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J H Ngui-Yen

Publications and source records attributed to J H Ngui-Yen.

12 recordsLinked to original sources

Persistence of bacteria on antibiotic loaded acrylic depots. A reason for caution.

Bacterial growth on the surface of antibiotic loaded acrylic cement was examined in an in vitro model. Tobramycin or vancomycin impregnated discs were incubated in broth containing either Staphylococcus epidermidis or Staphylococcus aureus organisms. At 24, 48, and 96 hours, the broth and the surface of the acrylic discs were examined for viable organisms. In the broth, only 6% (8 of 136) of samples contained viable organisms at 24 hours, and all samples were sterile by 96 hours. This is in contrast to the surface of the discs, which revealed the presence of viable organisms at all study time periods. Growth was noted in 99% and 30% of the Staphylococcus epidermidis and Staphylococcus aureus discs, respectively, at 24 hours. Viable organisms were found on both types of discs through 96 hours (20% of Staphylococcus epidermidis and 15% of Staphylococcus aureus). The surface of bone cement is therefore a suitable substrate for bacterial growth, even in the presence of antibiotics. In clinical practice, antibiotic loaded acrylic cement should therefore be used with caution and clear indications.

Anti-Bacterial Agents↗

Comparison of BACTEC 9240 and BacT/Alert blood culture systems in an adult hospital.

In a study comparing the BACTEC 9240 (Becton Dickinson, Canada Inc., Mississauga, Ontario, Canada) and the BacT/Alert (Organon Teknika, Scarborough, Ontario, Canada) blood culture systems, 6,437 sets of four bottles of 10,412 cultures submitted were deemed acceptable for evaluation. There were 586 clinically significant isolates from 544 positive blood cultures. Of the 544 positive blood cultures, 329 were positive in both systems, 157 were positive in the BACTEC 9240 system alone, and 58 were positive in the BacT/Alert system alone (P < 0.001). These cultures represented 421 bacteremic episodes, of which 290 were detected by both systems, 84 were detected by the BACTEC 9240 system alone, and 47 were detected by the BacT/Alert system alone (P < 0.001). The difference between the two systems in terms of microbial recovery was attributable largely to differences in the ability to grow staphylococci. Of 82 monomicrobial isolates of Staphylococcus aureus, 46 were isolated by both systems, 30 were isolated by the BACTEC 9240 system alone, and 6 were isolated by the BacT/Alert system alone (P < 0.0001). A similar pattern was noted in the case of coagulase-negative staphylococci, of which 48 were isolated in both systems, 46 were isolated in the BACTEC 9240 system alone, and 5 were isolated in the BacT/Alert system alone (P < 0.0001). The false-positive rate in the BACTEC 9240 system was 0.5%, and that in the BacT/Alert system was 1.2%. Both systems provided satisfactory service mechanically, and in terms of computer software and costs, both systems were similar. The differences in the recovery of organisms, notably staphylococci, may be due in part to the fact that in the present study the BacT/Alert medium did not contain antimicrobial agent-removing devices, whereas the BACTEC 9240 medium did. Until this difference is resolved, we consider the BACTEC 9240 system to more adequately meet our hospital's requirements.

Adult↗

Evaluation of the E test by using selected gram-positive bacteria.

The E test (AB Biodisk NA Inc.) was compared with standard reference methods using the National Committee for Clinical Laboratory Standards's recommendations for determining the MICs of four selected antibiotics against 208 clinical isolates of gram-positive bacteria. These bacteria included 32 strains of Streptococcus pneumoniae, 25 strains of Enterococcus faecium, 20 strains of oxacillin-sensitive Staphylococcus aureus (OSSA), 96 strains of oxacillin-resistant S. aureus (ORSA), and 35 strains of coagulase-negative staphylococci. Evaluation included MIC accuracy within 1 dilution, reproducibility testing, and cost analysis. There was 94% agreement between the E test and the reference method in testing S. pneumoniae and penicillin G. There was 92% agreement with ampicillin and 100% agreement with vancomycin in testing E. faecium isolates. Accuracy of the oxacillin E test with staphylococci was significantly improved by the use of salt-supplemented Mueller-Hinton agar, for an agreement of 100% with coagulase-negative staphylococci and oxacillin-sensitive S. aureus and that of 85% with oxacillin-resistant S. aureus, with no major discrepancies. The E test with American Type Culture Collection isolates and clinical strains gave excellent reproducibility and was less costly than microdilution panels when used to test fewer than three antibiotics. The E test is a simple, reliable, reproducible, and cost-effective method for MIC determination for gram-positive organisms.

Enterococcus faecalis↗

In vitro susceptibility of Pseudomonas species to carbenicillin and trimethoprim-sulfamethoxazole.

We compared susceptibility tests of 47 Pseudomonas aeruginosa isolates and 40 Pseudomonas species to carbenicillin and trimethoprim-sulfamethoxazole by the MS-2 and Sceptor systems and agar dilution. The major and very major errors encountered in these tests in the MS-2 and Sceptor systems raise doubts about the accuracy of these methods for testing P. aeruginosa and confirm that they should not be used for testing the susceptibility of Pseudomonas species to the two drugs tested.

Carbenicillin↗

Comparative analysis of two rapid, automated methods for determining aminoglycoside levels.

Two rapid automated methods, the Syva EMIT Autolab 6000 (Syva Corp., Syntex Diagnostics, Ottawa, Ontario, Canada) and the Abbott TDX (Abbott Diagnostics, Mississauga, Ontario, Canada) systems, for determining amikacin, gentamicin and tobramycin levels in serum were evaluated for accuracy, reproducibility, and cost. Both methods had a high degree of accuracy and reproducibility in assaying gentamicin, amikacin, and tobramycin. The Abbott TDX required an average of only 1 min and 43 s for a single assay compared with 4 min and 15 s for the Syva EMIT automated system. Excluding the capital cost of equipment, the cost per assay by the Abbott TDX was +3.55 Canadian compared with +3.00 Canadian with the Syva EMIT automated system. Both systems performed well during this evaluation in a general diagnostic laboratory, but the Syva EMIT required more daily maintenance than the Abbott TDX system.

Aminoglycosides↗

Rapid method for determining antimicrobial susceptibility of Haemophilus influenzae.

A method was developed to determine the susceptibility of Haemophilus influenzae to ampicillin, cefamandole, and chloramphenicol by using the MS-2 system (Abbott Laboratories) for determining minimum inhibitory concentrations (MIC). The MS-2 results for 132 strains of H. influenzae were compared with the results of agar disk diffusion, agar dilution, and beta-lactamase tests. Twenty-four strains (18.2%) of H. influenzae were resistant to ampicillin by the agar dilution method, as opposed to 25 strains by the MS-2 method. For a beta-lactamase-negative strain, the agar dilution MIC was 4 micrograms/ml, and the MS-2 MIC was 16 micrograms/ml. Twenty-one strains produced beta-lactamase; two beta-lactamase-negative strains were resistant by MS-2, agar dilution, and agar disk diffusion. In addition, one beta-lactamase-negative strain, for which the agar dilution MIC was 32 micrograms/ml and the MS-2 MIC was 16 micrograms/ml, was sensitive by agar disk diffusion. Overall, the MS-2 method compared favorably with the agar dilution method for determining the MIC of ampicillin, cefamandole, and chloramphenicol for H. influenzae.

Ampicillin↗

Anaerobic plate method for assaying antimicrobial agents in serum.

An anaerobic agar plate method was devised for the assay of antimicrobial agents in serum by using a strain of Clostridium bifermentans. The method gave reproducible and accurate in assays of chloramphenicol, clindamycin, and metronidazole alone or in the presence of beta-lactam or aminoglycoside antibiotics.

Anaerobiosis↗

Comparative evaluation of three methods for measuring gentamicin and tobramycin in serum.

Three procedures (radioimmunoassay, fluorescence immunoassay, and enzyme immunoassay) for the determination of gentamicin and tobramycin levels were compared. These systems were evaluated on the basis of accuracy, reproducibility, specificity, and cost. All three systems showed a high degree of accuracy and precision. The fluorescence immunoassay gave significantly lower values for gentamicin and tobramycin at levels below 5 microgram/ml. Of the three systems, the radioimmunoassay was the least expensive, provided that a minimum of 10 analyses were performed daily; single tests required more technical time and were more costly. Costs of single tests by fluorescence immunoassay and enzyme immunoassay systems were similar. The enzyme immunoassay system performed equally well for both gentamicin and tobramycin in giving rapid and accurate results.

Anti-Bacterial Agents↗

Evaluation of a clostridial alpha-toxin disk test for rapid presumptive identification of group B streptococci.

An alpha-toxin disk test is described in which group B streptococci completed the hemolysis of sheep erythrocytes partially lysed by the alpha-toxin of Clostridium perfringens. The test was performed satisfactorily on the sheep blood agar primary isolation plate, as well as on pure cultures. A total of 95% of strains of pure group B streptococci tested produced positive reactions within 5 h, and all were positive after overnight incubation, with patterns of synergistic hemolysis readily distinguishable from those seen with group A streptococci. The preparation of disks is well within the scope of most clinical laboratories.

Bacterial Toxins↗