Positive ELISpot results predict subsequent development of active tuberculosis in recent tuberculosis contacts. Although tuberculosis contacts with positive ELISpot results have an incidence rate of tuberculosis similar to that of contacts with positive tuberculin skin test results, ELISpot testing could allow more focused targeting of preventive therapy to fewer contacts.
cWe developed and validated a real-time PCR assay consisting of 7 triplexed reactions to identify 11 individual serotypes plus 10 small serogroups representing the majority of disease-causing isolates of Streptococcus pneumoniae. This assay targets the 13 serotypes included within the 13-valent conjugate vaccine and 8 additional key serotypes or serogroups. Advantages over other serotyping assays are described. The assay will be expanded to 40 serotypes/serogroups. We will provide periodic updates at our protocol website.
Purpose
Loss and gain of function (GOF) mutations in human signal transducer
and activator of transcription 1 (STAT1) lead to distinct phenotypes.
Although recurrent infections are common to both types of
STAT1 mutations, GOF mutations are distinguished by
chronic mucocutaneous candidiasis and autoimmunity. However, the clinical
spectra of STAT1 GOF mutations continue to expand. We here
describe two patients with STAT1 GOF mutations presenting
early in life with combined immunodeficiency (CID).
Methods
Clinical data and laboratory findings including immunophenotyping,
level of interferon (IFN)-γ/IL-17+ T cells,
interferon-induced STAT1 phosphorylation and JAK inhibitor assays were
evaluated. Sequencing of STAT1 gene was performed by Sanger
sequencer.
Results
Patient 1 (P1) had persistent oral candidiasis and cytomegalovirus
(CMV) infection since 2 months of age, and later developed cavitary lung
lesions due to Mycobacterium tuberculosis. Patient 2 (P2)
presented with oral candidiasis and recurrent pneumonia at 4 months of age,
and subsequently developed CMV pneumonitis. Both patients suffered
heterozygous missense mutations in STAT1, leading to
deleterious amino acid substitutions in the DNA binding domain (P1:
c.1154C>T; p.T385M; P2. c.971G>T; p.C324F). Circulating
CD4+ T cells of both patients exhibited increased
interferon-γ and decreased IL-17 expression as compared to controls.
They also exhibited increased IFN-β and -γ-induced STAT1
phosphorylation that was reversed upon treatment with the JAK kinase
inhibitor Ruxolitinib.
Conclusion
STAT1 GOF mutations may present early in life with
CID, consistent with the clinical heterogeneity of the disease. JAK kinase
inhibitors may potentially be useful in some patients as adjunct therapy
pending definitive treatment with bone marrow transplantation.
Background. The objective of this study was to assess the compliance of hand hygiene (HH) of healthcare workers (HCWs) in the neonatal and pediatric intensive care unit in a tertiary university hospital in Istanbul. Methods. An observational study was conducted on the compliance of HH for the five World Health Organization (WHO) indications. HCWs were observed during routine patient care in day shift. The authors also measured the technique of HH through hand washing or hand hygiene with alcohol-based disinfectant. Results. A total of 704 HH opportunities were identified during the observation period. Overall compliance was 37.0% (261/704). Compliance differed by role: nurses (41.4%) and doctors (31.9%) [P = 0.02, OR: 1.504, CI 95%: 1.058–2.137]. HCWs were more likely to use soap and water (63.6%) compared to waterless-alcohol-based hand hygiene (36.3%) [P < 0.05]. Conclusion. Adherence to hand hygiene practice and use of alcohol-based disinfectant was found to be very low. Effective education programs that improve adherence to hand hygiene and use of disinfectants may be helpful to increase compliance.
Introducere: Deşi leziunile la nivelul umărului sunt frecvente, cele ale claviculei mediane sunt prea puţin explorate. O clasificare aplicată este mai puţin utilizată ca management standard. Metode: O analiză retrospectivă a leziunilor claviculare medii (MCI) pe parcursul unui stagiu de tratament de 5 ani într-un Centru de Traumatologie de nivel 1. Am analizat, printre altele, leziunile concomitente, strategiile de terapie şi clasificarea conform standardelor AO. Rezultate: 19 (2,5%) din 759 de leziuni claviculare au fost mediale (11 fracturi de tip A, 6 B şi 2 C), dintre care 27,8% au fost deplasate şi drept urmare tratate chirurgical. Osteosinteza cu placă fixă a fost utilizată în fracturi instabile şi reconstrucţia ligamentelor în articulaţia sternoclaviculară (SCJ) în cazul întreruperii acestora. 84,2% dintre pacienţi au prezentat leziuni concomitente relevante. Numeroase fracturi de mediane au fost codificate greşit ca fracturi mediale, ceea ce a limitat populaţia de studiu Concluzii: MCI a rezultat din mecanisme de vătămare cu impact puternic, adesea cu dislocare semnificativă şi leziuni concomitente. În ceea ce priveşte complexitatea leziunilor mediale, tratamentul ar trebui efectuat în spitale specializate. Fracturile instabile şi leziunile ligamentelor SCJ trebuie luate în considerare pentru tratamentul chirurgical. Fracturile mediane ar trebui să se
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