Duodenal bulb tumour of unknown origin.

Gastrointestinal stromal tumours (GIST) are rare mesenchymal neoplasms of the gastrointestinal tract. Their development typically depends on mutations in the Kit or PDGFRA gene. We have diagnosed and treated a duodenal bulb GIST in a 63-year-old woman. The confirmation of the diagnosis was made on the basis of a histological test after radical resection of the tumour. Making the right diagnosis is crucial for patients, since complex surgical and pharmacological approaches are effective even in the advanced stages of the disease. Nevertheless, radical surgical treatment is still the primary choice for patients with GIST.

[Clinical strains isolation and antibiotic susceptibility of Stenotrophomonas maltophilia]. / Wystepowanie w materiale klinicznym i lekowrazliwosc szczepów Stenotrophomonas maltophilia.

Stenotrophomonas maltophilia is an opportunistic Gram-negative bacillus which is becoming increasingly recognized as an important nosocomial pathogen especially in debilitated or immune suppressed patients. S. maltophilia is found in a wide variety of environments. It has been isolated from a number of water sources, soil, variety of plants and food sources. S. maltophilia can form biofilm on synthetic materials for temporary or permanent implantation, i.e. central venous catheters, urinary catheters and prosthetic heart valves. In hospital the organism has been isolated from wet environments such as antiseptic fluids containing chlorhexidine, respiratory therapy equipment and air nebulizers. Little is known of the virulence factors of S. maltophilia. S. maltophilia is naturally resistant to many currently available broad-spectrum antimicrobial agents, including carbapenems. This study was carried out with the objective of evaluating clinical strains isolation and antibiotic susceptibility of S. maltophilia. A total of 80 clinical isolates of S. maltophilia were collected from individual patients, hospitalized at A. Jurasz University Hospital in Bydgoszcz, Poland. To identify S. maltophilia strains and receive biochemical profiles API 20 NE tests (bio Mérieux) ATB Expression computer system (bio Mérieux) with database V 2.4.7. were used. Antimicrobial agents susceptibility was evaluated for 19 different agents. For 18 out of 19 antimicrobial agent Etests (AB Biodisc) were used. For levofloxacine disc diffusion method was used. Most of analyzed strains were isolated from broncho-alveolar lavage (37.5%) from patients hospitalized in Intensive Care Unit (48.8%). 95.7% of isolated strains were susceptible to levofloxacine and 71,3% to trimethoprim/sulfametholxazole. 48 (60.0%) of S. maltophilia strains were identified as multi-drug resistant.