Kidney damage relates to agonal bacteremia: a single-center retrospective study.

BACKGROUND: Agonal bacteremia, diagnosed with postmortem positive blood culture results, is considered a possible contributing factor to death. We hypothesized that some premortem organ damage, such as kidney damage, can enhance agonal bacteremia. METHODS: We performed a postmortem blood and alveolar fluid culture study in 30 cadavers and evaluated the relationship between blood culture results and clinical parameters, including organ damage (brain, heart, lung, kidney, liver and gastrointestinal tract). RESULTS: A total of 23 cases (76.7%) were positive for blood culture; the number of cultured species was one in 12 cases, two in 7 cases, and three in 4 cases. The ratio of agonal bacteremia was significantly higher in patients with heart damage (100%, n = 13) and those with kidney damage (end-stage kidney damage, acute kidney injury, obstructive kidney failure, or metastatic kidney tumours) (100%, n = 13). The mean number of cultured species was 0.67 ± 0.98 in heart or kidney damage, 1.40 ± 0.55 in heart damage only, 1.40 ± 0.55 in kidney damage only, and 2.00 ± 0.93 in heart and kidney damage. As the number of damaged organs increased (0 organs, no heart/kidney damage; 1 organ, heart or kidney damage; and 2 organs, heart and kidney damage), the mean number of cultured species increased significantly (p for trend = 0.001964). CONCLUSION: Premortem kidney damage relates to agonal bacteremia.

Diagnostic test property of transcription-reverse transcription concerted reaction reagent TRCReady® SARS-CoV-2 i using nasopharyngeal swab samples.

TRCReady® SARS-CoV-2 i is a reagent for transcription-reverse transcription concerted reaction (TRC) to detect SARS-CoV-2 N2 gene, used with the automated rapid isothermal nucleic acid amplification test (NAAT) analyzer TRCReady®-80. Sensitivity and specificity of TRCReady® SARS-CoV-2 i was assessed by comparison with the results of real-time reverse transcription-polymerase chain reaction (RT-PCR) using nasopharyngeal swab samples. From November 2020 to March 2021, a total of 441 nasopharyngeal swabs were obtained and analyzed both with TRCReady® SARS-CoV-2 i and RT-PCR. Sensitivity and specificity of TRCReady® SARS-CoV-2 i were 94.6% (53/56) and 99.2% (382/385), respectively. Reaction time to positivity of TRCReady® SARS-CoV-2 i ranged from 1.166 to 9.805 (median: 2.887) min, and minimum detection sensitivity of TRCReady® SARS-CoV-2 i was 9 copies per test, with reaction time as 5.014 min. Detection of SARS-CoV-2 gene from nasopharyngeal swab sample using TRCReady® SARS-CoV-2 i shows comparative diagnostic test accuracy with RT-PCR, and can be used as a useful test to diagnose SARS-CoV-2 infection.

Retrospective evaluation of the symptom-based work restriction strategy of healthcare providers in the first epidemic of COVID-19 at a tertiary care hospital in Tokyo, Japan.

BACKGROUND: Effectiveness of restricting healthcare providers (HCPs) from working based on the coronavirus disease 2019 (COVID-19)-like symptoms should be evaluated. METHODS: A total of 495 HCPs in a tertiary care hospital in Tokyo, Japan, participated in this study between June and July in 2020. Analysis of serum anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody to identify infected HCPs, questionnaire surveys, and medical record reviews were conducted to evaluate the appropriateness of symptom-based work restriction for 10 days. RESULTS: Five participants (1.0%) were identified as infected. Forty-six participants (9.3%) experienced work restriction and all 5 infected participants (10.8%) restricted working, even though the real-time reverse transcription-polymerase chain reaction was positive only in 4 participants (80.0%). There were no unexpectedly infected participants among those who did not experience work restriction. However, only 46 of 110 HCPs with COVID-19-like symptoms (41.8%) restricted themselves from working. DISCUSSION: Symptom-based work restriction strategy successfully prevented infected HCPs to work, but showed low specificity to identify truly infected HCPs, and their low adherence to the strategy was revealed. CONCLUSIONS: HCPs with COVID-19-like symptoms should restrict working as the first step of infection prevention, but the strategy to identify truly infected HCPs is necessary.

[Usefulness of Polyethylene-Glycol Precipitation As a Screening Method for Macroprolactinemia].

Macroprolactin is mostly a complex of monomeric prolactin (PRL) with IgG and considered to be biological inactive. Its presence commonly leads to diagnostic confusion and misdiagnosis. Polyethylene-glycol (PEG) precipitation method is widely used for a screening of macroprolactinemia. We applied PEG precipi- tation method for 200 samples which was ordered test of PRL. The PRL recovery was 65.0±11.2% (mean ±SD). In our data, PRL recovery less than 42.5% (mean-2SD) indicates the presence of macroprolactin. The prevalence of macroprolactinemia was 4.5%(9/197) in total samples and 9.5%(2/21) in hyperprolac- tinemia. Our result indicates the need for PEG screening for macroprolactinemia to avoid misdiagnosis. [Short Communication].