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001-es BibID:	BIBFORM008925
Első szerző:	Bágyi Kinga (fogszakorvos)
Cím:	Role of pathogenic oral flora in postoperative pneumonia following brain surgery / Bágyi Kinga, Haczku Angela, Márton Ildikó, Szabó Judit, Gáspár Attila, Andrási Melinda, Varga Imre, Tóth Judit, Klekner Álmos
Dátum:	2009
Megjegyzések:	Post-operative pulmonary infection often appears to result from aspiration of pathogens colonizing the oral cavity. It was hypothesized that impaired periodontal status and pathogenic oral bacteria significantly contribute to development of aspiration pneumonia following neurosurgical operations. Further, the prophylactic effects of a single dose preoperative cefazolin on the oral bacteria were investigated. Methods: A matched cohort of 18 patients without postoperative lung complications was compared to 5 patients who developed pneumonia within 48 hours after brain surgery. Patients waiting for elective operation of a single brain tumor underwent dental examination and saliva collection before surgery. Bacteria from saliva cultures were isolated and periodontal disease was scored according to type and severity. Patients received 15 mg/kg cefazolin intravenously at the beginning of surgery. Serum, saliva and bronchial secretion were collected promptly after the operation. The minimal inhibitory concentrations of cefazolin regarding the isolated bacteria were determined. The actual antibiotic concentrations in serum, saliva and bronchial secretion were measured by capillary electrophoresis upon completion of surgery. Bacteria were isolated again from the sputum of postoperative pneumonia patients. Results: The number and severity of coexisting periodontal diseases were significantly greater in patients with postoperative pneumonia in comparison to the control group (p = 0.031 and p = 0.002, respectively). The relative risk of developing postoperative pneumonia in high periodontal score patients was 3.5 greater than in patients who had low periodontal score (p < 0.0001). Cefazolin concentration in saliva and bronchial secretion remained below detectable levels in every patient. Conclusion: Presence of multiple periodontal diseases and pathogenic bacteria in the saliva are important predisposing factors of postoperative aspiration pneumonia in patients after brain surgery. The low penetration rate of cefazolin into the saliva indicates that its prophylactic administration may not be sufficient to prevent postoperative aspiration pneumonia. Our study suggests that dental examination may be warranted in order to identify patients at high risk of developing postoperative respiratory infections.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk pneumonia egyetemen (Magyarországon) készült közlemény
Megjelenés:	BMC Infectious Diseases. - 9 (2009), p. 104-113. -
További szerzők:	Haczku Angela Márton Ildikó (1954-) (fogszakorvos) Szabó Judit (1963-) (szakorvos, klinikai mikrobiológus) Gáspár Attila (1970-) (vegyész, kémikus) Andrási Melinda (1979-) (gyógyszerész) Varga Imre (1960-) (tüdőgyógyász) Tóth Judit (1958-) (onkológus szakorvos) Klekner Álmos (1970-) (idegsebész)
Internet cím:	DOI elektronikus változat
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001-es BibID:	BIBFORM074742
Első szerző:	Fidler Gábor (molekuláris biológus, genetikus)
Cím:	Validation of a simplex PCR assay enabling reliable identification of clinically relevant Candida species / Fidler Gabor, Leiter Eva, Kocsube Sandor, Biro Sandor, Paholcsek Melinda
Dátum:	2018
ISSN:	1471-2334 1471-2334
Megjegyzések:	Background: Fungal bloodstream infections (BSI) may be serious and are associated with drastic rise in mortality and health care costs. Candida spp. are the predominant etiological agent of fungal sepsis. The prompt and species-level identification of Candida may influence patient outcome and survival. The aim of this study was to develop and evaluate the CanTub-simplex PCR assay coupled with Tm calling and subsequent high resolution melting (HRM) analysis to barcode seven clinically relevant Candida species. Methods: Efficiency, coefficient of correlation and the limit of reliable detection were estimated on purified Candida EDTA-whole blood (WB) reference panels seeded with Candida albicans, Candida glabrata, Candida parapsilosis, Candida tropicalis, Candida krusei, Candida guilliermondii, Candida dubliniensis cells in a 6-log range. Discriminatory power was measured on EDTA-WB clinical panels on three different PCR platforms; LightCycler?96, LightCycler? Nano, LightCycler? 2.0. Inter- and intra assay consistencies were also calculated. Results: The limit of reliable detection proved to be 0.2?2 genomic equivalent and the method was reliable on broad concentration ranges (106 ?10 CFU) providing distinctive melting peaks and characteristic HRM curves. The diagnostic accuracy of the discrimination proved to be the best on Roche LightCycler?2.0 platform. Repeatability was tested and proved to be % C.V.: 0.14 ? 0.06 on reference- and % C.V.: 0.14 ? 0.02 on clinical-plates accounting for a very high accuracy. Reproducibility was % C.V.: 0.11 between reference- and % C.V.: 0.12between clinicalpanels which is highly acceptable. Conclusion: Our assay demonstrates recent advances on Tm calling and HRM analysis for the molecular identification of relevant Candida species. This unique, simplex PCR assay may be capable to outperform conventional phenotypic methods by reducing time and providing accurate and reliable results directly from blood (2 h) or from whole blood culture bottles (12?24 h).
Tárgyszavak:	Orvostudományok Elméleti orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban Candida High resolution melting Tm calling Species level identification Simplex PCR
Megjelenés:	BMC Infectious Diseases. - 18 : 393 (2018), p. 1-13. -
További szerzők:	Leiter Éva (1976-) (biológus) Kocsubé Sándor Biró Sándor (1949-) (molekuláris genetikus) Paholcsek Melinda (1984-) (molekuláris biológus, genetikus)
Pályázati támogatás:	GINOP-2.3.2-15-2016-00042 GINOP
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM077691
035-os BibID:	(cikkazonosító)253
Első szerző:	Kolozsvári László Róbert (háziorvos)
Cím:	Patient-related factors, antibiotic prescribing and antimicrobial resistance of the commensal Staphylococcus aureus and Streptococcus pneumoniae in a healthy population - Hungarian results of the APRES study / László Róbert Kolozsvári, József Kónya, John Paget, Francois G. Schellevis, János Sándor, Gergő József Szőllősi, Szilvia Harsányi, Zoltán Jancsó, Imre Rurik
Dátum:	2019
ISSN:	1471-2334
Megjegyzések:	Background: Antimicrobial resistance (AMR) is an increasing public health problem worldwide. We studied some patient-related factors that might influence the antimicrobial resistance. and whether the volume of antibiotic prescribing of the primary care physicians correlate with the antibiotic resistance rates of commensal nasal Staphylococcus aureus and Streptococcus pneumoniae. Methods: The socio-demographic questionnaires, the antibiotic prescription and resistance data of commensal nasal S. aureus and S. pneumoniae were collected in the 20 participating Hungarian practices of the APRES study. Multivariate logistic regression analyses were performed on the patient-related data and the antimicrobial resistance of the S. aureus and S. pneumoniae on individual, patient level. Ecological analyses were performed with Spearman's rank correlations at practice level, the analyses were performed in the whole sample (all practices) and in the cohorts of primary care practices taking care of adults (adult practices) or children (paediatric practices). Results: According to the multivariate model, age of the patients significantly influenced the antimicrobial resistance of the S. aureus (OR = 0.42, p = 0.004) and S. pneumoniae (OR = 0.89, p < 0.001). Living with children significantly increased the AMR of the S. pneumoniae (OR = 1.23, p = 0.019). In the cohorts of adult or paediatric practices, neither the age nor other variables influenced the AMR of the S. aureus and S. pneumoniae. At practice level, the prescribed volume of penicillins significantly correlated with the resistance rates of the S. aureus isolates to penicillin (rho = 0.57, p = 0.008). The volume of prescribed macrolides, lincosamides showed positive significant correlations with the S. pneumoniae resistance rates to clarithromycin and/or clindamycin in all practices (rho = 0.76, p = 0.001) and in the adult practices (rho = 0.63, p = 0.021). Conclusions: The age is an important influencing factor of antimicrobial resistance. The results also suggest that there may be an association between the antibiotic prescribing of the primary care providers and the antibiotic resistance of the commensal S. aureus and S. pneumoniae. The role of the primary care physicians in the appropriate antibiotic prescribing is very important to avoid the antibiotic resistance.
Tárgyszavak:	Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban Antimicrobial resistance Antibacterial resistance Commensal Healthy population Patient-related factors Staphylococcus aureus Streptococcus pneumoniae
Megjelenés:	BMC Infectious Diseases. - 19 (2019), p. 1-8. -
További szerzők:	Kónya József (1964-) (szakorvos, klinikai mikrobiológus) Paget, John Schellevis, Francois G. Sándor János (1966-) (orvos-epidemiológus) Szőllősi Gergő József (1991-) (népegészségügyi ellenőr, népegészségügyi szakember) Kolozsváriné Harsányi Szilvia (1983-) (okleveles egészségpolitikai szakértő) Jancsó Zoltán (1973-) (orvos, háziorvos szakorvos, foglalkozás-orvostan szakorvos) Rurik Imre (1953-) (háziorvos, foglalkozás-egészségügyi szakorvos, urológus)
Pályázati támogatás:	223083 FP7
Internet cím:	DOI Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM059207
Első szerző:	Paholcsek Melinda (molekuláris biológus, genetikus)
Cím:	Combining standard clinical methods with PCR showed improved diagnosis of invasive pulmonary aspergillosis in patients with hematological malignancies and prolonged neutropenia / Melinda Paholcsek, Gabor Fidler, Jozsef Konya, Laszlo Rejto, Gabor Mehes, Evelin Bukta, Juergen Loeffler, Sandor Biro
Dátum:	2015
ISSN:	1471-2334
Megjegyzések:	Background: We assessed the diagnostic value of standard clinical methods and combined biomarker testing(galactomannan assay and polymerase chain reaction screening) in a prospective case?control study to detectinvasive pulmonary aspergillosis in patients with hematological malignancies and prolonged neutropenia.Methods: In this observational study 162 biomarker analyses were performed on samples from 27 febrile neutropenicepisodes. Sera were successively screened for galactomannan antigen and for Aspergillus fumigatus specific nucleic acidtargets. Furthermore thoracic computed tomography scanning was performed along with bronchoscopy with lavagewhen clinically indicated. Patients were retrospectively stratified to define a case-group with "proven" or "probable"invasive pulmonary aspergillosis (25.93 %) and a control-group of patients with no evidence for of invasive pulmonaryaspergillosis (74.07 %). In 44.44 % of episodes fever ceased in response to antibiotic treatment (group II). Empiricalantifungal therapy was administered for episodes with persistent or relapsing fever (group I). 48.15 % of patientsdied during the study period. Postmortem histology was pursued in 53.85 % of fatalities.Results: Concordant negative galactomannan and computed tomography supported by a polymerase chainreaction assay were shown to have the highest discriminatory power to exclude invasive pulmonary aspergillosis.Bronchoalveolar lavage was performed in 6 cases of invasive pulmonary aspergillosis and in 15 controls. Althoughbronchoalveolar lavage proved negative in 93 % of controls it did not detect IPA in 86 % of the cases. Remarkablypost mortem histology convincingly supported the presence of Aspergillus hyphae in lung tissue from a single casewhich had consecutive positive polymerase chain reaction assay results but was misdiagnosed by both computedtomography and consistently negative galactomannan assay results. For the galactomannan enzyme-immunoassay thediagnostic odds ratio was 15.33 and for the polymerase chain reaction assay it was 28.67. According to Cohen's kappaour in-house polymerase chain reaction method showed a fair agreement with the galactomannan immunoassay.Combined analysis of the results from the Aspergillus galactomannan enzyme immunoassay together with thosegenerated by our polymerase chain reaction assay led to no misdiagnoses in the control group.Conclusion: The data from this pilot-study demonstrate that the consideration of standard clinical methods combinedwith biomarker testing improves the capacity to make early and more accurate diagnostic decisions.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban Invasive pulmonary aspergillosis Biomarkers Combination testing Acute leukemia Neutropenic fever
Megjelenés:	BMC Infectious Diseases. - 15 : 1 (2015), p. 251. -
További szerzők:	Fidler Gábor (1987-) (molekuláris biológus, genetikus) Kónya József (1964-) (szakorvos, klinikai mikrobiológus) Rejtő László (1963-) (belgyógyász, haematológus) Méhes Gábor (1966-) (patológus) Bukta Evelin Loeffler, Juergen Biró Sándor (1949-) (molekuláris genetikus)
Pályázati támogatás:	SROP-4.2.2.B-15/1/KONV-2015-0001 Egyéb TÁMOP-4.2.4.A/ 2-11/1-2012-0001 TÁMOP
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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