Epidemiol Infect, 2000 Apr, 124(2), 215 - 20 Haemolytic uraemic syndrome and Shiga toxin-producing Escherichia coli infection in children in France . The Société de Néphrologie Pédiatrique; Decludt B et al.; We conducted a study to determine the incidence of haemolytic uraemic syndrome (HUS) in children in France and to assess the role of Shiga-toxin-producing Escherichia coli (STEC) infection in the aetiology of HUS . In collaboration with the Societe de Nephrologie Pediatrique we undertook a retrospective review of all cases of HUS hospitalized from January 1993 to March 1995 and a 1-year prospective study (April 1995-March 1996) of epidemiological and microbiological features of cases of HUS . The polymerase chain reaction (PCR) procedure was used to detect stx, eae, e-hlyA genes directly from case stool samples . Serum samples from cases were examined for antibodies to lipopolysaccharide (LPS) of 26 major STEC serogroups . Two hundred and eighty-six cases were reported . The average incidence per year was 0.7/10(5) children < 15 years and 1.8/10(5) children < 5 years . During the prospective study, 122/130 cases were examined for evidence of STEC infection using PCR and/or serological assays and 105 (86%) had evidence of STEC infection . Serum antibodies to E . coli O157 LPS were detected in 79 (67%) cases tested . In conclusion, this study showed that STEC infection is an important cause of HUS in children in France, with a high proportion related to the O157 serogroup. Stomatologiia (Mosk), 2000, 79(2), 20 - 1 {The effect of ozone on the microbiological characteristics of the oral fluid in patients with mandibular fractures}; Korotkikh NG et al.; Thirty-nine patients with mandibular fractures were treated with ozonized solutions . Qualitative and quantitative characteristics of oral fluid were studied and correlated to clinical data. Australas J Dermatol, 2000 May, 41(2), 90 - 4 Human cases of cattle ringworm due to Trichophyton verrucosum in Victoria, Australia; Maslen MM; Between 1962 and 1994, 32 isolates of Trichophyton verrucosum from cases of tinea corporis, tinea faciei and tinea capitis were referred to the Mycology Reference Laboratory of the Microbiological Diagnostic Unit at The University of Melbourne, Victoria, Australia . Patients had presented at clinics in metropolitan Melbourne and country towns in the State of Victoria, Australia . They included dairy and cattle farmers, a slaughterman who worked in an abattoir, a veterinary tutor and children who lived on farms . Many patients lived in one of the three dairy farming areas of Victoria . A few lived in the outer suburbs of Melbourne . One cattle farmer came from south-east New South Wales . Specimens were not received for examination from animal contacts of the patients . The only patient from overseas was a boy from Lebanon . The literature recording human infections due to T . verrucosum in Australia is reviewed. Obstet Gynecol, 2000 Jun, 95(6 Pt 2), 1056 - 64 Amniotic fluid interleukin-6 and preterm delivery: a review; El-Bastawissi AY et al.; OBJECTIVE: To evaluate the potential role of amniotic fluid (AF) interleukin (IL)-6 as a predictor of preterm delivery and to consider possible explanations for the proportion of women with elevated AF IL-6 who deliver preterm yet lack microbiologically detectable intra-amniotic infection . DATA SOURCES: We searched the English language human literature in MEDLINE, 1966 through September 1999, using the keywords "labor/infant," "premature," "cytokines/interleukin-6," and "AF." We also examined abstracts from the 1999 meetings of the Society for Maternal-Fetal Medicine and the Society for Epidemiologic Research . We identified other studies by reviewing the reference lists of published articles . METHODS OF STUDY SELECTION: The MEDLINE search yielded 55 citations . We focused on studies that reported on the association between AF IL-6 and preterm delivery . TABULATION, INTEGRATION, AND RESULTS: There is consensus in the literature that elevated AF IL-6 is a stronger predictor of preterm delivery than intra-amniotic infection detected by either microbiologic culture or polymerase chain reaction (PCR) . Among women with elevated AF IL-6, PCR could detect a higher proportion of intra-amniotic infection than culture . A number of women with elevated AF IL-6 (33-70%) deliver preterm and do not have evidence of intra-amniotic infection by either culture or PCR . Possible explanations for this observation are considered . CONCLUSION: Elevated AF IL-6 is strongly associated with preterm delivery and merits future consideration in clinical settings to predict preterm delivery and guide patient care . Development of improved polymerase chain reaction-based clinical methods to detect intra-amniotic infection is necessary to better understand the relationship between elevated AF IL-6, intra-amniotic infection, and preterm delivery. Blood Rev, 2000 Mar, 14(1), 14 - 30 Monocyte-macrophage system as targets for immunomodulation by intravenous immunoglobulin; Rhoades CJ et al.; Pooled human intravenous immunoglobulin (IVIg) has been used successfully to treat or ameliorate the clinical manifestations of humoral immune deficiencies, haematological disorders, HIV infection and many other diseases states . However, the mechanism of action of IVIg remains unclear . Several mechanisms of action of IVIg have been proposed . These include Fcy receptor blockade, accelerated clearance of endogenous pathogenic auto-antibodies, inhibition of components of the complement cascade, neutralization of super-antigens and bacterial toxins as well as anti-cytokine and anti-idiotype effects . A major contributor to host immunity and immune surveillance against infection, tissue or cell damage and malignancy is the monocyte/macrophage system . Monocyte-directed inflammation is a desirable consequence of microbiological or malignant challenge . However, monocyte hyperactivity may contribute to certain pathological conditions . These include the systemic inflammatory response syndrome (SIRS), septic shock, other dysregulated inflammatory disorders and auto-immunity . Novel therapies that can suppress the hyperactive state or correct monocyte/macrophage dysfunction without compromising normal host cell-mediated immunity are desirable . In this review, we discuss the immunomodulatory effects of IVIg focussing particularly upon the monocyte/macrophage system in pertinent disease states. Rinsho Byori, 2000 Jan, Suppl 111, 178 - 80 {"What an ideal clinical microbiological laboratory should be"--from the position of patient}; Shimakawa K; To think about the ideal clinical microbiological laboratory in patient's place, there are three important problems in present medical treatment . The first one, for patients, it is necessary to wait many hours to take a medical advice from a doctor . The second, patients should be checked many examinations . The third, the heavy patient's share in his medical expenses . To settle a bit these matters, the clinical laboratory should try to accept the rapid and economical examinations for patients. Rinsho Byori, 2000 Jan, Suppl 111, 173 - 7 {"What an ideal clinical microbiological laboratory should be"--from the position of medical technologist}; Nagasawa M; The evolution of the microbiology laboratory is necessary for correspondence to the transfiguration of infection and contribution to clinical applications . Especially, the correspondence of emergency tests such as smear strain and antigen detection, the report added value and the infection surveillance in team medical treatment are indispensable . Also, medical technologists need to be knowledge able about techniques related to infection overall, and participation in infection diagnosis and social responsibility are indispensable. Rinsho Byori, 2000 Jan, Suppl 111, 167 - 72 {"What an ideal clinical microbiological laboratory should be"--from the position of laboratory manager}; Yamanaka K; The most important thing for clinical laboratory is the "labor-power" . "Labor-power" involves knowledge, technique, activity, analysis, patience and above all else benevolence . All of these constitute an efficiency examination(that is a total analysis of necessity, rapidity, correctness, simplicity, cost). Rinsho Byori, 2000 Jan, Suppl 111, 159 - 66 {Proceeding of the workshop "What an ideal clinical microbiological laboratory should be" . The 33rd in-service training course for medical technologists of university hospitals in 1999}; Okuzumi K et al.; In the workshop of the 33rd in-service training course for University Hospital Medical Technologists in 1999(sponsorship: the ministry of Education), all groups of participants were charged with discussing an ideal clinical microbiology laboratory . In conclusion, the successful operation of the ideal system of clinical microbiology should require a high level of competence in every staff member of the hospital . It must not be focused solely on the sophistication of laboratory methods . We must modify our behavior effectively and establish a good collaborative partnership with physicians and other health care professionals. Acta Otorrinolaringol Esp, 2000 Mar, 51(2), 113 - 9 {Orbital cellulitis in childhood . Medical-surgical treatment}; Gomez Campdera J et al.; Orbital cellulitis is an uncommon complication resulting from a spectrum of disorders commonly found in pediatric practice . It usually occurs as a complication of infection of the paranasal sinuses, although it also can be caused by eyelid or dental juries, dental infection and external ocular infection . We studied the clinical, microbiological, and therapeutic features of 152 children diagnosed as periorbital cellulitis and 27 children with orbital cellulitis admitted to our hospital in a 16-year period from January 1983 to December 1998 . Twenty-four percent of patients (43 cases) had positive cultures . Thirty children with septal or preseptal cellulitis developed neurological or ophthalmological complications . Intravenous or oral antibiotic administration was effective in 150 patients, but a significant proportion required surgery of the paranasal sinus or orbit (16%). Schriftenr Ver Wasser Boden Lufthyg, 1999, 104, 321 - 402 {Recent methods for the detection of airborne microorganisms and source identification}; Kampfer P et al.; The detection of airborne microorganisms including selected cell constituents (e.g . allergens or endotoxins) depends on suitable methods and instruments for their collection . Furthermore, microbiological methods are necessary for their quantification and qualification . In the past these methods were largely based on the classical cultivation dependent approach . Modern molecular methods, e.g . direct staining procedures, hybridization assays with nucleic acids including the PCR-technology or immunological assays are promising new tools for a more sophisticated detection of bioaerosols . They allow a better detection rate, a more precise identification of certain members of the aerosol including cell constituents . With respect to speed and lower costs they are an important alternative to established detection methods. Arch Esp Urol, 2000 Mar, 53(2), 159 - 61 {Calcified bladder squamous carcinoma: radiologic considerations}; Villanueva Rincon JM et al.; OBJECTIVE: To report a case of squamous cell carcinoma of the bladder, an uncommon tumor type, that presented with wide calcified areas . The literature on calcified bladder tumors is reviewed with special reference to the diagnostic aspects . METHODS/RESULTS: The plain film, US and CT findings are presented . All the diagnostic imaging techniques demonstrated calcifications on the tumor surface and the characteristic curvilinear shape of this lesion . CONCLUSIONS: Calcified bladder carcinoma is rare and occurs in only 0.5% of the cases evaluated by conventional radiology . All calcifications probably arising in the bladder detected on conventional radiological evaluation should be studied further with other imaging techniques . If its etiology is unclear, cystoscopy with biopsy and/or a microbiological study should be performed. J Microbiol Methods, 2000 May, 40(3), 207 - 12 A bioluminescent Escherichia coli auxotroph for use in an in vitro lysine availability assay; Erickson AM et al.; Microbiological methods have been used to determine the amino acid availability of a variety of animal feed and human food protein sources . Growth of Escherichia coli auxotrophs have been shown to yield a consistent linear response to lysine concentration when compared to chemical measures . Extent of total growth of E . coli lysine mutant (American Type Culture Collection #23812) when measured as optical density (OD) displays a lysine-dependent growth response that can be used to estimate lysine in feed proteins . However, typical OD-based growth studies for amino acid quantitation using the mutant may require anywhere from 12 to over 40 h . To develop an improved rapid method for lysine quantitation in protein sources, the plasmid pJHD500 carrying genes that encode for expression of bioluminescence and ampicillin resistance was transformed into the E . coli mutant by electroporation (set at 1.80 kV) . The luminescence measured during early exponential growth allowed detectable differentiation of lysine concentration in the media in 4 h . When the luminescence method was compared with the conventional optical density lysine growth assay, the correlation coefficient was 0.989 . Lysine availability valued for enzymatically hydrolyzed protein sources were comparable with availability measures using animal methods for lysine availability . This research shows potential applications for more rapid quantitative measurement of bioavailable lysine. Clin Diagn Lab Immunol, 2000 May, 7(3), 451 - 6 Evaluation of 12 commercial tests for detection of Epstein-Barr virus-specific and heterophile antibodies; Bruu AL et al.; Ten microbiological departments in Norway have participated in a multicenter evaluation of the following commercial tests for detection of Epstein-Barr virus (EBV)-specific and heterophile antibodies: CAPTIA Select viral capsid antigen (VCA)-M/G/EBNA (Centocor Inc.), Enzygnost anti-EBV/immunoglobulin M (IgM) and IgG (Dade Behring), Vironostika EBV VCA IgM/IgG/EBNA enzyme-linked immunosorbent assay (ELISA) (Organon Teknika), SEROFLUOR immunofluorescence assay and EBV Combi-Test (Institute Virion Ltd.), anti-EBV recombinant IgM- and IgG-early antigen/EBNA IgG ELISA (Biotest Diagnostics), EBV IgM/IgG/EBNA ELISA (Gull Laboratories), Paul-Bunnell-Davidsohn test (Sanofi Diagnostics Pasteur), Monosticon Dri-Dot (Organon Teknika), Avitex-IM (Omega Diagnostics Ltd.), Alexon Serascan infectious mononucleosis test (Alexon Biomedical Inc . ), Clearview IM (Unipath Ltd.), and Cards+/-OS Mono (Pacific Biotech, Inc.) . The test panel included sera from patients with primary EBV infection, immunocompromised patients with recent cytomegalovirus infection, healthy persons (blood donors), and EBV-seronegative persons . Among the tests for EBV-specific antibodies the sensitivity was good, with only small differences between the different assays . However, there was a greater variation in specificity, which varied between 100% (Enzygnost) and 86% (Biotest) . Tests for detection of heterophile antibodies based on purified or selected antigen (Avitex, Alexon, Clearview IM, and Cards+/-OS Mono) were more sensitive than the Paul-Bunnell-Davidsohn and Monosticon tests. Cochrane Database Syst Rev . 2000;(2):CD001211. Antibiotics for acute bacterial conjunctivitis; Sheikh A et al.; BACKGROUND: There are concerns regarding whether antibiotic therapy confers significant benefit in the treatment of acute bacterial conjunctivitis . OBJECTIVES: The aim of this review is to assess the benefit and harm of antibiotic therapy in the management of acute bacterial conjunctivitis . SEARCH STRATEGY: We searched the Cochrane Eyes and Vision Group specialised register, the Cochrane Controlled Trials Register - Central, MEDLINE and the reference lists of identified trial reports . We used the Science Citation Index to look for articles that cited the relevant studies, and we contacted investigators and pharmaceutical companies for information about additional trials . The most recent searches were carried out in September 1998 . SELECTION CRITERIA: We included double masked randomised controlled trials in which any form of antibiotic treatment had been compared with placebo in the management of acute bacterial conjunctivitis . This included topical, systemic and combination (for example, antibiotics and steroids) antibiotic usage . DATA COLLECTION AND ANALYSIS: One reviewer extracted data and the accuracy was checked by a second reviewer . Relative risks were summarised . We tested for heterogeneity between studies . MAIN RESULTS: Six published trials were identified of which three fulfilled the eligibility criteria for inclusion in this review . One trial was single masked and therefore excluded . A second report, when translated, was found to have no placebo group and was therefore excluded . One trial is currently 'awaiting assessment' . This has been published in abstract form and has yet to be fully reported . All the trials thus far identified appear to have been conducted on a selected specialist care patient population . The trials were heterogeneous in terms of their inclusion and exclusion criteria, the nature of the intervention, and the outcome measures assessed . Meta-analysis indicates that acute bacterial conjunctivitis is frequently a self-limiting condition, as clinical remission (cure or significant improvement) occurred by days two to five in 64% (95% confidence interval (CI) 57% to 71%) of those treated with placebo . Treatment with antibiotics was, however, associated with significantly better rates of clinical remission (days two to five: relative risk (RR) 1.31 95% CI 1.11 to 1.55, NNT=5) with a suggestion that this benefit was maintained for late clinical remission (days six to 10: RR 1.27 95% CI 1.00 to 1.61, NNT=5) . Antibiotic treatment was associated with rates of microbiological remission (pathogen eradication or reduction) . No serious outcomes were reported in either the active or placebo arms of these trials, indicating that important sight-threatening complications are an infrequent occurrence . REVIEWER'S CONCLUSIONS: Acute bacterial conjunctivitis is frequently a self-limiting condition but the use of antibiotics is associated with significantly improved rates of early clinical remission and early and late microbiological remission . Since trials to-date have been conducted in selected specialist care patient populations these results may not necessarily be generalisable to a primary care based population . A trial based in primary care designed to assess the cost-effectiveness of commonly prescribed antibiotic(s) versus placebo in acute bacterial conjunctivitis is warranted. Cochrane Database Syst Rev . 2000;(2):CD000054. Interventions for treating genital chlamydia trachomatis infection in pregnancy; Brocklehurst P et al.; BACKGROUND: Chlamydia trachomatis is a sexually transmitted infection . Mother-to-child transmission can occur at the time of birth and may result in ophthalmia neonatorum or pneumonitis in the newborn . OBJECTIVES: The objective of this review was to assess the effects of antibiotics in the treatment of genital infection with Chlamydia trachomatis during pregnancy with respect to neonatal and maternal morbidity . SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register (Cochrane Library issue 1, 1999) . SELECTION CRITERIA: Randomised trials of any antibiotic regimen compared with placebo or no treatment or alternative antibiotic regimens in pregnant women with genital Chlamydia trachomatis infection . DATA COLLECTION AND ANALYSIS: Trial quality assessments and data extraction were done independently by two reviewers . Study authors were contacted for additional information . MAIN RESULTS: Eleven trials were included . Trial quality was generally good . Amoxycillin appeared to be as effective as erythromycin in achieving microbiological cure (odds ratio 0.54, 95% confidence interval 0.28 to 1.02) . Amoxycillin was better tolerated than erythromycin (odds ratio 0.16, 95% confidence interval 0.09 to 0.30) . Clindamycin and azithromycin also appear to be effective, although the numbers of women included in trials are small . REVIEWER'S CONCLUSIONS: Amoxycillin appears to be an acceptable alternative therapy for the treatment of genital chlamydial infections in pregnancy when compared with erythromycin . Clindamycin and azithromycin may be considered if erythromycin and amoxycillin are contra-indicated or not tolerated. Spectrochim Acta A Mol Biomol Spectrosc, 2000 Feb 15, 56(3), 547 - 55 Fourier transform Raman and infrared spectra and normal coordinate analysis of organo-arsenic(III), -antimony(III) and -bismuth(III) thiolates; Ludwig C et al.; The FT-Raman and infrared spectra of (PhS)BiPh2, (PhS)2BiPh, (PhS)3Sb, (PhS)3Sb, (PhS)3As and (PhSe)BiPh2 were measured in the range 3600-100 cm(-1) . A normal coordinate analysis was performed for all substances in terms of the calculation and discussion of the force constants which are dependent on the element-sulphur and element-selenium group using a modified valence force field . Furthermore, for all compounds 1H-NMR, 13C-NMR and MS data were also given . The investigation of the microbiological activity of some substances against Escherichia coli was an additional aspect because of their strong bactericidal and fungicidal effects. Dev Biol Stand, 2000, 102, 183 - 93 Reducing the risk of bacterial contamination of cellular blood components; Blajchman MA; Transfusion-associated septic reactions occurring during or following the transfusion of cellular blood components was one of the earliest recognised complications of allogeneic blood transfusions . The presence of bacteria in cellular blood products thus has been a problem for many decades and currently it is the most common microbiological cause of transfusion-associated morbidity and mortality . Transfusion-associated septic reactions due to contaminated platelet concentrates appear to be much more common than those due to red cell concentrates . The prevalence of contaminated cellular blood products (red cells and platelets) is approximately 1 in 2,000 . However, the transfusion to a recipient of a contaminated blood product may not be associated with morbidity, because many contaminated blood product units contain only few bacteria and such transfusions may be innocuous to the recipient . In other instances, contaminated blood product units may contain large numbers of virulent bacteria and endotoxins, and their transfusion may be associated with significant morbidity and may even be lethal to the recipient . The prevalence of severe episodes of transfusion-associated sepsis has not been clearly established, but is probably of the order of 1 in 50,000 for platelet units and 1 in 500,000 for red blood cell units transfused . As a result of the increased recognition that such transfusion-associated septic episodes can occur, a variety of measures have been proposed to try to prevent and/or control the rate of contamination of blood products. Arch Pediatr, 2000 Mar, 7 Suppl 1, 10S - 13S {Role of endoscopy in the diagnosis of respiratory distress}; Bremont F; In acute respiratory distress, bronchial endoscopy is useful to determine the nature of dyspnea: inspiratory dyspnea in laryngeal abnormalities and obstructions; mixed inspiratory and expiratory dyspnea in extrinsic and intrinsic compressions of the tracheobronchial tree; overall, foreign bodies . Moreover, it allows the evaluation of the lesions in bronchial contusions, tracheobronchial burns and hemoptysis . Flexible (fiberoptic) and rigid endoscopy are complementary methods . Bronchoalveolar lavage is useful in the microbiological investigation of pneumonias developing in immuno compromised children. J Clin Microbiol, 2000 May, 38(5), 1777 - 81 Immunoblot analysis of humoral immune response to Helicobacter pylori in children with and without duodenal ulcer; Rocha GA et al.; Several studies have demonstrated that enzyme-linked immunosorbent assay is not a sensitive and specific method to diagnose Helicobacter pylori infection in children, especially in the younger ones . Since serum immune response can also be determined by immunoblotting and it permits the detection of antibodies to virulence factors such as CagA and VacA, we evaluated the accuracy of a commercial immunoblotting test to diagnose H . pylori infection and to assess the humoral immune response to different H . pylori antigens in 122 children who underwent upper gastrointestinal endoscopy . The presence of H . pylori was determined in antral biopsy specimens by culture, preformed urease test, and histological analysis . H . pylori was identified by microbiological and histopathological methods in 66 children (including all of the 21 who had duodenal ulcer) . Antibodies to H . pylori were detected in 63 infected children and in 8 noninfected ones . The sensitivity, specificity, and positive and negative predictive values of the immunoblotting test were 95.5, 85.7, 88.7, and 94.1%, respectively . The number of immunoreactive bands increased with age (P = 0.003), and the bands of 35 kDa (P = 0.013); 89 kDa, the VacA antigen (P = 0.001); and 116 kDa, the CagA antigen (P = 0.00004) were more frequently observed in older children . The frequency of the bands of 89 kDa (P = 0.001) and 116 kDa (P = 0.03) was higher in children with duodenal ulcer than in H . pylori-positive children without the disease . In conclusion, the immunoblotting test appears to be useful for the diagnosis of H . pylori infection in children, even in the younger ones. CMAJ, 2000 Apr 18, 162(8), 1133 - 7 Surveillance for outbreaks of respiratory tract infections in nursing homes; Loeb M et al.; BACKGROUND: Outbreaks of respiratory tract infections are common in long-term care facilities for older people . The objective of our study was to determine both the frequency of such outbreaks and their clinical and epidemiological features . METHODS: Prospective surveillance for outbreaks of respiratory tract infections and a retrospective audit of surveillance records were conducted in 5 nursing homes in metropolitan Toronto over 3 years . The clinical manifestations of infected residents were identified and microbiological investigations for causal agents were conducted . RESULTS: Sixteen outbreaks, involving 480 of 1313 residents, were identified prospectively during 1 144 208 resident-days of surveillance, for an overall rate of 0.42 infections per 1000 resident-days . Another 30 outbreaks, involving 388 residents, were identified retrospectively . Outbreaks occurred year-round, with no seasonal pattern . Pathogens included influenza virus, parainfluenza virus, respiratory syncytial virus, Legionella sainthelensi and Chlamydia pneumoniae . Multiple pathogens were detected in 38% (6/16) of the prospectively identified outbreaks . Of the 480 residents in the prospectively identified outbreaks 398 (83%) had a cough, 194 (40%) had fever and 215 (45%) had coryza . Clinical findings were nonspecific and could not be used to distinguish between causal agents . Pneumonia developed in 72 (15%) of the 480 residents, and 58 (12%) required transfer to hospital . The case-fatality rate was 8% (37/480) . INTERPRETATION: Our findings emphasize the importance of adequate surveillance for outbreaks of respiratory tract infections in nursing homes and of early diagnosis so that appropriate interventions can be promptly instituted. Appl Environ Microbiol, 2000 May, 66(5), 1801 - 8 Molecular analyses of novel methanotrophic communities in forest soil that oxidize atmospheric methane; Henckel T et al.; Forest and other upland soils are important sinks for atmospheric CH(4), consuming 20 to 60 Tg of CH(4) per year . Consumption of atmospheric CH(4) by soil is a microbiological process . However, little is known about the methanotrophic bacterial community in forest soils . We measured vertical profiles of atmospheric CH(4) oxidation rates in a German forest soil and characterized the methanotrophic populations by PCR and denaturing gradient gel electrophoresis (DGGE) with primer sets targeting the pmoA gene, coding for the alpha subunit of the particulate methane monooxygenase, and the small-subunit rRNA gene (SSU rDNA) of all life . The forest soil was a sink for atmospheric CH(4) in situ and in vitro at all times . In winter, atmospheric CH(4) was oxidized in a well-defined subsurface soil layer (6 to 14 cm deep), whereas in summer, the complete soil core was active (0 cm to 26 cm deep) . The content of total extractable DNA was about 10-fold higher in summer than in winter . It decreased with soil depth (0 to 28 cm deep) from about 40 to 1 microg DNA per g (dry weight) of soil . The PCR product concentration of SSU rDNA of all life was constant both in winter and in summer . However, the PCR product concentration of pmoA changed with depth and season . pmoA was detected only in soil layers with active CH(4) oxidation, i.e., 6 to 16 cm deep in winter and throughout the soil core in summer . The same methanotrophic populations were present in winter and summer . Layers with high CH(4) consumption rates also exhibited more bands of pmoA in DGGE, indicating that high CH(4) oxidation activity was positively correlated with the number of methanotrophic populations present . The pmoA sequences derived from excised DGGE bands were only distantly related to those of known methanotrophs, indicating the existence of unknown methanotrophs involved in atmospheric CH(4) consumption. Intensive Care Med, 2000, 26 Suppl 1, S64 - 74 The epidemiology of the systemic inflammatory response; Brun-Buisson C; OBJECTIVE: To examine the incidence, risk factors, aetiologies and outcome of the various forms of the septic syndromes (the systemic inflammatory response syndrome {SIRS} sepsis, severe sepsis, and septic shock) and their relationships with infection . DESIGN: Review of published cohort studies examining the epidemiology of the septic syndromes, with emphasis on intensive care unit (ICU) patients . RESULTS: The prevalence of SIRS is very high, affecting one-third of all in-hospital patients, and >50% of all ICU patients; in surgical ICU patients, SIRS occurs in >80% patients . Trauma patients are at particularly high risk of SIRS, and most these patients do not have infection documented . The prevalence of infection and bacteraemia increases with the number of SIRS criteria met, and with increasing severity of the septic syndromes . About one-third of patients with SIRS have or evolve to sepsis . Sepsis may occur in approximately 25% of ICU patients, and bacteraemic sepsis in 10% . In such patients, sepsis evolves to severe sepsis in >50% of cases, whereas evolution to severe sepsis in non-ICU patients is about 25% . Severe sepsis and septic shock occur in 2%-3% of ward patients and 10%-15% or more ICU patients, depending on the case-mix; 25% of patients with severe sepsis have shock . There is a graded severity from SIRS to sepsis, severe sepsis and septic shock, with an associated 28-d mortality of approximately 10%, 20%, 20%-40%, and 40%-60%, respectively . Mortality rates are similar within each stage, whether infection is documented or not, and microbiological characteristics of infection do not substantially influence outcome, although the source of infection does . While about three of four deaths occur during the first months after sepsis, the septic syndromes significantly impact on long-term outcome, with an estimated 50% reduction of life expectancy over the following five years . The major determinants of outcome, both short-term and long-term, of patients with sepsis are the severity of underlying diseases and comorbidities, the presence of shock and organ failures at onset of sepsis or evolving thereafter . It has been estimated that two-thirds of the overall mortality can be attributed to sepsis . CONCLUSIONS: The prevalence of sepsis in ICU patients is very high, and most patients have clinically or microbiologically documented infection, except in specific subset of patients . The prognosis of septic syndromes is related to underlying diseases and the severity of the inflammatory response and its sequelae, reflected in shock and organ dysfunction/failures. Electrophoresis, 2000 Apr, 21(6), 1187 - 201 Proteomics in medical microbiology; Cash P; The techniques of proteomics (high resolution two-dimensional electrophoresis and protein characterisation) are widely used for microbiological research to analyse global protein synthesis as an indicator of gene expression . The rapid progress in microbial proteomics has been achieved through the wide availability of whole genome sequences for a number of bacterial groups . Beyond providing a basic understanding of microbial gene expression, proteomics has also played a role in medical areas of microbiology . Progress has been made in the use of the techniques for investigating the epidemiology and taxonomy of human microbial pathogens, the identification of novel pathogenic mechanisms and the analysis of drug resistance . In each of these areas, proteomics has provided new insights that complement genomic-based investigations . This review describes the current progress in these research fields and highlights some of the technical challenges existing for the application of proteomics in medical microbiology . The latter concern the analysis of genetically heterogeneous bacterial populations and the integration of the proteomic and genomic data for these bacteria . The characterisation of the proteomes of bacterial pathogens growing in their natural hosts remains a future challenge. Sex Transm Dis, 2000 Apr, 27(4), 226 - 9 Mycoplasma genitalium in males with nongonococcal urethritis: prevalence and clinical efficacy of eradication; Gambini D et al.; BACKGROUND: Mycoplasma genitalium is regarded as a potential pathogen of the human urogenital tract based on prevalence findings of several European studies . GOAL: To determine the prevalence of M genitalium in urethral specimens of symptomatic patients with nongonococcal urethritis and from asymptomatic patients attending a sexually transmitted disease clinic in Milan, and to verify the clinical efficacy of M genitalium eradication by antibiotic treatment . STUDY DESIGN: From May 1998 to late April 1999, a routine analysis for M genitalium by DNA amplification (polymerase chain reaction) was performed in patients attending the Institute of Dermatological Science in Milan . The authors examined urethral swabs from 178 symptomatic and 23 asymptomatic males . M genitalium-positive patients were clinically and microbiologically tested after treatment with either doxycycline or azithromycin . RESULTS: Among males with nongonococcal urethritis, M genitalium was detected in 14.0% of patients as the only agent; in 15.1% of patients in association with Chlamydia trachomatis and/or Ureaplasma urealyticum; and in 1 asymptomatic patient . In all symptomatic M genitalium-positive patients, antibiotic treatment eradicated the infection and cured clinical symptoms . CONCLUSION: These data reveal the high prevalence of M genitalium in symptomatic patients, the rarity of asymptomatic carriers, the high susceptibility to antibiotic treatment, and the clinical efficacy of M genitalium eradication . Moreover, data confirm the etiologic role of M genitalium in inflammatory processes of the human urogenital tract in the Mediterranean area. Infection, 2000 Mar-Apr, 28(2), 103 - 5 Tuberculosis in an area bordering east London: significant local variations when compared to national data; Melzer M et al.; From September 1996 to June 1997, in an area bordering East London, we prospectively collected epidemiological, clinical and microbiological data on all patients with newly diagnosed culture-positive tuberculosis and compared these to national data based on notifications . The significant differences were that tuberculosis was diagnosed almost exclusively in non-Caucasian patients (42/47 {89%}) and that there was a high percentage of extrapulmonary tuberculosis (27/47 {57%}) including four cases of tuberculous meningitis and five cases of osteomyelitis . We also observed that 19/27 (70%) of patients with extrapulmonary tuberculosis had normal chest X-rays, 3/17 (18%) sub-Saharan Africans were HIV antibody-positive and drug resistance strains were isolated from six sub-Saharan Africans and one Caucasian . Figures for treatment failures and mortality compared favorably to national averages at 6 months . National data do not accurately reflect local epidemiology and clinical presentations . Hospital-based surveillance and promoting awareness of local differences is essential to prevent delayed diagnosis, inappropriate management and poor clinical outcome. Dig Surg, 2000, 17(2), 126 - 31 Seromuscular enteric pedicles and prosthetic aortic graft complications in a porcine abdominal trauma model . An experimental study; Anderson CA et al.; BACKGROUND/AIMS: Abdominal vascular trauma may require prosthetic grafting despite peritoneal contamination by concurrent visceral injury . This study tested the use of vascularized, seromuscular enteric pedicles (VSEP) against the development of vascular prosthetic complications, in a porcine abdominal trauma model . METHODS: Eight pigs underwent aortic transection and reconstruction with a Dacron interposition graft (DIG) . A standard bacterial inoculum soaked the DIG in situ . An enteric segment was isolated on its mesenteric pedicle, and the mucosa stripped . This VSEP was wrapped around the DIG and oversewn . Animals received antibiotics for 5 days . Endpoints were 2-week survival, or evidence of sepsis . The animals underwent explantation of the DIG, VSEP, and native aorta for the purposes of histological, and microbiological analyses, and scanning electron microscopy (SEM) . Outcome measures were graft infection, graft thrombosis, tissue incorporation, and anastomotic integrity . RESULTS: Two pigs were excluded for perioperative death . All study group animals (n = 6), survived 2 weeks . Infection and thrombosis were found in 0/6 (0%) . Incorporation and anastomotic integrity were evident in 6/6 (100%) . VSEP had intact blood supplies . SEM demonstrated viable muscle, microcirculation, and fibroplasia in VSEP . CONCLUSION: We conclude that VSEP may help prevent prosthetic graft complications in the contaminated setting . Lab Anim, 1999 Jul, 33(3), 201 - 6 Techniques of embryo transfer and facility decontamination used to improve the health and welfare of transgenic mice; Morrell JM; 'Reduction' and 'Refinement' can be achieved in transgenic mouse studies by re-deriving transgenic mouse lines and subsequently maintaining them under high standards of husbandry in a unit with restricted access . This report describes the initial steps of a project to improve the health and welfare of transgenic mice at the European Molecular Biology Laboratory (EMBL), by re-deriving transgenic lines as microbiologically defined animals to be maintained in a barrier unit in a newly constructed animal facility . A pilot study showed that it was possible to transfer embryos obtained from contaminated donor mice in the old facility to specific pathogen free recipients housed in a ventilated cabinet in the new unit, without concomitant carry over of disease . The offspring born following embryo transfer were of high health status and did not show any evidence of contamination with any of the pathogens present in the mice in the old animal unit . Antibodies to various murine viruses (mouse hepatitis virus (MHV), rota virus, reo-3 virus, Theilers encephalomyelitis virus, adenovirus) and parasites were present in sentinel animals from the old animal house whereas the re-derived animals were found to be free of virus antibodies and parasites . Therefore the methods used were considered to be successful in terms of disease prevention and enhancement of welfare . The barrier unit was sterilized without the use of formaldehyde or related substances, to minimize the risks to personnel and to the environment from using potentially dangerous substances . From the results of in vitro and in vivo screening, the protocol for sterilization described here was found to be effective in achieving microbiological sterility of the barrier unit and was cost effective. Tohoku J Exp Med, 2000 Mar, 190(3), 213 - 22 PCR and RFLP analysis for identification and typing of Helicobacter pylori strains isolated from gastric biopsy specimens; Simsek IS et al.; Helicobacter pylori (H . pylori) infection is the most common gastrointestinal tract infection which plays an important role in the ethiopathogenesis of peptic ulcer and gastritis . In recent years, molecular biological methods have been presented for detection of H . pylori in addition to histopathological and microbiological methods . Among these methods, polymerase chain reaction (PCR) and following restriction fragment length polymorphism analyses (RFLP) are highly sensitive methods for diagnosis and follow up of patients . In this present study our aim was to amplify H . pylori urease A and B genes by PCR and perform RFLP analysis . Gastric biopsy specimens from 17 female and 18 male patients were included in the study . Amplified PCR products were subjected to RFLP analysis and typing of the bacteria in pre and posttreatment specimens were performed . H . pylori urease A and B gene amplification was observed in 32 pretreatment samples and in 8 of 21 posttreatment specimens . As a result, PCR is a sensitive method to determine the H . pylori infection . RFLP, which is another effective method in order to demonstrate the reinfection of H . pylori. Lab Anim, 1999 Oct, 33(4), 356 - 65 Electrophysiology and pathology evaluation of the Yucatan pig as a non-rodent animal model for regulatory and mechanistic toxicology studies; Jones RD et al.; Six male and six female Yucatan pigs were utilized to investigate the feasibility of this species as a non-rodent model for routine regulatory and mechanistic toxicology studies . This study evaluated disease surveillance and computerized electrophysiology, along with possible gross and micropathology changes . Two pigs were used as sentinel animals to evaluate the microbiological status of the vendor upon arrival; the other pigs were maintained as biomonitors and to provide baseline clinical chemistry, urinalysis, pathology and electrophysiology data . The electrophysiology tests conducted included electrocardiography (ECG), electroretinography (ERG) and quantitative electroencephalography (qEEG), which achieved consistent baseline values with acceptable intrasubject variation . Tissue cholinesterase and histochemical staining were done to determine their suitability for testing cholinesterase compounds . Evaluation of the serum chemistry profile demonstrated increased CPK and LDH, which was likely associated with slight haemolysis or minor subclinical muscle stress during handling . There were no additional clinical chemistry changes or findings in haematology, urinalysis parameters or gross pathology . Micropathology found an absence of background lesions which would interfere with routine toxicology studies, except for a mild rhinitis . The aetiological agent was identified by electron microscopy as being consistent with inclusion body rhinitis of swine, previously unreported in miniature swine . This would most notably interfere with inhalation studies . The anatomical and physiological similarities of the Yucatan pig, along with its ability to accept the performance of electrophysiology tests allow this species to be considered as a suitable model for organ system testing in toxicology studies. Int J Tuberc Lung Dis, 2000 Apr, 4(4), 340 - 4 Resolution of the acute-phase response in West African patients receiving treatment for pulmonary tuberculosis; Lawn SD et al.; SETTING: The Komfo Anokye Teaching Hospital, Kumasi, Ghana, West Africa . OBJECTIVE: To evaluate simple and commonly used parameters of the acute-phase response as correlates of successful resolution of smear-positive pulmonary tuberculosis (PTB) during drug treatment . DESIGN: Serum C-reactive protein (CRP) concentration, erythrocyte sedimentation rate (ESR), body weight, and blood haemoglobin were measured in human immunodeficiency virus (HIV) negative Ghanaian patients with PTB (n = 15) and in age- and sex-matched healthy controls (n = 15) . These parameters were subsequently measured in patients after 1, 2 and 3 months of antituberculosis treatment . Serum concentrations of soluble interleukin-2-receptor-alpha (sCD25) were also measured as a comparative index of resolution of the systemic inflammatory process . RESULTS: Anti-tuberculosis treatment resulted in sputum smear conversion in all 15 patients . After one month of treatment, reductions in serum CRP concentration (>20%) and increases in haemoglobin concentration (>0.4 g/dl) occurred in the majority of patients and correlated with steep reductions in serum levels of sCD25 . In contrast, weight loss and elevated ESR were slower to resolve, and were insensitive early markers of response to treatment . CONCLUSION: A fall in serum CRP and a rise in blood haemoglobin are correlates of the initial response to drug treatment of PTB . These parameters may assist in the evaluation of empiric trials of treatment in microbiologically unconfirmed cases of suspected PTB. Shock, 2000, 13(4), 291 - 6 A porcine model of sepsis resulting from the combined insults of hemorrhage and peritonitis; Parker SJ et al.; The physiological responses to either hemorrhage or sepsis have been well documented, however, their simultaneous delivery, as often seen in penetrating trauma, has not been extensively studied . A terminally-anesthetized porcine model of fixed-volume hemorrhage combined with intraperitoneal sepsis was developed . Large White pigs (45-60 kg) were bled 40% of blood volume and peritonitis was induced using an E . coil (O18:K1:H7) culture . Three groups of animals were sequentially studied . Group A (n = 8) received 10(8) bacteria, and Groups B (n = 4) and C (n = 5) received 10(10) organisms . All animals were maintained on a 2.5 mL/kg/h infusion of 0.9% saline . Group C was autotransfused at 1 h . Animals were monitored for up to 24 h . Cardiovascular features of hypovolemia were recorded in all animals . Animals in Group A improved clinically with little microbiological evidence of systemic sepsis . Group B showed rapid cardiovascular collapse, early E . coil-positive blood cultures, and an early rise in serum TNF-alpha levels . Autotransfusion of Group C significantly improved cardiopulmonary parameters, acid-base status, and survival . A reproducible model of hemorrhage and peritonitis, appropriate for abdominal trauma, which allows investigation of resuscitative and pharmacological interventions has been characterized. Respiration, 2000, 67(2), 173 - 6 A comparison of induced and expectorated sputum for the microbiological diagnosis of community acquired pneumonia; Bandyopadhyay T et al.; BACKGROUND: Sputum induction has proved useful in the diagnosis of Pneumocystis carinii pneumonia and mycobacterial infections but there are scant data on its use in the diagnosis of community-acquired pneumonia (CAP) . OBJECTIVE: To better define the usage of sputum induction by hypertonic saline in the setting of CAP . METHODS: A retrospective review of records of patients admitted to a community teaching hospital in the year 1995 with a diagnosis of CAP . RESULTS: Of 492 patients admitted with CAP, 71 (14%) had attempted sputum induction . A group of 66 patients with CAP and attempted sputum collection by spontaneous expectoration was compared with this group . Sputum induction failed to yield a sample in 22 patients (31%) . Forty-five of 49 patients (92%) with induced sputum had received prior antibiotics as compared to 23 of 34 patients (68%) with expectorated samples (p < 0.05), due to sputum induction often being attempted later in the hospital course . The diagnostic yield of sputum induction was 14 of 71 (20%) compared to 16 out of 66 (24%) for attempted spontaneously expectorated samples . Antibiotic therapy was changed for 5 of 34 patients (15%) who spontaneously expectorated samples and for 9 of 49 patients (18%) with successful induction . CONCLUSIONS: Sputum induction is effective in obtaining sputum in some patients with CAP who fail to expectorate a sample . Attempting induction early, preferably before starting antibiotics, may increase its diagnostic yield . Int J Antimicrob Agents, 2000 Apr, 14(3), 235 - 8 Effect of some psychotropic drugs and a barbiturate on mycoplasmas; Lind K et al.; The inhibitory effect of selected membrane stabilisers on Mycoplasma pneumoniae, M . hominis and Ureaplasma urealyticum was investigated in vitro . The phenothiazine chlorpromazine (CPZ) and the barbiturate thiopental (Leopental(R)) as well as the stereo-isomeric thioxanthene derivatives; cis(Z)-clopenthixol (Zu-clopenthixol(R))/ trans (E)-clopenthixol and cis (Z)-chlorprothixen (Truxal(R))/trans(E)-chlorprothixen, all have antimycoplasmal effect in the range 3.9-312 mg/l, measured as growth inhibition . It was also demonstrated that the enzymatic functions of the different mycoplasma strains, such as breakdown of glucose, arginine and urea, were abolished by concentrations of CPZ that were sufficiently low to allow multiplication of the organisms . A similar effect was obtained with Leopental(R) although the mycoplasmas were generally only half as sensitive to this drug . Also M . gallisepticum and Acholeplasma laidlawii were inhibited by CPZ and Thiopental . The four thioxanthenes were all inhibitory to mycoplasmal growth and the effect was independent of their stereo-isomeric configuration . The clopenthixol stereoisomers, but not the chlorprothixene isomers, inhibited colour change at concentrations lower than those which inhibited growth . While enzyme activity may continue for some time in vitro when classic antibiotics have inhibited mycoplasmal growth, the reverse effect was observed with phenothiazines and thioxanthenes . The membrane stabilisers may be useful tools in the investigation of microbiological activity on the mycoplasma membrane . From these drugs, new 'antibiotics' might be developed with another action than that of the known antimycoplasmal drugs. J AOAC Int, 2000 Mar-Apr, 83(2), 269 - 75 Use of Dacron as an alternative carrier for evaluating oxidizing sterilants in the AOAC sporicidal test; McDonnell G et al.; The AOAC sporicidal method (966.04) recommends the use of porcelain penicylinders and black waxed silk sutures as carriers for demonstrating the sporicidal activity of sterilants . However, the silk carriers are not suitable for evaluating the sporicidal efficacy of oxidizing agents, and an inert polyester material (Dacron) is recommended as an alternative . Dacron provides an equivalent microbial and physical challenge to silk . Microbiologically, both materials demonstrated similar HCI resistance, which is required by the AOAC test, as well as equivalent spore loading and spore wash-off . Electron microscopy showed that both materials present the same braided microstructure, providing an equivalent physical challenge to the test sterilant . Dacron was more consistent than silk, and did not require extraction prior to spore loading . The extraction method for black waxed silk was variable and incomplete, which may compromise the activity of oxidizing sterilants and add to method variability . Silk was also structurally altered in the presence of oxidizing sterilants and increased sterilant degradation . Dacron did not affect the sterilant and was inert in the presence of oxidizing agents . Dacron sutures are proposed as inert alternatives to silk for evaluating the sporicidal efficacy of oxidizing agents. Antimicrob Agents Chemother, 2000 May, 44(5), 1209 - 13 Comparison of high-performance liquid chromatographic and microbiological methods for determination of voriconazole levels in plasma; Perea S et al.; A new selective high-performance liquid chromatography (HPLC) method with UV detection for the determination of the investigational triazole voriconazole in human plasma by using acetonitrile precipitation followed by reverse-phase HPLC on a C(18) column was compared with a simple agar well diffusion bioassay method with Candida kefyr ATCC 46764 as the assay organism . Pooled plasma was used to prepare standard and control samples for both methods . The results of analyses with spiked serum samples (run as unknowns) were concordant by the bioassay and HPLC methods, with expected values being obtained . HPLC demonstrated an improved precision (3.47 versus 12.12%) and accuracy (0.81 versus 1.28%) compared to those of the bioassay method . The range of linearity obtained by both methods (from 0.2 to 10 microg/ml for HPLC and from 0.25 to 20 microg/ml for the bioassay) includes the range of concentrations of voriconazole (from 1.2 to 4.7 microg/ml) which are considered clinically relevant . Although either methodology could be used for the monitoring of patient therapy, the smaller variability observed with HPLC compared to that observed with the bioassay favors the use of HPLC for pharmacokinetic studies. Clin Infect Dis, 2000 Apr, 30(4), 662 - 78 Epub 2000 Apr 20. Practice guidelines for the treatment of candidiasis . Infectious Diseases Society of America; Rex JH et al.; Infections due to Candida species are the most common of the fungal infections . Candida species produce a broad range of infections, ranging from nonlife-threatening mucocutaneous illnesses to invasive process that may involve virtually any organ . Such a broad range of infections requires an equally broad range of diagnostic and therapeutic strategies . This document summarizes current knowledge about treatment of multiple forms of candidiasis and is the guideline of the Infectious Diseases Society of America (IDSA) for the treatment of candidiasis . Throughout this document, treatment recommendations are scored according to the standard scoring scheme used in other IDSA guidelines to illustrate the strength of the underlying data . The document covers 4 major topical areas . The role of the microbiology laboratory . To a greater extent than for other fungi, treatment of candidiasis can now be guided by in vitro susceptibility testing . The guidelines review the available information supporting current testing procedures and interpretive breakpoints and place these data into clinical context . Susceptibility testing is most helpful in dealing with infection due to non-albicans species of Candida . In this setting, especially if the patient has been treated previously with an azole antifungal agent, the possibility of microbiological resistance must be considered . Treatment of invasive candidiasis . In addition to acute hematogenous candidiasis, the guidelines review strategies for treatment of 15 other forms of invasive candidiasis . Extensive data from randomized trials are really available only for therapy of acute hematogenous candidiasis in the nonneutropenic adult . Choice of therapy for other forms of candidiasis is based on case series and anecdotal reports . In general, both amphotericin B and the azoles have a role to play in treatment . Choice of therapy is guided by weighing the greater activity of amphotericin B for some non-albicans species (e.g., Candida krusei) against the lesser toxicity and ease of administration of the azole antifungal agents . Flucytosine has activity against many isolates of Candida but is not often used . Treatment of mucocutaneous candidiasis . Therapy for mucosal infections is dominated by the azole antifungal agents . These drugs may be used topically or systemically and have been proven safe and efficacious . A significant problem with mucosal disease is the propensity for a small proportion of patients to suffer repeated relapses . In some situations, the explanation for such a relapse is obvious (e.g., relapsing oropharyngeal candidiasis in an individual with advanced and uncontrolled HIV infection), but in other patients the cause is cryptic (e.g., relapsing vaginitis in a healthy woman) . Rational strategies for these situations are discussed in the guidelines and must consider the possibility of induction of resistance over time . Prevention of invasive candidiasis . Prophylactic strategies are useful if the risk of a target disease is sharply elevated in a readily identified group of patients . Selected patient groups undergoing therapy that produces prolonged neutropenia (e.g., some bone-marrow transplant recipients) or who receive a solid-organ transplant (e.g., some liver transplant recipients) have a sufficient risk of invasive candidiasis to warrant prophylaxis. Minerva Stomatol, 1999 Nov, 48(11), 501 - 8 Bacterial colonisation during GTR treatment . A longitudinal analysis; Sbordone L et al.; The purpose of the present study was to evaluate the long-term biological and clinical effects of a controlled delivery system releasing tetracyclines during the healing of interproximal periodontal defects treated by the technique of guided tissue regeneration (GTR) using e-PTFE membranes . METHODS: Fifteen patients, each with two comparable interproximal periodontal defects, underwent surgical treatment with e-PTFE membranes in conjunction with tetracycline fibres at the test site and e-PTFE membranes alone at the control site . Microbiological specimens were taken from each site treated at baseline (T0) and one year after surgery (T4) . Plaque index (PI), gingival index (GI), pocket depth at probing (PD) and attachment level at probing (PAL) were recorded at baseline (T0) and one year after surgery (T4) . The presence of selected pathogenic microbial species, Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Fusobacterium Nucleatum (Fn) and Actinobaccillus Actinomicetemcomitans (Aa), was investigated and these species were identified by cultural methods . RESULTS: No statistically significant difference in the level of periodontal pathogens was detected between the test and control sites at time T4 . Likewise, no significant clinical difference between the test site and the control site was detected at time T4 . CONCLUSIONS: The results suggest that tetracycline fibres used in conjunction with e-PTFE membranes do not provide and further clinical and microbiological improvement or effect the healing of periodontal defects one year after GTR treatment. Gut, 2000 May, 46(5), 608 - 14 Rapid and specific detection of Helicobacter pylori macrolide resistance in gastric tissue by fluorescent in situ hybridisation; Trebesius K et al.; BACKGROUND: The development of macrolide resistance in Helicobacter pylori is considered an essential reason for failure of antibiotic eradication therapies . The predominant mechanism of resistance to macrolides, particularly clarithromycin, is based on three defined mutations within 23S rRNA, resulting in decreased binding of the antibiotic to the bacterial ribosome . AIM: To develop an rRNA based whole cell hybridisation method to detect Helicobacter species in situ within gastric tissue, simultaneously with its clarithromycin resistance genotype . METHODS: A set of fluorescent labelled oligonucleotide probes was developed, binding either to H pylori 16S rRNA or 23S rRNA sequences containing specific point mutations responsible for clarithromycin resistance . After hybridisation and stringent washing procedures, labelling of intact single bacteria was monitored by fluorescence microscopy . The new approach was compared with PCR based assays, histology, and microbiological culture . RESULTS: In comparison with the phenotypic resistance measurement by E test, the genotypic clarithromycin resistance correlated perfectly (100%) for 35 H pylori isolates analysed . In a set of gastric biopsy specimens (27) H pylori infection was confirmed by histology (17/27) and correctly detected by whole cell hybridisation . Five clarithromycin resistant strains were identified in gastric tissue specimens directly . Furthermore, non-cultivable coccoid forms of H pylori were easily detectable by whole cell hybridisation . CONCLUSIONS: Whole cell hybridisation of rRNA holds great promise for cultivation independent, reliable, and rapid (three hours) genotypic determination of clarithromycin resistance in H pylori . Compared with PCR techniques it is independent of nucleic acid preparations, not prone to inhibition, and allows semiquantitative visualisation of the bacteria within intact tissue samples. Ned Tijdschr Geneeskd, 2000 Mar 25, 144(13), 608 - 12 {Sexually transmitted diseases in Limburg in 1997; prevalence according to a survey of family practitioners and specialists and according to reports from microbiological laboratories}; Henquet CJ et al.; OBJECTIVE: To determine the incidence of sexually transmitted diseases (STDs) and to compare data reported by general practitioners (GPs) and specialists with those reported by microbiological laboratories . DESIGN: Retrospective . METHOD: All 593 GPs and gynaecologists, dermatologists and urologists in Limburg, the Netherlands, in 1998 were asked to fill in a questionnaire about the number of cases of Chlamydia trachomatis, condylomata acuminata, genital herpes and gonorrhoea in 1997, by sex, age and diagnostic test . Data were compared with information gathered from the six laboratories of medical microbiology . For gonorrhoea the results were compared with those from a study in 1985 . RESULTS: The response to the enquiry amounted to 75% . A total of 2730 cases were reported (32 per 10,000 of the population . Infection with C . trachomatis was the most frequent sexually transmitted disease (46%), followed by condylomata acuminata (28%), genital herpes (17%) and gonorrhoea (8%) . Of the diseases 84% occurred in persons younger than 35 years of age and 66% in women . The GPs saw 79% of the STDs, they diagnosed 'gonorrhoea' in 25% of the cases merely on the basis of the clinical picture . Compared to 1985 the number of gonorrhoea cases was decimated in Limburg in 1997 . Of those who answered the questions about warning the partner (approximately 50% of those concerned), 87% reported that they had let the partner know . It appears from the data of the six laboratories that the incidence of C . trachomatis infection was 3.2 and that of gonorrhoea 0.6 per 10,000 of the population . For the diagnosis of infection with C . trachomatis the GPs and specialists use a culture in 50% of the cases, as against 2% of the laboratories, for the ligase chain reaction and polymerase chain reaction tests these proportions were 20 and 78%. Eur Radiol, 2000, 10(3), 531 - 3 Mammary tuberculosis: percutaneous treatment of a mammary tuberculous abscess; Romero C et al.; It is currently very rare to find mammary involvement in cases of tuberculosis, in either primary or secondary form . Diagnosis is classically clinical and microbiological, and the basic techniques used in imaging diagnosis are mammography and ultrasound . Computed tomography may define the involvement of the thoracic wall in those cases which present as mammary masses adhering to deep levels, and is also able to evaluate accompanying pulmonary disease, if it is present . Traditionally, treatment has consisted of quadrantectomy and specific antibiotic therapy . We present a case of tuberculous mammary abscess secondary to pulmonary disease, which was treated by percutaneous drainage controlled by CT and specific antibiotic therapy . We revise the diagnosis, differential diagnosis and treatment of mammary tuberculosis. Rev Med Chir Soc Med Nat Iasi, 1999 Jan-Jun, 103(1-2), 182 - 5 Tetrazolium salts and metal complexes of some formazans; Stefanescu E et al.; This paper presents the synthesis of some tetrazolium salts and metal complexes combinations, which are derived from aromatic and heterocyclic formazans . Elemental quantitative analyses and spectral data confirmed the structure of the new synthesized compounds . The new synthesized compounds were submitted to microbiological tests. Prikl Biokhim Mikrobiol, 2000 Jan-Feb, 36(1), 74 - 9 {Reduction of nitro-substituted compounds by native and immobilized Escherichia coli cells}; Davidenko TI et al.; Reduction of nitro-substituted compounds, 1,4-benzodiazepine-2-ones, dibenzo{b,f}-1,4-diazepines, quinolones, and quinoxalinones, by Escherichia coli cells was studied . Physicochemical methods demonstrated the formation of corresponding amines . 4-(p-Nitrophenyl)-1H-6-R-quinolones-2 were nor reduced by Escherichia coli cells . Regiospecific reduction of 2,4-dinitro-5H-11-(p-R-phenyl)-dibenzo{b,f}-1,4-diazepines and 4-(2'-R-3',5'-dinitro)-benzoyl-3,4-dihydroquinoxalinones-2 was shown to result in the formation of 2-nitro-4-amino-5H-11-(p-R-phenyl)-dibenzo{b,f}-1,4-diazepines and 4-(2'-R-3'-nitro-5'-amino)-benzoyl-3,4-dihydroquinoxalinones-2, respectively . Methods for microbiological reduction of nitro compounds and immobilization of Escherichia coli cells into carrageenan and its modified forms were elaborated. J Dairy Sci, 2000 Mar, 83(3), 584 - 602 Microbiology and biochemistry of cheeses with Appélation d'Origine Protegée and manufactured in the Iberian Peninsula from ovine and caprine milks; Freitas C et al.; To support legal protection with objective technical data and to promote enforcement of high quality standards a few European countries have created Appelation d'Origine Protegees . This paper reviews and updates fundamental and applied aspects encompassing microbiological and biochemical characteristics of traditional cheeses with Appelation d'Origine Protegee manufactured in the Iberian Peninsula from ovine, caprine, or both milks . Ovine and caprine cheeses with Appelation d'Origine Protegee from Portugal and Spain can be divided into four distinct groups based on milk source and rennet type: 1) Azeitao, Castelo Branco, Evora, Nisa, Serpa, Serra da Estrela, and La Serena cheeses are manufactured with raw ovine milk and coagulated via plant rennet; 2) Terrincho, Idiazabal, Manchego, Roncal, and Zamorano cheeses are manufactured with raw ovine milk and coagulated via animal rennet; 3) Cabra Transmontano and Majorero are manufactured with raw caprine milk and coagulated via animal rennet; and 4) Amarelo da Beira Baixa, Picante da Beira Baixa, and Rabacal are manufactured with mixtures of raw ovine and caprine milks and coagulated via animal rennet. Cent Afr J Med, 1999 May, 45(5), 127 - 9 Pneumocystis carinii pneumonia (PCP) at Ga-Rankuwa Hospital; Sein PP et al.; Pneumocystis carinii is recognized as one of the leading causes of death in AIDS patients in developed countries but its role in this regard in developing countries appears to be less prominent . Sub-Saharan African countries, in spite of their high HIV prevalence, have hardly recorded any cases . We report the first microbiologically proven case of PCP in an adult patient at Ga-Rankuwa Hospital . A 37 year old African woman was referred to Ga-Rankuwa Hospital from the local clinic for chest infection with a non productive cough that had not responded to conventional treatment . On admission, she was febrile, emaciated and in respiratory distress with oral thrush . Chest radiography showed diffuse bilateral infiltrations and a preliminary diagnosis of atypical pneumonia and tuberculosis was made . The patient was begun on penicillin, gentamicin, contrimoxazole and anti-tuberculosis therapy . Laboratory investigations revealed a low haemoglobin, positive HIV test (after counselling) and Pneumocystis carinii trophozoites and cytes in the bronchoalveolar larvage specimen . In spite of appropriate treatment the patient died within three days . One wonders whether the outcome for this middle aged woman with advanced HIV infection would have been different had appropriate cotrimoxazole therapy been administered at the primary health care centre . It must be noted that PCP may no longer be a rare disease in sub-Saharan countries and intensive investigations should be carried out to avoid losing patients with treatable infectious diseases. Hum Exp Toxicol, 2000 Jan, 19(1), 85 - 97 Tales of two similar hypotheses: the rise and fall of chemical and radiation hormesis; Calabrese EJ et al.; This paper compares the historical developments of chemical and radiation hormesis from their respective inceptions in the late 1880's for chemical hormesis and early 1900's for radiation hormesis to the mid 1930's to 1940 during which both hypotheses rose to some prominence but then became marginalized within the scientific community . This analysis documents that there were marked differences in their respective temporal developments, and the direction and maturity of research . In general, the formulation of the chemical hormesis hypothesis displayed an earlier, more-extensive and more sophisticated development than the radiation hormesis hypothesis . It was able to attract prestigious researchers with international reputations from leading institutions, to be the subject of numerous dissertations, to have its findings published in leading journals, and to have its concepts incorporated into leading microbiological texts . While both areas became the object of criticism from leading scientists, the intensity of the challenge was greatest for chemical hormesis due to its more visible association with the medical practice of homeopathy . Despite the presence of legitimate and flawed criticism, the most significant limitations of both chemical and radiation hormesis and their respective ultimate undoing were due to their: (1) lack of development of a coherent dose-response theory using data of low dose stimulation from both the chemical and radiation domains; (2) difficulty in replication of low dose stimulatory responses without an adequate study design especially with respect to an appropriate number and properly spaced doses below the toxic threshold; (3) modest degree of stimulation even under optimal conditions which was difficult to distinguish from normal variation; and (4) lack of appreciation of the practical and/or commercial applications of the concepts of low dose stimulation. Commun Dis Public Health, 2000 Mar, 3(1), 14 - 23 Guidelines for the control of infection with Vero cytotoxin producing Escherichia coli (VTEC) . Subcommittee of the PHLS Advisory Committee on Gastrointestinal Infections; Can sterile and pyrogen-free on-line substitution fluid be routinely delivered? A multicentric study on the microbiological safety of on-line haemodiafiltration; Erzsebet Hospital Sopron, HungaryBACKGROUND: Microbial contamination is characterized not only by the presence of bacteria, but also by high concentrations of biologically active by-products . They are potentially able to cross ultrafiltration and dialysis membranes and stimulate immunocompetent blood cells to synthesize cytokines . In turn, cytokine induction causes acute symptoms and has been incriminated in the long-term complications of haemodialysis patients . Infusion of large volumes of substitution fluids following ultrafiltration of microbially contaminated dialysis fluids may place patients on on-line therapies at particular risk . METHODS: In this study we evaluated 30 machines with a two-stage ultrafiltration system in routine clinical haemodiafiltration settings in six centres for 6 months . Microbiological safety was assessed monthly and at the last use of the filters by determining microbial counts, endotoxin concentration and cytokine-inducing activity . RESULTS: No pyrogenic episodes were observed during the study period . Double-filtration of standard dialysis fluid (range, <1-895 cfu/ml, 0.0028-4.6822 IU/ml) resulted in sterile substitution fluids with endotoxin concentrations well below the Ph.Eur . standard for haemofiltration solutions (range, 0.0014-0.0281 vs 0.25 IU/ml) . Moreover, they did not differ from commercial haemofiltration solutions and depyrogenated saline . Likewise, there was no difference in the cytokine-inducing activity between the solutions tested . The high microbiological quality of the ultrafiltered dialysis fluid, which was in the same range as substitution fluid, translates into both the absence of cytokine induction by dialyser back-transport and a redundant safety mode of the on-line system by a second filtration step . CONCLUSION: On-line HDF treatment can routinely be provided with ultra-pure dialysis fluids and sterile substitution fluids at pyrogen-free levels . The online preparation of substitution fluids thus can be considered microbiologically safe. Akush Ginekol (Sofiia), 1999, 38(3), 54 - 6 {A clinical study of the local contraceptive C-Film Lucchini}; Porozhanova V et al.; OBJECT: To evaluate the compliance and efficient of C-Film Lucchini . METHODS: 20 sexually active women were treated for the period of 3 months . There were used condoms in 1/3 of the women . It was made a microbiological study to all the patients on the vaginal flora colposcopy and it was controlled their kidney function . RESULTS: During the treatment with C-Film Lucchini 10% of the patients complained about a vaginal discharge 5% of the women have a problem with the application . CONCLUSION: C-Film Lucchini is a high quality and well-tolerated local spermicidal contraceptive with a few side effects . Despite the complaints of the local irritation the tolerance of the C-Film Lucchini is excellent . But the main problem with C-Film Lucchini is need of its insertion the 10-15 minutes before coitus and its application in front of the cervix. Akush Ginekol (Sofiia), 1999, 38(3), 36 - 8 {Condylomata acuminata . The correlation between affecting sexual partners and the risk of developing preneoplasia of the cervix uteri . The therapeutic potentials of the Nd-Yag laser}; Buzalov S et al.; The present study summarized results from 206 patients (120 females and 80 males) with diagnosis condylomata acuminata . The diagnostic and surveillance methods used in the present work were: clinical, colposcopic, histologies and microbiological examination . 114 from all patients--46.5% females, and 62.2% males were sexual partners . In 25 women (43.8%) from that group HPV-lesions were found . In 8 patients with cervical lesions CIN I-III was diagnosed . Our results confirmed the previously announced literary data about an enhanced risk for CIN development in women with HPV infection, whose sexual partners had clinical data of Condylomata acuminata . Our therapeutic protocol with Nd-YAG laser treatment in a determined scheme and number of applications according to the stage of the disease and pathological diagnosis was very successful, as compared to data from the literature. Akush Ginekol (Sofiia), 1999, 38(3), 20 - 1 {Leukocytes in human seminal fluid}; Stanislavov R; The peroxidase method is sufficient for quantification of granulocytes, but immunocytology is the standard for detection of white blood cells (WBC) in semen . Granulocytes are the most prevalent WBC in semen (50 to 60%) followed by macrophages (20 to 30%) and T-lymphocytes (2 to 5%) . The frequency of leukocytospermia (> 106 WBC/ml) among male infertility patients is 29% . There are ample evidences for sperm damage by WBC: 1) Seminal WBC numbers were higher in infertile patients than among fertile men; 2) leukocytospermia was associated with decreased sperm numbers and impared sperm motility; 3) WBC damage sperm function and were an important prognostic factor for IVF-ET failure . Approximately 80% of leukocytospermic samples are microbiologically negative . In some cases Chlamydia trachomatis might have triggered a persistent inflammatory reaction . Genital tract inflammation facilitates the formation of sperm antibodies. Theriogenology, 1998 Oct 1, 50(5), 699 - 706 Comparison of bacteriological qualities of various egg yolk sources and the in vitro and in vivo fertilizing potential of bovine semen frozen in egg yolk or lecithin based diluents; Bousseau S et al.; The addition of components of animal origin (egg yolk, milk) to most commercial diluents used to freeze bull semen represents a potential risk of contamination of the doses with bacteria or mycoplasma . A series of quantitative and qualitative analyses were performed to detect microbiological contamination observed in Biociphos plus (a new lecithin-glycerol based freezing salt buffer), in an egg yolk diluent (Triladyl) or in an egg yolk + milk-based (Laiciphos) diluent of bull semen . The 2 diluents containing animal products showed moderate (10 to 60 CFU/mL) contamination (17/17 samples) with bacteria or mycoplasma, or both, while no contamination was observed in the 6 examined batches of Biociphos plus . Biociphos plus was also compared with another commercial diluent (Laiciphos) for use in freezing bull semen intended for in vitro and/or in vivo fertilization . No difference (P > 0.05) could be detected between the 2 diluents for in vitro fertility rates (percentage of cleaved zygotes: 85.7% and 88.0%, respectively, for Laiciphos and Biociphos plus) . Similarly, 2 series of comparisons conducted in dairy cows artificially inseminated with semen frozen in either Biociphos plus or Laiciphos showed no difference in fertilizing capacity (tested at 60 to 90 d; P > 0.05) irrespective of the age of the bulls (Trial 1, bulls aged 14 to 15 m.o.; Trial 2, bulls aged 2 to 5 yr, field trials) . It is concluded that, in addition to maintaining the fertilizing capacity of bull semen at levels comparable to those observed with standard freezing diluent, Biociphos plus also prevents microbiological contamination by bacteria or mycoplasma, both of which are generally present in the various commercially available sources of egg yolk. Pflege, 1999 Oct, 12(5), 315 - 21 {Effect of various dressings on the point of entry of an intravenous drip}; Kuhne-Ponesch S et al.; In modern health care systems nosocomial infection is a major cause of patient suffering and leads to high financial costs . Overall nursing care that is part of nursing staff's daily routine is not brought under scrutiny often enough . The goal of this research project is to look at a small part only of optimal intravenous drip care . The focus of the paper is the influence that the use of two different kinds of dressings and two different types of cleansing methods have on the general appearance, as well as the microbiological results at the point of entry of the i.v . drip into the central veins . In order to examine this, test patients from different types of intensive care units were used for an experiment under highly controlled conditions . The results show that a variation in nursing care of the i.v . drip leads to a variation in germ development and in the general appearance at the point of entry. Vasa, 2000 Feb, 29(1), 62 - 70 Bacterial population of chronic crural ulcers: is there a difference between the diabetic, the venous, and the arterial ulcer? Schmidt K, Debus ES, St Jessberger, Ziegler U, Thiede A. BACKGROUND: At the Surgical Department of Surgery of the University Hospital Wurzburg microbiological examinations were performed of the ulcer grounds from patients with diabetic-neuropathic, diabetic-ischemic, venous, and arterial leg ulcers . The aim of the examination was to evaluate possible differences in the healing process of these ulcers based on the knowledge of their bacterial populations . PATIENTS AND METHODS: In a period of four months, 63 patients were consecutively examined by taking a bacteriological swab of their ulcer area . The healing process of their wounds was followed and related to the impact of bacterial colonisation and clinical signs of infection . RESULTS: 95% of the venous and arterial leg ulcers had a positive smear, whereas only 70% of diabetic ulcers were positive for bacterial growth . Bacterial population of the three ulcer entities, however did not differ significantly . 100% of the clinically infected venous and arterial ulcers but only 80% of the diabetic wounds revealed a positive smear . On the other hand, only 22% of the venous ulcers with a positive smear developed a clinical infection in contrast to 70% of the arterial and diabetic . Venous ulcers showed only in a few patients prolonged healing, even in cases of marked bacterial contamination . Despite of clinical signs of infection however, diabetic wounds sometimes did not reveal a positive wound smear (20%) . All infected venous, but only 20% of the infected ischemic ulcers healed satisfactorily . Arterial wounds with no bacterial growth healed significantly better than contaminated wounds . This difference was not significant in the other entities . Radical removal of the infection by minor amputation increased the healing rate in diabetic ulcers over 80%, whereas ischemic wounds did not profit from this therapy . CONCLUSIONS: A positive bacterial wound smear is not inevitably correlated with a protracted leg ulcer healing . Nevertheless a fulminant infection often developed in diabetic ulcers despite the initial inability to demonstrate bacterial growth . In order to start antibiotic treatment as early as possible, a wound smear should be obtained routinely from patients with diabetic ulcers . In chronic venous ulcers, a routine swab does not appear to be indicated as it bears no clinical consequences . The same applies to patients with surgically fully treated peripheral arterial occlusive disease . As ischemia presents the limiting factor, antibiotic therapy in case of infection will not prevent imminent amputation. J Fr Ophtalmol, 2000 Jan, 23(1), 81 - 7 {Infectious complications of cataract surgery: revisiting acute endophthalmitis}; Salvanet-Bouccara A; We reviewed management procedures for endophthalmitis on the basis of epidemiological, clinical, microbiological and experimental data, mainly obtained from two prospective multi-center studies in France (Groupement d'Etudes Epidemiologiques et Prophylactiques, GEEP) and the American Endophthalmitis Vitrectomy Study (EVS) . We analyzed medical history of the patient, recent history involving the eye, and examination and laboratory findings to search for a better treatment protocol for each patient and to assess evidence-based prophylaxis for cataract surgery. An Med Interna, 2000 Jan, 17(1), 13 - 8 {Tuberculosis and human immunodeficiency virus infection: clinical manifestations and performance of diagnostic procedures according to distinct forms of the localization of disease}; Lado Lado FL et al.; OBJECTIVES: To analyse the clinical manifestations and performance of the diagnosis methods in tuberculosis (TB) diagnosed in patients with human immunodeficiency virus infection (HIV), according to the location forms of disease (LF) . MATERIAL AND METHODS: We revised 80 cases of TB diagnosed in patients with infection by HIV . The data were gathered in relation to TB location, the clinical data and the microbiological and histological diagnosed studies . In the statistic analysis the values p < 0.05 were taken into account . RESULTS: The prevalence of LF was: 1) pulmonary forms (PF) 32 (40%), of which 12 were typical pulmonary (TP) and 20 atypical pulmonary (AP); 2) mixed forms (MF) 21 (26%); 3) extrapulmonary forms (EF) 19 (24%), of which 17 were lymphadenitis; 4) miliary tuberculosis (MT) 8 cases (10%) . The prevailing symptoms were: fever (71%) mainly in MF and MT, cough (69%), with less frequency in AP, EF and MT (p < 0.05) and adenomegalies especially in EF and MF . The diagnosis was based on the study of the sputum smears and lymph node . The bacilloscope of the spontaneous sputum was 53% with a minor performance in the AP (p < 0.05), while in lymph node the smear for AFB was positive in 78% cases and caseous granulomas were observed in 87% . CONCLUSIONS: In our study the major confirmed locations were pulmonary and lymph node, the most important clinical symptoms were fever, cough and adenomegalies . The diagnosis was based, in the most of cases, on the microbiologic and histologic examination of bronchial secretion and lymph node samples. EDTNA ERCA J, 1996 Oct-Dec, 22(4), 5 - 6 Automated on-line bicarbonate concentrate production: microbiological, chemical and economic benefits; De Vos JY et al.; We all know that "bicarbonate dialysate" became the world wide used fluid for use in haemodialysis and related techniques . To prepare bicarbonate dialysate we actually have to use two separate concentrates: one containing sodium bicarbonate, solely or in combination with other electrolytes other than calcium, and a second concentrate containing mostly all the other electrolytes (sodium, magnesium, potassium, chloride and/or some acetate). Enferm Infecc Microbiol Clin, 2000 Feb, 18(2), 62 - 5 {The microbiology laboratory in the diagnosis of bacteremia associated with catheters}; Soloaga R et al.; Catheter related sepsis is an outstanding problem in patients in every age group . The microbiological diagnosis should consider the main pathways of infection (catheter-skin interface, endoluminal) . With this aim we analysed 1496 central and peripheral short term catheters and 119 episodes of catheter related bacteremia . Catheters were cultured according to the quantitative technique of Brun Buisson (QT), the semiquantitative technique of Maki (SQ) and qualitative broth culture (QL) . The following results of sensitivity, specificity, positive predictive value, negative predictive value and Youden index were obtained: SQ = 87%, 88%, 40%, 99%, 0.75; QT (> or = 10(2) CFU/ml) = 88%, 89%, 43%, 99%, 0.77; QT (> or = 10(3) CFU/ml) = 77%, 92%, 48%, 97%, 0.69; QL = 94%, 68%, 20%, 99%, 0.62 . Results of SQ and QT > or = 10(2) were comparable, nevertheless, the addition of QT to SQ increased the detection of bacteremia by 12.8%, while in the opposite situation the increase was 10% . According to this, it is advisable to combine routinely SQ and QT . Finally, in 42 episodes of bacteremia related to implanted catheters processed by quantitative differential culture of blood drawn through the catheter and blood drawn through the peripheral vein the relationships were: > 1000 in 79% of cases, between 100 and 1000 in 9% of cases and between 5 and 10 in just 5% of cases. Ann Ist Super Sanita, 1999, 35(3), 467 - 71 {The microbiological characterization of the bioaerosol and leachate from an urban solid refuse dump: preliminary data}; Borrello P et al.; The present paper shows the results of an experimental study aimed at arranging a microbiological characterization of bioaerosol and leachate resulting from a sanitary landfill for solid urban waste situated near Rome . Bioaerosol sampling was performed by using the active sampling method referred to as surface air system, that is extensively used during indoor environmental monitoring . The microorganisms (bacteria and fungi) believed to be of relevance on bioaerosol and leachate with a view to hygienic risks, were investigated in order to estimate the potential risks to which the population and the workers can be exposed and consequently to allow corrective measures by monitoring campaigns of the examined matrices and by models of low environmental impact landfill. Dig Surg, 2000, 17(1), 77 - 80 Fibrin glue-antibiotic mixture in the treatment of anal fistulae: experience with 69 cases; Patrlj L et al.; BACKGROUND/AIMS: To investigate the potential value of the use of the fibrin glue-antibiotic mixture in the treatment of anal fistulae . MATERIALS AND METHODS: This study included 69 patients with idiopathic nonspecific anal fistulae . Patients with IBD (inflammatory bowel disease), TBC, actinomycosis, and cancer were excluded from the study . The microbiological analysis of the discharge of the fistula was done routinely . If there was any doubt about vertical classification of the fistulous tract MR of anal canal was necessary . As regards the vertical disposition, 39 fistulae were classified as intersphincteric and 30 as transsphincteric, and as to the length of the fistulous tract, 24 fistulas had tracts </=3.5 cm long, and 45 fistulas had tracts >3.5 cm long . All fistulae were first treated with the lavage of the fistulous tract with antibiotic solution until a sterile microbiological finding was obtained . This was followed by electrocoagulation of the fistulous tract with a special probe for the eradication of granulomatous tissue . Finally the fibrin glue-antibiotic mixture (Tisseel, Immuno Ltd., Vienna, Austria) was applied . RESULTS: After a follow-up of 18-36 months (median 28) 18 patients (26%) had a recurrence; among these, intersphincteric fistula recurred in 9 patients (23%) and transsphincteric also in 9 (30%) . Regarding the length of the fistulous tract, a fistula with a </=3.5 cm long tract recurred in 13 patients (54%) and a fistula with a >3.5 cm long tract in 5 (11%) . CONCLUSION: The analysis showed that the success of the treatment of anal fistulae with fibrin glue-antibiotic mixture was independent of the vertical disposition of the fistula, and was dependent on the length of the fistulous tract . Surgical treatment remains a golden standard for simple fistulae with a tract </=3.5 cm . Anal fistulae with a longer tract usually present a more complex problem and are often more difficult to treat surgically, the use of the fibrin glue-antibiotic complex proved to be a feasible method for those cases . It is a safe, cheap, reproducible, pain-free procedure, which eliminates the possibility of anal incontinence and can be performed under local anesthesia . Toxicol Lett, 2000 Mar 15, 112-113, 371 - 8 Professional opportunities for toxicologists: the requirements of the private sector for education/teaching; Ettlin RA et al.; Toxicology, as a multidisciplinary field, provides career opportunities for graduates with medical (human or veterinarian), pharmacological, pharmaceutical, biological, microbiological, molecular biological, chemical, biochemical, genetic or other backgrounds . However, in today's environment specialists with a university degree in toxicology or a postgraduate training in toxicology have a clear advantage . Postgraduate diplomas are now available in most industrial countries . In addition, to be successful, modern toxicologists in the private sector also need a good understanding of how to turn a scientific project into a successful product, an expertise generally acquired by on-the-job training . Last, but not least, the rapid progress in essentially all toxicology-relevant sciences makes continuous training mandatory. Food Chem Toxicol, 2000, 38(1 Suppl), S29 - 36 Water as consumed and its impact on the consumer--do we understand the variables? Bates AJ. Water is the most important natural resource in the world, without it life cannot exist . In 1854 a cholera outbreak in London caused 10, 000 deaths and positively linked enteric disease with bacterial contamination of drinking water by sewage pollution . Since then, adequate water hygiene standards and sewage purification have played the most significant role in disease eradication and public health improvements everywhere . Standards for drinking water have become an extensive range of microbiological and chemical parametric values . Which has not increased consumer, if the media is to be believed . Customers rightly expect that the water they drink is safe and wholesome . Standard setting is perceived as a precise science and meaningful to health . Is this justified and do scientists and regulators who derive and set the standards understand the uncertainties in the system? Water is the universal solvent, therefore it will never be pure; it will contain impurities prior to and after treatment . Knowledge of its potential to become contaminated is necessary to understand the epidemiology associated with waterborne contaminants and their effects . Water use patterns vary considerably and affect assumptions based on toxicology derived from laboratory studies under tightly controlled conditions . Consideration must be given to the model systems used to assess toxicity and translate results from the laboratory to the real world, if sensible scientifically-based water quality standards are to be set and achieved cost effectively. J Bacteriol, 2000 Apr, 182(7), 1930 - 4 Spirochaeta aurantia has diacetyl chloramphenicol esterase activity; Sohaskey CD et al.; The free-living spirochete Spirochaeta aurantia was nearly as susceptible to diacetyl chloramphenicol, the product of chloramphenicol acetyltransferase, as it was to chloramphenicol itself . This unexpected susceptibility to diacetyl chloramphenicol was wholly or partly the consequence of intrinsic carboxylesterase activity, as indicated by high-performance liquid chromatography, thin-layer chromatography, and microbiological assays . The esterase converted the diacetate to chloramphenicol, thus inhibiting spirochete growth . The esterase activity was cell associated, reduced by proteinase K, eliminated by boiling, and independent of the presence of either chloramphenicol or diacetyl chloramphenicol . S . aurantia extracts also hydrolyzed other esterase substrates, and two of these, alpha-napthyl acetate and 4-methylumbelliferyl acetate, identified an esterase of approximately 75 kDa in a nondenaturing gel . Carboxylesterases occur in Streptomyces species, but in this study their activity was weaker than that of S . aurantia . The S . aurantia esterase could reduce the effectiveness of cat as either a selectable marker or a reporter gene in this species. J Infect, 1999 Nov, 39(3), 205 - 8 Length of time to laboratory diagnosis of Mycobacterium tuberculosis infection: comparison of in-house methods with reference laboratory results; Davies AP et al.; OBJECTIVES: To audit the time taken to obtain laboratory confirmation of infection with Mycobacterium tuberculosis using in-house methods of polymerase chain reaction (PCR) and culture and referral to a reference laboratory . METHODS: Retrospective collection of data from laboratory records covering a period of 1 year . RESULTS: Median time to microbiological diagnosis of a new infection using the in-house services in addition to the reference laboratory was 22.0 days . Using reference laboratory results alone, median time to diagnosis would have been 61.5 days . CONCLUSIONS: Development of on-site laboratory facilities to identify Mycobacterium tuberculosis can reduce the time to its identification by almost two-thirds. J Periodontol, 2000 Feb, 71(2), 209 - 18 Peptostreptococcus micros smooth and rough genotypes in periodontitis and gingivitis; Kremer BH et al.; BACKGROUND: Two genotypes can be distinguished within the species Peptostreptococcus micros: a smooth (Sm) and a rough (Rg) type . To date no systematic study has been performed on the prevalence and proportion of both types in untreated periodontitis patients and subjects without destructive periodontal disease . Therefore, the present study was performed to investigate: 1) the relative importance of the Sm and the Rg genotype of P micros in periodontitis and gingivitis; 2) the correlation between smoking and the 2 genotypes of P micros; and 3) the systemic antibody response against the 2 genotypes in relation to the periodontal condition and smoking . METHODS: A total of 104 untreated periodontitis patients and 41 individuals with gingivitis underwent clinical examination and microbiological sampling . Pocket samples were cultured anaerobically on blood agar plates to determine the prevalence and proportion of the Sm and Rg types of P micros . Serum antibody titers against both types of P micros were determined in all subjects by enzyme-linked immunosorbent assay (ELISA) using whole bacterial cells as antigen . Additionally, in a representative group of subjects, the antigen specificity of the serum antibodies was assessed by immunoblotting experiments . RESULTS: The prevalence of the Sm genotype was higher in subjects with periodontitis (94%) compared to subjects with gingivitis (59%), whereas the prevalence of the Rg type was not significantly different (38% versus 29%) . Similar analyses were performed for subgroups of smokers and non-smokers; within the periodontitis group, the prevalence of the Sm type was not different between smokers and non-smokers (96% and 92%, respectively), whereas the prevalence of the Rg type was higher in smokers (48%) compared to non-smokers (19%) . No difference in prevalence of both types was observed between smokers and non-smokers within the gingivitis group . The titers and specificity of P micros-specific immunoglobulins in periodontitis patients were not different from those in gingivitis subjects, nor were they related to smoking status or culture-positivity . CONCLUSIONS: The results of this study suggest that both the Sm and the Rg genotypes of P micros are part of the normal oral microbiota . However, the elevated prevalence of the Sm genotype in periodontitis and the elevated prevalence of the Rg type in periodontitis patients who smoke implies that both types can behave as opportunistic pathogens in destructive periodontal disease. Cesk Patol, 1999 Oct, 35(4), 140 - 3 {Helicobacter heilmanii, a spiral bacterium, in gastric mucosa biopsies}; Honsova E et al.; Interest in possible microbiological causes of gastritis has increased significantly since the discovery of Helicobacter pylori (Hp) . Recently a spiral bacterium named Helicobacter heilmannii (Hh) was described in association with chronic gastritis in adult and pediatric patients . Comparisons between these two organisms, as well as the literature on Hh, have also been reviewed . The incidence of Hh gastritis is far lower than that of Hp gastritis . Concomitant infections by Hh and Hp are very rare . It is very probable that Hh gastritis is transmitted from domestic animals or pets to humans . The frequency of Hh gastritis (11/6059 cases, 0.18%) in authors' material was similar to that reported in Western Europe . The role of touch cytology has been becoming more and more significant recently in the diagnosis of mucosal infections of the GIT. Crit Care Med, 2000 Feb, 28(2), 366 - 70 Evaluation of an antiseptic triple-lumen catheter in an intensive care unit; Hanley EM et al.; OBJECTIVE: To evaluate a decrease in catheter-related bloodstream infection rate in patients with antiseptic triple-lumen catheters in an intensive care unit . DATA SOURCES: Retrospective review of surveillance records, patient medical records, laboratory and microbiological reports, and antibiotic administration records . STUDY SELECTION: Patients admitted to the intensive care unit with triple-lumen catheters . DATA EXTRACTION: A subset of one entry per patient was extracted from 2 yrs of primary bloodstream infection surveillance data . Data collection included risk factors, laboratory and microbiological data, and insertion sites and dates of all intravascular catheters present during triple-lumen catheterization . DATA SYNTHESIS: The catheter-related bloodstream infection rate was 5.4 and 11.3 per 1000 catheter days in antiseptic and nonantiseptic triple-lumen catheter groups, respectively (p = .06) . By multivariate analysis using a Cox Proportional Hazards Model, the antiseptic triple-lumen catheters were associated with a significant reduction in catheter-related bloodstream infection (p = .03) . Model expansion to include intrajugular site was significant by a likelihood ratio test {2(log likelihood diff) = 4.26 P<.05 chi2(1)} CONCLUSIONS: The use of antiseptic triple-lumen catheters may substantially reduce catheter-related bloodstream infections in an intensive care population and may be subsequently associated with a decrease in length of stay. J Med Microbiol, 2000 Mar, 49(3), 271 - 8 A clinical, microbiological and economic analysis of a national service for the rapid molecular diagnosis of tuberculosis and rifampicin resistance in Mycobacterium tuberculosis; Drobniewski FA et al.; A clinical, microbiological and economic study of a national rapid molecular service for the identification of Mycobacterium tuberculosis and the determination of rifampicin resistance in smear-positive sputum samples (and other primary specimens) was performed . Ninety-one primary specimens, of which 55 were smear-positive sputum, were examined by molecular and conventional assays . Concordance of molecular results from smear-positive sputum specimens with tuberculosis diagnosis and rifampicin resistance by conventional analysis was 52 (94.5%) of 55 and 44 (91.7%) of 48, respectively . Concordance of molecular analysis on all primary specimens was 81 (89.0%) of 91 (diagnosis) and 55 (90.2%) of 61 (rifampicin resistance) . Approximately 28 days were saved in the time to diagnosis by using the molecular assay . Hospitals can reduce the cost of inappropriate isolation of patients with risk factors for multiple drug-resistant tuberculosis (MDRTB) who subsequently are shown to have drug-sensitive tuberculosis . At one hospital potential annual savings were between pound sterling 50000 and pound sterling 150000 . Of the nine MDRTB cases identified, all had a previous diagnosis of tuberculosis, 78% were born overseas, 44% were known to be non-compliant with therapy, but only one case (12.5%) was HIV positive . HIV status was not significantly different between MDRTB and drug-sensitive tuberculosis cases . Over 75% of specimens were taken while the patient was on therapy . Isolates from >50% of the MDRTB cases were resistant to three or more drugs and one was resistant to seven drugs . All patients were placed on additional therapy once the molecular result was known; this was subsequently modified based on the results of in-vitro drug susceptibility testing . All survived at least 6 months of follow-up . There was no difference in the proportion of successful cultures from smear-positive samples from patients with drug-sensitive tuberculosis or MDRTB who were on therapy . Molecular rifampicin resistance assays are reliable for diagnosis in cases with smear-positive disease. Vet Rec, 2000 Jan 29, 146(5), 124 - 31 Risk assessment of organoleptic postmortem inspection procedures for pigs; Pointon AM et al.; A systematic quantification of foodborne hazards in abnormal and normal tissues of pig carcases was undertaken to provide a risk-based assessment of the effectiveness of traditional organoleptic meat inspection . A total of 36,059 pigs, representing all major pig-producing areas and systems in Australia, were inspected on a seasonal basis at three abattoirs over 12 months . The prevalence of grossly detectable abnormalities of possible food-borne disease significance was recorded . A subset of the grossly detectable abnormalities, together with tissues classified by inspection as normal (controls) were submitted for the detection of a broad range of food-borne hazards . The potential exposure of consumers to hazards in fresh pork was characterised as the number of carcases per 10,000 containing hazards in selected tissues . The results indicated that the level of exposure of consumers to microbiological hazards in fresh pork is unlikely to be reduced significantly by the detection and removal of gross abnormalities in the tissues examined . On the basis of carcase throughput, the rate of contamination of normal lymph nodes was commonly 100 times higher, and no hazards were isolated from two types of grossly abnormal nodes . While further processing, cooking and handling may alter the exposure characterisation, the study nevertheless identifies the proportional contribution of abnormal and normal tissues to risks to consumers and clearly identifies the need for consideration of 'visual only' inspection in the re-evaluation of traditional inspection procedures. J Pharm Biomed Anal, 1999 Nov, 21(2), 347 - 53 Microbiological bioassay of erythromycin thiocyanate: optimisation and validation; Bernabeu JA et al.; The validation of an analytical method for the quantitative determination of erythromycin thiocyanate formulated in an antibiotic preparation for veterinary use was carried out . This method is based on the microbiological method described in the European Pharmacopoeia to analyze erythromycin thiocyanate as a raw material . This erythromycin thiocyanate preparation is presented as a powder for oral administration after mixing with feed . For that reason, it was planned to validate the method for the quantitative determination of erythromycin thiocyanate incorporated both in the medicated premix and the mixture with feed . The microbiological method followed a linear model and was not proportional . The number of replicates needed to obtain a valid result was less than four in all cases . The small difference in concentration, expressed in natural logarithm detected by the method, was 0.1. J Clin Periodontol, 2000 Feb, 27(2), 128 - 33 Long-term evaluation of osseointegrated dental implants in the treatment of partly edentulous patients; Hultin M et al.; AIM: The aim of this study was to evaluate the clinical, radiographic and microbiological status of implants after 10 years of functional load in patients treated for partial edentulism . METHOD: 15 patients, each successfully treated with 2-6 implants ad modum Branemark placed in free-standing fixed prostheses, were included in the study . RESULTS: Clinical evaluation revealed similar degrees of inflammation around teeth and implants . The probing pocket depth (PPD) was significantly greater around implants than around teeth . The mean marginal bone loss during 10 years of functional load was comparable to that found at the time of the 5-year follow-up . 74% of the implants remained free of marginal bone loss exceeding 1 mm . Marginal bone loss exceeding 2 mm, was found at only 5 sites . No marked differences in bacteria were present between teeth and implants . T . denticola, S . intermedia and P . micros were the commonest organisms detected around teeth and implants . The periodontal pathogens A . actinomycetemcomitans, P . gingivalis, P . intermedia, B . forsythus, and T . denticola, were found at implants with a marginal bone loss of more than 2 mm . CONCLUSION: Our study shows that the long-term results with implants in partially dentate patients are similar to those seen in edentulous patients and that no significant change occurred after 5-year follow-up over an additional period of 5 years. Haematologica, 2000 Mar, 85(3), 275 - 9 Comparison of two different time interval protocols for central venous catheter dressing in bone marrow transplant patients: results of a randomized, multicenter study . The Italian Nurse Bone Marrow Transplant Group (GITMO); Laura R et al.; BACKGROUND AND OBJECTIVE: Care of central venous catheter (CVC) in patients undergoing bone marrow transplantation (BMT) raises significant problems related to the high risk of local infections due to the immunodeficient status, which in itself is a predisposing factor for systemic blood-stream infections . Although frequent changes of CVC dressing might theoretically reduce the incidence of infections, they are also accompanied by significant skin toxicity and patient discomfort . No study has yet addressed these points . The objective of this study was to compare two different time interval protocols for CVC dressing in order to assess the effects on local infections and toxicity . DESIGN AND METHODS: In a multicenter study, 399 bone marrow transplant (BMT) patients with a tunneled CVC (Group A, 230 pts) or a non-tunneled one (Group B, 169 pts) were randomly allocated to receive CVC dressing changes every 5 or 10 days, if belonging to Group A, or 2 or 5 days, if in Group B . Transparent, impermeable polyurethane dressings were used for all patients . The rate of local infections at the site of CVC insertion was assessed by microbiological assays every 10 days, while the severity of skin toxicity was measured according to the ECOG scale . RESULTS: Sixty-five per cent of enrolled patients were finally evaluable . Patients (in both Groups) receiving CVC dressing changes at longer intervals did not show a significant increase in the rate of local infections, while those who received dressing every 2 days had a significant increase in local skin toxicity . Longer intervals were accompanied by a reduction in costs . INTERPRETATION AND CONCLUSIONS: The results of this study demonstrate that the increase in time interval between CVC dressing changes in BMT patients did not raise the risk of local infections, while significantly reducing patient discomfort and costs. Oral Dis, 2000 Mar, 6(2), 103 - 5 Isolation of fusobacteria from the oral cavities of malnourished Nigerian children living in agricultural and herding villages; Falkler WA et al.; A previous study demonstrated the presence and possible involvement of Fusobacterium necrophorum in the pathogenesis of noma lesions of children living in agricultural and herding villages in northwestern Nigeria . In order to determine if F . necrophorum was part of the oral flora of malnourished children with no noma lesions, a study of the fusobacteria present in the oral cavities of 30 children, 2-6 years of age in Sokoto State, was undertaken . Swabs taken of the oral cavity were cultured on selective fusobacteria medium using conventional anaerobic microbiological techniques . F . nucleatum was recovered from each child and F . necrophorum was isolated from the oral cavity of only one child . The presence of F . nucleatum and the lack of F . necrophorum, except in one case, suggests that the latter is not normal flora in the children at risk for noma . F . necrophorum, a putative trigger organism for noma may gain a foothold only when certain staging conditions (i.e., lowered host resistance and/or oral lesion) are present. Nahrung, 2000 Feb, 44(1), 13 - 8 Microbiological, nutritional and sensory evaluation of long-time stored amaranth biscuits produced from irradiation-treated amaranth grain; Hozova B et al.; The paper presents some results achieved by the evaluation of microbiological (total bacterial count, coliform bacteria, aerobic sporeforming bacteria, yeasts and moulds), nutritional (lysine) and sensory (shape, surface, colour consistency, taste, odour, the profiling of tastiness) quality and of the aw values of amaranth-based biscuits produced from the amaranth grain irradiated by various ionizing radiation doses (1.5, 3 and 5 kGy, source 60Co) and stored for the period of 12 months at the laboratory temperature (20-25 degrees C) . The irradiation dose providing the biscuits maximum hygienic, nutritional and sensory quality maintained up to the end of the one-year storage was 5 kGy. Appl Environ Microbiol, 2000 Mar, 66(3), 1126 - 32 Biomarker evidence for widespread anaerobic methane oxidation in Mediterranean sediments by a consortium of methanogenic archaea and bacteria . The Medinaut Shipboard Scientific Party; Pancost RD et al.; Although abundant geochemical data indicate that anaerobic methane oxidation occurs in marine sediments, the linkage to specific microorganisms remains unclear . In order to examine processes of methane consumption and oxidation, sediment samples from mud volcanoes at two distinct sites on the Mediterranean Ridge were collected via the submersible Nautile . Geochemical data strongly indicate that methane is oxidized under anaerobic conditions, and compound-specific carbon isotope analyses indicate that this reaction is facilitated by a consortium of archaea and bacteria . Specifically, these methane-rich sediments contain high abundances of methanogen-specific biomarkers that are significantly depleted in (13)C (delta(13)C