Transmission of Burkholderia cepacia complex: evidence for new epidemic clones infecting cystic fibrosis patients in Italy.

To analyze national prevalence, genomovar distribution, and epidemiology of the Burkholderia cepacia complex in Italy, 225 putative B. cepacia complex isolates were obtained from 225 cystic fibrosis (CF) patients attending 18 CF centers. The genomovar status of these isolates was determined by a polyphasic approach, which included whole-cell protein electrophoresis and recA restriction fragment length polymorphism (RFLP) analysis. Two approaches were used to genotype B. cepacia complex isolates: BOX-PCR fingerprinting and pulsed-field gel electrophoresis (PFGE) of genomic macrorestriction fragments. A total of 208 (92%) of 225 isolates belonged to the B. cepacia complex, with Burkholderia cenocepacia as the most prevalent species (61.1%). Clones delineated by PFGE were predominantly linked to a single center; in contrast, BOX-PCR clones were composed of isolates collected either from the same center or from different CF centers and comprised multiple PFGE clusters. Three BOX-PCR clones appeared of special interest. One clone was composed of 17 B. cenocepacia isolates belonging to recA RFLP type H. These isolates were collected from six centers and represented three PFGE clusters. The presence of insertion sequence IS 1363 in all isolates and the comparison with PHDC reference isolates identified this clone as PHDC, an epidemic clone prominent in North American CF patients. The second clone included 22 isolates from eight centers and belonged to recA RFLP type AT. The genomovar status of strains with the latter RFLP type is not known. Most of these isolates belonged to four different PFGE clusters. Finally, a third clone comprised nine B. pyrrocinia isolates belonging to recA RFLP type Se 13. They represented three PFGE clusters and were collected in three CF centers.

[Prevalence of Chlamydia pneumoniae in respiratory infections in children: an ambulatory diagnostic problem]. / Prevalenza di Chlamydia pneumoniae nelle infezioni respiratorie del bambino: un problema diagnostico ambulatoriale.

It has been recently suggested that Chlamydia Pneumoniae infection is a common finding among children with acute respiratory diseases. Chlamydia cell culture is difficult and time-consuming to perform. Polymerase chain reaction (PCR) is a more rapid but also more expensive technique used to identify Chlamydia in pharyngeal swab, but it can be performed only in few specialized laboratories. We tested a rapid enzyme immuno-assay to detect Chlamydia in 20 children with respiratory infections (mean age 3.29 years; male:female ratio = 12:8) and in 21 healthy children (mean age 4.70 years male:female ratio = 15:6). Prevalence of Chlamydia isolation from pharyngeal swab was very high in both patients and healthy children without a significative difference in the two considered groups (45% vs 42%, p = 0.8). Specific Chlamydia IgG antibodies were undetectable in all patients and healthy children. Nine out of 20 patients affected by acute respiratory disease were Chlamydia-positive and 11 out 20 were Chlamydia-negative: these two groups didn't differ in regard to clinical and laboratory features, whereas duration of symptoms was significantly longer in Chlamydia-positive patients (9.3 vs 5.5 days, p = 0.014). Our study suggests a high prevalence of Chlamydia pharyngeal swab positivity in both healthy and sick children. Diagnosis of Chlamydia infection was not feasible on the basis of the considered clinical and laboratory findings.

[Hbeag/Anti-hbe system and other markers for hepatitis b in a dialysis unit (author's transl)]. / Sistema HBeAg/anti-HBe ed altri markers: situazione in un centro di emodialisi.

The Authors study with radioimmunoassay for detection of HBeAg, anti-HBc, anti-HBs, anti-HBe, 22 patients on regular dialysis treatment, 41 their familiars, 10 staff dialysis unit members and 16 their familiars. There was found sure correlation between in the mean type presence of HBsAG and HBeAg and risk of infectious hepatitis B. The presence of the "e" antibody has not always protective significance and was stressed the importance of non parenteral virus transmission.

[Protein, immunological and "Gc", "Gm" and "Inv" picture in high-risk mastectomized subjects]. / Quadro proteico, immunologico e fattori "Gc" "Gm" ed "Inv" in soggetti mastectomizzati e ad alto rischio.

In the field of research on cancer we studied 294 women of which 142 who had undergone mastectomy, 70 selected for a high risk group, 82 normal. In order to determine some parameters who characterize the three groups we research for each the globulin factor Gc, Gm, and Inv, the proteic fractions and the immunoglobulins, as already pointed out by other investigators. The study of data points out results some times not according to previous reports. Comparing people who had undergone mastectomy and who had been selected for a high risk group, on the bases of GC phenotype together with immunoglobulins we obtained interesting values that characterize and delimit the two groups.

[Ulterior acquisitions regarding the salmonellosis (author's transl)]. / Ulteriori acquisizioni in tema di salmonellosi.

The Authors report the results of the bacteriological researches on the incidence of the Salmonella of our zone, after a brief consideration of general aspects salmonellosis. Our observations are refered to 1005 samples of feces of which 84 cases proved positive to Salmonella. It is pointed out that morbidity, represented by Salmonella typhi, paratyphi A and B is low, while it is high for the Salmonella typhimurium and Salmonella enteritidis. The Authors conclude stating that epidemiological situation of salmonellosis still represents a problem of remarkable importance which demands the intensification and the use of efficacious measures of prophylaxis.

Neonatal haemophilus aphrophilus meningitis.

Case report of a neonatal meningitis due to Haemophilus influenzae. The treatment with ampicillin was ineffective because of insensitivity. This case demonstrates the importance of a proper bacteriological identification in order to avoid ineffective or delayed treatment.