Faculty Bibliography

Strain typing of microbial pathogens has two major aims: (i). to index genetic microvariation for use in outbreak investigations and (ii). to index genetic macrovariation for use in phylogenetic and population-based analyses. Until now, there has been no clear indication that one genetic marker can efficiently be used for both purposes. Previously, we had shown that DNA sequence analysis of the protein A gene variable repeat region (spa typing) provides a rapid and accurate method to discriminate Staphylococcus aureus outbreak isolates from those deemed epidemiologically unrelated. Here, using the hypothesis that the genetic macrovariation within a low-level recombinogenic species would accurately be characterized by a single-locus marker, we tested whether spa typing could congruently index the extensive genetic variation detected by a whole-genome DNA microarray in a collection of 36 isolates, which was recovered from 10 countries on four continents over a period of four decades, that is representative of the breadth of diversity within S. aureus. Using spa and coa typing, pulsed-field gel electrophoresis (PFGE), and microarray and multilocus enzyme electrophoresis (MLEE) data in molecular epidemiologic and evolutionary analyses, we determined that S. aureus likely has a primarily clonal population structure and that spa typing can singly index genetic variation with 88% direct concordance with the microarray and can correctly assign isolates to phylogenetic lineages. spa typing performed better than MLEE, PFGE, and coa typing in discriminatory power and in the degree of agreement with the microarray at various phylogenetic depths. This study showed that genetic analysis of the repeat region of protein A comprehensively characterizes both micro- and macrovariation in the primarily clonal population structure of S. aureus

This article represents the proceedings of a symposium at the 2003 annual meeting of the Research Society on Alcoholism in Fort Lauderdale, FL. The organizers/chairs were Joseph Conigliaro and Amy Justice. The presentations were (1) Introduction, by Joseph Conigliaro and Tamra Madenwald; (2) Alcohol and HIV/AIDS: the importance of integrative and translational research, by Kendall Bryant; (3) Alcohol use and abuse among patients with HIV infection, by Joseph Conigliaro and Stephan Maisto; (4) Severity of comorbid alcohol use/abuse in HIV infection, by Amy Justice and Jeffrey Samet; (5) Estimating the impact of alcohol use on long-term HIV outcomes, by Scott Braithwaite and Amy Justice; (6) Homelessness, drug & alcohol use among HIV+ veterans, by Adam Gordon and Robert Cook; and (7) Hepatitis C & alcohol in the VACS 3 study, by Shawn Fultz and Kevin Kraemer. The symposium concluded with a discussion led and facilitated by Diedra Roach

The official, Dr. Klaus Stohr, said that on Friday his agency learned that initial genetic tests showed that the A(H5N1) strain was resistant to the less expensive class of anti-influenza virals. The class includes amantadine (Symmetrel) and rimantadine (Flumadiine). The number of human cases is small, and the A(H5N1) strain contains only avian genes. But WHO officials said they were concerned that the bird strain might pick up genes from a human virus to create an entirely new virus that could spread easily among people. It would take a combination of events, each of low probability, to produce a large outbreak. But the health agency said the implications for public health were so important that precautionary measures must be taken. Knowing that anti-influenza drugs may be needed in an outbreak of human bird flu and as part of the surveillance process, laboratories in the network have been testing the A(H5N1) strain's susceptibility to the small number of such drugs. The tests are being done at the Centers for Disease Control in Atlanta, and in London and in Hong Kong

The Central African Republic, polio-free since 2000, has confirmed a new case, the World Health Organization said

Developing a vaccine is a complex process. Because the H5N1 strain kills chickens, scientists cannot use chicken eggs to make the vaccine, as they do for human strains of influenza virus. Instead, scientists working with the health agency in London, at the Centers for Disease Control and Prevention in Atlanta, and elsewhere are using a newer laboratory technique known as reverse genetics. The tests clearly indicate that the viruses from Vietnam and South Korea are very closely related, said Dr. Klaus Stohr, a WHO influenza expert. But he said the two viruses were distinct from the strain found in Hong Kong last year. In 1997, that strain infected 18 people in Hong Kong, killing 6; it was found in duck meat in South Korea in 2001

I had ordered a CT scan on 'Mr. Azziz' during a routine physical because he was a smoker. I had always reassured smokers that the test was routine, that a CT scan was more sophisticated than an X- ray in analyzing a smoker's lungs. But knowing that a CT scan or other state-of-the-art test could tell the future made many patients anxious, worrying about the results. I decided to show the CT scan to my office mate, a prominent pulmonologist. He crisply snapped the scan up onto his view box. This type of precision and ease at looking at potential cancers could frighten a patient if he saw it. The report already had the words 'suspicious for a bronchogenic neoplasm' written on it. Like the lung doctor, the radiologist who had interpreted the X-ray was pronouncing sentence on a man he'd never met. The technology told your future and could take away your hopes and plans with a single verdict

New tests have turned up a disturbing problem with the avian influenza virus that is spreading in Asia: The strain appears resistant to one of the two main classes of drugs used to fight influenza viruses, a World Health Organization official said Saturday. The number of human cases is small, and the A(H5N1) strain contains only avian genes. But WHO officials said they were concerned that the bird strain might pick up genes from a human virus to create an entirely new virus that could spread easily among people. It would take a combination of events, each of low probability, to produce a large outbreak. But the health agency said the implications for public health were so important that precautionary measures must be taken. [Klaus Stoehr] said that Friday night, his agency learned that initial genetic tests showed that the A(H5N1) was resistant to the less expensive class of anti-influenza virals. The class includes amantadine (Symmetrel) and rimantadine (Flumadine)

P/>New tests have turned up a disturbing problem with the avian influenza virus that is spreading in Asia: The strain appears resistant to one of the two main classes of drugs used to fight influenza viruses, a World Health Organization official said Saturday.<P/>Meanwhile, the strain, A(H5N1), has been detected among birds in a sixth Asian country, Cambodia, and two more human cases have been diagnosed in a new area of Vietnam, said the official, Dr. Klaus Stoehr.<P/>Both Vietnamese cases were in children in Ho Chi Minh City, bringing to seven the total in that country. Six have been fatal. Five earlier Vietnamese cases were in Hanoi.<P/> Thailand has reported two fatal human cases.<P/>All the human cases are believed to be from contact with chickens or their waste, not from eating them or their eggs