Septicemia due to Yersinia pseudotuberculosis--a case report.

A case report is presented concerning Yersinia pseudotuberculosis septicemia presenting as an acute abdominal emergency in an elderly diabetic man with multiple medical problems.

Lyme disease in the highlands.

Serological results for Borrelia burgdorferi were examined for one year. The results suggest a 'pocket' of infection in one Highland general practice. In this practice, most of the patients had exposure to tick bites and rashes were frequent. There were difficulties in relating serological results to clinical features and management of some patients.

Estimations of serum arabinitol for diagnosing invasive candidosis.

Arabinitol concentrations were determined in 157 serum samples from 95 patients with suspected invasive candidosis and in 10 serum samples from healthy laboratory workers. Fifty eight of the 95 patients, subsequently diagnosed as not having invasive candidosis had concentrations of arabinitol below 1.2 micrograms/ml (mean 0.59 (SD) 0.26). Sera from the healthy laboratory workers gave similar results (mean 0.55 (0.05]. Concentrations above the normal range were found in 18 of the 19 cases of confirmed or probable invasive candidosis and in seven of eight patients with infected intravenous lines or cannulas and clinical evidence of systemic infection. Raised concentrations were also seen in 10 other patients, including nine with renal failure who did not have invasive infections. Multiple serum samples obtained from 33 patients showed that sequential estimations were of value for diagnosing a developing infection. Despite some difficulties of interpretation the technique is rapid and specific and is suitable for use in the diagnostic laboratory of a larger general hospital.

Role of antibody and enterobactin in controlling growth of Escherichia coli in human milk and acquisition of lactoferrin- and transferrin-bound iron by Escherichia coli.

Growth of Escherichia coli NCTC 8623 in human milk was slow during the first 10 h of incubation, but this bacteriostatic effect had disappeared by 24 h. The bacteriostatic phase could be abolished by adding sufficient iron to saturate the lactoferrin in human milk, and also by adding supernatant from a 24-h milk culture or by adding enterobactin, an enterobacterial iron chelator. Growth in the presence of enterobactin was even more rapid than in the presence of excess iron. Partial loss of bacteriostatic activity could be achieved by absorbing the milk with bacterial antigens, but no clear correlation with removal of antibodies to O, K, or H antigens was apparent. When E. coli was grown in human serum trace-labeled with 59Fe, the organisms acquired iron from transferrin during growth. Cultivation of E. coli in a minimal medium supplemented with transferrin or lactoferrin doubly labeled with 125I and 59Fe showed that iron acquisition occurred without either assimilation or degradation of the iron-binding proteins.

A scheme for the identification of clinical isolates of Gram-negative anaerobic bacilli by conventional bacteriological tests.

More than 1000 strains of gram-negative anaerobic bacilli, including reference strains, clinical isolates, and members of the normal flora of the mouth, lower gastro-intestinal tract and vagina of healthy human subjects, were studied by conventional bacteriological methods and by gas-liquid chromatographic analysis of metabolic products in a series of investigations. A short combined set of tests with particular discriminant value was selected, and a scheme for the identification of the species and subspecies encountered in the diagnostic bacteriological laboratory was based upon our composite results. The tests are: antibiotic-disk resistance tests with neomycin 1000 micrograms, kanamycin 1000 micrograms, penicillin 2 units and rifampicin 15 micrograms per disk; tolerance tests with sodium taurocholate, Victoria blue 4R and gentian violet; and tests for pigment production, indole production, aesculin hydrolysis and the fermentation of glucose, lactose, sucrose, rhamnose, trehalose, mannitol and xylose. Gram-negative anaerobic bacilli are divided into four groups: (1) the fragilis group with nine species, which include the five subgroups previously classified as subspecies of B. fragilis; (2) the melaninogenicus-oralis group, which includes the three saccharolytic subspecies (ss.) of B. melaninogenicus--ss. melaninogenicus, ss. intermedius and ss. levii--and four non-pigmented species; (3) the asaccharolytic group, which comprises B. asaccharolyticus (formerly B. melaninogenicus ss. asaccharolyticus), B. corrodens and other non-pigmented non-saccharolytic strains, and (4) the fusobacteria.

Gas-lipuid chromatographic analysis of metabolic products in the identification of bacteroidaceae of clinical interest.

The acid end-products of 185 isolates from the family Bacteroidaceae were separated and analysed by gas-liquid chromatography on broth cultures. Different media were evaluated and definitive studies were performed in a fully supplemented complex medium. The limitations of this approach to the identification of a wide range of strains from various clinical sources were determined and the results were compared with those of a series of morphological, biochemical, tolerance and antibiotic-resistance tests. All test strains were identified to generic level by simple microscopic and colonial observations and GLC analysis; additional tests were required to allow species or subspecies identification of most strains. Population differences were detected between some species or subspecies isolated from different clinical sites by quantitative analyses of fatty acids, but individual strains could not always be separated because of overlapping ranges of distribution of acids that were common products of more than one species or subspecies. Small differences in minor products between different species or subspecies were variable and are not considered adequate for discrimination at these taxonomic levels without support from other observations. The potential application of the GLC technique to the rapid and accurate identification of these organisms in hospital laboratories is considered.