Identification Of Bacterial Infections Research Articles

Role of neutrophils to lymphocytes ratio in identification of bacterial infection in adult population

Background: Bacterial infection are difficult to distinguish from viral infection. Neutrophils are the first cells mobilize to infectious site caused by bacteria and also apoptosis of lymphocytes in response to cell mediated immunity hence raised in neutrophils and decrease in lymphocyte count. The goal of this study is to determine the neutrophil to lymphocyte ratio in patient with positive blood culture for bacteria in patients admitted in hospital.
 Patients and methods: This cross-sectional study was conducted at Department of Pathology, Hamdard University Karachi, Pakistan from 1st January to 31st June 2022. Total 123 adult patients with positive blood cultures admitted in ward or ICU were enrolled in the study. CBC Samples were collected from patients admitted in ward or ICU and blood culture were already sent due to clinical condition, the organism isolated in blood culture were recorded As blood culture is a gold standard investigation to detect bacterial infection .In this study we will record neutrophil to lymphocyte ratio in patients admitted with positive blood culture for bacteria. Age less than 15 years, pregnant female, OPD patients, negative blood cultures and patients on antibiotic therapy were excluded. Complete blood count (CBC) was performed in Beckman coulter model DxH 520 made by Germany. Age and ward of patient, organism isolated from blood culture, CRP.
 Results: A total of 123 patients with positive blood culture were enrolled in the study. Out of 123 patients 61.8% (n=76) were male and 38.2% (n=47) were female. Mean NLR was 5.9± 13.1. Total 45.5% patients presented with high NLR. Mean CRP was 58.5± 68.7. 
 Conclusion: High NLR was seen in 45.5% which shows NLR is an important indicator of bacterial infection. More studies are needed to define true significance of NLR in all ages and negative blood cultures. 

O02 TRAIL, IP-10, CRP host-protein signature score distinguishes between viral and bacterial infection in sepsis patients

BackgroundSepsis is a life-threatening organ dysfunction syndrome caused by the body's response to infection. Timely and appropriate sepsis management, including appropriate treatment of bacterial infection, improves outcomes. MeMed BV (BV), a test for differentiating between bacterial and viral infection, is based on computational integration of the circulating levels of three proteins (TRAIL, IP-10, CRP). Here we evaluate its ability to differentiate bacterial from viral infection in sepsis patients.MethodsThis was a sub-analysis of sepsis patients recruited prospectively in the Apollo study (NCT04690569). Apollo eligibility required the attending physician's clinical suspicion of acute infection and reported fever. Sepsis was defined as two or more SIRS criteria and a suspected bacterial or viral infection classified by expert adjudication. A bacterial or viral classification required at least 2/3 experts to assign the same aetiology label with confidence ≥90% or all 3 assign with confidence ≥70%. BV was measured using a platform generating a bacterial likelihood score (0–100). Based on pre-defined thresholds, scores 0–34 indicated viral (or other non-bacterial) infection, scores 35 to 65 were equivocal and 66–100 indicated bacterial infection (or coinfection). BV performance was assessed against expert panel classifications.ResultsSeventy-nine out of 1016 eligible Apollo patients had missing heart rate and respiration rate data and a further 136 could not be classified by the experts. Out of the remaining 801 patients, 217 adults with median age of 41.8 years (IQR: 29.2–61) and 149 children with median age of 2.4 years (IQR: 1.4–5.4) had two or more SIRS criteria. A total of 119 patients had at least three SIRS criteria and 39.6% (145/366) of the patients were hospitalized with a median duration of 4 days (IQR: 3–6 days). In the sepsis cohort, 91 patients were classified as bacterial and 275 as viral. BV yielded sensitivity and specificity of 98.8% (95% CI: 93.6%–100%) and 89.7% (95% CI: 85.3%–93.2%) and NPV of 99.6% (95% CI: 97%–99.9%), outperforming PCT [cut-off 0.5 ng/mL; sensitivity 52.8% (95% CI: 42%–63.3%); specificity 86.2% (95% CI: 81.5%–90%); NPV 84.6% (95% CI: 81.5%–87.3%)].ConclusionsBV accurately distinguished bacterial from viral infection in sepsis patients. This new triage tool has the potential to help with timely identification of bacterial infection, enabling prompt treatment.

The value of PAP and AgNOR techniques in identification of bacterial infections and Cytomorphological changes in sputum of Sudanese pango Smokers

The value of PAP and AgNOR techniques in identification of bacterial infections and Cytomorphological changes in sputum of Sudanese pango Smokers

Comparative Study Between the Sequencing of 16sRNA gene and Traditional Identification Methods of Some Bacterial Pathogens Associated with A Systemic Bacterial Infections from Diseased Poultry Flocks

Poultry health problems of chickens are usually accompanied by bacterial systemic infections causing severe losses in flocks, sick birds were systemically could be infected by several bacteria regardless of the clinical signs. 16s RNA sequence is a modern approach for the diagnosis of bacterial infection, especially of multiple causative agents. Ten field cases suffering from systemic infections have been examined for bacterial causes, using conventional isolation and 16S rRNA sequencing, The ten sequenced samples were compatible with the results of isolation; six samples were similar to E.coli species with identity% = 97-99%, while it had similarity% < 96% with Salmonella enterica. While the other samples showed variable identity ranging from 94-99% with Salmonella enterica, E. coli, Enterobacter spp and Klebsiella spp In conclusion, although conventional isolation is the golden standard method for bacterial diagnosis, however, the 16s RNA sequencing has elaborated excellence in diagnosis and identification of bacterial infection, concerning the time consuming, detection of multi-caused infections and sensitivity.

The value of PAP and AgNOR techniques in identification of bacterial infections and Cytomorphological changes in buccal cavity of Sudanese Hookah Users

The value of PAP and AgNOR techniques in identification of bacterial infections and Cytomorphological changes in buccal cavity of Sudanese Hookah Users

The role of cytological smears in identification of bacterial infection and abnormalities in vaginal epithelium cells among apparently health married Sudanese Women

Background: Vaginal infection represents a major health problem in most part of the world. Many factors have been identified as important causative agents that responsible for the development of vaginal precancerous and cancerous lesions. In Sudan, infection has been identified as a major cause. Aim: To determine the role of cytological smears in identification of bacterial infection and abnormalities in vaginal epithelium cells among apparently health married Sudanese Women. Methods: In this study 100 apparently healthy women were selected. Cytological materials were obtained by scraping the surface of the vagina. The obtained materials were applied with Pap Staining Method. Results: A total of one hundred samples of vaginal smears were included in this study, the age of the participant ranged from 20 to 70 years. Infection: Out of 100 samples 26 samples (26 %) had a bacterial infection, 3 samples (3%) had Actinomyces infection, and 71 samples (71%) were negative. Out of 100 samples 6 samples (6%) had acute inflammation, 5 samples (5%) had chronic inflammation and 89 samples (89%) were negative. Out of 100 samples 22 samples (22%) had inflammatory changes and 84 samples (78%) were negative. Conclusion: Bacterial vaginosis appears to be the predominant cause of vaginitis. The conventional cytology for exfoliative cells from female genitalia by using PAP stain is routine, specific, and sensitive, technique easy and not expensive so it is ideal technique for screening.

Procalcitonin in general internal medicine: a bibliometric analysis.

Procalcitonin (PCT) plays an important role in the identification of bacterial infection and therapy guidance. The relevant literature is mainly classified under critical care medicine or infectious disease. The research status of PCT in general internal medicine (GIM) is currently unclear. This research aimed to analyze PCT-related literature in the GIM field and provide references for future research. A subject search strategy was used for the term PCT, with the search scope limited to Medicine, General & Internal. We conducted a search of relevant literature in the Science Citation Index Expanded (SCIE) database in the Web of Science Core Collection (WOSCC), with no publication date limit (1900 to May 16, 2021, the date of the final search for this study). The search results were analyzed using CiteSpace software to assess the status of PCT research in the GIM field based on annual paper publication numbers, the number of citations, country distribution, institution distribution, author distribution, journal distribution, and keyword usage. A total of 905 document records were retrieved. Articles were mainly from Europe, the United States, and China, and the number of citations totaled 15,917. There were 5 research institutions that published more than 10 related papers and 3 authors who published more than 10 papers. There was little cooperation between authors from different countries and institutions. This field should focus on leading journals in critical care medicine and quality comprehensive journals. Keyword analysis showed that the current research focus is the standardized application of PCT. There are few targeted studies on the application of PCT in GIM, and the relevant important literature mainly comes from other journals. GIM-specific research should be increased in the future.

Bacterial Infections in Patients with Chronic Lymphocytic Leukemia: A Longitudinal Nation-Wide Study

BackgroundBacterial infections remain one of the most important clinical problems in patients with chronic lymphocytic leukemia (CLL) causing significant morbidity and implicated in a third of all deaths among patients with CLL. Identification of bacterial infection by a culture is an important prognostic finding. Several studies have evaluated the incidence and type of bacterial infections in CLL, but often these have only evaluated bacteremia and patients who have been treated in a protocol.AimThe aim of the present study is to estimate incidence rates of- and risk factors for microbiologically verified bacterial infections in a nationwide cohort of treated as well as untreated patients with CLL.MethodsWe used the Danish National CLL registry to identify all patients diagnosed with CLL between 2008 and 2016. From the Danish National Microbiology database and the PERSIMUNE data warehouse we collected data on all microbiologically verified bacterial infections in these patients between January 2010 and April 2017. The study was approved by the Danish data protection agency and the Danish health authorities.ResultsWe identified 3720 CLL patients with 12,833 person-years of follow-up (median 3.1 years). Within our study period 913 patients had received treatment for CLL.A total of 26562 cultures (12,987 blood, 8,607 urine, 658 airway) were collected among 2377 patients during the study period. Of the blood cultures, 755 (5.8 %) were positive and 229 (1.7 %) were defined as possibly contaminated. Among the 755 positive blood cultures the microorganisms identified were Escherichia coli (188, 24.9 %), Enterococcus faecium (81, 10.7 %), Staphylococcus aureus (73, 9.7%), Streptococcus pneumoniae (72, 9.5 %).The rates of positive blood cultures for untreated and treated patients were 0.03 and 0.16 per patient year, respectively.ConclusionWe here report the largest study to date on bacterial infections in a nationwide cohort of consecutive CLL patients. By characterizing type of infection, we will be able to identify different patterns of infections in treated as well as untreated CLL patients and to identify risk factors for specific types of infections. This knowledge should be used to personalize prophylactic interventions as well as the initial treatment of infections in CLL patients. Further, results of this study could be used to guide prophylactic measures for specific subgroups of patients, which should be tested in prospective clinical trials. DisclosuresNiemann:The Danish Cancer Society: Research Funding; Janssen: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Travel grant; Gilead: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Travel grant; AbbVie: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Travel grant, Research Funding; Novo Nordisk Foundation: Research Funding; Novartis: Other: Travel grant; Roche: Consultancy, Other: Travel grant.

226. Evaluating the Unnecessary Use of Intravenous Broad-Spectrum Antibiotics in Patients Based on Systemic Inflammatory Response Syndrome Criteria in the Emergency Department (ED)

BackgroundRecognition of sepsis frequently occurs in the ED. To demonstrate the need to optimize antibiotic use for suspected sepsis and evaluate the reliability of systemic inflammatory response syndrome (SIRS) criteria in predicting bacterial infection, we quantified the rate of unnecessary intravenous (IV) broad-spectrum antibiotic use for suspected sepsis in the ED at an academic medical center.MethodsAdult patients who were admitted to the ED between January 2018 and June 2018 with suspected sepsis (≥ 2 SIRS) and received ≥ 1 dose of IV broad-spectrum antibiotic were included in this retrospective study. The presence of bacterial infection was determined using Centers for Disease Control and Prevention (CDC)/National Healthcare Safety Network (NHSN) definitions, microbiologic, radiographic, and laboratory findings. Suspected infections lacked microbiologic data. The primary outcome was the percentage of confirmed and suspected infections. Secondary outcomes included 90-day Clostridioides difficile infection (CDI) and 90-day drug-resistant organism (DRO) infections.ResultsA total of 218 patients were included. The percentages of confirmed/suspected and absence of bacterial infections were 63.8% and 36.2%, respectively. Elevated SIRS (≥ 2) and Quick Sequential Organ Failure Assessment (qSOFA; ≥ 2) scores were not associated with the presence of bacterial infections. 82% of patients were discharged from the ED. Antibiotic exposure in days of therapy in the ED and/or hospital admission did not significantly vary between patients with confirmed/suspected bacterial infection and those with absence of bacterial infections. Among patients who lacked evidence of bacterial infections, 44% were prescribed outpatient antibiotics after being discharged from the ED. 90-day CDI and DRO infections were identified in 7 and 6 patients, respectively, regardless of the presence of bacterial infections.Table 1. Baseline demographics of patients admitted to the ED with suspected sepsis ConclusionA third of the patients with suspected sepsis received IV broad-spectrum antibiotics in the ED but ultimately lacked bacterial infection. Our findings suggest that identification of bacterial infection and patients with sepsis using SIRS or qSOFA lack specificity and can lead to the overuse of unnecessary antibiotics in the ED.Disclosures All Authors: No reported disclosures

Respiratory Virus Co-infection in Acute Respiratory Infections in Children.

Purpose of ReviewThis investigation aims to understand the role and burden of viral co-infections for acute respiratory illnesses in children. Co-infection can be either viral-viral or viral-bacterial and with new technology there is more information on the role they play on the health of children.Recent FindingsWith the proliferation of multiplex PCR for rapid diagnosis of multiple viruses as well as innovations on identification of bacterial infections, research has been attempting to discover how these co-infections affect each other and the host. Studies are aiming to discern if the epidemiology of viruses seen at a population level is related to the interaction between different viruses on a host level. Studies are also attempting to discover the burden of morbidity and mortality of these viral-viral co-infections on the pediatric population. It is also becoming important to understand the interplay of certain viruses with specific bacteria and understanding the impact of viral-bacterial co-infections.SummaryRSV continues to contribute to a large burden of disease for pediatric patients with acute respiratory illnesses. However, recent literature suggests that viral-viral co-infections do not add to this burden and might, in some cases, be protective of severe disease. Viral-bacterial co-infections, on the other hand, are most likely adding to the burden of morbidity in pediatric patients because of the synergistic way they can infect the nasopharyngeal space. Future research needs to focus on confirming these conclusions as it could affect hospital cohorting, role of molecular testing, and therapeutic interventions.

Procalcitonin as a Biomarker in Early Sepsis in Cancer Patients Presenting to the Emergency Department

Abstract Background In the United States, sepsis is responsible for 9% of all cancer-related deaths. Patients with cancer presenting with sepsis have worse outcomes, which is probably because of immunosuppression, due to the disease burden itself or the effects of chemotherapy. Biomarkers are noninvasive rapid diagnostic tools, assisting in the early diagnosis of patients with suspected sepsis. The identification of a biomarker with reasonable sensitivity and specificity for early sepsis could potentially result in a beneficial effect on clinical outcomes in these patient populations. Procalcitonin (PCT) is a promising marker for identification of bacterial infections, but its role in oncology populations has less been studied. We investigated the performance characteristics of sepsis biomarkers for diagnosis of verified bacterial sepsis. Methods This was a retrospective study of patients admitted between June 1, 2018, and January 31, 2019, from the Emergency Department, MD Anderson Cancer Center. Approximately 51% adult patients were diagnosed with sepsis. Sepsis was defined by Surviving Sepsis Campaign (SSC) definitions. Three biomarkers were evaluated based on hospital records: (1) PCT ≥0.08 ng/mL, (2) C-reactive protein (CRP) ≥13 mg/L, (iii) white blood cells (WBCs) ≥11 K/µL. The diagnostic performances of the individual biomarkers were compared using the area under the receiver operating characteristic (ROC) curve (AUC). Results In total, 635 adult sepsis patients were included and investigated during the study period. For diagnosis of bacterial sepsis based on SSC criteria, the analysis yielded a CRP with sensitivity of 71% (95% CI, 56%-86%) and specificity of 22% (95% CI, 15%-29%), respectively. The area under the ROC curve was 52% (95% CI, 41%-68%). The sensitivity of WBCs was 18% (95% CI, 12%-24%), specificity was 84% (95% CI, 71%-97%), and the area under the ROC curve was 51% (95% CI, 43%-68%). However, the PCT reached the sensitivity of 77% (95% CI, 60%-93%) and specificity of 65% (95% CI, 48%-82%), respectively. The area under the ROC curve was 79% (95% CI, 67%-91%), significantly increased. Conclusion In this study, the diagnosis accuracy and specificity of PCT are much higher than those of CRP or WBC in cancer patients. PCT is a useful marker for early detection of sepsis in emergency department patients with suspected infection, especially in cancer patients with neutropenia. Further studies on the role of PCT in this population are warranted.

Clinical application of presepsin as diagnostic biomarker of infection: overview and updates.

The appropriate identification of bacterial infection is the basis for effective treatment and control of infective disease. Among this context, an emerging biomarker of infection is presepsin (PSP), recently described as early marker of different infections. PSP secretion has been shown to be associated with monocyte phagocytosis and plasmatic levels of PSP increase in response to bacterial infection and decrease after antibiotic treatment, therefore it can be considered a marker of activation of immune cell response towards an invading pathogen. Different methods have been developed to measure PSP and this review will briefly describe the different clinical fields of application of PSP, ranging from intensive care to neonatal infection, to orthopedic and pulmonary infection as well as fungal infections and cardiovascular infections.

The detection of bacterial infections in leukemia patients using procalcitionin levels

Bacteremic infections are the most common complications in patients with leukemia. This study aimed to assess the value of procalctionin levels in the detection of bacterial infections in leukemia patients. Blood samples of in-patients with leukemia were collected. Statistical analysis was performed to assess the correlation between the procalcitionin level on the day of the first positive blood culture and bacteremic infection. Infected patients had significantly higher procalctionin levels than uninfected patients (p < 0.001). Receiver operating characteristic curve analysis showed a high level of accuracy regarding the discrimination of bacterarmic infection (area under the curve, 0.883) and Gram-negative bateremia (area under the curve, 0.779). Procalctionin levels may help in the identification of bacterial infections in leukemia patients. Further multicentre studies are needed to verify our data regarding the use of procalctionin to distinguish between Gram-positive and Gram-negative infections.

Assessment of nonlinear optical refractive index in identification of bacterial infection

This study evaluates the Z-scan technique in determining Pseudomonas aeruginosa (P. aeruginosa), Staphylococcus aureus (S. aureus), and Escherichia coli (E. coli) titration. Ten in vitro samples were prepared for each bacteria. Closed-aperture Z-scan technique was employed for measuring the sign and magnitude of the nonlinear refractive index of each sample. Seven concentrations were used to design a standard graph model and three concentrations for each bacteria were used to test the model. Prior to application of Z-scan technique, all samples were fixed with 1 ml of 5% paraformaldehyde. The sign of nonlinear refractive index for P. aeruginosa and S. aureus was positive and negative for E. coli. The value of nonlinear refractive index decreases with increasing concentration of the samples. The results show that nonlinear refractive index has good potential in predicting the concentration of blind samples. The proposed method demonstrates that Z-scan technique is a reliable detection method with the potential to characterize bacterial samples of different concentrations. Nonlinear refractive index could also be used as a new identification technique for the evaluation of infections.

Accelerated bacterial detection in blood culture by enhanced acoustic flow cytometry (AFC) following peptide nucleic acid fluorescence in situ hybridization (PNA-FISH).

Bacteraemia is a risk factor for subsequent clinical deterioration and death. Current reliance on culture-based methods for detection of bacteraemia delays identification and assessment of this risk until after the optimal period for positively impacting treatment decisions has passed. Therefore, a method for rapid detection and identification of bacterial infection in the peripheral bloodstream in acutely ill patients is crucial for improved patient survival through earlier targeted antibiotic treatment. The turnaround time for current clinical laboratory methods ranges from 12 to 48 hours, emphasizing the need for a faster diagnostic test. Here we describe a novel assay for accelerated generic detection of bacteria in blood culture (BC) using peptide nucleic acid fluorescence in situ hybridization enhanced acoustic flow cytometry (PNA-FISH-AFC). For assay development, we used simulated blood cultures (BCs) spiked with one of three bacterial species at a low starting concentration of 10 CFU/mL: Escherichia coli, Klebsiella pneumoniae or Pseudomonas aeruginosa. Under current clinical settings, it takes a minimum of 12 hours incubation to reach positivity on the BacTEC system, corresponding to a bacterial concentration of 107−109 CFU/mL optimal for further analyses. In contrast, our PNA-FISH-AFC assay detected 103–104 CFU/mL bacteria in BC following a much shorter culture incubation of 5 to 10 hours. Using either PCR-based FilmArray assay or MALDI-TOF for bacterial detection, it took 7–10 and 12–24 hours of incubation, respectively, to reach the positive result. These findings indicate a potential time advantage of PNA-FISH-AFC assay for rapid bacterial detection in BC with significantly improved turnaround time over currently used laboratory techniques.

Value of combined determination of neutrophil CD64 and procalcitonin in early diagnosis of neonatal bacterial infection

To investigate the value of combined determination of neutrophil CD64 and procalcitonin (PCT) in the early diagnosis of neonatal bacterial infection. According to discharge diagnosis, 37 neonates with bacterial infection were divided into sepsis (n=15) and ordinary infection (non-sepsis) groups (n=22). Twenty-one neonates without infection who were hospitalized during the same period of time were enrolled as the control group. Venous blood samples were collected immediately after admission. Flow cytometry was used to measure the serum level of neutrophil CD64. Chemiluminescence and immune transmission turbidimetry were used to measure the serum levels of PCT and CRP respectively. The sepsis group had higher serum levels of neutrophil CD64, PCT, and CRP than the control group (P<0.01), the ordinary infection group had a higher serum level of neutrophil CD64 than the control group (P<0.01), and the sepsis group had higher serum levels of PCT and CRP than the ordinary infection group (P<0.01). The areas under the ROC curve (AUC) of neutrophil CD64, PCT, and CRP in diagnosing bacterial infection were 0.818, 0.818, and 0.704 respectively, and the AUC of combined neutrophil CD64 and PCT was 0.926. A combination of neutrophil CD64 and PCT had a sensitivity of 97.29% and an accuracy of 89.65% in the early diagnosis of neonatal bacterial infection.The sensitivity and accuracy were higher than those of a combination of CRP and neutrophil CD64 or PCT as well as neutrophil CD64, PCT, or CRP alone for the early diagnosis of neonatal bacterial infection. The combined determination of neutrophil CD64 and PCT can improve the sensitivity and accuracy in the diagnosis of neonatal bacterial infection, which helps with early identification of bacterial infection.

Development of a calcium phosphate nanocomposite for fast fluorogenic detection of bacteria.

Current procedures for the detection and identification of bacterial infections are laborious, time-consuming, and require a high workload and well-equipped laboratories. Therefore the work presented herein developed a simple, fast, and low cost method for bacterial detection based on hydroxyapatite nanoparticles with a nutritive mixture and the fluorogenic substrate. Calcium phosphate ceramic nanoparticles were characterized and integrated with a nutritive mixture for the early detection of bacteria by visual as well as fluorescence spectroscopy techniques. The composite was obtained by combining calcium phosphate nanoparticles (Ca:P ratio, 1.33:1) with a nutritive mixture of protein hydrolysates and carbon sources, which promote fast bacterial multiplication, and the fluorogenic substrate 4-methylumbellipheryl-β-d-glucuronide (MUG). The composite had an average particle size of 173.2 nm and did not show antibacterial activity against Gram-negative or Gram-positive bacteria. After an Escherichia coli suspension was in contact with the composite for 60–90 min, fluorescence detected under UV light or by fluorescence spectrophotometer indicated the presence of bacteria. Intense fluorescence was observed after incubation for a maximum of 90 min. Thus, this calcium phosphate nanocomposite system may be useful as a model for the development of other nanoparticle composites for detection of early bacterial adhesion.

Levels of Presepsin and Midregion-Proadrenomedullin in Septic Patients with End-Stage Renal Disease after Cardiovascular Surgery: 1-Year Follow Up Study

Background: Procalcitonin (PCT) is a marker for sepsis diagnosis, identification of bacterial infection and monitoring of antibiotic therapy. It has been shown that PCT is not a good choice in patients with hemodialysis. Therefore, we have explored two biomarkers: a) presepsin, and, b) midregion-proadrenomedullin (MR-proADM) in patients having End-Stage Renal Disease (ESRD). Patients and Methods: We prospectively enlisted 20 patients, who underwent cardiovascular surgery and had been on dialysis. The diagnosis of sepsis has been established clinically and confirmed by PCT. Blood samples were taken before and after dialysis. Additionally, plasma and sera of 10 healthy blood donors without any complications were used as controls. Results: Presepsin plasma concentrations (4368 ± 3088 vs. 694.1 ± 239.1 pg/mL) were significantly higher in patients with sepsis compared with controls (p 0.05) with no significance between alive and deceased (p=0.53) patients. Adjustments have shown that the difference for MR-proADM level is due to the random sampling variability (p=0.989), whereas difference for presepsin remained highly significant (p<0.001). Conclusions: Our results indicate that the accuracy of new biomarkers is equal to that of PCT in patients with ESRD. Presepsin might be as good marker in repeated measurements, before and after dialysis, as it is PCT.

Identification of Bacterial Infection in Neotropical Primates

Emerging infectious diseases usually arise from wild animal populations. In the present work, we performed a screening for bacterial infection in natural populations of New World primates. The blood cell bulk DNAs from 181 individuals of four Platyrrhini genera were PCR screened for eubacterial 16S rRNA genes. Bacteria were detected and identified in 13 distinct individuals of Alouatta belzebul, Alouatta caraya, and Cebus apella monkeys from geographically distant regions in the states of Mato Grosso and Pará, Brazil. Sequence analyses showed that these Platyrrhini bacteria are closely related not only to human pathogens Pseudomonas spp. but also to Pseudomonas simiae and sheep-Acari infecting Pseudomonas spp. The identified Pseudomonas possibly represents a group of bacteria circulating in natural monkey populations.

Identification of Bacterial Infections and Clinical Manifestation Associated With Cytomegalovirus in Liver Transplantation Patients

IntroductionLiver transplantation has become the most effective therapy for the treatment of patients with end-stage liver disease. With new immunosuppressive agents the incidence of acute rejection has been significantly reduced, but infection has become a serious problem. ObjectiveOur objective was to correlate cytomegalovirus (CMV) positivity of antigenemia and polymerase chain reaction (PCR) with clinical manifestations and bacterial infections among patients undergoing liver transplantation. MethodsThis prospective study included patients monitored for 6 months for early detection of CMV infection. Sample collections were performed at the time of surgery and weekly until the second month followed by fortnightly in the third month, and monthly in the fourth to sixth month. CMV infection was defined by positive antigenemia (>3 cells) or 2 positive PCR tests associated or not with clinical symptoms. The methodology for the diagnosis of bacterial infection was through biochemical tests and the automated VITEK/bioMérieux (identification and antibiogram) using samples of urine and blood cultures. Chi-square test was used for dicotomic variables with significant differences when P < .05. ResultsSixteen patients (32%) had CMV infections, including 13 (81%) with concomitant infections. Thirty-four patients (68%) did not have CMV infections and 8 of these (24%) had bacterial infection. There was a high correlation with bacterial infections among CMV-positive patients. ConclusionBacterial infections after liver transplantation were associated with CMV infection.