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Biomedical subjects

B Petrini

Publications and source records attributed to B Petrini.

At least 37 records · Page 2Linked to original sources
PubMed1999

Drug-resistant and multidrug-resistant tubercle bacilli.

Drug resistant (DR) and multidrug resistant (MDR) tuberculosis (TB) is a consequence of human activity and did not exist before chemotherapeutic drugs were introduced. Monotherapy with various drugs in sequence or other inadequate drug regimens have strongly contributed to the creation of MDR-TB. Such TB strains are mainly prevalent in regions with weak national TB programmes or poor socio-economic environments. Strains may also spread in some communities such as poorly administered prisons. From these and other sources, MDR-TB may spread in the population from which travellers might transfer strains between countries and continents. Therefore an effective surveillance of the resistance pattern of TB bacilli is a demanding task in all countries. In this review some aspects of epidemiology, diagnosis and mechanisms of DR in TB are discussed. MDR-TB is an important international problem of increasing significance for the whole global community.

Antitubercular Agents↗
PubMed1999

PCR and other non-culture methods for diagnosis of invasive Candida infections in allogeneic bone marrow and solid organ transplant recipients.

In this prospective study 197 serum and 152 urine samples were collected from 40 bone marrow and solid organ transplant recipients with clinically suspected invasive fungal infection before, during and after empirical treatment with lipid formulation of amphotericin B or fluconazole. Serum was analysed by Candida polymerase chain reaction (PCR) and urine by measurement of D/L-arabinitol ratio. One serum from each patient was also tested for concentration of (1-->3)-beta-glucan and two commercial Candida antigens. Invasive fungal infection was diagnosed in four candidosis and one aspergillosis patients (13%). Positive PCR, elevated D/L-arabinitol ratio, (1-->3)-beta-glucan concentration and antigens were detected in nine, 15, 17, and seven patients, respectively. The agreement between PCR and D/L-arabinitol assays was poor. However, 56% agreement was observed between positive PCR and beta-glucan and/or antigen assays, and 60% agreement between positive D/L-arabinitol and beta-glucan and/or antigen assays. Combination of several non-culture assays is needed to diagnose invasive fungal infection in high-risk transplant recipients. No single test was sufficient for diagnosis.

Adolescent↗
PubMed1998

[Advances in the diagnosis of mycoses. New tests detect Candida infections].

New techniques for the detection of deep fungal infections are reviewed with a focus on Candida albicans, the species most frequently isolated. The introduction provides an outline of the similarities and differences between bacteria and fungi on one hand and animal cells on the other, which are important to bear in mind in the detection and treatment of deep fungal infections. In addition to cultures of biopsy material, blood, and mucous membranes (colonisation), serum tests for such fungal constituents as antigens or beta-glucan, the PCR technique for the detection of fungal DNA, and a test for the D-/L-arabinitol ratio in urine, are all valuable approaches. As yet, no single laboratory test is available that reliably detects disseminated candidosis. Rapid, sensitive, and specific methods for mycological diagnosis need to be developed to minimize the necessity of resorting to empirical therapy when deep mycosis is suspected.

Antibodies, Fungal↗
PubMed1998

Low incidence of candidaemia among neutropenic patients treated for haematological diseases.

Candida colonization and haematogenous infection were studied retrospectively in 277 patients with haematological diseases by reviewing the microbiological reports of fungal surveillance and blood cultures over a 4-year period. Most patients (83%) were colonized by Candida and in the majority (68%) the same Candida species was isolated from at least 2 body sites. However, candidaemia was diagnosed in only 3 patients. During the same period invasive aspergillosis was diagnosed in 7 patients. Possible causes for the low incidence of candidaemia were fluconazole prophylaxis, empirical amphotericin B and strict indication for antibacterial therapy.

Adolescent↗
PubMed1998

Breast-feeding, pain and infection.

A syndrome of deep pain in the breast during and immediately after lactation has been ascribed to an infection with Candida albicans. A series of 20 patients with deep pain, another 20 with superficial infection and 20 healthy women were compared with respect to the growth of bacteria and fungi. C. albicans was found twice as often in the milk of women with superficial lesions compared to those with deep pain. Bacteria were often found on the nipple and in the milk of those complaining of deep pain. Thus, if the deep pain syndrome is caused by microbes, this study points to a pathogenic role of bacteria rather than fungi.

Adult↗
PubMed1997

Penicillium marneffei infection in a Swedish HIV-infected immunodeficient narcotic addict.

We report a case of Penicillium marneffei infection, acquired in Thailand, in a Swedish HIV-infected immunodeficient heroin addict. This is the first case of penicilliosis marneffei diagnosed in Sweden. The patient had fever without focal symptoms. Cultures from bronchoalveolar lavage fluid and a mediastinal lymph node yielded the dimorphic fungus Penicillium marneffei. Treatment with amphotericin B followed by itraconazole was successful. Penicillium marneffei infection should be considered in HIV patients with fever who have visited Southeast Asia, especially northern Thailand and southern China.

AIDS-Related Opportunistic Infections↗
PubMed1997

Mycobacterium fortuitum complex in Sweden during an 11-year period.

Records of patients have been retrospectively examined studied during an 11-y period, from whom Mycobacterium fortuitum or M. chelonae was isolated in Sweden. Respiratory isolates were obtained from 71 patients. Clinical information was accessible in 52, chest X-ray was pathological in 51, and 42 had underlying diseases. Four skin and 4 urine isolates were observed. Two cases of osteitis and 2 bone marrow isolates of M. chelonae were found. One girl had a submandibular lymph node abscess with M. fortuitum. Of 2 HIV patients, 1 had positive blood cultures with M. fortuitum and the other positive sputum culture with M. chelonae. The broad spectrum of infections with M. fortuitum complex necessitates an integrated judgement of clinical and bacteriological data to determine the relevance of such isolates.

Adult↗
PubMed1996

Clinical and laboratory diagnosis of invasive candida infection in neutropenic patients.

Cancer patients, especially those with acute leukaemia, represent a group that has the greatest risk for deep fungal infection. Almost no cases were seen before the advent of modern chemotherapy, and prior to the availability of antibacterial agents, less than 5% of patients with acute leukaemia died of fungal infection. These infections are now responsible for 40% or more of the deaths at some institutions. Candida species continues to be the most common fungal pathogen. Rapid and specific diagnosis of invasive candiosis enabling early effective therapy is therefore an important measure for reducing mortality in patients. Here the current status of clinical and laboratory diagnosis of invasive candida infection in neutropenic patients is discussed and recommendations made as to future development programmes.

Antineoplastic Agents↗
PubMed1996

Fatal outcome of disseminated Mycobacterium avium infection in childhood. A case of primary incompetent monocyte/macrophage function?

Disseminated BCG infection rarely heals, and disseminated disease caused by the Mycobacterium avium complex usually has a poor prognosis with a short time to death. The case of a boy who died after 9 years of diagnosed disseminated M. avium complex infection is described. He showed no signs of previously known immunodeficiency except an incompetent primary monocyte/macrophage function. This case has been commented on in Acta Paediatrica Scandinavia (1982) as "the first infant to survive a generalized BCG infection".

Adolescent↗
PubMed1996

RNA amplification for direct detection of mycobacterium tuberculosis in respiratory samples.

A target amplified test system (AMTDT, Gen-Probe, San Diego, California, USA) was compared with conventional standard methods in the detection of Mycobacterium tuberculosis in sputum and other respiratory specimens from patients with suspected tuberculosis. The highest incidence of positive samples was seen with the AMTDT test. Out of 450 samples from patients with known or suspected tuberculosis, 43 (9.6%) were positive by culture, and 47 (10.4%) with AMTDT. After discrepancy analysis, 7 of the culture-negative but AMTDT-positive samples were judged to be true positive, giving the AMTDT a sensitivity of 92.0% and a specificity of 99.8%. The AMTDT test was rapid, easy to perform, sensitive, and highly specific.

Bronchoalveolar Lavage Fluid↗
PubMed1996

Complicated course of local mycobacterial infection in an immunocompetent girl.

A complicated course of cervical Mycobacterium avium adenitis in a healthy 3-year-old girl is described. A retropharyngeal and a parotic abscess developed resulting in a salivary fistula. Surgery was not judged possible but chemotherapy was given for 6 months during which the infection healed. It is not clear whether the regression was spontaneous or caused by the therapy.

Abscess↗
PubMed1996

Multiple serovars of Mycobacterium avium complex in patients with AIDS.

Mycobacterium avium complex (MAC) was isolated and serotyped from 127 samples from 43 HIV-infected patients with disseminated disease in Sweden. Thirteen different serovars were observed. Serovar 6 was the most common, followed by 4, 9 and 11. Serovar 8 was rare. In 22 of the patients the same serovar was found in blood and at other sites. Clinical symptoms and outcome were compared in patients with different serovars. Analysis of patient records revealed no association between clinical picture and any specific serovar. The median survival time after MAC infection was 7 months. Somewhat shorter survival was observed in patients with serovar 4 than in those with serovar 6.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Oral Candida albicans isolates with reduced susceptibility to fluconazole in Swedish HIV-infected patients.

A total of 62 patients with HIV-related conditions were examined for clinical and mycological oral findings. Cultures from 51 patients were positive for yeasts and included 49 Candida albicans and 8 non-albicans isolates. Of patients with positive culture, 35% had pseudomembranous thrush. In vitro susceptibility testing of 49 C. albicans isolates revealed that the minimal inhibitory concentration for 50% of the strains (MIC50) was 2.0 mg/l for fluconazole, and the MIC50 was < or = 0.125 mg/l for both ketoconazole and itraconazole. Fluconazole resistance (MIC > or = 32.0 mg/l) was found for 14% of the C. albicans isolates tested. Two C. albicans isolates showed cross-resistance to ketoconazole and itraconazole. Associations between reduced susceptibility to fluconazole and low CD4+ cell counts, the length of time since the first AIDS-defining illness and the interval from the first fluconazole treatment, indirectly reflecting the total fluconazole exposure, were observed.

AIDS-Related Opportunistic Infections↗
PubMed1995

Fluconazole failure in two cases of disseminated candidosis.

Amphotericin B has been the standard treatment of disseminated candidosis although the less toxic fluconazole tends to be used more frequently. In a recent report, no significant difference in the efficacy of candidaemia treatment was observed between fluconazole and amphotericin B. However, we report on 2 cases of invasive candidosis where fluconazole failed to eradicate Candida albicans although the isolates were susceptible to fluconazole in vitro. Pulsed-field gel electrophoresis was used to confirm the persistence of the same C. albicans strain after therapy failure in both patients.

Aged↗