Enhancement of a culture-based bacterial detection system (eBDS) for platelet products based on measurement of oxygen consumption.

Background: An enhanced bacterial detection system (Pall eBDS) was developed that distinguishes itself from its predecessor (Pall BDS) by removal of the platelet (PLT)-retaining filter allowing for optimal bacterial transfer, modification of the culture tablet to reduce the confounding effects of respiring PLTs while enhancing bacterial growth, and facilitation of nutrients and gas exchange by agitating the sample pouch during incubation at 35 degrees C. The objective was to evaluate the performance of the new eBDS.

Study Design And Methods: Leukoreduced whole blood-derived PLT concentrates (LR-PCs) and LR single-donor PLTs (LR-SDPs) were inoculated with 1 to 15 colony-forming units (CFUs) of bacteria per mL in studies of each of 10 bacterial species associated with fatal transfusion-transmitted bacterial infection.

Detection of bacteria in WBC-reduced PLT concentrates using percent oxygen as a marker for bacteria growth.

Background: The risk of receiving a PLT concentrate (PC) contaminated with bacteria may be 1000-fold greater than that of pathogenic viral transmission, yet surveillance for this risk is not generally practiced. A novel bacteria detection system (BDS) that overcomes the limitations of current systems is described. The BDS monitors percent oxygen (%O2) in air above aliquots of PCs that have been filtered to remove the confounding effect of respiring PLTs and residual WBCs.

Wound irrigation in children: saline solution or tap water?

Study Objective: Irrigation, a critical component of wound management, is commonly performed with sterile normal saline solution. The purpose of this study was to compare the infection rates of wounds irrigated with normal saline solution versus those of wounds irrigated with running tap water.

Methods: A prospective trial was conducted in an urban pediatric emergency department.

Rapid film-based determination of antibiotic susceptibilities of Mycobacterium tuberculosis strains by using a luciferase reporter phage and the Bronx Box.

Detecting antibiotic resistance in Mycobacterium tuberculosis is becoming increasingly important with the global recognition of drug-resistant strains and their adverse impact on clinical outcomes. Current methods of susceptibility testing are either time-consuming or costly; rapid, reliable, simple, and inexpensive methods would be highly desirable, especially in the developing world where most tuberculosis is found. The luciferase reporter phage is a unique reagent well-suited for this purpose: upon infection with viable mycobacteria, it produces quantifiable light which is not observed in mycobacterial cells treated with active antimicrobials.

Contrasting effects of identical nutrients given parenterally or enterally after 70% hepatectomy: bacterial translocation.

High mortality occurs in rats with 70% hepatectomy fed intravenous (IV) total parenteral nutrition (TPN; 13.9% glucose, 4.17% amino acids, 1.

Single local instillation of nonviable Staphylococcus aureus or its peptidoglycan ameliorates glucocorticoid-induced impaired wound healing.

An excess in glucocorticoid steroids, either from endogenous or exogenous sources, has been shown to inhibit wound repair. Key to this impairment is a diminution of the inflammatory response to wounding, fibroplasia, capillary formation, reparative tissue collagen accumulation, and wound breaking strength. Because a single local application at operation of nonviable Staphylococcus aureus or its peptidoglycan increases all of these processes in normal rats, we hypothesized that nonviable S.

Accelerating effects of nonviable Staphylococcus aureus, its cell wall, and cell wall peptidoglycan.

We have previously reported that local application of viable Staphylococcus aureus dramatically accelerates wound healing, but viable Staphylococcus epidermidis does not. Because the S. aureus effect occurred in the absence of infection and because the cell walls of the two bacterial species differ, we hypothesized that nonviable S.

Restriction fragment length polymorphism analysis of Cryptococcus neoformans isolates from environmental (pigeon excreta) and clinical sources in New York City.

Restriction fragment length polymorphism analysis of environmental (pigeon excreta) and clinical Cryptococcus neoformans var. neoformans isolates in a limited geographic area distinguished 6 strains among 8 environmental isolates and 12 strains among 17 clinical isolates. Clusters of patients with three strains types accounted for 47% of clinical isolates.

False-negative cerebrospinal fluid cryptococcal latex agglutination tests for patients with culture-positive cryptococcal meningitis.

Three cases of false-negative cerebrospinal fluid latex agglutination test results for patients with culture-positive cryptococcal meningitis are reported. False-negative results occurred in settings of low cryptococcal antigen concentrations in cerebrospinal fluid and were dependent on the latex agglutination test kit used. Investigation of each case revealed that prozone phenomena or interference from bound antibody or protein could not account for the false-negative results.

Effect of prestorage white cell reduction on bacterial growth in platelet concentrates.

Platelet concentrates stored with and without autologous white cells were produced from units of whole blood that had been purposefully contaminated with bacteria immediately after phlebotomy. The blood was inoculated with one of five species of bacterium at either 10 or 50 colony-forming units per mL. The growth of the organisms was quantified throughout the conventional 5-day, 22 degrees C storage period of the platelet concentrates.

Persistence of initial infection in recurrent Cryptococcus neoformans meningitis.

Patients with cryptococcal meningitis tend to have recurrences of infection. Although the original strain of Cryptococcus neoformans is assumed to persist in recurrent infections, this assumption has not been tested. Southern blot hybridisation with two genomic DNA probes and pulsed-field electrophoresis of intact chromosomes were used to investigate the genetic relation between initial and relapse isolates of C neoformans from patients with recurrent cryptococcal meningitis.

Comparison of maternal sera, cord blood, and neonatal sera for detecting presumptive congenital syphilis: relationship with maternal treatment.

The incidence of congenital syphilis has increased rapidly over the past few years. Most infected mothers and their newborns are asymptomatic at birth and diagnosis depends on serologic testing during pregnancy and at delivery. This study was initiated to compare maternal sera, cord blood, and neonatal sera for detecting presumptive congenital syphilis and to assess the role of maternal treatment (administration of penicillin to the mother at least 1 month before delivery) on the serologic results at the time of delivery.

Prevention of growth of Yersinia enterocolitica in blood by polyester fiber filtration.

The ability of polyester white cell-reduction blood filters to prevent the growth of Yersinia enterocolitica in units of donated blood was studied. Sixteen units of freshly drawn blood were inoculated with 10, 50, 100, or 150 colony-forming units (CFU) per mL of a clinical isolate of Y. enterocolitica (serotype O:3).

Extensive allelic variation in Cryptococcus neoformans.

The orotidine monophosphate pyrophosphorylase (OMPPase) gene locus of the DNA of 13 Cryptococcus neoformans var. neoformans strains, including 10 recent clinical isolates, was studied by using restriction fragment length polymorphisms and nucleotide sequence analysis. The OMPPase locus (URA5) is highly polymorphic, and at least six alleles were identified.

Comparison of methods for the immunological identification of Neisseria gonorrhoeae in clinical specimens using commercially-obtained reagents.

Neither an immunofluorescent nor a co-agglutination method was adequately sensitive for the detection of Neisseria gonorrhoeae when commercially-obtained reagents were used to test oxidase positive organisms taken directly from Transgrow medium. The sensitivity of co-agglutination, the better of the two methods, was improved from 83% to 96% when organisms were subcultured for colony isolation prior to identification. False positive results were obtained with both methods.

Piperacillin: evaluation against inpatient and gentamicin-resistant bacteria.

When species-matched collections, each consisting of 128 bacterial strains, were compared, inpatient organisms were found to be significantly more resistant to piperacillin than outpatient organisms. A collection of 143 gentamicin-resistant gram-negative bacilli was significantly more resistant to piperacillin than a species-matched collection of gentamicin-sensitive organisms. Piperacillin resistance was transferred by conjugation from isolates of 8 different Enterobacteriaceae species to a recipient Escherichia coli strain.

Susceptibility of streptococci to newer tetracyclines and cephalosporins and to other antimicrobial agents.

Two hundred and thirty-nine strains of Streptococcus including 71 strains of Group A, 81 strains of Group B, 69 strains of enterococci, and 18 strains of S. pneumoniae were tested against 12 antimicrobial agents using an agar dilution method. Cefamandole was the most active cephalosporin tested.

Sensitivity of gentamicin-resistant Enterobacteriaceae to cefamandole and cefoxitin.

A collection of gentamicin-resistant Enterobacteriaceae strains was significantly more resistant to cefamandole than a species-matched collection of gentamicin-sensitive organisms. Cefamandole and gentamicin resistance could be simultaneously transferred by conjugation from four different species, Citrobacter freundii, Escherichia coli, Klebsiella pneumoniae and Serratia marcescens, to a recipient E. coli strain.

Laboratory evaluation of a multitest system for identification of gram-negative organisms.

Seventy-two oxidase-positive or nonfermentative organisms, or both, all of which could be identified with reasonable certainty by alternative means, were used to challenge the OXI/FERM tube. There was 91% concurrence of identification between the two methods. Three observers, working independently, agreed upon the interpretation of each of the tests in the OXI/FERM system from 91% to 100% of the time.

In vitro antibiotic sensitivity of Moraxella species.

Minimal inhibitory concentrations of 17 antibacterial agents for 34 Moraxella strains were determined using a plate dilution method. A strain of Moraxella nonliquefaciens was found which produced beta-lactamase and was resistant to ampicillin and carbenicillin but not to cephalothin. Several strains were relatively resistant to erythromycin and sulfisoxazole.

The clinical significance of Acinetobacter species.

Of 50 consecutive patients from whom Acinetobacter species were isolated, only one had an infection due to the organism which required antibiotic therapy. Fourteen of the isolates were associated with minor body surface infections and the remainder occurred as the result of either colonization without infection or culture contamination. The taxonomy, natural occurrence and antibiotic sensitivity of Acinetobacter species and their differentiation from more pathogenic organisms are reviewed.