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Yung-Ching Liu

Publications and source records attributed to Yung-Ching Liu.

At least 37 records · Page 2Linked to original sources

Antifungal susceptibilities of clinical isolates of Candida species, Cryptococcus neoformans, and Aspergillus species from Taiwan: surveillance of multicenter antimicrobial resistance in Taiwan program data from 2003.

The susceptibilities of nonduplicate isolates to six antifungal agents were determined for 391 blood isolates of seven Candida species, 70 clinical isolates (from blood or cerebrospinal fluid) of Cryptococcus neoformans, and 96 clinical isolates of four Aspergillus species, which were collected in seven different hospitals in Taiwan (as part of the 2003 program of the study group Surveillance of Multicenter Antimicrobial Resistance in Taiwan). All isolates of Candida species other than C. glabrata and C. krusei were susceptible to fluconazole. Among the 59 C. glabrata isolates, 16 (27%) were not susceptible to fluconazole, and all were dose-dependently susceptible or resistant to itraconazole. For three (5.1%) C. glabrata isolates, voriconazole MICs were 2 to 4 microg/ml, and for all other Candida species isolates, voriconazole MICs were </=0.5 microg/ml. The proportions of isolates for which amphotericin B MICs were >/=2 microg/ml were 100% (3 isolates) for C. krusei, 11% (23 of 207 isolates) for Candida albicans, 3.0% (2 of 67 isolates) for Candida tropicalis, 20% (12 of 59 isolates) for C. glabrata, and 0% for both Candida parapsilosis and Candida lusitaniae. For three (4%) Cryptococcus neoformans isolates, fluconazole MICs were >/=16 microg/ml, and two (3%) isolates were not inhibited by 1 mug of amphotericin B/ml. For four (4.2%) of the Aspergillus isolates, itraconazole MICs were 8 microg/ml. Aspergillus flavus was less susceptible to amphotericin B, with the MICs at which 50% (1 microg/ml) and 90% (2 microg/ml) nsrsid417869\delrsid7301351 of isolates were inhibited being twofold greater than those for Aspergillus fumigatus and Aspergillus niger. All Aspergillus isolates were inhibited by </=1 microg of voriconazole/ml, including isolates with increased resistance to amphotericin B and itraconazole. This study revealed the emergence in Taiwan of decreased susceptibilities of Candida species to amphotericin B and of C. neoformans to fluconazole and amphotericin B. Voriconazole was the most potent agent against the fungal isolates tested, including fluconazole- and amphotericin B-nonsusceptible strains.

Antifungal Agents↗

Laboratory-based surveillance and molecular epidemiology of influenza virus in Taiwan.

A laboratory-based surveillance network of 11 clinical virological laboratories for influenza viruses was established in Taiwan under the coordination of the Center for Disease Control and Prevention (CDC), Taiwan. From October 2000 to March 2004, 3,244 influenza viruses were isolated, including 1,969 influenza A and 1,275 influenza B viruses. The influenza infections usually occurred frequently in winter in the northern hemisphere. However, the influenza seasonality in Taiwan was not clear during the four seasons under investigation. For example, the influenza A viruses peaked during the winters of 2001, 2002, and 2003. However, some isolated peaks were also found in the summer and fall (June to November) of 2001 and 2002. An unusual peak of influenza B also occurred in the summer of 2002 (June to August). Phylogenetic analysis shows that influenza A isolates from the same year were often grouped together. However, influenza B isolates from the year 2002 clustered into different groups, and the data indicate that both B/Victoria/2/87-like and B/Yamagata/16/88-like lineages of influenza B viruses were cocirculating. Sequence comparison of epidemic strains versus vaccine strains shows that many vaccine-like Taiwanese strains were circulating at least 2 years before the vaccine strains were introduced. No clear seasonality of influenza reports in Taiwan occurred in contrast to other more continental regions.

Animals↗

Clinical manifestations of Kikuchi's disease in southern Taiwan.

Histiocytic necrotizing lymphadenitis, or Kikuchi's disease (KD), is a self-limiting cervical lymphadenitis of unknown origin. The diagnosis of KD is problematic due to the lack of specific laboratory tests. This study reviewed the clinical characteristics of 58 patients with KD. Clinical manifestations were of considerable diversity. The mean age of patients was 24.88 +/- 7.44 years and there was a female predominance (1.76:1). The most frequent clinical findings were enlarged tender lymph nodes (50%), fever (43%), sore throat (21%), non-productive cough (12%), headache (10%), chills (9%) and rhinorrhea (9%). The most common initial laboratory abnormalities were leukopenia (29%), elevated erythrocyte sedimentation rate (14%), liver function impairment (14%), elevated C-reactive protein level (12%), and anemia (10%). Most patients had unilateral lymph node involvement (79%), which was usually located in the posterior triangle of the cervical lymph nodes (90%). Most patients had no comorbid disease (93%). No recurrence occurred. KD should be included in the differential diagnosis of fever with cervical lymphadenopathy.

Adolescent↗

Preservation of clinical isolates of Mycobacterium tuberculosis complex directly from MGIT culture tubes.

Preservation of M. tuberculosis complex strains isolated from clinical specimens is important for epidemiological investigations related to tuberculosis. In this study the efficacy of preservation was evaluated by calculating the recovery rate of preserved strains, with various patterns of resistance, after periods of storage and subculture. The recovery rates from strains preserved in enriched solid medium were >90% for storage periods <or=6 yr. However, this procedure for storing mycobacteria is time-consuming, labor-intensive, and impractical for routine use in a clinical laboratory setting. This study shows that recovery rates for strains preserved directly from MGIT fluids are satisfactory for storage periods <or=2 yr. No significant difference in viability was observed within 3 categories of drug resistance: (i) all-susceptible, (ii) multi-drug resistant (MDR), and (iii) a combination of other patterns of resistance. Preserving clinical M. tuberculosis strains directly from MGIT culture fluid fits easily into laboratory routine and is feasible for use in a clinical laboratory setting.

Culture Media↗

In vitro antimicrobial effect of cefazolin and cefotaxime combined with minocycline against Vibrio cholerae non-O1 non-O139.

The most common clinical manifestation of Vibrio cholerae non-O1 non-O139 is gastroenteritis. This vibrion may also cause bacteremia, soft tissue infection, and other extraintestinal invasive disease, especially in immunocompromised patients. This study evaluated the current status of antimicrobial resistance in clinical isolates of V. cholerae non-O1 non-O139 in Taiwan as part of the SMART (Surveillance from Multicenter Antimicrobial Resistance in Taiwan) program. Minimal inhibitory concentrations (MICs) of 9 antimicrobial agents were determined by the agar dilution method. All of the isolates were susceptible to minocycline (MIC at which 90% of the isolates were inhibited [MIC(90)], 0.12 microg/mL), cefotaxime (MIC(90), 0.06 microg/mL), lomefloxacin (MIC(90), 0.12 microg/mL), levofloxacin (MIC(90), 0.03 microg/mL), ciprofloxacin (MIC(90), 0.03 microg/mL), moxifloxacin (MIC(90), 0.06 microg/mL), sparfloxacin (MIC(90), 0.06 microg/mL), gatifloxacin (MIC(90), 0.03 microg/mL), and cefazolin (MIC(90), 8 microg/mL). We conducted time-kill studies to evaluate the inhibitory activities of either cefazolin or minocycline alone or in combination against V. cholerae non-O1 non-O139 (Vc2). We also evaluated the inhibitory activity of cefazolin or cefotaxime combined with minocycline. The individual MICs of cefazolin, cefotaxime, and minocycline were 4 microg/mL, 0.0075 microg/mL, and 0.12 microg/mL, respectively, when approximately 5 x 105 colony-forming units/mL of V. cholerae non-O1 non-O139 was incubated. Bacterial growth was inhibited initially but resumed later when cefazolin, cefotaxime, or minocycline was used alone. When cefazoline or cefotaxime was combined with minocycline, V. cholerae non-O1 non-O139 was inhibited over 48 h and no regrowth was noted. We conclude that the combination of cefazolin or cefotaxime with minocycline has a synergistic inhibitory effect on V. cholerae non-O1 non-O139 in vitro.

Anti-Bacterial Agents↗

A prospective etiologic study of community-acquired pneumonia in Taiwan.

BACKGROUND AND PURPOSE: The treatment of community-acquired pneumonia (CAP) is complicated by the growing threat of antimicrobial resistance and the tendency to rely on empirical therapy. This study investigated the etiologic agents of adult CAP in Taiwan and the susceptibility of Streptococcus pneumoniae isolates from these patients. METHODS: A collaborative group was established in the emergency department to conduct a prospective study of the etiology of adult CAP. The etiologic agent was determined by a combination of microscopic, culture, serologic and antigen detection methods. Pneumococcal susceptibility testing was performed to determine the extent of penicillin resistance. RESULTS: A total of 100 consecutive cases of mild to moderate adult CAP prior to the severe acute respiratory syndrome epidemic were enrolled. The etiologic agent was determined in 72% of cases. The 5 most common causative pathogens were S. pneumoniae (26%), Mycoplasma pneumoniae (20%), Chlamydia pneumoniae (13%), Haemophilus influenzae (9%), and Klebsiella pneumoniae (5%). Atypical pathogens accounted for 40% of CAP. Bacteremic pneumonia was diagnosed in 6.2% of cases. Co-infections with 2 or more pathogens were found in 16% of the cases. Among the 20 isolates of S. pneumoniae, 85% (17/20) were susceptible to penicillin, 3 (15%) were intermediate, and none were resistant to penicillin. CONCLUSION: S. pneumoniae, M. pneumoniae and C. pneumoniae were the 3 leading causes of mild to moderate CAP in Taiwan. This study indicates that penicillin-resistant S. pneumoniae play a very limited role in this condition in adults.

Adolescent↗

Colon perforation with peritonitis in an acquired immunodeficiency syndrome patient due to cytomegalovirus and amoebic colitis.

Invasive amoebiasis is rarely seen in human immunodeficiency virus (HIV)-infected individuals, even in endemic areas. By contrast, cytomegalovirus (CMV) disease is recognized as a major clinical problem in acquired immunodeficiency syndrome patients. A 34-year-old HIV-infected man with amoeba colitis, disseminated Mycobacterium avian complex and CMV infection with cecum perforation, presented with the initial symptoms of fever, shortness of breath and painful sensation when swallowing. He was treated with fluconazole, trimethoprim-sulfamethoxazole and hydrocortisone under the impression of esophageal candidiasis and Pneumocystis jiroveci pneumonia. However, diarrhea and abdominal pain developed on day 6 of hospitalization. Invasive amoebiasis and CMV colitis was diagnosed after examination of colon pathological specimens. Emergent laparotomy was performed. Right hemicolectomy with double barrel ileostomy and colostomy was done due to perforation of the cecum. Iodoquinol was given, followed by metronidazole 14 days afterwards. He underwent closure of double barrel ileostomy and colostomy 5 months later. This case illustrates the diagnostic challenge of caring for acquired immunodeficiency syndrome persons with multiple illnesses and medication use. CMV infection, amoebic colitis and possibly corticosteroid may have played a role in colon perforation in our patient.

Acquired Immunodeficiency Syndrome↗

Streptococcus suis meningitis with ventriculoperitoneal shunt infection and spondylodiscitis.

Streptococcus suis is a zoonotic pathogen which causes meningitis, bacteremia, and endocarditis in pigs. Human infection is rare and often presents as meningitis with the sequela of permanent deafness and endocarditis. Previous cases were reported from pig-rearing countries such as Holland and Hong Kong. We report a 55-year-old bedridden man with S. suis meningitis complicated with ventriculoperitoneal shunt infection and lumbar spine spondylodiscitis. He presented with fever, delirium, neck stiffness, lower leg weakness and sudden onset hearing loss for several days. He was successfully treated with intravenous antibiotics, ventriculoperitoneal shunt replacement, lumbar spinal laminotomy and discectomy. Cerebrospinal fluid culture initially misidentified the organism as Streptococcus acidominimus, and S. suis was later identified by 16S rRNA sequencing. Misidentification of the microbiological findings may lead to a failure to correctly diagnose this disease. S. suis meningitis should be included in the differential diagnosis of patients with meningitis and sudden hearing loss.

Anti-Bacterial Agents↗

Use of MGIT 960 for rapid quantitative measurement of the susceptibility of Mycobacterium tuberculosis complex to ciprofloxacin and ethionamide.

OBJECTIVES: Tentative standards for testing MICs for Mycobacterium tuberculosis include agar dilution and the BACTEC method. However, the conventional agar dilution method requires 3-5 weeks to complete; whereas BACTEC, although a rapid test, involves the use of radioisotopes. In contrast, the MGIT 960 system uses a fluorescence quenching based oxygen sensor that can be read automatically. This system is not only robust, safe and simple, but has been validated for susceptibility tests of first-line antituberculous agents. METHODS: We evaluated 46 clinical strains of M. tuberculosis isolated from patients admitted to Kaohsiung Veterans General Hospital. Testing of MICs of ciprofloxacin and ethionamide was carried out by MGIT 960 and compared with the agar dilution method. RESULTS: Good agreement was found between MGIT 960 and agar dilution. The greatest concordance between the agar dilution and MGIT assay at +/-1 and +/-2 dilution was 80.4% and 97.8% for ciprofloxacin, and 82.6% and 93.5% for ethionamide, respectively. CONCLUSION: MGIT 960 was found to be comparable to the current NCCLS standard method, agar dilution, and has the advantage of being rapid (obtaining results within 5-17 days, average 8.9 days) and easy to achieve standardization.

Antitubercular Agents↗

Catheter-associated urinary tract infections in intensive care units can be reduced by prompting physicians to remove unnecessary catheters.

OBJECTIVE: Indwelling urinary catheters are the most common source of infections in intensive care units (ICUs). The aim of this study was to evaluate the efficacy of nurse-generated daily reminders to physicians to remove unnecessary urinary catheters 5 days after insertion. DESIGN: A time-sequence nonrandomized intervention study. SETTING: Adult ICUs (medical, surgical, cardiovascular surgical, neurosurgical, and coronary care) of a tertiary-care university medical center. PATIENTS: All patients admitted to the adult ICUs during a 2-year period. The study consisted of a 12-month observational phase (15,960 patient-days) followed by a 12-month intervention phase (15,525 patient-days). INTERVENTION: Daily reminders to physicians from the nursing staff to remove unnecessary urinary catheters 5 days after insertion. RESULTS: The duration of urinary catheterization was significantly reduced during the intervention phase (from 7.0 + 1.1 days to 4.6 +/- 0.7 days; P < .001). The rate of catheter-associated urinary tract infection (CAUTI) was also significantly reduced (from 11.5 +/- 3.1 to 8.3 +/- 2.5 patients with CAUTI per 1,000 catheter-days; P = .009). There was a linear relationship between the monthly average duration of catheterization and the rate of CAUTI (r = 0.50; P = .01). The excess monthly cost of antibiotics for CAUTI was reduced by 69% (from 4021 dollars +/- 1800 dollars to 1220 dollars +/- 941 dollars; P = .004). CONCLUSION: This study demonstrated that a simple measure instituted as part of a continuous quality improvement program significantly reduced the duration of urinary catheterization, rate of CAUTI, and additional costs of antibiotics to manage CAUTI.

Aged↗

Nontyphoid salmonellosis in taiwan children: clinical manifestations, outcome and antibiotic resistance.

OBJECTIVES: The purposes of this study were to investigate the epidemiologic, clinical, and microbiologic features of patients with nontyphoid salmonellosis and to elucidate the impact of resistance on the outcome of nontyphoid salmonellosis in Taiwan. The authors also sought to develop a severity score to derive an objective guideline for antibiotic use in nontyphoid salmonellosis in the era of increasing antibiotic resistance. METHODS: The authors prospectively monitored 311 children with nontyphoid salmonellosis in Kaohsiung, Taiwan. The demographic, clinical, and microbiologic features, underlying diseases, treatment regimen, complications, and outcome were analyzed. In vitro susceptibility testing of the isolates was performed. RESULTS: The median age of affected patients was 15 months. Salmonella enteritidis B caused 68.5% of episodes, followed by S. enteritidis C1 (11.9%), D (7.7%), C2 (7.1%), E (2.6%), S. choleraesuis (1.6%), and S. paratyphi (0.6%). Sixty percent of isolates were resistant to ampicillin. Patients with bacteremia could not be differentiated from patients without bacteremia on clinical grounds. Patients receiving antibiotics that were inactive in vitro (discordant therapy) had more days of fever and longer hospital stay compared with patients receiving antibiotics that were active in vitro (concordant therapy). Patients receiving no antibiotic treatment had the fewest days of fever and shortest hospital stays, especially among patients with mild illness (severity score, 0-1). CONCLUSION: Blood culture should be obtained in patients with nontyphoid salmonellosis to detect bacteremia. In treating antibiotic-resistant nontyphoid salmonellosis, antibiotics are still not mandatory for patients who present with primarily gastrointestinal symptoms and limited signs of systemic inflammation reflected by a low severity score (low C-reactive protein, fewer band cells in peripheral blood, and fewer days of fever before admission). Susceptibility data should be promptly obtained because use of discordant antibiotics appears to prolong illness.

Adolescent↗

Ciprofloxacin-resistant Salmonella enterica Typhimurium and Choleraesuis from pigs to humans, Taiwan.

We evaluated the disk susceptibility data of 671 nontyphoid Salmonella isolates collected from different parts of Taiwan from March 2001 to August 2001 and 1,261 nontyphoid Salmonella isolates from the National Taiwan University Hospital from 1996 to 2001. Overall, ciprofloxacin resistance was found in 2.7% (18/671) of all nontyphoid Salmonella isolates, in 1.4% (5/347) of Salmonella enterica serotype Typhimurium and in 7.5% (8/107) in S. enterica serotype Choleraesuis nationwide. MICs of six newer fluoroquinolones were determined for the following isolates: 37 isolates of ciprofloxacin-resistant (human) S. Typhimurium (N = 26) and Choleraesuis (N = 11), 10 isolates of ciprofloxacin-susceptible (MIC <1 mg/mL) (human) isolates of these two serotypes, and 15 swine isolates from S. Choleraesuis (N = 13) and Typhmurium (N = 2) with reduced susceptibility to ciprofloxacin (MIC >0.12 microg/mL). Sequence analysis of the gryA, gyrB, parC, parE, and acrR genes, ciprofloxacin accumulation, and genotypes generated by pulsed-field gel electrophoresis with three restriction enzymes (SpeI, XbaI, and BlnI) were performed. All 26 S. Typhimurium isolates from humans and pigs belonged to genotype I. For S. Choleraesuis isolates, 91% (10/11) of human isolates and 54% (7/13) of swine isolates belonged to genotype B. These two genotypes isolates from humans all exhibited a high-level of resistance to ciprofloxacin (MIC 16-64 mg/mL). They had two-base substitutions in the gyrA gene at codons 83 (Ser83Phe) and 87 (Asp87Gly or Asp87Asn) and in the parC gene at codon 80 (Ser80Arg, Ser80Ile, or Ser84Lys). Our investigation documented that not only did these two S. enterica isolates have a high prevalence of ciprofloxacin resistance nationwide but also that some closely related ciprofloxacin-resistant strains are disseminated from pigs to humans.

Adolescent↗

Vibrio vulnificus in Taiwan.

Residents in Taiwan are often exposed to marine microorganisms through seafood and occupational exposure. The number of reported cases of infection attributable to this organism has increased since the first case was reported in 1985. The increasing number of cases may be caused by greater disease activity or improved recognition by clinicians or laboratory workers. We analyze a clinical-case series of 84 patients with Vibrio vulnificus infection from 1995 to 2000 and describe the molecular epidemiologic features of pathogens isolated from these patients. The spectrum of clinical manifestations and outcomes, options of antimicrobial therapy, and virulence mechanisms were investigated. Results of molecular typing of isolates from humans and marine environment in this country had a high genetic divergence among these isolates. Education and measures are needed to prevent this emerging disease.

Humans↗

Double-blind, randomized, acyclovir-controlled, parallel-group trial comparing the safety and efficacy of famciclovir and acyclovir in patients with uncomplicated herpes zoster.

This randomized, double-blind, parallel-group study compared the efficacy and safety of famciclovir administered at 250 mg thrice daily with acyclovir 800 mg 5 times daily for the treatment of acute uncomplicated herpes zoster in immunocompetent adults. A total of 55 patients participated in this trial. Twenty seven patients (49.1%) were randomized into the famciclovir plus placebo treatment group and 28 (50.9%) into the acyclovir plus placebo group. Six of the 55 patients did not complete the study. Two of these patients were in the famciclovir plus placebo group and dropped out due to deviation from the study protocol. Four patients in the acyclovir plus placebo group did not complete the study protocol due to adverse events (n = 2), deviation from the protocol (n = 1), or loss to follow-up (n = 1). Treatment was initiated within 72 h of onset of the zoster rash and was continued for 7 days. When treatment was initiated within 72 h, famciclovir was as effective as acyclovir for healing the cutaneous lesion, as indicated by the time to full crusting, loss of acute phase pain, loss of vesicles, and loss of crusts. Famciclovir was well tolerated and had a more favorable adverse event profile compared to acyclovir. Constipation, hematuria, and glycosuria were the most commonly reported adverse events, but only constipation was considered to have a possible relationship to the treatment. In conclusion, famciclovir, administered less frequently and at lower unit doses than acyclovir, is an effective treatment for uncomplicated herpes zoster.

2-Aminopurine↗

Outbreak of eosinophilic meningitis associated with drinking raw vegetable juice in southern Taiwan.

The most common cause of eosinophilic meningitis is the rat lungworm Angiostrongylus cantonensis a parasite that is endemic in the southeast Asian and Pacific regions. Outbreaks of eosinophilic meningitis associated with drinking raw vegetable juice are rarely reported, even in regions of endemic infection. We performed a cohort study among Taiwanese with eosinophilic meningitis who drank raw vegetable juice within three months of the onset of the outbreak. Clinical manifestations, laboratory examinations, and outcomes were prospectively followed. Five native Taiwanese met the case definition of eosinophilic meningitis. Specific antibodies to A. cantonensis were detected in the serum of five of the patients and in the cerebrospinal fluid (CSF) of four of the patients. Central nervous system manifestations included headache (n = 5 [100%]), Brudzinski's sign/stiff neck (n = 5 [100%]), hyperesthesia/paresthesias (n = 5 [100%]), and cranial nerve palsy (n = 1 [20%]). Laboratory findings included peripheral (n = 5 [100%]) and CSF eosinophilia (n = 4 [80%]), transient increases in the white blood cell count (n = 1 [20%]), and in serum levels of creatine kinase (n = 1 [20%]). Meningeal enhancement, as well as high signal intensity, at the subcortical white matter on T2 weighted and fluid attenuated inversion recovery images were observed on magnetic resonance imaging in four patients. There were three episodes of relapse during treatment and all resolved with after a lumbar puncture and/or administration of steroids. At the 12-month follow up, all five patients had recovered without neurologic sequelae. Risk factors identification showed that consumption of raw vegetable juice was associated with illness (Pearson correlation test r = 0.867, P = 0.01). There was association between the presence of raw vegetable juice and CSF eosinophilia (Spearman's correlation test r = 0.816, P = 0.004).

Adult↗

Multicenter surveillance of antimicrobial resistance of Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis to 14 oral antibiotics.

BACKGROUND AND PURPOSE: Data on the in vitro activities of orally administered cephalosporins, particularly third-generation cephalosporins, against recent pathogens responsible for community-respiratory tract infection are lacking. METHODS: A susceptibility surveillance of 267 isolates of Streptococcus pneumoniae, 205 of Streptococcus pyogenes, 204 of Haemophilus influenzae, and 147 of Moraxella catarrhalis to 14 oral antimicrobial agents using the agar dilution method was carried out from March 2002 to October 2002 in Taiwan. RESULTS: High rates of non-susceptibility to penicillin (60%), cefaclor (67%), cefuroxime (62%), cefpodoxime (64%), clarithromycin (91%), and trimethoprim-sulfamethoxazole (98%) for S. pneumoniae isolates and high rates of non-susceptibility to ampicillin (70%), clarithromycin (34%), and trimethoprim-sulfamethoxazole (63%) for H. influenzae isolates were found. The rank order of oral cephalosporin activity based on the minimum concentrations at which 90% of the isolates were inhibited (MIC90s) for S. pneumoniae was cefpodoxime > cefuroxime > cefixime > cefaclor, cephradine > cephalexin and for H. influenzae and M. catarrhalis was cefixime > cefpodoxime > cefuroxime > cefaclor > cephalexin, cephradine. Among the 75 S. pneumoniae isolates resistant to penicillin (MICs ranged 2 to 4 mg/L), 4% were intermediate to amoxicillin and > 90% were resistant to cefaclor, cefuroxime, and cefpodoxime. For S. pyogenes isolates, all were susceptible to penicillin, 21% were not susceptible to clarithromycin and 4% were not susceptible to clindamycin. Thirty four percent of H. influenzae isolates were not susceptible to clarithromycin. The MIC90 of clarithromycin against M. catarrhalis isolates was 0.5 mg/L. CONCLUSIONS: Cefpodoxime, cefixime, and cefuroxime are promising agents against these bacterial pathogens, except for penicillin-non-susceptible S. pneumoniae isolates.

Anti-Bacterial Agents↗

Quantitation of severe acute respiratory syndrome coronavirus genome by real-time polymerase chain reaction assay using minor groove binder DNA probe technology.

The ability to rapidly recognize severe acute respiratory syndrome coronavirus (SARS-CoV) as a cause of infections is critical to quickly limiting further spread of the disease. A rapid, sensitive, and specific laboratory diagnostic test is needed to confirm outbreaks of SARS-CoV infection and distinguish it from other diseases that can cause similar clinical symptoms. An improved TaqMan technology using minor groove binder (MGB) probes was used to detect and quantify SARS-CoV in suspected patients. SARS-CoV primers and probe were designed based on the open reading frame 1b sequence, which encodes coronavirus replicase protein. A linear standard curve with R2 > 0.99 was obtained, and the threshold sensitivity was 10 genome equivalents per reaction. Interassay coefficients of variation were 1.73 to 2.72%, indicating good reproducibility of this method. A total of 228 specimens from 151 suspected patients were quantified by this method, 13 specimens from 6 patients were positive with viral load range from 362 to 36,240,000 genome equivalents/mL. In conclusion, the high sensitivity and reproducibility of the real-time polymerase chain reaction SARS-CoV RNA quantitation using MGB probe allowed the screening of large numbers of clinical samples.

Base Sequence↗