Cerebrospinal fluid shunt infection in children: efficiency of management protocol, rate of persistent shunt colonization, and significance of `off-antibiotics' trial

To evaluate the efficiency of our management protocol, 33 pediatric cases of bacteria-infected cerebrospinal fluid shunt were reviewed. The causative organism was staphylococcus in 23 patients. In 23 patients, shunt infection was managed according to the protocol. The complexity of the shunt system did not prolong hospitalization. Unchanged but externalized tubings showed persistent colonization despite adequate antibiotics in 10 of 21 patients. Staphylococcal infection was oxacillin-resistant in 7 of 19. The efficiency of an `off-antibiotics' trial was minimal. Further modification of the protocol is expected to enhance efficiency of the management. Received: 10 July 1998 Revised: 18 August 1998     

A randomized, controlled trial of tea tree topical preparations versus a standard topical regimen for the clearance of MRSA colonization

Two topical MRSA eradication regimes were compared in hospital patients: a standard treatment included mupirocin 2% nasal ointment, chlorhexidine gluconate 4% soap, silver sulfadiazine 1% cream versus a tea tree oil regimen, which included tea tree 10% cream, tea tree 5% body wash, both given for five days. One hundred and fourteen patients received standard treatment and 56 (49%) were cleared of MRSA carriage. One hundred and ten received tea tree oil regimen and 46 (41%) were cleared. There was no significant difference between treatment regimens (Fisher's exact test; P = 0.0286). Mupirocin was significantly more effective at clearing nasal carriage (78%) than tea tree cream (47%; P = 0.0001) but tea tree treatment was more effective than chlorhexidine or silver sulfadiazine at clearing superficial skin sites and skin lesions. The tea tree preparations were effective, safe and well tolerated and could be considered in regimens for eradication of MRSA carriage.     

单细胞真菌多糖对绿脓杆菌在小鼠肠道定植与转移的影响

选择粪便中绿脓杆菌(P.aeruginosa)数10~4/g的小鼠,经抗生素及抗生素加MFPS处理后,通过无菌饮水接种P.aeruginosa,定期测定粪便中该菌的数量。结果表明,MFPS可以有效地阻止由于抗生素对肠道菌群生态平衡的破坏而致的P.aeruginosa的定植及过度生长。即使在环磷酰胺诱发下,P.aeruginosa的转移也只发生在少数鼠(30％)的个别器官,也没有小鼠死亡。未有MFPS保护、经抗生素处理的全部小鼠的主要脏器(心、肺、肝、肾及脾)均由于该菌的转移而被感染,并有37.5％小鼠死亡。     

机械通气早产儿下呼吸道定植细菌和呼吸机相关性肺炎的病原菌及耐药性分析

目的了解机械通气早产儿下呼吸道定植细菌菌谱，并进一步探讨呼吸机相关性肺炎（YAP）的病原学细菌谱及耐药性。方法对2004年1月～2005年12月我院早产儿监护病房住院的165例机械通气患儿行支气管肺泡灌洗液定量培养和药敏试验，进行细菌监测。结果机械通气3d以上的患儿全部出现下呼吸道的细菌定植，其中有37．5％（62／165）的患儿诊断为VAP。支气管肺泡灌洗液定量培养均以G一杆菌为主，其中肺炎克雷自杆菌、铜绿假单胞菌、鲍曼不动杆菌分别占前3位；VAP的病原菌耐药性分析显示对头孢类抗生素广泛耐药，而对亚胺培南．西司他丁、头胞哌酮／舒巴坦钠、环丙沙星仍保持较高敏感性。结论G^-杆菌是机械通气患儿下呼吸道定植和VAP的优势菌群，对目前临床常用抗生素有多重耐药现象。     

Adherence properties of Helicobacter pylori: impact on pathogenesis and adaptation to the host

The adherence of the human gastric pathogen Helicobacter pylori to the gastric mucosa is widely assumed to play a substantial role in initial colonization and long-term persistence in the human stomach. In the past, a couple of putative adhesins were identified, most of which were members of the large outer membrane protein (OMP) family of H. pylori. Among these, the BabA protein was shown to recognize the Leb antigen, which is presented as a dominant surface structure in the gastric mucosa. The SabA adhesin binds to sialylated antigens, which are up-regulated in inflamed gastric tissue. Other OMPs, such as AlpAB or HopZ were also shown to be involved in binding to gastric epithelial cells, but the corresponding receptors are unknown. The aim of this review is to summarize recent data giving new insights in binding specificities of H. pylori adhesins and their role in pathogenesis and adaptation to the host.     

Colonization of Fresh and Defatted Feathers by Keratinophilic Fungi Besiedlung frischer und entfetteter Federn durch keratinophile Pilze

Summary: Feathers from 4 different birds were taken as substrate to find out the role of natural fatty material during the process of saprophytic colonization by some keratinophilic fungi. In the present investigation three fungi i.e., Keratinophyton terreum, Microsporum gypseum and Malbranchea aurantiaca were taken as test fungi. It is concluded that the presence of natural fatty materials on feathers have inhibitory effect on their colonization by some of the test organisms.
Zusammenfassung: Für die Prüfung, welche Rolle das natürliche Fettmaterial an Federn für die saprophytische Besiedlung durch keratinophile Pilze spielt, wurden Federn von 4 verschiedenen Vogelarten untersucht. Als Pilze wurden eingesetzt: Keratinophyton terreum, Microsporum gypseum und Malbranchea aurantiaca. Es wird der Schluß gezogen, daß die Gegenwart von natürlichen Fetten auf den Federn einen Hemmeffekt auf einige der Testpilze hat.     

Molecular and morphological systematics of the sandfly Sergentomyia (Sintonius) clydei Sinton, 1928 and questions about its record in the Seychelles

In the Phlebotomine sandflies, a few molecular studies related on the genus Sergentomyia have been published. The present study explored the genetic variability within Sergentomyia (Sintonius) clydei (Diptera, Psychodidae). The sampling included 15 populations originating from 12 countries. A morphological approach was coupled to the sequencing of two molecular markers (cytochrome b mtDNA and cacophony nuclear DNA). The most variable morphological characters resided in the cibarium of the females, especially (i) the pigment patch pattern and (ii) the number of cibarial teeth and denticles in the armature. However this morphological approach was unable to individualize any population within S. clydei. The NJ trees based on both molecular markers individualized the specimens from the Aldabra group of islands in the Seychelles. Surprisingly, cyt b variability was not compatible with the known data about the complete submersion of Aldabra occurring relatively recently some 125,000 years ago. The settlement of these islands by S. clydei from continental Africa, the Middle East or Asia, and the value of mtDNA markers are discussed.     

Unaltered pneumococcal carriage prevalence due to expansion of non-vaccine types of low invasive potential 8 years after vaccine introduction in Stockholm,Sweden

ObjectiveTo evaluate the carriage prevalence, serotype distribution, and antibiotic resistance for pneumococcal carriage isolates collected 4–8 years after introduction of pneumococcal conjugate vaccines (PCVs) in Stockholm, Sweden, and to identify risk factors for carriage and calculate the invasive disease potential for emerging serotypes.MethodsNasopharyngeal aspirates were collected from 3024 children aged 0–<5 years at regular visits at 23 Child Health Centers in Stockholm County in 2011–2015, and from 787 parents in 2014–2015. The invasive disease potential was calculated for serotypes using invasive disease isolates from 824 patients of all ages identified in the Stockholm County during the same time period as the carriage isolates.ResultsA total carriage prevalence of 30% did not change during the study period. Non-vaccine types (NVT) dominated (94% by 2015) and the most common serotypes in descending order were 11A, 23B, 35F and 21. Risk factors for carriage were: age ⩾3 months–<3 years, having siblings, attending day-care and having travelled abroad the last 3 months. Antibiotic resistance remained low. The invasive disease potential was high for NVT 8, 9N, 12F, and 22F, while low for a majority of emerging NVTs in carriage.ConclusionThe carriage prevalence remained the same 4–8 years after vaccine introduction, but serotype replacement became almost complete. A majority of emerging NVTs in carriage showed a low invasive disease potential. Carriage studies are an important complement to invasive disease surveillance to understand the full effect of PCV vaccine programs.