Rapid detection of Gram-positive organisms by use of the Verigene Gram-positive blood culture nucleic acid test and the BacT/Alert Pediatric FAN system in a multicenter pediatric evaluation.

Assays that expedite the reporting of organism identification and antibiotic susceptibility status in positive blood cultures can fast track interventions that improve clinical outcomes. We evaluated the Verigene Gram-positive blood culture nucleic acid test (BC-GP) in two pediatric hospitals. Positive BacT/Alert Pediatric FAN blood cultures with Gram-positive organisms were tested using the BC-GP in tandem with routine laboratory procedures. To test organisms underrepresented in the clinical blood culture evaluation, blood culture bottles were spiked with diluted organism suspensions at concentrations of 10 to 100 CFU per milliliter. A total of 249 Gram-positive bacterial isolates were recovered from 242 blood cultures. The BC-GP detected Staphylococcus aureus, methicillin-susceptible S. aureus, and methicillin-resistant S. aureus with sensitivities of 100%, 99%, and 100% and specificities of 100%, 100%, and 99.5%, respectively. The BC-GP detected Staphylococcus epidermidis, methicillin-susceptible S. epidermidis, and methicillin-resistant S. epidermidis with sensitivities of 95%, 80%, and 96%, respectively, and 100% specificity. The BC-GP correctly identified 14/15 cases of Enterococcus faecalis and Enterococcus faecium bacteremia and 9 cases of Streptococcus pneumoniae. It misidentified 5/15 clinical blood cultures with Streptococcus mitis/Streptococcus oralis and 1/3 blood cultures spiked with Streptococcus anginosus group as S. pneumoniae. The BC-GP detected a case of Streptococcus pyogenes bacteremia but failed to detect 2/3 clinical blood cultures with Streptococcus agalactiae. BC-GP's rapid accurate detection of Staphylococcus spp., E. faecium, and E. faecalis and its ability to ascertain mecA, vanA, and vanB status may expedite clinical decisions pertaining to optimal antibiotic use. False-positive S. pneumoniae results may warrant reporting of only "Streptococcus spp." when this organism is reported by the BC-GP.

[Treatment principles of brain arteriovenous malformations of supratentorial localization in children].

Treatment of arteriovenous malformations (AVM) in children is an important problem of children surgery. An aim of the study was to determine an optimal method of treatment. We analyzed the results of examination and treatment of 300 children, aged from 3 months to 18 years, with brain AVM who were admitted to the Burdenko Neurosurgery Institute in 1995-2010. AVM of large brain hemispheres were found in 223 children and 77 children had AVM of deep brain structures. The results of the following surgeries are reviewed: endovascular surgery (64 patients), dissections of AVM (87), radiosurgery (77), combined treatment (42). Surgeries were not performed in 30 cases. The total post surgery lethality was 0,7%. It has been concluded that the method of AVM treatment in children should be chosen individually for every child on the basis of the complex analysis of several criteria (age of the child, AVM localization and angioarchitectonics as well as a variant of clinical course of the disease).

Ultrasonographic examination and measurement of ram testicles.

Ten adult rams were used in a study to compare ultrasonographic and physical measurements of testicles. Scrotal circumference measurements were correlated with both physical and ultrasonographic measurements and with semen analysis results. Scrotal circumference correlated well with most of the physical and ultrasonographic measurements and with semen motility and percent abnormalities. Ultrasonographic measurements correlated with scrotal circumferences but not with the semen analysis. There were significant differences in physical and ultrasonographic measurements of testicle circumference and diameter, especially when the ultrasonographic measurements were made through the intact scrotal wall. There appear to be problems in the accuracy of ultrasonographic measurements of testicle size in rams.