bluuebunny/crossref_metadata_2025 huggingface dataset:
Epidemiology of falls in elderly semi‐independent residents in residential care
Authors: Fisher Alex A , Davis Michael W , McLean Allan J , Le Couteur David G
Published: June 2005

Objectives:  To determine the incidence and consequences of falls in elderly people living in hostels, and the role of comorbidity, orthostatic hypotension and medications as risk factors for falls.

Methods:  Cross‐sectional prevalence and event association was studied in eight aged‐care hostels (Canberra, ACT, 1999) of 179 residents aged 65 years and older (83 ± 7 years (mean ± standard deviation), 80% women) independent in activities of daily living. History of falls and injuries on falling, comorbidity, medications and mobility data were obtained. Measurements of blood pressure and heart rate were made supine after waking from overnight sleep and after standing for 1 and 3 min.

Results:  Forty‐three per cent of subjects had fallen in the last year (1.3 ± 2.6 falls per person per year) and 29% of these had sustained a fracture, 53% of fallers had recurrent falls. In multivariate analysis, four factors were associated independently with falling within a year: using a walking device, history of cancer, taking selective serotonin reuptake inhibitors (SSRI) and cigarette smoking. For recurrent falls, cerebrovascular disease and using nitrates were also independent risk factors. In univariate analysis, reversible inhibitors of monoamine oxidase and potassium‐sparing diuretics were negatively associated with falls. There were no differences between fallers and non‐fallers in blood pressure in supine and standing positions, although one‐third of residents had orthostatic hypotension.

Conclusions:  Falls in elderly hostel residents are common and often have serious consequences. Living in an institution is associated with an increased risk of fractures. The study identified several novel potential risk factors for falls in this population: using a walking device, history of falls, presence of cancer, presence of cerebrovascular disease, taking SSRIs, taking nitrates and cigarette smoking. These can be used to identify hostel residents at high risk of falling who can then be targeted for monitoring, specific treatment and prevention strategies.
Prevalence of skin disease among the elderly in different clinical environments
Authors: Smith Derek R , Leggat Peter A
Published: June 2005

Although skin disease is a common and inevitable consequence of ageing, relatively few epidemiological studies have focused on the elderly demographic. Those that do exist are often difficult to find, while matching studies from numerous countries can easily become a daunting task for the busy clinician. Therefore, we undertook a comprehensive literature search for any manuscripts targeting elderly skin disease published in peer‐reviewed medical journals over the past 60 years. A total of 61 reports from 12 countries were eventually selected for inclusion. Among the community‐dwelling elderly, seborrheic keratosis, xerosis and Campbell de Morgan spots were shown to have the highest prevalence rates, affecting 88%, 85% and 75% respectively. These diseases also affected nursing home residents (seborrheic keratosis 85% and xerosis 77%), as did tinea unguium at 57%. Prevalence rates within the dermatology clinic were different, however, with none exceeding 25%. By subcategory, the most frequently presented conditions were actinic keratosis (25%), fungal infections (17%) and xerosis (14%). Overall, our review has shown that skin disease is very common among the elderly and its prevalence varies widely depending on the patients’ clinical environment. Considerable work remains to be undertaken regarding skin disease risk factors. With the projected exponential ageing of almost all industrialised societies throughout the 21st century, a greater commitment should now be directed towards this burgeoning subdiscipline of clinical medicine.
Palliative care in aged care facilities for residents with a non‐cancer disease: results of a survey of aged care facilities in South Australia
Authors: Grbich Carol , Maddocks Ian , Parker Deborah , Brown Margaret , Willis Eileen , Hofmeyer Anne , Piller Neil
Published: June 2005

Objectives:  This study reports the results of a cross‐sectional study of residential aged care facilities in South Australia which sought to quantify the extent of specialist palliative care involvement in residential aged care facilities as well as identifying the current need for palliative care.

Method:  A questionnaire was completed by 51 Directors of Care from 51 of 90 facilities targeted, representing a response rate of 57% and representing 20% of the total number of South Australian licensed beds. Facilities responding were representative of residential aged care facilities in South Australia for location, type of funding and level of care.

Results:  Thirty facilities (59%) used specialist palliative care services during 2001 with the average number of residents consulted being four. There were 627 deaths recorded in the 2785 licensed beds, a death rate of 23%. The majority of these deaths were from non‐cancer diseases (83%) and up to two‐thirds of all deaths occurred away from low care facilities, usually in an acute care setting. Main reasons for transfer away from the facility were; an acute care episode requiring other expertise, rapid deterioration of the resident, care needs beyond the facility, or the general practitioner or family requested a transfer. Care Directors estimated that 7% of their current residents would be considered palliative and the majority of these had non‐cancer diseases (78%).

Conclusion:  These findings indicate that palliative care is an important aspect of care in residential aged care facilities for clients with a non‐cancer diagnosis.
Characteristics of older dietary supplement users: review of the literature
Authors: Brownie Sonya
Published: June 2005

Published literature reports rates of dietary supplement usage by individuals aged 60 years or more to be 16−60%. Prevalence figures are dependent on the population studied and the method of data collection. In general, older supplement users are female, Caucasian and well educated, with healthier lifestyle practices than non‐supplement users, and they are less likely to be overweight or to smoke. Neither income nor self‐rated health status are reliable predictors of supplement use in this group. In many cases older supplement users report higher intakes of several micronutrients from food than older non‐supplement users. Current patterns of supplement use by the older person reveal that although they consume a range of products, they do not supplement with nutrients that are of particular benefit to them. The supplements most commonly consumed by individuals aged 60 years and over are multivitamins and minerals, vitamin C and vitamin E preparations. There is insufficient data to quantify the dosage, frequency and duration of supplement use by the older population. Obtaining this information and data about herbal medicine use is an important step towards minimising the risk of drug–nutrient–herbal interactions. Identifying the health professionals who monitor the appropriateness and safety of supplement use in older individuals, particularly given the already high use of medication in this population, also needs to be a focus of future utilisation investigations. This systematic review of the literature published between 1982 and 2003 aims to measure the patterns of dietary supplement use by community‐living individuals aged 60 years and over and to profile the characteristics of older supplement users.
A Multinational Population Survey of Intravaginal Ejaculation Latency Time
Authors: Waldinger Marcel D. , Quinn Paul , Dilleen Maria , Mundayat Rajiv , Schweitzer Dave H. , Boolell Mitradev
Published: June 2005

Introduction

Intravaginal ejaculation latency time (IELT), defined as the time between the start of vaginal intromission and the start of intravaginal ejaculation, is increasingly used in clinical trials to assess the amount of selective serotonin reuptake inhibitor-induced ejaculation delay in men with premature ejaculation. Prospectively, stopwatch assessment of IELTs has superior accuracy compared with retrospective questionnaire and spontaneous reported latency. However, the IELT distribution in the general male population has not been previously assessed.

Aim

To determine the stopwatch assessed-IELT distribution in large random male cohorts of different countries.

Methods

A total of 500 couples were recruited from five countries: the Netherlands, United Kingdom, Spain, Turkey, and the United States. Enrolled men were aged 18 years or older, had a stable heterosexual relationship for at least 6 months, with regular sexual intercourse. The surveyed population were not included or excluded by their ejaculatory status and comorbidities. This survey was performed on a “normal” general population. Sexual events and stopwatch-timed IELTs during a 4-week period were recorded, as well as circumcision status and condom use.

Main Outcome Measures

The IELT, circumcision status, and condom use.

Results

The distribution of the IELT in all the five countries was positively skewed, with a median IELT of 5.4 minutes (range, 0.55–44.1 minutes). The median IELT decreased significantly with age, from 6.5 minutes in the 18–30 years group, to 4.3 minutes in the group older than 51 years (P < 0.0001). The median IELT varied between countries, with the median value for Turkey being the lowest, i.e., 3.7 minutes (0.9–30.4 minutes), which was significantly different from each of the other countries. Comparison of circumcised (N = 98) and not-circumcised (N = 261) men in countries excluding Turkey resulted in median IELT values of 6.7 minutes (0.7–44.1 minutes) in circumcised compared with 6.0 minutes (0.5–37.4 minutes) in not-circumcised men (not significant). The median IELT value was not affected by condom use.

Conclusion

The IELT distribution is positively skewed. The overall median value was 5.4 minutes but with differences between countries. For all five countries, median IELT values were independent of condom usage. In countries excluding Turkey, the median IELT values were independent of circumcision status.
Antibiotic Coating Reduces Penile Prosthesis Infection
Authors: Droggin Dmitry , Shabsigh Ridwan , Anastasiadis Aristotelis G.
Published: June 2005

Aim

To evaluate the efficacy of a new antibiotic-coated (rifampicin + monocycline) penile prosthesis in prevention of bacterial adhesion and reduction of penile prosthesis infection.

Methods

In a retrospective analysis of medical records of men who had undergone implantation of American Medical Systems (AMS) inflatable penile prostheses between July 1990 and November 2003, we compared patients with AMS antibiotic-coated prostheses and patients with AMS nonantibiotic-coated prostheses. A total of 152 men aged from 27 to 79 years with erectile dysfunction underwent implantation of the AMS inflatable penile prosthesis. Fifty-eight patients received the antibiotic-coated prosthesis between July 2001 and November 2003, and 94 patients received the nonantibiotic-coated prosthesis between July 1990 and June 2001.

Results

In most cases infection was present; it was detected 1–2 days or up to 3–6 months after implantation. Complications including infection, which required surgical intervention, were observed in 15 patients of the nonantibiotic-coated prosthesis group (three reoperations for infection), and  noninfection-related  failure  in  five  patients  of  the  antibiotic-coated  prosthesis  group.  In the nonantibiotic-coated prosthesis group of patients, time to infection ranged from 1 day to 6 months (mean 3.5 months). The antibiotic-coated prosthesis group of patients immediately after surgery and during the short- and intermediate-term follow-up had no infection of the penile prosthesis.

Conclusions

We suggest that the antibiotic locally delivered from the prosthesis coating might be an effective supplement for prevention of prosthesis-related infection in penile prosthesis surgery.
Premature Ejaculation—Does Country of Origin Tell Us Anything About Etiology?
Authors: Richardson Daniel , Goldmeier David
Published: June 2005

Introduction

Premature ejaculation is a common sexual problem. The etiology of this condition is unclear. It has been suggested that some racial groups may be more at risk than others. We had a clinical impression that in our unit in London, UK, there was a preponderance of men from Islamic and Asian backgrounds.

Aim

We therefore undertook a retrospective analysis of our clinic population over an eighteen-month period.

Methods

A total of 123 patients were identified with a clinical diagnosis of PE based on the DSM-IV and UK national guidelines.

Main Outcome Measure

Demographic and clinical data were collected retrospectively: parameters of patients seen in the previous 18 months were identified, including self-identified ethnicity and age. Patient-defined ethnicity was compared with the ethnicity of self-referring patients attending our general sexual health services (outpatients), and also with local population census data.

Results

A total of 60% of patients were from Islamic or Asian backgrounds but 12% and 11% came from those racial groups in local population census data and our general clinic population respectively (P < 0.001).

Conclusions

It thus appears that there is a preponderance of men from Islamic and Asian backgrounds presenting to our unit with premature ejaculation. The reasons for this are unclear. Possible mechanisms include psychosocial, familial, or genetic influences.
Cyclic Nucleotide Signaling in Cavernous Smooth Muscle
Authors: Lin Ching-Shwun , Lin Guiting , Lue Tom F.
Published: June 2005

Introduction

Penile erection depends on cavernous smooth muscle relaxation that is principally regulated by cyclic nucleotide signaling. It is hoped that a comprehensive review of publications relevant to this subject will be helpful to both scientists and clinicians who are interested in the sciences of erectile function/dysfunction.

Aims

To review the roles of extracellular signaling molecules, their receptors, intracellular effectors, and phosphodiesterases in cyclic nucleotide signaling that leads to cavernous smooth muscle relaxation. The involvement of these molecules in the development of erectile dysfunction and the possibility of using them as therapeutic agents or targets are also discussed.

Methods

Entrez, the search engine for life sciences, was used to search for publications relevant to the topics of this review. Keywords used in the searches included vascular, cavernous, penis, smooth muscle, signaling molecules (adenosine, nitric oxide, etc.), and key elements in the cyclic nucleotide signaling pathways (cAMP, cGMP, cyclases, PKG, PKA, etc.). Articles that are dedicated to the study of erectile function/dysfunction were prioritized for citation.

Results

More than 1,000 articles were identified, many of which are studies of the vascular system and are therefore reviewed but not cited. Studies on erectile function have identified both cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) signaling pathways in cavernous smooth muscle. Many signaling molecules of these two pathways have been shown capable of inducing erection when administered intracavernously. However, for sexually induced erection, nitric oxide (NO) is the responsible signaling molecule and it passes on the signal through soluble guanyl cyclase (sGC), cGMP, and protein kinase G (PKG).

Conclusions

The NO/sGC/cGMP/PKG pathway is principally responsible for sexually stimulated erection. Detumescence is mainly carried out by the degradation of cGMP by phosphodiesterase 5. Both cAMP and cGMP signaling pathways are susceptible to genetic and biochemical alterations in association with erectile dysfunction. Several key elements along these pathways are potential therapeutic targets.
Pattern of Endocrinal Changes in Patients with Sexual Dysfunction
Authors: El-Sakka Ahmed I. , Hassoba Howayda M. , Sayed Hisham M. , Tayeb Khalid A.
Published: June 2005

Introduction

Many patients with endocrinal changes (endocrinopathy) have some degrees of sexual dysfunction that necessitate assessment and treatment.

Aim

To assess the prevalence, and identify the pattern, of endocrinopathy in patients with sexual dysfunction in our community.

Methods

A total of 1,248 male patients with sexual dysfunction were enrolled in this study. Patients were screened for erectile dysfunction (ED) and sexual desire by the erectile function and the sexual desire domains of the International Index of Erectile Function (IEEF). Patients underwent routine laboratory investigations as well as total testosterone and prolactin assessment. All patients were referred to an endocrinologist for clinical and biochemical assessment of their endocrine function. The evaluation consisted of comprehensive history taking, physical examination, and, as needed, laboratory investigations.

Results

Mean ages ± SD were 51.9 ± 12.2 and 52.3 ± 11.7 years for patients with and without endocrinopathy, respectively. Of the study population, 23.8% had endocrinopathy. The most frequent endocrinal changes were low testosterone level (15%), hyperprolactinemia (13.7%), and hypothyroidism (3.1%). There were significant associations between endocrinopathy and obesity, smoking, low desire, and premature ejaculation (P < 0.05 for each). Also, significant associations were found between low desire and low testosterone level, hyperprolactinemia, and hypothyroidism (P < 0.05 for each). Hyperprolactinemia was significantly associated with premature ejaculation (P < 0.05) but not with low testosterone level (P > 0.05).

There was no significant association between endocrinopathy and age, cigarette smoking (number and duration), and ED (duration, severity, type of onset, and progression) (P > 0.05 for each).

Conclusion

Endocrinopathy is not a rare condition among ambulatory patients with sexual dysfunction. This study provides a quantitative estimate of endocrinopathy in ambulatory patients with sexual dysfunction.
A History of Sexual Medicine in the United Kingdom
Authors: Bancroft John
Published: June 2005

The history of sexual medicine in the United Kingdom since the 19th century is reviewed, with particular reference to masturbation, homosexuality, contraception, and in the past four decades, the treatment of sexual dysfunction. The medical profession's tendency to deal with sexual issues according to the sociopolitical and moral issues of the time is emphasized, and whereas “sex negativism” has prevailed within the medical profession for most of this historical period, there has been a succession of individuals within the profession who have presented a more positive approach to defining and promoting sexual health. Four tracks within sexual medicine over the past 30 years are described: the psychoanalytic approach of the Institute of Psychosexual Medicine, modern “sex therapy,” psychophysiological sex research, and the involvement of andrology in the assessment and treatment of erectile dysfunction. The impact of Viagra is seen as the most recent chapter in this history.
Identification, Molecular Characterization, and Experimental Transmission of a New Hemoplasma Isolate from a Cat with Hemolytic Anemia in Switzerland
Authors: Willi Barbara , Boretti Felicitas S. , Cattori Valentino , Tasker Séverine , Meli Marina L. , Reusch Claudia , Lutz Hans , Hofmann-Lehmann Regina
Published: June 2005

Recently, there has been a growing interest in hemotropic mycoplasmal species (also known as the hemoplasmas), the causative agents of infectious anemia in several mammalian species. In felids, two different hemoplasma species have been recognized:Mycoplasma haemofelis(formerlyHaemobartonella felis) and “CandidatusMycoplasma haemominutum.” Recently developed molecular methods have allowed sensitive and specific identification and quantification of these agents in feline blood samples. In applying these methods to an epidemiological study surveying the Swiss pet cat population for hemoplasma infection, we discovered a third novel and unique feline hemoplasma isolate in a blood sample collected from a cat that had exhibited clinical signs of severe hemolytic anemia. This agent was readily transmitted via intravenous inoculation to two specific-pathogen-free cats. One of these cats was immunocompromised by the administration of methylprednisolone acetate prior to inoculation, and this cat developed severe anemia. The other immunocompetent cat showed a moderate decrease in packed cell volume. Additionally, an increase in red blood cell osmotic fragility was observed. Sequencing of the entire 16S rRNA gene of the new hemoplasma isolate and phylogenetic analysis showed that the isolate was most closely related to two rodent hemotropic mycoplasmal species,M. coccoidesandM. haemomuris. A quantitative real-time PCR assay specific for this newly discovered agent was developed, which will be a prerequisite for the diagnosis of infections with the new hemoplasma isolate.
Comparison of Qualitative (COBAS AMPLICOR HCV 2.0 versus VERSANT HCV RNA) and Quantitative (COBAS AMPLICOR HCV Monitor 2.0 versus VERSANT HCV RNA 3.0) Assays for Hepatitis C Virus (HCV) RNA Detection and Quantification: Impact on Diagnosis and Treatment of HCV Infections
Authors: Desombere Isabelle , Van Vlierberghe Hans , Couvent Sibyl , Clinckspoor Filip , Leroux-Roels Geert
Published: June 2005

Quantitative measurements of serum hepatitis C virus (HCV) RNA are becoming increasingly important in the management of HCV-infected patients. Here we compared two quantitative assays, the COBAS AMPLICOR HCV Monitor 2.0 assay (Roche Diagnostics) and the branched DNA-based VERSANT HCV RNA 3.0 assay (Bayer Diagnostics) for HCV RNA measurement in 344 samples derived from 120 patients with chronic genotype 1 HCV infection. The overall concordance between the results of the two tests was 95%, and the HCV RNA titers within the dynamic ranges of the assays correlated very well (r2= 0.86). Furthermore, both tests performed equally well in determining an early viral response at week 1 or 4 during antiviral therapy. We also compared two qualitative HCV RNA detection assays: the COBAS AMPLICOR HCV 2.0 assay versus the transcription-mediated amplification (TMA)-based VERSANT HCV RNA qualitative assay. Stored samples from sustained responders to interferon-ribavirin therapy were retested by the HCV TMA assay and were found to contain no detectable HCV RNA, demonstrating complete concordance between the results of PCR and TMA. However, HCV RNA was detected by the TMA assay in end-of-treatment (ETR) samples from 33% of patients with relapses who were HCV RNA negative according to the COBAS AMPLICOR assay. This observation suggests that a TMA assay can lead to a more correct definition of the ETR response.
Characterization of
Clostridium botulinum
Strains Associated with an Infant Botulism Case in the United Kingdom
Authors: Johnson Eric A. , Tepp William H. , Bradshaw Marite , Gilbert Richard J. , Cook Paul E. , McIntosh E. David G.
Published: June 2005

The sixth case of infant botulism in the United Kingdom was reported in 2001. The case was caused by a type B strain of
Clostridium botulinum
. Strains of
C. botulinum
were isolated from the baby's feces and from foodstuffs in the household in an attempt to document transmission. The aims of this study were to characterize the strains of
C. botulinum
associated with the botulism case. This was performed using a variety of techniques, including
C. botulinum
culture phenotypic properties, neurotoxin characterization, and pulsed-field gel electrophoresis (PFGE) banding patterns. Cultures associated with this case as well as isolates from stored and historical samples were analyzed and compared.
C. botulinum
type B PFGE patterns from the infant and from an opened container of infant formula were indistinguishable, while the PFGE profile of a strain presumably isolated from an unopened archival container was unique. The results suggest that the unopened brand of formula was not the source for transmission of spores to the infant and that the strain was distinct from previous botulism cases in the United Kingdom. Since environmental testing was not performed, it is not possible to deduce other sources of transmission.
Distribution of
Nocardia
Species in Clinical Samples and Their Routine Rapid Identification in the Laboratory
Authors: Wauters Georges , Avesani Véronique , Charlier Jacqueline , Janssens Michèle , Vaneechoutte Mario , Delmée Michel
Published: June 2005

Eighty-six
Nocardia
strains isolated from clinical samples in Belgium were identified by 16S rRNA gene sequencing. Eighty-three (96%) strains belonged to only six
Nocardia
species:
N. farcinica
(38 [44%]),
N. nova
(19 [22%]),
N. cyriacigeorgica
(13 [15%]),
N. brasiliensis
(6 [6.9%]),
N. abscessus
(5 [5.8%]), and
N. paucivorans
(2 [2.3%]). A gallery of nine conventional and enzymatic tests was developed for the rapid identification of the most common species isolated during this survey. Pyrrolidonyl aminopeptidase, γ-glutamyl aminopeptidase, α-mannosidase, and α-glucosidase were found to be highly discriminating and could be used to develop an identification scheme.
Pet Dogs and Chicken Meat as Reservoirs ofCampylobacterspp. in Barbados
Authors: Workman Suzanne N. , Mathison George E. , Lavoie Marc C.
Published: June 2005

Campylobacterspp. are the second most common pathogen isolated from stools of patients with gastroenteritis in Barbados. The aim of this study was to identify reservoirs ofCampylobacterand the likely source(s) of human infection. Fecal specimens from 596 animals and 311 samples of animal food products were analyzed for the presence ofCampylobacterspp. by standard culture techniques. Isolates were characterized by conventional phenotypic tests, confirmed by latex agglutination and PCR with genus-specific primers, and identified by the use of species-specific primers. High isolation rates were obtained for chickens (94.2%), pigs (90.5%), dogs (46.9%), cats (37.3%), and wild birds (39.3%).Campylobacterwas also recovered from monkeys (17.1%) and sheep (4.2%) but not from cows. Chicken meat was frequently contaminated withCampylobacter(58.4%), but its recovery from other animal food products was rare.Campylobacter jejuniwas the most commonly identified species in humans (63.6%), chickens (86.6%), dogs (51.5%), and chicken meat (79.8%). Porcine isolates were predominantlyC. coli(98.4%), while cats harbored mainlyC. upsaliensisandC. helveticus. Wild birds alone carried urease-positive thermophilic campylobacters.C. jejuniandC. coliisolates from different sources were compared with isolates from humans by randomly amplified polymorphic DNA typing with the primers OPA 11 and HLWL 85. Genotyping revealed similarities between isolates from chicken meat and those from humans and could not distinguish between two clinical isolates and four canine strains. Our results suggest that dogs are significant reservoirs ofCampylobacterand contribute to human enteric infections and that chicken meat is a likely vehicle for the transmission of campylobacters to humans.
Novel Chemically Modified Liquid Medium That Will Support the Growth of Seven
Bartonella
Species
Authors: Maggi Ricardo G. , Duncan Ashlee W. , Breitschwerdt Edward B.
Published: June 2005

Bacteria of the genus
Bartonella
, a member of the
Alphaproteobacteria
, are fastidious, gram-negative, aerobic bacilli that comprise numerous species, subspecies, and subtypes. In human and veterinary medicine, species isolation remains a vital component of the diagnostic and therapeutic management of
Bartonella
infection. We describe a novel, chemically modified, insect-based liquid culture medium that supports the growth of at least seven
Bartonella
species. This medium will also support cocultures consisting of different
Bartonella
species, and it facilitated the primary isolation of
Bartonella henselae
from blood and aqueous fluid of naturally infected cats. This liquid growth medium may provide an advantage over conventional direct blood agar plating for the diagnostic confirmation of bartonellosis.
Multilocus Sequence Typing for Studying Genetic Relationships among
Yersinia
Species
Authors: Kotetishvili Mamuka , Kreger Arnold , Wauters Georges , Morris J. Glenn , Sulakvelidze Alexander , Stine O. Colin
Published: June 2005

The intra- and interspecies genetic relationships of 58 strains representing all currently known species of the genus
Yersinia
were examined by multilocus sequence typing (MLST), using sequence data from 16S RNA,
glnA
,
gyrB
,
recA
, and Y-HSP60 loci.
Yersinia
aldovae
,
Y. bercovieri
,
Y. intermedia
,
Y. pestis
,
Y. pseudotuberculosis
,
Y. rohdei
, and
Y. ruckeri
were genetically more homogeneous than were
Y. enterocolitica
,
Y. frederiksenii
,
Y. kristensenii
, and
Y. mollaretii
. The MLST data concerning the genetic relatedness within and among various species of
Yersinia
support the idea that
Y. pestis
and
Y. pseudotuberculosis
are two lineages within the same species rather than two distinct species.
Y. ruckeri
is the genetically most distant species within the genus. There was evidence of O-antigen switching and genetic recombination within and among various species of
Yersinia
. The genetic relatedness data obtained by MLST of the four housekeeping genes and 16S RNA agreed in most, but not all, instances. MLST was better suited for determining genetic relatedness among yersiniae than was 16S RNA analysis. Some strains of
Y. frederiksenii
and
Y. kristensenii
are genetically less related to other strains within those species, compared to strains of all other species within the genus. The taxonomic standing of these strains should be further examined because they may represent currently unrecognized
Yersinia
species.
Novel Multipurpose Methodology for Detection of Mycobacteria in Pulmonary and Extrapulmonary Specimens by Smear Microscopy, Culture, and PCR
Authors: Chakravorty Soumitesh , Tyagi Jaya Sivaswami
Published: June 2005

A novel, robust, reproducible, and multipurposeuniversalsampleprocessing (USP) methodology for highly sensitive smear microscopy, culturing on solid and liquid media, and inhibition-free PCR which is suitable for the laboratory diagnosis of both pulmonary and extrapulmonary tuberculosis (TB) has been developed. This method exploits the chaotropic properties of guanidinium hydrochloride for sample processing and involves incubating the specimen with USP solution, concentrating bacilli by centrifugation, and using the processed specimen for smear microscopy, culture, and PCR. The detection limit for acid-fast bacilli in spiked sputum by smear microscopy is approximately 300 bacilli per ml of specimen. USP solution-treated specimens are fully compatible with culturing on solid and liquid media. High-quality, PCR-amplifiable mycobacterial DNA can be isolated from all types of clinical specimens processed with USP solution. The method has been extensively validated with both pulmonary and extrapulmonary specimens. Furthermore, the USP method is also compatible with smear microscopy, culture, and PCR of mycobacteria other than tubercle bacilli. In summary, the USP method provides smear microscopy, culture, and nucleic acid amplification technologies with a single sample-processing platform and, to the best of our knowledge, is the only method of its kind described to date. It is expected to be useful for the laboratory diagnosis of TB and other mycobacterial diseases by conventional and modern methods.
Utility of Universal Sample Processing Methodology, Combining Smear Microscopy, Culture, and PCR, for Diagnosis of Pulmonary Tuberculosis
Authors: Chakravorty Soumitesh , Dudeja Mridu , Hanif M. , Tyagi Jaya Sivaswami
Published: June 2005

The universal sample processing (USP) multipurpose methodology was developed for the diagnosis of tuberculosis (TB) and other mycobacterial diseases by using smear microscopy, culture, and PCR (S. Chakravorty and J. S. Tyagi, J. Clin. Microbiol. 43:2697-2702, 2005). Its performance was evaluated in a blinded study of 571 sputa and compared with that of the direct and
N
-acetyl
l
-cysteine (NALC)-NaOH methods of smear microscopy and culture. With culture used as the gold standard, USP smear microscopy demonstrated a sensitivity and specificity of 98.2% and 91.4%, respectively, compared to 68.6% and 92.6%, respectively, for the direct method. For a subset of 325 specimens, the USP method recorded a 97.1% sensitivity and 83.2% specificity compared to the NALC-NaOH method, which had a sensitivity and specificity of 80.0% and 89.7%, respectively, with culture used as the gold standard. Thus, the USP method exhibited a highly significant enhancement in sensitivity (
P
< 0.0001) compared to the direct and NALC-NaOH methods of smear microscopy. The USP culture sensitivity was 50.1% and was not significantly different from that of conventional methods (53.6%). The sensitivity and specificity of IS
6110
PCR were 99.1% and 71.2%, respectively, with culture used as the gold standard, and increased to 99.7% and 78.8%, respectively, when compared with USP smear microscopy. Thus, the USP methodology was highly efficacious in diagnosing TB by smear microscopy, culture, and PCR in a clinical setting.
Comparison ofCampylobacter jejuniLipooligosaccharide Biosynthesis Loci from a Variety of Sources
Authors: Parker Craig T. , Horn Sharon T. , Gilbert Michel , Miller William G. , Woodward David L. , Mandrell Robert E.
Published: June 2005

Campylobacter jejunistrains exhibit significant variation in the genetic content of the lipooligosaccharide (LOS) biosynthesis loci with concomitant differences in LOS structure. TheC. jejuniLOS loci have been grouped into six classes based on gene content and organization. Utilizing PCR amplifications of genes from these loci, we were able to classify a majority (80%) of the LOS biosynthesis loci from 123 strains ofC. jejunithat included 39 of the Penner serotype reference strains. We found that a particular LOS class was not always associated with a specific Penner serotype, and 14 of 16 Guillain-Barré syndrome-associated isolates tested in this study shared the same LOS class. The remaining isolates that could not be classified were often distinguishable from each other based on the results of gene-specific PCR and the lengths of their LOS biosynthesis loci as determined by long (XL) PCR. Sequence analysis of two of these unique XL PCR products demonstrated two new LOS classes. These results support the hypothesis that the LOS locus is a hot spot for genetic exchange and rearrangements. Analysis of the LOS biosynthesis genes by PCR assays can be used for typingC. jejuniand offers the advantage of inferring potential LOS structures.
Epidemiologic Relationship between Fluoroquinolone-ResistantSalmonella entericaSerovar Choleraesuis Strains Isolated from Humans and Pigs in Taiwan (1997 to 2002)
Authors: Chang Chao-Chin , Lin Yi-Hsuan , Chang Chao-Fu , Yeh Kuang-Sheng , Chiu Cheng-Hsun , Chu Chishih , Chien Maw-Sheng , Hsu Yuan-Man , Tsai Li-Shu , Chiou Chien-Shun
Published: June 2005

The emergence of ciprofloxacin-resistantSalmonella entericaserovar Choleraesuis in recent years has become an important public health issue in Taiwan. The resistant strains that cause human infections are considered to be from pigs. In this study, we characterized 157 swine and 42 humanSalmonellaserovar Choleraesuis isolates by pulsed-field gel electrophoresis (PFGE) and drug susceptibility testing to investigate the epidemiologic relationship among the isolates. By PFGE analyses, two major clusters (clusters GA and GB) were identified. Isolates in cluster GA were of both human and swine origins, while those in cluster GB were from pigs only. Among the various genotypes identified, genotype gt-1a was the most prevalent, which was found in 71% (30 of 42) and 48% (76 of 157) of human and swine isolates, respectively. The susceptibility tests for the 106 gt-1a isolates identified 44 susceptibility profiles and showed that 73% of human isolates and 34% of swine isolates were resistant to three fluoroquinolones (ciprofloxacin, enrofloxacin, and norfloxacin). Our findings indicate that a clonal group ofSalmonellaserovar Choleraesuis may have been circulating in human and swine populations in Taiwan for years and that the fluoroquinolone-resistantSalmonellaserovar Choleraesuis strains most likely evolved from a gt-1a clone that emerged in 2000 and that then caused widespread infections in humans and pigs. Nevertheless, it is still debatable whether thoseSalmonellainfections in humans are caused by isolates derived from pigs, on the basis of the higher fluoroquinolone and other antimicrobial resistance percentages in human isolates than in pig isolates.
Antifungal Activities of Tacrolimus and Azole Agents against the Eleven Currently Accepted
Malassezia
Species
Authors: Sugita Takashi , Tajima Mami , Ito Tomonobu , Saito Masuyoshi , Tsuboi Ryoji , Nishikawa Akemi
Published: June 2005

The lipophilic yeast
Malassezia
is an exacerbating factor in atopic dermatitis (AD) and colonizes the skin surface of patients with AD. With the goal of reducing the number of
Malassezia
cells, we investigated the antifungal activities of a therapeutic agent for AD, tacrolimus, and the azole agents itraconazole and ketoconazole against
Malassezia
species in vitro. We examined 125 strains of the 11 currently accepted
Malassezia
species by using the agar dilution method. All strains of the 11
Malassezia
species were very susceptible to both azole agents, with MICs ranging from 0.016 to 0.25 μg/ml. Tacrolimus had antifungal activities against half of the strains, with MICs ranging from 16 to 32 μg/ml. Two of the major cutaneous floras,
Malassezia globosa
and
Malassezia restricta
, have several genotypes in the intergenic spacer region of the rRNA gene; the azole agents had slightly higher MICs for specific genotype strains of both microorganisms. A combination of azole agents and tacrolimus had a synergistic effect against
Malassezia
isolates, based on a fractional inhibitory index of 0.245 to 0.378. Our results provide the basis for testing these agents in future clinical trials to reduce the number of
Malassezia
cells colonizing the skin surface in patients with AD.
Species-Level Identification of Staphylococcal Isolates by Real-Time PCR and Melt Curve Analysis
Authors: Skow Áine , Mangold Kathy A. , Tajuddin Mohammed , Huntington Anne , Fritz Brett , Thomson Richard B. , Kaul Karen L.
Published: June 2005

A real-time PCR assay was developed to identify common staphylococcal species. A single set of consensus primers was designed to amplify a portion of the 16S rRNA gene, and a pair of fluorescence resonance energy transfer probes was used to identify species based on the unique melt properties of the probes resulting from sequence variations in the amplicons from each species. Nine common staphylococcal strains (S. aureus,S. capitis,S. epidermidis,S. haemolyticus,S. hominis,S. lugdunensis,S. schleiferi,S. simulans, andS. warneri) were used for assay development. The species-specific melting profiles were validated by correctly identifying 36 of 37 coagulase-negative staphylococcal (CoNS) isolates identified by ribotyping. In a study of clinical isolates, the PCR/melt curve approach correctly identified 56/56S. aureusisolates identified by coagulase/protein A latex agglutination. Fifty-four CoNS clinical isolates characterized using the API Staph assay were studied, with the PCR/melt curve approach yielding matching identifications for 32/54 (59%). The API Staph assay was unable to identify 18 CoNS isolates, and differing results were obtained for 4 isolates. Sequencing of the 22 discrepant or unidentified CoNS samples revealed that the PCR/melt curve results were correct for all but one isolate. Thus, PCR/melt curve analysis achieved a nearly 100% accuracy and performed better than biochemical testing. Performance of the PCR/melt curve approach requires less than 2 h after colony selection. This method thus provides a rapid and accurate approach to the identification of staphylococcal species in the clinical laboratory.
Use of the Genomic Subtractive Hybridization Technique To Develop a Real-Time PCR Assay for Quantitative Detection of
Prevotella
spp. in Oral Biofilm Samples
Authors: Nagashima Shiori , Yoshida Akihiro , Suzuki Nao , Ansai Toshihiro , Takehara Tadamichi
Published: June 2005

Genomic subtractive hybridization was used to design
Prevotella nigrescens
-specific primers and TaqMan probes. Based on this technique, a TaqMan real-time PCR assay was developed for quantifying four oral black-pigmented
Prevotella
species. The combination of real-time PCR and genomic subtractive hybridization is useful for preparing species-specific primer-probe sets for closely related species.
Use of Genotypic Identification by
sodA
Sequencing in a Prospective Study To Examine the Distribution of Coagulase-Negative
Staphylococcus
Species among Strains Recovered during Septic Orthopedic Surgery and Evaluate Their Significance
Authors: Sivadon V. , Rottman M. , Chaverot S. , Quincampoix J.-C. , Avettand V. , de Mazancourt P. , Bernard L. , Trieu-Cuot P. , Féron J.-M. , Lortat-Jacob A. , Piriou P. , Judet T. , Gaillard J.-L.
Published: June 2005

A total of 212 coagulase-negative
Staphylococcus
strains recovered prospectively during 119 surgeries for proven or suspected bone and joint infection (BJI) were identified by
sodA
sequencing. These strains were identified as 151
Staphylococcus epidermidis
isolates, 15
S. warneri
isolates, 14
S. capitis
isolates, 9
S. hominis
isolates, 6
S. lugdunensis
isolates, 5
S. haemolyticus
isolates, 4
S. caprae
isolates, 4
S. pasteuri
isolates, 3
S. simulans
isolates, and 1
S. cohnii
isolate. Only
S. epidermidis
,
S. lugdunensis
,
S. capitis
, and
S. caprae
were found to be infecting organisms and were involved, respectively, in 35 (81.4%), 3 (7.0%), 3 (7.0%), and 2 (4.6%) cases of BJI.
Survey of Methicillin-Resistant
Staphylococcus aureus
Strains from Two Hospitals in El Paso, Texas
Authors: O'Brien Frances G. , Lim Tien Tze , Winnett David C. , Coombs Geoffrey W. , Pearson Julie C. , Delgado Alejandro , Langevin Mark J. , Cantore Stephanie A. , Gonzalez Leti , Gustafson John E.
Published: June 2005

Seventy-one percent of 76 methicillin-resistant
Staphylococcus aureus
(MRSA) strains isolated from two medical centers in El Paso, Texas, represent three similar pulsed-field gel electrophoresis types. Overall, six pulsed-field types were identified represented by multilocus sequence/staphylococcal chromosomal cassette DNA
mec
(SCC
mec
) types: ST5-MRSA-II; ST36-MRSA-II; ST8 (untypeable SCC
mec
); and a newly described clonal cluster 8 strain, ST507-MRSA-IV. This study demonstrates the presence of multiple-antibiotic-resistant epidemic MRSA clones in El Paso.
Molecular Diagnosis of Lymphogranuloma Venereum in Patients with Genital Ulcer Disease
Authors: Sturm Patrick D. J. , Moodley Prashini , Govender Keshnie , Bohlken Louise , Vanmali Trusha , Sturm A. Willem
Published: June 2005

The detection of herpes, chancroid, and syphilis in genital ulcers is done by PCR. This is not so for lymphogranuloma venereum (LGV). We report on the use of a PCR with digestion that differentiates the LGV biovar from the trachoma biovar. Our findings suggest that the clinical description of LGV in current textbooks is incomplete.
Isolation and Characterization of
Mycoplasma sphenisci
sp. nov. from the Choana of an Aquarium-Reared Jackass Penguin (
Spheniscus demersus
)
Authors: Frasca Salvatore , Weber E. Scott , Urquhart Heather , Liao Xiaofen , Gladd Martha , Cecchini Katharine , Hudson Paul , May Meghan , Gast Rebecca J. , Gorton Timothy S. , Geary Steven J.
Published: June 2005

Strain UCMJ was isolated from the choana of a jackass penguin (
Spheniscus demersus
) with recurrent mucocaseous choanal discharge. Isolation of this mycoplasma expands the known range of species hosting mycoplasmas. The name
Mycoplasma sphenisci
sp. nov. is proposed for this new species, for which strain UCMJ is the type strain.
Recurrent Breast Abscess Caused by
Gordonia bronchialis
in an Immunocompetent Patient
Authors: Werno Anja M. , Anderson Trevor P. , Chambers Stephen T. , Laird Heather M. , Murdoch David R.
Published: June 2005

We present the first reported case of a recurrent breast infection caused by
Gordonia bronchialis
. The infection occurred in a 43-year-old immunocompetent female, and species level identification was obtained with 16S rRNA sequencing.
Atypical Serological Response Marked by a Lack of Detectable Anti-gp43 Antibodies in a Patient with Disseminated Paracoccidioidomycosis
Authors: Vidal Mônica S. M. , Benard Gil , de Brito Thales , Dantas Kátia C. , Pereira Cristiane N. , França Francisco O. S. , da Silva Ana M. G. , Martins José E. C.
Published: June 2005

Serological tests are frequently used to diagnosis paracoccidioidomycosis. A glycoprotein of 43 kDa is considered to be the main diagnostic antigen, being recognized by virtually all patients' sera. A case of atypical serological response, consisting of a lack of detectable anti-gp43 antibodies, in a patient with disseminated paracoccidioidomycosis is presented.
Compartmentalized Human Immunodeficiency Virus Type 1 Present in Cerebrospinal Fluid Is Produced by Short-Lived Cells
Authors: Harrington Patrick R. , Haas David W. , Ritola Kimberly , Swanstrom Ronald
Published: June 2005

Human immunodeficiency virus type 1 (HIV-1) invades the central nervous system (CNS) during primary infection and persists in this compartment by unknown mechanisms over the course of infection. In this study, we examined viral population dynamics in four asymptomatic subjects commencing antiretroviral therapy to characterize cellular sources of HIV-1 in the CNS. The inability to monitor viruses directly in the brain poses a major challenge in studying HIV-1 dynamics in the CNS. Studies of HIV-1 in cerebrospinal fluid (CSF) provide a useful surrogate for the sampling of virus in the CNS, but they are complicated by the fact that infected cells in local CNS tissues and in the periphery contribute to the population pool of HIV-1 in CSF. We utilized heteroduplex tracking assays to differentiate CSF HIV-1 variants that were shared with peripheral blood plasma from those that were compartmentalized in CSF and therefore presumably derived from local CNS tissues. We then tracked the relative decline of individual viral variants during the initial days of antiretroviral therapy. We found that HIV-1 variants compartmentalized in CSF declined rapidly during therapy, with maximum half-lives of approximately 1 to 3 days. These kinetics emulate the decline in HIV-1 produced from short-lived CD4+T cells in the periphery, suggesting that a similarly short-lived, HIV-infected cell population exists within the CNS. We propose that short-lived CD4+T cells trafficking between the CNS and the periphery play an important role in amplifying and maintaining HIV-1 populations in the CNS during the asymptomatic phase of infection.