The stability of IS6110 restriction fragment length polymorphism (RFLP) pattern was determined in 31 isolates from patients with multidrug-resistant tuberculosis (MDR-TB). These patients were in actual chains of transmission and they referred to the National Institute of Tuberculosis and Lung Diseases, Tehran, Iran. Susceptibility testing against first- and second-line drugs were performed by the proportional method on Lowenstein–Jensen culture media. Thereafter, DNA fingerprinting by IS6110 with direct repeat (DR) region as a probe was performed by standard protocols. The rate of IS6110 changes was 16%, although, no variation was found in the DR region, in a time-span of 1–63 months. The strains with unstable IS6110 patterns were resistant to all drugs tested, and the majority of them (60%) were collected from HIV-positive patients. The results demonstrated that for a reliable interpretation of strain typing, it is better to use an additional marker along with IS6110 RFLP.

Aboriginal Australians in remote communities have high rates of rheumatic heart disease (RHD); yet pharyngitis is reportedly rare whilst pyoderma is common. Some strains of group A streptococci (GAS) have preference for the throat and others for the skin depending on M protein type. A study in three remote communities provided 350 GAS isolates for emm sequence typing, 244 were also emm pattern typed. There was 100% correlation between emm sequence and pattern type. Patterns D and E (non-throat tropic) made up 71% of throat and 87% of skin isolates although patterns A–C (throat tropic) were more common in the throat than the skin (RR 2·3, 95% CI 1·4–3·8) whilst the opposite was found for pattern D (RR 2·2, 95% CI 1·7–3·0). Pattern E favoured the throat (RR 1·4, 95% CI 1·1–1·8). Where environmental factors predispose to skin infection, emm pattern types D and E prevail, whatever the recovery site.

Data from the 1997–2004 Surveys of Prevalent HIV Infections Diagnosed were analysed by three geographical areas of residence and treatment to describe the heterogeneous growth of the HIV epidemic in England and provide projections to 2007. Between 1997 and 2004, the number of diagnosed HIV-infected adults resident in England increased by 163% (14223 to 37459). Within the ‘London environs’ the increase was 360% (742 to 3411), within the rest of England 219% (4417 to 14088) and within London 120% (9064 to 19960). By 2004, the London environs had the largest proportion of infections acquired through heterosexual sex (and in particular women) and the most recently diagnosed population. Projections indicate over half of diagnosed HIV-infected adults will live outside London by 2007. The epidemiology of diagnosed HIV infection within the London environs is likely to be a predictor of future trends in England overall.

The objective of this study was to evaluate the degree of underreporting to the Italian National Legionellosis Register (NLR). For the year 2002, all cases of Legionellosis notified to the NLR were compared with cases recorded in the hospital discharge record (HDR) database. The number of unreported cases and the total number of cases in the population were estimated using the capture–recapture method with two independent data sources. Seventeen out of 21 Italian regions participated in the study. Overall, underreporting was estimated to be 21·4% and was found to be significantly greater in the Centre-South (28·2%) than in the North (20·0%). However, even after taking into account the higher degree of underreporting, a significantly lower incidence of the disease is registered in central-southern Italy. The hypothesis, which needs to be verified, is that, in addition to underreporting, under-diagnosis of legionellosis is more widespread in this geographical area.

We surveyed emm genotypes of group A streptococcus (GAS) isolates from patients with severe invasive streptococcal infections during 2001–2005 and compared their prevalence with that of the preceding 5 years. Genotype emm1 remained dominant throughout 2001 to 2005, but the frequency rate of this type decreased compared with the earlier period. Various other emm types have appeared in recent years indicating alterations in the prevalent strains causing severe invasive streptococcal infections. The cover of the new 26-valent GAS vaccine fell from 93·5% for genotypes of isolates from 1996–2000 to 81·8% in 2001–2005.

Due to an oversight the legend to Figure 1 appeared with errors in the key.

The figure, with its correct legend, is reproduced below.

Fig. 1.

Percentage survival on glass of all seven meningococcal strains by sampling time. □, NZ97/122; , Cu00162; ■, NZ03/280; , NZ98/254; , H44/76-SL; , NZ04/198; , NZ03/225.

Respiratory syncytial virus (RSV) infection produces more severe disease and increased hospitalization rates in high-risk babies. The monoclonal antibody palivizumab offers protection against complications, and the first of five monthly doses should be administered before the onset of community RSV activity. However, the required real-time prediction of this onset is problematic. We attempted to identify seasonal RSV patterns by retrospectively examining 10 years of laboratory reports for RSV and clinical episode reports for certain respiratory presentations in both primary and secondary care. Analysis of hospital laboratory reports, incidence of acute bronchitis in primary care, and hospital admissions for acute bronchitis and bronchiolitis in young children revealed a consistent increase in RSV activity during week 43 each year. Promptly commencing prophylaxis during the second week of each October (week 42) would precede the onset of the RSV season in the United Kingdom, and provide coverage until its decline in mid-March.

Although community-onset bloodstream infection (BSI) is recognized to be a major cause of morbidity and mortality, there is a paucity of population-based studies defining its overall burden. We conducted population-based laboratory surveillance for all community-onset BSI in the Calgary Health Region during 2000–2004. A total of 4467 episodes of community-onset BSI were identified for an overall annual incidence of 81·6/100 000. The three species, Escherichia coli, Staphylococcus aureus, and Streptococcus pneumoniae were responsible for the majority of community-onset BSI; they occurred at annual rates of 25·8, 13·5, and 10·1/100 000, respectively. Overall 3445/4467 (77%) episodes resulted in hospital admission representing 0·7% of all admissions to major acute care hospitals. The subsequent hospital length of stay was a median of 9 (interquartile range, 5–15) days; the total days of acute hospitalization attributable to community-onset BSI was 51 146 days or 934 days/100 000 annually. Four hundred and sixty patients died in hospital for a case-fatality rate of 13%. Community-onset BSI is common and has a major patient and societal impact. These data support further efforts to reduce the burden of community-onset BSI.

This study examined the geographical distribution and diversity of the intrinsic OXA-51-like class D carbapenemases among Acinetobacter baumannii clones recovered in three major Greek regions from 2000 to 2005. The blaOXA-66 allele was exclusively detected among clonally distinct A. baumannii isolates recovered in the regions of Thessaloniki and Larissa. This sequence was also the most widespread among A. baumannii isolates in Athens, while less frequent were blaOXA-69 and blaOXA-65 alleles. These findings highlight the high prevalence of a specific blaOXA-51-like allele in Greece, possibly indicating that our A. baumannii clones might have originated from a common ancestor. However, the possibility that blaOXA-51-like variants, with blaOXA-66 predominating, are widely disseminated among several unrelated A. baumannii strains cannot be excluded.

The occurrence of Brachyspira species and Lawsonia intracellularis was investigated by PCR analyses of faeces from 60 children living on European pig farms. In addition, 60 other children were included as controls. Two samples were positive for B. aalborgi but B. pilosicoli and L. intracellularis were not demonstrated.

Notifications of campylobacteriosis by New Zealand medical practitioners have increased steadily in the last two decades. To determine if this increase is real, as opposed to a surveillance artefact, we examined both available notification (1980–2003) and hospitalization data (1995–2003). The similarity in the temporal pattern of increasing hospitalizations for campylobacteriosis, with that of notifications, is suggestive that this increase is indeed real. Although some risk factors for this disease have been identified (e.g. uncooked poultry consumption) it is unclear what the likely causes of the increasing rates are. The overall disease burden is also high compared with other developed countries (an annual notification rate of 396 cases per 100000 population in 2003), with highest rates in children aged 1–4 years, males, Europeans, and those living in urban areas. Given the large disease burden, further research and intervention studies should be public health priorities in this country.

CYP2C19 polymorphisms and smoking influence the efficacy of H. pylori eradication therapy, but interaction between the two have hitherto not been examined. A total of 142 H. pylori-positive patients who received triple drug therapy with lansoprazole, amoxicillin and clarithromycin were categorized into three groups with regard to diplotypes of CYP2C19: homozygous extensive metabolizer (homEM), heterozygous EM (hetEM), and poor metabolizer (PM). The overall success rate was 61·3%. Smoking was an independent risk factor of eradication failure (OR 2·81, 95% CI 1·14–6·91), whereas CYP2C19 polymorphisms were less influential. Among non-smokers, the homEM and hetEM groups showed worse eradication rates (58·5 and 67·3%) relative to PM (76·2%) as expected; however, an opposite trend was observed among smokers (homEM 50·0%, hetEM 46·7%, PM 20·0%), indicating possible interactions with CYP2C19 polymorphisms. Smoking has a greater influence on H. pylori eradication than the CYP2C19 genotype. Interaction between smoking and CYP2C19 should be examined in the future.

Although Streptococcus agalactiae has emerged as an important cause of invasive disease, relatively little is known regarding the genetic basis of virulence of this organism. Three novel genes with characteristics suggesting a role in virulence were identified via comparison of sequenced genomes of S. agalactiae. The presence of these genes and of the previously identified genes bac, bca, rib, and spb1 was determined, and isolates were assigned a binary genetic signature. It was found that isolates containing spb1, previously suggested to be limited to serotype III-3, were represented by 18 different genetic signatures and several serotypes, and that the presence of both sbp1 and rib was more predictive of invasive disease than spb1 alone. Additionally, bac-positive isolates, reported to be genetically homogeneous, were represented by 14 different genetic signatures. Finally, the majority of serotype V isolates examined contained zero or only one of the genes tested, suggesting that much remains undiscovered regarding important virulence factors in isolates of this serotype.

The authors of the above article regret that there was an error in the heading for Table 4. It should read:

Table 4. Homogeneous pre-vaccination susceptibility among sites; heterogeneity of vaccine effect within sites and confounding from exposure to infection; no boosting; increasing proportion exposed to infection in trial (A: 1/125, once; B: 1/2, once; F: 1/1, once; G: 2; H: 3; I: 4; J: 5; K: 6; L: 7; M: 8) (VEc=0·5; VEc=0; TPc0=TPc=1; Nc=Nc=500)

The authors of the above article regret that several errors appear in their published paper:

On Page 360: In the section entitled ‘Case review of 1996 shigellosis food poisonings’, reference [22] should be reference [11].

On Page 362: In the section entitled ‘Case review of the 2000 Kosovo tularemia outbreak’, both references [77] should be reference [29]. Reference [82] should be reference [31].