Recognition of Yersinia enterocolitica multiple strain infection in twin infants using PCR-based DNA fingerprinting

AIMS

Yersinia enterocolitica causes several syndromes in humans. The most common presentation is enterocolitis in children, presenting as fever and diarrhoea. A Y. enterocolitica multiple strain infection in twin infants was investigated.

METHODS AND RESULTS

One isolate was recovered from one patient and two morphologically-different isolates were recovered from the other infant. Biochemically, all isolates were identified as Y. enterocolitica group. The genomic DNA from each strain was purified and DNA fingerprinting was performed. The banding patterns observed for Y. enterocolitica isolates 2 and 3, from patients 1 and 2, respectively, were identical when comparing the presence or absence of major bands. However, Y. enterocolitica isolate 1, from patient 1, showed a distinctive banding pattern from isolates 2 and 3.

CONCLUSION

The findings indicate that one infant was colonized by more than one strain of Y. enterocolitica, demonstrating that multiple strains can colonize and invade a patient.

SIGNIFICANCE AND IMPACT OF THE STUDY

Recognition of multiple strain infections can be important in diagnosis, treatment and prognosis of Y. enterocolitica infections, as well as in disease epidemiology. The technique described here offers a straightforward method for strain comparison.

Community acquired pneumonia in adults: a study comparing clinical features and outcome in Africa (Republic of Guinea) and Europe (France)

BACKGROUND

Community acquired pneumonia is the most common cause of death from infectious disease both in western and developing countries. A study was carried out in Conakry, Republic of Guinea and Tours, France in order to compare signs, symptoms, severity of illness, risk factors, and clinical outcome of community acquired pneumonia in adult patients admitted to hospital.

METHODS

The study was performed in the cities of Conakry and Tours over the same one year period. Patients with nosocomial pneumonia, tuberculosis, and those who were HIV positive were excluded. Data were recorded on the same forms in both centres. A severity score was calculated according to American Thoracic Society criteria. Follow up was evaluated at days 2, 7 and 15.

RESULTS

A total of 333 patients (218 from Conakry, 115 from Tours) were included in the study with a diagnosis of community acquired pneumonia, with or without lung abscess or pleural effusion. Mean age was higher and pre-existing illness rate, dehydration, agitation, and stupor were more frequent in patients in Tours. Respiration rates of > 30 breaths/min and the incidence of crackles were identical in the two centres. Fever above 39 degrees C, initial shock, chest pain, and herpes were significantly more frequent in Conakry. Initial chest radiographic abnormalities were similar in the two groups, ranging from unilateral pleuropulmonary involvement (89% and 83% in Conakry and Tours, respectively) to diffuse patchy parenchymal disease. Parapneumonic effusion was present in 17% and 16% of the patients of Conakry and Tours, respectively. Pneumonia was considered to be severe in 33% and 42% of the patients, respectively. In Conakry first line antibiotic therapy was penicillin alone (2 million units a day) for 197 patients (90%) and second line antibiotic therapy was prescribed for 25 patients (12%). In Tours first line therapy consisted of a single antibiotic (amoxicillin, third generation cephalosporins) for 65 patients (57%) and second line antibiotic therapy was prescribed for 55 patients (48%). The clinical outcome was similar in Conakry and Tours: 88% and 85% of patients, respectively, were afebrile or clinically cured at day 15. The mortality rate was similar (6% and 8%, respectively).

CONCLUSIONS

The problems encountered in the management of community acquired pneumonia are quite different in western and developing countries. This study shows that low doses of penicillin can cure 90% of African patients with pneumonia as effectively as more aggregative treatments in European patients who are both older and have greater comorbidity. Although pneumococci with reduced penicillin sensitivity occur in western countries, this does not seem to be the case in black Africa. For these reasons, low doses of penicillin or amoxicillin remain good first line treatment.

Chorionic villus sampling after first trimester diagnosis of fetal cystic hygroma colli

Diagnostic findings of four cases of cystic hygroma discovered at 11 weeks of gestation are reported. The discovery of cystic hygroma by echotomography was followed by sample taking of chorionic villi which revealed one case of monosomy X and three cases of trisomy 18. Caryotype determination in the presence of cystic hydroma is essential for diagnostic confirmation and subsequent genetic counselling.

Investigation of the presence of Salmonella in two Nigerian meat packing plants

Two large and very well established meat processing plants supervised by the Veterinary Public Health Department were examined to assess the incidence of Salmonella within the premises and on the processed carcasses. The overall incidence was 65 out of the 252 samples or 25.9%. Salmonella was found in forty-one of 167 samples (25%) in one and twenty-four out of eighty-five samples (29%) in the other. The high incidence shows a high degree of probability of contamination of the products from both plants. The public health significance of the findings is emphasized and control problems are high-lighted.

Bacteriological survey of leptospirosis in Zaria, Nigeria

A total of 252 rodents were trapped in the environs of Ahmadu Bello University, Zaria, over a two-year period, of which 221 were brown field rats (Arvicanthus niloticus). Only these were found positive (4.5%). Titers were detected against Leptospira interrogans, serovars australis, icterohaemorrhagiae, tarassovi and hardjo. All positive sera except one reacted against a single serovar. Eight isolates were obtained from field rats: five were serovar australis, one ballum and two unidentified. Five isolates were recovered from 74 bovine kidneys examined: one was serovar pyrogenes and four unidentified. One unidentified isolate failed to react with any of the 16 screening leptospira antisera and another was tentatively considered to be serovar ballum. Two isolates, one ballum and one unidentified, were recovered from the Kubani stream waters. No leptospira was isolated from piggery sewage effluents collected at Kano and Kaduna. It is suggested that serovar ballum be included in any screening battery for leptospirosis in man and animals in Nigeria.

Spurious hydrogen sulfide production by Providencia and Escherichia coli species

Hydrogen sulfide production was noted in two Escherichia coli strands and one Provaidenica alcalifaciens (Proteus inconstans A) strain isolated from clinical stool specimens durin the summer of 1979. An investigation into this phenomenon revealed the predence of Eubacterium lentum, an anaerobe, growing in synergism with the Enterobacteriaceae and producing H2s. The implications of this association are discssed with reference to clinical microbiology laboratory practice.