Résumé
Objective To evaluate the performance and clinical utility of Verigene gram-negative blood culture ( BC-GN ) assay for a rapid identification of gram-negative bacteria and resistance genes . Methods Non-repetitive blood culture samples containing gram-negative bacteria were collected from inpa-tients in the Second Affiliated Hospital of Zhejiang University School of Medicine from June to October , 2013 .BC-GN assay was performed to identify the species and genetic resistance determinants of gram -nega-tive bacteria directly from the positive blood culture bottles .VITEK MS and the VITEK 2 Compact were used for species identification and antimicrobial susceptibility test , the results of which were considered as gold standards.The resistance genes were further validated by PCR amplification and sequencing analysis .A comparison of the results and time between the BC-GN assay and routine methods was conducted . Results The detection range of BC-GN assay almost covered all of the common gram-negative bacteria .BC-GN assay showed an advantage of high accuracy in the identification of Escherichia coli (13/13), Klebsiella pneumoniae (19/24), Klebsiella oxytoca (9/9), Pseudomonas aeruginosa (39/39), Serratia marcescens (4/5), Enterobacter spp.(6/8), Citrobacter spp.(11/11), Proteus spp.(6/6) and Acinetobacter spp. (24/24) with an overall accuracy of 94.24%for the identification of mono-microbial blood culture samples . Moreover , BC-GN assay accurately identified all of the bacteria and resistance genes from the two multi -mi-crobial samples .Species identification and resistance profiles could be 42 hours earlier available by using BC-GN assay than those by using routine methods .Conclusion BC-GN assay could simultaneously and ac-curately identify bacteria and resistance determinants from blood cultures within 2 hours.More time for clini-cally effective therapy could be achieved by using BC-GN assay for the reduction of mortality associated with bloodstream infection .
Résumé
Objective To investigate the influence of enteral nutrition (EN) emulsion containing slowrelease starch on blood sugar level in patients with craniocerebral injury. Methods Totally 120 patients with severe craniocerebral injury complicated with hyperglycemia joined this open study and were randomized into control group and study group. Study group was given EN emulsion containing slow-release starch ( Fresubin Diabetes)and control group was given routine EN emulsion ( Fresubin), both for 15 days. Fasting blood glucose (FBG),2-hour postprandial glucose (2hPG), and glycosylated hemoglobin (HbA1c) were examined before EN support and 7 days and 15 days after EN support. Results In the study group, the levels of 2hPG before EN support and on the seventh and fifteenth day after EN support were ( 12.26 ± 2. 36 )mmol/L, (9.76 ± 2.90 ) mmol/L, and (9.78 ± 1.86) mmol/L, respectively. The levels of 2hPG after EN support were both significantly lower than that before EN support (P ＜ 0. 05). However, the levels of FBG and HbA1c in the study group were not significantly different before and after EN support ( P ＞ 0. 05 ). In the control group, the levels of 2hPG on the seventh and fifteenth day after EN support were ( 11.70 ± 2. 80) mmol/L and ( 11.39 ± 2. 44 ) mmol/L, respectively, which were significantly higher than those in study group ( P = 0. 033, P = 0. 020). The levels of FBG and HbA1c werenot significantly different between the study group and the control group ( P ＞ 0. 05 ). Conclusion EN emulsion containing slow-release starch may promote the control of blood sugar in patients with craniocerebral injury complicated with hyperglycemia and improve the level of postprandial blood sugar in those patients.