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PubMed2002

Threats in bioterrorism. I: CDC category A agents.

Although once considered unlikely, bioterrorism is now a reality in the United States since the anthrax cases began appearing in the fall of 2001. Intelligence sources indicate there are many countries and terrorist organizations that either possess biological weapons or are attempting to procure them. In the future it is likely that we will experience additional acts of bioterrorism. The CDC category A agents represent our greatest challenge because they have the potential to cause grave harm to the medical and public health systems of a given population. Thus, it is imperative that plans be developed now to deal with the consequences of an intentional release of any one or more of these pathogens.

Anthrax↗
PubMed1994

Differentiation of selected members of the family Neisseriaceae (Alysiella, Eikenella, Kingella, Simonsiella and CDC groups EF-4 and M-5) by carbohydrate fingerprints and selected phenotypic features.

On the basis of nucleic acid relationships, the family Neisseriaceae consists of the genera Neisseria, Kingella, Simonsiella and of Alysiella filiformis, Eikenella corrodens, and the CDC groups EF-4 and M-5. Differentiation, especially of the new members of the family, by conventional phenotypic characteristics is difficult and in some cases leads to doubtful results. On the other hand, cellular components proved to be suitable for the characterization of bacterial taxa. We investigated the cellular carbohydrates derived from whole cell hydrolysates of the above mentioned taxa with the exception of Neisseria by gas chromatography/mass-spectrometry. The analysis revealed characteristic patterns for all taxa considered, although with some species of which only few strains were investigated so far only preliminary results could be established. With the method used, the carbohydrate analysis could be completed within six hours starting from a pure culture. All strains investigated exhibited a common pattern with ribose, arabinose, glucose, and galactose. Qualitative and quantitative differences in contents of fucose, sorbose, rhamnose, threose, heptose, galactosamine and an amino sugar similar to glucosamine discriminated members of the taxa investigated. To achieve a taxonomically precise differentiation of the species investigated by conventional phenotypic features as available in commercial rapid test kits, these tests should be completed by the carbohydrate analysis technique presented.

Carbohydrates↗
PubMedDate not supplied

The CDC 2002 guidelines for the treatment of sexually transmitted diseases: implications for women's health care.

Persons rely on health care providers to make diagnostic and therapeutic decisions based on the most current information. With areas of practice changing rapidly, providers are challenged to keep abreast of new and changing treatment guidelines. The new Centers for Disease Control and Prevention (CDC) 2002 Sexually Transmitted Disease (STD) Treatment Guidelines provide clinical guidance in the appropriate assessment and management of STDs. This article reviews recent changes in the STD Treatment Guidelines for the most common disease entities and their sequelae encountered by women's health practitioners. The changes noted in this article include new screening recommendations, use of new diagnostics, new treatment algorithms, and changes in therapeutic regimens.

Adult↗
PubMed1997

CDC group IV c-2 infection in a stem cell transplant recipient.

Patients undergoing high-dose chemotherapy for cancer are at a high risk of infections caused by unusual microorganisms. Previous chemotherapy, use of indwelling catheters and prior antibiotic treatment are common predisposing factors. We present a case of septicaemia due to a rare non-fermentative bacillus, CDC group IV c-2, found in the blood and venous catheter from a patient with a testicular germ cell tumour undergoing high-dose consolidation chemotherapy.

Adult↗
PubMed2004

Role of modified CDC miniature light-traps as an alternative method for sampling adult anophelines (Diptera: Culicidae) in the National Mosquito Surveillance Programme in India.

The efficiency of modified CDC miniature light-traps for sampling adult mosquitoes was evaluated in comparison with indoor resting, outdoor resting, indoor man-landing and outdoor man-landing collections in the hilly district of Koraput, Orissa, India. Overall, light-traps captured 78% of adult mosquitoes collected by all methods. Of the 16 anopheline species recorded in the study area, light-traps effectively sampled 13, contributing about 72% of the total anophelines collected by all methods. Light-traps also caught a large number of female Culex vishnui Theobald (96%). As fully-fed mosquitoes were predominant (82%) and caught alive, light-traps can be used to catch large numbers of vector mosquitoes for studies on vector prevalence, distribution, vector incrimination and also for laboratory bioassays. Light-trap and indoor resting collections revealed similar seasonal trends in numbers of Anopheles culicifacies Giles, A. fluviatilis James, A. jeyporiensis James, A. vagus Doenitz, and A. splendidus Koidzumi. Age-structure of the samples did not vary significantly between the two methods. Light-traps could be used as an alternative to daytime indoor resting collections to monitor the seasonal fluctuations in the abundance and parity rates of these species. The light-trap collections correlated with indoor and outdoor man-landing collections of A. jeyporiensis and the outdoor man-landing collections of A. maculatusTheobald in measuring seasonal trends. Light-trap collections can thus be used as a substitute for man-landing collections of A. jeyporiensis and A. maculatus.

Animals↗
PubMed1994

Catheter-related septicemia caused by a vancomycin-resistant Coryneform CDC group A-5.

A case of catheter-related septicemia, due to Coryneform CDC group A-5, in an 11 yr old boy with acute myelomonocytic leukemia is discussed. The child failed to respond to initial antibiotic therapy, even following the addition of vancomycin. Laboratory studies later showed the organism to be vancomycin resistant but cefotaxime susceptible.

Actinomycetales↗
PubMed2000

Obstetricians' compliance with CDC guidelines on maternal screening and intrapartum prophylaxis for group B streptococcus.

How obstetricians' opinions regarding universal screening of pregnant woman for group B streptococcus and their attitude regarding chemoprophylaxis vary from the Centres for Disease Control (CDC) guidelines were studied, and the physician characteristics that predict divergent opinions were determined. Five hundred and eighty-two obstetricians in the Flanders region of Belgium were contacted by a postal survey. Ordinal logistic regression was used to assess obstetricians' characteristics that predict divergence. Only 44% agreed with routine prenatal screening for group B streptococcus of whom 72% would screen at 35 weeks. Intrapartum prophylaxis would be done on the basis of risk factors alone in 38%. Multivariate analysis revealed significant provincial differences (best in Antwerp, worst in West-Flanders) and increasing age was associated with decreasing compliance. It is concluded that a minority of the obstetricians believes in routine prenatal screening and one-third would give prophylaxis on the basis of risk factors alone. Obstetrician's age and province of practice predict divergent opinions.

Journal Article↗
PubMedDate not supplied

The AIDS risk narrative in the 1994 CDC campaign.

In 1994, as part of its continuing "America Responds to AIDS" campaign, the CDC launched an innovative, straightforward campaign comprising nine public service announcements (PSAs) that advocate either condom use for sexually active young adults or sexual inactivity. This article evaluates the persuasive appeals of the PSAs through use of Fisher's (1984) narrative theory. It argues that the ads are likely to be effective for two reasons: (a) Because they are told in a story fashion, they will appeal to larger audiences; (b) moreover, because they contain high narrative probability and narrative fidelity, and because they provide "good reasons," they will find greater acceptance. However, because of the PSAs' failure to address competing narratives adequately, as well as network hesitance to broadcast them during heavy viewing periods, their effectiveness may be lessened. Ultimately, it is concluded the PSAs are an important step forward in communicating concerns of the continuing HIV/AIDS epidemic.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Treating opportunistic infections among HIV-exposed and infected children: recommendations from CDC, the National Institutes of Health, and the Infectious Diseases Society of America.

In 2001, CDC, the National Institutes of Health, and the Infectious Diseases Society of America convened a working group to develop guidelines for therapy of human immunodeficiency virus (HIV)-associated opportunistic infections to serve as a companion to the Guidelines for Prevention of Opportunistic Infections Among HIV-Infected Persons. In recognition of unique considerations related to HIV infection among infants, children, and adolescents, a separate pediatric working group was established. Because HIV-infected women coinfected with opportunistic pathogens might be more likely to transmit these infections to their infants than women without HIV infection, guidelines for treating opportunistic pathogens among children should consider treatment of congenitally acquired infections among both HIV-exposed but uninfected children and those with HIV infection. In addition, the natural history of opportunistic infections among HIV-infected children might differ from that among adults. Compared with opportunistic infections among HIV-infected adults, which are often caused by reactivation of pathogens acquired before HIV infection when host immunity was intact, opportunistic infections among children often reflect primary acquisition of the pathogen and, among children with perinatal HIV infection, infection acquired after HIV infection has been established and begun to compromise an already immature immune system. Laboratory diagnosis of opportunistic infections can be more difficult with children. Finally, treatment recommendations should consider differences between adults and children in terms of drug pharmacokinetics, dosing, formulations, administration, and toxicities. This report focuses on treatment of opportunistic infections that are common in HIV-exposed and infected infants, children, and adolescents in the United States.

AIDS-Related Opportunistic Infections↗
PubMed1998

Thymic dysfunction and time of infection predict mortality in human immunodeficiency virus-infected infants. CDC Perinatal AIDS Collaborative Transmission Study Group.

The effect of human immunodeficiency virus (HIV)-induced thymic dysfunction (TD) on mortality was studied in 265 infected infants in the CDC Perinatal AIDS Collaborative Transmission Study. TD was defined as both CD4 and CD8 T cell counts below the 5th percentile of joint distribution for uninfected infants within 6 months of life. The 40 HIV-infected infants with TD (15%) had a significantly greater mortality than did the 225 children without TD (44% vs. 9% within 2 years). Infants with TD infected in utero had higher mortality than did those infected intrapartum (70% vs. 37% within 2 years), while no significant difference was noted between infants without TD with either mode of transmission. The TD profile was independent of plasma virus load. Virus-induced TD by particular HIV strains and the time of transmission are likely to explain the variation in pathogenesis and patterns of disease progression and suggest the need for early aggressive therapies for HIV-infected infants with TD.

CD4 Lymphocyte Count↗
PubMed2000

Loss control of Mcm5 interaction with chromatin in cdc6-1 mutated in CDC-NTP motif.

Saccharomyces cerevisiae Cdc6 plays an essential role in establishing and maintaining the prereplicative complex (pre-RC) by interacting with the origin recognition complex (ORC) and associating with chromatin origins. These interactions are required to load minichromosome maintenance proteins (MCMs) and other initiator proteins onto replication origins. Although the temperature-sensitive cdc6 mutant, cdc6-1, has been widely used for these studies, the molecular mechanism of the cdc6-1 mutation has been unclear. In this study, we have identified a base substitution at Gly260-->Asp, near the CDC-NTP motif. Using a chromatin immunoprecipitation assay (CHIP), we found that cdc6-1 fails to load Mcm5 onto the replication origins. Chromatin fractions were used to study Mcm5 binding in both the wildtype and mutant background. These studies indicated that Cdc6 is also involved in unloading Mcm5 from chromatin. Specifically, the cdc6-1 mutation protein, cdc6(G260D), which failed to load Mcm5 onto replication origins, also failed to unload the Mcm5 protein. Furthermore, the overexpression of wildtype CDC6 accelerated the unloading of Mcm5 from chromatin fractions. In the absence of functional Cdc6, the Mcm5 protein showed nonorigin binding to chromatin with the cell cycle arrested at the G1S phase transition. Our results suggested that the cdc6(G260D) mutant protein fails to assemble an operational replicative complex and that wildtype Cdc6 plays a role in preventing re-replication by controlling the unloading the MCMs from chromatin origins.

Amino Acid Substitution↗
PubMed2004

Report from the CDC. Physician and allied health professionals' training and fetal alcohol syndrome.

Maternal prenatal alcohol use is one of the leading preventable causes of birth defects and developmental disabilities. On the severe end of the spectrum of conditions related to drinking during pregnancy is fetal alcohol syndrome (FAS). Physicians and other health practitioners play a critical role in diagnosing FAS and in screening women of childbearing age for alcohol use during pregnancy. The Fetal Alcohol Syndrome Prevention Team at CDC's National Center on Birth Defects and Developmental Disabilities awarded funds to four medical school partners (Meharry and Morehouse Medical Colleges, St. Louis University, the University of Medicine and Dentistry of New Jersey, and the University of California at Los Angeles) to develop FAS regional training centers (RTCs). The RTCs are developing, implementing, evaluating, and disseminating educational curricula for medical and allied health students and practitioners that incorporate evidence-based diagnostic guidelines for FAS and other prenatal alcohol-related disorders.

Adult↗
PubMed2004

Report from the CDC. Vaccines in women.

Women's healthcare providers are encouraged to incorporate immunizations into their clients' care. Because women often rely on their healthcare provider for primary and preventive care, that provider may dramatically improve clients' quality of life by decreasing the risk of vaccine-preventable diseases. Women often assume responsibility for the entire family's health, and educating women can prevent disease in the household. Women's healthcare providers should offer and promote these vaccines: hepatitis B, varicella, measles/mumps/rubella, and combined tetanus/diphtheria toxoids for adolescent and young adult women, inactivated influenza vaccine during pregnancy, and pneumococcal, influenza, and tetanus/diphtheria vaccines for the adult or elderly woman. Education should include the importance of vaccines and the rationale for their necessity during each stage of life. Several strategies for implementing and supporting an immunization program have been shown to improve adult immunization rates. These include employing such protocols as standing orders, screening for adult immunizations at each office encounter, and using previously developed immunization documentation forms. The Advisory Committee on Immunization Practices (ACIP) recommendations, vaccine information statements (VIS), and storage and handling guidelines are readily available at low or no cost through CDC and professional organizations or immunization interest group websites. The current adult vaccine schedule assists providers to determine the need for vaccines by displaying graphically both age and medical risk factors.

Adolescent↗
PubMed2005

Report from the CDC: mental health of women in postwar Afghanistan.

More than two decades of war and a culture that has denied women freedom of movement, access to healthcare, and education have affected the mental health status of Afghan women more than that of men. In 2002, the Centers for Disease Control and Prevention (CDC) conducted a national population-based mental health survey in Afghanistan. The prevalence of symptoms of depression was 73% (standard error [SE] 8.15) and 59% (SE 5.59), of symptoms of anxiety was 84% (SE 2.98) and 59% (SE 8.65), and of posttraumatic stress disorder (PTSD) was 48% (SE 6.19) and 32% (SE 4.22) for female and male respondents, respectively. Mean scores for social functioning were lower for women (52.00 [SE 2.77]) than for men (66.63 [SE 3.92]). Women had significantly lower mental health status and poorer social functioning than did men. Results of our survey underscore the need for financial donors and healthcare planners to address the current lack of mental healthcare resources, facilities, and trained mental healthcare professionals in Afghanistan and to establish mental health services directed at the specific needs of women. This study highlights the negative impact that war, restrictions in freedoms, and socioeconomic hardship have had on the mental health and social functioning of women in Afghanistan.

Adolescent↗
PubMed2005

Report from the CDC. Pap test intervals used by physicians serving low-income women through the National Breast and Cervical Cancer Early Detection Program.

The National Breast and Cervical Cancer Early Detection Program (NBCCEDP), administered by the Centers for Disease Control and Prevention (CDC), provides breast and cervical cancer screening to low-income women who are uninsured or underinsured. For women with three consecutive annual Pap tests with normal findings, the NBCCEDP supports extending the screening interval to every 3 years. Thirteen telephone focus groups were conducted with physician providers in 17 states and the District of Columbia to investigate familiarity with NBCCEDP's triennial Pap test policy, the Pap test intervals actually used, and the factors influencing screening interval selection. No participants were familiar with NBCCEDP's triennial Pap test policy, and none reported routinely extending the screening interval after three consecutive annual Pap tests with normal findings. Two patterns of screening interval use were reported: annual screeners continued performing yearly Pap tests, and selective extended screeners offered an extended interval to select patients. Annual and selective extended screeners reported that both unique and common factors influenced the screening intervals they used. The NBCCEDP has established its cancer screening priorities to focus limited resources on the goal of providing services to eligible women who have rarely or never been screened. Increased efforts are needed to educate physicians about the science supporting an extended Pap screening interval and overcome the barriers associated with its adoption.

Adult↗
PubMed1992

Pleural infection caused by Capnocytophaga canimorsus, formerly CDC group DF-2.

An 80-year-old man with Waldenström's macroglobulinemia developed pneumonia and empyema due to Capnocytophaga canimorsus (formerly CDC group DF-2). No growth was detected in blood cultures, but the organism was identified from cultures of pleural fluid. The infection responded well to antibiotics and drainage via a chest tube. To our knowledge, this is the first report of a clinical isolate of C. canimorsus from a pulmonary source. The absence of concurrent bacteremia raises the possibility that the lower respiratory tract can be the site of primary infection with this organism.

Aged↗
PubMed1994

Native-valve endocarditis due to CDC coryneform group ANF-3: report of a case and review of corynebacterial endocarditis.

Endocarditis due to a bacterium of CDC coryneform group ANF-3 developed in the native aortic valve of a patient without predisposing factors other than valvular calcification. A review of the literature indicates that corynebacteria are an increasingly important cause of endocarditis. Problems in identification and treatment remain. Techniques for the culture and quick identification of these organisms and effective regimens for treatment of the infections they cause are needed.

Actinomycetales↗