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Pessoa RBG, de Oliveira WF, Correia MTDS, Fontes A, Coelho LCBB. Aeromonas and Human Health Disorders: Clinical Approaches. Front Microbiol 2022; 13:868890. [PMID: 35711774 PMCID: PMC9195132 DOI: 10.3389/fmicb.2022.868890] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/23/2022] [Indexed: 11/16/2022] Open
Abstract
The genus Aeromonas comprises more than 30 Gram-negative bacterial species and naturally inhabitants from aquatic environments. These microorganisms, commonly regarded as pathogens of fish and several other animals, have been gaining prominence on medical trial due to its ability to colonize and infect human beings. Besides water, Aeromonas are widely spreaded on most varied sources like soil, vegetables, and food; Although its opportunistic nature, they are able to cause infections on immunocompromised or immunocompetent patients. Aeromonas species regarded as potential human pathogens are usually A. hydrophila, A. caviae, and A. veronii biovar sobria. The main clinical manifestations are gastrointestinal tract disorders, wound, and soft tissue infections, as well as septicemia. Regarding to antibiotic responses, the bacteria present a diversified susceptibility profile and show inherence resistance to ampicillin. Aeromonas, as an ascending genus in microbiology, has been carefully studied aiming comprehension and development of methods for detection and medical intervention of infectious processes, not fully elucidated in medicine. This review focuses on current clinical knowledge related to human health disorders caused by Aeromonas to contribute on development of efficient approaches able to recognize and impair the pathological processes.
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Affiliation(s)
| | - Weslley Felix de Oliveira
- Departamento de Bioquímica, Centro de Biociências, Universidade Federal de Pernambuco, Recife, Brazil
| | | | - Adriana Fontes
- Departamento de Biofísica e Radiobiologia, Centro de Biociências, Universidade Federal de Pernambuco, Recife, Brazil
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Ghweil AA, Bazeed SES, Al Rawy MH, Khodeary A, El-Amir MI. Fluoroquinolone-resistant strains in cirrhotic patients with spontaneous bacterial peritonitis: microbiological and molecular aspects. Eur J Gastroenterol Hepatol 2022; 34:64-68. [PMID: 32804847 DOI: 10.1097/meg.0000000000001908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES This study aimed to determine the causative bacterial agents of spontaneous bacterial peritonitis (SBP) in patients with cirrhosis and to define antibiotic-resistance patterns in addition to identifying the genetic mutations in the quinolone resistance determining regions (QRDRs). PATIENTS AND METHODS Twenty milliliters of ascetic fluid was obtained from 51 patients with SBP. The antibiotic-sensitivity patterns of different strains were determined by the Kirby-Bauer method. Extracted bacterial DNA was used to determine the mutations in four different genes in QRDRs (gyrA, gyrB, parC, and parE) by sequencing after gene amplification by PCR. RESULTS Gram-negative bacilli were detected in 60.7% of the patients. Escherichia coli was detected in 33.3% of the patients, and Staphylococcus aureus was detected in 21.6%. Gram-negative bacilli showed the best sensitivity to meropenem (90.3%), followed by amikacin (83.9%). Gram-positive cocci were sensitive to vancomycin and oxacillin at 90 and 80%, respectively. Fluoroquinolone resistance was detected in 27% of the bacterial strains. Mutations in the gyrA and parC genes were detected in quinolone-resistant strains (64.3 and 35.7%, respectively). Several mutations were found in the gyrA gene (Ser83Leu, Ser81Phe, and Ser-84Leu). Ser80Ile and Ser79Tyr mutations were detected in the parC gene. No mutation was detected in the parE gene. CONCLUSION Frequent use of antibiotics as prophylaxis against SBP leads to an increase in antibiotic resistance and changes the microbial pattern of causative agents. The gyrA gene mutation was the most common mutation detected in fluoroquinolone-resistant strains.
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Affiliation(s)
- Ali A Ghweil
- Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, South Valley University, Qena
| | | | - M H Al Rawy
- Department of Clinical Pathology, Faculty of Medicine, Sohag University, Sohag
| | - Ashraf Khodeary
- Department of Clinical Pathology, Faculty of Medicine, Sohag University, Sohag
| | - Mostafa I El-Amir
- Department of Medical Microbiology and Immunology, Faculty of Medicine, South Valley University, Qena, Egypt
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3
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Performance of Leukocyte Esterase Reagent Strips in the Detection of Spontaneous Bacterial Peritonitis in Cirrhotic Patients: A Systematic Review and Meta-analysis. J Clin Exp Hepatol 2022; 12:519-532. [PMID: 35535110 PMCID: PMC9077197 DOI: 10.1016/j.jceh.2021.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/04/2021] [Indexed: 12/12/2022] Open
Abstract
Background Spontaneous bacterial peritonitis (SBP) is a bacterial infection associated with a high mortality rate in cirrhotic patients. The gold standard for the detection of SBP is a manual cell count from ascitic fluid; however, alternative screening methods are under investigation. In particular, leukocyte esterase reagent strips (LERS) has been studied as an alternative method to detect SBP with a low cost and instant turnaround time. Therefore, this study aims to evaluate the performance of LERS in the detection of SBP. Methods A literature search was performed for studies evaluating LERS for the detection of SBP on PubMed, Embase, Scopus, Cochrane, and clinical trial registries. Summary sensitivity, specificity, log diagnostic odds ratio (LDOR), and the area under the summary receiver operating curve (AUC) were calculated according to the respective manufacturer. Results In total, 31 studies were evaluated. The summary sensitivity of Aution Sticks, Combur, Multistix, Periscreen reagent strips was 0.962 (95% confidence interval [CI] 0.926, 0.998), 0.892 (95% CI 0.846, 0.938), 0.806 (95% CI 0.738, 0.874), and 0.939 (95% CI 0.900, 0.979), respectively. The summary specificity of Aution Sticks, Combur, Multistix, and Periscreen reagent strips was 0.940 (95% CI 0.904, 0.976), 0.922 (95% CI 0.874, 0.970), 0.974 (95% CI 0.962, 0.985), and 0.672 (95% CI 0.381, 0.963), respectively. Conclusion LERS appears to have a notable overall performance for the detection of SBP. LERS appeared to be an acceptable alternative to diagnose SBP in facilities without ability to perform cell count. However, there were significant differences in performance between each manufacturer.
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Fiore M, Di Franco S, Alfieri A, Passavanti MB, Pace MC, Kelly ME, Damiani G, Leone S. Spontaneous bacterial peritonitis caused by Gram-negative bacteria: an update of epidemiology and antimicrobial treatments. Expert Rev Gastroenterol Hepatol 2019; 13:683-692. [PMID: 31107612 DOI: 10.1080/17474124.2019.1621167] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction: Spontaneous bacterial peritonitis (SBP) is a main infectious complication in end-stage liver disease (ESLD) patients. The increasing trend of bacterial resistance in ESLD patients with SBP has been associated with low treatment efficacy of traditional therapy. Cephalosporin use has been restricted to community-acquired infections and in areas/health care settings with low rates of multidrug-resistant (MDR) bacteria. To date, several changes are necessary with regard to empiric therapy recommendations in areas/health care settings with high rates of MDR bacteria. Areas covered: An overview of the epidemiology and antimicrobial treatments of SBP caused by Gram-negative bacteria. Expert opinion: Broad-spectrum antibiotics have been recommended as empiric therapy for suspected SBP in areas/health care settings with high rates of MDR bacteria and secondary treatment, with newer antibiotics, for SBP caused by MDR-Gram-negative bacteria (i.e. new beta-lactam/beta-lactamase inhibitor combinations, cefiderocol, plazomicin, and eravacycline) either alone or in combination.
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Affiliation(s)
- Marco Fiore
- a Department of Women , Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Sveva Di Franco
- a Department of Women , Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Aniello Alfieri
- a Department of Women , Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Maria Beatrice Passavanti
- a Department of Women , Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Maria Caterina Pace
- a Department of Women , Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Molly E Kelly
- b Case Western Reserve University School of Medicine , Cleveland , OH , USA
| | - Giovanni Damiani
- c Department of Pathophysiology and Transplantation , University of Milan , Italy
| | - Sebastiano Leone
- d Division of Infectious Diseases , "San Giuseppe Moscati" Hospital , Avellino , Italy
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Swift CP, Gwaikolo C, Ssentamu J, Wachekwa I, Adeiza MA, Adu E, Harb R. Body Fluid Testing at John F. Kennedy Medical Center in Liberia. Am J Clin Pathol 2019; 152:86-90. [PMID: 31165167 DOI: 10.1093/ajcp/aqz027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVES To apply a simple method to validate testing for albumin, glucose, lactate dehydrogenase (LDH) and total protein (TP) in peritoneal, pleural, and cerebrospinal fluids (CSF) at a hospital in Liberia. METHODS Serum and body fluid specimens were mixed to create 100% serum and 25%, 50%, 75%, and 100% fluid tubes, which were tested on a Biotecnica BT3500. Differences less than 10% between calculated and measured concentrations were considered acceptable. RESULTS The means (confidence intervals) of the percent differences were: albumin/peritoneal 12.8 (6.0-19.7), albumin/pleural 2.8 (1.3-4.2), albumin/CSF 4.8 (2.2-7.5), glucose/peritoneal 4.0 (1.9-6.0), glucose/pleural 4.4 (3.1-5.7), glucose/CSF 2.9 (1.8-4.0), LDH/peritoneal 9.5 (6.3-12.7), LDH/pleural 9.5 (5.4-13.6), LDH/CSF 9.2 (5.2-13.3), TP/peritoneal 7.6 (3.8-11.4), TP/pleural 3.8 (1.5-6.2), and TP/CSF 4.5 (1.0-8.1). CONCLUSIONS All mean differences except for one were less than 10%, allowing for the adoption of clinical testing. The mixing study is a low-cost method for quality-assured testing that can be performed by resource-limited laboratories.
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Affiliation(s)
- Callum P Swift
- Tallaght University Hospital, Dublin, Ireland
- John F. Kennedy Medical Center, Monrovia, Liberia
| | | | - John Ssentamu
- Liberia College of Physicians and Surgeons, Monrovia, Liberia
| | - Ian Wachekwa
- John F. Kennedy Medical Center, Monrovia, Liberia
| | - Mukhtar A Adeiza
- Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
- John F. Kennedy Medical Center, Monrovia, Liberia
| | - Eric Adu
- John F. Kennedy Medical Center, Monrovia, Liberia
| | - Roa Harb
- John F. Kennedy Medical Center, Monrovia, Liberia
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT
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6
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Yu GH, Glaser LJ, Gustafson KS. Role of Ancillary Techniques in Fluid Cytology. Acta Cytol 2019; 64:52-62. [PMID: 31018204 DOI: 10.1159/000496568] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 01/02/2019] [Indexed: 01/11/2023]
Abstract
The cytologic evaluation of serous effusions may be challenging for a number of reasons. Distinction of benign, reactive conditions from malignancy represents the main focus when examining these specimens. The morphologic diagnosis of malignancy may be difficult due to the relative paucity of abnormal cells. In other situations, cellularity is not an issue, but the ability to confidently identify a second, foreign (i.e., tumor) population within a background mesothelial cells on the basis of cytomorphologic features alone may pose problems. Cases with definitive morphologic evidence of malignancy may require additional studies in order to determine the tumor subtype and, in the case of carcinoma, the primary site of origin. Cases in which a definitive and precise diagnosis of malignancy is made may be optimal candidates for further molecular testing in order to gain prognostic information and guide personal therapeutic decisions. Finally, while an inflammatory or infectious condition can be suggested on the basis of cellular components and associated background elements, the identification of causative agent(s) may be difficult without additional studies. In all of these situations, the use of ancillary studies and techniques is critical; their utility and appropriate application are the subject of this review.
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Affiliation(s)
- Gordon H Yu
- Hospital of the University of Pennsylvania, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA,
| | - Laurel J Glaser
- Hospital of the University of Pennsylvania, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Karen S Gustafson
- Hospital of the University of Pennsylvania, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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Sadat Mazloom S, Khoramian MK, Mohsenian L. Spontaneous Bacterial Peritonitis in Afebrile Cirrhotic Patients; Report from a Referral Transplantation Center. Bull Emerg Trauma 2018; 6:363-366. [PMID: 30402527 PMCID: PMC6215066 DOI: 10.29252/beat-060415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Spontaneous bacterial peritonitis (SBP) is a complication of liver cirrhosis with adverse effect on patient prognosis. Early diagnosis and treatment is highly important, especially in patients without remarkable manifestations. We designed this study to determine the prevalence of SBP among afebrile cirrhotic patients and identify high-risk subgroups in a referral center in southern Iran. This cross-sectional study evaluated all afebrile cirrhotic patients, admitted to the gastroenterology ward of Namazi hospital (affiliated with Shiraz University of Medical Sciences, Shiraz, Iran) over a 6-month period in 2017, for the presence and correlates of SBP. Demographic data, clinical findings, and comorbidities were recorded. Ascitic fluid white blood cells (WBC) count >500 and neutrophil count >250 indicated bacterial peritonitis. In total, 97 afebrile cirrhotic patients comprising of 63 (64.9%) men and 34 (35.1%) women were included. All patients had ascites and 89 (91.8%) had abdominal tenderness. Accordingly, abdominal distension was the top presentation. Confirmed etiologies or comorbidities such as HBS, HCV, and liver cancer or metastasis existed in 46 patients. Thirteen (13.4%) had SBP. The correlations of gender (p=0.331), decreased level of consciousness (p=0.145), tenderness (p=0.315). With regards to the type of presentations, only DLOC showed to be significantly higher in SBP negative patients (p=0.022, OR=0.09. 95%CI=0.01–0.62). Also, using binary logistic regression, the correlation of age with SBP was statistically non-significant (coefficient= ⎼0.013, p=0.595). Our findings indicated that routine paracentesis in all cirrhotic patients regardless of fever can help diagnose a number of potentially neglected patients and improve their outcome.
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Affiliation(s)
- Sara Sadat Mazloom
- Department of Emergency Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Leila Mohsenian
- Department of Emergency Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Shizuma T. Spontaneous bacterial and fungal peritonitis in patients with liver cirrhosis: A literature review. World J Hepatol 2018; 10:254-266. [PMID: 29527261 PMCID: PMC5838444 DOI: 10.4254/wjh.v10.i2.254] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 12/31/2017] [Accepted: 01/24/2018] [Indexed: 02/06/2023] Open
Abstract
Spontaneous bacterial (SBP) and spontaneous fungal peritonitis (SFP) can be a life-threatening infection in patients with liver cirrhosis (LC) and ascites. One of the possible mechanisms of developing SBP is bacterial translocation. Although the number of polymorphonuclear cells in the culture of ascitic fluid is diagnostic for SBP, secondary bacterial peritonitis is necessary to exclude. The severity of underlying liver dysfunction is predictive of developing SBP; moreover, renal impairment and infections caused by multidrug-resistant (MDR) organism are associated with a fatal prognosis of SBP. SBP is treated by antimicrobials, but initial empirical treatment may not succeed because of the presence of MDR organisms, particularly in nosocomial infections. Antibiotic prophylaxis is recommended for patients with LC at a high risk of developing SBP, gastrointestinal bleeding, or a previous episode of SBP, but the increase in the risk of developing an infection caused by MDR organisms is a serious concern globally. Less is known about SFP in patients with LC, but the severity of underlying liver dysfunction may increase the hospital mortality. SFP mortality has been reported to be higher than that of SBP partially because the difficulty of early differentiation between SFP and SBP induces delayed antifungal therapy for SFP.
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Affiliation(s)
- Toru Shizuma
- Department of Physiology, Tokai University School of Medicine, Isehara 2591193, Japan
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Lippi G, Sanchis-Gomar F. Procalcitonin in inflammatory bowel disease: Drawbacks and opportunities. World J Gastroenterol 2017; 23:8283-8290. [PMID: 29307988 PMCID: PMC5743499 DOI: 10.3748/wjg.v23.i47.8283] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 11/27/2017] [Accepted: 12/04/2017] [Indexed: 02/06/2023] Open
Abstract
The measurement of procalcitonin has recently become a mainstay for the diagnosis and therapeutic management of severe bacterial infections, especially those sustained by Gram-negative bacteria. Therefore, the aim of this article is to provide a narrative overview on the potential role of procalcitonin measurement in patients with inflammatory bowel disease (IBD). According to the available scientific literature, the clinical significance of procalcitonin for diagnosing IBD or monitoring disease activity remains elusive, and its association with disease severity is confined to a limited number of case-control studies, with low sample size. Nevertheless, literature data also suggests that a supranormal procalcitonin serum concentration (i.e., > 0.5 ng/mL) may reflect the presence of a number of infective complications in IBD, especially bacterial enterocolitis, bacterial gastroenteritis, intraabdominal abscess, postsurgical infection and sepsis. Rather than for diagnosing or assessing disease activity, the measurement of this biomarker may hence retain practical clinical significance for early prediction, timely diagnosis and therapeutic monitoring of many IBD-associated infections and complications.
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Affiliation(s)
- Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona 37134, Italy
| | - Fabian Sanchis-Gomar
- Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, NY 10016, United States
- Department of Physiology, Faculty of Medicine, University of Valencia and INCLIVA Biomedical Research Institute, Valencia 46010, Spain
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10
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The role of the neutrophil Fcγ receptor I (CD64) index in diagnosing spontaneous bacterial peritonitis in cirrhotic patients. Int J Infect Dis 2016; 49:154-60. [PMID: 27381937 DOI: 10.1016/j.ijid.2016.06.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 05/18/2016] [Accepted: 06/28/2016] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To investigate the role of the neutrophil Fcγ receptor I (CD64) index in the diagnosis of spontaneous bacterial peritonitis (SBP) in cirrhotic patients. METHODS A total of 123 cirrhotic patients with ascites who fulfilled the inclusion criteria were enrolled in this study. Ascites and blood samples were collected; the polymorphonuclear neutrophil (PMN) count, bacterial culture, and related laboratory tests were performed. The CD64 index was determined for each sample using flow cytometry. RESULTS The neutrophil CD64 index results were significantly higher in cirrhotic patients with SBP than in those without SBP (p<0.001). There was a positive correlation between the neutrophil CD64 index and the PMN count in ascites. In the receiver operating characteristic curve (ROC) analysis, the area under the curve (AUC) was 0.894 (95% confidence interval 0.823-0.964, p<0.001). The optimal cut-off value for the neutrophil CD64 index was 2.02. The sensitivity and specificity of the neutrophil CD64 index for cirrhotic patients with SBP were 80.49% and 93.90%, respectively. The elevated neutrophil CD64 index was down-regulated by antibiotic therapy (p=0.002). CONCLUSIONS The neutrophil CD64 index could be used as a sensitive and specific indicator for the diagnosis of SBP in cirrhotic patients with ascites and is also modulated by antibiotic therapy.
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Buoro S, Appassiti Esposito S, Vavassori M, Mecca T, Ottomano C, Dominoni P, Seghezzi M, Candiago E, Farina C, Gianatti A, Crippa A, Lippi G. Reflex Testing Rules for Cell Count and Differentiation of Nucleated Elements in Pleural and Ascitic Fluids on Sysmex XE-5000. ACTA ACUST UNITED AC 2016; 21:297-304. [DOI: 10.1177/2211068215593375] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Indexed: 12/29/2022]
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12
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Micó M, Navarro F, de Miniac D, González Y, Brell A, López C, Sánchez-Reus F, Mirelis B, Coll P. Efficacy of the FilmArray blood culture identification panel for direct molecular diagnosis of infectious diseases from samples other than blood. J Med Microbiol 2015; 64:1481-1488. [PMID: 26432445 DOI: 10.1099/jmm.0.000180] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Molecular-based techniques reduce the delay in diagnosing infectious diseases and therefore contribute to better patient outcomes. We assessed the FilmArray blood culture identification (BCID) panel (Biofire Diagnostics/bioMérieux) directly on clinical specimens other than blood: cerebrospinal, joint, pleural and ascitic fluids, bronchoscopy samples and abscesses. We compared the results from 88 samples obtained by culture-based techniques. The percentage of agreement between the two methods was 75 % with a Cohen κ value of 0.51. Global sensitivity and specificity using the FilmArray BCID panel were 71 and 97 %, respectively. Sensitivity was poorer in samples with a low bacterial load, such as ascitic and pleural fluids (25 %), whereas the sensitivity for abscess samples was high (89 %). These findings suggest that the FilmArray BCID panel could be useful to perform microbiological diagnosis directly from samples other than positive blood cultures, as it offers acceptable sensitivity and moderate agreement with conventional microbiological methods. Nevertheless, cost-benefit studies should be performed before introducing this method into algorithms for microbiological diagnostics.
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Affiliation(s)
- Miquel Micó
- Servei de Microbiologia. Hospital de la Santa Creu i Sant Pau Barcelona, Spain
| | - Ferran Navarro
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain.,Servei de Microbiologia. Hospital de la Santa Creu i Sant Pau Barcelona, Spain.,Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain and Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Daniela de Miniac
- Servei de Microbiologia. Hospital de la Santa Creu i Sant Pau Barcelona, Spain
| | - Yésica González
- Servei de Microbiologia. Hospital de la Santa Creu i Sant Pau Barcelona, Spain
| | - Albert Brell
- Servei de Microbiologia. Hospital de la Santa Creu i Sant Pau Barcelona, Spain
| | - Cristina López
- Servei de Microbiologia. Hospital de la Santa Creu i Sant Pau Barcelona, Spain
| | - Ferran Sánchez-Reus
- Servei de Microbiologia. Hospital de la Santa Creu i Sant Pau Barcelona, Spain.,Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain and Universitat Autònoma de Barcelona, Barcelona, Spain.,Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain
| | - Beatriz Mirelis
- Servei de Microbiologia. Hospital de la Santa Creu i Sant Pau Barcelona, Spain.,Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain and Universitat Autònoma de Barcelona, Barcelona, Spain.,Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain
| | - Pere Coll
- Servei de Microbiologia. Hospital de la Santa Creu i Sant Pau Barcelona, Spain.,Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain and Universitat Autònoma de Barcelona, Barcelona, Spain.,Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain
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Dipalo M, Guido L, Micca G, Pittalis S, Locatelli M, Motta A, Bianchi V, Callegari T, Aloe R, Da Rin G, Lippi G. Multicenter comparison of automated procalcitonin immunoassays. Pract Lab Med 2015; 2:22-28. [PMID: 28932801 PMCID: PMC5597721 DOI: 10.1016/j.plabm.2015.07.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 07/03/2015] [Accepted: 07/07/2015] [Indexed: 12/04/2022] Open
Abstract
Objectives A multicenter study to compare results of BRAHMS Kryptor PCT with those obtained using four BRAHMS-partnered procalcitonin (PCT) automated immunoassays (DiaSorin Liaison, BioMérieux Vidas, Roche Cobas E601 and Siemens Advia Centaur) and the Diazyme immunotubidimetric assay implemented on four clinical chemistry platforms (Abbott Architect c16000, Siemens Advia 2400, Roche Cobas C501 and Beckman Coulter AU5800). Design and methods One hundred serum samples from in-patients with PCT values between 0.10 and 58.7 ng/mL were divided into aliquots and tested with the nine different reagents and analyzers. BRAHMS PCT Kryptor results were used as reference. Results Compared to BRAHMS PCT Kryptor, significant differences in results were observed on Vidas, Advia Centaur, Architect, Cobas C501 and AU5800. However, the correlation coeffiecients (r) with BRAHMS PCT Kryptor were between 0.899 and 0.988. The mean bias was less than ±1.02 ng/mL, except for Vidas (2.70 ng/mL). The agreement at three clinically relevant cut-offs was optimal: between 83–98% at 0.50 ng/mL, 90–97% at 2.0 ng/mL, and 98% at 10 ng/mL. The comparison of Diazyme PCT across the four clinical chemistry analyzers yielded high correlation coefficients (r between 0.952 and 0.976), a mean bias less than ±0.9 ng/mL, acceptable agreement at 0.5 ng/mL (>82%), and high concordance at the 2.0 ng/mL (>97%) and 10 ng/mL (>98%) cut-offs. Conclusions The methods and applications evaluated in this multicenter study are aligned with BRAHMS PCT Kryptor and can be used for predicting the risk of progression to systemic inflammation in patients with bacterial infections using the conventional PCT diagnostic thresholds.
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Affiliation(s)
- Mariella Dipalo
- Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy
| | - Lorena Guido
- Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy
| | - Gianmatteo Micca
- Clinical Analysis Laboratory, "Cardinal Massaia" General Hospital, Asti, Italy
| | - Salvatore Pittalis
- Laboratory of Clinical Chemistry and Microbiology, "Maggiore" Hospital, Lodi, Italy
| | - Massimo Locatelli
- Laboratory of Clinical Chemistry, "San Raffaele" University Hospital, Milano, Italy
| | - Andrea Motta
- Laboratory of Clinical Chemistry, "San Raffaele" University Hospital, Milano, Italy
| | - Vincenza Bianchi
- Laboratory of Clinical Chemistry, "SS Antonio e Biagio e C. Arrigo" Hospital, Alessandria, Italy
| | - Tiziana Callegari
- Laboratory of Clinical Chemistry, "SS Antonio e Biagio e C. Arrigo" Hospital, Alessandria, Italy
| | - Rosalia Aloe
- Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy
| | - Giorgio Da Rin
- Department of Laboratory Medicine, Hospital of Bassano del Grappa, Bassano del Grappa (VI), Italy
| | - Giuseppe Lippi
- Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy
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Vicco MH, Rodeles L, Ferini F, Long AK, Musacchio HM. In-hospital mortality risk factors in patients with ascites due to cirrhosis. Rev Assoc Med Bras (1992) 2015; 61:35-9. [PMID: 25909206 DOI: 10.1590/1806-9282.61.01.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 06/07/2014] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION ascites is one of the most common complications of cirrhosis associated with a high rate of mortality. Although several scores have been developed in order to assess the prognosis of the disease, they were designed for predicting liver transplantation requirements and mortality in the short term, but not while in hospital. The aim of this study was to weigh risk factors for in-hospital mortality in adult patients with ascites due to alcoholic cirrhosis. MATERIAL AND METHODS we performed a cross-sectional study in 180 adult patients with diagnosis of cirrhosis with portal hypertension associated with high alcohol intake. The diagnosis of cirrhosis was made by liver echography and portal hypertension was defined by clinical features plus serum-ascites albumin gradient. Sampled individuals were subjected to complete clinical examination. Child Pugh and the MELD scores were applied in all the patients. RESULTS nineteen patients died while in-hospital. Mortality was associated with increased levels of serum white blood cell, urea, creatinine, prolonged prothrombin time, aspartate aminotransferase and alanine aminotransferase. We conducted a multiple binary logistic to predict in-hospital mortality which yielded that serum urea, creatinine and prothrombin time made a significant contribution to prediction with an OR 14 (95% CI 12.8 - 16.7 p = 0.03), 2 (95% CI 0.5 - 3.47, p = 0.04), and 2 (95% CI 1.03 - 2.31, p = 0.01) linearly-related. CONCLUSIONS our results suggest that acute renal failure and prolonged prothrombin time are predictors of in-hospital mortality in patients with portal hypertension due to alcoholic cirrhosis.
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Affiliation(s)
| | - Luz Rodeles
- Internal Medicine Service, Hospital J. B. Iturraspe, Santa Fe, Argentina
| | - Franco Ferini
- Internal Medicine Service, Hospital J. B. Iturraspe, Santa Fe, Argentina
| | - Ana Karina Long
- Internal Medicine Service, Hospital J. B. Iturraspe, Santa Fe, Argentina
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