Search

Fifty-five clinical isolates of avian pathogenic Escherichia coli (APEC) from seven outbreaks of acute haemorrhagic septicaemia in turkeys were characterized by serotyping, plasmid profiling including restriction analysis with HindIII, ribotyping with EcoRI and HindIII, multilocus sequence typing (MLST) and virulence profiling. A clonal relationship was demonstrated for each outbreak according to serotype, plasmid profiling, ribotyping, and MLST. In addition, isolates demonstrated highly similar virulence profiles, as all isolates were positive for F11 pili and possessed genes encoding aerobactin (iucD), increased serum survival (iss), temperature-sensitive haemagglutinin (tsh) and colicin V plasmid operon genes (cva/cvi). However, only 20% of the isolates produced colicin V and 42% exhibited serum resistance. All strains with O group O111 and a single O18ac strain (demonstrating non-clonal DNA profiles) were positive for enteroaggregative heat-stabile toxin (EAST1), while isolates of a single outbreak all possessed the enteroaggregative toxin gene (astA). All isolates were negative for genes encoding verocytotoxins (vtx/stx), iron-repressible protein (irp2), P-fimbria (papC), invasion plasmid antigen (ipaH), attaching and effacing gene (eae), enterohaemolysin (ehxA), and enterotoxins LT, STIa (STp) and STIb (STh). In conclusion, highly similar virulence profiles were demonstrated for isolates of E. coli associated with a single well-defined lesion type of colibacillosis in turkeys; acute haemorrhagic septicaemia. The isolates obtained, however, demonstrated a different phylogenetic background, underlining the importance of using well-defined strain collections for characterization of APEC pathotypes. [ABSTRACT FROM PUBLISHER]

20 patients were infected with a new group of verocytotoxin-producing E. coli (VTEC) strains of serotype O117:K1:H7 during a 5-y period. The main symptoms were persistent watery diarrhoea with abdominal cramps; 2 persons of the 20 were healthy carriers. The duration of gastrointestinal symptoms in patients was median 11 weeks with 80% being ill for more than 30 d. In 19 cases the infection was acquired during travel (Asia, Africa and Cuba), and 1 case was laboratory acquired. All strains were positive for the vtx1 gene and negative for the vtx2, the eae, the saa and the ehxA genes. 13 strains (65%) were resistant to 4 or more antimicrobial agents. By PFGE using the restriction enzyme XbaI, the strains were clonally related, but not identical. O117:K1:H7 is a clonal group of VTEC that should be considered in patients returning from Africa and Asia with long-lasting watery diarrhoea. [ABSTRACT FROM AUTHOR]

Aims: To study the prevalence of seven virulence and toxin genes, and cytolethal distending toxin (CDT) production of Campylobacter jejuni and C. coli isolates from Danish pigs and cattle. Methods and Results: The presence of the cadF, ceuE, virB11, flaA, cdtA, cdtB, cdtC and the cdt gene cluster among 40 C. jejuni and C. coli isolates was detected by polymerase chain reaction. The CDT production of the isolates was determined on Vero, colon 205 and chicken embryo cells. The cadF, flaA, ceuE and cdtB genes were detected from 100% of the isolates. The cdtA and cdtC genes were found in 95·0 and 90·0% of the isolates, respectively. The cdt gene cluster was detected in 82·5% isolates. Only 7·5% of the isolates were positive for virB11. Ninety-five per cent of the isolates produced CDT in Vero and colon 205 cell assays, and 90% of the isolates produced CDT in chicken embryo cell assays. Conclusions: High prevalence of the cadF, ceuE, flaA and cdtB genes was found. Data of the prevalence of cdt genes was consistent with the CDT titres produced by the isolates. Campylobacter coli from pigs produced high CDT titres. Significance and Impact of the Study: The high prevalence of seven virulence and toxin genes demonstrated that these putative pathogenic determinants are widespread among Campylobacter isolates from pigs and cattle. Campylobacter coli isolates from pigs produced much higher CDT titres compared with C. coli isolates from other sources suggesting that C. coli may be particularly adapted to or associated with this species. [ABSTRACT FROM AUTHOR]

Our aim was to identify determinants of utilization of dental services among 20- to 34-year-old Danes as outlined in a conceptual framework. Our sample consisted of a sample of 464 individuals who had been interviewed by 10 experienced interviewers from The Danish National Institute of Social Research. Our questionnaire comprised a battery of questions based on our conceptual model. The analysis was done in a hierarchical manner using a framework with three steps: Predisposing factors --> Enabling factors --> Need factors --> Utilization. Associations were evaluated with multivariate logistic regression analysis and expressed as odds ratios. The following factors were significantly associated with irregular use of dental services: age, sex, exercise habits, cost of dental treatment, dental anxiety, and perceived condition of teeth. Our findings suggest that a strategy aiming to increase young people's dental attendance should focus on the transition period that is, when the youngsters leave the public dental health care system and have to make use of the private system. The strategy should also take into account that young men are more likely to become non-users. A concerted effort could be dedicated to the non-negligible group of individuals with dental anxiety and dental phobia. [ABSTRACT FROM AUTHOR]

Measles IgG antibody levels were estimated in sera from 685 Tanzanian children, 374 (54.6%) boys and 311 (45.4%) girls aged 18 months to 5 years, using an enzyme-linked immunosorbent assay (ELISA). The children were screened for HIV-1 and 2 antibodies using ELISA, and reactive sera were confirmed by Western blot. Nutritional status was assessed by anthropometry. Overall measles vaccination coverage was 98.8%. Measles antibody activity was not detected in 41 (6.0%) children, and ten (1.5%) had antibody levels below 200 mIU/ml, the cut-off level considered to be protective. The non-reactive samples were from one unvaccinated child, one child with unknown vaccination status and 39 vaccinated children. Measles IgG antibody levels were higher in girls (3452.1 mIU/ml) than in boys (2928.2 mIU/ml) (p=0.02). Higher mean levels were found in children with a history of low birthweight (2.5 kg) (p=0.03). There were no significant differences in measles antibody levels with regard to variations in nutritional status. No correlation (r2=0.002) was found between antibody levels and time elapsed since vaccination. In a multivariable logistic regression analysis, children who were HIVseropositive (n=9) were more likely to have non-protective antibody levels 200 mIU/ml (OR =5.85; 95% CI: 1.37-24.93). [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Periodontology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Emergency oral health care, as conceived in Tanzania, is an on-demand service provided at a rural health centre or dispensary by a Rural Medical Aide. The service includes: simple tooth extraction under local anesthesia, draining of abscesses, control of acute oral infection with appropriate drug therapy, first aid for maxillo-facial trauma, and recognition with appropriate drug therapy, first aid for maxillo-facial trauma, and recognition of oral conditions requiring patient referral for further care at the district or regional hospital dental clinic. The objective of the present study was to describe patient satisfaction with emergency oral health care services in rural Tanzania and determine the relative importance of factors influencing patient satisfaction. The study was carried out as a cross-sectional interview survey between April 1993 and May 1994 using a patient satisfaction questionnaire in rural villages in the Rungwe district of Tanzania. It included 206 patients aged 18 years or more who had received emergency oral health care between April 1993 and March 1994. Overall, 92.7% of the respondents reported that they were satisfied with the service. Patients who were married, had no formal education and lived more than 3 km form the dispensary were more likely to be satisfied with treatment. In a logistic regression model, a good working atmosphere at the dispensary, a good relationship between care provider and patients (art of care) and absence of post-treatment complications significantly influenced patient satisfaction with odds ratio of 10.3, 17.4 and 6.2, respectively [ABSTRACT FROM AUTHOR]

The present study was undertaken to investigate the dental health of a group of parenteral drug addicts. The study population comprised 134 persons with a mean age of 25 yr (mm. 18, max. 37) examined in 1977-81. Mean DMFT was 18.3 and mean DMFS was 50.2, approximately twice as much as found in comparable age groups in Denmark. Even free smooth surfaces were often involved. The oral hygiene was measured by the use of the Visible Plaque Index (VPI) and the Bleeding Index (BI). Both indices were high, mean VPI = 77.4 and mean BI = 71.3. 12-40% of the teeth selected had a loss of periodontal attachment of more than 4mm. It is suggested that not only drug abuse, but also factors like low social status, low education and different barriers towards receiving dental treatment should be considered in a multifactorial cause-effect relationship. The effect of offering a free dental care system for this high-risk group will be dealt with in another paper. [ABSTRACT FROM AUTHOR]

The present study describes the experiences and results of the first 5-year period of a municipal dental clinic offering free dental care to drug addicts. One of the many problems was the instability of this socially deprived group whose erratic life style made it impossible to maintain regular dental care. The DMFS level of the drug addicts was 50.2 and mean caries increment per yr was 2.5 (1.3 new surfaces and 1.2 surfaces with recurrent decay). The caries increments among the present drug abusers and the individuals on methadone maintenance were higher than among the previous drug addicts, 3.1 and 1.3 surfaces per yr respectively, but this difference was not statistically significant. Only slight improvement in oral hygiene (VPI) could be demonstrated whereas gingivitis (BI) remained unaltered. Traumatic injuries of the orofacial region were frequent. The mean time expenditure concerning dental treatment was 5 hr per individual in the initial treatment phase but decreased to 1-2 h per individual per yr. Broken appointments and last minute cancellations were as a rule related to drug/alcohol abuse. The mean number of fillings was 8.2 per individual in the initial treatment phase and 1.7 per yr for individuals in a maintenance phase. The poor dental health of the drug addicts seems closely related to their life style habits and the clue to an improvement would probably follow the cure of the drug abuse and a concurrent resocialization. [ABSTRACT FROM AUTHOR]

The influx of refuges from Vietnam to the industrialized countries has attracted a certain interest to studies describing the oral health status of these population groups. The present study comprises 3621 refuges arriving in Malaysia from Vietnam and collected immediately at the refugee camp on Pulau Bidong. Dental caries, calculus, gingival bleeding and loss of periodontal attachment were recorded. Mean dmft increased from 1.3 for 0-2-yr-olds to 7.4 for 3-5-yr-olds. For 6-9-yr-olds mean DMFT was 2.4 while it ranged between 8.5 and 10.0 for the older age groups. The frequency of secondary lesions was high for all age groups. Calculus increased consistently with age, while gingival bleeding was common even in the youngest age group. Loss of periodontal attachment greater than or equal to 6 mm was rare in all age groups except the oldest (45 yr or older). A strategy for oral health care for these population groups is discussed. [ABSTRACT FROM AUTHOR]

A total of 84 HIV-infected homosexual men having either normal oral mucosa (NOM). erythematous candidiasis (EC) or pseudomembranous candidiasis (PsC) were included in the study, The patients were evaluated by median number of peripheral CD4 cells, CD8[SUP+] cells and by lymphocyte function assessed by pokeweed mitogen test. There was a significant difference between CD4[SUP+] counts among patients with the two subtypes of candidiasis (95% CI of median difference: 10-240/mm[SUP3]; P=0.03). but not for pokeweed mitogen response. Survival analysis showed that after 2 y there was no significant difference in development of AIDS between patients with EC and PsC (P=0.29). If patients with both types of oral candidiasis were pooled and compared with patients with NOM, a significant difference in development of AIDS was found (P=0.04). It is concluded that HIV-infected patients with oral candidiasis of any subtype (EC or PsC) are significantly more immune suppressed and show a faster development of AIDS than HIV-infected patients with NOM. However, in this cohort, EC and PsC are of equal importance as predictors for immune suppression and AIDS development. [ABSTRACT FROM AUTHOR]

Escherichia coli isolates from an immunocompetent woman with a history of repeated amnion infections and spontaneous abortion were characterized. Escherichia coli were isolated from stool, blood and cervix swab samples taken over a 21-month period after the last abortion which followed septicemia during pregnancy. All samples except the last cervix swab contained isolates of serotype O12∶K1∶H7, which produced adhesins, P fimbriae, type I fimbriae and the iron-chelator aerobactin. Pulsed-field gel electrophoresis revealed identical Xbal restriction patterns of the O12∶K1∶H7 isolates, suggesting that one particular Escherichia coli strain was responsible for the severe extraintestinal infections during pregnancy. The strain was able to persist in the intestine of the woman despite antibiotic therapy. [ABSTRACT FROM AUTHOR]