Persistence and reactivation of human adenoviruses in the gastrointestinal tract.

Reactivation of persistent human adenoviruses (HAdVs) is associated with high morbidity and mortality in paediatric haematopoietic stem cell transplant (HSCT) recipients. Although invasive HAdV infections mainly arise from the gastrointestinal (GI) tract, the specific sites of HAdV persistence are not well characterised. We prospectively screened biopsies from 143 non-HSCT paediatric patients undergoing GI endoscopy and monitored serial stool specimens from 148 paediatric HSCT recipients for the presence of HAdV by real-time PCR. Persistence of HAdV in the GI tract was identified in 31% of children, with the highest prevalence in the terminal ileum. In situ hybridisation and immunohistochemistry identified HAdV persistence in lymphoid cells of the lamina propria, whereas biopsies from five transplant recipients revealed high numbers of replicating HAdV in intestinal epithelial cells. The prevalence of HAdV species, the frequencies of persistence in the GI tract and reactivations post transplant indicated a correlation of intestinal HAdV shedding pre-transplant with high risk of invasive infection. HAdV persistence in the GI tract is a likely origin of infectious complications in immunocompromised children. Intestinal lymphocytes represent a reservoir for HAdV persistence and reactivation, whereas the intestinal epithelium is the main site of viral proliferation preceding dissemination. The findings have important implications for assessing the risk of life-threatening invasive HAdV infections.

Helicobacter pylori in children and adolescents: increase of primary clarithromycin resistance, 1997-2000.

BACKGROUND: The authors evaluate the prevalence of Helicobacter pylori resistance in 117 children and demonstrate the changes over a 4-year period. METHODS: In 117 children and adolescents, H. pylori-positive gastritis was revealed by diagnostic upper endoscopy. Biopsies from the antrum and body of the stomach were tested by histology, urease test, and culture. H. pylori was isolated using standard culture techniques, and susceptibility to amoxicillin, clarithromycin, and metronidazole was tested using the E-test (AB-Biodisk, Sweden). RESULTS: Endoscopy revealed gastric ulcers in 2 of 117 subjects, duodenal ulcers in 6 of 117, and erosive gastritis or duodenitis in 23 of 117. Almost all patients showed antral nodularity. Histology always showed chronic gastritis with different degrees of activity. During the 4-year study period, the authors noticed an increase of primary clarithromycin-resistant H. pylori strains, from 14.3% to 27.6% (mean, 20.3%). Metronidazole resistance varied between 5% and 25%. No resistance to amoxicillin was found. CONCLUSION: Eradication of H. pylori should take place only after testing of susceptibility. The general use of clarithromycin in children should be restricted to better-defined indications. Resistance to clarithromycin of H. pylori may also become a future problem for the treatment of adults.

[Liposomal amphotericin B in the treatment of candida infection in a 3-month-old infant]. / Liposomales Amphotericin B zur Behandlung einer Candidasepsis bei einem drei Monate alten Säugling.

Amphotericin B (Amph-B) is the treatment of choice for systemic fungal infections. The application of high doses is limited due to the high incidence of acute side effects (fever, chills) and organ toxicity (reduction in glomerular filtration rate, renal tubular damage). Amph-B was applied without success in a three months old infant, who suffered from systemic candidiasis. After a change to high doses (3-5 mg/kg/day) of liposomal Amph-B (Amph-lip) rapid improvement of the patient's condition occurred and the pulmonary lesions disappeared during six weeks of treatment (total dose 185.5 mg/kg). Acute side effects or renal function abnormalities did not occur. The reported case indicates that the application of high doses of Amph-lip is an alternative to conventional Amph-B in treatment of systemic fungal infections.

The formate dehydrogenase involved in electron transport from formate to fumarate in Vibrio succinogenes.

1. The formate dehydrogenase of Vibrio succinogenes, which is involved in electron transport with fumarate as terminal acceptor, was solubilized with Triton X-100 and purified some 200-fold by means of chromatography on hydroxyapatite, sucrose-density-gradient centrifugation and chromatography on DEAE-Sephadex. Gel filtration failed to increase the specific acitivity of the enzyme while gel electrophoresis in the presence of dodecylsulfate revealed that 73% of the protein of the preparation consisted of a polypeptide of Mr 110 000. The Mr of the functional enzyme was found to be 263 000 on the basis of the Stokes radius (5.8 nm) and the sedimentation coefficient (11.3 S). 2. The preparation contained 9 micronmol molybdenum/g protein and about 170 mumol iron-sulfur/g protein. The contents of b and c cytochromes varied and were lower than that of molybdenum. The low-potential cytochrome b [Kröger, A. and Innerhofer, A. (1976) Eur. J. Biochem. 69, 497-506] present in the preparation was reduced by formate. 3. The preparation catalyzed the reduction of a variety of dyes by formate, but not of NAD, FMN, ferredoxin or oxygen. The reduction of CO2 or bicarbonate by reduced methyl viologen was not catalyzed. The reaction with benzyl viologen obeyed the rate law consistent with a ping-pong mechanism. The Km for formate was 1.5 mM at infinite concentration of benzyl viologen while that for benzyl viologen was 0.53 mM at infinite formate concentration. Enzymic activity was inhibited by azide, KCN and HgCl2, but not by 4-chloromercuriphenylsulfonate or 2-(n-nonyl)-4-hydroxyquinoline-N-oxide, both of which inhibit overall electron transport. The inhibition by azide was competitive with formate; the Ki was 45 micron. 4. The midpoint potential of the low-potential cytochrome b of the membrane fraction was shifted -40 mV by the presence of 2-(n-nonyl)-4-hydroxyquinoline-N-oxide. 5. It is concluded that the formate dehydrogenase of V. succinogenes is isolated as a dimer consisting of two identical subunits of Mr 110,000, each of which carries one atom of molybdenum and iron-sulfur groups. The low-potential cytochrome b is the direct acceptor for the electrons of formate dehydrogenase in the electron transport of formate-fumarate reduction of V. succinogenes. Inhibition of electron transport of the membrane fraction between formate dehydrogenase and menaquinone by 2-(n-nonyl)-4-hydroxyquinoline-N-oxide [Kröger, A. and Innerhofer, A. (1976) Eur. J. Biochem. 69, 487-495] is caused by the inhibitor binding to the low-potential cytochrome b.