Forty Years of Molecular Diagnostics for Infectious Diseases.

Nearly 40 years have elapsed since the invention of the PCR, with its extremely sensitive and specific ability to detect nucleic acids via enzyme-mediated amplification. In turn, more than 2 years have passed since the onset of the coronavirus disease 2019 (COVID-19) pandemic, during which time molecular diagnostics for infectious diseases have assumed a larger global role than ever before. In this context, we review broadly the progression of molecular techniques in clinical microbiology, to their current prominence.

Improving Medical Image Decision-Making by Leveraging Metacognitive Processes and Representational Similarity.

Improving the accuracy of medical image interpretation can improve the diagnosis of numerous diseases. We compared different approaches to aggregating repeated decisions about medical images to improve the accuracy of a single decision maker. We tested our algorithms on data from both novices (undergraduates) and experts (medical professionals).

Disentangling prevalence induced biases in medical image decision-making.

Many important real-world decision tasks involve the detection of rarely occurring targets (e.g., weapons in luggage, potentially cancerous abnormalities in radiographs).

Pathogenesis-directed therapy of 2019 novel coronavirus disease.

The 2019 novel coronavirus disease (COVID-19) now is considered a global public health emergency. One of the unprecedented challenges is defining the optimal therapy for those patients with severe pneumonia and systemic manifestations of COVID-19. The optimal therapy should be largely based on the pathogenesis of infections caused by this novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Providing Laboratory Medicine Training in a Low-Resource Setting.

Objectives: We developed and participated in a 1-week laboratory medicine training presented from June 3, 2019, to June 7, 2019.

Methods: The training was a combination of daily morning lectures and case presentations as well as afternoon practical sessions in the clinical laboratory. The content was selected over months by local organizers and the visiting faculty and further modified on site to reflect local needs.

Data highlighting phenotypic diversity of urine-associated isolates.

This article provides a reusable dataset describing detailed phenotypic and associated clinical parameters in n=303 clinical isolates of urinary collected at Vanderbilt University Medical Center. De-identified clinical data collected with each isolate are detailed here and correlated to biofilm abundance and metabolomics data. Biofilm-abundance data were collected for each isolate under different conditions along with datasets quantifying biofilm abundance of each isolate under different conditions.

An evolving approach to the laboratory assessment of COVID-19.

As the 2019 novel coronavirus disease (COVID-19) outbreak has evolved in each country, the approach to the laboratory assessment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has had to evolve as well. This review addresses the evolving approach to the laboratory assessment of COVID-19 and discusses how algorithms for testing have been driven, in part, by the demand for testing overwhelming the capacity to accomplish such testing. This review focused on testing in the USA, as this testing is evolving, whereas in China and other countries such as South Korea testing is widely available and includes both molecular testing for SARS-CoV-2 as well as serological testing using both enzyme-linked immunosorbent assay methodology and lateral flow immunoassay methodology.

Laboratory Diagnosis of COVID-19: Current Issues and Challenges.

The COVID-19 outbreak has had a major impact on clinical microbiology laboratories in the past several months. This commentary covers current issues and challenges for the laboratory diagnosis of infections caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In the preanalytical stage, collecting the proper respiratory tract specimen at the right time from the right anatomic site is essential for a prompt and accurate molecular diagnosis of COVID-19.

Diagnosing Bacteremia in Real Time Using Next-Generation Sequencing-Based Technology.

This commentary highlights the article by Grumaz et al that describes the use of molecular sequencing for fast detection of pathogens directly from blood samples from septic patients.

Ceftolozane-tazobactam- and ceftazidime-avibactam-resistant mastoiditis.

is an important bacterial cause of a variety of infections and is associated with high morbidity and mortality. Infections caused by this bacterium are becoming more difficult to treat due to increasing resistance to many of the available antibiotics. Ceftolozane-tazobactam and ceftazidime-avibactam are two new cephalosporin/β-lactamase inhibitor combination antimicrobials that have demonstrated excellent activity against several multi-drug-resistant pathogens, including multi-drug-resistant .

Defining a Molecular Signature for Uropathogenic versus Urocolonizing Escherichia coli: The Status of the Field and New Clinical Opportunities.

Urinary tract infections (UTIs) represent a major burden across the population, although key facets of their pathophysiology and host interaction remain unclear. Escherichia coli epitomizes these obstacles: this gram-negative bacterial species is the most prevalent agent of UTIs worldwide and can also colonize the urogenital tract in a phenomenon known as asymptomatic bacteriuria (ASB). Unfortunately, at the level of the individual E.

Comparative Antimicrobial Activity of Commercial Wound Care Solutions on Bacterial and Fungal Biofilms.

Background: Biofilms represent a complex milieu of matrix-enclosed microorganisms, which can significantly contribute to the pathology of chronic wounds. In this study, we compare the activity of 3 commercial antimicrobial wound care solutions, Vashe (HOCl based), PhaseOne (HOCl based), and Sulfamylon (mafenide acetate), for their in vitro activity against bacterial and fungal biofilms.

Methods: Reference and clinical isolates of 6 Gram-negative bacterial species (36 total strains), 3 Gram-positive bacteria (21 strains), and 3 Candida species (9 strains) were used to create biofilms.

Mortality and morbidity rounds (MMR) in pathology: relative contribution of cognitive bias vs. systems failures to diagnostic error.

Background Heuristics and cognitive biases are thought to play an important role in diagnostic medical error. How to systematically determine and capture these kinds of errors remains unclear. Morbidity and mortality rounds (MMRs) are generally focused on reducing medical error by identifying and correcting systems failures.

Epidemiological and genetic characteristics of porcine reproductive and respiratory syndrome virus circulating in central and South China in 2016.

Porcine reproductive and respiratory syndrome virus (PRRSV) is a leading cause of reproductive failure in sows and respiratory disorders in all ages of pigs; PRRSV is one of the most serious threats to the global pig industry. Continuously monitoring the epidemiological and genetic characteristics of PRRSV epidemic strains is beneficial for PRRSV prevention and control. In this study, we detected PRRSV from different types of porcine samples collected from 257 pig farms in Central (Henan Province) and South China (Fujian, Guangdong, and Guangxi Provinces) in 2016.

Epidemiological and genetic characteristics of swine pseudorabies virus in mainland China between 2012 and 2017.

The outbreak of pseudorabies (PR) in many Bartha-K61 vaccinated farms in China in late 2011 has seriously damaged the pig industry of one of the largest producers of pork products in the world. To understand the epidemiological characteristics of the pseudorabies virus (PRV) strains currently prevalent in China, a total of 16,256 samples collected from pig farms suspected of PRV infection in 27 Provinces of China between 2012 and 2017 were evaluated for detection of PRV. Since the extensive use of gE-deleted PRV vaccine in China, the PRV-gE was applied for determining wild-type virus infection by PCR.

The Effective Duration of Antimicrobial Activity of Mafenide Acetate After Reconstitution.

Mafenide acetate is an effective but costly antimicrobial solution used for burn wounds. The package insert instructs the user to discard unused solution within 48 hours of opening. The purpose of this study is to evaluate the antimicrobial activity of mafenide acetate beyond 48 hours after reconstitution, to possibly reduce cost by eliminating product waste.

Advances in the diagnosis and treatment of Clostridium difficile infections.

Clostridium difficile is a leading cause of antibiotic-associated diarrhea worldwide. The diagnosis of C. difficile infection (CDI) requires both clinical manifestations and a positive laboratory test for C.