scholarly journals Harmonization status of procalcitonin measurements: what do comparison studies and EQA schemes tell us?

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Huu-Hien Huynh ◽  
Amandine Bœuf ◽  
Jens Pfannkuche ◽  
Philipp Schuetz ◽  
Marc Thelen ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Bacterial Infections ◽  
Medical Decision ◽  
Mortality And Morbidity ◽  
Current State ◽  
Measurement Results ◽  
Increasing Demand ◽  
Early Indication ◽  
Eqa Schemes ◽  
Comparability Of Results

Abstract Sepsis represents a global health priority because of its high mortality and morbidity. The key to improving prognosis remains an early diagnosis to initiate appropriate antibiotic treatment. Procalcitonin (PCT) is a recognized biomarker for the early indication of bacterial infections and a valuable tool to guide and individualize antibiotic treatment. To meet the increasing demand for PCT testing, numerous PCT immunoassays have been developed and commercialized, but results have been questioned. Many comparison studies have been carried out to evaluate analytical performance and comparability of results provided by the different commercially available immunoassays for PCT, but results are conflicting. External Quality Assessment Schemes (EQAS) for PCT constitute another way to evaluate results comparability. However, when making this comparison, it must be taken into account that the variety of EQA materials consist of different matrices, the commutability of which has not yet been investigated. The present study gathers results from all published comparison studies and results from 137 EQAS surveys to describe the current state-of-the-art harmonization of PCT results. Comparison studies globally highlight a significant variability of measurement results that nonetheless seem to have a moderate impact on medical decision-making. For their part, EQAS for PCT provides highly discrepant estimates of the interlaboratory CV. Due to differences in commutability of the EQA materials, the results from different peer groups could not be compared. To improve the informative value of the EQA data, the existing limitations such as non-harmonized conditions and suboptimal and/or unknown commutability of the EQA materials have to be overcome. The study highlights the need for commutable reference materials that could be used to properly evaluate result comparability and possibly standardize calibration, if necessary. Such an initiative would further improve the safe use of PCT in clinical routine.

scholarly journals Zinc deficiency may play a crucial role in dialysis-associated bacterial infections

2020 ◽  
Vol 11 (1) ◽  
pp. e9-e9
Author(s):  
Zahra Lotfi ◽  
Abbas Ali Zeraati ◽  
Elaheh Dashti ◽  
Tina Zeraati ◽  
Maryam Arghiany ◽  
...  
Keyword(s):  
Zinc Deficiency ◽  
Bacterial Infections ◽  
Critical Role ◽  
Serum Zinc ◽  
Zinc Level ◽  
Healthy Individuals ◽  
Mortality And Morbidity ◽  
Increased Risk ◽  
The Mean

Introduction: Systemic bacterial infections are a common cause of mortality and morbidity in hemodialysis patients. Zinc has a critical role in several immune system functions. Patients who have enough amounts of zinc are able to better face infections caused by various pathogens in comparison to those with zinc insufficiency Objective We sought to assess the role of zinc deficiency in dialysis-associated bacterial infections. Patients and Methods: Eighty-Three adult patients with end-stage renal disease (ESRD) on hemodialysis including 43 patients with bacterial infectious complications and 40 non-infected patients as well as 41 healthy individuals were enrolled. Clinical data, laboratory values including serum zinc level and imaging findings were collected. SPSS was utilized to analyze the data with a significance cutoff set at P < 0.05. Results: Out of 124 participants, 80 (64.51%) were males and 44 (35.49%) were females. The mean age of infected hemodialysis group, non-infected hemodialysis group, and healthy controls were 50.8 ± 16.25, 49.1 ± 18.1, and 56.3 ± 18.2 years, respectively. Catheter site infection (37.3%) and urinary tract infection (30.2%) were the most common infections. The mean serum zinc concentration was significantly lower in the infected patients, compared to non-infected patients and healthy individuals (P < 0.001). Conclusion: The ESRD patients on hemodialysis have lower serum zinc levels which are associated with increased risk of bacterial infection. The role of screening for zinc deficiency and use of supplemental zinc in these patients need to be studied.

scholarly journals Antimicrobial Synergy of Silver-Platinum Nanohybrids With Antibiotics

2021 ◽  
Vol 11 ◽  
Author(s):  
Bansi Ranpariya ◽  
Gayatri Salunke ◽  
Srikanta Karmakar ◽  
Kaushik Babiya ◽  
Santosh Sutar ◽  
...  
Keyword(s):  
Biofilm Formation ◽  
Bacterial Infections ◽  
Bacterial Biofilm ◽  
Antimicrobial Drugs ◽  
Mortality And Morbidity ◽  
Green Route ◽  
Antimicrobial Synergy ◽  
First Time ◽  
Tuber Extract ◽  
Powerful Strategy

Various bacterial pathogens are responsible for nosocomial infections resulting in critical pathophysiological conditions, mortality, and morbidity. Most of the bacterial infections are associated with biofilm formation, which is resistant to the available antimicrobial drugs. As a result, novel bactericidal agents need to be fabricated, which can effectively combat the biofilm-associated bacterial infections. Herein, for the first time we report the antimicrobial and antibiofilm properties of silver-platinum nanohybrids (AgPtNHs), silver nanoparticles (AgNPs), and platinum nanoparticles (PtNPs) against Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus. The AgPtNHs were synthesized by a green route using Dioscorea bulbifera tuber extract at 100°C for 5 h. The AgPtNHs ranged in size from 20 to 80 nm, with an average of ∼59 nm. AgNPs, PtNPs, and AgPtNHs showed a zeta potential of −14.46, −1.09, and −11.39 mV, respectively. High antimicrobial activity was observed against P. aeruginosa and S. aureus and AgPtNHs exhibited potent antimicrobial synergy in combination with antibiotics such as streptomycin, rifampicin, chloramphenicol, novobiocin, and ampicillin up to variable degrees. Interestingly, AgPtNHs could inhibit bacterial biofilm formation significantly. Hence, co-administration of AgPtNHs and antibiotics may serve as a powerful strategy to treat bacterial infections.

scholarly journals From Rise to Fall

Politeja ◽  
2019 ◽  
Vol 16 (5(62)) ◽  
pp. 175-192
Author(s):  
Leontiy Georgievich Byzov
Keyword(s):  
Public Opinion ◽  
Comparative Studies ◽  
Social Groups ◽  
Public Opinion Research ◽  
Strong State ◽  
Current State ◽  
Increasing Demand ◽  
Academy Of Sciences ◽  
Value Crisis ◽  
Current Stage

Based on the 2000–2018 comparative studies of the Institute of Sociology of the Russian Academy of Sciences and the Russian Public Opinion Research Center (VTsIOM), the author presents the process of transition of the “Putin era” from the stage of consolidation built upon public consensus achieved at the beginningof the “zero” (нулевых) years to the current stage of value crisis that arose in 2012–14 and lasts to this day. Although the current state of society canno tbe unequivocally interpreted as a split, contradictions in the system of values are growing. Implementation of the idea of a strong state is delegated to social groups that are least modernized. Moreover, within the state itself, frustration has been growing among the whole society. The increasing demand for change has not yet been materialized in the form of any political “body”, which makes the inevitable transit of epochs extremely risky for the country and the society.

scholarly journals Bacteriological profile and antibiogram of cancer patients admitted in intensive care unit of a tertiary care cancer hospital in central Kerala

2020 ◽  
Vol 8 (12) ◽  
pp. 4450
Author(s):  
Sanjana Ramakrishnan ◽  
Sourabh Radhakrishnan ◽  
Sonu Lazar Cyriac
Keyword(s):  
Cancer Patients ◽  
Bacterial Infections ◽  
Tertiary Care ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
Mortality And Morbidity ◽  
E Coli ◽  
Resistance To Penicillin ◽  
Study Laboratory

Background: Opportunistic bacterial infections remain a serious morbidity among cancer patients. This study was aimed to determine the bacteriological and antibiotic profile of cancer patients admitted to the ICU of a tertiary care centre.Methods: Cross sectional study was done among cancer patients admitted in the Oncology neutropenic ICU during the period from August 2017 to July 2019. All patients admitted with a proven diagnosis of cancer for whom at least one bacterial culture was sent from any site were included in the study. Laboratory on culture reports were obtained from patient files and analysed.Results: A total of 278 samples from 256 patients (60±11.6 years) were analysed. Among the 111/278 positive cultures, 29 were blood samples and 1 was a pleural fluid sample. Gram negative organisms were 62.1% with Escherichia coli (25, 36.2%) as prevalent. Among the 37.8% gram positives, Staphylococcus aureus (18. 42.8%) was prevalent. Most of the E. coli strains showed highest resistance to ceftazidime (96%) and highest sensitivity to amikacin. The commonest gram-positive organism, Staphylococcus species were 100 % sensitive to vancomycin and linezolid and 100 % resistance to penicillin.  Conclusions: E. coli (gram negative) showed highest resistance to ceftazidime and sensitivity to amikacin. S. aureus (gram positive) was sensitive to vancomycin and linezolid and resistance to penicillin. An antibiogram for cancer patients helps the clinician to initiate an appropriate empirical antibiotic therapy to reduce mortality and morbidity.

scholarly journals Reassessing the Role of Type II Toxin-Antitoxin Systems in Formation ofEscherichia coliType II Persister Cells

mBio ◽  
2018 ◽  
Vol 9 (3) ◽  
Author(s):  
Frédéric Goormaghtigh ◽  
Nathan Fraikin ◽  
Marta Putrinš ◽  
Thibaut Hallaert ◽  
Vasili Hauryliuk ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Bacterial Infections ◽  
Bacterial Population ◽  
Transient State ◽  
Health Concern ◽  
Type Ii ◽  
Direct Link ◽  
Persister Cells ◽  
Content Type ◽  
High Fluorescence

ABSTRACTPersistence is a reversible and low-frequency phenomenon allowing a subpopulation of a clonal bacterial population to survive antibiotic treatments. Upon removal of the antibiotic, persister cells resume growth and give rise to viable progeny. Type II toxin-antitoxin (TA) systems were assumed to play a key role in the formation of persister cells inEscherichia colibased on the observation that successive deletions of TA systems decreased persistence frequency. In addition, the model proposed that stochastic fluctuations of (p)ppGpp levels are the basis for triggering activation of TA systems. Cells in which TA systems are activated are thought to enter a dormancy state and therefore survive the antibiotic treatment. Using independently constructed strains and newly designed fluorescent reporters, we reassessed the roles of TA modules in persistence both at the population and single-cell levels. Our data confirm that the deletion of 10 TA systems does not affect persistence to ofloxacin or ampicillin. Moreover, microfluidic experiments performed with a strain reporting the induction of theyefM-yoeBTA system allowed the observation of a small number of type II persister cells that resume growth after removal of ampicillin. However, we were unable to establish a correlation between high fluorescence and persistence, since the fluorescence of persister cells was comparable to that of the bulk of the population and none of the cells showing high fluorescence were able to resume growth upon removal of the antibiotic. Altogether, these data show that there is no direct link between induction of TA systems and persistence to antibiotics.IMPORTANCEWithin a growing bacterial population, a small subpopulation of cells is able to survive antibiotic treatment by entering a transient state of dormancy referred to as persistence. Persistence is thought to be the cause of relapsing bacterial infections and is a major public health concern. Type II toxin-antitoxin systems are small modules composed of a toxic protein and an antitoxin protein counteracting the toxin activity. These systems were thought to be pivotal players in persistence until recent developments in the field. Our results demonstrate that previous influential reports had technical flaws and that there is no direct link between induction of TA systems and persistence to antibiotics.

scholarly journals Stochastic Variation in Expression of the Tricarboxylic Acid Cycle Produces Persister Cells

mBio ◽  
2019 ◽  
Vol 10 (5) ◽  
Author(s):  
Eliza A. Zalis ◽  
Austin S. Nuxoll ◽  
Sylvie Manuse ◽  
Geremy Clair ◽  
Lauren C. Radlinski ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Bacterial Infections ◽  
Tricarboxylic Acid Cycle ◽  
Tricarboxylic Acid ◽  
Resistant Bacteria ◽  
Chronic Infections ◽  
Persister Cells ◽  
Stochastic Variation ◽  
Content Type ◽  
Atp Levels

ABSTRACT Chronic bacterial infections are difficult to eradicate, though they are caused primarily by drug-susceptible pathogens. Antibiotic-tolerant persisters largely account for this paradox. In spite of their significance in the recalcitrance of chronic infections, the mechanism of persister formation is poorly understood. We previously reported that a decrease in ATP levels leads to drug tolerance in Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus. We reasoned that stochastic fluctuation in the expression of tricarboxylic acid (TCA) cycle enzymes can produce cells with low energy levels. S. aureus knockouts in glutamate dehydrogenase, 2-oxoketoglutarate dehydrogenase, succinyl coenzyme A (CoA) synthetase, and fumarase have low ATP levels and exhibit increased tolerance of fluoroquinolone, aminoglycoside, and β-lactam antibiotics. Fluorescence-activated cell sorter (FACS) analysis of TCA genes shows a broad Gaussian distribution in a population, with differences of over 3 orders of magnitude in the levels of expression between individual cells. Sorted cells with low levels of TCA enzyme expression have an increased tolerance of antibiotic treatment. These findings suggest that fluctuations in the levels of expression of energy-generating components serve as a mechanism of persister formation. IMPORTANCE Persister cells are rare phenotypic variants that are able to survive antibiotic treatment. Unlike resistant bacteria, which have specific mechanisms to prevent antibiotics from binding to their targets, persisters evade antibiotic killing by entering a tolerant nongrowing state. Persisters have been implicated in chronic infections in multiple species, and growing evidence suggests that persister cells are responsible for many cases of antibiotic treatment failure. New antibiotic treatment strategies aim to kill tolerant persister cells more effectively, but the mechanism of tolerance has remained unclear until now.

Mortality and morbidity from invasive bacterial infections during a clinical trial of acellular pertussis vaccines in Sweden

1988 ◽  
Vol 7 (9) ◽  
pp. 637-644 ◽  
Author(s):  
JANN STORSAETER ◽  
PATRICK OLIN ◽  
BERIT RENEMAR ◽  
TERESA LAGERGÅRD ◽  
RENÉE NORBERG ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Bacterial Infections ◽  
Mortality And Morbidity

Health Utility Measurement

2011 ◽  
pp. 787-813 ◽  
Author(s):  
Donna Rowen ◽  
John Brazier
Keyword(s):  
Economic Evaluation ◽  
Health Utility ◽  
Health State ◽  
Health States ◽  
Health State Description ◽  
Utility Measurement ◽  
Current State ◽  
Increasing Demand ◽  
Demand For Health

Measuring and valuing health is a major component of economic evaluation, meaning that health utility measurement has been growing in popularity in recent years due to the increasing demand for health state values in economic models and evaluations. The main issues in health utility measurement are how to describe health states, how to value the health state description and whose values should be used. This article briefly outlines these main issues and then focuses on recent methodological developments in health utility measurement. It assesses the current state of health utility measurement and discusses the question of assessment of a health state to be used in economic evaluation. The discussion whether experience utility should be used rather than conventional preference-based utility raises important issues about perspective and the role of various factors.

Underestimated Collateral Effects of Antibiotic Therapy in Prosthesis-Associated Bacterial Infections

2007 ◽  
Vol 30 (9) ◽  
pp. 786-791 ◽  
Author(s):  
L. Baldassarri ◽  
L. Montanaro ◽  
R. Creti ◽  
C. R. Arciola
Keyword(s):  
Antibiotic Therapy ◽  
Antibiotic Treatment ◽  
Virulence Factors ◽  
Medical Devices ◽  
Bacterial Infections ◽  
Bacterial Virulence ◽  
The Other ◽  
Aggressive Therapy ◽  
Collateral Effects ◽  
Stimulation Of

Antibiotic treatment of infections associated with the use of indwelling medical devices in ageing and/or severely ill patients represents a significant healthcare problem due to the difficulty of treating such infections and to the various collateral effects that may be observed following the often aggressive therapy We summarize some effects of antibiotics on the expression of virulence factors of the microorganisms which cause such infections. These effects, particularly those resulting in a stimulation of bacterial virulence, might be usefully included among the other well-known collateral effects of antibiotic therapy

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