Search

In vitro secretion of antibodies to cytomegalovirus was investigated by analysis of peripheral blood mononuclear cell culture supernatants from subjects infected with cytomegalovirus. Patients with primary or recurrent cytomegalovirus infection showed transient in vitro cytomegalovirus-specific antibody secretion. A high proportion of patients infected with human immunodeficiency virus and sero-positive for cytomegalovirus showed in vitro cytomegalovirus-specific antibody secretion. All peripheral blood mononuclear cell cultures from patients with symptomatic human immunodeficiency virus infection were found to secrete in vitro antibodies to cytomegalovirus, despite the fact that isolation of cytomegalovirus from some of these patients was not achieved. In human immunodeficiency virus-infected patients, in vitro secretion of anti-cytomegalovirus antibodies appeared to be persistent. In vitro cytomegalovirus-specific antibody secretion by peripheral blood lymphocytes probably reflects an in vitro cytomegalovirus-specific B cell activation. This new assay could be considered an interesting method for detecting both acute or chronic cytomegalovirus infection, with potential use in routine laboratory practice.

We followed the course of cytomegalovirus (CMV) viremia in 65 patients treated with zidovudine for symptomatic HIV-1 infection. Blood samples were tested for the presence of CMV before initiation of treatment and every 3 months thereafter. 13 patients (20%) showed a positive CMV viremia at initiation of treatment. After 3 months of therapy, only 2 patients (3%) remained viremic. However, the frequency of CMV viremia increased from the 6th month of treatment and 28 (43%) of our patients showed a persistence of, or conversion to, positive viremia during the course of treatment. CMV viremia was associated with a decline in the patients' clinical state in 79% of the cases. In contrast, among the 37 patients, who remained negative for CMV viremia, 73% did not show a progression of the HIV-associated disease. The results suggest that CMV viremia could be considered as a useful marker for HIV-associated disease and its progression as well as for the efficacy of therapy.

The authors compared the in vitro antifungal activity of fluconazole, a new triazole antifungal agent, and ketoconazole, an imidazole derivative. The MIC values were determined against 50 strains of Candida albicans, 10 strains of C. guilliermondii, 10 strains of C. krusei, 10 strains of C. parapsilosis, 10 strains of C. pseudotropicalis, 10 strains of C. tropicalis and 15 strains of Torulopsis glabrata. The fungistatic activity was evaluated by the agar dilution method using BHI and casitone media after incubation for 48 h at 28-30 degrees C. Both antifungal agents showed higher activity when tested on casitone medium; however, the G-MIC values for ketoconazole were lower than those for fluconazole.

Determinants of tetracycline resistance have been cloned from two different tetracycline-producing industrial strains of Streptomyces into Streptomyces lividans using the plasmid vector pUT206. Three plasmids, pUT250 and pUT260 with a 9.5 and a 7.5 kb insert respectively of Streptomyces rimosus DNA, and pUT270 with a 14.0 kb insert of Streptomyces aureofaciens DNA, conferring resistance to tetracycline, have been isolated. By in vitro sub-cloning, a similar fragment of 2.45 kb containing the tetracycline resistance gene (tet347) was further localized on these plasmids. The S. rimosus gene has been cloned into Escherichia coli and expressed under the control of lambda pL or Lpp promoters. Differential protein extraction of E. coli cells revealed the presence of an additional membrane-embedded protein in tetracycline-resistant cells. On the basis of available restriction endonuclease maps, the tet347 gene is probably identical to the tetB gene from S. rimosus recently identified by T. Ohnuki and co-workers as responsible for the reduced accumulation of tetracycline. The nucleotide sequence of a 2052 bp DNA fragment containing the TcR structural gene from S. rimosus has been determined. The amino acid sequence of the tet347 protein (Mr35818) deduced from the nucleotide sequence shows a limited but significant homology to other characterized tetracycline transport acting determinants from pathogenic bacteria.

A 48.5% of premunition in 421 pregnant women living in the Western part of Cameroon is observed with an anti-Toxoplasma gondii indirect immunofluorescence test. Considering the age, this study emphasizes the risk of contamination in genital activity period.

The many common factors linking rhizomelic pseudopolyarthritis and Horton's disease prompt to compare their respective evolutions and the long-term results of their treatments. The comparative study of 28 patients with temporal Horton's arteritis, proven histologically, and 28 rhizomelic pseudopolyarthritis without arteritis on biopsy, in a total population of 95 patients, confirms the similarity of their clinical and biological signs and show a closely related evolution in the three groups. The evolution leads to a cure approximately 16.4 +/- 14 months in 41 p. cent of the cases. 34 p. cent of the patients are at an advanced stage with a mean follow-up of 37 months and relapses during the weaning period were frequent. 25 p. cent of the patients died. Most deaths occur in the first month of the disease, and occur readily in patients who have received a short treatment with steroids discontinued because of a iatrogenic accident. Cerebral vascular accidents and coronary accidents, arterial hypertension and iatrogenic gastro-intestinal ulcerations are the most frequent complications.

Twenty nine patients with Rickettsiosis (Tick born fever, n: 22, Q fever, n: 7) has been treated with fluoroquinolones. These compounds was used alone n: 25 (Pefloxacin, n: 15; Ofloxacin, n: 10) or associated n: 4 (Pefloxacin + Rifampin). The general efficacy was excellent. Common Tick born fever and pulmonary forms of Q fever was fast cured. Severe Tick born fever (neurologic or polyvisceral forms, n: 5) and Q fever with long term hyperthermia, n: 4 cas always cured without complications but the time necessary to obtain apyrexia was often longer (6 cases).

Membranous laryngotracheobronchitis is a very serious infection which affects the larynx, trachea and bronchi, requiring aggressive therapeutic measures. It has been recently rediscovered as a cause of disease in children. However, it is a very unusual complication of measles. Two infants with measles and membranous laryngotracheobronchitis are reported.

Thirty-two patients were treated by ofloxacin on bacteriological documented infections. They were Enterobacterias: n = 15 (MIC less than or equal to 0.06 to 0.5 microgram/ml); Pseudomonas aeruginosa and Acinetobacter: n = 1 (MIC 0.5 and 4 micrograms/ml); Staphylococcus: n = 6 (MIC less than or equal to 0.06 to 4 micrograms/ml); Pneumococcus: n = 1; Mycoplasma: n = 1; Chlamydia psittaci: n = 2; Legionella pneumophila: n = 1; Rickettsias: n = 4 (three mediterranean fevers one query fever). Ofloxacin was given orally from 400 to 800 mg per day (5 to 15 mg/kg/day). It was used alone 26 times and on 6 occasions it was associated with rifampin on 6 staphylococcal infections. On 19 cases it was used after failure or intolerance of initial therapy. Thirty times it was the first antibiotic substance used. Results were good mainly: 1) on nine pneumonitis (enterobacterias: 4; Pneumococcus: 1; Mycoplasma: 1; Chlamydia: 2; Legionella: 1) during a mean duration of twenty days; 2) urinary infections (n:7) provoked by E. coli and Enterobacter cloacae (mean duration: 20 days); 3) 4 osteo-articular-infections (mean duration: 77 days); 4) Rickettsial infections (n:4) during a mean duration of 11 days. Results are particularly noteworthy because patients treated had severe infections: 12 bacteremias, 1 endocarditis and 1 purulent meningitis. None severe adverse effect was observed.