Rose Cheung

Epstein-Barr virus infection in transplant recipients: Summary of a workshop on surveillance, prevention and treatment.

Diseases caused by the Epstein-Barr virus are of great significance among organ transplant recipients. One of these diseases, post-transplant lymphoproliferative disease, is a major complication among organ transplant recipients. Management of this entity is problematic due to the difficulties with laboratory surveillance, diagnosis, prevention and treatment. A group of Canadian and American experts was assembled to discuss these aspects of Epstein-Barr virus diseases in Canadian organ transplant recipients. This report summarizes the relevant background literature and levels of evidence in relation to the outcomes of the deliberations and recommendations by the expert panel.

A family outbreak of hemolytic-uremic syndrome associated with verotoxin-producingEscherichia coli serotype 0157:H7

All five siblings (three boys and two girls, aged 1.5–9 years) in a family developed hemolytic-uremic syndrome associated with verotoxin-producingEscherichia coli 0157:H7 at a lakeside vacation cottage during the fall of 1985. All five were hospitalized and made a full recovery. Both parents remained asymptomatic, and neither had evidence of this infection. In four children who were investigated prospectively, free verotoxin was still detectable in the stools for between 3 and 7 weeks. The prodromal diarrheal illness in the children occurred over a 10-day period. The epidemic curve was consistent with a point-source outbreak, but continuous exposure or person-toperson transmission could not be ruled out. The source of the infection was not identified.

Successful Treatment of Candidaendophthalmitis With a Synergistic Combination of Amphotericin a and Rifampin

: Candida endophthalmitis, caused by transient candidemia, developed in a 14-year-old white girl receiving intravenous hyperalimentation. Antifungal synergism was established in vitro for the combination of amphotericin B and rifampin against the C. albicans isolate. A combined ten-day course of intravenous amphotericin B and oral rifampin was followed by the elimination of the infection and the preservation of good visual acuity.

Antimicrobial Susceptibility of Bordetella pertussis Strains Isolated from 1960 to 1981

The susceptibilities to erythromycin, rifampin, polymyxin B, ampicillin, tetracycline, gentamicin, fusidic acid, trimethoprim, and spectinomycin of 100 strains of Bordetella pertussis isolated between 1960 and 1981 were compared. No change in susceptibility to any of these drugs was noted.

Microassay for Amphotericin B

Depending on the hematocrit, duplicate or triplicate determinations of serum amphotericin B concentration may be made on as little as 100 μl of capillary blood obtained by finger prick. In an accurate plate diffusion bioassay, using Paecilomyces varioti as the indicator organism, levels of the drug in the therapeutic range can be determined fast enough for clinicians to modify their next dose.

Susceptibility of Candida albicans to Miconazole

A total of 439 clinical isolates of Candida albicans were tested for susceptibility to miconazole by the agar dilution technique. When tests were read at 48 and 24 h, 56 and 84%, respectively, of the strains were completely inhibited by 4.0 μg of miconazole per ml, the estimated upper limit of probable clinical susceptibility.

Comparative Susceptibility of Candida albicans to Amphotericin B and Amphotericin B Methyl Ester

The in vitro antifungal activities of amphotericin B (AMB) and amphotericin B methyl ester (AME) were compared against 465 clinical isolates of Candida albicans. AMB and AME possessed comparable activity against half of the strains, but against the remainder of the strains the activity of AME was slightly lower than that of AMB. Rarely did AME show superior antifungal activity to AMB.

The Complete Sequence of a Human Parainfluenzavirus 4 Genome

Although the human parainfluenza virus 4 (HPIV4) has been known for a long time, its genome, alone among the human paramyxoviruses, has not been completely sequenced to date. In this study we obtained the first complete genomic sequence of HPIV4 from a clinical isolate named SKPIV4 obtained at the Hospital for Sick Children in Toronto (Ontario, Canada). The coding regions for the N, P/V, M, F and HN proteins show very high identities (95% to 97%) with previously available partial sequences for HPIV4B. The sequence for the L protein and the non-coding regions represent new information. A surprising feature of the genome is its length, more than 17 kb, making it the longest genome within the genus Rubulavirus, although the length is well within the known range of 15 kb to 19 kb for the subfamily Paramyxovirinae. The availability of a complete genomic sequence will facilitate investigations on a respiratory virus that is still not completely characterized.

COMPARISON OF HUMAN METAPNEUMOVIRUS INFECTION WITH RESPIRATORY SYNCYTIAL VIRUS INFECTION IN CHILDREN

We aimed to validate a direct immunofluorescence assay (DFA) for the detection of human metapneumovirus (hMPV) from nasal swabs and to determine the incidence and clinical features of this viral infection in a pediatric population. One hundred twenty-one of 3026 nasal swabs were positive for hMPV by DFA (4.0%). Compared with reverse transcriptase polymerase chain reaction, the sensitivity and specificity of DFA were 90%, and 100%, respectively. Compared with RSV, hMPV infection was more common in children with congenital abnormalities, particularly those with cardio-pulmonary dysplasia and was associated with an increased ventilatory requirement.

Susceptibility of Haemophilus influenzae Type b to Rifampin and Sulfisoxazole

A total of 100 and 97% of Haemophilus influenzae type b strains from major infections were susceptible, respectively, to levels of rifampin and sulfisoxazole attainable in saliva. It is theoretically feasible to eliminate Haemophilus influenzae from the nasopharynx with these drugs.