1,721,002 research outputs found
EVALUATION OF THE CLINICAL PROFILE BEFORE THE ONSET OF PSYCHOSIS. a STUDY ON 296 IN-PATIENTS WITH DIAGNOSIS OF "NON-AFFECTIVE PSYCHOTIC DISORDER"
No full textA variety of symptoms are present before the onset of psychosis. More consistent efforts should be dedicated to effective prevention of psychotic onset in subjects potentially at risk
ECMM-FIMUA survey of Candida deep-seated infections in ICU patients: use of the DiversiLab for C. parapsilosis characterization in an outbreak setting
No full textIdentification of various medically important Candida species in clinical specimens by PCR-restriction enzyme analysis
Full text linkA single primer pair amplifying a cytochrome P-450 lanosterol-14α- demethylase (L1A1) gene fragment that encodes a highly conserved region was used to detect yeast DNA in clinical specimens. Positive PCR products were obtained from genomic DNAs of Candida albicans, C. parapsilosis, C. tropicalis, C. guilliermondii, C. krusei, C. (Torulopsis) glabrata, and C. kefyr. No human, bacterial, or parasitic DNA was amplified. The sensitivity was evaluated for C. albicans genomic DNA by using various DNA concentrations (200 pg to 2 fg). The amplified DNAs of Candida species with unknown P-450 L1A1 gene sequences were subcloned and sequenced. Identification at the species level was achieved by digestion of the PCR products with different restriction enzymes. A specific restriction enzyme analysis pattern was determined for each species investigated. Subsequently, we used PCR to detect specific yeast DNA directly with clinical specimens such as blood and bronchoalveolar lavage specimens. After appropriate treatment, the specimens were processed by PCR and the results were compared with those obtained by traditional diagnostic procedures such as cultures and serology. Although preliminary, the PCR results seem to correlate well, at least for blood, with those of antigen detection assays and traditional blood cultures, with a better and earlier detection of candidemia
FUSARIUM SPP, A NEW CAUSE OF CROSS-REACTIVITY WITH THE ASPERGILLUS GALACTOMANNAN ASSAY
No full textAspergillus galactomannan antigen assay (GM) using a sandwich enzyme linked immunosorbent assay (ELISA) has been a major advance for the diagnosis of invasive aspergillosis, especially in patients with haematological malignancy. The GM assay was recently included by the EORTC/MSG as a mycological criterion to define invasive aspergillosis. Cross-reaction with a large number of fungi, including yeasts, dimorphic fungi and some moulds, have been reported. Cross-reactivity of Fusarium spp in the GM assay is controversial (Kappe R et al, JCM 1993; Swanink CMA et al, JCM 1997; Cummings JR et al, DMID 2007).
The aim of the present study was to check GM results in patients with disseminated fusariosis and to test the cross-reactivity of different Fusarium spp in the GM ELISA.
Methods. A total of 12 Fusarium isolates - 2 F. oxysporum, 3 F. proliferatum, 4 F. solani species complex (FSSC) and 3 F. verticillioides - were grown in Sabouraud broth for 72 h at room temperature on a rotary shaker and the centrifuged supernatants were tested by ELISA (cutoff 0.5).
Results. Six out of eight leukaemia patients with disseminated Fusarium infection tested at least twice for GM had repeated positive GM ranging from 0.69 up to 4.4 in absence of isolation of Aspergillus spp.
All the Fusarium isolates produced positive reactions when tested with ELISA undiluted showing index values ranging from 1.49 (F. proliferatum) up to 4.14 (FSSC). Only three isolates (one F. verticillioides and two FSSC) tested positive (0.55-2.56) at the 1:100 dilution.
Conclusions. These results showed a cross-reactivity of Fusarium spp with Aspergillus GM that may constitute a drawback for the specificity of the ELISA test. Therefore a positive GM, like the presence of septate acute-angle branching hyphae in tissue and positive -D-glucan test, cannot help to reach a specific diagnosis. This may represent a crucial point for the choice of antifungal therapy and for the evaluation of treatment outcome of antifungals, such as echinocandins that were shown to be inactive in vitro against all Fusarium spp
CROSS-REACTIVITY OF FUSARIUM SPP IN THE ASPERGILLUS GALACTOMANNAN ENZYME LINKED IMMUNOSORBENT ASSAY
No full textAspergillus galactomannan antigen assay (GM) using a sandwich enzyme linked immunosorbent assay (ELISA) has been a major advance for the diagnosis of invasive aspergillosis, especially in patients with haematological malignancy. The GM assay was recently included by the EORTC/MSG as a mycological criterion to define invasive aspergillosis. Cross-reaction with a large number of fungi, including yeasts, dimorphic fungi and some moulds, have been reported. Cross-reactivity of Fusarium spp in the GM assay is controversial.The aim of the present study was to check GM results in patients with disseminated fusariosis and to test the cross-reactivity of different Fusarium spp in the GM ELISA.A total of 12 Fusarium isolates - 2 F. oxysporum, 3 F. proliferatum, 4 F. solani species complex (FSSC) and 3 F. verticillioides - were grown in Sabouraud broth for 72 h at room temperature on a rotary shaker and the centrifuged supernatants were tested by ELISA (cutoff 0.5). Six out of eight leukaemia patients with disseminated Fusarium infection tested at least twice for GM had repeated positive GM ranging from 0.69 up to 4.16 in absence of isolation of Aspergillus spp.All the Fusarium isolates produced positive reactions when tested with ELISA undiluted showing index values ranging from 1.49 (F. proliferatum) up to 4.14 (FSSC). Only three isolates (one F. verticillioides and two FSSC) tested positive (0.55-2.56) at the 1:100 dilution.These results showed a cross-reactivity of Fusarium spp with Aspergillus GM that may constitute a drawback for the specificity of the ELISA test. Therefore a positive GM, like the presence of septate acute-angle branching hyphae in tissue and positive -D-glucan test, cannot help to reach a specific diagnosis. This may represent a crucial point for the choice of antifungal therapy and for the evaluation of treatment outcome of antifungals, such as echinocandins that were shown to be inactive in vitro against all Fusarium spp
Cross-reactivity of Fusarium spp in the Aspergillus galactomannan enzyme linked immunosorbent assay
No full textNine of 11 hematological patients with disseminated/deep-seated Fusarium infection tested at least twice for Aspergillus galactomannan (GM) had repeated positive results in the absence of Aspergillus isolation in culture. The centrifuged supernatants of 12 Fusarium isolates were tested by a GM enzyme-linked immunosorbent assay (EIA). All the isolates produced positive reactions when tested undiluted. These results show cross-reactivity of Fusarium spp. with Aspergillus GM that may constitute a drawback with respect to the specificity of the Platelia EIA
Antimicrobial susceptibility profiles of Pseudomonas aeruginosa and Staphylococcus aureus isolated in Italy from patients with hospital-acquired infections.
No full textHere we report the results of the Sentinel Project 2000 and give the susceptibility to selected antibiotics of 108 Pseudomonas aeruginosa and 108 Staphylococcus aureus strains isolated from patients with hospital-acquired lower respiratory tract infections. In P. aeruginosa, susceptibility to aztreonam and ciprofloxacin was lower than 50%. The resistance rate to β-lactams was up to 25% and to amikacin 15.7%. Blood isolates showed 80–90% susceptibility to all antibiotics tested except for aztreonam and tobramycin. Overall, oxacillin resistance in S. aureus was 45%, reaching 64.3% among the bronchoalveolar lavage isolates, and 42.9% among the blood isolates. These worrying results confirm the need for continuous monitoring of bacterial resistance trends in the hospitals, mainly in ICUs
1985-2016 Geotrichum spp : nuova identificazione molecolare e studio della sensibilità in vitro
No full textLa tassonomia dei funghi filamentosi lievito-simili del genere Geotrichum ha subito negli anni numerose revisioni (Blastoschizomyces, Dipodascus ecc). Recentemente l’analisi di sequenze della regione ITS ha consentito di distinguere G. clavatum associato all’anamorfo Saprochaete clavata da G. capitatum associato a Magnusiomyces capitatus. Frequentemente le due specie vengono confuse a causa della loro somiglianza fenotipica e anche il ricorso alla biologia molecolare può essere fuorviante per la presenza di database limitati o non corretti (Desnos-Olivier 2014).
Le recenti segnalazioni in Lombardia di un numero crescente di fungemie da Geotrichum/Saprochaete/Magnusiomyces ci ha indotto ad analizzare i ceppi clinici di queste specie isolati dal 1985 al 2016 con l’obiettivo di una corretta identificazione mediante biologia molecolare e di saggiare la sensibilità in vitro agli antifungini.
Per l’identificazione molecolare il DNA genomico è stato amplificato e la regione ITS1-5.8S-ITS2 è stata sequenziata utilizzando i primers ITS1e ITS4. Le sequenze ottenute sono state confrontate con le sequenze presenti nel CBS database.
La sensibilità in vitro a 10 antifungini è stata saggiata mediante microbrododiluizione (metodica EUCAST, CLSI e YeastOne). Per saggiare l’attività di isavuconazolo è stato impiegato anche Etest.
Dei 41 ceppi, isolati ognuno da un singolo paziente, 25 sono stati identificati come M. capitatus, 15 come S. clavata e 1 come G. candidum.
Tra i 21 isolati da emocoltura è stata osservata una prevalenza di S. clavata (15 ceppi, isolati prevalentemente da pazienti ematologici e in un periodo successivo all’anno 2003) rispetto a M. capitatus (6 ceppi, isolati soprattutto da pazienti chirurgici e negli anni ’80-90). M. capitatus è risultato prevalente (19/20) tra gli isolati da altri materiali biologici, rappresentati in particolare da secrezioni respiratorie.
Le sensibilità in vitro hanno confermato la resistenza intrinseca di queste specie alle echinocandine, hanno evidenziato una buona sensibilità agli azoli itra, posa e vori. Per quanto riguarda isavuconazolo e flucitosina si evidenziano differenti pattern di sensibilità tra le due specie, S. clavata ha MIC di flucitosina inferiori e MIC di isavuconazolo superiori rispetto a M. capitatus.
Con sempre maggior frequenza sono segnalate le infezioni da Saprochaete/Magnusiomyces in particolare dall’Europa meridionale. Tuttavia risulta difficile confrontare l’eziologia data le difficoltà di identificazione.
Dall’analisi della nostra casistica emerge una differente distribuzione delle due specie (S. clavata e M. capitatus) nei differenti materiali biologici e un considerevole aumento negli anni più recenti della S. clavata da emocoltura in particolare da pazienti ematologici. La resistenza intrinseca di queste specie alle echinocandine, antifungini di sempre maggior impiego, potrebbe essere il motivo dell’emergenza di queste infezioni rare
The Sentinel Project: an update on the prevalence of antimicrobial resistance in community-acquired respiratory Streptococcus pneumoniae and Haemophilus spp. in Italy
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