Bladder irrigation in patients with indwelling catheters

The effect of intermittent bladder irrigation on the bacterial counts in urine samples was studied in patients with indwelling catheter and pre-existing urinary tract infection. Four different irrigating solutions were used. Irrigation with saline or 0.25% acetic acid had no effect on the urinary bacterial count. The bacterial counts were effectively reduced during intermittent irrigation both with 0.02% chlorhexidine and with 0.25% silver nitrate. Silver nitrate gave the greatest reduction of bacterial counts but chlorhexidine is preferable due to fewer side effects and greater convenience.     

Two cases of endocarditis caused by Neisseria elongata subspecies nitroreducens and phenotypic differentiation from Kingella denitrificans

Objective: To describe two cases of endocarditis caused by Neisseria elongata subsp. nitroreducens, and present some biochemical characteristics not previously described as useful for differentiating this taxon from Kingella denitrificans .
Methods: Biochemical and antimicrobial susceptibility tests were carried out on four field strains and three reference strains of N. elongata subsp. nitroreducens, the type strains of N. elongata subsp. elongata and N. elongata subsp. glycolytica, and five reference strains of K. denitrificans .
Results: Phenotypic characterization confirmed the identification of N. elongata subsp. nitroreducens in two cases of endocarditis in patients with pre-existing heart damage. Apart from the previously reported differential characteristics between N. elongata subsp. nitroreducens and K. denitrificans, N. elongata subsp. nitroreducens was found to have large mucoid colonies, a positive result of the phenylalanine test, acid production from ethanol and susceptibility to polymyxin, in contrast to K. denitrificans .
Conclusion: When blood cultures are positive for N. elongata subsp. nitroreducens, endocarditis should be suspected. Characteristics useful for differentiating N. elongata subsp. nitroreducens from K. denitrificans are larger colonies, reduction of nitrate and nitrite without gas formation, a positive result of the phenylalanine test, production of acid from ethanol and polymyxin susceptibility.     

Glucagon stimulated plasma cyclic adenosine-3',5'-monophosphate in the differential diagnosis of jaundice.

The amount of plasma cyclic adenosine-3',5'-monophosphate was estimated before and 15 minutes after the intravenous injection of 1 milligram of glucagon in 34 patients with obstructive and in 23 patients with nonobstructive jaundice. After stimulation with glucagon, the median adenosine-3',5'-monophosphate concentration in obstructive jaundice rose fortyfold or more, while in nonobstructive jaundice, the increase was twentyfold or less. The difference was highly significant. The results indicate that this test can be useful in the differential diagnosis of obstructive and nonobstructive jaundice.     

Pleural effusion disease agent as passenger of Treponema pallidum suspensions from rabbits. Survey of laboratories.

Material from rabbits used for the propagation of Treponema pallidum in 12 selected laboratories was examined for a viral passenger agent of the treponemal suspensions. An agent which causes clinical or subclinical pleural effusion disease (PED) in rabbits and which is serologically identical or related to the PED agent isolated in Copenhagen was found as a contaminant in treponemal suspensions in laboratories in Europe, the USA, and Japan. The experience gained in the Scandinavian treponematoses laboratories suggests that strains of T pallidum contaminated with the PED agent can be purified by passage through hamsters.