Our aim was to evaluate the performance of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), routinely used in the microbiology laboratory for bacterial identification, for bacterial typing in the setting of extended spectrum beta-lactamase producing Klebsiella pneumoniae (ESBL-KP) outbreak in the neonatal intensive care unit (NICU). Isolates from a 2011 outbreak in the NICU were retrieved from frozen stocks and analyzed by MALDI-TOF. The MALDI typing was compared with core genome multilocus sequence typing (cg-MLST). MALDI typing divided the 33 outbreak isolates into 2 clones sequence type (ST)-290 and 405. These results were in complete agreement with cg-MLST results. The differentiation of the outbreak isolates into two clones correlated with the patients' location in the NICU, but also with their place of residence.Conclusion Here, we show that MALDI-TOF MS, which has been integrated into the microbiology laboratory workflow for microbial species identification, can be secondarily used for epidemiological typing at no added cost.What is Known• Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is now routinely used in the microbiology laboratory for bacterial identificationWhat is New• MALDI typing was used for outbreak investigation in the NICU and divided the outbreak isolates into two clones• MALDI-TOF MS may be secondarily used for epidemiological typing at no added cost.Purpose of review The aim of this review paper is to evaluate the current data regarding clinical use of ultrasound (US) for diagnosis of systemic vasculitis. Recent findings In recent years, US has emerged as an image modality taking a central role in the diagnosis and monitoring of vasculitides by measuring vessel wall inflammation and changes in vessel wall thickness. US has been recognized as an important tool predominantly in the diagnosis of large vessel vasculitis (LVV). Signs like the "halo sign" in temporal arteries of patients with giant cell arteritis (GCA) have demonstrated to be a robust marker. In other types of vasculitides the role of US is not well defined yet but could be of help by diagnosing secondary findings when there is organ involvement, like interstitial lung disease in small vessel vasculitis (SVV). Different modes of ultrasound (US) are being studied for this purpose, especially since it is a non-invasive technique that can limit exposure to ionizing radiation. In conclusion there is clear evidence for the use of US particularly color duplex US (CDS) in the diagnosis of LVV like GCA and Takayasu's arteritis (TAK). https://www.selleckchem.com/products/ri-1.html Nevertheless, there is urgent need for more data in regard to the use of US in small/medium vessel vasculitis, as well as the role of US in monitoring of patients with LVV.Background We introduced a video consultation (VC) during the coronavirus (COVID-19) pandemic in an ophthalmology practice with eight doctors to ensure continuous ophthalmological care, infection prophylaxis and to compensate a decreased number of patient presentations. Objective Evaluation of the most common reasons for patient presentations in the VC, the proportion of re-presentations in the practice despite VC, practical challenges associated with the introduction of VC and patient satisfaction. Material and methods Patients with a recent acute visual deterioration and severe eye pain were excluded from the VC. The VC were carried out by a trained specialist in ophthalmology. A questionnaire with eight questions was completed after the VC appointment in order to evaluate the proportion of completed VC and patient satisfaction. Results We included 29 (13 male, Ø 52.6 years, 16 female, Ø 64.7 years) patients in this analysis. The VC could be performed with 68.97% of the participants who rated their overall experience with an average grade of 1.6 (1 very good to 6 insufficient) and all of them indicated that they would recommend the VC. Of presentations in VC 70% were related to the symptoms of the anterior eye segment. In 70% of the cases no re-presentations took place in the unit. Conclusion Our study represents a significant practical application of VC for the management of non-urgent ocular conditions with maximum infection prophylaxis. The introduction of VC was severely limited by technological or user-related issues by the establishment of video connections. Patient satisfaction with VC was high to very high.This article reports a case of severe, treatment refractory infectious keratitis. Multiple samples of the cornea and the anterior chamber were taken without detection of any pathogens. Ultimately a multidrug-resistant Pseudomonas aeruginosa was isolated and successfully treated with tobramycin and amikacin, according to its antibiotic sensitivity. If there is a clinical suspicion multiple samples should be taken and multidrug-resistant pathogens considered as a differential diagnosis.The SureID® PathFinder Plus is a new 6-dye, 41-plex Y-STR system that includes the 17 loci from the Yfiler® kit (DYS19, DYS385a/b, DYS389I/II, DYS390, DYS391, DYS392, DYS393, DYS437, DYS438, DYS439, DYS448, DYS456, DYS458, DYS635, and Y-GATA-H4) plus 14 rapidly mutating Y-STR loci (DYS449, DYS481, DYS518, DYS527a/b, DYS533, DYS549, DYS570, DYS576, DYS627, DYF387S1a/b, and DYF404S1), and 10 low-medium mutation loci (DYS388, DYS444, DYS447, DYS460, DYS522, DYS557, DYS593, DYS596, DYS643, and DYS645). The inclusion of the 14 rapidly mutating Y-STR loci improves the discrimination of related individuals. Conversely, the 10 low-medium mutation loci are suitable not only for familial searching but also for providing a higher refinement in the construction of Y chromosome phylogenetic relationships among lineages. The 41-plex Y-STR system is designed for direct amplification of reference samples, such as blood samples on an FTA® Card, gauze, tissue, or cotton substrates as well as hair root or buccal samples on swabs. We performed developmental validation work including accuracy, stability, stutter precision, species specificity, sensitivity, PCR inhibitors, reproducibility, parallel testing of the system, and suitability for use on DNA mixtures. In addition, mutations of the loci were analyzed by 754 DNA-confirmed father-son pairs. The results demonstrate that this kit, developed in-house, is time-efficient, accurate, reliable, and highly informative for forensic database, familial searching, and distinguishing related males.
Our aim was to evaluate the performance of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), routinely used in the microbiology laboratory for bacterial identification, for bacterial typing in the setting of extended spectrum beta-lactamase producing Klebsiella pneumoniae (ESBL-KP) outbreak in the neonatal intensive care unit (NICU). Isolates from a 2011 outbreak in the NICU were retrieved from frozen stocks and analyzed by MALDI-TOF. The MALDI typing was compared with core genome multilocus sequence typing (cg-MLST). MALDI typing divided the 33 outbreak isolates into 2 clones sequence type (ST)-290 and 405. These results were in complete agreement with cg-MLST results. The differentiation of the outbreak isolates into two clones correlated with the patients' location in the NICU, but also with their place of residence.Conclusion Here, we show that MALDI-TOF MS, which has been integrated into the microbiology laboratory workflow for microbial species identification, can be secondarily used for epidemiological typing at no added cost.What is Known• Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is now routinely used in the microbiology laboratory for bacterial identificationWhat is New• MALDI typing was used for outbreak investigation in the NICU and divided the outbreak isolates into two clones• MALDI-TOF MS may be secondarily used for epidemiological typing at no added cost.Purpose of review The aim of this review paper is to evaluate the current data regarding clinical use of ultrasound (US) for diagnosis of systemic vasculitis. Recent findings In recent years, US has emerged as an image modality taking a central role in the diagnosis and monitoring of vasculitides by measuring vessel wall inflammation and changes in vessel wall thickness. US has been recognized as an important tool predominantly in the diagnosis of large vessel vasculitis (LVV). Signs like the "halo sign" in temporal arteries of patients with giant cell arteritis (GCA) have demonstrated to be a robust marker. In other types of vasculitides the role of US is not well defined yet but could be of help by diagnosing secondary findings when there is organ involvement, like interstitial lung disease in small vessel vasculitis (SVV). Different modes of ultrasound (US) are being studied for this purpose, especially since it is a non-invasive technique that can limit exposure to ionizing radiation. In conclusion there is clear evidence for the use of US particularly color duplex US (CDS) in the diagnosis of LVV like GCA and Takayasu's arteritis (TAK). https://www.selleckchem.com/products/ri-1.html Nevertheless, there is urgent need for more data in regard to the use of US in small/medium vessel vasculitis, as well as the role of US in monitoring of patients with LVV.Background We introduced a video consultation (VC) during the coronavirus (COVID-19) pandemic in an ophthalmology practice with eight doctors to ensure continuous ophthalmological care, infection prophylaxis and to compensate a decreased number of patient presentations. Objective Evaluation of the most common reasons for patient presentations in the VC, the proportion of re-presentations in the practice despite VC, practical challenges associated with the introduction of VC and patient satisfaction. Material and methods Patients with a recent acute visual deterioration and severe eye pain were excluded from the VC. The VC were carried out by a trained specialist in ophthalmology. A questionnaire with eight questions was completed after the VC appointment in order to evaluate the proportion of completed VC and patient satisfaction. Results We included 29 (13 male, Ø 52.6 years, 16 female, Ø 64.7 years) patients in this analysis. The VC could be performed with 68.97% of the participants who rated their overall experience with an average grade of 1.6 (1 very good to 6 insufficient) and all of them indicated that they would recommend the VC. Of presentations in VC 70% were related to the symptoms of the anterior eye segment. In 70% of the cases no re-presentations took place in the unit. Conclusion Our study represents a significant practical application of VC for the management of non-urgent ocular conditions with maximum infection prophylaxis. The introduction of VC was severely limited by technological or user-related issues by the establishment of video connections. Patient satisfaction with VC was high to very high.This article reports a case of severe, treatment refractory infectious keratitis. Multiple samples of the cornea and the anterior chamber were taken without detection of any pathogens. Ultimately a multidrug-resistant Pseudomonas aeruginosa was isolated and successfully treated with tobramycin and amikacin, according to its antibiotic sensitivity. If there is a clinical suspicion multiple samples should be taken and multidrug-resistant pathogens considered as a differential diagnosis.The SureID® PathFinder Plus is a new 6-dye, 41-plex Y-STR system that includes the 17 loci from the Yfiler® kit (DYS19, DYS385a/b, DYS389I/II, DYS390, DYS391, DYS392, DYS393, DYS437, DYS438, DYS439, DYS448, DYS456, DYS458, DYS635, and Y-GATA-H4) plus 14 rapidly mutating Y-STR loci (DYS449, DYS481, DYS518, DYS527a/b, DYS533, DYS549, DYS570, DYS576, DYS627, DYF387S1a/b, and DYF404S1), and 10 low-medium mutation loci (DYS388, DYS444, DYS447, DYS460, DYS522, DYS557, DYS593, DYS596, DYS643, and DYS645). The inclusion of the 14 rapidly mutating Y-STR loci improves the discrimination of related individuals. Conversely, the 10 low-medium mutation loci are suitable not only for familial searching but also for providing a higher refinement in the construction of Y chromosome phylogenetic relationships among lineages. The 41-plex Y-STR system is designed for direct amplification of reference samples, such as blood samples on an FTA® Card, gauze, tissue, or cotton substrates as well as hair root or buccal samples on swabs. We performed developmental validation work including accuracy, stability, stutter precision, species specificity, sensitivity, PCR inhibitors, reproducibility, parallel testing of the system, and suitability for use on DNA mixtures. In addition, mutations of the loci were analyzed by 754 DNA-confirmed father-son pairs. The results demonstrate that this kit, developed in-house, is time-efficient, accurate, reliable, and highly informative for forensic database, familial searching, and distinguishing related males.
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