Septicaemia is associated with increased disease activity and mortality in systemic lupus erythematosus: a retrospective analysis from Taiwan.

OBJECTIVE: This study aimed to investigate how septicaemia, non-septicaemia infection and the disease itself are associated with disease activity and mortality in inpatients with systemic lupus erythematosus (SLE) in Taiwan. METHODS: We retrospectively reviewed 1115 patients and enrolled 427 with SLE admitted for lupus flare-ups and co-morbidities. Disease activity and infection type/site were recorded and categorized according to the causes of admission and mortality into three categories, of which two were specified as follows: (a) septicaemia admissions, non-septicaemia admissions; and (b) septicaemia mortality, non-septicaemia infection mortality and non-infection mortality. The relationships between lupus flare-ups and mortality in different groups were analysed using an unpaired t-test, Mann-Whitney U-test and logistic regression. RESULTS: Septicaemia was the major cause of mortality in SLE inpatients. There were 98 (22.95%) mortality patients among all 427 SLE patients. The septicaemia admissions had higher disease activity (SLE Disease Activity Index 2000 = 13.00 ± 7.98) than the non-septicaemia admissions (9.77 ± 5.72; p < 0.01). The mean current SLEDAI score of the septicaemia mortality group (14.91 ± 8.01) was higher than that of the non-septicaemia infection mortality group (10.05 ± 5.75; p = 0.02), in spite of the similar mean earlier SLEDAI score. The risk of mortality in the septicaemia mortality group due to previous septicaemia admissions was 13.2 times (odds ratio) higher than in the non-septicaemia infection mortality group and 15.6 times higher than in the non-infection mortality group. CONCLUSION: Septicaemia relates to increased lupus disease activity and is associated with a greater risk of mortality in the SLE patients than other causes of admission. Fewer previous septicaemia admissions decrease the risk of septicaemia mortality.

Frequency and risk factors for urinary tract infection in cats with diabetes mellitus.

BACKGROUND: Identification and control of infections are important in the management of diabetic cats. Urinary tract infections have not been well characterized in diabetic cats. This retrospective study was performed to review and characterize urinary tract infections in diabetic cats. HYPOTHESIS: Urinary tract infections are common in diabetic cats. ANIMALS: A review was made of the medical records of 141 diabetic cats that had had urine obtained for culture by antepubic cystocentesis and that had not been treated with antibiotics, undergone urinary tract catheterization or urinary tract surgery within 2 weeks of urine collection or had urethral obstruction at the time of urine collection. METHODS: A review of medical records. RESULTS: Urinary tract infection was identified in 18 of 141 diabetic cats. Escherichia coli was the most common isolate (67%). Female cats were at increased risk (prevalence odds ratios [POR], 3.7; 95% confidence interval [CI], 1.3 to 10.2; P = .013). Clinical signs of lower urinary tract disease and findings on urine sediment examination were good predictors of positive urine cultures. CONCLUSIONS AND CLINICAL IMPORTANCE: Urinary tract infections are common in diabetic cats regardless of status of diabetic control, suggesting routine monitoring with urine sediment exams or urine culture is warranted.

The effects of ethanol on the size-exclusion characteristics of type I dentin collagen to adhesive resin monomers.

During dentin bonding with etch-and-rinse adhesive systems, phosphoric acid etching of mineralized dentin solubilizes the mineral crystallites and replaces them with bound and unbound water. During the infiltration phase of dentin bonding, solvated adhesive resin comonomers are supposed to replace all of the unbound collagen water and polymerize into copolymers. A recently published review suggested that dental monomers are too large to enter and displace water from tightly-packed collagen molecules. Conversely, recent work from the authors' laboratory demonstrated that HEMA and TEGDMA freely equilibrate with water-saturated dentin matrices. However, because adhesive blends are solvated in organic solvents, those solvents may remove enough free water to allow collagen molecules to come close enough to exclude adhesive monomer permeation. The present study analyzed the size-exclusion characteristics of dentin collagen, using a gel permeation-like column chromatography technique, filled with dentin powder instead of Sephadex beads as the stationary phase. The elution volumes of different sized test molecules, including adhesive resin monomers, studied in both water-saturated dentin, and again in ethanol-dehydrated dentin powder, showed that adhesive resin monomers can freely diffuse into both hydrated and dehydrated collagen molecules. Under these in vitro conditions, all free and some of the loosely-bound water seems to have been removed by ethanol. These results validate the concept that adhesive resin monomers can permeate tightly-bound water in ethanol-saturated collagen molecules during infiltration by etch-and-rinse adhesives. STATEMENT OF SIGNIFICANCE: It has been reported that collagen molecules in dentin matrices are packed too close together to allow permeation of adhesive monomers between them. Resin infiltration, in this view, would be limited to extrafibrillar spaces. Our work suggests that monomers equilibrate with collagen water in both water and ethanol-saturated dentin matrices.

Dynamic modulation of electronic properties of graphene by localized carbon doping using focused electron beam induced deposition.

We report on the first demonstration of controllable carbon doping of graphene to engineer local electronic properties of a graphene conduction channel using focused electron beam induced deposition (FEBID). Electrical measurements indicate that an "n-p-n" junction on graphene conduction channel is formed by partial carbon deposition near the source and drain metal contacts by low energy (<50 eV) secondary electrons due to inelastic collisions of long range backscattered primary electrons generated from a low dose of high energy (25 keV) electron beam (1 × 10(18) e(-) per cm(2)). Detailed AFM imaging provides direct evidence of the new mechanism responsible for dynamic evolution of the locally varying graphene doping. The FEBID carbon atoms, which are physisorbed and weakly bound to graphene, diffuse towards the middle of graphene conduction channel due to their surface chemical potential gradient, resulting in negative shift of Dirac voltage. Increasing a primary electron dose to 1 × 10(19) e(-) per cm(2) results in a significant increase of carbon deposition, such that it covers the entire graphene conduction channel at high surface density, leading to n-doping of graphene channel. Collectively, these findings establish a unique capability of FEBID technique to dynamically modulate the doping state of graphene, thus enabling a new route to resist-free, "direct-write" functional patterning of graphene-based electronic devices with potential for on-demand re-configurability.

Isolation of Clostridium innocuum from cases of recurrent diarrhea in patients with prior Clostridium difficile associated diarrhea.

Clostridium innocuum isolates resistant to vancomycin (MIC values of 16-24 microg/mL) were isolated from three patients with recurrent Clostridium difficile -associated diarrhea (CDAD). We discuss the clinical significance and problems associated with the identification and differentiation of these two clostridial species, which may result in misdiagnosis of patients.

Distribution of indole-producing urease-negative pasteurellas in animals.

Three hundred fifty-six animal isolates of indole-positive urease-negative cultures of Pasteurella, which would formerly have been classified as P. multocida, were examined with respect to their relationship to the recently described P. multocida subspecies (ssp.) multocida, septica, and gallicida and P. canis, P. stomatis/Taxon 16, and Pasteurella sp. B. Two hundred sixty-three (73.9%) of the cultures could be identified with one of these taxa, and 93 isolates (26.1%), representing 17 different biotypes, were unassignable. Pasteurella multocida ssp. multocida was the predominant taxon throughout and in most of the 25 animal species from which isolations were made. In dogs, P. canis was the most frequent. Different degrees of host predilection were observed also in P. multocida ssp. septica for cats, P. canis for sheep, and 2 of the unassignable biotypes for cattle and dogs, respectively. Overall, the respiratory tract was the most frequent source of isolates, but a propensity of P. multocida ssp. septica for localization in the central nervous system of cats was noted.

Multiplex polymerase chain reaction for distinguishing Taylorella equigenitalis from Taylorella equigenitalis-like organisms.

It is difficult to distinguish isolates of Taylorella equigenitalis, the cause of contagious equine metritis, from a T. equigenitalis-like organism isolated from asymptomatic donkeys and horses. Although T. equigenitalis is responsible for a severe, contagious disease of the reproductive tract of equids, the T. equigenitalis-like organism, although contagious, does not appear to produce disease. Because of the economic consequences of correctly distinguishing isolates of these 2 microorganisms, a polymerase chain reaction (PCR)-based assay was developed that will distinguish isolates of T. equigenitalis from the T. equigenitalis-like microorganism. The primers used in the PCR assay were designed to amplify unique regions of the gene encoding the 16S ribosomal RNA.

Interrelations of organism prevalence, specimen collection method, and host age, sex, and breed among 8,354 canine urinary tract infections (1969-1995).

Selected information was compiled from canine urinalyses and urine cultures conducted between January 1969 and December 1995. Eight thousand three hundred fifty-four microbial isolates (bacteria and fungi) included 4,873 isolates from females and 3,481 from males. Ten bacterial genera accounted for 96.3% of the urinary isolates, including Escherichia coli (44.1%), Staphylococcus spp. (11.6%), Proteus spp. (9.3%), Klebsiella spp. (9.1%), Enterococcus spp. (8.0%), and Streptococcus spp. (5.4%) as the 6 most common isolates in both genders of dogs. Among these 6 genera, female dogs were generally predisposed over males, although males had more urinary tract infections (UTIs) caused by Klebsiella spp. Distributions of ages at UTI diagnosis tended to be similar between genders. Infection with a single microbial species was responsible for >72% of UTIs in both genders. Among females, 40 breeds and a mixed-breed group represented 90.2% of all positive urine cultures, 88.4% of the individual dogs with UTIs. and 88.2% of the microbial isolations. Among males, these same 41 breed groups represented 87.9% of all positive urine cultures, 87.6% of the individual dogs, and 88.2% of the microbial isolations.

Identity of Bacteroides isolates and previously named Bacteroides spp in clinical specimens of animal origin.

During the years 1984 through 1987 2,574 isolates of obligately anaerobic bacteria were isolated from samples submitted for analysis. The most common anaerobic isolates were members of the genus Bacteroides, representing 44.6% of the isolates. Of these, the most commonly isolated identifiable microorganisms were bile-resistant and nonpigmented, belonging to the B fragilis group of Bacteroides. Importantly, obvious predilections for any one species or group of Bacteroides were not apparent for animal or site (condition), except that the proportion of isolates belonging to the nonpigmented, bile-resistant group obtained from the respiratory tract was significantly (P less than 0.005) higher than that not belonging to this group. On the other hand, the proportion of isolates of the non-pigmented, bile-resistant group obtained from abscesses was significantly lower than that not belonging to this group.

Actinobacillus suis-like organisms in horses.

Actinobacillus suis-like organisms have been recognized in equine specimens at the University of California Veterinary Medical Teaching Hospital since 1975. The most common source (65%) of the organism was transtracheal washings. The organism was gram-negative, produced hemolysis on blood agar, and gave a positive reaction for oxidase, urease, o-nitrophenyl-beta-D-galactopyranoside, and esculin. Carbohydrate reactions were variable, consisting of 4 main patterns. Actinobacillus suis-like organisms were (90%) sensitive to therapeutic concentrations of amikacin, cephalothin, chloramphenicol, gentamicin, kanamycin, tetracycline, and trimethoprim-sulfamethoxazole. Other aerobic and anaerobic bacteria were recovered frequently with the organism.

Use of random fragments of chromosomal DNA to highlight restriction site heterogeneity for fingerprinting isolates of Salmonella typhimurium from hospitalized animals.

Random fragments of DNA were obtained from a cosmid library of Salmonella agona genomic DNA. From this library, 2 fragments were chosen and pooled to probe isolates of S typhimurium obtained during an episode of salmonellosis in a veterinary medical teaching hospital. Chromosomal DNA from the Salmonella isolates was digested with restriction endonucleases, and was probed with the random fragments of chromosomal DNA. This procedure resulted in a fingerprint pattern for each isolate. We found that the method permitted discrimination between isolates involved in the disease episode and S typhimurium obtained prior to the episode. We conclude that random fragments of chromosomal DNA are useful for fingerprinting isolates of S typhimurium. Analysis of plasmid DNA obtained from the isolates was not as useful. Some isolates found to be identical by restriction site analysis, had plasmids of different molecular weight. These results indicate that plasmid analysis may not be as useful a fingerprinting tool as previously reported.

Case-control study of risk factors associated with nosocomial Salmonella krefeld infection in dogs.

In a case-control study of risk factors associated with an episode of nosocomial Salmonella krefeld infection in dogs at the veterinary medical teaching hospital, data on 20 case dogs and 75 control dogs were obtained by review of hospital records. Univariate and multivariate statistical analyses were carried out for possible risk factors for infection to obtain odds of Salmonella krefeld isolation, given exposure to each risk factor of interest. Compared with control dogs, case dogs were 11.9 times more likely to have been fed rice, 7 times more likely to have had radiography done, 10.2 times more likely to have been a resident in ward 2, 5.6 times more likely to have been given antimicrobial agents orally, 11.3 times more likely to have been given antimicrobial agents parenterally, and 37.9 times more likely to have been given antimicrobial agents orally and parenterally (P less than 0.05).

Characteristics of Salmonella isolated from animals at a veterinary medical teaching hospital.

Salmonella belonging to 47 serotypes was isolated from animals at the University of California Veterinary Medical Teaching Hospital during the years 1974 to 1983. Salmonella belonging to 12 serotypes accounted for 89% of the 725 isolates. Salmonella typhimurium (including var copenhagen) was the most commonly isolated serotype, but during 1981 to 1983, S krefeld and S saint-paul were predominant. Certain serotypes seemed to be isolated more frequently from extraintestinal sources (S typhi-suis, S dublin). Although resistance to ampicillin, kanamycin, neomycin, streptomycin, and sulfonamides was common (greater than 60% of the isolates were resistant), resistance to chloramphenicol, gentamicin, and trimethoprim-sulfonamides was infrequent, except for isolates of S krefeld and S saint-paul.

Staphylococci in canine urolithiasis: species identification, using a commercially available tray micromethod.

Fifty-one coagulase-positive staphylococcal isolates from canine urinary calculi or from the urine of dogs with documented urolithiasis, and 17 coagulase-positive staphylococcal isolates from human beings and cattle were identified by a commercially available tray micromethod, as well as by conventional methods. Canine isolates had previously been classified as Staphylococcus aureus on the basis of a positive tube coagulase test. After 5 hours' incubation, the tray method identified all 51 canine urolithiasis isolates as S intermedius, rather than S aureus. All human and bovine isolates were identified as S aureus. Conventional methods supported these findings.

Antimicrobial susceptibility of Nocardia nova isolated from five cats with nocardiosis.

From 1992 through 1997, 5 cats were admitted to the hospital because of chronic, nonhealing lesions containing draining tracts. Exudate from 2 of the 5 cats contained macroscopically visible granules. On the basis of cytologic findings, lesions were described as pyogranulomatous. Degenerative neutrophils and activated macrophages, along with slender, branching, gram-positive, partially acid-fast microorganisms, were observed in stained smears of exudates obtained from all 5 affected cats. Nocardia nova was found in pure culture from all affected sites. Most isolates were susceptible to ampicillin, aminoglycosides (ie, amikacin, kanamycin), tetracyclines (ie, doxycycline, minocycline), macrolides (ie, erythromycin, clarithromycin), imipenem, sulfisoxazole, and trimethoprim-sulfamethoxazole. Other antimicrobials were less effective, and these included amoxicillin-clavulanic acid, the cephalosporins (ie, cefotaxime, ceftizoxime, ceftriaxone), and some aminoglycosides (ie, gentamicin, tobramycin). Four of the 5 cats were successfully treated, 3 with a trimethoprim-sulfonamide combination, and 1 with clarithromycin. The outcome of treatment of the fifth cat is unknown. Findings in this report may be useful in diagnosis and treatment of nocardiosis caused by N nova in cats.

Ulcerative keratitis associated with Salmonella arizonae infection in a horse.

Salmonella arizonae 61:1,5, was isolated in pure culture from the eye of a horse with unilateral ulcerative keratitis. The eye responded well to treatment with atropine sulfate and polymyxin B-bacitracin-neomycin ophthalmic ointments. In swab specimens taken after the lesion had healed, Salmonella was not found to be a constituent of the bacterial flora of the horse's eyes.

Cellulitis associated with coagulase-positive staphylococci in racehorses: nine cases (1975-1984).

Nine Thoroughbred racehorses were admitted with cellulitis (of one or more limbs) associated with coagulase-positive staphylococci. The right hindlimb was affected in 4 horses, the right forelimb in 2, the left hindlimb in 1, and both hindlimbs in 2. Typical abnormalities included high values for rectal temperature (9 horses) and heart rate (5 horses), hyperfibrinogenemia (7 horses), leukocytosis (7 horses), and neutrophilia (6 horses). The staphylococcal isolants were speciated in 3 horses and classified as Staphylococcus aureus. Complications included skin loss (5 horses), laminitis of the affected limb (2 horses), laminitis of the contralateral limb (4 horses), osteomyelitis and sequestrum formation (2 horses), and bacteremia (1 horse). Five horses were euthanatized because of the severity of the complications, ie, laminitis in 4 horses and severe skin loss in 1 horse. The remaining 4 horses were discharged from the clinic. At follow-up evaluation (mean, 16.7 months), the swelling in 3 of the horses had completely resolved. One horse returned to racing; of 2 used for pleasure riding, one was mildly lame. The remaining horse was not lame, but was used for breeding because of persistent swelling of the affected limb.

Microbiological study of transtracheal aspirates from dogs with suspected lower respiratory tract disease: 264 cases (1989-1995).

OBJECTIVE: To determine the most commonly isolated bacterial species associated with lower respiratory tract disease of dogs and to determine susceptibility of these isolates to antimicrobial agents. DESIGN: Retrospective case series. SAMPLE POPULATION: Transtracheal aspirates from 264 dogs with clinical evidence of lower respiratory tract disease. PROCEDURE: Records of microbiological analyses of transtracheal aspirates obtained from dogs with clinical evidence of lower respiratory tract disease were reviewed. Analyses performed included bacterial culture (anaerobic and aerobic organisms) and susceptibility testing (aerobic organisms). The medical record of each affected dog was evaluated to determine signalment and underlying condition. RESULTS: Bacteria were isolated from 116 of 264 (44%) samples, and 203 bacterial species were identified. Most (57%) of the samples from which bacteria could be isolated contained a single species, whereas 43% yielded cultures of mixed species. Bacterial species belonging to the family Enterobacteriaceae (particularly Escherichia coli) were isolated most commonly (45.7% of samples contained members of this group), followed by members of the genus Pasteurella (22.4%), obligate anaerobes (21.6%), beta-hemolytic Streptococcus (12.1%), Bordetella bronchiseptica (12.1%), nonhemolytic Streptococcus/Enterococcus sp group (12.1%), coagulase-positive Staphylococcus (9.5%), and Pseudomonas sp (7.8%). The most active antimicrobial drugs (inhibiting > 90% of the isolates) for aerobic microorganisms encountered most often (E. coli and Pasteurella sp) included amikacin, ceftizoxime sodium, enrofloxacin, and gentamicin sulfate. CLINICAL IMPLICATIONS: Amikacin, ceftizoxime, enrofloxacin, and gentamicin may be rational choices for treatment of suspected infectious lower respiratory tract disease of dogs, before identification of the causative agent(s) and before results of susceptibility tests become available.

Bacteria associated with pyothorax of dogs and cats: 98 cases (1989-1998).

OBJECTIVE: To determine the organisms most commonly isolated from pleural fluid from dogs and cats with pyothorax. DESIGN: Retrospective study. ANIMALS: 51 dogs and 47 cats. PROCEDURE: Results of bacteriologic culture of pleural fluid samples obtained by means of thoracentesis were obtained from medical records. To obtain information on in vitro antimicrobial susceptibility of organisms commonly isolated from dogs and cats, records of all dogs and cats examined during 1998 were reviewed, and information was obtained on identity and in vitro antimicrobial susceptibility of aerobic organisms isolated from samples other than urine or urinary tract samples. RESULTS: Median ages of dogs and cats were 4 years. Bacteria were isolated from pleural fluid samples from 47 of 51 (92%) dogs and 45 of 47 (96%) cats. Obligate anaerobic bacteria were isolated from 28 dogs and 40 cats. A mixture of obligate anaerobic and facultative bacteria was isolated from 17 dogs and 20 cats. Samples from cats most often yielded a member of the nonenteric group (most commonly members of the genus Pasteurella), whereas those from dogs more often yielded a member of the family Enterobacteriaceae (most commonly E coli). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that antimicrobial agents chosen for the initial treatment of dogs and cats with pyothorax should be active against a mixture of obligate anaerobic and facultative bacteria.

Erysipelas in a black and red tamarin.

Erysipelothrix rhusiopathiae was isolated in large numbers from the kidneys and was visualized histologically in the kidneys, heart muscle, skeletal muscle, selected lymph nodes, and the submandibular salivary glands of a black and red tamarin (Saguinus nigricollis) following an acute fatal illness. Sites (heart valves, joints) usually associated with disease mediated by E rhusiopathiae appeared uninvolved.