Search

Background Contrast-associated acute kidney injury (CA-AKI) can develop after intravascular administration of iodinated contrast media. Neutrophil gelatinase-associated lipocalin (NGAL) is an early marker for AKI that helps to detect subclinical CA-AKI. We investigated the incidence of and risk factors for clinical and subclinical CA-AKI in patients who underwent neuroendovascular surgery.Methods We retrospectively investigated 228 patients who underwent neuroendovascular surgery in 2020. Changes in serum creatinine and urine output were used to detect clinical CA-AKI. Urine NGAL concentration was used to detect subclinical CA-AKI in 67 out of 228 patients.Results In 228 patients, serum creatinine, hemoglobin, hematocrit, total protein, and blood urea nitrogen (BUN) decreased significantly (p< 0.001) after surgery. However, serum creatinine decreased less significantly (p< 0.05) than hemoglobin, hematocrit, total protein, and BUN on postoperative Day 3. Two patients out of 228 developed clinical CA-AKI, and seven patients out of 67 with urine NGAL measurements developed subclinical CA-AKI. Multivariate regression analysis revealed that diabetes mellitus and carotid artery stenosis were significantly (p< 0.05) associated with the development of clinical and/or subclinical CA-AKI.Conclusion There was a large difference between the incidences of clinical CA-AKI (0.88%) and subclinical CA-AKI (10.4%). The difference might have primarily resulted from the different sensitivities between serum creatinine and urine NGAL and possibly from underestimation of the incidence of clinical AKI due to a postoperative decrease in serum creatinine caused by hemodilution. In addition to diabetes mellitus, carotid artery stenosis could also be a risk factor for CA-AKI.

This study evaluated the antimicrobial potency of the combination of isepamicin (ISP) for Mycobacterium abscessusspecies (MABS). 34 clinical MABS strains were isolated from clinical samples. Of them, 11 (32.4 %) were M. abscessussubsp. abscessus(Mab), 22 (64.7 %) were M. abscessussubsp. massiliense(Mma), and one (2.9 %) was M. abscessussubsp. bolletii(Mbo). We compared susceptibility to sitafloxacin (STFX)-ISP and clarithromycin (CLR)-ISP combinations with those of the antimicrobial agents alone, and synergistic effects were observed in 41.2 % and 17.6 % when treated with STFX-ISP and CLR-ISP. By hierarchical cluster analysis, the isolates divided into treatment-sensitive and treatment-resistant groups. Non-Mma or rough colony isolates were significantly likely to belong to the treatment-sensitive group (p = 0.024, p < 0.001, respectively). These results suggest that the ISP-containing combination could be a new therapeutic strategy for MABS, especially in cases of non-Mma: treatment-refractory subspecies, and rough morphotypes: high-virulence morphotypes.

16S rRNA gene‐targeted probes were designed for the identification of corynebacteria at the genus and species levels. The genus‐specific probe hybridized all clinically important members of the genus Corynebacteriumand could distinguish them from other coryneform bacteria and phylogenetically related high G + C% gram‐positive bacteria, including Actinomyces, Rhodococcus, Gordona, Nocardia, Streptomyces, Brevibacteriumand Mycobacterium.The species‐specific probes for C. jeikeiumand C. diphtheriaecould differentiate these two species from other members of this genus. The probes were used to select corynebacteria among gram‐positive clinical isolates which had been tentatively identified as corynebacteria by biochemical tests. We screened 59 strains with the genus‐specific probe; 51 strains hybridized to the genus‐specific probe, 8 did not. Of the 51 strains that hybridized to the genus‐specific probe, 1 hybridized to the C. diphtheriaespecies probe and 13 hybridized to the C. jeikeiumspecies probe. The 8 strains that did not hybridize to the genus probe were further characterized by analyzing cell wall diaminopimelic acid and partial 16S rRNA sequencing. The results indicated that these strains were distributed in the genera Arthrobacterand Brevibacterium.

ABSTRACTThe BD GeneOhm MRSA assay could identify methicillin-resistant Staphylococcus aureus(MRSA) strains at a high ratio (97.8%). Analysis of 11 assay-negative MRSA strains suggested that insertion of non-mecstaphylococcal cassette chromosome elements (SCCs) downstream of orfX, and carriage of SCCmecs with a left extremity that cannot be detected by the kit, might lead to their being given an incorrect negative status.