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Biomedical subjects

B A Hanna

Publications and source records attributed to B A Hanna.

At least 19 recordsLinked to original sources
PubMed1999

Propionibacterium as a cause of postneurosurgical infection in patients with dural allografts: report of three cases.

OBJECTIVE AND IMPORTANCE: Although Propionibacterium acnes is a common inhabitant of human skin, it is an uncommon pathogen in postoperative infections. We report three cases of postoperative wound infection/osteomyelitis caused by P. acnes. CLINICAL PRESENTATION: Three patients underwent craniotomy for a supratentorial meningioma and had a dural allograft at the time of closure. The patients presented several weeks after surgery with clinical evidence of a wound infection. INTERVENTION: All patients were diagnosed with P. acnes infection and treated for this pathogen with appropriate antibiotics. The bone flap was removed in two patients. After antibiotic therapy, all patients demonstrated no further evidence of infection. CONCLUSION: To our knowledge, this is the first published report of P. acnes infection in patients with a dural substitute. The source of infection cannot be confidently ascertained; however, two patients had strains of P. acnes from one brand of graft, which were indistinguishable by pulsed field gel electrophoresis typing.

Adult↗
PubMed1999

Multicenter evaluation of the BACTEC MGIT 960 system for recovery of mycobacteria.

We evaluated the BACTEC MGIT 960 system, which is a fully automated, noninvasive system for the growth and detection of mycobacteria with a capacity to incubate and continuously monitor 960 7-ml culture tubes. We studied 3,330 specimens, 2,210 respiratory and 1,120 nonrespiratory specimens, collected from 2,346 patients treated at six sites. Processed specimens were inoculated into the BACTEC MGIT 960 and BACTEC 460 TB systems, as well as onto Lowenstein-Jensen slants and Middlebrook 7H11/7H11 selective plates. From all culture systems, a total of 362 isolates of mycobacteria were recovered; these were recovered from 353 specimens collected from 247 patients. The greatest number of isolates of mycobacteria (289, or 80% of the 362 isolates) was recovered with the BACTEC MGIT 960, followed by the BACTEC 460 TB (271, or 75%) and solid media (250, or 69%). From all culture systems a total of 132 isolates of Mycobacterium tuberculosis complex were recovered. The greatest number of isolates of M. tuberculosis complex was recovered when liquid medium was combined with conventional solid media; the number recovered with BACTEC 460 TB plus solid media was 128 (97%), that recovered with BACTEC MGIT 960 plus solid media was 121 (92%), that recovered with BACTEC 460 TB was 119 (90%) and that recovered with all solid media combined was 105 (79%). The recovery with BACTEC MGIT 960 alone was 102 (77%). The mean times to detection (TTD) for M. tuberculosis complex were 14.4 days for BACTEC MGIT, 15.2 days for BACTEC 460 TB, and 24.1 days for solid media. The numbers of isolates of Mycobacterium avium complex (MAC) recovered were 172 (100%) for all systems, 147 (85%) for BACTEC MGIT 960, 123 (72%) for BACTEC 460 TB, and 106 (62%) for all solid media combined. The TTD for MAC in each system were 10.0 days for BACTEC MGIT 960, 10.4 days for BACTEC 460 TB, and 25.9 days for solid media. Breakthrough contamination rates (percentages of isolates) for each of the systems were 8.1% for BACTEC MGIT 960, 4.9% for BACTEC 460 TB, and 21.1% for all solid media combined.

Automation↗
PubMed1996

Testing of susceptibility of Mycobacterium tuberculosis to isoniazid and rifampin by mycobacterium growth indicator tube method.

We tested isolates of Mycobacterium tuberculosis recovered from 117 patients for their susceptibilities to isoniazid (INH) and rifampin (RIF) by the Centers for Disease Control and Prevention's disk modification of the indirect method of proportions (MOP) test and a three-tube mycobacteria growth indicator tube (MGIT; BBL) antimycobacterial susceptibility test (AST). Sixty-seven of the M. tuberculosis isolates were recovered from Lowenstein-Jensen (BBL) subcultures, and 50 of the isolates were recovered from MGIT cultures of samples from various body sites. For the MGIT AST method, 0.5 ml of test organism suspension was inoculated into an MGIT with 0.1 micrograms of INH per ml, an MGIT with 1.0 micrograms of RIF per ml, and growth control MGIT. The tubes were incubated at 37 degrees C and were examined daily. The MGIT AST results were interpreted as follows: susceptible if the tubes containing INH or RIF did not fluoresce within 2 days of the time that the positive growth control fluoresced and resistant if the tubes containing INH or RIF did fluoresce within 2 days of the time that the positive growth control fluoresced. The mean time fluorescence for the positive growth control was 5.5 days. The two methods were in agreement for 114 of the 117 isolates from patients, while for 3 isolates there were minor discordant results.

Antibiotics, Antitubercular↗
PubMed1995

Recovery of mycobacteria from blood in mycobacteria growth indicator tube and Lowenstein-Jensen slant after lysis-centrifugation.

Five hundred five blood samples for culture were processed in the Isolator lysis-centrifugation system and were then inoculated into a Mycobacteria Growth Indicator Tube (MGIT) and onto a Lowenstein-Jensen (L-J) slant. Forty-nine isolates of Mycobacterium avium complex and three isolates of Mycobacterium tuberculosis were recovered from 50 of the blood culture specimens. Forty-five isolates from 43 specimens were recovered in the MGIT, with a mean time to detection of 21 days. Forty-one isolates from 40 specimens were recovered in the L-J slants, and the mean time to detection was 36 days. Nine specimens were positive in the MGIT alone, while seven specimens were positive only in L-J medium.

AIDS-Related Opportunistic Infections↗
PubMed1994

The third epidemic--multidrug-resistant tuberculosis.

We recently observed a striking increase in multidrug-resistant tuberculosis (MDR-TB) among patients admitted to the Chest Service at Bellevue Hospital Center in New York. We reviewed the laboratory susceptibility test results of 4,681 tuberculosis (TB) cases over the past 20 years, Combined resistance to isoniazid and rifampin increased from 2.5 percent in 1971 to 16 percent in 1991 with higher rates noted for individual drugs. We reviewed the medical records of 100 patients with drug-resistant TB, finding that these individuals were predominantly less than 40 years of age, minority, male, jobless, undomiciled, with a high percentage of drug abuse and human immunodeficiency virus infection. We conclude that the epidemics of AIDS and TB are complicated by a third epidemic of MDR-TB. This third epidemic requires urgent attention to achieve more rapid diagnosis, to develop new therapeutic regimens, and to address the social and hospital environment ot care for these individuals.

Adult↗
PubMed1992

Analyses of the FlashTrack DNA probe and UTIscreen bioluminescence tests for bacteriuria.

Five hundred urine specimens were selected at random and screened for bacteriuria by a DNA probe method, FlashTrack (Gen-Probe, San Diego, Calif.), and an automated bioluminescence method, UTIscreen (Los Alamos Diagnostics, Los Alamos, N.M.), and the results were compared with those of the semiquantitative plate culture method. The performance of each test versus culturing was evaluated at colony counts of greater than or equal to 10(4), greater than or equal to 5 x 10(4), and greater than or equal to 10(5) CFU/ml. Since the interpretive breakpoint of each test was user selectable, the results were reported as receiver operator characteristic curves. Optimum interpretive breakpoints were determined for each test at each colony count by calculating a performance index that emphasized sensitivity over specificity in a 70:30 ratio. Although both tests had less-than-optimal sensitivities and specificities, the performance of FlashTrack was significantly better than that of UTIscreen at two of the three colony counts (10(4) and 10(5) CFU/ml); however, FlashTrack costs more and is a labor-intensive procedure. Neither method was evaluated for the detection of colony counts of less than 10(4) CFU/ml.

Bacteriological Techniques↗
PubMed1988

Automated and rapid methods in clinical microbiology: past, present and future.

Instrument development in microbiology has focused on automating the traditional process of bacterial identification using growth-dependent technology. With the advent of genetic tools, advances in immunology, and engineering innovations microbiologists are moving away from the traditions of culture-dependent technology and are concentrating on the development of rapid, specific, nongrowth-dependent systems with a potential for automation.

Automation↗
PubMed1987

Evaluation of Gen-Probe DNA hybridization systems for the identification of Mycobacterium tuberculosis and Mycobacterium avium-intracellulare.

The Gen-Probe DNA hybridization system, rapid diagnostic assays for the identification of Mycobacterium tuberculosis (MTB) complex and Mycobacterium avium-intracellulare (MAIC) complex, were evaluated. Designed to identify a primary mycobacterial isolate, the former correctly identified 91 of 92 MTB and all 27 non-MTB isolates and controls when compared with conventional identification methods for a sensitivity of 98.91% and specificity of 100%. The latter correctly identified 63 of 64 MAIC isolates and controls and 31 of 32 non-MAIC isolates and controls when compared with conventional identification methods for a sensitivity of 98.43% and a specificity of 96.87%. The one false positive noted with the MAIC probe was an MTB misidentified as an MAIC. The two false negatives noted above were subsequently shown to be contaminated. The tests are fast and easy to perform and interpret.

DNA, Bacterial↗
PubMed1987

Effects of toxic shock syndrome Staphylococcus aureus, endotoxin and tampons in a mouse model.

Synthetic tampons and toxic shock syndrome toxin-one (TSST-1)-producing strains of Staphylococcus aureus have been linked to an increased incidence of toxic shock syndrome (TSS). While recent reports attempt to define the tampon connection as the creation of an optimal environment for the production of TSST-1, the role of other factors in disease expression in an animal model remain under investigation. To understand the role of tampons and bacteria, pools of Swiss mice were inoculated with permutations of effluents from TSS strains of S. aureus and Escherichia coli grown inside tampons. Depending on tampon brand, when all 3 factors were combined mortality ranged from 20-100%. In controls inoculated with single effluents, or effluents from growth in the presence of cotton, no deaths were observed. Likewise, when hairless mice were inoculated with exotoxin, endotoxin, and tampon leachables, mortality was 100%. In the absence of any 1 component, mortality ranged from 0-40%. Lethal toxicity can be the result of enhancement, since animal death in apparent shock was observed in all pools containing the 3 components, and in all pools containing effluents of TSS S. aureus and E. coli grown in the presence of synthetic tampons, but not in their absence. A retrospective analysis of fatal vs non-fatal TSS in humans supports the hypothesis of enhancement.

Adolescent↗
PubMed1986

Report of a wound infection caused by Vibrio parahaemolyticus and Vibrio vulnificus.

The present case describes a foot wound caused by a clam shell from which both Vibrio parahaemolyticus and Vibrio vulnificus were recovered. Although extraintestinal infections associated with Vibrio parahaemolyticus have been reported previously, the simultaneous isolation of two marine vibrios from our case suggests that these organisms may coexist in mixed infections from a common source.

Adult↗
PubMed1985

In vitro amplification of toxic shock syndrome toxin-1 by intravaginal devices.

Super-absorbent tampons and an exotoxin of Staphylococcus aureus have been associated with the recent emergence of toxic shock syndrome (TSS). In the majority of cases, when a TSS strain of S. aureus was cultivated in the presence of various tampons and a contraceptive sponge, increased amounts of toxic shock syndrome toxin-1 (TSST-1) were observed to be produced into the blood medium by the bacterium. The amplification of toxin by these products adds support to the epidemiologic data in establishing the causal link between tampons and TSS.

Bacterial Toxins↗