Contributions of GeneXpert® to TB diagnosis in Myanmar.

BACKGROUND: Xpert® MTB/RIF, a rapid, molecular TB diagnostic assay, can detect Mycobacterium tuberculosis and rifampin resistance directly from clinical sputum samples in <2 h with high sensitivity and specificity. The added diagnostic value of Xpert over smear microscopy at a national level in Myanmar has not been previously reported.METHODS: We evaluated 339,358 Xpert and demographic records captured from January 2015 to December 2018 as part of the Myanmar National TB Program Data Utilization and Connectivity Project to examine the additional diagnostic yield of Xpert relative to smear for the detection of M. tuberculosis for TB diagnosis in Myanmar, with a focus on people living with HIV (PLHIV) and sample type.RESULTS: Use of Xpert increased TB case detection by 40% compared to smear microscopy results. Among PLHIV, use of Xpert increased TB case detection by almost 100% compared to smear microscopy results.CONCLUSION: Xpert testing identified more patients with TB than smear microscopy alone, particularly in cohorts with significant proportions of PLHIV. The use of Xpert as a screening tool in countries with a high burden of TB could lead to significantly increased diagnosis of TB at a regional and national level.

Clonal diversity of Acinetobacter baumannii clinical isolates in Myanmar: identification of novel ST1407 harbouring blaNDM-1.

Recent Acinetobacter baumannii clinical isolates in a teaching hospital in Myanmar comprised three major sequence types (ST2, ST16 and ST23) and two sporadic STs, showing a high resistance rate to carbapenem associated with blaOXA-23 . The NDM-1 encoding gene was identified in only one isolate exhibiting novel ST1407 (a triple-locus variant of ST16).

First detection of the mcr-1 colistin resistance gene in Escherichia coli from a patient with urinary tract infection in Myanmar.

Colistin-resistance gene mcr-1 was detected in an Escherichia coli sample among 442 clinical isolates collected in a tertiary-care hospital in Yangon, Myanmar, in 2018. This isolate was classified into phylogroup A-ST23 complex and harboured bla CTX-M-15 and bla TEM-1, associated with multiple mutations in quinolone-resistance-determining regions in gyrA and parC.

Host Range and Population Survey of Spodoptera frugiperda Rhabdovirus.

The Sf9 and Sf21 cell lines derived from ovarian tissues of the wide-host-range phytophagous lepidopteran Spodoptera frugiperda are widely used for research and commercial-scale production of recombinant proteins. These cell lines are chronically infected with a rhabdovirus (Sf-RV) that does not cause any overt cytopathic effects. We demonstrate that wild populations of S. frugiperda in the eastern United States and Caribbean are infected with genetically diverse strains of Sf-RV and that this virus is also capable of infecting cells of Spodoptera exigua, Heliothis subflexa, and Bombyx mori Feeding studies demonstrated the ability of S. frugiperda larvae to deposit Sf-RV onto human-consumed vegetables during feeding. Although no evidence for replication in two species of plant cells was detected, subcellular localization studies demonstrated that the Sf-RV nucleocapsid was targeted to plasmodesmata, while two forms of the accessory protein were differentiated on the basis of their ability to localize to nuclei. Collectively, the results from this study suggest that environmental exposure of humans to Sf-RV is likely to be commonplace and frequent, but its inability to replicate in plant or human cells suggests that there is no substantial risk to human health.IMPORTANCE Insect-derived cell lines are widely used commercially for the production of vaccines and protein-based pharmaceuticals. After decades of safe and beneficial use, it was a surprise to the biotechnology industry to discover an endemic rhabdovirus in Sf9 cells. This discovery was made possible only by the substantial advancements in DNA sequencing technologies. Given the public health concerns associated with many rhabdovirus species, several initiatives were undertaken to establish that Spodoptera frugiperda rhabdovirus (Sf-RV) does not pose a threat to humans. Such actions include the generation of cell lines that have been cleared of Sf-RV. Given that Sf9 is derived from a moth whose larvae feed on human-edible foods, we explored the prevalence of Sf-RV in its wild and lab-grown populations, as well as its ability to be deposited on food items during feeding. Collectively, our data suggest that there is no overt risk from exposure to Sf-RV.

National anti-tuberculosis drug resistance survey, 2002, in Myanmar.

SETTING: Thirty townships of Myanmar. OBJECTIVES: To determine the proportions of drug-resistant tuberculosis (TB) in new and previously treated pulmonary tuberculosis (PTB) cases in Myanmar. DESIGN: A cross-sectional study. Drug susceptibility was tested by the proportion method at the National Tuberculosis Reference Laboratory, Yangon. RESULTS: Of 874 TB patients included from 30 sites, 849 isolates obtained from individual patients (733 from new cases and 116 from previously treated cases) were tested for susceptibility to four primary anti-tuberculosis drugs. Of 733 isolates tested from new TB patients, 10% were resistant to any one of the anti-tuberculosis drugs, 6.5% to isoniazid (INH), 4.6% to rifampicin (RMP) and 4.0% were multidrug-resistant (MDR). Of the 116 previously treated patients, 30.2% were resistant to any one of the drugs, 26.7% to INH, 15.5% to RMP and 15.5% were MDR. Previous anti-tuberculosis treatment of more than 1 month was strongly associated with the development of MDR-TB (adjusted OR 4.8, 95% CI 2.5-9.1). CONCLUSION: The first national drug resistance survey in Myanmar revealed 4% and 15.5% MDR-TB among new and retreatment cases, respectively. Previous antituberculosis treatment was an important risk factor for MDR-TB. Continuous monitoring of drug resistance trends is needed

Measurement of offline exhaled nitric oxide in a study of community exposure to air pollution.

As part of a large panel study in Seattle, Washington, we measured levels of exhaled nitric oxide (eNO) in children's homes and fixed-site particulate matter with aerodynamic diameters of 2.5 micro m or less (PM(2.5)) outside and inside the homes as well as personal PM(2.5) during winter and spring sessions of 2000-2001. Nineteen subjects 6-13 years of age participated; 9 of the 19 were on inhaled corticosteroid (ICS) therapy. Exhaled breath measurements were collected offline into a Mylar balloon for up to 10 consecutive days. Mean eNO values were 19.1 (SD +/- 11.4) ppb in winter sessions and 12.5 +/- 6.6 ppb in spring sessions. Fixed-site PM(2.5) mean concentrations were 10.1 +/- 5.7 microg/m(3) outside homes and 13.3 +/- 1.4 inside homes; the personal PM(2.5) mean was 13.4 +/- 3.2 microg/m(3). We used a linear mixed-effects model with random intercept and an interaction term for medications to test for within-subject-within-session associations between eNO and various PM(2.5) values. We found a 10 microg/m(3) increase in PM(2.5) from the outdoor, indoor, personal, and central-site measurements that was associated with increases in eNO in all subjects at lag day zero. The effect was 4.3 ppb [95% confidence interval (CI), 1.4-7.29] with the outdoor monitor, 4.2 ppb (95% CI, 1.02-7.4) for the indoor monitor, 4.5 ppb (95% CI, 1.02-7.9) with the personal monitor, and 3.8 ppb (95% CI, 1.2-6.4) for the central monitors. The interaction term for medication category (ICS users vs. nonusers) was significant in all analyses. These findings suggest that eNO can be used as an assessment tool in epidemiologic studies of health effects of air pollution.

Associations between air pollution and mortality in Phoenix, 1995-1997.

We evaluated the association between mortality outcomes in elderly individuals and particulate matter (PM) of varying aerodynamic diameters (in micrometers) [PM(10), PM(2.5), and PM(CF )(PM(10) minus PM(2.5))], and selected particulate and gaseous phase pollutants in Phoenix, Arizona, using 3 years of daily data (1995-1997). Although source apportionment and epidemiologic methods have been previously combined to investigate the effects of air pollution on mortality, this is the first study to use detailed PM composition data in a time-series analysis of mortality. Phoenix is in the arid Southwest and has approximately 1 million residents (9. 7% of the residents are > 65 years of age). PM data were obtained from the U.S. Environmental Protection Agency (EPA) National Exposure Research Laboratory Platform in central Phoenix. We obtained gaseous pollutant data, specifically carbon monoxide, nitrogen dioxide, ozone, and sulfur dioxide data, from the EPA Aerometric Information Retrieval System Database. We used Poisson regression analysis to evaluate the associations between air pollution and nonaccidental mortality and cardiovascular mortality. Total mortality was significantly associated with CO and NO(2) (p < 0.05) and weakly associated with SO(2), PM(10), and PM(CF) (p < 0. 10). Cardiovascular mortality was significantly associated with CO, NO(2), SO(2), PM(2.5), PM(10), PM(CF) (p < 0.05), and elemental carbon. Factor analysis revealed that both combustion-related pollutants and secondary aerosols (sulfates) were associated with cardiovascular mortality.

Origin of optical activity in the purple bacterial photoreaction center.

The photoreaction center (RC) of purple bacteria contains four bacteriochlorophyll (Bch) and two bacteriopheophytin (Bph) molecules as prosthetic groups. Their optical activity, as measured by circular dichroism (CD) spectroscopy, is largely increased in situ as compared to organic solutions. The all-exciton hypothesis posits that this enhanced optical activity is entirely due to excitonic interactions between the electronic transitions of all six bacteriochlorin molecules. Using the simple exciton theory, this model predicts that the near-infrared CD spectra should be conservative. The fact that they are not, whether the special pair of Bch (SP) that constitutes the primary electron donor is reduced or oxidized, has been explained by hyperchromic effects. The present work tests this hypothesis by successively eliminating the absorption and, therefore, the optical activity of the Bphs and of the non-special-pair (non-SP) Bchs. This was accomplished by trapping these pigments in their reduced state. RC preparations with the four non-SP bacteriochlorins trapped in their reduced state and, therefore, with an intact SP displayed conservative CD spectra. RC preparations with only the electronic transitions of SP and of one non-SP Bch also showed conservative CD spectra. These conservative CD spectra and their corresponding absorption spectra were simulated using simple exciton theory without assuming hyperchromic effects. Bleaching half of the 755-nm absorption band by phototrapping one of the two Bph molecules led to the complete disappearnce of the corresponding CD band. This cannot be explained by the all-exciton hypothesis. These results suggest that the optical activity of the SP alone, or with one non-SP Bch, is due to excitonic interactions.(ABSTRACT TRUNCATED AT 250 WORDS)

An aggressive surgical approach to the management of chronic osteomyelitis.

This is a review of 13 patients with chronic osteomyelitis treated at the author's institution using techniques similar to the management of giant cell tumors of bone. This included aggressive serial debridements and appropriate antibiotic coverage and subsequent bone-grafting or soft-tissue coverage procedures. The number of surgical procedures ranged from three to eight (average 4.2) and were performed every two to three days. Empiric antibiotics were started after cultures were taken at operation, and were changed to organism-specific therapy when culture results were available. Parenteral antibiotics were continued for a mean of five weeks (range, two to eight weeks) and seven of 13 patients received oral antibiotics for an additional two to six weeks after parenteral therapy. Bone grafting or muscle flaps or both were used in those patients with compromised structural integrity, or to fill created dead space and allow wound closure. In postoperative follow-up evaluation, none of the patients have had evidence for recurrent osteomyelitis (mean duration, 58 months; range, 27-89 months). This technique of serial operations with proper antimicrobial therapy, followed by bone grafting and local muscle flaps when needed, has led to excellent end results in the treatment of chronic osteomyelitis.

Physical injury risk versus risk from hazardous waste remediation: a case history.

This study was conducted to estimate the transportation risks associated with the removal of contaminated soils near the ASARCO copper smelter in Ruston, Washington. Three remediation options involving removal of differing amounts of soil were considered. The risks of death, disabling, and nondisabling injury were estimated. Under the scenario requiring the greatest soil removal, 3.62 disabling injuries, 14.46 possibly disabling injuries, and 0.67 deaths are expected to result from transporting the contaminated soil to an approved hazardous waste disposal facility. If the contaminated soil is not removed, the U.S. Environmental Protection Agency estimates that 2 arsenic-related skin cancers per 1000 lifetimes for exposed persons will occur.

Phototrapping of doubly reduced monomeric bacteriochlorophyll in the photoreaction center of Ectothiorhodospira sp.

The photoreaction center from the purple sulfur bacterium Ectothiorhodospira sp. was illuminated in the presence of reduced cytochrome c or dithionite under anaerobic conditions. This treatment first caused the monoelectronic reduction of both molecules of bacteriopheophytin (Bph), phi A and phi B, as witnessed by the appearance of EPR and optical signals typical of singly-reduced bacteriochlorins. Continued illumination under the same reducing conditions caused both of these signals to disappear. Such disappearance was accompanied by a complete bleaching of the Qx and Qy absorption bands of Bph but not of the corresponding transitions of bacteriochlorophyll (Bchl). These phenomena are interpreted by a double reduction of phi A and phi B. As long as the medium remained reducing and anaerobic, these changes were stable. Prolonged illumination under the same reducing conditions finally led to the bleaching of the Qx (600 nm) and Qy (800 nm) bands of Bchl but not of the 880-nm band. This generated no EPR or 645-nm absorption signals due to singly-reduced Bchl. The bleaching kinetics of the 800-nm band was biphasic and paralleled a shift of the peak wavelength. This is interpreted by a double reduction of both molecules of monomeric Bchl BA and BB in an undetermined order. After bleaching of the 800-nm band has reached saturation, the absorbance ratio of the 800/880-nm absorption bands remains constant, as would be expected if the ultimate spectrum was that of the primary electron donor. These experiments demonstrate the photoreduction of Bchl and allow the absorption spectrum of the primary donor to be measured for the first time.(ABSTRACT TRUNCATED AT 250 WORDS)

Use of computerized pattern recognition in the study of the cuticular hydrocarbons of imported fire ants. I. Introduction and characterization of the cuticular hydrocarbon patterns of Solenopsis invicta and S. richteri.

A method is described in which gas chromatographic (GC) data obtained from cuticular hydrocarbons are treated by methods of pattern recognition. Based on a recently described sample preparation procedure, GC data are normalized to eliminate slight variations in chromatographic conditions and converted into the proper format for discriminant analysis by computer. The results of several methods of data treatment and display are discussed, based upon the chemometric system package, ARTHUR. The approach has the advantage of largely removing operator bias.

Use of computerized pattern recognition in the study of the cuticular hydrocarbons of imported fire ants. II. Comparison of the cuticular hydrocarbon patterns between different colonies of Solenopsis richteri.

Gas chromatography (GC) data obtained from the cuticular hydrocarbons of the black imported fire ants are treated by methods of pattern recognition. Based on a recently described sample preparation procedure, GC data are normalized to eliminate slight variations in chromatographic conditions, and converted to the proper format for discriminant analysis by computer. The results of several methods of data treatment and display are discussed, based on the chemometrics system package, ARTHUR.

Use of 8-analino-1-naphthalene sulfonate as a monitor for possible phase transition involving water at low temperatures in photoreaction center from Rhodospirillum rubrum.

The increase in the rate of the primary back reaction on cooling the photoreaction center from Rhodospirillum rubrum was interpreted in terms of a model in which the peculiar temperature dependence of the rate results from a phase transition involving water. The primary back reaction is defined as the return of the electron from the reduced primary ubiquinone to the oxidized bacteriochlorophyll molecules following illumination. The dye 8-anilino-1-naphthalene sulfonate was used to detect the state of the water solvent as it transforms on cooling from a liquid to a solid glass. We inferred from studies with air-dried films of photoreaction center that the water which may be responsible for the unusual temperature dependence of the rate of the primary back reaction is not on the surface but is bound within the photoreaction center protein.

Measurement of mitochondrial volume independent of refractive index by light scattering.

Using latex spheres of accurately determined dimensions, it was found that, although the scattered light intensity at an angle within the forward scattering lobe varies with the refractive index of the medium, the ratio of the scattered light intensity at a pair of angles is independent of the refractive index. This finding is consistent with calculations from the Mie theory by Hodkinson that the shape of the forward scattering lobe depends only on the size of the sphere and is independent of the refractive index of the sphere or of the suspending medium. This method was applied to the measurement of volume changes in mitochondria induced either by suspending the mitochondria in solutions of different osmolality or by addition of ionophores to stimulate ion uptake. The volume changes measured were independent of the refractive index of the suspending medial. It is shown that measuring the ratio of the scattered light intensity at selected pair of angles within the forward scattering lobe is a good method to measure the average size of the mitochondria.

Evidence for monomeric bacteriochlorophyll in P800 of the photoreaction center from Rhodospirillum rubrum.

To find out whether weak or strong coupling exists between the bacteriochlorophyll molecules of the photoreaction center, the relative efficiency of energy transfer to P870 was measured at 795 nm and at 808 nm, at room temperature and at 77 degrees K. At room temperature, both relative efficiencies are close to 100%. However, at 77 degrees K, 795 nm light has a quantum efficiency of 76% and 808 nm light has an efficiency of 87%. These results confirm the fact that P800 is formed of at least one short wavelength component and one long wavelength component. Moreover, the short wavelength component is weakly coupled to both P870 and to the long wavelength component of P800. The conclusion is that the short wavelength component is due to monomeric bacteriochlorophyll. By comparison with other data, all four bacteriochlorophyll molecules of the photoreaction center are inferred to be monomeric.

Photodichroic studies of the photoreaction center from Rhodospirillum rubrum. I. Attribution of P870 to two non parallel dipoles.

A randomly oriented sample of photoreaction center prepared from Rhodospirillum rubrum was excited at 77 degrees K by an actinic linearly polarized light of 870 nm. Under such conditions, only those chromophores with components of their absorption dipoles oriented parallel to the polarization of the actinic light are bleached. The change in absorbance at 900 nm of this photoselected sample was observed while varying the angle of polarization of a weak measuring light. The polarization of the absorbance change was thus evaluated as 0.25. This value is interpreted to mean that P870 is attributable to two absorption dipoles forming an angle included between 35.75 degrees and 90 degrees. Comparison with the p value of 0.5 obtained on a similar preparation by polarization of fluorescence (Ebrey, T. G. and Clayton, R.K. (1969) Photochem. Photobiol. 10, 109-117) leads to the conclusion that either these two dipoles emit fluorescence without being coupled by singlet-singlet energy transfer or that only one of them is a fluorescence emitter in the absence of reversible singlet-singlet energy transfer.