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Azevedo LSD, França Y, Viana E, Medeiros RS, Morillo SG, Guiducci R, Ribeiro CD, Vieira HR, Barrio-Nuevo KM, Cunha MS, Guerra JM, Silva DDMCE, Filho VBD, Araújo ELL, Ferreira SRS, Batista CF, Silva GCDD, Nogueira ML, Ahagon CM, Moreira RC, Cunha L, Morais VS, da Costa AC, Luchs A. Lack of molecular evidence of fecal-borne viruses in capybaras from São Paulo state, Brazil, 2018-2020: a minor public health issue. Braz J Microbiol 2023; 54:543-551. [PMID: 36342660 PMCID: PMC9640885 DOI: 10.1007/s42770-022-00859-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/24/2022] [Indexed: 11/09/2022] Open
Abstract
Capybara (Hydrochoerus hydrochaeris) is the world's largest rodent species distributed throughout South America. These animals are incredibly tolerant to anthropogenic environments and are occupying large urban centers. Capybaras are known to carry potentially zoonotic agents, including R. rickettsia, Leishmania spp., Leptospira spp., Trypanosoma spp., Salmonella spp., Toxoplasma gondii, and rabies virus. Focusing on the importance of monitoring potential sources of emerging zoonotic viruses and new viral reservoirs, the aim of the present study was to assess the presence of fecal-borne viruses in the feces of capybaras living in urban parks in São Paulo state, Brazil. A total of 337 fecal samples were collected between 2018 and 2020 and screened for the following: (i) Rotavirus group A (RVA) by ELISA; (ii) non-RVA species and Picobirnavirus (PBV) using PAGE; (iii) Human Bocaparvovirus (HBoV), Bufavirus (BuV), Tusavirus (TuV), and Cutavirus (CuV) qPCR; (iv) Human Enterovirus (EV), Norovirus GII (NoV), and Hantavirus by in houses RT-qPCR; (v) SARS-CoV-2 via commercial RT-qPCR kit assay; and (vi) Astrovirus (AstV) and Adenovirus (AdV) using conventional nested (RT)-PCRs. All fecal samples tested were negative for fecal-borne viruses. This study adds further evidence that the fecal-borne viruses is a minor public health issue in Brazilian capybaras, at least during the surveillance period and surveyed areas. Continuous monitoring of sylvatic animals is essential to prevent and control the emergence or re-emergence of newly discovered virus as well as viruses with known zoonotic potential.
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Affiliation(s)
| | - Yasmin França
- Enteric Disease Laboratory, Virology Center, Adolfo Lutz Institute, Sao Paulo, Brazil
| | - Ellen Viana
- Enteric Disease Laboratory, Virology Center, Adolfo Lutz Institute, Sao Paulo, Brazil
| | | | | | - Raquel Guiducci
- Enteric Disease Laboratory, Virology Center, Adolfo Lutz Institute, Sao Paulo, Brazil
| | - Cibele Daniel Ribeiro
- Enteric Disease Laboratory, Virology Center, Adolfo Lutz Institute, Sao Paulo, Brazil
| | - Heloisa Rosa Vieira
- Enteric Disease Laboratory, Virology Center, Adolfo Lutz Institute, Sao Paulo, Brazil
| | | | - Mariana Sequetin Cunha
- Vector Borne Diseases Laboratory, Virology Center, Adolfo Lutz Institute, Sao Paulo, Brazil
| | - Juliana Mariotti Guerra
- Quantitative Pathology Laboratory, Pathology Center, Adolfo Lutz Institute, Sao Paulo, Brazil
| | | | | | - Emerson Luiz Lima Araújo
- General Coordination of Public Health, Laboratories of the Strategic Articulation, Department of the Health, Surveillance Secretariat, Ministry of Health (CGLAB/DAEVS/SVS-MS), Brasília, Brazil
| | | | | | | | | | - Cintia Mayumi Ahagon
- Blood and Sexual Diseases - Retrovirus Laboratory, Virology Center, Adolfo Lutz Institute, Sao Paulo, Brazil
| | | | - Lia Cunha
- Hepatitis Laboratory, Virology Center, Adolfo Lutz Institute, Sao Paulo, Brazil
| | - Vanessa Santos Morais
- Medical Parasitology Laboratory (LIM/46), Institute of Tropical Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Antonio Charlys da Costa
- Medical Parasitology Laboratory (LIM/46), Institute of Tropical Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Adriana Luchs
- Enteric Disease Laboratory, Virology Center, Adolfo Lutz Institute, Sao Paulo, Brazil.
- Centro de Virologia, Núcleo de Doenças Entéricas, Instituto Adolfo Lutz, Av. Dr Arnaldo, nº 355, São Paulo, SP, 01246-902, Brasil.
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Morillo SG, Luchs A, Cilli A, Ribeiro CD, de Cássia Compagnoli Carmona R, do Carmo Sampaio Tavares Timenetsky M. Norovirus GII.Pe Genotype: Tracking a Foodborne Outbreak on a Cruise Ship Through Molecular Epidemiology, Brazil, 2014. Food Environ Virol 2017; 9:142-148. [PMID: 27933493 DOI: 10.1007/s12560-016-9272-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 11/24/2016] [Indexed: 06/06/2023]
Abstract
Norovirus (NoV) is recognized as the most common cause of foodborne outbreaks. In 2014, an outbreak of acute gastroenteritis occurred on a cruise ship in Brazil, and NoV became the suspected etiology. Here we present the molecular identification of the NoV strains and the use of sequence analysis to determine modes of virus transmission. Food (cream cheese, tuna salad, grilled fish, orange mousse, and vegetables soup) and clinical samples were analyzed by ELISA, conventional RT-PCR, qRT-PCR, and sequencing. Genogroup GII NoV was identified by ELISA and conventional RT-PCR in fecal samples from 5 of 12 patients tested (41.7%), and in the orange mousse food sample by conventional RT-PCR and qRT-PCR. Two fecal GII NoV samples and the orange mousse GII NoV sample were successfully genotyped as GII.Pe (ORF 1), revealed 98.0-98.8% identities among them, and shared phylogenetically distinct cluster. Establishing the source of a NoV outbreak can be a challenging task. In this report, the molecular analysis of the partial RdRp NoV gene provided a powerful tool for genotyping (GII.Pe) and tracking of outbreak-related samples. In addition, the same fast and simple extraction methods applied to clinical samples could be successfully used for complex food matrices, and have the potential to be introduced in routine laboratories for screening foods for presence of NoV.
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Affiliation(s)
- Simone Guadagnucci Morillo
- Enteric Diseases Laboratory, Virology Center, Adolfo Lutz Institute, Avenida Dr Arnaldo, No 355, São Paulo, SP, CEP 01246-902, Brazil.
| | - Adriana Luchs
- Enteric Diseases Laboratory, Virology Center, Adolfo Lutz Institute, Avenida Dr Arnaldo, No 355, São Paulo, SP, CEP 01246-902, Brazil.
| | - Audrey Cilli
- Enteric Diseases Laboratory, Virology Center, Adolfo Lutz Institute, Avenida Dr Arnaldo, No 355, São Paulo, SP, CEP 01246-902, Brazil
| | - Cibele Daniel Ribeiro
- Enteric Diseases Laboratory, Virology Center, Adolfo Lutz Institute, Avenida Dr Arnaldo, No 355, São Paulo, SP, CEP 01246-902, Brazil
| | - Rita de Cássia Compagnoli Carmona
- Enteric Diseases Laboratory, Virology Center, Adolfo Lutz Institute, Avenida Dr Arnaldo, No 355, São Paulo, SP, CEP 01246-902, Brazil
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3
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Luchs A, Cilli A, Morillo SG, Ribeiro CD, Carmona RDCC, Timenetsky MDCST. Rotavirus genotypes and the indigenous children of Brazilian midwest in the vaccine era, 2008-2012: Footprints of animal genome. J Med Virol 2015; 87:1881-9. [PMID: 25963945 DOI: 10.1002/jmv.24241] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2015] [Indexed: 01/28/2023]
Abstract
World group A rotavirus (RVA) surveillance data provides useful estimates of the disease burden, however, indigenous population might require special consideration. The aim of this study was to describe the results of G- and P-types from Brazilian native children ≤ 3 years. Furthermore, selected strains have been analyzed for the VP7, VP6, VP4, and NSP4 encoding genes in order to gain insight into genetic variability of Brazilian strains. A total of 149 samples, collected during 2008-2012, were tested for RVA using ELISA and PAGE, following by RT-PCR and sequencing. RVA infection was detected in 8.7% of samples (13/149). Genotype G2P[4] was detected in 2008 and 2010, G8P[6] in 2009, and G3P[8] in 2011. The phylogenetic analysis of the VP7 and VP4 genes grouped the Brazilian G2P[4] and G3P[8] strains within the lineages currently circulating in humans worldwide. However, the phylogenetic analysis of the VP6 and NSP4 from the Brazilian G2P[4] strains, and the VP7 and NSP4 from the Brazilian G3P[8] strains suggest a distant common ancestor with different animal strains (bovine, caprine, and porcine). The epidemiological and genetic information obtained in the present study is expected to provide an updated understanding of RVA genotypes circulating in the native infant population, and to formulate policies for the use of RVA vaccines in indigenous Brazilian people. Moreover, these results highlight the great diversity of human RVA strains circulating in Brazil, and an in-depth surveillance of human and animal RVA will lead to a better understanding of the complex dynamics of RVA evolution.
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Affiliation(s)
- Adriana Luchs
- Enteric Disease Laboratory, Adolfo Lutz Institute, São Paulo, Brazil
| | - Audrey Cilli
- Enteric Disease Laboratory, Adolfo Lutz Institute, São Paulo, Brazil
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4
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Luchs A, Morillo SG, Ribeiro CD, Cilli A, Calux SJ, Carmona RDCC, Timenetsky MDCST. Rotavirus G2P[4] and G2P[4]+[6] infections during norovirus gastroenteritis outbreak: summer season 2010, Brazil. Rev Soc Bras Med Trop 2013; 46:227-30. [DOI: 10.1590/0037-8682-1162-2013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2011] [Accepted: 08/08/2011] [Indexed: 11/22/2022] Open
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5
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Luchs A, Morillo SG, Ribeiro CD, Vilanova BC, Calux SJ, Carmona RDCC, Timenetsky MDCST. Gastroenteritis outbreak due to G2P[4] rotavirus and GII norovirus at two correctional facilities in Brazil, 2010. J Clin Virol 2011; 51:213-4. [PMID: 21570903 DOI: 10.1016/j.jcv.2011.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Accepted: 04/11/2011] [Indexed: 10/18/2022]
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6
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Morillo SG, Luchs A, Cilli A, Ribeiro CD, Calux SJ, Carmona RDCC, Timenetsky MDCST. Norovirus 3rd Generation kit: An improvement for rapid diagnosis of sporadic gastroenteritis cases and valuable for outbreak detection. J Virol Methods 2011; 173:13-6. [DOI: 10.1016/j.jviromet.2010.12.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Revised: 12/09/2010] [Accepted: 12/21/2010] [Indexed: 12/13/2022]
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Morillo SG, Luchs A, Cilli A, Ribeiro CD, Calux SJ, Carmona RDCC, Timenetsky MDCST. Large gastroenteritis outbreak due to norovirus gii in São Paulo, Brazil, summer 2010. Rev Inst Med Trop Sao Paulo 2011; 53:119-20. [DOI: 10.1590/s0036-46652011000200011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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8
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Hosein IK, Hill DW, Tan TY, Butchart EG, Wilson K, Finlay G, Burge S, Ribeiro CD. Point-of-care controls for nosocomial legionellosis combined with chlorine dioxide potable water decontamination: a two-year survey at a Welsh teaching hospital. J Hosp Infect 2005; 61:100-6. [PMID: 16002178 DOI: 10.1016/j.jhin.2005.02.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2004] [Accepted: 02/07/2005] [Indexed: 10/25/2022]
Abstract
This study reports a two-year programme of attempted eradication of Legionella colonization in the potable water supply of a 1000-bed tertiary care teaching hospital in Wales. There was a simultaneous, point-of-care, sterile-water-only policy for all intensive care units (ICU) and bone marrow and renal transplant units in order to prevent acquisition of nosocomial Legionnaires' disease. The programme was initiated following a case of nosocomial pneumonia caused by Legionella pneumophila serogroup 1-Bellingham-like genotype A on the cardiac ICU. The case occurred 14 days after mitral and aortic valve replacement surgery. Clinical and epidemiological investigations implicated aspiration of hospital potable water as the mechanism of infection. Despite interventions with chlorine dioxide costing over 25000 UK pounds per annum, Legionella has remained persistently present in significant numbers (up to 20000 colony forming units/L) and with little reduction in the number of positive sites. Two further cases of nosocomial disease occurred over the following two-year period; in one case, aspiration of tap water was implicated again, and in the other case, instillation of contaminated water into the right main bronchus via a misplaced nasogastric tube was implicated. These cases arose because of inadvertent non-compliance with the sterile-water-only policy in high-risk locations. Enhanced clinical surveillance over the same two-year period detected no other cases of nosocomial disease. This study suggests that attempts at eradication of Legionella spp. from complex water systems may not be a cost-effective measure for prevention of nosocomial infections, and to the best of our knowledge is the first study from the UK to suggest that the introduction of a sterile-water-only policy for ICUs and other high-risk units may be a more cost-effective approach.
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Affiliation(s)
- I K Hosein
- Infection Prevention and Control Department, Cardiff and Vale NHS Trust, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, Wales, UK.
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Meldrum RJ, Ribeiro CD, Smith RMM, Walker AM, Simmons M, Worthington D, Edwards C. Microbiological quality of ready-to-eat foods: results from a long-term surveillance program (1995 through 2003). J Food Prot 2005; 68:1654-8. [PMID: 21132974 DOI: 10.4315/0362-028x-68.8.1654] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The coordination of food sampling activities across Wales, a part of the United Kingdom with a population of approximately 3 million, led to the establishment in 1995 of a coordinated food-sampling program designed to monitor on a long-term basis the microbiological quality and safety of specific ready-to-eat products. This surveillance system has been ongoing for 9 years and has generated a database of microbiological and associated demographic results for 15,228 ready-to-eat food samples. The food types that had the poorest overall results were sliced meats, unsliced poultry, sandwiches made without salad, and cakes made without dairy cream. For all food types, the overall unsatisfactory rate was 17% for aerobic colony counts, 1.6% for Escherichia coli, and 0.5% for Listeria spp. Overall unsatisfactory or unacceptable rates for pathogens such as Clostridium perfringens, Listeria monocytogenes, Bacillus cereus, and Staphylococcus aureus were all below 0.5%. No Campylobacter-positive samples and only one Salmonella-positive sample were found. The analysis of the results show that the ready-to-eat food types sampled over the 9 years of the program were generally of good microbiological quality when compared with current United Kingdom guidelines. The information contained in the database provides a baseline measurement of the microbial quality of a variety of ready-to-eat foods and allows environmental health officers and food microbiologists to generate hypotheses for targeted surveys or research work.
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Affiliation(s)
- R J Meldrum
- Public Health Laboratory, National Public Health Service (NPHS) for Wales, Llandough Hospital, Penlan Road, Penarth CF64 2XX, UK.
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10
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Affiliation(s)
- B Healy
- Microbiology Cardiff , NPHS Wales, UHW, Heath Park, Cardiff CF14 4XW, UK.
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11
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Abstract
Ready-to-eat foods at retail and catering establishments were randomly sampled at the point of sale for a period of 15 months. During this period, 4,469 food samples were examined for the presence of Campylobacter with the use of plate-based methodology. A range of different ready-to-eat food types, all of which have the potential to be contaminated with the organism, were examined. No viable Campylobacter cells were detected in any of the foods during the survey. There is no evidence that the foods examined in this study represent a risk to the consumer. Although these foods may be a vehicle for infection if cross-contamination occurs, other sources need to be investigated as causes of enteric infection caused by Campylobacter.
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Affiliation(s)
- R J Meldrum
- Food, Water and Environmental Section, Cardiff Public Health Laboratory, Public Health Laboratory Service in Wales, Llandough Hospital, Penlan Road, Penarth, CF64 2XX, United Kingdom.
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12
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Evans MR, Meldrum R, Lane W, Gardner D, Ribeiro CD, Gallimore CI, Westmoreland D. An outbreak of viral gastroenteritis following environmental contamination at a concert hall. Epidemiol Infect 2002; 129:355-60. [PMID: 12403111 PMCID: PMC2869894 DOI: 10.1017/s0950268802007446] [Citation(s) in RCA: 115] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
In January 1999, an outbreak of viral gastroenteritis affected more than 300 people who attended a metropolitan concert hall over a 5-day period. Norwalk-like virus (NLV) was confirmed in faecal samples by reverse transcription polymerase chain reaction assay. The index case was a concert attendee who vomited in the auditorium and adjacent male toilet. Gastrointestinal illness occurred among members of 8/15 school parties who attended the following day. Children who sat on the same level of the auditorium as the index case were much more likely to be ill than those seated elsewhere (relative risk 7.1, 95% confidence interval 5.4-9.2. P < 0.001). The majority of other reported cases had not been present on the evening of the vomiting incident. Disinfection procedure was poor and the disinfectant used contained no sodium hypochlorite. Transmission most likely occurred through direct contact with contaminated fomites. The outbreak has implications for disinfection procedures following vomiting incidents at public venues.
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Affiliation(s)
- M R Evans
- Public Health Directorate, Bro Taf Health Authority, Cardiff, UK
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13
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Ribeiro CD, Frost JA. Family clusters of campylobacter infection. Commun Dis Public Health 2000; 3:274-6. [PMID: 11280258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Possible family clusters of campylobacter infection among isolates referred to a single, large public health laboratory were reviewed to determine the proportion of clusters associated with more than one strain of campylobacter. A total of 23 clusters, each made up of members of a single household infected within two months of each other, were identified between September 1996 and January 1999. These accounted for about 5% of all campylobacter infections confirmed during the study period. Thirteen of these families were infected with single strains of C. jejuni and one with C. coli. In ten families specimens were taken over intervals ranging from six to 56 days. In eight clusters more than one strain of C. jejuni was identified and in one family two patients were infected with C. jejuni and one with C. lari. These findings are consistent with the observation that potential sources of campylobacter infection may be contaminated with more than one strain.
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Gilbert RJ, de Louvois J, Donovan T, Little C, Nye K, Ribeiro CD, Richards J, Roberts D, Bolton FJ. Guidelines for the microbiological quality of some ready-to-eat foods sampled at the point of sale. PHLS Advisory Committee for Food and Dairy Products. Commun Dis Public Health 2000; 3:163-7. [PMID: 11014026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
These guidelines for the microbiological quality of ready-to-eat foods represent a revision and expansion of guidelines first published by the PHLS in September 1992 and revised in March 1996. The latest guidelines incorporate many of the constructive comments received from food examiners and other microbiologists within and outside the PHLS and from environmental health officers throughout the United Kingdom. This document reviews the changes and the reasons they were made and sets out the new guidelines. It also clarifies the role of food examiners in interpreting the microbiological results of formal samples.
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Affiliation(s)
- R J Gilbert
- Food Safety Microbiology Laboratory, PHLS Central Public Health Laboratory, London
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Evans MR, Salmon RL, Nehaul L, Mably S, Wafford L, Nolan-Farrell MZ, Gardner D, Ribeiro CD. An outbreak of Salmonella typhimurium DT170 associated with kebab meat and yogurt relish. Epidemiol Infect 1999; 122:377-83. [PMID: 10459639 PMCID: PMC2809630 DOI: 10.1017/s0950268899002253] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
During July 1995, an outbreak of Salmonella typhimurium definitive type (DT) 170, an unusual strain, occurred in South Wales. A case-control study found that illness was associated with eating kebabs (odds ratio undefined, P = 0.002), doner kebabs (odds ratio 7.9, 95 % confidence interval 1.5-20.5, P = 0.02) and kebabs with yoghurt based relish (odds ratio undefined, P = 0.009) but not with eating kebabs with mayonnaise-based relish (odds ratio 2.4, 95 % confidence interval 0.4-13.9, P = 0.53). Environmental investigations discovered a complex web of producers and wholesale suppliers. Kebab meat and yoghurt had been supplied to the two main implicated outlets by a single wholesaler. Samples of raw minced lamb and several environmental swabs taken at the wholesaler were positive for S. typhimurium DT170. Blood-stained, unsealed yoghurt pots were observed to be stored under a rack of raw lamb. Investigators of food poisoning outbreaks linked to takeaway food should consider cross-contaminated relishes and dressings as well as undercooked meat as potential vehicles of infection.
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Affiliation(s)
- M R Evans
- Department of Public Health Medicine, South Glamorgan Health Authority, Cardiff
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Abstract
Salmonella Enteritidis phage type 6 (PT6) increased dramatically in the United Kingdom during 1997. The sharp rise suggests that PT6 contamination has spread rapidly throughout a basic food commodity; however, the source and food vehicle remain unknown. We present evidence from three outbreaks suggesting a possible link between PT6 and eggs. Poor documentation of the egg supply network continues to pose problems for public health investigators. Thorough investigation of all future PT6 outbreaks and case-control studies of sporadic infections are needed to confirm the etiology of PT6 infection.
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Affiliation(s)
- M R Evans
- Bro Taf Health Authority, Cardiff, United Kingdom.
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17
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Abstract
After a nursery school trip to a dairy farm, 20 (53%) of 38 children and 3 (23%) of 13 adult helpers developed gastrointestinal infection. Campylobacter jejuni was isolated from 15 primary cases and from 3 of 9 secondary household cases. A cohort study of the school party found illness to be associated with drinking raw milk (relative risk 5.4, 95% confidence interval 1.4-20.4, P = 0.001). There was a significant dose response relationship between amount of raw milk consumed and risk of illness (chi 2-test for linear trend 12.1, P = 0.0005) but not with incubation period, severity of symptoms or duration of illness. All 18 human campylobacter isolates were C. jejuni resistotype 02 and either biotype I (number 16) or biotype II (number 2). Campylobacter was also isolated from samples of dairy cattle and bird faeces obtained at the farm but these were of different resisto/biotypes. Educational farm visits have become increasingly popular in recent years and this outbreak illustrates the hazard of exposure to raw milk in this setting.
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Affiliation(s)
- M R Evans
- Department of Public Health Medicine, South Glamorgan Health Authority, Cardiff
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18
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Abstract
A 9-month trial of a simple typing scheme for ¿thermophilic' enteric campylobacter isolates at a large Public Health Laboratory is described. Resistotyping was performed with six agents in a method modified by Bolton and colleagues from an earlier scheme, and biotyping was performed by a modified Lior scheme involving three tests. Reproducibility was excellent in both schemes, with test variation < 2%. Five household clusters and one larger presumptive milk-borne outbreak were identified in this scheme, and confirmed in pyrolysis mass spectrometry. The 328 isolates from new patients, excluding duplication from these clusters, were divided into 35 resistotypes with the largest group comprising 22% of isolates. In combined bio- and resistotyping, 86 types were found, with the largest group comprising 9.5% of isolates. The results are contrasted with salmonella sero- and phage-typing, where, on the same basis, the 176 isolates in the same period were divided into 40 groups, with the largest comprising 45% of isolates. Resistotyping, with or without additional biotyping, proved to be a convenient, simple, rapid, highly discriminatory, reproducible and inexpensive method well suited to use in local laboratories. It is a strong candidate for first-line national and local surveillance of campylobacter infections, fulfilling a need for monitoring of this important cause of enteric disease.
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Affiliation(s)
- C D Ribeiro
- Department of Medical Microbiology, University Hospital of Wales, Cardiff
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Abstract
Two consecutive community outbreaks of Salmonella enteritidis phage type 4 (PT4) traced to the same bakery occurred in Cardiff, Wales during August-September 1992. In the first outbreak, illness was associated with eating custard slices (odds ratio 23.8, 95% confidence interval 6.5-94.4, P < 0.0001), and in the second, with eating fresh cream cakes (odds ratio 15.8, 95% confidence interval 1.6-374, P = 0.004). Environmental investigations implicated cross-contamination during preparation of the cold-custard mix as the cause of the first outbreak, and inadequate cleaning and disinfection of nozzles used for piping cream in the second outbreak. S. enteritidis PT4 was isolated from fresh cream sponge cake retained by a case and from two fresh cream cakes and four environmental swabs obtained at the bakery. This incident illustrates the hazard of widespread environmental contamination with salmonella and the need for thorough environmental cleansing for any premises implicated in an outbreak of food poisoning.
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Affiliation(s)
- M R Evans
- Department of Public Health Medicine, South Glamorgan Health Authority, Cardiff
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Abstract
In an outbreak of plasmid-free Salmonella enteritidis phage type 4 (PT4) food poisoning at a hospital for mentally handicapped people in July 1990, 101 residents and 8 staff were affected and a cohort study implicated beef rissoles cooked by deep-fat frying as the vehicle of infection (relative risk 2.92, 95% confidence interval 1.73-4.93, P << 0.001). Replication of the cooking process demonstrated that the rissoles achieved core temperatures of only 48-60 degrees C despite external temperatures of 91-95 degrees C and an oil temperature of 142-154 degrees C. No residual food was available for microbiological testing but plasmid-containing S. enteritidis PT 4 was isolated in shell eggs from the hospital kitchen.
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Affiliation(s)
- M R Evans
- Department of Public Health Medicine, South Glamorgan Health Authority, Cardiff
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Abstract
Following a buffet meal served to six guests at a private domestic function, five of the guests and the host developed symptoms of food poisoning. Salmonella enteritidis phage type 4 (PT4) was isolated from all four individuals who submitted faecal samples for investigation. Leftover samples of a savoury rice dish consumed by all six ill persons contained 6 x 10(3)/gm Salmonella enteritidis PT4. The rice salad comprised boiled rice, raw carrots, eggs, cheese and curry powder. The curry powder and remainder of the pack of six eggs were negative on microbiological analysis. The rice dish had been prepared by heating in a 500 W microwave oven with a rotating turntable on full power for 5 min. Although the hazards of inadequate microwave cooking are well recognized, this is only the second outbreak of food poisoning from microwave cooking to be reported.
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Affiliation(s)
- M R Evans
- Department of Public Health Medicine, South Glamorgan Health Authority, Cardiff
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22
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Dyson C, Ribeiro CD, Westmoreland D. Large scale use of ciprofloxacin in the control of a Salmonella outbreak in a hospital for the mentally handicapped. J Hosp Infect 1995; 29:287-96. [PMID: 7658008 DOI: 10.1016/0195-6701(95)90275-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
An outbreak of salmonella food poisoning occurred in a hospital for the mentally handicapped in July 1990. Salmonella enteritidis phage type 4 was identified in 101 patients and eight staff. Standard infection control measures were instituted. Ciprofloxacin was given to all resident patients and to all affected staff. The outbreak was rapidly controlled. There were no new cases after ciprofloxacin was started and there were no clinical relapses. Microbiological relapsers were retreated with ciprofloxacin. A gradual return to normal activity was possible and within two months the hospital was functioning normally. No salmonellae have been identified in the hospital since that time, confirming that the organism was eradicated, rather than just temporarily suppressed.
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Affiliation(s)
- C Dyson
- Department of Medical Microbiology, University Hospital of Wales, Cardiff, UK
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23
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Magee JT, Brazier JS, Hosein IK, Ribeiro CD, Hill DW, Griffiths A, Da Costa C, Sinclair AJ, Duerden BI. An investigation of a nosocomial outbreak of Clostridium difficile by pyrolysis mass spectrometry. J Med Microbiol 1993; 39:345-51. [PMID: 8246251 DOI: 10.1099/00222615-39-5-345] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Isolates from a presumptive nosocomial outbreak of Clostridium difficile infection at a large teaching hospital were typed by pyrolysis mass spectrometry (PMS) and antibiograms. One isolate, from the putative index case, was dissimilar from the outbreak strain, but 24 isolates from 16 patients were indistinguishable by both methods. The outbreak centred on two wards for the acute care of the elderly, with a few cases elsewhere. Transfer of patients appeared to be the route of transmission between wards. There was a significant fall in the incidence of cases following intervention by the Infection Control Unit. This included ward inspection, advice on antibiotic usage and advice on prevention of faecal-oral transfer, particularly by proper handwashing. Subsequent monitoring of C. difficile infection showed a background of sporadic, dissimilar isolates with occasional apparent cross-infection incidents limited to a few patients. In suspected outbreaks, patterns of antibiotic susceptibility may be useful in initial screening, before referral for more sophisticated typing. There was excellent correlation between PMS results, antibiograms and epidemiological information.
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Affiliation(s)
- J T Magee
- Department of Medical Microbiology, University Hospital of Wales, Heath Park, Cardiff
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24
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Salmon RL, Palmer SR, Ribeiro CD, Hutchings P, Coleman TJ, Willis FJ, Allsup TN, Ritchie WN. How is the source of food poisoning outbreaks established? The example of three consecutive Salmonella enteritidis PT4 outbreaks linked to eggs. J Epidemiol Community Health 1991; 45:266-9. [PMID: 1795143 PMCID: PMC1059457 DOI: 10.1136/jech.45.4.266] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Three consecutive outbreaks of Salmonella enteritidis PT4 occurred in Wales in 1989 in which epidemiological and microbiological investigation established eggs as the likely source although kitchen inspection and food preparation histories suggested other vehicles of infection. This paper examines the contribution of analytical epidemiology in attributing causation, with particular reference to those limitations which are regarded as inherent in epidemiological evidence. Such evidence, implicating eggs in the three outbreaks, fulfilled 6/7 widely accepted criteria for causation; data to assess the seventh were lacking. Collaboration between different agencies and professionals in investigating outbreaks is very important.
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Affiliation(s)
- R L Salmon
- PHLS Communicable Disease Surveillance Centre (Welsh Unit), Cardiff, United Kingdom
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25
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Evans MR, Riley CL, Ribeiro CD. Fried rice from the take-away. CDR (Lond Engl Rev) 1991; 1:R100. [PMID: 1669788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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26
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Abstract
Samples of 216 pâtés were examined for the presence of Listeria spp. between May and August 1989; 35% were contaminated with L. monocytogenes, 5% of samples having counts of greater than 10(4)/g. L. innocua was recovered from 2% of samples but no other species was isolated. Five serotypes of L. monocytogenes were represented (1/2, 4b, 4b(X), 4 not 4b or 4b(X), and NT), 4b was the predominant serotype and multiple serotypes were found in eight pâtés. The incidence of contamination with L. monocytogenes was greater in stored pâté (46%) than display pâté (30%). Sampling over a 21-day period showed an apparent increase in numbers of L. monocytogenes in 6 of 7 samples with multiple serotypes represented. There was no correlation between contamination of pâté by L. monocytogenes and the presence of coliforms. Comparisons are made between the contamination of soft cheese and pâté.
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Affiliation(s)
- I J Morris
- Public Health Laboratory, University Hospital of Wales, Heath Park, Cardiff
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27
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28
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Abstract
Epidemiological and microbiological investigation of the four outbreaks of Salmonella enteritidis phage type (PT) 4 that occurred in Wales in 1988 implicated foods containing shell eggs from hens as the vehicle of infection. In a case-control study of sporadic cases there was a significant association between infection and egg consumption in the 3 days before illness. These findings provide data to support the warnings from the Departments of Health in the United Kingdom about risks of infection from eating raw or undercooked hens' eggs.
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Affiliation(s)
- E F Coyle
- Cardiff Public Health Laboratory, University Hospital of Wales
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29
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Ribeiro CD, Fitzgerald TC. Is enrichment culture necessary for isolating Campylobacter jejuni from faeces? J Clin Pathol 1988; 41:1135. [PMID: 3192739 PMCID: PMC1141704 DOI: 10.1136/jcp.41.10.1135-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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32
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Ribeiro CD, Burge SH, Palmer SR, Tobin JO, Watkins ID. Legionella pneumophila in a hospital water system following a nosocomial outbreak: prevalence, monoclonal antibody subgrouping and effect of control measures. Epidemiol Infect 1987; 98:253-62. [PMID: 3595743 PMCID: PMC2235364 DOI: 10.1017/s0950268800062002] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Swabs and water samples from a hospital water system were cultured for legionellae over an extended period. Legionella pneumophila serogroup 1, including outbreak associated strains, were isolated in small numbers from approximately 5% of these samples despite implementation of the current DHSS/Welsh Office regulations. No cases of nosocomial legionnaires' disease were proven during the study. Physical cleaning and chemical sterilization of taps, and replacement of washers with 'approved' brands did not eradicate the organisms. Eradication of legionellae in hospital water supplies appears to be unnecessary in preventing nosocomial legionnaires' disease provided the current DHSS/Welsh Office recommendations are implemented.
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33
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O'Dowd TC, West RR, Ribeiro CD, Smail JE, Munro JA. Contribution of Gardnerella vaginalis to vaginitis in a general practice. Br Med J (Clin Res Ed) 1986; 292:1640-2. [PMID: 3013357 PMCID: PMC1340709 DOI: 10.1136/bmj.292.6536.1640] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
In a study of 154 adult women who presented to their general practitioner with vaginal symptoms 30 (20%) had Gardnerella vaginalis on its own and 51 (33%) had G vaginalis in combination with anaerobes or known pathogens. Thirty one (20%) patients were culture negative. Those who were culture negative had fewer symptoms and signs of vaginitis than those with G vaginalis alone or G vaginalis plus anaerobes. Those with known pathogens had more symptoms and signs than those with G vaginalis alone or G vaginalis plus anaerobes. Those with known pathogens plus G vaginalis had the most severe signs and symptoms of vaginitis. It is concluded that G vaginalis can cause vaginitis on its own, and it makes vaginitis worse when present with other organisms. G vaginalis was also found in 30 (21%) of the 138 control patients who, although they presented "asymptomatically," had worse signs than control patients without G vaginalis. It seems that G vaginalis can occur in a spectrum ranging from the uncomplaining patient to those with severe vaginitis.
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34
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Palmer SR, Zamiri I, Ribeiro CD, Gajewska A. Legionnaires' disease cluster and reduction in hospital hot water temperatures. Br Med J (Clin Res Ed) 1986; 292:1494-5. [PMID: 3087490 PMCID: PMC1340497 DOI: 10.1136/bmj.292.6534.1494-a] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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36
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Evans BK, Harding KG, Marks J, Ribeiro CD. The disinfection of silicone-foam dressings. J Clin Hosp Pharm 1985; 10:289-95. [PMID: 3934212 DOI: 10.1111/j.1365-2710.1985.tb00926.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The efficiency of four commonly used antiseptics, chlorhexidine, povidone-iodine, cetrimide and sodium hypochlorite was compared in the disinfection of silicone-foam dressing used in the management of open granulating wounds. An in vitro model was first used to determine the minimum effective concentration of each antiseptic in killing a standard culture of Pseudomonas. The appropriate concentrations were then compared in comparative studies of clinical wounds. Chlorhexidine proved to be the most effective antiseptic, povidone-iodine and cetrimide were moderately successful, but sodium hypochlorite gave poor results. A subsidiary study looked at the problem of wound irritation by carry-over of the antiseptic. A rinse of the dressing after disinfection prevented irritation by chlorhexidine without compromising its antibacterial effect, but this procedure sometimes failed to prevent irritation when using the other antiseptic agents. It is concluded that chlorhexidine is the preferred cleansing agent in the management of silicone-foam dressings on both grounds of bacteriological efficiency and lack of wound irritation. It should be noted that Hibitane concentrate used in this work contains non-ionic detergent and a stabilizing agent. Pure preparations of chlorhexidine may not behave similarly.
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39
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Abstract
A prospective study is reported of 100 pilonidal sinus excisions healing by open granulation. Delays in healing appeared to be due to infection, particularly by anaerobic bacteria. Comparisons are made between three groups studied consecutively - 30 wounds not treated with antibiotics, 20 given a fixed two-week course of metronidazole and 50 managed flexibly. In this last group, wound management was determined by clinical appearance; 24 wounds were clinically healthy throughout and received no antibiotic while 26 looked unhealthy initially or after an interval and were treated with metronidazole, supplemented in some cases with erythromycin. The best results were obtained in the group managed flexibly. It is considered that the problems of delayed healing are due to excisions which leave a wound of a shape ill-designed to maintain good drainage. Unhealthy wounds should be re-shaped if possible and treated early with a combination of metronidazole and erythromycin.
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Abstract
Thirty nine adult women who were not pregnant and had the urethral syndrome in a general practice underwent detailed microbiological investigations. Patients monitored their own symptoms, and those with persisting symptoms were entered into a randomised controlled trial of treatment with doxycycline and placebo. Chlamydia trachomatis and Neisseria gonorrhoeae were not isolated and fastidious organisms were not causally associated with the urethral syndrome. Treatment with doxycycline showed no benefit; each episode of the urethral syndrome was short and self limiting and there were no recurrences in a median observation period of 12 months.
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42
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Abstract
The application of Preston enrichment broth to isolation of 'thermophilic' campylobacters from water has been investigated. Enrichment substantially increased the yield of such organisms. The optimum timing for subculturing the broth was after 48 h incubation. Despite the addition of aerotolerant supplement to the broth the number and variety of isolates was greater when the broth was incubated microaerically than when it was incubated in air.
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43
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O'Dowd TC, Ribeiro CD, Smail JE, Menday AP, Howells CH. A comparative trial of pivmecillinam/pivampicillin and amoxycillin/clavulanate in the therapy of urinary tract infection in a general practice population. Curr Med Res Opin 1984; 9:310-5. [PMID: 6397334 DOI: 10.1185/03007998409109598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Fifty-eight patients seen in general practice presenting with symptoms of acute urinary tract infection were entered consecutively into an open randomized trial of 200 mg pivmecillinam plus 250 mg pivampicillin twice daily or 250 mg amoxycillin plus 125 mg clavulanate 3-times daily for 5 days. The results were analyzed in 41 patients with significant bacteriuria (23 on pivmecillinam/pivampicillin and 18 on amoxycillin/clavulanate). Both antibiotic combinations produced good overall bacteriological cure, but there were a considerable number of persisting symptoms despite the absence of significant bacteriuria. Eight patients in the pivmecillinam/pivampicillin group and 5 in the amoxycillin/clavulanate group had side-effects, principally thrush, vomiting and abdominal pain, and 1 patient from each group ceased treatment for this reason. Sensitivity profiles of urinary isolates (41 trial, 135 non-trial) to both combinations and to ampicillin and mecillinam showed that the majority were fully sensitive to amoxycillin/clavulanate and to a lesser extent to pivmecillinam/pivampicillin; resistance was highest to ampicillin.
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45
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Marks J, Hughes LE, Harding KG, Campbell H, Ribeiro CD. Prediction of healing time as an aid to the management of open granulating wounds. World J Surg 1983; 7:641-5. [PMID: 6636809 DOI: 10.1007/bf01655345] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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46
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47
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48
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Ribeiro CD. Prophylactic erythromycin for whooping-cough contacts. Lancet 1981; 1:951. [PMID: 6112363 DOI: 10.1016/s0140-6736(81)91653-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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49
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50
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Ribeiro CD, Parry P, Edwards M, Spragg BP. Is there a place for the GammaCoat (125I) Gentamicin Radioimmunoassy Kit in a routine clinical pathology laboratory? J Clin Pathol 1980; 33:509-10. [PMID: 7400352 PMCID: PMC1146122 DOI: 10.1136/jcp.33.5.509-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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