During the 13-year period from 1 November 1980 to 31 January 1993, we received and serotyped a total of 5,619 clinically significant strains of Streptococcus pneumoniae isolated in more than 75 laboratories in Belgium (4,079 [72.6%] were from blood or pleural fluid, 462 [8.2%] were from cerebrospinal fluid, 691 [12.3%] were from middle ear aspirates, and 387 [6.8%] were from various other body fluids). The isolates belonged to 64 of the 84 currently recognized serotypes. Among the 4,722 isolates tested for susceptibility since 1983, 22% were resistant to at least one antimicrobial agent. Resistance to penicillin has slowly increased since 1985 but remained stable at a level of 2%-4% between 1986 and 1993. Of the 119 isolates with reduced penicillin susceptibility, only 23 were fully resistant (MIC, > or = 2 micrograms/mL) and none of these proved to be resistant to cephalosporins. Resistance to erythromycin increased significantly from 5.2% in 1986 to 21.5% in 1993. Resistance to penicillin and erythromycin was also more frequently recognized in a smaller number of capsular types of S. pneumoniae.
BackgroundAsymptomatic nasopharyngeal carriage represents an important biological marker for monitoring pneumococcal serotype distribution and evaluating vaccine effects. Serotype determination by conventional method (Quellung reaction) is technically and financially challenging. On the contrary, PCR-based serotyping represents a simple, economic and promising alternative method.MethodWe designed a novel multiplex PCR assay for specific detection of the 30 classical colonizing S. pneumoniae serogroups/types. This multiplex assay is composed of 7 consecutive PCR reactions and was validated on a large and recent collection of Streptococcus pneumoniae isolated during a prospective study conducted in Belgium at the time of PCV7 adoption.ResultsThe multiplex PCR assay allowed the typing of more than 94% of the isolates of a collection of pneumococci isolated from Belgian preschool attendees (n = 332). Seventy-five percent of the isolates were typed after 3 subsequent PCR reactions. Results were in agreement with the Quellung identification.ConclusionOur novel multiplex assay is an accurate and reliable method which can be used in place of the conventional method for S. pneumoniae carriage studies.
the current analysis, older patients had significantly lower BMI values than young and middle-aged patients (mean BMI 24.7 kg/m 2 o65 vs 23.7 kg/m 2 ! 65) and included fewer obese patients. Thus, candesartan did not show significant differences from amlodipine with respect to a lower incidence of new-onset diabetes mellitus in elderly patients, who generally have lower RAS activity.Although the morbidity of diabetes mellitus increases with aging, the contribution of aging to new-onset diabetes mellitus remains controversial. Differences in study design and in the statistical analysis set may influence the incidence of new-onset diabetes mellitus related to aging. Elderly patients with hypertension in our series who did not have diabetes mellitus at the time of enrollment in the CASE-J trial were considered to represent a population surviving the onset of diabetes mellitus. Therefore, older patients with hypertension but without diabetes mellitus may represent individuals with less susceptibility to new-onset diabetes mellitus and may differ from younger patients with hypertension with new-onset diabetes mellitus in terms of the presence of risk factors for new-onset diabetes mellitus and in glucose metabolism function. This may also be a reason why the older subgroup of patients was less sensitive to the preventive effects of candesartan against new-onset diabetes mellitus.In conclusion, the ARB candesartan prevented new-onset diabetes mellitus significantly more effectively than the CCB amlodipine in the CASE-J trial in high-risk patients with hypertension, although there was a significant difference between ARB and CCB in the incidence of new-onset diabetes mellitus stratified according to age only for the younger subgroup (o65) and not for the older subgroup (! 65).
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