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Journal of clinical microbiology.

Periodical
Microbiology
Publisher:
American Society for Microbiology.
Frequency: Monthly
Country: United States
Language: English
Author(s):
American Society for Microbiology.
Start Year:1975 -
Identifiers
ISSN:0095-1137 (Print)
1098-660X (Electronic)
0095-1137 (Linking)
NLM ID:7505564
(DNLM):J16820000(s)
(OCoLC):01799460
Coden:JCMIDW
Classification:W1 JO5893M
Presence of new mecA and mph(C) variants conferring antibiotic resistance in Staphylococcus spp. isolated from the skin of horses before and after clinic admission.
Journal of clinical microbiology    September 27, 2006   Volume 44, Issue 12 4444-4454 doi: 10.1128/JCM.00868-06
Schnellmann C, Gerber V, Rossano A, Jaquier V, Panchaud Y, Doherr MG, Thomann A, Straub R, Perreten V.Because of the frequency of multiple antibiotic resistance, Staphylococcus species often represent a challenge in incisional infections of horses undergoing colic surgery. To investigate the evolution of antibiotic resistance patterns before and after preventative peri- and postoperative penicillin treatment, staphylococci were isolated from skin and wound samples at different times during hospitalization. Most staphylococci were normal skin commensals and belonged to the common coagulase-negative group. In some cases they turned out to be opportunistic pathogens present in wound infections. M...
Sequence variation of the SeM gene of Streptococcus equi allows discrimination of the source of strangles outbreaks.
Journal of clinical microbiology    February 4, 2006   Volume 44, Issue 2 480-486 doi: 10.1128/JCM.44.2.480-486.2006
Kelly C, Bugg M, Robinson C, Mitchell Z, Davis-Poynter N, Newton JR, Jolley KA, Maiden MC, Waller AS.Improved understanding of the epidemiology of Streptococcus equi transmission requires sensitive and portable subtyping methods that can rationally discriminate between strains. S. equi is highly homogeneous and cannot be distinguished by multilocus enzyme electrophoretic or multilocus sequence-typing methods that utilize housekeeping genes. However, on sequence analysis of the N-terminal region of the SeM genes of 60 S. equi isolates from 27 strangles outbreaks, we identified 21 DNA codon changes. These resulted in the nonsynonymous substitution of 18 amino acids and allowed the assignment of...
Detection of a bla(SHV) extended-spectrum {beta}-lactamase in Salmonella enterica serovar Newport MDR-AmpC.
Journal of clinical microbiology    November 8, 2005   Volume 43, Issue 11 5792-5793 doi: 10.1128/JCM.43.11.5792-5793.2005
Rankin SC, Whichard JM, Joyce K, Stephens L, O'shea K, Aceto H, Munro DS, Benson CE.Salmonella enterica serovar Newport MDR-AmpC expressing TEM-1b and extended-spectrum beta-lactamase SHV-12 was isolated from affected animals during an outbreak of salmonellosis that led to a 3-month closure of one of the largest equine hospitals in the United States.
Real-time reverse transcription PCR for detection and quantitative analysis of equine influenza virus.
Journal of clinical microbiology    October 7, 2005   Volume 43, Issue 10 5055-5057 doi: 10.1128/JCM.43.10.5055-5057.2005
Quinlivan M, Dempsey E, Ryan F, Arkins S, Cullinane A.Equine influenza is a cause of epizootic respiratory disease of the equine. The detection of equine influenza virus using real-time Light Cycler reverse transcription (RT)-PCR technology was evaluated over two influenza seasons with the analysis of 171 samples submitted for viral respiratory disease. Increased sensitivity was found in overall viral detection with this system compared to Directigen Flu A and virus isolation, which were 40% and 23%, respectively, that of the RT-PCR. The assay was also evaluated as a viable replacement for the more traditional methods of quantifying equine influe...
Regulated expression of the beta2-toxin gene (cpb2) in Clostridium perfringens type a isolates from horses with gastrointestinal diseases.
Journal of clinical microbiology    August 6, 2005   Volume 43, Issue 8 4002-4009 doi: 10.1128/JCM.43.8.4002-4009.2005
Waters M, Raju D, Garmory HS, Popoff MR, Sarker MR.Recent epidemiological studies suggested that cpb2-positive Clostridium perfringens isolates are associated with gastrointestinal (GI) diseases in horses. These putative relationships, indicated by PCR genotyping, were tested in the present study by further genotyping and phenotyping of 23 cpb2-positive C. perfringens isolates from horses with GI disease (referred to hereafter as horse GI disease isolates). Our beta2-toxin (CPB2) Western blot analyses demonstrated that all of the tested isolates were unable to produce detectable levels of CPB2. However, Southern blot and nucleotide sequencing ...
Ability of the vector tick Boophilus microplus to acquire and transmit Babesia equi following feeding on chronically infected horses with low-level parasitemia.
Journal of clinical microbiology    August 6, 2005   Volume 43, Issue 8 3755-3759 doi: 10.1128/JCM.43.8.3755-3759.2005
Ueti MW, Palmer GH, Kappmeyer LS, Statdfield M, Scoles GA, Knowles DP.The protozoan parasite Babesia equi replicates within erythrocytes. During the acute phase of infection, B. equi can reach high levels of parasitemia, resulting in a hemolytic crisis. Horses that recover from the acute phase of the disease remain chronically infected. Subsequent transmission is dependent upon the ability of vector ticks to acquire B. equi and, following development and replication, establishment of B. equi in the salivary glands. Although restriction of the movement of chronically infected horses with B. equi is based on the presumption that ticks can acquire and transmit the ...
Surveillance of Staphylococcus aureus in veterinary teaching hospitals.
Journal of clinical microbiology    June 16, 2005   Volume 43, Issue 6 2916-2919 doi: 10.1128/JCM.43.6.2916-2919.2005
Middleton JR, Fales WH, Luby CD, Oaks JL, Sanchez S, Kinyon JM, Wu CC, Maddox CW, Welsh RD, Hartmann F.Staphylococcus aureus isolates (n = 70) from 65 patients (36 canine, 18 equine, 7 bovine, 2 avian, and 2 feline) at seven veterinary teaching hospitals in the United States were studied. The majority of patients (83%) with an S. aureus infection were canine and equine, but this may have reflected a sample bias based on clinic case loads and diagnostic lab submissions at the participating institutions. Fourteen percent of patients with an S. aureus infection were infected with a methicillin-resistant S. aureus (MRSA) isolate. Six of seven institutions had at least one MRSA infection during the ...
Sequence analysis of the msp4 gene of Anaplasma phagocytophilum strains.
Journal of clinical microbiology    March 8, 2005   Volume 43, Issue 3 1309-1317 doi: 10.1128/JCM.43.3.1309-1317.2005
de la Fuente J, Massung RF, Wong SJ, Chu FK, Lutz H, Meli M, von Loewenich FD, Grzeszczuk A, Torina A, Caracappa S, Mangold AJ, Naranjo V, Stuen S....The causative agent of human granulocytic ehrlichiosis was recently reclassified as Anaplasma phagocytophilum, unifying previously described bacteria that cause disease in humans, horses, dogs, and ruminants. For the characterization of genetic heterogeneity in this species, the homologue of Anaplasma marginale major surface protein 4 gene (msp4) was identified, and the coding region was PCR amplified and sequenced from a variety of sources, including 50 samples from the United States, Germany, Poland, Norway, Italy, and Switzerland and 4 samples of A. phagocytophilum-like organisms obtained f...
Molecular characterizations of human and animal group a rotaviruses in the Netherlands.
Journal of clinical microbiology    February 8, 2005   Volume 43, Issue 2 669-675 doi: 10.1128/JCM.43.2.669-675.2005
van der Heide R, Koopmans MP, Shekary N, Houwers DJ, van Duynhoven YT, van der Poel WH.To gain more insight into interspecies transmission of rotavirus group A, human and animal fecal samples were collected between 1997 and 2001 in The Netherlands. A total of 110 human stool samples were successfully P and G genotyped by reverse transcriptase PCR. All strains belonged to the main human rotavirus genotypes G1 to G4, G9, [P4], [P6], [P8], and [P9]. [P8]G1 was predominant, and 5.5% belonged to the G9 genotype. Eleven percent of all P[8] genotypes could be genotyped only by a recently published modified primer. Rotavirus-positive fecal samples from 28 calf herds were genotyped by DN...
Association between respiratory disease and bacterial and viral infections in British racehorses.
Journal of clinical microbiology    January 7, 2005   Volume 43, Issue 1 120-126 doi: 10.1128/JCM.43.1.120-126.2005
Wood JL, Newton JR, Chanter N, Mumford JA.Respiratory disease is important in horses, particularly in young Thoroughbred racehorses, and inflammation that is detected in the trachea and bronchi (termed inflammatory airway disease [IAD]) is more significant in this population in terms of impact and frequency than other presentations of respiratory disease. IAD, which is characterized by neutrophilic inflammation, mild clinical signs, and accumulation of mucus in the trachea, may be multifactorial, possibly involving infections and environmental and immunological factors, and its etiology remains unclear. This 3-year longitudinal study ...
Nicoletella semolina gen. nov., sp. nov., a new member of Pasteurellaceae isolated from horses with airway disease.
Journal of clinical microbiology    December 8, 2004   Volume 42, Issue 12 5542-5548 doi: 10.1128/JCM.42.12.5542-5548.2004
Kuhnert P, Korczak B, Falsen E, Straub R, Hoops A, Boerlin P, Frey J, Mutters R.Gram-negative, nonmotile bacteria that are catalase, oxidase, and urease positive are regularly isolated from the airways of horses with clinical signs of respiratory disease. On the basis of the findings by a polyphasic approach, we propose that these strains be classified as Nicoletella semolina gen. nov, sp. nov., a new member of the family Pasteurellaceae. N. semolina reduces nitrate to nitrite but is otherwise biochemically inert; this includes the lack of an ability to ferment glucose and other sugars. Growth is fastidious, and the isolates have a distinctive colony morphology, with the ...
Development and evaluation of an enzyme-linked immunosorbent assay for quantifying antibodies to Japanese encephalitis virus nonstructural 1 protein to detect subclinical infections in vaccinated horses.
Journal of clinical microbiology    November 6, 2004   Volume 42, Issue 11 5087-5093 doi: 10.1128/JCM.42.11.5087-5093.2004
Konishi E, Shoda M, Ajiro N, Kondo T.Antibodies to Japanese encephalitis virus (JEV) nonstructural 1 (NS1) protein constitute a marker of natural JEV infection among populations vaccinated with inactivated JE vaccine. In Japan, with few recent human JE cases, the natural infection rate is critical to evaluate the necessity of continuing JE vaccination. A sensitive immunochemical staining method for detecting NS1 antibodies in individuals naturally and subclinically infected with JEV was previously established. Here, an enzyme-linked immunosorbent assay (ELISA) to detect NS1 antibodies in equine sera was developed and evaluated as...
Vibrio metschnikovii, a rare cause of wound infection.
Journal of clinical microbiology    October 9, 2004   Volume 42, Issue 10 4909-4911 doi: 10.1128/JCM.42.10.4909-4911.2004
Linde HJ, Kobuch R, Jayasinghe S, Reischl U, Lehn N, Kaulfuss S, Beutin L.We report the first case of a postoperative wound infection caused by Vibrio metschnikovii on the lower right leg of a patient after saphenectomy. Compared to the healing of an uninfected site, that of the right leg was delayed, and a cure was achieved by intensified wound care. Several swabs taken from the infected site grew a gram-negative rod in pure culture that was identified as V. metschnikovii by the VITEK 2 system. The source of the infection was not detected; however, the absence of putative risk factors (exposure to water or shellfish or an episode of diarrhea), the profession of the...
Helcococcus ovis isolated from a pulmonary abscess in a horse.
Journal of clinical microbiology    May 8, 2004   Volume 42, Issue 5 2224-2226 doi: 10.1128/JCM.42.5.2224-2226.2004
Rothschild CM, Oaks JL, Schaupp JK, Rurangirwa FR, Sellon DC, Hines MT.Helcococcus ovis, a recently described organism cultured from sheep, was isolated in pure culture from a pulmonary abscess in a horse. This is the first report of this organism in horses and the first report in veterinary medicine to clearly demonstrate a pathogenic role for this organism.
Comparison of sensitivities of virus isolation, antigen detection, and nucleic acid amplification for detection of equine influenza virus.
Journal of clinical microbiology    February 10, 2004   Volume 42, Issue 2 759-763 doi: 10.1128/JCM.42.2.759-763.2004
Quinlivan M, Cullinane A, Nelly M, Van Maanen K, Heldens J, Arkins S.Four seronegative foals aged 6 to 7 months were exposed to an aerosol of influenza strain A/Equi/2/Kildare/89 at 10(6) 50% egg infective doses (EID(50))/ml. Nasopharyngeal swabs were collected for 10 consecutive days after challenge. Virus isolation was performed in embryonated eggs, and the EID(50) was determined for all positive samples. The 50% tissue culture infective dose was determined using Madin-Darby canine kidney (MDCK) cells. Samples were also tested by an in vitro enzyme immunoassay test, Directigen Flu A, and by reverse transcription-PCR (RT-PCR) using nested primers from the nucl...
Development of an immunochromatographic test with recombinant EMA-2 for the rapid detection of antibodies against Babesia equi in horses.
Journal of clinical microbiology    January 13, 2004   Volume 42, Issue 1 359-361 doi: 10.1128/JCM.42.1.359-361.2004
Huang X, Xuan X, Xu L, Zhang S, Yokoyama N, Suzuki N, Igarashi I.An immunochromatographic test (BeICT) for the rapid detection of antibodies against Babesia equi was developed. It clearly differentiated B. equi-infected horses from B. caballi-infected and uninfected horses. The agreement with enzyme-linked immunosorbent assay results was 96.7% in the detection of field sera. The results suggest that BeICT is rapid, simple, reliable, and suitable for use to detect B. equi infection in the field.
Rapid identification of Rhodococcus equi by a PCR assay targeting the choE gene.
Journal of clinical microbiology    July 5, 2003   Volume 41, Issue 7 3241-3245 doi: 10.1128/JCM.41.7.3241-3245.2003
Ladrón N, Fernández M, Agüero J, González Zörn B, Vázquez-Boland JA, Navas J.The actinomycete Rhodococcus equi is an important pathogen of horses and an emerging opportunistic pathogen of humans. Identification of R. equi by classical bacteriological techniques is sometimes difficult, and misclassification of an isolate is not uncommon. We report here on a specific PCR assay for the rapid and reliable identification of R. equi. It is based on the amplification of a fragment of the choE gene encoding cholesterol oxidase. The choE-based PCR was assessed by using a panel of strains comprising 132 isolates from different sources and of different geographical origins, all i...
Epitope-blocking enzyme-linked immunosorbent assays for detection of west nile virus antibodies in domestic mammals.
Journal of clinical microbiology    June 7, 2003   Volume 41, Issue 6 2676-2679 doi: 10.1128/JCM.41.6.2676-2679.2003
Blitvich BJ, Bowen RA, Marlenee NL, Hall RA, Bunning ML, Beaty BJ.We evaluated the ability of epitope-blocking enzyme-linked immunosorbent assays (ELISAs) to detect West Nile virus (WNV) antibodies in domestic mammals. Sera were collected from experimentally infected horses, cats, and pigs at regular intervals and screened in ELISAs and plaque reduction neutralization tests. The diagnostic efficacies of these techniques were similar.
High-level expression and purification of a truncated merozoite antigen-2 of Babesia equi in Escherichia coli and its potential for immunodiagnosis.
Journal of clinical microbiology    March 8, 2003   Volume 41, Issue 3 1147-1151 doi: 10.1128/JCM.41.3.1147-1151.2003
Huang X, Xuan X, Yokoyama N, Xu L, Suzuki H, Sugimoto C, Nagasawa H, Fujisaki K, Igarashi I.The gene encoding a truncated merozoite antigen-2 (EMA-2t) of Babesia equi was cloned and highly expressed in Escherichia coli as a glutathione S-transferase fusion protein (G-rEMA-2t). Both G-rEMA-2t and rEMA-2t (after the removal of glutathione S-transferase) had good antigenicity. Either Western blot analysis with rEMA-2t or enzyme-linked immunosorbent assay (ELISA) with G-rEMA-2t clearly discriminated the sera of horses experimentally infected with B. equi from sera of horses infected with Babesia caballi and healthy horses, although rEMA-2t was not suitable for ELISA, probably owing to it...
Identification of a specific antigenic region of the P82 protein of Babesia equi and its potential use in serodiagnosis.
Journal of clinical microbiology    February 8, 2003   Volume 41, Issue 2 547-551 doi: 10.1128/JCM.41.2.547-551.2003
Hirata H, Xuan X, Yokoyama N, Nishikawa Y, Fujisaki K, Suzuki N, Igarashi I.The efficacy of the Be82 gene product fused with glutathione S-transferase (GST/Be82) in an enzyme-linked immunosorbent assay (ELISA) for the diagnosis of Babesia equi infection was reported previously (H. Hirata et al., J. Clin. Microbiol. 40:1470-1474, 2002). However, the ELISA with the GST/Be82 antigen cross-reacted with Babesia caballi-infected horse sera, despite the high rate of detection of B. equi. These results suggested that GST/Be82 has an antigen in common with B. caballi or antigenicity similar to that of B. caballi. In the present study, we constructed a series of five clones wit...
Equine abortion associated with the Borrelia parkeri-B. turicatae tick-borne relapsing fever spirochete group.
Journal of clinical microbiology    March 30, 2002   Volume 40, Issue 4 1558-1562 doi: 10.1128/JCM.40.4.1558-1562.2002
Walker RL, Read DH, Hayes DC, Nordhausen RW.Direct amplification and sequencing of the 16S rRNA gene and a variable region of the flagellin gene from fetal liver-associated spirochetes belonging to the Borrelia parkeri-B. turicatae tick-borne relapsing fever spirochete group with a late-term abortion in a mare are described.
Molecular analysis of Neorickettsia risticii in adult aquatic insects in Pennsylvania, in horses infected by ingestion of insects, and isolated in cell culture.
Journal of clinical microbiology    February 5, 2002   Volume 40, Issue 2 690-693 doi: 10.1128/JCM.40.2.690-693.2002
Mott J, Muramatsu Y, Seaton E, Martin C, Reed S, Rikihisa Y.Upon ingestion of adult aquatic insects, horses developed clinical signs of Potomac horse fever, and Neorickettsia risticii was isolated from the blood. 16S rRNA and 51-kDa antigen gene sequences from blood, isolates, and caddis flies fed to the horses were identical, proving oral transmission of N. risticii from caddis flies to horses.
Characterization of mutations in the rpoB gene associated with rifampin resistance in Rhodococcus equi isolated from foals.
Journal of clinical microbiology    July 28, 2001   Volume 39, Issue 8 2784-2787 doi: 10.1128/JCM.39.8.2784-2787.2001
Fines M, Pronost S, Maillard K, Taouji S, Leclercq R.Treatment with a combination of erythromycin and rifampin has considerably improved survival rates of foals and immunocompromised patients suffering from severe pneumonia caused by Rhodococcus equi. Frequently, because of monotherapy, emergence of rifampin-resistant strains has been responsible for treatment failure. Using consensus oligonucleotides, we have amplified and sequenced the rifampin resistance (Rif(r))-determining regions of 12 rifampin-resistant R. equi strains isolated from three foals and of mutants selected in vitro from R. equi ATCC 3701, a rifampin-susceptible strain. The ded...
Streptococcal meningitis resulting from contact with an infected horse.
Journal of clinical microbiology    May 29, 2001   Volume 39, Issue 6 2358-2359 doi: 10.1128/JCM.39.6.2358-2359.2001
Downar J, Willey BM, Sutherland JW, Mathew K, Low DE.We report a case of group C streptococcal meningitis in a woman with a history of close animal contact as well as head trauma as a result of a kick by a horse. Blood and cerebrospinal fluid cultures grew Streptococcus equi subsp. zooepidemicus, as did a throat culture taken from the colt that had kicked her 2 weeks prior to admission.
B-Cell epitope mapping of the VapA protein of Rhodococcus equi: implications for early detection of R. equi disease in foals.
Journal of clinical microbiology    April 3, 2001   Volume 39, Issue 4 1633-1637 doi: 10.1128/JCM.39.4.1633-1637.2001
Vanniasinkam T, Barton MD, Heuzenroeder MW.Linear B-cell epitopes of the Rhodococcus equi virulence-associated protein (VapA) were mapped using a synthetic peptide bank in this study. The peptides were screened in an enzyme-linked immunosorbent assay (ELISA) with a total of 70 sera from foals with current R. equi disease (51 sera), as well as from foals that had either recovered from R. equi infection 10 months previously (3 sera) or that had no known history of R. equi disease (16 sera). An epitope with the sequence NLQKDEPNGRA was identified and was universally recognized by all 51 sera from foals with R. equi disease and was not rec...
Comparison of nucleic acid amplification, serology, and microbiologic culture for diagnosis of Rhodococcus equi pneumonia in foals.
Journal of clinical microbiology    April 3, 2001   Volume 39, Issue 4 1289-1293 doi: 10.1128/JCM.39.4.1289-1293.2001
Sellon DC, Besser TE, Vivrette SL, McConnico RS.Recently, a technique was described for amplification of Rhodococcus equi-specific chromosomal and vapA DNA from blood and tracheal wash fluids. It was hypothesized that this technique would be more sensitive than standard culture techniques or serology for diagnosis of R. equi pneumonia in foals. Tracheal wash fluid, nasal swabs, whole blood samples, and serum samples from 56 foals with pneumonia were analyzed. Final clinical diagnosis was determined by the attending clinician on the basis of final interpretation of all available information about each foal, including clinical presentation, d...
Expression of Babesia equi merozoite antigen 1 in insect cells by recombinant baculovirus and evaluation of its diagnostic potential in an enzyme-linked immunosorbent assay.
Journal of clinical microbiology    February 7, 2001   Volume 39, Issue 2 705-709 doi: 10.1128/JCM.39.2.705-709.2001
Xuan X, Larsen A, Ikadai H, Tanaka T, Igarashi I, Nagasawa H, Fujisaki K, Toyoda Y, Suzuki N, Mikami T.The gene encoding the entire Babesia equi merozoite antigen 1 (EMA-1) was inserted into a baculovirus transfer vector, and a recombinant virus expressing EMA-1 was isolated. The expressed EMA-1 was transported to the surface of infected insect cells, as judged by an indirect fluorescent-antibody test (IFAT). The expressed EMA-1 was also secreted into the supernatant of a cell culture infected with recombinant baculovirus. Both intracellular and extracellular EMA-1 reacted with a specific antibody in Western blots. The expressed EMA-1 had an apparent molecular mass of 34 kDa that was identical ...
Characterization of a coronavirus isolated from a diarrheic foal.
Journal of clinical microbiology    December 2, 2000   Volume 38, Issue 12 4523-4526 doi: 10.1128/JCM.38.12.4523-4526.2000
Guy JS, Breslin JJ, Breuhaus B, Vivrette S, Smith LG.A coronavirus was isolated from feces of a diarrheic foal and serially propagated in human rectal adenocarcinoma (HRT-18) cells. Antigenic and genomic characterizations of the virus (isolate NC99) were based on serological comparison with other avian and mammalian coronaviruses and sequence analysis of the nucleocapsid (N) protein gene. Indirect fluorescent-antibody assay procedures and virus neutralization assays demonstrated a close antigenic relationship with bovine coronavirus (BCV) and porcine hemagglutinating encephalomyelitis virus (mammalian group 2 coronaviruses). Using previously des...
Acinetobacter baumannii-infected vascular catheters collected from horses in an equine clinic.
Journal of clinical microbiology    November 4, 2000   Volume 38, Issue 11 4280-4281 doi: 10.1128/JCM.38.11.4280-4281.2000
Vaneechoutte M, Devriese LA, Dijkshoorn L, Lamote B, Deprez P, Verschraegen G, Haesebrouck F.Acinetobacter baumannii was isolated from tips clipped from seven intravenous jugular catheters collected from horses in the Ghent University equine clinic. They originated from seven different horses. Three of the seven showed evidence of local infection.
Detection of Leptospira spp. in the aqueous humor of horses with naturally acquired recurrent uveitis.
Journal of clinical microbiology    July 6, 2000   Volume 38, Issue 7 2731-2733 doi: 10.1128/JCM.38.7.2731-2733.2000
Faber NA, Crawford M, LeFebvre RB, Buyukmihci NC, Madigan JE, Willits NH.Leptospiral organisms have long been presumed to be associated with the presence of equine recurrent uveitis. This project was undertaken to determine the presence of Leptospira spp. in the aqueous humor of horses with uveitis to determine if there was an association with inflammation. Thirty horses were determined to have recurrent uveitis based on clinical evaluation or history. Sixteen horses were judged clinically and historically to be free of uveitis and were used as controls. Aqueous humor samples were cultured and evaluated by PCR for the presence of Leptospira DNA. Serum was collected...