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Biomedical subjects

A C Sonnenwirth

Publications and source records attributed to A C Sonnenwirth.

At least 19 recordsLinked to original sources

Purulent pericarditis complicating systemic infection with Candida tropicalis.

A patient with a purulent pericarditis due to Candida tropicalis is described. A 77-year-old woman undergoing chemotherapy for Hodgkin's disease was admitted to the hospital with a history of several febrile episodes. She was thought to be septic and was begun on broad-spectrum antibiotics, despite treatment, however, the patient expired. Among the multiple premortem blood, urine, and cerebrospinal fluid cultures, one blood culture yielded C. tropicalis 2 days postmortem. Autopsy revealed purulent pericarditis accompanied by endocarditis and myocarditis due to culture-proven C. tropicalis. This is the first reported case of purulent pericarditis complicating systemic infection with this organism and is indicative of the fulminant course of fungal pericarditis.

Aged↗

Rapid isolation of Yersinia spp. from feces.

Direct plating or cold enrichment or both have been used to isolate Yersinia spp. from feces. Freeze-shock double enrichment and KOH treatment have been recommended for recovery of Yersinia enterocolitica from surface waters and food, respectively. These techniques were evaluated as alternatives for rapid recovery of Yersinia spp. from feces. Stool samples were homogenized in buffered saline and autoclaved. Escherichia coli. Klebsiella pneumoniae, and Pseudomonas aeruginosa were each added to the suspension at a final concentration of 1.5 x 10(6) colony-forming units per ml. Yersinia cells were then added to a final concentration of 1.5 x 10(3), 1.5 x 10(4), 1.5 x 10(5), or 1.5 x 10(6) colony-forming units per ml. A total of 21 strains of Y. enterocolitica, 2 of Yersinia kristensenii, and 1 each of Yersinia intermedia and Yersinia fredriksenii were tested. For freeze-shock double enrichment, seeded stool samples were frozen overnight (-70 degrees C), transferred successively to m-tetrathionate broth (6 h. 37 degrees C) and selenite broth (2 h 37 degrees C), and plated on MacConkey, salmonella-shigella, and cellobiose-arginine-lysine agars for quantitation. For KOH treatment, seeded stool samples were mixed with 0.5% KOH at a ratio of 1:2 for 2 min and plated as described above. E. coli, K. pneumoniae, and P. aeruginosa were virtually eliminated after either method was used. All Yersinia strains were recovered after KOH treatment even at the lowest initial concentration (1.5 x 10(3) colony-forming units per ml). However, after freeze-shock double enrichment, not all strains were retrievable, and those isolates which were recovered were grown only from samples containing the highest number of Yersinia strains (1.5 x 10(6) colony-forming units per ml). KOH treatment of stool samples seems to be a viable substitute for more protracted methods of recovering Yersinia spp.

Cold Temperature↗

Comparison of several test systems used for determination of rubella immune status.

Hemagglutination inhibition (HAI) is currently the most widely used technique for the determination of rubella immune status. However, two new methods, enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence (FIAX), have also been adapted for this purpose. In comparing a commercially available ELISA system (BIO-BEAD, Litton Bionetics) with an HAI system (RUBA-tect, Abbott Laboratories), some ELISA-positive sera were found to be rubella antibody negative by the HAI system. To determine which of these results more accurately reflected the immune status of the patient, 74 RUBA-tect-negative sera were retested by ELISA BIO-BEAD, FIAX (International Diagnostic Technology) and by modified HAI, employing fresh erythrocytes (using Flow Laboratories reagents). Eleven RUBA-tect-negative sera (15%) were positive by ELISA, FIAX, and modified HAI. Two sera were positive only by ELISA and FIAX, two sera were positive by ELISA and HAI, four sera were positive by ELISA only, and one serum was positive by FIAX only. Neutralization assays were subsequently performed on sera positive by only one or two of the procedures to determine the presence of protective rubella antibodies in these sera; all but three of the sera were positive for neutralizing antibody. Commercial ELISA and FIAX systems appear to be more sensitive indicators of rubella immune status than are commercial HAI kits which use stabilized erythrocytes. Neither ELISA nor FIAX require extraction of serum; moreover, the ELISA BIO-BEAD test assay can be performed without an expensive instrument for reading.

Enzyme-Linked Immunosorbent Assay↗

New latex agglutination test for rapid determination of rubella immune status.

A prototype rubella latex agglutination card assay (Hynson, Westcott and Dunning, Baltimore, Md.) was compared with a standard hemagglutination inhibition test for the detection of rubella antibodies in 500 sera. The sensitivity and specificity of the latex agglutination assay were 100% and 94%, respectively. This assay did not require pretreatment of serum, and the entire assay could be performed in 10 min.

Antibodies, Viral↗

Rapid detection and identification of Bacteroides fragilis and Bacteroides melaninogenicus by immunofluorescence.

Bacteroides fragilis group and Bacteroides melaninogenicus group fluorescent-antibody kits were evaluated with 188 clinical specimens and 116 fresh aerobic and anaerobic bacterial isolates. Fluorescent-antibody and culture results corresponded in 88% of clinical specimens of the B. fragilis group and 94% of clinical specimens of the B. melaninogenicus group. There was greater than or equal to 90% correlation for both kits with colony smears. Antigen sharing by Bacteroides bivius, Bacteroides disiens, and B. melaninogenicus was demonstrated.

Bacteriological Techniques↗

Corynebacterium group JK bacterial infection in a patient with an epicardial pacemaker.

Septicemia caused by Corynebacteria group JK bacterium has previously been reported to occur in patients who have predisposing illness, such as neoplasms, ventriculoatrial shunt, or prosthetic valve. This study documents the case of an epicardial abscess caused by a Corynebacterium group JK organism in a 69-year-old woman who had an epicardial pacemaker.

Abscess↗

Comparison of anaerobic susceptibility results obtained by different methods.

Susceptibility tests using 7 antimicrobial agents (carbenicillin, chloramphenicol, clindamycin, penicillin, cephalothin, metronidazole, and tetracycline) were run against 35 anaerobes including Bacteroides fragilis (17), other gram-negative bacilli (7), clostridia (5), peptococci (4), and eubacteria (2). Results in triplicate obtained by the microbroth dilution method and the aerobic modification of the broth disk method were compared with those obtained with an agar dilution method using Wilkins-Chalgren agar. Media used in the microbroth dilution method included Wilkins-Chalgren broth, brain heart infusion broth, brucella broth, tryptic soy broth, thioglycolate broth, and Schaedler's broth. A result differing by more than one dilution from the Wilkins-Chalgren agar result was considered a discrepancy, and when there was a change in susceptibility status this was termed a significant discrepancy. The microbroth dilution method using Wilkins-Chalgren broth and thioglycolate broth produced the fewest total discrepancies (22 and 24, respectively), and Wilkins-Chalgren broth, thioglycolate, and Schaedler's broth had the fewest significant discrepancies (6, 5, and 5, respectively). With the broth disk method, there were 15 significant discrepancies, although half of these were with tetracycline, which was the antimicrobial agent associated with the highest number of significant discrepancies (33), considering all of the test methods and media.

Anaerobiosis↗

Constraints under which the microbiology laboratory functions.

The relevance, usefulness, quality, and cost of performance of many clinical microbiology laboratories have been questioned. Major, common constraints under which most microbiology laboratories operate in the United States include lack of trained manpower, wide variation in the level and sophistication of clinical microbiology service, lack of physician-laboratory communication and interaction, inadequacies in medical education, and often inadequate laboratory space. Governmental regulations, requirements, and standards have improved the quality of many laboratories' work, but also result in greatly increased costs, excesses of often trivial procedures, and diversion of trained manpower from clinical service to regulatory procedures, with a resulting increase in manpower needs. The usefulness, relevance, and cost of regulatory requirements and procedures are unknown. Lack of reliable, standardized reagents impedes utilization of rapid and low cost procedures, and proliferation of complex tests results in costly additional demands on existing manpower.

Bacterial Infections↗

Proteus rettgeri infections: a review.

Proteus rettgeri is an aerobic gram-negative bacillus that displays marked resistance against most of the antibiotics presently available. This organism causes infections usually confined to the urinary tract of certain types of compromised patients. Occasionally, it is recovered from soft tissue abscesses, and rarely from the blood and respiratory tract. Proteus rettgeri is notorious for causing nosocomial outbreaks of urinary tract infections in urological and physical medicine wards. Our experience with a patient who had bacteremia with a multi-drug resistant strain of Proteus rettgeri prompted a review of the literature concerning infections with this organism. The salient features of these reports are discussed and summarized. Data on the antibiotic sensitivity of 15 other strains of Proteus rettgeri are included.

Adolescent↗

Preprototype of an automated microbial detection and identification system: a developmental investigation.

The AutoMicrobic System is an automated, computerized instrument that uses highly selective media and an optical system for detection, enumeration, and identification of bacteria and some yeasts in 13 h. A preprototype instrument (AutoMicrobic System-1) and its urine culture kit (Identi-Pak), developed for the detection, enumeration, and identification of eight species or groups of bacteria and of Candida species and Torulopsis glabrata in urine specimens, was evaluated during its development. An overall agreement of approximately 90% between the preprototype instrument and conventional (manual) culture methods has been obtained both with 1,473 seeded (simulated) and 1,688 clinical (mono- or polymicrobial) specimens containing 70,000 (or more) colony-forming units per ml of Escherichia coli, Klebsiella-Enterobacter species, Proteus species, Citrobacter freundii, Serratia species, group D enterococci, or yeasts (Candida species and T. glabrata). Lower agreements in identification were obtained with Pseudomonas aeruginosa-containing (average of 75% in clinical specimens) and Staphylococcus aureus-containing (76%) specimens. Comparison of specimens tested simultaneously in two preprototype systems resulted in =/<4% disagreement; true negativity agreements in all specimen groups tested were at least 94%. Among problems remaining are adaptation of system for specimens other than urine, improvement of sensitivity for P. aeruginosa and S. aureus, and standardization of manual methods used for comparison and validation.

Bacteria↗

An outbreak of nosocomial Proteus rettgeri urinary tract infection.

Between December 1, 1971, and November 30, 1972, 11 patients on a single physical rehabilitation ward in a large St. Louis, Missouri, community hospital developed Proteus rettgeri urinary tract infections; P. rettgeri isolates from each patient were indole-negative and resistant in vitro to all antibiotics tested. Infected patients were more likely to have indwelling urinary tract catheters than were matched control patients, and all had previously received systemic antibiotic therapy. Retrospective epidemiologic investigation and microbiologic samplig at the time of the investigation failed to detect a common source of infection. Infected patients appeared to be the major reservoir of the epidemic strain, and indirect-contact transmission of the organism via nursing personnel probably occurred. Data collected from a prospective study suggested that placing catheterized patients in rooms that did not contain other catheterized patients may be an effective control measure.

Anti-Bacterial Agents↗