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Biomedical subjects

R Rennie

Publications and source records attributed to R Rennie.

At least 19 recordsLinked to original sources
PubMed2006

Interlaboratory study of quality control isolates for a broth microdilution method (modified CLSI M38-A) for testing susceptibilities of dermatophytes to antifungals.

The Clinical and Laboratory Standards Institute (CLSI; formerly National Committee for Clinical Laboratory Standards, or NCCLS) M38-A standard for the susceptibility testing of filamentous fungi does not specifically address the testing of dermatophytes. In 2003, a multicenter study investigated the reproducibility of the microdilution method developed at the Center for Medical Mycology, Cleveland, Ohio, for testing the susceptibility of dermatophytes. Data from that study supported the introduction of this method for testing dermatophytes in the future version of the CLSI M38-A standard. In order for the method to be accepted by CLSI, appropriate quality control isolates needed to be identified. To that end, an interlaboratory study, involving the original six laboratories plus two additional sites, was conducted to evaluate potential candidates for quality control isolates. These candidate strains included five Trichophyton rubrum strains known to have elevated MICs to terbinafine and five Trichophyton mentagrophytes strains. Antifungal agents tested included ciclopirox, fluconazole, griseofulvin, itraconazole, posaconazole, terbinafine, and voriconazole. Based on the data generated, two quality control isolates, one T. rubrum isolate and one T. mentagrophytes isolate, were identified and submitted to the American Type Culture Collection (ATCC) for inclusion as reference strains. Ranges encompassing 95.2 to 97.9% of all data points for all seven drugs were established.

Antifungal Agents↗
PubMed2005

Routine antimicrobial susceptibility testing of coagulase-negative staphylococci isolated from blood cultures: is it necessary?

The clinical significance of discontinuing routine antibiotic susceptibility testing (AST) of coagulase-negative Staphylococcus (CNS) isolates from blood cultures was investigated. Prospectively, AST was requested primarily for patients with serious underlying illnesses. Antibiotic use did not change significantly when AST was not performed routinely. Laboratory cost savings were 75% if AST was not performed, but more specimens were submitted from these patients. Oxacillin resistance in coagulase-negative staphylococci from blood cultures has remained > 70% since implementation of this protocol, while annual vancomycin utilisation has shown only small, incremental increases. Therefore, it is suggested that routine AST of CNS isolates from blood culture is not essential.

Adolescent↗
PubMed2004

Development of a standardized susceptibility test for campylobacter with quality-control ranges for ciprofloxacin, doxycycline, erythromycin, gentamicin, and meropenem.

A standardized agar dilution susceptibility testing method was developed for Campylobacter that consisted of testing on Mueller-Hinton medium supplemented with 5% defibrinated sheep blood in an atmosphere of 10% CO2, 5% O2, and 85% N2. Campylobacter jejuni ATCC 33560 was identified as a quality-control (QC) strain. Minimal inhibitory concentration (MIC) QC ranges were determined for two incubation time/temperature combinations: 36 degrees C for 48 hr and 42 degrees C for 24 hr. Quality-control ranges were determined for ciprofloxacin, doxycycline, erythromycin, gentamicin, and meropenem. For all antimicrobial agents tested at both temperatures, 95-100% of the QC MIC results fell within recommended QC ranges. Twenty-one Campylobacter clinical isolates, encompassing five species of Campylobacter (C. jejuni, C. coli, C. jejuni, subsp. doylei, C. fetus, and C. lari) were tested in conjunction with the C. jejuni QC strain. While C. jejuni and C. coli could be reliably tested under both test conditions, growth of C. jejuni subsp. doylei, C. fetus, and C. lari isolates was inconsistent when incubated at 42 degrees C. Therefore, it is recommended that these species only be tested at 36 degrees C.

Campylobacter↗
PubMed2004

Quality control limits for voriconazole disk susceptibility tests on Mueller-Hinton agar with glucose and methylene blue.

An international collaborative study was performed in order to propose quality control limits for voriconazole disk diffusion tests on Mueller-Hinton agar with 2% glucose and 0.5 micro g of methylene blue per ml. The supplement may be added to the agar before autoclaving, or Mueller-Hinton agar plates may be flooded with a glucose-methylene blue solution. Replicate tests on both types of agar plates with 1- micro g voriconazole disks generated data to propose zone size limits for tests of Candida parapsilosis ATCC 22019 (28 to 37 mm), Candida albicans ATCC 90028 (31 to 42 mm), and Candida krusei ATCC 6258 (16 to 25 mm). Candida tropicalis ATCC 750 was not useful for this purpose.

Agar↗
PubMed2003

Quality control limits for fluconazole disk susceptibility tests on Mueller-Hinton agar with glucose and methylene blue.

An international collaborative study was performed in order to propose quality control limits for fluconazole disk diffusion susceptibility tests on Mueller-Hinton agar with 2% glucose and 0.5 micro g of methylene blue per ml. The supplements may be added before autoclaving the agar, or Mueller-Hinton agar plates may be flooded with a glucose-methylene blue solution. Replicate tests on both types of agar plates generated data to propose zone size limits for tests of Candida parapsilosis ATCC 22019 (22 to 33 mm), C. tropicalis ATCC 750 (26 to 37 mm), and C. albicans ATCC 90028 (28 to 39 mm). C. krusei ATCC 6258 was not useful for this purpose.

Agar↗
PubMed2001

Characterization of Pseudomonas aeruginosa isolates: occurrence rates, antimicrobial susceptibility patterns, and molecular typing in the global SENTRY Antimicrobial Surveillance Program, 1997-1999.

During 1997-1999, a total of 70,067 isolates (6631 Pseudomonas aeruginosa isolates) were analyzed in the SENTRY program by geographic region and body site of infection. The respiratory tract was the most common source of P. aeruginosa. P. aeruginosa isolation rates increased during the study interval. Europe was the only region to show a significant decline in beta-lactam and aminoglycoside susceptibility rates. There was a reduction in the rates of susceptibility of Canadian isolates to imipenem and of Latin American isolates to meropenem. A total of 218 multidrug-resistant P. aeruginosa isolates (MDR-PSA; resistant to piperacillin, ceftazidime, imipenem, and gentamicin) were observed; MDR-PSA occurrence rates (percentages of all isolates) ranged from 8.2% (Latin America) to 0.9% (Canada). No antimicrobial inhibited >50% of MDR-PSA strains. Molecular characterization of selected, generally resistant strains was performed. Isolates showing unique ribogroups were found in Europe, Latin America, and the United States, but clonal spread was documented in several medical centers.

Anti-Bacterial Agents↗
PubMed2001

Sputum isolation of Wangiella dermatitidis in patients with cystic fibrosis.

We report a case of invasive fungal pulmonary infection in a cystic fibrosis patient. Clinical deterioration coincided with isolation of Wangiella dermatitidis from her sputum, and treatment with amphotericin B followed by voriconazole resulted in clinical improvement and sterilization of the sputum. This case suggests that W. dermatitidis may be an etiologic agent of invasive pulmonary disease in the cystic fibrosis population.

Adult↗
PubMed2000

Acute vaginal candidosis model in the immunocompromized rat to evaluate delivery systems for antimycotics.

A rat model of vaginal candidosis, suitable for screening new antifungal compounds or novel formulations was developed and validated. Two strains of Candida albicans, different inoculation schedules, quantitative assays for fungal burden and the necessity for immunosuppression were tested. The infection was evaluated clinically and histologically by fungal counts from the vaginal discharge. The animals without immunosuppression did not sustain the infection beyond 2-3 days, however, after immunosuppression with cyclophosphamide, the infection can be maintained for about 2 weeks and is suitable for the testing of topical antifungal therapies.

Acute Disease↗
PubMed1998

Clinical evaluation of the ASTY colorimetric microdilution panel for antifungal susceptibility testing.

A method using a commercially prepared colorimetric microdilution panel (ASTY; Kyokuto Pharmaceutical Industrial Co., Ltd.) was compared in four different laboratories with the National Committee for Clinical Laboratory Standards (NCCLS) reference microdilution method by testing 802 clinical isolates of Candida spp. (C. albicans, C. glabrata, C. tropicalis, C. parapsilosis, C. krusei, C. lusitaniae, C. guilliermondii, C. lipolytica, C. rugosa, and C. zeylanoides) against amphotericin B, 5-fluorocytosine (5FC), fluconazole, and itraconazole. Reference MIC endpoints were established after 48 h of incubation, and ASTY endpoints were established after 24 and 48 h of incubation. ASTY endpoints were determined to be the time at which the color of the first well changed from red (indicating growth) to purple (indicating growth inhibition) or blue (indicating no growth). Excellent agreement (within 2 dilutions) between the reference and colorimetric MICs was observed. Overall agreement was 93% at 24 h and 96% at 48 h. Agreement ranged from 90% with itraconazole and 5FC to 96% with amphotericin B at 24 h and from 92% with itraconazole to 99% with amphotericin B and 5FC at 48 h. The ASTY colorimetric microdilution panel method appears to be comparable to the NCCLS reference method for testing the susceptibilities of Candida spp. to a variety of antifungal agents.

Amphotericin B↗
PubMed1997

Release of Candida albicans yeast antigens upon interaction with human neutrophils in vitro.

Candida albicans is the leading cause of invasive candidosis. As conventional tests do not reliably detect invasive infection, attention has turned to the detection of C. albicans antigens circulating in blood. As antigen tests for invasive candidosis could be improved if C. albicans antigens released upon phagocytosis were defined, this study was undertaken to characterise antigens released during the interaction of yeasts and human neutrophils in vitro. An enzyme immunoassay developed previously to detect what were believed to be predominantly C. albicans cytoplasmic antigens in patients with invasive candidosis was used to follow the neutrophil-mediated release of yeast antigens. Serum opsonisation enhanced antigen release, which was rapid and essentially complete by 1 h. When fresh C. albicans yeasts were added to medium from cultures of neutrophils plus yeasts or neutrophils plus latex beads, additional yeast antigens were released. Medium from neutrophils plus yeasts or from yeasts alone had similar immunoblot patterns with rabbit antibodies to a C. albicans cytoplasmic antigen preparation, with the reactive antigens generally being of higher mol. wt than the reactive antigens in the antigen mixture used for preparation of the antiserum. The two supernates also had similar immunoblot patterns with rabbit anti-C. albicans cell-wall mannan antibodies. These results suggest that yeast surface antigens are released quickly during phagocytosis by neutrophils. Detection of such yeast surface antigens, possibly together with selected yeast cytoplasmic antigens, should improve the sensitivity of C. albicans antigen assays.

Animals↗
PubMed1994

Evaluation of enzyme immunoassay for Candida cytoplasmic antigens in neutropenic cancer patients.

A Candida albicans cytoplasmic antigen enzyme immunoassay (CACP antigen EIA) was developed with antibodies raised against antigens prepared from yeast cells grown under standardized growth conditions. The C. albicans components reactive in the EIA were shown to be predominantly proteins with associated carbohydrates. Denaturing gel electrophoresis revealed the presence of five major CACP proteins with molecular weights between 36,000 and 44,000. The clinical usefulness of the CACP EIA was evaluated by retrospective blinded measurement of 89 serum samples from 31 granulocytopenic patient episodes. Twice-weekly surveillance cultures, sequential serum samples (approximately once per week or with change of the clinical course), and standard diagnostic criteria of fungal infection were used to categorize patients. The sensitivity and specificity of the CACP assay on the basis of serum samples were 82 and 100%, respectively (67 and 100% on the basis of patient episodes). The positive and negative predictive values were 100 and 97% for serum (100 and 93% for patient episodes). By comparison, the CANDTEC assay had low sensitivity (33%) and poor positive predictive values (50%). The CACP EIA may be a useful test suitable for further evaluations as a method for the diagnosis of invasive Candida infection in neutropenic cancer patients.

Adult↗
PubMed1992

Disseminated candidiasis due to amphotericin B-resistant Candida albicans.

Although development of resistance in Candida albicans to amphotericin B is considered rare, C. albicans was persistently recovered from a 28-year-old man after a prolonged course of broad-spectrum antimicrobial therapy for a pancreatic abscess. Determination of the MICs of drugs for C. albicans in Sabouraud broth revealed MICs of 2.5 mg/l amphotericin B, greater than 40 mg/l ketoconazole, 2.5 mg/l miconazole, and greater than 40 mg/l 5-fluorocytosine. Synergy testing revealed a MIC of 0.3 mg/l amphotericin B in the presence of 2.5 mg/l 5-fluorocytosine. When intravenous 5-fluorocytosine was added to the patient's antifungal regimen, achieving levels of 125 mg/l, negative blood cultures resulted for the first time. This suggests there may be a clinical use for in vitro synergy testing as an adjunct to guide antifungal therapy for fungemia due to amphotericin B-resistant C. albicans.

Abscess↗
PubMed1992

Laboratory and clinical evaluations of media for the primary isolation of Haemophilus species.

There has not previously been an objective comparison of medium formulations for the primary isolation of Haemophilus species. This study was undertaken to evaluate the components required for the optimal growth of large, easily identifiable colonies of these bacteria. We compared six medium bases and seven supplements for their ability to support the growth of 86 strains of Haemophilus influenzae and 17 strains of other species of Haemophilus. By using a growth index that combines colony size and the dilution factor, a formulation of GC agar base with 1% yeast autolysate and 5% sheep blood (chocolated) promoted the growth of large, easily recognizable colonies of H. influenzae and other Haemophilus species. This medium was designated GCYSB. The addition of hematin to supplements that supplied NAD (or factor V) to the medium was inhibitory to the growth of all of the Haemophilus species tested. In a clinical comparison of GCYSB with routinely used chocolate agar medium in two laboratories for the primary isolation of Haemophilus species, overall GCYSB promoted better growth of 124 strains of H. influenzae and H. parainfluenzae. GCYSB is easy to prepare and inexpensive compared with the ease of preparation and expense of other Haemophilus isolation media.

Bacteriological Techniques↗
PubMed1992

Neonatal Campylobacter fetus meningitis: a report of an unusual case.

Campylobacter fetus is a rare cause of meningitis in the pediatric age group and, in particular, among neonates. The clinical presentation of campylobacter meningitis in high-risk neonates is not well-described. A review of campylobacter meningitis by Lee et al in 1985 reported nine cases occurring in neonates, of which only one case was caused by C. fetus. In the ensuing six years only three more confirmed cases of neonatal meningitis caused by C. fetus have been reported. We here report another confirmed case of C. fetus meningitis in a neonate.

Campylobacter Infections↗
PubMed1991

Sensitivity of CAPD/IPD peritonitis organisms to ciprofloxacin.

Studies have suggested that oral quinolones may be useful in the treatment of peritonitis in peritoneal dialysis. We undertook a study of organisms causing peritonitis in our IPD and CAPD populations to determine if these organisms would be susceptible in vitro to Cipro. We determined the minimal inhibitory concentrations (MIC) of 62 non-duplicate isolates from episodes of peritonitis to Cipro by standard broth microdilution. Serial dilutions were done with Cipro and MIC50 and MIC90 were determined. The isolates were as follows: S, epidermidis (17), S. aureus (14), coliforms (11), Pseudomonas (8), Enterococci (8), Diphtheroids (4). The MIC50 and MIC90 for each of the isolate groups and overall are shown below.

Ciprofloxacin↗
PubMed1987

Data collection and analysis from a respiratory inductance plethysmograph.

A respiratory inductance plethysmograph, Respitrace, was used to assess the respiratory effects of narcotic analgesia for the first 24 hours after surgery. Data were collected on-line from the plethysmograph with an Apple][+ microcomputer and stored on disc for later analysis of respiratory rates and tidal volumes, and also periods of central or obstructive apnoea using the difference in phase angle between the abdominal and respiratory components. This involved the measurement of, on average, more than 20,000 breaths per patient and techniques of data compression were required to store this amount of information on a single floppy disc. Frequent nursing interventions reduced the accuracy of tidal volume and phase angle measurements, but respiratory rates were obtained accurately breath by breath.

Calibration↗