Positive Bacterial Culture Results Research Articles

Correlation between Duration of Placement of Non-tunneled Hemodialysis Catheter and Positive Bacterial Culture Incidence in Hemodialysis Patients

Non-tunneling hemodialysis catheter is one of the most convenient vascular accesses for hemodialysis in End Stage Kidney Disease (ESRD) patients. However, these catheters have the highest morbidity among all available accesses. Current guidelines recommend that non-tunneled hemodialysis catheters be placed for no more than 2 weeks to prevent bacterial contamination. This study was conducted in Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, throughout January-December 2021. A correlation test with a prospective observational analysis design was applied to find the link between the duration of non-tunneled hemodialysis catheter placement and the incidence of positive bacterial culture on the catheter. Pearson correlation test was used to see the strength of the correlation, with a significance limit of 0.05. This study involved 28 subjects. The most common location for catheter placement was in the jugular vein, and laboratory examinations showed no correlation between leukocyte values and positive bacterial culture results. Hypertension and diabetes mellitus were not significant risk factors (p-value 0.887). At ≤14 days of catheter placement, only 1 (6.7%) of the subjects presented a positive culture result. Most of the positive bacterial culture results were found at a duration of 15-30 days of placement, (n=8; 53.3%). The results of the Pearson test showed a p-value of 0.036 and an r-value of 0.399, indicating a significant result with a strong correlation between the two variables. The duration of placement of hemodialysis catheters has a positive correlation with the incidence of positive bacterial cultures, which can increase the risk of systemic infection associated with hemodialysis catheters.

Pneumatosis in cervical fascial space and necrotizing fasciitis of neck

Backgroud Pneumatosis in the cervical fascial space is a common imaging manifestation of cervical necrotizing fasciitis. At present, although there are some literature reports on pneumatosis in the cervical necrotizing fasciitis, there are few comparative reports. Objective To compare the imaging findings of necrotizing fasciitis of the neck and other cervical space infections, and explore the relationship between pneumatosis in cervical fascial space and necrotizing fasciitis of the neck. Methods A retrospective study was conducted on 56 cases of cervical fascia space infection in our department from May 2015 to March 2021, including 22 cases of necrotizing fasciitis and 34 cases of non-necrotizing fasciitis. 22 cases underwent incision, debridement and catheter drainage in the necrotizing fasciitis group. 26 cases underwent incision, debridement and catheter drainage, and 8 cases underwent ultrasound-guided puncture biopsy and catheter drainage in the non-necrotizing fasciitis group. All cases were confirmed by operation or pathological biopsy and took purulent secretions for bacterial culture and drug sensitivity test during or after operation. All cases were examined by neck CT or MRI before operation. The previous history of surgical incision or puncture and the rupture of cervical space infection were excluded. Results In 22 cases of necrotizing fasciitis, there were 19 cases had air accumulation in the fascial space (86.4%); In 34 cases of non necrotizing fasciitis, 2 cases had air accumulation in the fascial space (5.9%). There was significant difference between the two groups (χ2 = 36.9141, p < .01). Bacterial culture results were positive in 18 (81.8%) patients in the necrotizing fasciitis group. In the non necrotizing fasciitis group, 12 (35.3%) patients had positive bacterial culture results. There was significant difference in the positive rate of bacterial culture between the two groups (χ2 = 11.6239, p < .01). Except one death in necrotizing fasciitis group, all other patients were cured. There was no recurrence after follow-up for 3–6 months. Conclusions and Significance The pneumatosis of necrotizing fasciitis in the neck is dramatically more than that of other infectious diseases. It is suggested that pneumatosis in cervical fascial space is of great significance in the diagnosis of cervical necrosis, the gas production of bacteria may be closely related to the pathogenesis and development of necrotizing fasciitis of the neck, and early measures to block the generation and dissemination of gas is of great significance for treatment.

Early postoperative laboratory parameters are predictive of initial treatment failure in acute septic arthritis of the knee and shoulder joint

Septic arthritis is an orthopedic emergency potentially causing irreversible joint damage. However, the predictive value of potential risk factors such as early postoperative laboratory parameters remains uncertain. We investigated risk factors for initial surgical treatment failure using data from 249 patients (194 knees, 55 shoulders) treated for acute septic arthritis between 2003 and 2018. Necessity for further surgical intervention was defined as primary outcome. Demographic data, medical history, initial and postoperative laboratory parameters, Charlson Comorbidity Index (CCI), and Kellgren and Lawrence classification were collected. Two scoring systems were developed as tools for failure risk estimation after initial surgical irrigation and debridement. More than one intervention was necessary in 26.1% of cases. Treatment failure occurred significantly more often for those with longer symptom duration (p = 0.003), higher CCI grades (p = 0.027), Kellgren-Lawrence grade IV (p = 0.013), shoulder arthroscopy (p = 0.010), positive bacterial culture results (p < 0.001), slow postoperative CRP decline until day three (p = 0.032) and five (p = 0.015), reduced WBC-decline (p = 0.008), and lower hemoglobin (p < 0.001). Scores for third and fifth postoperative day achieved AUCs of 0.80 and 0.85, respectively. This study identified risk factors for treatment failure in patients with septic arthritis, suggesting that early postoperative laboratory parameters can guide further treatment.

The diagnostic value of blood sample NGS in patients with early periprosthetic joint infection after total hip arthroplasty.

The diagnostic value of next-generation sequencing (NGS) of blood samples from patients with periprosthetic joint infection (PJI) after total hip arthroplasty (THA) was evaluated by comparing it with drainage fluid NGS and bacterial culture. The study was designed as a retrospective diagnostic test. Thirty-six infected patients were diagnosed with PJI according to the Musculoskeletal Infection Society (MSIS) criteria and 57 volunteers were included in our study. NGS and bacterial culture were chosen to detect PJI after THA. Blood samples and drainage fluid were collected for NGS, and the drainage fluid, which was collected at the same time as the NGS drainage fluid sample, was used for bacterial culture. The primary outcomes of interest were sensitivity, specificity, and accuracy. In the infection group, 31 patients showed positive results by blood sample NGS, 33 patients showed positive results by drainage fluid NGS, and 17 patients showed positive bacterial culture results. In the control group, the results of 2 blood sample NGS, 16 drainage fluid NGS, and 3 bacterial cultures were positive. The sensitivity, specificity, and accuracy of the blood sample were 0.86, 0.96, and 0.92, respectively. The sensitivity, specificity, and accuracy of the drainage fluid samples were 0.92, 0.72, and 0.80, respectively. The sensitivity, specificity, and accuracy of bacterial culture were 0.47, 0.95, and 0.79, respectively. The study demonstrated that both the sensitivity and specificity of NGS were higher than those of bacterial culture, regardless of the kind of sample. Compared with drainage fluid NGS, the sensitivity of blood sample NGS was slightly lower (0.86 vs 0.92), but blood sample NGS showed higher specificity (0.96 vs 0.72). In total, the diagnostic value of blood sample NGS was superior to that of drainage fluid NGS and bacterial culture. The majority of infected patients could be identified by blood sample NGS. Moreover, because of its high specificity, blood sample NGS can not only detect infectious bacteria but also distinguish infectious from non-infectious bacteria, which is dramatically different from using drainage fluid NGS.

Bacteriological and oncological safety of complete laparoscopic radical resection of colorectal cancer without incision anastomosis based on propensity-matched scores.

Complete laparoscopic radical resection of colorectal cancer without incision anastomosis is performed by means of natural orifice specimen extraction (NOSE), which avoids a large abdominal wall incision. Although this procedure is increasingly practiced, it is still underdeveloped, one reason being that controversy still exists regarding bacteriological and oncological safety. To demonstrate the safety of complete laparoscopic radical resection of colorectal cancer without incision anastomosis in bacteriology and oncology. This study was a retrospective study with prospectively collected data. This study continuously collected 420 patients who underwent colorectal cancer surgery in our hospital from January 2018 to March 2022. According to the different surgical methods, they were divided into the NOSE group (the natural orifice specimen extraction group) and the N-NOSE group (specimen removed through abdominal wall auxiliary incision). The two groups were matched 1 : 1 using the propensity score matching (PSM) method to balance at baseline. Bacteriological and oncological outcomes, short-term complications, and long-term prognosis were compared between the two groups. One hundred and eighty-four of the 420 included patients were successfully matched. The differences in gender, body mass index, T stage, N stage, and diabetes status between the two groups after matching were not statistically significant. There were no significant differences in oncological outcomes, short-term complications, and 2-year postoperative disease-free survival between the two groups. There was no significant correlation between positive bacterial culture results and intra-abdominal infection. Compared with traditional laparoscopic surgery, complete laparoscopic radical resection of colorectal cancer without incision anastomosis has satisfactory bacteriological and oncological effects and is worthy of further clinical promotion.

Frequency of etiological agents of acute bacterial meningitis using culture and polymerase chain reaction assay

Bacterial meningitis is one of the most severe infectious diseases with high rate of morbidity and mortality in developing countries. The current study aimed to investigate the frequency of etiological agents of bacterial meningitis among patients admitted to three hospitals in Zanjan, Iran. A total of 100 cerebrospinal fluid (CSF) samples were collected aseptically, and cytochemical analysis, Gram staining, culture, and PCR were performed. Forty-six percent of CSF samples had positive bacterial culture results. However, PCR showed a higher detection rate of bacterial meningitis causing pathogens when compared with culture (52% vs. 46%; p > 0.05). Fifty-two percent of patients with bacterial meningitis were aged <1 year. The most prevalent pathogen was Streptococcus pneumoniae (36.5%), followed by Neisseria meningitidis (28.8%) and Streptococcus agalactiae (15.4%). Listeria monocytogenes was not isolated from CSF culture. The frequency of Haemophilus influenzae, L. monocytogenes and Escherichia coli was 7.7%, 1.9% and 9.6%, respectively. Although in patients aged <1 year, S. pneumonia, N. meningitidis and group B streptococcus were the most common pathogens causing meningitis, and in patients aged between 1 and 10 years, Escherichia coli was the most common. According to the results, the culture was less effective for diagnosis of bacterial meningitis than PCR. Our findings indicate that the most common causative agents of bacterial meningitis in Iran may be vaccine-preventable pathogens. Therefore, the prevention and control measures should be considered to reduce the incidence of bacterial meningitis.

The incidence and incubation period of false-positive culture results in shoulder surgery

Postoperative shoulder infection is a significant complication requiring timely identification and treatment. Indolent infections such as those involving Cutibacterium acnes (formerly Propionibacterium acnes) provide a diagnostic dilemma as they present differently, without the acute symptoms associated with most postoperative bone and joint infections. Furthermore, Cacnes is thought to be a common contaminant isolated from intraoperative cultures. With no consensus algorithm, long-held cultures play a major role in guiding management decisions in potential postoperative shoulder infection. Our study sought to determine the incidence of positive culture results in both open and arthroscopic procedures in noninfected patients, as well as to clarify whether an increase in the incubation time frame leads to an increased rate of culture growth. One hundred patients were prospectively enrolled into either the open or arthroscopic procedure group. Patients with abnormal inflammatory laboratory findings, a history of shoulder surgery, or corticosteroid injection within 6 months of surgery were excluded from the study. Three cultures were obtained for each patient: superficial tissue culture, tissue culture, and "sterile" control swab. Cultures were held for 28 days and checked at regular intervals. All patients were followed up clinically for 6 months to ensure no signs of postoperative infection occurred. Ultimately, 95 patients were included in the final analysis. The false-positive rate was 17.0% in those who underwent open shoulder surgery and 10.4% in those who underwent arthroscopic shoulder surgery. The incidence of positive Cacnes culture results was 6.4% in the open group, whereas Cacnes was not isolated in the arthroscopic group. All positive bacterial culture results were reported within 7 days of collection. One culture result was positive for moldat 26 days. A relatively high false-positive culture rate occurred in both open and arthroscopic shoulder surgery. Cacnes was the most commonly identified bacterium in cultures in the open surgery group. Knowledge of one's institutional false-positive culture rate could be important in avoiding potentially inappropriate treatment. Additionally, we found that holding cultures longer than 14 days did not lead to an increased rate of false-positive culture results.

Positive Bacterial Culture Results at a Dermatologic Surgery Center: A Single-Site Retrospective Review.

Typical prophylactic coverage of suspected cutaneous surgical-site infections (SSIs) predominantly covers gram-positive bacteria. Data regarding the frequency of infection with unusual bacteria, not covered by prophylaxis, are not available. A retrospective 10-year review of culture-positive infections at a single academic site was performed. All positive bacterial culture results at the Washington University Center for Dermatologic and Cosmetic Surgery between October 31, 2007, and October 31, 2017, were collected and analyzed. Coagulase-negative staphylococcus accounted for 20.8% of positive culture results. Staphylococcus aureus caused 45.4% of infections. The remaining 33.8% were due to non-S. aureus bacteria, most frequently with Pseudomonas aeruginosa (10.8%). Numerous other gram-negative organisms and unusual gram-positive organisms were cultured. The lower extremity and ear were the only sites more likely to be infected with non-S. aureus bacteria. Smokers and immunosuppressed individuals were not more likely to have an SSI with non-S. aureus bacteria. A significant proportion of all SSIs with positive culture results was due to bacteria that are not sensitive to beta-lactam prophylaxis. Broader coverage for suspected SSI should be considered, particularly on the lower extremity and ear.

Characteristics and outcomes of Ludwig's angina in patients admitted to the intensive care unit: A 6-year retrospective study of 29 patients

Background/PurposeLudwig's angina (LA) still presents regularly and various characteristics are documented, but patients admitted to the Intensive Care Unit (ICU) has not been studied. The purpose of this study was to investigate the clinical characteristics and outcomes of patients with LA who were admitted to ICU. Materials and methodsWe retrospectively reviewed all 29 patients with LA who were admitted to the ICU of a university hospital from January 2013 to October 2018. Results were evaluated via descriptive analysis. The Log–Rank test was used to analyze the hospital/ICU length of stay (LOS). ResultsThe male: female ratio was 2.63:1. Mean age was 53.41 ± 16.57 years (range 8–78 years). Concomitant conditions comprised diabetes mellitus in 10 patients (34.48%), and hypertension in six (20.69%). The main reason for ICU admission was surgical (44.83%). The mean Acute Physiology, Age, Chronic Health Evaluation II (APACHE II) and the Sequential Organ Failure Assessment (SOFA) scores were 13.52 ± 3.18 and 3.83 ± 2.89, respectively. Twenty-eight patients (96.55%) received respiratory support. Sixteen patients (55.17%) had positive bacterial culture results. Fourteen bacterial strains were detected, most of which were gram-positive (72.72%). Mean LOS was 6.89 ± 14.39 days (range 0.5–73 days), and 24.79 ± 16 days in the hospital. The ICU mortality rate was 10.34%. Compared with LA patients without descending necrotizing mediastinitis (DNM), those with DNM had longer ICU and hospital LOS. The laboratory investigations were higher. ConclusionLA patients in ICU were predominantly male, with a wide range age, high incidence of complications, long hospital LOS.

Clinical characteristics and etiological analysis of late fetal death

With the continuous improvement of obstetric quality, the death of the fetus caused by serious pregnancy complications showed a downward trend. However, the etiological analysis of late fetal death is still an urgent health problem and early detection is required to reduce the risk of stillbirth. This study aimed to investigate the clinical and pathological features of late fetal death, and to propose the intervention measures to reduce the incidence of perinatal mortality. This was a retrospective analysis with 131 cases of fetal death of more than 28 gestation weeks from February 2009 to December 2015 in International Peace Maternity and Child-health Hospital. The related factors of maternal and umbilical cord were analyzed by STATA software. Among the 131 cases of dead fetuses in the late stage, 71 (54.2%) cases died of umbilical cord factor. Maternal age of late fetal death usually occurred from 25~35 years (83.97%). History of hysteromyoma, syphilis, thyroid disease, diabetes or uterine abnormalities of pregnant women are risk factors contributed to fetal death. Most pregnant women had regular prenatal examination 107 (89.9%), among which the number of stillbirths with ultrasound screening abnormalities was 69 (58.0%), 47 (39.5%) cases with D-Dimer abnormal of blood coagulation function, and 32 (26.9%) cases with positive bacterial culture results of fetal death. There were no statistically significant differences in fetal death rate between fasting blood glucose, platelet counts, ultrasound of fetal biparietal diameter, and pregnancy age, with or without abortion history (all p > 0.05). Umbilical cord torsion, edema, necrosis, and funisitis were the most common factors associated with late fetal death. In conclusion, perinatal healthcare management and monitoring should be strengthened, and the umbilical cord length, diameter, spiral coil index, blood flow, with or without torsion, and other conditions should be classified as routine examination of fetal structural screening in the second trimester ultrasound.

A study of Antibacterial Resistance Associated with Otitis Media Patients in Al-Diwaniyah Teaching Hospital

This study is conducted on a group of patients with suppurative Otitis media from E.N.T. clinic in Al- Diwaniya Teaching Hospital during January to August 2010. A total number of (55) individuals of both sexes , as patients with suppurative otitis media, consisting of (25) males and (30)females. The age of patients range from(1-60)years.Samples (ear swab) are taken before treatment .The collected sample is processed for bacterial isolation , identification and antibiotic sensitivity test are assessed for each isolate. positive results of bacterial culture are (52) (94.54%) of ear swab samples from supurative Otitis media .Gram negative bacteria are more prevalent (29:50)(56%) compared with Gram positive which constitutes (19:50)(44%). As Gram negative Pseudomonas aeruginosa is the most common bacterial species isolated from patients with otitis media(30%), Proteus vulgaris (16%) ,other gram negative bacteria species (12%) . while Gram positive are Staphylococcus aureus (38%) and Staphylococcus epidermidis (4%). Antibiotics resistance phenomena was seen for many antibiotics, that may be cause of recurrent of Otitis media .

Analysis of 20 cases of patients with diabetes merged oral and maxillofacial space infection

Objective To discuss the methods of treating diabetes merged oral and maxillofacial space infec-tion and their effects. Methods Clinical data of 20 patients with diabetes merged oral and maxillofacial space infec-tion were retrosepectively analyzed. Results All 20 cases of patients with diabetes merged oral and maxillofacial space infection were cured. The mean length of treatment was(18.4±2.8)days. There were 20 cases of positive results of bacterial culture, the positive rate was 100%, and there were 15 cases of streptococcal infection,4 cases of klebsiella pneumoniae infection,1 case of candida albicans infection. 20 cases of patients was given incision and drainage,4 cases given incision of trachea. Conclusion It was easier for patients with diabetes having maxillofacial space infection, and more serious illness, more difficult for treating. Local infection should be treated, and systemic conditions should be improved as well. The risks of occurrence of serious complications should be reduced. Key words: Diabetes; Infection; Comprehensive modality therapy

Identification of bacteriology and risk factor analysis of asymptomatic bacterial colonization in pacemaker replacement patients.

BackgroundRecent researches revealed that asymptomatic bacterial colonization on PMs might be ubiquitous and increase the risk of clinical PM infection. Early diagnosis of patients with asymptomatic bacterial colonization could provide opportunity for targeted preventive measures.ObjectiveThe present study explores the incidence of bacterial colonization of generator pockets in pacemaker replacement patients without signs of infection, and to analyze risk factors for asymptomatic bacterial colonization.MethodsFrom June 2011 to December 2013, 118 patients underwent pacemaker replacement or upgrade. Identification of bacteria was carried out by bacterial culture and 16S rRNA sequencing. Clinical risk characteristics were analyzed.ResultsThe total bacterial positive rate was 37.3% (44 cases), and the coagulase-negative Staphylococcus aureus detection rate was the highest. Twenty two (18.6%) patients had positive bacterial culture results, of which 50% had coagulase-negative staphylococcus. The bacterial DNA detection rate was 36.4 % (43 cases). Positive bacterial DNA results from pocket tissues and the surface of the devices were 22.0% and 29.7%, respectively. During follow-up (median, 27.0 months), three patients (6.8%, 3/44) became symptomatic with the same genus of microorganism, S. aureus (n=2) and S. epidermidis (n=1). Multivariable logistic regression analysis showed that history of bacterial infection, use of antibiotics, application of antiplatelet drugs, replacement frequency were independent risk factors for asymptomatic bacterial colonization.ConclusionThere was a high incidence of asymptomatic bacterial colonization in pacemaker patients with independent risk factors. Bacterial culture combined genetic testing could improve the detection rate.

Positive Results of Bacterial Culture for Herniated Lumbar Disc-Preliminary Results

Introduction Recent studies have shown the possibility of involvement of bacterial infection during the intervertebral disc degeneration and low back pain, but there is still controversial. The aim of this study is to investigate whether there is bacterial materials in degenerated intervertebral disc tissues of patients. Materials and Methods A total of 20 degenerated intervertebral discs were collected from 16 patients who underwent spinal surgeries, due to disc herniation. Aerobic and anaerobic bacterial cultures were performed for each nucleus pulposus. Ligamentum flavums collected before discectomy were also conducted bacterial cultures for patients with Modic changes. Results The disc materials from four patients (six discs) had positive results of microbiological culture. Particles chain bacteria was found in one disc. The sample of two discs of one patient showed coagulase-negative staphylococci. Staphylococcus aureus and coagulase-negative staphylococci were found in another patient. Staphylococcus epidermidis existed in two discs of the same person who had fever after operation. The positive ratio of microbiological culture is 4 out of 16 (25%) patients or 6 out of 20 (30%) discs. All these four individuals had not Modic change. Conclusion These results showed the existence of bacteria in the disc materials obtained during back surgeries. These bacteria could be preexisted in the degenerated disc or just from contamination. The differentiation of these two causes is need for further study. Disclosure of Interest None declared References Stirling A, Worthington T, Rafiq M, Lambert PA, Elliott TS. Association between sciatica and Propionibacterium acnes. Lancet 2001;357(9273):2024–2025 Albert HB, Sorensen JS, Christensen BS, Manniche C. Antibiotic treatment in patients with chronic low back pain and vertebral bone edema (Modic type 1 changes): a double-blind randomized clinical controlled trial of efficacy. Eur Spine J 2013;22(4):697–707

Increased detection of mastitis pathogens by real-time PCR compared to bacterial culture

Rapid and accurate identification of mastitis pathogens is important for disease control. Bacterial culture and isolate identification is considered the gold standard in mastitis diagnosis but is time consuming and...

SAT0377 The Performance of a Novel Scoring System in the Differential Diagnosis Between Acute Gout and Septic Arthritis

BackgroundRecently, a novel scoring system was developed for the diagnosis of gout without joint fluid analysis (1). The performance of this scoring system in the differential diagnosis between acute gout...

Influence ofHelicobacter pyloriinfection on ghrelin levels in children

To compare ghrelin levels in plasma and gastric mucosa before and after Helicobacter pylori (H. pylori) treatment in children with H. pylori-associated functional dyspepsia. Children with H. pylori-associated functional dyspepsia were enrolled in this study. H. pylori infection was confirmed by positive bacterial culture results. All of the children received triple H. pylori eradication therapy (a 2 wk course of omeprazole, amoxicillin, and clarithromycin). The children were divided into two groups based on the success of the H. pylori treatment: group 1 (eradicated) - patients who had a negative 13C-urea breath test 2 mo after the end of therapy; and group 2 (non-eradicated) - patients who had a positive 13C-urea breath test. Plasma ghrelin, gastric ghrelin mRNA, and the body mass index were evaluated in both groups before and after the H. pylori treatment. The plasma ghrelin levels were measured by a radioimmunoassay. The expression of gastric ghrelin mRNA was determined by real-time reverse transcription polymerase chain reaction. A total of 50 children with H. pylori-associated functional dyspepsia were treated with triple H. pylori eradication therapy. The mean age of the children was 5.52 ± 0.83 years, and there were 28 males and 22 females. Among the 50 H. pylori-positive children, 30 successfully achieved eradication, and 20 did not. The mean plasma ghrelin levels of group 1 were 22.17 ± 1.73 ng/L and 26.59 ± 2.05 ng/L before and after the treatment, respectively, which was a significant increase (P = 0.001). However, the mean plasma ghrelin level of group 2 before and after the H. pylori treatment was 21.34 ± 2.40 ng/L and 22.24 ± 2.10 ng/L (P = 0.785). The plasma ghrelin levels increased substantially after treatment in group 1 but showed only minor changes in group 2. Similarly, the gastric ghrelin mRNA expression in group 1 before treatment was 2.84 ± 0.08. After treatment, the level was 3.11 ± 0.65, which was significantly different (P = 0.023). The gastric ghrelin mRNA expression in group 2 did not change significantly during the treatment (2.82 ± 0.44 vs 2.79 ± 0.31, P = 0.875). The plasma ghrelin and gastric ghrelin mRNA levels in group 1 increased substantially after the treatment but did not do so in group 2. In addition, the body mass index the two groups did not differ significantly 2 mo before and after the H. pylori treatment. H. pylori eradication increases the plasma and tissue ghrelin levels in children with H. pylori-associated functional dyspepsia.

High Incidence of Multidrug-Resistant Gram-Negative Bacteria Recovered from Afghan Patients at a Deployed US Military Hospital

To investigate potential sources and risks associated with multidrug-resistant (MDR) bacteria in a deployed US military hospital. Retrospective analysis of factors associated with recovery of MDR bacteria, supplemented by environmental sampling. The largest US military hospital in Afghanistan. US and Afghan patients with positive bacterial culture results, from September 2007 through August 2008. Microbiologic, demographic, and clinical data were analyzed. Potential risk factors included admission diagnosis or mechanism of injury, length of stay, gender, age, and nationality (US or Afghan). Environmental sampling of selected hospital high-touch surfaces and equipment was performed to help elucidate whether environmental MDR bacteria were contributing to nosocomial spread. A total of 266 patients had 411 bacterial isolates that were identified during the study period, including 211 MDR bacteria (51%). Gram-negative bacteria were common among Afghan patients (241 [76%] of 319), and 70% of these were classified as MDR. This included 58% of bacteria recovered from Afghan patients within 48 hours of hospital admission. The most common gram-negative bacteria were Escherichia coli (53% were MDR), Acinetobacter (90% were MDR), and Klebsiella (63% were MDR). Almost one-half of potential extended-spectrum β-lactamase (ESBL) producers were community acquired. Of 100 environmental swab samples, 18 yielded MDR bacteria, including 10 that were Acinetobacter, but no potential ESBL-producing bacteria. Gram-negative bacteria from Afghan patients had high rates of antimicrobial resistance. Patients experiencing complex trauma and prolonged hospital stays likely contribute to the presence of MDR bacteria in this facility. However, many of these patients had community-acquired cases, which implies high rates of colonization prior to hospital admission.

Immunization and Nutritional Profile of Cases with Atraumatic Microbial Keratitis in Preschool Age Group

To evaluate the role of protein energy malnutrition and immunization profile in cases of atraumatic microbial keratitis in preschool children. Retrospective case analysis. Case records of all children 5 years of age and younger with atraumatic microbial keratitis treated at the Dr Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi, India, between January and December 2006 were reviewed retrospectively. Main parameters evaluated were age, degree of protein-energy malnutrition, immunization profile, microbiologic profile, and final outcome. Fifty-four consecutive children were enrolled during the study period. The mean age was 33.69 ± 21.91 months (range, 3 to 60 months). Mean weight on presentation was 10.57 ± 3.87 kg (range, 4 to 17 kg), with an average protein-energy malnutrition grade of 1.77 ± 0.74. The immunization for age was complete in 43 (80%) children. Severe protein-energy malnutrition was associated with the occurrence of bilateral keratitis (P < .001) and incomplete immunization (P < .001). Positive bacterial culture results were obtained in 44 (82%) cases, with Staphylococcus species being the most prevalent isolate (33/44; 75%). Cases requiring emergency corneal transplantation (24%) were associated with severe protein-energy malnutrition (P < .00) and bilaterality (P < .00). In multivariate analyses, cases without severe protein-energy malnutrition were 36% less likely to undergo any kind of surgical intervention (odds ratio, 0.64; 95% confidence interval, 0.04 to 0.91). Our study highlights the association of protein-energy malnutrition and immunization profile with the occurrence of atraumatic microbial keratitis in preschool children. Most of these cases required corneal transplantation surgery to preserve the ocular integrity and to restore vision.

The diagnostic value of determination of positive and negative acute phase proteins in milk from dairy cows with subclinical mastitis

Currently, somatic cell count (SCC) and bacterial culture are considered as the gold standard methods for the diagnosis of bovine subclinical mastitis. However, SCC has a low diagnostic accuracy. Therefore, for identification of infected animals, new biomarkers with high diagnostic accuracy are needed. Acute phase proteins (APPs) are proteins that are increased (positive APPs) or decreased (negative APPs) in response to inflammation. The objective of this study was to determine the diagnostic value of milk APPs for the diagnosis of subclinical mastitis in dairy cows. A total of 90 clinically healthy cows were randomly selected. Of these, 52 cows were considered subclinical mastitic based on a SCC higher than 130 × 1,000 cells/mL of milk and positive bacterial culture results of milk samples obtained from at least one of the quarters. Milk amyloid A (MAA) concentration was measured using a commercial ELISA kit and albumin, α-lactalbumin, β-lactoglobulin, and immunoglobulin (Ig) were measured in the whey samples by the use of cellulose acetate electrophoresis. Diagnostic sensitivity and specificity and cutoff points for each test were determined via receiver-operating characteristics analysis. Significant (P 1.6 mg/L. The results of this study showed that determination of MAA can be used as a reliable method for the diagnosis of bovine subclinical mastitis.