Six-year study of the incidence of herpes in genital and nongenital cultures in a central Kentucky medical center patient population.

Herpes infections are among the most common sexually transmitted diseases and are the most common cause of genital ulcer disease in the United States. This study addresses the changing distribution of herpes simplex virus type 1 (HSV-1) and HSV-2 in patients presenting for evaluation of herpetic infections. Viral culture results from the University of Kentucky Clinical Microbiology Laboratory were reviewed for a 6-year period (1994 through 1999). Data were collected on patient sex, site of culture, and culture result. These data were analyzed statistically to identify yearly trends. Of the 4,498 cultures analyzed, nearly equal proportions of HSV-1 (13.3%) and HSV-2 (12.0%) were detected for an overall culture positivity rate of 25.3%. Approximately two-thirds of all positive cultures were from women. Although HSV-2 remained the predominant type of genital herpes, over the 6-year span of this study, there was a trend toward increasing proportions of HSV-1 genitalis, with 31.8% of male patients and 44.8% of female patients demonstrating HSV-1 genitalis by 1999. The majority of patients with HSV in nongenital sites grew HSV-1. Although there was significant yearly variation, HSV-2 was isolated from only 9.4% of patients with nongenital HSV for the entire 6-year period. This study therefore concludes that HSV-2 remains primarily a genital pathogen, while HSV-1 is taking on an increasingly important role in causing genital ulcer disease in addition to being the primary nongenital HSV.

Importance and emphasis of mycobacteriology competencies as perceived by educators.

OBJECTIVE: To compile a list of mycobacteriology competencies and to investigate the importance and emphasis of these competencies as perceived by clinical laboratory educators of three program types. DESIGN: Use of a survey instrument, which included 97 competency statements with Likert-type scales for the quantitative study of importance and emphasis of competencies. STUDY SELECTION: Randomly selected sample from all accredited college/university-based clinical laboratory science programs, hospital-based clinical laboratory science programs, and associate-degree clinical laboratory technician programs. DATA SYNTHESIS: For analysis, the competencies were divided into eight sub-categories. Means for each competency and each sub-category were calculated. Analysis of variance was used to determine any difference among the three program types for each sub-category of competencies. Chi-square analysis was used to determine significant differences for competencies requiring dichotomous responses. CONCLUSION: With the significant increase in tuberculosis and other mycobacterioses, the mycobacteriology experience for clinical laboratory students must be validated for relevance.

Sexual behavior, communication, and chlamydial infections among college women.

The sexual practices, partner communication patterns, and prevalence of chlamydial infection were determined in a sample of college women. Specific inclusion criteria were used to screen 146 participants. The presence of a mucopurulent cervical discharge was the only criterion significantly associated with infection. Only 12% of the sample used condoms alone or in combination with another birth control method, and only 31% of the women discussed with their partner their own or their partner's sexual history. Thirty-eight percent of the sample reported a history of one to four episodes of a sexually transmitted disease, and 21% of the women stated they had had two or more sexual partners within the past 6 months. Health providers, counselors, and women themselves must address this health issue with more assertive behavior and communication skills.

PIP: During a 4-month period, 146 sexually active college women aged over 18 who visited a student health clinic with a condition requiring a pelvic exam were studied. The two or more inclusion criteria were: new sexual partner within the past 6 months; presence of purulent cervical exudate; cervical bleeding induced by swabbing; lack of contraception; and vaginal smear with 10 or more white blood cells per high-power field. In addition, detailed information was also gathered about sexual behavior and partner communication. The mean age was 21 years; 91% were White and 98% were single. 15 (10%) of the sample tested positive for Chlamydia trachomatis. One test was inconclusive. Among 130 negative cases, 12.3% had purulent cervical discharge compared to 33.3% (8) of 15 chlamydia positive cases (p 0.05). 128 (88%) women reported using birth control: 107 (84%) used oral contraceptives (OCs); 15 used condoms; 2 used a diaphragm and condom; 1 used OCs and condom; 2 used a diaphragm; and 1 had had a tubal ligation. Only 14% (18) used condoms alone or in combination with another method. Only 31% (45) discussed the possibility of either partner having a sexually transmitted disease (STD) such as herpes, venereal warts, or pelvic inflammatory disease. 33% (5) of the positive group versus 20% (23) of the negative group discussed this issue. 32 students had had 2 or more partners in the past 6 months. The women in each group had an average of 1.20 partners. Only 18 (13%) women thought that their partner could have had another sexual partner in the past 6 months, whereas 6 did not know. 26% of the positive group versus 12% of the negative group thought that their partner might have had another sexual contact. 4 students thought that their partner may have had an STD, and 3 of them tested positive for chlamydia. 38% (55) of the sample reported a history of 1-4 episodes of an STD, amounting to a total of 76 cases. Health care providers must stress the health risks of sexual encounters in which a condom is not used.

Chlamydia trachomatis infections: a health problem of infants.

As a result of chlamydia epidemic in the adult population, the incidence of Chlamydia trachomatis in infants is increasing. Certain population groups are at risk for development of an infection. This article discusses the epidemiology, microbiology, symptomatology, and management of this problem.

Management of common parasitic infections encountered in primary care.

Ascaris lumbricoides, Enterobius vermicularis, Strongyloides stercoralis and Giardia lamblia are among the most frequently diagnosed human pathogenic parasites in the United States. Primary care practitioners need to be aware of the overt and covert signs and symptoms of these parasitic infections. This article focuses on the diagnosis and management of these common parasites.

Comparison of API 20E, API rapid E, and API rapid NFT for identification of members of the family Vibrionaceae.

Sixty isolates, from nine species of the family Vibrionaceae, were tested by the API 20E, API Rapid E, and API Rapid NFT systems. Results were compared with those obtained with standard biochemicals. Included were 7 Aeromonas caviae isolates, 27 Aeromonas hydrophilia isolates, 10 Aeromonas sobria isolates, 3 Plesiomonas shigelloides isolates, 3 Vibrio alginolyticus isolates, 3 Vibrio cholerae isolates, 1 Vibrio fluvialis isolate, 5 Vibrio parahaemolyticus isolates, and 1 Vibrio vulnificus isolate. The API 20E correctly identified all the isolates within 24 h. The API Rapid E correctly identified only 77%, misidentified 8%, and failed to identify 2% of the isolates in 4 h. The remaining 13% of the isolates gave a low selectivity identification, with one of the choices being correct. The API Rapid NFT correctly identified 87%, misidentified 5%, gave a low selectivity identification for 8% of the isolates, and in some instances, required up to 48 h of incubation. The API 20E is a valid system for use in the identification of the more commonly occurring members of the family Vibrionaceae and the most accurate and efficient of the three systems tested.

Minimal inhibitory concentrations of antimicrobial agents against Aeromonas hydrophila determined with the Autobac MTS.

Minimal inhibitory concentrations of seven antimicrobial agents for 22 strains of Aeromonas hydrophila were determined with the Autobac MTS procedure. The ranges of the minimal inhibitory concentrations were found to be similar to those obtained by a microdilution procedure. Depending upon the interpretive criteria used, there were discrepancies with carbenicillin, cephalothin, kanamycin, and tetracycline. It is recommended that the beta-lactam antibiotics ampicillin, carbenicillin, and cephalothin not be tested because of their lack of clinical usefulness, thus completely eliminating all of the significant discrepancies and reducing expendable costs by 50%.