A fastidious gram-negative bacterium was isolated from the blood of a 37-year-old man who had insidious endocarditis with a sudden rupture of a cerebral aneurysm. Characterization of the organism through phylogenetic and phenotypic analyses revealed a novel species of Cardiobacterium, for which the name Cardiobacterium valvarum sp. nov. is proposed. C. valvarum will supplement the current sole species Cardiobacterium hominis, a known cause of endocarditis. Surgeries and antibiotic treatment cured the patient's infection and associated complications. During cardiac surgery, a congenital bicuspid aortic valve was found to be the predisposing factor for his endocarditis.

A novel rapid peptide nucleic acid fluorescence in situ hybridization (FISH) method, Staphylococcus Quick FISH, for the direct detection of Staphylococcus species from positive blood culture bottles was evaluated in a multicenter clinical study. The method utilizes a microscope slide with predeposited positive- and negative-control organisms and a self-reporting 15-min hybridization step, which eliminates the need for a wash step. Five clinical laboratories tested 722 positive blood culture bottles containing Gram-positive cocci in clusters. The sensitivities for detection of Staphylococcus aureus and coagulase-negative staphylococci (CoNS) were 99.5% (217/218) and 98.8% (487/493), respectively, and the combined specificity of the assay was 89.5% (17/19). The combined positive and negative predictive values of the assay were 99.7% (696/698) and 70.8% (17/24), respectively. Studies were also performed on spiked cultures to establish the specificity and performance sensitivity of the method. Staphylococcus Quick FISH has a turnaround time (TAT) of <30 min and a hands-on time (HOT) of <5 min. The ease and speed of the method have the potential to improve the accuracy of therapeutic intervention by providing S. aureus /CoNS identification simultaneously with Gram stain results.

Despite the fact that bacterial vaginosis (BV) is the most prevalent cause of symptomatic vaginal discharge in the United States 1,2 and is a risk factor for preterm birth 3 and acquisition of HIV, 4 its cause remains unknown and its treatment suboptimal. Not only are initial cure rates of BV poor, but recurrence rates are high. 5 Debate exists as to whether recurrences are due to relapse or reinfection. However, 1 hypothesis is that relapse may occur secondary to inadequate treatment of BV-associated organisms, either due to resistance of BV-associated organisms to metronidazole or to inadequate penetration of a biofilm community. 6,7 Anecdotally it is more difficult to eradicate BV in some women compared with others. Recent data substantiates this by the finding that women with more complicated vaginal flora reflected by higher Nugent scores (predominantly because of morphotypes consistent with Mobiluncus), are more likely to fail therapy than those with lower scores. 8 The presence of Mobiluncus spp. (M. curtisii and M. mulieris) in the vagina is highly specific although not sensitive for the diagnosis of BV. 9,10 Of the two, M. curtisii appears to predominate and in vitro is resistant to metronidazole, the most commonly used therapy for BV. 11 Therefore, recurrence of BV could be related to failure to clear this organism. Using specimens obtained from a prospective study of the treatment of BV, we determined if there was an association between persistence of M. curtisii and recurrence of BV at 65 to 70 days after completion of initial therapy. Vaginal swabs were collected during a prospective treatment study of BV. Women attending the Jefferson County Health Department STD Clinic with symptomatic BV were enrolled and treated for BV as previously described. 8 All women received metronidazole for 7 or 14 days plus or minus azithromycin. Subjects were reevaluated at 21, 35 to 40, and 65 to 70 days after beginning the study. Subjects were discontinued from the study upon recurrence of symptomatic BV but were followed if the BV was asymptomatic. Vaginal swabs for Gram stain and polymerase chain reaction (PCR) were collected at baseline and each followup visit. For this substudy we included only those women who had M. curtisii present at baseline as detected by PCR and who completed 3 follow-up visits for the main study. Recurrence of BV at 65 to 70 days was defined as a Nugent score of 7 to 10 at that followup visit regardless of symptoms. Persistence of M. curtisii was defined as the organism being present at baseline and at least one of the follow-up visits. Baseline characteristics of the subsample and larger cohort were compared by the chi-square test for categorical variables and the t test for continuous variables. The relationship between the persistence of M. curtisii the development of recurrence was examined by the chi-square test. A stratified analysis was used to examine the relationship between M. curtisii and

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