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OBJECTIVE: To determine the effect of Plasmodium chabaudi infection on the plasma level of circulating immune complexes (CICs), haemoglobin (Hb) content, urine profile, and histological features of female BWF1 mice, the murine model of systemic lupus erythematosus (SLE). MATERIALS AND METHODS: A total of 30 female BWF1 lupus mice were randomly divided into three groups as follows: group (I) control group (P. chabaudi uninfected); group (II) lupus mice infected with live P. chabaudi; group (III) lupus mice infected with irradiated P. chabaudi. Urine samples were daily collected from the second week-post infection. Mice from the three groups were killed at day 14 post-infection and heparinized blood was collected for further haemoglobin contents and plasma analysis. Paraffin-embedded kidney, liver, lung, heart, brain, ovary and skin tissues were stained with Hematoxylin and Eosin (H&E) and examined under light microscope. RESULTS: Our results reveal that infection of lupus mice with live P. chabaudi was associated with an increase in urinary Hb and a decrease in plasma Hb and CIC levels. Interestingly, infection of lupus mice with live P. chabaudi ameliorates the histopathological alterations mediated by lupus disease in kidney tissues. Although no parasite sequestration was observed in any of the investigated organs, P. chabaudi pigment deposition was observed in the liver of both live and irradiated P. chabaudi infected groups. CONCLUSIONS: This study in lupus prone BWF1 mice indicated that gamma-irradiated P. chabaudi infection has the desired lupus ameliorating effect without negative effects of malaria which assist the understanding of different responses to plasmodium sp. infection in human lupus patients.

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In an aquatic environment, there is a profound and inverse relationship between environmental quality and disease status of fish. Parasites are one of the most serious limiting factors in aquaculture. Therefore, the present investigation was carried out during the period of February-December 2014 to determine the parasitic infections in the African sharptooth catfish Clarias gariepinus, relative to the capability of internal parasites to accumulate heavy metals. Up to 100 catfish were examined for gastrointestinal helminths and 38% of fish were found to be infected with the cestode Polyonchobothrium clarias. The morphology of this parasite species, based on light and scanning electron microscopy, revealed that the adult worm was characterized by a rectangular scolex measuring 0.43-0.58 (0.49 ± 0.1) mm long and 0.15-0.21 (0.19 ± 0.1) mm wide, with a flat to slightly raised rostellum armed with a crown with two semicircles each bearing 13-15 hooks, followed by immature, mature and gravid proglottids which were about 29-55 (45), 16-30 (24) and 15-39 (28) in number, respectively. The mature proglottid contained a single set of genitalia in which medullary testes measured 0.09-0.13 (0.11 ± 0.01) mm long and 0.05-0.08 (0.06 ± 0.01) mm wide; a bi-lobed ovary was situated near the posterior margin of the proglottid, extending laterally up to the longitudinal excretory canals; the tubular uterus arose from the ootype up to the anterior margin of the proglottid; and vitelline follicles were cortical. The greater portion of the gravid proglottid was occupied by a uterus filled with unoperculate and embryonated eggs. Chemical analysis confirmed that the concentrations of heavy metals (Zn, Cu, Mn, Cd, Ni and Pb) accumulated in P. clarias were higher than in fish tissues and values recommended by FAO/WHO, with the exception of Zn, which was found to be higher in fish kidneys than in the cestode. This supports the hypothesis that cestodes of fish can be regarded as useful bioindicators when evaluating the environmental pollution of aquatic ecosystems by heavy metals.

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The present study represents the first report on the gastrointestinal parasite fauna infecting the free-living and alive Indo-Pacific bottlenose dolphins (Tursiops aduncus) inhabiting waters of the Red Sea at Hurghada, Egypt. A total of 94 individual faecal samples of the examined bottlenose dolphins were collected during several diving expeditions within their natural habitats. Using classical parasitological techniques, such as sodium acetate acetic acid formalin method, carbol fuchsin-stained faecal smears, coproantigen ELISA, PCR and macroscopical analyses, the study revealed infections with 21 different parasite species belonging to protozoans and metazoans with some of them bearing zoonotic and/or pathogenic potential. Four identified parasite species are potential zoonotic species (Giardia spp., Cryptosporidium spp., Diphyllobothrium spp., Ascaridida indet.); three of them are known to have high pathogenic potential for the examined dolphin species (Nasitrema attenuata, Zalophotrema spp. and Pholeter gastrophilus) and some appear to be directly associated with stranding events. In detail, the study indicates stages of ten protozoan species (Giardia spp., Sarcocystis spp., Isospora (like) spp., Cystoisospora (like) spp., Ciliata indet. I and II, Holotricha indet., Dinoflagellata indet., Hexamita (like) spp., Cryptosporidium spp.), seven trematode species (N. attenuata, Nasitrema spp. I and II, Zalophotrema curilensis, Zalophotrema spp., Pholeter gastrophilus, Trematoda indet.), one cestode species (Diphyllobothrium spp.), two nematode species (Ascaridida indet, Capillaria spp.) and one crustacean parasite (Cymothoidae indet.). Additionally, we molecularly identified adult worms of Anisakis typica in individual dolphin vomitus samples by molecular analyses. A. typica is a common parasite of various dolphin species of warmer temperate and tropical waters and has not been attributed as food-borne parasitic zoonoses so far. Overall, these parasitological findings include ten new host records for T. aduncus (i.e. in case of Giardia spp., Sarcocystis spp., Cryptosporidium spp., Nasitrema spp., Zalophotrema spp., Pholeter gastrophilus, A. typica, Capillaria spp., Diphyllobothrium spp. and Cymothoidae indet.). The present results may be used as a baseline for future monitoring studies targeting the impact of climate or other environmental changes on dolphin's health conditions and therefore contribute to the protection of these fascinating marine mammals.

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Five new myxosporean species belonging to three different genera were described from the Nile tilapia Oreochromis niloticus in Bahr Shebin, Nile Tributary, Nile Delta, Egypt. These species are: Zschokkella nilei sp. n., Ortholinea africanus sp. n., Triangula egyptica sp. n., Myxobolus fomenai sp. n., and Myxobolus branchiophilus sp. n. Morphometry, light microscopy, and hand drawing of mature spores and plasmodia were presented for each species.

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Four new Ceratomyxa species were described from the gallbladder of four Red Sea fishes at Suez and Hurghada, Egypt. These species are Ceratomyxa bassoni sp. n. from Plectorhinchus gaterinus (Forsskal 1775) at Suez and Hurghada, Ceratomyxa entzerothi sp. n. from Valamugil seheli (Forsskal 1775) at Suez and Hurghada, Ceratomyxa swaisi sp. n. from Saurida undosquamis (Richardson 1848) at Suez only and Ceratomyxa hurghadensis sp. n. from Fistularia commersonii Ruppell 1838 at Hurghada only. Their taxonomic affinities to other species are discussed.

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Zschokkella helmii n. sp., a new parasite of Siganus rivulatus from the Red Sea, Egypt, was described using light and transmission electron microscopy. However, the infection was severe; single "histozoic" plasmodium was encountered in the gallbladder wall. Spores are ellipsoid with 9-11 valvar striations. Spore mean length is 10.8 microm (10.0-11.0), while the spore mean width is 7.5 microm (7.0-8.0). Polar capsules are nearly round with a diameter of 2.2 microm (2.0-3.0) and have five filaments. Ultrastructure of the plasmodial wall and sporogenesis of the present species followed the usual pattern valid for most studied myxosporean species.

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A new multivalvulid species, Kudoa pagrusi sp. n., was described from the sea bream Pagrus pagrus. The cysts were oval to ellipsoidal and restricted to the cardiac muscles. The mean spore measurements were 7.0 microm in length and 6.4 microm in width as well as in thickness, while the mean polar capsule measurements were 3.7 microm in length and 1.5 microm in width. The ultrastructural features of the present species proved that the spore have four polar capsules with four shell valves that are the main criteria for genus Kudoa.

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A new myxosporean parasite, Myxobolus lubati n. sp., was described from the wall of the intestine of haffara seabream Rhabdosargus haffara (Forsskal 1775), Red Sea, Egypt. Macroscopic plasmodia of about 300 mum diameter were located in the circular muscle layer of the intestine. The spores were ovoid and sometimes ellipsoid and measured 9.8 x 7.2 mum. The shell wall of the spore was thickened at the posterior end and marked with 5-7 sutural markings. Polar capsules were equal and pyriform with three polar filament turns situated in the posterior half of the polar capsule. Polar capsules measured 4.2 x 1.6 mum. Histological evaluation of the infection revealed a slight distention of the intestinal layer of muscularis. Ultrastructure of the plasmodial wall and sporogenesis of the present species followed the usual pattern valid for most studied myxosporean species.

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A new myxosporean parasite, Myxobolus stomum n. sp., is described from the oral cavity and lips of the blackspotted grunt Plectorhynicus gaterinus (Forsskal, 1775) in the Red Sea, Egypt. The parasite was observed as tiny aggregates of whitish cysts hardly noticed within the muscles of the oral cavity, especially within the lips. The spores were subspherical and measured 8.5x6.5 microm. Polar capsules were equal, pear-shaped, occupied about half of the spore length and measured 4.4x2.4 microm. Histological evaluation of the infection revealed no significant impact on the host. The ultrastructure of the plasmodial wall and sporogenesis of the present species followed the usual pattern valid for most studied myxosporean species.

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The prevalence of Sarcocystis infection among skinks, Scincus mitranus, was studied for the first time. Grossly macroscopic sarcocysts were found to infect the skeletal muscles of the skink (infection rate: 4.16%). Fecal examination for the presence of sporocysts was negative in this study. Sarcocysts were studied using light and transmission electron microscopes. Mature sarcocysts measuring 0.05-0.3 x 0.5-1.8 mm (mean 0.1 5x 1.2 mm) were observed. The characteristic primary cyst wall, with long, finger-like, non-branched and non-stalked protrusions, is described. The ground substance gives rise to numerous thick septa dividing the interior of the cyst into chamber-like compartments. Zoites, including metrocytes and merozoites, were found to have the main architecture of Apicomplexa. Peculiarities of these elements and the importance of the primary cyst-wall ultrastructure for identification and specification of Sarcocystis are discussed. Secondary cyst wall was completely absent. Alterations in the infected host cell were observed.

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Moxifloxacin, an 8-methoxyquinolone with broad-spectrum activity in vitro, was studied in the rabbit model of Escherichia coli meningitis. The purposes of this study were to evaluate the bactericidal effectiveness and the pharmacodynamic profile of moxifloxacin in cerebrospinal fluid (CSF) and to compare the bactericidal activity with that of ceftriaxone and meropenem therapy. After induction of meningitis, animals were given single doses of 10, 20, and 40 mg/kg or divided-dose regimens of 5, 10, and 20 mg/kg twice, separated by 6 h. After single doses, the penetration of moxifloxacin into purulent CSF, measured as percentage of the area under the concentration-time curve (AUC) in CSF relative to the AUC in plasma, was approximately 50%. After single doses of 10, 20, and 40 mg/kg, the maximum CSF concentration (C(max)) values were 1.8, 4.2, and 4.9 microg/ml, respectively; the AUC values (total drug) were 13.4, 25.4, and 27.1 microg/ml x h, respectively, and the half-life values (t(1/2)) were 6.7, 6.6, and 4.7 h, respectively. The bacterial killing in CSF for moxifloxacin, calculated as the Deltalog(10) CFU per milliliter per hour, at 3, 6, and 12 h after single doses of 10, 20, and 40 mg/kg were -5.70, -6.62, and -7.02; -7.37, -7.37, and -6.87; and -6.62, -6.62, and -6.62, respectively, whereas those of ceftriaxone and meropenem were -4.18, -5.24, and -4.43, and -3.64, -3.59, and -4.12, respectively. The CSF pharmacodynamic indices of AUC/MBC and C(max)/MBC were interrelated (r = 0.81); there was less correlation with T > MBC (r = 0.74). In this model, therapy with moxifloxacin appears to be at least as effective as ceftriaxone and more effective than meropenem therapy in eradicating E. coli from CSF.

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BMS-284756 is a novel des-fluoro(6) quinolone with a broad antimicrobial activity, including Streptococcus pneumoniae. The purpose of this study was to evaluate the pharmacodynamic profile and effectiveness of BMS-284756 for therapy of experimental meningitis caused by penicillin- and cephalosporin-resistant S. pneumoniae (CRSP). Meningitis was induced in rabbits by intracisternal inoculation of CRSP. BMS-284756 was given intravenously 16 h after intracisternal inoculation in single doses of 2.5 (n = 5 animals), 5 (n = 6), 10 (n = 6), 20 (n = 8), and 30 mg/kg (n = 6), in two doses of 10 mg/kg each separated by 5 h (n = 4), and as a 20-mg/kg dose followed 5 h later by 10 mg/kg (n = 5). The MICs and MBCs of BMS-284756, ceftriaxone, and vancomycin were 0.06 and 0.06, 4 and 4, and 0.25 and 0.25 microg/ml, respectively. After single doses of 10, 20, and 30 mg/kg, the maximum concentrations in cerebrospinal fluid (CSF) (mean +/- standard deviation) were 0.32 +/- 0.12, 0.81 +/- 0.38, and 1.08 +/- 0.43 microg/ml, respectively; the elimination half-life in CSF was 4.5 to 6.3 h. The CSF bacterial killing rates (BKR) at 5 h of the single-dose regimens of 10, 20 and 30 mg/kg were -0.84 +/- 0.48, -1.09 +/- 0.32, and -1.35 +/- 0.05 Deltalog(10) CFU/ml/h. The BKR(0-5) of the divided regimens (10 mg/kg twice and 20 mg/kg followed by 10 mg/kg) was -0.82 +/- 0.52 and -1.24 +/- 0.34 Deltalog(10) CFU/ml/h, respectively. The BKR(0-5) of the combined therapy with vancomycin and ceftriaxone was -1.09 +/- 0.39 Deltalog(10) CFU/ml/h. The penetration of BMS-284756 into purulent CSF relative to plasma was 14 to 25%. The bactericidal effect of BMS-284756 in CSF was concentration dependent. BMS-284756 at 30 mg/kg as a single or divided dose was as effective as standard therapy with vancomycin and ceftriaxone.

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BACKGROUND: In the preantibiotic era acute mastoiditis was the most common complication of acute otitis media, often resulting in substantial morbidity and mortality. Since 1989 several investigators have documented an increased frequency of acute mastoiditis in children. METHODS: The medical records of all children with a discharge diagnosis of acute mastoiditis, managed at Children's Medical Center, Dallas, TX, from 1983 through 1999 were reviewed. RESULTS: There were 57 cases of acute mastoiditis during the 17-year period of 1983 through 1999 compared with 57 cases in a 25-year period of 1955 through 1979 reported previously at the same institution. The number of cases of acute mastoiditis per 10,000 hospital admissions increased significantly (regression analysis P = 0.003) during the more recent 17 years. From 1993 through 1999 there were 4.5 cases or more per 10,000 admissions each year, whereas from 1983 through 1992, the incidence never exceeded 4.3 cases per 10,000 admissions (P = 0.018). The median age of the patients was 48 months. Twenty-two patients (38.5%) were younger than 24 months; 17 of these were 12 months of age or younger. Twenty-two (38.5%) patients had no history of previous episodes of acute otitis media. Streptococcus pneumoniae was the pathogen most often isolated from the cultures. Complications of mastoiditis occurred in 20 children (35%). CONCLUSIONS: We conclude that acute mastoiditis continues to be a problem in the post antibiotic era. It occurs mainly in young children and can be the first evidence of ear disease.

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The effect of antibiotic therapy on nasopharyngeal colonization by Streptococcus pneumoniae and Haemophilus influenzae was evaluated in children diagnosed with acute otitis media. Children were randomly assigned to receive either amoxicillin/clavulanate or azithromycin therapy, and nasopharyngeal swabs were obtained for culture before and after starting therapy. Amoxicillin/clavulanate therapy eradicated or suppressed all strains of S. pneumoniae susceptible to penicillin, 75% of strains with intermediate resistance, and 40% of strains resistant to penicillin. Azithromycin therapy cleared two-thirds of azithromycin-susceptible strains of S. pneumoniae but none of azithromycin-nonsusceptible strains. Selection for antibiotic-resistant strains in individual children was not observed in children who received amoxicillin/clavulanate therapy but was observed in 2 children who received azithromycin therapy. Carriage of H. influenzae was also reduced by antimicrobial therapy but more so by amoxicillin/clavulanate. Antibiotic therapy does not directly increase the number of resistant strains in the population but, by eradicating susceptible strains, allows greater opportunity for carriage and spread of resistant strains.

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An immunocompetent murine model of pneumococcal pneumonia and bacteremia was used to evaluate a PCR assay based on amplification of the pneumolysin gene. Mice were treated with trovafloxacin to determine the decline in sensitivity of PCR as lung bacterial concentrations decreased and blood cultures became sterile. Forty-three mice were studied for up to 120 h after start of antibiotic treatment. PCR of buffy coat specimens was more sensitive than PCR of plasma. Only 21% of animals had a positive blood culture, whereas 77% of PCR buffy coat assays were positive. After 48 h of therapy all blood culture specimens were sterile, whereas buffy coat PCR was positive in 57.8% of specimens. PCR of buffy coat specimens was negative in all mice colonized nasally with Streptococcus pneumoniae and in rabbits with Escherichia coli bacteremia. Our results demonstrate that our PCR technique using buffy coat specimens is highly specific for invasive pneumococcal disease and remains positive in the majority of animals for at least 48 h after start of antibiotic therapy.

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OBJECTIVE: We compared colonization and resistance rates of non-pneumococcal alpha-hemolytic streptococci (AHS) and Streptococcus pneumoniae in children receiving antibiotic therapy for acute otitis media. STUDY DESIGN: Between December 1997 and September 1998, children 6 months to 6 years of age, diagnosed with acute otitis media were randomly assigned to receive amoxicillin/clavulanate (Augmentin) 45 mg/kg/d in 2 divided doses for 10 days or azithromycin (Zithromax), 10 mg/kg, once on the first day, followed by 5 mg/kg daily for 4 days. Nasopharyngeal swabs for culture were obtained before and at 2 weeks and 2 months after the start of therapy. Streptococci were identified by species, and antibiotic susceptibility was determined by the epsilometric test. RESULTS: One hundred six children completed the 2-week follow-up and 2-month follow-up, respectively. The nasopharyngeal carriage rate of non-pneumococcal AHS increased from 14% before treatment to 32% at the 2-week follow-up (P =.02) and was similar in both treatment groups. In contrast, the carriage of S pneumoniae decreased from 51% before therapy to 27% at the 2-week follow-up (P =.002). The carriage of penicillin-resistant AHS strains (minimum inhibitory concentration > 1 microg/mL) increased from 9% before treatment to 26% at 2 weeks and 36% at 2 months. CONCLUSIONS: Amoxicillin/clavulanate and azithromycin therapy resulted in increased isolation of nasopharyngeal non-pneumococcal AHS, many of which were multidrug-resistant, in contrast to a decrease in pneumococcal carriage. This suggests that the competitive balance between these 2 groups of organisms was disturbed as a result of differential antibiotic susceptibility. The importance of drug-resistant AHS as a reservoir for resistance genes for S pneumoniae warrants further investigation.

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The effectiveness of gatifloxacin therapy (15 mg/kg every 5 h [q5h]) was compared with that of meropenem (75 mg/kg q5h) and cefotaxime (75 mg/kg q5h) therapy in experimental meningitis caused by a beta-lactamase-producing strain of Escherichia coli. Gatifloxacin therapy was more rapidly bactericidal than cefotaxime but similar to meropenem therapy (bacterial killing rates at 5 h, 0.83 +/- 0.26, 0. 46 +/- 0.3, and 0.73 +/- 0.17 CFU/ml/h, respectively; P = 0.03 for gatifloxacin versus cefotaxime). At 10 h, seven of eight animals treated with gatifloxacin had <10 CFU/ml in their cerebrospinal fluid, compared with one of seven treated with cefotaxime therapy (P = 0.01). Gatifloxacin was at least as effective as currently available antibiotics in this model of E. coli meningitis.

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Trovafloxacin is a potentially useful agent for treatment of infections caused by cephalosporin-resistant Streptococcus pneumoniae. We studied the effectiveness of trovafloxacin therapy and examined the correlation between pharmacodynamic indices in serum and lung, and bacterial killing. Immunocompetent Balb/c mice were infected by intranasal inoculation of a cephalosporin-resistant S. pneumoniae isolate (MIC of ceftriaxone and trovafloxacin 2 and 0.06 mg/L, respectively). Trovafloxacin 10-30 mg/kg/day in one or three divided doses was started 15 h after infection. Serum and lung drug concentrations were measured at multiple time points for 24 h. Serum concentrations peaked at 30-60 min and lung concentrations approximately 30 min later. The serum T1/2 was approximately 9 h and lung T1/2 varied from 5 to 9 h. Lung AUC and Cmax values were 2-3 times greater than those in serum. At the start of therapy lung bacterial concentrations were 8.4 +/- 0.3 log10 cfu/mL and 24 h later had decreased by 3.5 +/- 0.2, 4.0 +/- 0.2, 0.8 +/- 0.3 and 1.0 +/- 1.2 log10 cfu/mL with 30 mg/kg x 1, 10 mg/kg x 3, 10 mg/kg x 1 and 3.3 mg/kg x 3 regimens, respectively. Although the larger dosages were more effective (P < 0.001) the differences between divided and single dosage regimens were not significant. Trovafloxacin serum AUC/MIC ratio correlated best with bacterial killing in the lungs over 24 h. Trovafloxacin is likely to be useful in the treatment of cephalosporin-resistant S. pneumoniae pneumonia.

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