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Biomedical subjects

J M Barbaree

Publications and source records attributed to J M Barbaree.

At least 19 recordsLinked to original sources

Specific and selective biosensor for Salmonella and its detection in the environment.

The specific and selective detection of Salmonella typhymurium based on the use of a polyclonal antibody immobilized by the Langmuir-Blodgett method on the surface of a quartz crystal acoustic wave device was demonstrated in liquid samples. These biosensors were selective to S. typhymurium in the presence of large concentrations of Escherichia coli O157:H7. They were also specific to S. typhymurium since bacteria preincubated with free antibody produced no signal. Dark-field and electron microscopy showed that two different antibodies, polyvalent somatic O and flagellar H7, were immobilized on the sensor surface producing two distinct attachments of bacteria at the liquid-solid interface. The somatic O antibody exhibits a rigid, binding, while the flagellar H7 antibody forms a flexible connection allowing a large degree of freedom. When the attachment of bacteria was rigid and strong, the responses of the acoustic wave sensors correlated with changes in the mass of bacteria present at the liquid-solid interface. In contrast, when attachment was flexible, the sensor signals were inversely proportional to the additional mass of bound bacteria. This difference is probably determined by the interfacial viscoelasticity and by acoustic and electromagnetic coupling. The signals of environmentally aged sensors with either predominantly rigid or flexible positioning of bacteria were correlated with changes in mass at the liquid-solid interface. Sensors with O or H type of binding could be used for analytical purposes.

Acoustics↗

Molecular subtyping of Clostridium perfringens by pulsed-field gel electrophoresis to facilitate food-borne-disease outbreak investigations.

Clostridium perfringens is a common cause of food-borne illness. The illness is characterized by profuse diarrhea and acute abdominal pain. Since the illness is usually self-limiting, many cases are undiagnosed and/or not reported. Investigations are often pursued after an outbreak involving large numbers of people in institutions, at restaurants, or at catered meals. Serotyping has been used in the past to assist epidemiologic investigations of C. perfringens outbreaks. However, serotyping reagents are not widely available, and many isolates are often untypeable with existing reagents. We developed a pulsed-field gel electrophoresis (PFGE) method for molecular subtyping of C. perfringens isolates to aid in epidemiologic investigations of food-borne outbreaks. Six restriction endonucleases (SmaI, ApaI, FspI, MluI, KspI, and XbaI) were evaluated with a select panel of C. perfringens strains. SmaI was chosen for further studies because it produced 11 to 13 well-distributed bands of 40 to approximately 1,100 kb which provided good discrimination between isolates. Seventeen distinct patterns were obtained with 62 isolates from seven outbreak investigations or control strains. In general, multiple isolates from a single individual had indistinguishable PFGE patterns. Epidemiologically unrelated isolates (outbreak or control strains) had unique patterns; isolates from different individuals within an outbreak had similar, if not identical, patterns. PFGE identifies clonal relationships of isolates which will assist epidemiologic investigations of food-borne-disease outbreaks caused by C. perfringens.

Centers for Disease Control and Prevention, U.S.↗

Specific identification of Campylobacter fetus by PCR targeting variable regions of the 16S rDNA.

Campylobacter fetus is recognized as a human and animal pathogen. The isolation and differentiation of C. fetus in diagnostic laboratories is hindered by its relatively slow growth and lack of distinguishing biochemical characteristics. We developed a fast, reliable PCR assay that specifically amplifies a 554-bp segment of the 16S rDNA from C. fetus. Fifty-two ATCC reference strains and 255 bacterial field isolates comprising the genera Campylobacter, Arcobacter, Helicobacter, Escherichia, Listeria, Salmonella, and Wolinella were evaluated using this PCR protocol. Only C. fetus strains were amplified. Sequence analysis of amplicons from ATCC and field strains of C. fetus confirmed the presence of the target DNA fragment. The detection limit of the technique was 5.9 x 10(3) CFU/ml. This PCR assay can yield reliable detection of C. fetus within 3 h after isolation of presumptive colonies on agar plates.

Animals↗

Viability of Bordetella pertussis in four suspending solutions at three temperatures.

We studied the survival of Bordetella pertussis in four suspending solutions (Casamino Acids broth, deionized water, phosphate-buffered saline, and serum inositol), subjected to three storage temperatures (4, -20, and -70 degrees C) and two freezing methods (direct freezing and fast-freezing in an ethanol-dry-ice bath). Recovery rates were higher for longer periods for suspensions stored at -70 degrees C than those stored at -20 or 4 degrees C. Serum inositol showed the highest recovery rates for all experimental conditions, followed by Casamino Acids, deionized water, and phosphate-buffered saline. Cell viability was significantly reduced in phosphate-buffered saline suspensions fast-frozen before storage. These results identify optimal conditions for storing B. pertussis cells and are applicable to the collection, transport, and storage of aspirated nasopharyngeal samples for use in the laboratory diagnosis of pertussis.

Amino Acids↗

Rapid immunodot technique for identifying Bordetella pertussis.

We developed and evaluated a rapid test with monoclonal antibodies to identify cultures of Bordetella pertussis. Samples of 5 microliters of cells suspended in formalin-saline were dried onto a nitrocellulose disk. The disk was placed in a filtration device, and 5-microliters volumes of murine monoclonal antibody directed against B. pertussis lipooligosaccharide and peroxidase conjugate were added consecutively, with washing after each addition. The disk was removed and immersed in peroxidase substrate solution. All of 66 B. pertussis isolates confirmed by direct fluorescent-antibody assay were correctly identified by using four different monoclonal antibodies. One of the monoclonal antibodies did not react with over 20 bacterial species tested, including other Bordetella, Acinetobacter, Haemophilus, Moraxella, Mycobacterium, Neisseria, and Staphylococcus spp. This technique detected > or = 2 micrograms of lipooligosaccharide per ml or > or = 5 x 10(8) B. pertussis cells per ml. This rapid procedure used small amounts of reagents, needed less equipment, and was less subjective and more specific than the direct fluorescent-antibody assay.

Animals↗

Use of multiple molecular subtyping techniques to investigate a Legionnaires' disease outbreak due to identical strains at two tourist lodges.

A multistate outbreak of Legionnaires' disease occurred among nine tour groups of senior citizens returning from stays at one of two lodges in a Vermont resort in October 1987. Interviews and serologic studies of 383 (85%) of the tour members revealed 17 individuals (attack rate, 4.4%) with radiologically documented pneumonia and laboratory evidence of legionellosis. A survey of tour groups staying at four nearby lodges and of Vermont-area medical facilities revealed no additional cases. Environmental investigation of common tour stops revealed no likely aerosol source of Legionella infection outside the lodges. Legionella pneumophila serogroup 1 was isolated from water sources at both implicated lodges, and the monoclonal antibody subtype matched those of the isolates from six patients from whom clinical isolates were obtained. The cultures reacted with monoclonal antibodies MAB1, MAB2, 33G2, and 144C2 to yield a 1,2,5,7 or a Benidorm 030E pattern. The strains were also identical by alloenzyme electrophoresis and DNA ribotyping techniques. The epidemiologic and laboratory data suggest that concurrent outbreaks occurred following exposures to the same L. pneumophila serogroup 1 strain at two separate lodges. Multiple molecular subtyping techniques can provide essential information for epidemiologic investigations of Legionnaires' disease.

Adult↗

Communitywide outbreak of Legionnaires' disease associated with a grocery store mist machine.

From 10 October through 13 November 1989, 33 patients were hospitalized with legionnaires' disease in Bogalusa, Louisiana. A case-control study revealed case-patients were more likely than controls to have shopped at grocery store A (93% vs. 52%; odds ratio [OR], 11.6; 95% confidence interval [CI], 2.3-78.7) in the 10 days before illness. Among those who shopped at grocery store A, case-patients were more likely to shop for greater than 30 min (OR, 18.0; CI, 2.0-407.8) and to buy produce items located close to an ultrasonic mist machine (OR, 7.4; CI, 1.3-56.2). Employees of grocery store A were more likely than employees of other grocery stores in Bogalusa to have antibody titers of greater than or equal to 1:128 to Legionella pneumophila serogroup 1 (Lp-1; relative risk, 2.9; CI, 1.3-6.8). Lp-1 was isolated from water in the reservoir of the mist machine. The monoclonal antibody subtype of the isolate was identical to organisms identified in two patients. Viable Lp-1 was isolated from mist produced by the machine. Aerosols from a grocery store mist machine were the source of this outbreak.

Adult↗

Incubation of water samples containing amoebae improves detection of legionellae by the culture method.

Some protozoans isolated from aquatic habitats, including domestic water supplies, can support the intracellular replication of autochthonous legionellae in vitro. We studied the effect of incubating water samples containing amoebae on the sensitivity of culture for legionellae. Samples collected during investigations of legionellosis epidemics and shown by conventional culture procedures to contain amoebae, but not legionellae, were incubated at 35 degrees C and replated. Legionellae were recovered from 59 of 144 such samples. Species isolated included L. pneumophila, L. anisa, L. bozemanii, L. gormanii, L. micdadei, L. rubrilucens, L. sainthelensi, L. steigerwaltii, and an unnamed species. Acanthamoeba polyphaga, Acanthamoeba hatchetti, a Rosculus sp., Hartmannella vermiformis, and Vahlkampfia spp. were among the autochthonous amoebae identified. Legionellae were recovered by this procedure from only 3 of 63 samples that were negative for amoebae by conventional culture procedures. These results show that water samples negative for legionellae, but positive for amoebae, by standard culture techniques should be incubated and replated to maximize the sensitivity of culture for legionellae.

Amoeba↗

Virulence of a Legionella anisa strain associated with Pontiac fever: an evaluation using protozoan, cell culture, and guinea pig models.

Legionella anisa and the amoeba Hartmannella vermiformis were isolated from an indoor fountain implicated as the infectious reservoir in an outbreak of Pontiac fever. We evaluated the ability of this strain of L. anisa to multiply in cultures of an amoeba (H. vermiformis), a ciliated protozoan (Tetrahymena pyriformis), and human mononuclear cells and to infect guinea pigs. These bacteria multiplied in the culture of H. vermiformis but failed to infect guinea pigs or the cultures of T. pyriformis and human mononuclear cells. These findings suggest that some Legionella spp. may multiply only in specific protozoan hosts. The inability of this strain of L. anisa to multiply in human phagocytic cells may be related to the development of Pontiac fever rather than pneumonic legionellosis in exposed individuals. Further studies are necessary to determine whether the ability of legionellae to infect certain host cells can be correlated to differences in human disease.

Animals↗

Increased recovery of Legionella micdadei and Legionella bozemanii on buffered charcoal yeast extract agar supplemented with albumin.

The recovery of Legionella micdadei and L. bozemanii serogroups 1 and 2 from infected guinea pig spleens was evaluated by using two culture media: buffered charcoal yeast extract agar with 0.1% alpha-ketoglutarate (BCYE alpha) and the same medium supplemented with 1% bovine serum albumin (ABCYE alpha). At the lowest dilution of spleen tissue (10(-1)), recovery of all strains of L. micdadei and L. bozemanii was more efficient on ABCYE alpha than on BCYE alpha. L. micdadei strains had higher recovery rates on ABCYE alpha after another 10-fold dilution, but recoveries of L. bozemanii were similar on both media. Recovery rates for most test strains were comparable on BCYE alpha and ABCYE alpha at the highest dilution (10(-3)) of tissue tested. The presence of albumin in BCYE alpha increased the recovery rate of L. micdadei more than that of L. bozemanii. The use of ABCYE alpha medium in place of BCYE alpha may improve the recovery of L. micdadei and L. bozemanii from clinical specimens. Preliminary studies indicate that this medium also enhances recovery of certain Legionella spp. from environmental samples.

Animals↗

Effects of transport temperature and medium on recovery of Bordetella pertussis from nasopharyngeal swabs.

We compared relative recoveries of Bordetella pertussis from simulated nasopharyngeal (NP) specimens incubated in three separate transport media at different temperatures. Transport media included one-half-strength Regan-Lowe (RL.5), Regan-Lowe with one-half-strength agar (RL.5A), and buffered charcoal-yeast extract agar supplemented with alpha-ketoglutarate, lincomycin, and anisomycin (BCYE alpha LA). For each transport medium, recovery of B. pertussis was least efficient after storage at 25 degrees C. The highest recovery of B. pertussis from a mixed culture was achieved with RL.5 at 4 degrees C. Overall, RL.5 and RL.5A were comparable as transport media whether held at 4 or 25 degrees C, but fewer organisms were recovered from BCYE alpha LA. In addition, Regan-Lowe (RL), Bordet-Gengou, and cyclodextrin media were compared as primary isolation media for recovering B. pertussis from simulated NP swabs held at 4 and 35 degrees C in RL.5 medium. The highest recovery of B. pertussis was obtained on RL primary isolation medium. Bordet-Gengou medium recovered only 80% and cyclodextrin medium recovered less than 60% of the numbers recovered on RL medium. Based on these results, refrigeration (4 degrees C) of NP swabs shipped in RL.5 transport medium and using RL as the primary isolation medium are recommended for recovering B. pertussis from swab specimens.

Bordetella pertussis↗

Protocol for sampling environmental sites for legionellae.

A protocol for sampling environmental sites was developed and used to identify possible sources of Legionella species in support of epidemiologic investigations at two hospitals. In hospital A, legionellae were isolated from 43 of 106 (40%) different sites. Three separate Legionella pneumophila serotypes and a previously unrecognized species were present in different combinations in the positive samples. Two of five cooling towers contained the same L. pneumophila serogroup 1 monoclonal type (1,2,4,5) as was isolated from patients. The same monoclonal type was also isolated from make-up water for the two cooling towers, a hot water tank, water separators in four main air compressor systems for respiratory therapy, and cold and hot water faucets. In hospital B, 13 of 37 (38%) sample sites contained legionellae, all of which were L. pneumophila serogroup 1. The monoclonal type matching isolates from patients (1,2,4,5) was found at the highest concentration in a hot water tank, but it was also present at four other sample sites. Since legionellae not related to disease may be found in many of the sites sampled, an epidemiologic association with the probable source should be established before intervention methods, such as disinfection, are undertaken.

Air Conditioning↗

Isolation of protozoa from water associated with a legionellosis outbreak and demonstration of intracellular multiplication of Legionella pneumophila.

At the site of a legionellosis outbreak, amoebae and two ciliates, Tetrahymena sp. and Cyclidium sp., were isolated from cooling-tower water containing Legionella pneumophila. The Tetrahymena sp. and the amoebae repeatedly showed the ability to support intracellular multiplication of L. pneumophila. Both were isolated from cooling towers specifically implicated as the source for the spread of legionellosis. These protozoa may be reservoirs supporting the survival and multiplication of virulent legionellae in cooling-tower water.

Eukaryota↗

Comparison of guinea pig and protozoan models for determining virulence of Legionella species.

Legionella pneumophila organisms are able to infect and multiply within the ciliated protozoan Tetrahymena pyriformis. This ability may be associated with virulence, because an attenuated strain of L. pneumophila fails to multiply within this protozoan, whereas a virulent strain increases 10,000-fold in number when coincubated with T. pyriformis. Seventeen strains (11 species) of legionellae were evaluated for virulence by intraperitoneal injection of guinea pigs and inoculation of protozoan cultures. Analysis of the data indicates that there are four categories of legionellae with respect to virulence as follows: organisms that infect and kill guinea pigs and multiply in T. pyriformis; organisms that infect but do not kill guinea pigs and multiply in T. pyriformis; organisms that do not infect guinea pigs but are lethal at high concentrations and multiply in T. pyriformis; and organisms that neither infect nor kill guinea pigs and fail to multiply in T. pyriformis. Evidence suggests that these distinctions are based on two virulence factors: intracellular multiplication in a host and toxic activity.

Animals↗

Nosocomial Legionnaires' disease. Epidemiologic demonstration of cooling towers as a source.

Investigation of a recent outbreak of nosocomial legionnaires' disease--initially thought to be due to the documented presence of Legionella pneumophila in the hospital potable water--showed that aerosols from one or more cooling towers were the actual source of infection. From June 27 to Aug 25, 1983, nosocomial legionnaires' disease developed in 15 persons at a hospital in Rhode Island. Twelve (80%) of 15 case-patients occupied rooms in building 1, unit B, compared with eight (28%) of 29 control patients (odds ratio = 10.8; 95% confidence interval = 1.4 to 85.6). Subsequent investigation demonstrated that water in a cooling tower located 100 ft upwind of unit B was heavily contaminated with L pneumophila, serogroup 1, subgroup 1, 2, 4, 5. The same strain was isolated from nine of the patients and from the make-up water for the tower. Active surveillance during the ten months following decontamination of the cooling tower identified no additional cases of nosocomial legionnaires' disease, although the hospital potable water had not been treated. While recommendations have been made for controlling nosocomial legionnaires' disease by heating or hyperchlorination of hospital potable water, this outbreak demonstrates the importance of an adequate epidemiologic-environmental investigation in choosing the appropriate control strategy.

Adult↗

An outbreak of Pontiac fever related to whirlpool use, Michigan 1982.

Fourteen of 23 female members of a church group experienced an acute self-limited illness characterized by chills, fever, chest pain, cough, and nausea, consistent with the diagnosis of Pontiac fever. All 14 affected women had used a whirlpool located in the women's locker room during a racquetball party. Legionella pneumophila serogroup 6 was isolated from the women's whirlpool. Nine of 14 cases showed a seroconversion to heat-fixed antigen prepared from the L pneumophila serogroup 6 isolate. Aerosol size studies show that the whirlpool aerator produced water droplets small enough to travel deep into the tracheobronchial tree but large enough to transport L pneumophila. This outbreak demonstrated that Pontiac fever may be associated with L pneumophila serogroup 6, that whirlpools can serve as a reservoir for these organisms, and that seroconversion can occur in the absence of illness.

Adult↗