We estimated the prevalence of blood culture negative endocarditis (CNE) and described and analysed data with special attention to antibiotic treatment from patients with infective endocarditis (IE) reported to the Swedish endocarditis registry during the 10-y period 1995-2004. All 29 departments of infectious diseases in Sweden reported data to the registry. During the 10-y period, 2509 IE episodes (78% Duke definite) were identified in 2410 patients. 304 CNE episodes (25% Duke definite) were found. The proportion of CNE was measured to be 12% of all IE episodes. Fatal outcome occurred in 10.7% of all IE patients and in 5% of the CNE patients. The risk of dying was significantly increased in female (9%) compared to male (2%) CNE patients (OR 5.1). Mortality was significantly decreased in patients treated with an aminoglycoside (3%) versus patients without aminoglycoside therapy (13%), OR 0.2. In conclusion, the prevalence of CNE was 12% in Swedish IE patients in a 10-y survey. The mortality in IE was low (10.7%) and 4.6% for CNE. Women have higher mortality rates than men in CNE. CNE patients who received aminoglycoside therapy survived more frequently than CNE patients without this therapy.
The cultural characteristics of 1220 Campylobacter strains from a variety of sources are described. Forty-two were identified as Campylobacter fetus ssp. fetus (Véron & Chatelain, 1973), 1120 as members of the C. jejuni/C. coli group, and 58 did not conform to any known description. Sixteen of the latter strains had the basic characteristics of C. fetus but were atypical in certain other respects. The other 42 strains had the thermophilic characteristics of the jejuni/coli group, but were resistant to nalidixic acid and had other features in common; it is possible that they represent a new species. They were isolated from 19% of locally caught wild seagulls but only occasionally from other animals and man.Growth at 25 degrees C clearly distinguished strains of C. fetus from those of the jejuni/coli and the nalidixic acid-resistant thermophilic (NARTC) groups. Maximum growth temperature was less reliable for this purpose, and 43 degrees C was found to be better than the traditional 42 degrees C. By arranging the results of three tests (tolerance to 2,3,5-triphenyltetrazolium chloride, growth at 30.5 and 45.5 degrees C) serially in the form of a schema comprising nine categories, the jejuni/coli strains fell into two main groups resembling the Institute Pasteur C. jejuni and C. coli type strains, but these groups could not be clearly defined owing to the existence of strains with intermediate characteristics.Most of the strains from cattle resembled C. jejuni, whereas those from pigs resembled C. coli; poultry strains occupied a more intermediate position. Strains from man and other animals were of mixed types, but most human strains resembled C. jejuni rather than C. coli. The type distribution pattern that most nearly matched that of human indigenous strains was given by a half-and-half mixture of strains from cattle and poultry.
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Bacterial, nonnecrotizing cellulitis is a localized and often recurrent infection of the skin. The aim of this study was to identify the beta-hemolytic streptococci that cause acute nonnecrotizing cellulitis infection in Finland.
A case-control study of 90 patients hospitalized for acute cellulitis and 90 control subjects was conducted during the period of April 2004-March 2005. Bacterial swab samples were obtained from skin lesions or any abrasion or fissured toe web. Blood culture samples were taken for detection of bacteremia. The patients, their household members, and control subjects were assessed for pharyngeal carrier status. beta-Hemolytic streptococci and Staphylococcus aureus were isolated and identified, and group A and G streptococcal isolates were further analyzed by T serotyping and emm and pulsed-field gel electrophoresis typing.
beta-Hemolytic streptococci were isolated from 26 (29%) of 90 patients, 2 isolates of which were blood-culture positive for group G streptococci, and 24 patients had culture-positive skin lesions. Group G Streptococcus (Streptococcus dysgalactiae subsp. equisimilis) was found most often and was isolated from 22% of patient samples of either skin lesions or blood, followed by group A Streptococcus, which was found in 7% of patients. Group G streptococci were also carried in the pharynx of 7% of patients and 13% of household members but was missing from control subjects. Several emm and pulsed-field gel electrophoresis types were present among the isolates. Six patients (7%) had recurrent infections during the study. In 2 patients, the group G streptococcal isolates recovered from skin lesions during 2 consecutive episodes had identical emm and pulsed-field gel electrophoresis types.
Group G streptococci, instead of group A streptococci, predominated in bacterial cellulitis. No clear predominance of a specific emm type was seen. The recurrent nature of cellulitis became evident during this study.
The adherence of Escherichia coli to human uroepithelial cells obtained from midstream urine specimens of healthy women was studied. Bacteria labeled with [(3)H]uridine were used, and unattached organisms were separated from the epithelial cells by vacuum filtration with 5-mum-pore-size Nucleopore membrane filters. These techniques allowed adherence to be measured in large numbers of epithelial cells and overcame the problem of distinguishing experimental bacteria from the indigenous organisms present on uroepithelial cells. Adherence was not appreciably affected by temperature. Adherence was maximal at pH 4 to 5 and at bacterial-to-epithelial-cell ratios of 5,000 or more. The latter observation suggested that there are a limited number of receptors on the epithelial cell surface, an idea which was supported by competition experiments. Adherence occurred within 1 min and then decreased gradually or quickly, depending on the type of bacterial growth medium, to a stationary level of adherence, approximately 50% of that observed initially. The ability of epithelial cells from a single individual to bind E. coli varied in a cyclical and repetitive pattern. Adherence tended to be higher during the early phase of the menstrual cycle and diminished shortly after the time of expected ovulation; adherence frequently correlated with the value obtained on the same day of the menstrual cycle during the preceding months. Adherence was markedly enhanced by bacterial incubation in broth for 72 h and inhibited by alpha-d-mannose. These results suggest that adherence is a complex phenomenon perhaps mediated in part by bacterial pili and mannose residues on uroepithelial cells.
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The inotropic effects of noradrenaline (10(-7)-10(-5) M) and acetylcholine (10(-8)-10(-6) M) were studied in experiments carried out on preparations of the right atria and on papillary muscles of the right ventricle in adult (4-5 months) and old (18-24 months) guinea pigs. An age-related decrease in inotropic noradrenaline effects and the displacement of dose-effect relationships to the right was revealed. Similar changes of the dose-related effects of acetylcholine superfused against the background of noradrenaline action were observed. The direct inotropic action of the acetylcholine did not change with ageing. A lack of the essential atrial-ventricular differences in age-related changes in myocardial reactivity is apparently very significant for support of effective functional coupling of cardiac chambers in ageing.
Results of a comparative study of growth properties of elaborated nutrient medium VLACON and traditional Lovenshtein-Jensen medium are presented in the paper. It is established, that the rate of mycobacterium growth on VLACON medium is 10-20 times higher than on the traditional nutrient medium. Mycobacteria preserve their tinctorial, cultural and pathogenic properties during the cultivation on VLACON medium. Besides, the possibility of use of agglutination reaction with further coloring and microscopy of agglutinates for the accelerated differentiation of human and bull mycobacterium species from the bird species and atypical mycobacteria is shown.
Purified chlamydial bodies were solubilized by detergent solutions used in the following sequence: 1) 1% sarcosil, 2) 1% sarcosil + 10 mM dithiotreitol, 3) 2% sodium dodecyl sulfate + 10 mM dithiotreitol. After the third stage a good yield of protein, corresponding to major outer membrane protein as to its molecular weight and antigenic properties was obtained.