This is the first report of gonococci with high-level resistance to azithromycin circulating in Italy. Correlation between NG-MAST results and epidemiological data for some of the analysed strains and patients could be established. This study represents a reference point for future surveillance in Italy and suggests the need to add azithromycin to the antibiotic susceptibility panel for gonococci.

Background: Coeliac disease ( CD) is characterized by increased immunological responsiveness to ingested gliadin in genetically predisposed individuals. This genetic predisposition is not completely defined. A dysregulation of immunoglobulins (Ig) is present in CD: since antiendomysium antibodies (anti-EMA) are of the IgA class. One polymorphic enhancer within the locus control region (LCR) of the immunoglobulin heavy chain cluster at the 3' of the C alpha-1 gene was investigated. The correlation of the penetrance of the four different alleles of the HS1,2-A enhancer of the LCR-1 3' to C alpha-1 in CD patients compared to a control population was analysed. Methods: A total of 115 consecutive CD outpatients, on a gluten-free diet, and 248 healthy donors, age- and sex-matched, from the same geographical area were enrolled in the study. HS1,2-A allele frequencies were investigated by nested polymerase chain reaction (PCR). Results: The frequency of allele 2 of the enhancer HS1,2-A gene was increased by 30.8% as compared to the control frequency. The frequency of homozygosity for allele 2 was significantly increased in CD patients. Crude odds ratio ( OR) showed that those with 2/2 and 2/4 ( OR 2.63, P < 0.001 and OR 2.01, P = 0.03) have a significantly higher risk of developing the disease. In contrast, allele 1/2 may represent a protective genetic factor against CD ( OR 0.52, P = 0.01). Conclusions: These data provide further evidence of a genetic predisposition in CD. Because of the Ig dysregulation in CD, the enhancer HS1,2-A may be involved in the pathogenesis

The report of ceftriaxone-resistant isolates coupled with the emergence and spread of resistance to ciprofloxacin and azithromycin in Latin America and the Caribbean in the 2000s indicates the importance of active surveillance of N. gonorrhoeae antimicrobial susceptibility to determine antimicrobial resistance emerging trends so as to promptly inform and guide the development of effective treatment options for gonococcal infections.

The majority of Staphylococcus aureus infections from Isfahan, Iran, were caused by epidemic methicillinsusceptible S. aureus (MSSA) lineages, sequence type 8 (ST8), ST22, ST30, and ST6. The predominant methicillin-resistant S. aureus strain was ST239. We observed a high prevalence of Panton-Valentine leukocidin-positive MSSA strains (19.7%), which is a matter of considerable concern, since these strains have the ability to cause severe infections.

Neisseria gonorrhoeae is the etiological agent of gonorrhoea, an infectious disease characterized by acute inflammation of the urogenital tract with a massive infiltration of neutrophils. Polymorphonuclear leukocyte recruitment is one of the activities of the recently described interleukin-17A (IL-17A); thus, we analyzed the serum concentration of IL-17A, together with IL-23 and interferon-γ (IFN-γ), in 27 patients with gonorrhoea. The concentration of these cytokines in patients' sera was significantly higher than that detected in healthy controls and an inverse correlation was found between the concentrations of IL-17A and IFN-γ. This is the first report showing a significant increase of IL-17A and IL-23 serum levels in patients with gonorrhoea, suggesting new players in the immune response to N. gonorrhoeae.

Specific single or combined mutation patterns in penA, mtrR and porB and specific STs were associated with differences in susceptibility to ceftriaxone and cefixime.

Hepatitis C VIrUS (HCV) often has a more favorable course in younger patients. Considering the involution ofthe thymic function with age, we investigated the output of recent thymic emigrants (RTE) in HCV patients. To evaluate RTE, we used a competitive quantitative PCR in order to determine the percentages of cells with cj-T cell receptor excision circles (TREC). This study was performed in 14 HCV patients at diagnosis and before any anti-HCV treatment. The results obtained in this group were compared to those obtained in a group of age-matched controls. We found that in the 14 HCV patients naive for anti-HCV treatment the mean percentage of cj-TREC was 3%. We could not detect a correlation between the percentages of cj-TREC and age or patients' viremia. In contrast, in the 26 age-matched controls mean percentage of cj-TREC was 5.6% (P=O.OI). Our study describes a novel immune defect in HCV patients. Additional studies are needed to get further insight in the possible role ofTREC defect in the pathogenesis and prognosis ofthe disease.Hepatitis C virus infection (HCV) is a major issue in world public health, affecting approximately 2% of the world's population (1). The infection has a variable clinical course. The outcome has been related to the evolution of the viral quasispecies (2). Since HCV replicates in lymphatic tissue, several immunological disorders, linked to persistent antigenic stimulation, are associated to patients with chronic active hepatitis. Apart from the viral factors, the immune mechanisms responsible for the highly variable natural history in a given patient are only partially known. Some reports have pointed out a more favorable prognosis in younger patients (3-4). T-lymphocytes are of pivotal importance in host defense against viruses. T-cells are produced in the thymus and this organ undergoes a physiological involution with age.In the last decades, it became possible to evaluate the thymic output, measuring the T-cell receptor excision circles (TREC) present in the so called "recent thymic emigrants" (RTE) (5-6). TREC are DNA fragments representing a byproduct of T-cell receptor rearrangement; there are at least two possible molecules, named coding-joint (cj) and signal-joint (sj) TREC, each of which is produced in a defined moments of the intrathymic maturation of T cells. Since their DNA exists in a circular form, they are not duplicate during mitosis, but progressively diluted in peripheral blood T-cells. TREC are present only in virgin cells, i.e. those newly produced in the thymus, and thus their measurement allows the determination ofRTE. These cells have been proved to be altered in several clinical conditions, with clinical and prognostic implications (7-9).For these reasons, we aimed to verify the hypothesis of thymic impairment in patients with HCV infection by analysis of means of RTE in a prospective case-control study. 0394-6320 (2005) Copyright© by BIOLIFE,s.a.s. This publicationand/orarticleis for individualuse only and may not be further reproducedwithoutwrittenpermi...

The aim of this study was to examine tetracycline-resistant gonococci and to set up a real-time PCR method to identify, in the same assay, both the chromosomally and the plasmid-mediated tetracycline-resistant genotypes. A retrospective analysis for tetracycline susceptibility was performed by the E-test and agar dilution methods on 289 gonococci isolated in Italy from 2003 to 2005. Molecular mechanisms of resistance were investigated by both sequence analyses of the three main genes associated with chromosomally mediated resistance (mtrR, penB and rpsJ genes) and by the identification of plasmids carrying the tetM determinant associated with plasmid-mediated resistance, by PCR (American- or Dutch-type plasmids). The genetic relatedness of nonsusceptible strains was evaluated by pulsed field gel electrophoresis (PFGE). The results showed the presence of 22.5% tetracycline-resistant and 49.5% tetracycline-intermediate gonococci. Coexistence of chromosomally and plasmid-mediated resistance to tetracycline was observed in the majority of resistant isolates. No clonal structure was highlighted by analysis of PFGE pattern profiles. Real-time PCR assay was able to identify all the tetracycline nonsusceptible gonococci correctly for the presence of both chromosomally and/or plasmid-mediated genotypes.