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PL
W ramach Programu Zewnętrznej Oceny Jakości Badań Mikrobiologicznych Sprawdzian 2001 oceniono wiarygodność identyfikacji i oznaczenia wrażliwości na antybiotyki i chemioterapeutyki 4 szczepów pałeczek z rodziny Enterobacteriaceae w laboratoriach 49 stacji sanitarno-epidemiologicznych. Poniższa praca zawiera analizę wyników przeprowadzonego sprawdzianu badań ze zwróceniem uwagi na przyczyny najczęściej popełnianych błędów.
EN
The aim of this study was to evaluate reliability of identification and determination of sensitivity to antibiotics and chemotherapeutics of some Enterobacteriaceae strains in 49 sanitary-epidemiological stations. All laboratories engaged in this study received 4 strains each (S. marcescens phenotype ESBL+, K. pneumoniae phonotype ESBL+, S. Typhimurium and S. Newport) previously identified in the Department of Bacteriology of National Instituted of Hygiene. The laboratories included in the survey were asked to determine the genus (serovar) of each control strain using the lowest number of biochemical test recommended by Institute and to determine of the sensitivity of the identified strains to antibiotics in accordance with the guidelines of the NCCLS and domestic recommendations. Only in 2 participating laboratories the identification of one of studied strains (K. pneumoniae) was completely bad and in 9 laboratories the serological identification of S. Newport was incomplete or serological type was not correctly recognized. In the determination of the sensitivity of the control strains to chemotherapeutic agents abnormalities were found in the technique of antibiogram and test for ESBL performing and incorrect selection of disc for antibiograms as well as erroneous interpretation of the results.
PL
Przedmiotem badań była próba retrospektywnej analizy wiarygodności serologicznej diagnostyki mykoplazmozy w następstwie wprowadzenia w Polsce metody ELISA w miejsce klasycznych metod diagnostycznych, jak odczyn wiązania dopełniacza i odczyn immunoelektroprecypitacji. Analizą objęto wyniki badań przeprowadzonych w latach 1970-2010 u ponad 300 tysięcy osób z zakażeniami układu oddechowego.
EN
The aim of the study was evaluation of the reliability of serodiagnosis of mycoplasmosis in Poland after replaced of classical assays, as complement fixation test (CFT) and immunoelectroprecipitation test (IEPT), by the ELISA method. The data were obtained from National Public Health Institute in Warsaw (NPHI), which receives quarterly reports of serologically confirmed infection from Sanitary and Epidemiological Stations through the country. Previously, from the 1970 to 1999 the serodiagnosis in Poland was performed only by uniform CFT using the same M. pneumoniae FH antigen prepared at the Mycoplasma Laboratory of NPHI. The first data of M. pneumoniae serological investigation performed by commercial ELISA, mainly Virotech, which gradually replaced the CFT, were obtained in 2000. In the studied period 1970-2010 a total of over 300 thousand patients with respiratory tract infections (85% were children below 18 years old) were tested. During these studies five epidemics of mycoplasmosis were noted in Poland before 2000. However, after introduction of ELISA for serodiagnosis this characteristic distinct difference in epidemic and endemic occurrence of M. pneumoniae infections have not been seen. In our opinion it may be caused by changes in the epidemiological pattern of M. pneumoniae infections in Poland as well as, paradoxical, by the decrease of sensitivity and specificity of serological investigation performed by ELISA since 2000. First of all, for the economical reasons 98% of the patients were tested by ELISA only once, secondly, the mycoplasmosis in many laboratories was confirmed only on the basis of the presence of IgG antibodies. The results of our analysis showed also usefulness in the serodiagnosis of mycoplasmosis, mainly during the first 2 weeks of the disease, of IEPT, which detect only specific IgM antibodies to M. pneumoniae antigens.
EN
The development of rapid and simple typing methods is required in order to identify possible sources of human exposure to opportunistic pathogens. Klebsiella spp. belongs to a group of bacteria that are opportunistic pathogens responsible for an increasing number of multi-resistant infections in hospitals. Recently, we showed the high genetic diversity of K. oxytoca using a large collection of strains isolated from the patients of several hospitals in Poland over a 50-year period. Our results showed that the internal transcribed spacer polymerase chain reaction method (ITS-PCR) is useful for the phylogenetic delineation of genetic groups in K. oxytoca and the high discriminatory power of the PCR melting profiles (PCR MP) method can be useful for epidemiological studies of K. oxytoca. In the present study the usefulness of PCR MP was tested on two sets of strains isolated from a single unit over a short period of time. The results revealed that PCR MP has a high discriminatory power and can be useful for epidemiological studies of closely related strains of K. oxytoca isolated from a single unit over a short period of time to identify the source, reservoirs and the tract of infection spread. The advantage of PCR MP for the above application was shown by using the procedure at increasing denaturation temperature during PCR to confirm genotyping results. Considering this feature and the high discriminatory power of PCR MP, as shown in this report for determination of the genetic similarities of consecutive K. oxytoca strains, we propose that PCR MP is one of the best techniques for short-term epidemiology analysis.
PL
Określono wrażliwość na antybiotyki i chemioterapeutyki 510 szczepów pałeczek Salmonella enterica subsp. enterica reprezentujących 56 serotypów, izolowanych w latach 1998 - 2000 z próbek kału ludzi chorych i zdrowych oraz próbek żywności i ścieków. Stwierdzono, że 42,9% szczepów było opornych na 2 lub więcej antybiotyków (szczepy MDR). Oporne szczepy należały głównie do serotypów Typhimurium, Hadar i Virchow. Wykryto dwa szczepy Salmonella wytwarzające ESBL
EN
A total of 510 Salmonella enterica subsp. enterica strains representing 56 serotypes, isolated from human stool specimens during 1998-2000 in sanitary-epidemiological units in Poland were tested for their susceptibility by a standard disk diffusion method for: ampicillin, cefotaxime, chloramphenicol, tetracycline, streptomycin, gentamicin, kanamycin, nalidixic acid, ciprofloxacin, furayolidone, cotrimoxazole, sulfonamides and trimethoprim. For 201 of the investigated strains, belonging to 5 most common isolated serotypes (S. Enteritidis, S. Typhimurium, S. Hadar, S. Infantis and S. Virchow) the minimal inhibitory concentrations (MICs) for the aforementioned antibiotic, as well as for amoxicillin with clavulanian were determined. Selected strains were screened for production extended spectrum b-lactamases (ESBLs). It was observed that 42.9% of Salmonella enterica subsp. enterica strains were resistant to 2 or more antibiotics, with the highest prevalence of MDR strains among serotypes Typhimurium, Hadar and Virchow, Resistance to ampicillin, streptomycin, tetracycline, nalidixic acid, furayolidone and sulphonamides was observed most frequently. Over 93% of S. Virchow strains were resistant to furazolidone. No strains resistant to ciprofloxacin were detected according to the NCCLS guidelines, but 31.3% of isolates exhibiting reduced ciprofloxacin susceptibility (MICs ranging between 0.125 and 0.5 mg/1). Two strains S. Mbandaka and Salmonella group D (variant motility -) were resistant to cefotaxime and probably produced ESBL.
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