ABSTRACT
BACKGROUND: Pichia anomala is a rare cause of fungemia. From February to April, 1998, eight cases of fungemia occurred in the intensive care and high risk units of the Nursery. There were four infants with P. anomala infection, one of whom also had Candida parapsilosis infection, two cases with C. parapsilosis infection and two with Candida albicans infection. OBJECTIVE: To determine factors associated with fungemia in the intensive care and high risk units of the Nursery, especially P. anomala. METHODS: A cohort study with 59 newborns. RESULTS: Factors associated with fungemia were: central venous catheter (CVC) (P = 0.0006); total parenteral nutrition (TPN) (P = 0.0005); lipid emulsion (P = 0.002); previous antimicrobial use (P = 0.002); and other invasive procedures (P = 0.002). Factors associated with P. anomala fungemia were: CVC (P = 0.004); TPN (P = 0.018); previous antibiotic use (P = 0.037); and other invasive procedures (P = 0.037). Evaluation of the units demonstrated that there were several technical problems involving administration of TPN that was manipulated in the Nursery without precautions. Changes in TPN formulation and education as to adequate technique were implemented. During follow-up (1998 to 1999) only two fungemias occurred that were caused by C. albicans. Cultures of hands of personnel were negative for P. anomala. Electrophoretic karyotyping of P. anomala showed three profiles. CONCLUSIONS: Factors associated with fungemia were catheter use, invasive procedures and total parenteral nutrition, suggesting that the acquisition of P. anomala was exogenous.
Subject(s)
Cross Infection/epidemiology , Disease Outbreaks , Fungemia/epidemiology , Intensive Care, Neonatal , Pichia/isolation & purification , Analysis of Variance , Brazil/epidemiology , Cohort Studies , Cross Infection/diagnosis , Female , Fungemia/diagnosis , Humans , Incidence , Infant, Newborn , Male , Parenteral Nutrition/adverse effects , Probability , Risk Assessment , Risk Factors , Urinary Catheterization/adverse effectsABSTRACT
The cyanmethemoglobin (HiCN) method has been adopted as the international standard procedure for hemoglobin (Hb) determinations due to the accuracy and stability of result. However, the presence of potassium cyanide (KCN) and potassium ferricyanide (K3-Fe(CN)6) in the reagents has raised problems of laboratory and environmental pollution. In 1981, Oshiro and colleagues developed a cyanide free method of Hb determination that is based on a low toxicity compound Sodium Lauryl Sulfate (SLS). The SLS-Hb method provides stable SLS-Hb formation through the following steps. 1) Reaction of SLS to erythrocytic membrane (disruption of the erythrocytic membrane). 2) Conformation change of Hb by SLS. 3) Iron oxidation by oxygen (Fe2+----Fe2+). 4) Formation of stable SLS-Hb (coordination of SLS). The paper presents several findings on the reaction mechanism of the SLS-Hb method.
Subject(s)
Blood Cell Count/methods , Hemoglobins/analysis , Sodium Dodecyl Sulfate , Circular Dichroism , Electron Spin Resonance Spectroscopy , HumansABSTRACT
A case of adult T-cell leukemia (ATL) in a 23-yr-old Japanese man without immunoglobulin (Ig)G antibody to ATL-associated antigen (ATLA) (anti-ATLA) is presented. Comparative studies revealed that there were no differences between the present case and the anti-ATLA-positive ATL cases, except for the onset of the former at a younger age. Serologic and epidemiologic studies were performed to determine whether in this case the disease was still dependent on ATLA. As serum IgE and IgA had been persistently elevated, the serum was examined for these antibodies to ATLA. Furthermore, after the patient's serum was treated with glycine buffer to dissociate possibly existing immune complexes, it was assayed for antibodies (IgG, IgE and IgA) to ATLA. However, no antibody activity could be demonstrated. Sero-epidemiologic studies revealed that there were no anti-ATLA-positive healthy adults (ATLA-HA) in either his family or among the residents of his birthplace, whereas some ATLA-HA have been found among the residents of the birthplaces of other ATL patients. Although further investigation is necessary, it seems reasonable for the present to consider that a minor group of ATL patients independent of ATL virus may exist.
Subject(s)
Antibodies, Viral/analysis , Leukemia/immunology , Lymphoma/immunology , Retroviridae/immunology , Skin Neoplasms/immunology , Adult , Antigens, Surface/analysis , Humans , Immunoglobulins/analysis , Japan , Leukemia/epidemiology , Lymphoma/epidemiology , Male , Microscopy, Electron , Skin Neoplasms/epidemiology , T-Lymphocytes/immunology , T-Lymphocytes/pathologyABSTRACT
We have developed a new method for hemoglobin determinations using sodium lauryl sulfate (SLS), a surfactant. The detailed action of SLS is still unknown, but presumably SLS will convert hemoglobin into methemoglobin in the order of oxyhemoglobin, hemochrome and methemoglobin, and its oxidative activity. Therefore, unlike others, this method does not need oxidative reagents and does not generate toxic wastes such as KCN and NaN3 which cause environmental pollution. The proposed method is applicable for the manual and Hemalog-8/90 procedures often used in clinical laboratories. Tentatively we have designated it as the "SLS-methemoglobin (SLS-Hb) method."
