Immune status during albendazole therapy for hydatidosis.

Immunological monitoring of cystic hydatid patients undergoing medico-surgical management has revealed that it is possible to assess individual host responses throughout therapy and subsequently be guided by the results obtained. The analysis has involved the demonstration of variation in haemagglutination antibodies, specific IgG and IgM immunoglobulins and circulating immune complexes before, during, and months after albendazole therapy.

Identification of an epidemic strain of Acinetobacter baumannii using electrophoretic typing methods.

Nosocomial infections due to Acinetobacter baumannii dramatically increased in a Lebanese medical center following an outbreak of hostilities in Lebanon in 1984. The incidence of infection caused by this organism has remained high in this institution, thus requiring the implementation of a strain typing system to aid in infection control. Three methods were investigated for their utility in differentiating among a representative group of 36 nosocomial Acinetobacter baumannii isolates obtained over a 10 month period from specimens of hospitalized patients. Isolates were typed by antibiogram analyses, plasmid fingerprinting, and total cell protein profiles. Only three distinct total cell protein profiles were detected, with one pattern accounting for 26 (72.2%) of the isolates. However, eight different plasmid profiles were observed, with 20 (55.5%) isolates having the same profile. Eleven distinct antibiograms were seen with the most prevalent pattern occurring in 21 isolates. Twenty of the 21 (95%) isolates with the common antibiogram also had the same plasmid profile and total protein profile (44.4% of total isolates). The combination of these three typing methods was useful in tracing the spread of these organisms in the medical center. The data obtained suggest the distribution of a common strain among at least six wards of this hospital.

Monitored medico-surgical approach to the treatment of cystic hydatidosis.

Significant improvements in the health of patients with chronic multifocal abdominal hydatidosis, leading to recovery, have been observed after combined medico-surgical treatment. The benefits of massive surgical removal of cysts, accompanied by effective doses of albendazole, were assessed by the clinical, radiological, and immunological responses of individual patients. Variations in the levels of specific classes of immunoglobulins and circulating immunocomplexes provided additional measures of the state of host response and the persistence of parasitic activity.

A simplified radioimmunoassay technique for hydatid disease and human trichinosis.

A. A comparative study of a simplified radioimmunoassay (RIA) technique with the indirect haemagglutination (IHA) test in the diagnosis of 72 patients with hydatid disease indicated the greater sensitivity of the former. Both methods had an equal specificity in 60 control patients. RIA will serve as a useful addition to tests already available in hydatid serology. B. A comparison of the (RIA) technique with fluorescent antibody test (FAT) in the diagnosis of 33 patients with early, active trichinosis and 30 healthy controls indicated an equal sensitivity and specificity of both methods. The adoption of RIA as an easier method is recommended. This study of a simplified radioimmunoassay technique for the diagnosis of hydatid disease and trichinosis in man is presented in two sections.

The serodiagnosis of human hydatid disease: 2. Additional studies on selected sera using indirect haemagglutination (IHA), enzyme linked immunosorbent assay (ELISA) and defined antigen substrate spheres (DASS).

Sixty-one serum samples selected on the basis of reactivity in the complement fixation (CF) and latex agglutination (LA) test, were further examined for sensitivity and specificity by indirect haemagglutination (IHA), enzyme linked immunosorbent assay (ELISA) and defined antigen substrate spheres (DASS). Twenty sera from healthy Europeans and 48 samples from patients with either schistosomiasis or trichinosis were also tested. Comparable levels of sensitivity were found between the CF and LA positive sera and IHA, ELISA and DASS. Of the CF positive LA negative group of sera, many were positive by DASS but only a few reacted in IHA and ELISA. Some cross reactivity was also observed in the schistosomiasis sera tested by IHA and ELISA.

The role of non-biting flies in the transmission of enteric pathogens (Salmonella species and Shigella species) in Beirut, Lebanon.

In the summer and early autumn of 1974, flies were trapped in the Beirut districts of Ashraffiyah, Burj, Burj-Hammoud, Quarantine, the New Slaughter House, Ras Beirut, American University Campus, and the suburbs of Chiyah and Mreyjieh. Musca domestica, Muscina stabulans, Calliphora vicina, Phormia regina, Phaenicia sericata, Sarcophagidae spp. and Fannia canicularis were identified. The rural areas of Mreyjieh and Chiyah had higher densities of Musca domestica while higher densities of Calliphoridae spp. were found in the Slaughter House, Quarantine and Burj-Hammoud districts. Twenty-nine isolates, ten of Shigella spp. and 19 of Salmonella spp. were obtained from the bacteriological studies of 72 batches of Muscidae spp. and 84 Calliphoridae spp. These results indicate the hyperendemicity of salmonellosis and shigellosis in the areas under study, due to the prevalent poor sanity conditions and high fly infestation. It is suggested that in countries where valid health statistics are not available, bacteriological studies of flies may provide essential epidemiological information.

Bacillus laterosporus endophthalmitis.

A strain of Bacillus laterosporus was isolated from the aqueous and vitreous humors of a patient with endophthalmitis that developed after a penetrating injury of the cornea. Intravitreal inoculation of the isolate into rabbits produced severe panophthalmitis, corneal perforation, orbital cellulitis, and even meningitis. These observations suggest that B laterosporus, hitherto classified as nonpathogenic, is an opportunist that can cause disease when conditions are favorable.

Studies on the mechanism of lysis of Echinococcus granulosus protoscoleces incubated in normal serum.

Brood capsules were obtained from freshly collected cysts of equine and ovine strains of Echinococcus granulosus. Protoscoleces were freed from brood capsules either by mechanical disruption or pepsin-HCI digestion. Preparations of protoscoleces studied included: mechanically released protoscoleces without further treatment, or incubated either in HCI pH 2.0 or in evaginating solution (containing Na taurocholate) for 24 h; pepsin-HCI released protoscoleces without further treatment or incubated in evaginating solution for 24 h or 7 days. Half of each preparation of ovine protoscoleces was fixed in absolute methanol. All fresh preparations of protoscoleces lysed rapidly when incubated in normal human serum. Studies with a fluorescein isothiocyanate (FITC) labelled sheep anti-human C3 antiserum revealed the presence of C3 on the surface of lysing protoscoleces. Antibody could not be detected on the surface of any of the preparations of fresh or methanol-fixed protoscoleces using direct or indirect fluorescent antibody tests suggesting that the classical pathway of complement activation was not involved in the lytic process. Strong evidence for lysis by the alternate pathway of complement activation was the lysis of protoscoleces which had been treated with pepsin-HCI and lysis of protoscoleces in guinea-pig serum deficient in C4 component of complement.

Direct immunofluorescence in the diagnosis of toxoplasmic lymphadenitis.

The diagnosis of toxoplasmic lymphadenitis was established through the demonstration, by direct immunofluorescence, of toxoplasma cysts and trophozoites in a cervical lymph node biopsy which also had a characteristic histopathology. The patient had cervical lymphadenopathy and increased specific fluorescent antitoxoplasma IgG and IgM antibodies.

The host response in secondary hydatidosis of mice. I. Circulating antibodies.

The infection of young albino mice by the intraperitoneal injection of viable hydatid protoscolices provided a suitable model for the investigation of the factors controlling the subsequent host immune response. Antibodies detectable by haemagglutination and complement fixation appeared around the 14th week after infection. Increases in antibody titres were related to the potency of the antigenic impulse(s) produced by the healthy germinal membrane and viable protoscolices. Our results suggest that qualitative and quantitative variations in excretory, secretory and somatic antigens, occurring during the different phases of parasite development, incite the production of a multitude of antibodies, only a few of which are detectable by conventional methods.

The host response in secondary hydatidosis of mice. II. Cell mediated immunity.

The presence of cell mediated immunity to Echinococcus granulosus antigen was detected in syngeneic mice with secondary hydatidosis. Significant increases of thymidine uptake were observed in spleen cells from infected animals exposed to protoscolex or hydatid fluid antigens. A definite decrease in the number and size of cysts occurred in mice following the simultaneous intraperitoneal injection of viable protoscolices and a suspension of 1 x 10(7) sensitized spleen cells.

Variation in serum immunoglobulin levels in acute trichinosis.

An early rise in serum IgE levels was observed in five of seven patients with acute primary trichinosis. Parallel increases in the total IgG, IgM, and Iga levels, as well as specific IgG and IgM antibody titres to Trichinella spiralis larval antigen, were detected in two. The elevated levels persisted long after the clinical recovery of the patients.

Hydatidosis: a global problem of increasing importance.

This review of recent literature reporting the occurrence of hydatid disease due to Echinococcus granulosus and E. multilocularis throughout the world emphasizes the global nature of the problem and the threat of its spread into those countries currently free from it. Attention is drawn to the urgent need for measures to prevent the importation of infected livestock and this would require the development of techniques for pre-mortem diagnosis and differentiation of hydatidosis and cysticercosis of animals. There must also be increased awareness of the possible occurrence of biological strains of the parasite which may be of greater or lower infectivity for man. In the absence of information on infectivity, studies concerning the prevalence of the disease may be meaningless.

The immunological diagnosis of human hydatid disease.

There is evidence that the yearly incidence rate of hydatid disease may be increasing in endemic areas and in regions of the world hitherto free of the infection. The availability of an accurate method of detection in both man and other animals would facilitate understanding of the global epidemiology. The diagnostic procedures in use in human hydatidosis have often given inconclusive results in animal infections. The following tests are discussed and their usefulness appraised: intradermal, complement fixation, haemagglutination, latex agglutination, indirect fluorescent antibody, immunoelectrophoresis, counter immunoelectrophoresis, enzyme linked immunosorbent assay, radio-immuno assay and lymphocyte transformation.

Diagnosis of pulmonary hydatidosis by sputum cytology.

Patients with pulmonary hydatid cysts have been noted to have lower incidence of positive serologic tests than patients with hepatic cysts. Two patients with hydatid cysts of the lung and negative serologies in whom diagnoses were made by demonstration of scoleces in sputum samples prepared for cytologic study are discussed.