Journal of Medical Microbiology current issue

Effect of bile salts on the DNA and membrane integrity of enteric bacteria [REVIEW]

Merritt, M. E., Donaldson, J. R. — Mon, 09 Nov 2009 16:48:43 PST

Enteric bacteria are able to resist the high concentrations of bile encountered throughout the gastrointestinal tract. Here we review the current mechanisms identified in the enteric bacteria Salmonella, Escherichia coli, Bacillus cereus and Listeria monocytogenes to resist the dangerous effects of bile. We describe the role of membrane transport systems, and their connection with DNA repair pathways, in conferring bile resistance to these enterics. We discuss the findings from recent investigations that indicate bile tolerance is dependent upon being able to resist the detergent properties of bile at both the membrane and DNA level.

Burkholderia cenocepacia O antigen lipopolysaccharide prevents phagocytosis by macrophages and adhesion to epithelial cells [PATHOGENICITY AND VIRULENCE]

Saldias, M. S., Ortega, X., Valvano, M. A. — Mon, 09 Nov 2009 16:48:43 PST

Chronic respiratory infections by the Burkholderia cepacia complex (Bcc) are of great concern to patients with cystic fibrosis. Bcc isolates may survive intracellularly within amoebae, respiratory epithelial cells and macrophages. The molecular mechanisms facilitating colonization and pathogenesis remain unclear. Given the importance of bacterial adhesion to host surfaces in microbial pathogenesis, we investigated the role of the O antigen LPS in the interaction of Burkholderia cenocepacia, a member of the Bcc, with macrophages and epithelial cells. Our results demonstrated that the O antigen modulates phagocytosis but does not affect intracellular survival of B. cenocepacia. Internalization of strains that lack O antigen was significantly increased compared to that of their isogenic smooth counterparts. However, no differences between rough and smooth strains were found in their ability to delay phagosomal maturation. We also found that the O antigen interfered with the ability of B. cenocepacia to adhere to bronchial epithelial cells, suggesting that this polysaccharide may mask one or more bacterial surface adhesins.

Pathogenic potential of Aeromonas hydrophila isolated from surface waters in Kolkata, India [PATHOGENICITY AND VIRULENCE]

Bhowmik, P., Bag, P. K., Hajra, T. K., De, R., Sarkar, P., Ramamurthy, T. — Mon, 09 Nov 2009 16:48:43 PST

Members of the genus Aeromonas (family Aeromonadaceae) are medically important, Gram-negative, rod-shaped micro-organisms and are ubiquitous in aquatic environments. Aeromonas species are increasingly recognized as enteric pathogens; they possess several virulence factors associated with human disease, and represent a serious public health concern. In the present study, putative virulence traits of Aeromonas hydrophila isolates collected from different natural surface waters of Kolkata, India, were compared with a group of clinical isolates from the same geographical area using tissue culture and PCR assays. Enteropathogenic potential was investigated in the mouse model. Of the 21 environmental isolates tested, the majority showed cytotoxicity to HeLa cells (81 %), haemolysin production (71 %) and serum resistance properties (90 %), and they all exhibited multi-drug resistance. Some of the isolates induced fluid accumulation (FA ratio≥100), damage to the gut and an inflammatory reaction in the mouse intestine; these effects were comparable to those of clinical strains of A. hydrophila and toxigenic Vibrio cholerae. Interestingly, two of the isolates evoked a cell vacuolation effect in HeLa cells, and were also able to induce FA. These findings demonstrate the presence of potentially pathogenic and multi-drug-resistant A. hydrophila in the surface waters, thereby indicating a significant risk to public health. Continuous monitoring of surface waters is important to identify potential water-borne pathogens and to reduce the health risk caused by the genus Aeromonas.

Effect of age on susceptibility to Salmonella Typhimurium infection in C57BL/6 mice [HOST RESPONSE]

Mon, 09 Nov 2009 16:48:43 PST

Ageing is associated with a decline in immune function, which predisposes the elderly to a higher incidence of infections. Information on the mechanism of the age-related increase in susceptibility to Salmonella enterica serovar Typhimurium (S. Typhimurium) is limited. In particular, little is known regarding the involvement of the immune response in this age-related change. We employed streptomycin (Sm)-pretreated C57BL/6 mice to develop a mouse model that would demonstrate age-related differences in susceptibility and immune response to S. Typhimurium. In this model, old mice inoculated orally with doses of 3x10⁸ or 1x10⁶ c.f.u. S. Typhimurium had significantly greater S. Typhimurium colonization in the ileum, colon, Peyer's patches, spleen and liver than young mice. Old mice had significantly higher weight loss than young mice on days 1 and 2 post-infection. In response to S. Typhimurium infection, old mice failed to increase ex vivo production of IFN- and TNF- in the spleen and mesenteric lymph node cells to the same degree as observed in young mice; this was associated with their inability to maintain the presence of neutrophils and macrophages at a ‘youthful’ level. These results indicate that Sm-pretreated C57BL/6 old mice are more susceptible to S. Typhimurium infection than young mice, which might be due to impaired IFN- and TNF- production as well as a corresponding change in the number of neutrophils and macrophages in response to S. Typhimurium infection compared to young mice.

Quantitative detection of periodontopathic bacteria in atherosclerotic plaques from coronary arteries [DIAGNOSTICS, TYPING AND IDENTIFICATION]

Mon, 09 Nov 2009 16:48:43 PST

Oral pathogens, including periodontopathic bacteria, are thought to be aetiological factors in the development of cardiovascular disease. In this study, the presence of Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum–periodonticum–simiae group, Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens and Tannerella forsythia in atheromatous plaques from coronary arteries was determined by real-time PCR. Forty-four patients displaying cardiovascular disease were submitted to periodontal examination and endarterectomy of coronary arteries. Approximately 60–100 mg atherosclerotic tissue was removed surgically and DNA was obtained. Quantitative detection of periodontopathic bacteria was performed using universal and species-specific TaqMan probe/primer sets. Total bacterial and periodontopathic bacterial DNA were found in 94.9 and 92.3 %, respectively, of the atheromatous plaques from periodontitis patients, and in 80.0 and 20.0 %, respectively, of atherosclerotic tissues from periodontally healthy subjects. All periodontal bacteria except for the F. nucleatum–periodonticum–simiae group were detected, and their DNA represented 47.3 % of the total bacterial DNA obtained from periodontitis patients. Porphyromonas gingivalis, A. actinomycetemcomitans and Prevotella intermedia were detected most often. The presence of two or more periodontal species could be observed in 64.1 % of the samples. In addition, even in samples in which a single periodontal species was detected, additional unidentified microbial DNA could be observed. The significant number of periodontopathic bacterial DNA species in atherosclerotic tissue samples from patients with periodontitis suggests that the presence of these micro-organisms in coronary lesions is not coincidental and that they may in fact contribute to the development of vascular diseases.

Development of an indirect ELISA for the detection of serum IgG antibodies against region IV of phase 1 flagellin of Salmonella enterica serovar Brandenburg in sheep [DIAGNOSTICS, TYPING AND IDENTIFICATION]

Perera, K., Murray, A. — Mon, 09 Nov 2009 16:48:43 PST

Region IV of phase 1 flagellin (FliC) of Salmonella enterica serovar Brandenburg (S. Brandenburg) was expressed in Escherichia coli and purified by nickel chelate affinity chromatography. The purified recombinant protein was evaluated for its suitability as an antigen in an indirect ELISA for the detection of antibodies in sheep sera. A cut-off value of 0.1 was calculated using 80 serum samples collected from sheep with no previous history of S. Brandenburg. In the present study we show the results of ELISA with field sera collected from 81 sheep naturally infected with S. Brandenburg. The assay was able to detect antibodies belonging to the IgG class with a sensitivity of 93.8 %. Thus, indirect ELISA might be a suitable screening tool for serological monitoring of sheep flocks infected with S. Brandenburg.

Constitutive expression of the ileS-2 gene responsible for high-level mupirocin resistance in Staphylococcus aureus [ANTIMICROBIAL AGENTS AND CHEMOTHERAPY]

Mon, 09 Nov 2009 16:48:43 PST

Mupirocin is a topical antimicrobial agent that is used for the treatment of skin and postoperative wound infections, and the prevention of nasal carriage of meticillin-resistant Staphylococcus aureus (MRSA). However, the prevalence of mupirocin resistance in S. aureus, particularly in MRSA, has increased. High-level mupirocin resistance, with MICs ≥512 µg ml^–1, is mediated by the ileS-2 gene, which is located on conjugative plasmids. In the present study, we investigated whether mupirocin influences the expression of the ileS-2 gene responsible for high-level mupirocin resistance, and we present some evidence that this gene is not upregulated but constitutively expressed in S. aureus.

High prevalence of plasmid-mediated quinolone resistance determinants in commensal members of the Enterobacteriaceae in Ho Chi Minh City, Vietnam [ANTIMICROBIAL AGENTS AND CHEMOTHERAPY]

Mon, 09 Nov 2009 16:48:43 PST

Antimicrobial-resistant pathogenic members of the Enterobacteriaceae are a well-defined global problem. We hypothesized that one of the main reservoirs of dissemination of antimicrobial resistance genes in Vietnam is non-pathogenic intestinal flora, and sought to isolate antimicrobial-resistant organisms from hospitalized patients and non-hospitalized healthy individuals in Ho Chi Minh City. The results identified substantial faecal carriage of gentamicin-, ceftazidime- and nalidixic acid-resistant members of the Enterobacteriaceae in both hospitalized patients and non-hospitalized healthy individuals. A high prevalence of quinolone resistance determinants was identified, particularly the qnrS gene, in both community- and hospital-associated strains. Furthermore, the results demonstrated that a combination of quinolone resistance determinants can confer resistance to nalidixic acid and ciprofloxacin, even in the apparent absence of additional chromosomal resistance mutations in wild-type strains and laboratory strains with transferred plasmids. These data suggest that intestinal commensal organisms are a significant reservoir for the dissemination of plasmid-mediated quinolone resistance in Ho Chi Minh City.

Diversity of intestinal Escherichia coli populations in Nicaraguan children with and without diarrhoea [EPIDEMIOLOGY]

Mon, 09 Nov 2009 16:48:43 PST

Escherichia coli remains an important aetiological agent of infantile diarrhoea in Nicaragua. However, little is known about whether there is a high prevalence of endemic strains or whether infection is due to the epidemic spread of virulent clones. This study was undertaken to determine the diversity and distribution of clonal groups in a population of intestinal E. coli isolated from the faeces of children from León, Nicaragua, with (n=381) and without (n=145) diarrhoea, between March 2005 and September 2006. All samples had been screened previously for the presence of diarrhoeagenic E. coli (DEC) markers by multiplex PCR. From each sample, 8 E. coli colonies (where available) were analysed by biochemical fingerprinting (PhP-RE system), yielding a total of 4009 tested isolates. On average, three different biochemical phenotypes (BPTs) were found among the eight colonies analysed from each sample. The total diversity, measured as Simpson's diversity index (Di), was 0.97 among all 4009 isolates studied. Cluster analysis of data from all 4009 isolates revealed 24 common BPTs (identified in at least 1 % of the isolates) and 234 less common BPTs. Similar Di values were obtained among isolates from infants with and without diarrhoea, indicating that no widespread outbreak of DEC had occurred. Moreover, among samples that were positive for the DEC types enteroaggregative E. coli, enteropathogenic E. coli and enterotoxigenic E. coli (ETEC) carrying the eltB gene, the diversities were almost as high as among non-DEC samples, whereas samples positive for ETEC carrying estA, enteroinvasive E. coli and enterohaemorrhagic E. coli showed lower diversities, indicating the prevalence of virulent clonal groups among these samples. The PhenePlate patterns of the 24 common BPTs identified here were compared with those obtained from E. coli isolated in a cohort infant study performed in 1991–1992 in the same area. Only 4 % of the isolates from the 1990s were similar to any of the common BPTs found in the present study.

Report of two unlinked cases of infant botulism in the UK in October 2007 [CLINICAL MICROBIOLOGY AND VIROLOGY]

Mon, 09 Nov 2009 16:48:43 PST

Infant botulism is a rare disease in the UK, with the first case being recognized in 1978 and only five subsequent cases being reported before 2007. This study reports two unlinked cases of infant botulism, caused by two distinct strains of Clostridium botulinum (toxin types A and B, respectively), that occurred within a single month in the south-east of England in October 2007. The use of real-time PCR to detect C. botulinum neurotoxin genes in clinical specimens to improve the diagnostic procedure and to follow carriage of the causative organism in the infant gut is described. The laboratory investigation of these two cases demonstrated that a combination of the mouse bioassay, real-time PCR assays and conventional microbiological culture can provide rapid confirmation of a clinical diagnosis and affect patient management. Both infants (aged 4 and 8 months) were previously healthy prior to the onset of symptoms, and in both cases, a diagnosis of infant botulism was delayed for at least 10 days after initial admission to hospital. Once diagnosed, one of the infants was the first in the UK to be treated with human-derived botulism immunoglobulin. Real-time PCR was used to demonstrate that C. botulinum was excreted in the infants' faeces for up to 68 and 81 days, respectively. Despite the infrequency of infant botulism in the UK, clinicians should be aware of this rare but serious condition and should seek microbiological advice when presented with young infants with compatible symptomologies.

MICs and minimum fungicidal concentrations of amphotericin B, itraconazole, posaconazole and terbinafine in Sporothrix schenckii [CLINICAL MICROBIOLOGY AND VIROLOGY]

Mon, 09 Nov 2009 16:48:43 PST

The in vitro susceptibility of 62 isolates of Sporothrix schenckii in its mycelial form, from Latin-American countries (Peru, Venezuela, Brazil and Uruguay) and Spain, to amphotericin B (AB), itraconazole (IZ), posaconazole (PZ) and terbinafine (TB) was determined by measuring the MICs and minimum fungicidal concentrations (MFCs) using a standardized Clinical and Laboratory Standards Institute method. In general, TB was the most active drug, with the lowest geometric mean (GM) MIC and MFC values amongst isolates from the five countries tested. IZ and PZ showed almost the same activity against all strains tested, except for isolates from Uruguay where IZ gave the highest GM MIC (10.68 mg l^–1). AB showed the widest MIC range (0.03–16.0 mg l^–1); however, this drug was less active against 79 % of isolates (MICs above 1 mg l^–1). MFCs were 5 to 20 times higher than the MICs, but the lowest GM MFC and range values were found for TB. IZ and PZ gave the highest GM MFC. MFC may be a better predictor of therapeutic response than MIC, especially in immunosuppressed patients, making the use of IZ and PZ an inappropriate treatment. There were some differences in susceptibility according to the geographical source of the isolates, with the MIC being lower for TB in Venezuelan strains (P=0.066) and the MFC higher for PZ in Peruvian strains (P=0.02). Thus, geographical origin may be important for appropriate treatment, and may relate to the identification of species of the S. schenckii complex.

Molecular characterization of a rare G1P[19] rotavirus strain from India: evidence of reassortment between human and porcine rotavirus strains [CLINICAL MICROBIOLOGY AND VIROLOGY]

Chitambar, S. D., Arora, R., Chhabra, P. — Mon, 09 Nov 2009 16:48:43 PST

This study pertains to the characterization of a human rotavirus strain (NIV929893) with a rare specificity of G1P[19]. Three structural genes (VP4, VP6 and VP7) and one non-structural gene (NSP4) of strain NIV929893 were subjected to RT-PCR for amplification of entire coding regions. All of the amplicons were sequenced to carry out phylogenetic analysis. The complete amino acid sequences of the VP7 and VP4 gene products showed clustering of the VP7 gene with G1 strains of human origin and the VP4 gene with P[19] strains of porcine origin. The two viral proteins VP6 and NSP4, described previously as genetically linked proteins, were shown to be subgroup II and genotype B of human and porcine origins, respectively. The findings of this study provide evidence of reassortment between VP7/VP6 genes of humans and VP4/NSP4 genes of porcine species and an independent segregation of VP6 and NSP4 genes in a group A human rotavirus strain with G1P[19] specificity.

Comparative evaluation of real-time PCR and conventional RT-PCR during a 2 year surveillance for influenza and respiratory syncytial virus among children with acute respiratory infections in Kolkata, India, reveals a distinct seasonality of infection [CLINICAL MICROBIOLOGY AND VIROLOGY]

Mon, 09 Nov 2009 16:48:43 PST

Acute respiratory tract infections (ARTIs) are one of the most common causes of morbidity and mortality in young children worldwide. Influenza virus and respiratory syncytial virus (RSV) are the predominant aetiological agents during seasonal epidemics, and thus rapid and sensitive molecular tests for screening for such agents and timely identification of epidemics are required. This study compared real-time quantitative PCR (qPCR) with conventional RT-PCR for parallel identification of influenza A virus (IAV) or influenza B virus (IBV) and RSV. A total of 1091 respiratory samples was examined from children with suspected ARTIs between January 2007 and December 2008. Of these, 275 (25.21 %) were positive for either influenza or RSV by qPCR compared with 262 (24 .01%) positive by RT-PCR. Overall, IAV, IBV and RSV were detected in 121 (11.09 %), 59 (5.41 %) and 95 (8.71 %) samples, respectively. In spite of overlapping clinical symptoms, RSV and influenza virus showed distinct seasonal peaks. IAV correlated positively and RSV negatively with rainfall and temperature. No distinct seasonality was observed in IBV infections. This is, to the best of our knowledge, the first report of a systemic surveillance of respiratory viruses with seasonal correlation and prevalence rates from eastern India. This 2 year comparative analysis also confirmed the feasibility of using qPCR in developing countries, which will not only improve the scope for prevention of epidemics, but will also provide crucial epidemiological data from tropical regions.

Escherichia coli and its lipopolysaccharide modulate in vitro Candida biofilm formation [ORAL MICROBIOLOGY]

Mon, 09 Nov 2009 16:48:43 PST

Demystification of microbial behaviour in mixed biofilms could have a major impact on our understanding of infectious diseases. The objectives of this study were to evaluate in vitro the interactions of six different Candida species and a Gram-negative coliform, Escherichia coli, in dual-species biofilms, and to assess the effect of E. coli LPS on Candida biofilm formation. A single isolate of E. coli ATCC 25922 and six different species of Candida, Candida albicans ATCC 90028, Candida glabrata ATCC 90030, Candida krusei ATCC 6258, Candida tropicalis ATCC 13803, Candida parapsilosis ATCC 22019 and Candida dubliniensis MYA-646, were studied using a standard biofilm assay. Each Candida species was co-cultured with E. coli on a polystyrene surface and biofilm formation was quantified by a c.f.u. assay. The biofilm was then analysed by Live/Dead staining and fluorescence microscopy (confocal laser-scanning microscopy, CLSM), whilst scanning electron microscopy (SEM) was employed to visualize the biofilm architecture. The effect of E. coli LPS on Candida biofilm cell activity at defined time intervals was assessed with an XTT reduction assay. A significant quantitative reduction in c.f.u. counts of C. tropicalis (after 90 min), C. parapsilosis (after 90 min and 24 h), C. krusei (after 24 h) and C. dubliniensis (after 24 and 48 h) was noted on incubation with E. coli in comparison with their monospecies biofilm counterparts (P <0.05). On the other hand, a simultaneous and significant reduction in E. coli cell numbers occurred on co-culture with C. albicans (after 90 min), and an elevation of E. coli cell numbers followed co-culture with C. tropicalis (after 24 h) and C. dubliniensis (after 24 h and 48 h) (P <0.05). All quantitative findings were confirmed by SEM and CLSM analyses. By SEM observation, dual-species biofilms demonstrated scanty architecture with reduced visible cell counts at all stages of biofilm development, despite profuse growth and dense colonization in their single-species counterparts. Significantly elevated metabolic activity, as assessed by XTT readings, was observed in E. coli LPS-treated C. tropicalis and C. parapsilosis biofilms (after 48 h), whilst this had the opposite effect for C. dubliniensis (after 24 h) (P <0.05). These data indicate that E. coli and Candida species in a mixed-species environment mutually modulate biofilm development, both quantitatively and qualitatively, and that E. coli LPS appears to be a key component in mediating these outcomes.

An imprint method for detecting leptospires in the hamster model of vaccine-mediated immunity for leptospirosis [MODELS OF INFECTION]

Mon, 09 Nov 2009 16:48:43 PST

In determining the efficacy of new vaccine candidates for leptospirosis, the primary end point is death and an important secondary end point is sterilizing immunity. However, evaluation of this end point is often hampered by the time-consuming demands and complexity of methods such as culture isolation (CI). In this study, we evaluated the use of an imprint (or touch preparation) method (IM) in detecting the presence of leptospires in tissues of hamsters infected with Leptospira interrogans serovar Copenhageni. In a dissemination study, compared to CI, the IM led to equal or improved detection of leptospires in kidney, liver, lung and blood samples collected post-infection and overall concordance was good (=0.61). Furthermore, in an evaluation of hamsters immunized with a recombinant leptospiral protein-based vaccine candidate and subsequently challenged, the agreement between the CI and IM was very good (=0.84). These findings indicate that the IM is a rapid method for the direct observation of Leptospira spp. that can be readily applied to evaluating infection in experimental animals and determining sterilizing immunity when screening potential vaccine candidates.

Structural analysis of a p44/msp2 expression site of Anaplasma phagocytophilum in naturally infected ticks in Japan [HUMAN AND ANIMAL MICROBIAL ECOLOGY]

Mon, 09 Nov 2009 16:48:43 PST

Anaplasma phagocytophilum, an agent of human granulocytic anaplasmosis, infects neutrophils and causes an emerging tickborne febrile disease. The genome of this bacterium contains a large number of p44/msp2-related genes encoding 44 kDa major outer-membrane proteins, and it is known that a specific p44/msp2 gene is predominantly transcribed from a single expression locus. This study successfully characterized the genomic expression site for p44/msp2 (3.8 kb) in uncultured A. phagocytophilum from Ixodes persulcatus ticks inhabiting a northern part of Japan. Comparative analysis of the sequences revealed that the structures of the expression sites in Japanese A. phagocytophilum were similar to those of US strains from human patients and European strains from a dog and sheep, but omp-1N (upstream from p44/msp2) and a truncated recA (downstream from p44/msp2) in the p44/msp2 expression site seemed to share similarities with those of US and European strains. The central hypervariable region sequences of Japanese p44/msp2 were found to be quite diverse (24.4–100 % amino acid similarities) and distinct from their closest relatives from US human patients or animal host origins (56.3–97.6 % amino acid similarities) with some exceptions. Thus, this study provides significant information about the molecular characteristics of A. phagocytophilum in East Asia, as well as the global diversity of p44/msp2.

Lemierre's syndrome and septicaemia caused solely by Arcanobacterium haemolyticum in a young immunocompetent patient [CASE REPORTS]

Mon, 09 Nov 2009 16:48:43 PST

We present a case of septicaemia caused by Arcanobacterium haemolyticum in a previously healthy 23-year-old man suffering from acute pharyngotonsillitis, who developed complicated Lemierre's syndrome. Three blood cultures (both aerobic and anaerobic) revealed the exclusive presence of A. haemolyticum. The presence of Fusobacterium necroforum was not essential for the development of this pathology. To our knowledge, this is the first reported case of Lemierre's syndrome caused solely by A. haemolyticum. We confirm that this organism must be considered a potential pathogen in immunocompetent patients.

Prurigo nodularis due to Mycobacterium tuberculosis [CASE REPORTS]

Saporito, L., Florena, A. M., Colomba, C., Pampinella, D., Di Carlo, P. — Mon, 09 Nov 2009 16:48:43 PST

Prurigo nodularis (PN) is a rare chronic skin disorder of unknown origin. Here we describe what is believed to be the first case of PN associated with tuberculosis. For the first time, culture and PCR analysis of skin biopsy confirmed the presence of Mycobacterium tuberculosis complex in PN skin lesions. The pruritus and skin lesions resolved following antitubercular therapy. Our case provides further evidence in favour of a link between PN and mycobacterial infection.

Gemella morbillorum: an underestimated aetiology of central nervous system infection? [CASE REPORTS]

Benedetti, P., Rassu, M., Branscombe, M., Sefton, A., Pellizzer, G. — Mon, 09 Nov 2009 16:48:43 PST

A case is reported of cerebellar abscess and diffuse cerebritis due to Gemella morbillorum. The clinical course was ‘biphasic’, developing with an acute meningeal infection followed shortly afterwards by suppuration in the cerebellar and cerebral parenchyma; this pattern seemed to suggest a latent survival of the aetiological agent, probably within the central nervous system (CNS), despite systemic antibiotic therapy. Based upon a review of cases so far described, infections of the CNS caused by G. morbillorum appear to be an emerging reality.

Detection and characterization of Clostridium difficile from patients with antibiotic-associated diarrhoea in a tertiary care hospital in North India [CORRESPONDENCE]

Joshy, L., Chaudhry, R., Dhawan, B. — Mon, 09 Nov 2009 16:48:44 PST

Role of bronchoalveolar lavage in evaluating new pulmonary infiltrates on computed tomography in haematology patients with fever unresponsive to broad-spectrum antibiotics [CORRESPONDENCE]

Todd, T., Enoch, D. A. — Mon, 09 Nov 2009 16:48:44 PST

Comparison between the Abbott RealTime High Risk HPV assay and the Hybrid Capture 2 assay for detecting high-risk human papillomavirus DNA in cervical specimens [CORRESPONDENCE]

Kaliterna, V., Zidovec Lepej, S., Vince, A. — Mon, 09 Nov 2009 16:48:44 PST

Opportunistic intestinal parasites and TCD4+ cell counts in human immunodeficiency virus seropositive patients [CORRESPONDENCE]

Ramana, K. V., Mohanty, S. K. — Mon, 09 Nov 2009 16:48:44 PST

Activity of the phenothiazine methdilazine alone or in combination with isoniazid or streptomycin against Mycobacterium tuberculosis in mice [CORRESPONDENCE]

Dutta, N. K., Mazumdar, K., DasGupta, A., Dastidar, S. G. — Mon, 09 Nov 2009 16:48:44 PST