Objective: Increasing the emergence of Metallo-β-lactamase (MBL) producing gram-negative bacteria and their dexterous horizontal transmission demands rapid and accurate detection. This study was conducted to determin...Objective: Increasing the emergence of Metallo-β-lactamase (MBL) producing gram-negative bacteria and their dexterous horizontal transmission demands rapid and accurate detection. This study was conducted to determine a suitable method to promptly detect MBL-producing gram-negative bacteria. Methods: A total of 103 gram-negative bacteria were identified from various clinical samples at a tertiary care hospital in Dhaka city. MBL producers were detected by two phenotypic methods, the Disk Potentiation Test (DPT) and the Double Disk Synergy Test (DDST) based on β-lactam chelator combinations where EDTA/SMA has been used as an inhibitor and Imipenem, Ceftazidime as substrates. Results: 103 isolates which were identified as Escherichia coli spp, Klebsiella spp, Pseudomonas spp, Acinetobacter spp, Proteus spp, Providencia spp were found to be multidrug-resistant in antibiogram test. Isolates showed complete resistance (100%) to Imipenem, Meropenem, and Amoxiclav. The highest carbapenem-resistant etiological agents were Acinetobacter spp 40 (38.8%) followed by Pseudomonas spp 27 (26.2%), Klebsiella spp 26 (25.2%), Escherichia coli 8 (7.8%), Proteus spp 1 (1%) and Providencia spp 1 (1%). DPT method detected significantly (p = 0.000009) a higher number of MBL-producers (Imipenem with 0.5 M EDTA n = 61, 59.2% & Ceftazidime with 0.5 M EDTA n = 56, 54.4%) compared to the DDST method (Imipenem -0.5 M EDTA n = 43, 41.7%, Imipenem – SMA n = 38, 36.9% & Ceftazidime -0.5 M EDTA n = 15, 14.6%). Conclusion: Pieces of evidence suggest that DPT is a more sensitive method than DDST and could be recommended for identifying MBL-producing bacteria in Bangladeshi hospitals for the proper management of patients, to reduce time constraints and treatment costs.展开更多
目的测试基于Synergy加速器微光刀立体定向放射治疗系统(Dual Camera 2 mm Stereotactic Radiosurgery,D2SRS)的准确性和可靠性。方法对Synergy加速器机械性能进行测试,判断加速器现有状态是否满足D2SRS及相关放射治疗技术的使用条件。...目的测试基于Synergy加速器微光刀立体定向放射治疗系统(Dual Camera 2 mm Stereotactic Radiosurgery,D2SRS)的准确性和可靠性。方法对Synergy加速器机械性能进行测试,判断加速器现有状态是否满足D2SRS及相关放射治疗技术的使用条件。同时对D2SRS的多叶准直器系统、图像引导系统、治疗计划系统分别进行测试,确定其临床实施的可靠性和准确性。结果加速器性能测试各参数指标均符合相应标准,其中机架及小机头等中心旋转测试中,在150°机架时偏离基线最大(0.9 mm),在30°小机头角度时偏离基线最大(0.8 mm),且外挂多叶光栅(Multi-leaf Collimator,MLC)并未对其精度产生影响。D2SRS各参数精准度均在要求范围之内,MLC与加速器中心无偏差,位置精度验证中在(-5,-3)位置偏差最大为0.7 mm,具备了实施立体定向放射治疗技术的先决条件。结论对加速器现有状态及D2SRS各系统测试结果总体满足临床要求,在做好日常质量控制的基础上可用于患者治疗。展开更多
文摘Objective: Increasing the emergence of Metallo-β-lactamase (MBL) producing gram-negative bacteria and their dexterous horizontal transmission demands rapid and accurate detection. This study was conducted to determine a suitable method to promptly detect MBL-producing gram-negative bacteria. Methods: A total of 103 gram-negative bacteria were identified from various clinical samples at a tertiary care hospital in Dhaka city. MBL producers were detected by two phenotypic methods, the Disk Potentiation Test (DPT) and the Double Disk Synergy Test (DDST) based on β-lactam chelator combinations where EDTA/SMA has been used as an inhibitor and Imipenem, Ceftazidime as substrates. Results: 103 isolates which were identified as Escherichia coli spp, Klebsiella spp, Pseudomonas spp, Acinetobacter spp, Proteus spp, Providencia spp were found to be multidrug-resistant in antibiogram test. Isolates showed complete resistance (100%) to Imipenem, Meropenem, and Amoxiclav. The highest carbapenem-resistant etiological agents were Acinetobacter spp 40 (38.8%) followed by Pseudomonas spp 27 (26.2%), Klebsiella spp 26 (25.2%), Escherichia coli 8 (7.8%), Proteus spp 1 (1%) and Providencia spp 1 (1%). DPT method detected significantly (p = 0.000009) a higher number of MBL-producers (Imipenem with 0.5 M EDTA n = 61, 59.2% & Ceftazidime with 0.5 M EDTA n = 56, 54.4%) compared to the DDST method (Imipenem -0.5 M EDTA n = 43, 41.7%, Imipenem – SMA n = 38, 36.9% & Ceftazidime -0.5 M EDTA n = 15, 14.6%). Conclusion: Pieces of evidence suggest that DPT is a more sensitive method than DDST and could be recommended for identifying MBL-producing bacteria in Bangladeshi hospitals for the proper management of patients, to reduce time constraints and treatment costs.
文摘目的测试基于Synergy加速器微光刀立体定向放射治疗系统(Dual Camera 2 mm Stereotactic Radiosurgery,D2SRS)的准确性和可靠性。方法对Synergy加速器机械性能进行测试,判断加速器现有状态是否满足D2SRS及相关放射治疗技术的使用条件。同时对D2SRS的多叶准直器系统、图像引导系统、治疗计划系统分别进行测试,确定其临床实施的可靠性和准确性。结果加速器性能测试各参数指标均符合相应标准,其中机架及小机头等中心旋转测试中,在150°机架时偏离基线最大(0.9 mm),在30°小机头角度时偏离基线最大(0.8 mm),且外挂多叶光栅(Multi-leaf Collimator,MLC)并未对其精度产生影响。D2SRS各参数精准度均在要求范围之内,MLC与加速器中心无偏差,位置精度验证中在(-5,-3)位置偏差最大为0.7 mm,具备了实施立体定向放射治疗技术的先决条件。结论对加速器现有状态及D2SRS各系统测试结果总体满足临床要求,在做好日常质量控制的基础上可用于患者治疗。