Introduction: Measurement and monitoring of blood glucose levels in hospitalized patients with portable glucose meters (PGMs) is performed widely and is an essential part of diabetes monitoring, despite the increasing evidence of several interferences which can negatively bias the accuracy of measurements. The purpose of this study was to evaluate the eff ect of the hematocrit on the analytical performances of diff erent PGMs as compared with a reference laboratory assay. Materials and methods:The eff ect of various hematocrit values (~0.20, ~0.45 and ~0.63 L/L) were assessed in three whole blood specimens with diff erent glucose concentration (~1.1, ~13.3, and ~25 mmol/L) by using six diff erent commercial PGMs. The identical samples were also tested with the laboratory reference assay (i.e., hexokinase). The percentage diff erence from the laboratory assay (%Diff ) was calculated as follows: % Diff = average PGM value -value from laboratory assay x 100 / value from laboratory assay. Results: The %Diff of the six diff erent PGMs were rather broad, and comprised between 56.5% and -34.8% in the sample with low glucose concentration (~1.1 mmol/L), between 40% and -32% in the sample with high glucose concentration (~13.3 mmol/L), and between -50% and 15% in the sample with very high glucose concentration (~25 mmol/L), respectively. It is also noteworthy that a very high hematocrit value (up to 0.63 L/L) generated a remarkable negative bias in blood glucose (-35%) as measured with the laboratory assay, when compared with the reference sample (hematocrit 0.45 L/L). Conclusion:The results of this analytical evaluation clearly confi rm that hematocrit produces a strong and almost unpredictable bias on PGMs performances, which is mainly dependent on the diff erent type of devices. As such, the healthcare staff and the patients must be aware of this limitation, especially in the presence of extreme hematocrit levels, when plasma glucose assessment with the reference laboratory technique might be advisable.
The objective of the study presented here was to compare antimicrobial use and resistance of bacterial isolates in the haematology ward and the intensive care unit of Bolzano General Hospital. The bacterial organisms isolated most frequently from patients in the two wards (coagulase-negative staphylococci, Enterococcus spp., and Pseudomonas aeruginosa) were investigated for antimicrobial resistance. Isolates obtained from patients in the haematology ward were more often resistant to antimicrobial agents than isolates obtained from patients in the intensive care unit, and the agents against which the highest rates of resistance were found were third-and fourth-generation cephalosporins, carbapenems and monobactams, quinolones, aminoglycosides, and trimethoprim-sulfamethoxazole. These classes of antimicrobial agents were also used more frequently in the haematology ward than in the intensive care unit. Conversely, penicillinic β-lactam antibiotics, rifamycins, macrolides and lincosamides were used less frequently in the haematology ward than in the intensive care unit, and the rates of resistance against these classes of antimicrobial agents were significantly lower in the haematology ward than in the intensive care unit. The results support the hypothesis that a causal relationship exists between antimicrobial use and the development of resistance and indicate that careful monitoring of antimicrobial use in hospitals is required to identify situations in which prescription patterns are contributing to the development of resistance.
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