[Evaluation of a PCR-multiplex technique for the rapid diagnosis of bacteriemia]. / Valoración de una técnica de PCR-múltiple en el diagnóstico rápido de la bacteriemia.

OBJECTIVE: Rapid and safe diagnosis of bacteremia is a continuous challenge in clinical microbiology. In this work, we evaluated a multiple PCR system that identifies 23 common pathogens as well as the production of 3 resistance mechanisms potentially present in them. METHODS: During a period of 2 months the positive blood cultures were processed in the usual way for identification and determination of their antimicrobial sensitivity. At the same time were incorporated into FilmArray panels. RESULTS: The agreement between two methods for bacterial identification was 100%. The time of obtaining the results by the molecular technique did not exceed 1 hour 15 minutes and in 7 cases of the 21 studied (33%) a modification of the empirical therapy was carried out. CONCLUSIONS: The implementation of rapid techniques such as multiple PCR offers a fast, reliable and easy to perform diagnosis in the therapeutic management of sepsis.

Detection of BVDV persistently infected animals in Belgium: evaluation of the strategy implemented.

Until now, no official bovine virus diarrhea virus (BVDV) control program has been implemented in Belgium. The only legislation dealing with the detection of BVDV-infected animals concerns the purchase of animals. A strategy of control, based on the identification and elimination of persistently infected (PI) animals and the vaccination of cows before insemination has been designed in both the Northern and the Southern part of the country. The strategy of detection of PI animals relies on PCR testing of pools of blood. Individual blood samples corresponding to the positive pools are then tested by BVDV-antigen ELISA. A first evaluation of the measures already applied in Belgium is presented. Data obtained in 2003 are presented and discussed regarding the validation of the laboratory strategy, the prevalence of positive herds, the genotype of circulating viruses, the outcome of antigen positive animals and the need for improvement of the current legislation.

Detection of polychlorinated biphenyls and dioxins in Belgian cattle and estimation of the maximal potential exposure in humans through diets of bovine origin.

The methodology used to detect a polychlorinated biphenyl (PCB)/dioxin contamination in a Belgian cattle population that was not exposed to the PCB/dioxin incident in 1999 is presented. This population is directly or indirectly destined for human consumption. The methodology consisted in the systematic sampling of all calf-fattening stations and groups of cattle destined for export, and in the random sampling of slaughter cattle. This approach is compared to the method described in directive 96/23/CE from the European Council. When PCB concentrations exceeded the tolerance level of 0.2 micro g/g body fat (seven congeners with numbers 28, 52, 101, 118, 138, 153, and 180), dioxins (seventeen 2,3,7,8-substituted congeners of PCDD and PCDF) were also determined. The prevalence of Belgian slaughter cattle with PCB concentrations above this cutoff was 0.3% (95% confidence interval: 0.01-1.50%). Results indicate that the incidence of contamination was minimal, with environmental origin and common in all industrial countries. The maximal potential exposure of an adult human consumer to dioxins through diet of bovine origin is estimated in two worst-case scenarios. The first one corresponds to the consumption of contaminated food products by a small number of consumers during a long period (local consumption) and the second simulates the consumption of contaminated products by a large number of consumers during a short period (supermarket purchase). The theoretical maximum daily intake of dioxins in adults was respectively 374 and 123 pg TEQ/d. The estimated maximum increase of dioxin body burden corresponds to 7 pg TEQ/g fat in the local consumption scheme and 0.07 pg TEQ/g fat in the supermarket consumption scheme.

Intramedullary sarcoidosis presenting as incomplete paraplegia: case report and literature review.

Sarcoidosis is a chronic, multisystem noncaseating granulomatous disease of unknown etiology. Sarcoidosis typically presents clinically in individuals between the ages of 20 and 40 years. Although sarcoidosis most commonly affects the respiratory system, nearly any organ system can be involved. Spinal cord involvement by sarcoidosis is a rare event, occurring in less than 1% of patients with systemic disease. The case presented is that of a 29-year-old black male with benign past medical history who presented with a 6-week history of progressive incomplete paraplegia and bowel dysfunction. Magnetic resonance imaging revealed an intramedullary mass at the T-4-T-5 levels. The patient underwent thoracic laminectomy and debulking of the mass. The pathology was consistent with granulomatous disease. Postoperatively, the patient was placed on prednisone. He subsequently received comprehensive inpatient and outpatient rehabilitation and at present is bowel and bladder continent and ambulating at community levels with a rolling walker. The diagnosis of sarcoidosis; potential treatment options, including debulking and long-term steroid use; and prognosis will be discussed.

Neurofibromatosis: an unusual cause of cervical myopathy.

Generalized neurofibromatosis (NF) is characterized by café au lait spots, deformity of the skeleton and tumors involving the skin as well as spinal, peripheral and cranial nerves. The spine is that part of the skeleton most commonly affected in NF, although involvement of the cervical spine in NF has only rarely been reported. The majority of neurofibromas involving spinal nerves are asymptomatic or present with symptoms consistent with nerve root involvement. Classic symptoms of myelopathy secondary to spinal cord compression in NF are rare. We describe a 35-year-old male with generalized NF who presented with worsening gait instability. Magnetic resonance imaging (MRI) revealed enhancing masses producing spinal cord compression at the C1-C2 and C4 levels. The patient underwent decompressive laminectomy and, at eight weeks after surgery, was once again ambulatory. The literature discussing the sequelae and treatment of NF when it produces myelopathy is reviewed.

Identification of yebG as a DNA damage-inducible Escherichia coli gene.

The nucleotide sequence upstream of the Escherichia coli yebG gene presents features similar to those found in SOS system regulatory sites (putative SOS box, -10 and -35 promoter boxes and a ribosome binding site). Operon fusion assays demonstrate now that this region controls transcription in a recA-, lexA-dependent way and that the reporter gene expression is inducible by DNA damage consequent to mitomycin C treatment. Increased expression does not result from an increase in plasmid copy number. These results indicate that yebG is a novel SOS regulon gene. The yebG product is predicted to be a 96 amino acid residue, 10.7 kDa protein whose function is not yet known. Unlike other SOS genes, the construct carrying the yebG regulatory region is not stationary phase inducible.