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Biomedical subjects

N Cimolai

Publications and source records attributed to N Cimolai.

At least 19 recordsLinked to original sources
PubMed2002

Clinical validation for oxacillin susceptibility testing of coagulase negative staphylococci.

Oxacillin susceptibility of coagulase negative staphylococci as assessed by conventional methods was confirmed by a modified Etest method, extended to detect heteroresistance. Verification of susceptibility was followed by successful treatment for six consecutive children with deep seated infections. Physicians' trust in such a validated method will contribute to the appropriate use of antibiotics.

Microbial Sensitivity Tests↗
PubMed2001

Utilization of herpes simplex PCR assays for cerebrospinal fluid in a pediatric health care setting.

An assessment was made of the utilization and impact of a diagnostic polymerase chain reaction (PCR) assay for the diagnosis of herpes simplex viruses (HSV) 1 and 2 in cerebrospinal fluid of children who attended a Canadian pediatric referral centre. One hundred and three assays were performed on specimens from 103 patients during the period August 1997 to September 1998. Patient ages ranged from newborn to 16 years. Indications for HSV PCR included seizures with or without fever (56.3%), aseptic meningitis (16.5%), and encephalopathy with or without fever (10.7%). Only 2 of 103 (1.9%) assays were positive, including one each for HSV1 and HSV2. Control specimens that were seeded with virus indicated inhibition for 24.3, 8.8, and 6.8% of assays for HSV1, HSV2, and both HSV1 and HSV2, respectively. The mean turn-around time for HSV PCR was 2.5 days, and 90.3% were completed in less than 5 days. Acyclovir was administered to 78.6% of the patients overall; the results of the HSV PCR impacted on the treatment courses for 36 individuals. Nevertheless, 16.5% of patients continued to receive extended courses of antiviral therapy despite negative HSV PCR assays. Although it is desirable to decrease the frequency of PCR inhibitions and to further decrease the interval to assay completion, HSV PCR does have a significant impact on antiviral use in this setting.

Adolescent↗
PubMed2001

Do mycoplasmas cause human cancer?

A linkage between mycoplasmas and malignancy was mainly proposed in the 1960s when human-associated mycoplasmas were becoming of interest given the novel characterization of the human respiratory pathogen Mycoplasma pneumoniae. Associations with leukemia and other malignancies, however, were largely ascribed to tissue-culture contamination, which is now recognized as a significant potential problem in molecular biology circles. A few epidemiological studies, however, continue to raise concern over such a linkage. As well, in vitro data have demonstrated the potential for some mycoplasmas to induce karyotypic changes and malignant transformation during chronic tissue-culture infestation. As cellular and molecular mechanisms for such transformation become studied, a resurgence of interest in this area is inevitable. A role for mycoplasmas in malignancy of any sort is conjectural, but there remains a need to continue with focussed epidemiological and laboratory investigations.

Animals↗
PubMed2000

Bartonella henselae infection in British Columbia: evidence for an endemic disease among humans.

Human bartonellosis in North America is mainly associated with Bartonella henselae, and the availability of laboratory diagnostic tools has significantly heightened awareness of the spectrum of human disease that is caused by this bacterium. We detail herein examples of illness in a pediatric population which serve to confirm that B. henselae-associated disease exists in British Columbia. Seroprevalence studies among asymptomatic adults and among children with symptomatic respiratory illness of other causation demonstrated that 36.8% and 18.5% of sera, respectively, had IFA-IgG titres > or = 1:256. IFA-IgG titres did not vary significantly whether B. henselae ATCC 49793 or a local wild-type B. henselae isolate were used as substrate. An assessment of IgM response was consistent with the proposal that endemic seroprevalence is a function of past rather than recent exposure. Both clinical and serological studies are concordant in providing evidence that B. henselae is endemic in British Columbia.

Adolescent↗
PubMed1999

Nosocomial transmission of penicillin-resistant Streptococcus pneumoniae.

Two patients were found to harbor intermediate-level penicillin-resistant Streptococcus pneumoniae in a pediatric hospital setting. For the first patient, the bacterium was isolated from a tracheal aspirate, and for the second patient, a positive blood culture was found a short time after the index case. Two molecular typing techniques (enterobacterial repetitive intergenic consensus sequence polymerase chain reaction, and repetitive sequence-based polymerase chain reaction) demonstrated homology among these isolates, which suggests person-to-person spread. We propose the need for institution-based infection control precautions that will limit the spread of penicillin-resistant pneumococci.

Child, Preschool↗
PubMed1998

Bacterial genotype and neurological complications of Escherichia coli O157:H7-associated haemolytic uraemic syndrome.

We examined the possibility of an association between the bacterial genotype of Escherichia coli O157:H7 and the likelihood of progression to neurological complications in childhood gastroenteritis-associated haemolytic uraemic syndrome (D+HUS). Bacterial stool isolates were available from 51 patients with HUS; 11 of these patients suffered a neurological complication. Bacteria were assessed for plasmid content, verotoxin (Shiga-like toxin) profile, verotoxin 2 subtype, and presence of the eaeA (effacement and attachment) marker. No association of bacterial genotype with central nervous system (CNS) manifestations was observed. Whilst the cause of CNS manifestations may be multifactorial, there is no evidence at present to implicate specific bacterial traits.

Bacterial Toxins↗
PubMed1997

Verification of a PCR-based typing method for Acinetobacter baumannii in a pseudo-outbreak investigation.

Acinetobacter spp. isolates were increasingly obtained from clinical specimens and sterility samples, and a subsequent epidemiological investigation implicated an intermittently contaminated supply of commercially acquired enrichment broths. Typing was performed with DNA amplification by the polymerase chain reaction (PCR) using enterobacterial repetitive intergenic consensus sequence primers, ERIC2 and reverse ERIC1R. The reliability of this PCR-based typing method was verified by the ability of the technique to demonstrate homology and differences among isolates from an epidemiologically well-defined pseudo-outbreak.

Acinetobacter↗
PubMed1997

ERIC-PCR typing profiles of Enterobacter cloacae are stable after development of advanced cephalosporin resistance.

Enterobacterial repetitive intergenic consensus (ERIC) sequence polymerase chain reaction genotype profiles of Enterobacter cloacae were prepared for paired isolates which were obtained before and after the high level expression of the chromosomal cephalosporinase. These profiles were homologous within strain pairs which suggests that the acquired resistance does not lead to major chromosomal alterations. ERIC genotypes are therefore reliable markers in epidemiological investigations where antibiogram modifications may arise as a consequence of antibiotic exposure and beta-lactamase over-production..

Bacterial Typing Techniques↗
PubMed1997

Anti-smooth muscle antibody in clinical human and experimental animal Mycoplasma pneumoniae infection.

Autoantibody formation is possibly integral to the development of non-respiratory manifestations of acute Mycoplasma pneumoniae infection. We sought to confirm the occurrence of smooth muscle antibodies (SMA) in humans with acute Myc. pneumoniae respiratory infection and furthermore to assess whether similar autoantibodies would develop in a hamster model of respiratory infection. Paired sera from 21 patients with acute infection were assayed for SMA by immunofluorescence on mouse kidney/stomach substrates. The frequency of SMA was then determined for 52 paediatric patients with acute Myc. pneumoniae infection and 16 controls, and for sera from a hamster model of infection. Five of 21 paired sera had an increment in SMA between acute and convalescent specimens. At a screening dilution of 1:40, 18/52 infected and 0/16 controls had positive sera (P = 0.003); positive specimens demonstrated IgG rather than IgM SMA. In the hamster model of Myc. pneumoniae respiratory infection, significant IgG SMA increases occurred in 7/19 infections but not in 11 controls (P = 0.02). Immunoblotting did not identify actin as the substrate for SMA. Smooth muscle antibody increases are found in a significant minority of Myc. pneumoniae-infected humans and hamsters. A role for SMA in the pathogenesis of Myc. pneumoniae infection remains to be defined.

Adolescent↗
PubMed1997

Heterogeneous Serratia marcescens genotypes from a nosocomial pediatric outbreak.

OBJECTIVE: Define the applicability of a rapid molecular typing scheme to study the epidemiology of a Serratia marcescens outbreak. DESIGN: With the assistance of a simple bacterial lysis technique, isolates of S marcescens from a putative outbreak were genotyped with the polymerase chain reaction technology for which primers were chosen on the basis of previously defined enterobacterial repetitive intergenic consensus sequences. SETTING: Pediatric ICU. PATIENTS: Intensively monitored patients who were found to yield S marcescens from any body site during the epidemic period. RESULTS: Over an 8-month period, 12 ICU patients were either infected or colonized with S marcescens. All of these patients were transiently supported by artificial ventilation. During the epidemiologic investigation, a dilution error in a high-level glutaraldehyde disinfectant, which was being used for some ventilator components, was observed. Rectification of the error was associated with an abrupt termination of the outbreak. Enterobacterial repetitive intergenic consensus polymerase chain reaction was easily applicable to this setting and it defined 4 distinct genotypes among the 12 isolates. CONCLUSION: The typing method is easily implemented and offers great promise as an epidemiologic tool. The associated investigation served to emphasize that an outbreak may occur with more than one epidemic strain and that strain heterogeneity itself does not exclude an outbreak.

Bacterial Typing Techniques↗
PubMed1997

Impact of infection by verotoxigenic Escherichia coli O157:H7 on the use of surgical services in a children's hospital.

OBJECTIVES: To determine the impact of Escherichia coli O157:H7 infection in children on the need for surgical assessment in a pediatric surgical practice and whether clinical and bacteriologic variables might contribute to that need. DESIGN: Examination of a case series. SETTING: A tertiary-care pediatric hospital. PATIENTS: Between 1990 and 1994, E. coli O157:H7 gastrointestinal infections were documented among 85 children, 29 of whom suffered from hemolytic-uremic syndrome. INTERVENTION: Surgical consultation for presumed or proven complications of the infection. MAIN OUTCOME MEASURES: The frequency of and reasons for surgical consultation, clinical and bacteriologic variables between patients who did or did not require surgical assessment. RESULTS: Of the 85 children, 17 (20%) were assessed by the surgical service. The majority of these children were inpatients. Two required abdominal surgery. Female gender, older age and progression to hemolytic-uremic syndrome were factors associated in univariate analyses with a likelihood of need for surgical assessment; variation in bacterial genotype was not. CONCLUSION: There is the potential for verotoxigenic E. coli O157:H7 infection to have a considerable impact on the utilization of pediatric surgical services.

Adolescent↗