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101.
Guido M. Voets Maurine A. Leverstein-van Hall Susanne Kolbe-Busch Adri van der Zanden Deirdre Church Martin Kaase Andrea Grisold Mathew Upton Elaine Cloutman-Green Rafael Cantón Alexander W. Friedrich Ad C. Fluit 《Journal of clinical microbiology》2013,51(12):3944-3949
Successful multidrug-resistant clones are increasing in prevalence globally, which makes the ability to identify these clones urgent. However, adequate, easy-to-perform, and reproducible typing methods are lacking. We investigated whether DiversiLab (DL), an automated repetitive-sequence-based PCR bacterial typing system (bioMérieux), is suitable for comparing isolates analyzed at different geographic centers. A total of 39 Escherichia coli and 39 Klebsiella species isolates previously typed by the coordinating center were analyzed. Pulsed-field gel electrophoresis (PFGE) confirmed the presence of one cluster of 6 isolates, three clusters of 3 isolates, and three clusters of 2 isolates for each set of isolates. DL analysis was performed in 11 centers in six different countries using the same protocol. The DL profiles of 425 E. coli and 422 Klebsiella spp. were obtained. The DL system showed a lower discriminatory power for E. coli than did PFGE. The local DL data showed a low concordance, as indicated by the adjusted Rand and Wallace coefficients (0.132 to 0.740 and 0.070 to 1.0 [E. coli] and 0.091 to 0.864 and 0.056 to 1.0 [Klebsiella spp.], respectively). The central analysis showed a significantly improved concordance (0.473 to 1.0 and 0.290 to 1.0 [E. coli] and 0.513 to 0.965 and 0.425 to 1.0 [Klebsiella spp.], respectively). The misclassifications of profiles for individual isolates were mainly due to inconsistent amplification, which was most likely due to variations in the quality and amounts of the isolated DNA used for amplification. Despite local variations, the DL system has the potential to indicate the occurrence of clonal outbreaks in an international setting, provided there is strict adherence to standardized, reproducible DNA isolation methods and analysis protocols, all supported by a central database for profile comparisons. 相似文献
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Omar Hayani Lyall AJ Higginson Baldwin Toye Ian G Burwash 《The Canadian journal of cardiology》2009,25(4):e130-e132
Infective endocarditis caused by zoonotic microorganisms is an uncommon clinical entity. A 55-year-old man was diagnosed with endocarditis due to Capnocytophaga canimorsus, a commensal bacterium contained in the saliva of dogs, that involved the aortic and tricuspid valves and was complicated by a para-aortic valve abscess and aorta-to-right atrial fistula. The patient was successfully treated with antibiotic therapy and surgical intervention. C canimorsus endocarditis should be considered in patients with culture-negative endocarditis, particularly in immunosuppressed, asplenic or alcoholic individuals who have recently suffered a dog bite or have had close contact with dogs. 相似文献
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The childhood-adolescent psychiatrics field has, for various years, been confronted by a very significant increase in cases of nervous anorexia, a serious eating disorder characterized by a noticeable loss of weight. At the bottom of this situation lie complex biological, psychological and social-cultural problems, which demand an interdisciplinary approach to solve them. This article presents the predisposing factors, the initial factors, the factors which maintain this disorder...; what behaviors are considered to be normal; what the physical and psychological manifestations are; as well as what the medical evaluation carried out is ... to finalize with an explanation of the different functions to be performed by each member of a multidisciplinary team. 相似文献
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Regueiro F Arnau A Pérez D Cañizares MA Martínez P Cantó A 《Archivos de bronconeumología》2000,36(1):55-57
The association of pneumothorax and lung cancer is rare and diagnosis is complex in such cases. Clinical suspicion of cancer must be based on radiological findings and the existence of risk factors. We discuss the mechanisms involved in the development of pneumothorax in patients with lung cancer, the clinical significance of the association, and the recommended diagnostic approach and therapeutic guidelines. 相似文献
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Cañizares MA Arnau A Fortea A Zarzuela V Martínez-Vallina P Cantó A 《Archivos de bronconeumología》2000,36(1):52-54
We describe a patient with a history of psychiatric disorder who was brought to our hospital after attempted suicide by hanging. Severe subcutaneous facial, palpebral and cervical emphysema was present, with dysphonia, dysphagia and slight respiratory difficulty. Fiberoptic bronchoscopy revealed upper airway obstruction due to edema in an intact airway. Successive CAT scans gave evidence of hyoid fracture and laryngocele, in addition to the corresponding emphysema of the subcutaneous area and pneumomediastinum. Given the persistence of dysphagia, we ordered esophageal tests, which showed functional alteration of the upper esophageal sphincter. Suprasternal cervicotomy to drain the pneumomediastinum and laryngeal microsurgery to treat the laryngocele resolved the problem. 相似文献
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