Showing papers in "Japanese Journal of Infectious Diseases in 2004"

Defense mechanisms against influenza virus infection in the respiratory tract mucosa.

Abstract: The respiratory tract mucosa is not only the site of infection for influenza viruses but also the site of defense against virus infection. Viruses are initially detected and destroyed non-specifically by innate immune mechanisms, but if the viruses escape the early defense mechanisms, they are detected and eliminated specifically by adaptive immune mechanisms. The major adaptive immune mechanisms are as follows. (i) Specific secretory-IgA (S-IgA) antibodies (Abs) and CTLs (CD8+ cytotoxic T lymphocytes) are involved in the recovery from influenza following viral infection of naive mice. (ii) Preexisting specific S-IgA and IgG Abs in the immunized animals are involved in viral elimination by forming virus-Ig complexes shortly after re-infection. By their polymeric nature, the S-IgA Abs, which are carried to the mucus by transepithelial transport used for dimeric IgA (dIgA) Abs, provide not only protection against homologous virus infection but also cross-protection against drift virus infection. The IgG Abs, which transude from the serum to the mucus by diffusion, provide protection against homologous virus infection. They are largely distributed on the alveolar epithelia to prevent influenza pneumonia. (iii) In the absence of Abs in the pre-immunized animals, the production of specific IgA and IgG Abs by B memory cells is accelerated after re-infection, and these antibodies play a role in viral elimination from day 3 onwards after re-infection. (iv) In epithelial cells of infected animals, specific dIgA Abs being trafficked through the epithelial cells may be involved in the prevention of viral assembly by binding to newly synthesized viral proteins. (v) In the pre-immunized animals, CTL production by memory T cells is also accelerated and these cells appear to participate in the killing of the host cells infected with different subtype viruses (within the same type) from day 3 onwards after re-infection. (vi) Similarly, memory Th1 cells that mediate an accelerated delayed-type hypersensitivity response are involved in blockade of virus replication by secreting IFN-gamma in mice challenged with different subtype viruses. These defense mechanisms suggest that the development of a mucosal vaccine, capable of inducing S-IgA Abs, which provide cross-protection against variant viruses within the same subtype, serum IgG Abs to prevent lethal influenza pneumonia and CTLs, which provide broad cross-protection against different subtype viruses, is strategically important to control influenza.

Tissue Distribution and Putative Physiological Function of NOX Family NADPH Oxidases

Abstract: The NOX family of ROS-generating NADPH oxidases consists of 7 members: NOX1 to NOX5, DUOX1 and 2. NOX1 is predominantly found in the colon, where it possibly plays a role in the host defense. NOX2 is the phagocyte NADPH oxidase, a clearly established host defense enzyme. NOX3 is almost exclusively expressed in the inner ear, where it is involved in otoconia morphogenesis, but based on its localization might also play a role in the auditory system. NOX4, widely expressed in kidney, vascular cells, osteoclasts etc.; it might be a constitutively active enzyme, regulated on the level of gene expression but its precise physiological function remains unknown. NOX5, a Ca2+ activated enzyme is predominantly expressed in lymphoid tissues and testis, where it might be involved in signaling processes. DUOX1 is expressed in the thyroid and in respiratory epithelia, and DUOX2 in the thyroid and in gastrointestinal glandular epithelia. Both DUOX enzymes are involved in thyroid hormone synthesis, but possibly also in epithelial host defense.

Toxoplasmosis in HIV/AIDS patients: a current situation.

Abstract: The seroprevalence of toxoplasmosis among 505 of human immunodeficiency virus (HIV)/AIDS patients was 226 (44.8%; 95% CI 42.64-51.76): 27 (47.4%) and 199 (44.4%) showed Toxoplasma seropositivity with and without toxoplasmic encephalitis (TE), respectively (P <0.05). The majority of these patients were in the 25-34 age group (44 versus 39%), male (86 versus 76%), and Chinese (49 versus 53%), though no statistical significance was found between the two. Significant differences between these two groups were noted, however, in terms of marital status, occupation, and present address. The heterosexual exhibited the most frequent behavior at risk for HIV infection, and accounted for 51 and 59% of patients with and without TE, respectively. Only 17/260 (6.5%) and 1/137 (0.7%) of them later acquired TE after receiving primary chemoprophylaxis (cotrimoxazole) and antiretroviral therapy including HAART (P <0.05). Fifty-seven (11.3%) out of those 505 patients were diagnosed with AIDS-related TE. The most common clinical manifestation was headache (56%). The computed tomography scan findings showed most lesions to be multiple (96.4%), hypodense (66.7%), and in the parietal region (39.3%). Twenty-seven (47.4%) patients had chronic (latent) Toxoplasma infection as evidenced by seropositivity for anti-Toxoplasma (IgG) antibody. At the time of diagnosis, the range of CD4 cell count was from 0-239 with a median of 25 cells/cumm. We also found that a CD4 count of less than 100 cells/cumm was significantly associated with development of TE (P <0.05). Clinical outcomes showed that among those who survived, 21 (36.8%), 16 (28.1%), and 2 (3.5%) of patients had completed treatment, transferred out, and were lost to follow up, respectively. Unfortunately, 18 (31.6%) of the cases were officially pronounced dead. Overall, 7 (12.3%) patients were detected as recurrent TE in this study.

Mosquito larvicidal properties of essential oil of an indigenous plant, Ipomoea cairica Linn.

Abstract: Laboratory bioassay of the essential oil extracted from an indigenous plant, Ipomoea cairica, commonly known as 'Railway creeper', was carried out against the larvae of four vector species of mosquitoes in order to evaluate its mosquito larvicidal effect. Bioassay test revealed that the essential oil of the plant possess remarkable larvicidal properties as it could induce 100% mortality in the larvae of Culex tritaeniorhynchus (100 ppm), Aedes aegypti (120 ppm), Anopheles stephensi (120 ppm), and Culex quinquefasciatus (170 ppm) mosquitoes at concentrations rangeing from 100 to 170 ppm. The LC(50) and LC(90) values estimated for Cx. tritaeniorhynchus, Ae. aegypti, An. stephensi, and Cx. quinquefasciatus were 14.8 and 78.3, 22.3 and 92.7, 14.9 and 109.9, and 58.9 and 161.6 ppm, respectively. The essential oil was found to be most highly toxic to the larvae of Cx. tritaeniorhynchus followed by Ae. aegypti, An. stephensi, and Cx. quinquefasciatus mosquitoes.

Intestinal parasitic infections in HIV/AIDS and HIV seronegative individuals in a teaching hospital, Ethiopia.

Abstract: The magnitude of intestinal parasitic infection in human immunodeficiency virus (HIV) /AIDS patients requires careful consideration in the developing world. However, there have been very few studies addressing this issue in Ethiopia. This study was conducted to determine the prevalence of intestinal parasitic infection in HIV/AIDS patients at Jimma Hospital, Southwest Ethiopia, between January and February 2002. Stool specimens from HIV/AIDS patients and control groups were screened for intestinal parasitic infections using direct and formalin-ether sedimentation concentration methods. Out of 78 HIV/AIDS patients, 52.6% (41/78), and out of 26 HIV-negative individuals, 42.3% (11/26), were infected with one or more types of intestinal protozoa and/or helminthes. The parasites detected among HIV/AIDS patients included Ascaris lumbricoides (30.8%), Blastocystis spp. (14.1%), Entamoeba histolytica (10.3%), Trichuris trichiura (6.4%), Strongyloides stercoralis (5.1%), Giardia lamblia (3.8%), Schistosoma mansoni (2.5%), hookworm species (2.5%), and Taenia spp. (1.3%). Multiple infections were more common among HIV/AIDS patients. Blastocystis spp. were found to be significantly higher in HIV/AIDS patients than in controls (P < 0.05). The magnitude of intestinal parasitic infection was high both in HIV/AIDS patients and in controls. Routine examinations of stool samples for parasites would significantly benefit the HIV-infected and uninfected individuals by contributing to reduce morbidity.

Antimicrobial susceptibility of isolates from neonatal septicemia.

Abstract: A retrospective study of bacterial isolates from cases of neonatal septicemia was undertaken over a period of 5 years (July 1998 - June 2003) at the Government Medical College Hospital, Chandigarh, India. The study was carried out to determine the bacterial profile, the antimicrobial susceptibility of the isolates, and the change in trends over the study period. A total of 3,064 blood samples for blood culture were obtained, out of which 588 were positive for bacterial isolates. Most of the cases detected by blood culture occurred in the first week of life (64.4%). Gram-negative bacilli (58.5%) predominated over Gram-positive cocci (41.5%). Staphylococcus aureus was found to be the most common isolate (35.0%). The incidence of Gram-positive and Gram-negative organisms changed little over the 5 year span. However, a constant and significant rise in the incidence of Acinetobacter spp. was observed between the first to fifth year of the study period. Amikacin was found to be the most effective drug against Gram-negative bacteria. For S. aureus and Pseudomonas aeruginosa, overall resistance percentages of 5 years show that netilmicin and ciprofloxacin, respectively, were the most effective drugs.

Terrestrial distribution of the Lyme borreliosis agent Borrelia burgdorferi sensu lato in East Asia.

Abstract: Lyme borreliosis is the most prevalent tick-borne zoonosis and an important emerging infection in Europe, North America, and Far Eastern countries. The geographical distribution of Borrelia spp. and the relationship between Borrelia spp. and tick spp. in East Asian countries have been studied. In Northern Asian countries, Ixodes persulcatus carries Eurasian-type Borrelia garinii (20047 type), Borrelia afzelii, and Asian-type B. garinii (variant NT29), whereas Borrelia burgdorferi sensu stricto has not been isolated. In contrast, Asian-type B. garinii has not been found in the European vector tick Ixodes ricinus. These Borrelia spp. cause Lyme borreliosis in their respective countries. The specificity between Borrelia spp. and tick spp. has been confirmed from studies in the Moscow region, which is a sympatric region for the tick spp. I. persulcatus and I. ricinus. In Southeast Asian countries including the southernmost island of Okinawa, the Borrelia valaisiana-related genomic group is carried by Ixodes granulatus. In Japan, a similar borrelia strain Am501, is transmitted by Ixodes columnae. Ixodes ovatus transmits Borrelia japonica but not other species. On other hand, in central China and Nepal, the ticks harbor Borrelia sinica. It is believed that these molecular epidemiological surveys will provide useful information for the diagnoses and prevention of Lyme borreliosis in these countries.

Prevalence of intestinal parasitic pathogens among HIV-positive individuals in Iran.

Abstract: Parasites are important enteric pathogens among patients with human immunodeficiency virus (HIV) infection. There have been very few reports on the prevalence of intestinal parasites among such patients in Iran. To determine the prevalence of intestinal parasites among HIV-positive individuals, we collected single stool samples and analyzed them for detection of various intestinal parasites from 206 HIV-positive individuals with different immune status visited in different medical centers in Iran. The data were tested for statistical significance with chi(2) and Mann-Whitney U tests. The overall prevalence of intestinal parasites was 18.4% (95%CI: 13.7, 24.3). More specifically, the following parasites were identified: Giardia lamblia (7.3%), Blastocystis hominis (4.4%), Entamoeba coli (3.9%), and Cryptosporidium parvum (1.5%). Other parasites observed included Strongyloides stercoralis and Hymenolepis nana in two cases and Dicrocoelium dendriticum in one. Of the 38 patients who tested positive for intestinal parasites, 15 (39.2%) had diarrhea. Intestinal parasites were significantly more common among patients with diarrhea than those without (P < 0.001). Further, CD4 counts were significantly lower among individuals with diarrhea than those without (P < 0.001). This study highlights the importance of testing for intestinal parasites among Iranian HIV-positive patients, especially those with low immunity presenting with diarrhea.

Infection of cerebrospinal fluid shunts: causative pathogens, clinical features, and outcomes.

Abstract: This retrospective chart review describes the clinical features, pathogens, and outcomes of 46 patients with cerebrospinal fluid (CSF) shunt infections collected over 16 years. The overall CSF shunt infection rate was 2.1%, broken down into 1.7 and 9.3% in adult and pediatric groups, respectively. Fever and progressive consciousness disturbance were the most clinical features in the adult patient group, whereas disturbance of consciousness and abdominal symptoms and signs were the two most common clinical features in the pediatric patient group. The most frequently isolated microorganisms were of the Staphylococcus spp., including Staphylococcus aureus and coagulase negative Staphylococcus, which accounted for 47% of the episodes. Furthermore, increases in polymicrobial and Gram-negative bacilli infections were observed in our study. Due to the high proportion of oxacillin-resistant Staphylococcus spp. and polymicrobial infections, we recommend initial empirical antibiotics with both vancomycin and a third-generation cephalosporin for cases in which the causative bacteria has not been identified or for which the results of antimicrobial susceptibility tests are not available. For patients who develop smoldering fevers, progressive disturbed consciousness, seizures, or abdominal fullness after ventriculoperitoneal shunt procedures, CSF shunt infections should be suspected. Although some infections have been managed successfully with antimicrobial therapy alone, the timely use of appropriate antibiotics according to antimicrobial susceptibility testing and the removal of the shunt apparatus are essential for successful treatment.

Prevalence and treatment of Chlamydia trachomatis, Ureaplasma urealyticum, and Mycoplasma hominis in patients with non-gonococcal urethritis.

Abstract: The aim of present study was to evaluate the occurrence of Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum in non-gonococcal urethritis (NGU) and to determine the bacterial resistance to six antibiotics in order to determine the most suitable treatment strategy. A total of 50 patients were enrolled into the study. Urethral samples were taken with a dacron swab placed into urethra 2 - 3 cm in males, and vaginal samples were taken from the endocervical region in women. The patient samples that did not grow Neisseria gonorrhoeae were accepted as NGU. Direct immunofluorescence technique was used for the investigation of C. trachomatis. Mycoplasma IST was used for the isolation of M. hominis and U. urealyticum. U. urealyticum was isolated from 24 patients. Thirteen of them had only U. urealyticum, and the rest had mixed pathogen organisms (7 U. urealyticum + M. hominis; 3 U. urealyticum + C. trachomatis, and 1 U. urealyticum + M. hominis + C. trachomatis). C. trachomatis was detected in 12 patients. While 8 patients had C. trachomatis only, the rest had a mixture of the pathogen organisms listed above. Partner examinations could be performed for only 22 patients' partners. In the evaluation of antibiotic susceptibility, higher resistance was obtained against ofloxacin in U. urealyticum, and against erythromycin with M. hominis. Our results indicated that doxycycline or ofloxacin should be the first choice when empirical treatment is necessary.

Markers for transfusion-associated hepatitis in north Indian blood donors: prevalence and trends.

Abstract: Transfusion-associated hepatitis is a great problem in developing countries including India due to endemic hepatitis infections and a lack of voluntary donors, trained personnel, and funds. The prevalence of post-transfusion hepatitis B and C in India is about 1-5% and 1%, respectively. A total of 128,589 blood donors were screened for hepatitis B surface antigen (HBsAg) and 76,089 donors were screened for anti-hepatitis C virus (HCV) from 1997 - 2002. Data were tabulated annually. Out of the total 83.6% were replacement donors. Our study concluded that the prevalence of HBsAg and antibodies for HCV ranged between 1.7 - 2.2% and 0.25 - 0.9%, respectively among all of the donors. Seropositivity was definitely higher in replacement donors than in voluntary donors. Based on these results, we recognize an urgent need to establish a non-remunerated voluntary donor base in India. A stringent deferral system should be developed. The use of sensitive laboratory tests and the addition of core antigen (anti-HBc) to the mandatory screening test list would further reduce the incidence of post-transfusion hepatitis.

Isolation and characterization of Candida spp. in Jordanian cancer patients: prevalence, pathogenic determinants, and antifungal sensitivity.

Abstract: SUMMARY: The presence of Candida spp. in the oral cavity was evaluated in 95 cancer patients (57 in-patients and 38 out-patients) and in 65 healthcare workers in Amman, Jordan. Candida carriage occurred in 72.6% of cancer patients and 33.8% of healthcare workers, with Candida albicans being the species most commonly recovered, followed by C. glabrata. In-patients were found to harbor Candida spp. at significantly higher levels than out-patients (P = 0.0044). The number of adhered C. albicans cells and the secretion of extracellular proteinase was significantly higher in the in-patient group than in the out-patient group (P = 0.0016 and 0.00007, respectively); this significant difference was not observed regarding phospholipase secretion. Antifungal sensitivity testing data suggest that isolates were most sensitive to amphotericin B and nystatin, and least sensitive to miconazole and fluconazole, which are commonly used antifungal agents in Jordan.

Norovirus and sapovirus infections in Thailand.

Abstract: Stool specimens collected between November 2002 and April 2003 from hospitalized infants with acute gastroenteritis from four distinct geographical regions in Thailand were examined for norovirus (NoV) and sapovirus (SaV) by reverse transcription-PCR and sequence analysis. Of the 80 specimens examined, we identified 11 NoV and 9 SaV single infections, and 3 NoV/SaV mixed infections. The majority of NoV strains (64%) belonged to genogroup II/ genotype 4 (GII/4; Lordsdale cluster). Other NoV strains co-circulating belonged to GII/1, GII/3, GII/6, and one new genotype cluster (GII/New). The majority of SaV strains (83%) were from the Manchester cluster. One isolated SaV strain represented a recently discovered novel genogroup within the SaV genus (SG-V), and another isolated SaV strain represented a novel SaV genogroup II cluster.

Cryptosporidium Spp., a frequent cause of diarrhea among children at the Korle-Bu Teaching Hospital, Accra, Ghana.

Abstract: This report presents the results of a study conducted at the Child Health Department, Korle-Bu Teaching Hospital, Accra, Ghana, between the months of October 2001 and June 2002. Stool samples from 227 children with diarrhea and 77 children without diarrhea, aged less than 5 years, were tested for Cryptosporidium spp. Prevalence rates were 27.8 and 15.6% in children with and without diarrhea, respectively. Cryptosporidium infection was found to be high in children between the ages of 6 and 24 months. Cryptosporidium spp. was more common in malnourished children, but was not isolated in children under 6 months of age who were exclusively breastfed. Neither the presence of domestic animals, abdominal pain, blood in stool, nausea, vomiting, nor the consumption of untreated water was associated with Cryptosporidium spp. infection. Shigella, Salmonella, and yeast-like organisms were the most frequently identified enteropathogenic bacteria. In summary, this study demonstrates the prevalence of Cryptosporidium spp. among Ghanaian children.

Comparative Characterization of Staphylococcus aureus Isolates from Throats and Noses of Healthy Volunteers

Abstract: Staphylococcus aureus isolates in 2001 from the nose and the throat of an adult population were characterized for their incidence and type. The incidence was 51%, present in 80 out of 157 individuals examined, consisting of 34 nasal carriers, 24 throat carriers, and 22 who carried the isolates in both the nose and throat. Among these isolates, 2 and 5 from the nose and the throat, respectively, were identified as methicillin-resistant S. aureus. S. aureus from the nose and throat of the same individuals were characterized for identification. Examination of their phenotypes revealed that in 11 individuals the clone of S. aureus in the throat was different from the nasal clone. These results suggested that staphylococcal flora in the nose and the throat were independently formed, and that attention should also be directed to the carriers of S. aureus in the throat for the control of nosocomial infection.

Changing epidemiology of Angiostrongyliasis cantonensis in Okinawa prefecture, Japan.

Abstract: *Corresponding author: Mailing address: Okinawa Prefectural Institute of Health and Environment, Ozato 2085, Ozato-son, Okinawa 901-1202, Japan. Fax: +81-98-945-9366, E-mail: asatoryj@pref.okinawa.jp Okinawa Prefecture experienced an outbreak of angiostrongyliasis in January of 2000 (1). The origin of the infection’s outbreak could not be identified. We examined the past records of Angiostrongylus cantonensis (Ac) infection outbreaks and investigated the current distribution of Ac’s intermediate and paratenic hosts with infective third-stage larvae in Okinawa. In order to find the infective larvae of Ac in the giant African snail, Achatina fulica, the pallial organ (lung) of the snail was compressed between two glass plates and examined under a microscope (2) (Figs. 1A, 1B). In other host animals, the whole body was digested in artificial gastric juice (1% pepsin/1% HCl), and the digested material was allowed to sediment; the sediment thus formed was then examined microscopically. In particular, albino rats were given larvae from Platydemus manokwari (Fig. 2) and Parmarion martensi (Fig. 3) orally with the specimen, and identification was made based on the morphology of the adult Ac recovered at 59 days post-inoculation. As shown in Table 1, the Ac epidemic showed different features before and after 1990. Before 1990, 17 in 21 (80%) of the infections were traced to their infection sources, while after 1990 only 2 in 14 could be traced to its source. The infection was more frequent (15/21) in April November before 1990, although it was more frequent (11/14) in DecemberFig. 1A. Achatina fulica (the giant African snail), the pallial organ (lung) is shown. Scale: 1 cm. Fig. 1B. I nfective third-stage larvae of Ac in the tissue. Scale: 100 μm. Fig. 2. Platydemus manokwari; newly discovered paratenic host of Ac in Okinawa. Scale: 1 cm. Fig. 3. Parmarion martensi; newly discovered intermediate host of Ac in Okinawa. Scale: 1 cm. 1A 1B

Prevalence of Clinical Strains Resistant to Various β-Lactams in a Tertiary Care Hospital in India

Abstract: The incidence of infection due to extended spectrum beta-lactamases (ESBLs) producing Enterobacteriaceae has markedly increased in recent years. The traditional susceptibility methods lack sensitivity and/or specificity and this issue has prompted the search for an accurate test to detect the presence of ESBL. The present study included 300 bacterial strains and was undertaken to determine the prevalence of ESBL-producing strains. Here, compared three tests: a double disk synergy test (DDS), a three-dimensional test (3-D), and an inhibitor potentiated disk diffusion test (IPT); each test employed three different antibiotic discs, i.e., ceftazidime, ceftriaxone, and cefotaxime, in order to screen for ESBL strains. A strain was said to be an ESBL producer if it showed positive result(s) on any one of the three tests. The prevalence rate of ESBL in our hospital was 12.6% (38/300). IPT detected the most strains (34/38), followed by 3-D (23/38), and then DDS (15/38). The ceftriaxone disc was found to detect more ESBLs than either the ceftazidime or the cefotaxime disc.

Regulation by innate immune T lymphocytes in the host defense against pulmonary infection with Cryptococcus neoformans.

Abstract: Recently, innate immune lymphocytes, such as natural killer (NK) T cells and gamma/delta antigen receptor-bearing T (gamma delta T) cells, have garnered much attention, and their biological significance in the tumor immunity, allergic diseases and infectious diseases is extensively exploited We have addressed the role of these cells in the host defense using a mouse model of pulmonary infection with Cryptococcus neoformans, which frequently causes fatal meningoencephalitis in AIDS patients Host defense to this fungal pathogen is largely mediated by cellular immunity, and type-1 helper T (Th1) cells play a central role in this process This infection causes a prompt accumulation of both NKT and gamma delta T cells in the lung tissues in a monocyte chemoattractant protein (MCP)-1-dependent or -independent manner, respectively Genetic deletion of V alpha 14+ NKT cells ameliorates the Th1 response and clearance of microorganisms in the lungs, whereas these host protective responses are rather enhanced in mice lacking gamma delta T cells Thus, in some aspect, these innate immune lymphocytes may co-regulate the Th1-mediated response for induction of the moderate host defense gamma delta T cells may act to keep the balance of Th1-Th2 responses in a proper manner by suppressing the exaggerated Th1 response caused by NKT cells In this review, I describe the recent research development in the innate immune host defense against cryptococcal infection in respiratory organs with emphasis on our data in the regulatory role of NKT cells and gamma/delta T cells

Serological and molecular evidence of HTLV-I infection among Japanese immigrants living in the Amazon region of Brazil.

Abstract: SUMMARY: Human T-lymphotropic virus type I (HTLV-I) infection was investigated in 168 Japanese immigrants (64 males and 104 females) living in the Tome-Acu county located in the State of Para, Brazil. The serological screening was performed using an enzyme-linked immunosorbent assay, and showed the presence of anti-HTLV in four women whose ages ranged from 50 to 88. Confirmation of infection and discrimination HTLV typing was performed using a nested PCR on the extracted DNA targeting the pX region. In three of the samples, infection was confirmed to be HTLV-I. Sequencing HTLV-I 5´LTR and the RFLP pattern using DraI and SacI endonucleases indicated that the virus is a member of the Cosmopolitan group. These three women originated from the Kyushu region, though two of the corresponding HTLV-I strains were phylogenetically related to the Japanese subgroup and the third to the Transcontinental subgroup, which probably reflects the geographical origin of the infected individuals. The Japanese community residing in the northern Brazil apparently have not contributed to increase the prevalence of HTLV-I in the country.

Possible horizontal transmission of crimean-congo hemorrhagic Fever virus from a mother to her child.

Abstract: The case of a child with Crimean-Congo hemorrhagic fever (CCHF) presumably infected with CCHF virus from her 27-year-old mother is described. The mother with CCHF was treated with ribavirin and did not present with any symptoms of obvious hemorrhage. The child developed fever on the 5th day after the mother's onset. The partial virus genome was amplified by RT-PCR, and nested PCR from the child and the genome sequence were identical to that from the mother, indicating possible transmission of the virus from mother to child. This case indicates the importance of preventive measures for in-house outbreaks of CCHF.

An epidemiological analysis of Stenotrophomonas maltophilia strains in a university hospital.

Abstract: The aim of this investigation was to evaluate the epidemiology of Stenotrophomonas maltophilia in a university hospital of Turkey. From June 2000 to December 2001, S. maltophilia strains were collected, clinical presentations were noted, and MIC determinations were performed by means of E-test. Enterobacterial repetitive intergenic consensus sequences-PCR (ERIC-PCR) was used for molecular typing of the strains. Forty-four strains of S. maltophilia were isolated from 41 hospitalized patients in a teaching hospital. The majority of specimens were from the blood and respiratory tract. Antimicrobial sensitivities of these strains were as follows: 97.7 % trimethoprim-sulfamethoxazole, 15.9% ticarcillin, and 95.4% ticarcillin- clavulanate. The strains were evaluated using the ERIC-PCR method. It was of interest to note that epidemiological typing revealed three small outbreaks that were caused by a total of 12 strains. The remaining isolates generated singular DNA patterns. DNA amplification was possible in 38 isolates and yielded 26 different patterns in a period of 20 months, leading to the suggestion that commensal bacteria becomes selected in the presence of a suitable host.

Progress toward Effective Gene Therapy for Chronic Granulomatous Disease

Abstract: peripheral blood hematopoietic stem cells (PBSC) ex vivo in serum-free medium in gas permeable bags with amphotropic envelope pseudotyped MFGS retrovirus encoding normal p47phox (20% transduction rates) or gp91phox (70% transduction rates using Retronectin ® ), respectively (4). In eight of ten patients, peak levels of 0.004 to 0.13% oxidase normal corrected peripheral blood neutrophils and monocytes were observed at 3 - 6 weeks with the effect lasting several months per cycle of gene therapy. Repeated cycles prolonged correction >1 year, but was not permanent. We conclude that clinically beneficial gene therapy for CGD will require improved transduction of primitive stem cells, use of non-ablative marrow conditioning and possibly also co- expression of an in vivo selectable gene. We used feline endogenous virus RD114 envelope pseudotyped MFGS-gp91phox vector to achieve >95% ex vivo transduction. In a NOD/SCID mouse xenograft model engrafted with human X-linked CGD patient PBSC transduced with amphotropic MFGS-gp91phox versus RD114 MFGS-gp91phox vector, in vivo levels of gene corrected human neutrophils were 2.2% versus 22%, respectively (6). CGD vectors also containing selectable P140K mutant methyguanine methyl- transferase gene allowed use of O 6 -benzyl guanine/temozolamide in vivo selection to further enhance human neutrophil correction several fold in the NOD/SCID mouse xenograft model (7). A new

The role of myeloperoxidase in the pathogenesis of coronary artery disease

Abstract: A growing body of evidence continues to emerge implicating the role of myeloperoxidase (MPO) and its oxidant products in the promotion of atherogenesis. A major mechanism by which MPO impacts the arterial wall is through its modification of net cellular cholesterol flux. MPO promotes lipid peroxidation and conversion of LDL to an atherogenic form, where it is taken up by macrophages, a critical step in foam cell formation. Emerging evidence suggests that HDL can also be modified by MPO derived oxidants, resulting in an impairment of cholesterol efflux. In addition, modified HDL appears to be a strong predictor of clinical risk. These features highlight MPO and its products as potential predictive markers and targets in atheroprotection.

Neisseria Gonorrhoea, Chlamydia Trachomatis, and Treponema Pallidum Infection in Antenatal and Gynecological Patients at Korle-Bu Teaching Hospital, Ghana

Abstract: Five hundred and seventeen women attending the gynecology and obstetrics clinics of the Korle-Bu Teaching Hospital were examined for sexually transmitted infections (STIs). Vaginal swabs were examined for Trichomonas vaginalis, Candida albicans, and Gardnerella vaginalis infection. Endocervical swabs were examined for Neisseria gonorrhoea and Chlamydia trachomatis using a recently developed RNA detection kit. Strain typing was performed to identify serovars of C. trachomatis. Sera were analyzed for Treponema pallidum with a passive-particle agglutination assay kit. The prevalence of infection with N. gonorrhoea was 0.6%, C. trachomatis 3.0%, and T. pallidum 5.6%. Eight samples were PCR-positive for C. trachomatis. Five of these were serovar G, and the rest were serovar E. All cases of mixed infections occurred in pregnant women. In conclusion, a high transmissible risk of T. pallidum infection was observed among our study population and in particular among our pregnant women. The absence of association between the presenting symptoms, clinical findings, and specific pathogens has implications for the syndromic approach to STI case management. The low prevalence of C. trachomatis and N. gonorrhoea may be due to self medication and requires further research in primary health institutions in rural areas to compare rates.

An unexpected outbreak of Japanese encephalitis in the Chugoku district of Japan, 2002.

Abstract: Six patients unexpectedly presented with Japanese encephalitis (JE) from early August to mid-September 2002 in the Chugoku district of Japan. The mean age was 67.5 years (range 42 - 89 years); the onset period in two patients shifted to the middle of September. The JE virus was isolated from the cerebrospinal fluid samples from two patients, and the strain isolated in the one was identified as genotype III. Neurologically, consciousness impairment, meningeal signs, rigidity, hemiparesis, tetraparesis, and convulsive seizures were commonly observed. Magnetic resonance imaging uniformly revealed high signal intensities in the bilateral thalami, brainstem (substantia nigra), hippocampi, and brain cortices. In all patients, acyclovir was used, due to the unexpected outbreak of JE. Five patients, except for one without sequelae, had a severe outcome, including one death. This report indicates that JE in Japan is still a threat to adults and the elderly with decreased or absent immunity to the JE virus.

An outbreak of Dipodascus capitatus infection in the ICU: three case reports and review of the literature.

Abstract: A mini epidemic of Dipodascus capitatus (teleomorph of Geotrichum capitatum) involving three cases is reported. The index case was pulmonary infection and a fulminant course of fungal infection, which resulted in the patient's death with acute myelocytic leukemia. In the other cases, the patients were simultaneously hospitalized, the first in the intensive care unit. In all cases, D. capitatus was identified in different samples (sputum, deep tracheal aspiration, blood, and urine) from each of the patients. Growing evidence indicates that D. capitatus should be added to the lengthening list of opportunistic fungal pathogens that can cause infection in people of all ages and particularly in those who are immunocompromised. Further, the danger of cross-contamination and potential "outbreak" should be kept in mind during hospital management.

Reactions of superoxide with myeloperoxidase and its products.

Abstract: SUMMARY: Myeloperoxidase (MPO) uses hydrogen peroxide to oxidize chloride to hypochlorous acid. It also converts numerous substrates to reactive free radicals. When released by neutrophils, the enzyme operates in the presence of a flux of superoxide. We show that superoxide has a profound influence on oxidative reactions catalysed by MPO. It reacts directly with the enzyme to modulate production of hypochlorous acid. Within neutrophil phagosomes, where MPO functions to kill micro-organisms, it may be the preferred substrate for the enzyme. Superoxide also reacts rapidly with radicals generated by MPO, e.g. from tyrosine and tyrosyl peptides. Initial products are organic peroxides. These species are likely to be toxic and contribute to the pathophysiological actions of MPO.

Molecular mechanism underlying activation of superoxide-producing NADPH oxidases: roles for their regulatory proteins.

Abstract: The phagocyte NADPH oxidase is dormant in resting cells but becomes activated during phagocytosis to produce superoxide, a precursor of microbicidal oxidants, thereby playing a crucial role in host defence. The catalytic core of this enzyme comprises the two membranous subunits gp91phox/Nox2 and p22phox. The oxidase activation requires the small GTPase Rac and the SH3 domain-containing proteins p47phox and p67phox; they normally exist in the cytoplasm and translocate upon cell stimulation to the membrane. The translocation depends on a stimulus-induced conformational change of p47phox, which leads to the SH3 domain-mediated interaction with p22phox, a binding required for the gp91phox/Nox2-dependent superoxide production. Activation of Nox1, an oxidase that is likely involved in host defence at the colon, requires novel proteins homologous to p47phox and p67phox, designated Noxo1 and Noxa1, respectively. Noxo1 and Noxa1, both expressed abundantly in the colon, are capable of constitutively activating Nox1. The constitutive activation may be due to the property of Noxo1: in contrast with p47phox, Noxo1 seems to normally associate with p22phox, which is required for the Nox1 activation. We will also describe the mechanism underlying regulation of the third oxidase Nox3, which exits in fetal kidney and inner ears.

HIV and syphilis infection among elderly people in northwest Ethiopia.

Abstract: The prevalence of HIV has been continually increasing both in urban and rural Ethiopia. As yet, there has been no report on the magnitude of the problem in the elderly and rural population. This study assessed the seroprevalence of HIV and syphilis infection among 706 elderly and predominantly rural subjects in Northwest Ethiopia. Socio-demographic information was collected using a structured questionnaire. Venous blood was collected and the serostatus of HIV and that of syphilis were checked by ELISA and RPR, respectively. The total HIV-1 seroprevalence was 5% (35/706). Sex-specific prevalences of HIV for males and females were 5.6 and 4.7% respectively. A 4.2% difference in prevalence was observed by area of residence, which was statistically significant, P = 0.018. Only 6% of subjects positive for syphilis were also positive for HIV, while 4.9% of subjects negative for syphilis were positive for HIV. The data indicates that the prevalence of HIV among elderly people in Northwest Ethiopia was high. This indicates the importance of involving the elderly in HIV/AIDS prevention and control programs.

A Nosocomial Outbreak of Febrile Bloodstream Infection Caused by Heparinized-Saline Contaminated with Serratia marcescens, Tokyo, 2002

Abstract: In January 2002, 12 patients with Serratia marcescens bloodstream infection (BSI) were identified in a hospital in Tokyo, Japan. We conducted an epidemiological investigation of this outbreak. We undertook a medical-records review and employee interviews, and performed a case-control study to determine risk factors for S. marcescens BSI. An observational study of the hospital's procedures and an environmental microbiologic sampling were performed. We identified 12 suspected and 12 confirmed patients with S. marcescens BSI, including 7 who died. A case-control study showed that vascular access devices (odds ratio [OR] = 30.46; 95% confidence interval [CI] = 3.5-685.6) and the use of heparin-locks, between December 26 and January 15 (OR = 25.7; 95% CI = 2.3-680.4) were significant risk factors for S. marcescens BSI. The observational study revealed multiple lapses in infection control, including use of multi-dose vials of heparin. The outbreak strain was isolated from a hand-towel in the nurse station. The use of multi-dose vials of heparinized-saline during a particularly busy period was associated with BSI risk. The results underscore the risks inherent in infection-control lapses and the use of multi-dose vials.