Candiduria in intensive care unit: significance and value of yeast numeration in urine

JUSTIFICATION: Candiduria is increasingly frequent among patients admitted to intensive care units but its significance remains unclear. OBJECTIVES: Search for eventual correlation between quantitative candiduria and known risk factors for invasive candidiasis. STUDY DESIGN: Prospective. PATIENTS AND METHODS: A four-month study was conducted in 162 patients hospitalized in the intensive care unit for more than 72 hours. All patients underwent a weekly research of candiduria added to sampling from different body sites to determine the Pittet Candida colonization index. RESULTS: Candiduria has been proved in 56 cases (34%). It was superior or equal to 10(4) UFC/ml among 28 patients (50%). Candida tropicalis, Candida glabrata and Candida albicans has been isolated in 41, 22 and 20% respectively. All patients had at least one major and two minor risk factors for Candida infection. Six patients (10%) developed invasive candidiasis. The global mortality rate was at 52%. Pittet colonization index was significantly different between patients with candiduria and those with invasive candidiasis (p=0.01). There was a statistically significant correlation between candiduria superior or equal to 10(4) UFC/ml and Pittet colonization index superior or equal to 0.5 (p=0.01). CONCLUSION: Candiduria superior or equal to 10(4) UFC/ml associated with risk factors may predict invasive candidiasis in critically ill patients.     

Primary vertebral echinococcosis: four cases reports and review of literature

Primary vertebral echinococcosis has been considered to be a hypothetical and exceptional possibility. It affects bones in 1% of reported cases. Spine is involved in 45-50% of these. The disease preferentially affects the thoracic spine. It begins as a single primary cyst containing daughter cysts. We report four cases of primary vertebral echinococcosis, extending into the extradural space without any other primary site of infection. We conclude that primary vertebral echinococcosis, although rare should be considered in destructive lesions of the vertebrae and spine in regions that the disease is endemic. Advanced imaging studies should be performed to diagnose the disease. Early decompressive surgery of the spine, with chemotherapy, is the treatment of choice for these patients.     

Posttraumatic meningitis: incidence, bacteriology, and outcomes

BACKGROUND AND PURPOSE: The aim of our study was to search for the incidence, the responsible organisms and the favoring causes of death of post-traumatic meningitis (PTM). METHODS: This retrospective study was conducted over a seven-year period (January 1st, 1996 - December 31, 2002) in the ICU and the neurosurgery department of the Habib-Bourguiba University Hospital, Sfax, Tunisia. RESULTS: Over the study period, 38 patients presented PTM (0.96% of patients hospitalized for head injury), 92% of them had received antibiotic prophylaxis on admission. Mean time between head injury and the diagnosis of PTM was 9+/- 8 days (range: 2-34 days). The most common isolated organisms were multidrug resistant A. baumanii, and K. pneumoniae and reduced susceptibility S. pneumoniae. Factors predictive of prognosis in the 14 days following the diagnosis of meningitis were Glasgow coma score (GCS) on the day of diagnosis of PTM, absence of nuchal rigidity, CSF protein, CSF/blood glucose ratio, and S. pneumoniae as the causal agent of PTM. CONCLUSIONS: Antibioprophylaxis in patients with head trauma must be avoided to prevent the emergence of multidrug resistant bacteria when PTM occurs. GCS on the day of diagnosis of PTM, CSF protein concentration, CSF/blood glucose ratio, and S. pneumoniae as the causal agent of PTM are predictive factors of mortality of patients with PTM.     

Development of an Elastic,Electrically Conductive Coating for TPU Filaments

Electrically conductive filaments are used in a wide variety of applications, for example, in smart textiles and soft robotics. Filaments that conduct electricity are required for the transmission of energy and information, but up until now, most electrically conductive fibers, filaments and wires offer low mechanical elongation. Therefore, they are not well suited for the implementation into elastomeric composites and textiles that are worn close to the human body and have to follow a wide range of movements. In order to overcome this issue, the presented study aims at the development of electrically conductive and elastic filaments based on a coating process suited for multifilament yarns made of thermoplastic polyurethane (TPU). The coating solution contains TPU, carbon nanotubes (CNT) and N-Methyl-2-pyrrolidone (NMP) with varied concentrations of solids and electrically conductive particles. After applying the coating to TPU multifilament yarns, the mechanical and electrical properties are analyzed. A special focus is given to the electromechanical behavior of the coated yarns under mechanical strain loading. It is determined that the electrical conductivity is maintained even at elongations of up to 100%.