Biomedical subjects
Publications and source records attributed to N Cimolai.
"Campylobacter cinaedi" was isolated from the blood of a 29-year-old homosexual man with previously diagnosed acquired immune deficiency syndrome. Subculturing of the organism was achieved with the use of 7% lysed horse blood and 10% sheep blood agars at 37 degrees C in a microaerophilic atmosphere. Problems associated with the culturing of this organism are reviewed.
Implication of the beta-hemolytic non-group A streptococci (BHNAS) as pharyngeal pathogens has been based predominantly on reports of a few outbreaks, small case clusters, and anecdotes. These organisms have long been noted to constitute a significant number of the beta-hemolytic streptococcal isolates from throats of symptomatic and asymptomatic patients in a variety of populations. Laboratory studies have demonstrated the usefulness of anaerobic atmosphere and prolonged incubation in maximizing isolation of the BHNAS. More recently, genetic studies have furthered our appreciation of the taxonomy and have defined two major groups: Streptococcus anginosus-milleri group and large-colony BHNAS; the latter can be further separated on the basis of serogrouping and biotyping. Recognition of this diversity gives justification to the reexamination of the epidemiology and disease course of BHNAS pharyngitis. Treatment studies will also be required if all or subsets of these organisms can be confirmed as pharyngeal pathogens.
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We investigated the epidemiology and clinical features of invasive S. pyogenes infection in a pediatric population over a 7-year period (1984-90) by retrospective review. An increasing frequency in invasive infections had occurred (0-11.81/10,000 admissions). A large proportion (48%) of these were orthopedic infections. An epidemic strain was typed as M1T1. This increase appears to have occurred in the context of an overall increase in S. pyogenes infections ("scarlet fever" 1.47-11.22/10,000 outpatients; "strep throat" 4.41-46.54/10,000 outpatients).
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A questionnaire survey concerning Streptococcal pharyngitis was completed by 85 southern Alberta family physicians. The data revealed a significant trend to overtreat pharyngitis with antibiotics because of the unreliability of clinical diagnosis and the lack of diagnostic manoeuvres with suitable ability to influence management. These data and a further questionnaire survey directed to the appreciation of other bacterial pharyngitides, demonstrate the importance of laboratory reports in biasing treatment, and further suggest that significant overtreatment of non-Streptococcal pharyngitis also occurs.
We assessed the frequency of proposed enteropathogenic virulence factor genes (eaeA and eaf) by genetic amplification for a series of prospectively collected putative enteropathogenic Escherichia coli serogroup isolates that were acquired from the stool specimens of children. Among 102 isolates, eaeA and eaf markers were determined among 27.5% and 4.9%, respectively. Eaf positivity was found to be coexisting in only a minority of eaeA+ E. coli; the eaeA+/eaf- genotype was most common among strains that had evidence of at least one virulence marker. When clinical variables were compared for two groups of patients whose strains did or did not possess eaeA, the eaeA+ group was more likely to have had an acute diarrheal illness (P = .05) and less likely to have had an underlying chronic illness (P = .03). Localized adherence in vitro was easily recognized for eaeA+/eaf+ E. coli but eaeA+/eaf- isolates were less consistent in manifesting this phenotype. The availability of genetic amplification technologies has the potential to rekindle diagnostic interests in this area, although a rational approach has yet to be defined.