bluuebunny/crossref_metadata_2025 huggingface dataset:
An outbreak of waterborne cryptosporidiosis in Swindon and Oxfordshire
Authors: Richardson A. J. , Frankenberg R. A , Buck A. C. , Selkon J. B. , Colbourne J. S. , Parsons J. W. , Mayon-White R. T.
Published: May 2009

An outbreak of cryptosporidiosis resulted in 516 cases in Wiltshire and Oxfordshire. The outbreak caused widespread interest and led to an official inquiry. The majority of cases were in children; 8% of cases were admitted to hospital and the median duration of illness was 3 weeks. The geographical distribution of cases matched the distribution of water supplies from three treatment works and eryptosporidium oocysts were found at these works and in the treated water. Attack rates in electoral wards supplied by the three treatment works were significantly higher than in other wards. The cause of the outbreak appeared to be the failure of normal treatment to remove oocysts. Measures at the treatment works reduced the number of oocysts detected in treated water, after which the outbreak came to an end. The conclusion of the investigations was that cryptosporidiosis is a risk of conventionally treated public water supplies.
rDNA fingerprinting as a tool in epidemiological analysis ofSalmonella typhiinfections
Authors: Nastasl A. , Mammina C. , Villafrate M. R.
Published: May 2009

Characterization of 169 strainsof Salmonella typhiof phage types C1, C4, D1and D9isolated in 1975–88 was carried out by rDNA gene restriction pattern analysis. Twenty-four isolates had been recovered during four large waterbone outbreaks in the last 20 years in Sicily; 145 strains, isolated from apparently sporadic cases of infection in Southern Italy in the same period of time, were also examined.

Application of rRNA–DNA hybridization technique after digestion of chromosomal DNA withClaI showed the identity of patterns of the epidemic strains of phage types C1and D1, confirming attribution of the outbreaks to single bacterial clones. Patterns of the two available strains of lysotype D9were slightly different, whilst the 12 epidemic strains of phage type C4could be assigned to two distinct patterns scarcely related to each other and, consequently, to two different clones. A considerable heterogeneity was detected among all apparently sporadic isolates of the four phage types under study.

This fingerprinting method appears a reliable tool to complement phage typing in characterizing isolates ofS. typhi.In particular, epidemiological features of spread of this salmonella serovar in areas, where simultaneous circulation of indigenous and imported strains occurs, can be elucidated.
Epidemiology and aetiology of acute bronchiolitis in Hong Kong infants
Authors: Sung R. Y. T. , Chan R. C. K. , Tam J. S. , Cheng A. F. B. , Murray H. G. S.
Published: May 2009

The epidemiological, clinical and virological features of 1220 children with acute bronchiolitis admitted to the Prince of Wales Hospital, Hong Kong, from 1985 to 1988 are reported. They accounted for 6·6% of total paediatric admissions and provided a case incidence of bronchiolitis requiring admission to hospital of approximately 21 per 1000 children 0–24 months of age.

The clinical course and outcome was in general benign. The average hospital stay was 5 days and there were no deaths. Ten per cent of patients were repeatedly admitted to hospital with recurrent wheezing after discharge. Two infants developed bronchiolitis obliterans.

Respiratory syncytial virus (RSV) was shown by direct immunofluorescence, virus culture and serology to be the commonest cause of acute bronchiolitis in Hong Kong. Other aetiological agents included parainfluenza and influenza viruses, adenoviruses, andMycoplasma pneumoniae.

In contrast to western countries, a seasonal variation of bronchiolitis was found with a peak incidence in the summer months. The significance of these observations is discussed.
A 2-year survey of the prevalence of enteric viral infections in children compared with contamination in locally-harvested oysters
Authors: Yamashita T. , Sakae K. , Ishihara Y. , Isomura S.
Published: May 2009

We studied, for two years, the prevalence of indigenous human enteric viruses in wild oysters gathered each month from the bottom of Mikawa Bay, Aichi Prefecture, Japan. Viruses were detected periodically in 9 out of 54 oyster pools prepared by the acid or polyethylene glycol precipitation method although all these 9 pools met current national bacteriological safety standards. Since most of the serotypes of the enteric viruses detected in the oysters were identical with those of viruses isolated from sick children living in the area, it is suggested that contamination of enteric viruses in the oysters would depend on the prevalence of enteric viral infections in the local inhabitants.
Each water outlet is a unique ecological niche forLegionella pneumophila
Authors: Marrie T. J. , Haldane D. , Bezanson G. , Peppard R.
Published: May 2009

We determined the natural history of the colonization of our hospital's potable water by culturing water approximately biweekly from 20 sites throughout the hospital for 4 years. Overall, 545 (24.7%) of the 2200 samples grewLegionella pneumophila. During hyperchlorination, 11·7% of the samples were positive while 41·6% were positive in the absence of chlorination. There was no seasonal trend towards positivity, but there was marked inter-site variation in the semi-quantitative culture results. However, a single strain of legionella (as defined by plasmid profiling) tended to persist at a site. Such a site was a unique ecological niche in that different sites in the same wing were populated by distinct strains.

The two wings of our hospital had a significantly different distribution of strains of legionella – plasmid profile type III predominated in the Victoria Wing while types II and VI predominated in Centennial Wing. Twenty-four of our 28 cases of nosocomial Legionnaires' disease occurred in the Centennial Wing. Three of the four cases in the Victoria Wing were caused by plasmid profile type III while 18 of the 24 isolates from patients who acquired their infection in the Centennial Wing were type II. We conclude that each water outlet serves as its own ecological niche ofL. pneumophila.
Virulence determinants inPseudomonas aeruginosastrains from urinary tract infections
Authors: Visca P. , Chiarini F. , Mansi A. , Vetriani C. , Serino L. , Orsi N.
Published: May 2009

A total of 121 uropathogenicPseudomonas aeruginosastrains were examined for production of several virulence-related factors. These strains were distributed in five predominant O-serotypes, i.e. O 4, O 12, O 11, O 6 and O 5, which accounted respectively for 23·9, 23·1, 12·3, 8·2 and 5·7% of isolates. Pyochelin and pyoverdin siderophores were produced by most of the isolates, defective variants occurring at very low frequency (2·4% for pyochelin and 7·4% for pyoverdin). Adherence to uroepithelial cells and production of cytotoxins was demonstrated in 52·8 and 67·7% of the strains, respectively, with higher frequencies for epidemiologically related strains belonging to serotypes O 4 and O 12. Titration of total proteases, elastase and phospholipase C revealed a high degree of heterogeneity among isolates. However, examination of individual O-serotypes by exoenzyme production showed that elevated levels of total proteases and elastase were characteristics of serotypes of minor numerical importance, i.e. O 1, O 10, O 11 and O 17, whilst low levels of elastase were produced by strains belonging to the predominant serotypes, namely O 4 and O 12. Moreover, epidemiologically related strains belonging to serotypes O 4 and O 12 appeared more homogeneous than the whole serogroup, when compared with other groups on the basis of exoenzyme levels.
Antigenic and genetic analyses of eight influenza C strains isolated in various areas of Japan during 1985–9
Authors: Ohyama S. , Adachi K. , Sugawara K. , Hongo S. , Nishimura H. , Kitame F. , Nakamura K.
Published: May 2009

Eight strains of influenza C virus isolated in various areas of Japan between January 1985 and January 1989 were compared using monoclonal antibodies to the haemagglutinin-esterase (HE) glycoproteins and by oligonucleotide mapping of total vRNA. Five of six strains isolated during 1986–9 were closely related to one another and also resembled the virus, C/Aichi/1/81, isolated in 1981 in Aichi prefecture. This suggests that the C/Aichi/l/81-related viruses had an epidemiological advantage over any co-circulating viruses at least during that period. One of two 1985 isolates (C/Nara/1/85) was antigenically indistinguishable from the C/Mississippi/1/80 strain though their oligonucleotide patterns were markedly different from each other. This raises the possibility that C/Nara/1/85 may be a recombinant virus which receives its HE gene from the C/Mississippi/l/80-related parent.
Distribution and characteristics of verocytotoxigenicEscherichia coliisolated from Ontario dairy cattle
Authors: Wilson J. B. , McEwen S. A. , Clarke R. C. , Leslie K. E. , Wilson R. A. , Waltner-Toews D. , Gyles C. L.
Published: May 2009

Faecal swabs obtained from a random sample of 1131 cows and 659 calves on 100 southern Ontario dairy farms were examined for verocytotoxigenicEscherichia coli(VTEC) using a Vero cell assay. Five isolates from each positive culture were tested similarly. Positive colonies were examined with DNA probes for Shiga-like toxin I (SLT-I) and SLT-II sequences. Probe-negative colonies were tested for neutralization of verocytotoxicity using anti-SLT-I and anti-SLT-IIv antisera. Colonies showing no neutralization response were examined in a polymerase chain reaction procedure. Colonies positive by any test were confirmed to beE. colibiochemically, serotyped, biotyped and tested for antimicrobial resistance. Faecal culture supernatants which were positive in the Vero cell assay, but culture negative, were examined using the neutralization assay. Animals were classified positive by faecal culture supernatant or by positive VTEC isolate. The prevalence rates of VTEC infection in cows and calves were estimated to be 9·5 and 24·7%, respectively. The proportion of animals infected on each farm ranged from 0 to 60% for cows and 0 to 100% for calves. Of 206 VTEC isolates identified, few were of serotypes which have been isolated from humans and none wereE. coliO 157. H7.
Transmission ofNeisseria meningitidisamong asymptomatic military recruits and antibody analysis
Authors: Caugant D. A. , Høiby E. A. , Rosenqvist E. , Frøholm L. O. , Selander R. K.
Published: May 2009

Following the occurrence of a case of systemic meningococcal disease in a military camp in Norway, throat cultures and blood samples were collected from 33 healthy individuals belonging to the same troop as the patient (troop A) and from 29 individuals from a different troop (troop B) in the same camp. Serological studies showed that 91% of the recruits had bactericidal antibodies against the disease-causing strain. The isolates ofNeisseria meningitidisrecovered from the throat cultures were serogrouped, serotyped, and assigned to a clone on the basis of an analysis of the electrophoretic mobilities of 14 metabolic enzymes. None of the 23 carriers in troop A harboured the clone responsible for the case of disease, but 6 carried isolates of the same electrophoretic type, ET-7, which was not identified in any of the 19 carriers of troop B. Individuals in troop A were resampled 2 and 17 weeks after the meningococcal disease episode. Five of the carriers had acquired different clones and one of them changed clone twice in that period. Four of the six newly acquired clones had previously been identified in other carriers of troop A, demonstrating transmission of clones among individuals living and working in close proximity.
The serological grouping system forSerpulina (Treponema) hyodysenteriae
Authors: Lau T. T. A. , Hampson D. J.
Published: May 2009

Lipopolysaceharide from serostrains ofSerpulina (Treponema) hyodysenteriaefor serogroups A to I was characterized using sodium dodecylsulphate polyacrylamide gel electrophoresis and silver staining. All strains had lipo-polysaccharide components ranging from 10 to 16 kDa that represented lipid A-core polysaccharide regions, and short O-antigen side chain were also recognized in certain immunoblots.

Serological reactions between lipopolysaceharide and antisera against each of these serostrains were examined by Western immunoblotting. There was relatively little antigenic cross-reactivity between LPS from the nine strains, thus confirming their suitability as serostrains.

Using cross-absorbed sera, isolates within serogroups A and E were shown to possess unique epitopes on the core lipopolysaceharide, distinct from serogroup reactivities. These isolates were therefore identified as serovars within the serogroups.

This study confirmed the usefulness of the serotyping scheme forS. hyodysenteriae, in which the bacteria can be placed into serogroups using unabsorbed sera, and into serovars within these using cross-absorbed sera.
Serological cross-reaction betweenLegionella pneumophilaand Campylobacter in the indirect fluorescent antibody test
Authors: Boswell T. C. J. , Kudesia G.
Published: May 2009

Sera from 50 patients with culture-proven Campylobacter gastroenteritis were examined for the presence of antibodies toLegionella pneumophila. Ten patients (20%) had a positive titre (≥16) as measured by indirect immunofluorescence. Antibodies were detected in only 1 of 36 acute sera but in 10 of 14 (71%) sera obtained more than 10 days after the onset of symptoms. All positive sera contained specific IgM antibodies but specific IgG or IgA could not be detected in any sample. No legionella antibodies could be detected in sera from 42 similar patients with salmonella gastroenteritis. These results were shown to be due to serological cross-reaction betweenL. pneumophilaand Campylobacter.
The distribution of the DHFR genes in trimethoprim-resistant urinary tract isolates from Taiwan
Authors: Chang Lin-Li , Chang Shui-Feng , Chow Teh-Yuan , Wu Wen-Jeng , Chang Jong-Chou
Published: May 2009

Between July 1987 and June 1989, 1054 urinary isolates of enterobacteria from Kaohsiung, Taiwan were studied for their trimethoprim resistance. Trimethoprim resistance was defined as MIC greater than 4 μg/ml and high-level resistance by MIC greater than 1000 μg/ml. The incidence of trimethoprim resistance increased from 33·6% in 1987 to 42·1% in 1989. Among the resistant strains studied, 90% were resistant to high levels of trimethoprim. An increase in the proportion of resistant strains (33·9–46·3%) exhibiting high-level non-transferable trimethoprim resistance was noted. The distribution of the dihydrofolate reductase (DHFR) genes by colony hybridization in 374 trimethoprim-resistant isolates revealed the presence of type I and type V DHFR genes in most of these isolates (45·4% and 10·4% respectively). Type I was predominant inEscherichia coliwhereas type V was frequently seen inEnterobacterspp. None showed homology with the type II and type III DHFR probe DNA. In addition, transposon Tn7 was present in 7·8% of 374 trimethoprim-resistant enterobacteria.
Circulating antibodies against faecal bacteria assessed by immunomorphometry: combining quantitative immunofluorescence and image analysis
Authors: Apperloo-Renkema H. Z. , Wilkinson M. H. F. , Waaij D. van der
Published: May 2009

A new technique to study the prevalence of circulating antibodies directed against different morphological groups (‘morphotypes’) of bacteria in fresh faeces is presented. The technique combines quantitative indirect immunofluorescence with digital image analysis. Plasma antibody titres and patterns of IgA, IgG and IgM isotype against morphotypes of faecal bacteria were determined in ten healthy individuals.
A prospective study of exposure to verotoxin-producingEscherichia coliamong Canadian children with haemolytic uraemic syndrome
Authors: Rowe P. C. , Orrbine E. , Lior H. , Wells G. A. , McLaine P. N.
Published: May 2009

Haemolytic uraemic syndrome (HUS) is a leading cause of acute renal failure in childhood. Although infection withEscherichia coliO 157. H7 has been associated with HUS in North America and Europe, only a limited number of studies have examined the role of other verotoxin-producingE. coli(VTEC) serotypes in this condition. To address this issue, we conducted a comprehensive, prospective microbiological study of patients treated for HUS at eight Canadian hospitals in the summer of 1990. Of the 34 consecutive patients with HUS enrolled over 4 months,E. coli0 157. H7 was isolated from the stools of 26, and otherE. coliserotypes were isolated from four patients. In four subjects no pathogenicE. coliserotypes were identified on stool culture. Using oligonucleotide probes specific for VT-1 and VT-2, verotoxin genes were detected in the stool isolates of all patients withE. coliO 157.H7, and from two with otherE. coliserotypes. Two other patients had at least a fourfold rise in anti-verotoxin antibodies. Strong evidence of exposure to a verotoxin was present in 30/34 (88%). Patients withE. coli0 157.H7 infection were more likely to develop an antibody response to VT-2 than to VT-1 (22/22 vs 12/22; P = 0.002). These results further strengthen the association of HUS with verotoxin-producingE. coliin North America, and confirm thatE. coliserotypes other than 0 157. H7 are isolated in a small proportion of summertime HUS episodes.
A comparison ofSalmonella enteritidisphage types from egg-associated outbreaks and implicated laying flocks
Authors: Altekruse S. , Koehler J. , Hickman-Brenner F. , Tauxe R. V. , Ferris K.
Published: May 2009

Infections due toSalmonella enteritidisare increasing worldwide. In the United States, between 1985 and 1989. 78% of theS. enteritidisoutbreaks in which a food vehicle was identified implicated a food containing raw or lightly cooked shell eggs.

Under a US Department of Agriculture regulation published in 1990, eggs implicated in human food-borneS. enteritidisoutbreaks were traced back to the source flock. The flock environment and the internal organs of a sample of hens were tested forS. enteritidis. We compared theS. enteritidisphage types of isolates from 18 human, egg-associated outbreaks and the 15 flocks implicated through traceback of these outbreaks. The predominant human outbreak phage type was recovered from the environment in 100% of implicated flocks and from the internal organs of hens in 88% of implicated flocks we tested. The results support the use of phage typing as a tool to identify flocks involved in humanS. enteritidisoutbreaks.
Sialic acid content and surface hydrophobicity of group B streptococci
Authors: Teixeira L. A. , Figueiredo A. M. S. , Ferreira B. T. , Alves V. M. L. , Nagao P. E. , Alviano C. S. , Angluster J. , Silva-Filho F. C. , Benchetrit L. C.
Published: May 2009

The sialic acid content and the cell-surface hydrophobicity index of 40 group B streptococci (GBS) strains were assessed. GBS isolated from invasive infections (virulent strains) presented an increased level of sialic acid content (1.4%) when compared with GBS isolated from asymptomatic patients (0.53%). Treatment of GBS strain 85634 with neuraminidase resulted in a decrease (about 25%) in the net negative surface charge as assessed by cell electrophoresis. This finding suggests that sialic acid residues are important anionogenic groups exposed on GBS cell surface.N-acetylneuraminic acid was the only sialic acid derivative characterized in the strain 85634 as evaluated by gas-liquid chromatography. GBS from different serotypes presented a hydrophobic index mean value of 0.9. Even though the sialic acid contributed effectively to the negative charge on GBS cell surface, no difference was observed in the hydrophobic index when virulent and avirulent strains were compared.
Corresponding type-specificity of vibriocidal and agglutinating activities ofVibrio choleraeantisera: relevance to vaccine immunogenicity
Authors: Preston N. W.
Published: May 2009

Cholera vibrios can be allocated to one of three biotypes (classical, intermediate and El Tor), each of which can be sub-divided into two serotypes (Ogawa and Inaba). Vibriocidal tests with absorbed antisera have shown no evidence of biotype specificity in the killing of bacteria, but they have confirmed the role of the two serotype-specific antigens in immunity to cholera. The same presence of serotype specificity, and absence of biotype specificity, has been found by bacterial agglutination, an easier and quicker serological test. The use of this simpler test in ensuring a balanced serotype response to cholera vaccine is discussed, together with evidence that may lead to the production of more effective vaccine and better immunity.
Serological diagnosis of leishmaniasis: on detecting infection as well as disease
Authors: Dye C. , Vidor E. , Dereure J.
Published: May 2009

Serological tests are very frequently used in epidemiological surveys of leishmaniasis and other parasitoses. Their sensitivity and specificity are generally defined with respect to parasitism and diseases, rather than infection. The reason is that known positives are those individuals most likely to yield parasites, or who have distinctive clinical signs, and concomitantly high antibody titres. This paper investigates the performance of one serological method, the indirect fluorescent antibody test (IFAT), in detectingLeishmania infantuminfection during an intensive 2-year cohort study of dogs in southern France. The results show that sensitivity and specificity with respect to infection can be simultaneously high, but maximum sensitivity is probably <80%, and lasts for a relatively short period of 2–3 months after a lengthy incubation period. The IFAT gave the incidence of infection as 18–65% in the first year, whereas the best estimate of incidence based on parasite isolation and clinical observation was 72%. But data from the second year suggest that the 72% was itself an underestimate. We argue that, during epidemiological surveys, the IFAT in particular, and serological tests for leishmania in general, will underestimate prevalence, incidence and hence the scale of the control problem. However, there is evidence that tests for canine leishmaniasis employing high threshold titres will identify the most infectious animals, allowing selective treatment or culling of those which contribute disproportionately to transmission.
A model-based design of a vaccination strategy against rubella in a non-immunized community of São Paulo State, Brazil
Authors: Massad E. , Burattini M. Nascimento , De Azevedo Neto R. S. , Mo Yang Hyun , Coutinho F. A. B. , Zanetta D. M. T.
Published: May 2009

A mixed vaccination strategy against rubella is proposed. We describe how the vaccination strategy was designed with the help of mathematical techniques. The strategy was designed for application in a non-immunized community of the State of São Paulo, Brazil, and was implemented by local health authorities in 1992. This strategy comprises a pulse vaccination campaign, covering the age interval between 1 and 10 years, followed by the introduction of the vaccine in the immunization calendar at 15 months of age. The expected impact of the proposed strategy is discussed.
The role of home-made ice cream as a vehicle of Salmonella enteritidis phage type 4 infection from fresh shell eggs
Authors: Morgan D. , Mawer S. L. , Harman P. L.
Published: May 2009

A family outbreak of Salmonella enteritidis PT4 infection is described in which home-made ice cream was identified as the vehicle of infection. The ice cream contained approximately 105S. enteritidis PT4 organisms per gm and was probably contaminated by an infected shell egg containing between 105−108 organisms. The continued relevance of the Chief Medical Officer's warning on the use of raw shell eggs is highlighted.

Home-made ice cream using the same recipe as ice cream that had been incriminated as the cause of the family outbreak of S. enteritidis PT4 infection was used to study the growth of the organism that might have occurred in the 3–4 h it took to prepare the product. When the inoculum was in the stationary phase, as it would be from shell or other cross contamination, there was a lag phase of 3 h before growth occurred at room temperature. Even when actively multiplying organisms were introduced, as may be found in an infected egg, there was less than 3 log10 increase in the salmonella count in 4 h at room temperature. It was, therefore, given the high S. enteritidis count, unlikely that the ice cream was cross-contaminated.

By contrast, raspberry sorbet at pH 3·73 proved to be lethal to a large inoculum of S. enteritidis and may be a relatively safe raw egg containing product.
Sero/subtyping ofNeisseria meningitidisisolated from patients in Spain
Authors: Vazquez J. A. , Marcos C. , Berron S.
Published: May 2009

To know the types of meningococcal strains in Spain, we serotyped and subtyped 743Neisseria meningitidisisolates recovered between 1990 and 1992 from patients. A great number of serogroup B, serogroup C and non-groupable meningoccoci reacted with the serotyping reagents while many serogroup C and non-groupable isolates did not react with the serosubtyping reagents (78·2% and 54·8 % respectively); only 8·9 % of serogroup B meningococci were non-subtypeable (NST). Distribution of serotypes was similar in serogroup C and in non-groupable strains. Isolates showed great variability in antigenic phenotypes (71 in serogroup B, 20 in serogroup C and 25 in non-groupable meningococci). The most frequent antigenic combinations were 4:P1. 15 (39·8%) in serogroup B, 2b:NST (55·8%) in serogroup C and 2b:NST (35·6%) in non-groupable meningococci.
Typhoid fever from water desalinized using reverse osmosis
Authors: Al-Qarawi S. M. , El Bushra H. E. , Fontaine R. E. , Bubshait S. A. , El Tantawy N. A.
Published: May 2009

In May 1992, 81 bacteriologically confirmed cases of typhoid fever (TF) were identified in all districts of Tabuk City in northwestern Saudi Arabia. Attack rates (AR) in residential districts ranged from 0·9–10·3 per 10000. Confirmed cases included 9 workers in the city's referral hospital, King Khalid Hospital (AR 140/10000), 2 in families of medical staff, 57 in the community (AR 4·4/10000) and 13 in a local military cantonment (AR 0·8/10000). The outbreak began with the onset of TF in the three areas within 5 days, continued for 7 weeks, and ended 2 weeks after chlorination began. Among water sources, the odds ratio (OR) was highest (2·6; 95% confidence interval [CI] 1·25–5·39) for water purchased from reverse osmosis (RO) plants, especially RO plants supplied by one well (ASUW) (OR = 7·05; 95% CI 2.51–20·7). The aquifer for ASUW lay partially beneath a depression where city sewage collected. Unchlorinated water samples from ASUW 1 month after the outbreak ended yielded coliforms. ASUW probably became contaminated withSalmonella typhiwhen KKH demand overtaxed the aquifer and drew in surface water. Membranes in RO plants using this unchlorinated well water could then become fouled withS. typhi. RO plants, which are common throughout Saudi Arabia, need close monitoring. WTater for RO must be prechlorinated to prevent microbiologic fouling of the membranes.
Vibrio cholerae O139 in Thailand in 1994
Authors: Bodhidatta L. , Echeverria P. , Hoge C. W. , Pitarangsi C. , Serichantalergs O. , Henprasert-Tae N. , Harikul S. , Kitpoka P.
Published: May 2009

Vibrio cholerae O139 first appeared in India and Bangladesh in 1992. Surveillance for O139 was started at three hospitals in Thailand in 1993. By 1994 all three hospitals surveyed in Thailand had experienced an increase in Vibrio cholerae O139 infections.
Host-microflora interaction in systemic lupus erythematosus (SLE): circulating antibodies to the indigenous bacteria of the intestinal tract
Authors: Apperloo-Renkema H. Z. , Bootsma H. , Mulder B. I. , Kallenberg C. G. M. , Van der Waaij D.
Published: May 2009

Experimental data suggest a role for the microflora in the disease expression of systemic lupus erythematosus (SLE). In active SLE anti-ds-DNA antibodies are supposed to be pathogenic by forming immune complexes with DNA. Bacteria might induce the production of anti-ds-DNA antibodies. To explore the relation between the host and his microflora in SLE in comparison with healthy controls we studied the prevalence of systemic antibodies to faecal bacteria that were discriminated by their morphology by indirect immunofluorescence.

IgM titres against their own faecal microflora were found to be lower both in active and inactive SLE when compared to healthy individuals. IgG-class antibacterial antibodies were increased in inactive SLE but decreased in active SLE compared to inactive SLE and healthy controls, although plasma levels of total IgG were almost doubled in active SLE. The lower IgG antibacterial antibody titres in active SLE might possibly result from sequestration of these IgG antibodies in immune complexes, indicating a possible role for antibacterial antibodies in exacerbations of SLE.
A comparative study of food retail premises by means of visual inspection and microbiological quality of food
Authors: Powell S. C. , Attwell R. W.
Published: May 2009

The relationship between visual inspection ratings given to ten food retail premises and the microbiological quality of food samples was examined. Viable counts of bacteria and of Staphylococcus aureus were determined for cooked meat samples from each of the premises. There was no correlation between potential risk of foodborne infection, as assessed by total inspection rating, and bacteriological counts in food (P < 0·05). Neither was there a consistent relationship between scores given to any component of the total rating and the bacteriological quality of food.

The effectiveness of the current UK inspection scheme in assessing risk of foodborne infection is questioned. Inclusion of appropriately weighted criteria such as food temperature abuse is suggested to improve the scheme.
Usefulness of ribotyping in a molecular epidemiology study of shigellosis
Authors: Mendoza M. C. , Martín M. C. , González-Hevia M. A.
Published: May 2009

Ribotyping performed with six restriction endonucleases was used to study the molecular epidemiology of shigellosis in Asturias, Spain. The series includedShigella sonneifrom 34 sporadic cases, 3 outbreaks and 3 reference strains, andS. flexnerifrom 13 sporadic cases and 1 reference strain. TheS. sonneistrains were grouped into 5 ribotypes withSalI, 4 withHindIII andPvuII, 3 withBglII andEcoR I and 2 withHincII (Discriminatory Index (DI) between 0·54 and 0·14); theS. flexneriinto 5 ribotypes withSalI, Hinc II andHindIII, and 4 with the other enzymes (DI = 0·71–0·63). The combination of results for 2 or more enzymes facilitated an additional discrimination, the highest values inS. sonneiwere for the 6 enzymes (16 types, DI = 0·91) and inS. flexnerifor some combinations of 3 or more enzymes (7 types, DI = 0·81). Ribotypes with the 6 enzymes defined 16 clonal lines inS. sonneiand 7 inS. flexneri, which showed a different degree of genetic heterogeneity, and all the lines of each species falling into a different cluster. No line appeared as clearly endemic in the bowels of Asturian people.
Consecutive salmonella outbreaks traced to the same bakery
Authors: Evans M. R. , Tromans J. P. , Dexter E. L. S. , Ribeiro C. D. , Gardner D.
Published: May 2009

Two consecutive community outbreaks of Salmonella enteritidis phage type 4 (PT4) traced to the same bakery occurred in Cardiff, Wales during August–September 1992. In the first outbreak, illness was associated with eating custard slices (odds ratio 23·8, 95% confidence interval 6·5–94·4, P < 0·0001), and in the second, with eating fresh cream cakes (odds ratio 15·8, 95% confidence interval 1·6–374, P = 0·004). Environmental investigations implicated cross-contamination during preparation of the cold-custard mix as the cause of the first outbreak, and inadequate cleaning and disinfection of nozzles used for piping cream in the second outbreak. S. enteritidis PT4 was isolated from fresh cream sponge cake retained by a case and from two fresh cream cakes and four environmental swabs obtained at the bakery. This incident illustrates the hazard of widespread environmental contamination with salmonella and the need for thorough environmental cleansing of any premises implicated in an outbreak of food poisoning.
Burkholderia cepacia respiratory tract acquisition: epidemiology and molecular characterization of a large nosocomial outbreak
Authors: Pegues C. F. , Pegues D. A. , Ford D. S. , Hibberd P. L. , Carson L. A. , Raine C. M. , Hooper D. C.
Published: May 2009

In 1994 we investigated a large outbreak of Burkholderia (formerly Pseudomonas) cepacia respiratory tract acquisition. A case patient was defined as any patient with at least one sputum culture from which B. cepacia was isolated from 1 January to 31 December 1994. Seventy cases were identified. Most (40 [61 %]) occurred between 1 February and 31 March 1994; of these, 35 (86%) were mechanically ventilated patients, 30 of whom were in an intensive-care unit (ICU) when B. cepacia was first isolated. Compared with control patients who were mechanically ventilated in an ICU, these 30 case-patients were significantly more likely to have been ventilated for 2 or more days (30/30 v. 15/30; P < 0·001) or to have been intubated more than once (12/30 v. 2/30; OR = 9·3, 95% CI 1·6–68·8; P = 0·002) before the first isolation of B. cepacia. By multivariate analysis, the 35 mechanically ventilated case-patients were significantly more likely to have received a nebulized medication (OR = 11·9, 95% CI = 1·6–553·1; P < 0·001) and a cephalosporin antimicrobial (OR = 11·9, 95% CI = 1·6–553·1) in the 10 days before the first isolation of B. cepacia, compared with B. cepacia-negative control-patients matched by date and duration of most recent mechanical ventilation. Although B. cepacia was not cultured from medications or the hospital environment, all outbreak strains tested had an identical DNA restriction endonuclease digestion pattern by pulsed-field gel electrophoresis. Review of respiratory therapy procedures revealed opportunities for contamination of nebulizer reservoirs. This investigation suggests that careful adherence to standard procedures for administration of nebulized medications is essential to prevent nosocomial respiratory infections.
A Comparison of DNA and immunoblot fingerprinting of the SII biotype of coagulase negative staphylococci
Authors: Burnie J. P. , Lee Woei
Published: May 2009

Thirty-eight isolates of the SII biotype of coagulase negative staphylococci were examined by phage typing, antibiograms, DNA and immunoblot fingerprinting. Multiple isolates were available from 5 patients with clinically proven infections and from 12 further patients who were epidemiologically distinct. Only 3 of the isolates were phage typable and antibiograms produced only 9 types. All isolates were typable by both DNA and immunoblot fingerprinting and reproducibility was excellent provided the conditions were standardized. Discrimination was better with immunoblot fingerprinting (17 types) than DNA fingerprinting (11 types). Both techniques were successful in assessing the significance of multiple isolates from a single patient.
Incidence and nature of human tuberculosis due to bovine tubercle bacilli in South-East England: 1977–1987
Authors: Yates Malcolm D. , Grange John M.
Published: May 2009

A total of 201 new cases of tuberculosis due to bovine tubercle bacilli was confirmed in South–East England between 1977 and 1987 inclusive. This represents about 1% of all cases of tuberculosis in this region. Most cases occurred amongst older individuals of indigenous white British origin, although some younger patients of Southern European and Indian subcontinent ethnic origin were also diagnosed. The lung was the most frequent site of disease, followed by the genitor–urinary tract. In view of the known risk of transmission of disease from man to cattle via the respiratory and urinary tracts, continued surveillance of this relatively uncommon form of tuberculosis is still indicated.
Use of colistin and sorbitol for better isolation ofSerratia marcescensin clinical samples
Authors: Grasso G. M , D'errico M. M , Schioppa F , Romano F , Montanaro D
Published: May 2009

A comparison was made of different culture media and procedures for detection ofSerratia marcescensfrom faecal, pharyngeal and ocular swabs collected from 213 neonates. MacConkey agar and MacConkey agar with sorbitol (1%) and/or colistin (200 i.u./ml) were used both for primary isolation and after enrichment using Mossel Enterobacteriaceae broth with colistin (200 i.u./ml). The use of MacConkey agar supplemented with colistin for primary isolation improved considerably the isolation rate ofS. marcescensfrom faecal swabs but not from pharyngeal swabs; the number of ocular isolations were insufficient to demonstrate differences between procedures. Moreover the enrichment procedures consistently increased the number ofS. marcescensisolates especially from pharyngeal and ocular swabs. Use of sorbitol made detection ofS'. marcescensfrom clinical specimens easier and time– and cost–efficient.
Seroepidemiology of group B streptococcus type II antibody specificity
Authors: Gray B. M. , Pritchard D. G. , Springfield J. D. , Benak R. J. , Dillon H. C.
Published: May 2009

The specificity of human antibodies for the two major sidechain determinants of the type II group B streptococcal (GBS) polysaccharide was examined in 90 pairs of maternal and cord sera. Using an ELISA system, total antibody was measured against the complete (sialylated) type II antigen and the proportion of antibody against the galactose determinant was estimated by inhibition with free β–methylgalactopyranosided. Mothers colonized by type II or by other GBS types had higher levels of total specific antibody (means, 33 and 4–7 µg/ml, respectively) than those not colonized (mean, 2–2 µg/ml). Cord sera averaged 1–2 µg/ml lower than maternal sera. Colonization with GBS was also associated with higher levels against the galactose determinant (mean, 1.5&µg/ml, compared to 0–7µg/ml for those not colonized). The distribution of specificities favoured antibodies against the sialic acid determinant in maternal but not cord sera. Specificity as well as antibody level may play a role in the epidemiology of GBS type II.
Laboratory evaluation of disposable and reusable disinfectant cloths for cleaning food contact surfaces
Authors: Tebbutt G. M.
Published: May 2009

A comparison of five methods of cleaning Formica surfaces contaminated with bacteria dried in milk has been carried out. A standardized procedure was developed, and impression plates were found to be at least as sensitive as a swab-rinse method for detecting bacteria on the surfaces. The most satisfactory results were obtained with one type of disposable alcohol-impregnated wipe and with a detergent/hypochlorite solution applied with paper. A reusable cloth impregnated with disinfectant initially performed well against all test organisms, but was less reliable against Staphylococcus aureus and Streptococcus faecalis after the cloth had been used and rinsed several times. The importance of introducing methods to reduce the high risk of cross–contamination presently associated with the use of wiping cloths in catering premises is stressed.
Maintenance of cooling towers following two outbreaks of Legionnaires' disease in a city
Authors: Bhopal R. S. , Barr G.
Published: May 2009

This survey assessed the maintenance of evaporative cooling towers in Glasgow, following two Legionnaires' disease outbreaks. Information was obtained from 76 of 81 premises and a maintenance score was calculated for each of 174 towers. The quality of maintenance was extremely varied (range of maintenance scores, 8–30 mean, 22 (S. D., 5.0); median, 23; maximum possible, 33) and some towers were neglected. Breaches of maintenance principles were mainly structural and organizational, e.g. inadequate drift control, rather than failure to use chemicals. Low maintenance scores were associated with no log book, no guidelines, no change in procedures in last 5 years, solitary cooling towers, and towers on industrial premises. Despite intense publicity the standard of cooling tower maintenance in Glasgow remained a concern. Information campaigns directed at those responsible for cooling–tower maintenance are neccessary.
Prevalance of antibodies to 15 antigens of Legionellacae in patients with community-acquired pneumonia
Authors: McIntyre M. , Kurtz J. B. , Selkon J. B.
Published: May 2009

Sera from 252 patients with community-acquired pneumonia were examined for the presence of antibodies to 15 antigens of 7Legionellaspp. by indirect immunofluorescent antibody testing. The sera had been collected as part of the British Thoracic Society/Public Health Laboratory Service study of community-acquired pneumonia in adults. We also examined sera from 20 patients with gram-negative sepsis.
Protective efficacy of BCG vaccine against leprosy in southern Malaŵi
Authors: Baker D. M. , Nguyen-Van-Tam J. S. , Smith S. J.
Published: May 2009

This paper describes a matched case-control study to determine the efficacy of BCG vaccine in preventing the occurrence of leprosy in southern Malaŵi, a previously unstudied area. The BCG immunization rate amongst 145 individuals with leprosy was 44.8%, compared to 62.5% in 290 matched controls. The protective efficacy of BCG vaccine against leprosy in this region was estimated to be 63.6%; smallpox immunization had no effect. These findings support the view that BCG vaccine should be considered as a control measure in areas where leprosy is endemic.
Levels of anti-pneumococcal antibodies in young children in Papua New Guinea
Authors: Pomat W. S. , Smith T. A. , Sanders R. C. , Witt C. S. , Montgomery J. , Lehmann D. , Alpers M. P.
Published: May 2009

Anti-pneumococcal polysaccharide antibody (anti-PPS) levels were measured in 153 serum samples collected from children aged between 2 and 47 months living in the highlands of Papua New Guinea (PNG). Fifty-seven of the samples were collected during acute episodes of lower respiratory tract infection (ALRI). Total IgA and IgG increased steadily with age; however, no association was found between the levels of these antibodies and the health status of the child. Total IgM levels showed little relationship to the age of the child but under 12 months of age levels were somewhat higher on average in children with pneumonia. For most of eight pneumococcal serotypes tested, specific IgG levels were found to decline rapidly in the first 6–8 months, reaching a minimum at approximately 12 months of age. Serotype 3 was exceptional in having very low titres in the youngest children. A separate analysis of 24 cord sera suggested that antibodies to this serotype do not usually cross the placenta in PNG. Children with pneumonia tended to have lower levels of specific IgG than healthy controls of the same age. Specific anti-PPS IgA levels were found to increase steadily with age, but were not associated with health status.
Replicon typing characterization of plasmids encoding resistance to gentamicin and apramycin inEscherichia coliandSalmonella typhimuriumisolated from human and animal sources in Belgium
Authors: Pohl P. , Glupczynski Y. , Marin M. , Van Robaeys G. , Lintermans P. , Couturier M.
Published: May 2009

Escherichia coliand salmonella strains with plasmids conferring resistance to gentamicin and apramycin have been isolated with increasing frequency both from cattle and hospital patients in Belgium. The apramycin-gentamicin resistance plasmids were characterized in recipient strains by their profiles and molecular weights using agarose gel electrophoresis, by their antimicrobial resistance patterns and by replicon typing using a series of DNA probes specific for the genes controlling their systems of replication. Overall, most of the plasmids differed in their DNA electrophoretic patterns. Seventeen different antimicrobial resistance profiles were observed, and there were six different types of replicons. However, two replication genes predominated and had a preferential distribution in different bacterial species. The rep FIC.a plus rep Q multireplicon was found mainly in plasmids recovered from gentamicin- and apramycin-resistantE. coliwhile replicon of the type rep FIC.b largely prevailed inS. typhimurium. Identical replication genes were found in most animal and human strains, hence suggesting a high homology between apramycin- gentamicin plasmids in these communities. Finally, our results indicate that the rapid spread of apramycin-gentamicin-resistance in several species of Enterobacteriaceae isolated from animals and from humans in Belgium is not due to a single plasmid, but rather that the gene encoding AAC(3)-IV is carried by various replicons.
Virulence properties ofEscherichia colistrains belonging to serogroups O26, O55, O111 and O128 isolated in the United Kingdom in 1991 from patients with diarrhoea
Authors: Scotland S. M. , Willshaw G. A. , Smith H. R. , Said B. , Stokes N. , Rowe B.
Published: May 2009

Some strains ofEscherichia colibelonging to serogroups O26, O55, O111 or O128 produce Vero cytotoxin (VT). These serogroups are included in the range of enteropathogenicE. coli(EPEC) serogroups for which commercial antisera are available. In an attempt to obtain information on VT-producing strains other than those of serogroup O157, 122 strains belonging to these four serogroups and isolated in 1991 from patients with diarrhoea in the United Kingdom were tested for hybridization with VT probes. Only 18 of the 122 strains were VT-positive and these were O26 or O128. However 90 strains hybridized with theE. coliattaching and effacing (eae) probe (including 14 VT-positive strains) and 17 with the enteroaggregativeE. coli(EAggEC) probe. For 78eae-positive and 9 EAggEC-positive strains, tissue culture tests correlated with the probe results as the strains gave, respectively, either localized adhesion and a positive fluorescent-actin staining test or a characteristic aggregative attachment. A total of 111 of the 122 strains belonging to serogroups O26, O55, O111 or O128 possessed properties that may be associated with the ability to cause human diarrhoeal disease, and similar studies are needed on strains from the other classical EPEC serogroups.
Changing patterns among the subgroups of strains of Staphylococcus aureus of phage group II in Danish hospitals from 1961–91
Authors: Eriksen N. H. R. , Hartzen S. H. , Bangsborg J. , Andersen L. P. , Rosdahl V. T. , Espersen F.
Published: May 2009

During the period 1961–91 a total of 567 635 strains of Staphylococcus aureus from hospitalized patients in Denmark have been characterized according to their antibiotic resistance, site of isolation and phage type. Strains of phage group II (typed by the phages 3A, 3C, 55 and 71) have been analysed further. The occurrence of group II strains was relatively constant (approximately 16%) from 1961 until 1983. Since then the frequency of group II strains increased; in 1991 they accounted for 22.7% of all S. aureus strains isolated. Strains of group II can, on the basis of their phage types, be divided in four subgroups: 3A, 71, 71 + and the ‘rest of group II’. Furthermore, within these groups strains may differ from one another in respect to their sensitivity to phages.

The increased isolation of group II strains during recent years was because of an increase in strains of subgroups 71 + and the ‘rest of group II strains’. In 1991 these two subgroups accounted for 89.7% of all group II strains. Furthermore, an increasing number of group II strains, 71.4% in 1991, was typable only at RTD × 100. The increase in the number of group II strains was even throughout Denmark. All four subgroups of group II have, during the observation period, become more frequently resistant to penicillin and/or tetracycline. Strains typed at 100 × RTD of subgroup 71 + and the ‘rest of group II’ are more frequently antibiotic resistant than the rest of the group II strains.

Strains of the increasing subgroups occurred most often in abscesses.