[Detection of vancomycin-resistant Enterococcus faecium: 2 years' experience in a high complexity hospital ]. / Detección de Enterococcus faecium resistente a vancomicina: experiencia de dos años en un hospital de alta complejidad.

The presence of vancomycin-resistant enterococci (VRE) in our hospital prompted us to apply an appropriate method for assessing its rectal carriage. A screening method with bile-esculin azide agar plus different concentrations of vancomycin was used. The antimicrobial susceptibility study of enterococci isolated from clinical samples was also emphasized. The present study includes the surveillance and detection of VRE in our hospital during two years. A total of 260 samples corresponding to 138 patients were studied, 158 of them resulting positive. All EVR were Van A Enterococcus faecium, with MICs of vancomycin > or = 256 micrograms/ml. The analysis of susceptibility patterns shows variations with chloramphenicol, tetracycline and high level gentamicin concentrations. This method was easily applied because materials could be available in any clinical microbiology laboratory, and in our hands it has demonstrated to be useful for epidemiological surveillance for EVR.

Detección de Enterococcus faecium resistente a vancomicina: experiencia de dos años en un hospital de alta complejidad / [Detection of vancomycin-resistant Enterococcus faecium: 2 years’ experience in a high complexity hospital ]

The presence of vancomycin-resistant enterococci (VRE) in our hospital prompted us to apply an appropriate method for assessing its rectal carriage. A screening method with bile-esculin azide agar plus different concentrations of vancomycin was used. The antimicrobial susceptibility study of enterococci isolated from clinical samples was also emphasized. The present study includes the surveillance and detection of VRE in our hospital during two years. A total of 260 samples corresponding to 138 patients were studied, 158 of them resulting positive. All EVR were Van A Enterococcus faecium, with MICs of vancomycin > or = 256 micrograms/ml. The analysis of susceptibility patterns shows variations with chloramphenicol, tetracycline and high level gentamicin concentrations. This method was easily applied because materials could be available in any clinical microbiology laboratory, and in our hands it has demonstrated to be useful for epidemiological surveillance for EVR.

Detección de Enterococcus faecium resistente a vancomicina: experiencia de dos años en un hospital de alta complejidad. / [Detection of vancomycin-resistant Enterococcus faecium: 2 years experience in a high complexity hospital ]

The presence of vancomycin-resistant enterococci (VRE) in our hospital prompted us to apply an appropriate method for assessing its rectal carriage. A screening method with bile-esculin azide agar plus different concentrations of vancomycin was used. The antimicrobial susceptibility study of enterococci isolated from clinical samples was also emphasized. The present study includes the surveillance and detection of VRE in our hospital during two years. A total of 260 samples corresponding to 138 patients were studied, 158 of them resulting positive. All EVR were Van A Enterococcus faecium, with MICs of vancomycin > or = 256 micrograms/ml. The analysis of susceptibility patterns shows variations with chloramphenicol, tetracycline and high level gentamicin concentrations. This method was easily applied because materials could be available in any clinical microbiology laboratory, and in our hands it has demonstrated to be useful for epidemiological surveillance for EVR.

Spinal involvement in Pyle's disease.

BACKGROUND: Pyle's disease is a rare skeletal dysplasia involving the metaphyses of long bones. To date, spinal involvement has been only rarely described in the literature. OBJECTIVE: To show that spinal changes, which are an expression of the same growth defect of the long bones, are an important and constant sign of the disease in the families studied. MATERIALS AND METHOD: The radiographic skeletal changes in five patients have been observed. RESULTS: The pathognomonic metaphyseal widening of tubular bones (known as the 'Erlenmeyer flask sign') was associated with the spinal changes in all cases. Radiographic findings in the spine varied from moderate platyspondyly to the bodies having the appearance of a biconcave lens. This may be attributed to two main causes: (1) a defect in the modelling process of the vertebrae (comparable to that observed in the metaphyses) and (2) chronic pathological fractures secondary to osteoporosis (a typical feature of Pyle's disease). CONCLUSIONS: The finding of platyspondyly of varying severity widens the spectrum of radiographic findings in this disease and can assist in diagnosis.

Neuropsychological assessment of relatively intact individuals: pychometric lessons from an HIV+ sample.

The assessment of relatively intact individuals poses special problems for neuropsychologists, because fine discriminations are often needed to identify subtle deficits or gradual declines in performance. Many neuropsychological tests, however, are not well-suited for making such exact discriminations. 117 HIV+ individuals were administered 26 different neuropsychological tests that produce 48 scores. Measures of skewness and kurtosis were used to identify nonnormal sampling distributions. While many tests showed good sampling distributions, several demonstrated ceiling effects and other restrictions of range. This included some tests, such as Boston Naming and Lafayette Grooved Pegboard, that are not ordinarily considered screening instruments. Such nonnormal distributions distort the interpretation of clinical and research data, and indicate a need to use tests that are suited to the abilities of the population being assessed.