The use of nuclear medicine in evaluating liver disease.
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Two patients with renal cortical abscesses were treated successfully by an intensive antibiotic regimen together with percutaneous aspiration, rather than by the conventional treatment of open drainage, which often is followed by secondary nephrectomy. This adaptation of percutaneous aspiration to the management of renal carbuncle coincides with a change in the causative microorganism which today is often a gram-negative coliform rather than a hematogenously borne staphylococcus, which usually complicates some pre-existing abnormality in the urinary tract.
A neutral O-polysaccharide was obtained by mild acid degradation of the lipopolysaccharide of Proteus mirabilis OC (CCUG 10702) and studied by sugar and methylation analyses and (1)H and (13)C NMR spectroscopy. The following structure of the tetrasaccharide repeating unit of the polysaccharide was established: [structure: see text]. Based on the unique structure of the O-polysaccharide and serological data, we propose classifying P. mirabilis OC (CCUG 10702) into a new separate Proteus serogroup O75. A weak cross-reaction of O-antiserum against P. mirabilis OC with the lipopolysaccharide of P. mirabilis O49 was accounted for by a similarity in the O-polysaccharide structures.
CTX-M-14- and -2-like extended-spectrum beta-lactamases were detected in 5 and 1 Proteus mirabilis isolates, respectively, among 92 non-duplicate strains tested from December 2002 to September 2003. This is the first report of the CTX-M-14 enzyme in P. mirabilis to the best of our knowledge and suggests that the CTX-M-type enzyme is gradually spreading to this species. bla(TEM), bla(SHV-1), and/or bla(OXA-10) alleles were also detected in 35 ampicillin-resistant isolates tested.
Strains of Proteus mirabilis belonging to serogroups O24 and O29 are frequent in clinical specimens. Anti-P. mirabilis O24 serum cross-reacted with the lipopolysaccharide (LPS) of P. mirabilis O29 and vice versa. The structures of the O-specific polysaccharides (OPSs, O-antigens) of both LPSs were established using sugar analysis and one- and two-dimensional 1H- and 13C-NMR spectroscopy and found to be different. SDS-PAGE and Western immunoblotting suggested that the serological cross-reactivity of the LPSs is due to a common epitope(s) on the core-lipid A moiety, rather than on the OPS. Therefore, the epitope specificity and the structures of the O-antigens studied are unique among Proteus serogroups.
Psoas muscle abscess is rare and presents a diagnostic challenge requiring a high index of suspicion. We report an unusual case of primary psoas abscess caused by Proteus mirabilis. Primary psoas abscess is most commonly present in children and is usually caused by Staphylococcus aureus. A total of 434 cases of psoas abscess has been reported. The subject is discussed noting the differences between primary and secondary cases, and emphasizing the importance of ultrasound and computerized tomography guided drainage of psoas abscess. A flow chart for the evaluation and management of primary and secondary abscess is presented, taking into consideration the success rate of the various methods of treatment described in the literature.
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Yellow nail syndrome was first described in 1964 by Samman and White. The full syndrome consists of the triad yellow nails, lymphedema, and pleural effusions with associated respiratory tract involvement. However, yellow nails alone or with any combination of the triad is termed yellow nail syndrome. We are describing a patient with yellow nails and pulmonary disease, whose nails cleared after resolution of his pulmonary condition. Although various therapeutic approaches have been used, the treatment of pulmonary disease was important in our patient.
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The ability to identify pathogenic organisms rapidly provides significant benefits to clinicians; in particular, with respect to best prescription practices and tracking of recurrent infections. Conventional bioassays require 3-5 days before identification of an organism can be made, thus compromising the effectiveness with which patients can be treated for bacterial infections. We analysed 20 clinical isolates of urinary tract infections (UTI) by ultra-violet resonance Raman (UVRR) spectroscopy, utilising 244 nm excitation delivering approximately 0.1 mW laser power at the sample, with typical spectral collection times of 120 s. UVRR results in resonance-enhanced Raman signals for certain chromophoric segments of macromolecules, intensifying those selected bands above what would otherwise be observed for a normal Raman experiment. Utilising the whole-organism 'fingerprints' obtained by UVRR we were able to discriminate successfully between UTI pathogens using chemometric cluster analyses. This work demonstrates significant improvements in the speed with which spectra can be obtained by Raman spectroscopic techniques for the discrimination of clinical bacterial samples.
Two series of experiments are reported which result in the discrimination between Helicobacter pylori and other bacterial gastroesophageal isolates using a newly developed odour generating system, an electronic nose and a hybrid intelligent odour recognition system. In the first series of experiments, after 5 h of growth (37 degrees C), 53 volatile 'sniffs' were collected over the headspace of complex broth cultures of the following clinical isolates: Staphylococcus aureus, Klebsiella sp., H. pylori, Enterococcus faecalis (10(7) ml(-1)), Mixed infection (Proteus mirabilis, Escherichia coli, and E. faecalis 3 x 10(6) ml each) and sterile cultures. Fifty-six normalised variables were extracted from 14 conductive polymer sensor responses and analysed by a 3-layer back propagation neural network (NN). The NN prediction rate achieved was 98% and the test data (37.7% of all data) was recognised correctly. Successful clustering of bacterial classes was also achieved by discriminant analysis (DA) of a normalised subset of sensor data. Cross-validation identified correctly seven 'unknown' samples. In the second series of experiments after 150 min of microaerobic growth at 37 degrees C, 24 volatile samples were collected over the headspace of H. pylori cultures in enriched (HPP) and normal (HP) media and 11 samples over sterile (N) cultures. Forty-eight sensor parameters were extracted from 12 sensor responses and analysed by a 3-layer NN previously optimised by a genetic algorithm (GA). GA-NN analysis achieved a 94% prediction rate of 'unknown' data. Additionally the 'genetically' selected 16 input neurones were used to perform DA-cross validation that showed a clear clustering of three groups and reclassified correctly nine 'sniffs'. It is concluded that the most important factors that govern the performance of an intelligent bacterial odour detection system are: (a) an odour generation mechanism, (b) a rapid odour delivery system similar to the mammalian olfactory system, (c) a gas sensor array of high reproducibility and (d) a hybrid intelligent model (expert system) which will enable the parallel use of GA-NNs and multivariate techniques.
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Chelocardin (1) was condensed with numerous hydrazines, hydrazides, and anilines, yielding 2'-substituted derivatives with antibacterial spectra similar to the parent antibiotic. The hydrazone derivatives 9 and 10 and the two anilino derivatives 42 and 44 had more in vivo antibacterial activity than chelocardin.
We report an unusual case of psoas abscess, which developed twenty-one years after ipsilateral nephrectomy and was caused by infrequent pathogen, Proteus mirabilis. It was diagnosed by computed tomography and was drained percutaneously with a nephrostomy tube guided by ultrasonography.
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