pyrophosphate and Staphylococcal-Infections

Technetium-99 (99Tc) pyrophosphate bone scanning often identifies patients with osteomyelitis before roentgenographic findings appear. However, recent studies have shown that 99Tc bone scanning often gives false-negative results, especially in neonates. The accuracy of computed tomographic scanning and indium-111 leukocyte scanning for diagnosis of early osteomyelitis has not been established. 99Tc bone scanning often gives false-positive results in patients with other conditions leading to bone injury and repair, such as trauma or recent surgery, further limiting the usefulness of this imaging procedure. Newer imaging techniques have not been adequately evaluated to establish their specificity. Because of their high cost and unproved accuracy, these new imaging procedures should not be routinely applied until their usefulness has been established. Bone biopsy remains the procedure of choice for establishing the diagnosis in patients suspected clinically to have osteomyelitis with negative findings on roentgenography and 99Tc bone scanning. Although Staphylococcus aureus is the leading cause of osteomyelitis, other pathogens cause 30 to 40 percent of cases. Aspiration or biopsy of the involved bone is usually required to choose appropriate antibiotic therapy. Bone biopsy is essential in chronic osteomyelitis, since cultures of sinus drainage are unreliable. Osteomyelitis in diabetics with foot infection and in association with decubitus ulcers presents special problems. Radionuclide scanning often give false-positive results in these patients. Proper diagnosis usually requires careful assessment of clinical and roentgenographic findings. Although bone biopsy seems useful in diagnosing osteomyelitis underlying decubitus ulcers, its role in diabetic patients with foot infections is not established. I do not recommend biopsy of foot bones in diabetic patients, since culture of bone biopsy specimens often give unreliable results in these situations because of contamination with ulcer organisms.

Topics: Acute Disease; Bone and Bones; Chronic Disease; Costs and Cost Analysis; Diabetes Complications; Diagnostic Errors; Diphosphates; Foot Diseases; Humans; Osteomyelitis; Radiography; Radionuclide Imaging; Skin Ulcer; Staphylococcal Infections; Technetium; Technetium Tc 99m Pyrophosphate; Wound Infection

As antibiotic resistance is being a threat to public health worldwide, bacteriophages are re-highlighted as alternative antimicrobials to fight with pathogens. Various wild-type phages isolated from diverse sources have been tested, but potential mutant phages generated by genome engineering or random mutagenesis are drawing increasing attention. Here, we applied a chelating agent, sodium pyrophosphate, to the staphylococcal temperate Siphoviridae phage SA3821 to introduce random mutations. Through 30 sequential sodium pyrophosphate challenges and random selections, the suspected mutant phage SA3821

Topics: Anti-Bacterial Agents; Diphosphates; Genome, Viral; Host Specificity; Mutagenesis; Staphylococcal Infections; Staphylococcus aureus; Staphylococcus Phages

Bacterial replication is a fast and accurate process, with the bulk of genome duplication being catalyzed by the α subunit of DNA polymerase III within the bacterial replisome. Structural and biochemical studies have elucidated the overall properties of these polymerases, including how they interact with other components of the replisome, but have only begun to define the enzymatic mechanism of nucleotide incorporation. Using transient-state methods, we have determined the kinetic mechanism of accurate replication by PolC, the replicative polymerase from the Gram-positive pathogen Staphylococcus aureus. Remarkably, PolC can recognize the presence of the next correct nucleotide prior to completing the addition of the current nucleotide. By modulating the rate of pyrophosphate byproduct release, PolC can tune the speed of DNA synthesis in response to the concentration of the next incoming nucleotide. The kinetic mechanism described here would allow PolC to perform high fidelity replication in response to diverse cellular environments.

Topics: Bacterial Proteins; Diphosphates; DNA Replication; DNA-Directed DNA Polymerase; Humans; Kinetics; Staphylococcal Infections; Staphylococcus aureus

We describe an infrequent case of combined infection of bone, articulation and lung by Staphylococcus aureus, with affectation of all pelvic bones. Studies with 99m Tc pyrophosphate were repeatedly negative, becoming positive following the appearance of radiological signs.

Topics: Adolescent; Bronchopneumonia; Diphosphates; Humans; Male; Osteomyelitis; Pelvic Bones; Radionuclide Imaging; Sacroiliac Joint; Staphylococcal Infections; Technetium; Technetium Tc 99m Pyrophosphate; Tomography, X-Ray Computed; Ultrasonography

A patient with infective endocarditis was evaluated by Ga-67 citrate imaging, Tc-99m pyrophosphate imaging, equilibrium gated blood pool imaging, and Tl-201 imaging of the chest. The diagnosis of ventricular abscess was first suggested by an abnormal gallium scan. At surgery, an abscess was identified in the area where the scan was abnormal, and postoperatively a repeat scan was normal.

Topics: Abscess; Aged; Diphosphates; Endocarditis, Bacterial; Gallium Radioisotopes; Heart Diseases; Humans; Male; Radioisotopes; Radionuclide Imaging; Staphylococcal Infections; Technetium; Thallium

Scintigraphic exploration of the sacroiliac (S.I.) joints by 99 m-technetium pyrophosphate is simple and free of all danger. The fixation of the isotope in the right sacroiliac (R.S.I.) and the "normal" limits of the fixation ratios R.S.I./L.R. and the lumbar rachis (L.R.), visible on the same film. A series of 28 controls having made it possible to calculate the "normal" limits of the fixation ratios R.S.I./L.R. and L.S.I./L.R., the isotopic fixation was measured in 25 patients with sacroiliac inflammation, 21 of whom were rheumatic, 3 infectious. It was shown that scintigraphy could yield useful information on the evolution of sacroiliac inflammation, making an early diagnosis possible, and also contributing to differentiation between rheumatic and infectious inflammation.

Topics: Adult; Aged; Arthritis, Reactive; Back Pain; Bacterial Infections; Bone and Bones; Diphosphates; Female; Humans; Ilium; Joint Diseases; Male; Middle Aged; Osteoarthritis; Psoriasis; Radionuclide Imaging; Rheumatic Diseases; Sacroiliac Joint; Sacrum; Spinal Diseases; Spondylitis, Ankylosing; Staphylococcal Infections; Technetium; Tuberculosis, Spinal

Topics: Diphosphates; Micrococcus; Nucleotides; Staphylococcal Infections; Staphylococcus aureus; Uridine; Uridine Diphosphate