The return of the Wapiti to Arizona. A salute to Robert N. LOONEY, pioneer Arizona physician.
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Animals↗
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[Isolation of a new Salmonella (S.II 41:b:1,5) as well as Arizona serotypes (Arizona 21:24:25) from a viper (Vipera russellii)].
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Animals↗
[Eight new Arizona serotypes with emphasis on 2 O-antigens previously only found in Salmonella (author's transl)].
Description of eight new Arizona serotypes isolated from snakes and lizards (exception: Arizona 7a, 7c:23-21) in various countries and submitted to the National Salmonella Centre Hamburg for identification. No. 4-36/70 Arizona 10a, 10b:29-25 = S. arizonae 40(1), 40(2):k:z53 No. 159-36/70 Arizona 7a, c..:26-21 (with a new O-antigen) = S. arizonae 1, 6, 14, 25:z53:z35 No. 160-36/70 Arizona 30:32-31 = S. arizonae 65:c:z No. 162-36/70 Arizona 10a, 10b, (10c):23-31 (with a new O-antigen) = S. arizonae 40(1), 40(2):1, v:z No. 167-36/70 Arizona 25:23-31-41 = S. arizonae 16:1, v:z:z61 No. 2-36/71 Arizona 20:33-21 = S. arizonae 35:i:z35 No. 227-36/72 Arizona 26a, 26b:26-21 = S. arizonae 61(1), 61(2):z52:z35 No. 305-36/72 Arizona 7a, 7c:23-21 = S. arizonae (6), 14:1, v:z35 The two new Arizona O-antiges traced in strains nos. 159-36/70 and 162-36/70 testify the close relationship between Arizona and Salmonella justifying the inclusion of all Arizona serotypes with their corresponding Salmonella-formulae in the Kauffmann-White-Schema. The O-antigen of strain no. 159-36/70 was verified only by using Salmonella O-antisera, the O-antigen of no. 162-36/70 by serological comparative tests with a certain Salmonella-species = S. bukavu. Strain no. 167-36/70: it is pointed out that phase 3 could probably be a so-called R-phase.
Agglutination Tests↗
On the serological relationship between Salmonella O-groups 48 and 64 and the corresponding Arizona O-groups 5 and 29 which would justify a merger of these groups.
In 1963 Kauffmann divided O-group Y (O:48) of the Kauffmann-White schema into 3 sub-groups, e.g. 48(1),48(2) (S. dahlem), 48(1),48(2),48(3) (S. djakarta), 48(1),48(3),48(4) (Citrobacter 2624/36). He also recommended the use of the two serotypes S. dahlem and S. djakarta for the preparation of a diagnostic group-serum. At that time, serological relations--especially O-antigenic relations (and even some identities)--between the separate Salmonella and Arizona genera were known, viz. between the Salmonella group O:48 and the Arizona group O:5. It has now been found that there exist also close serological relations between the Salmonella O-groups 48 and 64 on the one hand and to the corresponding Arizona O-groups 5 and 29 on the other hand, in connection with which the special factor 48(4) defined by Kauffmann in the Citrobacter culture 2624/36 enbraces the whole Salmonella group O:64 (Arizona group O:29). Therefore, every Salmonella O:64 strain and Arizona O:29 serotype respectively can be agglutinated with factor-serum 48(4), defined by Kauffmann. A special O:64 serum is no longer required. The Salmonella antigen 64 (Arizona O:29 or O:5,29) has as a rule the partial antigens 48(1),48(3),48(4) (Arizona O:29). Only a few serotypes do not possess factor 48(3): their components are 48(1) and 48(4) (Arizona O:29). The evidence of our findings demonstrates that the Salmonella O-group 64 (Arizona O:29) should be combined with O-group 48 (Arizona O:5) and erased from the original Kauffmann-White schema and the Arizona antigenic schema to avoid a wrong diagnosis.
Agglutination Tests↗
Can child deaths be prevented? The Arizona Child Fatality Review Program experience.
OBJECTIVE: To determine the causes and preventability of child deaths; to assess the accuracy of death certificate information; and to assess the number of child abuse deaths that are misdiagnosed as deaths attributable to natural or accidental causes. METHODS: Analysis of deaths of children <18 years old that occurred between 1995-1999 using the data collected by the Arizona Child Fatality Review Program (ACFRP). RESULTS: From 1995-1999, local multidisciplinary child fatality review teams (CFRTs) have reviewed 95% of all deaths of children <18 years old in Arizona. Each team has access to the child's death certificate, autopsy report, hospital records, child protective services records, law enforcement reports, and any other relevant documents that provide insight into the cause and preventability of a child's death. After reviewing these documents, the team determines the cause of death, its preventability, and the accuracy of the death certificate. The ACFRP defines a child's death as preventable if an individual or the community could reasonably have done something that would have changed the circumstances that led to the child's death. The ACFRP determined that 29% (1416/4806) of these deaths could have been prevented, and preventability increased with the age of the child. Only 5% (81/1781) of neonatal deaths were considered preventable, whereas the deaths of 38% of all children older than 28 days were considered preventable. By 9 years of age, the majority of child deaths (56%) were considered preventable. Deaths attributable to medical conditions were far less likely to be considered preventable than deaths attributable to unintentional injuries. Although 62% of all deaths in Arizona during the 5-year period were attributable to medical conditions, only 8% (253/2983) of these deaths were considered preventable. In contrast, 91% (852/934) of the deaths attributable to unintentional injuries were considered preventable. Motor vehicle crashes accounted for 634 of the deaths resulting from injuries, and drowning accounted for 187 deaths. Motor vehicle crashes were the leading cause of death for all children in Arizona over 1 year of age. Only 18% of child passengers and 3% of adolescent drivers who died were known to be appropriately restrained. The typical drowning victim was a young child who drowned in the family's backyard pool. Indeed, 70% (131/187) of the drowning victims were <5 years old, and 62% (81/131) of these children died in a backyard pool. Supervision of the child and pool fencing could have prevented 90% of these deaths. Most deaths attributable to medical conditions occurred in the first year of life. Prematurity was the most common medical condition (1036 deaths) followed by congenital anomalies (662 deaths) and infectious diseases (470 deaths). Some of the reasons why CFRTs believed a medical death was preventable included inadequate emergency medical services, poor continuity of care, and delay in seeking care because of lack of health insurance. There were 4 deaths resulting from infections that were vaccine-preventable. There were 263 deaths attributable to sudden infant death syndrome. Only 38 of these infants were found lying on their back; 35 were found lying on their side. The death rate from sudden infant death syndrome decreased from 1.1 per 1000 infants <1 year of age in 1995 to 0.5 in 1999. There were 33 deaths that the CFRTs concluded were attributable to unsafe sleeping arrangements that resulted in unintentional suffocation. From 1995-1999, 317 Arizona children died from gun shot wounds. Most of these deaths were homicides (175) or suicides (109). All suicide deaths occurred in children >9 years old, and 77% of these children were >14 years old. The typical suicide victim was male (83%) and used a gun (70%) to kill himself. After review by the CFRTs, it was determined that 5 of the 67 child abuse deaths were misdiagnosed as attributable to natural or accidental causes on the death certificate. In 3 of these 5 cases, the child was in a persistent vegetative state and died many years after the episode of child abuse. Although inaction or inappropriate action by Child Protective Services (CPS) is often thought to be the cause of child abuse deaths, the ACFRP determined that in 79% of child abuse deaths, there had been no previous CPS involvement with the child's family. Although 61% of child abuse deaths were considered to be preventable, much of the responsibility for preventing these deaths rests with community members (eg, relatives, neighbors) who were aware of the abuse but failed to report the family to CPS. The CFRTs, who had received training in the proper completion of death certificates, reported that the cause of death was incorrect on 13% of all death certificates and in 16 cases, the CFRTs disagreed with the medical examiner on the manner of death (eg, natural, accidental, undetermined). Because CFRTs have access to additional information that may not have been available to the physician who completes a child's death certificate, CFRTs may be able to more accurately determine the cause and manner of death than the physician who completed the death certificate. CONCLUSIONS: Arizona's child death rate is above the national average (82.16/100 000), but the ACFRP determined that many of these deaths could have been prevented by using known prevention strategies (eg, child safety restraints, pool fencing). Most child mortality data are based on death certificate information that often is incorrect and cannot be used to assess preventability. Although most states have child fatality review programs that review suspected child abuse deaths, <3% of all preventable deaths in Arizona were attributable to child abuse. If all child deaths in the United States were reviewed from a prevention/needs assessment perspective, targeted and data-driven recommendations for prevention could be developed for each community, and potentially 38% of all child deaths that occur after the first month of life could be prevented. The ACFRP is an excellent example of a statewide system with a public health focus. To assist other states in developing similar programs, national support is needed. The establishment of a public health focused federally funded national program would provide us with the opportunity to standardize data collection among states and better utilize this data at a national level.
Accidents, Traffic↗
In vivo transfer of antibiotic resistance to a strain of Salmonella arizonae.
Two trials were conducted to determine the transferability of antibiotic resistance in vivo between two strains of enteric bacteria. Newly hatched turkey poults were inoculated per os with a strain of Escherichia coli resistant to kanamycin, tetracycline, and ampicillin, a strain of Salmonella arizonae resistant to nalidixic acid and streptomycin, or both strains. Kanamycin was added to the drinking water of some poults. To test for S. arizonae cells which had received transferable resistance determinants in vivo from the E. coli strain, samples were collected by swabbing the recta of the poults and by removing segments of the intestines and livers after the birds were sacrificed. Nalidixic acid was added to the isolation media to prevent in vitro transfer from occurring after the samples were collected. Salmonella arizonae resistant to nalidixic acid, streptomycin, kanamycin, tetracycline, and ampicillin were isolated from 20% of the rectal samples taken from poults that had received both bacterial strains. S. arizonae cells which had received resistance determinants in vivo were also isolated from 73% of the intestinal samples and 8% of the liver samples taken from birds inoculated with both donor E. coli and recipient S. arizonae. Salmonella arizonae demonstrating resistance to all five antibiotics were recovered from all intestinal samples taken from birds given kanamycin in their drinking water immediately after the last S. arizonae inoculation but from only 43% of such samples taken from birds given no kanamycin.
Animals↗
Role of Salmonella arizonae and other infective agents in enteric disease of lambs.
Fecal samples from 545 diarrheic lambs on 12 ranches in southern Idaho and western Montana were examined for potential enteric pathogens. On 3 of the 12 ranches, enterotoxigenic Escherichia coli, Salmonella typhimurium, or S dublin was implicated as the etiologic agent. Rotavirus and coronavirus were identified on 1 ranch and rotavirus alone on another. Salmonella arizonae serotype 26:30 was isolated from the feces of diarrheic lambs on 6 of the 12 ranches in this study. Pregnant ewes from 1 of the 6 ranches in which S arizonae was enzootic were transported to the Montana Veterinary Research Laboratory and studies on S arizonae were conducted in lambs from these ewes. Salmonella arizonae was shown to elaborate an enterotoxin, the activity of which was reduced when assayed in the gut loop test, using lambs from ewes vaccinated with an S arizonae 26:30 bacterin. Oral challenge inoculation of 22 young colostrum-fed lambs with S arizonae 26:30 failed to produce any significant enteric disease, in contrast to oral challenge inoculation with S. oranienburg which resulted in death, with severe diarrhea and dehydration, in 4 of 6 lambs tested. Salmonella arizonae serotype 26:30 appears to be well adapted to the ovine host and may not be a significant cause of diarrheal disease on ranches where it is enzootic.
Animals↗
[Allergic seasonal rhinoconjunctivitis without indigenous pollen sensitization: the example of the Arizona cypress].
A 37-year old man from Lithuania presented with the typical symptoms of allergic rhinoconjunctivitis that appeared in spring this and the year preceding presentation. Skin prick tests for aeroallergens indigenous in Switzerland were all negative. A detailed history revealed that the patient was working in a building of a United Nation's agency surrounded by a park with numerous cypresses of Arizona trees. A skin prick test for pollens from Cupressus arizona was strongly positive, supporting the diagnosis of allergic rhinoconjunctivitis to pollens from this tree. Allergy to pollens from C. arizona is a widely prevalent as winter pollinosis in subtropical and Mediterranean areas but is exceptional in the continental and alpine climates of Switzerland. Five cases of C. arizona pollinosis have been diagnosed in the last 3 years in Geneva. It is notoriously difficult to diagnose cypressus pollen allergy, mainly because of the poor quality of in vivo and in vitro available tests. Horticulture with non-indigenous plants is responsible for pollinosis from C. arizona in Switzerland. The specialists in countries in which pollinosis from C. arizona is not endemic, need to be aware of arboriculture with non-indigenous plants, as well as the possibility of allergy to C. arizona.
Adult↗
Evaluation of the Arizona Medical Student Exchange Program.
In this article the authors describe and present an evaluation of the Arizona Medical Student Exchange Program of the Western Interstate Commission for Higher Education. The program is designed to help defray the cost that an Arizona student faces in attending an out-of-state medical school by paying, in the student's behalf, the difference between the resident and nonresident tuition at the out-of-state school. Furthermore, the accepting medical school is paid an additional sum as an inducement to accepts more Arizona students in the future. The program's goal is to increase the number of graduating physicians who will return to practice in Arizona, especially in areas of medical need. While the program apparently has been successful in increasing the number of Arizona students studying medicine and the number of physicians returning to the state--both to metropolitan areas and to areas of medical need--these increases have not kept pace with Arizona's growing population.
Arizona↗
Osteomyelitis associated with Salmonella enterica SS arizonae in a colony of ridgenose rattlesnakes (Crotalus willardi).
The identification of three Arizona ridgenose rattlesnakes (Crotalus willardi) with Salmonella arizonae-associated osteomyelitis led to a 5-yr prospective study of radiographic signs and Salmonella intestinal carriage rates in a 19-member colony of this rattlesnake species. Ventrodorsal radiographs were performed and cloacal swabs were cultured for Salmonella spp. annually. Ten snakes survived the 5-yr period, with six of them remaining free of bony lesions. Three snakes that had no bony lesions in 1995 developed radiographic signs of osteomyelitis during the study. Six snakes with bony lesions at the beginning of the study died or were euthanatized due to osteomyelitis during the study. The radiographic signs of osteomyelitis were progressive for five snakes that were serially radiographed. Only one snake with radiographic signs of osteomyelitis at the beginning of the study was still alive at the end of the study, and this animal's bony lesions were more extensive at the end. Thirty-nine intestinal S. arizonae isolates, representing 13 serotypes, were obtained from the 19 snakes. Salmonella arizonae serotype 56:Z4,Z23 was isolated only once from a cloacal culture, from a snake that had no radiographic bone lesions. Twelve extraintestinal Salmonella isolates, representing two serotypes, were isolated from six snakes. All extraintestinal isolates except one were of S. arizonae serotype 56:Z4,Z23, and all isolates from bone were of this serotype. One snake with characteristic bone lesions died, and Providencia rettgeri was cultured from each of the tissues cultured, whereas no Salmonella spp. were isolated from this snake. Salmonella arizonae serotype 56:Z4,Z23 [corrected] appears to have a tropism for bone and other extraintestinal sites in C. willardi and may cause a progressive, ultimately fatal disease in this species.
Administration, Oral↗
Tobacco use among adults--Arizona, 1996 and 1999.
In 1994, Arizona passed the Tobacco Tax and Healthcare Act (Proposition 200) that increased the tax on cigarettes from $0.18 to $0.58, and allocated 23% of the resulting revenues to tobacco-control activities. Since 1995, Arizona has used the tobacco-control funds (approximately $30 million per year) to support the Arizona Department of Health Services (ADHS) Tobacco Education and Prevention Program (TEPP), a comprehensive program to prevent and reduce tobacco use. To track changes in tobacco use, the knowledge and opinions of Arizona residents about tobacco use, and the proportion of smokers advised to quit smoking by health-care providers, ADHS conducted the Arizona Adult Tobacco Survey (ATS) in 1996 and a follow-up survey in 1999. This report compares results of these two surveys, which indicate that prevalence of tobacco use among adults decreased, and the proportion of adults who were both asked about tobacco use and advised to quit by health-care providers and dentists increased. On the basis of these findings, if all states implemented comprehensive programs similar to those in Arizona, the national health objective for 2010 of reducing the adult smoking rate by half during this decade could be achieved.
Adult↗
Bone and joint infection with Arizona hinshawii: report of a case and a review of the literature.
The Arizona group of gram-negative enteric microorganisms is closely related to the genus Salmonella. Arizona infection is common in avian and reptilian species. Whereas Arizona intestinal infection has been observed in humans, extraintestinal disease has infrequently been described. A case of a 23-year-old woman with systemic lupus erythematosus and sickle cell trait who acquired Arizona hinshawii osteomyelitis and septis arthritis is presented. The patient recovered after treatment with ampicillin and cephalosporins. Three previously described cases of bone and/or joint infection with Arizona are summarized. Because Arizona species frequently ferment lactose, it is possible that they are discarded from fecal isolates by bacteriology laboratories. It is conceivable that many intestinal and extraintestinal infections are either overlooked or mistakenly identified.
Adult↗
Occurrence and distribution of serotypes of the Arizona subgroup of Salmonella strains in the United States from 1967 to 1976.
The Salmonella Arizona subgroup contains gram-negative enteric bacteria that are closely related to other salmonellae biochemically, serologically, and genetically. Although the Arizona subgroup may be isolated from a wide variety of nonhuman and human sources, the arizonae are uncommonly recognized as human pathogens, and surprisingly little is known about their epidemiology. From 1967 through 1976, the Centers for Disease Control received 858 Arizona subgroup cultures from human and nonhuman sources representing 143 different serotypes in 33 somatic groups; several serotypes had not been previously reported. The 374 cultures from humans represent 71 different serotypes; extraintestinal isolates were present in 31 (44%) serotypes. Compared with data from a previous 20 years of surveillance, the proportion of Arizona subgroup strains isolated from stools, blood, and other sites was remarkably stable, but several serotypes showed marked changes in their frequency of isolation. In total, the ratio of extraintestinal to intestinal isolates was 0.37, but marked serotype-specific variation was noted, suggesting differences in virulence associated with serotype.
Amphibians↗
Salmonella arizona infections in Latinos associated with rattlesnake folk medicine.
In 1987 two Los Angeles County (California) hospitals reported four Latino patients with serious Salmonella arizona (Salmonella subgroup 3) infections who gave a medical history of taking rattlesnake capsules prior to illness. Capsules supplied by the patients or household members grew Salmonella arizona. We reviewed surveillance data for this Salmonella species and conducted a case-control study to determine the magnitude of this public health problem. Eighteen (82 percent) of the 22 Latino cases in 1986 and 1987 who were questioned reported ingesting snake capsules compared to two (8 percent) of 24 matched Latino controls with non-subgroup 3 salmonellosis or shigellosis (matched pair odds ratio = 18.0, CI = 4.2, 76.3). An average of 18 cases per year of Salmonella arizona were reported in the county between 1980 and 1987. In this investigation the majority of S. arizona cases reporting snake capsule ingestion had underlying illnesses such as acquired immunodeficiency syndrome (AIDS), diabetes, arthritis, cancer. The capsules were obtained primarily from Tijuana, Mexico and from Los Angeles, California pharmacies in Latino neighborhoods. Despite publicity and attempts to remove the capsules from sale in California, Salmonella arizona cases associated with snake-capsule ingestion continue to occur.
Animals↗
Spontaneous Arizona hinshawii peritonitis in cirrhosis with ascites.
Arizona hinshawii, a gram-negative enteric pathogen, causes serious infections in fowl, reptiles, and other animals. In humans, gastroenteritis, enteric fever, septicemia, and localized infections due to Arizona have occurred. There are no previous reports of spontaneous bacterial peritonitis secondary to Arizona, however. We report here a case of spontaneous bacterial peritonitis due to Arizona occurring in a patient with cirrhosis of the alcoholic type. The patient was treated with a 10-day course of gentamicin, and although she improved clinically, Arizona was cultured from the blood and bile postmortem.
Aged↗
Arizona hinshawii osteomyelitis with antecedent enteric fever and sepsis. A case report with a review of the literature.
A case of Arizona osteomyelitis of the spine which occurred 11 months after an episode of gastroenteritis and enteric fever is presented. As close biochemical and antigenic relative of Salmonella, Arizona infection produces a similar clinical course with gastrointestinal manifestations frequently preceding localized infections by several months. The boney lesion in the present case and in three of the four other cases of Arizona osteomyelitis described in the literature was a chronic inflammation which may have a xanthomatous component. The bone destruction caused by Arizona infection is less severe than that of tuberculosis or pyogenic osteomyelitis. Proposed treatment of Arizona osteomyelitis consists of debridement of the localized infection and long term antimicrobial therapy.
Child, Preschool↗
Treatment of Salmonella-Arizona-infected turtle eggs with terramycin and chloromycetin by the temperature-differential egg dip method.
Attempts to eliminate Salmonella and Arizona infection from newly hatched turtles were made by dipping fresh eggs in cold solutions of Terramycin and Chloromycetin at 1,000, 1,200, 1,500 and 2,000 mug per ml for either 10, 20, or 30 min. Control groups consisted of hatchings produced from nondipped eggs or eggs dipped in chilled water. In two of the four experiments 5 to 10 eggs were blended on days 15, 30, and 45 post antibiotic dip treatment. Twenty-five to 60 hatchlings from each control or experimental dip groups were held in containers and the water was tested (excretion method) for Salmonella and Arizona every 15 or 30 days for 180 to 210 days after hatching. Representative turtles were homogenized (blending method) to determine if systemic infections were present. All specimens tested were enriched in tetrathionate and selenite cystine broth. Nondipped eggs and water-dipped eggs routinely showed Salmonella and Arizona present in egg homogenate and hatchlings emerging from these eggs excreted these pathogens. Terramycin- and Chloromycetin-dipped eggs were uniformly negative for these pathogens, only if fresh eggs were dipped. Bacteriological assay of container water and whole turtle homogenate from hatchlings were negative for Salmonella and Arizona if eggs were dipped in 1,000 mug of Terramycin early in the egg laying season or if eggs were dipped in 1,500 or 2,000 mug of Terramycin per ml late in the egg laying season. The results of temperature-differential egg dip studies suggest that this is a feasible and promising method by which to eradicate Salmonella and Arizona from the turtle.
Animals↗
Fatty acid composition of paracolons: Arizona, Citrobacter, and Providencia.
The fatty acid compositions of stationary-phase cultures of Arizona arizonae, Citrobacter freundii, Providencia alcalifaciens, Providencia stuartii, and Providencia sp. were studied. The major fatty acids of A. arizonae, C. freundii, and Providencia were 16:0, 16:1, 17:cyclopropane, and 19:cyclopropane. The fatty acid compositions of the two strains of A. arizonae examined were similar to each other, but the three strains of C. freundii differed from one another in their fatty acid compositions. In both A. arizonae and C. freundii, the relative quantities of saturated, unsaturated, and cyclopropane fatty acids were similar to those which have been found in stationary-phase cultures of other members of the Enterobacteriaceae. The three strains of Providencia also differed from one another in their fatty acid compositions. In all three strains, the total quantity of unsaturated fatty acids was larger and that of the cyclopropane fatty acids was smaller than those found in stationary-phase cultures of other enteric bacteria.
Chromatography, Gas↗