Comparison of epidemiologic markers for Staphylococcus epidermidis.
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Cultures of Staphylococcus epidermidis from the eyes or nose of the same individual were compared by their antimicrobial phenotype, Staph-Ident (Analytab Products, Inc., Plainview, N.Y.) profile number, phage type, and plasmid profile to determine which parameters provide the most compelling data for their identity. None of the parameters alone provided this type of information. The most conclusive data for the identity of strains resulted when two cultures had the same long phage type and identical or similar plasmid profiles. The presence of a large, slowly migrating plasmid band(s) in a culture that agreed with its pair in all other parameters and, in all likelihood, was the same strain casts doubt in some instances on the reliability of the plasmid profile alone for strain identification in an epidemiologic study. (+info)
Analysis of the free fatty acid component of meibomian secretions in chronic blepharitis.
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Meibomian secretions were collected from 43 patients with chronic blepharitis and 8 normal controls. Patients were divided into six clinically distinct groups of chronic blepharitis. Individual secretions were weighed and separated into specific lipid classes by thin-layer chromatography. The free fatty acid (FFA) fraction was recovered, methylated, and analyzed by gas-liquid chromatography. Quantitation was achieved through the use of an internal standard, and qualitative analyses were aided by the use of commercial external standards. Carbon numbers were expressed in terms of their equivalent chain lengths (E.C.L.). For statistical comparisons, specific acid weights were expressed as nanograms per milligram of secretion. Data from individual subjects were tabulated by group and analyzed by a nonparametric analysis of variance. The FFA portion made up from 0.21% to 1.3% of the total meibomian secretion. Acids ranged in length from 12 to 29 carbon atoms. Iso-branched and anteisobranched carbon chains made up approximately 33% of the FFA fraction. E.C.L.'s corresponding to C16:0, C18:0, and C18:1 together made up a major portion of the total FFA fraction (mean = 49%). When compared to normals, a significantly decreased amount of C12:0 was seen in the mixed seborrheic/staphylococcal group and the meibomian seborrhea group. A significantly decreased amount of anteiso-branched C15:0 was seen in the mixed seborrheic/staphylococcal group. Significantly decreased amounts of anteiso-branched C23:0 were seen in all of the seborrheic blepharitides. A significantly increased amount of isobranched C22:0 was seen in the meibomian keratoconjunctivitis group. No significant differences were seen in the staphylococcal group. (+info)
Bacterial lipases and chronic blepharitis.
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Eyelids and conjunctivae of 36 normal individuals and 60 patients from six clinical groups of chronic blepharitis were cultured for aerobic and anaerobic bacteria. The most common species isolated were coagulase-negative staphylococci (C-NS) and Propionibacterium acnes. All strains of these species, and all Staphylococcus aureus strains isolated were tested for the ability to break down triglycerides, cholesterol esters, and fatty waxes. Each strain was incubated independently with appropriate substrates in nutrient media. Each medium was then extracted and assayed for the presence of substrate hydrolysis products by thin-layer chromatography. The percentage of strains capable of hydrolyzing a particular substrate was determined for each individual. S. aureus was a consistent and strong lipase producer, able to hydrolyze all three substrates. P. acnes was able to hydrolyze triolein and behenyl oleate but not cholesteryl oleate. No differences were observed among groups for P. acnes or S. aureus. C-NS showed a high degree of strain variability. Eighty-three percent of C-NS strains could hydrolyze triolein, 82% behenyl oleate, and 40% cholesteryl oleate. Significant group differences were seen in the percentage of lipase positive C-NS strains isolated per individual. Patients in the mixed staphylococcal/seborrheic, meibomian seborrheic, secondary meibomitis, and the meibomian keratoconjunctivitis (MKC) groups harbored significantly more C-NS strains capable of hydrolyzing cholesteryl oleate than did normal individuals. Patients in the meibomian seborrheic, secondary meibomitis, and MKC groups harbored significantly more C-NS strains capable of hydrolyzing behenyl oleate than did normals. No group differences were seen among groups with triolein hydrolyzing C-NS strains. (+info)
Microbial and immunological investigations of chronic non-ulcerative blepharitis and meibomianitis.
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Concentrations of tear lysozyme, lactoferrin, ceruloplasmin, IgG, and IgA have been measured by enzyme linked immunosorbent assay (ELISA) in patients with chronic non-ulcerative blepharitis and meibomianitis at the same time as the lid and conjunctivae were cultured for bacteria and fungi by a semiquantitative method. A group of normal controls aged 20 to 80 were similarly sampled, when strains of Staphylococcus epidermidis from their eyes and the patients' eyes were biotyped according to Baird-Parker's scheme. 5% of blepharitis cases had increased numbers of Staph. aureus present on the lids, compared with only a scanty growth obtained from 5% of normals. 7% of blepharitis cases had increased numbers of Staph. epidermidis type VI (coagulase-negative, mannitol-fermenting) present compared with a scanty growth obtained from 6% of normals. Isolation rates of other types of Staph. epidermidis did not differ from those in normals; no types were associated with meibomianitis. Tear protein profiles were normal in most patients, and there was no increase in tear IgA or IgG, which is expected with chronic infection. Overall our evidence suggests that in 88% of cases these lid conditions have an inflammatory aetiology not associated with infection. Staphylococcal isolates often found in the eye usually represent a normal commensal rather than pathogenic flora. (+info)
A clinical survey of paraquat formulation workers.
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A group of 18 male Caucasian workers from the United Kingdom and a further group of 18 male mixed race (mainly Malay) workers from Malaysia employed in the formulation of paraquat-based herbicides were examined for evidence of chronic ill health after long-term exposure to paraquat. Clinical records were examined, medical and occupational histories were obtained and a clinical examination, particularly of the skin, was undertaken. Skin rashes, nail damage and epistaxes were encountered by most workers as a result of direct contact of skin and mucous membranes with paraquat. These conditions subsided rapidly and no worker reported any sequelae. There was no clinical evidence of long-term effects on skin, mucous membranes or general health following exposure to paraquat over several years in these workers. (+info)
Comparative bacteriology of chronic blepharitis.
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One hundred and fifteen patients with chronic blepharitis were compared with 47 normal controls. Six clinically distinct groups of blepharitis were observed: staphylococcal; seborrhoeic, alone, with associated staphylococcal superinfection, meibomian seborrhoea, or secondary inflammation of the meibomian glands; and meibomian keratoconjunctivitis (MKC). Staphylococcus aureus was isolated in appreciable frequency from the staphylococcal and the mixed staphylococcal/seborrhoeic groups in contrast to the normal and non-staphylococcal groups. Coagulase-negative Staphylococcus spp., Propionibacterium acnes, and cornyneform bacteria were the most commonly isolated bacteria from the lid for all groups. Cultures of material expressed from the meibomian glands yielded similar organisms but in reduced frequency. Testing of antibiotic susceptibility revealed Staph aureus to be usually sensitive to most commonly used ophthalmic antimicrobials except sulphonamides. (+info)
Aetiology and treatment of acute bacterial infection of the external eye.
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The microbial flora of 738 patients with acute bacterial conjunctivitis, corneal ulceration, blepharitis, dacryocystitis, and discharging sockets has been investigated. Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae were the main pathogens isolated. Str. viridans was associated with conjunctivitis in patients aged under 1 year. moraxella sp. was isolated on only one occasion. Overall, 40% of specimens were associated with Staph. epidermidis or mixed skin flora, which also occurred with cultures of the normal eye. Clostridium welchii was isolated on 3 occasions but was not associated with bullae or gas gangrene. The least overall resistance, of 6%, was to chloramphenicol, but no one antibiotic was effective against all pathogens. Gentamicin remains the antibiotic of choice for Pseudomonas aeruginosa infection. (+info)
Piecemeal degranulation of mast cells in the inflammatory eyelid lesions of interleukin-4 transgenic mice. Evidence of mast cell histamine release in vivo by diamine oxidase-gold enzyme-affinity ultrastructural cytochemistry.
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We used light and electron microscopy to analyze the eyelid inflammation that develops in transgenic mice that overexpress interleukin-4 (IL-4; Tepper et al, Cell 62:457, 1990). Analysis of alkaline Giemsa-stained plastic sections examined by light microscopy (Dvorak et al, J Exp Med 132:558, 1970), as well as by routine transmission electron microscopy, indicated that the mast cells in the inflammatory eyelid lesions were undergoing piecemeal degranulation, a form of secretion in which the cells' cytoplasmic granules exhibit characteristic morphologic changes that are thought to be associated with the prolonged, vesicle-mediated release of the granules' constituents. Moreover, by using a newly reported enzyme affinity-gold method, which stains histamine based on binding to diamine oxidase-gold (Dvorak et al, J Histochem Cytochem 41:787, 1993), we show that these activated mast cells had released much of their histamine content. The eyelid lesions also exhibited increased numbers of mast cells; interstitial fibrosis, particularly around cutaneous nerves and blood vessels; activated fibroblasts; focal axonal damage; venules with endothelial cells containing numerous vesiculo-vacuolar organelles; and infiltrates of neutrophils and eosinophils. Our findings illustrate that overexpression of the IL-4 gene in vivo can result in eyelid lesions associated with piecemeal degranulation of mast cells, as well as tissue fibrosis and a variety of other pathologic changes. These results also represent the first direct morphologic evidence for histamine secretion by mast cells in vivo. (+info)