Diagnostic microbiology and infectious disease
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Diagn. Microbiol. Infect. Dis. · May 2012
ReviewThe preanalytical optimization of blood cultures: a review and the clinical importance of benchmarking in 5 Belgian hospitals.
Bloodstream infections remain a major challenge in medicine. Optimal detection of pathogens is only possible if the quality of preanalytical factors is thoroughly controlled. Since the laboratory is responsible for this preanalytical phase, the quality control of critical factors should be integrated in its quality control program. ⋯ Most unexpected, in each of the 5 laboratories, more than one third of the blood culture bottles were incorrectly filled, irrespective of the manufacturer of the blood culture vials. As a consequence of this shortcoming, one manufacturer recently developed an automatic blood volume monitoring system. In conclusion, clear recommendations for standardized blood culture collection combined with quality control of critical factors of the preanalytical phase are essential for diagnostic blood culture improvement.
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Diagn. Microbiol. Infect. Dis. · May 2012
Comparative StudyThe utility of cerebrospinal fluid parameters in the early microbiological assessment of meningitis.
The measurement of cerebrospinal fluid (CSF) protein, glucose, and white cell count (WCC) is an essential part of the initial examination of CSF. The aim of this study was to determine the utility of CSF parameters in assessing the likely aetiological agent. A total of 2290 CSF samples from a 13-year period were retrospectively reviewed. ⋯ A protein concentration of <600 mg/L and a WCC <90 × 10(6)/L were found to be optimal cut-offs for excluding bacterial meningitis. A WCC of <25 × 10(6)/L was found to be optimal for excluding cryptococcal meningitis and a WCC of <10 × 10(6) for excluding viral meningitis. Decreased glucose concentration was found to be a poor indicator of the aetiological agent.
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Diagn. Microbiol. Infect. Dis. · May 2012
Comparison of three preparatory methods for detection of bacteremia by MALDI-TOF mass spectrometry.
We evaluated 3 preparatory methods for processing positive blood culture bottle broths prior to matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) analysis-differential centrifugation, 10% sodium dodecyl sulfate (SDS), and the Sepsityper kit. Initial evaluation used genus and species level cutoff scores of 1.700-1.999 and ≥ 2.000, respectively. ⋯ Both yielded genus-level identifications for 77 (76%), and the 2 yielded species-level identifications for 49 (49%) and 54 (54%) of bottles, respectively. Adjustment of the score cutoff criteria for genus (1.500-1.699) and species (≥ 1.700) improved identification percentages, particularly for species-level identifications (P < 0.05).
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Diagn. Microbiol. Infect. Dis. · Nov 2011
Case ReportsCombination therapy with daptomycin, linezolid, and rifampin as treatment option for MRSA meningitis and bacteremia.
Methicillin-resistant Staphylococcus aureus (MRSA) meningitis is associated with a high mortality rate. Treatment is challenging in patients with allergy to vancomycin. Herein, we describe a case of MRSA bacteremia secondary to medical device infection with MRSA that was complicated by MRSA meningitis. This case provides evidence for a possible role of combination therapy of daptomycin, linezolid, and rifampin in cases of MRSA meningitis and bacteremia.
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Diagn. Microbiol. Infect. Dis. · Oct 2011
Comparative StudyMethicillin-susceptible Staphylococcus aureus nasal colonization and the risk of subsequent methicillin-resistant Staphylococcus aureus infections among hospitalized patients.
Few data exist on the risk of methicillin-resistant Staphylococcus aureus (MRSA) infections among known methicillin-susceptible S. aureus (MSSA) carriers. In a cohort of 2991 hospitalized MSSA carriers, 22 (22%) of 98 S. aureus infections that occurred within a subsequent 6-month period were caused by MRSA. Recent fluoroquinolone use was an independent predictor of MRSA infections (P < .001).