Non-tuberculous mycobacteria: a retrospective review of Scottish isolates from 2000 to 2010.

There is growing recognition of the clinical importance of non-tuberculous mycobacteria (NTM), a group of versatile opportunistic bacterial pathogens. We describe the characteristics of NTM isolates in Scotland over an 11-year period using data held by the Scottish Mycobacteria Reference Laboratory. American Thoracic Society microbiological criteria were used to evaluate the clinical significance of isolates. Data presented include analysis of trends across time, species/body site associations, gender and age differences, geographical variations and the association between cystic fibrosis and Mycobacterium abscessus. We emphasise the need for standardised reporting criteria for NTM isolates to ensure optimal surveillance of NTM disease.

Space cannot be cut-why self-identity naturally includes neighbourhood.

Psychology is not alone in its struggle with conceptualizing the dynamic relationship between space and individual or collective identity. This general epistemological issue haunts biology where it has a specific focus in evolutionary arguments. It arises because of the incompatibility between definitive logical systems of 'contradiction or unity', which can only apply to inert material systems, and natural evolutionary processes of cumulative energetic transformation. This incompatibility makes any attempt to apply definitive logic to evolutionary change unrealistic and paradoxical. It is important to recognise, because discrete perceptions of self and group, based on the supposition that any distinguishable identity can be completely cut free, as an 'independent singleness', from the space it inescapably includes and is included in, are a profound but unnecessary source of psychological, social and environmental conflict. These perceptions underlie Darwin's definition of 'natural selection' as 'the preservation of favoured races in the struggle for life'. They result in precedence being given to striving for homogeneous supremacy, through the competitive suppression of others, instead of seeking sustainable, co-creative evolutionary relationship in spatially and temporally heterogeneous communities. Here, I show how 'natural inclusion', a new, post-dialectic understanding of evolutionary process, becomes possible through recognising space as a limitless, indivisible, receptive (non-resistive) 'intangible presence' vital for movement and communication, not as empty distance between one tangible thing and another. The fluid boundary logic of natural inclusion as the co-creative, fluid dynamic transformation of all through all in receptive spatial context, allows all form to be understood as flow-form, distinctive but dynamically continuous, not singularly discrete. This simple move from regarding space and boundaries as sources of discontinuity and discrete definition to sources of continuity and dynamic distinction correspondingly enables self-identity to be understood as a dynamic inclusion of neighbourhood, through the inclusion of space throughout and beyond all natural figural forms as configurations of energy. Fully to appreciate and communicate the significance of this move, it is necessary to widen the linguistic, mathematical and imaginative remit of conventional scientific argument and explication so as to include more poetic, fluid and artistic forms of expression.

Evaluation of the GenoType Mycobacteria Direct assay for the simultaneous detection of the Mycobacterium tuberculosis complex and four atypical mycobacterial species in smear-positive respiratory specimens.

A novel, commercially available reverse hybridization assay [GenoType Mycobacteria Direct (GTMD), version 2.0; Hain Lifescience] was evaluated for the direct detection of five clinically relevant mycobacterial species [Mycobacterium tuberculosis complex (MTBC), Mycobacterium avium, Mycobacterium malmoense, Mycobacterium kansasii and Mycobacterium intracellulare] from 54 smear-positive respiratory specimens and the findings were compared with culture results. Three approaches were used for specimen preparation using either whole or 'split' sample volumes and N-acetyl-l-cysteine/3 % NaOH or 4 % NaOH as decontamination chemicals. Forty-three out of 52 samples in which RNA amplification was successful gave GTMD results that concurred with the identification of the cultured isolate. All cases of MTBC were detected. Twenty-two samples contained M. tuberculosis complex, seven had M. kansasii, four had M. malmoense, seven contained atypical mycobacteria other than those detectable using the GTMD assay and three specimens contained no viable mycobacteria. The assay is easy to use and can be completed in one working day. Results interpretation is facilitated by the inclusion of an internal amplification control with each sample to allow identification of specimens containing amplification inhibitors. A positive GTMD result will quickly identify patients with MTBC infection or provide specific identification of four other atypical mycobacteria from the same specimen. This allows more rapid drug susceptibility testing, treatment, and public health and infection control decisions.

Human and animal infections with Mycobacterium microti, Scotland.

During 1994-2005, we isolated Mycobacterium microti from 5 animals and 4 humans. Only 1 person was immunocompromised. Spoligotyping showed 3 patterns: vole type, llama type, and a new variant llama type.

Off-pump coronary artery bypass grafting in a heparin-induced thrombocytopenia type II patient using hirudin.

Heparin is routinely used for anticoagulation during cardiopulmonary bypass; it is fast acting, is easily monitored, and has an antidote. Heparin-induced thrombocytopenia (HIT) can be a life-threatening condition requiring an alternative anticoagulant (hirudin) if cardiac surgical intervention is considered. At full anticoagulant doses, the effects of hirudin are difficult to monitor; therefore, we present a case in which off-pump coronary artery bypass grafting was performed in an HIT patient in whom the lower doses of hirudin could safely be monitored with easily available tests.

Imbalanced nuclear ratios, post-germination mortality and phenotype-genotype relationships in allopatrically-derived heterokaryons of Heterobasidion annosum.

Twelve heterokaryotic strains of Heterobasidion annosum (Fr.) Bref. containing nuclei and mitochondria derived from British and North European populations were prepared by pairing homokaryotic strains and isolating hyphal tips from either side of interaction interfaces. Conidia derived from the heterokaryons had high germinability and were predominantly uninucleate. The nuclear genotypes recovered from these conidia were predominantly nonresident in origin, reflecting the marked asymmetry m nuclear ratios (as high as 9:1) in favour of invasive nuclei that developed in the mycelium. In spite of this asymmetry, the heterokaryons had similar phenotypes to the resident homokaryons that they were derived from. Whereas the relative ability of sib-related nuclei to become established in a homokaryon was about equal in sympatric protoplasm, it could be very different in allopatric protoplasm. Post-germination mortality due to the cessation of development following transfer of germlings to fresh medium was on average similar for allopatric and sympatric conidia, but there was a marked trend for reduction in mortality as nuclear ratio asymmetry increased. Homokaryons derived via conidia from a common heterokaryon exhibited less somatic incompatibility when paired together than did the original, basidiospore-derived strains. These findings indicate that phenotype-genotype relationships resulting from allopatric matings, such as could occur following geographical transposition, are liable to differ radically from those in sympatric matings and so have potentially profound effects on resident population structure.

Distribution patterns of number of nuclei in conidia from heterokaryons of Heterobasidion annosum (Fr.) Bref. and their interpretation in terms of genomic conflict.

Ratios of nuclear genotypes observed in conidia from heterokaryotic strains of Heterobasidion annosum (Fr.) Bref., obtained from pairings between sympatrically derived, sib-related and non-sib-related homokaryons, commonly deviated from 1:1. Ratios were temporally stable, and the genotypes examined could be ranked in a strict dominance hierarchy, linked both to the relatedness of the association partners and to the growth rates of the parental homokaryons. Parental homokaryons and sibrelated heterokaryons produced conidia with a mean number of nuclei of about two, whereas non-sib-related-d heterokaryons produced conidia that were predominantly uninucleate. Moreover, whereas conidia containing more than one nucleus germinated most rapidly when derived from homokaryons or sib-related heterokaryons, uninucleate conidia germinated more readily if derived from non-sib-related heterokaryons. In a study of naturally occurring heterokaryons, distribution patterns of the number of nuclei in conidia were found to be similar to those of the homokaryons. The possible interpretation of these findings in terms of inter-nuclear genomic conflict is discussed.