Every bacteriologist is only too well aware of the many problems presented by the preparation of culture media for the growth of bacteria in vitro.

Two cases of fatal melioidosis are described. The first a robust Indian labourer; the second a well-nourished, muscular European.

Case 1. Gradual onset. Irregular fever. Pain in the epigastrium. No physical signs of disease at first, except enlarged spleen; later, there were signs of consolidation at the bases of both lungs. Constipated at first; diarrhoea came on towards the end and the patient collapsed and died at the end of the third week.

At the autopsy; there were small patches of consolidation in the lungs, composed of minute suppurating tubercles. In the liver there were similar aggregations of small suppurating tubercles and two circumscribed abscesses. The gall-bladder was thickened. The spleen was enlarged and contained septic infarcts and abscesses. In the caecum there were small superficial ulcers. B. whitmori was cultivated from the lungs, spleen, liver and gall-bladder.

Animals were inoculated as follows: A guinea-pig, inoculated in the anterior nares with pus from the liver, died nine days later with caseous inflammation of the nasal passages and a caseous inguinal gland from which B. whitmori was recovered. A guinea-pig, inoculated subcutaneously with pus from the liver, died on the twenty-fifth day with abscesses in the lymphatic glands from which B. whitmori was cultivated. A guinea-pig, inoculated subcutaneously with a culture of the organism, died within sixteen hours from septicaemia. B. whitmori was recovered from the heart and spleen. A guinea-pig, inoculated subcutaneously with an attenuated culture, died on the twenty-fifth day with suppurating buboes and with abscesses in the liver and lungs from which B. whitmori was cultivated. Two horses were inoculated subcutaneously with cultures of the strain of B. whitmori cultivated from the patient. An abscess developed at the site of inoculation, in each case, but the local lesion healed and the animals have, so far, remained healthy.

Case 2. The illness commenced gradually with pain after food, occasional vomiting and looseness of the bowels. The temperature became high and of the swinging type, accompanied by rigors and sweats. The liver was enlarged. The patient died on the twenty-fifth day.

At the autopsy, two large abscesses were found in the liver, the gall-bladder was thickened and there were a few small superficial ulcers in the caecum. B. whitmori was cultivated from the liver abscess. No amoebae were found.

The following animals were inoculated. Two wild rats were inoculated subcutaneously with a culture from this case and both died from septicaemia in less than twenty-four hours. B. whitmori was recovered from the heart's blood. The result of the subcutaneous inoculation of a guinea-pig was the same. A guinea-pig, inoculated in the nostril, died on the fifth day with a cheesy deposit in the nose and septicaemia. Another guinea-pig, inoculated in the same way, but after the organism had been subcultivated repeatedly, died on the twelfth day, with caseous tracheal glands containing B. whitmori. A rabbit, inoculated subcutaneously, died in twenty-six hours from septicaemia with tubereles in the peritoneum. B. whitmori was cultivated from the peritoneum and from the heart's blood. A monkey fed on a culture remained healthy. A pony inoculated intravenously recovered after a week's fever.

High Staphylococcus hyicus colonization rates were found in vaginal samples of healthy breeding sows and in skin samples of their offspring. Twenty-two different phage types were identified among the 720 isolates of S. hyicus examined. Two to 13 different phage types were isolated per herd. Phage typing, as well as characterization of about 10% of the isolates by plasmid profiles and antibiogram patterns, showed that, several different clones of S. hyicus could be present simultaneously in vagina of gilts and also on skin of piglets. Generally isolates from the vagina of one animal were identical as regards to phage types, plasmid profiles, and antibiogram patterns during the entire investigation period. Isolates from the skin of piglets were of the same type as their mothers, indicating that vertical transmission had taken place. S. hyicus strains isolated from the skin of piglets within 24 h after birth were identical to strains isolated 3 weeks after birth from the same litter, indicating that the vaginal strains became part of a stable skin flora.

Calculations have been carried out which suggest that as few as 6 × 104 molecules of anti-poliovirus antibody per millilitre of serum may be sufficient to prevent the clinical disease under certain epidemic conditions. Other calculations have been made involving therapy of the experimental disease in monkeys and certain factors required for successful serum therapy have been discussed.

Japanese encephalitis (JE) is a serious health problem in the southwestern region of Nepal. Serological diagnostic kits for routine diagnostic use in this region have not been available. This study was performed to examine if the particle agglutination (PA) assay for Japanese encephalitis virus (JEV) IgM could be applicable to the samples collected in Nepal and also to evaluate the accuracy of clinical diagnosis of JE. One hundred and ninety-three blood samples were collected from the patients clinically diagnosed with JE or other infectious diseases in the JE-endemic, southwestern region of Nepal, in 2000. The PA assay was performed on these 193 serum samples and the results were compared with those by IgM-capture ELISA. Eighty-six samples were IgM-positive by the PA assay, and 71 of 86 were also positive by IgM-capture ELISA (sensitivity, 99%; specificity, 88%; positive predictive value, 0·82; negative predictive value, 0·99). These results suggest that the PA assay is a simple, reliable and useful diagnostic test to support clinical diagnosis in rural hospitals of Asia including Nepal.

Hispanic/Latino populations are disproportionately impacted by coronavirus disease 2019 (COVID-19) in the United States. The impact of state reopening on COVID-19 in this population after stay-at-home orders is unknown. We evaluated the incidence, prevalence and trends during reopening of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) at a major federally qualified health centre in Providence, Rhode Island. A total of 14 505 patients were tested for SARS-CoV-2 from 19 March to 18 August 2020, of which, data on 13 318 (91.8%) patients were available; 70.0% were Hispanic/Latino, and 2905 were positive for SARS-CoV-2 infection. The urban Hispanic/Latino population was almost five times more likely to test positive for SARS-CoV-2 (risk ratio 4.97, 95% CI 2.59–9.53, P < 0.001) compared to non-Hispanic White. The positivity rates among the urban Hispanic/Latino population remained >10% during all phases of reopening. The trends of the incidence rates showed similar associations to those we observed for positivity rates. Public health interventions to address SARS-CoV-2 in Hispanic/Latino communities are urgently needed, even in latter phases of state reopening.

Massive use of antibiotics has led to increased bacterial resistance to these drugs, making infections more difficult to treat. Few studies have assessed the overall antimicrobial resistance (AMR) burden, and there is a paucity of comprehensive data to inform health policies. This study aims to assess the overall annual incident number of hospitalised patients with AMR infection in France, using the National Hospital Discharge database. All incident hospitalisations with acute infections in 2016 were extracted. Infections which could be linked with an infecting microorganism were first analysed. Then, an extrapolation of bacterial species and resistance status was performed, according to age class, gender and infection site to estimate the total number of AMR cases. Resistant bacteria caused 139 105 (95% CI 127 920–150 289) infections, resulting in a 12.3% (95% CI 11.3–13.2) resistance rate. ESBL-producing Enterobacteriaceae and methicillin-resistant Staphylococcus aureus were the most common resistant bacteria (>50%), causing respectively 49 692 (95% CI 47 223–52 142) and 19 493 (95% CI 15 237–23 747) infections. Although assumptions are needed to provide national estimates, information from PMSI is comprehensive, covering all acute bacterial infections and a wide variety of microorganisms.

1. An outbreak is described of fatal epidemic enteritis due to B. dysenteriae Sonne which occurred in the autumn, 1928, in the infant wards of a hospital in Glasgow.

2. The clinical histories of two fatal cases are given.

3. The bacteriological and immunological examination of two strains of B. dysenteriae Sonne is described.

4. The results are given of a series of animal inoculations undertaken to study the virulence of B. dysenteriae Sonne and the nature of the lesions which it produces. To these are added the results of certain feeding experiments.

In a preliminary report (Hewlett, Villar and Revis, 1909, p. 278) published last year a summary of conclusions at which we had arrived with regard to the nature of the cellular elements present in milk was set forth. These conclusions were formulated on results obtained during a prolonged quantitative and qualitative examination of these cellular elements in milks obtained from known sources under veterinary supervision, and possess, we believe, a chronological significance which, with the exception of results published by Russell and Hoffmann (1907), has been somewhat lacking in many investigations. For this purpose we selected four dairy farms at which milk was being produced for sale on ordinary commercial lines, but under various conditions of environment, both architectural and sanitary. Together with these we were also enabled, through the kindness of Professor Percival, to make use of cows in the experimental herd of the University College of Reading.

In this study, we investigated the antigenic and genetic characteristics of influenza viruses circulating in Bulgaria during the 2017/2018 season. The detection and typing/subtyping of influenza viruses were performed using real-time RT-PCR. Results of antigenic characterisation, phylogenetic and amino acid sequence analyses of representative influenza strains are presented. The season was characterised by the predominance of B/Yamagata viruses, accounting for 77% of detected influenza viruses, followed by A(H1N1)pdm09 (17%), B/Victoria (3.7%) and A(H3N2) (2.4%). The sequenced B/Yamagata, B/Victoria, A(H1N1)pdm09 and A(H3N2) viruses belonged to the genetic groups 3, 1A, 6B.1 and 3C.2a1, respectively. Amino acid analysis of B/Yamagata isolates revealed the presence of three changes in haemagglutinin (HA), eight changes in neuraminidase (NA) and a number of substitutions in internal proteins compared with the B/Phucket/3073/2013 vaccine virus. Despite the amino acid changes, B/Yamagata viruses remained antigenically related to the vaccine strain. B/Victoria isolates fell into a group of viruses with double deletion (Δ162–163) in HA1. Substitutions in HA and NA sequences of B/Victoria, A(H1N1)pdm09 and A(H3N2) viruses were also identified compared with the vaccine strains, including in antigenic sites. The results of this study confirm the genetic variability of circulating influenza viruses and the need for continual antigenic and molecular surveillance.

Ribotype, biotype and resistance phenotype were used to characterize 37 Acinetobacter baumannii–A. calcoaceticus complex isolates responsible for nosocomial infections in Buenos Aires. Nineteen isolates were recovered from endemic infections at 2 hospitals and 18 represent an intensive care unit outbreak that occurred in a third hospital. By ribotyping isolates were classified into five different clones of A. baumannii biotype 2, 3 of A. baumannii biotype 9, and 3 of Acinetobacter genospecies 13. Combination of the three epidemiological markers permitted categorization of 18 outbreak isolates into four probable strains: 2 A. baumannii biotype 2. named type I. and II, and 2 A. baumannii biotype 9. Type I (15 isolates) was the most prevalent strain at one hospital and was responsible for the outbreak. In conclusion, combined analysis of biotypes, resistance phenotypes, and ribotypes was an accurate approach for epidemiologic investigation of A. baumannii. Furthermore, ribotyping discriminated Acinetobacter genospecies 13 isolates which were phenotypically difficult to type.

Cytomegalovirus (CMV) enters latency after primary infection and can reactivate periodically with virus excreted in body fluids which can be called shedding. CMV shedding during the early stage of pregnancy is associated with adverse pregnancy outcome. The shedding pattern in healthy seropositive women who plan to have babies has not been well characterised. Vaginal swabs, urine and blood were collected from 1262 CMV IgG-positive women who intended to have babies and tested for CMV DNA by fluorogenic quantitative PCR method. Serum IgM was also detected. The association between sociodemographic characteristics and CMV shedding prevalence was analysed. Among 1262 seropositive women, 12.8% (161/1262) were detected CMV DNA positive in at least one body fluid. CMV DNA was more frequently detected in vaginal secretion (10.5%) than in urine (3.2%) and blood (0.6%) also with higher viral loads (P < 0.00). CMV shedding was more likely detected in IgM-positive women than IgM-negative women (29.5% (13/44) vs. 12.2% (148/1218); OR 3.03, 95% CI 1.55–5.93; P = 0.001). CMV shedding in vaginal secretion was highly correlated with shedding in urine, the immune state of IgM, the adverse pregnant history and younger age. CMV shedding was more commonly detected in vaginal secretion than in urine or blood with higher viral loads among healthy seropositive women of reproductive age. Further studies are needed to figure out whether the shedding is occasional or continuous and whether it is associated with adverse pregnancy outcomes.

Campylobacter species such as C. jejuni and C. coli are recognized as major causes of acute gastroenteritis world-wide. Although C. jejuni and C. coli are usually non-pathogenic in birds and animals, they cause enteric disease in humans and the source of infection is often the consumption of contaminated foodstuffs. In this paper we report on the development and use of a multiplex PCR of C. jejuni genomic DNA which yielded a PCR product with a unique polymorphic site that can be used to quickly and accurately identify and group C. jejuni isolates from any source including DNA, cell culture, skin washings and faecal samples. The test is simple and sensitive and can detect purified DNA from a single bacterium 102 cells from crude lysates, 103 cells in seeded faeces and 120 cells/ml of washing of 1 cm2 skin fragments of chicken skin.

The extraction of group A streptococcal antigens by group C phage-associated lysin has been confirmed. In addition to the T antigen the extract contained M-protein, group-specific polysaccharide and mucopeptide antigen which was difficult to remove. This method of extraction of the T antigen was compared with the trypsin method. The latter method was found to be of advantage in giving a pure specific antigen.

Bacteriostatic activity for milk-sensitive and milk-resistant strains of Escherichia coli is reduced when IgA is removed from milk by precipitation. Lysozyme is not involved in bacteriostasis and can be removed without loss of activity; heavy bentonite absorption however removes some lactoferrin causing partial loss of activity.

The heat-labile antigen eliciting bacteriostatic antibody for E. coli is present in milk-sensitive and milk-resistant strains and in some other Enterobacteriaceae, e.g. salmonella; it cross reacts with the antigen in others, e.g. proteus and enterobacter. The antibody is therefore likely to be present in all human milk as a result of the normal commensal gut flora and with widespread activity.

1. A marked sex variation in susceptibility to warfarin was found in 6-month old L.A.C. Grey mice, males being more susceptible than females. No sex difference in response was evident in young mice 6 weeks old.

2. Susceptibility to warfarin poisoning increased markedly with age in males but not in females.

3. No significant increase in mortality following warfarin poisoning occurred in adult female mice given methyl testosterone.

(1) Fifty S. aureus and 30 S. albus strains obtained from infective processes in man have been investigated. Such cultural reactions as were completed did not differentiate between strains of S. albus and S. aureus, or serve to group these cocci; we found, however, that 94 per cent, of the S. aureus strains fermented mannite, as opposed to 40 per cent, of the S. albus strains. These results are in accordance with the findings of Cummins and Cumming (1913) and Hine (1922).

(2) A close degree of correlation between pathogenicity for rabbits, pigment formation, and biochemical activity was noticed among the S. aureus strains. Out of 19 pathogenic strains of S. aureus, 9 showed medium pigmentation and 10 were strongly pigmented.

(3) Anti-sera were prepared by inoculating rabbits with living cultures, 24 hours old, of the various strains. The S. aureus rabbits and a few of the S. albus received two preliminary doses of the specific vaccine, but little or no protective action was afforded from the doses of living cocci injected.

(4) Nineteen out of 25 cultures of S. aureus killed rabbits, but only 3 out of 18 cultures of S. albus.

(5) Fifteen strains of S. aureus and 15 of S. albus were used for the preparation of anti-sera, and tested against as many antigens as possible, by the methods described by Dudgeon and Bamforth.

(6) Cultures of S. aureus produced efficient anti-sera more readily than S. albus cultures, but when an active S. albus anti-serum was produced, it appeared to be as effective as the S. aureus anti-sera.

(7) A marked difference in efficiency between S. aureus and S. albus antigens was noted. S. aureus antigens were almost three times more active than S. albus antigens.

(8) Pathogenic strains of S. aureus and S. albus produced more efficient precipitin antigens than non-pathogenic.

(9) From the microscopical examination of the deposit formed in the precipitin reactions, a difference was noted between S. aureus and S. albus antigens.

(10) The study of the precipitin reactions has failed to show any hard and fast dividing line between staphylococci of different colours, or of different cultural reactions. We are inclined to agree with Winslow, Rothberg and Parsons (1920) and with Dudgeon's original view in 1908, that the pyogenic, Gram-positive staphylococci must be regarded as members of one common family.

In a maternity hospital in which the umbilicus and trunk of healthy newborn infants were treated with 0·33% hexachlorophane dusting powder, the hexachlorophane content of blood was measured in mothers before delivery, in infants' umbilical samples at birth, and at 8 days of age in capillary blood samples. One mother and her baby had rather high blood concentrations of hexachlorophane, probably derived from a toilet preparation used before admission to hospital. Hexachlorophane was absent or barely detectable in the other mothers' blood and in the infants' umbilical blood. The hexachlorophane concentrations in the blood of 8-day-old infants ranged from nil to 0·166 μg./ml. (mean 0·066 μg./ml.). These were much less than the concentrations reported to be toxic in animals.

In a previous trial now reported here, a dusting powder containing chlorhexidine instead of hexachlorophane was found to delay the separation of the umbilical cord.

We investigated the epidemiology and characterization of isolates of Staphylococcus aureus within the Yorkshire and Humber (YH) region in the UK. In July 2015, each laboratory within YH (n = 14) was assigned two consecutive days during which all clinical isolates of S. aureus were collected. Isolates were tested for antibiotic susceptibilities and the presence of genes encoding methicillin resistance (mecA and mecC), Panton–Valentine leukocidin (PVL) (lukS-PV), and efflux-mediated chlorhexidine resistance (qacA); isolates were also characterized by spa-types. Minimum inhibitory concentrations (MICs) to chlorhexidine were determined by the broth dilution method. Of 520 isolates collected, 6·2% were methicillin-resistant S. aureus (MRSA, all mecA-positive) and mupirocin resistance was low [0·8%, 95% confidence interval (CI) 0·3–2·0] and only found in MRSA. Carriage of the qacA gene was identified in 1·7% (95% CI 0·8–3·3) of isolates and 3·5% (95% CI 2·2–5·4) had a chlorhexidine MIC of 4 mg/l. The PVL gene was infrequent (3·7%, 95% CI 2·4–5·6). Genotyping identified 234 spa-types that mapped to 22 clonal complexes. Comparison of these current data with previous work suggest that the widespread use of staphylococcal decolonization regimens over the past decade or more has not had an adverse impact on resistance rates, PVL carriage or the prevalence of specific S. aureus lineages.

The subject of the following remarks is the mode of spread of bubonic plague in epidemic form as deduced from observations made during the outbreak at Sydney. The nature of the disease, and the whole of the circumstances which accompanied its appearance, having been described at length in my official report, only those points which have a direct bearing on the subject just defined are here mentioned; but a brief preliminary statement of certain local conditions is necessary.