The present review aims to update and improve anaerobic microbiology in laboratories with optimal conditions as well as encourage its routine implementation in laboratories with restricted resources.

This study emphasizes the importance of infection control measures to limit transmission of VREfm between patients. However, the diversity of the VREfm isolates points to the fact that other important factors may also affect the VREfm increase in Denmark. Finally, WGS is suitable for typing of VREfm and has replaced PFGE for typing of VREfm in Denmark.

A drastic decrease in incidence has been observed for most human immunodeficiency virus (HIV)-related opportunistic manifestations after use of highly active antiretroviral therapy (HAART). We assessed the trend of incidence of central nervous system (CNS) diseases in a prospective multicenter observational study involving 9,803 patients across Europe in the period 1994 to 2002 and analyzed patient and treatment variables associated with these conditions. Overall, 568 patients (5.8%) received a diagnosis of a new CNS disease. Incidence decreased significantly from 5.9 per 100 person-year in 1994 to 0.5 in 2002. Overall, the decrease was 40% per calendar year, and it was similar to that of non-CNS diseases and less evident after year 1998. In multivariable models, low CD4 cell count and high plasma viral load, but not HAART or calendar year, were significantly associated with risk to develop CNS disease, indicating that the effect of HAART was likely mediated by both improved immunological conditions and inhibition of viral replication. In contrast, use of nucleoside reverse transcriptase inhibitors, irrespective of use of protease inhibitors or non-nucleoside reverse transcriptase inhibitors, appeared to protect specifically against acquired immunodeficiency disease syndrome dementia complex, suggesting that, in this condition, therapy might have a direct, additive effect in the CNS.

We compared two matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) systems (Shimadzu/SARAMIS and Bruker) on a collection of consecutive clinically important anaerobic bacteria (n ‫؍‬ 290). The Bruker system had more correct identifications to the species level (67.2% versus 49.0%), but also more incorrect identifications (7.9% versus 1.4%). The system databases need to be optimized to increase identification levels. However, MALDI-TOF MS in its present version seems to be a fast and inexpensive method for identification of most clinically important anaerobic bacteria.Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) is a fast and inexpensive technology for identification of bacteria. The technique has in a short time been widely adopted and is integrated into many clinical microbiology laboratories. Several papers have reported the advantages and performance of MALDI-TOF MS versus conventional systems (1, 14-16). Although MALDI-TOF MS has revolutionized bacterial identification, there are still some limitations (e.g., the viridans group streptococci), and moreover, there are groups of bacteria which have not been evaluated on a larger scale or in a clinical setting (2). This is partly the case for the anaerobic bacteria. The Bacteroides fragilis group has been evaluated by Nagy et al. as part of an antibiotic resistance surveillance study (13). Veloo et al. have evaluated the Gram-positive anaerobic cocci and also compared two MALDI-TOF MS systems on a collection (n ϭ 79) of clinically relevant anaerobic bacteria (17,18). The existing data from these studies were recently reviewed by Veloo et al., the application of MALDI-TOF MS in routine identification of anaerobic bacteria was discussed, and it was concluded that the existing databases need optimizing for routine identification of anaerobic bacteria (19). However, databases are continuously updated, and MALDI-TOF MS represents a fast and inexpensive technology for species identification. Species identification of anaerobic bacteria from serious infections (e.g., blood cultures) is important because information about virulence, potential resistance to certain antimicrobial agents, and primary site of infection can be obtained (5). MALDI-TOF MS can be applied as a first-line identification system without delaying the final identification result. To our knowledge, an evaluation of MALDI-TOF MS in a clinical setting with consecutive clinical isolates, regardless of whether the species included are present in the system databases, has not been performed before.To evaluate the performance of the Bruker system (Bruker Daltonik, Bremen, Germany) and the Shimadzu/SARAMIS system

Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry with a Bruker Daltonics microflex LT system was applied to 90 well-characterized catalase-negative, Gram-positive cocci not belonging to the streptococci or enterococci. Biotyper version 2.0.43.1 software was used singly or in combination with a database extension generated in this study with 51 collection strains from 16 genera. Most strains were identified by using both databases individually, and some were identified only by applying the combined database. Thus, the methodology is very useful and the generated database extension was helpful.