Wendy L. Schell

Aeromonas Intestinal Infections in the United States

To evaluate the clinical and epidemiologic aspects of aeromonas enteritis, we studied the cases of 34 persons nationwide from whom Aeromonas hydrophila had been isolated in large numbers from stool in 1984. Compared with 68 control subjects, these patients were more likely to have drunk untreated water, usually from private wells (odds ratio = 20.9; p less than 0.01). Eighteen of the isolates belonged to a single DNA-relatedness group of the eight described for Aeromonas species, but no clear correlation between illnesses in patients and any tested genotypic or phenotypic characteristic of recovered organisms was found. Gastrointestinal complaints tended to be chronic in infected adults and acute and severe in children. Nine patients had become ill after taking antimicrobial agents to which recovered Aeromonas species were resistant; 5 persons took antimicrobials to which their Aeromonas strains were susceptible and had alleviation or resolution of their gastrointestinal symptoms. These findings indicate that at least some Aeromonas strains are enteropathogenic for the normal host and that these organisms are acquired by drinking untreated water.

Molecular Epidemiology of Antibiotic Resistance in Salmonella from Animals and Human Beings in the United States

We collected serotyped isolates of salmonella from reference laboratories in the United States, tested their susceptibility to antibiotics, and extracted plasmids from isolates that were resistant to a different combination of antibiotics from each of three serotypes. Restriction-endonuclease digestion showed that within each of the three groups, plasmid molecules from animal and human isolates were often identical or nearly identical. One serotype-plasmid combination appeared to be endemic in cattle in 20 states and infected 26 persons in two states. The human cases, which were not recognizably related except for their common plasmids, appeared to be clustered in time but geographically dispersed, like cases in previous outbreaks spread by food products. These findings suggest that resistance plasmids may be extensively shared between animal and human bacteria, and that spread of multiresistant strains of salmonella among animals and human beings, as observed in Britain, may have been undetected in the United States for lack of comparable surveillance.

Tri-State Toxic Shock Syndrome Study: Evaluation of Case Definition and Prevention of Recurrence

Abstract The clinical and laboratory findings in 80 nonfatal cases of toxic shock syndrome were examined as part of the Tri-State Toxic-Shock Syndrome Study conducted by the state health department...

Serodiagnosis of rotavirus during an epidemic of gastroenteritis on an adult orthopedic unit

Abstract Epidemiologic features of adult rotavirus infection are incompletely understood. Between 18 May and 8 June 1982, acute gastroenteritis occurred in 14 of 100 (14%) patients and eight of 57 (14%) staff at a hospital orthopedic unit. Ill persons ranged in age from 24 to 87 years (median 69 years). Anti-rotavirus IgM antibody in an acutephase serum or IgG seroconversion in paired serum specimens was present in nine of 16 persons with gastroenteritis, compared to two of 15 unit staff without gastroenteritis, suggesting that a rotavirus infection was associated with the outbreak. The index case occurred in an 84-year-old woman admitted to the unit on 18 May and attended without enteric precautions until 20 May. To assess risk factors for the development of gastroenteritis on the unit, we conducted a case-control study in eight patients with gastroenteritis and 16 matched controls; we also reviewed the roster of staff assignments to patients during the outbreak period. Illness in patients was associated with the extent of handling by staff (P