RESUMEN
Donor-derived bacterial infection is a recognized complication of solid organ transplantation (SOT). The present report describes the clinical details and successful outcome in a liver transplant recipient despite transmission of methicillin-resistant Staphylococcus aureus (MRSA) from a deceased donor with MRSA endocarditis and bacteremia. We further describe whole genome sequencing (WGS) and complete de novo assembly of the donor and recipient MRSA isolate genomes, which confirms that both isolates are genetically 100% identical. We propose that similar application of WGS techniques to future investigations of donor bacterial transmission would strengthen the definition of proven bacterial transmission in SOT, particularly in the presence of highly clonal bacteria such as MRSA. WGS will further improve our understanding of the epidemiology of bacterial transmission in SOT and the risk of adverse patient outcomes when it occurs.
Asunto(s)
Genoma Bacteriano , Trasplante de Hígado/efectos adversos , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Infecciones Estafilocócicas/transmisión , Donantes de Tejidos , Adulto , Cadáver , ADN Bacteriano/genética , Femenino , Humanos , Staphylococcus aureus Resistente a Meticilina/genética , Análisis de Secuencia de ADN , Infecciones Estafilocócicas/microbiologíaRESUMEN
Although studies that use the double-blind placebo-controled food challenge (DBPCFC) suggest that the prevalence of food allergy is about 2%, public belief in food allergy appears to be considerably higher. The study was undertaken to determine the magnitude and features of the American public's belief in food allergy by surveying a large, demographically balanced population. A simple question about food allergy was incorporated into a broad, self-reported, mailed consumer questionnaire. Demographically representative American households (5000) were surveyed by means of quota sample in 1989, 1992, and 1993. The response rate was 79, 75, and 74%, respectively. Of responding households, 16.2, 16.6, and 13.9%, respectively, of responding households reported an average of 1.17 household members with food allergy. Individuals reported to be allergic to foods were more likely to be female, particularly adult women. Male individuals with reported food allergy tended to be young, whereas no such skew was noted among female subjects. Geographic differences were observed in reported food allergy, with the highest rate in the Pacific region. Milk and chocolate were the individual foods most frequently implicated in food allergy. Trends were consistent over the time period studied. Perceived food allergy is widespread and persistent. The characteristics and demographic patterns of this belief are not reflective of known food allergy epidemiology derived from studies in which the DBPCFC is used.
RESUMEN
BACKGROUND: Although studies that use the double-blind placebo-controlled food challenge suggest that the prevalence of food allergy is about 2%, public belief in food allergy appears to be considerably higher. OBJECTIVE: The study was undertaken to determine the magnitude and features of the American public's belief in food allergy by surveying a large, demographically balanced population. METHODS: A simple question about food allergy was incorporated into a broad, self-reported, mailed consumer questionnaire. Five thousand demographically representative American households were surveyed by means of quota sample in 1989, 1992, and 1993. RESULTS: The response rates were 79%, 75%, and 74%, respectively. Of responding households, 16.2%, 16.6%, and 13.9%, respectively, reported an average of 1.17 household members with food allergy. Individuals reported to be allergic to foods were more likely to be female, particularly adult women. Male individuals with reported food allergy tended to be young, whereas no such skew was noted among female subjects. Geographic differences were observed in reported food allergy, with the highest rate in the Pacific region. Milk and chocolate were the individual foods most frequently implicated in food allergy. Trends were consistent over the period studied. CONCLUSIONS: Perceived food allergy is widespread and persistent. The characteristics and demographic patterns of this belief are not reflective of known food allergy epidemiology derived from studies in which the double-blind placebo-controlled food challenge is used.
