Persistence of human T cell lymphotropic virus type 1 (HTLV-1) sequences in peripheral blood mononuclear cells from patients with mycosis fungoides.

Mycosis fungoides (MF) is a rare form of cutaneous T cell lymphoma suspected of having a viral etiology. As in adult T cell leukemia, the virus involved may be human T lymphotropic virus type 1 (HTLV-1). We cultured the peripheral blood mononuclear cells (PBMC) of 29 patients with MF HTLV-1 seronegative by enzyme-linked immunosorbent assay and Western blot. The presence of reverse transcriptase (RT) and p24 antigen was investigated in the concentrate supernatant of the culture. The DNA of all studied patients was submitted to polymerase chain reaction and Southern blot analysis using primers and probes recognizing the tax region of HTLV-1/2 and the pol region of HTLV-1. 10 of 29 patients were found positive to HTLV-1, whereas they were always negative to RT and p24. The same results were confirmed in double blind after 6 mo. Our findings suggest HTLV-1 may be involved in the etiology of MF, at least in certain cases.

Nosocomial infections in the rehabilitation department.

AIM: The patients of a Rehabilitation Department are at high risk of nosocomial infections because they generally have a long term hospitalisation and more and more frequently immune-compromised subjects, like old patients or with chronic illness, are admitted to rehabilitation programs. However, to evaluate the real infectious risk of a Rehabilitation Unit, it is important to consider also that a high number of patients are transferred from other hospitals after a specific therapy of the acute phase of their medical or surgical pathology and so many nosocomial microrganisms previously acquired may spread to a Rehabilitation Unit. METHODS: From January to December 2003 we have performed a screening of the bacteruria among the patients at admittance to the Rehabilitation Unit of S. Orsola Fatebenefratelli Hospital of Brescia (Italy). RESULTS: A significant bacteruria (>100000 cfu/mL) in 28.9% of 114 patients coming from home and in 41.9% of 179 patients transferred from other hospitals without antibacterial treatment has been documented. CONCLUSIONS: These findings confirm the presence of an high number of patients colonized or infected by nosocomial bacteria previously acquired in hospital and underline the need, in addition to specific skill, of wide infectious knowledge among the medical staff of a Rehabilitation Unit. A specific approach to the infectious problem in the Rehabilitation Department in order to reduce the risk of nosocomial infections may be suggested.

In vitro antibacterial activity of the new quinolone Bay y3118 against clinical isolates.

The in vitro antibacterial activity of the new fluoroquinolone Bay y3118 against 609 clinical isolates was evaluated. Bay y3118 exhibited activity against a broad spectrum of organisms, including Gram-negative bacilli, Gram-positive cocci, mycobacteria. The activity of Bay y3118 was often superior to that of other quinolones. Against Gram-negative bacilli its activity was similar to that of ceftriaxone, cefotaxime, ceftazidime and imipenem except for Serratia marcescens, Klebsiella pneumoniae, Enterobacter spp. and Xanthomonas maltophilia, where its activity was superior. Gentamicin and piperacillin sometimes were less active. Bay y3118 was active against a large number of Gram-positive cocci. The fluoroquinolones tested were active against all the strains of Mycobacterium tuberculosis, but only Bay y3118 was effective against Mycobacterium avium.

Comparison of the in vitro antibacterial activity of teicoplanin and vancomycin against gram-positive cocci.

The antibacterial activity of teicoplanin and vancomycin against 231 clinical isolates of staphylococci and enterococci was evaluated by standardized agar dilution testing. The two antibiotics showed similar activity against staphylococci. However teicoplanin was significantly more active against enterococci. Killing curves indicated that the bactericidal activity of teicoplanin at the concentration of 2 X MIC was equal to its activity at 8 X MIC.

Rufloxacin (MF-934): in vitro and in vivo antibacterial activity.

Rufloxacin (MF-934) is a new quinolone which shows in vitro antibacterial activity against E. coli, Salmonella, Klebsiella, Proteus and Staphylococcus spp. Lower in vitro activity was observed with Pseudomonas, Serratia, Enterobacter and the streptococci group D. The antimicrobial activity of MF-934 in vitro is higher than that of nalidixic acid but lower than that of ciprofloxacin, ofloxacin, pefloxacin or norfloxacin. The protective effects of MF-934 in systemic infections in mice are lower than those of ciprofloxacin and ofloxacin. In respiratory infections in rats and in subcutaneous infections in guinea-pigs, the protective effects of MF-934 are of the same order as ciprofloxacin and ofloxacin. This is probably due to the pharmacokinetic properties of MF-934, i.e. the long half-life and tissue concentrations higher than plasma levels.

Isolation of HTLV-1 from an aggressive form of ATL in a Romanian patient not at risk of infection and with seronegative family members.

We present the clinical, virological and haematochemical data of a 22 year old patient from Romania with Adult T Cell Leukaemia (ATL). Viral isolation in peripheral mononuclear blood cells (PMBC), detection of DNA sequences of HTLV-1 by Polymerase Chain Reaction (PCR) and of antibodies by Elisa and Western blot were performed. The patient does not belong to any risk group and additionally all members of her family are seronegative for HTLV-1, the aetiological agent of ATL. The role of viral infection remains open.

Rapid methods for microbial diagnosis of mycobacterial infections.

The Authors describe their experience in rapid diagnosis of mycobacterial infections using a combination of a radiometric blood culture (Bactec 13 A) and a nucleic acid hybridization system (Gen probe, Accuprobe) to detect and identify Mycobacteria. They found out that a high number of septicaemias in HIV positive patients are due to Mycobacterium avium, while in HIV negative subjects Mycobacterium tuberculosis is the most frequent mycobacterium.

HTLV-1 sequences in lymphocytes of a patient with non-tropical spastic tetraparesis and her asymptomatic husband.

We describe a 65-year-old woman born and living in Northern Italy affected by non tropical spastic tetraparesis and her asymptomatic husband presenting HTLV-1 sequences in their lymphocytes detected by polymerase chain reaction (PCR). We discuss the significance of the case and the mechanism involved in HTLV-1 infection and the relationship with neurological disorders, stressing that this case is the first reported in Italy.

[Laboratory diagnosis of idiopathic myelofibrosis. Review of the literature and presentation of 15 cases]. / Diagnostica di laboratorio della mielofibrosi idiopatica. Rassegna della letteratura e presentazione di quindici casi.

We report on 15 patients affected by myelofibrosis. The main clinical aspects were hepatosplenomegaly, anemia and leukocytosis. Immature cells and anisopoikilocytosis of the erythrocytes were frequently found in the peripheral blood. At bone biopsy, various aspects of panhyperplasia, increase in the reticular fibers, myeloid fibrosis and osteosclerosis were observed. Leukocyte alkaline phosphatase was frequently elevated. The clinical and laboratory course of the disease, causes of death and the possible etiopathogenetic aspects of this disease are considered and discussed.

[Usefulness of plasma cell acid phosphatase in the differential diagnosis of monoclonal gammopathies]. / Utilità della fosfatasi acida plasmacellulare nella diagnostica differenziale delle gammopatie monoclonali.

The acid phosphatase activity has been studied cytochemically in bone marrow plasma cells of 12 patients with multiple myeloma and 15 with non-myeloma plasmocytosis. The acid phosphatase activity has been significantly higher in the myeloma group. The utilization and usefulness of this cytochemical reaction for the diagnosis of multiple myeloma are proposed.

[Diagnostic cytochemistry of acute leukemias (author's transl)]. / Diagnostica citochimica di laboratorio delle leucemie acute.

We have described the principal haematological features of 35 cases of acute leukemias, showing the usefulness of cytochemical reactions for the purpose of a right diagnosis and prognosis. The PAS, Sudan Black B and Peroxidase reactions have been very important in the differential diagnosis between lymphoblastic and myeloblastic acute leukemias. The specific and non specific esterases reactions have been useful in the monocytic leukemias diagnosis.

[Laboratory diagnosis of acute monocytic leukaemias]. / Diagnostica di laboratorio delle leucemie monocitiche acute.

The haemathological features of nine patients with acute monocytic leukaemia are presented. The peripheral blood and bone marrow showed differentiated and apparently undifferentiated blasts. It was necessary to type these blast cells using cytochemical reaction for specific and unspecific esterases. It is very important to differentiate this variety of acute leukaemia from the other non limphoblastic leukaemias for different prognosis and therapeutic assays.

Antibacterial activity of the new carbapenem meropenem (SM-7338) against clinical isolates.

The in vitro antibacterial activity of the new carbapenem antibiotic meropenem (SM-7338) against 567 clinical isolates was evaluated. SM-7338 exhibited activity against a broad spectrum of organisms, including aerobes and anaerobes, and was superior to the other beta-lactam drugs tested (piperacillin, cefotaxime, ceftazidime, ceftriaxone, cefoxitin). SM-7338 was more active than imipenem, gentamicin and amikacin against Enterobacter cloacae and Pseudomonas aeruginosa. SM-7338 was less potent than imipenem against staphylococci and enterococci, but the activity of the two antibiotics against anaerobes was similar. SM-7338 and imipenem showed a high bactericidal activity at a concentration of 2-4 x MIC.