European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
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Eur. J. Clin. Microbiol. Infect. Dis. · Apr 2012
Lower catheter-related bloodstream infection in arterial than in venous femoral catheter.
In previous studies no differences were found in catheter-related bloodstream infection (CRBSI) between arterial and venous catheters. However, the distribution of each venous and arterial site could influence the results as in some studies a higher CRBSI incidence in venous and arterial femoral accesses has been found than in other venous and arterial accesses. Possibly, to eliminate this confounding, it might be more appropriate to compare the CRBSI incidence between arterial and venous catheters in the same site as the femoral access. ⋯ Exact logistic regression analysis showed that venous femoral catheters had a higher risk of CRBSI than arterial femoral catheters (OR = 1.02; 95%CI =1.01-infinite; P < 0.001) controlled by APACHE-II score and duration of the catheter. The novel finding of our study is that the risk of CRBSI was higher in venous than in arterial femoral catheters. Thus, special approaches to prevent CRBSI might play a more important role in venous than in arterial catheters.
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Eur. J. Clin. Microbiol. Infect. Dis. · Mar 2012
Prevalence of community-associated meticillin-resistant Staphylococcus aureus and Panton-Valentine leucocidin-positive S. aureus in general practice patients with skin and soft tissue infections in the northern and southern regions of The Netherlands.
The purpose of this investigation was to determine the prevalence of community-associated meticillin-resistant Staphylococcus aureus (CA-MRSA) and Panton-Valentine leucocidin (PVL)-positive S. aureus in general practice (GP) patients with skin and soft tissue infections (SSTI) in the northern (Groningen and Drenthe) and southern (Limburg) regions of The Netherlands. Secondary objectives were to assess the possible risk factors for patients with SSTI caused by S. aureus and PVL-positive S. aureus using a questionnaire-based survey. From 2007 to 2008, wound and nose cultures were obtained from patients with SSTI in general practice. ⋯ The prevalence of CA-MRSA in GP patients with SSTI in The Netherlands is low. Regional differences were found in the prevalence of PVL-positive S. aureus isolates from GP patients with SSTI. Household contacts having similar symptoms were found to be a risk factor for SSTI with S. aureus.
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Eur. J. Clin. Microbiol. Infect. Dis. · Nov 2011
Comparative StudyComparison of culture media for detection of Acinetobacter baumannii in surveillance cultures of critically-ill patients.
The objective of this study was to evaluate the performance of CHROMagar Acinetobacter when compared to sheep blood agar, MacConkey agar and MacConkey agar with 6 μg/ml of imipenem for the detection of A. baumannii in surveillance cultures of hospitalized patients. We utilized peri-anal swabs and sputum samples from patients admitted to the University of Maryland Medical Center ICUs from December 7 through December 21, 2009. Samples were plated onto four media in the following order: (1) 5% sheep blood agar (SBA), (2) MacConkey agar, (3) MacConkey agar with 6 μg/ml of imipenem, and (4) CHROMagar Acinetobacter (CHROMagar). ⋯ MacConkey agar detected 16 of 18 (89%) Acinetobacter and 10 of 11 (91%) MDR- A. baumannii while MacConkey agar with 6 μg/ml imipenem detected 9 of 11 (82%) MDR-A. baumannii. CHROMagar did not differentiate MDR- A. baumannii from non-MDR-A. baumannii. CHROMagar may be useful for rapid detection of patients with MDR-A. baumannii if improved upon to better select for MDR-A. baumannii.
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Eur. J. Clin. Microbiol. Infect. Dis. · Nov 2011
Elevated soluble urokinase plasminogen activator receptor (suPAR) predicts mortality in Staphylococcus aureus bacteremia.
The soluble form of urokinase-type plasminogen activator receptor (suPAR) is a new inflammatory marker. High suPAR levels have been shown to associate with mortality in cancer and in chronic infections like HIV and tuberculosis, but reports on the role of suPAR in acute bacteremic infections are scarce. To elucidate the role of suPAR in a common bacteremic infection, the serum suPAR levels in 59 patients with Staphylococcus aureus bacteremia (SAB) were measured using the suPARnostic ELISA assay and associations to 1-month mortality and with deep infection focus were analyzed. ⋯ The presence of deep infection focus was not associated with elevated suPAR levels as compared to patients with no deep infection focus. suPAR was found to be prognostic for mortality in receiver operator characteristic (ROC) curve analysis, which was not observed for serum C-reactive protein (CRP); the area under the curve (AUC) for suPAR was 0.754 (95% confidence interval [CI], 0.615-0.894, p = 0.003) and for CRP, it was 0.596 (95% CI, 0.442-0.750, p = 0.253). The optimal suPAR cut-off value in predicting 1-month mortality was 9.25 ng/mL. In conclusion, our study demonstrates that the new promising biomarker, serum suPAR concentration, was able to predict mortality in SAB.
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Eur. J. Clin. Microbiol. Infect. Dis. · Oct 2011
ReviewChanging paradigms in Whipple's disease and infection with Tropheryma whipplei.
More than a century after its first description through G. H. Whipple, the understanding of the chronic multisystemic infection called Whipple's disease is still limited. ⋯ Moreover, besides classical Whipple's disease, there are newly recognized infections with T. whipplei, which do not fit in the concept of classical Whipple's disease, for example, acute self-limiting infection and isolated T. whipplei endocarditis. Antibiotic therapy is usually successful. However, several problems are still unresolved, of which the most important are the following: which antibiotic should be used; how long treatment should be continued; how the immunoreconstitution inflammatory syndrome, which may occur after initiation of treatment, should be managed; and which is the best treatment of severe neurological manifestations.