bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expenditure on healthcare in the UK: A review of the issues
Authors: Propper Carol 
Published: December 2007

AbstractThis review examines the performance of the UK healthcare system. After presenting data on the level and distribution of resources, three topics are examined. The first is the lessons from international comparisons of evidence on expenditure, equity and healthcare outcomes. The second is the lessons from the recent internal market reforms. The third is the lessons from an analysis of the role for private finance in UK healthcare. The review concludes that economists and policymakers need to focus more attention on the relationship between healthcare inputs — expenditure — and health outcomes, and, within this, on the incentives facing suppliers and demanders of healthcare.
The development of competition in the English and Welsh water and sewerage industry
Authors: Sawkins John W. 
Published: December 2007

AbstractThis paper examines the introduction of competition into the English and Welsh water and sewerage industry following privatisation of the 10 regional water authorities in 1989. It outlines the development of comparative, capital and product market competition, arguing that the greatest opportunities now lie with the last through the introduction of common carriage agreements, the extension of Inset appointments and the introduction of transferable abstraction licences. Despite competitive innovations, the industry remains highly regulated, complex and difficult to enter. One of Ofwat's outstanding challenges for the next decade is to examine the means by which the regulatory burden might be lightened and barriers to entry lowered, to encourage potential entrants to compete with incumbents.
Risk Factors for Trimethoprim-Sulfamethoxazole Resistance in Patients with Acute Uncomplicated Cystitis
Authors: Colgan Richard , Johnson James R. , Kuskowski Michael , Gupta Kalpana 
Published: December 2007

ABSTRACT

Emerging antimicrobial resistance among uropathogens makes the management of acute uncomplicated cystitis increasingly challenging. Few prospective data are available on the risk factors for resistance to trimethoprim-sulfamethoxazole (TMP-SMX), the drug of choice in most settings. In order to evaluate this, we prospectively enrolled women 18 to 50 years of age presenting to an urban primary care practice with symptoms of cystitis. Potentially eligible women provided a urine sample for culture and completed a questionnaire regarding putative risk factors for TMP-SMX resistance.
Escherichia coli
isolates were tested for clonal group A (CGA) membership by a
fumC
-specific PCR. Of 165 women with cystitis symptoms, 103 had a positive urine culture and were eligible for participation.
E. coli
was the predominant uropathogen (86%). Fifteen (14.6%) women had a TMP-SMX-resistant (TMP-SMX
r
) organism (all of which were
E. coli
). Compared with the women who had a TMP-SMX-susceptible organism, women in the TMP-SMX
r
group were more likely to have traveled (odds ratio [OR], 15.4; 95% confidence interval [CI], 4.4 to 54.3;
P
< 0.001) and to be Asian (OR, 6.1; 95% CI, 1.0 to 36.4;
P
= 0.048). CGA was also independently associated with TMP-SMX resistance (OR, 105; 95% CI, 6.3 to 1,777.6;
P
= 0.001). No association with TMP-SMX resistance was demonstrated for the use of either TMP-SMX or another antibiotic in the past 3 months or with having a child in day care. Among these women with acute uncomplicated cystitis, Asian race and recent travel were independently associated with TMP-SMX resistance. TMP-SMX
r
isolates were more likely to belong to CGA. Knowledge of these risk factors for TMP-SMX resistance could facilitate the accurate selection of empirical therapy.
Molecular and Phenotypic Data Supporting Distinct Species Statuses for
Scedosporium apiospermum
and
Pseudallescheria boydii
and the Proposed New Species
Scedosporium dehoogii
Authors: Gilgado Fèlix , Cano Josep , Gené Josepa , Sutton Deanna A. , Guarro Josep 
Published: December 2007

ABSTRACT

Based on the morphological, physiologic, and molecular (β-tubulin gene) study of 141 isolates of the
Pseudallescheria boydii
species complex (including several synonyms) and relatives, the new species
Scedosporium dehoogii
is proposed.
Scedosporium apiospermum
and
P. boydii
are considered two different species and the new name
Scedosporium boydii
is proposed for the anamorph of the latter species. A summary of the key morphological and physiological features for distinguishing the species of
Pseudallescheria/Scedosporium
is provided.
Comprehensive Study of
Corynebacterium freneyi
Strains and Extended and Emended Description of
Corynebacterium freneyi
Renaud, Aubel, Riegel, Meugnier, and Bollet 2001
Authors: Funke Guido , Frodl Reinhard 
Published: December 2007

ABSTRACT

In 2001,
Corynebacterium freneyi
was described as a new fermentative, α-glucosidase-positive
Corynebacterium
species related to
C. xerosis
based on data from three strains. During a review of our extensive culture collection we encountered 18 additional
C. freneyi
strains and further characterized them in detail. Thirteen of the 18 strains were isolated from female genital tract specimens without any obvious disease association. Phenotypically,
C. freneyi
can be easily differentiated from
C. xerosis
by its distinct wrinkled colonies whereas nearly all other routinely applied phenotypic tests do not allow a unanimous separation of
C. freneyi
from
C. xerosis
. Restriction length polymorphism analysis using CfoI of the 16S-23S rRNA gene intragenic spacer definitively allows differentiation between the two species. Surprisingly, comparative 16S rRNA gene analysis does not discriminate between
C. freneyi
and
C. xerosis
because the designated type strain of
C. freneyi
is not the most representative strain for this species. The present report also includes detailed data on the antimicrobial susceptibility pattern of
C. freneyi
presented here for the first time. Based on the large number of additional
C. freneyi
strains from our culture collection, we provide an extended and emended species description of
C. freneyi
.
Pulsed-Field Gel Electrophoresis ofStaphylococcus aureusIsolates from Atopic Patients Revealing Presence of Similar Strains in Isolates from Children and Their Parents
Authors: Bonness Sonja , Szekat Christiane , Novak Natalija , Bierbaum Gabriele 
Published: December 2007

ABSTRACTSkin colonization withStaphylococcus aureusis often associated with atopic dermatitis, and staphylococcal enterotoxins have been implicated in the etiology of atopic disease. In this study, the colonization of patients with atopic dermatitis and their parents was investigated in order to evaluate the possibility of intrafamiliar transmission.S. aureusstrains were isolated from 30 of 45 patients (66%). In 19 of 29 families (65%), at least one parent carriedS. aureus, and the overall colonization rate of the parents was 48%. All strains were typed by pulsed-field gel electrophoresis (PFGE), and the presence of enterotoxin genes in the strains was assayed by multiplex PCR. A high percentage (84%) of the isolates present on the children and on at least one of their parents displayed identical PFGE and enterotoxin patterns as well as identical antibiotic resistance profiles, indicating intrafamiliar transmission. Forty-five percent of the strains did not carry any enterotoxin gene. The most frequently found enterotoxin genes weresegandsei, which were present in 36% of the strains, andseb, which was found in 24% of the strains. The other toxin genes occurred only in low frequencies. Most strains were resistant to penicillin (82%), and 15% showed resistance to more than one antibiotic. Intermediately-vancomycin-resistantS. aureusor methicillin-resistantS. aureusstrains were not detected. In conclusion, this study indicates that the colonization rate of parents of atopic children is rather high and may increase the risk of recolonization of the child.
High-Level Fluoroquinolone Resistance in Ophthalmic Clinical Isolates Belonging to the Species
Corynebacterium macginleyi
Authors: Eguchi Hiroshi , Kuwahara Tomomi , Miyamoto Tatsuro , Nakayama-Imaohji Haruyuki , Ichimura Minoru , Hayashi Tetsuya , Shiota Hiroshi 
Published: December 2007

ABSTRACT

The clinical importance of nondiphtherial
Corynebacterium
, a ubiquitous member of the normal human microflora of the skin and mucous membrane, for ocular surface infections has been recognized recently. We performed an antimicrobial susceptibility test with Etest strips for three fluoroquinolones (ciprofloxacin, norfloxacin, and levofloxacin) and a taxonomic analysis on 21 isolates of
Corynebacterium
from ophthalmic samples. Of these, 16 isolates were identified as
C. macginleyi
at the species level on the basis of 16S rRNA gene sequence comparisons. The remaining five isolates were determined to be
C. mastitidis
(four) or
C. accolens
(one). Eleven of the
C. macginleyi
isolates showed high levels of resistance to all of the fluoroquinolones tested, and one isolate was resistant to norfloxacin alone. An analysis of the amplified quinolone-resistance-determining regions of the
gyrA
genes revealed that a single amino acid substitution in position 83 of the
gyrA
product was sufficient to generate the norfloxacin resistance phenotype, and double mutations leading to amino acid changes in positions 83 and 87 were necessary for high-level resistance against the other fluoroquinolones. We conducted the first example of multilocus sequence typing (MLST) analysis on
C. macginleyi
. The MLST analysis grouped the majority of
C. macginleyi
isolates into a single lineage, and another molecular strain typing by random amplified polymorphic DNA fragment patterns supported the finding, indicating that a particular lineage of
C. macginleyi
is dominant on the human ocular surface. This type of population might be particularly adaptable to the milieu on the human ocular surface.
Evaluation of Quantitative Analysis of Cultures from Sonicated Retrieved Orthopedic Implants in Diagnosis of Orthopedic Infection
Authors: Esteban Jaime , Gomez-Barrena Enrique , Cordero Jose , Martín-de-Hijas Nieves Zamora , Kinnari Teemu J. , Fernandez-Roblas Ricardo 
Published: December 2007

ABSTRACT
To improve the microbiological diagnosis of device-related osteoarticular infections, we have developed a protocol based on the sonication of device samples, followed by concentration and inoculation of the sonicate in a broad variety of media in a quantitative manner. Sixty-six samples from 31 patients were included in the study (17 of them with clinical diagnosis of infection). The sonication procedure had a sensitivity of 94.1%, which is better than that of conventional cultures (88.2%). One case of contamination and six cases of unexpected positive cultures were detected (specificity of 42.8%): two of these were considered to represent true infection, while the other four were considered to be nonsignificant (corrected specificity of 50%), although the clinical importance of these isolates is questionable. When we analyzed the number of CFU, no breakpoint between significant and nonsignificant isolates could be established. Based on our results, the procedure of sonication of retrieved implants is better than conventional cultures for the diagnosis of device-related infections. The significance of some isolates in patients without clinical infection remains uncertain. However, they may become pathogens and cannot be routinely considered to be contamination.
Genotypic Characteristics of
Staphylococcus aureus
Isolates from a Multinational Trial of Complicated Skin and Skin Structure Infections
Authors: Campbell Steven J. , Deshmukh Hitesh S. , Nelson Charlotte L. , Bae In-Gyu , Stryjewski Martin E. , Federspiel Jerome J. , Tonthat Giang T. , Rude Thomas H. , Barriere Steven L. , Corey Ralph , Fowler Vance G. 
Published: December 2007

ABSTRACT

The impact of bacterial genetic characteristics on the outcome of patients with
Staphylococcus aureus
infections is uncertain. This investigation evaluated potential associations between bacterial genotype and clinical outcome using isolates collected as part of an international phase 2 clinical trial (FAST II) evaluating telavancin for the treatment of complicated skin and skin structure infections (cSSSI). Ninety
S. aureus
isolates from microbiologically evaluable patients with cSSSI enrolled in the FAST II trial from 11 sites in the United States (56 isolates, or 62%) and 7 sites in South Africa (34 isolates, or 38%) were examined for staphylococcal cassette chromosome
mec
,
agr
, and the presence of 31 virulence genes and subjected to pulsed-field gel electrophoresis (PFGE). South African methicillin-susceptible
S. aureus
(MSSA) isolates were more likely to carry certain virulence genes, including
sdrD
(
P
= 0.01),
sea
(
P
< 0.01), and
pvl
(
P
= 0.01). All 44 (49%) methicillin-resistant
S. aureus
(MRSA) isolates were from the United States; 37 (84%) were strain USA 300 by PFGE. In the United States, MRSA isolates were more likely than MSSA isolates to carry genes for
sdrC
(
P
= 0.03),
map/eap
(
P
= 0.05),
fnbB
(
P
= 0.11),
tst
(
P
= 0.02),
sea
(
P
= 0.04),
sed
(
P
= 0.04),
seg
(
P
= 0.11),
sej
(
P
= 0.11),
agr
(
P
= 0.09),
V8
(
P
= 0.06),
sdrD
,
sdrE
,
eta
,
etb
, and
see
(
P
< 0.01 for all). MRSA isolates were more often clonal than MSSA isolates by PFGE. Isolates from patients who were cured were significantly more likely to contain the
pvl
gene than isolates from patients that failed or had indeterminate outcomes (79/84 [94%] versus 3/6 [50%];
P
= 0.01).
S. aureus
strains from different geographic regions have different distributions of virulence genes.
Identification of
Brachyspira hyodysenteriae
and Other Pathogenic
Brachyspira
Species in Chickens from Laying Flocks with Diarrhea or Reduced Production or Both
Authors: Feberwee Anneke , Hampson David J. , Phillips Nyree D. , La Tom , van der Heijden Harold M. J. F. , Wellenberg Gerard J. , Dwars R. Marius , Landman Wil J. M. 
Published: December 2007

ABSTRACT

Cecal samples from laying chickens from 25 farms with a history of decreased egg production, diarrhea, and/or increased feed conversion ratios were examined for anaerobic intestinal spirochetes of the genus
Brachyspira
. Seventy-three samples positive in an immunofluorescence assay for
Brachyspira
species were further examined using selective anaerobic culture, followed by phenotypic analysis, species-specific PCRs (for
Brachyspira hyodysenteriae
,
B. intermedia
, and
B. pilosicoli
), and a
Brachyspira
genus-specific PCR with sequencing of the partial 16S rRNA gene products.
Brachyspira
cultures were obtained from all samples. Less than half of the isolates could be identified to the species level on the basis of their biochemical phenotypes, while all but four isolates (5.2%) were speciated by using PCR and sequencing of DNA extracted from the bacteria. Different
Brachyspira
spp. were found within a single flock and also in cultures from single chickens, emphasizing the need to obtain multiple samples when investigating outbreaks of avian intestinal spirochetosis. The most commonly detected spirochetes were the pathogenic species
B. intermedia
and
B. pilosicoli
. The presumed nonpathogenic species
B. innocens
,
B. murdochii
, and the proposed “
B. pulli
” also were identified. Pathogenic
B. alvinipulli
was present in two flocks, and this is the first confirmed report of
B. alvinipulli
in chickens outside the United States.
Brachyspira hyodysenteriae
, the agent of swine dysentery, also was identified in samples from three flocks. This is the first confirmed report of natural infection of chickens with
B. hyodysenteriae
. Experimental infection studies are required to assess the pathogenic potential of these
B. hyodysenteriae
isolates.
Candida krusei
, a Multidrug-Resistant Opportunistic Fungal Pathogen: Geographic and Temporal Trends from the ARTEMIS DISK Antifungal Surveillance Program, 2001 to 2005
Authors: Pfaller M. A. , Diekema D. J. , Gibbs D. L. , Newell V. A. , Nagy E. , Dobiasova S. , Rinaldi M. , Barton R. , Veselov A. ,   the Global Antifungal Surveillance Group
Published: December 2007

ABSTRACT

Candida krusei
is well known as a fungal pathogen for patients with hematologic malignancies and for transplant recipients. Using the ARTEMIS Antifungal Surveillance Program database, we describe geographic and temporal trends in the isolation of
C. krusei
from clinical specimens and the in vitro susceptibilities of 3,448 isolates to voriconazole as determined by CLSI (formerly NCCLS) disk diffusion testing. In addition, we report the in vitro susceptibilities of bloodstream infection isolates of
C. krusei
to amphotericin B (304 isolates), flucytosine (254 isolates), anidulafungin (121 isolates), caspofungin (300 isolates), and micafungin (102 isolates) as determined by CLSI broth microdilution methods. Geographic differences in isolation were apparent; the highest frequency of isolation was seen for the Czech Republic (7.6%) and the lowest for Indonesia, South Korea, and Thailand (0 to 0.3%). Overall, 83% of isolates were susceptible to voriconazole, ranging from 74.8% in Latin America to 92.3% in North America.
C. krusei
was most commonly isolated from hematology-oncology services, where only 76.7% of isolates were susceptible to voriconazole. There was no evidence of increasing resistance of
C. krusei
to voriconazole from 2001 to 2005. Decreased susceptibilities to amphotericin B (MIC at which 90% of isolates were inhibited [MIC
90
], 4 μg/ml) and flucytosine (MIC
90
, 16 μg/ml) were noted, whereas 100% of isolates were inhibited by ≤2 μg/ml of anidulafungin (MIC
90
, 0.06 μg/ml), micafungin (MIC
90
, 0.12 μg/ml) or caspofungin (MIC
90
, 0.25 μg/ml).
C. krusei
is an uncommon but multidrug-resistant fungal pathogen. Among the systemically active antifungal agents, the echinocandins appear to be the most active against this important pathogen.
Human Parechovirus Type 1, 3, 4, 5, and 6 Detection in Picornavirus Cultures
Authors: de Vries Michel , Pyrc Krzysztof , Berkhout Ron , Vermeulen-Oost Wilma , Dijkman Ronald , Jebbink Maarten F. , Bruisten Sylvia , Berkhout Ben , van der Hoek Lia 
Published: December 2007

ABSTRACT
Picornavirus cultures that could not be typed in neutralization assays were analyzed by VP1 reverse transcription-PCR (RT-PCR) and a virus discovery tool (VIDISCA). Human parechoviruses (HPeVs) were frequently identified, among which were the uncommon isolates HPeV-4, HPeV-5, and HPeV-6. The HPeV-5 isolate could be amplified only by VIDISCA and not by VP1 RT-PCR.
Bartonella tamiae
sp. nov., a Newly Recognized Pathogen Isolated from Three Human Patients from Thailand
Authors: Kosoy Michael , Morway Christina , Sheff Kelly W. , Bai Ying , Colborn James , Chalcraft Linda , Dowell Scott F. , Peruski Leonard F. , Maloney Susan A. , Baggett Henry , Sutthirattana Saithip , Sidhirat Anussorn , Maruyama Soichi , Kabeya Hidenori , Chomel Bruno B. , Kasten Rickie , Popov Vsevolod , Robinson Jennilee , Kruglov Alexander , Petersen Lyle R. 
Published: December 2007

ABSTRACT

Three strains of a novel
Bartonella
species (
Bartonella tamiae
) were isolated from human patients from Thailand. Sequence analysis of six chromosomal regions (16S rRNA,
gltA
,
groEL
,
ftsZ
,
rpoB
, and the intergenic spacer region) and phenotypical analysis supported the similarity of the three strains and placed them within the genus
Bartonella
separately from previously described species.
Prevalence and Genetic Diversity of Hepatitis B and Delta Viruses in Pregnant Women in Gabon: Molecular Evidence that Hepatitis Delta Virus Clade 8 Originates from and Is Endemic in Central Africa
Authors: Makuwa Maria , Caron Mélanie , Souquière Sandrine , Malonga-Mouelet Gabriel , Mahé Antoine , Kazanji Mirdad 
Published: December 2007

ABSTRACT
Hepatitis B virus (HBV) surface antigen (HBsAg) was found in 9.2% of 1,186 pregnant women from Gabon, of whom 10.1% had the HBe antigen and 89.9% had anti-HBe antibodies. Antibodies to the hepatitis delta virus (HDV) were found in 15.6% of the HBsAg-positive women. The HBV strains were of the A3 and E genotypes. The HDV strains belonged to HDV clades 1 and 8. These results provide clear evidence that HDV clade 8 is indigenous to Africa.
Difference in Receptor Usage between Severe Acute Respiratory Syndrome (SARS) Coronavirus and SARS-Like Coronavirus of Bat Origin
Authors: Ren Wuze , Qu Xiuxia , Li Wendong , Han Zhenggang , Yu Meng , Zhou Peng , Zhang Shu-Yi , Wang Lin-Fa , Deng Hongkui , Shi Zhengli 
Published: December 2007

ABSTRACT
Severe acute respiratory syndrome (SARS) is caused by the SARS-associated coronavirus (SARS-CoV), which uses angiotensin-converting enzyme 2 (ACE2) as its receptor for cell entry. A group of SARS-like CoVs (SL-CoVs) has been identified in horseshoe bats. SL-CoVs and SARS-CoVs share identical genome organizations and high sequence identities, with the main exception of the N terminus of the spike protein (S), known to be responsible for receptor binding in CoVs. In this study, we investigated the receptor usage of the SL-CoV S by combining a human immunodeficiency virus-based pseudovirus system with cell lines expressing the ACE2 molecules of human, civet, or horseshoe bat. In addition to full-length S of SL-CoV and SARS-CoV, a series of S chimeras was constructed by inserting different sequences of the SARS-CoV S into the SL-CoV S backbone. Several important observations were made from this study. First, the SL-CoV S was unable to use any of the three ACE2 molecules as its receptor. Second, the SARS-CoV S failed to enter cells expressing the bat ACE2. Third, the chimeric S covering the previously defined receptor-binding domain gained its ability to enter cells via human ACE2, albeit with different efficiencies for different constructs. Fourth, a minimal insert region (amino acids 310 to 518) was found to be sufficient to convert the SL-CoV S from non-ACE2 binding to human ACE2 binding, indicating that the SL-CoV S is largely compatible with SARS-CoV S protein both in structure and in function. The significance of these findings in relation to virus origin, virus recombination, and host switching is discussed.
Role of APOBEC3G/F-Mediated Hypermutation in the Control of Human Immunodeficiency Virus Type 1 in Elite Suppressors
Authors: Gandhi Shiv K. , Siliciano Janet D. , Bailey Justin R. , Siliciano Robert F. , Blankson Joel N. 
Published: December 2007

ABSTRACT
While many studies show that the APOBEC3 family of cytidine deaminases can inhibit human immunodeficiency virus type 1 (HIV-1) replication, the clinical significance of this host defense mechanism is unclear. Elite suppressors are HIV-1-infected individuals who maintain viral loads below 50 copies/ml without antiretroviral therapy. To determine the role of APOBEC3G/F proteins in the control of viremia in these patients, we used a novel assay to measure the frequency of hypermutated proviral genomes. In most elite suppressors, the frequency was not significantly different than that observed in patients on highly active antiretroviral therapy. Thus, enhanced APOBEC3 activity alone cannot explain the ability of elite suppressors to control viremia.