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RISS 인기검색어
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- 저자 : Arti Kapil (검색결과 2 건)
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Utility of 16S rRNA PCR in the Synovial Fluid for the Diagnosis of Prosthetic Joint Infection
Sujeesh Sebastian,Rajesh Malhotra,Vishnubhatla Sreenivas,Arti Kapil,Rama Chaudhry,Benu Dhawan 대한진단검사의학회 2018 Annals of Laboratory Medicine Vol.38 No.6
Conventional culture has been the mainstay for diagnosing prosthetic joint infections (PJIs), with synovial fluid and periprosthetic tissue samples being the preferred sample types [1]. However, culture-based methods often give false-negative results in patients with a high likelihood of PJI [2]. To overcome the limitations of culture methods, molecular techniques like universal 16S rRNA gene and pathogen-specific PCRs were developed for PJI diagnosis [2, 3]. Although PCR assays have shown satisfactory results in tests of periprosthetic tissue samples and sonication fluid, the diagnostic utility of PCR is less clear in tests of the synovial fluid [2-4]. Most studies that evaluated the utility of 16S rRNA PCR in the synovial fluid for diagnosing PJI have not used the Musculoskeletal Infection Society (MSIS) consensus criteria as the gold standard for PJI [2, 5]. Therefore, we evaluated the utility of 16S rRNA PCR in the synovial fluid for diagnosing PJI using MSIS criteria.
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Prabhjot Singh,Ashish Kumar,Siddharth Yadav,Lok Prakash,Brusabhanu Nayak,Rajeev Kumar,Arti Kapil,Prem Nath Dogra 대한비뇨의학회 2017 Investigative and Clinical Urology Vol.58 No.5
Purpose: To assess the prevalence of fluoroquinolone resistance among patients undergoing transrectal ultrasound (TRUS)-guided prostate biopsy and the impact of rectal swab culture-directed antibiotic prophylaxis on postbiopsy infectious complications. Materials and Methods: We prospectively analyzed all patients undergoing TRUS-guided prostate biopsy from April 2013 to February 2015. Antibiotic prophylaxis was tailored to the results of rectal swab cultures. If the organism was fluoroquinolone-sensitive, oral ciprofloxacin 500 mg with tinidazole 600 mg was prescribed. If the organism was fluoroquinolone-resistant, then a culture-directed antibiotic was prescribed. In both cases the antibiotic was continued for 3 days. All patients were followed for 14 days after biopsy to record infectious complications. Results: A total of 247 patients were included, and Escherichia coli was isolated on rectal swab cultures in 99.5% of the patients. Of these, 41.7% harbored fluoroquinolone-resistant E. coli. Piperacillin/tazobactam was the most common culture-directed antibiotic prescribed (59.3%), with amoxicillin/clavulanic being the second most common (25.5%) for the fluoroquinolone-resistant group. Only 2 patients (0.9%) developed postbiopsy fever and none had sepsis. Conclusions: Colonization of rectal flora with fluoroquinolone-resistant E. coli was seen in 40% of men undergoing prostate biopsy. Targeted prophylaxis, which uses the results of prebiopsy rectal swab culture to direct antibiotic prophylaxis, results in low rates of postbiopsy infections.
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