scholarly journals Validity Of Congo Red Agar And Modified Congo Red Agar To Detect Biofilm Of Enterococcus Faecalis

2020 ◽  
Vol 16 (1) ◽  
pp. 55
Author(s):  
Rina Normanita
Keyword(s):  
Enterococcus Faecalis ◽  
Congo Red ◽  
Gold Standard ◽  
False Positive Rate ◽  
High Sensitivity ◽  
P Value ◽  
Standard Result ◽  
Tract Infections ◽  
Abdominal Infections ◽  
Kappa Agreement

Purpose: Enterococcus faecalis causes nosocomial infections such as bacteremia, urinary tract infections, intra-abdominal infections, and endocarditis. These infection is associated with biofilm and intrinsically resistant to many antibiotics. This study aims to determine the validity of the CRA and MCRA for detecting biofilms of Enterococcus faecalis  Method: This is a laboratory observational study with 30 sample of Enterococcus faecalis. We performed biofilm examination for Enterococcus faecalis by using Congo red Agar, Modified Congo red Agar and Microtitter Plate Assay as gold standard. Result: Both MCRA and CRA were compared MPA as a gold standard was obtained p value is 0.309 (p> 0.05), with a Kappa agreement coefficient is 0.067, which indicates there is no significant agreement to detect biofilm of Enterococcus faecalis. MCRA and CRA have almost no compatibility with MPA for biofilm forming of Enterococcus faecalis. Conclusion: Both MCRA and CRA has a very high sensitivity (100%), but the specificity is very low 6.67% for detecting the biofilms of Enterococcus faecalis. MCRA and CRA can not determine negativity well and it have a high false positive rate, so to increase specificity of biofilm forming, we must combine these method with the others. Keywords: Biofilm, Enterococcus faecalis, CRA, MCRA, MPA.

scholarly journals Evaluation of the Diagnostic Value of Contrast-Enhanced Voiding Urosonography with Regard to the Further Therapy Regime and Patient Outcome—A Single-Center Experience in an Interdisciplinary Uroradiological Setting

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 56
Author(s):  
Constantin A. Marschner ◽  
Vincent Schwarze ◽  
Regina Stredele ◽  
Matthias F. Froelich ◽  
Johannes Rübenthaler ◽  
...  
Keyword(s):  
Gold Standard ◽  
High Sensitivity ◽  
Diagnostic Value ◽  
Voiding Cystourethrography ◽  
Single Center ◽  
Clinical Implementation ◽  
Single Center Experience ◽  
Experienced Radiologist ◽  
Contrast Enhanced ◽  
Tract Infections

Background and Objectives: Vesicoureteral reflux (VUR) describes a common pediatric anomaly in pediatric urology with a prevalence of 1–2%. In diagnostics, in addition to the gold standard of voiding cystourethrography (VCUG), contrast-enhanced urosonography (ceVUS) offers a radiation-free procedure, which, despite its advantages, is not yet widely used. In the present single-center study, subsequent therapeutic procedures and outcomes after ceVUS of 49 patients were investigated. The aim of the study is to investigate the efficacy of ceVUS with the intention of broader clinical implementation. Materials and Methods: Between 2016 and 2020, 49 patients were retrospectively included and received a ceVUS to evaluate VUR. With a distribution of 47:2 (95.9%), a clear female predominance was present. The age of the patients varied between 5 months and 60 years at the time of ceVUS. All examinations were all performed and subsequently interpreted by a single experienced radiologist (EFSUMB level 3). Results: Compared to intraoperative findings, ceVUS shows a sensitivity of 95.7% with a specificity of 100%. Allergic reactions to the contrast medium could not be observed. Conclusion: With its high sensitivity and intraoperative validation, ceVUS offers an excellent alternative to VCUG, the gold standard in the diagnosis of VUR. In addition, ceVUS is a radiation-free examination method with a low risk profile that offers an exceptional diagnostic tool in the diagnostic clarification of recurrent urinary tract infections with the suspected diagnosis of VUR and should also be included in the consideration of a diagnosis next to the established VCUG, especially in younger children.

scholarly journals Urinary Excretion and Bactericidal Activities of Gemifloxacin and Ofloxacin after a Single Oral Dose in Healthy Volunteers

2001 ◽  
Vol 45 (12) ◽  
pp. 3524-3530 ◽  
Author(s):  
Christoph K. Naber ◽  
Michaela Hammer ◽  
Martina Kinzig-Schippers ◽  
Christian Sauber ◽  
Fritz Sörgel ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Urinary Tract ◽  
Urinary Excretion ◽  
Enterococcus Faecalis ◽  
Urinary Tract Infections ◽  
Parent Drug ◽  
Oral Dosage ◽  
Tract Infections ◽  
Cumulative Excretion

ABSTRACT In a randomized crossover study, 16 volunteers (8 men, 8 women) received single oral doses of 320 mg of gemifloxacin and 400 mg of ofloxacin on two separate occasions in the fasting state to assess the urinary excretion and urinary bactericidal titers (UBTs) at intervals for up to 144 h. Ofloxacin showed higher concentrations in urine compared with those of gemifloxacin. The median (range) cumulative excretion of gemifloxacin was 29.7% (8.4 to 48.7%) of the parent drug administered, and median (range) cumulative excretion of ofloxacin was 84.3% (46.5 to 95.2%) of the parent drug administered. The UBTs, i.e., the highest twofold dilutions (with antibiotic-free urine as the diluent) of urine that were still bactericidal, were determined for a reference strain and nine uropathogens for which the MICs of gemifloxacin and ofloxacin were as follows:Escherichia coli ATCC 25922, 0.016 and 0.06 μg/ml, respectively; Klebsiella pneumoniae, 0.03 and 0.06 μg/ml, respectively; Proteus mirabilis, 0.125 and 0.125 μg/ml, respectively; Escherichia coli, 0.06 and 0.5 μg/ml, respectively; Pseudomonas aeruginosa, 1 and 4 μg/ml, respectively; Staphylococcus aureus, 0.008 and 0.25 μg/ml, respectively; Enterococcus faecalis, 0.06 and 2 μg/ml, respectively;Staphylococcus aureus, 0.25 and 4 μg/ml, respectively;Enterococcus faecalis, 0.5 and 32 μg/ml, respectively; and Staphylococcus aureus, 2 and 32 μg/ml, respectively. Generally, the UBTs for gram-positive uropathogens were higher for gemifloxacin than for ofloxacin and the UBTs for gram-negative uropathogens were higher for ofloxacin than for gemifloxacin. According to the UBTs, ofloxacin-resistant uropathogens (MICs, ≥4 mg/liter) should also be considered gemifloxacin resistant. Although clinical trials have shown that gemifloxacin is effective for the treatment of uncomplicated urinary tract infections, whether an oral dosage of 320 mg of gemifloxacin once daily is also adequate for the treatment of complicated urinary tract infections has yet to be confirmed.

The role of pre-biopsy mpMRI in lymph node staging for prostate cancer

2021 ◽  
pp. 039156032110168
Author(s):  
Nassib Abou Heidar ◽  
Robert El-Doueihi ◽  
Ali Merhe ◽  
Paul Ramia ◽  
Gerges Bustros ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
High Risk ◽  
Gleason Score ◽  
Gold Standard ◽  
Cross Sectional ◽  
Significant Difference ◽  
Cross Sectional Imaging ◽  
Sectional Imaging ◽  
Kappa Agreement

Introduction: Prostate cancer (PCa) staging is an integral part in the management of prostate cancer. The gold standard for diagnosing lymph node invasion is a surgical lymphadenectomy, with no superior imaging modality available at the clinician’s disposal. Our aim in this study is to identify if a pre-biopsy multiparametric MRI (mpMRI) can provide enough information about pelvic lymph nodes in intermediate and high risk PCa patients, and whether it can substitute further cross sectional imaging (CSI) modalities of the abdomen and pelvis in these risk categories. Methods: Patients with intermediate and high risk prostate cancer were collected between January 2015 and June 2019, while excluding patients who did not undergo a pre-biopsy mpMRI or a CSI. Date regarding biopsy result, PSA, MRI results, CSI imaging results were collected. Using Statistical Package for the Social Sciences (SPSS) version 24.0, statistical analysis was conducted using the Cohen’s Kappa agreement for comparison of mpMRI with CSI. McNemar’s test and receiver operator curve (ROC) curve were used for comparison of sensitivity of both tests when comparing to the gold standard of lymphadenectomy. Results: A total of 143 patients fit the inclusion criteria. We further stratified our patients into according to PSA level and Gleason score. Overall, agreement between mpMRI and all CSI was 0.857. When stratifying patients based on Gleason score and PSA, the higher the grade or PSA, the higher agreement between mpMRI and CSI. The sensitivity of mpMRI (73.7%) is similar to CSI (68.4%). When comparing CSI sensitivity to that of mpMRI, no significant difference was present by utilizing the McNemar test and very similar receiver operating characteristic curve. Conclusion: A pre-biopsy mpMRI can potentially substitute further cross sectional imaging in our cohort of patients. However, larger prospective studies are needed to confirm our findings.

scholarly journals Adding stress biomarkers to high sensitivity troponin measurements increases precision and efficacy of rapid rule out protocols for NSTEMI

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
I Restan ◽  
O.T Steiro ◽  
H.L Tjora ◽  
J Langoergen ◽  
T Omland ◽  
...  
Keyword(s):  
Chest Pain ◽  
Acute Chest Pain ◽  
High Sensitivity ◽  
Final Diagnosis ◽  
Public Institution ◽  
P Value ◽  
Funding Source ◽  
University Hospitals ◽  
High Sensitivity Troponin ◽  
Rule Out

Abstract Background NSTEMI may be ruled out in patients presenting with acute chest pain based on low baseline high sensitivity troponin (cTn) at admission. This procedure is limited by a low expected frequency of ruled out non-cardiac chest pain (NCCP) patients. Purpose To investigate if stress-induced biomarkers (glucose or copeptin) combined with cTn can increase the rate of NCCP ruled out without an unacceptable increase in incorrectly ruled out NSTEMI. Method 971 patients with suspected NSTE-ACS were included. Final diagnosis was adjudicated by two independent cardiologists using clinical data including routine cTnT. Additionally, baseline cTnI, cTnI from Singulex Clarity System (cTnI(sgx)), copeptin and glucose were measured. Diagnostic performance to rule out NSTEMI was compared between the ESC rule out algorithms for cTnT and cTnI(Abbott), a local cTnI(sgx) algorithm and different combinations of cTn with copeptin or glucose Results Median age 61 years, 60% male. 13% had NSTEMI, 12% had UAP and 60% NCCP. Distribution of copeptin and glucose concentrations (NSTEMI and NCCP) is shown in figure 1. Copeptin and cTnT produces an algorithm with lower miss rate for NSTEMI, increased rule out rate for NCCP and significantly higher AUC (DeLong test, p value <0.001) compared to the ESC algorithm (Table 1). cTnI(sgx) and copeptin showed higher rule out for NCCP and higher AUC (p value <0.001), however an increased rule out rate for NSTEMIs. Combining cTnI(Abbott) and glucose gave a similar miss rate for NSTEMI as ESC, but increased rule out rate for NCCP and higher AUC (p value <0.001). Conclusion Combining cTnT or cTnI(sgx) with copeptin; or cTnI with glucose, improves diagnostic precision and efficacy of rule out protocols for NSTEMI in patients presenting with acute chest pain. Figure 1 Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Western Norway Regional Health Authority; Haukeland and Stavanger University Hospitals

scholarly journals Development of an Electronic Algorithm to Identify Inappropriate Antibiotic Prescribing for Pediatric Pharyngitis

2020 ◽  
Vol 41 (S1) ◽  
pp. s188-s189
Author(s):  
Jeffrey Gerber ◽  
Robert Grundmeier ◽  
Keith Hamilton ◽  
Lauri Hicks ◽  
Melinda Neuhauser ◽  
...  
Keyword(s):  
Predictive Value ◽  
Gold Standard ◽  
Antibiotic Stewardship ◽  
Chart Review ◽  
Antibiotic Use ◽  
Audit And Feedback ◽  
Urgent Care ◽  
Antibiotic Prescribing ◽  
Tract Infections ◽  
The Impact

Background: Antibiotic overuse contributes to antibiotic resistance and unnecessary adverse drug effects. Antibiotic stewardship interventions have primarily focused on acute-care settings. Most antibiotic use, however, occurs in outpatients with acute respiratory tract infections such as pharyngitis. The electronic health record (EHR) might provide an effective and efficient tool for outpatient antibiotic stewardship. We aimed to develop and validate an electronic algorithm to identify inappropriate antibiotic use for pediatric outpatients with pharyngitis. Methods: This study was conducted within the Children’s Hospital of Philadelphia (CHOP) Care Network, including 31 pediatric primary care practices and 3 urgent care centers with a shared EHR serving >250,000 children. We used International Classification of Diseases, Tenth Revision (ICD-10) codes to identify encounters for pharyngitis at any CHOP practice from March 15, 2017, to March 14, 2018, excluding those with concurrent infections (eg, otitis media, sinusitis), immunocompromising conditions, or other comorbidities that might influence the need for antibiotics. We randomly selected 450 features for detailed chart abstraction assessing patient demographics as well as practice and prescriber characteristics. Appropriateness of antibiotic use based on chart review served as the gold standard for evaluating the electronic algorithm. Criteria for appropriate use included streptococcal testing, use of penicillin or amoxicillin (absent β-lactam allergy), and a 10-day duration of therapy. Results: In 450 patients, the median age was 8.4 years (IQR, 5.5–9.0) and 54% were women. On chart review, 149 patients (33%) received an antibiotic, of whom 126 had a positive rapid strep result. Thus, based on chart review, 23 subjects (5%) diagnosed with pharyngitis received antibiotics inappropriately. Amoxicillin or penicillin was prescribed for 100 of the 126 children (79%) with a positive rapid strep test. Of the 126 children with a positive test, 114 (90%) received the correct antibiotic: amoxicillin, penicillin, or an appropriate alternative antibiotic due to b-lactam allergy. Duration of treatment was correct for all 126 children. Using the electronic algorithm, the proportion of inappropriate prescribing was 28 of 450 (6%). The test characteristics of the electronic algorithm (compared to gold standard chart review) for identification of inappropriate antibiotic prescribing were sensitivity (99%, 422 of 427); specificity (100%, 23 of 23); positive predictive value (82%, 23 of 28); and negative predictive value (100%, 422 of 422). Conclusions: For children with pharyngitis, an electronic algorithm for identification of inappropriate antibiotic prescribing is highly accurate. Future work should validate this approach in other settings and develop and evaluate the impact of an audit and feedback intervention based on this tool.Funding: NoneDisclosures: None

The False Positive Rate of Transcutaneous Tissue Oximetry Alarms in Microvascular Breast Reconstruction Rises after 24 Hours

2020 ◽  
Author(s):  
Phu C. Tran ◽  
Will DeBrock ◽  
Mary E. Lester ◽  
Brett C. Hartman ◽  
Juan Socas ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Postoperative Period ◽  
False Positive ◽  
False Positive Rate ◽  
High Sensitivity ◽  
Flap Loss ◽  
Vascular Compromise ◽  
Positive Rate ◽  
Tissue Oximetry ◽  
Salvage Rate

Abstract Background Transcutaneous tissue oximetry is widely used as an adjunct for postoperative monitoring after microvascular breast reconstruction. Despite a high sensitivity at detecting vascular issues, alarms from probe malfunctions/errors can generate unnecessary nursing calls, concerns, and evaluations. The purpose of this study is to analyze the false positive rate of transcutaneous tissue oximetry monitoring over the postoperative period and assess changes in its utility over time. Patients and Methods Consecutive patients undergoing microvascular breast reconstruction at our institution with monitoring using transcutaneous tissue oximetry were assessed between 2017 and 2019. Variables of interest were transcutaneous tissue oximetry alarms, flap loss, re-exploration, and salvage rates. Results The study included 175 patients (286 flaps). The flap loss rate was 1.0% (3/286). Twelve patients (6.8%) required re-exploration, with 9 patients found to have actual flap compromise (all within 24 hours). The salvage rate was 67.0%. The 3 takebacks after 24 hours were for bleeding concerns rather than anastomotic problems. Within the initial 24-hour postoperative period, 43 tissue oximetry alarms triggered nursing calls; 7 alarms (16.2%) were confirmed to be for flap issues secondary to vascular compromise. After 24 hours, none of the 44 alarms were associated with flap compromise. The false positive rate within 24 hours was 83.7% (36/43) compared with 100% (44/44) after 24 hours (p = 0.01). Conclusion The transcutaneous tissue oximetry false positive rate significantly rises after 24 hours. The benefit may not outweigh the concerns, labor, and effort that results from alarms after postoperative day 1. We recommend considering discontinuing this monitoring after 24 hours.

scholarly journals Clinical Value of Multiplexed Bead-Based Immunoassays for Detection of Autoantibodies to Nuclear Antigens

2007 ◽  
Vol 14 (5) ◽  
pp. 505-509 ◽  
Author(s):  
Erik Avaniss-Aghajani ◽  
Sophia Berzon ◽  
Arlen Sarkissian
Keyword(s):  
Lupus Erythematosus ◽  
Fluorescent Antibody ◽  
False Positive Rate ◽  
High Sensitivity ◽  
Test System ◽  
Lower Percentage ◽  
Clinical Value ◽  
Specificity And Sensitivity ◽  
Relative Specificity ◽  
Positive Results

ABSTRACT The advent of multiplexed bead assays in recent years has introduced a new dimension of testing for complex diseases such as lupus, which can involve multiple autoantibodies. The ability to rapidly identify multiple autoantibodies, with high sensitivity and specificity in an automated fashion, is highly attractive. The aim of this study was to assess the performance and clinical value of multiplexed bead-based (AtheNA Multi-Lyte ANA-II test system) immunoassays both by comparing the results with those achieved by indirect fluorescent-antibody assay (IFA) or conventional enzyme immunoassays (EIAs) and by independent identification of autoantibodies in well-characterized samples. To achieve this goal, 984 samples were tested for seven analytes (SS/A, SS/B, Sm, RNP, Scl-70, double-stranded DNA [dsDNA], and centromere B) in both traditional and bead-based assays. The average concordance for the different analytes was 91%, ranging from 81% (dsDNA) to 97% (centromere B). The average relative specificity and sensitivity for the analytes were also high, 92% and 81%, respectively. An examination of 93 “normal controls” demonstrated a 7% false-positive rate, which was comparable to IFA. Percentages of different autoantibodies found in patients with a variety of disease conditions (34 with calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia; 41 with mixed connective tissue disease; 24 with scleroderma; and 35 with Sjogren's syndrome) were well within the range expected from each group. A scrutiny of results from AtheNA and EIA and Farr results for 185 systemic lupus erythematosus samples revealed comparable results by both methods, with the exception of SS/A and dsDNA, where AtheNA had a higher percentage of SS/A-positive results compared to EIA (51% versus 29%) and a lower percentage of dsDNA-positive results (18% versus 28% at a cutoff of 5 IU/ml).

THE RELEVANCE OF RT-PCR TEST TO THE INFECTION WITH SARS-COV-2 VIRUS.

2021 ◽  
pp. 2-4
Author(s):  
Sujan Narayan Agrawal
Keyword(s):  
Rna Virus ◽  
High Sensitivity ◽  
Standard Test ◽  
Laboratory Method ◽  
Global Public Health ◽  
Rt Pcr ◽  
Mild Disease ◽  
Pathogenic Virus ◽  
Appropriate Treatment ◽  
Tract Infections

It is now a fact that the disease COVID-19 is caused by the virus SARC-CoV-2. This virus is a member of the Coronavridae family and Coronavirinae subfamily. It is an RNA virus. The outer surface of the virus has characteristic projections which are club-shaped or spiked. This gives virion a typical look like the solar corona hence the name coronavirus. These viruses primarily cause respiratory tract infections which may range from mild disease to lethal one. The recent outbreak caused by this virus has posed a great threat to global public health and is now declared a pandemic. It is of vital importance to have a rapid and accurate identication of the pathogenic virus. This will help in selecting appropriate treatment, saving people’s lives, and preventing its spread. The RT-PCR is regarded as the gold standard test for the molecular diagnosis of this viral infection. It has got high sensitivity and specicity. This review summarises the characteristics of the virus and the laboratory method of its detection by RT-PCR.

scholarly journals The XXL Survey

2018 ◽  
Vol 620 ◽  
pp. A18 ◽  
Author(s):  
C. H. A. Logan ◽  
B. J. Maughan ◽  
M. N. Bremer ◽  
P. Giles ◽  
M. Birkinshaw ◽  
...  
Keyword(s):  
Angular Resolution ◽  
False Positive Rate ◽  
High Sensitivity ◽  
Point Sources ◽  
Selection Function ◽  
X Rays ◽  
Cluster Emission ◽  
X Ray ◽  
Wide Range ◽  
Function Modelling

Context. The XMM-XXL survey has used observations from the XMM-Newton observatory to detect clusters of galaxies over a wide range in mass and redshift. The moderate PSF (FWHM ~ 6″ on-axis) of XMM-Newton means that point sources within or projected onto a cluster may not be separated from the cluster emission, leading to enhanced luminosities and affecting the selection function of the cluster survey. Aims. We present the results of short Chandra observations of 21 galaxy clusters and cluster candidates at redshifts z > 1 detected in the XMM-XXL survey in X-rays or selected in the optical and infra-red. Methods. With the superior angular resolution of Chandra, we investigate whether there are any point sources within the cluster region that were not detected by the XMM-XXL analysis pipeline, and whether any point sources were misclassified as distant clusters. Results. Of the 14 X-ray selected clusters, 9 are free from significant point source contamination, either having no previously unresolved sources detected by Chandra or with less than about 10% of the reported XXL cluster flux being resolved into point sources. Of the other five sources, one is significantly contaminated by previously unresolved AGN, and four appear to be AGN misclassified as clusters. All but one of these cases are in the subset of less secure X-ray selected cluster detections and the false positive rate is consistent with that expected from the XXL selection function modelling. We also considered a further seven optically selected cluster candidates associated with faint XXL sources that were not classed as clusters. Of these, three were shown to be AGN by Chandra, one is a cluster whose XXL survey flux was highly contaminated by unresolved AGN, while three appear to be uncontaminated clusters. By decontaminating and vetting these distant clusters, we provide a pure sample of clusters at redshift z > 1 for deeper follow-up observations, and demonstrate the utility of using Chandra snapshots to test for AGN in surveys with high sensitivity but poor angular resolution.

In Vitro Activity of Cefixime and Six Other Agents Against Nosocomial Pathogens of the Enterobacteriaceae Family

1987 ◽  
Vol 8 (6) ◽  
pp. 241-244 ◽  
Author(s):  
Maury E. Mulligan ◽  
Y.Y. Kwok
Keyword(s):  
Respiratory Infections ◽  
Nosocomial Pathogens ◽  
The Family ◽  
Vascular Infections ◽  
Resistant Strains ◽  
Providencia Stuartii ◽  
Tract Infections ◽  
Abdominal Infections ◽  
Orally Active

AbstractCefixime, a broad-spectrum, orally active cephalosporin, was more active in vitro than ampicillin, cefaclor, cephalothin, and trimethoprim/sulfamethoxazole against 194 nosocomial pathogens of the family Enterobacteriaceae. Activity was especially good against Klebsiella spp, Proteus spp, Serratia spp, and Providencia stuartii. Although gentamicin had equivalent or better activity against Citrobacter spp, Enterobacter spp, Escherichia coli, and Morganella morganii, all 23 of the gentamicin-resistant strains studied were susceptible to Cefixime. Isolates tested were from urinary tract infections, abdominal infections, wounds, vascular infections, and respiratory infections; they were sequentially collected nosocomial pathogens from a single institution. This orally active cephalosporin should be considered for therapy of a variety of nosocomial infections involving gram-negative bacillary pathogens.

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