymphocyte count was 66.3 106/l . The nocardiosis was manifested as disseminated disease in eight patients, only pulmonary disease in four cases, lymphocutaneous or soft-tissue nocardiosis in five, and pericarditis in the remaining patient . In the ten cases with pulmonary involvement, the chest X-ray revealed an alveolar, interstitial, and mixed pattern in five, three, and two patients, respectively . Most patients were treated with cotrimoxazole, with good clinical and microbiological responses in 88.8% of them . Some surgical procedures were required in six patients . Eight patients died, three on account of nocardiosis and five on account of other causes . There were three relapses . CONCLUSIONS: Nocardia spp . infection is rare among patients with AIDS and occurs in immunosuppressed patients and drug users . The pulmonary, cutaneous, and soft-tissue were the most commonly observed forms in our series . Despite the high frequency of disseminated infection, the response to th

Infect Control Hosp Epidemiol, 2002 Jul, 23(7), 402 - 4
Clinical, microbiological, and economic benefit of a change in antibiotic prophylaxis for cardiac surgery; Spelman D et al.; Vancomycin and rifampicin replaced cephazolin as antibiotic prophylaxis for coronary artery bypass surgery at our institution . Following this intervention, there was a significant decrease (P < .001) in the surgical-site infection rate from 10.5 (95% confidence interval, 8.2 to 13.3) to 4.9 (95% confidence interval, 3.2 to 7.1) infections per 100 procedures . An estimated $576,655 (Australian) was saved between two 12-month periods.

Cochrane Database Syst Rev . 2002;(3):CD003043.
Ursodeoxycholic acid and/or antibiotics for prevention of biliary stent occlusion; Galandi D et al.; BACKGROUND: Malignant biliary obstruction, which requires endoscopic stenting as palliative therapy, is often complicated by clogging of the stent with subsequent jaundice and/or cholangitis . Stent clogging may be caused by microbiological adhesion and biliary stasis . Therefore, antibiotics and choleretic agents like ursodeoxycholic acid (UDCA) have been investigated to see whether they prolong stent patency . OBJECTIVES: To evaluate if UDCA and/or antibiotics may prolong stent patency and survival in patients with strictures of the biliary tract and endoscopically inserted stents . SEARCH STRATEGY: The Trials Register of The Cochrane Hepato-Biliary Group, The Cochrane Library, MEDLINE, Current Contents, EMBASE, and CancerLit were searched until June 2001 . Reference lists of the identified articles were checked for further trials . SELECTION CRITERIA: All randomised or quasi-randomised clinical trials investigating UDCA and/or antibiotics in patients with biliary stents were considered for inclusion, regardless of blinding, language, and publication status . DATA COLLECTION AND ANALYSIS: Trial inclusion, quality assessment, and data extraction were performed independently by two reviewers . Principal investigators were contacted for further information . Survival data were combined by using hazard ratios (with 95% confidence interval (95% CI)) . MAIN RESULTS: Five non-blinded randomised trials with 258 patients with malignant strictures treated with polyethylene stents were included . Three trials, including 152 patients, investigated a combination of UDCA and antibiotics versus no treatment . The meta-analysis of these three trials does not show a significant treatment effect on the duration of stent patency (hazard ratio (random effects model) 0.58, 95% CI 0.22 to 1.54) or mortality (hazard ratio (fixed effect model) 0.99, 95% CI 0.68 to 1.43) . Two trials with 106 patients compared antibiotics with no treatment, one of these trials used a combination of antibiotics and rowachol (an 'alternative' drug of the 'mint' family) . The pooled results of these two trials do not show significant effects of antibiotics on the duration of stent patency (hazard ratio (fixed effect model) 0.69 (95% CI 0.37 to 1.30)) or mortality (hazard ratio (fixed effect model) 1.23 (95% CI 0.72 to 2.08) . Data concerning duration of hospital stay, frequency of cholangitis, and rate of infectious complications due to selection of antibiotic resistant bacteria strains were not available . REVIEWER'S CONCLUSIONS: Treatment with UDCA and/or antibiotics to prevent clogging of biliary stents in patients with malignant stricture of the biliary tract cannot be recommended routinely on the basis of the existing randomised clinical trials . Further trials are needed with rigorous methodology and sufficient statistical power.

Int J Antimicrob Agents, 2002 Jun, 19(6), 475 - 9
Prostatitis: what is the role of infection; Krieger JN et al.; Although bacterial prostatitis is a common diagnosis, well documented infections of the prostate are uncommon . Culture studies of prostate tissue led our group to hypothesize that bacterial colonization/invasion of the prostate gland might occur more commonly than is appreciated by standard microbiological techniques . Specific polymerase chain reaction (PCR) assays were used for each of the pathogens previously implicated in chronic prostatitis as well as broad-spectrum PCR assays to identify tetracycline resistance genes and bacterial ribosomal-encoding genes (16S rDNAs), followed by cloning and sequencing of the PCR products . Only ten (8%) of the 135 patients with chronic prostatitis had positive specific PCR assays including: Mycoplasma genitalium in four men, Chlamydia trachomatis in three and Trichomonas vaginalis in two, as well as one man positive for both M . genitalium and C . trachomatis . In contrast to the specific probes, the broad-spectrum PCR assays had a substantial proportion of positives . We found evidence of tetracycline resistance in 25% of patients . 16S rDNA-encoding sequences in 77% of the subjects . The tetracycline resistance positives were a subset of the 16S rDNA positive patients . Patients with 16S rDNA-encoding sequences were significantly more likely to have expressed prostatic secretion leukocytes . Many patients with chronic prostatitis/chronic pelvic pain syndrome have a wide variety of bacterial DNA-encoding sequences despite extensive negative microbiological investigations . Understanding the precise role of infection in this syndrome may well lead to better methods to elucidate the microbiology of the prostate in health and disease.

Clin Nutr, 2002 Aug, 21(4), 315 - 20
Is a 24-h cyclic closed enteral feeding system microbiologically safe in geriatric patients?
Lafourcade P, Boulestrau H, Arnaud-Battandier F, Rogues AM, Texier-Maugein J, Pinganaud G, Bourdel-Marchasson I.
BACKGROUND AND AIMS: The microbiological quality of a 1-l closed enteral feeding system (CS) was prospectively monitored under clinical conditions simulating cyclic feeding over a 24-h period in geriatric patients . METHOD: The set was connected after diet sampling (T0) . After 5-h feeding, the set was disconnected and a sample taken (T5) . Diet was sampled after 12 h before (T12A) and after a 10 ml diet-flush of the set (T12B), after 24-h (T24) and in the pouch (P24) . Concentrations of micro-organisms were considered significant when above 10(4) colony-forming units per millilitre . RESULTS: Twenty-one CS were examined . T0 samples were all sterile; 10 out of 21 T5 were contaminated . The microbiological content of the diet was lower in T12B, compared to T12A (P=0.002) . None of the P24 samples was contaminated; 19 were sterile and two contained low levels of micro-organisms that had been previously found in the sets . CONCLUSION: The CS was sterile before connecting to the patient . Retrograde contamination of the set was observed without contamination of the pouch after 24-h hanging time . Performing a diet-flush decreased the rate of diet contamination at the distal extremity of the set . Thus, cyclic enteral nutrition using the same pouch during a 24-h period seems to be safe in geriatric patients.

Boll Chim Farm, 2002 Mar-Apr, 141(2), 128 - 37
Quality control in the meat industry: application of the HACCP system to a slaughterhouse of ostriches; Roncero-Heras JM et al.; The Hazard Analysis and Critical Control Point (HACCP) is a preventive system that tries to guarantee the safety and food innocuousness, anticipating the protection and correction of failures, improving the quality costs for faults of microbiological, physical and chemical type, and saving almost the final super control, which though it allows a relative guarantee of the product, its consequence will be the destruction of the product in case of detection of the failure too much late, with the consequent incremental cost . In this work, the specific hazards which can be found in the slaughter line of ostriches, the preventive measurements that can be applied in the slaughterhouse, the surveillance systems to implement, the corrective actions foreseen and the control records to be kept by the plant are described in detail . Putting in practice these knowledge will allow, to any slaughterhouse of ostriches, a self-control of its productions based on the HACCP system.

Pneumonol Alergol Pol, 2001, 69(11-12), 677 - 86
{Nocardia and human nocardiosis}; Hidri N et al.; Nocardia spp . are pathogens commonly found in soil worldwide, and they cause mostly opportunistic infections in humans and animals, complicating both immunodepressive states and primary diseases . Nocardiosis is difficult to proper microbiological and clinical diagnosis because of its non-specific symptoms, which manifest as the cutaneous and sub-cutaneous infections, lung symptoms and the dissemination through the bloodstream to other organs . General characteristics of Nocardia, human nocardiosis as well as the microbiological diagnostics routine and treatment are discussed.

J Med Screen, 2002, 9(2), 64 - 6
Measurement of phenylalanine in blood on filter paper as a method of monitoring PKU treatment; Tylek-Lemanska D et al.; OBJECTIVES: Phenylketonuria (PKU) is a genetic disease with autosomal recessive inheritance . In Poland the microbiological Guthrie test for this disease was replaced by an enzymatic colorimetric test . The question is whether the colorimetric test might be used in monitoring treatment of PKU . SETTING: In 80 patients with PKU on routine treatment monitoring of serum phenylalanine concentrations (SPh) was compared with phenylalanine concentrations in blood on filter paper (PhBFP) . METHODS: Measurements of SPh were by a fluorimetric method (McCaman and Robins), and those of PhBFP were by an enzymatic colorimetric method . RESULTS: The regression analysis of SPh compared with PhBFP gave the equation y=0.9219x+0.2389; for the reversed ratio: it gave y=1.0220x+0.55083 . The correlation was 0.97 at p<0.05 . DISCUSSION: Concentrations of SPh accepted for children with PKU are not uniform . In the Cracow centre, the range of accepted SPh concentrations are 2-6 mg/dl for children and <12 mg/dl for older patients . The concentrations of PhBFP accepted are somewhat higher than SPh, range from 4 to 10 mg/dl, and are a good indicator of an appropriate diet . CONCLUSIONS: (1) The comparison indicated that colorimetric measurements of PhBFP are effective in monitoring therapeutic PKU management . Tests can be performed more often and are more comfortable both for the patients and their parents . (2) The comparative results indicated a concentration of PhBFP ranging from 4 to 10 mg/dl to be the accepted value for children treated for PKU.

J Microbiol Methods, 2002 Oct, 51(2), 125 - 39
A review of spectroscopic methods for characterizing microbial transformations of minerals; Geesey GG et al.; Over the past decade, advances in surface-sensitive spectroscopic techniques have provided the opportunity to identify many new microbiologically mediated biogeochemical processes . Although a number of surface spectroscopic techniques require samples to be dehydrated, which precludes real-time measurement of biotransformations and generate solid phase artifacts, some now offer the opportunity to either isolate a hydrated sample within an ultrahigh vacuum during analysis or utilize sources of radiation that efficiently penetrate hydrated specimens . Other nondestructive surface spectroscopic techniques permit determination of the influence of microbiological processes on the kinetics and thermodynamics of geochemical reactions . The ability to perform surface chemical analyses at micrometer and nanometer scales has led to the realization that bacterial cell surfaces are active sites of mineral nucleation and propagation, resulting in the formation of both stable and transient small-scale surface chemical heterogeneities . Some surface spectroscopic instrumentation is now being modified for use in the field to permit researchers to evaluate mineral biotransformations under in situ conditions . Surface spectroscopic techniques are thus offering a variety of opportunities to yield new information on the way in which microorganisms have influenced geochemical processes on Earth over the last 4 billion years.

J Med Microbiol, 2002 Jul, 51(7), 601 - 5
A prospective study on fungal infection in children with cancer; el-Mahallawy HA et al.; A prospective study was conducted in 1999 at the National Cancer Institute, Cairo University, to estimate the incidence, morbidity and mortality of fungal infections along with the evaluation of risk factors influencing outcome of infections among paediatric cancer patients . Of 1917 infectious episodes, the fungal infection rate as documented both clinically and microbiologically was 3.7% (70 cases) . Fungal pathogens isolated were yeasts in 55 patients (78.6%) and moulds in 15 patients (21.11%) . Among yeasts, Candida parapsilosis was the commonest, followed by C . tropicalis . Pneumonia was the most common fungal infection (n = 25, 35.7%), followed by fungaemia (n = 18, 25.7%) . The overall mortality rate was 40% (n = 28), with an infection-related mortality of 28.5% (n = 20) . Risk factors that accompanied mortality were relapsing or recurrent disease, profound neutropenia, ADE (Ara-C, daunorubocin and etoposide) protocol of chemotherapy, C . tropicalis isolated and fungaemia as a site of infection . Early use of empirical antifungal therapy (day 4) was not associated with a better outcome . In the light of the poor outcome of patients with fungaemia and fungal pneumonia, every effort should be made to prevent these infections in paediatric cancer patients.

J Surg Res, 2002 Jul, 106(1), 196 - 201
Fertility assessment of hydatid cyst by proton MR spectroscopy; Garg M et al.; BACKGROUND: Hydatid cysts, the larvae of the parasite Echinococcus granulosus, may lodge in any organ of intermediate hosts, namely, man and sheep . Complete cyst removal is the treatment of choice; however, spillage of fertile cysts during surgery leads to disease recurrence that may be prevented by preoperative detection of the fertility status of the cyst . With this perspective, ex vivo proton (1H) MR spectroscopy of hydatid fluid of human and sheep origin was performed to differentiate fertile from sterile cysts on the basis of their metabolite pattern . PATIENTS AND MATERIALS: Cysts of sheep and human origin were used as source of hydatid fluid . A fraction of this fluid was tested for cyst fertility and the rest was used for ex vivo1H spectroscopy . Histopathology of the cyst wall was done as a gold standard for this study . RESULTS: Of 10 sheep samples, 7 were fertile and 3 were sterile, while among 6 human samples, 5 were fertile and 1 was sterile . Spectroscopic and histopathological results corroborated each other . The fluid from microbiologically proven fertile cysts contained malate and fumarate along with other resonances and the histopathology of the fertile cyst wall demonstrated germinal lining and protoscoleces . CONCLUSIONS: The ex vivo spectroscopic differentiation of fertile and sterile cysts may be a stepping-stone for their in vivo separation in future and thus help in framing strategies for percutaneous/surgical management.

Environ Microbiol, 2002 Jul, 4(7), 401 - 13
Characterization of the bacterial consortium associated with black band disease in coral using molecular microbiological techniques; Cooney RP et al.; The bacterial community associated with black band disease (BBD) of the scleractinian corals Diploria strigosa, Montastrea annularis and Colpophyllia natans was examined using culture-independent techniques . Two complementary molecular screening techniques of 16S rDNA genes {amplified 16S ribosomal DNA restriction analysis (ARDRA) of clone libraries and denaturing gradient gel electrophoresis (DGGE)} were used to give a comprehensive characterization of the community . Findings support previous studies indicating low bacterial abundance and diversity associated with healthy corals . A single cyanobacterial ribotype was present in all the diseased samples, but this was not the same as that identified from Phormidium corallyticum culture isolated from BBD . The study confirms the presence of Desulfovibrio spp . and sulphate-reducing bacteria that have previously been associated with the BBD consortium . However, the species varied between diseased coral samples . We found no evidence of bacteria from terrestrial, freshwater or human sources in any of the samples . We report the presence of previously unrecognized potential pathogens {a Cytophaga sp . and an alpha-proteobacterium identified as the aetiological agent of juvenile oyster disease (JOD)} that were consistently present in all the diseased coral samples . The molecular biological approach described here gives an increasingly comprehensive and more precise picture of the bacterial population associated with BBD . To understand the pathogenesis of BBD, our attention should be focused on the pervasive ribotypes identified in this study (the Cyanobacterium sp., the Cytophaga sp . and the JOD pathogen).

Z Gastroenterol, 2002 Jul, 40(7), 531 - 42
{Reprocessing of flexible endoscopes and endoscopic accessories - an international comparison of guidelines}; Leiss O et al.; Endoscopic examinations and procedures are essential for diagnosis and treatment of gastrointestinal diseases . As a result of poor reprocessing practice microorganisms can be transmitted via endoscope . The majority of infection transmissions is due to insufficient performance of cleaning and disinfection disregarding guidelines of societies of gastrointestinal endoscopy . A review of the literature and a comparison of European and American guidelines for reprocessing flexible endoscopes are given . Differences in the classification of endoscopic devices, on the possibility of prion transmission, recommendations on staff training and protection, quality assurance of reprocessing and evidence-based graduation of guidelines are stressed and discussed . With respect to the procedure of endoscope reprocessing, differences concerning the cleaning solution to choose, necessity of thoroughly manual cleaning and brushing of the accessible endoscope channels (even in the case of subsequent automatic reprocessing endoscopes in washers-disinfectors), disinfection solution, microbiological quality of water for final rinsing and rationale for alcohol flush of endoscope channels for better drying are mentioned . The need for experimental investigations of the cleaning and disinfection process is stressed . In contrast to recent guidelines of European and American societies of gastrointestinal endoscopy, the now updated recommendations of the Robert Koch-Institute for reprocessing flexible endoscopes and endoscopic accessories are evidence-based and graduated.

Pancreatology, 2001, 1(3), 210 - 2
Infections in pancreatic inflammatory disease: clinical trials for antibiotic prophylaxis; Bassi C; The clinical significance and incidence of the specific pancreatic infections during severe pancreatitis, such as infected pancreatic necrosis and pancreatic abscesses, is very well known in the literature . The up-to-date knowledge in both the microbiological and pharmacological field related to pancreatitis suggests a series of antibiotics which are potentially useful in the prophylaxis of pancreatic infections . Here we review the most important controlled clinical experiences reported up to now.

Rev Gastroenterol Disord, 2001, 1(4), 169 - 76
Update on medical management of inflammatory bowel disease: ulcerative colitis; Hanauer SB; Significant advances have been made regarding our understanding of the etiopathogenesis of inflammatory bowel disease . This review focuses on the most recent applications of medical therapy for ulcerative colitis . Therapeutic approaches continue to evolve regarding inductive and maintenance strategies with oral and topical aminosalicylates, systemic and non-systemic corticosteroids, and cyclosporine and alternative immunomodulators . As further investigations continue to discern microbiological and immunoinflammatory targets, future therapies may include both probiotics and novel biological agents.

MMW Fortschr Med, 2002 May 30, 144(22), 29 - 32
{Patient with questionable Lyme borreliosis . Which laboratory parameters validate your clinical suspicion?}; Wilske B et al.; Lyme borreliosis is the most common of the infectious diseases transmitted by ticks in the Northern hemisphere . In Europe, Lyme borreliosis can be caused by three species of Borrelia: B . burgdorferi sensu stricto, B . garinii and B . afzelii . The microbiological diagnosis is established primarily on the basis of antibody detection, and secondarily by detection of the pathogen itself . Suitable material for the detection of the latter are various body fluids (CSF, joint fluid and biopsy material, in particular in the skin) . In the case of antibodies, the substrate is usually serum . If neuroborreliosis is suspected, CSF should always be investigated (CSF/serum, pairwise, same day!) . The microbiological findings must be interpreted in conjunction with the clinical presentation . A negative serological result does not exclude an early manifestation, a positive finding is no proof of a clinically manifest infection--it might be a titer from an earlier infection.

Acta Vet Hung, 2002, 50(2), 133 - 42
Stress-induced Cushing's syndrome in fur-chewing chinchillas; Tisljar M et al.; One of the most serious problems in the chinchilla industry is 'fur-chewing', when the chinchilla bites off areas of its own or some other animal's fur . The condition generally develops in both genders at the age of 6-8 months . In chinchilla farms in Croatia an incidence of 15-20% has been observed . A pathomorphological, microbiological and parasitological investigation was conducted on eleven 6- to 11-month-old chinchillas of both sexes with clinical symptoms of 'fur-chewing' and three chinchillas without such signs . Histopathology of the adrenal glands and of the chewed skin revealed changes typical of Cushing's syndrome in 'fur-chewed' chinchillas, such as hyperkeratinisation of the epidermis, epidermal atrophy, pronounced follicular and sebaceous gland atrophy, hyperkeratinisation of the follicles with comedo formations and the presence of calcium salts in subcutis.

Eur J Clin Microbiol Infect Dis, 2002 Jun, 21(6), 465 - 7 Epub 2002 Jun 14.
Occurrence and clinical presentation of systemic pneumococcal infections in an unselected population in Oslo, Norway, between 1993 and 1997; Holm AM et al.; In order to describe the clinical and microbiological manifestations of systemic pneumococcal infection in an unselected urban population, 147 cases that occurred in the period 1993-1997 were retrospectively reviewed . An unexpected finding was that gastrointestinal symptoms were remarkably common . All pneumococcal isolates were fully susceptible to penicillin . The 7-valent conjugated vaccine covered 71% of those under 2 years of age, but only 21% of those 15-65 years of age were covered . Although the case fatality rate was 17%, the rate of early fatality due to systemic pneumococcal infection was unchanged compared with data published in the era before antibiotics . This study emphasizes the importance of continuing efforts to prevent systemic pneumococcal infections.

Eur J Clin Microbiol Infect Dis, 2002 Jun, 21(6), 432 - 7 Epub 2002 Jun 13.
Changing epidemiology of infective endocarditis: a retrospective survey of 108 cases, 1990-1999; Fefer P et al.; The aim of this study was to report the experience with infective endocarditis over the past decade, describe the changing clinical and epidemiological features of the disease, and attempt to determine the optimal number of blood culture sets required for diagnosis . All cases diagnosed during a 10-year period were reviewed clinically and microbiologically . In addition, a retrospective assessment of blood culture data was performed . From the period 1990-1999, 108 cases that met the von Reyn or Duke's criteria were recorded . The major underlying cardiac condition was the presence of a prosthetic valve ( n=33 patients, 31%) . Among patients with native valves, nonrheumatic valvular heart disease of the elderly was the most common underlying factor ( n=19 patients, 25%) . Overall, 13 patients (11%) died . Predictors on admission for increased mortality were shortness of breath, age >60 years, time to defervescence, erythrocyturia, hemoglobin level <10 g/dl, and leukocytosis >15,000 (all P<0.05) . Analysis of blood culture data showed that the diagnostic yield among groups from whom either only one or more than six blood culture sets were drawn was reduced compared with that among groups from whom between two and five culture sets had been taken . The outcome of endocarditis in this series from a community hospital was much more favorable compared with that reported in surveys from large tertiary centers . Moreover, obtaining more than two or three blood cultures is neither helpful nor cost-effective in the initial assessment of patients with suspected endocarditis.

Appl Microbiol Biotechnol, 2002 Jul, 59(2-3), 125 - 34 Epub 2002 Jun 12.
Drugs from the seas - current status and microbiological implications; Proksch P et al.; The oceans are the source of a large group of structurally unique natural products that are mainly accumulated in invertebrates such as sponges, tunicates, bryozoans, and molluscs . Several of these compounds (especially the tunicate metabolite ET-743) show pronounced pharmacological activities and are interesting candidates for new drugs primarily in the area of cancer treatment . Other compounds are currently being developed as an analgesic (ziconotide from the mollusc Conus magus) or to treat inflammation . Numerous natural products from marine invertebrates show striking structural similarities to known metabolites of microbial origin, suggesting that microorganisms (bacteria, microalgae) are at least involved in their biosynthesis or are in fact the true sources of these respective metabolites . This assumption is corroborated by several studies on natural products from sponges that proved these compounds to be localized in symbiotic bacteria or cyanobacteria . Recently, molecular methods have successfully been applied to study the microbial diversity in marine sponges and to gain evidence for an involvement of bacteria in the biosynthesis of the bryostatins in the bryozoan Bugula neritina.

Kidney Int, 2002 Aug, 62(2), 632 - 8
Intercurrent clinical events are predictive of plasma C-reactive protein levels in hemodialysis patients; van Tellingen A et al.; BACKGROUND: In chronic hemodialysis (HD) patients, the repetitive induction of the acute phase response (APR) may induce a chronic micro-inflammatory state, leading to various long-term complications . METHODS: The present prospective study was designed to assess the alterations in the APR in 74 patients who were randomized to HD with a high-flux polysulfone (PS; F 60S), a super-flux PS (F 500S), or a super-flux cellulosic tri-acetate (CTA and CTA with filtered dialysate, CTA(f)) dialyzer . Blood samples collected at the start of the study and after twelve weeks were analyzed for interleukin-6 (IL-6) and C-reactive protein (CRP) . In addition to the microbiological quality of the dialysate, the appearance of a "clinical event" was assessed . RESULTS: At baseline, mean IL-6 levels were within the reference range whereas mean CRP levels were slightly elevated . Mean values did not change after 12 weeks of HD with either modality . After subdividing the patients in quartiles with increasing change in plasma CRP, 23.0% of the patients showed a change of more than 8.0 mg/L . In a multiple regression analysis, CRP levels appeared to be independent of the degree of dialysate contamination, the material and the flux characteristics of the devices . In fact, the variable "clinical events" was the only significant predictor of the plasma CRP levels (P < 0.001) . CONCLUSIONS: Based on these results, both PS and CTA super-flux dialyzers appear safe for clinical use . Whether changes in CRP values, which are associated with intercurrent clinical events, influence the long-term prognosis of chronic HD patients remains to be established.

Nahrung, 2002 Jun, 46(3), 144 - 50
Microbiological and sensory quality of stored croissant-type bakery products depending on external (sorbic acid) and internal (dough, aw value) conditions; Hozova B et al.; The work presents some results from the evaluation of microbiological (total bacterial count, coliform bacteria, moulds and yeasts) and sensory (shape, odour, colour, taste, consistency, crust, soft inside, etc.) quality and of the aw value and pH during the 90-day storage (interval of 0, 30, 45, 60, 75 and 90 days) under laboratory conditions at 20 +/- 2 degrees C in eight types of the bakery croissant-type product with the nougat cream differing by the type of dough (brioche, croissant), aw value of the cream, and by the presence or absence of sorbic acid in the spirit spray applied onto the surface of products . The above-indicated parameters were examined also in the nougat cream samples (on the zero and 90th day of storage) . The chosen quality parameters permitted the level of the durability influence of croissants depending on external (sorbic acid) as well as internal (recipe, aw) conditions to be estimated.

Przegl Lek, 2002, 59 Suppl 1, 38 - 42
{Diagnostic and prognostic reliability of interleukin-10 measurements in very low birth weight infants with late-onset sepsis}; Kwinta P et al.; BACKGROUND: There exists little data on releasing Interleukin-10 (IL-10) and on the clinical usefulness of its measurements in very low birth weight (VLBW) infants . AIM: The evaluation of diagnostic and prognostic reliability of IL-10 measurement in VLBW infants with sepsis . METHODS: 87 newborns with the median birth weight (BW) 1060 g and median gestational age (GA) 28 wks were divided into 3 groups: A) with no clinical signs of sepsis in the first month of life-control group (n = 28), B) with clinical signs of sepsis but with negative blood cultures (n = 13), and C) with clinically and microbiologically confirmed sepsis (n = 46) . In the control group IL-10 was measured on admission and in the 10th, 20th and 30th day of life . The remaining newborns had IL-10 measured when sepsis was suspected . RESULTS: IL-10 levels did not correlate with GA (R = -0.01) or BW (R = -0.04) . In the control group there was no correlation between IL-10 levels and the calendar age . IL-10 levels were statistically higher in the group C than in the remaining ones (Me: 0 vs 1.32 vs 99.8 pg/ml) . IL-10 level > 20 pg/ml allowed to distinguish between the group B and C with 79% sensitivity and 82% specificity . The highest levels of IL-10 were detected in the newborns who died of sepsis (Me = 889 pg/ml) . IL-10 level > 680 pg/ml predicted the death of a newborn with 80% sensitivity and 100% specificity . CONCLUSIONS: IL-10 measurements possess a great diagnostic and prognostic reliability and allow the detection of newborns with poor outcome, thus the measurement of IL-10 may be useful in clinical practice.

J Infect, 2002 May, 44(4), 236 - 9
Necrotizing periorbital Fusarium infection--an emerging pathogen in immunocompetent individuals; Pushker N et al.; Fungal infections of the skin and deeper tissues of the periorbital region are quite rare . We report a case of a localized, deep periorbital necrotizing Fusarium infection in an otherwise healthy, elderly lady . Since the clinical features and histopathological findings of Fusarium infection are by no means characteristic, the definitive diagnosis was achieved with the help of microbiological examination of cultured organisms . A combined medical and surgical therapy led to adequate control of infection . To conclude, localized, deep periorbital necrotizing soft tissue infection by Fusarium in an immunocompetent lady is not reported in literature . One should have a high index of suspicion for emerging fungal pathogens in the differential diagnosis of necrotizing orbital or adnexal conditions, even in an immunocompetent patient . The histologic findings of septate, branching hyphae and vascular invasion cannot distinguish Fusarium species from various other moulds such as Aspergillus species; microbiologic studies are essential for confirming the diagnosis .

J Ultrasound Med, 2002 Jul, 21(7), 727 - 9
The microbiological effects of endovaginal sonographic assessment of cervical length; Krebs-Jimenez J et al.; OBJECTIVE: To determine whether performance of endovaginal sonography for the measurement of cervical length results in a statistically significant change in endocervical culture results . METHODS: Women attending a routine prenatal clinic were offered enrollment in the study . Exclusion criteria included the presence of a cervical cerclage, vaginal examination or coitus within the preceding 24 hours, antibiotic therapy within the preceding 7 days, or the presence of ruptured membranes . A sterile speculum examination and collection of cervical cultures were performed before (initial) and immediately after (final) endovaginal sonographic measurement of cervical length . Quantitative cultures were completed and evaluated for differences in growth by a standardized 4-quadrant technique . RESULTS: A total of 25 women enrolled and completed the study protocol . Quantitative assessment of colony growth showed that the mean growth in the initial samples +/- SD was 3.48+/-1.74, with 1+ indicating growth in 1 quadrant; 2+, growth in the first and second quadrants; 3+, growth in the first, second, and third quadrants; and 4+, growth in all quadrants . The mean growth cultured in the final sample was 3.79+/-2.26 (P = .364; 95% confidence interval of the difference, -1.00 to +381) . CONCLUSIONS: The results of this study do not show a statistically significant inoculation effect associated with performance of endovaginal sonography for the measurement of cervical length.

J Antimicrob Chemother, 2002 Jul, 50(1), 79 - 88
Cefepime plus amikacin versus piperacillin-tazobactam plus amikacin for initial antibiotic therapy in haematology patients with febrile neutropenia: results of an open, randomized, multicentre trial; Sanz MA et al.; BACKGROUND: Standard therapy for suspected infections in patients with profound neutropenia is the combination of a beta-lactam antibiotic plus an aminoglycoside . Cefepime's broad-spectrum activity makes it an option for initial empirical therapy in neutropenic patients . The aim of this study is to evaluate the efficacy and safety of cefepime plus amikacin compared with piperacillin-tazobactam plus amikacin for initial empirical treatment of fever in adult haematology patients with severe neutropenia . METHODS: In this prospective multicentre trial, 969 patients with 984 febrile neutropenic episodes were randomized to receive iv amikacin (20 mg/kg every 24 h) combined with either cefepime (2 g every 8 h) or piperacillin-tazobactam (4 g/500 mg every 6 h) . Clinical response was determined at 72 h and at completion of therapy . RESULTS: Eight hundred and sixty-seven episodes were assessable for efficacy (432 cefepime, 435 piperacillin-tazobactam) . The frequency of success without modification of the empirical therapy was nearly identical for cefepime plus amikacin (49%) compared with piperacillin-tazobactam plus amikacin (51%) . Similar rates of success were found for microbiologically documented infection: 40% versus 39%, respectively . Antibiotic modification was necessary in 49% of cefepime and 44% of piperacillin-tazobactam patients . The overall response rate, with or without modification of the assigned treatment, was 94% in both groups . Drug-related adverse events were reported in 10% of cefepime plus amikacin versus 11% of piperacillin-tazobactam plus amikacin patients . Mortality due to infection occurred in a total of 10 patients (two cefepime, eight piperacillin-tazobactam) . CONCLUSION: The empirical regimen of cefepime plus amikacin is equivalent to piperacillin-tazobactam plus amikacin in febrile adult haematology patients with severe neutropenia . Keywords: cefepime, piperacillin-tazobactam, amikacin, empirical antibiotic therapy, febrile neutropenia, haematological malignancy

Nutrition, 2002 Jul-Aug, 18(7-8), 546 - 52
Infection, multiple organ failure, and survival in the intensive care unit: influence of glutamine-supplemented parenteral nutrition on acquired infection; Griffiths RD et al.; OBJECTIVE: We investigated the effect of a glutamine-supplemented parenteral nutrition on intensive-care-acquired infection (ICAI) and its relation to outcome.METHODS: We analyzed new data prospectively collected during a double-blind, randomized, and controlled trial in an adult general intensive care unit previously reported (Nutrition 1997;13:295) . Eighty-four patients were randomized to receive glutamine-supplemented total parenteral nutrition or an isonitrogenous, isoenergetic control . Sepsis was present on admission in 71% of the patients . Clinical and microbiological data were collected on all new infective episodes and associated treatment decisions . Data were analyzed blind to the randomization and study outcome.RESULTS: There was no significant difference in the number of patients developing new infections or in the number occurring during the first 5 d . There was a non-significant trend to increased numbers of infections in those patients receiving the control feed for at least 5 d . In these patients the glutamine recipients showed significantly fewer catheter-related infections: 21 versus 12 (P = 0.026) . The difference in overall 6-mo mortality was almost completely described by those patients fed for at least 5 d: 9 of 25 versus 18 of 27 using the control nutrition (P = 0.05) . Of the deaths in the intensive care unit due to multiple organ failure, 8 of 8 in the glutamine group and 14 of 16 in the control group sustained one or more ICAI and accounted for 38% versus 74%, respectively, of the ICAIs occurring in those patients . In those patients, despite a similar high incidence of colonization with Candida, those receiving glutamine developed fewer Candida infections and none died, whereas six control patients who developed Candida infections died from multiple organ failure (P = 0.02) . Survival was not related to the reduced occurrence of the first acquired infection; however, binary logistic regression analysis of glutamine and the incidence of ICAI after starting total parenteral nutrition to outcome showed that only glutamine was significantly associated with improved 6-mo survival (P = 0.027).CONCLUSIONS: In these severely ill patients, parenteral nutrition containing glutamine may not reduce the overall incidence of ICAI, but it may reduce the risk of dying from acquired infections . The improved survival seen at 6 mo appeared related mostly to reduced mortality in the intensive care unit from multiple organ failure in those patients in whom acquired infections are common.

J Food Prot, 2002 Jun, 65(6), 918 - 23
Development, implementation, and analysis of an on-farm food safety program for the production of greenhouse vegetables; Powell DA et al.; Fresh fruits and vegetables are increasingly recognized as vectors for foodborne illness . Consequently, an on-farm food safety program was developed, implemented, and analyzed for the Ontario Greenhouse Vegetable Growers in Ontario, Canada, during a 2 1/2-year period . This hazard analysis critical control point-based system was designed to reduce the potential of microbial contamination along the entire production and distribution process . Through the use of microbiological testing, on-site visits, and producer surveys, it was determined that the program has increased grower knowledge, understanding, and awareness of microbial risks associated with fresh produce and caused improvements in practices used within the greenhouse and packing sheds.

J Food Prot, 2002 Jun, 65(6), 911 - 7
Efficacy of sanitation and cleaning methods in a small apple cider mill; Keller SE et al.; The efficacy of cleaning and sanitation in a small apple cider processing plant was evaluated by surface swab methods as well as microbiological examination of incoming raw ingredients and of the final product . Surface swabs revealed that hard-to-clean areas such as apple mills or tubing for pomace and juice transfer may continue to harbor contaminants even after cleaning and sanitation . Use of poor quality ingredients and poor sanitation led to an increase of approximately 2 logs in aerobic plate counts of the final product . Reuse of uncleaned press cloths contributed to increased microbiological counts in the finished juice . Finally, using apples inoculated with Escherichia coli K-12 in the plant resulted in an established population within the plant that was not removed during normal cleaning and sanitation . The data presented in this study suggest that current sanitary practices within a typical small cider facility are insufficient to remove potential pathogens.

J Food Prot, 2002 Jun, 65(6), 1024 - 32
Influence of chilling methods on the quality of sardines (Sardina pilchardus); Garcia R et al.; The aim of this study was to determine for sardines (Sardina pilchardus) the effect of (i) chilling in ice and water in small expanded polystyrene boxes during distribution and in ice thereafter and (ii) chilling in ice and water for the entire storage period . These storage methods were compared with storage of the fish in ice in wooden boxes or in expanded polystyrene boxes . Three storage experiments were performed to take into account the variability in handling conditions and seasonality . There were significant (P < 0.05) differences in the results of some of the sensory, physical, chemical, and microbiological analyses performed that showed that the fish were of better quality when preserved in water and ice than when preserved in ice alone . The effects of dewatering of the fish after transport and subsequent storage in ice were also significantly different (P < 0.05) from those of storage in ice, with the former storage method resulting in better sensory and microbial indices . However, oxidative rancidity, as measured by thiobarbituric acid-reactive substances, was higher for the dewatered fish than for fish preserved in water and ice throughout the storage period . It is concluded that for sardines, storage in water and ice, either only during transport or throughout the storage period, can be useful as an alternative preservation method during distribution and retail sale.

Rev Med Chir Soc Med Nat Iasi, 2001 Oct-Dec, 105(4), 795 - 8
Zeolitical materials for microbiological filtrations; Ciobanu O et al.; The paper presents some aspects about synthesis of new materials called zeolites which can be utilised as filters with wide application in clinical practice in microbiology and in pharmaceutical industry . The SAPO-5, SAPO-11 and SAPO-34 zeolites were synthesised by hydrothermal crystallisation and using different mixtures . The crystallisation was carried out in teflon-lined stainless steel autoclaves at 180-195 degrees C for 1-2 days, under autogenous pressure . Filtering properties of these materials are different because their pore diameters are different.

Rev Med Chir Soc Med Nat Iasi, 2001 Jul-Sep, 105(3), 481 - 5
{Fever of unknown origin : infectious etiology and diagnosis principles}; Duca E; The paper has 3 parts: definitions, causes and diagnosis principles in prolonged fevers of infections etiology . The non infections causes of FUO are only mentioned . The infections causes are presented as: Bacteria, Viruses, Mycetes and Protozoa . The part regarding the etiological diagnosis firstly includes data about the microbiological diagnosis methods and samples in four steps: a) routine samples done for every febrile patient in a general hospital; b) all the accessible samples and c) samples obtained by invasive procedures (needle biopsies and open biopsies) . When all of these had negative results in microbiological tests, a last possibility is adopted: exploratory laparatomy, eventually by sampling some specimens . Finally, conditions of obtaining interpretable serological tests are listed.

Clin Chest Med, 2002 Jun, 23(2), 369 - 76
Non-tuberculous mycobacterial pulmonary infections; Zumla AI et al.; Pulmonary disease due to EM occurs worldwide, and its prevalence has increased as a consequence of the HIV pandemic . It is not often detected in the tropics owing to a lack of laboratory facilities, but when sought it has been found . In addition to HIV infection certain occupations such as mining render the work force more susceptible to disease and calls for a revision of working conditions . Resolution by therapy can be achieved in many cases . As the prevalence of TB diminishes worldwide--and hopefully it will in the wake of the resurgence of interest and the widespread application of the World Health Organization's Directly Observed Therapy Short Course (DOTS) strategy--disease due to EM will become relatively more important and will necessitate revised strategies in clinical, microbiological, and public health approaches to mycobacterial disease.

Nephrol Dial Transplant, 2002, 17 Suppl 5, 60 - 5
Optimizing dose and mode of renal replacement therapy in anaemia management; Locatelli F; Iron supplementation is probably the most important factor affecting response to treatment with recombinant human erythropoietin (rHuEPO) in patients with renal anaemia . However, the adequacy of dialysis is also significant . Many factors affect the process of dialysis and its effects . The purity of water used to make up the dialysate from concentrate is important . Inhibitors of erythropoiesis including ions and disinfectants may often be present in treated mains water . In addition, microbiological and pyrogenic contamination of the dialysate frequently occurs, sometimes leading to development or aggravation of anaemia in haemodialysis (HD) patients and also causing an immune response via cytokine activation . Inhibitors of erythropoiesis are also present in endogenous blood in patients with impaired renal function . Adequate dialysis is responsible for removing these mainly small, and possibly medium and large inhibitor molecules, thereby improving anaemia and enhancing response to rHuEPO . The biocompatibility and flux of the membrane used in HD may also have an effect . The removal of medium or large inhibitors of erythropoiesis is inefficient with cellulose membranes, but can potentially be achieved by using more permeable, high-flux membranes . However, in patients with adequate dialysis and sufficient iron and vitamin supplementation, the beneficial effects of a switch from standard cellulose to high-flux membranes have yet to be proven conclusively . Another area in which positive results on correction of anaemia have been seen in small studies is in the use of on-line haemodiafiltration, haemofiltration, or sterile dialysate . However, further large, controlled studies are needed to confirm these effects.

J Clin Virol, 2002 Jul, 25 Suppl 1, S71 - 8
Herpes Consensus PCR test: a useful diagnostic approach to the screening of viral diseases of the central nervous system; Calvario A et al.; BACKGROUND: Infections of the central nervous system (CNS) are a difficult diagnostic problem for both clinicians and microbiologists . Various clinical signs, such as encephalitis, myelitis, meningitis, may be associated with herpesviruses . The use of multiplex 'Herpes Consensus' polymerase chain reaction (HC-PCR) in association with nested PCR (nPCR), in addition to classical techniques, made it possible to optimise the management of cerebrospinal fluid (CSF) and serum samples from patients affected by these viral diseases of the CNS . OBJECTIVES: To test by HC-PCR by nPCR and cell culture the CSF and sera from patients with viral infections of the CNS . STUDY DESIGN: We analysed 320 CFS, 154 serum samples and 11 various samples from 286 patients with clinically suspected encephalitis, meningitis or other diseases of the CNS by HC-PCR, nPCR and traditional investigations (cell culture and serological tests) . RESULTS: On molecular analysis with the HC-PCR test, 51 CFS samples (15.9%) were positive for at least one of the six target Herpes viruses: fourteen for Herpes simplex 1 (HSV-1), seven for HSV-2, 12 for Cytomegalovirus (CMV; one of which was from an HIV-positive patient), five for Epstein-Barr virus (EBV; four of which were from HIV-positive patients), three for Varicella-Zoster virus (VZV), five for Human Herpes virus type 6 (HHV-6), three for HSV-1 with HHV-6 co-infection (two cases) and HSV-2 co-infection (one case), and two for HHV-6 with CMV or EBV co-infection (both from patients with immune deficiency) . A further 12 samples were positive in nPCR for HHV-7 (8), ADV (1), Enterovirus (1), HSV-1 (1), EBV (1) . Of the 154 serum samples, 17 (11.0%) tested positive by HC-PCR for HSV-1 (4), HSV-2 (1), CMV(1), EBV(1), VZV(3) or HHV-6(6), 1 with co-HSV-2/VZV infection . A further five samples tested positive for HHV-7 in nPCR . Culture and tests for antibodies did not supply sufficiently sensitive and specific data . CONCLUSIONS: Our laboratory experience shows that herpesviruses play a central aetiological role in viral infections of the CNS . PCR analysis, especially the HC-PCR test, have revolutionised the diagnostic approach to such infections, making possible rapid, specific and highly sensitive baseline screening . In this way, microbiological investigations can lead to prompt diagnosis, which was limited in the past to a very small number of cases.

An Med Interna, 2002 Apr, 19(4), 192 - 4
{Legionnaire's disease with predominant liver involvement}; Magro Molina A et al.; Like other pneumonias due to atypical agents, pneumonia due to Legionela Pneumophila has no characteristic clinical facts, although fever and non-productive cough are almost constant and diarrhea with changes in mental status are common . Hyponatremia and moderate transient hypertransaminasemia are common too . Severe systemic affectation after hematogenous dissemination similar to those described with typical bacterial pneumonias is a prominent difference with other atypical agents, with high mortality rates in the absence of appropriate treatment . Etiological diagnosis is very difficult and it is normally achieved late in the course of the infection . Because of diagnostic difficulties and potential mortality in predisposed patients, empirical antibiotherapy has been extensively recommended . We present a patient affected by critical community-acquired pneumonia due to Legionela Pneumophila serogroup 1 with liver alteration as the main manifestation and good response to empirical antibiotherapy with claritromycine and rifampin . We recommended the empirical use of such therapy in those pneumonias without microbiological diagnosis and torpid evolution.

Nucl Med Commun, 2002 Jul, 23(7), 655 - 61
Comparison of 99mTc ciprofloxacin, 99mTc white blood cell and three-phase bone imaging in the diagnosis of hip prosthesis infections: improved diagnostic accuracy with extended imaging time; Larikka MJ et al.; The purpose of this study was to compare the utility of 99mTc labelled ciprofloxacin (Infecton) imaging with the 99mTc white blood cell and three-phase bone imaging procedures for identifying hip prosthesis infection . We studied 30 symptomatic patients in whom infection was confirmed in eight and excluded in 22 cases based on clinical and microbiological findings . 99mTc ciprofloxacin images were obtained at 1, 4 and 24 h after the injection of the tracer, and the data were compared to those obtained from 99mTc leukocyte and three-phase bone imaging . The 99mTc ciprofloxacin imaging correctly identified all true infections . In 13 (59%) of the non-infected patients, non-specific uptake of 99mTc ciprofloxacin was found in the 1-h and 4-h images, which disappeared, however, in the 24-h images . When the early and late 99mTc ciprofloxacin images were compared, the specificity was found to improve from 41% to 95%, positive predictive value from 38% to 89%, and the diagnostic accuracy from 57% to 97% . The accuracy of the conventional 99mTc leukocyte imaging was 90% . Dynamic bone imaging also yielded abnormal findings in all the infected patients although also in 23% of the non-infected patients . Current data indicate that 99mTc ciprofloxacin is a useful method for confirming hip prosthesis infection . The diagnostic efficiency of this method is improved when the imaging time is extended to 24 h post-injection of the tracer.

Infez Med, 2001 Dec, 9(4), 212 - 6
{Microbial circulation and control in two Intensive Care Units}; Puddu R et al.; A microbiological survey was carried out in two medical Intensive Care Units from January to June 2000 . The patients, staff (hands and upper respiratory tract) and environment were monitored . The results obtained in both Care Units give cause for concern . They showed particularly high cultural positivities in bronchoaspirates collected from artificially ventilated patients, a high percentage of positive environmental samples, and frequently contaminated hands in hospital staff, conditions which may facilitate microbial circulation in the medical Intensive Care Units . It would therefore seem necessary to promptly apply specific preventive measures for both the environment and patients.

Contemp Top Lab Anim Sci, 1999 Nov, 38(6), 47 - 49
Peritonitis in Nude Mice in a Xenograft Study; Buetow BS et al.; After 30 Sim: (NCR) nu/nu mice were anesthetized with intraperitoneal tribromoethanol, they were injected with 106 human breast cancer cells or phosphate buffered saline (PBS) into the mammary fat pad through a surgical incision . Over the next six days, 24 of 30 mice became ill or died . Necropsies showed peritonitis, and a variety of bacteria were isolated from the peritoneal cavities of the mice . The tribromoethanol solution, PBS solution, and neoplastic cell line were all cultured and were microbiologically negative . Three immunocompetent mice were subsequently injected intraperitoneally with the same tribromoethanol solution used for the 30 nude mice . All three of the immunocompetent mice showed histologic evidence of peritonitis, but only one yielded positive peritoneal bacterial cultures and showed gross evidence of peritonitis . The tribromoethanol solution, previously reported to cause peritonitis, likely induced a chemical peritonitis in these mice, and the bacteria isolated were a secondary infection from normal gastrointestinal flora . We conclude that adequate mixing and storage of tribromoethanol are essential and that it is a safe and effective anesthetic when properly used.

Recenti Prog Med, 2002 Jun, 93(6), 355 - 60
{Clinico-microbiological comments on various cases of candidemia}; Pasticci MB et al.; During a 3 year period 48 patients with one or more blood cultures positive for Candida spp . were enrolled in the study . One patient presented 3 consecutives episodes of candidemia with infection of the port a cath . Fifty cases of candidemia were diagnosed . Candidemia with infection of the central venous catheter was the most frequent diagnosis (52%); in 20% of cases a tissue localization was also present (disseminated candidiasis) . Thirty-four out of 50 episodes occurred in the Surgical Department . Among risk factors the most frequent resulted: prolonged antibiotic treatment (100%), intravascular catheter (86%), parenteral nutrition (74%), abdominal surgery (46%) . C . albicans was identified more frequently than others Candida spp., resistance to fluconazole was detected in 20% of strains tested . 34/45 episodes of fungemia were treated with fluconazole, none reported side effects . In 5 cases fluconazole was discontinued for clinical failure . Clinical outcome in patients with Candida infection depends on other factors beside in vitro drug susceptibility tests.

Br J Ophthalmol, 2002 Jul, 86(7), 755 - 60
Polymerase chain reaction based detection of fungi in infected corneas; Gaudio PA et al.; AIMS: To evaluate a polymerase chain reaction (PCR) based assay to detect fungi in scrapings from infected corneas . METHODS: A PCR assay was developed to amplify a portion of the fungal 18S ribosome gene . Corneal scrapings from 30 patients with presumed infectious keratitis were evaluated using this assay, as well as by standard microbiological techniques, and the results were compared . Conjunctival swabs from each patient's healthy, fellow eye were also evaluated by PCR . RESULTS: PCR and fungal culture results matched (were both positive or both negative for fungi) in 22 (74%) of 30 scrapings from infected corneas . Three (10%) of 30 samples were PCR positive but fungal culture negative; two of these appeared clinically to represent fungal infections, and the third was clinically indeterminate . Four (13%) scrapings were positive by PCR but also by bacterial and not fungal culture . One specimen (3%) was PCR negative but fungal culture positive . Of the conjunctival swabs from each patient's healthy fellow eye, five (17%) of 30 were positive by PCR, and the opposite, infected eye of all five of these harboured a fungal infection . CONCLUSIONS: PCR is promising as a means to diagnose fungal keratitis and offers some advantages over culture methods, including rapid analysis and the ability to analyse specimens far from where they are collected.

Clin Microbiol Infect, 2002 Jun, 8(6), 317 - 20
Antibiotic resistance -- from pathogen to disease surveillance; Finch R; Surveillance is central to defining the epidemiology of antibiotic resistance, developing new strategies for its control, informing disease management, identifying targets for new drugs and vaccines and in turn, evaluating and refining the impact of these interventions . Current surveillance systems often fall short of this ideal . Since antibiotics are prescribed for the treatment of specific disease, surveillance that reliably links diagnosis, pathogen and antibiotic usage is likely to be more informative . By identifying diseases that are readily recognized, and are usually reliably defined microbiologically, and in turn have clear links to public-health issues, a broader ownership of surveillance data should result . The case is argued for a more disease-focused microbiological surveillance approach than exists at present . Examples are provided which reflect a cross-section of community, nosocomial, zoonotic and imported infectious disease challenges, and where new approaches are urgently required to combat the upward spiral of resistance.

Rinsho Byori, 2002 May, 50(5), 479 - 82
{The newly certified 105 Japanese medical technologists in clinical microbiology}; Kumasaka K; Interest in quality assurance(QA) in clinical laboratories in Japan has increased over the past 30 years . We have however been lagging behind countries such as the USA, Canada and the UK in QA of clinical microbiology . The main problem of QA in Japan is human resources . There are only about 400 laboratory physicians certified by the Japanese Society of Laboratory Medicine(JSLM) . Almost no academics in microbiology are interested in QA and they mostly lack clinical competence . There is a small number of faculty positions, and promotions are mostly based on research productivity while medical graduates are increasingly drawn to bench work for basic, short-term research . The Japanese Society for Clinical Microbiology (JSCM) was established in 1990 in order to promote the development of clinical microbiology and its relevant fields in Japan . And 2001 was a milestone in sustained efforts of the JSLM to initiate qualifying examinations of medical technologists(MT) in clinical microbiology . 105 MT in clinical microbiology were newly certified by the Joint Committee of JSCM, JSLM, Japanese Association of Medical Technologists (JAMT) and College of Clinical Pathology of Japan(CCPJ) . The certified MTs have appropriate educational background and are well motivated . With good on-the-job training, they are expected to perform effectively various tasks, including laboratory management . Recent radical changes in the health care delivery system have also had serious implications on laboratory services and QA of microbiological tests . The primary goal of the clinical microbiology laboratory is to provide accurate diagnostic testing and high-quality service at a low cost for its customers . It is believed that the Joint Committee and the newly certified MTs will contribute to narrowing the gap between Japan and other countries in clinical microbiology.

Gig Sanit, 2002 Mar-Apr, (2), 23 - 6
{Methodological aspects of hygienic evaluation of small-sized plants safety for biological purification of household waste waters}; Zholdakova ZI et al.; The paper deals with the studies of the efficiency of four small-sized plants for biological purification of household waste waters (WW), which were conducted by using a complex of sanitary criteria, such as organoleptic, sanitary-and-chemical and sanitary-and-microbiological parameters of water quality of water objects, such as purified WW reservoirs, and presents a comparative assessment of their efficiency . The used methodological scheme is shown to provide an objective evaluation of the sanitary efficiency of the equipment under test with an compulsory set of regulated and additional integral parameters that should be regarded in combination . It is recommended that preference should be given to WW purification technologies that are effective in removing the environmentally hazardous chemical substances used in household chemistry.

Int J Artif Organs, 2002 May, 25(5), 379 - 85
Filtration fluid for hemodialysis treatment; Ikonomov V et al.; Bacterial contamination of dialysis fluid has long been recognized as a problem in hemodialyis . Cytokines released as a consequence of contaminated dialysis fluid are believed to be responsible for many acute and chronic side effects in patients undergoing renal replacement therapy . For several years now, attempts have been made to eliminate pyrogenic substances and ensure a sterile and endotoxin-free dialysis fluid . A recent dialysis fluid filter known as DIASAFE, containing a membrane based on Polysulfone (Fresenius), was tested for a period of 1,000 hours (approx . 14 weeks) . Dialysis fluid samples were collected once weekly before and behind the filter and cultivated for detection of microorganisms and endotoxins . Additionally, starting after the fourth week of the study, serum samples were collected weekly and the beta2-microglobulin concentration was determined . The filter reduced microorganisms at a rate of at least 10(5) and in the majority of cases (86% of samples) by more than 106 . Under clinical conditions the stability and microbiological functionality of the filters could be demonstrated for more than 1,000 hours and 150 disinfecting cycles . In four cases of endotoxin burden (> 0.5 IU/ml) in the dialysis fluid in front of the filter the concentration behind the filter was lower than 0.1 IU/ml, indicating effective reduction of endotoxins . A tendency to a reduction of beta2-microglobulin in serum from 32.5+/-3.9 mg/L to 21.5+/-5.3 mg/L was observed . These results indicate that the dialysis fluid filter used was effective, dramatically reducing the bacterial contaminants in dialysis fluid, thus protecting patients from the potentially harmful acute and long-term life-threatening consequences of contaminated dialysis fluid.

Graefes Arch Clin Exp Ophthalmol, 2002 May, 240(5), 348 - 53 Epub 2002 Apr 09.
First evidence of an endogenous Spiroplasma sp . infection in humans manifesting as unilateral cataract associated with anterior uveitis in a premature baby; Lorenz B et al.; PURPOSE: To elucidate a previously unknown aetiology of rapidly progressive unilateral cataract in a premature baby associated with severe anterior uveitis . METHODS: The lens and vitreous material were saved as part of a special protocol in a 4-month-old premature baby at the time of pars plana lensectomy with anterior vitrectomy . We performed (1) microbiological cultures to detect viable bacterial and fungal organisms; (2) PCR reaction to viral, bacterial and fungal agents; (3) transmission electron microscopy (TEM) . In addition, serological examinations were performed for HSV-1 and -2, CMV, VZV and Mycoplasmainfection . RESULTS: PCR detected Spiroplasma sp.; TEM confirmed the presence of Spiroplasma within the lens fibres . Serological testing and microbiological cultures of the vitreous and lens were negative . CONCLUSION: Endogenous Spiroplasma infection in a premature baby may manifest as rapidly progressive acquired unilateral cataract with anterior uveitis . Beyond this, Spiroplasma infection has never been reported to occur naturally in vertebrates, although experimentally Spiroplasma mirum produces panophthalmitis associated with cataract in a wide range of rodents and in chicks . In acquired infantile cataract with inflammatory signs, PCR and TEM should be performed in the lensectomy/vitrectomy material to detect infectious agents not evident on routine laboratory and microbiological examinations.

Clin Exp Dermatol, 2002 May, 27(3), 188 - 91
Tuberculosis verrucosa cutis on the sole of the foot; Gruber PC et al.; We report an unusual case of tuberculosis verrucosa cutis on the plantar aspect of the foot that had been present for more than 40 years in a 62-year-old Indian man . He had a grade IV positive Heaf test and a normal chest radiograph . Mycobacterium tuberculosis was successfully cultured from the third biopsy taken from the lesion . This case demonstrates the indolent nature of the lesion and stresses the importance of taking adequate biopsies for microbiological culture when there is a high index of suspicion for M . tuberculosis . The diagnosis of tuberculosis verrucosa cutis should be based on history and evolution of the disease, cardinal morphological features and histopathological characteristics . Response to anti-tuberculosis drugs may be of assistance.

Commun Dis Public Health, 2002 Mar, 5(1), 54 - 8
Outbreak of Vero cytotoxin-producing Escherichia coli O157 in a child day care facility; O'Donnell JM et al.; In December 1998, an outbreak of Vero cytotoxin-producing Escherichia coli (VTEC) O157 in a creche affected ten out of 45 children and one out of five staff members . Eight cases were symptomatic and three were asymptomatic . There were two asymptomatic adult family contacts of child cases . All specimens were identified as VTEC O157:H7, phage type 32 . None of the cases were seriously ill and none developed haemolytic uraemic syndrome (HUS) . One child continued to excrete the organism for 14 weeks . The origin of the outbreak was not found but epidemiological investigation was suggestive of person-to-person spread . All children and staff were screened and excluded from the creche until microbiological clearance was obtained . An inspection of the creche revealed overcrowding and inadequacies in cleaning and in the food preparation facilities . These problems were remedied before children were re-admitted to the creche . This outbreak demonstrates the ease with which VTEC O157 can be transmitted between small children . Two specific features of this outbreak were notable: (1) the mild self-limiting nature of the illness and (2) the prolonged shedding of the bacterium by one child.

Probl Tuberk, 2002, (3), 50 - 3
{Molecular genetic characteristics of Mycobacterium tuberculosis isolated from patients operated on for pulmonary tuberculosis}; Narvskaia OV et al.; The RFLP-IS6110 assay was used to genotype 67 Mycobacterium tuberculosis isolated from different specimens (including intraoperative ones) of 24 patients operated on for chronic progressive pulmonary tuberculosis who lived in north-western Russia . More than half (53%) of 17 types of RFLP profiles of isolates are identical and typical of M . tuberculosis of the Beijing family . Comparing the results of isolate genotyping with clinical, microbiological, and pathomorphological findings allows cases of endogenous reactivation to be differentiated from exogenous (nosocomial, in particular) reinfection in recurrence . Beijing genotype strains are shown to cause more severe unarrested course of drug-resistant fibrocavernous tuberculosis . At the same time such strains are more frequently detected in relatively young persons with a shorter duration of the disease, which reflects current clonal Beijing genotype dissemination that present a severe epidemiological hazard.

Chest, 2002 Jun, 121(6), 2069 - 72
Endobronchial actinomycosis associated with foreign body: four cases and a review of the literature; Chouabe S et al.; Four cases of primary endobronchial actinomycosis associated with an inhaled foreign body are described . In the light of these cases and those previously reported in the literature, we describe the main features of this uncommon association . All patients were > 55 years old, were predominantly men, and were usually in a debilitated state . In > 50% of cases, the clinical presentation was suggestive of lung cancer . Thoracic CT rarely revealed a foreign body, but the granulomatous reaction of the bronchial wall was sometimes suggestive of bronchial thickening . Sulfur granules identified on bronchial biopsies were highly suggestive of actinomycosis in most cases, but microbiological culture findings were usually negative . Antibiotics generally ensure good recovery . Extraction of the foreign body was delayed after antibiotic therapy in one half of cases, suggesting the need for endoscopic follow-up in bronchial actinomycosis.

Scand J Infect Dis, 2002, 34(4), 303 - 4
Tuberculosis of the pancreas diagnosed with needle aspiration; Riaz AA et al.; Tuberculosis of the pancreas is very rare and can present with many signs and symptoms, including obstructive jaundice, weight loss and a mass in the head of the pancreas . Hence the diagnosis of pancreatic tuberculosis remains a challenge and a high index of suspicion is required . If a tumour is suspected then an ultrasound- or CT-guided fine needle aspiration should be performed . Even if the initial microbiological results are negative, using conventional techniques, PCR can yield more rapid results and avoid an unnecessary laparotomy.

Boll Chim Farm, 2002 Jan-Feb, 141(1), 33 - 44
Applicational possibilities of linear and non-linear (polynomial) regressions and analysis of variance: kinetics of chloramphenicol; Arambasic MB et al.; The dependance of the content and microbiological activity of Chloramphenicol (active substance) at dissolution on time and on pH, as well as that of the content and microbiological activity of Chloramphenicol (250 mg capsules) at release, on time, in in-vitro conditions, was determined using linear and non-linear (polynomial and generalized dilution) regressions . Based on the square error value, the dependance of the content and microbiological activity of Chloramphenicol (active substance) at dissolution on time and different pH values, as well as the dependance of the content and microbiological activity of Chloramphenicol (capsules) at release on time were best described by polynomial function . The comparison of the content and microbiological activity of Chloramphenicol (active substance) at dissolution at different pH values, as well as of Chloramphenicol (capsules) at release showed the significant correlation between these parameters (r = 0.999, P << 0.001) . The comparision of the content, on one hand, and microbiological activity of Chloramphenicol (active substance), on the other, at dissolution at different pH values, as a function of time, was done using a modified method of one-way analysis of variance for linear regression comparisons . Based on the value of Fischer's coefficient (F), there is a statistically very significant difference between the contents and between the microbiological activities of chloramphenicol (active substance) at dissolution and different pH as a function of time (P << 0.005).

Clin Infect Dis, 2002 Jul 1, 35(1), 46 - 52 Epub 2002 Jun 05.
The diagnostic accuracy of Kernig's sign, Brudzinski's sign, and nuchal rigidity in adults with suspected meningitis; Thomas KE et al.; To determine the diagnostic accuracy of Kernig's sign, Brudzinski's sign, and nuchal rigidity for meningitis, 297 adults with suspected meningitis were prospectively evaluated for the presence of these meningeal signs before lumbar puncture was done . Kernig's sign (sensitivity, 5%; likelihood ratio for a positive test result {LR(+)}, 0.97), Brudzinski's sign (sensitivity, 5%; LR(+), 0.97), and nuchal rigidity (sensitivity, 30%; LR(+), 0.94) did not accurately discriminate between patients with meningitis (>/=6 white blood cells {WBCs}/mL of cerebrospinal fluid {CSF}) and patients without meningitis . The diagnostic accuracy of these signs was not significantly better in the subsets of patients with moderate meningeal inflammation (>/=100 WBCs/mL of CSF) or microbiological evidence of CSF infection . Only for 4 patients with severe meningeal inflammation (>/=1000 WBCs/mL of CSF) did nuchal rigidity show diagnostic value (sensitivity, 100%; negative predictive value, 100%) . In the broad spectrum of adults with suspected meningitis, 3 classic meningeal signs did not have diagnostic value; better bedside diagnostic signs are needed.

Rev Clin Esp, 2002 May, 202(5), 249 - 54
{Tuberculosis in the Zaragoza province . Estimation by means of the capture-recapture method}; Iglesias Gozalo MJ et al.; INTRODUCTION: Tuberculosis (TB) is an underreported condition to the Communicable Diseases Control System (CDCS) . The objective of this work was to estimate the actual incidence of tuberculosis and the epidemiological characteristics of the diseases in the Zaragoza province . MATERIAL AND METHODS: Retrospective study in which the capture-recapture method was used to estimate the number of tuberculosis cases, by using the microbiology laboratories and the CDSC as data sources . The socio-demographic and clinical characteristics of diagnosed patients throughout three years in this province were analyzed . RESULTS: The mean annual incidence rate of TB was 22.02 per 100,000 inhabitants according to microbiological data, and 48.5 per 100,000 according to the capture-recapture method . A total of 569 patients were studied, and 400 of them were males (70.3%) . The mean age was 43.2 years, and the 25-34 year-old group had the highest number of cases (27.9%) . Twenty-three percent of cases were co-infected with HIV, and 77.4% were parenteral drug abusers, and 4.4% immigrants . CONCLUSIONS: The capture-recapture method has demonstrated to be useful to know the relevance of TB in our setting . The actual incidence of tuberculosis was higher than that pointed out by the CDCS . Relevant differences were observed regarding incidence rates by age and sex groups . HIV infection and immigration do not appear to explain the frequency of this disease in our setting.

Bull Soc Belge Ophtalmol, 2002, (283), 45 - 8
Subconjunctival Loa Loa worm: case report; Carbonez G et al.; A 38-year old Ghanaian suddenly had the sensation of a foreign body in his right eye . Slit-lamp examination revealed a transparent worm underneath the conjunctiva . With topical anesthesia, the complete worm, 3.5 cm long, was removed surgically . A microbiological analysis at the Institute of Tropical Medicine confirmed the diagnosis of Loa Loa . Laboratory tests showed negative blood eosinophilia, positive blood film examination for microfilariae and positive results for filarial serology . The postoperative treatment consisted of progressive doses of di-ethyl-carbamazine (50-->100-->200 mg/d) . A subconjunctival Loa Loa worm is rare in Belgium and usually occurs in immigrants or travellers returning from Tropical (Equatorial) West and Central Africa . Our patient visited Nigeria in 1985 and Ivory Coast in 1986 . Those regions are highly endemic for Loa Loa.

Aust Vet J, 2002 Apr, 80(4), 234 - 8
Cytological and microbiological findings in guttural pouch lavages of clinically normal horses with head restraint; Chiesa OA et al.; OBJECTIVE: To evaluate the cytological and microbiological contents of guttural pouch washes of ten randomly selected horses restrained so as to prevent them lowering their heads, and to assess the possible effects on the guttural pouch environment in these horses . PROCEDURE: Cytological and microbiological studies were performed on guttural pouch washes of ten clinically normal horses restrained in a standing position so as to prevent them from lowering their heads below normal, as would happen during transportation on long journeys . They were restrained for 12 or 24 h and cytological, bacteriological and mycological findings in guttural pouch washes were recorded . RESULTS: The cytological gradings and neutrophil concentrations of guttural pouch washings were higher in horses that had their heads restrained for a longer period . Washings from these horses were more likely to contain cultivable bacteria and were the only washes yielding potentially pathogenic bacterial species . CONCLUSION: Variation in the cytological differential counts and bacterial cultures of guttural pouch lavages may be found in clinically normal horses which have had their heads restrained in an elevated position for periods from 12 to 24 h . This should be considered when examining this site and care must be taken when interpreting cytology of guttural pouch lavages in samples taken after transportation for more than 12 h . Restriction of head movement could also affect the normal pouch enviroment and predispose it to disease.

Neurol Neurochir Pol, 2002 Jan-Feb, 36(1), 131 - 42
{Effect of Chlamydia pneumoniae infection on carotid atherosclerosis development}; Kazmierski R et al.; Recently, a growing number of epidemiological, histopathological and microbiological studies have shown that chronic Chlamydia pneumoniae (C . pneumoniae) infection accelerates the progression of atherosclerosis of carotid and cerebral arteries and thus could constitute a risk factor for stroke . We present a number of mechanisms postulated in recent papers that link C . pneumoniae infection with the development of atherosclerosis . The one most important seems to be the effect of activation of nuclear factor--kappa B and the phenomenon of antigenic mimicry between human and C . pneumoniae heat shock proteins . We also discuss the problem of immunological reaction against myosin filaments of carotid artery wall smooth muscle cells and the problem of antigenic mimicry between heavy chains of myosin filaments and antigens presented on C . pneumoniae outer membrane.

Acta Chir Plast, 2002, 44(1), 23 - 9
New safety assurance for biological skin covers; Mericka P et al.; The described system of safety assurance of cryopreserved allogeneic and xenogeneic dermoepidermal transplants comprises serological examination of deceased tissue donors, long-term storage of sera of all donors, microbiological control of prepared allogeneic and xenogeneic dermoepidermal grafts, labelling of released tissue grafts and monitoring of temperatures inside the mechanical freezer (-80 degrees C) . From a total number of 76 donors from whom tissues were collected for transplantation during 1999-2001, tissues were discarded in two instances . One because of a positive HBsAg test, the others second one because of presence of anti-HTLV antibodies . In xenogeneic dermoepidermal grafts, out of a total number of 1,203 grafts prepared during the same period, 84 (6.9%) were discarded because of the presence of pathogeneic or potentially pathogeneic microbes . The system of labelling released grafts makes unequivocal identification of the pathway from recipient to donor possible, while at the same time respecting the anonymous character of the donor's data . In xenogeneic grafts it ensures the identification of the appropriate batch . Storage of cryopreserved biological skin covers at a temperature of -80 degrees C in low temperature cabinets with emergency back-up cooling with liquid nitrogen and a supplementary source of electric power, proved very useful . The system responds to the gradual implementation of the principles of Quality Management System ISO 9000 and Good Manufacturing Practice into the activities of tissue banks . Further tightening of the demands for the safety of allo- and xeno-transplantation is foreseen in conjunction with the occurrence of transmissible spongiform encephalopathy and porcine retroviruses.

Ginecol Obstet Mex, 2002 Apr, 70, 190 - 5
{Biochemical and ultrastructural characterization of the effect of interleukin 1-beta as mediator of the degradation of connective tissue in human chorioamniotic membranes in culture}; Estrada Gutierrez Gdel C et al.; OBJECTIVE: To characterize the effect of IL-1 beta, on connective tissue metabolism in a human chorioamniotic membrane tissue culture (CAM) . TYPE OF STUDY: Experimental, in an in vitro model . MATERIAL AND METHODS: CAM explants obtained from cesarean sections were cultured . The presence of local infection was excluded by microbiological methods . An XTT viability essay of the explants was carried out . Explants were stimulated with different doses of IL-1 beta within a 0-10 ng/mL range . After the stimulation, protein content was measured, MMP-9 production was determined by zymography, and each explant was divided in two parts: one was used for collagen measurement and the other analyzed by electronic microscopy . RESULTS: CAMs kept adequate viability and functionality . IL-1 beta stimulation produced an increase in the amount of MMP-9 expressed, as determined by the zymography method with a maximum effect 36 hours after stimulation . Collagen content decreased in a progressive manner after IL-1 beta stimulation and reached its minimum after 36 hours . The characteristic pattern of collagen fibers gradually lost its organization, and could not be observed any more after 36 hours . CONCLUSIONS: The information presented here allows us to conclude that IL-1 beta is capable of inducing an enzymatic expression affecting connective tissue, thus confirming its participation in membrane degradation processes under inflammatory conditions.

Clin Microbiol Infect, 2002 May, 8(5), 295 - 309
Overview of catheter-related infections with special emphasis on prevention based on educational programs; Eggimann P et al.; Intra-vascular access is an unavoidable tool in sophisticated modern medical practice, and catheter-related infection remains a leading cause of nosocomial infections, particularly in intensive care units where it is associated with significant patient morbidity, mortality, and additional hospital costs . The incidence of catheter-related bloodstream infection ranges from 2 to 14 episodes per 1000 catheter-days . On average, microbiologically documented, device-related bloodstream infections complicate the use of a central venous line in three to five per 100 cases . But this represents only the visible part of the iceberg and most episodes of clinical sepsis are nowadays considered to be catheter-related . We briefly review the pathophysiology of these infections, highlighting the importance of the skin insertion site and the intravenous line hub as principal sources of colonization and infection . Principles of therapy are briefly addressed . A large proportion of these infections are preventable and this has been the objective of creating precise guidelines . It was recently suggested that the situation may evolve with the introduction of antibiotic/antiseptic-coated devices, whose impact on the epidemiology of antibiotic resistance remains to be determined . Recently, educational programs and/or a global preventive strategy based on the strict application of specific preventive measures and careful control of all factors associated with infection proved to be even more effective than coated devices in reducing rates of infection . Practical aspects regarding educational approaches will help clinicians to adapt and incorporate educational programs into clinical practice.

Med Clin (Barc), 2002 May 18, 118(18), 694 - 5
{Lymphocytic meningitis in Spain: a possible epidemic situation in 2000}; de la Loma A et al.; In order to clarify the unexpected increase in 2000 of lymphocyticmeningitis analyzed in the Centro Nacional de Microbiologia,Instituto de Salud Carlos III, Madrid, here we present their microbiological features . PATIENTS AND METHOD: Samples of 732 patients were tested by virological and serological methods to detect infections by neurotrophic agents . RESULTS: Infections were identified in 375 (51%) cases . Nopolio enteroviruses were identified in 90% cases . Echovirus 30 and 13 were mainly characterized, the latter for the first time in Spain . CONCLUSIONS: The emergence of Echovirus 13 may explain the past epidemic situation.

Food Addit Contam, 2002 Jun, 19(6), 519 - 23
Use of polarography as a quality-control method for determining diacetyl in citrus and vegetable juices, yoghurt and butter; Esteve MJ et al.; The determination of diacetyl permits the detection of microbial growth in the processing of citrus fruit before the appearance of other organoleptic, chemical or microbiological changes . It also makes it possible to detect a break in the cold chain during distribution and sale . The study proposed a polarographic method for the determination of diacetyl that allowed routine analysis with the aim of detecting possible contamination in the citrus juice manufacturing chain (orange and orange-carrot) . The analytical performance of the method in terms of a linearity from 0 to 960 microg ml(-1), a recovery of 97 to 98%, a precision of 3.2 to 4.8%, and a sensitivity of 0.2 ng ml(-1) for juices indicated the robustness of the method . The same method was also applied to butter and yoghurt with detection limits of and 0.4 ng g(-1).

J Chemother, 1991 Jan, 3 Suppl 1, 86 - 8
Fungal infections: correlation with previous treatment and use of antimycogram; Grandis C et al.; From July 1987 to November 1988, 427 strains of mycetes (2.3% out of all microbiological samples) were isolated; 280 of these strains (146 from 84 in-patients, 134 from out-patients) were clinically relevant, and the cause of serious or systemic infections in 47 in-patients . Candida sp . (albicans and non-albicans) were the most frequently isolated (62% in-patients, 72% out-patients): Torulopsis sp., more frequent among in-patients (28% against 16%), were responsible for a limited hospital epidemic . 108 antimycograms were done; 7 patients had antimycotic treatment . In our hands antimycograms were useful in tracing hospital fungal infections . Before mycoses were detected, 78% of in-patients were on antibiotic treatment: 54 on 3rd generation cephalosporins, which seem to foster the outburst of fungi . The authors discuss the phenomenon and suggest some interpretation.

J Chemother, 1991 Jan, 3 Suppl 1, 30 - 2
Female genital tissue concentrations of roxithromycin; Furneri PM et al.; A new macrolide, roxithromycin, appears to have some interesting pharmacokinetic characteristics dissimilar to those of erythromycin, e.g . it has the unusual property of a long serum half-life and the possibility of once daily dosing . Moreover tissue levels are higher than those obtained with other macrolides, and the drug is still present in the tissues up to 24 h . after dosing . The pharmacokinetics of roxithromycin were studied in 36 women undergoing gynecological surgery, and divided by means of the time of sampling into six different groups . Each group received an initial 300 mg dose followed by 8 successive doses of 150 mg at 12 h intervals . Blood and tissues samples were taken during surgery at 2, 6, 9, 12, 18 and 24 h after the last dose of roxithromycin and the patients were then allocated to one of the six groups by means of the sampling time . Tissue fragments were obtained from ovary, fallopian tubes, endometrium, myometrium, cervix and vagina immediately after the surgical resection of the organs . Tissue and serum concentrations were determined by the microbiological method using Sarcina lutea ATCC 9341; the lowest limit of detection was 0.01 microg/ml or 0.01 microg/g . Roxithromycin reached the highest concentration at the 9th hour after last administration and its tissue levels would encourage a wide use of this drug as a satisfactory alternative to tetracyclines for the therapy of some gynecological infections.

Appl Environ Microbiol, 2002 Jun, 68(6), 3055 - 66
Extensive profiling of a complex microbial community by high-throughput sequencing; Hill JE et al.; Complex microbial communities remain poorly characterized despite their ubiquity and importance to human and animal health, agriculture, and industry . Attempts to describe microbial communities by either traditional microbiological methods or molecular methods have been limited in both scale and precision . The availability of genomics technologies offers an unprecedented opportunity to conduct more comprehensive characterizations of microbial communities . Here we describe the application of an established molecular diagnostic method based on the chaperonin-60 sequence, in combination with high-throughput sequencing, to the profiling of a microbial community: the pig intestinal microbial community . Four libraries of cloned cpn60 sequences were generated by two genomic DNA extraction procedures in combination with two PCR protocols . A total of 1,125 cloned cpn60 sequences from the four libraries were sequenced . Among the 1,125 cloned cpn60 sequences, we identified 398 different nucleotide sequences encoding 280 unique peptide sequences . Pairwise comparisons of the 398 unique nucleotide sequences revealed a high degree of sequence diversity within the library . Identification of the likely taxonomic origins of cloned sequences ranged from imprecise, with clones assigned to a taxonomic subclass, to precise, for cloned sequences with 100% DNA sequence identity with a species in our reference database . The compositions of the four libraries were compared and differences related to library construction parameters were observed . Our results indicate that this method is an alternative to 16S rRNA sequence-based studies which can be scaled up for the purpose of performing a potentially comprehensive assessment of a given microbial community or for comparative studies.

Appl Environ Microbiol, 2002 Jun, 68(6), 2822 - 8
Rapid and quantitative detection of the microbial spoilage of meat by fourier transform infrared spectroscopy and machine learning; Ellis DI et al.; Fourier transform infrared (FT-IR) spectroscopy is a rapid, noninvasive technique with considerable potential for application in the food and related industries . We show here that this technique can be used directly on the surface of food to produce biochemically interpretable "fingerprints." Spoilage in meat is the result of decomposition and the formation of metabolites caused by the growth and enzymatic activity of microorganisms . FT-IR was exploited to measure biochemical changes within the meat substrate, enhancing and accelerating the detection of microbial spoilage . Chicken breasts were purchased from a national retailer, comminuted for 10 s, and left to spoil at room temperature for 24 h . Every hour, FT-IR measurements were taken directly from the meat surface using attenuated total reflectance, and the total viable counts were obtained by classical plating methods . Quantitative interpretation of FT-IR spectra was possible using partial least-squares regression and allowed accurate estimates of bacterial loads to be calculated directly from the meat surface in 60 s . Genetic programming was used to derive rules showing that at levels of 10(7) bacteria.g(-1) the main biochemical indicator of spoilage was the onset of proteolysis . Thus, using FT-IR we were able to acquire a metabolic snapshot and quantify, noninvasively, the microbial loads of food samples accurately and rapidly in 60 s, directly from the sample surface . We believe this approach will aid in the Hazard Analysis Critical Control Point process for the assessment of the microbiological safety of food at the production, processing, manufacturing, packaging, and storage levels.

Haematologia (Budap), 2002, 31(4), 341 - 5
Influence of the kind of delivery on umbilical cord blood collection; Pafumi C et al.; From December 1999 to February 2001, the Microbiological and Gynaecological Science Department of the University of Catania has been involved in the collection of umbilical cord blood samples . Eight hundred and sixty-three cord blood units were collected and sent to Sciacca's UCB bank . Among them, 429 were collected from newborns delivered vaginally, while the remaining were collected from Caesarean sections . The aim of this study was to evaluate the difference between umbilical cord blood samples collected during a vaginal delivery and those from a Caesarean section . In particular, the blood volume collected and cord blood CD34+ stem cell count were considered . The method of blood collection consisted of puncturing the umbilical cord vein with an 18-gauge needle and withdrawing the blood into a sterile bag immediately after clamping and newborn assistance . The blood was collected when the placenta was still in utero and the indication to the kind of delivery was, independently of the study, according to obstetrical good practice . The results of the analysis showed that the cord blood volume and the number of CD34+ cells collected were similar for the two groups . The higher median volume of blood collected from infants delivered by Caesarean section seems mainly due to the different clamping time, rather than to the kind of delivery.

J Clin Microbiol, 2002 Jun, 40(6), 2234 - 7
Direct detection of Helicobacter pylori mutations associated with macrolide resistance in gastric biopsy material taken from human immunodeficiency virus-infected subjects; Scarpellini P et al.; One hundred forty gastric biopsies were tested by microbiological methods and by amplifying a sequence of 23S rRNA and identifying mutations associated to clarithromycin resistance . Seventy-six specimens were positive for Helicobacter pylori . Mutational analysis revealed alterations in 18 (39.1%) of 46 and 2 (8.7%) of 23 samples from human immunodeficiency virus-seropositive and -seronegative persons, respectively . The results of the mutational analysis fully correlated with those of the susceptibility tests.

J Cataract Refract Surg, 2002 Jun, 28(6), 982 - 7
Prophylactic intracameral cefuroxime . Evaluation of safety and kinetics in cataract surgery; Montan PG et al.; PURPOSE: To evaluate the safety and kinetics of prophylactic intracameral cefuroxime in cataract surgery . SETTING: Department of Ophthalmology, St . Eriks Hospital, Stockholm, Sweden . METHODS: In a nonrandomized observer-masked best-case trial, the visual rehabilitation and the evolution of laser flare intensity and corneal endothelial cell density after cataract surgery were assessed in 45 patients receiving intracameral cefuroxime and in 45 control patients . Immunoglobulin E-mediated sensitivity was evaluated using a skin prick test to cefuroxime in a screening program comprising all cataract patients operated on in 1997 . Intracameral concentrations of cefuroxime in samples retrieved 30 seconds (n = 10) and 1 hour (n = 9) postoperatively were evaluated in an observer-masked fashion with a microbiological assay . RESULTS: Intracameral cefuroxime did not have a statistically significant effect on postoperative visual acuity, induced laser flare intensity, or endothelial cell loss compared with nonadministration of intracameral antibiotic prophylaxis . Three positive skin prick tests to cefuroxime were found in the 5813 screened cataract patients . The median aqueous humor concentration of cefuroxime at 30 seconds was 2742 mg/L, declining to 756 mg/L 1 hour after drug instillation . CONCLUSIONS: Intracameral cefuroxime 1 mg appears safe in terms of local toxicity . Immunoglobulin E-mediated allergy to cefuroxime is rare in the cataract population . The treatment achieved high aqueous concentrations even 1 hour after surgery.

Vet Microbiol, 2002 Jun 20, 87(2), 139 - 47
A multiplex PCR for the detection of Brucella spp . and Leptospira spp . DNA from aborted bovine fetuses; Richtzenhain LJ et al.; Bovine brucellosis and leptospirosis are important causes of bovine abortion around the world . Both diseases can be serologically diagnosed, but many factors may cause false positive and negative results . Direct methods based on bacteriological isolation are usually employed, but they are difficult, time consuming and dangerous . Monoplex polymerase chain reaction (PCR) have been successfully described for the detection of Brucella spp . and Leptospira spp . Aiming at improvement in the direct diagnosis, a multiplex PCR (mPCR) for the detection of these agents in aborted bovine fetuses is described . The detection threshold of the mPCR was evaluated in experimentally contaminated bovine clinical samples using a conventional proteinase K/SDS or a boiling-based extraction protocols . The mPCR was applied to two groups of clinical samples: 63 episodes of bovine abortion and eight hamsters experimentally infected with Leptospira interrogans serovar pomona . Adopting microbiological isolation as reference, the test showed a sensitivity of 100% in both groups of clinical samples . Seven samples collected from bovine fetuses were Brucella spp . culture negative but showed positive results in mPCR . Regarding Leptospira spp . detection, similar results were observed in three bovine clinical samples . All hamsters infected with Leptospira were positive in both microbiological culture and mPCR . The boiling extraction protocol showed better results in some clinical samples, probably by the removal of PCR inhibitors by heat treatment . The high sensitivity, simplicity and the possibility of detection of both bacteria in a single tube reaction support the use of the mPCR described in the routine diagnosis.

Proc Natl Acad Sci U S A, 2002 May 28, 99(11), 7663 - 8
Multiple archaeal groups mediate methane oxidation in anoxic cold seep sediments; Orphan VJ et al.; No microorganism capable of anaerobic growth on methane as the sole carbon source has yet been cultivated . Consequently, information about these microbes has been inferred from geochemical and microbiological observations of field samples . Stable isotope analysis of lipid biomarkers and rRNA gene surveys have implicated specific microbes in the anaerobic oxidation of methane (AOM) . Here we use combined fluorescent in situ hybridization and secondary ion mass spectrometry analyses, to identify anaerobic methanotrophs in marine methane-seep sediments . The results provide direct evidence for the involvement of at least two distinct archaeal groups (ANME-1 and ANME-2) in AOM at methane seeps . Although both archaeal groups often occurred in direct physical association with bacteria, they also were observed as monospecific aggregations and as single cells . The ANME-1 archaeal group more frequently existed in monospecific aggregations or as single filaments, apparently without a bacterial partner . Bacteria associated with both archaeal groups included, but were not limited to, close relatives of Desulfosarcina species . Isotopic analyses suggest that monospecific archaeal cells and cell aggregates were active in anaerobic methanotrophy, as were multispecies consortia . In total, the data indicate that the microbial species and biotic interactions mediating anaerobic methanotrophy are diverse and complex . The data also clearly show that highly structured ANME-2/Desulfosarcina consortia are not the sole entities responsible for AOM at marine methane seeps . Other microbial groups, including ANME-1 archaea, are capable of anaerobic methane consumption either as single cells, in monospecific aggregates, or in multispecies consortia.

Aliment Pharmacol Ther, 2002 Jun, 16(6), 1059 - 66
Review article: Pathogenesis of sporadic and familial gastric cancer--implications for clinical management and cancer prevention; Ebert MP et al.; Gastric cancer remains a great clinical challenge despite its decreasing incidence . While major progress has been achieved in the understanding of the pathogenesis and molecular biology of sporadic gastric cancer, only recently has the role of familial aggregation of gastric cancers been rediscovered . The genetic changes underlying sporadic and familial gastric cancer have been revealed, and recent studies indicate that this familial aggregation combines genetic and microbiological aspects . Thus, for the prevention of gastric cancers these findings might be helpful for the early diagnosis and for the screening of risk groups and family members.

Arch Bronconeumol, 2002 May, 38(5), 246 - 8
{Tuberculous liver abscess in an immigrant patient with pulmonary tuberculosis}; Bernabeu Mora R et al.; Liver abscess due to Mycobacterium tuberculosis associated with pulmonary tuberculosis is a rare diagnosis, particularly in patients without AIDS . We report the case of a male immigrant with no HIV infection who developed a tuberculous liver abscess and pulmonary tuberculosis simultaneously . Ziehl-Neelsen stain, PCR and Lowenstein-Jensen culture of material sampled from the abscess established the microbiological diagnosis . The patient's course was good, with disappearance of symptoms and the abscess after tuberculostatic treatment and drainage of the abscess with monitoring by computed tomography.

J Cutan Pathol, 2002 Apr, 29(4), 215 - 25
Disseminated cutaneous histoplasmosis in patients infected with human immunodeficiency virus; K Ramdial P et al.; BACKGROUND: In the pre-AIDS era disseminated histoplasmosis was rare and the cutaneous manifestations thereof were reported infrequently . A range of unusual clinical manifestations of disseminated cutaneous histoplasmosis (DCH) in AIDS patients has been documented, but the cutaneous histopathological descriptions are short and incomplete . In addition, the histopathological spectrum of AIDS-associated DCH is poorly recognized . METHODS: This is a prospective 32-month study of all HIV positive patients diagnosed with histoplasmosis in the Departments of Anatomical Pathology and Dermatology, Nelson R . Mandela School of Medicine and King Edward VIII Hospital, Durban, South Africa . Clinical distribution and morphology of the individual skin lesions and CD4+ lymphocyte counts in the peripheral blood were analysed in relation to the histopathological features of biopsied lesional tissue . Ultrastructural examination of tissue retrieved from the wax blocks of three cases that exhibited dermal karyorrhexis and collagen necrosis was undertaken . Fungal culture of lesional skin tissue was undertaken in all patients . RESULTS: Twenty-one biopsies of papules (7), nodules (4), plaques (5), erythema multiforme-like lesions (2), vasculitic lesions (2) and exfoliative dermatitis (1) from 14 patients were examined . Of four biopsies (CD4 range: 120-128 cells/mm3) one and three demonstrated necrotizing and non-necrotizing granulomatous inflammation with a paucity of intrahistiocytic microorganisms . Seven biopsies (CD4 range: 2-56 cells/mm3) demonstrated diffuse dermal and intravascular accumulation of histiocytes densely parasitized by Histoplasma capsulatum var . capsulatum . Vasculitis, karyorrhexis or collagen necrosis was not present . Ten biopsies (CD4 range: 2-72 cells/mm3) demonstrated diffuse dermal karyorrhexis, collagen necrosis and interstitial, extracellular H . capsulatum var . capsulatum . Histiocytic disintegration and nuclear fragmentation and release of intact microorganisms and intact and ruptured lysosomes were identified ultrastructurally . Leucocytoclastic vasculitis was present in two biopsies of vasculitic clinical morphology . Microbiological culture confirmed histoplasmosis in all cases . Three patients died before treatment was commenced . Two patients died within the first two days of induction of therapy . Nine patients demonstrated dramatic healing of the cutaneous lesions . CONCLUSIONS: Despite the clinicopathological spectrum of DCH and the attendant host immunocompromise, timely and appropriate treatment of DCH may be lifesaving and allows rapid healing of skin lesions . A high index of clinical suspicion and skin biopsies and culture are crucial for accurate diagnosis.

Joint Bone Spine, 2002 Mar, 69(2), 114 - 22
New pathogenic hypotheses for spondyloarthropathies; Berthelot JM et al.; Pathogenic hypotheses for spondyloarthropathies are evolving . Several candidates have been added to the list of inciting microorganisms, and genes other than HLA-B27 are under scrutiny . Above all, the chiefly 'immunological' theory of spondyloarthropathies incriminating a cross-reaction between self-proteins and bacterial peptides is giving way to a more 'microbiological' concept in which latent bacteria residing within macrophagic or dendritic cells undergo reactivation through a process facilitated by HLA-B27 . This molecule is prone to misfolding, which decreases the presentation of bacterial peptides to the immune system and stimulates the Nf-KB inflammation pathway within infected macrophages and/or dendritic cells . Migration of these infected cells from the mucous membranes to the tissues targeted by spondyloarthropathies, particularly the bone marrow located near entheses, may facilitate transient reactivation of dormant intracellular bacteria by creating a favorable cytokine environment . This environment may include high levels of TGFbeta and IL-10, noted also at other sites that enjoy immune privilege, such as the eye . The reactivation may be stopped by a local response of CD4+ and/or CD8+ T cells at the expense of local inflammation responsible for clinical manifestations . This scenario seems consistent with results from studies of murine models transgenic for the HLA-B27 antigen: exposure to bacteria is necessary to the development of spondyloarthropathy, but the disease occurs even when only the heavy chain of HLA-B27 is present (i.e., beta2-microgloblin is not indispensable) . Improved understanding of the mechanisms that confer to some bacterial strains a strong potential for persisting within cells, including macrophagic cells, may open the way toward new treatment approaches capable of complementing antagonists of TNF-alpha and other monokines, which merely suspend the disease process, and antibiotic therapy, which fails to kill dormant bacteria located within cells . Pathogenic hypotheses for spondyloarthropathies are evolving . This review presents the most recent concepts . These concepts have not all received confirmation from experimental data . However, the high degree of consistency among them prompted us to consolidate them into a single picture . Although this approach may yield a motley composite of fact and speculation, it may open up new avenues of thought for rheumatologists interested in the links between chronic intracellular infections and inflammatory joint disease.

Ann Chim, 2002 Mar, 92(3), 217 - 27
Winter evolution of DMS and DMSP in Venice lagoon water and sediment; Gambaro A et al.; The evolution of dimethylsulphide (DMS) and dimethylsulphoniopropionate (DMSP) concentrations in the water and sediment of the Venice lagoon were studied together with the concentration of chlorophyll a, temperature and the composition and density of phytoplankton to understand the role of the sediment as a source of DMS during the winter period . The temporal trend of water DMS concentration in this period showed a maximum concentration in February (75.7 nmol S l-1) related to low DMSP and chlorophyll a concentrations but to high phytoplanktonic abundance . The DMS and DMSP concentrations were greater in the sediment than in the water . The temporal trend of DMS concentration in sediment showed a maximum in February (1155 nmol S l-1) related to the maximum of DMS concentration in surface water . These observations suggested that in the winter period DMS could be produced by the conversion of the DMSP present in the bulk water but principally by that present in the sediment (microbiological degradation of DMSP or other sulphur-containing compounds) that subsequently diffuse in water.

Oper Dent, 2002 May-Jun, 27(3), 231 - 7
Relating visual and radiographic ranked scoring systems for occlusal caries detection to histological and microbiological evidence; Ricketts DN et al.; This study compared a visual ranked scoring system and a radiographic ranked scoring system for occlusal caries detection with the level of infection of dentin . Seventy-five third-molars, designated for extraction, were professionally cleaned . Caries was scored according to a visual ranked scoring system at a selected site in the groove-fossa system . Radiographs of the teeth were available and caries was recorded along a five-point ranked scoring system . Each tooth was extracted and hemi-sectioned through the investigation site under aseptic conditions . A burful of dentin was removed from the EDJ of one of the section faces and these samples were processed to establish the level of dentin infection . The depth of the lesion was assessed on the other section face using a five-point ranked histological scoring system . A strong relationship was observed between the histological lesion depth and visual score (r(s)=0.93) while a moderate relationship was seen between lesion depth and radiographic scores (r(s)=0.77) . The dentin from teeth with cavities exposing dentin was heavily infected . The dentin from teeth with microcavities or grey discoloration of the dentin was less infected than the lesions with frank cavitation (score 4) (p<0.05, t-test), but more infected than the initial lesions (p<0.05, t-test) . The latter lesions showed minimal infection . A similar tendency was seen with respect to increasing radiographic scores and the level of infection of the dentin.

Compend Contin Educ Dent Suppl, 1997, 18(21), S39 - 44; quiz S47
A microbiological and clinical study of the safety and efficacy of baking-soda dentifrices; Zambon JJ et al.; This article reports the results of a study that examined the clinical and microbiological changes associated with regular use of baking-soda dentifrices . Two dentifrice formulations were examined in a 6-month longitudinal study of 101 adult subjects with assessments for plaque, gingival inflammation, and stain at baseline and 3 and 6 months during the active phase of the study, and at 3 months after cessation of product use . One dentifrice contained 52% baking soda and 3% sodium percarbonate (Arm & Hammer PeroxiCare) while the other dentifrice contained 65% baking soda (Arm & Hammer Dental Care) . Both dentifrices resulted in statistically significant reductions in dental plaque, gingival inflammation, and stain at all time periods compared to baseline . Dental plaque and buccal soft-tissue samples were obtained for microbiological analysis from a 50-subject subset . Microbiological assays, including bacterial culture, phase-contrast microscopy, and immunofluorescence microscopy, confirmed the safety of both formulations . Beneficial alterations in dental plaque bacteria were noted, including significant reductions in the levels of Actinomyces species . The data from this study indicate that dentifrices containing high levels of baking soda are clinically effective and microbiologically safe.

Clin Ther, 2002 Apr, 24(4), 605 - 15
A prospective, double-blind, multicenter study comparing clarithromycin extended-release with trovafloxacin in patients with community-acquired pneumonia; Sokol WN Jr et al.; BACKGROUND: Treatment guidelines for community-acquired pneumonia (CAP) generally include use of a macrolide, a fluoroquinolone, or doxycycline, although there is some debate concerning the use of a fluoroquinolone . OBJECTIVE: The efficacy and tolerability of a new once-daily, extended-release (ER) formulation of clarithromycin were compared with those of a fluoroquinolone, trovafloxacin, in the treatment of patients with CAP . METHODS: This was a prospective, multicenter, double-blind, double-dummy, parallel-group trial in which outpatients were randomized to receive 7 days of once-daily treatment with either clarithromycin ER (two 500-mg tablets) or trovafloxacin (200 mg) . Eligible patients were > or = 18 years old with signs and symptoms of pneumonia, radiologic evidence of an acute infiltrate, and mild to moderate infection, as classified by the investigator . RESULTS: One hundred seventy-six patients were randomized to study treatment . They were primarily white (88%) and equally distributed between the sexes (52% female) . Their mean (+/-SD) age was 47.5 +/- 16.2 years . Results were similar between treatment groups in rates of clinical cure, microbiologic cure, bacteriologic eradication, and radiologic success at the test-of-cure visit (14-21 days posttreatment) for both the per-protocol and intent-to-treat analyses . Among clinically evaluable patients, clinical cure rates for clarithromycin ER and trovafloxacin were 87% (74/85) and 95% (63/66), respectively, and radiologic success rates were 95% (80/84) and 95% (63/66), respectively . There were no statistically significant differences between groups . In clinically and microbiologically evaluable patients, overall bacteriologic eradication rates were 89% (85/95) for clarithromycin ER and 96% (64/67) for trovafloxacin, with no significant differences between groups . Both antibiotics demonstrated high eradication rates against target microorganisms . There were no clinically meaningful differences in the incidence of specific drug-related adverse events . The majority of drug-related adverse events (>90%) were considered mild or moderate and resolved without the need for additional treatment . CONCLUSIONS: Although the study was prematurely terminated, resulting in inadequate power to demonstrate equivalence, once-daily clarithromycin ER was effective and well tolerated in the treatment of ambulatory adult (age > or = 18 years) outpatients with CAP.

Int J Tuberc Lung Dis, 2002 May, 6(5), 447 - 53
Detection of mycobacteria in patients with pulmonary tuberculosis undergoing chemotherapy using MGIT and egg-based solid medium culture systems; Hasegawa N et al.; SETTING: National Minami-Yokohama Hospital, Kanagawa, Japan . OBJECTIVE: To compare the performance of a liquid medium system using the Mycobacteria Growth Indicator Tube (MGIT) with that of the conventional Japanese culture system using egg-based Ogawa medium, equivalent to Lowenstein-Jensen medium, in cases with pulmonary tuberculosis on chemotherapy . DESIGN: A single-centre prospective case study of 61 hospitalised patients from 1 May to 31 July 1998 on a standard 6-month regimen of anti-tuberculosis chemotherapy including isoniazid, rifampin, streptomycin or ethambutol, and pyrazinamide . Sputum cultures using both culture systems were performed bi-weekly up to week 16 of treatment, and were further monitored by MGIT alone at the end of chemotherapy and every 6 months after the end of chemotherapy up to 2 years . RESULTS: The detection time by MGIT gradually became longer with the progression of chemotherapy . The recovery rate at weeks 2, 4, 6, 8, and 10 by MGIT were significantly higher (P < 0.05) than on the Ogawa slants . Although one case was microbiologically diagnosed as a relapse, using the more sensitive MGIT system did not increase the relapse rate . CONCLUSION: The gradual prolongation of detection time with the progression of treatment and an attainment of negativity of sputum culture at 4 months after chemotherapy could be a useful intermediate marker to monitor the efficacy of treatment for patients with pulmonary tuberculosis by the MGIT system . Further evaluation is necessary to establish the utility of MGIT in monitoring the treatment process.

Water Sci Technol, 2002, 45(8), 195 - 8
Workshop 8 (synthesis): challenges of expanding ecological sanitation into urban areas; Milburn A et al.; After seven papers discussing specific examples of ecological sanitation projects, the workshop considered the background, motivation and feasibility of this technology . It was agreed that ecological sanitation could help tackle water scarcity, health protection and, by recycling water and nutrients into agriculture, food scarcity . Dense cities are probably unsuitable for its implementation, but rural, town and peri-urban areas are promising . Key issues that remains are: the microbiological and chemical risks associated with the technology; the need for major information, education and support programmes; effective linking to reuse schemes; tailoring systems to meet local physical, socio-economic and cultural circumstances.

Zhonghua Liu Xing Bing Xue Za Zhi, 2002 Apr, 23(2), 105 - 7
{A study on acute renal failure after an outbreak of diarrhea in Suixian county, Henan province}; Zhang J et al.; OBJECTIVE: To study the distributional feature and clinical characteristics of infectious diarrhea caused by enterohemorrhagic Escherichia coli O157:H7, and to understand its pollution to the environment and the carrier status among livestock and poultry . METHODS: To describing the incidence of diarrhea, to isolate and culture the pathogenic bacteria from samples of the patients with diarrhea and livestock or poultry with methods of microbiology, molecular biology and cytology, and then to determine the toxic factors . RESULTS: In the first epidemic area in Suixian county, Henan province, 35 cases had been found during 17 March and 6 July with 91% of them above age of 60 . Of them, 32 were complicated with acute renal failure, including 28 death (death rate: 87.50%) . One hundred and seven strains of O157:H7 were isolated from the samples of livestock or poultry and 48 strains were isolated from patients . It was found that 67 strains having toxic gene through microbiological, molecular biological and cytological technologies . Five types of toxic factors were found . CONCLUSION: The main factor causing death was the complicated acute renal failure from diarrhea infected by E . coli O157:H7 . The pathogen from livestock or poultry with high carrying rate might infect people through polluted water, food flies and close contacts . The outbreak of acute hemolytic uremic syndrome in Suixian county was caused by Enterohemorrhagic Escherichia coli O157:H7 infection.

Biopolymers, 2002, 67(4-5), 327 - 30
Raman spectroscopy investigation of biological materials by use of etched and silver coated glass fiber tips; Gessner R et al.; The results for surface enhanced Raman scattering (SERS) studies on biological samples are reported . Etched and silver coated glass fiber tips were used as a SERS substrate . This method enabled the recording of spectra of biological samples, such as plant tissue or microbiological cells, with a high spatial resolution . Because of the low laser power used with the fiber tips, it was even possible to investigate tissues that are very sensitive toward laser power as it is used in a common micro-Raman setup .

J Fr Ophtalmol, 2002 Apr, 25(4), 367 - 73
{Use of a pair of blood culture bottles for sterility testing of corneal organ culture media}; Gain P et al.; PURPOSE: To test the effectiveness and rapidity of a pair of blood culture bottles in the diagnosis of bacterial and fungal contamination of corneal organ culture media . MATERIAL: and methods: Seven hundred and sixty one microbiological analysis of storage media (Inosol(R) and Exosol(R), Opsia, Toulouse, France), sampled in all phases of the organ culture at 31 degrees C of 410 consecutive corneas, were analyzed . Each medium was inoculated in a pair of Bactec Plus Aerobic/F(R) and Bactec Lytic/10 Anaerobic/F(R) blood bottles (Becton Dickinson, Cockeysville, MD) and placed in a Bactec 9240 incubator for 14 days at 37 degrees C and in a Sabouraud broth at 20 degrees C . Changes in color or turbidity of storage media were evaluated daily at the corneal bank . Recipients were screened after graft for signs of infection . RESULTS: The overall contamination rate was 2.4% (18/761) . Contamination was detected in less than 1 day in 78% (14/18) and in less than 2 days in 94% (17/18) . Positivity of the microbiological controls of starting media preceded medium color changes in 10 out of 14 cases . Bactec blood bottles allowed detection of bacteria as well as Candida sp . yeasts . DISCUSSION: The use of a pair of aerobic and anaerobic blood culture bottles is a simple, effective and rapid method for the diagnosis of a wide range of microbiological contaminations of organ-cultured corneas during banking . CONCLUSION: The validation of this protocol will require a prospective study to compare it with the conventional microbiological method.

Haematologica, 2002 May, 87(5), 535 - 41
Chronic disseminated candidiasis in patients with hematologic malignancies . Clinical features and outcome of 29 episodes; Pagano L et al.; BACKGROUND AND OBJECTIVES: To evaluate the characteristics of patients affected by hematologic malignancies who developed a chronic disseminated candidiasis (CDC), and to ascertain the factors that influenced the outcome, in a retrospective study conducted between January 1990 and December 2000, in 4 Hematology Divisions . DESIGN AND METHODS: CDC was diagnosed by clinical features combined with radiological and/or histologic and/or microbiological data . RESULTS: Twenty-eight patients (male/female 14/14; average age 42 years, range 12-67) developed a CDC . Twenty had acute myeloid leukemia, 5 had acute lymphocytic leukemia and 3 had non-Hodgkin's lymphoma . All patients received chemotherapy, including cytarabine for 21 of them (75%) . Before the infection, 22 patients (79%) were neutropenic (absolute neutrophil count < 0.5 x 10(9)/L) for an average of 20 days (8-36), but at CDC diagnosis only 3 patients (11%) were neutropenic . Twenty-two patients (75%) received antifungal prophylaxis for an average of 15 days (10-60) . Before diagnosis of CDC, 9 patients (32%) had a candidemia . The sites compromised by CDC were: liver in 27 patients (96%) and/or spleen in 11 patients (38%) . Ten patients had other organs involved: lung in 6 patients (21%), kidney in 4 patients (14%), other sites 2 patients (7%) . Abdominal ultrasonography was positive in 96% of patients (27/28), and abdominal computed tomography-scan was positive in 100% of cases in which it was performed (21/21) . Liver biopsy was positive in 10/15 patients (67%) . The main signs and symptoms were: fever 86%, abdominal pain 54%, diarrhea 32%, tenderness 25%, vomiting 25%, jaundice 29%, dysphagia 7% . Among chemical analyses, the most sensitive test was alkaline phosphatase, with a 3-5-fold increase in 24 patients (86%); an increase of liver transaminases and g-glutamyl transferase was observed in less than 50% of patients . By 30 days after diagnosis 4 patients had died, 1 from infection, and 3 progression of the hematologic malignancy without signs of active CDC . Within 3 months from diagnosis 14 out of the remaining 24 patients (58%) received further chemotherapy: in particular, 2 patients underwent transplantation procedures . INTERPRETATION AND CONCLUSIONS: In our experience CDC is not a fatal complication of patients with hematologic malignancy, on the contrary to that observed for other fungal infections (i.e . aspergillosis, candidemia), characterized by a higher mortality rate . The major problem of this fungal complication is correlated to the delay in the following treatment for the hematologic malignancy with a high risk of progression of malignancy.

Eur J Med Res, 2002 Apr 30, 7(4), 177 - 80
Aspergillus antigen and PCR assays in bone marrow transplanted children; Bialek R et al.; Screening for Aspergillus antigen and DNA has been introduced for the early diagnosis of invasive aspergillosis (IA) in adults, but data in children at risk are scarce . Seventeen 1-108 month-old children were screened for Aspergillus antigenaemia by a commercial assay before and after bone marrow transplantation (BMT) . Seventy-one serum samples were examined retrospectively by a novel nested PCR assay . Results of both assays were correlated with clinical, radiological and microbiological findings used for the definition of invasive aspergillosis by the European Organisation for Research and Treatment of Cancer (EORTC) . Three cases of probable or possible IA were defined, and in 14 children invasive aspergillosis was ruled out . In 10 children, Aspergillus antigen was detected in at least two consecutive serum samples, a microbiological EORTC criteria of IA . Specific DNA was detected in 8 antigen-positive and 2 antigen-negative sera . A positive predictive value of 20% was calculated for both assays . Hence, a high rate of positive results of antigen Elisa and PCR assays in BMT children are due to transient antigenaemia and fungaemia without clinical relevance . According to our data, prospective studies in well defined pediatric patients are urgently needed to determine the value of serial Aspergillus PCR assays for the early diagnosis of invasive aspergillosis in children at risk.

Anaesthesia, 2002 Jun, 57(6), 557 - 61
Efficacy of microfiltration in decreasing propofol-induced pain; Davies AF et al.; In a randomised, double-blinded, two-centre trial we evaluated the effect of a microbiological filter (Supor, Pall Life Sciences) on propofol injection pain . We studied 336 unpremedicated adult patients, who graded pain experienced during induction of anaesthesia with propofol on a 4-point verbal rating scale . Use of the microfilter reduced both the incidence and severity of propofol injection pain (p < 0.001) . Incidence of severe pain in the filter group was 2.4% compared with 16.6% in the control group . Overall, 33.7% in the filter group experienced pain compared with 62.1% in the control group . A microbiological filter may provide a non-pharmacological alternative to a lidocaine/propofol mixture for reducing injection pain . It would also reduce the risk of any glass and bacterial contamination.

Clin Oral Implants Res, 2002 Jun, 13(3), 227 - 33
Elastase, alpha2-macroglobulin and alkaline phosphatase in crevicular fluid from implants with and without periimplantitis; Plagnat D et al.; The aim of this investigation was to determine the presence of selected enzymes and enzyme inhibitors in crevicular fluid collected from implants with and without clinical, radiographic and microbiological signs of periimplantitis . Eleven implants with symptoms of periimplantitis in eight patients (four men and four women) were compared to eleven implants in seven subjects (one man and six women) without periimplantitis . Periimplant crevicular fluid (PICF) was collected at the mesial and distal sites of each implant . Alkaline phosphatase activity (ALP) was measured by using p-nitrophenyl-phosphate as substrate, elastase activity (EA) by the use of a low molecular weight fluorogenic substrate, and the inhibitor alpha2-macroglobulin (alpha2M) by ELISA . ALP, EA and alpha2M were detected in the majority of samples in both groups . In comparison to the clinically healthy implants, total amounts of each of these substances were significantly higher in PICF collected around implants with periimplantitis . The mean total amounts of EA, alpha2M and ALP in the healthy group were: EA: 1.8 ng, alpha2M: 3.1 ng, ALP: 24.1 U, and in the periimplantitis group EA: 23.1 ng, alpha2M: 25.2 ng and ALP: 142.3 U . In addition, all three mediators were correlated with the clinical parameters . The results confirm the similarity of the inflammatory response of tissues surrounding implants and natural teeth, and suggest that ALP and EA could be promising markers of bone loss around dental implants.

Bioelectrochemistry, 2002 May 15, 56(1-2), 77 - 9
The role of hydrogenases in the anaerobic microbiologically influenced corrosion of steels; Da Silva S et al.; The direct electron transfer between 316 L stainless steel and the NAD-dependent hydrogenase from Ralstonia eutropha was studied by spectroelectrochemistry . The presence of hydrogenase and NAD+ clearly increased the quantity of electricity, which was consumed during the electrolysis performed at potential lower than -0.70 V/SCE . The involvement of hydrogenase in the cathodic depolarisation theory was discussed in the light of these results.

Pathology, 2002 Apr, 34(2), 178 - 84
Limiting potential infectious risks of transplanting insulin-producing pig cells into humans; Kumar G et al.; AIMS: Prior to commencing a study of grafting foetal/neonatal pig islet-like cell clusters into type I diabetic human subjects, the microbiological risks of transplanting porcine pancreatic tissue were assessed . METHODS: An exclusion list for screening donor animals and graft tissue in Australia was compiled following evaluation of the disease risks posed by 121 organisms, including 36 bacteria, 12 fungi, four mycoplasma, 31 parasites and 38 viruses . The list of evaluated agents was derived from the literature, interviews with veterinarians and physicians, and a survey of laboratories . RESULTS: The exclusion list contains 35 organisms (including 20 bacteria, four fungi, one mycoplasma, one parasite and nine viruses) that are zoonotic, pathogens of immunocompromised hosts (including human allograft recipients), pathogens resistant to antibiotics or potentially able to recombine with the human genome . These 35 agents can be detected by culture (e.g., Actinomyces), serological testing (e.g., influenza viruses) or nucleic acid amplification (e.g., Mycobacteria) . CONCLUSIONS: It is recommended that: (i) source pigs designated for use in human xenotransplantation trials should be tested regularly for the 35 organisms; (ii) the mothers of donor foetal/neonatal pigs and, when possible, the foetal/ neonatal pigs themselves should be tested immediately prior to the grafting of tissue into humans; and (iii) the exclusion list be modified for designated source pig herds in countries other than Australia.

Ann Rheum Dis, 2002 Jun, 61(6), 493 - 8
The value of synovial fluid assays in the diagnosis of joint disease: a literature survey; Swan A et al.; OBJECTIVE: To carry out a critical appraisal of the literature in an attempt to assess the current value of synovial fluid (SF) analysis in the diagnosis of joint disease . METHODS: A literature search was undertaken using the Medline, Biomed, Bids, Pubmed, and Embase electronic databases using the keywords: synovial fluid (SF) analysis, SF crystals, joint sepsis, acute arthritis, and SF cell counts, cytology, biomarkers, and microbiology . RESULTS: Publications fell into three main categories . Firstly, reports assessing the value of the three traditional assays (microbiology, white blood cell counts, and microscopy for pathogenic crystals) . For these quality control evidence was found to be sparse, and tests for sensitivity, specificity, and reliability showed worrying variations . These poor standards in SF analysis may be due to lack of inclusion of some tests within routine pathology services . Secondly, claims for the usefulness of "new" assays (cytology and biochemical markers) . For cytology, the supporting evidence was mainly anecdotal and there were no reports on specificity, sensitivity, and reliability . Interpretation difficulties are a major hindrance to the clinical use of biochemical assays, which remain primarily research tools . Finally, work on the diagnostic value of SF analysis in general . The appraisal confirmed that SF analysis remains of major diagnostic value in acute arthritis, where septic arthritis or crystal arthropathy is suspected, and in intercritical gout . CONCLUSIONS: Given the importance of SF tests, rationalisation of their use, together with improved quality control, should be immediate priorities . Further investigation is recommended into the contribution of SF inspection and white cell counts to diagnosis, as well as of the specificity and sensitivity of SF microbiological assays, crystal identification, and cytology.

Pediatr Infect Dis J, 2002 Mar, 21(3), 203 - 9
Cefepime versus ceftazidime as empiric monotherapy for fever and neutropenia in children with cancer; Chuang YY et al.; BACKGROUND: Monotherapy with cefepime or ceftazidime is an effective alternative to combination therapy for the treatment of febrile neutropenic adult cancer patients . We compared the efficacy and safety of cefepime and ceftazidime as empiric monotherapy of febrile neutropenia in children with cancer . MATERIALS AND METHODS: A prospective, open label, randomized, comparative study in pediatric cancer patients was conducted at Chang Gung Children's Hospital from January 1, 2000, to April 15, 2001 . Patients with fever and neutropenia (absolute neutrophil count of < or = 500/mm3) were randomized to receive either intravenous cefepime or ceftazidime (50 mg/kg/dose as two or three doses daily) . Febrile episodes were classified as microbiologically documented infection, clinically documented infection or unexplained fever . Clinical response to therapy was classified as success and failure . RESULTS: Ninety-five pediatric cancer patients with 120 febrile neutropenic episodes were randomized to receive empiric treatment with cefepime or ceftazidime . After 72 h of treatment, 82.8% (48 of 58) of the eligible patients in the cefepime group continued with unmodified therapy, compared with 87.9% (51 of 58) in the ceftazidime group . The neutrophil count was <100/mm3 at randomization for 76% of the patients in the cefepime group and 83% of those in the ceftazidime group; the median durations of neutropenia (<500/mm3) were 8.5 and 6.5 days, respectively . Of the 96 evaluable episodes the overall success rate with unmodified empiric therapy until the end of the treatment course in the cefepime group was comparable with that in the ceftazidime group (69% vs . 71%, P = 0.95) . The response rate after glycopeptides were added to the regimens was 79.2% for the cefepime group and 77.1% for the ceftazidime group . The bacterial eradication rate was 33% for the cefepime group and 20% for the ceftazidime group (P = 0.85), and the rates of new infections were 10.4% vs . 4.2% (P = 0.67), respectively . Both study drugs were well-tolerated . Three (6.4%) patients in the cefepime group and 2 (4.3%) patients in the ceftazidime group died . CONCLUSION: Cefepime appeared to be as effective and safe as ceftazidime for empiric treatment of febrile episodes in neutropenic pediatric cancer patients.

J Med Assoc Thai, 2001 Dec, 84 Suppl 3, S658 - 68
Rapid detection of Chlamydia pneumoniae DNA in peripheral blood mononuclear cells of coronary artery disease patients by real-time fluorescence PCR; Leowattana W et al.; Several recent reports including serological, pathological and animal studies have associated Chlamydia pneumoniae with coronary artery disease (CAD) . In order to establish whether chronic C . pneumoniae infection is linked to coronary artery disease, clinical intervention trials may be needed . However, to detect eligible patients with persistent infection, a reliable diagnostic marker must be developed for identifying cases and assessing efficacy of antichlamydial therapy . Moreover, the prevalence of circulating C . pneumoniae DNA in CAD patients varied widely from previous reports . A real-time PCR has been established by using HL-1 and HR-1 primer to amplify 437 base pairs product . Confirmation of the product was performed on LightCycler by melting curve analysis of detection probes labeled with LC-Red705 . Ninety-five angiographically confirmed CAD patients and 104 normal, healthy volunteers were recruited . The mononuclear cell layer was separated from collected blood and rapid, single step real-time PCR was used to detect C . pneumoniae DNA . C . pneumoniae DNA in peripheral blood mononuclear cells (PBMC) was found in 17 per cent of 95 CAD patients and 1 per cent of 104 normal healthy volunteers (odds ratio 20.86, 95% confidence interval 2.71 - 160.67, p < 0.0001) . There was no association between C . pneumoniae DNA in PBMC and serological status . The rapid, real-time PCR showed a clear-cut result between positive and negative cases . PBMC-based real-time PCR may be a useful tool for identifying subjects carrying C . pneumoniae in the circulation or in the vascular wall as well . It will be a specific indicator of current infection and will be used as a marker for assessing the microbiological efficacy of antichlamydial therapy in clinical intervention trials.

Leuk Lymphoma, 2002 Mar, 43(3), 657 - 9
Prior invasive pulmonary and cerebellar mucormycosis is not a primary contraindication to perform an autologous stem cell transplatation in leukemia; Tedeschi A et al.; Mucormycosis infections, caused by fungi of the families Rhizopus, Mucor or Absidia, are typically rapidly progressive and often fatal . We report a 27-year-old male with acute myeloid leukemia (AML) developing an invasive pulmonary-CNS mucormycosis during the neutropenic period after salvage induction chemotherapy; the infection was successfully controlled with surgery and antifungal therapy . The patient received two courses of consolidation chemotherapy and underwent autologous stem cells transplantation (ASCT) while receiving secondary antifungal systemic prophylaxis with liposomal Amphotericin B (L-AMB, Ambisome) . There was no clinical, radiological or microbiological evidence of mycotic reactivation during the bone marrow transplantation (BMT) procedure.

J Chromatogr A, 2002 Mar 8, 949(1-2), 367 - 72
Capillary electrophoresis for the determination of new markers of natural latex quality; Galli V et al.; Nowadays, increasing use of latex products in the healthcare area has also led to an increase in new scientific controls of raw material and manufactured products in order to maintain higher standards in quality control . Since field latex is a rich environment for microbial growth, in the absence of adequate preservation, the carbohydrates that it contains become microbiologically oxidised to the so-called volatile fatty acids (VFAs) . Samples of natural rubber latex coming from different countries and processed in different ways have been tested by applying a capillary electrophoresis method for the measurement of the short-chain organic acids present in sera . The separation was performed with phosphate buffer at pH 6.25 and cetyltrimethylammonium bromide (CTAB) as background electrolyte in an uncoated fused-silica capillary with -10 kV of applied potential . The sample needs no other pre-treatment more than coagulation to obtain the serum . In the assayed samples, it has been shown that poorly-preserved latex presented higher amounts of succinic acid and lower amounts of malic acid . The succinic to malic acid ratio may be an important parameter because it cannot be altered by dilution or similar processes such as the traditional VFA index, used to determine the quality of latex . Ratios for succinic to malic acid <0.6 have been found for well-preserved latex and >0.6 for poorly-preserved latex.

Int J Food Microbiol, 2002 May 5, 75(1-2), 111 - 8
Microbiological activity in stored olive oil; Ciafardini G et al.; The disappearance of the bitter taste of newly produced olive oil during storage is due to the enzymatic hydrolysis of the bitter-tasting secoiridoid compound known as oleuropein . Current knowledge attributes the enzymatic hydrolysis of the oleuropein to the beta-glucosidase present in the olives . The present study, however, has demonstrated for the first time that oleuropein present in olive oil can be hydrolysed by beta-glucosidase from the yeasts Saccharomyces cerevisiae and Candida wickerhamii . The enzymatic analyses carried out directly on the untreated olive oil and on sterilized olive oil inoculated with the above-mentioned yeasts proved the beta-glucosidase activity through the hydrolysis of both the synthetic substrate p-nitrophenyl-beta-D-glucopyranoside (PNPG) and the oleuropein . The absence of lipases in the isolated S . cerevisiae and C . wickerhamii examined lead us to believe that the yeasts contribute in a positive way towards the improvement of the organological quality of the oil without altering the composition of the triglycerides.

Eur Respir J, 2002 Apr, 19(4), 743 - 55
Diagnosis and treatment of invasive pulmonary aspergillosis in neutropenic patients; Reichenberger F et al.; Invasive pulmonary aspergillosis is a major cause of morbidity and mortality in neutropenic patients . Microbiological and serological tests are of limited value . The diagnosis should be considered in neutropenic patients with fever not responding to antibiotics, and typical findings on thoracic computed tomography scan . Whenever possible, diagnosis should be confirmed by tissue examination . Newer techniques, such as polymerase chain reaction may change the current diagnostic approach . Therapeutic strategies consist of prophylaxis in risk groups and the early application of antifungal agents in suspected or probable disease . Amphotericin B as desoxycholate or lipid formulation is the current standard medication in invasive infection, although it has major side effects . Its role is challenged by the new azole derivates, such as itraconazole and voriconazole, and the new echinocandins . Additional therapies with cytokines, such as granulocyte macrophage colony stimulating factor and interferon-gamma, and with granulocyte transfusions are under evaluation . In selected cases lung resection is of proven diagnostic and therapeutic value . This paper analyses the current understanding of the pathogenesis and epidemiology of invasive aspergillosis and reviews the actual diagnostic and therapeutic strategies for invasive pulmonary aspergillosis in neutropenic patients.

Life Sci Space Res, 1973, 11, 77 - 88
Some results of medical investigations performed during the flight of the research orbital station Salyut; Gurovsky NN et al.; The paper presents the main results of physiological studies carried out during the flight of the Salyut station . Details of atmospheric composition, diet, provisions for personal hygiene, the on-board medical kit, prophylactic measures, work and rest schedule are given . Methods of investigation, particularly for studying the cardiovascular response, are described, including tests using the application of lower body negative pressure . The subjective and objective in-flight condition of the cosmonauts is dealt with in detail . An evaluation of the cardiovascular response is made, as compared with previous flights, both at rest and during tests . Results of clinical and biochemical studies of the blood, certain indices of visual perception and microbiological investigations are described . It is concluded that the observed physiological changes are reversible.

Life Sci Space Res, 1973, 11, 25 - 31
Antarctica as a Martian model; Vishniac WV et al.; Previous investigators have reported that the microbiological population of the glacier free valleys of southern Victorialand, Antarctica, is sparse, and that from about 10% of the soil samples examined no micro-organisms could be cultivated . Since these areas are assumed to be more favorable to the growth of terrestrial organisms than any Martian environment, the previous authors concluded that the probability of terrestrial organisms growing on Mars would therefore be so small that sterilization standards could be relaxed by many orders of magnitude . The unsuitability of the Antarctic environment to the multiplication of terrestrial micro-organisms was ascribed by them to limiting amounts of water . We have carried out a survey of a variety of environments in the dry valleys, ranging from mountain crests to valley floors . The main purpose of our investigation was the determination of active microbial multiplication in the soil . A series of techniques was employed which permitted the detection of bacterial growth in situ . All evidence points to an active growth of micro-organisms in the Antarctic soil in all locations which we examined . The measurements were supported by electron micrographs of soil films which showed colonial growth covering soil particles . These findings suggest that Antarctica does not serve as a useful model for the Martian environment in evaluating quarantine standards.

Arch Orthop Trauma Surg, 2002 Feb, 122(1), 53 - 5
Osteolytic lesion in the greater trochanter mimicking tumor; Kalbermatten DF et al.; Two patients with an osteolytic lesion of the greater trochanter suggesting a malignant bone tumor are presented . Biopsy, microbiological and histological examination suggested a diagnosis of trochanteric tuberculosis . Treatment consisted of multiple surgical debridements and antituberculous chemotherapy . The incidence of similar cases is expected to increase with the rising incidence of tuberculosis.

Exp Dermatol, 2002 Apr, 11(2), 159 - 87
What is the 'true' function of skin?
Chuong CM, Nickoloff BJ, Elias PM, Goldsmith LA, Macher E, Maderson PA, Sundberg JP, Tagami H, Plonka PM, Thestrup-Pederson K, Bernard BA, Schroder JM, Dotto P, Chang CM, Williams ML, Feingold KR, King LE, Kligman AM, Rees JL, Christophers E.
Conventional textbook wisdom portrays the skin as an organ that literally enwraps whatever each of us stands for as a more or less functional, individual member of the mammalian species, and has it that the skin primarily establishes, controls and transmits contacts with the external world . In addition, the skin has long been recognized to protect the organism from deleterious environmental impacts (physical, chemical,microbiological), and is well-known as crucial for the maintenance of temperature, electrolyte and fluid balance . Now, ever more studies are being published that show the skin to also operate as a huge and highly active biofactory for the synthesis,processing and/or metabolism of an astounding range of e.g . structural proteins, glycans, lipids and signaling molecules . Increasingly, it becomes appreciated that the skin, furthermore, is an integral component of the immune, nervous and endocrine systems, with numerous lines of cross-talk between these systems established intracutaneously (e.g . Ann NY Acad Sci Vol 885, 1999; Endocrine Rev 21:457-487, 2000; Physiol Rev 80:980-1020, 2001; Exp Dermatol 10: 349-367, 2001) . All these emerging cutaneous functions beyond the classical image of the skin as a barrier and sensory organ are immediately relevant for many of the quandaries that clinical dermatology, dermatopathology, and dermatopharmacology are still struggling with to-date, and offer the practising dermatologist attractive new targets for therapeutic intervention . Yet, many of these skin functions are not even mentioned in dermatology textbooks and await systematic therapeutic targeting . Following a suggestion by Enno Christophers, the current 'Controversies' feature brings together an unusually diverse council of biologists and clinicians, who share their thought-provoking views with the readers and allow us to peek into the future of research in cutaneous biology, not the least by reminding us of the -- often ignored -- evolutionary and embryonal origins of our favorite organ . Hopefully, this unique discussion feature will foster an understanding of the 'true' skin functions that is both more comprehensive and more profound than conventional teaching on this topic, and will stimulate more than 'skin-deep' reflections on the full range of skin functions.

Ying Yong Sheng Tai Xue Bao, 2002 Feb, 13(2), 239 - 42
{Interaction between microorganisms and heavy metals and its application}; Chen S et al.; Interactions between microorganisms and heavy metals were expatriated in many ways . Because of their resistance and detoxification to heavy metals, microorganisms are able to leach, absorb and transform heavy metals, which has been actively applied to extract heavy metals from low-rate ore in mine exploitation . Although heavy metals are toxic to microorganisms population and harmful to its processes, some special microorganisms have been applied to the treatment of industrial waste materials and the remediation of soils polluted by heavy metals . The application of microbiological biomass and activity to evaluating the pollution situation and ecological risk of heavy metals in environment media is also significant.

Ann Otol Rhinol Laryngol, 2002 Apr, 111(4), 323 - 7
Isolated sphenoid sinus disease: an analysis of 122 cases; Wang ZM et al.; Isolated sphenoid sinus disease (ISSD) is a relatively uncommon disease . The present study is a retrospective review of 122 patients with ISSD who were treated at the Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital at Shanghai Medical University over a 25-year period . The diagnosis of ISSD was made on the basis of history and physical examination, signs and symptoms, nasal endoscopy, and computed tomography (CT) and magnetic resonance imaging (MRI) . The final diagnosis of ISSD was confirmed by histopathologic and microbiological examinations of the surgical specimens . The pathological findings in this study included sphenoid cyst (47 cases), sphenoid sinusitis (31 cases), fungal disease (19 cases), inverted papilloma (4 cases), sphenochoanal polyp (1 case), foreign body (8 cases), malignant tumors (8 cases), and others (4 cases) . The most common initial symptom was headache, followed in decreasing order by visual changes, cranial nerve palsies, and nasal symptoms . The more frequent use of routine CT and MRI scanning, as well as endoscopy, in the diagnosis of sinus disease has led to an increase in the early diagnosis of ISSD . The recent advances in endoscopic sphenoidotomy has allowed for relatively safe and immediate treatment of ISSD, preventing late extension into adjacent vital structures, which is commonly fatal . Endoscopic surgery also enables the surgeon to make a precise pathological diagnosis.

Bioresour Technol, 2002 May, 82(3), 253 - 60
Isolation of a biodegradable sterol-rich fraction from industrial wastes; Dias AC et al.; Several industrial waste materials were screened for their sterol content . The possibility of using these industrial by-products as sterol sources for the microbiological production of 4-androsten-3,17-dione (AD) and 1,4-androsta-diene-3,17-dione (ADD) was investigated . Two methods of obtaining the sterol fraction from wastes were developed . Sterol-rich (96-98%) fractions were isolated in a yield above 70%, from a tall-oil effluent of a paper pulp industry and from edible-oil deodorizates . These fractions were subsequently used as a substrate for microbial degradation by a Mycobacterium sp . strain and proved to be easily converted to AD and ADD.

Crit Care Med, 2002 Mar, 30(3), 541 - 7
Significance of Candida recovered from intraoperative specimens in patients with intra-abdominal perforations; Sandven P et al.; OBJECTIVE: Determine the significance of recovering yeasts from intraoperative specimens from the abdominal cavity and to evaluate the effect of a single intraoperative dose of fluconazole on clinical outcome in patients with intra-abdominal perforations . DESIGN: Prospective, randomized, double-blind study . SETTING: Multicenter study from 13 hospitals in Norway . PATIENTS: One hundred nine patients with intra-abdominal perforations . INTERVENTIONS: Patients were randomized to receive either a single 400-mg fluconazole dose or placebo during the operation . MEASUREMENTS AND MAIN RESULTS: An intra-abdominal specimen for microbiological culture was obtained at the time of the operation . The primary response variable in the study was death . Secondary response variables were three parameters indicating a complicated postoperative period: mechanical ventilation for > or = 5 days, intensive care treatment for > or = 10 days, and use of a central venous catheter for > or = 10 days . Yeasts were recovered from a intraoperative intra-abdominal specimen from only 1 (3.5%) of 28 patients with perforated appendicitis and from 32 (39.5%) of 81 nonappendicitis patients . Excluding the appendicitis patients, the yeast recovery rate was high both for patients hospitalized at the time of the perforation (45%) and for nonhospitalized patients (32%) . The overall mortality was 11% (12 patients) . Single-dose intraoperative fluconazole prophylaxis did not reach a statistically significant effect on mortality (4 of 53 patients in the fluconazole group and 8 of 56 patients in the placebo group died {p = .059}) . The only two explanatory variables significantly related to death were a intraoperative finding of yeast from an intra-abdominal specimen and the occurrence of a spontaneous perforation in a patient already hospitalized for nonsurgical cancer treatment . Detection of yeast was also a significant explanatory variable for a prolonged period of mechanical ventilation, intensive care treatment, and prolonged use of a central venous catheter . CONCLUSIONS: Single-dose intraoperative fluconazole prophylaxis did not have a statistically significant effect on overall mortality (odds ratio = 0.21; 95% confidence interval, 0.04-1.06; p = .059) in patients with intra-abdominal perforation . The recovery rate of yeast from intraoperative specimens from the abdominal cavity was high (>30%) and was associated with death and a complicated postoperative course.

Crit Care Med, 2002 Mar, 30(3), 529 - 35
Diagnosis and follow-up of infections in intensive care patients: value of C-reactive protein compared with other clinical and biological variables; Reny JL et al.; OBJECTIVE: To evaluate diagnostic and prognostic values of C-reactive protein (CRP) dosage in critically ill patients . DESIGN: Prospective, observational study . SETTING: Medical intensive care unit (ICU) in a university hospital . PATIENTS: A consecutive series of 74 patients admitted to the ICU . INTERVENTION: CRP measurements at admission and every 4 days thereafter . MEASUREMENTS AND MAIN RESULTS: At admission, 28 patients (38%) had microbiologically proven infections . Compared with uninfected patients, their mean +/- SD CRP level was 191 +/- 123 vs . 83 +/- 91 mg/L (p < .0001), respectively, white blood cell count was 15.3 +/- 7.5 vs . 11.4 +/- 5.3 G/L (p = .01), and the systemic inflammatory response syndrome (SIRS) was present for 96% vs . 67% (p = .008) . No threshold value could be identified to discriminate between these two populations . Multivariate analysis retained CRP and SIRS as the only variables independently associated with the presence of an infection . The combination of CRP > or = 50 mg/L with SIRS was identified as the best model to diagnose infection at admission . This multivariate model performed better than temperature, CRP alone, and white blood cell count . Among the 28 infected patients, 10 recovered; CRP values decreased significantly in this population as compared with patients with persistent infection (-130 +/- 110 vs . 12 +/- 97 mg/L, respectively; p = .004) . A CRP decrease > or = 50 mg/L between admission and day 4 was the best cutoff value to diagnose recovery (sensitivity 89%, specificity 79%) . CONCLUSION: CRP in combination with SIRS was useful to diagnose infection in ICU patients; a CRP decrease > or = 50 mg/L between admission and day 4 was the best predictor of recovery.

Ann Dermatol Venereol, 2002 Mar, 129(3), 294 - 7
{Acute generalized exanthematous pustulosis due to fluconazole}; Fabre B et al.; INTRODUCTION: Fluconazole (Triflucan(R)), a systemic triazole antifungal agent is largely prescribed and some cutaneous side effects have already been described . We report the first case of acute generalized exanthematous pustulosis due to this molecule in a patient with cutaneous candidosis . CASE REPORT: A 65 year-old-woman was treated with fluconazole (200 mg/day) for a persistent cutaneous candidosis infection on the buttocks . After the third dose, the patient presented with a pustular eruption with erythema located on her trunk and in her large skin folds . The eruption was associated with fever at 39 degrees C, asthenia and neutrophilia (9,000/mm(3)) . The histologic examination and the negativity of microbiological cultures were consistent with the diagnosis of acute generalized exanthematous pustulosis . The eruption cleared with local steroids in about ten days . Nineteen days later, the same pustular eruption occurred but without fever nor neutrophilia . DISCUSSION: Clinical, biological and histological manifestations were consistent with the diagnosis of acute generalized exanthematous pustulosis due to fluconazole . According to the imputability criteria of Begaud et al., intrinsic imputability of fluconazole was possible (I2) . According to the classification of the EuroSCAR study, it was certain . No similar case of recurrence had already been described after the withdrawal of the molecule . We believe this is the first case of acute generalized exanthematous pustulosis due to fluconazole (extrinsic imputability: B0).

J Ind Microbiol Biotechnol, 2002 Apr, 28(4), 213 - 8
An implementation of the HACCP system in the production of food-packaging material; Sjoberg AM et al.; The Hazard Analysis Critical Control Point (HACCP) system according to the Codex Alimentarius model was applied to the processes of five paper and paperboard mills and four plants further converting paper or board intended for contact with foodstuffs . The generalised flow diagrams of the processes are presented . Each of the overall processes contained 40-150 process steps . Normally three to five sessions with HACCP teams and additional private negotiations were needed for each mill or plant . Hazards leading to critical control points (CCPs) were microbiological (handling/storage, circulation water, starch, process environment) and physical (process environment) in mills, and microbiological (storage, lacquers or glues, packaging and process environment), chemical (printing) and physical (storage of products, packaging and process environment) in plants . Specifications, critical limits (e.g., based on different kinds of reports and instructions), monitoring methods (microbiological and visual) and frequency, responsibilities and corrective actions of the processes are presented . Most of the improvements focused on improving the process environment . In five cases, hygiene training was included in the implementation of the HACCP system.

Med Device Technol, 2002 Mar, 13(2), 18 - 20
Experiences with microbiological validation of radiation sterilisation; Harries J; Apart from process control, the two most critical activities associated with radiation sterilisation of medical devices are the dosimetric and microbiological analyses required to validate the process . This article discusses some of the problems experienced in the field of microbiological validation and highlights the coming changes to the standards.

Crit Care, 2002 Apr, 6(2), 117 - 20 Epub 2002 Feb 13.
Pro/con clinical debate: the use of a protected specimen brush in the diagnosis of ventilator associated pneumonia; Heyland D et al.; Although mechanical ventilation is instituted as a life-saving technique, it may lead to complications that can negatively impact on patients' morbidity and/or mortality . Ventilator associated pneumonia (VAP) is one such complication that is a common challenge to intensivists . Although most experts would agree that early 'appropriate' antibiotic use is essential in patients who develop VAP, the best diagnostic test to guide decision-making is far from clear . One diagnostic test that is capable of providing microbiological samples from the lower respiratory tree is invasive bronchoscopy with a protected specimen brush . Such a procedure has long been available to intensivists and is frequently employed in many intensive care units . However, this procedure has associated costs and potential complications, and its utility in VAP has been challenged . In this issue of Critical Care Forum, the two sides of this debate are brought forward with compelling arguments . The authors' arguments should fuel future trials.

Monaldi Arch Chest Dis, 2001 Dec, 56(6), 521 - 6
Impact of BAL on the diagnosis and treatment of nosocomial pneumonia in ICU patients; Ferrer R et al.; Nosocomial pneumonia and ventilator-associated pneumonia are currently the second leading cause of nosocomial infections and account for approximately 10-15% of all hospital-acquired infections . Crude mortality rates range from 24% to 76% depending on the population and clinical setting studied . During the last ten years, several diagnostic methods have been developed to microbiologically confirm the clinical diagnosis, especially in mechanically ventilated patients . This article seeks to clarify the issues surrounding the use of invasive fiberoptic bronchoscopic techniques in the diagnosis and treatment of nosocomial pneumonia.

Indoor Air, 2000 Jun, 10(2), 74 - 80
Microbiology on indoor air '99--what is new and interesting? An overview of selected papers presented in Edinburgh, August, 1999; Gravesen S; A multidisciplinary approach to microbiological implications of indoor air is fruitful for research as well as management of health and building problems . The Finnish and the Danish mold programs are examples of such productive collaborative studies . Dust samples taken from classrooms in schools where occupants complain of building-related symptoms (BRS) demonstrated an inflammatory potential in vitro, measured as a release of cytokine interleukin (IL)-8 . An increase of the metabolite NO and liberation of tumor necrosis factor (TNF)-alpha and other cytokines during exposure were obtained in vivo, was presented based on these programs and on epidemiological studies on residential fungal contamination and health conducted in Canada and The Netherlands . New methods for assessing fungal exposure are PCA analysis for the toxigenic mold Stachybotrys chartarum and EPS-Asp/Pen for detecting of Aspergillus and Penicillium in dust . Based on a limited data set it is shown that emission rates of fungal spores are inversely proportional to relative humidity (RH), directly related to flow rate and to surface loading . Poor maintenance, risk constructions and risk materials are described in several studies as the main causes of water damage in buildings.

Curr Opin Infect Dis, 2001 Apr, 14(2), 181 - 6
Mycoplasma pneumoniae infections; Hammerschlag MR; Mycoplasma pneumoniae is a frequent cause of community-acquired respiratory infections in children and adults . Although the organism is felt to be the most frequent 'atypical' pathogen responsible for community-acquired pneumonia in adults, the prevalence of M . pneumoniae varies greatly from study to study, depending on the population and the diagnostic methods used . Recent studies have found the prevalence of M . pneumoniae in adults with pneumonia to range from 1.9 to over 30% . M . pneumoniae is also a frequent cause of outbreaks of respiratory disease in institutional settings . However, the diagnosis of M . pneumoniae infection is hampered by the lack of standardized, rapid, specific methods . This problem was illustrated by the results of an investigation of an outbreak of M . pneumoniae infection in a federal training facility . Accurate diagnosis required a combination of polymerase chain reaction and serology, as IgM antibodies were not present early in the course of the infection in many patients . Several papers evaluating various serological and polymerase chain reaction assays were published during the period of this review . An assessment of the actual performance of these tests was also hampered by the lack of standardized comparative methods . M . pneumoniae is susceptible in vitro to macrolides, tetracyclines and quinolone antibiotics; however, data are limited on the microbiological efficacy of these agents . Several pneumonia treatment studies were published during this period, practically all of them based the diagnosis of M . pneumoniae infection on serology; different methods and criteria were used in each study, and thus the microbiological efficacy could not be assessed . The Infectious Disease Society of America recently stated in their revised Practice Guidelines for the Management of Community-Acquired Pneumonia in Adults that, as there were no diagnostic tests available that reliably and rapidly detect M . pneumoniae, therapy must usually be empirical.

Pneumologia, 2001 Oct-Dec, 50(4), 220 - 4
{Clinical and therapeutical correlations in Moraxella catarrhalis respiratory infection in children.}; Gotia S et al.; In childhood recurrent respiratory infection with Moraxella catarrhalis have high incidence demonstrated by multiple risk factors association (atopia, immunsuppresion, chronic diseases, malnutrition) that makes this common bacteria pathogen . The study was carried on 56 children (0-16 years old) . Authors try to find correlations between clinical signs and microbiological markers that determine recurrent respiratory infection with Moraxella catarrhalis . Treatment consisted of association between "target" antibiotherapy and immunomodulation drugs . Efficacy of this treatment was proven by decreased numbers of recurrent infection (in 35% cases comparing to 53% selected cases for immunomodulation), improvement of evolution of chronic diseases, decreased number of days and price of hospitalisation.

Life Sci Space Res, 1967, 5, 119 - 21
The results of biological studies made on board the Voskhod and Voskhod 2 spaceships; Antipov VV et al.; The biological effects of flight and outer space factors were studied on biological specimens of various organization, viz . spiderwort microspores, dry seeds of the pine tree, wheat, onion and of other higher plants as well as on lysogenic bacteria and wine flies . Furthermore, lysogenic bacteria were studied for the effectiveness of a number of well known ray-proof substances (such as mercaptopropylamine, 5-methoxytriptamine, etc.) . The specimens were secured in special containers both on board the spaceships and in the hip pockets of the astronaut Leonov's spacesuit . Biological effectiveness of the factors was evaluated by means of cytogenic, genetic and microbiological procedures . The analysis of the data obtained has shown that under the impact of the complex of flight and outer space factors, including ionizing radiation, both qualitative and quantitative changes occurred in the hereditary structures of some of the specimens, viz.: wheat seeds, spiderwort microspores and lysogenic bacteria . These changes were similar to the effects recorded in the flights of Vostok-2, 3, 6 . As compared to the controls, an enlargement was found in the cells of wheat sprout radicles, accompanied by chromosome rearrangements (N . L . Deloney et al.) . Increased phage production by lysogenic bacteria (N . N . Zhukov-Verezhnikov, N . I . Rybakov et al.) and impairment of the mitosis mechanism in the spiderwort macrospores were demonstrated (N . L . Deloney, etc.) . Higher frequency of dominant lethals and more frequent than normal chromosome indivergence in the wine flies were recorded . Quantitatively, the recorded drifts were insignificant (as was the case with the 'Vostok' spaceships' flights) . Of interest are the results of the experiments on spiderwort microspores carried out with B . B . Yegorov's participation . The data obtained show that 1) during the mitosis stage spiderwort microspores show differing sensitivity to the space flight factors, and that 2) the mitosis stages support the previous hypothesis that impairment of the mitosis mechanism is due to the state of weightlessness, while chromosome rearrangements are chiefly induced by the effects of the complex of factors related to the take-off and touch-down stages of the flight . (N . L . Deloney et al.) . The analysis of beta-mercaptopropylamine and 5-methoxytriptamine tests indicates that these substances significantly reduce the phage producing activities of the lysogenic bacteria not only blocking the induced phage production but reducing the amount of spontaneous phage production as well (N . N . Zhukov-Verezhnikov, N . I . Rybakov et al.) . Thus, the results of biological experiments on various specimens with differing degrees of radiosensitivity agree well among themselves and are consistent with the data on the dosage of space radiation.

Rev Chir Orthop Reparatrice Appar Mot, 2002 Apr, 88(2), 113 - 6
{Contribution of systematic culture of drainage fluids in Altemeier class 1 and 2 procedures}; Cosseron M et al.; PURPOSE OF THE STUDY: We conducted a prospective study to determine the therapeutic impact of systematic culture of suction drainage collections in Altemeier class I and II procedures . MATERIALS AND METHODS: We examined the following questions: how many microbiologically positive samples and infections of the operative site were present in the included patients? for positive cases, what was the antibiotic prescription (excluding antibiotic prophylaxy protocols planned before surgery for cleaning)? if the sample was positive in a patient with no clinical infection, what antibiotics were prescribed? RESULTS: A total of 1039 samples were collected in 470 patients undergoing Altemeier class I and II procedures . One hundred five cultures were positive in 34 patients who had undergone major surgery . There were 11 postoperative infections during the study period . Mean delay to diagnosis of infection was 19.5 days . Only one infected patient with positive drainage samples developed an infection on the 7(th) day; the causal germ was different from that identified in the drainage collection . Only one of the patients with a positive drainage sample was given antibiotics, but this treatment was initiated at peroperative reception of the laboratory results . DISCUSSION: Our findings demonstrate that systematic samples of drainage collections make no contribution to therapeutic decision making in patients undergoing class I and II surgery.

J Appl Microbiol, 2002, 92(5), 920 - 6
Enhancement of solar inactivation of Escherichia coli by titanium dioxide photocatalytic oxidation; Salih FM; AIMS: To improve solar water disinfection using a photocatalysing semi-conductor and to study the mechanisms involved in this process . METHODS AND RESULTS: Cells of Escherichia coli were used as the microbiological indicator to study the possibility of improving the efficiency of solar water disinfection using titanium dioxide (TiO2) as a photooxidizing semi-conductor . TiO2 was used either as a suspended powder or in an immobilized form . Both applications improved the efficiency of solar disinfection . TiO2 in suspension was more effective than the immobilized form, producing enhancement factors of 1.62 and 1.34, respectively . The concentration of TiO2 greatly affected efficiency, with a maximum effect at 1 mg ml(-1) . Higher TiO2 concentrations reduced the efficiency . Dimethyl sulphoxide (DMSO) and cysteamine (Cys), hydroxyl radical (OH.) scavengers, were used to elucidate the mechanisms involved in the presence of TiO2 . Both DMSO and Cys totally abolished the enhancing effect produced by the presence of TiO2 . CONCLUSIONS: Sunlight has a potential water disinfecting capacity . The use of TiO2 greatly improved this efficiency . The effect of TiO2 was mainly concentration-dependent, giving maximum efficiency at 1 mg ml(-1) . The presence of DMSO and Cys removed the TiO2-induced enhancement, indicating that OH . may be involved in the process of cell killing . SIGNIFICANCE AND IMPACT OF THE STUDY: The efficiency of solar disinfection is limited and time-consuming and needs to be improved . The use of a semi-conductor is promising as it reduces the time of exposure and therefore increases the efficiency of solar disinfection . This would allow for the availability of good quality water, and hence would improve the quality of life.

Arch Dis Child, 2002 May, 86(5), 336 - 8
Deaths from pertussis are underestimated in England; Crowcroft NS et al.; AIMS: To improve estimates of deaths from pertussis in England and to identify reasons for under ascertainment . METHODS: Comparison of deaths identified from enhanced laboratory pertussis surveillance, hospital episode statistics (HES), and Office for National Statistics (ONS) death registrations in England, 1994 to 1999 . RESULTS: A total of 33 deaths were identified, 88% of infants less than 4 months old . There was overlap between all sources; 22 deaths were identified in the enhanced pertussis surveillance system, 18 in ONS mortality data, and nine in HES . Children who had died from pertussis without mention of pertussis on the death certificate were more likely to have been certified by coroners than those with mention of pertussis (p = 0.0005) . Using capture-recapture analysis, the total number of deaths from pertussis in the five and a half year period is estimated to be 46 (95% CI 37 to 71), or around nine deaths per year . CONCLUSIONS: National mortality statistics significantly under estimate deaths from pertussis in England and are inadequate for monitoring the national immunisation programme . The largest number of deaths is identified through enhanced laboratory surveillance . Death registration systems should take into account available microbiological information to ensure that cause of death is accurately assigned.

J Vet Dent, 2001 Dec, 18(4), 177 - 83
Clinical and microbiological effects of oral zinc ascorbate gel in cats; Clarke DE; The clinical and microbiological effects of zinc ascorbate gel applied orally in cats were evaluated during a 42-day study period . Cats were divided randomly into two equal groups, with the treatment group (18 cats) receiving zinc ascorbate gel and the control group (18 cats) receiving a placebo (0.9% sterile saline) . Clinical parameters evaluated biweekly included halitosis, plaque, calculus, and gingivitis . Aerobic and anaerobic bacterial cultures were obtained from cats in the treatment group at Days 0 and 42 . There was a significant decrease in plaque, gingivitis, and anaerobic periodontal pathogens in treatment group cats . Halitosis and calculus scores were not significantly different in treatment group compared with control group cats . The results of this study suggest that zinc ascorbate gel used as an oral antiseptic improves feline oral health, and may be most effective in decreasing bacterial growth, plaque formation, and gingivitis when applied following a professional teeth cleaning procedure.

Rinsho Shinkeigaku, 2001 Sep, 41(9), 606 - 11
{A case of cavernous sinus syndrome following a mycotic aneurysm of extracranial carotid artery}; Takahashi K et al.; A 66-year-old man was admitted to our department with left abducens palsy and pain in the territory of the left trigeminal nerve . He had a history of left mandibular osteomyelitis that had been treated for five years in the dental department . However, the osteomyelitis was resistant to therapy . Two months before this admission, he had an infectious aneurysm of the left extracranial carotid artery with occlusion . On admission, the ESR was 140 mm/hour . P-ANCA and antinuclear antibody were negative . Lumbar puncture revealed elevated cell counts (43% neutrophils) and protein . Microbiological studies were negative . Cranial MR images showed an enhanced lesion in the left cavernous sinus . His condition gradually improved with high dose of penicillin and low dose of corticosteroid . However, he died of pulmonary embolism after 81 days . At autopsy, the left extracranial carotid aneurysm was highly fibrose . The left CCA, ICA, and ECA were occluded from the origin of the left common carotid artery to the ICA in the cavernous sinus . There were also fibrosis, hemosiderin, and macrophages around these arteries, and parts of these arteries were destroyed . The left cavernous sinus lesion was also highly fibrose . These pathological findings indicated that there was old inflammation around the left extracranial carotid aneurysm, left carotid artery, and left cavernous sinus . We believe that the left cavernous sinus syndrome in our patient was caused by left carotid artery vasculitis induced by the left infectious extracranial carotid aneurysm . We also believe that this infectious aneurysm was caused by the left mandibular osteomyelitis.

Helicobacter, 2002 Apr, 7(2), 71 - 5
Helicobacter pylori-related iron deficiency anemia: a review; Barabino A; Several clinical reports have demonstrated that Helicobacter pylori gastric infection has emerged as a new cause of refractory iron deficiency anemia, unresponsive to iron therapy, and not attributable to usual causes such as intestinal losses or poor intake, malabsorption or diversion of iron in the reticulo-endothelial system . Although the interaction between infection and iron metabolism is now well consolidated, our understanding of the pathogenetic mechanism underlying the anemia is still wanting . Microbiological and ferrokinetic studies seem to suggest that Helicobacter pylori infected antrum could act as a sequestering focus for serum iron by means of outer membrane receptors of the bacterium, that in vitro are able to capture and utilize for growth iron from human lactoferrin . The proposed hypothesis does not answer why this complication is such a rare disease outcome in a common human infection but it may be used as a template for further controlled studies to determine the mechanisms of this atypical, medically important putative sequelae of H . pylori infection.

Food Addit Contam, 2002, 19 Suppl, 79 - 92
Food-contact paper and board based on recycled fibres: regulatory aspects--new rules and guidelines; Escabasse JY et al.; The question of recycled papers in contact with foods is discussed in detail with respect to regulatory and technical aspects . The legal context is given, and major existing regulations are reviewed . The safety of recycled fibre use is examined with respect to chemical, microbiological and organoleptic contamination . Toxicological testing possibilities on finished paper products are discussed . The harmonization work in progress at the Council of Europe level is presented in detail, and the authors give their personal view on future evolution.

Public Health, 2002 Mar, 116(2), 75 - 80
Surveillance of foodborne outbreaks of infectious intestinal disease in England and Wales 1992-1999: contributing to evidence-based food policy?
O'Brien SJ, Elson R, Gillespie IA, Adak GK, Cowden JM.
Between 1992 and 1999, a total of 1426 general outbreaks of infectious intestinal disease reported to the Public Health Laboratory Service (PHLS) Communicable Disease Surveillance Centre (CDSC) were described as foodborne . Where the evidence base to support the conclusions drawn was provided (66.3% of outbreaks) a combination of microbiological and analytical evidence was reported in 4% of outbreaks (60/1426); microbiological evidence alone in 10% of outbreaks (149/1426); analytical evidence alone in 23% of outbreaks (322/1426); microbiological evidence in combination with descriptive epidemiology in 3% of outbreaks (46/1426) and descriptive epidemiology alone in 26% of outbreaks (365/1426) . Information supplied to CDSC by local investigators appears to be of varying quality and depth and may be influenced by the individual characteristics of outbreaks such as size and duration, outbreak setting, causative organism, vehicles of infection and time of year . These findings have implications for the use of these surveillance data in developing evidence-based food policy.

Neurol India, 2002 Mar, 50(1), 90 - 2
Primary cutaneous nocardiosis with epidural abscess caused by Nocardia brasiliensis: a case report; Lakshmi V et al.; Dissemination of primary cutaneous nocardiosis is a rare event . An interesting case of a 20 year old female labourer with progressive weakness in both the lower limbs and large multiple subcutaneous abscesses over the back, since 4 years, is presented . MRI showed an epidural abscess compressing the cord . Histopathology of skin lesions suggested a chronic suppurative lesion . Microbiological tests on the aspirate from the skin lesion identified the causative organism as Nocardia brasiliensis.

Appl Microbiol Biotechnol, 2002 Apr, 58(5), 669 - 74 Epub 2002 Feb 08.
Effects of high and fluctuating pressure on microbial abundance and activity in a water hydraulic system; Soini SM et al.; The effects of high and fluctuating pressure up to 220 bar on microbial growth and activity were determined in a pilot-scale water hydraulic system . An increase in the pipeline pressure from 70 to 220 bar decreased the total and the viable cell number in the pressure medium from 2.2(+/-0.5)x10(5) to 4.9(+/-1.5)x10(4) cells/ml and from 5.7(+/-2.8)x10(4) to 1.3(+/-0.7)x10(4) cfu/ml, respectively . Microbial attachment in the non-pressurised tank of the hydraulic system increased with increasing pipeline pressure {from 1.0(+/-0.3) to 3.8(+/-2.7)x10(5) cells/cm(2) on stainless steel} . The phosphatase, aminopeptidase and beta-glucosidase activities in the pressurised medium were between 0.02 and 1.4 micromol/lh ( V(max)) and decreased in response to increasing pipeline pressure . The alpha-glucosidase activity was detected only at 70 bar and the glucuronidase activity only occasionally . Based on principal component and cluster analyses, both the pressure applied and the original filling water quality affected substrate utilisation patterns . This study demonstrated the capability of freshwater bacteria to tolerate high and fluctuating pressure in a technical water system . Microbial survival was due to attachment and growth on the surfaces of the non-pressurised components and the nutrient flux released by cell lysis in the pressurised components . In summary, high pressures in water hydraulic systems do not prevent potential microbiologically related operational problems.

Int J Food Sci Nutr, 2002 May, 53(3), 209 - 16
Bottle wars: England versus Scotland versus France; Thurman RB et al.; Four batches of four brands of bottled water from England, Scotland and France were tested for their microbiological and physicochemical characteristics during a 2-month study . The lowest priced brand of water had the highest nitrate content (46.9 mg/L), while the most expensive brand did not necessarily have the best values for pH, total dissolved solids, turbidity or plate count . While no sample was positive for E . coli, the range of other measured values varied widely between brands and batches during the study . The bottled water samples from France on average demonstrated better results than the other countries studied.

Commun Dis Intell, 2002, 26(1), 28 - 32
Australia's Imported Food Program--a valuable source of information on micro-organisms in foods; Bull AL et al.; Foods imported into Australia are subject to laboratory testing for microbiological and chemical hazards under the Imported Food Program (IFP) for the purposes of protecting public health and safety . The program, operating under the Imported Food Control Act 1992, is jointly administered by the Australian Quarantine Inspection Service (AQIS) and the Australia New Zealand Food Authority (ANZFA) . Foods that fail under the IFP are subsequently subjected to appropriate treatment to rectify the problem, or are destroyed or re-exported . This article presents a limited analysis of IFP test results on selected foods imported between 1995 and 1999 . As corrective action is taken immediately on the basis of failing test results, regular analysis of collated data is not considered a priority . Nonetheless these data potentially represent an important source of information on the nature of food microorganisms detected in imported foods . For example, IFP data could be used to focus local and state-based food surveillance efforts, provide information to importers, to inform national initiatives such as OzFoodNet, and to better target investigative and preventative efforts concerning foodborne illness.

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