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Infectious diseases pharmacists in the UK: Promoting their role and establishing a national network
A31
FIS 99 Abstracts P75
P76 INVliSTl(.iA’I’If.)S0I;‘I‘liE I,W.r\l’lON iF
CHARACTERISATION OF VIRULENT ATYPICAL-CELL FORMS OF LISTERIA MONOCUOGENES SECTRETlNG WILD-‘l?‘PE LEVELS OF ~60. N. J. Rowan’, A. Bubert*, J. McLaughlin’, Department of Bioscience, University of Strathclyde, Glasgow’, Department of Microbiology, University of Wilrzburg, Gerrman~, Food Hygiene, Public Health Laboratoy, Colindale, UK3.
WlSSkKIA ME.UINGI’I’IL)I~ IN THE HUMAN I!I’I’ER NIBIIKATOKY THACI’. a. Xl Harrison. I-. K hlow~. C ‘fang. Ilsiwnity Dqxut~~wtI I’wliitlrics.
of
O.&rd.
Atypical rough cell forms of L. monocylogenes, isolated from clinical samples, demonstrated wild-type levels of cytotoxicity, adherence, and invasion of human epithelial I+~-2 and HeLa cells. The identity of these virulent rough strains occurred by analyzing secretions of the major extracellular protein p60 in culture supernatants by indirect enzyme-linked immunosorbent assay (ELISA) and Western blot (immunoblot) analysis with a recently developed L. monocyrogenes-specific anti-p60 monoclonal antibody (mAb). Unlike previously-described rough mutants of L. monocytogenes which secrete diminished levels of cell-free p60 and form long chains consisting of multiple cells of similar size with markedly reduced virulence, these virulent rough cell forms secrete wild-type or greater levels of ~60. The latter virulent R strains also differ as they form unseptated or paired-filaments up to 96 pm in length. All R variants were shown to be incapable of the characteristic tumbling motion, and had a rough colony morphology that did not give a characteristic blue-green sheen upon oblique illumination. These data suggest that atypical rough cell forms of L. monocytogenes may arise in clinical samples that may be dismissed as inconsequential contaminants, but are of underrecognised clinical significance.
P76a
* PROGRESSION OF LIVER FIBROSIS IN MILDHBPATlTlS C: A PROSPECTIVE PAIRED LIVER BIOPSY STUDY MJ Wiselka. On behalf of The Trent Hepatitis C Study Group. Leicester Royal
Injrmary,
Leicester LEI
5wW.
Introduction. There is little prospective data on the factors associated with an increased risk of progression of liver disease in chronic hepatitis C. Patients in the Trent HCV Study Cohort with mild or moderate biopsy changes are followed with a repeat liver biopsy at two years. This aims of this study were to identify the rate of progression and risk factors for hepatic fibrosis in this patient group. Patients and Methods The Trent Cohort contains 1149 patients with 695 known PCR positive. 127 patients with mild liver disease were prospectively followed with a repeat liver biopsy at a median interval of 28 months. A full risk factor assessment was made. Variables were correlated with the biopsy appearances assessed on the I&dell scale by a single pathologist unaware of the sequence of biopsy samples. &su.l.& Initial median biopsy total Knodell score was 2 (O14). 33 patients (26%) showed progression of fibrosis by 1 or more points and three variables predicted more rapid fibrosis progression, necroinflammatory score on index biopsy @=O.OOl), male gender @=0.02), and age at infection (p=O.Ol). No other variable reached significance although there was a higher ethanol intake in progressors (19.3 u/wk versus 8.8u/week, p=O.O9). Conclusions 26% of patients with mild hepatitis C show progression of fibrosis over 28 months. This study shows that necroinflammation, age and male gender are signiticant risk factors for increased liver fibrosis rates,
P77 INFECTIOUS DISEASES PHARMACISTS IN THE UK: PROMOTING THEIR ROLE AND ESTABLISHING A NATIONAL NETWORK. W.Lawson’, K. Ridge’., A. Jacklin’ and A. Holmes3, Department of Pharmacy, Hammersmith Hospitals NHS Trust’, Department of HeaItb2, Department of Infectious Diseases, Imperial College3, London W12 ONN. The important role of pharmacists in improving antimicrobial use was recognised by the Standing Medical Advisory Committee sub-group on antimicrobial resistance. The distribution of pharmacists specialising in Infectious Diseases (ID) and the need for a national network was examined. A telephone survey was conducted in September 1999. 85 hospitals were contacted, ID pharmacists were identified and asked if a network would be of value. 60 hospitals (70%) had no dedicated ID pharmacist, while 25 (30%) did. Of these, 20 (80%) had responsibilities for both ID and HIV, while 5 (20%) had sole ID responsibilities. All 25 were interested in a national ID pharmacy network and attending related meetings. They all wished to share information on antibiotic prescribing and restrictions, resistance patterns and to develop a national bulletin. The need for a national ID pharmacy network is warranted in order to promote their role, to share and disseminate information and to optimise anti-infective prescribing in the UK. This proposed organisation should also be represented in FIS.
FIS 99 Abstracts P75
P76 INVliSTl(.iA’I’If.)S0I;‘I‘liE I,W.r\l’lON iF
CHARACTERISATION OF VIRULENT ATYPICAL-CELL FORMS OF LISTERIA MONOCUOGENES SECTRETlNG WILD-‘l?‘PE LEVELS OF ~60. N. J. Rowan’, A. Bubert*, J. McLaughlin’, Department of Bioscience, University of Strathclyde, Glasgow’, Department of Microbiology, University of Wilrzburg, Gerrman~, Food Hygiene, Public Health Laboratoy, Colindale, UK3.
WlSSkKIA ME.UINGI’I’IL)I~ IN THE HUMAN I!I’I’ER NIBIIKATOKY THACI’. a. Xl Harrison. I-. K hlow~. C ‘fang. Ilsiwnity Dqxut~~wtI I’wliitlrics.
of
O.&rd.
Atypical rough cell forms of L. monocylogenes, isolated from clinical samples, demonstrated wild-type levels of cytotoxicity, adherence, and invasion of human epithelial I+~-2 and HeLa cells. The identity of these virulent rough strains occurred by analyzing secretions of the major extracellular protein p60 in culture supernatants by indirect enzyme-linked immunosorbent assay (ELISA) and Western blot (immunoblot) analysis with a recently developed L. monocyrogenes-specific anti-p60 monoclonal antibody (mAb). Unlike previously-described rough mutants of L. monocytogenes which secrete diminished levels of cell-free p60 and form long chains consisting of multiple cells of similar size with markedly reduced virulence, these virulent rough cell forms secrete wild-type or greater levels of ~60. The latter virulent R strains also differ as they form unseptated or paired-filaments up to 96 pm in length. All R variants were shown to be incapable of the characteristic tumbling motion, and had a rough colony morphology that did not give a characteristic blue-green sheen upon oblique illumination. These data suggest that atypical rough cell forms of L. monocytogenes may arise in clinical samples that may be dismissed as inconsequential contaminants, but are of underrecognised clinical significance.
P76a
* PROGRESSION OF LIVER FIBROSIS IN MILDHBPATlTlS C: A PROSPECTIVE PAIRED LIVER BIOPSY STUDY MJ Wiselka. On behalf of The Trent Hepatitis C Study Group. Leicester Royal
Injrmary,
Leicester LEI
5wW.
Introduction. There is little prospective data on the factors associated with an increased risk of progression of liver disease in chronic hepatitis C. Patients in the Trent HCV Study Cohort with mild or moderate biopsy changes are followed with a repeat liver biopsy at two years. This aims of this study were to identify the rate of progression and risk factors for hepatic fibrosis in this patient group. Patients and Methods The Trent Cohort contains 1149 patients with 695 known PCR positive. 127 patients with mild liver disease were prospectively followed with a repeat liver biopsy at a median interval of 28 months. A full risk factor assessment was made. Variables were correlated with the biopsy appearances assessed on the I&dell scale by a single pathologist unaware of the sequence of biopsy samples. &su.l.& Initial median biopsy total Knodell score was 2 (O14). 33 patients (26%) showed progression of fibrosis by 1 or more points and three variables predicted more rapid fibrosis progression, necroinflammatory score on index biopsy @=O.OOl), male gender @=0.02), and age at infection (p=O.Ol). No other variable reached significance although there was a higher ethanol intake in progressors (19.3 u/wk versus 8.8u/week, p=O.O9). Conclusions 26% of patients with mild hepatitis C show progression of fibrosis over 28 months. This study shows that necroinflammation, age and male gender are signiticant risk factors for increased liver fibrosis rates,
P77 INFECTIOUS DISEASES PHARMACISTS IN THE UK: PROMOTING THEIR ROLE AND ESTABLISHING A NATIONAL NETWORK. W.Lawson’, K. Ridge’., A. Jacklin’ and A. Holmes3, Department of Pharmacy, Hammersmith Hospitals NHS Trust’, Department of HeaItb2, Department of Infectious Diseases, Imperial College3, London W12 ONN. The important role of pharmacists in improving antimicrobial use was recognised by the Standing Medical Advisory Committee sub-group on antimicrobial resistance. The distribution of pharmacists specialising in Infectious Diseases (ID) and the need for a national network was examined. A telephone survey was conducted in September 1999. 85 hospitals were contacted, ID pharmacists were identified and asked if a network would be of value. 60 hospitals (70%) had no dedicated ID pharmacist, while 25 (30%) did. Of these, 20 (80%) had responsibilities for both ID and HIV, while 5 (20%) had sole ID responsibilities. All 25 were interested in a national ID pharmacy network and attending related meetings. They all wished to share information on antibiotic prescribing and restrictions, resistance patterns and to develop a national bulletin. The need for a national ID pharmacy network is warranted in order to promote their role, to share and disseminate information and to optimise anti-infective prescribing in the UK. This proposed organisation should also be represented in FIS.