OBJECTIVETo improve the sample collection methods and bacteriologic localization patterns in male genital tract infection, and to investigate the influence of specimen collection and pathogen isolation on the diagnosis and treatment of prostatitis.

METHODSWe collected the samples of the initial urinary stream, the third portion of the urinary stream, expressed prostatic secretion (ESP), and semen from 200 adult males with chronic prostatitis-like symptoms, inoculated them quantitatively in culture media for isolation of microorganisms, and evaluated their laboratory diagnostic significance according to the count of colonies and distribution of the isolates.

RESULTSA total of 468 strains of microorganisms were isolated from the samples, including 414 strains of bacteria spp (88.5%), 12 strains of fungi spp (2.6%), 40 strains of mycoplasma spp (8.5%), and 2 strains of chlamydia spp (0.4%). Pathogens were isolated from the ESP in 66 cases (33.0%), from the semen in 34 cases (17.0%), and from both the ESP and semen in 100 cases (50.0%). Only 1 species of pathogen was found in the ESP samples of 36 cases (18.0%), in the semen samples of 20 cases (10%), and in both the ESP and semen samples of 39 cases (19.5%); 2 species in the ESP samples of 30 cases (15.0%), in the semen samples of 14 cases (7.0%), and in both the ESP and semen samples of 60 cases (30.0%); and 3 species in both the ESP and semen samples of 1 case (0.5%).

CONCLUSIONMultiple microbial infection (MMI), multi-organ infection (MOI) and drug-resistance strains infection are common in patients with prostatitis-like symptoms, frequently leading to missed diagnosis and misdiagnosis in clinic and laboratory, and affecting the effect of antimicrobial therapy. MMI and MOI can be diagnosed and differentially diagnosed with the improved sample collection methods and bacteriologic localization patterns.

Adult ; Bacterial Load ; Chronic Disease ; Genital Diseases, Male ; diagnosis ; microbiology ; Humans ; Male ; Prostatitis ; diagnosis ; microbiology ; Reproductive Tract Infections ; diagnosis ; microbiology ; Semen ; microbiology ; Specimen Handling ; methods ; Urethra ; microbiology

Anti-Bacterial Agents ; Clostridium Infections ; diagnosis ; microbiology ; Clostridium difficile ; genetics ; Drug Resistance, Bacterial ; genetics ; Humans

Bacterial Infections ; diagnosis ; therapy ; Humans ; Liver Cirrhosis ; diagnosis ; microbiology ; therapy ; Peritonitis ; diagnosis ; therapy

INTRODUCTIONThe aim of this case series is to describe the clinical course of 2 patients with Neisseria meningitidis corneal ulcers.

CLINICAL PICTUREA 49-year-old man (Patient 1) and a 22- year-old man (Patient 2) both experienced eye pain and were found to have corneal ulcers with surrounding infiltrate and ground-glass appearance. Gram-negative diplococci were seen in the first case. N. meningitidis was isolated in culture of corneal scrapings from both patients.

TREATMENTPatient 1 was treated with levofloxacin (0.5%) and cefazolin (50 mg/mL) eye drops hourly and intravenous ceftriaxone and oral rifampicin. Patient 2 was treated with cefazolin (50 mg/mL) and gentamicin (14 mg/mL) eye drops hourly, as well as intravenous ceftriaxone.

OUTCOMEThe corneal ulcers resolved with anterior stromal scarring and no impairment of vision.

CONCLUSIONSCorneal ulcers caused by N. meningitidis may respond well to treatment without permanent visual sequelae. However, in view of the potential ocular and systemic complications, it is important to investigate and treat patients with N. meningitidis infection aggressively.

Adult ; Cornea ; microbiology ; pathology ; Diagnosis, Differential ; Eye Infections, Bacterial ; microbiology ; pathology ; Humans ; Keratitis ; microbiology ; pathology ; Male ; Meningococcal Infections ; microbiology ; pathology ; Middle Aged ; Neisseria meningitidis ; isolation & purification

INTRODUCTIONCommunity-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has emerged worldwide. In contrast to healthcare-associated MRSA (HA-MRSA), CA-MRSA isolates are usually susceptible to multiple non-beta-lactam antibiotics and cause a distinct spectrum of infections in epidemiologically disparate populations - in particular, cutaneous abscesses, necrotising fasciitis and necrotising pneumonia. They arise from a broader genetic background, and possess differing virulence genes. We aim to describe the distribution of different molecular subtypes of CA-MRSA among various regions and discuss briefly the implications of CA-MRSA from a local perspective.

METHODSLiterature review of articles on CA-MRSA, focusing mainly on reports where the genetic background of isolates had been analysed using multi-locus sequence typing (MLST). Singapore data were obtained from the local CA-MRSA database.

RESULTSMLST analysis demonstrated the presence of epidemic subtypes of CA-MRSA within most geographic areas. In parts of the United States, community MRSA infections currently exceed those caused by their methicillin-susceptible counterparts. In Singapore, CA-MRSA infections are increasing, predominantly as a result of the spread of ST30 clones.

CONCLUSIONAvailable evidence suggests that the emergence of MRSA from the community is not going to be a transient phenomenon. Local guidelines for dealing with this phenomenon at both therapeutic and preventive levels are needed prior to the potential development of a situation mirroring that of meso-endemic HA-MRSA in local hospitals or CA-MRSA epidemics in parts of USA.

Bacterial Typing Techniques ; Community-Acquired Infections ; epidemiology ; microbiology ; Cross Infection ; diagnosis ; microbiology ; Humans ; Methicillin Resistance ; Risk Factors ; Singapore ; epidemiology ; Staphylococcal Infections ; epidemiology ; microbiology ; Staphylococcus aureus ; classification ; drug effects

No abstract available.
Antigens, Bacterial/*analysis ; Feces/*microbiology ; Helicobacter Infections/*diagnosis ; Helicobacter pylori/*isolation & purification ; Humans ; Immunoenzyme Techniques

OBJECTIVEThe rapid identification of pathogenic bacteria is important for earlier effective patient management and antimicrobial therapy, especially for the infant patient, whose immunological system is not fully developed. However conventional microbiogical techniques of bacterial identification, culture and isolation of pathogenic bacteria, identification by biochemistry and serological assay, are time-consuming and require intensive labor. On the basis of special gene sequence, PCR provides simple and rapid way to identify bacteria. But it is difficult to identify all of bacteria species which are suspicious of pathogenic agents. Oligonucleotide arrays provide a powerful tool for parallel detection of target genes. The objective of this study was to test a reverse oligonucleotide assay, which hybridize with the PCR product of 16SrDNA using a pair of universal primers, to rapidly identify common infant pathogenic bacteria.

METHODSBy comparison and analysis of the 16SrDNA sequences of common pathogenic bacteria, a region, which has numerous sequence variations and flanked by highly conserved sequences, was found. A pair of universal primers was designed according to its flanking conservative sequence, and a set of probes specially targeting to eight species of infant pathogenic bacteria, including staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, Streptococcus faecalis, Hemophilus influenzae, Enterobacter cloacae, Escherichia coli, and Acinetobacter baumannii,according to the variable sequences. The probes were fixed on the nylon membrane with positive electricity, and hybridized them with the products of PCR using the universal primers.

RESULTSThe universal primers could amplify the target sequence from bacteria including the eight common infant pathogenic bacteria and Staphylococcus epidermidis, Enterobacter aerogenes, Streptococcus pneumoniae,beta-hemolytic streptococcus, Neisseria meningitides, Citrobacter freundii, Bacillus subtilis, and Salmonella infantis,but could not amplify rotavirus and human DNA as control. The results showed that the oligonucleotide array could specially hybridize with the eight bacteria to be examined and could not hybridize with other bacteria. The lowest concentration of DNA (product of PCR) for oligonucleotide array was about 25 ng/ml. The results proved that the probes are highly selective and the oligonucleotide arrays could parallelly detect the eight common infant pathogenic bacteria. The results suggested that the oligonucleotide array system was able to identify the eight common infant pathogenic bacteria from clinical specimens and the results were the same as identified by automated bacterial detection machine. From the further experiments, the oligonucleotide array system could directly diagnose the common infant pathogenic bacteria from the broths of samples culture.

CONCLUSIONSDespite limited number of identifiable bacteria and lack of information on antibiotic susceptibility of bacteria, the reverse oligonucleotide assay system, which contains amplification of the segment of 16rDNA from samples using the universal primers and parallel detection of PCR products using specific probes, is an effective method to rapidly identify the eight common infant pathogenic bacteria.

Bacterial Infections ; diagnosis ; microbiology ; Humans ; Infant ; Infant, Newborn ; Oligonucleotide Array Sequence Analysis

OBJECTIVETo detect the genes of Neisseria spp. isolated from patients with male genitourinary tract infections, and to study the pathogenicity of non-gonococcal strains of Neisseria and the laboratory diagnosis for the infections caused by Neisseria spp.

METHODSUsing polymerase chain reaction and nucleotide sequencing, we amplified and sequenced 4 genes of Neisseria spp. isolated from patients with male genitourinary tract infections, including 16S rRNA, orfl, cppB and nspA.

RESULTSFourteen Neisseria strains were identified through analysis of the 16S rRNA gene, including 3 N. mucosa strains, 3 N. cinerea strains, 2 N. gonorrhoea strains, 2 N. sicca strains, 2 N. subflava strains, 1 N. lactamica strain, and 1 N. polysaccharea strain. Among them, 9 showed positive results in gonococcal fluorescence-labeled multiplex-PCR detection, 1 in cppB gene reaction, 5 in orfl gene reaction, and 3 in nspA gene reaction. The consistency rate was 85.7% between the above results from our gene detection and those from the routine bacteriological methods.

CONCLUSIONThe cppB gene is absent in the non-gonococcal strains of Neisseria spp. that can cause male genitourinary tract infection. Most of the strains not only lack virulence-associated orfl and nspA genes, but also show positive results in gonococcal fluorescence-labeled multiplex-PCR detection, which is one of the important reasons for the misdiagnosis and missed diagnosis of gonorrhea infection. The combination of routine bacteriological methods and gene detection in laboratory examinations may help improve the accuracy rates of Neisseria species identification and clinical diagnosis of the infections caused by Neisseria spp.

Genes, Bacterial ; Gonorrhea ; diagnosis ; microbiology ; Humans ; Male ; Neisseria gonorrhoeae ; classification ; genetics ; Polymerase Chain Reaction ; Urinary Tract Infections ; microbiology

Considering the popular use of antibiotic-containing eyedrops in Korea, it is important to know the emerging antibiotic-resistant strains of bacteria before treating infectious eye diseases. This is especially important in high-risk groups because of the high incidence of resistant infections and the subsequent treatment requirements. We report two cases of methicillin-resistant Staphylococcus aureus (MRSA) corneal ulcers in high-risk groups. The first case involved a patient who had keratitis after using antibiotic- and steroid-containing eyedrops to treat a corneal opacity that developed after repeated penetrating keratoplasty. The second case involved a patient who used antibiotic-containing eyedrops and a topical lubricant on a regular basis for >1 month to treat exposure keratitis due to lagophthalmos. The second patient's problems, which included a persistent superficial infiltration, developed after brain tumor surgery. Both cases showed MRSA on corneal culture, and the corneal ulcers improved in both patients after the application of vancomycin-containing eyedrops. In conclusion, MRSA infection should be considered in corneal ulcers that have a round shape, mild superficial infiltration, and slow progression, especially in high-risk groups. This report includes descriptions of the characteristic features, antibiotic sensitivities, prevention, and successful treatment with vancomycin-containing eyedrops for MRSA corneal ulcers.
Cornea/*microbiology/pathology ; Corneal Ulcer/diagnosis/*microbiology ; Diagnosis, Differential ; Eye Infections, Bacterial/diagnosis/*microbiology ; Female ; Follow-Up Studies ; Humans ; Male ; Methicillin-Resistant Staphylococcus aureus/*isolation & purification ; Middle Aged ; Staphylococcal Infections/diagnosis/*microbiology

OBJECTIVETo improve the diagnosis and treatment level of spontaneous bacterial peritonitis (SBP) in the patients with advanced liver disease, get better curative effect and prognosis.

METHODSRegistered the body temperature, symptoms and signs in the abdomen, and blood routine test, the polymorphonuclear (PMN) cell count, and ascites culture in the patients with cirrhosis and fulminant hepatitis. These patients were given supporting therapies including use plasma and albumin as well as antibiotics treatment according to drug sensitivity or empiric. Changes of the body temperature, symptoms and signs were used to evaluate the effect of therapy.

RESULTS186 of 275 inward patients with end-stage liver disease during this period were considered as SBP by ascites culture or clinical experience with various degree symptoms and signs such as pain, distention, higher tension and touch pain in the abdomen. Infective rate was 67.6%. Among them 138 patients had abnormal body temperature more than 37.4 degrees C. 106 patients with leukocyte count in the peripheral blood more than 10 x 10(9)/L; 137 patients with PMN more than 80% in differential cell count; 103 patients with PMN more than 250/mm(3) in ascites. Only 29 patients were culture positive. 82 patients were cured, 17 patients with improvement, 18 patients with inefficacy or deterioration. 42 patients died of hepatic-renal failure and 27 patients died because of upper alimentary tract bleeding, respectively.

CONCLUSIONSigns and symptoms of SBP were atypical in the patients with end-stage liver disease. Ascites culture positive rate was not high. Early diagnosis and proper use antibiotics according to culture and empirics were important to increase effect and improve prognosis

Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Bacterial Infections ; diagnosis ; microbiology ; therapy ; Female ; Humans ; Liver Diseases ; complications ; Male ; Middle Aged ; Peritonitis ; diagnosis ; microbiology ; therapy ; Prognosis