Prenatal substance use in a Western urban community.

To assess the extent of prenatal substance use in a predominantly white population in an urban area of the western United States and to develop a risk profile for this population, a cross-sectional prevalence study was done. Prenatal clinics (10 public and 10 private) anonymously recorded demographic information about and collected aliquots of routinely obtained urine specimens from women during prenatal visits. Urine specimens were screened by enzyme immunoassay for amphetamines, marijuana, cocaine, opiates, and ethanol. Of the 935 women screened, 92 (9.8%) had urine specimens positive for one or more of these substances. Urine screens were positive in 56 (10.0%) of 562 women attending private clinics and 36 (9.6%) of 373 women attending public clinics. Only 7 of the 935 women (0.7%) had screens positive for cocaine. Ethanol was the most frequently detected substance in the private clinic group (6.4%), whereas marijuana was most common among women attending public clinics (5.1%). Although substance use in this group of pregnant women occurs at a lower rate and a different pattern from those found in other more densely populated areas, the rate is high enough to be of concern to all prenatal care professionals, who should incorporate substance use history taking and selective urine drug screening into their routine prenatal practices.     

不同地区人群咽部正常菌群抑制脑膜炎双球菌生长的调查

应用琼脂铺层技术检查了健康者咽部正常菌群对脑膜炎余瑟氏菌(Nm)生长的抑制作用。有些健康者咽部正常菌群对 A 群、B 群和 C 群 Nm 的生长均有抑制作用,而且这种抑菌作用较稳定.1989年冬～1990年春选择流脑发病高的江西宁都县青塘乡和该县未发病的东山坝乡与北京昌平县百善乡作为未发病地区的对照.在流脑发病率高的青塘乡只有8.5%的健康者咽部正常菌群具有抑菌作用;在东山坝乡和百善乡中分别有30%与50%的健康者咽部正常菌群可以抑制 A 群 Nm 生长。这种抑菌作用随年龄增长而增强。初步调查结果表明,健康者咽部正常菌群对 Nm 原发感染似乎有一定的影响。我们对调查中所收集的对 Nm 具有抑菌作用的细菌按 Bergey 氏手册进行了鉴定,现已确定它们是血液链球菌、缓症链球菌、米勒氏链球菌和唾液链球菌四种。     

Mycoplasma Recovery from the Male Genitourinary Tract: Voided Urine Versus the Urethral Swab

A study of Mycoplasma recovery from the genitourinary tract was made on a group of 50 males attending a venereal disease clinic. The purpose of the investigation was to compare recovery rates of mycoplasma from two types of clinical specimens-the urethral swab and voided urine. The total number of positive cultures did not differ significantly when either the swab or urine was used; Mycoplasma hominis type 1 was the only taxonomic species isolated, either alone or mixed with T-strain mycoplasma. Recovery rates of the two types from both the swab and the urine did not differ significantly. Age did not relate to the presence of mycoplasma in the group studied.     

Growth of Chlamydia trachomatis in McCoy Cells Treated with Cytochalasin B

When the fungal metabolite cytochalasin B was added to McCoy cells, multinucleated giant cells developed. Monolayers of these cells proved as efficient as irradiated cells for the growth of three different serotypes of Chlamydia trachomatis and for the primary isolation of chlamydiae from clinical specimens obtained from patients attending a venereal disease clinic. Cytochalasin treatment of McCoy cells provides a convenient alternative to irradiation and should be of value in the isolation of chlamydiae from the eye and genital tract.     

Proved viraemia in asian influenza (Hong Kong variant) during incubation period

During an outbreak of influenza specimens were obtained from 21 patients with influenza-like illnesses and from 29 healthy subjects in close contact with the patients. Throat washings from 12 of the patients were positive for influenza virus but virus was not detected from the blood specimens. One healthy contact became ill 12 hours after the specimens were obtained, and the virus was isolated from his blood and throat washings. The remaining contacts showed no clinical illness; but the virus was isolated from the throat washings of four of them, with no viral isolation from the blood specimens.     

IgA肾病患者血液、尿液及咽拭子标本中穿通支原体的分离检出

目的探讨IgA肾病患者血液、尿液及咽拭子标本中穿通支原体（Mycoplasma penetrans,Mp）的分离检出率以及与病理型别相关性。方法采用分离培养法,共计从26例IgA肾病患者血液、尿液及咽拭子标本及38例正常对照相应标本中进行穿通支原体分离检测,对培养阳性标本用穿通支原体套式PCR进行证实。结果在11例（42．3％）患者血液与尿液或（和）咽拭子中同时分离到穿通支原体,单独尿液或咽拭子标本阳性分别为1例（3．8％）与7例（26．9％）。26例IgA肾病患者血液、尿液及咽拭子穿通支原体的分离检出率分别为42．3％、23．1％与57．7％;与38例正常对照组血液、尿液及咽拭子检出0例、2例（5．3％）与7例（18．4％）相比较,差异有非常显著性（P〈0．01）,在正常对照组中无2种以上标本同时检出穿通支原体。结论穿通支原体在ISA肾病患者的血液、尿液与咽拭子标本中均有较高的检出率且与病理型别有一定的相关性。     

Atypical Mycobacteria in the Niagara Peninsula

From 1960 to 1965, 44,629 cultures were performed on persons attending chest clinics in the Niagara Peninsula.Tubercle bacilli were cultured from 965 biological specimens (2.16%) and atypical mycobacteria from 281 specimens (0.62%).Twelve subjects had more than one variety of atypical mycobacterium in their secretions, suggesting the occurrence of mutation. The administration of antituberculous drugs may have contributed to the emergence of atypical mycobacteria in some instances, but 41 patients had never received antituberculous drugs.Of 113 persons from whom atypical mycobacteria were cultured only two had lung infection primarily due to the atypical mycobacterium isolated.     

West Indian diabetic population of a large inner city diabetic clinic.

West Indians form a sizable minority of diabetics attending many inner city diabetic clinics. There are 554 diabetics of West Indian origin on our computer files--7% of the total recorded clinic population. Of these 554 patients (56% female, 44% male), 70% have been diagnosed within the past five years; and only 9% have had diabetes for over 10 years; in only five (1%) was diabetes diagnosed before the age of 20. Sixteen per cent were taking insulin, but only 4% of the total West Indian population were truly insulin dependent. Of 65 patients admitted in hyperglycaemic coma or precoma over the past three years, 10 were of West Indian origin; eight of these 10 had hyperosmolar coma compared with only six of the remaining 55. We conclude that diabetics of West Indian origin attending our clinic show differences in the distribution of age and duration of diabetes from the caucasian population. Most are non-insulin dependent, and the frequency of hyperosmolar coma is higher than that of ketoacidosis. Diabetics of West Indian origin may have a different pattern of disease from the rest of the clinic population.     

Acceptance of neonatal genetic screening for hereditary hemochromatosis by informed parents

The aim of this study was to assess attitudes to neonatal genetic screening for hereditary hemochromatosis. A total of 135 consecutive, pregnant women and their partners attending a hospital antenatal clinic in the Australian Capital Territory were given detailed written and verbal information about potential risks and benefits of neonatal genetic screening. Issues such as uncertainty of disease expression, confidentiality, genetic discrimination, and storage of genetic data were addressed. Attitudes were assessed by interview and questionnaire. There was a high level of acceptance for neonatal genetic screening in general (99%) and for hemochromatosis in particular (91.5%). There was no association of prior knowledge of hemochromatosis, family history of hemochromatosis, ethnicity, age, education, or occupation class with nonacceptance. Of the subjects, 39.5% reported feeling "a little anxious" about the prospect of screening their infants, although only 5.4% reported feeling "very anxious." Reasons given for nonacceptance of screening included inability of the child to give informed consent, insufficient evidence that diagnosis of hemochromatosis in childhood is beneficial, risk of discrimination on genetic grounds, lack of agreement between partners, and privacy issues. These data suggest that an Australian neonatal genetic screening program for hemochromatosis is likely to be accepted by this and similar groups of subjects, but there should be an opportunity for parents who object to screening to opt out of any such program.     

Detection of Group A Streptococci in Throat Swabs by Direct Fluorometry

A direct fluorometric test for the rapid detection of group A streptococci from throat swabs was compared with the microscopic fluorescent-antibody test. Formalinized throat swab cultures (490) were examined by the two methods, and the results agreed on 84% of the specimens. In another comparison, 15-hr broth cultures of 103 freshly taken throat swabs were tested by both methods. Of the specimens tested, 101 (98%) were either positive or negative by both methods. In all cases, the latter results correlated with the demonstration of presence or absence of group A streptococci in the specimens by cultural isolation and precipitin grouping tests. It may be feasible to use the direct fluorometric test in a diagnostic laboratory as described or possibly to adapt it for automatic processing of throat swab cultures.     

Identification of beta-hemolytic streptococci isolated from hospitalized children in Baghdad.

Two hundred and twenty four hospitalized children in Baghdad aged between 1 month and 10 years were examined for Streptococcal infections. Thirty-four percent of the throat and saliva specimens were positive for beta-hemolytic streptococci. Males were more susceptible to infection with group A streptococci than females. Streptococcus of group A was isolated from 39.5% of the positive cases while group G was 47.4%. The etiological significance of the latter group in tonsillitis and otitis media is to be further investigated. Ninety six percent of the isolated streptococci were T typable and 13.3% of the strains were M typable. A high frequency of type T-11 was found in streptococcal infections. T type 3875 was found to be a new provisional type. All isolates were M untypable, and antiopacity factor negative except for two isolates of T type 4 which were positive in both typings.     

Aetiology of upper respiratory tract infections in children in Arak city: a community based study

Viruses are frequent causes of upper respiratory tract infections in children. We investigated the viral aetiology of community-acquired upper respiratory tract infections (URIs) in young children treated as outpatients in community settings. During November 2008, nasal swab specimens were taken from children with recent onset of upper respiratory tract infections. The patients attended day care or primary schools; the specimens were randomly obtained by pediatricians from schools and childcare institutions and sent for identification by PCR method. A total of 300 specimens were collected. From all samples, 40.67% were positive for at least 1 virus, viz. adenovirus 11.76%, rhinovirus 9.8%, respiratory syncytial virus 6.08%, influenza virus 5.56%, parainfluenza virus 4.9%, enterovirus 2.94% and a combination of 2 viruses 2%. Clinical manifestations of the respiratory infections were as follows: 70.7% of the patients had coryza, 69.3% cough, 26% sneezing, 19.7% sore throat, 2.7% headache, 7.7% fever, 2.3% conjunctivitis, 1.3% abdominal pain and 1% hoarseness. The results of this study demonstrate that adenoviruses and rhinoviruses are the two most common viral agents isolated from pediatric outpatients with acute URIs in autumn in Arak City. Coryza and cough were the most common symptoms in children. Sore throat and hoarseness were more prevalent in infections caused by influenza virus, conjunctivitis in parainfluenza, and coryza in rhinovirus infections.     

2007年重庆市流脑流行季节前健康人群抗体水平和带菌率调查

为了解重庆市流脑流行季节前健康人群免疫水平和带菌状况,预测发病趋势,提出新的免疫策略,提供有效的预防措施。按照全国流脑监测方案并结合重庆市2006年流脑疫情情况,选择重庆市北碚区、长寿区和万盛区为2007年流脑监测点,采集0~、5~、10~、15~、25~、35~及45岁以上共7个年龄组人群的静脉血和咽拭子,分别进行抗体水平和带菌率检测。结果显示,重庆市健康人群A群流脑IgG抗体的阳性率为76.02%(485/638),C群流脑IgG抗体的阳性率为47.65%(304/638),健康人群脑膜炎奈瑟菌(简称Nm)带菌率为0.47%(3/638)。重庆市健康人群A群流脑IgG抗体阳性率维持在较高水平,而C群流脑IgG抗体的阳性率较低,提示该市大部分人群对A群流脑有免疫作用,但C群抗体水平较低,有引起局部流脑爆发的风险。     

An audit of cervical cytology in HIV‐positive women

O. E. O. Hotonu, J. Hussey, M. S. T. Basta, V. Wadehra, P. Cross and M. L. Schmid
An audit of cervical cytology in HIV‐positive women Objective: To investigate whether a cohort of human immunodeficiency virus‐positive (HIV+) women were having annual cervical cytology as recommended by the English National Health Service cervical screening programme (NHSCSP) guidelines. Methods: An audit of cervical cytology in an HIV+ cohort of 187 women by obtaining their last cervical cytology result and recall from local cytology services. Results: Of the 187 women in the audit, two were ineligible, leaving 185 women, 167 (90.3%) of whom were aged 25–64 years and eligible for screening. Of the 185 women, 126 (68.1%) had a cytology history, 50 (27%) had never had cervical cytology and nine (4.9%) had inadequate details to ascertain whether or not they had a cytology history. Of the 126 with a cytology record, 34 (27%) had a current cytological abnormality, which was low grade in 25 (19.8%) and high grade in nine (7.1%). Among women aged 25–64 years attending the clinic, these percentages were significantly higher than expected for England as a whole (P < 0.001). Of 126 women with a cytology record, 29 (23%) were overdue for their recall date and of these the previous test was abnormal in 14 (48.3%). Cytology tests were taken within the community setting in 61 (48.4%), whereas 65 (51.6%) were seen either at an HIV sexual health clinic or were under colposcopy follow‐up. Of 91 women with negative cytology only 50 (54.9%) were recommended for repeat in 12 months. Conclusion: This audit demonstrates a high rate of cytological abnormalities among HIV+ women compared with the screening population at large. Implementation of NHSCSP guidelines has been difficult and requires improved care pathways between HIV clinics, primary care and laboratories.     

Use of ristomycin diffused into the culture medium for separation of meningococci from nasopharyngeal mucus

The method for enhancing the growth of meningococci after the inoculation of the specimens of nasopharyngeal mucus is proposed. The method is based on the diffusion of ristomycin into agar from ristomycin-impregnated filter paper strips. During the study of 694 specimens of nasopharyngeal mucus the above-mentioned method allowed isolation of 108 meningococcal cultures, while in serum agar only 21 cultures were isolated. The effectiveness coefficient of this method was found to be 80.6%, its effectiveness index being 5.1. The method facilitated the isolation of meningococci and in some cases reduced the time of analysis by 1 day.     

Hemagglutination Inhibition for Serogrouping of Neisseria meningitidis

A hemagglutination inhibition (HI) test has been studied as an alternative to bacterial agglutination (BA) for serogrouping strains of Neisseria meningitidis isolated from clinical specimens. The HI test consists of polysaccharide antigens adsorbed to sheep red blood cells which were then agglutinated by group-specific antisera. Supernatant fluids from suspensions of meningococci were used to inhibit the agglutination. Results of the two tests agreed for 381 (80%) carrier strains. Of the remaining 95 strains, 82 (86%) were identified by HI although they were nongroupable by BA. Thus, the HI test has been shown to be more highly specific and sensitive and to be more economical of reagents and time than the BA test.     

Genetic analysis of Streptococcus agalactiae strains isolated from neonates and their mothers

Streptococcus agalactiae or group B streptococcus (GBS) is the most common cause of neonatal sepsis and meningitis in neonates. One of the major questions is whether the GBS strains able to cause neonatal invasive disease have peculiar genetic features. A collection of S. agalactiae strains, isolated from cervix, vagina and rectum of 10 mothers and from throat, ear and umbilicus of their newborns was genetically characterized by pulsed-field gel electrophoresis (PFGE). This study demonstrated that the strains isolated from each mother and her child were all genetically identical but that the strains from the 10 mother/child pairs mutually were genetically heterogeneous and 10 different PFGE patterns were found. Although it has been suggested that PFGE would be able to identify virulence traits to direct decisions in antibiotic management, the heterogeneous feature of GBS strains does not support broad application.     

Types of meningococci isolated from carriers and patients in a non-epidemic period in the netherlands

In a non-epidemic period the carrier rate of meningococci among 60 members of the laboratory staff during a long-term observation period of 1.5 years was 38%.In a children's home only a few children were carriers. The meningococci practically did not spread.In 161 recruits observed for periods of at most eight weeks the percentage of positives was 39.1 on the day of joining up and reached its maximum of 80.1 in the course of the period of observation.Among the strains isolated from patients and from carriers, type B predominated. In patients, type C was second in frequency; in carriers, type Y. Type A was found very rarely in carriers and somewhat more frequently in patients.The high carrier rate of type B in adults, together with its low aggressiveness for persons older than ten, may explain the relatively high frequency of the disease in the younger age groups.     

Sero-epidemiology of Neisseria meningitidis infections in parts of Eastern Nigeria.

The prevalence of antibodies to meningococci in the Nsukka area, East Central Nigeria, was studied by the indirect hemagglutination test employing tanned chicken erythrocytes. Of the 1332 apparently healthy persons, whose sera were tested, 982 samples (73.8%) were positive at 1:8 dilution of the sera. Fifty-six per cent of the population had antibodies to Group B, followed by 13% of Group C and 5% to Group A. Twenty-five sera from patients with meningococcal infections, from whom Group B meningococci were isolated, 100% were positive. Percentage reactivity in the 2-5-year age group was low (15%), whereas it increased rapidly from 78% (6-10-year group) to 95% (31 years and above).