Out of 24 nosocomial strains of Pseudomonas aeruginosa from Recife, Brazil, 15 (62%) were metallo-β-lactamase producers. Such isolates were resistant to main antipseudomonas drugs, except polymixyn B and aztreonam. The enzyme responsible for the carbapenem-resistance belongs to SPM-1 class, and the gene involved, blaspm-1, is likely plasmid located.
-Context -Clarithromycin is the most effective drug used in the eradication of infection by Helicobacter pylori. Due to worldwide increase in resistance, pre-treatment susceptibility testing for clarithromycin is recommended.
Objective: To assess quantitative real-time polymerase chain reaction
(q-PCR) for the sputum smear diagnosis of pulmonary tuberculosis (PTB) in patients
living with HIV/AIDS with a clinical suspicion of PTB.
Method: This is a prospective study to assess the accuracy of a
diagnostic test, conducted on 140 sputum specimens from 140 patients living with
HIV/AIDS with a clinical suspicion of PTB, attended at two referral hospitals for
people living with HIV/AIDS in the city of Recife, Pernambuco, Brazil. A
Löwenstein-Jensen medium culture and 7H9 broth were used as gold standard.
Results: Of the 140 sputum samples, 47 (33.6%) were positive with the
gold standard. q-PCR was positive in 42 (30%) of the 140 patients. Only one (0.71%)
did not correspond to the culture. The sensitivity, specificity and accuracy of the
q-PCR were 87.2%, 98.9% and 95% respectively. In 39 (93%) of the 42 q-PCR positive
cases, the CT (threshold cycle) was equal to or less than 37.
Conclusion: q-PCR performed on sputum smears from patients living with
HIV/AIDS demonstrated satisfactory sensitivity, specificity and accuracy, and may
therefore be recommended as a method for diagnosing PTB.
Little is known about the etiology of progressive macular hypomelanosis, although it has been suggested that Propionibacterium acnes plays an important role. While microbiological culture is commonly employed to identify Propionibacterium acnes, new identification methods have been under investigation, amongst them polymerase chain reaction. To determine the cut-off point for the number of genome copies of Propionibacterium acnes in the lesional skin of patients with progressive macular hypomelanosis as a positive marker, employing quantitative real-time polymerase chain reaction and anaerobic culture, considered gold standard. An observational study with a comparison group, included 35 patients with dermatosis, attended at the Oswaldo Cruz University Hospital, Pernambuco, Brazil, between March and May 2008. Lesional skin was compared to non-lesional skin through positive testing with real-time polymerase chain reaction and culture. The Statistical Package for Social Sciences, version 12.0, was employed for the association analysis with the McNemar test, and the cut-off point with the ROC curve for maximum values. Propionibacterium acnes was most frequently encountered in lesional areas (p<0,025). The cut-off point of Propionibacterium acnes in lesional skin was 1,333 genome copies, with a sensitivity of 87,9% and a specificity of 100,0%. Since Propionibacterium acnes is a saprophyte, identifying the cut-off point may assist in determining its positivity in lesional skin in patients suffering with this dermatosis.
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