We retrospectively reviewed 419 HIV/AIDS patients in Hospital Kuala Lumpur from 1994 to 2001. In the male group, the age range was 20 - 74, with a mean age 37 years, while in the female group it was 17 - 63, with a mean age of 33 years. With regard to age group, it was found that the preponderant age group was 25 - 34 years. The majority of male subjects were Chinese (52.5%), single (56.3%), and unemployed (55.1%), whereas the females were Malay (42.3%), married (79.5%), and non-laborer (64.1%). Also, both groups resided in Kuala Lumpur and had heterosexual contact as the leading cause of HIV transmission. More than half of the patients had CD4 cell counts of < 200 cells/cumm. We found that the acquisition of HIV infection via intravenous drug use (IDU) was directly related to the incidence of tuberculosis infection (P < 0.05). Further analysis showed HIV-related tuberculosis with IDU was also dependently correlated with occupational status (unemployed) (P < 0.05). The four main AIDS-defining diseases include tuberculosis (48%), Pneumocystis carinii pneumonia (13%), toxoplasmic encephalitis (11%), and cryptococcal meningitis (7%); in addition, 53% of these patients were found to have CD4 cell counts of less than 200 cells/cumm at the time of diagnosis.

To investigate encephalitis in Taiwan, a multicenter study was conducted with patients who had acute severe neurological dysfunction and suspected encephalitis from May 2000 to December 2001. Demographic data such as age, sex, and seasons were analyzed. Polymerase chain reaction analyses were performed to determine the microbiologic diagnosis. The patients included 73 males and 54 females, with a peak age of 10 - 40 years old. Microbiologic diagnoses in 86 (69%) of 124 cases involved herpes simplex virus (HSV, 45 cases), varicella zoster (16 cases), Mycobacterium tuberculosis (10 cases), cytomegalovirus (8 cases), adenovirus (5 cases), influenza (1 case), and enterovirus (1 case). Pathogens were found in 69% of the cases. Encephalitis was most likely to occur in June and July. Based on the results, HSV is still the major viral cause of encephalitis in Taiwan.

The usefulness of an automated ribotyping system (RiboPrinter) was evaluated for characterizing and identifying clinical isolates of 37 verocytotoxin-producing Escherichia coli (VTEC) strains and 16 non-VTEC strains. All strains were successfully ribotyped with satisfactory reproducibility and stability and characterized into 10 different ribogroups. All VTEC O157 strains were characterized into a specific ribogroup and correctly typed into the specific DuPont ID for VTEC O157:H7, while all of the non-VTEC O157 strains were clearly distinguished from VTEC O157. VTEC O26 and O111 strains, the most prevalent VTEC serotypes after O157, were also well characterized into specific ribogroups and identified. These results suggest that the RiboPrinter may have an advantage over other typing systems in that it can rapidly and easily discriminate VTEC from non-VTEC strains of the most prevalent VTEC serotypes in Japan, even though it provides a lesser degree of discrimination than pulsed-field gel electrophoresis (PFGE). With a hierarchical or sequential typing combining the RiboPrinter and PFGE, rapid and accurate typing can be achieved during an outbreak of VTEC, which may be useful in clinical and public health settings.

Dengue fever and dengue hemorrhagic fever are serious illnesses in many tropical and subtropical countries. Laboratory tests are essential for the confirmation of dengue virus infection. In the present study, we examined the reliability of reverse transcriptase polymerase chain reaction (RT-PCR) in the laboratory diagnosis of dengue, especially in secondary dengue virus infections. We defined the day when fever subsided as fever day 0. In primary dengue virus infection, the dengue viral genome was detected in all of the 7 samples which were collected on fever day –1 or earlier, in 3 of 4 samples on fever day 0, and in 1 of 2 samples on fever day 1. None of the samples collected on fever day 2 or later were positive by RT-PCR. In secondary dengue virus infection, the dengue viral genome was detected in all of the 28 samples which were collected on fever day –2 or earlier, in 25 of 26 on fever day –1, in 29 of 34 on fever day 0, and in 5 of 10 on fever days 1 - 2. None of the samples collected on fever day 3 or later were positive. Virus isolation and direct titration were attempted using the plasma samples. When the data of secondary infection cases were analyzed based on fever day, dengue viruses were isolated from all of the 5 samples which were collected on fever day –2 or earlier, in 5 of 13 samples on fever day –1, and in 4 of 22 on fever day 0, but were not isolated from any of the 4 samples collected on fever days 1 - 2. Viruses were directly detected in 7 of 11 samples on fever day –2 or earlier, in 4 of 13 on fever day –1, and in 1 of 16 on fever day 0. These results indicate that RT-PCR is more sensitive than virus isolation and direct virus titration for determining secondary dengue virus infection. The results also suggest that RT-PCR is a useful diagnostic test for confirmation of dengue virus infection in secondary infection as well as in primary infection, especially when plasma samples are collected before the fever subsides.

Using the guidelines of the National Committee for Clinical Laboratory Standards (NCCLS), a total of 421 blood culture isolates of Salmonella enterica serovar Typhi obtained during 1991 - 2001 were tested for susceptibility to ofloxacin (OFX) by the disc diffusion method, and for the determination of minimum inhibitory concentration (MIC) values of OFX by the agar dilution method. Among 421 isolates, 248 were fully OFX-sensitive showing MICs of 0.0125 - 0.075 μg/ml and inhibitory zone diameters of ≧24 mm. The remaining 173 isolates (MICs of 0.5 - 1.5 μg/ml) that were treated with OFX did not respond to the therapy. However, 169 (97.69%) of the 173 isolates were determined to be susceptible (zone diameter ≧16 mm) by the disc diffusion method, whereas only 3 were intermediately-susceptible (zone diameter 13 - 15 mm) and the final isolate showed OFX-resistance (zone diameter 12 mm). Thus, following the NCCLS guidelines, OFX-resistance in S. enterica serovar Typhi was not detected by the disc diffusion test. The present data suggest a revision of the NCCLS breakpoints in selecting OFX as the preferred treatment regimen for S. enterica serovar Typhi.

This study aimed to detect the age-specific mumps seroprevalence of an unvaccinated population of adolescents in Ankara, Turkey and to compare the prevaccination epidemiology of mumps with those of some other countries. Four hundred and forty adolescents (227 females, 213 males) aged 9 - 16 years who were admitted to the Adolescent Unit were included in this study. For each participant, a questionnaire was completed and mumps-specific IgG antibodies were screened quantitatively by enzyme-linked fluorescent assay. Of the 440 patients screened for mumps antibodies, 48 (10.9%) were seronegative. Mumps seronegativity according to sex and age groups were 13.6, 9.9, and 10.4% in females and 18, 10.2, and 6.2% in males in the age groups of 9 - 10, 11 - 13, and 14 - 16, respectively. Mumps immunization models similar to those of European countries might be acceptable for Turkey, but since a low vaccination coverage may shift mumps infection to older ages, mumps immunization of adolescents is important until a national mumps vaccination program with a high coverage could be sustained. The routine health supervision visit at ages 11 to 12 years is an ideal time to immunize unvaccinated adolescents.