The colorimetric Vitek 2 YST card and the yeast susceptibility test (AST-YS01) were evaluated for their identification efficacy and their use in assessing the in vitro susceptibility of Candida spp. to fluconazole, voriconazole and amphotericin B. Ninety-one percent or 62 of 68 Candida isolates from blood specimens were correctly identified, as compared to determinations of the ITS2 fragment length. The overall essential agreements between Vitek 2 and the Sensititre YeastOne (SYO) colorimetric method were 78.4%, 84.6% and 90.8%, for fluconazole, voriconazole and amphotericin B, respectively. The overall categorical agreements between Vitek 2 and SYO for fluconazole and voriconazole were 76.9% and 96.9%, respectively. The poorest agreement between Vitek 2 and SYO was seen with C. glabrata (n = 27), particularly for fluconazole. The MIC values of 2 C. glabrata strains (3%) could not be determined with the Vitek 2 due to an insufficient growth in the control well. For other Candida species (n = 38) Vitek 2 and SYO showed acceptable agreements.
Background
There is a clear need for a better assessment of independent risk factors for in-hospital mortality, ICU admission, and bacteremia in patients presenting with suspected sepsis at the ED.
Methods
A prospective observational cohort study including 1690 patients was performed. Two multivariable logistic regression models were used to identify independent risk factors.
Results
SOFA score of ≥2 and serum lactate of ≥2mmol/L were associated with all outcomes. Other independent risk factors were individual SOFA variables and SIRS variables but varied per outcome. MAP<70 mmHg negatively impacted all outcomes.
Conclusion
These readily available measurements can help with early risk stratification and prediction of prognosis.
A straightforward approach to a novel class of ribo-type cyclohexenyl nucleosides is described. An electron-demand Diels-Alder reaction forms the key-step of the chosen synthetic pathway. Although the difference is small, conformational analysis using NMR shows that this nucleoside analogue adopts preferentially an 2H3 conformation (S-type), while the "deoxy" cyclohexenyl analogue has a preference for a C3' endo conformation (N-type). Analyses of the conformational equilibrium reveal that, in the given experimental conditions, the difference between adenosine and its cyclohexenyl congener resides in their different DeltaG values; furthermore, in adenosine, the conformational preference is of enthalpic origin, whereas in the cyclohexenyl congener, the conformational preference is of entropic origin.
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