ABSTRACT
Most causative organisms of sepsis in immunocompromised patients are the same species as those that colonize their own nasopharynx or intestinal tract. To determine whether the strains recovered from blood originate mainly from patients' own flora, isolates from blood and throat and/or stool were investigated by genomic analyses. Surveillance cultures of throat and stool were taken prospectively from cancer patients being treated with intensive chemotherapy followed by haematopoietic stem-cell transplantation. In those cases of sepsis in which the isolate from blood was the same species as that from the throat and/or stool, the genomic profiles of the isolates were compared by PFGE. Ten cases of blood culture-positive sepsis were documented in six of 14 subjects during a 2 year period; isolates of Pseudomonas aeruginosa, Staphylococcus epidermidis, Enterococcus sp., viridans streptococci and Fusobacterium sp. were recovered from blood. In five of seven cases in which the blood isolate was the same species as that from the throat or stool, the genotypes of the isolates from both sites were identical. In the majority of immunocompromised patients, the causative organisms of bloodstream infections originated mainly from their own flora.
Subject(s)
Bacteremia/microbiology , Bacteria/genetics , Immunocompromised Host , Intestines/microbiology , Pharynx/microbiology , Adolescent , Bacteria/classification , Bacteria/isolation & purification , Child , Child, Preschool , Electrophoresis, Gel, Pulsed-Field , Feces/microbiology , Female , Genotype , Humans , Infant , MaleABSTRACT
Paraurethral cyst is a rare cause of interlabial mass formation in female neonates. Paraurethral cysts are generally asymptomatic, and spontaneous regression is expected. However, the management of paraurethral cysts is a controversial topic. Here, we report the case of a female neonate with a paraurethral cyst that regressed spontaneously on day 3 after birth. Urgent surgical treatment of these cysts is not recommended during the early neonatal period.
Subject(s)
Cysts/physiopathology , Urethral Diseases/physiopathology , Cysts/diagnosis , Female , Humans , Infant, Newborn , Remission, Spontaneous , Urethral Diseases/diagnosisABSTRACT
OBJECTIVE: To evaluate the parameters associated with significant gastrointestinal (GI) involvement in Henoch-Schönlein Purpura (HSP), and construct a scoring system for the identification of patients at high risk of gross blood in stools. STUDY DESIGN: Data for HSP patients hospitalized at each of seven institutes were retrospectively analyzed. Patients were divided into four groups according to the consequent severity of GI involvement. Identification of laboratory parameters at the time of admission were then used to differentiate the groups, and a scoring system to predict gross intestinal bleeding was constructed. Prognostic efficiency, correlation with the subsequent duration of abdominal pain, and association with manifestations excluding abdominal pain were also analyzed. RESULTS: An analysis of variance (ANOVA) test showed significant intergroup differences in white blood cell (WBC) count, neutrophil count, serum albumin, potassium, plasma D-dimer and coagulation factor XIII activity. A scoring system consisting of these parameters showed a good prognostic value for gross intestinal bleeding in a receiver operating characteristic (ROC) analysis, and a cut-off value of 4 points showed a sensitivity of 90.0% and specificity of 80.6%. The score was also correlated with the duration of abdominal pain after admission. A significantly higher score (s) was observed in patients presenting with nephritis, although the predictive value was poor. CONCLUSION: A scoring system consisting of generally available parameters was of use in predicting severe GI involvement in HSP patients. Although further study is needed, initial therapy in accordance with disease activity may be taken into consideration using this scoring system.
Subject(s)
Cytomegalovirus Infections/congenital , Cytomegalovirus Infections/diagnosis , Cytomegalovirus/isolation & purification , Umbilical Cord/virology , Cytomegalovirus/genetics , Cytomegalovirus Infections/virology , DNA, Viral , Hearing Loss, Sensorineural/etiology , Hearing Loss, Sensorineural/virology , Humans , Infant , Male , Polymerase Chain Reaction/methods , Retrospective Studies , Sensitivity and SpecificitySubject(s)
Cystic Fibrosis Transmembrane Conductance Regulator/genetics , Pancreatitis, Chronic/genetics , Adolescent , Amylases/blood , Cough/genetics , Cystic Fibrosis/genetics , Female , Humans , Mutation , Pancreatic Ducts/surgery , Recurrence , Respiratory Sounds/genetics , Sputum/cytology , StentsABSTRACT
BACKGROUND: Nosocomial infections caused by methicillin-resistant Staphylococcus aureus (MRSA) are one of the most serious problems in pediatric wards. Epidemiological analysis of strains isolated in the ward is essential for infection control. There have been few reports in which a molecular epidemiological study of MRSA was performed in pediatric wards. METHODS: Fifty-six MRSA strains isolated in the pediatric ward of Asahikawa Medical College Hospital between 1995 and 1997 were studied. Fifty-two and four isolates were obtained from 27 patients and from two medical staff members, respectively. Forty-one isolates were regarded as colonizing strains and 15 were causes of infections. Genotypes of the isolates were investigated by pulsed-field gel electrophoresis (PFGE). RESULTS: The PFGE patterns of 56 isolates were classified into nine types: type A, its subtypes, A1 and A2, and types B through to G. Seventeen isolates were type A, 32 were type A1, and one of each type of A2 and B through to G were identified. Fifty of 56 isolates, which were isolated from 24 of 29 cases, belonged to type A or its subtypes. CONCLUSIONS: The predominant strain of MRSA isolates in the pediatric ward was a certain strain that may be originated from the one clone. Cross-infection control therefore is the major procedure in the prevention of MRSA dissemination in the ward.