Comparison of screening methods for detection of extended-spectrum beta-lactamases and their prevalence among Escherichia coli and Klebsiella species in Hong Kong

Three tests, the disk diffusion test, the double-disc synergy test and the inhibitor-potentiated disc diffusion test, were compared for their abilities to detect production of extended-spectrum beta-lactamases (ESBL) in 702 Escherichia coli and 472 Klebsiella spp. strains from four hospitals. Eleven percent E. coli and 13% Klebsiella spp. were found to produce ESBL. As an indicator of ESBL activity, the sensitivities of the five extended-spectrum beta-lactams were as follows: cefotaxime (100%), cefpodoxime (99.3%), ceftriaxone (98.6%), aztreonam (93%) and ceftazidime (57.7%) when interpreted using the National Committee for Clinical Laboratory Standards criteria. Their positive predictive values ranged from 67.8-83.8%. Both the inhibitor-potentiated disc diffusion test and the double-disc synergy test (at three inter-disc widths of 20, 25 and 30 mm) were capable of identifying all the ESBL-producers. However, at a single inter-disc width of 30 mm, the double-disc synergy test has limited sensitivity (83.8%). As a second test for confirming ESBL activity in strains with reduced susceptibility to beta-lactams, the inhibitor-potentiated disc diffusion test is therefore a simple and reliable option.     

Assessment of HBV persistent infection in an adult population in Taiwan

In order to study the prevalence of hepatitis B virus (HBV) in the adult population of Taiwan, we screened for the presence of HBV DNA in 205 blood samples from adult (20-59-year-old) volunteers. According to the serological markers of HBV, samples were divided into three groups: group I (173 subjects) was negative for both HBsAg and HBeAg; group II (14 subjects) was positive for both HBsAg and HBeAg; and group III consisted of 18 subjects who were HBsAg-positive but HBeAg-negative. Plasma HBV DNA was not detected in group I, but it was found in 85.7% and 11.8% of samples in group II and group III, respectively. A free-form HBV DNA was found in 14.3% of the leukocyte samples in group II. Furthermore, an integrated form of HBV DNA was detected in the leukocytes of two cases of group I who remained healthy based on clinical data. HBV DNA was also detected in the spermatozoa and liver cells of one of the cases.     

Characterization of rubella virus-specific antibody responses by using a new synthetic peptide-based enzyme-linked immunosorbent assay.

Rubella virus (RV)-specific immunoglobulin G antibodies were studied by enzyme-linked immunosorbent assay (ELISA) techniques in sera from RV (RA 27/3)-vaccinated individuals, patients experiencing natural RV infection, congenital rubella syndrome patients, and individuals failing to respond to repeated RV immunization. Results obtained by using whole-RV ELISAs (detergent-solubilized M33 strain or intact Gilchrist strain) and hemagglutination inhibition (HAI) and neutralization (NT) assays were compared with results obtained with the same sera by using ELISAs employing a synthetic peptide, BCH-178, representing a putative neutralization domain on the RV E1 protein. Murine RV E1-specific monoclonal antibodies with HAI and NT activities exhibited strong reactivity in ELISAs with BCH-178 peptide. In sera from RA 27/3-vaccinated individuals collected at 0 (prevaccine), 1, 2, 3, 4, 5, 6, 12, and 24 to 52 weeks postvaccine, the development of E1-peptide-reactive antibodies closely paralleled increases in RV-specific antibodies measured by whole-RV ELISAs and HAI and NT assays. Similarly, sequential serum samples obtained from patients during acute and convalescent phases of natural RV infection showed a coordinate increase in RV-specific antibodies as measured by whole-RV and peptide ELISAs. Conversely, congenital rubella syndrome patient sera, although exhibiting high levels of antibody in whole-RV ELISAs, had little or no antibody directed to the neutralization domain peptide. Sera from patients failing to respond to repeated RV immunization contained very low levels of RV-specific antibody in all ELISAs. Our results that the sequence represented by BCH-178 peptide may be a previously unidentified neutralization epitope for human antibodies on the RV E1 protein and may prove useful in determining effective RV immunity.     

An improved technique for monitoring the drinking behavior of mice

A set of calibrated lickometers provides continuous, quantitative monitoring of fluid consumption. It has been used in our laboratory at four levels of temporal resolution: 24 hr, 1 hr, 6 min, and for counting of individual licks. Convenient features are mounting of the licking tube-bottle assembly on the cage top (which permits the use of disposable plastic cages with litter) and automated collection of data with microcomputers.     

Phenotypic changes and proliferative activity of human gamma delta T cell receptor-bearing cells upon activation.

We first compared the proliferative activity of alpha beta T cell receptor (TCR) (beta F1+) and gamma delta TCR (TCR delta-1+) human T cells after phytohaemagglutinin (PHA) stimulation by using double-colour immunofluorescence staining with Ki67 and anti-BrdU monoclonal antibodies (MoAbs). The dividing activity was higher within the alpha beta TCR cells: after 3 days of culture 69.9 +/- 5.9% of beta F1+ cells expressed Ki67, and 44.8 +/- 4.8% of these cells synthesized DNA as revealed by BrdU incorporation. In contrast, only 18.9 +/- 1.6% and 12.0 +/- 1.2% of TCR delta-1+ cells in the same samples were Ki67+ and BrdU+, respectively. Cells with V delta 1-J delta 1 usage (delta TCS-1+) showed a higher cycling activity than the rest of gamma delta TCR cells: after 3 days of PHA stimulation, 51.1 +/- 18.3% and 18.3 +/- 6.1% of such cells were in cycle and synthesized DNA, respectively. Next, we studied the expression of CD45 isoforms on peripheral blood alpha beta TCR and gamma delta TCR lymphocytes. Within the alpha beta TCR cells, two distinct subpopulations were distinguishable after labelling with SN130 (CD45RA) MoAb: 64.1 +/- 10.2% were bright, and 35.9 +/- 10.2% were dim or negative. Likewise, most TCR delta-1+ cells expressed SN130 (CD45RA): 87.5 +/- 3.0% were bright and 12.5 +/- 3.0% were dim. However, in contrast to alpha beta TCR+ cells, a high proportion (55.6 +/- 4.0%) of gamma delta TCR+ cells also expressed CD45RO molecules. Thus, most resting gamma delta TCR cells showed a pattern of CD45 isoform expression similar but not identical to that of 'memory' alpha beta TCR cells. Within the gamma delta TCR cell population the expression of CD45RO was heterogeneous because only 19.8 +/- 5.9% of cells bearing the V delta 1-J delta 1 form of the receptor (delta TCS-1+) were UCHL1 (CD45RO)+. Therefore, most gamma delta TCR cells with V delta 1-J delta 1 usage showed a CD45 isoform profile resembling that of 'naive' alpha beta TCR cells. These phenotypic features changed upon PHA stimulation: after 5 days of culture the proportion of TCR delta-1+ cells expressing UCHL1 increased to 86.0 +/- 3.1% and a two-fold increase in CD45RO expression was also observed in the delta TCS-1+ subpopulation.     

Mg(2+)-dependent inward rectification of ROMK1 potassium channels expressed in Xenopus oocytes.

1. ROMK1 potassium channel currents were examined in Xenopus oocytes by two-microelectrode voltage-clamp and patch-clamp techniques following injection of oocytes with in vitro transcribed ROMK1 cRNA. Macroscopic currents recorded from intact cells rectified inwardly at positive potentials. 2. In inside-out membrane patches rectification is manifested as an apparent reduction of single channel current (at 500 Hz) in the presence of 0.1-10 mM Mg2+, without a decrease in the channel open probability. No inward rectification is observed when membrane patches are isolated into solutions containing potassium as the only internal inorganic cation. 3. Mg2+ block can be described by a simple one-site model for Mg2+ binding with K0 ([Mg2+] causing half-maximal block at 0 mV) of 16.7 mM and delta (the fraction of the membrane field sensed by the blocking Mg2+) of 0.35. 4. The voltage dependence of channel block by cytoplasmic Mg2+ was shifted approximately -50 mV by a reduction in extracellular [K+] from 140 to 0 mM, corresponding to a decrease of K0 to 4.4 mM. 5. At negative membrane potentials, ROMK1 channels exhibit a single subconducting state that is approximately 4/10 of the full conductance. The incidence of subconductance states is not appreciably enhanced in the presence of Mg2+.     

Differential effects of interleukin-12, interleukin-15, and interleukin-2 on human immunodeficiency virus type 1 replication in vitro.

Cytokines may have clinical utility as therapeutic agents for human immunodeficiency virus type 1 (HIV-1) infection and as an adjuvant for vaccines. The effect of interleukin-12 (IL-12) and IL-15 on in vitro HIV-1 replication was investigated. IL-12 and IL-15 at doses up to 10 ng/ml had little effect on basal HIV-1 p24 antigen production by chronically HIV-infected T (ACH-2) and monocytic (U1) cell lines. For ACH-2 cells stimulated with phorbol 12-myristate 13-acetate (PMA; 50 ng/ml), IL-12 and IL-15 significantly increased p24 antigen production by 20 and 30%, respectively (n = 6). In contrast, IL-12 and IL-15 (10 ng/ml) treatment of PMA-stimulated U1 cells decreased p24 antigen production by 16 and 15%, respectively (n = 6). We next studied the effect of IL-12 and IL-15 on HIV-infected peripheral blood mononuclear cells (PBMCs). In 10 HIV-seropositive patients' PBMCs cocultured with mitogen-activated HIV-seronegative donor cells, two patterns of p24 antigen production were observed in response to IL-2: low (p24 antigen production < 10(3) pg/ml; n = 8) and high (p24 antigen production > 10(3) pg/ml; n = 2) response. For the low-response pattern, IL-12 and IL-15 increased viral replication by 97-fold and 100-fold, respectively (P = 0.05 and 0.004, respectively). For the high-response pattern, both IL-12 and IL-15 suppressed HIV replication. The effect of IL-2, IL-12, and IL-15 on acute in vitro infection by HIV-1JRCSF was also examined. IL-12 did not increase p24 antigen production above basal levels while IL-2 and IL-15 significantly enhanced p24 antigen production (by approximately 2-fold). In conclusion, IL-12 and IL-15 may have differential effects on latent and acute HIV infection, and their ability to enhance HIV production may depend on cell activation. Thus, the use of these cytokines may be dictated by the clinical state of the patient.     

Giemsa staining for cysts and trophozoites of Pneumocystis carinii.

Although Giemsa staining has been routinely used for the detection of trophozoites and intracystic bodies in smears of bronchoalveolar lavage fluid (BAL) from patients with Pneumocystis carinii pneumonia, it does not normally stain the cyst wall. For detection of the cysts other stains such as toluidine Blue 'O' and methenamine silver must be used as well. Sulphation of smears before staining with Giemsa allows cysts to be visualised, thus enabling a single stain to be used to show all the stages of BAL or sputum, which is particularly useful, considering the increase in the prevalence of P carinii pneumonia in conjunction with the spread of AIDS.     

Differences in mouse interferons according to cell source and mode of induction.

Mouse interferon induced by ultraviolet-irradiated Newcastle disease virus or polyriboinosinic-polyribocytidylic acid in T lymphocytes, B lymphocytes, macrophages, and primary mouse embryonic cell culture was studied. Irrespective of the inducer, interferons produced by T or B lymphocytes were relatively heat stable and of low antigenicity when reacted with antiserum against L-cell interferon (ALI), whereas interferons produced by macrophages and mouse embryo cells were heat labile and of high antigenicity against ALI. Mouse interferons induced by ultraviolet-irradiated Newcastle disease virus were separated into three components by chromatography on CH-Sepharose 4B. Interferons produced by T and B lymphocytes consisted primarily of component 1 (unbound fraction), whereas interferons produced by macrophages or mouse embryo cells consisted primarily of component 3 (eluted by 0.5 M NaCl). Component 1 was heat stable and of low antigenicity against ALI, properties characteristic of T- and B-cell interferon. Components 2 and 3 were heat labile and of high antigenicity against ALI, properties characteristic of macrophage and mouse embryo cell interferon. In contrast, interferon induced in mice sensitized with BCG differed from these interferons induced in B cells, T cells, macrophages, and fibroblasts in being extremely acid labile and nonreactive against ALI.     

Motor outcome according to the integrity of the corticospinal tract determined by diffusion tensor tractography in the early stage of corona radiata infarct

Diffusion tensor tractography (DTT) is useful for exploring the state of the corticospinal tract (CST). An accurate estimation of the integrity of the CST in the early stage of a cerebral infarct would enable a determination of motor recovery. DTT was performed to classify CST integrity following a corona radiata infarct to evaluate if the procedure could characterize the motor outcome of the affected hand. Fifty-five patients with completely paralyzed hands due to a corona radiata infarct were recruited for the study, and DTT images were obtained within 7–30 days after a stroke. The DTI findings for the patients were classified into four groups. In type A, the CST was preserved around the infarct; in type B, the CST originated from a cortex other than the primary motor cortex; in type C, the CST was interrupted at the infarct; in type D, the CST failed to reach the infarct due to degeneration. Six months after a stroke, the motor function of the affected hand was evaluated with the motricity index (MI) for the hand, the Medical Research Council score (MRC) for finger extensors and the modified Brunnstrom classification (MBC). These indices were significantly influenced by the DTT type (p < 0.05). The highest MI, MRC and MBC were seen in the DTT type A patients; the lowest MI, MRC and MBC were seen in the DTT type D patients (p < 0.05). The integrity of the corticospinal tract determined by DTT obtained during the early stage of a corona radiata infarct seems to be helpful in predicting the motor outcome of the affected hand.