Identification of coryneform and other gram-positive rods with several methods.

The identification of 202 isolates of aerobically growing Gram-positive rods from clinical material was attempted by using a combination of "traditional" morphological and biochemical tests (Hollis & Weaver (20)) plus patterns of cellular and metabolic fatty acids. This system served as the "gold standard" for three others, i.e. API Coryne (Rapid Coryne), MIDI TSBA and MIDI CLIN Aerobic. In addition, several growth, biochemical and susceptibility tests (growth on cystine-tellurite blood agar, DNase, hippurate and starch hydrolysis, methanethiol formation, API ZYM, CAMP reaction, susceptibility to O/129 and to six antimicrobials) were done in order to check their usefulness for the identification of this group of bacteria. Our system, with the help of chemotaxonomic tests (m-DAP and mycolic acids), was able to identify 154/202 (76%) of the isolates by species and an additional 41/202 (21%) by genus only; 7 (3%) could not be identified. The API Coryne system identified to species or genus level 140/195 isolates (72%). Corresponding figures for the MIDI TSBA and CLIN systems were 63/195 (32%) and 88/195 (45%); further details of species and genus identification are presented in the text. The main drawback of the commercial systems is the extent and probably the numerical depth of the data base. We recommend the use of our multisystem approach for the identification of Gram-positive rods until commercial systems are based on a broader and numerically more extensive data base. The additional tests did not prove species- or genus-specific.

Analysis by ELISA and Western blotting of antibody reactivities in cattle infected with Mycobacterium paratuberculosis after absorption of serum with M phlei.

Preabsorption of cattle serum with Mycobacterium phlei was of value in eliminating falsely positive reactions in an enzyme-linked immunosorbent assay (ELISA) for the detection of antibodies against M paratuberculosis. Specific antibody titres from 16 animals naturally infected with M paratuberculosis were unaffected by absorption. Analysis by Western blotting indicated that a different set of antigens of M paratuberculosis were recognised by serum from falsely positive reactors compared with that from animals with established infection. After experimental infection the time required for seroconversion in the ELISA in nine calves lay between 10 and 28 months, although one animal had not seroconverted after 30 months when the experiment ended. All animals shed M paratuberculosis in their faeces before seroconversion.

[Accidents in children and adolescents. Analysis of the accident event]. / Unfälle von Kindern und Jugendlichen. Analyse des Unfallgeschehens.

BACKGROUND: Accidents are the most frequent cause of death in children and adolescents. The aim of this study was to determine factors, which affect injury severity and to compare the absolute number of accidents with exposition data. PATIENT AND METHODS: From 1 January 1999 to 31 December 2001 a school survey of 2325 pupils was carried out. The 3645 accidents sustained by children and adolescents aged between 6 and 17 years treated at the surgical emergency department of the University Hospital Dresden were analyzed. RESULTS: Of the 3645 patients, 620 (17%) were admitted to hospital and 3025 (83%) were treated as outpatients. The most frequent diagnosis of the hospitalized patients was commotio cerebri; 83% of 36 severely injured patients had a head injury. 55.5% (297 of 536) of children between 6 and 9 years were using a protective helmet. In contrast only 14% of adolescents carried a protective helmet. None of 50 injured bicycle drivers with helmet had an AIS for head injuries >2. Twenty-for of 233 injured bicycle drivers without helmet had an AIS for head injuries >2. CONCLUSIONS: Head injuries are the main cause of hospitalization in traumatized children and adolescents. However, the use of a protective helmet becomes significantly less frequent with increasing age.

Logopaedic findings following advancement of the maxilla.

From 1972 to 1974, the authors carried out logopaedic examinations of over 100 patients with retrodisplaced maxillae at the Clinic for Maxillo-Facial Surgery at the University of Zurich (Director: Prof. H. Obwegeser, M.D., D.M.D.). From this clinical material, 40 cases which were fully documented in respect of medical history, surgical treatment and speech behavior were selected, and the effect of the advancement of the maxilla on the individual ability to articulate was studied.

[Molecular biology detection and antibiotic sensitivities of Shigella spp. and entero-invasive Escherichia coli (EIEC) in patients returning from the tropics]. / Molekularbiologischer Nachweis und Antibiotika-Empfindlichkeiten von Shigella spp. und enteroinvasiver Escherichia coli (EIEC) bei Tropenrückkehrern.

1579 stool samples from patients with travel-associated diarrhea were examined by conventional culture methods to detect Shigella spp. (48 positive samples or 3.2%) and by PCR to detect shigellae and enteroinvasive Escherichia coli (EIEC) (87 positive samplers or 5.8%). The numerical relation of shigellae to EIEC in PCR-positive samples was about 60 to 40%. However, the lack of discrimination between shigellae and EIEC is not important for the physician because the choice of antibiotics remains the same.

[An experiment on the theory of visual motion perception]. / Ein Experiment zur Theorie der visuellen Bewegungswahrnehmung.

Two classes of theories of motion perception were studied: correlation and gradient models (in the sense of D. Marr). Random-dot kinematograms with a shifted square were presented to subjects, and the 80% threshold for detection of correct direction of movement was determined. Correlation models predict scale invariance, that is, a constant shift measured in units of texture elements of the translated pattern in spite of a geometric magnification. This was refuted for all subjects. The increase of the recognizable translation with the area of the translated form was verified except for the patterns with the largest texture elements (8 minutes of arc). This prediction, however, is not very specific for competing theories. Gradient models are not yet fully specified, and they contain some free parameters. They cannot be tested strictly, but there exist reasonable numerical parameter values by which our data can be satisfactorily explained.

An outbreak of nontoxigenic Corynebacterium diphtheriae infection: single bacterial clone causing invasive infection among Swiss drug users.

From 1990 to 1996, a total of 65 patients from whom Corynebacterium diphtheriae had been isolated were reported to the Swiss Federal Office of Public Health. A retrospective review of medical and microbiological records as well as results of ribotyping of available isolates was performed. Twenty-seven patients had acquired their infection without evidence of use of illicit drugs, mostly as a skin infection imported from subtropical areas (20 patients); 38 isolations were associated with intravenous drug use (IVDU) (skin, 15; respiratory tract, 10; blood, 13). Endocarditis was documented in nine patients with bloodstream infection, four of whom died. There were two additional deaths due to overwhelming sepsis. The same ribotype of nontoxigenic C. diphtheriae was found in 31 of the 32 examined isolates associated with IVDU. All non-IVDU isolates had different ribotypes. Among Swiss drug users, a single clone of nontoxigenic C. diphtheriae was found over a period of several years with a high potential to cause severe invasive infection.

Nontoxigenic Corynebacterium diphtheriae isolated from intravenous drug users.

During a prospective study 117 intravenous drug users were screened for infection with Corynebacterium diphtheriae. Nontoxigenic C. diphtheriae was found in 5 of 132 throat swab specimens and in 5 of 28 skin ulcer specimens taken from July 1991 to April 1992. When phenotypic and molecular typing methods were used, these 10 strains were shown to belong to a single clone. During the same period no strain was isolated from 200 controls. Clinical manifestations of infection were not clearly attributable to C. diphtheriae--no typical membranous pharyngitis was present. The presence of a single clone among homeless intravenous drug users in Zurich indicates the presence of C. diphtheriae in parts of the population with poor standards of hygiene and low socioeconomic status.

Brevibacterium species as a cause of osteomyelitis in a neonate.

A case of osteomyelitis of the sternum due to Brevibacterium sp. in a neonate following mastitis of the mammary gland 20 days previously is described. The disease was successfully treated with cefazolin and oxacillin. The results of microbiological examinations and their significance are discussed.

Characterization of Brevibacterium spp. from clinical specimens.

Nonfermenting coryneform bacteria identified as Brevibacterium spp. were isolated from routine clinical specimens. Four strains were derived from peritoneal fluid and has presumably been involved in the pathogenesis of continuous ambulatory peritoneal dialysis peritonitis. Another five isolates most probably represented skin contaminants. Cell wall and lipid analyses confirmed the genus identification. Strains in this taxon are difficult to distinguish from other biochemically inactive and nonmotile coryneform species but show characteristics cellular fatty acid profiles. In vitro susceptibilities to commonly used antibiotics were determined.

Shigellemia in AIDS patients: case report and review of the literature.

Shigella bacteremia in adult patients is rare and is usually associated with immunosuppressive diseases. To date, 12 HIV-positive patients with Shigella bacteremia have been reported in the medical literature. We report a case of Shigella dysenteriae bacteremia in a 39-year-old HIV-positive patient. Although the patient presented with bloody and watery diarrhea, stool cultures failed to grow enteric pathogens. The patient responded well to appropriate antibiotic therapy.

Brucellosis: an occupational hazard for medical laboratory personnel. Report of five cases.

Five cases of laboratory-acquired infection with Brucella melitensis are reported. This pathogen is highly contagious when handled in the laboratory. Clinicians should alert technologists when brucellosis is suspected so that specimens are handled under the most stringent safety measures. Serological surveys and instructions of laboratory workers regarding the clinical diversity of the disease are helpful for early recognition of secondary cases. On the other hand, clinicians should consider brucellosis in medical laboratory workers with unexplained signs and symptoms.

Ribotyping of Pseudomonas aeruginosa strains isolated from surgical intensive care patients.

To elucidate the sources of Pseudomonas aeruginosa on a surgical intensive care unit, rDNA restriction fragment length polymorphism analysis (ribotyping) was applied to analyze strains isolated during a 4-month prospective study. Samples included 1635 from 153 patients, 2463 from 97 staff members, and 581 from the environment. Only 18 patients were colonized. Isolation from their animate and inanimate environment was very low, with 3 and 2 samples, respectively, being positive. Samples from tap water were negative. Ribotyping could easily distinguish 16 different digest patterns with identical follow-up isolates of the same patient. Horizontal transmission occurred only twice. The discriminatory power of ribosomal DNA in differentiating strains was dependent on the restriction enzymes used; among eight different enzymes, PvuII was the most sensitive, producing 15 different patterns. Ribotyping showed high sensitivity in typing P. aeruginosa isolates and confirmed that colonization occurs from endogenous rather than from exogenous sources.

Molecular epidemiology of Salmonella enteritidis.

Sixteen strains of Salmonella enteritidis isolated in 1991 from 13 unrelated poultry-associated sources, 7 strains from 2 community outbreaks, and 18 human sporadic isolates were investigated by phage typing, analysis of rRNA gene restriction patterns (ribotyping) and plasmid profiles. Four different phage types and 10 SphI patterns were found, whereas plasmids were identical in all but 4 isolates. Only one ribotype (RT A) occurred among both human and avian strains. This particular ribotype was also responsible for the two outbreaks investigated, suggesting that such strains may be of special significance for the increase of S. enteritidis infections.