Prevalence and mechanisms of resistance to carbapenems in Enterobacteriaceae

Objectives: To determine the point prevalence of carbapenem-non-susceptible Enterobacteriaceae (CNSE) and carbapenemase-producing Enterobacteriaceae (CPE) isolates among hospitalized patients in Belgium. Methods: Twenty-four hospital-based laboratories prospectively collected 200 non-duplicated Enterobacteriaceae isolates from clinical specimens of hospitalized patients over a 2 month period. All isolates were screened locally for decreased susceptibility to carbapenem drugs using a disc diffusion method according to CLSI interpretative criteria. CNSE strains were referred centrally for confirmation of carbapenemase by phenotypic and molecular testing. Results: From February to April 2012, 158 of the 4564 screened Enterobacteriaceae isolates were categorized as non-susceptible to carbapenems, resulting in a point prevalence of CNSE of 3.5% (95% CI: 2.9%–4.2%; range per centre: 0.5%–8.5%). Of the 125 referred CNSE isolates, 11 Klebsiella pneumoniae isolates [OXA-48 (n=7), KPC type (n=3) and NDM type (n=1)], 1 OXA-48-positive Escherichia coli isolate and 1 KPC-positive Klebsiella oxytoca isolate were detected in eight hospitals. None of the 72 carbapenem-non-susceptible Enterobacter spp. isolates were confirmed as CPE. The minimal estimated point prevalence of CPE isolates was 0.28% (13/ 4564; 95% CI: 0.13%–0.44%) overall (range per centre: 0%–1.5%). Conclusions: Despite the overall low prevalence of CNSE found in this study, the detection of CPE isolates in one-third of the participating centres raises concerns and highly suggests the spread and establishment of CPE in Belgian hospitals

Critical Use of Nucleic Acid Amplification Techniques To Test for Mycobacterium tuberculosis in Respiratory Tract Samples

The usefulness of employing Belgian selection criteria before performing nucleic acid amplification techniques (NAT) was evaluated. The results of this study show that for smear-negative patients with an abnormal chest radiology result in the absence of a respiratory tract infection by bacterial pathogens, testing with NAT is of major benefit

Evaluation of the ProSpecT Microplate Assay for detection of Campylobacter: a routine laboratory perspective.

To evaluate the use of the new enzyme-linked immunosorbent assay, the ProSpecT Campylobacter Microplate Assay (Alexon-Trend, Minneapolis, MN, USA), which allows 2-h detection of both Campylobacter jejuni and Campylobacter coli antigen directly in stool specimens.Comparative StudyEvaluation StudiesJournal Articleinfo:eu-repo/semantics/publishe

Prevalence and Clinical features of non jejuni/coli Campylobacter species and related organisms in stool specimens.

info:eu-repo/semantics/nonPublishe

Cancer du col utérin et épanchement péricardique : Uterine cervical carcinoma and pericardial effusion

Une patiente de 64 ans est traitée par chimiothérapie pour un cancer du col utérin avec adénopathies abdominales et thoraciques connues. Elle est admise aux Soins Intensifs dans un contexte de fièvre et de tamponnade cardiaque secondaire à un volumineux épanchement péricardique. Aucun diagnostic précis ne sera apporté par l’analyse du liquide ou l’histologie du péricarde. Une mise au point complémentaire est réalisée et le diagnostic différentiel des épanchements péricardiques est discuté dans le contexte d’une affection néoplasiqu

Evaluation of ProSpecT Campylobacter Microplate Assay under routine conditions

info:eu-repo/semantics/nonPublishe

Feasibility of matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS) networking in university hospitals in Brussels

The mutualisation of analytical platforms might be used to address rising healthcare costs. Our study aimed to evaluate the feasibility of networking a unique matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS) system for common use in several university hospitals in Brussels, Belgium. During a one-month period, 1,055 successive bacterial isolates from the Brugmann University Hospital were identified on-site using conventional techniques; these same isolates were also identified using a MALDI-TOF MS system at the Porte de Hal Laboratory by sending target plates and identification projects via transportation and the INFECTIO-MALDI software (Infopartner, Nancy, France), respectively. The occurrence of transmission problems (<2 %) and human errors (<1 %) suggested that the system was sufficiently robust to be implemented in a network. With a median time-to-identification of 5 h and 11 min (78 min, min-max: 154-547), MALDI-TOF MS networking always provided a faster identification result than conventional techniques, except when chromogenic culture media and oxidase tests were used (p<0.0001). However, the limited clinical benefits of the chromogenic culture media do not support their extra cost. Our financial analysis also suggested that MALDI-TOF MS networking could lead to substantial annual cost savings. MALDI-TOF MS networking presents many advantages, and few conventional techniques (optochin and oxidase tests) are required to ensure the same quality in patient care from the distant laboratory. Nevertheless, such networking should not be considered unless there is a reorganisation of workflow, efficient communication between teams, qualified technologists and a reliable IT department and helpdesk to manage potential connectivity problems. © 2013 Springer-Verlag.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Arcobacter in stools: clinical features, diagnosis and antibiotic susceptibility

info:eu-repo/semantics/publishe