Detection of DNA strand breaks by comet assay in sputum leucocytes of bitumen-exposed workers: a pilot study.

DNA strand breaks were determined in leucocytes of induced sputum (IS) and compared with DNA strand breaks in blood lymphocytes from 42 bitumen-exposed workers pre and post shift. Comet assay results were expressed in arbitrary units based on visual scoring (sputum leucocytes) and Olive tail moment (OTM, blood lymphocytes). DNA damage in IS leucocytes was overall high but did not change during shift. Level of DNA strand breaks in IS samples correlated with total cell count and neutrophil content (Spearman rank correlation coefficient r(s) = 0.47, p = 0.001, r(s)= 0.48, p = 0.001, respectively) and with IL-8 concentration before and after shift (r(s) = 0.31, P = 0.048, and r(s) = 0.43, P = 0.005). DNA damage in IS was not associated with DNA strand breaks in blood lymphocytes (r(s) = -0.04, p = 0.802 before shift, r(s) = 0.27, p = 0.088 after shift). A higher level of DNA strand breaks was measured in blood lymphocytes before shift (median OTM 1.7 before and 1.3 after shift, p = 0.023). A strong correlation was found between the number of neutrophils and IL-8 concentration in IS before and after shift (r(s) = 0.77 and r(s)= 0.75, p < 0.001). This study showed an association between genotoxic and inflammatory effects in the lower airways and compared simultaneously DNA strand breaks in IS and blood of bitumen-exposed workers.

[Severe soft tissue infection with bulla formation, sepsis, multiple organ failure]. / Schwere Weichteilinfektion mit Blasenbildung, Sepsis, Multiorganversagen.

A 53-year old patient with diabetes mellitus presented with a painful swelling of the left thigh in an out-of-town hospital. Because of the slow progression associated with multiorgan dysfunction, a soft-tissue infection with sepsis was suspected. Strains of streptococcus of serogroup B were isolated from specimens, taken from certain areas of the affected skin. After transferring the patient to our hospital the diagnosis of a B-streptococcal associated necrotizing fasciitis was confirmed. Despite intensive medical treatment and several surgical interventions the patient deceased due to an acute severe liver failure as a consequence of a secondarily developed septic shock. In comparison to the well-known cases caused by streptococcus group A, the B-streptococcal associated necrotizing fasciitis is a rather rare occurring disease.