Livestock grazing and biodiversity: Effects on CO2 exchange in semi-arid Karoo ecosystems, South Africa

Livestock use in semi-arid South African ecosystems has not been extensively studied in relation to the Net Ecosystem Exchange (NEE) of carbon dioxide (CO2). We present four years of measurements from twinned eddy-covariance towers in Nama-Karoo, South Africa, to investigate the carbon fluxes and the impact of grazing intensity on NEE. The design contrasted NEE at a long-term site grazed at recommended levels (LG) with a long-term heavily grazed (EG) site that had been rested for 10 years, and was monitored for two years after which intensive grazing was reintroduced for this experiment. This allowed for the quantification of long-term NEE trends on "recovering" vegetations (years I, II) and short-term responses to an intensified land use (years III, IV). The results showed that the net release of CO2 was slightly higher at LG than on "recovering" vegetation at the EG site, where near-neutral exchange was observed during years I and II. However, after grazing was reintroduced to the EG site, differences between sites was reduced but not eliminated. These findings suggest that there is a somewhat higher carbon sequestration potential at the resting EG site than at the LG site, apparently associated with the dominance of unpalatable drought-tolerant grass species and local elimination of many palatable shrubs. Reduction of this sink potential by reintroduction of high-intensity grazing indicates the sensitivity of C-sequestration in this "recovering" system to heavy grazing, but underlines continued resilience of NEE under far heavier grazing than in the LG system. These data suggest notable trade-offs in these ecosystems between carbon storage, biodiversity, and livestock production with rainfall variability being a critical inter-annual driver. PLAIN LANGUAGE SUMMARY: This study suggests that long-term resting of previously over-utilized southern African semi-arid vegetation supports enhanced carbon sequestration potential, even if over-utilization has transformed vegetation composition (i.e. has caused degradation through reduced plant species richness). However, this enhanced carbon sequestration potential can be quickly negated by the reintroduction of grazing, even after 10 years of resting. Achievement of carbon sequestration is dependent on average to above-average precipitation and its distribution throughout the year, with sink activity evident mainly after seasonal rains during the warm season.

Overcoming the coupled climate and biodiversity crises and their societal impacts

Earth's biodiversity and human societies face pollution, overconsumption of natural resources, urbanization, demographic shifts, social and economic inequalities, and habitat loss, many of which are exacerbated by climate change. Here, we review links among climate, biodiversity, and society and develop a roadmap toward sustainability. These include limiting warming to 1.5°C and effectively conserving and restoring functional ecosystems on 30 to 50% of land, freshwater, and ocean "scapes." We envision a mosaic of interconnected protected and shared spaces, including intensively used spaces, to strengthen self-sustaining biodiversity, the capacity of people and nature to adapt to and mitigate climate change, and nature's contributions to people. Fostering interlinked human, ecosystem, and planetary health for a livable future urgently requires bold implementation of transformative policy interventions through interconnected institutions, governance, and social systems from local to global levels.

Assessing protected area vulnerability to climate change in a case study of South African national parks

Climate change is challenging the ability of protected areas (PAs) to meet their objectives. To improve PA planning, we developed a framework for assessing PA vulnerability to climate change based on consideration of potential climate change impacts on species and their habitats and resource use. Furthermore, the capacity of PAs to adapt to these climate threats was determined through assessment of PA management effectiveness, adjacent land use, and financial resilience. Users reach a PA-specific vulnerability score and rank based on scoring of these categories. We applied the framework to South Africa's 19 national parks. Because the 19 parks are managed as a national network, we explored how resources might be best allocated to address climate change. Each park's importance to the network's biodiversity conservation and revenue generation was estimated and used to weight overall vulnerability scores and ranks. Park vulnerability profiles showed distinct combinations of potential impacts of climate change and adaptive capacities; the former had a greater influence on vulnerability. Mapungubwe National Park emerged as the most vulnerable to climate change, despite its relatively high adaptive capacity, largely owing to large projected changes in species and resource use. Table Mountain National Park scored the lowest in overall vulnerability. Climate change vulnerability rankings differed markedly once importance weightings were applied; Kruger National Park was the most vulnerable under both importance scenarios. Climate change vulnerability assessment is fundamental to effective adaptation planning. Our PA assessment tool is the only tool that quantifies PA vulnerability to climate change in a comparative index. It may be used in data-rich and data-poor contexts to prioritize resource allocation across PA networks and can be applied from local to global scales.

Organizing principles for vegetation dynamics

Plants and vegetation play a critical-but largely unpredictable-role in global environmental changes due to the multitude of contributing processes at widely different spatial and temporal scales. In this Perspective, we explore approaches to master this complexity and improve our ability to predict vegetation dynamics by explicitly taking account of principles that constrain plant and ecosystem behaviour: natural selection, self-organization and entropy maximization. These ideas are increasingly being used in vegetation models, but we argue that their full potential has yet to be realized. We demonstrate the power of natural selection-based optimality principles to predict photosynthetic and carbon allocation responses to multiple environmental drivers, as well as how individual plasticity leads to the predictable self-organization of forest canopies. We show how models of natural selection acting on a few key traits can generate realistic plant communities and how entropy maximization can identify the most probable outcomes of community dynamics in space- and time-varying environments. Finally, we present a roadmap indicating how these principles could be combined in a new generation of models with stronger theoretical foundations and an improved capacity to predict complex vegetation responses to environmental change.

The commonness of rarity: Global and future distribution of rarity across land plants

A key feature of life's diversity is that some species are common but many more are rare. Nonetheless, at global scales, we do not know what fraction of biodiversity consists of rare species. Here, we present the largest compilation of global plant diversity to quantify the fraction of Earth's plant biodiversity that are rare. A large fraction, ~36.5% of Earth's ~435,000 plant species, are exceedingly rare. Sampling biases and prominent models, such as neutral theory and the k-niche model, cannot account for the observed prevalence of rarity. Our results indicate that (i) climatically more stable regions have harbored rare species and hence a large fraction of Earth's plant species via reduced extinction risk but that (ii) climate change and human land use are now disproportionately impacting rare species. Estimates of global species abundance distributions have important implications for risk assessments and conservation planning in this era of rapid global change.

Human impacts in African savannas are mediated by plant functional traits

Tropical savannas have a ground cover dominated by C₄ grasses, with fire and herbivory constraining woody cover below a rainfall-based potential. The savanna biome covers 50% of the African continent, encompassing diverse ecosystems that include densely wooded Miombo woodlands and Serengeti grasslands with scattered trees. African savannas provide water, grazing and browsing, food and fuel for tens of millions of people, and have a unique biodiversity that supports wildlife tourism. However, human impacts are causing widespread and accelerating degradation of savannas. The primary threats are land cover-change and transformation, landscape fragmentation that disrupts herbivore communities and fire regimes, climate change and rising atmospheric CO₂ . The interactions among these threats are poorly understood, with unknown consequences for ecosystem health and human livelihoods. We argue that the unique combinations of plant functional traits characterizing the major floristic assemblages of African savannas make them differentially susceptible and resilient to anthropogenic drivers of ecosystem change. Research must address how this functional diversity among African savannas differentially influences their vulnerability to global change and elucidate the mechanisms responsible. This knowledge will permit appropriate management strategies to be developed to maintain ecosystem integrity, biodiversity and livelihoods.

A Socio-Ecological Approach for Identifying and Contextualising Spatial Ecosystem-Based Adaptation Priorities at the Sub-National Level

Climate change adds an additional layer of complexity to existing sustainable development and biodiversity conservation challenges. The impacts of global climate change are felt locally, and thus local governance structures will increasingly be responsible for preparedness and local responses. Ecosystem-based adaptation (EbA) options are gaining prominence as relevant climate change solutions. Local government officials seldom have an appropriate understanding of the role of ecosystem functioning in sustainable development goals, or access to relevant climate information. Thus the use of ecosystems in helping people adapt to climate change is limited partially by the lack of information on where ecosystems have the highest potential to do so. To begin overcoming this barrier, Conservation South Africa in partnership with local government developed a socio-ecological approach for identifying spatial EbA priorities at the sub-national level. Using GIS-based multi-criteria analysis and vegetation distribution models, the authors have spatially integrated relevant ecological and social information at a scale appropriate to inform local level political, administrative, and operational decision makers. This is the first systematic approach of which we are aware that highlights spatial priority areas for EbA implementation. Nodes of socio-ecological vulnerability are identified, and the inclusion of areas that provide ecosystem services and ecological resilience to future climate change is innovative. The purpose of this paper is to present and demonstrate a methodology for combining complex information into user-friendly spatial products for local level decision making on EbA. The authors focus on illustrating the kinds of products that can be generated from combining information in the suggested ways, and do not discuss the nuance of climate models nor present specific technical details of the model outputs here. Two representative case studies from rural South Africa demonstrate the replicability of this approach in rural and peri-urban areas of other developing and least developed countries around the world.

Antimicrobials in animal agriculture: parables and policy

In addition to the scientific, economic, regulatory and other policy factors that impact on antimicrobial decision-making in different jurisdictions around the world, there exist ethical, social and cultural bases for the contemporary use of these products in animal agriculture. Thus, the use of the word 'parable' to describe the contemporary moral stories that help to guide ethical antimicrobial use practices and broader policy decisions in animal agriculture is appropriate. Several of these stories reflect difficult decisions that arise from conflicting moral imperatives (i.e. both towards animal welfare and towards human health). Understanding the factors that combine to define the past and present paradigms of antimicrobial usage is crucial to mapping a path forward. There exist barriers, as well as opportunities, for advancing scenarios for reducing antimicrobial usage under a variety of voluntary, regulatory and legal policy frameworks. Any new approaches will ideally be structured to extend the use of present-day antimicrobials into the future, to provide novel alternatives for regulating any newly introduced antimicrobial products so as to maximize their useful life span and to ensure the optimal use of these products in animal agriculture to protect not only the health of animals and the interests of animal health/agriculture stakeholders, but also the human health and the interests of the public at large. A full range of policy approaches, which span the realm from strictly enforced regulations and laws to voluntary guidelines and compliance, should be explored with respect to their risks and benefits in a variety of worldwide settings and in full consideration of a range of stakeholder values.

To converge or not to converge in environmental space: testing for similar environments between analogous succulent plants of North America and Africa

BACKGROUND AND AIMS

Convergent evolution is invoked to explain similarity between unrelated organisms in similar environments, but most evaluations of convergence analyse similarity of organismal attributes rather than of the environment. This study focuses on the globular succulent plants of the Americas, the cacti, and their counterparts in Africa in the ice-plant, spurge and milkweed families. Though often held up as paragons of convergent morphological evolution, the environmental similarity of these plants has remained largely unexamined from a quantitative perspective.

METHODS

Five hotspots (centres of high species diversity of globular succulents) were selected, two in Mexico and three in South Africa. Their environments were compared using niche modelling tools, randomization tests of niche similarity and multivariate analyses to test for environmental similarity.

KEY RESULTS

Although the sites selected have 'similar' but unrelated life forms, almost all our results highlighted more climate differences than similarities between the hotspots. Interprediction of niches within and between continents, a niche equivalence test, and MANOVA results showed significant differences. In contrast, a niche similarity test showed that the comparisons of Cuatrociénegas-Richtersveld, Huizache-Knersvlakte and Huizache-Richtersveld were similar.

CONCLUSIONS

Differences in rainfall and temperature regimes and the potential effect of edaphic factors may be involved in the differences between the hotspots. In addition, differences in structure, morphology and physiology of the globular succulents may coincide with some of the climatic dissimilarities; i.e. given convergence as the evolution of similar morphologies under similar conditions, then it may be that differing environments diagnose inconspicuous morphological differences. Moreover, although fine-scale differences between sites were found, a coarser perspective shows that these sites are clearly similar as drylands with relatively moderate drought and mild temperatures, illustrating how all studies of convergence must address the issue of how similar two entities must be before they are considered convergent.

Life on the edge: rare and restricted episodes of a pan-tropical mutualism adapting to drier climates

• The fig tree-fig wasp obligate pollination mutualism has strong ancestral affinities with tropical communities, but is present in much drier contemporary biomes, especially at higher latitudes at the edge of their range. The extent to which adaptation to environmental variables is evolutionarily conserved and whether environmental differences function in ecological speciation of the mutualism are unknown. • Here we use climate models and phylogenetic reconstructions to test whether the Ficus-fig wasp mutualism has adapted and radiated into drier climates and led to ecological speciation in both plant and insect. • The results showed phylogenetic correspondence between closely related Ficus species with either savanna, forest, or riparian habitat categories, were most strongly explained by both climate and environmental variables. Rare episodes of adaptation to dry apotypic conditions have resulted in substantial radiations into savanna. • Inferences were consistent with predictions of niche conservatism and support the postulate that ecological speciation of the mutualism occurs, but under contrasting and intertwined circumstances among plant-pollinator adaptation and tolerance to the environment.

A fundamental, eco-hydrological basis for niche segregation in plant communities

• Ecologists still puzzle over how plant species manage to coexist with one another while competing for the same essential resources. The classic answer for animal communities is that species occupy different niches, but how plants do this is more difficult to determine. We previously found niche segregation along fine-scale hydrological gradients in European wet meadows and proposed that the mechanism might be a general one, especially in communities that experience seasonal saturation. • We quantified the hydrological niches of 96 species from eight fynbos communities in the biodiversity hotspot of the Cape Floristic Region, South Africa and 99 species from 18 lowland wet meadow communities in the UK. Niche overlap was computed for all combinations of species. • Despite the extreme functional and phylogenetic differences between the fynbos and wet meadow communities, an identical trade-off (i.e. specialization of species towards tolerance of aeration and/or drying stress) was found to cause segregation along fine-scale hydrological gradients. • This study not only confirms the predicted generality of hydrological niche segregation, but also emphasizes its importance for structuring plant communities. Eco-hydrological niche segregation will have implications for conservation in habitats that face changing hydrology caused by water abstraction and climate change.

Optimizing dispersal corridors for the Cape Proteaceae using network flow

We introduce a new way of measuring and optimizing connectivity in conservation landscapes through time, accounting for both the biological needs of multiple species and the social and financial constraint of minimizing land area requiring additional protection. Our method is based on the concept of network flow; we demonstrate its use by optimizing protected areas in the Western Cape of South Africa to facilitate autogenic species shifts in geographic range under climate change for a family of endemic plants, the Cape Proteaceae. In 2005, P. Williams and colleagues introduced a novel framework for this protected area design task. To ensure population viability, they assumed each species should have a range size of at least 100 km2 of predicted suitable conditions contained in protected areas at all times between 2000 and 2050. The goal was to design multiple dispersal corridors for each species, connecting suitable conditions between time periods, subject to each species' limited dispersal ability, and minimizing the total area requiring additional protection. We show that both minimum range size and limited dispersal abilities can be naturally modeled using the concept of network flow. This allows us to apply well-established tools from operations research and computer science for solving network flow problems. Using the same data and this novel modeling approach, we reduce the area requiring additional protection by a third compared to previous methods, from 4593 km2 to 3062 km , while still achieving the same conservation planning goals. We prove that this is the best solution mathematically possible: the given planning goals cannot be achieved with a smaller area, given our modeling assumptions and data. Our method allows for flexibility and refinement of the underlying climate-change, species-habitat-suitability, and dispersal models. In particular, we propose an alternate formalization of a minimum range size moving through time and use network flow to achieve the revised goals, again with the smallest possible newly protected area (2850 km2). We show how to relate total dispersal distance to probability of successful dispersal, and compute a trade-off curve between this quantity and the total amount of extra land that must be protected.

No forest left behind

Mitigating climate change by reducing deforestation should involve incentives for countries that currently have high forest cover and low deforestation rates.

Scalp ringworm in south-east London and an analysis of a cohort of patients from a paediatric dermatology department

BACKGROUND

Scalp ringworm or tinea capitis has become an increasingly important public health issue in the past decade in Great Britain. Recently, certain dermatology departments in London have seen a large increase in tinea capitis in all its forms.

OBJECTIVES

The aim of this paper is to present the detailed analysis of a cohort of 277 patients with tinea capitis seen during a 2-year period together with the latest local figures of tinea capitis cases from an inner city paediatric dermatology service. Methods Demographic, clinical and laboratory data were collected prospectively over 2 years from all cases of ringworm in patients seen in a paediatric clinic specially set up for scalp problems.

RESULTS

Sixty-two per cent of 277 cases of scalp ringworm were caused by Trichophyton tonsurans, occurring mainly (91%) in patients with Afro-Caribbean hair type, more often in boys (68%), and in the 3-8 year olds (70%). Only 7% of the patients had received appropriate treatment with oral griseofulvin. An additional 156 cases from the general paediatric dermatology clinic showed 91%T. tonsurans infections.

CONCLUSIONS

The prevalence of scalp ringworm appears to be reaching epidemic proportions in certain areas that include south-east London. The clinical problem is not yet well recognized by local general practitioners.

IgE-reactivity to seven Malassezia species

BACKGROUND

Malassezia yeasts play a role in the pathogenesis of atopic eczema/dermatitis syndrome (AEDS). The revised genus Malassezia includes several species which all are natural habitants of the human skin. In this study, we evaluated the presence of immunoglobulin E (IgE) antibodies to different Malassezia spp. in AEDS patients to allow optimization of the characterization of the IgE antibody profile of IgE-associated AEDS.

METHODS

Ninety-six adult patients, with a clinical diagnosis of AEDS, were included in the study. Seventeen of the patients had IgE antibodies to M. sympodialis, ATCC 42132 (m70 ImmunoCAP, Pharmacia, Diagnostic AB, Uppsala, Sweden). The IgE antibodies to seven Malassezia spp. were measured and inhibition immunoblotting was performed to investigate whether M. sympodialis contains all the allergen components present in the other Malassezia spp.

RESULTS

Twenty per cent of 79 AEDS patients with a negative m70 ImmunoCAP test had IgE antibodies to at least one of the other six Malassezia spp. tested. Our inhibition studies indicated that Malassezia spp. to a great extent, share allergenic determinants. However, Malassezia species also contained species-specific allergens.

CONCLUSION

The use of only one species of Malassezia is not sufficient to detect all patients IgE sensitized to Malassezia. To obtain an optimal allergen preparation both common allergenic components as well as species-specific allergens have to be considered.

New chromogenic agar medium for the identification of Candida spp

A new chromogenic agar medium (Candida diagnostic agar [CDA]) for differentiation of Candida spp. is described. This medium is based on Sabouraud dextrose agar (Oxoid CM41) and contains (per liter) 40.0 g of glucose, 10.0 g of mycological peptone, and 15.0 g of agar along with a novel chromogenic glucosaminidase substrate, ammonium 4-(2-[4-(2-acetamido-2-deoxy-beta-D-glucopyranosyloxy)-3-methoxyphenyl]-vinyl)-1-(propan-3-yl-oate)-quinolium bromide (0.32 g liter(-1)). The glucosaminidase substrate in CDA was hydrolyzed by Candida albicans and Candida dubliniensis, yielding white colonies with deep-red spots on a yellow transparent background after 24 to 48 h of incubation at 37 degrees C. Colonies of Candida tropicalis and Candida kefyr were uniformly pink, and colonies of other Candida spp., including Candida glabrata and Candida parapsilosis, were white. CDA was evaluated by using 115 test strains of Candida spp. and other clinically important yeasts and was compared with two commercially available chromogenic agars (Candida ID agar [bioMerieux] and CHROMagar Candida [CHROMagar Company Ltd.]). On all three agars, colonies of C. albicans were not distinguished from colonies of C. dubliniensis. However, for the group containing C. albicans plus C. dubliniensis, both the sensitivity and the specificity of detection when CDA was used were 100%, compared with values of 97.6 and 100%, respectively, with CHROMagar Candida and 100 and 96.8%, respectively, with Candida ID agar. In addition, for the group containing C. tropicalis plus C. kefyr, the sensitivity and specificity of detection when CDA was used were also 100%, compared with 72.7 and 98.1%, respectively, with CHROMagar Candida. Candida ID agar did not differentiate C. tropicalis and C. kefyr strains but did differentiate members of a broader group (C. tropicalis, C. kefyr, Candida lusitaniae plus Candida guilliermondii); the sensitivity and specificity of detection for members of this group were 94.7 and 93.8%, respectively. In addition to the increased sensitivity and/or specificity of Candida detection when CDA was used, differentiation of colony types on CDA (red spotted, pink, or no color) was unambiguous and did not require precise assessment of colony color.

The lipophilic yeasts: state of the art and prospects

Malassezia yeasts (lipophilic yeasts), have been classified to include seven species. Although molecular methods such as sequencing of RNA and karyotyping were used to determine the species, traditional techniques are also being explored for their identification. These include studies of morphology and the utilization of individual lipids. Reports now show the predominance of individual species recovered from normal skin and from patients with diseases such as pityriasis versicolor and seborrhoeic dermatitis. The majority of systemic infections reported have been in the bloodstream of premature neonates. Clusters of cases have occurred and molecular techniques employed to study the epidemiology. With the development of discriminatory methods to determine individual species and strains present in disease and in nature, our understanding of the pathogenicity and the epidemiology of this genus can be advanced.

Tinea capitis in Europe: new perspective on an old problem

A survey of tinea capitis conducted under the auspices of the European Confederation of Medical Mycology showed that laboratories contributing to a voluntary scheme for reporting have recently been seeing a different pattern of scalp ringworm. The survey was conducted among 92 medical mycology laboratories across 19 European countries by postal questionnaire comparing the years 1987 with 1997. The survey shows an overall increase in the numbers of cases caused by anthropophilic infections, which, in 1997, were the dominant causes of scalp infection; the greatest increase was seen in laboratories covering urban populations and in African Caribbean children living in Europe. While the commonest infection remains Microsporum canis, the largest overall increase has been in Trichophyton tonsurans, which in 1997 was the second commonest cause of infection overall and the commonest in urban populations. The pattern of change is not uniform in Europe and while some cities have reported large increases in T. tonsurans others, e.g. in France, have seen more cases of infection due to T. soudanense and M. audouinii. While these figures do not necessarily reflect changes in the underlying prevalence of infection, the trends are important to recognize as the control measures for anthropophilic tinea capitis differ from those used in zoophilic infections. In particular there is a need for an increased level of surveillance and more advice on control given to primary care physicians, dermatologists and school health authorities.

A randomized comparison of 4 weeks of terbinafine vs. 8 weeks of griseofulvin for the treatment of tinea capitis

BACKGROUND

Tinea capitis is a common childhood infection that has recently become more frequent in urban areas in Europe and the U.S.A. The current licensed treatment in children is griseofulvin 10 mg kg(-1) daily, which is usually given for 6--8 weeks.

OBJECTIVES

To compare this treatment with a 4-week course of oral terbinafine.

METHODS

Terbinafine was given at the following doses: in children weighing < 20 kg, 62.5 mg daily; 20--40 kg, 125 mg daily; > 40 kg, 250 mg daily. Two hundred and ten children aged 2--16 years, with mycologically confirmed tinea capitis, were randomized to 4 weeks treatment with terbinafine or 8 weeks with griseofulvin, and followed for a total of 24 weeks to determine the difference between treatments with respect to short- and long-term efficacy and tolerability.

RESULTS

One hundred and forty-seven patients were evaluable (terbinafine 77, griseofulvin 70). Although the 4-week course of terbinafine resulted in a trend to more rapid clearance of tinea capitis, there were no statistically significant differences between the two drugs in terms of overall outcome or tolerability, apart from in a subgroup of patients with Trichophyton infections, and weighing > 20 kg, who responded better to terbinafine than to griseofulvin at 4 weeks. By contrast, there was a better response to griseofulvin than to terbinafine in patients with Microsporum audouinii infections.

CONCLUSIONS

Overall, the study showed that 4 weeks of treatment with oral terbinafine has similar efficacy to 8 weeks of treatment with griseofulvin for the management of tinea capitis in children.

Pityriasis versicolor with a unique clinical appearance

We experienced an atypical case of pityriasis versicolor with a unique clinical appearance and undescribed mycological features. Although Malassezia sp. was cultured from the keratotic material, the fungal elements observed in the material were not readily identified as Malassezia. The diagnosis was established with the aid of immunohistochemical and ultrastructural studies with the aetiological agent being identified as M. globosa.

Polymerase chain reaction and restriction fragment length polymorphism mediated detection and speciation of Candida spp causing intraocular infection

PURPOSE

To determine the usefulness of polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analysis in the identification and speciation of Candida spp that causes ocular infection.

METHODS

Oligonucleotide primers based on the cytochrome P450 L1 A1 demethylase gene were used to successfully amplify by PCR a single 1.0-kb and a single 500-bp DNA fragment from C. albicans, C. tropicalis, C. krusei, C. glabrata, C. parapsilosis, and C. pelliculosa genomic DNA. RFLPs within the PCR product were identified after restriction enzyme digestion.

RESULTS

The sensitivity of the amplification reaction after two rounds of PCR was 10 fg genomic C. albicans DNA or one copy of the gene. No amplification product was obtained when DNA from C. guilliermondii, Aspergillus fumigatus, Fusarium solani, human leukocytes, or 10 species of bacteria was used as a template. Experiments with spiked normal vitreous demonstrated equal sensitivity as long as the volume of vitreous did not exceed 20% of the total PCR volume. RFLP analysis of the PCR product generated from each species obtained from the first- and second-round amplification products enabled species identification after digestion with specific endonucleases. Application of the technique to four clinical samples was successful.

CONCLUSIONS

It is expected that the simplicity of the DNA extraction technique allied with the broad specificity of the outer primers for all ophthalmically relevant Candida spp and the sensitivity of the second-round PCR will aid in the detection of fungal DNA in small intraocular samples. PCR-RFLP analysis has great potential in the rapid detection and identification of Candida spp and in the provision of a useful laboratory tool for the future.

An epidemic of Malassezia pachydermatis in an intensive care nursery associated with colonization of health care workers' pet dogs

BACKGROUND

Malassezia species are lipophilic yeasts that are emerging as nosocomial pathogens, particularly in low-birth-weight neonates who receive lipid emulsions. When a cluster of patients with Malassezia pachydermatis infection was identified in an intensive care nursery, we initiated an investigation.

METHODS

A case patient was defined as any infant in the intensive care nursery who had a positive culture for M. pachydermatis between October 17, 1993, and January 18, 1995. We conducted a cohort study to identify risk factors for colonization and infection with M. pachydermatis. We collected cultures from the infants and the health care workers and from the health care workers' pets, since this organism has been associated with otitis externa in dogs.

RESULTS

Fifteen infants met the case definition: eight with bloodstream infections, two with urinary tract infections, one with meningitis, and four with asymptomatic colonization. The case patients were significantly more likely than the other infants to weigh 1300 g or less (15 of 65 vs. 0 of 419, P<0.001). In a multivariate analysis of infants weighing 1300 g or less, the independent risk factors for colonization or infection with M. pachydermatis were a greater severity of concomitant illness (odds ratio, 19.7; P=0.001), arterial catheterization for nine or more days (odds ratio, 29.5; P=0.027), and exposure to Nurse A (odds ratio, 74.7; P=0.004). In a point-prevalence survey, 9 additional infants, 1 health care worker, and 12 of the health care workers' pet dogs had positive cultures for M. pachydermatis. The isolates from all 15 case patients, the 9 additional colonized infants, 1 health care worker, and 3 of the 12 dogs had identical patterns of restriction-fragment-length polymorphisms.

CONCLUSIONS

In this outbreak, it is likely that M. pachydermatis was introduced into the intensive care nursery on health care workers' hands after being colonized from pet dogs at home. The organism persisted in the nursery through patient-to-patient transmission.

Tinea capitis in south-east London--a new pattern of infection with public health implications

Recent observations on tinea capitis cases in London suggest that there has been a change in the pattern of infection with a recent and significant rise in the incidence of infections due to anthropophilic fungi. The purpose of this study was to investigate the prevalence and identity of tinea capitis in schools in south-east London and factors which might affect the spread of infection. This was achieved by carrying out a survey of all children, with parental consent for scalp examination, in 14 nursery, infant or junior schools in Lambeth. In addition, the accuracy of clinical diagnosis was compared with mycological findings. There were 1057 children from 4 to 14 years of age in the study. The infection rate in different schools ranged from 0 to 12% with a mean of 2.5%. A further 4.9% of children were scalp carriers of dermatophytes (range in classes 0-47%). A striking feature was that all infections were caused by anthropophilic fungi, mainly Trichophyton tonsurans or Microsporum rivalieri, and there was a correlation between the presence of two or more carriers within a class and the infection in the other children. There was a poor correlation between ability of trained observers to predict infection on clinical grounds and mycological results. This investigation shows variable but significant levels of scalp ringworm in schools and that the dominant organisms are anthropophilic. It provides support for the observation that there has been a shift in the pattern of tinea capitis in London and, possibly, other U.K. centres, with a trend towards more infections transmissible among children, with T, tonsurans being the commonest organism. The implications for control, which involve screening in schools, where appropriate, and guidance to general practitioners on treatment, are discussed.

The genus Malassezia with description of four new species

The genus Malassezia has been revised using morphology, ultrastructure, physiology and molecular biology. As a result the genus has been enlarged to include seven species comprising the three former taxa M. furfur, M. pachydermatis and M. sympodialis, and four new taxa M. globosa, M. obtusa, M. restricta and M. slooffiae. The descriptions of all the species include morphology of the colonies and of the cells, together with ultrastructural details. The physiological properties studied were the presence of catalase, the tolerance of 37 degrees C and the ability to utilize certain concentrations of Tween 20, 40, 60 and 80 as a source of lipid in a simple medium. Information is given for each of the taxa on mole% GC and also the rRNA sequence from the comparison previously described for the genus.

Nail infections

The increasing prevalence of onychomycoses, along with the wider range of organisms now recognized as potential pathogens, necessitates the accurate laboratory identification of the specific fungus involved. Although the majority of infections still are caused by dermatophyte and Candida species, many other nondermatophyte molds, such as Scytalidium dimidiatum, have been shown to be common agents of disease in certain geographic areas. It is well recognized that infections by nondermatophytes such as Scopulariopsis, Acremonium, and Aspergillus species occur worldwide. The availability of a range of new antifungal agents with various spectra of activity means that the exact identification of the pathogen is necessary to select the optimum treatment.

HIV disease and Malassezia yeasts: a quantitative study of patients presenting with seborrhoeic dermatitis

Seborrhoeic dermatitis (SD) is a disease that affects 1-3% of the general population, 3-5% of young adults and 20-83% of patients with AIDS. Malassezia yeasts have been associated with the pathogenesis of this condition. The association between the Malassezia yeasts and HIV-related SD is still a controversial subject. The objective of our study was to investigate the role of Malassezia yeasts in the pathogenesis of SD in the HIV population comparing the number of yeasts' cells with the severity of the disease and degree of immunosuppression. We used two quantitative counting methods: direct counting with Sellotape-stripped skin and recovery of the yeasts in culture using contact plates. This investigation has demonstrated that there is a trend between numbers of yeasts present on lesional skin, severity of SD and CD4-positive T lymphocytes count in HIV-positive patients. No quantitative differences were observed between HIV-related and non-HIV related SD.

Adherence of Malassezia isolates to human keratinocytes in vitro--a study of HIV-positive patients with seborrhoeic dermatitis

Adherence of Malassezia yeast cells to human keratinocytes was assessed by a novel technique using double-sided Sellotape. Although adherence using double-sided Sellotape is still merely a model for in vivo adherence, it approximates to the conditions found on the skin surface. There were no differences in adhesive properties to human keratinocytes between Malassezia strains originating from HIV-positive and HIV-negative patients with seborrhoeic dermatitis, nor was there a relationship between the severity of seborrhoeic dermatitis and in vitro adherence to human keratinocytes.

Mycology of nail disorders

Cases of onychomycosis represent up to 30% of diagnosed superficial fungal infections and are caused by three groups of fungi: dermatophytes, yeasts, and nondermatophytic molds. The majority of toenail infections are caused by dermatophytes; Trichophyton rubrum is isolated with the greatest frequency. In infections of fingernails, Candida species can be isolated as frequently as the dermatophytes. Of the molds, Scytalidium species can infect both fingernails and toenails, as well as adjacent skin, and represent 3% of the nail infections in a temperate country such as the United Kingdom but a much higher proportion in tropical countries. Other molds such as Scopulariopsis, Acremonium, and Aspergillus species can infect damaged nails. The isolation of a dermatophyte is always considered indicative of infection, but the presence of other molds, which may be aerial contaminants, must be interpreted with care.

Nosocomial Malassezia pachydermatis bloodstream infections in a neonatal intensive care unit

Malassezia pachydermatis, a lipophilic yeast, has been described to cause sporadic nosocomial bloodstream infections (BSI). Nosocomial outbreaks of M. pachydermatis BSI have never been described. A cluster of M. pachydermatis BSIs in the neonatal intensive care unit at Louisiana State University Medical Center, University Hospital provided the opportunity to investigate the epidemiology of this organism and apply molecular epidemiologic typing techniques. A case-patient was defined as any neonatal intensive care unit patient in University Hospital with a blood culture positive for M. pachydermatis from January 1, 1989, through August 15, 1991. Five patients met the case definition. Case-patients were premature as estimated by gestational age and required prolonged hospitalization. Case-patients received parenteral nutrition and intravenous lipids for twice as many days as randomly selected controls. No environmental source of M. pachydermatis was identified; however, infants on each side of a previously identified M. pachydermatis-colonized infant became colonized with M. pachydermatis during a 20-day period. Chromosomal analysis of five M. pachydermatis blood isolates from two case-patients had identical banding patterns. These data show that M. pachydermatis can cause nosocomial BSI outbreaks, that premature infants receiving parenteral nutrition and/or lipids may be at greatest risk and that transmission is most likely from person to person, probably via the hands of medical personnel.

Karyotypes of oval cell forms of Malassezia furfur

Karyotypes of different morphological forms of oval cell types of Malassezia furfur (previously called Pityrosporum ovale) were examined by pulsed-field gel electrophoresis. All strains produced patterns containing seven chromosome bands. These patterns could be separated into three distinct groups, which appeared to correlate with groups based on morphology.

The social context of vocational rehabilitation for ex-psychiatric patients

The main task of vocational rehabilitation facilities is to help people to return to work or, if they have never worked, to find a job for the first time. In the past seven years controversy has surfaced with regard to the role vocational rehabilitation plays in the economy. Some authors have claimed that it implicitly supports an ideology of individualism which actually acts against the interests of people with mental health problems looking for work. While accepting the need to offer a work adjustment service, these writers make a case for further socio-political intervention to help clients. The purpose of this article is to explore some of these ideas and examine their practical implications.

Ketoconazole in the treatment of blepharitis

A double masked, placebo controlled clinical trial, of topical 2% ketoconazole cream with lid hygiene, for the treatment of seborrhoeic and mixed seborrhoeic/staphylococcal blepharitis was conducted. Forty patients with symptomatic blepharitis, 20 randomly allocated to ketoconazole, 20 to placebo were entered. Treatment efficacy was assessed by improvement of symptoms using visual analogue scales, appearance of the eyelids and reduction in numbers of pityrosporum yeasts on the eyelids. Both groups showed a similar reduction in symptoms, and signs of inflammation. The overall clinical impression in the ketoconazole group was better at week five than in the placebo group. Sixty nine per cent were either normal or markedly improved, as compared to 42% in the placebo group, although this was not statistically significant (p less than 0.1, one-sided Mann-Whitney). Pityrosporum numbers were reduced significantly in both groups during the treatment period. Ketoconazole was no better than placebo at improving the symptoms of blepharitis. More ketoconazole treated patients had normal or markedly improved lids after treatment than the placebo group. Pityrosporum yeasts may play a role in blepharitis, and treatment with an antifungal has some advantages over conventional therapy.

Onychomycosis caused by Trichophyton equinum

A case of onychomycosis caused by Trichophyton equinum affecting the right thumbnail of a 13-year-old girl is described. Trichophyton equinum appears to be an extremely rare cause of nail infection.

UVA sunbeds: tanning, photoprotection, acute adverse effects and immunological changes

The effects on 31 normal subjects following exposure to sunbeds containing UVA lamps with minimal UVB emission have been compared in a double-blind study with the effects on nine control subjects of a similar exposure course three times weekly for 4 weeks to sunbeds emitting visible light. On previously untanned areas, all those subjects on active treatment developed a mild tan; in tanned areas they all developed a moderate tan, while all control subjects developed a minimal to mild tan. The mean protection factor against later UVB-induced erythema was 3.2 +/- 0.3 after the active course and 1.6 +/- 0.2 among the controls. Significantly more frequent adverse cutaneous effects for active subjects were pruritus, erythema, freckling, burning sensation, dryness and polymorphic light eruption. Cutaneous Langerhans cell numbers, and blood CD3+ (pan T-cell) and CD4+ (helper T-cell) lymphocyte subsets were reduced in both active and control groups. CD8+ (cytotoxic/suppressor T-cell) counts were similarly but not significantly reduced in both groups. Pityrosporum yeast counts were significantly reduced in both groups. The changes found in both groups seem attributable to small amounts of UVB emission from both active and control lamps.