0000000000030836
AUTHOR
J. M. Nogueira
Becton Dickinson Directigen EZ Flu A+B assay in the diagnosis of pandemic influenza A H1N1 2009 virus infection in adult patients
To the editor: The recent emergence and spread of the pandemic influenza A H1N1 2009 virus demands the evaluation of rapid antigen assays for their ability to detect this novel subtype of influenza A virus. Data on the ability of BD Directigen EZ Flu A+B immunochromatographic (IC) assay (Beckton Dickinson and Company, Sparks, MD, USA) to detect the pandemic influenza A virus strain in fresh clinical samples have been recently published. 1 , 2 , 3 , 4 , 5 In these studies, the majority of specimens were collected from pediatric patients, and the sensitivities reported ranged from 46·8% to 76·6%. As viral shedding in the upper respiratory tract during influenza virus infection is of greater m…
Diagnosis of systemic candidiasis by enzyme immunoassay detection of specific antibodies to mycelial phase cell wall and cytoplasmic candidal antigens
Diagnosis of systemic Candida infections was attempted by the use of an enzyme-linked immunosorbent assay (EIA) to detect IgG antibodies towards cell wall-bound and cytoplasmic candidal antigens. Cell wall antigens were sequentially solubilized by treatment of germinated blastoconidia of Candida albicans (ATCC 26555 strain) with beta-mercaptoethanol (beta ME extract) and digestion with Zymolyase 20T, a beta-glucanase preparation (Zymolyase extract). Protoplasts obtained after treatment with Zymolyase were osmotically lysed (cytoplasmic antigens). Sera were obtained from patients with systemic (n = 28) and superficial (n = 46) candidiasis. Control sera were obtained from normal healthy indiv…
DNA Amplification Fingerprinting for Subtyping Neisseria gonorrhoeae Strains
Background and Objectives DNA amplification fingerprinting is used in most epidemiologic studies as a substitute for conventional typing methods. DNA amplification fingerprinting and conventional typing methods were compared in this epidemiologic study of Neisseria gonorrhoeae. Goal of This Study To differentiate 70 Neisseria gonorrhoeae isolates from untreated patients with urogenital gonococcal infection. Study Design Gonococcal strains were characterized by auxo-typing, serotyping, plasmid profile, antibiotic sensitivity, and DNA amplification fingerprinting. The method of unweighted pair-group average linkage was used for cluster analysis. Discriminatory power was calculated applying Si…
Influence of inadequate antimicrobial therapy on prognosis in elderly patients with severe urinary tract infections.
Abstract Background Inadequate empirical antimicrobial therapy (IEAT) in intensive care unit (ICU) is associated with adverse outcomes. However, the influence of IEAT on prognosis for elderly patients with urinary tract infection (UTI) in non-ICU settings is unknown. Methods A retrospective cross-sectional study of elderly patients admitted to a non-ICU ward in a university hospital with a primary diagnosis of UTI over a 3-year period was done. Data relating to age, sex, background comorbidities, severity of infection, bacteremia, microorganisms isolated in urine, treatment given, length of stay and prognosis were obtained using chart review. Cases were segregated according to the adequacy …
The influence of inadequate empirical antimicrobial treatment on patients with bloodstream infections in an intensive care unit
Objective To determine the occurrence of inadequate antimicrobial therapy among critically ill patients with bacteremia and the factors associated with it, to identify the microorganisms that received inadequate antimicrobial treatment, and to determine the relationship between inadequate treatment and patients outcome. Methods From June 1995 to January 1999 we collected data on all clinically significant ICU-bacteremias in our teaching hospital. Clinical and microbiological characteristics were recorded and the adequacy of empirical antimicrobial treatment in each case was determined. We defined inappropriate empirical antimicrobial treatment as applying to infection that was not being eff…
A comparative study on cell wall antigens and cell surface hydrophobicity in clinical isolates ofCandida albicans
Characterization of common cell surface-bound antigens in Candida albicans strains, particularly those expressed in the walls of mycelial cells might be useful in the diagnosis of systemic candidiasis. Hence, antigenic similarities among wall proteins and mannoproteins from C. albicans clinical serotype A and B isolates, were studied using polyclonal (mPAbs) and monoclonal (MAb 4C12) antibodies raised against wall antigens from the mycelial form of a common C. albicans serotype A laboratory strain (ATCC 26555). Zymolyase digestion of walls isolated from cells of the different strains studied grown at 37 degrees C (germination conditions), released, in all cases, numerous protein and mannopr…
Community-onset Pseudomonas aeruginosa urinary sepsis in elderly people: Predictive factors, adequacy of empirical therapy and outcomes.
Purpose To know the predictive factors for Pseudomonas aeruginosa (PA) urinary sepsis in hospitalised elderly patients coming from community, the adequacy of empirical antibiotic therapy and its outcomes. Methods Retrospective case-control study conducted between 2007 and 2017. Patients aged 65 years or older with PA urinary sepsis were included as cases. Three age-matched controls, with urinary sepsis caused by other microorganisms, were selected for each case. Predictors for PA urinary sepsis were determined by logistic regression analysis. Adequacy of empirical antibiotic therapy and outcomes were compared between both groups. Results A total of 332 patients, from which 83 were cases, we…
Effect of Bacteremia in Elderly Patients With Urinary Tract Infection.
The clinical effect of bacteremia on outcomes in urinary tract infection (UTI) is still debated. This study aims to examine the clinical effect of bacteremia in elderly patients with UTI requiring hospital admission.This retrospective observational study recorded the clinical features, microbiology and outcomes in a Spanish cohort of patients aged ≥65 years hospitalized for UTI in whom blood cultures were performed in the emergency department. The primary outcome of the study was in-hospital mortality.Of 333 patients, with a mean age of 81.6 years, 137 (41.1%) had positive blood cultures. Escherichia coli, with 223 (66.9%) cases, was the most common microorganism isolated. Independent risk …
La gestión de los laboratorios de microbiología: una asignatura (casi) pendiente
Resumen Un centro sanitario, en el que trabajan profesionales de distintas disciplinas, debe considerarse como una empresa de servicios, ya que se trata de un conjunto de recursos humanos, materiales y financieros orientados a la prestacion de un servicio demandado por la sociedad. Un hospital es uno de los tipos de empresa mas complejos, en el que se producen y consumen diversos bienes y servicios. Al igual que el hospital en su conjunto, las distintas unidades o servicios en las que se puede dividir un hospital, entre los que se incluye el servicio de microbiologia, son tan diferentes que puede hablarse, en cierta forma, de distintas subempresas diferenciadas entre si, aunque relacionadas…
Missing Cases of Herpes Simplex Virus (HSV) Infection of the Central Nervous System When the Reller Criteria Are Applied for HSV PCR Testing: a Multicenter Study
ABSTRACT Previous studies suggested that herpes simplex virus (HSV) PCR testing can be safely deferred in patients with normal cerebrospinal fluid (CSF) white blood cell (WBC) counts and protein levels as long as they are older than 2 years of age and are not immunocompromised, the so-called Reller criteria. In this multicenter study, we retrospectively assessed the validity of these screening criteria in our setting. A total of 4,404 CSF specimens submitted for HSV PCR testing to the respective microbiology laboratories at the participating hospitals between 2012 and 2018 were included. Six commercially available HSV PCR assays were used across the participating centers. Ninety-one of the …
Predictive factors for Enterococcus faecalis in complicated community‐acquired urinary tract infections in older patients
AIM Risk factors for complicated community acquired Enterococcus faecalis urinary tract infection (UTI) in older patients are not well known. METHODS We identified the predictive factors for E. faecalis on a cohort of 659 older patients admitted to hospital with complicated UTI. We also examined the adequacy of empirical antimicrobial therapy and outcomes in E. faecalis UTI. Multivariable logistic regression was used to identify predictors of E. faecalis UTI. RESULTS A total of 87 (13.2%) patients had E. faecalis UTI; of these 63.2% were men, their mean age was 82.3 years and they had a great number of comorbidities. Severe sepsis or septic shock was present in 50.5%, and bacteremia was pre…
Prospective cohort study of risk factors for extended-spectrum ß-lactamase-producing Escherichia coli urinary tract infections in elderly patients admitted to hospital
Producción Científica