In several recent studies, MDR efflux pumps of phytopathogenic ba

In several recent studies, MDR efflux pumps of phytopathogenic bacteria were shown to be involved in the extrusion of plant-derived antimicrobial metabolites, which promotes host colonization and enhances virulence (Martinez et al., 2009, and references therein). Plant-associated soil bacteria

are challenged in several ways, for example by abiotic environmental stresses or competing organisms and their metabolic products. At least conceptually, symbiotic and phytopathogenic bacteria appear to initiate similar programs for invasion and colonization (Soto et al., 2006; Deakin & Broughton, 2009). Therefore, the expression of efflux proteins seems to be a useful common trait of these bacteria that allows them to cope with the toxic selleck screening library compounds that they may encounter click here during infection. In this work, we have characterized an RND-type multidrug efflux system, termed BdeAB, in the legume symbiont B. japonicum. Another putative efflux pump, RagCD, was described previously in B. japonicum (Krummenacher & Narberhaus, 2000). However,

ragCD mutants did not differ from the wild type in their antibiotic susceptibility profile and in their symbiotic phenotype. By contrast, we have shown here that the loss of the BdeAB proteins increases the susceptibility toward aminoglycoside antibiotics, supporting the idea that these proteins principally function as a drug efflux pump. Unlike the RmrAB efflux pump of the bean symbiont R. etli, which was shown to be required for nodulation (Gonzalez-Pasayo

& Martinez-Romero, 2000), the B. japonicum bdeAB mutant was not affected in nodule formation. However, soybean nodules elicited by this strain contained fewer bacteroids as compared with nodules formed by the wild type. The impaired colonization by the ΔbdeAB strain might account for the decreased nitrogen-fixation activity in these nodules. It is known that legumes synthesize phytoalexins not only in response to a pathogenic attack but also in the presence of rhizobia Liothyronine Sodium (see the review by Baron & Zambryski, 1995, and references therein). In fact, the RmrAB efflux pump confers tolerance to plant-derived antimicrobial compounds (Gonzalez-Pasayo & Martinez-Romero, 2000). Recently, another example of the importance of export proteins in plant–microorganisms interactions was reported. In Mesorhizobium tianshanense, a LysE-family exporter for the antimetabolite canavanine was identified, which helps those rhizobia to survive in a canavanine-rich legume rhizosphere (Cai et al., 2009). It is tempting to speculate that the BdeAB system provides a similar advantage to B. japonicum, perhaps coping with an as yet unidentified soybean-derived compound. The observation that symbiosis of the B.

The low sequence identity score of IdpA is partially attributed t

The low sequence identity score of IdpA is partially attributed to insertions and deletions in the PoiBI IdpA sequence relative to that of WX IdpA. In

a comparison of nucleotide sequences, the numbers of nonsynonymous and synonymous substitutions per site (dN and dS, respectively) and their ratio (dN/dS) are important indicators of selective pressure at the protein level. Calculated dN/dS values of <1, 1, and >1 imply stabilizing selection, neutral mutation, and diversifying positive selection, respectively. To investigate whether dnaD, imp, and idpA evolved under positive selection pressure, we determined the dN/dS value of the nucleotide sequences of these genes from PoiBI and WX. For dnaD, dN/dS was 0.444, which is < 1. For imp, dN/dS ranged from 1.278 to 1.556, but was GSK1120212 mw not statistically significant (P = 0.3233–0.3716). In contrast,

the dN/dS value for idpA was 1.500 with P = 0.0639, which 17-AAG is significant at the 10% level (Table 2). To prepare materials for the production of anti-PoiBI-Imp and anti-PoiBI-IdpA antisera, we attempted to express His-tagged full-length and truncated forms of these proteins in E. coli. Attempts to express some proteins in E. coli were successful only for His-tagged full-length Imp and for His-tagged IdpA-N, which lacks the two transmembrane regions of IdpA, as well as half of the hydrophilic domain. These purified proteins were used to immunize rabbits. Use of the purified anti-Imp and anti-IdpA IgG in Western blots analysis of the Imp and IdpA hydrophilic domain proteins expressed in E. coli confirmed that the titers of the antibodies were similar (data not shown). To confirm that Imp and IdpA are expressed in PoiBI-infected poinsettia, crude protein extracts were prepared from the PoiBI-infected cultivar ‘Jester Red’ (‘infected’ extract) and from the healthy control cultivar ‘Flaming Sphere’ (‘control’ extract). Western blot analysis of these samples using anti-Imp antibody Tangeritin revealed a distinct protein band in the infected extract, but not in the control extract (Fig. 3a). However, multiple attempts to detect IdpA using anti-IdpA antibody failed to detect IdpA in either the

infected or control extracts (Fig. 3b). The Western blot analysis estimated the molecular mass of Imp in the ‘infected’ as 19.6 kDa, which is the calculated mass of full-length Imp. This result suggests that the signal sequence of Imp is not cleaved, and that Imp exists as a membrane protein in infected poinsettia plants. In contrast, the strongest Imp band detected in E. coli extracts was smaller by approximately 3 kDa, suggesting that the Imp signal sequence is cleaved when the recombinant protein is expressed in E. coli. To investigate the localization of Imp and IdpA proteins in infected plants, we performed immunohistochemical analysis using anti-Imp and anti-IdpA antibodies. Both Imp and IdpA were specifically detected in the phloem of ‘Jester Red’ (‘infected’; Fig. 4b and d), but not in ‘Flaming Sphere’ (‘control’; Fig.

This might cause confounding because patterns of smoking behaviou

This might cause confounding because patterns of smoking behaviour may be different in different geographical regions of our country. However, a prospective long-term observational study of such a large unselected population may better reflect routine care than would a randomized trial including selected patients. Smoking activity indicated by patients was not verified using biomarkers, such as cotinine measurement. However, most other community-based studies on this topic RO4929097 used self-declaration [32].

Motivation levels to change behaviour were not assessed using standardized questionnaires but rather discussed between patients and physicians. Unfortunately, prescribed medications to support smoking cessation were not covered by health insurance, whereas medication was free in other studies showing efficacy of counselling including pharmacological support [23, 33]. Furthermore, the majority of physicians in our setting are in postgraduate Selleck AG-14699 training and spend a limited period of around 1 year in HIV care. Behavioural change counselling needs a physician–patient relationship which often does not develop in a short time frame. Furthermore, the possibility cannot be excluded that the rather complex

field of HIV care is so demanding for physicians beginning their training that there is not sufficient capacity or time to approach topics such as smoking cessation. Finally, our intervention was not compared with no intervention. CVD risk factors have been considered in standard-of-care for many years in all SHCS institutions, and many centres reported some counselling

activities, but no other centre had a structured smoking cessation programme. The strength of our approach is that we integrated structured smoking cessation counselling into routine HIV care, provided at our institution by physicians in infectious diseases postgraduate education and by infectious diseases specialists. Various approaches to introduce tobacco cessation programmes into standard HIV care are essential, and smoking cessation efforts should be a topic of discussion in any physician–patient contact [34]. Previous studies have shown the feasibility of smoking cessation programmes in HIV care, but mostly evaluated selected or highly motivated Dimethyl sulfoxide smokers, or were of a pilot character [20, 22, 23], and the effects of interventions were contradictory [19, 35, 36]. Our approach of an institution-wide training programme for infectious diseases physicians to improve smoking cessation counselling can be well integrated into routine HIV care, was well accepted by patients and physicians, and can support patients’ efforts to stop smoking. We thank the participants, physicians, study nurses and data managers of the Swiss HIV Cohort Study. Funding: This study was financed in the framework of the Swiss HIV Cohort Study, supported by the Swiss National Science Foundation. The members of the Swiss HIV Cohort Study Group are: J. Barth, M. Battegay, E. Bernasconi, J. Böni, H. C. Bucher, C.

When cultured in nutrient medium at high temperature (37 °C), btk

When cultured in nutrient medium at high temperature (37 °C), btkB mutant showed reduced maximum cell density as compared to the wild type. Under starvation conditions, btkB mutant cells formed fruiting bodies and spores about 24 h later than the wild-type strain. The btkB mutant overproduced yellow pigment during development. Also, btkB mutant showed a decrease in EPS production when compared with the wild-type strain. These results suggested that BtkB may play multiple roles in M. xanthus cells. Myxococcus xanthus is a Gram-negative soil bacterium that exhibits a complex life cycle and social

behavior. This bacterium has two genetically distinct motility systems: adventurous (A) motility and social (S) motility (Hodgkin & Kaiser, 1979). Gefitinib The A-motility system allows movement of isolated cells and does not require cell–cell contact, while the S-motility system is typically employed for coordinated group movement of cells. The S-motility in M. xanthus involves the interaction between two organelles, type IV pili and exopolysaccharide (EPS). When deprived

of nutrients, thousands of cells move by gliding toward centers of aggregation to multicellular fruiting bodies, where the long vegetative rods change to spherical optically refractile cells with resistance properties (Reichenbach, 1986). Bacteria are able to adapt to a wide variety of environmental conditions through the regulation of gene expression, and they use ALOX15 sophisticated signal transduction mechanisms to control specific gene expression. In bacteria, Obeticholic Acid price protein phosphorylation is catalyzed mainly by histidine kinases, which are key enzymes of the so-called ‘two-component systems’ (Laub & Goulian, 2007). From recent genomic analysis, eukaryotic-like protein serine/threonine kinases were found in various bacteria and coexist with histidine kinases (Pereira et al., 2011). In addition to these protein kinases, the presence of bacterial tyrosine (BY) kinases has been proven in several bacterial species (Shi et al., 2010). BY kinases have been shown to be mainly involved in the production of capsular polysaccharide (CPS) and EPS (Cuthbertson et al., 2009).

For example, in Escherichia coli, tyrosine kinases, Wzc and Etk, have been reported to participate in the synthesis and transportation of CPS (Whitfield, 2006). Also, BY kinases have been found to phosphorylate heat-shock sigma and antisigma factors and single-stranded DNA-binding proteins (Klein et al., 2003; Mijakovic et al., 2006), suggesting that BY kinases are also involved in the heat-shock response and DNA metabolism. They show no sequence similarity with eukaryotic protein kinases. BY kinases from Gram-negative bacteria have two functional domains, N-terminal periplasmic and C-terminal cytoplasmic domains encoded by a single gene (Doublet et al., 2002). By contrast, BY kinases from Gram-positive bacteria are usually separated into two distinct proteins.

To think otherwise would be to decide not to pull a child out of

To think otherwise would be to decide not to pull a child out of the way of a speeding car for fear of injuring the child’s arm. Although laws and attitudes toward this issue may differ between countries, Pattenden’s paper highlights the fact that it may be time to actively investigate this problem and attempt to establish standards of care that would ensure that expedition medical kits are safely carried along on expeditions. The authors state they

have no conflicts of interest to declare. “
“The number of people, both adults and children, traveling abroad, is on the rise. Some seek counseling at travel medicine centers before departure. A prospective study was conducted among children <16 years visiting a travel medicine center in Marseille, France, from February 2010 to February 2011. Parents PI3K inhibitor were contacted by telephone 4 weeks after their return, and asked about compliance with pre-travel advice. One hundred sixty-seven children were evaluated GSK2118436 molecular weight after their trip. Compliance with immunizations, malaria chemoprophylaxis, and food-borne disease prevention was 71, 66, and 31%, respectively. Compliance with malaria chemoprophylaxis varied significantly with destination, and was higher for African destinations. Significant features associated with poor compliance with chemoprophylaxis were a trip to Asia or the Indian Ocean, age <5 years, and a monoparental family. Compliance with prevention of food- and

water-borne diseases was higher in children < 2 years of age. A ≥80% compliance with pre-travel counseling in children traveling overseas was achieved only for drinking bottled water, using repellents, a routine vaccine update, and yellow fever immunization. In France, it is estimated that half a million children travel to the tropics annually.[1] Their main purpose of travel is tourism, but some of them are visiting friends and relatives MYO10 (VFR) abroad with their caregivers.[2] Travel medicine centers provide authentic information[3, 4] and health education to families regarding travel-related risks and their

preventive measures. Compliance with pre-travel advice has never been well evaluated in families with children. This 1-year prospective study, conducted in a travel medicine center in southern France, aimed to report pediatric data on compliance with the prophylactic measures. The study took place in the Marseille Travel Medicine Center located in a tertiary university hospital in southern France (CHU Nord, Marseille) from February 2010 to February 2011. It was approved by the Ethical Committee of the Marseille Faculty of Medicine. During the stated period, the center counseled more than 3,800 travelers. Families with children under 16 years of age seeking advice before a journey to the tropics were invited to take part in the study. “Tropics” included sub-Saharan Africa and Indian Ocean islands, Southeast Asia and India, and Central and South America.


“cAMP signaling affects a large number of the developmenta


“cAMP signaling affects a large number of the developmental processes needed for the construction of the CNS, including cell differentiation, axon outgrowth, response to guidance molecules or modulation of synaptic connections. This points to a key role of adenylate cyclases (ACs), the synthetic enzymes of cAMP, for neural development. ACs exist as 10 different isoforms, which are activated by distinct signaling pathways. The implication of specific

AC isoforms in neural wiring was only recently demonstrated in mouse mutants, knockout (KO) for different AC isoforms, AC1, AC3, AC5, AC8 and soluble Cabozantinib mouse (s)AC/AC10. These studies stressed the importance of three of these isoforms, as sensors of neural activity that could modify the survival of neurons (sAC), axon outgrowth (sAC), or the response of axons to guidance molecules such as ephrins (AC1) or semaphorins (AC3). We summarize here the current knowledge on the role of these ACs for the development of sensory maps, in the somatosensory, visual and olfactory systems, which have been the most extensively studied. In these systems, AC1/AC3 KO revealed targeting mistakes due to the defective pruning and lack of discrimination of incoming axons to signals present in target structures. In contrast, no changes in cell differentiation, survival or axon outgrowth were noted

in these mutants, suggesting a specificity of cAMP production routes for individual cellular processes within a given neuron. Further studies indicate that the subcellular localization of ACs could Ixazomib supplier be key to their specific role in axon targeting Casein kinase 1 and may explain their selective roles in neuronal wiring. “
“The effects of gastrin-releasing peptide (GRP) on the circadian clock in the suprachiasmatic nucleus (SCN) are dependent on the activation of N-methyl-d-aspartate (NMDA) receptors in the SCN. In this study, the interaction between GRP, glutamate and serotonin in the regulation of circadian phase in Syrian hamsters was evaluated. Microinjection of GRP into the third ventricle induced c-fos and

p-ERK expression throughout the SCN. Coadministration of an NMDA antagonist or 8-hydroxy-2-di-n-propylamino-tetralin [a serotonin (5-HT)1A,7 agonist, DPAT] with GRP limited c-fos expression in the SCN to a region dorsal to GRP cell bodies. Similar to the effects of NMDA antagonists, DPAT attenuated GRP-induced phase shifts in the early night, suggesting that the actions of serotonin on the photic phase shifting mechanism occur downstream from retinorecipient cells. c-fos and p-ERK immunoreactivity in the supraoptic (SON) and paraventricular hypothalamic nuclei also increased following ventricular microinjection of GRP. Because of this finding, a second set of experiments was designed to test a potential role for the SON in the regulation of clock function. Syrian hamsters were given microinjections of GRP into the peri-SON during the early night.

Post-contrast images showed there was peripherally an avid ring o

Post-contrast images showed there was peripherally an avid ring of enhancement along the cysts. There was also an irregular rim with effacement of the roots along the peripheral aspect, and likely there was enhancement of the roots in this location as well (Figure 1). Hematological evaluation and biochemical parameters were normal. The clinical diagnosis was arachnoid cyst or arachnoiditis or possibly spinal tumors, and surgery was believed to be warranted because of the patient’s progressive neurological symptoms. A lumbar

laminectomy L1 to L4 was performed and the underlying dura mater was opened. Beneath were grossly abnormally thickened arachnoid and a round thick fluid-filled Bleomycin in vivo sac that was directly compressing the conus medullaris and the cauda equina. This was carefully removed and sent for pathology. Histological examination was compatible with neurocysticercosis (NCC;

Figure 2). The serum was positive for anticysticercus antibodies by enzyme-linked immunosorbent assay (ELISA), using glycoproteins purified from Taenia solium cyst fluid as antigens. Examination of stools was negative for the presence of parasites, proglottids, and ova. The patient underwent full craniospinal axis MRI evaluation, which demonstrated no evidence of other cysticercosis lesions. She recovered from the surgery uneventfully, and at a 3-month follow-up visit she complained of mild residual left leg numbness and weakness in the legs after prolonged standing. She had subjective decrease in light touch sensation on the left OSI-906 in vitro lower leg compared with the right and strength was slightly diminished on the left compared with the right leg that had normal strength. To further evaluate where the infection was acquired from, we analyzed cytochrome c oxidase l (cox1) of mitochondrial DNA (mtDNA) using the formalin-fixed DNA ligase and paraffin-embedded histological specimen prepared from the patient and stored in the pathology department in tissue blocks.1 Comparing with the GenBank database, the sequence was completely identical to the cox1 sequence of T solium from Korea and China (data not shown).1 NCC is a neurologic

infestation caused by the larval form of T solium. Taenia solium has a complex life cycle that requires two hosts. Humans are the only known definitive hosts for the adult cestode, whereas pigs are the natural intermediate host and humans may become accidental intermediate hosts for the larval form or cysticercus.2 Humans acquire the intestinal tapeworm T solium by eating raw pork. They acquire NCC by ingesting T solium eggs through fecal oral contamination. In the United States, NCC has become an increasingly important emerging infection. This has largely been driven by the influx of immigrants from endemic regions.3 Despite an increasing number of NCC cases overall, the number of spinal NCC cases remains very low.4 The incidence of spinal NCC among travelers is extremely rare.

[9] Khabbazi et al[10] showed that vitamin D levels were lower i

[9] Khabbazi et al.[10] showed that vitamin D levels were lower in BD patients than the healty subjects, but this did not relate to disease activity. Dormohammadi et al.[11] demonstrated OA resistant to treatment was not related to iron deficiency. Yoon in a series of 624 patients reported click here neuro-BD to be 3.5% in South Korea,[12] very near to the previous report of Bang et al.[13] from 2001. Shadmanfar reports that, contrary to previous reports, there was no relationship

between plasma homocysteine levels and HLA B-51 in BD patients, nor in their control group.[14] Lin reports 6.3% of malignancy in hospitalized BD patients[15], which is much higher than previous reports (6.3% vs. 0.24%).[16] “
“Aims:  The aim of this study was to investigate the prevalence of chronic kidney disease (CKD) among comparable patients with rheumatoid

arthritis (RA) and seronegative inflammatory arthritis, and to explore any predictive factors for renal impairment. Methods:  Consecutive patients with peripheral joint disease (oligo and polyarthritis) were recruited from our inflammatory arthritis clinics. We divided patients in two groups: RA group and seronegative inflammatory arthritis group. The cohort consisted of 183 patients (RA = 107, seronegative arthritis = 76 [psoriatic arthritis = 69, undifferentiated oligoarthritis = 7]). Estimated glomerular filtration rate (eGFR) was calculated Selleck Forskolin using the established Modification of Diet in Renal Disease equation. Demographic details, disease-specific

characteristics, anti-rheumatic drugs and the presence of cardiovascular diseases were recorded. Results:  In total, 17.48% (n = 32) of the cohort had CKD. There was no statistically significant variation between the two groups as regards baseline demographics, disease characteristics, use of anti-rheumatic drugs and the presence of individual cardiovascular diseases. We found that eGFR and the presence of CKD were similar among these groups. Among patients with CKD, 72% had undiagnosed CKD. No association of statistical significance was noted between CKD and the use of corticosteroids, disease-modifying antirheumatic drugs and anti-tumor necrosis factor agents. The association of cardiovascular diseases Methane monooxygenase with CKD remained significant after adjusting for confounders (age, gender, duration of arthritis, high C-reactive protein, use of anti-rheumatic drugs). Conclusions:  Patients with inflammatory arthritis are more prone to have CKD. This could have serious implications, as the majority of rheumatology patients use non-steroidal anti-inflammatory drugs and different immunosuppressives, such as methotrexate. No association of kidney dysfunction was noted with inflammatory disease-specific characteristics; rather it appears to have a positive independent association with cardiovascular diseases.

coli (Savic et al, 2009) Regardless of the provenance of the 16

coli (Savic et al., 2009). Regardless of the provenance of the 16S rRNA MTase gene responsible

for aminoglycoside resistance, MK-1775 supplier the enzyme seems to be functional to some extent in any bacterial species, although each bacteria species would need the optimal promoter region in each 16S rRNA MTase gene for its expression. This study was supported by the Ministry of Health, Labour, and Welfare of Japan (grant H21-Shinkou-Ippan-008). We thank the National Bioresource Project (National Institute of Genetics, Japan) for providing the E. coli BW25113 and BW25113ΔgidB strains, and Drs. Haruyoshi Tomita and Shuhei Fujimoto for supplying the E. coli–S. aureus shuttle expression vector, pMGS100. “
“Members of the fungal genus Pneumocystis colonize healthy mammalian hosts without causing apparent disease, but colonization in immunocompromised hosts may result in a potentially fatal pneumonia known as Pneumocystis pneumonia. Although Pneumocystis are fungi, this genus has characteristics that ABT-199 order make it atypical among other fungi. Pneumocystis do not

appear to synthesize the major fungal sterol, ergosterol, and biochemical analyses have shown that they utilize cholesterol rather than ergosterol as the bulk sterol. Pneumocystis carinii appears to scavenge exogenous sterols, including cholesterol, from its mammalian host. As a result, it has long been held that their ability to scavenge cholesterol from their hosts, and their inability to undergo sterol biosynthesis, makes them resistant to antifungal drugs that target ergosterol or ergosterol biosynthesis. However, genome scans and in vitro assays indicate the presence of sterol biosynthetic genes within the P.

carinii genome, and targeted inhibition of these enzymes resulted in reduced viability of P. carinii, suggesting that these enzymes are functional within the organism. Heterologous expression of P. carinii sterol genes, along with biochemical analyses of the lipid content of Silibinin P. carinii cellular membranes, have provided an insight into sterol biosynthesis and the sterol-scavenging mechanisms used by these fungi. Members of the genus Pneumocystis are opportunistic fungi capable of causing a lethal pneumonia in mammalian hosts. Pneumocystis colonization of immunocompetent hosts appears to have minimal clinical consequences, but colonization in hosts with debilitated or compromised immune systems may result in the development of Pneumocystis pneumonia (PCP). Before the AIDS epidemic in the early 1980s, PCP was a rare occurrence seen only in malnourished children, transplant recipients, cancer patients and those with immune deficiencies (Gajdusek, 1957).

coli (Savic et al, 2009) Regardless of the provenance of the 16

coli (Savic et al., 2009). Regardless of the provenance of the 16S rRNA MTase gene responsible

for aminoglycoside resistance, www.selleckchem.com/products/gsk2126458.html the enzyme seems to be functional to some extent in any bacterial species, although each bacteria species would need the optimal promoter region in each 16S rRNA MTase gene for its expression. This study was supported by the Ministry of Health, Labour, and Welfare of Japan (grant H21-Shinkou-Ippan-008). We thank the National Bioresource Project (National Institute of Genetics, Japan) for providing the E. coli BW25113 and BW25113ΔgidB strains, and Drs. Haruyoshi Tomita and Shuhei Fujimoto for supplying the E. coli–S. aureus shuttle expression vector, pMGS100. “
“Members of the fungal genus Pneumocystis colonize healthy mammalian hosts without causing apparent disease, but colonization in immunocompromised hosts may result in a potentially fatal pneumonia known as Pneumocystis pneumonia. Although Pneumocystis are fungi, this genus has characteristics that Enzalutamide supplier make it atypical among other fungi. Pneumocystis do not

appear to synthesize the major fungal sterol, ergosterol, and biochemical analyses have shown that they utilize cholesterol rather than ergosterol as the bulk sterol. Pneumocystis carinii appears to scavenge exogenous sterols, including cholesterol, from its mammalian host. As a result, it has long been held that their ability to scavenge cholesterol from their hosts, and their inability to undergo sterol biosynthesis, makes them resistant to antifungal drugs that target ergosterol or ergosterol biosynthesis. However, genome scans and in vitro assays indicate the presence of sterol biosynthetic genes within the P.

carinii genome, and targeted inhibition of these enzymes resulted in reduced viability of P. carinii, suggesting that these enzymes are functional within the organism. Heterologous expression of P. carinii sterol genes, along with biochemical analyses of the lipid content of PFKL P. carinii cellular membranes, have provided an insight into sterol biosynthesis and the sterol-scavenging mechanisms used by these fungi. Members of the genus Pneumocystis are opportunistic fungi capable of causing a lethal pneumonia in mammalian hosts. Pneumocystis colonization of immunocompetent hosts appears to have minimal clinical consequences, but colonization in hosts with debilitated or compromised immune systems may result in the development of Pneumocystis pneumonia (PCP). Before the AIDS epidemic in the early 1980s, PCP was a rare occurrence seen only in malnourished children, transplant recipients, cancer patients and those with immune deficiencies (Gajdusek, 1957).