No abstract

NBL is a simple, safe, cheap, readily-available method of diagnosing ventilator-associated pneumonia with comparable diagnostic accuracy to bronchoscopic techniques. Quantitation of respiratory tract cultures can exclude pneumonia in patients with equivocal clinical signs. The diagnostic threshold should vary depending on the length of ventilation, likelihood of pneumonia and antibiotic administration. The Bacterial Index is a flawed mathematical device that has no contributory role in pneumonia diagnosis. The CPIS has some diagnostic role in selected cohorts of ventilated patients.

No abstract

Summary. Clinical (101) and collection (26) strains of gram-positive anaerobic cocci were examined in conventional tests and pyrolysis mass spectrometry (PMS). Numerical classifications based upon conventional test reaction patterns (CTRPs) and PMS showed 27 and 22 clusters. respectively. Cross-tabulation of cluster membership in the two classifications showed excellent correlation, with the combined classifications showing clear groups corresponding to the currently recognised species Peptostreptococcus anaerobius, P. heliotrinreriucens, P. hydrogennlis. P. indolicus, P. lactoljyticus, P. magnus, P. micros and Peptococcus niger. Strains of P. precotii and P. tetradius clustered together in a heterogeneous group of saccharolytic organisms. However, strains previously identified as P. asaccharo-/j.ticus were divided into three distinct groups in PMS, two of which differed only in indoleassociated pyrolysis products. A further four groups and several single-member clusters were distinct from these species. PMS data supported the validity of identification by pre-formed enzyme profiles and confirmed that Hare group 111 is synonymous with P. hydrogenalis, Hare group IV with P. maynus, and the "ADH group" with P. uaginalis. There is clearly a need for a taxonomic revision of the genus Peptostreptococcus, which probably encompasses several generic groups.

The emergence of a clonal group of gonococci showing decreased susceptibility to cefixime in England and Wales highlights the need for continued surveillance.