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1.
R. Zaidenstein C. Peretz I. Nissan A. Reisfeld S. Yaron V. Agmon M. Weinberger 《European journal of clinical microbiology & infectious diseases》2010,29(9):1103-1109
Extraintestinal disease occurs in 5–8% of non-typhoid Salmonella enterica (NTS) infections and is more likely to be associated with hospitalization and death. The study examined the epidemiology
of extraintestinal NTS infections in Israel and the possible effects of patients’ age and sex. NTS isolates passively submitted
to the National Salmonella Reference Center during 1996–2006 were the source for the study cohort. Poisson regression models were used to assess incidence
trends over the study years and to evaluate the effects of patients’ age and sex on the incidence of extraintestinal NTS manifestations.
A total of 36,822 stool and 1,415 (3.7%) patient-unique NTS isolates from blood (74.1%), urine (18.3%), and other sources
(3.7%) were studied. Serotypes Enteritidis, Virchow, and Typhimurium accounted for 66.3% of the isolates. Analysis showed
a highly significant quadratic (U-shaped) relationship between patients’ age and the incidence of extraintestinal isolation
(p < 0.001), with increasing risk in the two extremes of age. Differences between the incidence of blood and urine sources were
significant in patients <10 and ≥60 years old (relative risk [RR] = 5.88, 95% confidence interval [CI] 3.36–10.30, p < 0.001 and RR = 1.66, 95% CI 1.09–2.53, p = 0.017, respectively). Males ≥60 years of age were more likely than females of the same age to have bacteremia (RR = 1.90,
95% CI 1.39–2.61, p > 0.001) and less likely to have urinary NTS isolation (RR = 0.50, 95% CI 0.28–0.89, p = 0.018). Serotype Virchow had the highest incidence in patients <10 years of age, while serotype Enteritidis had the highest
incidence in patients ≥60 years old. The study revealed a complex effect of patients’ age and sex on the epidemiology of extraintestinal
NTS manifestations. 相似文献
2.
Prognostic value of procalcitonin in <Emphasis Type="Italic">Legionella</Emphasis> pneumonia 总被引:1,自引:0,他引:1
J. Haeuptle R. Zaborsky R. Fiumefreddo A. Trampuz I. Steffen R. Frei M. Christ-Crain B. Müller P. Schuetz 《European journal of clinical microbiology & infectious diseases》2009,28(1):55-60
The diagnostic reliability and prognostic implications of procalcitonin (PCT) (ng/ml) on admission in patients with community-acquired
pneumonia (CAP) due to Legionella pneumophila are unknown. We retrospectively analysed PCT values in 29 patients with microbiologically proven Legionella-CAP admitted to the University Hospital Basel, Switzerland, between 2002 and 2007 and compared them to other markers of infection,
namely, C-reactive protein (CRP) (mg/l) and leukocyte count (109/l), and two prognostic severity assessment scores (PSI and CURB65). Laboratory analysis demonstrated that PCT values on admission
were >0.1 in over 93%, >0.25 in over 86%, and >0.5 in over 82% of patients with Legionella-CAP. Patients with adverse medical outcomes (59%, n = 17) including need for ICU admission (55%, n = 16) and/or inhospital mortality (14%, n = 4) had significantly higher median PCT values on admission (4.27 [IQR 2.46–9.48] vs 0.97 [IQR 0.29–2.44], p = 0.01), while the PSI (124 [IQR 81–147] vs 94 [IQR 75–116], p = 0.19), the CURB65 (2 [IQR 1–2] vs 1 [1–3], p = 0.47), CRP values (282 [IQR 218–343], p = 0.28 vs 201 [IQR 147–279], p = 0.28), and leukocyte counts (12 [IQR 10–21] vs 12 [IQR 9–15], p = 0.58) were similar. In receiver operating curves, PCT concentrations on admission had a higher prognostic accuracy to predict
adverse outcomes (AUC 0.78 [95%CI 0.61–96]) as compared to the PSI (0.64 [95%CI 0.43–0.86], p = 0.23), the CURB65 (0.58 [95%CI 0.36–0.79], p = 0.21), CRP (0.61 [95%CI 0.39–0.84], p = 0.19), and leukocyte count (0.57 [95%CI 0.35–0.78], p = 0.12). Kaplan-Meier curves demonstrated that patients with initial PCT values above the optimal cut-off of 1.5 had a significantly
higher risk of death and/or ICU admission (log rank p = 0.003) during the hospital stay. In patients with CAP due to Legionella, PCT levels on admission might be an interesting predictor for adverse medical outcomes.
Jeannine Haeuptle, Roya Zaborsky, and Rico Fiumefreddo contributed equally to this article. 相似文献
3.
Y. Bitterman A. Laor S. Itzhaki G. Weber 《European journal of clinical microbiology & infectious diseases》2010,29(4):391-397
The purpose of this study was to identify differences in the sensitivity of anatomical sites sampling for methicillin-resistant
Staphylococcus aureus (MRSA) colonization related to age, gender, clinical situation, and acquisition source as a base for screening protocols.
We used a database that included all MRSA-positive cultures (Carmel Medical Center, 2003–2006) taken from nares, throat, perineum,
and infection sites. The study population of 597 patients was divided into: “screening sample” (SS), which were cases of routine
screening, and “clinical diagnostic sample” (CDS), which were patients with concurrent MRSA infection. MRSA acquisition sources
were classified as internal medicine, surgical, referral patients, or intensive care unit (ICU). CDS patients were older than
SS patients (median age 78 vs. 74 years, p = 0.0002), more commonly throat colonized (47.5% vs. 31.8%, p = 0.0001), and colonized in more multiple sites (65.7% vs. 43.3% were colonized in three sites in the CDS and SS groups,
respectively, p < 0.001) than SS patients. In the SS, group throat colonization was higher in internal medicine wards than in the ICU (odds
ratio [OR] = 3.98, p < 0.0001). In the CDS group, perineal colonization was more common in referral patients than in the ICU (OR = 4.52, p < 0.05). Patient age was the most influential factor on nares and multiple sites colonization in the SS and CDS groups, respectively.
Our data support multiple sites sampling. Throat cultures are crucial in MRSA-infected patients and internal medicine ward
patients. Multiple body sites colonization is more likely in older or MRSA-infected patients, affecting decisions regarding
eradication using topical antibiotics. 相似文献
4.
Fungal colonization and/or infection in non-neutropenic critically ill patients: results of the EPCAN observational study 总被引:1,自引:0,他引:1
C. León F. álvarez-Lerma S. Ruiz-Santana M. á. León J. Nolla R. Jordá P. Saavedra M. Palomar The EPCAN Study Group 《European journal of clinical microbiology & infectious diseases》2009,28(3):233-242
The purpose of this paper is to determine the incidence of fungal colonization and infection in non-neutropenic critically
ill patients and to identify factors favoring infection by Candida spp. A total of 1,655 consecutive patients (>18 years of age) admitted for ≥7 days to 73 medical-surgical Spanish intensive
care units (ICUs) participated in an observational prospective cohort study. Surveillance samples were obtained once a week.
One or more fungi were isolated in different samples in 59.2% of patients, 94.2% of which were Candida spp. There were 864 (52.2%) patients with Candida spp. colonization and 92 (5.5%) with proven Candida infection. In the logistic regression analysis risk factors independently associated with Candida spp. infection were sepsis (odds ratio [OR] = 8.29, 95% confidence interval [CI] 5.07–13.6), multifocal colonization (OR = 3.49,
95% CI 1.74–7.00), surgery (OR = 2.04, 95% CI 1.27–3.30), and the use of total parenteral nutrition (OR = 4.37, 95% CI 2.16–8.33).
Patients with Candida spp. infection showed significantly higher in-hospital and intra-ICU mortality rates than those colonized or non-colonized
non-infected (P < 0.001). Fungal colonization, mainly due to Candida spp., was documented in nearly 60% of non-neutropenic critically ill patients admitted to the ICU for more than 7 days. Proven
candidal infection was diagnosed in 5.5% of cases. Risk factors independently associated with Candida spp. infection were sepsis, multifocal colonization, surgery, and the use of total parenteral nutrition. 相似文献
5.
Chen CY Sheng WH Lai CC Liao CH Huang YT Tsay W Huang SY Tang JL Tien HF Hsueh PR 《European journal of clinical microbiology & infectious diseases》2012,31(6):1059-1066
We retrospectively analyzed the clinical and microbiological characteristics of adult patients with hematological malignancy
and nontuberculous mycobacteria (NTM) infections from 2001 to 2010. During the study period, 50 patients with hematological
malignancy and tuberculosis (TB) were also evaluated. Among 2,846 patients with hematological malignancy, 34 (1.2%) patients
had NTM infections. Mycobacterium avium-intracellulare complex (13 patients, 38%) was the most commonly isolated species, followed by M. abscessus (21%), M. fortuitum (18%), and M. kansasii (18%). Twenty-six patients had pulmonary NTM infection and eight patients had disseminated disease. Neutropenia was more
frequently encountered among patients with disseminated NTM disease (p = 0.007) at diagnosis than among patients with pulmonary disease only. Twenty-five (74%) patients received adequate initial
antibiotic treatment. Five of the 34 patients died within 30 days after diagnosis. Cox regression multivariate analysis showed
that chronic kidney disease (p = 0.017) and neutropenia at diagnosis (p = 0.032) were independent prognostic factors of NTM infection in patients with hematological malignancy. Patients with NTM
infection had higher absolute neutrophil counts at diagnosis (p = 0.003) and a higher 30-day mortality rate (15% vs. 2%, p = 0.025) than TB patients. Hematological patients with chronic kidney disease and febrile neutropenia who developed NTM infection
had significant worse prognosis than patients with TB infection. 相似文献
6.
T. M?lk?nen E. Ruotsalainen C. W. Thorball A. J?rvinen 《European journal of clinical microbiology & infectious diseases》2011,30(11):1417-1424
The soluble form of urokinase-type plasminogen activator receptor (suPAR) is a new inflammatory marker. High suPAR levels
have been shown to associate with mortality in cancer and in chronic infections like HIV and tuberculosis, but reports on
the role of suPAR in acute bacteremic infections are scarce. To elucidate the role of suPAR in a common bacteremic infection,
the serum suPAR levels in 59 patients with Staphylococcus aureus bacteremia (SAB) were measured using the suPARnostic™ ELISA assay and associations to 1-month mortality and with deep infection
focus were analyzed. On day three, after the first positive blood culture for S. aureus, suPAR levels were higher in 19 fatalities (median 12.3; range 5.7–64.6 ng/mL) than in 40 survivors (median 8.4; range 3.7–17.6 ng/mL,
p = 0.002). This difference persisted for 10 days. The presence of deep infection focus was not associated with elevated suPAR
levels as compared to patients with no deep infection focus. suPAR was found to be prognostic for mortality in receiver operator
characteristic (ROC) curve analysis, which was not observed for serum C-reactive protein (CRP); the area under the curve (AUC)
for suPAR was 0.754 (95% confidence interval [CI], 0.615–0.894, p = 0.003) and for CRP, it was 0.596 (95% CI, 0.442–0.750, p = 0.253). The optimal suPAR cut-off value in predicting 1-month mortality was 9.25 ng/mL. In conclusion, our study demonstrates
that the new promising biomarker, serum suPAR concentration, was able to predict mortality in SAB. 相似文献
7.
G. Aisenberg K. V. Rolston B. F. Dickey D. P. Kontoyiannis I. I. Raad A. Safdar 《European journal of clinical microbiology & infectious diseases》2007,26(1):13-20
In order to elucidate the spectrum of Stenotrophomonas maltophilia pneumonia in cancer patients without traditional risk factors, 44 cancer patients (cases) with S. maltophilia pneumonia in whom S. maltophilia pneumonia risk factors were not present were compared with two S. maltophilia pneumonia risk groups (controls) including 43 neutropenic non-intensive care unit (ICU) and 21 non-neutropenic ICU patients.
The case and control patients had similar demographic and underlying clinical characteristics. Compared with case patients
with S. maltophilia pneumonia, neutropenic patients had higher exposure to carbapenem antibiotics (58 vs. 41%; p < 0.03), more frequent hematologic malignancy (95 vs. 64%; p < 0.0003), and they presented with concurrent bacteremia more often (23 vs. 0%; p < 0.0005). Patients with S. maltophilia pneumonia in the ICU needed vasopressor therapy more frequently than cases (62 vs. 5%; p < 0.0001). Hospital-acquired S. maltophilia pneumonia was more common among controls than cases (98 vs. 61%; p < 0.000002). Among the cases, 15 (34%) received outpatient oral antimicrobial therapy, while 29 were hospitalized and eight
(28%) were subsequently admitted to the ICU. The mean duration of ICU stay, even among these eight patients (19 ± 40 days),
was comparable to that of patients with neutropenia (23 ± 26 days) and those who developed S. maltophilia pneumonia during their ICU stay (34 ± 22 days; p = 0.46). The overall infection-associated mortality in the 108 patients with S. maltophilia pneumonia was 25%. Twenty percent of patients without traditional risk factors for S. maltophilia pneumonia died due to progressive infection. In a multivariate logistic regression analysis, only admission to the ICU predicted
death (odds ratio 33; 95% confidence interval, 4.51–241.2; p < 0.0006). The results of this study indicate S. maltophilia pneumonia is a serious infection even in non-neutropenic, non-ICU patients with cancer.
This work was presented in part at the 15th European Congress of Clinical Microbiology and Infectious Diseases, Copenhagen,
Denmark, April 2–5, 2005 (abstract no P1374) and at the 45th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy,
Washington D.C., December 16–19, 2005 (abstract no K-1535). 相似文献
8.
Alagarasu K Selvaraj P Swaminathan S Narendran G Narayanan PR 《Journal of clinical immunology》2009,29(2):196-204
Introduction Vitamin D receptor (VDR) gene polymorphisms in the 5′ regulatory region (Cdx2 and A-1012G), coding region (FokI), and 3′ untranslated region (UTR; BsmI, ApaI, and TaqI) were studied to find out whether these polymorphisms are associated with susceptibility to or protection against HIV-1
and development of tuberculosis (TB) in human immunodeficiency virus (HIV)-1-infected patients.
Study Subjects and Methods The study was carried out in 131 HIV patients without TB (HIV+ TB−) and 113 HIV patients with TB (HIV+ TB+; includes 82 patients
with pulmonary TB (HIV+ PTB+) and 31 with extra pulmonary TB), 108 HIV-negative pulmonary TB patients (HIV− PTB+), and 146
healthy controls.
Results Among the 5′ regulatory and coding region polymorphisms, significantly increased frequency of G/A genotype of Cdx-2 was observed
in HIV+ TB− group compared to controls (p = 0.012, odds ratio (OR) 1.89 95% confidence interval (CI) 1.14–3.15). In the 3′ UTR genotypes, a decreased frequency of
b/b genotype of BsmI in total HIV patients (p = 0.014, OR 0.54 95% CI 0.32–0.89) and increased frequencies of A/A genotype of ApaI in HIV+ TB+ patients (p = 0.041, OR 1.77 95% CI 1.02–3.06) and t/t genotype of TaqI in HIV+ PTB+ patients (p = 0.05, OR 2.32 95% CI 0.99–5.46) were observed compared to controls. Haplotype analysis revealed significantly increased
frequencies of 3′ UTR haplotype B-A-t in HIV+ TB+ and HIV+ PTB+ groups (Pc = 0.030, OR 1.75 95% CI 1.14–2.66) and decreased
frequencies of b-A-T haplotype in total HIV patients (Pc = 0.012, OR 0.46 95% CI 0.27–0.77), HIV+ TB− (p = 0.031 OR 0.48 95% CI 0.25–0.89), and HIV+ PTB+ groups (Pc = 0.04, OR 0.47 95% CI 0.23–0.89) compared to controls.
Conclusions The results suggest that VDR gene 3′ UTR haplotype b-A-T may be associated with protection against HIV infection while B-A-t
haplotype might be associated with susceptibility to development of TB in HIV-1-infected patients. 相似文献
9.
S. F. L. van Lelyveld C. M. Wind T. Mudrikova H. J. van Leeuwen D. W. de Lange A. I. M. Hoepelman 《European journal of clinical microbiology & infectious diseases》2011,30(9):1085-1093
The purpose of this investigation was to analyse the impact of the availability of highly active antiretroviral therapy (HAART)
on the long-term outcome of human immunodeficiency virus (HIV)-infected patients admitted to the intensive care unit (ICU).
A retrospective cohort study of HIV-infected patients admitted to the ICU was undertaken. Outcomes in the pre-HAART era (1990–June
1996), early- (July 1996–2002), and recent-HAART (2003–2008) periods and total HAART era (July 1996–2008) were analysed and
compared with those reported of the general population. A total of 127 ICU admissions were included. The 1-year mortality
decreased from 71% in the pre-HAART era to 50% in the recent-HAART period (p = 0.06). The 5-year mortality decreased from 87% in the pre-HAART era to 59% in the early-HAART period (p = 0.005). Independent predictors of 1-year mortality in the HAART era were age (odds ratio [OR] = 1.16 [95% confidence interval
[CI] = 1.06–1.27]), APACHE II score > 20 (6.04 [1.25–29.22]) and mechanical ventilation (40.01 [3.01–532.65]). The 5-year
survival after hospitalisation was 80% and in the range of the reported survival of non-HIV-infected patients (83.7%). Predictors
of 1-year mortality for HIV patients admitted to the ICU in the HAART era were all non-HIV-related. Short- and long-term outcome
has improved since the introduction of HAART and is comparable to the outcome data in non-HIV-infected ICU patients. 相似文献
10.
M.-S. Hsu C.-H. Liao Y.-T. Huang C.-Y. Liu C.-J. Yang K.-L. Kao P.-R. Hsueh 《European journal of clinical microbiology & infectious diseases》2011,30(10):1271-1278
A total of 118 patients with Elizabethkingia meningoseptica bacteremia at a medical center in Taiwan from 1999 to 2006 were studied. Minimum inhibitory concentrations (MICs) of 99 preserved
isolates were determined. The incidence (per 100,000 admissions) of E. meningoseptica bacteremia increased from 7.5 in 1996 to 35.6 in 2006 (p = 0.006). Among them, 84% presented with fever, 86% had nosocomial infections, and 60% had acquired the infection in intensive
care units (ICUs). The most common underlying diseases were malignancy (36%) and diabetes mellitus (25%). Seventy-eight percent
of patients had primary bacteremia, followed by pneumonia (9%), soft tissue infection, and catheter-related bacteremia (6%).
Forty-five patients (38%) had polymicrobial bacteremia. Overall, the 14-day mortality was 23.4%. Multivariate analysis revealed
E. meningoseptica bacteremia acquired in an ICU (p = 0.048, odds ratio [OR] 4.23) and presence of effective antibiotic treatment after the availability of culture results (p = 0.049, OR 0.31) were independent predictors of 14-day mortality. The 14-day mortality was higher among patients receiving
carbapenems (p = 0.046) than fluoroquinolones or other antimicrobial agents. More than 80% of the isolates tested were susceptible to trimethoprim-sulfamethoxzole,
moxifloxacin, and levofloxacin. The MIC50 and MIC90 of the isolates to tigecycline and doxycycline were both 4 μg/mL and 8 μg/ml, respectively. 相似文献
11.
Ramani P Dungwa JV May MT 《Virchows Archiv : an international journal of pathology》2012,460(2):183-191
Neuroblastoma (NB) accounts for 15% of all childhood cancer deaths. The majority of patients have widespread lymphatic and/or
haematogenous metastases at diagnosis, but lymphangiogenesis has not been well documented. Sixty-seven NBs were immunostained
for the lymphatic endothelial marker, LYVE-1, and the lymphatic density (LD) and lymphatic invasion (LI), were counted in
LYVE-1-expressing lymphatics. LYVE-1-stained lymphatic vessels and LI were present in 26/67 (39%) and 14/67 (21%) of the NBs,
respectively. Central LD (CLD) and LI were higher in NBs from stage 4 (p = 0.012, p = 0.004, respectively), high-risk group (p = 0.030, p = 0.002), NBs with high mitosis karyorrhexis index (MKI) (p = 0.011, p = 0.005), unfavourable histology group (p = 0.040, p = 0.017) and distant lymph node metastasis (LNM) (p < 0.001 for each). Marginal LD (MLD) was higher in patients with LNM (p < 0.001). CLD and MLD correlated with LI (p < 0.001 each). Total LYVE-1 protein levels, quantified by a sensitive enzyme-linked immunosorbent assay (n = 55), were also higher in NBs from patients with stage 4 disease (p = 0.046), high-risk group (p = 0.028), MYCN-amplified NBs (p = 0.034) and LNM (p = 0.038). Kaplan–Meier analysis showed that the presence of CLD was associated with both worse OS at 5 years (77% [95% CI:
62–87%] versus 60% [95% CI: 32–80%], p = 0.062) and EFS (74% [95% CI: 58–85%] versus 43% [95% CI: 15–69%], p = 0.070) and LI with OS (71% [95% CI: 57–81%] versus 56% [95% CI: 26–78%], p = 0.055). Significant upregulation of LYVE-1 and the presence of LI in patients with stage 4 and high-risk disease, MYCN-amplification and LNM suggests that LYVE-1 may have value as predictors of outcome. 相似文献
12.
T.-X. Nhan R. Leclercq V. Cattoir 《European journal of clinical microbiology & infectious diseases》2011,30(6):719-725
Even if Panton–Valentine leukocidin (PVL), toxic shock syndrome toxin-1 (TSST-1), staphylococcal enterotoxins (SEB and SEC),
and exfoliative toxins (ETA and ETB) may be associated with severe infections, the clinical significance of their presence
in clinical isolates of Staphylococcus aureus remains poorly documented. In this study, we evaluated the prevalence of toxin genes and the relationship between their presence
and the severity of infection. We screened for the presence of these six toxin genes among 186 consecutive S. aureus clinical isolates (resistant or not to methicillin) during a two-month period. We compared the toxin gene profile between
strains recovered from patients presenting uncomplicated infections (n = 151) and from patients suffering from severe infections (n = 35). At least one toxin gene was detected in 55 (29.6%) isolates as follows: pvl (n = 1), tst + sec (n = 5), seb (n = 19), seb + sec (n = 1), sec (n = 28), and eta (n = 1). The proportion of toxin-producing strains among patients with uncomplicated infections (27.8%) and patients with severe
infections (37.1%) was not statistically different (p = 0.3044), even if the severity of infection tended to be associated with the presence of sec (p = 0.0655). Although the prevalence of toxin genes was relatively high herein, no statistically significant association between
the severity of infection and the presence of toxin genes was observed. 相似文献
13.
D. Viasus C. Gudiol N. Fernández-Sabé I. Cabello C. Garcia-Vidal M. Cisnal R. Duarte M. Antonio J. Carratalà 《European journal of clinical microbiology & infectious diseases》2011,30(1):77-82
Although it has been suggested that statins have a beneficial effect on the outcome of bloodstream infection (BSI) in immunosuppressed
patients, prospective studies testing this hypothesis are lacking. We performed an observational analysis of consecutive cancer
patients and transplant recipients hospitalized at two tertiary hospitals in Spain (2006–2009). The first episode of BSI occurring
in statin users was compared with those occurring in non-statin users. During the study period, 668 consecutive episodes of
BSI in 476 immunosuppressed patients were recorded. Underlying diseases were solid tumor (46.2%), hematologic malignancy (35.1%),
and transplantation (18.7%). Fifty-nine (12.4%) patients were receiving statins at the onset of BSI. Comparing with statin
non-users, patients on statin treatment were older (67.3 vs. 58.7 years; p < 0.001) and had higher frequency of comorbidities (74.6% vs. 40.6%; p < 0.001). There were no significant differences in intensive care unit admission (6.8% vs. 7.7%; p = 1) and overall mortality (15.3% vs. 24%; p = 0.13) between groups. In a multivariate analysis, prior statin use was not associated with increased survival (odds ratio
[OR], 0.52; 95% confidence interval [CI], 0.22–1.23; p = 0.14). In conclusion, prior statin use is not associated with increased survival in immunosuppressed patients with BSI.
Caution is warranted in attributing beneficial effects to statin use in infections among immunocompromised patients. 相似文献
14.
O. Santiago J. Gutierrez A. Sorlozano J. de Dios Luna E. Villegas O. Fernandez 《European journal of clinical microbiology & infectious diseases》2010,29(7):857-866
Numerous studies have been carried out to determine whether infection by the Epstein-Barr virus (EBV) can be considered as
a risk factor for multiple sclerosis (MS). This work is a meta-analysis of case–control observational studies published before
January 2009 aimed at assessing the degree of association between EBV and MS infections. A Medline electronic database search
was carried out using “Epstein-Barr virus” and “multiple sclerosis” as keywords, from which we selected 30 published studies
that met our methodology criteria. We found an association between MS and an exposure to EBV, studied by determining the anti-VCA
IgG antibodies (odds ratio [OR] = 5.5; 95% confidence interval [CI] = 3.37–8.81; p < 0.0001), anti-complex EBNA IgG (OR = 5.4; 95% CI = 2.94–9.76; p < 0.0001) and anti-EBNA-1 IgG (OR = 12.1; 95% CI = 3.13–46.89; p < 0.0001). No significant association could be found when studying anti-EA IgG (OR = 1.3; 95% CI = 0.68–2.35; p = 0.457), EBV DNA in serum (OR = 1.8; 95% CI = 0.99–3.36; p = 0.051) and DNA in brain tissues and in cerebrospinal fluid (CSF) (OR = 0.9; 95% CI = 0.38–2.01; p = 0.768). This meta-analysis detected an association between infection by EBV and MS through the investigation of antibodies,
mainly anti-EBNA-1, anti-complex EBNA and anti-VCA IgG. 相似文献
15.
B. Quintero M. Araque C. van der Gaast-de Jongh F. Escalona M. Correa S. Morillo-Puente S. Vielma P. W. M. Hermans 《European journal of clinical microbiology & infectious diseases》2011,30(1):7-19
Streptococcus pneumoniae and Staphylococcus aureus cause significant morbidity and mortality worldwide. We investigated both the colonization and co-colonization characteristics
for these pathogens among 250 healthy children from 2 to 5 years of age in Merida, Venezuela, in 2007. The prevalence of S. pneumoniae colonization, S. aureus colonization, and S. pneumoniae–S. aureus co-colonization was 28%, 56%, and 16%, respectively. Pneumococcal serotypes 6B (14%), 19F (12%), 23F (12%), 15 (9%), 6A (8%),
11 (8%), 23A (6%), and 34 (6%) were the most prevalent. Non-respiratory atopy was a risk factor for S. aureus colonization (p = 0.017). Vaccine serotypes were negatively associated with preceding respiratory infection (p = 0.02) and with S. aureus colonization (p = 0.03). We observed a high prevalence of pneumococcal resistance against trimethoprim–sulfamethoxazole (40%), erythromycin
(38%), and penicillin (14%). Semi-quantitative measurement of pneumococcal colonization density showed that children with
young siblings and low socioeconomic status were more densely colonized (p = 0.02 and p = 0.02, respectively). In contrast, trimethoprim–sulfamethoxazole- and multidrug-resistant-pneumococci colonized children
sparsely (p = 0.03 and p = 0.01, respectively). Our data form an important basis to monitor the future impact of pneumococcal vaccination on bacterial
colonization, as well as to recommend a rationalized and restrictive antimicrobial use in our community. 相似文献
16.
G. Dimopoulos A. Karabinis G. Samonis M. E. Falagas 《European journal of clinical microbiology & infectious diseases》2007,26(6):377-384
The purpose of this study was to compare the risk factors, clinical manifestations, and outcome of candidemia in immunocompromised
(IC) and nonimmunocompromised (NIC) critically ill patients. Data were collected prospectively over a 2-year period (02/2000–01/2002)
from patients in a 25-bed, medical–surgical intensive care unit (ICU). Eligible for participation in this study were patients
who developed candidemia during their ICU stay. Patients under antifungal therapy and with a confirmed systemic fungal infection
prior to the diagnosis of candidemia were excluded. Cultures of blood, urine, and stool were performed for all patients in
the study, and all patients underwent endoscopy/biopsy of the esophagus for detection of Candida. Smears and/or scrapings of oropharyngeal and esophageal lesions were examined for hyphae and/or pseudohyphae and were also
cultured for yeasts. During the study period, 1,627 patients were hospitalized in the ICU, 57% for primary medical reasons
and 43% for surgical reasons. After application of the study’s inclusion and exclusion criteria, 24 patients with candidemia
(9 IC and 15 NIC) were analyzed. Total parenteral nutrition was more common in IC than in NIC patients (9/9 [100%] vs 8/15
[53%], p = 0.02). Oropharyngeal candidiasis was detected in 5 of 9 (55.5%) IC patients and in 1 of 15 (6.5%) NIC patients (p = 0.015). Esophageal candidiasis was also more common in IC than in NIC patients (4/9 [44%] vs 0/15 [0%], p = 0.012). Among the 9 IC patients, all except 2 died, resulting in a crude mortality of 78%; among the 15 NIC patients, 9
died, resulting in a crude mortality of 60% (p > 0.05). Autopsy was performed in two IC and in six NIC patients, with disseminated candidiasis found in one IC patient.
Oropharyngeal and esophageal candidiasis are frequent in IC patients with candidemia. In contrast, this coexistence is rare
in NIC critically ill patients with Candida bloodstream infections. A high mortality was noted in both IC and NIC critically ill patients with candidemia. 相似文献
17.
I. Suárez-García A. Rodríguez-Blanco J. L. Vidal-Pérez M. A. García-Viejo M. J. Jaras-Hernández O. López A. Noguerado-Asensio 《European journal of clinical microbiology & infectious diseases》2009,28(4):325-330
The setting for this retrospective cohort study was a specialised tuberculosis unit in Madrid, Spain. The objective was to
describe the risk factors for multidrug-resistant tuberculosis (MDR-TB). The medical records of all patients admitted to the
unit were reviewed retrospectively to identify factors associated with multidrug resistance. Patients with positive culture
for M. tuberculosis and with available drug-susceptibility tests were included. The variables assessed were age, gender, country of origin, homelessness,
alcohol consumption, intravenous drug use, methadone substitution therapy, contact with a tuberculosis patient, sputum smear,
site of disease, previous tuberculosis treatment, HIV infection, history of imprisonment, diabetes mellitus and chronic obstructive
pulmonary disease. Thirty patients with MDR-TB and 666 patients with non-MDR-TB were included from the years 1997 to 2006.
The only factors associated with MDR-TB in multivariate analysis were previous tuberculosis treatment (OR: 3.44; 95% CI: 1.58–7.50;
p = 0.003), age group 45–64 years (OR: 3.24; 95% CI: 1.34–7.81; p = 0.009) and alcohol abuse (OR: 0.12; 95% CI: 0.03 to 0.55; p = 0.003). In our study, patients who had had previous treatment for tuberculosis, who were 45–64 years of age or who had
no history of alcohol abuse were more likely to have MDR-TB. 相似文献
18.
D. Bendayan A. Hendler V. Polansky M. Weinberger 《European journal of clinical microbiology & infectious diseases》2011,30(3):375-379
MDR-TB has emerged in Israel following an immigrations wave from the Former Soviet Union (FSU) and Ethiopia. The purpose of
this study was to outline characteristics and outcome of hospitalized MDR-TB patients. We retrospectively summarized charts
of MDR-TB patients hospitalized in the national referral tuberculosis centers from January 2000 to December 2005, and followed
them for 2 years. One hundred thirty-two patients were identified with a median age of 40 years and male predominance (77%).
The majority of the patients were immigrants from FSU (83%) and Ethiopia (7.6%). They were characterized by alcohol (25.8%)
and IV drug abuse (23.5%), presented with advanced disease manifested by hypoalbuminemia (50.8%) and smear positivity (70.5%).
Cure was achieved in 50.3% and 30.4% died. Factors independently associated with death were patients’ age (OR = 1.036 for
each year, 95%CI 1.0–1.1, p = 0.014), hypoalbuminemia (OR = 2.95, 95%CI 1.1–7.6, p = 0.025), smear positivity at diagnosis (OR = 3.7, 95%CI 1.2–11.4, p = 0.023), alcohol abuse (OR = 4.8, 95%CI 1.7–13.7, p = 0.004) and XDR-TB resistance pattern (OR 8.3, 95%CI 1.5–44.6, p = 0.014). This study brings out the poor prognosis of a highly vulnerable immigration population. Efforts should be focused
on earlier diagnosis and treatment in a well controlled hospital environment and to professional support groups to attend
to this population’s special needs. 相似文献
19.
C. Maoz D. Shitrit Z. Samra N. Peled L. Kaufman M. R. Kramer J. Bishara 《European journal of clinical microbiology & infectious diseases》2008,27(10):945-950
To identify the clinical and radiological features distinguishing Mycobacterium simiae respiratory infection from pulmonary tuberculosis, the demographics, underlying conditions, and clinical and radiological
findings of 121 consecutive patients with pulmonary tuberculosis and 102 with M. simiae respiratory infection were compared retrospectively. In the M. simiae group, the patients were older (mean age 69 ± 16 years vs. 47 ± 21 years, p = 0.0001), with a female predominance (62% vs. 45%, p = 0.008). Only 4% were of Ethiopian origin compared to 25% of the tuberculosis group (p = 0.0001). M. simiae infection was associated with significantly higher rates of smoking history, underlying chronic obstructive pulmonary disease,
zero human immunodeficiency virus (HIV) infection compared to 10% in the tuberculosis group (p = 0.001), blunted symptoms, and noncavitary infiltrates in the lower/middle lobes on chest X-ray. HIV-negative patients with
M. simiae respiratory infection are distinguishable from patients with pulmonary tuberculosis by several demographic, clinical, and
radiological features. These findings have important diagnostic and therapeutic implications. 相似文献
20.
J. Benito-León D. Pisa R. Alonso P. Calleja M. Díaz-Sánchez L. Carrasco 《European journal of clinical microbiology & infectious diseases》2010,29(9):1139-1145
Candida infection among multiple sclerosis (MS) patients has not been studied in depth. We determined whether there is an
association between serological evidence of Candida infection and MS. Blood specimens were obtained from 80 MS patients and
240 matched controls. Immunofluorescence analysis and ELISA were used to detect Candida species antibodies and slot-blot to
detect antigens. Using immunofluorescence analysis, moderate to high concentrations of serum antibodies to Candida famata
were present in 30 (37.5%) MS patients vs. 30 (12.5%) controls (p < 0.001). Results for Candida albicans were 47.5% (38/80) in MS patients vs. 21.3% (51/240) in controls (p < 0.001), for Candida parapsilosis 37% (28/80) vs. 17.1% (41/240) (p < 0.001) and for Candida glabrata 46.3% (37/80) vs. 17.5% (42/240) (p < 0.001), respectively. After adjusting for age and gender, the odds ratios (95% confidence intervals) for MS, according
to the presence of Candida antigens were: 2.8 (0.3–23.1, p = 0.337) for Candida famata; 1.5 (0.7–3.4, p = 0.290) for Candida albicans; 7.3 (3.2–16.6, p < 0.001) for Candida parapsilosis; and 3.0 (1.5–6.1, p = 0.002) for Candida glabrata. The results were similar after excluding ten patients on immunosuppressants. The results of this single study suggest that
Candida species infection may be associated with increased odds of MS. 相似文献