Five individual colonies of Haemophilus influenzae were isolated from each of one to three cultures of sputum collected from 18 patients with chronic obstructive pulmonary disease (COPD). The isolates were studied to investigate whether the major outer membrane proteins (MOMPs) changed during persistence. The relationship between isolates was analyzed by fingerprinting their chromosomal DNA. The fingerprints of eight strains (isolated from eight patients) with various MOMP compositions were different, whereas fingerprints of isolates with identical MOMP compositions were indistinguishable. In 12 patients, two or more strains with different MOMP compositions were found; one strain was isolated from the sputum samples of each of the six remaining patients. In seven of the 12 patients, strains with different MOMPs but with indistinguishable fingerprints were found. The differences were found in proteins b,c (five patients) and d (five patients). In patients with COPD, the MOMPs of H. influenzae are subject to changes that may enable this bacterium to escape immunological defense mechanisms.
Eight cases of neonatal meningitis due to Enterobacter sakazakii (formerly known as yellow-pigmented Enterobacter cloacae) which occurred in The Netherlands during the last 6 years were investigated retrospectively. Two patients had necrotizing enterocolitis and meningitis simultaneously. Despite treatment (in most cases with ampicillin and gentamicin), the fatality rate was 75%. Strains were much more susceptible to some of the new beta-lactam antibiotics than to ampicillin. A mode of transmission other than passage through the birth canal was likely, at least for some patients. A cluster of four patient strains in one hospital had almost identical plasmid DNA profiles. However, two strains isolated from formula at the same hospital 2 days after the onset of one case had different profiles, as did the strains from patients in other hospitals.
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