Evaluation of phenotypic and molecular methods for detection of oxacillin resistance in members of the Staphylococcus sciuri group

In this paper we report on an experimental evaluation of phenotypic and molecular methods as means for the detection of oxacillin resistance in members of the Staphylococcus sciuri group. A total of 109 S. sciuri group member isolates (92 S. sciuri isolates, 9 S. lentus isolates, and 8 S. vitulinus isolates) were tested by the disk diffusion method, the agar dilution method, the oxacillin salt-agar screening method, slide latex agglutination for PBP 2a, and PCR assay for mecA as the reference method. The mecA gene was detected in 29 S. sciuri isolates, and the true-positive and true-negative results of the other tests were defined on the basis of the presence or the absence of the mecA gene. For the different methods evaluated, the sensitivities and specificities were as follows: for the disk diffusion test with a 1-microg oxacillin disk, 100% and 55.9%, respectively; for the disk diffusion test with a 30-mug cefoxitin disk, 93.5% and 100%, respectively; for the agar dilution method, 100% and 50%, respectively; for the oxacillin salt-agar screen test (with 6 microg of oxacillin per ml and 4% NaCl) 100% and 100%, respectively; and for the slide latex agglutination test for PBP 2a, 100% and 100%, respectively. The disk diffusion test with various beta-lactam antibiotics was performed to evaluate their use for the prediction of oxacillin resistance. The results indicate that meropenem, cefazolin, cefamandole, cefuroxime, cefotetan, cefoperazone, cefotaxime, ceftriaxone, moxalactam, cefaclor, and cefprozil may be used as surrogate markers of oxacillin resistance, although further studies of their use for the detection of oxacillin resistance are required.     

PHYSICAL HEALTH OF TEN-YEAR-OLD CHILDREN An Epidemiological Study of School Children and a Follow-up of Previous Health Care

ABSTRACT. At 10 years of age, all 223 children in a school district underwent a physical examination and a screening for vision and hearing defects within the school health services. The purpose of the study was to detect health problems of importance for the day-to-day functioning of the child. In 26.1% significant deviations were found. Physical disorders comprised 11.7%, visual defects 11.7% and auditory impairment 2.7%. The vast majority of significant health problems were previously known and in only 4.4% of the 223 children newly detected, 0.9% by the physical examination, 2.7% by the vision screening and 0.9% by the auditory screening. The most frequent health problem of all was allergy in 13.5%, in 5.4% regarded as functionally important. Minor orthopaedic deviations and motor disturbances were common but not often considered to affect the functioning of the child significantly. As a whole, the children's health was very good and the outcome of the physical examination at this age was not impressive. It is evident that the physician's role in the school health system needs to be reconsidered.     

CHYMOTRYPTIC ACTIVITY IN STOOL OF LOW BIRTH WEIGHT INFANTS IN THE FIRST WEEK OF LIFE

ABSTRACT: Jodl, J., Kornfalt, R. and Svenningsen, N. YV. (The Motol Paediatric Clinic, University of Prague, Prague, Czechoslovakia, and the Department of Paediatrics, University Hospital, Lund, Sweden). Chymotryptic activity in stool of low birth weight infants in the first week of life. Acta Paediatr Scand, 64:619, 1975.–Pancreatic enzyme activity in low birth weight (LBW) infants during the first postnatal week has been evaluated by analysing the chymotrypsin content of 198 stool specimens from 42 LBW infants with birth weights ranging between 750 and 2570 g. A wide variation in chymotryptic activity yet with a tendency to initially low values with a peak on the third day after birth was found. Small-for-gestational age (SGA) infants had significantly lower values than appropriate-for-gestational age (AGA) infants. This is considered due to intra-uterine malnutrition with secondary pancreatic dysfunction in SGA infants. In screening program for cystic fibrosis or other defects of exocrine pancreatic activity, low stool chymotrypsin values cannot be considered pathological until after the fourth day of life.     

Acute Respiratory Tract Infections in Children

ABSTRACT. Respiratory tract infections (RTIs) in small children account for a considerable proportion of health care expenditure. In 113 children, followed for the first three years of life, we studied the frequency of acute RTI and its relationship to the factors: type of day-care, age, sex, family size, living conditions, allergic predisposition, family smoking habits, and season. To elucidate the influence of age, the frequency of acute RTI and its relationship to type of day-care was longitudinally studied on a quarterly basis. The frequency of acute RTI diagnosis increased gradually from birth culminating in a peak at the beginning of the second year. Besides age and season, type of day-care was the only factor studied to show any relationship with the frequency of acute RTI diagnosis. Up to the age of almost 2 1/2 years, children attending day-care centres accounted for more RTI diagnoses than did those in home care or family day-care, categories with comparable frequncies.     

Electron microscopy study of genesis and dynamics of immunodeposition in IgMk-IgG cryoglobulin-induced glomerulonephritis in mice

Cryoglobulinemic glomerulonephritis is particularly frequent in type II mixed IgMk-IgG cryoglobulinemia. The typical form is a membranoproliferative glomerulonephritis with a particular monocyte infiltration. In the most severe cases, there is occlusion of the capillary lumina by the same immunoglobulin constituents of the cryoprecipitate. While it is generally accepted that the "hyaline thrombi" are endoluminal aggregates of IgG-IgM immune complexes, probably favored by high endocapillary concentration of cryoglobulins, the modality of generation has not been studied. To study the dynamic formation of such "thrombi," we reproduced an experimental model of cryoglobulinemic glomerulonephritis in mice by injecting them twice a day for 3 days with 4 mg human IgMk-IgG cryoglobulins previously solubilized at 37 degrees C. The dynamic formation of immunodeposits was studied by immunofluorescence and electron microscopy. After 1 day, only mesangial deposits were found; after 3 days, in addition to mesangial deposition, all the capillary lumina were occluded by huge electron-dense bodies. To look for and quantify the contacts between such "thrombi" and mesangial or subendothelial deposits, we obtained serial, ultrathin, 0.5-microm sections that allowed us to reconstruct the whole glomerular tuft. Within each serial section, there was continuity between hyaline thrombi and mesangial or subendothelial deposits ranging from 80% to 85% of the capillary loops. The percentage was 100% for two adjacent serial sections. In conclusion, our data demonstrate directly for the first time that hyaline thrombi follow mesangial deposits. The high percentage of contacts between thrombi and mesangial or subendothelial deposits suggests that they result from in situ build-up of true huge endoluminal immunodeposits after saturation of the clearance capacity of the mesangium.     

Suppression of experimental autoimmune myocarditis by sodium fusidate (fusidin)

Fusidic acid and its sodium salt sodium fusidate (fusidin) are widely used antibiotics that possess immunomodulating properties. It has been shown that fusidin ameliorates the course of several organ-specific immunoinflammatory diseases and thus we investigated the effect of fusidin on myosin-induced experimental autoimmune myocarditis (EAM) in rats, a well-established animal model for human giant cell myocarditis and postmyocarditis dilated cardiomyopathy (DCM). Fusidin at doses of 80 mg kg(-1) was administrated i.m. to male Dark Agouti (DA) rats, either from days 0 to 10 (early treatment group), or from days 10 to 20 (late treatment group) after induction of EAM. Efficacy of fusidin treatment was determined on day 21 of EAM development. It was observed that both early and late treatment with fusidin markedly ameliorated clinical, histological and immunohistochemical signs of the disease. The treated rats had significantly decreased incidence of EAM, heart weight and heart weight/body weight ratio (Hw/Bw) compared with untreated animals. In contrast to the severe myocardial damage and cellular infiltration in the EAM rats, there was only focal infiltration of inflammatory cells in the myocardium of the treated rats. In both treated groups the mean microscopic score was markedly lower compared with vehicle-treated animals. In addition, the number of CD4+, ED1+ and OX6+ cells was significantly lower in myocardium of fusidin-treated rats than that in untreated group. The present findings suggest that fusidin exhibited both early and late therapeutical effect in EAM.     

Prevalence of HLA sensitization in female apheresis donors

BACKGROUND: Transfusion-related acute lung injury (TRALI) is a serious complication of plasma-containing blood components. Studies have implicated HLA antibodies along with biologically active lipids in stored blood in the pathogenesis of TRALI. It has been proposed that the exclusion of HLA-untested, multiparous donors of plasma-rich components, including plasma and single-donor apheresis platelets, would substantially reduce the risk of TRALI. STUDY DESIGN AND METHODS: To investigate the feasibility of such an exclusion, 332 female plateletpheresis donors with a record of over 9000 donations, none of which were associated with TRALI, were studied. RESULTS: Seventeen percent of female donors demonstrated HLA sensitization. Parity and HLA sensitization were significantly correlated (p<0.0001), with sensitized donors having an average of 2.9 (+/− 0.6 95% CI) prior pregnancies and unsensitized donors having an average of 1.8 (+/− 0.2 95% CI) prior pregnancies. The percentage of HLA-sensitized women with 0, 1 to 2, and > or = 3 pregnancies was 7.8, 14.6, and 26.3, respectively. CONCLUSION: These findings confirm the hypothesis that multiparous women (> or = 3 pregnancies) represent an increased potential risk for TRALI. However, the exclusion of multiparous plateletpheresis donors would eliminate one-third of our female donor pool. Screening such donors for HLA sensitization may represent the optimal approach for identifying donors at risk for causing TRALI, but this still would result in the deferral of 8 percent of female plateletpheresis donors. At present, prospective screening to identify donors at risk for causing TRALI is not justified.     

新型无机微粒栓塞材料BaFe12O19的血液相容性实验

目的:评价BaFe12O19微粒作为一种新开发的具有潜在应用前景的新型血管内栓塞材料的血液相容性,并观察其对机体的出血时间、凝血时间及凝血酶原时间、纤维蛋白原测定、活化部分凝血活酶时间、凝血酶时间的影响。方法:BaFe12O19微粒材料于2005-07/2006-05在武汉理工大学生物材料与工程研究中心实验室完成,血液相容性实验于2006-05/09在解放军广州军区武汉总医院中心实验室完成。①溶血实验:取人新鲜全血,分别加入生理盐水(阴性对照组)、蒸馏水(阳性对照组)、无机微粒浸提液(实验组),观察溶血情况,计算溶血率。②出血、凝血时间测定:健康NIH小鼠随机分为实验组和对照组,分别腹腔注射无机微粒混悬液或生理盐水1 mL,7 d后测定出血、凝血时间。③凝血功能实验:取健康Wistar大鼠静脉血,随机分为实验组及对照组,分别注入1 g/L微粒混悬液或生理盐水1 mL,30 min后测量凝血功能。结果:①溶血实验结果:实验组和阴性对照组均无溶血现象,阳性对照组全部溶血,实验组的溶血率为2.08%,符合ISO规定的不大于5%的标准。②出血、凝血时间测定结果:实验组和对照组小鼠的出血、凝血时间比较差异无显著性意义(P>0.05)。③凝血功能实验结果:实验组和对照组凝血酶原时间、纤维蛋白原、活化部分凝血活酶时间、凝血酶时间比较均无显著差别(P>0.05)。结论:BaFe12O19微粒符合血液相容性标准,具有良好的血液相容性能。     

Serbian lymphoma study group (SLG): the prognosis of AIDS-related non-Hodgkin's lymphoma.

BACKGROUND: The majority of patients with AIDS-related non-Hodgkin's lymphoma (ARL) present with advanced disease, aggressive histological type, B-symptoms, and often with an extranodal localization. The prognosis is generally poor. The use of highly active antiretroviral therapy (HAART), in combination with chemotherapy, has improved the outcome of ARL. AIMS: The aims of this study were to detect prognostic factors for patients with ARL and estimate efficacy of concomitant chemotherapy and HAART on overall survival (OS) of these patients. Also, two different chemotherapy regimens have been tested: low dose (ld) mBACOD and CHOP. METHODS: The study series involved 28 patients with ARL treated at the Clinical Center of Serbia in Belgrade during the period 1996-2006. Twenty-six patients had an aggressive type of lymphoma while 2 had an indolent type. Nineteen patients were treated with chemotherapy, 10 with ld mBACOD and 9 with CHOP. Concomitant HAART and chemotherapy were used in 14 patients. RESULTS: This study demonstrated that significant factors for OS in patients with ARL were the high International Prognostic Index (P=0.019), previous AIDS event (P=0.04), aggressive histological type of NHL (P=0.007) and extranodal disease (P=0.04). The usage of concomitant HAART and chemotherapy had significant effect on median survival (90 months), compared with chemotherapy alone (10 months) (P=0.0002). The patients treated with CHOP had a better response than patients treated with ld mBACOD, but this difference was not significant. CONCLUSIONS: Our data suggest that aggressive presentation of ARL implicates the need not only for more intensive chemotherapy regimens, but the concomitant usage of HAART, which should result in higher rates of OS in ARL patients.