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S Blot

Publications and source records attributed to S Blot.

At least 19 recordsLinked to original sources
PubMed2006

Effect of fluconazole consumption on long-term trends in candidal ecology.

BACKGROUND: Fluconazole is an antifungal agent that is widely used for the treatment of Candida infection. Because of its favourable safety profile it is extensively used for prophylaxis in patient populations with a substantial risk for Candida infection. At the individual patient level, exposure to fluconazole selects for Candida non-albicans strains such as Candida glabrata and Candida krusei, with reduced susceptibility or intrinsic resistance to fluconazole. The effect of the volume of consumption of fluconazole on candidal ecology, however, is poorly investigated. OBJECTIVES: The long-term effect of fluconazole consumption on distribution of species causing candidaemia was investigated in a university hospital during an 11 year period (1994-2004). METHODS: In a historical cohort the incidence of nosocomial candidaemia (expressed per 100,000 patient days) was linked with volume consumption of fluconazole [expressed as defined daily doses (DDDs) per 100,000 patient days] and evaluated over time. RESULTS: During the study period 308 episodes of candidaemia occurred (63.3% caused by Candida albicans). The incidence of candidaemia varied from 6.0 to 13.8 per 100,000 patient days. The percentage candidaemia caused by Candida non-albicans spp. varied between 21% and 50%. No trends in the number of candidaemias or in the proportion of C. albicans versus Candida non-albicans spp. were observed. Fluconazole consumption was high but stable ranging from 5013 to 6807 DDDs per 100,000 patient days. No relationship could be demonstrated between volume of fluconazole consumption and Candida spp. distribution (Pearson's correlation coefficient: -0.083; P=0.808). CONCLUSIONS: Despite long-term exposure to fluconazole, no change in candidal ecology was observed.

Antifungal Agents↗
PubMed2006

Hospital consumption of antibiotics in 15 European countries: results of the ESAC Retrospective Data Collection (1997-2002).

OBJECTIVES: To collect reliable, comparable and publicly available data on hospital use of antibiotics in Europe aggregated at the national level (1997-2002). METHODS: Consumption data of systemic antibiotics in Anatomical Therapeutic Chemical (ATC) class J01 were collected and expressed in defined daily doses (DDD) per 1000 inhabitants per day. Valid data for 2002 were available for 15 countries, and 6 year trends for 10 countries. Comparison with ambulatory care (AC) consumption data was possible in 14 countries. RESULTS: In 2002, median national hospital antibiotic consumption in Europe was 2.1 DDD/1000 inhabitants/day in Europe, ranging from 3.9 in Finland and France to 1.3 in Norway and Sweden. Hospital care (HC) consumption as a proportion of total antibiotic consumption ranged from 17.8% to 6.4%. The consumption of hospital-specific antibiotics ranged from 0.43 DDD/1000 inhabitants/day in Greece and 0.08 in Sweden. Six-year trends in consumption were stable, except for rising co-amoxiclav exposure and more rapid market penetration of new antibiotics (e.g. levofloxacin) in some countries. There was a strong, positive correlation between the extent of antibiotic use in AC and in HC (Spearman coefficient 0.745; P = 0.002), both for overall use and for use of five main classes (not macrolides and 'others'). In contrast to AC consumption no substantial seasonal variation in consumption was observed. CONCLUSIONS: It was cumbersome but feasible to collect ecological data on hospital antibiotic consumption in a set of 15 European countries on a retrospective basis, illustrating substantial cross-national variations in the extent and distribution of exposure to antibiotics in hospital care.

Anti-Bacterial Agents↗
PubMed2006

Saline volume in transvesical intra-abdominal pressure measurement: enough is enough.

OBJECTIVE: The objective was to determine the minimum volume of instillation fluid for intra-abdominal pressure (IAP) measurement, and to evaluate the effect of instillation volume on transvesically measured IAP. DESIGN: Prospective cohort study SETTING: Twenty-two-bed surgical ICU of the Ghent University Hospital. PATIENTS AND PARTICIPANTS: Twenty patients at risk of intra-abdominal hypertension (IAH). INTERVENTIONS: Transvesical IAP measurement using volumes from 10 to 100 ml. Minimal volume at which an IAP was measured was recorded (IAP(min)), as well as IAP at 50 and 100 ml of instillation volume (IAP(50) and IAP(100)). The percentage difference for IAP(50) and IAP(100) was calculated. MEASUREMENTS AND RESULTS: The minimal volume for IAP measurement was 10 ml in all patients. Mean IAP(min) was 12.8 mmHg (+/- 4.9), mean IAP(50 )15 mmHg (+/- 4.5) and mean IAP(100) 17.1mmHg (+/- 4.7). The mean percentage difference for IAP(50) was 21% (+/- 17%), and 40% (+/-29%) for IAP(100.) Twelve patients were categorised as suffering from IAH when 10 ml of saline was used for IAP measurement, increasing to 15 and 17 patients respectively when using 50 and 100 ml. In patients with IAH, there was a significant correlation between the duration of bladder drainage and percentage difference for IAP(100) (Pearson correlation coefficient 0.60, p = 0.03). CONCLUSIONS: Using 50 or 100 ml of saline for IAP measurement in critically ill patients results in higher IAP values compared with the use of 10 ml, and possibly, in overestimation of the incidence of intra-abdominal hypertension.

Abdomen↗
PubMed2005

Temporal scanner thermometry: a new method of core temperature estimation in ICU patients.

BACKGROUND AND AIMS: Temperature measurement is a routine task of patient care, with considerable clinical impact, especially in the ICU. This study was conducted to evaluate the accuracy and variability of the Temporal Artery Thermometer (TAT) in ICU-patients. Therefore, a convenience sample of 57 adult patients, with indwelling pulmonary artery catheters (PAC) in a 40-bed intensive care unit in a university teaching hospital was used. METHODS: The study design was a prospective, descriptive comparative analysis. Body temperature was thereby measured simultaneously with the TAT and the Axillary Thermometer (AT), and was compared with the temperature recording of the PAC. The use of vasoactive medication was recorded. RESULTS AND CONCLUSIONS: Mean temperature of all measurements was: PAC: 37.1 degrees C (SD: 0.87), TAT 37.0 degrees C (SD: 0.68) and axillary thermometer: 36.6 degrees C (SD: 0.94). The measurements of the TAT and the PAC were not significantly different (man differnce: 0.14 degrees C; SD: 0.51; p = 0.33); whereas the measurements of the PAC and the AT differed significantly (mean difference: 0.46 degerees C; SD: 0.39; p < 0.001). Mean diference in PAC versus TAT analyses, between patients with vasopressor therapy (0.12 degrees C; SD: 0.55), and without vasopressor therapy (0.19 degrees C; SD: 0.48) was not statistically significant (p = 0.47). CONCLUSION: We can conclude that the temporal scanner has a relatively good reliability with an acceptable accuracy and variability in patients with normothermia. The results are comparable to those of the AT, but they do not seem to be sufficient to prove any substantial benefit compared to rectal, oral or bladder thermometry.

Adult↗
PubMed2004

First isolation of Mycobacterium microti (Llama-type) from a dog.

We report the first isolation of Mycobacterium microti from a dog with lesions of acute peritonitis. The isolate was demonstrated to be M. microti of Llama-Type by spoligotyping. Epidemiological implications of the isolation of this possibly zoonotic agent from a dog are discussed.

Acute Disease↗
PubMed2004

Bloodstream infections after surgery for severe acute pancreatitis.

OBJECTIVE: To analyze the incidence and outcome of bloodstream infections (BSIs) in patients operated on for severe acute pancreatitis to identify the source and associated risk factors. METHODS: We retrospectively (1995-2001) analyzed 45 patients treated surgically for severe acute pancreatitis. We recorded demographic characteristics, data on surgical and medical treatment and disease severity, the occurrence of BSIs, microbiological data concerning the BSIs and other infectious processes, the incidence of organ failure, and data on surgical and infectious complications. RESULTS: Fifteen episodes of BSI were found in 7 of 45 patients (15%), with 18 organisms involved. In all but 1 episode, the source of the BSI was pancreatic necrosis. Most of the organisms were gram positive (11); the others were gram negative (6) or fungi (1). Mortality was statistically not different in patients with a BSI (57% vs. 35%). Multivariate analysis demonstrated that only the length of intensive care unit (ICU) stay was associated with the occurrence of BSIs (OR, 1.05; 95% CI, 1.02-1.09; P < 0.01). CONCLUSION: A BSI is not a rare finding after surgery for severe acute pancreatitis, especially in patients with a prolonged ICU stay. The source is the infected necrosis in most of BSI episodes.

Acute Disease↗
PubMed2004

European surveillance of antimicrobial consumption (ESAC): data collection performance and methodological approach.

BACKGROUND: Europe is a continent with strong public healthcare systems, but diverging antibiotic policies and resistance patterns. AIMS: To describe the performance and methodological approach in a retrospective data collection effort (1997-2001), through an international network of surveillance systems, aiming to collect publicly available, comparable and reliable data on antibiotic use in Europe. METHODS: A central multidisciplinary management team co-ordinated a network of national representatives, liasing with national data providers and bodies responsible for antibiotic policy. The data collected were screened for bias, using a checklist. We focused on detection bias in sample and census data; errors in assigning medicinal product packages to the Anatomical Therapeutic Chemical Classification (ATC); errors in calculations of defined daily doses (DDD) per package; bias by over-the-counter sales and parallel trade; and bias in ambulatory care (AC)/hospital care (HC) mix. Datasets were corrected after national feedback, and classified as valid; valid but with minor bias; not valid. RESULTS: Of the 31 participating countries, 21 countries delivered AC data suitable for cross-national comparison (14 for all 5 years). Of these, 17 countries provided data on a quarterly basis for at least 1 year. For HC, 14 countries were able to deliver valid data (nine for all 5 years). A valid estimate of the total exposure of national populations to human antibiotic consumption could be made in 17 countries. CONCLUSION: In cross-national comparisons of antibiotic consumption in Europe, methodological rigour in correcting for various sources of bias and checking the validity of ATC/DDD assignment is needed.

Anti-Bacterial Agents↗
PubMed2003

Fungal infections in patients with severe acute pancreatitis and the use of prophylactic therapy.

Data from an 8-year period for 46 patients with severe acute pancreatitis and infected pancreatic necrosis were analyzed to determine the incidence of fungal infection, to identify risk factors for the development of fungal infection, and to assess the use of early fluconazole treatment. Intraabdominal fungal infection was found in 17 (37%) of 46 patients. Candida albicans was isolated most frequently (15 patients); Candida tropicalis and Candida krusei were found in 1 patient each. Characteristics of patients with fungal infection were not different from patients without fungal infection. The difference in mortality was not statistically significant between patients with fungal infection and patients without fungal infection. Early antifungal therapy (prophylactic or preemptive antifungal therapy) was administered to 18 patients, and only 3 of them developed fungal infection. In this cohort of critically ill patients, no risk factors for fungal infection could be demonstrated, and mortality among patients who received early antifungal therapy was not different. Early treatment with fluconazole seems to prevent fungal infection in these high-risk patients.

Acute Disease↗
PubMed2003

Reappraisal of attributable mortality in critically ill patients with nosocomial bacteraemia involving Pseudomonas aeruginosa.

In a retrospective study, population characteristics and outcome were investigated in intensive care unit (ICU) patients with hospital-acquired Pseudomonas aeruginosa bacteraemia admitted over a seven-year period (January 1992 through December 1998). A matched cohort study was performed in which all ICU patients with P. aeruginosa bacteraemia were defined as cases (N=53). Matching (1:2 ratio) of the controls (N=106) was based on the APACHE II classification: an equal APACHE II score (+/-1 point) and an equal diagnostic category. Patients with P. aeruginosa bacteraemia had a higher incidence of acute respiratory failure, haemodynamic instability, a longer ICU stay and length of ventilator dependence (P<0.05). In-hospital mortalities for cases and controls were 62.3 vs. 47.2% respectively (P=0.073). Thus, the attributable mortality was 15.1% (95% confidence intervals: -1.0-31.2). In a multivariate survival analysis the APACHE II score was the only variable independently associated with mortality. In conclusion, P. aeruginosa bacteraemia is associated with a clinically relevant attributable mortality (15%). However, we could not find statistical evidence of P. aeruginosa being an independent predictor of mortality.

APACHE↗
PubMed2002

Stereotactic CT-guided brain biopsy in the dog.

This study evaluated the accuracy of a new stereotactic CT-guided brain biopsy (SCTGBB) device on 23 client-owned dogs which presented with a brain lesion. Biopsy of the lesion was achieved in 95 per cent of cases. The target tissue was not sampled in one dog. Complications were observed in six dogs. Two dogs with highly vascularised brainstem tumours died after SCTGBB. Minor complications (slight variation in the neurological status) were observed in a further four cases. A diagnosis was reached in 16 dogs after cytological examination and in 21 dogs after histological evaluation. SCTGBB is an accurate diagnostic method for the diagnosis of brain lesions.

Animals↗
PubMed2001

The electroretinographic phenotype of dogs with Golden Retriever muscular dystrophy.

OBJECTIVE: To characterize the flash electroretinogram (ERG) in the Golden Retriever muscular dystrophy (GRMD) dog and to compare the results with those from a control group of Golden Retrievers. To investigate whether similar abnormalities of the ERG as those found in a majority of human patients with Duchenne muscular dystrophy (DMD) are also observed in the GRMD dog, the canine model for DMD. Animals Five GRMD dogs and five age-matched clinically normal Golden Retrievers. PROCEDURE: An ophthalmic examination was carried out prior to performing electroretinography under general anesthesia. Rod, combined rod-cone and oscillatory potentials responses were recorded after dark adaptation. Responses to 30-Hz-flicker were recorded after light adaptation. The ERG responses of the GRMD dogs were compared with those of the control dogs by use of a Wilcoxon signed rank test. RESULTS: GRMD dogs had significantly reduced a and b-wave amplitudes after dim white flash stimuli (rod response) and reduced a-wave amplitude after bright white flash stimuli (rod-cone response). CONCLUSION AND CLINICAL RELEVANCE: The ERG abnormalities observed in the GRMD dog suggest a dysfunction in the rod signaling pathway. These ERG alterations are different from those observed in human patients with DMD.

Animals↗
PubMed2001

Outcome in critically ill patients with candidal fungaemia: Candida albicans vs. Candida glabrata.

In a retrospective study (1 January 1992-12 December 1998), we investigated population characteristics and outcome in critically ill patients with fungaemia involving C. albicans (n=41) and C. glabrata (n=15). Patients with C. glabrata fungaemia were significantly older compared with patients in the C. albicans group (P=0.024). There were no other differences in population characteristics or severity of illness. Logistic regression analysis showed age (P=0.021), the presence of a polymicrobial blood stream infection (P=0.039), and renal failure (P=0.044) to be independent predictors of mortality. There was no significant difference in in-hospital mortality between the C. glabrata and C. albicans groups (60.0% vs. 41.5%; P=0.24). Since age was an independent predictor of mortality, the trend towards a higher mortality in patients with C. glabrata can be explained by this population being significantly older. In conclusion, we found no difference in mortality between patients with fungaemia involving C. albicans and C. glabrata.

Adolescent↗
PubMed1997

Transforming growth factor alpha expression as a response of murine motor neurons to axonal injury and mutation-induced degeneration.

We previously showed that degenerating adult motor neurons of the murine mutant wobbler, a model of spinal muscular atrophy, express Transforming Growth Factor alpha (TGF alpha), a growth factor endowed with glio- and neurotrophic activities. Here, we evaluated whether TGF alpha expression is a general response of adult motor neurons to injury. Synthesis of its precursor (pro-TGF alpha) was investigated in another model of motoneuronal degeneration, the murine mutant muscle deficient, and in hypoglossal motor neurons following axonal crush and cut. In control conditions, motor neurons were devoid of pro-TGF alpha immunoreactivity. In the mutant lumbar spinal cord, pro-TGF alpha immunoreactive motor neurons appeared as soon as the disease developed and pro-TGF alpha expression persisted until the latest stages of degeneration. Motor neurons and astrocytes of the white matter weakly immunoreactive for the TGF alpha receptor were also present in both control and mutant lumbar spinal cords. Following hypoglossal nerve crush and cut, motoneuronal pro-TGF alpha expression was precocious and transient, visible at one day post-injury and lasting for only 3 days, during which time astrocyte-like cells immunoreactive for both TGF alpha and its receptor appeared within the injured nucleus. Enhanced TGF alpha mRNA levels following nerve crush showed that activation occurred at the transcriptional level. These results show that upregulation of TGF alpha is an early and common response of adult murine motor neurons to injury, regardless of its experimental or genetic origin.

Animals↗