Publications by authors named "P Kohner"
Background: Rapid blood culture diagnostics are of unclear benefit for patients with gram-negative bacilli (GNB) bloodstream infections (BSIs). We conducted a multicenter, randomized, controlled trial comparing outcomes of patients with GNB BSIs who had blood culture testing with standard-of-care (SOC) culture and antimicrobial susceptibility testing (AST) vs rapid organism identification (ID) and phenotypic AST using the Accelerate Pheno System (RAPID).
Methods: Patients with positive blood cultures with Gram stains showing GNB were randomized to SOC testing with antimicrobial stewardship (AS) review or RAPID with AS.
Article Synopsis
- Plasmid-mediated colistin resistance (PMCR) is a significant global health issue due to its ability to spread easily among bacteria.
- This study assessed two detection methods for PMCR: the NG-Test MCR-1 lateral flow immunoassay and the EDTA-colistin broth disk elution screening test, using clinical isolates from U.S. hospitals.
- Both methods demonstrated high levels of accuracy, with the MCR-1 test achieving a positive percent agreement of 100% and the EDTA-CBDE method a similar 100%, making them effective tools for identifying and managing colistin resistance in clinical settings.
Article Synopsis
- Susceptibility testing for polymyxins (colistin and polymyxin B) is complex for labs, leading the CLSI Antimicrobial Susceptibility Testing Subcommittee to evaluate two specific methods: colistin broth disk elution (CBDE) and colistin agar test (CAT) using two different inoculum volumes (CAT-1 and CAT-10).
- The evaluation involved 270 bacterial isolates, showing high agreement rates of 94.4% for CBDE and varying results for CAT-1 (94.9%) and CAT-10 (98.3%), with most errors being minor.
- The CLSI recommends using CBDE and CAT-10 as reliable methods for accurately testing susceptibility of colistin against the isolates evaluated
Objective: To evaluate whole-genome sequencing (WGS) as a molecular typing tool for MRSA outbreak investigation.
Design: Investigation of MRSA colonization/infection in a neonatal intensive care unit (NICU) over 3 years (2014-2017).
Setting: Single-center level IV NICU.
Daptomycin has become a mainstay therapy for the treatment of serious vancomycin-resistant infections. However, concern exists that current testing methods do not accurately predict the clinical success of daptomycin therapy. We evaluated a collection of 40 isolates of across three centers by reference broth microdilution (BMD), and two gradient strips, to determine the precision of daptomycin MICs by these methods and the correlation of daptomycin MIC testing with mutations in the system, one of the primary daptomycin resistance mechanisms among the enterococci.
View Article and Find Full Text PDF