Q106984303 Dotaz Zobrazit nápovědu
- Publikační typ
- abstrakt z konference MeSH
Streptococcus milleri group (SMG) is a group of three streptococcal species (S. anginosus, intermedius and constellatus) that act as opportunist pathogens, among others in cystic fibrosis. Due to their fastidious character, they are both difficult to cultivate and to differentiate from less pathogenic streptococcal species, therefore being most probably underdiagnosed. Semi-selective McKay agar and NAS agar were developed to facilitate SMG recovery from clinical samples; however, direct comparison of recovery rates has not been published yet. We tested the performance of both media on 123 patient samples and demonstrated general superiority of NAS agar for SMG recovery during primary cultivation convincingly. This observation was also confirmed by quantitative drop tests during subculture. Despite the undisputed overall superiority of NAS agar over McKay agar, a smaller fraction of strains grew better on McKay agar. Inter-strain differences were the most probable explanation. Therefore, when economic conditions are not limiting and maximum recovery rate is desirable, both plates are advised to be used in parallel for primary cultivation of clinical samples.
BACKGROUND AND AIMS: Haemophilus influenzae new strain acquisition has been demonstrated to increase the relative risk of acute exacerbation fourfold in contrast to colonisation or chronic infection by the same strain in chronic obstructive pulmonary disease (COPD). Unfortunately, molecular typing techniques are not suitable for routine use due to cost, labour-intensity and need for special expertise. We tested two techniques potentially useful for routine typing, namely the newly available MALDI-TOF MS and the modified McRAPD compared to MLST as the gold standard. METHODS: In 10 patients (10.8%) suffering from COPD or cystic fibrosis, H. influenzae isolates were recovered repeatedly at different timepoints from the same patient during the study period. This allowed for thirteen pairwise comparisons of typing results in isolates recovered consecutively from the same patient to test the ability of the techniques to uncover new strain acquisition. RESULTS: MLST detected 9 cases of new strain acquisition among the 13 pairwise comparisons. However, MALDI-TOF MS reported all 13 pairs as different and thus new. In contrast, McRAPD was able to differentiate all the new strain acquisitions from pre-existing ones, both by visual inspection of melting profiles and by Relative Significant Difference values. CONCLUSIONS: Unlike MALDI-TOF MS, McRAPD appears to be a suitable candidate for routine discrimination of new strain acquisitions because of its accuracy and, rapid, easy and economic performance.
- MeSH
- chronická obstrukční plicní nemoc diagnóza MeSH
- cystická fibróza diagnóza MeSH
- diferenciální diagnóza MeSH
- Haemophilus influenzae izolace a purifikace MeSH
- hemofilové infekce diagnóza MeSH
- lidé MeSH
- senzitivita a specificita MeSH
- spektrometrie hmotnostní - ionizace laserem za účasti matrice metody normy MeSH
- techniky typizace bakterií metody normy MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
x
x
- Klíčová slova
- prodloužená kultivace,
- MeSH
- Achromobacter izolace a purifikace MeSH
- časové faktory MeSH
- cystická fibróza * mikrobiologie MeSH
- dítě MeSH
- dospělí MeSH
- infekce dýchací soustavy * mikrobiologie MeSH
- kultivační techniky * metody MeSH
- lidé MeSH
- odběr biologického vzorku MeSH
- Pseudomonas aeruginosa izolace a purifikace MeSH
- sputum mikrobiologie MeSH
- Stenotrophomonas maltophilia izolace a purifikace MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- Publikační typ
- hodnotící studie MeSH
- práce podpořená grantem MeSH
BACKGROUND AND AIMS: S. anginosus, constellatus and intermedius, also known as the Streptococcus milleri group (SMG) are three streptococcal species more frequently detected in cases of invasive disease, abscesses and empyema in particular. Recent research suggests they play a role in exacerbations of cystic fibrosis (CF). Owing to poor recovery on standard culture media and difficult differentiation from non-pathogenic streptococci, SMG may be underdiagnosed in routine settings. We aimed to establish the incidence of SMG in chronic obstructive pulmonary disease (COPD) patients compared to CF patients and to examine possible links of SMG to exacerbations that plays a key role in progression of COPD. METHODS: Altogether, 90 respiratory tract samples of patients suffering from CF or COPD were examined during the period from July 2012 to December 2013. Semi-selective McKay agar was used for primary cultivation of SMG and MALDI TOF MS was used for species identification that was confirmed by biochemical profiling and specific PCR. RESULTS: We confirmed the presence of SMG in CF (17.6% incidence in adult patients) and newly established its presence in COPD (10.3% incidence). In COPD, SMG was detected in 4 cases of acute exacerbations, where no other bacterial pathogen was detected. In 3/4 cases, increased CRP level indicated bacterial infection as a cause of the exacerbation and in all 3 cases, patients recovered during antibiotic treatment. CONCLUSIONS: Our data indicate SMG may act as opportunist pathogens able to cause exacerbations in COPD.
- MeSH
- akutní nemoc MeSH
- chronická obstrukční plicní nemoc MeSH
- cystická fibróza mikrobiologie MeSH
- dospělí MeSH
- infekce dýchací soustavy mikrobiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- oportunní infekce mikrobiologie MeSH
- senioři MeSH
- skupina Streptococcus milleri izolace a purifikace MeSH
- sputum mikrobiologie MeSH
- streptokokové infekce mikrobiologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Bronchial asthma (BA) is chronic inflammation of the respiratory tract with a role played by a variety of cells, particularly mast cells, eosinophils (Eo), and T lymphocytes. The serum levels of Eo cationic protein (S-ECP) reflect the severity of bronchial inflammation and the level of bronchial hyperreactivity in asthma patients. One of the most important adhesion molecules is CD44. We examined S-ECP, the percentage of Eo with surface CD44 expression (EoCD44), and Eo count in the peripheral blood of newly diagnosed pediatric atopic patients with intermittent and persistent mild BA according to the Global Iniative for Asthma 2002, in a proportion of patients 3 months after initiation of montelukast therapy. Ninety-seven children with BA had their medical history taken, and S-ECP, with the percentage of EoCD44 determined by direct fluorescence from whole blood using flow cytometry with a Coulter EPICS XL cytometer, and Eo count, total serum immunoglobulin E levels (S-IgE) were determined. Therapy with montelukast (5 mg daily) was started in 23 children. Three months after the first collection, a second S-ECP level and EoCD44 count determinations were made. An inverse correlation between S-ECP and EoCD44 (-0.602; p < 0.0001) was found in the 97 children with BA. In the 23 children receiving montelukast we documented inverse correlation of fluctuation on S-ECP and EoCD44 after 3 months. These results were not significant. An inverse correlation between S-ECP and percent of EoCD44 was established in the 97 children with asthma before therapy initiation. The lower percentage of EoCD44 in peripheral blood in asthmatic children is due to Eo inflammation activity and attests to massive Eo invasion into the airways. Determination of the percentage proportion of EoCD44 is another potential indirect marker of the multiple features of Eo inflammation.
- MeSH
- acetáty aplikace a dávkování terapeutické užití MeSH
- antagonisté leukotrienů aplikace a dávkování terapeutické užití MeSH
- antigeny CD44 krev MeSH
- bronchiální astma farmakoterapie krev MeSH
- chinoliny aplikace a dávkování terapeutické užití MeSH
- dítě MeSH
- eozinofilní kationtový protein krev MeSH
- eozinofily MeSH
- imunoglobulin E krev MeSH
- lidé MeSH
- mladiství MeSH
- následné studie MeSH
- počet leukocytů MeSH
- předškolní dítě MeSH
- rozvrh dávkování léků MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
Úvod. S nárůstem obézních dětí a adolescentů přibývá pacientů s nealkoholickým ztučněním jater (NAFLD) a pacientů s prokázaným metabolickým syndromem (MS). U dětských pacientů s NAFLD jsme v retrospektivní studii sledovali jejich vztah k MS. Metody. Diagnóza NAFLD byla stanovena na základě zvýšených hladin transamináz a sonografického obrazu. MS byl definován podle kritérií Mezinárodní diabetologické federace. Jaterní biopsie byla provedena u pacientů se zvýšením transamináz déle než 1 rok. Histologická aktivita vzorků byla hodnocena podle skóre aktivity NAFLD (NAS) a podle pediatrického histologického skóre NAFLD (PNHS). Výsledky. NAFLD bylo diagnostikováno u 39 dětí a 20 dětí splnilo kritéria pro MS. Mezi pacienty s MS a bez MS byl signifikantní rozdíl ze sledovaných parametrů v inzulinové rezistenci (IR) (< 0,001), hladině cholesterolu (< 0,04) a GMT (< 0,05). Jaterní biopsie byla provedena u 20 dětí, z toho u 10 dětí s MS. U těchto souborů nebyl rozdíl v rozsahu steatózy a NAS. Nebyl nalezen rozdíl v kritériích pro MS včetně sledovaných parametrů u dětí s nealkoholickou steatohepatitidou (NASH) a bez NASH hodnocených podle PNHS. Závěr. Rizikovými faktory pro vznik NAFLD jsou obezita, přítomnost inzulinové rezistence a dyslipidémie, které se úzce váží k MS. K určení histologické aktivity NAFLD je nutná biopsie, protože žádné neinvazivní vyšetření neurčí jednoznačný rozsah jaterního postižení.
Aim. In recent years, nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS) in children have increased in line with the increased prevalence of obesity. The aim of this retrospective study was to evaluate a relation between NAFDL and MS in children. Methods. NAFLD was defined as an elevation of serum transaminase level and hyperechogenic feature of liver on ultrasonography. MS definition was based on the diagnostic criteria of the International Diabetes Federation. The biopsies were done in patients with elevated transaminase levels lasting more than one year. Liver biopsy features were graded according to the NAFLD activity scoring (NAS) and Paediatric NAFLD Histological Score (PNHS). Results. NAFLD was diagnosed in 39 patients and MS was confirmed in 20 patients. The significant differences between patients with MS and without MS were found in the insulin resistance (IR) (P < 0,001), cholesterol levels (P < 0,04) and GGT levels (P < 0,05). Biopsies were done in 20 patients. MS was present in 10 children. No difference was found in the degree of steatosis and NAS in groups with and without MS. No differences were observed in the occurrence of MS diagnostic criteria between patients with and without nonalcoholic steatohepatitis which were evaluated by PNHS. Conclusion. Prediction factors for NAFLD are obesity, IR, dyslipidemia. NAFLD is frequently associated with MS. Liver biopsy is necessary for determination of NAFLD histological activity because no non-invasive examination defines the degree of liver pathology.
- Klíčová slova
- nealkoholické ztučnění jater, portální zánět, nealkoholická steatohepatitida,
- MeSH
- biopsie MeSH
- dítě MeSH
- dyslipidemie * MeSH
- gama-glutamyltransferasa krev MeSH
- HDL-cholesterol krev MeSH
- index tělesné hmotnosti MeSH
- inzulinová rezistence * MeSH
- játra patologie MeSH
- krevní tlak MeSH
- lidé MeSH
- metabolický syndrom * diagnóza komplikace MeSH
- mladiství MeSH
- nemoci jater diagnóza epidemiologie MeSH
- obezita * MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- statistika jako téma MeSH
- transaminasy krev MeSH
- ztučnělá játra * diagnóza komplikace patologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
Autoři popisují dvě dívky kojeneckého věku s atypickou tříselnou kýlou. Kýlní vak obsahoval vaječník. Diagnóza byla provedena na základě fyzikálního a sonografického vyšetření a byla potvrzena v průběhu chirurgické korekce. Autoři doporučují ultrazvukové vyšetření jako součást diagnostického procesu u (nezralých) dívek kojeneckého věku s atypickou tříselnou kýlou.
The authors describe two female infants with atypical ingiunal hernia. The hernial sac contained ovary. The diagnosis was made by physical and sonographic examination amd was confirmed during surgical correction. The authors suggest sonography in the diagnostic workup in (premature) female infants with atypical inguinal hernia. radiology.
- Klíčová slova
- hernia inguinalis, tříselná kýla, vaječník, tříselná kýla s vaječníkem, dětství, pediatrická radiologie,
- MeSH
- dítě MeSH
- inguinální hernie chirurgie komplikace ultrasonografie MeSH
- kojenec MeSH
- lidé MeSH
- ovarium ultrasonografie MeSH
- ultrasonografie dopplerovská využití MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- Publikační typ
- kazuistiky MeSH
