Search PubMedSearch

Biomedical subjects

T L Overman

Publications and source records attributed to T L Overman.

15 recordsLinked to original sources

Reproducibility of API Staph-Ident system identifications of coagulase-negative staphylococci isolated from blood.

Fifty-five isolates of coagulase-negative staphylococci from blood were identified four times each by using the API Staph-Ident (API-SI) system to determine the identification reproducibility of the system. Identifications were determined by using both Version 1 and Version 2 of the API-SI Profile Index. The 75 to 100% reproducibility levels, including reproducible nonidentifications, were 98.2% for Version 1 and 96.4% for Version 2. Version 1 gave an identification for 92.5% of the isolates with a 75 to 100% reproducibility, while Version 2 gave an identification for 100% of the isolates with a 75 to 100% reproducibility. The reproducibility of the API-SI identifications of coagulase-negative staphylococci from blood was good.

Bacteriological Techniques

Safety and efficacy of using high-dose topical and nebulized anesthesia to obtain endobronchial cultures.

We evaluated the safety and efficacy of high-dose topical and nebulized airway anesthesia in normal volunteers and in patients undergoing diagnostic fiberoptic bronchoscopy. Lidocaine solution (4 percent) was used for gargling, for spraying the palate and oropharynx with an atomizer, and for nebulization with an air-powered nebulizer (mean total dose, 1,682 mg) and 2 percent lidocaine (Xylocaine) jelly for anesthetizing nasal passages. In six normal subjects and in eight patients, lidocaine blood levels were measured at baseline, after gargling, after spraying, after nebulization, and then at 5, 10, 15, 30, and 60 min; 19 normal subjects and ten patients underwent the same anesthesia protocol but had no blood drawn. Fiberoptic bronchoscopy was performed in 21 normal volunteers and in 18 patients and cultures obtained using the protected specimen brush. Additional endobronchial lidocaine (mean 256 mg) was given to the 18 patients after collecting the microbiology specimens. Peak lidocaine blood levels remained below 6 micrograms/ml in all cases. Cough and discomfort during bronchoscopic examination was absent or minimal in 17 of 21 normal subjects (80 percent) and in 14 of 18 patients (77 percent) and was severe in only one instance (5 percent). There were no related complications. Using only topical and nebulized anesthesia is safe and effective for performing fiberoptic bronchoscopy, especially when bacterial cultures are to be obtained and endobronchial instillation of lidocaine must be avoided.

Adolescent

Vibrio vulnificus sepsis after eating raw oysters.

Vibrio vulnificus, a marine vibrio found in coastal waters of the United States, may contaminate certain seafoods, particularly raw oysters. Patients with underlying liver disease are particularly susceptible to severe illness. Unexplained febrile diseases in patients who have eaten raw oysters may be caused by Vibrio vulnificus. A fatal and a nonfatal case are reported in two such patients. These patients are the first two reported cases of Vibrio vulnificus infection in Kentucky.

Animals

Effect of Prompt Inoculator on results of Sceptor system minimal inhibitory concentration determinations for Listeria monocytogenes.

The minimal inhibitory concentrations (MICs) of eight antimicrobial agents were determined for each of 36 isolates of Listeria monocytogenes with the Sceptor system. Two different inoculation procedures, the standard Sceptor log-phase broth (LB) culture and the Prompt Inoculator (PI) (Bauer-Kirby type), were used. The PI MIC/LB MIC ratio (PI/LB ratio) was determined for each antimicrobial agent for each of the isolates. Of the 217 on-scale PI/LB ratio results, all were within the expected range of 0.5 to 2.0. The PI was found to be a convenient, rapid, and suitable method of preparing an inoculum of L monocytogenes for use with the Sceptor system and should function equally well when testing L monocytogenes isolates with other commercially available MIC systems.

Anti-Bacterial Agents

Feasibility of same-day identification of members of the family Vibrionaceae by the API 20E system.

Sixty isolates, comprising nine species of the family Vibrionaceae, were tested with the API 20E 5-h same-day procedure (Analytab Products, Plainview, N.Y.). Included were 27 Aeromonas hydrophila isolates, 10 Aeromonas sobria isolates, 7 Aeromonas caviae isolates, 3 Plesiomonas shigelloides isolates, 3 Vibrio alginolyticus isolates, 3 Vibrio cholerae isolates, 1 Vibrio fluvialis isolate, 5 Vibrio parahaemolyticus isolates, and 1 Vibrio vulnificus isolate. The 5-h profile numbers were specific for the five Vibrio species and the Plesiomonas isolates. The three Aeromonas species shared seven 5-h profile numbers. Of the 63 5-h profile numbers generated by testing each isolate twice, 22 were identical to those found in the overnight analytical profile index. Of these, 20 were correct identifications, and two were incorrect. The remaining 41 5-h profile numbers were not found in the overnight analytical profile index. Because the 5-h analytical profile index does not contain any oxidase-positive organisms, the oxidase value was subtracted from the 63 5-h profile numbers to determine whether misidentifications could occur if the oxidase test was either not performed or not performed correctly. Only five of these factored profile numbers resulted in a possible misidentification. It is feasible, within limitations, to use the 5-h API 20E same-day procedure to identify the more commonly occurring members of the Vibrionaceae. The manufacturer should develop a data base for this purpose.

Aeromonas

Comparison of the API rapid E four-hour system with the API 20E overnight system for the identification of routine clinical isolates of the family Enterobacteriaceae.

Four hundred forty-one clinical isolates of the family Enterobacteriaceae were identified in parallel by using the API Rapid E 4-h and the API 20E overnight procedures (Analytab Products, Plainview, N.Y.). The results obtained by using the API Rapid E were compared with those obtained by using the API 20E. Discrepancies were resolved by using standard biochemicals. The API 20E identified 98.9% (436 of 441) of the isolates without the use of additional biochemicals and was found to be correct in each case of a discrepancy among the 436 isolates. The API Rapid E gave the same identification as the API 20E for 94.0% (410 of 436) of the isolates, misidentified 3.0% (13 of 436), and gave a correct but low-selectivity answer for the remaining 3.0% (13 of 436). The API Rapid E is a suitable alternative for the rapid identification of the Enterobacteriaceae.

Bacteriological Techniques

Comparison of API 20E, API rapid E, and API rapid NFT for identification of members of the family Vibrionaceae.

Sixty isolates, from nine species of the family Vibrionaceae, were tested by the API 20E, API Rapid E, and API Rapid NFT systems. Results were compared with those obtained with standard biochemicals. Included were 7 Aeromonas caviae isolates, 27 Aeromonas hydrophilia isolates, 10 Aeromonas sobria isolates, 3 Plesiomonas shigelloides isolates, 3 Vibrio alginolyticus isolates, 3 Vibrio cholerae isolates, 1 Vibrio fluvialis isolate, 5 Vibrio parahaemolyticus isolates, and 1 Vibrio vulnificus isolate. The API 20E correctly identified all the isolates within 24 h. The API Rapid E correctly identified only 77%, misidentified 8%, and failed to identify 2% of the isolates in 4 h. The remaining 13% of the isolates gave a low selectivity identification, with one of the choices being correct. The API Rapid NFT correctly identified 87%, misidentified 5%, gave a low selectivity identification for 8% of the isolates, and in some instances, required up to 48 h of incubation. The API 20E is a valid system for use in the identification of the more commonly occurring members of the family Vibrionaceae and the most accurate and efficient of the three systems tested.

Reagent Kits, Diagnostic

Minimal inhibitory concentrations of antimicrobial agents against Aeromonas hydrophila determined with the Autobac MTS.

Minimal inhibitory concentrations of seven antimicrobial agents for 22 strains of Aeromonas hydrophila were determined with the Autobac MTS procedure. The ranges of the minimal inhibitory concentrations were found to be similar to those obtained by a microdilution procedure. Depending upon the interpretive criteria used, there were discrepancies with carbenicillin, cephalothin, kanamycin, and tetracycline. It is recommended that the beta-lactam antibiotics ampicillin, carbenicillin, and cephalothin not be tested because of their lack of clinical usefulness, thus completely eliminating all of the significant discrepancies and reducing expendable costs by 50%.

Aeromonas

Role of pH in oxidase variability of Aeromonas hydrophila.

Some strains of Aeromonas hydrophila may be oxidase negative or only weakly oxidase positive by the Kovacs method taken from the surface of a differential medium, such as MacConkey agar. Six strains of A. hydrophila, two oxidase variable, one oxidase constant, and three weakly oxidase positive on MacConkey agar, were studied to determine the cause of oxidase variability. The bacteriostatic dyes in MacConkey agar were considered possible inhibitors of the oxidase reaction. The concentration of these dyes was varied from twice the normal concentration in zero. No change in the oxidase reaction of any of the six strains was noted. Carbohydrate utilization was also studied. When lactose was deleted from the MacConkey agar formula, the oxidase-variable and weakly oxidase-positive stains become strongly oxidase positive. When glucose was substituted for lactose in the MacConkey agar formula, all strains became oxidase negative. Substitution of nonfermentable carbohydrates, such as dulcitol or raffinose, returned all strains to the oxidase-positive state. When trehalose, which is utilized by all of the strains, was substituted for lactose, the oxidase-variable strains and two of the three weakly oxidase-positive strains became oxidase negative. The other weakly oxidase-positive strain remained weakly positive and the oxidase-constant strain remained strongly oxidase positive when trehalose was substituted for lactose. Oxidase reactions were found to be negative when the pH of the medium was 5.1 or lower. Negative oxidase reactions could be reversed by raising the pH above 5.2, and positive oxidase reactions could be reversed by lowering the pH to 5.1. Therefore, the fermentation of lactose in MacConkey agar results in the inhibition of the oxidase reaction. The acid end products of the fermentation of lactose include acetic, formic, lactic, oxaloacetic, pyruvic, and succinic acids.

Aeromonas

Rapid oxidase method for testing oxidase-variable Aeromonas hydrophila strains.

A rapid, same-day oxidase test procedure which obviates the problem of false-negative oxidase reactions of Aeromonas hydrophila removed from the surface of differential media such as MacConkey agar is described. This method allows oxidase testing to be performed within 3 h, rather than delaying the oxidase test for an additional 18 to 24 h. This procedure is applicable to any rapidly growing gram-negative rod.

Aeromonas

Antimicrobial susceptibility of Aeromonas hydrophila.

Minimal inhibitory concentration determinations and disk diffusion and Autobac 1 susceptibility tests were performed on 22 strains of Aeromonas hydrophila. Eleven of the strains had discrepancies between Autobac and disk diffusion or minimal inhibitory concentration results. These discrepancies occurred with the beta-lactam antibiotics, primarily carbenicillin and cephalothin. It is recommended that any strain of A. hydrophila found to be susceptible to any of the beta-lactam antibiotics by using Autobac 1 should be retested by a disk diffusion or minimal inhibitory concentration method.

Aeromonas

Incidence of "oxidase-variable" strains of Aeromonas hydrophila.

Certain strains of Aeromonas hydrophila are oxidase negative when grown on gram-negative selective and differential media. Of 100 strains of A. hydrophila examined, 8 were found to possess this characteristic. Information is provided on how to detect these common variants of A. hydrophila.

Aeromonas

Media-dependent oxidase reaction in a strain of Aeromonas hydrophila.

A strain of Aeromonas hydrophila isolated from bile was oxidase positive only when grown on nonselective media. The isolate was oxidase negative when grown on gram-negative selective and/or differential media. It is proposed that oxidase tests on gram-negative rods be performed on colonies grown on nonselective media to assure valid results.

Aeromonas

Septicemia due to Neisseria lactamica.

Neisseria lactamica was isolated from the blood of a pediatric patient who had signs of septicemia and otitis media. Organisms morphologically resembling Neisseria, as well as gram-positive cocci, were seen on a Gram stain of fluid from the middle ear. It is hypothesized that the N. lactamica septicemia was secondary to infection of the middle ear by this organism.

Female