Investigating causal relationships between the gut microbiota and inflammatory skin diseases: A Mendelian randomization study.

BACKGROUND: Numerous inflammatory skin diseases are associated with the gut microbiota. Studies of the association between gut microbiota and inflammatory skin diseases have yielded conflicting results owing to confounding factors, and the causal relationship between them remains undetermined. METHODS: Two-sample Mendelian randomization (MR) was used to examine the association between gut microbiota and four common inflammatory skin diseases: acne, psoriasis, urticaria and atopic dermatitis. The summary statistics of the gut microbiota from the largest available genome-wide association study meta-analysis (n = 13,266) conducted by the MiBioGen consortium along with the summary statistics of the four diseases were obtained from the FinnGen consortium. Causal relationships were assessed using the inverse variance weighted (IVW), weighted median, MR-Egger and maximum likelihood methods, and several sensitivity analyses were performed to ensure the accuracy of the results. Finally, reverse and multivariable MR analyses were performed to verify the robustness of the results. RESULTS: We found causal associations of Bacteroidaceae [odds ratio (OR), 2.25; 95% confidence interval (CI), 1.48-3.42; pivw = 0.0001], Allisonella (OR, 1.42; 95% CI, 1.18-1.70; pivw = 0.0002) and Bacteroides (OR, 2.25; 95% CI, 1.48-3.42; pivw = 0.0001) with acne, the Eubacterium fissicatena group with psoriasis (OR, 1.22; 95% CI, 1.10-1.35; pivw = 0.0002) and Intestinibacter with urticaria (OR, 1.28; 95% CI, 1.13-1.45; pivw = 0.0001). These results were corrected for a false discovery rate. Sensitivity analyses were performed to validate the robustness of the associations and reverse MR confirmed that the results were not influenced by the reverse effect. CONCLUSION: Our study revealed that some gut microbiota are risk factors for inflammatory skin diseases, providing new information on potential therapeutic targets. Additionally, a possible association with the gut-skin axis was confirmed. Further research is required to elucidate the mechanisms underlying these relationships.

ALA-PDT combined with 2940 nm ablative fractional Er:YAG laser for Darier's disease.

Darier's disease is a rare, genetically determined dyskeratotic skin disorder. Although many conventional treatments have been reported, management of Darier's disease remains challenging. Most patients are at high risk of recurrence during long-term follow-up. Here, we present two patients who were successfully treated with ALA photodynamic therapy (PDT) and ablative 2940 nm Er:YAG fractional laser. Both patients exhibited significant improvements in the affected areas with moderate pain, transient erythema and edema. Remission durations of up to 2 years were observed in both patients after combination treatment. Our findings suggest that the combination of ALA-PDT and 2940 nm fractional Er:YAG laser may be an effective, safe and well-tolerated treatment option for Darier's disease.

Topical 5-aminolevulinic acid photodynamic therapy for recalcitrant facial flat warts.

Photodynamic therapy (PDT) uses light energy to excite a photosensitizing agent, leading to production of reactive oxygen species, which exert cytotoxic effects on targeted cells. PDT has emerged as a promising therapeutic modality for the treatment of flat warts caused by human papillomavirus (HPV) infection, by targeting infected keratinocytes and inactivating nonenveloped viral particles. Some patients with recalcitrant flat warts on the face who have poor response to traditional treatment often seek effective therapy to have the warts removed. In this report, we retrospectively evaluated the efficacy of topical 10% 5-aminolevulinic acid PDT (ALA-PDT) in the treatment of 15 patients with recalcitrant facial flat warts. Patients received treatment once every two weeks for a total of two or three sessions. At 24 weeks after the start of treatment, 86.67% of patients showed complete or excellent response. Further more, the remission rate of 100% lesion clearance was 46.67% (seven patients), and the remission rate of 70-100% lesion clearance was 40.00% (six patients). None of the patients experienced disease recurrence or progression. The adverse reactions were generally well tolerated by the patients and mostly resolved in a few days without special treatment. Our findings showed that topical 10% ALA-PDT is a safe and effective treatment for recalcitrant facial flat warts.

Fangji Dihuang formulation ameliorated DNCB-induced atopic dermatitis-like skin lesions by IL-17 signaling pathway: integrating network analysis and experimental validation.

Background: The Fangji Dihuang formulation (FJDHF) is a widely recognized Traditional Chinese Medicine (TCM) formula that consists of five plant drugs: Stephaniae Tetrandrae Radix, Cinnamomi Ramulus, Rehmanniae Radix, Saposhnikoviae Radix, and Glycyrrhiza Urensis Fisch. This formulation has been known to exhibit clinical therapeutic effects in the treatment of inflammatory skin diseases. However, there is a lack of pharmacological research on its anti-atopic dermatitis (AD) activity. Methods: To investigate the potential anti-AD activity of FJDHF, DNCB was used to induce AD-like skin inflammation in the back of mice. Following successful modeling, the mice were administered FJDHF orally. The extent of the inflammatory skin lesions was recorded at day 4, 7, 14 and 28. UHPLC-Q-Exactive Orbitrap MS was used to identify and match the compounds present in FJDHF with ITCM, TCMIP and TCMSID. In silico predictions of potential target proteins of the identified compounds were obtained from SwishTargetPrediction, ITCM and TargetNet databases. AD-related genes were identified from GSE32924 data set, and FJDHF anti-AD hub genes were identified by MCODE algorithm. ClueGo enrichment analysis was employed to identify the core pathway of FJDHF's anti-AD effect. To further investigate the anti-AD effect of FJDHF, single-cell RNA sequencing data set (GSE148196) from AD patients was analyzed to determine the target cells and signaling pathways of FJDHF in AD. Finally, rt-PCR, flow cytometry, and mouse back skin RNA sequencing were utilized to validate our findings. Results: FJDHF was found to be effective in improving the degree of the AD-like lesions in the mice. Network pharmacological analysis revealed the core pathway of FJDHF to be the IL-17 signaling pathway, which is interactively associated with cytokines. Single-cell RNA sequencing analysis suggested that FJDHF may play an anti-AD role by influencing dendritic cells. Flow cytometry and rt-PCR results showed that FJDHF can reduce the influence of AD sample of IL-4, IFN-γ and the expression of IL-17. The RNA sequencing of mouse back skin also confirmed our conclusion. Conclusion: FJDHF may inhibit DNCB-induced AD-like skin inflammation in mice by inhibiting the IL-17 signaling pathway. Thus, FJDHF can be considered as a potential therapeutic agent for AD.

First Report of Leaf blight Caused by Stagonosporopsis citrulli on Garden Geranium in China.

Garden geranium (Pelargonium × hortorum L.H. Bailey, Geraniaceae) is a popular ornamental plant cultivated worldwide, whose extracts are used in cosmetics and medicine (Jugulam et al. 2001). On the University of Electronic Science and Technology of China campus (Chengdu, China), leaf blight on the garden geranium was observed during April-September 2021. The average disease incidence was around 40%-50%, which caused severe loss of ornamental value. Initially, circular, brown necrotic areas appear on the margin of the leaves. In the advanced stage of infection, lesions may enlarge rapidly, become irregular in shape, with the central portion of the lesion falling out and defoliation. To isolate the pathogen, symptomatic tissues obtained from diseased leaves were surface-sterilized for 1 min with 0.3% NaClO, rinsed in sterile distilled water, and plated onto potato dextrose agar (PDA). The inoculated plates were incubated for 7 days at 25°C. Successively, pure cultures were obtained by transferring hyphal tips to new PDA plates. A total of 20 isolates were obtained across 25 garden geranium plants investigated. The colonies on the PDA plates reached a diameter of 60-70 mm after 10 days at 25°C, spreading with a regular margin, aerial mycelium white, and black mycelia on the undersides cottony and solitary and globose pycnidia were produced after ten days. Conidia were either cylindrical or short cylindrical, hyaline 4-11 µm × 2-5 µm. These morphologies corresponded to those of Stagonosporopsis species. Sequence data for the 28S nrDNA, the internal transcribed spacer, ß-tubulin, and RNA polymerase II subunit (White et al. 1990, Liu et al. 1999, Aveskamp et al. 2009) were obtained randomly for one of the pure isolates (P1-L4-1-L1-1), which resulted in the GenBank accession numbers ON667723, ON667722, ON677462, and ON677463, respectively. The RAxML analysis (Stamatakis 2014) of the combined sequence data of the isolate P1-L4-1-L1-1 and the reference sequences obtained from GenBank demonstrated that the isolate P1-L4-1-L1-1 formed a strongly support clade with the type isolates (C5-5) of Stagonosporopsis citrulli M.T. Brewer & J.E. Stewart, which has been found on cucurbits (Stewart et al. 2015). The procedure for Koch's postulates was followed to confirm fungal pathogenicity using 4-day-old mycelial disks. A total of 15 same-aged healthy leaves were divided into three groups, and each group received a different treatment. Artificial wounds were created on one group of leaves using a sterile pin, and a 5-mm mycelial plug of the fungus was placed on the injured tissues. Mycelial plugs were also placed on the surfaces of the sets of unwounded leaves. The remaining leaves were maintained as control and inoculated with sterile PDA plugs. The test was repeated three times. Both the wounded and non-wounded leaves exhibited symptoms after 4-9 days identical to those observed in the field. The control group remained asymptomatic, and the morphology of the fungus reisolated from the inoculated leaves was similar to that of S. citrulli. The phylogeny, together with morphological identification and inoculation results, confirmed the identity of the pathogen on garden geranium as S. citrulli. To our knowledge, this is the first report of leaf spot caused by S. citrulli in the garden geranium in the world. Our results may help to provide crucial information for studying the epidemiology and management of this disease.

A Survey of Chinese Pig Farms and Human Healthcare Isolates Reveals Separate Human and Animal Methicillin-Resistant Staphylococcus aureus Populations.

There has been increasing concern that the overuse of antibiotics in livestock farming is contributing to the burden of antimicrobial resistance in people. Farmed animals in Europe and North America, particularly pigs, provide a reservoir for livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA ST398 lineage) found in people. This study is designed to investigate the contribution of MRSA from Chinese pig farms to human infection. A collection of 483 MRSA are isolated from 55 farms and 4 hospitals in central China, a high pig farming density area. CC9 MRSA accounts for 97.2% of all farm isolates, but is not present in hospital isolates. ST398 isolates are found on farms and hospitals, but none of them formed part of the "LA-MRSA ST398 lineage" present in Europe and North America. The hospital ST398 MRSA isolate form a clade that is clearly separate from the farm ST398 isolates. Despite the presence of high levels of MRSA found on Chinese pig farms, the authors find no evidence of them spilling over to the human population. Nevertheless, the ST398 MRSA obtained from hospitals appear to be part of a widely distributed lineage in China. The new animal-adapted ST398 lineage that has emerged in China is of concern.

Photodynamic therapy with methyl-5-aminolevulinate for basal cell carcinoma: A systematic review and meta-analysis.

BACKGROUND: Basal cell carcinoma (BCC) is the most common type of non-melanoma skin cancer worldwide. Methyl-5-aminolevulinate (MAL) photodynamic therapy (PDT) is an effective and acceptable treatment for BCC. The purpose of this analysis was to compare the benefit and tolerability of MAL-PDT with other modalities for the treatment of BCC. METHODS: PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched from inception until 5 August 2019. Eligible studies were prospective and retrospective clinical trials of MAL-PDT for superficial and nodular BCC. At least one of the following outcomes were reported: complete response (CR) at 3 months and sustained at 12 months; recurrence at 12 months and sustained at 5 years; cosmetic outcome at ≥ 3 months; adverse events. RESULTS: From 427 search results, 11 articles including seven randomized controlled trials (1339 patients; 1568 lesions) and one retrospective study (108 lesions) were eligible. CR was inferior with MAL-PDT versus surgery (3 months: Risk Ratio [RR]: 0.93, 95 % confidence interval [CI] 0.89-0.97, p = 0.002; 12 months: RR: 0.90, 95 % CI 0.85-0.95, p = 0.0002). Moreover, MAL-PDT had higher 12 months recurrence rate (RR: 10.43, 95 % CI 1.98-55.03, p = 0.006) and more toxicities (RR: 2.12, 95 % CI 1.46-3.09, p < 0.0001) in comparison with surgery. However, MAL-PDT cosmesis was superior to excisional surgery (RR: 1.99, 95 % CI 1.50-2.63, p < 0.00001). Additionally, MAL-PDT was associated with similar CR in comparison with 5-aminolaevulinic acid (ALA)-PDT and ALA nanoemulsion (BF-200 ALA)-PDT, but had higher recurrence rate at 12 months and worse cosmesis compared with BF-200 ALA-PDT, even though the differences were not statistically significant. CONCLUSION: MAL-PDT might not be the best first-line treatment option for BCC, although cosmetic outcome could be good-to-excellent.

Efficacy and safety of photodynamic therapy with amino-5-laevulinate nanoemulsion versus methyl-5-aminolaevulinate for actinic keratosis: A meta-analysis.

BACKGROUND: Photodynamic therapy is an effective treatment for actinic keratosis. 5-aminolevulinic acid nanoemulsion (BF-200 ALA) and methyl-5-aminolevulinate (MAL) are both prodrugs for the treatment of actinic keratosis with photodynamic therapy. A comparison of the efficacy and safety between the drugs is critical for clinical practice. OBJECTIVES: To investigate if photodynamic therapy in combination with BF-200 ALA is superior to photodynamic therapy with MAL for actinic keratosis. METHODS: We performed a meta-analysis to investigate the combination of photodynamic therapy with BF-200 ALA and with MAL. The PubMed, Cochrane Library, Web of Science and EMBASE databases were searched to select eligible randomized controlled trials. Our search was conducted on April 1, 2019, and included the search terms "5-aminolevulinic acid nanoemulsion or BF-200 ALA", "methyl-5-aminolevulinate or methyl aminolaevulinate" and "actnic keratosis". Cochrane Risk of Bias Tool was used to estimate the risk of bias. RESULTS: The meta-analysis consisted of 5988 actinic keratosis lesions in five eligible randomized controlled trials, with a total of 2953 actinic keratosis lesions treated with BF-200 ALA and 3035 actinic keratosis lesions treated with MAL. BF-200 ALA in combination with photodynamic therapy showed significantly higher overall complete clearance rates (RR: 1.07, 95% CI 1.02-1.12, p = 0.01) and 3 month complete clearance rates (RR: 1.09, 95% CI 1.06-1.12, p < 0.00001) compared to MAL. A subgroup analysis was performed for photodynamic therapy combined with BF-200 ALA, revealing increased complete clearance rates of grade II-III lesions in comparison with MAL (RR: 1.24, 95% CI 1.05-1.46, p = 0.01). Compared with MAL, the pooled relative risk for the meta-analysis for recurrence was 0.67 (95% CI 0.48-0.92, p = 0.01) at 12 month after BF-200 ALA treatment. CONCLUSION: Photodynamic therapy with BF-200 ALA has a 9% better chance of complete clearance at 3 months and a 24% better chance of grade II-III lesions after treatment than with MAL for patients with actinic keratosis.

International Society of Human and Animal Mycology (ISHAM)-ITS reference DNA barcoding database--the quality controlled standard tool for routine identification of human and animal pathogenic fungi.

Human and animal fungal pathogens are a growing threat worldwide leading to emerging infections and creating new risks for established ones. There is a growing need for a rapid and accurate identification of pathogens to enable early diagnosis and targeted antifungal therapy. Morphological and biochemical identification methods are time-consuming and require trained experts. Alternatively, molecular methods, such as DNA barcoding, a powerful and easy tool for rapid monophasic identification, offer a practical approach for species identification and less demanding in terms of taxonomical expertise. However, its wide-spread use is still limited by a lack of quality-controlled reference databases and the evolving recognition and definition of new fungal species/complexes. An international consortium of medical mycology laboratories was formed aiming to establish a quality controlled ITS database under the umbrella of the ISHAM working group on "DNA barcoding of human and animal pathogenic fungi." A new database, containing 2800 ITS sequences representing 421 fungal species, providing the medical community with a freely accessible tool at http://www.isham.org/ and http://its.mycologylab.org/ to rapidly and reliably identify most agents of mycoses, was established. The generated sequences included in the new database were used to evaluate the variation and overall utility of the ITS region for the identification of pathogenic fungi at intra-and interspecies level. The average intraspecies variation ranged from 0 to 2.25%. This highlighted selected pathogenic fungal species, such as the dermatophytes and emerging yeast, for which additional molecular methods/genetic markers are required for their reliable identification from clinical and veterinary specimens.

[Efficacy observation on fire needling therapy for moderate to severe acne vulgaris].

OBJECTIVE: To compare the efficacy differences between fire needling therapy and oxycycline tablets for the treatment of moderate to severe acne vulgaris. METHODS: Sixty cases of moderate to severe acne vulgaris were randomly divided into a fire needling group and a medication group, 30 cases in each one. The pricking method of fire needling at Ashi points around damaged skin was applied in the fire needling group, once every five days for totally 4 times. The oral administration of oxycycline tablets, 100 mg, was applied in the medication group, twice daily for 20 days, also external application of adapalene gel before sleep was adopted. The fading time of skin damage, including papule, pustule, nodule and cyst in the two groups was recorded and clinical efficacy was compared. After the treatment, two-month follow-up was performed to observe the recurrence rate in the two groups. RESULTS: The curative rate was 69.0% (20/29) in the fire needling group, which was statistically different from 40.0% (12/30) in the medication group (P < 0.05). The fading time of each type of skin damage in the fire needling group was shorter than that in the medication group [papule: (2.67 +/- 0.66) d vs (4.36 +/- 0.61) d; pustule: (2.47 +/- 0.57) d vs (4.27 +/- 0.55) d; nodule: (7.76 +/- 1.06) d vs (9.88-1.30) d; cyst: (11.81 +/- 1.54) d vs (14.79 +/- 0.89) d, all P < 0.05]. The recurrence rate was 46.4% (13/28) in the fire needling group, which was not significantly different from 44.0% (11/24) in the medication group (P > 0.05). CONCLUSION: The acne vulgaris could be fast and effectively treated by fire needling therapy, which has shorter fading time than oxycycline tablets. However, the preventive effect is not different between the two theraies.

Distributed dictionary learning for sparse representation in sensor networks.

This paper develops a distributed dictionary learning algorithm for sparse representation of the data distributed across nodes of sensor networks, where the sensitive or private data are stored or there is no fusion center or there exists a big data application. The main contributions of this paper are: 1) we decouple the combined dictionary atom update and nonzero coefficient revision procedure into two-stage operations to facilitate distributed computations, first updating the dictionary atom in terms of the eigenvalue decomposition of the sum of the residual (correlation) matrices across the nodes then implementing a local projection operation to obtain the related representation coefficients for each node; 2) we cast the aforementioned atom update problem as a set of decentralized optimization subproblems with consensus constraints. Then, we simplify the multiplier update for the symmetry undirected graphs in sensor networks and minimize the separable subproblems to attain the consistent estimates iteratively; and 3) dictionary atoms are typically constrained to be of unit norm in order to avoid the scaling ambiguity. We efficiently solve the resultant hidden convex subproblems by determining the optimal Lagrange multiplier. Some experiments are given to show that the proposed algorithm is an alternative distributed dictionary learning approach, and is suitable for the sensor network environment.

A combined assay of hTERT and E6 oncoprotein to identify virus-infected keratinocytes with higher telomerase activity in human papillomaviruses 16 and 18-related bowenoid papulosis.

In the present study, we aim to evaluate the application potential of a combined assay of human telomerase reverse transcriptase (hTERT) and E6 oncoprotein in screening the virus-infected keratinocytes with higher telomerase activity in human papillomaviruses (HPV) 16- and 18-related bowenoid papulosis (BP). HPV16/18 DNA in BP (n = 123) was identified by in situ hybridization, the expression of hTERT and E6 in HPV16/18-related BP (n = 68) was determined by immunohistochemistry. We demonstrated that the expression of hTERT correlated well with that of E6 oncoprotein in HPV16/18-related BP lesions (Spearman rho = 0.868, P < 0.01). Furthermore, the majority of keratinocytes with positive nuclear staining for hTERT or E6 in the consecutive sections of each HPV16/18-related BP lesion showed nuclear paleomorphism or nuclear mitosis. In conclusion, we suggested that a combined assay of hTERT and E6 oncoprotein can be used to screen the HPV-infected keratinocytes with higher telomerase activity in HPV16-related and HPV18-related BP lesions.

Agar dilution method for detection of inducible clindamycin resistance in Staphylococcus spp.

We describe the development and validation of an agar dilution method for the detection of inducible clindamycin resistance by using 227 previously characterized erythromycin-resistant, clindamycin-susceptible Staphylococcus sp. isolates. Mueller-Hinton agar with defibrinated horse blood containing a range of erythromycin concentrations (1 to 8 mg/liter) combined with clindamycin at 0.5 mg/liter was used to determine the optimal concentration that produced growth of inducible isolates while inhibiting that of isolates without the inducible phenotype. A concentration of clindamycin of 0.5 mg/liter with erythromycin at 1 mg/liter was the optimal combination for detection of inducible resistance and resulted in a sensitivity of 100% (95% confidence interval [CI], 97.9 to 100) and a specificity of 100% (95% CI, 93.0 to 100). Attention must be paid to ensuring that a sufficient inoculum has been used, since an inoculum below the standard 10(7) bacteria/ml may result in false-negative results. This method has been incorporated into routine use in our laboratory.

Comparison of single- and multilocus sequence typing and toxin gene profiling for characterization of methicillin-resistant Staphylococcus aureus.

We compared three novel methicillin-resistant Staphylococcus aureus (MRSA) genotyping methods with multilocus sequence typing (MLST) and spa typing to assess their utility for routine strain typing. The new methods were femA and nuc sequence typing and toxin gene profiling (TGP), using a multiplex-PCR-based reverse line blot assay to detect 13 pyrogenic superantigen and exfoliative toxin genes. Forty-two well-characterized MRSA strains, representing 15 MLSTs or 9 clonal clusters (CCs), were genotyped by all methods. Twenty-two spa, nine femA, and seven nuc sequence types were identified. The femA sequence types correlated exactly with CCs; nuc sequences types were less discriminatory but generally correlated well with femA types and CCs. Ten isolates contained none of 13 toxin genes; TGPs of the remainder comprised 1 to 5 toxin genes. The combination of spa typing and TGPs identified 26 genotypes among the 42 strains studied. A combination of two or three rapid, inexpensive genotyping methods could potentially provide rapid MRSA strain typing as well as useful information about clonal origin and virulence.

Reverse line blot hybridization assay for identification of medically important fungi from culture and clinical specimens.

We evaluated a combined panfungal PCR-reverse line blot (RLB) hybridization assay based on internal transcribed spacer 1 (ITS1) and ITS2 region polymorphisms to identify 159 Candida, Cryptococcus neoformans, and Aspergillus isolates (22 species). Its utility to identify fungal pathogens directly from 27 clinical specimens was also determined. ITS sequence analysis was performed to resolve discrepant identifications or where no RLB result was obtained. Species-specific ITS2- and ITS1-based probes correctly identified 155 of 159 isolates (98%) and 149 (93.7%) isolates, respectively. All strains were unambiguously differentiated with the exception of cross-reactivity between the Candida norvegensis probe and Candida haemulonii DNA product. Species identification of the pathogen was made for all 21 specimens (sensitivity of 100%) where species-specific probes were included in the RLB; however, there was no ITS2 probe-based hybridization signal for two specimens. Results were concordant with the culture results for 18 (85.7%) specimens. The assay was able to provide species identification in the absence of a culture result (two specimens) and to detect mixed infection (one specimen). The results indicate that the RLB assay is capable of reliably detecting yeasts and Aspergillus spp. in clinical specimens and that the incorporation of both ITS1- and ITS2-targeted probes is required for optimal sensitivity. The test has potential utility in the early diagnosis of invasive fungal infection, since "fungal" DNA was detected in all 27 specimens. Prior to incorporation of probes to detect other fungal species, ITS sequencing may be performed to achieve species identification.

A practical method for subtyping of Streptococcus agalactiae serotype III, of human origin, using rolling circle amplification.

Group B streptococcus (GBS; Streptococcus agalactiae) serotype III is one of the most common and virulent serotypes of the species. It can be divided into several subtypes, which vary in their distribution among invasive isolates from different patient groups. In this study, we used 91 well-characterized GBS serotype III isolates to compare three subtyping methods, and developed a novel padlock probe and rolling circle amplification (RCA) method to identify informative single nucleotide polymorphisms (SNPs) that define the major subtypes. There was good agreement between partial sequencing of the capsule polysaccharide synthesis (cps) gene cluster, a 3-set genotyping system and multilocus sequence typing (MLST). Serosubtype III-2/multilocus sequence type (ST)-17 represents a virulent clone which is significantly associated with late onset GBS neonatal infections. RCA provides a simple, reproducible method for rapid identification of the two most common GBS serotype III subtypes (III-1/ST-19 and III-2/ST-17).

Evaluation of a multiplex PCR-based reverse line blot-hybridization assay for identification of serotype and surface protein antigens of Streptococcus agalactiae.

A 33-primer multiplex PCR-based reverse line blot (mPCR/RLB) assay was developed to identify Streptococcus agalactiae serotypes and surface protein antigen genes simultaneously. It was evaluated by using 551 clinical isolates. The mPCR/RLB assay was more sensitive than conventional serotyping, especially for protein antigen typing, but otherwise the results correlated well.

Influence of disk separation distance on accuracy of the disk approximation test for detection of inducible clindamycin resistance in Staphylococcus spp.

We undertook this study to assess the accuracy of the clindamycin-erythromycin disk approximation test (D-test) for detection of inducible clindamycin resistance in Staphylococcus spp. One hundred sixty-three Staphylococcus aureus and 68 coagulase-negative Staphylococcus (CoNS) spp. which were erythromycin nonsusceptible but clindamycin susceptible were tested using the D-test performed at both 15-mm and 22-mm disk separations and compared with genotyping as the "gold standard." The rate of inducible clindamycin resistance was 96.3% for S. aureus and 33.8% for CoNS spp. The sensitivities of the D-tests performed at 15 mm and 22 mm were 100% and 87.7%, respectively, and specificities were 100% for both. The use of 22-mm disk separation for the D-test to detect inducible clindamycin resistance results in an unacceptably high very major error rate (12.3%). All isolates with false-negative results harbored the ermA gene, and the majority were methicillin-resistant Staphylococcus aureus. False-negative results were associated with smaller clindamycin zone sizes and double-edged zones. We recommend using a disk separation distance of

Molecular serotype identification of Streptococcus agalactiae of bovine origin by multiplex PCR-based reverse line blot (mPCR/RLB) hybridization assay.

We used a multiplex PCR-based reverse line blot (mPCR/RLB) hybridization assay and sequencing of a variable region of the cps cluster to identify serotypes of 140 Streptococcus agalactiae (group B Streptococcus; GBS) isolates from cattle. Only 71 (51%) isolates were typeable using antisera, but molecular serotypes (MS) were assigned to 133 (95%) and 139 (99%) isolates by partial cpsE-cpsF-cpsG sequencing and mPCR/RLB, respectively. Ninety-four isolates (67%) belonged to MS III and most belonged to a molecular serosubtype (msst) III-3, which is uncommon among GBS isolates from humans. Our results demonstrate that cps clusters of bovine GBS differ significantly from those of GBS isolates from humans.