Evaluation of two colored latex kits, the Wellcolex Colour Salmonella Test and the Wellcolex Colour Shigella Test, for serological grouping of Salmonella and Shigella species.

Two colored latex kits (the Wellcolex Colour Salmonella Test [WCT-Salmonella] and the Wellcolex Colour Shigella Test [WCT-Shigella]; Division Diagnostics, Laboratories Wellcome S.A., Paris, France), which allow identification of the most frequently encountered Salmonella serogroups and Shigella species, respectively, were evaluated. WCT-Salmonella and WCT-Shigella yielded sensitivities of 98.4 and 98%, respectively, and a specificity of 100% when they were tested on pure cultures received at a reference laboratory.     

Immunoglobulin G antibodies in human vaginal secretions after parenteral vaccination.

The induction of antibodies in vaginal secretions by systemic (intramuscular) immunization in humans was investigated by using the tetanus toxoid vaccine. Five women, 30 to 40 years old, were injected with a currently used dose of toxoid (40 IU), and serum, saliva, and vaginal secretion samples were collected on day 0 and on day 6 or day 10. All of these subjects had been previously vaccinated at least 5 years before; four were in good health, whereas one suffered from AIDS in clinical category B3. In most cases, analysis of specific antibodies in the vaginal wash showed a dramatic rise after boosting. These antibodies were primarily of the immunoglobulin G (IgG) isotype. The specific activity (ratio of antibody titer to IgG concentration) was shown to increase after the booster injection, irrespective of variations in the IgG level during the menstrual cycle. Comparison between serum and genital antibodies showed no difference in terms of both specific activity and level of avidity. These results demonstrate that parenteral injections can induce a systemic-derived antibody release in the vaginal fluid. Hence, systemic vaccinations can be efficient at the genital level and thus could reinforce or even replace a local vaccine.     

Spontaneous angina caused by spasm of the left coronary artery]

A 42 year old woman presented with a one year history of retrosternal chest pain and back pain on effort and at rest sometimes accompanied by minor syncopal attacks. Transient atrioventricular block was documented during one such episode associated with hypotension. Coronary angiography showed spontaneous spasm of the left main coronary artery with clinical symptoms but no electrocardiographic changes. The spasm was relieved by injection of SIN-1. The similarity between the previous clinical symptoms and those observed at coronary angiography was in favour of the diagnosis of spasm of the left main coronary artery without atherosclerotic coronary disease. Treatment with calcium atherosclerotic coronary disease. Treatment with calcium blockers and platelet antiaggregants led to total regression of her symptoms with a follow-up of 5 months.     

Epidemiological markers for epidemic strain and carrier isolates in an outbreak of nosocomial oxacillin-resistant Staphylococcus aureus.

An outbreak of nosocomial infections occurring in a postoperative intensive care unit was caused by a single strain of oxacillin-resistant Staphylococcus aureus. Six patients were infected, or colonized, by this strain, which was traced by using the following four epidemiological markers: antibiogram, bacteriophage type, capsular polysaccharide type, and esterase electrophoretic type. This strain was compared with S. aureus isolates obtained from the noses of 13 carriers from a group of 42 staff members. A good correlation in terms of phenotypic markers was found between the epidemic strain and a strain isolated from one carrier. Both exhibited the same pattern of multiple resistance as well as the same phage type, 77, capsular polysaccharide type, 5, and esterase electrophoretic type, 6. In contrast, an oxacillin-resistant strain, isolated from another carrier, differed from the epidemic strain by susceptibility to rifampin and by susceptibility to four additional bacteriophages. The other 11 strains isolated from carriers were susceptible to oxacillin and exhibited widely different phenotypes. These results confirm the interest of using several epidemiological markers to trace the spread of epidemic S. aureus strains and to delineate the carrier strains.     

Natural polyreactive secretory immunoglobulin A autoantibodies as a possible barrier to infection in humans.

Secretory immunoglobulin A (S-IgA) was investigated in human secretions for the presence of natural antibodies (Abs) acting as the first "immune barrier" to infection before induction or boosting of specific responses. These molecules could be the secretory counterpart of the natural Abs in serum that were previously shown by our laboratory to be polyreactive to autoantigens. Significant levels of S-IgA Abs to human actin, myosin, tubulin, and spectrin were detected in 10 saliva and 8 colostrum samples from normal subjects. Computer-assisted analysis of immunoblots of extracts from human muscles showed these Abs to react with a large number of autoantigens. Their polyreactivity was confirmed by cross-inhibition and by immunoblotting studies of affinity-purified natural Abs, assayed against a large variety of surface or secreted antigens from Streptococcus pyogenes. The thiocyanate elution method showed that functional affinities of some natural Abs can be of the same order of magnitude as those of tetanus vaccine antitoxins. Moreover, nonimmune binding of these natural Abs to the gut protein Fv (Fv-fragment binding protein) can enhance their effector functions. This demonstrates that human secretions contain polyreactive auto-Abs which can also react with pathogens. These secretory Abs of "skeleton key" specificities are possibly produced by a primordial B-1-cell-associated immune system and can be involved in a plurispecific mucosal protection against pathogens, irrespective of the conventional immune response.     

Restricted association between biotypes and serotypes within group A streptococci.

Investigating individual variations between different isolates of group A streptococci, we observed a close correlation between biotypes and serotypes in 46 strains from pharyngitis patients. Biotyping, carried out with a commercially available rapid identification gallery, delineated 10 different associations of characteristics, designated biotypes 1 to 10, observed both in the manufacturer's (127 strains) and our personal (98 strains) collections of group A strains. Only the most frequent biotypes (biotypes 1 to 6) were observed in the pharyngitis cohort, but the overall frequencies of the biotypes did not display striking differences compared with the control collections. Serotyping of the pharyngitis strains showed that each M type was restricted to a sole biotype. For example, M types 1, 4, and 28 were found only in biotype 1 and M type 6 was found only in biotype 6 strains. This association was not due to an epidemiologic bias, since it was also observed in a control series consisting of reference strains and isolates from distant countries (the United States and Czech Republic versus France). An exception was for M type 78, which exhibited biotype 3 or biotype 4. Investigation of the heterogeneity of the strains at the DNA level showed no significant variations of the ribotype patterns between strains of different biotypes, confirming that group A streptococci belong to a unique and homogeneous species. This previously undescribed association between serotypes and biotypes is of interest for a rapid and preliminary characterization of strains isolated in individual patients or during an outbreak. A possible pathogenic association of some biotypic characteristics with specific M proteins is envisaged.     

Characterization of nutritionally variant streptococci by biochemical tests and penicillin-binding proteins.

A comparative study of 60 strains of nutritionally variant streptococci (NVS) with 34 strains of Streptococcus mitis and 37 strains of Streptococcus sanguis II showed the presence of a red chromophore which was absent in the other streptococcal species. By using the conventional microbiological tests, only small differences were found between the NVS and the two other related species. In contrast a clear-cut delineation was found by the API 20 Strep system of identification. All NVS contained pyrrolidonylarylamidase, an enzyme which was absent in S. mitis and S. sanguis II strains, and lacked the alkaline phosphatase enzyme which was present in 56% of S. mitis strains and 62% of S. sanguis II strains. According to the additional enzymatic and biochemical tests of the API 20 Strep system, there were three biotypes among NVS. The major biotype included 33 of 60 strains which were characterized by the presence of both alpha- and beta-galactosidases and the capacity to hydrolyze trehalose. This biotype also showed a specific pattern of penicillin-binding proteins. These results show that NVS are recognized as a separate variety distinct from S. mitis and S. sanguis II species, despite some common biochemical properties. Moreover, the delineation of 33 strains with a specific biotype and a specific penicillin-binding protein pattern strongly suggests that a large part of NVS strains belong to an individual species.     

Bacteremia caused by an undescribed species of Janibacter

A yellow-pigmented rod- to coccoid-shaped coryneform microorganism was isolated from the blood of a patient with acute myeloid leukemia. It was identified by 16S rRNA gene sequencing as a previously undescribed species of Janibacter. The isolate was susceptible to penicillins, aminoglycosides, fluoroquinolones, and glycopeptides.