MALDI-TOF identification of Gram-negative bacteria directly from blood culture bottles containing charcoal: Sepsityper® kits versus centrifugation-filtration method.

Matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry has dramatically altered the way microbiology laboratories identify clinical isolates. Direct blood culture (BC) detection may be hampered, however, by the presence of charcoal in BC bottles currently in clinical use. This study evaluates an in-house process for extraction and MALDI-TOF identification of Gram-negative bacteria directly from BC bottles containing charcoal.

Use of portable electronic devices in a hospital setting and their potential for bacterial colonization.

Portable electronic devices are increasingly being used in the hospital setting. As with other fomites, these devices represent a potential reservoir for the transmission of pathogens. We conducted a convenience sampling of devices in 2 large medical centers to identify bacterial colonization rates and potential risk factors.

Invasive Bordetella holmesii infections.

Bordetella holmesii is a rare cause of invasive human disease. The fastidious and unusual nature of this organism makes routine isolation and identification challenging. We report two cases of B.

Clinical value of chest computerized tomography scans in patients admitted with pneumonia.

Patients admitted with pneumonia often receive a chest computed tomography (CT) scan for a variety of reasons. We conducted this study to evaluate our overall utilization and the clinical impact of CT scans in patients admitted to our institution with pneumonia. Patients admitted to our facility from January 2008 through November 2011 with a confirmed diagnosis of pneumonia were eligible for evaluation.

The role of intravenous catheters in cardiovascular implantable electronic device infections: identifying potential targets for prevention.

Infections related to cardiac implantable electronic devices (CIEDs) are increasing in prevalence and carry substantial morbidity and mortality. Complications involving peripheral intravenous catheters resulting in CIED infections have not yet been investigated and may pose an important risk factor. We report 5 cases of CIED infection related to documented complications of peripheral vascular devices.

Analysis of antibiotic resistance genes in multidrug-resistant Acinetobacter sp. isolates from military and civilian patients treated at the Walter Reed Army Medical Center.

Military medical facilities treating patients injured in Iraq and Afghanistan have identified a large number of multidrug-resistant (MDR) Acinetobacter baumannii isolates. In order to anticipate the impact of these pathogens on patient care, we analyzed the antibiotic resistance genes responsible for the MDR phenotype in Acinetobacter sp. isolates collected from patients at the Walter Reed Army Medical Center (WRAMC).

Nocardia kruczakiae sp. nov., a pathogen in immunocompromised patients and a member of the "N. nova complex".

Molecular methodologies have become useful techniques for the identification of pathogenic Nocardia species and for the recognition of novel species that are capable of causing human disease. Two isolates recovered from immunocompromised patients were characterized as Nocardia nova by biochemical and susceptibility testing results. The restriction fragment length polymorphism (RFLP) patterns obtained by restriction endonuclease analysis (REA) of an amplified portion of the heat shock protein gene were identical to those obtained with the type strain of N.

Aerosolized biologic toxins as agents of warfare and terrorism.

Incomplete participation in the 1972 Biological Weapons Convention treaty and noncompliance by several signatory nations makes the malicious use of aerosolized biologic toxins a continuing threat. Unfortunately,prompt diagnosis of toxin exposure may be confounded by a paucity of pathognomonic features and limited diagnostics, but the scenario of patients presenting en masse with a similar pulmonary syndrome should alert the clinician to the possibility of aerosolized toxin exposure. As knowledge of these agents increases, so too should the capabilities for detection,protection, diagnosis, and therapy.

Eosinophilic meningitis: a case series report and review of the literature.

Prompted by a case of eosinophilic meningitis (EM), a review of the literature was performed to evaluate the strength of the diagnoses associated with EM and compares these results with our hospital's experience. Articles were critically reviewed for supporting evidence, method of diagnosis, and established standards for specific diagnosis. EM has been defined as > or = 10 eosinophils per mm3 or > or = 10% eosinophils of total cell count.

Nosocomial transmission of methicillin-resistant Staphylococcus aureus: a blinded study to establish baseline acquisition rates.

Objective: To define the extent of nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to a tertiary-care hospital.

Design: A blinded, prospective surveillance culture study of patients admitted to the hospital to determine the transmission (acquisition) rate of MRSA. Risk factors associated with the likelihood of MRSA colonization on admission were investigated.

Tuberculous tenosynovitis of the tibialis anterior tendon: a case report.

Tuberculous tenosynovitis is an uncommon form of extrapulmonary tuberculosis occurring primarily in the hands and wrists with limited reports involving the lower extremities. We report a rare case of tuberculous tenosynovitis of the tibialis anterior tendon occurring in a 37-year-old Filipino male. The tendon was surgically debrided and the patient was given a six month course of antituberculin chemotherapy.

Surveillance for methicillin-resistant Staphylococcus aureus in Battambang, Cambodia.

Methicillin-resistant Staphylococcus aureus (MRSA) and humanitarian missions are increasing worldwide. The prevalence of MRSA in the populations served may be unknown. A BRAVA (Blast Resuscitlation and Victim Assistance) mission was conducted at Battambang, Cambodia that included microbiology support.

Empiric immunization versus serologic screening: developing a cost-effective strategy for the use of hepatitis A immunization in travelers.

Background: Older individuals and those born overseas are thought at increased risk of prior exposure and thus have naturally acquired immunity to hepatitis A. Whether these individuals or other groups of international travelers should be screened for acquired immunity or empirically immunized is not clear. Hepatitis A serology and risk factor data was obtained prospectively in patients presenting for hepatitis A immunization and used to develop a cost-effective strategy for the use of serologic screening and empiric immunization in our traveler population.