The role of bacterial genes in the determination of the clinical spectrum of Campylobacter jejuni infection is unclear. We compared clinical isolates from invasive blood-stream infection with stool isolates from gastroenteritis and found no association of the putative virulence genes iam, capA, virB and cdtB with clinical presentation.

BACKGROUND AND STUDY AIMS: No previous studies have evaluated the ability of endoscopic ultrasonography to describe the anatomic location of lymph nodes on the basis of a node-to-node comparison. The aim of this study was to assess the feasibility and safety of a new endoscopic ultrasound (EUS)-guided fine-needle technique for marking lymph nodes. PATIENTS AND METHODS: Twenty-five patients with suspected or confirmed malignancies of the upper gastrointestinal tract were prospectively included. EUS-guided fine-needle marking (EUS-FNM) was performed with a silver pin with a diameter that allowed it to fit into a 19-gauge needle. The position of the pin was verified by EUS. End points were the ability to identify and isolate the marked lymph node during surgery and a comparison between the location of the pin as suggested by EUS and the actual location found in the resected specimen. RESULTS: Twenty-three lymph nodes were marked. Nineteen intended surgical isolations were performed. The lymph nodes were isolated in the resection specimens in 18 patients (95 %). In 2 out of 20 cases the pin was not localized by laparoscopic ultrasonography. In 89 % of the cases the marked lymph node was in the same location as described by EUS. One pin (5 %) was not retrieved. In three cases, a small hematoma was observed. There was no sign of long-term complications. CONCLUSION: EUS-FNM with a silver pin in lymph nodes is feasible and safe. EUS-FNM seems to be a suitable tool for evaluating lymph nodes on the basis of a node-to-node comparison.

ABSTRACT Until recently, Q fever was notified in very few numbers annually in Denmark and it was always believed to be acquired abroad. Preliminary reports now describe C. burnetii in milk samples from Danish dairy cattle. Serum samples of a large cohort of farmers, veterinarians, inseminators and hoof trimmers, all having occupational contact with dairy cattle, were tested for the presence of immunoglobulin G to phase I and phase II antigens of C. burnetii. In 39 of 359 study persons (11%) the presence of antibodies to C. burnetii was found. Veterinarians had the highest seropositive rate (36%). This survey suggests that C. burnetii is a recently acknowledged domestic infection in Denmark and that risk of infection is associated with occupation.

Summary. Acute hepatitis C virus (HCV) infection may lead to chronic HCV-infection with detectable HCV RNA or to spontaneous clearance with no HCV RNA, but detectable HCV antibodies. It is unknown whether HCV RNA status is associated with mortality in HIV-infected injection drug users (IDUs). We conducted a nationwide population-based cohort study to examine the impact of HCV RNA status on overall and cause-specific mortality in HIV-infected IDUs. We computed cumulative mortality and used Cox Regression to estimate mortality rate ratios (MRR). We identified 392 HIV-infected patients of whom 284 (72%) had chronic HCV-infection (HCV RNA positive patients) and 108 (28%) had cleared the HCV-infection (HCV RNA negative patients). During 1286 person-years of observation (PYR), 157 persons died (MR = 122/1000 PYR, 95% CI: 104-143). The estimated 5-year probabilities of survival were 0.58 (95% CI: 0.51-0.65) in the chronically HCV-infected and 0.52 (95% CI: 0.40-0.63) in the cleared HCV group. Chronic HCV-infection was not associated with overall mortality: MRR 0.85, 95% CI: 0.59-1.21. In HIV-infected Danish IDUs, chronic HCV-infection is not associated with increased mortality compared to patients who have cleared the infection.

Clin Microbiol InfectAbstract Invasive disease as a result of Campylobacter is rarely reported. We reviewed 46 cases of blood stream infection with Campylobacter in a Danish population with complete follow-up. The incidence was 2.9 per 1 million person-years with a peak incidence in the age group above 80 years. In the population, the ratio of notified bacteraemia/enteritis patients with Campylobacter infection was 0.004. Patients with bacteraemia were older and had higher comorbidity, e.g. alcoholism, immunosuppression, previous gastrointestinal surgery or HIV infection. We found 26% of blood isolates resistant to ciprofloxacin. The length of hospitalization was significantly longer in bacteraemia patients, whereas the outcome was favourable with 28-day mortality of 4% in bacteraemia patients and 1% in enteritis patients. None of the bacteraemia patients relapsed within 365-day follow-up.

Abstract Aim: Comorbidity has a major impact on short-term and long-term survival of colorectal cancer (CRC) and many CRC patients suffer from comorbidities. Mortality rates for comorbidities like cardio-respiratory diseases exhibit distinct seasonal variations with highest rates in the winter. Therefore, we hypothesized some seasonal variation in 30-day mortality after surgery for CRC as well. Methods: In a nationwide study, we examined the seasonal pattern in 30-day mortality after surgery for CRC from 1996 to 2006. We identified 33,556 CRC patients in the Danish hospital discharge registries. Monthly 30-day mortality rates were calculated and we constructed a fitted curve of the monthly mortality rates using a periodic regression model. We stratified the analyses for tumour site, urgency of surgery for colon cancer and the level of comorbidity based on American Society of Anaesthesiologists (ASA) score. Results: The overall 30-day mortality was 8.7%(95% CI: 8.4%-9.0%). Significant seasonal variation in monthly 30-day mortality could not be identified. For colon cancer, a non-significant increase was seen in July. An even higher increase in July was observed for CRC patients with moderate or severe comorbidity (ASA score >/=III), but was also non-significant. Conclusion: Although comorbidity is a well-known negative predictor of short-term survival of CRC, monthly 30-day mortality after surgery for CRC did not exhibit seasonal variation like that observed for comorbid conditions such as cardio-respiratory diseases.

SUMMARYWe evaluated magnitude of bacteraemia as a predictor of mortality, comprising all adult patients with a first-time mono-microbial bacteraemia. The number of positive bottles [1 (reference), 2, or 3] in the first positive blood culture (BC) was an index of magnitude of bacteraemia. We used Cox's regression analysis to determine age and comorbidity adjusted risk of mortality at days 0-7, 8-30, and 31-365. Of 6406 patients, 31.1% had BC index 1 (BCI 1), 18.3% BCI 2, and 50.6% BCI 3. BCI 3 patients had increased risk of mortality for days 0-7 (1.30, 95% CI 1.10-1.55) and days 8-30 (1.37, 95% CI 1.12-1.68), but not thereafter. However, in surgical patients mortality increased only beyond day 7 (8-30 days: 2.04, 95% CI 1.25-3.33; 31-365 days: 1.27, 95% CI 0.98-1.65). Thus, high magnitude of bacteraemia predicted mortality during the first month with a shift towards long-term mortality in surgical patients.

Three hundred fifty-seven isolates of Fusobacterium necrophorum from human infections in Denmark were consecutively collected over a 3 year period for the purpose of establishing the minimum requirements for rapid and reliable routine identification of Fusobacterium necrophorum using phenotypic characters. The first 40 isolates were fully characterized by the most common phenotypic tests mentioned in the literature, while the last 317 where identified solely by the established minimum requirements for rapid and reliable routine identification of Fusobacterium necrophorum. All but one isolate were identical in all phenotypic tests. The outlying strain differed in morphology and the ability to agglutinate erythrocytes. On the basis of our findings it should be possible within 3-4 days to identify and differentiate F. necrophorum from other species including other Fusobacterium spp. by the unique but subspecies specific colony morphology, susceptibility to kanamycin and metronidazole, the smell of butyric acid, chartreuse colour fluorescence, and beta-haemolysis on horse blood agar. Three-hundred fifty-six isolates were identified as F. necrophorum subsp. funduliforme while one strain was F. necrophorum subsp. necrophorum. The species and subspecies level was confirmed for the first 40 isolates by real-time PCR. MIC in mg/l was determined for the 40 isolates. MIC(90) was 0.047 for penicillin, 0.047 for clindamycin, 0.25 for metronidazole, 0.38 for cefuroxime,>32 for imipenem, 0.012 for meropenem, and 2 for erythromycin. All 357 isolates were susceptible to penicillin and metronidazole indicating that these antibiotics are still the drugs of choice in antibiotic therapy of F. necrophorum infections, but therapy with clindamycin may be an alternative. Erythromycin should be avoided.

A study was carried out to determine the efficacy of topical eprinomectin against nymphal infestation of Otobius megnini in cattle, where a group of 14 individuals were treated with a dose of 0.5mg/per kg of body weight applied on the dorsal midline, and a group of 14 individuals remained as control. Tick burdens between treated and control groups showed no statistically significant differences (P>0.05), and the mortality of the nymphs was similar in both groups (P: 0.828). All females obtained from nymphs of both groups were able to copulate with males from the corresponding group and laid eggs that produced visually normal larvae. The failure of eprinomectin and other biocides applied per os or by injection to control nymphs of O. megnini in cattle indicate that sanitary measures and applications of biocides into the ears would represent the most reasonable approach to control of this tick on cattle.

This study was performed with the aim of to investigate the infestation by the cat fur-mite Lynxacarus radovskyi in cats from Recife Metropolitan Region, State of Pernambuco, Brazil, during the period of May through December of 2003. Hair samples were taken from cats of both sexes and different ages and submitted to microscopical examination. The results showed that 75.84%(254/335) of cats were infested with L. radovskyi, but statistically significant differences were not observed among the presence of mite and sex, race and age. The results indicate that the mite L. radovskyi is endemic in this population.