RESUMEN
The rapid detection of KPC-producing Enterobacteriaceae by microbiology laboratories has been required for infectious control programs. Herein we evaluated the performance of a novel immunochromatographic test for detecting KPC-2-, KPC-3-, KPC-4-, KPC-6-, KPC-7-, KPC-8-, and KPC-11-producing isolates and the influence of different growth media on the test performance.
Asunto(s)
Proteínas Bacterianas/genética , Enterobacteriaceae Resistentes a los Carbapenémicos/genética , Cromatografía de Afinidad/métodos , Klebsiella pneumoniae/genética , beta-Lactamasas/genética , Enterobacteriaceae Resistentes a los Carbapenémicos/enzimología , Enterobacteriaceae Resistentes a los Carbapenémicos/aislamiento & purificación , Infecciones por Enterobacteriaceae/microbiología , Humanos , Klebsiella pneumoniae/enzimología , Pruebas de Sensibilidad MicrobianaRESUMEN
Carbapenemase-producing Enterobacteriaceae may exhibit in vitro susceptibility to carbapenems, especially those producing weak carbapenemases. Routine clinical laboratories have employed phenotypic tests for screening such isolates. BKC-1 is a recently reported carbapenemase that shows weak carbapenemase activity. In this study, we aimed to evaluate the behavior of distinct phenotypic methods against BKC-1-producing Enterobacteriaceae.
Asunto(s)
Antibacterianos/farmacología , Proteínas Bacterianas/biosíntesis , Enterobacteriaceae/efectos de los fármacos , Enterobacteriaceae/enzimología , Pruebas de Sensibilidad Microbiana , beta-Lactamasas/biosíntesis , Antibacterianos/metabolismo , Proteínas Bacterianas/genética , Carbapenémicos/metabolismo , Carbapenémicos/farmacología , Pruebas Antimicrobianas de Difusión por Disco , Enterobacteriaceae/clasificación , Enterobacteriaceae/genética , Humanos , Hidrólisis , Pruebas de Sensibilidad Microbiana/métodos , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , beta-Lactamasas/genéticaRESUMEN
OBJECTIVE: The aim of this study was to evaluate whether chronotropic incompetence (CI), the inability to reach 85% of the maximal predicted heart rate during exercise, affects the assessment of myocardial ischemia and prognosis in patients undergoing myocardial perfusion single-photon emission computed tomography (MPS). METHODS: Patients undergoing exercise/rest MPS were studied. Those taking drugs with negative chronotropic properties were excluded. Summed stress, rest, and difference scores (SSS, SRS, and SDS, representing, respectively, the extent and severity of the total perfusion defect, fibrosis, or ischemia) were calculated. Patients were followed up for the occurrence of hard events (death or myocardial infarction) or myocardial revascularization for 36±20 months. RESULTS: A total of 391 patients were studied; among them, 11.5% had CI. All perfusion scores were higher in patients with CI. On logistic regression, history of myocardial infarction and SDS were found to be independent predictors of CI. On comparing patients with and without CI, the former more often had hard events (12.5 vs. 0.9%, P=0.007) and revascularization (20.0 vs. 8.1%, P=0.003). CONCLUSION: CI was associated with myocardial ischemia. Higher rates of hard events and revascularization were observed in patients with CI, in accordance with the larger extent of myocardial ischemia found in these patients. Performing MPS in the setting of CI may maintain the diagnostic and prognostic abilities of the test.