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Biomedical subjects

N Cimolai

Publications and source records attributed to N Cimolai.

At least 37 records · Page 2Linked to original sources
PubMed1996

Mycoplasma pneumoniae reinfection and vaccination: protective oral vaccination and harmful immunoreactivity after re-infection and parenteral immunization.

Animal model studies of Mycoplasma pneumoniae infection after live respiratory challenge were conducted to investigate the issues of challenge-rechallenge associated accentuated pathology, postparenteral vaccination associated accentuated pathology, and oral vaccination. Live M. pneumoniae inocula were grown in hamster serum-based medium in order to reduce the potential for the serum growth component to participate in the hyperaccentuated histopathological response as seen with challenge-rechallenge experiments which have used horse serum-based growth media. Despite the use of homologous animal serum, an early hyperaccentuated response occurred (day 3 score 13.3 vs day 10 score 7.7; P = 0.02) which included perivascular infiltrates, and histopathological scores for early (day 3) and late (day 10) disease were similar (P > 0.10) between experiments of challenge-rechallenge when either homologous or heterologous sera were used in inoculum growth media. Parenteral vaccination with heat-killed bacteria also led to an early hyperaccentuated histopathological response after live respiratory challenge (scores on day 3: vaccinated 18.3, unvaccinated 6.2; P < 0.01) and this response was not significantly diminished when inocula were cleaned of growth medium components. An early accentuated response did not follow oral vaccination with heat-killed bacteria (score on day 3: vaccinated 5.7) and the late reaction was significantly less after challenge (scores on day 10: vaccinated 10.3, unvaccinated 14.6; P = 0.011). Studies of parenteral vaccination should include analyses for early disease after live challenge. Oral vaccination offers a promising route for stimulating protective immunity while minimizing undesirable recall immune events.

Administration, Oral↗
PubMed1996

An assessment of a new diagnostic indirect enzyme immunoassay for the detection of anti-Mycoplasma pneumoniae IgM.

A new and rapid IgM enzyme immunoassay (EIA)(Immuno Well, Gen-Bio, San Diego, CA) was evaluated for its ability to accurately establish a serodiagnosis for acute Mycoplasma pneumoniae infection. Case definitions were established with the combination of complement fixation (CF) serology, IgM anti-P1 immunoblotting, and clinical and other laboratory data. In an asymptomatic population of 52 children and adults, the EIA was positive for 3.9%. For 17 serum pairs for which there was evidence of a greater than or equal to 4-fold rise in CF titer, 5 acute sera (29.4%) and 14 convalescent sera (82.3%) were positive. In applying the assay to sera that were acquired from a prospective study of childhood infection where the positive case definition was maintained for 22.3% of patients, the sensitivity, specificity, positive predictive value, and negative predictive value for the EIA was 90.5%, 93.2%, 79.2%, and 97.1%, respectively. When the EIA results of a "low-positive," as defined by the manufacturer, were excluded from the positive group, the respective values were 81.0%, 97.3%, 89.5%, and 94.7%. The accuracy of this new assay will be influenced by the prevalence of true illness in the populations to which it may be applied.

Adolescent↗
PubMed1996

Diagnosis of whooping cough: a new era with rapid molecular diagnostics.

A rapid diagnostic procedure, which is based upon the polymerase chain reaction (PCR) genetic amplification technology, was utilized to establish the presence of Bordetella pertussis in nasopharyngeal washes from children. Overall, 14.7% of 456 specimens were positive by either culture or the rapid assay. Culture and PCR were concordant for 62.7% of positive samples; PCR provided an additional increment of 37.3%. PCR-positive, culture-negative specimens were more likely to be found among older patients with more prolonged illness and previous erythromycin therapy (P < 0.01 for all three comparisons). As a single laboratory assay, PCR should be recognized as the current standard for diagnosis.

Bacteriological Techniques↗
PubMed1995

Bases for the early immune response after rechallenge or component vaccination in an animal model of acute Mycoplasma pneumoniae pneumonitis.

The pathology of Mycoplasma pneumoniae pulmonary infection for a hamster model was examined after whole bacterium rechallenge or component vaccination. Animals which, after an initial infection, were rechallenged with either live or heat-killed M. pneumoniae inocula developed severe early recall lesions in the first 3 days. In contrast, animals infected once develop maximum histopathology at approximately 10-14 days. A severe perivascular inflammatory cellular infiltrate developed in the rechallenged groups, and pulmonary pathology could also be elicited by rechallenge with bacterial growth medium components. Component vaccination with protein P1 did not reduce disease in comparison to once-infected controls, and vaccination promoted an early immune recall response as well. We conclude that an early immune response needs to be sought in all future experiments of challenge/rechallenge or vaccination. Vaccine studies will require an understanding of both protective and harmful immunogens.

Acute Disease↗
PubMed1995

Contemporary context for early-onset group B streptococcal sepsis of the newborn.

We examined early-onset newborn group B streptococcal (GBS) infection among the population of a large obstetric center in western Canada for the contemporary period 1987 to 1992. Attack rates for "definite" (bacteremic) and "presumptive" (urine group B antigen positive with clinical evidence) GBS infections were 0.85 and 0.90 per 1000. Ten GBS-associated stillbirths were recorded. Seven deaths occurred among bacteremic newborns (18.4%). Using definitions of Boyer and Gotoff, 87.2% of all mothers with infected newborns manifested at least one risk factor, and 69.8% of all febrile pregnancies with either definition of infected newborn and 61.9% of a subset of the same with bacteremic offspring had maternal temperature 38 degrees C or higher prior to delivery. For our population, recommendations for universal antepartum GBS screening and intrapartum prophylaxis must be discussed in the context of an existing low frequency of bacteremic disease and with the understanding that fever in pregnancy may be enough to warrant greater intervention that might further reduce the rate of infection.

Bacteremia↗
PubMed1995

Mycoplasma pneumoniae as a cofactor in severe respiratory infections.

We report the clinical events associated with severe bacterial or viral infections in four patients whose illnesses followed or coincided with acute Mycoplasma pneumoniae respiratory infection. We propose that M. pneumoniae has the ability to act as a cofactor in severe respiratory disease by facilitating alterations in local respiratory immunity or structure and function.

Adenovirus Infections, Human↗
PubMed1995

Insertional sequence primers for Bordetella pertussis diagnostic polymerase chain reaction differentiate strains of Pseudomonas cepacia.

Insertion sequence primers originally intended to amplify a singular specific product for the rapid diagnosis of Bordetella pertussis respiratory infection were used to differentiate strains of Pseudomonas (Burkholderia) cepacia. A modified sample preparation of proteinase K treatment and boiling was used in lieu of DNA extraction. The method was simple, rapid, and reproducible. This scheme identified 10 variations among 35 strains. Repeat strains from patients with cystic fibrosis and epidemiologically linked strains from an infection associated with a jet gun injection device were homologous in each setting.

Bacteremia↗
PubMed1995

Selective media for isolation of Burkholderia (Pseudomonas) cepacia from the respiratory secretions of patients with cystic fibrosis.

One hundred and six specimens from 90 patients with cystic fibrosis were evaluated for the presence of Burkholderia cepacia using a current routine diagnostic protocol as well as a research protocol involving polymyxin B-MacConkey agar without crystal violet, PC agar, OFPVL agar, and a selective brain-heart infusion broth. Ten specimens from eight patients (8.9%) were positive by any method. The selective enrichment broth was the only medium that yielded B cepacia from all 10 positive samples, although the routine protocol was successful for eight of these. Transient carriage was identified in one patient. Epidemiological studies may be better served by the use of selective enrichment rather than selective solid media alone. Carrier status for B cepacia requires more strict definition if positive carrier status is to be accepted as having medical importance.

Adolescent↗
PubMed1994

Immunodominant antigens of Streptococcus equisimilis shared by other beta-haemolytic streptococci.

Three immunodominant antigens of Streptococcus equisimilis (Lancefield group C) with approximate mol. wts of 46, 66 and 105 kDa were recognised by human serum IgG and IgA immunoblotting. These antigens were identified consistently by various human sera but immunoblots with IgA (heavy chain) and secretory IgA (J chain) from human respiratory secretions gave more variable results. Antigens with similar migration rates were demonstrated in S.pyogenes, large colony human biotype group G streptococci, and streptococci of groups C and G from the "S. anginosus-milleri group". Polyclonal antibody which was eluted from immunoblot substrates that contained the S. equisimilis 66-kDa antigen reacted with the 60-kDa antigen of S. pyogenes. Both polyclonal and monoclonal anti-vimentin antibodies identified the 46-kDa and 66-kDa antigens of S. equisimilis. The homology of these antigens among beta-haemolytic streptococci has the potential to complicate both a strategy for the utilisation of immunoblotting for diagnostic purposes and the understanding of how such antigens may be involved in the pathogenesis of post-infectious sequelae.

Antigens, Bacterial↗
PubMed1994

Implications of Yersinia enterocolitica biotyping.

The utility of a simple biotyping scheme to differentiate pathogenic and non-pathogenic strains of Yersinia enterocolitica was determined for 79 patients who were admitted to or attended a reference children's hospital in western Canada. Biotyping defined predominantly two subsets of Y enterocolitica. 'Pathogenic' strains were more likely to have been obtained from younger patients (mean age 61.9 months) who experienced an acute gastrointestinal illness that was occasionally associated with bloody diarrhoea or a surgical procedure. Growth of Y enterocolitica from selective solid bacteriological growth media were often in the moderate to heavy range (82.0%). In contrast, 'non-pathogenic' strains were more often obtained from older patients (mean 116.0 months) who were already recognised to have suffered from a chronic illness and who were likely to have been admitted to hospital. Moderate to heavy growth of bacterium in stool specimens were infrequently (17.4%) obtained from the latter patients. The use of a simple biotyping scheme for the differentiation of Y enterocolitica strains has the potential to improve patient care.

Bacterial Typing Techniques↗
PubMed1994

Mycoplasma pneumoniae.

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Central Nervous System Diseases↗
PubMed1994

Anticentriolar autoantibodies in children with central nervous system manifestations of Mycoplasma pneumoniae infection.

Serum samples from 49 children with acute Mycoplasma pneumoniae infection were screened for the presence of antibodies to mitotic spindle apparatus. None of these serum samples showed such antibodies at a screening dilution of 1:40, though anticentriolar antibodies at titres of 1:320 were observed in two children with acute cerebellar dysfunction. Anticentriolar antibodies may play a part in the pathogenesis of CNS disease associated with M pneumoniae infection.

Adolescent↗
PubMed1994

Mycoplasma pneumoniae lacks immunologically-active eukaryotic actin-like antigens.

Mycoplasma pneumoniae was tested for immunologically active eukaryotic actin-like antigens with the use of both polyclonal and monoclonal anti-actin antibodies. No reactivity was demonstrable. Monoclonal antibody OC2F5, which reacts with a M. pneumoniae antigen that co-migrates with actin in one-dimensional sodium dodecyl sulphate polyacrylamide electrophoresis, did not recognize actin. Organism-specific actin antigens are not likely to be responsible for the development of smooth muscle antibodies during acute M. pneumoniae infection.

Actins↗
PubMed1994

A continuing assessment of risk factors for the development of Escherichia coli O157:H7-associated hemolytic uremic syndrome.

Univariate and multivariate analyses were applied to determine risk factors for the progression of Escherichia coli O157:H7 enteritis to hemolytic uremic syndrome (HUS). Both clinical and laboratory variables were assessed for 118 pediatric patients (28 HUS; 90 enteritis only). Verotoxins 1 and 2 were produced by 89% of E. coli strains whereas verotoxin 2 only was produced by 11%. Although a greater frequency of strains producing verotoxin 2 only occurred in HUS isolates (p = 0.11), toxin phenotype was not significantly associated with risk after multivariate analyses. HUS patients with or without neurological manifestations had similar frequencies of the two toxin phenotypes among their isolates. Significant associations for young age (RR = 0.984; 95% CI = 0.971-0.998) and prolonged use of antidiarrheal agents (RR = 44.11; 95% CI = 8.48-229.4) with HUS were apparent. A lesser chance of progression was observed for patients whose strains possessed a 4 kb plasmid (RR = 0.27; 95% CI = 0.08-0.94). Our results are consistent with the hypothesis that progression to HUS is dependent upon both bacterial virulence factors and the clinical characteristics of the individual patient.

Bacterial Toxins↗
PubMed1994

A comparison of whole cell protein profiles for sporadic human isolates of Streptococcus equisimilis and beta-haemolytic group G streptococci.

Whole cell protein profiles were resolved for Streptococcus equisimilis (group C) and large colony human biotype beta-haemolytic group G streptococci by the use of one dimensional sodium dodecyl sulphate-polyacrylamide gel electrophoresis. Strains of S. equisimilis (27 in toto) were distributed among eight patterns designated A to H. Pattern A represented 48.2% of the latter isolates. Strains of group G streptococci (59 in toto) were distributed among sixteen patterns designated 1-16, and there were no predominant patterns which represented more than 20% of all strains. Profiles were reproducible, not susceptible to strain passage, but susceptible to variation in growth media. Considerable homology was observed among bacteria in either Lancefield group.

Bacterial Proteins↗