Opportunistic urine ligase chain reaction screening for sexually transmitted diseases in adolescents seeking care in an urban emergency department.

STUDY OBJECTIVE: Neisseria gonorrhoeae and Chlamydia trachomatis are the most common bacterial sexually transmitted diseases (STDs) in sexually active youth and many infections are asymptomatic or unrecognized. This study used ligase chain reaction assays for determination of prevalence of gonococcal and chlamydial infections in adolescents seeking care at an urban emergency department. METHODS: An unlinked prevalence study was performed with ligase chain reaction tests on voided urine specimens from a convenience sample of adolescents 14 years or older who sought care at the Children's Hospital of Alabama ED. Demographic data and data on care provided in the ED were determined from retrospective chart review of those patients whose urine specimens were tested. RESULTS: Of 282 urine specimens screened, 13.5% (38) yielded positive findings on ligase chain reaction testing for either or both pathogens (20 [7%] positive for N gonorrhoeae, 23 [8%] positive for C trachomatis). In the context of acute care, gonorrhea or chlamydial infection was diagnosed in 5 (1.8%). STD prevalence did not vary significantly by age. Only 39% (15/38) of patients with infections detected by ligase chain reaction testing received potentially effective antibiotics as a result of their urgent care evaluation. CONCLUSION: Many adolescents use the ED for nonurgent care and unsuspected STDs are often missed. Urine ligase chain reaction testing is a sensitive, noninvasive means of detecting STDs by which unsuspected adolescent STD cases can be detected in an ED setting.

Lack of interaction of HLA and IgG heavy chain allotypes in insulin-dependent diabetes mellitus.

Because of conflicting previous reports showing the presence or absence of Gm-HLA interaction in insulin-dependent diabetes mellitus (IDDM), we report results for a group of Wisconsin families having 2 or more siblings with IDDM. Although this study is very similar to one by Field et al., who found HLA-Gm interaction in IDDM, we find no evidence for such an interactive effect p = 0.33). We discuss published data on HLA-Gm interaction in IDDM, and conclude that overall there is little reason to postulate such an interaction.

Simulator Technique for Assessing the Bacteriological Control of Food Equipment Surfaces by Cleaning Systems.

A cleaning simulator is described which permitted assessment of the control of surface bacteria by food equipment cleaning systems. Test pieces were sequentially exposed in test cells to soiling and cleaning solutions over a 2.5-h period and then left untreated for 9.5 h, after which the sequence was repeated. Four test cells received variations of the basic system sequentially within each 12-h period. Temperature and chemical composition of the soiling solutions were accurately controlled. Milk used for soiling was inoculated with two species of bacteria. Test pieces were removed from the test cells and evaluated bacteriologically and gravimetrically. Five bacterial species were studied for their value as soil contaminants; Streptococcus faecalis , Micrococcus luteus , Enterobacter aerogenes , Pseudomonas aeruginosa and Escherichia coli . P. aeruginosa , E. coli and M. luteus were the most resistant to an iodophor sanitizer, while P. aeruginosa and S. fuecalis were most resistant to both a quaternary ammonium compound and chlorhexidene. Studies of growth rates in milk after refrigerated storage for 48 h showed all five organisms suitable for use as milk contaminants. These studies, and other characteristics of these organisms, led to selection of S. faecalis , paired with either E. coli or E. aerogenes as the milk contaminants for simulator experiments.