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Positive stool culture could predict the clinical outcomes of haploidentical hematopoietic stem cell transplantation

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Frontiers of Medicine 2019年第4期13卷 492-503页

作者： Lijuan Hu Qi Wang Xiaohui Zhang Lanping Xu Yu Wang Chenhua Yan Huan Chen Yuhong Chen Kaiyan Liu Hui Wang Xiaojun Huang Xiaodong Mo Peking University People's Hospital Peking University Institute of Hematology Beijing 100044 China Peking- Tsinghua Center for Lifs Sciences Beijing 100044 China Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation Beijing 100044 China Peking University People's Hospital Department of Clinical Laboratory Beijing 100044 China

We aimed to identify the effect of positive stool cultures (PSCs) on the clinical outcomes of patients undergoing haploidentical hematopoietic stem cell transplantation (haplo-HSCT)(n = 332). PSCs were observed in 61 patients (PSC group, 18.4%). Enterobacteriaceae in stool specimens was associated with a higher risk of bloodstream infection, and Candida in stool specimens was related to a higher risk of platelet engraftment failure. The cumulative incidence of infection-related mortality 1 year after haplo-HSCT in the PSC group was higher than that of the patients who showed persistently negative stool cultures (NSC group;19.2% vs. 8.9%, P = 0.017). The probabilities of overall survival (71.4% vs. 83.8%, P = 0.031) and disease-free survival (69.6% vs. 81.0%, P = 0.048) 1 year after haplo-HSCT for the PSC group were significantly lower than those for the NSC group, particularly for patients who had Candida in their stool specimens. In multivariate analysis, Candida in stool specimens significantly increased the risk of mortality and was associated with poorer survival. Our results showed that PSC influenced the clinical outcomes after haplo-HSCT, particularly those who had Candida in their stool specimens .

关键词： haploidentical hematopoietic stem cell transplantation stool culture Candida

stool antigen tests for the management of Helicobacter pylori infection

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World Journal of Gastroenterology 2013年第45期19卷 8188-8191页

作者： Tadashi Shimoyama Department of Gastroenterology Hirosaki University Graduate School of Medicine Hirosaki 036-8562Japan

stool antigen tests(SATs)are noninvasive diagnostic modules for Helicobacter pylori(***)*** types of SATs exist for the diagnosis of *** infection,one based on enzyme immunoassay(EIA)and another on immunochromatography(ICA).SATs do not require expensive chemical agents or specified equipment;hence,they are less expensive compared with the urea breath *** European and Japanese guidelines have shown that EIA-based SATs using monoclonal antibodies are useful for primary diagnosis as well as for the assessment of eradication ***-based tests do not require particular equipment and are therefore useful in developing *** are also useful for the diagnosis of *** infection in children and post gastric surgery *** performed via EIA can assess *** infection in a large number of subjects,almost as well as ***,SATs would be useful or detecting current infection in such a survey to identify and eradicate *** *** accuracy of SATs is lower when the stool samples are unformed or watery,because *** antigens in the stool samples are *** and the interval between stool sample collection and measurement also affect the results of *** choice of test kit depends on the sensitivity and specificity in each region and the circumstances of each patient.

关键词： Helicobacter pylori stool antigen test Diagnosis Enzyme immunoassay Immunochromatography

Accuracy of early detection of colorectal tumours by stool methylation markers:A meta-analysis

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World Journal of Gastroenterology 2014年第38期20卷 14040-14050页

作者： Hu Zhang Jian Qi Ya-Qiong Wu Ping Zhang Jun Jiang Qi-Xian Wang You-Qing Zhu Department of Gastroenterology and Clinical Centre of Intestinal and Colorectal Diseases of Hubei Province Zhongnan Hospital of Wuhan University Department of Gastroenterology Hubei Provincial Corps HospitalChinese People’s Armed Police Force Department of Dermatology Yijishan Hospital of Wannan Medical College

AIM: To evaluate the accuracy of methylation of genes in stool samples for diagnosing colorectal tumours.

关键词： Colorectal carcinoma Colorectal adenoma stool Methylation Meta-analysis

Detection of KRAS G12D in colorectal cancer stool by droplet digital PCR

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World Journal of Gastroenterology 2017年第39期23卷 7087-7097页

作者： Susana Olmedillas-López Dennis César Lévano-Linares Carmen Laura Aúz Alexandre Luz Vega-Clemente Edurne León Sánchez Alejandro Villagrasa Jaime Ruíz-Tovar Mariano García-Arranz Damián García-Olmo Foundation Health Research Institute-Fundación Jiménez Díaz University Hospital Department of Surgery School of Medicine Universidad Autónoma de Madrid Department of Surgery Rey Juan Carlos University Hospital Department of Pathology Fundación Jiménez Díaz University Hospital Department of Biomedicine and Biotechnology Universidad de Alcalá Department of Surgery Fundación Jiménez Díaz University Hospital

AIMTo assess KRAS G12D mutation detection by droplet digital PCR (ddPCR) in stool-derived DNA from colorectal cancer (CRC) *** this study, tumor tissue and stool samples were collected from 70 patients with stage I-IV CRC diagnosed by preoperative biopsy. KRAS mutational status was determined by pyrosequencing analysis of DNA obtained from formalin-fixed paraffin-embedded (FFPE) tumor tissues. The KRAS G12D mutation was then analyzed by ddPCR in FFPE tumors and stool-derived DNA from patients with this point mutation. Wild-type (WT) tumors, as determined by pyrosequencing, were included as controls; analysis of FFPE tissue and stool-derived DNA by ddPCR was performed for these patients as *** the total 70 patients included, KRAS mutations were detected by pyrosequencing in 32 (45.71%), whereas 38 (54.29%) had WT tumors. The frequency of KRAS mutations was higher in left-sided tumors (11 located in the right colon, 15 in the left, and 6 in the rectum). The predominant point mutation was KRAS G12D (14.29%, n = 10), which was more frequent in early-stage tumors (I-IIA, n = 7). In agreement with pyrosequencing results, the KRAS G12D mutation was detected by ddPCR in FFPE tumor-derived DNA, and only a residual number of mutated copies was found in WT controls. The KRAS G12D mutation was also detected in stool-derived DNA in 80% of all fecal samples from CRC patients with this point *** is a reliable and sensitive method to analyze KRAS G12D mutation in stool-derived DNA from CRC patients, especially at early stages. This non-invasive approach is potentially applicable to other relevant biomarkers for CRC management.

关键词： Droplet digital PCR KRAS stool Formalin-fixed paraffin-embedded Pyrosequencing Colorectal cancer

Multitarget stool DNA tests increases colorectal cancer screening among previously noncompliant Medicare patients

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World Journal of Gastroenterology 2017年第3期23卷 464-471页

作者： Mark Prince Lynn Lester Rupal Chiniwala Barry Berger USMD Health System ArlingtonTX 76017United States USMD Health System Fort WorthTX 76104United States USMD Health System Irving TexasTX 75039United States Exact Sciences Corporation MadisonWI 53729United States

AIM To determine the uptake of noninvasive multitarget stool DNA (mt-s DNA) in a cohort of colorectal cancer(CRC) screening non-compliant average-risk Medicare *** This cross sectional primary care office-based study examined mt-s DNA uptake in routine clinical practice among 393 colorectal cancer screening non-compliant Medicare patients ages 50-85 ordered by 77 physicians in a multispecialty group practice (USMD Physician Services, Dallas, TX) from October, 2014-September, 2015. Investigators performed a Health Insurance Portability and Accountability Act compliant retrospective review of electronic health records to identify mt-s DNA use in patients who were either > 10 years since last colonoscopy and/or > 1 year since last fecal occult blood test. Test positive patients were advised to get diagnostic colonoscopy and thereafter patients were characterized by the most clinically significant lesion documented on histopathology of biopsies or excisional tissue. Descriptive statistics were employed. Key outcome measures included mt-s DNA compliance and diagnostic colonoscopy compliance on positive *** Over 12 mo, 77 providers ordered 393 mt-sD NA studies with 347 completed (88.3% compliance). Patient mean age was 69.8 (50-85) and patients were 64% female. Mt-sD NA was negative in 85.3%(296/347) and positive in 14.7%(51/347). Follow-up colonoscopy was performed in 49 positive patients (96.1% colonoscopy compliance) with two patients lost to follow up. Index findings included: colon cancer(4/49, 8.2%), advanced adenomas (21/49, 42.9%), non-advanced adenomas(15/49, 30.6%), and negative results (9/49, 18.4%). The positive predictive value for advanced colorectal lesions was 51.0% and for any colorectal neoplasia was 81.6%. The mean age of patients with colorectal cancer was 70.3 and all CRC's were localized Stage Ⅰ(2) and Stage Ⅱ (2), three were located in the proximal colon and one was located in the distal *** Mt-s DNA provided medi

关键词： Multitarget stool DNA Advanced adenoma Screening compliance Colonoscopy Colorectal cancer screening Preventive

Comparison of direct fecal smear microscopy,culture,and polymerase chain reaction for the detection of Blastocystis *** human stool samples

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Asian Pacific Journal of Tropical Medicine 2013年第10期6卷 780-784页

作者： Herbert J Santos Windell L Rivera Institute of Biology College of ScienceUniversity of the Philippines Molecular Protozoology Laboratory Natural Sciences Research InstituteUniversity of the Philippines

Objective:To compare the sensitivity and specificity of direct fecal smear microscopy,culture,and polymerase chain reaction in the detection of Blastocystis *** human ***:Human stool samples were collected from a community in San Isidro,Rodriguez,Rizal,*** samples were subjected to direct fecal smear microscopy,culture and polymerase chain reaction to detect the presence of Blastocystis ***:Of the 110 stool samples collected,28(25%)were detected positive for the presence of Blastocystis *** two or more *** method detected the highest number of Blastocystis-positive stool samples(n=36),followed by PCR of DNA extracted from culture(n=26),PCR of DNA extracted from stool(n=10),and direct fecal smear(n=9).Compared to culture,the sensitivity of the other detection methods were 66.7%for PCR from culture and 19.4%for both PCR from stool and direct fecal *** of the methods was high,with PCR from culture and direct fecal smear having97.3%,while PCR from stool at 95.9%.Conclusions:In this study,in vitro culture is the best method for detecting Blastocystis *** human stool samples.

关键词： Blastocystis sp. Direct fecal smear Culture Polymerase chain reaction(PCR) Human stool Sensitivity Specificity

Influence of proton pump inhibitor treatment on Helicobacter pylori stool antigen test

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World Journal of Gastroenterology 2012年第1期18卷 44-48页

作者： Masaaki Kodama Kazunari Murakami Tadayoshi Okimoto Yoshihiro Fukuda Tadashi Shimoyama Masumi Okuda Chieko Kato Intetsu Kobayashi Toshio Fujioka Department of Gastroenterology Faculty of Medicine Oita University Faculty of Medicine Hasama Division Health Science Center Oita University General Medicine and Community Health Science Hyogo College of Medicine Department of Gastroenterology Hirosaki University Graduate School of Medicine Toyama City Medical Association Health Management Center Department of Microbiology Toho University

AIM: To investigate the effects of proton pump inhibitor (PPI) treatment on stool antigen test using the TestMate pylori enzyme immunoassay. METHODS: This study assessed 28 patients [16 men and 12 women; mean age (63.1 ± 5.9) years; range, 25-84 years] who underwent stool antigen test and urea breath test (UBT) before and after PPI administration. RESULTS: Using the UBT as the standard, the sensitivity, specif icity and agreement of the stool antigen test in all 28 patients were 95.2%, 71.4%, and 89.3%, respectively, before PPI administration, and 88.9%, 90.9%, and 89.3%, respectively, after PPI treatment. Mean UBT values were 23.98% ± 5.33% before and 16.19% ± 4.75% after PPI treatment and, in 15 patients treated for ≥ 4 wk, were signif icantly lower after than before 4 wk of PPI treatment (12.58% ± 4.49% vs 24.53% ± 8.53%, P = 0.048). The mean optical density (A450/630) ratios on the stool antigen test were 1.16 ± 0.20 before and 1.17 ± 0.24 after PPI treatment (P = 0.989), and were 1.02 ± 0.26 and 0.69 ± 0.28, respectively, in the group treated for > 4 wk (P = 0.099).

关键词： Helicobacter pylori stool antigen test Urea breath test Proton pump inhibitor

Analysis of microsatellite instability in stool DNA of patients with colorectal cancer using denaturing high performance liquid chromatography

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World Journal of Gastroenterology 2006年第41期12卷 6689-6692页

作者： Seok-Byung Lim Seung-Yong Jeong Il-Jin Kim Dae Yong Kim Kyung Hae Jung Hee Jin Chang Hyo Seong Choi Dae Kyung Sohn Hio Chung Kang Yong Shin Sang-Geun Jang Jae-Hyun Park Jae-Gahb Park Research Institute and Hospital National Cancer CenterGoyangKorea Cancer Research Institute and Cancer Research Center Seoul National UniversitySeoulKorea

AIM： To evaluate the usefulness of denaturing high performance liquid chromatography （DHPLC） for analyzing microsatellite instability （MSI） status in stool DNA of patients with colorectal cancer. METHODS： A total of 80 cancer tissues from patients with primary sporadic colorectal tumor （proximal cancer： 27, distal cancer： 53） and matched stool （which were employed for comparison with the tissues） were analyzed for MSI status in BAT 26. DNA samples extracted from stool were evaluated by nested polymerase chain reaction （PCR） and DHPLC for MSI analysis. RESULTS： Six cases （7.5%） of MSI were identified in BAT 26 from 80 cancer tissues. All the stool DNA samples from patients whose cancer tissue showed IVlSI also displayed MSI in BAT 26. CONCLUSION： As MSI is one of the established fecal DNA markers to screen colorectal cancer, we propose to use DHPLC for the IVlSI analysis in fecal DNA.

关键词： Colorectal cancer Denaturing high performance liquid chromatography Fecal DNA MicrosateUite instability stool

stool as Appropriate Sample for the Diagnosis of <i>Mycobacterium</i><i>tuberculosis</i>by Gene Xpert Test

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Open Journal of Respiratory Diseases 2014年第3期4卷 83-89页

作者： Seble Haile Welday Andrew Nyerere Kimang’a Beatrice Muthoni Kabera Josphine Wahogo Mburu Christina Mwachari Elizabeth Mungai Stanley Mugambi Ndwiga Joseph Kariuki Mbuthia Gunturu Revathi Department of Medical Microbiology Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya Department of Pathology Aga Khan University Hospital Nairobi Kenya Gertrude Children’s Hospital Nairobi Kenya Kiambu District Hospital Kiambu Kenya National Reference TB Laboratory Nairobi Kenya University of Maryland Program Nairobi Kenya

Background: Diagnosis of pediatric pulmonary tuberculosis (PTB) is a challenge. Symptoms are nonspecific. Young children are unable to expectorate sputum samples;the procedures for obtaining respiratory samples are invasive. Thus Mycobacterium tuberculosis cultures and smears often are not performed. stool samples were used as an alternative to respiratory samples for the diagnosis of pediatric PTB using stool Xpert MTB/RIF and its sensitivity for detecting the DNA of MTB in stool was determined. Methods: The study was a laboratory-based cross-sectional prospective design. stool specimen was collected from PTB suspected children (stool for Xpert was processed in two ways, direct and prior extraction of DNA using QIAGEN stool DNA extraction kit. Result: A total sample of 91 stool specimen was collected from patients. Of these 53 (58.2%) had sputum ZN smear microscopy. Six (11.3%) of them were confirmed smear positive for PTB. stool Gene Xpert was positive in all the six smear positive children. Four (7.5%) smear negative patients tested positive by stool Gene Xpert test. This association is significant (P = 0.000). Conclusion: This study reports that Mycobacterium tuberculosis DNA can be detected in stool using Xpert testing with a higher sensitivity. Therefore stool which can easily be obtained is an appropriate alternative sample for the diagnosis of PTB using Xpert assay for children unable to give respiratory samples. Furthermore Xpert turn round time is less than 2 hours.

关键词： Pulmonary Tuberculosis (PTB) Pediatric stool Xpert MTB/RIF Smear Microscopy Mycobacterium tuberculosis