- Volume 55, Issue 7, 2006
Volume 55, Issue 7, 2006
- Review
-
-
-
Invasive fungal infections: a review of epidemiology and management options
More LessFungi are increasingly recognised as major pathogens in critically ill patients. Candida spp. and Cryptococcus spp. are the yeasts most frequently isolated in clinical practice. The most frequent filamentous fungi (moulds) isolated are Aspergillus spp., but Fusarium spp., Scedosporium spp., Penicillium spp., and Zygomycetes are increasingly seen. Several reasons have been proposed for the increase in invasive fungal infections, including the use of antineoplastic and immunosuppressive agents, broad-spectrum antibiotics, and prosthetic devices and grafts, and more aggressive surgery. Patients with burns, neutropenia, HIV infection and pancreatitis are also predisposed to fungal infection. The epidemiology and clinical features of fungal infections are reviewed, together with antifungal agents currently or soon to be available.
-
-
- Pathogenicity And Virulence
-
-
-
Influence of colostrum deprivation and concurrent Cryptosporidium parvum infection on the colonization and persistence of Escherichia coli O157 : H7 in young lambs
Escherichia coli O157 : H7 and Cryptosporidium parvum infections of man have been associated with direct contact with small ruminants. Colostrum protects neonates against gastrointestinal pathogens, and orphan lambs, which are common on petting farms, may be deprived of this protection. In a recent study, it was demonstrated that high shedding of E. coli O157 : H7 by an 8-week-old goat kid was associated with coincidental C. parvum infection. Furthermore, both pathogens were co-located in the distal gastrointestinal tract. It was hypothesized that colostrum deprivation and pre-infection with C. parvum predisposed young ruminants to colonization and increased shedding of E. coli O157 : H7. To test this, 21 lambs 5 weeks of age were divided into four groups as follows: (A) colostrum-deprived and inoculated with E. coli O157 : H7, (B) colostrum-deprived and inoculated with C. parvum and then E. coli O157 : H7, (C) conventionally reared and inoculated with E. coli O157 : H7, (D) conventionally reared and inoculated with C. parvum and then E. coli O157 : H7. C. parvum was detected between 8 and 12 days post-inoculation in most of the infected lambs. At 24 h post-inoculation with E. coli O157 : H7, all lambs were shedding between 5×104 and 5×107 c.f.u. E. coli O157 : H7 per gram of faeces. E. coli O157 : H7 was shed in higher numbers in the groups pre-inoculated with C. parvum, whether conventionally reared or colostrum-deprived. Interestingly, for the colostrum-deprived lambs on day 3, a significant difference in shedding of E. coli O157 : H7 was observed (P=0.038), with the lambs inoculated with E. coli alone yielding higher counts than those pre-inoculated with C. parvum. From day 15 onwards, shedding of E. coli O157 : H7 was highest from the colostrum-deprived C. parvum-infected lambs, then (in descending order of shedding) the colostrum-deprived lambs, the conventionally reared lambs infected with C. parvum, and the conventionally reared animals. In total, four animals were euthanized, two at 24 h and two at 96 h post inoculation with E. coli O157 : H7 (two conventionally reared and two colostrum-deprived). All animals euthanized were from groups pre-inoculated with C. parvum prior to challenge with E. coli O157 : H7. On examination of tissues, in three of the four animals examined, multifocal attaching and effacing lesions were observed in the caecum, colon, rectum and at the recto-anal junction, and were confirmed by immunohistochemistry to be associated with E. coli O157 : H7.
-
-
-
-
Streptococcus agalactiae Cβ protein gene (bac) sequence types, based on the repeated region of the cell-wall-spanning domain: relationship to virulence and a proposed standardized nomenclature
More LessThe Cβ protein (Bac) of Streptococcus agalactiae (group B streptococcus; GBS) is an IgA binding protein encoded by bac, of which at least 39 sequence types have been described, based on polymorphisms in the repeated region of the cell-wall-spanning domain (‘bac sequence types’). Cβ is usually found in serotype Ib, less commonly in serotype II, and rarely in other serotypes. The aim of this study was to examine the prevalence, variety and distribution, among GBS serotypes and between invasive and superficial isolates, of bac sequence types. A total of 1101 GBS isolates were tested, from 10 countries, with a bac-specific PCR, and amplicons from all 255 (23 %) with positive results were sequenced. Ninety-seven percent (184/190) of serotype Ib and 37 % of serotype II isolates were bac positive. The Cα protein gene (bca) was present in 98 % (251/255), and insertion sequences IS1381 and IS861 in 94 % (239/255), of bac-positive isolates. The authors identified 59 bac sequence types belonging to 19 groups, based on length, from 496 to 946 bp, with up to six sequence variants (a–f) in each group. The median bac sequence length of invasive isolates was significantly shorter than that of superficial isolates overall (640 versus 586 bp; P <0.001) and specifically for serotype Ib (541 versus 676 bp; P <0.001), and invasive isolates were significantly (P <0.001) more likely to have one or more 18 bp deletions relative to the original published bac sequence (X59771). bac sequence typing is a useful addition to the previously described genotyping system, and will help to predict relative virulence among S. agalactiae serotype Ib strains.
-
-
-
Clinical relevance of virulence genes in Campylobacter jejuni isolates in Bahrain
There are no data describing the genetic make-up of Campylobacter strains (an important aetiological agent of diarrhoea) circulating in the Arabian Gulf region. Here, the molecular characterization of two virulence genes in Campylobacter jejuni from Bahrain and the relationship with clinical infection are reported. Molecular screening for cytolethal distending toxin (cdtB) and invasion-associated marker (iam) genes was carried out on C. jejuni stool isolates collected from January 2002 to January 2004 in Bahrain. The molecular characterization was correlated with the patients' socio-demographic and clinical parameters. Of the 96 C. jejuni strains tested, 50 (52 %) were cdtB +/iam +, 30 (31 %) were cdtB +/iam − and 16 (17 %) were cdtB −/iam −. Sixty-nine per cent (66/96) of patients were less than 3 years old, with significantly higher detection of cdtB +/iam + and cdtB +/iam − strains (P <0.001 and P <0.01, respectively) in this age group. Seventy patients (73 %) were symptomatic. In the group that were less than 3 years old, 62 and 85 % of those with cdtB +/iam + and cdtB +/iam − strains, respectively, were symptomatic compared with 100 % for those over 3 years of age. However, the presence of cdtB −/iam − strains still resulted in clinical infection in the children under 3 years but not in the older patients. This is the first report describing the molecular characterization of virulence genes in Campylobacter isolates from this region. The findings indicate that strains of different virulence genetic make-up are circulating in the population, with children under the age of 3 years being most vulnerable. Further work on the molecular characterization, gene expression and determination of the invasive phenotypes of C. jejuni strains circulating in different regions is needed.
-
- Host Response
-
-
-
Immunological alterations during the clinical and recovery phases of experimental swine dysentery
More LessThe aim of this study was to examine changes in the systemic immune response during the incubation period and following the onset of clinical swine dysentery, including the recovery period. Ten healthy conventional pigs were inoculated with Brachyspira hyodysenteriae. Blood was sampled at pre-inoculation, at days 4 and 14 post-inoculation, during the first 4 days with clinical signs of dysentery and at days 1, 3, 7, 11 and 15 of the recovery period. Eight pigs developed haemorrhagic diarrhoea. Flow-cytometric analyses of lymphocyte subpopulations showed that all animals, including the two that remained healthy, had an increase in CD8α + CD4− cells and γδ T cells at days 4 and 14 post-inoculation. In addition, an increase in CD4+ CD8α + cells and CD8α + CD8β + cells was observed at days 4 and 14 post-inoculation in animals that developed dysentery. During clinical signs of dysentery, the acute-phase protein serum amyloid A was increased. There was a two- to threefold increase in both neutrophils and monocytes during signs of dysentery and at the beginning of the recovery period. The numbers of CD8α + CD8β − CD4−, CD45RA− lymphocytes also increased during the dysentery period. Circulating CD21+ cells and CD21+ CD45RA− cells decreased at the end of the incubation period, during signs of dysentery and at the beginning of the recovery period. The dysentery-affected animals developed antibodies to B. hyodysenteriae-specific antigens (∼16 kDa and ∼30 kDa) from the first day of recovery, and γδ T cells showed an increase during the recovery period. In comparison with pre-inoculation, increased numbers of monocytes, neutrophils, CD8α + CD8β − CD4− lymphocytes and CD45RA− lymphocytes were observed during clinical dysentery. Increased numbers of neutrophils, γδ T cells and specific antibodies were seen during the recovery period.
-
-
- Antimicrobial Agents And Chemotherapy
-
-
-
Application of the resazurin microtitre assay for detection of multidrug resistance in Mycobacterium tuberculosis in Algiers
This study assessed the performance of a rapid, low-cost, colorimetric method, the resazurin microtitre assay (REMA) plate method, for the detection of resistance to isoniazid and rifampicin in 136 clinical isolates of Mycobacterium tuberculosis from two hospitals in Algiers. MICs were determined and the results were compared with those obtained with the conventional proportion method on Löwenstein–Jensen medium. Excellent results were obtained for the REMA plate method, with a sensitivity of 100 % for both isoniazid and rifampicin and a specificity of 98.3 and 99.2 %, respectively. The REMA plate method appears to be a reliable method for the rapid determination of multidrug-resistant tuberculosis and is a good alternative for use in resource-limited countries such as Algeria.
-
-
-
-
Nitrate reductase assay for detection of drug resistance in Mycobacterium tuberculosis: simple and inexpensive method for low-resource laboratories
The nitrate reductase assay (NRA) was used as an alternative method for detection of resistance to the first-line antituberculous drugs isoniazid, rifampicin, ethambutol and streptomycin. A total of 320 strains of Mycobacterium tuberculosis were studied and the results compared with the proportion method (PM) on Löwenstein–Jensen medium. The mean time to obtain results was 10 days and the overall agreement between the NRA and PM was 98.8 %. The NRA was easy to perform and represents a useful tool for rapid and accurate determination of drug-resistant M. tuberculosis strains in low-resource countries.
-
-
-
Antifungal effect of voriconazole on intracellular Candida glabrata, Candida krusei and Candida parapsilosis in human monocyte-derived macrophages
More LessInfections caused by Candida species other than Candida albicans are increasingly common, and decreased susceptibility to azoles has made them more difficult to treat. Since phagocytic killing is important in elimination of Candida infections, intracellular killing of fluconazole-resistant Candida glabrata, Candida krusei and Candida parapsilosis (four strains each) by voriconazole was investigated in human monocyte-derived macrophages (MDMs). MDMs were infected with Candida, and voriconazole was then added. MDMs were lysed at 0, 24 or 48 h after infection, and viable Candida in the lysates enumerated. Compared to the starting inoculum, the number of viable intracellular C. parapsilosis and C. glabrata in untreated MDMs increased to 28 121 and 351 %, respectively, in 48 h. In contrast, the number of C. krusei decreased to 42 %. In MDMs treated with voriconazole, the decrease in viable count was dependent upon drug concentration. At 48 h, C. glabrata was killed only at 5× MIC (P<0.05), C. krusei was killed at all voriconazole concentrations, while C. parapsilosis was inhibited at 0.5 and 1× MIC and killed at ⩾2.5× MIC (P<0.05). The data show that intracellular growth and survival of these Candida species in the absence or presence of voriconazole vary markedly. The activity of voriconazole depends on the concentration of the drug and the time of exposure. For the 12 Candida strains studied, regression curves show that the maximum intracellular anticandidal activity of voriconazole was reached at 3.5–5× MIC.
-
-
-
Molecular characterization of antimicrobial resistance in Shigella sonnei isolates in Korea
The antimicrobial resistance of 122 Shigella sonnei isolates obtained in Korea during the period 1991–2000 was characterized. These isolates were highly resistant to traditional antibiotics such as trimethoprim (100 %), streptomycin (100 %), sulfamethoxazole (94 %), tetracycline (93 %) and nalidixic acid (90 %). All S. sonnei isolates carried Tn7 in their chromosomes. The 8.4 kb non-transferable resistance (R) plasmid carrying tetA, strA-strB and sul1 was found in 93 % of the S. sonnei isolates. Resistance to nalidixic acid first appeared in a S. sonnei isolate in 1997, and then in all S. sonnei isolates from 1998 and 1999. Resistance to commonly prescribed antibiotics such as ampicillin was increased in S. sonnei isolates during the outbreak period 1998–2000. Resistance to ampicillin was mediated by the conjugative R plasmids carrying bla TEM-1. In conclusion, S. sonnei acquired antimicrobial resistance to commonly prescribed antibiotics through the horizontal transfer of conjugative R plasmids, while the genetic stability of transposon and non-transferable R plasmids was responsible for resistance to traditional antibiotics.
-
-
-
Naturally occurring amino acids differentially influence the development of Chlamydia trachomatis and Chlamydia (Chlamydophila) pneumoniae
More LessThe differential influence of individual amino acids on the growth of Chlamydia trachomatis versus Chlamydia (Chlamydophila) pneumoniae was investigated. Certain essential amino acids added in excess at the middle of the infection course resulted in varying degrees of abnormality in the development of the two species. If amino acids were added as early as 2 h post-infection, these effects were even more pronounced. The most effective amino acids in terms of C. trachomatis growth inhibition were leucine, isoleucine, methionine and phenylalanine. These amino acids elicited similar effects against C. pneumoniae, except methionine, which, surprisingly, showed a lower inhibitory activity. Tryptophan and valine marginally inhibited C. trachomatis growth and, paradoxically, led to a considerable enhancement of C. pneumoniae growth. On the other hand, some non-essential amino acids administered at the middle of or throughout the infection course differentially affected the development of the two species. For example, C. trachomatis growth was efficiently inhibited by glycine and serine, whereas C. pneumoniae was relatively less sensitive to these agents. Another difference was apparent for glutamate, glutamine and aspartate, which stimulated C. pneumoniae growth more than that of C. trachomatis. Overall, several distinctive patterns of susceptibility to excess amino acid levels were revealed for two representative C. trachomatis and C. pneumoniae isolates. Perturbation of amino acid levels, e.g. of leucine and isoleucine, might form a basis for the development of novel treatment or preventive regimens for chlamydial diseases.
-
- Epidemiology
-
-
-
Epidemiology of meningococcal disease in England and Wales 1993/94 to 2003/04: contribution and experiences of the Meningococcal Reference Unit
The laboratory confirmation of meningococcal disease and characterization of Neisseria meningitidis isolates was improved considerably in England and Wales by the Meningococcal Reference Unit between epidemiological years 1993/94 and 2003/04 to meet the challenge of increasing numbers of cases of clinical disease and the requirement for enhanced surveillance. Improved case ascertainment was made possible by the rapid introduction of an innovative centralized reference service for non-culture PCR-based DNA detection of meningococci utilizing the ctrA and siaD PCR assays, complemented by consistent phenotypic characterization of submitted isolates from culture-proven cases. This allowed the increased prevalence of serogroup C disease in specific age groups and the apparent associated increase in mortality from 1995/96 to 1999/00 to be defined, thereby prompting accelerated intervention with the newly licensed meningococcal serogroup C conjugate (MCC) vaccines into the under-25-year UK population (in November 1999). The continued increase in and predominance of serogroup B cases (1993/94 to 2000/01) were observed in conjunction with their diverse and changing phenotypic characteristics. Trends observed to be associated with the predominant phenotypic combinations of serogroup, serotype and sero-subtype were: a decline of both C : 2b and B : 2b meningococci, and a decline of B : 15 : P1.7,16 with a concomitant increase of B : 4 : P1.4 over the 11-year period. Detailed routine surveillance rapidly confirmed the introduction of W135 : 2a : P1.5,2 meningococci into the UK during 2000 and 2001. The importance of continued detailed surveillance of this important pathogen cannot be overestimated, both to monitor the effectiveness of the MCC vaccine and to identify changes within the meningococcal population that can inform the design of anti-serogroup B vaccines.
-
-
- Clinical Microbiology And Virology
-
-
-
Protean clinical manifestations and diagnostic challenges of human brucellosis in adults: 16 years' experience in an endemic area
A prospective study was carried out to elucidate the clinical, epidemiological and laboratory features of human brucellosis. A total of 26 948 blood samples (from adults aged 15 years and above) were screened for serological evidence of brucellosis over a period of 16 years. The slide agglutination/Rose Bengal plate agglutination test gave positive results in 517 patients, of which 509 had detectable titres by the standard tube agglutination test (SAT). The diagnosis of brucellosis was documented in 495 (1.8 %) patients based on diagnostic titres (⩾1 : 160, 490 cases) and rising titres from insignificant titres (four cases) by serology and for one case by blood-culture isolation alone. Blood cultures were carried out in 345 cases, of which 191 cases (55.3 %) yielded Brucella melitensis. In 77/79 cases undertaken for follow up, there was a steady fall in 2-mercaptoethanol (2ME) agglutination titres along with clinical improvement (P <0.01). SAT titres remained detectable in most cases for a longer period in spite of an effective antimicrobial therapy and clinical recovery. A substantial number of patients (84.2 %) presented with fever, this being the only complaint in 51.1 % of the cases. Complications were present in 8.8 % of the patients (arthritis excluded): this included the unusual complications of hydrocele (two cases), Stevens–Johnson syndrome (one case) and urinary tract infection (one case). Brucella agglutinins were demonstrated in synovial, testicular, hydrocele and cerebrospinal fluids. There was no clinical suspicion of brucellosis in 439 cases (88.7 %) and the diagnosis was made only by routine serology. A two-drug regimen for 42–84 days with a follow-up 2ME test resulted in lower levels of relapse. These results suggest that, in endemic areas of the world, it should be mandatory to screen routinely for brucellosis due to protean clinical manifestations.
-
-
-
-
Helicobacter pylori-associated oxidant monochloramine induces reactivation of Epstein–Barr virus (EBV) in gastric epithelial cells latently infected with EBV
To investigate the possibility of an interaction between two ubiquitous human pathogens, Helicobacter pylori and Epstein–Barr virus (EBV), the effect of monochloramine (NH2Cl), locally produced by H. pylori infection, on gastric epithelium latently infected with EBV was examined, by assessing the induction of EBV lytic infection. AGS cells harbouring latently infected EBV were used as the indicator of lytic change caused by NH2Cl treatment. Lytic infection, determined by morphological change and EA-D antigen expression, occurred immediately after treatment with in vitro-synthesized NH2Cl. Analysis of EBV infection in human gastric tissue revealed that out of 48 H. pylori-positive patients, 24 were positive for EBER-1, and 18 and 13 were positive for EBNA1 and LMP-1 antigen, respectively. The results suggest that H. pylori-associated NH2Cl induces EBV lytic conversion in gastric epithelium latently infected with EBV.
-
-
-
Effect of N-chlorotaurine on Aspergillus, with particular reference to destruction of secreted gliotoxin
More LessThe fungistatic and fungicidal activity of N-chlorotaurine (NCT), a long-lived oxidant produced by stimulated neutrophils, was investigated. Physiological concentrations (75–100 μM) of NCT showed clear fungicidal activity against a range of Aspergillus isolates. Moreover, killing by NCT was significantly increased in the presence of ammonium chloride, explained by the formation of monochloramine by halogenation of ammonium. One clinical isolate of Aspergillus fumigatus was characterized for the production of the immunosuppressive agent gliotoxin, and NCT was shown to cause destruction of gliotoxin, possibly via reduction of the disulphide bridge. Because of its endogenous nature and its high antifungal activity, NCT appears to be a good choice for topical treatment of Aspergillus infections, and the results of this study further substantiate its therapeutic efficacy.
-
-
-
Visceral leishmaniasis/human immunodeficiency virus co-infection in India: the focus of two epidemics
More LessIndia contributes heavily to the global burden of visceral leishmaniasis (VL, kala-azar) and human immunodeficiency virus (HIV)/AIDS. The prevalence of HIV seropositivity in VL patients at a tertiary care centre in northern India, as observed during a prospective study over a period of 2 years, is presented. Of the 104 cases of VL/post-kala-azar dermal leishmaniasis, six (5.7 %) were found to be HIV positive, compared to 11 (5.5 %) seropositive for HIV of 198 patients with fever due to other causes. Four of the six (67 %) VL/HIV co-infected patients had a chronic/relapsing course, not responding to antileishmanial treatment. A CD4 T-cell count of <200 mm−3 was found in four of the five (80 %) co-infected patients in whom the test was done. Although the level of HIV/VL co-infection in the present study was lower than that of Mediterranean countries, there is a trend towards rising co-infection. The VL-endemic states of India have a huge population of migrant labourers, who work in high-HIV-prevalence states. The reported increase in the prevalence of HIV in the VL-endemic, populous states of India is a cause of grave concern, and co-infection may assume epidemic proportions in the coming decade if left unchecked.
-
- Veterinary Microbiology
-
-
-
Evaluation of the immunogenicity of the P97R1 adhesin of Mycoplasma hyopneumoniae as a mucosal vaccine in mice
More LessThe immunogenicity of P97 adhesin repeat region R1 (P97R1) of Mycoplasma hyopneumoniae, an important pathogenesis-associated region of P97, was evaluated in mice as a mucosal vaccine. Mice were immunized orally with attenuated Salmonella typhimurium aroA strain CS332 harbouring a eukaryotic or prokaryotic expression vector encoding P97R1. Local and systemic immune responses were analysed by ELISA on mouse sera, lung washes and splenocyte supernatants following splenocyte stimulation with specific antigens in vitro. Although no P97R1-specific antibody responses were detected in serum and lung washes, significant gamma interferon was produced by P97R1-stimulated splenocytes from mice immunized orally with S. typhimurium aroA harbouring either expression system, indicating induction of a cell-mediated immune response. These results suggested that live bacterial vectors carrying DNA vaccines or expressing heterologous antigens preferentially induce a Th1 response. Surprisingly, however, mice immunized with the vaccine carrier S. typhimurium aroA CS332 induced serum IgG, but not mucosal IgA, against P97R1 or S. typhimurium aroA CS332 whole-cell lysate, emphasizing the importance of assessing the suitability of attenuated S. typhimurium antigen-carrier delivery vectors in the mouse model prior to their evaluation as potential vaccines in the target species, which in this instance was pigs.
-
-
- Oral Microbiology
-
-
-
Immunoproteomics of Actinobacillus actinomycetemcomitans outer-membrane proteins reveal a highly immunoreactive peptidoglycan-associated lipoprotein
In a search for novel bioactive cell surface structures of periodontal pathogens, it was found that sera from two patients with Actinobacillus actinomycetemcomitans-associated infections reacted strongly at 17 kDa on immunoblots of A. actinomycetemcomitans outer-membrane protein (OMP) preparations. The 17 kDa antigen was also recognized by anti-CsgA (Escherichia coli curli major subunit) antibody. The 17 kDa A. actinomycetemcomitans protein was identified as peptidoglycan-associated lipoprotein (PAL; AaPAL) by two-dimensional immunoblotting and subsequent sequence analysis by mass spectrometry and bioinformatics tools. AaPAL was an OMP and a lipoprotein, and it had an OmpA-like domain. In a group of middle-aged subjects (n=26), serum reactivity to AaPAL was associated with the presence of periodontitis but not with the oral detection of A. actinomycetemcomitans. Both human sera and rabbit antisera against three different types of antigens, the gel-purified AaPAL, A. actinomycetemcomitans whole-cell antigens, and CsgA, recognized putative PALs of oral haemophili in addition to AaPAL. The results demonstrated that the novel AaPAL is a conserved bacterial lipoprotein. It is expressed in vivo and is strongly immunoreactive. The antigenic cross-reactivity found between AaPAL and oral haemophili may enhance local and systemic immuno-inflammatory reactions in periodontitis.
-
-
-
-
Frequency of recovery of pathogens causing acute maxillary sinusitis in adults before and after introduction of vaccination of children with the 7-valent pneumococcal vaccine
More LessThe objective of the study was to compare the proportions of the recovery of pathogens of acute maxillary sinusitis in adults in the 4-year period prior to the 5-year period that followed the introduction of vaccination of children with the 7-valent pneumococcal vaccine (PCV7). Cultures were obtained through endoscopy from 385 adults with acute maxillary sinusitis, 156 between 1997 and 2000, and 229 between 2001 and 2005. One hundred and seventeen potentially pathogenic organisms were isolated from the cultures obtained between 1997 and 2000. The predominant organisms were Streptococcus pneumoniae (54 or 46 % of all isolates), Haemophilus influenzae non-type b (42 or 36 %), Moraxella catarrhalis (7 or 6 %), Streptococcus pyogenes (8 or 7 %) and Staphylococcus aureus (6 or 5 %). One hundred and sixty-seven potentially pathogenic organisms were isolated from the cultures obtained between 2001 and 2005. The most predominant organisms were H. influenzae non-type b (71 or 43 % of all isolates), Strep. pneumoniae (58 or 35 %), M. catarrhalis (13 or 8 %), Strep. pyogenes (12 or 7 %) and Staph. aureus (13 or 8 %). Significant statistical differences were noted in the rates of recovery of H. influenzae non-type b (P<0.05) and Strep. pneumoniae (P<0.05). A decrease occurred in the recovery of Strep. pneumoniae resistant to penicillin from 41 to 29 %, and an increase was noted in the isolation of beta-lactamase-producing H. influenzae from 33 to 39 %; however, neither change was statistically significant. These data illustrate that a significant shift occurred in the causative pathogens of acute maxillary sinusitis in adults in the 5 years after the introduction of vaccination of children with the PCV7 compared to the previous 4 years.
-
- Models Of Infection
-
-
-
Chlamydia pneumoniae infection of microglial cells in vitro: a model of microbial infection for neurological disease
More LessChlamydia pneumoniae is the aetiological cause of a wide variety of chronic inflammatory diseases and may be associated with neurological disease. Microbiological and immunological aspects of the interaction between C. pneumoniae and the central nervous system (CNS) are not well understood because of the lack of a suitable infection model for neuronal studies. In the present study, an in vitro C. pneumoniae infection model was developed in the established microglial cell line EOC 20. Infection of the cells resulted in obvious induction of proinflammatory cytokines. The infection also selectively induced matrix metalloproteinase-9 (MMP-9) but not MMP-2. Moreover, beta interferon, which is known to modulate CNS disease, inhibited induction of MMP-9 following C. pneumoniae infection. These results support the view that C. pneumoniae infection may be associated with marked alteration of the ability of microglial cells to enhance cytokine production as well as induction of an MMP.
-
-
- Case Reports
-
-
-
Acute peritonitis and salpingitis associated with streptococcal toxic shock syndrome caused by Lancefield group G α-haemolytic Streptococcus dysgalactiae subsp. equisimilis
More LessThe authors treated a patient for what appears to be the first reported occurrence of acute peritonitis and salpingitis associated with streptococcal toxic shock syndrome (STSS). This was caused by Lancefield group G α-haemolytic Streptococcus dysgalactiae subsp. equisimilis TKCH2004-001. The isolate showed M protein type stc36 and carried the spegg gene. To the best of the authors' knowledge, the present report represents the first case of STSS complicating acute peritonitis and salpingitis caused by Lancefield group G α-haemolytic S. dysgalactiae subsp. equisimilis.
-
-
Volumes and issues
-
Volume 73 (2024)
-
Volume 72 (2023 - 2024)
-
Volume 71 (2022)
-
Volume 70 (2021)
-
Volume 69 (2020)
-
Volume 68 (2019)
-
Volume 67 (2018)
-
Volume 66 (2017)
-
Volume 65 (2016)
-
Volume 64 (2015)
-
Volume 63 (2014)
-
Volume 62 (2013)
-
Volume 61 (2012)
-
Volume 60 (2011)
-
Volume 59 (2010)
-
Volume 58 (2009)
-
Volume 57 (2008)
-
Volume 56 (2007)
-
Volume 55 (2006)
-
Volume 54 (2005)
-
Volume 53 (2004)
-
Volume 52 (2003)
-
Volume 51 (2002)
-
Volume 50 (2001)
-
Volume 49 (2000)
-
Volume 48 (1999)
-
Volume 47 (1998)
-
Volume 46 (1997)
-
Volume 45 (1996)
-
Volume 44 (1996)
-
Volume 43 (1995)
-
Volume 42 (1995)
-
Volume 41 (1994)
-
Volume 40 (1994)
-
Volume 39 (1993)
-
Volume 38 (1993)
-
Volume 37 (1992)
-
Volume 36 (1992)
-
Volume 35 (1991)
-
Volume 34 (1991)
-
Volume 33 (1990)
-
Volume 32 (1990)
-
Volume 31 (1990)
-
Volume 30 (1989)
-
Volume 29 (1989)
-
Volume 28 (1989)
-
Volume 27 (1988)
-
Volume 26 (1988)
-
Volume 25 (1988)
-
Volume 24 (1987)
-
Volume 23 (1987)
-
Volume 22 (1986)
-
Volume 21 (1986)
-
Volume 20 (1985)
-
Volume 19 (1985)
-
Volume 18 (1984)
-
Volume 17 (1984)
-
Volume 16 (1983)
-
Volume 15 (1982)
-
Volume 14 (1981)
-
Volume 13 (1980)
-
Volume 12 (1979)
-
Volume 11 (1978)
-
Volume 10 (1977)
-
Volume 9 (1976)
-
Volume 8 (1975)
-
Volume 7 (1974)
-
Volume 6 (1973)
-
Volume 5 (1972)
-
Volume 4 (1971)
-
Volume 3 (1970)
-
Volume 2 (1969)
-
Volume 1 (1968)