Nationwide surveillance of bacterial respiratory pathogens conducted by the Japanese Society of Chemotherapy in 2007: general view of the pathogens' antibacterial susceptibility.

For the purpose of a nationwide surveillance of the antimicrobial susceptibility of bacterial respiratory pathogens in patients in Japan, the Japanese Society of Chemotherapy conducted their second year survey, during the period from January to August, 2007. A total of 1178 strains were collected from clinical specimens obtained from adult patients with well-diagnosed respiratory tract infections. Susceptibility testing was evaluable for 1108 strains (226 Staphylococcus aureus, 257 Streptococcus pneumoniae, 6 Streptococcus pyogenes, 206 Haemophilus influenzae, 120 Moraxella catarrhalis, 122 Klebsiella pneumoniae, and 171 Pseudomonas aeruginosa). A total of 44 antibacterial agents, including 26 beta-lactams (four penicillins, three penicillins in combination with beta-lactamase inhibitors, four oral cephems, eight parenteral cephems, one monobactam, five carbapenems, and one penem), three aminoglycosides, four macrolides (including ketolide), one lincosamide, one tetracycline, two glycopeptides, six fluoroquinolones, and one oxazolidinone were used for the study. Analysis was conducted at the central reference laboratory according to the method recommended by the Clinical and Laboratory Standards Institute (CLSI). The incidence of methicillinresistant Staphylococcus aureus (MRSA) was high, at 59.7%, and the incidences of penicillin-intermediateresistant and -resistant Streptococcus pneumoniae (PISP and PRSP) were 30.4% and 5.1%, respectively. Among Haemophilus influenzae strains, 19.9% of them were found to be beta-lactamase-non-producing ampicillin (ABPC)-intermediately-resistant (BLNAI), 29.1% to be beta-lactamasenon-producing ABPC-resistant (BLNAR), and 6.7% to be beta-lactamase-producing ABPC-resistant (BLPAR) strains. Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae was not isolated. Two isolates (1.2%) of Pseudomonas aeruginosa were found to be metallo-beta-lactamase-producing strains, including one (0.6%) suspected multidrug-resistant strain showing resistance to imipenem, amikacin, and ciprofloxacin. These data will be a useful reference for future periodic surveillance studies and for investigations to control resistant infections as well. Continued surveillance is required to prevent the further spread of these antimicrobial resistances.

The first nationwide surveillance of bacterial respiratory pathogens conducted by the Japanese Society of Chemotherapy. Part 1: a general view of antibacterial susceptibility.

The Japanese Society of Chemotherapy (JSC) conducted the first nationwide surveillance of bacterial respiratory pathogens during the period from January to August 2006. With the cooperation of 32 medical institutions throughout Japan, a total of 924 strains belonging to seven clinically relevant bacterial species were collected from adult patients with well-diagnosed respiratory tract infections (RTIs). Antimicrobial susceptibility testing of the 887 evaluable strains (205 Staphylococcus aureus, 200 Streptococcus pneumoniae, 9 Streptococcus pyogenes, 165 Haemophilus influenzae, 91 Moraxella catarrhalis, 74 Klebsiella pneumoniae, and 143 Pseudomonas aeruginosa) to 42 antibacterial agents was conducted at the Central Laboratory of the Research Center for Anti-infective Drugs of the Kitasato Institute, according to recommendations issued by the Clinical and Laboratory Standards Institute (CLSI). The antibacterial agents employed were 25 beta-lactams, three aminoglycosides, four macrolides (including one azalide and one ketolide), one lincosamide, one tetracycline, two glycopeptides, five fluoroquinolones, and one oxazolidinone. The incidence of methicillin-resistant S. aureus (MRSA) was 63.4%, and the incidences of penicillin-intermediately resistant S. pneumoniae (PISP) and penicillin-resistant S. pneumoniae (PRSP) were 35.0% and 4.0%, respectively. Among H. influenzae, 21.2% of the strains were found to be beta-lactamase-nonproducing ampicillin (ABPC)-intermediately resistant (BLNAI), 29.1% to be beta-lactamase-nonproducing ABPC-resistant (BLNAR), and 4.8% to be beta-lactamaseproducing ABPC-resistant (BLPAR) strains. The incidence of extended-spectrum beta-lactamase-producing K. pneumoniae was 2.7% (2 of 74 strains). Three (2.1%) of the 143 P. aeruginosa strains were found to be metallo-beta-lactamaseproducing, including 1 (0.7%) multidrug-resistant strain. Through the nationwide surveillance, we obtained fundamental antimicrobial susceptibility data of clinically relevant bacterial pathogens in adult RTI to various antibacterial agents. These data will be a useful reference for future periodic surveillance studies, as well as for investigations to control antimicrobial-resistant pathogens.

Cervical intraepithelial neoplasia in adolescents: study of cytological findings between 1987 and 1995 in São Paulo State-Brazil.

The purpose of the present study was to ascertain the frequency of Pap smears abnormalities (SIL/carcinoma) in two populations in the State of S. Paulo (Brazil) who were screened for cervical cancer during the last nine years: adolescents (up to the age of 21) and adults (over 21). Statistical analysis showed a tendency to linear increase in frequency of abnormal Pap smears in both groups (adolescent: slope = 0.118 +/- 0.56; adult: slope = 0.079 +/- 0.021), being greater in the adolescent group (slope 0.039 +/- 0.038) than in the adult group. Between 1987 and 1995 the prevalence of abnormal smears tripled in the adult group (from 0.37 to 1.18) and almost quadruplicated in the adolescent group (from 0.64 to 2.10). Low grade squamous intraepithelial lesions (SIL) were the most frequent findings in cervical cytology in both groups: 92.3% in the adolescent group and 69.8% in the adult group. Few cases of high grade squamous intrapeithelial lesions (HSIL) (7.7%) and no cases of carcinoma were found in adolescent population. We suggested that sexually active adolescents should be included in cervical screening programs.

Garantia de qualidade em citopatologia: aspectos da correlaçäo cito-histopatológica / Quality assurance in cytopathology: aspects of the cytohistological correlation

Os autores avaliaram a concordância diagnóstica cito-histológica de lesöes de colo uterino e discutiram as eventuais discrepâncias. OBJETIVO. Averiguar o nível de concordância cito-histológica nos casos da Divisäo de Patologia do Instituto Adolfo Lutz (IAL) e aprimorar a estratégia de garantia de qualidade na instituiçäo. MATERIAL E MÉTODO. Estudaram 157 casos consecutivos dos arquivos do IAL em que foram enviadas citologia cérvico-vaginal e biópsia. RESULTADO. Houve concordância absoluta em 119 (75,8 por cento) casos; nos demais, a citologia superestimou 11 lesöes (7,0 por cento) e subestimou 27 (17,2 por cento). Observou-se que em 5 casos, inicialmente diagnosticados como inflamatório pela citologia, dois foram, à revisäo, considerados como NIC 1; os demais foram ratificados como inflamatórios, apesar de suas respectivas biópsias terem diagnóstico de neoplasia intra-epitelial cervical. CONCLUSÄO. Tais resultados demonstram a importância da correlaçäo cito-histológica para o sistema de garantia de qualidade em diagnóstico citológico e apontam para a colheita como um dos fatores determinantes nas discrepâncias diagnósticas.

[Quality assurance in cytopathology: aspects of the cytohistological correlation]. / Garantia de qualidade em citopatologia: aspectos da correlação cito-histopatológica.

UNLABELLED: The cytohistologic diagnosis concordance of the cervix-uterine lesions was evaluated and the discordances are discussed. PURPOSE: To evaluate the level of cytohistological diagnosis agreement in the Pathology Division of the Adolfo Lutz Institute and enhance parameters of quality assurance system developed in this institution. METHODS: The authors retrospectively evaluated 157 pairs of cytologyhistology consecutive cases from the files the Adolfo Lutz Institute (Division of Pathology). RESULTS: Agreement was found in 119 cases (75.8%); in the remaining cases cytologic diagnosis were higher than histology in 11 lesions (7.0%) and lower in 27 (17.2%). We also observed that in 5 cases previously diagnosed as inflammatory, 2 of them were reclassified as CIN 1; after revision, the others remained as inflammatory even though they had a histological diagnosis of CIN. CONCLUSION: These results showed the role of cytohistological correlation to the quality assurance system of cytological diagnosis and also stressed the importance of taking the cervical scrapes with accurate care to avoid diagnostic discrepancies.

Nuclear magnetic resonance study and secondary structure determination of the antibiotic peptide, aibellin.

Aibellin is a 20-residue peptide antibiotic that has been isolated from the fungus Verticimonosporium ellipticum. Sequence-specific assignment of the 1H- and 13C-NMR signals of aibellin in a methanol solution was achieved by using the two-dimensional NMR technique. Furthermore, its secondary structure was characterized by circular dichroism (CD) and NOESY spectra. The observed NOEs, 3JNHC alpha H coupling constants and amide hydrogen-deuterium (H-D) exchange rates show that the peptide consisted of two alpha-helices and a bent structure around a Pro-14 residue.

Structural elucidation of aibellin, a new peptide antibiotic with efficiency enhancing activity on rumen fermentation.

A new peptide antibiotic, aibellin, that had the efficiency enhancing activity on rumen fermentation, was isolated from the culture broth of the fungus, Verticimonosporium ellipticum D1528, and its primary structure was elucidated from spectrometric analysis and chemical degradation. Aibellin is a 20-residue peptaibol, and it has a unique structural feature in the novel C-terminal amino alcohol. Moreover, aibellin is the first peptaibol that possesses two acidic amino acids in the C-terminal region and a Phe residue in the middle of the sequence.

Archaea contain a novel diether phosphoglycolipid with a polar head group identical to the conserved core of eucaryal glycosyl phosphatidylinositol.

The structure of a major ether polar lipid of the methanogenic archaeon Methanosarcina barkeri was identified as glucosaminyl archaetidylinositol. This lipid had archaeol (2,3-di-O-phytanyl-sn-glycerol) as a core lipid portion, and the polar head group consisted of 1 mol each of phosphate, myo-inositol and D-GlcN. The polar head group was identified by means of chemical degradations, phosphatidylinositol-specific phospholipase C treatment, permethylation analysis, and fast atom bombardment-mass spectrometry as glucosaminylinositol phosphate, which was linked to the glycerol backbone via a phosphodiester bond. The stereochemical configuration of the phospho-myo-inositol residue of glucosaminyl archaetidylinositol was determined to be 1-D-myo-inositol 1-phosphate by measuring optical rotation of phospho-myo-inositol prepared by nitrous acid deamination and alkaline hydrolysis from the lipid. 1H NMR of the intact lipid showed that GlcN was linked to C-6 position of myo-inositol as an alpha-anomer. It is, finally, concluded that the complete structure of this lipid is 2,3-di-O-phytanyl-sn-glycero-1-phospho- 1'[6'-O-(2"-amino-2"-deoxy-alpha-D-glucopyranosyl)]-1'-D-myo-inositol. This lipid has a hybrid nature of an archaeal feature in alkyl glycerol diether core portion and an eucaryal feature in the polar head group identical to the conserved core structure (GlcNp(alpha 1-6)-myo-inositol 1-phosphate) of glycosylated phosphatidylinositol which serves as a membrane protein anchor in eucaryal cells.

[Program of quality control in gynecologic cytology at the Adolfo Lutz Institute: strategies and critical analysis of results of its pilot implementation]. / Programa de controle de qualidade em citologia ginecológica do Instituto Adolfo Lutz: estratégias e análise crítica dos resultados de sua implantação-piloto.

The Quality Control in the Gynecological Cytology Program, Instituto Adolfo Lutz, was designed to assure a high-standard of laboratory analysis for the Gynecological Cancer Detection and Prevention System in the São Paulo State Public Health Service. This study presents strategies for intra-laboratorial quality control as well as preliminary results on 32,018 cases. The methods applied for the selection of cases to be reviewed were based on clinical and cytological conditions that could mean higher risk of development of neoplasia and/or conditions that might induce difficulties of interpretation. The classification and analysis of the discrepancies found in this initial experience are the highlight points of this Program. Out of the 492 cases submitted to review, 45 had received underscored initial interpretation, although none of them fit international criteria for "false-negative". Overscores were found in 51 cases, with only three cases fitting the criteria for "false-positive". Based on this initial experience, the Quality Control Program will be applied to the other laboratories of the Public Health Service. This intra-laboratory model of control will be coupled with external supervision by Instituto Adolfo Lutz.