These findings demonstrate that the incidence of MRSA is higher than previously reported and that hospital contact is the single most important risk factor for the acquisition of MRSA in our community. Screening for MRSA in previously hospitalized patients at the time of hospitalization may reduce nosocomial spread and indirectly reduce the incidence of MRSA in the community.
1. Low-temperature difference spectra of gradient-purified mitochondria of Acanthamoeba castellanii reveal the presence of cytochromes b-555, b-562 and c-549, with a-type cytochromes having a broad asymmetrical maximum at 602 nm; these components were also observed in specta of whole cells. 2. The a-type cytochromes are unusual in that they have split Soret absorption maxima (at 442 and 449 nm) and an uncharacteristic CO difference spectrum. 3. CO difference spectra of whole cells and 'microsomal' membranes show large amounts of cytochrome P-420 compared with cytochrome P-450. 4. Difference spectra in the presence of cyanide indicate the presence of an a-type cytochrome and two cyanide-reacting components, one of which may be cytochrome a3. 5. Whole-cell respiration in a N2/O2 (19:1) atmosphere was decreased by 50%, suggesting the presence of a low-affinity oxidase. This lowered respiration is inhibited by 50% by CO, and the inhibition is partially light-reversible; photochemical action spectra suggest that cytochrome a3 contributes to this release of inhibition. Other CO-reacting oxidases are also present. 6. The results are discussed with the view that cytochrome a3 is present in A. castellanii, but its identification in CO difference spectra is obscured by other component(s).
We studied 557 nonduplicate fresh stool specimens from adult patients clinically suspected of having Clostridium difficile-associated diarrhea. All samples were tested in parallel with an in-house cytotoxin B tissue culture assay (CTA), the C DIFFICILE TOX A/B II test (TA/B; TechLab, Blacksburg, VA), and the Triage Micro C DIFFICILE Panel (Biosite Diagnostics, San Diego, CA). The Triage device detects toxin A (TA) and glutamate dehydrogenase (GDH) simultaneously. Of the specimens, 350 were negative and 95 were positive for all markers. Another 112 specimens yielded discrepant results. The CTA found 143 positive specimens. Results of the components of the Triage and TA/B were compared separately with those of CTA. GDH was the most sensitive but least specific marker, whereas TA and TA/B were less sensitive but highly specific. Because of these attributes and a quick turnaround time, GDH would be the best screening test for C difficile-associated diarrhea. CTA detected the highest number of cases of C difficile-associated diarrhea and would be most useful as a confirmatory test for GDH-positive and TA-negative specimens.
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