The herpes simplex virus type 1 BgKL variant, unlike the BgOL variant, shows a higher association with orolabial infection than with infections at other sites, supporting the variant-dispersion-replacement hypothesis.

The identification and geographic distribution of the herpes simplex virus type 1 (HSV-1) BglII restriction fragment length polymorphism (RFLP) variants named BgK(L) and BgO(L) in clinical isolates from orolabial and cutaneous sites were described in our previous reports, in which the dispersion and replacement of HSV-1 variants were proposed. The base substitution sites deduced from the BgK(L) multiple RFLP variations were mapped to the U(L)12 (DNase), R(L)2 (alpha0 transactivator), and latency-associated transcript genes in the present study. The results show that the relative frequencies (RFs) of BgK(L) are significantly higher in orolabial and cutaneous HSV-1 infections than in ocular infections. For the BgO(L) variant, the opposite was found; i.e., the RF of BgO(L) was significantly lower in orolabial and cutaneous infections than in ocular infections. No significant differences in the RFs of non-BgK(L):non-BgO(L) isolates were observed. The ratio of the BgK(L) RF to the BgO(L) RF was much higher for the orolabial and cutaneous infection groups than for the ocular infection group, whereas the BgK(L) RF-to-non-BgK(L):non-BgO(L) RF ratios for the former groups were slightly higher than those for the latter group. The higher efficiency of orolabial and cutaneous infections caused by BgK(L) compared to the efficiency of infections caused by BgO(L) allows BgK(L) to spread more efficiently in human populations and to displace BgO(L), because the mouth and lips are the most common HSV-1 infection sites in children. The present study supports our HSV-1 dispersion-and-replacement hypothesis and suggests that HSV-1, the latency-reactivation of which allows variants to accumulate in human populations, has evolved under competitive conditions, providing a new perspective on the polymorphism or variation of HSV-1.

Strategy of control of nosocomial infections: application of disinfectants such as povidone-iodine.

At Morioka Yuai Hospital, the Infection Control Division was set up 5 years ago, and it has made efforts to actively control infections. In particular, the division succeeded in increasing the frequency of general round table discussions for patients with infections. We strongly recommend to frequently gargle with Isodine at operations. Recently, we have followed up patients with infections caused by MRSA, Pseudomonas aeruginosa and Serratia or carriers of these bacteria, and determined the drug sensitivities of clinical isolates. In addition, because of the current highly aged society, a high percentage of inpatients has various underlying diseases. In particular, there are quite a few cases in which pneumonia occurs as an opportunistic infection. From studies in these patients and patients of the dental department, it has been shown that oral microorganisms clearly decrease in count by careful tooth brushing and gargling with Isodine, with prevention of pneumonitis caused by oral microorganisms. As we consider that antisepsis with povidone-iodine is useful for the prevention of nosocomial and opportunistic infections, we would like to report the findings of our study currently under way.

Estudo prospectivo de casos de conjuntivite viral aguda na cidade de Säo Paulo: caracterizaçäo do enterovírus 70 (conjuntivite hemorrágica aguda) / Prospective study of cases of acute viral conjunctivitis in the city of Säo Paulo

Noventa e oito pacientes portadores de conjuntivite viral aguda que procuraram a Clínica de Oftalmologia da Escola Paulista de Medicina no período de fevereiro de 1983 a fevereiro de 1984 foram avaliados clínica e laboratorialmente. De acordo com o exame oftalmológico, os pacientes foram classificados como portadores de ceratoconjuntivite epidêmica, febre faringoconjuntival, conjuntivite folicular aguda inespecífica e conjuntivite hemorrágica aguda. Amostras pareadas de soro obtidas na fase aguda e na convalescença do processo infeccioso foram avaliados quanto à presença de anticorpos contra adenovírus e enterovírus 70 pelas técnicas de fixaçäo de complemento e neutralizaçäo, respectivamente. Observou-se diagnóstico sorológico positivo para adenovírus e enterovírus 70 em 5% e 51% dos casos, respectivamente, enquanto que em 44% dos casos näo houve conversäo sorológica para ambos os tipos de vírus. Casos esporádicos foram diagnosticados até 9 meses antes da epidemia. Os pacientes apresentaram quadro clínico semelhante ao de outras epidemias, com hemorragia subconjuntival, ceratite e linfadenopatia