ABSTRACT
Clostridium difficile is the agent of many cases of antibiotic associated diarrhea. The prevalence of the toxigenic Clostridium difficile strains was assessed by real-time PCR between May 2014- January 2015, at the Emergency University Hospital, Bucharest, Romania. The incidence of the Clostridium difficile infection was 0.47%. Among the 1119 stool specimens tested, 165 (13.8%) were positive for C. difficile toxins A and B by immunochromatography test. All 165 positive samples were investigated by real time PCR and 134 (81%) samples were positive for toxin B and for the binary toxin, while the rest were positive for toxin B. A high number of samples positive for binary toxin was recorded in the General surgery department (29.85%), Neurology (13.43%), and Internal medicine (12.68%). Many of the infected patients presented as underlying pathology, cancer, diabetes mellitus and stroke. A rapid decision concerning the antibiotic therapy was made, to decrease the risk of nosocomial spread.
Subject(s)
ADP Ribose Transferases/genetics , Bacterial Proteins/genetics , Bacterial Toxins/genetics , Clostridioides difficile/isolation & purification , Clostridium Infections/epidemiology , Enterotoxins/genetics , Genes, Bacterial , Population Surveillance , Adult , Aged , Aged, 80 and over , Chromatography, Affinity , Clostridioides difficile/classification , Clostridioides difficile/genetics , Clostridium Infections/diagnosis , Clostridium Infections/microbiology , Clostridium Infections/prevention & control , Cross Infection/epidemiology , Cross Infection/microbiology , Cross Infection/prevention & control , Cross-Sectional Studies , Female , Hospital Departments , Hospital Mortality , Humans , Male , Middle Aged , Romania/epidemiology , Sensitivity and SpecificityABSTRACT
AIM: The aim of our study was to assess macro- and microscopically the knee cartilaginous lesions outcome treated by mosaicplasty. MATERIAL AND METHOD: Our study included 32 patients who underwent mosaicplasty for nondegenerative cartilaginous lesions of the knee and a second look arthroscopy. In 21 patients, minibiopsies from the repaired lesion were performed under arthroscopic control (from the cartilaginous region of the transplanted osteocartilaginous grafts and from the spaces between grafts). All repaired lesions were carefully examined during arthroscopy and all harvested minifragments were studied by optical microscopy (staining method - hematoxylin eosin). RESULTS: Macroscopically, the articular surface of the repaired cartilaginous lesions was smooth and congruent to the adjacent surfaces. The aspect and resistance to compression of grafted area was similar to those of the normal surrounding cartilage. The transferred cartilage maintained its height, being at the level of the neighboring cartilage. One year postoperatively, the limits of the cartilaginous autografts were still visible. Two years postoperatively, these limits were no longer visible. Microscopically, the region of the former lesion was constituted mainly by viable hyaline cartilage. Fibrous cartilaginous tissue was visualized in the spaces between the grafts. CONCLUSIONS: The second look arthroscopy showed that after mosaicplasty the repaired articular surface was smooth, leveled, homogenous and congruent to adjacent cartilage. The spaces between grafts are progressively covered by fibrous cartilaginous tissue with a more textured and uneven surface. Mosaicplasty is a biological surgical technique, which restores the normal osteocartilaginous architecture of the most part of the grafted area. The transplanted osteocartilaginous cylindrical grafts maintain its viability and mechanical properties.
