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The oxazolidinone antimicrobial, linezolid, has been approved for the treatment of infections caused by various gram-positive bacteria, including vancomycin-resistant enterococci (VRE). This is the first report on isolation of a linezolid resistant, vancomycin-resistant Enterococcus faecium (LRVREF) strain in Poland, from a Haematological Unit patient in the Clinical Hospital in Gdańsk. PCR-RFLP analysis of rDNA and allele-specific PCR of the domain V region of the 23S ribosomal RNA gene demonstrated the presence of the G2576U mutation previously reported to be associated with linezolid resistance. Both assays detected heterozygous in this position.
Extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae (EPKP) strains are frequently implicated in outbreaks in neonatal units. From April 2002 to January 2003, 149 neonates were colonized/infected with EPKP In the Neonatal Clinic of the Teaching Hospital at the Medical University of Gdansk, Poland. A novel assay based on suppression of PCR, ADSRRS-fingerprinting, was successfully evaluated for typing EPKP isolates. The results showed that the genotypes of all outbreak-related strains were identical, which suggested that the outbreak originated from a single clone. This conclusion was confirmed by using different methods - RAPD and PFGE. The outbreak was stopped by adopting improved hygiene and instituting outbreak control measures.
To confirm the sensitivity of the polymerase chain reaction (PCR) technique (versus blood cultures) and to gain a better understanding of the incidence of true- and false-positive results when using this technique, one hundred randomly chosen patients treated operationally because of valve defects were examined. In our studies we found that PCR techniques using universal primers complementary to the bacterial 16S rDNA showed promise as being more sensitive than conventional blood culture (BC) techniques. From the time that a blood culture is positive, conventional methods of culture and antibiotic susceptibility testing require at least 64 h for the detection of infection or colonization. Rapid identification of bacteria from blood using PCR technique accelerates the microbiological diagnosis.
A number of Enterococcus strains with high-level inducible resistance to vancomycin have been identified, and the relative incidence of these strains has increased significantly in the last years. The first outbreak caused by vancomycin-resistant enterococci in Poland was reported in 1999. Vancomycin-resistant Enterococcus faecium is known for its propensity to cause infections which are difficult to eradicate. In this study, we determined the genetic similarities between vancomycin-resistant E. faecium isolates consecutively recovered from single patients to assess the duration of infection or colonization. The isolates taken in the study were identified by the conventional methods as E. faecium. PCRmelting profile (PCR-MP) and pulsed-field gel electrophoresis (PFGE) typing revealed that the isolates belonged to six distinct genotypes and that two of them were predominant. Consecutive E. faecium isolates with identical genotypes were found in 7 of 12 (58.0%) patients. The delay between the times of recovery of the first and last isolates of identical genotypes from each patient was from 9 days to about 1 year. In six patients, paired blood and non-blood isolates showed identical genotypes. Data presented here demonstrate the complexity of the epidemiological situation concerning vancomycin-resistant enterococci that may occur in a single medical ward. We also show for the first time the evaluation of PCR-MP technique in enterococci strains differentiation and we revealed that there is at least a similar power of discrimination between the presentjjold-standard REA-PFGE and a PCR-MP method.
Szczepy H. influenzae wytwarzające otoczkę polisacharydową, odmiennie do szczepów bezotoczkowych stanowią zwartą klonalnie grupę. Celem pracy było określenie poziomu zmienności szczepów H. influenzae typu b izolowanych od zdrowych dzieci z przedszkoli oraz domów dziecka oraz szczepów izolowanych z zakażeń inwazyjnych. W pracy oceniono przydatność metody PFGE w badaniach transmisji szczepów Hib krążących w populacji oraz dochodzeniach epidemiologicznych w obrębie trzech wykrytych ognisk zakażenia inwazyjnego szczepami Hib.
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