Bottled Water Not So Safe
Bacteria or fungi were found in 40% of bottled water samples in a recent study.
A total of 70 samples from 16 different countries were tested; 68 were commercial bottled mineral water, 1 was tap water, and 1 was water from a natural well, Rocus R. Klont, M.D., reported in a poster at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy in Washington.
“We found high levels of bacterial contamination in commercially bottled mineral water,” said Dr. Klont of University Medical Center, Nijmegen, the Netherlands.
The findings debunk the common belief that bottled water is purer than tap water—an important finding, because hospitals are increasingly providing bottled water to immunocompromised patients, he said.
Bacteria, including coagulase-negative staphylococci, nonfermenters, or gram-positive rods, grew from 21 samples. Legionella pneumophila DNA was detected in six samples, and Legionella antigen was detected in six samples, but only two of these were antigen- and polymerase chain reaction-positive. Fungi, including penicillium or nonspeciated fungi, grew from three samples, Dr. Klont said.
Endometritis and BV Linked
Bacterial vaginosis-associated organisms found frequently in women with pelvic inflammatory disease also were strongly associated with endometritis, Catherine L. Haggerty, Ph.D., of the University of Pittsburgh and her colleagues reported.
The investigators looked at associations between endometritis and Neisseria gonorrhoeae, Chlamydia trachomatis, anaerobic bacteria, facultative bacteria, lactobacilli, and bacterial vaginosis (BV) in 278 women from the PID Evaluation and Clinical Health Study. Those with acute endometritis were more likely to be infected with C. trachomatis (odds ratio [OR] 16.2), N. gonorrhoeae (OR 11.6), diphtheroids (OR 5.0), black-pigmented gram-negative rods (OR 3.1), and anaerobic gram-positive cocci (OR 2.1) (Clin. Infect. Dis. 2004:39;990-5).
The associations between acute endometritis and black-pigmented gram-negative rods, anaerobic gram-positive cocci, and BV remained significant after excluding the 41% of women infected with N. gonorrhoeae and/or C. trachomatis. Treatment in most PID patients is directed at N. gonorrhoeae and C. trachomatis, but these account for fewer than half of all cases. The frequency of BV-associated organisms in PID patients suggests that treatment with a regimen containing metronidazole to improve anaerobic coverage is warranted, the investigators said.
GBS Risk After Flu Vaccine
Guillain-Barré syndrome remains the neurologic condition most frequently reported following influenza vaccination in the United States, but the number of reported cases has declined significantly since 1990, Penina Haber, Ph.D., of the Centers for Disease Control and Prevention and colleagues reported.
The annual reporting rate for Guillain-Barré syndrome (GBS) decreased significantly from 0.17/100,000 at its high in 1993-1994 to 0.04/100,000 in 2002-2003. The onset interval (median 13 days) and the low prevalence of preexisting illnesses (seen in 24% of cases) suggest a possible causal relationship between flu vaccine and GBS, they said (JAMA 2004:292;2478-81).
They noted that the flu vaccine is typically made from chicken eggs, and campylobacter—known to cause GBS—is endemic among chickens. The decline in GBS cases coincided with stepped-up food safety interventions that led to a 28% decrease in campylobacter infections. During about the same time frame, there was a decline in GBS hospital discharges in the U.S. from 3.1 to 2.5 per 100,000 population.
Additional research is needed to explore the relationship between GBS and influenza vaccine, the investigators said.
Pertussis Vaccine Urged
Adolescents and certain adults should be vaccinated against Bordetella pertussis to better protect infants from this deadly organism, the Global Pertussis Initiative has said.
A vaccine suitable for booster vaccination in these groups was developed about 5 years ago, reported Kevin Forsyth, M.D., of Flinders University, Adelaide, Australia, and his colleagues.
Such vaccinations could help prevent transmission of the infection—commonly known as whooping cough—to infants, they said (Clin. Infect. Dis. 2004;39:1802-9). About 300,000 people worldwide die each year from whooping cough; most are infants who have not yet completed their primary vaccination series.
Pertussis infections are increasing due to loss of immunity in previously vaccinated adolescents and adults who haven't received booster shots. Among the immediate goals for improving immunity are universal adolescent vaccination and vaccination of adult target groups, including parents and other close contacts of newborns.