RESUMEN
We report the exceptional case of a severe intraocular Abiotrophia defectiva infection which developed after cataract surgery. Retinal involvement as a complication of A. defectiva endophthalmitis or the combination of acute-onset endophthalmitis with infiltrative keratitis caused by this pathogen has not been described. Moreover, our report represents the first documented ocular A. defectiva infection in Germany. A. defectiva was identified using biotyping and 16S ribosomal RNA gene sequence analysis. Despite vigorous antimicrobial therapy and repeated ocular surgery, visual outcome was poor.
Asunto(s)
Aerococcaceae/aislamiento & purificación , Endoftalmitis/microbiología , Infecciones por Bacterias Grampositivas/diagnóstico , Queratitis/microbiología , Retinitis/microbiología , Aerococcaceae/clasificación , Aerococcaceae/genética , Aerococcaceae/metabolismo , Anciano , Técnicas de Tipificación Bacteriana , Extracción de Catarata/efectos adversos , ADN Bacteriano/química , ADN Bacteriano/genética , ADN Ribosómico/química , ADN Ribosómico/genética , Endoftalmitis/complicaciones , Femenino , Alemania , Infecciones por Bacterias Grampositivas/microbiología , Humanos , Queratitis/complicaciones , ARN Ribosómico 16S/genética , Retinitis/complicaciones , Análisis de Secuencia de ADN , Homología de Secuencia de Ácido Nucleico , Infección de la Herida Quirúrgica/microbiologíaRESUMEN
To enhance the inhibitory potential of 1-beta-D-ribofuranosyl-1,2,4-triazole-3-carboxamide (ribavirin) vs hepatitis C virus (HCV) NTPase/helicase, ribavirin-5'-triphosphate (ribavirin-TP) was synthesized and investigated. Ribavirin-TP was prepared with the use of modified Yoshikawa-Ludwig-Mishra-Broom procedure (cf. Mishra & Broom, 1991, J. Chem. Soc., Chem. Commun, 1276-1277) involving phosphorylation of unprotected nucleoside. Kinetic analysis revealed enhanced inhibitory potential of ribavirin-TP (IC50=40 microM) as compared to ribavirin (IC50 > 500 microM). Analysis of the inhibition type by means of graphical methods showed a competitive type of inhibition with respect to ATP. In view of the relatively low specificity towards nucleoside-5'-triphosphates (NTP) of the viral NTPase/helicases, it could not be ruled out that the investigated enzyme hydrolyzed the ribavirin-TP to less potent products. Investigations on non- hydrolysable analogs of ribavirin-TP or ribavirin-5'-diphosphate (ribavirin-DP) are currently under way.
Asunto(s)
Ácido Anhídrido Hidrolasas/metabolismo , Adenosina Trifosfato/metabolismo , Antivirales/farmacología , ADN Helicasas/metabolismo , Hepacivirus/enzimología , Hepatitis C/tratamiento farmacológico , Ácido Anhídrido Hidrolasas/efectos de los fármacos , Antivirales/uso terapéutico , Sitios de Unión , ADN Helicasas/efectos de los fármacos , Nucleósido-TrifosfatasaRESUMEN
97% of the vaccinees developed anti-HBs independently of the applied vaccine (experimental vaccine or H-B-Vax). With the experimental vaccine the mean antibody titre was 1095 IMU/ml four weeks after third inoculation. Follow up revealed that during a period of 18 month individual antibody titres declined continuously to approximately one tenth. Therefore the duration of protection depends on the titre of anti-HBs which was measured after the third immunization. A control of the antibody titres should be performed after about 3-5 years, when the antibody titres are greater than 1000 IMU/ml 4 weeks after vaccination. But a control should be made already after about 1 1/2-3 years if the antibody titres are 200-1000 IMU/ml. Antibody titres between 100 and 200 IMU/ml should be estimated about 6-18 months later and titres between 10 and 100 IMU/ml already about 3-6 months later. We recommend an immediate revaccination for persons with anti-HBs titres below 10 IMU/ml. Serological findings in hospital staff of the University in Hamburg revealed the presence of protective antibodies in 11,6% which is due to a previous hepatitis B infection. In this cases vaccination was unnecessary.
