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An increase in the number of new cases of tuberculosis (TB) combined with poor clinical outcome was identified among HIV-infected injecting drug users attending a large HIV unit in central Lisbon. A retrospective epidemiological and laboratory study was conducted to review all newly diagnosed cases of TB from 1995 to 1996 in the HIV unit. Results showed that from 1995 to 1996, 63% (109/173) of the Mycobacterium tuberculosis isolates from HIV-infected patients were resistant to one or more anti-tuberculosis drugs; 89% (95) of these were multidrug-resistant, i.e., resistant to at least isoniazid and rifampicin. Eighty percent of the multidrug-resistant strains (MDR) available for restriction fragment length polymorphism (RFLP) DNA fingerprinting clustered into one of two large clusters. Epidemiological data support the conclusion that the transmission of MDR-TB occurred among HIV-infected injecting drug users exposed to infectious TB cases on open wards in the HIV unit. Improved infection control measures on the HIV unit and the use of empirical therapy with six drugs once patients were suspected to have TB, reduced the incidence of MDR-TB from 42% of TB cases in 1996 to 11% in 1999., (Copyright 2001 The Hospital Infection Society.)

Saltmarshes, seagrass meadows and mudflats are key habitats in estuarine ecosystems. Despite being involved in key ecological processes, the influence of different estuarine habitats on sediment bacterial communities remains understudied. Few studies have analysed and compared the bacterial communities of more than one estuarine habitat at different depths. Here, we investigated to what extent different habitats (mudflats; mono-specific plots of seagrass [ Zostera noltei] and two saltmarsh plants [ Juncus maritimus and Spartina maritima]) and sampling depth (0, 5, 10 cm) influence variation in sediment bacterial composition. Our results showed significant differences in the abundance of selected higher taxa amongst habitats and depths. Surface sediment was characterized by bacteria assigned to the Acidimicrobiia, Flavobacteriia, Thiotrichales, Alteromonadales and Rhodobacterales, whereas in deeper sediment Deltaproteobacteria and Anaerolineae were dominant. Juncus sediment, in turn, presented the most distinct bacterial community, with Myxococcales abundant in this habitat. Sampling depth and habitat proved significant predictors of variation in sediment bacterial composition. The compositional dissimilarities amongst habitats and depths suggest functional divergence and complementarity, thus enhancing ecosystem functioning and health. Given the compositionally distinct communities found in different habitats and depths, our study corroborates the importance of conserving a diverse array of estuarine habitats. [ABSTRACT FROM AUTHOR]