Antibacterial antibodies for some enterobacteria in sera of patients with reactive arthritis and other rheumatoid diseases.

The presence of the specific antibodies for some enterobacteria--Yersinia, Salmonella and Shigella was investigated in patients hospitalized in the period 2000-2007 with reactive arthritis and other rheumatoid diseases. The antibacterial antibodies in the diagnosis titres were found in 172 out of 1102 (15.6%) patients. Increased antibodies levels to Yersinia were detected in the sera from 113 (65.7%) of the 172 patients, for Shigella in 47 (27.3%) and for Salmonella in 12 (7.0%) cases. From all serologically positive patients 126 (73.2 %) had clinical diagnosis of reactive arthritis and 46 (26.7%) other rheumatoid diseases (ankylosing spondilytis, Reiter's syndrome, sacroilitis). The most serologically positive cases (63.9%) were of middle-age (30-50 years). There were no significant differences between sexes among serologically positive cases.

Development of resistance in Shigella flexneri isolates obtained in the past 20 years in eastern Romania.

Our study is focused on the antimicrobial activity for a number of 626 Shigella flexneri strains collected from epidemic outbreaks and hospitalised patients during 1976-1995 period, in Eastern Romania. The metodology used for determining the in vitro activity of the antimicrobials was that described by NCCLS. The agents which are currently used in therapy (ampicillin, tetracycline, chloramphenicol) are less active than the newer drugs (third generation cephalosporins, aztreonam, imipenem, ciprofloxacin) for which sensitivity ranged between 93-100% The associated resistance between ampicillin, tetracycline, chloramphenicol was demonstrated. Isolates with MIC values for ampicillin > 8 micrograms/ml are still sensitive to the modern beta-lactams. For ampicillin/sulbactam association, sensitivity decreases from 100% in 1990-1993 to 43% in 1994-1995.

Studies of bacterial, rotaviral and Cryptosporidium etiology of acute diarrheal diseases in hospitalized children.

657 hospitalized children with acute diarrheal disease were studied for bacterial and rotaviral etiology. Cryptosporidium presence was followed in 123 children. Intestinal pathogens were detected in 195 (29.6%) cases: 132 (20.3%) enterobacteria, 47 (7.1%) rotaviruses, 4 (3.2%) Cryptosporidium sp. and 12 (1.8%) combined infections. Among enterobacteria, E. coli was the most frequent (10% cases) with enteropathogenic (EPEC), enterotoxigenic (ETEC), enterohemorrhagic (EHEC) and enteroinvasive (EIEC) groups. Other isolated pathogens were Salmonella--21 (3.1%), C. jejuni/coli--13 (1.9%), Shigella--3 (0.9%), Y. enterocolitica O3--1 (0.1%). Among opportunistic pathogenic enterobacteria, the following were isolated: Kl. pneumoniae--24 (3.7%), Enterobacter species--4 (0.6%), Providencia alcalifaciens--1 (0.1%). Aeromonas hydrophila was isolated in 1 child. Combined infections were detected in 12 children: 10--enterobacteria + rotaviruses associations and 2--pathogenic enterobacteria associations.

The presence of some yeasts species in occupational dermatitis.

The samples of skin lesions were collected from forearms, palms and phalanges of ten females working in a manufacturing section (clothes tailoring and assemblage) using imported textiles. The samples were examined for bacteriological and mycotic flora by using classical methods. The textile fragments of 1-2 square centimeters from four samples were investigated using the same classical methods. The gauze fragments were used as toxic negative control samples. In 6 out of 10 samples from cutaneous lesions, Candida albicans was isolated and in 5 samples Rhodotorula species was identified. The yeasts species were identified by cultural and biochemical characteristics. All C. albicans strains were positive for the germ tube test and produced spherical chlamydospores on corn meal agar. The Rhodotorula strains grew on Sabouraud agar pure orange-red pigmented and mucoid colonies of 2-3 mm diameter. The textile samples incubated on blood--agar (10% sheep blood) demonstrated a high toxic activity producing a surrounding beta-hemolysis area of 3-5 cm. This lysis of the sheep red cell was caused by an unidentified chemical agent. In our cases, dermatites were associated with chemical and yeasts agents. The chemical agents irritated and made the derma sensitive, favouring C. albicans and Rhodotorula species multiplication.

Serological diagnosis in human Yersinia infections.

Serological examinations revealed Y. enterocolitica 0:3 specific antibodies in 34% of 80 children affected by a yersiniosis epidemic at titres of 1/40-1/640 and in all sporadic Yersinia enteritis cases. Similarly, agglutinins were identified for Y. enterocolitica 0:3 and 0:9 in 3.4% of 430 appendectomized children hospitalized with painful syndrome in the right iliac fossa. In 10% of 101 patients hospitalized with arthritis and Reiter's syndrome antibodies to Y. enterocolitica 0:3 (8 cases) and Y. pseudotuberculosis (3 cases) were detected at titres of 1/80-1/640. Our results stress the importance of serological examinations in diagnosing human infections with Yersinia.

[The presence of the Yersinia group in environmental factors, food and some animal species]. / Prezenta grupului Yersinia in factorii de mediu, alimente si unele specii de animale.

In a broad bacteriologic investigation, including more than 3,000 examination of domestic animals (porcines, bovines), fish, food (milk, ice cream), surface waters and soil, 27 strains of Yersinia enterocolitica were isolated. Of them 22 belonged to the O3(-8); O5(-6); O5,7,8(-2); O6(-2); O7(-2); O9(-2) serotypes, and 5 could not be serotyped, but were included in the biotype I. The strains isolated from fish, food and environment had a biochemical and/or serologic behaviour similar to that usually referred to man. The O3 and O9 serotypes, frequently present in man, were found, in the present investigation, only in porcines. Due to this wide serologic dispersion, the author suggests in each situation a biochemical selection of the suspected colonies for their retention and complete identification, even if they do not agglutinate with the O3 anti Y. enterocolitica serum in the routine examination.

[Enterobacteriaceae isolated in eastern Romania: the evolution of ampicillin sensitivity in the 1970-1995 period]. / Enterobacteriaceae izolate în estul României: evolutia sensibilitatii la ampicilina în perioada 1970-1995.

The activity of ampicillin against 3383 Enterobacteriaceae (community and clinical isolates), collected in Eastern Romania, during 25 years was tested. Data were prelucrated by the box-plot method proposed by Simpson and Donnelly. The resistance degree for all species tested has progressively increased. In the studied region Enterobacteriaceae strains maintain their natural sensitivity only exceptionally: e.g., S. typhi and S. java, with limited circulation. Enterobacteriaceae which have contact with the resistance genic reservoir of the colon microbiota during the justified or nonjustified antibiotic treatment development resistance to usual antibiotics in the same ratio as most existent commensals present in this habitat.

Isolation of Yersinia group in human infections, animals and environment factors.

The presence of Y. enterocolitica and Y. pseudotuberculosis was studied in 4479 enteritis cases, 430 children, presenting appendicular syndrome, and 60 hospitalized patients with arthritis and Reiter syndrome. Y. enteritis was detected in 41 (0.9%) enteritis cases, 15 (3.4%) appendectomized children and 5 (8.3%) arthritis cases. Antibodies to Y. pseudotuberculosis were detected in 2 (3.3%) arthritis patients. Y. enterocolitica was isolated in swine, fish and environment factors (water, soil, food). Y. pseudotuberculosis was isolated in soil. The isolated strains belonged to biotypes 1, 2, 4 and serotypes 0:3; 0:5; 0:5.27; 0:5, 6, 7, 8; 0:6; 0:9; some were non-typable and polyagglutinable. The strains were sensitive to bacteriophages for Yersinia, obtained in our laboratory.

Presence of Yersinia specific antibodies in hospitalized patients with arthritis and Reiter syndrome.

A number of 50 patients admitted with arthritis and Reiter syndrome were investigated to detect the presence of Yersinia specific antibodies. The specific antibodies were evidenced in 5 patients (10%)--3 with antibodies to Y. enterocolitica and 2 with antibodies to Y. pseudotuberculosis, in titers greater than or equal to 1/160. The patients were followed in dynamics up to 3-4 months. The antibodies to Y. enterocolitica persisted in time longer than those to Y. pseudotuberculosis. For a better knowledge concerning the germs responsible for sero-negative arthritis, serological investigations for Yersinia, in the patients with arthritis, appeared as necessary.

[Mixed viral-bacterial infections in infants with gastroenteritis]. / Infections mixtes virobactériennes chez des enfants atteints de gastro-entérite.

Fecal specimens from 84 children with gastroenteritis were submitted to virological and bacteriological analysis. Enteroviruses other than poliovirus were found in 8.3%, rotavirus in 4.8% and enterobacteria in 1.9% of the investigated subjects. Mixed infections were detected in 8.4% of the cases.

Detection of beta-lactamase production and enzyme profiles in Enterobacteriaceae isolated in Moldova.

In our study, out of 449 Enterobacteriaceae strains isolated between 1985 and 1990, 16 strains (3 Proteus, 6 nontyphoidal Salmonella, 7 Escherichia coli) were resistant both to Ampicillin- Sulbactam and Amoxycillin-Clavulanic acid associations. The activity profiles of the beta-lactamases produced by these resistant strains are described. Sarcina lutea ATCC 9341 was used as test strain. The effect of the enzymatic filtrate against beta-lactam antibiotics: Ampicillin, Cloxacillin, Cefadroxil, Cefuroxime, Cefotaxime, Ceftriaxone, was followed up. The enzyme types were established according to the ability of inactivating the tested antibiotics. Penicillins and cephalosporins were inactivated by these enzymes, except for Carbenicillin and Oxacillin. These beta-lactamases were resistant to Sulbactam and Clavulanic acid. In the studied Salmonella strains they are plasmidic codified, demonstrating that they belong to a new beta-lactamase class.

[Presence of the rotavirus antigen in newborn infants at maternity hospitals in Moldavia]. / Présence de l'antigène rotaviral de groupe chez des nouveau-nés des maternités de Moldavie.

Studies conducted on 417 feces samples collected from newborn infants from seven maternity homes revealed the presence of rotavirus in 1.2 to 9.5% of the subjects. The infants get infection during the first 24 to 48 hours of life (1.8%) and the positivity rate reaches a peak the 7th day (9.7%). Enteroviruses were found in 3.4% and enterobacteria in 11.8% of the samples.

Sensitivity of Enterobacteriaceae strains to the third generation cephalosporins.

The aim of this study was to evaluate the in vitro activity of cefotaxime, ceftriaxone, ceftazidime, ceftibuten and aztreonam against the clinical isolates of Enterobacteriaceae. MICROORGANISMS: A total of 973 enterobacteria isolated from clinical material (urine and faeces) were tested. Strains were collected during 1996-1998 period, in some centers of Eastern Romania. SENSITIVITY STUDY: MICs were performed using the agar dilution method following standardized techniques (NCCLS, 1994). Stock solutions of antibacterial agents were prepared from their respective powder forms, in concentrations ranging from 0.03 to 128 mg/ml. Our results show a good activity of the tested antimicrobials on Escherichia coli, Shigella spp and Klebsiella spp tested, and reveal a particular behaviour for Salmonella spp, characterized by a heterogenous susceptibility. In conclusion, cefotaxime, ceftriaxone, ceftazidime, ceftibuten and aztreonam were active at low concentrations against tested isolates. Against Salmonella spp, these agents were less active: percent of resistant strains by beta-lactamase production was significant.

[Detection of the rotavirus group antigen by a screening test using the ELISA-IC kit in subjects with acute gastroenteritis, at the pediatric services of Moldavia]. / Détection de l'antigène rotaviral de groupe par le test de screening à l'aide de la trousse ELISA-IC chez des sujets atteints de gastro-entérite aiguë, des services de pédiatrie de Moldavie.

The rotaviral antigen was detected by a screening test using the ELISA-IC kit in 17.6% out of 415 children with acute gastroenteritis. The highest frequency (28.9%) was found in children hospitalized in pediatric services with a diagnosis of diarrhoeic disease associated to acute respiratory infection. The rotavirus infection incidence was about three times higher during the cold season than during summer (30.4% versus 10.5%). The 6-11 month age group was the most severely affected.

[Epidemiological study of salmonelloses in the Moldavia area]. / Contributii la studiul epidemiologic al salmonelozelor pe teritoriul Moldovei.

A study was carried out on the epizooto-epidemiologic potential of certain domestic and wild animal species (cold-blooded), of the environment (residual waters) and food products, and their role in maintaining Salmonella endemics (others than the typhoid-parathyphoid group). Account was kept of the incidence of Salmonella and its circulation in subjects exposed to occupational risks and in the mass of the population, including those with clinically manifest salmonellosis and the clinically healthy carriers. The results showed the importance of domestic animals in maintaining the endemic (fowl 15%, swine 10%, bovine 5%). The isolated serotypes were identical to those found in residual eaters, in patients and in carriers. The sensitivity test to antibiotics revealed resistance to more than two antibiotics in 65%, except for the strains isolated from reptiles. Reorganization measures appear necessary in order to restrict the circulation of Salmonella in farm animals and to reduce the risks of infection in humans.