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Biomedical subjects

E Manso

Publications and source records attributed to E Manso.

At least 19 recordsLinked to original sources

Value of antigen and antibody detection in the serological diagnosis of invasive aspergillosis in patients with hematological malignancies.

In a study to determine the value of antigen and antibody detection in the serological diagnosis of invasive aspergillosis in patients with hematological malignancies, 436 sequential serum samples from 79 neutropenic patients were tested. Circulating galactomannan antigen was detected with a latex agglutination method (Pastorex Aspergillus) and antibody to Aspergillus fumigatus with an immunodiffusion test on agar gel. Among the 79 patients 18 cases of invasive aspergillosis were detected (4 proven, 6 highly probable, 3 probable, 5 suspected). Antigen was detected in 7 of these 18 patients. The sensitivity of the antigen test was 38.8% and the specificity 95%. The antibody test showed 55.5% sensitivity and 100% specificity. In this study the antigen test was less sensitive than previously reported but highly specific and might serve as a supplementary diagnostic test.

Antibodies, Fungal

Bilateral Acanthamoeba keratitis in a gas-permeable contact lens wearer.

Acanthamoeba keratitis is an uncommon but potentially devastating complication of contact lens wear that has been reported with increasing frequency since its first description in 1974. We describe a case of bilateral Acanthamoeba keratitis, which occurred in a 24-year-old man, wearing gas-permeable contact lenses. This is to our knowledge the first case of Acanthamoeba keratitis reported in Italy, and the fourth bilateral case reported in the literature. Medical therapy (carried out after the first week by a different institution, due to the absence of essential antiamebic drugs on the Italian market) was effective in stopping the progression of the disease.

Acanthamoeba

Survey of clinical isolates of Staphylococcus aureus for borderline susceptibility to antistaphylococcal penicillins.

On the basis of the MICs of methicillin and oxacillin, 975 clinical isolates of Staphylococcus aureus were categorized as having resistance, borderline susceptibility or full susceptibility to penicillinase-resistant penicillins (PRPs). The borderline phenotype accounted for 122 isolates (12.5%), whereas 562 isolates were fully susceptible and 290 resistant; one remaining isolate had resistance to methicillin and borderline susceptibility to oxacillin. Reductions in the MICs of methicillin and oxacillin in the presence of sulbactam were greater in strains with borderline PRP susceptibility than in fully susceptible or resistant isolates. Over 99% of fully PRP-susceptible strains, 93% with borderline susceptibility and 71% of resistant strains were susceptible to ampicillin/sulbactam. The production of beta-lactamase, assayed in all strains using nitrocefin as substrate, could be detected without prior induction in 729 strains and after induction only in another 156 strains. With only two exceptions, the beta-lactamase negative strains were part of the fully PRP-susceptible group of organisms (88 of 562 isolates). Among the borderline isolates, strong beta-lactamase reactions were encountered with particular frequency, but not in all strains and not exclusively in borderline strains. Although associated with the majority of borderline strains, beta-lactamase hyperproduction thus did not appear to be an essential feature of the borderline phenotype. The results obtained may have implications for laboratory and clinical medicine, also in the light of recent findings suggesting that other mechanisms besides beta-lactamase hyperproduction may account for borderline susceptibility to PRPs.

Ampicillin

In vitro activities of ramoplanin and four glycopeptide antibiotics against clinical isolates of Clostridium difficile.

Seventy strains of Clostridium difficile, all isolated from symptomatic patients, were found to be uniformly susceptible to ramoplanin, a new glycolipodepsipeptide antibiotic, and to four glycopeptides (vancomycin, teicoplanin, and two semisynthetic teicoplanin derivatives). Ramoplanin is recommended for further evaluation in the treatment of C. difficile-associated disease.

Anti-Bacterial Agents

Nosocomial outbreak of systemic candidosis associated with parenteral nutrition.

Eight patients in two surgical units developed systemic candidosis during a 40-day period from June 5 to July 13, 1987 (in five cases Candida albicans was identified). Three of them died. All cases belonged to a group of 27 patients receiving parenteral nutrition (PN), while among the 108 patients who did not receive PN, no cases were observed (p = .000001). Candida was cultured from two PN bags administered to the cases. A specialized nutrition nurse was responsible for the PN compounding and for maintaining administration sets in the two wards involved. An epidemiological investigation, in which 19 uninfected patients who had had PN were used as controls, showed no significant difference between cases and controls except that lipids were more frequently added to bags administered to cases (p = .0005). Furthermore, the bags administered to cases contained a higher average number of multidose constituents (p = .0008) when the comparison was focused on the two days before the onset of symptoms. Given the favorable medium provided by lipids, even a low level contamination of PN solutions during compounding and/or administration could have been responsible for the exposure of cases to multidose vials suggests, although not conclusively, that an extrinsic contamination occurred during compounding. Six isolates of C albicans were available from four cases. C albicans was cultured from the pharyngeal swabs of two physicians and three nurses, including the specialized nutrition nurse.

Aged

Childhood enteritis: a community study.

The population aged 0-12 years living in the area of an Italian Local Health Unit (about 8,800 children) was studied for one year in order to estimate the overall incidence rate of enteritis and the incidence rates of diarrheas from bacterial agents. All children complaining of acute diarrhea and seen by the pediatric practices of the study area were recorded by date, age, and sex; the microbiological study of stools was performed for a sample of patients. All hospitalized cases of childhood enteritis occurring in the same period in the study population were studied too. Campylobacter jejuni and Salmonella were cultured from 5 out of 71 examined out-patients (7.0%), with a projected annual consultation rate of 2.1 per 1000 population aged 0-12 years. Yersinia enterocolitica was cultured from 2 out-patients (2.8%), while no cases from Shigella and enterotoxigenic Escherichia coli were observed in this group. Data concerning hospitalized cases confirmed this pattern of results. Bacterial enteritis is an important public health problem in the study area and its occurrence is possibly related to animal reservoirs of infection, with particular regard to poultry and pets.

Campylobacter Infections

[Campylobacter pyloridis and gastritis: endoscopic, histological and microbiological correlations].

Biopsy specimens from antral mucosa in 65 consecutive patients presenting for gastroscopy were assessed histologically and microbiologically for the presence of C. pyloridis. Spiral bacteria were found in 63% of cases by Warthin-Starry silver stain and in 72% by culture on blood agar plates with Skirrow's antibiotic supplement. A significant association between the occurrence of C. pyloridis and chronic gastritis was noted; the association is not influenced by the type of gastritis, superficial or atrophic, or the degree of activity of gastritis.

Adolescent

Endocarditis due to Cardiobacterium hominis.

A case of subacute bacterial endocarditis was caused by Cardiobacterium hominis in a 55-year-old man who had a history of rheumatic fever. A survey of the literature showed few reports dealing with the isolation of these organisms from human sources. Microbiologically, the chief distinguishing features of C. hominis are its characteristic colonial morphotype, a positive reaction, and its production of indole.

Aortic Valve Insufficiency

[Incidence and origin of Clostridium difficile in neonatology].

The epidemiology of Clostridium difficile was studied prospectively in 101 newborn infants by screening of fecal samples collected in the first or second day of life and in the fourth or fifth one. A vaginal swab and a stool specimen were collected from mothers before delivery. Environmental cultures were obtained from selected sites in the ward, while colonization of intestinal tract and contamination of the hands were evaluated in the personnel. C. difficile was isolated from the feces of 13 infants (13%); colonization rate was higher in infants delivered by cesarean section, but the difference was not significant. Intestinal carriage was demonstrated in two mothers (2%); the baby of one colonized mother was positive for C. difficile. All vaginal swabs were negative. Fecal samples of 2 nurses (18%) were positive; none of the environmental cultures yielded C. difficile. It was concluded that the mothers are not the sources of their infants' organisms and that the contamination of the environmental surfaces is the most likely explanation for the spread of C. difficile in the hospital setting.

Adult

[Diagnosis of acute abdomen by means of laparoscopy (experience in 6,400 cases)].

A study of 6,400 cases of Emergency Laparascopy (E.L.) was made in the Instituto de Gastroenterología de Habana, Cuba. The objective of the E.L. is to provide a diagnosis when other methods have been unable to do so. The most frequent diseases found were: gynecological problems, acute appendicities, and acute cholecystopathies. The E.L. is of great usefulness as in many cases an exact diagnosis is possible thus avoiding unnecessary surgery. The reliability of the method is good, permitting an exact diagnosis in 98% of the cases. In all the authors' cases the diagnosis was confirmed by either surgery or the evolution of the disease. The authors recommend the creation of emergency laparascopy services in which all the resources would be centralized: sufficient medical staff to ensure 24-hour service, specialized technicians, and the necessary material. They add that even though in their country it is of little importance, their experience leads to the conclusion that this type of organization is medically profitable.

Abdomen, Acute