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Biomedical subjects

U Larinkari

Publications and source records attributed to U Larinkari.

12 recordsLinked to original sources

Evaluation of a new dipslide with a selective medium for the rapid detection of beta-glucuronidase-positive Escherichia coli.

A selective medium was incorporated into a new three-media dipslide (Uricult Trio, Orion Diagnostica) to allow rapid identification of Escherichia coli. The medium is supplemented with a recently described chromogenic substrate, hydroxyquinoline-beta-D-glucuronide, for beta-glucuronidase enzyme. The performance of the medium was compared to that of three other beta-glucuronidase detection methods in tests of 602 routine urine samples. Of 324 Escherichia coli strains isolated, 92% grew brown colonies on dipslide, thus being beta-glucuronidase positive. The proportion of beta-glucuronidase-positive Escherichia coli detected by the three methods was 93% for BGA II agar plates (Tammer-Tutka), 91% for PGUA tablets (Rosco) and 84% for Fluorocult Brolacin agar plates (Merck). No false-positive reactions were seen in the case of 209 significant isolates of species other than Escherichia coli grown on the selective medium.

Bacteriuria↗

Triggering infections in reactive arthritis.

Certain microbes like yersinia, salmonella, shigella, campylobacter, chlamydia, and possibly gonococcus can trigger reactive arthritis especially in patients of the HLA-B27 type. In the present study we have used serological and culture methods to identify the probable triggering infection in 50 consecutive HLA-B27 positive patients diagnosed as having reactive arthritis. The two most common triggering agents thus identified were Yersinia enterocolitica (12 patients) and Chlamydia trachomatis (11 patients). In addition six patients had high antistreptolysin O titres and two high teichoic acid antibody titres suggesting group A streptococci and Staphylococcus aureus as triggering agents. In 13 patients no preceding infection could be identified. The identity of the infective agent seems to have very little effect on the clinical picture of the reactive arthritis - the only difference between the various aetiological groups in the present material was absence of fever in the patients with a preceding C. trachomatis infection, of whom only one out of 11 had a temperature greater than or equal to 38 degrees C, whereas 13 of 16 patients with a preceding enterobacterial, and five of the eight patients with a streptococcal or staphylococcal infection had raised temperatures.

Arthritis, Infectious↗

Comparison of anti-alpha-haemolysin and teichoic acid antibody tests in patients with Staphylococcus aureus endocarditis or bacteraemia.

To assess the value of serological tests in differentiating endocarditis and complicated bacteraemia due to Staphylococcus aureus from uncomplicated S. aureus bacteraemia and from nonstaphylococcal endocarditis we measured teichoic acid antibodies (TAA) (by means of a gel diffusion method) and antibodies to alpha-haemolysin (ASta) in the serum of 22 patients with S. aureus endocarditis, 42 patients with complicated S. aureus bacteraemia, 21 patients with uncomplicated S. aureus bacteraemia, 27 patients with other than S. aureus endocarditis, 17 patients with culture-negative endocarditis and 337 non-infected control patients. TAA and ASta titres were found significantly more often in staphylococcal endocarditis than in non-staphylococcal endocarditis, 59 per cent versus 4 per cent for the TAA test and 32 per cent versus 0 per cent for the ASta assay. The combined use of the two tests proved best for differentiating the two groups of endocarditis from each other, 72 per cent versus 4 per cent respectively. In the culture-negative endocarditis group there were two serologically positive patients whose anti-staphylococcal antibiotic therapy based on the serological findings was successful, supporting the clinical usefulness of staphylococcal serological tests in endocarditis of unknown bacterial aetiology. The serological tests were not useful, however, in differentiating S. aureus endocarditis from complicated or uncomplicated bacteraemia due to S. aureus without endocarditis.

Adolescent↗

Occurrence of antibodies to teichoic acid in patients with diseases other than staphylococcal infection.

To determine the usefulness of the teichoic acid antibody (TAA) test in conditions where unspecific viral and bacterial antibodies are often encountered, we measured TAA by the gel-diffusion method in 475 patients without known staphylococcal disease; they included 213 patients with arthritis, 108 with liver diseases, 100 with gastro-intestinal disorders and 54 with acute pharyngitis. Positive controls were 104 patients with Staphylococcus aureus bacteraemia and 203 healthy adults were negative controls. Thirteen (6%) of the healthy adults had positive TAA titres (greater than or equal to 4), and the highest titre was 8 in two people (1%). Positive titres were found in 38% of patients with S. aureus bacteraemia and high titres (greater than or equal to 8) were seen in 24%. Among the patients with arthritis, positive TAA titres were found significantly more often than in healthy controls in patients with Yersinia arthritis (p less than 0.01) and systemic lupus erythematosus (SLE; p less than 0.02). In other patient groups, the percentage of positive TAA titres did not differ significantly from that in healthy adults. Eight (2%) of the 475 patients without known staphylococcal infection had TAA titres greater than or equal to 8 but these high titres were not associated with any particular disease group. Only two of these eight patients had slightly raised antibody to staphylococcal alpha-haemolysin. We conclude that the TAA test cannot be used as a reliable indicator of septic staphylococcal disease in patients with Yersinia arthritis or SLE, but that in general, TAA titres greater than or equal to 8 point strongly to S. aureus infection even in patients with autoimmune or liver diseases.

Adolescent↗

Serum antibody to staphylococcal teichoic acid and alpha-haemolysin in dermatological patients.

Teichoic acid antibody (TAA) titres and antibody to alpha-haemolysin of Staphylococcus aureus (ASta) were measured in 274 dermatological patients and 200 normal controls. Positive ASta values (greater than or equal to 2.0 iu/ml) were common in patients with chronic pruritic dermatoses such as atopic dermatitis (44% ASta positive) and infective eczema (28% ASta positive), but patients with primary pyoderma were all ASTa negative. Positive TAA titres (greater than or equal to 1:4) were seen less frequently than positive ASta values, but still significantly more often in atopic dermatitis patients than in controls. Routine skin swabs were taken from all patients, but positive TAA or ASta tests correlated neither with growth of Staphylococcus aureus from skin lesions nor with signs of clinical infection. This study shows that the TAA test cannot be used as an indicator of septic staphylococcal infection in patients with atopic dermatitis.

Adolescent↗

Assay of teichoic acid antibodies and antistaphylolysin in the diagnosis of Staphylococcal osteomyelitis.

Teichoic acid antibodies (TAA), measured by gel diffusion, and antistaphylolysin (ASa) values were determined in 46 osteomyelitis patients and 200 healthy controls. A positive TAA titer (greater than or equal to 4) was seen in 4/16 patients with acute hematogenous osteomyelitis caused by Staphylococcus aureus and in 7/22 patients with chronic staphylococcal osteomyelitis, while ASta was positive (greater than or equal to 2.0 IU/ml) in 9 patients in both groups all except 2 exceeding 4.0 IU/ml. No positive TAA titres or ASta values were seen in 8 patients with chronic nonstaphylococcal osteomyelitis. The rate of positive test results in 200 controls was 7% for TAA and 4% for ASta. Basing diagnosis on a positive value in either of the tests gave 21 positive results in 38 patients with staphylococcal osteomyelitis; 18 by ASta alone and 11 by TAA alone. Both tests were positive at the same time in 3 patients with acute and in 5 patients with chronic staphylococcal osteomyelitis but never in controls.

Adolescent↗

Hepatic actinomycosis presenting as repeated cholestatic reactions.

A patient with hepatic actinomycosis caused by Actinomyces odontolyticus is presented. The clinical course was characterized by 2 yr of episodic abdominal pains and fever together with marked acute elevations of serum alkaline phosphatase. The diagnosis escaped extensive laboratory studies, 2 liver biopsies and 1 laparotomy and was finally verified at a second laparotomy by histology and a positive culture. Histopathology showed multiple small abscesses. No primary focus of infection was found. Treatment with doxycycline was successful.

Actinomycosis↗

Antibodies against antigens of Candida albicans in patients with fungaemia and bacteraemia, studied by ELISA, precipitation, passive haemagglutination and immunofluorescence techniques.

Antibodies against commercially available antigens of Candida albicans were assayed in 54 sera from 24 patients with fungaemia and in 66 sera from 33 patients with bacteraemia. In patients with persistent fungaemia, antibody was found during the week after the fungus was first cultured from the blood, but peak titres did not usually occur until the end of the second week. A significant rise in titre in C. albicans infection was observed in 50% of paired sera tested by passive haemagglutination (PHA), indirect immunofluorescence (IF) and Ouchterlony immunodiffusion (ID). The same percentage was obtained by counterimmunoelectrophoresis (CIE) against candida metabolic antigens, whereas it was increased to 88% when somatic antigens were used. Enzyme-linked immunosorbent assay (ELISA) demonstrated a rise of titre in 25, 75 and 50% of sera in IgM, IgG and IgA assays, respectively. Sera from patients with transient fungaemia demonstrated persistent antibody titres. In paired sera from patients with bacteraemia, ID and CIE titres were low (greater than or equal to 4). There was an increase of candida antibodies in 0-9% of patients by ELISA, ID or CIE and in 18-21% by PHA or IF. Clinically significant fungaemia was most reliably differentiated serologically from bacteraemia by CIE S-antigen and ELISA IgG assays.

Adolescent↗

Occurrence and specificity of antibodies against group-specific polysaccharides in beta-hemolytic streptococcal infections.

We studied the possibility of detecting beta-hemolytic streptococcal infections by determining antibodies against the group specific polysaccharides from streptococci of groups A, A-variant, C and G. The methods used were radio-immunoassay with these four polysaccharides and hemagglutination of group A polysaccharide sensitized erythrocytes. Significant increases in these antibodies were rare in tonsillitis patients, whereas high concentrations of antibodies could often be observed in association with severe systemic infections or rheumatic fever. Both strictly immunogen-restricted and crossreactive antibodies could be demonstrated by isoelectric focusing and inhibition of antigen-binding. Although previously considered nonexistent, group specific carbohydrate antibodies of IgM class could also be demonstrated.

Adolescent↗

Susceptibility of abortion patients to infection: Correlation to cervical flora.

Cervical bacterial microflora was studied with a semiquantitative method in 29 women both before and after the termination of their pregnancy. The main findings were high prevalence of anaerobic bacteria (in 72%-79% of the specimens) consisting predominantly of Bacteroides species and anaerobic Gram-positive cocci, and low prevalence of aerobic bacteria (in 24%-38% of the specimens). Among the other microbes studied, the prevalence of Chlamydia excretors was high (24%), probably reflecting a promiscuous study population. Seventeen percent of the women developed febrile postabortion endometritis or salpingits. However, the cervical culture results predicted neither the patient prone to infection nor her response to antimicrobial treatment, suggesting the need for more data concerning the virulence properties of the bacteria, together with isolation of the organism from an infected site.

Abortion, Spontaneous↗