Cross-reactivity in the Platelia™ Aspergillus enzyme immunoassay caused by blastomycosis.

It is well known that cross reactions with other fungal pathogens including Histoplasma capsulatum can occur with the use of the Platelia™ Aspergillus galactomannan assay. We report two patients with confirmed blastomycosis whose bronchoalveolar lavage (BAL) fluid tested positive for Aspergillus galactomannan despite no evidence of aspergillosis.

Assessment of candidacy for pneumococcal vaccination in intensive care patients.

OBJECTIVES: The 23-valent pneumococcal vaccine has been shown to be effective in reducing mortality and complications from pneumonia. The US Centers for Disease Control (CDC) have published guidelines for vaccination eligibility. The intensive care unit (ICU) may represent a missed opportunity for administration of the pneumococcal vaccine to eligible patients. This study assessed the characteristics of patients in an ICU in relation to their candidacy for pneumococcal vaccination. RESEARCH METHODOLOGY/SETTING: A retrospective chart review was performed of all patients with a single admission to a mixed 25 bed ICU of a tertiary-care community teaching hospital from October 2010 to January 2011. Information procured included demographic information, pneumococcal vaccine eligibility, documentation of prior vaccination status or vaccine administration and patient outcomes. RESULTS: Two-hundred and sixty three individual medical and surgical admissions to the ICU occurred during the study period. The mean number of indicator risk factors for pneumococcal vaccine was 2.3 (95% CI (2.117-2.513), with the majority of patients being over age 65 (57%) and having chronic heart or lung disease (81%). Despite this only seven patients had immunisation status documented and only 14 patients received pneumococcal vaccination during the index hospital stay. CONCLUSION: In a large tertiary-care teaching hospital, most patients admitted to the ICU had multiple indications for pneumococcal vaccination. However, only a small percentage were assessed or given vaccination during their hospital stay. ICU protocols that give nurses the ability to assess and administer pneumococcal vaccines may improve immunisation rates.

Fatty acid-binding proteins inhibit hydration of epoxyeicosatrienoic acids by soluble epoxide hydrolase.

Epoxyeicosatrienoic acids (EETs) are potent regulators of vascular homeostasis and are bound by cytosolic fatty acid-binding proteins (FABPs) with K(d) values of approximately 0.4 microM. To determine whether FABP binding modulates EET metabolism, we examined the effect of FABPs on the soluble epoxide hydrolase (sEH)-mediated conversion of EETs to dihydroxyeicosatrienoic acids (DHETs). Kinetic analysis of sEH conversion of racemic [(3)H]11,12-EET yielded K(m) = 0.45 +/- 0.08 microM and V(max) = 9.2 +/- 1.4 micromol min(-1) mg(-)(1). Rat heart FABP (H-FABP) and rat liver FABP were potent inhibitors of 11,12-EET and 14,15-EET conversion to DHET. The resultant inhibition curves were best described by a substrate depletion model, with K(d) = 0.17 +/- 0.01 microM for H-FABP binding to 11,12-EET, suggesting that FABP acts by reducing EET availability to sEH. The EET depletion by FABP was antagonized by the co-addition of arachidonic acid, oleic acid, linoleic acid, or 20-hydroxyeicosatetraenoic acid, presumably due to competitive displacement of FABP-bound EET. Collectively, these findings imply that FABP might potentiate the actions of EETs by limiting their conversion to DHET. However, the effectiveness of this process may depend on metabolic conditions that regulate the levels of competing FABP ligands.