ABSTRACT
Trichosporon pullulans has recently been recognized as a human pathogen. Given its rarity, however, few reports describe infection attributable to this fungal pathogen. In immunocompromised hosts, T. pullulans infection is associated with significant mortality. For the first time in Korea, we report a case of T. pullulans infection in a non.neutropenic patient. A 70.year.old woman was diagnosed with metastatic colon cancer. She did not undergo chemotherapy and received only supportive care and intravenous nutrition via the subclavian vein. Sixteen days after admission, a fever developed. Three sets of blood culture and a catheter tip culture were carried out and T. pullulans grew in all cultures. Although she was treated with amphotericin B deoxycholate and catheter removal, she died on hospital day 40 due to persistent fungemia.
Subject(s)
Female , Humans , Amphotericin B , Catheters , Colonic Neoplasms , Deoxycholic Acid , Drug Combinations , Fever , Fungemia , Immunocompromised Host , Korea , Subclavian Vein , TrichosporonABSTRACT
BACKGROUND: Colonial morphology of Candida albicans known as 'spiking' on a primary isolation blood agar plate (BAP) allows rapid and presumptive identification of C. albicans. We evaluated the 'spiking' appearance to identify C. albicans. METHODS: A total of 144 fully identified clinical isolates of yeasts and 10 type strains of yeasts were tested. All isolates obtained from the 5% CO2 incubation on BAP and chocolate agar plate (CHOC) were macroscopically examined for the presence of an irregular margin (spiking). The germ tube test was performed by incubating test organisms in 0.5 mL of pooled human sera. RESULTS: The sensitivity for BAP-spiking, CHOC-spiking and germ tube test were 93.7%, 91.1%, and 98.7%, respectively. The specificity for three methods was 100%. CONCLUSION: Use of the spiking identification on BAP can be useful for the economic and rapid presumptive identification of C. albicans in routine laboratories.
Subject(s)
Humans , Agar , Cacao , Candida albicans , Candida , Sensitivity and Specificity , YeastsABSTRACT
BACKGROUND: The main causes of thrombocytopenia in cirrhosis are thought to be platelet destruction and the reduction of thrombopoietin (TPO) expression in the liver. Immature platelet fraction (IPF) has been measured by a fully automated analyzer (Sysmex XE-2100, Japan) as reticulated platelet (RP), which is reflected with thrombopoiesis in bone marrow. In this study, we tried to compare the percentage of IPF (IPF) with that of RP (RP) in patients with liver cirrhosis (LC) and controls. METHODS: We compared IPF to RP in 72 liver cirrhosis patients and 30 healthy normal controls. RP was stained with acridine orange, followed by FC500 (Beckman Coulter, USA) analysis and the IPF was identified by flow cytometry with the use of a nucleic acid specific dye in the reticulocyte channel on the Sysmex XE-2100 (TOA Medical Electronics Co., Ltd., Japan). RESULTS: IPF value in the healthy control was 2.2% (1.7-5.2). RP and IPF were significantly higher in the patients with liver cirrhosis (P<0.05). IPF appeared to be correlated with RP (y=0.19x+3.35, r=0.34, P<0.05). In ROC for diagnosis of LC, IPF was significantly more useful than RP. CONCLUSIONS: This results show that a rapid, inexpensive automated method for measuring the IPF is feasible and should become a standard parameter in evaluating reticulated platelets.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Liver Cirrhosis/complications , Platelet Count/methods , Stem Cells/cytology , Thrombocytopenia/diagnosisABSTRACT
BACKGROUND: To estimate the influence of a change in the hospital environment on a hospital-acquired urinary tract infection (HAUTI), we analyzed and compared the rates of HAUTI and the associated risk factors between an old hospital (Phil-dong) and a new hospital (Heucksuck-dong) of Chung-Ang University. METHODS: Retrospective studies of patients with urinary tract infection were conducted at the old and new hospital during the period from July 2003 to June 2004 and from January to December 2005, respectively. HAUTI was defined as the isolation of one or two microorganisms at greater than 10(5)CFUs/mL from urine at 48 hours or more after admission. The risk factors of HAUTI included sex, age, duration of hospitalization, as well as malignancy, chronic disease, diabetes mellitus, intensive care unit care, immune deficiency, renal function, Foley catheterization, and immobility. RESULTS: The rates of HAUTI at the old and new hospital were 2.9% (206 cases per 7,088 patients) and 2.0% (289 per 14,704), respectively (P0.05). CONCLUSION: Although both the old and new hospitals were served by the same health-care staff and inspectors using the same methods, the rate of HAUTI was significantly lower at the new hospital. This suggests that a change of the hospital environment, including new instruments and equipment, has an influence on the rate of HAUTI.