Novel Image Processing Method for Detecting Strep Throat (Streptococcal Pharyngitis) Using Smartphone.

In this paper, we propose a novel strep throat detection method using a smartphone with an add-on gadget. Our smartphone-based strep throat detection method is based on the use of camera and flashlight embedded in a smartphone. The proposed algorithm acquires throat image using a smartphone with a gadget, processes the acquired images using color transformation and color correction algorithms, and finally classifies streptococcal pharyngitis (or strep) throat from healthy throat using machine learning techniques. Our developed gadget was designed to minimize the reflection of light entering the camera sensor. The scope of this paper is confined to binary classification between strep and healthy throats. Specifically, we adopted k-fold validation technique for classification, which finds the best decision boundary from training and validation sets and applies the acquired best decision boundary to the test sets. Experimental results show that our proposed detection method detects strep throats with 93.75% accuracy, 88% specificity, and 87.5% sensitivity on average.

[Intestinal Microbiota in Migrating Barn Swallows around Osaka].

Migratory birds are considered as vectors of infectious diseases, owing to their potential for transmitting pathogens over large distances. The populations of barn swallow (Hirundo rustica) migrate from Southeast Asia to the Japanese mainland during spring and migrate back to Southeast Asia during autumn. This migratory population is estimated to comprise approximately hundreds to thousands of individuals per year. However, to date, not much is known about the gastrointestinal microbiota of the barn swallow. In this study, we characterized the fecal bacterial community in barn swallow. Using 16S rRNA gene metagenomic sequencing analysis, we examined the presence and composition of potentially pathogenic bacteria in the fecal samples, which were collected during spring season from Osaka. The number (±S.D.) of total bacteria was approximately 2.1(±3.4)×108 per gram of feces. In most samples, the bacterial community composition was dominated by families, such as Enterobacteriaceae, Pseudomonadaceae, Mycoplasmataceae, Enterococcaceae, Streptococcaceae, and Alcaligenaceae. However, no relationship was found between the bacterial community composition and geographical area in the fecal samples. Potentially pathogenic bacteria were detected at the rate of >0.1%, which included Pseudomonas spp., Escherichia/Shigella spp., Enterobacter spp., Yersinia spp., Mycoplasma spp., Enterococcus spp., Achromobacter spp., and Serratia spp. Our results suggested that barn swallow is instrumental in the transmission of these genera over large distances.

Orbital Cellulitis in a Psoriatic Patient Treated With Adalimumab.

INTRODUCTION: Psoriatic patients on tumor necrosis factor alpha inhibitors (TNFi) may be at increased risk for upper respiratory tract infections, including chronic rhino-sinusitis (CRS). Rarely, CRS can progress to orbital cellulitis (OC), an emergent ophthalmic complication wherein respiratory flora from paranasal sinus disease intrude the retro-orbital space. MATERIALS AND METHODS: Single case report. RESULTS: We report the first case, to our knowledge, of an invasive sinusitis that rapidly evolved into OC in a patient receiving adalimumab treatment for plaque psoriasis and psoriatic arthritis. After TNFi withdrawal and appropriate medical and surgical intervention, the patient fully recovered. However, on resumption of TNFi therapy, symptoms of recalcitrant CRS returned. CONCLUSION: More investigation is needed to explore how TNFi might predispose to chronic, refractory rhino-sinusitis and subsequent progression to OC. Military physicians and other medical providers should be aware of this proposed new disease entity and the potential for rapidly evolving and invasive infections in immunocompromised patients. Screening and monitoring for chronic infectious disease, such as CRS before initiating and during TNFi therapy is warranted.

Brain abscess associated with cerebral amyloid angiopathy and hemorrhage.

PURPOSE: We want to report an extremely rare condition, brain abscess associated with cerebral amylid angiopathy and hemorrhage. CASE REPORT: We report on a 64-year-old woman who presented initially with moderate fever and headache. She was initially misdiagnosed with a bleeding tumor or arteriovenous malformation rupture and treated without antibiotic therapy. The mass was surgically drained due to neurological deterioration on day 14 after admission. Streptococcus virdians was isolated from the pus culture. The pathology evaluation showed cerebral amyloid angiopathy. She received intravenous antibiotic therapy for 4 weeks. She was eventually discharged home with left quadrantanopia. CONCLUSION: This case reminds us early recognition of brain abscess formation at the site of intracerebral hemorrhage is very important for prompt and appropriate treatment to improve the overall prognosis.

Six cases of Aerococcus sanguinicola infection: clinical relevance and bacterial identification.

Aerococcus sanguinicola is a Gram-positive coccus first described in 2001. Infections in humans are rare but the use of 16S rRNA gene sequencing and improved phenotypic methods has facilitated the identification of A. sanguinicola. We report here 6 cases of A. sanguinicola bacteraemia, 2 of which were associated with infective endocarditis. Most patients were elderly (median age 70 y) and had underlying neurological disorders including dementia, cerebral degeneration, and myelomeningocele. The primary focus of infection was the urinary tract in 3 cases and the gallbladder in 1; no focus was detected in 2 cases. Long-term prognosis was poor reflecting the frailty of the patients. All strains were susceptible to penicillin, ampicillin, cefuroxime, vancomycin, erythromycin, and rifampicin. The optimal treatment of infection with A. sanguinicola has yet to be determined.

Evaluation of pathogenic indicator bacteria in structural best management practices.

This study evaluated the bacteria removal efficiency, re-suspension and survivability within two structural Best Management Practices (BMPs) called Vortechs installed at two different sites in Providence, Rhode Island. Twelve rain storms were sampled during years 2004 and 2005. Five pathogenic indicator bacteria, E. coli, enterococci, fecal streptococci, total coliform, fecal coliform, were analyzed. Results showed that Vortechs was effective in partial removal of pathogenic indicator bacteria (PIB, 39-86%), however, the PIB concentrations after Vortechs treatment were still significantly high, which could limit the use of receiving waters and raise concerns for public health. The indicator bacteria concentrations in the sump water were 1.2-2.6 times higher than that contributed by the incoming stormwater. This result suggests some bacteria were re-suspended from the sediments within the Vortechs. Low bacterial survivability of bacteria was found in the sump water at both sampling sites; however, much lower bacteria concentrations were detected at Site 2, suggesting a higher bacteria contamination from highway runoff.

Autophagy vs. Group A Streptococcus.

We have identified several mammalian protein components of the autophagy pathway. By using them as powerful tools to examine the functional significance of this degradation pathway, we recently showed that autophagy efficiently kills a pathogenic bacterium, Group A Streptococcus, after it invades host cells. However, the autophagosomes induced by these bacteria have features distinct from those of the canonical pathway.

Cloning of a crustin-like, single whey-acidic-domain, antibacterial peptide from the haemocytes of the European lobster, Homarus gammarus, and its response to infection with bacteria.

Degenerate PCR was used to isolate a 221-base pair nucleotide sequence of a new crustin-like antibacterial peptide from the haemocytes of the European lobster, Homarus gammarus. Rapid amplification of cDNA ends was used to extend the sequence to determine the complete open reading frame and un-translated regions. The inferred amino acid sequence of this peptide was found to be similar to crustin-like peptides isolated for several species of shrimp as well as the shore crab, Carcinus maenas. The sequence also contains a single-whey-acidic protein (WAP) domain, similar to novel antibacterial single-whey-acidic domain (SWD) peptides that have been recently described in the tiger shrimp, Penaeus monodon, and the Pacific white shrimp, Litopenaeus vannamei. Real-time PCR was used to analyse the expression of the gene coding for this peptide. The gene is up regulated after inoculation with the Gram-positive lobster pathogen Aerococcus viridans var. homari but down regulated after inoculation with the Gram-negative bacteria Listonella anguillarum. Phylogenetic analysis of this new peptide shows that it is most related to other antimicrobial crustin peptides and that the crustins are only distantly related to the antibacterial SWD peptides recently described.

Prospective study of the long term change of the oral flora after radiation therapy.

OBJECTIVES: The aim of this prospective study was to evaluate the long term change in oral pathogens following radiation therapy. METHODS: Twenty-two patients with planned radiation therapy (>30 Gy) of head and neck squamous cell carcinoma were included. Before radiation therapy, after 3, 6, and 12 months samples from the deepest periodontal pocket were drawn. Five major periodontal pathogens were studied using DNA probes (Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Bacteriodes forsythus, Treponema denticola). Stimulated saliva was sampled for the microbiologic study of caries pathogens (streptococci and lactobacilli). Plaque index and decayed, missing, filled tooth surfaces (DMF-S) were recorded. RESULTS: A normalisation of the caries bacteria is not found correlating to a significant increase in the number of affected teeth (DMF-S) from 80.7 to 88.5 after 12 months. The plaque index remained unchanged. The incidence of periodontal pathogens did not significantly change during the follow up. CONCLUSION: In contrast to radiation caries there seems to be no microbiological evidence for "radiation periodontitis". Despite of the intensive oral hygiene no reduction of the high number of caries pathogens is found, which leads to a high risk of tooth decay even 12 months after radiation.

[Interaction of bacteria and red blood cells].

The interaction of staphylococci, streptococci, meningococci, enterobacteria, leptospires and other microorganisms with red blood cells is considered. Three forms of the interaction of bacteria and red blood cells are discussed: adhesion, the influence of secretory factors on red blood cells, the action of pathogenic bacteria on hemoglobin. The applied aspects of the interaction of bacteria and red blood cells in the human body are presented in accordance with the results of clinical and laboratory studies.

Studies on the virulence of Aerococcus viridans (var.) homari, the causative agent of gaffkemia, a fatal disease of homarid lobsters.

Virulent and avirulent strains of Aerococcus viridans (var.) homari were used to extend previous studies to determine and confirm differences between the 2 types. Virulent strains possessed polysaccharide capsules and were not agglutinated by lobster hemolymph serum; avirulent strains did not have capsules, were agglutinated by the lobster hemolymph serum, and most did not grow well in lobster hemolymph serum. Growth of the avirulent strains in sterile lobster hemolymph serum induced the production of capsules (which reached a maximum after 5 to 7 d incubation), eliminated susceptibility of the strains to the lobster serum agglutinin, and restored their virulence against lobsters. The factor(s) in lobster hemolymph serum inducing the long-lasting phenotypic response of virulence was (were) heat labile.

Total knee arthroplasty infection due to Abiotrophia defectiva.

The first documented case of knee alloarthroplasty infection due to Abiotrophia defectiva, formerly known as nutritionally variant streptococci (NVS) and Streptococcus defectivus, is presented. The microbiology of this bacterium is discussed and clinical features of previously reported cases of infections by NVS are reviewed briefly.

[Aerococcus urinae and urinary tract infection]. / Aerococcus urinae og urinveisinfeksjon.

BACKGROUND: Bacteriological investigation of urine often shows the presence of alpha-haemolytic streptococci, but the clinical significance of this finding may be unclear. Among the alpha-haemolytic streptococci found in urine is Aerococcus urinae, which is pathogenic. MATERIAL AND METHODS: We present a prospective study of the prevalence and antibiotic susceptibility of A urinae in urine samples sent to a microbiology laboratory in Norway. RESULTS: Seven out of 27 alpha-haemolytic streptococcal isolates were A urinae. This represents 0.3% of all urine isolates from our laboratory. Appropriate methods for identification and resistance determination are described. INTERPRETATION: Microbiological laboratories should include identification of A urinae in their diagnostic repertoire. Recommended treatment against A urinae is ampicillin or nitrofurantoin.

Estimated prevalence of Aerococcus viridans and Anophryoides haemophila in American lobsters Homarus americanus freshly captured in the waters of Prince Edward Island, Canada.

The Canadian lobster industry holds lobsters Homarus americanus in captivity for various periods to supply markets with live product year-round. Mortality during holding results in considerable losses, estimated at 10 to 15 % yr(-1) by the industry. This study examined the prevalence of Anophryoides haemophila and Aerococcus viridans, causative agents of 'bumper car' disease and gaffkemia, respectively, in lobsters freshly captured in the waters of Prince Edward Island during the spring and fall fishing seasons of 1997. A total of 116 lobsters were sampled in the spring, and 138 in the fall. A. haemophila was not detected in the spring, while the prevalence was 0.72 % in the fall with a 95% confidence interval (CI) of 0.02 to 3.97% and an overall prevalence of 0.39% (95% CI: 0.01 to 2.17%). The prevalence of A. viridans was estimated at 6.9% (95% CI: 3.0 to 13.14%) in the spring, 5.8% in the fall (95% CI: 2.54 to 11.10%), and 6.30% overall (95% CI: 3.64 to 10.03%). Because of the reduced interest in food of diseased lobsters, and compromised metabolism in the case of gaffkemia, these prevalence estimates are likely underestimates of the true prevalence of gaffkemia and 'bumper car' disease in the wild populations of lobster around Prince Edward Island.

Lipid peroxidation, osmotic fragility and antioxidant status in children with acute post-streptococcal glomerulonephritis.

Plasma and erythrocyte samples from acute post-streptococcal glomerulonephritis (APSGN) children and control children were enrolled in this study. Lipid peroxidation (LPO), measured in terms of thiobarbituric acid-reactive substances (TBARS) was found to be significantly increased in plasma and RBCs of APSGN children (P<0.05) than in control children. Osmotic fragility of erythrocytes was examined. RBCs of APSGN patients were found to be osmotically more sensitive towards hypotonic saline (50% hemolysis at 7 g/l saline) when compared to control RBCs (50% hemolysis at 4 g/l saline). The activities of antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and glutathione S-transferase (GST) were significantly lowered (P<0.05) in APSGN RBCs when compared to control RBCs. Plasma ascorbic acid, reduced glutathione (GSH), RBC ascorbic acid, GSH and RBC total sulphydryl content (TSH) were significantly depleted in APSGN children relative to controls. The susceptibility of RBCs of APSGN children to lipid peroxidation was confirmed in this study.

Urinary tract infections in adults with diabetes.

Urinary tract (UTI) is a major disease burden for many patients with diabetes. Asymptomatic bacteriuria is several-fold more common among women and acute plyelonephritis is five to ten times more common in both sexes. The complications of pyelonephritis are also more common in patients with diabetes. These complications include acute papillary necrosis, emphysematous pyelonephritis, and bacteremia with metastatic localization to other sites. The management of urinary infection in patients with diabetes is essentially the same as patients without diabetes. Most infections should be managed as uncomplicated except when they occur in a milieu with obstruction or other factors that merit a diagnosis of complicated UTI. Strategies to prevent these infections and reduce morbidity should be a priority for research.

Heterologous inducible expression of Enterococcus faecalis pCF10 aggregation substance asc10 in Lactococcus lactis and Streptococcus gordonii contributes to cell hydrophobicity and adhesion to fibrin.

Aggregation substance proteins encoded by the sex pheromone plasmid family of Enterococcus faecalis have been shown previously to contribute to the formation of a stable mating complex between donor and recipient cells and have been implicated in the virulence of this increasingly important nosocomial pathogen. In an effort to characterize the protein further, prgB, the gene encoding the aggregation substance Asc10 on pCF10, was cloned in a vector containing the nisin-inducible nisA promoter and its two-component regulatory system. Expression of aggregation substance after nisin addition to cultures of E. faecalis and the heterologous bacteria Lactococcus lactis and Streptococcus gordonii was demonstrated. Electron microscopy revealed that Asc10 was presented on the cell surfaces of E. faecalis and L. lactis but not on that of S. gordonii. The protein was also found in the cell culture supernatants of all three species. Characterization of Asc10 on the cell surfaces of E. faecalis and L. lactis revealed a significant increase in cell surface hydrophobicity upon expression of the protein. Heterologous expression of Asc10 on L. lactis also allowed the recognition of its binding ligand (EBS) on the enterococcal cell surface, as indicated by increased transfer of a conjugative transposon. We also found that adhesion of Asc10-expressing bacterial cells to fibrin was elevated, consistent with a role for the protein in the pathogenesis of enterococcal endocarditis. The data demonstrate that Asc10 expressed under the control of the nisA promoter in heterologous species will be an useful tool in the detailed characterization of this important enterococcal conjugation protein and virulence factor.