Brevibacterium casei bacteremia and line sepsis in a patient with AIDS.

Brevibacteria are obligately aerobic gram-positive bacilli that are associated with milk products and are also found on human skin. Strains of Brevibacterium casei have been found to correspond to Centers for Disease Control coryneform groups B-1 and B-3 and have been isolated from a variety of human clinical specimens. In this report, we describe a case of B. casei bacteremia and sepsis in a patient with AIDS associated with a contaminated Hickmann catheter and review the microbiology and characteristics of these emerging opportunistic pathogens.

Latex allergy in Saudi children with spina bifida.

BACKGROUND: Children with spina bifida (SB) are exposed to latex soon after birth during bladder catheterization, rectal disimpaction, and multiple surgical procedures. IgE-mediated latex-allergic reactions have been reported recently in these children. Our study was designed to assess the prevalence of allergic reactions to latex products in a group of Saudi Arabian children with SB in a tertiary care hospital. METHODS: Fifty-nine patients, aged 1-20 years, with SB were evaluated by a questionnaire on type of latex reactions; family and personal history of other allergic disorders, such as asthma, rhinitis, and urticaria; type and number of surgical procedures; and frequency of bladder catheterization and manipulation with latex materials. Confirmation of latex sensitivity was measured by skin prick test (SPT), CAP test, and latex skin challenge. RESULTS: Allergy to latex was detected in 25% of the study group. There was a significant variation in allergic reaction by sex (males 42%, females 12%) (P<0.01), use of catheters (yes 38%, no 13%) (P<0.05), and urologic surgery (yes 60%, no 18%) (P<0.01). The number of surgical procedures, age of patient, and V-P shunt were not significantly related to allergic reactions. CONCLUSIONS: Our findings support previous studies indicating a high prevalence of latex allergy among SB patients. The CAP test was a more sensitive measure of latex allergy in SB patients than SPT or latex challenge. There was significant correlation with urologic procedures and the use of urethral catheters.

Cultivar-specific epitopes in date palm (Phoenix dactylifera L.) pollenosis. Differential antigenic and allergenic properties of pollen from ten cultivars.

Pollen from ten staminate cultivars of the date palm (Phoenix dactylifera L.) were compared for their antigenic and allergenic potentials. Crude extracts from the various cultivars were tested in 6 atopic patients with confirmed allergy to date pollen in order to determine any differences or similarities in the antigenic and allergenic properties of these cultivars. Results of skin prick tests, ELISA, IgG and IgE immunoblot analyses, peripheral blood lymphocyte proliferation and concomitant interleukin-4 (IL-4) production indicated inter-cultivar heterogeneity. One of the cultivars, No. 8, failed to elicit any skin test reactivity or bind IgE in atopic sera as determined by ELISA, immunoblotting or any of the other parameters examined. However, there were individual differences in patient responses but in the main and contrary to the results obtained with cultivars No. 1, 2, 4, 5 and 8, five of the cultivars, namely No. 3, 6, 7, 9 and 10, showed more enhanced differential antigenic and allergenic properties. Our results strongly indicate that the antigenicity and allergenicity of date palm pollen is more of a cultivar-specific phenomenon than a species-specific phenomenon, which is governed by the number, quantities or both of the major allergen epitopes possessed by that variety or cultivar.

Peak expiratory flow rates in healthy Saudi Arabian children living in Riyadh.

The peak expiratory flow rate (PEFR) was measured in 457 healthy Saudi schoolchildren (235 boys and 222 girls) aged 6 to 16 years, living in Riyadh, using two simple and commercially available airflow meters, Wright peak flow meter and the mini-Wright peak flow meter. All measurements were obtained in the standing position and the best of three trials was recorded. Standing height and age were used as independent variables. The regression equations for PEFR were determined for boys and girls separately. The boys had higher values than the girls at all heights. The difference was not significant. Both boys and girls had lower PEFRs as compared with European children and American children of different racial origin (P < .0001). When age was added to height as the second independent variable the Saudi boys and girls had significantly lower PEFRs than Swedish and British children (P < .0001). One explanation for these differences may be that the Saudi children on the average are shorter and have lower body weights than, eg, American children. The PEFR did not differ when using the Wright peak flow meter or the mini-Wright peak flow meter. These findings will serve as an important basis for preparing charts for normal PEFR values for Saudi children.

Major allergens of date palm (Phoenix dactylifera L.) pollen. Identification of IgE-binding components by ELISA and immunoblot analysis.

The IgE-binding components of date palm (Phoenix dactylifera L.) pollen were determined by ELISA and Western blotting in atopic patients in order to identify its major allergens. From a pool of previously identified allergenic fractions and sera from 15 skin-test-positive, atopic subjects, four components of 12, 14.4, 57, and 65-67 kDa were found to bind IgE in 80-93% of sera. Two other components of molecular masses 28-30 and 37-40 kDa also bound 60-80% of atopic sera. The immunologic specificity of date-pollen allergen that induced antibody response in sera of atopic patients was confirmed with ELISA. Furthermore, most of the reactivity in pooled positive atopic serum and antiserum raised in rabbits was eliminated after the sera were absorbed with the allergen. IgG immunoblot analyses showed varying degrees of cross-reactivity with common local allergens, notably Bermuda grass, but were generally of low intensity. These results indicate that date pollen has six major allergens with the 12, 14.4, 57, and 65-67 kDa bands binding 80-93%, and the 28-30 and 37-40 kDa bands 60-80% of atopic sera. We propose that these major allergens be assigned the notations "Pho d I" to "Pho d VI" in the order listed.

Characterization of antigens and allergens of date palm (Pheonix dactylifera) pollen. Immunologic assessment of atopic patients by whole extract and its fractions [corrected].

Antigenic and allergenic components of date palm (Phoenix dactylifera) pollen were investigated to observe their effects on the skin test reactivity, lymphocyte blastogenesis and cytokine production in atopic and healthy individuals. Date pollen extracts were fractionated using SDS-PAGE and Sephacryl S-200 gel filtration. Western blotting of SDS-PAGE separated components with antiserum raised against whole pollen extract in rabbits revealed at least 22 immunoreactive bands ranging in molecular weight between 12 and 94 kD. The immunogenicity of the pollen extract was further confirmed by strong positive reactions in ELISA and Ouchterlony's double diffusion tests. Immunoblot analyses revealed IgG and IgE reactive components (14-94 kD for IgG and 12-90 kD for IgE) in the skin test-positive patients' sera against whole pollen extract. Fifteen of 60 atopics reacted positively to either whole or some fractions of date pollen extract when skin tested. In response to whole or components of date pollen extract atopic patients showed differential peripheral blood lymphocyte (PBL) proliferative response and cytokine (IL-2, IL-4) production when compared with PBL of normal subjects. Our findings strongly suggest that date palm pollen should be considered a reaginic component and should be included in the battery of allergens for determining the allergic status of atopic patients, particularly in those parts of the world where the date palm is grown commercially.

IgE antibodies to Mycoplasma pneumoniae in asthma and other atopic diseases.

IgE antibodies to Mycoplasma pneumoniae antigens were measured by RAST assay in 152 patients with asthma and other IgE and non-IgE mediated diseases. Five patients with asthma and/or atopic dermatitis had highly elevated Mycoplasma RAST binding ratios, p < 0.001. For these five patients the ratios ranged from 1.78 to 4.74. These increased ratios persisted at least two to 16 months in three of four individuals who were evaluated sequentially. RAST inhibition studies using Mycoplasma pneumoniae, Mycoplasma control, Streptococcus MG and viral antigens showed the specificity of binding for M. pneumoniae in these five patients indicating the presence of IgE antibodies to M. pneumoniae.