ABSTRACT
This study proposes an algorithm for microbiological diagnosis of urinary tract infections based on screening by luminometry and Gram-stain, followed by identification by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). Positive urine samples detected with the luminometry screening Coral UTI ScreenTM system underwent Gram staining and identification of the causative organism was performed by MALDI-TOF Microflex LT mass spectrometer (Bruker Daltonics, Germany). Subsequently, the results were compared with those of conventional culture identification using WIDER MIC/id system (Francisco Soria Melguizo SA, Spain). Considering the conventional approach as the gold standard, the proposed algorithm presented both a high specificity (98.1%) and a positive likelihood ratio of 37.42. The implementation of this algorithm would allow diagnosis of urinary tract infection in less than an hour in 92.4% of positive samples. This combination of techniques would be useful particularly for patients with severe UTI, pyelonephritis or urinary sepsis.
Subject(s)
Algorithms , Bacteria/chemistry , Gentian Violet/chemistry , Phenazines/chemistry , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization/methods , Urinary Tract Infections/diagnosis , Urinary Tract Infections/microbiology , Urine/microbiology , Adult , Bacteria/classification , Bacteria/isolation & purification , Coloring Agents , Female , Humans , Male , Middle Aged , Molecular Typing , Prospective Studies , Staining and LabelingABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Adult , Genotype , Hepacivirus/genetics , Hepatitis C/epidemiology , Hepatitis C/virology , Spain/epidemiologyABSTRACT
No disponible
Subject(s)
Humans , Bacteremia/microbiology , Staphylococcus aureus/pathogenicity , Anti-Bacterial Agents/therapeutic use , Staphylococcal Infections/complications , Methicillin ResistanceABSTRACT
Fundamento y objetivo: Es necesario predecir una neumonía nosocomial (NN) por Staphylococcus aureus resistente a meticilina (SARM) para facilitar la inclusión de un antibiótico específico en la terapia empírica. En este estudio se desarrolla un modelo para predecir la probabilidad de NN por SARM cuando se desconoce el estado de portador y el diagnóstico microbiológico. Pacientes y método: Se diseñó un estudio de casos y controles, realizándose una regresión logística multivariable para identificar los factores de riesgo de NN por SARM. Se incluyeron factores demográficos, relacionados con la hospitalización, la inmunodepresión, neutropenia, la medicación y la gravedad.Resultados: Se estudiaron 363 pacientes (121 casos y 242 controles). Permanecieron en el modelo final la edad>14 años (odds ratio [OR] 7,4, intervalo de confianza del 95% [IC 95%] 1,5-37,4, p<0,015), la aparición de la NN>6 días después del ingreso (OR 4,1, IC 95% 2,4-7,1, p<0,001), el desarrollo de la NN fuera del verano (OR 2,5, IC 95% 1,2-5,2, p = 0,015), las enfermedades respiratorias (OR 4,9, IC 95% 1,5-15,8, p = 0,007) y la afectación multilobar (OR 4, IC 95% 2,3-7,2, p<0,001). Con estas variables se calculó la probabilidad de desarrollar neumonía por SARM para cada una de las posibles combinaciones, clasificándose en criterios mayores y menores.Conclusiones: Se debe incluir cobertura de SARM en el tratamiento empírico de la NN cuando: a) un paciente adulto (>14 años) tiene, al menos, 2 criterios mayores o un criterio mayor y 2 menores, y b) un paciente<14 años tiene los 2 criterios mayores y los 2 menores (AU)
Background and objective: To include a specific antibiotic in the empiric therapy, it is necessary to predict when a nosocomial pneumonia (NP) is caused by methicillin-resistant Staphylococcus aureus (MRSA). We have developed a model for the prediction of the probability of a NP being caused by MRSA, when the carrier status and the microbiological diagnosis are unknown. Patients and methods: A retrospective case-control study (1999-2005) was designed. A univariate and multivariate logistic regression was performed to identify the risk factors for suffering a NP due to MRSA. Demographic factors, related to hospitalization, immunosuppression or neutropenia, to medication and severity were included. Results:Three hundred and sixty three patients (121 cases and 242 controls) were studied. The final model of multivariate logistic regression included an age>14 years (OR 7.4, CI 95% 1.5-37.4, P<.015), NP appearance>6 days after admittance (OR 4.1, CI 95% 2.4-7,1, P<.001), NP development excluding summers (OR 2.5, CI 95% 1.2-5.2, P<.015), respiratory diseases (OR 4.9, CI 95% 1.5-15.8, P<.007) and multilobar involvement (OR 4, CI 95% 2.3-7.2, P<.001).The probability of developing a pneumonia due to MRSA was studied for each of the possible combinations and subsequently classified in minor and major criteria. Conclusions: MRSA coverage should be included in the empirical treatment of NP when: a) an adult patient (>14 years old) presents, at least, 2 major criteria or 1 major criterion together with 2 minor criteria, and b) a patient <14 years-old has 2 major criteria as well as 2 minor criteria Ç(AU)
Subject(s)
Humans , Pneumonia/epidemiology , Methicillin-Resistant Staphylococcus aureus/pathogenicity , Cross Infection/epidemiology , Risk Factors , Predictive Value of Tests , ProbabilityABSTRACT
BACKGROUND AND OBJECTIVE: To include a specific antibiotic in the empiric therapy, it is necessary to predict when a nosocomial pneumonia (NP) is caused by methicillin-resistant Staphylococcus aureus (MRSA). We have developed a model for the prediction of the probability of a NP being caused by MRSA, when the carrier status and the microbiological diagnosis are unknown. PATIENTS AND METHODS: A retrospective case-control study (1999-2005) was designed. A univariate and multivariate logistic regression was performed to identify the risk factors for suffering a NP due to MRSA. Demographic factors, related to hospitalization, immunosuppression or neutropenia, to medication and severity were included. RESULTS: Three hundred and sixty three patients (121 cases and 242 controls) were studied. The final model of multivariate logistic regression included an age>14 years (OR 7.4, CI 95% 1.5-37.4, P<.015), NP appearance>6 days after admittance (OR 4.1, CI 95% 2.4-7,1, P<.001), NP development excluding summers (OR 2.5, CI 95% 1.2-5.2, P<.015), respiratory diseases (OR 4.9, CI 95% 1.5-15.8, P<.007) and multilobar involvement (OR 4, CI 95% 2.3-7.2, P<.001).The probability of developing a pneumonia due to MRSA was studied for each of the possible combinations and subsequently classified in minor and major criteria. CONCLUSIONS: MRSA coverage should be included in the empirical treatment of NP when: a) an adult patient (>14 years old) presents, at least, 2 major criteria or 1 major criterion together with 2 minor criteria, and b) a patient <14 years-old has 2 major criteria as well as 2 minor criteria.
Subject(s)
Cross Infection/diagnosis , Decision Support Techniques , Methicillin-Resistant Staphylococcus aureus , Pneumonia, Staphylococcal/diagnosis , Staphylococcal Infections/diagnosis , Adult , Age Factors , Aged , Case-Control Studies , Cross Infection/etiology , Cross Infection/mortality , Female , Humans , Logistic Models , Male , Middle Aged , Pneumonia, Staphylococcal/etiology , Pneumonia, Staphylococcal/mortality , Probability , ROC Curve , Retrospective Studies , Risk Factors , Staphylococcal Infections/etiology , Staphylococcal Infections/mortalityABSTRACT
The tuberculosis is one of the most important and mortal diseases of the world. The microbiological confirmatory diagnosis and the microbiological therapeutic orientation are fundamental nowadays in the tuberculosis in AIDS and in the Resistant tuberculosis. They are described throughout the time by the classic Microbiology: From 1882 to final 20th century (130 years). With the modern current Microbiology: In the beginning of the 21st century (20-30 years). And as will be done with the future Microbiology: From the years 2020-30. The important advances are outlined in the modern and future clinical microbiology, for the control of the Tuberculosis.
Subject(s)
Infections/therapy , Microbiology , History, 19th Century , History, 20th Century , Humans , Microbiology/history , Microbiology/trends , Tuberculosis/drug therapy , Tuberculosis/microbiologyABSTRACT
A case of Scedosporium apiospermum keratitis is reported in a 65-year-old farmer referred for treatment of an extensive corneal ulcer in the left eye. Direct examination of scrapes revealed abundant filamentous septate hyphae; all cultures were consistently positive for the same fungus, identified later as Scedosporium apiospermum. The patient successfully responded to treatment with amphotericin B.
Subject(s)
Eye Infections, Fungal/diagnosis , Keratitis/diagnosis , Keratitis/microbiology , Scedosporium , Aged , Eye Infections, Fungal/drug therapy , Humans , Keratitis/drug therapy , MaleABSTRACT
No disponible
Subject(s)
Humans , Reproducibility of Results , Mycobacterium kansasii , Bacteriological Techniques , Mycobacterium Infections, NontuberculousABSTRACT
Hemos efectuado estudio micológico durante 3 años (1994-96) a 783 enfermos, hallando 555 cultivos positivos, de los cuales 95 correspondieron a dermatofitos. Las especies aisladas fueron: T. mentagrophytes (45), T. rubrum (24), M. canis (16), M. gypseum (tres), T. tonsurans (tres), E.floccosum (dos), T. violaceum (uno), T. terrestre (uno) y M. persicolor (uno). Las formas clínicas halladas fueron T. corporis (37 casos), T. faciei (16 casos), T. cruris (14 casos), T. capitis (12 casos), T. pedis (ocho casos), T. unguium (cinco casos) y T manuum (tres casos). En cuanto a la frecuencia por sexos, los varones son los más afectados (AU)
