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Fatty acid characterization of rapidly growing pathogenic aerobic actinomycetes as a means of identification.

The fatty acid compositions of 39 type strains and 529 clinical or reference strains of pathogenic aerobic actinomycetes were analyzed after standardized culture by using the Microbial Identification System (MIS). Library entries for each type strain were created by using the MIS Library Generation Software, and the fatty acid profiles of clinical and reference strains were compared to these library entries. The bacteria separated into two large groups based upon major amounts of branched-chain or of saturated or monounsaturated straight-chain fatty acids. Identification of isolates was possible by using only the type strains for comparison, but fatty acid heterogeneity occurred within most species.

Actinomycetaceae↗

Research on rapid identification of auto-microbiology system for pathogenic yeast.

The auto-microbiology system yeast biochemical card (AMS-YBC; Vitek System, Inc.) was studied in 77 clinical isolates and 50 laboratory kept isolates on the basis of routine identification. Results of 123 isolates were obtained in 24 hours, while that of the other 4 in 48 hours. 122 (96.1%) were coincidently identified with AMS and routine method. The results suggest that AMS is a rapid, accurate and simple identification method for common pathogenic yeast.

Candida albicans↗

Identification of Streptococcus iniae by commercial bacterial identification systems.

The fish pathogen Streptococcus iniae cannot be identified by most commercial bacterial identification systems. The results presented here indicate that over 70% of our S. iniae isolates have been identified using the Biolog(R) GP microplate panels and Microlog(R) database. The isolates were confirmed as S. iniae by specific PCR methods and have been found to conform to the result obtained with the type strain S. iniae ATCC 29178.

Animals↗

Viral and microbial genotyping by a combination of multiplex competitive hybridization and specific extension followed by hybridization to generic tag arrays.

Detection and identification of microbial pathogens are important for disease diagnosis, treatment and prophylaxis measurements. By introducing an innovative technique, we show a robust, reliable and accurate microarray-based method for identification of microbial pathogens. The technique utilizes a unique combination of multiplex competitive hybridization, which enhances hybridization accuracy of oligonucleotides to the specific target, and apyrase-mediated allele-specific extension, which improves specific extension. As a model system, different clinically relevant human papillomaviruses were selected for this study. The method generated accurate results and proves to be promising for specific and correct microbial and viral typing.

DNA Primers↗

Identification of atherosclerosis-modifying genes: pathogenic insights and therapeutic potential.

Atherosclerosis is a common, complex trait, with genetic variation in many genes and the environment contributing to risk for this condition, which has multiple and highly variable phenotypic manifestations. Progress has been made in the identification of atherosclerosis-modifying genes in both human studies and through the use of animal models. In the future, it may be possible to administer a genetic test for variation in a handful of the most common atherosclerosis-modifier genes, and thus predict if a patient is likely to develop atherosclerosis and ischemic heart disease. These patients could then be treated aggressively to lower their low-density lipoprotein cholesterol levels and other risk factors, including counseling to make adjustments in their lifestyle. This review will summarize the methods and results thus far in the identification of atherosclerosis-modifier genes.

Animals↗

Industry and government perspective in influenza control.

We have had recent reminders of the threats posed by naturally occurring and bioengineered pandemic respiratory infections. It is estimated that if a pandemic infection were to arise anywhere in the world, such an infection would become widespread within 3 months and would have its maximum effect within 6 months. At present, the fastest that a vaccine effective against a new combination of antigens can be developed, purified, and produced is 9-12 months, not counting time for mass production. The current rate at which the production of influenza vaccines can be accelerated is limited by the fact that production is carried out in eggs. Therefore, there is urgent need for cell-based vaccine technologies. These are under way in several centers, yet attainment of a safe product remains several years away. Furthermore, there is need for public and private investment in manufacturing surge capacity and/or dedicated National Institutes of Health facilities to enable accelerated production. We must support efforts to shorten development time by developing and approving subunit antigens and immunogens that anticipate the most virulent viral mutations. Surveillance sites and their electronic interconnections must be expanded. Another component still lacking is funding for laboratories with high throughput screening and strong informatics capabilities to enable the fingerprinting and cataloguing of all known specimens of influenza and other pathogenic organisms for rapid identification of emerging or bioengineered pathogens. In all these efforts, we look to the federal government and to the biomedical research community in both public and private sectors.

Bioterrorism↗

Clindamycin phosphate in the treatment of endometritis due to anaerobic bacteria.

Treatment of endometritis due to anaerobic pathogens demands early isolation and identification of the offending pathogen by the appropriate culture and optimum use of antibiotics according to the sensitivity test. Clindamycin phosphate has been used as a highly active antibiotic against both gram-positive and gram-negative anaerobic pathogens, including bacteroides fragilis. The concentration of clindamycin phosphate in blood from the uterus was tested in 30 women after administration of one single dose (600 mg) intramuscularly. The levels of clindamycin in the above-mentioned tests state how samples were compared with the minimal inhibitory concentration of the offending anaerobic pathogens in cases of endometritis.

Anaerobiosis↗

Serratia marcescens.

Over the last 30 years, Serratia marcescens has become an important cause of nosocomial infection. There have been many reports concerning the identification, antibiotic susceptibility, pathogenicity, epidemiological investigations and typing of this organism. Accurate identification is important in defining outbreaks. The API 20E system has been used widely, but is not individually satisfactory. The growth of S. marcescens in the environment has been investigated in relation to water, disinfectants and plastics such as blood bags. Certain extracellular products are unique to S. marcescens. Pigment (prodigiosin) biosynthesis by S. marcescens has been investigated fully since the emergence of the organism as a cause of infection. Many other aspects of the pathogenicity and virulence of S. marcescens have been studied, including adherence and hydrophobicity, lipopolysaccharide (LPS) and extracellular products. Two modes of adhesion to host epithelial surfaces have been suggested. These are mannose-resistant (MR) pili and mannose-sensitive (MS) pili. LPS, which is responsible for the biological activity of endotoxin, has been investigated fully and 24 somatic antigens have been described. The production of different enzymes by S. marcescens as virulence factors has also been reported, including chitinase, lipase, chloroperoxidase and an extracellular protein, HasA. Antibiotics used to treat serratia infection include beta-lactam agents, aminoglycosides and fluoroquinolones and a variety of different resistance mechanisms have been demonstrated. Typing methods used to study the epidemiology of S. marcescens include biotyping, bacteriocin typing, phage typing, plasmid analysis, polymerase chain reaction amplification of enterobacterial repetitive intergenic consensus sequences (ERIC-PCR) and ribotyping. Serological typing has also been used and this method seems to be a suitable first-line typing method for S. marcescens, although some strains remain untypable. RAPD-PCR has also been applied to a small number of isolates and seems to be a promising method, especially for rapid monitoring of an outbreak and tracing the source of initial infection.

Aminoglycosides↗

The automicrobic system for detection of bacteriuria. Efficacy of revised urine identification cards.

The results of clinical urine specimens tested in the Vitek AutoMicrobic System (AMS) using two different urine identification (UID) cards were compared with the results obtained by a quantitative culture method. AMS injector UID card results were evaluated with the use of 1,136 consecutive clinical specimens collected March 4 to May 23, 1983. Revised AMS UID cards were used to test 1,634 clinical specimens from November 8, 1983, to March 2, 1984. The revised UID card was less sensitive, more specific, had a greater predictive value for positive results, and had greater accuracy than the injector UID card in detecting organisms in urine. The revised urine card accurately quantified organisms in 90.1% of specimens versus 85.1% in injector cards. The revised card was superior in the predictive value of positive identification of urinary pathogens. Ninety percent of all organisms were identified within nine hours with either card. Improved accuracy of the revised cards makes it practical to electronically report automated urine screening results (detection, quantitation, and preliminary identification of urinary pathogens) by interfacing the AMS with hospital information systems.

Autoanalysis↗

Identification of Erwinia amylovora, the Fireblight Pathogen, by Colony Hybridization with DNA from Plasmid pEA29.

All strains of Erwinia amylovora characterized carry a medium-size plasmid of 29 kilobases (pEA29). We mapped this plasmid with various restriction enzymes, cloned the whole DNA into an Escherichia coli plasmid, and subcloned restriction fragments. These DNA species were used for identification of E. amylovora after handling of strains in the laboratory and also in field isolates. About 70 strains of E. amylovora and 24 strains from nine other species, mainly found in plant habitats, were checked in a colony hybridization test. Virulent and avirulent E. amylovora strains reacted positively, whereas the other species were negative. Apart from the hybridization assay, the positive strains were additionally tested for ooze production on rich agar with 5% sucrose and on immature-pear slices. Unspecific background hybridization of non-E. amylovora strains found for hybridization with the whole E. amylovora plasmid was almost eliminated when a 5-kilobase SalI fragment from pEA29 was used as a probe and when the washes after the hybridization procedure were done with high stringency. Under these conditions, E. amylovora could be readily identified from field isolates.

Journal Article↗

Identification of virulence genes in a pathogenic strain of Pseudomonas aeruginosa by representational difference analysis.

Pseudomonas aeruginosa is an opportunistic pathogen that may cause severe infections in humans and other vertebrates. In addition, a human clinical isolate of P. aeruginosa, strain PA14, also causes disease in a variety of nonvertebrate hosts, including plants, Caenorhabditis elegans, and the greater wax moth, Galleria mellonella. This has led to the development of a multihost pathogenesis system in which plants, nematodes, and insects have been used as adjuncts to animal models for the identification of P. aeruginosa virulence factors. Another approach to identifying virulence genes in bacteria is to take advantage of the natural differences in pathogenicity between isolates of the same species and to use a subtractive hybridization technique to recover relevant genomic differences. The sequenced strain of P. aeruginosa, strain PAO1, has substantial differences in virulence from strain PA14 in several of the multihost models of pathogenicity, and we have utilized the technique of representational difference analysis (RDA) to directly identify genomic differences between P. aeruginosa strains PA14 and PAO1. We have found that the pilC, pilA, and uvrD genes in strain PA14 differ substantially from their counterparts in strain PAO1. In addition, we have recovered a gene homologous to the ybtQ gene from Yersinia, which is specifically present in strain PA14 but absent in strain PAO1. Mutation of the ybtQ homolog in P. aeruginosa strain PA14 significantly attenuates the virulence of this strain in both G. mellonella and a burned mouse model of sepsis to levels comparable to those seen with PAO1. This suggests that the increased virulence of P. aeruginosa strain PA14 compared to PAO1 may relate to specific genomic differences identifiable by RDA.

ATP-Binding Cassette Transporters↗

[Periprosthetic knee infection. One-stage exchange].

Systematic diagnostics and successful therapy of periprosthetic infection of the knee can only be achieved under optimal conditions. History, clinical examination and an elevated CRP level are the basis for suspicion of infection. Diagnosis is confirmed by identification of the pathogen through aspiration of the joint under sterile conditions. The microbiological examination is done in a laboratory, which is specialised in foreign body infections. Identification of the causing pathogens and their resistance pattern are essential to determine the topical and systemic course of antibiotics. When these conditions are fulfilled, the one-stage exchange procedure offers great advantages in comparison with procedures performed in two or more stages for all those involved--patients, surgeons and health care systems--while providing the same chance of a successful elimination of the infection, with an even better functional outcome. Currently, the treatment costs are not adequately reimbursed. In the future, prompt treatment of these especially unfortunate patients will only be possible, if the tremendous resources consumed by these patients are fully covered.

Anti-Infective Agents↗

Magnetic resonance imaging and the nonoperative treatment of spinal epidural abscess.

This report describes three patients with spinal epidural abscess diagnosed by magnetic resonance imaging and treated nonoperatively. Prior to treatment, one patient was neurologically intact, one patient demonstrated a moderate neurological deficit, and one patient was severely paraparetic with loss of bladder and bowel control. Following identification of the pathogenic organism, antibiotic therapy was continued until the patients demonstrated clinical improvement and radiological resolution of the abscess. All patients remained stable or improved neurologically. Analysis of 33 previously reported patients treated with antibiotics suggests that nonoperative treatment may be a reasonable alternative therapy under certain clinical conditions. These include (1) identification of the pathogenic organism, (2) a stable neurological condition, (3) access to magnetic resonance imaging or computed tomography for potentially rapid reevaluation, and (4) appropriate neurosurgical consultation and nursing care. Nonoperative treatment may also be considered as a reasonable alternative for patients who have severe concurrent medical illness.

Adult↗

Extraction-free, filter-based template preparation for rapid and sensitive PCR detection of pathogenic parasitic protozoa.

Within the last several years, the protozoan parasites Cyclospora cayetanensis, Cryptosporidium parvum, and microsporidia have become recognized as important, rapidly emerging human pathogens in immunocompromised and immunocompetent individuals. Since the early 1990s, many of the reported outbreaks of enteric illness caused by these microorganisms have been attributed to food- and water-borne contamination. Many inherent obstacles affect the success of current surveillance and detection methods used to monitor and control levels of contamination by these pathogens. Unlike methods that incorporate preenrichment for easier and unambiguous identification of bacterial pathogens, similar methods for the detection of parasitic protozoa either are not currently available or cannot be performed in a timely manner. We have developed an extraction-free, filter-based protocol to prepare DNA templates for use in PCR to identify C. cayetanensis and C. parvum oocysts and microsporidia spores. This method requires only minimal preparation to partially purify and concentrate isolates prior to filter application. DNA template preparation is rapid, efficient, and reproducible. As few as 3 to 10 parasites could be detected by PCR from direct application to the filters. In studies, as few 10 to 50 Encephalitozoon intestinalis spores could be detected when seeded in a 100-microliter stool sample and 10 to 30 C. cayetanensis oocysts could be detected per 100 g of fresh raspberries. This protocol can easily be adapted to detect parasites from a wide variety of food, clinical, and environmental samples and can be used in multiplex PCR applications.

Animals↗

Flavobacterium meningosepticum sepsis: disease due to bacteria with unusual antibiotic susceptibility.

The three cases we have presented implicate F meningosepticum as a significant pathogen causing disease in immunocompromised adult patients. Since this organism is of low pathogenicity but may be found in the hospital environment, its identification as a pathogen raises the suspicion of a nosocomial source of infection, and a search for the source should be made. Furthermore, with regard to the choice of antimicrobial therapy, it must be remembered that this organism is resistant to most antibiotics commonly used to treat gram-negative bacilli, and disk diffusion technics may not reliably predict actual antibiotic sensitivity.

Anti-Bacterial Agents↗

Development of a polymerase chain reaction assay for identification and detection of the fish pathogen Flavobacterium psychrophilum.

A PCR-based method was developed to identify and detect Flavobacterium psychrophilum, the causative agent of "cold-water disease" and "rainbow trout fry syndrome" in salmonid fish. Two oligonucleotide primers were designed by comparing the 16S rRNA sequence of all taxa in the genus Flavobacterium and of representative species in most related genera within rRNA superfamily V. Purified chromosomal DNAs from all these bacterial species, from 25 F. psychrophilum isolates and from several other fish-pathogenic bacteria were used to assess the specificity of the reaction. Amplification products were generated only with F. psychrophilum DNA. The detection level, equivalent to approximately 10 to 100 bacterial cells, was increased 10-fold by hybridization with a radioactive probe. Preliminary experiments demonstrated that this procedure can also be applied to samples of infected tissue. This PCR assay is therefore a rapid, specific, and sensitive alternative to conventional plate culture methods for the identification and detection of F. psychrophilum.

Animals↗

Diagnostic methods current best practices and guidelines for identification of difficult-to-culture pathogens in infective endocarditis.

Culture-negative endocarditis currently represents a diagnostic challenge for physicians. Traditional methods such as histology, serology, and culture have been improved and new molecular techniques have been developed to improve the detection of difficult-to-culture agents. Serologic tests for the two most frequent etiologic agents, Coxiella burnetii and Bartonella spp, should be performed first because they can usually be identified easily in this way. The sensitivity of culture for intracellular bacteria has been improved by inoculation of samples in shell vials and by the use of novel tissue cell lines. Recently, universal and species-specific primers have been designated to amplify bacterial DNA directly from resected valves, allowing positive identification.

Bacteria↗

[Gimenez staining: a rapid method for initial identification of legionella pneumophila in Amoeba trophozoite].

OBJECTIVE: To establish a rapid staining method for facilitating initial identification of Legionella pneumophila in amoebal trophozoite. METHODS: Acanthamoeba polyphaga and Legionella pneumophila were co-cultured under laboratory condition. At consecutive time points during the culture, smears of the cultured products were made on glass slides for staining purposes. Different types of stainings including Gram's staining, Gimenez staining, Giemsa staining and immunofluorescence were used to determine the best method for the identification of amoebal pathogens. RESULTS: Gimenez staining technique is simpler and yields better results as compared with the other three stainings. Gimenez stain gives the best color and contrast for amoeba and amoebal Legionella Amoeba trophozoites and/or cysts showed a distinct purplish blue with amoebal Legionella in red. Amoebal Legionella can be distinguished clearly at an earlier time of co cul ture, providing a proper sensitivity. It takes only 10 minutes to finish the operation. The other techniques require the use of expensive reagents, are relatively time-consuming, and involve complex staining procedures. CONCLUSION: Gimenez staining is of value for the initial identification of amoebal pathogens, and it is suitable for laboratory diagnosis.

Amoeba↗