Isolation of enteric pathogeic agents in Côte d'Ivoire: Escherichia coli O157:H7 and enteroaggregative E. coli

New pathogens including Escherichia coli O157:H7 have emerged and spread world-wide as the most important cause of foodborne infections. We established a prospective study in Abidjan from 1996 to 1999 to determine the prevalence of Shiga-toxin producing E. coli (STEC) in our environment. Two O157 strains were found. One (EA47) O157:H7 was isolated from chicken and the other (EH144) O157:HNM from human diarrhoeal stool specimens. Both O157 strains carried stx2, eae, and UidA genes, but not e-hly one. Four other pathogenic E. coli were isolated, including three enteroaggregative E. coli (EAggEC) and one isolate which expresses a cytolethal distending toxin gene (cdtB). This is the first report of Shiga-toxin producing E. coli (STEC) in C?te d'Ivoire. Given its low prevalence (0.8%), E. Coli does not appear to be a public health problem in C?te d'Ivoire.     

Human T-lymphotropic type-1 virus specific antibody detected in sera of HIV/AIDS patients in Ghana

Serum samples from 124 acquired immunodeficiency syndrome (AIDS) hospitalized patients at the Fevers Unit, Korle-Bu Teaching Hospital, Accra, Ghana, were examined by the particle agglutination test for antibodies to human T-lymphotropic virus type 1 (HTLV-1) core proteins. The subjects included 84 males and 40 females, aged 16 to 54 years. Specific antibodies were detected in only 14 out of the 124 sera samples, giving an overall prevalence rate of 11.29%. The incidence was lower in males (5.95%; 5/84) than in females (22.50%; 9/40) (P<0.05). In both sexes, the age distribution of subjects positive for HTLV-1 antibodies ranged from 35 to 54 years. The prevalence rate reported herein is too low to suggest an association of HTLV-1 with AIDS, though it may indicate an opportunistic infection of AIDS patients by HTLV-1. Whether HTLV-1 is an underlying disease association or whether HTLV-1 plays some auxiliary role in the acquisition and progression of AIDS remains to be determined.     

Isoniazid plus sulphadoxine-pyrimethamine can reduce morbidity of HIV-positive patients treated for tuberculosis in Africa: a controlled clinical trial

An annual 20% excess mortality rate is observed in HIV-seropositive patients after treatment for tuberculosis. An affordable secondary prophylaxis against main opportunistic diseases is needed, i.e. against tuberculosis, toxoplasmosis, pneumocystosis and other infections occurring in this target population. This open prospective randomized study assessed morbidity and mortality in 2 cohorts of HIV-seropositive patients having recently recovered from pulmonary tuberculosis: 134 patients assigned to prophylactic treatment with isoniazid (INH, 300 mg once daily) plus sulphadoxine-pyrimethamine (S, 500 mg/P, 25 mg once weekly), and 129 were controls, comparable for sex, age, weight and HIV-serology. Patients were followed-up for up to 2 years: 192 person-years (PY) in the prophylaxis group and 142 PY in the control group. Four patients developed tuberculosis and 20 patients died in the prophylaxis group, compared to 10 and 23 controls, respectively. Sick days were reported by 22 patients in the prophylaxis group and by 77 patients in the control group. This prophylaxis was associated with a moderate decrease of mortality (log rank test: p = 0.1736), a significant decrease of tuberculosis incidence (log rank test: p = 0. 0234), a highly significant reduction of adverse events and sick days, and a prevention of wasting (p = 0.008) and anaemia (p = 0. 045). No death from toxoplasmosis occurred in the prophylaxis group as compared to 2 possible cases among controls; toxoplasmosis IgG levels declined in treated patients, but increased in controls (p = 0.01). There was no adverse drug reaction due to SP (10,006 doses) or to INH. Compliance with SP intake was good, but moderate as with INH intake. We conclude that a secondary prophylaxis with INH+SP represents a cost-effective measure to improve health conditions of HIV-infected adults in C?te d'Ivoire, following a full treatment course against tuberculosis.     

Ca2+ store determines gating of store operated calcium entry in mammalian skeletal muscle

This work describes the gating of the store operated calcium entry (SOCE) in adult mammalian skeletal muscle. Flexor digitorum brevis fibers (FDB) were isolated from adult mice and exposed to conditions to deplete the sarcoplasmic reticulum (SR). A transient SR depletion caused either by repetitive depolarizations, chlorocresol (CMC) or, cyclopiazonic acid (CPA) induced a bell shaped calcium entry that raised the [Ca²⁺]_i to a maximum of 27.09 ± 4.35 nM from the resting value. The activation time to reach 10–90% of the maximum amplitude was 112 ± 10 s (n = 22). On the other hand, any mechanism that caused a permanent SR depletion (like thapsigargin, continuous CPA, or continuous CMC) triggered a calcium entry pathway that lasted 325 ± 23 s and raised the [Ca²⁺]_i to 129.50 ± 13.05 nM from the resting level (n = 28). Then, a prolonged depletion triggered an increase in [Ca²⁺]_i to higher values and for a longer time than when the SR is transiently depleted (p < 0.001). Our results, in skeletal muscle, showed that calcium store depletion was the signal for SOCE activation and how the SR got depleted was not relevant. Also, we found that SOCE deactivation was not caused by [Ca²⁺]_i but by the SR content. Our results suggest that the SR calcium content plays an important role in SOCE gating in mammalian skeletal muscle and a calcium sensor is located inside the SR.     

The erroneous perception of a clinical sign: Cholestasis preceding sepsis mimicking hepatitis in an adolescent patient

Jaundice should be considered as a first clinical sign preceding severe invasive bacterial infection or sepsis in patients of all ages including childhood and adolescence. Early laboratory investigations and MR imaging studies for osteomyelitis or myositis are paramount to avoid progression to life‐threatening sepsis and significant morbidity and mortality.     

Unintentionally retained pelvic drainage tube found on Imaging; A case report

A retained drainage tube after surgery is rare and patients may be asymptomatic if it occurs. The presence of a retained drainage tube may be first recognized on imaging and this requires a high index of suspicion by radiologists. In this case report, we described an incidental finding of an asymptomatic retained fractured drainage tube in the pelvis of a 32-year-old female on ultrasonography for renal evaluation. This highlighted the need for radiologists to have a high index of suspicion when performing ultrasonography on postoperative patients and surgeons should be meticulous when removing drainage tubes postsurgery. The possibility of a foreign body should be considered when unfamiliar findings are encountered on imaging. Surgeons should inspect drainage tubes after removal to ensure the full length of the tube is removed.