IOVS MS 11-7777 (Article 2207) Proofs Available _______________________ Dear Author: The proofs of your article above are available for your review. Please download the file located at this URLaddress: http://rapidproof.cadmus.com/RapidProof/retrieval/index.jsp Login: [your e-mail address]Password: 99S4UntgTcU9 You will need to have Adobe Acrobat Reader software to read this file. This is free software and is availablefor user downloading at http://www.adobe.com/products/acrobat/readstep.html. If you experience technical problems, please contact Tracey Ritchey(e-mail: ritcheyt@cadmus.com; phone: 717-721-2646) This file contains: -- Instructions to Author-- Adobe Acrobat Comments and Notes Instructions-- Publication Fees and Reprint Order Form-- Page Proofs for your article, table of contents precis blurb, and author queries - containing 5 pages Please insert your comments electronically (instructions enclosed), or print the PDF proofs and add yourcomments manually. Follow the enclosed instructions for emailing, faxing, or mailing your corrections.Return all materials within 48 hours (two business days) to assure quick publication of your article. NOTE: Effective with the January 2010 issue IOVS will be available online only. No printed issues will beproduced. Printed reprints may still be ordered using the file provided. If you have any questions regarding your article, please contact me. ALWAYS INCLUDE YOURARTICLE NO. (IOVS MS 11-7777) WITH ALL CORRESPONDENCE. Cathy FreyTel: 717-721-2616Fax: 717-738-9479 or 717-738-9478freyc@cadmus.com

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Investigative Ophthalmology and Visual Science

It has been almost 10 years since a major review on the association of Aeromonas with human disease has been published. During that period the number of valid species in the genus has grown to 14, with a new family (Aeromonadaceae) established to house this genus. Despite this explosion in the number of new genomospecies, only five (Aeromonas hydrophila, A. caviae, A. veronii, A. jandaei, and A. schubertii) are currently recognized as human pathogens. New syndromes attributed to this genus include hemolytic uremic syndrome, burn-associated sepsis, and a variety of respiratory tract infections, including epiglottitis. Convincing evidence suggests that some aeromonads do cause gastroenteritis, but it is presently unclear whether many of the strains isolated from feces are involved in diarrheal disease. Many questions regarding this genus remain unanswered.

Evolving Concepts Regarding the Genus Aeromonas: An Expanding Panorama of Species, Disease Presentations, and Unanswered Questions

Shifting trends in bacterial keratitis in South Florida and emerging resistance to fluoroquinolones

Aeromonas spp. clinical microbiology and disease

Staphylococcus lugdunensis has gained recognition as an atypically virulent pathogen with a unique microbiological and clinical profile. S. lugdunensis is coagulase negative due to the lack of production of secreted coagulase, but a membrane-bound form of the enzyme present in some isolates can result in misidentification of the organism as Staphylococcus aureus in the clinical microbiology laboratory. S. lugdunensis is a skin commensal and an infrequent pathogen compared to S. aureus and S. epidermidis, but clinically, infections caused by this organism resemble those caused by S. aureus rather than those caused by other coagulase-negative staphylococci. S. lugdunensis can cause acute and highly destructive cases of native valve endocarditis that often require surgical treatment in addition to antimicrobial therapy. Other types of S. lugdunensis infections include abscess and wound infection, urinary tract infection, and infection of intravascular catheters and other implanted medical devices. S. lugdunensis is generally susceptible to antimicrobial agents and shares CLSI antimicrobial susceptibility breakpoints with S. aureus. Virulence factors contributing to this organism's heightened pathogenicity remain largely unknown. Those characterized to date suggest that the organism has the ability to bind to and interact with host cells and to form biofilms on host tissues or prosthetic surfaces.

From Clinical Microbiology to Infection Pathogenesis: How Daring To Be Different Works for Staphylococcus lugdunensis

AIMS—To identify and determine antibiotic susceptibility of coagulase negative staphylococci (CoNS) isolated from patients with chronic blepharitis, purulent conjunctivitis, and suppurative keratitis.
METHODS—A retrospective review of all culture positive cases of chronic blepharitis, purulent conjunctivitis, and suppurative keratitis between July 1995 and December 1996 was performed. Cases in which CoNS were the sole isolates were analysed. Species identification was performed by using a commercially available standardised biochemical test system. Antibiotic susceptibility to penicillin, gentamicin, tetracycline, erythromycin, ciprofloxacin, and teicoplanin was determined by agar disc diffusion (Kirby-Bauer method). Teicoplanin resistance was confirmed by agar dilution.
RESULTS—42 Staphylococcus epidermidis, four S warneri, three S capitis, two S hominis, one each of S xylosus, S simulans, S equorum, and S lugdunensis were identified. 37 CoNS were penicillin resistant, 12 gentamicin resistant, 28 tetracycline resistant, 18 erythromycin resistant, four ciprofloxacin resistant, and one teicoplanin resistant (MIC, 32 µg/ml). In total, 16 strains were resistant to three or more antibiotics.
CONCLUSION—Species of CoNS apart from S epidermidis may be isolated from patients with corneal and external infection. Antibiotic susceptibility of CoNS is unpredictable and multiresistant strains are common. As a result, antibiotic susceptibility testing should be performed in all cases of clinically significant ocular infections caused by CoNS.

https://bjo.bmj.com/content/bjophthalmol/83/7/771.full.pdf

Identification and antibiotic susceptibility of coagulase negative staphylococci isolated in corneal/external infections

Introduction Antibiotics that suppress Propionibacterium acnes are the standard treatment for acne but are becoming less effective, due to the appearance of antibiotic-resistant strains. Many plants are known to have innate antimicrobial action and can be used as alternatives to antibiotics; thus, it is necessary to prove their effectiveness in vivo. This study aimed to evaluate the anti-acne efficacy of a new cream based on three natural extracts, comparing it to erythromycin cream and placebo. Patients and methods Sixty patients with mild to moderate acne vulgaris were randomly divided into three groups: treated with cream containing 20% propolis, 3% "tea tree oil", and 10% "Aloe vera" (PTAC) (n=20); or with 3 % erythromycin cream (ERC) (n=20); or with placebo (n=20). At baseline, after 15 and 30 days, investigators evaluated response to treatment by counting acne lesions through noninvasive measurements and macrophotography. Results All the clinical and instrumental values studied were statistically different from placebo except for sebometry, pHmetry, and erythema index values, measured on healthy skin. Unlike in the placebo group, papular and scar lesions showed high erythema reduction after 15 and 30 days of PTAC and ERC application. Conclusion The PTAC formulation was better than ERC in reducing erythema scars, acne severity index, and total lesion count.

https://www.dovepress.com/getfile.php?fileID=46939

Treatment of acne with a combination of propolis, tea tree oil, and Aloe vera compared to erythromycin cream: two double-blind investigations.

The aim of the research was to evaluate a heavy metal, Cadmium (Cd), which was used to produce alterations in human breast cancer cell line MCF-7. Moreover, we analyzed both immunohistochemical and ultrastructural alterations induced by the antineoplastic drug, 5-Fluorouracil (5-FU), after exposure to different concentrations of Cadmium. Also, we compared the effects of these compounds on actin and tubulin cytoskeleton proteins. Under ultramicroscopic observation, control cells looked polymorphous with filopodia. In cells already treated with small concentrations of Cd, after brief times of incubation, we observed an intense metabolic activity with larger, clearer, and elongated mitochondria characterized by thin and numerous dilated cristae. 5-FU-treated cells showed cytotoxicity signs with presence of pore-like alterations in the cell membrane and evident degeneration of cytoplasm and cell nuclei. The addition of 5-FU (1.5 μM) to the cells treated with Cd (5 μM-20 μM) did not induce significant ultrastructural changes in comparison with cells treated only with Cd. In Cd+5FU-treated cells mitochondria with globular aspect and regular cristae indicated the active metabolic state. In cells treated only with Cd we observed alterations in actin distribution, while tubulin branched out throughout the cytoplasm. With the association of Cd+5FU, we observed less morphological alterations in both tubulin and actin cytoskeleton proteins. Although the mechanism remains unknown at present, our findings suggest that Cd prevents the cytotoxic effect of 5-FU on breast cancer cells. These preliminary results could have an important clinical application in patients with breast cancer.

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Cadmium influences the 5-Fluorouracil cytotoxic effects on breast cancer cells

Corneal ulcer caused by Aeromonas species.

Editor,—We examined a 33-year-old woman with a week long history of a progressively inflamed left eye who showed oculoglandular conjunctivitis and a marginal corneal ulcer. Three days later she presented with fever and cutaneous maculopapular exanthema. The patient revealed that 2 weeks earlier a jet of blood had splashed into her left eye as she accidentally crushed a tick on her dog. Blood samples from the patient were positive to the Weil–Felix test; therefore, Mediterranean spotted fever was diagnosed. Systemic and topical treatment with tetracyclines was successful. The possibility that spotted fever may be acquired through the eye should be kept in mind.

### CASE REPORT

A previously healthy 33-year-old woman was admitted with a week long history of a progressively painful and inflamed left eye. She had eyelid erythema and swelling, mucopurulent discharge, marked conjunctival hyperaemia, …

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Mario Sotgiu

Papers

Identification and antibiotic susceptibility of coagulase negative staphylococci isolated in corneal/external infections

Treatment of acne with a combination of propolis, tea tree oil, and Aloe vera compared to erythromycin cream: two double-blind investigations.

Cadmium influences the 5-Fluorouracil cytotoxic effects on breast cancer cells

Corneal ulcer caused by Aeromonas species.

Oculoglandular syndrome in Mediterranean spotted fever acquired through the eye