Influence of multiple isolates on antimicrobial susceptibility patterns from blood cultures.
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Bacteriological Techniques↗
Biomedical subjects
B L Wasilauskas
Publications and source records attributed to B L Wasilauskas.
The use of C-reactive protein from cerebrospinal fluid for differentiating meningitis from other central nervous system diseases.
C-reactive protein (C-RP) determinations were performed by using the latex slide agglutination test on cerebrospinal fluid (CSF) from 235 patients. The patients were categorized into the following groups: bacterial meningitis (n = 74); viral meningitis (n = 10); fever without bacterial meningitis (n = 80); neurological symptoms without infection (n = 25); intracranial hemorrhage (n = 10); increased intracranial pressure that was secondary to pseudotumor cerebri or hydrocephalus (n = 16); and malignancies (n = 20). On the initial lumbar puncture, the C-RP was positive in 97% (72 of 74) of the patients in group 1, as compared with 0% (0 of 10), 6% (5 of 80), 20% (5 of 25), 50% (5 of 10), 6% (1 of 16), and 30% (6 of 20) in groups 2-7, respectively (P less than .0001). The C-RP test was able to detect bacterial meningitis with a sensitivity of 97% (72 of 74), a specificity of 86% (139 of 161), a positive predictive value of 77% (72 of 94), and a negative predictive value of 99% (139 of 141). These data indicate that C-RP determinations performed on CSF are useful and rapid clinical tests for the exclusion of the presence of bacterial meningitis in a patient.
Adolescent↗
Rapid identification of Clostridium species by high-pressure liquid chromatography.
High-pressure liquid chromatography was evaluated as a rapid means of identifying various species of clostridia. Isolates were inoculated into a defined medium and incubated aerobically for 1 h at 35 degrees C. The organisms were removed, and the supernatants were derivatized for 1 min at room temperature by the addition of o-phthalaldehyde. The total time required to run each chromatogram was approximately 50 min. Standardized peak heights for each medium component and any new peaks formed were calculated for each isolate and compared with those for uninoculated control medium. Multiple isolates of various Clostridium species gave consistent patterns of medium utilization that could be used for identification. This rapid method can easily be adapted for laboratory use and has the potential for automation.
Amino Acids↗
An analysis of Streptococcus pneumoniae identification using biochemical and serological procedures.
Five methods for identification of Streptococcus pneumoniae were evaluated with stock strains representing all 83 capsular types and 130 fresh clinical isolates of alpha-hemolytic streptococci. The identification methods included bile solubility, optochin sensitivity, countercurrent-immunoelectrophoresis (CIEP), and coagglutination (CoA) using laboratory-prepared reagents (LPR) and the Phadebact Pneumococcus Test (Phadebact). The Quellung reaction was performed on the 83 capsular types of S. pneumoniae and on the clinical isolates that produced serological cross reactions with the three serological tests and those that were bile-soluble and optochin-sensitive. All 83 pneumococcal types were in complete agreement with each of the different test methods. Of the 130 alpha-hemolytic streptococci, 26 were identified as S. pneumoniae, and 104 isolates were identified as viridans streptococci using biochemical, physiologic, Quellung, or mouse virulence tests. All 104 viridans streptococci were bile-insoluble and optochin-resistant; however, 63 reacted with either one, both, or all three serological methods. Our data suggest that bile solubility and optochin tests are more reliable for pneumococcal identification than serological methods currently available.
Animals↗
Use of the directigen latex agglutination test for detection of Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis antigens in cerebrospinal fluid from meningitis patients.
Cerebrospinal fluid specimens from 257 persons were tested for the presence of bacterial antigens by counterimmunoelectrophoresis and the Directigen meningitis test (Hynson, Westcott & Dunning, Div. Becton Dickinson & Co., Baltimore, Md.). The specimens were obtained from 162 patients with meningitis caused by Haemophilus influenzae type b, Streptococcus pneumoniae, or Neisseria meningitidis serogroups A and C and from 95 patients without bacterial meningitis or meningitis caused by other bacterial agents. Directigen detected H. influenzae type b antigen in 83% (69 of 83) of the specimens obtained from patients with H. influenzae disease, pneumococcal antigen in 77% (30 of 39) of the specimens from patients with pneumococcal disease, and N. meningitidis antigen in 93% (37 of 40) of the specimens from patients with disease caused by N. meningitidis serogroups A and C. The comparable figures for counterimmunoelectrophoresis were 66% (55 of 83), 79% (31 of 39), and 78% (31 of 40), respectively. No false-positive reactions were reported with the Directigen reagents. Nonspecific reactions (agglutination with more than one of the four Directigen latex reagents) were noted with five specimens. The nonspecific reactions were resolved in four of the five specimens by heating (100 degrees C for 3 min). The accumulated data demonstrate that the sensitivity of the Directigen meningitis test is better than or at least equivalent to the sensitivity of counterimmunoelectrophoresis for the detection of antigens in cerebrospinal fluid.
Antigens, Bacterial↗
Evaluation of the Strep-A-Fluor identification method for group A streptococci.
Strep-A-Fluor (Bio Spec, Inc., Dublin, Calif.) is a new test designed for the rapid identification of group A streptococci. A filter paper strip impregnated with a synthetic substrate is used to detect a specific aminopeptidase present in group A streptococci by UV fluorescence. In a blind study, 305 beta-hemolytic streptococcal isolates were correctly categorized as group A or non-group A.
Bacteriological Techniques↗
Successful ketoconazole treatment of protothecosis with ketoconazole-associated hepatotoxicity.
A 46-year-old woman had a chronic, unresponsive wrist infection that was proved to be due to the algaelike organism Prototheca wickerhamii. Treatment with ketoconazole resulted in prompt improvement and ultimate healing. Therapy was complicated by hepatitis that was ketoconazole-related. Ketoconazole may be effective and easily administered therapy for this generally unresponsive infection.
Chemical and Drug Induced Liver Injury↗
Prospective, randomized, controlled trial of ticarcillin and cephalothin as prophylactic antibiotics for gastrointestinal operations.
The effectiveness of ticarcillin (one 6 g dose at the start of the operation) and cephalothin (three 2 g doses given at 4 hour intervals from the start of the operation) as prophylactic antibiotics in operations on the colon, stomach, small bowel or obstructed biliary tract was determined in a prospective, randomized, blind study of 190 patients. Data from the 152 patients forming the definitive study revealed a significant reduction in the rate of wound and peritoneal infections with the use of ticarcillin (3.4 percent) and cephalothin (5.3 percent) over that with the use of a placebo (27.8 percent). Cultures showed no evidence of antibiotic resistance in the contaminant organisms of patients who later developed infections. Both antibiotic regimens offered excellent protection against infection after gastrointestinal operations; neither produced untoward side effects. The very short duration of treatment, particularly with ticarcillin, conferred the additional benefits of low cost, simplicity of drug administration, and negligible risk of the emergence of resistant bacterial strains.
Adolescent↗
Determination of bacterial meningitis: a retrospective study of 80 cerebrospinal fluid specimens evaluated by four in vitro methods.
A total of 80 cerebrospinal fluid specimens were analyzed for bacterial meningitis by four procedures readily available to most laboratories. These tests included routine culturing. Gram staining, countercurrent immunoelectrophoresis, staphylococcal coagglutination (CoA) with laboratory-prepared reagents, and CoA with Pharmacia Diagnostics reagents. A total of 56 specimens were positive for bacterial agents by routine culturing: Gram stain results were positive for 64% of all specimens positive by culturing. For 36 specimens from patients with suspected meningitis due to either Haemophilus influenzae type b, Streptococcus pneumoniae, or group B streptococci, detection was 97% with Pharmacia CoA reagents, 94% with laboratory-prepared CoA reagents, 89% with routine culturing, 78% with countercurrent immunoelectrophoresis, and 75% with Gram staining. One specimen which contained Klebsiella pneumoniae was false positive for S. pneumoniae in tests with both of the CoA reagents and in countercurrent immunoelectrophoresis. A Gram stain of this specimen clearly showed gram-negative bacilli, which were confirmed by culturing. Although a positive culture and a positive Gram stain are definitive evidence of bacterial meningitis, rapid immunological tests can provide valuable clinical information as an adjunct to culture and Gram stain results. Serological tests with Pharmacia CoA reagents produced more positive results than either laboratory-prepared CoA reagents or countercurrent immunoelectrophoresis.
Agglutination↗
Comparative in vitro activity of 5 cephalosporins with other antibiotics tested against 887 recent clinical isolates.
Five cephalosporins including 3 newer agents were tested along with several aminoglycosides, penicillins and other antimicrobials against 887 recent clinical bacterial isolates. Of the newer cephalosporins, cefotaxime appeared to be the most effective against gram-negative bacilli. However, with gram-positive cocci, cephalothin seemed to be the most effective cephalosporin. Superior antipseudomonal activity still resides with the aminoglycosides although moxalactam and cefotaxime appeared to offer some alternatives.
Anti-Bacterial Agents↗
A rapid staphylococcal coagglutination technic to differentiate group A from other streptococcal groups.
A rapid staphylococcal coagglutination technic for differentiating group A from other streptococcal groups properly classified 500 isolates of beta-hemolytic streptococci when compared with the results of a reference capillary precipitin test. Presumptive classification of the same 500 isolates by bacitracin susceptibility produced a significant number of incorrect identifications. The findings further document the inherent inaccuracy of the bacitracin susceptibility test and suggest that the staphylococcal coagglutination technic may be a simple, accurate, inexpensive alternative for identification of group A streptococci.
Agglutination Tests↗
Comparison of a slide coagglutination technique with the Minitek system for confirmation of Neisseria gonorrhoeae.
The Phadebact gonococcus test was performed on 314 bacterial isolates to compare the coagglutination technique with the Minitek system for the confirmation of Neisseria gonorrhoeae. Direct testing, using colonies of N. gonorrhoeae mixed with the Phadebact gonococcus test reagents, produced noninterpretable results in many cases. However, an alternative method, described by the manufacturer, of heating several colonies in distilled water for 20 min before testing alleviated most interpretation difficulties. Complete agreement was achieved with both the Phadebact and Minitek tests for all 236 isolates of N. gonorrhoeae. Of the 78 nongonococcal isolates tested with Phadebact, two isolates gave false-positive results, whereas one isolate was reported as noninterpretable. The Phadebact gonococcus test appears to be a simple and rapid alternative to confirmatory biochemical procedures for N. gonorrhoeae.
Agglutination Tests↗
Adaptation of the staphylococcal coagglutination technique for detection of heat-labile enterotoxin of Escherichia coli.
Protein A-containing staphylococci coated with specific antiserum were tested for heat-labile enterotoxin of Escherichia coli. The immunological cross-reactivity of E. coli heat-labile enterotoxin with Vibrio cholerae toxin (choleragen) was the basis for sensitizing stabilized suspensions of the Cowan I strain of Staphylococcus aureus with anticholeragen. Unconcentrated culture supernatant fluid containing E. coli heat-labile enterotoxin produced macroscopic agglutination when mixed with sensitized staphylococci in capillary tubes. A total of 15 toxigenic and 61 nontoxigenic isolates were tested by the staphylococcal coagglutination technique in a coded fashion and found to be in agreement with previous results of the Chinese hamster ovary cell assay and the passive immune hemolysis test. The staphylococcal coagglutination technique is simple, relatively inexpensive to perform, and requires the immunoglobulin fraction of anticholeragen as the only specific reagent. The staphylococcal coagglutination technique appears to have potential for routine use in diagnostic microbiology laboratories.
Agglutination Tests↗
Isolation of oxidase-negative Pseudomonas aeruginosa from sputum culture.
Two isolates of Pseudomonas aeruginosa lacking characteristic indophenol oxidase were recovered from a sputum specimen. A discussion of the characteristic biochemical tests and antibiograms along with a possible explanation for this phenomenon is presented.
Aged↗
Cardiobacterium hominis endocarditis.
This report describes the isolation of Cardiobacterium hominis from a patient with a history of rheumatic heart disease. Seven blood cultures yielded the organism. This investigation includes the case history, significant details of the hospital course, and the bacteriological, biochemical, and antimicrobial characteristics of Cardiobacterium hominis, integrated with a brief review of the literature.
Aged↗
A randomized prospective evaluation of orally administered antibiotics in operations on the colon.
In this randomized, prospective study of 91 patients undergoing operations on the colon, we found that neomycin, neomycin-phthalylsulfathiazole and neomycin-erythromycin base all provided adequate intestinal antisepsis. Wound infection rates for all groups were also similar and close to the national average for operations on the colon. A detailed analysis of the wound infections in our series revealed that 60 per cent of these infections were from organisms different from those found on the colonic mucosa. This evidence indicates the possible advantage of parenteral antibiotic therapy to achieve adequate tissue levels of antibiotics not presently possible with orally administered agents.
Administration, Oral↗
Subacute bacterial endocarditis caused by group G beta-hemolytic Streptococcus.
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Child↗
Letter: Novel inoculum replication device for antibiotic agar plate dilutions.
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Agar↗