J Microbiol Immunol Infect, 2002 Mar, 35(1), 29 - 36 Clinical manifestations of strongyloidiasis in southern Taiwan; Tsai HC et al.; The diagnosis and management of strongyloidiasis present a continuous challenge in developing countries including Taiwan . In this study, the clinical characteristics and microbiological findings of 27 patients with Strongyloides stercoralis infection were retrospectively analyzed . Intestinal infection was identified in 17 patients and hyperinfection syndrome or disseminated disease in 10 (including 2 autopsy cases) . The most frequent clinical findings were diarrhea (74%), fever (70%), abdominal pain (59%), cough (37%), dyspnea (33%), and constipation (26%) . The common initial laboratory abnormalities were leukocytosis (81%), anemia (67%), liver function impairment (52%), and eosinophilia (44%) . Most of the 27 patients had comorbid conditions, including malnutrition in 20 (74%), corticosteroid dependence in 15 (55%), chronic obstructive pulmonary disease in 9 (33%), chronic liver disease or cirrhosis in 8 (30%), and peptic ulcer disease in 7 (26%) . There was no difference in the time interval from symptom onset to diagnosis between the intestinal infection group and the hyperinfection/disseminated group (22 +/- 15 vs 17 +/- 9 days) . Larvae of S . stercoralis were identified in the stool of 24 patients, in the sputum smear of 5, in the gastric biopsy of one, and on histology of autopsy specimens in 2 . Twenty-six patients received antiparasitic drug therapy of variable duration (mebendazole in 24, albendazole in 2, combined therapy in one) . The overall cure rate was 52% (14/27) . Relapse occurred in 4 patients . The overall mortality was 26% (7/27) . There was a high mortality (up to 50%) in the hyperinfection/disseminated disease group . In conclusion, diagnosis of strongyloidiasis is often delayed and overlooked because of nonspecific symptoms . Physicians in endemic regions should include strongyloidiasis in the differential diagnosis when patients present with gastrointestinal and/or pulmonary symptoms with peripheral eosinophilia. Chest, 2002 Apr, 121(4), 1177 - 82 Assessment of lymph node tuberculosis in northern Germany: a clinical review; Geldmacher H et al.; AIM OF STUDY: To evaluate patient profiles, diagnostic approaches, and treatment strategies in patients with lymph node tuberculosis . METHODS: Demographic data, diagnostic findings, and therapies were retrospectively analyzed in 60 patients with lymph node tuberculosis who were hospitalized between 1992 and 1999 . RESULTS: Thirty percent (n = 18) of patients were natives, and 70% were immigrants (n = 42) . The cervical lymph nodes were most frequently involved (63.3%), followed by the mediastinal lymph nodes (26.7%) and the axillary lymph nodes (8.3%) . All patients (except one patient who was HIV-positive) showed a positive response to tuberculin skin testing . Lymph node excision and fine-needle aspiration (FNA) were similarly effective in obtaining sufficient material for histologic and microbiological analysis . Mycobacterium tuberculosis was identified in 43.3% of patients by microbiological testing, and culture methods showed the highest sensitivity . Despite standard treatment, the initial enlargement of the lymph nodes occurred in 20% of patients and local complications occurred in 10% . CONCLUSION: Lymph node tuberculosis is still an important issue in developed countries and has to be considered in differential diagnosis . The best approach appears to be a combination of skin testing and FNA . Negative results in the identification of M tuberculosis do not exclude the diagnosis of lymph node tuberculosis. Life Sci Space Res, 1971, 9, 69 - 74 The ecology of micro-organisms in a closed environment; Fox L; Experimental data are presented which have a bearing on the susceptibility of astronauts to infectious diseases . These experiments include the observation of growth by two bacteria in Biosatellite 2, in which higher mean densities were attained than in earth-based controls . In addition, weightlessness combined with the special environment of a space vessel may affect the physiology of the astronauts . Earth-based studies in closed chambers were carried out under a variety of conditions with regard to pressure and oxygen content . One notable result was the transfer of micro-organisms from subject to subject . Comparative experiments were carried out in Antarctica and it was shown that the tests in closed chambers differed markedly from the Antarctica experience . The objectives and procedures of microbiological tests of the Gemini and Apollo programs are outlined. Lett Appl Microbiol, 2002, 34(4), 283 - 6 Does calculation of the 95th percentile of microbiological results offer any advantage over percentage exceedence in determining compliance with bathing water quality standards? Hunter PR. AIMIS: Draft WHO guidance is likely to suggest a calculated 95th percentile method, rather than percentage exceedence, in assessing compliance of bathing waters with microbiological standards . This study set out to determine whether this was an appropriate development . METHODS AND RESULTS: A series of Monte Carlo studies compared five non-parametric methods for calculating the 95th percentile with the parametric method and compares results with percentage exceedence . It is shown that the Hazen method gives the closest proximity to the parametric method for calculating 95th percentile values . However, the difference between 95th percentile results and percentage exceedence, as currently used, is trivial compared to uncertainty due to sample variation . CONCLUSIONS: It is concluded that a calculated 95th percentile for beach classification offers little advantage compared to percentage exceedence, other than offering a false sense of certainty . Furthermore, the additional calculation needed in determining 95th percentile values will demand electronic calculation, increase the chance of calculation errors and make the results less understandable to beach managers and the general public . SIGNIFICANCE AND IMPACT OF THE STUDY: This study should encourage the European Commission to keep percent compliance rather than calculation of 95th percentiles in any new bathing water directive. Lett Appl Microbiol, 2002, 34(4), 258 - 62 Arsenic (III) oxidizing Microbacterium lacticum and its use in the treatment of arsenic contaminated groundwater; Mokashi SA et al.; AIMS: To develop a microbially-assisted process for the removal of arsenic from contaminated groundwater . METHODS AND RESULTS: A culture of Microbacterium lacticum oxidizing up to 50 mmol l(-1) arsenic (III) was isolated from municipal sewage by an enrichment culture technique . Using culture immobilized on brick pieces and packed in a glass column, complete oxidation of As (III) from groundwater could be quickly achieved at neutral pH and ambient temperature with methanol as substrate . The oxidized As species were removed from groundwater using three different methods: zero valent iron, activated charcoal and ferric chloride . CONCLUSIONS: The oxidation of groundwater As (III) by a M . lacticum-immobilized column, followed by its removal using activated carbon, could be an efficient method for the treatment of As (III)-contaminated groundwater . SIGNIFICANCE AND IMPACT OF THE STUDY: The study will be useful in developing a combined microbiological-chemical process for treating arsenic-contaminated groundwater. Anaesth Intensive Care, 2002 Feb, 30(1), 11 - 20 Non-bronchoscopic bronchoalveolar lavage in the microbiological diagnosis of pneumonia in mechanically ventilated patients; Arora SC et al.; A prospective study comparing standardized non-bronchoscopic bronchoalveolar lavage (sNB-BAL) and non-specific endotracheal aspirate (NsETA) in the microbiological diagnosis of pneumonia in mechanically ventilated patients is described . One hundred episodes in 82 mechanically ventilated patients with or without radiological and clinical diagnostic criteria of pneumonia were studied . NsETA and sNB-BAL was performed on the day of study . Fifty-one patients had pneumonia (21 ventilator-associated, 12 hospital-acquired, 18 community-acquired) and 49 had no pneumonia as defined by widely accepted clinico-radiological criteria . The sNB-BAL was found to be significantly more specific (0 . 73) compared to NsETA (0.35) for the microbiological diagnosis of pneumonia . Colonization rates with NsETA were significantly higher compared to sNB-BAL (P value <0.0001) . No patient had complications attributable to the sNB-BAL procedure . We conlude that sNB-BAL is a safe, effective, sensitive, specific and inexpensive procedure for the serial evaluation of pneumonia in mechanically ventilated patients. Vet Rec, 2002 Mar 16, 150(11), 340 - 3 Efficacy of avian pneumovirus vaccines against an avian pneumovirus/Escherichia coli O2:K1 dual infection in turkeys; Van de Zande S et al.; The clinical, pathological and microbiological outcome of a challenge with avian pneumovirus (APV) and Escherichia coli O2:K1 was evaluated in turkeys vaccinated with an attenuated APV vaccine and with or without maternally derived antibodies . Two groups of two-week-old poults, one with and one without maternally derived antibodies against APV, were vaccinated oculonasally with attenuated APV subtype A or B . A third group remained unvaccinated . Eleven weeks later, the turkeys were inoculated intranasally with either virulent APV subtype A, or E . coli O2:K1, or with both agents three days apart . After the dual infection, birds vaccinated with attenuated subtype A or B, and with or without maternally derived antibodies, had lower mean clinical scores than the unvaccinated birds . In the vaccinated birds, virus replication was significantly reduced and no bacteria were isolated, except from the birds vaccinated with attenuated subtype B . In the unvaccinated turkeys, large numbers of E . coli O2:K1 were isolated from the turbinates of the dually infected birds between one-and-a-half and seven days after they were inoculated. Int J Tuberc Lung Dis, 2002 Apr, 6(4), 295 - 300 Tuberculosis in Spain: epidemiological pattern and clinical practice; Diez M et al.; SETTING: Thirteen Autonomous Regions in Spain . OBJECTIVE: To study the incidence of all forms of tuberculosis (TB) and investigate clinical practice in TB . DESIGN: Cases of all forms of tuberculosis diagnosed in the study setting from May 1986 to April 1997 were identified though active search of different databases . Clinical and epidemiological information on cases was collected from clinical records or by interview with physicians . RESULTS: The overall incidence of all forms of tuberculosis was 38.5/100,000 and the incidence of smear-positive disease was 13.83/100,000 . Most cases (97.1%) were Spanish nationals, with rates higher in men than in women (52.7/100,000 vs . 24.87/100,000) and in groups aged 25-34 and 75 years and over (61.35/100,000 and 59.35/100,000, respectively) . Disseminated forms were frequent (6.6%), and the most common risk factor was human immunodeficiency virus (HIV) infection (17.7% of cases) . Hospitalisation was common (71.6%) . Microbiological confirmation of diagnosis was sought for 87.7% of the cases (91.8% of pulmonary vs . 75.5% of extra-pulmonary cases), and 65.2% were culture-positive (73.8% of pulmonary vs . 39.7% of extra-pulmonary cases) . HIV-infected patients were treated in almost equal proportions with three or four drugs (49.7% and 48.2%, respectively), while HIV-negative cases or those whose HIV status was unknown were usually treated with three drugs . CONCLUSION: The epidemiological pattern of TB in Spain is different to other industrialised countries in the age distribution of cases and the proportions of foreigners and cases with HIV infection . Microbiological confirmation of diagnosis is more common in pulmonary than in extra-pulmonary disease, and treatment with four drugs more frequent in HIV-positive cases. Eur J Ophthalmol, 2002 Jan-Feb, 12(1), 34 - 9 Factors influencing treatment results in pseudophakic endophthalmitis; Koc F et al.; PURPOSE: To evaluate risk factors, therapeutic approaches and factors associated with the poor visual outcome in pseudophakic endophthalmitis . METHODS: Data related to 28 cases with the diagnosis of endophthalmitis after cataract surgery and IOL implantation were gathered retrospectively . RESULTS: Preceding surgery was extracapsular cataract extraction (ECCE) in 18, phacoemulsification in 8 and scleral fixated intraocular lens implantation in two cases . Posterior capsule rupture and diabetes mellitus were considered to contribute to the development of endophthalmitis because of their high incidences (50% and 25%) in the study group . Microbiological studies from aqueous and vitreous humour were done in 85% of the cases and 58% were positive . S . Epidermidis was the most common organism, accounting for 50% of the isolates . All cases were given topical and systemic antibiotics . Inflammation was controlled by addition of subconjunctival antibiotics to this regimen in two, intravitreal antibiotic injection in 14, pars plana vitrectomy, total capsular and lens extraction and intravitreal antibiotic injection in three, lens exchange, intracapsular and intravitreal antibiotic injection in three cases . Six (21%) cases eventually needed evisceration . Visual acuity of 20/40 or better was achieved in 25%, and 20/100 or better in 64% . CONCLUSIONS: Treatment delay (p=0.039), capsular rupture complicating cataract surgery, especially with extracapsular cataract extraction (p=0.015), and initial visual acuity worse than hand motion (p=0.003) were strong predictors of poor visual outcome . The risk of endophthalmitis was not different forplanned ECCCE (0.26%) andphacoemulsification (0.27%) but the prognosis was better with the latter. J Chemother, 2001 Nov, 13 Spec No 1(1), 84 - 8 Microbial epidemiology patterns of surgical infection pathogens; Debbia EA et al.; Resistance, as assessed in vitro, has a number of serious consequences in clinical situations . Treatment failures are common when an inappropriate drug has been prescribed and this, in turn, may lead to hospitalization of patients who normally would have been treated on an outpatient basis, as well as to longer hospital stay for inpatients and to the use of alternative drugs, which may be more expensive and more toxic . These factors all contribute to increased health care costs, morbidity and mortality . Microbiological procedures may identify the causative pathogen and provide the appropriate susceptibility pattern to the physician, thus reducing the chances of therapeutic failures . However, for a number of reasons including cost--even in hospitals--not to mention general practice, infections are seldom diagnosed on an etiological basis . From what has been stated, the knowledge of bacterial epidemiology and resistance represents basic support for correct therapeutic decision-making. Dig Dis, 2001, 19(4), 288 - 91 Parasitic infections and hepatic neoplasia; Abdel-Rahim AY; Parasitic infections are highly prevalent in the general population . Detecting a relationship between a parasitic infection and cancer is not an easy task; it requires epidemiological, microbiological and molecular biology techniques . In this article the important mechanisms by which parasitic infections may induce carcinogenesis are reviewed . The association between Schistosoma japonicum, Schistosoma mansoni and hepatocellular carcinoma is covered . The cause-and-effect relationship between the liver flukes Opisthorchis viverrini, Opisthorchis felineus, Clonorchis sinensis, and cholangiocarcinoma is also reviewed . The evidence supporting the role of schistosomes and liver flukes in carcinogenesis is discussed . Finally the importance of the primary prevention of these parasitic infections with oncogenic potentials is emphasized . Nutrition, 2002 Apr, 18(4), 334 - 7 Oral glutamine does not prevent bacterial translocation in rats subjected to intestinal obstruction and Escherichia coli challenge but reduces systemic bacteria spread; Salvalaggio PR et al.; OBJECTIVE: We investigated whether oral glutamine prevents bacterial translocation.Methods: Male Wistar rats were fed with isocaloric and isoproteic standard rat chow and randomly assigned to receive glutamine (GLN) or glycine administered through an orogastric tube at 1.5 g.kg(-1).d(-1) for 7 d . On day 8 of the study, the animals were anesthetized and intestinal obstruction was produced by ligature of the terminal ileum . A suspension containing 10(9) colony-forming units per milliliter of Escherichia coli ATCC 25992 was injected into the lumen of the ileum . Twenty-four hours later, blood was withdrawn, and mesenteric lymph nodes and fragments of spleen, liver, and lung were sent for microbiological analysis . Cultures were done on blood agar and MacConkey agar . Student's t test and analysis of variance between two proportions were used . P < 0.05 was considered significant . RESULTS: Rats in both groups lost body weight during the experiment (not significant) . Mesenteric lymph node cultures were positive in both groups . The GLN group had a smaller percentage of E . coli in blood and organ cultures (65.45% versus 82.67% in the glycine group; P = 0.027) . Positive cultures of blood, spleen, liver and lung also were higher on glycine group, although not significantly . CONCLUSIONS: Oral GLN does not prevent bacterial translocation in rats after intestinal obstruction and E . coli challenge . No specific organ was protected by GLN . Nevertheless, its use was associated with a reduced number of positive E . coli cultures in blood and remote organs, and thus diminished bacteria spread . This association suggests a role for GLN in gut barrier protection, possibly by immune system enhancement. Crit Rev Food Sci Nutr, 2002 Mar, 42(2), 123 - 49 Application of hazard analysis critical control points (HACCP) to organic chemical contaminants in food; Ropkins K et al.; Hazard Analysis Critical Control Points (HACCP) is a systematic approach to the identification, assessment, and control of hazards that was developed as an effective alternative to conventional end-point analysis to control food safety . It has been described as the most effective means of controlling foodborne diseases, and its application to the control of microbiological hazards has been accepted internationally . By contrast, relatively little has been reported relating to the potential use of HACCP, or HACCP-like procedures, to control chemical contaminants of food . This article presents an overview of the implementation of HACCP and discusses its application to the control of organic chemical contaminants in the food chain . Although this is likely to result in many of the advantages previously identified for microbiological HACCP, that is, more effective, efficient, and economical hazard management, a number of areas are identified that require further research and development . These include: (1) a need to refine the methods of chemical contaminant identification and risk assessment employed, (2) develop more cost-effective monitoring and control methods for routine chemical contaminant surveillance of food, and (3) improve the effectiveness of process optimization for the control of chemical contaminants in food. Int J Food Microbiol, 2002 Mar, 73(2-3), 297 - 304 Modelling bacterial growth in quantitative microbiological risk assessment: is it possible? Nauta MJ. Quantitative microbiological risk assessment (QMRA), predictive modelling and HACCP may be used as tools to increase food safety and can be integrated fruitfully for many purposes . However, when QMRA is applied for public health issues like the evaluation of the status of public health, existing predictive models may not be suited to model bacterial growth . In this context, precise quantification of risks is more important than in the context of food manufacturing alone . In this paper, the modular process risk model (MPRM) is briefly introduced as a QMRA modelling framework . This framework can be used to model the transmission of pathogens through any food pathway, by assigning one of six basic processes (modules) to each of the processing steps . Bacterial growth is one of these basic processes . For QMRA, models of bacterial growth need to be expressed in terms of probability, for example to predict the probability that a critical concentration is reached within a certain amount of time . In contrast, available predictive models are developed and validated to produce point estimates of population sizes and therefore do not fit with this requirement . Recent experience from a European risk assessment project is discussed to illustrate some of the problems that may arise when predictive growth models are used in QMRA . It is suggested that a new type of predictive models needs to be developed that incorporates modelling of variability and uncertainty in growth. Int J Food Microbiol, 2002 Mar, 73(2-3), 275 - 89 Modelling microbial growth in structured foods: towards a unified approach; Wilson PD et al.; Historically, the ability of foods to support the growth of spoilage organisms and food-borne pathogens has been assessed by inoculating a food with an organism of interest, and following its growth over a period of time . Information gained from such challenge tests, together with knowledge of the organoleptic stability of the product, can then be used to determine an appropriate shelf-life for the food . Whilst this approach may be seen as the "gold-standard" of microbiological assessment of food, it is both time-consuming and costly . A major advance to complement challenge testing was the development of predictive modelling, when it was demonstrated that the growth of a wide range of organisms of interest could be quite accurately modelled as a function of only a few environmental parameters-primarily temperature, pH and water activity (a(w)), with perhaps other factors such as nitrite, organic acids and oxygen . This approach to predictive microbiology is embodied in software tools such as the UK Food MicroModel and the Pathogen Modeling Program from the USA . Whilst modelling of this form yields accurate predictions of the growth of organisms in the majority of foods, there are occasions when there are discrepancies between the model and the observed growth . These discrepancies are most often described as "fail-safe", i.e . the observed growth is slower than predicted by the model . This paper examines the role of food structure in the development of microbial populations and communities, and describes the methodologies we propose to begin to tackle some of these complex and interlinked issues. Microbes Infect, 2002 Apr, 4(4), 425 - 32 Biosensor technologies for detecting microbiological foodborne hazards; Hall RH; The convergence of molecular biology and miniaturized instrumentation has accelerated development of biosensors with the specifications necessary to support pathogen reduction and quality programs in the food supply . Advances in optoelectronics, thin layer deposition, and microfabrication have provided many options for achieving microbiological detection goals . Some promising technologies are reviewed. Radiologe, 2002 Jan, 42(1), 42 - 5 {Pulmonary aspergillosis as initial manifestation of septic granulomatosis (chronic granulomatous disease, CGD) in a premature monozygotic female twin and FDG-PET diagnosis of spread of the disease}; Theobald I et al.; PURPOSE: To present the unusual case of chronic granulomatous disease (CGD) manifestating as pulmonal aspergillosis in female enzygotic twins during the neonatal period . To demonstrate and to discuss the complex diagnosis and the diagnostic value of FDG-PET in monitoring the spread and activity of the disease . PATIENTS: Plain chest x-ray and CT of the lung showed multiple, mostly round lesions in one of the former preterm twins at the age of 8 weeks . The girl with known ASD II was then suffering from dyspnoea and recurrent pulmonary infections . Because of the imaging findings invasive pulmonary aspergillosis due to an underlying immunodeficiency was suspected . RESULTS: Aspergillosis was confirmed histologically and microbiologically by specimens taken from an open lung biopsy . Because of coexisting granulocytic dysfunction the diagnosis of CGD was made . This diagnosis was equally confirmed by noninvasive methods in the asymptomatic sister . FDG-PET did not show any evidence of extra-pulmonary spread of disease . CONCLUSION: CGD can present as isolated pulmonal aspergillosis even in the neonatal period when an immunodeficiency is discussed . In enzygotic twins screening of the asymptomatic twin is mandatory . FDG-PET is a useful tool in screening for spread of the disease and in evaluating disease activity. Int J Food Microbiol, 2002 Mar 25, 74(1-2), 119 - 30 Prevalence of enterovirus and hepatitis A virus in bivalve molluscs from Galicia (NW Spain): inadequacy of the EU standards of microbiological quality; Romalde JL et al.; A study of the presence of hepatitis A virus (HAV) and enterovirus (EV) in shellfish from the northwestern coast of Spain, one of the most important mussel producers in the world, was carried out employing dot-blot hybridization and RT-PCR techniques . In addition, bacterial contamination of the samples was evaluated by Escherichia coli (EC) counts, according to the European Union (EU) standards of shellfish microbiological quality . Shellfish samples included raft-cultured and wild mussels, as well as wild clams and cockles . Bacterial counts showed that the majority of samples (40.8%) could be classified as moderately polluted following the EU standards, and therefore should undergo depuration processes . However, differences in bacterial contamination were observed between cultured mussel and wild shellfish . Thus, percentage of clean samples (<230 EC/100 g shellfish) was clearly higher in cultured mussels (49.1%) than in wild mussels (22.8%) or clams and cockles (10.7%) . HAV was detected in 27.4% and EV in 43.9% of the samples that were analyzed . Simultaneous detection of both viral types occurred in 14.1% of the samples . Statistical tests of dependence (chi-square test) showed no relationship either between viral and bacterial contamination, or between the presence of HAV and EV . Comparative analysis of hybridization and RT-PCR for viral detection yielded different results depending on the virus type that was studied, RT-PCR being effective for HAV but not for EV detection . The obtained results reinforce once again the inadequacy of bacteriological standards to assess viral contamination and suggest that although virological analysis of shellfish is possible by molecular techniques, interlaboratory standardization and validation studies are needed before the routine use in monitoring shellfish microbiological safety. Ned Tijdschr Tandheelkd, 1997 Sep, 104(9), 342 - 5; discussion 346-7 {Quality of the sterilization process in the dental practice}; de Graaff J et al.; A survey was performed among 249 Dutch dentists on the use and functioning of sterilizers in their practice and on the quality control of the sterilization process . 99% of the dentists use a sterilizer . Only 1% uses only a thermodesinfector . 7.3% of the sterilizers tested did not function properly, based on a microbiological test . 76% of the sterilizers are not serviced on a regular basis . These sterilizers show more often failures in the sterilization process . It is concluded that although over 92% of the sterilizers in Dutch dental offices do function well, improvement on the quality control of the sterilization process is feasible and necessary . Besides an annual service, a regular control of the sterilization process itself, e.g . by using biological indicators, in combination with physical and/or chemical monitoring, is one of het methods to achieve this. Lab Anim (NY), 2001 Nov, 30(10), 34 - 42 Diagnostic molecular microbiology in laboratory animal health monitoring and surveillance programs; Feldman SH et al.; Molecular microbiology provides a rapid, reliable, sensitive, and specific means of detecting pathogens in laboratory animals . The author discusses the interpretation of the results of molecular microbiological testing done in conjunction with serologic, bacteriologic, and histopathologic tests, focusing on molecular microbiology as it fits in an overall program of animal health diagnostic profiling. Electrophoresis, 2002 Mar, 23(6), 847 - 57 Evaluation of molecule-microbe interactions with capillary electrophoresis: procedures, utility and restrictions; Berthod A et al.; Understanding the interactions between molecules and living organisms is of paramount importance for the evaluation of pharmaceutical activity, chemical toxicity and all manner of microbiological studies . The capability of capillary electrophoresis (CE) in the evaluation of molecule-microbe interactions is examined in the present paper . The fundamental chemical concept of the binding or association constant for molecular systems measured in free solution is discussed for biological systems where microorganisms uptake or associate with molecules from their environment . The heterogeneity of the living organisms must be understood and accounted for including differences related to semantics such as concentration units and the nature of the associations between two entities and large differences in the size and number of microorganisms as compared to molecules . Finally, the added complexity and even inhomogeneity of a cell compared to most molecular systems must be considered and possibly controlled . The binding of specific molecules to viruses is discussed . CE can be utilized to quickly determine if a molecule binds very strongly or not at all to a cell (i.e., a binary yes/no answer) . This could be useful for initial high-throughput screening purposes when using capillary arrays, for example . CE can be useful for determining unusual (large) molecule/microbe stoichiometries . Finally, CE can sometimes be used to determine the size of binding constants (K(RL)) within certain limits provided experimental conditions can be formulated that minimize problems of biological heterogeneity. Hematol J, 2000, 1(2), 111 - 6 Surveillance of Aspergillus galactomannan antigenemia for invasive aspergillosis by enzyme-linked immunosorbent assay in neutropenic patients treated for hematological malignancies; Ulusakarya A et al.; INTRODUCTION: The incidence of invasive fungal infections is increasing in patients with hematological malignancies . Invasive aspergillosis is one of the most frequently encountered infections with a high mortality rate . New diagnostic tests for invasive aspergillosis such as the detection of Aspergillus galactomannan antigen by a sandwich enzyme-linked immunosorbent assay (ELISA) have recently been described . The objective of this study was to evaluate this assay as a potential surrogate for invasive procedures used to diagnose IA . MATERIALS AND METHODS: We analyzed the performance of a commercially available ELISA test which we routinely use for the surveillance of galactomannan antigenemia in patients with hematological malignancies experiencing chemotherapy-induced prolonged neutropenia (ANC < 500/mm(3) for more than 7 days) . Serum samples were collected on a weekly basis . Test positivity was defined in accordance with the manufacturer's recommendations . RESULTS: Over the 2 year study period, we analyzed 507 samples obtained during 193 neutropenic episodes from 135 patients . Ten, six and two patients were considered to have proven, probable or possible invasive aspergillosis, respectively, based on clinical, radiological or microbiological data . Forty-four positive (Index>1.5) and 26 'undetermined' (1.5 > Index > 1.0) test results were observed in 17 and ten patients respectively . All invasive aspergillosis cases had at least a positive or an undetermined test result . Only one positive and one undetermined result were found in two patients before the onset of clinical or radiological signs suggesting invasive aspergillosis . Sensitivity was 69% and specificity 96% if only positive results are considered; when 'undetermined' test results were combined with positive results, sensitivity attained 100% and specificity 92% suggesting that the cutoff value for positivity can be lowered from 1.5 to 1.0 . CONCLUSIONS: Although the ELISA test did not appear to play a role in the early diagnosis of invasive aspergillosis and in the anticipation of antifungal therapy in our experience, it clarifies the diagnosis of infection in probable or possible invasive aspergillosis especially when the cutoff value is lowered and is useful for monitoring patients receiving specific therapy. Aust Fam Physician, 2002 Feb, 31(2), 141 - 4 A child with earache . Are antibiotics the best treatment? Del Mar C, Glasziou P. BACKGROUND: Conventional management of acute otitis media, deduced from pathophysiology, embodies scant regard to analgesia, but concentrates on the microbiological cure by the use of antibiotics . OBJECTIVE: A commonly encountered case of uncomplicated acute otitis media in a child of three is presented . An evidence based approach to management is offered . RESULTS: The search for empirical evidence of patient relevant benefits and harms challenges the conventional approach . A Cochrane review of the literature on the use of antibiotics for acute otitis media shows that the benefits of antibiotic use (reduced pain in those children who go on to suffer pain beyond 24 hours) are offset by adverse events from the antibiotics themselves (gastrointestinal symptoms and rashes) . There is insufficient information to be sure about rare complications of not using antibiotics as well using them, but it seems that in either case, catastrophe is very rare . DISCUSSION: Thinking in terms of a balance of harms and benefits would result in a decreased proportion of children prescribed antibiotics for acute otitis media. Indian J Public Health, 2001 Jan-Mar, 45(1), 8 - 13 Reproductive tract infection in women of reproductive age group in Sitapur/Shahjahanpur District of Uttar Pradesh; Nandan D et al.; CARE India with its UP Office has initiated demand generation and acceptability of services for reproductive health and birth spacing services at community level in two districts in the state of Uttar Pradesh . A total of 3,49,000 women of reproductive age will benefit from participation in program activities over the next five years . Out of total surveyed population of 3662, 798 women of reproductive age group were identified of whom 272 were found to be symptomatically positive in relation of STDs/RTIs giving the overall prevalence rate of 34% . Clinical as well as the microbiological examination was carried out on 193 of these 272 women in field conditions . Those found clinically and/or microbiologically positive were provided treatment and preventive advice . Total of 150 (77.7%) women were diagnosed on the basis of symptoms (syndromic approach) and 151 (78.2%) were diagnosed on the basis of clinical examinations . However, 137 (70.9%) were confirmed microbiologically positive . A large extent was found in the age group of 15 to 24 years . Confirmed cases were comparatively less among nulliparous women (63.6%) than multipara (73.2%) cases . 64.1% women were having watery discharge while 29.1% were having complaint of curd discharge . The discharge was offensive in only 1.9% cases while 4.9% reported mixed discharge . 54.4% women complaining of vaginal discharge were suffering from PID . The discharge were either bacterial alone (26.1%) or bacterial mixed with candidiasis (16.5%) or trichomoniasis (8.7%) . Compared to syndromic approach, an improvement in the sensitivity (81.8%) and predictive accuracy (74.1%) was noted when cases were detected with the help of clinical examination. Appl Environ Microbiol, 2002 Apr, 68(4), 2089 - 92 Propionate formation by Opitutus terrae in pure culture and in mixed culture with a hydrogenotrophic methanogen and implications for carbon fluxes in anoxic rice paddy soil; Chin KJ et al.; Propionate-forming bacteria seem to be abundant in anoxic rice paddy soil, but biogeochemical investigations show that propionate is not a correspondingly important intermediate in carbon flux in this system . Mixed cultures of Opitutus terrae strain PB90-1, a representative propionate-producing bacterium from rice paddy soil, and the hydrogenotrophic Methanospirillum hungatei strain SK maintained hydrogen partial pressures similar to those in the soil . The associated shift away from propionate formation observed in these cultures helps to reconcile the disparity between microbiological and biogeochemical studies. Infect Dis Obstet Gynecol, 2001, 9(4), 233 - 7 A randomized controlled trial of interleukin-1 receptor antagonist in a rabbit model of ascending infection in pregnancy; McDuffie RS Jr et al.; OBJECTIVE: To determine whether treatment with interleukin-1 receptor antagonist (IL1-ra) would affect amniotic fluid concentrations of tumor necrosis factor alpha (TNF-alpha) and prostaglandins or clinical or microbiological outcomes in a model of ascending bacterial infection in pregnancy . METHODS: Timed pregnant New Zealand white rabbits at 70% of gestation underwent endoscopic inoculation of the cervices with 10(6) - 10(7) cfu Escherichia coli . Animals were randomly assigned in a blinded manner to a 5-h intravenous infusion of human IL1-ra (10 mg/kg) or placebo beginning 1-2 h after inoculation . Blood was drawn from the does for assay of serum IL1-ra concentration before inoculation, at mid-infusion, after the infusion ended and at necropsy . At necropsy, temperature and cultures were taken, and aspirated amniotic fluid was pooled for assays of TNF-aalpha, prostaglandin E2 (PGE2) and ILI-ra . RESULTS: Serum IL1-ra concentrations rose to a mean of 2 microg/ml at mid-infusion and fell markedly after the infusion to concentrations barely detectable at necropsy . Between the two groups, there were no significant differences in the rates of fever or positive cultures or in amniotic fluid concentrations of PGE2 or TNF-alpha . One unique finding was the demonstration that administration of human IL1-ra to the does resulted in measurable concentrations of human IL1-ra in the amniotic fluid . CONCLUSIONS: Treatment with an intravenous infusion of human IL1-ra after cervical inoculation with E . coli did not affect clinical or microbiological outcomes or amniotic fluid concentrations of TNF-alpha or PGE2 . This experiment providesthefirstdemonstration of passage of human IL1-ra from the maternal bloodstream to the amniotic fluid. Life Sci Space Res, 1966, 4, 121 - 30 The possibility of life in outer space; Imshenetsky AA et al.; Experiments were carried out dealing with the effect of extreme factors on microorganisms . Methods for microbiological analysis of meteorites were developed . The effect of temperature, from -20 degrees C to +15 degrees C, on trypsine activity was studied . It was shown that at about -3 degrees C a definite intramolecular reorganization occurs in the enzyme, leading to decreased activation energy . Previously reported resistance of microorganisms to high vacuum was confirmed . New species were tested at l0(-8)-10(-9) mm Hg . It was shown that very thin metal and metal oxide films, as well as films from other substances, may fully protect microorganisms from the hazardous effect of UV rays . By using an artificial climate, camera forms of microorganisms were selected which have the highest resistance to the whole complex of Martian climatic factors . Pigmented and spore-forming microorganisms resist UV up to a dose of 4.04 x 10(8) erg/cm2 . There are microorganisms on Earth which show some activity in soil at a relative humidity of 0.096-0.196% . Preliminary data permit one to assume the possibility of existence of Earth-like forms on Mars . The majority of meteorites are accessible to Earth microorganisms . While choosing a meteorite for microbiological analysis it is necessary to consider the soil and climatic factors of the country where the latter has been found. Neurochirurgie, 2001 Dec, 47(6), 568 - 71 {Tuberculous abscess of the cerebellum . Apropos of a case}; Kaya JM et al.; A 22-year-old Asian man developed intracranial hypertension with a 38 degrees C fever . Two months earlier, he had undergone surgery and medical treatment for tuberculous otomastoiditis and pulmonary tuberculosis . The CT scan revealed multiple tuberculous abscesses of the cerebellum . Histological, microbiological and biological proof of diagnosis was obtained . We advocate surgical treatment of intracranial tuberculous abscesses associated with antituberculosis chemotherapy for 18 months . The earlier the treatment, the better the prognosis . This pathology must be kept in mind when treating patients from countries with a high endemic rate of tuberculosis and suffering from immunodeficiency syndrome. Curr Opin Obstet Gynecol, 2002 Apr, 14(2), 195 - 202 Cervical screening for preterm delivery; Welsh A et al.; The ability of sonographic cervical length screening to detect those at risk of spontaneous preterm delivery has been extensively explored over the past few years . This applies both to high-risk and low-risk groups . Cervical length measurement appears to be superior to biochemical, microbiological or hormonal methods of screening . The screening technique has been standardized, but the cervical length for intervention and the timing and nature of intervention have not been defined . Cervical cerclage appears to be of use to prevent or arrest the progress of cervical dilation in high-risk cases, but the management of the screen-positive low-risk case has yet to be determined . Future management may be stratified according to actual cervical length, and prospective randomized trials of treatment for the short cervix are needed. Ned Tijdschr Geneeskd, 2002 Mar 9, 146(10), 464 - 9 {Pleural effusion and empyema as complications of pneumonia}; Bauwens AM et al.; Parapneumonic effusion is observed radiologically in approximately 40% of the patients with a bacterial pneumonia . In most cases the course of the disease is uncomplicated, and the parapneumonic effusion (PPE) resolves with antibiotic therapy . However, in 5-10% of the patients, PPE becomes more complicated (loculation) and the effusion eventually leads to the formation of an empyema if no drainage has been performed . In view of negative impact on morbidity and mortality, it is important to recognise and evaluate a PPE as soon as possible . Intrapleural pus is the only absolute indication for drainage . In all other cases, the risk of a complicated PPE has to be established in the early phase of the illness, based on radiological, biochemical and microbiological parameters of the effusion . Based on these findings one or more of the following therapeutic strategies can be chosen: tube installation with drainage, fibrinolytical therapy, video-assisted thoracoscopic surgery, thoracotomy with or without decortication, or open drainage . Although every PPE needs to be evaluated on an individual basis, an attempt has been made to formulate a strategy that can be used in clinical practice, based on recent literature and expert opinions. J Can Dent Assoc, 2002 Mar, 68(3), 165 - 9 Periodontal disease and preterm delivery of low-birth-weight infants; McGaw T; Preterm delivery of low-birth-weight infants (PLBW) remains a significant public health issue and a leading cause of neonatal death and long-term neurodevelopmental disturbances and health problems . Recent epidemiological and microbiological immunological studies have suggested that periodontal disease may be an independent risk factor for PLBW . Postulated mechanisms include translocation of periodontal pathogens to the fetoplacental unit and action of a periodontal reservoir of lipopolysaccharides or inflammatory mediators . However, non-causal explanations for the correlation between periodontitis and PLBW can also be offered . Prospective studies, and eventually interventional studies, will be necessary before periodontitis can be considered as a causal factor for PLBW. Mikrobiologiia, 2002 Jan-Feb, 71(1), 111 - 8 {Intensity of the microbiological processes of the methane cycle in different types of Baltic lakes}; Dziuban AN; The intensity of the microbiological processes of methane formation (MF) and methane oxidation (MO) was determined in the sediments and water of different types of Baltic lakes . The emission of methane from the lake sediments and methane distribution in the water column of the lakes were studied as functions of the lake productivity and hydrologic conditions . During summers, the intensity of MF in the lake sediments and waters varied from 0.001 to 106 ml CH4/(dm3 day) and from 0 to 3.2 ml CH4/(1 day), respectively, and the intensity of MO in the sediments and water varied from 0 to 11.2 ml CH4/(dm3 day) and from 0 to 1.1 ml CH4/(1 day), respectively . The total methane production (MP) in the lakes varied from 15 to 5000 ml CH4/(m2 day) . In anoxic waters, the MP comprised 9-18% of the total PM in the lakes . The consumption of organic carbon for methanogenesis varied from 0.03 to 9.7 g/(m2 day) . The role of the methane cycle in the degradation of organic matter in the lakes increased with their productivity. Intensive Care Med, 2002 Feb, 28(2), 147 - 53 Epub 2002 Jan 12. The combination of a heat and moisture exchanger and a Booster: a clinical and bacteriological evaluation over 96 h; Thomachot L et al.; OBJECTIVE: To determine whether the combination with a new device (Booster ) for active humidification improves the efficacy of a hydrophobic heat and moisture exchanger (HME) . DESIGN AND SETTING: Prospective, interventional study in the ICU of a university hospital . PATIENTS: Consecutive patients requiring controlled mechanical ventilation INTERVENTIONS: Patients were ventilated with a HME, and a Booster was added for 96 h to the ventilatory circuit . MEASUREMENTS AND RESULTS: During the inspiration phase the following factors were measured: peak and mean airway pressures, maximal (beginning of inspiration), minimal (end of inspiration), and mean values of temperature of inspired gases, and relative and absolute humidity of inspired gases . Microbiological samples were obtained from the Booster, the ventilator side of the HME, and the tracheal secretions on days 1 and 4 . Minimal and mean temperatures were increased as soon as the Booster was used and this increase was maintained for 96 h until the Booster was withdrawn . Then the temperature returned to baseline values . Absolute humidity values followed the same course . There was also some indirect evidence of very little, if any, changes in the HME resistance . The ventilatory side of the HMEs remained sterile in each patient, and the Booster was colonized by the same bacteria as those in the tracheal secretions . CONCLUSIONS: Adding the Booster to a hydrophobic HME improved the heat and water preservation of ventilatory gas. J Hum Nutr Diet, 2001 Oct, 14(5), 397 - 403 Application of Hazard Analysis Critical Control Points system to enteral tube feeding in hospital; Oliveira MR et al.; An HACCP system was implemented for the quality assurance of preparation, storage and delivery of enteral feeds to patients in hospital . Routine methods of feed preparation, storage and delivery to patients were studied and a flow chart was initially made . After identifying hazards, an HACCP team was assembled, a flow chart was modified and critical control points were defined using a decision tree . Control measures for each step of the process and its monitoring and corrective measures to be applied were also defined . In addition, feed samples were analysed for microbiological quality and feed storage temperatures were also recorded, before and after the implementation of the HACCP system . When the control measures were applied and monitored, the hazard was reduced . Bacterial counts in feed were reduced from 105 cfu mL-1 to < 101 cfu mL-1 . The results show that contamination of enteral feed may be reduced or eliminated if a systematic approach such as HACCP is applied effectively. Clin Microbiol Infect, 2002 Jan, 8(1), 14 - 25 Clinafloxacin monotherapy (CI-960) versus ceftazidime plus amikacin for empirical treatment of febrile neutropenic cancer patients; Glauser MP et al.; OBJECTIVE: To assess the efficacy and safety of clinafloxacin as a single agent for the empirical treatment of febrile episodes and bacterial infections in neutropenic cancer patients . METHODS: An open label, active-controlled, randomized, parallel treatment, multicenter study was conducted where clinafloxacin monotherapy was compared to the combination of ceftazidime plus amikacin (plus optional vancomycin or teicoplanin) . Four hundred and nineteen patients were randomized to receive either intravenous clinafloxacin 200 mg every 12 h or intravenous ceftazidime (2 g) iv every 8 h plus intravenous amikacin (15 mg/kg) per day in divided doses . All randomized patients were to receive a minimum of 48 h of primary study drug treatment, after which the primary treatment could be modified . Clinical and microbiological responses were evaluated at 7-21 days post-treatment after study treatment and long term (maximum 28 days), in intent-to-treat and modified intent-to-treat populations . RESULTS: Clinafloxacin and ceftazidime-amikacin were statistically equivalent for the 72-h defervescence rate, overall defervescence rate, time to defervescence, clinical success rate, by-pathogen microbiological eradication rate, and survival rate . Clinical cure was achieved in 84% (59/70) of patients who received clinafloxacin monotherapy . There were no significant differences between treatments in rates of adverse events or treatment discontinuation rates due to adverse events . CONCLUSIONS: Clinafloxacin appears to be an appropriate agent for empirical treatment in febrile neutropenic cancer patients. Crit Care Med, 2002 Jan, 30(1), 232 - 7 Randomized clinical trial of extended use of a hydrophobic condenser humidifier: 1 vs . 7 days; Thomachot L et al.; OBJECTIVE: To determine whether extended use (7 days) would affect the efficiency on heat and water preservation of a hydrophobic condenser humidifier as well as the rate of ventilation-acquired pneumonia, compared with 1 day of use . DESIGN: Prospective, controlled, randomized, not blinded, clinical study . SETTING: Twelve-bed intensive care unit of a university hospital . PATIENTS: One hundred and fifty-five consecutive patients undergoing mechanical ventilation for > or = 48 hrs . INTERVENTIONS: After randomization, patients were allocated to one of the two following groups: a) heat and moisture exchangers (HMEs) changed every 24 hrs; b) HMEs changed only once a week . Devices in both groups could be changed at the discretion of the staff when signs of occlusion or increased resistance were identified . MEASUREMENTS AND MAIN RESULT: Efficient airway humidification and heating were assessed by clinical variables (numbers of tracheal suctionings and instillations required, peak and mean airway pressures) . The frequency rates of bronchial colonization and ventilation-acquired pneumonia were evaluated by using clinical and microbiological criteria . Endotracheal tube occlusion, ventilatory support variables, duration of mechanical ventilation, length of intensive care, acquired multiorgan dysfunction, and mortality rates also were recorded . The two groups were similar at the time of randomization . Endotracheal tube occlusion never occurred . In the targeted population (patients ventilated for > or = 7 days), the frequency rate of ventilation-acquired pneumonia was 24% in the HME 1-day group and 17% in the HME 7-day group (p > .05, not significant) . Ventilation-acquired pneumonia rates per 1000 ventilatory support days were 16.4/1000 in the HME 1-day group and 12.4/1000 in the HME 7-day group (p > .05, not significant) . No statistically significant differences were found between the two groups for duration of mechanical ventilation, intensive care unit length of stay, acquired organ system derangements, and mortality rate . There was indirect evidence of very little, if any, change in HME resistance . CONCLUSIONS: Changing the studied hydrophobic HME after 7 days did not affect efficiency, increase resistance, or altered bacterial colonization . The frequency rate of ventilation-acquired pneumonia was also unchanged . Use of HMEs for > 24 hrs and up to 7 days is safe. Ann Intern Med, 2002 Mar 19, 136(6), 421 - 8 Clinical characteristics and treatment outcome of early Lyme disease in patients with microbiologically confirmed erythema migrans; Smith RP et al.; BACKGROUND: Lyme disease has a wide spectrum of clinical manifestations . Diagnosis is usually based on the clinical and serologic picture rather than on microbiological confirmation . OBJECTIVE: To examine the clinical presentation and treatment outcome of early Lyme disease in patients with microbiologically confirmed erythema migrans . DESIGN: Observational cohort study . SETTING: 31 university-based or clinician-practice sites in 10 endemic states . PARTICIPANTS: 10 936 participants enrolled in a phase III trial of Lyme disease vaccine; 118 participants had erythema migrans in which Borrelia burgdorferi was detected by culture or polymerase chain reaction . MEASUREMENTS: Clinical characteristics and treatment outcome were noted . Skin biopsies of erythema migrans were performed for culture and detection of B . burgdorferi by polymerase chain reaction; serologic responses were determined by Western blot . RESULTS: The 118 patients with microbiologically confirmed erythema migrans presented a median of 3 days after symptom onset . Early erythema migrans commonly had homogeneous or central redness rather than a peripheral erythema with partial central clearing . The most common associated symptoms were low-grade fever, headache, neck stiffness, arthralgia, myalgia, or fatigue . By convalescence, 65% of patients had positive IgM or IgG antibody responses to B . burgdorferi . Most patients responded promptly to antibiotic treatment . CONCLUSIONS: In major endemic areas in the United States, Lyme disease commonly presents as erythema migrans with homogeneous or central redness and nonspecific flu-like symptoms . Clinical outcome is excellent if antibiotic therapy is administered soon after symptom onset. Int J Pharm, 2002 Feb 21, 233(1-2), 207 - 15 The effect of ionizing radiation on some derivatives of 1,4-dihydropyridine in the solid state; Marciniec B et al.; The effect of gamma and beta radiation in doses between 10 and 100 kGy on physico-chemical properties of four derivatives of 1,4-dihydropyridine (nifedipine, nitrendipine, felodipine and nimodipine) in the solid state was analysed . A number of qualitative and quantitative methods such as UV, IR, TLC, GLC, DSC, EPR as well as organoleptic and gravimetric analysis were used to determine and analyse any changes resulting from irradiation . In order to determine the effectiveness of sterilization with ionizing radiation of doses from 10 to 25 kGy, various microbiological tests were used . It was established that only doses 10-20 kGy of both kinds of radiation ensure total sterilization without any degradation of physico-chemical properties of the compounds studied . For the doses 50-100 kGy a decrease in the content of the compounds, appearance of the products of their decomposition and changes in the melting point and IR spectra appeared . Felodipine (with chlorophenyl substituent) was found to be much more sensitive to ionising radiation than nifedipine, nitrendipine and nimodipine (all with nitrophenyl substituent). J Oral Rehabil, 2002 Mar, 29(3), 232 - 9 Influence of removable partial denture on periodontal indices and microbiological status; Vanzeveren C et al.; Thirty patients (19 men and 11 women) were provided with a removable partial denture (RPD) and assigned randomly to two groups: 15 patients were called back twice a year for plaque control, reinforcement of instructions, denture hygiene control and professional prophylaxis; the other 15 were not called back . The 30 patients were examined after 2-3 weeks following the end of the prosthetic treatment, after 1 and 2 years . At each examination, the following parameters were recorded {gingival inflammation, plaque index (Pl I), tooth mobility, attachment level, pocket depth} and a bacteriological examination of subgingival plaque was carried out . Few differences appeared between the two groups; the values observed show a relatively low level of hygiene and but little motivation with regard to prophylaxis techniques. J Oral Pathol Med, 2002 Jan, 31(1), 5 - 10 Oral candidiasis as a clinical marker related to viral load, CD4 lymphocyte count and CD4 lymphocyte percentage in HIV-infected patients; Campo J et al.; BACKGROUND: High viral load is currently considered to be one of the main indicators of the progression of HIV-induced immunodepression, but few studies have analysed its relationship to the presence of oral candidiasis (OC) . The aim of this cross-sectional study is to analyse the relationship between viral load, total CD4 lymphocyte count, and percentage of CD4 lymphocytes to the occurrence of OC . METHODS: The present cross-sectional study included 156 HIV-infected patients seen at a clinic for sexually transmitted diseases and HIV . We assessed the presence or absence of OC, and microbiological samples were obtained from the palatine mucosa and dorsal tongue for a smear stained with KOH (potassium hydroxide) and culture on Sabouraud's dextrose agar in all patients . Viral load was determined by quantification of viral RNA in peripheral blood with a minimum detectable level of 500 RNA copies/ml . CD4+ counts/CD4+ percentage were categorized as <200/<14%, 200-499/14-28%, and >500/>29%, and HIV viral loads were categorized as <500, 500-10,000, >10,000 copies/ml . RESULTS: Thirty-eight percent (37.8%) of the patients had OC . Patients with CD4+ lymphocyte counts below 200 x 10(6)/l and CD4+ percentages below 14% showed a significantly higher frequency of OC (57.9% and 48.0%, respectively) . Patients with a viral load over 10,000 copies/ml also had OC more frequently (44.8%) . In the multiple logistic regression analysis, OC showed a statistically significant association with high viral load {>10,000 vs <500, odds ratio (OR)=11.4}, low percentage of CD4+ lymphocytes (<14% vs >28%, OR=5), and injection drug use (IDU vs heterosexual transmission, OR=10.2) . In HIV-infected patients, high viral load was associated with more frequent OC, regardless of CD4+ lymphocyte level . CONCLUSIONS: These findings suggest that oral candidiasis could be a useful clinical marker of patients with high viral load . In view of these results, emphasis should be placed on the importance of systematic examination of the oral cavity in all medical follow-up examinations of HIV-infected patients. Curr Top Med Chem, 2001 May, 1(1), 31 - 57 Siderotyping--a powerful tool for the characterization of pyoverdines; Fuchs R et al.; Tools for the identification of bacteria are of great importance especially for taxonomical and medical purposes . In the case of fluorescent pseudomonads a quick and unambiguous identification is possible by methods that are referred to as "siderotyping" . All of them are based upon the characterization of the bacterial siderophores or the receptors expressed for the uptake of these compounds . Different microbiological and bioanalytical tests that are accurate, rapid and easy to use will be described. J Qual Clin Pract, 2001 Sep, 21(3), 86 - 8 Rational prescribing for childhood pneumonia; Dawson KP; The aim of this study was to assess the management and prescribing patterns for community acquired pneumonia in children in a provincial hospital setting and, further, to discover the evidence on which treatment choices were made and ascertain the need for management guidelines . The method employed was to obtain the relevant data by a retrospective audit of the case notes of children admitted with pneumonia to Wairau Hospital, Blenheim, New Zealand . The findings indicated that there were 12 different treatment regimens employed . There appeared to be no rational basis for the choices made and no microbiological evidence to support the frequent use of broad spectrum antibiotics . No difference in clinical efficacy was found between the main regimens used . It is concluded that a simple management protocol for childhood pneumonia using a narrow spectrum antibiotic initially would be as effective, more logical and cheaper. Nucl Med Commun, 2002 Feb, 23(2), 167 - 70 99m Tc-ciprofloxacin (Infecton) imaging in the diagnosis of knee prosthesis infections; Larikka MJ et al.; The purpose of this study was to evaluate the usefulness of 99mTc labelled ciprofloxacin imaging in detecting the presence of infection in patients with symptomatic knee prostheses . Among 16 randomly selected patients of whom seven had infection based on clinical and microbiological findings and nine did not, 99mTc-ciprofloxacin images were obtained at 1, 4 and 24h after the injection of the tracer . While there was some diffuse non-specific accumulation of 99mTc-ciprofloxacin in large synovial joints and in prosthetic knee joints, the infected knee prostheses were found to show more intensive focal uptake, which also extended outside the synovial cavity . The infection related uptake remained visible in the 24h images, whereas non-specific uptake had a fading tendency at this time point . 99mTc-ciprofloxacin imaging showed diagnostic sensitivity of 86% and a specificity of 78% for correctly classifying the presence of infection . The data indicate that 99mTc-ciprofloxacin imaging may be used in the diagnosis of knee prosthesis infections . Infection-related uptake remains visible in the 24h images and is typically found also outside the synovial cavity, which should be noted in the evaluation of the images. Injury, 2002 Mar, 33(2), 151 - 5 Histological assessment of the presence or absence of infection in fracture non-union; Simpson AH et al.; BACKGROUND: Infection is a major cause of non-unions . Infection is not always evident clinically, nor on bacteriological analysis . If it is untreated, non-union treatment may fail . AIM: To establish whether histological analysis is of value as an adjunct to microbiology in establishing the diagnosis of infection . METHODS: Sixty patients who had both bacteriological and histological analysis of their non-unions were studied . Infection was indicated by an acute inflammatory response . In 45 of the 60 fractures, microbiological and clinical diagnoses were in agreement; in this subset the histology results were compared to the established diagnoses . RESULTS: The histological diagnosis for the 45 fractures in the group with a definite diagnosis gave four false negatives but no false positives . This represents a sensitivity of 87.1%, (95% CI, 70-96%) and a 100% specificity (95% CI, 77-100%) . The overall accuracy was 91.1% . (95% CI, 79-98%) The predictive value of a positive test was 100% and of a negative test was 77.8% . In 25% of the series a definite diagnosis could not be made with purely clinical and microbiological information; with the additional histological information it was possible to determine the infection status of the non-union . CONCLUSION: Histology is of particular use when the microbiology is negative or equivocal. Int Surg, 2001 Jan-Mar, 86(1), 57 - 61 Mesenteric actinomycosis with retroperitoneal involvement; Diaz-Oller J et al.; Mesenteric or retroperitoneal actinomycosis is an extremely rare disease . The international databases have revealed only 10 cases affecting the mesenterium and another 52 cases affecting the retroperitoneum . We report a 78-year-old female who was admitted with complaints of abdominal pain . Laboratory examination revealed anemia and the clinical examination revealed an irregular mass in the abdomen . Ultrasound and computed tomography (CT) scans showed a solid mass in the mesenteric-retroperitoneal region . Biopsy of the nonresectable mass revealed the presence of chronic inflammation in the mesenteric area with Actinomyces colonies . The patient was treated with oral amoxicillin, 500 mg every 6 hours for 6 months . The symptoms disappeared, but the mesenteric-retroperitoneal mass remains, but smaller in size . Based on the review of the literature and the case reported here, we conclude that mesenteric-retroperitoneal actinomycosis is difficult to diagnose by means of noninvasive techniques as it can masquerade as a malignant process . An accurate diagnosis is always obtained in a histological or microbiological examination, often requiring surgical intervention . Treatment with penicillin has proven to be effective. Ostomy Wound Manage, 2001 Oct, 47(10), 38 - 43 Screening evaluation of an ionized nanocrystalline silver dressing in chronic wound care; Sibbald RG et al.; The successful topical treatment of chronic wounds requires adequate debridement, bacterial balance, and moisture balance . An ionized nanocrystalline silver dressing was evaluated through an uncontrolled, prospective study of a case series of 29 patients with a variety of chronic nonhealing wounds . The four arms of the study included nine patients with foot ulcers, six patients with venous stasis ulcers, two patients with pressure ulcers, and 12 patients with miscellaneous wounds . All wounds were assessed for the usual signs of clinical infection, with most of these parameters being measured and recorded . Microbiologically, bacterial load was determined via quantitative biopsies and semi-quantitative swabs . In general, the results showed a marked clinical improvement for the majority of wounds treated with the dressing . Among improved parameters included decreased exudate and decreased purulence . The quantitative bacterial biopsies did not show any decrease in organism numbers, although the semi-quantitative swabs indicated a decrease in the wound surface bacterial loading . This was indicative of the dressing's ability to reduce surface bacteria and achieve an element of bacterial balance in the superficial dermal compartment . The proposed mechanism of action for this ionized nanocrystalline based dressing is through bacterial and moisture balance within the superficial wound space compartment. Enferm Infecc Microbiol Clin, 2002 Feb, 20(2), 53 - 6 {Oral and cervicofacial actinomycosis . Presentation of five cases}; Aguirrebengoa K et al.; BACKGROUND: Actinomycosis is a suppurative and granulomatous chronic infectious disease caused by Actinomyces sp . and most commonly affecting the cervicofacial area . AIM: To study the clinical characteristics of patients with actinomycosis, with regard to clinical history, presentation, method of diagnosis, treatment and follow up . PATIENTS AND METHODS: A retrospective review was performed on all cases of microbiologically or histologically proven oral or cervicofacial actinomycosis . RESULTS: Five patients were studied, 2 men and 3 women, 25-69 years old . Four patients had a history of surgical procedures and/or dental manipulations . Three patients showed the classic presentation of a lump and fistulization, and two patients presented intra-oral lesions . Four patients were diagnosed by cultures positive to A . israelii on microbiologic study and the remaining patient by cytologic detection of a sulfur granule . The first patient received the classic initial regimen of iv penicillin and 3 were treated with third-generation cephalosporins, continuing with oral amoxicillin during 12 months . Patient no.2 required a second surgical procedure . Patient no . 5, who had an exclusively oral process, received a short course of amoxicillin . There were no relapses during follow-up . CONCLUSION: Actinomycosis is an uncommon disease . Establishment of the definite diagnosis requires a high index of suspicion and good clinical-microbiological collaboration . The classic course of iv penicillin and oral amoxicillin during 6-12 months is effective . For the acute phase treatment, iv penicillin can be replaced by third-generation cephalosporins. J Hosp Infect, 2002 Mar, 50(3), 228 - 31 A survey of rotational use of biocides in hospital pharmacy aseptic units; Murtough SM et al.; A postal survey of biocide rotation in UK hospital pharmacy aseptic units was carried out . Seventy per cent of respondents stated that biocides were rotated, most frequently in areas outside critical work zones . High-level disinfection was employed when 'aseptic' conditions were required . Decisions on frequency of rotation were most often based on in-house validation or consultation with colleagues . Toxicity and corrosiveness were the criteria rated most important in a rotation policy . Microbiological monitoring was carried out most frequently in critical work zones but less often for handwashing . Most QC hospital pharmacists supported rotation and would prefer a standard period for all applications (monthly).Guidelines need to be clarified to assist staff in decisions regarding biocide rotation . Cytokine, 2002 Jan 7, 17(1), 28 - 35 Interleukin (IL)-4 inhibits phorbol-ester induced HIV-1 expression in chronically infected U1 cells independently from the autocrine effect of endogenous tumour necrosis factor-alpha, IL-1beta, and IL-1 receptor antagonist; Goletti D et al.; The anti-inflammatory cytokine interleukin 4 (IL-4) has shown both inductive and inhibitory effects on the replication of the human immunodeficiency virus type 1 (HIV-1) in primary CD4+ T cells and mononuclear phagocytes . In this study, IL-4 did not induce virus production, but inhibited phorbol esters (PMA)-stimulated HIV expression in chronically infected promonocytic U1 cells . This effect, however, was not accounted for by a decreased secretion of endogenous TNF-alpha induced by phorbol myristate acetate (PMA) . We also observed that PMA upregulated the production of both IL-1beta and of IL-1 receptor antagonist (IL-1ra) . IL-4 inhibited the secretion of IL-1beta and strongly increased that of IL-1ra; however, these effects were not responsible of IL-4-mediated inhibition of PMA-induced HIV expression since anti-IL-1ra antibodies did not revert IL-4 mediated suppression . U1 cells were transiently transfected with both wild-type (WT) long terminal repeat (LTR) constructs, or with LTR plasmids containing deletions of either the NF-kappaB or the Sp-1 binding sites . IL-4 inhibited LTR-driven transcription triggered by PMA stimulation of U1 cells, and this effect was dependent upon intact NF-kappaB but not Sp-1 binding sites . Thus, IL-4 may favour a state of microbiological quiescence in infected monocytic cells bypassing the induction of HIV expression mediated by pro-inflammatory cytokines . Clin Experiment Ophthalmol, 2002 Feb, 30(1), 52 - 4 Combined coliform and anaerobic infection of the lacrimal sac; McKeag D et al.; A case is reported of combined coliform and anaerobic bacterial infection of the lacrimal sac, a condition of which there is only one other published case report . In addition, a literature review is presented of the bacteriology of acute dacryocystitis as it applies to this case . Recommendations for the microbiological investigation and management of acute dacryocystitis are made. Vet Surg, 2002 Mar-Apr, 31(2), 174 - 80 Open peritoneal drainage versus primary closure for the treatment of septic peritonitis in dogs and cats: 42 cases (1993-1999); Staatz AJ et al.; OBJECTIVE: To determine survival rates in dogs and cats with septic peritonitis treated with open peritoneal drainage (OPD) versus primary closure (PC) after laparotomy . STUDY DESIGN: Retrospective analysis of medical records from Colorado State University Veterinary Teaching Hospital from 1993 to 1999 . SAMPLE POPULATION: Thirty-six dogs and 6 cats with septic peritonitis documented by cytological examination or microbiological culture of abdominal fluid . METHODS: Medical records of dogs and cats with septic peritonitis treated by OPD or PC were reviewed . Age, weight, species, white blood cell (WBC) count, band neutrophil count, platelet count, serum glucose concentration, heart rate, body temperature, duration of hospitalization, and clinical outcome were recorded for each animal . Differences in treatments administered between the OPD and PC groups as well as the underlying cause of septic peritonitis were determined . RESULTS: There was no significant difference in survival between animals in the OPD versus PC groups (P =.26) with an overall survival rate of 71% . White blood cell count, band neutrophil count, platelet count, serum glucose and total bilirubin concentrations, heart rate, age, and weight were not significantly different between groups (P >.05) . A significantly greater number of animals in the OPD group received plasma (P =.009), blood (P =.037), and a jejunostomy tube (P =.02) than animals in the PC group . There was a significant difference in the number of days spent in critical care unit with a mean of 6.0 +/- 4.1 days for the OPD group and 3.5 +/- 2.3 days for the PC group (P =.02) . CONCLUSIONS: Open peritoneal drainage for the management of septic peritonitis in dogs and cats is an acceptable alternative to PC . Environ Sci Technol, 2002 Feb 15, 36(4), 646 - 52 Influence of phosphate on bacterial adhesion onto iron oxyhydroxide in drinking water; Appenzeller BM et al.; The transport and storage of drinking water in water distribution systems can modify its initial composition and properties . The accumulation of bacteria on corroded pipes is prejudicial and may lower the microbiological quality of the water . Previous results have shown that when pipes are highly corroded, the addition of phosphate, used as an anticorrosion treatment, decreases the bacterial concentration in the water . We studied the possibility of using phosphate to reverse the surface charge of iron oxyhydroxide (FeOOH) to limit bacterial adhesion . Iron oxyhydroxide (IOH) particles and Escherichia coli SH 702 were used as models of corrosion products and bacterial contamination, respectively . Electrophoresis was used to characterize the initial surface charges of both types of particles and the modifications that occurred after the addition of phosphate anions . Flow cytometry and adhesion assays were used to build adsorption isotherms of bacteria on IOH versus (phosphated-) IOH . X-ray photoelectron spectroscopy permitted to determine the chemical composition of the E . coli envelope and to discuss on functional groups responsible for bacterial surface properties . In the present conditions, adding phosphate to water allowed a decrease of 75% of the bacteria adhering to IOH. J AOAC Int, 2002 Jan-Feb, 85(1), 72 - 81 Determination of vitamin B12 in milk products and selected foods by optical biosensor protein-binding assay: method comparison; Indyk HE et al.; Biomolecular interaction analysis was evaluated for the automated determination of vitamin B12 in a range of foods . The analytical technique was configured as a biosensor-based, nonlabeled inhibition protein-binding assay using nonintrinsic R-protein . Sample extraction conditions were optimized, and both ligand specificity and nonspecific binding considerations were evaluated . Performance parameters included a quantitation range of 0.08-2.40 ng/mL, recoveries of 89-106%, agreement against assigned reference values for 3 independent certified food reference materials, and a mean between-laboratory reproducibility relative standard deviation of 4.9% . The proposed method was compared with reference microbiological and radioisotope protein-binding methods for a range of food samples . A wide selection of milks, infant formulas, meats, and liver were evaluated for their vitamin B12 content . The influence of season was studied in herd milk, early lactation was followed for a single animal, and the cobalamin content of bovine, caprine, and ovine milks was compared. Life Sci Space Res, 1964, 2, 124 - 32 "Gulliver", an experiment for extraterrestrial life detection and analysis; Levin GV et al.; Based on the probability that extraterrestrial life is biochemically somewhat similar to life on Earth, a life detection experiment is being prepared to explore Mars . The experiment will be performed by an automated device which will carry a microbiological medium being developed to support a wide range of earth microorganisms . Selected ingredients of the medium will be labeled with radioactive isotopes . A sticky string, shot out from and reeled back into the device, will gather a sample of the Martian soil . It is hoped the radioactive atoms in the compounds will be metabolized by the unknown organisms in the soil and evolved in a labelled gas . The gas will be collected by a chemical "getter" and the radioactivity measured for transmission to Earth . A positive response from the test unit and a negative, or lesser, response from a poisoned control unit would constitute evidence of life . The device can also differentiate between photosynthetic and nonphotosynthetic metabolic activity . Data from field tests on Earth are presented. Stomatologiia (Mosk), 2001, 80(6), 18 - 21 {Clinical and microbiological efficiency of silard gel-immobilized ethonium in the treatment of periodontal inflammations}; Rogovaia EP et al.; In the course of examination and treatment of 250 patients studied the effect of medical sorbent, sylard-gel, and aethony immobilized on it upon inflammatory periodontal diseases . The results of the microbiological examination shaved good sorption and inhibitory characteristics of immobilized aethony . The best clinical results were achieved in the treatment chronic generalized gingivitis and chronic generalized periodontitis. J Clin Microbiol, 2002 Mar, 40(3), 943 - 50 Specificities and functions of the recA and pps1 intein genes of Mycobacterium tuberculosis and application for diagnosis of tuberculosis; Saves I et al.; The worldwide recrudescence of tuberculosis and the widespread appearance of antibiotic resistance have strengthened the need for rapid and specific diagnostic tools . The prevailing microbiological identification of Mycobacterium tuberculosis, the causative agent of tuberculosis, which implies the use of in vitro cultures and acid-fast staining microscopy, is time-consuming . Detection of M . tuberculosis directly in clinical samples through PCR amplification of mycobacterium-specific genes, designed to shorten diagnostic delay, demonstrated reliability and high sensitivity . However, the quality of the diagnosis depends on the specificity of the target sequence for M . tuberculosis complex strains . In the present study, we demonstrated the specificity of recA and pps1 inteins for this complex and thus the feasibility of using intein-coding sequences as a new target for PCR diagnosis . Indeed, the recA and pps1 genes of 36 clinical isolates of M . tuberculosis and 10 field strains of M . bovis were found to be interrupted by an intein sequence at the RecA-a and Pps1-b sites, respectively, while a large number of nontuberculous mycobacterial species failed to demonstrate these insertions . Besides, the MtuPps1, which was cloned and expressed in Escherichia coli, was shown to possess an endonuclease activity . The intein cleaves the 40-bp sequence spanning the intein insertion site Pps1-b in the inteinless pps1 gene . In addition to the PCR amplification of recA and pps1 intein genes as a tool for diagnosis, the specific endonuclease activity could represent a new molecular approach to identify M . tuberculosis. Immunology, 2002 Feb, 105(2), 213 - 21 Fc receptor regulation of protective immunity against Chlamydia trachomatis; Moore T et al.; The prevailing paradigm for designing potentially efficacious vaccines against the obligate intracellular bacterium, Chlamydia trachomatis, advocates regimens capable of inducing a mucosal antigen-specific T helper type 1 (Th1) response . However, recent reports indicate that rapid and efficient clearance of a secondary infection also requires certain B-cell functions . We investigated the hypothesis that Fc receptor (FcR)-mediated antibody effector mechanisms are important B-cell-related functions involved in controlling a chlamydial genital reinfection . Microbiological analysis of genital chlamydial infection in FcR knockout (FcRKO) mice lacking the activatory FcgammaRI (CD64) and FcRgammaIII (CD16), as well as the inhibitory FcgammaRIIB1 (CD32), revealed a greater intensity of secondary infection (i.e . bacterial shedding) in FcRminus sign/minus sign as compared to FcR+/+ mice; however, the course of the primary infection was indistinguishable in both animals . Pathologically, FcRKO mice suffered greater ascending infection than immunocompetent wild-type (WT) mice after a secondary infection . Immunological evaluation indicated that the presence of specific anti-chlamydial antibodies enhanced chlamydial antigen presentation for induction of a Th1 response by FcR+/+, but not FcRminus sign/minus sign, antigen-presenting cells . In addition, specific anti-chlamydial antibodies augmented both macrophage killing of infected epithelial cells by antibody-dependent cellular cytotoxicity (ADCC) and macrophage inhibition of productive growth of chlamydiae in co-cultures . These results indicate that B cells participate in anti-chlamydial immunity via FcR-mediated effector functions of antibodies, which are operative during reinfections . Such effector functions include ADCC, and possibly enhanced uptake, processing and presentation of chlamydial antigens for rapid induction of a Th1 response, all facilitating the early clearance of an infection . These findings suggest that a future anti-chlamydial vaccine should elicit both humoral and T-cell-mediated immune responses for optimal memory response and vaccine efficacy. Artif Organs, 2002 Jan, 26(1), 10 - 7 Atomic force microscopic observation of mechanically traumatized erythrocytes; Ohta Y et al.; Erythrocytes are damaged or stimulated mechanically by artificial organs assisting in circulation . For several decades, a large number of research studies have been conducted to investigate the traumatizing phenomena due to nonphysiological flow conditions . These phenomena are thought to be the physical interaction between the cell membrane and the various fluidic conditions . To elucidate or evaluate the phenomena, however, chemical components emerging into the circulating solution, such as liberated hemoglobin or lactic dehydrogenase (LDH), have been measured as a main parameter . Naturally, the physical reaction caused on the membrane itself cannot be detailed by these parameters because they are the secondary products resulting from the mechanical membrane rupture . The aim of this study is to understand the traumatizing mechanism directly from a microbiological viewpoint . As a first step, we visualized the surface of sheep erythrocytes loaded with shear stress and measured erythrocyte surface roughness by atomic force microscopy (AFM) on a nanometer scale (10(-9) m) . The constant shear rate was set at 1,800 (1/s), and the exposure time was set at 0.5, 1, and 2 h . We also measured the liberated hemoglobin concentration . As a result, it was found that the fine structure on the cell surface was changed drastically by the stress . It was also found that the surface roughness value increased with the exposure time, and correlated to the hemoglobin concentration . The visualization and the measurement of surface roughness of traumatized erythrocytes by AFM were thought to offer a new parameter for both hemolytic and subhemolytic studies. Toxicol Lett, 2002 Mar 10, 128(1-3), 35 - 44 The EU precautionary bans of animal feed additive antibiotics; Pugh DM; Toxicologists, with good reason, will feel that the biological safety of chemical products across the market sectors rests largely on their efforts . However, one sector has received much adverse attention from the media, consumers, politicians, legislators and advisory groups in recent years . It is food animal production in intensive systems and, within those, various types of chemical additives included in the compound diets fed . No additive class received more adverse comment than those antibiotics used for the purpose of enhancing the efficiency of animal production . This paper considers the safety of the antibiotic feed additives (AFAs) against the background of the regulatory measures in place, defines their role and describes the relevant concerns . It closes with comment on the microbiologically-based health risk which underpinned the AFA bans and sounds a warning over the precedent created by the use of the precautionary principle in the recent banning of six of their number. EDTNA ERCA J, 2001 Jul-Sep, 27(3), 135 - 9 Dialysis fluid contamination of pathways and life of microbes; Nystrand R; The fluid systems of a dialysis clinic are reviewed from a microbiological standpoint . Water, concentrate and dialysis fluid are the main fluids in the clinic . The quality of these fluids cannot be dealt with, without at the same time reviewing the systems delivering these fluids.The handling of fluids must be seen in a system perspective where every part is important . In the pretreatment of water before reverse osmosis, the incoming water determines the quality.After reverse osmosis,the maintenance in form of disinfection activities is decisive for the microbiological quality in the water system . The dialysis fluid quality is dependent on the water quality as it is produced at the end of the water system . It must be noted that it is not only the number of microorganisms that is of importance but also what the microorganisms do in the fluid systems . Microbiological analysis is not normally able to tell the complete microbiological quality of the fluid systems, as the inner surfaces where the microbial growth takes place are not sent to any laboratory . Consequently, what is seen in samples is only what can come off the surface . The only action that can prevent growth of microorganisms is disinfection but disinfection only is not the solution, it must also be performed regularly . Additionally, all areas of the fluid system must be disinfected . The principle of Quality Assurance including equipment, education and maintenance must be applied in order to ensure microbiological quality. EDTNA ERCA J, 2001 Jul-Sep, 27(3), 132 - 4 Microbiological survey of dialysate: vantage of use of sterile bag concentrate; Pansini S et al.; Haemodialysed patients are exposed to nearly 400 litres of dialysis water weekly . The bacterial contamination of treated dialysate and water induces acute pyrogenic reactions or chronic damage and cytokine activation . The aim of this study was to value the microbiological parameters of dialysis water and dialysate of our monitors by bacterial culture (measured as colony forming units {CFU}) of water samples at 37 degrees C after 48 hours, at 22 degrees C after 72 hours and after seven days, and by measuring endotoxin levels (endotoxin units {EU}) . In our centre, there are 16 monitors (6 monitors use sterile dialysate fluid and 10 monitors use non sterile dialysate fluid) . The chemicals used for disinfection are chlorine and paracetic acid . Water samples were taken under sterile procedures every three months for a year . No bacteria were found in the samples of water of the dialysis ring; EU were lower than the limit value of 0.25 EU/ml fixed by the European Pharmacopoeia . The concentration of CFU and EU of the dialysate, taken from monitors with a sterile bag, were lower than those of other monitors (p < 0.05 t Student test) . However, the levels of CFU/ml and EU/ml of dialysate samples, taken from monitors with a non-sterile bag, were lower than the guideline value of the European Pharmacopoeia (v.n . CFU < 50 CFU/ml and EU < 0.05 EU/ml) . Frequent examination of CFU and EU is essential to reduce the damage caused by the use of contaminated water, therefore the goal of future dialytic techniques will be the use of "sterile dialysate". Gravit Space Biol Bull, 2001 Jun, 14(2), 1 - 6 Microbial contamination of spacecraft; Pierson DL; Spacecraft and space habitats supporting human exploration contain a diverse population of microorganisms . Microorganisms may threaten human habitation in many ways that directly or indirectly impact the health, safety, or performance of astronauts . The ability to produce and maintain spacecraft and space stations with environments suitable for human habitation has been established over 40 years of human space flight . An extensive database of environmental microbiological parameters has been provided for short-term (< 20 days) space flight by more than 100 missions aboard the Space Shuttle . The NASA Mir Program provided similar data for long-duration missions . Interestingly, the major bacterial and fungal species found in the Space Shuttle are similar to those encountered in the nearly 15-year-old Mir . Lessons learned from both the US and Russian space programs have been incorporated into the habitability plan for the International Space Station . The focus is on preventive measures developed for spacecraft, cargo, and crews . On-orbit regular housekeeping practices complete with visual inspections are essential, along with microbiological monitoring . Risks associated with extended stays on the Moon or a Mars exploration mission will be much greater than previous experiences because of additional unknown variables . The current knowledge base is insufficient for exploration missions, and research is essential to understand the effects of space flight on biological functions and population dynamics of microorganisms in spacecraft . Equally important is a better understanding of the immune response and of human-microorganism-environment interactions during long-term space habitation. PDA J Pharm Sci Technol, 2002 Jan-Feb, 56(1), 11 - 9 Definition of a correlation between microbiological and physical particulate barrier performances for porous medical packaging materials; Sinclair CS et al.; An experimental set up, assembled principally from components of commercially available filter test equipment, has allowed assessment of physical particulate barrier performance of porous materials . Employing twelve specially made papers with graded and widely different barrier properties, a physical particulate/microbiological correlation has been derived covering the 50,000 fold range of microbiological barrier performances seen in commercial porous medical packaging materials . The derived correlation has been shown to be independent of sheet structure and is applicable to the diverse structures that comprise commercial materials . A simple measurement of particle penetration is proposed as a means of assessing microbial barrier properties of such materials. Clin Microbiol Infect, 1998 May, 4(5), 255 - 263 Whole cell protein and partial 16S rRNA gene sequence analysis suggest the existence of a second Rothia species; Kronvall G et al.; OBJECTIVE: To subject ten clinical isolates grouped together based on their biochemical and microbiological profile to further investigations aimed at correct species identification . METHODS: The 16S rRNA gene was partially sequenced using nested amplification . Whole cell protein analysis (SDS-PAGE) and cluster analysis were performed on the 10 strains and also for comparison on 31 reference strains . The API Coryne biochemical kit as well as API 20 Strep were used for analysis of the phenotypic diversity of the strains by use of computerized numerical identification procedures . Antibiotic susceptibility testing was performed using a standardized disk diffusion test . RESULTS: The 265--556-bp-long 16S rRNA gene sequences of all 10 strains showed highest similarity to Rothia dentocariosa . Three strains showed complete identity between the sequences obtained and the sequence of the type strain of Rothia dentocariosa 16S rRNA gene (M59055), and the other seven ranged between 99.7% and 98.3% similarity . Detailed analysis of the sequences revealed a clustering of the strains into two groups . One group consisted of four isolates with the highest degrees of similarity with the reference strain (type I), while the members of another group (type II) showed differences in their nucleotide sequence at four distinct positions in the variable V7 region . T was replaced by C at position 597, C by T at position 608, T by C at position 610, and G by A at position 684 (position numbers according to reference sequence M59055, EMBL/GenBank) . Whole cell protein analysis (SDS-PAGE) and cluster analysis also segregated the 10 Rothia dentocariosa strains into two different clusters, with one cluster containing all four strains belonging to 16S rRNA gene type I, and a second cluster containing all six strains belonging to 16S rRNA gene type II . CONCLUSIONS: Partial sequence data of the 16S rRNA gene as well as whole cell protein analysis showed a subdivision of the Rothia species into two groups, genomovar I (Rothia dentocariosa sensu stricto) and genomovar II, a possible new Rothia species. Clin Microbiol Infect, 1998 Feb, 4(12), 717 - 723 Community-acquired pneumonia due to Escherichia coli; Marrie TJ et al.; OBJECTIVE: To describe the features of community-acquired Escherichia coli pneumonia and to compare these patients with patients with pneumonia caused by other etiologic agents . PATIENTS AND METHODS: This prospective study was carried out at five medical institutions in three geographic locations---Pittsburgh, PA, Boston, MA and Halifax, NS . Pneumonia etiology was assigned, based on results of microbiological investigations, by a committee consisting of five investigators using rules established prior to the study . Demographic and clinical features and outcomes of patients with E . coli pneumonia were compared with those of pneumonia due to other microorganisms . RESULTS: Nineteen patients (9 (47.4%) blood culture positive) had pneumonia due to E . coli and 430 (69 (16.0%) blood culture positive) had pneumonia caused by other etiologic agents . E . coli was the second most common cause of bacteremic pneumonia . The E . coli patients were older, and more likely to be female, from a nursing home and confused compared with patients with pneumonia due to other microbial agents . They were more severely ill as measured by a validated pneumonia specific severity of illness scoring measure . Although there was no in-hospital mortality for the patients with E . coli pneumonia, the 90-day mortality was 21% . Thirty-two (7.4%) of the patients with pneumonia due to other agents died in hospital and the 90-day mortality rate was 13.5% (p NS) . Eight of the 19 patients with E . coli pneumonia were admitted from a nursing home and an additional four patients (63.2%) were discharged to such a facility . In contrast, only 44 (10.2%) of the patients with pneumonia due to other agents were discharged to a nursing home (p<0.001) . CONCLUSIONS: Patients diagnosed with E . coli pneumonia are frequently bacteremic . They are older than patients with pneumonia due to other etiologies, and more likely to be female, from a nursing home and severely ill . Despite the absence of in-hospital mortality, 21% of these patients died within 90 days of presentation. Clin Microbiol Infect, 1998 Feb, 4(12), 710 - 716 Aspergillus species isolated from clinical specimens: suggested clinical and microbiological criteria to determine significance; Greub G et al.; OBJECTIVE: To test a case-definition score for its usefulness in the diagnosis of pulmonary aspergillosis and to determine microbiological criteria useful in assessing the significance of isolating Aspergillus species from lower respiratory tract specimens (LRTS) . METHODS: With the exception of cystic fibrosis patients, all patients with Aspergillus isolated from LRTS were classified according to a clinical case-definition ratio as: (i) colonized patients; (ii) patients with isolates of undetermined significance; (iii) patients with proven or probable pulmonary aspergillosis . Retrospective review of pathology records led to the identification of additional patients with histologically compatible pulmonary aspergillosis . Microbiological variables were compared between aspergillosis and colonization groups . RESULTS: Seventy-six isolates of Aspergillus species were obtained from 73 patients . For patients with proven (n=2) or histologically compatible pulmonary aspergillosis (n=5), the case definition ratio was always higher than 0.3; no patient with proven disease was classified into the colonized group . Compared to patients considered to be colonized (n=26), patients with proven or probable pulmonary aspergillosis showed a significant difference in the total number of Aspergillus colonies cultured per episode . In addition, for bronchoalveolar lavage specimens, the mean number of Aspergillus colonies/agar plate was also significantly higher in the latter group . The sensitivity and specificity of Aspergillus spp . detection by culture of LRTS for proven or probable pulmonary aspergillosis was 35.7% and 70.4%, respectively . CONCLUSION: The case-definition ratio used in this study helps interpret the clinical significance of Aspergillus isolated from LRTS . Data for assessment should include the absolute number of colonies recovered from culture of any LRTS and, for bronchoalveolar lavage, the mean number of Aspergillus colonies per agar plate. Clin Microbiol Infect, 1997 Feb, 3(6), 599 - 604 Atypical respiratory pathogens; Saikku P; The main atypical pathogens in respiratory tract infections are classified on the basis of their ability to cause atypical pneumonia . This is not a well-defined clinical entity, and it is evident that atypical pathogens can sometimes cause 'typical' pneumonias and vice versa . This emphasizes the need for microbiological diagnosis, since it affects the selection of proper treatment, in which beta-lactam antibiotics and aminoglycosides are not effective . Moreover, mixed infections caused by atypical and typical pathogens together are common . At this moment rapid and sensitive diagnostic methods are lacking . Besides numerous viruses, the main bacterial pathogens causing atypical pneumonias are Mycoplasma pneumoniae, two chlamydial species, Chlamydia pneumoniae and C . psittaci, one rickettsia, Coxiella burnetti, and several Legionella species . The majority of these pathogens cause upper respiratory tract infections more often than overt pneumonias . An atypical agent, Chlamydia pneumoniae, has also been associated with chronic inflammatory conditions in the cardiovascular system . The most recently discovered pathogen in atypical pneumonias is a hantavirus causing hantavirus pulmonary syndrome. Clin Microbiol Infect, 1997, 3(5), 518 - 522 An audit of microbiology laboratory utilization: the diagnosis of infection in orthopedic surgery; Gyssens IC et al.; OBJECTIVE: To analyse the quality of ordering, collection and transport of specimens for microbiological analysis by a department of orthopedic surgery . METHODS: The analysis consisted of a prospective formal evaluation performed by two consultant microbiologists . RESULTS: One hundred and seventeen consecutive requests were audited . These requests belonged to 55 clinical episodes, 39 of which were of (presumed) infection and 16 of surveillance . The main sites sampled were: joint 28 (51%), and extra-articular bone or tissue 6 (11%) . Of 98 surgical specimens, 20 (20%) yielded a relevant microorganism . The requests were classified as definitely appropriate in 67% and 85% of episodes, by the two consultants respectively . No request was considered unjustified . Collection, handling and transport were categorized as definitely appropriate in 56% and 73% of requests . Analysis of compliance with an existing protocol for prosthetic joint revision revealed similar errors . CONCLUSION: Audits of this type can give invaluable information about the area of uncertainty between the clinician and the laboratory and can identify appropriate measures for corrective action. Clin Microbiol Infect, 1997 Jun, 3(3), 352 - 355 Rapid recovery of Mycobacterium tuberculosis complex from clinical specimens using the BACTEC 9000 MB system, a new automated fluorimetric technique; Mosca A et al.; OBJECTIVE: To evaluate the new non-radioactive automated method BACTEC 9000 MB system for the rapid detection of mycobacteria in clinical specimens . METHODS: Ninety clinical specimens from 90 patients with a clinical diagnosis of tuberculosis were tested by both BACTEC 9000 and standard microbiological methods, and the results compared . RESULTS: The BACTEC 9000, in comparison with the standard method, showed significantly higher detection rates (45 of 90 positive versus 34), shorter time to culture positivity (mean time 18.8 versus 27.4 days) and lower contamination rate (2.2% versus 5.5%) . CONCLUSIONS: These results encourage the use of this new system and suggest its use in microbiological laboratories involved in mycobacteriology. Acta Pharm Hung, 2001 Aug, 71(2), 213 - 4 {Does medicine lose its value near the expiration date?}; Torok I; This is the question raised to the pharmacists by the patients very often . Medicines, being usually not selected by the customers but prescribed for the patients by their physicians are of a special sort of merchandise . As their efficacy is affected even by psychological factors it is necessary to emphasise that the quality and efficacy of medicines are shown to be constant by the date of expiry . In marketing authorization procedure not only the efficacy and safety but also the quality of the medicines are assessed and a special attention is paid to the chemical, physico-chemical and microbiological stability of the products . Detailed documentation on stability together with the good manufacturing practice of the pharmaceutical factories inspected regularly by the authorities and the system of post marketing surveillance assure that medicines do not loose their good quality and consequently their efficacy and safety by the expiry date stated on the label. Annu Rev Immunol, 2002, 20, 581 - 620 Epub 2001 Oct 04. Genetic dissection of immunity to mycobacteria: the human model; Casanova JL et al.; Humans are exposed to a variety of environmental mycobacteria (EM), and most children are inoculated with live Bacille Calmette-Guerin (BCG) vaccine . In addition, most of the world's population is occasionally exposed to human-borne mycobacterial species, which are less abundant but more virulent . Although rarely pathogenic, mildly virulent mycobacteria, including BCG and most EM, may cause a variety of clinical diseases . Mycobacterium tuberculosis, M . leprae, and EM M . ulcerans are more virulent, causing tuberculosis, leprosy, and Buruli ulcer, respectively . Remarkably, only a minority of individuals develop clinical disease, even if infected with virulent mycobacteria . The interindividual variability of clinical outcome is thought to result in part from variability in the human genes that control host defense . In this well-defined microbiological and clinical context, the principles of mouse immunology and the methods of human genetics can be combined to facilitate the genetic dissection of immunity to mycobacteria . The natural infections are unique to the human model, not being found in any of the animal models of experimental infection . We review current genetic knowledge concerning the simple and complex inheritance of predisposition to mycobacterial diseases in humans . Rare patients with Mendelian disorders have been found to be vulnerable to BCG, a few EM, and M . tuberculosis . Most cases of presumed Mendelian susceptibility to these and other mycobacterial species remain unexplained . In the general population leprosy and tuberculosis have been shown to be associated with certain human genetic polymorphisms and linked to certain chromosomal regions . The causal vulnerability genes themselves have yet to be identified and their pathogenic alleles immunologically validated . The studies carried out to date have been fruitful, initiating the genetic dissection of protective immunity against a variety of mycobacterial species in natural conditions of infection . The human model has potential uses beyond the study of mycobacterial infections and may well become a model of choice for the investigation of immunity to infectious agents. Contemp Top Lab Anim Sci, 2002 Jan, 41(1), 10 - 2 Alcohol as a disinfectant for aseptic surgery of rodents: crossing the thin blue line? Huerkamp MJ. Recently, the use of alcohol (i.e., ethanol or isopropanol) has been discouraged as disinfectants for survival surgical procedures for rats and mice because of perceptions of inadequacy of killing of bacterial spores and lack of efficacy in the presence of organic debris . However, spore-forming bacteria are a minor (essentially nonexistent) threat for causing postoperative infections in rats and mice (but not necessarily hamsters, guinea pigs, or other rodents), and organic debris, with appropriate effort, can be removed from soiled instruments by using physical scrubbing . Although the metal-corrosive properties of alcohol and the lengthy times needed for adequate disinfection are drawbacks, there are essentially no microbiologically relevant reasons to discourage disinfection by ethanol or isopropanol in rat and mouse surgery. Probl Tuberk, 2002, (1), 15 - 7 {Microbiological blood studies in the diagnosis of tuberculosis in adolescents}; Kosareva MV et al.; Luminescence bacterioscopy of capillary blood has been found to be an additional rapid laboratory method that verifies a clinical diagnosis in cases of negative sputum bacterioscopic tests in 48.8% of the adolescent patients . The Boy luminescence microscopy shows that in adolescent tuberculosis patients, Mycobacteria are significantly more frequently present in the capillary blood (72.4%) than in the sputum (30.9%) and bronchial washes (34.8%) . The detection of Mycobacteria in the capillary blood has been evidenced by cultural tests of some venous blood samples in the BACTEC 460 TB system. An Otorrinolaringol Ibero Am, 2001, 28(6), 613 - 20 {Head and neck abscesses}; Morales-Angulo C et al.; OBJECTIVE: To review the clinical, microbiological and therapeutic characteristics of all head and neck abscess seen in a Community Hospital . MATERIALS AND METHODS: Medical records of all patients admitted to Sierrallana Hospital (Torrelavega, Cantabria) from January 1995 till June 1998, because of head and neck abscess were reviewed . RESULTS: Fyfty-seven head and neck abscess of 54 patients were considered . Age of patients ranged from 14 to 78-year-old . Periamygdaline region was the most frequent location, where as tonsillar and dental infections were the origins of the abscess in the large majority of cases . Most of the abscess cultures yield mixed flora . Intravenous penicillin was used in 77.3 percent of patients and surgical drainage was required in almost 80 percent of cases . Treatment response was good with no serious complications in any case . CONCLUSIONS: Head and neck abscess are a relative common cause of hospital admissions . Among them periamygdaline abscess are frequently found . The treatment is surgical drainage with local or general anesthesia (depending of location) and simultaneous i.v . course of antibiotic (Penicillin G sodium salt) efficacious in the great number of patients . Serious complications are very rare. J Med Virol, 2002 Apr, 66(4), 493 - 6 Case report: human herpesvirus 7 associated fatal encephalitis in a peripheral blood stem cell transplant recipient; Chan PK et al.; Previous studies have suggested a neuroinvasive and neuropersistent potential of human herpesvirus 7 (HHV-7) . In this report, a case of fatal encephalitis is described and its association with HHV-7 infection is discussed . An 8-year-old girl received a peripheral blood stem cell transplant for relapsed acute lymphoblastic leukaemia . The post-transplant period was uneventful and a course of intrathecal chemotherapy was given on Day-30 . On Day-41, she developed acute encephalopathy with diplopia and nystagmus . She ran a rapid downhill course and succumbed despite antiviral treatment . The only positive pathological finding was the multiple microscopic foci of haemorrhage associated with neuronal degeneration detected in the brain stem . All microbiological investigations were negative, except for the presence of HHV-7 DNA in cerebrospinal fluid and brain stem tissue samples . Clin Microbiol Infect, 1999 Jul, 5(7), 396 - 403 Individual value of each of the Duke criteria for the diagnosis of infective endocarditis; Rognon R et al.; OBJECTIVES: To assess the value of each of the Duke criteria for the diagnosis of infective endocarditis (IE) . METHODS: Detailed review was done of charts of all cases discharged with the diagnosis of IE, and classification as 'definite', 'possible' and 'rejected' cases was made according to the Duke criteria . The diagnostic impact of each criterion was assessed by reclassifying each 'definite' case after subtraction of each individual criterion and by reclassifying each 'possible' and 'rejected' case after addition of each individual criterion . RESULTS: From 1983 to 1993, 179 cases were identified in the databases of two hospitals . When the Duke criteria were applied, 124 (6967%) were classed as 'definite', 43 (2466%) as 'possible' and 12 (763%) as 'rejected' cases . Of the 67 pathologically proven cases, 52 (78610%) were 'definite' cases when the criteria were applied before pathology . If the major microbiological criterion is subtracted, 53% (69%) of the 'definite' cases become 'possible' or 'rejected' . When the echocardiographic criterion is subtracted, 34% (68%) of the 'definite' cases become possible or rejected . Among minor criteria, fever and predisposition, contributing to the classification of respectively 31% (68%) and 27% (68%) of the 'definite' cases, were the most powerful . On the other hand, the minor microbiological criterion and immunologic phenomena were responsible for the classification of only 2% (62%) and 6% (64%) respectively, of the 'definite' cases . CONCLUSIONS: Depending on the criterion examined, 47-98% of the 'definite' cases of IE would remain 'definite' if this particular criterion were absent . The major microbiological criterion had the hig