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Biomedical subjects

R R Facklam

Publications and source records attributed to R R Facklam.

At least 91 records · Page 5Linked to original sources
PubMed1991

Serotypes of respiratory isolates of Streptococcus pneumoniae compared with the capsular types included in the current pneumococcal vaccine.

The serotypes of 474 clinically significant Streptococcus pneumoniae respiratory isolates collected during a national surveillance study in 1987-1988 were compared to the capsular types included in the 23-valent pneumococcal polysaccharide vaccine licensed for use in the United States. Overall, 355 isolates (74.9%) belonged to types included in the current vaccine, while another 65 (13.7%) were types serologically related to vaccine types and likely to be protective by virtue of cross-reactivity. Relatively few isolates (9.1%) belonged to nonvaccine serotypes, and only 2.3% were nontypable. The mucoid serotype 3 was most frequent (13.1% of total), followed by 19F (9.3%), 23F (7.4%), 6B and 14 (5.7% each), and 4 and 6A (5.5% each). The most frequent type not included in the vaccine was type 16 (2.1% of all isolates). Thus, nearly 89% of respiratory isolates included in this study were encompassed within the antigenic spectrum of the currently marketed pneumococcal vaccine.

Adult↗
PubMed1991

Antimicrobial resistance of Streptococcus pneumoniae in the United States, 1979-1987. The Pneumococcal Surveillance Working Group.

The increasing number of Streptococcus pneumoniae isolates identified as relatively or fully resistant to penicillin or fully resistant to other antimicrobials in the United States supports the need to monitor for this resistance. Thus, 5459 S. pneumoniae isolates submitted to the Centers for Disease Control in 1979-1987 by 35 hospitals in a hospital-based pneumococcal surveillance system were evaluated. The MIC to penicillin or ampicillin was greater than or equal to 0.1 micrograms/ml for 274 (5%) isolates; 1 had an MIC of 4.0 micrograms/ml to penicillin. Seventeen (0.3%) were resistant to erythromycin (MIC, greater than or equal to 8 micrograms/ml), 157 (2.9%) were resistant to tetracycline (MIC, greater than or equal to 16 micrograms/ml), and 34 (0.6%) were resistant to sulfamethoxazole/trimethoprim (MIC, greater than or equal to 76 and 4 micrograms/ml). Isolates relatively resistant to penicillin represented 1.8% of isolates in 1979, 8% in 1982, and 3.6% in 1987. Sixty-five multiply resistant isolates were identified. Pneumococci from the southwestern United States (region 4) were more likely to be relatively resistant to penicillin. Using logistic regression analysis, serotypes 14 and 19A, isolates from region 4, and isolates from middle ear fluid were associated with penicillin resistance (P less than or equal to .008, chi 2. These data confirm that antimicrobial resistance among pneumococcal isolates remained at low levels in the United States through 1987.

Age Factors↗
PubMed1991

Specific and intraspecific molecular typing of lactococci based on polymorphism of DNA encoding rRNA.

The rRNA gene restriction patterns or species of the genus Lactococcus were determined. Chromosomal DNA was digested with endonucleases and probed with radiolabelled DNA complementary to rRNA synthesized by random oligonucleotide priming using reverse transcriptase. Highly discriminatory restriction patterns were obtained which served to distinguish the five currently recognized lactococcal species. In addition the observed variations in the patterns at intra-specific level indicate that rRNA gene restriction fingerprinting may be of value in distinguishing the individual strains for epidemiological studies, and monitoring and checking authenticity of starter strains.

Blotting, Southern↗
PubMed1991

Enterococcus dispar sp. nov. a new Enterococcus species from human sources.

The partial 16S rRNA sequences of two unknown human enterococcal isolates were determined by reverse transcription in an attempt to clarify their taxonomic position. The sequence data indicate that they belong to a hitherto unknown species of Enterococcus, for which the name Enterococcus dispar sp. nov. is proposed. The type strain is NCIMB 13000.

Base Sequence↗
PubMed1991

Differentiation of Lactococcus lactis and Lactococcus garvieae from humans by comparison of whole-cell protein patterns.

We tested 12 reference and 24 clinical strains of lactococci for physiologic characteristics using a conventional test system, the Gen-Probe Enterococcus 2 chemiluminescence assay (Gen-Probe Inc., San Diego, Calif.), the Rapid Strep identification system (Analytab Products, Plainview, N.Y.), and whole-cell protein analysis. The Gen-Probe Enterococcus 2 chemiluminescence assay for Enterococcus identification was negative with all strains. Neither the conventional test nor the Rapid Strep identification system could differentiate between the two Lactococcus spp. most commonly isolated from humans. A simple procedure, based on sodium dodecyl sulfate-polyacrylamide gel electrophoresis, was developed for comparing the whole-cell protein patterns of Lactococcus spp. L. lactis and L. garvieae were differentiated by unique protein patterns.

Bacterial Proteins↗
PubMed1990

Changing epidemiology of group A streptococcal infection in the USA.

To see whether changes in the epidemiology of group A streptococcal disease in the USA have been accompanied by a corresponding change in serotype distribution, epidemiological and M-typing and T-typing data for 5193 strains sent to the Centers for Disease Control, Atlanta, between 1972 and 1988 were analysed. The proportions of M-types 1, 3, and 18 increased significantly during the study period. These M-types were more likely to be invasive, to cause fatal infection, and to occur in a cluster of infections than were other types. By contrast, the proportions of M-types 4 and 12 decreased; they were less invasive and were less likely to be found in clusters than were other types. These data suggest that changes in the epidemiology of group A streptococcal disease may be related to changes in the distribution of M-types causing infection.

Adult↗
PubMed1990

Vancomycin-resistant Pediococcus acidilactici: nine cases of bacteremia.

Pediococci, vancomycin-resistant gram-positive cocci, have been isolated from human specimens, but an association with clinical illness has not been established. Clinical and epidemiologic data were obtained on nine patients who had Pediococcus acidilactici isolated from blood. Patients were eight elderly adults with complicated medical problems and one infant with congenital jejunoileal atresia. Seven patients were hospitalized before P. acidilactici was isolated. Eight had received multiple antibiotics; however, only two had received vancomycin. In all cases there was a delay in correct bacterial identification, and the significance of the isolate was uncertain. There was no clearly identified syndrome associated with P. acidilactici bacteremia. All eight adults had fever and six had pneumonia potentially attributable to other causes. The findings underscore the importance of proper identification of vancomycin-resistant gram-positive cocci. P. acidilactici may be an opportunistic pathogen in severely compromised hosts; however, further observations are necessary to clarify its role in human disease.

Aged↗
PubMed1990

The role of human immunodeficiency virus infection in pneumococcal bacteremia in San Francisco residents.

Human immunodeficiency virus (HIV) is an important risk factor for invasive pneumococcal disease, but information on clinical course and infecting serotypes is limited. To help develop strategies to reduce the morbidity due to invasive pneumococcal disease, episodes of pneumococcal bacteremia were identified by retrospective review of microbiology records (November 1983-November 1987) at 10 San Francisco hospitals and, for patients 20-55 years old living in San Francisco, HIV antibody status was determined by review of medical records. Pneumococcal isolates from one hospital were serotyped. Of 294 patients with pneumococcal bacteremia identified, 32 (11%) had AIDS at the time pneumococcal bacteremia was diagnosed and another 43 (15%) were HIV-infected but did not have AIDS; 12 HIV-infected patients developed AIDS after the episode of pneumococcal bacteremia. The rate of pneumococcal bacteremia in AIDS patients was estimated to be 9.4/1000 patient-years. Serotypes of 27 (82%) of 33 pneumococcal isolates from HIV-infected patients and 107 (90%) from 119 patients without known HIV infection were among the 23 serotypes included in the currently available polysaccharide vaccine. The rate of pneumococcal bacteremia is approximately 100-fold greater in AIDS patients in San Francisco than rates reported before the AIDS epidemic, but more than half the episodes of pneumococcal bacteremia in HIV-infected patients occurred in patients without AIDS. Data on pneumococcal serotypes causing invasive disease in HIV-infected patients suggest that the current pneumococcal vaccine, if effective in this population, could provide significant protection against pneumococcal disease.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Bacterial meningitis in the United States, 1986: report of a multistate surveillance study. The Bacterial Meningitis Study Group.

A prospective, laboratory-based surveillance project obtained accurate data on meningitis in a population of 34 million people during 1986. Haemophilus influenzae was the most common cause of bacterial meningitis (45%), followed by Streptococcus pneumoniae (18%), and Neisseria meningitidis (14%). Rates of H. influenzae meningitis varied significantly by region, from 1.9/100,000 in New Jersey to 4.0/100,000 in Washington state. The overall case fatality rates for meningitis were lower than those reported in several studies from the early 1970s, suggesting that improvements in early detection and antibiotic treatment may have occurred since that time. Concurrent surveillance was also performed for all invasive disease due to the five most common causes of bacterial meningitis. Serotypes of group B streptococcus other than type III caused more than half of neonatal group B streptococcal disease and mortality, suggesting that an optimal vaccine preparation must be multivalent. Of the organisms evaluated, group B streptococcus was the second most common cause of invasive disease in persons greater than 5 years old.

Adolescent↗
PubMed1990

Antimicrobial susceptibility of vancomycin-resistant Leuconostoc, Pediococcus, and Lactobacillus species.

Eighty-five strains of vancomycin-resistant gram-positive bacteria from three genera, Leuconostoc, Pediococcus, and Lactobacillus, were tested to determine susceptibility to 24 antimicrobial agents by broth microdilution and to 10 agents by disk diffusion. The MICs of vancomycin and teicoplanin ranged from 64 to greater than 512 micrograms/ml; however, the MICs of daptomycin, a new lipopeptide, were all less than or equal to 0.25 micrograms/ml. None of the organisms were resistant to imipenem, minocycline, chloramphenicol, gentamicin, or daptomycin. The MICs of penicillin were in the moderately susceptible range for all but three strains. Susceptibility to the other agents varied by genus and, in some cases, by species. When disk diffusion results were compared with MICs for drugs recommended for streptococci by the National Committee for Clinical Laboratory Standards, Villanova, Pa., few very major or major errors were obtained, but the number of minor errors was 19.3%. Therefore, we recommended that MIC testing be used instead of disk diffusion testing for these organisms.

Anti-Bacterial Agents↗
PubMed1990

Phenotypic characterization, cellular fatty acid composition, and DNA relatedness of aerococci and comparison to related genera.

Aerococci can be misidentified as streptococci, enterococci, pediococci, lactococci, or leuconostocs. To distinguish the genus and determine if another species is needed in the present taxon, we analyzed 37 aerococci for cellular fatty acids and compared them with 377 strains of gram-positive cocci, including the species type strains from each of the related genera. The cellular fatty acid profile of aerococci was distinguishable from other genera. Two relatively novel fatty acids found in the aerococci were identified as C16:1 omega 9c and C16:1 omega 9t. Eleven strains of aerococci (including a strain originally identified as "Gaffkya" species) were chosen for DNA-DNA reassociation studies with the type strain Aerococcus viridans ATCC 11563; DNAs from eight of these strains were more than 75% related to the type strain and had 1 to 4% divergence in related sequences. The remaining three strains were 60 to 70% related to the type strain, had 7 to 11.5% divergence, and may represent a second species, Aerococcus genospecies 2. beta-Glucuronidase, alpha-galactosidase, and beta-galactosidase were useful in characterizing the aerococci.

Chloramphenicol O-Acetyltransferase↗
PubMed1990

Whole-cell protein patterns of nonhemolytic group B, type Ib, streptococci isolated from humans, mice, cattle, frogs, and fish.

Whole-cell protein and physiological patterns of nonhemolytic group B, type Ib, streptococci isolated from humans, cattle, frogs, fish, and mice were compared. Isolates from humans, fish, and mice were identical. Only minor differences were seen in the isolates from human, bovine, and frog sources. Nonhemolytic group B streptococci from humans, fish, and mice and, to a lesser extent, from cattle and frogs share several characteristics, including a high similarity in proteins (on the basis of molecular weight); this suggests that they may have a common ancestry.

Animals↗
PubMed1990

Major subtypes of invasive Haemophilus influenzae from 1983 to 1985 in Atlanta, Ga.

We compared outer membrane protein (OMP) patterns of Haemophilus influenzae isolated in metropolitan Atlanta, Ga., from July 1983 to June 1985. Of 74 randomly selected H. influenzae serotype b, biotype I, isolates (24% of the total number of H. influenzae, and 32% of the total number of H. influenzae serotype b, biotype I, isolates), 66 (89.2%) had the same OMP pattern. Of the remaining eight, five (6.7%) had an identical OMP pattern. The other three isolates had separate and distinct patterns. A greater diversity of OMP patterns was found with H. influenzae serotype b, biotype II, and nonserotypeable H. influenzae. Of the 18 H. influenzae serotype b, biotype II, isolates (5.8% of the total number of H. influenzae isolates), 1 had an OMP pattern similar to that of the predominate biotype I OMP type, 6 (33% of the biotype II) had the same pattern, and 11 had heterogeneous patterns. Of the 19 recoverable, nonserotypeable biotype II isolates (6.8% of the total number of H. influenzae), 18 had different OMP patterns, and no pattern was similar to those observed with serotype b. These findings indicate that most H. influenzae strains isolated during this 2-year period were indistinguishable by serotype, biotype, or OMP patterns.

Bacterial Outer Membrane Proteins↗
PubMed1990

Pneumococcal vaccination. Controversies and opportunities.

The morbidity and mortality associated with pneumococcal infections are preventable in many high-risk individuals by immunization with 23-valent pneumococcal vaccine. While the clinical effectiveness of the current vaccine is less than ideal, use of the vaccine is cost effective. In spite of recommendations for pneumococcal vaccination of elderly and other high-risk persons, and federal reimbursement for vaccination Medicare enrollees, it was estimated in 1985 that only 10% to 15% of this target population was immunized. Strategies for immunizing high-risk individuals with pneumococcal vaccine need to involve physicians, public health professionals, health advocacy groups, and persons in the targeted populations.

Antibodies, Bacterial↗
PubMed1989

Invasive pneumococcal disease in an Alaska native population, 1980 through 1986.

From 1980 through 1986, one hundred fourteen Alaska Native patients from the Yukon-Kuskokwim Delta had community-acquired invasive pneumococcal disease confirmed by isolates of Streptococcus pneumoniae from normally sterile body sites. The annual bacteremia rates per 100,000 persons were 105 cases for all ages, 1195 cases for infants under 2 years of age, and 130 cases for adults over 59 years of age. These were six to 34 times higher than rates reported for other US populations. The most common underlying conditions in infants diagnosed before 24 months of age were previously diagnosed anemia and pneumonia, while alcoholism and anemia were most common in adults. The case-fatality rate for infants under 2 years of age was 3.2%, and the case-fatality rate for adults over 59 years of age was 30%. Serotyping of more than half the isolates identified 96% of these isolates to be present in the currently available pneumococcal polysaccharide vaccine. The pneumococcal disease rates reported herein are likely to be underestimates since most diseases that occur in this region are treated at the village level without laboratory confirmation.

Adolescent↗
PubMed1989

Enterococcus raffinosus sp. nov., Enterococcus solitarius sp. nov. and Enterococcus pseudoavium sp. nov.

Deoxyribonucleic acid base composition, deoxyribonucleic acid-deoxyribonucleic acid hybridization, and biochemical studies were performed on some enterococci from clinical sources of uncertain taxonomic position. Our results indicate that 6 human strains, a single clinical isolate and a strain from bovine mastitis are genetically distinct from each other and all other previously described Enterococcus species and constitute three new species, for which the names Enterococcus raffinosus, Enterococcus solitarius and Enterococcus pseudoavium are proposed.

Base Composition↗