RESUMEN
A method for rapid detection of one extended-spectrum ß-lactamase (ESBL) and five carbapenemase-encoding genes as well as vancomycin resistance markers directly from blood cultures using the Allplex™ Entero-DR assay (Seegene, Seoul, South Korea) is presented. Altogether 28 previously well-characterized resistant Gram-negative bacilli and Enterococcus spp., and 142 clinical blood cultures containing Gram-negative bacilli or Gram-positive cocci were analyzed. The method had 100% sensitivity and specificity for detecting blaOXA-48-like, blaKPC, blaVIM, blaIMP, blaNDM, blaCTX-M, vanA, and vanB. The lowest detectable amount of viable cells in blood culture samples were 5.39·104 CFU/mL, 6.66·104 CFU/mL, 5.13·103 CFU/mL, 6.09·104 CFU/mL, 6.66·104 CFU/mL, 6.66·104 CFU/mL, 3.12·104 CFU/mL, and 5.34·104 CFU/mL for the blaKPC, blaOXA-48-like, blaVIM, blaIMP, blaNDM, blaCTX-M, vanA, and vanB, respectively. The results were available within 90 min from signal positive blood cultures, as no separate DNA extraction steps were needed, and the assay showed no interference from blood or culture media used allowing reliable and simplified detection of the resistance markers.
Asunto(s)
Antibacterianos/farmacología , Técnicas Bacteriológicas/métodos , Cultivo de Sangre/métodos , Farmacorresistencia Bacteriana , Técnicas Bacteriológicas/instrumentación , Biomarcadores , Cultivo de Sangre/instrumentación , Medios de Cultivo , Humanos , Reacción en Cadena de la Polimerasa , Sensibilidad y Especificidad , Manejo de EspecímenesRESUMEN
The immunosuppressive microenvironment in glioblastoma (GBM) prevents an efficient antitumoral immune response and enables tumor formation and growth. Although an understanding of the nature of immunosuppression is still largely lacking, it is important for successful cancer treatment through immune system modulation. To gain insight into immunosuppression in GBM, we performed a computational analysis to model relative immune cell content and type of immune response in each GBM tumor sample from The Cancer Genome Atlas RNA-seq data set. We uncovered high variability in immune system-related responses and in the composition of the microenvironment across the cohort, suggesting immunologic diversity. Immune cell compositions were associated with typical alterations such as IDH mutation or inactivating NF1 mutation/deletion. Furthermore, our analysis identified three GBM subgroups presenting different adaptive immune responses: negative, humoral, and cellular-like. These subgroups were linked to transcriptional GBM subtypes and typical genetic alterations. All G-CIMP and IDH-mutated samples were in the negative group, which was also enriched by cases with focal amplification of CDK4 and MARCH9. IDH1-mutated samples showed lower expression and higher DNA methylation of MHC-I-type HLA genes. Overall, our analysis reveals heterogeneity in the immune microenvironment of GBM and identifies new markers for immunosuppression. Characterization of diverse immune responses will facilitate patient stratification and improve personalized immunotherapy in the future.Significance: This study utilizes a computational approach to characterize the immune environments in glioblastoma and shows that glioblastoma immune microenvironments can be classified into three major subgroups, which are linked to typical glioblastoma alterations such as IDH mutation, NF1 inactivation, and CDK4-MARCH9 locus amplification.Graphical Abstract: http://cancerres.aacrjournals.org/content/canres/78/19/5574/F1.large.jpg Cancer Res; 78(19); 5574-85. ©2018 AACR.