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October 18, 2001 Vol. 345 No. 16
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This study of ground chicken, turkey, beef, and pork purchased from supermarkets in the Washington, D.C., area showed that 20 percent of the samples contained salmonella of 13 different serotypes. Eighty-four percent of the isolates were resistant to at least one antibiotic, and more than half were resistant to three or more antibiotics.
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Quinupristin-dalfopristin was approved two years ago for use in vancomycin-resistant Enterococcus faecium infections, but a related streptogramin has been used for decades as a growth promoter in farm animals. In this study, cultures of samples from chickens purchased at supermarkets in four states identified quinupristin-dalfopristin–resistant E. faecium in at least 17 percent of the samples in each state. Low-level resistance in E. faecium was also identified in 1 percent of 334 stool samples from outpatients.
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Antibiotic-resistant organisms are often found in retail meats, but it has been unclear whether the ingestion of these organisms has any clinical consequences. Resistant strains of E. faecium obtained from raw chicken and pork were ingested by 12 healthy volunteers. Various concentrations of these strains were isolated from stool samples for up to two weeks.
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Up to half of people with classic Ehlers–Danlos syndrome, a condition marked by hyperextensible skin, hypermobile joints, and tissue fragility, have mutations of the genes for type V collagen, raising the possibility that other genes may also be involved. Because tenascins are extracellular-matrix proteins with high levels of expression in connective tissues affected in the Ehlers–Danlos syndrome, these investigators searched for genetic defects in tenascin-X as a potential cause. Tenascin-X deficiency was found in 5 unrelated patients with the Ehlers–Danlos syndrome (of 151 screened), all of whom had distinct mutations in the tenascin-X gene.
The French neurologist Georges Gilles de la Tourette first described this syndrome, which consists of motor tics sometimes accompanied by uncontrollable noises or utterances, attention-deficit–hyperactivity disorder, obsessive–compulsive disorder, and poor impulse control. Although the pathogenesis of the disorder remains obscure, tics may be treated effectively with haloperidol or pimozide, and other clinical features may also respond to pharmacologic therapy.
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