Adenoid reservoir for pathogenic biofilm bacteria.

Biofilms of pathogenic bacteria are present on the middle ear mucosa of children with chronic otitis media (COM) and may contribute to the persistence of pathogens and the recalcitrance of COM to antibiotic treatment. Controlled studies indicate that adenoidectomy is effective in the treatment of COM, suggesting that the adenoids may act as a reservoir for COM pathogens. To investigate the bacterial community in the adenoid, samples were obtained from 35 children undergoing adenoidectomy for chronic OM or obstructive sleep apnea. We used a novel, culture-independent molecular diagnostic methodology, followed by confocal microscopy, to investigate the in situ distribution and organization of pathogens in the adenoids to determine whether pathogenic bacteria exhibited criteria characteristic of biofilms. The Ibis T5000 Universal Biosensor System was used to interrogate the extent of the microbial diversity within adenoid biopsy specimens. Using a suite of 16 broad-range bacterial primers, we demonstrated that adenoids from both diagnostic groups were colonized with polymicrobial biofilms. Haemophilus influenzae was present in more adenoids from the COM group (P = 0.005), but there was no significant difference between the two patient groups for Streptococcus pneumoniae or Staphylococcus aureus. Fluorescence in situ hybridization, lectin binding, and the use of antibodies specific for host epithelial cells demonstrated that pathogens were aggregated, surrounded by a carbohydrate matrix, and localized on and within the epithelial cell surface, which is consistent with criteria for bacterial biofilms.

Effect of Se on selenoprotein activity and thyroid hormone metabolism in beef and dairy cows and calves.

Although Se is essential for antioxidant and thyroid hormone function, factors influencing its requirement are not well understood. A survey and two experiments were conducted to determine the influence of cattle breed and age on selenoprotein activity and the effect of maternal Se supplementation on cow and calf selenoprotein activity and neonatal thyroid hormone production. In our survey, four cowherds of different ages representing three breeds were bled to determine the influence of breed and age on erythrocyte glutathione peroxidase activity (RBC GPX-1). All females were nonlactating, pregnant, and consumed total mixed diets (Holstein) or grazed pasture (Angus and Hereford). In our survey of beef breeds, yearlings had greater average RBC GPX-1 activity than mature cows. In Exp. 1, neonatal Holstein heifers (n = 8) were bled daily from 0 to 6 d of age to determine thyroid hormone profile. An injection of Se and vitamin E (BO-SE) was given after the initial bleeding. Thyroxine (T4) and triiodothyronine (T3) concentrations were greatest on d 0 and decreased (P < 0.05) continuously until d 5 postpartum (156.13 to 65.88 and 6.69 to 1.95 nmol/L, d 0 to 5 for T4 and T3, respectively). Reverse T3 concentrations were 3.1 nmol/L on d 0 and decreased (P < 0.05) to 0.52 nmol/ L by d 5. In Exp. 2, multiparous Hereford cows were drenched weekly with either a placebo containing 10 mL of double-deionized H2O (n = 14) or 20 mg of Se as sodium selenite (n = 13). After 2 mo of treatment, Se-drenched cows had greater (P < 0.01) plasma concentrations than control cows (84.92 vs. 67.08 ng/mL), and at parturition, they had plasma Se concentrations twofold greater than (P < 0.05) control cows (95.51 vs. 47.14 ng Se/mL). After 4 mo, cows receiving Se had greater (P < 0.05) RBC GPX-1 activity than controls; this trend continued until parturition. Colostrum Se concentration was twofold greater (P < 0.05) in Se-drenched cows than control cows (169.97 vs. 87.00 ng/mL). Calves born to cows drenched with Se had greater (P < 0.05) plasma Se concentration, RBC GPX-1, and plasma glutathione peroxidase activity on d 0 compared with calves born to control cows. By d 7, no differences in plasma glutathione peroxidase activity in calves were observed. Maternal Se supplementation did not influence calf thyroid hormone concentrations. Selenium provided by salt and forages is not adequate for cattle in Se-deficient states.

Low efficiency of active immunization against diphtheria in chronic hemodialysis patients.

Recent epidemiological studies indicate a low immunity to diphtheria in adults in industrialized countries. In the light of the epidemic increase of diphtheria in countries such as Russia and the Ukraine, systematic vaccination against this disease is recommended. We analyzed the immunity to diphtheria of 228 hemodialysis patients and the efficiency of single versus triple vaccination against diphtheria. Antibodies against diphtheria toxoid were determined by enzyme immunoassay in sera of 228 adult hemodialysis patients. Fifty-four patients were triple vaccinated against diphtheria and were followed for six months; 17 patients were single immunized and antitoxoid titers were determined 1 and 12 months later. The overall protection rate against diphtheria was 22% and equal in male and female patients. After triple immunization, only 35% of the patients developed protective antibody concentration (> 0.1 i.e./ml) six months after the third vaccination. A single vaccination caused protective titres twelve months later in 41% of the patients. There was no difference between responders and non-responders in the duration, intensity or modality of hemodialysis treatment or the response to previous vaccinations against hepatitis-B. We suggest to monitor antibodies against diphtheria toxoid in vaccinated hemodialysis patients at risk for diphtheria since protective titers are often not attained by the standard vaccination protocol.

[Necrotizing fasciitis--a frequently mistaken disease (author's transl)]. / Fasciitis necroticans--ein häufig verkanntes Krankheitsbild.

A case of Fasciitis necroticans on the leg is reported in a female patient, age 28. The disease began with symptoms of an erysipelas, but it was resistant to penicillin. Within a few days necrotic decay of circumscribed skin areas occurred and the adjacent skin was widely undermined by the necrotizing process. Beta-hemolytic streptococci and Staphylococcus aureus haemolyticus were isolated. However, the disease could not be managed by adequate antibiotic therapy. Finally, the process was brought under control by extended incisions and removal of the necrotic masses. Defects were covered by plastic surgery.