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1.
Ann Intern Med ; 177(6): 729-737, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38710093

RESUMO

BACKGROUND: Giant cell arteritis (GCA) is the most prevalent systemic vasculitis in people older than 50 years. Any delay in diagnosis impairs patients' quality of life and can lead to permanent damage, particularly vision loss. OBJECTIVE: To evaluate a diagnostic strategy for GCA using color Doppler ultrasound of the temporal artery as a first-line diagnostic test, temporal artery biopsy (TAB) as a secondary test, and physician expertise as the reference method. DESIGN: Prospective multicenter study with a 2-year follow-up. (ClinicalTrials.gov: NCT02703922). SETTING: Patients were referred by their general practitioner or ophthalmologist to a physician with extensive experience in GCA diagnosis and management in one of the participating centers: 4 general and 2 university hospitals. PATIENTS: 165 patients with high clinical suspicion of GCA, aged 79 years (IQR, 73 to 85 years). INTERVENTION: The diagnostic procedure was ultrasound, performed less than 7 days after initiation of corticosteroid therapy. Only ultrasound-negative patients underwent TAB. MEASUREMENTS: Bilateral temporal halo signs seen on ultrasound were considered positive. Ultrasound and TAB results were compared with physician-diagnosed GCA based on clinical findings and other imaging. RESULTS: Diagnosis of GCA was confirmed in 44%, 17%, and 21% of patients by ultrasound, TAB, and clinical expertise and/or other imaging tests, respectively. Their diagnosis remained unchanged at 1 month, and 2 years for those with available follow-up data. An alternative diagnosis was made in 18% of patients. The proportion of ultrasound-positive patients among patients with a clinical GCA diagnosis was 54% (95% CI, 45% to 62%). LIMITATION: Small sample size, no blinding of ultrasound and TAB results, lack of an objective gold-standard comparator, and single diagnostic strategy. CONCLUSION: By using ultrasound of the temporal arteries as a first-line diagnostic tool in patients with high clinical suspicion of GCA, further diagnostic tests for patients with positive ultrasound were avoided. PRIMARY FUNDING SOURCE: Tender "Recherche CH-CHU Poitou-Charentes 2014."


Assuntos
Arterite de Células Gigantes , Artérias Temporais , Ultrassonografia Doppler em Cores , Humanos , Arterite de Células Gigantes/diagnóstico por imagem , Artérias Temporais/diagnóstico por imagem , Artérias Temporais/patologia , Estudos Prospectivos , Idoso , Feminino , Masculino , Idoso de 80 Anos ou mais , Biópsia
2.
Clin Microbiol Rev ; 33(2)2020 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-32102900

RESUMO

Clinical microbiology is experiencing revolutionary advances in the deployment of molecular, genome sequencing-based, and mass spectrometry-driven detection, identification, and characterization assays. Laboratory automation and the linkage of information systems for big(ger) data management, including artificial intelligence (AI) approaches, also are being introduced. The initial optimism associated with these developments has now entered a more reality-driven phase of reflection on the significant challenges, complexities, and health care benefits posed by these innovations. With this in mind, the ongoing process of clinical laboratory consolidation, covering large geographical regions, represents an opportunity for the efficient and cost-effective introduction of new laboratory technologies and improvements in translational research and development. This will further define and generate the mandatory infrastructure used in validation and implementation of newer high-throughput diagnostic approaches. Effective, structured access to large numbers of well-documented biobanked biological materials from networked laboratories will release countless opportunities for clinical and scientific infectious disease research and will generate positive health care impacts. We describe why consolidation of clinical microbiology laboratories will generate quality benefits for many, if not most, aspects of the services separate institutions already provided individually. We also define the important role of innovative and large-scale diagnostic platforms. Such platforms lend themselves particularly well to computational (AI)-driven genomics and bioinformatics applications. These and other diagnostic innovations will allow for better infectious disease detection, surveillance, and prevention with novel translational research and optimized (diagnostic) product and service development opportunities as key results.


Assuntos
Serviços de Laboratório Clínico/organização & administração , Técnicas de Laboratório Clínico/métodos , Doenças Transmissíveis/diagnóstico , Animais , Inteligência Artificial , Automação , Humanos
3.
Rheumatology (Oxford) ; 60(8): 3579-3587, 2021 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-33374013

RESUMO

OBJECTIVES: To evaluate the reliability of the OMERACT paediatric ultrasound (US) synovitis definitions and scoring system in JIA. METHODS: Thirteen sonographers analysed 75 images for the presence/absence of elementary lesions (binary scoring) and for grading synovitis, synovial hypertrophy, effusion and Doppler signals. Static US images of the second metacarpophalangeal joint (MCP-II), wrist, elbow, knee and ankle in JIA patients at different ages and different disease stages were collected with standardized scanning by two experienced sonographers. Intra- and inter-reader reliability were analysed with kappa coefficients. RESULTS: Intra-reader reliability was good for binary scoring (Cohen's kappa 0.62, range 0.47-0.75), synovitis and synovial hypertrophy; excellent for Doppler signals (quadratic weighted kappa 0.77, 0.66-0.86; 0.76, 0.61-0.84; and 0.87, 0.77-0.94, respectively); and moderate for effusion (0.55, 0.24-0.76). Inter-reader reliability was good for synovitis and synovial hypertrophy (Light's kappa 0.68, 95% CI: 0.61, 0.75 and 0.63, 0.54-0.71, respectively), excellent for Doppler signals (0.85, 95% CI: 0.77, 0.90), and moderate for binary scoring and effusion (0.48, 95% CI: 0.36, 0.64 and 0.49, 0.40-0.60, respectively). We obtained the best scores for the knee (0.71, 0.54-0.85) except for Doppler signals, with reliability higher for MCP-II. We found a trend toward better results in older children. CONCLUSIONS: This is the first study establishing the reliability of the OMERACT paediatric US synovitis definitions and scoring system in the five most commonly affected joints in JIA. The reliability was good among a large group of sonographers. These results support the applicability of these definitions and scoring system in clinical practice and multicentre studies.


Assuntos
Artrite Juvenil/diagnóstico por imagem , Articulações/diagnóstico por imagem , Sinovite/diagnóstico por imagem , Ultrassonografia/métodos , Humanos , Reprodutibilidade dos Testes , Índice de Gravidade de Doença
4.
Neuromodulation ; 24(1): 86-101, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32865344

RESUMO

BACKGROUND: Recent studies have highlighted multicolumn spinal cord stimulation (SCS) efficacy, hypothesizing that optimized spatial neural targeting provided by new-generation SCS lead design or its multicolumn programming abilities could represent an opportunity to better address chronic back pain (BP). OBJECTIVE: To compare multicolumn vs. monocolumn programming on clinical outcomes of refractory postoperative chronic BP patients implanted with SCS using multicolumn surgical lead. MATERIALS AND METHODS: Twelve centers included 115 patients in a multicenter, randomized, double-blind, controlled trial. After randomization, leads were programmed using only one or several columns. The primary outcome was change in BP visual analogic scale (VAS) at six months. All patients were then programmed using the full potential of the lead up until 12-months follow-up. RESULTS: At six months, there was no significant difference in clinical outcomes whether the SCS was programmed using a mono or a multicolumn program. At 12 months, in all patients having been receiving multicolumn SCS for at least six months (n = 97), VAS decreases were significant for global pain (45.1%), leg pain (55.8%), and BP (41.5%) compared with baseline (p < 0.0001). CONCLUSION: The ESTIMET study confirms the significant benefit experienced on chronic BP by patients implanted with multicolumn SCS, independently from multicolumn lead programming. These good clinical outcomes might result from the specific architecture of the multicolumn lead, giving the opportunity to select initially the best column on a multicolumn grid and to optimize neural targeting with low-energy requirements. However, involving more columns than one does not appear necessary, once initial spatial targeting of the "sweet spot" has been achieved. Our findings suggest that this spatial concept could also be transposed to cylindrical leads, which have drastically improved their capability to shape the electrical field, and might be combined with temporal resolution using SCS new modalities.


Assuntos
Síndrome Pós-Laminectomia , Estimulação da Medula Espinal , Dor nas Costas/terapia , Humanos , Medição da Dor , Estudos Prospectivos , Medula Espinal , Resultado do Tratamento
5.
Mycoses ; 59(8): 535-8, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27292939

RESUMO

Candida auris is an emerging antifungal resistant yeast species causing nosocomial and invasive infections, emphasising the need of improved diagnostics and epidemiological typing methods. We show that MALDI-TOF VITEK-MS followed by amplified length polymorphisms allows for accurate species identification and subsequent epidemiological characterisation of strains encountered during potential outbreaks.


Assuntos
Candida/classificação , Candida/isolamento & purificação , Candidíase/microbiologia , Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candida/patogenicidade , Candidíase/diagnóstico , Surtos de Doenças , Humanos , Testes de Sensibilidade Microbiana , Polimorfismo Genético , Análise de Sequência de DNA , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos
6.
J Clin Microbiol ; 53(3): 760-5, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25056329

RESUMO

The integration of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) in clinical microbiology has revolutionized species identification of bacteria, yeasts, and molds. However, beyond straightforward identification, the method has also been suggested to have the potential for subspecies-level or even type-level epidemiological analyses. This minireview explores MALDI-TOF MS-based typing, which has already been performed on many clinically relevant species. We discuss the limits of the method's resolution and we suggest interpretative criteria allowing valid comparison of strain-specific data. We conclude that guidelines for MALDI-TOF MS-based typing can be developed along the same lines as those used for the interpretation of data from pulsed-field gel electrophoresis (PFGE).


Assuntos
Bactérias/classificação , Técnicas de Tipagem Bacteriana/métodos , Técnicas de Tipagem Bacteriana/normas , Fungos/classificação , Técnicas de Tipagem Micológica/métodos , Técnicas de Tipagem Micológica/normas , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos , Bactérias/química , Fungos/química , Guias como Assunto , Humanos
7.
J Antimicrob Chemother ; 70(1): 167-72, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25239465

RESUMO

OBJECTIVES: Precise assessment of potential therapeutic synergy, antagonism or indifference between antimicrobial agents currently depends on time-consuming and hard-to-standardize in vitro chequerboard titration methods. We here present a method based on a novel two-dimensional antibiotic gradient technique named Xact™. METHODS: We used a test comprising a combination of perpendicular gradients of meropenem and colistin in a single quadrant. We compared test outcomes with those obtained with classical chequerboard microbroth dilution testing in a study involving 27 unique strains of multidrug-resistant Acinetobacter baumannii from diverse origins. RESULTS: We were able to demonstrate 92% concordance between the new technology and classical chequerboard titration using the A. baumannii collection. Two strains could not be analysed by Xact™ due to their out-of-range MIC of meropenem (>128 mg/L). CONCLUSIONS: The new test was shown to be diagnostically useful, easy to implement and less labour intensive than the classical method.


Assuntos
Acinetobacter baumannii/efeitos dos fármacos , Antibacterianos/farmacologia , Colistina/farmacologia , Farmacorresistência Bacteriana Múltipla , Sinergismo Farmacológico , Testes de Sensibilidade Microbiana/métodos , Tienamicinas/farmacologia , Meropeném
8.
J Clin Microbiol ; 52(12): 4286-92, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25297329

RESUMO

The objective of this research was to extend the Vitek MS fungal knowledge base version 2.0.0 to allow the robust identification of clinically relevant dermatophytes, using a variety of strains, incubation times, and growth conditions. First, we established a quick and reliable method for sample preparation to obtain a reliable and reproducible identification independently of the growth conditions. The Vitek MS V2.0.0 fungal knowledge base was then expanded using 134 well-characterized strains belonging to 17 species in the genera Epidermophyton, Microsporum, and Trichophyton. Cluster analysis based on mass spectrum similarity indicated good species discrimination independently of the culture conditions. We achieved a good separation of the subpopulations of the Trichophyton anamorph of Arthroderma benhamiae and of anthropophilic and zoophilic strains of Trichophyton interdigitale. Overall, the 1,130 mass spectra obtained for dermatophytes gave an estimated identification performance of 98.4%. The expanded fungal knowledge base was then validated using 131 clinical isolates of dermatophytes belonging to 13 taxa. For 8 taxa all strains were correctly identified, and for 3 the rate of successful identification was >90%; 75% (6/8) of the M. gypseum strains were correctly identified, whereas only 47% (18/38) of the African T. rubrum population (also called T. soudanense) were recognized accurately, with a large quantity of strains misidentified as T. violaceum, demonstrating the close relationship of these two taxa. The method of sample preparation was fast and efficient and the expanded Vitek MS fungal knowledge base reliable and robust, allowing reproducible dermatophyte identifications in the routine laboratory.


Assuntos
Arthrodermataceae/química , Arthrodermataceae/classificação , Técnicas Microbiológicas/métodos , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos , Arthrodermataceae/isolamento & purificação , Análise por Conglomerados , Dermatomicoses/diagnóstico , Humanos , Micologia/métodos , Fatores de Tempo
10.
Expert Rev Anti Infect Ther ; 20(3): 391-405, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34384319

RESUMO

INTRODUCTION: Bone and Joint Infections (BJI) are medically important, costly and occur in native and prosthetic joints. Arthroplasties will increase significantly in absolute numbers over time as well as the incidence of Prosthetic Joint Infections (PJI). Diagnosis of BJI and PJI is sub-optimal. The available diagnostic tests have variable effectiveness, are often below standard in sensitivity and/or specificity, and carry significant contamination risks during the collection of clinical samples. Improvement of diagnostics is urgently needed. AREAS COVERED: We provide a narrative review on current and future diagnostic microbiology technologies. Pathogen identification, antibiotic resistance detection, and assessment of the epidemiology of infections via bacterial typing are considered useful for improved patient management. We confirm the continuing importance of culture methods and successful introduction of molecular, mass spectrometry-mediated and next-generation genome sequencing technologies. The diagnostic algorithms for BJI must be better defined, especially in the context of diversity of both disease phenotypes and clinical specimens rendered available. EXPERT OPINION: Whether interventions in BJI or PJI are surgical or chemo-therapeutic (antibiotics and bacteriophages included), prior sensitive and specific pathogen detection remains a therapy-substantiating necessity. Innovative tests for earlier and more sensitive and specific detection of bacterial pathogens in BJI are urgently needed.


Assuntos
Artrite Infecciosa , Doenças Transmissíveis , Infecções Relacionadas à Prótese , Infecções Estafilocócicas , Antibacterianos/uso terapêutico , Artrite Infecciosa/epidemiologia , Bactérias , Doenças Transmissíveis/tratamento farmacológico , Humanos , Infecções Relacionadas à Prótese/diagnóstico , Infecções Relacionadas à Prótese/tratamento farmacológico , Infecções Relacionadas à Prótese/epidemiologia , Infecções Estafilocócicas/tratamento farmacológico
11.
J Clin Microbiol ; 48(5): 1696-700, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-20305014

RESUMO

The most common complications of varicella are bacterial skin and soft tissue infections, generally due to Staphylococcus aureus and group A beta-hemolytic streptococci. The aim of this study was to characterize the toxin and antibiotic resistance profiles of S. aureus isolates involved in varicella complications. Between 2002 and 2007, the French Reference Centre for Staphylococci collected 58 S. aureus isolates involved in varicella superinfection. All the isolates were characterized by screening for 12 toxin genes, agr typing, and mecA gene detection; some isolates were also studied by spa typing, multilocus sequence typing (MLST), and resistance profiling. A major toxin gene was detected in 53% (31/58) of the isolates (genes for exfoliative toxins A and B, 17.2%; Panton-Valentine leukocidin gene, 8.6%; toxic shock syndrome toxin 1 gene, 27.6%). Most clinical manifestations were directly compatible with the classical activity of these toxins. Nineteen isolates (33%) were resistant to methicillin, and 12 of these isolates belonged to an emerging agr-2, ST5 clone that harbors the toxic shock syndrome toxin 1 gene. These data should be considered in the management and treatment of patients with varicella complicated by S. aureus superinfection. Antibiotics that decrease toxin production, such as clindamycin, may provide benefit, and their efficacy against bacterial superinfections in children with varicella should be studied.


Assuntos
Toxinas Bacterianas/genética , Varicela/complicações , Infecções dos Tecidos Moles/microbiologia , Infecções Cutâneas Estafilocócicas/microbiologia , Staphylococcus aureus/patogenicidade , Superinfecção/microbiologia , Adolescente , Técnicas de Tipagem Bacteriana , Criança , Pré-Escolar , Análise por Conglomerados , Impressões Digitais de DNA , DNA Bacteriano/genética , Feminino , França , Genótipo , Humanos , Lactente , Masculino , Testes de Sensibilidade Microbiana , Análise de Sequência de DNA , Staphylococcus aureus/classificação , Staphylococcus aureus/genética , Staphylococcus aureus/isolamento & purificação , Adulto Jovem
12.
Cancers (Basel) ; 12(10)2020 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-33050025

RESUMO

The survival rate of multiple myeloma (MM) patients has drastically increased recently as a result of the wide treatment options now available. Younger patients truly benefit from these innovations as they can support more intensive treatment, such as autologous stem cell transplant or multiple drug association (triplet, quadruplet). The emergence of immunotherapy allowed new combinations principally based on monoclonal anti-CD38 antibodies for these patients. Still, the optimal induction treatment has not been found yet. While consolidation is still debated, maintenance treatment is now well acknowledged to prolong survival. Lenalidomide monotherapy is the only drug approved in that setting, but many innovations are expected. Older patients, now logically named not transplant-eligible, also took advantage of these breakthrough innovations as most of the recent drugs have a more acceptable safety profile than previous cytotoxic agents. For this heterogenous subgroup, geriatric assessment has become an essential tool to identify frail patients and provide tailored strategies. At relapse, options are now numerous, especially for patients who were not treated with lenalidomide, or not refractory at least. Concerning lenalidomide refractory patients, approved combinations are lacking, but many trials are ongoing to fill that space. Moreover, innovative therapeutics are increasingly being developed with modern immunotherapy, such as chimeric antigen receptor T-cells (CAR-T cells), bispecific antibodies, or antibody-drug conjugates. For now, these treatments are usually reserved to heavily pre-treated patients with a poor outcome. MM drug classes have tremendously extended from historical alkylating agents to current dominant associations with proteasome inhibitors, immunomodulatory agents, and monoclonal anti-CD38/anti SLAMF7 antibodies. Plus, in only a couple of years, several new classes will enter the MM armamentarium, such as cereblon E3 ligase modulators (CELMoDs), selective inhibitors of nuclear export, and peptide-drug conjugates. Among the questions that will need to be answered in the years to come is the position of these new treatments in the therapeutic strategy, as well as the role of minimal residual disease-driven strategies which will be a key issue to elucidate. Through this review, we chose to enumerate and comment on the most recent advances in MM therapeutics which have undergone major transformations over the past decade.

13.
J Clin Microbiol ; 46(10): 3454-8, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18667599

RESUMO

We conducted a prospective multicenter study of methicillin-resistant Staphylococcus aureus (MRSA) isolates, including the first five consecutive clinical isolates, collected between September 2006 and February 2007 in 23 hospitals located throughout France (Fig. 1). The 111 isolates were tested for their antibiotic susceptibility patterns and were extensively characterized by screening for drug resistance and agr alleles, multilocus sequence typing (ST), staphylococcal cassette chromosome mec (SCCmec) typing, spa typing, and PCR profiling of 21 toxin genes. Clones were designated by their ST followed by their SCCmec type (I to VI). The Lyon clone ST8-IV or ST8-IV(variant) (n = 77; 69.4%) was widely distributed. Four minor clones were also detected, namely, the "classical" Pediatric clone ST5-IV (n = 9; 8.1%), the "new" Pediatric clone ST5-VI (n = 8; 7.2%), the clone Geraldine ST5-I(truncated) (n = 7; 6.3%), and the European clone ST80-IV (n = 4; 3.6%). The six other isolates were related to five rare clones. Relative to that of other European countries, the situation in France is marked by the predominance of a specific major clone and the worrying emergence of minor clones with enhanced virulence and new antibiotic susceptibility profiles.


Assuntos
Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Resistência a Meticilina , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/classificação , Staphylococcus aureus/efeitos dos fármacos , Proteínas de Bactérias/genética , Toxinas Bacterianas/genética , Técnicas de Tipagem Bacteriana , Análise por Conglomerados , DNA Bacteriano/genética , França/epidemiologia , Genótipo , Hospitais , Humanos , Testes de Sensibilidade Microbiana , Epidemiologia Molecular , Polimorfismo Genético , Estudos Prospectivos , Análise de Sequência de DNA/métodos , Proteína Estafilocócica A/genética , Staphylococcus aureus/genética , Staphylococcus aureus/isolamento & purificação , Transativadores/genética
14.
J Solgel Sci Technol ; 88(2): 430-441, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30956401

RESUMO

The influence of the water content in the initial composition on the size of silica particles produced using the Stöber process is well known. We have shown that there are three morphological regimes defined by compositional boundaries. At low water levels (below stoichiometric ratio of water:tetraethoxysilane), very high surface area and aggregated structures are formed; at high water content (>40 wt%) similar structures are also seen. Between these two boundary conditions, discrete particles are formed whose size are dictated by the water content. Within the compositional regime that enables the classical Stöber silica, the structural evolution shows a more rapid attainment of final particle size than the rate of formation of silica supporting the monomer addition hypothesis. The clearer understanding of the role of the initial composition on the output of this synthesis method will be of considerable use for the establishment of reliable reproducible silica production for future industrial adoption.

15.
Front Microbiol ; 9: 511, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29616014

RESUMO

The French National Reference Center for Staphylococci currently uses DNA arrays and spa typing for the initial epidemiological characterization of Staphylococcus aureus strains. We here describe the use of whole-genome sequencing (WGS) to investigate retrospectively four distinct and virulent S. aureus lineages [clonal complexes (CCs): CC1, CC5, CC8, CC30] involved in hospital and community outbreaks or sporadic infections in France. We used a WGS bioinformatics pipeline based on de novo assembly (reference-free approach), single nucleotide polymorphism analysis, and on the inclusion of epidemiological markers. We examined the phylogeographic diversity of the French dominant hospital-acquired CC8-MRSA (methicillin-resistant S. aureus) Lyon clone through WGS analysis which did not demonstrate evidence of large-scale geographic clustering. We analyzed sporadic cases along with two outbreaks of a CC1-MSSA (methicillin-susceptible S. aureus) clone containing the Panton-Valentine leukocidin (PVL) and results showed that two sporadic cases were closely related. We investigated an outbreak of PVL-positive CC30-MSSA in a school environment and were able to reconstruct the transmission history between eight families. We explored different outbreaks among newborns due to the CC5-MRSA Geraldine clone and we found evidence of an unsuspected link between two otherwise distinct outbreaks. Here, WGS provides the resolving power to disprove transmission events indicated by conventional methods (same sequence type, spa type, toxin profile, and antibiotic resistance profile) and, most importantly, WGS can reveal unsuspected transmission events. Therefore, WGS allows to better describe and understand outbreaks and (inter-)national dissemination of S. aureus lineages. Our findings underscore the importance of adding WGS for (inter-)national surveillance of infections caused by virulent clones of S. aureus but also substantiate the fact that technological optimization at the bioinformatics level is still urgently needed for routine use. However, the greatest limitation of WGS analysis is the completeness and the correctness of the reference database being used and the conversion of floods of data into actionable results. The WGS bioinformatics pipeline (EpiSeqTM) we used here can easily generate a uniform database and associated metadata for epidemiological applications.

16.
J Hosp Infect ; 65 Suppl 2: 105-9, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17540252

RESUMO

Staphylococcus aureus produces many virulence factors, most of which act in a synergistic and coordinated fashion. Some appear to be specifically associated with certain severe infections and are produced by meticillin-resistant Staphylococcus aureus (MRSA) clones distributed worldwide. Superantigenic exotoxins appear to be major virulence factors in hospital MRSA clones (HA-MRSA), and staphylococcal enterotoxin A (SEA) may be involved in the physiopathology of septic shock. Panton Valentine Leucocidin (PVL) has emerged as a major virulence factor in community-acquired Staphylococcus aureus (CA-MRSA) infections. In particular, the leukotoxic action of PVL is responsible for the high mortality rate associated with necrotizing pneumonia. CA-MRSA can also harbour the toxic shock toxin 1 (TSST-1) and rarely the exfoliative toxin.


Assuntos
Resistência a Meticilina/genética , Staphylococcus aureus/patogenicidade , Fatores de Virulência/genética , Toxinas Bacterianas/genética , Infecções Comunitárias Adquiridas/microbiologia , Infecção Hospitalar/microbiologia , Exotoxinas/genética , Humanos , Leucocidinas/genética , Infecções Estafilocócicas/genética , Staphylococcus aureus/genética
17.
Materials (Basel) ; 11(1)2017 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-29267195

RESUMO

New bio-materials have recently gained interest for use in insulation panels in walls, but wider adoption by the building industry is hindered by their intrinsic properties. The fact that such materials are mainly composed of cellulose makes them combustible, and their hydrophilic surface presents a high water uptake, which would lead to faster biodegradation. A hydrophobic treatment with silica particles was successfully synthesised via Stöber process, characterised, and deposited on hemp shiv. The surface of hemp shiv coated several times with 45 and 120 nm particles were uniformly covered, as well as extensively water repellent. Those samples could withstand in humidity chamber without loss of their hydrophobic property and no sign of mould growth after 72 h of exposure.

18.
Diagn Microbiol Infect Dis ; 87(1): 7-10, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27802877

RESUMO

We here show adequate species identification for bacterial isolates of the genus Nocardia spp. through VITEK mass spectrometry. Application of a specific sample preparation method in combination with a robust matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) database leads to 94% accurate identification to the species level on a set of 164 isolates. The possibility to identify Nocardia spp. using MALDI-TOF MS will be available in the next release of VITEK MS update (IVD Version 3.0).


Assuntos
Técnicas Bacteriológicas/métodos , Nocardiose/diagnóstico , Nocardia/química , Nocardia/classificação , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos , Humanos , Manejo de Espécimes/métodos
19.
Rev Prat ; 56(6): 585-94, 2006 Mar 31.
Artigo em Francês | MEDLINE | ID: mdl-16705914

RESUMO

Treatment of bone metastases differs depending on whether the original cancer was diagnosed, whether it is hormone sensitive or chemosensitive, whether metastases are exclusively found in bones and thus unique, or multiple, whether they also occur in viscera and depending on the diathesis. In the last few years, treatment has benefited from a better knowledge of the efficacy of bisphosphonates, radioisotopes, percutaneous vertebroplasty and the development of new hormone therapies and chemotherapies. Given the uncertain life prognosis in the short or longer term, it remains true that cautious use of these methods is essential to reduce as far as possible the number and duration of hospitalizations.


Assuntos
Neoplasias Ósseas/secundário , Neoplasias Ósseas/terapia , Humanos
20.
Diagn Microbiol Infect Dis ; 86(3): 277-283, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27567285

RESUMO

Identification of microorganisms by MALDI-TOF MS has been widely accepted in clinical microbiology. However, for Mycobacterium spp. and Nocardia spp. such identification has not yet reached the optimal level of routine testing. Here we describe the development of an identification tool for 49 and 15 species of Mycobacterium spp. and Nocardia spp., respectively. During database construction, a number of ambiguous reference identifications were revealed and corrected via molecular analyses. Eventually, more than 2000 individual mass spectra acquired from 494 strains were included in a reference database and subjected to bio-statistical analyses. This led to correct species identification and correct combination of species into several complexes or groups, such as the Mycobacterium tuberculosis complex. With the Advanced Spectrum Classifier algorithm, class-specific bin weights were determined and tested by cross-validation experiments with good results. When challenged with independent isolates, overall identification performance was 90% for identification of Mycobacterium spp. and 88% for Nocardia spp. However, for a number of Mycobacterium sp. isolates, no identification could be achieved and in most cases, this could be attributed to the production of polymers that masked the species-specific protein peak patterns. For the species where >20 isolates were tested, correct identification reached 95% or higher. With the current spectral database, the identification of Mycobacterium spp. and Nocardia spp. by MALDI-TOF MS can be performed in routine clinical diagnostics although in some complicated cases verification by sequencing remains mandatory.


Assuntos
Técnicas Bacteriológicas/métodos , Meios de Cultura , Mycobacterium/isolamento & purificação , Nocardia/isolamento & purificação , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos , Humanos , Mycobacterium/química , Infecções por Mycobacterium/microbiologia , Nocardia/química , Nocardiose/microbiologia
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