. The objective of this study was to determine the association between the level of exposure to Burkholderia pseudomallei and the incidence rate of melioidosis and to survey the transmission modes of B. pseudomallei in the Er-Ren River Basin. The serosurveillance of melioidosis gave seropositivity rates of 36.6%, 21.6%, and 10.9%, respectively, for residents in regions A, B, and C within the Er-Ren Basin area. Culture and PCR-based detection of B. pseudomallei from soil demonstrated that the geographical distribution of this bacterium was confined to a particular site in region B. The distribution of seropositive titers was significantly associated with the incidence rate of melioidosis (120, 68, or 36 incidence cases per 100,000 population in region A, B, or C in 2005), whereas it did not correlate with the geographical distribution of B. pseudomallei within the soil. A survey of transmission modes showed that residents with seropositivity were linked to factors such as having confronted flooding and having walked barefoot on soil, which are potential risk factors associated with exposure to B. pseudomallei. Our findings indicated that the Er-Ren River Basin in Taiwan has the potential to become a high-prevalence area for melioidosis. This is the first report that documents a high prevalence of melioidosis in an area north of latitude 20°N.

No abstract

No abstract

No abstract

LETTERSsequencing. This infection rate is within the range (13.5%-90%) that has been reported for R. felis infecting Ctenocephalides fl eas in Brazil and Uruguay (2,3,7). Sixteen (72.7%) cats contained R. felis-reactive antibodies; 4 of them showed titers to R. felis at least 4-fold higher than those to the other 5 rickettsial strains, fi ndings that enabled us to technically conclude that these cats were exposed to R. felis or a closely related organism (1,7,9). Our fi nding of 70% R. felis infection in fl eas infesting the cats indicates that cats acquired the infection through infected fl eas. However, the mechanism of R. felis transmission by fl eas is yet to be demonstrated under experimental conditions.To our knowledge, the presence of R. felis, or a spotted fever group Rickettsia species, has not been reported in Chile. Recent investigations have provided clinical and serologic evidence of canine (10) and human (K. Abarca and J. Lopez, unpub. data) infection by spotted fever rickettsia in Chile, confi rmed by IFA that used R. conorii commercial antigen. Since substantial serologic cross-reaction occurs between R. conorii and R. felis antigens (1), R. felis could be causing infection in dogs or humans in Chile.

BackgroundWe examined the risk for Group B streptococcus (GBS)-related diseases in newborns born to mothers who participated in a universal GBS screening program and to determine whether differences are observed in factors affecting the morbidity for neonatal early-onset GBS-related diseases.MethodsThis is a retrospective study and the study subjects were women who had undergone GBS screening and who gave birth naturally and their newborns between April 15, 2012 and December 31, 2013. Data from the GBS screening system database and the National Health Insurance database were collected to calculate the GBS prevalence in pregnant women and morbidity of newborns with early-onset GBS-related diseases.ResultsThe GBS prevalence in pregnant women who gave birth naturally was 19.58%. The rate of early-onset infection caused by GBS in newborns decreased from the original 0.1% to 0.02%, a decrease of as high as 80%. After the implementation of the universal GBS screening program, only three factors, including positive GBS screening result (OR = 2.84), CCI (OR = 2.45), and preterm birth (OR = 4.81) affected the morbidity for neonatal early-onset GBS-related diseases, whereas other factors had no significant impact.ConclusionThe implementation of the universal GBS screening program decreased the infection rate of neonatal early-onset GBS diseases. The effects of socioeconomic factors and high-risk pregnancy on early-onset GBS infections were weakened.

Legionellosis (LG, infection by members of the genus Legionella) can range from mild respiratory illness to acute life-threatening pneumonia. The majority of LG cases are caused by Legionella pneumophila (LP), particularly serogroup 1 (18). Since the first outbreak in Philadelphia in 1976 (12), LP has been recognized as an important etiological agent of hospital-and community-acquired pneumonia. This microbe can survive in a wide range of temperature (5-65 C) and pH (5.5-9.5), particularly in warm and damp environments of 35-45 C which is their favorable growth temperature range. Because of their high survival rate in a thermal and wet environment, which happens to be the atmosphere regularly established in a whirlpool spa, numerous outbreaks of LG have been traced to the spa water as the source of their causative agents (2,17,20,21,23,31).Tracing the source of LG was often determined by linking environmental isolates to clinical isolates by various molecular subtyping methods, of which at least 7 kinds have been reported (15). Among them, amplified fragment length polymorphism (AFLP) and pulsefield gel electrophoresis (PFGE) were two methods most often used and highly recommended (3, 13).

A total of 522 Streptococcus pneumoniae invasive isolates from diverse sources were collected from January 2002 to December 2003 in Taiwan in order to understand the serotype distribution of invasive isolates in Taiwan. The most frequently isolated serotypes of S. pneumoniae were types 14 (18?4 %), 23F (15?1 %), 3 (13?8 %), 19F (13?4 %), 6B (8?2 %), 9V (3?6 %) and 4 (2?5 %). The majority of cases were either under 5 years of age (24?1 %) or older than 65 years (36?6 %). Serotype distribution in adults aged over 14 years and children aged under 2 years was similar, except for that of type 3, which was more prevalent in adults. Penicillin-non-susceptible strains accounted for 67?7 % of all strains and were the predominant strains of serotypes 23F, 19F, 6B and 14. Most strains were susceptible to cephem drug, 85?7 % of isolates were susceptible to cefotaxime and 92?9 % were susceptible to ceftriaxone. A total of 72?6 % (379/522) of the isolates were resistant to at least two antibiotics. The 23-valent vaccine in the current commercial market would cover 87?2 % of the serotypes and 100 % of the penicillin-non-susceptible serotypes of S. pneumoniae in Taiwan. The coverage of 7-and 11-valent protein conjugate vaccines of the serotypes in children under 2 years of age would be 78?8 and 86?5 %, respectively. These results will help to assess the adequacy of the vaccine formulations marketed in Taiwan.