Nasal Swab Cultures Research Articles

Methicillin-resistant Staphylococcus aureus: prevalence, incidence and risk factors associated with colonization in Sri Lanka

We studied the prevalence of and risk factors for nasal colonization with methicillin-resistant Staphylococcus aureus (MRSA) on admission and the incidence and risk factors for nosocomial acquisition of MRSA in a 60 bed, male surgical unit in the National Hospital of Sri Lanka (NHSL). Nasal swab cultures were obtained from 271 patients admitted for routine surgery within 36 h of admission and repeated every other day until discharge. Clinical and epidemiological risk factors for colonization were compared between patients with MRSA at the time of admission or colonized after admission, and patients who were not colonized. MRSA was isolated from 35 patients (12.9%) with 20 (7.4%) colonized on admission and 15 (6%) acquiring MRSA after admission. Hospitalization within the previous year, antibiotic use within the previous two months, and transfer from another ward within the NHSL were associated with colonization with MRSA on admission. Risk factors for nosocomial acquisition of MRSA were the prophylactic and empiric use of antibiotics. The duration of antibiotic use and the duration of stay in hospital were significantly longer in patients who acquired MRSA. MRSA surveillance and control programmes in this unit would be more cost-effective if targeted at patients with these risk factors.

The microbiology of ethmoid and maxillary sinuses in patients with chronic sinusitis

Purpose: To investigate aerob-anearob microorganisms growth in maxillary and ethmoid sinuses by evaluating aspiration materials from patients with chronic sinusitis. Patients and Methods: The study was performed prospectively, and there were 31 patients (23 men, 8 women; mean age, 31.4±14.15, between 18-65 years) who had endoscopic sinus surgery because of chronic sinusitis. During the operation, when the maxillary sinus ostium and ethmoid sinus were opened, readily aspirated materials from sinuses were evaluated regarding aerob and anaerob bacteria. Nose and throat swap samples were collected preoperatively to determine the upper respiratory tract flora and also to understand the relationship between the flora and the microorganisms aspirated from sinuses. Results: Total aerob bacteria count, which was isolated from preoperative nasal swab cultures, was 36, and aerob-anaerob bacteria count that included cultures taken from maxillary and ethmoid sinuses during the functional endoscopic sinus surgery was 42. For each 2 samples, the most common isolated aerob bacteria were coagulase (−) staphylococci. Microorganisms were isolated in 87.0% of 27 patients, in which cultures taken from maxillary and ethmoid sinuses during the functional endoscopic sinus surgery were included. It is determined that the isolated aerob bacteria rate was 90.4%, and the isolated anaerob bacteria rate was 14.2%. All of the 6 samples in which anaerob bacteria isolated were all maxillary sinus aspiration materials. Microorganisms that isolated from the nose and the sinuses were similar with the rate of 25.8%, and microorganisms that isolated from the throat cultures and sinuses were similar with the rate of 22.5%. Conclusions: This study reveals the aerob and anaerob microbiology of the maxillary and ethmoid sinuses so the treatment of chronic sinusitis will be easier.

The Role of the Staphylococcus Aureus Nasal Carriage and Type of Vascular Access in the Outcome of High-Risk Patients on Hemodialysis

Populations of elderly and type-II diabetics are increasing worldwide. Therefore elderly diabetics on hemodialysis (HD), known to have higher nasal carriage rates, are also increasing. These patients are more often dialyzed through central venous catheters (CVCs). They represent the high-risk groups for Staphylococcus aureus linked vascular access-related septicemia (VRS) and ensuing mortality. The outcome of VRS in terms of mortality was studied in the three high-risk groups: elderly; type-II diabetics; elderly diabetics, following optimization of arteriovenous fistula (AVF) prevalence to at least 50%. Persistent nasal carriage was defined by two or more positive standardized nasal swab cultures performed on 187 ESRD patients undergoing HD from July 1997 to July 2000. Peripheral blood samples were collected for culture and sensitivity on clinical suspicion of septicemia. Overall, AVF prevalence of over 50% was achieved through joint efforts of nephrology and vascular surgery departments. A nasal carriage rate of 47.6% was observed in this HD cohort. This included nasal carriage rates of 16.4% in <65 years non-diabetic (reference) group, 55.8% in elderly and 70.7% among type-II diabetics along with that of 75.5% in elderly-diabetic group. We achieved an overall AVF prevalence of 72.7% inclusive of 66.17% in elderly, 65.5% in type-II diabetics and 86.8% in reference group along with 37.7% in elderly-diabetic group. We recorded a mortality due to S. aureus nasal carriage-related VRS of 6.86% in elderly (RR-1.50, p-NS), 10.91% in type-II diabetics (RR-1.52, p<0.02) and 13.20% in the elderly-diabetic group (RR-2.87, p<0.0004) as compared to that of 4.4% per year in the reference group (assigned RR of one) with overall mortality of 7.3% per year. AVF prevalence of over 50% is achievable in all the high-risk groups except among elderly-diabetics due to the predominance of peripheral vasculopathy. Optimizing AVF placement is a physiological and safer approach for achieving significant reductions in mortality associated with S. aureus nasal carriage-related VRS among high-risk groups.

THE IMPACT OF NASAL CARRIAGE OF METHICILLIN-RESISTANT AND METHICILLIN-SUSCEPTIBLE STAPHYLOCOCCUS AUREUS (MRSA & MSSA) ON VASCULAR ACCESS-RELATED SEPTICEMIA AMONG PATIENTS WITH TYPE-II DIABETES ON DIALYSIS

Background: Fairly higher nasal carriage rates among type-II diabetics place them at a greater risk of endogenous Staphylococcus aureus linked vascular access-related septicemia (VRS) that is also dependent on the type of vascular access used for hemodialysis (HD). The prevalence of nasal carriage of methicillin susceptible and methicillin-resistant S. aureus (MSSA and MRSA) and its impact on VRS was determined in order to identify most vulnerable group and plan potential prophylactic strategies, accordingly. Methods: Five standardized nasal swab cultures were performed in 208 patients enrolled for long-term HD through July 1996 to July 1999. Persistent nasal carriage was defined by two or more positive cultures for MSSA or MRSA. Peripheral blood cultures were collected on clinical suspicion of septicemia. Results: The prevalence of type-II diabetes of 28.0% with 72.4% of nasal carriage rate and three folds higher S. aureus related VRS (RR-3.19, p<0.0001) than diabetic non-carriers on HD, was observed. Type-II diabetics also had higher MSSA and MRSA nasal carriage rates (53.4% and 19.0%) than non-diabetic nasal carriers (18.6 and 6.0%) yet, carried a comparable (RR-4.0 vs. 4.5) risk of VRS between MSSA and MRSA nasal carriers. Among diabetic type-II S. aureus nasal carriers, central venous catheters (CVCs) carried 35 and 38 times higher collective risk of developing MSSA and MRSA nasal carriage-related VRS respectively than Arterio-venous fistula (AVF). The AVF recorded the lowest risk of developing MSSA and MRSA nasal carriage-related VRS (0.013 and 0.010 episodes/patient-year) in both diabetic type-II MSSA and MRSA nasal carrier groups. Conclusions: Diabetic type-II S. aureus nasal carriers on HD through CVCs make an extremely high-risk group for MSSA and MRSA nasal carriage-related VRS. The incidence of S. aureus nasal carriage-related VRS could reasonably be reduced through a challenging obligation of optimizing AVF prevalence in this high-risk group, while limiting the use of CVCs, at the same time.

Étude de la colonisation par Staphylococcus aureus résistant à la méticilline dans des services de soins de suite

Purpose. – Prevalence of methicillin-resistant Staphylococcus aureus is high in the Poitiers teaching hosiptal, particularly in the intermediate care facilities. We performed a survey of methicillin-resistant Staphylococcus aureus colonization in the intermediate care facilities and 265 patients were included. Methods. – Nasal, cutaneous and wound swab cultures were done at the time of admission and at the time of the patients’ departure. A decolonization procedure of methicillin-resistant Staphylococcus aureus carriers was performed using nasal application of fusidic acid and different soaps for the skin. At entry, 17.7% of patients were methicillin-resistant Staphylococcus aureus carriers (of at least one location). At departure, 30.4% were methicillin-resistant Staphylococcus aureus carriers. Among methicillin-resistant Staphylococcus aureus non-carriers at entry, 24.3% became methicillin-resistant Staphylococcus aureus carriers. Results. – The principal risk factor of carriage was the initial presence of a wound (RR = 3.6). The incidence rate of methicillin-resistant Staphylococcus aureus infection among the 265 patients included was 3%. Conclusion. – The systematic screening of patients at the time of admission is expensive and isolation technically hard to manage in the intermediate care facilities. The risk factor we found in this study allow us to propose a ‘light’ screening limited to patients with wounds.

Detection of fungi in the nasal mucosa using polymerase chain reaction.

Fungi have been increasingly recognized as important pathogens in sinusitis. However, detection of fungus with conventional culture techniques is insensitive and unreliable. Polymerase chain reaction (PCR) is an exquisitely sensitive assay that can detect the DNA of 10 or less fungal elements. The aim of this study was to compare the sensitivity of conventional culture techniques using PCR analysis. Nasal swabs and DNA samples were collected from the nasal cavities of control subjects and patients with chronic sinusitis. Fungal-specific PCR analysis and standard cultures were performed on every sample. chi2 analysis was used to test for statistical differences between groups. PCR analysis detected fungal DNA in 42% and 40% of control subjects and patients with chronic sinusitis while standard cultures were positive in 7% and 0%, respectively. There was no statistically significant difference in the prevalence of fungi in the normal volunteers and patients with chronic rhinosinusitis. PCR is significantly more sensitive than nasal swab cultures in detecting the presence of fungi in nasal mucosa. In addition, our study suggests that the presence of fungi alone is insufficient to implicate it as the pathogen in chronic sinusitis.

High frequency of colonization and absence of identifiable risk factors for methicillin-resistant Staphylococcus aureus (MRSA)in intensive care units in Brazil.

Colonization of hospitalized patients with methicillin-resistant Staphylococcus aureus (MRSA) is of increasing concern. To evaluate this problem in Intensive Care Units (ICUs) in Brazil, we studied 100 patients admitted to two ICUs from April to June, 1997. Of the 100 patients, 70 were male, 53 were age 60 years or older, 55 were previously hospitalized, 78 were transferred to the ICU from other hospital units, 49 had received antibiotic therapy, and 66 had undergone recent surgery. Nasal and axillary swab cultures were obtained on admission and every 48 hours thereafter until discharge. MRSA were identified by plating any cultured S. aureus on Mueller-Hinton agar containing 6 microg/ml of oxacillin. At the time of admission, 46 (46%) of the patients were colonized with MRSA. No associated risk factors for acquiring MRSA (age, previous hospitalization, prior surgery) could be identified. Of the 54 patients negative for MRSA on admission, 28 (52%) became colonized while in the ICU. Sixteen (22%) of the 74 colonized patients (colonized either on admission or during ICU stay) had associated respiratory or urinary tract infections due to MRSA, and 9 (56%) died. No correlation with special risk factors (invasive procedures, antibiotic use, age, chronic disease) was identified. MRSA occurred frequently, but there was minimal evidence of associated risk factors. Thus, control of MRSA cannot be accomplished by targeting special factors alone, but requires attention to preventing microbial spread in all areas. Of special concern is the high frequency of acquiring the organism in the ICU (52%). Education concerning the importance of hand washing, environmental surface cleaning, and barrier protection from infected patients is needed.

Epidemiological and virological influenza survey in Dakar, Senegal: 1996-1998.

An influenza survey was conducted in seven sentinel sites in Dakar, Senegal from June 1996 to December 1998. Throat or nasal swab cultures were randomly collected from 804 patients suffering from influenza-like symptoms. Influenza viruses were isolated at a similar proportion in adults and in children (P = 0.29). Strains of influenza B viruses were isolated from sporadic cases in 1997, whereas type A virus was associated with an isolated peak. Proportions of influenza virus isolation varied from 17.5% to 40.0% between 1996 and 1998 during the peak period (July/September) of acute respiratory infection in Dakar. Rainfall, humidity, and temperatures rose during the same period. Influenza in Dakar seems to be an-all-age groups respiratory infection characterized by high transmission during the hot and rainy season. The antigenic similarity of the A(H3N2) and B viruses to those circulating elsewhere in the world at the same time was confirmed. However, the A(H1N1) strains were found to be more closely related to an Asiatic strain which had not been isolated outside Asia previously. Consequently, the strain close to the A(H1N1)/Wuhan/371/95 strain isolated in Dakar was included in the composition of the 1998/1999 influenza vaccine. This reinforces the importance of setting up a national influenza control strategy in tropical regions.

Endoscopically guided sinonasal cultures: A direct comparison with maxillary sinus aspirate cultures

Sinusitis is a common medical problem that can at times be challenging to treat. Although most cases respond to empiric therapy, success is not achieved universally. If empiric therapy fails, it is important to identify the causative bacterial pathogen. Antral puncture is the traditional diagnostic method to recover and identify pathogens in sinusitis; however, it remains a painful, invasive test with potential complications. In contrast, rigid sinonasal endoscopy permits recovery of mucopus emanating from the sinus ostia with little pain and few possible complications. Endoscopy also affords important visual information that can confirm or refute a historical/clinical diagnosis of sinusitis. Although previous studies have shown poor correlation between nasal cavity swab cultures and maxillary sinus aspiration cultures, few investigations have compared endoscopically guided middle meatal cultures with cultures obtained from maxillary sinus aspiration. Thirteen patients with maxillary sinusitis in one or both sinuses underwent endoscopically guided culture of the middle meatus and maxillary sinus puncture with aspiration and culture (16 total study samples). Results from the microbiologic analysis were compared. Endoscopically guided middle meatal cultures accurately identified the predominant bacterial pathogen and correlated with the cultures from maxillary sinus aspiration in more than 90% of infections. These preliminary results suggest that endoscopically guided sinonasal cultures hold promise as a viable alternative to maxillary sinus aspiration. Endoscopically guided cultures appear to be an effective, noninvasive diagnostic tool for otolaryngologists managing sinusitis.

Endoscopically guided sinonasal cultures: A direct comparison with maxillary sinus aspirate cultures

Sinusitis is a common medical problem that can at times be challenging to treat. Although most cases respond to empiric therapy, success is not achieved universally. If empiric therapy fails, it is important to identify the causative bacterial pathogen. Antral puncture is the traditional diagnostic method to recover and identify pathogens in sinusitis; however, it remains a painful, invasive test with potential complications. In contrast, rigid sinonasal endoscopy permits recovery of mucopus emanating from the sinus ostia with little pain and few possible complications. Endoscopy also affords important visual information that can confirm or refute a historical/clinical diagnosis of sinusitis. Although previous studies have shown poor correlation between nasal cavity swab cultures and maxillary sinus aspiration cultures, few investigations have compared endoscopically guided middle meatal cultures with cultures obtained from maxillary sinus aspiration. Thirteen patients with maxillary sinusitis in one or both sinuses underwent endoscopically guided culture of the middle meatus and maxillary sinus puncture with aspiration and culture (16 total study samples). Results from the microbiologic analysis were compared. Endoscopically guided middle meatal cultures accurately identified the predominant bacterial pathogen and correlated with the cultures from maxillary sinus aspiration in more than 90% of infections. These preliminary results suggest that endoscopically guided sinonasal cultures hold promise as a viable alternative to maxillary sinus aspiration. Endoscopically guided cultures appear to be an effective, noninvasive diagnostic tool for otolaryngologists managing sinusitis. (Otolaryngol Head Neck Surg 2000;122:370-3.)

Bacterial colonization patterns in mechanically ventilated patients with traumatic and medical head injury. Incidence, risk factors, and association with ventilator-associated pneumonia.

We prospectively evaluated the relation of upper airway, lower airway, and gastric colonization patterns with the development of pneumonia and its etiology in 48 patients with surgical (n = 25) and medical (n = 23) head injury. Initial colonization was assessed by cultures of nasal and pharyngeal swabs, tracheobronchial aspirates, gastric juice, and bronchoscopically retrieved protected specimen brush. Follow-up colonization was determined until the end points extubation, suspected ventilator-associated pneumonia (VAP), or death. The initial colonization rate at any site at ICU admission was 39/47 (83%). It mainly accounted for Group I pathogens (Streptococcus pneumoniae, Staphylococcus aureus, Hemophilus influenzae) of the upper and lower airways. At follow-up, colonization rates with Group II pathogens (Gram-negative enteric bacilli and Pseudomonas spp.) increased significantly. The high initial bacterial load with Group I pathogens of the upper airways and trachea decreased during Days 2 to 4, whereas that of Group II pathogens increased. Upper airway colonization was an independent predictor of follow-up tracheobronchial colonization (odds ratio [OR], 9.9; 95% confidence interval [CI], 1.8 to 56.3 for initial colonization with Group I pathogens; OR, 23.9; 95% CI, 3.8 to 153.3 for follow-up colonization with Group II pathogens). Previous (short-term) antibiotics had a protective effect against colonization with Group I pathogens of the lower respiratory tract (OR, 0.2; 95% CI, 0.05 to 0.86), but they were a risk factor for colonization with Group II pathogens (OR, 6.1; 95% CI, 1.3 to 29). Initial tracheobronchial colonization with Group I pathogens was associated with a higher probability of early onset pneumonia (OR, 4. 1; 95% CI, 0.7 to 23.3), whereas prolonged antibiotic treatment (> 24 h) independently predicted late-onset pneumonia (OR, 9.2; 95% CI, 1.7 to 51.3). We conclude that patients with head injury are colonized in the airways mainly by Group I pathogens early in the evolution of illness. The upper airways represent the main reservoir for subsequent lower airway colonization with Group I pathogens. Previous (short-term) antibiotic treatment is protective against initial tracheobronchial colonization with Group I pathogens, but it represents a risk factor for subsequent lower airway colonization by Group II pathogens.

Selective screening of carriers for control of methicillin-resistant Staphylococcus aureus (MRSA) in high-risk hospital areas with a high level of endemic MRSA.

Screening for methicillin-resistant Staphylococcus aureus (MRSA) carriage in patients at risk was evaluated as part of a control program in a 26-bed medical intensive care unit (ICU) of a university hospital with a high level of endemic MRSA. Control measures included isolation and barrier precautions, skin decolonization with chlorhexidine of patients from whom MRSA was recovered, and mupirocin treatment of nasal carriers of MRSA. Of 3,686 patients admitted during a 4-year period, 44% were screened, which occurred during admission for 38%; MRSA was recovered from 293 patients (8%). There were 150 imported cases and 143 ICU-acquired cases, of which 51% and 45%, respectively, were first identified through screening. Nasal swab cultures identified 84% of MRSA carriers. The incidence of all ICU-acquired cases and of acquired colonization or infection decreased from 5.8% and 5.6% to 2.6% and 1.4% (P = .002 and P < .001), respectively, whereas that of imported cases remained unchanged (range, 3.8% to 4.3%; P = .8). Selective screening for nasal carriage during admission to high-risk areas may contribute to identification of a substantial proportion of cases of MRSA and to early implementation of effective control measures.

Nasal Carriage and Peritonitis by Staphylococcus Aureus in Patients on Continuous Ambulatory Peritoneal Dialysis: A Prospective Study

To establish whether or not patients on continuous ambulatory peritoneal dialysis (CAPD) using current infection control measures who are nasal carriers of Staphylococcus aureus are at risk for the development of S. aureus peritonitis. A prospective 22-month study analyzing nasal and skin/nasal (i.e., nasal and/or exit-site) carrier status for S. aureus and peritonitis episodes. Nasal swab cultures for S. aureus were taken with 1- to 3-month intervals; swab cultures from the catheter exit site were taken only when infection was suspected. Renal unit, tertiary-care center. All patients on CAPD at our center that could be observed during at least 2 months. None. Nasal and skin/nasal carrier status, occurrence of peritonitis. Of 54 enrolled patients, 31 (57%) were nasal carriers for S. aureus: 6 of these 31 developed S. aureus peritonitis as opposed to none of 23 non-carriers (p = 0.03). The S. aureus peritonitis rate in 28 skin/nasal carriers was increased when compared to non-carriers (p = 0.02), but there was no difference between chronic and intermittent skin/nasal carriers (p = 0.63). In our population, nasal carriers are at increased risk for the development of S. aureusperitonitis. Further studies should evaluate the effect of eradication of nasal carriage of S. aureus and the effect of additional preventive hygienic measures on the occurrence of peritonitis by S. aureus.

Leishmania donovani Parasites in the Nasal Secretions, Tonsillopharyngeal Mucosa, and Urine Centrifugates of Visceral Leishmaniasis Patients in Kenya

In the early 1930s, investigators of visceral leishmaniasis stated that Leishman-Donovan bodies are found in body fluids of kala-azar patients, for example, in urine, feces, semen, and nasal and pharyngeal secretions. Based on this finding, we investigated the diagnostic potential of nasal secretions, tonsillopharyngeal mucosal swabs, and urine centrifugates inoculated into Schneider's Drosophila Medium (containing antibiotics and antifungal agents) as well as with Giemsa-stained smears. Consequently, 64 randomly selected patients with visceral leishmaniasis from Kenya (59 who were splenic culture or Giemsa stain positive and five who were culture negative but Giemsa stain positive) were tested by three noninvasive methods. These tests were all performed before the patients were treated with Pentostam. Cultures of nasal and tonsillopharyngeal swabs and urine centrifugates produced 28 positive samples representing 24 patients (37.5%). Moreover, a set of 25 Giemsa-stained slide smears made from the nasal and tonsillopharyngeal mucosa of 25 patients with visceral leishmaniasis who had not tested positive in cultures produced nine positives. Therefore, the overall total of patients who tested positive by all of the above methods was 33 or 51.6%. The cryopreserved Leishmania isolates were characterized by cellulose acetate electrophoresis using 20 enzyme systems. The isoenzyme profiles produced by the parasites were represented in five different L. donovani s.l. zymodemes. Representatives of these isolates were also characterized by DNA Southern blotting analysis, which corroborated the isoenzyme results.

メチシリン耐性黄色ブドウ球菌 (MRSA) 院内感染における医療従事者鼻腔保有株の意義に関する検討

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most important microorganisms in nosocomial infection. Healthy medical staff working in MRSA endemic wards are known to have MRSA in their nasal cavity, swabs, but the significance of their positive nasal swab cultures in infections among the patients has not been confirmed. The purpose of this study was to compare the antibiotic susceptibility and coagulase typing of strains isolated from the infected patients and from nasal swab cultures of medical staff working in ICU. Twenty-six nurses and 20 doctors working in ICU where MRSA was endemic were examined. Six nurses and 10 doctors gave positive nasal swab cultures for S. aureus, and 2 of the nurses' strain and 5 of the doctors' strains were methicillin-resistant. These strains were sensitive to IPM, GM, MINO and OFLX, while the strains clinically isolated from infected patients were resistant to these antibiotics. MRSA isolated from nasal swab cultures from medical staff developed marked resistance to IPM, GM, MINO, and OFLX by incubating with these drugs, whereas they remained sensitive to VCM when they were incubated in VCM-containing medium. Methicillin-sensitive S. aureus (MSSA) isolated from nasal swab cultures of medical staff became resistant to DMPPC, CMZ, in addition to IPM, GM, MINO, and OFLX, but these strains did not develop resistance to VCM. Resistance to these drugs developed by incubating with these drugs did not diminish by incubating in drug-free medium for 3 weeks. The patients infected by MRSA had been previously given several kinds of antibiotics, whereas the medical staff had not been exposed to any kind of antibiotics during the same period. (ABSTRACT TRUNCATED AT 250 WORDS)

Preoperative screening cultures in the identification of staphylococci causing wound and valvular infections in cardiac surgery

Cultures of nasal or presternal swabs form part of the routine preoperative screening of patients on the cardiac surgical ward. During a trial of antibiotic prophylaxis in 314 patients, preoperative isolates of Staphylococcus aureus and coagulase-negative staphylococci were compared with strains associated with postoperative sternal wound breakdown (24 patients) and prosthetic valve endocarditis (3 patients). Morphology, antibiotic sensitivity pattern, plasmid analysis and phage typing were used to differentiate strains. In only three cases of wound infection and one of prosthetic valve endocarditis were pathogenic staphylococci not distinguishable from preoperative isolates. The collection of superficial swabs for this purpose before cardiac surgery is therefore unlikely to be cost effective.

Experimental contact transmission of Pasteurella haemolytica from clinically normal domestic sheep causing pneumonia in Rocky Mountain bighorn sheep.

Two Rocky Mountain bighorn lambs (Ovis canadensis canadensis) were held in captivity for 120 days before being housed with two domestic sheep. The lambs were clinically normal and had no Pasteurella spp. on nasal swab cultures. The domestic sheep were known to carry Pasteurella haemolytica biotype A in the nasal passages. After being in close contact for 19 days. P. haemolytica biotype A was cultured from nasal swabs of one of the bighorn lambs. By 26 days, both bighorn sheep developed coughs, were anorectic and became lethargic and nasal swabs yielded P. haemolytica biotype T, serotype 10. Twenty-nine days after contact, the lambs were necropsied and found to have extensive fibrinous bronchopneumonia. From affected tissues pure cultures of beta-hemolytic P. haemolytica biotype T, serotype 10 were grown. Both domestic sheep remained clinically normal and had no gross or microscopic lesions, but they carried the same P. haemolytica serotype in their tonsils. Behavioural observations gave no indication of stress in the bighorn lambs.

Direct Sibling Contact Bacterial Colonization in Newborns

A two-phase, experimental study tested the hypothesis that no significant association exists between direct sibling contact and the bacterial colonization rates of neonates during their initial hospital stay. In Phase I, 44 infants were randomly assigned to experimental (N = 23) and control (N = 21) groups. Infants in the experimental group had direct contact with an older sibling who had been screened for communicable diseases; infants in the control group did not. The dependent variable, bacterial colonization, was measured using cultures of nasal and umbilical swabs of all neonates in the study. Swabs were taken at admission and discharge. In Phase II, the same procedures were followed except that swabs were taken from the neonates (N = 33 in each group) at admission, before the sibling contact, and at discharge. Analysis of the data using the standard error of the difference between proportions showed no significant differences in the proportion of infants colonized by staphylococcal and streptococcal organisms. Thus, bacterial colonization rates and older sibling contact were not associated. Implications for care and further research are discussed.

Infection of Bighorn Sheep (Ovis canadensis) with Myxovirus parainfluenza-3 and Other Respiratory Viruses. Results of Serologic Tests and Culture of Nasal Swabs and Lung Tissue

Hemagglutination-inhibition (HI) tests of serum samples from 51 bighorn sheep (Ovis canadensis) and 4 bighorn-domestic hybrid sheep from Wyoming and Montana revealed bovine myxovirus parainfluenza-3 antibody titers of 1:20 or greater in 6 animals. The serums of two bighorns with pneumonia were negative for neutralizing antibodies against IBR virus and the serums of 9 animals failed to show significant titers against 2 strains of human Asian influenza virus. Tissue cultures of nasal swabs and lung tissue were negative for cytopathogenic effects and hemadsorption.