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Lo. Prevalence o. Carbapenem Resistance in Clinical Iso.ates o. Extended Spectrum Beta Lactamase (ESBL) Pro.ucing <i>Escherichia co.i</i>in No.th Central, Nigeria

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Advances in Infectio.s Diseases 2018年第3期8卷 109-120页

作者： Kenneth I. o.yedibe Emmanuel o. Sho.o.ale mark o. okolo Michael o. Iro.zindu To.ulo.e o. Afo.aranmi Francisca o. Nwao.o.ie So.o.o. o. o.ajo.i Samso. E. Isa Daniel Z. Egah Department o. Medical Micro.io.o.y University of Jos Jos Nigeria Department o. Medical Micro.io.o.y Babcock University Ilishan-Remo Nigeria Department o. Medicine University of Nigeria Nsukka Nigeria Department o. Epidemio.o.y & Co.munity Health University of Jos Jos Nigeria Divisio. o. Mo.ecular Bio.o.y Nigerian Institute of Medical Research Lagos Nigeria Department o. Medicine University of Jos Jos Nigeria

Extended Spectrum Beta Lactamase (ESBL) pro.ucing Escherichia co.i is a glo.al cause o. life threatening infectio.s. We determined the presence o. ESBL and carbapenemase pro.uctio. in clinical iso.ates o. E. co.i and their antibio.ic susceptibility. Clinical iso.ates o. co.munity and ho.pital acquired E. co.i fro. 220 patients seen at a tertiary ho.pital were evaluated. Antibio.ic susceptibility testing was by the mo.ified Kirby-Bauer pro.o.o. while ESBL pro.uctio. was determined by the Do.ble Disk Synergy Test (DDST). Carbapenem resistance was co.firmed by the Mo.ified Ho.ge Test. o. the 220 iso.ates, 122 (55.5%) were fro. females;41 (18.6%) were ESBL po.itive. Abo.t 90% o. the ESBL pro.ucing iso.ates were resistant to.nine o. the 15 antimicro.ial agents tested. Ho.ever, o.ly o.e (2.4%) o. the 41 ESBL pro.ucing iso.ates exhibited carbapenem resistance. The ESBL negative iso.ates were susceptible to.Mero.enem (100%), Cefepime (97.8%), Ceftriaxo.e (96.6%) and Cefo.axime (96.6%). All the ESBL pro.ucing iso.ates harbo.ed detectable plasmids with sizes ranging fro. 2322 to.23,130 base pairs. o.r findings sho. that altho.gh multidrug resistant ESBL pro.ucing E. co.i are prevalent in bo.h the ho.pital and the co.munity in this enviro.ment, carbapenem resistance is still lo.. We reco.mend that institutio.s develo. guidelines fo. the early pheno.ypic detectio. o. ESBLs and carbapenem resistance.

关键词： E. co.i ESBL Plasmids Carbapenem Resistance Nigeria

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Retro.rade-viewing device impro.es adeno.a detectio. rate in co.o.o.co.ies fo. surveillance and diagno.tic wo.kup

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Wo.ld Jo.rnal o. Gastro.ntero.o.y 2012年第26期18卷 3400-3408页

作者： Peter D Siersema Amit Rasto.i Anke M Leufkens Paul A Akerman Kassem Azzo.zi Richard I Ro.hstein Frank P Vleggaar Alessandro.Repici Giaco.o.Rando.Patrick I okolo o.ivier Dewit Ana Ignjato.ic Elizabeth o.strcil James East Pierre H Deprez Brian P Saunders Antho.y N Kallo. Bradley Creel Vikas Singh Anne Marie Lenno. Daniel C DeMarco Department o. Gastro.ntero.o.y and Hepato.o.y University Medical Center Utrecht3508 GA UtrechtThe Netherlands Divisio. o. Gastro.ntero.o.y and Hepato.o.y Kansas City Veterans Administration Medical CenterKansas CityMO 64128United States Department o. Gastro.ntero.o.y Bayside Endoscopy Center33 Staniford StreetProvidenceRI 02905United States Department o. Gastro.ntero.o.y Cliniques Universitaires Saint-LucUniversité Catholique de LouvainB-1200 BrusselsBelgium Department o. Gastro.ntero.o.y and Hepato.o.y Dartmouth-Hitchcock Medical CenterOne Medical Center DriveLebanonNH 03756United States Department o. Gastro.ntero.o.y Istituto Clinico Humanitas20089 RozzanoItaly Department o. Internal Medicine Division of Gastroenterology and HepatologyJohns Hopkins HospitalBaltimoreMD 21205United States Wo.fso. Unit fo. Endo.co.y St.Mark's HospitalHarrow HA1 3UJUnited Kingdom Department o. Internal Medicine Division of GastroenterologyBaylor University Medical CenterDallasTX 75246United States

AIM:To.determine which patients might benefit mo.t fro. retro.rade viewing during co.o.o.co.y thro.gh subset analysis o. rando.ized,co.tro.led trial ***:The Third Eye Retro.co.e Rando.ized Clinical Evaluatio.(TERRACE) was a rando.ized,co.tro.led,multicenter trial designed to.evaluate the efficacy o. a retro.rade-viewing auxiliary imaging device that is used during co.o.o.co.y to.pro.ide a seco.d video.image which allo.s viewing o. areas o. the pro.imal aspect o. haustral fo.ds and flexures that are difficult to.see with the co.o.o.co.e's fo.ward *** perfo.med a po.t-ho. analysis o. the TERRACE data to.determine whether certain subsets o. the patient po.ulatio. wo.ld gain mo.e benefit than o.hers fro. use o. the *** were patients scheduled fo. co.o.o.co.y fo. screening,surveillance o. diagno.tic wo.kup,and each underwent same-day tandem examinatio.s with standard co.o.o.co.y(SC) and Third Eye co.o.o.co.y(TEC),rando.ized to.SC fo.lo.ed by TEC o. vice ***:Indicatio. fo. co.o.o.co.y was screening in 176/345 subjects(51.0%),surveillance after previo.s po.ypecto.y in 87(25.2%) and diagno.tic wo.kup in 82(23.8%).In 4 subjects no.indicatio. was *** repo.ted o.erall results had sho.n a net additio.al adeno.a detectio. rate(ADR) with TEC o. 23.2% co.pared to.*** risk(RR) o. missing adeno.as with SC vs TEC as the initial pro.edure was 1.92(P = 0.029).Po.t-ho. subset analysis sho.s additio.al ADRs fo. TEC co.pared to.SC were 4.4% fo. screening,35.7% fo. surveillance,55.4% fo. diagno.tic and 40.7% fo. surveillance and diagno.tic *** RR o. missing adeno.as with SC vs TEC was 1.11(P = 0.815) fo. screening,3.15(P = 0.014) fo. surveillance,8.64(P = 0.039) fo. diagno.tic and 3.34(P = 0.003) fo. surveillance and diagno.tic *** a multivariate Po.sso. regressio. suggested gender as a po.sibly significant facto.,subset analysis sho.ed that the difference between genders was no. statistically ***

关键词： Co.o.o.co.y Co.o.ectal cancer Adeno.as Miss rates Retro.rade-viewing

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