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PubMed1997

Sensitivity of Entamoeba histolytica and Entamoeba dispar patient isolates to human complement.

Twenty-one Entamoeba histolytica and 56 Entamoeba dispar patient isolates were investigated for their sensitivity to the classical and alternative pathway of human complement, E. histolytica and E. dispar patient isolates were differentiated by polymerase chain reaction and hexokinase isoenzyme typing. It was found that 90.3% (+/- 12.0%) of the trophozoites of E. histolytica were lysed after 30 min by the alternative pathway of complement in the presence of 50% human serum (19 isolates showed lysis rates higher than 80%), whereas E. dispar cells were less susceptible to the alternative pathway as 68.8% (+/- 28.2%) of lysis occurred. However, 23 of the E. dispar isolates were lysed between 100 and 80% (90.9% +/- 9.1%), demonstrating that about half of the tested E. dispar isolates were highly sensitive to complement lysis. Only 11 of the E. dispar isolates were proven to be ¿resistant' to the alternative pathway of complement and were lysed less than 40%. These results are in conflict to earlier publications, describing resistance of E. dispar to complement lysis (Hamelmann et al. 1992, 1993).

Animals↗
PubMed2005

Identification of moaA3 gene in patient isolates of Mycobacterium tuberculosis in Kerala, which is absent in M. tuberculosis H37Rv and H37Ra.

BACKGROUND: Tuberculosis is endemic to developing countries like India. Though the whole genome sequences of the type strain M. tuberculosis H37Rv and the clinical strain M. tuberculosis CDC1551 are available, the clinical isolates from India have not been studied extensively at the genome level. This study was carried out in order to have a better understanding of isolates from Kerala, a state in southern India. RESULTS: A PCR based strategy was followed making use of the deletion region primers to understand the genome level differences between the type strain H37Rv and the clinical isolates of M. tuberculosis from Kerala. PCR analysis of patient isolates using RD1 region primers revealed the amplification of a 386 bp region, in addition to the expected 652 bp amplicon. Southern hybridization of genomic DNA with the 386 bp amplicon confirmed the presence of this new region in a majority of the patient isolates from Kerala. Sequence comparison of this amplicon showed close homology with the moaA3 gene of M. bovis. In M. bovis this gene is present in the RvD5 region, an IS6110 mediated deletion that is absent in M. tuberculosis H37Rv. CONCLUSION: This study demonstrates the presence of moaA3 gene, that is absent in M. tuberculosis H37Rv and H37Ra, in a large number of local isolates. Whether the moaA3 gene provides any specific advantage to the field isolates of the pathogen is unclear. Field strains from Kerala have fewer IS6110 sequences and therefore are likely to have fewer IS6110 dependent rearrangements. But as deletions and insertions account for much of the genomic diversity of M. tuberculosis, the mechanisms of formation of sequence polymorphisms in the local isolates should be further examined. These results suggest that studies should focus on strains from endemic areas to understand the complexities of this pathogen.

Base Sequence↗
PubMed2004

Rate of nosocomial transmission of vancomycin-resistant enterococci from isolated patients.

To evaluate an isolation policy for patients colonised with vancomycin-resistant enterococci (VRE), we instituted active surveillance for transmission to uncolonised patients. Surveillance rectal swabs were taken and pulsed-field gel electrophoresis was performed on positive isolates. VRE transmission with an identical genotype occurred in 5 patients, giving a transmission rate of 3.7 per 1000 patient days, or 1 patient per ward each week. The present study provides a baseline for -assessment of VRE transmission and will be useful in evaluation of the effectiveness of infection control interventions.

Cross Infection↗
PubMed1994

[Patient isolation in a psychiatric clinic].

Restrictive measures are widely used in psychiatric hospitals. But they are ill reputed. Little is known about them. This study is about the administration of isolation of mentally ill patients in a psychiatric hospital. 274 isolations of 100 patients within 11 months are recorded. Isolations concern 5% of the treated patients. That means two isolations on 1000 days of hospitalization. Mostly concerned are patients with schizophrenia or manic episodes. The most frequent reasons given were protection or irritation, danger for the patient or others but also molestation or provocation.

Adult↗
PubMed1997

Studies of polymorphic DNA fingerprinting and lipid pattern of Mycobacterium tuberculosis patient isolates in Japan.

Strain differentiation by DNA restriction fragment length polymorphism (RFLP) has been used mainly for the epidemiological purpose of Mycobacterium tuberculosis infection. In this study, we tried to connect the molecular and phenotypic characteristics of M. tuberculosis patient isolates by comparing the DNA fingerprints obtained by RFLP using IS6110 and lipid patterns using two-dimensional thin-layer chromatography (2-D TLC) with silica gel, since M. tuberculosis has a lipid-rich cell envelope which contributes to the virulence and immunomodulatory properties. We found that 66 isolates of M. tuberculosis from tuberculosis patients showed that the occurrence of IS6110 varied from 1 to 24 copies. The IS6110 patterns were highly variable among isolates. Fifty different RFLP patterns were observed, and 12 RFLP patterns were shared by two or more strains. By computerized analysis of the RFLP patterns of M. tuberculosis patient isolates, we found that 95% of the isolates fell into seven clusters, from A to G, with at least two isolates in each (> 30% similarity). Among the cellular lipids, the phospholipid composition did not differ by strain, whereas the glycolipid pattern differed markedly. Especially, the relative concentration of cord factor and sulfolipid, both of which were known as virulent factors, varied by strain. The fingerprints of some strains showed an association between the DNA and glycolipid patterns, even though some of the same DNA fingerprint strains showed differences in lipid patterns. Among the patient isolates, M. tuberculosis strain 249 possessed a specific glycolipid with 2-O-methyl-L-rhamnose and L-rhamnose, which is rarely found in other strains. This glycolipid showed serological activity against the sera of tuberculosis patients, even if the reactivity was not as strong as trehalose dimycolate. It also showed the inhibition of phagosome-lysosome fusion in macrophages, suggesting involvement with virulence. These results suggest that RFLP analysis using IS6110 is useful for clustering the human isolates of M. tuberculosis, however, for further strain differentiation on virulence, a lipid analysis provides more information.

Antibodies, Bacterial↗
PubMed1996

Patient isolates of Borrelia burgdorferi sensu lato with genotypic and phenotypic similarities of strain 25015.

Strain 25015 is an atypical tick isolate that belongs to a distinct genomic group (DN127) within the general taxon Borrelia burgdorferi sensu lato. Similarities between this strain and a white-footed mouse isolate from Illinois, strain CT39, have been reported. In the course of isolating B. burgdorferi sensu lato in culture from Slovenian patients, 9 isolates were identified with the same genetic profiles as strains 25015 and CT39, as evidenced by restriction enzyme MluI digestion patterns of genomic DNA. The aim of the present study was to molecularly characterize all 11 isolates to examine the extent of their genotypic and phenotypic similarity. The results of molecular studies suggest a close relationship between the patient isolates and strains 25015 and CT39. However, CT39 and several patient isolates possessed unique characteristics that reflect their discrete ontogeny.

Animals↗
PubMed1998

Evaluation of a room for tuberculosis patient isolation using theatrical fog.

OBJECTIVE: To develop a method to evaluate directional airflow patterns, air dilution, and air mixing in facilities where tuberculosis patients are seen. DESIGN: A tuberculosis patient isolation room was evaluated by analyzing pressure differential between the room and the corridor and by using theatrical fog to visualize room air movement and impact of dilution and exchange, as well as air capture and displacement. Tracer gas was compared to fog results and used to calculate air exchange rates. SETTING: A small research hospital. RESULTS: By adding theatrical fog to the patient room at several locations, we quickly learned that most of the air entering the room through the transom and around the door to the corridor was exhausted through the three exhaust vents. Little air appeared to move toward the exhaust fan. For comparison and to confirm the room air exchange rate, tracer gas was distributed and sampled. The kinetics of decay were very similar whether the tracer gas and room air were mixed during sampling or not. CONCLUSIONS: The fog procedure allowed good visual confirmation of air mixing and airflow patterns and provided quantitative data for evaluating the efficacy of air capture and displacement or dilution and exchange.

Aerosols↗
PubMed1997

Isoenzyme patterns of Blastocystis hominis patient isolates derived from symptomatic and healthy carriers.

Isolates of Blastocystis hominis derived from patients with intestinal symptoms and from healthy carriers were cultured in vitro and isoenzyme patterns of hexokinase (E.C. 2.7.1.1), phosphoglucomutase (E.C. 2.7.5.1) and glucose phosphate isomerase (E.C. 5.3.1.9) were investigated to find evidence for pathogenic and non-pathogenic subspecies of B. hominis. For this purpose we examined 2000 patients of the out-patient department of the Institute for Tropical Medicine in Tübingen. From these, we obtained 232 B. hominis patient isolates; 119 isolates could be tested for the three isoenzymes. Blastocystis hominis possesses 5 patterns for hexokinase, 11 for phosphoglucomutase and 35 for glucose phosphate isomerase, showing that B. hominis is highly polymorphic. However, there was no correlation between isoenzyme patterns and disease of patients.

Animals↗
PubMed1998

Transition to becoming a leukaemia patient: or putting up barriers which increase patient isolation.

When two or more persons, e.g. nurses and patients, act together interaction takes place. The expectations of nurses and their definition of the patient's illness status affect their behaviour towards the patient and how they practice nursing. The aim of this study was to examine the interaction between adults with leukaemia and their nurses and how this interaction affected the individual. Grounded theory method guided the data collection and analysis. Four adults with leukaemia and their nursing staff were observed for 124 h in a haematological ward. The core category emerging from the data was transition--the individual passing from one phase to another. This denotes a change in role relations, in expectations and in abilities. The individual makes their transition in three stages. First, the person seeks out information in the corridors and at the same time tries to maintain social status. Next, the patient accepts the disease in the confines of their room and feels insecure in a totally new situation and role. Finally, the leukaemia patient isolates themselves within the confines of the bed, and becomes aware of the leukaemia and its side-effects.

Adaptation, Psychological↗