We present the first clinical report of a Staphylococcus pseudintermedius infection in a human. Biochemically, S. pseudintermedius can be easily misidentified as S. aureus. Therefore, the final microbiological identification requires the combination of phenotypic and genotypic tests. CASE REPORTA 60-year-old male patient was referred to our center because of ischemic cardiomyopathy and ventricle tachycardia, for which he had received an implantable cardioverter-defibrillator (ICD) in January 2004. In addition, his medical history comprised arterial hypertension, hypercholesterolemia, and a prostate carcinoma. In August 2005, he presented with complaints of migration of the ICD device. No other symptoms of note were elicited. The patient was hemodynamically stable and afebrile (body temperature of 36.7°C). Hematological investigations revealed a hemoglobin level and platelet and leukocyte counts within the normal ranges. His C-reactive protein level was slightly increased, at 1.61 mg/liter (normal, 0 to 5 mg/liter). Clinical examination revealed a perforation of the ICD pocket. Infection was suspected by the presence of pus in the eroded pocket. The infected ICD was surgically removed, and several samples (the ventricular lead, pus, and a tissue sample from the pocket) were sent for culture.Gram staining of the pus showed gram-positive cocci. The specimens were plated onto sheep blood agar (BioMérieux, Benelux S.A./N.V.) and chocolate agar (BioMérieux), both incubated at 37°C in air supplemented with 5% CO 2 , and mannitol salt lipovitellinase agar (homemade), MacConkey agar (BioMérieux), and D-Coccosel agar (BioMérieux), all incubated at 37°C in air. In addition, thioglycolate broth (BD, Belgium) was inoculated and incubated at 37°C in air.
Due to poor harmonisation of RF and ACPA assays and of test result interpretation, RA classification according to 2010 ACR/EULAR criteria may vary when different assays are used.
A binary classification system has been established for group A rotaviruses, with the viral capsid protein VP7 defining G types and VP4 defining P types. At least 15 G types and 21 P types have been isolated globally with various G and P combinations. Most of the currently circulating human rotaviruses belong to G1P[8], G2P[4], G3P[8], and G4P[8]. We report a human rotavirus strain (B1711) with a novel genotypic VP7/VP4 combination of G6P[6]. This unique rotavirus was isolated from a 13-month-old human immunodeficiency virus (HIV)-negative child of an HIV-seropositive Malian mother that was hospitalized with severe diarrhea in Belgium after returning from a trip to Mali. The VP7 and VP4 genes of the rotavirus strain were sequenced, and phylogenetic trees were constructed. Nucleotide and amino acid sequence comparisons with 15 known G genotypes indicated that the VP7 sequence of strain B1711 was most closely related to an American (Se584) and an Italian (PA151) human G6 strain (95 to 96% nucleotide and 98% amino acid identity). Comparison of the VP4 sequence with 21 P types showed the closest similarity to P[6] genotypes, with greatest similarity to a G8P[6] Malawi strain (mw131) (97% nucleotide and 98% amino acid identity). The B1711 strain is the first reported rotavirus isolate with a G6P[6] genotypic combination. The discovery and surveillance of novel human and nonhuman rotavirus G or P types or of novel G/P combinations is essential for the design of future rotavirus vaccines and for our understanding of rotavirus diversity and evolution.Group A rotaviruses are the single most important etiological agent associated with gastroenteritis in infants and young children (2, 40). Rotavirus-associated diarrhea leads to more than 125 million cases of infantile gastroenteritis and 870,000 deaths each year, primarily in less developed countries (54). In the United States it also results in $274 million in medical care costs and a total of $1 billion in societal costs (including indirect cost of lost parental work time) per year (47). Rotaviruses contain 11 segments of double-stranded RNA within a core shell and are members of the Reoviridae family. Each segment encodes a single viral polypeptide, for a total of five nonstructural and six structural proteins (17). The two outer capsid proteins VP7 and VP4, which independently elicit neutralizing antibodies, are the basis of a binary classification system for rotaviruses: G types (derived from the VP7 glycoprotein) and P types (derived from the protease sensitive VP4 protein). Thus far, 15 different G genotypes and 21 different P genotypes have been reported (2,26,31,48). Because VP4 and VP7 are encoded by different RNA segments, various combinations of G and P types can be observed (40). Most G genotypes were serologically confirmed as serotypes (25). Due to the lack of appropriate antibody reagents, a dual P-typing system (P serotype and P genotype) has been used (18). Strains sharing more than 89% sequence identity at the amino acid level are considered to belong to...
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