Acyclovir-resistant herpes simplex virus infections in a bone marrow transplant population.

Over a 3-month period, four patients who had received unrelated donor (UD) bone marrow transplants (BMT) presented with severe mucocutaneous herpes simplex virus (HSV) infection while receiving acyclovir (ACV) prophylaxis. Sensitivity testing of the isolates revealed three to be acyclovir-resistant and in one patient the infection was also characterised by a marked failure to respond to foscarnet (phosphonoformic acid). The emergence of ACV-resistant HSV infections in themselves is a new and challenging problem, and yet a far greater problem will become evident if these infections develop resistance to non thymidine kinase dependent therapy.

Cytomegalovirus pneumonitis and bone marrow transplantation: identification of a specific high risk group.

AIMS: To study the association between cytomegalovirus (CMV) excretion and interstitial pneumonitis in allogeneic bone marrow transplant (BMT) recipients, with reference to donor and recipient CMV antibody response. METHODS: The incidence of CMV excretion was prospectively studied in 62 allogeneic bone marrow transplantations performed on adults and children. All recipients received CMV seronegative blood products. Prophylaxis with high dose acyclovir and CMV immune globulin was given to high risk patients (donor or recipient, or both, CMV seropositive). RESULTS: CMV excretion was detected in eight of 26 (31%) high risk patients but in only one of 36 low risk patients (donor and recipient both CMV seronegative). Five of the eight (63%) excretors in the high risk category developed CMV, of whom four (80%) belonged to the seropositive recipient/seronegative donor group, and included the three CMV seropositive recipients whose CMV complement fixation antibody titres were 64 or greater before transplantation. CONCLUSIONS: These findings suggest that there is a subgroup of patients at especially high risk of developing CMV.

Transmission of virus particles by cryotherapy and multi-use caustic pencils: a problem to dermatologists?

The possibility of transmission of virus particles from patient to patient by multi-use silver nitrate sticks and styptic pencils and by cotton wool swabs that have been dipped repeatedly into Dewar flasks of liquid nitrogen was studied. The results showed that transmission by the sticks and pencils is unlikely but that virus particles can be transferred into and out of a Dewar flask on cotton wool swabs. We suggest that swabs should not be dipped repeatedly into the flask of liquid nitrogen but that, instead, a small aliquot of nitrogen should be decanted into a smaller 'clean' vessel and a new cotton swab used for each patient.

A correlation between the weather and the incidence of ocular adenovirus infections.

Cyclical changes in the frequency of adenovirus isolation from patients with non-epidemic conjunctivitis were shown to correlate with monthly total hours of sunshine. Sunlight may predispose to clinical infection eyes already contaminated with adenovirus.

Simplified restriction endonuclease method for typing and subtyping adenoviruses.

Restriction endonuclease digestion of viral DNA labelled in vivo with phosphorus-32 has been used to type and to subtype both conventional and enteric adenoviruses. The method is a modification of that already described for typing and subtyping herpes simplex virus and, like the latter, needs far less material than methods previously described.

Comparison of a commercial ELISA system with restriction endonuclease analysis for typing herpes simplex virus.

Isolates of herpes simplex virus which had previously been typed by restriction enzyme analysis were typed again with a commercial ELISA system using polyclonal antibodies. There was complete correlation between the two techniques. Although restriction is more precise and definitive, when typing only is required the simplicity of ELISA makes it the preferred technique.

Comparison of the continuous cell line 293 with human embryo kidney cells and human embryo fibroblast cells for the cultivation of ocular viruses.

The continuous cell line 293 was evaluated as a replacement for primary human embryo kidney (HEK) cells in the cultivation of ocular viruses. The 293 cells were found to be as sensitive as HEK cells and human embryo fibroblast (HEF) cells for the cultivation of adenoviruses and herpes simplex virus (HSV) respectively. As a continuous cell line, 293 cells are preferable to HEK and HEF cells for the routine isolation of ophthalmic viruses.