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Issue Cover for Volume 6, Number 5—October 2000

Volume 6, Number 5—October 2000

[PDF - 3.39 MB - 126 pages]

Perspective

Competitive Exclusion of Salmonella Enteritidis by Salmonella Gallinarum in Poultry [PDF - 45 KB - 6 pages]
W. Rabsch et al.

Salmonella Enteritidis emerged as a major egg-associated pathogen in the late 20th century. Epidemiologic data from England, Wales, and the United States indicate that S. Enteritidis filled the ecologic niche vacated by eradication of S. Gallinarum from poultry, leading to an epidemic increase in human infections. We tested this hypothesis by retrospective analysis of epidemiologic surveys in Germany and demonstrated that the number of human S. Enteritidis cases is inversely related to the prevalence of S. Gallinarum in poultry. Mathematical models combining epidemiology with population biology suggest that S. Gallinarum competitively excluded S. Enteritidis from poultry flocks early in the 20th century.

EID Rabsch W, Hargis BM, Tsolis RM, Kingsley RA, Hinz K, Tschäpe H, et al. Competitive Exclusion of Salmonella Enteritidis by Salmonella Gallinarum in Poultry. Emerg Infect Dis. 2000;6(5):443-448. https://doi.org/10.3201/eid0605.000501
AMA Rabsch W, Hargis BM, Tsolis RM, et al. Competitive Exclusion of Salmonella Enteritidis by Salmonella Gallinarum in Poultry. Emerging Infectious Diseases. 2000;6(5):443-448. doi:10.3201/eid0605.000501.
APA Rabsch, W., Hargis, B. M., Tsolis, R. M., Kingsley, R. A., Hinz, K., Tschäpe, H....Bäumler, A. J. (2000). Competitive Exclusion of Salmonella Enteritidis by Salmonella Gallinarum in Poultry. Emerging Infectious Diseases, 6(5), 443-448. https://doi.org/10.3201/eid0605.000501.

Microbial Genomics: From Sequence to Function [PDF - 28 KB - 3 pages]
I. Schwartz
EID Schwartz I. Microbial Genomics: From Sequence to Function. Emerg Infect Dis. 2000;6(5):493-495. https://doi.org/10.3201/eid0605.000508
AMA Schwartz I. Microbial Genomics: From Sequence to Function. Emerging Infectious Diseases. 2000;6(5):493-495. doi:10.3201/eid0605.000508.
APA Schwartz, I. (2000). Microbial Genomics: From Sequence to Function. Emerging Infectious Diseases, 6(5), 493-495. https://doi.org/10.3201/eid0605.000508.

Genomics and Bacterial Pathogenesis [PDF - 55 KB - 9 pages]
G. M. Weinstock

Whole-genome sequencing is transforming the study of pathogenic bacteria. Searches for single virulence genes can now be performed on a genomewide scale by a variety of computer and genetic techniques. These techniques are discussed to provide a perspective on the developing field of genomics.

EID Weinstock GM. Genomics and Bacterial Pathogenesis. Emerg Infect Dis. 2000;6(5):496-504. https://doi.org/10.3201/eid0605.000509
AMA Weinstock GM. Genomics and Bacterial Pathogenesis. Emerging Infectious Diseases. 2000;6(5):496-504. doi:10.3201/eid0605.000509.
APA Weinstock, G. M. (2000). Genomics and Bacterial Pathogenesis. Emerging Infectious Diseases, 6(5), 496-504. https://doi.org/10.3201/eid0605.000509.

Comparative Genomics and Understanding of Microbial Biology [PDF - 85 KB - 8 pages]
C. M. Fraser et al.

The sequences of close to 30 microbial genomes have been completed during the past 5 years, and the sequences of more than 100 genomes should be completed in the next 2 to 4 years. Soon, completed microbial genome sequences will represent a collection of >200,000 predicted coding sequences. While analysis of a single genome provides tremendous biological insights on any given organism, comparative analysis of multiple genomes provides substantially more information on the physiology and evolution of microbial species and expands our ability to better assign putative function to predicted coding sequences.

EID Fraser CM, Eisen J, Fleischmann RD, Ketchum KA, Peterson S. Comparative Genomics and Understanding of Microbial Biology. Emerg Infect Dis. 2000;6(5):505-512. https://doi.org/10.3201/eid0605.000510
AMA Fraser CM, Eisen J, Fleischmann RD, et al. Comparative Genomics and Understanding of Microbial Biology. Emerging Infectious Diseases. 2000;6(5):505-512. doi:10.3201/eid0605.000510.
APA Fraser, C. M., Eisen, J., Fleischmann, R. D., Ketchum, K. A., & Peterson, S. (2000). Comparative Genomics and Understanding of Microbial Biology. Emerging Infectious Diseases, 6(5), 505-512. https://doi.org/10.3201/eid0605.000510.

Using DNA Microarrays to Study Host-Microbe Interactions [PDF - 97 KB - 13 pages]
C. A. Cummings and D. A. Relman

Complete genomic sequences of microbial pathogens and hosts offer sophisticated new strategies for studying host-pathogen interactions. DNA microarrays exploit primary sequence data to measure transcript levels and detect sequence polymorphisms, for every gene, simultaneously. The design and construction of a DNA microarray for any given microbial genome are straightforward. By monitoring microbial gene expression, one can predict the functions of uncharacterized genes, probe the physiologic adaptations made under various environmental conditions, identify virulence-associated genes, and test the effects of drugs. Similarly, by using host gene microarrays, one can explore host response at the level of gene expression and provide a molecular description of the events that follow infection. Host profiling might also identify gene expression signatures unique for each pathogen, thus providing a novel tool for diagnosis, prognosis, and clinical management of infectious disease.

EID Cummings CA, Relman DA. Using DNA Microarrays to Study Host-Microbe Interactions. Emerg Infect Dis. 2000;6(5):513-525. https://doi.org/10.3201/eid0605.000511
AMA Cummings CA, Relman DA. Using DNA Microarrays to Study Host-Microbe Interactions. Emerging Infectious Diseases. 2000;6(5):513-525. doi:10.3201/eid0605.000511.
APA Cummings, C. A., & Relman, D. A. (2000). Using DNA Microarrays to Study Host-Microbe Interactions. Emerging Infectious Diseases, 6(5), 513-525. https://doi.org/10.3201/eid0605.000511.
Synopses

Antigenic Variation in Vector-Borne Pathogens [PDF - 67 KB - 9 pages]
A. G. Barbour and B. I. Restrepo

Several pathogens of humans and domestic animals depend on hematophagous arthropods to transmit them from one vertebrate reservoir host to another and maintain them in an environment. These pathogens use antigenic variation to prolong their circulation in the blood and thus increase the likelihood of transmission. By convergent evolution, bacterial and protozoal vector-borne pathogens have acquired similar genetic mechanisms for successful antigenic variation. Borrelia spp. and Anaplasma marginale (among bacteria) and African trypanosomes, Plasmodium falciparum, and Babesia bovis (among parasites) are examples of pathogens using these mechanisms. Antigenic variation poses a challenge in the development of vaccines against vector-borne pathogens.

EID Barbour AG, Restrepo BI. Antigenic Variation in Vector-Borne Pathogens. Emerg Infect Dis. 2000;6(5):449-457. https://doi.org/10.3201/eid0605.000502
AMA Barbour AG, Restrepo BI. Antigenic Variation in Vector-Borne Pathogens. Emerging Infectious Diseases. 2000;6(5):449-457. doi:10.3201/eid0605.000502.
APA Barbour, A. G., & Restrepo, B. I. (2000). Antigenic Variation in Vector-Borne Pathogens. Emerging Infectious Diseases, 6(5), 449-457. https://doi.org/10.3201/eid0605.000502.
Research

Toxin Gene Expression by Shiga Toxin-Producing Escherichia coli: the Role of Antibiotics and the Bacterial SOS Response [PDF - 145 KB - 8 pages]
P. T. Kimmitt et al.

Toxin synthesis by Shiga toxin-producing Escherichia coli (STEC) appears to be coregulated through induction of the integrated bacteriophage that encodes the toxin gene. Phage production is linked to induction of the bacterial SOS response, a ubiquitous response to DNA damage. SOS-inducing antimicrobial agents, particularly the quinolones, trimethoprim, and furazolidone, were shown to induce toxin gene expression in studies of their effects on a reporter STEC strain carrying a chromosome-based stx2::lacZ transcriptional fusion. At antimicrobial levels above those required to inhibit bacterial replication, these agents are potent inducers (up to 140-fold) of the transcription of type 2 Shiga toxin genes (stx2); therefore, they should be avoided in treating patients with potential or confirmed STEC infections. Other agents (20 studied) and incubation conditions produced significant but less striking effects on stx2 transcription; positive and negative influences were observed. SOS-mediated induction of toxin synthesis also provides a mechanism that could exacerbate STEC infections and increase dissemination of stx genes. These features and the use of SOS-inducing antibiotics in clinical practice and animal husbandry may account for the recent emergence of STEC disease.

EID Kimmitt PT, Harwood CR, Barer MR. Toxin Gene Expression by Shiga Toxin-Producing Escherichia coli: the Role of Antibiotics and the Bacterial SOS Response. Emerg Infect Dis. 2000;6(5):458-465. https://doi.org/10.3201/eid0605.000503
AMA Kimmitt PT, Harwood CR, Barer MR. Toxin Gene Expression by Shiga Toxin-Producing Escherichia coli: the Role of Antibiotics and the Bacterial SOS Response. Emerging Infectious Diseases. 2000;6(5):458-465. doi:10.3201/eid0605.000503.
APA Kimmitt, P. T., Harwood, C. R., & Barer, M. R. (2000). Toxin Gene Expression by Shiga Toxin-Producing Escherichia coli: the Role of Antibiotics and the Bacterial SOS Response. Emerging Infectious Diseases, 6(5), 458-465. https://doi.org/10.3201/eid0605.000503.

Imported Lassa Fever in Germany: 
Molecular Characterization of a New Lassa Virus Strain [PDF - 246 KB - 11 pages]
S. Günther et al.

We describe the isolation and characterization of a new Lassa virus strain imported into Germany by a traveler who had visited Ghana, Côte D'Ivoire, and Burkina Faso. This strain, designated "AV," originated from a region in West Africa where Lassa fever has not been reported. Viral S RNA isolated from the patient's serum was amplified and sequenced. A long-range reverse transcription polymerase chain reaction allowed amplification of the full-length (3.4 kb) S RNA. The coding sequences of strain AV differed from those of all known Lassa prototype strains (Josiah, Nigeria, and LP) by approximately 20%, mainly at third codon positions. Phylogenetically, strain AV appears to be most closely related to strain Josiah from Sierra Leone. Lassa viruses comprise a group of genetically highly diverse strains, which has implications for vaccine development. The new method for full-length S RNA amplification may facilitate identification and molecular analysis of new arenaviruses or arenavirus strains.

EID Günther S, Emmerich P, Laue T, Kühle O, Asper M, Jung A, et al. Imported Lassa Fever in Germany: 
Molecular Characterization of a New Lassa Virus Strain. Emerg Infect Dis. 2000;6(5):466-476. https://doi.org/10.3201/eid0605.000504
AMA Günther S, Emmerich P, Laue T, et al. Imported Lassa Fever in Germany: 
Molecular Characterization of a New Lassa Virus Strain. Emerging Infectious Diseases. 2000;6(5):466-476. doi:10.3201/eid0605.000504.
APA Günther, S., Emmerich, P., Laue, T., Kühle, O., Asper, M., Jung, A....Schmitz, H. (2000). Imported Lassa Fever in Germany: 
Molecular Characterization of a New Lassa Virus Strain. Emerging Infectious Diseases, 6(5), 466-476. https://doi.org/10.3201/eid0605.000504.

Naturally Occurring Ehrlichia chaffeensis Infection in Coyotes from Oklahoma [PDF - 71 KB - 4 pages]
A. Kocan et al.

A nested polymerase chain reaction assay was used to determine the presence of Ehrlichia chaffeensis, E. canis, and E. ewingii DNA in blood samples of free-ranging coyotes from central and north-central Oklahoma. Of the 21 coyotes examined, 15 (71%) were positive for E. chaffeensis DNA; none was positive for E. canis or E. ewingii. Results suggest that E. chaffeensis infections are common in free-ranging coyotes in Oklahoma and that these wild canids could play a role in the epidemiology of human monocytotropic ehrlichiosis.

EID Kocan A, Levesque GC, Whitworth LC, Murphy GL, Ewing SA, Barker RW. Naturally Occurring Ehrlichia chaffeensis Infection in Coyotes from Oklahoma. Emerg Infect Dis. 2000;6(5):477-480. https://doi.org/10.3201/eid0605.000505
AMA Kocan A, Levesque GC, Whitworth LC, et al. Naturally Occurring Ehrlichia chaffeensis Infection in Coyotes from Oklahoma. Emerging Infectious Diseases. 2000;6(5):477-480. doi:10.3201/eid0605.000505.
APA Kocan, A., Levesque, G. C., Whitworth, L. C., Murphy, G. L., Ewing, S. A., & Barker, R. W. (2000). Naturally Occurring Ehrlichia chaffeensis Infection in Coyotes from Oklahoma. Emerging Infectious Diseases, 6(5), 477-480. https://doi.org/10.3201/eid0605.000505.

Atypical Chryseobacterium meningosepticum and Meningitis and Sepsis in Newborns and the Immunocompromised, Taiwan [PDF - 77 KB - 6 pages]
C. Chiu et al.

From 1996 to 1999, 17 culture-documented systemic infections due to novel, atypical strains of Chryseobacterium meningosepticum occurred in two newborns and 15 immunocompromised patients in a medical center in Taiwan. All clinical isolates, which were initially misidentified as Aeromonassalmonicida by an automated bacterial identification system, were resistant to a number of antimicrobial agents. The isolates were characterized as atypical strains of C. meningosepticum by complete biochemical investigation, 16S rRNA gene sequence analysis, cellular fatty acid analysis, and random amplified polymorphic DNA fingerprinting (RAPD). This is the first report of a cluster of atypically variant strains of C. meningosepticum, which may be an emerging pathogen in newborns and the immunocompromised.

EID Chiu C, Waddingdon M, Hsieh W, Greenberg DE, Schreckenberger PC, Carnahan AM. Atypical Chryseobacterium meningosepticum and Meningitis and Sepsis in Newborns and the Immunocompromised, Taiwan. Emerg Infect Dis. 2000;6(5):481-486. https://doi.org/10.3201/eid0605.000506
AMA Chiu C, Waddingdon M, Hsieh W, et al. Atypical Chryseobacterium meningosepticum and Meningitis and Sepsis in Newborns and the Immunocompromised, Taiwan. Emerging Infectious Diseases. 2000;6(5):481-486. doi:10.3201/eid0605.000506.
APA Chiu, C., Waddingdon, M., Hsieh, W., Greenberg, D. E., Schreckenberger, P. C., & Carnahan, A. M. (2000). Atypical Chryseobacterium meningosepticum and Meningitis and Sepsis in Newborns and the Immunocompromised, Taiwan. Emerging Infectious Diseases, 6(5), 481-486. https://doi.org/10.3201/eid0605.000506.

Testing Umbilical Cords for Funisitis due to Treponema pallidum Infection, Bolivia [PDF - 68 KB - 6 pages]
J. Guarner et al.

To establish the frequency of necrotizing funisitis in congenital syphilis, we conducted a prospective descriptive study of maternal syphilis in Bolivia by testing 1,559 women at delivery with rapid plasma reagin (RPR). We examined umbilical cords of 66 infants whose mothers had positive RPR and fluorescent treponemal antibody absorption tests. Histologic abnormalities were detected in 28 (42%) umbilical cords (seven [11%] had necrotizing funisitis with spirochetes; three [4%] had marked funisitis without necrosis; and 18 [27%] had mild funisitis), and 38 [58%] were normal. Of 22 umbilical cords of infants from mothers without syphilis (controls), only two (9%) showed mild funisitis; the others were normal. Testing umbilical cords by using immunohistochemistry is a research tool that can establish the frequency of funisitis due to Treponema pallidum infection.

EID Guarner J, Southwick K, Greer P, Bartlett J, Fears M, Santander A, et al. Testing Umbilical Cords for Funisitis due to Treponema pallidum Infection, Bolivia. Emerg Infect Dis. 2000;6(5):487-492. https://doi.org/10.3201/eid0605.000507
AMA Guarner J, Southwick K, Greer P, et al. Testing Umbilical Cords for Funisitis due to Treponema pallidum Infection, Bolivia. Emerging Infectious Diseases. 2000;6(5):487-492. doi:10.3201/eid0605.000507.
APA Guarner, J., Southwick, K., Greer, P., Bartlett, J., Fears, M., Santander, A....Zaki, S. (2000). Testing Umbilical Cords for Funisitis due to Treponema pallidum Infection, Bolivia. Emerging Infectious Diseases, 6(5), 487-492. https://doi.org/10.3201/eid0605.000507.
Dispatches

Pertussis Infection in Fully Vaccinated Children in Day-Care Centers, Israel [PDF - 28 KB - 4 pages]
I. Srugo et al.

We tested 46 fully vaccinated children in two day-care centers in Israel who were exposed to a fatal case of pertussis infection. Only two of five children who tested positive for Bordetella pertussis met the World Health Organization's case definition for pertussis. Vaccinated children may be asymptomatic reservoirs for infection.

EID Srugo I, Benilevi D, Madeb R, Shapiro S, Shohat T, Somekh E, et al. Pertussis Infection in Fully Vaccinated Children in Day-Care Centers, Israel. Emerg Infect Dis. 2000;6(5):526-529. https://doi.org/10.3201/eid0605.000512
AMA Srugo I, Benilevi D, Madeb R, et al. Pertussis Infection in Fully Vaccinated Children in Day-Care Centers, Israel. Emerging Infectious Diseases. 2000;6(5):526-529. doi:10.3201/eid0605.000512.
APA Srugo, I., Benilevi, D., Madeb, R., Shapiro, S., Shohat, T., Somekh, E....Lahat, N. (2000). Pertussis Infection in Fully Vaccinated Children in Day-Care Centers, Israel. Emerging Infectious Diseases, 6(5), 526-529. https://doi.org/10.3201/eid0605.000512.

Prevalence of Non-O157:H7 Shiga Toxin-Producing Escherichia coli in Diarrheal Stool Samples from Nebraska [PDF - 30 KB - 4 pages]
P. D. Fey et al.

We determined the prevalence of Shiga-toxin producing Escherichia coli (STEC) in diarrheal stool samples from Nebraska by three methods: cefixime-tellurite sorbitol MacConkey (CT-SMAC) culture, enterohemorrhagic E. coli (EHEC) enzyme immunoassay, and stx1,2 polymerase chain reaction (PCR). Fourteen (4.2%) of 335 specimens were positive by at least one method (CT-SMAC culture [6 of 14], EHEC enzyme immunoassay [13 of 14], stx1,2 PCR [14 of 14]). Six contained serogroup 0157, while non-0157 were as prevalent as 0157 serogroups.

EID Fey PD, Wickert R, Rupp M, Safranek T, Hinrichs S. Prevalence of Non-O157:H7 Shiga Toxin-Producing Escherichia coli in Diarrheal Stool Samples from Nebraska. Emerg Infect Dis. 2000;6(5):530-533. https://doi.org/10.3201/eid0605.000513
AMA Fey PD, Wickert R, Rupp M, et al. Prevalence of Non-O157:H7 Shiga Toxin-Producing Escherichia coli in Diarrheal Stool Samples from Nebraska. Emerging Infectious Diseases. 2000;6(5):530-533. doi:10.3201/eid0605.000513.
APA Fey, P. D., Wickert, R., Rupp, M., Safranek, T., & Hinrichs, S. (2000). Prevalence of Non-O157:H7 Shiga Toxin-Producing Escherichia coli in Diarrheal Stool Samples from Nebraska. Emerging Infectious Diseases, 6(5), 530-533. https://doi.org/10.3201/eid0605.000513.

Fecal Colonization with Vancomycin-Resistant Enterococci in Australia [PDF - 21 KB - 3 pages]
A. A. Padiglione et al.

To assess the rate of fecal vancomycin-resistant enterococci (VRE) colonization in Australia, we examined specimens from 1,085 healthy volunteers. VRE was cultured from 2 (0.2%) of 1,085 specimens; both were vanB Enterococcus faecium, identical by pulsed-field gel electrophoresis, but with a pattern rare in Melbourne hospitals.

EID Padiglione AA, Grabsch EA, Olden D, Hellard M, Sinclair MI, Fairley C, et al. Fecal Colonization with Vancomycin-Resistant Enterococci in Australia. Emerg Infect Dis. 2000;6(5):534-536. https://doi.org/10.3201/eid0605.000514
AMA Padiglione AA, Grabsch EA, Olden D, et al. Fecal Colonization with Vancomycin-Resistant Enterococci in Australia. Emerging Infectious Diseases. 2000;6(5):534-536. doi:10.3201/eid0605.000514.
APA Padiglione, A. A., Grabsch, E. A., Olden, D., Hellard, M., Sinclair, M. I., Fairley, C....Grayson, M. L. (2000). Fecal Colonization with Vancomycin-Resistant Enterococci in Australia. Emerging Infectious Diseases, 6(5), 534-536. https://doi.org/10.3201/eid0605.000514.

Falciparum Malaria in European Tourists to the Dominican Republic [PDF - 17 KB - 2 pages]
T. Jelinek et al.

Thirteen cases of falciparum malaria acquired by Europeans in the Dominican Republic occurred from June 1999 to February 2000. The cases were identified by the European Network on Imported Infectious Disease Surveillance (TropNetEurop).

EID Jelinek T, Corachan M, Grobusch MP, Harms-Zwingenberger G, Kollaritsch H, Richter J, et al. Falciparum Malaria in European Tourists to the Dominican Republic. Emerg Infect Dis. 2000;6(5):537-538. https://doi.org/10.3201/eid0605.000515
AMA Jelinek T, Corachan M, Grobusch MP, et al. Falciparum Malaria in European Tourists to the Dominican Republic. Emerging Infectious Diseases. 2000;6(5):537-538. doi:10.3201/eid0605.000515.
APA Jelinek, T., Corachan, M., Grobusch, M. P., Harms-Zwingenberger, G., Kollaritsch, H., Richter, J....Zieger, B. (2000). Falciparum Malaria in European Tourists to the Dominican Republic. Emerging Infectious Diseases, 6(5), 537-538. https://doi.org/10.3201/eid0605.000515.

Two Cases of Mycobacterium microti-Derived Tuberculosis in HIV-Negative Immunocompetent Patients [PDF - 51 KB - 4 pages]
S. Niemann et al.

We describe two cases of Mycobacterium microti infection causing pulmonary tuberculosis (TB) in HIV-seronegative immunocompetent patients in Germany. The isolates were identified as M. microti of the llama and vole types, according to spoligotype patterns. Our data demonstrate that M. microti can cause severe pulmonary TB in immunocompetent patients.

EID Niemann S, Richter E, Dalügge-Tamm H, Schlesinger H, Graupner D, Königstein B, et al. Two Cases of Mycobacterium microti-Derived Tuberculosis in HIV-Negative Immunocompetent Patients. Emerg Infect Dis. 2000;6(5):539-542. https://doi.org/10.3201/eid0605.000516
AMA Niemann S, Richter E, Dalügge-Tamm H, et al. Two Cases of Mycobacterium microti-Derived Tuberculosis in HIV-Negative Immunocompetent Patients. Emerging Infectious Diseases. 2000;6(5):539-542. doi:10.3201/eid0605.000516.
APA Niemann, S., Richter, E., Dalügge-Tamm, H., Schlesinger, H., Graupner, D., Königstein, B....Rüsch-Gerdes, S. (2000). Two Cases of Mycobacterium microti-Derived Tuberculosis in HIV-Negative Immunocompetent Patients. Emerging Infectious Diseases, 6(5), 539-542. https://doi.org/10.3201/eid0605.000516.

Trichinella pseudospiralis Outbreak in France [PDF - 43 KB - 5 pages]
S. Ranque et al.

Four persons became ill with trichinellosis after eating meat from a wild boar hunted in Camargue, France. Nonencapsulated larvae of Trichinella pseudospiralis were detected in meat and muscle biopsy specimens. The diagnoses were confirmed by molecular typing. Surveillance for the emerging T. pseudospiralis should be expanded.

EID Ranque S, Faugère B, Pozio E, La Rosa G, Tamburrini A, Pellissier J, et al. Trichinella pseudospiralis Outbreak in France. Emerg Infect Dis. 2000;6(5):543-547. https://doi.org/10.3201/eid0605.000517
AMA Ranque S, Faugère B, Pozio E, et al. Trichinella pseudospiralis Outbreak in France. Emerging Infectious Diseases. 2000;6(5):543-547. doi:10.3201/eid0605.000517.
APA Ranque, S., Faugère, B., Pozio, E., La Rosa, G., Tamburrini, A., Pellissier, J....Brouqui, P. (2000). Trichinella pseudospiralis Outbreak in France. Emerging Infectious Diseases, 6(5), 543-547. https://doi.org/10.3201/eid0605.000517.

Double infection with a Resistant and a Multidrug-Resistant Strain of Mycobacterium tuberculosis [PDF - 50 KB - 4 pages]
S. Niemann et al.

During the last decade, drug-resistant Mycobacterium tuberculosis (TB) strains have emerged, posing a major threat to global TB control efforts. The incidence of drug-resistant TB has increased in many parts of the world, not only in developing countries but also in industrialized countries, where the prevalence of drug-resistant TB had been low (1). The emergence of drug resistance during antituberculous therapy results mainly from inadequate therapy, i.e., improper prescription of treatment regimens, addition of single drugs to failing treatment regimens, and patient noncompliance. However, inconsistent drug-susceptibility patterns or delayed responses to TB therapy may also indicate exogenous reinfection with a strain resistant to multiple drugs or mixed infection with a sensitive and a multidrug-resistant TB strain. Such infections occur in immunocompromised and immunocompetent persons (2-7) and may be more common in areas with high prevalence of resistant TB.

EID Niemann S, Richter E, Rüsch-Gerdes S, Schlaak M, Greinert U. Double infection with a Resistant and a Multidrug-Resistant Strain of Mycobacterium tuberculosis. Emerg Infect Dis. 2000;6(5):548-551. https://doi.org/10.3201/eid0605.000518
AMA Niemann S, Richter E, Rüsch-Gerdes S, et al. Double infection with a Resistant and a Multidrug-Resistant Strain of Mycobacterium tuberculosis. Emerging Infectious Diseases. 2000;6(5):548-551. doi:10.3201/eid0605.000518.
APA Niemann, S., Richter, E., Rüsch-Gerdes, S., Schlaak, M., & Greinert, U. (2000). Double infection with a Resistant and a Multidrug-Resistant Strain of Mycobacterium tuberculosis. Emerging Infectious Diseases, 6(5), 548-551. https://doi.org/10.3201/eid0605.000518.

Antimicrobial-Drug Use and Changes in Resistance in Streptococcus pneumoniae [PDF - 33 KB - 5 pages]
D. J. Diekema et al.

Resistance of Streptococcus pneumoniae to antimicrobial drugs is increasing. To investigate the relationship between antimicrobial use and susceptibility of S. pneumoniae isolates at 24 U.S. medical centers, we obtained data on outpatient antimicrobial-drug use for the regions surrounding 23 of these centers. We found an association between decreased penicillin susceptibility and use of beta-lactam antimicrobial drugs.

EID Diekema DJ, Brueggemann AB, Doern GV. Antimicrobial-Drug Use and Changes in Resistance in Streptococcus pneumoniae. Emerg Infect Dis. 2000;6(5):552-556. https://doi.org/10.3201/eid0605.000519
AMA Diekema DJ, Brueggemann AB, Doern GV. Antimicrobial-Drug Use and Changes in Resistance in Streptococcus pneumoniae. Emerging Infectious Diseases. 2000;6(5):552-556. doi:10.3201/eid0605.000519.
APA Diekema, D. J., Brueggemann, A. B., & Doern, G. V. (2000). Antimicrobial-Drug Use and Changes in Resistance in Streptococcus pneumoniae. Emerging Infectious Diseases, 6(5), 552-556. https://doi.org/10.3201/eid0605.000519.
Letters

Will Avilamycin Convert Ziracine into Zerocine? [PDF - 15 KB - 1 page]
P. Courvalin
EID Courvalin P. Will Avilamycin Convert Ziracine into Zerocine?. Emerg Infect Dis. 2000;6(5):558. https://doi.org/10.3201/eid0605.000521
AMA Courvalin P. Will Avilamycin Convert Ziracine into Zerocine?. Emerging Infectious Diseases. 2000;6(5):558. doi:10.3201/eid0605.000521.
APA Courvalin, P. (2000). Will Avilamycin Convert Ziracine into Zerocine?. Emerging Infectious Diseases, 6(5), 558. https://doi.org/10.3201/eid0605.000521.

Medical Examiners, Coroners, and Bioterrorism [PDF - 17 KB - 2 pages]
K. B. Nolte et al.
EID Nolte KB, Yoon SS, Pertowski C. Medical Examiners, Coroners, and Bioterrorism. Emerg Infect Dis. 2000;6(5):559-560. https://doi.org/10.3201/eid0605.000522
AMA Nolte KB, Yoon SS, Pertowski C. Medical Examiners, Coroners, and Bioterrorism. Emerging Infectious Diseases. 2000;6(5):559-560. doi:10.3201/eid0605.000522.
APA Nolte, K. B., Yoon, S. S., & Pertowski, C. (2000). Medical Examiners, Coroners, and Bioterrorism. Emerging Infectious Diseases, 6(5), 559-560. https://doi.org/10.3201/eid0605.000522.

Seroprevalence of Human Hantavirus Infection in the Ribeirão Preto Region of São Paulo State, Brazil [PDF - 18 KB - 2 pages]
R. Holmes et al.
EID Holmes R, Boccanera R, Figueiredo LT, Mançano SR, Pane C. Seroprevalence of Human Hantavirus Infection in the Ribeirão Preto Region of São Paulo State, Brazil. Emerg Infect Dis. 2000;6(5):560-561. https://doi.org/10.3201/eid0605.000523
AMA Holmes R, Boccanera R, Figueiredo LT, et al. Seroprevalence of Human Hantavirus Infection in the Ribeirão Preto Region of São Paulo State, Brazil. Emerging Infectious Diseases. 2000;6(5):560-561. doi:10.3201/eid0605.000523.
APA Holmes, R., Boccanera, R., Figueiredo, L. T., Mançano, S. R., & Pane, C. (2000). Seroprevalence of Human Hantavirus Infection in the Ribeirão Preto Region of São Paulo State, Brazil. Emerging Infectious Diseases, 6(5), 560-561. https://doi.org/10.3201/eid0605.000523.

Molecular Characterization of Mycobacterium Abscessus Strains Isolated from a Hospital Outbreak [PDF - 20 KB - 2 pages]
L. A. Raman et al.
EID Raman LA, Siddiqi N, Shamim M, Deb M, Mehta G, Hasnain SE. Molecular Characterization of Mycobacterium Abscessus Strains Isolated from a Hospital Outbreak. Emerg Infect Dis. 2000;6(5):561-562. https://doi.org/10.3201/eid0605.000524
AMA Raman LA, Siddiqi N, Shamim M, et al. Molecular Characterization of Mycobacterium Abscessus Strains Isolated from a Hospital Outbreak. Emerging Infectious Diseases. 2000;6(5):561-562. doi:10.3201/eid0605.000524.
APA Raman, L. A., Siddiqi, N., Shamim, M., Deb, M., Mehta, G., & Hasnain, S. E. (2000). Molecular Characterization of Mycobacterium Abscessus Strains Isolated from a Hospital Outbreak. Emerging Infectious Diseases, 6(5), 561-562. https://doi.org/10.3201/eid0605.000524.
Books and Media

Digging for Pathogens: Ancient Emerging Diseases--Their Evolutionary, Anthropological and Archaeological Context [PDF - 14 KB - 1 page]
R. Vaidyanathan
EID Vaidyanathan R. Digging for Pathogens: Ancient Emerging Diseases--Their Evolutionary, Anthropological and Archaeological Context. Emerg Infect Dis. 2000;6(5):557. https://doi.org/10.3201/eid0605.000520
AMA Vaidyanathan R. Digging for Pathogens: Ancient Emerging Diseases--Their Evolutionary, Anthropological and Archaeological Context. Emerging Infectious Diseases. 2000;6(5):557. doi:10.3201/eid0605.000520.
APA Vaidyanathan, R. (2000). Digging for Pathogens: Ancient Emerging Diseases--Their Evolutionary, Anthropological and Archaeological Context. Emerging Infectious Diseases, 6(5), 557. https://doi.org/10.3201/eid0605.000520.
About the Cover

The Hallucinogenic Toreador by Salvador Dalí [PDF - 13 KB - 1 page]
EID The Hallucinogenic Toreador by Salvador Dalí. Emerg Infect Dis. 2000;6(5):563. https://doi.org/10.3201/eid0605.ac0605
AMA The Hallucinogenic Toreador by Salvador Dalí. Emerging Infectious Diseases. 2000;6(5):563. doi:10.3201/eid0605.ac0605.
APA (2000). The Hallucinogenic Toreador by Salvador Dalí. Emerging Infectious Diseases, 6(5), 563. https://doi.org/10.3201/eid0605.ac0605.
Conference Summaries

Borna Disease Virus: A Veterinary and Public Health Problem?
EID Borna Disease Virus: A Veterinary and Public Health Problem?. Emerg Infect Dis. 2000;6(5):0. https://doi.org/10.3201/eid0605.000525
AMA Borna Disease Virus: A Veterinary and Public Health Problem?. Emerging Infectious Diseases. 2000;6(5):0. doi:10.3201/eid0605.000525.
APA (2000). Borna Disease Virus: A Veterinary and Public Health Problem?. Emerging Infectious Diseases, 6(5), 0. https://doi.org/10.3201/eid0605.000525.
Corrections

Erratum Vol. 6, No. 4 [PDF - 15 KB - 1 page]
EID Erratum Vol. 6, No. 4. Emerg Infect Dis. 2000;6(5):562. https://doi.org/10.3201/eid0605.000527
AMA Erratum Vol. 6, No. 4. Emerging Infectious Diseases. 2000;6(5):562. doi:10.3201/eid0605.000527.
APA (2000). Erratum Vol. 6, No. 4. Emerging Infectious Diseases, 6(5), 562. https://doi.org/10.3201/eid0605.000527.
Page created: December 02, 2011
Page updated: December 02, 2011
Page reviewed: December 02, 2011
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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