RESUMEN
In a survey involving 34 sheep flocks spread over the Netherlands anthelmintic resistance (AR), based on a fecal egg count reduction (FECR) test, was determined for six different products. The study was conducted in ewes shortly after lambing during spring 2015. A FECR of less than 90%, indicating presence of AR against one or more nematode genera producing strongylid eggs, was found in 22 of 30 (73.3%) flocks against oxfendazole, 18 of 23 (78.3%) flocks against ivermectin, 15 of 32 (46.9%) flocks against moxidectin, and 2 of 26 (7.7%) flocks against monepantel. No AR was observed against levamisole. If oxfendazole resistance was observed, Haemonchus contortus was involved in 90.5% of the cases. If resistance against ivermectin, moxidectin or monepantel was observed, it invariably involved H. contortus. In the majority of cases resistance was also observed for Teladorsagia circumcincta and/or Trichostrongylus spp, between which no distinction was made in this study. Based on FECR 9 of 15 (60.0%) flocks showed resistance against closantel, which was mainly due to closantel not being effective against most other nematode species than H. contortus. However, in 44.4% of flocks showing reduced FECR it did involve H. contortus as well. Multi-drug resistance (excluding closantel) was found in 16 flocks, of which 8 showed resistance against 2 products, 7 against 3 products and 1 flock showed resistance against 4 products. If resistance against 3 or 4 products was present, there invariably was resistance against both ivermectin and moxidectin. Overall, of the 22 flocks in which both macrocyclic lactones (ML) were tested, 4 (18.2%) showed no resistance against both products, 9 (40.9%) showed resistance against ivermectin only, and 9 (40.9%) showed resistance against both MLs. It is concluded that AR is widespread in sheep in the Netherlands and involves products from all major anthelmintic classes, with possibly the exception of levamisole. It appears that the macrocyclic lactones have lost much of their efficacy against sheep nematodes over the last decade.
Asunto(s)
Antihelmínticos/farmacología , Resistencia a Medicamentos , Hemoncosis/veterinaria , Haemonchus/efectos de los fármacos , Parasitosis Intestinales/veterinaria , Enfermedades de las Ovejas/epidemiología , Aminoacetonitrilo/análogos & derivados , Aminoacetonitrilo/farmacología , Animales , Bencimidazoles/farmacología , Heces/parasitología , Hemoncosis/tratamiento farmacológico , Hemoncosis/epidemiología , Hemoncosis/parasitología , Parasitosis Intestinales/tratamiento farmacológico , Parasitosis Intestinales/epidemiología , Parasitosis Intestinales/parasitología , Ivermectina/farmacología , Levamisol/farmacología , Macrólidos/farmacología , Recuento de Huevos de Parásitos/veterinaria , Salicilanilidas/farmacología , Ovinos , Enfermedades de las Ovejas/tratamiento farmacológico , Enfermedades de las Ovejas/parasitologíaRESUMEN
Genetic markers are important resources for individual identification and parentage assessment. Although short tandem repeats (STRs) have been the traditional DNA marker, technological advances have led to single nucleotide polymorphisms (SNPs) becoming an attractive alternative. SNPs can be highly multiplexed and automatically scored, which allows for easier standardization and sharing among laboratories. Equine parentage is currently assessed using STRs. We obtained a publicly available SNP dataset of 729 horses representing 32 diverse breeds. A proposed set of 101 SNPs was analyzed for DNA typing suitability. The overall minor allele frequency of the panel was 0.376 (range 0.304-0.419), with per breed probability of identities ranging from 5.6 × 10-35 to 1.86 × 10-42 . When one parent was available, exclusion probabilities ranged from 0.9998 to 0.999996, although when both parents were available, all breeds had exclusion probabilities greater than 0.9999999. A set of 388 horses from 35 breeds was genotyped to evaluate marker performance on known families. The set included 107 parent-offspring pairs and 101 full trios. No horses shared identical genotypes across all markers, indicating that the selected set was sufficient for individual identification. All pairwise comparisons were classified using ISAG rules, with one or two excluding markers considered an accepted parent-offspring pair, two or three excluding markers considered doubtful and four or more excluding markers rejecting parentage. The panel had an overall accuracy of 99.9% for identifying true parent-offspring pairs. Our developed marker set is both present on current generation SNP chips and can be highly multiplexed in standalone panels and thus is a promising resource for SNP-based DNA typing.
Asunto(s)
Dermatoglifia del ADN , Caballos/genética , Polimorfismo de Nucleótido Simple , Animales , Cruzamiento , Frecuencia de los Genes , Marcadores Genéticos , GenotipoRESUMEN
This article provides nomenclature recommendations developed by an international workgroup to increase transparency and standardization of pharmacogenetic (PGx) result reporting. Presently, sequence variants identified by PGx tests are described using different nomenclature systems. In addition, PGx analysis may detect different sets of variants for each gene, which can affect interpretation of results. This practice has caused confusion and may thereby impede the adoption of clinical PGx testing. Standardization is critical to move PGx forward.
Asunto(s)
Alelos , Pruebas Genéticas/normas , Farmacogenética/normas , Terminología como Asunto , Genes , Pruebas Genéticas/tendencias , Variación Genética , Humanos , Farmacogenética/tendencias , Medicina de PrecisiónRESUMEN
Working memory is crucial for meeting the challenges of daily life and performing academic tasks, such as reading or arithmetic. Very preterm born children are at risk of low working memory capacity. The aim of this study was to examine the visuospatial working memory network of school-aged preterm children and to determine the effect of age and performance on the neural working memory network. Working memory was assessed in 41 very preterm born children and 36 term born controls (aged 7-12 years) using functional magnetic resonance imaging (fMRI) and neuropsychological assessment. While preterm children and controls showed equal working memory performance, preterm children showed less involvement of the right middle frontal gyrus, but higher fMRI activation in superior frontal regions than controls. The younger and low-performing preterm children presented an atypical working memory network whereas the older high-performing preterm children recruited a working memory network similar to the controls. Results suggest that younger and low-performing preterm children show signs of less neural efficiency in frontal brain areas. With increasing age and performance, compensational mechanisms seem to occur, so that in preterm children, the typical visuospatial working memory network is established by the age of 12 years.
Asunto(s)
Envejecimiento/fisiología , Recien Nacido Extremadamente Prematuro/fisiología , Recien Nacido Extremadamente Prematuro/psicología , Memoria a Corto Plazo/fisiología , Factores de Edad , Mapeo Encefálico , Niño , Femenino , Lóbulo Frontal/fisiología , Humanos , Recién Nacido , Imagen por Resonancia Magnética , Masculino , Pruebas Neuropsicológicas , Estimulación LuminosaRESUMEN
Abomasal carnitine infusion during acute feed restriction increases hepatic fatty acid oxidation and decreases liver lipid in dairy cows. Eight mid-lactation Holstein cows were used in a replicated 4×4 Latin square design with 14-d periods. A 2×2 factorial arrangement was used to determine the effects of water infusion+ad libitum dry matter intake (DMI), water infusion+restricted DMI (50% of previous 5-d average), l-carnitine infusion (20 g/d)+ad libitum DMI, or l-carnitine infusion+restricted DMI. Liver RNA from 7 healthy cows was used for transcriptome profiling using a bovine microarray. An ANOVA with a false discovery rate was used to identify treatment and interaction effects. A substantial transcriptome change was observed only with DMI restriction, resulting in 312 (155 downregulated, 157 upregulated) differentially expressed genes. Quantitative PCR was performed to verify microarray data and measure expression of additional genes not present on the microarray. The quantitative PCR data confirmed the effect of feed restriction but not of l-carnitine treatment. Feed restriction increased expression of GPX3 and of genes associated with gluconeogenesis (PC, PDK4), inflammation (SAA3), and signaling (ADIPOR2). In contrast, feed restriction downregulated BBOX, a key for l-carnitine biosynthesis, and the transcription factor HNF4A. The bioinformatics functional analysis of genes affected by DMI restriction uncovered biosynthesis of cholesterol and energy generation by mitochondrial respiration as the most relevant and inhibited functions. The data also indicated an increase of flux toward gluconeogenesis. We interpreted those results as a likely response of the liver to spare energy and provide glucose for the lactating mammary gland during feed deprivation.
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Carnitina/administración & dosificación , Privación de Alimentos/fisiología , Hígado/química , Fosforilación Oxidativa , Esteroles/biosíntesis , Transcriptoma/genética , Animales , Bovinos , Metabolismo Energético , Femenino , Gluconeogénesis/genética , Gluconeogénesis/fisiología , Lactancia/fisiología , Metabolismo de los Lípidos/genética , Análisis por Micromatrices/veterinaria , Mitocondrias Hepáticas/metabolismoRESUMEN
An in vitro model was used to investigate effects of ß-hydroxybutyrate and isoproterenol (ß-adrenergic receptor agonist) on lipolysis in isolated adipocytes from late pregnant and recently calved dairy cows (n=5) and cows with clinical ketosis (n=3). Incubation with 3.0 mmol/L ß-hydroxybutyrate reduced lipolysis in isolated adipocytes. This inhibitory effect was lower in the first lactation week (47%±16%) compared with late pregnancy (71%±6.5%). Incubation with 0.3 µmol/L isoproterenol stimulated lipolysis in isolated adipocytes from periparturient dairy cows. Basal lipolysis resulted in non-esterified fatty acid to glycerol ratios in the incubation media of 2.0±0.23 in prepartum samples, 2.1±0.23 in the first lactation week and 2.2±0.09 in cows with clinical ketosis. ß-Hydroxybutyrate reduced lipolysis by 45%±9.6% in isolated adipocytes from cows with clinical ketosis, indicating that impaired feedback of ß-hydroxybutyrate may not play a role in the disease etiology.
Asunto(s)
Ácido 3-Hidroxibutírico/farmacología , Adipocitos/efectos de los fármacos , Enfermedades de los Bovinos/metabolismo , Isoproterenol/farmacología , Cetosis/veterinaria , Lipólisis/efectos de los fármacos , Adipocitos/metabolismo , Animales , Bovinos , Relación Dosis-Respuesta a Droga , Femenino , Técnicas In Vitro , Cetosis/metabolismo , Periodo Periparto/metabolismo , EmbarazoRESUMEN
Bovine mammary parenchyma (PAR) and fat pad (MFP) development are responsive to preweaning level of nutrient intake. We studied transcriptome alterations in PAR and MFP from Holstein heifer calves (n=6/treatment) fed different nutrient intakes from birth to ca. 65 d age. Conventional nutrient intake received 441 g of dry matter (DM)/d of a control milk replacer (MR) [CON; 20% crude protein (CP), 20% fat, DM basis]. Calves in the accelerated nutrition groups received 951 g/d of high-protein/low-fat MR (HPLF; 28% CP, 20% fat, DM basis), 951 g/d of high-protein/high-fat MR (HPHF; 28% CP, 28% fat, DM basis), or 1,431 g/d of HPHF (HPHF+) MR. Out of 13,000 genes evaluated, over 1,500 differentially expressed genes (DEG) were affected (false discovery rate <0.10) by level of nutrient intake in PAR or MFP. Feeding HPLF versus CON resulted in the most dramatic changes in gene expression, with 278 and 588 DEG having ≥1.5-fold change in PAR and MFP. In PAR, the most-altered molecular functions were associated with metabolism of the cell (molecular transport and lipid metabolism) with most of the genes downregulated in HPLF versus CON. In MFP, DEG also were primarily associated with metabolism but changes also occurred in genes linked to cell morphology, cell-to-cell signaling, and immune response. Compared with CON, feeding HPHF or HPHF+ did not result in substantial additional effects on DEG beyond those observed with HPLF. The pentose phosphate, mitochondrial dysfunction, and ubiquinone biosynthesis pathways were among the most enriched due to HPLF versus CON in PAR and were inhibited, whereas glycosphingolipid biosynthesis, arachidonic acid metabolism, and eicosanoid synthesis pathways were among the most enriched due to HPLF versus CON in MFP and were inhibited. These responses suggest that, in PAR, doubling nutrient intake from standard feeding rates inhibited energy metabolism and activity of oxidative pathways that partly serve to protect cells against oxidative stress. The MFP in those heifers appeared to decrease production of lipid-derived metabolites that may play roles in signaling pathways within the adipocyte. Overall, results indicated that prepubertal/preweaned mammary transcriptome is responsive to long-term enhanced nutrient supply to achieve greater growth rates before weaning. The biological significance of these results to future milk production remains to be elucidated.
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Fenómenos Fisiológicos Nutricionales de los Animales/fisiología , Expresión Génica/fisiología , Glándulas Mamarias Animales/fisiología , Animales , Animales Recién Nacidos/metabolismo , Animales Recién Nacidos/fisiología , Bovinos , Dieta/veterinaria , Femenino , Glándulas Mamarias Animales/crecimiento & desarrollo , Glándulas Mamarias Animales/metabolismo , Análisis de Secuencia por Matrices de Oligonucleótidos/veterinaria , Reacción en Cadena de la Polimerasa/veterinaria , DesteteRESUMEN
Brucellosis is a worldwide zoonotic infectious disease that has a significant economic impact on animal production and human public health. We characterized the gene expression profile of B. abortus-infected monocyte-derived macrophages (MDMs) from naïve cattle naturally resistant (R) or susceptible (S) to brucellosis using a cDNA microarray technology. Our data indicate that (1) B. abortus induced a slightly increased genome activation in R MDMs and a down-regulated transcriptome in S MDMs, during the onset of infection, (2) R MDMs had the ability to mount a type 1 immune response against B. abortus infection which was impaired in S cells, and (3) the host cell activity was not altered after 12 h post-B. abortus infection in R MDMs while the cell cycle was largely arrested in infected S MDMs at 12 h p.i. These results contribute to an improved understanding of how host responses may be manipulated to prevent infection by brucellae.
Asunto(s)
Brucella abortus/inmunología , Brucelosis Bovina/genética , Susceptibilidad a Enfermedades/veterinaria , Inmunidad Innata , Macrófagos , Animales , Brucelosis Bovina/inmunología , Bovinos , Susceptibilidad a Enfermedades/inmunología , Regulación hacia Abajo/inmunología , Perfilación de la Expresión Génica/veterinaria , Análisis de Secuencia por Matrices de Oligonucleótidos/veterinariaRESUMEN
Rhabdomyolysis induced acute renal failure as a rare complication of influenza A infection has been mainly described in adults. Consideration of this potentially life-threatening complication in pediatric patients presenting with influenza is important as clinical symptoms may be unspecific and early diagnosis leading to prompt treatment is essential to decrease associated morbidity and mortality. We report a 9 year old girl who developed severe rhabdomyolysis with myoglobinuric renal failure associated with influenza A virus infection. Receiving supportive therapy including intensive care management the patient recovered renal function completely.
Asunto(s)
Virus de la Influenza A , Gripe Humana/complicaciones , Rabdomiólisis/etiología , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/etiología , Lesión Renal Aguda/terapia , Niño , Terapia Combinada , Cuidados Críticos/métodos , Diagnóstico Diferencial , Diagnóstico Precoz , Femenino , Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/etiología , Insuficiencia Cardíaca/terapia , Humanos , Gripe Humana/diagnóstico , Gripe Humana/terapia , Mioglobinuria/diagnóstico , Mioglobinuria/etiología , Mioglobinuria/terapia , Rabdomiólisis/diagnóstico , Rabdomiólisis/terapiaRESUMEN
BACKGROUND: Treatment of patients with attention deficit hyperactivity disorder (ADHD) with homeopathy is difficult. The Swiss randomised, placebo controlled, cross-over trial in ADHD patients (Swiss ADHD trial) was designed with an open-label screening phase prior to the randomised controlled phase. During the screening phase, the response of each child to successive homeopathic medications was observed until the optimal medication was identified. Only children who reached a predefined level of improvement participated in the randomised, cross-over phase. Although the randomised phase revealed a significant beneficial effect of homeopathy, the cross-over caused a strong carryover effect diminishing the apparent difference between placebo and verum treatment. METHODS: This retrospective analysis explores the screening phase data with respect to the risk of failure to demonstrate a specific effect of a randomised controlled trial (RCT) with randomisation at the start of the treatment. RESULTS: During the screening phase, 84% (70/83) of the children responded to treatment and reached eligibility for the randomised trial after a median time of 5 months (range 1-18), with a median of 3 different medications (range 1-9). Thirteen children (16%) did not reach eligibility. Five months after treatment start, the difference in Conners Global Index (CGI) rating between responders and non-responders became highly significant (p = 0.0006). Improvement in CGI was much greater following the identification of the optimal medication than in the preceding suboptimal treatment period (p < 0.0001). CONCLUSIONS: Because of the necessity of identifying an optimal medication before response to treatment can be expected, randomisation at the start of treatment in an RCT of homeopathy in ADHD children has a high risk of failure to demonstrate a specific treatment effect, if the observation time is shorter than 12 months.
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Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Homeopatía/métodos , Materia Medica/uso terapéutico , Selección de Paciente , Adolescente , Trastorno por Déficit de Atención con Hiperactividad/tratamiento farmacológico , Niño , Estudios Cruzados , Método Doble Ciego , Esquema de Medicación , Femenino , Humanos , Masculino , Análisis Multivariante , Proyectos de Investigación , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Suiza , Resultado del TratamientoRESUMEN
We report the results of three years of the population-based, prospective Swiss NeuroPaediatric Stroke Registry (SNPSR) of children (up to 16 years) with childhood arterial ischaemic stroke (AIS1), neonatal stroke (AIS2), or symptomatic sinus venous thrombosis (SVT). Data on risk factors (RF), presentation, diagnostic work-up, localisation, and short-term neurological outcome were collected. 80 children (54 males) have been included, 40 AIS1, 23 AIS2, and 17 SVT. The data presented will be concentrated on AIS. The presentation for AIS1 was hemiparesis in 77% and cerebellar symptoms and seizures in 20%, respectively. AIS2 presented in 83% with seizures and in 38% with abnormality of muscle tone. Two or more RF were detected in 54%, one RF in 35%. The most prominent RF for AIS1 were infections (40%), followed by cardiopathies and coagulopathies (25% each). AIS2 were frequently related to birth problems. Neurological outcomes in AIS1 and AIS2 were moderate/severe in 45 % and 32 %, respectively. The outcome correlated significantly with the size of infarction (p = 0.013) and age at stroke (p = 0.027). The overall mortality was 6%. Paediatric stroke is a multiple risk problem, which leads to important long-term sequelae.
Asunto(s)
Estudios de Cohortes , Sistema de Registros , Accidente Cerebrovascular/epidemiología , Adolescente , Factores de Edad , Análisis de Varianza , Infarto Encefálico/diagnóstico , Niño , Preescolar , Femenino , Lateralidad Funcional , Historia Antigua , Humanos , Incidencia , Lactante , Imagen por Resonancia Magnética/métodos , Masculino , Examen Neurológico/métodos , Estudios Retrospectivos , Factores de Riesgo , Accidente Cerebrovascular/clasificación , Encuestas y Cuestionarios , Suiza/epidemiología , Factores de TiempoRESUMEN
The dog serves as an animal model for several human diseases including X-chromosome diseases. Although the canine X-chromosome is one of the largest chromosomes in the dog, only a few markers have been mapped to it to date. Using a commercially available canine whole genome radiation hybrid (RH) panel we have localized 14 microsatellite markers, 18 genes and 13 STSs on the canine X-chromosome, extending the total number of mapped markers to 45 covering an estimated 830 cR. Out of these 45 markers, seven distinct groups of markers could be established with an average spacing of 18.8 cR(3000) and ten markers remained unlinked. Using FISH analysis, six markers could be mapped physically to the p- or q-arm of the X-chromosome. Combined with the FISH mapping, three RH groups could be assigned to the p-arm and two RH groups to the q-arm. Comparison with the human X-chromosome map revealed conserved synteny up to 234 cR (TIMP1-ALAS2-AR-IL2RG-XIST). We show here that the similarity of the canine and human X-chromosomes is the largest for any mammalian species beyond the primates.
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Perros/genética , Mapeo de Híbrido por Radiación/métodos , Cromosoma X , Animales , Secuencia de Bases , Mapeo Cromosómico , Cartilla de ADN , Marcadores Genéticos , Humanos , Hibridación Fluorescente in Situ , Repeticiones de Microsatélite/genética , Reacción en Cadena de la Polimerasa , Especificidad de la EspecieRESUMEN
To assess the risk of contamination, we reviewed retrospectively 1,408 matched pairs of simultaneous catheter-drawn and venipuncture blood cultures. Catheter-drawn cultures were equally likely to be truly positive (14.4 versus 13.7%) but more likely to be contaminated (3.8 versus 1.8% [P = 0.001]). Direct venipuncture cultures are preferred.
Asunto(s)
Recolección de Muestras de Sangre/métodos , Sangre/microbiología , Catéteres de Permanencia , Contaminación de Equipos , Bacteriemia/diagnóstico , Bacteriemia/microbiología , Medios de Cultivo , HumanosRESUMEN
BACKGROUND: Staphylococcus aureus bacteraemia (SAB) is a common complication of S. aureus infection and is associated with a high mortality. AIMS: To document prospectively the pattern of illness associated with SAB in New Zealand and, by recording patient demographic factors and clinical features, to identify risk factors associated with a poor outcome. METHODS: From 1 July 1996 to 31 December 1997, adults with SAB were prospectively studied in six tertiary care hospitals. All information obtained from patients' records was recorded on worksheets and transferred to a computerized spreadsheet for analysis. RESULTS: There were 424 patients with SAB. Maori (relative risk (RR)= 1.8, 95% confidence interval (CI) = 1.3-2.6) and Pacific Island people (RR = 4.0, 95% CI = 3.1-5.3) were significantly more likely than people of European descent to acquire SAB, but not to die from the infection. Fifty per cent of cases were community acquired. A source was identified for 85%: intravenous catheter (31%), primarily hospital acquired, and skin/soft tissue (22%), primarily community acquired, were the most common foci. The 30-day mortality was 19%, 83% of whom died within 2 weeks. Risk factors for a poor outcome were: increasing age above 60, female sex (RR = 1.4, 95% CI = 1.0-2.1), diabetes mellitus (RR = 1.5, 95% CI = 1.0-2.4), immunosuppression (RR = 1.5, 95% CI = 1.0-2.4), pre-existing renal impairment (RR = 1.8, 95% CI = 1.2-2.7), malignancy (RR= 2.2, 95% CI = 1.4-3.5), lung as a source (RR = 2.8, 95% CI = 1.9-4.2) and unknown source (RR = 2.3, 95% CI = 1.5-3.3). Mortality was also accurately predicted by two multifactor scoring systems. There was a low rate of methicillin resistance (5%). CONCLUSIONS: Staphylococcus aureus bacteraemia is more likely to occur in certain ethnic groups, while mortality is associated with other identifiable risk factors and continues to be high. Intravenous catheters remain the most common and most preventable cause of SAB.
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Bacteriemia/epidemiología , Cateterismo/métodos , Infecciones Estafilocócicas/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Bacteriemia/mortalidad , Infecciones Comunitarias Adquiridas/epidemiología , Infección Hospitalaria/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nueva Zelanda/epidemiología , Estudios Prospectivos , Factores de Riesgo , Infecciones Estafilocócicas/mortalidadRESUMEN
PURPOSE: To assess the utility of donor corneoscleral rim cultures. METHODS: A retrospective review of the culture results of 774 corneoscleral rims that remained after trephination of corneas for transplantation into patients at our academic medical center between January 1992 and November 1997. RESULTS: Forty-one (5.3%) corneoscleral rim cultures yielded microorganisms, mostly coagulase-negative staphylococci. Two patients developed endophthalmitis (one with Staphylococcus aureus and one with Pseudomonas aeruginosa) within 3 months after transplantation; each had a negative corneoscleral rim culture and neither patient's infection was temporally related to the transplant procedure. CONCLUSIONS: Preoperative donor corneoscleral rim cultures are unreliable predictors of endophthalmitis complicating corneal transplantation and, therefore, are not useful in the clinical management of patients having corneal transplants. Moreover, the discrepancy between the results of corneoscleral rim cultures and subsequent endophthalmitis renders them invalid as a quality assurance procedure. Instead, for patients with suspected endophthalmitis after corneal transplantation, we recommend that corneal surgeons select antimicrobial therapy based on current guidelines and the results of directed sampling. Furthermore, eye banks should prospectively track recipients who develop clinical endophthalmitis, immediately notify the corneal surgeon who transplanted the matched cornea of that used for the index case, and, in selected situations, attempt to identify a possible source of contamination.
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Bacterias/aislamiento & purificación , Córnea/microbiología , Trasplante de Córnea , Endoftalmitis/prevención & control , Infecciones Bacterianas del Ojo/prevención & control , Esclerótica/microbiología , Toma de Decisiones , Endoftalmitis/microbiología , Bancos de Ojos , Infecciones Bacterianas del Ojo/microbiología , Humanos , Garantía de la Calidad de Atención de Salud , Control de Calidad , Estudios RetrospectivosRESUMEN
To evaluate the performance of BacT/ALERT FA (FA) medium, a new aerobic BacT/ALERT FAN (FAN) medium (Organon Teknika Corporation, Durham, N.C.) that does not require the added cost and inconvenience of a venting unit, we inoculated blood specimens from adult patients with suspected sepsis into an original FAN aerobic culture bottle and an FA bottle. Of 7,745 blood culture sets containing both bottles, 5,256 (68%) met the criteria for adequacy of filling. A total of 466 isolates judged to represent the causes of true infections were recovered from 276 patients; 271 isolates were recovered from both bottles, 82 were recovered from the FAN bottle only, and 113 were recovered from the FA bottle only (P < 0.05). More Burkholderia cepacia isolates (P < 0.01), Candida albicans isolates (P < 0.001), Cryptococcus neoformans isolates (P < 0.01), yeasts overall (P < 0.001), and total microorganisms (P < 0.05) were recovered from FA bottles. Of cultures found to be positive within the first 72 h of incubation, the mean times to detection were almost identical for FAN (20.4 h) and FA (20.7 h) bottles. Of 263 isolates that caused monomicrobic episodes of bloodstream infections, 180 were detected in both bottles, 32 were detected in FAN bottles only, and 51 were detected in FA bottles only (P < 0.05). Of 186 isolates considered to be contaminants, 63 were detected in both media, 64 were detected in FAN bottles only, and 59 were detected in FA bottles only (P was not significant). The number of false-positive results were comparable: 69 (1.3%) in FAN bottles and 56 (1.1%) in FA bottles. However, there were 14 isolates with false-negative results (6 yeasts, 6 nonfermenters, and 1 isolate each of Propionibacterium acnes and coagulase-negative staphylococci) in FAN bottles, whereas there were none in FA bottles. On the basis of these results, we conclude that the new nonvented FA bottle is superior to the original vented FAN medium for the recovery of B. cepacia and yeasts, especially C. albicans and C. neoformans, and is comparable to FAN medium for other microorganisms.
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Bacteriemia/microbiología , Bacterias/aislamiento & purificación , Sangre/microbiología , Fungemia/microbiología , Hongos/aislamiento & purificación , Aerobiosis , Bacterias/crecimiento & desarrollo , Medios de Cultivo , Hongos/crecimiento & desarrollo , Humanos , Juego de Reactivos para DiagnósticoRESUMEN
To examine the validity of cultures of fluid collected through drainage catheters, we reviewed retrospectively fluid specimens that had been collected through catheters in place for at least 2 days. These specimens were taken from patients at a large tertiary-care hospital. A total of 974 specimens representing 620 patient episodes were received. For 554 (89%) episodes there was no reliable imaging evidence for localized infection, rendering the results uninterpretable. The remaining 66 (11%) episodes were followed within 2 days by radiologically guided or open aspiration of one or more fluid collections (predominantly in the abdomen or pelvis) near the drainage catheter, allowing comparison of culture results of 59 direct aspirates with those of prior catheter drainage. In 33 (56%) of these 59 cases, matched culture results were equivalent for therapeutic decision making. However, relying on results of catheter drainage cultures would have led to inadequate antimicrobial therapy in 13 (22%) cases, to excessive therapy in 11 (19%) cases, and to both in 2 cases (3%). We conclude that radiological imaging should be standard practice in the assessment of deep-tissue infections in patients with drainage catheters, and that direct aspiration of potentially infected fluid collections is the most reliable method of obtaining specimens for culture that should be used to guide therapy.
Asunto(s)
Bacterias/aislamiento & purificación , Infecciones Bacterianas/microbiología , Líquidos Corporales/microbiología , Cateterismo , Drenaje , Infecciones Bacterianas/diagnóstico por imagen , Infecciones Bacterianas/tratamiento farmacológico , Medios de Cultivo , Humanos , Radiografía , Estudios Retrospectivos , SucciónRESUMEN
Genomic Representational Difference Analysis (gRDA) is a subtractive DNA method to clone the differences between two related genomes, called tester and driver. We have evaluated this method to obtain polymorphic DNA markers for pedigree dogs. Amplified size-selected genomic restriction fragments (amplicons) of two dog littermates were repeatedly hybridized to each other in order to remove (subtract) those restriction fragments common to both sibs. Already after two rounds of subtractive hybridization, a clear enrichment of presumably tester-specific restriction fragments was observed, which was even more pronounced after the third round of subtraction. A plasmid library of 3000 recombinant clones was constructed of the second round and of the third round difference product. DNA sequence determination of randomly chosen clones of each difference product showed that approximately 1000 unique clones were obtained in the second-round difference product and approximately 500 in the third-round difference product. About half of the clones identified in the second-round difference product were also present in the third-round difference product. Of the second-round difference product, 39 different gRDA fragments could be identified, of which 21 were tester specific. In the third-round difference product, 22 different gRDA fragments were identified, of which 18 were tester specific. There were 13 fragments in common, resulting in a total of 48 different fragments. In order to establish the localization of these markers, we performed mapping using the dog radiation hybrid panel RHDF5000. Of 39 mapped clones, 29 were mapped to 20 existing RH groups, and 10 remained unlinked. It is concluded that gRDA is suitable to generate DNA markers to track disease genes within lines of pedigree dogs.
Asunto(s)
ADN/aislamiento & purificación , Marcadores Genéticos/genética , Genoma , Animales , Cruzamiento , Mapeo Cromosómico , Cricetinae , ADN/química , ADN/genética , Perros , Femenino , Células Híbridas , Masculino , Datos de Secuencia Molecular , Hibridación de Ácido Nucleico/métodos , Linaje , Análisis de Secuencia de ADNRESUMEN
OBJECTIVE: To investigate and control an apparent outbreak of lower respiratory tract infections due to Aureobasidium species. DESIGN: Outbreak investigation. SETTING: University-affiliated medical center. PATIENTS: Nine patients who underwent bronchoscopy between June and August 1998. RESULTS: Ten bronchoalveolar lavage (BAL) fluid cultures from nine patients grew Aureobasidium species during the outbreak period; whereas, respiratory specimens from only two patients grew Aureobasidium species during the preceding 6 years. No patient was judged to have true infection due to Aureobasidium species either before or after bronchoscopy. Nine of the 10 bronchoscopies that yielded Aureobasidium species were performed in the outpatient bronchoscopy suite. The Aureobasidium isolates were not associated with any one bronchoscope. Observation of bronchoscopy procedure revealed that plastic stopcocks labeled for single use were reused on different patients during BAL. There was no record of how many times each stopcock was being reused. After each use, the stopcocks were placed in an automated disinfection machine designed for bronchoscopes. Culture of the stopcocks after they had been "disinfected" yielded a heavy growth of Aureobasidium species, while culture of fluid from the automated disinfection machine was negative. Reuse of the stopcocks was halted, and, during the following 6-month period, Aureobasidium species were not isolated from any BAL specimen. CONCLUSIONS: Reuse of medical equipment labeled for single use is potentially hazardous, especially if no quality control system is in place to monitor sterility and function after reprocessing.
Asunto(s)
Broncoscopios/microbiología , Infección Hospitalaria , Equipo Reutilizado , Hongos Mitospóricos/patogenicidad , Infecciones del Sistema Respiratorio/transmisión , Lavado Broncoalveolar , Brotes de Enfermedades , Contaminación de Equipos , Humanos , Control de Infecciones , Hongos Mitospóricos/aislamiento & purificación , Infecciones del Sistema Respiratorio/microbiologíaRESUMEN
AIMS: To determine the incidence, microbial cause, and outcome of nosocomial pneumonia in adult general medical and surgical patients at Christchurch Hospital. METHOD: A one-year prospective study of consecutive patients developing nosocomial pneumonia in a university-affiliated hospital. Expanded diagnostic laboratory testing was undertaken to identify the microbial cause of pneumonia. RESULTS: We recruited 126 patients, which represented an incidence of 6.1 per 1,000 admissions. Only 52 (41%) patients submitted sputum that satisfied the cytological screening criteria for testing. A microbial cause was identified in 47 cases (37%): the most common was Legionella spp. (sixteen cases), followed by Influenza A (six cases) and Staphylococcus aureus (four cases). We did not identify an environmental source of the Legionella species. Fourteen patients (11%) died as a consequence of pneumonia and nearly all of these had significant comorbidity. Renal impairment, alcohol excess, and severity of pneumonia were the most powerful predictors of a fatal outcome by univariate analysis. CONCLUSIONS: In most patients we did not identify a microbial cause of pneumonia; when we did, Legionella species were the most common, although this micro-organism has a long incubation period so some subjects may have acquired it before admission. These results guide preventative efforts, diagnostic testing and selection of antimicrobial therapy for nosocomial pneumonia in our hospital.