Influence of optic and haptic materials on the adherence of Staphylococcus epidermidis to intraocular lenses: a pilot study.

To evaluate in vitro the adherence of Staphylococcus epidermidis to intraocular lenses (IOL) of different optic and haptic materials and design, we used a quantitative cultural method. Polymethylmethacrylate (PMMA), PMMA-prolene, polyHEMA, silicone and surface-modified PMMA (wet and dry) implants were tested. Adherence differed significantly in the various groups, with the best performance by all-PMMA IOL.

Fungal peritonitis in peritoneal dialysis: critical review of six cases.

Fungal peritonitis (FP) is uncommon in patients on peritoneal dialysis (PD); it is difficult to treat and has a high mortality rate. We report 6 cases of fungal peritonitis observed between 1980 and 1992 in our center. The etiologic agents were: Candida spp., C. guilliermondi, C. parapsilosis, C. albicans, and Verticillium spp. All 6 patients had suffered at least one episode of bacterial peritonitis in the two months before the fungal infection appeared and were all treated by intraperitoneal administration of antibiotics. The catheter was removed early in 3 patients followed by antimycotic therapy, while the remaining 3 patients received antimycotic therapy, with removal of the catheter in a later stage. The result in the first group was that they all switched permanently to hemodialysis, while in the second group there were 2 deaths and 1 transfer to hemodialysis. In the light of these 6 cases, we analyzed 22 published reports to assess risk factors, therapy, and outcome of this pathology. The major predisposing factors were intraperitoneal antibiotics and bacterial peritonitis, and the best results were obtained by continuing PD plus intraperitoneal and systemic antifungal agents.

[Systemic antimicrobial treatment of prosthesis related infections: a comparative study of ornidazole and minocycline. A microbiological evaluation and experimental protocol]. / La terapia antimicrobic sistemica delle perimplantiti mediante uso comparato di ornidazolo e minociclina. Valutazione microbiologica e protocollo sperimentale.

BACKGROUND: The aim of this study was to evaluate the efficacy of two chemotherapeutic agents against bacterial forms responsible for prosthesis-related infections. METHODS: The evaluation was made on the basis of a count using optical microscope 1000x after GRAM staining of the main bacterial forms found in periprosthetic inflammatory exudate both before and after treatment. Two drugs used: ornidazole and minocycline. A group of 20 patients were studied (12 women and 8 men) aged between 42 and 71 years old with an advanced stage of periprosthetic inflammatory pathology. The pharmacological protocol was administered to the two groups of patients for a period of approximately 15 days. RESULTS: At the end of treatment there was a marked reduction in all the bacterial forms involved in periprosthetic pathology in both groups, with a gradual recovery of normal bacterial flora (gram forms) coupled with a clinical improvement in the implant sites examined. CONCLUSIONS: Given the specificity of action shown by ornidazole against pathogenic anaerobic, gram-; bacteroides and sporigenic forms, it is recommended for systemic use against prosthesis-related inflammatory disease.

Evaluation of the HB&L System for the Microbiological Screening of Storage Medium for Organ-Cultured Corneas.

Aims. To compare HB&L and BACTEC systems for detecting the microorganisms contaminating the corneal storage liquid preserved at 31°C. Methods. Human donor corneas were stored at 4°C followed by preservation at 31°C. Samples of the storage medium were inoculated in BACTEC Peds Plus/F (aerobic microorganisms), BACTEC Plus Anaerobic/F (anaerobic microorganisms), and HB&L bottles. The tests were performed (a) after six days of storage, (b) end of storage, and (c) after 24 hours of preservation in deturgescent liquid sequentially. 10,655 storage and deturgescent media samples were subjected to microbiological control using BACTEC (6-day incubation) and HB&L (24-hour incubation) systems simultaneously. BACTEC positive/negative refers to both/either aerobic and anaerobic positives/negatives, whereas HB&L can only detect the aerobic microbes, and therefore the positives/negatives depend on the presence/absence of aerobic microorganisms. Results. 147 (1.38%) samples were identified positive with at least one of the two methods. 127 samples (134 identified microorganisms) were positive with both HB&L and BACTEC. 14 HB&L+/BACTEC- and 6 BACTEC+/HB&L- were identified. Sensitivity (95.5%), specificity (99.8%), and positive (90.1%) and negative predictive values (99.9%) were high with HB&L considering a 3.5% annual contamination rate. Conclusion. HB&L is a rapid system for detecting microorganisms in corneal storage medium in addition to the existing methods.

A family outbreak of Escherichia coli O157 haemorrhagic colitis caused by pork meat salami.

A family outbreak of Escherichia coli O157 infection was microbiologically associated with consumption of dry-fermented salami made with pork meat only and produced in a local plant. E. coli O157 strains isolated from a wife and husband, both hospitalized with bloody diarrhoea, and from the salami carried vt1, vt2 and eae genes and shared the same PFGE pattern. The food vehicle implicated in this outbreak is unusual because of both the animal species from which it originates and the fermentation and drying steps of the manufacturing process. This could be the first report of an outbreak associated with a product containing pork meat only. Even though sources of contamination other than pork meat could not be excluded, pork products should not be neglected in E. coli O157 outbreak investigations.

Serum beta-2-microglobulin level and residual renal function in peritoneal dialysis.

In 32 noncirrhotic patients on peritoneal dialysis, mean serum beta 2-microglobulin (s beta 2M) was 26.58 +/- 12.32 mg/l (9.7-63.5). We found a significant correlation between s beta 2M and serum creatinine (sCr; r = 0.760), blood urea nitrogen (BUN; r = 0.573), total creatinine and BUN clearance (r = 0.623 and 0.599, respectively), 24-hour Kt/V (r = 0.638), glomerular filtration rate (r = 0.623), 24-hour urine output (r = 0.669), serum total protein (r = 0.584) (p < 0.01 for all the above r values); beta 2M peritoneal clearance and mass transfer (r = 0.414 and 0.427, respectively; p < 0.05). Our data demonstrate and confirm the contribution of residual renal function in determining s beta 2M levels and it is seemingly more important than beta 2M peritoneal clearance.

Verticillium peritonitis in a patient on peritoneal dialysis.

We describe a case of peritonitis due to Verticillium spp. in a 33-year-old farmer on continuous ambulatory peritoneal dialysis (CAPD) for 3 months for end-stage renal failure due to chronic pyelonephritis. The etiologic agent was a hyaline hyphomycete which we report as a new human opportunistic pathogen. The fungus was isolated from the peritoneal fluid culture and from the tip of the catheter; identification was made on the basis of macroscopic and microscopic features. The patient had previously been admitted to our hospital for peritonitis caused by mixed enteric flora and treated for 8 days with intraperitoneal broad-spectrum antibiotic therapy. Five days after discharge he was readmitted for severe abdominal pain and cloudy drainage fluid. Two days of intraperitoneal broad-spectrum antimicrobial therapy produced no clinical improvement. Intravenous fluconazole and oral flucytosine were administered upon identifying the fungus. After another 2 days without improvement, peritoneal dialysis was discontinued and the catheter removed. Antimycotic therapy was continued for 4 days with complete resolution of the peritonitis. The patient chose to start hemodialysis and was discharged in good clinical condition.