Living Donor Kidney Transplantation in a Patient With Epidermolysis Bullosa: A Case Report.

Severe recessive dystrophic epidermolysis bullosa is a very rare inherited disease with excessive blisters forming starting at birth. Surgical intervention in this population creates a challenge: preventing formation of new lesions while managing previously scarred tissues. We present a case of a 27-year-old patient with end-stage renal disease caused by rapidly progressive IgA nephropathy. Living donor kidney transplantation was performed under local, spinal and epidural anesthesia. Living kidney transplantation in epidermolysis bullosa patients with end-stage renal disease should not be a contraindication for transplantation and should be considered as a viable and feasible option after careful preparation.

Multiplex real-time PCR and culture methods for detection of Shiga toxin-producing Escherichia coli and Salmonella Thompson in strawberries, a lettuce mix and basil.

An appropriate approach of high throughput multi-screening was verified for Shiga toxin-producing Escherichia coli (STEC) and Salmonella spp. in strawberries, lettuce and basil. Sample replicates were inoculated with STEC O157 or O26 and Salmonella Thompson (ca. 10-70, 100-700 and 1000-7000 cfu/25 g) and analysed after 1 and 5 days of storage (strawberries and lettuce at 7 °C and basil at 10 °C). After 18-24 h of enrichment at 37 °C in buffered peptone water, detection was performed using the GeneDisc multiplex PCR (stx1, stx2, eae and iroB genes) and selective culture media for isolation of STEC (with immunomagnetic separation (IMS)) and Salmonella spp. in parallel. After 1 day, the pathogenic strains were recovered from all samples for all inoculum levels, whereas reduced detection rates of STEC O157 and S. Thompson were observed after 5 days of storage in case of strawberries, in particular for the lowest inoculums level, suggesting superior survival potential for STEC O26. Overall, this study indicates the ability of PCR based screening methods for reproducible multi-detection of low numbers (10-70 cfu/25 g) of STEC and Salmonella in this type of foods. However, for the basil samples, PCR needed twofold dilution of the DNA extract to overcome inhibition. It was noted that on several occasions growth of competitive microbiota obstructed finding presumptive colonies on the selective agar media, whereas the use of an additional agar medium such as CHROMagar STEC (without IMS) improved recovery rate of STEC.

Small Bacillus cereus ATCC 14579 subpopulations are responsible for cytotoxin K production.

AIMS: Bacillus cereus diarrhoeal food poisoning can be caused by several potential enterotoxins, including the nonhaemolytic enterotoxin (Nhe), haemolysin BL (Hbl) and cytotoxin K (CytK). To get more insights into the CytK expression, a fluorescent reporter strain was created for CytK expression. METHODS: Bacillus cereus ATCC 14579 was used as the reporter strain that contained the cyan fluorescent protein (CFPopt) gene under control of the cytK promoter. Transcription of enterotoxin genes nheB, hblC and cytK was assessed by messenger RNA analysis (RT-qPCR), and their full expression was assessed by immunological protein detection in the case of Nhe and Hbl and fluorescence microscopy in the case of CytK, using the reporter gene CFPopt. RESULTS: Transcription of enterotoxins Nhe, Hbl and CytK showed similar kinetics with a peak during the late exponential growth phase. Toxin expression of the reporter strain was unaltered in comparison with the wild type. However, fluorescence, and thus CytK expression, only occurred in a small (1-2%) portion of the cell population. CONCLUSIONS: These results suggest that a small subpopulation of B. cereus ATCC 14579 is responsible for CytK production in a homogeneous monoculture. SIGNIFICANCE AND IMPACT OF THE STUDY: Future research is warranted to determine whether genetically homogeneous B. cereus populations utilize differential gene expression for other toxins and virulence genes than CytK and whether this also applies to other B. cereus strains. If so, differential expression of toxin genes could be used by these bacteria to increase the fitness and survival chances of their population by diversification and specialization into different subpopulations.

A. carotis thrombosis with ocular ischemic syndrome: acute glaucoma postendarterectomy: a case report.

A patient develops neovascular glaucoma a few weeks after endarterectomy for carotid artery occlusion. The ocular tension is normalised after retinal photocoagulation, followed by trabeculectomy.