Clinical presentations and outcomes of HIV-1 and HIV-2 among infected children in Guinea-Bissau: a nationwide study

OBJECTIVES

Disease progression, loss to follow-up, and mortality of HIV-2 compared with HIV-1 in children is not well understood. This is the first nationwide study reporting outcomes in children with the two HIV types in Guinea-Bissau.

STUDY DESIGN

Nationwide retrospective follow-up study.

METHODS

This is a retrospective follow-up study among HIV-infected children <15 years at nine ART centers from 2006 to 2021. Baseline parameters and disease outcomes for children with HIV-2 and HIV-1 were compared.

RESULTS

The annual number of children diagnosed with HIV peaked in 2017. HIV-2 (n = 64) and HIV-1 (n = 1945) infected children were different concerning baseline median age (6.5 vs 3.1 years, P < 0.01), but had similar levels of severe immunodeficiency (P = 0.58) and severe anemia (P = 0.26). Within the first year of follow-up, 36.3% were lost, 5.9% died, 2.7% had transferred clinic, and 55.2% remained for follow-up. Mortality (HR = 1.05 95% CI: 0.53-2.08 for HIV-2) and attrition (HR = 0.86 95% CI: 0.62-1.19 for HIV-2) rates were similar for HIV types.

CONCLUSIONS

The decline in children diagnosed per year since 2017 is possibly due to lower HIV prevalence, lack of HIV tests, and the SARS-CoV-2 epidemic. Children with HIV-2 were twice as old as HIV-1 infected when diagnosed, which suggests a slower disease progression. However, once they develop immunosuppression mortality is similar.

Liquid-cell transmission electron microscopy for imaging of thermosensitive recombinant polymers

Various polymers used in controlled release applications exhibit solution-based thermal responses. Unfortunately, very few characterization and imaging techniques permit resolution of individual polymers during their thermally-triggered phase transitions. Here, we demonstrate the use of temperature-ramp liquid-cell transmission electron microscopy (LCTEM) for real-time evaluation of the solution and interfacial behavior of elastinlike polypeptides (ELPs) and their self-assembled nanostructures over a temperature range incorporating their intrinsic lower critical solution temperatures (LCSTs). Individual polymers and supramolecular assemblies were discriminated dependent upon solubility states. The recombinant polymers were shown to adsorb to the silicon-nitride chip window from the buffered saline solution and desorb in a temperature-dependent manner. Silk-elastinlike protein block copolymers (SELPs) (composed of repeat peptide motifs of silk and elastin) differed from ELPs in thermal behavior. While both polymers were shown to cluster, only SELPs formed robust amyloid-like fibers upon heating.

Location of stimuli-responsive peptide sequences within silk-elastinlike protein-based polymers affects nanostructure assembly and drug-polymer interactions

Silk-elastinlike protein polymers (SELPs) self-assemble into nanostructures when designed with appropriate silk-to-elastin ratios. Here, we investigate the effect of insertion of a matrix metalloproteinase-responsive peptide sequence, GPQGIFGQ, into various locations within the SELP backbone on supramolecular self-assembly. Insertion of the hydrophilic, enzyme-degradable sequence into the elastin repeats allows the formation of dilution-stable nanostructures, while insertion into the hydrophobic silk motifs inhibited self-assembly. The SELP assemblies retained their lower critical solution temperature (LCST) thermal response, allowing up to eightfold volumetric changes due to temperature-induced size change. A model hydrophobic drug was incorporated into SELP nanoassemblies utilising a combination of precipitation, incubation and tangential flow filtration. While the nanoconstructs degraded in response to MMP activity, drug release kinetics was independent of MMP concentration. Drug release modelling suggests that release is driven by rates of water penetration into the SELP nanostructures and drug dissolution. In vitro testing revealed that SELP nanoassemblies reduced the immunotoxic and haemolytic side effects of doxorubicin in human blood while maintaining its cytotoxic activity.

A dual-functional Embolization-Visualization System for Fluorescence image-guided Tumor Resection

Rationale: Intraoperative bleeding impairs physicians' ability to visualize the surgical field, leading to increased risk of surgical complications and reduced outcomes. Bleeding is particularly challenging during endoscopic-assisted surgical resection of hypervascular tumors in the head and neck. A tool that controls bleeding while marking tumor margins has the potential to improve gross tumor resection, reduce surgical morbidity, decrease blood loss, shorten procedure time, prevent damage to surrounding tissues, and limit postoperative pain. Herein, we develop and characterize a new system that combines pre-surgical embolization with improved visualization for endoscopic fluorescence image-guided tumor resection. Methods: Silk-elastinlike protein (SELP) polymers were employed as liquid embolic vehicles for delivery of a clinically used near-infrared dye, indocyanine green (ICG). The biophysical properties of SELP, including gelation kinetics, modulus of elasticity, and viscosity, in response to ICG incorporation using rheology, were characterized. ICG release from embolic SELP was modeled in tissue phantoms and via fluorescence imaging. The embolic capability of the SELP-ICG system was then tested in a microfluidic model of tumor vasculature. Lastly, the cytotoxicity of the SELP-ICG system in L-929 fibroblasts and human umbilical vein endothelial cells (HUVEC) was assessed. Results: ICG incorporation into SELP accelerated gelation and increased its modulus of elasticity. The SELP embolic system released 83 ± 8% of the total ICG within 24 hours, matching clinical practice for pre-surgical embolization procedures. Adding ICG to SELP did not reduce injectability, but did improve the gelation kinetics. After simulated embolization, ICG released from SELP in tissue phantoms diffused a sufficient distance to deliver dye throughout a tumor. ICG-loaded SELP was injectable through a clinical 2.3 Fr microcatheter and demonstrated deep penetration into 50-µm microfluidic-simulated blood vessels with durable occlusion. Incorporation of ICG into SELP improved biocompatibility with HUVECs, but had no effect on L-929 cell viability. Principle Conclusions: We report the development and characterization of a new, dual-functional embolization-visualization system for improving fluorescence-imaged endoscopic surgical resection of hypervascular tumors.

Temperature-responsive silk-elastinlike protein polymer enhancement of intravesical drug delivery of a therapeutic glycosaminoglycan for treatment of interstitial cystitis/painful bladder syndrome

Interstitial cystitis (IC), also known as painful bladder syndrome, is a debilitating chronic condition with many patients failing to respond to current treatment options. Rapid clearance, mucosal coating, and tight epithelium create strong natural barriers that reduce the effectiveness of many pharmacological interventions in the bladder. Intravesical drug delivery (IDD) is the administration of therapeutic compounds or devices to the urinary bladder via a urethral catheter. Previous work in improving IDD for IC has focused on the sustained delivery of analgesics within the bladder and other small molecule drugs which do not address underlying inflammation and bladder damage. Therapeutic glycosaminoglycans (GAG) function by restoring the mucosal barrier within the bladder, promoting healing responses, and preventing irritating solutes from reaching the bladder wall. There is an unmet medical need for a therapy that provides both acute relief of symptoms while alleviating underlying physiological sources of inflammation and promoting healing within the urothelium. Semi-synthetic glycosaminoglycan ethers (SAGE) are an emerging class of therapeutic GAG with intrinsic anti-inflammatory and analgesic properties. To reduce SAGE clearance and enhance its accumulation in the bladder, we developed a silk-elastinlike protein polymer (SELP) based system to enhance SAGE IDD. We evaluated in vitro release kinetics, rheological properties, impact on bladder function, pain response, and bladder inflammation and compared their effectiveness to other temperature-responsive polymers including Poloxamer 407 and poly(lactic-co-glycolic acid)-poly(ethylene glycol). SAGE delivered via SELP-enhanced intravesical delivery substantially improved SAGE accumulation in the urothelium, provided a sustained analgesic effect 24 h after administration, and reduced inflammation.

Fever increases heart rate and respiratory rate; a prospective observational study of acutely admitted medical patients

BACKGROUND

The relationship between increase in body temperature, heart rate, and respiratory rate has only been studied in young, healthy subjects.

AIM

To show the changes in heart and respiratory rate associated with fever in acutely admitted medical patients.

DESIGN

A prospective observational cohort study.

METHODS

Vital parameters from 4,493 patients were retrospectively extracted. Linear and multiple variable regression analysis was used to calculate the change in heart and temperature rate for every degree rise in temperature (i.e. ΔHR/°C and ΔRR/°C) in the entire study group and in those with low (<36.1°C), normal (36.1-38°C) and high (>38°C) body temperatures.

RESULTS

The ΔHR/°C and ΔRR/°C was 7.2±0.4 beats per minute (bpm) and 1.4 ±0.1 (1.2 to 1.62) breaths per minute (bpm). Adjusting for age, oxygen saturation and mean blood pressure, the results were 6.4±0.4 (5.7 to 7.1) bpm and 1.2±0.1 (1.0 to 1.4) bpm. In low, normal and high body temperature the ΔHR/°C were 2.7±1.9, 6.9±1.9 and 7.4±0.9 bpm, respectively; for ΔRR/°C the values were -0.5±0.5, 1.5±0.5 and 2.3±0.3 bpm, respectively.

CONCLUSIONS

We only found a modest association between fever and changes in heart rate and respiratory rate.

Matrix-metalloproteinases as targets for controlled delivery in cancer: An analysis of upregulation and expression

While commonly known for degradation of the extracellular matrix, matrix metalloproteinases (MMPs) exhibit broad potential for use in targeting of bioactive and imaging agents in cancer treatment. MMPs are upregulated at all stages of expression in cancers. A comprehensive analysis of published literature on expression of all MMP subtypes at the genetic, protein, and activity levels in normal and diseased tissues indicate targeting applicability in a variety of cancers. This expression significantly increases at advanced cancer stages, providing an improved opportunity for controlled release in higher-stage patients. Since MMPs are integral at every stage of metastasis, MMP roles in cancer are discussed with a focus on MMP distribution and mobility within cells and tumors for cancer targeting applications. Several strategies for MMP utilization in targeting - such as matrix degradation, MMP cleavage, MMP binding, and MMP-induced environmental changes - are addressed.

Hypoglycaemia in adults with insulin-treated diabetes in the UK: self-reported frequency and effects

AIM

Few real-life studies of non-severe (self-treated) hypoglycaemic events are available. This survey quantified the self-reported frequency of non-severe hypoglycaemia and its effects in adults with insulin-treated diabetes in the UK.

METHODS

Adults aged > 15 years with Type 1 diabetes or insulin-treated Type 2 diabetes completed ≤ 4 weekly questionnaires (7-day recall). Respondents with Type 2 diabetes were grouped by insulin regimen: basal-only, basal-bolus and 'other'.

RESULTS

Overall, 1038 respondents (466 with Type 1 diabetes, 572 with Type 2 diabetes) completed 3528 questionnaires. Mean numbers of non-severe events per week were 2.4 (Type 1 diabetes; median = 2) and 0.8 (Type 2 diabetes; median = 0); 23% and 26% of non-severe events occurred at night, respectively. Fatigue and reduced alertness were the commonest issues following events (78% and 51% of respondents, respectively). The effects of nocturnal events persisted longer than those of daytime events: Type 1 diabetes = 10.6 vs. 4.9 h (P = 0.0002); Type 2 diabetes = 15.3 vs. 5.1 h (P < 0.0001). In the week following an event, respondents' blood glucose measurements increased by 4.3 (Type 1 diabetes; 12% increment) and 4.2 (Type 2 diabetes; 21% increment) tests/week. In employed respondents, 20% of events caused work-time loss, more so following nocturnal (vs. daytime) hypoglycaemia: Type 1 diabetes = 2.7 vs. 1.1 h (P = 0.0184); Type 2 diabetes = 2.5 vs. 1.6 h (P = 0.1340). Most respondents rarely/never informed healthcare professionals about events (Type 1 diabetes = 82%, Type 2 diabetes = 69%).

CONCLUSIONS

Non-severe hypoglycaemia is common in adults with insulin-treated diabetes in the UK, with consequent health-related/economic effects. Communication about non-severe hypoglycaemia is limited and the burden of hypoglycaemia may be underestimated.

Bacteriophage aerosol challenge of installed air contamination control systems

The effectiveness of installed air contamination control systems for removal of airborne microorganisms was determined. Seven separate systems were challenged with aerosolized T1 bacteriophage. Air samples were collected with Andersen samplers containing agar plates that had been swabbed with susceptible Escherichia coli. The advantages of using bacteriophage for testing air-handling systems are discussed. The air systems employed both filtration and ultraviolet irradiation and air-flow rates varied from 600 to 18,000 ft/min. Reduction rates of airborne bacteriophage passing through the various air systems ranged from 99.8 to 99.99%.

The Outpatient Developmental Services Project: integration of pediatric psychology with primary medical care for children infected with HIV

OBJECTIVE

To present a model in which pediatric psychology services are programmatically integrated into the primary care of children seen in a special immunology program. The program centers around serial neurodevelopmental/neuropsychological evaluation of children infected with HIV.

METHOD

We describe the population served and the particular services provided, with specific focus on how the program was developed. We include a discussion of the barriers to service provision that have been encountered and the strategies employed to overcome these challenges.

CONCLUSIONS

This approach, while not ideal, serves as a good example of how pediatric psychology can merge with primary medical care to maximize the benefits of both specialties for a patient population that is underserved in many respects.

Single-dose spinal anaesthesia versus incremental dosing for lower limb vascular surgery

BACKGROUND

In patients scheduled for vascular surgery, atherosclerotic disease is highly prevalent. Haemodynamic reactions are often aggravated when spinal analgesia is used in this population. No randomized studies have been conducted comparing single shot (SS) with continuous spinal analgesia (CSA) for vascular patients. We did a prospective randomized study comparing haemodynamics when SS versus CSA was performed.

METHODS

Sixty patients were randomized to have SS or CSA. The power of the study was 0.90. Patients in the SS group received 17.5 mg bupivacaine and in the CSA group 5 mg was given initially and incremental doses of 2.5 mg were given until an analgesic level of T-11 was reached. Mean arterial pressures (MAP) were measured invasively. ST-analysis was done continuously. Postoperatively, the patients were interviewed using a standardized questionnaire. Back pain, neurologic sequelae and post-dural puncture headache (PDPH) were investigated.

RESULTS

There was no significant difference between the analgesic levels (T-7/T-8), the decrease in MAP, the number of patients needing ephedrine and the total amount of ephedrine given in the two groups. The motor blockade was more pronounced in the SS group (P < 0.001) and the total amount of bupivacaine used was 17.5 mg compared to 7.5 mg (5-17.5) in the CSA group (P < 0.001). One patient suffered PDPH which was slight and responded to a nonsteroidal anti-inflammatory drug. Two patients in each group had transient paraesthesias in the legs. There were technical problems with the spinal catheter in 4 patients, and these were excluded from the study.

CONCLUSION

In this study we found no difference in the haemodynamic response to SS or CSA in patients scheduled for vascular surgery of the legs. SS is easier to apply and is recommended when the duration of surgery allows for it.

Colicin V38 and microcin C38 produced by Escherichia coli strain 38

Escherichia coli strain 38, an isolate from turkeys, has been previously shown to produce one or more broad-spectrum bacteriocins against other related enteric bacteria. Using a collection of E. coli strains that synthesized well-characterized colicins or microcins, along with a set of colicin/microcin-insensitive mutants, we were able to classify the bacteriocins produced by strain 38. We determined that strain 38 produced a microcin (microcin C38) and a colicin (colicin V38) and that the amount of microcin C38 depended on the type of media on which it was grown. Escherichia coli strain 38 was found to have cross-immunity with the microcin C7-producing strain MC4100 and with the colicin V-producing strain 4674. OmpF mutant cells were found to be insensitive to microcin C38, whereas colicin V38 was not active on cells that had a cir mutation. Both microcin C38 and colicin V38 were inactivated by proteases. Microcin C38 was stable at extremes of pH (pH 1.5 and pH 13) and heat (10 min at 98 C) conditions, whereas colicin V38 was not. In addition, microcin C38 was found to be active against a broader spectrum of gram-negative bacteria than was colicin V38.

Correlation between level of (n - 3) polyunsaturated fatty acids in brain phospholipids and learning ability in rats. A multiple generation study

The effects of dietary n - 3 polyunsaturated fatty acids (PUFAs) on major brain phospholipids were examined in the rat throughout four generations. Dietary fats were: a seal oil (22:6(n - 3) located mainly in the sn-1/3-position of the TG); a fish oil (22:6(n - 3) located mainly in the sn-2 position of the TG); or a vegetable oil containing 18:3(n - 3). The effect of the TG structure of the dietary fat and chain length of n - 3 PUFA on assimilation in the brain was compared with chow fed rats. The rats fed marine fats had significantly higher levels of long-chain n - 3 PUFAs in brain PE and PS, compared to the vegetable oil and chow fed rats, but no effects of TG structure of dietary fat were observed. Dietary 18:3(n - 3) raised the amount of 22:6(n - 3) compared to the control group, but not to the levels of the marine groups that received preformed 22:6(n - 3). Fish oil fed rats had higher levels of 20:5(n - 3) and 22:5(n - 3) compared with the seal oil fed rats, whereas 22:6(n - 3) were similar. Only minor changes in PI, PIP, and PIP2 were found. The fourth generation was tested for spatial learning ability in a Morris water maze. The experimental groups had similar learning abilities, which were increased compared to the control group.

Influence of triacylglycerol structure and fatty acid profile of dietary fats on milk triacylglycerols in the rat. A two-generation study

We investigated the influence of dietary fatty acid profile and triacylglycerol structure on the fatty acid profile and triacylglycerol structure of milk lipids in two generations of rats. Three groups of rats received diets containing 20% fat of which approximately 20% was n-3 fatty acids located in different positions of the triacylglycerol: a fish oil-based diet [docosahexaenoic acid (22:6n-3) predominantly in the sn-2 position], a seal oil-based diet (22:6n-3) predominantly in the sn-1/sn-3 position, or a plant oil-based diet [alpha-linolenic acid (18:3n-3) distributed evenly between the three positions]. This design allowed us to investigate (i) the effect of the triacylglycerol structure of the dietary fat; (ii) the effect of receiving the n-3 fatty acids as long-chain derivatives or as the precursor, 18:3n-3; and (ii) the long-term effects over two generations. The fatty acid profiles of the milk lipids largely reflected the diets, but in the second generation, the level of medium-chain fatty acids was higher (P < 0.05) in the milk from rats fed the fish oil diet (24%) compared with the other dietary groups (15 and 18%). This suggests an increased endogenous synthesis of fatty acids in the mammary glands of the fish oil-fed rats. The levels of long-chain n-3 fatty acids in milk were higher (P < 0.05) in rats fed marine oils (8-12%) compared with rats fed vegetable oil (1%) in both generations. The level of long-chain n-3 fatty acids was significantly higher in the milk from the fish oil-fed rats (12.3%) compared to the seal- oil fed rats (8.0%) in the first generation, but not in the second generation (8.9 vs. 9.1%). The general structure of milk triacylglycerols was maintained in the three experimental groups with 16:0 acylated in the sn-2 position and 18:1 in the sn-1/sn-3 positions. The triacylglycerol structure of mammalian milk appears to be conserved even during extreme dietary manipulation over two generations and an extensive enrichment with long-chain n-3 polyunsaturated fatty acids requires their presence in the diet.

Intestinal absorption of octanoic, decanoic, and linoleic acids: effect of triglyceride structure

The influence of triglyceride structure on the intestinal absorption of specific triglycerides was investigated. A bolus of either a structured or a randomized oil was given to lymph-cannulated rats. The structured oil contained medium-chain fatty acids (MCFA) in the sn-1 and sn-3 position of the triglyceride, and linoleic acid (C18:2 n-6) in the sn-2 position, whereas in the randomized oil the same fatty acids were distributed randomly between the three positions. The absorption of MCFA was highest from the randomized oil, where approximately 33% of the MCFA were located in the sn-2 position. The absorption of C18:2 n-6 was highest from the structured oil, where C18:2 n-6 is located in the sn-2 position, indicating that the intestinal absorption is influenced by triglyceride structure, and that the absorption is enhanced for fatty acids located in the sn-2 position. Prior to lymph collection, the rats were fed either a fish oil or a vegetable oil diet. The absorption of C18:2 n-6 was highest in the rats previously fed the fish oil diet. The incorporation of the highly unsaturated fatty acids from the fish oil into the membrane phospholipids may thus influence the absorption of fat.

Staphylococcosis of turkeys. 6. Development of penicillin resistance in an interfering strain of Staphylococcus epidermidis

Staphylococcus epidermidis strain 115, used as an interfering agent to help reduce the incidence of staphylococcosis in turkeys, was converted into a penicillin- and chloramphenicol-resistant strain designated 115R. This was accomplished by introducing a plasmid carrying the beta-lactamase (penicillinase) and chloramphenicol-resistance genes into S. epidermidis 115 by electroporation. The resultant strain, 115R, was an efficient producer of beta-lactamase and had marked increased resistance to penicillin and chloramphenicol. A beta-lactamase DNA probe was used to confirm the presence of the beta-lactamase gene in strain 115R. S. epidermidis strain 115R retained the characteristics of tissue adherence, bacteriocin production, and non-virulence that were present in the original non-transformed strain 115, and in addition should theoretically remain colonized in poults following treatment with penicillin.

Occlusive laryngotracheitis in turkeys following drinking water administration of gentian violet

Acute respiratory signs and increased mortality due to suffocation occurred in a flock of 5-week-old male turkey poults following water administration of gentian violet. Gross lesions of laryngeal edema and occlusion of the tracheal opening with caseous plugs were present. Microscopic lesions in the tracheas consisted of vascular congestion, mucosal degeneration, and necrosis. The condition was reproduced experimentally in turkey poults by giving drinking water containing gentian violet.

An outbreak of meningo-encephalitis in fallow deer caused by Listeria monocytogenes

An outbreak of listeric meningo-encephalitis occurred in a population of 1800 fallow deer (Dama dama) in a park during the winter and early spring of 1985 to 1986. Listeriosis was diagnosed in 41 of 42 fallow deer that showed the typical central nervous system signs of circling disease or were found dead. The diagnosis was verified by bacteriological examination of the brains of 35 animals. In five of the seven remaining cases listeriosis was diagnosed by histological examination, and in one animal by clinical signs alone. Listeria monocytogenes was isolated in three of 23 soil samples taken from the park. In addition, L monocytogenes was isolated from the intestinal contents of apparently normal fallow deer. Fifty isolates from animals and soil were serotyped and all of them belonged to serovar 4b except one from brain (serovar 1/2b) and three from intestinal contents (serovar 1/2a). In phage typing of 54 isolates, the 35 isolates from the brain and spleen of diseased animals belonged to the same lysovar, as did most isolates from other sources, but strains from intestinal contents belonged to three other phage types. No external source of L monocytogenes was demonstrated in the outbreak and stress due to the poor beech-mast crop, an increased stocking rate and a sudden change in the weather are suspected as predisposing factors.

Staphylococcosis of turkeys. 3. Bacterial interference as a possible means of control

Two Staphylococcus epidermidis isolates from turkeys were used as interfering agents to help control staphylococcosis. Both isolates adhered to tissues of the turkeys' respiratory tract, interfered with attachment of virulent S. aureus, produced bacteriocins bacteriocidal to S. aureus, and were avirulent for turkeys. About 200,000 turkeys in commercial flocks were exposed to aerosols of these interfering isolates between 1 and 6 weeks of age, and many became colonized with these bacteria. The aerosol-treated turkeys had lower levels of colonization with S. aureus and had a 3% higher gross survival rate than untreated control turkeys.

Staphylococcosis of turkeys. 4. Characterization of a bacteriocin produced by an interfering Staphylococcus

A Staphylococcus epidermidis isolate designated strain 115, which is used as an interfering agent against staphylococcosis of turkeys, produces a bacteriocin that was partially purified and characterized in this study. This bacteriocin diffused through agar media, but it was not found in appreciable quantities in the supernatant fluid of broth cultures. Extraction of the bacterial cells with 7 M urea, 1% sodium dodecyl sulfate, or 1% Triton X-100 caused considerable amounts of the bacteriocin to go into solution. This substance was partially purified by selective chemical extraction and by gel filtration chromatography using a Sephacryl S-300 column. This bacteriocin had two active forms: an aggregate, and a small-molecular-weight form estimated by gel filtration chromatography to be less than 6500. Activity was not affected by heat, repeated freeze-thaw cycles, pH 2 and pH 10, or a variety of proteolytic enzymes, nucleases, a lipase, and lysozyme.

Preliminary studies on bacterial interference of staphylococcosis of chickens

Previous studies indicated that Staphylococcus epidermidis strain 115 might be an effective interfering agent in reducing the rate of staphylococcosis in turkeys. In the present study, strain 115 was avirulent when administered to 3-day-old chicks by oral, aerosol, or intravenous route. Strain 115 adhered specifically to tracheal, lung, air-sac, and liver cells in vitro and interfered with subsequent colonization by virulent Staphylococcus aureus. In vivo colonization of lungs and livers of young chicks occurred following exposure to aerosols of strain 115. Strain 115 interfered with the in vivo colonization of lungs and livers by virulent S. aureus.

Staphylococcosis of turkeys. 1. Portal of entry and tissue colonization

Staphylococcus aureus and various coagulase-negative staphylococci were isolated from turkeys with staphylococcosis. Virulent S. aureus adhered well (averaged more than 100 bacteria per tissue cell) in vitro to cells from tissues of the respiratory tract but did not adhere well (averaged fewer than 12 bacteria per tissue cell) to cells from tissues of the alimentary tract. Some avirulent coagulase-negative staphylococci also adhered well to cells from the respiratory tissues. Lungs and livers of turkeys became colonized with virulent S. aureus following experimental aerosol exposure. Tracheas, livers, and hock joints of some market-age turkeys were naturally colonized with S. aureus and various species of coagulase-negative staphylococci.

Staphylococcosis of turkeys. 5. Large-scale control programs using bacterial interference

Staphylococcus epidermidis strain 115 was used as an interfering agent to reduce the incidence of staphylococcosis in turkeys. In 1984, the entire Utah turkey population of about 3 million turkeys was exposed at 1 to 10 days and at 4 to 6 weeks of age to aerosols of strain 115. Some staphylococcosis was still observed in range turkeys but appeared to be at a lower rate than in previous years. At processing, about 30% of the turkeys were still colonized with strain 115. A control study was carried out in 1985 to quantitate the level of reduction of staphylococcosis in turkeys treated with strain 115. About 1 million turkeys were treated, and 2 million remained untreated. Flocks from both groups were examined periodically for existing cases of staphylococcosis. Of 174,250 treated turkeys examined, 90 had staphylococcosis on the days examined, whereas 255 of the 183,500 untreated turkeys that were examined had staphylococcosis. Turkeys housed in range sheds had five times the incidence of staphylococcosis that turkeys in enclosed coops had. The gross mortality rate of 200,636 treated turkeys was 2.7% lower (P less than 0.001) than that of 189,450 untreated control turkeys that were monitored.

Staphylococcosis of turkeys. 2. Assay of protein A levels of staphylococci isolated from turkeys

Ninety-eight Staphylococcus aureus isolates and 227 coagulase-negative staphylococcal isolates from turkeys were assayed for protein A content. The amount of protein A of each isolate was quantitated using a direct enzyme-linked immunosorbent assay. Of the S. aureus isolates, 83% possessed some protein A, whereas only 13% of the coagulase-negative staphylococci contained some protein A. No correlation was seen between protein A content and ability to adhere to turkey cells. No differences in virulence were seen between isolates of S. aureus possessing high or low levels of protein A; however, an isolate with no protein A was avirulent.

Control of turkey Alcaligenes rhinotracheitis in Utah with a live vaccine

During the 1980 growing season in the Sanpete Valley of Utah, about half of the 250 to 300 flocks of turkeys were vaccinated with an oral vaccine against alcaligenes rhinotracheitis (ART). The vaccine consisted of a temperature-sensitive mutant of Alcaligenes faecalis. Most vaccinated birds developed serum antibodies. No outbreaks of ART occurred in vaccinated flocks, although some outbreaks occurred in unvaccinated flocks. During 1979, when on flocks were vaccinated, over 90% of the flocks experienced outbreaks of ART during late summer.

Use of an enzyme-linked immunosorbent assay to measure antibody responses in turkeys against Pasteurella multocida

AN enzyme-linked immunosorbent assay (ELISA) and a microtiter agglutination (MA) test were used in a comparative study to measure the humoral antibody responses of turkeys receiving oral vaccination against fowl cholera. The ELISA was sensitive and measured antibody titers as high as 1:4,409, whereas the highest titers the MA test measured were 1:128. A close correlation was seen between ELISA antibody titers and protection against oral challenge with virulent Pasteurella multocida, whereas a poor correlation was seen between antibody titers measured by MA tests and protection. ELISA substrate reactions from a single serum dilution, measured with a spectrophotometer, could be converted directly from absorbance to antibody titers using a linear regression plot.

Field vaccination trials against turkey coryza using a temperature-sensitive mutant of Alcaligenes faecalis

In field trials, 14 flocks of turkeys were vaccinated against coryza (rhinotracheitis) with a temperature-sensitive mutant of Alcaligenes faecalis via drinking water. Vaccine doses of 5 to 250 million bacteria per turkey were used. Turkeys ranged in age from 2.5 to 13 weeks. Doses of 5 to 7 million bacteria did not induce complete protection. Doses of 50 million bacteria or more appeared to induce substantial immunity in most flocks. Six-week-old birds receiving doses of 90 million bacteria developed a high degree of protection against challenge with virulent A. faecalis.

Immunization against turkey coryza by colonization with mutants of Alcaligenes faecalis

Temperature-sensitive mutants of Alcaligenes faecalis that exhibited reduced growth at 42 C but grew well at 30 C were induced by N-methyl-N'-nitro-N-nitrosoguanidine. Four of the 5 mutants that were studied readily colonized the nasal mucosa of turkeys when given intranasally or in drinking water. Several mutants caused no signs of coryza or depression and produced minimal colonization of the trachea. Colonization of the nasal mucosa lasted 3 to 4 weeks and induced moderate levels of serum antibodies. When challenged with virulent isolates of A. faecalis 4 to 6 weeks after having been exposed to the mutants, unstressed turkeys were protected; turkeys subjected to water deprivation exhibited some colonization with the virulent strain and showed slight signs of coryza.

[Comparison of Micro-ID, API 20 E and a conventional technique for the identification of Enterobacteriaceae]

A new system, Micro-ID, for the identification of Enterobacteriaceae is described. 100 strains of Enterobacteriaceae (Table I) are identified by Micro-ID and the identifications are compared with the identifications performed by conventional techniques and by the API 20 E system. There is a total agreement between Micro-ID and conventional techniques on 96.5% and between API 20 E and conventional techniques on 90% (Tables II and III). The differences in the reactions between the systems are discussed and explained. It is concluded, that the Micro-ID and the API 20 E both are very suitable for the identification of Enterobacteriaceae.

Growth curves and stabilization of fresh vaccine cultures of the Clemson University strain of Pastuerella multocida

Growth curves at 37 C for the Clemson University strain of Pasteurella multocida were about the same in either brain-heart-infusion broth or in a recently developed broth called "special broth TV". Counts in both broths were usually greater than 1 x 10(9) viable bacteria per ml. With the addition of 5 g of dried skim milk to each 100 ml of broth culture in the stationary phase of the growth curve, only a slight decrease in viable counts occurred over the next 7 to 14 days when held at 4 C. Such stabilization of broth cultures of P. multocida gives added flexibility to the use of fresh cultures as a live oral turkey cholera vaccine.

The inhibitory effect of Corynebacterium parvum and Pasteurella multocida pretreatment on staphylococcal synovitis in turkeys

Corynebacterium parvum and Pasteurella multocida were shown to be immunostimulants in turkeys, increasing the ability of whole blood to kill Staphylococcus aureus and prolonging the incubation time of experimental staphylococcal synovitis.

The response of turkeys to varying doses of live oral Pasteurella multocida vaccine

Groups of 30 turkeys were vaccinated by the drinking water route against fowl cholera with varying doses of the low virulence, CU strain, of Pasteurella mulocida. One group (heavy dose) received 1.2 x 107, another (medium dose) 1.5 x 105, and a third (light dose) 1.0 x 103 bacteria per ml. of drinking water. Two (6.7%) vaccine induced cholera deaths occurred in the heavy dose group. No deaths resulted in the other groups. Maximum serum antibody titers per group were; light dose 1:32, medium dose 1:128, and heavy dose 1:256. Three weeks after vaccination all turkeys were challenged with a large dose of virulent P. multocida (P-1059). Mortalities resulting from the challenge were 100% in the light group, 23% in the medium group, 4% in the heavy group, and 100% in the unvaccinated controls.

Bacteriophage aerosol challenge of installed air contamination control systems

The effectiveness of installed air contamination control systems for removal of airborne microorganisms was determined. Seven separate systems were challenged with aerosolized T1 bacteriophage. Air samples were collected with Andersen samplers containing agar plates that had been swabbed with susceptible Escherichia coli. The advantages of using bacteriophage for testing air-handling systems are discussed. The air systems employed both filtration and ultraviolet irradiation and air-flow rates varied from 600 to 18,000 ft/min. Reduction rates of airborne bacteriophage passing through the various air systems ranged from 99.8 to 99.99%.