Diagnostic microbiology and infectious disease
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Diagn. Microbiol. Infect. Dis. · Jun 2008
Comparison of usefulness of plasma procalcitonin and C-reactive protein measurements for estimation of severity in adults with community-acquired pneumonia.
Although procalcitonin (PCT) measurement has been performed in patients with infectious diseases, there are few reports on its usefulness in community-acquired pneumonia (CAP) associated with systemic inflammatory response syndrome (SIRS). We investigated 88 patients who visited the internal medicine departments of Nagasaki University Hospital, Nagasaki, Japan, and its 11 affiliated hospitals in Japan because of CAP with or without SIRS. ⋯ In addition, 93.3% (28/30) of patients with mild CAP had negative PCT, and 48.3% (28/58) of patients positive for PCT had moderate or severe CAP. Our findings suggest that PCT level might be more useful for estimating CAP severity than CRP level at the 1st visit.
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Diagn. Microbiol. Infect. Dis. · Jun 2008
Antimicrobial susceptibility of Pseudomonas aeruginosa isolates obtained from patients in Canadian intensive care units as part of the Canadian National Intensive Care Unit study.
The antimicrobial susceptibility profile of 419 clinical isolates of Pseudomonas aeruginosa obtained from intensive care unit patients was determined. Amikacin and piperacillin/tazobactam were the most active antimicrobials evaluated. Fifty isolates (11.9%) were resistant to antimicrobials from > or =3 classes. Ninety-six percent of multidrug-resistant (MDR) isolates remained fully susceptible to colistin (polymyxin E).
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Diagn. Microbiol. Infect. Dis. · Apr 2008
Case ReportsDiminished vancomycin and daptomycin susceptibility during prolonged bacteremia with methicillin-resistant Staphylococcus aureus.
An elderly patient with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia was treated sequentially with vancomycin plus rifampin then daptomycin plus gentamicin. The MRSA strain developed diminished susceptibility to vancomycin (MIC increase and tolerance), daptomycin, and gentamicin, and resistance to rifampin during therapy.
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Diagn. Microbiol. Infect. Dis. · Oct 2007
Value of serum procalcitonin, neopterin, and C-reactive protein in differentiating bacterial from viral etiologies in patients presenting with lower respiratory tract infections.
The values of procalcitonin (PCT), neopterin, and C-reactive protein (CRP) alone and in combination to differentiate bacterial from viral etiology in patients with lower respiratory tract infections (LRTIs) were evaluated. Sera obtained on the day of hospitalization for LRTI from 139 patients with confirmed bacterial etiology and 128 patients with viral etiology were examined. A further 146 sera from healthy Chinese subjects with no infection were included as controls. ⋯ The AUC for distinguishing viral from bacterial infections was 0.832 for neopterin (P < 0.05). When the markers were used in combination, AUC of ROC (CRP/neopterin) was 0.857, whereas (CRP x PCT)/neopterin was 0.856. Combination of 2 or all 3 of the biomarkers may improve the discriminatory power in delineating bacterial versus viral etiology in LRTI.
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Diagn. Microbiol. Infect. Dis. · Sep 2007
Performance of TechLab C. DIFF QUIK CHEK and TechLab C. DIFFICILE TOX A/B II for the detection of Clostridium difficile in stool samples.
Two membrane-bound enzyme immunoassays by TechLab, Blacksburg, VA, were evaluated and compared with the Triage Micro C. difficile Panel (Biosite Diagnostics, San Diego, CA), with culture, and with cytotoxic assay. The TechLab panels were C. DIFF QUIK CHEK (QC-GDH) and C. DIFFICILE TOX A/B II (QC-toxinA/B), which detect glutamate dehydrogenase (GDH) and Clostridium difficile toxins A and B, respectively. The Triage Panel detects GDH (TR-GDH) and toxin A (TR-toxinA). ⋯ The GDH tests had a faster turnaround time than the traditional culture methods. QC-GDH was most sensitive for the detection C. difficile-positive stools and was easy to use.