Molecular characterization of non-B HIV type 1 subtypes from Africa in Spain.

All of the known HIV-1 subtypes are present in sub-Saharan Africa. The B subtype is predominant in the United States and Europe, but previous studies have revealed that other subtypes are also in circulation. We report here on the genetic characterization of eight non-B subtype VIH-1 virus strains detected during 1999 in patients living in Spain and having epidemiological relationships with African countries. Five isolates clustering with recombinant form CRF02-AG came from West and Central Africa. One isolate was characterized as being of the D subtype in the gp41 region, and clustered with subtype A outside the CRF02-AG recombinant form, in regions C2V3 and p17. Another isolate was a G subtype, and the remaining isolate was an O subtype. In Spain, the B subtype is the most frequently detected HIV-1 subtype, although in more recent years non-B subtypes have been introduced through immigrant HIV-1-infected individuals coming from African countries, or through infected persons having relationships with endemically affected areas.

Molecular evidence supporting the existence of two major groups in uropathogenic Escherichia coli.

Molecular methods allow an extremely fine strain typing that can be used to establish the population structure of bacterial species. This methodology has been used to characterize a collection of 74 uropathogenic Escherichia coli obtained from three hospitals located in geographically distant towns in Spain, some representatives of the ECOR collection and other reference strains. Genomic DNA was analyzed by RAPD (Random Amplified Polymorphic DNA) that can characterize a bacterial strain to the level of defining individual clones. The 16S rDNA-23S rDNA spacers were amplified by PCR and submitted to restriction analysis. Finally, the presence or absence of G adhesins in Escherichia coli as well as the type of adhesin (three types are known) have been shown by PCR amplification followed by digestion with restriction enzymes. As expected a wide diversity was shown by RAPD and identical patterns were only found in the case of strains isolated from the same individual, an obvious case of relapse. Analysis of the spacers' restriction patterns showed the presence of two markedly differentiated clusters that we have named alpha and beta. Both RAPD and spacer restriction patterns originated similar clusters of strains showing a consistency in the evolution of the global genome with the sequence variation of the ribosomal spacers. Furthermore, most of the strains having G-adhesin, with only a few exceptions, corresponded to the alpha rRNA spacer group. The two spacer types detected were also consistent with some phenotypic markers such as sucrose and raffinose utilization. The alpha and beta clusters could be intraspecific groups produced by partial sexual isolation or other barriers that are originating a divergent evolution.

Nocardial keratitis after laser in situ keratomileusis.

PURPOSE AND METHODS: Corneal interface central nodules appeared in a patient who underwent uncomplicated laser in situ keratomileusis (LASIK) retreatment for residual myopia. RESULTS/CONCLUSIONS: Nocardia asteroides keratitis was confirmed by microbiologic studies, which guided treatment. Six months after the appearance of the keratitis, the patient's uncorrected visual acuity was 20/45, and spectacle-corrected visual acuity was 20/40. The postoperative refraction was +0.75 -0.75 X 95 degrees, and slit-lamp examination revealed a clear cornea with a mild rounded scar in the central area. Night halos and starbursts were the main complaints in this patient. The immediate management of lifting the corneal flap for stromal bed scraping, fast microbial identification, and proper treatment was the key for the results in this patient.

[Bacteremia caused by Capnocytophaga sp: presentation of 2 cases, one with endocarditis. Review of the literature]. / Bacteriemia por Capnocytophaga sp: presentación de dos casos, uno con endocarditis. Revisión de la literatura.

Capnocytophaga sp. is a gram-negative bacilli, scarcely documented as the cause of bacteremias. Two cases of bacteremia caused by Capnocytophaga sp, one of them with endocarditis, are reported here. A review of previous published cases is also presented. One of the patients was immunocompromised, because of chemotherapy, the other, suffered from a rheumatic-cardiopathy which was complicated with endocarditis. Both patients developed an alteration of the oral mucosa. Antibiotic therapy proved to be effective with two patients.

[Chilaiditi syndrome in the differential diagnosis of renal colic]. / Síndrome de Chilaiditi en el diagnóstico diferencial del cólico renal.

We report on a case of hepatodiaphragmatic interposition of the colon in a 45-year-old patient who presented at the emergency department with a clinical picture of renal colic. When making the differential diagnosis, we should take into account that the clinical picture known as Chilaiditi syndrome may mimic renal colic.

Staphylococcus lugdunensis as a cause of abscesses in the perineal area.

The first two patients with skin infections in the perineal area due to Staphylococcus lugdunensis are described. One had an abscess of the Bartholin gland, and the other presented with several cutaneous abscesses in the pubic area, which had a prolonged and recurrent clinical course despite appropriate antibiotic treatment. This report emphasizes the pathogenic role of Staphylococcus lugdunensis and the importance of identifying coagulase-negative staphylococci to species level in some instances.

Brucellar prosthetic arthritis in a total knee replacement.

The infecting pathogens most commonly implicated in prosthetic joint infections are staphylococci, streptococci, and gram-negative rods. Prosthetic infections caused by Brucella spp. are rarely described in the literature. Treatment of prosthetic infections remains complex and controversial, the most accepted course being antibiotic treatment with removal or retention of prosthetic components. The case of a 60-year-old man who developed Brucella septic arthritis of the right knee in a total knee replacement is reported. Conservative treatment using a three-drug therapy was employed, with excellent results.