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Pyrolysis-mass spectrometry (Py-MS) for the rapid epidemiological typing of clinically significant bacterial pathogens.

Fresh clinical isolates of Salmonella spp. and Streptococcus pyogenes were analysed by pyrolysis-mass spectrometry (Py-MS). The results formed the basis of mathematically derived characterizations of individual strains and these were compared with the results of phage typing for the salmonellas and M protein typing for the streptococci. Py-MS was shown to be a rapid and reproducible method for inter-strain comparisons, giving evidence of identity and non-identity between strains that agreed well with the results of conventional tests. Py-MS has potential value as a rapid, relatively inexpensive and highly discriminatory method of epidemiological analysis in bacterial disease.

Bacterial Typing Techniques↗

Epidemiological typing of coagulase-negative staphylococci by pyrolysis mass spectrometry.

Pyrolysis mass spectrometry (PMS) was evaluated for the epidemiological typing of coagulase-negative staphylococci (CNS) in situations in which it was necessary to distinguish between repeated isolation of the same strain from a single patient (genuine infection) and coincidental isolation of unrelated strains (contamination). Thirteen CNS isolates were examined, consisting of five pairs, each pair isolated from a single patient, and three unrelated strains. PMS analysis gave results equivalent to a conventional typing system comprising antibiogram, biotype and plasmid profile analysis. Both methods facilitate differentiation between genuine infection with CNS and the isolation of contaminants. The speed, reproducibility, versatility and relatively low cost of PMS suggest that it may be a valuable new technique for the epidemiological typing of CNS in routine clinical settings.

Coagulase↗

Typing of Streptococcus pyogenes by pyrolysis mass spectrometry.

Strains of Streptococcus pyogenes from an outbreak in an oncology ward (13) and routine isolates from sporadic cases (6) were examined blind by pyrolysis mass spectrometry (Py-MS), extending previous work on epidemiological typing. This outbreak appeared more complex than one reported previously, but Py-MS and conventional typing results were in complete agreement. The results confirm the potential of Py-MS as a rapid method for identification at strain level in studies of cross infection.

Bacterial Typing Techniques↗

A numerical taxonomic study of the "Streptococcus milleri" group based upon conventional phenotypic tests and pyrolysis mass spectrometry.

Clinical strains presumptively identified as Streptococcus milleri (60), and blind coded collection strains (21) were characterised in conventional tests and pyrolysis mass spectrometry. Comparison of the clusters found by these two approaches revealed five clearly distinct centres of variation. Three corresponded to the DNA homology groups suggested by Whiley and Hardie (1989) as representing the species S. anginosus, S. intermedius and S. constellatus; a fourth comprised three Lancefield group C beta-haemolytic strains; the fifth may represent a biotype of S. anginosus. The characteristics of the latter group are described.

Cluster Analysis↗

Classification of oral pigmented anaerobic bacilli by pyrolysis mass spectrometry and biochemical tests.

Clinical (66) and reference (5) strains of pigmented gram-negative anaerobic bacilli, identified as Prevotella intermedia (47), Pr. melaninogenica (1), Pr. corpora (8), Porphyromonas asaccharolyticus (12), P. endodontalis (1) and P. gingivalis (2), were examined by pyrolysis mass spectrometry (PMS) and in conventional tests. Numerical classification based on conventional test reaction patterns (CTRPs) resolved five clusters, four comprising strains identified as Pr. intermedia, Pr. corpora, Pr. melaninogenica, and P. gingivalis respectively, and one comprising strains identified as P. asaccharolyticus and P. endodontalis. Numerical classification based on PMS showed a similar division, with decreasing homogeneity of chemical composition in the order Pr. intermedia, Pr. corpora, P. asaccharolyticus, which agreed with the order of homogeneity in CTRPs. PMS clusters corresponding to the genus Porphyromonas were clearly distinct from those of the genus Prevotella. PMS and CTRP classification disagreed on cluster membership for six strains. PMS identification from blind challenge sets was in agreement with conventional identification for 64 of 67 strains.

Cluster Analysis↗

A pyrolysis mass spectrometry study of the non-pigmented Prevotella species.

Collection strains (21) and non-pigmented clinical isolates (96) provisionally identified as Prevotella spp. were classified numerically on the basis of pyrolysis mass spectrometry (PMS) data and reaction patterns in conventional tests (CTRPs) for volatile and non-volatile fatty acids, pre-formed enzymes and biochemical activity. PMS and CTRP classifications were compared with a previous classification based on visual analysis of SDS-PAGE patterns. Although the order of clusters differed, cross-tabulation of cluster membership revealed strong correlations between classifications. Cluster membership in the PMS classification correlated particularly well with SDS-PAGE results. CTRP clusters corresponded largely to the recognised species of Prevotella, but PMS and SDS-PAGE divided two species into sub-groups: two in P. buccae and five in P. veroralis. The latter subgroups could be discriminated by small but consistent differences in CTRPs. An undesignated, well differentiated cluster of strains appeared closest to the main group of P. buccae strains in PMS and CTRPs. B. (P.) capillus could not be distinguished from P. buccae; these species are regarded as synonymous. Strains of P. zoogleoformans and B. (P.) pentosaceus were well separated from other strains in PMS. A complex comprising clusters of P. disiens, P. oralis, P. veroralis, P. loescheii and a further undesignated group similar to P. melaninogenica was well differentiated from P. buccae and P. oris in PMS; clusters corresponding to P. bivia, P. corporis, P. intermedia and P. denticola formed another complex.

Bacterial Typing Techniques↗

Nosocomial infection with Clostridium difficile investigated by pyrolysis mass spectrometry.

Fifty-eight isolates of Clostridium difficile from two distinct outbreaks were examined for inter-strain similarity by pyrolysis mass spectrometry (PMS). The first outbreak began on a geriatric acute unit and spread to a long stay geriatric facility. PMS analysis showed that most isolates from both sites were indistinguishable. Isolates obtained in the preceding year from the long stay facility were found to be closely similar to these outbreak isolates. In the second, smaller outbreak on a female medical ward in another general hospital, PMS again showed that a single strain was probably responsible. Representative isolates from these two different outbreaks were shown to be distinct. The ability to compare rapidly large numbers of isolates of C. difficile makes PMS attractive for initial screening in suspected outbreaks, providing important information for outbreak management and allowing conventional typing methods to be concentrated on relevant isolates.

Aged↗

An investigation of a nosocomial outbreak of Clostridium difficile by pyrolysis mass spectrometry.

Isolates from a presumptive nosocomial outbreak of Clostridium difficile infection at a large teaching hospital were typed by pyrolysis mass spectrometry (PMS) and antibiograms. One isolate, from the putative index case, was dissimilar from the outbreak strain, but 24 isolates from 16 patients were indistinguishable by both methods. The outbreak centred on two wards for the acute care of the elderly, with a few cases elsewhere. Transfer of patients appeared to be the route of transmission between wards. There was a significant fall in the incidence of cases following intervention by the Infection Control Unit. This included ward inspection, advice on antibiotic usage and advice on prevention of faecal-oral transfer, particularly by proper handwashing. Subsequent monitoring of C. difficile infection showed a background of sporadic, dissimilar isolates with occasional apparent cross-infection incidents limited to a few patients. In suspected outbreaks, patterns of antibiotic susceptibility may be useful in initial screening, before referral for more sophisticated typing. There was excellent correlation between PMS results, antibiograms and epidemiological information.

Aged↗

Pyrolysis typing of isolates from a recurrence of systemic cryptococcosis.

Cryptococcal meningitis was diagnosed in a 71-year-old male diabetic patient with underlying ischaemic heart disease, asthma and bilateral axillo-femoral vascular grafts. After treatment with fluconazole for 2 months, the patient appeared to be cured. Two years later he presented with an aneurysm of the right graft that was resected and replaced with a new graft segment. Cryptococcus neoformans var. neoformans was grown from post-operative blood cultures and samples of the excised graft. The patient was treated with fluconazole and discharged after 6 weeks. Multiple isolates from both episodes had been preserved, and these, together with isolates from other UK patients, were cultured in duplicate, blind coded and characterised by pyrolysis mass spectrometry (PMS). Duplicate culture and re-isolate sets formed tight clusters, with each patient set clearly distinct. Sets of isolates from the two episodes in this patient formed a single tight cluster and were indistinguishable by PMS. These results support the contention that C. neoformans infection can be reactivated after being dormant for a prolonged period.

Aged↗

Rapid identification of species within the Mycobacterium tuberculosis complex by artificial neural network analysis of pyrolysis mass spectra.

An artificial neural network (ANN) was trained to distinguish between Mycobacterium tuberculosis and M. bovis with averaged pyrolysis mass spectra from duplicate subcultures of four strains of each of these species, each pyrolysed in triplicate. Once trained, the ANN was interrogated with spectrum data from the original organisms (the "training set") and from 26 other mycobacterial isolates (the "challenge set") of the M. tuberculosis complex (MTBC). Eight strains of M. bovis and 13 of M. tuberculosis, whether sensitive or variously resistant to antituberculosis drugs, were identified in agreement with conventional identification. Four strains of "M. africanum" were identified as M. bovis. Of two atypical M. tuberculosis strains from South India, one was identified as M. tuberculosis and the other as M. bovis. Six strains of BCG proved heterogeneous; two gave equivocal identifications, three were identified as M. bovis and one was identified as M. tuberculosis.

Humans↗

Application of pyrolysis mass spectroscopy and SDS-PAGE in the study of the epidemiology of Pseudomonas cepacia in cystic fibrosis.

Representative isolates of Pseudomonas cepacia from 15 cystic fibrosis (CF) patients attending the Respiratory Unit of Alder Hey Childrens' Hospital were investigated by SDS-PAGE of whole-cell polypeptides and by pyrolysis mass spectroscopy (PMS). SDS-PAGE was less discriminatory than PMS. Eleven isolates were indistinguishable by PMS and considered to represent re-isolates of an endemic strain; four isolates were distinct from this group, and from one another. P. cepacia was first isolated on the unit in July 1989 from a patient who had attended a UK selection meeting for a Canadian CF camp. A ward and outpatient segregation policy was introduced, but colonisation of further patients occurred. In August 1991, the Adult CF Association recommended that all social activities involving colonised patients should cease. This, and an increased awareness amongst older CF patients of the risks of person-to-person transmission, was associated with a marked decline in new cases. Social activity and hospital admissions were compared for colonised patients during the year before colonisation with P. cepacia, and matched patients who did not acquire the endemic strain. This showed a significantly higher attendance at CF social events for colonised patients, but no significant association between colonisation and hospital admission. These results are strong indirect evidence that transmission of P. cepacia occurs through social contact outside the hospital environment.

Adolescent↗

Rapid characterisation of Candida albicans by pyrolysis mass spectrometry.

Clinical isolates (41) of Candida spp. from three possible outbreaks of nosocomially-acquired infection were compared by pyrolysis mass spectrometry (PMS) and by a combined morphotyping and resistotyping (M-R typing) method. Both systems characterised all the isolates and distinguished one isolate of C. tropicalis and another of C. glabrata from the 39 isolates of C. albicans. Results from both systems suggested that cross-infection with a single strain contributed to two of the outbreaks. In several instances, more than one strain of C. albicans was found amongst multiple isolates from the same patient. PMS is a simple, rapid and objective technique capable of characterising C. albicans isolates; discrimination was similar to M-R typing.

Candida albicans↗

A comparative study of Fusobacterium necrophorum strains from human and animal sources by phenotypic reactions, pyrolysis mass spectrometry and SDS-PAGE.

Fusobacterium necrophorum strains from human infection (21) were compared with strains from animals (17 biotype A, 2 biotype AB, 4 biotype B, 1 biotype unknown), and the type strain NCTC 10575 in conventional tests reaction patterns (CTRPs), SDS-PAGE and pyrolysis mass spectrometry (PMS). Classifications from the three approaches showed one major consensus group comprising all human strains, and another comprising animal biotype A strains. Animal biotype B strains and one animal strain, designated with some doubt to biotype A, were outliers of the consensus 'human strain' group. Again, animal biotype AB strains were outliers of the consensus 'animal biotype A group', as was the type strain, which was clearly atypical in conventional tests and PMS. Colonial and microscopic characters showed good discrimination between the major consensus groups. However, only haemagglutination and the API-ZYM leucine arylamidase of the biochemical tests discriminated well between these groups. The 'animal biotype A group' clearly corresponds to F. necrophorum subsp. necrophorum, but synonymy of F. necrophorum subsp. funduliforme with the group of human strains was less certain. The latter subspecies was described solely on the basis of animal strains, all of biotype B, but each of four animal biotype B strains in this study was an outlier of the 'human strain group' in one or more of the characterisation approaches. Strains of F. necrophorum causing human infection were clearly distinct from the biotype A strains commonly found in animal infection. This has implications for the validity of animal models of human necrobacillosis. In view of these differences, it would be useful to have a validated designation for strains causing human infection. However, it would be premature to assume that the definition of F. necrophorum subsp. funduliforme encompasses the human strains in the absence of confirmatory DNA-homology and 16S rRNA-sequencing studies.

Animals↗

Pyrolysis mass spectrometry in epidemiological and population genetic studies of Haemophilus influenzae.

Haemophilus influenzae serotype b (Hib) vaccines have reduced the amount of invasive Hib disease in immunised infants. However, Hib disease remains in unvaccinated infants and adults and non-capsulate H. influenzae (NCHi) still causes infections, including outbreaks of respiratory disease. Characterisation of strains and the bacterial population as a whole is therefore necessary to detect outbreaks of infection with NCHi or changes in the population, for example, to vaccine-resistant clones of Hib. The rapid, simple and objective technique of pyrolysis mass spectrometry (PMS) was investigated as an alternative to current complex, subjective methods. PMS was compared with ribotyping and multilocus enzyme electrophoresis (MLEE) for population genetic analyses of Hib and with ribotyping and protein profiling for epidemiological analyses of NCHi. PMS clustered all the isolates of Hib together whereas MLEE and ribotyping distinguished certain clones - this is probably because the three methods examine different (and unrelated) characteristics of the organisms. The PMS results were essentially similar to those from ribotyping and protein profiling for the epidemiological analyses of outbreaks of NCHi disease. Therefore, PMS is probably unsuitable for comparisons of Hib populations but it is a useful addition to the arsenal of techniques for the characterisation of NCHi.

Adult↗

Differentiation of strains of Mycoplasma fermentans from various sources by pyrolysis mass spectrometry.

Mycoplasma fermentans has attracted much interest both as a cofactor for the progression of AIDS and as a pathogenic agent in non-AIDS related diseases. Previous studies with serological and genetic techniques suggest that M. fermentans represents a homogeneous group of organisms, with no significant differences identified among the strains examined. In this study, 25 cultures of M. fermentans, including isolates from human sources and tissue culture cells, were compared by pyrolysis mass spectrometry (PMS). It was possible to distinguish the 'type' strain PG-18 from an AIDS-associated M. fermentans strain 'incognitus' by this technique. PMS was also able to differentiate laboratory-induced aminoglycoside-resistant variants from their fully susceptible parents. Four AIDS-associated isolates were distinguished from each other, whilst five European cell culture isolates were shown to be closely related, as were six M. fermentans isolates from an outbreak of acute respiratory infection in Canada. PMS has proved useful in distinguishing isolates of M. fermentans, providing epidemiological data. In addition, PMS may help in determining the likely origin of a given isolate, and in the future may be of use in assessing the role of this micro-organism in human disease.

Acquired Immunodeficiency Syndrome↗

PCR-ribotyping and pyrolysis mass spectrometry fingerprinting of environmental and hospital isolates of Clostridium difficile.

The relationships between environmental isolates of Clostridium difficile were examined by two typing methods, PCR ribotyping and pyrolysis mass spectrometry (PyMS). The 184 isolates were divided into 23 different PCR ribotypes, 13 of which were producers of toxins A and B; the remaining 10 types did not produce either toxin A or B. PyMS analysis resolved 31 groups with 60 (32.5%) isolates in one group (group 9). In both methods most of the isolates showed similar clustering. PCR ribotypes of the environmental isolates were compared with those of clinical isolates that had been typed previously. Seventeen PCR types (13 toxigenic PCR types and four non-toxigenic types) were found in both sets of isolates.

Animals↗

XANES analysis of sulfur form change during pyrolysis of coals.

Three kinds of coal and their density separated samples were rapidly pyrolyzed in a free-fall reactor under a nitrogen stream at a terminal temperature of 1253 K. X-ray absorption near edge structure analysis was applied to directly determine the sulfur forms in the coal and pyrolysis char. The results showed that the low-density group contained sulfide and sulfoxide, which could contribute to the high extent of organic sulfur removal. Thermally stable thiophenic sulfur was observed in the higher density groups as a major form of organic sulfur.

Journal Article↗

Characterization of Aspergillus isolates by pyrolysis mass spectrometry.

Pyrolysis mass spectrometry (PYMS) is a useful typing method for many bacterial and Candida species. We attempted to type Aspergillus spp. by PYMS. Four distinct A. fumigatus isolates could not be distinguished from each other, whereas one A. niger and one A. terreus could. Poor reproducibility was shown using multiple identical cultures of a single A. fumigatus isolate and several isolates of the same DNA type. PYMS is obviously an unsuitable typing method for Aspergillus spp.

Aspergillosis↗