American Society for Microbiology evidence-based laboratory medicine practice guidelines to reduce blood culture contamination rates: a systematic review and meta-analysis.

SUMMARYBlood cultures (BCs) are one of the critical tests used to detect bloodstream infections. BC results are not 100% specific. Interpretation of BC results is often complicated by detecting microbial contamination rather than true infection.

A Literature Review on How We Can Address Medical Laboratory Scientist Staffing Shortages.

Objective: Laboratories are facing a critical shortage of medical laboratory scientists (MLS) and medical laboratory technicians (MLT) to address an increasing demand for laboratory testing. Training program closures, fewer student applicants, and financial decisions have contributed to staffing shortages. Lack of visibility, low wages, and perceived lack of opportunities for upward career mobility contribute to challenges in recruiting and retaining qualified individuals and students who are unaware of laboratory medicine careers.

Reducing Blood Culture Contamination Rates: Experiences of Four Hospital Systems.

Introduction: Blood cultures (BCs) frequently become contaminated during the pre-analytic phase of collection leading to downstream ramifications. We present a summary of performance improvement (PI) interventions provided by four hospital systems and common factors that contributed to decreased blood culture contamination (BCC) rates.

Methods: Each hospital independently formed a multidisciplinary team and action plan for implementation of their intervention, focusing on the use of educational and training tools.

A multi-laboratory comparison of two molecular methods for the detection of toxigenic Clostridium difficile.

Introduction: Diarrheal disease due to toxigenic Clostridium difficile (CD) accounts for an increased number of hospitalizations and deaths each year. Published guidelines recommend reflex testing of CD antigen-positive samples to molecular testing or testing samples directly by a molecular assay. This multicenter study was designed to compare the accuracy of two different molecular methods targeting different CD genes: Xpert C.

Infectious Endocarditis in 49-Year-Old Man and Discussion of Phenotypic Characteristics of Aerococcus urinae and Viridans Streptococci.

Patient: 49 year-old man.

Chief Complaint: Dyspnea at rest and dyspnea on exertion.

History Of Present Illness: Diagnosed with upper respiratory tract infection 10 days previously.

Controlled clinical comparison of new pediatric medium with adsorbent polymeric beads (PF Plus) versus charcoal-containing PF medium in the BacT/alert blood culture system.

We conducted a controlled clinical comparison of PF Plus, the new pediatric medium with adsorbent polymeric beads, versus the charcoal-containing PF medium in the BacT/Alert blood culture system. A total of 2,381 pediatric cultures were enrolled, and 1,703 (71.5%) were deemed to be compliant and acceptable for analysis.

Respiratory virus identification by interval polymerase chain reaction testing in the southeastern United States.

Background: This study was designed to determine if testing the first ~40 nasal washings (interval) each month for 1 year, could be used as an epidemiologic tool for seasonality and prevalence of respiratory viruses such as human metapneumovirus in an adult and pediatric population in the southeastern United States.

Materials And Methods: Results of interval polymerase chain reaction (PCR) testing of 469 specimens for 8 viruses were compared with our current procedures using PCR, culture, or respiratory synctial virus antigen for all 7435 specimens (routine).

Results: One hundred thirty-six viruses out of 469 specimens (29.

Molecular epidemiology of carbapenem-nonsusceptible Acinetobacter baumannii in the United States.

Acinetobacter baumannii is emerging as an important nosocomial pathogen worldwide. We report molecular epidemiology of 65 carbapenem-nonsusceptible A. baumannii isolates identified from hospitals in New York, Pennsylvania, Florida, Missouri, Nevada, and California between 2008 and 2009.

Recombinant Adenovirus (AdV) Type 3 and Type 14 Isolated From a Fatal Case of Pneumonia.

We report a fatal case of pneumonia apparently due to adenovirus infection in a 53-year-old male who had recently returned from Iraq. The isolate was identified by sequence analysis as AdV3 and AdV14. Based on restriction analysis (REA), the virus appeared to be a recombinant virus containing properties of both AdV3 and AdV14 rather than a coinfection with these two viruses.

Klebsiella pneumoniae Carbapenemase-producing Enterobacteriaceae, Northeast Florida.

Background: Since 2001 there have been several reported outbreaks due to carbapenem-resistant Klebsiella pneumoniae (Kp), particularly in the northeastern states.

Methods: Carbapenemase-producing Enterobacteriaceae from healthcare facilities in Northeast Florida were phenotypically identified and confirmed using PCR amplification and sequencing of the blaKPC gene.

Results: Results from PFGE analysis of these isolates demonstrated possible horizontal spread from two possible "outbreak" strains during the study period.

Differences between ceftriaxone and cefotaxime: microbiological inconsistencies.

Objective: To review data to determine why pneumococcal isolates appear to be increasingly resistant to cefotaxime, historically regarded as having the same in vitro susceptibility to ceftriaxone, and what this observation might imply clinically.

Data Sources: Literature was accessed through MEDLINE (1966-October 2007) using the MeSH terms cefotaxime, ceftriaxone, susceptibility, microbial sensitivity tests, antibiotics, pneumococcal infections, Streptococcus pneumoniae, resistance, and cephalosporin resistance. Abstracts and surveillance databases were reviewed and unpublished data were provided by state departments of health and institutions.

Antimicrobial susceptibility among Acinetobacter calcoaceticus-baumannii complex and Enterobacteriaceae collected as part of the Tigecycline Evaluation and Surveillance Trial.

Objective: To measure the in vitro activity of a panel of antimicrobial agents against gram-negative pathogens collected from the nine census regions of the USA.

Methods: Isolates were collected from 76 centers between January 2004 and September 2005. In vitro activity was assessed using CLSI guidelines and CLSI or FDA interpretive criteria.

Clinical correlation of the CLSI susceptibility breakpoint for piperacillin- tazobactam against extended-spectrum-beta-lactamase-producing Escherichia coli and Klebsiella species.

We assessed infections caused by extended-spectrum-beta-lactamase-producing Escherichia coli or Klebsiella spp. treated with piperacillin-tazobactam to determine if the susceptibility breakpoint predicts outcome. Treatment was successful in 10 of 11 nonurinary infections from susceptible strains and in 2 of 6 infections with MICs of >16/4 mug/ml.