bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection ofmecA, femA, andfemBgenes in clinical strains of staphylococci using polymerase chain reaction
Authors: Kobayashi N. , Wu H. , Kojima K. , Taniguchi K. , Urasawa S. , Uehara N. , Omizu Y. , Kishi Y. , Yagihashi A. , Kurokawa I.
Published: May 2009

MecA, a structural gene located on the chromosome ofStaphylococcus aureus, characterizes methicillin-resistantS. aureus(MRSA), andfemAandfemB(fem)genes encode proteins which influence the level of methicillin resistance ofS. aureus. In order to examine effectiveness of detectingmecAandfemgenes in identification of MRSA, the presence of these genes in 237 clinically isolated strains of staphylococci was investigated by polymerase chain reaction (PCR). An amplifiedmecADNA fragment of 533 base pairs (bp) was detected in 100% of oxacillin-resistantS. aureus, in 16·7 % of oxacillin-sensitiveS. aureus, in 81·5% ofS. epidermidis, and in 58·3% of other coagulase-negative staphylococci (CNS). While the PCR product offemA(509 bp) orfemB(651 bp) was obtained from almost all theS. aureusstrains except for five oxacillin-resistant strains (2·5%), neither of these genes were detected in CNS. Therefore, the detection offemAandfemBtogether withmecAby PCR was considered to be a more reliable indicator to identify MRSA by differentiating it frommecA-positive CNS than single detection ofmecA.
Estimated costs of postoperative wound infections
Authors: Poulsen K. B. , Bremmelgaard A. , Sørensen A. I. , Raahave D. , Petersen J. V.
Published: May 2009

A cohort of 4515 surgical patients in ten selected intervention groups was followed. Three hundred and seventeen developed postoperative wound infections, and 291 of these cases were matched 1:1 to controls by operation, sex and age. In comparison to the controls the cases stayed longer in hospital after the intervention and had more contact after discharge with the social security system.

Using data from a national sentinel reference database of the incidence of postoperative wound infections, and using national activity data, we established an empirical cost model based on the estimated marginal costs of hospital resources and social sick pay. It showed that the hospital resources spent on the ten groups, which represent half of the postoperative wound infections in Denmark, amounted to approximately 0·5% of the annual national hospital budget. This stratified model creates a better basis for selecting groups of operations which need priority in terms of preventive measures.
Parvovirus B19 outbreak on an adult ward
Authors: Seng C. , Watkins P. , Morse D. , Barrett S. P. , Zambon M. , Andrews N. , Atkins M. , Hall S. , Lau Y. K. , Cohen B. J.
Published: May 2009

In November and December 1992, an outbreak of parvovirus B19 infection occurred among patients and staff on an adult mixed surgical ward at a large hospital in London. Three patients and 15 staff members were serologically confirmed as acute cases. The attack rate among susceptible members of staff was 47%. In those infected, arthralgia (80%) and rash (67%) were the most common symptoms. Of six susceptible in-patients on the ward, three became infected. One of the in-patients who had carcinoma of the mouth was viraemic for more than 10 days with marrow suppression resulting in the postponement of chemotherapy until intravenous immunoglobulin was given and he was no longer viraemic. Control measures taken included closure of the ward to new admissions, transfer of only immune staff to the ward, and restriction of the ward nursing staff to working only on that ward. Although no specific exposure was conclusively identified as a risk factor, there was a suggestion of an increased risk of acquiring parvovirus B19 infection among those staff who did not adopt strict hand washing procedures after each physical contact with a patient (RR = 2·33; P = 0·07). Knowledge of parvovirus B19 among interviewed health care workers was poor: only 42% reported knowing about parvovirus B19 and only 38% could name a patient category at risk of a severe outcome following infection. This is the first report of a nosocomial outbreak affecting an adult ward and of possible transmission of parvovirus B19 infection from staff to in-patients. Hospital control of infection teams should include parvovirus B19 in their outbreak containment plans.
Outbreak of measles in a teenage school population: the need to immunize susceptible adolescents
Authors: Morse D. , O'shea M. , Hamilton G. , Soltanpoor N. , Leece G. , Miller E. , Brown D.
Published: May 2009

An outbreak of measles occurred in a community school and the surrounding area in Crowborough, East Sussex, UK, from December 1992 to February 1993. There were 96 suspected cases reported: 66 cases among 1673 students at one school and 30 community cases. The majority of suspected cases were in those aged 11–17 (78%), 2 cases occurred in infants < 1 year old and 8 cases in adults aged 18 years or over. Data collected on 60 (91 %) of the 66 suspect school cases showed 56 (93%) had an illness which met a case definition of measles. Eighteen had confirmatory IgM measles antibody. Two cases were hospitalized. The local percentage uptake for measles immunization for the school age years affected varied between 64 % and 84 %. A survey of parents showed that approximately 74% of the students attending the school had a history of measles immunization. The immunization rates reported by parents for children who developed measles was 21 %. (29 % based on GP records) compared with 77 % for those who remained well. Vaccine efficacy was estimated to be 92%. This outbreak, along with others recently reported in older unimmunized children in the UK, reinforces the need for catch-up immunization programmes to reach this susceptible group of adolescents.
Western blot analysis of virus-specific antibody responses for capripox and contagious pustular dermatitis viral infections in sheep
Authors: Chand P. , Kitching R. P. , Black D. N.
Published: May 2009

This paper reports the development and evaluation of serological tests for the differentiation of antibodies in animals infected with capripox and parapox viruses. Agar-gel immunodiffusion tests using sera from sheep with naturally-acquired infections and from sheep experimentally inoculated with orf or capripox viruses showed cross reactions. Virus-specific antibody responses to structural proteins of the viruses were analysed by Western-blot analysis. This analysis readily differentiated the infections as either capripox or contagious pustular dermatitis. The antibody responses to the 32 kDa and 26 kDa proteins of capripox virus provided a firm basis for differention.
Direct milk excretion ofCampylobacter jejuniin a dairy cow causing cases of human enteritis
Authors: Orr K. E. , Lightfoot N. F. , Sisson P. R. , Harkis B. A. , Tweddle J. L. , Boyd P. , Carroll A. , Jackson C. J. , Wareing D. R. A. , Freeman R.
Published: May 2009

Consumption of milk contaminated withCampylobacter jejunihas been described as a cause of human enteritis. Although faecal contamination of milk with the organism has frequently been described, direct milk excretion ofCampylobacter jejuniinto milk has rarely been linked with cases of human infection. We describe the investigations undertaken following the isolation ofCampylobacter jejunifrom samples of unpasteurized milk prior to retail. Results of epidemiological investigations including typing ofCampylobacter jejuniisolates using pyrolysis mass spectrometry, Penner and Lior serotyping, biotyping, phage typing and restriction fragment length polymorphism analysis provided convincing evidence implicating direct milk excretion ofCampylobacter jejuniby one asymptomatic dairy cow as the source of the milk contamination and the cause of local cases of human enteritis.
Distribution and virulence ofVibrio choleraebelonging to serogroups other than O1 and O139: A nationwide survey
Authors: Mukhopadhyay A. K. , Saha P. K. , Garg S. , Bhattacharya S. K. , Shimada T. , Takeda T. , Takeda Y. , Nair G. Balakrish
Published: May 2009

The distribution and virulence ofVibrio choleraeserogroups other than O1 and O139 in India before, during and after the advent of O139 serogroup was investigated. A total of 68 strains belonging to 31 different ‘O’ serogroups were identified during the study period. With the exception of O53, there was no spatial or temporal clustering of any particular non-O1 non-O139 serogroup at any given place. Two of the 68 strains examined produced cholera toxin (CT) which could only be partially absorbed with anti-CT immunoglobulin G. Tissue culture assay revealed that some of the non-O1 non-O139 strains produced factors which evoked either a cell rounding or cell elongation response depending upon the medium used. This study indicates that serogroups other than O1 and O139 should also be continuously monitored.
Incidence and spread ofHaemophilus influenzaeon an Antarctic base determined using the polymerase chain reaction
Authors: Hobson R. P. , Williams A. , Rawal K. , Pennington T. H. , Forbes K. J.
Published: May 2009

A PCR-based method of detectingHaemophilus influenzaein cultures inoculated from throat swabs was evaluated using samples from groups of laboratory staff and medical students and then applied to samples originating from the closed human community of an Antarctic research station. Suitable PCR primers to anH. influenzaegene (ompP2) were used to amplify the gene from DNA preparations made from mixed growth on chocolate agar with added vancomycin. PCR product was reamplified and subjected to restriction endonuclease digestion to allow temporal and spatial mapping of strains over an 8-month period. Eleven different strains ofH. influenzaewere detected. One particular strain was detected in a third of the base members.
Prevalence ofLeptospiraspp. in wild brown rats (Rattus norvegicus) on UK farms
Authors: Webster J. P. , Ellis W. A. , Macdonald D. W.
Published: May 2009

Wild brown rats (Rattus norvegicus) are frequently implicated in the carriage and spread ofLeptospiraspp. Wild brown rats (n= 259) were trapped from 11 UK farms and tested forLeptospiraspp. using a number of diagnostic tests. The prevalence of leptospiral infection was low, but there was variation in the results obtained with the different diagnostic tests. Estimates of prevalence ranged between 0% by silver-staining of tissues, 1% by the microscopic agglutination test, 4% by the enzyme-linked immunosorbent assay, 4% by culture, and 8% by fluorescent antibody technique. In total, 37 (14%) rats were positive by at least one of the tests, which contrasts with the frequently reported prevalences of 50–70% for wild rats in the UK. Serovarbratislavawas as prevalent asicterohaemorrhagiae, although it was present only on farms with larger rat populations.
High prevalence of antibodies toChlamydia pneumoniae; determinants of IgG and IgA seropositivity among Jerusalem residents
Authors: Paltiel O. , Kark J. D. , Leinonen M. , Saikku P.
Published: May 2009

The prevalence of antibodies toChlamydia pneumoniaewas examined in a stratified random sample of 581 Jerusalem adult residents between August 1987 and March 1989. IgG and IgA titres were measured by microimmunofluorescence, and associations with smoking and socio-demographic variables were assessed. IgG antibodies were found in 84·5% (95% confidence interval (CI): 80·4–87·9) of men and 68·7% (95% CI: 61·6–75·0) of women (P < 0·0001 for sex difference), indicating a very high rate of exposure in this population. IgA antibodies, postulated to represent persistent infection, were present in 45·1% (95% CI: 40·1–50·2) of men and 23% (95% CI: 17·4–29·7) of women (P < 0.0001 for sex difference). Factors associated with IgG seropositivity included family size, education and social class. On the other hand, age (in men) and smoking were associated with IgA seropositivity. These findings support the hypothesis that low socioeconomic status and household crowding may be predictive of exposure to or infection with this organism (IgG seropositivity), whereas they do not explain persistence of the infection putatively expressed as IgA seropositivity.
Isolation of epidemic poliovirus from sewage during the 1992–3 type 3 outbreak in the Netherlands
Authors: van der Avoort H. G. A. M. , Reimerink J. H. J. , Ras A. , Mulders M. N. , van Loon A. M.
Published: May 2009

To examine the extent of wild poliovirus circulation during the 1992–3 epidemic in the Netherlands caused by poliovirus type 3, 269 samples from sewage pipelines at 120 locations were examined for the presence of poliovirus. The epidemic virus strain was found in 23 samples, all from locations inside the risk area which contained communities that refuse vaccination for religious reasons. By sewage investigation, the wildtype virus was shown to be present in the early phase of the epidemic at two locations, one week before patients were reported from that area. The wild type 3 poliovirus was also detected retrospectively in a river water sample collected for other reasons three weeks before notification of the first poliomyelitis case, at a site a few kilometres upstream the home village of this patient. Oral poliovirus vaccine (OPV) virus was found at 28 locations inside or at the border of the risk area. Trivalent OPV was offered to unvaccinated or incompletely-vaccinated persons living in this region as part of the measures to control the epidemic.
Epidemics of serogroup ANeisseria meningitidisof subgroup III in Africa, 1989–94
Authors: Guibourdenche M. , Høiby E. A. , Riou J.-Y. , Varaine F. , Joguet C. , Caugant D. A.
Published: May 2009

A total of 125 strains ofNeisseria meningitidisrecovered in the course of outbreaks from patients with systemic disease in 11 African countries between 1989 and 1994 were analysed by serogrouping, serotyping and multilocus enzyme electrophoresis. Of the 125 patient strains 115 (92%) belonged to the clone-complex of serogroup A meningococci, designated subgroup III. Among the remaining strains, 4 were also serogroup A, but belonged to the clonal groups I and IV-1 (2 strains each), whilst 6 strains (4 serogroup C and 2 serogroup W135) represented clones of the ET-37 complex. Our results indicated that the second pandemic caused by clones of subgroup III is still spreading in Africa. Towards the West it has reached Niger, Mali, Guinea and The Gambia, and towards the South, the Central African Republic, Uganda, Rwanda, Burundi, Tanzania and Zambia.
The development and use of a vaccinia-rabies recombinant oral vaccine for the control of wildlife rabies; a link between Jenner and Pasteur
Authors: Pastoret P.-P. , Brochier B.
Published: May 2009

To improve both safety and stability of the oral vaccines used in the field to vaccinate foxes against rabies, a recombinant vaccinia virus, which expresses the immunizing G protein of rabies virus has been developed by inserting the cDNA which codes for the immunogenic glycoprotein of rabies virus into the thymidine kinase (TK) gene of the Copenhagen strain of vaccinia virus. The efficacy of this vaccine was tested by the oral route, primarily in foxes. The immunity conferred, a minimum of 12 months in cubs and 18 months in adult animals, corresponds to the duration of the protection required for vaccination of foxes in the field. Innocuity was tested in foxes, domestic animals, and in numerous European wild animal species that could compete with the red fox for the vaccine bait. No clinical signs or lesions were observed in any of the vaccinated animals during a minimum of 28 days post vaccination. Moreover, no transmission of immunizing doses of the recombinant occurred between foxes or other species tested. To study the stability of the vaccine strain, baits containing the vaccine were placed in the field. Despite considerable variations of environmental temperatures, the vaccine remained stable for at least one month. Because bait is taken within one month, it can be assumed that most animals taking the baits are effectively vaccinated. To test the field efficacy of the recombinant vaccine, large-scale campaigns of fox vaccination were set up in a 2200 km2 region of southern Belgium, were rabies was prevalent. A dramatic decrease in the incidence of rabies was noted after the campaigns. The recombinant is presently used to control wildlife rabies in the field both in several European countries and in the United States.
Virulence and genotype stability ofSalmonella entericaserovar Berta during a natural outbreak
Authors: Olsen J. E. , Skov M. N. , Brown D. J. , Christensen J. P. , Bisgaard M.
Published: May 2009

Strains ofSalmonella entericaserotype Berta, collected over a period of 6 years from a well documented natural outbreak in Denmark, have been characterized in order to assess the stability of chromosomal typing systems and virulence properties. Outbreak strains were identical inPvuII andPstI IS200profiles, all but two strains showed the sameSmaI ribotype, and all but one strain showed the sameNotI pulsed field gel electrophoretic pattern, indicating that these molecular markers remained almost constant during the outbreak. In general, strains ofS. Berta were found to be of moderate to low virulence; log VC10values were found to vary between 3·0 and 4·4 after i.p. challenge of mice, and maximum CFU in internal organs of day-old chicks varied between 2 and 4 log10units following oral challenge. The minor differences observed between strainsin vivodid not correlate with differences inin vitroinvasion into cultured MDCK cells, nor within vitrogrowth characteristics. A succession of different plasmid profile types was observed during the outbreak but a hierarchical selection of clones based on differences in virulence was unlikely to have caused the succession of types ofS. Berta during this outbreak.
Do intestinal parasites interfere with the seroepidemiologic surveillance ofSchistosoma mansoniinfection?
Authors: Alarcón De Noya B. , Colmenares C. , Losada S. , Fermin Z. , Masroua G. , Ruiz L. , Soto L. , Noya O.
Published: May 2009

In view of the known cross-reactivity of sera from patients with intestinal parasites to someSchistosoma mansoniantigens, field work was conducted in an area of Venezuela non-endemic for schistosomiasis using the routine immunoenzymatic assay (ELISA) with soluble egg antigen (SEA). False positive reactions represented 15·3% of the total population as determined by SEA–ELISA. SEA-immunoblotting of the false positive sera indicated that protein fractions of 91 and 80 kDa appear to be responsible for cross-reactivity. Sera from hookworm infected individuals produced a higher frequency and intensity of cross-reaction than other sera. SEA-fractions of 105, 54, 46, 42, 32, 25 and 15 kDa were the most specific.
Failure of vaccination to prevent outbreaks of foot-and-mouth disease
Authors: Woolhouse M. E. J. , Haydon D. T. , Pearson A. , Kitching R. P.
Published: May 2009

Outbreaks of foot-and-mouth disease persist in dairy cattle herds in Saudi Arabia despite revaccination at intervals of 4–6 months. Vaccine trials provide data on antibody responses following vaccination. Using this information we developed a mathematical model of the decay of protective antibodies with which we estimated the fraction of susceptible animals at a given time after vaccination. The model describes the data well, suggesting over 95% take with an antibody half-life of 43 days. Farm records provided data on the time course of five outbreaks. We applied a ‘SLIR’ epidemiological model to these data, fitting a single parameter representing disease transmission rate. The analysis provides estimates of the basic reproduction number,R0, which may exceed 70 in some cases. We conclude that the critical intervaccination interval which would provide herd immunity against FMDV is unrealistically short, especially for heterologous challenge. We suggest that it may not be possible to prevent foot-and-mouth disease outbreaks on these farms using currently available vaccines.
Restriction enzyme analysis of faecal adenoviruses in Newcastle upon Tyne
Authors: Willcocks M. M. , Carter M. J. , Laidler F. R. , Madeley C. R.
Published: May 2009

Adenovirus DNA was isolated directly from virus-containing stools and digested with restriction endonucleases. The resulting fragments were separated by polyacrylamide gel electrophoresis (PAGE) and visualized by silver staining. This enabled us to assign most of the viruses detected to subgenus, serotype and, sometimes, unique strains. Although less sensitive than electron microscopy, the method allowed more information about the infecting virus to be obtained and no cultivation was necessary. Comparison with culture also allowed dual infections to be recognized.

A 2-year survey of faecal adenoviruses in Newcastle upon Tyne showed that type 41 (strain 41a) was the predominant type and strain 41p was not recorded. Heterogeneity in strain 41a was also noted as found elsewhere. Adenovirus type 40 was common prior to 1985 but was absent during the last 2 years.
Lack of association ofEscherichia coliexhibiting both mannose-resistant haemagglutination and diffuse adherence to Hep-2 cells with acute diarrhoea in children
Authors: Čobeljić M. , Stojiljković I. , Budišin A. , Lepšanović Z. , Lerš N
Published: May 2009

Stool specimens from 631 children with acute diarrhoea and from 277 healthy controls were tested for the presence of non-enteropathogenic, non-enterotoxigenicEscherichia colistrains which mediated mannose-resistant haemagglutination of human erythrocytes (MRHA + ). Fifty-nine (34·9%) of 169 isolated MRHA + strains but none of 210 MRHA - strains exhibited diffuse adherence (DA+) to HEp–2 cells. DA+ strains were found in 37 (5·9%) children with diarrhoea and in 22 (7·9%) controls. MRHA + /DA + strains in comparison to MRHA + /DA - strains significantly less frequently expressed P fimbriae (10·7 vs. 73·6%), haemolysin production (12·5 vs. 63·2%), and MRHA of other species erythrocytes (21·4 vs. 84%).

These data demonstrate that E. coli which exhibit the diffuse pattern of adherence to HEp–2 cells also cause MRHA of human erythrocytes. Since these strains were found with similar frequencies in children with and without diarrhoea it seems that DA is not a marker of enteropathogenicity of E. coli.
Prevention of hepatitis B in Italy: lessons from surveillance of type-specific acute viral hepatitis
Authors: Mele A. , Stazi M. A. , Gill O. N. , Pasquini P. ,   Seieva Collaborating Group
Published: May 2009

The relative contribution of various risk factors to the incidence of acute hepatitis B in Italy was estimated using a special surveillance system (SEIEVA) for type-specific acute viral hepatitis. At present 146 health departments (USLs) which contain 21% of the Italian population participate in SEIEVA out of the total of 650. Data on 2460 hepatitis B cases and 708 hepatitis A cases were compared.

Hospitalization, surgical intervention, dental therapy, other percutaneous exposures, barber shop shaving, i.v. drug abuse and household contact with HBsAg carriers were associated with acute hepatitis B and a large number of cases were attributable to these risk factors.

Because the control programme based on vaccination will not be effective in the short term at reducing hepatitis B incidence, other additional interventions are recommended.
Cell-surface hydrophobicity ofStaphylococcus saprophyticus
Authors: Schneider P. F. , Riley T. V.
Published: May 2009

The cell-surface hydrophobicity of 100 urinary isolates ofStaphylococcus saprophyticus, cultured from symptomatic females in the general population, was assessed using a two-phase aqueous: hydrocarbon system. Relatively strong cell-surface hydrophobicity was exhibited by 79 isolates using the criteria employed, while only 2 of the remaining 21 isolates failed to demonstrate any detectable hydrophobicity. Cell-surface hydrophobicity may be a virulence factor ofS. saprophyticus. important in adherence of the organism to uroepithelia. Additionally, the data support the concept that cell-surface hydrophobicity may be a useful predictor of clinical significance of coagulase-negative staphylococci isoated from clinical sources.
The changing ecology of hospital bacteria and the selective role of cephalosporins
Authors: Mulgrave L.
Published: May 2009

More than 12800 clinical isolates from 115373 in-patient specimens obtained at the Sir Charles Gairdner Hospital, Perth, Western Australia, were identified and analysed statistically for relationships with usage of three generations of cephalosporins over the 5-year period from July 1984 to June 1989. A positive relationship between cephalosporin usage and significantly increasing isolation rates for those species capable of producing chromosomal β-lactamases was observed. Simultaneously, a small increase in the isolation frequency of non-chromosomal β-lactamase-producing strains was noted and no correlation with cephalosporin usage was demonstrated. The trend toward predomination in the hospital environment of strains possessing substantial cephalosporin resistance has implications for future antimicrobial policy, choice of empiric therapy and the predictive value of standard antimicrobial susceptibility tests.
Hepatitis A outbreak involving bread.
Authors: Warburton A. R. E , Wreghitt T. G. , Rampling A. , Buttery R. , Ward K. N. , Perry K. R , Parry J. V
Published: May 2009

An outbreak of hepatitis A involved more than 50 residents of a group of villages in the late spring and summer of 1989. The only food that was common to all the laboratory-confirmed cases was bread, purchased either unwrapped or as rolls, sandwiches or filled rolls, and supplied either directly from one shop or indirectly through its subsidiary outlets. It was concluded that this bread was the most likely vehicle of transmission of the hepatitis A virus and that the bread was contaminated by soiled hands which were inadequately washed because of painful skin lesions. Comprehensive control measures were successful in limiting further spread of the infection. This outbreak highlights the transmissibility of hepatitis A virus on food. The use of disposable gloves when handling food which is to be consumed without further cooking would prevent transmission of this or other infectious agents by this route.
The clinical spectrum of human hantavirus infection in Somerset, UK
Authors: Pether J. V. S. , Lloyd G.
Published: May 2009

The signs and symptoms exhibited by 29 patients with an acute illness in whom antibodies to hantavirus were detected are described. In the severe cases the most striking signs and symptoms were the persistence for 2 or 3 weeks of a severe sore throat with pyrexia that developed early in the illness, followed by swelling of the face, neck and extremities, with arthropathy and prolonged malaise that lasted for months. A macular erythematous rash, hepatomegaly with abnormal liver function tests, and a tendency to haemorrhage was a later feature of the severe cases. Mild cases presented with a variety of signs and symptoms that were very difficult to link together as a syndrome.
The influence of local antichlamydial antibody on the acquisition and persistence of human ocular chlamydial infection: IgG antibodies are not protective
Authors: Bailey R. L. , Kajbaf M. , Whittle H. C. , Ward M. E. , Mabey D. C. W.
Published: May 2009

In order to study the effect of antichlamydial antibodies in ocular secretions on resistance to ocular chlamydial infection and clearance of this infection, we have performed linked longitudinal studies in a Gambian village in which trachoma is endemic. We have measured IgG and IgA antibody levels to a local serotype B isolate ofChlamydia trachomatisby amplified enzyme immunoassay, and chlamydial antigen levels in conjunctival swabs using a commercially available immunoassay which detects chlamydial glycolipid. Having previously demonstrated that sharing a bedroom with a case of active trachoma is a risk factor for acquisition of the disease, we have analysed the effect of IgG and IgA antibody on the acquisition and persistance of clinical trachoma after controlling for age, sex, exposure to infection and for the presence of chlamydial antigen using a Poisson regression model. We have found that the presence of antichlamydial IgG in ocular secretions of disease-free subjects is associated with an increased incidence of trachoma. IgA antibody shows an opposite trend, but this is not statistically significant. One possible explanation of these findings is that antichlamydial IgG antibodies enhance the infectivity ofC. trachomatisfor the human eye; this could have major implications for the development of a chlamydial vaccine.
Weather factors in the prediction of western equine encephalitis epidemics in Manitoba
Authors: Sellers R. F. , Maarouf A. R.
Published: May 2009

Cases of western equine encephalitis in horses in 1987 in western USA and Manitoba, Canada were examined by backward trajectory analysis of winds.Culex tarsalismosquitoes infected with western equine encephalitis virus could have been carried on southerly winds from Texas and Oklahoma to northern LTSA and from there to Manitoba. The presence of the Polar front over North Dakota and Minnesota at the end of July would have led to the landing ofCx. tarsalisin Montana and Wisconsin and prevented further carriage into Manitoba. Temperatures in southern Texas during the winter months (average daily maximum temperatures 19.7 °C and higher) would have permitted continuous transmission of western equine encephalitis virus byCx. tarsalisin this area.

Weather factors involved in outbreaks from 1975–88 were analysed to see if epidemics in Manitoba (23 or more cases in horses) could be predicted. The conditions for epidemics could be defined as follows: (a) the number of cases in horses in LTSA was 98 or more, (b) winds were southerly with speeds 45 kmh-1 or higher, and (c) counts ofCx. tarsalisfemales/light trap per day were 3·2 or higher. There were 3 or fewer cases in Manitoba, when the number of cases in USA was 27 or less, even when Cx. tarsalis counts were higher than 3·2. WithCx. tarsaliscounts below 3 and/or unsuitable winds, or the Polar front further south, the number of cases in Manitoba was between 0 and 17, even when the number of cases in USA was from 38–172. Without information on the extent of infection further south, the weather variables would probably be more useful in excluding the possibility of an epidemic in Manitoba than in predicting one.
Genetic diversity and clonal relationships ofAcinetobacter baumanniistrains isolated in a neonatal ward: epidemiological investigations by allozyme, whole-cell protein and antibiotic resistance analysis
Authors: Thurm V. , Ritter E.
Published: May 2009

Sixty-five strains ofAcinetobacter baumanniiwhich had been isolated from patients and the indoor environment of a neonatal intensive care unit and, for comparative purposes, isolates from three other wards, were examined by means of electrotyping and analysis of whole-cell protein and antibiotic resistance patterns. Fourteen different electrotypes were determined. The predominant type, a multiply resistant acinetobacter clone, persisted in the neonatal ward over several months. The results underline the usefulness of electrophoretic subtyping, in particular by means of allozyme pattern and as a supplement to whole-cell protein pattern analysis, in epidemiological investigations into the routes of transmission of nosocomialA. baumanniiinfections.
Ribotyping ofStaphylococcus aureus: an assessment using well–defined strains
Authors: Richardson J. F. , Aparicio P. , Marples R. R. , Cookson B. D.
Published: May 2009

Ribotyping, with homologous or heterologous (Escherichia coli) r–RNA, of the propagating strains for phages of the international set for strains ofStaphylococcus aureusof human origin was undertaken to determine the discrimination of this typing method. Ribotyping could distinguish between strains of different phage groups, but could not distinguish between seven phage group III strains of different phage type. Ribotyping may be a useful adjunct to phage typing inS. aureusbut is unlikely to replace it as the primary method of epidemiological typing.
Aminoglycoside resistance patterns ofSerratia marcescensstrains of clinical origin
Authors: Coria-Jiménez R. , Ortiz-Torres C.
Published: May 2009

Aminoglycoside resistance patterns of 147Serratia marcescensstrains of clinical origin were studied. All strains analysed belonged to three different bacterial populations. The periods of study and the institutions the strains were isolated from correlated significantly with the resistance patterns shown by the strains. The most frequent resistance patterns found were the following: ACC (6')-I at the Hospital Infantil de México (Children's Hospital of México), and ANT (2″) +AAC(6′)-I at the Instituto Nacional de Pediatría (INPed or National Institute of Pediatrics) in Mexico City. Furthermore, the isolation frequency of aminoglycoside-sensitive strains decreased remarkably at the INPed over a 12-year period. These results suggest that there has been a selection ofSerratia marcescensstrains that are very resistant to aminoglycosides.
Sources of sporadicYersinia enterocoliticainfections in Norway: a prospective case–control study
Authors: Ostroff S. M. , Kapperud G. , Hutwagner L. C. , Nesbakken T. , Bean N. H. , Lassen J. , Tauxe R. V.
Published: May 2009

Yersinia enterocoliticais a recognized cause of gastroenteritis in northern Europe. During October 1988-January 1990, a prospective case-control study was performed to address risk factors associated with sporadic.Y. enterocoliticainfections in southeastern Norway. Sixty-seven case-patients (mean age 23.4 years, range 8 months-88 years) and 132, age-, sex- and geographically-matched controls were enrolled in the study. Multivariate analysis of the data showed that persons withY. enterocoliticainfection reported having eaten significantly more pork items(3.79v. 2.30 meals,P= 0.02) and sausage (2.84v. 2.20 meals,P= 0.03) in the 2 weeks before illness onset than their matched controls; only one patient had eaten raw pork. Patients were also more likely than controls to report a preference for eating meat prepared raw or rare (47v. 27%,P= 0.01), and to report drinking untreated water (39v. 25%,P= 0.01) in the 2 weeks before illness onset. Each of these factors was independently associated with disease, suggesting a link between yersiniosis and consumption of undercooked pork and sausage products and untreated water. Efforts should be directed towards developing techniques to reduceY. enterocoliticacontamination of pork and educating consumers about (1) proper handling and preparation of pork items and (2) the hazards of drinking untreated water.
An additional set of phages to characterize epidemic methicillin–resistant Staphylococcus aureus strains from Spain (1989–92)
Authors: Vindel A. , Trincado P. , Gomez E. , Aparicio P. , de Nicolas M. Martin , Boquete T. , Nieto JA. Saez
Published: May 2009

In recent years, methicillin–resistant Staphylococcus aureus (MRSA) isolates in Spain have increased dramatically; in 1986 there were only 1.2% MRSA amongst all nosocomial Staphylococcus aureus (SA) isolates, by 1989 this percentage had risen to 44% in some hospital causing a very serious epidemic situation in the country. We have characterized these isolates by direct, reverse and Fisk phage typing and we have also looked for an additional local set of phages to help us to differentiate these strains. We have been able to differentiate an epidemic strain from other MRSA strains which cause sporadic hospital outbreaks, and we have also distinguished between some variants of the epidemic strain.
Smoking, the environment and meningococcal disease: a case control study
Authors: Stanwell R. E. , Stuart J. M. , Hughes A. O. , Robinson P. , Griffin M. B. , Cartwright K.
Published: May 2009

This case control study investigated environmental factors in 74 confirmed cases of meningococcal disease (MD). In children aged under 5, passive smoking in the home (30 or more cigarettes daily) was associated with an odds ratio (OR) of 7.5 (95% confidence interval (CI) 1.46–38.66). ORs increased both with the numbers of cigarettes smoked and with the number of smokers in the household, suggesting a dose–response relationship. MD in this age group was also significantly associated with household overcrowding (more than 1.5 persons per room) (OR 6.0, 95% CI 1.10–32.8), with kisses on the mouth with 4 or more contacts in the previous 2 weeks (OR 2.46, 95% CI 1.09–5.56), with exposure to dust from plaster, brick or stone in the previous 2 weeks (OR 2.24, 95% CI 1.07–4.65); and with changes in residence (OR 3.0, 95% CI 1.0–8.99), marital arguments (OR 3.0, 95 % CI 1.26–7.17) and legal disputes in the previous 6 months (OR 3.10, 95% CI 1.24–7.78). These associations were independent of social class. Public health measures to lower the prevalence of cigarette smoking by parents of young children may reduce the incidence of MD. The influence of building dust and stressful life events merits further investigation.
Host–microflora interaction in Systemic Lupus Erythematosus (SLE): colonization resistance of the indigenous bacteria of the intestinal tract
Authors: Apperloo-Renkema H. Z. , Bootsma H. , Mulder B. I. , Kallenberg C. G. , Van Der Waaij D.
Published: May 2009

Experimental data suggest a role for the microflora in Systemic Lupus Erythematosus (SLE). Anti–ds–DNA antibodies may be pathogenic in SLE by forming immune complexes with DNA. Foreign bacteria in the intestines could constitute the stimulus for anti–ds–DNA antibody production in SLE. Colonization Resistance (CR) is the defence capacity of the indigenous microflora against colonization of the intestines by foreign bacteria. A low CR implies increase of translocation of bacteria and a higher chance of subsequent, possibly DNA–cross–reacting antibacterial antibody production.

We measured CR by a comprehensive biotyping technique in healthy individuals and patients with inactive and active SLE. CR tended to be lower in active SLE patients than in healthy individuals (P= 0.09, Wilcoxon one sided, with correction for ties). This could indicate that in SLE more and different bacteria translocate across the gut wall due to a lower CR. Some of these may serve as polyconal B cell activators or as antigens cross-reacting with DNA.
Potable water and nosocomial Legionnaires' disease – check water from all rooms in which patient has stayed
Authors: Marrie T. J. , Johnson W. , Tyler S. , Bezanson G. , Haldane D. , Burbridge S. , Joly J.
Published: May 2009

We studied 7 patients with nosocomial Legionnaires' disease to determine the relationship between isolates ofLegionella pneumophilarecovered from potable water and those recovered from patients. Potable water was cultured from all rooms in which patients had stayed prior to the diagnosis of Legionnaires' disease. The 38 isolates ofL. pneumophila(31 environmental, 7 patient) were resolved into 9 distinct patterns by pulse-field gel electrophoresis (PFGE), 3 by plasmid content and 2 each with monoclonal antibodies and conventional agarose gel electrophoresis of small fragments of DNA.

Using PFGE it was determined that 4 of the 7 patients were infected withL. pneumophilaidentical to an isolate recovered from the potable water supply in one of the rooms each had occupied prior to the diagnosis of Legionnaires' disease. Patients had resided in a mean of 3·57 rooms before a diagnosis of nosocomial Legionnaires' disease. We conclude that in the setting of contaminated potable water and nosocomial Legionnaires' disease water from all the rooms which the patient has occupied prior to this diagnosis should be cultured. PFGE of large DNA fragments discriminated best among the isolates ofL. pneumophila.
Distribution ofAeromonasphenospecies and genospecies among strains isolated from water, foods or from human clinical samples
Authors: Hänninen M. L. , Siitonen A.
Published: May 2009

A total of 332Aeromonasspp. originating from drinking water (n= 75), fresh water (n= 57), chicken and ground beef (107), human faecal samples in association with travelling (n= 49), human faecal samples not associated with travelling (n= 38), and six strains from human blood cultures were studied by phenotypic methods and by using analysis of ribopatterns as a molecular method for the identification of the 13 known hybridization groups (HGs). Also included were the reference strains of each HG.A. hydrophilaHG 1,A. caviaeHG 4 andA. veroniibiotypesobriaHG 8/10 were the most important genospecies identified in human faecal samples.A. hydrophilaHG 2 andA. mediaHG 5B predominated in drinking water andA. hydrophilaHG 2 and HGS,A. mediaHG 5A and HG 5B predominated in fresh water. In drinking water only one isolate wasA. hydrophilaHG 1 and two isolates wereA. caviaeHG 4. Clinically importantAeromonasspp. HG 1 (A. hydrophila), HG 4 (A. caviae) and HG 8/10 (A. veroniibiotypesobria) were common in chicken and ground beef. In contrast to the drinking water samples, HG 5A was common in chicken and ground beef samples. Atypical, unidentified isolates were most often found in fresh water samples (12/57 strains). Although water has been suspected of being an important source of humanaeromonasinfections, clinically important HGs were found to be in the minority amongAeromonasspp. identified in drinking water or fresh water. The distribution ofAeromonasspp. HGs among drinking water, chicken and ground beef samples was also different, suggesting that contamination of meat or chicken may not originate from water.
Clonal structure of invasiveStreptococcus pyogenesin Northern Scotland
Authors: Upton M. , Carter P. E. , Morgana M. , Edwards G. F. , Pennington T. H.
Published: May 2009

We have used molecular techniques to characterize 51 group A streptococci from Scotland and 17 ‘serious disease’ isolates from other countries, in order to establish the clonal structure of invasiveStreptococcus pyogenesstrains circulating between 1986 and 1993. Strains were grouped by restriction endonuclease analysis, pulsed field gel electrophoresis and ribotyping patterns, and were examined for the presence of alleles of thespeAgene by polymerase chain reaction and DNA sequence analysis. Serious and fatal infections in Scotland were caused by several clones. One clone (9 of 51 strains) was M type 1 and possessed thespeAgene allele 2. This was the clone previously identified as causing severe infection in the USA. Another clone (5 of 51 strains) was M type 3 and hadspeAgene allele 3. In view of the clear association of more than one clone with severe, invasive and fatal infections, horizontal gene exchange between genotypes merits further investigation.
Prevalence and genetic location of non-transferable trimethoprim resistant dihydrofolate reductase genes in South African commensal faecal isolates
Authors: Adrian P. V. , Thomson C. J. , Klugman K. P. , Amyes S. G. B.
Published: May 2009

In a recent survey of trimethoprim resistance. 357 Gram-negative aerobic organisms were isolated from healthy volunteers from rural and urban populations in South Africa. Trimethoprim resistance did not transfer to anEscherichia coliJ62–2 recipient strain by conjugation in a liquid mating in 161 (45·1%) of the isolates. These isolates which did not transfer their resistance were probed with intragenic oligonucleotide probes for the types Ia. Ib. IIIa. V. VI. VII. VIII. IX. X and XII dihydrofolate reductase genes. Contrary to all previous data, the most prevalent dihydrofolate reductase gene in this group of non-transferable isolates which hybridized, was the type VII (38%) followed by the type Ia (25%). Ib (12%). V (1·7%) and VIII (1·2%). None of the strains hybridized to the types IIIa. VI. XI. X and the XII dihydrofolate reductase probes. Southern blots of plasmid and chromosomal DNA from selective isolates revealed that the type VII dihydrofolate reductase genes were located on the chromosome and were associated with the integrase gene of Tn21. However, the type Ib and V dihydrofolate reductase genes were all found on plasmids which could not be mobilized. The type Ia dihydrofolate reductase genes were found on both non-transferable plasmids and on the chromosome. The nature of the genetic structures associated with a dihydrofolate reductase gene strongly affects the means of spread of the gene in a population.
The transmission of Jembrana disease, a lentivirus disease ofBos javanicuscattle
Authors: Soeharsono S. , Wilcox G. E. , Putra A. A. , Hartaningsih N. , Sulistyana K. , Tenaya M.
Published: May 2009

Methods of transmission of Jembrana disease, an acute and severe disease of Bali cattle (Bos javanicus) caused by a recently-identified bovine lentivirus known as Jembrana disease virus, are described. During the acute disease virus can be detected in saliva and milk. There is evidence of direct transmission from acutely affected animals in close contact with susceptible cattle, possibly by virus in these secretions infecting cattle by the conjunctiva!, intranasal or oral routes, by which it was possible to infect cattle experimentally. During the acute disease the titre of infectious virus in blood is high, about 10850% cattle infectious units (ID50)/ml, and it is probable that the virus is also transmitted mechanically by haematophagous arthropods. Recovered cattle are also a potential but probably infrequent source of infection; recovered cattle are persistently viraemic but the titre of infectious virus in blood decreases to about 101ID50/ml by 60 days after recovery from the acute disease, and virus cannot be detected in secretions.
A cluster of cases of streptococcal necrotizing fasciitis in Gloucestershire
Authors: Cartwright K. , Logan M. , McNulty C. , Harrison S. , George R. , Efstratiou A. , McEvoy M. , Begg N.
Published: May 2009

We describe the first cluster of cases of necrotizing fasciitis (NF) in this century in the United Kingdom (UK). Between 1 January and 30 June 1994 there were six cases (five confirmed, one probable) ofStreptococcus pyogenesNF in west Gloucestershire, population 320000. Two cases died. The first two patients probably acquired their infections during the course of elective surgery performed in the same operating theatre, possibly from a nasopharyngeal carrier amongst the theatre staff. The remaining infections were community-acquired. Of 5S. pyogenesisolates there were 2 M1 strains, 1 M3, 1 M5 and 1 M non-typeable strain.S. pyogenesNF had not been recorded in west Gloucestershire in the preceding 10 years and the incidence ofS. pyogenesbacteraemia in England and Wales had not risen in the past 5 years.

The two presumably theatre-acquired infections raised several issues. The need for detailed bacteriological investigation of all cases of post-surgical NF was confirmed. Clusters ofS. pyogenesinfection following surgery should be managed by closure of the operating theatre until all staff have been screened for carriage. Closure of an operating theatre and screening of staff following a sporadic case is probably not justified because of the infrequency of surgical cross-infection withS. pyogenes. Regular, routine screening of theatre staff is neither practical nor necessary.