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PubMed2005

The genus Cyclospora (Apicomplexa: Eimeriidae), with a description of Cyclospora schneideri n.sp. in the snake Anilius scytale scytale (Aniliidae) from Amazonian Brazil--a review.

A review is made of the recorded species of the coccidian genus Cyclospora and major events leading up to the discovery of C. cayetanensis, which is responsible for serious outbreaks of diarrhoea in man and is one of the aetiological agents of "traveller's diarrhoea". Humans appear to be the specific hosts, with the entire life-cycle in the intestine: to date there is no convincing evidence that the disease is a zoonosis. A description is given of oocysts and endogenous stages of C. schneideri n.sp., in the snake Anilius scytale scytale. Sporulation is exogenous and completed after about one week at 24-26 degrees. Mature oocysts 19.8 x 16.6 (15.1 x 13.8-25.7 x 20.1), shape-index 1.2 (1.0-1.3): no oocyst residuum or polar bodies. Oocyst wall a single colourless, smooth layer with no micropyle: it is rapidly deformed or broken. Sporocysts 13.6 x 9.4 (11.3 x 8.3-15.1 x 9.9), shape-index 1.4 (1.2-1.5) with an inconspicuous Stieda body. Sporozoites 11-13 x 2.5-3. Endogenous stages are intracytoplasmic in the epithelial cells of the small intestine and with the characters of the Eimeriorina.

Animals↗

PubMed1996

National legislation in Great Britain for the control of fish diseases.

The Diseases of Fish Act 1937 of Great Britain is almost certainly the longest-standing example of national legislation specifically devised to control fish diseases. It was introduced in response to several outbreaks of furunculosis disease in wild salmon and other fish species in the rivers of England, Wales and Scotland, which were attributed to the importation of infected live rainbow trout from Germany. The Act totally prohibited the importation of live salmonids into Great Britain, and made it illegal to import salmonid ova and all live freshwater fish species without a licence. The Act also provided powers for authorised persons to enter onto any land to confiscate any fish, ova, foodstuff or articles suspected to have been illegally imported into Great Britain. Moreover, the Act enabled any disease to be designated as 'notifiable', meaning that even the suspicion of its presence in any waters must be reported to the official services. This legislation was eventually amended and extended by the Diseases of Fish Act 1983 to make it a legal requirement for all fish-farming businesses to become registered with the official services, and to maintain records of the movement of fish and fish ova into and from their sites. In 1986, additional powers were introduced under the Animal Health Act 1981 to limit the importation of dead, ungutted salmonid fish. In 1993, the legislation was amended to remove any legal conflict with European Economic Community Council Directive 91/67/EEC. In addition, the Diseases of Fish (Control) Regulations have since been passed so that new European Union rules for the control of infectious salmon anaemia, viral haemorrhagic septicaemia and infectious haematopoietic necrosis may be enforced nationally.

Animals↗

PubMed2003

Extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae: considerations for diagnosis, prevention and drug treatment.

Extended spectrum beta-lactamase (ESBL)-producing organisms pose unique challenges to clinical microbiologists, clinicians, infection control professionals and antibacterial-discovery scientists. ESBLs are enzymes capable of hydrolysing penicillins, broad-spectrum cephalosporins and monobactams, and are generally derived from TEM and SHV-type enzymes. ESBLs are often located on plasmids that are transferable from strain to strain and between bacterial species. Although the prevalence of ESBLs is not known, it is clearly increasing, and in many parts of the world 10-40% of strains of Escherichia coli and Klebsiella pneumoniae express ESBLs. ESBL-producing Enterobacteriaceae have been responsible for numerous outbreaks of infection throughout the world and pose challenging infection control issues. Clinical outcomes data indicate that ESBLs are clinically significant and, when detected, indicate the need for the use of appropriate antibacterial agents. Unfortunately, the laboratory detection of ESBLs can be complex and, at times, misleading. Antibacterial choice is often complicated by multi-resistance. Many ESBL-producing organisms also express AmpC beta-lactamases and may be co-transferred with plasmids mediating aminoglycoside resistance. In addition, there is an increasing association between ESBL production and fluoroquinolone resistance. Although in in vitro tests ESBLs are inhibited by beta-lactamase inhibitors such as clavulanic acid, the activity of beta-lactam/beta-lactamase inhibitor combination agents is influenced by the bacterial inoculum, dose administration regimen and specific type of ESBL present. Currently, carbapenems are regarded as the drugs of choice for treatment of infections caused by ESBL-producing organisms. Unfortunately, use of carbapenems has been associated with the emergence of carbapenem-resistant bacterial species such as Stenotrophomonas sp. or Pseudomonas sp.

Anti-Bacterial Agents↗

PubMedDate not supplied

Experience of severe acute respiratory syndrome in singapore: importation of cases, and defense strategies at the airport.

BACKGROUND: The importation of SARS was responsible for the outbreaks in Singapore, Hong Kong, Vietnam and Canada at a time when this new disease had not been identified. We report the incidence and impact of cases of SARS imported to Singapore between 25 February and 31 May 2003, and describe national measures to prevent further importation. METHODS: Information on imported cases of SARS and measures taken at entry points to Singapore was retrieved from the Ministry of Health and the Civil Aviation Authority of Singapore. RESULTS: Of the 6 imported cases, which all occurred before screening measures were implemented at the airport, only the first resulted in extensive secondary transmission. Of 442973 air passengers screened after measures were implemented, 136 were sent to a designated hospital for further SARS screening; none was diagnosed as having SARS. CONCLUSIONS: The SARS outbreak in Singapore can be traced to the first imported case. The absence of transmission from the other imported cases was probably a result of relatively prompt identification and isolation of cases, together with a low potential for transmission. New imported SARS cases therefore need not lead to major outbreaks if systems are in place to identify and isolate them early. Screening at entry points is costly, has a low yield and is not sufficient in itself, but may be justified in light of the major economic, social and international impact which even a single imported SARS case may have.

Adolescent↗

PubMedDate not supplied

Molecular population genetic analysis of emerged bacterial pathogens: selected insights.

Research in bacterial population genetics has increased in the last 10 years. Population genetic theory and tools and related strategies have been used to investigate bacterial pathogens that have contributed to recent episodes of temporal variation in disease frequency and severity. A common theme demonstrated by these analyses is that distinct bacterial clones are responsible for disease outbreaks and increases in infection frequency. Many of these clones are characterized by unique combinations of virulence genes or alleles of virulence genes. Because substantial interclonal variance exists in relative virulence, molecular population genetic studies have led to the concept that the unit of bacterial pathogenicity is the clone or cell line. Continued new insights into host parasite interactions at the molecular level will be achieved by combining clonal analysis of bacterial pathogens with large-scale comparative sequencing of virulence genes.

Bacteria↗

PubMed2006

VEB-1 Extended-spectrum beta-lactamase-producing Acinetobacter baumannii, France.

VEB-1 extended-spectrum beta-lactamase-producing Acinetobacter baumannii was responsible for an outbreak in hospitals in France. A national alert was triggered in September 2003 when 4 hospitals reported clusters of A. baumannii infection with similar susceptibility profiles. Case definitions and laboratory guidelines were disseminated, and prospective surveillance was implemented; strains were sent to a single laboratory for characterization and typing. From April 2003 through June 2004, 53 hospitals reported 290 cases of A. baumannii infection or colonization; 275 isolates were bla(VEB-1)-positive and clonally related. Cases were first reported in 5 districts of northern France, then in 10 other districts in 4 regions. Within a region, interhospital spread was associated with patient transfer. In northern France, investigation and control measures led to a reduction of reported cases after January 2004. The national alert enabled early control of new clusters, demonstrating the usefulness of early warning about antimicrobial drug resist.

Acinetobacter Infections↗

PubMed2001

An investigation of the etiology of a mild diarrhea observed in a group of grower/finisher pigs.

An investigation into a mild diarrhea in a group of grower/finisher pigs was carried out in order to determine the etiology. A tiamulin injection and a carbadox-medicated ration were given to pens of pigs in a 2 x 2 factorial experimental design. Pens of pigs were assessed a score, based on the consistency of the feces in the pen, each week. The clinical investigation looked for the intestinal pathogens Brachyspira pilosicoli, B. hyodysenteriae, Lawsonia intracellularis, Salmonella spp., Yersinia spp., transmissible gastroenteritis virus, and rotavirus. Despite a rigorous investigation, the diarrhea was not attributed to any pathogen. A mild colitis was noted among pigs necropsied while affected with diarrhea. Improved diagnostic tools may allow a more effective response to an outbreak of mild disease, while at the same time reducing the amount of antimicrobials used in swine production.

Animals↗

PubMed2005

Bound for Sydney town: health surveillance on international cruise vessels visiting the Port of Sydney.

A program for routine health surveillance on international cruise ships visiting the Port of Sydney has been developed since 1998. Before introduction of this program, ships only reported quarantinable diseases and were not aware of the Australian requirement to report other infectious diseases. Voluntary routine reporting, developed in partnership with the cruise ship industry, provides timely information on all infectious diseases of public health interest during every cruise. During 1999-2003, the program resulted in detection of and response to 14 outbreaks of gastroenteritis or acute respiratory infection, affecting more than 1400 passengers and crew. The program has improved preventive action, and risk communication and management by cruise ship operators, and led to more timely investigation and support by public health authorities.

Communicable Disease Control↗

PubMed1999

Typing of Pasteurella multocida from haemorrhagic septicaemia in Danish fallow deer (Dama dama).

Isolates of Pasteurella multocida ssp. multocida (n = 31) from a Danish population of fallow deer which succumbed to haemorrhagic septicaemia during 1992 1993 and isolates from the palatine tonsils of apparently healthy fallow deer from the same area (n=6) were typed and compared with P. multocida from other sources. Plasmids were net observed in the fallow deer strains and one unique pattern was observed by ribotyping using HindIII and by pulsed-field gel electrophoresis using SanlI as restriction endonuclease. All Danish fallow deer isolates belonged to serotype B:3,4. On restriction endonuclease analysis using HhaI as restriction endonuclease, all had a profile identical to that of a fallow deer isolate from the United Kingdom: profile 0033 of Wilson et al. On restriction endonuclease analysis using HpaII as restriction endonuclease, the Danish fallow deer isolates had a unique profile, designated 0062, which differed slightly from that of a fallow deer isolate from the United Kingdom. P. multocida from other animal species were genotypically different from the fallow deer isolates. It is concluded that a specific clone of P. multocida was responsible for the outbreak of haemorrhagic septicaemia among Danish fallow deer. A carrier rate of 27% was demonstrated among apparently normal animals from the same population.

Animals↗

PubMed2000

[Serological diagnosis and nasopharyngeal washings in pediatric infections].

In the course of respiratory infections, the efficacy of microbiologic diagnosis has increased years after years, in term of specificity, sensitivity and rapidity. New pathogenic agents have been described such as: Legionella pneumophila, Chlamydia pneumoniae, Hantavirus. Some viruses have been well characterized as responsible for seasonal outbreaks using rapid tools for identification. Needs for efficient diagnostic tools became more obvious when specific antiviral drugs appeared on the market. So technologic developments improved the efficacy of microbiologic diagnosis and anticipate a better specificity as well as sensitivity with the help of molecular biology. Respiratory syncytial virus is one of the major infectious agents found in respiratory infections in young children and newborns. On the whole it was detected in more than one third of pediatric nasopharyngeal aspirations received in our laboratory and more than 50% during the peak of the winter epidemics. The method of direct antigen detection by immunofluorescence with the help of monoclonal antibodies allowed us to establish an incidence curve of these recurrent outbreaks, beginning in December to stop usually by the end of April. During this same period, influenza A virus, seldom influenza B virus, were detected in many nasopharyngeal specimens. Other viruses, parainfluenza 1 to 3 and Adenovirus, were irregularly detected all along the year. In the great majority of nasopharyngeal aspirations with a positive virus detection, one virus only was observed. Antigen detection methods were also developed for some bacteria such as Chlamydia pneumoniae, Legionella pneumophila. Although serology is not frequently used by pediatricians, it is still necessary for the diagnosis of Mycoplasma pneumoniae infections. A direct antigen detection test is now available, but its sensitivity needs to be evaluated. On the other hand serologic diagnosis may be extremely useful when long lasting or treatment resistant respiratory infections occur. Seroconversion or four-fold increasing titers to one pathogen may be observed when a second serum sample is tested together with the first serum of this patient. The diagnostic yield will be all the more efficient that time between both samples is long. Molecular biology techniques will significantly change the way to investigate an infection. Presently these methods are used in research laboratories, but automated technologies will facilitate routine laboratory workload. Screening methods using multiplex PCR are also promising.

Humans↗

PubMed2001

Unexpected deaths in young New Zealand white rabbits (Oryctolagus cuniculus).

Five weeks after the arrival of a batch of six New Zealand White rabbits for use in antisera production, four died unexpectedly within a 48-h period. Necropsy findings showed a consistent pattern of liver pathology in all animals, with multiple miliary abscesses in all liver lobes. Of the remaining two animals in the cohort, one showed weight loss, mild jaundice, and ascites, and the other rabbit had only weight loss. The differential diagnosis for these unexpected deaths included parasitic and bacterial infections. Histopathologic examination of the liver confirmed a diagnosis of hepatic coccidiosis. The possible origin of the coccidia responsible for this outbreak is discussed.

Animals↗

PubMed2001

Some problems of molecular biology of poliovirus infection relevant to pathogenesis, viral spread and evolution.

Molecular mechanisms of poliovirus reproduction in the human gut remain largely unexplored. Nevertheless, there are grounds to believe that the virus spreads from cell to cell, like that from person to person during natural circulation, and involves a relatively small proportion of the highly heterogeneous viral population generated by the previous host. This mechanism of random sampling is responsible for the majority of fixed mutations, and contributes to the maintenance of a certain level of viral fitness (virulence). In the long term, random sampling may lead to the decrease in fitness and even to extinction of some viral evolutionary branches, explaining cases of self-limiting poliovirus infection in immunodeficient patients. A low propensity of the Sabin viruses for natural circulation may also be a related phenomenon. The trend to decrease in fitness may be interrupted by the appearance of rare, fitter (more virulent) variants, which may be responsible for poliomyelitis outbreaks caused by wild type virus, and for the development of paralytic disease in chronic carriers of the Sabin vaccine. All these evolutionary events are largely stochastic and hence are unpredictable in principle.

Digestive System↗

PubMed2002

Animal health and foodborne pathogens: enterohaemorrhagic O157:H7 strains and other pathogenic Escherichia coli virotypes (EPEC, ETEC, EIEC, EHEC).

The majority of interactions between microorganisms and animals are based on convenient relations for both of them. Symbiotic microorganisms, like intestinal microbiota, produce important vitamins for animals and protects them from putative pathogens. In general, for monogastric animals, the main contribution of intestinal microorganisms is to supply with growth factors the animal diet, and in some cases they are responsible for providing essential vitamins (e.g. vitamin K). Some particular and relatively few microbes like viruses, bacteria, fungi, protozoa and algae are responsible for animal illness. Because microorganisms are easily dispersed, display physiological diversity, and tolerate extreme conditions, they are ubiquitous and may contaminate and grow in many products, including food and raw materials. Foodborne diseases are caused by consumption of contaminated food or beverages. Many different disease-causing pathogens can contaminate food, so there are many different foodborne infections. In addition, poisonous chemicals and biological toxins can cause disease if they are present in food. To know how a particular disease is spreading is an important matter to take appropriate steps to stop it. For example Escherichia coli O157:H7 infections can spread through contaminated food (meat, vegetables, cheese, etc.), contaminated drinking water or juices, contaminated swimming water and from person to person. Among foodborne pathogens, the most frequently detected are bacteria, but also parasitic protozoa and worms, viruses, natural toxins and other pathogenic agents like prions are important agents for foodborne diseases. Particular pathogenic types of E. coli, classified by their specific pathogenic mechanisms (toxins, adhesins, invasiveness, etc.) are actually known as E. coli virotypes. Enterohaemorrhagic E. coli (EHEC), which constitute the main part of this review, were also named verotoxigenic E. coli (VTEC) or Shiga toxigenic E. coli (STEC). EHEC strains cause haemorrhagic colitis (HC), haemolytic uremic syndrome (HUS) and thrombotic thrombocytopaenic purpura (TP) in humans. They synthetize shigatoxins (verotoxins) which are potent cytotoxic substances, adherence factors and enterohaemolysin. EHEC are responsible for many outbreaks of bloody diarrhoea caused by contaminated foods: beef, milk, fruits, juice, water, etc. The most important serogroups among EHEC are O26, O111 and O157, being O157:H7 the most relevant serotype in foodborne outbreaks. The normal intestinal microflora of cattle was found to be the most relevant reservoir of EHEC strains.

Animals↗

PubMedDate not supplied

BCG vaccine and post-BCG complications among infants in Gaza Strip, 1999.

The relationship between post-BCG complications and the practices of administration and/or use of certain batches of BCG vaccine was investigated. A questionnaire were given to nurses administering BCG vaccination. An abstraction sheet was used to analyse cases with BCG complications among infants (n = 552) and schoolchildren (n = 97). The rate of complications was 14.7/1000 among infants and 2.5/1000 among schoolchildren in 1997. The complications rate was 19.1/1000 at UNRWA and 8.3/1000 at governmental health services. It was found that a single batch of BCG 2611-11 combined with incorrect administering of the vaccine was responsible for this outbreak of complications. Therefore, the establishment of a surveillance system to monitor adverse events following immunization is needed.

Abscess↗

PubMed2003

First record of Aedes (Stegomyia) unilineatus in the Kingdom of Saudi Arabia.

Entomological surveillance was conducted in Asir, Jizan, and Makkah regions, Kingdom of Saudi Arabia, during December 2000 in response to an outbreak of Rift Valley fever. Aedes (Stegomyia) unilineatus was collected in CO2-baited Centers for Disease Control miniature light traps at 4 widely spaced sites. This represents the 1st record of this species from the Arabian Peninsula. Previously, the distribution of Ae. unilineatus included Africa, Pakistan, and India. No arboviruses were isolated from 18 females tested by Vero cell plaque assay.

Aedes↗

PubMed1958

Antibiotic resistant staphylococci.

An antibiotic resistant staphylococcus with bacteriophage pattern 52/42B/80/81* is frequently responsible for infectious outbreaks in the newborn nursery. Some time after an outbreak had occurred in the University of California's hospital nursery, family members of the infants were found to be infected with this strain. Two families were studied in detail. In one of them, infection developed in six of the seven members within eight months after the infant's arrival. In the other, half of the family members had recurrent infections during a 13-month period.Infants who left the nursery as asymptomatic carriers were found as likely to transmit the infectious strain as those with clinical infection. Considerable time sometimes elapsed before infection developed in either the infant or the family members. In one instance the first familial infection occurred six months after the infant had left the nursery as an asymptomatic carrier. Newborn infants are quite likely to disseminate antibiotic resistant staphylococci which they may acquire from a hospital nursery. Infections developing among persons in contact with a young infant must be treated with the possibility of a resistant hospital staphylococcus in mind.

Anti-Bacterial Agents↗

PubMed1992

[Staphylococcus aureus nosocomial infections in an intensive care milieu (1985-1989) in Tunis].

221 strains of Staphylococcus aureus oxacillin resistant (MetiR) caused nosocomial infections were isolated from 1985 to 1989 in a medical intensive care unit. The survey of susceptibility to antibiotics was established according to the computerized data of disk susceptibility test. The resistance phenotypes to beta-lactams, aminoglycosides and macrolides were established for epidemiological study. S. aureus infections were mainly bacteraemia (31%) and peritonitis (12%). These isolates were resistant to oxacillin with a high level (mean MIC 386 micrograms/ml). Their resistance phenotypes were MLSBc (constitutive resistance to macrolides, lincosamine and streptogramines B) in 53% and S + KGT (resistance to streptomycin, kanamycin, gentamicin and tobramycin) in 61%. All the isolates were susceptible to pristinamycin and vancomycin (MIC 0.1 and 2 micrograms/ml). These phenotypes related to the spread of multiply drug resistant strains were responsible of nosocomial outbreaks. Strains with the same pattern of resistance were isolated among the medical staff and in the environment. Infection control measures allowed to stop these outbreaks.

Cross Infection↗

PubMed2003

Occurrence & detection of AmpC beta-lactamases at a referral hospital in Karnataka.

BACKGROUND & OBJECTIVES: AmpC beta-lactamases confer resistance to a wide variety of beta-lactam drugs except for cefepime, cefpirome and carbapenems. They are known to be responsible for nosocomial outbreaks, therapeutic failures and multidrug resistance. Although reported with increasing frequency the true rate of occurrence of these beta-lactamases in Enterobacteriaceae is not known. Hence the present study was undertaken to determine the occurrence of AmpC enzymes among clinical isolates. METHODS: A total of 520 consecutive, non-repeat clinical isolates were included in the present study. Twenty eight strains resistant to cefoxitin were tested for AmpC beta-lactamases by the modified 3-dimensional extract method. Isolates harbouring AmpC beta-lactamases were tested for inducible beta-lactamases by disc diffusion. RESULTS: Sixteen (3.3%) isolates were positive for AmpC beta-lactamases. Based on the species 9 (3.3%) Escherichia coli, 4 (2.2%) Klebsiella pneumoniae, 2 (5%) Citrobacter freundii and 1 (5.5%) isolate of Enterobacter aerogenes harboured AmpC enzymes. Nine (56.3%) of AmpC harbouring strains, were urinary isolates. All the isolates were sensitive to imipenem and variably sensitive to aminoglycosides and co-trimoxazole. INTERPRETATION & CONCLUSION: Our findings document the presence of AmpC enzymes in this region. Hence AmpC beta-lactamase detection should be undertaken in clinical isolates showing resistance to broad-spectrum cephalosporins.

Bacterial Proteins↗