Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 81
Filter
1.
BMC Public Health ; 19(Suppl 3): 476, 2019 May 10.
Article in English | MEDLINE | ID: mdl-32326932

ABSTRACT

We review the current state of quality assurance in laboratories of the five Central Asia Republics (CARs), focusing on laboratory equipment, and compare quality assurance approaches with CLSI standards. The laboratories of the CARs faced exceptional challenges including highly-structured laboratory systems that retain centralized and outmoded Soviet-era approaches to quality assurance, considerably jeopardizing the validity of laboratory tests. The relative isolation of the CARs, based on geography and almost exclusive use of the Russian language, further hamper change. CARs must make high-level government decisions to widely implement quality assurance programs within their laboratory systems, within which approaches to the management of laboratory equipment will be a prominent part.


Subject(s)
Equipment and Supplies/standards , Laboratories/standards , Quality Assurance, Health Care/methods , Asia, Central , Developing Countries , Humans , Maintenance , Program Evaluation
2.
Am J Infect Control ; 44(12): 1650-1655, 2016 12 01.
Article in English | MEDLINE | ID: mdl-27378008

ABSTRACT

INTRODUCTION: There are only few reports describing the influence of central line-associated bloodstream infection (CLABSI) prevention strategies on the incidence of bacterial bloodstream infections (BBSIs). METHODS: We performed a retrospective cohort study among pediatric recipients of allogeneic hematopoietic stem cell transplantation (allo-HCT) to assess potential changes in BBSI rates during 3 time periods: pre-CLABSI prevention era (era 1, 2004-2005), CLABSI prevention implementation era (era 2, 2006-2009), and maintenance of CLABSI prevention era (era 3, 2010-2012). BBSI from day 0-365 following allo-HCT were studied. The comparison of person-years incidence rates among different periods was carried out by Poisson regression analysis. RESULTS: The mean age of patients was 10.0 years. During the study period, 126 (65%) of 190 patients had at least a single BBSI. From day 0-30, day 31-100, day 101-180, and day 181-365, 20%, 28%, 30%, and 17% of patients, respectively, experienced BBSIs. The rate of Staphylococcus epidermidis and gram-negative pathogens significantly declined from 3.16-0.93 and 6.32-2.21 per 100 person-months during era 1 and era 3, respectively (P = .001). CONCLUSIONS: Patients undergoing allo-HCT during era 3 were associated with decreased risk of BBSI (P = .012). Maintenance of CLABSI protocols by nursing staff and appropriate education of other care providers is essential to lower incidence of BBSI in this high-risk population, and further strategies to decrease infection burden should be studied.


Subject(s)
Bacteremia/epidemiology , Bacteremia/prevention & control , Catheter-Related Infections/epidemiology , Catheter-Related Infections/prevention & control , Catheterization, Central Venous/adverse effects , Infection Control/methods , Transplant Recipients , Adolescent , Bacteria/classification , Bacteria/isolation & purification , Child , Child, Preschool , Female , Hematopoietic Stem Cell Transplantation , Hospitals, Pediatric , Humans , Incidence , Infant , Male , Retrospective Studies , Risk Assessment , Transplantation, Homologous
3.
PLoS One ; 11(6): e0156924, 2016.
Article in English | MEDLINE | ID: mdl-27272665

ABSTRACT

A surveillance study in 1996 identified the USA100 clone (ST5/SCCmecII)-also known as the "New York/Japan" clone-as the most prevalent MRSA causing infections in 12 New York City hospitals. Here we update the epidemiology of MRSA in seven of the same hospitals eighteen years later in 2013/14. Most of the current MRSA isolates (78 of 121) belonged to the MRSA clone USA300 (CC8/SCCmecIV) but the USA100 clone-dominant in the 1996 survey-still remained the second most frequent MRSA (25 of the 121 isolates) causing 32% of blood stream infections. The USA300 clone was most common in skin and soft tissue infections (SSTIs) and was associated with 84.5% of SSTIs compared to 5% caused by the USA100 clone. Our data indicate that by 2013/14, the USA300 clone replaced the New York/Japan clone as the most frequent cause of MRSA infections in hospitals in Metropolitan New York. In parallel with this shift in the clonal type of MRSA, there was also a striking change in the types of MRSA infections from 1996 to 2014.


Subject(s)
Methicillin-Resistant Staphylococcus aureus/classification , Soft Tissue Infections/microbiology , Staphylococcal Infections/epidemiology , Staphylococcal Skin Infections/microbiology , Anti-Bacterial Agents/pharmacology , Bacterial Typing Techniques , Hospitals , Humans , Methicillin-Resistant Staphylococcus aureus/genetics , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Microbial Sensitivity Tests , Molecular Typing , New York/epidemiology , Staphylococcal Infections/microbiology
4.
J Clin Microbiol ; 52(11): 3853-5, 2014 Nov.
Article in English | MEDLINE | ID: mdl-25122866

ABSTRACT

The high sensitivity of PCR assays for diagnosing Clostridium difficile infection (CDI) has greatly reduced the need for repeat testing after a negative result. Nevertheless, a small subset of patients do test positive within 7 days of a negative test. The aim of this study was to evaluate the clinical characteristics of these patients to determine when repeat testing may be appropriate. The results of all Xpert C. difficile PCR (Cepheid, Sunnyvale CA) tests performed in the clinical microbiology laboratory at New York-Presbyterian Hospital, Columbia University Medical Center (NYPH/CUMC) from 1 May 2011 through 6 September 2013, were reviewed. A retrospective case-control study was performed, comparing patients who tested positive within 7 days of a negative test result to a random selection of 50 controls who tested negative within 7 days of a negative test result. During the study period, a total of 14,875 tests were performed, of which 1,066 were repeat tests (7.2%). Eleven of these repeat tests results were positive (1.0%). The only risk factor independently associated with repeat testing positive was history of a prior CDI (odds ratio [OR], 19.6 [95% confidence interval {CI}, 4.0 to 19.5], P < 0.001). We found that patients who test positive for C. difficile by PCR within 7 days of a negative test are more likely to have a history of CDI than are patients who test negative with repeat PCR. This finding may be due to the high rate of disease relapse or the increased likelihood of empirical therapy leading to false-negative results in these patients.


Subject(s)
Clostridioides difficile/isolation & purification , Clostridium Infections/diagnosis , Clostridium Infections/pathology , Polymerase Chain Reaction/methods , Academic Medical Centers , Case-Control Studies , Clostridioides difficile/genetics , Clostridium Infections/epidemiology , Clostridium Infections/microbiology , Female , Humans , Male , Middle Aged , New York City/epidemiology , Retrospective Studies , Risk Factors
5.
Am J Infect Control ; 42(6): 626-31, 2014 Jun.
Article in English | MEDLINE | ID: mdl-24725516

ABSTRACT

BACKGROUND: Extremely drug-resistant gram-negative bacilli (XDR-GNB) increasingly cause health care-associated infections (HAIs) in intensive care units (ICUs). METHODS: A matched case-control (1:2) study was conducted from February 2007 to January 2010 in 16 ICUs. Case and control subjects had HAIs caused by GNB susceptible to ≤1 antibiotic versus ≥2 antibiotics, respectively. Logistic and Cox proportional hazards regression assessed risk factors for HAIs and predictors of mortality, respectively. RESULTS: Overall, 103 case and 195 control subjects were enrolled. An immunocompromised state (odds ratio [OR], 1.55; P = .047) and exposure to amikacin (OR, 13.81; P < .001), levofloxacin (OR, 2.05; P = .005), or trimethoprim-sulfamethoxazole (OR, 3.42; P = .009) were factors associated with XDR-GNB HAIs. Multiple factors in both case and control subjects significantly predicted increased mortality at different time intervals after HAI diagnosis. At 7 days, liver disease (hazard ratio [HR], 5.52), immunocompromised state (HR, 3.41), and bloodstream infection (HR, 2.55) predicted mortality; at 15 days, age (HR, 1.02 per year increase), liver disease (HR, 3.34), and immunocompromised state (HR, 2.03) predicted mortality; and, at 30 days, age (HR, 1.02 per 1-year increase), liver disease (HR, 3.34), immunocompromised state (HR, 2.03), and hospitalization in a medical ICU (HR, 1.85) predicted mortality. CONCLUSION: HAIs caused by XDR-GNB were associated with potentially modifiable factors. Age, liver disease, and immunocompromised state, but not XDR-GNB HAIs, were associated with mortality.


Subject(s)
Cross Infection/mortality , Drug Resistance, Multiple, Bacterial , Gram-Negative Bacterial Infections/mortality , Immunocompromised Host , Liver Diseases/mortality , Acinetobacter Infections/mortality , Adolescent , Age Factors , Aged , Amikacin/therapeutic use , Anti-Bacterial Agents , Case-Control Studies , Cross Infection/microbiology , Female , Gram-Negative Bacterial Infections/microbiology , Hospital Mortality , Humans , Intensive Care Units , Klebsiella Infections/microbiology , Klebsiella Infections/mortality , Klebsiella pneumoniae , Levofloxacin/therapeutic use , Male , Middle Aged , Pseudomonas Infections/microbiology , Pseudomonas Infections/mortality , Pseudomonas aeruginosa , Risk Factors , Time Factors
7.
Pathog Dis ; 67(2): 132-5, 2013 Mar.
Article in English | MEDLINE | ID: mdl-23620158

ABSTRACT

Bordetella holmesii is an emerging opportunistic pathogen that causes respiratory disease in healthy individuals and invasive infections among patients lacking splenic function. We used 16S rRNA gene analysis to confirm B. holmesii as the cause of bacteremia in a child with sickle cell disease. Semiconductor-based draft genome sequencing provided insight into B. holmesii phylogeny and potential virulence mechanisms and also identified a toluene-4-monoxygenase locus unique among bordetellae.


Subject(s)
Anemia, Sickle Cell/complications , Bacteremia/microbiology , Bordetella Infections/microbiology , Bordetella/classification , Bordetella/genetics , Genome, Bacterial , Genomics/methods , Opportunistic Infections/microbiology , Anemia, Sickle Cell/genetics , Bordetella/isolation & purification , Bordetella Infections/complications , Child , Female , Humans , Opportunistic Infections/complications , Oxygenases/genetics , Phylogeny , RNA, Ribosomal, 16S/genetics , Sequence Analysis, DNA
8.
Genome Announc ; 1(1)2013 Jan.
Article in English | MEDLINE | ID: mdl-23405291

ABSTRACT

Streptococcus intermedius is a human pathogen with a propensity for abscess formation. We report a high-quality draft genome sequence of S. intermedius strain BA1, an isolate from a human epidural abscess. This sequence provides insight into the biology of S. intermedius and will aid investigations of pathogenicity.

9.
J Clin Microbiol ; 51(3): 874-9, 2013 Mar.
Article in English | MEDLINE | ID: mdl-23284029

ABSTRACT

While much is known about the geographic distribution of different clonal types of methicillin-resistant Staphylococcus aureus (MRSA), few studies have assessed the molecular epidemiology of methicillin-susceptible S. aureus (MSSA), despite its continued clinical importance. In each U.S. Census region, reference laboratories collected successive MSSA isolates from patients with invasive or superficial staphylococcal infections for use in the Tigecycline Evaluation and Surveillance Trial. All isolates from the periods of 2004 to 2005 and 2009 to 2010 underwent antimicrobial susceptibility testing and characterization of their staphylococcal protein A (spa) type. Of the 708 isolates analyzed, 274 spa types were identified and divided into 15 genetic clusters. The most common clones were spa t002 (n = 63, 8.9%) and t008 (n = 56, 7.9%). While the distribution of the predominant spa types did not differ by U.S. Census region or time period, spa t008 was nearly twice as common in community skin and soft tissue infections than in nosocomial bloodstream infections (11.1% versus 5.6%, respectively; P = 0.008). Despite such differences, both community and nosocomial settings had diverse staphylococcal clonal types representing all major spa clusters. In contrast to those of MRSA, MSSA infectious isolates show wide genetic diversity without clear geographical or temporal clustering. Notably, the prevalent MSSA strains (spa t002 and spa t008) are analogous to the predominant MRSA clones, further demonstrating the importance of both lineages.


Subject(s)
Molecular Typing , Staphylococcal Infections/epidemiology , Staphylococcal Infections/microbiology , Staphylococcus aureus/classification , Staphylococcus aureus/genetics , Adolescent , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/pharmacology , Child , Child, Preschool , Cluster Analysis , Community-Acquired Infections/epidemiology , Community-Acquired Infections/microbiology , Cross Infection/epidemiology , Cross Infection/microbiology , Female , Genetic Variation , Genotype , Humans , Infant , Male , Microbial Sensitivity Tests , Middle Aged , Molecular Epidemiology , Prevalence , Staphylococcal Protein A/genetics , Staphylococcus aureus/drug effects , Staphylococcus aureus/isolation & purification , United States/epidemiology , Young Adult
11.
J Clin Microbiol ; 50(6): 1994-8, 2012 Jun.
Article in English | MEDLINE | ID: mdl-22493336

ABSTRACT

A novel rapid peptide nucleic acid fluorescence in situ hybridization (FISH) method, Staphylococcus QuickFISH, for the direct detection of Staphylococcus species from positive blood culture bottles was evaluated in a multicenter clinical study. The method utilizes a microscope slide with predeposited positive- and negative-control organisms and a self-reporting 15-min hybridization step, which eliminates the need for a wash step. Five clinical laboratories tested 722 positive blood culture bottles containing gram-positive cocci in clusters. The sensitivities for detection of Staphylococcus aureus and coagulase-negative staphylococci (CoNS) were 99.5% (217/218) and 98.8% (487/493), respectively, and the combined specificity of the assay was 89.5% (17/19). The combined positive and negative predictive values of the assay were 99.7% (696/698) and 70.8% (17/24), respectively. Studies were also performed on spiked cultures to establish the specificity and performance sensitivity of the method. Staphylococcus QuickFISH has a turnaround time (TAT) of <30 min and a hands-on time (HOT) of <5 min. The ease and speed of the method have the potential to improve the accuracy of therapeutic intervention by providing S. aureus/CoNS identification simultaneously with Gram stain results.


Subject(s)
Bacteremia/diagnosis , Bacteriological Techniques/methods , Blood/microbiology , In Situ Hybridization, Fluorescence/methods , Molecular Diagnostic Techniques/methods , Staphylococcal Infections/diagnosis , Staphylococcus/isolation & purification , Bacteremia/microbiology , Humans , Predictive Value of Tests , Sensitivity and Specificity , Staphylococcal Infections/microbiology , Staphylococcus/genetics
12.
Am J Clin Pathol ; 137(4): 627-32, 2012 Apr.
Article in English | MEDLINE | ID: mdl-22431540

ABSTRACT

Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae are endemic in New York City hospitals and have been associated with serious infections globally. A real-time polymerase chain reaction (RT-PCR) assay was developed to detect carbapenem resistance attributable to KPC from blood culture bottles positive for gram-negative bacilli. Culture confirmation of carbapenemase production included automated imipenem and meropenem susceptibility testing and ertapenem susceptibility testing by disk-diffusion. A total of 323 Enterobacteriaceae isolates were tested, of which 8.7% (n = 28) demonstrated carbapenem-resistance by automated and manual susceptibility testing methods or by RT-PCR. The sensitivity, specificity, and positive and negative predictive values of the RT-PCR assay when compared with the automated method were 92.9%, 99.3%, 92.9%, and 99.3%, respectively, and 96.4%, 99.7%, 96.4%, and 99.7%, respectively, when compared with the ertapenem disk-diffusion method. RT-PCR is a rapid and reliable means of detecting carbapenem resistance due to KPC-plasmids in Enterobacteriaceae directly from blood culture bottles.


Subject(s)
Klebsiella pneumoniae/genetics , Real-Time Polymerase Chain Reaction , Cell Culture Techniques/instrumentation , Enterobacteriaceae/genetics , Enterobacteriaceae/isolation & purification , Humans , Klebsiella pneumoniae/isolation & purification , Microbial Sensitivity Tests , New York City , Predictive Value of Tests , Sensitivity and Specificity
13.
Br J Haematol ; 156(1): 99-108, 2012 Jan.
Article in English | MEDLINE | ID: mdl-22008222

ABSTRACT

Adenovirus infection is a significant complication in paediatric AlloSCT recipients with a mortality rate for disseminated adenovirus that may exceed 80%. We sought to determine the incidence, risk factors, and associated outcomes of adenovirus infection in 123 consecutive paediatric AlloSCT recipients. Adenovirus was diagnosed by antigen detection or viral culture, and was defined by isolation of virus with presence of correlating clinical symptoms. The probability of developing adenovirus infection was 12.3% (CI(95) 6.0-18.6). There were no statistically significant differences in probability of adenovirus infection in univariate analysis of risk factors including donor source, use of ATG/Alemtuzumab, ≥ Grade II GVHD, among others (age, diagnosis, conditioning regimen). Probability of overall survival for patients that experienced adenovirus infection was 15.4% vs. 50% for those without adenovirus (P = 0.0286). In multivariate analysis, the most important risk factor for an increased risk of death was adenovirus infection [HR 3.15 (CI(95) 1.6-6.18) P = 0.0009]. In this series of paediatric AlloSCT recipients, the development of adenovirus infection was the leading multivariate predictor of treatment-related mortality. Enhanced surveillance with adenovirus PCR and identification of the risk factors associated with poor outcomes from adenovirus infection may identify patients that may benefit from pre-emptive therapeutic interventions including adenovirus-specific cellular immunotherapies.


Subject(s)
Adenoviridae Infections/etiology , Adenoviridae Infections/mortality , Hematopoietic Stem Cell Transplantation/mortality , Adolescent , Child , Child, Preschool , Female , Graft vs Host Disease/etiology , Humans , Infant , Kaplan-Meier Estimate , Male , Risk Assessment , Risk Factors , Transplantation, Homologous , Young Adult
14.
Pediatr Crit Care Med ; 13(4): 375-80, 2012 Jul.
Article in English | MEDLINE | ID: mdl-22198811

ABSTRACT

OBJECTIVE: We previously reported the epidemiology of 2009 Influenza A (H1N1) in our pediatric healthcare facility in New York City during the first wave of illness (May-July 2009). We hypothesized that compared with the first wave, the second wave would be characterized by increased severity of illness and mortality. DESIGN: : Case series conducted from May 2009 to April 2010. SETTING: Pediatric emergency departments and inpatient facilities of New York-Presbyterian Hospital. PATIENTS: All hospitalized patients ÷ 18 yrs of age with positive laboratory tests for influenza A. MEASUREMENTS AND MAIN RESULTS: We compared severity of illness during the first and second wave assessed by the number of hospitalized children, including those in the pediatric intensive care unit, bacterial superinfections, and mortality rate. Compared to the first wave, fewer children were hospitalized during the second wave (n = 115 vs. 76), but a comparable portion were admitted to the pediatric intensive care unit (30.4% vs. 19.7%; p = .10). Pediatric Risk of Mortality III scores, length of hospitalization in the pediatric intensive care unit, incidence of respiratory failure and pneumonia, and peak oxygenation indices were similar during both waves. Bacterial superinfections were comparable in the first vs. second wave (3.5% vs. 1.3%). During the first wave, no child received extracorporeal membrane oxygenation and one died, while during the second wave, one child received extracorporeal membrane oxygenation and there were no deaths. CONCLUSIONS: At our pediatric healthcare facility in New York City, fewer children were hospitalized with 2009 Influenza A (H1N1) during the second wave, but both waves had a similar spectrum of illness severity and low mortality rate.


Subject(s)
Influenza A Virus, H1N1 Subtype/isolation & purification , Influenza, Human/epidemiology , Severity of Illness Index , Adolescent , Child , Child, Preschool , Emergency Service, Hospital/statistics & numerical data , Female , Hospitalization/statistics & numerical data , Hospitals, Pediatric/statistics & numerical data , Humans , Infant , Infant, Newborn , Influenza, Human/diagnosis , Influenza, Human/mortality , Influenza, Human/virology , Male , New York City/epidemiology
15.
Diagn Microbiol Infect Dis ; 72(1): 14-9, 2012 Jan.
Article in English | MEDLINE | ID: mdl-22015323

ABSTRACT

We investigated the relatedness of multidrug-resistant Acinetobacter baumannii isolates from a burn intensive care unit (BICU) outbreak, control isolates, and isolates from a previous 2007 outbreak by 3 molecular typing methods (repetitive sequence-based polymerase chain reaction [rep-PCR], broad-range PCR and electrospray ionization mass spectrometry [PCR/ESI-MS], and pulsed-field gel electrophoresis [PFGE]). Partial rpoB gene sequencing confirmed all tested isolates as A. baumannii. Molecular typing analysis showed that 17 of 19 outbreak isolates were indistinguishable or closely related to each other. Three of 4 non-BICU outbreak control isolates and 5 of 6 isolates from the previous outbreak closely matched the BICU outbreak genotype. The outbreak strain represented a novel strain type, ST96, on PCR/ESI-MS with a new combination of alleles not previously seen in the United States. The ST96 strain also represented a novel rpoB Seqtype. Results of PCR/ESI-MS and PFGE genotyping were most closely correlated, while rep-PCR and PCR/ESI-MS systems generated rapid results.


Subject(s)
Acinetobacter Infections/epidemiology , Acinetobacter baumannii/classification , Bacterial Typing Techniques , Cross Infection/epidemiology , Disease Outbreaks , Multiplex Polymerase Chain Reaction/methods , Spectrometry, Mass, Electrospray Ionization/methods , Acinetobacter Infections/microbiology , Acinetobacter baumannii/genetics , Acinetobacter baumannii/isolation & purification , Adolescent , Adult , Aged , Aged, 80 and over , Child , Cross Infection/microbiology , DNA-Directed RNA Polymerases/genetics , Electrophoresis, Gel, Pulsed-Field , Female , Genotype , Hospitals , Humans , Male , Middle Aged , Molecular Sequence Data , Molecular Typing , Sequence Analysis, DNA , United States/epidemiology , Young Adult
16.
Br J Haematol ; 155(2): 218-34, 2011 Oct.
Article in English | MEDLINE | ID: mdl-21848882

ABSTRACT

Immune reconstitution appears to be delayed following myeloablative conditioning (MAC) and umbilical cord blood transplantation (UCBT) in paediatric recipients. Although reduced toxicity conditioning (RTC) versus MAC prior to allogeneic stem cell transplantation is associated with decreased transplant-related mortality, the effects of RTC versus MAC prior to UCBT on immune reconstitution and risk of graft-versus-host disease (GVHD) are unknown. In 88 consecutive paediatric recipients of UCBT, we assessed immune cell recovery and immunoglobulin reconstitution at days +100, 180 and 365 and analysed risk factors associated with acute and chronic GVHD. Immune cell subset recovery, immunoglobulin reconstitution, and the incidence of opportunistic infections did not differ significantly between MAC versus RTC groups. In a Cox model, MAC versus RTC recipients had significantly higher risk of grade II-IV acute GVHD [Hazard Ratio (HR) 6·1, P = 0·002] as did recipients of 4/6 vs. 5-6/6 HLA-matched UCBT (HR 3·1, P = 0·03), who also had significantly increased risk of chronic GVHD (HR 18·5, P = 0·04). In multivariate analyses, MAC versus RTC was furthermore associated with significantly increased transplant-related (Odds Ratio 26·8, P = 0·008) and overall mortality (HR = 4·1, P = 0·0001). The use of adoptive cellular immunotherapy to accelerate immune reconstitution and prevent and treat opportunistic infections and malignant relapse following UCBT warrants further investigation.


Subject(s)
Cord Blood Stem Cell Transplantation , Graft vs Host Disease/epidemiology , Leukocyte Count , Myeloablative Agonists/therapeutic use , Transplantation Conditioning/methods , Alemtuzumab , Antibiotic Prophylaxis , Antibodies, Monoclonal, Humanized/administration & dosage , Antibodies, Monoclonal, Humanized/therapeutic use , Antibodies, Neoplasm/administration & dosage , Antibodies, Neoplasm/therapeutic use , Antilymphocyte Serum , Busulfan/administration & dosage , Busulfan/therapeutic use , Child , Child, Preschool , Cord Blood Stem Cell Transplantation/methods , Cyclophosphamide/administration & dosage , Cyclophosphamide/therapeutic use , Female , Genetic Diseases, Inborn/surgery , Graft Survival , Graft vs Host Disease/etiology , Graft vs Host Disease/prevention & control , Granulocyte Colony-Stimulating Factor/therapeutic use , Granulocyte-Macrophage Colony-Stimulating Factor/therapeutic use , Humans , Male , Melphalan/administration & dosage , Melphalan/therapeutic use , Myeloablative Agonists/administration & dosage , Neoplasms/surgery , Neutrophils , Recombinant Proteins/therapeutic use , Retrospective Studies , T-Lymphocytes , Transplantation, Homologous , Vidarabine/administration & dosage , Vidarabine/analogs & derivatives , Vidarabine/therapeutic use , Whole-Body Irradiation
17.
J Clin Microbiol ; 49(6): 2259-61, 2011 Jun.
Article in English | MEDLINE | ID: mdl-21490185

ABSTRACT

A multicenter evaluation was undertaken to evaluate the performance of a new three-color peptide nucleic acid fluorescence in situ hybridization assay that identifies isolates directly from blood cultures positive for Gram-negative bacilli (GNB). The assay correctly identified 100% (186/186) of the Escherichia coli isolates, 99.1% (109/110) of the Klebsiella pneumoniae isolates, and 95.8% (46/48) of the Pseudomonas aeruginosa isolates in this study. Negative assay results were correctly obtained for 162 of 165 other GNB (specificity, 98.2%).


Subject(s)
Bacteriological Techniques/methods , Blood/microbiology , Escherichia coli/isolation & purification , In Situ Hybridization, Fluorescence/methods , Klebsiella pneumoniae/isolation & purification , Peptide Nucleic Acids , Pseudomonas aeruginosa/isolation & purification , Color , Humans , Sensitivity and Specificity
18.
J Clin Microbiol ; 49(5): 1795-8, 2011 May.
Article in English | MEDLINE | ID: mdl-21367993

ABSTRACT

We report MIC agreement and error rates between broth microdilution (BMD), Vitek 2, and Etest against 48 clinical KPC-producing Klebsiella pneumoniae isolates for polymyxin B, tigecycline, cefepime, and meropenem. Both commercial testing methods were useful for tigecycline testing; Etest provided a conservative estimate of polymyxin B susceptibility. We suggest that laboratories consider the supplemental use of reference BMD or Etest for cefepime and meropenem for susceptibility testing of KPC-producing K. pneumoniae, as Vitek 2 did not provide reliable results.


Subject(s)
Anti-Bacterial Agents/pharmacology , Klebsiella pneumoniae/drug effects , Klebsiella pneumoniae/enzymology , Minocycline/analogs & derivatives , Polymyxin B/pharmacology , beta-Lactamases/metabolism , beta-Lactams/pharmacology , Humans , Microbial Sensitivity Tests/methods , Minocycline/pharmacology , Tigecycline
19.
Cell Tissue Bank ; 12(2): 111-6, 2011 May.
Article in English | MEDLINE | ID: mdl-20058088

ABSTRACT

Cryopreservation of parathyroid tissue (PT) provides patients undergoing parathyroidectomy with an option for delayed autologous heterotopic parathyroid transplantation. A standard protocol for quality monitoring of PT has not been established. This article describes a method for detecting the presence of bacterial contamination in PT tissue intended for autologous transplantation. PT was received in the tissue bank, processed under aseptic conditions, and placed into cryopreservation medium. Sterility testing was performed at 2 time points prior to cryopreservation. From January 2005 to October 2008, 47 PT samples were cryopreserved. The following bacteria were isolated from 11 PT specimens: Staphylococcus epidermidis, Staphylococcus capitis subspecies ureolyticus, Staphylococcus lugdunensis, Bacillus pumilus, and corynebacteria (diphtheroids). 23% of PTs were contaminated at the time of collection, predominantly with indigenous bacteria. Quality monitoring using this protocol is a useful tool to identify tissues contaminated with bacteria.


Subject(s)
Bacteria/isolation & purification , Cryopreservation , Parathyroid Glands/microbiology , Tissue Banks , Actinomycetales/isolation & purification , Bacillus/isolation & purification , Humans , Quality Control , Staphylococcus/isolation & purification , Tissue Banks/standards , Transplantation, Autologous
20.
J Clin Microbiol ; 48(10): 3675-80, 2010 Oct.
Article in English | MEDLINE | ID: mdl-20686089

ABSTRACT

In 2005, the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) anovaginal colonization in pregnant women at our center (Columbia University Medical Center) was 0.5%, and MRSA-colonized women were less likely to carry group B streptococcus (GBS). In this study, our objectives were to identify changing trends in the prevalence of MRSA and methicillin-susceptible S. aureus (MSSA) anovaginal colonization in pregnant women, to assess the association between MRSA and GBS colonization, and to characterize the MRSA strains. From February to July 2009, Lim broths from GBS surveillance samples were cultured for S. aureus. MRSA strains were identified by resistance to cefoxitin and characterized by MicroScan, staphylococcal cassette chromosome mec (SCCmec) typing, pulsed-field gel electrophoresis (PFGE), spa typing, and Panton-Valentine leukocidin PCR. A total of 2,921 specimens from different patients were analyzed. The prevalences of MSSA, MRSA, and GBS colonization were 11.8%, 0.6% and 23.3%, respectively. GBS colonization was associated with S. aureus colonization (odds ratio [OR], 1.9; 95% confidence interval [95% CI], 1.5 to 2.4). The frequencies of GBS colonization were similar in MRSA-positive (34.2%) versus MRSA-negative patients (21.8%) (P = 0.4). All MRSA isolates from 2009 and 13/14 isolates from 2005 were SCCmec type IV or V, consistent with community-associated MRSA; 12/18 (2009) and 0/14 (2005) isolates were the USA300 clone. Levofloxacin resistance increased from 14.3% (2005) to 55.6% (2009) (P = 0.028). In conclusion, the prevalence of MRSA anovaginal colonization in pregnant women in New York City, NY, remained stable from 2005 to 2009, and USA300 emerged as the predominant clone with a significant increase in levofloxacin-resistant isolates.


Subject(s)
Carrier State/epidemiology , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Perineum/microbiology , Pregnancy Complications, Infectious/epidemiology , Staphylococcal Infections/epidemiology , Academic Medical Centers , Adult , Anti-Bacterial Agents/pharmacology , Bacterial Toxins/genetics , Bacterial Typing Techniques , Carrier State/microbiology , DNA Fingerprinting , Exotoxins/genetics , Female , Genotype , Humans , Leukocidins/genetics , Methicillin-Resistant Staphylococcus aureus/classification , Methicillin-Resistant Staphylococcus aureus/genetics , New York City/epidemiology , Polymerase Chain Reaction , Pregnancy , Prevalence , Staphylococcal Infections/microbiology , Streptococcal Infections/epidemiology , Streptococcal Infections/microbiology , Streptococcus agalactiae/isolation & purification , Virulence Factors/genetics
SELECTION OF CITATIONS
SEARCH DETAIL
...