Identification of non-B human immunodeficiency virus type 1 subtypes in rural Georgia.

As part of an ongoing molecular epidemiological investigation of human immunodeficiency virus type 1 (HIV-1) in rural Georgia, the 5' half of reverse transcriptase (RT) genotypes from 30 patients was sequenced and phylogenetically analyzed. Two patients, GA132 and GA169, were infected with pol sequences of non-B subtype origin that were found to cluster phylogenetically with subtype A-E of Thai origin. Sliding window bootstrap analysis of GA169 showed clear evidence of A/B recombination within the pol gene segment, whereas in the other patient, GA132, no break point within RT could be identified.

Antimicrobial therapy for chronic osteomyelitis in adults: role of the quinolones.

The development of antimicrobial therapy for osteomyelitis is reviewed. The disease, especially when chronic, is notoriously resistant to antibiotic therapy. The duration of disease defining chronicity has decreased considerably in the last 30 years.

Epidemiology of HIV-1 infection in rural Georgia: demographic trends and analysis at the Medical College of Georgia.

We have conducted a retrospective study of 100 HIV-infected patients enrolled in an AZT monotherapy clinical study at the Medical College of Georgia (MCG) in Augusta, Georgia. When compared to the national trends, our results confirm previous studies that describe an overall increase in the burden of HIV infections among blacks, and, in particular, black women in the rural Southeast. In our cohort, infections due to homosexual contact accounted for approximately 40% of all cases while heterosexual contact and intravenous drug use (IDU) comprised 33% and 13%, respectively.

Group B streptococcal vertebral osteomyelitis with bacteremia.

Group B streptococcal vertebral osteomyelitis is rare in adults. Osteomyelitis due to this organism is in general related to contiguous infections, recent surgery, or peripheral vascular disease. All reported cases of group B streptococcal vertebral osteomyelitis, however, have had no association with these predisposing factors and have usually been presumed to be of hematogenous origin, though bacteremia has never been demonstrated.

The effect of growth temperature on Staphylococcus aureus binding to type I collagen.

Many strains of Staphylococcus aureus produce a collagen-binding surface protein that could enable these strains to colonize tissues such as bone. Previous studies indicated that the expression of the collagen receptor varies with growth conditions. We report here that the growth temperature influences the ability of some S.

Tuberculosis surveillance: lessons from a cluster of skin test conversions.

Mycobacterium tuberculosis has reemerged as a significant public health problem. Elderly persons, especially those in long-term care facilities, are among those at high risk for infection with M. tuberculosis.

Management considerations for an HIV positive dental student.

Health care workers who are HIV positive or who have AIDS are faced with unique and perplexing problems. Likewise dental students who are HIV positive present a special circumstance that demands review of ethical, legal, managerial, and medical considerations. The purpose of this paper is to describe the management considerations at the Medical College of Georgia following a recent report of an HIV positive dental student.

Animal models of osteomyelitis. Knowledge, hypothesis, and speculation.

Each animal model has provided insights. Particularly important was the considerable resistance of bone to infection without manipulation (no morrhuate, fracture, rod, wax, or prosthesis). Such perturbations allow bone infection with much smaller inocula.

An antibiotic resistant experimental model of Pseudomonas osteomyelitis.

We report a model of chronic Pseudomonas aeruginosa osteomyelitis in the rat that was reproducible, simple and inexpensive. No promoting agent was required to cause infection. Infected animals yielded consistent pseudomonal colony counts (log): 4.

The promotional effect of bone wax on experimental Staphylococcus aureus osteomyelitis.

The consequences of using surgical bone wax are not well studied. We evaluated the infection-promoting potential of sterile bone wax in a rat model of chronic Staphylococcus aureus osteomyelitis. The addition of bone wax greatly reduced the quantitative bacterial inoculum (log colony-forming units) required to establish chronic osteomyelitis in 50% and 100% of challenged animals.

Binding of a Staphylococcus aureus bone pathogen to type I collagen.

We contrasted the collagen-binding potential of the experimental osteomyelitis pathogen, Staphylococcus aureus strain SMH, to several other strains. These included Cowan 1 (binder), Wood 46 (non-binder) and six capsular variants. These measurements were made using an 125I-collagen binding assay.

Treatment of chronic experimental Staphylococcus aureus osteomyelitis with LY146032 and vancomycin.

LY146032 and vancomycin were compared as therapeutic agents in the treatment of chronic Staphylococcus aureus osteomyelitis in the rat. Quantitative cultures disclosed that one of 16, none of 16 and two of 17 tibiae were sterile from the control LY146032, and vancomycin groups, respectively. From positive cultures, geometric mean staphylococcal CFU per gram of bone were as follows: control, 5.

Transmission of human immunodeficiency virus (HIV) by transplantation: clinical aspects and time course analysis of viral antigenemia and antibody production.

The human immunodeficiency virus (HIV) was transmitted to a patient who received a cadaveric renal transplant from a donor who had received massive blood component replacement. A negative HIV antibody test was obtained on serum drawn immediately after transfusion. After transplantation, pretransfusion sera and sera obtained several hours after transfusion tested positive for HIV antibody, suggesting that transfusions had transiently diluted the patient's serum and resulted in a false-negative HIV antibody test.

In vivo glycocalyx expression by Staphylococcus aureus phage type 52/52A/80 in S. aureus osteomyelitis.

Osteomyelitic rat tibiae were examined by scanning electron microscopy for the extracellular glycocalyx of Staphylococcus aureus. S. aureus and fractured tibiae from normal rats were incubated together in vitro and examined similarly.

Synergism between Bacteroides fragilis and Staphylococcus aureus in experimental tibial osteomyelitis.

We explored the potential role of microbial synergy in an experimental rat osteomyelitis model. Osteomyelitis was assessed by gross pathologic conditions and quantitative cultivation of rat tibiae for the implanted organisms 21 days after challenge. When Staphylococcus aureus was used alone, the 50% infective dose (ID50) and the 100% infective dose (ID100) were 400 and 25,000 colony-forming units (CFU), respectively.

In vitro activity of BMY 28100, a new oral cephalosporin.

BMY 28100, a new oral cephalosporin, demonstrated good in vitro activity against common gram-positive and gram-negative respiratory and urinary tract pathogens. Its activity was shown by microdilution techniques to be generally higher than those of ampicillin, cephalothin and cephalexin, but comparable to those of cefaclor and, except for Haemophilus spp. and Branhamella spp.

Iontophoresis of vidarabine monophosphate for herpes orolabialis.

The cutaneous application of antiviral agents was studied by iontophoresis, a process that increases penetration of most drugs 20- to 60-fold. Twenty-seven subjects with vesicular orolabial herpes were treated one time in a double-blind, placebo-controlled clinical study: nine received vidarabine monophosphate (ara-AMP), nine received acyclovir (ACV), and nine received NaCl. Ara-AMP-treated lesions yielded lower titers of virus after 24 hr compared with lesions treated with NaCl or ACV (P less than .

Effect of ibuprofen on gross pathology, bacterial count, and levels of prostaglandin E2 in experimental staphylococcal osteomyelitis.

Infections with Staphylococcus aureus were induced in rat tibiae without sclerosing agents. Animals received ibuprofen or 0.9% NaCl.

Disseminated candidiasis: a comparison of two immunologic techniques in the diagnosis.

Eighty-five subjects were tested for the presence of circulating candidal antigen (CAg) and anti-candidal antibody (CAb) using both an enzyme immunoassay (ELISA) and counterimmunoelectrophoresis (CIE). The 72 studied controls included laboratory volunteers; hospitalized patients without evidence of infection; febrile hospitalized patients without evidence of candidiasis; and patients with superficial candidiasis and candiduria. The control subjects were compared with 13 patients with proven disseminated candidal infection (disease prevalence = 15%).

In-vitro activity of BMY 28142, a new aminothiazolyl cephalosporin.

The in-vitro activity of BMY 28142, a new alpha-methoxyimino aminothiazolyl cephalosporin, was determined by microdilution broth techniques. The agent demonstrated excellent activity against recent clinical Enterobacteriaceae isolates with a 90% minimum inhibitory concentration (MIC90) of 0.25 mg/l or less for all but one species tested.

Multistrain comparison of three antimicrobial prophylaxis regimens in experimental postoperative Pseudomonas endophthalmitis.

We compared subconjunctivally administered ceftazidime and BMY 28142, two third-generation cephalosporins, to a regimen of gentamicin and cefazolin for their ability to prevent experimental Pseudomonas postoperative endophthalmitis in rabbits. After extracapsular lens extraction, an inoculum of Pseudomonas was injected into the vitreous; one of the three antimicrobial regimens was then administered subconjunctivally. All 25 eyes treated with gentamicin and cefazolin become infected (P = 1).

Physician and coding errors in patient records.

The Veterans Administration's discharge abstract system was studied to identify error frequency, source, and effect in five Veterans Administration hospitals. We reviewed 1,829 medical records from 21 services for concordance with the abstract; sampling provided 95% confidence for each service. Of these records, 1,499 (82%) differed from the abstract in at least one item.

Arachidonic acid facilitates experimental chronic osteomyelitis in rats.

Arachidonic acid was used as a facilitating agent in experimental rat Staphylococcus aureus osteomyelitis and compared with the more commonly used agent, sodium morrhuate. The injection of arachidonic acid or sodium morrhuate and S. aureus into rat tibiae caused increased quantitative bacterial bone counts, gross bone pathology, roentgenographic changes, and weight loss.