Evaluation of a Newly Developed Multiplex Real-time PCR Assay for the Detection of Vancomycin-Resistant Enterococci from Rectal Swabs / 대한임상미생물학회지

BACKGROUND: Asymptomatic vancomycin-resistant enterococci (VRE) colonization precedes infection. VRE-colonized patients serve as silent reservoirs of enterococci that go on to colonize other patients. Rapidly identifying colonized patients is crucial to prevent the spread of VRE. The culture-based method of VRE screening is time-consuming. We evaluated the diagnostic performance of a recently developed multiplex real-time PCR for the detection of VRE. METHODS: We obtained 105 rectal swabs from patients who were being monitored for carriage of VRE. After 24 hour incubation of swabs in enterococcosel broth (EB) supplemented with 6 microg/mL vancomycin, multiplex real-time PCR was performed using the Anyplex(TM) VanR Real-time Detection (VanR) kit (Seegene, Inc., Seoul, Korea). The results of multiplex real-time PCR were compared to those of culture. We evaluated the specificity and detection limits of multiplex real-time PCR using VanR for VRE. RESULTS: A total of 96/105 (91.4%) samples were VRE positive according to multiplex real-time PCR with EB while 85/105 (80.9%) samples were positive in culture. Eleven discordant results (10.4%) (multiplex real-time PCR positive, culture negative) were noted. All non-enterococcal bacteria and vancomycin-susceptible enterococci were negative. The DNA detection limits of VanR were 0.035 pg per reaction (3 microL) for Enterococcus faecium and 0.35 pg for Enterococcus faecalis. CONCLUSION: The application of multiplex real-time PCR after EB incubation allows rapid and sensitive detection in 26-28 hours for VRE screening from rectal swabs. This method could facilitate the timely implementation of contact isolation to prevent the spread of VRE.

A Comparative Study between Rheumatoid Arthritis Patients and Healthy Persons on Activities of Daily Living, Fatigue and Depression / 성인간호학회지

This study was conducted to compare activities of daily living, fatigue and depression between rheumatoid arthritis patients and healthy persons. The subjects consisted of 53 rheumatoid arthritis patients and 53 healthy persons at a university hospital in Daegu City. Data were collected by means of structured interviews with questionnaires from July 20, 1999 to August 25, 1999. The instrument used in this study were the activities of daily living scale developed by Katz et al. (1970) and Barthel(1973), Multidimensional Assessment of Fatigue by Belza et al.(1995) and CES-D(Center for Epidemiologic Studies-Depression) scale. Analysis of data was done by use of descriptive statistics, Pearson Correlation, Chi-square test, t-test, ANOVA, MANCOVA and Duncan with the SPSS program. The major findings are summarized as follows: 1. The first hypothesis that the rheumatoid arthritis patients will have a lower degree of activities of daily living than the healthy persons was supported (F=4.584, p=.035). 2. The second hypothesis that the rheumatoid arthritis patient will have a higher degree of fatigue than the healthy persons was supported (F=7.799, p=.006). 3. The third hypothesis that the rheumatoid arthritis patients will have a higher degree of depression than the healthy persons was supported (F=4.768, p=.031). With the above results, it can be concluded that rheumatoid arthritis patients had a lower degree of activities of daily living and a higher degree of fatigue and depression than the healthy persons. Therefore, by providing appropriate nursing intervention, activities of daily living would be much better and fatigue and depression would be alleviated.