RESUMO
Ehrlichiosis is a bacterial zoonosis, spread through the bites of infected ticks, that is most commonly caused in the United States by infection with the bacterium Ehrlichia chaffeensis. We retrospectively reviewed samples from an 18-month study of ehrlichiosis in the United States and found that E. ewingii was present in 10 (9.2%) of 109 case-patients with ehrlichiosis, a higher rate of infection with this species than had previously been reported. Two patients resided in New Jersey and Indiana, where cases have not been reported. All patients with available case histories recovered. Our study suggests a higher prevalence and wider geographic distribution of E. ewingii in the United States than previous reports have indicated.
Assuntos
Ehrlichia/classificação , Ehrlichiose/diagnóstico , Ehrlichiose/epidemiologia , Adulto , Idoso , Doenças dos Animais/epidemiologia , Animais , Antibacterianos/uso terapêutico , Anticorpos Antibacterianos/imunologia , Ehrlichia/genética , Ehrlichia/imunologia , Ehrlichiose/tratamento farmacológico , Ehrlichiose/microbiologia , Ensaio de Imunoadsorção Enzimática , Humanos , Masculino , Vigilância da População , Prevalência , RNA Ribossômico 16S/genética , Estudos Retrospectivos , Resultado do Tratamento , Estados Unidos/epidemiologia , Adulto JovemRESUMO
Microscopic examination of feces is a standard laboratory method for diagnosing gastrointestinal parasite infections. In North America, the ovum and parasite (O&P) examination is typically performed using stool that is chemically fixed in polyvinyl alcohol (PVA) and formalin, after which the stool is concentrated by filtration to enhance sensitivity. Mini Parasep solvent-free (SF) tubes allow collection and concentration within a single collection vial. The goal of the study was to determine whether consolidated processing and concentration with the Parasep tubes using an alcohol-based fixative (Alcorfix) provide O&P examinations equivalent to or better than those done by processing of PVA-formalin-fixed stool using a SpinCon concentration device. Parasep tubes revealed filtration performance equivalent to that of the SpinCon concentration device using PVA-formalin-fixed stool containing protozoa. Specimens cocollected in Parasep tubes containing PVA-formalin and Alcorfix revealed comparable morphology and staining for various protozoa. Alcorfix effectively fixed live Cryptosporidium and microsporidia such that morphology and staining were conserved for modified acid-fast and modified trichrome stains. A work flow analysis revealed significant time savings for batches of 10 or 30 O&P specimens in tubes with Alcorfix compared to the amount of time that it took to analyze the same number of specimens in tubes with PVA-formalin. The direct hands-on time savings with Mini Parasep tubes were 17 min and 41 s and 32 min and 1 s for batches of 10 and 30 specimens, respectively. Parasep tubes containing Alcorfix provide significant work flow advantages to laboratories that process medium to high volumes of O&P specimens by streamlining processing and converting to a single tube. These improvements in work flow, reduction of the amount of formalin used in the laboratory, and equivalent microscopy results are attractive advancements in O&P testing for North American diagnostic parasitology laboratories.
Assuntos
Fezes/parasitologia , Enteropatias Parasitárias/diagnóstico , Parasitos/isolamento & purificação , Manejo de Espécimes/métodos , Animais , Humanos , Microscopia , América do Norte , Parasitologia/métodos , Sensibilidade e Especificidade , Fatores de Tempo , Fluxo de TrabalhoRESUMO
Neonatal Streptococcus agalactiae infections cause significant morbidity and mortality, and antenatal screening is recommended. We compared three U.S. Food and Drug Administration (FDA)-cleared nucleic acid amplification tests (NAATs) to culture using 314 vaginal/rectal swabs after 18 to 24 h (recommended period) and 4 to 8 h (shortened period) of broth enrichment. Agreement of the NAATs with each other was high (97.1% to 98.4%), but culture was less sensitive than all NAATs (67% to 73%). A shortened period of broth culture enrichment resulted in 1 false-negative result in 68 (1.5%). The NAATs performed comparably and were more sensitive than culture.
Assuntos
Técnicas Bacteriológicas/métodos , Programas de Rastreamento/métodos , Técnicas de Diagnóstico Molecular/métodos , Complicações Infecciosas na Gravidez/genética , Diagnóstico Pré-Natal/métodos , Infecções Estreptocócicas/diagnóstico , Streptococcus agalactiae/isolamento & purificação , Erros de Diagnóstico , Feminino , Humanos , Recém-Nascido , Gravidez , Reto/microbiologia , Sensibilidade e Especificidade , Infecções Estreptocócicas/microbiologia , Fatores de Tempo , Estados Unidos , Vagina/microbiologiaRESUMO
The STAT! Campy immunochromatographic assay for Campylobacter antigen was compared to culture for 500 clinical stool specimens. Antigen was detected in six culture-negative, PCR-positive specimens. C. upsaliensis, a pathogenic species that is traditionally difficult to recover in routine stool cultures, was detected in two of these culture-negative specimens. This study provides evidence that antigen testing may cross-react with at least one additional non-jejuni and -coli Campylobacter species that may be missed by routine culture for campylobacteriosis.
Assuntos
Antígenos de Bactérias/análise , Técnicas Bacteriológicas/métodos , Campylobacter/classificação , Campylobacter/isolamento & purificação , Cromatografia de Afinidade/métodos , Antígenos de Bactérias/imunologia , Campylobacter/crescimento & desenvolvimento , Campylobacter/imunologia , Infecções por Campylobacter/microbiologia , Fezes/microbiologia , HumanosAssuntos
Técnicas Bacteriológicas/métodos , Infecções por Escherichia coli/diagnóstico , Fezes/química , Imunoensaio , Toxinas Shiga/análise , Escherichia coli Shiga Toxigênica/isolamento & purificação , Fezes/microbiologia , Humanos , Técnicas Imunoenzimáticas , Reação em Cadeia da Polimerase , Kit de Reagentes para Diagnóstico , Sensibilidade e EspecificidadeRESUMO
Campylobacter upsaliensis is a zoonotic, emerging pathogen that is not readily recovered in traditional stool culture. This case represents the first report of persistent bloody diarrhea with C. upsaliensis that was confirmed by filtration culture, PCR, and sequencing.
Assuntos
Infecções por Campylobacter/diagnóstico , Infecções por Campylobacter/patologia , Campylobacter upsaliensis/isolamento & purificação , Diarreia/microbiologia , Diarreia/patologia , Idoso de 80 Anos ou mais , Antibacterianos/farmacologia , Infecções por Campylobacter/microbiologia , Campylobacter upsaliensis/classificação , Campylobacter upsaliensis/efeitos dos fármacos , DNA Bacteriano/química , DNA Bacteriano/genética , DNA Ribossômico/química , DNA Ribossômico/genética , Fezes/microbiologia , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/patologia , Humanos , Masculino , Testes de Sensibilidade Microbiana , Reação em Cadeia da Polimerase , RNA Ribossômico 16S/genética , Análise de Sequência de DNARESUMO
Displaced persons living in camps are at an increased risk of diarrheal diseases. Subclinical carriage of pathogens may contribute to the spread of disease, especially for microbes that require a low infectious dose. Multiplex real-time polymerase chain reaction was performed to detect a panel of 20 bacterial, viral, and protozoal targets, and we report a high prevalence of enteropathogen carriage, including Shigella spp. or enteroinvasive Escherichia coli in 14%, among a sample of 88 asymptomatic individuals in an internally displaced persons camp in South Sudan. Further studies are needed to determine the contribution of such carriage to the spread of disease.
Assuntos
Refugiados/estatística & dados numéricos , Adolescente , Adulto , Criança , Pré-Escolar , Disenteria Bacilar/epidemiologia , Escherichia coli/patogenicidade , Infecções por Escherichia coli/epidemiologia , Fezes/microbiologia , Feminino , Humanos , Lactente , Masculino , Prevalência , Campos de Refugiados/estatística & dados numéricos , Shigella/patogenicidade , Sudão do Sul/epidemiologiaRESUMO
BACKGROUND: First-line treatment of influenza A 2009 H1N1 relies on neuraminidase inhibitors such as oseltamivir. Resistance conferred by the H275Y neuraminidase gene mutation is concerning and likely to increase. OBJECTIVES: To characterize oseltamivir resistance in a hospital-based patient population. PATIENTS AND METHODS: All available respiratory specimens positive for influenza A by direct fluorescent antibody, RT-PCR, or culture from patients at the University of Utah 5/09-12/09 were collected. Specimens were confirmed as 2009 H1N1 by the Utah Department of Health. RT-PCR and pyrosequencing were used to test for the H275Y mutation (CDC protocol). PyroMark Q24 AQ software (Qiagen, Valencia, CA, USA) was used to allow for quantitative H275Y mutation analysis. Medical records of patients with resistant virus were reviewed. RESULTS: We tested 191 influenza A virus-positive samples from 187 unique patients. Fifty (27%) patients were hospitalized. Four patient specimens (2.1%) were found to carry the H275Y mutation. Three patients were hospitalized, representing 6% of inpatient samples tested. Three patients had undergone hematopoietic stem cell transplant in the past year. Two patients died. Their influenza viruses were confirmed to be oseltamivir-resistant at an independent reference laboratory and through the Center for Disease Control and Prevention (CDC). One patient reported no history of prior oseltamivir exposure. CONCLUSIONS: Widespread oseltamivir resistance among 2009 H1N1 remains a potential threat. Rapid techniques, such as pyrosequencing, which has the additional benefit of identifying mixed mutant populations of virus, may play a key role in identifying at-risk individuals and potentially unsuspected cases. Targeted surveillance of immunocompromised patients will be critical toward improving future influenza planning and therapy.