Diagnostic microbiology and infectious disease
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Diagn. Microbiol. Infect. Dis. · Sep 2012
Patients with nontuberculous mycobacteria: comparison of updated and previous diagnostic criteria for lung disease.
We classified patients with respiratory nontuberculous mycobacteria (NTM) isolates using updated (2007) and previous (1997) American Thoracic Society/Infectious Diseases Society of America criteria for NTM lung disease. We found that a greater proportion of such patients have disease using updated criteria due to improved sensitivity of the microbiologic component of the disease definition.
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Diagn. Microbiol. Infect. Dis. · Aug 2012
Comparative StudyDiagnostic utility of LightCycler SeptiFast and procalcitonin assays in the diagnosis of bloodstream infection in immunocompromised patients.
Sepsis is an increasingly prevalent cause of death, and management in the early stage is a critical issue. However, microbiological findings are generally obtained late during the course of the disease. ⋯ Our results demonstrate that while the PCT value correlates highly with sepsis, the results do not discriminate adequately enough to justify its independent use as a diagnostic tool. The SF test, combined with blood cultures, improves microbiological data in immunocompromised patients, especially in cases of previous antibiotic therapy and invasive fungal infection.
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Diagn. Microbiol. Infect. Dis. · Jul 2012
ReviewProcalcitonin and the role of biomarkers in the diagnosis and management of sepsis.
Sepsis and severe sepsis cause significant morbidity and mortality among populations worldwide; the rapid diagnosis poses a considerable challenge to physicians in acute care settings. An ideal biomarker should allow, with high diagnostic accuracy, for an early and rapid recognition of sepsis. Procalcitonin (PCT) is a recently rediscovered biomarker that fulfills many of these requirements, especially in comparison to "older" and commonly used biomarkers, and that has demonstrated superior diagnostic accuracy for a variety of infections, including sepsis. ⋯ Laboratories and clinicians must appreciate the complexity of diagnostic algorithms for sepsis and understand the particular information that biomarkers, such as PCT, can offer. In that context, it is necessary to not only recognize the importance of critical clinical awareness and thorough physical patient examination, but also to understand traditional microbiological methods and the need for highly sensitive biomarker assays in order to facilitate an early diagnosis and goal-directed therapy in patients suspected of sepsis. This review is intended to provide additional information for clinicians and microbiologists to better understand the physiology and diagnostic utility of procalcitonin for sepsis and other infectious disease conditions.
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Diagn. Microbiol. Infect. Dis. · Jul 2012
Sensitivity of QuantiFERON-TB GOLD In-Tube for diagnosis of recent versus remote M. tuberculosis infection.
The sensitivity of QuantiFERON-TB GOLD In-Tube was measured in 104 subjects with recent (≤2 years) and remote Mycobacterium tuberculosis infection using tuberculin skin test conversion as the reference standard. The sensitivity was not significantly different between the 2 groups (33% versus 20%, P = 0.3). This finding suggests interferon-γ release assays may not be more sensitive for diagnosis of recent than remote infection. Longitudinal studies are needed to validate this finding.
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Diagn. Microbiol. Infect. Dis. · Jun 2012
Prediction of community-onset bacteremia among febrile adults visiting an emergency department: rigor matters.
Bacteremia is a severe bacterial infection with significant mortality and morbidity. Clinical parameters that reliably predict the presence of community-onset bacteremia are less elucidated. ⋯ Some easily determined clinical parameters were independently associated with community-onset bacteremia among febrile adults, and the most significant predictor was the presence of rigor. Although the proposed predictive model needs further validation, it may be of use for the early identification of bacteremic episodes in ED practice.