Virulence and antimicrobial resistance determinants of verotoxigenic Escherichia coli (VTEC) and of multidrug-resistant E. coli from foods of animal origin illegally imported to the EU by flight passengers.

The aim of this study was to reveal phenotype/genotype characteristics of verotoxigenic Escherichia coli (VTEC) and multidrug resistant E. coli in food products of animal origin confiscated as illegal import at Austrian, German and Slovenian airports. VTEC isolates were obtained by using ISO guidelines 16654:2001 for O157 VTEC or ISO/ TS13136:2012 for non-O157 VTEC, with additional use of the RIDASCREEN® Verotoxin immunoassay. The testing of 1526 samples resulted in 15 VTEC isolates (1.0%) primarily isolated from hard cheese from Turkey and Balkan countries. Genotyping for virulence by using a miniaturized microarray identified a wide range of virulence determinants. One VTEC isolate (O26:H46) possessing intimin (eae) and all other essential genes of Locus of Enterocyte Effacement (LEE) was designated as enterohemorrhagic E. coli (EHEC). None of the other VTEC strains belonged to serogroups O157, O145, O111, O104 or O103. VTEC strains harbored either stx(1) (variants stx1(a) or stx(1c)) or st(x2) (variants stx(2a), stx(2b), stx(2a/d) or stx(2c/d)) genes. Pulsed field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) demonstrated high genetic diversity and identified three new sequence types (STs): 4505, 4506 and 4507. Food samples collected from the Vienna airport were also tested for E. coli quantities using the ISO 16649:2001, and for detection of multidrug resistant phenotypes and genotypes. The resulting 113 commensal E. coli isolates were first tested in a pre-screening against 6 selected antimicrobials to demonstrate multidrug resistance. The resulting 14 multidrug resistant (MDR) E. coli isolates, representing 0.9% of the samples, were subjected to further resistance phenotyping and to microarray analyses targeting genetic markers of antimicrobial resistance and virulence. Genotyping revealed various combinations of resistance determinants as well as the presence of class 1, class 2 integrons. The isolates harbored 6 to 11 antibiotic resistance genes as well as 1 to 14 virulence genes. In this panel of 14 MDR E. coli two strains proved to carry CTX-M type ESBLs, and one single isolate was identified as enteropathogenic E. coli (EPEC). In general, isolates carrying a high number of resistance determinants had lower number of virulence genes and vice versa. In conclusion, this first pilot study on the prevalence of VTEC and of MDR/ESBL E. coli in illegally imported food products of animal origin suggests that these strains could represent reservoirs for dissemination of potentially new types of pathogenic and MDR E. coli in Europe.

[Accumulated occurrence of illnesses with Salmonella enteritidis in hospitals and nursing homes in the district Oberallgaeu, Bavaria, in July 2004]. / Gehäuftes Auftreten von Erkrankungen mit Salmonella Enteritidis in Krankenhäusern und Altenheimen im Landkreis Oberallgäu (Bayern) im Juli 2004.

We report on the investigation of a Salmonella enteritidis outbreak in hospitals and nursing homes in the district Oberallgaeu, Bavaria, in July 2004. Affected by this outbreak were hospital patients, inhabitants of nursing homes, kitchen coworkers and maintenance personnel. Within this outbreak six deaths were observed. A forensic medical investigation of four deaths revealed two cases of Salmonella enteritis as the primary cause of death, another cause of death was due to other causes and one cause of death remained unclear. The microbiological investigation of stool samples linked all positive samples to an outbreak during this period. The epidemiological outbreak curve pointed towards a foodborne transmission of the pathogen. The infection period could be limited to the weekend of the 3./4.7.2004. All affected institutions were supplied by a catering service with several sites. All tested food samples were negative for Salmonella enteritis. Epidemiological investigations revealed that a contaminated pudding was probably responsible for the outbreak.

Evidence of a charge-density threshold for optimum efficiency of biocidal cationic surfaces.

The deposition of organic monolayers containing quaternary ammonium groups has been shown by many authors to confer biocidal properties on a large variety of solid surfaces. In a search for the controlling factors, the authors have grafted quaternized poly(vinylpyridine) chains on glass surfaces by two different methods and varied the charge density within the organic layer between 10(12) and 10(16) positive charges per cm2. The measurements show that this parameter has a large influence on the killing efficiency. Bacterial death occurs in less than 10 min in the quiescent state above a threshold value. The value is smaller for bacteria in the growth state. It also depends on the bacterial type. An electrostatic mechanism based on the exchange of counterions between the functionalized cationic surface and the bacterial membrane is proposed and appears consistent with the results.

Gold-nanoparticle-assisted oligonucleotide immobilisation for improved DNA detection.

Colloidal gold nanoparticles are investigated as a potential scaffold for the assisted immobilisation of probe oligonucleotides on silicon surfaces. A preliminary study is devoted to the examination of the immobilisation of DNA-modified gold nanoparticles as a function of time, concentration, salt and pH. The DNA-modified nanoparticles self-assembled onto solid surfaces in a three-dimensional self-assembled architecture. The functionalised surfaces are evaluated in diagnostic assays, where their potential to improve the efficiency of the hybridisation reaction is tested. The system utilising DNA-modified nanoparticles produced an enhancement in the hybridisation efficiency and the sensitivity limit by a factor 10 to 100 as compared to a conventional DNA immobilisation system on a planar surface.

Polyelectrolyte-supported lipid membranes.

In this work, we report the influence of the electrostatic interaction between lipid bilayer membranes and their solid polyelectrolyte multilayer support on the properties of the membrane. All involved sample preparation steps were carried out as convenient adsorption procedures from aqueous solutions. The lipid fluidity within the membrane as well as the surface coverage of the support could be tailored via the electrostatic interaction strength between the lipid bilayer and the supporting polyelectrolyte cushion.

Endometrial polyps. A clinical study of 245 cases.

OBJECTIVES: Endometrial polyps (EPs) are among the common cases of abnormal uterine bleeding. Hormonal factors may be involved in the pathogenesis as indicated by endometrial abnormalities in patients treated with tamoxifen. This study was designed to analyse the patient characteristics which may be associated with polyp occurrence and assess the diagnostic and therapeutic difficulties. Group of 245 patients was formed to 152 postmenopausal and 93 premenopausal women with EP diagnosed hysteroscopically and confirmed histologically. Evaluated factors were as follows: 1) patient characteristics: age, body mass, systemic hypertension, diabetes mellitus, nulliparity, late menopause, estrogen replacement therapy, and tamoxifen treatment; 2) clinical features of EPs, and 3) the number of curettage's (D & C) and hysteroscopies. RESULTS: Hypertension associated with obesity appears to be an important factor in combination which may play role in the pathogenesis of EPs like the late menopause which was noted in 30% of examined postmenopausal women. An association between EPs and tamoxifen was found in 8% patients with breast cancer. 2. Postmenopausal uterine bleeding and menstrual disorders were prominent clinical symptoms in 44% post- and in 82% of premenopausal women. The other 56% post- and 18% premenopausal patients were asymptomatic. 3. The multiple EPs were present in 26% of postmenopausal and in 15% premenopausal women. 4. Transvaginal ultrasonography supplemented by sonohysterography in cases with abnormal ultrasonographic findings should be the main diagnostic method. 5 Hysteroscopical polypectomy is regarded as the optimal therapy and the removal of the endometrial basalis in the EP origin area prevents persistence or recurrence of EP.

[Infections with enterohemorrhagic Escherichia coli (EHEC)--results of an epidemiologic survey in Bavaria for the April 1996 to May 1997 time frame]. / Infektionen mit enterohämorrhagischen Escherichia coli (EHEC)--Ergebnisse einer epidemiologischen Erhebung in Bayern für den Zeitraum April 1996 bis März 1997.

Using a report system of the Bavarian Public Health services 300 EHEC infections were registered within one year (Apr 1, 1996, to Mar 31, 1997) in Bavaria. These consisted of 22 cases of haemolytic uraemic syndrome (HUS) (mean age, 2.8 yr), 6 cases of incomplete HUS (1.3 yr), 188 cases of enteritis (3.3 yr) and 84 asymptomatic infections (12.9 yr), respectively. From this follows an incidence rate for all infections of approximately 2.5 per 100,000 inhabitants and for HUS in the age group of children and juveniles up to 18 years of approximately 0.8, respectively. Possible sources (paths) of infection registered in relevant frequencies were: raw milk consumption (18% of the infected), farm-animal associated contact (43%), and contact with patients suffering from diarrhoea (36%).

[The results of primary radiotherapy in vaginal carcinoma]. / Ergebnisse der primären Strahlentherapie beim Vaginalkarzinom.

BACKGROUND: Cancer of the vagina is the least frequent primary malignant tumor of the female genital tract except carcinoma of the fallopian tube. Radiation therapy is the preferred treatment in most cases. PATIENTS AND METHOD: Between 1965 and 1991, 39 patients (median age 66 years) with primary carcinoma of the vagina were treated with radiation therapy at our clinic. The mean observation period was 37 months. Classification according to the FIGO yielded a stage I in 43%, stage II in 24%, stage III in 22% and stage IV in 11%. Histological differentiation resulted in 35 squamous cell carcinomas and 4 adenocarcinomas. In 69%, the tumor was found on the posterior or lateral wall of the vagina, in 43% it arose from the upper third of the vagina. Standard therapy consisted of combined brachy- and teletherapy. Most of the brachytherapy applications were performed with a radium source. RESULTS: Median survival was 37 months, calculated according to the Kaplan-Meier method. The 5-year actuarial survival rate for all stages was 41% (stage 1: 62%, stage II: 44%, stage III: 25%). Sixty-eight percent of all patients achieved a complete remission, 19% a partial response. Significant prognostic factors were stage of disease and histological grading. CONCLUSION: Our results demonstrate the value of radiation therapy for the treatment of primary carcinoma of the vagina. Combined treatment with both external beam radiation and brachytherapy should be preferred.

[Results of radiotherapy for primary vaginal cancer]. / Ergebnisse der primären Strahlentherapie beim Vaginalkarzinom.

BACKGROUND: Cancer of the vagina is the least frequent primary malignant tumor of the female genital tract except carcinoma of the fallopian tube. Radiation therapy is the preferred treatment in most cases. PATIENTS AND METHOD: Between 1965 and 1991, 39 patients (median age 66 years) with primary carcinoma of the vagina were treated with radiation therapy at our clinic. The mean observation period was 37 months. Classification according to the FIGO yielded a stage I in 43%, stage II in 24%, stage III in 22% and stage IV in 11%. Histological differentiation resulted in 35 squamous cell carcinomas and 4 adenocarcinomas. In 69%, the tumor was found on the posterior or lateral wall of the vagina, in 43% it arose from the upper third of the vagina. Standard therapy consisted of combined brachy-and teletherapy. Most of the brachytherapy applications were performed with a radium source. RESULTS: Median survival was 37 months, calculated according to the Kaplan-Meier method. The 5-year actuarial survival rate for all stages was 41% (stage I: 62%, stage II: 44%, stage III: 25%). Sixty-eight percent of all patients achieved a complete remission, 19% a partial response. Significant prognostic factors were stage of disease and histological grading. CONCLUSION: Our results demonstrate the value of radiation therapy for the treatment of primary carcinoma of the vagina. Combined treatment with both external beam radiation and brachytherapy should be preferred.

[Objective evaluation of compensation of permanent loss of vestibular function]. / W sprawie obiektywnej oceny kompensacji trwalych ubytków czynnosci przedsionka.

The method of quantitative assessment of the dynamics of compensation of peripheral equilibrium disturbances was applied in patients with sudden permanent unilateral loss of vestibular function of different aetiology. The course of compensation was assessed by means of the test of threshold excitability during rotation for establishing the threshold of practical compensation. It was found that the rate of the compensation process was influenced by: 1) greater adaptation of the central nervous system in young subjects, 2) earlier beginning of exercises. The clinical importance of early detection of the threshold of practical compensation and its significance for expert opinion are discussed.