RESUMEN
Previous work has shown that nicotine treatment protects against nigrostriatal degeneration in rodents, findings that may be of relevance to the decreased incidence of Parkinson's disease in cigarette smokers. In the present studies, we investigated the effect of nicotine against 1-methyl-4-phenylpyridinium-induced toxicity in dopaminergic ventral mesencephalic cultures to identify the nicotinic receptor population that may be involved. [3H]Epibatidine, a ligand that binds to receptors containing alpha2-alpha6 subunits, bound to at least two populations of sites that were up-regulated by nicotine in a time and dose dependent manner. We next examined the effect of nicotine on cultures treated with 1-methyl-4-phenylpyridinium, a neurotoxin that selectively damages nigrostriatal dopaminergic neurons. Pre-treatment with nicotine, at 10(-7)-10(-4) M, partially prevented the toxin-induced decline in dopaminergic cells. Pre-exposure to nicotine for 24 h resulted in optimal protection, suggesting that receptor up-regulation may contribute to the observed neuroprotective effect. Nicotine-mediated protection was blocked by pre-incubation with the nicotinic receptor antagonist d-tubocurarine (10(-4) M), but not the alpha7 receptor-selective antagonist alpha-bungarotoxin (10(-7) M). Our results show that nicotinic receptor activation partially protects nigral dopaminergic neurons from 1-methyl-4-phenylpyridinium-induced toxicity in culture and that this appears to occur through an interaction at non-alpha7 containing receptors.
Asunto(s)
1-Metil-4-fenilpiridinio/toxicidad , Dopamina/metabolismo , Neuronas/efectos de los fármacos , Fármacos Neuroprotectores/farmacología , Nicotina/farmacología , Receptores Nicotínicos/efectos de los fármacos , Sustancia Negra/efectos de los fármacos , Animales , Muerte Celular/efectos de los fármacos , Muerte Celular/fisiología , Femenino , Inmunohistoquímica , Neuronas/metabolismo , Técnicas de Cultivo de Órganos , Enfermedad de Parkinson/tratamiento farmacológico , Enfermedad de Parkinson/fisiopatología , Enfermedad de Parkinson/prevención & control , Embarazo , Ratas , Ratas Sprague-Dawley , Receptores Nicotínicos/metabolismo , Sustancia Negra/metabolismo , Sustancia Negra/fisiopatología , Tabaquismo/metabolismo , Tabaquismo/fisiopatología , Tirosina 3-Monooxigenasa/metabolismo , Receptor Nicotínico de Acetilcolina alfa 7RESUMEN
Helicobacter pylori, the causative agent of gastritis and ulcer disease in humans, secretes a toxin called VacA (vacuolating cytotoxin) into culture supernatants. VacA was initially characterized and purified on the basis of its ability to induce the formation of intracellular vacuoles in tissue culture cells. H. pylori strains possessing different alleles of vacA differ in their ability to express active toxin. Those strains expressing higher toxin levels are correlated with more severe gastric disease. However, the specific role(s) played by VacA during the course of infection and disease is not clear. We have used a mouse model of H. pylori infection to begin to address this role. A null mutation of vacA compromises H. pylori in its ability to initially establish infection. If an infection by a vacA mutant is established, the bacterial load and degree of inflammation are similar to those associated with an isogenic wild-type strain. Thus, in this infection model, vacA plays a role in the initial colonization of the host, suggesting that strains of H. pylori expressing active alleles of vacA may be better adapted for host-to-host transmission.
Asunto(s)
Proteínas Bacterianas/fisiología , Infecciones por Helicobacter/etiología , Helicobacter pylori/patogenicidad , Animales , Proteínas Bacterianas/genética , Modelos Animales de Enfermedad , Femenino , Ratones , Ratones Endogámicos C57BL , MutaciónRESUMEN
Legionella pneumophila is a facultative intracellular gram-negative rod that causes pneumonia in humans. Free-living amoebas are thought to serve as a reservoir for Legionella infections. Signature-tagged mutagenesis was employed to identify Legionella pneumophila genes necessary for survival in the amoeba Acanthamoeba castellanii. Six mutant strains were defective in assays of invasion and intracellular growth. Four mutants also exhibited invasion and replication defects in Hartmannella vermiformis, an amoeba linked to hospital outbreaks of Legionella pneumonia. The six mutants also were tested in macrophages derived from peripheral blood mononuclear cells. Two mutants had intracellular replication defects, and two different strains entered cells less efficiently. Two transposon insertions were in known L. pneumophila genes, lspK and aroB. The other four were in novel genes. One gene has similarity to a cytochrome c-type biogenesis protein of Pseudomonas fluorescens. Another has similarity to a transcriptional activator regulating flagellar biosynthesis in Vibrio cholera. The third is similar to traA of Rhizobium sp. strain NGR234, which is involved in conjugal transfer of DNA. The fourth has no homology. By using survival in amoeba as a selection, we have isolated mutant strains with a range of phenotypes; and we have potentially identified new L. pneumophila virulence genes.
Asunto(s)
Amoeba/microbiología , Genes Bacterianos , Legionella pneumophila/genética , Animales , Medios de Cultivo , Elementos Transponibles de ADN , Humanos , Legionella pneumophila/patogenicidad , Macrófagos/microbiología , Mutagénesis , Cloruro de Sodio/farmacología , Células U937 , VirulenciaRESUMEN
Modern medicine has led to dramatic changes in infectious diseases practice. Vaccination and antibiotic therapy have benefited millions of persons. However, constrained resources now threaten our ability to adequately manage threats of infectious diseases by placing clinical microbiology services and expertise distant from the patient and their infectious diseases physician. Continuing in such a direction threatens quality of laboratory results, timeliness of diagnosis, appropriateness of treatment, effective communication, reduction of health care-associated infections, advances in infectious diseases practice, and training of future practitioners. Microbiology laboratories are the first lines of defense for detection of new antibiotic resistance, outbreaks of foodborne infection, and a possible bioterrorism event. Maintaining high-quality clinical microbiology laboratories on the site of the institution that they serve is the current best approach for managing today's problems of emerging infectious diseases and antimicrobial agent resistance by providing good patient care outcomes that actually save money.
Asunto(s)
Enfermedades Transmisibles , Atención a la Salud , Laboratorios/normas , Microbiología , Control de Enfermedades Transmisibles , Enfermedades Transmisibles/diagnóstico , Enfermedades Transmisibles/microbiología , Enfermedades Transmisibles/terapia , Humanos , Laboratorios/organización & administración , Laboratorios/tendenciasRESUMEN
The methylene blue stain for fecal leukocytes (FL) is widely used as an adjunct to slower but more accurate tests of diarrheal etiology, such as stool culture (SCx) or toxin assays for Clostridium difficile. Prior studies investigating the utility of FL for predicting SCx and C. difficile toxin assay (CDTA) results did not evaluate the importance of inpatient versus outpatient status. We conducted a study of patients who submitted a stool specimen to the Stanford Hospital Microbiology Laboratory between May 1998 and April 1999. The results for stool specimens that were tested by FL and by a confirmatory test (either SCx or CDTA) were used to determine whether the FL method helped to predict the results of these tests. Of 797 stools that were tested by FL method and at least one confirmatory test, 502 stools were tested by CDTA, and 473 stools were cultured. The FL test was 14% sensitive and 90% specific for C. difficile with a diagnostic threshold of one white blood cell/high-power field (WBC/HPF). The overall likelihood ratio (LR) for a positive CDTA was 1.4 with a 95% confidence interval (CI) of 0. 5 to 3.7 (P = 0.5) and was similar among inpatients and outpatients. In contrast, the presence of >/=1 WBC/HPF was 52% sensitive and 88% specific for the 27 positive SCx results and helped to predict a positive SCx result (LR, 4.2; 95% CI, 2.7 to 6.5; P < 0.001). The sensitivity of >/=1 WBC/HPF was 57%, and its predictive value for SCx was higher among outpatients (outpatient LR, 5.0; 95% CI, 2.9 to 8.6; P < 0.001; inpatient LR, 1.9; 95% CI, 0.3 to 10.8; P = 0.5). Among inpatients, only 4 (1.5%) of the 273 SCx results were positive, and the presence of >/=1 WBC/HPF was insensitive (25%) and did not predict a positive SCx (LR, 1.9; 95% CI, 0.3 to 10.8; P = 0.5). When the data were reanalyzed using a diagnostic threshold of five WBC/HPF for FL, the predictive power of the FL method was similar. Thus, FL was of no value in predicting CDTA positivity, nor was it helpful in predicting SCx results for inpatients. Neither SCx nor the FL method should routinely be performed on samples from inpatients. Among outpatients, presence of FLs should suggest a bacterial diarrhea in clinically compatible cases.
Asunto(s)
Proteínas Bacterianas , Diarrea/diagnóstico , Enterocolitis Seudomembranosa/diagnóstico , Heces/citología , Leucocitos , Coloración y Etiquetado/métodos , Toxinas Bacterianas/análisis , Clostridioides difficile/metabolismo , Medios de Cultivo , Diarrea/etiología , Enterocolitis Seudomembranosa/microbiología , Enterotoxinas/análisis , Heces/microbiología , Humanos , Pacientes Internos , Azul de Metileno , Pacientes Ambulatorios , Valor Predictivo de las Pruebas , Sensibilidad y EspecificidadRESUMEN
Helicobacter pylori colonizes the stomach of half of the world's population, causing a wide spectrum of disease ranging from asymptomatic gastritis to ulcers to gastric cancer. Although the basis for these diverse clinical outcomes is not understood, more severe disease is associated with strains harboring a pathogenicity island. To characterize the genetic diversity of more and less virulent strains, we examined the genomic content of 15 H. pylori clinical isolates by using a whole genome H. pylori DNA microarray. We found that a full 22% of H. pylori genes are dispensable in one or more strains, thus defining a minimal functional core of 1281 H. pylori genes. While the core genes encode most metabolic and cellular processes, the strain-specific genes include genes unique to H. pylori, restriction modification genes, transposases, and genes encoding cell surface proteins, which may aid the bacteria under specific circumstances during their long-term infection of genetically diverse hosts. We observed distinct patterns of the strain-specific gene distribution along the chromosome, which may result from different mechanisms of gene acquisition and loss. Among the strain-specific genes, we have found a class of candidate virulence genes identified by their coinheritance with the pathogenicity island.
Asunto(s)
Variación Genética , Genoma Bacteriano , Helicobacter pylori/genética , ADN Bacteriano/análisis , Genes Bacterianos , Helicobacter pylori/patogenicidad , Humanos , Análisis de Secuencia por Matrices de Oligonucleótidos/métodosRESUMEN
To accommodate both high sensitivity as well as the ability to respond to a broad range of stimulus concentrations, an organism must possess some means of modulating the gain of its sensory systems. This phenomenon is known as adaptation. Here, we demonstrate that Drosophila larvae can adapt to three odorants in a behavioral paradigm. Larval olfactory adaptation is concentration- and dose-dependent. Olfactory and visual adaptation in Drosophila melanogaster adults is dependent on the transient receptor potential (trp) calcium channel. Recovery from olfactory adaptation, which is TRP-dependent in adults, is shown to be unaffected by a loss-of-function trp mutation in larvae. Moreover, the TRP gene product is not expressed in the larval olfactory organs. These observations suggest a role for trp in mediating sensory function that is conserved between sensory modalities in adults but is not conserved between developmental stages.
Asunto(s)
Adaptación Fisiológica , Drosophila melanogaster/fisiología , Olfato/fisiología , Adaptación Fisiológica/efectos de los fármacos , Adaptación Fisiológica/genética , Animales , Conducta Animal , Canales de Calcio Tipo T/genética , Canales de Calcio Tipo T/fisiología , Relación Dosis-Respuesta a Droga , Drosophila melanogaster/genética , Drosophila melanogaster/crecimiento & desarrollo , Femenino , Técnicas para Inmunoenzimas , Larva/fisiología , Masculino , Mutación , Odorantes , Propionatos/farmacología , Olfato/genéticaRESUMEN
The brain contains a subpopulation of glucosensing neurons that alter their firing rate in response to elevated glucose concentrations. In pancreatic beta-cells, glucokinase (GK), the rate-limiting enzyme in glycolysis, mediates glucose-induced insulin release by regulating intracellular ATP production. A similar role for GK is proposed to underlie neuronal glucosensing. Via in situ hybridization, GK mRNA was localized to hypothalamic areas that are thought to contain relatively large populations of glucosensing neurons (the arcuate, ventromedial, dorsomedial, and paraventricular nuclei and the lateral area). GK also was found in brain areas without known glucosensing neurons (the lateral habenula, the bed nucleus stria terminalis, the inferior olive, the retrochiasmatic and medial preoptic areas, and the thalamic posterior paraventricular, interpeduncular, oculomotor, and anterior olfactory nuclei). Conversely, GK message was not found in the nucleus tractus solitarius, which contains glucosensing neurons, or in ependymal cells lining the third ventricle, where others have described its presence. In the arcuate nucleus, >75% of neuropeptide Y-positive neurons also expressed GK, and most GK+ neurons also expressed KIR6.2 (the pore-forming subunit of the ATP-sensitive K+ channel). The anatomic distribution of GK mRNA was confirmed in micropunch samples of hypothalamus via reverse transcription-polymerase chain reaction (RT-PCR). Nucleotide sequencing of the recovered PCR product indicated identity with nucleotides 1092-1411 (within exon 9 and 10) of hepatic and beta-cell GK. The specific anatomic localization of GK mRNA in hypothalamic areas known to contain glucosensing neurons and the coexpression of KIR6.2 and NPY in GK+ neurons support a role for GK as a primary determinant of glucosensing in neuropeptide neurons that integrate multiple signals relating to peripheral energy metabolism.
Asunto(s)
Encéfalo/fisiología , Expresión Génica/fisiología , Glucoquinasa/genética , Canales de Potasio de Rectificación Interna , Animales , Núcleo Arqueado del Hipotálamo/metabolismo , Secuencia de Bases/genética , Encéfalo/metabolismo , Hipotálamo/metabolismo , Hibridación in Situ , Masculino , Canales de Potasio/metabolismo , Punciones , ARN Mensajero/metabolismo , Ratas , Ratas Sprague-Dawley , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Distribución TisularAsunto(s)
Infecciones por Chlamydia/diagnóstico , Chlamydophila pneumoniae/aislamiento & purificación , Anticuerpos Antibacterianos/sangre , Técnicas Bacteriológicas/normas , Infecciones por Chlamydia/microbiología , Chlamydophila pneumoniae/efectos de los fármacos , Chlamydophila pneumoniae/inmunología , Medios de Cultivo , Directrices para la Planificación en Salud , Humanos , Pruebas de Sensibilidad Microbiana/normas , Reacción en Cadena de la Polimerasa , Pruebas Serológicas/normasRESUMEN
Remarkably little is known about the molecular mechanisms that drive sexual behavior. We have identified a new gene, quick-to-court (qtc), whose mutations cause males to show high levels of male-male courtship. qtc males also show a novel phenotype: when placed in the presence of a virgin female, they begin courtship abnormally quickly. qtc mutations are striking in their specificity, in that many aspects of male sexual behavior are normal. We have cloned the qtc gene and found that it encodes a predicted coiled-coil protein and is expressed in the olfactory organs, central nervous system, and male reproductive tract.
Asunto(s)
Proteínas de Drosophila , Drosophila/genética , Proteínas de Insectos/genética , Conducta Sexual Animal , Secuencia de Aminoácidos , Animales , Secuencia de Bases , Encéfalo/metabolismo , ADN Complementario , Drosophila/fisiología , Femenino , Genitales Masculinos/metabolismo , Proteínas de Insectos/química , Proteínas de Insectos/fisiología , Masculino , Datos de Secuencia Molecular , Vías Olfatorias/metabolismo , Conformación ProteicaRESUMEN
Helicobacter pylori, present in half of the world's population, is a very successful pathogen. It can survive for decades in the human stomach with few obvious consequences to the host. However, it is also the cause of gastric diseases ranging from gastritis to ulcers to gastric cancer and has been classified a type 1 carcinogen by the World Health Organization. We have previously shown that phosphorylation of a 145-kDa protein and activation of signal transduction pathways are associated with the attachment of H. pylori to gastric cells. Here we identify the 145-kDa protein as the H. pylori CagA protein. We also show that CagA is necessary to induce a growth-factor-like phenotype (hummingbird) in host gastric cells similar to that induced by hepatocyte growth factor (HGF). Additionally, we identify a second cellular phenotype induced after attachment by H. pylori, which we call SFA (stress fiber associated). SFA is CagA independent and is produced by type I and type II H. pylori.
Asunto(s)
Antígenos Bacterianos , Proteínas Bacterianas/fisiología , Mucosa Gástrica/patología , Helicobacter pylori/patogenicidad , Secuencia de Aminoácidos , Animales , División Celular , Perros , Técnica del Anticuerpo Fluorescente , Humanos , Datos de Secuencia Molecular , Peso Molecular , FosforilaciónRESUMEN
Since Legionella pneumophila is an intracellular pathogen, entry into and replication within host cells are thought to be critical to its ability to cause disease. L. pneumophila grown in one of its environmental hosts, Acanthamoeba castellanii, is phenotypically different from L. pneumophila grown on standard laboratory medium (BCYE agar). Although amoeba-grown L. pneumophila displays enhanced entry into monocytes compared to BCYE-grown bacteria, the mechanisms of entry used and the effects on virulence have not been examined. To explore whether amoeba-grown L. pneumophila differs from BCYE-grown L. pneumophila in these characteristics, we examined entry into monocytes, replication in activated macrophages, and virulence in mice. Entry of amoeba-grown L. pneumophila into monocytes occurred more frequently by coiling phagocytosis, was less affected by complement opsonization, and was less sensitive to microtubule and microfilament inhibitors than was entry of BCYE-grown bacteria. In addition, amoeba-grown L. pneumophila displays increased replication in monocytes and is more virulent in A/J, C57BL/6 Beige, and C57BL/6 mice. These data demonstrate for the first time that the intra-amoebal growth environment affects the entry mechanisms and virulence of L. pneumophila.
Asunto(s)
Acanthamoeba/microbiología , Legionella pneumophila/crecimiento & desarrollo , Legionella pneumophila/patogenicidad , Monocitos/microbiología , Animales , Línea Celular , Colchicina/farmacología , Proteínas del Sistema Complemento/inmunología , Citocalasina D/farmacología , Humanos , Líquido Intracelular , Legionella pneumophila/inmunología , Ratones , Ratones Endogámicos C57BL , Nocodazol/farmacología , Fagocitosis , VirulenciaAsunto(s)
Calcio/análisis , Animales , Humanos , Concentración de Iones de Hidrógeno , Líquido IntracelularRESUMEN
Wild-type (Canton-S) Drosophila melanogaster larvae are generally repelled by white light. Mutant larval photokinesis A (lphA) larvae are less strongly repelled than controls. Mutant Larval photokinesis B (LphB) larvae are unresponsive to light, as are larvae from LI2, an isofemale line whose progenitors were recently derived from a natural population. To characterize the behavior of larvae from the mutant stocks and the isofemale line more precisely, we determined the range of wavelengths that repel wild-type (Canton-S) D. melanogaster larvae and identified wavelengths to which larvae are most sensitive. In comparison to adult flies, Canton-S larvae are much less sensitive to white light and respond to a narrower range of wavelengths. The wavelengths to which Canton-S larvae are maximally sensitive are 500 nm (green), 420 nm (indigo), and 380 nm (ultraviolet). Mutant lphA larvae respond abnormally to green and indigo light but are as strongly repelled by ultraviolet light as controls. In contrast, mutant LphB larvae and larvae from the LI2 isofemale line are unresponsive to green, indigo, or ultraviolet light. Thus, lphA larvae have a wavelength-specific defect, while LphB and LI2 larvae are generally unresponsive to wavelengths that repel wild-type larvae.
Asunto(s)
Percepción de Color , Drosophila melanogaster/efectos de la radiación , Animales , Conducta Animal , Drosophila melanogaster/genética , Drosophila melanogaster/crecimiento & desarrollo , Femenino , Genotipo , Larva/efectos de la radiación , Iluminación , Mutación , Estimulación Luminosa/métodosRESUMEN
Observations of newly mated Drosophila melanogaster females suggest that females control the times at which components of the ejaculate cause behavioural and physiological changes characteristic of fertilized females. Females that were assayed immediately after they mated elicited as much courtship as they did when they were virgins, but were unreceptive to copulation. Within a few minutes of when they disengaged from copulation, most females performed ovipositor extrusion, which has been classified as a rejection behaviour, in response to courting males or males that had previously performed courtship. Most females that were assayed immediately after mating had already ovulated. The females, however, do not begin to lay eggs until 4-6 h after mating, at which time they elicit very little courtship (Scott & Richmond 1985, Anim. Behav., 33, 817-824). Our observations suggest that neither ovipositor extrusion nor male-synthesized pheromones that are transferred to females' cuticles during copulation inhibit males' courtship of newly fertilized females. Thus, males cannot determine that newly fertilized females are unreceptive to copulation. These observations also indicate that the failure of newly fertilized females to mate with males is not a consequence of the females' inability to elicit vigorous courtship. Copyright 1998 The Association for the Study of Animal Behaviour. Copyright 1998 The Association for the Study of Animal Behaviour.
Asunto(s)
Angiomatosis Bacilar/microbiología , Bartonella/clasificación , Peliosis Hepática/microbiología , Infecciones Oportunistas Relacionadas con el SIDA/microbiología , Angiomatosis Bacilar/transmisión , Animales , Bartonella/genética , Bartonella henselae/clasificación , Bartonella henselae/genética , Gatos/microbiología , ADN Bacteriano/análisis , Humanos , Epidemiología Molecular , Factores de RiesgoRESUMEN
Environmental mycobacteria are a common cause of human infections. Recently, contaminated domestic water supplies have been suggested as a potential environmental source of several mycobacterial diseases. Since many of these mycobacterial species replicate best intracellularly, environmental hosts have been sought. In the present study, we examined the interaction of Mycobacterium avium with a potential protozoan host, the water-borne amoeba Acanthamoeba castellanii. We found that M. avium enters and replicates in A. castellanii. In addition, similar to that shown for mycobacteria within macrophages, M. avium inhibits lysosomal fusion and replicates in vacuoles that are tightly juxtaposed to the bacterial surfaces within amoebae. In order to determine whether growth of M. avium in amoebae plays a role in human infections, we tested the effects of this growth condition on virulence. We found that growth of M. avium in amoebae enhances both entry and intracellular replication compared to growth of bacteria in broth. Furthermore, amoeba-grown M. avium was also more virulent in the beige mouse model of infection. These data suggest a role for protozoa present in water environments as hosts for pathogenic mycobacteria, particularly M. avium.
Asunto(s)
Amoeba/microbiología , Mycobacterium avium/patogenicidad , Animales , Reservorios de Enfermedades , Humanos , Intestinos/microbiología , Hígado/microbiología , Lisosomas/microbiología , Ratones , Microscopía Electrónica , Mycobacterium/crecimiento & desarrollo , Mycobacterium avium/crecimiento & desarrollo , Bazo/microbiología , Temperatura , Células Tumorales Cultivadas , Vacuolas/microbiologíaRESUMEN
Adherence of Helicobacter pylori to cultured gastric epithelial cells is associated with several cellular events, including the tyrosine phosphorylation of a 145-kDa host protein; the reorganization of the host cell actin and associated cellular proteins, like vasodilator-stimulated phosphoprotein, adjacent to the attached bacterial cell; and the subsequent release of the cytokine, interleukin 8 (IL-8). H. pylori isolated from patients with ulcer disease and gastric cancer contain a DNA insertion, the cag pathogenicity island (PAI), that is not present in bacteria isolated from individuals with asymptomatic infection. Mutations in a number of PAI genes abolish tyrosine phosphorylation and IL-8 synthesis but not the cytoskeletal rearrangements. Kinase inhibition studies suggest there are two distinct pathways operative in stimulating IL-8 release from host cells and one of these H. pylori pathways is independent of the tyrosine phosphorylation step.
Asunto(s)
Helicobacter pylori/fisiología , Interleucina-8/metabolismo , Transducción de Señal , Estómago/microbiología , Línea Celular , Epitelio/metabolismo , Epitelio/microbiología , Epitelio/patología , Mucosa Gástrica/metabolismo , Humanos , Estómago/patologíaRESUMEN
From 25 August to 28 September 1994, 7 cardiovascular surgery (CVS) patients at a California hospital acquired postoperative Serratia marcescens infections, and 1 died. To identify the outbreak source, a cohort study was done of all 55 adults who underwent CVS at the hospital during the outbreak. Specimens from the hospital environment and from hands of selected staff were cultured. S. marcescens isolates were compared using restriction-endonuclease analysis and pulsed-field gel electrophoresis. Several risk factors for S. marcescens infection were identified, but hospital and hand cultures were negative. In October, a patient exposed to scrub nurse A (who wore artificial fingernails) and to another nurse-but not to other identified risk factors-became infected with the outbreak strain. Subsequent cultures from nurse A's home identified the strain in a jar of exfoliant cream. Removal of the cream ended the outbreak. S. marcescens does not normally colonize human skin, but artificial nails may have facilitated transmission via nurse A's hands.