ABSTRACT
BACKGROUND: The present study was performed to evaluate clinical usefulness of pp65 antigenemia assay (pp65 Ag), plasma polymerase chain reaction (P-PCR) and peripheral blood mononuclear cell PCR (PBMC-PCR) in patients with cytomegalovirus (CMV) diseases. METHODS: Sixty samples from 41 patients admitted in Seoul National University Hospital from Sep, 2001 through Feb, 2002 were evaluated. Twenty-eight patients who had symptoms and signs of CMV disease and 13 patients who were asymptomatic were tested for CMV infection. Among 60 samples, 59 samples were tested for pp65 Ag by Clonab CMV kit (Biotest, Dreieich, Germany). Fifty-six samples were tested for P-PCR and PBMC-PCR, respectively. RESULTS: Fifteen (25%) out of 59 samples showed positive by pp65 Ag, 16 (29%) and 24 (43%) out of 56 samples showed positive by P-PCR and PBMC-PCR, respectively. The concordance rate of pp65 Ag and P-PCR in the same blood sample was 82%. CMV disease was diagnosed in 15 (37%) patients. The sensitivities of pp65 Ag, P-PCR and PBMC-PCR were 60, 53 and 80%, respectively, and in specificities were 96, 92, 88%, respectively. Of the 15 patients with CMV diseases, 4 patients who underwent allogenic bone marrow transplantation showed positive results by all the three assays, and the number of pp65 positive cells in these patients was high (3-30/4X10(5)). Eight out of the 15 patients with CMV diseases had CMV gastroenteritis. Four of them showed positive by pp65 Ag(the number of pp65 positive cells : 1-3/4X10(5)) and 2 patients showed positive by P-PCR. CONCLUSION: The senstivity of PBMC-PCR was high and the specificity was relatively low. It is quite likely PBMC-PCR was not able to distinguish CMV reactivation from latent infection. The sensitivity and specificity of pp65 Ag were similar to those of P-PCR. CMV pp65 positive cells could be quantitated by pp65 Ag.
Subject(s)
Humans , Bone Marrow Transplantation , Cytomegalovirus , Diagnosis , Gastroenteritis , Plasma , Polymerase Chain Reaction , Sensitivity and Specificity , SeoulABSTRACT
BACKGROUND: The present study was performed to evaluate clinical usefulness of pp65 antigenemia assay (pp65 Ag), plasma polymerase chain reaction (P-PCR) and peripheral blood mononuclear cell PCR (PBMC-PCR) in patients with cytomegalovirus (CMV) diseases. METHODS: Sixty samples from 41 patients admitted in Seoul National University Hospital from Sep, 2001 through Feb, 2002 were evaluated. Twenty-eight patients who had symptoms and signs of CMV disease and 13 patients who were asymptomatic were tested for CMV infection. Among 60 samples, 59 samples were tested for pp65 Ag by Clonab CMV kit (Biotest, Dreieich, Germany). Fifty-six samples were tested for P-PCR and PBMC-PCR, respectively. RESULTS: Fifteen (25%) out of 59 samples showed positive by pp65 Ag, 16 (29%) and 24 (43%) out of 56 samples showed positive by P-PCR and PBMC-PCR, respectively. The concordance rate of pp65 Ag and P-PCR in the same blood sample was 82%. CMV disease was diagnosed in 15 (37%) patients. The sensitivities of pp65 Ag, P-PCR and PBMC-PCR were 60, 53 and 80%, respectively, and in specificities were 96, 92, 88%, respectively. Of the 15 patients with CMV diseases, 4 patients who underwent allogenic bone marrow transplantation showed positive results by all the three assays, and the number of pp65 positive cells in these patients was high (3-30/4X10(5)). Eight out of the 15 patients with CMV diseases had CMV gastroenteritis. Four of them showed positive by pp65 Ag(the number of pp65 positive cells : 1-3/4X10(5)) and 2 patients showed positive by P-PCR. CONCLUSION: The senstivity of PBMC-PCR was high and the specificity was relatively low. It is quite likely PBMC-PCR was not able to distinguish CMV reactivation from latent infection. The sensitivity and specificity of pp65 Ag were similar to those of P-PCR. CMV pp65 positive cells could be quantitated by pp65 Ag.
Subject(s)
Humans , Bone Marrow Transplantation , Cytomegalovirus , Diagnosis , Gastroenteritis , Plasma , Polymerase Chain Reaction , Sensitivity and Specificity , SeoulABSTRACT
BACKGROUND: Staphylococcus aureus is one of the most important pathogens, causing severe morbidity and fatal infections. To date rapid evolution of antibiotic resistance in S. aureus, including recent emergence of vancomycin-resistant S. aureus (VRSA), has been a serious concern and an obstacle to the effective treatment. The purpose of this study is to update the resistance patterns against aminoglycoside antibiotics which play an important role in the therapy of serious staphylococcal infections. METHODS: Clinical isolates were collected from 8 university-affiliated hospitals during the period of June 1999 to January 2001. Susceptibility tests against 9 antibiotics were performed by disk diffusion method. Minimum inhibitory concentrations (MICs) of arbekacin against non-susceptible strains were determined by microbroth dilution method RESULTS: Among total 682 isolates exclusive of consecutive ones from the same patients, 199 (29%) were from pus, 152 (22%) from respiratory specimens, 137 (20%) from blood, 38 (6%) from urine. Of 682 isolates, 588 (87%) isolates were resistant to at least one of the aminoglycosides tested. Overall prevalence of MRSA was 64% (439/682), and resistance rates of MRSA were summarized as follows; kanamycin (KM) 98%, tobramycin (TOB) 98%, gentamicin (GM) 95%, amikacin (AMK) 90%, neomycin (NEO) 63%, streptomycin (SM) 31%, netilmicin (NET) 18%, arbekacin (ABK) 13%. MRSA isolates were resistant to multiple aminoglycosides, and 88% of them were resistant to all four aminoglycosides of KM, TOB, GM, and AMK. MICs of ABK against 58 non-susceptible strains ranged from 2 to 128 microgram/mL. CONCLUSION: More than 90% of MRSA isolates were resistant against kanamycin, tobramycin, gentamicin, and amikacin. Moreover, most of MRSA isolates were multi-drug resistant to all these four aminoglycosides. Resistance rates against arbekacin and netilmicin were less than 20%. Arbekacin was the most susceptible antibiotic of the aminoglycosides tested.