RESUMO
Idaho Chlamydia trachomatis-Neisseria gonorrhoeae specimens from July 2009 were pooled by stratified specimen pooling, an approach that removes high-risk specimens from the pooling population and pools low-risk specimens to maximize pooling efficiency. This approach reduced pool positivity rates by 8%, repeated tests by 9%, and saved 47.4% in direct costs.
Assuntos
Infecções por Chlamydia/diagnóstico , Chlamydia trachomatis/isolamento & purificação , Gonorreia/diagnóstico , Neisseria gonorrhoeae/isolamento & purificação , Manejo de Espécimes/economia , Manejo de Espécimes/métodos , Técnicas Bacteriológicas/economia , Infecções por Chlamydia/economia , Infecções por Chlamydia/epidemiologia , Redução de Custos , Feminino , Gonorreia/economia , Gonorreia/epidemiologia , Humanos , Idaho/epidemiologia , Masculino , Prevalência , Sensibilidade e EspecificidadeAssuntos
Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Escherichia coli O157/isolamento & purificação , Escherichia coli Shiga Toxigênica/isolamento & purificação , Infecções por Escherichia coli/diagnóstico , Fezes/microbiologia , Humanos , Idaho/epidemiologia , IncidênciaRESUMO
BACKGROUND: Community-acquired methicillin-resistant Staphylococcus aureus strains have recently been associated with severe necrotizing infections. Greater than 75% of these strains carry the genes for Panton-Valentine leukocidin (PVL), suggesting that this toxin may mediate these severe infections. However, to date, studies have not provided evidence of toxin production. METHODS: Twenty-nine community-acquired methicillin-resistant Staphylococcus aureus and 2 community-acquired methicillin-susceptible S. aureus strains were collected from patients with infections of varying severity. Strains were analyzed for the presence of lukF-PV and SCCmecA type. PVL production in lukF-PV gene-positive strains was measured by ELISA, and the amount produced was analyzed relative to severity of infection. RESULTS: Only 2 of the 31 strains tested, 1 methicillin-resistant Staphylococcus aureus abscess isolate and 1 nasal carriage methicillin-susceptible S. aureus isolate, were lukF-PV negative. All methicillin-resistant Staphylococcus aureus strains were SCCmec type IV. PVL was produced by all strains harboring lukF-PV, although a marked strain-to-strain variation was observed. Twenty-six (90%) of 29 strains produced 50-350 ng/mL of PVL; the remaining strains produced PVL in excess of 500 ng/mL. The quantity of PVL produced in vitro did not correlate with severity of infection. CONCLUSIONS: Although PVL likely plays an important role in the pathogenesis of these infections, its mere presence is not solely responsible for the increased severity. Factors that up-regulate toxin synthesis in vivo could contribute to more-severe disease and worse outcomes in patients with community-acquired methicillin-resistant Staphylococcus aureus infection.
