Hernández-Neuta I, Varela A, Martin A, von Groll A, Jureen P, López B, Imperiale B, Skenders G, Ritacco V, Hoffner S, Morcillo N, Palomino JC, Del Portillo P. Rifampin-Isoniazid Oligonucleotide Typing: an Alternative Format for Rapid Detection of Multidrug-Resistant Mycobacterium tuberculosis. J Clin Microbiol. 2010 Dec; 48(12):4386-91. Epub 2010 Sep 29.
http://www.ncbi.nlm.nih.gov/pubmed/20881173
Kopsavilkums
A reverse line blot DNA hybridization format for rapid detection of multidrug-resistant tuberculosis was developed. Simultaneous detection of rifampin and isoniazid resistance in clinical isolates of Mycobacterium tuberculosis was based on the same amplification/reverse hybridization principle of the widely used spoligotyping. The test involved probing nine DNA regions that are targets of common drug resistance-associated mutations in the genes rpoB, katG, and inhA. Addition of quaternary amine tetramethyl ammonium chloride to the hybridization buffer promoted multiple hybrid formations at a single annealing temperature irrespective of the different GC contents of probes. The assay was standardized using 20 well-documented strains from the Institute of Tropical Medicine (Belgium) and evaluated blindly in a central laboratory with 100 DNA samples that were obtained from cultured clinical isolates and shipped dried from three other countries. Compared with drug susceptibility testing, both sensitivity and specificity for rifampin resistance detection were 93.0% while for isoniazid the values were 87.7% and 97.7%, respectively. Compared with sequencing and GenoType MTBDRplus methods, sensitivity and specificity reached 96.4% and 95.5% for rifampin and 92.7% and 100% for isoniazid. Altogether, 40/45 (89%) multidrug-resistant isolates were correctly identified. Advantages of this in-house development include versatility, capacity to run up to 41 samples by triplicate in a single run, and reuse of the membrane at least 10 times. These features substantially reduce cost per reaction and make the assay an attractive tool for use in reference laboratories of countries that have a high burden of multidrug-resistant tuberculosis but that cannot afford expensive commercial tests because of limited resources.
Nodieva A, Jansone I, Broka L, Pole I, Skenders G, Baumanis V. Recent nosocomial transmission and genotypes of multidrug-resistant Mycobacterium tuberculosis. Int J Tuberc Lung Dis. 2010 Apr;14(4):427-33.
http://www.ncbi.nlm.nih.gov/pubmed/20202300
Kopsavilkums
Multidrug-resistant tuberculosis (MDR-TB) is a serious health problem in Eastern European countries, including Latvia.
To investigate the proportion of tuberculosis, including MDR-TB cases, attributable to recent transmission and risk factors associated with clustering.
Retrospective nested case-control study. The data set incorporated a wide spectrum of social features, as well as genotypes of Mycobacterium tuberculosis isolates determined by insertion sequence 6110 restriction fragment length polymorphism analysis of PvuII cleaved genomic DNA and spoligotyping.
In comparison with non-clustered M. tuberculosis, the Beijing genotype (OR 12.15) and multidrug resistance (OR 5.61, P < 0.01) were associated with clustering. In comparison with clustered drug-susceptible M. tuberculosis, clustering of MDR M. tuberculosis was associated with Beijing genotype (OR 41.67), previous hospitalisation (OR 18.33) and previous TB treatment (OR 17.68, P < 0.05). Direct epidemiological links in hospitals were found for almost one third (32%) of MDR Beijing cases.
MDR cases were more likely to be found in clusters than drug-susceptible cases (74.0% vs. 33.6%). Recent nosocomial transmission of MDR-TB is an important risk factor for the spread of multiresistance, and is associated with the Beijing genotype. Special attention should be paid to infection control measures in hospitals and ambulatory treatment should be enforced.
Devaux I, Manissero D, Fernandez de la Hoz K, Kremer K, van Soolingen D; EuroTB network. Surveillance of extensively drug-resistant tuberculosis in Europe, 2003-2007. Euro Surveill. 2010 Mar 18;15(11). pii: 19518.
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19518
Kopsavilkums
This paper describes the results of second-line drug (SLD) susceptibility tests among multidrug-resistant tuberculosis (MDR TB) cases reported in 20 European countries aiming to identify extensively drug-resistant tuberculosis (XDR TB) cases. A project on molecular surveillance of MDR TB cases was conducted by EuroTB and the National Institute for Public Health and the Environment (RIVM) from 2005 to 2007. Information on drug susceptibility testing (DST) was provided to this project and case-based data on MDR TB cases were reported on a quarterly basis by 20 countries of the World Health Organization's European Region, including 15 European Union Member States. Data included SLD susceptibility test results, enabling a retrospective description of XDR TB cases notified between 2003 and 2007. In 18 countries DST was performed for two or more of the SLD included in the XDR TB definition. The proportion of MDR TB isolates tested for SLD varied widely between countries (range 20 to 100 percent). In the 18 countries, 149 (10%) XDR TB cases were reported among MDR TB cases with available DST results for SLD. Sixteen additional MDR TB cases were reported by the MDR TB surveillance system when compared with the number of routinely reported MDR TB cases to EuroTB in ten countries with representative data reported during three consecutive years (2003-2005). To counter the threat of XDR TB in Europe, a standardised approach to XDR TB surveillance and DST for SLD is needed, as well as increased laboratory capacity across European countries.
Leimane V, Dravniece G, Riekstina V, Sture I, Kammerer S, Chen MP, Skenders G, Holtz TH. Treatment outcome of multidrug/extensively drug-resistant tuberculosis in Latvia, 2000-2004. Eur Respir J. 2010 Sep;36(3):584-93. Epub 2010 Feb 25.
de Kraker ME, Wolkewitz M, Davey PG, Koller W, Berger J, Nagler J, Icket C, Kalenic S, Horvatic J, Seifert H, Kaasch A, Paniara O, Argyropoulou A, Bompola M, Smyth E, Skally M, Raglio A, Dumpis U, Melbarde Kelmere A, Borg M, Xuereb D, Ghita MC, Noble M, Kolman J, Grabljevec S, Turner D, Lansbury L, Grundmann. Burden of antimicrobial resistance in European hospitals: excess mortality and length of hospital stay associated with bloodstream infections due to Escherichia coli resistant to third-generation cephalosporins. J Antimicrob Chemother. 2010 Nov 23.
http://www.ncbi.nlm.nih.gov/pubmed/21106563
Kopsavilkums
This study determined excess mortality and length of hospital stay (LOS) attributable to bloodstream infection (BSI) caused by third-generation-cephalosporin-resistant Escherichia coli in Europe.
A prospective parallel matched cohort design was used. Cohort I consisted of patients with third-generation-cephalosporin-resistant E. coli BSI (REC) and cohort II consisted of patients with third-generation-cephalosporin-susceptible E. coli BSI (SEC). Patients in both cohorts were matched for LOS before infection with patients free of the respective BSI. Thirteen European tertiary care centres participated between July 2007 and June 2008.
Cohort I consisted of 111 REC patients and 204 controls and cohort II consisted of 1110 SEC patients and 2084 controls. REC patients had a higher mortality at 30 days (adjusted odds ratio = 4.6) and a higher hospital mortality (adjusted hazard ratio = 5.7) than their controls. LOS was increased by 8 days. For SEC patients, these figures were adjusted odds ratio = 1.9, adjusted hazard ratio = 2.0 and excess LOS = 3 days. A 2.5 times [95% confidence interval (95% CI) 0.9-6.8] increase in all-cause mortality at 30 days and a 2.9 times (95% CI 1.2-6.9) increase in mortality during entire hospital stay as well as an excess LOS of 5 days (95% CI 0.4-10.2) could be attributed to resistance to third-generation cephalosporins in E. coli BSI.
Morbidity and mortality attributable to third-generation-cephalosporin-resistant E. coli BSI is significant. If prevailing resistance trends continue, high societal and economic costs can be expected. Better management of infections caused by resistant E. coli is becoming essential.
Dumpis U, Iversen A, Balode A, Saule M, Miklasevics E, Giske CG. Outbreak of CTX-M-15-producing Klebsiella pneumoniae of sequence type 199 in a Latvian teaching hospital. APMIS. 2010 Sep 1;118(9):713-6.
http://www.ncbi.nlm.nih.gov/pubmed/20718724
Kopsavilkums
Previous studies on the epidemiology of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in Latvia are lacking. ESBL-producing Klebsiella pneumoniae (n = 32) were subjected to pulsed-field gel electrophoresis (PFGE) and selected isolates to multi-locus sequence typing (MLST). Species identification and susceptibility testing were performed using VITEK2, and sequencing of bla(CTX-M) was performed in selected isolates. PFGE revealed one major clone (n = 23), with most of the isolates derived from the ICU. The clone harboured bla(CTX-M-15), was sequence type 199 and comprised two ertapenem non-susceptible isolates. This is the first report of an ESBL outbreak in Latvia, and calls for increased epidemiological typing of ESBL-producing Enterobacteriaceae, as well as improved infection control routines.
Kakurina N., Kadisa A., Lejnieks A., Mikazane H., Kozireva S., Murovska M. The usage of exploratory factor analysis for determination of the association between human parvovirus B19 infection activity and Rheumatoid arthritis clinical activity. Raksts iesniegts Medicina (Kaunas) (iesniegts).
Bratslavska O.; Kozireva S.; Uzamemeckis D., Russev R.; Aleksandrov M,; Murovska M. The increase of cell proliferative activity in non-permissive for viral replication cell line infected by human parvovirus B19 (sagatavots iesniegšanai J Gen Virol).
Viksna L, Sondore V, Keiss J, Jeruma A, Prieditis P, Strumfa I, Rozentale B. Noninvasive alternatives of liver biopsy. - The Chapter abstract for the book „Liver Biopsy", InTech - Open Access Publisher, November 2010 (iesniegts)
Bratslavska O, Kozireva S, Uzameckis D, Russev R, Murovska M. Parvovirus B19 infection in non-permissive cells: primary synovial fluid cells and epithelial-like cells of HOS TE85 cell line. Rīga Stradiņš University Collection of Scientific Papers 2009, Rīga, RSU, 89-95 (2010).
Kakurina N., Kadiša A., Lejnieks A., Kozireva S., Mikažāne H., Murovska M. Cilvēka parvovīrusa B19 infekcija sievietēm un vīriešiem ar reimatoīdo artrītu. RSU Zinātniskie raksti 2010 „ Internā medicīna, ķirurģija, medicīnas bāzes zinātnes, Stomatoloģija, farmācija" (pieņemts publicēšanai).
Kadiša A, Bratslavska O, Kakurina N, Kozireva S, Lejnieks A, Mikažāne H, Murovska M. Parvovīrusa B19 infekcijas nozīme reimatoīdā artrīta etiopatoģenēzē un klīniskajā gaitā. RSU Zinātniskie raksti 2010 „ Internā medicīna, ķirurģija, medicīnas bāzes zinātnes, Stomatoloģija, farmācija" (pieņemts publicēšanai).
Priedītis P, Krūmiņa G, Vīksna L, Štrumfa I. Steatozes un ķermeņa masas ietekme uz hemodinamiku aknu vēnās hroniska vīrusu hepatīta C slimniekiem. RSU Zinātniskie raksti 2010 „ Internā medicīna, ķirurģija, medicīnas bāzes zinātnes, Stomatoloģija, farmācija" (pieņemts publicēšanai).
