Could epithelial ovarian cancer be associated with chlamydial infection?

PURPOSE OF INVESTIGATION: Epithelial ovarian cancer (EOC) is the leading cause of death from gynaecological malignancy in the UK. The pathogenesis of this disease is poorly understood. Our hypothesis was that chlamydial infection might play a role in the pathogenesis of EOC. METHODS: 122 serum samples of patients undergoing surgery for benign or malignant gynaecological conditions were analysed. There was a total of 41 patients with EOC (33.6%), 27 with benign cystadenomas (22.1%) and 54 with normal ovaries (44.3%). RESULTS: There was a higher incidence of IgA seropositivity and lower incidence of IgG seropositivity in the EOC group compared with the other groups; however, this was not statistically significant. There was no statistical difference in the serum IgM antibodies to chlamydia in the three different groups. CONCLUSION: Although chronic infection and persistent inflammation may contribute to the pathogenesis of EOC, and chlamydia is a common genital tract pathogen, our study did not find an association between chlamydia and EOC.

Lack of specificity of a single positive 50-kDa band in the electroimmunotransfer blot (EITB) assay for cysticercosis.

Diagnosis of the parasitic infection cysticercosis is usually confirmed by serological assays. The electroimmunotransfer blot (EITB) for cysticercosis is a sensitive and specific assay, which uses six glycoprotein antigens on a strip to detect antibodies to Taenia solium cysticerci. Although the appearance of bands at any of these six sites is considered to be a positive result, a growing body of evidence suggests that the presence of a single 50-kDa band in this assay may not indicate infection. An audit of 984 samples tested over a 3-year period showed that only two (15.4%) of 13 samples with a single 50-kDa band were associated with a diagnosis of cysticercosis. Possible reasons for this include technical problems, cross-reactivity with other parasites or other diseases, or the presence of a non-specific band. The results suggest that the finding of a single 50-kDa band should be interpreted with caution.

Lack of serum oligoclonal antibody responses to Chlamydophila pneumoniae in multiple sclerosis.

Chlamydophila pneumoniae has been proposed as an aetiological agent in MS via a mechanism involving molecular mimicry. We undertook to investigate whether the presence of CSF oligoclonal IgG OCB or oligoclonal bands correlated with serum IgG raised against C. pneumoniae. Paired serum and CSF of 19 MS patients and 27 control patients with other neurological diseases were studied by IEF and Western blotting. Only 1 of 19 MS patients had serum antibodies against C. pneumoniae compared with 2 of the 26 control patients. This was not significant, leading us to conclude that this study does not support the theory of an association between C. pneumoniae and MS.

Comparison of PCR and antigen detection methods for diagnosis of Entamoeba histolytica infection.

AIMS: To assess different laboratory methods for the identification of Entamoeba histolytica in clinical samples. METHODS: Antigen detection enzyme linked immunosorbent assay, polymerase chain reaction solution hybridisation enzyme linked immunoassay (PCR-SHELA), and a commercial Lightcycler PCR were compared using 101 stool and pus samples. RESULTS: Fifteen of the 101 samples were positive for E histolytica by one or more method. There were discrepancies between the results in five of these 15 samples when the assays were compared. CONCLUSIONS: All three methods performed adequately, so that the choice of assay will depend on each individual laboratory's budget and projected turnaround time.

Chlamydophila pneumoniae infection of the central nervous system in patients with multiple sclerosis.

BACKGROUND: Chlamydophila pneumoniae has been postulated as an aetiological agent in the pathophysiology of multiple sclerosis. Previous studies show conflicting results. OBJECTIVE: To investigate patients with multiple sclerosis and other neurological diseases for evidence of past or present infection with C pneumoniae. METHODS: 19 patients with multiple sclerosis and 29 with other neurological diseases were studied. Evidence was sought for past or present infection with C pneumoniae using polymerase chain reaction (PCR) and cell culture of cerebrospinal fluid (CSF), and enzyme linked immunosorbent assay and microimmunofluorescence of serum. RESULTS: C pneumoniae was grown from the CSF of one patient with multiple sclerosis. PCR was negative in all cases. Anti-chlamydial antibodies were detected in the same proportion in each group. CONCLUSIONS: This study does not support the theory of an association between C pneumoniae and multiple sclerosis.

Corridor consultations and the medical microbiological record: is patient safety at risk?

The performance procedures of the General Medical Council are aimed at identifying seriously deficient performance in a doctor. The performance procedures require the medical record to be of a standard that enables the next doctor seeing the patient to give adequate care based on the available information. Setting standards for microbiological record keeping has proved difficult. Over one fifth of practising medical microbiologists (including virologists) in the UK (139 of 676) responded to a survey undertaken by the working group developing the performance procedures for microbiology, to identify current practice and to develop recommendations for agreement within the profession about the standards of the microbiological record. The cumulative frequency for the surveyed recording methods used indicated that at various times 65% (90 of 139) of respondents used a daybook, 62% (86 of 139) used the back of the clinical request card, 57% (79 of 139) used a computer record, and 22% (30 of 139) used an index card system to record microbiological advice, suggesting wide variability in relation to how medical microbiologists maintain clinical records.