Achromobacter xylosoxidans respiratory tract infections in cystic fibrosis patients

Achromobacter xylosoxidans is a ubiquitous Gram‐negative non‐fermenting rod, recently characterized as an emerging pathogen in cystic fibrosis (CF) patients. Its pathogenic potential and prevalent transmission routes are still unclear. This study investigated the PFGE genetic pattern and antimicrobial resistance profile of 42 A. xylosoxidans isolates obtained over 4 years from the respiratory tract of 22 CF patients. By genotypic analysis, 31 isolates were attributed to 8 distinct PFGE patterns (A–H), whereas 11 isolates were not typable because their DNA was not restricted by XbaI and DraI restriction enzymes. The majority of the isolates showed multidrug resistance; imipenem and piperacillin were the most active drugs. During the course of A. xylosoxidans chronic infection forced expiratory volume and body mass index values were not significantly lowered. The demonstration of widespread antibiotic resistance underscores the importance of antibiogram‐directed therapy. Our data suggest that in some cases the infection may have been acquired from other patients or from a common contaminated source. Further epidemiological studies may be important for the design and implementation of prophylactic measures in CF centers.     

Gonadal function in male heroin and methadone addicts

Gonadal function was elevated in 80 male heroin and/or methadone addicts by measuring basal plasma levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) and testosterone. In 41 subjects semen analyses were also undertaken. Three groups were distinguished consisting of 15 heroin addicts, 42 undergoing methadone treatment but continuing to take heroin, and 23 taking only methadone. All patients had normal plasma levels of FSH, LH and testosterone. Prolactin levels were normal in all subjects except for the 15 heroin addicts, in whom they were significantly higher than in controls (P less than 0.025). Semen analyses from all of the heroin addicts and from the dual heroin-methadone users were abnormal, whereas only 10 out of 22 (45%) of the methadone takers were pathological. In all cases asthenospermia was one of the abnormalities (100%). Twenty-four per cent also showed teratospermia and hypospermia and 17% showed oligozoospermia. Such seminal pathology, especially of forward motility, even in combination with normal hormone levels, might be an early indication of heroin toxicity to the male reproductive tract.     

The release of β- thromboglobulin and platelet factor 4 during extracorporeal circulation for open heart surgery

Cardiopulmonary bypass is extremely damaging to platelets and it causes a quantitative and qualitative alteration in their functions. We evaluated the release of two platelet-specific proteins, beta-thromboglobulin (beta TG) and platelet factor 4 (PF4), in patients who underwent extracorporeal circulation for open heart surgery. A parallel release (basal value beta TG: 119.6 ng/ml, PF4 30 ng/ml) was present for both proteins in a time dependent fashion until the end of extracorporeal circulation. High average levels were observed in patients in whom the bypass was stopped after about 1 h (beta TG 1606 ng/ml, PF4 745 ng/ml) and similarly in those in whom the bypass was stopped after about 2 h (beta TG 1540 ng/ml, PF 4754 ng/ml). No correlation was found either between the level of PF4 and the additional heparin administered after the initial standard dose (r = 0.29, P greater than 0.10) and between the level of PF4 and the amount of heparin consumed during the bypass (r = 0.05, P greater than 0.5).