Concordance. A 10-item scale adapted from Elwyn et al. [11] and based on the

concordance model was developed to capture the overall shared decision-making process around treatment change in an HIV clinical situation. Respondents were asked to indicate the extent to which the doctor carried out the following: (a) described issues behind the need to change treatment; (b) clarified s/he had a balanced view on their options; (c) outlined options available; (d) provided information in their preferred format; (e) checked their understanding of issues and their preferred role in the decision-making; (f) explored their concerns, expectations check details and options; (g) gave them time to talk to others before reaching a decision; (h) made and reviewed a final decision. selleck inhibitor Each item was coded as: 1 (did not happen), 2 (not very good), 3 (adequate) and 4 (very good). A concordance score was then generated by summing the 10 item

scores. It ranged from 10 (low) to 40 (high). Sexual behaviour. Information on partnership and sexual risk behaviour in the preceding 3 months was recorded. HIV sexual risk behaviour was defined as unprotected sexual intercourse with someone of unknown or discordant HIV status during the previous 3 months. Treatment switching. The use of HAART and whether such treatment had been switched once, twice or more, or stopped, were recorded. Symptom and pain levels. The Memorial Symptom Assessment Short Form (MSAS) Florfenicol inventory, a multiple symptom inventory measuring the 7-day prevalence of physical and psychological symptoms, and their associated burden, was used [23]. Three subscales (physical, psychological and global distress

indices) were calculated. Two additional items (feeling optimistic and suicidal thoughts) were also included and independently analysed. Quality of life. EuroQol 5D, which includes five dimensions of quality of life (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) and a quality of life visual analogue scale (VAS), was used [24]. Satisfaction. Five-point Likert type rating scales were employed to assess satisfaction in relation to medical treatment and care. Perceived involvement in decision-making and doctor–patient agreement. Five-point Likert type rating scales were used. Adherence. Patient self-report recall over the preceding 7 days was used to assess antiretroviral adherence. Full adherence was coded as no missed doses and all taken within 1 h of the correct time and in accordance with any dietary requirements. Partial adherence was coded as those who had taken all doses, but had not been fully adherent to dose timing and/or requirements [25]. Nonadherence included all other responses – where doses had been missed and timing/circumstance had been inconsistent. For a subset of patients who provided consent, questionnaire data were linked to clinical information which provided the VL and CD4 cell count at the time of the questionnaire and 6–12 months afterwards.

To achieve this, they continue induction therapy until CSF cultures are negative. Others will give a fixed course of therapy, most often two weeks, and switch the patient to a maintenance regimen, if well, without further lumbar puncture. This may be the preferred option for most individuals, bearing in mind that, assuming HAART

is started, the risk of relapse and mortality is likely to be lower than that reported in older studies. There should be consideration of a lumbar puncture and extension of therapy in individuals whose initial poor prognostic factors or slow response to therapy raise concerns that they are less likely to be cured by only two weeks’ induction (category IV recommendation). Options for maintenance therapy are daily fluconazole PLX4032 cost or itraconazole, or weekly liposomal amphotericin B. Fluconazole has been shown to be superior to amphotericin B with less drug-associated BAY 80-6946 molecular weight toxicity and lower rates of relapse [54], and also

to itraconazole which was associated with higher rates of CSF culture-positive relapse [40]. The optimal dose of fluconazole as maintenance therapy remains unclear. Although the standard dose is 200 mg daily, one retrospective study showed a benefit to a higher dose of 400 mg daily with a lower rate of relapse [55]. Serum cryptococcal antigen measurement is not useful in monitoring for relapse of disease [56]. 2.4.4.4 Cryptococcal infection without CNS involvement. Pulmonary cryptococcal infection, isolated cryptococcaemia or cryptococcal disease at another site outside the CNS and lungs should be assessed for associated occult CNS infection by performing an LP. If this is present, treatment is as for meningitis. If CSF examination is negative, isolated pulmonary disease can be treated with fluconazole. There are no controlled clinical studies of the treatment of isolated pulmonary cryptococcal disease in either the HIV

or the non-HIV setting. All HIV patients with isolated pulmonary disease should be treated due to the almost certain risk of dissemination. In those with moderate symptoms the treatment of choice is fluconazole 400 mg daily followed by secondary prophylaxis [57,58]. In those with more Dehydratase severe disease, liposomal amphotericin B should be used [57,59] until symptoms are controlled; again this should be followed by secondary prophylaxis. Similarly, in patients with isolated cryptococcaemia there are no studies to guide treatment options. Due to the rapid progression to meningitis from this condition [17] patients should be treated with either fluconazole 400 mg daily if mild or moderately symptomatic or liposomal amphotericin B if symptoms are more severe. Routine prophylaxis for cryptococcal disease is not recommended (category IV recommendation).

This is the visual response on neck muscles that we have reported previously in a variety selleck chemicals of tasks (Corneil et al., 2004, 2008; Chapman & Corneil, 2011); relative to the side of the SEF electrode, contralateral muscles increase following the presentation of contralateral cues and decrease following the presentation of ipsilateral cues, regardless of whether the monkey ultimately looks toward or away from the cue. Following this visual response, we observed a rebound in recruitment that peaked about 90–110 ms after cue presentation, with activity

decreasing following contralateral cues, and increasing following ipsilateral cues. We now turn to the quantification of the EMG response evoked by short-duration ICMS-SEF. We focus first on the activity evoked during the fixation interval, collapsed across saccade direction. We include the first stimulation time in the post-cue interval (i.e. 10 ms after cue presentation), as this precedes the arrival of visual information in the SEF. Figure 5A displays the normalized EMG response to short-duration ICMS-SEF for a representative site (the same as shown in Fig. 4A), segregated by task and the time of stimulation relative to cue onset. ICMS-SEF evoked robust recruitment at all times, but the magnitude of such recruitment depended on both the task and the

time of stimulation, with ICMS-SEF evoking the greatest recruitment when delivered just

after cue onset in the anti-saccade task. Our analysis of these patterns across our sample selleck screening library is shown in Fig. 5B–E. As shown in Fig. 5C, L-gulonolactone oxidase the increase in evoked neck EMG above baseline diverged progressively as the monkeys prepared to make anti- vs. pro-saccades. Importantly, the magnitude of evoked neck EMG is not simply the reflection of baseline activity (Fig. 5B); ICMS-SEF evoked greater neck EMG as the monkeys prepared to make anti-saccades, despite a lower amount of baseline recruitment preceding stimulation. We observed this trend regardless of eventual saccade direction, and hence the influence of task on stimulation-evoked responses in this interval is not simply an interaction with the subsequent visual response on neck muscles. A repeated-measures two-way anova of the increase in evoked neck EMG above baseline revealed significant effects of task (P < 10−5), time of stimulation (P = 0.0001) and the interaction between these two factors (P = 0.007). The filled symbols in Fig. 5B and C represent observations that differed significantly (Bonferroni-corrected for multiple comparisons) from that observed at the first stimulation interval prior to the consolidation of task instruction. The histograms in Fig. 5D and E represent the comparison of the baseline or increase above baseline on pro- vs. anti-saccades at each stimulation interval across the sample. Note how the bottom two histograms in Fig.

e. estimated to be 80.7 °C using 1.5-iTech software). These data were confirmed by the analysis of two strains carrying three repeats, 20 with four repeats and 20 with five repeats (Table 1). The allele with three repeats was less frequent than those with four and five repeats, but we were not able to check the method with a sample carrying the allele with six repeats because of its rarity among Map strains. In selleck kinase inhibitor fact, despite the multitude of studies that have analysed the SSR8 locus, this rare allele has been described in only five strains (isolated in the USA from different host species) (Amonsin et al., 2004; Ghadiali et al., 2004; Harris et al., 2006; Thibault et al., 2008).

Moreover, as PCR is an in vitro assay, the use of synthetic DNA should not interfere

with the reaction. Perfect concordance was observed between our approach and the results of the direct sequencing (K = 1), and low SDs confirmed the precision of the method. As with many other Mycobacteria, Map http://www.selleckchem.com/products/AZD2281(Olaparib).html is characterized by a genome very rich in GC (Li et al., 2005) and this feature could make it difficult to design appropriate primers for the amplification of specific targets. However, the design of the primers according to the LATE-PCR strategy allowed us to overcome this problem. Erali & Wittwer (2010) showed that full-amplicon HRM analysis performed with specific HRM instruments allowed the identification of various single nucleotide polymorphisms, even those belonging to class 4 (A  T), which showed a difference in Tm near 0.25 °C. As previously shown (Zhou et al., 2004), the use of short unlabelled probe directly in the PCR reaction mix enhanced the differences between each variant and allowed an unbiased identification

of the polymorphism present. The method proposed here is robust and reproducible and in comparison stiripentol with direct sequencing, its results are more cost effective (€1.5 for each sample vs. €8–10) and faster (3 h to obtain a final result vs. 4 h). Moreover, it is a closed-tube technique requiring only a qPCR system, minimizing contamination risks. Finally, as HRM analysis is not destructive, and is compatible with sequencing techniques, it potentially allows new alleles or mutations inside the probe-matching site (peaks with unexpected Tm) to be found. To the best of our knowledge, this is the first article suggesting the application of HRM analysis in the analysis of short repeat number. Further studies should investigate the usefulness of the method proposed for the identification of mononucleotide SSR loci, such as SSR1 and SSR2. We thank Dr S.P. Pongolini (Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia Romagna) for helpful discussion during the set up of the method. The study was supported with grants from the Ministry of Health, Italy (IZSLER 19/09 RC). Part of this work was submitted as an abstract to the 5th International qPCR Symposium & Industrial Exhibition & Application Workshop, 2011, Freising, Germany.

(1996) reported aflatoxin production by one isolate defined as A. tamarii; however, Ito et al. (2001)

described this isolate as well as a second one as a new closely related species, Aspergillus pseudotamarii. Because some species of the Aspergillus section Flavi have the ability to produce aflatoxins and cause several diseases in humans, an accurate identification of each species would provide fundamental information concerning their aflatoxigenic and pathogenic properties. Classical identification methods of Aspergillus section Flavi strains are performed by examining several morphological traits observed on fungal cultures grown on different media (Samson et al., 2000). However, these procedures are time-consuming, require important mycological knowledge and are inaccurate because of intra- Inhibitor Library cell line and interspecific morphological divergences (Klich & Pitt, 1988). Several molecular

genetic techniques have been tested to classify Aspergillus section Flavi strains: random amplification of polymorphic DNA (RAPD) (Yuan et al., 1995), amplified fragment http://www.selleckchem.com/products/chir-99021-ct99021-hcl.html length polymorphism (Montiel et al., 2003), DNA restriction fragment polymorphism (Klich & Mullaney, 1987; Moody & Tyler, 1990a, b), and sequence analyses of (1) the mitochondrial cytochrome b gene (Wang et al., 2001), (2) the internal transcribed spacer (ITS) region (Kumeda & Asao, 1996; Henry et al., 2000; Kumeda & Asao, 2001; Rigo et al., 2002) and (3) the aflatoxin gene cluster (Chang et al., 1995; Watson et al., 1999; Tominaga et al., 2006). Although these studies

provided important information about the phylogenetic relationships between species, none of them used singly was able to solve problems of identification. Based on these studies, it appears that two aflatoxin genes (aflT and aflR) and the ITS regions are good candidates for further taxonomic investigations. The aflT gene, which is present in the species of the section Flavi, encodes a major facilitator superfamily transporter (Chang et al., 2004). The aflR is a regulatory gene of several enzymatic steps involved in the aflatoxin biosynthetic pathway (Payne et al., 1992). Woloshuk et al. (1994) revealed similar sequences of aflR gene in four species of the section: A. flavus, A. oryzae, FAD A. parasiticus and A. sojae. Kumeda & Asao (2001) showed that most sequence differences among Aspergillus section Flavi species were sparsely observed in the ITS1 and ITS2 genes. In this paper, we have developed a six-step strategy using real-time PCR as the key tool, complemented if necessary by RAPD and DNA restriction enzyme fragment polymorphism technique, to set up a decision-making tree allowing an accurate identification process for nine of the 11 species described within the Aspergillus section Flavi. This method, focusing on the six most economical species, is proposed as a specific, sensitive and rapid diagnostic tool. Strains used in this study are listed in Table 1.

Conditional (eg, the increased severity of malaria infection if pregnant; the unlikely occurrence of a vaccine preventable

disease after immunization against the same disease, such as hepatitis A). Also, by evaluating a specific risk over a person’s lifetime, one may address future risks at a time when the traveler is unable to address them because of the changes in his/her health status [eg, immunizing a client with rheumatoid arthritis with YF vaccine prior to starting a disease-modifying antirheumatic drug (DMARD) causing immunosuppression]. Rossi and Genton[8] indicate that the differences between intended and actual travel itineraries would not have significantly altered the pre-travel recommendations, except around rabies pre-exposure prophylaxis (PrEP). Many destinations in the developing world share travel-related hazards (eg, poor medical care, enteric selleck kinase inhibitor pathogens contaminating food and water, personal security issues). Also, countries within a larger geographic region may share similar hazards (eg, meningitis in the Sahel region of Africa, hypoxia on the Tibetan Plateau). Pre-travel health recommendations should therefore be robust enough to deal with significant changes in any travel plans. The best example of this approach is dealing with backpackers with no fixed itineraries traveling within a given region

(eg, Southeast Asia). One usually tries to identify the priority destinations and activities of the traveler, and then address as many of the likely risks anticipated by assuming the worst. The concept of using travel environments rather than specific itineraries to assess travelers’ risks is also illustrated by the recently Veliparib revised Chapter Four on select destinations found in

the CDC Yellow Book (2012).[9] In the authors’ study, the activity of “bike riding” was used as one surrogate for rabies exposure. Another was “staying in rural zones or with local people,” in addition to “close contact with animals.” Yet the potential for animal bites is much larger, if one considers all the possible travel activities anticipated in a developing country, where rabies is an endemic problem. Thus, rabies exposure during travel could be viewed as avoidable, manageable, and potentially preventable using different strategies including bite avoidance counseling, rabies vaccine post-exposure prophylaxis (PEP), and rabies SPTLC1 vaccine PrEP. While it is important to discuss animal bite avoidance through counseling, there is no clear evidence that such an intervention reduces the incidence of rabies exposure.[10, 11] Also, risk avoidance counseling does not appear as one of the referenced strategies of national or international rabies prevention guidelines.[12-14] Animal bites (ie, primarily dog bites) remain a common occurrence among travelers[15] with an estimated frequency similar to that of hepatitis A infections among unimmunized travelers in developing countries.

2 μL of DNA (DNA concentration was in the of 24–187 ng) and 0.8 U of Taq DNA polymerase (Qiagen). The initial denaturation step at 94 °C for 3 min was followed

by 30 cycles of DNA denaturation at 94 °C for 10 s, primer annealing at 57 °C for 20 s, strand extension at 72 °C for 1 min and final extension step at 72 °C for 7 min. PCR products were separated by 1.5% agarose gel electrophoresis. The presence of the cyrJ gene was checked in all 24 water samples collected from BY and BN, and the C. raciborski culture Bleomycin price from BY. PCR-generated fragment of cyrJ from four of 24 water samples (BY 18 August 2006; BN 18 August 2006 and BY 30 August 2007; BN 30 August 2007) was used for sequencing. Although PCR and amplification conditions were different than described in subchapter 2.5., the PCRs were performed in 50-μL reaction volumes containing 1× Pfu polymerase buffer with 2 mM MgCl2, 0.2 mM dNTPs, 10 pmol μL−1 each of the forward cynsulfF and reverse cylnamR primers, 1 μL of DNA (DNA concentration was in the of 319–934 ng) Everolimus price and 1.25 U of thermostable Pfu DNA polymerase (Fermentas). Cycling began with a denaturing step at 95 °C for 3 min followed by 35 cycles of denaturation at 94 °C for 30 s, annealing at 57 °C for 30 s and extension at 72 °C for 1 min. Amplification was completed by a final extension step at 72 °C for 7 min. Purified PCR products were cloned into a pJET1.2/blunt vector (Fermentas). Expected length of the PCR products cloned

was confirmed by restriction analysis using BglII restriction enzyme and agarose gel electrophoresis. The constructs prepared were PI-1840 then subjected to a sequence analysis. The homology searches were performed using the National Center for Biotechnology Information microbial and nucleotide blast network service (http://blast.ncbi.nlm.nih.gov/Blast.cgi) (Zhang et al., 2000). A modified protocol of PCR based on amplification of C. raciborskii-specific rpoC1 gene fragment, developed by Wilson et al. (2000), was used for the specific identification of C. raciborskii in two of 24 water samples from BY and BN lakes (BY 18 August 2006; BN 18 August 2006) and the C. raciborskii culture from BY. The cyl2, cyl4 and cyl-int primers as well

as the preparation of internal control fragment (ICF) were described previously by Wilson et al. (2000) (Table 1). The ICF was constructed by performing PCRs with cyl-int and cyl4, and the PCR product was used in a final PCR with cyl2 and cyl4 to give a 247-bp ICF (Table 1). PCRs were performed in 50-μL reaction volumes containing 1× AccuPrime PCR Buffer II with 2 mM MgCl2 and 0.2 mM dNTPs, 10 pmol μL−1 of cyl2 and cyl4 primers, genomic DNA and 1 U of AccuPrime Taq High Fidelity DNA polymerase (Invitrogen) and 200 fg of ICF. Cycling began with a denaturing step at 94 °C for 1 min followed by 35 cycles of denaturation at 94 °C for 30 s, annealing at 58 °C for 30 s and extension at 68 °C for 30 s.

In view of the high frequency of these autoantibodies, we postulate that they might be of potential use for additional diagnostics for mycobacterial infections, and further studies may shed light on the pathomechanisms of these two autoantibodies. “
“Lipoatrophy is a long-term adverse effect of some antiretrovirals that affects quality of life, compromises adherence and may limit the clinical impact of HIV treatments. This paper explores the effect of tenofovir/emtricitabine (TDF/FTC) on the amount of limb fat in patients with virological suppression. A randomized, prospective clinical trial was performed to compare continuation on a zidovudine/lamivudine (ZDV/3TC)-based

regimen with switching to a TDF/FTC-based regimen in terms of the effect on limb fat mass as assessed by DEXA over a 72-week period. Eighty patients were included (39 in the TDF/FTC I-BET-762 datasheet arm and 41 in the ZDV/3TC arm) and 73 completed the study (37 and 36, respectively). In the switch arm, limb fat increased by a median of 540 g from

baseline (P = 0.022), while in the ZDV/3TC arm it decreased by a median of 379 g (P = 0.112; p between groups = 0.007). LDK378 Subjects with baseline limb fat ≤ 7200 g, previous time on ZDV > 5 years or a body mass index > 25 kg/m2 experienced higher limb fat gains than other subjects, and these differences were statistically significant. Haemoglobin increased by a median of 1.0 g/dL in the TDF/FTC arm (P < 0.001) and remained unchanged Cell press in the ZDV/3TC arm (p between groups = 0.0002). There were no significant differences between groups in other secondary endpoints (body weight, total body and trunk fat content, total body bone mineral density, laboratory parameters, CD4 cell count and

viral load). Switching from a ZDV/3TC-based to a TDF/FTC-based regimen led to a statistically significant improvement in limb fat, in contrast to the progressive loss of limb fat in subjects continuing ZDV/3TC. “
“General review definition divides PUO as classical, nosocomial, HIV-related and immunosuppression-related [1]. For HIV infection, pyrexia of unknown origin (PUO) identifies a pattern of fever with temperature higher than 38.3 °C on several occasions over more than 4 weeks for outpatients, or more than 3 days duration in hospital, in which the diagnosis remains uncertain after an initial diagnostic work-up, including at least 2 days of incubation of microbiological cultures [2]. It is a common clinical manifestation in HIV-seropositive patients with severe immunosuppression and probability of an infection-related aetiology for PUO in HIV infection increases with CD4 decline, i.e. greater risk if CD4 count <50 cells/μL than <100 cells/μL than >200 cells/μL [3]. Fever is rarely the result of the effects of HIV itself and investigation of a specific cause should be actively pursued [4] (level of evidence IV).

In view of the high frequency of these autoantibodies, we postulate that they might be of potential use for additional diagnostics for mycobacterial infections, and further studies may shed light on the pathomechanisms of these two autoantibodies. “
“Lipoatrophy is a long-term adverse effect of some antiretrovirals that affects quality of life, compromises adherence and may limit the clinical impact of HIV treatments. This paper explores the effect of tenofovir/emtricitabine (TDF/FTC) on the amount of limb fat in patients with virological suppression. A randomized, prospective clinical trial was performed to compare continuation on a zidovudine/lamivudine (ZDV/3TC)-based

regimen with switching to a TDF/FTC-based regimen in terms of the effect on limb fat mass as assessed by DEXA over a 72-week period. Eighty patients were included (39 in the TDF/FTC GSK2118436 arm and 41 in the ZDV/3TC arm) and 73 completed the study (37 and 36, respectively). In the switch arm, limb fat increased by a median of 540 g from

baseline (P = 0.022), while in the ZDV/3TC arm it decreased by a median of 379 g (P = 0.112; p between groups = 0.007). MDV3100 mouse Subjects with baseline limb fat ≤ 7200 g, previous time on ZDV > 5 years or a body mass index > 25 kg/m2 experienced higher limb fat gains than other subjects, and these differences were statistically significant. Haemoglobin increased by a median of 1.0 g/dL in the TDF/FTC arm (P < 0.001) and remained unchanged next in the ZDV/3TC arm (p between groups = 0.0002). There were no significant differences between groups in other secondary endpoints (body weight, total body and trunk fat content, total body bone mineral density, laboratory parameters, CD4 cell count and

viral load). Switching from a ZDV/3TC-based to a TDF/FTC-based regimen led to a statistically significant improvement in limb fat, in contrast to the progressive loss of limb fat in subjects continuing ZDV/3TC. “
“General review definition divides PUO as classical, nosocomial, HIV-related and immunosuppression-related [1]. For HIV infection, pyrexia of unknown origin (PUO) identifies a pattern of fever with temperature higher than 38.3 °C on several occasions over more than 4 weeks for outpatients, or more than 3 days duration in hospital, in which the diagnosis remains uncertain after an initial diagnostic work-up, including at least 2 days of incubation of microbiological cultures [2]. It is a common clinical manifestation in HIV-seropositive patients with severe immunosuppression and probability of an infection-related aetiology for PUO in HIV infection increases with CD4 decline, i.e. greater risk if CD4 count <50 cells/μL than <100 cells/μL than >200 cells/μL [3]. Fever is rarely the result of the effects of HIV itself and investigation of a specific cause should be actively pursued [4] (level of evidence IV).

, 2011). In our study, amino acid sequence analysis revealed the presence of different A. baumannii NU7441 PilA groups (Fig. 3). The isolates within these PilA groups were clonally related and exhibited the same motility characteristics, e.g. the international clone I isolates shared a highly similar PilA amino acid sequence and all exhibited a twitching phenotype. Interestingly, the PilA sequences from other motile bacterial species clustered with PilA from the motile A. baumannii isolates, e.g. the P. aeruginosa and D. nodosus PilA shared the highest homology levels with PilA from international clone I isolates

and X. fastidiosa PilA with that from ATCC strain 17978. Linking adherence phenotypes to genotypes was also attempted, as multiple adherence mechanisms have been identified. Although Bap (Loehfelm et al., 2008) showed major sequence variation, no direct link between adherence characteristics and sequence homology could be established. The pgaABCD cluster responsible for production of poly-beta-1-6-N-acetylglucosamine (Choi et al., 2009), and ompA (Gaddy et al., 2009) displayed a high level

of conservation between NVP-BKM120 chemical structure the investigated strains, therefore, sequence differences that may be linked to a phenotype could not be observed. In total, four different type I pili clusters were identified in the six sequenced strains included in this study; AB57_1744-1747, AB57_2565-2570 (csu cluster) (Tomaras et al., 2003), AB57_2420-2423 and AB57_2003-2007. The csu gene cluster was well conserved between the strains investigated; however, csuB of ATCC 17978 contained a single base-pair (bp) insertion, which resulted in a truncation Progesterone of the open reading frame. Subsequently, the gap between the csuB and csuC open reading frames increased from 5 bp to 96 bp. Although transcription is unlikely to

be influenced by the single bp insertion, the increase between csuB and csuC may affect translation of csuC and other downstream genes in this operon. Interestingly, this strain showed the lowest level of binding to abiotic surfaces of all A. baumannii strains investigated, with the exception of strain RB02c (Fig. 1). The first open reading frame of the AB57_1744-1747 and AB57_2420-2423 polycistronic gene clusters contained homopolymeric tracts of varying lengths, and were therefore reanalysed by Sanger sequencing. Sequence differences were rebutted for AB57_1744_1747 using Sanger sequencing, however, strains ATCC 17978 and ATCC 19606 appeared to have an additional thymine in AB57_2423, which resulted in a frame-shift. However, even with this additional information, no direct correlation could be determined between the presence of type I pili clusters AB57_1744-1747, AB57_2420-2423 or AB57_2003-2007 and adherence to either biotic or abiotic surfaces. The Australian clinical A. baumannii isolates showed a similar clonal distribution to that found in Europe, viz.