Molecular tracking of coagulase-negative staphylococcal isolates from catheter-related infections

Three molecular typing methods (pulsed-field electrophoresis, localization of the mecA gene, and probing the vicinity of mec) have been used for the characterization of 40 catheter-related isolates of coagulase-negative staphylococci (CNS) in 14 patients admitted to the same hospital. The 40 isolates yielded 14 different SmaI banding patterns and corresponding unique localizations of mecA, each associated with a unique ClaI mecA polymorph. In 6 of the 14 patients the contaminated skin at the catheter entry site was the source of 4 local infections and 2 cases of bacteremia. A contaminated hub was the origin of 2 local infections and 4 cases of bacteremia in 6 more patients. The remaining 2 patients had positive cultures from both skin and catheter hub. In each bacteremic patient, the CNS recovered from catheter-related sites (tip, skin, and/or hub) and the CNS recovered from blood were identical, but each of these matching isolates was unique to the particular patient, indicating a low rate of cross-infection from patient to patient. Although classical methods for typing CNS (e.g., biotype and antibiotype) are readily available for most hospital laboratories, they have limitations concerning reproducibility and discriminatory power. Molecular epidemiologic techniques can provide powerful support to traditional techniques in determining the etiologic role of CNS in the disease process

Grain yield, carbon isotope discrimination and mineral content in mature kernels of barley under irrigated and rainfed conditions

The relationship between yield, carbon isotope discrimination and ash content in mature kernels was examined for a set of 13 barley (Hordeum vulgare) cultivars. Plants were grown under rainfed and well-irrigated conditions in a Mediterranean area. Water deficit caused a decrease in both grain yield and carbon isotope discrimination (Δ). The yield was positively related to Δ and negatively related to ash content, across genotypes within each treatment. However, whereas the correlation between yield and Δ was higher for the set of genotypes under well-irrigated (r=0.70, P<0.01) than under rainfed (r=0.42) conditions, the opposite occurred when yield and ash content were related, ie r=-0.38 under well-irrigated and r=-0.73, (P<0.01) under rainfed conditions. Carbon isotope discrimination and ash content together account for almost 60% of the variation in yield, in both conditions. There was no significant relationship (r=-0.15) between carbon isotope discrimination and ash content in well-irrigated plants, whereas in rainfed plants, this relationship, although significant (r=-0.54, P< 0.05), was weakly negative. The concentration of several mineral elements was measured in the same kernels. The mineral that correlated best with ash content, yield and A, was K. For yield and Δ, although the relationship with K followed the same pattern as the relationhip with ash content, the correlation coefficients were lower. Thus, mineral accumulation in mature kernels seems to be independent of transpiration efficiency. In fact, filling of grains takes place through the phloem pathway. The ash content in kernels is proposed as a complementary criterion, in addition to kernel Δ, to assess genotype differences in barley grain yield under rainfed conditions.

Acute Infection in Total Knee Arthroplasty: Diagnosis and Treatment

Infection is one of the most serious complications after total knee arthroplasty (TKA). The current incidence of prosthetic knee infection is 1-3%, depending on the series(.) For treatment and control to be more cost effective, multidisciplinary groups made up of professionals from different specialities who can work together to eradicate these kinds of infections need to be assembled. About the microbiology, Staphylococcus aureus and coagulase-negative staphylococcus were among the most frequent microorganisms involved (74%). Anamnesis and clinical examination are of primary importance in order to determine whether the problem may point to a possible acute septic complication. The first diagnosis may then be supported by increased CRP and ESR levels. The surgical treatment for a chronic prosthetic knee infection has been perfectly defined and standardized, and consists in a two-stage implant revision process. In contrast, the treatment for acute prosthetic knee infection is currently under debate. Considering the different surgical techniques that already exist, surgical debridement with conservation of the prosthesis and polythene revision appears to be an attractive option for both surgeon and patient, as it is less aggressive than the two-stage revision process and has lower initial costs. The different results obtained from this technique, along with prognosis factors and conclusions to keep in mind when it is indicated for an acute prosthetic infection, whether post-operative or haematogenous, will be analysed by the authors.