Nine of 10 strains of Actinobaculum schaalii caused urinary tract infections in predisposed individuals. Identification included 16S rRNA gene sequence analysis and use of the API Coryne and Rapid ID32A test systems. A. schaalii is easily overlooked due to its slow growth in ambient air and its resemblance to the normal bacterial flora on skin and mucosa.The genus Actinobaculum, first described in 1997, includes the Actinobaculum suis and Actinobaculum schaalii species. A. suis is an important cause of urinary tract infections (UTIs) and abortions in sows and was formerly assigned to a variety of genera, including Corynebacterium, Eubacterium, and Actinomyces (9, 17). A. schaalii is a new species recovered from human blood and urine and is suspected to cause UTIs (9, 12). Two newly described species, Actinobaculum massiliae and Actinobaculum urinale, were recovered from the urine of elderly women with chronic cystitis (6, 7). A. massiliae is also described as a new cause of superficial skin infections (16). Problems with identifying Actinobaculum spp. with traditional phenotypic tests have obscured their pathological role for many years. We describe 10 cases of A. schaalii infections.Nine strains of A. schaalii were available for growth, biochemical, and susceptibility tests. The strains were cultured on nine different culture media at 35°C in ambient air, in air with 5% CO 2 , and anaerobically. The media were 5% Columbia sheep blood agar (Becton Dickinson [BD], Heidelberg, Germany), 5% and 10% horse blood agar (Statens Serum Institut [SSI], Copenhagen, Denmark), chocolate agar (SSI), Brucella blood agar with hemin and vitamin K1 (BD), anaerobic plates (SSI), nutrient agar plates (SSI), semisolid agar containing pepsin blood and thioglycolate (SSI), and serum broth (SSI). The CAMP reaction was performed on CAMP plates containing sheep erythrocytes (SSI) with a streak of a beta-hemolytic strain of Staphylococcus aureus. The strains were characterized by using the API Coryne and Rapid ID32A systems in accordance with the manufacturer's instructions (API bioMérieux, Marcy l'Etoile, France). Carbohydrate fermentation reactions were read after 24 and 48 h of incubation.A Quantitect SYBR green kit (QIAGEN) was used with real-time PCR mixtures (50-l total volume) containing 1ϫ PCR buffer and a 200 M concentration of each primer. The primers used for amplification of the 16S rRNA gene, BSF-8 (5Ј-AGAGTTTGATCCTGGCTCAG-3Ј) and BSR-534 (5Ј-ATTACCGCGGCTGCTGGC-3Ј), produced a 526-bp fragment of the 16S rRNA gene. Samples of 1 and 5 l were tested by PCR. PCRs were performed by using an Opticon DNA engine (MJ Research). The amplification profile included incubation at 95°C for 15 min followed by 40 cycles at 94°C for 30 s, 55°C for 30 s, and 72°C for 30 s. PCR samples were spin column purified using Microcon YM-100 filter units (Millipore) for DNA sequencing. DNA strands of the amplicons were sequenced on an ABI PRISM 3100 Avant genetic analyzer (Applied Biosystems) using BSF-8 and BSR-534 as sequencing primers and a BigDye v....

Cryptosporidium parvum causes persistent diarrhea in young children in developing countries. To determine the interaction between nutritional status and cryptosporidiosis, an open cohort of 1064 children younger than 3 y of age was followed for 1441 child-years by weekly diarrhea recall visits. A total of 5072 weight and 4264 height measurements was made. There were no tendencies of low weight (P = 0.38) or height (P = 0.16) in children who acquired cryptosporidiosis. Cryptosporidiosis in infancy was accompanied by an estimated weight loss of 392 g (95% CI: 247, 538 g) in boys and 294 g (95% CI: 109, 479 g) in girls, corresponding to 3.7% and 2.9% of mean weight, respectively, at 2 y of age. No significant catch-up growth covered for this loss in weight. A similar effect in linear growth was shown (P = 0.02). Although it has been suggested that the effect of infections on nutrition is usually transient because of catch-up growth, the present study suggests that cryptosporidiosis in infancy has a permanent effect on growth.

No abstract

A potential enteropathogen was found in 50% of 1219 diarrheal episodes and 48% of 511 asymptomatic controls in a 1-year community study of childhood diarrhea. Rotavirus (3% of episodes), Cryptosporidium species (6%), and enteropathogenic Escherichia coli (EPEC) with EPEC adherence factor (4%) were more prevalent in cases than controls. Giardia lamblia (19%) was the most prevalent organism but was not associated with diarrhea. Enterotoxigenic E. coli (12%), Strongyloides stercoralis (5%), Shigella species (2%), Entamoeba histolytica trophozoites (2%), and Vibrio cholerae (1%) were found at nonsignificantly higher rates. Salmonella and Campylobacter species were more prevalent among control infants. Cryptosporidium species and sequential infections from other pathogens caused persistent diarrhea.

ment would need to be examined. It is important that women without cervical intraepithelial neoplasia and perhaps those with cervical intraepithelial neoplasia grade I, are not overtreated; a randomised trial is needed to address this issue.In conclusion, this study shows that cytological surveillance is not an efficient strategy for managing women with mildly abnormal smears and that women with any grade of dyskaryosis should be referred for colposcopy. We 8 Richart RM, Barron BA. A follow-up study of patients with cervical dyskaryosis. AmJ Obstet Gynecol 1969;105:386-93. 9 Nasiell K, Roger V, Nasiell M. Behaviour of mild cervical dysplasia during long term follow up. AmJ Obstet Gynecol 1986;67:665-9. 10 Fletcher A, Mehaxes N, Grubb G, Chamberlain J. Four and a half years' follow up ofwomen with dyskaryotic cervical smears. BMJ 1990;301:641-4 Subjects-849 children aged less than 3 years. Main outcome measures-Incidence and duration ofdiarrhoea, weight for age, and death ofa child.Results-The incidence of diarrhoea was higher in weaned children than in partially breast fed children, both in 1 year olds (relative risk 1*41; 95% confidence interval 123 to 1.62) and in 2 year olds (1.67; 1-29 to 2.15). The mean duration of an episode of diarrhoea was 5'3 days in breast fed children compared with 6-3 days in weaned children (P= 0.001). Independent of the age of weaning, a similar increase was found in an analysis comparing, for each child, the rate and duration of diarrhoea one month before and one month after weaning. Children with low weight for age were breast fed longer than the better nourished children (P=0.02). Children aged 12-35 months who were not breast fed had a 3'5 times higher mortality (1.4 to 8.3) than breast fed children.Conclusions-The beneficial effects of breast feeding are not restricted to infancy. Though children who are partially breast fed after infancy may have a lower state of nutrition than the weaned ones, the benefit in terms of lower morbidity may be more important for child survival in places with a high morbidity from diarrhoea and with high mortality.