Identification and initial characterization of elastase activity associated with Vibrio cholerae.

Strains of Vibrio cholerae O1 (Ogawa, Inaba) and non-O1 serogroups have been found to produce an elastolytic protease that can be detected on 0.3% elastin agar plates or in broth cultures. The elastase enzyme appears to be maximally expressed in late log phase (14-18 h postinoculation) and has optimum activity at a pH range between 7 and 8.

An untypeable Shigella flexneri strain associated with an outbreak in California.

Eleven Shigella flexneri (group B) isolates were recovered from epidemiologically linked patrons and food handlers from a restaurant-associated outbreak of shigellosis. Six isolates available for pulsed-field gel electrophoresis were identical. All strains agglutinated in group B and subgroup factor 6 sera but not in group 1 through group 6 sera.

Two outbreaks of multidrug-resistant Salmonella serotype typhimurium DT104 infections linked to raw-milk cheese in Northern California.

Context: Salmonella serotype Typhimurium definitive type 104 (DT104), with resistance to 5 drugs (ampicillin, chloramphenicol, streptomycin, sulfonamides, and tetracycline), has emerged as the most common multidrug-resistant Salmonella strain in the United States. However, illnesses resulting from this strain have not been associated definitively with a source in this country.

Objective: To determine the source of 2 outbreaks of Salmonella Typhimurium DT104.

Patient education: pre- and post-procedure upper endoscopy.

In this article, the author describes the responsibility of the admitting nurse to inform the patient about the procedure before the consent form is signed. The importance of an informed patient in relation to the legal implications and also the increased comfort level that the patient will experience are described. Results of a research program on pre-procedure patient education will be referenced.

The benefits of patient education.

In this article, the role of the nurse in patient education is described, as well as the benefits of patient education, such as improved quality of care, improved patient satisfaction, increased compliance, improved staff satisfaction, and effective use of resources. Strategies for effective patient teaching also are presented.

Evolving concepts regarding the genus Aeromonas: an expanding Panorama of species, disease presentations, and unanswered questions.

It has been almost 10 years since a major review on the association of Aeromonas with human disease has been published. During that period the number of valid species in the genus has grown to 14, with a new family (Aeromonadaceae) established to house this genus. Despite this explosion in the number of new genomospecies, only five (Aeromonas hydrophila, A.

Invasion of HEp-2 and other eukaryotic cell lines by Providenciae: further evidence supporting the role of Providencia alcalifaciens in bacterial gastroenteritis.

Wild-type strains of Providencia species were evaluated for their ability to invade HEp-2 monolayers based upon microscopic and semi-quantitative assays. Of 14 P. alcalifaciens strains tested, 3 (17%) were found to be highly invasive, 4 (22%) moderately invasive, and the remaining 61% weakly or noninvasive.

Synthesis and activity of dipeptides, linked to targeting ligands, as specific NK cell enhancers.

Water soluble analogues of the lipophilic immunostimulant, octadecyl D-alanyl-L-glutamine, BCH-527, were synthesized and evaluated for the ability to stimulate natural killer (NK) cells. One of these compounds in which the octadecyl chain of BCH-527 was replaced with a shorter chain alcohol, 6-(D-alanyl-L-glutaminylamino)hexan-1-ol, 9, displayed an in vitro stimulation of NK cells comparable to that of interleukin 2 (IL 2). However, when the hydroxyl of 9 was linked to L-fucose to yield 1-beta-[6-(D-alanyl-L-glutaminylamino)hex-1-yl]-L- fucopyranose (BCH-2537, 1), the observed stimulation of NK cells was greater than that observed with IL 2.

Degradation of hydrocarbons in crude oil by the ascomycete Pseudallescheria boydii (Microascaceae).

Four unique strains of Pseudallescheria boydii were isolated from oil-soaked soils in British Columbia and Alberta and compared to strains from cattle dung and raw sewage. Considerable variability in morphology, colony appearance, colony diameter, and temperature tolerance occurred among the strains. They also varied in the sporogenous states produced in culture; all strains had a Scedosporium anamorph and either the Graphium anamorph or cleistothecial teleomorph.

Misidentification of unusual Aeromonas species as members of the genus Vibrio: a continuing problem.

Two unusual cases of Aeromonas infection are described, one associated with bacteremia (Aeromonas schubertii) and another in which the organism was recovered from an infected gall bladder (Aeromonas veronii biotype veronii). These strains were initially identified as Vibrio damsela and Vibrio cholerae by the Vitek and API 20E systems, respectively. Use of appropriate screening tests and familiarity with the newer Aeromonas species could prevent initial misidentifications and potential public health consequences.

Who is a heavy service user? Preliminary development of a screening instrument for prospective consumers of a mobile intensive treatment team.

Objective: The mobile intensive treatment team (MITT) of the Valley Integrated Adult Mental Health Service in Brisbane, Australia, aims to provide services in the community to people with severe and persistent mental illness who have traditionally been heavily reliant on inpatient services (i.e. heavy service users).

Citrobacter farmeri bacteremia in a child with short-bowel syndrome.

A case of sepsis in a pediatric patient due to the newly described Citrobacter species C. farmeri is described. Factors predisposing this child to infection included short-bowel syndrome requiring total parenteral nutrition.

Multicenter evaluation of the MicroScan Rapid Gram-Negative Identification Type 3 Panel.

The accuracy and performance of the revised MicroScan Rapid Gram-Negative Identification Type 3 Panel (Dade MicroScan Inc., West Sacramento, Calif.) were examined in a multicenter evaluation.

Analysis of the thermostable direct hemolysin (tdh) gene and the tdh-related hemolysin (trh) genes in urease-positive strains of Vibrio parahaemolyticus isolated on the West Coast of the United States.

Urease-positive (Ure+) and urease-negative (Ure-) strains of Vibrio parahaemolyticus isolated from patients on the West Coast of the United States between 1979 and 1995 were analyzed for the thermostable direct hemolysin (tdh) gene and the tdh-related hemolysin (trh) genes (trh1 and trh2). The DNA colony hybridization method with the polynucleotide probes was used to determine the distribution of the genes. Of 60 Ure+ strains, 59 strains (98%) had the trh (either trh1 or trh2) gene and 54 strains (90%) carried the tdh gene.

Overview of the etiology of wound infections with particular emphasis on community-acquired illnesses.

Wound cultures represent a general catchall category for a group of extremely diverse anatomic samples that range from superficial specimens of cutaneous structures (folliculitis, cellulitis) to specimens revealing invasive infections involving deep fascial planes and muscle (myonecrosis). Because of the complex nature of these infective processes, the terminology associated with such infections is often imprecise and confusing. Wounds are the result of trauma, either intentionally or accidentally induced.

Enterobacter cancerogenus ("Enterobacter taylorae") infections associated with severe trauma or crush injuries.

Five cases of Enterobacter cancerogenus infections (wound, n = 4; bacteremia, n = 1) in adults are described. All infections seemed to be community acquired and occurred after precipitating events such as multiple trauma to the head or severe crush injuries. All five strains of E cancerogenus were recovered in pure culture, and three of these were isolated on multiple occasions.

Further studies on biochemical characteristics and serologic properties of the genus Aeromonas.

We characterized a collection of 268 Aeromonas isolates from diverse sources (clinical, animal, and environmental sources) for their species and serogroup designations. Overall, 97% of these strains could be identified to the genomospecies level by using an expanded battery of biochemical tests. Members of the Aeromonas hydrophila complex (A.

A cluster of Escherichia coli O157:H7 infections with the hemolytic-uremic syndrome and death in California. A mandate for improved surveillance.

In mid-January 1993, an outbreak of Escherichia coli O157:H7 infections associated with eating hamburger patties at a fast-food restaurant chain (chain A) was reported in Washington State. From mid-December to mid-January, 9 cases of E coli O157:H7-associated bloody diarrhea and the hemolytic-uremic syndrome had been reported in San Diego County, California. A total of 34 persons had bloody diarrhea, the hemolytic-uremic syndrome, or E coli O157:H7 organisms isolated from stool during the period November 15, 1992, through January 31, 1993.

Assessment of worker exposure to airborne molds in honeybee overwintering facilities.

Airborne fungi in honeybee overwintering and equipment cleaning facilities were enumerated and identified to determine worker exposure during cleaning and routine beekeeping operations. Testing was prompted by observations of extensive mold growth on dead bees and associated material and by results of a preliminary study at one Alberta beekeeping facility that showed very high numbers of mold colonies on air samples taken during worker activity. To evaluate whether high mold counts were indicative of a problem at a single site or were industry wide, approximately 120 air samples were collected with a Reuter centrifugal sampler inside 10 overwintering facilities before and during routine beekeeping activity during fall, winter, and spring periods.

Dynamic bone remodeling in later Pleistocene fossil hominids.

Histomorphometric analysis of femoral and tibial diaphyseal fragments from seven Late Archaic and three Early Modern humans are compared with those of the Pecos, a pre-Columbian Native American population. The ten samples, from Broken Hill (EM-793), Shanidar 2, 3, 4, 5, and 6, Tabun 1, and Skhul 3, 6, and 7, provide age-at death results consistent with earlier estimates for most individuals. The Pleistocene groups exhibit less bone turnover and smaller osteons than Recent populations.

Biochemical investigations of biogroups and subspecies of Morganella morganii.

We determined the subspecies and biogroup designations for 73 strains of Morganella morganii principally recovered from routine clinical specimens. On the basis of trehalose fermentation, 90% of all strains were identified as M. morganii subsp.

Fatal cerebral mycoses caused by the ascomycete Chaetomium strumarium.

Three cases of fatal cerebral mycosis in males with prior histories of intravenous drug use from the United States and Australia are reported. Infection in each case was limited to brain abscess; no other sites of infection were observed. The fungus seen by histopathology and isolated from the brain tissue in each case was identified as Chaetomium strumarium.