ABSTRACT
We have developed a one-point microcapsule agglutination test (MCAT) for the serodiagnosis of leptospirosis. The MCAT kit was evaluated for use in humans by six WHO Collaborating Centres for Reference and Research on Leptospirosis. The laboratories classified their serum samples on the basis of the microscopic agglutination test (MAT) and the following screening tests: enzyme-linked immunosorbent assay (ELISA), macroscopic (slide) agglutination test, or the complement fixation test. The MCAT may in some instances give a positive result earlier in the course of the disease than MAT or the ELISA IgM; on the other hand, it did not detect antibodies against some serovars, for example, those of the Sejroe or Australis serogroup in Slovakia. In contrast, however, the MCAT detected antibodies to serovar hardjo (the same serogroup as Sejroe) in patients from the United Kingdom and the Russian Federation.
Subject(s)
Agglutination Tests/methods , Leptospirosis/diagnosis , Complement Fixation Tests , Enzyme-Linked Immunosorbent Assay , Humans , Leptospira/classification , Leptospira/immunology , Leptospirosis/microbiology , Sensitivity and Specificity , SerotypingABSTRACT
Leptospirosis remains a potential hazard to farmers, agricultural workers and those coming into contact with rats or natural inland waters. The annual reported incidence in England and Wales ranged between 29 and 48 cases during 1990-92.
Subject(s)
Leptospirosis/epidemiology , England/epidemiology , Humans , Leptospirosis/diagnosis , Leptospirosis/therapy , Wales/epidemiologyABSTRACT
In November 1986 a large-scale survey was undertaken in the Gloucestershire town of Stonehouse during an outbreak of meningococcal disease due to group B type 15 subtype P1.16 sulphonamide-resistant strains. There were 15 cases in Stonehouse residents during the 4 years from April 1983, an annual attack rate of 56.5 per 100,000. Four secondary cases occurred despite rifampicin prophylaxis. The objectives of this community survey were to investigate patterns of meningococcal carriage, transmission and immunity and to determine the proportion of non-secretors of blood group antigens in the Stonehouse population and amongst meningococcal carriers. A total of 6237 subjects participated including 75% of the 6635 Stonehouse residents. Over 97% of the participants provided all three of the requested specimens-nasopharyngeal swabs, saliva and blood samples. The co-operation between the many organizations involved in the detailed preliminary planning was instrumental in the success of the survey; in particular the value of effective collaboration between Departments of Community Medicine and Microbiology and of the Public Health Laboratory Service network of laboratories in undertaking investigations of this size and type was clearly demonstrated.
Subject(s)
Disease Outbreaks , Meningococcal Infections/epidemiology , Adolescent , Adult , Age Factors , Aged , Blood/microbiology , Child , Child, Preschool , Epidemiologic Methods , Female , Health Surveys , Humans , Male , Mass Screening , Meningococcal Infections/immunology , Middle Aged , Saliva/microbiology , Sex FactorsABSTRACT
Gas liquid chromatography was employed to detect lactic acid in the cerebrospinal fluid of patients suspected of having bacterial meningitis. The technique was found to be both rapid and reliable. Differentiation between aseptic, purulent, and partially treated bacterial meningitis was readily achieved. The effectiveness of therapy in bacterial meningitis was indicated by a rapid fall in the concentration of lactic acid.
Subject(s)
Chromatography, Gas , Lactates/cerebrospinal fluid , Meningitis/diagnosis , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Meningitis/cerebrospinal fluid , Middle AgedABSTRACT
A double-blind randomised trial was carried out among 46 patients undergoing elective colonic surgery; 27 patients received prophylactic metronidazole and 19 received placebo. Anaerobic infections did not develop in any of the metronidazole-treated patients, but did develop in 11 (58%) of 19 controls who were subsequently successfully treated with metronidazole.
Subject(s)
Bacteroides Infections/prevention & control , Colon/surgery , Metronidazole/therapeutic use , Postoperative Complications/prevention & control , Bacterial Infections/epidemiology , Clinical Trials as Topic , Gram-Negative Anaerobic Bacteria , Humans , Male , Middle AgedABSTRACT
The frequency of non-clostridial anaerobic infection was studied in 95 patients who had undergone acute appendicectomy: 49 received prophylactic metronidazole and 46 received placebo. Anaerobic infection did not develop in any of the metronidazole-treated patients, but infections did develop in nine (19%) of the 46 controls. Metronidazole is conveniently administered by suppository to patients who cannot take oral drugs. Five patients with intra-abdominal infections caused by non-clostridial anaerobes were successfully treated with metronidazole.
