bluuebunny/crossref_metadata_2025 huggingface dataset:
Sensitive quantitation of endotoxin by enzyme-linked immunosorbent assay with monoclonal antibody against Limulus peptide C
Authors: Zhang G H , Baek L , Nielsen P E , Buchardt O , Koch C
Published: January 2020

Limulus peptide C, a 28-amino-acid fragment of coagulogen formed by the reaction of endotoxin with Limulus amebocyte lysate, was synthesized, and a monoclonal antibody against it was raised. A new microassay for endotoxin was developed, using this antibody in an enzyme-linked immunosorbent assay for generated peptide C-like immunoreactivity. A linear relationship between absorbance and endotoxin concentration was obtained. Control standard endotoxin in water could be detected to a level of 0.001 endotoxin unit per ml. The endotoxin levels in plasma samples from normal humans, rabbit, mice, and guinea pigs were generally found to be below the detection limit of 0.01 endotoxin unit per ml of plasma. The color and turbidity of specimens did not interfere with the assay. The consumption of Limulus amebocyte lysate in the assay was less than 5% of that in the gel-clot and chromogenic assays. With raw lysate, which was much more stable in solution than chloroform-treated lysate, the assay was still highly sensitive to endotoxin but was totally unresponsive to natural glucans. The monoclonal antibody cross-reacted with peptide C-like immunoreactivity generated in Tachypleus amebocyte lysate, which gave equal sensitivity in the endotoxin assay.
Comparison of E test with standard broth microdilution for determining antibiotic susceptibilities of penicillin-resistant strains of Streptococcus pneumoniae
Authors: Macias E A , Mason E O , Ocera H Y , LaRocco M T
Published: January 2020

We compared the E test (AB Biodisk North America, Inc., Culver City, Calif.) with the National Committee for Clinical Laboratory Standards broth microdilution method for the determination of MICs of penicillin and cefotaxime for 108 isolates of Streptococcus pneumoniae. The E test was performed following manufacturer's recommendations with Mueller-Hinton blood agar, and the broth microdilution procedure was performed with lysed horse blood-supplemented Mueller-Hinton broth. The microdilution method classified 26 isolates as highly penicillin resistant (MIC, > or = 2 micrograms/ml), 33 as intermediately resistant to penicillin (MIC, > or = 0.1 < 2.0 micrograms/ml), and 49 as susceptible to penicillin (MIC, < 0.1 micrograms/ml). Discordant results obtained with the E test for penicillin susceptibility testing compared with broth microdilution occurred for 19 of the 108 isolates tested. Cefotaxime MICs for 90% of isolates found highly resistant, intermediately resistant, and susceptible to penicillin by broth microdilution were 2.0, 0.5, and 0.06 micrograms/ml, respectively. There were 16 susceptibility category changes when the E test was used to determine cefotaxime MICs. All of the discrepancies in the penicillin and cefotaxime MICs determined by the E test occurred at the susceptibility category breakpoints, and all represented differences of only one twofold dilution factor. Properly performed and controlled, the E test should be a reliable quantitative procedure for more accurately predicting the susceptibility of S. pneumoniae to several antibiotics.
Nonrepresentative PCR amplification of variable gene sequences in clinical specimens containing dilute, complex mixtures of microorganisms
Authors: Wright C J , Jerse A E , Cohen M S , Cannon J G , Seifert H S
Published: January 2020

PCR amplification and DNA sequencing of the expression locus from Neisseria gonorrhoeae contained in urine sediments collected from experimentally infected human subjects produced two observations. First, different pilin sequences were obtained when separate aliquots of the same sample were amplified and sequenced. In contrast, the same pilin sequence was obtained when repeated amplifications were performed on individual colonies grown from the clinical samples. Second, mixed sequences (i.e., more than one nucleotide at variable positions in the pilin gene sequence) were observed in both the direct clinical isolates and individual cultures grown from the isolates. These results suggest that when clinical samples are directly examined by PCR amplification and sequencing, multiple amplifications may be required to detect sequence variants in the sample and minority variant sequences will not always be detected.
An integrated target sequence and signal amplification assay, reverse transcriptase-PCR-enzyme-linked immunosorbent assay, to detect and characterize flaviviruses
Authors: Chang G J , Trent D W , Vorndam A V , Vergne E , Kinney R M , Mitchell C J
Published: January 2020

We previously described a reverse transcriptase-PCR using flavivirus genus-conserved and virus species-specific amplimers (D. W. Trent and G. J. Chang, p. 355-371, in Y. Becker and C. Darai; ed., Frontiers of Virology, vol. 1, 1992). Target amplification was improved by redesigning the amplimers, and a sensitive enzyme-linked immunosorbent assay (ELISA) technique has been developed to detect amplified digoxigenin (DIG)-modified DNA. A single biotin motif and multiple DIG motifs were incorporated into each amplicon, which permitted amplicon capture by a biotin-streptavidin interaction and detection with DIG-specific antiserum in a colorimetric ELISA. We evaluated the utility of this assay for detecting St. Louis encephalitis (SLE) viral RNA in infected mosquitoes and dengue viral RNA in human serum specimens. The reverse transcriptase-PCR-ELISA was as sensitive as isolation of SLE virus by cell culture in detecting SLE viral RNA in infected mosquitoes. The test was 89% specific and 95 to 100% sensitive for identification of dengue viral RNA in serum specimens compared with isolation of virus by Aedes albopictus C6/36 cell culture and identification by the indirect immunofluorescence assay.
Ribotyping for differentiating Flavobacterium meningosepticum isolates from clinical and environmental sources
Authors: Colding H , Bangsborg J , Fiehn N E , Bennekov T , Bruun B
Published: January 2020

On the basis of DNA-DNA hybridization data, two main genomic relatedness groups (I and II) have been reported for a geographically varied collection of 52 strains of Flavobacterium meningosepticum. Herein, we have shown that genomic group II can be further divided into four subgroups (II:1 to II:4). To examine the taxonomic relevance of the ribosomal patterns of the 52 F. meningosepticum strains, the patterns were compared with existing DNA-DNA hybridization data with restriction enzymes PstI and HindIII. Ribotyping of the 52 F. meningosepticum strains showed banding patterns that could identify them correctly to one of the five genomic groups or subgroups. To assess the value of ribotyping for the interpretation of epidemiological data, the discriminatory power of the method was investigated for the 52 F. meningosepticum strains. With one to four restriction enzymes (PstI, HindIII, ClaI, EcoRI), a discriminatory index of 0.95 to 0.97 was found. The value of ribotyping in an epidemiological setting was assessed for three clinical isolates of F. meningosepticum from an outbreak of meningitis and bacteremia in the neonatal intensive care unit, Rigshospitalet, Copenhagen, Denmark. The three clinical isolates were shown to belong to the same ribotype, characteristic of genomic subgroup II:1. This ribotyping method will prove to be a useful tool for epidemiological studies concerning F. meningosepticum in the future.
Early recognition of atypical Francisella tularensis strains lacking a cysteine requirement
Authors: Bernard K , Tessier S , Winstanley J , Chang D , Borczyk A
Published: January 2020

Seven cultures referred to in our laboratories as unidentified gram-negative bacilli or Haemophilus species were identified as atypical strains of Francisella tularensis lacking a requirement for cysteine or enriched medium for growth. The use of cellular fatty acid composition analysis facilitated early recognition of this pathogen and prompt implementation of appropriate biosafety measures.
Improved performance of PACE 2 with modified collection system in combination with probe competition assay for detection of Chlamydia trachomatis in urethral specimens from males
Authors: Kluytmans J A , Goessens W H , van Rijsoort-Vos J H , Niesters H G , Stolz E
Published: January 2020

The Gen-Probe PACE 2 assay (GP) in combination with a modified collection system was compared with cell culture (CC) for the detection of Chlamydia trachomatis in urethral specimens from males. Analysis of discordant results was performed by PCR. The modifications, i.e., application of a more rigid swab type and a 50% reduction in the amount of transport medium, were made to improve the sensitivity of the assay. By using the modified GP on 302 urethral specimens from males, a sensitivity of 89.5% and a specificity of 100% were determined. In addition, performance of a probe competition assay on all GP samples with a result > 0.6 and < 1.0 times the cutoff factor (gray zone) detected three more true-positive samples. The sensitivity of GP in combination with the probe competition assay increased to 94.9%, with a specificity of 100%. This was identical to the performance of CC. The modified GP offers a very sensitive and specific alternative to CC.
Survival of human immunodeficiency virus in suspension and dried onto surfaces
Authors: van Bueren J , Simpson R A , Jacobs P , Cookson B D
Published: January 2020

Cell-free and cell-associated human immunodeficiency virus cultures suspended in 10% serum remained infectious for several weeks at room temperature. The stability was further increased when cell-associated virus was suspended in neat serum. When dried onto a glass coverslip, virus remained infectious for several days, although cell-associated virus lost infectivity more rapidly than cell-free virus.
Analysis of western blotting (immunoblotting) technique in diagnosis of congenital syphilis
Authors: Meyer M P , Eddy T , Baughn R E
Published: January 2020

The diagnosis of congenital syphilis in apparently healthy infants continues to be problematic. Immunoglobulin M antibodies specific for a subset of Treponema pallidum antigens have been detected by Western blotting (immunoblotting). In the present study we investigated the sensitivity and specificity of this method. We tested 26 infants aged 0 to 4 months who fulfilled the accepted criteria for the diagnosis of congenital syphilis. There were 14 symptomatic infants. Sera from 13 of these infants were positive for the 47-kDa treponemal antigen (92% sensitivity). The remaining 12 infants were clinically asymptomatic when tested at birth but subsequently displayed features consistent with the disease. Reactive blots (antibodies to the 47- and/or the 15-kDa antigens) were noted in 10 of the 12 infants (83% sensitivity). Thirty infants whose mothers had syphilis were monitored and shown to be uninfected. Nonreactive blots were seen in sera from 27 infants, while sera from 3 older infants had false-positive tests (90% specificity). The Western blotting technique is sensitive (even in the diagnosis of clinically inapparent cases) and, in the absence of immunoglobulin M rheumatoid factor, is a useful confirmatory test for congenital syphilis.
Detection of Bacteroides fragilis in clinical specimens by PCR
Authors: Yamashita Y , Kohno S , Koga H , Tomono K , Kaku M
Published: January 2020

The direct detection of Bacteroides fragilis from clinical specimens was examined by using the PCR method for amplifying a specific fragment of the glutamine synthetase gene from B. fragilis. By this method, all five B. fragilis strains tested were detected, but DNAs from anaerobic bacteria of 24 other species tested, from aerobic bacteria of 12 species tested, and from human leukocytes were not amplified. Using the nested PCR method, we were able to detect as little as one bacterial cell or 100 fg of chromosomal DNA of B. fragilis. A total of 39 clinical specimens, which consisted of 19 bronchial aspirates, 10 percutaneous lung aspirates, 2 transtracheal aspirates, 6 pleural fluid specimens, and 2 pus specimens, were tested. All four culture-positive samples, of which two were bronchial aspirates, one was pleural fluid, and one was pus, were positive by PCR. Among 35 culture-negative samples, 2 bronchial aspirates were positive by PCR. One was from a patient whose two previous samples were positive by both culture and PCR. It had been submitted for culture several hours after collection, and clindamycin had been administered to the patient before collection of the specimen. The other bronchial aspirate positive by PCR was from a pneumonia patient who had also been administered clindamycin. We believe that B. fragilis was present in these two specimens but that either it was dead, it was below the level detectable by culture, or the process of anaerobic culture was unsuccessful. Thus, the PCR method may be considered useful for the sensitive and rapid detection of anaerobes in clinical specimens.
Molecular epidemiology of nosocomial invasive aspergillosis
Authors: Girardin H , Sarfati J , Traoré F , Dupouy Camet J , Derouin F , Latgé J P
Published: January 2020

Moderately repeated DNA sequences were used to fingerprint strains of Aspergillus fumigatus isolated from patients with invasive aspergillosis and their hospital environment. Most strains sampled from the environment displayed different Southern blot hybridization patterns. A temporal survey of air contaminants showed that some strains can persist in the same environment for at least 6 months. Patients with invasive aspergillosis were infected by a single strain. In two patients, a nosocomial origin of infection was suggested.
Recurrent Escherichia coli bacteremia
Authors: Maslow J N , Mulligan M E , Arbeit R D
Published: January 2020

Escherichia coli is the most common gram-negative organism associated with bacteremia. While recurrent E. coli urinary tract infections are well-described, recurrent E. coli bacteremia appears to be uncommon, with no episodes noted in multiple series of patients with gram-negative bacteremias. We report on 5 patients with recurrent bloodstream infections identified from a series of 163 patients with E. coli bacteremia. For each patient, the isolates from each episode were analyzed by pulsed-field gel electrophoresis (PFGE) and ribotyping and for the presence of E. coli virulence factors. For each of four patients, the index and recurrent episodes of bacteremia represented the same strain as defined by PFGE, and the strains were found to carry one or more virulence factors. The remaining patient, with two episodes of bloodstream infection separated by a 4-year interval, was infected with two isolates that did not carry any virulence factors and that were clonally related by ribotype analysis but differed by PFGE. All five patients had either a local host defense defect (three patients) or impaired systemic defenses (one patient) or both (one patient). Thus, recurrent E. coli bacteremia is likely to represent a multifactorial process that occurs in patients with impaired host defenses who are infected with virulent isolates.
Escherichia coli O157:H7 generates a unique biochemical profile on MicroScan conventional gram-negative identification panels
Authors: Abbott S L , Hanson D F , Felland T D , Connell S , Shum A H , Janda J M
Published: January 2020

More than 90% of the strains of Escherichia coli O157:H7 that were identified on a MicroScan gram-negative dried conventional (overnight) panel gave one of two unique biochemical profile numbers that were not detected in other d-sorbitol-negative E. coli or in other strains isolated from pathogenic processes. This suggests that the panel has the capability of being used as a preliminary screening tool for O157:H7 strains involved in hemorrhagic colitis when MacConkey-sorbitol agar is not available.
Identification of serotype 1-, 3-, and 6-specific antigens of Ureaplasma urealyticum by using monoclonal antibodies
Authors: Cheng X , Naessens A , Lauwers S
Published: January 2020

Little is known about the antigens responsible for serotype specificity in Ureaplasma urealyticum. We produced monoclonal antibodies to U. urealyticum serotypes 1, 3, and 6, the serotypes most commonly found in pregnant women, and analyzed serotype-specific antigens for the three serotypes. Clinical isolates belonging to serotype 1, 3, or 6 were tested in immunoblots with these monoclonal antibodies. The immunoblot patterns of these isolates were, in most cases, different from each other as well as from those of the reference strains, indicating a high rate of antigenic variation among U. urealyticum strains.
An unusual case of coccidioidomycosis
Authors: Smith M A , Anderson A E , Kostroff K
Published: January 2020

Dissemination of coccidioidomycosis is rare. The skin, musculoskeletal system, and central nervous system have been described as the most common sites of extrapulmonary disease. We present a case of an asymptomatic patient in whom the diagnosis of coccidioidomycosis was made on a lymph node biopsy. The biopsy was performed because of an abnormal mammogram and physical findings suggestive of malignancy.
DNA polymorphisms detected in Mycobacterium haemophilum by pulsed-field gel electrophoresis
Authors: Yakrus M A , Straus W L
Published: January 2020

Nineteen isolates of Mycobacterium haemophilum were analyzed by pulsed-field gel electrophoresis of large restriction fragments generated by digestion of chromosomal DNA with XbaI. Six patterns were observed. Twelve of 16 M. haemophilum isolates (75%) collected in the New York Metropolitan Area from 1990 to 1991 shared the same pattern, including all six isolates submitted from one hospital. Two different patterns were seen among the other four isolates. Individual isolates from Albany, N.Y., Florida, and Texas had unique patterns. Pulsed-field gel electrophoresis is the first method reported with the capability to type strains of M. haemophilum and will hopefully provide insight into the source and transmission of this emerging pathogen.
Detection of rat, porcine, and bovine group B rotavirus in fecal specimens by solid-phase enzyme immunoassay
Authors: Vonderfecht S L , Lindsay D A , Eiden J J
Published: January 2020

An enzyme immunoassay that uses easily regenerated reagents was developed and evaluated for the ability to detect group B rotaviruses (GBR) in fecal specimens. Homologous rat GBR and heterologous porcine and bovine GBR were detected by this immunoassay, although a human GBR isolate was not. This immunoassay should prove useful in studies of GBR infections of animals.
Aeromonas species exhibit aggregative adherence to HEp-2 cells
Authors: Neves M S , Nunes M P , Milhomem A M
Published: January 2020

Clinical and environmental isolates of Aeromonas species (five A. hydrophila isolates, three A. caviae isolates, and two A. sobria isolates) were tested for their adherence to HEp-2 cells. Clinical isolates of A. hydrophila and A. sobria exhibited aggregative adherence similar to that presented by enteroadherent-aggregative Escherichia coli. Bacterial aggregates adhered to cells with a typical "stacked-brick" appearance. In contrast, A. caviae strains showed a diffuse adherence pattern.
A chromosomal Borrelia burgdorferi gene encodes a 22-kilodalton lipoprotein, P22, that is serologically recognized in Lyme disease
Authors: Lam T T , Nguyen T P , Fikrig E , Flavell R A
Published: January 2020

We describe the isolation of the gene encoding a 22-kDa antigen from Borrelia burgdorferi, the etiologic agent of Lyme disease. The p22 gene is 582 nucleotides in length and encodes a protein of 194 amino acids with a predicted molecular mass of 21.8 kDa. The leader signal sequence of P22 consists of a positively charged short amino terminus, a central hydrophobic domain, and at the carboxyl terminus, a cleavage site that is presumably recognized and cleaved by a B. burgdorferi signal peptidase. P22 has 98.5% homology with the recently described B. burgdorferi protein IpLA7. P22 is processed as a lipoprotein, as demonstrated by [3H]palmitate labeling. Pulsed-field gel electrophoresis showed that p22, like LA7, is localized to the linear chromosome of B. burgdorferi. Examination of sera from patients with Lyme disease revealed that antibodies to P22 are rarely detected in patients with early-stage disease characterized by erythema migrans (2 of 20), and 35% of the patients with late-stage disease characterized by arthritis (9 of 26) developed antibodies to P22. Sera from patients with syphilis did not react with P22. When patients with late-stage disease were tested for their antibody reactivities to four other outer surface proteins (OspA), OspB, OspE, and OspF), 75% of these patients responded to P22 or to one or more outer surface proteins.
Geographical distribution of hepatitis C virus genotypes in blood donors: an international collaborative survey
Authors: McOmish F , Yap P L , Dow B C , Follett E A , Seed C , Keller A J , Cobain T J , Krusius T , Kolho E , Naukkarinen R
Published: January 2020

The frequency of infection with the six classified major genotypes of hepatitis C virus (HCV) was investigated in 447 infected volunteer blood donors from the following nine countries: Scotland, Finland, The Netherlands, Hungary, Australia, Egypt, Japan, Hong Kong, and Taiwan. Viral sequences in plasma from blood donors infected with HCV were amplified in the 5'-noncoding region and were typed by restriction fragment length polymorphism analysis. Electrophoresis of DNA fragments produced by cleavage with HaeIII-RsaI and ScrFI-HinfI allowed HCV types 1 (or 5), 2, 3, 4, and 6 to be identified. Further analysis with MvaI-HinfI allowed sequences of the type 5 genotype to be distinguished from sequences of the type 1 genotype. Types 1, 2, and 3 accounted for almost all infections in donors from Scotland, Finland, The Netherlands, and Australia. Types 2 and 3 were not found in the eastern European country (Hungary), where all but one of the donors were infected with type 1. Donors from Japan and Taiwan were infected only with type 1 or 2, while types 1, 2, and 6 were found in those from Hong Kong. HCV infection among Egyptians was almost always by type 4. Donors infected with HCV type 1 showed broad serological reactivity with all four antigens of the second generation Chiron RIBA-2 assay (Chiron Corporation, Emeryville, Calif.), while infection with divergent HCV genotypes elicited antibodies mainly reactive to c22-3 and c33c. Reactivities with antibodies 5-1-1 and c100-3 were infrequent and were generally weak, irrespective of the geographical origin of the donor. Because the envelope region of HCV is even more variable than the NS-4 region, it is likely that vaccines based on these proteins need to be multivalent and perhaps specifically adapted for different geographical regions.
C-reactive protein and alpha 1-acid glycoprotein levels in dogs infected with Ehrlichia canis
Authors: Rikihisa Y , Yamamoto S , Kwak I , Iqbal Z , Kociba G , Mott J , Chichanasiriwithaya W
Published: January 2020

To elucidate whether acute-phase protein responses occur in dogs infected with Ehrlichia canis, C-reactive protein (CRP) and alpha 1-acid glycoprotein (AAG) levels were serially measured in the plasma of five dogs experimentally inoculated with E. canis and 10 sham-inoculated or noninoculated control dogs. The CRP concentration was measured by a canine-specific capture enzyme-linked immunosorbent assay, and the AAG concentration was measured by a canine-specific radial immunodiffusion method. In all E. canis-inoculated dogs, a 3.3- to 6.5-fold increase in the plasma CRP concentration and a 1.9- to 8.6-fold increase in the plasma AAG concentration over the preinoculation level occurred at days 4 to 6 postexposure. Despite the persistence of E. canis and high antibody titers, both CRP and AAG concentrations gradually declined to preexposure levels by day 34 postexposure. E. canis-infected dogs had mild and transient clinical signs which resolved without treatment by day 14 postexposure. The CRP and AAG concentrations in control inoculated or nontreated dogs remained within the normal range throughout the experimental period. Of 12 dogs naturally infected with E. canis, 75% had greater than 50 micrograms of CRP per ml and 83% had greater than 500 micrograms of AAG per ml. All of these 12 dogs had chronic and severe clinical signs of canine ehrlichiosis. Thus, elevations in the levels of acute-phase proteins occur in both acute and chronic canine ehrlichiosis. Determination of CRP and AAG concentrations may help in assessing the severity of inflammatory damage in dogs with E. canis infections.
Diagnosis of amebic dysentery by detection of Entamoeba histolytica fecal antigen by an invasive strain-specific, monoclonal antibody-based enzyme-linked immunosorbent assay
Authors: Gonzalez-Ruiz A , Haque R , Rehman T , Aguirre A , Hall A , Guhl F , Warhurst D C , Miles M A
Published: January 2020

An invasive strain-specific monoclonal antibody against Entamoeba histolytica has been used in a capture enzyme-linked immunosorbent assay (ELISA) for the detection of invasive E. histolytica fecal antigen in clinical specimens and for the diagnosis of amebic dysentery in patients from Bangladesh. The fecal antigen capture ELISA (FAC-ELISA) did not cross-react with other parasite species in the clinical specimens or with noninvasive E. histolytica present in those specimens and in experimentally seeded stools. The limit of detection of the assay for invasive E. histolytica crude antigen diluted in phosphate-buffered saline or in stools was 0.58 and 3.9 micrograms/ml, respectively, which is the equivalent of approximately 72 and 487 E. histolytica trophozoites per well, respectively. The sensitivity, specificity, and efficiency of the FAC-ELISA were 87, 100, and 98%, respectively, for the detection of invasive E. histolytica antigens and 100, 100, and 100%, respectively, for the diagnosis of amebic dysentery. The FAC-ELISA is a potential alternative for the field diagnosis of amebic dysentery and for epidemiological studies to define the distribution of invasive E. histolytica.
Neutralization enzyme immunoassay for influenza virus
Authors: Benne C A , Harmsen M , De Jong J C , Kraaijeveld C A
Published: January 2020

A neutralization enzyme immunoassay (N-EIA) was developed for the detection of antibody titer rises in sera of patients infected with influenza A (H3N2) virus. In this N-EIA, a selected strain of influenza A (H3N2) virus was added to monolayers of LLC-MK2 cells in microtiter plates. After 24 h, the replicated virus could be demonstrated with a virus-specific enzyme-labeled monoclonal antibody. Preincubation of the influenza virus with convalescent-phase sera of patients infected with influenza A (H3N2) virus resulted 1 day later in decreased absorbance values that could be used for calculation of neutralization titers. From use of paired serum samples from 10 patients with a history of flu-like symptoms, the results obtained with N-EIA correlated well (r = 0.83) with those of the standard hemagglutination inhibition test.
Outbreak of multidrug-resistant Enterococcus faecium with transferable vanB class vancomycin resistance
Authors: Boyce J M , Opal S M , Chow J W , Zervos M J , Potter-Bynoe G , Sherman C B , Romulo R L , Fortna S , Medeiros A A
Published: January 2020

Enterococcus faecium strains resistant to ampicillin, high levels of gentamicin, and vancomycin but susceptible to teicoplanin (vanB class vancomycin resistance) were recovered from 37 patients during an outbreak involving a 250-bed university-affiliated hospital. Three isolates with vancomycin MICs ranging from 8 to 256 micrograms/ml all hybridized with a vanB probe. Restriction endonuclease analysis of chromosomal and plasmid DNA suggested that all isolates tested were derived from a single clone. Vancomycin resistance was shown to be transferable. Risk factors for acquiring the epidemic strain included proximity to another case patient (P, 0.0005) and exposure to a nurse who cared for another case patient (P, 0.007). Contamination of the environment by the epidemic strain occurred significantly more often when case patients had diarrhea (P, 0.001). Placing patients in private rooms and requiring the use of gowns as well as gloves by personnel controlled the outbreak. These findings suggest that multidrug-resistant E. faecium strains with transferable vanB class vancomycin resistance will emerge as important nosocomial pathogens. Because extensive environmental contamination may occur when affected patients develop diarrhea, barrier precautions, including the use of both gowns and gloves, should be implemented as soon as these pathogens are encountered.
Use of PCR with feces for detection of Helicobacter pylori infections in patients
Authors: van Zwet A A , Thijs J C , Kooistra-Smid A M , Schirm J , Snijder J A
Published: January 2020

PCR was performed for the detection of Helicobacter pylori in feces from 24 patients with proven infections. Several precautions were taken to overcome possible inhibition of PCR with feces. In the first 12 patients, feces were examined shortly after endoscopy. In another group of 12 patients, who were treated during 2 weeks with omeprazole (40 mg each day) to increase gastric pH, feces were examined as well. H. pylori target DNA could not be detected in the stools of any of the 24 infected patients. It was concluded that there was no substantial shedding of H. pylori in feces from either group of patients.
Comparison of agar dilution, tube dilution, and broth microdilution susceptibility tests for determination of ramoplanin MICs
Authors: Kenny M T , Brackman M A
Published: January 2020

Standard broth microdilution (with and without bovine serum albumin [BSA] supplementation), tube dilution, and agar dilution susceptibility tests were compared for determining ramoplanin MICs. With a data base of 246 clinical isolates of gram-positive bacteria from 33 U.S. sites, it was shown that (i) agar and tube dilution susceptibility tests gave essentially the same results (93.9% of the test results were within 1 doubling dilution of equivalence), (ii) broth microdilution susceptibility tests gave results up to 5 doubling dilutions higher than agar or tube assays, and (iii) this data skewing could be reversed by BSA supplementation (final concentration, 0.02%) of the broth microdilution test medium.
Selective isolation of poliovirus in recombinant murine cell line expressing the human poliovirus receptor gene
Authors: Hovi T , Stenvik M
Published: January 2020

Sixty-eight laboratory strains representing 49 enterovirus, 10 adenovirus, and 3 reovirus serotypes were inoculated in a recombinant murine cell line expressing the human poliovirus receptor gene (L alpha cells). Only polioviruses caused cytopathic effect over a 10-day period. Likewise, only polioviruses were isolated, by use of L alpha cells, from 168 fecal specimens from children from developing countries. These results suggest that the recombinant L alpha cells can be used for selective isolation of poliovirus from clinical specimens.
Detection of Rickettsia tsutsugamushi in Experimentally infected mice by PCR
Authors: Kee S H , Choi I H , Choi M S , Kim I S , Chang W H
Published: January 2020

We developed a rapid procedure for the detection of Rickettsia tsutsugamushi DNA by the PCR technique. The primer pair used for the PCR was designed from the DNA sequence of the gene encoding a 120-kDa antigen, which was proven to be group specific by immunoblot analysis with mouse hyperimmune sera against various rickettsial strains. This PCR method was able to detect up to 10 ag of plasmid DNA (pKT12). Specific PCR products were obtained with DNAs from R. tsutsugamushi Kato, Karp, Gilliam, TA716, TA1817, and Boryong, but not with DNAs from other rickettsiae, such as R. prowazekii, R. typhi, R. akari, and strain TT118. In a study with experimentally infected mice, the PCR method could detect rickettsial DNA from 2 days after inoculation (DAI), whereas serum antibody against R. tsutsugamushi could be detected from 6 to 8 DAI by an immunofluorescence test. Although clinical manifestations subsided after 14 DAI, rickettsial DNA in blood samples could be detected by PCR for up to 64 DAI. These results suggest that this PCR method can be applied to the early diagnosis of scrub typhus and can also be used to detect the residual rickettsiae after clinical symptoms subside.
Evaluation of five immunoassays for detection of Chlamydia psittaci in cloacal and conjunctival specimens from turkeys
Authors: Vanrompay D , Van Nerom A , Ducatelle R , Haesebrouck F
Published: January 2020

Five commercially available immunoassays were evaluated for the detection of Chlamydia psittaci in cloacal and conjunctival swabs from industrially raised turkeys: IMAGEN (DAKO Diagnostics, Ely, Cambridgeshire, United Kingdom), Chlamydia CEL-VET IF (Cellabs, Brookvale, Australia), IDEIA (DAKO Diagnostics), CELISA (Cellabs), and CLEARVIEW (Unipath, Bedford, United Kingdom). Results were compared with isolation in Buffalo Green Monkey cells as a reference method. For the conjunctival samples, the sensitivities of the IMAGEN test, the Chlamydia CEL-VET IF test, the IDEIA, the CELISA, and the CLEARVIEW test were found to be 100, 66, 0, 0, and 0%, respectively, as compared to the reference test. Also for the conjunctival samples, the specificities of the IMAGEN test, the Chlamydia CEL-VET IF test, and the IDEIA were found to be 100, 11, and 92.8%, respectively. For the cloacal specimens, the sensitivities of the IMAGEN test, the Chlamydia CEL-VET IF test, the IDEIA, the CELISA, and the CLEARVIEW test were found to be 100, 93.3, 26.6, 0, and 53.3%, respectively. Also for the cloacal specimens, the specificities of the IMAGEN test, the Chlamydia CEL-VET IF test, the IDEIA, and the CLEARVIEW test were found to be 92, 12, 100, and 88%, respectively. The IMAGEN test was the most sensitive and specific direct chlamydia antigen detection test for cloacal and conjunctival samples from turkeys.
Identification of individual genotypes of Chlamydia trachomatis from experimentally mixed serovars and mixed infections among trachoma patients
Authors: Dean D , Stephens R S
Published: January 2020

Genetic polymorphisms in the major outer membrane protein gene (omp-1) of Chlamydia trachomatis B and Ba serovars have been demonstrated in Tunisian isolates. A total of 15 of 27 unique sequence signatures or omp-1 genotypes were identified. However, differentiation of unique signatures from sequences that reflect those of strains involved in a mixed infection is necessary to define the molecular epidemiology of chlamydial ocular infections. We devised a strategy for identifying mixed infections by characterizing their effects on omp-1 genotyping. Various ratios of elementary bodies from organisms of serovars A, B, Ba, and C that cause trachoma were amplified by PCR and were subjected to automated and manual sequencing. Serovar-specific primers were also designed so that each serovar could be individually amplified and its omp-1 genotype unequivocally determined. One of 27 Tunisian samples showed a mixed infection with sequences comparable to those of serovars B and D. The omp-1 genotypes of organisms involved in mixed infections can be accurately identified by automated sequencing and will be useful for molecular epidemiologic studies of populations worldwide who live where trachoma is endemic.
Septic Abortion with Intact Fetal Membranes Caused by
Campylobacter fetus
subsp.
fetus
Authors: Steinkraus Gregory E. , Wright Brent D.
Published: January 2020

We report a case of septic abortion with intact fetal membranes caused by
Campylobacter fetus
subsp.
fetus
in an 18-year-old woman who was 9 1/2 weeks pregnant.
Quantification of human immunodeficiency virus in plasma by RNA PCR, viral culture, and p24 antigen detection
Authors: Van Kerckhoven I , Fransen K , Peeters M , De Beenhouwer H , Piot P , van der Groen G
Published: January 2020

A semiquantitative PCR technique for detecting human immunodeficiency virus type 1 (HIV-1) RNA in plasma was compared with quantitative viral culture and p24 antigen detection in plasma. Ninety-three samples from 20 symptomatic, 10 asymptomatic, and 10 seronegative individuals were tested. For most of the seropositive patients, consecutives samples were examined. Viral RNA was extracted from plasma by the method described by Boom et al. (R. Boom, C.J. A. Sol, M. M. M. Salimans, C.L. Jansen, P. M. E. Wertheim-van Dillen, and J. van der Noordaa, J. Clin. Microbiol. 28:495-503, 1990). The RNA PCR was the most sensitive method (100 and 74% sensitivity for symptomatic and asymptomatic patients, respectively) and produced less divergent results with the consecutive samples from individual patients compared with the other techniques. All samples positive by viral culture or p24 antigen assay were also positive in the RNA PCR. For each of the three assays, the number of positive results obtained correlated with the disease stage. The estimated mean number of HIV-1 RNA copies was significantly higher in symptomatic patients (22,750 copies per ml) than in asymptomatic patients (1,820 copies per ml). It was also higher in samples positive for viral culture than in culture-negative samples. No close correlation was found between the amount of HIV-1 RNA and the amount of p24 antigen or the titer of infectious virus in plasma or between this titer and the level of p24 antigen. The plasma RNA PCR may be a useful additional marker of disease progression and may be valuable for monitoring the effects of antiviral therapy.
Competitive inhibition enzyme-linked immunosorbent assay for antibody in sheep and other ruminants to a conserved epitope of malignant catarrhal fever virus
Authors: Li H , Shen D T , Knowles D P , Gorham J R , Crawford T B
Published: January 2020

Malignant catarrhal fever (MCF) is a severe, usually fatal, acute systemic disease syndrome of certain domestic and wild ruminants caused by members of the family Gammaherpesvirinae. Two distinct but closely related viruses cause clinically indistinguishable syndromes: one that is indigenous to the widebeest and the other that apparently is indigenous to domestic sheep. Neither the pathogenesis nor the epidemiology of sheep-associated MCF (SA-MCF) is understood, primarily because of a lack of adequate detection methods for the etiologic agent or antibody against it. No acceptably documented isolates of SA-MCF virus have been reported, and existing antibody assays suffer from significant cross-reactivity with other viruses. As a basis for a specific serologic assay, an attempt was made to identify an epitope conserved among all isolates of MCF viruses, by using a monoclonal antibody (MAb) produced against a previously reported U.S. isolate of MCF virus. A MAb (15-A) which bound a conserved epitope present on all four isolates of MCF virus examined was found. MAb 15-A did not react with eight common sheep and goat viruses or five common bovine viruses. Immunoprecipitation revealed that the 15-A epitope was located on the viral glycoprotein complex, with molecular masses of 115, 110, 105, 78, and 45 kDa. Sera from experimentally and naturally infected animals which yielded a similar glycoprotein complex immunoprecipitation pattern competed with MAb 15-A for its epitope. A competitive inhibition enzyme-linked immunosorbent assay (ELISA) based on MAb 15-A was therefore developed. The assay detected antibody in inapparently infected sheep and in cattle, deer, and bison with clinical MCF. Of the 149 serum samples from sheep associated with MCF outbreaks, 88 (55%) were seropositive by competitive inhibition ELISA.
Production of extracellular slime by coryneforms colonizing hydrocephalus shunts
Authors: Bayston R , Compton C , Richards K
Published: January 2020

Corynebacterium spp. are responsible for an important minority of cases of colonization of cerebrospinal fluid shunts used for the treatment of hydrocephalus. In common with coagulase-negative staphylococci, they present a serious therapeutic problem because they are often resistant to multiple antibiotics. We studied the morphologies of coryneforms in colonized hydrocephalus shunts removed from patients and observed extracellular slime similar in appearance to that seen in coagulase-negative staphylococci. We also studied a series of such isolates from other cases of hydrocephalus shunt colonization using an established laboratory model and consistently observed slime production in these shunts as well. We propose that this might be a further reason for failure to eradicate these organisms without shunt removal as well as a factor in their pathogenesis in device-related infections.
Persistence of Campylobacter fetus bacteremia associated with absence of opsonizing antibodies
Authors: Neuzil K M , Wang E , Haas D W , Blaser M J
Published: January 2020

Campylobacter fetus causes systemic infections in immunocompromised hosts. We describe a case in which C. fetus bacteremia apparently relapsed after 7 years in a patient with hypogammaglobulinemia and characterize the serum resistance of the patient's C. fetus strain and the inability of the patient's serum, with and without commercial intravenous immunoglobulin, to opsonize this and another C. fetus strain effectively. The probable presence of a sequestered site of infection in bone, the intrinsic serum resistance of the C. fetus strain, and the absence of specific antibody may account for the persistent infection in this patient. These studies suggest that intravenous immunoglobulin treatment is not useful in eradicating C. fetus bacteremia.
Differentiation of Brevibacterium spp. encountered in clinical specimens
Authors: Funke G , Carlotti A
Published: January 2020

Forty-three strains belonging to the genus Brevibacterium which were encountered in clinical materials over 2 decades were compared with reference strains, including the type strains, of B. casei, B. epidermidis, B. mcbrellneri, B. iodinum, and B. linens. By means of carbohydrate assimilation tests (CATs) the 43 clinical isolates could be assigned to the species B. casei (n = 41) and B. epidermidis (n = 2). DNA-DNA hybridizations were performed for 20 clinical isolates and confirmed the species identification of the isolates. Cellular fatty acid profiles of all strains were determined and found to have less discriminative power than CATs. This is the first report indicating that most clinical Brevibacterium isolates are B. casei and that CATs provide an easy-to-perform method for species determination within the genus, thus avoiding nucleic acid techniques.
Detection of microsporidial spores in fecal specimens from patients diagnosed with cryptosporidiosis
Authors: Garcia L S , Shimizu R Y , Bruckner D A
Published: January 2020

Patients infected with Cryptosporidium parvum may have concurrent infections with microsporidia. Two modified trichrome stains and a polyclonal indirect fluorescent-antibody procedure were used for the detection of microsporidia; the Merifluor Cryptosporidium-Giardia monoclonal direct immunofluorescence detection kit was used for the detection of C. parvum. Formalinized stool specimens from 60 immunocompromised patients strongly suspected of having or previously diagnosed with cryptosporidiosis or microsporidiosis were examined. All patients were positive for one or both parasites, 18 (30%) with C. parvum only, 25 (42%) with microsporidia only, and 17 (28%) with both C. parvum and microsporidia. These findings emphasize the importance of considering both organisms as potential causative agents of diarrhea in compromised patients.
Restriction fragment length polymorphism analysis of clinical isolates of Mycobacterium haemophilum
Authors: Kikuchi K , Bernard E M , Kiehn T E , Armstrong D , Riley L W
Published: January 2020

Mycobacterium haemophilum is an emerging opportunistic pathogen, and since 1989, infections caused by this organism have been identified more frequently in the New York City area than in any other region of the United States. A DNA fingerprinting method, based on restriction fragment length polymorphisms (RFLPs) was developed. A genomic library of M. haemophilum isolate 1A was constructed; screening the library yielded a recombinant strain that incorporated a genetic element present in multiple copies in the M. haemophilum genome. This clone was used to produce a probe for RFLP analyses of PvuII digests of genomic DNA. We used this probe to determine the RFLP patterns of 43 clinical isolates of M. haemophilum from 28 patients. A total of six distinct patterns were observed. Two patterns, designated types 1 and 2, accounted for 91% of the infections in patients from the New York City area. Two isolates from Arizona had identical patterns but were distinct from those of New York isolates, and an isolate from Israel, the type strain, had another distinct pattern (type 6). The type 6 pattern was also seen in a recent isolate from Norway. All of the type 1 isolates and 60% of the type 2 isolates were recovered from patients with AIDS in the New York City area. This molecular subtyping method should provide a useful tool for epidemiological studies and may help identify the associated risk factors, vehicles, and possible reservoirs of this newly emerging pathogen.
Cutaneous zygomycosis caused by Saksenaea vasiformis in a diabetic patient
Authors: Bearer E A , Nelson P R , Chowers M Y , Davis C E
Published: January 2020

A 49-year-old woman with diabetes mellitus rapidly developed necrotizing cellulitis with fat necrosis and vasculitis after minor trauma to the right arm. Zygomycosis was diagnosed histologically. The lesion responded to aggressive debridement, amphotericin B, and normalization of blood glucose. Cultures yielded structures characteristic of Saksenaea vasiformis only after transfer to saline agar.
Astrovirus as a cause of gastroenteritis in Japan
Authors: Utagawa E T , Nishizawa S , Sekine S , Hayashi Y , Ishihara Y , Oishi I , Iwasaki A , Yamashita I , Miyamura K , Yamazaki S
Published: January 2020

We used an enzyme immunoassay (EIA) to screen for astrovirus in stool specimens from outbreaks and sporadic cases of gastroenteritis collected between 1982 and 1992 in six prefectural public health institutes in Japan. Three outbreaks of gastroenteritis involving schoolchildren and adults were confirmed to be attributable to astrovirus. Astrovirus was detected in 6 to 10% of the specimens from patients with sporadic gastroenteritis from whom no other bacterial or viral agent had been identified. Among the sporadic cases, astrovirus was most frequently detected in infants less than 1 year of age, and the incidence peaked in March and April. Using specimens from recent outbreaks, we found that the EIA was more sensitive than electron microscopy (EM) for the detection of astrovirus, and many EM-negative specimens were positive by EIA. However, some stool specimens previously found to have astrovirus-like particles by EM were negative by EIA, perhaps because of inadequate storage conditions, such as long-term storage and repeated freezings and thawings. Our results indicate that astrovirus is more commonly associated with childhood gastroenteritis than has been previously appreciated and suggest that further studies to examine the epidemiology and disease burden of this virus are needed.