•IVDA and HIV patients with IE emerged during the era of economic crisis.•S. aureus and MRSA predominated in the youth and Enterococci in the elderly.•Compared to previous cohort, rheumatic fever ...decreases and renal disease increases.•Both cardiac surgery and compliance with antimicrobial treatment promoted survival.
The clinical profile, management and outcome of infective endocarditis (IE) may be influenced by socioeconomic issues.
A nationwide prospective study evaluated IE during the era of deep economic crisis in Greece. Epidemiological data and factors associated with 60-day mortality were analyzed through descriptive statistics, logistic and Cox-regression models.
Among 224 patients (male 72.3%, mean age 62.4 years), Staphylococcus aureus (n = 62; methicillin-resistant S. aureus (MRSA) 33.8%) predominated in the young without impact on mortality (p = 0.593), whilst Enterococci (n = 36) predominated in the elderly. Complications of IE were associated with mortality: heart failure OR 2.415 (95% CI: 1.159–5.029), p = 0.019, stroke OR 3.206 (95% CI: 1.190–8.632), p = 0.018 and acute kidney injury OR 2.283 (95% CI: 1.085–4.805), p = 0.029. A 60-day survival benefit was solely related to cardiac surgery for IE during hospitalization HR 0.386 (95% CI: 0.165–0.903), p = 0.028 and compliance with antimicrobial treatment guidelines HR 0.487 (95% CI: 0.259–0.916), p = 0.026. Compared with a previous country cohort study, history of rheumatic fever and native valve predisposition had declined, whilst underlying renal disease and right-sided IE had increased (p < 0.0001); HIV infection had emerged (p = 0.002). No difference in rates of surgery and outcome was assessed.
A country-wide survey of IE highlighted emergence of HIV, right-sided IE and predominance of MRSA in the youth during a severe socioeconomic crisis. Compliance with treatment guidelines promoted survival.
Neutrophil gelatinase-associated lipocalin (NGAL) is a promising biomarker for acute kidney injury. NGAL can be measured in both blood and urine. Apart from kidney injury, NGAL levels in both plasma ...and urine can be influenced by various pathological situations. Accurate evaluation and comparison of results deriving from clinical studies require robust assays, appropriate specimen handling and reference intervals that will reflect its levels in a healthy population for both biological matrices.
We report the analytical validation of a latex particle-enhanced turbidimetric immunoassay (PETIA) aimed to measure NGAL in plasma and urine on an automated biochemistry analyzer (ABBOTT-Architect-8000). Assay performance characteristics were evaluated using standard protocols. Urine and plasma specimen storage requirements were determined and reference ranges for blood and urine were determined using healthy controls.
The assay is precise (total CV%<4.8%), and sensitive (limit of quantification: 8.4ng/mL for plasma and 9.0ng/mL for urine), showing no hook effect. Calibration is stable for at least 30days. The assay showed excellent linearity over the studied interval (20–4450ng/mL). The analyte is stable at 4°C for at least 5days, and at 20°C for 4h. Gender specific reference ranges for plasma (male: 38.7–157.6ng/mL, female: 24.4–142.5ng/mL) and unisex for urine (<9.0–49.41ng/mL) are proposed.
Our data indicate that NGAL can be measured with adequate precision and sensitivity on automated biochemistry analyzers and its measurement could easily be added to a standard panel to screen kidney diseases.
•A PETIA based method can be used to measure NGAL on automated analyzers.•Common and fast protocol for both urine and plasma NGAL measurements•Analytical characteristics (precision, linearity and sensitivity) are excellent.•Calibration and short-term analyte stability are adequate for routine use.•Gender specific reference ranges for plasma and unisex for urine are proposed.
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