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A Multipathogen Bile Sample-based PCR Assay Can Guide Empirical Antimicrobial Strategies in Cholestatic Liver Diseases

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Journal of Clinical and Translational Hepatology 2022年第5期10卷 788-795页

作者： Michael Jahn Mustafa KÖzçürümez sebastian dolff Hana Rohn Dominik Heider Alexander Dechêne Ali Canbay Peter M.Rath Antonios Katsounas Department of Nephrology University Hospital EssenUniversity of Duisburg-EssenEssenGermany Department of Medicine Universitätsklinikum Knappschaftskrankenhaus BochumRuhr-University BochumBochumGermany Department of Infectious Diseases University Hospital EssenUniversity of Duisburg-EssenEssenGermany Department of Mathematics and Computer Science University of MarburgMarburgGermany Department for Internal Medicine Nuremberg Hospital NorthParacelsus Private Medical University NurembergNurembergGermany Institute of Medical Microbiology University Hospital EssenUniversity of Duisburg-EssenEssenGermany

Background and objectives:Polymerase chain reaction(PCR)techniques provide rapid detection of *** pilot study evaluated the diagnostic utility and clinical impact of multiplex real-time PCR(mRT-PCR,SeptiFast)*** microbial culture(CMC)in bile samples of patients with chronic cholestatic liver diseases(cCLDs),endoscopic retrograde cholangio-pancreatography(ERCP),and peri-interventional-antimicrobial-prophylaxis(pAP).Methods:We prospectively collected bile samples from 26 patients for microbiological analysis by CMC and *** of the results of both methods was determined by Krippendorff's alpha(α)for inter-rater reliability and the Jaccard index of ***:mRT-PCR_(bile)and CMC_(bile)results were concordant for only Candida albicans(α=0.8406;Jaccard index=0.8181).mRT-PCR_(bile)detected pathogens in 8/8 cases(100%),CMC_(bile)in 7/8(87.5%),and CMCblood in 5/8(62.5%)with clinical signs of ***_(bile),CMC_(bile),and CMCblood had identical detection results in 3/8(37.5%)with clinical signs of infection(two Klebsiella *** one Enterococcus faecium).The total pathogen count was significantly higher with mRT-PCR_(bile)than with CMC_(bile)(62 vs.31;χ^(2)=30.031,p<0.001).However,pathogens detected by mRT-PCR_(bile)were more often susceptible to pAP according to the patient infection/colonization history(PI/CH)and surveillance data for antibiotic resistance in our clinic(DARC).Pathogens identified by mRT-PC_(Rbile)and resistant to pAP by PI/CH and DARC were likely to be clinically ***:mRT-PCR in conjunction with CMCs for bile analysis increased diagnostic sensitivity and may benefit infection management in patients with cholestatic *** of mRT-PCR in a bile sample-based diagnostic routine can support more rapid and targeted use of antimicrobial agents in cCLD-patients undergoing ERCP and reduce the rate/length of unnecessary administration of broad-spectrum antibiotics.

关键词： ERCP PCR Antibiotic prophylaxis Cholestasis Cholangitis

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Intrinsic T-cell regulator miR-142-3p/5p-a novel therapeutic target?

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Cellular & Molecular Immunology 2021年第2期18卷 508-509页

作者： sebastian dolff Wayel H.Abdulahad Benjamin Wilde Department of Infectious Diseases University Hospital EssenUniversity of Duisburg-EssenEssenGermany Department of Rheumatology and Clinical Immunology University Medical Centre GroningenUniversity of GroningenGroningenNetherlands Department of Nephrology University Hospital EssenUniversity of Duisburg-EssenEssenGermany

Systemic lupus erythematosus(SLE)is an autoimmune disease characterized by the presence of autoantibodies against various *** inflammation affects the skin,joints,central nervous system and,in particular,kidneys through so-called lupus nephritis(LN).1 The exact pathogenesis of systemic lupus erythematosus remains ***,a growing body of evidence suggests that B-cells,a source of autoantibodies and effector T-cells,contribute to the pathogenesis of SLE by secreting cytokines.T-cell/B-cell interaction via their costimulation is crucial for an orchestrated immune *** interaction is modulated by IL-21-producing T-follicular helper(Tfh)cells,which are located mainly in germinal *** cells are required to help B-cells secrete high-affinity IgG antibodies.

关键词： stimulation lupus pathogenesis

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