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use of several inducer and substrate antibiotic combinations in a disk approximation assay format to screen for ampc induction in patient isolates of pseudomonas aeruginosa, enterobacter spp., citrobacter spp., and serratia spp.two-hundred consecutive, single patient isolates of enterobacter spp., serratia spp., citrobacter spp., and pseudomonas aeruginosa were evaluated for ampc production using a variety of inducer-substrate antibiotic combinations in a disk approximation format. the combinations examined included cefoxitin-piperacillin, imipenem-cefotaxime, imipenem-ceftazidime, imipenem-piperacillin-tazobactam, and imipenem-cefoxitin. all isolates were also screened for the presence of extended-spectrum beta-lactam ...200516333080
pcr classification of ctx-m-type beta-lactamase genes identified in clinically isolated gram-negative bacilli in japan.of 1,456 strains isolated from 2001 to 2003 demonstrating resistance to either oxyimino-cephalosporin, 317 strains, isolated in 57 of 132 clinical facilities, were found to harbor bla(ctx-m) genes by pcr. fifty-seven, 161, and 99 strains harbored bla(ctx-m) genes belonging to the bla(ctx-m-1), bla(ctx-m-2), and bla(ctx-m-9) clusters, respectively.200616436748
characterization of the chromosomal class a beta-lactamase cko from citrobacter koseri.the gene bla(cko) encoding the chromosomal class a beta-lactamase of citrobacter koseri was cloned and sequenced. cko was found to display only 41% identity with sed-1 from citrobacter sedlakii and 36% with cdia from citrobacter amalonaticus (formerly citrobacter diversus). no transcriptional regulator was found upstream from bla(cko). silent and missense mutations were detected in four bla(cko) genes amplified from different c. koseri clinical isolates, but the cko variants displayed identical ...200616445758
use of electrochemical dna biosensors for rapid molecular identification of uropathogens in clinical urine specimens.we describe the first species-specific detection of bacterial pathogens in human clinical fluid samples using a microfabricated electrochemical sensor array. each of the 16 sensors in the array consisted of three single-layer gold electrodes-working, reference, and auxiliary. each of the working electrodes contained one representative from a library of capture probes, each specific for a clinically relevant bacterial urinary pathogen. the library included probes for escherichia coli, proteus mir ...200616455913
ameba-associated microorganisms and diagnosis of nosocomial pneumonia.to elucidate the role of ameba-associated microorganisms (aams) as etiologic agents of pneumonia, we screened for legionella spp., parachlamydia acanthamoeba, afipia sp., bosea spp., bradyrhizobium spp., mesorhizobium amorphae, rasbo bacterium, azorhizobium caulinodans, acanthamoeba polyphaga mimivirus, and conventional microorganisms in 210 pneumonia patients in intensive-care units by using culture, polymerase chain reaction, and serologic testing. these resulted in 59 diagnoses in 40 patients ...200616494750
a nosocomial outbreak due to novel ctx-m-2-producing strains of citrobacter koseri in a hematological ward. 200616495644
evaluation of the phoenix 100 id/ast system and nid panel for identification of enterobacteriaceae, vibrionaceae, and commonly isolated nonenteric gram-negative bacilli.the phoenix 100 id/ast system (becton dickinson co., sparks, md.) is an automated system for the identification and antimicrobial susceptibility testing of bacterial isolates. this system with its negative identification (nid) panel was evaluated for its accuracy in the identification of 507 isolates of the family enterobacteriaceae, 57 other nonenteric gram-negative isolates that are commonly isolated in clinical microbiology laboratories, and 138 isolates of the family vibrionaceae. all of the ...200616517878
[nationwide surveillance of parenteral antibiotics containing meropenem activities against clinically isolated strains in 2004].the antibacterial activity of meropenem (mepm) and other parenteral antibiotics against clinical isolates of 907 strains of gram-positive bacteria, 1790 strains of gram-negative bacteria, and 192 strains of anaerobic bacteria obtained from 30 medical institutions during 2004 was measured. the results were as follows; 1. mic90 of mepm for almost all of enterobacteriaceae and haemophilus influenzae were 4-fold to 32-fold lower than those of other carbapenems. mepm was more active than other carbap ...200516521347
glutathione-s-transferase activity and metabolism of glutathione conjugates by rhizosphere bacteria.glutathione-s-transferase (gst) activity was determined in 36 species of rhizosphere bacteria with the substrate 1-chloro-2,4-dinitrobenzene (cdnb) and in 18 strains with the herbicide alachlor. highest levels of cdnb-gst activity (60 to 222 nmol (middot) h(sup-1) (middot) mg(sup-1)) were found in gram-negative bacteria: enterobacter cloacae, citrobacter diversus, klebsiella planticola, pseudomonas cepacia, pseudomonas fluorescens, pseudomonas putida, and xanthomonas campestris. there was very l ...199516534956
qnrb, another plasmid-mediated gene for quinolone resistance.a novel plasmid-mediated quinolone resistance gene, qnrb, has been discovered in a plasmid encoding the ctx-m-15 beta-lactamase from a klebsiella pneumoniae strain isolated in south india. it has less than 40% amino acid identity with the original qnr (now qnra) gene or with the recently described qnrs but, like them, codes for a protein belonging to the pentapeptide repeat family. strains with qnrb demonstrated low-level resistance to all quinolones tested. the gene has been cloned in an expres ...200616569827
quantitative real-time legionella pcr for environmental water samples: data interpretation.quantitative legionella pcrs targeting the 16s rrna gene (specific for the genus legionella) and the mip gene (specific for the species legionella pneumophila) were applied to a total of 223 hot water system samples (131 in one laboratory and 92 in another laboratory) and 37 cooling tower samples (all in the same laboratory). the pcr results were compared with those of conventional culture. 16s rrna gene pcr results were nonquantifiable for 2.8% of cooling tower samples and up to 39.1% of hot wa ...200616597985
emergence of an invasive clone of nontoxigenic corynebacterium diphtheriae in the urban poor population of vancouver, canada.invasive disease due to corynebacterium diphtheriae is rare in north america. here we describe the emergence of a predominant clone of a nontoxigenic strain of c. diphtheriae in the impoverished population of vancouver's downtown core. this clone has caused significant morbidity and contributed to at least two deaths. over a 5-year period, seven cases of bacteremia due to c. diphtheriae were detected in patients admitted to vancouver hospitals. injection drug use, diabetes mellitus, skin coloniz ...200616672385
trends in production of extended-spectrum beta-lactamases among enterobacteria of medical interest: report of the second italian nationwide survey.results of a 2003 survey carried out in italy to evaluate the prevalence of extended-spectrum beta-lactamase (esbl)-producing enterobacteria are presented. eleven italian microbiology laboratories investigated 9,076 consecutive nonreplicate isolates (inpatients, 6,850; outpatients, 2,226). esbl screening was performed by mic data analysis. confirmation was obtained using the double-disk synergy test and the combination disk test based on clsi methodology. esbl determinants were investigated by c ...200616672390
panophthalmitis secondary to infection with citrobacter koseri. 200616691260
adhesive properties of enterobacter sakazakii to human epithelial and brain microvascular endothelial cells.enterobacter sakazakii is an opportunistic pathogen that has been associated with sporadic cases and outbreaks causing meningitis, necrotizing enterocolitis and sepsis especially in neonates. however, up to now little is known about the mechanisms of pathogenicity in e. sakazakii. a necessary state in the successful colonization, establishment and ultimately production of disease by microbial pathogens is the ability to adhere to host surfaces such as mucous membranes, gastric and intestinal epi ...200616800879
citrobacter infections in a tertiary care hospital in northern india.this prospective study was carried out to look for the frequency of isolation of citrobacter species from clinical specimens and study their antimicrobial susceptibility pattern.200716815552
ai-3 synthesis is not dependent on luxs in escherichia coli.the quorum-sensing (qs) signal autoinducer-2 (ai-2) has been proposed to promote interspecies signaling in a broad range of bacterial species. ai-2 is spontaneously derived from 4,5-dihydroxy-2,3-pentanedione that, along with homocysteine, is produced by cleavage of s-adenosylhomocysteine (sah) and s-ribosylhomocysteine by the pfs and luxs enzymes. numerous phenotypes have been attributed to ai-2 qs signaling using luxs mutants. we have previously reported that the luxs mutation also affects the ...200616885435
fishmeal extract bile salt lactose agar--a differential medium for enteric bacteria.fishmeal extract bile salt lactose agar (febla), a new differential medium for enteric bacteria was developed and evaluated for its ability to grow and differentiate lactose fermenters (lf) from non-lactose fermenters (nlf) in comparison with macconkeys agar. performance of febla was at par with the latter. on febla medium, the contrast between lf and nlf colonies was pronounced and klebsiella pneumoniae produced more mucoid colonies than on macconkeys agar (hi media). unlike macconkeys agar, a ...200616924840
mobilizable incq-related plasmid carrying a new quinolone resistance gene, qnrs2, isolated from the bacterial community of a wastewater treatment plant.plasmid-encoded quinolone resistance was previously reported for different bacteria isolated from patients not only in the united states and asia but also in europe. here we describe the isolation, by applying a new selection strategy, of the quinolone resistance plasmid pgnb2 from an activated sludge bacterial community of a wastewater treatment plant in germany. the hypersensitive escherichia coli strain kam3 carrying a mutation in the multidrug efflux system genes acrab was transformed with t ...200616940104
isolation of a lactobacillus salivarius strain and purification of its bacteriocin, which is inhibitory to campylobacter jejuni in the chicken gastrointestinal system.we evaluated anti-campylobacter jejuni activity among >1,200 isolates of different lactic acid bacteria. lactobacillus salivarius strain nrrl b-30514 was selected for further study. the cell-free, ammonium sulfate precipitate from the broth culture was termed the crude antimicrobial preparation. ten microliters of the crude preparation created a zone of c. jejuni growth inhibition, and growth within the zone resumed when the crude preparation was preincubated with proteolytic enzymes. bacterioci ...200616940109
genetic environment of quinolone resistance gene qnrb2 in a complex sul1-type integron in the newly described salmonella enterica serovar keurmassar.a qnrb2 determinant was described for a new complex sul1-type integron from salmonella enterica serovar keurmassar. the genetic structure contained two class 1 integrons surrounding two common regions (crs) separated by a partial 3' conserved segment. the qnrb2 gene is adjacent to the first cr.200616940131
phenotypic detection of carbapenem-susceptible metallo-beta-lactamase-producing gram-negative bacilli in the clinical laboratory.rapid detection of metallo-beta-lactamase (mbl)-producing gram-negative pathogens is critical to prevent their widespread dissemination. thus far, no standardized phenotypic method is available, and previously reported techniques have poor sensitivity for detecting carbapenem-susceptible mbl-carrying isolates, an increasingly described phenomenon. we developed a phenotypic detection method using both a double-disk synergy test and a combined-disk test with imipenem and 292 microg edta on one aga ...200616954239
prevalence of newer beta-lactamases in gram-negative clinical isolates collected in the united states from 2001 to 2002.newer beta-lactamases such as extended-spectrum beta-lactamases (esbls), transferable ampc beta-lactamases, and carbapenemases are associated with laboratory testing problems of false susceptibility that can lead to inappropriate therapy for infected patients. because there appears to be a lack of awareness of these enzymes, a study was conducted during 2001 to 2002 in which 6,421 consecutive, nonduplicate clinical isolates of aerobically growing gram-negative bacilli from patients at 42 intensi ...200616954267
detection of enterobacter sakazakii in dried infant milk formula by cationic-magnetic-bead capture.enterobacter sakazakii has been associated with life-threatening infections in premature low-birth-weight infants. contaminated infant milk formula (imf) has been implicated in cases of e. sakazakii meningitis. quick and sensitive methods to detect low-level contamination sporadically present in imf preparations would positively contribute towards risk reduction across the infant formula food chain. here we report on the development of a simple method, combining charged separation and growth on ...200616957259
ft-ir microspectroscopy for early identification of some clinically relevant pathogens.to investigate the potentials and limitations of fourier transform-infrared (ft-ir) microspectroscopy as a tool to identify, at the level of microcolonies, pathogenic bacteria frequently isolated in the clinical environment.200616968290
diffuse pneumocephalus in neonatal citrobacter meningitis.pneumocephalus, intracranial air or gas collection, associated with neonatal meningitis is extremely rare. we report the first case in the united states and the second case in the world of intracranial gas accumulation in a neonate with citrobacter koseri meningitis. the clinical presentation was acute with pneumocephalus demonstrated by cranial sonography and computed tomography. the clinical course was fatal despite the prompt administration of antibiotics.200617000783
two-center collaborative evaluation of performance of the bd phoenix automated microbiology system for identification and antimicrobial susceptibility testing of gram-negative bacteria.the performance of the bd phoenix automated microbiology system (bd diagnostic systems, sparks, md) was assessed for identification (id) and antimicrobial susceptibility testing (ast) of the majority of clinically encountered bacterial isolates in a european collaborative two-center trial. a total of 494 bacterial isolates including various species of the enterobacteriaceae and 110 nonfermentative gram-negative bacteria were investigated: of these, 385 were single patient isolates, and 109 were ...200617005752
increased serum iga and igm against lps of enterobacteria in chronic fatigue syndrome (cfs): indication for the involvement of gram-negative enterobacteria in the etiology of cfs and for the presence of an increased gut-intestinal permeability.there is now evidence that chronic fatigue syndrome (cfs) is accompanied by immune disorders and by increased oxidative stress. the present study has been designed in order to examine the serum concentrations of iga and igm to lps of gram-negative enterobacteria, i.e. hafnia alvei; pseudomonas aeruginosa, morganella morganii, proteus mirabilis, pseudomonas putida, citrobacter koseri, and klebsiella pneumoniae in cfs patients, patients with partial cfs and normal controls. we found that the preva ...200717007934
sensitive quantitative detection of commensal bacteria by rrna-targeted reverse transcription-pcr.a sensitive rrna-targeted reverse transcription-quantitative pcr (rt-qpcr) method was developed for exact and sensitive enumeration of subdominant bacterial populations. using group- or species-specific primers for 16s or 23s rrna, analytical curves were constructed for escherichia coli, enterococcus faecalis, staphylococcus aureus, clostridium perfringens, and pseudomonas aeruginosa, and the threshold cycle value was found to be linear up to an rna amount of 10(-3) cell per rt-pcr. the number o ...200717071791
sensitive quantitative detection of commensal bacteria by rrna-targeted reverse transcription-pcr.a sensitive rrna-targeted reverse transcription-quantitative pcr (rt-qpcr) method was developed for exact and sensitive enumeration of subdominant bacterial populations. using group- or species-specific primers for 16s or 23s rrna, analytical curves were constructed for escherichia coli, enterococcus faecalis, staphylococcus aureus, clostridium perfringens, and pseudomonas aeruginosa, and the threshold cycle value was found to be linear up to an rna amount of 10(-3) cell per rt-pcr. the number o ...200717071791
comparison of media for the isolation of enterobacter sakazakii.enterobacter sakazakii is associated with neonatal infections and is occasionally present at low levels (<1 cfu/g) in powdered infant formula milk (ifm). it has been previously reported that some e. sakazakii strains do not grow in standard media for enterobacteriaceae and coliform bacteria; therefore, a reliable method is needed for recovery of the organism. three e. sakazakii enrichment broths-enterobacteriaceae enrichment broth (ee), e. sakazakii selective broth (essb), and modified lauryl su ...200717071794
comparison of media for the isolation of enterobacter sakazakii.enterobacter sakazakii is associated with neonatal infections and is occasionally present at low levels (<1 cfu/g) in powdered infant formula milk (ifm). it has been previously reported that some e. sakazakii strains do not grow in standard media for enterobacteriaceae and coliform bacteria; therefore, a reliable method is needed for recovery of the organism. three e. sakazakii enrichment broths-enterobacteriaceae enrichment broth (ee), e. sakazakii selective broth (essb), and modified lauryl su ...200717071794
segmental tracheal dysplasia in a mixed breed dog.a 6-month-old, spayed female, mixed breed dog was referred for respiratory difficulty. radiographic and bronchoscopic evaluations showed tracheal narrowing from the thoracic inlet to its bifurcation. under anesthesia, the trachea ruptured and the dog died. microscopic evaluation revealed underlying segmental tracheal and bronchial cartilaginous malformation (dysplasia).200617078250
[clinical results of resection arthroplasty for infected shoulder arthroplasty].infection is a rare complication of shoulder arthroplasty. various therapeutic solutions have been proposed: antibiotics alone, one-stage or two-stage reimplantation, surgical or arthroscopic cleaning without prosthesis removal, scapulohumeral arthrodesis or simple arthroscopic resection. we evaluated the mid-term clinical outcome after resection arthroplasty for the treatment of infected shoulder arthroplasty.200617088753
antimicrobial-resistant enteric bacteria from dairy cattle.a study was conducted to understand the descriptive and molecular epidemiology of antimicrobial-resistant gram-negative enteric bacteria in the feces of healthy lactating dairy cattle. gram-negative enteric bacteria resistant to ampicillin, florfenicol, spectinomycin, and tetracycline were isolated from the feces of 35, 8, 5, and 42% of 213 lactating cattle on 74, 39, 9, 26, and 82% of 23 farms surveyed, respectively. antimicrobial-resistant gram-negative bacteria accounted for 5 (florfenicol) t ...200717098918
antimicrobial-resistant enteric bacteria from dairy cattle.a study was conducted to understand the descriptive and molecular epidemiology of antimicrobial-resistant gram-negative enteric bacteria in the feces of healthy lactating dairy cattle. gram-negative enteric bacteria resistant to ampicillin, florfenicol, spectinomycin, and tetracycline were isolated from the feces of 35, 8, 5, and 42% of 213 lactating cattle on 74, 39, 9, 26, and 82% of 23 farms surveyed, respectively. antimicrobial-resistant gram-negative bacteria accounted for 5 (florfenicol) t ...200717098918
flip influences citrobacter koseri macrophage uptake, cytokine expression and brain abscess formation in the neonatal rat.citrobacter koseri causes neonatal meningitis frequently complicated with multiple brain abscesses. during c. koseri central nervous system infection in the neonatal rat model, previous studies have documented many bacteria-filled macrophages within the neonatal rat brain and abscesses. previous studies have also shown that c. koseri is taken up by, survives phagolysosomal fusion and replicates in macrophages in vitro and in vivo. in this study, in order to elucidate genetic and cellular factors ...200617108264
novel ambler class a beta-lactamase lap-1 and its association with the plasmid-mediated quinolone resistance determinant qnrs1.the plasmid-mediated quinolone resistance determinant qnrs1 was identified in non-clonally related enterobacter cloacae isolates in association with a transferable narrow-spectrum beta-lactam resistance marker. cloning experiments allowed the identification of a novel ambler class a beta-lactamase, named lap-1. it shares 62 and 61% amino acid identity with the most closely related beta-lactamases, tem-1 and shv-1, respectively. it has a narrow-spectrum hydrolysis of beta-lactams and is strongly ...200717116662
novel ambler class a beta-lactamase lap-1 and its association with the plasmid-mediated quinolone resistance determinant qnrs1.the plasmid-mediated quinolone resistance determinant qnrs1 was identified in non-clonally related enterobacter cloacae isolates in association with a transferable narrow-spectrum beta-lactam resistance marker. cloning experiments allowed the identification of a novel ambler class a beta-lactamase, named lap-1. it shares 62 and 61% amino acid identity with the most closely related beta-lactamases, tem-1 and shv-1, respectively. it has a narrow-spectrum hydrolysis of beta-lactams and is strongly ...200717116662
peritumoral citrobacter koseri abscess associated with parasagittal meningioma.this is the second report of a citrobacter-associated brain abscess in an adult and the first report of its association with an intradural tumor. excluding those associated with trauma, neurosurgical procedures, and proximity to the skull base, only seven other cases of abscesses associated with intracranial tumors have been published. five of seven tumor-associated abscesses with a microbiological diagnosis involved gram-negative bacteria, a finding that may indicate a predilection of these mic ...200517152669
a robotic dna purification protocol and real-time pcr for the detection of enterobacter sakazakii in powdered infant formulae.enterobacter sakazakii is the causative agent of rare but severe food-borne infections associated with meningitis, necrotizing enterocolitis and sepsis in infants. rehydrated powdered infant formulae have been implicated as the source of infection in several outbreaks and sporadic cases. in this work, a real time fluorescence resonance energy transfer pcr assay incorporating an internal amplification control (iac) was developed for the specific detection of e. sakazakii in foods. performance of ...200617166252
evaluation of a new selective chromogenic agar medium for detection of extended-spectrum beta-lactamase-producing enterobacteriaceae.a novel chromogenic agar medium (esbl-bx; biomérieux, marcy l'etoile, france) was compared to macconkey agar supplemented with 2 mg ceftazidime/liter (mckc) for the selective isolation and presumptive identification of extended-spectrum beta-lactamase (esbl)-producing enterobacteriaceae directly from clinical samples. of a total of 644 clinical specimens (including 551 fecal samples), 496 yielded no growth and 148 yielded growth on one or both media. overall, 44 esbl-producing enterobacteriaceae ...200717182756
evaluation of a new selective chromogenic agar medium for detection of extended-spectrum beta-lactamase-producing enterobacteriaceae.a novel chromogenic agar medium (esbl-bx; biomérieux, marcy l'etoile, france) was compared to macconkey agar supplemented with 2 mg ceftazidime/liter (mckc) for the selective isolation and presumptive identification of extended-spectrum beta-lactamase (esbl)-producing enterobacteriaceae directly from clinical samples. of a total of 644 clinical specimens (including 551 fecal samples), 496 yielded no growth and 148 yielded growth on one or both media. overall, 44 esbl-producing enterobacteriaceae ...200717182756
multicenter beta trial of the genexpert enterovirus assay.the genexpert dx system (cepheid, sunnyvale, ca) is a fully integrated and automated nucleic acid sample preparation, amplification, and real-time detection system. it consists of an instrument, a personal computer, and disposable fluidic cartridges. the analytical sensitivity and specificity of the genexpert enterovirus assay (gxea) were determined with a panel of 63 different enterovirus serotypes and 24 other microorganisms, respectively. the potential for blood, hemoglobin, white blood cells ...200717251395
in vitro and in vivo activities of pd 0305970 and pd 0326448, new bacterial gyrase/topoisomerase inhibitors with potent antibacterial activities versus multidrug-resistant gram-positive and fastidious organism groups.pd 0305970 and pd 0326448 are new bacterial gyrase and topoisomerase inhibitors (quinazoline-2,4-diones) that possess outstanding in vitro and in vivo activities against a wide spectrum of bacterial species including quinolone- and multidrug-resistant gram-positive and fastidious organism groups. the respective mics (microg/ml) for pd 0305970 capable of inhibiting>or=90% of bacterial strains tested ranged from 0.125 to 0.5 versus staphylococci, 0.03 to 0.06 versus streptococci, 0.25 to 2 versus ...200717261623
characterization of the gene encoding the 16s rrna of enterobacter sakazakii and development of a species-specific pcr method.the gene encoding the 16s rrna of enterobacter (e.) sakazakii (atcc 29544, plus four strains isolated from powdered infant formula) was studied, and the sequence compared with those of other enterobacteriaceae in aspects of genetic variability. sequence differences between e. sakazakii and other enterobacteriaceae within the hypervariable regions v1, v2, and v3, respectively, were used to develop two pcr methods for e. sakazakii. pcr1 employed a primer pair located in v1/v2, while pcr2 utilized ...200717289198
accelerated in vitro differentiation of blood monocytes into dendritic cells in human sepsis.summary sepsis-induced immune depression is characterized by infection susceptibility and monocyte early deactivation. because monocytes are precursors for dendritic cells (dc), alterations in their differentiation into dc may contribute to defective immune responses in septic patients. we therefore investigated the ability of monocytes to differentiate into functional dc in vitro in patients undergoing surgery for peritonitis. monocytes from 20 patients collected immediately after surgery (d0), ...200717302891
characteristics of beta-lactamases and their genes (blaa and blab) in yersinia intermedia and y. frederiksenii.the presence of beta-lactamases in y. enterocolitica has been reported to vary with serovars, biovars and geographical origin of the isolates. an understanding of the beta-lactamases in other related species is important for an overall perception of antibiotic resistance in yersiniae. the objective of this work was to study the characteristics of beta-lactamases and their genes in strains of y. intermedia and y. frederiksenii, isolated from clinical and non-clinical sources in india.200717407578
peptoniphilus gorbachii sp. nov., peptoniphilus olsenii sp. nov., and anaerococcus murdochii sp. nov. isolated from clinical specimens of human origin.three groups of previously unknown gram-positive, anaerobic, coccus-shaped bacteria were characterized using phenotypic and molecular taxonomic methods. phenotypic and genotypic data demonstrate that these organisms are distinct, and each group represents a previously unknown subline within clostridium cluster xiii. two groups are most closely related to peptoniphilus harei in the genus peptoniphilus, and the other group is most closely related to anaerococcus lactolyticus in the genus anaerococ ...200717428937
the taxonomy of enterobacter sakazakii: proposal of a new genus cronobacter gen. nov. and descriptions of cronobacter sakazakii comb. nov. cronobacter sakazakii subsp. sakazakii, comb. nov., cronobacter sakazakii subsp. malonaticus subsp. nov., cronobacter turicensis sp. nov., cronobacter muytjensii sp. nov., cronobacter dublinensis sp. nov. and cronobacter genomospecies 1.enterobacter sakazakii is an opportunistic pathogen that can cause infections such as necrotizing enterocolitis, bacteraemia, meningitis and brain abscess/lesions. when the species was defined in 1980, 15 biogroups were described and it was suggested that these could represent multiple species. in this study the taxonomic relationship of strains described as e. sakazakii was further investigated.200717439656
urinary symptoms in adolescent females: sti or uti?to determine if urinary symptoms or urinary tract infections (uti) were associated with sexually transmitted infections (sti) and which history, clinical, and laboratory findings could distinguish these infections in symptomatic women.200717448399
do antibiotic-impregnated shunts in hydrocephalus therapy reduce the risk of infection? an observational study in 258 patients.shunt infection in hydrocephalus patients is a severe, even life-threatening complication. antibiotic-impregnated shunts (ais) have been developed in an attempt to reduce rate of shunt infection. the study was performed to analyze if ais can diminish the rate of shunt infection. the pathogenic nature of shunt infection in patients with ais systems and those without antibiotic impregnated shunts (non-ais) was compared.200717488498
comparative in vitro antimicrobial activity of tigecycline, a new glycylcycline compound, in freshly prepared medium and quality control.the in vitro spectra of activity of tigecycline and tetracycline were determined for 2,490 bacterial isolates representing 50 different species or phenotypic groups. all isolates were tested simultaneously by broth microdilution using freshly prepared mueller-hinton broth and by disk diffusion. portions of these data were submitted to the food and drug administration (fda) in support of the sponsor's application for new drug approval. in a separate study, mic and disk diffusion quality control r ...200717494717
new plasmid-mediated fluoroquinolone efflux pump, qepa, found in an escherichia coli clinical isolate.plasmid-mediated qnr and aac(6')-ib-cr have been recognized as new molecular mechanisms affecting fluoroquinolone (fq) resistance. c316, an escherichia coli strain demonstrating resistance to various fqs, was isolated in japan. resistance to fqs was augmented in an e. coli csh2 transconjugant, but pcr failed to detect qnr genes, suggesting the presence of novel plasmid-mediated fq resistance mechanisms. susceptibility tests, dna manipulation, and analyses of the gene and its product were perform ...200717548499
comparison of hand-held test kits, immunofluorescence microscopy, enzyme-linked immunosorbent assay, and flow cytometric analysis for rapid presumptive identification of yersinia pestis.an in-house immunochromatographic test, plague biothreat alert test strips, abicap columns, enzyme-linked immunosorbent assay, flow cytometry, and immunofluorescence microscopy were compared for the detection of the fraction 1 capsular antigen of yersinia pestis, using spiked buffer and clinical specimens. hand-held test kits proved to be excellent benchtop tools.200717652472
biochemical analysis of tem-134, a new tem-type extended-spectrum beta-lactamase variant produced in a citrobacter koseri clinical isolate from an italian hospital.kinetic characterization of tem-134, a new tem-type extended-spectrum beta-lactamase variant isolated from citrobacter koseri during an italian nationwide survey. tem-134 is a natural derivative of tem-2 with the following substitutions: e104k, r164h and g238s.200717673478
identification of human pathogens isolated from blood using microarray hybridisation and signal pattern recognition.pathogen identification in clinical routine is based on the cultivation of microbes with subsequent morphological and physiological characterisation lasting at least 24 hours. however, early and accurate identification is a crucial requisite for fast and optimally targeted antimicrobial treatment. molecular biology based techniques allow fast identification, however discrimination of very closely related species remains still difficult.200717697354
maternal serum soluble cd30 is increased in pregnancies complicated with acute pyelonephritis.normal pregnancy is characterized by activation of the innate immunity and suppression of the adaptive limb of the immune response. however, pregnant women are more susceptible to the effects of infection and microbial products than non-pregnant women. cd30 is a member of the tumor necrosis factor receptor superfamily and is preferentially expressed by activated t cells producing th2-type cytokines. its soluble form (scd30) is proposed to be an index of th2 immune response. high serum concentrat ...200717853184
dry stress and survival time of enterobacter sakazakii and other enterobacteriaceae in dehydrated powdered infant formula.powdered infant formula is not a sterile product, and opportunistic pathogens could multiply in the reconstituted product, resulting in neonatal infections. in this study, the generation of sublethally injured enterobacteriaceae during desiccation and their persistence in dehydrated powdered infant formula was assessed during a 2.5-year period. the study included 27 strains of enterobacter sakazakii, enterobacter cloacae, salmonella enteritidis, citrobacter koseri, citrobacter freundii, escheric ...200717900090
interrupted time series analysis of vancomycin compared to cefuroxime for surgical prophylaxis in patients undergoing cardiac surgery.the increased incidence of methicillin-resistant staphylococcus aureus (mrsa), the emergence of community-acquired mrsa, and the continued high incidence of methicillin-resistant staphylococcus epidermidis have required that certain institutions choose vancomycin for surgical prophylaxis. however, the data supporting the use of vancomycin for surgical prophylaxis are controversial. the purpose of this project was to assess the effect of the change from cefuroxime to vancomycin for surgical site ...200818025116
interrupted time series analysis of vancomycin compared to cefuroxime for surgical prophylaxis in patients undergoing cardiac surgery.the increased incidence of methicillin-resistant staphylococcus aureus (mrsa), the emergence of community-acquired mrsa, and the continued high incidence of methicillin-resistant staphylococcus epidermidis have required that certain institutions choose vancomycin for surgical prophylaxis. however, the data supporting the use of vancomycin for surgical prophylaxis are controversial. the purpose of this project was to assess the effect of the change from cefuroxime to vancomycin for surgical site ...200818025116
a rare case of lethal retroperitoneal abscess caused by citrobacter koseri.retroperitoneal abscesses are very uncommon clinical conditions. the characteristically vague symptomatology of retroperitoneal abscess and the inherent difficulty of identifying retroperitoneal disease by physical examination contributed to these dismal therapeutic outcomes. we present an unusual case of lethal retroperitoneal abscess, caused by citrobacter diversus(koseri), treated with surgical drainage. citrobacter species have rarely been involved in deep tissue infection and there is no re ...200718025858
identification of type 3 fimbriae in uropathogenic escherichia coli reveals a role in biofilm formation.catheter-associated urinary tract infection (cauti) is the most common nosocomial infection in the united states. uropathogenic escherichia coli (upec), the most common cause of cauti, can form biofilms on indwelling catheters. here, we identify and characterize novel factors that affect biofilm formation by upec strains that cause cauti. sixty-five cauti upec isolates were characterized for phenotypic markers of urovirulence, including agglutination and biofilm formation. one isolate, e. coli m ...200818055599
detection of intracellular bacterial communities in human urinary tract infection.urinary tract infections (utis) are one of the most common bacterial infections and are predominantly caused by uropathogenic escherichia coli (upec). while utis are typically considered extracellular infections, it has been recently demonstrated that upec bind to, invade, and replicate within the murine bladder urothelium to form intracellular bacterial communities (ibcs). these ibcs dissociate and bacteria flux out of bladder facet cells, some with filamentous morphology, and ultimately establ ...200718092884
rapid antimicrobial susceptibility determination of uropathogens in clinical urine specimens by use of atp bioluminescence.we describe the first direct testing of the antimicrobial susceptibilities of bacterial pathogens in human clinical fluid samples by the use of atp bioluminescence. we developed an atp bioluminescence assay that eliminates somatic sources of atp to selectively quantify the bacterial load in clinical urine specimens with a sensitivity of <1,000 cfu per milliliter. there was a log-log relationship between light emission and the numbers of cfu in clinical urine specimens. a clinical study was perfo ...200818272708
the gut-brain barrier in major depression: intestinal mucosal dysfunction with an increased translocation of lps from gram negative enterobacteria (leaky gut) plays a role in the inflammatory pathophysiology of depression.there is now evidence that major depression (mdd) is accompanied by an activation of the inflammatory response system (irs) and that pro-inflammatory cytokines and lipopolysacharide (lps) may induce depressive symptoms. the aim of the present study was to examine whether an increased gastrointestinal permeability with an increased translocation of lps from gram negative bacteria may play a role in the pathophysiology of mdd. toward this end, the present study examines the serum concentrations of ...200818283240
gram-negative bacteraemia in non-icu patients: factors associated with inadequate antibiotic therapy and impact on outcomes.a considerable number of gram-negative bacteraemias occur outside intensive care units (icus). inadequate antibiotic therapy in icus has been associated with adverse outcomes; however, there are no prospective studies in non-icu patients.200818344548
virulence studies of enterobacter sakazakii isolates associated with a neonatal intensive care unit outbreak.in 1994, an outbreak of enterobacter sakazakii infections in france occurred in a neonatal intensive care unit during which 17 neonates were infected. more than half of the infected neonates had severe clinical symptoms; 7 cases of necrotising enterocolitis (one with abdominal perforation), one case of septicemia, and one case of meningitis. the other 8 neonates were shown to be colonized but remained asymptomatic. there were three deaths. four distinguishable pulsotypes of e. sakazakii were iso ...200818423002
[nationwide surveillance of parenteral antibiotics containing meropenem activities against clinically isolated strains in 2006].the antibacterial activity of meropenem (mepm) and other parenteral antibiotics against clinical isolates of 876 strains of gram-positive bacteria, 1764 strains of gram-negative bacteria, and 198 strains of anaerobic bacteria obtained from 30 medical institutions during 2006 was measured. the results were as follows; 1. mepm was more active than the other carbapenem antibiotics tested against gram-negative bacteria, especially against enterobacteriaceae and haemophilus influenzae. mepm was also ...200718447206
mgta expression is induced by rob overexpression and mediates a salmonella enterica resistance phenotype.rob is a member of the sox/mar subfamily of arac/xyls-type transcriptional regulators implicated in bacterial multidrug, heavy metal, superoxide, and organic solvent resistance phenotypes. we demonstrate that, in salmonella enterica, rob overexpression upregulates the transcription of mgta, which codes for the mgta mg2+ transporter. mgta was previously characterized as a member of the mg2+-modulated phopq regulon. here we demonstrate that rob (but not its paralog protein soxs or mara) is able to ...200818487336
fluoroquinolone resistance during 2000-2005: an observational study.moxifloxacin is a respiratory fluoroquinolone with a community acquired pneumonia indication. unlike other fluoroquinolones used in our healthcare system, moxifloxacin's urinary excretion is low and thus we hypothesized that increased use of moxifloxacin is associated with an increase in fluoroquinolone resistance amongst gram negative uropathogens.200818501015
the escherichia coli rutr transcription factor binds at targets within genes as well as intergenic regions.the escherichia coli rutr protein is the master regulator of genes involved in pyrimidine catabolism. here we have used chromatin immunoprecipitation in combination with dna microarrays to measure the binding of rutr across the chromosome of exponentially growing e. coli cells. twenty rutr-binding targets were identified and analysis of these targets generated a dna consensus logo for rutr binding. complementary in vitro binding assays showed high-affinity rutr binding to 16 of the 20 targets, w ...200818515344
characterization of klebsiella pneumoniae type 1 fimbriae by detection of phase variation during colonization and infection and impact on virulence.klebsiella pneumoniae is recognized as an important gram-negative opportunistic pathogen. the ability of bacteria to adhere to host structures is considered essential for the development of infections; however, few studies have examined the influence of adhesion factors on k. pneumoniae virulence. in this study, we cloned and characterized the type 1 fimbria gene cluster of a clinical k. pneumoniae isolate. although this cluster was not identical to the escherichia coli type 1 fimbria gene clust ...200818559432
treatment of citrobacter koseri infection with ciprofloxacin and cefotaxime in a preterm infant.to report a case of successful treatment of citrobacter koseri infection in a preterm infant as a means of challenging the current treatment recommendations on the basis of pharmacodynamic and pharmacokinetic considerations.200818577764
antimicrobial activity and durability of a novel antimicrobial-impregnated bladder catheter.the main objective of this study was to examine the antimicrobial activity and durability of a novel indwelling bladder catheter impregnated with minocycline and rifampin. thirty antimicrobial-impregnated bladder catheters were inserted transurethrally in spinal cord-injured patients and removed, in six groups of five catheters each, at 3, 7, 10, 14, 17 or 21 days. removed catheters had detectable zones of inhibition against two different clinical isolates of each of the 10 tested uropathogens ( ...199718611809
rapid detection of blakpc carbapenemase genes by real-time pcr.carbapenem resistance among enterobacteriaceae is an emerging problem worldwide. klebsiella pneumoniae carbapenemase (bla(kpc)) enzymes are among the most common beta-lactamases described. in this study, we report the development and validation of a real-time pcr (q-pcr) assay for the detection of bla(kpc) genes using taqman chemistry. the q-pcr amplification of bla(kpc) dna was linear over 7 log dilutions (r(2) = 0.999; slope, 3.54), and the amplification efficiency was 91.6%. the q-pcr detecti ...200818614657
repression of small toxic protein synthesis by the sib and ohsc small rnas.the sequences encoding the quad1 rnas were initially identified as four repeats in escherichia coli. these repeats, herein renamed sib, are conserved in closely related bacteria, although the number of repeats varies. all five sib rnas in e. coli mg1655 are expressed, and no phenotype was observed for a five-sib deletion strain. however, a phenotype reminiscent of plasmid addiction was observed for overexpression of the sib rnas, and further examination of the sib repeat sequences revealed conse ...200818710431
in vitro antibacterial activity of vertilmicin and its susceptibility to modifications by the recombinant aac6'-aph2'' enzyme.vertilmicin is a new semisynthetic aminoglycoside with a structure similar to that of netilmicin except for a methyl group at the c-6' position. in the present study, the in vitro antibacterial activity of vertilmicin was studied, and its susceptibility to modifications by the recombinant aminoglycoside bifunctional modifying enzyme aac(6')-aph(2'') was compared with those of verdamicin and netilmicin. a total of 1,185 clinical isolates collected from hospitals in beijing between 2000 and 2001 w ...200818710917
urinary tract infections in a south american population: dynamic spread of class 1 integrons and multidrug resistance by homologous and site-specific recombination.one hundred four bacterial strains mediating urinary tract infections in separate individuals from a uruguayan community were isolated. forty-six strains conferred a multidrug resistance phenotype. all 104 strains were examined for the presence of class 1, 2, and 3 integrons. class 1 integrons were found in 21 isolates across four distinct bacterial genera. a large class 1 integron in a klebsiella pneumoniae strain was fully sequenced and was 29,093 bp in length. this integron probably arose by ...200818753343
analysis of the 16s-23s rrna gene internal transcribed spacer region in klebsiella species.the 16s-23s rrna gene internal transcribed spacer (its) regions of klebsiella spp., including klebsiella pneumoniae subsp. pneumoniae, klebsiella pneumoniae subsp. ozaenae, klebsiella pneumoniae subsp. rhinoscleromatis, klebsiella oxytoca, klebsiella planticola, klebsiella terrigena, and klebsiella ornithinolytica, were characterized, and the feasibility of using its sequences to discriminate klebsiella species and subspecies was explored. a total of 336 its sequences from 21 representative stra ...200818753345
characterization of endemic shigella boydii strains isolated in iran by serotyping, antimicrobial resistance, plasmid profile, ribotyping and pulsed-field gel electrophoresis.shigellosis is one of the major causes of morbidity in children with diarrhea in iran. the present study was undertaken to characterize apparently sporadic shigella boydii strains isolated from pediatric patients in iran.200818755045
aromatic amino acid-dependent expression of indole-3-pyruvate decarboxylase is regulated by tyrr in enterobacter cloacae uw5.the plant growth-promoting rhizobacterium enterobacter cloacae uw5 synthesizes the plant growth hormone indole-3-acetic acid (iaa) via the indole-3-pyruvate pathway utilizing the enzyme indole-3-pyruvate decarboxylase that is encoded by ipdc. in this bacterium, ipdc expression and iaa production occur in stationary phase and are induced by an exogenous source of tryptophan, conditions that are present in the rhizosphere. the aim of this study was to identify the regulatory protein that controls ...200818757531
[infectious complications of surgically treatment pelvic fractures].based on case histories, the authors draw attention to important infectious complications in patients surgically treated for pelvic injuries. these complications were recorded in four out of 75 patients (5.3%) undergoing surgery for pelvic fracture in the period from 2001 to 2005. the chief risk factors for the development of infection included the poor state of health of a polytraumatized patient in combination with a long stay in an acute care unit, and severe trauma and bleeding of soft tissu ...200818760086
characterization of puo-stvr2, a virulence-resistance plasmid evolved from the pslt virulence plasmid of salmonella enterica serovar typhimurium.puo-stvr2 is a virulence-resistance plasmid which originated from pslt of salmonella enterica serovar typhimurium through acquisition of a complex resistance island, flanked by regions that provide a toxin-antitoxin system and an iron uptake system. the presence of resistance and virulence determinants on the same plasmid allows coselection of both properties, potentially increasing health risks.200818852276
uncultivated bacteria as etiologic agents of intra-amniotic inflammation leading to preterm birth.intra-amniotic infection and inflammation are major causes of preterm birth (ptb). however, intra-amniotic inflammation is often detected in the absence of infection. this may partly be due to the culturing methods employed in hospital laboratories, which are unable to detect the uncultivated species. in this study, intra-amniotic microbial infections associated with ptb were examined by both culture and 16s rrna-based culture-independent methods and were corroborated by the presence of intra-am ...200918971361
uncultivated bacteria as etiologic agents of intra-amniotic inflammation leading to preterm birth.intra-amniotic infection and inflammation are major causes of preterm birth (ptb). however, intra-amniotic inflammation is often detected in the absence of infection. this may partly be due to the culturing methods employed in hospital laboratories, which are unable to detect the uncultivated species. in this study, intra-amniotic microbial infections associated with ptb were examined by both culture and 16s rrna-based culture-independent methods and were corroborated by the presence of intra-am ...200918971361
structure, membrane orientation, mechanism, and function of pexiganan--a highly potent antimicrobial peptide designed from magainin.the growing problem of bacterial resistance to conventional antibiotic compounds and the need for new antibiotics have stimulated interest in the development of antimicrobial peptides (amps) as human therapeutics. development of topically applied agents, such as pexiganan (also known as msi-78, an analog of the naturally occurring magainin2, extracted from the skin of the african frog xenopus laevis) has been the focus of pharmaceutical development largely because of the relative safety of topic ...200919010301
structure, membrane orientation, mechanism, and function of pexiganan--a highly potent antimicrobial peptide designed from magainin.the growing problem of bacterial resistance to conventional antibiotic compounds and the need for new antibiotics have stimulated interest in the development of antimicrobial peptides (amps) as human therapeutics. development of topically applied agents, such as pexiganan (also known as msi-78, an analog of the naturally occurring magainin2, extracted from the skin of the african frog xenopus laevis) has been the focus of pharmaceutical development largely because of the relative safety of topic ...200919010301
characterization of the myo-inositol utilization island of salmonella enterica serovar typhimurium.knockout mutation of stm4432 resulted in a growth-deficient phenotype of salmonella enterica serovar typhimurium in the presence of myo-inositol (mi) as the sole carbon source. stm4432 is part of a 22.6-kb genomic island which spans stm4417 to stm4436 (genomic island 4417/4436) and is responsible for mi degradation. genome comparison revealed the presence of this island in only six salmonella strains and a high variability of the iol gene organization in gram-negative bacteria. upon nonpolar del ...200919011032
characterization of the myo-inositol utilization island of salmonella enterica serovar typhimurium.knockout mutation of stm4432 resulted in a growth-deficient phenotype of salmonella enterica serovar typhimurium in the presence of myo-inositol (mi) as the sole carbon source. stm4432 is part of a 22.6-kb genomic island which spans stm4417 to stm4436 (genomic island 4417/4436) and is responsible for mi degradation. genome comparison revealed the presence of this island in only six salmonella strains and a high variability of the iol gene organization in gram-negative bacteria. upon nonpolar del ...200919011032
haem acquisition is facilitated by a novel receptor hma and required by uropathogenic escherichia coli for kidney infection.iron acquisition, mediated by specific outer membrane receptors, is critical for colonization of the urinary tract by uropathogenic escherichia coli (upec). the role of specific iron sources in vivo, however, remains largely unknown. in this study, we identified a 79 kda haem receptor, haemacquisition protein hma, and established that it functions independently of chua to mediate haemin uptake by upec strain cft073. we demonstrated that expression of hma promotes tonb-dependent haemin utilizatio ...200919019144
haem acquisition is facilitated by a novel receptor hma and required by uropathogenic escherichia coli for kidney infection.iron acquisition, mediated by specific outer membrane receptors, is critical for colonization of the urinary tract by uropathogenic escherichia coli (upec). the role of specific iron sources in vivo, however, remains largely unknown. in this study, we identified a 79 kda haem receptor, haemacquisition protein hma, and established that it functions independently of chua to mediate haemin uptake by upec strain cft073. we demonstrated that expression of hma promotes tonb-dependent haemin utilizatio ...200919019144
increased isolation and characterization of shigella sonnei obtained from hospitalized children in tehran, iran.shigella flexneri has been the most frequent cause of shigellosis in children in iran. to evaluate the changes in frequency of serogroups, 302 shigella species were isolated in 2003 from hospitalized children, aged less than 12 years, with acute diarrhoea in tehran, iran. the number of collected s. sonnei, s. flexneri, s. boydii, and s. dysenteriae isolates was 178 (58.9%), 110 (37.4%), 10 (3.3%), and 4 (1.3%) respectively. most (94%) s. sonnei isolates were resistant to co-trimoxazole. they wer ...200819069621
naturally occurring class a ss-lactamases from the burkholderia cepacia complex.chromosomally encoded ss-lactamases from the burkholderia cepacia complex species (formerly pseudomonas cepacia) were characterized. cloning and sequencing identified an ambler class a ss-lactamase (penb) from b. cenocepacia. it shares 82% amino acid identity with the pena ss-lactamases previously identified from b. multivorans 249. its expression was dependent upon a lysr-type regulatory protein. its narrow-spectrum hydrolysis activity mostly included penicillins but also included expanded-spec ...200919075063
naturally occurring class a ss-lactamases from the burkholderia cepacia complex.chromosomally encoded ss-lactamases from the burkholderia cepacia complex species (formerly pseudomonas cepacia) were characterized. cloning and sequencing identified an ambler class a ss-lactamase (penb) from b. cenocepacia. it shares 82% amino acid identity with the pena ss-lactamases previously identified from b. multivorans 249. its expression was dependent upon a lysr-type regulatory protein. its narrow-spectrum hydrolysis activity mostly included penicillins but also included expanded-spec ...200919075063
utility of pyrosequencing in identifying bacteria directly from positive blood culture bottles.growth in liquid media is the gold standard for detecting microorganisms associated with bloodstream infections. the gram stain provides the first clue as to the etiology of infection, with phenotypic identification completed 1 or 2 days later. providing more detailed information than the gram stain can impart, and in less time than subculturing, would allow the use of more directed empirical therapy and, thus, reduce the patient's exposure to unnecessary or ineffective antibiotics sooner. the s ...200919091813
utility of pyrosequencing in identifying bacteria directly from positive blood culture bottles.growth in liquid media is the gold standard for detecting microorganisms associated with bloodstream infections. the gram stain provides the first clue as to the etiology of infection, with phenotypic identification completed 1 or 2 days later. providing more detailed information than the gram stain can impart, and in less time than subculturing, would allow the use of more directed empirical therapy and, thus, reduce the patient's exposure to unnecessary or ineffective antibiotics sooner. the s ...200919091813
evaluation and implementation of a chromogenic agar medium for salmonella detection in stool in routine laboratory diagnostics.we evaluated which chromogenic agar medium for salmonella detection in stool would be most sensitive and specific in our culture protocol. the use of bbl chromagar salmonella chromogenic medium combined with xylose-lysine-deoxycholate agar yielded a sensitivity of 100% and also reduced workload and costs.200919091816
evaluation and implementation of a chromogenic agar medium for salmonella detection in stool in routine laboratory diagnostics.we evaluated which chromogenic agar medium for salmonella detection in stool would be most sensitive and specific in our culture protocol. the use of bbl chromagar salmonella chromogenic medium combined with xylose-lysine-deoxycholate agar yielded a sensitivity of 100% and also reduced workload and costs.200919091816
normalization of leaky gut in chronic fatigue syndrome (cfs) is accompanied by a clinical improvement: effects of age, duration of illness and the translocation of lps from gram-negative bacteria.there is now evidence that an increased translocation of lps from gram negative bacteria with subsequent gut-derived inflammation, i.e. induction of systemic inflammation and oxidative & nitrosative stress (io&ns), is a new pathway in chronic fatigue syndrome (cfs).200819112401
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