Prolonged paradoxical reaction of tuberculosis in an HIV-infected patient after initiation of highly active antiretroviral therapy.
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Biomedical subjects
Publications and source records attributed to I Perales.
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Strains of Salmonella enterica (n = 212) of different serovars and phage types were used to establish a library typing computerized system for serovar Enteritidis on the basis of PCR fingerprinting, infrequent-restriction-site PCR (IRS-PCR), or pulsed-field gel electrophoresis (PFGE). The rate of PCR fingerprinting interassay and intercenter reproducibility was low and was only increased when DNA samples were extracted at the same time and amplified with the same reaction mixtures. Reproducibility of IRS-PCR technique reached 100%, but discrimination was low (D = 0.52). The PFGE procedure showed an intercenter reproducibility value of 93.3%. The high reproducibility of PFGE combined with the previously determined high discrimination directed its use for library typing. The use of PFGE with enzymes XbaI, BlnI, and SpeI for library typing of serovar Enteritidis was assessed with GelCompar 4.0 software. Three computer libraries of PFGE DNA profiles were constructed, and their ability to recognize new DNA profiles was analyzed. The results obtained pointed out that the combination of PFGE with computerized analysis could be suitable in long-term epidemiological comparison and surveillance of Salmonella serovar Enteritidis, specially if the prevalence of genetic events that could be responsible for changes in PFGE profiles in this serovar was low.
Survival of Campylobacter jejuni at 4 and 20 degrees C was investigated by using cellular integrity, respiratory activity, two-dimensional (2D) protein profile, and intact DNA content as indicators of potential viability of nonculturable cells. Intact DNA content after 116 days, along with cellular integrity and respiring cells, was detected for up to 7 months at 4 degrees C by pulsed-field gel electrophoresis. Most changes in 2D protein profiles involved up- or down-regulation.
Phage typing (PT) combined with pulsed-field gel electrophoresis (PFGE) and a random amplified polymorphic DNA (RAPD) fingerprinting method was used to characterize Salmonella enteritidis strains. Twenty-four epidemiologically unrelated isolates, sampled from diverse ecological niches and fifteen isolates from four well-defined outbreaks of foodborne gastroenteritis, were studied. Seven phage types, with a predominance of PT 4 (63% of isolates), were observed when analysing the epidemiologically unrelated group. PT 4 was detected in all of the ecological niches studied, including food and fecally polluted river and beach water. The discriminatory power for phage typing, the average probability that the typing system will assign a different type to two unrelated strains randomly sampled in the microbial population, was 0.62. Ten PFGE pattern types were obtained with Xba I restriction endonuclease enzyme among the unrelated isolates; thirteen isolates belonged to PFGE pattern type 1 and the rest of the PFGE types were assigned to one or two isolates. The Dice coefficient clustered the similarities of the PFGE patterns between 80-100%. PFGE showed a discriminatory power of 0.72. Five clearly distinct RAPD patterns were observed with the OPS-19 oligonucleotide, but the discrimination obtained was low (0.46). The combination of the three typing methods increased the number of types to seventeen, giving high discrimination (0.92). Seven of the isolates recovered from various ecological niches belonged to the combination PT 4/PFGE 1/RAPD A and other combinations were unique or included only two strains. The four epidemiologically well-defined foodborne outbreaks were associated with the PT 4 phage type. In two of the outbreaks, other phage types (PT 7a and RDNC) were also observed in two isolates. Most of the isolates belonging to the foodborne outbreaks had an identical PFGE pattern (PFGE pattern type 1), but a difference in a restriction band was observed in an isolate belonging to an outbreak. Two RAPD patterns were observed in the outbreaks; RAPD pattern type A was detected in three of the four outbreaks. When the combined typing method was applied to the study, high concordance was observed and most of the outbreak strains belonged to the combination PT 4/PFGE 1/RAPD A. It is concluded that the combination of phage type with PFGE and RAPD provides a powerful discriminatory tool for the epidemiological analysis of unrelated and related strains of S. enteritidis.
Fifty-nine isolates of Salmonella spp. were typed by PCR fingerprinting using three single primers: ERIC2, M13 and OPS-19. First, their discrimination power in a group of nine different serotypes were studied and considerable differences in the band patterns were obtained. Further, a panel of 51 isolates of Salmonella enteritidis with eight different phage types were analysed with the three primers. The discriminating power increased by combining the patterns of the three primers, and in this case it was possible to distinguish between some phage types of Salm. enteritidis, but not all of them were differentiated.
Kanamycin-esculin-azide agar was modified by increasing the concentration of sodium azide to 0.4 g liter-1 and replacing kanamycin sulfate with 5 mg of oxolinic acid liter-1. The modification, named oxolinic acid-esculin-azide (OAA) agar, was compared with Slanetz-Bartley and KF agars by using drinking water and seawater samples. The OAA agar showed higher specificity, selectivity, and recovery efficiencies than those obtained by using the other media. In addition, no confirmation of typical colonies was needed when OAA agar was used, which significantly shortens the time of sample processing and increases the accuracy of the method.
Two semisolid media poured in petri dishes, semisolid Rappaport and modified semisolid Rappaport Vassiliadis were compared for the recovery of Salmonella spp. from 154 high- and low-moisture foods and feeds. Semisolid media were inoculated after pre-enrichment in buffered peptone water and after enrichment in Müller-Kauffmann tetrathionate broth and selenite cystine broth. Also a conventional procedure was used, where the enrichment broths were streaked on Brilliant Green and bismuth sulphite agars. Of 62 samples found positive for Salmonella by one or more methods, semisolid Rappaport detected all of them and 60 when inoculated directly from the pre-enrichment broth. Modified semisolid Rappaport-Vassiliadis gave only 20 positive samples. The difference in productivity between semisolid Rappaport and the other media poured in plates (modified semisolid Rappaport-Vassiliadis, Brilliant Green and bismuth sulphite agar) was statistically significant (P less than 0.001). The incubation temperature recommended for modified semisolid Rappaport-Vassiliadis (42 degrees C) was found to be too high. By comparison to the other media, semisolid Rappaport gave a 500% increase in the detection of the enteritidis serotype of Salmonella.
In investigations on three outbreaks of Bacillus cereus food poisoning in Spain and The Netherlands, the causative strains grew within a temperature range of 4-37 degrees C, but not at 43 degrees C. Such psychrotrophic types were found to occur in various dairy products (including ca 25% of 35 samples of pasteurized milk) and some mousses and cook/chill meals. Growth of and enterotoxin production by psychrotrophic B. cereus could be prevented by temperatures below 4 degrees C and pH-values not exceeding 5.0.
A selective and differential medium (PALCAM agar) was elaborated for the isolation and enumeration of Listeria monocytogenes. PALCAM is based on Columbia agar with 0.05% glucose made selective by the addition of 0.001% polymyxin B, 0.0005% acriflavin, 1.5% lithium chloride and 0.002% ceftazidime. The diagnostic traits were attained by the incorporation of (i) 0.08% aesculin and 0.05% ferric salt; and (ii) 1% mannitol plus 0.008% phenol red. PALCAM recovered test strains of L. monocytogenes and other Listeria spp quantitatively and suppressed most other bacteria of common occurrence in fresh food. L. monocytogenes colonies were approximately 2 mm grey-green with a black sunken centre and a black halo on a cherry-red background. The occasional Enterococcus or Staphylococcus strains developing on the medium gave rise to grey colonies with a brown-green halo or yellow colonies with a yellow halo. PALCAM was the preferred medium out of 13 tested Listeria selective agars in current use. A similar differential enrichment broth, L-PALCAMY was developed based on peptone yeast extract broth with 2.5% egg yolk emulsion. The diagnostic traits and inhibitors used in this medium were the same as in PALCAM agar, through in different concentrations. Growth rate and cellcrop of L. monocytogenes in L-PALCAMY were of the same order as in Columbia broth. The growth of the majority of other bacteria of common occurrence in fresh foods was inhibited. The medium recovered L. monocytogenes more effectively from severely contaminated food than other current enrichment media.
Most outbreaks of salmonellosis occurring in Spain are transmitted by hens' eggs. This prompted a study on the incidence of Salmonella in eggs. Salmonella was found in 5 of 372 eggs associated with foodborne disease; one strain was isolated from the inside of the egg. In 998 eggs not associated with human salmonellosis, Salmonella was found on 6 occasions, including once inside the egg. These percentages are in general higher than those found in other Western countries. The possibility of eggs being contaminated before laying is discussed and an approach for controlling salmonellosis transmitted in this way is presented.
The use of two semisolid media (semisolid Rappaport and semisolid Rappaport-Vassiliadis) for the isolation of Salmonella spp. from coastal waters was compared with the use of conventional media. Two hundred and fifty six samples were studied; Salmonella spp. were detected in 83. The semisolid media were the most sensitive, detecting 73 samples instead of the 53 detected by the conventional media (P less than 0.001). The rate of isolation of Salmonella spp. showed an increase of 56.6% when the semisolid media were added to the conventional media, it being possible to detect 54.2% of the total organisms 1 day earlier.
The results of the study of 117 outbreaks of food poisoning in the Basque Autonomous Community during 1984-1986 are reported. In 76% of these outbreaks the causative agent could be isolated. Bacteria of the genus Salmonella accounted for 86.5% of the outbreaks with a known etiology, S. enteritidis being the most commonly found serotype. In 90% of the outbreaks caused by Salmonella, the transmission was by eggs or egg containing products. The features of food poisoning in the Basque Autonomous Community are discussed.
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A new medium, called RAPAMY agar, has been elaborated for the isolation from and the enumeration of Listeria spp. in foods. It is based on Ralovich's nalidixic acid-trypaflavin-agar with the following modifications: (i) the slight inhibitory properties of that medium were overcome by the use of Columbia Blood agar base instead of tryptose agar and the addition of 0.05% ferric ammonium citrate and 2.5% egg yolk emulsion; (ii) selectivity was improved by the addition of 0.25% 2-phenyl ethanol and incubation under microaerobic conditions; (iii) the medium was provided with two diagnostic traits by the addition of (a) aesculin + ferric ammonium citrate; and (b) D-mannitol and phenol red. The growth of Enterococcus spp., the only organisms other than Listeria spp. which grow on RAPAMY agar, was not inhibited by the addition of 20 microgram.ml-1 Cefoxitin (Moxolactam). Higher levels inhibited some Listeria spp., but not the enterococci. The medium recovered Listeria spp. quantitatively and allowed recovery from foods colonized by Enterococcus spp. at levels upto 10(2) per g.
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We present herein a case of an unusual variant of lichen planus characterized by chronic and painful ulcerations of the feet, erosive oral lesions and nail alterations. We emphasized the importance of the oral lesions in the correct diagnostic of these patients.
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