Etiologic role of Mycoplasma hominis and Ureaplasma urealyticum in women with the acute urethral syndrome

In an assessment of the possible etiologic role of Mycoplasma hominis and Ureaplasma urealyticum in the acute urethral syndrome (AUS) in women, 79 women with AUS, 35 women with acute bacterial cystitis, and 66 asymptomatic volunteers were studied. Evidence against an etiologic role for M. hominis in AUS included: (1) a similar prevalence of the organism among women with AUS (18%), women with cystitis (29%), and asymptomatic women (15%); (2) a lack of association of M. hominis with AUS cases for which no other infectious cause was found; (3) a lack of association of pyuria with cases of infection in which M. hominis was isolated; and (4) an absence of M. hominis from cultures of bladder urine obtained by suprapubic aspiration. A possible etiologic role for U. urealyticum in some cases of AUS was suggested by the association of counts of this organism of greater than or equal to 10(3)/ml with pyuria in women whose AUS had no other apparent etiology and by the isolation of the organism from suprapubic aspirates from four of 15 women with AUS of unknown etiology. Further studies, similar to those done in men with nongonococcal urethritis, are necessary for confirmation of the causative role of U. urealyticum in AUS.

Persistence of Mycoplasma hominis after therapy: importance of tetracycline resistance and of coexisting vaginal flora

In past studies Mycoplasma hominis has persisted after treatment with placebo, penicillins, or rifampin in 88-97% of women and 49-77% of men with infections of the lower genital tract. Among women with nonspecific vaginitis, M. hominis persisted in only a third of those treated with metronidazole as compared with at least 70% of those treated with ampicillin (P = 0.01), even though M. hominis is resistant in vitro to metronidazole and to its acid and hydroxy metabolites. Persistence of M. hominis after treatment with metronidazole was significantly associated with persistence of Bacteroides species in the vagina (P = .03). These results suggest that colonization of the vagina with M. hominis is partly dependent on other components of the vaginal microbial flora. In prior studies, M. hominis has persisted in zero to 50% of women and in zero to 30% of men after treatment with tetracycline or lincomycin, but the role of tetracycline resistance in treatment failure was not defined. The susceptibility of M. hominis to tetracycline is bimodal; and the minimal inhibitory concentration (MIC) of tetracycline for strains isolated before or soon after treatment was greater than or equal to 16 micrograms/ml for seven (78%) of nine that did persist and for two (17%) of 12 that did not persist after tetracycline therapy for cervicitis in women (P = .002). The MIC of tetracycline was greater than or equal to 16 micrograms/ml for two (12%) of 17 isolates from women in Seattle in 1972-1973, as compared with 27 (34%) of 79 isolates from Seattle men and women in 1979-1982.(ABSTRACT TRUNCATED AT 250 WORDS)

Selective differential human blood bilayer media for isolation of Gardnerella (Haemophilus) vaginalis

New selective and differential human blood bilayer agar media with Tween 80 (HBT medium) or without Tween 80 (HB medium), developed for the isolation of Gardnerella (Haemophilus) vaginalis, permitted significantly higher G. vaginalis isolation rates than have been obtained for other media used for this purpose. HB medium consists of a basal layer of Columbia agar base containing colistin and naladixic acid with added amphotericin B and an overlayer of the same composition plus 5% human blood. HBT agar also contains Proteose Peptone No. 3 (Difco Laboratories) and Tween 80 in the basal layer and the overlayer. Both Tween 80 and the bilayer composition enhanced G. vaginalis production of human blood hemolysis, permitting detection of this organism even in the presence of heavy growth of other vaginal flora. The use of HB or HBT medium thus permitted the demonstration that G. vaginalis was present in vaginal fluid from a large percentage (up to 68%) of normal women. However, the concentration of G. vaginalis was found by semiquantitative analysis to be significantly higher in vaginal fluid from women with nonspecific vaginitis than in fluid from normal women.

Tetracycline-resistant Ureaplasma urealyticum: a cause of persistent nongonococcal urethritis

We treated 289 men with nongonococcal urethritis in a randomized, double-blind study with minocycline, 100 mg once or twice daily for 7 or 21 days. Ureaplasma urealyticum was isolated before treatment from 167 (58%). The pretherapy isolates from 82 men re-examined 6 to 8 days after initiation of treatment were viable. In six (7%) isolates were resistant to 256 microgram/mL or more of tetracycline. Tetracycline resistance was significantly correlated with persistence of U. urealyticum and persistence of nongonococcal urethritis during treatment. Recurrence of nongonococcal urethritis after initial resolution and recurrence of U. urealyticum after interim negative cultures were not correlated with tetracycline resistance of U. urealyticum. Thus tetracycline-resistant strains of U. urealyticum are a cause of persistent but not of recurrent nongonococcal urethritis.

Testing installed plate glass used as secondary protective barriers in diagnostic radiology

A simple instrument to test the thickness of installed plate glass used as secondary protective barriers in diagnostic radiology is described. The attenuating properties of glass are not affected critically by density or chemical composition.

Step-wedge sensitometry

An aluminum step-wedge filter placed far from the film cassette provides the constant variation of subject contrast required for quantitative sensitometry while virtually eliminating scatter radiations. Attenuation curves made with this configuration are almost exponentially linear.

Adolescent parent education: a maturational model

Health care, educational and social programs are frequently required to assist increasing numbers of adolescent mothers to meet their own needs and those of their babies. This paper presents a maturational rationale for development of a comprehensive parent education program. Some pertinent aspects of adolescent psychological development are first presented to provide a perspective for understanding the models illustrating the teenage mother's responses to her child. Barriers are then delineated which commonly restrict the young mother from attaining the mature relationship with her baby presented in a maturational model. Specific recommendations are offered in the areas of program development, content, and structure.

Asymptomatic gonorrhea in men: caused by gonococci with unique nutritional requirements

In a retrospective case-control study, gonococci with nutritional requirements for arginine, hypoxanthine, and uracil were recovered from 24 of 25 men with asymptomatic gonorrhea and 10 of 25 men with symptomatic gonorrhea (P = .0001). These strains represent a smaller proportion of gonococcal isolate from blacks than from whites. Asymptomatic urethral infection is important in the epidemiology of gonorrhea, particularly among whites.