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- af Bjerkén, Sara, et al.
(author)
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Reliability and validity of visual analysis of [18F]FE-PE2I PET/CT in early Parkinsonian disease
- 2023
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In: Nuclear medicine communications. - : Wolters Kluwer. - 0143-3636 .- 1473-5628. ; 44:5, s. 397-406
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Journal article (peer-reviewed)abstract
- Objective: [18F]FE-PE2I (FE-PE2I) is a new radiotracer for dopamine transporter (DAT) imaging with PET. The aim of this study was to evaluate the visual interpretation of FE-PE2I images for the diagnosis of idiopathic Parkinsonian syndrome (IPS). The inter-rater variability, sensitivity, specificity, and diagnostic accuracy for visual interpretation of striatal FE-PE2I compared to [123I]FP-CIT (FP-CIT) single-photon emission computed tomography (SPECT) was evaluated.Methods: Thirty patients with newly onset parkinsonism and 32 healthy controls with both an FE-PE2I and FP-CIT were included in the study. Four patients had normal DAT imaging, of which three did not fulfil the IPS criteria at the clinical reassessment after 2 years. Six raters evaluated the DAT images blinded to the clinical diagnosis, interpreting the image as being ‘normal’ or ‘pathological’, and assessed the degree of DAT-reduction in the caudate and putamen. The inter-rater agreement was assessed with intra-class correlation and Cronbach’s α. For calculation of sensitivity and specificity, DAT images were defined as correctly classified if categorized as normal or pathological by ≥4/6 raters.Results: The overall agreement in visual evaluation of the FE-PE2I- and FP-CIT images was high for the IPS patients (α = 0.960 and 0.898, respectively), but lower in healthy controls (FE-PE2I: α = 0.693, FP-CIT: α = 0.657). Visual interpretation gave high sensitivity (both 0.96) but lower specificity (FE-PE2I: 0.86, FP-CIT: 0.63) with an accuracy of 90% for FE-PE2I and 77% for FP-CIT.Conclusion: Visual evaluation of FE-PE2I PET imaging demonstrates high reliability and diagnostic accuracy for IPS.
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| 2. |
- Alsterlund, Rolf, et al.
(author)
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Long-term carriage of extended-spectrum beta-lactamase-producing Escherichia Coli
- 2012
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In: Scandinavian Journal of Infectious Diseases. - : Taylor and Francis Ltd.. - 0036-5548 .- 2374-4243 .- 1651-1980. ; 44:1, s. 51-54
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Journal article (peer-reviewed)abstract
- In 2009 we described an outbreak caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli in southern Sweden that occurred during 2005–2006. An important finding from the investigation was the long carriage times of the ESBL-producing E. coli in several of the patients, which in some cases exceeded 30 months. Here we report findings from the continued follow-up of bacterial carriage. In September 2010, 5 of the 42 patients still carried the bacteria after a median of 58 months (range 41–59 months), 18 had had repeatedly negative cultures after shedding bacteria for a median of 7.5 months (range 0–39 months), 16 had died while still shedding the bacteria for a median of 9 months (range 0–38 months), and 3 had been lost to follow-up.
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| 4. |
- Axelsson, Carolina, et al.
(author)
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Optimization of several parameters in order to reduce time in antibiotic susceptibility testing in a clinical laboratory
- 2017
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Conference paper (other academic/artistic)abstract
- Background - When sepsis or bacteraemia is suspected, patient blood samples are cultivated in blood culture bottles and then further incubated for identification of the organism and antimicrobial susceptibility testing. These methods are slow, identifying causative pathogens in a couple of hours, and antibiotic susceptibility results within 18-36 hours. Here we present optimization of several parameters in order to evaluate if the MBT ASTRA™ method can be a rapid tool, used for routine antibiotics susceptibility testing, in a clinical laboratory. Methods – MALDI-TOF MS measurements were performed with a Microflex LT/SH bench-top mass spectrometer (Bruker) with standard settings. The resulting spectra were uploaded in the MBT-ASTRA™ software, which normalizes the peaks and determines the AUC and RG values for each setup. Results - The bacterial preparation steps generated a new protocol, which reduced time with 30-60 minutes. The antibiotics susceptibility test was optimized for 90 minutes incubation time.200 µl McFarland 0.5 bacterial suspension in broth were incubated in broth at 37°C, with and without 32 µg/ml Cefotaxime, 16 µg/ml Meropenem and 4 µg/ml Ciprofloxacin. The suspensions were transferred to 0.45 µm pore size filter membraned 96 well plate. They were centrifuged; washed; fixated and eluted; put on a MALDI-target, and covered by matrix solution. All could be automated with robot, which reduced time with 60 minutes. Conclusion – Rapid susceptibility testing becomes more requested with the increase of resistance bacteria causing infections. Our study can be a valuable tool for clinical laboratories striving for reduction in time handling of antibiotic susceptibility testing.
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| 5. |
- Axelsson, Carolina, et al.
(author)
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Rapid detection of antibiotic resistance in positive blood cultures by MALDI-TOF MS and an automated and optimized MBT-ASTRA protocol for Escherichia coli and Klebsiella pneumoniae
- 2020
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In: Infectious Diseases. - : Informa UK Limited. - 2374-4235 .- 2374-4243. ; 52:1, s. 45-53
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Journal article (peer-reviewed)abstract
- Introduction: For fast and effective antibiotic therapy of serious infections like sepsis, it is crucial with rapid information about antibiotic susceptibility, especially in a time when the number of infections caused by multi resistant bacteria has escalated in the world. Methods: Here, we have used a semi-quantitative MALDI-TOF-MS based method for antibiotic resistance detection, MBT-ASTRA™, which is based on the comparison of growth rate of the bacteria cultivated with and without antibiotics. We demonstrate a new protocol where several parameters have been optimized and automated leading to reduced hands-on time and improved capacity to simultaneously analyse multiple clinical samples and antibiotics. Results: Ninety minutes of incubation at 37 °C with agitation was sufficient to differentiate the susceptible and resistant strains of E. coli and K. pneumoniae, for the antibiotics cefotaxime, meropenem and ciprofloxacin. In total, 841 positive blood culture analyses of 14 reference strains were performed. The overall sensitivity was 99%, specificity 99% and the accuracy 97%. The assay gave no errors for cefotaxime (n = 263) or meropenem (n = 289) for sensitive and resistant strains, whilst ciprofloxacin (n = 289) gave six (0.7%) major errors (false resistance) and four (0.5%) very major errors (false susceptibility). The intermediate strains showed a larger variety compared to the E-test MIC values. Conclusions: The hands-on time and the analysis time to detect antibiotic resistance of clinical blood samples can be substantially reduced and the sample capacity can be increased by using automation and this improved protocol.
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