Faculty Bibliography

The bacteriology of chronic rhinosinusitis is an area of great interest among rhinologists. Numerous studies have reported culture results implicating a variety of aerobic and anaerobic organisms in the etiology of this disease process. Sampling is generally accomplished through the nasal cavity, creating the potential for contamination with resident nasal flora. In some reports, strict anaerobic techniques have not been used, possibly accounting for the failure to recover these fastidious organisms. In an attempt to clarify the microbiology of chronic rhinosinusitis, we used a novel culture and transport system in 50 patients undergoing endoscopic sinus surgery. The Accu-CulShure (MLA Systems, Pleasantville, NY, USA) is a self-contained polyethylene culture swab and transport device, capable of collecting a representative sample from the sinus without contamination, and preserving the quality of the material during transport. Our aerobic and anaerobic culture results, as well as pertinent patient data, are presented. The Accu-CulShure device may permit standardization of culture techniques for future studies, and allow for more accurate determination of the microbiology of chronic rhinosinusitis

Meat-eating primates avoid scavenging for dietary protein and micronutrients even when carrion is relatively fresh. Chimpanzees, baboons, and modern hunter-gatherers supplement their diets of high-energy, low-protein fruit with protein obtainedfrom leaves, insects, and animal prey. Most primates, especially leaf-eating primates, digest the cellulose cell walls of ingested plant material in a well developed caecum and/or large intestine through fermentation caused by enzymes released by their normal gut flora. The primate digestive strategy combines a rapid passage through the stomach and prolonged digestion in the ileum of the small intestine and caecum, and this combination increases the likelihood of colonization of the small intestine by ingested bacteria that ai-e the cause of gastrointestinal disease. Carrion is very quickly contaminated with a high bacterial load because the process of dismemberment of a car-cass exposes the meat to the bacteria from the saliva of the predator, from the digestive tracts of insects, and from the carcasses' own gut. Thus, the opportunistic eating of uncooked carrion or even unusually large quantities of fresh-killed meat by nonhuman primates or humans is likely to result in gastrointestinal illness. We propose that among meat-eating primates, carrion avoidance is a dietary strategy that develops during their lifetime as a response to the association of gastrointestinal illness with the ingestion of contaminated meat from scavenged carcasses. This has important implications for our understanding of early hominid behavior

Human parvovirus B19, which infects and lyses erythroid precursors, can cause severe anemia in patients with immunodeficiency. The incidence of parvovirus infection in adult acquired immunodeficiency syndrome (AIDS) patients is unknown. Eighty-one archival formalin-fixed, paraffin-embedded (FFPE) bone marrow biopsies from 73 AIDS adults were immunostained with monoclonal R92F6 against B19 VP1 and VP2 capsid proteins using streptavidin peroxidase and streptavidin alkaline phosphatase techniques. In addition, the same tissues were hybridized in situ with a digoxigenin-labeled parvovirus B19 DNA probe. Five FFPE bone marrows, from 3 HIV-negative patients with positive immunoglobulin M (IgM) serology for parvovirus B19, and 1 parvovirus B19-infected fetal liver were positive controls. By immunoperoxidase, all tissues were negative with R92F6 except the fetal liver, which exhibited strong positivity predominantly in viral inclusions. With immunoalkaline phosphatase, all positive controls were immunoreactive with R92F6; however, the AIDS marrows were negative. With in situ hybridization (ISH), all positive controls and 7 of 81 (8.6%) of AIDS marrows were positive for B19 parvovirus DNA. We conclude that ISH is more sensitive than R92F6 immunohistochemistry in parvovirus B19 detection. A small but significant number of bone marrows from AIDS adults shows evidence of human parvovirus B19 infection

Despite the tendency to rely considerably on laboratory test results for the differential diagnosis of Lyme disease, considerable problems exist with such testing. In this article we compare the effectiveness of five main categories of laboratory tests used for the detection of Lyme disease. Our goal is to enable the reader to better understand the limitations of different test methods and to realize that until better tests become available, diagnosis of Lyme disease still must be made clinically. Clinical data, however, can be used to increase the predictive power of any laboratory test as well as to help judge its validity

Antimicrobial susceptibility testing expense may be a significant portion of a clinical microbiology laboratory's budget. This study compares the BIOMIC VIDEO system (Giles Scientific, Inc., New York, N.Y.) with the Vitek system (bioMerieux Vitek, Inc., Hazelwood, Mo.), an established automated method of antimicrobial susceptibility testing with the ability to generate MIC data. The BIOMIC system is relatively inexpensive and automates the reading of the classical disk agar diffusion test to provide both qualitative (susceptibility interpretation) and quantitative (MIC) data. The overall MIC correlation between the two systems for the 2,913 drug-organism combinations tested was 92.6%. The overall agreement for susceptibility interpretation was 97.4%. The BIOMIC system offers a 57.4% savings per test over the Vitek system. The BIOMIC system utilizes an older technology which is more efficient and yet yields results comparable to those of established automated MIC methods. The savings achievable in laboratories and hospitals nationwide may contribute significantly to the containment of national health care expenditures