Dynamic sex chromosomes in Old World chameleons (Squamata: Chamaeleonidae).

Much of our current state of knowledge concerning sex chromosome evolution is based on a handful of 'exceptional' taxa with heteromorphic sex chromosomes. However, classifying the sex chromosome systems of additional species lacking easily identifiable, heteromorphic sex chromosomes is indispensable if we wish to fully understand the genesis, degeneration and turnover of vertebrate sex chromosomes. Squamate reptiles (lizards and snakes) are a potential model clade for studying sex chromosome evolution as they exhibit a suite of sex-determining modes yet most species lack heteromorphic sex chromosomes. Only three (of 203) chameleon species have identified sex chromosome systems (all with female heterogamety, ZZ/ZW). This study uses a recently developed method to identify sex-specific genetic markers from restriction site-associated DNA sequence (RADseq) data, which enables the identification of sex chromosome systems in species lacking heteromorphic sex chromosomes. We used RADseq and subsequent PCR validation to identify an XX/XY sex chromosome system in the veiled chameleon (Chamaeleo calyptratus), revealing a novel transition in sex chromosome systems within the Chamaeleonidae. The sex-specific genetic markers identified here will be essential in research focused on sex-specific, comparative, functional and developmental evolutionary questions, further promoting C. calyptratus' utility as an emerging model organism.

Human leptospirosis in Denmark 1970-1996: an epidemiological and clinical study.

Epidemiological and clinical aspects of 118 laboratory confirmed cases of human leptospirosis in Denmark from 1970 to 1996 were reviewed. Icterohaemorrhagiae (72%) and sejroe (20%) were the most frequent serovars. The incidence of leptospirosis was 0.09/100,000 inhabitants/y. 93% of the patients were 18-64 y old, 90% were men and 72% of the cases occurred from July to November. Occupational exposure was present in 63% (74/118) of the cases (41% fish farmers, 28%, farmers). Eight percent of the patients had travelled abroad, 7% had been exposed to sewers and 4%, had been exposed through recreational activities (fishing). Initial symptoms were generally non-specific. Weil's disease developed in 63%, of the patients, more often in patients infected with the serovar icterohaemorrhagiae (73%) compared to patients infected with serovars sejroe or saxkoebing (25%). The fatality rate was 7%, all due to icterohaemorrhagiae. Though a rare disease in Denmark, leptospirosis should be considered in certain risk groups as a possible diagnosis in patients with acute febrile illness.

The surgical team as a source of postoperative wound infections caused by Streptococcus pyogenes.

Postoperative wound infection, caused by Streptococcus pyogenes transmitted during the operation from members of the surgical team, is a rare but serious complication of surgery. This study describes three cases, which could be traced to an orthopaedic surgeon, who carried the epidemic strain in this throat. Epidemiological characteristics of 14 other outbreaks, published in the English-language literature, are summarized. In total, these 15 outbreaks involved 136 patients. The overall case fatality rate was 12%. Anaesthesiologists and other assisting staff members were involved more often than surgeons and obstetricians. In outbreaks where an attack rate could be calculated, it was at least 7%. T-28 was the most commonly involved T-type, accounting for seven outbreaks. The anus and vagina were the most common carrier sites in staff members. A combination of penicillin and oral vancomycin seemed to be the most efficient treatment for anal and vaginal carriage. Relapse of carriage could occur several months after apparent eradication, and was often associated with a carrier in the family household.

Incidence of invasive pneumococcal disease and distribution of capsular types of pneumococci in Denmark, 1989-94.

During the period 1989-94, 4620 strains of Streptococcus pneumoniae (4063 from blood and 557 from cerebrospinal fluid), from cases of invasive disease in Denmark, were received for capsular typing and penicillin susceptibility testing. During the study period the incidence of bacteraemic pneumococcal disease increased from 10 to 18 cases per 100000 inhabitants per year. The highest rates were seen in the very young, age less than 5 years (23/100000/year, in 1994), and in the elderly, age greater than 60 years (55/100000/year, in 1994). The annual number of cases of meningitis did not vary. Overall, 92% (93% blood, 87% CSF) of isolates and 94% of all childhood isolates belonged to the 23 vaccine types. The capsular types occurring most commonly among the 4123 pneumococcal strains from adults were types 1, 4, 14, 6A + 6B, 7F, 9V, 3, 12F, and 8 (in order of frequency). The ten most frequently occurring types from children (6A + 6B, 18C, 14, 1, 7F, 19F, 9V, 4, and 23F) covered 84% of the cases of bacteraemia and meningitis. Reduced susceptibility to penicillin was rare (< 1%).

Bacterial gastroenteritis among hospitalized patients in a Danish County, 1991-93.

BACKGROUND: Denmark has in recent years experienced an increase in the number of bacterial gastrointestinal infections. METHODS: We have reviewed patients hospitalized with culture-confirmed bacterial gastroenteritis in Roskilde County during 1991-93. RESULTS: Two hundred and seven patients were included; 68 were children (< 15 years). The microorganism isolated was Salmonella in 61% of the cases, Campylobacter in 20% and Yersinia enterocolitica in 13%. Ninety-three per cent of the patients had diarrhea, 74% had fever (> 38 degrees C), and 66% abdominal pain. Blood in stools was most frequent in patients infected with Campylobacter. Leukocytosis was rare. Twenty-four patients had bacteremia. Reactive arthritis occurred in 4.8%. Three patients died, all infected with zoonotic Salmonella types. Three stool cultures were made for 115 patients, and in 73% all 3 cultures were positive. CONCLUSIONS: Bacterial gastroenteritis requiring hospitalization affects mainly children and young adults. Infections due to zoonotic Salmonella types were more severe than Campylobacter and Y. enterocolitica gastroenteritis. It seems necessary to make at least three stool cultures to secure a bacteriologic diagnosis.

Detection of pneumococcal polysaccharide antigens in the urine of patients with bacteraemic and non-bacteraemic pneumococcal pneumonia.

Countercurrent-immunoelectrophoresis (CIE) was used to detect pneumococcal capsular polysaccharide and C-polysaccharide (C-Ps) antigens in urine. The neutral capsular polysaccharides of types 7F and 14 were detected by coagglutination. We found pneumococcal polysaccharide in urine with the same frequency in two groups of patients, i.e. a non-bacteraemic pneumonia group (68%) and a group of patients with pneumococcal bacteraemia (66%). C-Ps was detected in the urine of two patients (4%) and, therefore, this test has no value in the diagnosis of pneumococcal infections. Since there is no sensitive, non-invasive, single procedure for the diagnosis of non-bacteraemic pneumococcal pneumonia we conclude that attempts to detect pneumococcal capsular polysaccharide by CIE in combination with coagglutination (types 7F and 14) may be a useful diagnostic supplement in the search for the etiological agent in pneumonia in adults until new, more sensitive diagnostic methods have been developed.

Bacteraemia due to different groups of beta-haemolytic streptococci: a two-year survey and presentation of a case of recurring infection due to Streptococcus "equisimilis".

We present a 2-year survey of bacteraemic episodes due to beta-haemolytic streptococci and a case of recurring infection due to group C streptococcus, Streptococcus "equisimilis". We found 53 episodes of bacteraemia with beta-haemolytic streptococci. Group A was the most common, followed by groups B, G and C. The proportion of nosocomial cases was the same in all four groups i.e. 24% (neonatal cases excluded). The clinical picture presented by groups C and G streptococcal cases was indistinguishable from that caused by group A streptococci, but patients with group G bacteraemia were older than patients with group A bacteraemia. Obvious clinical foci were more common in group A than group G cases. Disregarding neonatal cases, most patients had predisposing conditions. There was no difference in foci of bacteraemia, predisposing factors, treatment and outcome of disease. The overall mortality was 25%.

Outbreak of infection in a burns unit due to Pseudomonas aeruginosa originating from contaminated tubing used for irrigation of patients.

Five patients with extensive deep burns developed septicaemia due to Pseudomonas aeruginosa serogroup O-7.8 and phage type 21 or 21/188 shortly after they had been admitted to hospital. Four other burned patients became colonized with the same strain. The source of infection was contaminated tap water used for irrigation of the burns, as part of the first-aid treatment which the patients received when entering the hospital. Contamination was restricted to showers and tubing that were permanently connected to the taps, and the outbreak stopped after they had been disinfected. Tubing and showers used for irrigation of burns should be dismantled and heat-disinfected after each patient and not reconnected to the taps until immediately before the next treatment. Taps used for irrigation of burns should be monitored regularly for the presence of P. aeruginosa and other potentially pathogenic bacteria. Routine typing of P. aeruginosa isolates from burned patients is indicated in order to detect and eliminate hidden sources of infection.

Antibodies against pneumococcal C-polysaccharide are not protective.

The ability of antibodies against C-polysaccharide (C-Ps) to protect against experimental pneumococcal infection was examined in a mouse model. No protection against types 6A and 14 pneumococcal infection could be demonstrated neither with mouse monoclonal antibodies against C-Ps, specific for phosphorylcholine (PC) or for C-Ps backbone, nor for polyclonal rabbit immunsera against C-Ps. The monoclonal antibody with PC-specificity was protective against infection with type 27 pneumococcus, that has PC as part of its capsular polysaccharide. Type-specific mono- and polyclonal antibodies were highly protective against infection with the homologous type. We conclude that no species-specific protection can be achieved against intraperitoneal Streptococcus pneumoniae infection with optimally capsulated bacteria in outbred mice by passive immunization with antibodies to C-Ps.

Capsular types and susceptibility to penicillin of pneumococci isolated from cerebrospinal fluid or blood in Denmark, 1983-1988.

By means of the capsular reaction test, we typed 2,294 pneumococcal strains isolated from blood or cerebrospinal fluid (CSF) in Denmark during 1983-88.91% of the strains belonged to types included in the 23-valent vaccine. Among 254 pneumococcal isolates from blood and CSF from Danish children, types 6A + 6B, 18C, 14, 7F, 1 and 19F, in that order of frequency, were the most common ones, accounting for 68%. Among 2,031 pneumococcal strains from adults, the most common isolates were types 1, 3, 14, 7F, 4, and 6A + 6B, accounting for 50% of all pneumococcal strains isolated from patients with invasive disease. Penicillin-resistant invasive strains of Streptococcus pneumoniae are rare in Denmark (< 1%).

Capsular types of Streptococcus pneumoniae isolated from blood and CSF during 1982-1987.

Knowledge about the type distribution of Streptococcus pneumoniae is fundamental to ensure an effective formulation of pneumococcal vaccine, especially with the possibility of producing a polysaccharide-protein-conjugated vaccine for the prevention of invasive disease in children. During the 6-year period 1982-1987, we received and typed 10,298 isolates from patients with invasive pneumococcal disease: 7,812 (76%) from blood and 2,486 (24%) from CSF. Of all isolates, 81% were recovered from individuals in Europe and 23% were from children. In order of frequency, S. pneumoniae types 6A + 6B, 14, 18C, 19F, 1, 7F, 23F, 19A, 4, and 5 were most commonly isolated from children, and types 3, 1, 14, 7F, 4, 6A + 6B, 8, 23F, 9V, and 19F, from adults. The pneumococcal types in the currently available 23-valent vaccine represented 87% of all isolates in this study, but the proportion of vaccine types varied somewhat with age and source. In all pneumococcal groups included in the vaccine, the vaccine types represented > 80% of the isolates, except in groups 6, 15, and 18.

[Prevention of pneumococcal infections in the elderly by vaccination]. / Forebyggelse af pneumokokinfektioner hos aeldre ved vaccination.

Streptococcus pneumoniae still causes serious infections especially in elderly people, despite relevant antibiotic treatment and intensive therapy. At present, Statens Serum-institut annually receives about 650 pneumococcal strains isolated from blood and cerebrospinal fluid for typing from the departments of Clinical Microbiology in Denmark. Of these strains about 55% were isolated from persons aged 60 years or older. The incidence of pneumococcal pneumonia in elderly people is said to be 4-8/1000 persons/year in countries similar to Denmark. In the USA, pneumococcal vaccination is recommended for groups at risk including immunocompetent adults > or = 65 years old. Since 1978, pneumococcal vaccine has been available in Denmark, where the only indication for vaccination has been and still is intended or already performed splenectomy in persons older than two years of age. According to the literature, the protective efficacy of vaccination of elderly persons is 60-70%. Since vaccination is, furthermore, without risks we believe that vaccination of elderly people in Denmark should be advised.

[Incidence and diagnosis of pneumococcal pneumonias requiring admission to hospital]. / Incidens og diagnostik af indlaeggelseskraevende pneumonier forårsaget af pneumokokker.

A prospective investigation of patients admitted to the local hospital during a period of one year was undertaken. A total of 107 patients participated. 50% of the cases of pneumonia were found by Streptococcus pneumoniae. The diagnosis was established partly by demonstration of antigens and increase in antibody titre and also employing the traditional methods: Blood culture, microscopic examination and culture of the expectorate or tracheal secretion. 70% of the patients were over the age of 60 years. The mortality was found to be 17%. The difficulties in etiological investigations of infections in the lower respiratory tract are discussed.

Oxygen-dependent catabolism of indole-3-acetic acid in Bradyrhizobium japonicum.

Some strains of Bradyrhizobium japonicum have the ability to catabolize indole-3-acetic acid (IAA). Examination of this catabolism in strain 110 by in vivo experiments has revealed an enzymatic activity catalyzing the degradation of IAA and 5-hydroxy-indole-3-acetic acid. The activity requires addition of the substrates for induction and is oxygen dependent. The highest activity is obtained when the concentration of inducer is 0.2 mM. Spectrophotometric data are consistent with the suggestion that the indole ring is broken during degradation of IAA. We hypothesize that the enzyme catalyzes an oxygen-consuming opening of the indole ring analogous to the one catalyzed by tryptophan 2,3-dioxygenase. The pattern of metabolite usage by known tryptophan-auxotrophic mutants and studies of metabolites by high-performance liquid chromatography indicate that anthranilic acid is a terminal degradation product in the proposed pathway.

[2 fatal cases of pneumococcal septicemia after bone marrow transplantation]. / To letale tilfaelde af pneumokokseptikaemi efter knoglemarvstransplantation.

Patients with bone-marrow transplants have an increased risk of developing fulminant pneumococcal infections for years after transplantation. In order to illustrate this, two cases of fetal pneumococcal septicaemia in patients with bone-marrow transplants are described. Self-medication with penicillin in case of fever is recommended.

Prophylaxis with whole gut irrigation and antimicrobials in colorectal surgery. A prospective, randomized double-blind clinical trial.

In a prospective, randomized double-blind trial, the efficacy of whole gut irrigation as preoperative bowel preparation for elective colorectal surgery was evaluated alone and in combination with two antimicrobial agents in 148 patients. The antimicrobial regimens were metronidazole alone or metronidazole and ampicillin administered systemically preoperatively and continued for 3 days. Whole gut irrigation was completed without any discomfort in 87 percent of the patients. In 3 percent, the irrigation was stopped and the patients were excluded from the study. Abdominal wound infection developed in 32 percent of the patients after whole gut irrigation, and the addition of metronidazole decreased this incidence to 22 percent (not significant). The incidence in wound infections in the group receiving metronidazole as well as ampicillin was 2 percent, and this difference was highly significant compared with both other groups. No significant difference was found for the incidence of intraabdominal abscesses (p = 0.06), infection of the perineal wound, or anastomotic leakage. No difference in the postoperative infection rate was found between a bowel containing fecal fluid or fecal masses, but when a bowel was clean, significantly fewer infectious complications were found. Whole gut irrigation is a rapid, well-tolerated, easily performed, and safe form of preoperative bowel preparation in elective colorectal surgery if combined with systemic antimicrobial prophylaxis consisting of antimicrobial agents effective against anaerobic and aerobic organisms.