Turkey rhinotracheitis virus isolated from broiler chicken with swollen head syndrome in Japan

Turkey rhinotracheitis (TRT) virus was first isolated from a commercial broiler chicken with swollen head syndrome (SHS) in Japan. At the same time, Newcastle disease virus (NDV), infectious bronchitis virus (IBV), avian reovirus (ARV), Escherichia coli (E.coli), Morganella morganii, and Proteus mirabilis were also isolated from the same broiler chicken. The presence of antibodies to TRT virus was confirmed in the sera of 34-day-old chickens of the flock with SHS, however the antibodies to TRT virus were undetectable in the sera of 17-day-old chickens. In this investigation, we confirmed avian pneumovirus infection in chickens in Japan, and the virus and other agents may be considered as a cause of SHS.

Nosocomial infections caused by selected gram-negative bacteria at the Anaesthesiology and Intensive Care Unit of the Teaching Hospital in Brno

In the course of 13 months we monitored the occurrence of strains of P. mirabilis, P. vulgaris, Kl. pneumoniae, including its indole-positive variant and S. marcescens in patients of the Anaesthesiology and Intensive Care Unit (AICU) of the Teaching Hospital (TH) in Brno. Out of 436 patients hospitalized at that time, 95 (21.8%) were colonized or infected by one or all of the bacterial species studied. Out of those 95 patients, 48 (50.5%) came to the AICU already colonized or infected by one of the studied agents mostly from other wards of the TH or from other hospitals. At the AICU, 32 of them were reinfected or superinfected by one, two or all of the bacterial species studied. Of the 436 hospitalized patients, 79 (18.1%) were newly infected, reinfected or superinfected. By serotyping, proticine production and proticine sensitivity (P-S) typing and phage typing we demonstrated the endemization of some P-S types and phage types of the bacterial species studied and their spreading among the contemporaneously hospitalized patients. The endemic strains of P. mirabilis included P-S types P5/S6, S7, S9 and P5/S6, S7; P0/S9; P1/S2, S11 and P1/S11. The two biotypes of Klebsiella, i.e. K. pneumoniae and K. oxytoca, were identically sensitive to some of the phages 1, 2, 3, 8 and 106, particularly to phages 2 and 3, or 2, 3 and 106. The isolated strains of Serratia were absolutely resistant to the 26 bacteriophages used.

Proteus mirabilis bacteremia: a review of 176 cases during 1980-1992

Patients with Proteus mirabilis bacteremia at a large community teaching hospital during a 13-year period (1980-1992) were retrospectively reviewed. There were 176 patients whereof 44 (25%) had polymicrobial bacteremia. The median age of patients was 75 years and 64.2% were 70 years or older. Of the patients 56.8% came from a nursing home, 64.2% had an indwelling Foley catheter, and 20.5% nosocomial bacteremia. The most common source of bacteremia was the urinary tract (52.8%) whereas the lower respiratory tract was an uncommon source. Hypotension was present in 30.1% of patients. The overall mortality rate was 29.0% with an attributable mortality rate of 25.6%. The mortality rate of polymicrobial bacteremia (38.6%) was higher than that of monomicrobial bacteremia (25.8%). For patients with monomicrobial bacteremia, significant increase in mortality was found in patients who had nosocomial infection (p < 0.02), whose source of bacteremia was other than the urinary tract (p < 0.01), who had ultimately fatal underlying conditions (p < 0.01), who had hypotension (p < 0.001), who had increase in serum creatinine (p < 0.05), or who had increase in serum bilirubin (p < 0.05).

[HLA-system antigens in patients with food poisonings caused by opportunistic bacteria]

A total of 286 convalescents after toxico-infections caused by opportunistic microorganisms were examined. The panel of anti-HLA sera permitted the typing of 34 HLA antigens, class 1. As a result, the development of the disease was found to be directly associated with antigen HLA-B17 and inversely with antigen HLA-A2. The relationship of antigens of the HLA system with alimentary toxico-infections caused by opportunistic microorganisms manifested not by the absolute resistance or predisposition to the disease, but by an increased severity of the pathological process, paralleled by a decreased level of protective antigens and an increased one of provoking antigens of the HLA system.

[Urinary tract infections in the community]

4,612 urine samples were sent to this laboratory in 1990, and the results of those sent during a single week in each of the 4 seasons were studied. Of 4501 urinary cultures sent from the general population, 811 (80%) were positive for E. coli, Klebsiella and Proteus mirabilis. 60% were resistant to ampicillin, 35% to cotrimoxazole and 20% to cephalexin. Of 111 urine samples sent from senior citizen homes, 57 (80%) were positive for E. coli, Proteus mirabilis, Klebsiella and Pseudomonas. 74% were resistant to ampicillin, 72% to cotrimoxazole and 46% to cephalexin. Ofloxacin and norfloxacin were very effective in urinary tract infections in the general population, with 94% and 97% sensitive to them, respectively. 68% of the urinary cultures sent from the senior citizen centers were sensitive to each of them.

Arbitrarily primed polymerase chain reaction provides rapid differentiation of Proteus mirabilis isolates from a pediatric hospital

During a systematic survey, maternal carriage of Proteus mirabilis was found over a 25-day period in 18 pregnant women admitted to the delivery ward of our hospital maternity. Five neonates born to these mothers were found to be colonized with P. mirabilis. We report here on the use of DNA fingerprinting by the arbitrarily primed polymerase chain reaction technique (AP-PCR) for the epidemiological investigation of this sudden outbreak. This approach was compared with the analysis of restriction fragment length polymorphisms of ribosomal DNA regions (ribotyping). Results of the AP-PCR and of ribotyping were in complete agreement in showing the genetic unrelatedness of the isolates obtained from each mother. Moreover, the results showed mother-to-infant vertical transmission of P. mirabilis in the neonates. AP-PCR is a rapid and discriminative method which seems particularly well suited to the epidemiological study of P. mirabilis.

[Epidemiological features of hospital purulent-septic infections in otolaryngological wards]

Prospective epidemiological observation in an otorhinolaryngological hospital has made it possible to distinguish the specific features of pyoseptic nosocomial infections. Such infections, appearing as cross re- and superinfections, are most frequently induced by staphylococci, as well as by Proteus and Pseudomonas aeruginosa. High risk groups include patients with purulent otitis and sinusitis, who have contacted infection through instruments in examination and dressing rooms. The main sources of infection are patients with pyoseptic infections of the ear and sinuses.

Breast-feeding and urinary tract infection

A case-control study was conducted to study the association between breast-feeding and urinary tract infection. Case patients were 128 infants aged birth to 6 months with urinary tract infection. Control infants were 128 infants admitted to the same ward with an acute illness. The results support the hypothesis that breast-feeding protects infants against urinary tract infection.

The bacteriology of cholelithiasis--China versus Japan

Cholelithiasis differs considerably from area to area in the world. Calcium bilirubinate stones or brown pigment stones are said to predominate in the Orient, however, this situation may differ within the Orient. In order to compare cases in China and Japan, 102 consecutive cases of cholelithiasis operated on in Shenyang, China were analyzed for the composition of gallstones and bacterial species isolated from bile in relation to the location and composition of gallstones. In Shenyang, calcium bilirubinate stones predominated, occurring in 49.0 per cent of the cholelithiasis cases. This was much higher than in Japan, which had 17.5 per cent. The incidence of bacteria was also very high, ranging from 20 to 96 per cent, with an average of 66.7 per cent depending on the kind of gallstone present. Bacterial species possessing beta-glucuronidase activity were present in nearly all the cases of calcium bilirubinate stones (92.0 per cent). The incidence of bacteria with beta-glucuronidase activity especially of E. coli was much higher than in Japan (50.8 per cent versus 21.8 per cent) in concordance with the higher incidence of calcium bilirubinate stones in China (49.0 versus 17.5 per cent).

The incidence and beta-lactam resistance of Proteus vulgaris in hospital infections: the last decade

During the period of 1980-1990, 581 Proteus vulgaris strains were obtained in a general hospital. They were considered as the significant isolate in 0.6% of soft tissue infections, 0.6% of urinary tract infections and in 0.2% of bacteremic episodes. Sixty-three percent of the 393 tested strains showed resistance to ampicillin, cefazolin and cefamandole or cefuroxime. About 7% were susceptible to all beta-lactam drugs, and showed a very low beta-lactamase activity and 5% of the strains showed a phenotype of resistance including ampicillin, carbenicillin-ticarcillin, cefazolin and cefamandole or cefuroxime, and presented increased chromosomal beta-lactamase activity. Cefotaxime-resistance was detected in 2% of the isolates which appeared in the period 1987-1990.

ESWL monotherapy for large-volume renal calculi: efficacy and morbidity

We assessed the efficacy and morbidity of extracorporeal shock-wave lithotripsy (ESWL) monotherapy in the treatment of 25 consecutive patients with large-volume renal calculi (surface area greater than or equal to 5.0 cm2). Eighteen of the calculi were infection (struvite) stones and 7 were sterile stones. In 21 cases internal ureteral stents were positioned before ESWL, but no patient underwent pretreatment percutaneous nephrostomy (PCN) or percutaneous nephrostolithotomy (PNL). An average of 2.1 procedures including ESWL, PCN, or ureteral interventions were required to achieve a stone-free renal collecting system and ureter, or residual stone particles less than 4 mm in diameter confined to the renal collecting system. Sixty percent of the patients required no ancillary procedures after ESWL. There were no differences in the mean duration of hospitalization, need for post-treatment ancillary procedures, time to clearance of ureteral fragments, and incidence of residual stone particles among patients with infection and sterile stones. Of 23 patients observed greater than three months (mean 10.9 mos) after ESWL, 43 percent had residual stone particles in the renal collecting system. Expansion of these particles or stone recurrence in the absence of residual particles has not been observed. We conclude that large volume renal calculi may be managed effectively and safely with ESWL monotherapy.

Proteeae groin skin carriage in ambulatory geriatric outpatients

Aerobic gram-negative bacillus (AGNB) groin skin carriage was prospectively studied in ambulatory geriatric outpatients: 42 from three nursing homes and 44 from private homes. Initially, 12 (28.6%) Proteeae carriers were in the former group and 3 (6.8%) were in the latter (P = 0.01). At one year, 6 of 7 surviving nursing home carriers remained Proteeae carriers while none from private homes remained carriers (P = 0.007). The annual prevalence of Proteeae carriage was 14 (33.3%) in nursing homes and 4 (9.1%) in private homes (P = 0.008); of non-Proteeae AGNB carriage, the annuyal prevalence was 2 (4.8%) and 4 (11.4%), respectively. Nursing home subjects had similar initial health characteristics; however, by one year, 5 of 12 carriers in contrast to 3 of 30 noncarriers were dead of chronic disease (P = 0.03). These nursing homes included persons with chronic diseases that apparently facilitated Proteeae carriage. Urethral catheters, skin ulcers, and recent antibiotics were not factors.

MR/K hemagglutination of Providencia stuartii correlates with adherence to catheters and with persistence in catheter-associated bacteriuria

Providencia stuartii was the most prevalent bacterial species isolated, for one year, from weekly urine specimens from 51 long-term catheterized patients. Significantly more strains causing bacteriuric episodes of long duration expressed MR/K (mannose-resistant/Klebsiella-like) hemagglutination (74%) than did those causing episodes of short duration (26%; P = .004). Isolates expressing MR/K hemagglutinin bound in higher numbers to catheter material (P = .023) than did those not expressing this hemagglutinin. Significantly more strains causing bacteriuric episodes of short duration expressed the mannose-sensitive (MS) hemagglutinin (43%) than did those causing episodes of long duration (7%; P = .014). Isolates expressing MS hemagglutinin bound significantly more 125I-labeled Tamm-Horsfall protein (THP) than did isolates not expressing this hemagglutinin (P = .0001). Our results indicate that MR/K hemagglutinin plays an important role in the ability of P. stuartii to persist and suggest that MR/K adheres to the catheter. Conversely, MS hemagglutinin binds to THP and may prevent persistence of P. stuartii in the catheterized urinary tract.

A hospital outbreak caused by a chlorhexidine and antibiotic-resistant Proteus mirabilis

An outbreak of urinary-tract infection involving a strain of Proteus mirabilis resistant to gentamicin and several other antibiotics affected 90 patients in Southampton between July 1980 and May 1985. The outbreak strain was also resistant to chlorhexidine and this, in combination with the antibiogram and Dienes' test, permitted differentiation from other P. mirabilis strains. The outbreak had features in common with other Enterobacteriaceae outbreaks, although certain aspects of the population involved have made it particularly difficult to control. The outbreak commenced shortly after the introduction of a catheter care policy which involved the use of chlorhexidine, and although the majority of the cases were colonized before this policy was enforced, chlorhexidine had been used extensively for other procedures within the district. Preliminary evidence suggests that there is no genetic linkage between the chlorhexidine and multiple antibiotic resistance.

Survey of multiply resistant Providencia stuartii in a chronic care unit

Providencia stuartii was cultured over a 4-year period from the urinary tract, throat, perineum, axilla and stools of patients in a long-term chronic care unit, the most common site of colonization being the urinary tract. A total of 17 patients had Prov. stuartii bacteraemia and manipulation of the urinary tract preceded bacteraemia in 10 cases. Eighty-two per cent of the patients had long-term urinary tract colonization from 1 month to 4 years. Although most isolates were resistant to all aminoglycosides except amikacin, the organisms were all susceptible to thienamycin, ceftazidime, cefotaxime, ceftizoxime and moxalactam.

Spectrum of bacterial pathogens in uncomplicated and complicated urinary tract infections

The spectra of bacterial organisms of urinary tract infections (UTI) in patients with and without abnormalities in the urinary tract (complicated and uncomplicated UTIs) are compared. Data from the United Kingdom and the Federal Republic of Germany are included. In addition, the susceptibility of the pathogens to antibiotics (for oral or parenteral application) in both countries are compared. In conclusion, rational antibiotic therapy of complicated UTIs should strictly follow the antibiogram of the causative organism. For therapy of uncomplicated UTIs, the regional state of antibiotic susceptibility of the pathogens according to geographical location should be considered and kept up to date.

[Escherichia coli, coliform bacteria, Pseudomonas aeruginosa, Proteus and Staphylococcus aureus carriers among children 5-15 years old]

The throat swap cultures of 250 children between 5-15 years ages examined for the microorganisms, E. coli, Coliform, Protus, Ps. aeruginosa and S. aureus. 66 (26.4%) E. coli, 64 (25.6%) S. aureus, 9 (3.6%) Coliform, 3 (1.2%) Ps. aeruginosa, 2 (0.2%) Proteus organisms were isolated from throat swaps cultures of 144 (57.6%) children. 106 (42.4%) children had contained normal oral flora. S. aureus and E. coli strains were tested using disk method for the sensitivity of some antibiotics. S. aureus strains were resistant 12.5% to gentamycin, 9.4% to cefoperazone and (1% to cefazolin, 48.4% to lincomycin and 87.5% to ampicillin. E. coli strains were resistant 42% to gentamycin, 37% to cefoperazone and 74% to cefazolin.