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Identifying extrapulmonary legionellosis is difficult due to the lack of clinical suspicion and limitations of conventional microbiologic methods. We present a case series of hematopoietic cell transplant recipients with extrapulmonary legionellosis diagnosed via molecular diagnostics: 16S ribosomal ribonucleic acid gene Sanger sequencing and matrix-assisted laser desorption/ ionization time-of-flight mass spectrometry. [ABSTRACT FROM AUTHOR]

There is a clear need for an instrument-free molecular diagnostic system for detecting human immunodeficiency virus type 1 (HIV-1) RNA or DNA that can be used in developing countries. Such a test could be used for early diagnosis of HIV-1 infection during infancy and could serve as a surrogate end point for vaccine trials. We developed the IsoAmp HIV-1 assay (BioHelix Corporation), which targets the HIV-1 gag gene with use of isothermal reverse-transcription helicase-dependent amplification chemistry. The IsoAmp HIV assay uses a disposable amplicon containment device with an embedded vertical-flow DNA detection strip to detect the presence of HIV-1 amplicons. The vertical-flow DNA detection strip has a control line to validate the performance of the device and a test line to detect the analyte. The analyte is detected by a sandwich immunoassay for reporter moieties on a capture probe and a detection probe. The control line consists of the detection probe reporter moiety conjugated to the vertical-flow DNA detection strip. The preliminary limit of detection of the IsoAmp HIV assay was evaluated by testing serial dilutions of HIV-1 armored RNA (Assuragen). We found that 21(75%) of 28 assays yielded positive results when 50 copies of HIV-1 armored RNA were input into the IsoAmp HIV reaction. [ABSTRACT FROM AUTHOR]

After changes to assay and specimen-processing methods, plasma human immunodeficiency virus type 1 (HIV-1) RNA was frequently detectable in patients who previously had well-suppressed HIV-1 RNA levels. This artifact is attributable to shipping frozen plasma in primary plasma preparation tubes and is not caused by the HIV-1 RNA detection assay; it can be avoided by shipping plasma in a secondary tube. [ABSTRACT FROM AUTHOR]

We analyzed the relationship between host gene polymorphisms and responses in recipients of inactivated influenza vaccine, who were classified into poor, normal, or adverse response groups. The frequency of the mannose-binding lectin —2 codon 54 allele was significantly different among the 3 types of responders, with a decreased odds ratio for the development of poor or adverse responses (P = .033). There was no statistical relationship between responses and either tumor necrosis factor-or or interleukin (IL)-10 promoter polymorphisms among the 3 response groups. When poor and normal responses were combined, the —1082 A allele in the IL-b promoter conferred a significantly decreased risk of the development of adverse responses (P = .041). These data indicate that host polymorphisms play a role in determining responses to influenza vaccine. [ABSTRACT FROM AUTHOR]

Cytomegalovirus encephalitis occurs rarely in transplant recipients. We describe a patient with cytomegalovirus ventriculoencephalitis who had a very high CSF viral load but a low peripheral blood viral load. No resistance mutations were present in cerebro spinal fluid viral DNA, whereas DNA from blood showed a resistance mutation in the UL54 gene but not in the UL97 gene. Viral replication was intense in the brain ependyma and periventricular areas without evidence of peripheral cytomegalovirus disease. The data provide evidence for compartmentalization of cytomegalovirus infection. Levels of ganciclovir and foscarnet in the cerebro spinal fluid may be inadequate for treatment, even for some drug- susceptible strains, and, together with periventricular replication, may explain the disparity between cerebrospinal fluid viral load and peripheral blood viral load. [ABSTRACT FROM AUTHOR]

The diagnostic accuracy of the rectal swab (RS) culture method in identifying gastrointestinal colonization with vancomycin-resistant enterococci (VRE) is not known. Serial quantitative stool cultures, skin cultures, and RS cultures were performed for patients with VRE infections to assess the false-negative rate of the RS and the prevalence of skin colonization, a prerequisite for cross-transmission, at varying VRE stool densities. A total of 35 stool samples were obtained from 13 patients. The sensitivity of the RS culture was 58%; it ranged from 100%, at VRE densities of 7.5 log10 colony forming units (cfu) per gram of stool, to 0%, at densities of 4.5 log10 cfu per gram of stool. Skin colonization was detected at these low VRE stool densities, but it was more common at higher VRE densities ( ). Antibiotic exposure was significantly associated P !.001 with higher VRE stool densities ( ). The high false-negative rate of the RS may be contributing to the P !.001 continued increase in the prevalence of VRE. [ABSTRACT FROM AUTHOR]

Summarizes the characteristics of patients coinfected with HIV and Ehrlichia chaffeensis or Ehrlichia ewingii. Epidemiology of the infections; Demographics of the patients; Clinical and laboratory characteristics of the patients; Severity of the infections.

Presents a study which reported an immunocompromised patient with hyper-immunoglobulin M syndrome who suffered from episodes of Achromobacter xylosoxidans bacteremia. Information on Achromobacter xylosoxidans; Susceptibilities of Achromobacter xylosoxidans isolated from a lymph node and from blood; Sources of Achromobacter xylosoxidans.

Presents a study which investigated the effective use of polymerase chain reaction for the diagnosis of central nervous system (CNS) infections. Background on CNS infections; Data and methods used; Results and discussion.

Discusses the properties of the IgA monoclonal antibody for protecting laboratory mice from respiratory syncytial virus (RSV). Measurement of how the antibody can reduce severity of lower respiratory tract infection; Comparison of glycoprotein compared with an Ig antibody.

Examines a sample of predominantly female patients with recurrent aseptic meningitis Mollaret's meningitis or (MM) that is associated with herpes simplex virus (HSV)-caused infection. Diagnosis of HSV type 2 in all the patients; Evidence of an association between women with HSV 2 and HSV-related Mollaret's meningitis; Likelihood that multiple factors play a role in the pathogenesis of MM.