Pediatr Dev Pathol, 1999 Sep-Oct, 2(5), 432 - 9 Investigation of nonimmune hydrops fetalis: multidisciplinary studies are necessary for diagnosis--review of 94 cases; Lallemand AV et al.; This review of 94 cases of nonimmune hydrops fetalis (NIHF) over a 10-year period was undertaken to evaluate the frequency of this pathology among fetal and infant deaths and to determine the most common likely etiologies in a northeastern region of France . NIHF represented 6% of the fetal deaths examined in our laboratory . The combination of findings from morphologic examination of the placenta and fetus with the results of microbiological and cytogenetic investigations (conventional cytogenetic study, fluorescent in situ hybridization {FISH}, or DNA ploidy image analysis) led to an etiologic diagnosis for NIHF in two-thirds of the cases and suggested a diagnosis in an additional 23% of cases . The most common causes of NIHF were chromosome abnormalities (33%), infections (16%), and cardiac pathology (13.8%) . The detection of a cause for NIHF is important for genetic counseling and management of subsequent pregnancies . Our experience suggests that a diagnosis is possible in a large majority of NIHF when obstetricians and pathologists carefully coordinate the management of prenatal and postnatal investigations and when new techniques, such as molecular biology and DNA quantification, are used. Fungal Genet Biol, 1999 Jul-Aug, 27(2-3), 199 - 208 Mechanistic and mathematical inactivation studies of food spoilage fungi; Brul S et al.; Fungal spoilage forms an increasing economic problem in the food industry . Chemical antifungals are becoming less attractive as food preservatives and hygiene agents due to the development of resistance and due to stricter legal regulations concerning the permitted concentrations . Finally, consumers tend to demand more "naturally preserved" or preservative-free products . Here we review our understanding of the mechanisms of action and resistance to classical antifungals . Next, we evaluate the scientific basis underlying the application of novel, natural antifungals . Finally, we discuss the mathematical modelling of fungal growth and the development of preliminary predictive lag-time models . The eventual aim of the reviewed work is to generate mathematical lag-time models in real foods that predict the microbiological stability of the food and are based on a mechanistic understanding of the chain of events that leads to cell death, or an extension of lag-time of the initiation of outgrowth . Nature, 1999 Jul 29, 400(6743), 446 - 9 Missing lithotroph identified as new planctomycete; Strous M et al.; With the increased use of chemical fertilizers in agriculture, many densely populated countries face environmental problems associated with high ammonia emissions . The process of anaerobic ammonia oxidation ('anammox') is one of the most innovative technological advances in the removal of ammonia nitrogen from waste water . This new process combines ammonia and nitrite directly into dinitrogen gas . Until now, bacteria capable of anaerobically oxidizing ammonia had never been found and were known as "lithotrophs missing from nature" . Here we report the discovery of this missing lithotroph and its identification as a new, autotrophic member of the order Planctomycetales, one of the major distinct divisions of the Bacteria . The new planctomycete grows extremely slowly, dividing only once every two weeks . At present, it cannot be cultivated by conventional microbiological techniques . The identification of this bacterium as the one responsible for anaerobic oxidation of ammonia makes an important contribution to the problem of unculturability. Hum Reprod, 1999 Aug, 14(8), 2025 - 30 Seminal leukocyte concentration and related specific reactive oxygen species production in patients with male accessory gland infections; Vicari E; The aim of this study was to determine whether differences occur in seminal concentrations of white blood corpuscles (sWBC) and whether WBC production of reactive oxygen species (ROS) is related to the infiltration of one or more male sexual glands . We studied 70 infertile patients affected by bacterial male accessory gland infections (MAGI) who were divided clinically and, by ultrasound (US), into four well-characterized, aged-matched groups . Three of the groups presented an abnormal US scan (MAGI US+ groups): group P with prostatitis alone (n = 15), group PV with prostato-vesiculitis (n = 19), and group PVE with prostato-vesiculo-epididymitis (n = 22) . The fourth group presented with a normal US scan (MAGI US- group) and was diagnosed with presumptive MAGI according to laboratory criteria (n = 14) . In addition, 20 fertile males acted as controls . All patients underwent seminal and microbiological analyses as well as US scans . In addition, the WBC concentrations of whole semen and the WBC-rich 45% Percoll fraction (Pf45) as well as WBC-specific ROS production in the same sperm fraction were analysed . Semen samples from the PVE patient group exhibited significantly (P < 0.01) lower values of sperm parameters than those obtained from P, PV, MAGI US- and the control groups . The sWBC and Pf45 WBC concentration as well as baseline and fMLP-stimulated ROS counts in each MAGI US+ group were significantly (P < 0.01) higher than those found in the MAGI US- group and controls. Rev Inst Med Trop Sao Paulo, 1998 Nov-Dec, 40(6), 355 - 62 Influence of dietary protein content on Trypanosoma cruzi infection in germfree and conventional mice; Cintra IP et al.; Germfree (GF) and conventional (CV) mice were fed on diets containing 4.4, 13.2 or 26.4% of protein (weight/weight) . CV mice fed on low protein diet did not gain weight during four weeks, whereas the protein deficient diet did not affect the growth of GF mice . After four weeks on these diets, the mice were inoculated with 5 x 10(3) trypomastigotes of Trypanosoma cruzi . The protein deficiency affected less the GF than the CV mice, according to the following parameters: weight gain, hemoglobin, plasma protein and albumin levels and water and protein contents of the carcass . Infection with T . cruzi produced a significant decrease in hemoglobin levels, red blood cell count, and water and protein contents in the carcass . This decrease was more pronounced in the GF mice . Histopathologically, there was no difference between the treatments in animals with the same microbiological status (GF or CV) . However, the disease was more severe in the GF than in the CV mice. Medicina (B Aires), 1999, 59 Suppl 1, 39 - 46 {The role of trovafloxacin in the treatment of nosocomial pneumonia}; Mandell LA; In order to understand the role of trovafloxacin in the treatment of nosocomial pneumonia, the nature and characteristics of this infection have to be first reviewed . During the first part of this revision the principal aspects of the epidemiology are reviewed, some concepts which take part in the pathogenia of the illness and the immunology of these patients are analysed and the microbiological characteristics of nosocomial pneumonia are evaluated . In the second part of the revision the bacterial resistance to the main groups of antibiotics is considered, listing the different mechanisms used by the bacteria to develop this resistance . They are: production of enzymes which inactivate the antibiotic, access reduction of the drug to the target site, increase of the antibiotic efflux or changes in the target site . Current controversies concerning diagnostic methods and some controversial issues regarding this pathology are here discussed . Finally, the proposed guidelines for the treating hospital acquired pneumonia are revised as well as the role of special new antibiotics . In this sense special reference is made to trovafloxacin, listing its principal characteristics, as its broad spectrum of activity, its excellent pharmacokinetic properties, its availability in i.v . and oral formulations and its good tolerance, which makes trovafloxacin a very interesting option for treatment of hospital acquired pneumonia. Zentralbl Chir, 1999, 124(6), 483 - 8 {Pulmonary complications following esophageal surgery . Significance of aspiration}; Wahl W et al.; Objective of this study was to show the different causes and the importance of pulmonary complications after esophageal surgery and their management by general and intensive care measures . In the University Hospital for General and Abdominal Surgery of Mainz 222 patients were treated for esophageal cancer from 9/1985 to 5/1997 . Data of 214 patients were available for this investigation . In 65 cases a transhiatal dissection (blunt dissection) and in 149 patients a abdomino-thoracic dissection were performed . 54 (25.2%) patients had to be reintubated . 30-day lethality was 7.9% (n = 17) and hospital lethality was 13.1% (n = 28) . 82 (38.3%) patients developed pulmonal dysfunction (pneumonia) which was aggravated by a following ARDS in 16 patients (19.5%) . 21 (25.6%) of these patients died . In only 24 (29.3%) patients an isolated pneumonia occurred without evidence of general or surgical complications . In 65 of 82 patients further microbiologically examinations were documented . In 39 (60%) cases gastrointestinal bacteria were found . Therefore aspiration or microaspiration respectively are considered to co-cause pulmonary complications . Postoperative psychosyndrome, recurrent nerve palsy and ASA-risk stratification were accompanied by elevated rates of pneumonia . Careful selection of patients for esophageal resection, atraumatic surgical technique and reduction of general and surgical complications and intensive care measures can help to avoid postoperative pulmonary complications . Reduction of mediators activated by surgical trauma is not feasible so in the moment prevention of aspiration seems to be the most effective therapy in the postoperative course. Analyst, 1998 Dec, 123(12), 2443 - 7 Metabolism of chlortetracycline: drug accumulation and excretion in the hen's egg; Kennedy DG et al.; Chlortetracycline (CTC) is one of the few antibiotics that can be used without any withdrawal period in chickens laying eggs intended for human consumption . 6-Iso-CTC and 4-epi-6-iso-CTC have recently been identified as the principal metabolites of CTC in eggs . Although not covered by the European Union (EU) maximum residue limit (MRL) for CTC, these compounds, taken together, accumulate in the eggs of birds treated therapeutically with CTC to a mean concentration equivalent to more than twice the EU MRL (200 micrograms kg-1) in eggs . Plateau concentrations in eggs were achieved after approximately 3 d of medication . Following withdrawal of medication, mean egg concentrations of these compounds were maintained for 48 h, before falling below a level equivalent to the MRL after 5 d . Feeds containing typical sub-therapeutic contamination concentrations of CTC did not produce mean concentrations of 6-iso-CTC plus 4-epi-6-iso-CTC, combined, greater than 200 micrograms kg-1 . It is not known whether these compounds are formed as a result of metabolism or of chemical degradation . However, analysis of ovules pre-lay showed that all of the CTC present in this matrix was in the form of 6-iso-CTC and 4-epi-6-iso-CTC, and not as the parent drug . Although microbiologically inactive, the toxicological properties of 6-iso-CTC and 4-epi-6-iso-CTC are not known. Gene Ther, 1999 Feb, 6(2), 171 - 81 A transfecting peptide derived from adenovirus fiber protein; Zhang F et al.; New strategies to improve the outcome of gene therapy often employ a nonviral gene delivery, which is most likely to fulfil microbiological safety criteria and be retained in the clinical setting . Here we show that efficient gene transfer can be achieved in vitro using as a vector a polyvalent peptide derived from the N-terminal sequence of the human adenovirus fiber protein . The level of transfection is better than that obtained with the two liposomes, DOTAP and DOSPER . Internalization was studied by confocal microscopy using fluorescently marked peptide and DNA . The peptide alone is targeted to the nucleus and concentrated within the nucleolus . Similarly, DNA complexed with peptide also enters the nucleolus, where it is retained for at least 48 h . Peptide I appears to attach to cells by a saturable process, as preincubation of cells with peptide blocks transfection and there is no transfection at 4 degrees C . The peptide contains three domains: a nuclear localization signal of adenovirus fiber protein; a domain containing hydrophobic and polar residues harboring an internalization signal for receptor-mediated endocytosis; and a stretch of lysines . Each of these domains is required for optimum gene transfer . Peptide I may be an interesting alternative to known vectors for gene transfer, for local administration and for ex vivo applications. Rinsho Byori, 1999 Jun, 47(6), 501 - 8 {Microbiological laboratories for sepsis in the 21st century}; Matsuno Y et al.; A new concept, "SIRS (systemic inflammatory response syndrome)", introduced for the use of innovative therapies in sepsis, indicates the importance of clinically satisfying services in the laboratories . Appropriate laboratory management of the host, parasite and environment, is needed for the diagnosis, treatment and prevention of sepsis . Improvement of environmental conditions is expected to contribute to the prevention of sepsis by nosocomial infections . Another important key in the management is quality assurance in blood cultures, which involves three issues that must be improved . Concerning the first two issues, high sensitivity and low contamination, balanced procedures must be performed to ensure cost-effectiveness . Regarding the third issue, we proposed a quick return system for positive blood cultures . We need to reconsider the traditional concept of "time" in microbiological tests and employ practical measures for sepsis in clinical laboratories. Acta Otorrinolaringol Esp, 1999 May, 50(4), 333 - 5 {Cervical abscess due to Turicella otitidis}; Fernandez Perez A et al.; We report an extraotic infection by a relatively new pathogen, Turicella otitidis, which to ur knowledge has not been described elsewhere . It was isolated from a cervical abscess in a 7-year-old boy . The clinical and microbiological features of this infection are reviewed. Am J Health Syst Pharm, 1999 Jul 15, 56(14), 1433 - 6 Barrier isolators as an alternative to a cleanroom; Tillett L; The use of barrier isolators as an alternative to a cleanroom for the preparation of sterile products at ASHP-defined risk levels 2 and 3 and cytotoxic and hazardous drugs is described . The two isolators selected provide enclosed microenvironments . The isolator used for preparing products of risk level 2 has white acrylic and polycarbonate rigid walls that isolate the sterile product from the operator . The isolator used for preparing level 3 products and cytotoxic and hazardous drugs has epoxy-painted steel walls, a front window, and a pair of glove ports; its design theoretically prevents cross contamination between the operator and the product under preparation and between the product and the external environment . An independent contractor familiar with barrier isolators certifies the equipment every six months . A random microbiological sampling is periodically compared with a control . The isolators have been in operation since July 1998 without microbial growth in any sample tested . The barrier isolators cost more than traditional laminar-airflow hoods, but the hospital considers the barrier isolators to be more cost-effective than a cleanroom . A cost saving in supplies for cytotoxic and hazardous drug preparation as a result of a reduction in overall gown and glove use was observed . Barrier isolators offer an alternative to a cleanroom for the preparation of products at risk levels 2 and 3 and offer an aseptic, safe environment for preparing cytotoxic and hazardous agents. Acta Gastroenterol Belg, 1999 Apr-Jun, 62(2), 221 - 5 Contribution of large animal models to the development of clinical intestinal transplantation; Pirenne J; The intestine has long been seen as a "forbidden" organ to transplant and even nowadays it remains the most challenging abdominal organ to transplant . Large animal experiments have been pivotal, first in developing reproducible and clinically applicable surgical techniques for transplanting the intestine and second, in revealing the unique physiological, immunological, and microbiological challenge that intestinal transplantation (ITx) represents . More recently, large animal models have been used to test new immunosuppressive drugs (FK 506) that have been then successfully used clinically . ITx is no more an experimental endeavor and survival figures of about 70% can be reached at one year, justifying routine application of ITx to patients who do not tolerate total parenteral nutrition . However, ITx remains in 1999 an "unfinished product" and further research will need to be done to allow wider application of ITx to patients without total parenteral nutrition (TPN) related complications . Further research will focus on the following aspects: (1) refined understanding of the factors accounting for the high immunogenicity of the intestine; (2) development of immunomodulatory strategies to reduce graft immunogenicity and to induce specific hyporesponsiveness; (3) development of new immunosuppressants, and their usage in combination, to act more specifically on the immune response, and at the price of less toxicity; (4) development of surgical alternatives to alleviate the organ shortage: graft size reduction, live related ITx . Importantly these questions will need to be addressed in clinically relevant animal models before they are applied to man. Appl Environ Microbiol, 1999 Aug, 65(8), 3717 - 20 Development and testing of a microbiological assay to detect residual effects of disinfectant on hard surfaces; Mariscal A et al.; We describe a glucuronidase bioassay for detecting residual bactericidal activity from the use of disinfectants on hard surfaces; in this assay we used formaldehyde, ethanol, isopropanol, chlorine, and a commercial preparation containing 2-bromo-2-nitro-1, 3-propanediol . Chlorine and the commercial preparation showed bactericidal activity (53.5% and 98.2%, respectively) for a week after disinfection. Am Heart J, 1999 Aug, 138(2 Pt 2), S55 - 60 From plaque biology to clinical setting; Arbustini E et al.; Coronary atherosclerosis may cause acute and chronic ischemic syndromes; the former are caused by "acute plaque events," mostly thrombosis complicating vulnerable ruptured plaques, namely severe lesions with large core, thin cap, and weak shoulder infiltrated by activated inflammatory cells . Plaque rupture may also occur in nonischemic settings and is not obligatorily complicated by thrombosis . Furthermore, plaque rupture is not the only thrombus substrate in acute ischemic syndromes: Superficial erosion of fibrous plaques is found in 44% of acute thrombi in sudden coronary deaths and in 25% of those in acute myocardial infarctions . Coronary thrombosis appears to be triggered by superficial intimal inflammation in plaque ulceration and by neointimal hyperplasia in plaque erosion . "Endogenous" and, recently, exogenous factors, particularly infective intracellular organisms, have been proposed as major contributors to plaque inflammation, activation, and vulnerability . Possible exogenous triggers are DNA and RNA viruses and intracellular bacteria such as Chlamydia pneumoniae, which has been identified with microbiological, ultrastructural, immunohistochemical, and molecular tools in a consistent proportion of human plaque samples . Chlamydia increases local thrombogenicity and is associated with an atherogenic lipid profile . Systemic indexes of inflammation, such as PCR, SAA, and fibrinogen, are also increased in acute syndromes and common infectious diseases with high morbidity and minimal clinical impact are good candidates; Helicobacter pylori is a major one . Infectious agents could link local and systemic inflammation: White cells infected in its target tissue could circulate into the flow and be captured, on a specific local trigger, into vessel walls thus stimulating local inflammation. Int J Food Microbiol, 1999 May 1, 48(2), 87 - 96 Identities of the Pseudomonas spp . in flora from chilled chicken; Arnaut-Rollier I et al.; Nine broilers from each of two different broiler farms were collected at the slaughterhouse . Microbiological samples were collected from broiler chicken carcasses which were stored aerobically at 3+/-0.5 degrees C for 0, 3 or 8 days . By characterizing 40 colonies per broiler it was possible to evaluate the shift in psychrotrophic bacteria on the skin during cold storage . Most of these bacteria belong to the pseudomonads . The Shewan scheme was used in order to distinguish between four groups of pseudomonads . On fresh poultry group II pseudomonads were most abundantly represented, followed by group IV; group I and III strains were present in lower amounts . Non-fluorescing group II pseudomonads always predominated as spoilage became obvious (day 8) . By including 36 reference strains, numerical analysis based on the simple matching coefficient was performed on 180 representatively selected strains . This revealed that Pseudomonas species indeed predominated when spoilage was obvious . Non-fluorescing species were identified mainly as P . fragi, but also as other strains belonging to P . fluorescens biovars A, B, C and F, P . lundensis and cluster 7 strains (unidentified) . Microorganisms already substantially present on the fresh poultry were found in the highest numbers at the time of spoilage. Rev Argent Microbiol, 1999 Apr-Jun, 31(2), 82 - 6 {The mutagenic potential of the fungicide thiram}; Andres JA et al.; Chemical products used in agriculture require detailed formulation and knowledge on their mode of action and uses . This is essential for understanding the pesticide's biological behavior and also to establish safety criteria for humans and animals . At the present time, there are numerous studies concerning physical and chemical agents present in the media which increase the incidence of tumors . In this paper, we demonstrate the mutagenic capacity of the fungicide thiram, using the microbiological Ames test, at a concentration of 1 mg/ml active ingredient in the culture medium . Higher concentrations were lethal to the microorganisms used in the test. J Infect, 1999 May, 38(3), 191 - 2 Infection due to Absidia corymbifera in a patient with a massive crush trauma of the foot; Scalise A et al.; We report the case of a patient with a massive crushing trauma of the right foot who developed a local infection due to Absidia corymbifera . Systemic and local antifungal therapy with ketoconazole associated with hyperbaric oxygen therapy (HBO) yielded a rapid clinical and microbiological resolution . Controlled clinical studies are warranted to further elucidate the potential utility of HBO/antifungal combination therapy. Chest, 1999 Jul, 116(1), 107 - 14 Bacteremic pneumococcal pneumonia in HIV-seropositive and HIV-seronegative adults; Feldman C et al.; STUDY OBJECTIVES: To compare the demographic, clinical, laboratory, and microbiological data, and the hospital course and outcome of HIV-seropositive and HIV-seronegative adults with bacteremic pneumococcal pneumonia . DESIGN: Retrospective observation study conducted over a 2-year period . SETTING: Academic teaching hospital attached to the University of the Witwatersrand, Johannesburg, South Africa . PATIENTS: Consecutive patients with bacteremic pneumococcal pneumonia were identified on the basis of positive blood culture results . INTERVENTIONS: All available demographic, clinical, routine laboratory, radiographic, and microbiological data were recorded retrospectively for each of the patients, and the combined data for the HIV-seropositive patients were compared with those of the HIV-seronegative patients . MEASUREMENT AND RESULTS: A total of 112 patients (31 HIV-seropositive and 81 HIV-seronegative patients) were entered into the study . The HIV-seropositive patients were significantly younger than the HIV-seronegative patients (32.8 vs 39.6 years old) and had lower admission hemoglobin (11.8 vs 13.4 g/dL), WBC count (10.3 vs 14.3 x 10(9)/L), serum albumin (31 vs 36 g/L), sodium (129 vs 132 mmol/L), and potassium (3.0 vs 3.5 mmol/L), respectively . Although the HIV-seropositive patients appeared to have more multilobar pulmonary consolidation on the chest radiograph than the HIV-seronegative patients (60% vs 34%), this did not quite reach statistical significance . In addition, the HIV-seropositive patients had significantly more infections (48.4% vs 20.8%) with pneumococcal serogroups/serotypes (serogroups 6, 19, 23, and serotype 14) that are found more commonly in children, and they also had more penicillin-resistant isolates (13% vs 2.5%) than the HIV-seronegative patients, respectively . Similarly, it was noted that when these data were analyzed according to gender (irrespective of HIV status), women had significantly more infections than men (47% vs 21%) with serogroups/serotypes that are usually found in children, more penicillin-resistant isolates (15% vs 1%), and more co-trimoxazole-resistant isolates (21% vs 5%), respectively . There were no differences noted in any of the other parameters, including initial APACHE (acute physiology and chronic health evaluation) II score, PaO2/fraction of inspired oxygen ratio, duration of temperature, duration of IV therapy, duration of hospitalization, complications, and outcome, when comparing HIV-seropositive and HIV-seronegative patients . Two patients in each group died . CONCLUSIONS: The clinical features of bacteremic pneumococcal pneumonia are similar in HIV-seropositive and HIV-seronegative patients . Although differences are noted in various laboratory and microbiological parameters, they do not appear to have an impact on outcome. Eur J Gynaecol Oncol, 1999, 20(1), 69 - 73 Detection of viral and bacterial infections in women with normal and abnormal colposcopy; Pisani S et al.; Signs and symptoms of sexually-transmitted diseases (STD) do not allow any etiological diagnosis in women . Colposcopic findings are seldom pathognomic . Consequently, the microbiology laboratory with the recent availability of molecular diagnostic tools is required to detect the infectious bacterial and/or viral agents involved in STD . In cervical samples of women submitted to gynaecological screening for past or present signs and symptoms of inflammation and with different colposcopic findings, we searched by molecular approaches Chlamydia trachomatis, Mycoplasma genitalium, herpes simplex virus type 1 and 2, adenovirus and 45 genotypes of papillomaviruses and, by cultural methods Mycoplasma hominis and Ureaplasma urealyticum . Colposcopy permitted us to divide the studied population into three groups: 48 women had negative colposcopic findings, 50 presented signs of flogosis and 100 resulted positive for an abnormal transformation zone (ANTZ) and/or for HPV colposcopic findings . Results obtained by microbiological assays indicated that the prevalence of infectious agents did not always correlate with colposcopy . Double and triple infections were found in groups 2 and 3, with mycoplasmas being the most common microrganisms present in association and quite almost copresent with papillomaviruses. Ann Intern Med, 1999 Jul 20, 131(2), 112 - 6 Whipple endocarditis without overt gastrointestinal disease: report of four cases; Gubler JG et al.; BACKGROUND: Cardiac manifestations of Whipple disease are rarely diagnosed before death . OBJECTIVE: To describe four patients with endocarditis caused by Tropheryma whippelii who did not have overt gastrointestinal disease . DESIGN: Case series . SETTING: Five hospitals in eastern Switzerland . PATIENTS: Three men and one woman undergoing replacement of insufficient heart valves . MEASUREMENTS: Histologic characteristics of heart valves and intestinal biopsy; broad-range and specific polymerase chain reaction for T . whippelii . RESULTS: Tropheryma whippelii was found in the heart valves (three aortic valves and one mitral valve) of four patients with culture-negative endocarditis necessitating valve replacement . All patients had arthralgia for different lengths of time . Only one patient had mild gastrointestinal symptoms . Histologic characteristics of intestinal mucosa were normal in all patients, and polymerase chain reaction on intestinal biopsy was positive for T . whippelii in only one patient, who did not have diarrhea . In all patients, arthralgia resolved promptly after institution of antibiotic therapy . Disease did not recur in any patient after prolonged antibiotic therapy with cotrimoxazole . CONCLUSION: In patients with culture-negative endocarditis, the absence of clinical, microscopic, or microbiological evidence of gastrointestinal disease did not rule out T . whippelii. Br J Dermatol, 1999 Jul, 141(1), 94 - 102 A high prevalence of cytomegalovirus antigenaemia in patients with moderate to severe chronic plaque psoriasis: an association with systemic tumour necrosis factor alpha overexpression; Asadullah K et al.; Microbiological aspects are considered to be of pathophysiological importance in psoriasis, but there has so far been no information regarding cytomegalovirus (CMV) infection . This is of interest due to the high prevalence of latent infection in the general population, the frequent reactivation in inflammatory diseases, and the immunomodulating capacity of CMV . To detect active infection we analysed CMV antigen expression of peripheral blood mononuclear cells (PBMC) from psoriatic patients (n = 30) in comparison with healthy volunteers (n = 65) . Using three monoclonal antibodies and immunocytological staining (alkaline phosphatase-antialkaline phosphatase technique), we frequently found CMV antigenaemia in psoriasis (43%) compared with healthy laboratory staff (12%, P < 0 . 01) and blood donors (6%, P < 0.001) . Clearance of CMV antigenaemia was observed with antipsoriatic treatment . CMV antigenaemia was symptomless, and was associated with seropositivity for anti-CMV IgG but not IgM antibodies, indicating subclinical activation of latent infection . Serological investigations in 85 psoriatic patients gave no evidence for a higher prevalence of latent CMV infection . In psoriatic lesions, CMV DNA was only rarely detected by polymerase chain reaction . As it has been shown that tumour necrosis factor (TNF)-alpha can induce CMV reactivation, we determined TNF-alpha plasma concentrations and mRNA expression in PBMC from psoriatic patients . Elevated TNF-alpha levels were found and correlated with the frequency of CMV antigen-expressing PBMC, suggesting a critical role of TNF-alpha in CMV activation . We speculate that active, subclinical CMV infection may be of pathophysiological importance in psoriasis. Eur J Clin Microbiol Infect Dis, 1999 May, 18(5), 341 - 5 Evaluation of a single-sample serological technique for diagnosing pertussis in unvaccinated children; Wirsing von Konig CH et al.; This study was performed to evaluate the sensitivity of immunoglobulin (Ig)G and IgA antibodies to pertussis toxin and filamentous hemagglutinin in diagnosing pertussis from a single serum sample . The pertussis group was defined according to the World Health Organization pertussis case definition . The control group coughed for 21 days or more but had no microbiological or serological evidence of Bordetella infection . Both cohorts were divided into infants (< 12 months of age), toddlers (1-4 years) and school children (5-10 years) . There were 525 subjects in the pertussis group and 321 in the control group, with an even distribution of genders . IgG and IgA antibodies to pertussis toxin and filamentous hemagglutinin were measured in a standardized enzyme immunoassay . Antibody levels beyond the 95 percentile of the control cohort were regarded as indicative of recent contact, setting the specificity level at 0.95 . Acute serum samples drawn between 1 week and 3 weeks after the onset of coughing showed a low sensitivity (2-19%) for diagnosing pertussis . In convalescent samples taken 5-10 weeks after the onset of symptoms, detection of IgG anti-pertussis toxin was the best single test, with a sensitivity of 61%, 65%, and 74% in infants, toddlers and school children, respectively . A combination of IgG anti-pertussis toxin and IgA anti-filamentous hemagglutinin using age-specific reference values had a sensitivity of 81-89% in diagnosing pertussis from a single serum sample taken 5-10 weeks after the beginning of symptoms. Probl Tuberk, 1999, (2), 39 - 42 {Detection and characteristics of rpoB gene mutations in rifampicin-resistant clinical strains of M . tuberculosis}; Generozov EV et al.; The resistance of M . tuberculosis to rifampicin, one of the key agents used in the treatment of tuberculosis is due to point mutations in the rpoB gene encoding for the B-subunit of PNA polymerase . Based on the detection of such mutations, genotypic determinations of rifampicin resistance is a serous alternative to routine microbiological assays that take much more time . Nevertheless, the efficiency of genotypic methods largely depends how completely the resistance-associated mutations are studied and characterized . It is shown that the types and detection rates of certain rpoB mutations can greatly vary in the Mycobacterium strains spread in different geographical regions . By applying the approach based on the direct sequencing of PCR with rpoB gene fragments, the present paper analyzed 48 rifampicin-sensitive and 52 rifampicin-resistant clinical M . tuberculosis strains provided by Moscow tuberculous control facilities . Mutations responsible for rifampicin resistance were detected in 51 (98%) of the 52 resistant strains . The mutations involving codons 531 (46%), 526 (23%), and 516 (23%) of the rpoB gene were proved to be dominant . An unusual double mutation combining the replacement of F by L in codon 514 and previously uncharacterized methionine deletion in the position 515 was detected in the single investigated strain . The efficiency of the employed approach for rapid diagnosis of rifampicin-resistant M . tuberculosis strains is discussed. Ophthalmologica, 1999, 213(4), 250 - 7 Topical lomefloxacin 0.3% twice daily versus tobramycin 0.3% in acute bacterial conjunctivitis: A multicenter double-blind phase III study; Gallenga PE et al.; AIMS/BACKGROUND: To evaluate in a double-masked comparative, prospective, randomized multicenter trial the efficacy of lomefloxacin 0.3% eye drops twice daily and of tobramycin eye drops 4 times daily in patients with acute bacterial conjunctivitis . METHODS: Ninety-nine subjects were enrolled: 50 were treated with lomefloxacin 0.3% eye drops twice daily and 49 with tobramycin 0.3% eye drops 4 times daily . In all patients, conjunctival swabbing and assessment of objective signs and of subjective symptoms were performed . RESULTS: There was no statistical difference for any individual sign or symptom or for the sum score of either key or other signs and symptoms at any of the examination days . The sum score of both key and other signs and symptoms decreased in both groups at day 3-4 as compared to baseline values (p < 0.0001) . The decrease in both these scores continued significantly from day 3-4 to day 7-8 (p < 0.05) and was similar in the two treatment groups (p > 0.4) . The lowest resistance rate was seen in lomefloxacin (3.5%) and in neomycin (7.0%), while tobramycin showed resistance in 10 out of 88 resistance strains (11.4%) . CONCLUSION: Both lomefloxacin 0.3% twice daily and tobramycin 0.3% administered 4 times daily were well tolerated and showed a high degree of clinical and microbiological efficacy in the treatment of acute bacterial conjunctivitis . Lomefloxacin caused less resistance than other antibiotics evaluated. Klin Oczna, 1999, 101(2), 119 - 21 {Therapeutic contact lenses in infant corneal ulcerations}; Koraszewska-Matuszewska B et al.; PURPOSE: We present our own results of treatment in corneal ulcerations with therapeutic contact lenses in 4 infants aged between 3 days to 5 weeks . MATERIAL AND METHODS: Four patients (5 eyes) with deep corneal ulcerations of various origin were treated with soft contact lenses at the Clinic of Pediatric Ophthalmology in Katowice . All eyes received one type of the therapeutic lens . Contact lenses were worn between 8 and 21 days . After application of contact lenses pharmacological therapy was used individually for each patient, according to the result of microbiological tests . RESULTS: All patients were successfully cured . A scar of cornea was observed only in one infant because the contact lens had been used too late . Four infants had no corneal haze after the treatment . CONCLUSION: The best results were obtained using the contact lenses early, during the first days of treatment . Contact lenses caused decreasing of pain and reduced application of medicines . They were a good protection for injured cornea. Eur Radiol, 1999, 9(6), 1066 - 77 Spinal infection; Tyrrell PN et al.; Spinal infection is a significant cause of morbidity . Despite advances in antibiotic treatment regimens, the incidence is not decreasing due at least in part to an increase in 'at-risk' populations, namely the elderly and the immunocompromised . Prompt diagnosis is greatly facilitated by early and appropriate imaging techniques together with microbiological assessment following culture from blood, needle aspirate and biopsy material . This article gives an overview of imaging of spinal infection with an emphasis on MR imaging, which has greatly contributed to early diagnosis, thus allowing implementation of timely appropriate treatment. Hum Pathol, 1999 Jul, 30(7), 874 - 9 Fatal Chaetomium cerebritis in a bone marrow transplant patient; Thomas C et al.; The number of opportunistic infections in the central nervous system (CNS) has been steadily increasing because of a rising number of immunocompromised patients . A rare form of CNS infection can be caused by Chaetomium species, one of the largest genera of saprophytic ascomycetes . The CNS lesions in the present case were caused by Chaetomium atrobrunneum . The main characteristic of almost all Chaetomium species is presence of hairs or setae covering the ascomata . Microbiological studies are the only definitive way to correctly identify this fungal organism . The rapid evolvement of the cerebral infection suggests that the brain tissue provides a favorable environment for growth and proliferation of these fungi . This is the second documented case of a fatal brain abscess caused by Chaetomium atrobrunneum, and the first case report in a bone marrow transplant patient. Eur J Epidemiol, 1999 Apr, 15(4), 389 - 93 Prevalence and clinical relevance of Blastocystis hominis in diverse patient cohorts; Cirioni O et al.; The pathogenicity of Blastocystis hominis is extensively debated in the medical literature . Therefore, we did a prevalence study to investigate the association between the presence of several intestinal parasites and gastrointestinal symptoms in diverse patient cohorts . The study population consisted of 1216 adults, including immunocompromised patients, institutionalized psychiatric or elder subjects, immigrants from developing countries, travellers to developing tropical countries and controls . Several variables for each risk group were considered . Stools specimens, collected in triplicate, were processed by the same technicians . Clinical data about each subject were provided by standardized questionnaires . The presence of gastrointestinal symptoms were related to the presence of any parasite . In addition, on the basis of microbiological results, five subgroups of subjects were evaluated . The results showed a high prevalence of parasites in all the risk groups . Immunocompromised status, recent arrival from developing countries and the presence of behavioural aberrations were significantly related to presence of parasites . B . hominis was the parasite most frequently detected in each studied group . B . hominis showed a significant correlation with gastrointestinal symptoms only when detected in the group including subjects with a severe immunodepression . Immunodepression seems to be a factor of primary importance of the pathogenic role of B . hominis. J Clin Periodontol, 1999 Jul, 26(7), 453 - 60 Differences in the inflammatory response in young and old human subjects during the course of experimental gingivitis; Fransson C et al.; The aim of the present experiment was to study changes in (i) the composition of the inflammatory cell infiltrates and (ii) levels of alpha 2-macroglobulin, lactoferrin and IgG subclasses in gingival crevicular fluid in young and old individuals during 3 weeks of plaque formation . To establish healthy gingival conditions, all subjects received professional tooth cleaning during a 4 week pre-experimental period . The experimental sites included the mesio-palatal, palatal, and disto-palatal surfaces of all teeth present in the 15...25 tooth region . At baseline (day 0) assessments of plaque and gingivitis, microbial sampling and gingival fluid assessment were performed and one gingival biopsy harvested from each subject . Following the baseline examination, the participants abolished mechanical tooth cleaning measures in the palatal and approximal surfaces of 15...25 . The clinical examination and the gingival fluid measurement were repeated on days 7, 14 and 21 of no oral hygiene . The microbiological sampling and the biopsy procedure were repeated on days 7 and 21 . The gingival crevicular fluid samples harvested from the old individuals had higher levels of alpha 2-macroglobulin and IgG3 compared to young subjects . The immunohistochemical analyses of the biopsies demonstrated that the gingival lesion representing the old individuals harbored a higher proportion of B-cells and a lower density of PMN cells compared to the infiltrate in the young group of subjects . It is suggested that differences exist in the inflammatory response to de novo plaque formation in young and old individuals. Pathologe, 1999 May, 20(3), 200 - 3 {The Chemnitz Pathologic-Hygienic Institute and its leader from 1898 to 1998}; Kunzel W; The 100-year-history of Pathological Anatomy in Chemnitz is described by edification and fall of its buildings as well as the main dates of its leaders . From these the founder of the institute Coelestin Nauwerck, his most important disciple Martin Staemmler and the newfounder after the 2nd world war Walther Panofsky are especially mentioned . The article also refers to the involvement of Staemmler in Nazism and the injury done to Panofsky by it . The importance of the microbiological-hygienical departure during a long period is accented. J Clin Microbiol, 1999 Aug, 37(8), 2479 - 82 PCR and blood culture for detection of Escherichia coli bacteremia in rats; Heininger A et al.; Critically ill patients often develop symptoms of sepsis and therefore require microbiological tests for bacteremia that use conventional blood culture (BC) techniques . However, since these patients frequently receive early empirical antibiotic therapy before diagnostic procedures are completed, examination by BC can return false-negative results . We therefore hypothesized that PCR could improve the rate of detection of microbial pathogens over that of BC . To test this hypothesis, male Wistar rats were challenged intravenously with 10(6) CFU of Escherichia coli . Blood was then taken at several time points for detection of E . coli by BC and by PCR with E . coli-specific primers derived from the uidA gene, encoding beta-glucuronidase . In further experiments, cefotaxime (100 or 50 mg/kg of body weight) was administered intravenously to rats 10 min after E . coli challenge . Without this chemotherapy, the E . coli detection rate decreased at 15 min and at 210 min after challenge from 100% to 62% of the animals with PCR and from 100% to 54% of the animals with BC (P, >0.05) . Chemotherapy decreased the E . coli detection rate at 25 min and at 55 min after challenge from 100% to 50% with PCR and from 100% to 0% with BC (P, <0.05) . Thus, at clinically relevant serum antibiotic levels, PCR affords a significantly higher detection rate than BC in this rat model . The results suggest that PCR could be a useful adjunct tool supplementing conventional BC techniques in diagnosing bacteremia. Acta Ophthalmol Scand, 1999 Jun, 77(3), 277 - 8 Corneal transplantation with donor tissue kept in organ culture for 7 weeks; Ehlers H et al.; PURPOSE: To study the fate of corneal grafts after extended organ culture (7 weeks) . METHODS: Six patients with symmetrical eye diseases were grafted bilaterally, in one eye with a cornea prepared by routine organ culture (mean 16 days), in the other eye with a donor cornea kept for 7 weeks (mean 49 days) in organ culture . The outcome was evaluated by biomicroscopy, graft thickness, endothelial cell density and visual performance after an observation time of at least 1 year . RESULTS: Penetrating 7-8 mm grafting was uncomplicated in all cases . The endothelial densities were in both groups in the range 1000-2000 cells/mm2, and visual acuity 0.2-0.9 in cases with no other ocular pathology . Postoperative graft thickness and deswelling did not differ between 2- and 7-week cultured corneas . At final examination the thicknesses were 0.50 mm and 0.49 mm for 2- and 7-weeks cultured corneas . CONCLUSION: Seven-week cultured corneas give clinical results comparable to those obtained using shorter culture periods . An extended culture period may be used to improve other qualities of the graft (compatibility, cell number, cell metabolism) and microbiological control. J Clin Microbiol, 1999 Aug, 37(8), 2737 - 9 Destructive knee joint infection caused by Peptostreptococcus micros: importance of early microbiological diagnosis; Riesbeck K et al.; Peptostreptococcus micros is a commensal of the oral cavity and the genitourinary tract that rarely causes serious infections . A case of a destructive knee joint infection with rapid progress caused by P . micros is presented . The significance of the microbiological findings was initially not acknowledged, which contributed to a nonsuccessful clinical outcome. Soc Sci Med, 1999 Jun, 48(12), 1833 - 50 Disease and immunity in the pre-Spanish Philippines; Newson LA; It is generally asserted that Filipino populations did not suffer the same demographic collapse that followed Spanish conquest in the Americas because they had previously acquired immunity to Old World diseases through trading contacts with Asia . This assertion is examined by trying to establish which diseases were present in the islands in pre-Spanish times and whether populations there could have acquired immunity to them . This is done through an analysis of the evidence for the presence of infections in China and Japan in particular and the existence of trading contacts with and between the Philippine islands . The likelihood of immunity being acquired is addressed first through a discussion of the physical and human geography of the islands and what is known of the epidemiology of individual diseases from modern scientific research . Second, it reviews evidence from early colonial documents and Filipino dictionaries for the presence and impact of Old World diseases in the early colonial period . The study suggests that Filipino populations had not acquired significant immunities to acute infections in pre-Spanish times, and that their limited demographic impact in the colonial period derived more from the particular geography of the islands . It suggests that in terms of its disease history, the Philippines had more in common with the Pacific islands than mainland Asia, and that the microbiological boundary between the Old World and the New is better conceived of as a broad zone. Poult Sci, 1999 Jul, 78(7), 1065 - 73 The effect of evaporative air chilling and storage temperature on quality and shelf life of fresh chicken carcasses; Mielnik MB et al.; The effect of evaporative air chilling on quality of fresh chicken carcasses was compared with air chilling as reference method . Cooling efficiency and total heat loss were significantly higher for evaporative air chilling . The chilling method was of great importance for weight loss . Chicken chilled in cold air lost considerably more weight than chicken cooled by evaporative air chilling; the difference was 1.8% . The chilling method also affected the skin color and the amount of moisture on skin surface . After evaporative air chilling, the chicken carcasses had a lighter color and more water on the back and under the wings . The moisture content in skin and meat, cooking loss, and pH were not affected by chilling method . Odor attributes of raw chicken and odor and flavor attributes of cooked chicken did not show any significant differences between the two chilling methods . The shelf life of chicken stored at 4 and -1 C were not affected significantly by chilling method . Storage time and temperature appeared to be the decisive factors for sensory and microbiological quality of fresh chicken carcasses. J Thorac Imaging, 1999 Jul, 14(3), 185 - 93 Thoracic computed tomography of patients infected with the human immunodeficiency virus: relevance for the course of disease; Knollmann FD et al.; To determine the diagnostic accuracy and prognostic implications of thoracic computed tomography (CT) in patients with human immunodeficiency virus infection (HIV), CT scans of 154 HIV-infected patients (mean age, 41 years; range 23-65 years; 18 female) with suspicion of pulmonary disease were retrospectively reviewed for signs of disease by two investigators blinded to clinical data other than positive HIV serology . Abnormal CT features were correlated with CD4-T lymphocyte count, histologic or microbiologic diagnosis, and survival . Computed tomography detected features of pulmonary disease in 133 patients . A recent chest film was available in 96 patients, and it was normal in 16 . In 17 of 99 patients (17%) with histologic or microbiologic correlation, pathologic CT features could be demonstrated, though histologic and microbiological studies were unrevealing . Median survival was 649 days . Confluent pulmonary infiltrates and bilateral masses on CT indicated advanced disease with a median survival of 115 days (n = 11, p = 0.0005) and 174 days (n = 15, p < 0.0001), respectively . The authors concluded that thoracic CT detects pulmonary lesions in an appreciable portion of HIV-infected patients in whom chest radiographs, microbiologic methods, or histology failed to establish a diagnosis, and that CT findings allow for an estimation of patient survival in acquired immunodeficiency syndrome. Diagn Microbiol Infect Dis, 1999 Jul, 34(3), 229 - 43 Epidemiology and diagnosis of Shiga toxin-producing Escherichia coli infections; Karch H et al.; Shiga toxin-producing Escherichia coli (STEC) have been identified as a worldwide cause of serious human gastrointestinal disease and the life-threatening hemolytic uremic syndrome . The most common serotype implicated is E . coli O157: H7, but infections involving various non-O157 serotypes have been found with increasing frequency in many countries . Food-borne outbreaks caused by STEC can affect large numbers of people and cause serious morbidity, making the bacteria one of the most important emerging pathogens . Because there is no specific treatment of the disease currently available, there is an urgent need for effective preventive measures based on a detailed understanding of the epidemiology of STEC infections . Such measures will also be dependent on the availability of rapid, sensitive, and simple procedures for the detection of the pathogens both in human samples and in samples of nonhuman origin such as food . This review summarizes the current knowledge on the epidemiology of STEC infection and presents a survey of laboratory methods currently available for diagnosis of STEC . Special attention is given to new diagnostic procedures for the less readily detectable non-O157 STEC strains and to simple procedures, usually based on commercially available kits, that can be used in routine clinical microbiological laboratories. Diagn Microbiol Infect Dis, 1999 Jul, 34(3), 199 - 204 Controversies on diagnosis and prevention of ventilator-associated pneumonia; Bonten MJ; Ventilator-associated pneumonia (VAP) is the most frequent infection among intensive care patients . There is a great deal of controversy about the methods for diagnosis and prevention of this infection . VAP is usually diagnosed on a combination of clinical, microbiological, and radiographic criteria . Although these criteria have a high sensitivity, specificity is low, resulting in unnecessary antibiotic use in many patients . Bronchoscopic techniques, suh as protected specimen brush and bronchoalveolar lavage, in combination with quantitative culture techniques, do have a higher specificity . However, whether implementation of these techniques influences patient care, and to what costs, remains to be determined . Prevention of VAP relies on basic infection control practices . Many specific strategies interfering with colonization routes have been studied . So far, only the use of topical nonabsorbable antibiotics, either of the whole digestive tract or the oropharynx only, consistently reduced the incidence of VAP . However, the effects on patient survival were disappointing and the possibility of selection of antibiotic-resistant bacteria limit the widespread use of these strategies. Commun Dis Public Health, 1999 Jun, 2(2), 101 - 7 A study of infectious intestinal disease in England: plan and methods of data collection; Sethi D et al.; The Committee on the Microbiological Safety of Food, set up in 1989 by the Department of Health in response to national epidemics of foodborne infection, considered the available evidence and commissioned a study of infectious intestinal disease (IID) in England . Seventy practices (with 489,500) patients overall) recruited from the Medical Research Council's General Practice Research Framework between August 1993 and January 1995 collected data for one year . The practice populations were representative of practices in England by area and urban/rural location, but with fewer small and affluent practices . There were five main components . i) A population cohort of 9776 (40% of those eligible) were enrolled to estimate the incidence and aetiology of IID in the community, and a large proportion were followed up . A median of 10% of patients on practice age-sex registers had moved away or died . ii) A nested case control component based on cases ascertained in the cohort was used to identify risk factors for IID in the community . iii) In a case control component used to identify risk factors and to estimate the incidence and aetiology of IID presenting in 34 general practices 70% of the 4026 cases returned risk factor questionnaires, 75% submitted stools, and matched controls were found for 75% of cases . iv) An enumeration component was used to estimate the incidence of IID presenting to general practitioners (GPs) in 36 practices and the proportion of specimens sent routinely for microbiological examination . v) In a socioeconomic costs component used to estimate the burden of illness of IID in the community and presenting to GPs 63% of those who returned a risk factor questionnaire also returned a socioeconomic questionnaire and were representative by age, sex, and social class . Despite variable enrolment and compliance the study sample had sufficient power for the multivariable analysis . The characteristics associated with low enrollment and compliance must be considered in the interpretation of the main study results. Commun Dis Public Health, 1999 Jun, 2(2), 96 - 100 Weekly Returns Service of the Royal College of General Practitioners; Fleming DM; General practitioners in 69 practices in England and Wales monitor the spread of epidemic diseases in the community through the Weekly Returns Service (WRS) of the Royal College of General Practitioners, which has existed for over 30 years . Participating general practitioners summarise diagnoses and consultation/episode type (new episodes/ongoing consultations) for a defined population (currently about 570,000) and data are extracted to provide the 'weekly return', which includes age specific weekly incidence of new episodes of selected illnesses . The service has been used extensively to measure the burden of influenza and total acute respiratory illness in the community and the impact of enteric infections . It also provides information about illnesses for which there are no other major data sources--for example, chickenpox, scabies, and (historically) mumps . The entire network is electronically linked . Direct links with microbiological laboratories are being forged in order to integrate clinical and microbiological data in defined populations. Laryngoscope, 1999 Jul, 109(7 Pt 1), 1084 - 7 Anti-endothelial autoantibodies in patients with sudden hearing loss; Ottaviani F et al.; OBJECTIVES/HYPOTHESIS: Sudden hearing loss (HL) can be caused by autoimmune disorders localized to the inner ear or secondary to systemic immune diseases . Studies in autoimmune animal strains showing HL have reported changes in the cochlear stria vascularis . The authors investigated the presence of antiendothelial cell antibodies (AECA) to see if immune-mediated vasculitis may play a role in human sudden HL . STUDY DESIGN: A prospective study in patients with sudden HL . METHODS: Fifteen consecutive patients (mean age, 32 y) affected by sudden HL and 14 normal subjects were included . Patients with familial deafness and metabolic diseases were excluded . Extensive audiovestibular, imaging, microbiological, immunological, and routine examinations were performed . AECA were detected on rat kidney tissue sections on the sera collected at -20 degrees C . RESULTS: AECA were positive in 8 of 15 patients (53%) (2 of 5 men and 6 of 10 women), thus differing significantly from the normal control population, in which only 2 of 14 tested AECA positive (P = .023) . CONCLUSIONS: In patients with sudden HL, immune-mediated vascular damage can have a pathogenetic role and AECA might represent a serological marker of vasculitis. J Dent, 1999 Aug, 27(6), 449 - 54 Ion release from orthodontic appliances; Staffolani N et al.; OBJECTIVE: The microbiological and enzymatic characteristics of the oral cavity would seem to provide a suitable environment for the corrosion of metals . We assayed the release of metal ions from one orthodontic appliance which included two 304 and 316 steel molar bands, ten 316 steel brackets, one nickel-titanium archwire and a brazing alloy to connect the elements of molar bands and brackets . METHODS: The orthodontic appliance was dipped in both inorganic (pH 3.5-6.5) and organic acid solutions (w/v 1% each of tartaric, citric and ascorbic acid at pH 2.2 or 1.5% each of lactic and acetic acid at pH 2.5) . The release of nickel (Ni), chromium (Cr), copper (Cu), silver (Ag) and palladium (Pd) was determined using an atomic absorption spectrophotometer Varian AA 10 . RESULTS: The release of Ni, Cr and Cu was markedly less at pH 6.5 than at pH 3.5 at all time points in acid solution . Daily release/single appliance after the first day decreased . Contrary to expectations, appliances immersed in organic acid solutions at pH 2.2 or 2.5 after 28 days generally released an amount of ions similar to that observed in inorganic acid solution at pH 3.5, with the exception of Cu . Release of silver and palladium, two metals present in the brazing alloy, proved to be very low (approximately 0.2 microgram after 28 days) . CONCLUSIONS: The daily release of Ni, Cu and Cr by an orthodontic appliance in acid pH, particularly favourable to corrosion, was well below that ingested with a normal daily diet . It is therefore concluded that the quantities of metal ions released in our experimental conditions should not be cause for concern in utilising the appliance. Med Pediatr Oncol, 1999 Aug, 33(2), 95 - 8 Role of surgical biopsies in the management of bone marrow transplant patients; Arul GS et al.; BACKGROUND: Bone marrow transplantation (BMT) patients frequently develop life-threatening problems that have similar clinical presentations but differing aetiologies . Despite intensive investigation by haematological, biochemical, and microbiological means, accurate diagnosis is not always possible . Histological and microbiological examination of biopsies from the affected organ may be indicated to enable an accurate diagnosis to be made in these patients . Here we assess the indications, findings, and outcomes in patients who have required surgical biopsy after BMT . PROCEDURE: We retrospectively reviewed all BMT patients who had surgical biopsies between February 1994 and January 1997 . Twenty-six patients (1-46 years, median age 10 years) underwent 40 biopsies from the upper and lower GI tract, lung, or liver . Indications for BMT were: relapsed leukaemia = 18; other types of leukaemia = 3; aplastic anaemia=3; other diseases = 2 . Type of BMT: matched related donor = 3, unrelated T-cell depleted donor = 23 . RESULTS: Eleven (42%) cases had a change in management; 4 (16%) patients avoided further aggressive therapy because of poor prognosis . Unexpected diagnoses were found in 7 biopsies: 1 acute colitis, 1 duodenal ulcer, 1 liver aspergilloma, 2 transfusion siderosis, 1 radiation fibrosis of the lung, and 1 cytomegalovirus infection of the lung . Three patients were noted to have complications after their procedure . CONCLUSIONS: Surgical biopsies for undiagnosed problems can be of benefit in the management of very sick patients who have received bone marrow transplantations . Despite the fact that these patients are so unwell, there is a low rate of complications related to surgery and anaesthesia . J Periodontol, 1999 Jun, 70(6), 657 - 67 A 15-month evaluation of the effects of repeated subgingival minocycline in chronic adult periodontitis; van Steenberghe D et al.; BACKGROUND: A double-blind, randomized, parallel, comparative study was designed to evaluate the long-term safety and efficacy of subgingivally administered minocycline ointment versus a vehicle control . METHODS: One hundred four patients (104) with moderate to severe adult periodontitis (34 to 64 years of age; mean 46 years) were enrolled in the study . Following scaling and root planing, patients were randomized to receive either 2% minocycline ointment or a matched vehicle control . Study medication was administered directly into the periodontal pocket with a specially designed, graduated, disposable applicator at baseline; week 2; and at months 1, 3, 6, 9, and 12 . Scaling and root planing was repeated at months 6 and 12 . Standard clinical variables (including probing depth and attachment level) were evaluated at baseline and at months 1, 3, 6, 9, 12, and 15 . Microbiological sampling using DNA probes was done at baseline; at week 2; and at months 1, 3, 6, 9, 12, and 15 . RESULTS: Both treatment groups showed significant and clinically relevant reductions in the numbers of each of the 7 microorganisms measured during the entire 15-month study period . When differences were detected, sites treated with minocycline ointment always produced statistically significantly greater reductions than sites which received the vehicle control . For initial pockets > or =5 mm, a mean reduction in probing depth of 1.9 mm was seen in the test sites, versus 1.2 mm in the control sites . Sites with a baseline probing depth > or =7 mm and bleeding index >2 showed an average of 2.5 mm reduction with minocycline versus 1.5 mm with the vehicle . Gains in attachment (0.9 mm and 1.1 mm) were observed in minocycline-treated sites, with baseline probing depth > or =5 mm and > or =7 mm, respectively, compared with 0.5 mm and 0.7 mm gain at control sites . Subgingival administration of minocycline ointment was well tolerated . CONCLUSIONS: Overall, the results demonstrate that repeated subgingival administration of minocycline ointment in the treatment of adult periodontitis is safe and leads to significant adjunctive improvement after subgingival instrumentation in both clinical and microbiologic variables over a 15-month period. J Periodontol, 1999 Jun, 70(6), 646 - 56 One stage full- versus partial-mouth disinfection in the treatment of chronic adult or generalized early-onset periodontitis . II . Long-term impact on microbial load; Quirynen M et al.; BACKGROUND: Recent studies showed the clinical benefits of a one stage full-mouth disinfection, when compared to the worldwide standard treatment strategy of consecutive root planings per quadrant without proper disinfection of the remaining intraoral niches . The purpose of this study was to investigate the microbiological benefits of such a one stage full-mouth disinfection with special attention to all intraoral niches for periodontopathogens and to evaluate the perception by the patients of the new treatment strategy . METHODS: Sixteen patients with early-onset periodontitis and 24 patients with severe adult periodontitis were randomly assigned to test and control groups . The control group was scaled and root planed, per quadrant, at 2-week intervals and given oral hygiene instructions . The test group received the one stage full-mouth disinfection treatment . At baseline and after 1, 2, 4, and 8 months, microbiological samples were taken from all niches (tongue, mucosa, saliva, and pooled samples from single- and multi-rooted teeth) . The samples were cultured on selective and non-selective media . Patient perception of the treatment was evaluated using a questionnaire . RESULTS: In comparison to the standard therapy, the one stage full-mouth disinfection resulted in significant additional microbial improvements . The test group showed larger reductions in the proportions of spirochetes and motile organisms in the subgingival flora, and more significant reductions in the density of key pathogens, with even the eradication of P . gingivalis . The beneficial effects in the other niches were primarily restricted to the number of colony-forming units/ml of black-pigmented bacteria, especially on the mucosa and in the saliva and to a lesser extent on the tongue . Both treatments were well tolerated by the patients and the overall severity rating for both therapies was comparable, although 4 quadrants were treated within 24 hours in the test group versus only 1 in the control group . The full-mouth disinfection approach resulted more frequently in a slight increase of body temperature, especially after the second day . CONCLUSIONS: These findings support the benefit of a one stage full-mouth disinfection in the treatment of patients with either chronic adult or early-onset periodontitis. Analyst, 1998 Nov, 123(11), 2361 - 5 Detection of antibiotics in muscle tissue with microbiological inhibition tests: effects of the matrix; Okerman L et al.; The effects of the tissue matrix on detection limits of antibiotics with microbiological inhibition tests, intended for muscle tissue, were measured . Pieces of frozen meat were laid directly on top of paper disks impregnated with aqueous antibiotic solutions . Inhibition zones were compared with those obtained by the same standard solution without tissue . Only tetracyclines were detected as efficiently with as without muscle tissue . Inhibition zones of the beta-lactam antibiotics ampicillin and penicillin G, and the fluoroquinolone antibiotics enrofloxacin and ciprofloxacin were smaller when muscle tissue was added to low levels of standard solution . At higher levels the differences were not substantial . Inhibition zones of tylosin were smaller and irregular or had disappeared completely, while ceftiofur, sulfadimidine, erythromycin, lincomycin, and streptomycin were not detected in spiked muscle tissue at concentrations fivefold higher than the detection limits without tissue . These results indicate that ceftiofur, sulfonamides, streptomycin and some macrolide antibiotics cannot be detected in intact meat with the plates and bacterial strains prescribed in the European Four Plate Test, a test which was initially intended as a multi-residue method for muscle tissue . Two plates of this system are not suitable for screening purposes; a third one detects tetracyclines and beta-lactam antibiotics in spiked tissue; the fourth one is sensitive for beta-lactam antibiotics and for some but not all macrolides . Samples spiked with the fluoroquinolones enrofloxacin and ciprofloxacin can be detected with an additional plate, not included in the Four Plate Test. J Clin Pathol, 1999 Feb, 52(2), 118 - 23 An assessment of the histological criteria used to diagnose infection in hip revision arthroplasty tissues; Pandey R et al.; AIM: To characterise the number and nature of the inflammatory cells seen in cases of septic or aseptic loosening of hip arthroplasty, and to establish reliable histological criteria to distinguish between these two conditions . METHODS: Histological examination of paraffin sections of periprosthetic tissues (pseudocapsule, femoral and acetabular pseudomembranes) of 523 cases of aseptic loosening and 79 cases of microbiology culture proven septic loosening . The cellular composition of the inflammatory cell infiltrate was determined semiquantitatively . RESULTS: The finding of a 2+ or greater neutrophil polymorph infiltrate (one or more cells per high power field (x400) on average after examination of 10 fields) in arthroplasty tissues correlated strongly with the microbiological diagnosis of septic loosening: diagnostic sensitivity 100%, specificity 97%, accuracy 99%, positive predictive value 92%, negative predictive value 100% . The finding of a 3+ neutrophil polymorph infiltrate (five or more cells on average per high power field) had a diagnostic sensitivity of 72%, specificity 100%, accuracy 98%, positive predictive value 100%, and negative predictive value 97% . In some cases of septic loosening the finding of a heavy lymphocytic and plasma cell infiltrate was of low diagnostic sensitivity . A neutrophil polymorph infiltrate (generally less than one cell per 10 high power fields) was also seen in cases of aseptic loosening . CONCLUSIONS: The presence of 2+ or more (more than one neutrophil polymorph per high power field (x400) on average after examination of at least 10 high power fields) in periprosthetic tissues provides the most sensitive and accurate histopathological criterion for distinguishing between septic and aseptic loosening of hip arthroplasty. J Microbiol Methods, 1999 Jul, 37(1), 45 - 9 Hypothetical model for monitoring microbial growth by using capacitance measurements--a minireview; Noble PA; Microbiological impedance devices are used routinely by food and manufacturing industries, and public health agencies to measure microbial growth and metabolism . In this paper a hypothetical model explaining the effects of microbial growth and metabolism on capacitance at electrode-medium interfaces, that can be supported by fundamental theories and principles of electrochemistry, is presented . This model provides a framework to interpret changes in capacitance during microbial growth and metabolism and can be used to generate and test hypotheses on factors (i.e., temperature, microbial cell density, microbial growth and medium conductivity) contributing to increases or decreases in capacitance. Gig Sanit, 1999 May-Jun, (3), 15 - 7 {The sanitary microbiological and biochemical characteristics of the soils under the conditions of urbanization}; Naprasnikova EV et al.; The study of soils under technogenesis and urbanization has shown that their biogenic properties are preserved . Sanitary assessment of urban soils has demonstrated their moderate and severe pollution, bean plants being found to have self-purifying capacities in the soils. EDTNA ERCA J, 1998 Apr-Jun, 24(2), 52 - 7 Impacts on dialysis therapy; Passon S et al.; Improvement of clinical outcome of dialysis therapy is a task for everybody working in a dialysis unit . Here we consider dialysis conditions such as choice of treatment parameters and composition of dialysis fluid which may influence clinical outcome of dialysis therapy . Providing 'adequate' dialysis is the aim of the daily work of a dialysis nurse . Haemodialysis parameters with potential impact on dialysis adequacy are discussed with respect to quantification and optimisation . Every year, each patient comes in contact with 20,000 I dialysis fluid during HD treatment . The composition of the fluid, its physical and microbiological quality and their impact on clinical outcome are considered . The function of PD fluid is different from that of an HD fluid thus additional aspects have to be considered regarding its composition . Information is given how the composition and biocompatibility of PD solutions impact the dialysis therapy and how individual patient needs are considered. Pneumonol Alergol Pol, 1998, 66(11-12), 517 - 23 {Tuberculous lymphadenitis--diagnostic difficulties}; Snarska-Furla I et al.; Three cases of tuberculous lymphadenitis hospitalized in Department of Parasitology and Neuroinfection are presented . In all patients tuberculin test was positive . In 2 patients minimal lesions in lungs were present . In non patient BK in sputum was found . In microscopic picture of enlarged lymph nodes non specific inflammation granulomatosis was found but microbiological examinations were not done . In all patients the results of smears of lymph nodes pus were negative . In 2 patients culture was positive . Persistent enlarged peripheral lymphatic nodes, especially with fistula should be suspected of tuberculous etiology . Material obtained from node's biopsy should be taken to microbiological and histological examination. Semin Respir Infect, 1999 Jun, 14(2), 128 - 34 Microbiological investigations; Salo P et al.; Causative diagnosis of pneumonia is problematic . The lack of a reliable gold standard for diagnosis has also made the development of new diagnostic methods for different microbes causing pneumonia difficult . Serologic methods are continuously used in the diagnosis of pneumonia caused by viruses and atypical bacteria . However, rapid diagnostic methods are urgently needed to guide clinicians to choose proper antibiotic treatment because resistant bacteria are emerging in different parts of the world. J Appl Microbiol, 1999 Jun, 86(6), 962 - 70 Performance of open-fronted microbiological safety cabinets: the value of operator protection tests during routine servicing; Osborne R et al.; The performance of class I and II microbiological safety cabinets over 7 years, employed in a force-ventilated containment level 3 (CL-3) laboratory, is described . Operator Protection (OP) provided by the cabinets, assessed by still and latterly limited 'in-use' KI-Discus tests, showed no overall deterioration during the review period . Comparisons show that a selected class II unit, but not a second, and a new class II MSC in a recently commissioned, similar CL-3 facility, provide the same order of OP as a class I cabinet . From the experiences described, it is strongly recommended that OP tests (OPTs) should be part of the routine servicing regime to ensure that cabinets meet required performance levels, and additionally to allow detection and rectification of poor containment, particularly where induced by environmental factors . The value of OPTs is discussed with reference to certain national standards. Eur J Clin Microbiol Infect Dis, 1999 Apr, 18(4), 237 - 41 Prospective clinical and microbiological study of pleural effusions; Ferrer A et al.; A prospective clinical microbiological study of pleural fluid samples was conducted to investigate the etiology of pleural effusions and to evaluate two different methods for transport and culture of these samples . A total of 245 pleural fluid specimens were inoculated into a transport vial, an aerobic and an anaerobic blood culture vial, and a sterile tube . One hundred nine samples were from infectious patients and 128 from noninfectious patients . Gram stain had a sensitivity of 48% and a specificity of 100% as compared to culture . Of the total, 15.5% of the samples were positive for microorganisms, and 60% of the positive samples were nonpurulent pleural fluid . Single-organism growth was found in 23 samples (60.5%) . Sixty-three microorganisms were isolated: 25 (39.7%) aerobic, 22 (35%) anaerobic, 13 (20.6%) mycobacteria, and three (4.7%) fungi . Of the 25 positive samples, excluding those samples that grew mycobacteria, nine (36%) were positive exclusively in the blood culture vials . Twelve organisms were isolated, only one of which did not grow in the anaerobic vial . Two (8%) samples were positive by conventional culture only, and 14 (56%) were positive by both methods . The microorganism isolation rate obtained with use of blood culture vials was significantly greater than that obtained with the conventional method of transport and culture . Sixty-three percent of the empyema patients had an associated underlying pathology, pneumonia being the most frequent . In conclusion, for microbiological study of pleural fluid, it seems appropriate to inoculate all samples, including nonpurulent samples, into both a sterile tube and an anaerobic blood culture vial. Curr Opin Microbiol, 1999 Jun, 2(3), 317 - 22 DGGE/TGGE a method for identifying genes from natural ecosystems; Muyzer G; Five years after the introduction of denaturing gradient gel electrophoresis(DGGE) and temperature gradient gel electrophoresis (TGGE) in environmental microbiology these techniques are now routinely used in many microbiological laboratories worldwide as molecular tools to compare the diversity of microbial communities and to monitor population dynamics . Recent advances in these techniques have demonstrated their importance in microbial ecology. J Food Prot, 1999 Jun, 62(6), 625 - 31 Identification and control of processing variables that affect the quality and safety of fluid milk; Gruetmacher TJ et al.; The objective of this study was to increase quality and safety of fluid milk by eliminating postpasteurization contamination as measured by extended shelf life . Milk shelf life was defined as the number of days for standard plate count to reach 20,000 CFU/ml in milk stored at 7 degrees C . Sequential analysis of the fluid milk processing system indicated filling machine and pasteurizer were significant sources of postpasteurization contamination . Aseptically sampled milk from the pasteurizer outlet indicated a maximum shelf life of more than 30 days could be achieved . The pasteurizer can be a source of contamination when inadequately cleaned or maintained . The filling machine was a significant source of contamination . Shelf life of milk in 236-ml containers was reduced 20 days compared with milk sampled before the filling machine . Carton-forming mandrels, filling heads, and airborne microorganisms were sources of contamination within the filling machine . Eliminating sources of postpasteurization contamination and proper cleaning followed by sanitizing with chlorine significantly increased milk shelf life in paperboard containers to 20.4 days from an initial shelf life of 9 days . Changing the sanitizing agent to peroxyacetic acid significantly increased milk shelf life to 33.9 days . Enclosing the filling chamber and adding sterile laminar flowing air significantly improved microbiological quality of air inside the chamber and reduced variance among milk shelf life samples. Br J Surg, 1999 Jun, 86(6), 771 - 5 Uptake of tetracycline by aortic aneurysm wall and its effect on inflammation and proteolysis; Franklin IJ et al.; BACKGROUND: Proteolytic degradation of the aortic wall by matrix metalloproteinases (MMPs) is considered important in the pathogenesis of abdominal aortic aneurysms (AAAs) . Many of these MMPs are inhibited by tetracycline derivatives, which may have the potential to retard aneurysm growth . METHODS: Patients undergoing elective repair of an AAA (n = 5) received an intravenous bolus of tetracycline (500 mg) on induction of anaesthesia and levels of tetracycline in serum, aneurysm wall and mural thrombus were assessed by microbiological assay . In a separate series of patients (n = 7) aneurysm biopsies were placed into explant culture (with and without tetracyline) and the accumulation of protein, hydroxyproline, MMP-9, interleukin (IL) 6 and monocyte chemoattractant protein (MCP) 1 in the medium was assessed by colorimetric assay or immunoassay . RESULTS: At aortic cross-clamping the median concentration of tetracycline was 8.3 microg/ml in serum, 2.9 microg per g tissue in aortic wall and zero in mural thrombus . Tetracycline inhibited, in a concentration-dependent manner, both MMP-9 and MCP-1 secretion (P = 0.022 and P = 0.018 respectively), but did not alter hydroxyproline or IL-6 secretion . At the highest concentration of tetracycline (100 microg/ml) median MMP-9 secretion was reduced from 27 to 5 ng/ml (P = 0.007) and median MCP-1 secretion was reduced from 50 to 10 ng/ml (P = 0.008) . CONCLUSION: Tetracycline rapidly penetrates the aortic wall, but the concentration achieved may be insufficient to alter collagen turnover through limitation of MMP production or activity. J Food Prot, 1999 Jun, 62(6), 674 - 7 Assessment of the microbiological conditions of tails, tongues, and head meats at two beef-packing plants; Gill CO et al.; Newly skinned tails of beef carcasses at two packing plants were similarly contaminated with total aerobes and with coliforms that were largely Escherichia coli at log mean numbers about 3.5/cm2 and 4.5/100 cm2, respectively . The log mean numbers of aerobes and coliforms on the skinned tails after washing at plant A were, respectively, 1 and 2 log units less than the numbers on the newly skinned tails . At plant B, the log mean numbers of aerobes on skinned and on washed tails were similar while the log mean numbers of E . coli on washed tails were only about 1 log unit less than the numbers on skinned tails . Cooling of tails on racks in a chiller at plant B reduced the log mean numbers of E . coli by about 1 log unit but did not reduce the numbers of total aerobes . Tongues in the heads of carcasses at both plants were similarly contaminated with total aerobes and with coliforms that were largely E . coli at log mean numbers of about 4.5/cm2 and 4.5/100 cm2, respectively . The log mean numbers of aerobes on and the log total number of E . coli recovered from washed tongues were, respectively, about 2 and 4 log units less than for unwashed tongues at plant A and about 1 and 3 log units less than for unwashed tongues at plant B . The log mean numbers of aerobes and E . coli on washed cheeks and lips were both about 2 log units less than the numbers on unwashed tongues at both plants . With appropriate collection and washing procedures, the microbiological conditions of beef tails, tongues, and head meats can apparently be comparable to those of primal cuts and manufacturing beef at the times that the products are packed. J Clin Periodontol, 1999 Jun, 26(6), 335 - 40 Laboratory animal models in periodontology; Weinberg MA et al.; Animal models are needed to objectively evaluate the pathogenesis of human periodontal diseases and its various treatment modalities . Selection of the appropriate animal model depends on the similarity of the periodontium and the nature of the disease to that of humans . The more commonly used animal models for studying the pathogenesis of periodontal disease, use of implants and guided tissue regeneration have been dogs and nonhuman primates . Periodontal disease in rodents has not been found to be as closely related to the human varieties . Rats and hamsters are best suited for caries and calculus research . Ferrets may be a promising new model for studying periodontal disease and calculus formation . Variables unique to each animal species are manifested by a wide range of clinical and histopathological features . Different species have distinct diets, habits, life spans, tissue structures, host defense mechanisms and genetic traits . This article describes the diversity seen in animal models used to study microbiological, immunological, and clinical features of periodontal disease and its prevention and treatment. Radiat Res, 1999 Jul, 152(1), 71 - 5 Resuscitation of microorganisms after gamma irradiation; Pitonzo BJ et al.; Microbiological analysis of rock exposed to gamma-radiation doses between 0 and 9.34 kGy indicated that some microorganisms became viable but nonculturable (VBNC) and lost metabolic capacity as measured by BIOLOG microtiter plates . To investigate this phenomenon, portions of irradiated rock were placed at 4 degrees C for 2 months in an attempt to resuscitate the microbes to a culturable state . Culturable heterotrophs were enumerated and BIOLOG plates were used to determine the metabolic capability of the microbial community . Culturable bacteria that had previously been nonculturable were found at all doses . The number of colony types decreased from 26 in the nonirradiated control rock to between 9 and 10 in rock irradiated at doses ranging from 2.34 to 9.34 kGy . BIOLOG plates indicated partial recovery of metabolic capacity in all the samples tested . Fatty acid methyl ester analysis of the recovered isolates using the MIDI system (Microbial ID, Inc.) yielded three distinct groups of related bacteria . All resuscitated isolates clustered with the original nonirradiated isolates at the genus level, and 92% of them clustered at the species level . These results indicate that microbes were likely resuscitated from a VBNC state. J Antimicrob Chemother, 1999 Jan, 43(1), 153 - 5 The concentrations of clinafloxacin in alveolar macrophages, epithelial lining fluid, bronchial mucosa and serum after administration of single 200 mg oral doses to patients undergoing fibre-optic bronchoscopy; Honeybourne D et al.; The concentrations of clinafloxacin were measured in serum, bronchial mucosa, alveolar macrophages and epithelial lining fluid after single 200 mg oral doses of clinafloxacin had been administered to 15 subjects who were undergoing bronchoscopy . Concentrations were measured using a microbiological assay method . Mean concentrations in serum, bronchial mucosa, alveolar macrophages and epithelial lining fluid at a mean of 1.27 h post-dose were 1.54, 2.65, 15.60 and 2.71 mg/L respectively . These site concentrations exceeded the MIC90 for common respiratory pathogens and indicate that clinafloxacin is likely to be effective in the treatment of a wide range of respiratory tract infections. Recenti Prog Med, 1999 May, 90(5), 280 - 5 {Acute purulent meningitis: a clinical and therapeutic update}; Manfredi R; A brief overview of the epidemiological and microbiological profile of acute bacterial meningitis during late nineties is outlined, as a basis for an update of the most relevant diagnostic and therapeutic features of this disease, in the different life ages. Infection, 1999, 27 Suppl 1, S54 - 5 Silver catheter study: methods and results of microbiological investigations; Schoerner C et al.; Within the framework of the clinical study of the Erlangen silver catheter 104 silver catheters and 105 control catheters were tested by microbiological culture . This was done by rolling the catheter on a blood agar plate, washing the lumen through with tryptic soy broth (TSB) and, after ultrasound treatment, incubating the catheter tip in TSB as an enrichment culture for detecting very low bacterial counts . There was good agreement in the numbers of colony-forming units (CFU) detected by the roll plate and luminal washout cultures in 92% of the silver and 89% of the control catheters tested . Seventy-six (73%) of the 104 silver catheters showed no bacterial growth and 16 (15%) showed very low bacteria counts (< 15 CFU), or growth only after enrichment, which were attributed in both instances to catheter contamination . Twelve catheter tips (12%) showed significant bacterial counts greater than 15 CFU which were indicative of colonization or catheter-related infection . Corresponding results in the control catheters were 59 (56%), 28 (27%) and 18 (17%), respectively, a higher rate of infection or contamination which was statistically significant (chi-square test: P = 0.04). Eur J Gynaecol Oncol, 1999, 20(2), 127 - 30 Evaluation of the risk of cervical intraepithelial neoplasia and human papilloma virus infection in renal transplant patients receiving immunosuppressive therapy; Ozsaran AA et al.; OBJECTIVE: To investigate the risk of cervical intraepithelial neoplasia and the coexistence of human papilloma virus (HPV) infection in renal transplant patients receiving immunosuppressive therapy . MATERIALS AND METHODS: Cervical Papanicolaou (Pap) smear and colposcopic examinations were performed in 48 renal transplant patients receiving immunosuppressive therapy . Microbiological and histopathologic findings were discussed . RESULTS: The patients were evaluated as to cervical neoplasia risk factors and the results were found to be statistically insignificant (p>0.05) . Genital neoplasia was encountered in 20 of the 48 renal transplant patients . Koilocytosis developed in 6 out of 8 (75%) patients who were receiving high dose immunosuppressive therapy due to transplant rejection . HPV was found in 2 out of 48 patients; these 2 patients had koilocytosis in their cervical biopsies . The difference between the positive predictive value of colposcopic evaluation and the Pap smear was found to be insignificant (p>0.05) . However, if colposcopy had not been performed in two cases of cervical intraepithelial neoplasia class I (CIN-I) and in one case of cervical microinvasive carcinoma, the cases would have been incorrectly diagnosed as normal by the false-negative results of the Pap smear . CONCLUSION: Renal transplant patients who were undergoing immunosuppressive therapy were found to be at increased risk of developing cervical intraepithelial neoplasia . All the patients using immunosuppressive agents should be followed-up by Pap smears every six months and by colposcopic evaluation every year . Avoiding high-risk sexual acts will decrease the risk of HPV transmission and the risk of genital neoplasia as well. Folia Med (Plovdiv), 1998, 40(4), 45 - 7 A case of Chlamydia trachomatis infection in a renal allograft patient; Dimitrakov J et al.; We describe a renal allograft patient with a Chlamydia trachomatis infection . A 43 year-old man was diagnosed with end-stage renal disease in 1985 which necessitated the transplantation of a cadaver kidney in 1986 . The kidney was rejected two years later . A second transplantation was performed in 1991 . At the beginning of 1998 symptoms and signs of chronic renal failure and dysuria set in . Routine microbiological studies were negative . Cell culture on McCoy cell line was positive for an active infection with C . trachomatis--initially 3+, then 2+, 1+ and negative following treatment . The patient was positive on the AMPLICOR CT/NG test (Roche Diagnostic Systems, Branchburg, USA) twice with OD values OVER--above 2 at 450 nm wavelength measured on an ELISA reader . The patient received treatment with azithromycin and doxycycline for 10 days following which the serum creatinine levels fell and the creatinine clearance values improved . Dynamic microbiological follow-up showed disappearance of C . trachomatis as evidenced by the negative PCR test . We conclude that the deterioration of renal function in our patient is complex but the infection with C . trachomatis is part of the complex of the underlying chronic renal failure and immunosuppressive treatment. Infect Dis Obstet Gynecol, 1999, 7(3), 128 - 32 Circulating heat shock proteins in women with a history of recurrent vulvovaginitis; Giraldo PC et al.; OBJECTIVE: Predisposing factors influencing recurrences of bacterial vaginosis (BV) or vaginitis from Candida remain unidentified for most women . As a component of studies to determine host susceptibility factors to genital tract infections in women, we measured expression of the 60-kDa and 70-kDa heat shock proteins (hsp60 and hsp70, respectively) in the circulation of women with or without a history of recurrent BV or candidal vaginitis and with or without a current lower genital tract infection . Heat shock protein expression is associated with a down-regulation of pro-inflammatory immune responses that would inhibit microbial infection . METHOD: The investigators measured hsp60 and hsp70, antibodies to these proteins, the pro-inflammatory cytokine tumor necrosis factor-alpha (TNF-alpha), and the anti-inflammatory cytokine interleukin-10 (IL-10) in sera by ELISA . The study population consisted of 100 women who attended a gynecology clinic in Campinas, Brazil . Of those, 55 had a history of recurrent vulvovaginitis (RV), while 45 were controls with no such history . Only women who were asymptomatic for at least 1 month were studied . RESULTS: Although all were asymptomatic, clinical and microbiological examination revealed that five of the women with a history of RV and two controls had a current candidal vaginal infection; 16 RV patients and 12 controls had BV; and six RV patients had both BV and candidiasis . Twenty-eight RV patients and 31 controls had no clinical or microbiological detectable vaginal infection . Among the RV patients, hsp60 and hsp70 were more prevalent in those with current BV (40.9% and 50.0%, respectively) or a candidal infection (45.5% and 54.5%) than in women with no current infection (21.4% and 17.9%) . In the women with no history of RV, BV was not associated with a high prevalence of hsp60 (8.3%) or hsp70 (8.3%) . Interleukin-10 and TNF were not more prevalent in vaginitis patients or controls with a current candidal infection or BV than in uninfected subjects . CONCLUSION: The high prevalence of circulating hsp60 and hsp70 in women with a history of RV and current BV or vaginal candidiasis, but not in women with no history of RV, suggests that differences in heat shock protein induction may be related to susceptibility to recurrent vaginal infections. Clin Chem Lab Med, 1999 Apr, 37(4), 477 - 80 Recent activities of EC4 in the harmonization of clinical chemistry in the European Union; Sanders GT et al.; This article describes the recent activities of the European Communities Confederation of Clinical Chemistry (EC4) . Main goal of EC4 is harmonization of clinical chemistry in the European Union and Europe . EC4's actions connected to that are training and registration of professionals, and accreditation of laboratories . The 35000 professionals practising clinical chemistry in the EU have different backgrounds (medical, pharmaceutical, science-oriented, veterinary, or microbiological) . Thus, for the harmonization of training of clinical chemists, EC4 has published a European Syllabus for Postgraduate Training, and instituted a European Union Register for Clinical Chemists . The Syllabus is an indication of the level of requirements in postgraduate training . The EC4 initiative to implement the European Register for Clinical Chemists is based on the 8 years vocational training necessary to obtain sufficient knowledge in clinical chemistry according to the European Syllabus . A guide to the EC4 Register has been published; registration leads to the title European Clinical Chemist (EurClinChem) . The accreditation of laboratories must be based on a total quality management system . EC4 has described guidelines (essential criteria) which it judges appropriate for establishing the quality of medical laboratory service; it does not wish to fulfil the role of an accrediting body . Moreover, a working group has been set up to seek to harmonize the work of national accrediting bodies . Therefore, it is logical that EC4 monitors the activities of the different standardizing bodies that might influence the practice of clinical chemistry in the EU . Finally, some aspects concerning the future strategy of EC4 are brought forward. Ned Tijdschr Geneeskd, 1999 May 15, 143(20), 1041 - 5 {Cold tap water as a source of fatal nosocomial pneumonia due to Legionella pneumophila in a rehabilitation center}; Hoebe CJ et al.; OBJECTIVE: Report of the technical, microbiological and epidemiological investigation following 2 cases of fatal Legionella pneumonia . DESIGN: Descriptive . METHOD: Faced with 2 nosocomial cases in a rehabilitation centre in the South of Limburg, the Netherlands, the water supply was investigated . Water temperatures from different taps were measured . Legionella cultures were made from respiratory patients' specimens, water samples and smears from all mixing taps (used in showers), samples from hot and cold water taps from the infected ward and from the five other wards . The strains were typed by serotyping and polymerase chain reaction . RESULTS: The circulating cold water sometimes warmed up to 40 degrees C (within the Legionella growth range) . From the sputum of the 2 male patients with rheumatoid arthritis who died of Legionella pneumonia the same Legionella pneumophila (serotype I) was cultured as from the water supply . Of the showers on the contaminated ward 19% (12/63) were positive for Legionella as were 59% (35/59) of the cold water taps . Cultures from the hot water supply were negative just like control cultures from five other wards and swabs from showerheads and hoses . The cold water tubes ran next to the hot water tubes and the central heating system in the same shaft . On the infected ward patients were absent during the weekends . As one of the subsequent measures, the cold water pipes were relocated to another shaft . CONCLUSION: The combination of an elevated cold water temperature caused by heating along a distance by nearby hot water and heating piping and the regular stasis of water during the weekends when the ward was closed, most probably stimulated the multiplication of Legionella in the water supply . In order to minimize contamination of cold water its temperature must be kept below 20 degrees C . Surveillance of intramural water systems is necessary to prevent nosocomial infections. Toxicol Pathol, 1999 Jan-Feb, 27(1), 101 - 3 Safety evaluation of human living skin equivalents; Nemecek GM et al.; Human living skin equivalents (LSEs) offer an alternative to the use of split-thickness autografts for the treatment of hard-to-heal wounds . LSEs consist of 4 active components: a well-differentiated stratum corneum derived from epidermal keratinocytes, dermal fibroblasts, and an extracellular collagen matrix . Neonatal foreskins are used as the source of keratinocytes and dermal fibroblasts for the manufacture of LSEs . Following isolation and expansion in vitro, the cells are cultured on a 3-dimensional scaffold to give an upper epidermal layer and supporting dermal layer . The resulting product has the appearance and handling characteristics of human skin . Safety evaluation of LSEs begins with insuring that foreskins are obtained only from healthy infants whose mothers are negative for a panel of adventitious agents . Keratinocyte and fibroblast cell banks are characterized using morphologic, biochemical, and histologic criteria; checked for the absence of contaminating cell types such as melanocytes, macrophages, lymphocytes, and Langerhans cells; subjected to rigorous microbiological testing (with any production materials of biological origin); and evaluated for in vivo tumorigenicity . The consistency of certain key morphologic and functional characteristics are regularly assessed . Because an LSE represents an allogeneic graft, preclinical safety studies include in vitro and in vivo determinations of its potential immunogenicity . Immunocompromised (SCID) mice reconstituted with human leukocytes or engrafted with human fetal hematolymphoid organs have been useful animal models for assessing possible immunologic responses to LSEs . Additional preclinical studies are being conducted to show that LSEs are noncytotoxic and lack allergenic, sensitizing, or irritation potential. J Clin Microbiol, 1999 Jul, 37(7), 2330 - 2 Amplification of a 500-base-pair fragment from cultured isolates of Mycobacterium bovis; Rodriguez JG et al.; The presence of a 500-bp fragment which amplifies a region from the genome of Mycobacterium bovis (J . G . Rodriguez, G . A . Meija, P . Del Portillo, M . E . Patarroyo, and L . A . Murillo, Microbiology 141:2131-2138, 1995) was evaluated by carrying out PCR on 121 M . bovis isolates . The M . bovis strains, previously characterized by culture and biochemical tests, were isolated from cattle in different regions of Argentina, Mexico, and Colombia . Four additional strains isolated from sea lions that belong to the M . tuberculosis complex were also included in the study . All of the isolates tested were PCR positive, rendering the expected 500-bp band and giving a correlation of 100% with previous microbiological characterization . Southern blot analysis revealed a common band of 1, 800 bp and a polymorphic high-molecular-mass hybridization pattern . The results show that this assay may be useful for diagnosis and identification of M . bovis in cattle. Br J Surg . 1999 May;86(5):708. Vascular surgical society of great britain and ireland: uptake of tetracycline in aortic aneurysms: influence on inflammation and proteolysis Franklin IJ, Harley SL, Greenhalgh RM, Powell JT. BACKGROUND: Derivatives of tetracycline (TC), through their inhibition of matrix metalloproteinases (MMPs), have been suggested as potential medical therapy to limit growth of abdominal aortic aneurysms (AAAs), but penetration of the aortic wall in vivo has not been demonstrated . The uptake and concentration of TC in aneurysm wall, and its effect on MMP and cytokine production, were investigated . METHODS: Patients undergoing elective AAA repair (n = 5) were given a single bolus of intravenous TC 500 mg on induction of anaesthesia . The TC concentrations achieved in serum, aneurysm wall and mural thrombus were determined using a microbiological assay . In separate patients, not given TC, AAA biopsy explants were established and the effect of TC (0, 10 and 100 &mgr;g ml-1) on hydroxyproline, MMP-9 and cytokine (MCP-1 and interleukin (IL) 6) secretion were investigated using colorimetric assays and immunoassays . RESULTS: At the time of aortic cross-clamping median TC concentration was 9 (range 5-12) &mgr;g ml-1 in serum, 2.7 (1.3-9 . 6) &mgr;g g-1 in AAA wall and nil in mural thrombus (see Table ) . CONCLUSION: TC rapidly penetrates AAA wall in vivo and inhibits MMP-9 and MCP-1 release by AAA explants . This suggests that TCs have the potential to limit aneurysm growth. Int J Clin Pharmacol Ther, 1999 May, 37(5), 243 - 8 Topical netilmicin compared with tobramycin in the treatment of external ocular infection; Milazzo G et al.; In a pilot double-blind, randomized, prospective controlled study the effectiveness and safety of 0.3% netilmicin ophthalmic solution were compared with those of 0.3% tobramycin in treating external bacterial ocular infections in 45 eligible patients . The treatment with both study medications resulted in a significant (p < 0.001, Wilcoxon test) reduction in the mean cumulative score of the signs and symptoms . However, no statistically significant differences were observed between the two groups . The clinical improvement rate was almost complete with either antibiotics . There was a statistically positive trend in the netilmicin group with regard to the microbiological improvement that was achieved in (87% of the netilmicin patients) compared with 77% of the tobramycin patients (77%) . Antibiotic sensitivity revealed that 84% of the organisms isolated were sensitive to netilmicin whereas only 64% of them were sensitive to tobramycin . Only minor adverse events occurred in patients treated with either netilmicin or tobramycin . In conclusion, this study demonstrates that netilmicin is a promising new antibiotic for treating external ocular infections. Int J STD AIDS, 1999 May, 10(5), 316 - 23 An epidemiological evaluation of the use of microbiological tools for identifying gonorrhoea infection networks; Pierce RL et al.; We aimed to assess the utility of various techniques for identifying gonorrhoea infection networks . All residents of a non-metropolitan North Carolina county visiting a sexually transmitted disease (STD) clinic during a 17-month period were screened for gonorrhoea . Infection networks were estimated by serovar type combined with antibiotic resistance, arbitrarily primed polymerase chain reaction (AP-PCR), or temporal clustering . The residential addresses of infected patients were geocoded and mapped . Among 2 serovar types, the presence of distinguishing characteristics of a network, based on questionnaire data, was assessed with prevalence ratios and 95% confidence intervals (CIs) relative to those not in the network . Twenty-five serovar types were identified among 759 gonorrhoea infections . In one serovar, the networks further delineated by temporal clusters correlated with particular AP-PCR types . In most instances, however, different typing techniques painted different network pictures . No refined serovar network stood out as having a particular set of characteristics that could be used to shape intervention . Teasing out an individual infection network with unique characteristics will require the development and use of other microbiological tools. Vet Rec, 1999 Apr 24, 144(17), 470 - 5 Transfer of sulphamethazine from contaminated dairy feed to cows' milk; McEvoy JD et al.; Four groups of four healthy mid-lactation Friesian cows were fed a compound feeding stuff containing either 2, 10 or 250 mg sulphamethazine/kg, corresponding to 0, 2, 10 and 250 per cent of the therapeutic inclusion rate in rations for pigs, at a flat rate of 3 kg twice daily for 21 days, followed by a seven-day withdrawal period . The cows were machine-milked twice daily and pooled milk samples from each cow were analysed by a commercially available microbiological assay with a sensitivity of 100 micrograms/litre and by a high performance liquid chromatography (HPLC) procedure with a limit of detection of 10 micrograms/litre . No sulphamethazine was detected by HPLC in the milk samples taken from any of the cows fed the concentrate containing 2 or 10 mg/kg . The milk samples from all four cows fed the highest concentration of sulphamethazine contained from 21 to 120 micrograms/litre while they were being fed the contaminated concentrate . The cow with the highest concentrations of sulphamethazine was the only one which repeatedly tested positive by the microbiological assay . The concentration of sulphamethazine declined rapidly during the withdrawal period and the drug was not detectable by either method in samples taken from two days after the contaminated feed was withdrawn. Epidemiol Infect, 1999 Apr, 122(2), 185 - 92 Lessons from a large outbreak of Escherichia coli O157:H7 infections: insights into the infectious dose and method of widespread contamination of hamburger patties; Tuttle J et al.; Between November 1992 and February 1993, a large outbreak of Escherichia coli O157:H7 infections occurred in the western USA and was associated with eating ground beef patties at restaurants of one fast-food chain . Restaurants that were epidemiologically linked with cases served patties produced on two consecutive dates; cultures of recalled ground beef patties produced on those dates yielded E . coli O157:H7 strains indistinguishable from those isolated from patients, confirming the vehicle of illness . Seventy-six ground beef patty samples were cultured quantitatively for E . coli O157:H7 . The median most probable number of organisms was 1.5 per gram (range, < 0.3-15) or 67.5 organisms per patty (range, < 13.5-675) . Correlation of the presence of E . coli O157:H7 with other bacterial indicators yielded a significant association between coliform count and the presence of E . coli O157:H7 (P = 0.04) . A meat traceback to investigate possible sources of contamination revealed cattle were probably initially colonized with E . coli O157:H7, and that their slaughter caused surface contamination of meat, which once combined with meat from other sources, resulted in a large number of contaminated ground beef patties . Microbiological testing of meat from lots consumed by persons who became ill was suggestive of an infectious dose for E . coli O157:H7 of fewer than 700 organisms . These findings present a strong argument for enforcing zero tolerance for this organism in processed food and for markedly decreasing contamination of raw ground beef . Process controls that incorporate microbiological testing of meat may assist these efforts. J Clin Periodontol, 1999 May, 26(5), 269 - 75 Salivary lactoferrin and low-Mr mucin MG2 in Actinobacillus actinomycetemcomitans-associated periodontitis; Groenink J et al.; Concentrations and output of lactoferrin and of low-Mr mucin MG2 were determined in saliva of subjects suffering from Actinobacillus actinomycetemcomitans-associated periodontal disease and healthy subjects . Periodontal patients were clinically examined and a microbiological sample was taken from the deepest bleeding pockets in each quadrant . The number of viable A . actinomycetemcomitans was determined in the sampled sites of each patient . The MG2 output in the diseased subjects (13.6 microg protein/min) was decreased at least by a factor three compared to periodontal healthy subjects (44.3 microg protein/min) . On the other hand, output of lactoferrin was not significantly different in healthy (9.5 microg/min) and diseased subjects (7.6 microg/min) . Western analyses demonstrated a higher iron-saturation of lactoferrin in diseased subjects in comparison with the healthy subjects . Lactoferrin degrading enzymes, probably derived from microbial sources, could be detected in saliva of the periodontally diseased subjects, but not in saliva of healthy subjects . The combination of iron-saturation and degradation of lactoferrin suggests that anti-microbial properties of lactoferrin are diminished in periodontitis patients . Moreover, the low concentration of mucin MG2 suggests a decline in mucin defence and consequently a higher susceptibility for oral infection . A negative correlation (r= -0.4, p < 0.05) between the number of subgingival A . actinomycetemcomitans and lactoferrin in saliva suggested that low concentrations of lactoferrin favour the growth of the bacterium . These data indicate that a decline in the salivary defence system might increase the risk for oral infection by A . actinomycetemcomitans. Nippon Hinyokika Gakkai Zasshi, 1999 Apr, 90(4), 521 - 5 {High-dose chemotherapy followed by peripheral blood stem cell transplantation in advanced extragonadal germ cell tumor--a case report}; Matsuura H et al.; We reported the expe