Comparison of chemiluminescent DNA probe to cell culture for the screening of Chlamydia trachomatis in a gynecology clinic population.

Two hundred ninety-five endocervical swab specimens were obtained from patients presenting to a gynecology clinic in order to compare a nonradioactive chemiluminescent DNA probe with cell culture for detection of Chlamydia trachomatis. Discrepancies between cell culture and DNA probe were resolved by retesting and reculturing samples. In a population with a 10.8% prevalence, the corrected sensitivity, specificity, positive predictive value, and negative predictive value for the DNA probe were 80.6, 95.8, 71.4, and 97.3%, respectively. These results compare favorably to other non-culture methods such as direct fluorescent antibody and enzyme immunoassay tests for the detection of C trachomatis in populations with similar prevalence rates.

In vitro susceptibility studies of vancomycin-resistant Enterococcus faecalis.

Vancomycin resistance exhibited by Enterococcus faecalis isolates V583, V586, and V587 is described. The vancomycin MICs ranged from 32 to 64 micrograms/ml. Although resistant to vancomycin, the isolates were susceptible to teicoplanin (MIC, less than or equal to 0.5 micrograms/ml). Such a glycopeptide susceptibility profile has not been previously described for E. faecalis. Time kill studies showed that vancomycin resistance adversely affected the synergistic activity that vancomycin and aminoglycoside combinations usually demonstrate against enterococci. However, the ability to detect vancomycin resistance varied with the susceptibility testing method used. Whereas broth microdilution, broth macrodilution, and agar dilution methods detected resistance, disk-agar diffusion and the AutoMicrobic system Gram-Positive GPS-A susceptibility card (Vitek Systems Inc., Hazelwood, Mo.) did not. To detect vancomycin resistance reliably and establish the incidence of such E. faecalis isolates, adjustments in some susceptibility testing methods may be necessary.

Gamma-glutamyltranspeptidase levels as an aid in the management of human cancer.

Plasma gamma-glutamyltranspeptidase (GGTP) levels were measured in 435 cancer patients, 120 healthy controls, 15 patients with systemic lupus erythematosis, and 10 patients with rheumatoid arthritis. The mean GGTP activity of all cancer patients studied, with the exception of malignant lymphoma, was significantly elevated compared to control values. Several patient groups were retrospectively analyzed to determine whether GGTP levels correlated with clinical status. Patients who were disease-free had GGTP levels in the normal range, whereas patients with metastases had elevated levels. Serially increasing GGTP levels were associated with disease progression and death. Persons who remained free of disease had serial GGTP levels within the normal range. Furthermore, decreasing levels were associated with response to therapy. These results indicate that GGTP levels may have prognostic value in various human malignancies.