Streptococcus taonis sp. nov., a novel bacterial species isolated from a blood culture of a patient.

One Gram stain-positive, catalase-negative, α-hemolytic, chain-forming or paired cocci, designated ST22-14T, was isolated from a blood culture of a child with suspected infection. The results of 16S rRNA gene sequences analyses showed that the most closely related species to strain ST22-14T were "Streptococcus vulneris" DM3B3T (99.2%), Streptococcus mitis NCTC 12261T (99.0%), "Streptococcus gwangjuense" ChDC B345T, (99.0%), Streptococcus oralis subsp. dentisani 7747T (99.0%), Streptococcus downii CECT 9732T (99.0%), and Streptococcus infantis ATCC 700779T (98.9%). The genome of strain ST22-14T consists of 2,053,261 bp with a G + C content of 39.4%. Average nucleotide identity values between strain ST22-14T and Streptococcus mitis NCTC 12261T or other five species were from 82.2 to 88.0%. In silico DNA-DNA hybridization of ST22-14T showed an estimated DNA reassociation value of 34.6% with the closest species. The main cellular fatty acids of strain ST22-14T were 16:0, 18:0, 14:0, 18:1ω7c and 18:1ω6c. Based on these results, strain ST22-14T should be classified as a novel species of genus Streptococcus, for which the name Streptococcus taonis sp. nov. is proposed (type strain ST22-14T = NBRC 116002T = BCRC 81402T).

Combination of XEOL, TR-XEOL and HB-T interferometer at the TPS 23A X-ray nanoprobe for exploring quantum materials.

In this study, a combination of X-ray excited optical luminescence (XEOL), time-resolved XEOL (TR-XEOL) and the Hanbury-Brown and Twiss (HB-T) interferometer at the Taiwan Photon Source (TPS) 23A X-ray nanoprobe beamline for exploring quantum materials is demonstrated. On the basis of the excellent spatial resolution rendered using a nano-focused beam, emission distributions of artificial micro-diamonds can be obtained by XEOL maps, and featured emission peaks of a selected local area can be obtained by XEOL spectra. The hybrid bunch mode of the TPS not only provides a sufficiently high peak power density for experiments at each beamline but also permits high-quality temporal domain (∼200 ns) measurements for investigating luminescence dynamics. From TR-XEOL measurements, the decay lifetime of micro-diamonds is determined to be approximately 16 ns. Furthermore, the XEOL spectra of artificial micro-diamonds can be investigated by the HB-T interferometer to identify properties of single-photon sources. The unprecedented strategy of combining XEOL, TR-XEOL and the HB-T interferometer at the X-ray nanoprobe beamline will open new avenues with significant characterization abilities for unraveling the emission mechanisms of single-photon sources for quantum materials.

IgE antibody responses in cerebrospinal fluids relate to the brain pathologic injury of hosts with Angiostrongylus cantonensis infection.

BACKGROUND: The immunoglobulin E (IgE) response to Angiostrongylus cantonensis infection increases in the host. This study analyzed the IgG and IgE responses detected in different body fluids of A. cantonensis-infected mice. METHODS: BALB/c (high susceptibility), CBA (medium), and C57BL/6 and C57BL/10 (resistance) strain mice were used in this study. The levels of IgM, IgG, and IgE in the serum and cerebrospinal fluid (CSF) from infected mice were compared. A. cantonensis-reactive antigens from BALB/c and C57BL/6 mice CSF were also analyzed. RESULTS: Antibodies against fifth-stage larvae (L5) antigens increased in mice CSF, particularly IgE, relate to worm rejection and the susceptibility of different mouse strains. The increased IgE level in BALB/c mice CSF is lower than that from others, suggesting IgE response in brain is more important than that in serum. Anti-L5 and anti-excretory/secretory (ES) antigen IgE and IgG responses in CSF were analyzed. In addition, the antibody-dependent eosinophil-mediated cytotoxicity induced by anti-excretory/secretory (ES) antigen antibodies may be the reason of severe brain inflammation in infected BALB/c mice. IgE and IgG antibodies against a 105 kDa protein of L5 antigen was detected at week 3 post-infection in C57BL/6 mice and week 5 post-infection in BALB/c mice. We suggest that 105 kDa protein is related with the antibody response of A. cantonensis-infected mice. CONCLUSION: We found that IgE antibodies in mice CSF against L5 antigens related to worm rejection in mice brains. This study may help to identify specific angiostrongyliasis markers that can be applied for clinical diagnosis and treatment in future.

Water-cooled magnetic coupling drive attenuator design for wiggler light source in the TPS 31A beamline.

An attenuator is generally used to decrease the power of an X-ray beam and prevent damage to detector sensors and other optical components. Therefore, attenuators are designed using foil or gas to absorb light source power. In this project, a large aperture and a water-cooling attenuator system are construed for the TPS 31A Projection X-ray Microscope and Transmission X-ray Microscope beamline. The source size of the wiggler is 300 µm × 7 µm on TPS 31A. The X-ray beam size at the sample position is 50 mm × 20 mm, located 49.5 m from the source. The light emission power is 1000 W in white-beam operation mode. The attenuator is needed to absorb energy for the light source and it has 12 foil carriers. The absorption foil size is 56 mm × 46 mm for the beam size across different beamline operation modes, and the cooling capacity is greater than 1000 W. This study applies a magnetic coupling-type attenuator system with foil carrier cooling carried out by the side chamber walls without the feedthrough having water enter the chamber to solve the thermal dissipation issue.

Visualizing the valence states of europium ions in Eu-doped BaAl2O4 using X-ray nanoprobe mapping.

This study develops and successfully demonstrates visualization methods for the characterization of europium (Eu)-doped BaAl2O4 phosphors using X-ray nanoprobe techniques. X-ray fluorescence (XRF) mapping not only gives information on the elemental distributions but also clearly reveals the valence state distributions of the Eu2+ and Eu3+ ions. The accuracy of the estimated valence state distributions was examined by performing X-ray absorption spectroscopy (XAS) across the Eu L3-edge (6.977 keV). The X-ray excited optical luminescence (XEOL) spectra exhibit different emission lines in the selected local areas. Their corresponding emission distributions can be obtained via XEOL mapping. The emission properties can be understood through correlation analysis. The results demonstrate that the main contribution to the luminescence intensity of the Eu-doped BaAl2O4 comes from the Eu2+ activator and the emission intensity will not be influenced by the concentration of Eu2+ or Eu3+ ions. It is anticipated that X-ray nanoprobes will open new avenues with significant characterization ability for unravelling the emission mechanisms of phosphor materials.

Streptococcal toxic shock syndrome after hemorrhoidectomy: A case report.

BACKGROUND: Streptococcal toxic-shock syndrome after hemorrhoidectomy is rare but may be catastrophic. Group A streptococci have produced various surface proteins and exotoxins due to genetic changes to fight the human body's immune response. Though life threatening infection after hemorrhoidectomy rarely occurs, all surgeons should be aware of the potential complications of severe sepsis after hemorrhoidectomy and keep in mind their clinical presenting features in order to diagnose early and administer appropriate and effective therapeutic drugs early. CASE SUMMARY: Here, we present a case of a 56-year-old man with a painful thrombotic external hemorrhoid who presented to our outpatient department for management. There was no history of systemic diseases or recent disease infection. Hemorrhoidectomy was suggested and performed. After surgery, the patient developed hypotension, tachycardia, fever with chills and renal function impairment on day 2 post-operation. The clinical condition progressed to severe septic shock and metabolic acidosis. The patient responded poorly to treatment and expired after 1 d even with use of extracorporeal membrane oxygenation. The results of the blood and wound cultures showed group A streptococcus pyogenes. CONCLUSION: Although extremely uncommon, all surgeons should be aware of these potential life-threatening septic complications and alert to the presenting features for patients receiving hemorrhoidectomy.

Characteristics of HIV-positive pregnant women and HIV- and antiretroviral therapy-exposed fetuses: A case-control study.

INTRODUCTION: This study determined risk factors, obstetric comorbidities, and fetal conditions among HIV-positive mothers to improve their maternal care. METHODOLOGY: This retrospective case-control study included HIV-positive pregnant women 18 years of age or older and age-, parity-, and delivery method-matched HIV-negative controls between 2011 and 2018. Those who had stillbirth were excluded. Baseline demographics, labor process, CD4 count, plasma HIV viral load, and antiretroviral therapy (ART) regimen were recorded. Fetal conditions were recorded as well. RESULTS: Forty HIV-positive women (45 parities; 22 via NSD, 23 via C/S) were included, with 45 HIV-negative parities as controls. Twenty-nine (72.5%) HIV-positive women had illicit drug use. In the HIV-positive group, 17% received ART prior to first perinatal visit, and 75.6% reached viral suppression pre-delivery. Zidovudine and ritonavir-boosted lopinavir were the majorly prescribed ART. Mild perineal lacerations via NSD were observed in HIV-positive women. Fetal body weight was lower in HIV- and ART-exposed fetuses (2665 vs 3010 g, p < 0.001). Preterm delivery PTB (28.9% vs 8.9%, p= 0.015) and small-for gestational age SGA (28.9% vs 8.8%, p = 0.003) rates were higher in the HIV-positive group. There was no vertical transmission of HIV. CONCLUSIONS: HIV-positive women tend to deliver fetuses with low body weight and have higher SGA and PTB rates. Given that most women received zidovudine and protease inhibitors, benefits of newer agents for HIV-positive pregnancies should be studied.

Capabilities of time-resolved X-ray excited optical luminescence of the Taiwan Photon Source 23A X-ray nanoprobe beamline.

Time-resolved X-ray excited optical luminescence (TR-XEOL) was developed successfully for the 23A X-ray nanoprobe beamline located at the Taiwan Photon Source (TPS). The advantages of the TR-XEOL facility include (i) a nano-focused X-ray beam (<60 nm) with excellent spatial resolution and (ii) a streak camera that can simultaneously record the XEOL spectrum and decay time. Three time spans, including normal (30 ps to 2 ns), hybrid (30 ps to 310 ns) and single (30 ps to 1.72 µs) bunch modes, are available at the TPS, which can fulfil different experimental conditions involving samples with various lifetimes. It is anticipated that TR-XEOL at the TPS X-ray nanoprobe could provide great characterization capabilities for investigating the dynamics of photonic materials.

Investigation of Cavity Enhanced XEOL of a Single ZnO Microrod by Using Multifunctional Hard X-ray Nanoprobe.

The multifunctional hard X-ray nanoprobe at Taiwan Photon Source (TPS) exhibits the excellent ability to simultaneously characterize the X-ray absorption, X-ray excited optical luminescence (XEOL) as well as the dynamics of XEOL of materials. Combining the scanning electron microscope (SEM) into the TPS 23A end-station, we can easily and quickly measure the optical properties to map out the morphology of a ZnO microrod. A special phenomenon has been observed that the oscillations in the XEOL associated with the confinement of the optical photons in the single ZnO microrod shows dramatical increase while the X-ray excitation energy is set across the Zn K-edge. Besides having the nano-scale spatial resolution, the synchrotron source also gives a good temporal domain measurement to investigate the luminescence dynamic process. The decay lifetimes of different emission wavelengths and can be simultaneously obtained from the streak image. Besides, SEM can provide the cathodoluminescence (CL) to be a complementary method to analyze the emission properties of materials, we anticipate that the X-ray nanoprobe will open new avenues with great characterization ability for developing nano/microsized optoelectronic devices.

Immunologic evaluation of extracted intestinal proteins from Angiostrongylus cantonensis adult worms.

BACKGROUND: To determine whether intestinal Angiostrongylus cantonensis antigens can induce protective immunity in rats, gut antigens prepared from female adults (FAGP) and somatic antigens prepared from both male (MA) and female (FA) adult worms were used to immunize rats. METHODS: Rats were immunized twice with MA, FA, or FAGP antigens and then challenged with 50 third-stage A. cantonensis larvae, and different readouts were used to monitor protective immunity. Additionally, protein profiles of MA, FA, and FAGP extracts were analyzed and characterized by immunodetection methods. RESULTS: A 15% reduction in fifth-stage larvae from brains and a 14% reduction in adult worms from pulmonary arteries were observed in rats immunized with FAGP compared to controls. However, there was a >50% reduction in rats immunized with MA or FA. The lengths of larvae and adults recovered from FAGP-immunized rats were shorter than those recovered from other groups. The number of first-stage larvae recovered from fecal material in FAGP-immunized rats was significantly reduced. Additionally, FAGP induced the highest splenocyte proliferation. Serum IgG titers were not directly correlated with protective immunity. An 84 kDa gut membrane protein was strongly recognized by anti-FAGP antibodies. CONCLUSION: We demonstrated that immune responses induced by FAGP reduced the growth, development, and reproduction of A. cantonensis in subsequent infections. While the possibility of using FAGP combining with MA or FA antigens as a multi-function vaccine in immune protection against A. cantonensis needs to be further elucidated, we hope that it provides a novel strategy for this parasite vaccine development.

Peculiar near-band-edge emission of polarization-dependent XEOL from a non-polar a-plane ZnO wafer.

Polarization-dependent hard X-ray excited optical luminescence (XEOL) was used to study not only the optical properties but also the crystallographic orientations of a non-polar a-plane ZnO wafer. In addition to a positive-edge jump and extra oscillations in the near-band-edge (NBE) XEOL yield, we observed a blue shift of the NBE emission peak that follows the polarization-dependent X-ray absorption near-edge structure (XANES) as the X-ray energy is tuned across the Zn K-edge. This NBE blue shift is caused by the larger X-ray absorption, generating higher free carriers to reduce the exciton-LO phonon coupling, which causes a decrease in the exciton activation energy. The extra oscillations in XANES and XEOL as the polarization is set parallel to the c-axis is attributed to simultaneous excitations of the Zn 4p - O 2pπ -bond along the c-axis and the bilayer σ-bond, whereas only the σ-bond is excited when the polarization is perpendicular to the c-axis. The polarization-dependent XEOL spectra can be used to determine the crystallographic orientations.

Prospective antimicrobial audit and feedback did not decrease case fatality: Experiences from a hospital in northern Taiwan.

INTRODUCTION: Although a prospective antimicrobial audit and feedback is an effective strategy in an antibiotic stewardship program, previous researchers have not adequately demonstrated a successful impact on patient outcomes. In this study, the causes of fatalities associated with a prospective antimicrobial audit and feedback were analyzed. METHODOLOGY: Between June and September 2014, applications for 16 target parenteral formulas (including ceftriaxone, ceftazidime, cefepime, piperacillin/tazobactam, vancomycin, teicoplanin, ertapenem, imipenem/cilastatin, meropenem, levofloxacin, moxifloxacin, ciprofloxacin, tigecycline, linezolid, daptomycin, and amikacin), which were not approved by infectious diseases (ID) specialists, were followed up until patients were either discharged or passed away. RESULTS: Of the 292 cases studied, 193 (66%) were male, with a mean age (standard deviation) of 65.5 (19.3) years. There were five reasons for rejection, including dosage adjustments (37%), no evidence of bacterial infection (28.8%), modifications according to antimicrobial susceptibility (18.8%), target pathogens not being covered (7.2%), and redundant therapy (4.1%). Multiple logistic regression analysis demonstrated that an age greater than 75 years (odds ratio [OR]: 2.58; 95% confidence interval [CI]: 1.32-5.50; p = 0.005) was associated with significant mortality, while urinary tract (OR: 0.26; 95% CI: 0.09-0.70; p = 0.013) and soft tissue/bone infections (OR: 0.18; 95% CI: 0.05-0.61; p = 0.006) were associated with survival. Adjustments according to ID physicians' recommendations were not statistically significant (OR: 0.53; 95% CI: 0.27-1.06; p = 0.074). CONCLUSIONS: Antimicrobial adjustments according to ID physicians' recommendations showed only marginally preventative effects against fatalities.

Orbital cellulitis caused by community-associated methicillin-resistant Staphylococcus aureus in a previously healthy neonate.

A 30-day-old, previously healthy, near-term neonate presented with fever and swelling of the left eye. Orbital cellulitis of the left eye was diagnosed by computed tomography. Both blood culture and pus that was drained from the orbital abscess were positive for methicillin-resistant Staphylococcus aureus (MRSA), which was found to be a strain indigenous to the local community by a molecular method. Using vancomycin therapy and surgical drainage, the infant recovered uneventfully. Orbital cellulitis in neonates may rapidly progress to abscess formation, even to sepsis, and S. aureus is the most common pathogen. With the increasing prevalence of community-associated MRSA, empiric antibiotics effective against MRSA should be first considered in endemic areas.

Epidemiology, clinical features, treatment, and outcomes of cases of influenza A infection during the 2009 influenza pandemic in northern Taiwan.

BACKGROUND: In April 2009, confirmed cases of influenza A (H1N1) infections were reported worldwide, spreading from Mexico and southern California. In order to determine the clinical features of patients infected with this virus before vaccine implementation and evaluate the response of antiviral treatment in Taiwan, we reviewed medical charts and collected clinical data from outpatients and inpatients at the Tao-Yuan General Hospital. METHODS: From May 19, 2009, to October 31, 2009, clinical data from patients confirmed by the rapid antigen-screening test for influenza A virus and/or reverse transcriptase-polymerase chain reaction analysis at the Tao-Yuan General Hospital were reviewed retrospectively. RESULTS: A total of 1158 patients (94.6%) received outpatient management, 66 patients (5.4%) were hospitalized, and no patients died. More than two-thirds of patients were younger than 16 years old. The most common symptoms were fever (99.8%), cough (91.4%), sore throat (63.7%), and rhinorrhea (53.8%). Ninety patients (13.3%) had complications, including lower respiratory tract infections (11.1%). Among the 677 patients receiving follow-ups, none needed mechanical ventilation due to lower respiratory tract infection. Most of the patients (87.2%) began antiviral therapy within 2 days after the onset of symptoms. Ninety percent of patients became afebrile within 2 days after the initiation of antiviral therapy. The number of screening specimens and the positivity rate of the rapid influenza A antigen test were dramatically decreased 4 weeks later, after universal implementation of the pandemic influenza A (H1N1) 2009 vaccine to infants and school-age children. CONCLUSION: The clinical spectrum of pandemic influenza A (H1N1) 2009 infection was broad and the severity of disease was mild. Early antiviral treatment was effective in decreasing mortality and morbidity. Early and universal implementation of a novel influenza A vaccine is an effective approach for preventing pandemic community influenza outbreaks, particularly among infants and school-age children.

Characterization of 13 multi-drug resistant Salmonella serovars from different broiler chickens associated with those of human isolates.

BACKGROUND: Salmonella are frequently isolated from chickens and their products. Prevalent serogroups and serovars of Salmonella as well as their genotypes and antibiograms were determined for cloacal samples from 1595 chickens. To understand the possible serovar and H antigens for transmission between chicken and human, serovars and their H antigens of 164 chicken and 5314 human isolates were compared. RESULTS: Prevalence of Salmonella differed among chicken lines and ages. Chicken and human isolates belonged mainly to serogroup B, C1, C2-C3, D, and E. 13 serovars and 66 serovars were identified for chicken and human isolates respectively. The common serovars for chicken and human isolates were S. Typhimurium, S. Enteritidis, S. Albany, S. Derby, and S. Anatum and shared common H1 antigens "g complex; i; e,h; and z4,z24" and H2 antigens "1 complex and -". In human isolates, H1 antigen "i" and H2 antigen "-" were common in all serogroups. In chicken, antimicrobial susceptibility differed among serogroups, serovars and three counties. All isolates were susceptible to cefazolin and ceftriaxone, but highly resistant to ampicillin, chloramphenicol, flumequine, streptomycin, sulfamethoxazole-trimethoprim, and tetracycline. Except those isolates of serogroup C1 of Chick group and serogroup G, all isolates were multi-drug resistance. Only S. Kubacha, S. Typhimurium, S. Grampian, and S. Mons were resistant to ciprofloxacin and/or enrofloxacin. CONCLUSION: In chicken, prevalent serogroups and serovars were associated with chicken ages, lines and regions; and flouroquinolone-resistant and MDR isolates emerged. H1 antigens "g complex and i" and H2 antigens "1 complex and -" might be important for transmission of Salmonella between chicken and human.

Methicillin-resistant Staphylococcus aureus bacteremia in neonatal intensive care units: genotyping analysis and case-control study.

To assess the relatedness of methicillin-resistant Staphylococcus aureus (MRSA) isolates and to identify the risk factors for the acquisition of MRSA bacteremia in infants hospitalized in neonatal intensive care units (NICUs), 21 bloodstream isolates from 21 infants were genotyped and other 21 infants without MRSA bacteremia were matched for a case-control study. Two genotypes (A and C) were identified by pulsed-field gel electrophoresis and three genotypes (I, II and III) by infrequent-restriction-site polymerase chain reaction. Genotype C-III in 9 isolates and genotype A-I in 7 isolates were the two most common genotypes. The presence of skin infection at onset, prolonged prior duration of central venous catheter indwelling and prolonged hospital stay were significantly associated with MRSA bacteremia in these infants. With multiple logistic regression analysis, the presence of skin infection at onset was the only significant risk factor of MRSA bacteremia, with an odds ratio of 20.8 (95% CI 2.95-145.4, p =.002). Conclusively, two major clones of MRSA prevailed in our NICUs, and the presence of skin infection at onset was the risk factor for the acquisition of MRSA bacteremia in these infants.

Multidrug-resistant non-typhoid Salmonella infections in a medical center.

Due to the high incidence of antimicrobial-resistant Salmonella in Taiwan, the emergence of multidrug-resistant Salmonella has become of particular concern. This retrospective study assessed the clinical features of patients with multidrug-resistant Salmonella treated from January 1998 through June 2000. A total of 201 children and 33 adults with multidrug-resistant Salmonella infections treated during a 2.5-year period were included. Sixty-percent of these patients had used antibiotics before multidrug-resistant Salmonella infection developed. The incidence of extra-intestinal infections was higher in adults (51.4%) than in children (4.9%). Infection with an invasive serotype of Salmonella, such as Salmonella choleraesuis, and host factors appeared to be predisposing factors for bacteremia or extra-intestinal infections. None of the patients had mortality attributable to multidrug-resistant salmonellosis. The increasing rate of resistance to third-generation cephalosporins and fluoroquinolones and the high multidrug-resistant rate of S. choleraesuis found in this study indicate the importance of judicious use of antimicrobial agents in both humans and animals to reduce the selection and spread of resistant strains.