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Biomedical subjects

M A Menegus

Publications and source records attributed to M A Menegus.

72 records · Page 4Linked to original sources
PubMed1982

Concurrent outbreaks of rhinovirus and respiratory syncytial virus in an intensive care nursery: epidemiology and associated risk factors.

An outbreak of viral respiratory disease occurred in eight infants in a neonatal intensive care unit during the 1980 winter respiratory season. Four infections with respiratory syncytial virus and four infections with rhinovirus were identified. Epidemiologic investigation revealed that viral respiratory infection was significantly associated with intubation with orotracheal tubes (P = 0.001), with the presence of both a nasal feeding tube plus an orotracheal tube together (P = 0.007), and with assisted ventilation (P = 0.009) when compared to uninfected controls. Twenty-seven of 85 (30.6%) personnel working in the unit at the time of the outbreak reported a history of upper respiratory illness during the week prior to the outbreak, and 46 (54.1%) of them had had contact with patients in areas of the hospital where patients infected with RSV and rhinovirus were housed. The data suggest that both viruses were transmitted to the babies by hospital personnel. Rhinoviruses can be nosocomial pathogen in neonates with compromised pulmonary function, and the clinical presentation of rhinovirus infection in neonates may be difficult to distinguish from that produced by RSV.

Cross Infection↗
PubMed1982

Increased Efficiency of Group B Coxsackievirus Isolation from Clinical Specimens by Use of BGM Cells.

A continuous African green monkey kidney cell line, designated BGM, was compared with primary cynomolgus monkey kidney cells and human embryonic lung cells for efficiency of enterovirus isolation. A selective enhanced sensitivity of BGM cells both in terms of isolation rate and speed of isolation was found for group B coxsackieviruses but could not be demonstrated for a number of other nonpolio enteroviruses.

Journal Article↗
PubMed1981

Enterovirus 71 infection: report of an outbreak with two cases of paralysis and a review of the literature.

Enterovirus 71 (E-71) infection was first reported in 19745 in the United States; subsequent outbreaks were reported in worldwide distribution. In the summer of 1977, we identified 12 patients, mostly children, with E-71 infection. The striking feature of this outbreak is the occurrence of two cases with polio-like paralytic disease. Other diseases associated with E-71 included aseptic meningitis, meningoencephalitis, respiratory disease, gastroenteritis, and hand-foot-mouth disease. The spectrum of illness observed in our community was compared to that seen in other outbreaks. It is suggested that the significance of E-71 lies in its neuropathogenic potential.

Adolescent↗
PubMed1980

Diffuse pneumonitis due to adenovirus type 21 in a civilian.

A patient with severe pneumonitis due to adenovirus type 21 responded to oxygen delivered by continuous positive airway pressure through a face mask. Pulmonary function studies over ten months demonstrated resolving, restrictive lung disease. The prognosis of severe adenovirus pneumonia may be better than expected based on previous reports.

Adenoviridae Infections↗
PubMed1978

RNA polymerase associated with human rotaviruses in diarrhea stools.

RNA polymerase activity was detected in six stools which were partially purified by high-speed centrifugation from infants with rotavirus gastroenteritis, but was not detected in five stools which were negative for rotavirus by counterimmunoelectrophoresis and radioimmunoassay. The polymerase activity was associated with the 1.38-g/ml rotavirus band after purification in a CsCl gradient.

Centrifugation, Density Gradient↗
PubMedDate not supplied

Nosocomial viral infections: I. Epidemiology and significance.

Viral illnesses in Strong Memorial Hospital were monitored over a 17-month period. Using criteria based primarily on the incubation periods for a number of common virus infections, the infections we found were classified as hospital- or community-acquired. Hospital-acquired viral infections occurred on most hospital services; the majority of infections occurred on the pediatric and psychiatric services. Infections due to herpesviruses were seen more frequently in a group of patients aged 14 years or older, while infections in patients aged three years or younger were more likely to be due to respiratory syncytial virus, influenzavirus, adenovirus, or parainfluenza virus. Patients with nosocomial infections due to viruses were hospitalized an average of 9.3 days longer than uninfected controls; thus nosocomial viral infections result in increased costs of hospitalization.

Adenoviridae Infections↗
PubMedDate not supplied

Nosocomial viral infections: III. Guidelines for prevention and control of exanthematous viruses, gastroenteritis viruses, picornaviruses, and uncommonly seen viruses.

This communication is the third in a four-part series on nosocomial viral infections from the Strong Memorial Hospital. This third article discusses guidelines for prevention and control of exanthematous viruses, gastroenteritis, viruses, adenoviruses and the picornaviruses other than rhinoviruses. Several uncommonly seen viruses, such as the virus of Creutzfeldt-Jakob disease and Marburg, Ebola, and Lassa fever viruses, also are reviewed briefly.

Adenovirus Infections, Human↗
PubMedDate not supplied

Nosocomial viral infections: IV. Guidelines for cohort isolation, the communicable disease survey, collection, and transport of specimens for virus isolation, and considerations for the future.

Virus transmission within the hospital is related to transmissibility of the virus and susceptibility of the population at risk. General guidelines for the use of cohort isolation, for the control of virus transmission in the hospital, and for the use of the communicable disease survey for pediatric patients and visitors to the hospital are out-lined. We also present a brief review of how to collect and transport specimens for virus isolation to assist the infection control practitioner and the clinician and conclude with recommendations for further investigations in the areas of virology and infection control.

Child↗
PubMedDate not supplied

Placental examination in intrauterine coinfection with herpes simplex virus and cytomegalovirus.

Intrauterine coinfections have rarely been reported. However, pregnancies exposed to multiple sexually transmitted infectious agents and drugs are likely to occur with increasing frequency and lead to complex pathology in the newborn. Often it will be difficult to establish a diagnosis, above all when this has to be done retrospectively. A premature (34 weeks) newborn presented with a complex clinical picture after exposure to multiple infectious and noninfectious teratogens during gestation. Immunocytochemical staining of the placental membranes and parenchyma suggested intrauterine coinfection by herpes simplex virus (HSV) type 2 and cytomegalovirus. This case illustrates the importance of careful placental investigation with modern techniques for the diagnosis of intrauterine HSV infection and coinfections.

Adolescent↗
PubMedDate not supplied

Staphylococcal protein A in the serologic diagnosis of congenital rubella and toxoplasmosis.

Staphylococcal protein A (SPA) has been used to remove maternal IgG from cord or neonatal sera to make serologic testing for congenital infection more IgM specific. To evaluate the clinical usefulness of this procedure, sera sent for TORCH titers that had rubella hemagglutination inhibition (RHI) reciprocal titers greater than or equal to 8 or toxoplasmosis indirect fluorescent antibody (TFA) titers greater than or equal to 16 were adsorbed with SPA and retested. Nine of 109 sera were TFA positive by routine testing, and all but one from an infant with congenital toxoplasmosis became negative after SPA adsorption. A repeat TFA at 4 to 26 months of age was negative in all six children without evidence of toxoplasmosis who returned for follow-up. Fifty of 55 sera were RHI positive by routine testing, and all but one from an infant with congenital rubella became negative after SPA adsorption. The repeat routine RHI was negative in 32 of 35 children whose sera were initially negative after SPA adsorption. SPA adsorption greatly increased the specificity of routine RHI and TFA tests in the diagnosis of congenital rubella and toxoplasmosis.

Female↗
PubMedDate not supplied

Neutralizing antibodies to non-polio enteroviruses in human immune serum globulin.

Neutralizing antibodies to selected non-polio enteroviruses were found in three lots of human immune serum globulin (ISG) prepared from the sera of persons from different geographic regions. Reciprocal titers to coxsackieviruses B3 and B4 ranged from 400 to greater than or equal to 2000, whereas titers to coxsackievirus A9 and ECHO viruses 5 and 9 ranged from 100 to 400 in all three lots of ISG. The presence of neutralizing antibodies to commonly occurring (coxsackieviruses B1 to B5 and A9 and ECHO viruses 3, 4 and 9) and infrequently encountered (ECHO viruses 5 and 13) serotypes, coupled with the increasing evidence that antibodies are an important factor in preventing illness, support recommending the administration of ISG to those at high risk for serious disease.

Antibodies↗
PubMedDate not supplied

A solid-phase enzyme immunoassay (Gonozyme) test for direct detection of Neisseria gonorrhoeae antigen in urogenital specimens from patients at a sexually transmitted disease clinic.

The Gonozyme test (Abbott Laboratories; North Chicago, IL), a solid-phase enzyme immunoassay (EIA), was evaluated for direct detection of antigens from Neisseria gonorrhoeae in clinical specimens. Results of the EIA were compared with those of culture and gram stain. Separate swab specimens for each procedure were collected from cervical secretions of 119 females and urethral exudate of 198 males (total, 324 specimens) seen in a sexually transmitted disease clinic. Cultures from 132 specimens were positive for gonococci (27 women and 105 men), and gram stains of 119 specimens were positive (14 women and 105 men). The EIA test was positive for 145 specimens (34 women and 111 men). The sensitivities of EIA for females and males were 88.5% and 99.0%, respectively, as compared with 29.6% and 98.1% for gram stain. Specificities of EIA were 89.2% and 92.5%, while those of gram stain were 93.5% and 86.0%, respectively. Overall accuracy of the EIA was 89.1% for females and 95.9% for males. In veiw of the speed and independence from viable organisms of the EIA test, the lack of good gram stain sensitivity for females, and the inherent drawbacks of culture, the Gonozyme test, if used in conjunction with culture, can detect a higher percentage of patients with genital gonorrhea than can culture alone. However, EIA in its present form cannot be used as the sole criterion for a laboratory diagnosis of gonococcal disease because of the ethical and medicolegal consequences of an EIA-positive, culture-negative result.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens, Bacterial↗
PubMedDate not supplied

Isolation of Chlamydia trachomatis from men with urethritis: relative value of one vs. two swabs and influence of concomitant gonococcal infection.

Two successive urethral swabs were used to obtain specimens for culture of Neisseria gonorrhoeae and Chlamydia trachomatis from 136 heterosexual men with urethritis. The first swab was used to culture N. gonorrhoeae and then C. trachomatis; the second was used to culture C. trachomatis only. C. trachomatis cultures from the second swab were positive more often (30 of 31 pairs) than were cultures from the first swab (22 of 31 pairs) (P less than .05). In addition, cultures from swab 2 had greater numbers of inclusions per coverslip more frequently (23 of 31 pairs) than did cultures from the first swab (six of 31 pairs) (P = .003). Numbers of chlamydial inclusions per coverslip were lower in specimens positive for both C. trachomatis and N. gonorrhoeae than in specimens positive for C. trachomatis only (P less than .02). In addition, the presence of N. gonorrhoeae in a specimen adversely affected the quality of the McCoy cell monolayer. In 17 of 21 instances of monolayer toxicity, cultures for N. gonorrhoeae were positive (P less than .01). These results demonstrate that when specimens from men with urethritis are cultured for N. gonorrhoeae and C. trachomatis, use of a second swab will improve rates of recovery of C. trachomatis. Material present in specimens that contain N. gonorrhoeae may adversely affect rates of isolation of C. trachomatis.

Chlamydia Infections↗
PubMedDate not supplied

Comparison of direct fluorescent antibody, acridine orange, wet mount, and culture for detection of Trichomonas vaginalis in women attending a public sexually transmitted diseases clinic.

To define the performance characteristics of two newer tests for Trichomonas vaginalis (TV), the authors compared direct fluorescent antibody (DFA) (mixed monoclonal antibody, Integrated Diagnostics, Inc, Berkeley, CA) and acridine orange (AO) tests to standard wet mount (WM) preparations and culture (modified Diamond medium) of vaginal wash specimens in consecutively examined women presenting to a public sexually transmitted diseases (STD) clinic. Cultures for Neisseria gonorrhoeae (GC), Chlamydia trachomatis (CT), and yeast were also performed on all patients. Of 104 women, 59 (57%) were infected with one or more pathogens. Trichomonas vaginalis was detected by WM and/or culture in 38 (37%) women and was the most prevalent infection. Of the 38 patients with TV, 95% were detected by culture, 83% by DFA, 66% by AO, and 66% by WM. An additional patient was DFA positive but negative for TV by all other methods. The sensitivity of DFA was superior to AO and WM in women with TV infection alone (96% compared to 67% and 53%, respectively). It was comparable to AO and WM in women with multiple infections (67% compared to 53% and 73%). Even in the presence of other pathogens, DFA appears to be a reasonable alternative to culture for detection of TV. In addition, DFA is rapid, easy to perform, and relatively inexpensive.

Acridine Orange↗
PubMedDate not supplied

Communitywide laboratory-based influenza surveillance focused on older persons, 1989-1992.

We collected surveillance data as part of the Medicare Influenza Vaccine Demonstration to describe communitywide epidemiology of influenza, focusing on the elderly. Laboratory-based surveillance was established in medical practices, hospitals, and nursing homes in a two-county demonstration in upstate New York. Time course and intensity of epidemic influenza were compared between counties, between influenza A and B epidemics, and among several levels of surveillance involving elderly persons as well as children during the years 1989-1992. The counties experienced parallel epidemics during each of the three demonstration years. Influenza A/H3N2, predominant in 1989-1990 and 1991-1992, was equally intense among young and old, accounted for 11%-28% of acute cardiopulmonary hospitalizations of older persons, and caused focal outbreaks in 30%-40% of nursing homes in the respective epidemics. Influenza B, predominant in 1990-1991, showed modest impact among the elderly as compared with children. Influenza A/H1N1 occurred among children each year but was virtually absent among the elderly. Systematic surveillance during the "influenza season" consistently confirms widespread infection among older patients, both in the community and in institutions. However, much febrile respiratory illness in this age group during periods of epidemic influenza is culture-negative for influenza virus and thus may be caused by other respiratory pathogens.

Aged↗