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Sample records for disc susceptibility testing

  1. BSAC standardized disc susceptibility testing method (version 11).

    PubMed

    Howe, R A; Andrews, J M

    2012-12-01

    This article highlights key amendments incorporated into version 11 of the BSAC standardized disc susceptibility testing method, available as Supplementary data at JAC Online (http://jac.oxfordjournals.org/) and on the BSAC web site (http://bsac.org.uk/susceptibility/guidelines-standardized-disc-susceptibility-testing-method/). The basic disc susceptibility testing method remains unchanged, but there have been a number of alterations to the interpretive criteria for certain organism/drug combinations due to continuing harmonization with the EUCAST MIC breakpoints and constant efforts to improve the reliability and clinical applicability of the guidance.

  2. Comparison of three standardized disc susceptibility testing methods for colistin.

    PubMed

    Tan, Thean Yen; Ng, Lily Siew Yong

    2006-10-01

    With increasing antibiotic resistance in Gram-negative bacteria, the use of the polymyxins has increased in recent years. Antibiotic disc susceptibility testing remains the most widely used method in clinical laboratories, but there is very little data on the accuracy of disc testing methods for colistin. In this study, the accuracy of three standardized methods of disc susceptibility testing for colistin was compared with agar dilution. A total of 228 clinical isolates of Acinetobacter spp., Pseudomonas aeruginosa and Enterobacteriaceae were included in the study. Isolates were tested by agar dilution for susceptibility to colistin, and results were compared with those obtained by three disc susceptibility testing methods (product insert based on CLSI methodology, British BSAC and French SFM). Colistin displayed good activity against Acinetobacter spp., Klebsiella spp. and Escherichia coli (MIC(90) 2 mg/L) but was less active against P. aeruginosa (MIC(90) 4 mg/L) and Enterobacter spp. (MIC(90) >or= 128 mg/L). Totally, 81%, 79% and 89% of colistin-resistant isolates were falsely reported as susceptible when tested by the product insert, BSAC and SFM testing methods, respectively. There were no false-resistant results. Disc susceptibility testing methods are unreliable at detecting colistin resistance. Dilution methods should be the method of choice for susceptibility testing of colistin.

  3. 21 CFR 866.1620 - Antimicrobial susceptibility test disc.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... of antimicrobic-impregnated paper discs used to measure by a disc-agar diffusion technique or a disc... antimicrobial agents. In the disc-agar diffusion technique, bacterial susceptibility is ascertained by directly...

  4. 21 CFR 866.1620 - Antimicrobial susceptibility test disc.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... of antimicrobic-impregnated paper discs used to measure by a disc-agar diffusion technique or a disc... antimicrobial agents. In the disc-agar diffusion technique, bacterial susceptibility is ascertained by directly...

  5. 21 CFR 866.1620 - Antimicrobial susceptibility test disc.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... of antimicrobic-impregnated paper discs used to measure by a disc-agar diffusion technique or a disc... antimicrobial agents. In the disc-agar diffusion technique, bacterial susceptibility is ascertained by directly...

  6. 21 CFR 866.1620 - Antimicrobial susceptibility test disc.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... of antimicrobic-impregnated paper discs used to measure by a disc-agar diffusion technique or a disc... antimicrobial agents. In the disc-agar diffusion technique, bacterial susceptibility is ascertained by directly...

  7. 21 CFR 866.1620 - Antimicrobial susceptibility test disc.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Antimicrobial susceptibility test disc. 866.1620 Section 866.1620 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... to determine the antimicrobial agent of choice in the treatment of bacterial diseases....

  8. BSAC standardized disc susceptibility testing method (version 10).

    PubMed

    Andrews, J M; Howe, R A

    2011-12-01

    The BSAC standardized disc susceptibility testing method remains unchanged, but there are considerable changes to the interpretative criteria due to continuing harmonization with the European Committee on Antimicrobial Susceptibility Testing (EUCAST) MIC breakpoints. There are a number of agents for which interpretative criteria have been removed. These MIC and/or zone diameter breakpoints will be published on the BSAC web site as a 'Legacy' table; they may be used for research or comparative purposes, but are not recommended for clinical management. Notably, testing of staphylococci for susceptibility to glycopeptides by disc diffusion has been removed because this method has been found to be unreliable, particularly for the detection of low-level resistance; low-level vancomycin resistance in staphylococci is increasingly deemed to be of clinical relevance. The tables for anaerobes have been expanded to include MIC breakpoints that have been determined by EUCAST. There are currently no zone diameter breakpoints for these organisms and an MIC method is recommended if susceptibility testing is required.

  9. Standardized Antimicrobial Disc Susceptibility Testing of Anaerobic Bacteria. I. Susceptibility of Bacteroides fragilis to Tetracycline

    PubMed Central

    Sutter, Vera L.; Kwok, Yung-Yuan; Finegold, Sydney M.

    1972-01-01

    A modified Bauer-Kirby-Sherris-Turck method for disc susceptibility testing of anaerobic bacteria is presented. When tetracycline was used against 100 strains of Bacteroides fragilis as a model, reasonably reproducible results were obtained after overnight incubation in both the GasPak atmosphere and an atmosphere achieved by adding 10% CO2 to a mixture of 10% H2 and 90% N2. The minimal inhibitory concentration for the strains determined by the agar dilution technique correlated well with the results of disc tests performed in the GasPak atmosphere with 30-μg tetracycline discs. Among 63 strains isolated from 1970 to the present, only 24 (38.1%) were found to be susceptible to tetracycline. PMID:5017675

  10. BSAC standardized disc susceptibility testing method (version 8).

    PubMed

    Andrews, J M

    2009-09-01

    azithromycin, clarithromycin, erythromycin and telithromycin (Table 15); clarithromycin and erythromycin MIC and zone diameter BPs for Moraxella catarrhalis (Table 16); azithromycin MIC BPs for Neisseria gonorrhoeae (Table 17); chloramphenicol and rifampicin MIC BPs for Neisseria meningitidis (Table 18); azithromycin MIC BPs for Haemophilus influenzae (Table 19); MIC BPs for metronidazole for Bacteroides fragilis, Bacteroides thetaiotaomicron and Clostridium perfringens (Tables 23-25, respectively); susceptibility testing of Listeria spp. (Appendix 3); the acceptable range for ATCC 25923 to a 10 microg tobramycin disc (Table 26).

  11. BSAC standardized disc susceptibility testing method (version 7).

    PubMed

    Andrews, J M

    2008-08-01

    The changes that have been made to the previous version of the recommendations (version 6) are as follows: medium and incubation condition for testing Acinetobacter spp. (Tables 1 and 6); use of cefoxitin as an indicator antibiotic for detecting methicillin/oxacillin/cefoxitin resistance in coagulase-negative staphylococci (Tables 1, 6 and 11); MIC breakpoint for co-trimoxazole based on the trimethoprim concentration in a 1:19 combination with sulfamethoxazole (Tables 7, 10, 11, 12, 15, 16 and 19); advice on the use of azithromycin for the treatment of infections with Salmonella typhi (footnote to Table 7); amendment to the recommendation for cefuroxime for the treatment of infections with Proteus mirabilis (footnote Table 7); MIC and zone diameter breakpoints for Stenotrophomonas maltophilia only (Table 10); MIC breakpoints for daptomycin (Tables 11 and 15); clarification for staphylococci that the neomycin zone diameter breakpoints are for topical use only and differentiate the isolates outside the 'wild-type' population in Table 11; clarification for beta-haemolytic streptococci that the linezolid zone diameter breakpoints relate to an MIC breakpoint of 2 mg/L as no data for the intermediate category are currently available (Table 15); clarification that strains with reduced susceptibility to fluoroquinolones give no zone of inhibition with a 30 microg nalidixic acid disc (Tables 16 and 21); erythromycin is no longer used for therapy of Neisseria gonorrhoeae, but may be tested for epidemiological purposes (Table 17); clarification that the ciprofloxacin zone diameter breakpoint for Neisseria meningitidis relates to the MIC breakpoint of 0.03 mg/L as no data for the intermediate category are currently available; clarification that the ciprofloxacin zone diameter breakpoints for Campylobacter spp. relate to an MIC breakpoint of 0.5 mg/L as no data for the intermediate category are currently available; clarification that for ciprofloxacin and vancomycin zone

  12. Rifaximin disc diffusion test for in vitro susceptibility testing of Clostridium difficile.

    PubMed

    Huhulescu, Steliana; Sagel, Ulrich; Fiedler, Anita; Pecavar, Verena; Blaschitz, Marion; Wewalka, Guenther; Allerberger, Franz; Indra, Alexander

    2011-08-01

    Rifaximin is a rifampicin derivative, poorly absorbed by the gastro-intestinal tract. We studied the in vitro susceptibility to rifamixin of 1082 Clostridium difficile isolates; among these, 184 isolates from a strain collection were tested by an in-house rifaximin disc (40 µg) diffusion test, by an in-house rifaximin broth microdilution test, by rifampicin Etest and by rpoB gene sequencing. In the absence of respective CLSI or EUCAST MIC breakpoints for rifaximin and rifampicin against C. difficile we chose MIC ≥32 µg ml(-1) as criterion for reduced in vitro susceptibility. To further validate the disc diffusion test 898 consecutive clinical isolates were analysed using the disc diffusion test, the Etest and rpoB gene sequence analysis for all resistant strains. Rifaximin broth microdilution tests of the 184 reference strains yielded rifaximin MICs ranging from 0.001 (n = 1) to ≥1024 µg ml(-1) (n = 61); 62 isolates showed a reduced susceptibility (MIC ≥32 µg ml(-1)). All of these 62 strains showed rpoB gene mutations producing amino acid substitutions; the rifampicin- and rifaximin-susceptible strains showed either a wild-type sequence or silent amino acid substitutions (19 strains). For 11 arbitrarily chosen isolates with rifaximin MICs of >1024 µg ml(-1), rifaximin end-point MICs were determined by broth dilution: 4096 µg ml(-1) (n = 2), 8192 µg ml(-1) (n = 6), 16,384 µg ml(-1) (n = 2) and 32,678 µg ml(-1) (n = 1). Rifampicin Etests on the 184 C. difficile reference strains yielded MICs ranging from ≤0.002 (n = 117) to ≥32 µg ml(-1) (n = 59). Using a 38 mm inhibition zone as breakpoint for reduced susceptibility the use of rifaximin disc diffusion yielded 59 results correlating with those obtained by use of rifaximin broth microdilution in 98.4 % of the 184 strains tested. Rifampicin Etests performed on the 898 clinical isolates revealed that 67 isolates had MICs of ≥32 µg ml(-1). There were no discordant

  13. Rifaximin disc diffusion test for in vitro susceptibility testing of Clostridium difficile

    PubMed Central

    Huhulescu, Steliana; Sagel, Ulrich; Fiedler, Anita; Pecavar, Verena; Blaschitz, Marion; Wewalka, Guenther; Allerberger, Franz

    2011-01-01

    Rifaximin is a rifampicin derivative, poorly absorbed by the gastro-intestinal tract. We studied the in vitro susceptibility to rifamixin of 1082 Clostridium difficile isolates; among these,184 isolates from a strain collection were tested by an in-house rifaximin disc (40 µg) diffusion test, by an in-house rifaximin broth microdilution test, by rifampicin Etest and by rpoB gene sequencing. In the absence of respective CLSI or EUCAST MIC breakpoints for rifaximin and rifampicin against C. difficile we chose MIC ≥32 µg ml−1 as criterion for reduced in vitro susceptibility. To further validate the disc diffusion test 898 consecutive clinical isolates were analysed using the disc diffusion test, the Etest and rpoB gene sequence analysis for all resistant strains. Rifaximin broth microdilution tests of the 184 reference strains yielded rifaximin MICs ranging from 0.001 (n = 1) to ≥1024 µg ml−1 (n = 61); 62 isolates showed a reduced susceptibility (MIC ≥32 µg ml−1). All of these 62 strains showed rpoB gene mutations producing amino acid substitutions; the rifampicin- and rifaximin-susceptible strains showed either a wild-type sequence or silent amino acid substitutions (19 strains). For 11 arbitrarily chosen isolates with rifaximin MICs of >1024 µg ml−1, rifaximin end-point MICs were determined by broth dilution: 4096 µg ml−1 (n = 2), 8192 µg ml−1 (n = 6), 16 384 µg ml−1 (n = 2) and 32 678 µg ml−1 (n = 1). Rifampicin Etests on the 184 C. difficile reference strains yielded MICs ranging from ≤0.002 (n = 117) to ≥32 µg ml−1 (n = 59). Using a 38 mm inhibition zone as breakpoint for reduced susceptibility the use of rifaximin disc diffusion yielded 59 results correlating with those obtained by use of rifaximin broth microdilution in 98.4 % of the 184 strains tested. Rifampicin Etests performed on the 898 clinical isolates revealed that 67 isolates had MICs of ≥32 µg ml−1. There were no

  14. Comparison of disc diffusion, Etest and agar dilution for susceptibility testing of colistin against Enterobacteriaceae.

    PubMed

    Maalej, S M; Meziou, M R; Rhimi, F M; Hammami, A

    2011-11-01

    In this study, we compared different methods of colistin susceptibility testing, disc diffusion, agar dilution and Etest using a set of Enterobacteriaceae isolates that included colistin-resistant strains. Susceptibility of 200 clinical isolates of Enterobacteriaceae to colistin was tested to compare agar dilution (reference method), disc diffusion (50 and 10 μg) and Etest. MICs (minimum inhibitory concentrations) were interpreted using the criteria established by the European Committee on Antimicrobial Susceptibility Testing (EUCAST). Colistin exhibited excellent activity against Escherichia coli and E. cloacae (MIC90 = 0·5 mg l(-1)). In contrast, colistin was less active against Klebsiella pneumoniae (MIC90 = 16 mg l(-1)). Resistance rates varied from 0% in E. coli to 1·8% in E. cloacae and 13% in K. pneumoniae. High rates of very major errors were observed in the disc diffusion test using either the criteria of the Comité de l'antibiogramme de la Société Française de Microbiologie (CA-SFM) or the criteria of the Clinical and Laboratory Standards Institute (CLSI), respectively, 3·5 and 2·5%. When the criteria of Gales et al. were applied, the number of very major errors was reduced to one (0·5%). The Etest showed good concordance with agar dilution method. Disc susceptibility testing methods are unreliable on detecting colistin resistance. MIC should be determined to confirm the susceptibility results by disc diffusion. We recommend the determination of MIC by Etest for all multidrug-resistant Enterobacteriaceae when colistin is required for the treatment. © 2011 The Authors. Letters in Applied Microbiology © 2011 The Society for Applied Microbiology.

  15. Evaluation of a Computer-Associated Electronic Zone Analyzer in Single-Disc Antimicrobial Susceptibility Testing

    PubMed Central

    Moellering, Robert C.; Mercier, Bettie A.; Kunz, Lawrence J.; Poitras, James W.

    1972-01-01

    A computer-associated electronic zone analyzer was evaluated for use in measuring zones of inhibition for single-disc antimicrobial susceptibility testing. This unit gave measurements which were reproducible and comparable to those obtained by the standard manual technique. By feeding results directly into the computer, this system eliminates errors in interpretation of zone sizes and in transcription of results to clinical reports. It has also been shown to eliminate possible sources of observer bias. In routine high-volume use, this system has resulted in a substantial saving of man-hours of work. Images PMID:4670493

  16. Reproducibility of control organism zone diameters for batches of IsoSensitest agar manufactured from 1996 to 2000 using the BSAC disc susceptibility test method.

    PubMed

    Landrygan, Janine; James, Peter A; Brooks, Dawn; Kubiak, Elizabeth M

    2002-02-01

    The BSAC Working Party on Susceptibility Testing has recently suggested that the performance of IsoSensitest agar has changed since 1991. Twenty batches of IsoSensitest agar that had been manufactured between 1996 and 2000 were tested using the BSAC standardized disc susceptibility testing method. Antibiotic discs containing amoxicillin 10 microg, ceftazidime 30 microg, gentamicin 10 microg, ciprofloxacin 1 microg and colistin sulphate 25 microg were tested on each batch of media 12 times against Escherichia coli ATCC 25922, Staphylococcus aureus ATCC 25923 and Pseudomonas aeruginosa ATCC 27853 where appropriate. There was a small reduction in zone sizes for most antibiotics on batches of media that were near their expiration date, but otherwise zone sizes were remarkably consistent. We could find no evidence to suggest that a change in the performance of IsoSensitest agar for the disc diffusion method had occurred since 1996.

  17. Comparison of disc diffusion and epsilometer (E-test) testing techniques to determine antimicrobial susceptibility of Campylobacter isolates of food and human clinical origin.

    PubMed

    McGill, K; Kelly, L; Madden, R H; Moran, L; Carroll, C; O'Leary, A; Moore, J E; McNamara, E; O'Mahony, M; Fanning, S; Whyte, P

    2009-11-01

    The antibiotic resistance profiles of 75 Campylobacter isolates of food and human clinical origin was determined by two agar diffusion susceptibility methods; disc diffusion and epsilometer-test (E-test). The most common therapeutic antimicrobials, erythromycin, ciprofloxacin and tetracycline were studied, along with chloramphenicol, ampicillin and naladixic acid. The resistance observed for each antimicrobial, as determined by both of methods, were statistically compared using Fisher two-tailed analysis. Of the six antimicrobials studied only two were shown to have statistically different patterns when resistance was compared by disc diffusion and E-test. The percentage of isolates resistant to clinically relevant antimicrobials using both techniques ranged from 6.6 to 21.3% for erythromycin, 25.3-26.6% for tetracycline and 33.3-36.0% for ciprofloxacin. The prevalence of multi-drug resistant (MDR) campylobacters (isolates resistant to 2 or more antimicrobials) for both disc diffusion and E-test was 44%. It can be concluded that, for four of the six antimicrobials assessed, antimicrobial resistance prevalences could be equally determined by either of the methods studied.

  18. Comparative Evaluation of Disc Diffusion and E-test with Broth Micro-dilution in Susceptibility testing of Amphotericin B, Voriconazole and Caspofungin against Clinical Aspergillus isolates

    PubMed Central

    Khare, Vineeta; Kumar, Deepak; Ahmad, Abrar; Banerjee, Gopa; Singh, Mastan

    2015-01-01

    Background: Clinical importance of Aspergillus has increased over the past few decades because of rise in immunosuppressive drugs and immune-modulating diseases. Antifungal susceptibility of Aspergillus is rarely performed by clinical laboratories because of lack of easier method. This study has investigated and compared susceptibility pattern of Aspergillus isolates by disc diffusion, E-test and broth micro-dilution for amphotericin B, voriconazole and caspofungin. Materials and Methods: Disk diffusion (DD) method of antifungal susceptibility (AFS) was evaluated for three different classes of antifungals: amphotericin B (AMB), voriconazole (VCZ) and caspofungin (CAS). Forty four clinical isolates of Aspergillus were selected; these included 34 A.fumigatus, 8 A.flavus and 2 A. terreus. AFS by DD and E-test was done on non-supplemented Mueller Hinton Agar (MHA) and was compared to Clinical Laboratory Standard Institute(CLSI) broth micro-dilution (BMD) method of AFS. Results: Disk diffusion method for amphotericin B showed 87.5% agreement while E-test showed 93.8% agreement with broth micro-dilution. The agreement with broth micro-dilution was similar for both disk diffusion and E-test in case of voriconazole (93.8%) and caspofungin (100%). 31.8% and 9.1% Aspergillus isolates were found to have amphotericin B and voriconazole MIC values above epidemiological cut off value (ECV) respectively. All isolates were within ECV for caspofungin. Conclusion: CLSI method of DD promises to be easier, reproducible and cost effective method of susceptibility testing, but this method must be interpreted with caution in case of amphotericin B susceptibility testing. E-test correlates better than DD with BMD. PMID:25737984

  19. Comparative Evaluation of Disc Diffusion and E-test with Broth Micro-dilution in Susceptibility testing of Amphotericin B, Voriconazole and Caspofungin against Clinical Aspergillus isolates.

    PubMed

    Gupta, Prashant; Khare, Vineeta; Kumar, Deepak; Ahmad, Abrar; Banerjee, Gopa; Singh, Mastan

    2015-01-01

    Clinical importance of Aspergillus has increased over the past few decades because of rise in immunosuppressive drugs and immune-modulating diseases. Antifungal susceptibility of Aspergillus is rarely performed by clinical laboratories because of lack of easier method. This study has investigated and compared susceptibility pattern of Aspergillus isolates by disc diffusion, E-test and broth micro-dilution for amphotericin B, voriconazole and caspofungin. Disk diffusion (DD) method of antifungal susceptibility (AFS) was evaluated for three different classes of antifungals: amphotericin B (AMB), voriconazole (VCZ) and caspofungin (CAS). Forty four clinical isolates of Aspergillus were selected; these included 34 A.fumigatus, 8 A.flavus and 2 A. terreus. AFS by DD and E-test was done on non-supplemented Mueller Hinton Agar (MHA) and was compared to Clinical Laboratory Standard Institute(CLSI) broth micro-dilution (BMD) method of AFS. Disk diffusion method for amphotericin B showed 87.5% agreement while E-test showed 93.8% agreement with broth micro-dilution. The agreement with broth micro-dilution was similar for both disk diffusion and E-test in case of voriconazole (93.8%) and caspofungin (100%). 31.8% and 9.1% Aspergillus isolates were found to have amphotericin B and voriconazole MIC values above epidemiological cut off value (ECV) respectively. All isolates were within ECV for caspofungin. CLSI method of DD promises to be easier, reproducible and cost effective method of susceptibility testing, but this method must be interpreted with caution in case of amphotericin B susceptibility testing. E-test correlates better than DD with BMD.

  20. Comparative assessment of CDS, CLSI disc diffusion and Etest techniques for antimicrobial susceptibility testing of Neisseria gonorrhoeae: a 6-year study

    PubMed Central

    Singh, Vikram; Kakran, Monika; Ramesh, V

    2012-01-01

    Background A variety of techniques are available for antimicrobial susceptibility testing of Neisseria gonorrhoeae. Objective The aim of this study was to find a cost-effective, reliable and easily applicable microbiological method to detect antimicrobial susceptibilities of N. gonorrhoeae in resource-poor countries. Design Prospective study. Setting Male and female STD clinic of Regional STD Teaching, Training and Research Centre, New Delhi, India. Participants N. gonorrhoeae isolates from all male and female patients presenting with acute gonococcal urethritis and cervical discharge. Material and methods A total of 295 consecutive N. gonorrhoeae isolates during 2005–2010 was used to compare the Clinical and Laboratory Standards Institute (CLSI) and CDS disc diffusion technique with Etest by performing antimicrobial susceptibility testing in parallel for penicillin, tetracycline, ceftriaxone, ciprofloxacin and spectinomycin. WHO reference strains were used as controls. Results CDS disc diffusion zones of inhibition showed that complete percentage agreement for penicillin, ciprofloxacin and tetracycline was high with their analogous Etest minimal inhibitory concentrations in comparison to CLSI disc diffusion technique, that is, 91.5%, 92.9% and 99.3% versus 87.5%, 88.5% and 74.9%, respectively. CDS results had less number of major and minor category discrepancies in comparison to CLSI and CDS method showed excellent correlation coefficient (r=1) with Etest for all five antimicrobial agents tested in comparison to CLSI (r=0.92). It was very poor (r=0.61) by CLSI method for tetracycline. The correlation coefficients between the two methods and the Etest were identical if tetracycline was removed from the CLSI analysis. Conclusions The CDS technique is an attractive alternative for N. gonorrhoeae susceptibility testing and is recommended for monitoring the antimicrobial susceptibility in less developed and resource-poor settings to facilitate enhanced antimicrobial

  1. Comparative assessment of CDS, CLSI disc diffusion and Etest techniques for antimicrobial susceptibility testing of Neisseria gonorrhoeae: a 6-year study.

    PubMed

    Singh, Vikram; Bala, Manju; Kakran, Monika; Ramesh, V

    2012-01-01

    A variety of techniques are available for antimicrobial susceptibility testing of Neisseria gonorrhoeae. The aim of this study was to find a cost-effective, reliable and easily applicable microbiological method to detect antimicrobial susceptibilities of N. gonorrhoeae in resource-poor countries. Prospective study. Male and female STD clinic of Regional STD Teaching, Training and Research Centre, New Delhi, India. N. gonorrhoeae isolates from all male and female patients presenting with acute gonococcal urethritis and cervical discharge. A total of 295 consecutive N. gonorrhoeae isolates during 2005-2010 was used to compare the Clinical and Laboratory Standards Institute (CLSI) and CDS disc diffusion technique with Etest by performing antimicrobial susceptibility testing in parallel for penicillin, tetracycline, ceftriaxone, ciprofloxacin and spectinomycin. WHO reference strains were used as controls. CDS disc diffusion zones of inhibition showed that complete percentage agreement for penicillin, ciprofloxacin and tetracycline was high with their analogous Etest minimal inhibitory concentrations in comparison to CLSI disc diffusion technique, that is, 91.5%, 92.9% and 99.3% versus 87.5%, 88.5% and 74.9%, respectively. CDS results had less number of major and minor category discrepancies in comparison to CLSI and CDS method showed excellent correlation coefficient (r=1) with Etest for all five antimicrobial agents tested in comparison to CLSI (r=0.92). It was very poor (r=0.61) by CLSI method for tetracycline. The correlation coefficients between the two methods and the Etest were identical if tetracycline was removed from the CLSI analysis. The CDS technique is an attractive alternative for N. gonorrhoeae susceptibility testing and is recommended for monitoring the antimicrobial susceptibility in less developed and resource-poor settings to facilitate enhanced antimicrobial resistance surveillance when the WHO Gonococcal Antimicrobial Surveillance Programme is

  2. Comparative Analysis of Disc Diffusion and E-test with Broth Micro-dilution for Susceptibility Testing of Clinical Candida Isolates Against Amphotericin B, Fluconazole, Voriconazole and Caspofungin

    PubMed Central

    Bhattacharyya, Sayan; Gupta, Prashant; Banerjee, Gopa; Singh, Mastan

    2015-01-01

    Background Antifungal susceptibility testing remains an area of intense interest because of the increasing number of clinical isolates resistant to antifungal therapy. Clinical and Laboratory Standards Institute has proposed reference broth micro dilution (BMD) method for susceptibility testing. The reference method is time-consuming and poorly suited for the routine clinical laboratory setting. Agar-based susceptibility testing methods, disk diffusion (DD) method and the E-test method can be an easier, reliable and less time consuming alternative for the BMD method. Aim To compare the results of Amphotericin B, fluconazole, voriconazole, and Caspofungin susceptibility testing by DD, and the E-test method with the CLSI reference method for clinical Candida isolates. Materials and Methods Broth Microdilution (BMD), E-test and Disk diffusion testing of the various clinical Candida isolates was performed in accordance with CLSI documents. The results obtained were analysed and compared. Results The categorical agreement for Amphotericin B, fluconazole, voriconazole, and Caspofungin susceptibility results by E-test and DD method was 65.2%, 67.4%; 100%, 82.6%; 100%, 100%; 100%, 97.8% respectively. Conclusion The agar-based E-test and disk diffusion methods are reliable alternatives to the BMD method for Candida isolates when test susceptible to fluconazole, voriconazole, and Caspofungin, however the susceptibility testing results must be interpreted with caution in case of Amphotericin B. PMID:26675415

  3. Comparative Analysis of Disc Diffusion and E-test with Broth Micro-dilution for Susceptibility Testing of Clinical Candida Isolates Against Amphotericin B, Fluconazole, Voriconazole and Caspofungin.

    PubMed

    Kumar, Deepak; Bhattacharyya, Sayan; Gupta, Prashant; Banerjee, Gopa; Singh, Mastan

    2015-11-01

    Antifungal susceptibility testing remains an area of intense interest because of the increasing number of clinical isolates resistant to antifungal therapy. Clinical and Laboratory Standards Institute has proposed reference broth micro dilution (BMD) method for susceptibility testing. The reference method is time-consuming and poorly suited for the routine clinical laboratory setting. Agar-based susceptibility testing methods, disk diffusion (DD) method and the E-test method can be an easier, reliable and less time consuming alternative for the BMD method. To compare the results of Amphotericin B, fluconazole, voriconazole, and Caspofungin susceptibility testing by DD, and the E-test method with the CLSI reference method for clinical Candida isolates. Broth Microdilution (BMD), E-test and Disk diffusion testing of the various clinical Candida isolates was performed in accordance with CLSI documents. The results obtained were analysed and compared. The categorical agreement for Amphotericin B, fluconazole, voriconazole, and Caspofungin susceptibility results by E-test and DD method was 65.2%, 67.4%; 100%, 82.6%; 100%, 100%; 100%, 97.8% respectively. The agar-based E-test and disk diffusion methods are reliable alternatives to the BMD method for Candida isolates when test susceptible to fluconazole, voriconazole, and Caspofungin, however the susceptibility testing results must be interpreted with caution in case of Amphotericin B.

  4. Susceptibility Testing

    MedlinePlus

    ... Testing ; MRSA ; Fungal Tests ; Sputum Culture ; Stool Culture ; Gram Stain ; Body Fluid Analysis ; Pleural Fluid Analysis ; Pericardial ... to Get Tested? As follow up to a positive bacterial or fungal culture ; when you have an ...

  5. Evaluation of the mastascanelite image analysis system for measuring zones of inhibition in disc diffusion susceptibility tests.

    PubMed

    Clarke, R E H; Winstanley, T G; Ridgway, E J

    2003-01-01

    In this evaluation a mastascanelite image analysis system is compared with manual measurement of disc diffusion inhibition zones. Data for 213 diverse organisms and a total of 1679 organism/antibiotic combinations gave an overall correlation coefficient of 0.988. The mean difference between readings was +0.425 mm, with 95% confidence limits of +/-2.94 mm, and the majority of scanned zones (97.51%) fell within +/-3 mm of the manual measurement. The mastascanelite system forms part of a laboratory suite and was found to be objective, accurate and rapid, reading and interpreting each plate in less than a second. Interfacing to the laboratory computer system facilitated data handling and performance control.

  6. Instrumentation in antimicrobial susceptibility testing.

    PubMed

    Felmingham, D; Brown, D F

    2001-07-01

    Studies in the 1960s demonstrated the problems of variability in susceptibility testing methods, especially those affecting the performance of disc diffusion procedures. These studies made apparent the need for standardization and resulted in more clearly defined performance limits for growth medium, incubation conditions, inoculum concentration, disc content for diffusion methods, the setting of interpretative MIC breakpoints and the establishment of quality control parameters. More recently, there has been a growing interest in the use of instrumentation for reading disc diffusion tests and the endpoints of agar or broth dilution MIC determinations. Instrumentation ranges in complexity from the simple optical reading of zones of inhibition or growth endpoints, requiring operator interpretation, to more sophisticated devices for reading, recording and 'expert system' analysis of results with interfacing of instruments to laboratory information management systems. Some of the more developed systems are fully automated and can also identify the organisms tested. The pressure to reduce labour costs and provide results earlier favours the use of more automated systems whilst the requirement for resistance surveillance provides impetus for the use of systems that provide quantitative results and electronic data handling.

  7. Real-time video imaging as a new and rapid tool for antibiotic susceptibility testing by the disc diffusion method: a paradigm for evaluating resistance to imipenem and identifying extended-spectrum β-lactamases.

    PubMed

    Le Page, Stéphanie; Raoult, Didier; Rolain, Jean-Marc

    2015-01-01

    The disc diffusion method has long been considered the standard technique for antibiotic susceptibility testing (AST) in clinical microbiology laboratories because of its simplicity, reproducibility and low cost compared with commercial automated microdilution systems that are usually more rapid but less sensitive for detecting important mechanisms of resistance. Here we measured reading zone diameters around antibiotics in a series of 25 well-characterised Gram-negative bacteria by the disc diffusion technique in real-time using an Advencis Bio-System instrument consisting of a real-time high-resolution video imager in a dedicated incubator. The susceptibility of wild-type Gram-negative bacteria to imipenem, determined by reading the diameter of inhibition, was detectable as early as 3.5h (mean time 3.7 ± 0.45 h), whereas carbapenemase-producing Gram-negative bacteria could be correctly categorised as early as 3h (mean time 4.2 ± 0.8 h) of incubation. Similarly, the characteristic champagne cork aspect of extended-spectrum β-lactamase (ESBL) could be detected by the system as early as 3.5 h. Moreover, we present here for the first time video movies of the appearance of the diameter of inhibition by disc diffusion in real-time. This preliminary study using a new and innovative technology provides for a renewed interest for microbiologists who wish to continue to use the disc diffusion method as a reference method for AST. New video imaging technology presents a proof of concept that could improve the real-time management of patients with AST within a very rapid turnaround time and can provide a large financial saving for hospitals.

  8. Antifungal susceptibility testing.

    PubMed Central

    Rex, J H; Pfaller, M A; Rinaldi, M G; Polak, A; Galgiani, J N

    1993-01-01

    Unlike antibacterial susceptibility testing, reliable antifungal susceptibility testing is still largely in its infancy. Many methods have been described, but they produce widely discrepant results unless such factors as pH, inoculum size, medium formulation, incubation time, and incubation temperature are carefully controlled. Even when laboratories agree upon a common method, interlaboratory agreement may be poor. As a result of numerous collaborative projects carried out both independently and under the aegis of the Subcommittee on Antifungal Susceptibility Testing of the National Committee for Clinical Laboratory Standards, the effects of varying these factors have been extensively studied and a standard method which minimizes interlaboratory variability during the testing of Candida spp. and Cryptococcus neoformans has been proposed. This review summarizes this work, reviews the strengths and weaknesses of the proposed susceptibility testing standard, and identifies directions for future work. PMID:8269392

  9. Antifungal susceptibility testing.

    PubMed

    Rex, J H; Pfaller, M A; Rinaldi, M G; Polak, A; Galgiani, J N

    1993-10-01

    Unlike antibacterial susceptibility testing, reliable antifungal susceptibility testing is still largely in its infancy. Many methods have been described, but they produce widely discrepant results unless such factors as pH, inoculum size, medium formulation, incubation time, and incubation temperature are carefully controlled. Even when laboratories agree upon a common method, interlaboratory agreement may be poor. As a result of numerous collaborative projects carried out both independently and under the aegis of the Subcommittee on Antifungal Susceptibility Testing of the National Committee for Clinical Laboratory Standards, the effects of varying these factors have been extensively studied and a standard method which minimizes interlaboratory variability during the testing of Candida spp. and Cryptococcus neoformans has been proposed. This review summarizes this work, reviews the strengths and weaknesses of the proposed susceptibility testing standard, and identifies directions for future work.

  10. Antimicrobial susceptibility of Bacteroides fragilis group organisms in Hong Kong by the tentative EUCAST disc diffusion method.

    PubMed

    Ho, Pak-Leung; Yau, Chong-Yee; Ho, Lok-Yan; Lai, Eileen Ling-Yi; Liu, Melissa Chun-Jiao; Tse, Cindy Wing-Sze; Chow, Kin-Hung

    2017-04-14

    This study used a recently developed EUCAST disc diffusion method to measure the susceptibility of 741 B. fragilis group isolates to six antibiotics. Isolates nonsusceptible to imipenem and metronidazole by the disc method were further investigated by E-test. Species identification was obtained by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS), PCR assays and 16S rRNA sequencing. The most common species were B. fragilis (n = 424, including 81 division II and 343 division I isolates), B. thetaiotaomicron (n = 111), B. ovatus (n = 53) and B. vulgatus (n = 46). Overall, metronidazole following by imipenem and amoxicillin-clavulanate are the most active agents with over 90% of all the isolates being susceptible at the tentative disc breakpoints. Susceptibility rates for moxifloxacin (69.5%), piperacillin-tazobactam (58.2%) and clindamycin (37.2%) were much lower. Metronidazole is the only agent active against >90% of B. fragilis, non-fragilis Bacteroides and Parabacteroides isolates. With the exception of B. fragilis division II, imipenem was active against 88.0%-98.3% of isolates of the other species. Susceptibility rates for clindamycin (14.4%-54.3%) and moxifloxacin (33.3%-80.6%) were low across all species and many isolates had no inhibition zone around the discs. E-test testing confirmed 8.2% (61/741) and 1.6% (12/741) isolates as nonsusceptible to imipenem and metronidazole, respectively with B. fragilis and B. thetaoiotaomicron accounting for a large share of the observed resistance to both agents. Two imipenem-resistant and one metronidazole-resistant B. dorei were misidentified as B. vulgatus by MALDI-TOF MS. These data highlights the importance anaerobic susceptibility testing in clinical laboratories to guide therapy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Research on a Mini-Disc Machine for Gear Testing.

    DTIC Science & Technology

    1988-01-01

    those of the gear tooth profiles at the point of contact. Thus the relative radius of curvature of the two discs is the same as that of the pinion...34.. A..-2 "M nil’ 11 l1.8 "L5 JL.MBI1. irii FILE COPY AFWAL-TR-87-2081 RESEARCH ON A MINI-DISC MACHINE FOR GEAR TESTING 00 00 David M.Nicolson Richard...Classification) RESEARCH ON A MINI-DISC MACHINE FOR GEAR TESTING 12. PERSONAL AUTHOR(S) D. M. NICOLSON AND DR R. S. SAYLES 13a. TYPE OF REPORT 13b TIME

  12. Testing hydrodynamics schemes in galaxy disc simulations

    NASA Astrophysics Data System (ADS)

    Few, C. G.; Dobbs, C.; Pettitt, A.; Konstandin, L.

    2016-08-01

    We examine how three fundamentally different numerical hydrodynamics codes follow the evolution of an isothermal galactic disc with an external spiral potential. We compare an adaptive mesh refinement code (RAMSES), a smoothed particle hydrodynamics code (SPHNG), and a volume-discretized mesh-less code (GIZMO). Using standard refinement criteria, we find that RAMSES produces a disc that is less vertically concentrated and does not reach such high densities as the SPHNG or GIZMO runs. The gas surface density in the spiral arms increases at a lower rate for the RAMSES simulations compared to the other codes. There is also a greater degree of substructure in the SPHNG and GIZMO runs and secondary spiral arms are more pronounced. By resolving the Jeans length with a greater number of grid cells, we achieve more similar results to the Lagrangian codes used in this study. Other alterations to the refinement scheme (adding extra levels of refinement and refining based on local density gradients) are less successful in reducing the disparity between RAMSES and SPHNG/GIZMO. Although more similar, SPHNG displays different density distributions and vertical mass profiles to all modes of GIZMO (including the smoothed particle hydrodynamics version). This suggests differences also arise which are not intrinsic to the particular method but rather due to its implementation. The discrepancies between codes (in particular, the densities reached in the spiral arms) could potentially result in differences in the locations and time-scales for gravitational collapse, and therefore impact star formation activity in more complex galaxy disc simulations.

  13. Optimizing Antimicrobial Susceptibility Test Reporting

    PubMed Central

    Schreckenberger, Paul C.; Binnicker, Matthew J.

    2011-01-01

    A meeting of clinical microbiologists, representing a diverse group of practice settings, together with representatives from industry partners, discussed the pitfalls of current practices for testing and reporting antimicrobial susceptibility test results. The participants in this session identified several needs. Regarding what antibiotics to test, the discussants noted that the CLSI M100 documents must be readily accessible to all those who need them and presented in a way that is easily understood. Engineering controls (e.g., software programs) are needed that incorporate intrinsic resistance and susceptibility information and contain pathways that would allow the reporting of antibiotics for only those body locations where the antibiotic reaches therapeutic concentrations. These programs should be linked with the patient electronic medical record (EMR) and flag the physician or clinical pharmacist using an active alert messenger when testing reveals that the antibiotic(s) that the patient is receiving may not be optimal or de-escalation of the antibiotic treatment regimen is indicated. Guidelines for the practice of cascade reporting are needed and should be developed to assist laboratories in the identification and reporting of therapeutic and cost-effective antimicrobials. Personalized antibiotic reporting (PAR) software programs are needed that would deduce the optimal antibiotic for each individual patient based on a number of clinical and laboratory features. These would include the following: (i) organism identification; (ii) MIC; (iii) patient-specific factors such as weight, immune status, allergies, creatinine clearance, and albumin level; (iv) site of infection; (v) desired method of dosing (bolus versus continuous infusion); (vi) patient convenience (oral versus intravenous); (vii) drug interactions; and (viii) cost.

  14. Antifungal susceptibility of Candida albicans biofilms on titanium discs with different surface roughness.

    PubMed

    Tsang, C S P; Ng, H; McMillan, A S

    2007-12-01

    Although it is well known that fungal biofilms have increased resistance to antimicrobial agents, limited information is available on the formation of candidal biofilms on implant surfaces with different surface roughness and their resistance to conventional antifungal therapy. In the current study, the effect of increasing the surface roughness of titanium discs on the susceptibility of Candida albicans biofilms to amphotericin B was determined. Grade I commercially pure titanium discs were sandblasted with 99.6% aluminium oxide of different grit sizes, producing surface roughness of 0.90, 1.88 and 3.82 microm (Groups A, B and C), respectively (P < 0.001). The antifungal susceptibility of C. albicans biofilm grown on different Ti discs was determined using XTT assay. The 50% reduction in metabolic activity (50% RMA) of planktonic C. albicans (0.5 microg/mL) was much lower than those from Groups A, B and C (2, 16, 2 microg/mL, respectively), while the 50% RMA from Group B was three-fold higher than those from Groups A and C. In conclusion, difference in titanium surface roughness was associated with variations in the antifungal resistance of the candidal biofilm. Group C appeared to have an optimum surface roughness for biofilm resistance.

  15. Antifungal susceptibility testing of Malassezia yeast: comparison of two different methodologies.

    PubMed

    Rojas, Florencia D; Córdoba, Susana B; de Los Ángeles Sosa, María; Zalazar, Laura C; Fernández, Mariana S; Cattana, María E; Alegre, Liliana R; Carrillo-Muñoz, Alfonso J; Giusiano, Gustavo E

    2017-02-01

    All Malassezia species are lipophilic; thus, modifications are required in susceptibility testing methods to ensure their growth. Antifungal susceptibility of Malassezia species using agar and broth dilution methods has been studied. Currently, few tests using disc diffusion methods are being performed. The aim was to evaluate the in vitro susceptibility of Malassezia yeast against antifungal agents using broth microdilution and disc diffusion methods, then to compare both methodologies. Fifty Malassezia isolates were studied. Microdilution method was performed as described in reference document and agar diffusion test was performed using antifungal tablets and discs. To support growth, culture media were supplemented. To correlate methods, linear regression analysis and categorical agreement was determined. The strongest linear association was observed for fluconazole and miconazole. The highest agreement between both methods was observed for itraconazole and voriconazole and the lowest for amphotericin B and fluconazole. Although modifications made to disc diffusion method allowed to obtain susceptibility data for Malassezia yeast, variables cannot be associated through a linear correlation model, indicating that inhibition zone values cannot predict MIC value. According to the results, disc diffusion assay may not represent an alternative to determine antifungal susceptibility of Malassezia yeast.

  16. Association between TRAIL gene polymorphisms and the susceptibility and severity of lumbar disc degeneration

    PubMed Central

    Du, Heng; Bai, Bin; Qiu, Yusheng; Yin, Si; Bian, Weiguo

    2015-01-01

    Aim: The aim of the present study was to investigate the association between tumor necrosis factor related apoptosis-inducing ligand (TRAIL) gene polymorphisms and the susceptibility and severity of lumbar disc degeneration (LDD) in the Chinese Han population. Methods: A total of 153 patients with LDD and 131 healthy subjects were enrolled in the study. Four single-nucleotide polymorphisms (SNPs) in the 3’ untranslated region (3’UTR) of TRAIL gene, including 1289 C/A, 1525 G/A, 1588 G/A and 1595 C/T, were genotyped with polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Results: The genotypes and alleles frequencies of TRAIL at 1525 and 1595 positions in all subjects were the same. There was a significant association between TRAIL 1525/1595 polymorphisms and the susceptibility of LDD. The frequencies of 1525 GG /1595 CC genotype, and 1525 G/1595 C allele were higher in the patients group than that in the control group. In addition, we found patients with the 1525 AA /1595 TT genotype, as well as 1525 A/1595 T allele exhibit significantly low frequency of high grades of disc degeneration. However, there were no significant differences in the genotype or allele distribution of TRAIL 1289 C/A or 1588 G/A between the patients and the control group. Conclusion: TRAIL 1525/1595 polymorphisms were associated with the susceptibility and severity of LDD in the Chinese Han population. PMID:26261645

  17. Diffusion Disk Susceptibility Testing with Cefaclor

    PubMed Central

    Shadomy, Smith; Carver, Melinda

    1978-01-01

    The reliability of the standardized 30-μg cephalothin disk and that of an experimental 30-μg cefaclor disk in predicting probable clinical susceptibility to cefaclor were compared. Quantitative determinations of cefaclor susceptibility were measured by the World Health Organization International Collaborative Study agar dilution procedure; diffusion disk tests were performed by the standardized U.S. Food and Drug Administration disk test. The cephalothin disk erred in predicting probable susceptibility in 52% of isolates of Enterococcus spp. resistant to 16 μg or less of cefaclor per ml; the cefaclor disk did not. The cephalothin disk erred in correctly predicting susceptibility in only 20% of cefaclor-susceptible isolates of Enterobacter spp.; the cefaclor disk correctly predicted susceptibility for 70%. These results indicate the need for further evaluation of a separate cefaclor disk for use in susceptibility testing with this new cephalosporin. PMID:646345

  18. Antifungal susceptibility testing of Trichophyton rubrum by E-test.

    PubMed

    da Silva Barros, Maria Elisabete; de Assis Santos, Daniel; Soares Hamdan, Júnia

    2007-05-01

    Trichophyton rubrum isolates were used in susceptibility testing for azoles by E-test. Voriconazole was the most and fluconazole was the less-active drug. Our results are in agreement with susceptibility data observed by researchers that used others' methodologies. E-test seems to be a reliable methodology to susceptibility-testing for T. rubrum.

  19. Evaluation of the Epsilometer test (E test) for testing the susceptibility of coagulase-negative staphylococci to teicoplanin.

    PubMed

    Martin, E; Nouvellon, M; Pestel, M; Pons, J L; Lemeland, J F

    1995-07-01

    The antimicrobial susceptibilities of 118 clinical isolates of coagulase-negative staphylococci to teicoplanin were determined by disc diffusion and the Epsilometer test (E test) and the results were compared with the MICs determined by the agar dilution method of the National Committee for Clinical Laboratory Standards (NCCLS). There was a poor correlation of r = 0.5 between the zone diameters of inhibition and agar dilution MICs and 10 and four of the 11 isolates for which the MICs were > or = 32 mg/L were misclassified as susceptible by the disc test after applying the interpretative criteria of the NCCLS and the Comité de l'Antibiogramme de la Société Française de Microbiologie (CASFM), respectively. The E test tended to result in MICs that were lower than those determined by agar dilution and only 66% of MIC were within +/- 1 log2 dilution of each other. Only one of 11 resistant strains was detected by the E test and, although there was no false resistance, six resistant strains were misclassified as susceptible after applying the criteria of the NCCLS as were four such isolates when the criteria of the CASFM were employed, probably as a result of using too light an inoculum. Disc diffusion is not a reliable means of determining the susceptibility of coagulase-negative staphylococci but might be replaced by the E-test provided that discrepant results can be resolved by using a denser inoculum.

  20. Antimicrobial susceptibility and susceptibility testing of Mycoplasma hominis: a review.

    PubMed

    Bygdeman, S M; Mårdh, P A

    1983-01-01

    The determination of the minimal growth-inhibiting concentration (MIC), the minimal metabolism-inhibiting concentration (MMC), and the minimal mycoplasmacidal concentration (MCC) of various antimicrobial compounds for Mycoplasma hominis is influenced by the pH of the test media, the inoculum size, and the incubation time, although each of these factors generally do not affect the minimal concentration more than fourfold. M. hominis is resistant to beta-lactam antibiotics, vancomycin, sulfonamides, trimethoprim, and polymyxin B. There are great differences in the susceptibility of M. hominis to various macrolide antibiotics. Thus the organism is resistant to erythromycin and oleandomycin, moderately resistant to tylosin and spiramycin, susceptible to josamycin as well as to another macrolide drug, labelled M-4365G. M. hominis is also highly susceptible to the macrolide-like compound rosaramicin and to the tetracyclines (although resistant strains occur). It is susceptible to lincomycin and clindamycin, and moderately susceptible to chloramphenicol and rifampicin. The aminoglycosides have limited activity against M. hominis.

  1. Antifungal susceptibility testing: a primer for clinicians.

    PubMed

    Kuper, Kristi M; Coyle, Elizabeth A; Wanger, Audrey

    2012-12-01

    Antifungal susceptibility testing is not as commonly performed as antibacterial susceptibility testing. The methodology for detecting antifungal resistance is newer and requires different testing supplies that may not be readily available in a clinical laboratory setting. Breakpoints for molds are lacking. Yeast breakpoints are available for most antifungals but are continually updated based on epidemiologic surveillance. Reliable and reproducible antifungal susceptibility testing methods, as well as more research on the role of susceptibility testing in patient care, are necessary in order to provide the clinician with information that can be translated into positive clinical outcomes at the bedside. There are nuances with current testing methods that, if unrecognized, could lead to misinterpretation of results and inappropriate antifungal selection. Clinicians who have an understanding of qualitative and quantitative methods, automated susceptibility testing systems, and other commercial tests can successfully engage this knowledge to improve antifungal use and patient outcomes. This primer describes the common antifungal susceptibility tests used in the clinical microbiology laboratory and reviews literature related to the impact of appropriate drug selection, timing, fungal resistance mechanisms, pharmacokinetics, and pharmacodynamics on clinical outcomes. Both conventional and modern testing methods are discussed. © 2012 Pharmacotherapy Publications, Inc.

  2. A comparison of antibiotic susceptibility testing methods for cotrimoxazole with Burkholderia pseudomallei.

    PubMed

    Piliouras, Peter; Ulett, Glen C; Ashhurst-Smith, Christopher; Hirst, Robert G; Norton, Robert E

    2002-05-01

    Melioidosis is caused by the Gram-negative soil saprophyte, Burkholderia pseudomallei and is endemic in tropical and subtropical regions of southeast Asia and northern Australia. Cotrimoxazole has been traditionally used for the therapy of melioidosis despite results indicating resistance often produced in the disc diffusion test against B. pseudomallei. This inconsistency was addressed by comparing this method with the agar dilution, MicroScan and E-test methods. The results demonstrated that by disc diffusion, 41.3% of 80 B. pseudomallei clinical isolates tested were susceptible to cotrimoxazole, whereas the MicroScan, agar dilution and the E-test demonstrated 92.5, 90 and 97.5% of the isolates to be susceptible, respectively. These results indicate that an MIC based method is required to test the susceptibility of B. pseudomallei against cotrimoxazole.

  3. Colistin susceptibility testing: evaluation of reliability for cystic fibrosis isolates of Pseudomonas aeruginosa and Stenotrophomonas maltophilia

    PubMed Central

    Moskowitz, Samuel M.; Garber, Elizabeth; Chen, Yunhua; Clock, Sarah A.; Tabibi, Setareh; Miller, Amanda K.; Doctor, Michael; Saiman, Lisa

    2010-01-01

    Objectives Antibiotic susceptibility methods that are commonly used to test bacterial isolates from patients with cystic fibrosis are of uncertain reliability for the polymyxins. To assess the reliability of four standard testing methods, this pilot study used a challenge set that included polymyxin-resistant isolates of Pseudomonas aeruginosa and Stenotrophomonas maltophilia. Methods Twenty-five P. aeruginosa and 12 S. maltophilia isolates were tested for susceptibility to colistin (polymyxin E). Repeatability (concordance of replicates performed concurrently), reproducibility (concordance of replicates performed over time) and comparability (concordance of different methods) of agar dilution, broth microdilution, Etest and disc diffusion were assessed through the use of descriptive statistics and scatterplot analyses. Results All four methods displayed excellent repeatability (overall concordance rate of 99%). However, analysis of reproducibility revealed substantially lower rates of concordance (74% for agar dilution, 84% for broth microdilution and Etest, and 91% for disc diffusion). In addition, comparability to agar dilution of the three other methods was generally poor, with overall rates of very major error ranging from 12% for broth microdilution to 18% for Etest and disc diffusion. Conclusions Compared with agar dilution, other susceptibility testing methods give high rates of apparent false polymyxin susceptibility for cystic fibrosis isolates of P. aeruginosa and S. maltophilia. Prospective study of the correlation between in vitro susceptibility and clinical response is needed to clarify whether these discrepancies reflect oversensitivity of the agar dilution method or insensitivity of the other methods. PMID:20430789

  4. Antianaerobic Antimicrobials: Spectrum and Susceptibility Testing

    PubMed Central

    Wexler, Hannah M.; Goldstein, Ellie J. C.

    2013-01-01

    SUMMARY Susceptibility testing of anaerobic bacteria recovered from selected cases can influence the choice of antimicrobial therapy. The Clinical and Laboratory Standards Institute (CLSI) has standardized many laboratory procedures, including anaerobic susceptibility testing (AST), and has published documents for AST. The standardization of testing methods by the CLSI allows comparisons of resistance trends among various laboratories. Susceptibility testing should be performed on organisms recovered from sterile body sites, those that are isolated in pure culture, or those that are clinically important and have variable or unique susceptibility patterns. Organisms that should be considered for individual isolate testing include highly virulent pathogens for which susceptibility cannot be predicted, such as Bacteroides, Prevotella, Fusobacterium, and Clostridium spp.; Bilophila wadsworthia; and Sutterella wadsworthensis. This review describes the current methods for AST in research and reference laboratories. These methods include the use of agar dilution, broth microdilution, Etest, and the spiral gradient endpoint system. The antimicrobials potentially effective against anaerobic bacteria include beta-lactams, combinations of beta-lactams and beta-lactamase inhibitors, metronidazole, chloramphenicol, clindamycin, macrolides, tetracyclines, and fluoroquinolones. The spectrum of efficacy, antimicrobial resistance mechanisms, and resistance patterns against these agents are described. PMID:23824372

  5. Antimicrobic susceptibility testing. A personal perspective.

    PubMed

    Sherris, J C

    1989-06-01

    The development of antimicrobic susceptibility testing is outlined with particular reference to standardization of procedures and organizational developments that have led to substantially improved performance. Special problems continue to be posed by increased proportions of opportunistic pathogens and newly recognized mechanisms of resistance, and these require updating. The role of automated procedures and technical problems in MBC and serum bactericidal testing are considered.

  6. Susceptibility testing of Entamoeba histolytica

    SciTech Connect

    Cedeno, J.R.; Krogstad, D.J.

    1983-12-01

    The growth of Entamoeba histolytica in microtiter plates in vitro in a variety of environments with reduced oxygen tensions is reported. With 3% O/sub 2/, 3% CO/sub 2/, and 94% N/sub 2/, the parasite growth in microtiter plates was identical to that in screw-capped culture tubes, as measured by (/sup 3/H)thymidine incorporation and by quantitative parasite counts. There were no significant differences between the drug concentrations necessary to inhibit parasite growth by 50% based on (/sup 3/H)thymidine incorporation vs those defined by quantitative parasite counts for the 15 antimicrobial agents tested (including seven drugs used for the treatment of amebiasis). This technique provides a reproducible method to quantitate the activity of potential antiamebic agents in vitro. The isotopic method should be of particular value in defining the metabolism of the parasite and effects of antimicrobial agents on it, whereas the morphologic method may be more valuable for workers with limited resources available to them.

  7. Hydrogen gas embrittlement and the disc pressure test

    NASA Technical Reports Server (NTRS)

    Bachelet, E. J.; Troiano, A. R.

    1973-01-01

    A disc pressure test has been used to study the influenced of a hydrogen gas environment on the mechanical properties of three high strength superalloys, Inconel 718, L-605 and A-286, in static and dynamic conditions. The influence of the hydrogen pressure, loading rate, temperature, mechanical and thermal fatigue has investigated. The permeation characteristics of Inconel 718 have been determined in collaboration with the French AEC. The results complemented by a fractographic study are consistent either with a stress-sorption or with an internal embrittlement type of mechanism.

  8. [Rapid antibiotic susceptibility test in Clinical Microbiology].

    PubMed

    March Rosselló, Gabriel Alberto; Bratos Pérez, Miguel Ángel

    2016-01-01

    The most widely used antibiotic susceptibility testing methods in Clinical Microbiology are based on the phenotypic detection of antibiotic resistance by measuring bacterial growth in the presence of the antibiotic being tested. These conventional methods take typically 24hours to obtain results. A review is presented here of recently developed techniques for the rapid determination of antibiotic susceptibility. Data obtained with different methods such as molecular techniques, flow cytometry, chemiluminescence, mass spectrometry, commercial methods used in routine work, colorimetric methods, nephelometry, microarrays, microfluids, and methods based on cell disruption and sequencing, are analyzed and discussed in detail.

  9. Rapid direct antibiotic susceptibility testing in endophthalmitis.

    PubMed

    Miño de Kaspar, Herminia; Neubauer, Aljoscha S; Molnar, Alexander; Hoepfner, Angela S; Ta, Christopher N; Grasbon, Thomas; Engelbert, Michael; Thiel, Martin; Klauss, Volker; Kampik, Anselm

    2002-04-01

    To compare a new rapid antibiotic susceptibility test (RAST) to the conventional method in patients with endophthalmitis. Prospective nonrandomized comparative trial. Intraocular aspirates from 24 consecutive patients with endophthalmitis were tested. Approximately 0.25 ml of vitreous or anterior chamber aspirate was obtained and tested for antibiotic sensitivity using the Kirby-Bauer agar disk diffusion method. Using this conventional testing method, the aspirates were cultured for bacterial growth before antibiotic susceptibility testing (AST). In contrast, for direct RAST, the aspirates were inoculated directly onto agar plates with antibiotic disks without first culturing for bacterial growth. Of the 24 endophthalmitis aspirates studied, 4 (17%) could not be tested by direct RAST because either more than one bacterial species was present or no bacteria were cultured. The remaining 20 cases provided 467 antibiotic-microorganism combinations. The two methods yielded identical susceptibility results in 409 (88%) of the 467 tests. In 42 tests (9%), a minor discrepancy occurred between the conventional method and RAST, in which one resulted in intermediate susceptibility, whereas the other was either resistant or sensitive. Significant discrepancy, defined as a bacterial sample reported as sensitive in one method yet resistant in the other, occurred with 16 samples (3%). Results of the RAST were available within 6 to 10 hours compared with more than 24 hours for the conventional method. Of clinical significance, the results of the RAST revealed that in 11 cases of epidemic Stenotrophomonas maltophilia endophthalmitis, the bacteria were resistant to the antibiotics prescribed, and change of antibiotic therapy was made on the basis of the RAST results. RAST provided accurate antibiotic susceptibility results in a much shorter time than did the conventional method. We suggest that conventional AST be performed for confirmation of the RAST results, but initial

  10. [Methods for in vitro antifungal susceptibility testing].

    PubMed

    Dannaoui, Eric

    2006-01-01

    During the last years, a large amount of work has been completed to improve the methods used for in vitro antifungal susceptibility testing. Reference techniques are currently available both for yeasts and filamentous fungi, but in some instances, technical improvement are needed. Etest is another well standardized method that can be used as an alternative on a routine basis in the clinical microbiology laboratory. Studies of in vitro-in vivo correlations have led to the definition of susceptibility breakpoints for yeasts for fluconazole, itraconazole, and flucytosine.

  11. [Antimicrobial susceptibility testing of anaerobic bacteria].

    PubMed

    García-Sánchez, José E; García-Sánchez, Enrique; García-García, María Inmaculada

    2014-02-01

    The anaerobic bacteria resistance to antibiotics is increasing, and even has appeared against the most active of those, like metronidazol and carbapenems. This fact forces to make and periodical sensibility tests -at least in the most aggressive and virulent species, in cases that they are isolated from life locations and in the absence of therapeutic response- to check the local sensibility and to establish suitable empiric therapies, all based on multicentric studies carried out in order to this or well to check the activity of new antibiotics. For the laboratory routine, the easiest sensibility method is the E-test/MIC evaluator. Another alternative is microdilution, that's only normalized for Bacteroides. There are preliminary facts that allow the use of disc diffusion method in some species of Bacteroides and Clostridium. For the temporal and multicentric studies, the procedure is dilution in agar plate, the reference method. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  12. Tests and developments of the PANDA Endcap Disc DIRC

    NASA Astrophysics Data System (ADS)

    Etzelmüller, E.; Belias, A.; Dzhygadlo, R.; Gerhardt, A.; Götzen, K.; Kalicy, G.; Krebs, M.; Lehmann, D.; Nerling, F.; Patsyuk, M.; Peters, K.; Schepers, G.; Schmitt, L.; Schwarz, C.; Schwiening, J.; Traxler, M.; Zühlsdorf, M.; Britting, A.; Eyrich, W.; Lehmann, A.; Pfaffinger, M.; Uhlig, F.; Düren, M.; Föhl, K.; Hayrapetyan, A.; Kröck, B.; Merle, O.; Rieke, J.; Schmidt, M.; Cowie, E.; Keri, T.; Achenbach, P.; Cardinali, M.; Hoek, M.; Lauth, W.; Schlimme, S.; Sfienti, C.; Thiel, M.

    2016-04-01

    The PANDA experiment at the future Facility for Antiproton and Ion Research (FAIR) requires excellent particle identification. Two different DIRC detectors will utilize internally reflected Cherenkov light of charged particles to enable the separation of pions and kaons up to momenta of 4 GeV/c. The Endcap Disc DIRC will be placed in the forward endcap of PANDA's central spectrometer covering polar angles between 5° and 22°. Its final design is based on MCP-PMTs for the photon detection and an optical system made of fused silica. A new prototype has been investigated during a test beam at CERN in May 2015 and first results will be presented. In addition a new synthetic fused silica material by Nikon has been tested and was found to be radiation hard.

  13. Real-Time Optical Antimicrobial Susceptibility Testing

    PubMed Central

    Andersen, Klaus R.; Jørgensen, Erik; Droce, Aida; Olesen, Tom; Jensen, Bent B.; Rosenvinge, Flemming S.; Sondergaard, Teis E.

    2013-01-01

    Rapid antibiotic susceptibility testing is in high demand in health care fields as antimicrobial-resistant bacterial strains emerge and spread. Here, we describe an optical screening system (oCelloScope) which, based on time-lapse imaging of 96 bacteria-antibiotic combinations at a time, introduces real-time detection of bacterial growth and antimicrobial susceptibility with imaging material to support the automatically generated graphs. Automated antibiotic susceptibility tests of a monoculture showed statistically significant antibiotic effects within 6 min and within 30 min in complex samples from pigs suffering from catheter-associated urinary tract infections. The oCelloScope system provides a fast high-throughput screening method for detecting bacterial susceptibility that might entail an earlier diagnosis and introduction of appropriate targeted therapy and thus combat the threat from multidrug-resistant pathogenic bacteria. The oCelloScope system can be employed for a broad range of applications within bacteriology and might present new vistas as a point-of-care instrument in clinical and veterinary settings. PMID:23596243

  14. Utility of direct susceptibility testing on blood cultures: is it still worthwhile?

    PubMed

    Menon, Vidthiya; Lahanas, Sophie; Janto, Catherine; Lee, Andie

    2016-06-01

    Earlier targeted therapy for bacteraemia optimizes patient outcomes and reduces broad spectrum antibiotic use. Standardized susceptibility testing results are available at 36-48 h. Direct disc susceptibility testing from blood culture broth reduces time to results but the inoculum is not standardized. No studies have looked at the clinical utility of direct susceptibility results. This retrospective cohort study aimed to assess the correlation between direct and formal testing methods as well as the clinical utility of direct susceptibility results. 160 episodes of bacteraemia with paired direct and formal susceptibility testing were studied. Direct disc testing was performed on blood culture broth. Formal testing was performed on isolates, using automated broth microdilution or Etests. The rate of error was 9.0 % (95 % CI 7.0-11.6 %). In 10 cases (6.3 %, 95 % CI 3.0-11.2 %), inappropriate antibiotics were used due to direct susceptibility results, including two cases with ineffective (as opposed to too broad) antibiotics being used. Antibiotics were changed in 28.1 % of cases once direct susceptibility data was available. There was a decreased time to effective antibiotics in 9.3 % (95 % CI 5.3-15.0 %), and a decreased time to a targeted antibiotics in 14.3 % (95 % CI 9.3-20.8 %) of cases. Despite the error rate, the advantages of earlier times to effective and targeted antibiotics justifies continuing direct testing in bacteraemia episodes with Gram-negative rods. In the Gram-positive group, given the contamination rate, the availability of adjunctive PCR, and the fact that early identification of the isolate could equally influence antibiotic choices, direct susceptibility testing may no longer be warranted.

  15. Vitamin D Receptor Gene, Matrix Metalloproteinase 3 Polymorphisms and the Risk of Intervertebral Disc Degeneration Susceptibility: Meta-Analysis

    PubMed Central

    Huang, Yongjing; Zhao, Shujie; Xu, Nanwei

    2016-01-01

    Several studies have evaluated the association between vitamin D receptor, matrix metalloproteinase 3 (MMP-3) polymorphisms and the risk of intervertebral disc degeneration susceptibility. The findings were inconsistent. This meta-analysis aimed to systematically assess the association between vitamin D receptor, MMP-3 polymorphisms and the risk of intervertebral disc degeneration susceptibility. A search of various databases was done covering all papers published until December 31th, 2014. Eight, 4, 3 studies were finally included that addressed the risk of intervertebral disc degeneration susceptibility and vitamin D receptor FokI (rs2228570), ApaI (rs7975232), and MMP-3 (rs731236) polymorphisms, respectively. FokI (f vs. F: summary odds ratio [OR], 1.13; 95% confidence interval [CI], 0.76–1.69; ff vs. FF: OR, 1.02; 95% CI, 0.59–1.77; ff vs. Ff/FF: OR, 1.05; 95% CI, 0.70–1.58), ApaI (a vs. A: OR, 0.73; 95% CI, 0.45–1.19; aa vs. AA: OR, 0.53; 95% CI, 0.22–1.25 p=0.14; aa vs. AA/Aa: OR, 0.69; 95% CI, 0.53–0.89) in the vitamin D receptor gene and MMP3 polymorphisms (5A vs. 6A: OR, 1.92; 95% CI, 0.77–4.80; 5A5A vs. 6A6A: OR, 2.17; 95% CI, 0.75–6.24; 5A5A vs. 5A6A/6A6A: OR, 1.58; 95% CI, 0.72–3.44) were not obviously associated with risk of intervertebral disc degeneration susceptibility. FokI, ApaI polymorphisms in the vitamin D receptor gene and MMP-3 polymorphism are not obvious risk factors for intervertebral disc degeneration susceptibility. PMID:27790329

  16. Microfluidics for Antibiotic Susceptibility and Toxicity Testing

    PubMed Central

    Dai, Jing; Hamon, Morgan; Jambovane, Sachin

    2016-01-01

    The recent emergence of antimicrobial resistance has become a major concern for worldwide policy makers as very few new antibiotics have been developed in the last twenty-five years. To prevent the death of millions of people worldwide, there is an urgent need for a cheap, fast and accurate set of tools and techniques that can help to discover and develop new antimicrobial drugs. In the past decade, microfluidic platforms have emerged as potential systems for conducting pharmacological studies. Recent studies have demonstrated that microfluidic platforms can perform rapid antibiotic susceptibility tests to evaluate antimicrobial drugs’ efficacy. In addition, the development of cell-on-a-chip and organ-on-a-chip platforms have enabled the early drug testing, providing more accurate insights into conventional cell cultures on the drug pharmacokinetics and toxicity, at the early and cheaper stage of drug development, i.e., prior to animal and human testing. In this review, we focus on the recent developments of microfluidic platforms for rapid antibiotics susceptibility testing, investigating bacterial persistence and non-growing but metabolically active (NGMA) bacteria, evaluating antibiotic effectiveness on biofilms and combinatorial effect of antibiotics, as well as microfluidic platforms that can be used for in vitro antibiotic toxicity testing. PMID:28952587

  17. Rapid radiometric susceptibility testing of Mycobacterium tuberculosis.

    PubMed

    Kertcher, J A; Chen, M F; Charache, P; Hwangbo, C C; Camargo, E E; McIntyre, P A; Wagner, H N

    1978-04-01

    A 48-hour radiometric test for determining the drug susceptibility of Mycobacterium tuberculosis has been developed. The test is based on the measurement of 14CO2 produced by the oxidation of formate labeled with carbon-14. The test system uses 5 X 10(7) organisms in 1 ml of Middlebrook 7H9 medium plus albumin-dextrose-catalase enrichment and 1 muCi of [14C]formate. The 14CO2 produced is measured in an ionization chamber at 24-, 48-, and 72-hour intervals, with and without the addition of antituberculous drugs. Isoniazid, streptomycin, rifampin, and ethambutol were each tested at 3 concentrations by the radiometric method and the reference (agar dilution) method. Six standard strains and 21 patient isolates were compared by both methods. Production of 14CO2 was quantitatively decreased in the presence of drugs that inhibit the organism. The radiometric method requires 2 days; the agar dilution, 14 to 21 days.

  18. [A new rapid antibiotic susceptibility test for enteric bacteria using a color change method].

    PubMed

    Kocagöz, T; Hayran, M; Kocagöz, S

    1988-01-01

    The rapid antibiotic susceptibility tests that have been developed so far cannot be used in daily work, because of their many difficulties and disadvantages. We have developed a new antibiotic susceptibility test for enteric bacteria which gives the result in 4 hours, easy to perform and inexpensive. This method depends upon the mechanism which detects the acid formed by the bacteria, by the change of the color of the pH indicator in the medium. The susceptibility of 110 different isolates of enteric bacteria (E. coli, Klebsiella, Salmonella, Shigella, Proteus, Enterobacter) to ampicillin, amikacin, trimethoprim-sulfamethoxazole, cephradine, cefazolin, erythromycin, gentamicin, and ofloxacin is examined by this new "Rapid Color Change Test" and disc diffusion method. For most organisms tested, there was a good correlation between the results of the two methods. The overall agreement is found to be 91.43%.

  19. Comparison of E-test with other conventional susceptibility testing methods for ciprofloxacin and gentamicin against gram negative enteric bacilli.

    PubMed

    Ogbolu, D O; Terry-Alli, O A; Daini, O A; Olabiyi, F A; Igharo, E A

    2012-06-01

    Increasing antibiotic resistance in Gram negative bacteria has led to the need for a faster and reliable method for determining antimicrobial susceptibility testing. In a resource poor setting like ours, it's also important to look for methods that will be clinically and economically beneficial to the patient. This study was aimed at evaluating the Epsilometer test (E-test) and conventional methods for determining antimicrobial susceptibility of isolates of Gram-negative enteric bacteria to ciprofloxacin and gentamicin. Disc diffusion, E-test, broth dilution and agar dilution methods were performed on 54 bacterial isolates. Using the E-test, 88.9% of bacterial isolates were resistant to ciprofloxacin, 92.6% were resistant using broth microdilution, 96.3% were resistant using agar dilution and 72.2% were resistant using disc diffusion. Minimum inhibitory concentration (MIC50) of isolates for gentamicin showed significant difference for all the techniques (p < 0.05) while MIC90 for gentamicin and MIC50 and MIC90 for ciprofloxacin for all the techniques had no significant difference (p > 0.05). Both E-test and broth dilution methods showed high levels of agreement (p > 0.05), there were low levels of agreement between E-test and agar dilution method (p < 0.05), especially at MIC50. The E-test can therefore be considered a reliable method to determine antimicrobial susceptibility testing and it gives results which are at least as accurate as those obtained by the broth dilution method.

  20. The Vitek analyser for routine bacterial identification and susceptibility testing: protocols, problems, and pitfalls.

    PubMed Central

    Shetty, N; Hill, G; Ridgway, G L

    1998-01-01

    Automated and semiautomated technology in microbiology has seen great advances in recent years. The choice of automated equipment for the identification and susceptibility testing of bacteria in a routine diagnostic laboratory depends on speed, accuracy, ease of use, and cost factors. The Vitek analyser (bioMerieux, UK) was installed in a busy diagnostic teaching hospital laboratory in London. This report describes one year's experience. Changes to work practice as a result of incorporating the equipment into the laboratory, and the advantages and disadvantages of automation in key areas are described in detail, together with possible solutions to problems. The Vitek analyser was found to be valuable for the speed and accuracy with which results were available for the common bacterial pathogens. Results of susceptibility testing were standardised according to NCCLS guidelines and used breakpoint MICs to ascertain susceptibility and resistance; they were an improvement on disc testing. This equipment is not a reference facility for difficult to identify organisms and many manual techniques, including some disc susceptibility testing, will have to be retained by the laboratory. PMID:9659247

  1. Comparison of a novel, inhibitor-potentiated disc-diffusion test with other methods for the detection of extended-spectrum beta-lactamases in Escherichia coli and Klebsiella pneumoniae.

    PubMed

    Ho, P L; Chow, K H; Yuen, K Y; Ng, W S; Chau, P Y

    1998-07-01

    A novel, inhibitor-potentiated disc-diffusion test for detecting extended-spectrum beta-lactamases (ESBLs) in bacteria was evaluated. This test uses the principle of augmentation (by > or = 10 mm) of inhibition zones produced by ceftazidime, cefotaxime, ceftriaxone or aztreonam discs on Mueller-Hinton agar supplemented with clavulanate (4 mg/L). The test was initially compared with the double-disc synergy test, Kirby-Bauer disc-diffusion test and Etest ESBL screen with a panel of 45 reference strains with known resistance profiles. This panel consisted of 27 ESBL-positive Escherichia coli strains expressing 14 Bush group 2be enzymes and 18 other E. coli and Klebsiella pneumoniae strains (14 non-ESBL beta-lactamase producers and four non-beta-lactamase producers). The Kirby-Bauer disc-diffusion test was the least sensitive method: 11-44% of the ESBL-positive control strains were misclassified as susceptible to ceftazidime, cefotaxime, ceftriaxone or aztreonam when interpreted by National Committee for Clinical Laboratory Standards (NCCLS) criteria. The sensitivities of the inhibitor-potentiated disc-diffusion test, the double-disc synergy test (when discs were 25 or 30 mm apart) and the Etest ESBL screen (with a breakpoint of > 4-fold reduction in ceftazidime MIC in the presence of clavulanate) were 100%, 96% and 89-96%, respectively. The inhibitor-potentiated disc-diffusion test was further evaluated with 81 E. coli and K. pneumoniae clinical isolates, which were identified as putative ESBL-producers by the double-disc synergy test. For these isolates, the sensitivity of both the inhibitor-potentiated disc-diffusion test and the Etest ESBL screen was 100%. In conclusion, the inhibitor-potentiated disc-diffusion test is a sensitive, convenient and inexpensive method of screening for ESBLs in E. coli and K. pneumoniae isolates, with potential for incorporation into routine clinical laboratory service.

  2. Electromagnetic Radiation System (EMRS) for Susceptibility Testing.

    DTIC Science & Technology

    ELECTROMAGNETIC COMPATIBILITY, *ELECTROMAGNETIC SUSCEPTIBILITY, COMMUNICATION EQUIPMENT, ELECTRONIC EQUIPMENT, ELECTROMAGNETIC RADIATION , ANTENNAS, ELECTROMAGNETIC INTERFERENCE, RADAR SIGNALS, RADIO SIGNALS, FIELD INTENSITY.

  3. Neuropsychological Test Performance and Hypnotic Susceptibility.

    ERIC Educational Resources Information Center

    Query, William T.; And Others

    1983-01-01

    Examined the relationship between brain-behavior and hypnotic susceptibility in 70 alcoholic patients, using the Stanford Hypnotic Susceptibility Scale and its Fromm-Weingarten modification. Results showed the two scales were interchangeable insofar as they measured the same ability, and indicated that hypnotic susceptibility is related to…

  4. Neuropsychological Test Performance and Hypnotic Susceptibility.

    ERIC Educational Resources Information Center

    Query, William T.; And Others

    1983-01-01

    Examined the relationship between brain-behavior and hypnotic susceptibility in 70 alcoholic patients, using the Stanford Hypnotic Susceptibility Scale and its Fromm-Weingarten modification. Results showed the two scales were interchangeable insofar as they measured the same ability, and indicated that hypnotic susceptibility is related to…

  5. Comparison of European Committee on Antimicrobial Susceptibility Testing (EUCAST) and CLSI screening parameters for the detection of extended-spectrum β-lactamase production in clinical Enterobacteriaceae isolates.

    PubMed

    Polsfuss, Silke; Bloemberg, Guido V; Giger, Jacqueline; Meyer, Vera; Hombach, Michael

    2012-01-01

    To compare the performance of European Committee on Antimicrobial Susceptibility Testing (EUCAST) and CLSI breakpoints following their revision in 2010, for the detection of extended-spectrum β-lactamase (ESBL) production in Enterobacteriaceae. 236 well-characterized clinical isolates (including 118 ESBL producers) were investigated by antibiotic disc testing with cefpodoxime, ceftriaxone, cefepime, cefotaxime EUCAST (5 μg/disc), ceftazidime EUCAST (10 μg/disc), cefotaxime CLSI (30 μg/disc) and ceftazidime CLSI (30 μg/disc) with the Kirby-Bauer method. Additionally, synergy phenomena were recorded between amoxicillin/clavulanic acid discs (20/10 μg/disc) and cefepime (30 μg/disc), EUCAST cefotaxime (5 μg/disc), EUCAST ceftazidime (10 μg/disc), CLSI cefotaxime (30 μg/disc) and CLSI ceftazidime [30 μg/disc; disc approximation method (DAM)]. Overall sensitivity of the cefotaxime EUCAST non-susceptible breakpoint equalled sensitivity of the cefotaxime CLSI ESBL screening breakpoint (99.2%). With the ceftazidime EUCAST non-susceptible breakpoint, 27/118 ESBL-producing isolates were not detected, whereas the ceftazidime CLSI ESBL screening breakpoint missed 41/118 ESBL-producing isolates. For cefpodoxime the resistant EUCAST breakpoint showed higher sensitivity for ESBL detection compared with the CLSI ESBL screening breakpoint/disc content (100% versus 98.3%, respectively). Sensitivities of ceftazidime and cefotaxime DAM with CLSI or EUCAST disc contents were comparable (sensitivities ranging from 84.7% to 89.8%). DAM with cefepime displayed the highest overall sensitivity (96.6%). In AmpC-producing isolates, synergy of amoxicillin/clavulanic acid with cefepime showed sensitivity and specificity for ESBL detection of 100% and 97.4%, respectively. EUCAST non-susceptible breakpoints for ceftazidime and cefpodoxime detect more ESBL-producing Enterobacteriaceae isolates compared with corresponding CLSI ESBL screening breakpoints. Implementation of the cefepime

  6. Awareness of Cancer Susceptibility Genetic Testing

    PubMed Central

    Mai, Phuong L.; Vadaparampil, Susan Thomas; Breen, Nancy; McNeel, Timothy S.; Wideroff, Louise; Graubard, Barry I.

    2014-01-01

    Background Genetic testing for several cancer susceptibility syndromes is clinically available; however, existing data suggest limited population awareness of such tests. Purpose To examine awareness regarding cancer genetic testing in the U.S. population aged ≥25 years in the 2000, 2005, and 2010 National Health Interview Surveys. Methods The weighted percentages of respondents aware of cancer genetic tests, and percent changes from 2000–2005 and 2005–2010, overall and by demographic, family history, and healthcare factors were calculated. Interactions were used to evaluate the patterns of change in awareness between 2005 and 2010 among subgroups within each factor. To evaluate associations with awareness in 2005 and 2010, percentages were adjusted for covariates using multiple logistic regression. The analysis was performed in 2012. Results Awareness decreased from 44.4% to 41.5% (p<0.001) between 2000 and 2005, and increased to 47.0% (p<0.001) in 2010. Awareness increased between 2005 and 2010 in most subgroups, particularly among individuals in the South (p-interaction=0.03) or with a usual place of care (p-interaction=0.01). In 2005 and 2010, awareness was positively associated with personal or family cancer history and high perceived cancer risk, and inversely associated with racial/ethnic minorities, age 25–39 or ≥60 years, male gender, lower education and income levels, public or no health insurance, and no provider contact in 12 months. Conclusions Despite improvement from 2005 to 2010, ≤50% of the U.S. adult population was aware of cancer genetic testing in 2010. Notably, disparities persist for racial/ethnic minorities and individuals with limited health care access or income. PMID:24745633

  7. Development of EUCAST disk diffusion method for susceptibility testing of the Bacteroides fragilis group isolates.

    PubMed

    Nagy, Elisabeth; Justesen, Ulrik Stenz; Eitel, Zsuzsa; Urbán, Edit

    2015-02-01

    With the emergence of antibiotic resistance among Bacteroides fragilis group isolates the need of susceptibility testing in routine laboratories is increasing. The aims of the present study were to evaluate the disk diffusion method for susceptibility testing in case of different clinical isolates of Bacteroides spp by comparing zone diameter results with MICs obtained earlier during an Europe-wide antibiotic susceptibility surveillance, and to propose zone diameter breakpoints, which correlate for the EUCAST MIC breakpoints. We tested 381 clinical isolates of the B. fragilis group to amoxicillin/clavulanic acid, cefoxitin, clindamycin, imipenem, metronidazole, moxifloxacin, piperacillin/tazobactam, tigecycline by agar dilution method previously. The inhibition zones of the same antibiotics including meropenem disc were determined by the disc diffusion on Brucella blood agar supplemented with haemin and vitamin K1. Plates were incubated at 37 °C in an anaerobic atmosphere for 24 h. The zone diameters were read at 100% inhibition. In case of discrepant results MICs were determined by gradient test and compared with the inhibition zones on the same plate. We found a good agreement between the inhibition zone diameters and the MICs for imipenem, metronidazole, moxifloxacin and tigecyclin. The inhibition zone diameters of meropenem also separated clearly the isolates, which can be considered wild-type isolates. In case of amoxicillin/clavulanic acid and piperacillin/tazobactam intermediate and susceptible isolates according to the MIC determination, overlap during the zone diameter determination. Isolates with an inhibition zone <23 mm for amoxicillin/clavulanic acid and <25 mm for piperacillin/tazobactam should be retested by a MIC determination method. The 10 μg clindamycin disc clearly separated the resistant and the susceptible population of B. fragilis group strains. In the case of cefoxitin only resistant population could be separated with an inhibition

  8. [Should metal alloy discs be used for patch testing in suspected metal implant intolerance reaction?].

    PubMed

    Thomas, P; Geier, J; Dickel, H; Diepgen, T; Hillen, U; Kreft, B; Schnuch, A; Szliska, C; Mahler, V

    2015-11-01

    Intolerance reactions to metal implants may be caused by metal allergy. However, prior to implantation, patch testing should not be done in a prophylactic-prophetic approach. Pre-implant patch testing should only be performed to verify or exclude metal allergy in patients with a reported respective history. In the case of implant-in particular arthroplasty-related complications like, for example, pain, effusion, skin changes, reduced range of motion, or loosening, orthopedic-surgical differential diagnostics should be performed first. Allergological workup of suspected metal implant allergy should be done with the DKG baseline series which contains nickel-, cobalt- and chromium-preparations. Various studies assessing the usefulness of metal alloy discs for patch testing proved that this approach does not give reliable information about metal allergy. Positive patch test reactions to the discs cannot be assigned to a specific metal within the disc alloy components. Furthermore, availability of such metal discs might be an invitation to uncritical testing. Accordingly, due to lack of benefit in comparison to patch testing with standardized metal salt preparations, we do not recommend patch testing with metal alloy discs.

  9. Cytotoxicity Test of One-Step Self-Etching Bonding Agents by Standardized Dentin Barrier Test Using Polyurethane Discs

    PubMed Central

    Kim, Mi-Joo; Kim, Kyoung-Nam; Kim, Kwang-Mahn

    2014-01-01

    This study was performed to standardize a dentin barrier test with the substitute and evaluate the cytotoxicity of one-step self-etching bonding agents. Each of the natural bovine dentin and polyurethane discs were 500-μm thick and were tested using a perfusion device. Following the treatment with 0.05% phenol on the natural bovine disc or three kinds of polyurethane discs—30, 40, and 50 pcf (pounds per cubic foot)—cell viability of L-929 was measured by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and expressed as percentages of non-treated group, respectively. A substitute showing permeability similar to that of bovine dentin was determined based on this result. Cytotoxicity test of bonding agents was performed by the selected substitute, the results of which were expressed as percentages of the control. In addition, SEM images were taken after the tests. The cell viability by 40-pcf polyurethane disc was not statistically different from that by bovine dentin disc (P > 0.05). Futurabond DC resulted in the highest cell viability and Bond force the lowest by the 40-pcf polyurethane disc (P < 0.05). The adhesives on the 40-pcf polyurethane disc changed cellular morphology with different degrees on the SEM images. This standardized test might be useful for assessing the cytotoxicity of dental materials applied to dentin before clinical applications. PMID:28788442

  10. Consequences of switching from a fixed 2 : 1 ratio of amoxicillin/clavulanate (CLSI) to a fixed concentration of clavulanate (EUCAST) for susceptibility testing of Escherichia coli.

    PubMed

    Leverstein-van Hall, Maurine A; Waar, Karola; Muilwijk, Jan; Cohen Stuart, James

    2013-11-01

    The CLSI recommends a fixed 2 : 1 ratio of co-amoxiclav for broth microdilution susceptibility testing of Enterobacteriaceae, while EUCAST recommends a fixed 2 mg/L clavulanate concentration. The aims of this study were: (i) to determine the influence of a switch from CLSI to EUCAST methodology on Escherichia coli susceptibility rates; (ii) to compare susceptibility results obtained using EUCAST-compliant microdilution with those from disc diffusion and the Etest; and (iii) to evaluate the clinical outcome of patients with E. coli sepsis treated with co-amoxiclav in relation to the susceptibility results obtained using either method. Resistance rates were determined in three laboratories that switched from CLSI to EUCAST cards with the Phoenix system (Becton Dickinson) as well as in 17 laboratories that continued to use CLSI cards with the VITEK 2 system (bioMérieux). In one laboratory, isolates were simultaneously tested by both the Phoenix system and either disc diffusion (n = 471) or the Etest (n = 113). Medical and laboratory records were reviewed for E. coli sepsis patients treated with co-amoxiclav monotherapy. Only laboratories that switched methodology showed an increase in resistance rates - from 19% in 2010 to 31% in 2011 (P < 0.0001). All isolates that tested susceptible by microdilution were also susceptible by disc diffusion or the Etest, but of 326 isolates that tested resistant by microdilution, 43% and 59% tested susceptible by disc diffusion and the Etest, respectively. Among the 89 patients included there was a better correlation between clinical response and measured MICs using the Phoenix system than the Etest. EUCAST methodology resulted in higher co-amoxiclav E. coli resistance rates than CLSI methodology, but correlated better with clinical outcome. EUCAST-compliant microdilution and disc diffusion provided discrepant results.

  11. Reliability of provocative tests of motion sickness susceptibility

    NASA Technical Reports Server (NTRS)

    Calkins, D. S.; Reschke, M. F.; Kennedy, R. S.; Dunlop, W. P.

    1987-01-01

    Test-retest reliability values were derived from motion sickness susceptibility scores obtained from two successive exposures to each of three tests: (1) Coriolis sickness sensitivity test; (2) staircase velocity movement test; and (3) parabolic flight static chair test. The reliability of the three tests ranged from 0.70 to 0.88. Normalizing values from predictors with skewed distributions improved the reliability.

  12. Automatic Radiated Susceptibility Test System for Payload Equipment

    NASA Technical Reports Server (NTRS)

    Ngo, Hoai T.; Sturman, John C.; Sargent, Noel B.

    1995-01-01

    An automatic radiated susceptibility test system (ARSTS) was developed for NASA Lewis Research Center's Electro-magnetic Interference laboratory. According to MSFC-SPEC 521B, any electrical or electronic equipment that will be transported by the spacelab and space shuttle must be tested for susceptibility to electromagnetic interference. This state-of-the-art automatic test system performs necessary calculations; analyzes, processes, and records a great quantity of measured data; and monitors the equipment being tested in real-time and with minimal user intervention. ARSTS reduces costly test time, increases test accuracy, and provides reliable test results.

  13. Use of a proposed antimicrobial susceptibility testing method for Haemophilus parasuis.

    PubMed

    Dayao, Denise Ann E; Kienzle, Marco; Gibson, Justine S; Blackall, Patrick J; Turni, Conny

    2014-08-27

    The aim of this study was to examine the antimicrobial susceptibility of 97 Haemophilus parasuis cultured from Australian pigs. As there is no existing standard antimicrobial susceptibility technique available for H. parasuis, methods utilising the supplemented media, BA/SN for disc diffusion and test medium broth (TMB) for a microdilution technique, were initially evaluated with the reference strains recommended by the Clinical and Laboratory Standards Institute. The results of the media evaluation suggested that BA/SN and TMB can be used as suitable media for susceptibility testing of H. parasuis. The proposed microdilution technique was then used with 97 H. parasuis isolates and nine antimicrobial agents. The study found that Australian isolates showed elevated minimum inhibitory concentrations (MICs) for ampicillin (1%), penicillin (2%), erythromycin (7%), tulathromycin (9%), tilmicosin (22%), tetracycline (31%) and trimethoprim-sulfamethoxazole (40%). This study has described potential antimicrobial susceptibility methods for H. parasuis and has detected a low percentage of Australian H. parasuis isolates with elevated antimicrobial MICs.

  14. Posterior pelvic pain provocation test is negative in patients with lumbar herniated discs.

    PubMed

    Gutke, Annelie; Hansson, Eva Roos; Zetherström, Gunilla; Ostgaard, Hans Christian

    2009-07-01

    The classification of pelvic girdle pain can only be reached after lumbar causes have been excluded by a clinical examination. During clinical examination, the posterior pelvic pain provocation test is a well-established method for verifying pelvic girdle pain. However, a criticism of pelvic pain provocation tests is that they may have an effect on lumbar structures, thus yielding false-positive results. The posterior pelvic pain provocation test was performed with four groups of patients: patients with computed tomography-verified disc herniations (1) on the waiting list for surgery (14 women; 9 men); (2) 6 weeks after disc surgery (18 women, 12 men); (3) pregnant women seeking care for pelvic girdle pain (n = 25); and (4) women with persistent pelvic girdle pain after delivery (n = 32). The sensitivity of the posterior pelvic pain provocation test was 0.88 and the specificity was 0.89. The positive predictive value was 0.89 and the negative predictive value was 0.87. Analysis of only women showed similar results. In our study, the posterior pelvic pain provocation test was negative in patients with a well-defined lumbar diagnosis of lumbar disc herniation, both before and after disc surgery. Our results are an important step toward the more accurate classification of lumbopelvic pain.

  15. Susceptibility testing of Rhodococcus equi: An interlaboratory test.

    PubMed

    Riesenberg, Anne; Kaspar, Heike; Feßler, Andrea T; Werckenthin, Christiane; Schwarz, Stefan

    2016-10-15

    Due to the importance of antimicrobial susceptibility testing (AST) for veterinary diagnostics, a standardised protocol for AST of Rhodococcus equi by broth microdilution has recently been developed and approved by the Clinical and Laboratory Standards Institute (CLSI). The aim of the present study was to test this protocol in an interlaboratory comparative study for its fitness for use in routine laboratory diagnostics. All of the 18 participating laboratories determined the minimum inhibitory concentrations (MIC) of two R. equi strains against 24 antimicrobial agents. The modal MIC values were determined and the acceptable ranges were set as the modal MIC ±1 dilution step. The R. equi field strain Rh110 showed a slightly better performance than the type strain R. equi ATCC(®) 25729. For the different antimicrobial agents tested, the percentage of MIC values within the acceptable ranges varied from 75.9 to 100% for R. equi ATCC(®) 25729, and from 85.2 to 100% for R. equi Rh110. The most homogeneous MIC results (i.e. modal MIC ±1 dilution step) were obtained for oxacillin and vancomycin, while the most divergent results were seen with cefotaxime and ceftiofur. Using a success rate of at least 80% of the strain-specific MICs being within the acceptable ranges as an arbitrary cut-off, only one of the participating laboratories failed to reach this cut-off value for one of the two R. equi strains. Thus, we consider the new protocol fit for use in routine AST of R. equi. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Are Creativity Tests Susceptible to Coaching?

    ERIC Educational Resources Information Center

    Fairweather, Elizabeth C.; Cramond, Bonnie; Landis, Rebecca Nordin

    2015-01-01

    Critics of creativity tests, some of which are used widely in determining student eligibility for special educational opportunities such as gifted programs, claim that scores on these tests can be improved with specific training on the scoring components of the tests. However, we could find no empirical evidence supporting this claim. So, we…

  17. Are Creativity Tests Susceptible to Coaching?

    ERIC Educational Resources Information Center

    Fairweather, Elizabeth C.; Cramond, Bonnie; Landis, Rebecca Nordin

    2015-01-01

    Critics of creativity tests, some of which are used widely in determining student eligibility for special educational opportunities such as gifted programs, claim that scores on these tests can be improved with specific training on the scoring components of the tests. However, we could find no empirical evidence supporting this claim. So, we…

  18. A biphasic finite element model of in vitro plowing tests of the temporomandibular joint disc.

    PubMed

    Spilker, R L; Nickel, J C; Iwasaki, L R

    2009-06-01

    Disorders of the temporomandibular joint (TMJ) afflict 3-29% of people aged 19-40 years. Degenerative joint disease (DJD) of the TMJ generally occurs 15 years earlier than in other human joints and 1.5-2 times more often in women than men. The TMJ disc is the primary stress distribution mechanism within the joint. Mechanical failure of the TMJ disc precedes clinical signs of DJD. Unlike postcranial synovial joints, biomimetic replacements of the disc have not been successful, probably due to the paucity of knowledge about TMJ biomechanics. Translation of stress-fields mediolaterally across the TMJ disc may lead to fatigue failure because of the effect of traction forces on the tissue surface and because the disc is relatively weak in this aspect. Traction forces are composed of friction forces, which are known to be low in the TMJ, and plowing forces which are relatively much higher and result from movement and pressurization of fluids within the tissues due to translating surface loads. In the in vitro plowing experiment, a rigid curve-ended indenter is lowered into a TMJ disc that has been mounted on a stage with pressure gauges, and the indenter is then translated in a prescribed mediolateral motion that is intended to simulate the motion of the mandibular condyle on the TMJ disc in vivo. As a first step, these plowing experiments have quantified the variables thought to be important in tissue failure. A next step is to define the full role of these variables in the pathomechanics of TMJ disc tissue through a validated model. Therefore, the aim of this study was to develop and test a finite element model of the plowing experiments based on an orthotropic biphasic description of the soft tissue behavior of the TMJ disc. For this plowing model, the arbitrary Lagrange Eulerian method was used to approximate the moving load problem, where in vitro the indenter slid along the tissue's superior surface. Approximate validation of the plowing model was based on

  19. Vancomycin-resistant Enterococcus spp.: validation of susceptibility testing and in vitro activity of vancomycin, linezolid, tigecycline and daptomycin.

    PubMed

    Rathe, Mathias; Kristensen, Lise; Ellermann-Eriksen, Svend; Thomsen, Marianne Kragh; Schumacher, Helga

    2010-01-01

    Vancomycin-resistant enterococci (VRE) have emerged to become a significant nosocomial pathogen. However, detection may be challenging and treatment possibilities are limited. Reports of resistance to linezolide, daptomycin and tigecycline underline the need for reliable susceptibility testing with respect to these compounds. We evaluated the in vitro activity of vancomycin, linezolid, daptomycin and tigecycline against a panel of VRE and vancomycin-susceptible enterococci by broth microdilution (BMD). Etest for determination of minimum inhibitory concentration of these four antibiotics and two disc diffusion assays for detecting VRE and for susceptibility testing against tigecycline and linezolid were evaluated. Before susceptibility testing, all isolates were classified by polymerase chain reaction as vanA or vanB gene positive or vanA/B gene negative. Linezolid, daptomycin and tigecycline had excellent in vitro activity towards all isolates. For daptomycin and tigecycline, the overall agreement between BMD and Etest was suboptimal. For both disc diffusion assays, use of current break points was inadequate to detect vancomycin resistance for isolates carrying the vanB gene. Inspection of the inhibition zone for a diffuse edge, as recommended, accurately predicted presence of the vanB gene.

  20. A Rapid Antimicrobial Susceptibility Test for Bacillus anthracis▿

    PubMed Central

    Weigel, Linda M.; Sue, David; Michel, Pierre A.; Kitchel, Brandon; Pillai, Segaran P.

    2010-01-01

    An effective public health response to a deliberate release of Bacillus anthracis will require a rapid distribution of antimicrobial agents for postexposure prophylaxis and treatment. However, conventional antimicrobial susceptibility testing for B. anthracis requires a 16- to 20-h incubation period. To reduce this time, we have combined a modified broth microdilution (BMD) susceptibility testing method with real-time quantitative PCR (qPCR). The growth or inhibition of growth of B. anthracis cells incubated in 2-fold dilutions of ciprofloxacin (CIP) (0.015 to 16 μg/ml) or doxycycline (DOX) (0.06 to 64 μg/ml) was determined by comparing the fluorescence threshold cycle (CT) generated by target amplification from cells incubated with each drug concentration with the CT of the no-drug (positive growth) control. This ΔCT readily differentiated susceptible and nonsusceptible strains. Among susceptible strains, the median ΔCT values were ≥7.51 cycles for CIP and ≥7.08 cycles for DOX when drug concentrations were at or above the CLSI breakpoint for susceptibility. For CIP- and DOX-nonsusceptible strains, the ΔCT was <1.0 cycle at the breakpoint for susceptibility. When evaluated with 14 genetically and geographically diverse strains of B. anthracis, the rapid method provided the same susceptibility results as conventional methods but required less than 6 h, significantly decreasing the time required for the selection and distribution of appropriate medical countermeasures. PMID:20439614

  1. Penicillin-susceptible Staphylococcus aureus: susceptibility testing, resistance rates and outcome of infection.

    PubMed

    Hagstrand Aldman, Malin; Skovby, Annette; I Påhlman, Lisa

    2017-06-01

    Staphylococcus aureus (SA) is an important human pathogen that causes both superficial and invasive infections. Penicillin is now rarely used in the treatment of SA infections due to widespread resistance and a concern about the accuracy of existing methods for penicillin susceptibility testing. The aims of the present study were to determine the frequency of penicillin-susceptible SA isolates from blood and wound cultures in Lund, Sweden, and to evaluate methods for penicillin testing in SA. We also wanted to investigate if penicillin-susceptible isolates are associated with higher mortality. Hundred blood culture isolates collected 2008/2009, 140 blood culture isolates from 2014/2015, and 141 superficial wound culture strains from 2015 were examined. Penicillin susceptibility was tested with disk diffusion according to EUCAST guidelines, and results were confirmed with a cloverleaf assay and PCR amplification of the BlaZ gene. Patient data for all bacteraemia cases were extracted from medical records. The disk diffusion method with assessment of both zone size and zone edge appearance had high accuracy in our study. About 57% of bacteraemia isolates from 2008/2009 were sensitive to penicillin compared to 29% in 2014/2015 (p < .0001). In superficial wound cultures, 21% were penicillin susceptible. There was no difference in co-morbidity or mortality rates between patients with penicillin resistant and penicillin sensitive SA bacteraemia. Disk-diffusion is a simple and reliable method to detect penicillin resistance in SA, and susceptibility rates are significant. Penicillin has many theoretical advantages and should be considered in the treatment of SA bacteraemia when susceptible.

  2. Comparison of susceptibility patterns using commercially available susceptibility testing methods performed on prevalent Candida spp.

    PubMed

    Cretella, David; Barber, Katie E; King, S Travis; Stover, Kayla R

    2016-12-01

    The rising rates of invasive fungal infections caused by non-albicans Candida and the increasing emergence of antifungal resistance complicate the management of invasive candidiasis. Accurate and timely antifungal susceptibility testing is critical to targeting antifungal therapy. The purpose of this study was to compare commercially available susceptibility testing methods using prospectively collected Candida isolates. Susceptibility testing was performed on 74 Candida isolates collected from July 2014 to March 2015 using broth microdilution according to the Clinical and Laboratory Standards Institute method, Etest, Vitek 2 (YS-05) and Sensititre. Essential agreement and categorical agreement (CA) were assessed using the reference method. Of the 34 total blood isolates collected, Candida albicans comprised only 38 % (13) of the Candida spp. with Candidaglabrata being nearly as prevalent (29 %, 10). CA using Etest was 86 % for fluconazole, 72 % for caspofungin, 98 % for micafungin and 97 % for anidulafungin. Vitek 2 CA was 90 % for fluconazole and 98 % for caspofungin. Sensititre CA was 93 % for fluconazole, 98 % for caspofungin, 98 % for micafungin and 100 % for anidulafungin. Although our study tested a small population of Candida isolates, our results were variable by method. When implementing antifungal susceptibility testing, clinicians should be aware of the strengths and limitations of each testing method.

  3. Antifungal Susceptibility Testing of Ascomycetous Yeasts Isolated from Animals

    PubMed Central

    Álvarez-Pérez, Sergio; García, Marta E.; Peláez, Teresa; Martínez-Nevado, Eva

    2016-01-01

    Recent studies suggest that antifungal resistance in yeast isolates of veterinary origin may be an underdiagnosed threat. We tested a collection of 92 ascomycetous yeast isolates that were obtained in Spain from birds, mammals and insects for antifungal susceptibility. MICs to amphotericin B and azoles were low, and no resistant isolates were detected. Despite these results, and given the potential role of animals as reservoirs of resistant strains, continuous monitoring of antifungal susceptibility in the veterinary setting is recommended. PMID:27216048

  4. Susceptibility testing of anaerobic bacteria: myth, magic, or method?

    PubMed Central

    Wexler, H M

    1991-01-01

    The demand for susceptibility testing of anaerobes has increased, yet consensus as to procedure and interpretation in this area has not been achieved. While routine testing of anaerobic isolates is not needed, certain isolates in specific clinical settings should be tested. Also, laboratories may monitor their local antibiograms by doing periodic surveillance batch testing. The National Committee for Clinical Laboratory Standards has published a protocol of methods approved for susceptibility testing of anaerobic bacteria. Both agar and broth microdilution are included; however, the broth disk elution method is no longer approved by the National Committee for Clinical Laboratory Standards because of method-related interpretive errors. A number of newer methods are undergoing evaluation and seem promising. Clinicians and microbiologists reviewing susceptibility reports should be aware of sources of variability in the test results. Variables in susceptibility testing of anaerobes include the media and methods used, organisms chosen for testing, breakpoints chosen for interpretation, antibiotic, and determination of endpoint. Clustering of MICs around the breakpoint may lead to significant variability in test results. Adherence of testing laboratories to approved methods and careful descriptions of the method and the breakpoints used for interpretation would facilitate interlaboratory comparisons and allow problems of emerging resistance to be noted. A variety of resistance mechanisms occurs in anaerobic bacteria, including the production of beta-lactamase and other drug-inactivating enzymes, alteration of target proteins, and inability of the drug to penetrate the bacterial wall. Antimicrobial resistance patterns in the United States and abroad are described. PMID:1747863

  5. Improved method for azole antifungal susceptibility testing.

    PubMed Central

    Gordon, M A; Lapa, E W; Passero, P G

    1988-01-01

    A reproducible method is described for the determination of the MICs of ketoconazole, miconazole, fluconazole, and itraconazole with sharp endpoints when employed with either yeasts or molds. A semisolid medium is used with controlled pH and standardized inoculum. The time of reading results is a critical factor in the conduct of this test. The medium is simple to prepare and has a relatively long refrigerator shelf life in a user-ready state, requiring only the addition of a freshly prepared inoculum after restoration to room temperature. Images PMID:2846651

  6. Mechanical testing and modelling of carbon-carbon composites for aircraft disc brakes

    NASA Astrophysics Data System (ADS)

    Bradley, Luke R.

    The objective of this study is to improve the understanding of the stress distributions and failure mechanisms experienced by carbon-carbon composite aircraft brake discs using finite element (FE) analyses. The project has been carried out in association with Dunlop Aerospace as an EPSRC CASE studentship. It therefore focuses on the carbon-carbon composite brake disc material produced by Dunlop Aerospace, although it is envisaged that the approach will have broader applications for modelling and mechanical testing of carbon-carbon composites in general. The disc brake material is a laminated carbon-carbon composite comprised of poly(acrylonitrile) (PAN) derived carbon fibres in a chemical vapour infiltration (CVI) deposited matrix, in which the reinforcement is present in both continuous fibre and chopped fibre forms. To pave the way for the finite element analysis, a comprehensive study of the mechanical properties of the carbon-carbon composite material was carried out. This focused largely, but not entirely, on model composite materials formulated using structural elements of the disc brake material. The strengths and moduli of these materials were measured in tension, compression and shear in several orientations. It was found that the stress-strain behaviour of the materials were linear in directions where there was some continuous fibre reinforcement, but non-linear when this was not the case. In all orientations, some degree of non-linearity was observed in the shear stress-strain response of the materials. However, this non-linearity was generally not large enough to pose a problem for the estimation of elastic moduli. Evidence was found for negative Poisson's ratio behaviour in some orientations of the material in tension. Additionally, the through-thickness properties of the composite, including interlaminar shear strength, were shown to be positively related to bulk density. The in-plane properties were mostly unrelated to bulk density over the range of

  7. AGARD Engine Disc Cooperative Test Programme, Addendum, (Rapport sur le Programme d’Essais Commun des DIsques Moteur (Supplement)

    DTIC Science & Technology

    1993-04-01

    DTC aims to exploit in scriice.Apart from economic adv-antages, the DTC approach offers a practical. method for usinge modern high-strength disc...Engine Disc Cooperative Test Programme 1-1 1w- .N. Raienne Cnhaper 2 Part I Fractograpliic and Microstructural Anal)sis of Fatigue Crack 2-1 Grouth in Ti

  8. [Comparison of disc diffusion, E-test, and broth microdilution methods for the determination of resistance to colistin, polymyxin B, and tigecycline in multi-resistant Acinetobacter baumannii isolates].

    PubMed

    Akin, F Ebru Ozgür; Bayram, Ayşen; Balci, Iclal

    2010-04-01

    The increased rate of antimicrobial resistance in Acinetobacter baumannii made it necessary to reconsider old antibiotics such as polymyxins and develop new drugs such as tigecycline. The aim of this study was to investigate the susceptibility rates of multi-drug resistant A. baumannii clinical isolates to colistin, polymyxin B, and tigecycline by three different methods in microbiology laboratory of Gaziantep University Research Hospital, between September 2006 and April 2008. A total of 200 A. boumannii strains isolated from various clinical samples (tracheal aspirate, blood, sputum, surgical wound, catheter, pleural fluid, urine, and others) were included to the study. Identification of bacteria was performed by conventional microbiological methods and by an automatized identification system (Vitek 2, bioMerieux, France). Antimicrobial susceptibility pattern of A. baumannii isolates was determined by disc diffusion method and 95 multiple resistant A. baumannii isolates were identified. Susceptibilities of these multiple resistant bacteria to colistin, polymyxin B, and tigecycline were tested with disc diffusion, E-test, and broth microdilution methods. All of the isolates (100%) were sensitive to colistin with all three methods. Ninety-two (96.8%) of them were sensitive to polymyxin B with both disc diffusion and broth microdilution methods, and 90 (94.7%) of them were sensitive to polymyxin B with E-test. Eighty-three (87.4%) of them were sensitive to tigecycline by disc diffusion method, 78 (82.1%) by E-test, and 90 (94.7%) by broth microdilution method. No statistically significant difference was detected for the three methods in terms of susceptibility testing for polymyxin B (p > 0.05). However, while no significant difference wa detected for tigecycline susceptibility testing by disk diffusion and broth microdilution (p > 0.05), statistically significant difference was determined for broth microdilution and E-test methods (p = 0.000). In conclusion

  9. A test of truncation in the accretion discs of X-ray Binaries.

    NASA Astrophysics Data System (ADS)

    Eckersall, A.

    2016-06-01

    The truncated-disc model is generally used to help explain the change between the soft and hard states in X-ray Binaries, where the standard accretion disc is truncated in the inner regions and replaced by a radiatively inefficient accretion flow. There is still disagreement though in the extent of this truncation, particularly in at what point truncation begins. Here we analyze XMM EPIC-pn spectra in both the soft and hard states for a number of galactic XRBs, along with RGS data and the latest absorption and emission models to get an independent fit for the ISM column densities for each source. Specifically, we assume the 'canonical' model where the luminous accretion disc extends down to the innermost stable orbit at 6r_g, and construct a spectral model accounting for thermal, reflection and Compton processes ensuring consistent geometrical properties of the models. Rather than attempting to infer the inner disc location from spectral fitting and/or reflection models, we instead attempt a direct test of whether a consistent model will fit assuming no truncation. We discuss the implications for emission models of XRBs.

  10. Comparison of clinical optic disc assessment with tests of early visual field loss.

    PubMed

    Landers, John A; Goldberg, Ivan; Graham, Stuart L

    2002-10-01

    Clinical optic disc assessment may identify glaucomatous optic neuropathy prior to a patient developing visual field abnormalities on achromatic automated peri-metry (AAP). Tests targeting axons that are selectively damaged or whose redundancy is low, such as short wavelength automated perimetry (SWAP) and frequency doubling perimetry (FDP), may detect visual field loss before it is seen on AAP. This study investigated whether patients in whom characteristic glaucomatous optic disc damage was present without AAP abnormalities had visual field abnormalities with SWAP and FDP. A sample of patients (n = 50) with ocular hypertension (normal AAP) were selected, who had SWAP, FDP and stereofundus photography performed. The photographs were then analysed by two glaucoma subspecialists who were masked to the assessments of the other and to the patients' SWAP and FDP results. A categorization of the optic discs was made as either normal or abnormal and this was compared with their SWAP and FDP findings. On comparing SWAP and FDP with clinical optic disc assessment as the 'gold standard', the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 33%, 92%, 57% and 81%, respectively, for SWAP and 25%, 89%, 49% and 79%, respectively, for FDP. In glaucoma suspects, the study suggests that SWAP and FDP identify subjects with early glaucomatous optic neuropathy missed by AAP.

  11. Effect of lubricants on friction in laboratory tests of a total disc replacement device.

    PubMed

    Moghadas, Parshia; Mahomed, Aziza; Hukins, David W L; Shepherd, Duncan E T

    2013-09-01

    Some designs of total disc replacement devices have articulating bearing surfaces, and these devices are tested in vitro with a lubricant of diluted calf serum. It is believed that the lubricant found in total disc replacement devices in vivo is interstitial fluid that may have properties between that in Ringer's solution and diluted calf serum. To investigate the effect of lubricants, a set of friction tests were performed on a generic model of a metal against metal ball-and-socket total disc replacement device. Two devices were tested: one with a ball radius of 10 mm and other with a ball radius of 16 mm; each device had a radial clearance of 0.015 mm. A spine simulator was used to measure frictional torque for each device in axial rotation, flexion-extension and lateral bending at frequencies of 0.25-2 Hz, under 1200 N axial load. Each device was tested with two different lubricants: a solution of new born calf serum diluted with deionised water and Ringer's solution. The results showed that the frictional torque generated between the bearing surfaces was significantly higher in Ringer's solution than in diluted calf serum. The use of Ringer's solution as a lubricant provides a stringent test condition to detect possible problems. Diluted calf serum is more likely to provide an environment closer to that in vivo. However, the precise properties of the fluid lubricating a total disc replacement device are not known; hence, tests using diluted calf serum may not necessarily give the same results as those obtained in vivo.

  12. Rapid Antimicrobial Susceptibility Testing Using Forward Laser Light Scatter Technology

    PubMed Central

    Clinton, Lani K.; Hewitt, Carolyn; Koyamatsu, Terri; Sun, Yilun; Jamison, Ginger; Perkins, Rosalie; Tang, Li; Pounds, Stanley; Bankowski, Matthew J.

    2016-01-01

    The delayed reporting of antimicrobial susceptibility testing remains a limiting factor in clinical decision-making in the treatment of bacterial infection. This study evaluates the use of forward laser light scatter (FLLS) to measure bacterial growth for the early determination of antimicrobial susceptibility. Three isolates each (two clinical isolates and one reference strain) of Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa were tested in triplicate using two commercial antimicrobial testing systems, the Vitek2 and the MicroScan MIC panel, to challenge the BacterioScan FLLS. The BacterioScan FLLS showed a high degree of categorical concordance with the commercial methods. Pairwise comparison with each commercial system serving as a reference standard showed 88.9% agreement with MicroScan (two minor errors) and 72.2% agreement with Vitek (five minor errors). FLLS using the BacterioScan system shows promise as a novel method for the rapid and accurate determination of antimicrobial susceptibility. PMID:27558176

  13. Antimicrobial resistance in campylobacter: susceptibility testing methods and resistance trends.

    PubMed

    Ge, Beilei; Wang, Fei; Sjölund-Karlsson, Maria; McDermott, Patrick F

    2013-10-01

    Most Campylobacter infections are self-limiting but antimicrobial treatment (e.g., macrolides, fluoroquinolones) is necessary in severe or prolonged cases. Susceptibility testing continues to play a critical role in guiding therapy and epidemiological monitoring of resistance. The methods of choice for Campylobacter recommended by the Clinical and Laboratory Standards Institute (CLSI) are agar dilution and broth microdilution, while a disk diffusion method was recently standardized by the European Committee on Antimicrobial Susceptibility Testing (EUCAST). Macrolides, quinolones, and tetracyclines are among the common antimicrobials recommended for testing. Molecular determination of Campylobacter resistance via DNA sequencing or PCR-based methods has been performed. High levels of resistance to tetracycline and ciprofloxacin are frequently reported by many national surveillance programs, but resistance to erythromycin and gentamicin in Campylobacter jejuni remains low. Nonetheless, variations in susceptibility observed over time underscore the need for continued public health monitoring of Campylobacter resistance from humans, animals, and food.

  14. Cyclic flattened Brazilian disc tests for measuring the tensile fatigue properties of brittle rocks

    NASA Astrophysics Data System (ADS)

    Liu, Yi; Dai, Feng; Xu, Nuwen; Zhao, Tao

    2017-08-01

    We propose a cyclic flattened Brazilian disc (FBD) testing method to measure the tensile fatigue properties of brittle rocks. Our method has obvious merits in its specimen preparation and experimental operation. Two parallel flattens are introduced in the disc specimen, which facilitate easily and uniformly loading the specimen without special loading devices required. Moreover, the contact regions between two flattens and loading planes barely change during the entire loading and unloading process, ensuring a consistent contact condition. With certain appropriate loading angles, this method guarantees that the very first breakage of the specimen occurs at the center of the disc, which is the prerequisite of the Brazilian-type indirect tensile tests. To demonstrate our new method, nine cyclic FBD tensile tests are conducted. The fatigue load-deformation characteristics of FBD specimens are revealed. The tensile fatigue lives of tested specimens are observed to increase with the increase in cyclic loading frequency. Our proposed method provides a convenient and reliable approach to indirectly measure the fatigue tensile properties of brittle rocks and other brittle solids subjected to cyclic tensile loadings.

  15. Paper based point-of-care testing disc for multiplex whole cell bacteria analysis.

    PubMed

    Li, Chen-zhong; Vandenberg, Katherine; Prabhulkar, Shradha; Zhu, Xuena; Schneper, Lisa; Methee, Kalai; Rosser, Charles J; Almeide, Eugenio

    2011-07-15

    Point-of-care testing (POCT) of infectious bacterial agents offers substantial benefits for disease diagnosis, mainly by shortening the time required to obtain results and by making the test available bedside or at remote care centers. Immunochromatographic lateral flow biosensors offer a low cost, highly sensitive platform for POCT. In this article, we describe the fabrication and testing of a multiplex immuno-disc sensor for the specific detection of Pseudomonas aeruginosa and Staphylococcus aureus. Antibody conjugated gold nanoparticles were used as the signaling agents. The detection range of the bacteria lies within 500-5000 CFU/ml. The advantage of the immuno-disc sensor is that it does not require any preprocessing of biological sample and is capable of whole cell bacterial detection. We also describe the design and fabrication of a compact portable device which converts the color intensity of the gold nanoparticles that accumulate at the test region into a quantitative voltage reading proportional to the bacterial concentration in the sample. The combination of the immuno-disc and the portable color reader provides a rapid, sensitive, low cost, and quantitative tool for the detection of a panel of infectious agents present in the patient sample.

  16. Cyclic flattened Brazilian disc tests for measuring the tensile fatigue properties of brittle rocks.

    PubMed

    Liu, Yi; Dai, Feng; Xu, Nuwen; Zhao, Tao

    2017-08-01

    We propose a cyclic flattened Brazilian disc (FBD) testing method to measure the tensile fatigue properties of brittle rocks. Our method has obvious merits in its specimen preparation and experimental operation. Two parallel flattens are introduced in the disc specimen, which facilitate easily and uniformly loading the specimen without special loading devices required. Moreover, the contact regions between two flattens and loading planes barely change during the entire loading and unloading process, ensuring a consistent contact condition. With certain appropriate loading angles, this method guarantees that the very first breakage of the specimen occurs at the center of the disc, which is the prerequisite of the Brazilian-type indirect tensile tests. To demonstrate our new method, nine cyclic FBD tensile tests are conducted. The fatigue load-deformation characteristics of FBD specimens are revealed. The tensile fatigue lives of tested specimens are observed to increase with the increase in cyclic loading frequency. Our proposed method provides a convenient and reliable approach to indirectly measure the fatigue tensile properties of brittle rocks and other brittle solids subjected to cyclic tensile loadings.

  17. AGARD (Advisory Group for Aerospace Research & Development) Engine Disc Cooperative Test Programme,

    DTIC Science & Technology

    1988-08-01

    4薗ii 759 so A AOR!nRU spa A44 IFOR I L J32 I 2 11I1L2 1. 1111. BBIC fiLL W;UV AGARM36R-766 AGARD REPORT No.766 AGARD Engine Disc Cooperative Test...J \\ND MlR I ItON \\I (MROi\\NIS.\\I ION 1)t I RiNI Ir iIM I 1~ .\\%NII I NORIp A(6ARI) Report No.700 AGARD ENGINE DISC (’O )PERAI IVE TEST PROG;RAMME h...cim p, met for manyv years. In I 9X2 a Suh-comrnittee on ’-Damage Tolerance Concepts for Critical Engine Comiponents’ "as formed ito studs the

  18. Frost Susceptibility of Soil, Review of Index Tests,

    DTIC Science & Technology

    1981-12-01

    methods, such as the shear vane and cone type. The second test recommended for further penetrometer , cannot be used with coarse- evaluation is the more... CBR -after-thaw test. DD i~~iI IMI=n o ovs sosL D JA , Unclassified SECURITY CLASSIFICATION OF THIS PAGE (Mvet, Date Itnteres) PREFACE The CRREL...79 Thaw- CBR test 82 Conclusions . . ... ... 83 Literature cited 83 Appendix A: Frost susceptibility classification methods based on grain size

  19. US physicians' attitudes toward genetic testing for cancer susceptibility.

    PubMed

    Freedman, A N; Wideroff, L; Olson, L; Davis, W; Klabunde, C; Srinath, K P; Reeve, B B; Croyle, R T; Ballard-Barbash, R

    2003-07-01

    Genetic testing for an inherited susceptibility to cancer is an emerging technology in medical practice. Little information is currently available about physicians' attitudes toward these tests. To assess US physicians' opinions on unresolved issues surrounding genetic testing, a 15-min survey was administered to a stratified random sample of 1,251 physicians from 8 specialties, selected from a file of all licensed physicians in the US (response rate = 71.0%). Dependent measures included physicians' attitudes toward genetic counseling and testing qualifications, availability of guidelines, patient confidentiality and insurance discrimination issues, and clinical utility of genetic tests. More than 89% of physicians reported a need for physician guidelines, 81% thought that patients with positive genetic test results are at risk for insurance discrimination, and more than 53% thought that it was difficult to ensure the confidentiality of test results. Almost 25% indicated that genetic tests for cancer susceptibility have too many inaccurate or ambiguous results; nearly 75% thought that clear guidelines are not available for managing patients with positive test results. Only 29% of physicians reported feeling qualified to provide genetic counseling to their patients. More than 84% of oncologists considered themselves qualified to recommend genetic testing to their patients compared with 40% of primary care physicians (PCPs), and 57% of tertiary care physicians (TCPs). US physicians expressed great uncertainty about issues surrounding genetic testing for cancer susceptibility. Results of this national survey underscore the need to provide physicians with clear guidelines on the use of genetic cancer susceptibility tests and effective medical training on their appropriate implementation.

  20. Antimycobacterial susceptibility testing methods for natural products research

    PubMed Central

    Sánchez, Juan Gabriel Bueno; Kouznetsov, Vladimir V.

    2010-01-01

    The emergence of multidrug-resistant strains of Mycobacterium tuberculosis underscores the need of continuous developments on new and efficient methods to determine the susceptibility of isolates of M. tuberculosis in the search for novel antimicrobial agents. Natural products constitute an important source of new drugs, but design and implementation of antimycobacterial susceptibility testing methods are necessary for evaluate the different extracts and compounds. A number of biological assay methodologies are in current use, ranging from the classical disk diffusion and broth dilution assay format, to radiorespirometric (BACTEC), dye-based, and fluorescent/luminescence reporter assays. This review presents an analysis on the in vitro susceptibility testing methods developed for determinate antitubercular activity in natural products and related compounds (semi-synthetic natural products and natural products-derived compounds) and the criteria to select the adequate method for determination of biological activity of new natural products. PMID:24031490

  1. Rapid flow cytometric susceptibility testing of Candida albicans.

    PubMed Central

    Ramani, R; Ramani, A; Wong, S J

    1997-01-01

    A rapid flow cytometric assay for in vitro antifungal drug susceptibility testing was developed by adapting the proposed reference method for broth macrodilution testing of yeasts. Membrane permeability changes caused by the antifungal agent were measured by flow cytometry using propidium iodide, a nucleic acid-binding fluorochrome largely excluded by the intact cell membrane. We determined the in vitro susceptibility of 31 Candida albicans isolates and two quality control strains (Candida parapsilosis ATCC 22019 and Candida krusei ATCC 6258) to amphotericin B and fluconazole. Amphotericin B MICs ranged from 0.03 to 2.0 microg/ml, while fluconazole MICs ranged from 0.125 to 128 microg/ml. This method results in clear-cut endpoints that were reproducible. Four-hour incubation was required for fluconazole, whereas a 2-h incubation was sufficient for amphotericin B to provide MICs comparable to the reference macrodilution method developed by the National Committee for Clinical Laboratory Standards Subcommittee on Antifungal Susceptibility Tests. Results of these studies show that flow cytometry provides a rapid and sensitive in vitro method for antifungal susceptibility testing of C. albicans. PMID:9276410

  2. 21 CFR 866.1640 - Antimicrobial susceptibility test powder.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Antimicrobial susceptibility test powder. 866.1640 Section 866.1640 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Diagnostic Devices § 866.1640 Antimicrobial...

  3. 21 CFR 866.1640 - Antimicrobial susceptibility test powder.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Antimicrobial susceptibility test powder. 866.1640 Section 866.1640 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Diagnostic Devices § 866.1640 Antimicrobial...

  4. 21 CFR 866.1640 - Antimicrobial susceptibility test powder.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Antimicrobial susceptibility test powder. 866.1640 Section 866.1640 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Diagnostic Devices § 866.1640 Antimicrobial...

  5. 21 CFR 866.1640 - Antimicrobial susceptibility test powder.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Antimicrobial susceptibility test powder. 866.1640 Section 866.1640 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Diagnostic Devices § 866.1640 Antimicrobial...

  6. 21 CFR 866.1640 - Antimicrobial susceptibility test powder.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Antimicrobial susceptibility test powder. 866.1640 Section 866.1640 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Diagnostic Devices § 866.1640 Antimicrobial...

  7. E-test: an alternative method for susceptibility testing of Mycobacterium tuberculosis.

    PubMed

    Akcali, Sinem; Cicek, Candan; Surucuoglu, Suheyla; Ozbakkaloglu, Beril

    2005-01-01

    The purpose of this study was to compare the agar proportion method with the E-test method for susceptibility testing of Mycobacterium tuberculosis. A total of 100 isolates were tested for isoniazid, rifampin, streptomycin and ethambutol susceptibility using an indirect-proportion method as well as the E-test method. Categorical agreement between the methods was 100% for isoniazid, rifampin, streptomycin, and ethambutol. The E-test method appears to be an alternative method to agar proportion for testing the susceptibility of M. tuberculosis isolates to the first-line antituberculous agents. Copyright (c) 2005 S. Karger AG, Basel.

  8. In vitro susceptibility testing of Paracoccidioides brasiliensis to sulfonamides.

    PubMed Central

    Restrepo, A; Arango, M D

    1980-01-01

    A total of 60 clinical isolates of Paracoccidioides brasiliensis were tested for susceptibility to sulfadiazine and sulfadimethoxyne by the agar dilution technique. A modification of the Mueller-Hinton medium was devised which gave good growth of the yeast form. The minimum inhibitory concentrations for only 51.6% of the isolates were in the range of the recommended blood serum concentration (50 micrograms/ml). For 6 to 8% of the isolates, the minimum inhibitory concentrations were above 200 micrograms of both sulfadiazine and sulfadimethoxyne per ml. A significant decreases in susceptibility was demonstrated for one isolate obtained from a patient relapsing during sulfonamide therapy. Images PMID:7416744

  9. Antifungal Susceptibility Testing of Ascomycetous Yeasts Isolated from Animals.

    PubMed

    Álvarez-Pérez, Sergio; García, Marta E; Peláez, Teresa; Martínez-Nevado, Eva; Blanco, José L

    2016-08-01

    Recent studies suggest that antifungal resistance in yeast isolates of veterinary origin may be an underdiagnosed threat. We tested a collection of 92 ascomycetous yeast isolates that were obtained in Spain from birds, mammals and insects for antifungal susceptibility. MICs to amphotericin B and azoles were low, and no resistant isolates were detected. Despite these results, and given the potential role of animals as reservoirs of resistant strains, continuous monitoring of antifungal susceptibility in the veterinary setting is recommended. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  10. Innovative antimicrobial susceptibility testing method using surface plasmon resonance.

    PubMed

    Chiang, Ya-Ling; Lin, Chi-Hung; Yen, Muh-Yong; Su, Yuan-Deng; Chen, Shean-Jen; Chen, How-Foo

    2009-03-15

    Utilizing the ultra sensitivity of surface plasmon resonance (SPR) biosensor to examine drug resistance of bacteria was studied in this research. Susceptible and resistant strains of Escherichia coli JM109 to ampicillin and those of Staphylococcus epidermidis to tetracycline, served as a blind test, were examined. The bacteria adhered on the Au thin film was treated by the injection of antibiotic flow. The optical property change of the bacteria responded to antibiotics were recorded through SPR mechanism. As a result, the susceptible strain of E. coli generally revealed more than three times of SPR angle shift when compared to the resistant one; the susceptible strain of S. epidermidis revealed irregular SPR angle shift while the resistant strain kept the SPR angle almost unchanged. The new SPR method took less than 2h of antibiotic treatment time to complete the antimicrobial susceptibility test. Different from conventional applications of SPR, specific antibodies is not required in this method. As compared to the conventional assays, Kirby-Bauer disk diffusion and variations of broth microdilution usually take 1 day to weeks to issue the report. Using this SPR assay can greatly reduce the waiting period for laboratory tests, and can therefore benefit patients who need proper antibiotic treatments to control bacterial infections. The sensitivity of the SPR biosensor built for the application is around 1.4 x 10(-4) on the refractive index.

  11. High frequency fluoroptic thermometry current sensing for weapon susceptibility testing

    SciTech Connect

    Cernosek, R.W.

    1988-01-01

    A high frequency current measurement technique for susceptibility testing is proposed. This technique uses a resistive element to produce a temperature change that is sensed by a fluoroptic thermometer. Laboratory testing has shown that RF currents as small as 1.5 mA are measureable for frequencies up to 10 GHz. Errors bounds in determining the current are 6 dB. 7 refs., 6 figs.

  12. Nonweekend schedule for BACTEC drug susceptibility testing of Mycobacterium tuberculosis.

    PubMed Central

    Hawkins, J E

    1986-01-01

    Determination of the drug susceptibility of Mycobacterium tuberculosis by conventional methods using an agar-based medium may take 3 weeks or more to complete. On the other hand, results on positive cultures are generally available in 4 to 7 days with the radiometric (BACTEC, Johnston Laboratories, Towson, Md.) procedure. One disadvantage to the latter is the requirement to determine the quantity of 14CO2 in each test vial on a daily basis from the day of inoculation. Growth index readings often must be made over weekends, adding to the work load of clinical laboratories during periods of reduced staff or necessitating compensatory pay or time. Susceptibility tests with streptomycin, isoniazid, ethambutol, and rifampin against 104 M. tuberculosis strains were performed by the submerged disk method, the recommended BACTEC method with daily growth index readings, and the radiometric procedure with readings delayed for 2 days after inoculation. Criteria for interpretation of "delayed" tests were established. Drug concentrations tested included some modifications of those available commercially. Overall agreement for the four drugs by the three methods was greater than 90%. We conclude that under our test conditions a schedule of inoculation of radiometric test vials on Friday with growth index readings commencing on Monday gives susceptibility results that correlate well with the daily BACTEC method and with a conventional 7H10 agar method. PMID:3086371

  13. Radiated Susceptibility Tests in Thermal Vacuum Chambers for Space Systems

    NASA Astrophysics Data System (ADS)

    Anon Cancela, Manuel; Hernandez-Gomez, Daniel; Vazquez-Pascual, Mercedes; Lopez-Sanz, Daniel

    2016-05-01

    INTA EMC Area has a wide experience in performing Radiated Susceptibility (RS) tests according to civilian, military and aeronautical standards in Mode Tuned Chambers (MTC) for national and international projects; besides, INTA has two Thermal Vacuum Chamber (TVC) facilities in service for Space Systems tests. In order to perform RS tests to Space Systems in a more realistic environment, INTA EMC Area has stablished an internal research program to develop a procedure to perform this kind of tests inside a TVC as a Mode Tuned Chamber (MTC). In this paper the results of the TVC-04 validation measurements as a MTC are presented.

  14. Genetic susceptibility testing for neurodegenerative diseases: ethical and practice issues.

    PubMed

    Roberts, J Scott; Uhlmann, Wendy R

    2013-11-01

    As the genetics of neurodegenerative disease become better understood, opportunities for genetic susceptibility testing for at-risk individuals will increase. Such testing raises important ethical and practice issues related to test access, informed consent, risk estimation and communication, return of results, and policies to prevent genetic discrimination. The advent of direct-to-consumer genetic susceptibility testing for various neurodegenerative disorders (including Alzheimer's disease (AD), Parkinson's disease, and certain prion diseases) means that ethical and practical challenges must be faced not only in traditional research and clinical settings, but also in broader society. This review addresses several topics relevant to the development and implementation of genetic susceptibility tests across research, clinical, and consumer settings; these include appropriate indications for testing, the implications of different methods for disclosing test results, clinical versus personal utility of risk information, psychological and behavioral responses to test results, testing of minors, genetic discrimination, and ethical dilemmas posed by whole-genome sequencing. We also identify future areas of likely growth in the field, including pharmacogenomics and genetic screening for individuals considering or engaged in activities that pose elevated risk of brain injury (e.g., football players, military personnel). APOE gene testing for risk of Alzheimer's disease is used throughout as an instructive case example, drawing upon the authors' experience as investigators in a series of multisite randomized clinical trials that have examined the impact of disclosing APOE genotype status to interested individuals (e.g., first-degree relatives of AD patients, persons with mild cognitive impairment). Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Genetic susceptibility testing for neurodegenerative diseases: Ethical and practice issues

    PubMed Central

    Roberts, J. Scott; Uhlmann, Wendy R.

    2013-01-01

    As the genetics of neurodegenerative disease become better understood, opportunities for genetic susceptibility testing for at-risk individuals will increase. Such testing raises important ethical and practice issues related to test access, informed consent, risk estimation and communication, return of results, and policies to prevent genetic discrimination. The advent of direct-to-consumer genetic susceptibility testing for various neurodegenerative disorders (including Alzheimer’s disease, Parkinson’s disease, and certain prion diseases) means that ethical and practical challenges must be faced not only in traditional research and clinical settings, but also in broader society. This review addresses several topics relevant to the development and implementation of genetic susceptibility tests across research, clinical, and consumer settings; these include appropriate indications for testing, the implications of different methods for disclosing test results, clinical versus personal utility of risk information, psychological and behavioral responses to test results, testing of minors, genetic discrimination, and ethical dilemmas posed by whole-genome sequencing. We also identify future areas of likely growth in the field, including pharmacogenomics and genetic screening for individuals considering or engaged in activities that pose elevated risk of brain injury (e.g., football players, military personnel). APOE gene testing for risk of Alzheimer’s disease is used throughout as an instructive case example, drawing upon the authors’ experience as investigators in a series of multisite randomized clinical trials that have examined the impact of disclosing APOE genotype status to interested individuals (e.g., first-degree relatives, persons with mild cognitive impairment). PMID:23583530

  16. A new rapid resazurin-based microdilution assay for antimicrobial susceptibility testing of Neisseria gonorrhoeae.

    PubMed

    Foerster, Sunniva; Desilvestro, Valentino; Hathaway, Lucy J; Althaus, Christian L; Unemo, Magnus

    2017-07-01

    Rapid, cost-effective and objective methods for antimicrobial susceptibility testing of Neisseria gonorrhoeae would greatly enhance surveillance of antimicrobial resistance. Etest, disc diffusion and agar dilution methods are subjective, mostly laborious for large-scale testing and take ∼24 h. We aimed to develop a rapid broth microdilution assay using resazurin (blue), which is converted into resorufin (pink fluorescence) in the presence of viable bacteria. The resazurin-based broth microdilution assay was established using 132 N. gonorrhoeae strains and the antimicrobials ceftriaxone, cefixime, azithromycin, spectinomycin, ciprofloxacin, tetracycline and penicillin. A regression model was used to estimate the MICs. Assay results were obtained in ∼7.5 h. The EC 50 of the dose-response curves correlated well with Etest MIC values (Pearson's r  = 0.93). Minor errors resulting from misclassifications of intermediate strains were found for 9% of the samples. Major errors (susceptible strains misclassified as resistant) occurred for ceftriaxone (4.6%), cefixime (3.3%), azithromycin (0.6%) and tetracycline (0.2%). Only one very major error was found (a ceftriaxone-resistant strain misclassified as susceptible). Overall the sensitivity of the assay was 97.1% (95% CI 95.2-98.4) and the specificity 78.5% (95% CI 74.5-82.9). A rapid, objective, high-throughput, quantitative and cost-effective broth microdilution assay was established for gonococci. For use in routine diagnostics without confirmatory testing, the specificity might remain suboptimal for ceftriaxone and cefixime. However, the assay is an effective low-cost method to evaluate novel antimicrobials and for high-throughput screening, and expands the currently available methodologies for surveillance of antimicrobial resistance in gonococci.

  17. Radiated Susceptibility Test Procedure and Setup Exploiting Crosstalk

    NASA Astrophysics Data System (ADS)

    Grassi, F.; Pignari, S. A.; Spadacini, G.; Bisognin, P.; Pelissou, P.; Marra, S.

    2016-05-01

    In this work, basic principles of an alternative test procedure exploiting crosstalk to reproduce in the terminal loads of a wiring structure the same disturbances that would be induced by traditional radiated susceptibility (RS) tests are presented. Equivalence with radiation is achieved by the use of a generator circuit properly fed with two synchronized RF generators, and holds for whatever loads (even not linear) connected to the terminations of the cable harness. The proposed procedure is here tailored to the specific conditions of incidence foreseen by aerospace Standards on RS. Its effectiveness is validated by measurements carried out in an ad hoc test setup.

  18. Bacterial Nanoscale Cultures for Phenotypic Multiplexed Antibiotic Susceptibility Testing

    PubMed Central

    Weibull, Emilie; Antypas, Haris; Kjäll, Peter; Brauner, Annelie; Andersson-Svahn, Helene

    2014-01-01

    An optimal antimicrobial drug regimen is the key to successful clinical outcomes of bacterial infections. To direct the choice of antibiotic, access to fast and precise antibiotic susceptibility profiling of the infecting bacteria is critical. We have developed a high-throughput nanowell antibiotic susceptibility testing (AST) device for direct, multiplexed analysis. By processing in real time the optical recordings of nanoscale cultures of reference and clinical uropathogenic Escherichia coli strains with a mathematical algorithm, the time point when growth shifts from lag phase to early logarithmic phase (Tlag) was identified for each of the several hundreds of cultures tested. Based on Tlag, the MIC could be defined within 4 h. Heatmap presentation of data from this high-throughput analysis allowed multiple resistance patterns to be differentiated at a glance. With a possibility to enhance multiplexing capacity, this device serves as a high-throughput diagnostic tool that rapidly aids clinicians in prescribing the optimal antibiotic therapy. PMID:24989602

  19. Development of Rifapentine Susceptibility Tests for Mycobacterium tuberculosis

    PubMed Central

    Heifets, L.; Sanchez, T.; Vanderkolk, J.; Pham, V.

    1999-01-01

    Two methods for testing the susceptibility of Mycobacterium tuberculosis to rifapentine have been developed: the agar proportion method and the radiometric BACTEC technique. A critical concentration of 0.5 μg of rifapentine per ml is proposed for both methods since it provides a reliable means of distinguishing between susceptible and resistant M. tuberculosis isolates. It is recommended that two quality control M. tuberculosis strains be used at the introduction of these tests in a clinical laboratory: one that is pansusceptible (H37Rv) and one that is resistant to rifapentine. The resistant strain can be obtained from the American Type Culture Collection, where it is deposited under the number ATCC 700457. PMID:9869560

  20. Improved medium for fluconazole susceptibility testing of Candida albicans.

    PubMed Central

    Rodriguez-Tudela, J L; Martinez-Suarez, J V

    1994-01-01

    We have compared fluconazole susceptibilities of 92 clinical isolates of Candida albicans by broth microdilution in two different media: standard RPMI 1640 (RPMI) and the same medium supplemented with 18 g of glucose per liter (RPMI-glucose). Preparation of media, drugs, and inocula, as well as incubation conditions, followed the preliminary recommendations of the National Committee for Clinical Laboratory Standards (Villanova, Pa.) antifungal agent working group for broth macrodilution tests with antifungal agents, adapted to microdilution. Microtiter plates were agitated for 5 min before spectrophotometric readings were performed with an automatic plate reader set at 405 mm. The MIC endpoint was defined as an inhibitory concentration calculated from the turbidimetric data as a function of the turbidity in the drug-free control wells. The mean absorbances in the drug-free wells in RPMI and RPMI-glucose were, respectively, 0.38 (41.6% transmission) and 0.99 (10.2% transmission) (P < 0.001; Student's t test). Despite the increased growth in RPMI-glucose, 98.9% of the C. albicans strains tested for fluconazole susceptibility yielded similar MICs (+/- 1 dilution) in both media. Moreover, strains with decreased susceptibility to fluconazole displaying similar MICs in both media are easier to detect in RPMI-glucose because of the greater differences between turbidimetric readings in wells with grown or fluconazole-inhibited cultures. This objective turbidimetric method, with an easy-to-read improved medium (RPMI with glucose), together with previous experience of the National Committee for Clinical Laboratory Standards antifungal agent subcommittee, could overcome some of the present problems associated with lack of reproducibility of azole susceptibility testing. PMID:8141578

  1. Fracturing and Failure Behavior of Carrara Marble in Quasistatic and Dynamic Brazilian Disc Tests

    NASA Astrophysics Data System (ADS)

    Wong, Louis Ngai Yuen; Zou, Chunjiang; Cheng, Yi

    2014-07-01

    The tensile strength and fracturing behavior of Carrara marble subjected to the dynamic Brazilian disc test using the split Hopkinson pressure bar technique are determined and compared with those obtained by the conventional quasistatic Brazilian disc test. Detailed observation of the cracking processes is aided by high-speed video footage captured at a frame rate of 100,000 frames per second. The dynamic increase factor is computed, revealing a strong strain rate dependence of the Carrara marble when subjected to strain rates above 1 s-1. Similar to the quasistatic loading tests, conspicuous white zones/patches commonly appear prior to the initiation of visible cracks in the dynamic loading tests. Identification of the white patch initiation and evolution is aided by image comparison software. Comparing the cracking and failure processes under quasistatic and dynamic loading, some distinct differences in the white patch geometry and initiation load are observed. In addition, the extent of the compressive failure zones around the contact points between the loading platens and specimens is found to increase with the strain rate.

  2. Localized strain measurements of the intervertebral disc annulus during biaxial tensile testing.

    PubMed

    Karakolis, Thomas; Callaghan, Jack P

    2015-01-01

    Both inter-lamellar and intra-lamellar failures of the annulus have been described as potential modes of disc herniation. Attempts to characterize initial lamellar failure of the annulus have involved tensile testing of small tissue samples. The purpose of this study was to evaluate a method of measuring local surface strains through image analysis of a tensile test conducted on an isolated sample of annular tissue in order to enhance future studies of intervertebral disc failure. An annulus tissue sample was biaxial strained to 10%. High-resolution images captured the tissue surface throughout testing. Three test conditions were evaluated: submerged, non-submerged and marker. Surface strains were calculated for the two non-marker conditions based on motion of virtual tracking points. Tracking algorithm parameters (grid resolution and template size) were varied to determine the effect on estimated strains. Accuracy of point tracking was assessed through a comparison of the non-marker conditions to a condition involving markers placed on tissue surface. Grid resolution had a larger effect on local strain than template size. Average local strain error ranged from 3% to 9.25% and 0.1% to 2.0%, for the non-submerged and submerged conditions, respectively. Local strain estimation has a relatively high potential for error. Submerging the tissue provided superior strain estimates.

  3. Susceptibility testing for bovine respiratory and enteric disease.

    PubMed

    Apley, Michael D

    2003-11-01

    The interpretation of susceptibility results for antimicrobials with NCCLS-approved veterinary-specific breakpoints and where the methods also were NCCLS-approved are well established. When these same breakpoints are applied to other applications, however, the interpretation is not so clear. In these cases, a finding of S based on serial-dilution breakpoints puts the isolate in a defined population of bacteria with an MIC equal to or below the S breakpoint. An R result, in these cases, indicates that the organism may have an MIC equal to or greater (with no limits) than the R breakpoint. Extended-dilution testing yields more specific information about the isolate MIC. The relationship of disk-diffusion zone diameters to serial-dilution MICs is correlated on the basis of specific bacterial populations. When disk-diffusion results are interpreted for isolates other than those used for interpretive criteria development, the clinician is left wondering if the zone-diameter results now have a different relationship to serial-dilution results. Furthermore, the question of predictive value of the serial-dilution break-points still remains. The veterinary clinician should be aware of the differences in susceptibility testing predictive value for different applications. When approved veterinary-specific interpretive criteria are not available, then it is appropriate to keep records of clinical response related to susceptibility testing results for common therapies. Advice should be sought on the relationship of pathogen MICs to pharmacokinetic-pharmacodynamic parameters in these situations.

  4. Rolling contact fatigue of surface modified 440C using a 'Ge-Polymet' type disc rod test rig

    NASA Technical Reports Server (NTRS)

    Thom, Robert L.

    1989-01-01

    Through hardened 440 C martensitic stainless steel test specimens were surface modified and tested for changes in rolling contact fatigue using a disc on rod test rig. The surface modifications consisted of nitrogen, boron, titanium, chromium, tantalum, carbon, or molybdenum ion implantation at various ion fluences and energies. Tests were also performed on specimens reactively sputtered with titanium nitride.

  5. Rolling contact fatigue of surface modified 440C using a 'Ge-Polymet' type disc rod test rig

    SciTech Connect

    Thom, R.L.

    1989-03-01

    Through hardened 440 C martensitic stainless steel test specimens were surface modified and tested for changes in rolling contact fatigue using a disc on rod test rig. The surface modifications consisted of nitrogen, boron, titanium, chromium, tantalum, carbon, or molybdenum ion implantation at various ion fluences and energies. Tests were also performed on specimens reactively sputtered with titanium nitride.

  6. Improved medium for antimicrobial susceptibility testing of Haemophilus influenzae.

    PubMed Central

    Jorgensen, J H; Redding, J S; Maher, L A; Howell, A W

    1987-01-01

    The need for complex growth media has complicated routine susceptibility testing of Haemophilus influenzae because of antagonism of certain antimicrobial agents by the medium or because of difficulties in interpretation of growth endpoints. Haemophilus test medium (HTM) is a simple, transparent medium for broth- or agar-based tests with H. influenzae. HTM incorporates Mueller-Hinton medium with additions of 15 micrograms of hematin per ml, 15 micrograms of NAD per ml, and 5 mg of yeast extract per ml as growth-promoting additives. Agar or broth microdilution MICs of 10 antimicrobial agents for a collection of 179 H. influenzae isolates determined by using HTM compared favorably with MICs determined by the conventional agar or broth dilution methods recommended by the National Committee for Clinical Laboratory Standards. Disk diffusion tests performed with HTM allowed accurate categorization of susceptible and resistant strains and were easier to interpret than tests performed with Mueller-Hinton chocolate agar. A particular advantage of HTM was the reliability of broth- or agar-based test results with trimethoprim-sulfamethoxazole. The results of the study suggest modification of current National Committee for Clinical Laboratory Standards MIC-interpretive criteria for H. influenzae with amoxicillin-clavulanate, chloramphenicol, and trimethoprim-sulfamethoxazole. Error rate-bounded analysis of MICs and disk diffusion zone sizes also suggest modified zone-interpretive criteria for ampicillin, amoxicillin-clavulanate, chloramphenicol, and tetracycline with HTM or conventional media. Interpretive zone sizes are newly proposed for cefaclor and rifampin disk diffusion tests. PMID:3500965

  7. High-throughput metal susceptibility testing of microbial biofilms.

    PubMed

    Harrison, Joe J; Turner, Raymond J; Ceri, Howard

    2005-10-03

    Microbial biofilms exist all over the natural world, a distribution that is paralleled by metal cations and oxyanions. Despite this reality, very few studies have examined how biofilms withstand exposure to these toxic compounds. This article describes a batch culture technique for biofilm and planktonic cell metal susceptibility testing using the MBEC assay. This device is compatible with standard 96-well microtiter plate technology. As part of this method, a two part, metal specific neutralization protocol is summarized. This procedure minimizes residual biological toxicity arising from the carry-over of metals from challenge to recovery media. Neutralization consists of treating cultures with a chemical compound known to react with or to chelate the metal. Treated cultures are plated onto rich agar to allow metal complexes to diffuse into the recovery medium while bacteria remain on top to recover. Two difficulties associated with metal susceptibility testing were the focus of two applications of this technique. First, assays were calibrated to allow comparisons of the susceptibility of different organisms to metals. Second, the effects of exposure time and growth medium composition on the susceptibility of E. coli JM109 biofilms to metals were investigated. This high-throughput method generated 96-statistically equivalent biofilms in a single device and thus allowed for comparative and combinatorial experiments of media, microbial strains, exposure times and metals. By adjusting growth conditions, it was possible to examine biofilms of different microorganisms that had similar cell densities. In one example, Pseudomonas aeruginosa ATCC 27853 was up to 80 times more resistant to heavy metalloid oxyanions than Escherichia coli TG1. Further, biofilms were up to 133 times more tolerant to tellurite (TeO3(2-)) than corresponding planktonic cultures. Regardless of the growth medium, the tolerance of biofilm and planktonic cell E. coli JM109 to metals was time

  8. High-throughput metal susceptibility testing of microbial biofilms

    PubMed Central

    Harrison, Joe J; Turner, Raymond J; Ceri, Howard

    2005-01-01

    Background Microbial biofilms exist all over the natural world, a distribution that is paralleled by metal cations and oxyanions. Despite this reality, very few studies have examined how biofilms withstand exposure to these toxic compounds. This article describes a batch culture technique for biofilm and planktonic cell metal susceptibility testing using the MBEC assay. This device is compatible with standard 96-well microtiter plate technology. As part of this method, a two part, metal specific neutralization protocol is summarized. This procedure minimizes residual biological toxicity arising from the carry-over of metals from challenge to recovery media. Neutralization consists of treating cultures with a chemical compound known to react with or to chelate the metal. Treated cultures are plated onto rich agar to allow metal complexes to diffuse into the recovery medium while bacteria remain on top to recover. Two difficulties associated with metal susceptibility testing were the focus of two applications of this technique. First, assays were calibrated to allow comparisons of the susceptibility of different organisms to metals. Second, the effects of exposure time and growth medium composition on the susceptibility of E. coli JM109 biofilms to metals were investigated. Results This high-throughput method generated 96-statistically equivalent biofilms in a single device and thus allowed for comparative and combinatorial experiments of media, microbial strains, exposure times and metals. By adjusting growth conditions, it was possible to examine biofilms of different microorganisms that had similar cell densities. In one example, Pseudomonas aeruginosa ATCC 27853 was up to 80 times more resistant to heavy metalloid oxyanions than Escherichia coli TG1. Further, biofilms were up to 133 times more tolerant to tellurite (TeO32-) than corresponding planktonic cultures. Regardless of the growth medium, the tolerance of biofilm and planktonic cell E. coli JM109 to metals

  9. Comparison of phenotypic and genotypic methods for pyrazinamide susceptibility testing.

    PubMed

    Shenai, Shubhada; Rodrigues, Camilla; Sadani, Meeta; Sukhadia, Nesline; Mehta, Ajita

    2009-04-01

    To evaluate Pyrazinamide (PZA) susceptibility results obtained by phenotypic MGIT 960 TB system against enzymatic Pyrazinamidase assay and genotypic pncA gene sequencing. To find the prevalence of infections caused by M. bovis in PZA resistant M. tuberculosis complex isolates. 33 consecutive PZA resistant and 30 consecutive PZA susceptible isolates reported for PZA susceptibility testing by MGIT 960 TB system were included in this study. Presence of active pyrazinamidase enzyme was sought by using the Wayne assay. The pncA gene was amplified by PCR and then sequenced to screen mutations. All the PZA resistant isolates were further spoligotyped to identify M. bovis, if present. Of 33 PZA resistant strains by MGIT 960, 31 were Wayne assay negative and two were positive. Of the 30 susceptible PZA strains six were Wayne assay negative reporting false resistance. PncA gene sequencing revealed that 32 of the 33 MGIT PZA resistant isolates had diverse nucleotide changes scattered throughout the pncA gene (one isolate did not show any mutation). Of the 30 phenotypically susceptible isolates, 21 were wild types whilst nine isolates showed the presence of a silent mutation C-T at codon 195. Fifteen mutations found in this study has not been described earlier. Not a single isolate of M. bovis was detected among PZA resistant M. tuberculosis complex isolates. MGIT 960 showed better concordance with sequencing results in comparison with Wayne assay. In present study, a high proportion (85%) of MDR-TB isolates from patients receiving anti-TB treatment were found to be resistant to PZA.

  10. Genetic susceptibility testing for beryllium: worker knowledge, beliefs, and attitudes.

    PubMed

    Silver, Ken; Kukulka, Gary; Gorniewicz, John; Rayman, Kathleen; Sharp, Richard

    2011-07-01

    We sought to gain insight into workers' knowledge, beliefs, and attitudes on the subject of testing for genetic susceptibility to beryllium. Five focus groups were held with 30 current and former beryllium workers and nine family members. Audio recordings were transcribed and assessed by hierarchical coding using an inductive approach. Some workers were unclear about the distinction between genotoxicity and heritability. A key finding is that they perceived the benefits of a positive test result to be related to enhanced autonomous decision-making. The major concern cited by participants was potential abuse of genetic information by employers. Complete financial separation of a prospective testing entity from the employer was seen as crucial. A window of opportunity exists to create regional partnerships for translational research on genetic susceptibility testing. Such partnerships would involve labor, management, public health scientists, primary care professionals, and other stakeholders. They would be critical to identifying testing strategies that maximize worker autonomy along with the public health advantages of genetic testing. Copyright © 2011 Wiley-Liss, Inc.

  11. A multiplexed microfluidic platform for rapid antibiotic susceptibility testing.

    PubMed

    Mohan, Ritika; Mukherjee, Arnab; Sevgen, Selami E; Sanpitakseree, Chotitath; Lee, Jaebum; Schroeder, Charles M; Kenis, Paul J A

    2013-11-15

    Effective treatment of clinical infections is critically dependent on the ability to rapidly screen patient samples to identify antibiograms of infecting pathogens. Existing methods for antibiotic susceptibility testing suffer from several disadvantages, including long turnaround times, excess sample and reagent consumption, poor detection sensitivity, and limited combinatorial capabilities. Unfortunately, these factors preclude the timely administration of appropriate antibiotics, complicating management of infections and exacerbating the development of antibiotic resistance. Here, we seek to address these issues by developing a microfluidic platform that relies on fluorescence detection of bacteria that express green fluorescent protein for highly sensitive and rapid antibiotic susceptibility testing. This platform possesses several advantages compared to conventional methods: (1) analysis of antibiotic action in two to four hours, (2) enhanced detection sensitivity (≈ 1 cell), (3) minimal consumption of cell samples and antibiotic reagents (<6 µL), and (4) improved portability through the implementation of normally closed valves. We employed this platform to quantify the effects of four antibiotics (ampicillin, cefalexin, chloramphenicol, tetracycline) and their combinations on Escherichia coli. Within four hours, the susceptibility of bacteria to antibiotics can be determined by detecting variations in maxima of local fluorescence intensity over time. As expected, cell density is a major determinant of antibiotic efficacy. Our results also revealed that combinations of three or more antibiotics are not necessarily better for eradicating pathogens compared to pairs of antibiotics. Overall, this microfluidic based biosensor technology has the potential to provide rapid and precise guidance in clinical therapies by identifying the antibiograms of pathogens.

  12. A new approach for pyrazinamide susceptibility testing in Mycobacterium tuberculosis.

    PubMed

    Zimic, Mirko; Loli, Sebastian; Gilman, Robert H; Gutierrez, Andrés; Fuentes, Patricia; Cotrina, Milagros; Kirwan, Daniela; Sheen, Patricia

    2012-08-01

    Pyrazinamide (PZA) is an important drug in the treatment of tuberculosis. Microbiological methods of PZA susceptibility testing are controversial and have low reproducibility. After conversion of PZA into pyrazinoic acid (POA) by the bacterial pyrazinamidase enzyme, the drug is expelled from the bacteria by an efflux pump. To evaluate the rate of POA extrusion from Mycobacterium tuberculosis as a parameter to detect PZA resistance. The rate of POA extrusion and PZA susceptibility determined by BACTEC 460 were measured for 34 strains in a previous study. PZA resistance was modeled in a logistic regression with the pyrazinoic efflux rate. POA efflux rate predicted PZA resistance with 70.83%-92.85% sensitivity and 100% specificity compared with BACTEC 460. POA efflux rate could be a useful tool for predicting PZA resistance in M. tuberculosis. Further exploration of this approach may lead to the development of new tools for diagnosing PZA resistance, which may be of public health importance.

  13. Antifungal Susceptibility Testing: Practical Aspects and Current Challenges

    PubMed Central

    Rex, John H.; Pfaller, Michael A.; Walsh, Thomas J.; Chaturvedi, Vishnu; Espinel-Ingroff, Ana; Ghannoum, Mahmoud A.; Gosey, Linda L.; Odds, Frank C.; Rinaldi, Michael G.; Sheehan, Daniel J.; Warnock, David W.

    2001-01-01

    Development of standardized antifungal susceptibility testing methods has been the focus of intensive research for the last 15 years. Reference methods for yeasts (NCCLS M27-A) and molds (M38-P) are now available. The development of these methods provides researchers not only with standardized methods for testing but also with an understanding of the variables that affect interlaboratory reproducibility. With this knowledge, we have now moved into the phase of (i) demonstrating the clinical value (or lack thereof) of standardized methods, (ii) developing modifications to these reference methods that address specific problems, and (iii) developing reliable commercial test kits. Clinically relevant testing is now available for selected fungi and drugs: Candida spp. against fluconazole, itraconazole, flucytosine, and (perhaps) amphotericin B; Cryptococcus neoformans against (perhaps) fluconazole and amphotericin B; and Aspergillus spp. against (perhaps) itraconazole. Expanding the range of useful testing procedures is the current focus of research in this area. PMID:11585779

  14. Preparation of a blood culture pellet for rapid bacterial identification and antibiotic susceptibility testing.

    PubMed

    Croxatto, Antony; Prod'hom, Guy; Durussel, Christian; Greub, Gilbert

    2014-10-15

    Bloodstream infections and sepsis are a major cause of morbidity and mortality. The successful outcome of patients suffering from bacteremia depends on a rapid identification of the infectious agent to guide optimal antibiotic treatment. The analysis of Gram stains from positive blood culture can be rapidly conducted and already significantly impact the antibiotic regimen. However, the accurate identification of the infectious agent is still required to establish the optimal targeted treatment. We present here a simple and fast bacterial pellet preparation from a positive blood culture that can be used as a sample for several essential downstream applications such as identification by MALDI-TOF MS, antibiotic susceptibility testing (AST) by disc diffusion assay or automated AST systems and by automated PCR-based diagnostic testing. The performance of these different identification and AST systems applied directly on the blood culture bacterial pellets is very similar to the performance normally obtained from isolated colonies grown on agar plates. Compared to conventional approaches, the rapid acquisition of a bacterial pellet significantly reduces the time to report both identification and AST. Thus, following blood culture positivity, identification by MALDI-TOF can be reported within less than 1 hr whereas results of AST by automated AST systems or disc diffusion assays within 8 to 18 hr, respectively. Similarly, the results of a rapid PCR-based assay can be communicated to the clinicians less than 2 hr following the report of a bacteremia. Together, these results demonstrate that the rapid preparation of a blood culture bacterial pellet has a significant impact on the identification and AST turnaround time and thus on the successful outcome of patients suffering from bloodstream infections.

  15. Preparation of a Blood Culture Pellet for Rapid Bacterial Identification and Antibiotic Susceptibility Testing

    PubMed Central

    Croxatto, Antony; Prod'hom, Guy; Durussel, Christian; Greub, Gilbert

    2014-01-01

    Bloodstream infections and sepsis are a major cause of morbidity and mortality. The successful outcome of patients suffering from bacteremia depends on a rapid identification of the infectious agent to guide optimal antibiotic treatment. The analysis of Gram stains from positive blood culture can be rapidly conducted and already significantly impact the antibiotic regimen. However, the accurate identification of the infectious agent is still required to establish the optimal targeted treatment. We present here a simple and fast bacterial pellet preparation from a positive blood culture that can be used as a sample for several essential downstream applications such as identification by MALDI-TOF MS, antibiotic susceptibility testing (AST) by disc diffusion assay or automated AST systems and by automated PCR-based diagnostic testing. The performance of these different identification and AST systems applied directly on the blood culture bacterial pellets is very similar to the performance normally obtained from isolated colonies grown on agar plates. Compared to conventional approaches, the rapid acquisition of a bacterial pellet significantly reduces the time to report both identification and AST. Thus, following blood culture positivity, identification by MALDI-TOF can be reported within less than 1 hr whereas results of AST by automated AST systems or disc diffusion assays within 8 to 18 hr, respectively. Similarly, the results of a rapid PCR-based assay can be communicated to the clinicians less than 2 hr following the report of a bacteremia. Together, these results demonstrate that the rapid preparation of a blood culture bacterial pellet has a significant impact on the identification and AST turnaround time and thus on the successful outcome of patients suffering from bloodstream infections. PMID:25350577

  16. Development of a national EUCAST challenge panel for antimicrobial susceptibility testing.

    PubMed

    Desmet, S; Verhaegen, J; Glupzcynski, Y; Van Eldere, J; Melin, P; Goossens, H; Piérard, D; Declercq, P; Lagrou, K; Boel, A; Cartuyvels, R; Denis, O; Vandewal, W; Saegeman, V

    2016-08-01

    A challenge panel of bacterial strains useful for clinical laboratories to validate their European Committee on Antimicrobial Susceptibility Testing (EUCAST) antimicrobial susceptibility test (AST) system was established. A total of 117 strains, obtained from Belgian Reference Centres (n = 57) and from routine clinical samples (n = 60) was selected based on resistance pattern. These strains were analysed in seven different laboratories by three different automated AST systems (Vitek (n = 2), Phoenix (n = 2) and Microscan (n = 2)) and by disc diffusion from five different manufacturers (Rosco (n = 2), Becton-Dickinson (n = 2), Biomérieux (n = 1), Bio-rad (n = 1) and i2a (n = 1)). To select the challenge panel, selection criteria were set for categorical agreement between the different systems and the number of very major errors, major errors and minor errors. Very major and major errors for at least two antibiotics were observed in 43% of all strains, leading to the exclusion of these strains from the selected panel. In only 10% of all tested strains was there 100% categorical agreement for all antibiotics. Finally, 28 strains (14 Gram-positive and 14 Gram-negative) covering a wide spectrum of resistance mechanisms were selected. Pilot-testing of this challenge panel in 20 laboratories mainly confirmed the results of the validation study. Only six strains withheld for the pilot study could not be used as challenge strain due to an overall (very) major error rate of >5% for a particular antibiotic (n = 5) or for two antibiotics (n = 1). To conclude, this challenge panel should facilitate the implementation and use of EUCAST breakpoints in laboratories.

  17. The disc damage likelihood scale: Diagnostic accuracy and correlations with cup-to-disc ratio, structural tests and standard automated perimetry.

    PubMed

    Kara-José, Andrea C; Melo, Luiz Alberto S; Esporcatte, Bruno L B; Endo, Angelica T N H; Leite, Mauro Toledo; Tavares, Ivan Maynart

    2017-01-01

    Our objective was to compare the diagnostic accuracies of and to determine the correlations between the disc damage likelihood scale (DDLS) and anatomical and functional tests used for glaucoma detection. A total of 54 healthy subjects (54 eyes) and 47 primary open-angle glaucoma patients (47 eyes) were included in this cross-sectional observational study. DDLS scores and cup-to-disc (C/D) ratios were evaluated. Subjects underwent standard automated perimetry (SAP), optic disc and retinal nerve fiber layer (RNFL) imaging with time and spectral-domain optical coherence tomography (TD and SD-OCT), Heidelberg Retina Tomograph (HRT II), and scanning laser polarimetry (GDx-VCC). Areas under the receiver operating characteristic curves (AROCs) for DDLS and diagnostic tests parameters were calculated. DDLS correlations (Spearman's rank) among these parameters were analyzed. Fifty-four eyes were healthy and 47 had glaucoma, including 16 preperimetric glaucoma. DDLS, vertical and horizontal C/D ratios had the largest AROCs (0.92, 0.94 and 0.91, respectively). DDLS diagnostic accuracy was better than the accuracies of HRT II parameters, TD and SD-OCT RNFL thicknesses, and SAP mean deviation (MD) index. There were no significant differences between the accuracies of the DDLS and the C/D ratios, TD-OCT vertical (0.89) and horizontal (0.86) C/D ratios, TD-OCT C/D area ratio (0.89), and GDx-VCC NFI (0.81). DDLS showed significant strong correlations with vertical (r = 0.79) and horizontal (0.74) C/D ratios, and with the parameters vertical C/D ratio and C/D area ratio from HRT II (both 0.77) and TD-OCT (0.75 and 0.72, respectively). DDLS had significant moderate correlations with most of the other structural measurements and SAP MD. The optic disc clinical evaluation with DDLS system and C/D ratio demonstrated excellent accuracy in distinguishing glaucomatous from healthy eyes. DDLS had moderate to strong correlations with most structural and functional parameters. These

  18. Rapid cytometric antibiotic susceptibility testing utilizing adaptive multidimensional statistical metrics.

    PubMed

    Huang, Tzu-Hsueh; Ning, Xinghai; Wang, Xiaojian; Murthy, Niren; Tzeng, Yih-Ling; Dickson, Robert M

    2015-02-03

    Flow cytometry holds promise to accelerate antibiotic susceptibility determinations; however, without robust multidimensional statistical analysis, general discrimination criteria have remained elusive. In this study, a new statistical method, probability binning signature quadratic form (PB-sQF), was developed and applied to analyze flow cytometric data of bacterial responses to antibiotic exposure. Both sensitive lab strains (Escherichia coli and Pseudomonas aeruginosa) and a multidrug resistant, clinically isolated strain (E. coli) were incubated with the bacteria-targeted dye, maltohexaose-conjugated IR786, and each of many bactericidal or bacteriostatic antibiotics to identify changes induced around corresponding minimum inhibition concentrations (MIC). The antibiotic-induced damages were monitored by flow cytometry after 1-h incubation through forward scatter, side scatter, and fluorescence channels. The 3-dimensional differences between the flow cytometric data of the no-antibiotic treated bacteria and the antibiotic-treated bacteria were characterized by PB-sQF into a 1-dimensional linear distance. A 99% confidence level was established by statistical bootstrapping for each antibiotic-bacteria pair. For the susceptible E. coli strain, statistically significant increments from this 99% confidence level were observed from 1/16x MIC to 1x MIC for all the antibiotics. The same increments were recorded for P. aeruginosa, which has been reported to cause difficulty in flow-based viability tests. For the multidrug resistant E. coli, significant distances from control samples were observed only when an effective antibiotic treatment was utilized. Our results suggest that a rapid and robust antimicrobial susceptibility test (AST) can be constructed by statistically characterizing the differences between sample and control flow cytometric populations, even in a label-free scheme with scattered light alone. These distances vs paired controls coupled with rigorous

  19. OT1_bmatthew_4: Testing Planetary Dynamics and Evolutionary History in the HR 8799 Planet/Disc System

    NASA Astrophysics Data System (ADS)

    Matthews, B.

    2010-07-01

    We propose to map the debris disc associated with the multi-planet system HR 8799 in order to constrain the current dynamical state of the planetary system and refine models for dust production in the disc, thereby testing models for the origins of the three known giant planets. Herschel's sensitivity and resolution make it possible to image both the cold planetesimal disc (posited to lie between radii of 90-300 AU) as well as the fainter extended halo (300 - 1000 AU radius) at multiple wavelengths. Direct detection of the edges of the cold belt of dust and an independent measure of the system's inclination will provide critical constraints on models of the planetary orbits within the system, particularly for the outer-most planet for which mass and orbit information can be constrained by simultaneous fits to the planet and disc. The combination of three massive, coeval, and spectroscopically characterizable planets, together with the dust disc, makes this system a "Rosetta Stone" for planet formation studies. The disc is also important for differentiating between planet formation scenarios. Models predict variations in resonance structure for migration versus in situ formation, and multi-wavelength variations in observed structure within Herschel's wavelength range in the case of planetary migration. This proposal is at the very heart of Herschel's top science goal of understanding the mechanisms involved in the formation of stars and planetary bodies. The resolution, sensitivity and multi-wavelength imaging of Herschel are crucial to this program.

  20. In Vitro Susceptibility Testing of Bedaquiline against Mycobacterium avium Complex.

    PubMed

    Brown-Elliott, Barbara A; Philley, Julie V; Griffith, David E; Thakkar, Foram; Wallace, Richard J

    2017-02-01

    We performed bedaquiline broth microdilution susceptibility testing using Clinical and Laboratory Standards Institute (CLSI) guidelines on 103 respiratory isolates of Mycobacterium avium complex (MAC), including multidrug-resistant isolates. Approximately 90% of isolates had bedaquiline MICs of ≤0.008 μg/ml, and 102/103 isolates had MICs of ≤0.015 μg/ml. Bedaquiline has excellent potential for use in patients with MAC infections, although for reasons of its metabolism by the cytochrome P450 system, it should not be given with rifampin.

  1. DVD technology-based molecular diagnosis platform: quantitative pregnancy test on a disc.

    PubMed

    Li, Xiaochun; Weng, Samuel; Ge, Bixia; Yao, Zhihui; Yu, Hua-Zhong

    2014-05-21

    A diagnosis platform based entirely on DVD technology was developed for on-site quantitation of molecular analytes of interest, e.g., human chorionic gonadotropin (hCG) in urine samples ("quantitative pregnancy test on a disc"). An hCG-specific monoclonal antibody-binding assay prepared on a regular DVD-R was labeled with nanogold-streptavidin conjugates for signal enhancement with a customized silver-staining protocol. An unmodified, conventional computer optical drive was used for assay reading, and free disc-quality analysis software for data processing. The performance (sensitivity and selectivity) of this DVD assay is comparable to that of well-established colorimetric methods (determination of optical darkness ratios) and standard enzyme-linked immunosorbent assays (ELISA). As validated by examining its linear correlation with the ELISA results on the same set of samples, the DVD assay promises to be a low-cost, multiplex, point-of-care (POC) diagnostic tool for physicians and even for individuals at home, producing prompt results.

  2. An Innovative Concept for Testing Rutting Susceptibility of Asphalt Mixture

    NASA Astrophysics Data System (ADS)

    Mohseni, Alaeddin; Azari, Haleh

    Currently, flow number (FN) is being used for measuring permanent deformation resistance of asphalt mixtures. The provisional AASHTO TP 79-10 test method specifies the requirements of the FN test; however, there are undefined levels of test variables, such as temperature, axial stress, and confinement. Therefore, agreeable FN criteria that can reliably discriminate between various mixtures have not been established yet. As the asphalt industry continues to develop more sophisticated mixtures (Warm Mix, RAP and RAS), the FN value has failed to capture the true complexity of the asphalt mixtures. These shortcomings and the unpredictable testing time of the FN test have affected its usefulness for evaluating high temperature performance of asphalt mixtures. A new test procedure for evaluation of rutting susceptibility of asphalt mixtures is being proposed. The new procedure is conducted at one temperature and multiple stresses on the same replicate in three increments of 500 cycles, which only takes 33 minutes to complete. The property of the test is the permanent strain due to the last cycle of each test increment (Minimum Strain Rate, or MSR). A master curve is developed by plotting the MSR values versus parameter TP, which is a product of Temperature and Pressure. The MSR master curve represents the unit rutting damage (rut per axle) of asphalt mixtures at any stress and temperature and can be used in laboratory for material characterization, mix design verification, ranking of the mixtures, or for pavement design applications to predict rut depth for project climate and design traffic.

  3. Antimicrobial susceptibility testing in biofilm-growing bacteria.

    PubMed

    Macià, M D; Rojo-Molinero, E; Oliver, A

    2014-10-01

    Biofilms are organized bacterial communities embedded in an extracellular polymeric matrix attached to living or abiotic surfaces. The development of biofilms is currently recognized as one of the most relevant drivers of persistent infections. Among them, chronic respiratory infection by Pseudomonas aeruginosa in cystic fibrosis patients is probably the most intensively studied. The lack of correlation between conventional susceptibility test results and therapeutic success in chronic infections is probably a consequence of the use of planktonically growing instead of biofilm-growing bacteria. Therefore, several in vitro models to evaluate antimicrobial activity on biofilms have been implemented over the last decade. Microtitre plate-based assays, the Calgary device, substratum suspending reactors and the flow cell system are some of the most used in vitro biofilm models for susceptibility studies. Likewise, new pharmacodynamic parameters, including minimal biofilm inhibitory concentration, minimal biofilm-eradication concentration, biofilm bactericidal concentration, and biofilm-prevention concentration, have been defined in recent years to quantify antibiotic activity in biofilms. Using these parameters, several studies have shown very significant quantitative and qualitative differences for the effects of most antibiotics when acting on planktonic or biofilm bacteria. Nevertheless, standardization of the procedures, parameters and breakpoints, by official agencies, is needed before they are implemented in clinical microbiology laboratories for routine susceptibility testing. Research efforts should also be directed to obtaining a deeper understanding of biofilm resistance mechanisms, the evaluation of optimal pharmacokinetic/pharmacodynamic models for biofilm growth, and correlation with clinical outcome. © 2014 The Authors Clinical Microbiology and Infection © 2014 European Society of Clinical Microbiology and Infectious Diseases.

  4. Chemically defined antimicrobial susceptibility test medium for Pseudomonas aeruginosa.

    PubMed

    Jorgensen, J H; Lee, J C; Jones, P M

    1977-03-01

    A chemically defined growth medium containing physiological concentrations of magnesium and calcium ions was utilized in a microdilution procedure for antimicrobial drug susceptibility testing of Pseudomonas aeruginosa. Determinations of growth end points were simplified by use of sodium citrate as a sole carbon source and bromothymol blue as a pH indicator. Growth of the test organisms was detectable by a change in the indicator color from green to blue after alkalinization of the medium due to citrate utilization. Minimal inhibitory concentrations of amikacin, carbenicillin, gentamicin, and tobramycin were determined on 100 recent clinical isolates of Pseudomonas. Parallel determinations using the microdilution procedure and a conventional tube-broth dilution technique incorporating Mueller-Hinton broth with identical magnesium and calcium content generally agreed within one twofold dilution. Modal minimal inhibitory concentrations for susceptible strains using the microdilution method were: amikacin, 6 mug/ml; carbenicillin, 50 mug/ml; gentamicin, 1.5 mug/ml; tobramycin, 1.5 mug/ml. This modified microdilution technique allowed rapid, definitive minimal inhibitory concentration determinations, using growth end points defined by a color indicator change.

  5. Reliability of the Kirby-Bauer disc diffusion method for detecting methicillin-resistant strains of Staphylococcus aureus.

    PubMed

    Drew, W L; Barry, A L; O'Toole, R; Sherris, J C

    1972-08-01

    The resistance of Staphylococcus aureus to methicillin and related drugs can be reliably determined by using the Kirby-Bauer method of susceptibility testing if the incubation temperature is 35 C or below, but resistance may be missed at 37 C. The 1-mug discs of oxacillin and nafcillin or the 5-mug discs of methicillin may be used for this purpose but not the 1-mug discs of cloxacillin. The latter fail to discriminate between sensitive and resistant staphylococci by zone measurement; some resistant strains of staphylococci may show larger zones of inhibition than sensitive strains. Stability of these antibiotic-containing discs was studied under conditions of temperature and humidity variation that might be encountered in a clinical laboratory refrigerator. Oxacillin discs were the most stable and are to be preferred for susceptibility testing. Nafcillin discs were less stable, and methicillin discs lose their potency rapidly unless carefully stored in a refrigerator with a desiccant.

  6. Laboratory tests to study the influence of rock stress confinement on the performances of TBM discs in tunnels

    NASA Astrophysics Data System (ADS)

    Innaurato, N.; Oggeri, C.; Oreste, P.; Vinai, R.

    2011-06-01

    To clarify some aspects of rock destruction with a disc acting on a high confined tunnel face, a series of tests were carried out to examine fracture mechanisms under an indenter that simulates the tunnel boring machine (TBM) tool action, in the presence of an adjacent groove, when a state of stress (lateral confinement) is imposed on a rock sample. These tests proved the importance of carefully establishing the optimal distance of grooves produced by discs acting on a confined surface, and the value (as a mere order of magnitude) of the increase of the thrust to produce the initiation of chip formation, as long as the confinement pressure becomes greater.

  7. Everlasting sliding-disc valve. METC SOA test valve No. B-3, State-of-the-art lockhopper valve testing and development project. Summary test report

    SciTech Connect

    Gardner, J.F.; Hall, R.C.; Hornbeck, R.G.; Griffith, R.A.; Yost, T.M.; Harvey, D.M.; Galvin, W.E.; Gayheart, T.R.; Kapur, S.K.

    1980-08-01

    The Everlasting Sliding-Disc Valve (METC SOA Test Valve No. B-3) accumulated 740 valve cycles in the Valve Static Test Unit and over 16,000 valve cycles in the Valve Dynamic Test Unit. Only minor operating problems, primarily erratic motion and some scoring of the seating surface, where encountered with coarse limestone (5/16'' x 1/8'') particles. Operation with fine solids (100-mesh limestone) showed excellent performance. The actuator level arm failed twice but a change in clearances solved the problem. Based on its performance in testing, the Everlastinc Sliding-Disc Valve, with minor modifications, is a very promising choice for feedside lockhopper service in coal conversion and utilization.

  8. Predicting Susceptibility of Streptococcus pneumoniae to Ceftriaxone and Cefotaxime by Cefuroxime and Ceftizoxime Disk Diffusion Testing

    PubMed Central

    Williams-Bouyer, Natalie; Hernandez, Antonio; Reisner, Barbara S.

    1999-01-01

    In this study, disk diffusion testing with ceftizoxime and cefuroxime was evaluated for use in predicting the susceptibility of Streptococcus pneumoniae to ceftriaxone and cefotaxime. Of the 194 isolates included in this study, 138 were susceptible, 34 were intermediate, and 22 were resistant to cefotaxime by MIC testing; 138 isolates were susceptible, 35 were intermediate, and 21 were resistant to ceftriaxone by MIC testing. A zone of inhibition around the cefuroxime disk of ≥32 mm correctly categorized 101 of 138 isolates as susceptible to cefotaxime and ceftriaxone. A zone of inhibition around the ceftizoxime disk of ≥26 mm correctly categorized 111 of 138 isolates as susceptible to cefotaxime and 114 of 138 as susceptible to ceftriaxone. We conclude that disk diffusion can separate S. pneumoniae isolates susceptible to ceftriaxone and cefotaxime from those that are not susceptible. Isolates not falling into the susceptible category by disk diffusion require additional testing to determine the MIC. PMID:10523580

  9. Collaborative Evaluation of Optimal Antifungal Susceptibility Testing Conditions for Dermatophytes

    PubMed Central

    Fernández-Torres, Belkys; Cabañes, Francisco J.; Carrillo-Muñoz, Alfonso J.; Esteban, Alexandre; Inza, Isabel; Abarca, Lourdes; Guarro, Josep

    2002-01-01

    A multicenter study was conducted to define the most suitable testing conditions for antifungal susceptibility of dermatophytes. Broth microdilution MICs of clotrimazole, itraconazole, and terbinafine were determined in three centers against 60 strains of dermatophytes. The effects of inoculum density (ca. 103 and 104 CFU/ml), incubation time (3, 7, and 14 days), endpoint criteria for MIC determination (complete [MIC-0] and prominent [MIC-2] growth inhibition), and incubation temperature (28 and 37°C) on intra- and interlaboratory agreement were analyzed. The optimal testing conditions identified were an inoculum of 104 CFU/ml, a temperature of incubation of 28°C, an incubation period of 7 days, and MIC-0. PMID:12409365

  10. Comparison of the Antifungal Susceptibility Testing Subcommittee of the European Committee on Antibiotic Susceptibility Testing Proposed Standard and the E-Test with the NCCLS Broth Microdilution Method for Voriconazole and Caspofungin Susceptibility Testing of Yeast Species

    PubMed Central

    Chryssanthou, Erja; Cuenca-Estrella, Manuel

    2002-01-01

    The proposed standard of the Antifungal Susceptibility Testing Subcommittee of the European Committee on Antibiotic Susceptibility Testing (AFST-EUCAST) and the E-test procedures were compared with the NCCLS reference broth microdilution method for voriconazole and caspofungin susceptibility testing of 102 clinical Candida species and Saccharomyces cerevisiae isolates. The voriconazole MIC at which 50% of strains were inhibited (MIC50) was ≤0.125 mg/liter for all yeast species except for Candida glabrata and Candida krusei, which yielded MIC50 values of 0.25 to 1 mg/liter depending on the method. Caspofungin exhibited in vitro activity (MIC50 of ≤0.125 to 2 mg/liter) against all yeast species except for Candida guilliermondii. The agreements between MICs within ±2 dilutions obtained by the NCCLS method and the EUCAST standard were 97% for voriconazole and 96% for caspofungin. Intraclass correlation coefficients were statistically significant (P < 0.05). The agreements between voriconazole MICs provided by the E-test and the NCCLS and between the E-test and the AFST-EUCAST method were 100 and 90%, respectively. Because of lower caspofungin MICs provided by the E-test, the agreement was slightly poorer with the NCCLS method (89%) than with the AFST-EUCAST procedure (94%). Both the EUCAST and the E-test procedures can be reliable techniques for susceptibility testing of yeasts to voriconazole and caspofungin. PMID:12354895

  11. A New Approach for Pyrazinamide Susceptibility Testing in Mycobacterium tuberculosis

    PubMed Central

    Loli, Sebastian; Gilman, Robert H.; Gutierrez, Andrés; Fuentes, Patricia; Cotrina, Milagros; Kirwan, Daniela; Sheen, Patricia

    2012-01-01

    Background: Pyrazinamide (PZA) is an important drug in the treatment of tuberculosis. Microbiological methods of PZA susceptibility testing are controversial and have low reproducibility. After conversion of PZA into pyrazinoic acid (POA) by the bacterial pyrazinamidase enzyme, the drug is expelled from the bacteria by an efflux pump. Objective: To evaluate the rate of POA extrusion from Mycobacterium tuberculosis as a parameter to detect PZA resistance. Methods: The rate of POA extrusion and PZA susceptibility determined by BACTEC 460 were measured for 34 strains in a previous study. PZA resistance was modeled in a logistic regression with the pyrazinoic efflux rate. Result: POA efflux rate predicted PZA resistance with 70.83%–92.85% sensitivity and 100% specificity compared with BACTEC 460. Conclusion: POA efflux rate could be a useful tool for predicting PZA resistance in M. tuberculosis. Further exploration of this approach may lead to the development of new tools for diagnosing PZA resistance, which may be of public health importance. PMID:22372927

  12. [Rapid test for detection of susceptibility to cefotaxime in Enterobacteriaceae].

    PubMed

    Jiménez-Guerra, Gemma; Hoyos-Mallecot, Yannik; Rodríguez-Granger, Javier; Navarro-Marí, José María; Gutiérrez-Fernández, José

    In this work an "in house" rapid test based on the change in pH that is due to hydrolysis for detecting Enterobacteriaceae susceptible to cefotaxime is evaluated. The strains of Enterobacteriaceae from 1947 urine cultures were assessed using MicroScan panels and the "in house" test. This rapid test includes red phenol solution and cefotaxime. Using MicroScan panels, 499 Enterobacteriaceae isolates were evaluated, which included 27 isolates of Escherichia coli producing extended-spectrum beta-lactamases (ESBL), 16 isolates of Klebsiella pneumoniae ESBL and 1 isolate of Klebsiella oxytoca ESBL. The "in house" test offers the following values: sensitivity 98% and specificity 97%, with negative predictive value 100% and positive predictive value 78%. The "in house" test based on the change of pH is useful in our area for detecting presumptively cefotaxime-resistant Enterobacteriaceae strains. Copyright © 2016 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Susceptibility Testing and Molecular Classification of Paecilomyces spp.▿

    PubMed Central

    Castelli, Maria Victoria; Alastruey-Izquierdo, Ana; Cuesta, Isabel; Monzon, Araceli; Mellado, Emilia; Rodriguez-Tudela, Juan L.; Cuenca-Estrella, Manuel

    2008-01-01

    In vitro susceptibility profiles of 58 Paecilomyces clinical isolates are reported. Amphotericin B, itraconazole, and echinocandins showed poor activity against Paecilomyces lilacinus, while the new triazoles were active against it. Paecilomyces variotii exhibited a different susceptibility pattern, being susceptible to most antifungal agents apart from voriconazole and ravuconazole. PMID:18519716

  14. Susceptibility testing and molecular classification of Paecilomyces spp.

    PubMed

    Castelli, Maria Victoria; Alastruey-Izquierdo, Ana; Cuesta, Isabel; Monzon, Araceli; Mellado, Emilia; Rodriguez-Tudela, Juan L; Cuenca-Estrella, Manuel

    2008-08-01

    In vitro susceptibility profiles of 58 Paecilomyces clinical isolates are reported. Amphotericin B, itraconazole, and echinocandins showed poor activity against Paecilomyces lilacinus, while the new triazoles were active against it. Paecilomyces variotii exhibited a different susceptibility pattern, being susceptible to most antifungal agents apart from voriconazole and ravuconazole.

  15. Reevaluation of the diametral compression test for tablets using the flattened disc geometry.

    PubMed

    Mazel, V; Guerard, S; Croquelois, B; Kopp, J B; Girardot, J; Diarra, H; Busignies, V; Tchoreloff, P

    2016-11-20

    Mechanical strength is an important critical quality attribute for tablets. It is classically measured, in the pharmaceutical field, using the diametral compression test. Nevertheless, due to small contact area between the tablet and the platens, some authors suggested that during the test, the failure could occur in tension away from the center which would invalidate the test and the calculation of the tensile strength. In this study, the flattened disc geometry was used as an alternative to avoid contact problems. The diametral compression on both flattened and standard geometries was first studied using finite element method (FEM) simulation. It was found that, for the flattened geometry, both maximum tensile strain and stress were located at the center of the tablet, which was not the case for the standard geometry. Experimental observations using digital image correlation (DIC) confirmed the numerical results. The experimental tensile strength obtained using both geometries were compared and it was found that the standard geometry always gave lower tensile strength than the flattened geometry. Finally, high-speed video capture of the test made it possible to detect that for the standard geometry the crack initiation was always away from the center of the tablet.

  16. Evaluation of the Kirby-Bauer disc diffusion test as a screening test for high-level aminoglycoside resistance in enterococci.

    PubMed

    Pfaller, M A; Niles, A C; Murray, P R

    1984-10-01

    The Kirby-Bauer disc diffusion test was evaluated as a test to detect high-level aminoglycoside (streptomycin, kanamycin, tobramycin, and gentamicin) resistance in isolates of enterococci. The authors found that high-level resistance could not be predicted accurately with the diffusion test.

  17. ATPD-2354 Revision 10 Verification Test, Disc Brake Version Only (16 NOV 06) Article Test of High Mobility Multipurpose Wheeled Vehicle (HMMWV-ECV)

    DTIC Science & Technology

    2007-05-23

    VEHICLE (HMMWV- ECV ) DATES OF TESTS: 19 December 2006 through 16 April 2007 PREPARED BY: Carlos E. Agudelo Jeffrey A. Gist Alex...Verification Test, Disc Brake Verson Only (16 NOV 06) Article Test of High Mobility Multipurpose Wheeled Vehicle (HMMWV- ECV ) 5a. CONTRACT NUMBER

  18. Resistance pattern of mupirocin in methicillin-resistant Staphylococcus aureus in trauma patients and comparison between disc diffusion and E-test for better detection of resistance in low resource countries.

    PubMed

    Rajkumari, Nonika; Mathur, Purva; Bhardwaj, Nidhi; Gupta, Gunjan; Dahiya, Rajrani; Behera, Bijayini; Misra, Mahesh Chandra

    2014-07-01

    Mupirocin is an effective antibiotic for elimination of methicillin-resistant Staphylococcus aureus (MRSA) from nasal colonization and has been used to control outbreaks. Current reports show an increasing trend of resistance to this antibiotic. This study was conducted to analyze the resistance pattern of MRSA to mupirocin among the patients admitted following trauma to an apex trauma care center of India and to compare the efficacy between two methods of antimicrobial sensitivity testing. A total of 150 isolates of MRSA from various clinical samples of trauma patients over a period of 2 years were included in this study. These strains were confirmed for MRSA using VITEK(®) 2 Compact and the Clinical Laboratory Standard Institute disc diffusion methods. The mupirocin susceptibility of the strains was tested by using E-test and 5 μg mupirocin disc in parallel each time, and the results were compared. Clear zones of inhibition were observed in both tests. Though, good correlation was observed between the disc diffusion and E-tests in >98%, E-test showed a tendency to show lower minimum inhibitory concentration (MIC) in the remaining. These finding did not affect the final interpretation or outcomes. Of the total 150 strains, 138 (92%) showed sensitivity with the zone size in the range of 30-45 mm by 5 μg disc; rest (8%) showed sensitivity with the zone in the range of 18-30 mm by 5 μg disc, but 143 (95%) showed MIC ≤ 0.094 μg/ml and 8 (5%) gave MIC ≤ 0.75 μg/ml but ≥0.094 μg/ml by E-test. However, when both tests were compared, 5 (3.3%) showed zone size between 14 and 25 mm with ≤0.75 but >0.25 μg/ml MIC; 7 (5%) falling between 25 and 30 mm zone with MIC of ≤0.25 but >0.094 μg/ml and 138 (92%) showed zone >30 mm with MIC ≤0.094 but >0.064 μg/ml. All the MRSA isolates in our study were sensitive to mupirocin which is an encouraging finding. Though good screening for sensitivity can be done with 5 μg mupirocin disc, E-test provides a much clear

  19. Resistance pattern of mupirocin in methicillin-resistant Staphylococcus aureus in trauma patients and comparison between disc diffusion and E-test for better detection of resistance in low resource countries

    PubMed Central

    Rajkumari, Nonika; Mathur, Purva; Bhardwaj, Nidhi; Gupta, Gunjan; Dahiya, Rajrani; Behera, Bijayini; Misra, Mahesh Chandra

    2014-01-01

    Introduction: Mupirocin is an effective antibiotic for elimination of methicillin-resistant Staphylococcus aureus (MRSA) from nasal colonization and has been used to control outbreaks. Current reports show an increasing trend of resistance to this antibiotic. Objective: This study was conducted to analyze the resistance pattern of MRSA to mupirocin among the patients admitted following trauma to an apex trauma care center of India and to compare the efficacy between two methods of antimicrobial sensitivity testing. Materials and Methods: A total of 150 isolates of MRSA from various clinical samples of trauma patients over a period of 2 years were included in this study. These strains were confirmed for MRSA using VITEK® 2 Compact and the Clinical Laboratory Standard Institute disc diffusion methods. The mupirocin susceptibility of the strains was tested by using E-test and 5 μg mupirocin disc in parallel each time, and the results were compared. Results: Clear zones of inhibition were observed in both tests. Though, good correlation was observed between the disc diffusion and E-tests in >98%, E-test showed a tendency to show lower minimum inhibitory concentration (MIC) in the remaining. These finding did not affect the final interpretation or outcomes. Of the total 150 strains, 138 (92%) showed sensitivity with the zone size in the range of 30-45 mm by 5 μg disc; rest (8%) showed sensitivity with the zone in the range of 18-30 mm by 5 μg disc, but 143 (95%) showed MIC ≤ 0.094 μg/ml and 8 (5%) gave MIC ≤ 0.75 μg/ml but ≥0.094 μg/ml by E-test. However, when both tests were compared, 5 (3.3%) showed zone size between 14 and 25 mm with ≤0.75 but >0.25 μg/ml MIC; 7 (5%) falling between 25 and 30 mm zone with MIC of ≤0.25 but >0.094 μg/ml and 138 (92%) showed zone >30 mm with MIC ≤0.094 but >0.064 μg/ml. Conclusions: All the MRSA isolates in our study were sensitive to mupirocin which is an encouraging finding. Though good screening for sensitivity

  20. The biochemical characteristics of wear testing lubricants affect polyethylene wear in orthopaedic pin-on-disc testing.

    PubMed

    Guenther, Leah E; Turgeon, Thomas R; Bohm, Eric R; Brandt, Jan-M

    2015-01-01

    Lubricant protein concentration is known to affect crosslinked polyethylene wear in in vitro testing; however, the biochemical nature of these lubricants may also have a significant effect on wear and dictate its clinical relevance. A modified approach to pin-on-disc testing was implemented to explore the effect of four biochemically different lubricants on the wear of two types of crosslinked polyethylene materials (XLK™ and Marathon™; DePuy Synthes, Warsaw, IN, USA). XLK was associated with higher wear rates than Marathon. In comparison to lubricants containing deionized water, lubricants containing phosphate buffered saline solution and hyaluronic acid increased osmolality by up to 1.2 times and thermal stability by up to 1.4 times. This biochemical change reduced wear by up to 12.5 times. Wear rates for XLK and Marathon differed by a factor of 3.2 using lubricants with phosphate buffered saline solution as the dilutive media, but only 2.0 for lubricants with deionized water. Interestingly, varying the concentration of hyaluronic acid did not have a significant effect on wear, and differences between XLK and Marathon wear rates were not found to be statistically significant when hyaluronic acid was added to the lubricant. The findings of this study showed that increasing the osmolality and thermal stability of lubricants to more clinical levels decreased wear; however, the effect of hyaluronic acid on wear may not be apparent in simplistic pin-on-disc testing. It was suggested that phosphate buffered saline solution be used as the dilutive media of choice in order to better differentiate the ranking of materials while maintaining some clinical relevance. © IMechE 2015.

  1. High-Throughput Intracellular Antimicrobial Susceptibility Testing of Legionella pneumophila

    PubMed Central

    Chiaraviglio, Lucius

    2015-01-01

    Legionella pneumophila is a Gram-negative opportunistic human pathogen that causes a severe pneumonia known as Legionnaires' disease. Notably, in the human host, the organism is believed to replicate solely within an intracellular compartment, predominantly within pulmonary macrophages. Consequently, successful therapy is predicated on antimicrobials penetrating into this intracellular growth niche. However, standard antimicrobial susceptibility testing methods test solely for extracellular growth inhibition. Here, we make use of a high-throughput assay to characterize intracellular growth inhibition activity of known antimicrobials. For select antimicrobials, high-resolution dose-response analysis was then performed to characterize and compare activity levels in both macrophage infection and axenic growth assays. Results support the superiority of several classes of nonpolar antimicrobials in abrogating intracellular growth. Importantly, our assay results show excellent correlations with prior clinical observations of antimicrobial efficacy. Furthermore, we also show the applicability of high-throughput automation to two- and three-dimensional synergy testing. High-resolution isocontour isobolograms provide in vitro support for specific combination antimicrobial therapy. Taken together, findings suggest that high-throughput screening technology may be successfully applied to identify and characterize antimicrobials that target bacterial pathogens that make use of an intracellular growth niche. PMID:26392509

  2. Comparing test-specific distress of susceptibility versus deterministic genetic testing for Alzheimer’s disease

    PubMed Central

    Cassidy, Michael R.; Roberts, J. Scott; Bird, Thomas D.; Steinbart, Ellen J.; Cupples, L. Adrienne; Chen, Clara A.; Linnenbringer, Erin; Green, Robert C.

    2008-01-01

    Background Genetic risk for Alzheimer’s disease (AD) may be conferred by the susceptibility polymorphism apolipoprotein E (APOE), where the ε4 allele increases the risk of developing late-onset Alzheimer’s disease but is not a definitive predictor of the disease, or by autosomal dominant mutations (e.g., the presenilins), which almost inevitably result in early-onset familial Alzheimer’s disease. The purpose of this study was to compare the psychological impact of using these two different types of genetic information to disclose genetic risk for AD to family members of affected patients. Methods Data were compared from two separate protocols. The Risk Evaluation and Education for Alzheimer’s Disease (REVEAL) Study is a randomized, multi-site clinical trial that evaluated the impact of susceptibility testing for Alzheimer’s disease with APOE in 101 adult children of Alzheimer’s disease patients. A separate study, conducted at the University of Washington, assessed the impact of deterministic genetic testing by disclosing presenilin-1, presenilin-2, or TAU genotype to 22 individuals at risk for familial Alzheimer’s disease or frontotemporal dementia. In both protocols, participants received genetic counseling and completed the Impact of Event Scale (IES), a measure of test-specific distress. Scores were analyzed at the time point closest to one year post-disclosure at which IES data were available. The role of genetic test result (positive vs. negative) and type of genetic testing (deterministic vs. susceptibility) in predicting log-transformed IES scores was assessed with linear regression, controlling for age, gender, and time from disclosure. Results Subjects from the REVEAL Study who learned that they were positive for the susceptibility gene APOE ε4+ experienced similar, low levels of test-specific distress compared to those who received positive results of deterministic testing in the University of Washington study (p= 0.78). APOE ε4

  3. Echinocandin Resistance, Susceptibility Testing and Prophylaxis: Implications for Patient Management

    PubMed Central

    Perlin, David S.

    2014-01-01

    This article addresses the emergence of echinocandin resistance among Candida species, mechanisms of resistance, factors that promote resistance and confounding issues surrounding standard susceptibility testing. Fungal infections remain a significant cause of global morbidity and mortality, especially among patients with underlying immunosupression. Antifungal therapy is a critical component of patient management for acute and chronic diseases. Yet, therapeutic choices are limited due to only a few drug classes available to treat systemic disease. Moreover, the problem is exacerbated by the emergence of antifungal resistance, which has resulted in difficult to manage multidrug resistant strains. Echinocandin drugs are now the preferred choice to treat a range of candidiasis. These drugs target and inhibit the fungal-specific enzyme glucan synthase, which is responsible for the biosynthesis of a key cell wall polymer. Therapeutic failures involving acquisition of resistance among susceptible organisms like Candida albicans is largely a rare event. However, in recent years, there is an alarming trend of increased resistance among strains of Candida glabrata, which in many cases are also resistant to azole drugs. Echinocandin resistance is always acquired during therapy and the mechanism of resistance is well established to involve amino acid changes in “hot-spot regions of the Fks subunits carrying the catalytic portion of glucan synthase. These changes significantly decrease the sensitivity of the enzyme to drug resulting in higher MIC values. A range of drug responses, from complete to partial refractory response, is observed depending on the nature of the amino acid substitution, and clinical responses are recapitulated in pharmacodynamic models of infection. The cellular processes promoting the formation of resistant Fks strains involve complex stress response pathways, which yield a variety of adaptive compensatory genetic responses. Stress-adapted cells

  4. Microplate Alamar blue assay for Staphylococcus epidermidis biofilm susceptibility testing.

    PubMed

    Pettit, Robin K; Weber, Christine A; Kean, Melissa J; Hoffmann, Holger; Pettit, George R; Tan, Rui; Franks, Kelly S; Horton, Marilyn L

    2005-07-01

    Biofilms are at the root of many infections largely because they are much more antibiotic resistant than their planktonic counterparts. Antibiotics that target the biofilm phenotype are desperately needed, but there is still no standard method to assess biofilm drug susceptibility. Staphylococcus epidermidis ATCC 35984 biofilms treated with eight different approved antibiotics and five different experimental compounds were exposed to the oxidation reduction indicator Alamar blue for 60 min, and reduction relative to untreated controls was determined visually and spectrophotometrically. The minimum biofilm inhibitory concentration was defined as < or = 50% reduction and a purplish well 60 min after the addition of Alamar blue. All of the approved antibiotics had biofilm MICs (MBICs) of >512 microg/ml (most >4,096 microg/ml), and four of the experimental compounds had MBICs of < or = 128 microg/ml. The experimental aaptamine derivative hystatin 3 was used to correlate Alamar blue reduction with 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide (XTT) reduction and viable counts (CFU/ml) for S. epidermidis ATCC 35984, ATCC 12228, and two clinical isolates. For all four strains, Alamar blue results correlated well with XTT (r = 0.83 to 0.97) and with CFU/ml results (r = 0.85 to 0.94). Alamar blue's stability and lack of toxicity allowed CFU/ml to be determined from the same wells as Alamar blue absorbances. If the described method of microplate Alamar blue biofilm susceptibility testing, which is simple, reproducible, cost-effective, nontoxic, and amenable to high throughput, is applicable to other important biofilm forming species, it should greatly facilitate the discovery of biofilm specific agents.

  5. Radiometric and conventional drug susceptibility testing of Mycobacterium tuberculosis.

    PubMed

    Hoel, T; Eng, J

    1991-11-01

    One hundred and four clinical isolates of M. tuberculosis were susceptibility tested by the radiometric method (RAD) using the BACTEC system in parallel with a conventional modified proportion method (CON). In the latter, the strains were tested against four concentrations of drugs in Lowenstein-Jensen medium (isoniazid (INH), streptomycin (SM) and ethambutol (EMB)) OR 7H10 agar medium (rifampicin (RIF)) and reported as "sensitive", "intermediate" or "resistant" from the minimum inhibitory concentrations observed. The radiometric results were classified in the same three groups in accordance with the BACTEC methodology. The overall agreement between the results obtained by the two methods was 97.4% (INH 95.2%, EMB 96.2%, SM 98.1% and RIF 100%). In addition, the agreement between RAD and each of the drug concentration steps employed in CON was examined and the results discussed in relation to the established critical concentrations of the drugs. The BACTEC technique was found to be a rapid and convenient method for routine use.

  6. Rapid drug susceptibility test of mycobacterium tuberculosis by bioluminescence sensor

    NASA Astrophysics Data System (ADS)

    Lu, Bin; Xu, Shunqing; Chen, Zifei; Zhou, Yikai

    2001-09-01

    With the persisting increase of drug-resistant stains of M. Tuberculosis around the world, rapid and sensitive detection of antibiotic of M. Tuberculosis is becoming more and more important. In the present study, drug susceptibility of M. tuberculosis were detected by recombination mycobacteriophage combined with bioluminescence sensor. It is based on the use of recombination mycobacteriophage which can express firefly luciferase when it infects viable mycobacteria, and can effectively produce quantifiable photon. Meanwhile, in mycobacterium cells treated with active antibiotic, no light is observed. The emitted light is recorded by a bioluminscence sensor, so the result of drug-resistant test can be determined by the naked eye. 159 stains of M. tuberculosis were applied to this test on their resistant to rifampin, streptomycin and isoniazid. It is found that the agreement of this assay with Liewenstein- Jensen slat is: rifampin 95.60 percent, isoniazid 91.82 percent, streptomycin 88.68 percent, which showed that it is a fast and practical method to scene and detect drug resistant of mycobacterium stains.

  7. Drug susceptibility testing of Mycobacterium tuberculosis with nitrate reductase assay.

    PubMed

    Coban, Ahmet Yilmaz; Birinci, Asuman; Ekinci, Bora; Durupinar, Belma

    2004-09-01

    The nitrate reductase assay (NRA) was evaluated for susceptibility testing of Mycobacterium tuberculosis using 80 clinical isolates of M. tuberculosis and H37Rv as a control strain. All isolates were tested by the proportion method and the NRA for isoniazid (INH), rifampicin (RIF), streptomycin (STR) and ethambutol (ETM). The proportion method was carried out according to NCCLS on Löwenstein-Jensen (LJ) medium and the NRA on LJ medium containing 1000 microg/ml potassium nitrate (KNO(3)). After incubation for 7, 10, 14 and 21 days, Griess reagent was added to each LJ medium and nitrate reduction was determined by a colour change. Comparing the NRA with the proportion method, sensitivities were 100, 100, 82.1 and 92.2% for INH, RIF, STR and ETM, respectively. Specificities were 100, 100, 92.3 and 100% for INH, RIF, STR and ETM, respectively. The results of 2, 22 and 56 isolates were obtained after 7, 10 and 14 days, respectively. The proportion method result were read at 21-28 days. The NRA is rapid, inexpensive and easy to perform. Our results indicated that the NRA is suitable for the early determination of INH and RIF resistance in countries where sophisticated procedures are not always available.

  8. [Comparative evaluation of e-test and disk diffusion methods for susceptibility testing of Nocardia species].

    PubMed

    Perçin, Duygu; Sümerkan, Bülent; Inci, Ramazan

    2011-04-01

    Variations in antimicrobial susceptibility among different Nocardia species limit the options for therapy. It is very difficult to perform antimicrobial susceptibility testing of these bacteria due to their slow growth rate and problems in inoculum preparation. The aim of this study was to compare E-test and disk diffusion methods for the determination of antimicrobial susceptibilities of Nocardia isolates. Since E-test is considered as 90% consistent with the gold standard microdilution method recommended by Clinical and Laboratory Standards Institute (CLSI), it was chosen for comparison with disk diffusion and in order to determine the use of disk diffusion in routine practice. A total of 21 Nocardia strains isolated from clinical specimens (12 lung, 7 brain and 2 skin/soft tissue samples) were included in the study. Six of the isolates were identified as N.asteroides, six were N.farcinica, five were N.cyriacigeorgica and four were Nocardia spp. By conventional methods. Susceptibilities of strains to ampicillin, ampicillin-sulbactam, amoxicillin-clavulanic acid, ceftazidime, sefepime, imipenem, gentamicin, erythromycin, levofloxacin, moxifloxacin, trimethoprim- sulfamethoxazole, piperacillin-tazobactam, tigecycline, and linezolid were investigated by using E-test and/or disk diffusion methods. The results were interpreted according to the CLSI breakpoints for Staphylococcus spp. All of the strains were found to be resistant to ceftazidime, piperacillin-tazobactam and ampicillin, however susceptible to levofloxacin, moxifloxacin, trimethoprim-sulfamethoxazole tigecycline, and linezolid. The concordance between the methods in terms of susceptibility testing were 100% for ampicillin, ceftazidime, imipenem, gentamicin and linezolid; 85.7% for erythromycin, 76.2% for sefepime, 73.7% for moxifloxacin, 71.4% for piperacillin-tazobactam, 70% for ampicillin-sulbactam and 46.2% for amoxicillin- clavulanic acid. In conclusion, the therapy must be planned according to the

  9. Rapid diagnosis of Mycobacterium tuberculosis infection and drug susceptibility testing.

    PubMed

    Wilson, Michael L

    2013-06-01

    The global control of tuberculosis remains a challenge from the standpoint of diagnosis, detection of drug resistance, and treatment. This is an area of special concern to the health of women and children, particularly in regions of the world with high infant mortality rates and where women have limited access to health care. Because treatment can only be initiated when infection is detected, and is guided by the results of antimicrobial susceptibility testing, there recently has been a marked increase in the development and testing of novel assays designed to detect Mycobacterium tuberculosis complex, with or without simultaneous detection of resistance to isoniazid and/or rifampin. Both nonmolecular and molecular assays have been developed. This review will summarize the current knowledge about the use of rapid tests to detect M tuberculosis and drug resistance. Review of the most recent World Health Organization Global Tuberculosis Report, as well as selected publications in the primary research literature, meta-analyses, and review articles. To a large extent, nonmolecular methods are refinements or modifications of conventional methods, with the primary goal of providing more rapid test results. In contrast, molecular methods use novel technologies to detect the presence of M tuberculosis complex and genes conferring drug resistance. Evaluations of molecular assays have generally shown that these assays are of variable sensitivity for detecting the presence of M tuberculosis complex, and in particular are insensitive when used with smear-negative specimens. As a group, molecular assays have been shown to be of high sensitivity for detecting resistance to rifampin, but of variable sensitivity for detecting resistance to isoniazid.

  10. Improvement of mupirocin E-test for susceptibility testing of Staphylococcus aureus.

    PubMed

    Mondino, Pedro Juan José; Dos Santos, Kátia Regina Netto; de Freire Bastos, Maria do Carmo; Giambiagi-deMarval, Marcia

    2003-05-01

    Interpretation of the mupirocin E-test for low-level mupirocin-resistant Staphylococcus aureus strains has been improved by adding the indicator dye tetrazolium. E-tests were compared with agar dilution methods for assessing mupirocin susceptibility. MICs obtained by the agar dilution method and E-tests showed 89.3% agreement within 2 log(2) dilution criteria. The agreement between MICs increased to 100% in the 1 log(2) dilution definition when the indicator dye tetrazolium was added to the E-test. The use of the E-test with tetrazolium reduction is more accurate for determining mupirocin MICs for S. aureus strains.

  11. Antibacterial susceptibility of plaque bacteria.

    PubMed

    Newman, M G; Hulem, C; Colgate, J; Anselmo, C

    1979-07-01

    Selected anaerobic, capnophilic and facultative bacteria isolated from patients with various forms of periodontal health and disease were tested for their susceptibility to antibiotics and antimicrobial agents. Specific bactericidal and minimum inhibitory concentrations were compared to disc zone diameters, thereby generating new standards for the potential selection of antimicrobial agents.

  12. DKG statement on the use of metal alloy discs for patch testing in suspected intolerance to metal implants.

    PubMed

    Thomas, Peter; Geier, Johannes; Dickel, Heinrich; Diepgen, Thomas; Hillen, Uwe; Kreft, Burkhard; Schnuch, Axel; Szliska, Christiane; Mahler, Vera

    2015-10-01

    Intolerance reactions to metal implants may be caused by metal allergy. However, prior to implantation, 'prophetic'/prophylactic patch testing should not be performed. Pre-implant patch testing should only be done to verify or exclude metal allergy in patients with a corresponding history. In case of implant-related complications - in particular following replacement arthroplasty - such as pain, effusion, skin lesions, reduced range of motion or implant loosening, orthopedic causes should be ruled out first. Workup of suspected metal implant allergy should then be done using the DKG standard series, which includes nickel, cobalt, and chromium preparations. Various studies assessing the usefulness of metal alloy discs for patch testing have shown this particular approach to be ineffective with respect to providing reliable information on metal allergy. Any positive reaction in such tests cannot be assigned to a specific metal contained within the alloy. Furthermore, there is a risk of broad and indiscriminate use of these readily available discs. Accordingly, given the lack of additional benefit compared to patch testing with standardized metal salt preparations, we do not recommend patch testing with metal alloy discs.

  13. Rapid Bead-Based Antimicrobial Susceptibility Testing by Optical Diffusometry

    PubMed Central

    Chung, Chih-Yao; Wang, Jhih-Cheng; Chuang, Han-Sheng

    2016-01-01

    This study combined optical diffusometry and bead-based immunoassays to develop a novel technique for quantifying the growth of specific microorganisms and achieving rapid AST. Diffusivity rises when live bacteria attach to particles, resulting in additional energy from motile microorganisms. However, when UV-sterilized (dead) bacteria attach to particles, diffusivity declines. The experimental data are consistent with the theoretical model predicted according to the equivalent volume diameter. Using this diffusometric platform, the susceptibility of Pseudomonas aeruginosa to the antibiotic gentamicin was tested. The result suggests that the proliferation of bacteria is effectively controlled by gentamicin. This study demonstrated a sensitive (one bacterium on single particles) and time-saving (within 2 h) platform with a small sample volume (~0.5 μL) and a low initial bacteria count (50 CFU per droplet ~ 105 CFU/mL) for quantifying the growth of microorganisms depending on Brownian motion. The technique can be applied further to other bacterial strains and increase the success of treatments against infectious diseases in the near future. PMID:26863001

  14. Anchor/Darling Double-Disc Gate Valve, METC SOA Test Valve No. A-12 and Test Valve No. A-12R state-of-the-art Lockhopper Valve-Testing and Development Project. Summary test report

    SciTech Connect

    Gardner, J.F.; Galvin, W.E.; Gayheart, T.R.; Griffith, R.A.; Hall, R.C.; Hornbeck, R.G.; Maxfield, D.A.; Nieman, H.D.; Chester, S.O.

    1981-03-01

    The Anchor/Darling Double-Disc Gate Valve (METC SOA Test Valve Nos. A-12 and A-12R) performed well in testing with clean gases. The packing developed some leakage, but it could be controlled by tightening the packing gland. In both dynamic and slurry testing, solids accumulated in the bonnet and internals, jamming the valve. The forces on internal parts as a result of the jamming were sufficient to crack the hardfacing on the seats and discs. Any design with voids that can be packed with particles will have difficulty handling solids media. It is recommended that no further testing be performed on this valve.

  15. The timed up and go test for lumbar degenerative disc disease.

    PubMed

    Gautschi, Oliver P; Corniola, Marco V; Joswig, Holger; Smoll, Nicolas R; Chau, Ivan; Jucker, Dario; Stienen, Martin N

    2015-12-01

    We report on the use and performance of an objective measure of functional impairment, the timed up and go (TUG) test, in clinical practice for patients with lumbar degenerative disc disease (DDD). We illustrate nine representative patients with lumbar DDD, who were selected from an ongoing prospective study, to report our clinical experience with the TUG test. In addition, a preliminary sample of 30 non-selected consecutive patients is presented. The following parameters were assessed preoperatively, and 3 days and 6 weeks postoperatively: back and leg pain using the visual analogue scale (VAS); functional impairment using the Oswestry disability index (ODI) and Roland-Morris disability index (RMDI); health-related quality of life using the EuroQol 5D (EQ5D) and Short-Form 12 (SF-12). The TUG test results improved by 2.6 and 5.4s after 3 days and 6 weeks compared to the baseline assessment. The mean VAS for back and leg pain decreased by 2.3 and 5.3, respectively, after 3 days, and by 2.7 and 4.6 after 6 weeks. The mean RMDI and ODI decreased by 3.4 and 23.3, respectively, after 3 days, and by 7.0 and 28.0 after 6 weeks. The mean EQ5D increased by 0.38 after 3 days and 0.358 after 6 weeks. The mean SF-12 mental component scale decreased by 0.2 after 3 days and increased by 5.6 after 6 weeks, whereas the mean SF-12 physical component scale increased by 6.4 after 3 days and by 9.8 after 6 weeks. The TUG test proved to be a useful, easy to use tool that could add a new, objective dimension to the armamentarium of clinical tests for the diagnosis and management of DDD. From our preliminary experience, we conclude that the TUG test accurately reflects a patient's objective functional impairment before and after surgery. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Viscoelastic properties and residual strain in a tensile creep test on bovine temporomandibular articular discs.

    PubMed

    Tanaka, E; Tanaka, M; Aoyama, J; Watanabe, M; Hattori, Y; Asai, D; Iwabe, T; Sasaki, A; Sugiyama, M; Tanne, K

    2002-02-01

    This study was designed to evaluate the creep characteristics and residual strain of bovine temporomandibular joint (TMJ) discs in tension. Twenty discs were divided into three specimens each: central, lateral and medial regions. Tension of 1.0 MPa was applied and sustained for 20 min to the specimens from 10 right-side discs, and tension of 1.5 MPa to specimens from 10 left-side discs. After the period of tension for creep, the specimens were removed from the tension devices and restoration observed for 20 min. Time-dependent creep curves showed a marked change in strain during the initial 5s. The essential time delay in strain ceased after 2 min, and strain reached an almost steady level after 3 min. At a tensile stress of 1.5 MPa, a strain of 14.5% on average was produced after 20 min creep in the central specimens; peripheral specimens showed strains of 12.4% on average. There were significant differences in strain between the central and peripheral specimens. The residual strain after 20 min restoration was 0.93% on average and there were no significant regional differences. This creep feature could be well represented by a generalized linear viscoelastic model. It was concluded that the regional differences in viscoelasticity might be caused by the complicated articulating functions of the TMJ, and that the residual strain caused by sustained stress could be an important factor in disc deformation.

  17. Comparison of E-Test and Broth Microdilution Methods for Antifungal Drug Susceptibility Testing of Molds

    PubMed Central

    Szekely, Adrien; Johnson, Elizabeth M.; Warnock, David W.

    1999-01-01

    We compared the E test with a broth microdilution method, performed according to National Committee for Clinical Laboratory Standards document M27-A guidelines, for determining the in vitro susceptibilities of 90 isolates of pathogenic molds (10 Absidia corymbifera, 10 Aspergillus flavus, 10 Aspergillus fumigatus, 10 Aspergillus niger, 10 Aspergillus terreus, 10 Exophiala dermatitidis, 10 Fusarium solani, 10 Scedosporium apiospermum, 5 Scedosporium prolificans, and 5 Scopulariopsis brevicaulis). Overall, there was 71% agreement between the results of the two methods for amphotericin B (E-test MICs within ±2 log2 dilutions of broth microdilution MICs) and 88% agreement with the results for itraconazole. The overall levels of agreement (within ±2 log2 dilutions) were ≥80% for 5 of the 10 species tested against amphotericin B and 8 of the 10 species tested against itraconazole. The best agreement between the results was seen with A. fumigatus and A. terreus (100% of results for both agents within ±2 log2 dilutions). The poorest agreement was seen with S. apiospermum, S. prolificans, and S. brevicaulis tested against amphotericin B (20% of results within ±2 log2 dilutions). In every instance, this low level of agreement was due to isolates for which the broth microdilution MICs were low but for which the E-test MICs were much higher. The E test appears to be a suitable alternative procedure for testing the susceptibility of Aspergillus spp. and some other molds to amphotericin B or itraconazole. PMID:10203509

  18. Cervical total disc replacement exhibits similar stiffness to intact cervical functional spinal units tested on a dynamic pendulum testing system.

    PubMed

    Esmende, Sean M; Daniels, Alan H; Paller, David J; Koruprolu, Sarath; Palumbo, Mark A; Crisco, Joseph J

    2015-01-01

    The pendulum testing system is capable of applying physiologic compressive loads without constraining the motion of functional spinal units (FSUs). The number of cycles to equilibrium observed under pendulum testing is a measure of the energy absorbed by the FSU. To examine the dynamic bending stiffness and energy absorption of the cervical spine, with and without implanted cervical total disc replacement (TDR) under simulated physiologic motion. A biomechanical cadaver investigation. Nine unembalmed, frozen human cervical FSUs from levels C3-C4 and C5-C6 were tested on the pendulum system with axial compressive loads of 25, 50, and 100 N before and after TDR implantation. Testing in flexion, extension, and lateral bending began by rotating the pendulum to 5°, resulting in unconstrained oscillatory motion. The number of rotations to equilibrium was recorded and the bending stiffness (Newton-meter/°) was calculated and compared for each testing mode. In flexion/extension, with increasing compressive loading from 25 to 100 N, the average number of cycles to equilibrium for the intact FSUs increased from 6.6 to 19.1, compared with 4.1 to 12.7 after TDR implantation (p<.05 for loads of 50 and 100 N). In flexion, with increasing compressive loading from 25 to 100 N, the bending stiffness of the intact FSUs increased from 0.27 to 0.59 Nm/°, compared with 0.21 to 0.57 Nm/° after TDR implantation. No significant differences were found in stiffness between the intact FSU and the TDR in flexion/extension and lateral bending at any load (p<.05). Cervical FSUs with implanted TDR were found to have similar stiffness, but had greater energy absorption than intact FSUs during cyclic loading with an unconstrained pendulum system. These results provide further insight into the biomechanical behavior of cervical TDR under approximated physiologic loading conditions. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Development of a new protocol for rapid bacterial identification and susceptibility testing directly from urine samples.

    PubMed

    Zboromyrska, Y; Rubio, E; Alejo, I; Vergara, A; Mons, A; Campo, I; Bosch, J; Marco, F; Vila, J

    2016-06-01

    The current gold standard method for the diagnosis of urinary tract infections (UTI) is urine culture that requires 18-48 h for the identification of the causative microorganisms and an additional 24 h until the results of antimicrobial susceptibility testing (AST) are available. The aim of this study was to shorten the time of urine sample processing by a combination of flow cytometry for screening and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) for bacterial identification followed by AST directly from urine. The study was divided into two parts. During the first part, 675 urine samples were processed by a flow cytometry device and a cut-off value of bacterial count was determined to select samples for direct identification by MALDI-TOF-MS at ≥5 × 10(6) bacteria/mL. During the second part, 163 of 1029 processed samples reached the cut-off value. The sample preparation protocol for direct identification included two centrifugation and two washing steps. Direct AST was performed by the disc diffusion method if a reliable direct identification was obtained. Direct MALDI-TOF-MS identification was performed in 140 urine samples; 125 of the samples were positive by urine culture, 12 were contaminated and 3 were negative. Reliable direct identification was obtained in 108 (86.4%) of the 125 positive samples. AST was performed in 102 identified samples, and the results were fully concordant with the routine method among 83 monomicrobial infections. In conclusion, the turnaround time of the protocol described to diagnose UTI was about 1 h for microbial identification and 18-24 h for AST.

  20. Testing the Susceptibility of GNSS Receivers to Radio Frequency Interference

    NASA Astrophysics Data System (ADS)

    Berglund, H. T.; Blume, F.; Gallaher, W. W.

    2015-12-01

    Global Navigational Satellite Systems (GNSS) receivers are employed by the scientific community for measuring a variety of geodetic, geophysical and atmospheric phenomena. Data acquisition frequently occurs in a variety of challenging environments, which include locations with high Radio Frequency (RF) noise characteristics. Tracking the relatively low powered GNSS carrier signals broadcast from space becomes even more challenging in the presence of adjacent band RF noise. The demand for terrestrial RF spectrum use for a variety of non-GNSS applications is ever increasing, which poses potential challenges for GNSS site operators who would like to acquire the highest quality data possible. In recent years, UNAVCO has observed an increase in the number of GNSS sites which are negatively impacted by RF interference. In previous work, we have shown that telemetry systems utilizing the Iridium satellite constellation can degrade GNSS data quality, as the adjacent-band (1610-1616 Mhz) signals transmitted by Iridium data transmitters are close in proximity to the L1 frequency of GNSS. The impact of RF interference from Iridium data transmitters on GNSS receivers can cause reduced Signal-to-Noise (SNR), increased cycle slips, and in worst case scenarios, prevent the receiver from tracking. To better characterize GNSS receiver susceptibility to RF interference, UNAVCO has performed a variety of tests with Continuous Wave (CW) noise sources in RF bands adjacent to the GNSS spectrum. We simulate a subset of discrete noise frequencies commonly observed in the field using a frequency generator, which supplies a signal with varying power output from a transmitter located within 1 m of the GNSS antenna. Signal power is incremented in small steps until receiver tracking fails. All receivers are simultaneously evaluated using an 8-way splitter. In addition, we investigate receiver tracking performance with a simulated increase in the RF noise floor. To analyze the results we use

  1. Preparation of ormetoprim sulfadimethoxine medicated discs for disc diffusion assay

    USDA-ARS?s Scientific Manuscript database

    Romet (a blend of ormetoprim and sulfadimethoxine) is a typeA medicated article for the manufacture of medicated feed in the catfish industry. Recently, the commercial manufacture of ormetoprim–sulfadimethoxine susceptibility discs was discontinued. Ormetoprim–sulfadimethoxine discs were prepared at...

  2. Appropriateness of Repeating Helicobacter pylori Culture and Susceptibility Testing Following Failure of Individualized Antibiotic Therapy.

    PubMed

    Boltin, Doron; Ben-Zvi, Haim; Perets, Tsachi Tsadok; Gingold-Belfer, Rachel; Dickman, Ram; Niv, Yaron

    2015-01-01

    Current guidelines recommend direct Helicobacter pylori culture and antibiotic susceptibility testing following 2 failed eradication attempts. If this process is followed and yet subsequent treatment is unsuccessful, it is unclear whether susceptibility testing should be repeated. This is the first study to examine the appropriateness of repeated H. pylori culture and susceptibility testing following failure of individualized treatment. Between 2007 and 2014, consecutive patients who underwent at least 2 upper gastrointestinal endoscopies with H. pylori culture and susceptibility testing at our institution following several treatment failures were retrospectively identified. Antibiotic susceptibility was recorded and linked to demographic data. A total of 68 cultures from 34 patients were included (12 (35.3%) men, 41.4 ± 16.6 years), and 20 (58.8%) cultures had a different antibiotic susceptibility profile on repeat testing (8 (23.5%) with new susceptibility and 13 (38.2%) with new resistance). Acquired resistance to clarithromycin, levofloxacin and metronidazole was observed in 9 (26.5%), 2 (5.9%) and 10 (29.4%) cultures, respectively. Subjects with resistance to ≤1 antibiotic at baseline were more likely to develop resistance to at least 1 antibiotic on subsequent culture, compared to subjects with resistance to ≥2 antibiotics at baseline (13 (100%) vs. 5 (23.8%), p < 0.01). Repeating H. pylori culture and susceptibility testing usually yields new antimicrobial susceptibility data. However, the clinical usefulness of this approach remains unclear. © 2015 S. Karger AG, Basel.

  3. 21 CFR 866.1700 - Culture medium for antimicrobial susceptibility tests.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Culture medium for antimicrobial susceptibility tests. 866.1700 Section 866.1700 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND....1700 Culture medium for antimicrobial susceptibility tests. (a) Identification. A culture medium...

  4. 21 CFR 866.1700 - Culture medium for antimicrobial susceptibility tests.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Culture medium for antimicrobial susceptibility tests. 866.1700 Section 866.1700 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND....1700 Culture medium for antimicrobial susceptibility tests. (a) Identification. A culture medium...

  5. 21 CFR 866.1700 - Culture medium for antimicrobial susceptibility tests.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Culture medium for antimicrobial susceptibility tests. 866.1700 Section 866.1700 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND....1700 Culture medium for antimicrobial susceptibility tests. (a) Identification. A culture medium...

  6. Liofilchem(®) Chromatic VRE and vancomycin MIC Test Strip detected glycopeptide resistance in a vanB neonatal Enterococcus faecium isolate showing alternate vancomycin susceptibility and resistance with bioMérieux Vitek2.

    PubMed

    Savini, Vincenzo; Marrollo, Roberta; Coclite, Eleonora; Fusilli, Paola; D'Incecco, Carmine; Fazii, Paolo; Gherardi, Giovanni

    2014-01-01

    A 1-month old neonate urine sample yielded vanB Enterococcus faecium; nevertheless, the isolate alternatively showed susceptibility and resistance to vancomycin with bioMérieux Vitek2 (cards AST592, AST632, AST586), while glycopeptide resistance was detected by Liofilchem(®) vancomycin MIC Test Strip and disc along with the Chromatic VRE chromogenic medium. This communication emphasizes that, as vanB gene may be heterogeneously expressed within a given Enterococcus population, glycopeptide resistance may be missed when using automated systems for antibiotic susceptibility testing. We suggest therefore that vancomycin in vitro activity be studied on all clinical isolates through agar methods, including use of chromogenic media.

  7. Susceptibility testing of pathogenic fungi with itraconazole: a process analysis of test variables.

    PubMed

    Rambali, B; Fernandez, J A; Van Nuffel, L; Woestenborghs, F; Baert, L; Massart, D L; Odds, F C

    2001-08-01

    A 2(10-5) fractional factorial model was used to investigate the influence of 10 process variables in broth microdilution susceptibility tests with itraconazole against eight isolates of Candida species and six isolates of filamentous fungi in two growth media. An analysis of variance (ANOVA) indicated that glucose concentration and incubation time both significantly influenced control turbidity optical density (OD) values for most of the Candida spp. isolates, while incubation in >10% CO(2) versus ambient air, incubation temperature and inoculum size significantly influenced these OD values for about half of the yeast isolates. Control OD values for the mould isolates were most influenced by incubation time and temperature, and by occlusion of the wells with an adhesive sticker. Three statistical approaches, ANOVA, rank transformation and Mann-Whitney U-test, were used to assess the influence of the variable combinations on MIC, determined with a 50% growth reduction end-point. Incubation temperature and time, glucose concentration and inoculum size were the variables that most often affected susceptibility results to the level of statistical significance; however, the supplier of RPMI 1640 medium, the use of adhesive stickers and the atmosphere of incubation significantly influenced the MIC for some isolates. The medium used to prepare the test inoculum, the solvent used to prepare the stock solution and the shape of the microdilution plate wells significantly affected outcome, but only sporadically. A principal component analysis of the data matrix confirmed this order of relative influence of the test variables on the MIC. Since each fungal isolate responded differently to combinations of process variables in the test, we conclude that any unified method for antifungal susceptibility determination represents a compromise, rather than an idealized system.

  8. Antimicrobial susceptibility of Histophilus somni isolated from clinically affected cattle in Australia.

    PubMed

    Goldspink, Lauren K; Mollinger, Joanne L; Barnes, Tamsin S; Groves, Mitchell; Mahony, Timothy J; Gibson, Justine S

    2015-02-01

    This study investigated antimicrobial resistance traits, clonal relationships and epidemiology of Histophilus somni isolated from clinically affected cattle in Queensland and New South Wales, Australia. Isolates (n = 53) were subjected to antimicrobial susceptibility testing against six antimicrobial agents (ceftiofur, enrofloxacin, florfenicol, tetracycline, tilmicosin and tulathromycin) using disc diffusion and minimum inhibitory concentration (MIC) assays. Clonal relationships were assessed using repetitive sequence PCR and descriptive epidemiological analysis was performed. The H. somni isolates appeared to be geographically clonal, with 27/53 (47%) isolates grouping in one cluster from one Australian state. On the basis of disc diffusion, 34/53 (64%) isolates were susceptible to all antimicrobial agents tested; there was intermediate susceptibility to tulathromycin in 12 isolates, tilmicosin in seven isolates and resistance to tilmicosin in one isolate. Using MIC, all but one isolate was susceptible to all antimicrobial agents tested; the non-susceptible isolate was resistant to tetracycline, but this MIC result could not be compared to disc diffusion, since there are no interpretative guidelines for disc diffusion for H. somni against tetracycline. In this study, there was little evidence of antimicrobial resistance in H. somni isolates from Australian cattle. Disc diffusion susceptibility testing results were comparable to MIC results for most antimicrobial agents tested; however, results for isolates with intermediate susceptibility or resistance to tilmicosin and tulathromycin on disc diffusion should be interpreted with caution in the absence of MIC results.

  9. Improvement of sensory function after sequestrectomy for lumbar disc herniation: a prospective clinical study using quantitative sensory testing.

    PubMed

    Tschugg, Anja; Lener, Sara; Hartmann, Sebastian; Neururer, Sabrina; Wildauer, Matthias; Thomé, Claudius; Löscher, Wolfgang N

    2016-11-01

    Previous studies have investigated sensory recovery in patients with lumbar disc herniation using rather subjective methods. There have been no reports on changes of sensory function in patients suffering from a preoperative sensory deficit using quantitative sensory testing (QST). The aims of this prospective study were (1) to assess the recovery of preoperative sensory dysfunction after lumbar sequestrectomy and (2) to quantify the strength of relationship between a sensory deficit and the patient's quality of life. We applied the QST protocol of the German Research Network on Neuropathic Pain (DFNS) in fifty-two patients with a single lumbar disc herniation confirmed on MRI treated by lumbar sequestrectomy. Further evaluation included a detailed medical history, a physical examination, numeric rating scale for leg, EQ-5D questionnaire, and thermometer. Disc surgery resulted in a significant reduction of leg pain and a significant gain of quality of life. Thermal, mechanical, and vibration perception thresholds showed an obvious side-to-side difference preoperatively (p < 0.005). An early recovery of mechanical and vibration perception thresholds was detected, whereas cold perception needed more than 6 months to recover (p < 0.05). Quality of life was independent from perception thresholds, but correlated significantly with pain reduction. Our data clearly show that there is a subjective and quantifiable improvement in sensory dysfunction postoperatively. The current data suggest that a sensory dysfunction does not influence a patient's quality of life.

  10. Antimicrobial susceptibility testing of Spanish field isolates of Brachyspira hyodysenteriae.

    PubMed

    Hidalgo, A; Carvajal, A; García-Feliz, C; Osorio, J; Rubio, P

    2009-08-01

    This study is the first conducted in Spain to evaluate antimicrobial susceptibility of field isolates of Brachyspira hyodysenteriae. One hundred and eight isolates of the bacterium, recovered from different Spanish swine farms between 2000 and 2007, were investigated. The minimum inhibitory concentrations (MIC) of erythromycin, tylosin, tiamulin, valnemulin, clindamycin and lincomycin were determined using a broth microdilution technique. Most of the isolates showed poor susceptibility to erythromycin (MIC(90)>256 microg/ml), tylosin (MIC(90)>256 microg/ml), clindamycin (MIC(90)>4 microg/ml) and lincomycin (MIC(90)=128 microg/ml). Reduced susceptibility to tiamulin and valnemulin was observed with a MIC>2 microg/ml in 17.6% and 7.41% of the B. hyodysenteriae isolates, respectively. Moreover, a survival analysis permitted the detection of an increasing trend in the MIC values for almost all the antimicrobials used in the treatment of swine dysentery when comparing recent isolates (from 2006 to 2007) with those recovered in earlier years (between 2000 and 2004).

  11. In vitro susceptibility testing of Malassezia pachydermatis to gentamicin.

    PubMed

    Silva, Freddy A; Ferrer, Otilia; Déniz, Soraya; Rosario, Inmaculada; Conde-Felipe, Magnolia; Díaz, Esther L; Acosta-Hernández, Begoña

    2017-08-01

    Two studies have observed that growth media containing gentamicin can inhibit the growth of the yeast organism Malassezia pachydermatis. The minimum inhibitory concentration (MIC) of this bactericidal antibiotic for this organism has not been previously determined. To evaluate the susceptibility of M. pachydermatis isolates to gentamicin. The MIC of gentamicin was determined using a modified version of the M27-A3 microdilution method following the guidelines of the Clinical and Laboratory Standards Institute. A modified Christensen's urea broth was used to enhance the growth of the M. pachydermatis isolates. Visual and spectrophotometric end-point readings were performed to detect the presence or absence of yeast growth. The MIC50 and MIC90 of gentamicin were 8.12 μg/mL and 32.5 μg/mL, respectively; M. pachydermatis strains were classified as susceptible (S), intermediate (I) and resistant (R). The susceptibility of these isolates to gentamicin in vitro, by visual and spectrophotometric end-point reading, was: S, 54-56%; I, 40-41%; and R, 3-6%. Prospective MICs for M. pachydermatis have been established for gentamicin. © 2017 ESVD and ACVD.

  12. Survey of antimicrobial susceptibility testing practices of veterinary diagnostic laboratories in the United States.

    PubMed

    Brooks, Matthew B; Morley, Paul S; Dargatz, David A; Hyatt, Doreene R; Salman, M D; Akey, Bruce L

    2003-01-15

    To describe antimicrobial susceptibility testing practices of veterinary diagnostic laboratories in the United States and evaluate the feasibility of collating this information for the purpose of monitoring antimicrobial resistance in bacterial isolates from animals. Cross-sectional study. A questionnaire was mailed to veterinary diagnostic laboratories throughout the United States to identify those laboratories that conduct susceptibility testing. Nonrespondent laboratories were followed up through telephone contact and additional mailings. Data were gathered regarding methods of susceptibility testing, standardization of methods, data management, and types of isolates tested. Eighty-six of 113 (76%) laboratories responded to the survey, and 64 of the 86 (74%) routinely performed susceptibility testing on bacterial isolates from animals. Thirty-four of the 36 (94%) laboratories accredited by the American Association of Veterinary Laboratory Diagnosticians responded to the survey. Laboratories reported testing > 160,000 bacterial isolates/y. Fifty-one (88%) laboratories reported using the Kirby-Bauer disk diffusion test to evaluate antimicrobial susceptibility; this accounted for 65% of the isolates tested. Most (87%) laboratories used the NCCLS (National Committee for Clinical Laboratory Standards) documents for test interpretation. Seventy-five percent of the laboratories performed susceptibility testing on bacterial isolates only when they were potential pathogens. The veterinary diagnostic laboratories represent a comprehensive source of data that is not easily accessible in the United States. Variability in testing methods and data storage would present challenges for data aggregation, summary, and interpretation.

  13. A Biosensor Platform for Rapid Antimicrobial Susceptibility Testing Directly From Clinical Samples

    PubMed Central

    Mach, Kathleen E.; Mohan, Ruchika; Baron, Ellen Jo; Shih, Mei-Chiung; Gau, Vincent; Wong, Pak Kin; Liao, Joseph C.

    2014-01-01

    Purpose A significant barrier to efficient antibiotic management of infection is that the standard diagnostic methodologies do not provide results at the point of care. The delays between sample collection and bacterial culture and antibiotic susceptibility reporting have led to empirical use of antibiotics, contributing to the emergence of drug resistant pathogens. As a key step toward the development of a point of care device for determining the antibiotic susceptibility of urinary tract pathogens, we report on a biosensor based antimicrobial susceptibility test. Materials and Methods For assay development bacteria were cultured with or without antibiotics, and growth was quantitated by determining viable counts and electrochemical biosensor measurement of bacterial 16S rRNA. To determine antibiotic susceptibility directly from patient samples, urine was cultured on antibiotic plates for 2.5 hours and growth was determined by electrochemical measurement of bacterial 16S rRNA. For assay validation 252 urine samples were collected from patients at the Spinal Cord Injury Service at Veterans Affairs Palo Alto Health Care System. The biosensor based antimicrobial susceptibility test was completed for samples containing gram-negative organisms. Pathogen identification and antibiotic susceptibility results were compared between our assay and standard microbiological analysis. Results A direct biosensor quantitation of bacterial 16S rRNA can be used to monitor bacterial growth for a biosensor based antimicrobial susceptibility test. Clinical validation of a biosensor based antimicrobial susceptibility test with patient urine samples demonstrated that this test was 94% accurate in 368 pathogen-antibiotic tests compared to standard microbiological analysis. Conclusions This biosensor based antimicrobial susceptibility test, in concert with our previously described pathogen identification assay, can provide culture and susceptibility information directly from a urine sample

  14. E Test versus Agar Dilution for Antimicrobial Susceptibility Testing of Viridans Group Streptococci

    PubMed Central

    Rosser, S. J.; Alfa, M. J.; Hoban, S.; Kennedy, J.; Harding, G. K.

    1999-01-01

    Viridans group streptococci (VGS) are commonly isolated from the blood of hospitalized patients. The E test represents a convenient method for determining the MICs for VGS, but for this purpose it has not been well validated against reference methods. In this study, 180 unselected VGS isolates were identified to a species level, and the MICs of penicillin, cefuroxime, cefotaxime, and vancomycin were determined by both agar dilution and the E test. Available data regarding demographic and laboratory variables for each VGS bacteremic episode were collected, the significance of each VGS isolate was assessed, and the associations between and among laboratory and clinical variables were investigated. Among all VGS isolates, 68.3% (median of three runs) were found to be fully susceptible to penicillin by agar dilution. The E test and agar dilution showed average agreements (within ±1 dilution) of 92.2% for penicillin, 95.7% for cefuroxime 91.3% for cefotaxime, and 86.7% for vancomycin. Agreements over serial E tests and serial agar dilutions were excellent for β-lactam agents (intraclass correlation coefficients, >0.9) but less impressive for vancomycin. Very major error rates for the E test were ≤0.7%, and combined major and minor error rates were within acceptable limits for all antimicrobial agents tested. Lysis-centrifugation culture methods were more often associated with clinically insignificant VGS isolates; otherwise, no associations between clinical and laboratory variables were noted. PMID:9854058

  15. Combination antimicrobial susceptibility testing for acute exacerbations in chronic infection of Pseudomonas aeruginosa in cystic fibrosis.

    PubMed

    Waters, Valerie; Ratjen, Felix

    2008-07-16

    Antibiotic therapy for acute pulmonary exacerbations in people with cystic fibrosis (CF) is usually chosen based on the results of antimicrobial susceptibility testing of individual drugs. Combination antimicrobial susceptibility testing assesses the efficacy of drug combinations including two or three antibiotics in vitro and can often demonstrate antimicrobial efficacy against bacterial isolates even when individual antibiotics have little or no effect. Therefore, choosing antibiotics based on combination antimicrobial susceptibility testing could potentially improve response to treatment in people with CF with acute exacerbations. To compare antibiotic therapy based on conventional antimicrobial susceptibility testing to antibiotic therapy based on combination antimicrobial susceptibility testing in the treatment of acute pulmonary exacerbations in people with CF and chronic infection with P. aeruginosa. We identified relevant trials from the Group's Cystic Fibrosis Trials Register. Most recent search: November 2007. Randomised and quasi-randomised controlled trials of antibiotic therapy based on conventional antimicrobial susceptibility testing compared to antibiotic therapy based on combination antimicrobial susceptibility testing in the treatment of acute pulmonary exacerbations in CF due to chronic infection with P. aeruginosa. Both authors independently selected trials, assessed their quality and extracted data from eligible studies. Additionally, the authors contacted the study investigators to obtain further information. The search identified one study eligible for inclusion in the review. This study prospectively assessed whether the use of multiple combination bactericidal antibiotic testing (MCBT) improved clinical outcomes in participants with acute pulmonary exacerbations of CF who were infected with multiresistant bacteria. 132 participants were randomised in the study. The study investigators provided data specific to the participants who were only

  16. Validation of microscopic observation drug susceptibility testing for rapid, direct rifampicin and isoniazid drug susceptibility testing in patients receiving tuberculosis treatment

    PubMed Central

    Coronel, J; Roper, M H; Herrera, C; Bonilla, C; Jave, O; Gianella, C; Sabogal, I; Huancaré, V; Leo, E; Tyas, A; Mendoza-Ticona, A; Caviedes, L; Moore, D A J; Drancourt, M

    2014-01-01

    Drug susceptibility testing (DST) is often needed in patients clinically failing tuberculosis (TB) therapy. Most studies of phenotypic direct drug susceptibility tests, such as microscopic observation drug susceptibility (MODS) tests, have been performed in patients not receiving TB treatment. The effect of ongoing TB treatment on the performance of MODS direct DST has not been previously explored, but patients failing such therapy constitute an important target group. The aim of this study was to determine the performance of MODS direct rifampicin and isoniazid DST in patients clinically failing first-line TB treatment, and to compare MODS direct DST with indirect proportion method DST. Sputa from 264 TB patients were cultured in parallel in Lowenstein–Jensen (LJ) and MODS assays; strains were tested for rifampicin and isoniazid susceptibility by the proportion method at the national reference laboratory. Ninety-three samples were culture-positive by LJ and MODS (concordance of 96%; kappa 0.92). With conventional MODS plate DST reading (performed on the same day as the sample is classified as culture-positive), the isoniazid DST concordance was 96.8% (kappa 0.89), and the concordance for rifampicin susceptibility testing was 92.6% (kappa 0.80). Reading of MODS DST plates 1 week after cultures had been determined to be culture-positive improved overall performance marginally—the isoniazid DST concordance was 95.7% (kappa 0.85); and the rifampicin DST concordance was 96.8% (kappa 0.91). Sensitivity for detection of multidrug-resistant TB was 95.8%. MODS testing provided reliable rifampicin and isoniazid DST results for samples obtained from patients receiving TB therapy. A modified DST reading schedule for such samples, with a final reading 1 week after a MODS culture turns positive, marginally improves the concordance with reference DST. PMID:24107197

  17. Validation of microscopic observation drug susceptibility testing for rapid, direct rifampicin and isoniazid drug susceptibility testing in patients receiving tuberculosis treatment.

    PubMed

    Coronel, J; Roper, M H; Herrera, C; Bonilla, C; Jave, O; Gianella, C; Sabogal, I; Huancaré, V; Leo, E; Tyas, A; Mendoza-Ticona, A; Caviedes, L; Moore, D A J

    2014-06-01

    Drug susceptibility testing (DST) is often needed in patients clinically failing tuberculosis (TB) therapy. Most studies of phenotypic direct drug susceptibility tests, such as microscopic observation drug susceptibility (MODS) tests, have been performed in patients not receiving TB treatment. The effect of ongoing TB treatment on the performance of MODS direct DST has not been previously explored, but patients failing such therapy constitute an important target group. The aim of this study was to determine the performance of MODS direct rifampicin and isoniazid DST in patients clinically failing first-line TB treatment, and to compare MODS direct DST with indirect proportion method DST. Sputa from 264 TB patients were cultured in parallel in Lowenstein-Jensen (LJ) and MODS assays; strains were tested for rifampicin and isoniazid susceptibility by the proportion method at the national reference laboratory. Ninety-three samples were culture-positive by LJ and MODS (concordance of 96%; kappa 0.92). With conventional MODS plate DST reading (performed on the same day as the sample is classified as culture-positive), the isoniazid DST concordance was 96.8% (kappa 0.89), and the concordance for rifampicin susceptibility testing was 92.6% (kappa 0.80). Reading of MODS DST plates 1 week after cultures had been determined to be culture-positive improved overall performance marginally-the isoniazid DST concordance was 95.7% (kappa 0.85); and the rifampicin DST concordance was 96.8% (kappa 0.91). Sensitivity for detection of multidrug-resistant TB was 95.8%. MODS testing provided reliable rifampicin and isoniazid DST results for samples obtained from patients receiving TB therapy. A modified DST reading schedule for such samples, with a final reading 1 week after a MODS culture turns positive, marginally improves the concordance with reference DST.

  18. A Novel Hypoxia Challenge Test Demonstrates Cardiovascular and Pulmonary Susceptibility to Acrolein Gas in Hypertensive Rats.

    EPA Science Inventory

    High levels of air pollution increase the risk of cardiovascular morbidity and mortality, especially in susceptible populations including those with hypertension. Stress tests are useful for manifesting latent effects of exposure, particularly at low concentrations, often when no...

  19. A Novel Hypoxia Challenge Test Demonstrates Cardiovascular and Pulmonary Susceptibility to Acrolein Gas in Hypertensive Rats.

    EPA Science Inventory

    High levels of air pollution increase the risk of cardiovascular morbidity and mortality, especially in susceptible populations including those with hypertension. Stress tests are useful for manifesting latent effects of exposure, particularly at low concentrations, often when no...

  20. Standard versus biofilm antimicrobial susceptibility testing to guide antibiotic therapy in cystic fibrosis.

    PubMed

    Waters, Valerie; Ratjen, Felix

    2012-11-14

    The antibiotics used to treat pulmonary infections in people with cystic fibrosis are typically chosen based on the results of antimicrobial susceptibility testing performed on bacteria traditionally grown in a planktonic mode (grown in a liquid). However, there is considerable evidence to suggest that Pseudomonas aeruginosa actually grows in a biofilm (or slime layer) in the airways of cystic fibrosis patients with chronic pulmonary infections. Therefore, choosing antibiotics based on biofilm rather than conventional antimicrobial susceptibility testing could potentially improve response to treatment of Pseudomonas aeruginosa in people with cystic fibrosis. To compare biofilm antimicrobial susceptibility testing-driven therapy to conventional antimicrobial susceptibility testing-driven therapy in the treatment of Pseudomonas aeruginosa infection in people with cystic fibrosis. We searched the Cochrane Cystic Fibrosis Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. We also searched a registry of ongoing trials and the reference lists of relevant articles and reviews.Most recent search: 02 August 2012. Randomized controlled trials of antibiotic therapy based on biofilm antimicrobial susceptibility testing compared to antibiotic therapy based on conventional antimicrobial susceptibility testing in the treatment of Pseudomonas aeruginosa pulmonary infection in individuals with cystic fibrosis. Both authors independently selected trials, assessed their risk of bias and extracted data from eligible trials. Additionally, the authors contacted the trial investigators to obtain further information. The search identified one multicentre, randomized, double-blind controlled clinical trial eligible for inclusion in the review (39 participants). This trial prospectively assessed whether the use of biofilm antimicrobial susceptibility testing improved microbiological and clinical outcomes in participants

  1. Development of a rapid ATP bioluminescence assay for biocidal susceptibility testing of rapidly growing mycobacteria.

    PubMed

    Kapoor, Renuka; Yadav, Jagjit S

    2010-10-01

    An ATP-based biocide susceptibility assay for mycobacteria was developed by optimizing the cell lysis and assay conditions. Compared to the conventional agar plating method, the assay was rapid (1.5 h) and showed high sensitivity and specificity as determined by receiver operating characteristic (ROC) analysis. The test species, Mycobacterium immunogenum, M. chelonae, and M. abscessus, showed various susceptibilities to the glutaraldehyde- and isothiazolone-based test biocides.

  2. Numerical simulation of a relaxation test designed to fit a quasi-linear viscoelastic model for temporomandibular joint discs.

    PubMed

    Commisso, Maria S; Martínez-Reina, Javier; Mayo, Juana; Domínguez, Jaime

    2013-02-01

    The main objectives of this work are: (a) to introduce an algorithm for adjusting the quasi-linear viscoelastic model to fit a material using a stress relaxation test and (b) to validate a protocol for performing such tests in temporomandibular joint discs. This algorithm is intended for fitting the Prony series coefficients and the hyperelastic constants of the quasi-linear viscoelastic model by considering that the relaxation test is performed with an initial ramp loading at a certain rate. This algorithm was validated before being applied to achieve the second objective. Generally, the complete three-dimensional formulation of the quasi-linear viscoelastic model is very complex. Therefore, it is necessary to design an experimental test to ensure a simple stress state, such as uniaxial compression to facilitate obtaining the viscoelastic properties. This work provides some recommendations about the experimental setup, which are important to follow, as an inadequate setup could produce a stress state far from uniaxial, thus, distorting the material constants determined from the experiment. The test considered is a stress relaxation test using unconfined compression performed in cylindrical specimens extracted from temporomandibular joint discs. To validate the experimental protocol, the test was numerically simulated using finite-element modelling. The disc was arbitrarily assigned a set of quasi-linear viscoelastic constants (c1) in the finite-element model. Another set of constants (c2) was obtained by fitting the results of the simulated test with the proposed algorithm. The deviation of constants c2 from constants c1 measures how far the stresses are from the uniaxial state. The effects of the following features of the experimental setup on this deviation have been analysed: (a) the friction coefficient between the compression plates and the specimen (which should be as low as possible); (b) the portion of the specimen glued to the compression plates (smaller

  3. Levofloxacin susceptibility testing for Helicobacter pylori in China: comparison of E-test and disk diffusion method.

    PubMed

    Yu, Chaohui; Li, Lan; Chen, Wenguo; Jiao, Yangwen; Yang, Ningmin; Yang, En; Zhang, Jianzhong; Chen, Lihua; Li, Youming

    2011-04-01

     The aims of this study were to compare disk diffusion with E-test method for levofloxacin susceptibility testing of Helicobacter pylori and standardized breakpoints for disk diffusion as a stable and reliable method for determining qualitative levofloxacin susceptibility.  We determined the levofloxacin susceptibility of 45 H. pylori strains isolated from Chinese patients by the E-test method. Disk diffusion was evaluated as an alternative method to determine susceptibility and compared with the E-test results by linear regression analysis.  The minimum inhibitory concentration (MIC) values tested by E-test method ranged from 0.047 to 32 μg/mL. Resistance to levofloxacin was detected in 16 (35.6%) isolates. The levofloxacin disk zone sizes obtained by disk diffusion method correlated well (r² = .877) with the MICs obtained by E-test method. As a consequence of regression analysis, isolates with inhibition diameters < 12 mm were considered resistant to levofloxacin. There was 100% agreement between the two methods for levofloxacin, applying the regression-based breakpoints. The disk diffusion method is equivalent to the E-test method for testing levofloxacin susceptibility of H. pylori strains; it is more practical and inexpensive, and it is suitable for the analysis of a small number of isolates compared with the E-test method. © 2011 Blackwell Publishing Ltd.

  4. Effects of follower load and rib cage on intervertebral disc pressure and sagittal plane curvature in static tests of cadaveric thoracic spines.

    PubMed

    Anderson, Dennis E; Mannen, Erin M; Sis, Hadley L; Wong, Benjamin M; Cadel, Eileen S; Friis, Elizabeth A; Bouxsein, Mary L

    2016-05-03

    The clinical relevance of mechanical testing studies of cadaveric human thoracic spines could be enhanced by using follower preload techniques, by including the intact rib cage, and by measuring thoracic intervertebral disc pressures, but studies to date have not incorporated all of these components simultaneously. Thus, this study aimed to implement a follower preload in the thoracic spine with intact rib cage, and examine the effects of follower load, rib cage stiffening and rib cage removal on intervertebral disc pressures and sagittal plane curvatures in unconstrained static conditions. Intervertebral disc pressures increased linearly with follower load magnitude. The effect of the rib cage on disc pressures in static conditions remains unclear because testing order likely confounded the results. Disc pressures compared well with previous reports in vitro, and comparison with in vivo values suggests the use of a follower load of about 400N to approximate loading in upright standing. Follower load had no effect on sagittal plane spine curvature overall, suggesting successful application of the technique, although increased flexion in the upper spine and reduced flexion in the lower spine suggest that the follower load path was not optimized. Rib cage stiffening and removal both increased overall spine flexion slightly, although with differing effects at specific spinal locations. Overall, the approaches demonstrated here will support the use of follower preloads, intact rib cage, and disc pressure measurements to enhance the clinical relevance of future studies of the thoracic spine. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. EFFECTS OF FOLLOWER LOAD AND RIB CAGE ON INTERVERTEBRAL DISC PRESSURE AND SAGITTAL PLANE CURVATURE IN STATIC TESTS OF CADAVERIC THORACIC SPINES

    PubMed Central

    Anderson, Dennis E.; Mannen, Erin M.; Sis, Hadley L.; Wong, Benjamin M.; Cadel, Eileen S.; Friis, Elizabeth A.; Bouxsein, Mary L.

    2016-01-01

    The clinical relevance of mechanical testing studies of cadaveric human thoracic spines could be enhanced by using follower preload techniques, by including the intact rib cage, and by measuring thoracic intervertebral disc pressures, but studies to date have not incorporated all of these components simultaneously. Thus, this study aimed to implement a follower preload in the thoracic spine with intact rib cage, and examine the effects of follower load, rib cage stiffening and rib cage removal on intervertebral disc pressures and sagittal plane curvatures in unconstrained static conditions. Intervertebral disc pressures increased linearly with follower load magnitude. The effect of the rib cage on disc pressures in static conditions remains unclear because testing order likely confounded the results. Disc pressures compared well with previous reports in vitro, and comparison with in vivo values suggests the use of a follower load of about 400 N to approximate loading in upright standing. Follower load had no effect on sagittal plane spine curvature overall, suggesting successful application of the technique, although increased flexion in the upper spine and reduced flexion in the lower spine suggest that the follower load path was not optimized. Rib cage stiffening and removal both increased overall spine flexion slightly, although with differing effects at specific spinal locations. Overall, the approaches demonstrated here will support the use of follower preloads, intact rib cage, and disc pressure measurements to enhance the clinical relevance of future studies of the thoracic spine. PMID:26944690

  6. Antimicrobial susceptibility testing for bovine respiratory disease: getting more from diagnostic results.

    PubMed

    Lubbers, Brian V; Turnidge, John

    2015-02-01

    Bovine respiratory disease (BRD) is one of the most common diseases of cattle worldwide. Given the significant bacterial component of this disease, antimicrobial agents remain one of the mainstays of therapy. However, the potential welfare and economic impact resulting from the selection of inappropriate antimicrobial therapy for BRD poses significant risks to both animal and animal owner. To determine the 'best' antimicrobial agent for a specific case, the decision-making process needs to incorporate all available evidence, often including the results of bacterial culture and antimicrobial susceptibility testing. While antimicrobial susceptibility testing can be a valuable diagnostic tool, integrating the test results into the clinical decision making process can be a challenging experience. This review details the process by which interpretive criteria for susceptibility tests are developed. Principles for how to best integrate antimicrobial susceptibility testing, both at the individual animal test and aggregate test levels, into the clinical decision making process are discussed. Non-traditional testing methodologies and how they may improve susceptibility testing in the future are also reviewed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Rapid identification and antibiotic susceptibility testing of Yersinia pestis using bioluminescent reporter phage.

    PubMed

    Schofield, David A; Molineux, Ian J; Westwater, Caroline

    2012-08-01

    The rapid identification and antibiotic susceptibility testing of Yersinia pestis is paramount for a positive prognosis. We previously engineered a Y. pestis-specific 'bioluminescent' reporter phage for the identification of Y. pestis. In this study, we generated an improved reporter phage and evaluated the ability of this phage to provide direct and rapid susceptibility testing. Compared to the first generation reporter, the second generation reporter exhibited a 100-fold increase in signal strength, leading to a 10-fold increase in assay sensitivity. Y. pestis antimicrobial testing in the presence of the reporter elicited bioluminescent signals that were drug concentration-dependent, and produced susceptibility profiles that mirrored the standard CLSI method. The phage-generated susceptibility profiles, however, were obtained within hours in contrast to days with the conventional method.

  8. Rapid identification and antibiotic susceptibility testing of Yersinia pestis using bioluminescent reporter phage

    PubMed Central

    Schofield, David A.; Molineux, Ian J.; Westwater, Caroline

    2012-01-01

    The rapid identification and antibiotic susceptibility testing of Yersinia pestis is paramount for a positive prognosis. We previously engineered a Y. pestis-specific ‘bioluminescent’ reporter phage for the identification of Y. pestis. In this study, we generated an improved reporter phage and evaluated the ability of this phage to provide direct and rapid susceptibility testing. Compared to the first generation reporter, the second generation reporter exhibited a 100-fold increase in signal strength, leading to a 10-fold increase in assay sensitivity. Y. pestis antimicrobial testing in the presence of the reporter elicited bioluminescent signals that were drug concentration-dependent, and produced susceptibility profiles that mirrored the standard CLSI method. The phage-generated susceptibility profiles, however, were obtained within hours in contrast to days with the conventional method. PMID:22579583

  9. Impact of genetic testing for breast-ovarian cancer susceptibility.

    PubMed

    Loader, Starlene; Shields, Cleveland G; Rowley, Peter T

    2004-01-01

    Previously, we have reported a clinical trial in which any woman in a defined geographic region who had a qualifying family history and who was referred by her physician or who was identified through a regional cancer registry was offered free genetic counseling, BRCA testing, and recommendations based on test results. Each family was represented by one affected and one unaffected person. Of the 87 families actually tested, 13 were found to have deleterious mutations. To assess the impact of the counseling and testing process, we contacted the tested individuals 1 month and 1 year after receiving the test result and those with an abnormal test result after 4 years. Index subjects, we found, differed significantly from relatives. Before coming for counseling, index subjects perceived both their general health and emotional health as worse than did their relatives. After counseling and testing, index subjects continue to worry more about breast cancer than do relatives. Affected subjects, we found, differed significantly from unaffected subjects. Before counseling, affected subjects knew more about breast cancer, perceived their general health as poorer, and reported greater adherence to recommended breast cancer surveillance than did unaffected subjects. After counseling and testing, affected subjects were less satisfied than unaffected subjects with having been tested. This study indicates that the group most prone to distress by cancer risk genetic counseling and testing is not the recruited relatives, nor even those affected with cancer, but rather the index patients themselves. The index patients, i.e., the ones who want the risk information most, appear to undergo the most stress in obtaining it.

  10. A Genetic Lung Cancer Susceptibility Test may have a Positive Effect on Smoking Cessation.

    PubMed

    Kammin, Tammy; Fenton, Andrew K; Thirlaway, Kathryn

    2015-06-01

    Smoking increases the risk of developing lung cancer. Genetic loci have been identified which could form the basis of a lung cancer susceptibility test; but little is known whether such a test would interest or motivate those trying to quit smoking. To address this, we investigated the attitudes of people trying to quit smoking towards genetic susceptibility testing for lung cancer. Participant's attitudes to topics associated with lung cancer susceptibility testing were assessed; were they interested in genetic testing? What impact would a hypothetical high- or low- risk result have on smoking cessation? 680 self-completion questionnaires were given to individuals attending National Health Service stop smoking clinics in three different areas of the United Kingdom between 2011 and 2012. 139 questionnaires were returned, giving a 20 % response rate. Participants expressed an interest in a genetic susceptibility test for lung cancer and almost all reported that a high-risk result would increase their motivation to stop smoking. However, many participants had a neutral attitude towards a low-risk result. Most participants agreed their smoking habit could lead to lung cancer. Lung cancer susceptibility testing may be a useful incentive to help people quit smoking. This study suggests the need for genetic services to work with smoking cessation teams if routine testing becomes available in the future.

  11. Microplate alamarBlue Assay for Paracoccidioides Susceptibility Testing

    PubMed Central

    de Paula e Silva, A. C. A.; Oliveira, H. C.; Silva, J. F.; Sangalli-Leite, F.; Scorzoni, L.; Fusco-Almeida, A. M.

    2013-01-01

    CLSI method M27-A3 is not available for use with dimorphic fungi, such as those of the Paracoccidioides genus. In this study, we developed a microdilution method and added the alamarBlue reagent to test the responses of Paracoccidioides brasiliensis and Paracoccidioides lutzii against amphotericin B and itraconazole antifungals. The test proved to be sensitive, practical, and inexpensive and can be used to monitor the activity of low-growth microorganisms and their response to various drugs. PMID:23345296

  12. Microplate alamarBlue assay for Paracoccidioides susceptibility testing.

    PubMed

    de Paula e Silva, A C A; Oliveira, H C; Silva, J F; Sangalli-Leite, F; Scorzoni, L; Fusco-Almeida, A M; Mendes-Giannini, M J S

    2013-04-01

    CLSI method M27-A3 is not available for use with dimorphic fungi, such as those of the Paracoccidioides genus. In this study, we developed a microdilution method and added the alamarBlue reagent to test the responses of Paracoccidioides brasiliensis and Paracoccidioides lutzii against amphotericin B and itraconazole antifungals. The test proved to be sensitive, practical, and inexpensive and can be used to monitor the activity of low-growth microorganisms and their response to various drugs.

  13. Dynamic biomechanical examination of the lumbar spine with implanted total disc replacement using a pendulum testing system.

    PubMed

    Daniels, Alan H; Paller, David J; Koruprolu, Sarath; McDonnell, Matthew; Palumbo, Mark A; Crisco, Joseph J

    2012-11-01

    Biomechanical cadaver investigation. To examine dynamic bending stiffness and energy absorption of the lumbar spine with and without implanted total disc replacement (TDR) under simulated physiological motion. The pendulum testing system is capable of applying physiological compressive loads without constraining motion of functional spinal units (FSUs). The number of cycles to equilibrium observed under pendulum testing is a measure of the energy absorbed by the FSU. Five unembalmed, frozen human lumbar FSUs were tested on the pendulum system with axial compressive loads of 181 N, 282 N, 385 N, and 488 N before and after Synthes ProDisc-L TDR implantation. Testing in flexion, extension, and lateral bending began by rotating the pendulum to 5º resulting in unconstrained oscillatory motion. The number of rotations to equilibrium was recorded and bending stiffness (N·m/º) was calculated and compared for each testing mode. In flexion/extension, the TDR constructs reached equilibrium with significantly (P < 0.05) fewer cycles than the intact FSU with compressive loads of 282 N, 385 N, and 488 N. Mean dynamic bending stiffness in flexion, extension, and lateral bending increased significantly with increasing load for both the intact FSU and TDR constructs (P < 0.001). In flexion, with increasing compressive loading from 181 N to 488 N, the bending stiffness of the intact FSUs increased from 4.0 N·m/º to 5.5 N·m/º, compared with 2.1 N·m/º to 3.6 N·m/º after TDR implantation. At each compressive load, the intact FSU was significantly stiffer than the TDR (P < 0.05). Lumbar FSUs with implanted TDR were found to be less stiff, but absorbed more energy during cyclic loading with an unconstrained pendulum system. Although the effects on clinical performance of motion-preserving devices are not fully known, these results provide further insight into the biomechanical behavior of these devices under approximated physiological loading conditions.

  14. Magnetohydrodynamic Turbulence in Accretion Discs: A Test Case for Petascale Computing in Astrophysics

    NASA Astrophysics Data System (ADS)

    Joos, M.; Fromang, S.; Méheut, H.

    2015-10-01

    Angular momentum transport in accretion discs is one of the major issues of modern astrophysics and is crucial to understand as various astrophysical problematics as black hole dynamics or planet formation. Angular momentum transport relies on magnetohydrodynamic (MHD) turbulence, responsible for the non-linear evolution of the magneto-rotational instability (MRI). 3D simulations are essential to determine the physical properties of the flow resulting from that instability. In particular, the angular momentum transport rate induced by the MRI is difficult to estimate, depending on dissipation rates which are linked to viscous and resistive scales. These dissipation scales can be much smaller than the typical scale of the system and to simulate flows with such properties is very challenging. We recently realized a simulation on a BlueGene/Q with the smallest viscous dissipation coefficient ever reached. We discuss the challenges encountered in this context and the developments realized regarding efficient parallel Input/Output, hybridation and porting on GPGPU.

  15. Minimally invasive metabolic testing for malignant hyperthermia susceptibility: a systematic review of the methodology and results.

    PubMed

    Metterlein, Thomas; Schuster, Frank; Kranke, Peter; Roewer, Norbert; Anetseder, Martin

    2010-03-01

    Malignant hyperthermia (MH) is a potentially lethal hypermetabolic syndrome that develops in susceptible individuals exposed to volatile anesthetics or depolarizing neuromuscular blocking agents. Because genetic screening is successful only in 30 - 50% of all suspected cases, contracture testing following an open muscle biopsy is performed to diagnose MH susceptibility. Two different protocols exist, the in vitro contracture test (IVCT) for Europe and the caffine halothane contracture test for the US. As replacement for the IVCT, an in vivo metabolic test might allow an equal discrimination of MH susceptible individuals. In this systematic review, all available metabolic testing methods are analyzed. The reader will gain insight in methods and results of alternative approaches to diagnose MH. Relevant studies involving in vivo metabolic testing were systematically searched (Medline) and reviewed. Their ability to discriminate MH susceptible individuals was analyzed and compared. Any systemic or local side effects were documented and evaluated in order to allow more robust conclusions based on larger sample sizes than the single trials. All discussed study protocols allowed an adequate discrimination of MH susceptible individuals. The latest study protocol reaches a specificity of 79% with a sensitivity of 100%. No severe systemic or local adverse effects could be seen in the pooled analysis. Minimally invasive metabolic testing is a promising novel approach to diagnose MH. Further multi-center studies have to be conducted to optimize the results in order to replace the IVCT.

  16. Bacterial Cytological Profiling (BCP) as a Rapid and Accurate Antimicrobial Susceptibility Testing Method for Staphylococcus aureus

    PubMed Central

    Quach, D.T.; Sakoulas, G.; Nizet, V.; Pogliano, J.; Pogliano, K.

    2016-01-01

    Successful treatment of bacterial infections requires the timely administration of appropriate antimicrobial therapy. The failure to initiate the correct therapy in a timely fashion results in poor clinical outcomes, longer hospital stays, and higher medical costs. Current approaches to antibiotic susceptibility testing of cultured pathogens have key limitations ranging from long run times to dependence on prior knowledge of genetic mechanisms of resistance. We have developed a rapid antimicrobial susceptibility assay for Staphylococcus aureus based on bacterial cytological profiling (BCP), which uses quantitative fluorescence microscopy to measure antibiotic induced changes in cellular architecture. BCP discriminated between methicillin-susceptible (MSSA) and -resistant (MRSA) clinical isolates of S. aureus (n = 71) within 1–2 h with 100% accuracy. Similarly, BCP correctly distinguished daptomycin susceptible (DS) from daptomycin non-susceptible (DNS) S. aureus strains (n = 20) within 30 min. Among MRSA isolates, BCP further identified two classes of strains that differ in their susceptibility to specific combinations of beta-lactam antibiotics. BCP provides a rapid and flexible alternative to gene-based susceptibility testing methods for S. aureus, and should be readily adaptable to different antibiotics and bacterial species as new mechanisms of resistance or multidrug-resistant pathogens evolve and appear in mainstream clinical practice. PMID:26981574

  17. Disk prediffusion is a reliable method for testing colistin susceptibility in porcine E. coli strains.

    PubMed

    Boyen, F; Vangroenweghe, F; Butaye, P; De Graef, E; Castryck, F; Heylen, P; Vanrobaeys, M; Haesebrouck, F

    2010-08-26

    During the last few years, acquired resistance to colistin in Escherichia coli, but also in other bacterial species, has been reported. It has been shown that the disk diffusion test is not a reliable method for the detection of this resistance. Therefore, there is a need for a reliable and cheap test to determine colistin susceptibility of pathogenic E. coli strains. In the current research, the colistin susceptibility of E. coli isolated during the period 2005-2006 from pigs was determined. Results obtained with the Kirby Bauer disk diffusion test (Neosensitabs, Rosco), the disk prediffusion test (Neosensitabs, Rosco) and the E-test (AB Biodisk) were compared with the results of the reference agar dilution assay. The MIC values or inhibition zones showed a bimodal distribution for the results obtained by all test methods, except the disk diffusion assay, suggesting acquired resistance in 15 strains (9.6%). The E-test and disk prediffusion assay generated results within acceptable levels compared to the reference agar dilution assay. The categorical agreement with the results obtained by the agar dilution method were good to very good for all tests, except the disk diffusion assay. In conclusion, current results suggest that, in addition to the E-test, the disk prediffusion test is a reliable, alternative agar-based colistin susceptibility method for testing colistin susceptibility of E. coli isolates in diagnostic bacteriology.

  18. Perceived susceptibility and self-protective behavior: a field experiment to encourage home radon testing

    SciTech Connect

    Weinstein, N.D.; Sandman, P.M.; Roberts, N.E. )

    1991-01-01

    Tested in a field experiment (N = 647) the hypothesis that perceptions of personal susceptibility are important in decisions to test one's home for radioactive radon gas. Experimental group subjects received a personal telephone call to tell them they lived in a high-risk area and a personal letter to reinforce the telephone message. After the intervention, experimental subjects were significantly more likely than minimal-treatment subjects to acknowledge the possibility of high radon levels in their homes. Perceptions of susceptibility and illness severity were significantly correlated with orders of radon test kits and with testing intentions. Nevertheless, there were no differences between groups in test orders or intentions. Results are discussed in terms of the difficulty of getting people to acknowledge susceptibility and the factors other than risk perceptions that influence self-protective behavior.

  19. Pyrazinamide susceptibility testing: proposed new standard with the BACTECTM MGITTM 960 system.

    PubMed

    Piersimoni, C; Mustazzolu, A; Iacobino, A; Giannoni, F; Santoro, G; Gherardi, G; Del Giudice, A; Perna, R; Fattorini, L

    2016-12-01

    The susceptibility of 253 Mycobacterium tuberculosis complex isolates to pyrazinamide (PZA) was assessed using the BACTECTM MGITTM 960 (M960) system. Resistant strains underwent paired repeat testing using 1) a critical concentration of 200 g/ml (PZA-200), and 2) a reduced inoculum of 0.25 ml. They were also examined using the BACTEC 460 (B460) reference method and investigated for pncA mutations. On M960, 37 isolates were resistant. In the PZA-200 assay, 20 of these were resistant and 17 susceptible, while 18 were resistant and 19 susceptible with reduced inoculum. The B460 assay and pncA sequencing confirmed results with reduced inoculum.

  20. Wear characteristics of an unconstrained lumbar total disc replacement under a range of in vitro test conditions

    PubMed Central

    Fisher, John; Hall, Richard M.

    2015-01-01

    Abstract The effect of kinematics, loading and centre of rotation on the wear of an unconstrained total disc replacement have been investigated using the ISO 18192‐1 standard test as a baseline. Mean volumetric wear rate and surface morphological effects were reported. Changing the phasing of the flexions to create a low (but finite) amount of crossing path motion at the bearing surfaces resulted in a significant fall in wear volume. However, the rate of wear was still much larger than previously reported values under zero cross shear conditions. Reducing the load did not result in a significant change in wear rate. Moving the centre of rotation of the disc inferiorly did significantly increase wear rate. A phenomenon of debris re‐attachment on the UHMWPE surface was observed and hypothesised to be due to a relatively harsh tribological operating regime in which lubricant replenishment and particle migration out of the bearing contact zone were limited. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 46–52, 2017. PMID:26411540

  1. Comparison of spiral gradient and conventional agar dilution for susceptibility testing of anaerobic bacteria.

    PubMed Central

    Wexler, H M; Molitoris, E; Jashnian, F; Finegold, S M

    1991-01-01

    Antimicrobial susceptibility tests were performed on brucella laked blood agar with 340 isolates and 14 antimicrobial agents by the standard agar dilution technique and the spiral gradient technique in which antibiotic concentrations were established by diffusion from the agar surface. For comparison, spiral gradient MICs were determined by calculating antimicrobial concentrations at growth endpoints and rounding up to the next twofold incremental concentration. The cumulative percentage of strains susceptible at the breakpoint determined from spiral gradient data was within 10%, generally, of the percentage of strains susceptible at the breakpoint determined from agar dilution data. The overall agreement between the two techniques (within one doubling dilution) was 90.6%. The spiral gradient agar dilution technique is a reasonable alternative to the conventional agar dilution technique for susceptibility testing of anaerobic bacteria. Images PMID:1929262

  2. What's New in Genetic Testing for Cancer Susceptibility?

    PubMed

    Plichta, Jennifer K; Griffin, Molly; Thakuria, Joseph; Hughes, Kevin S

    2016-09-15

    The advent of next-generation sequencing, and its transition further into the clinic with the US Food and Drug Administration approval of a cystic fibrosis assay in 2013, have increased the speed and reduced the cost of DNA sequencing. Coupled with a historic ruling by the Supreme Court of the United States that human genes are not patentable, these events have caused a seismic shift in genetic testing in clinical medicine. More labs are offering genetic testing services; more multigene panels are available for gene testing; more genes and gene mutations are being identified; and more variants of uncertain significance, which may or may not be clinically actionable, have been found. All these factors, taken together, are increasing the complexity of clinical management. While these developments have led to a greater interest in genetic testing, risk assessment, and large-scale population screening, they also present unique challenges. The dilemma for clinicians is how best to understand and manage this rapidly growing body of information to improve patient care. With millions of genetic variants of potential clinical significance and thousands of genes associated with rare but well-established genetic conditions, the complexities of genetic data management clearly will require improved computerized clinical decision support tools, as opposed to continued reliance on traditional rote, memory-based medicine.

  3. Validation of clinical tests for patients with long-lasting painful temporomandibular disorders with anterior disc displacement without reduction.

    PubMed

    Julsvoll, Elisabeth Heggem; Vøllestad, Nina Køpke; Robinson, Hilde Stendal

    2016-02-01

    To evaluate the validity of single clinical tests and cluster of tests used to identify anterior disc displacement without reduction (ADDWOR). Treatment-seeking patients with temporomandibular pain and limited mouth-opening were recruited among patients from health-professionals in the region of Oslo in 2012. Thirty-five persons, aged 18-70 years, with 58 symptomatic joints or pain in surrounding area were included. The examinations were performed by one experienced manual therapist. Magnetic resonance imaging (MRI) was used as reference standard. Sensitivity, specificity, false positive, false negative and likelihood-ratios (LRs) with 95% confidence intervals (CIs) were calculated for single and cluster of tests. Receiver Operating Curve - ROC analysis were used to see how well pain provocation tests discriminated between positive and negative ADDWOR. The main result is that a cluster of 7 clinical tests (5 positive) can be used to diagnose ADDWOR with an accuracy of 71%. The dental stick test is the best single test with equal sensitivity as the cluster, but with lower specificity. To reveal ADDWOR in patients with TMD, we recommend using the cluster of the dental stick test, the isometric test, the joint provocation test, the joint sound test, the deviation test, the laterotrusion test and joint mobility test. The tests require no advanced equipment, they are easy to perform and suitable for use in clinical settings. MRI can be seen as more of a supplement to the clinical tests than a necessity to start a clinical intervention. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Wide variability in Pseudomonas aeruginosa aminoglycoside results among seven susceptibility testing procedures.

    PubMed Central

    Staneck, J L; Glenn, S; DiPersio, J R; Leist, P A

    1989-01-01

    Seven commonly used antimicrobial susceptibility testing methods were used to test the susceptibility of 150 isolates of Pseudomonas aeruginosa against gentamicin, tobramycin, amikacin, carbenicillin, and piperacillin. Results were compared with respect to the susceptibility characteristics of the population of isolates as defined by each method. Conventional methods included agar disk diffusion and agar dilution, carried out in accordance with current recommendations of the National Committee for Clinical Laboratory Standards, as well as broth microdilution testing with cation-supplemented Mueller-Hinton broth (CSMHB). Methods in which instrumentation was used for result determination included the Autobac I, Avantage, Sensititre Autoreader (using a breakpoint panel at 18 h of incubation), and Vitek (AMS-240, using the GNS susceptibility card). When necessary for comparison, MIC data were converted to categorical interpretations (susceptible, intermediate, and resistant). With respect to gentamicin, no significant differences were noted among the results of disk diffusion, broth microdilution, Sensititre Auto breakpoint, or Vitek methods which characterized 60 to 67% of isolates as susceptible, 16 to 22% as intermediate, and 13 to 17% as resistant. In contrast, agar dilution, Autobac, and Avantage, although yielding gentamicin results similar to those of one another, were each significantly different in result reporting from the other four methods above for gentamicin results, and they characterized the Pseudomonas population largely as susceptible (88 to 97%), with 0 to 6% intermediate and only 3% to 6% resistant. More isolates were characterized as being resistant to gentamicin in the Avantage test if an assay broth supplemented with increased amounts of calcium was used. Cation impregnation of Autobac disks did not appreciably change Autobac results. The geometric mean MIC of gentamicin was 4 micrograms/ml lower in the agar dilution method than in the CSMHB

  5. Utility of in-house fluconazole disk diffusion susceptibility testing in the treatment of candidemia.

    PubMed

    Kubiak, David W; Farmakiotis, Dimitrios; Arons, Viktoria; Hollins, Randy M; Rostas, Sara E; Weiser, Linda M; Baden, Lindsey R; Marty, Francisco M; Koo, Sophia

    2016-03-01

    Among 302 first candidemia episodes, 210 (69.6%) were initially treated with an echinocandin or polyene (E/P) antifungal drug. In 137 (72.5%) patients with fluconazole-susceptible isolates, treatment was changed to fluconazole based on disk diffusion susceptibility testing. Clinical outcomes were not compromised in patients receiving E/P who were de-escalated to fluconazole for treatment of candidemia based on disk diffusion results. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Identification of Candida parapsilosis Sensu Lato in Pediatric Patients and Antifungal Susceptibility Testing.

    PubMed

    Cattana, Maria Emilia; Dudiuk, Catiana; Fernández, Mariana; Rojas, Florencia; Alegre, Liliana; Córdoba, Susana; Garcia-Effron, Guillermo; Giusiano, Gustavo

    2017-07-01

    A total of 59 Candida parapsilosis sensu stricto and 1 Candida orthopsilosis recovered from catheters and blood cultures of pediatric patients from the northeastern region of Argentina were studied. Susceptibility to azoles, amphotericin B, and echinocandins was tested by the broth microdilution method. According to CLSI clinical breakpoints, >91% of the strains were azole susceptible, whereas 15% showed high amphotericin B MICs. Copyright © 2017 American Society for Microbiology.

  7. Screening for cephalosporin-resistant Streptococcus pneumoniae with the Kirby-Bauer disk susceptibility test.

    PubMed

    Friedland, I R; Shelton, S; McCracken, G H

    1993-06-01

    Kirby-Bauer disk susceptibility tests with five standard cephalosporin disks were performed on 23 penicillin-resistant Streptococcus pneumoniae isolates for which ceftriaxone MICs were 0.125 to 4 micrograms/ml. Cefuroxime disk inhibition zone diameters distinguished clearly isolates for which ceftriaxone MICs were > or = 2 micrograms/ml from more susceptible strains, whereas cephalothin, ceftizoxime, cefotaxime, and ceftriaxone disks distinguished these isolates less clearly than the cefuroxime disk did.

  8. Utility of in-house fluconazole disk diffusion susceptibility testing in the treatment of candidemia

    PubMed Central

    Kubiak, David W.; Farmakiotis, Dimitrios; Arons, Viktoria; Hollins, Randy M.; Rostas, Sara E.; Weiser, Linda M.; Baden, Lindsey R.; Marty, Francisco M.; Koo, Sophia

    2016-01-01

    Among 302 first candidemia episodes, 210 (69.6%) were initially treated with an echinocandin or polyene (E/P) antifungal drug. In 137 (72.5%) patients with fluconazole-susceptible isolates, treatment was changed to fluconazole based on disk diffusion susceptibility testing. Clinical outcomes were not compromised in patients receiving E/P who were de-escalated to fluconazole for treatment of candidemia based on disk diffusion results. PMID:26763713

  9. A Simplified Test for Blanching Susceptibility of Copper Alloys

    NASA Technical Reports Server (NTRS)

    Thomas-Ogbuji, Linus U.; Humphrey, Donald; Setlock, John

    2003-01-01

    GRCop-84 (Cu-8Cr-4Nb) is a dispersion-strengthened alloy developed for space-launch rocket engine applications, as a liner for the combustion chamber and nozzle ramp. Its main advantage over rival alloys, particularly NARloy-Z (Cu-Ag-Zr), the current liner alloy, is in high temperature mechanical properties. Further validation required that the two alloys be compared with respect to service performance and durability. This has been done, under conditions resembling those expected in reusable launch engine applications. GRCop-84 was found to have a superior resistance to static and cyclic oxidation up to approx. 700 C. In order to improve its performance above 700 C, Cu-Cr coatings have also been developed and evaluated. The major oxidative issue with Cu alloys is blanching, a mode of degradation induced by oxidation-reduction fluctuations in hydrogen-fueled engines. That fluctuation cannot be addressed with conventional static or cyclic oxidation testing. Hence, a further evaluation of the alloy substrates and Cu-Cr coating material necessitated our devising a test protocol that involves oxidaton-reduction cycles. This paper describes the test protocols used and the results obtained.

  10. A Simplified Test for Blanching Susceptibility of Copper Alloys

    NASA Technical Reports Server (NTRS)

    Thomas-Ogbuji, Linus U.; Humphrey, Donald; Setlock, John

    2003-01-01

    GRCop-84 (Cu-8Cr-4Nb) is a dispersion-strengthened alloy developed for space-launch rocket engine applications, as a liner for the combustion chamber and nozzle ramp. Its main advantage over rival alloys, particularly NARloy-Z (Cu-Ag-Zr), the current liner alloy, is in high temperature mechanical properties. Further validation required that the two alloys be compared with respect to service performance and durability. This has been done, under conditions resembling those expected in reusable launch engine applications. GRCop-84 was found to have a superior resistance to static and cyclic oxidation up to approx. 700 C. In order to improve its performance above 700 C, Cu-Cr coatings have also been developed and evaluated. The major oxidative issue with Cu alloys is blanching, a mode of degradation induced by oxidation-reduction fluctuations in hydrogen-fueled engines. That fluctuation cannot be addressed with conventional static or cyclic oxidation testing. Hence, a further evaluation of the alloy substrates and Cu-Cr coating material necessitated our devising a test protocol that involves oxidaton-reduction cycles. This paper describes the test protocols used and the results obtained.

  11. [E-test susceptibility results of brucella strains for streptomycin, rifampicin, ciprofloxacin and tetracycline].

    PubMed

    Sengöz, G; Yaşar, K Kart; Kutlu, S Bati; Durdu, Y Bilgin; Ozdemir, R; Nazlican, O

    2006-07-01

    Although Brucella species are susceptible to many antimicrobial agents in vitro, the susceptibility tests for these bacteria are not well standardized and the break point values are not described yet clearly. The aim of this study was to investigate the minimum inhibitory concentration (MIC) values of 43 Brucella strains isolated from blood cultures by E-test. Streptomycin and rifampicin E-tests were performed for all of the strains, however, tetracycline and ciprofloxacin were tested for only 27 and 17 strains, respectively. The MIC interval for streptomycin was 0.025-1 mg/L, for rifampicin 0.19-1.5 mg/L, for tetracycline <0.016-0.032 mg/L, and for ciprofloxacin 0.094-0.64 mg/L. One strain was found intermediately susceptible to rifampicin. In may be concluded that development of resistance is not eligible against antibiotics which are currently used for brucellosis therapy.

  12. Correlation between E-test, disk diffusion, and microdilution methods for antifungal susceptibility testing of fluconazole and voriconazole.

    PubMed

    Matar, Madonna J; Ostrosky-Zeichner, Luis; Paetznick, Victor L; Rodriguez, Jose R; Chen, Enuo; Rex, John H

    2003-05-01

    The activities of fluconazole and voriconazole against isolates of Candida spp. (n = 400) were tested by the E-test, disk diffusion, and the National Committee for Clinical Laboratory Standards (NCCLS) M27-A2 broth microdilution-based reference methods. More than 96% of isolates found to be susceptible to fluconazole by the reference method were identified as susceptible by the agar-based methods. Lesser degrees of correlation with the reference method were seen for isolates identified as resistant by the agar-based methods. Interpretive categories are not available for voriconazole, but results qualitatively similar to those for fluconazole were seen. The agar-based E-test and disk diffusion methods are reliable alternatives to the NCCLS M27-A2 reference microdilution method for isolates that test susceptible to fluconazole.

  13. Expression of DISC1-Interactome Members Correlates with Cognitive Phenotypes Related to Schizophrenia

    PubMed Central

    Rampino, Antonio; Walker, Rosie May; Torrance, Helen Scott; Anderson, Susan Maguire; Fazio, Leonardo; Di Giorgio, Annabella; Taurisano, Paolo; Gelao, Barbara; Romano, Raffaella; Masellis, Rita; Ursini, Gianluca; Caforio, Grazia; Blasi, Giuseppe; Millar, J. Kirsty; Porteous, David John; Thomson, Pippa Ann; Bertolino, Alessandro; Evans, Kathryn Louise

    2014-01-01

    Cognitive dysfunction is central to the schizophrenia phenotype. Genetic and functional studies have implicated Disrupted-in-Schizophrenia 1 (DISC1), a leading candidate gene for schizophrenia and related psychiatric conditions, in cognitive function. Altered expression of DISC1 and DISC1-interactors has been identified in schizophrenia. Dysregulated expression of DISC1-interactome genes might, therefore, contribute to schizophrenia susceptibility via disruption of molecular systems required for normal cognitive function. Here, the blood RNA expression levels of DISC1 and DISC1-interacting proteins were measured in 63 control subjects. Cognitive function was assessed using neuropsychiatric tests and functional magnetic resonance imaging was used to assess the activity of prefrontal cortical regions during the N-back working memory task, which is abnormal in schizophrenia. Pairwise correlations between gene expression levels and the relationship between gene expression levels and cognitive function and N-back-elicited brain activity were assessed. Finally, the expression levels of DISC1, AKAP9, FEZ1, NDEL1 and PCM1 were compared between 63 controls and 69 schizophrenic subjects. We found that DISC1-interactome genes showed correlated expression in the blood of healthy individuals. The expression levels of several interactome members were correlated with cognitive performance and N-back-elicited activity in the prefrontal cortex. In addition, DISC1 and NDEL1 showed decreased expression in schizophrenic subjects compared to healthy controls. Our findings highlight the importance of the coordinated expression of DISC1-interactome genes for normal cognitive function and suggest that dysregulated DISC1 and NDEL1 expression might, in part, contribute to susceptibility for schizophrenia via disruption of prefrontal cortex-dependent cognitive functions. PMID:24940743

  14. In Vitro Antibiotic Susceptibilities of Burkholderia mallei (Causative Agent of Glanders) Determined by Broth Microdilution and E-Test

    PubMed Central

    Heine, Henry S.; England, Marilyn J.; Waag, David M.; Byrne, W. Russell

    2001-01-01

    In vitro susceptibilities to 28 antibiotics were determined for 11 strains of Burkholderia mallei by the broth microdilution method. The B. mallei strains demonstrated susceptibility to aminoglycosides, macrolides, quinolones, doxycycline, piperacillin, ceftazidime, and imipenem. For comparison and evaluation, 17 antibiotic susceptibilities were also determined by the E-test. E-test values were always lower than the broth dilution values. Establishing and comparing antibiotic susceptibilities of specific B. mallei strains will provide reference information for assessing new antibiotic agents. PMID:11408233

  15. A Meta-Analytic Investigation of the Susceptibility of Integrity Tests to Faking and Coaching.

    ERIC Educational Resources Information Center

    Alliger, George M.; Dwight, Stephen A.

    2000-01-01

    Performed a meta-analysis of studies of the extent to which individuals can inflate their integrity test scores when coached or instructed to fake good. Results from 14 studies indicate that overt tests are more susceptible to both fake-good and coaching instructions than are personality-based measures. (SLD)

  16. An in vitro metronidazole susceptibility test for trichomoniasis using the InPouch TV test.

    PubMed

    Borchardt, K A; Li, Z; Zhang, M Z; Shing, H

    1996-04-01

    An efficient anaerobic culture system, the InPouch TV test, was used to determine the susceptibility of Trichomonas vaginalis to metronidazole. Glacial acetic acid was employed as a solvent for metronidazole. T vaginalis isolates were cultured from 16 symptomatic female patients. The 11 who responded to oral metronidazole, 250 mg tid for 7 days, were considered as having sensitive trichomonads; the 5 who remained infected after treatment were considered to have resistant organisms. All isolates were cultured for minimum lethal concentrations (MLC). Metronidazole was added to a series of pouches; two-fold dilution of the most concentrated was 50 micrograms/ml and the least was 0.4 micrograms/ml. The inoculum of viable trichomonads was 1 x 105/ml in each pouch. Pouches were incubated at 37 degrees C for 48 h, examined microscopically for motile trichomonads, and then 0.5 ml was subcultured to drug free pouches. After 5 days incubation at 37 degrees C, each subculture and culture were examined microscopically for viable trichomonads. Eleven isolates of T vaginalis from patients responding to metronidazole treatment had MLC between 0.4 to 3.1 micrograms/ml. The MLC from the 5 treatment failure patients were between 12.5 to 50 micrograms/ml. For the 16 patients in this study, the MLC values determined with the InPouch TV test differentiated between infection caused by metronidazole sensitive and resistant trichomonads. The mean MLC of clinically resistant isolates was approximately eleven fold higher than the mean MLC of clinically sensitive isolates (15 micrograms/ml vs 1.32 micrograms/ml). There was a significant difference between clinically resistant and sensitive isolates (t = 5.47, p < 0.0005). This study suggests that the InPouch TV test could be used for distinguishing between metronidazole resistant and sensitive isolates.

  17. Guidance for clinical and public health laboratories testing for influenza virus antiviral drug susceptibility in Europe.

    PubMed

    Pozo, Francisco; Lina, Bruno; Andrade, Helena Rebelo de; Enouf, Vincent; Kossyvakis, Athanasios; Broberg, Eeva; Daniels, Rod; Lackenby, Angie; Meijer, Adam

    2013-05-01

    Two classes of antiviral drugs are licensed in Europe for treatment and prophylaxis of influenza; the M2 ion-channel blockers amantadine and rimantadine acting against type A influenza viruses only and the neuraminidase enzyme inhibitors zanamivir and oseltamivir acting against type A and type B influenza viruses. This guidance document was developed for but not limited to the European Union (EU) and other European Economic Area (EEA) countries on how and when to test for influenza virus antiviral drug susceptibility. It is aimed at clinical and influenza surveillance laboratories carrying out antiviral drug susceptibility testing on influenza viruses from patients suspected of harbouring viruses with reduced susceptibility or for the monitoring of the emergence of such among circulating viruses, respectively. Therefore, the guidance should not be read as a directive or an algorithm for treatment. Monitoring for emergence of influenza viruses with reduced drug susceptibility in hospitalized cases is crucial for decision making on possible changes to antiviral treatment. Therefore, it is important to test for antiviral susceptibility in certain patient groups, such as patients treated with influenza antiviral drugs. It is also important to determine the frequency of viruses with natural (not related to drug use) reduced susceptibility among community and hospitalized cases, as this knowledge is essential for making empirical antiviral treatment decisions. Furthermore, testing of specimens from community influenza patients is needed to determine the frequency of viruses with reduced susceptibility and good viral fitness that are readily transmissible, as they may become dominant among circulating viruses. Phenotypic neuraminidase enzyme inhibition assays are recommended to determine the level of inhibition of the neuraminidase enzyme by antiviral drugs as a measure of drug susceptibility of the virus. Genotypic assays are recommended to identify amino acid

  18. Standard versus biofilm antimicrobial susceptibility testing to guide antibiotic therapy in cystic fibrosis.

    PubMed

    Waters, Valerie; Ratjen, Felix

    2015-03-05

    The antibiotics used to treat pulmonary infections in people with cystic fibrosis are typically chosen based on the results of antimicrobial susceptibility testing performed on bacteria traditionally grown in a planktonic mode (grown in a liquid). However, there is considerable evidence to suggest that Pseudomonas aeruginosa actually grows in a biofilm (or slime layer) in the airways of people with cystic fibrosis with chronic pulmonary infections. Therefore, choosing antibiotics based on biofilm rather than conventional antimicrobial susceptibility testing could potentially improve response to treatment of Pseudomonas aeruginosa in people with cystic fibrosis. This is an update of a previously published Cochrane Review. To compare biofilm antimicrobial susceptibility testing-driven therapy to conventional antimicrobial susceptibility testing-driven therapy in the treatment of Pseudomonas aeruginosa infection in people with cystic fibrosis. We searched the Cochrane Cystic Fibrosis Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. We also searched a registry of ongoing trials and the reference lists of relevant articles and reviews.Most recent search: 19 November 2014. Randomized controlled trials of antibiotic therapy based on biofilm antimicrobial susceptibility testing compared to antibiotic therapy based on conventional antimicrobial susceptibility testing in the treatment of Pseudomonas aeruginosa pulmonary infection in people with cystic fibrosis. Both authors independently selected trials, assessed their risk of bias and extracted data from eligible trials. Additionally, the review authors contacted the trial investigators to obtain further information. The searches identified two multicentre, randomized, double-blind controlled clinical trials eligible for inclusion in the review with a total of 78 participants; one trial was done in people who were clinically stable, the other in people

  19. Comparison and Development of Pyrazinamide Susceptibility Testing Methods for Tuberculosis in Thailand

    PubMed Central

    Foongladda, Suporn; Klayut, Wiphat; Pholwat, Suporn; Houpt, Eric

    2015-01-01

    Pyrazinamide (PZA) plays a critical role in shortening tuberculosis treatment duration and in treating MDR-TB. The standard phenotypic MGIT PZA susceptibility testing method is imperfect because it is slow and has potential for false resistance. In this study we evaluated two different phenotypic based methods, qPCR phage assay and MTT assay, as well as genotypic sequencing. The assay was evaluated on 71 clinical M. tuberculosis isolates (37 MGIT PZA susceptible, 34 MGIT PZA resistant) and compared to the MGIT result. Of these methods the qPCR phage assay yielded an accuracy of 89% versus standard MGIT while MTT yielded 83%. The genotypic sequencing method yielded 90% accuracy. We conclude that any of these faster PZA susceptibility methods perform reasonably well against a MGIT PZA susceptibility standard. PMID:26298819

  20. [Assessment of in vitro susceptibility to antimicrobials of rapidly growing mycobacteria by E-test].

    PubMed

    García-Agudo, Lidia; García-Martos, Pedro; Jesús, Iría; Rodríguez-Iglesias, Manuel

    2009-07-01

    Rapidly growing mycobacteria (RGM) are considered opportunistic pathogens. An increasing number of post traumatic or surgical infections are caused by these microorganisms. To determine the antimicrobial susceptibility of RGM using the E-test method. A total of 54 isolates of RGM was obtained from several clinical samples and selected for this study Strains were identified to the species level by phenotypic and biochemical characteristics, PCR-restriction enzyme analysis of the hsp65 gene (PRA) and sequencing of the 16S rRNA. Susceptibility was investigated by E-test to amikacin, cefoxitin, ciprofioxacin, clarithromycin, imipenem, quinupristin/dalfopristin, linezolid and tigecycline. Twelve different species of RGM were identified: Mycobacterium fortuitum (23 strains), M chelonae (11), M abscessus (10), Msenegalense (2), Malvei (1), Mbrumae (1), Mmageritense (1), mucogenicum (1), M neoaurum (1), Mperegrinum (1), M septicum (1) y M smegmatis (1). All the strains were inhibited by low concentrations of amikacin and tigecycline. Susceptibility to cefoxitin, fluoroquinolones, clarithromycin, imipenem and linezolid was variable. All but two strains were resistant to quinupristin/ dalfopristin. Due to the uneven antimicrobial susceptibility of different species of RGM, an antimicrobial susceptibility test is mandatory for these microorganisms. The E-test method is well suited to determine minimum inhibitory concentrations.

  1. Plaque inhibition assay for drug susceptibility testing of influenza viruses.

    PubMed Central

    Hayden, F G; Cote, K M; Douglas, R G

    1980-01-01

    The relative antiviral activities of four drugs against contemporary strains of influenza A and B viruses were determined in Madin-Darby canine kidney cell monolayers with a plaque inhibition assay. This assay proved to be a reliable, rapid method of determining 50% inhibitory concentrations that correlated well with clinically achievable drug levels and the results of clinical trials. Contemporary strains of influenza A viruses (subtypes H1N1, H3N2, HSW1N1) required amantadine hydrochloride and rimantadine hydrochloride 50% inhibitory concentrations in the range of 0.2 to 0.4 microgram/ml, whereas 50% inhibitory concentrations ranged from approximately 50 to 100 micrograms/ml against influenza B viruses. Ribavirin was approximately 10-fold less active than amantadine hydrochloride against influenza A viruses, and the ribavirin 50% inhibitory concentrations against both influenza A and B viruses ranged from 2.6 to 6.8 micrograms/ml. Inosiplex had no antiviral activity in this test system. PMID:7396473

  2. Comparison of agar dilution and antibiotic gradient strip test with broth microdilution for susceptibility testing of swine Brachyspira species.

    PubMed

    Mirajkar, Nandita S; Gebhart, Connie J

    2016-03-01

    Production-limiting diseases in swine caused by Brachyspira are characterized by mucohemorrhagic diarrhea (B. hyodysenteriae and "B. hampsonii") or mild colitis (B. pilosicoli), while B. murdochii is often isolated from healthy pigs. Emergence of novel pathogenic Brachyspira species and strains with reduced susceptibility to commonly used antimicrobials has reinforced the need for standardized susceptibility testing. Two methods are currently used for Brachyspira susceptibility testing: agar dilution (AD) and broth microdilution (BMD). However, these tests have primarily been used for B. hyodysenteriae and rarely for B. pilosicoli. Information on the use of commercial susceptibility testing products such as antibiotic gradient strips is lacking. Our main objective was to validate and compare the susceptibility results, measured as the minimum inhibitory concentration (MIC), of 6 antimicrobials for 4 Brachyspira species (B. hyodysenteriae, "B. hampsonii", B. pilosicoli, and B. murdochii) by BMD and AD (tiamulin, valnemulin, lincomycin, tylosin, and carbadox) or antibiotic gradient strip (doxycycline) methods. In general, the results of a high percentage of all 4 Brachyspira species differed by ±1 log2 dilution or less by BMD and AD for tiamulin, valnemulin, lincomycin, and tylosin, and by BMD and antibiotic gradient strip for doxycycline. The carbadox MICs obtained by BMD were 1-5 doubling dilutions different than those obtained by AD. BMD for Brachyspira was quicker to perform with less ambiguous interpretation of results when compared with AD and antibiotic gradient strip methods, and the results confirm the utility of BMD in routine diagnostics.

  3. Standardization of disk diffusion test and its clinical significance for susceptibility testing of metronidazole against Helicobacter pylori.

    PubMed Central

    Xia, H; Keane, C T; Beattie, S; O'Morain, C A

    1994-01-01

    Susceptibilities of 121 clinical Helicobacter pylori strains to metronidazole were determined by both a 5-micrograms metronidazole disk diffusion test and a plate dilution method in duplicate and after different periods of incubation. The distribution of MICs of metronidazole against H. pylori among the strains was found to be bimodal. The diameters of inhibitory zones obtained by the disk diffusion test and the MICs obtained by the plate dilution method correlated well, especially after 4 days of incubation (r = 0.77). An inhibitory zone diameter of 20 mm was found to correspond to a MIC of 8 micrograms/ml and is recommended as a suitable zone for differentiating susceptibility and resistance with a 5-micrograms metronidazole disk. Three interpretive categories of susceptibility results were defined; strains with inhibitory zone diameters of more than 26 mm were defined as susceptible (MIC, < 4 micrograms/ml), strains with zone diameters of 20 to 26 mm were deemed intermediate (MIC, 4 to 8 micrograms/ml), and those with zone diameters of less than 20 mm were deemed resistant (MIC, > 8 micrograms/ml). Furthermore, 76 H. pylori-positive patients with duodenal ulcers or nonulcer dyspepsia were treated with a 1 week of triple therapy (colloidal bismuth subcitrate, metronidazole, and tetracycline). H. pylori strains were isolated before treatment from antral biopsies from those patients, and the metronidazole susceptibilities of the strains were determined by the disk diffusion test. H. pylori status was evaluated again 4 weeks after completion of treatment. The eradication rates for susceptible, intermediate, and resistant strains were 95.9% (47 of 49), 62.5% (5 of 8), and 52.6% (10 of 19), respectively. It is included that the 5-micrograms disk diffusion test is easy to perform and gives final results similar to those of the plate dilution method. The three interpretive categories of susceptibility may be of benefit for clinical choice of chemotherapy in eradicating

  4. A two-hour antibiotic susceptibility test by ATP-bioluminescence.

    PubMed

    March Rosselló, Gabriel Alberto; García-Loygorri Jordán de Urries, María Cristina; Gutiérrez Rodríguez, María Purificación; Simarro Grande, María; Orduña Domingo, Antonio; Bratos Pérez, Miguel Ángel

    2016-01-01

    The antibiotic susceptibility test (AST) in Clinical Microbiology laboratories is still time-consuming, and most procedures take 24h to yield results. In this study, a rapid antimicrobial susceptibility test using ATP-bioluminescence has been developed. The design of method was performed using five ATCC collection strains of known susceptibility. This procedure was then validated against standard commercial methods on 10 strains of enterococci, 10 staphylococci, 10 non-fermenting gram negative bacilli, and 13 Enterobacteriaceae from patients. The agreement obtained in the sensitivity between the ATP-bioluminescence method and commercial methods (E-test, MicroScan and VITEK2) was 100%. In summary, the preliminary results obtained in this work show that the ATP-bioluminescence method could provide a fast and reliable AST in two hours.

  5. Recovery and susceptibility testing of Mycobacterium tuberculosis from extrapulmonary specimens by the BACTEC radiometric method.

    PubMed Central

    Fadda, G; Roe, S L

    1984-01-01

    This study was carried out to evaluate the sensitivity and rapidity of the BACTEC radiometric techniques for isolation and susceptibility testing of mycobacteria from extrapulmonary specimens. Concentrated specimens of urine, pleural fluid, and blood as well as other extrapulmonary specimens were processed for the recovery of mycobacteria and for drug susceptibility testing, employing conventional and BACTEC radiometric methods. Out of 483 specimens processed, 20 were found to be positive for Mycobacterium tuberculosis on the conventional Lowenstein -Jensen medium, and 19 were found to be positive in the BACTEC 7H12 medium. Average recovery times were 22.5 days for the conventional method and 10.9 days for the BACTEC method. When isolated cultures were tested for susceptibility to streptomycin, isoniazid, rifampin, and ethambutol, results were reported at an average time of 22 and 5.4 days for the conventional and BACTEC methods, respectively, with good correlation. PMID:6429193

  6. Evaluation of a radiometric method for pyrazinamide susceptibility testing of Mycobacterium tuberculosis.

    PubMed Central

    Tarrand, J J; Spicer, A D; Gröschel, D H

    1986-01-01

    Pyrazinamide susceptibility testing of Mycobacterium tuberculosis requires an acid environment. By controlling the method of acidification and the quality and quantity of the inoculum, the test can be performed with the BACTEC radiometric system (Johnston Laboratories, Towson, Md.). We acidified BACTEC 7H12 medium with buffered phosphoric acid and adjusted the test inoculum to 1/10 of that usually employed in BACTEC protocols; after 5 days of growth we correctly identified 36 of 36 strains susceptible to 50 micrograms of pyrazinamide per ml. All 18 resistant strains were classified as pyrazinamide resistant. (Susceptibility or resistance had been determined by standard plate assays.) The test was able to detect small resistant populations in artificial mixtures of 1 or 2% resistant bacteria with a susceptible strain (10 mixtures each). We tested 70 M. tuberculosis strains in acidified BACTEC 7H12 medium and by the plate dilution test at pH 5.5. All strains grew in the BACTEC medium, but three strains failed to grow on plates and were not tested further; the results of both methods agreed for the remaining strains. PMID:3101586

  7. Effect of non-uniform thickness of samples in stress relaxation tests under unconfined compression of samples of articular discs.

    PubMed

    Commisso, Maria S; Martínez-Reina, Javier; Mayo, Juana; Domínguez, Jaime; Tanaka, Eiji

    2014-04-11

    A precise information of the biomechanical properties of soft tissues is required to develop a suitable simulation model, with which the distribution of stress and strain in the complex structures can be estimated. Many soft tissues have been mechanically characterized by stress relaxation tests under unconfined or confined compression. In general, full-thickness samples are extracted to reduce the damage in the tissue as much as possible. However, it is not guaranteed that these samples have a uniform thickness or, in other words, planar parallel faces. In particular, in the articular disc of the temporomandibular joint, many studies can be found testing full-thickness samples for which that thickness is known to be non-uniform, while making the assumption of uniaxial stress state to extract the mechanical properties from those tests. That inaccuracy may have a strong influence in some cases and needs a profound revision. The main goal of this work is to quantify the error committed in that assumption and the influence of the variation of thickness on that error in a particular test: stress relaxation tests under unconfined compression. Based on this error and defining an allowable tolerance, a criterion is established to reject samples depending on their aspect ratio. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Comparison of animal discs used in disc research to human lumbar disc: torsion mechanics and collagen content.

    PubMed

    Showalter, Brent L; Beckstein, Jesse C; Martin, John T; Beattie, Elizabeth E; Espinoza Orías, Alejandro A; Schaer, Thomas P; Vresilovic, Edward J; Elliott, Dawn M

    2012-07-01

    Experimental measurement and normalization of in vitro disc torsion mechanics and collagen content for several animal species used in intervertebral disc research and comparing these with the human disc. To aid in the selection of appropriate animal models for disc research by measuring torsional mechanical properties and collagen content. There is lack of data and variability in testing protocols for comparing animal and human disc torsion mechanics and collagen content. Intervertebral disc torsion mechanics were measured and normalized by disc height and polar moment of inertia for 11 disc types in 8 mammalian species: the calf, pig, baboon, goat, sheep, rabbit, rat, and mouse lumbar discs, and cow, rat, and mouse caudal discs. Collagen content was measured and normalized by dry weight for the same discs except the rat and the mouse. Collagen fiber stretch in torsion was calculated using an analytical model. Measured torsion parameters varied by several orders of magnitude across the different species. After geometric normalization, only the sheep and pig discs were statistically different from human discs. Fiber stretch was found to be highly dependent on the assumed initial fiber angle. The collagen content of the discs was similar, especially in the outer annulus where only the calf and goat discs were statistically different from human. Disc collagen content did not correlate with torsion mechanics. Disc torsion mechanics are comparable with human lumbar discs in 9 of 11 disc types after normalization by geometry. The normalized torsion mechanics and collagen content of the multiple animal discs presented are useful for selecting and interpreting results for animal disc models. Structural organization of the fiber angle may explain the differences that were noted between species after geometric normalization.

  9. A functional polymorphism in COL11A1, which encodes the alpha 1 chain of type XI collagen, is associated with susceptibility to lumbar disc herniation.

    PubMed

    Mio, Futoshi; Chiba, Kazuhiro; Hirose, Yuichiro; Kawaguchi, Yoshiharu; Mikami, Yasuo; Oya, Takeshi; Mori, Masaki; Kamata, Michihiro; Matsumoto, Morio; Ozaki, Kouichi; Tanaka, Toshihiro; Takahashi, Atsushi; Kubo, Toshikazu; Kimura, Tomoatsu; Toyama, Yoshiaki; Ikegawa, Shiro

    2007-12-01

    Lumbar disc herniation (LDH), degeneration and herniation of the nucleus pulposus of the intervertebral disc (IVD) of the lumbar spine, is one of the most common musculoskeletal diseases. Its etiology and pathogenesis, however, remain unclear. Type XI collagen is important for cartilage collagen formation and for organization of the extracellular matrix. We identified an association between one of the type XI collagen genes, COL11A1, and LDH in Japanese populations. COL11A1, which encodes the alpha 1 chain of type XI collagen, was highly expressed in IVD, but its expression was decreased in the IVD of patients with LDH. The expression level was inversely correlated with the severity of disc degeneration. A single-nucleotide polymorphism (c.4603C-->T [rs1676486]) had the most significant association with LDH (P=3.3 x 10(-6)), and the transcript containing the disease-associated allele was decreased because of its decreased stability. These observations indicate that type XI collagen is critical for IVD metabolism and that its decrease is related to LDH.

  10. Conditions that may affect the results of susceptibility testing of Mycobacterium tuberculosis to pyrazinamide.

    PubMed

    Zhang, Ying; Permar, Sallie; Sun, Zhonghe

    2002-01-01

    Pyrazinamide (PZA) is an important front-line anti-tuberculosis drug that is active only at acid pH. However, acid pH causes significant difficulty for PZA susceptibility testing. A common problem in PZA testing is false resistance caused by large bacterial inocula. This study investigated the relationship of false resistance to numbers of bacilli, pH and other factors that potentially affect susceptibility to PZA. Large inocula (10(7-8) bacilli/ml) of M. tuberculosis H37Ra caused significant increase in medium pH from 5.5 towards neutrality, and thus produced false resistance results. The increase in medium pH was determined to be a function of live bacilli; heat-killed bacilli had little or no effect. Susceptibility to PZA and its active derivative pyrazinoic acid (POA) was comparable on 7H11 agar medium, but POA was less active than PZA in liquid medium containing bovine serum albumin (BSA), suggesting that susceptibility to PZA or POA was reduced in the presence of BSA, because of its neutralising effect on medium pH and significant POA binding. A 3-month-old H37Ra culture was shown to be more susceptible to PZA exposure than a 4-day log-phase culture, suggesting that PZA is more active for non-growing bacilli. Finally, reserpine, an inhibitor of POA efflux pump, increased susceptibility to PZA even near neutral pH 6.8, with an MIC of 400 mg/L compared with 1,000 mg/L without reserpine. These findings should have implications for understanding the mode of action of PZA and for PZA susceptibility testing.

  11. A Microfluidic Channel Method for Rapid Drug-Susceptibility Testing of Pseudomonas aeruginosa.

    PubMed

    Matsumoto, Yoshimi; Sakakihara, Shouichi; Grushnikov, Andrey; Kikuchi, Kazuma; Noji, Hiroyuki; Yamaguchi, Akihito; Iino, Ryota; Yagi, Yasushi; Nishino, Kunihiko

    2016-01-01

    The recent global increase in the prevalence of antibiotic-resistant bacteria and lack of development of new therapeutic agents emphasize the importance of selecting appropriate antimicrobials for the treatment of infections. However, to date, the development of completely accelerated drug susceptibility testing methods has not been achieved despite the availability of a rapid identification method. We proposed an innovative rapid method for drug susceptibility testing for Pseudomonas aeruginosa that provides results within 3 h. The drug susceptibility testing microfluidic (DSTM) device was prepared using soft lithography. It consisted of five sets of four microfluidic channels sharing one inlet slot, and the four channels are gathered in a small area, permitting simultaneous microscopic observation. Antimicrobials were pre-introduced into each channel and dried before use. Bacterial suspensions in cation-adjusted Mueller-Hinton broth were introduced from the inlet slot and incubated for 3 h. Susceptibilities were microscopically evaluated on the basis of differences in cell numbers and shapes between drug-treated and control cells, using dedicated software. The results of 101 clinically isolated strains of P. aeruginosa obtained using the DSTM method strongly correlated with results obtained using the ordinary microbroth dilution method. Ciprofloxacin, meropenem, ceftazidime, and piperacillin caused elongation in susceptible cells, while meropenem also induced spheroplast and bulge formation. Morphological observation could alternatively be used to determine the susceptibility of P. aeruginosa to these drugs, although amikacin had little effect on cell shape. The rapid determination of bacterial drug susceptibility using the DSTM method could also be applicable to other pathogenic species, and it could easily be introduced into clinical laboratories without the need for expensive instrumentation.

  12. Antibiotic Susceptibility Testing of the Gram-Negative Bacteria Based on Flow Cytometry

    PubMed Central

    Saint-Ruf, Claude; Crussard, Steve; Franceschi, Christine; Orenga, Sylvain; Ouattara, Jasmine; Ramjeet, Mahendrasingh; Surre, Jérémy; Matic, Ivan

    2016-01-01

    Rapidly treating infections with adequate antibiotics is of major importance. This requires a fast and accurate determination of the antibiotic susceptibility of bacterial pathogens. The most frequently used methods are slow because they are based on the measurement of growth inhibition. Faster methods, such as PCR-based detection of determinants of antibiotic resistance, do not always provide relevant information on susceptibility, particularly that which is not genetically based. Consequently, new methods, such as the detection of changes in bacterial physiology caused by antibiotics using flow cytometry and fluorescent viability markers, are being explored. In this study, we assessed whether Alexa Fluor® 633 Hydrazide (AFH), which targets carbonyl groups, can be used for antibiotic susceptibility testing. Carbonylation of cellular macromolecules, which increases in antibiotic-treated cells, is a particularly appropriate to assess for this purpose because it is irreversible. We tested the susceptibility of clinical isolates of Gram-negative bacteria, Escherichia coli and Pseudomonas aeruginosa, to antibiotics from the three classes: β-lactams, aminoglycosides, and fluoroquinolones. In addition to AFH, we used TO-PRO®-3, which enters cells with damaged membranes and binds to DNA, and DiBAC4 (3), which enters cells with depolarized membranes. We also monitored antibiotic-induced morphological alterations of bacterial cells by analyzing light scattering signals. Although all tested dyes and light scattering signals allowed for the detection of antibiotic-sensitive cells, AFH proved to be the most suitable for the fast and reliable detection of antibiotic susceptibility. PMID:27507962

  13. Rapid Screening Tests for Determining In Vitro Susceptibility of Herpes Simplex Virus Clinical Isolates

    PubMed Central

    de la Iglesia, Pedro; Melón, Santiago; López, Beatriz; Rodriguez, Mercedes; Blanco, Maria I.; Mellado, Purificación; de Oña, Maria

    1998-01-01

    The susceptibility of human herpes simplex virus (HSV) to acyclovir (ACV) was determined with the use of a single dose of the drug (1 and 2 μg of ACV per ml for HSV-1 and HSV-2, respectively) in two rapid assays: a rapid cytopathic effect inhibitory assay (Rapid CIA) and a rapid dye uptake assay (Rapid DUA). These tests allow the simultaneous determination of virus titer and susceptibility to ACV at a determined viral concentration (100 50% tissue culture infective doses and 100 50% dye uptake units). These tests were compared with a conventional susceptibility assay (dye uptake assay) and showed similar results. Indeterminate results with the Rapid CIA appeared in 3 of 30 samples. With the use of both Rapid CIA and Rapid DUA, we were able to determine the susceptibility of 100% of the isolates. The rapid tests, unlike conventional assays, are able to provide susceptibility results within 3 days after the virus has been isolated from a clinical specimen and could thus play a direct role in therapeutic decisions. PMID:9666034

  14. Rapid screening tests for determining in vitro susceptibility of herpes simplex virus clinical isolates.

    PubMed

    de la Iglesia, P; Melón, S; López, B; Rodriguez, M; Blanco, M I; Mellado, P; de Oña, M

    1998-08-01

    The susceptibility of human herpes simplex virus (HSV) to acyclovir (ACV) was determined with the use of a single dose of the drug (1 and 2 micrograms of ACV per ml for HSV-1 and HSV-2, respectively) in two rapid assays: a rapid cytopathic effect inhibitory assay (Rapid CIA) and a rapid dye uptake assay (Rapid DUA). These tests allow the simultaneous determination of virus titer and susceptibility to ACV at a determined viral concentration (100 50% tissue culture infective doses and 100 50% dye uptake units). These tests were compared with a conventional susceptibility assay (dye uptake assay) and showed similar results. Indeterminate results with the Rapid CIA appeared in 3 of 30 samples. With the use of both Rapid CIA and Rapid DUA, we were able to determine the susceptibility of 100% of the isolates. The rapid tests, unlike conventional assays, are able to provide susceptibility results within 3 days after the virus has been isolated from a clinical specimen and could thus play a direct role in therapeutic decisions.

  15. Combination antimicrobial susceptibility testing for acute exacerbations in chronic infection of Pseudomonas aeruginosa in cystic fibrosis.

    PubMed

    Waters, Valerie; Ratjen, Felix

    2015-11-02

    Antibiotic therapy for acute pulmonary exacerbations in people with cystic fibrosis (CF) is usually chosen based on the results of antimicrobial susceptibility testing of individual drugs. Combination antimicrobial susceptibility testing assesses the efficacy of drug combinations including two or three antibiotics in vitro and can often demonstrate antimicrobial efficacy against bacterial isolates even when individual antibiotics have little or no effect. Therefore, choosing antibiotics based on combination antimicrobial susceptibility testing could potentially improve response to treatment in people with CF with acute exacerbations. This is an updated version of a previously published review. To compare antibiotic therapy based on conventional antimicrobial susceptibility testing to antibiotic therapy based on combination antimicrobial susceptibility testing in the treatment of acute pulmonary exacerbations in people with CF and chronic infection with P. aeruginosa. We identified relevant trials from the Group's Cystic Fibrosis Trials Register.Latest search: 27 July 2015. Randomised and quasi-randomised controlled trials of antibiotic therapy based on conventional antimicrobial susceptibility testing compared to antibiotic therapy based on combination antimicrobial susceptibility testing in the treatment of acute pulmonary exacerbations in CF due to chronic infection with P. aeruginosa. Both authors independently selected trials, assessed their quality and extracted data from eligible studies. Additionally, the authors contacted the study investigators to obtain further information. The search identified one study eligible for inclusion in the review. This study prospectively assessed whether the use of multiple combination bactericidal antibiotic testing (MCBT) improved clinical outcomes in participants with acute pulmonary exacerbations of CF who were infected with multiresistant bacteria. A total of 132 participants were randomised in the study. The study

  16. Antimicrobial susceptibility testing of bovine digital dermatitis treponemes identifies macrolides for in vivo efficacy testing.

    PubMed

    Evans, N J; Brown, J M; Hartley, C; Smith, R F; Carter, S D

    2012-12-07

    Digital dermatitis (DD) is a major infectious lameness of dairy cattle and sheep considered to be caused by treponemes. The aim of this study was to identify antibiotics effective against DD treponemes that might be useful in the treatment of ruminant DD in the future or to identify antibiotics useful in isolation studies. Here, a microdilution method was used to identify in vitro antimicrobial susceptibility of treponemes cultured from DD lesions to eight relevant antibiotics. DD treponemes exhibited highest susceptibility to amoxicillin, azithromycin and gamithromycin. Unfortunately, amoxicillin whilst having potential for DD treatment in other animals (e.g. sheep) would require milk withhold periods in dairy cattle. DD treponemes were not particularly susceptible to two cephalosporins: cefalexin and ceftiofur, which do not require milk withhold. The bacteria demonstrated low susceptibility to trimethoprim and especially colistin suggesting these antimicrobials may be particularly useful in isolation of DD treponemes. The most promising high susceptibility results for macrolides indicate a rationale to consider veterinary licensed macrolides as DD treatments. Furthermore, given the DD treponeme antibiotic susceptibility similarities to established treatments for human treponematoses, identification of treponemacidal, long acting β-lactam analogues not requiring milk withhold may allow for development of a successful treatment for dairy cattle DD.

  17. Change of antibiotic susceptibility testing guidelines from CLSI to EUCAST: influence on cumulative hospital antibiograms.

    PubMed

    Wolfensberger, Aline; Sax, Hugo; Weber, Rainer; Zbinden, Reinhard; Kuster, Stefan P; Hombach, Michael

    2013-01-01

    We studied whether the change in antibiotic susceptibility testing (AST) guidelines from CLSI to EUCAST influenced cumulative antibiograms in a tertiary care hospital in Switzerland. Antibiotic susceptibilities of non-duplicate isolates collected within a one-year period before (period A) and after (period B) changing AST interpretation from CLSI 2009 to EUCAST 1.3 (2011) guidelines were analysed. In addition, period B isolates were reinterpreted according to the CLSI 2009, CLSI 2013 and EUCAST 3.1 (2013) guidelines. The majority of species/drug combinations showed no differences in susceptibility rates comparing periods A and B. However, in some gram-negative bacilli, decreased susceptibility rates were observed when comparing CLSI 2009 with EUCAST 1.3 within period B: Escherichia coli / cefepime, 95.8% (CLSI 2009) vs. 93.1% (EUCAST 1.3), P=0.005; Enterobacter cloacae / cefepime, 97.0 (CLSI 2009) vs. 90.5% (EUCAST 1.3), P=0.012; Pseudomonas aeruginosa / meropenem, 88.1% (CLSI 2009) vs. 78.3% (EUCAST 1.3), P=0.002. These differences were still evident when comparing susceptibility rates according to the CLSI 2013 guideline with EUCAST 3.1 guideline. For P. aeruginosa and imipenem, a trend towards a lower antibiotic susceptibility rate in ICUs compared to general wards turned into a significant difference after the change to EUCAST: 87.9% vs. 79.8%, P=0.08 (CLSI 2009) and 86.3% vs. 76.8%, P=0.048 (EUCAST 1.3). The change of AST guidelines from CLSI to EUCAST led to a clinically relevant decrease of susceptibility rates in cumulative antibiograms for defined species/drug combinations, particularly in those with considerable differences in clinical susceptibility breakpoints between the two guidelines.

  18. Change of Antibiotic Susceptibility Testing Guidelines from CLSI to EUCAST: Influence on Cumulative Hospital Antibiograms

    PubMed Central

    Wolfensberger, Aline; Sax, Hugo; Weber, Rainer; Zbinden, Reinhard

    2013-01-01

    Objective We studied whether the change in antibiotic susceptibility testing (AST) guidelines from CLSI to EUCAST influenced cumulative antibiograms in a tertiary care hospital in Switzerland. Methods Antibiotic susceptibilities of non-duplicate isolates collected within a one-year period before (period A) and after (period B) changing AST interpretation from CLSI 2009 to EUCAST 1.3 (2011) guidelines were analysed. In addition, period B isolates were reinterpreted according to the CLSI 2009, CLSI 2013 and EUCAST 3.1 (2013) guidelines. Results The majority of species/drug combinations showed no differences in susceptibility rates comparing periods A and B. However, in some gram-negative bacilli, decreased susceptibility rates were observed when comparing CLSI 2009 with EUCAST 1.3 within period B: Escherichia coli / cefepime, 95.8% (CLSI 2009) vs. 93.1% (EUCAST 1.3), P=0.005; Enterobacter cloacae / cefepime, 97.0 (CLSI 2009) vs. 90.5% (EUCAST 1.3), P=0.012; Pseudomonas aeruginosa / meropenem, 88.1% (CLSI 2009) vs. 78.3% (EUCAST 1.3), P=0.002. These differences were still evident when comparing susceptibility rates according to the CLSI 2013 guideline with EUCAST 3.1 guideline. For P. aeruginosa and imipenem, a trend towards a lower antibiotic susceptibility rate in ICUs compared to general wards turned into a significant difference after the change to EUCAST: 87.9% vs. 79.8%, P=0.08 (CLSI 2009) and 86.3% vs. 76.8%, P=0.048 (EUCAST 1.3). Conclusions The change of AST guidelines from CLSI to EUCAST led to a clinically relevant decrease of susceptibility rates in cumulative antibiograms for defined species/drug combinations, particularly in those with considerable differences in clinical susceptibility breakpoints between the two guidelines. PMID:24223893

  19. Serogenotyping and antimicrobial susceptibility testing of Salmonella spp. isolated from retail meat samples in Lagos, Nigeria.

    PubMed

    Smith, Stella; Braun, Sascha; Akintimehin, Faith; Fesobi, Toun; Bamidele, Moses; Coker, Akitoye; Monecke, Stefan; Ehricht, Ralf

    2016-08-01

    Microarray-based serogenotyping, antimicrobial susceptibility tests and the detection of relevant resistance genes were performed on isolates of Salmonella spp. from retail meat samples obtained in Lagos, Nigeria. Out of 151 meat samples, 33 Salmonella isolates were obtained. Nine different Salmonella serovars (S. Amoutive, S. Bargny, S. Drac, S. Ealing, S. Urbana, S. Hadar, S. Nyborg, S. Anatum and S. Havana) were identified by microarray-based serogenotyping and confirmed afterwards using classical serotyping. Antibiotic susceptibility tests with 17 antibiotics showed that almost all isolates were fully susceptible to this panel. The results of this study indicated a high prevalence of Salmonella in retail meat, the presence of some previously rather rarely described Serovars in retail meat samples from Lagos, and a need to monitor for Salmonella and their antibiotic resistance determinants. The microarray-based system used herein proved to be perfectly suited as epidemiological tool to replace classical serotyping. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Results of in vitro contracture tests for the diagnosis of malignant hyperthermia susceptibility in monozygote twins.

    PubMed

    Islander, G; Ranklev Twetman, E

    1997-06-01

    Malignant hyperthermia susceptibility is a pharmacogenetic disorder in which susceptible individuals may develop a potentially life-threatening hypermetabolism when exposed to certain anaesthetic agents. The most common diagnostic method is the in vitro contracture test (IVCT) of skeletal muscle biopsies. There is a wide variation in the size of contractures between susceptible individuals and the reproducibility of the test in humans has not been evaluated. We have performed the IVCT in 4 monozygote pairs of twins, which gave us on opportunity to study the reproducibility. The clinical diagnoses were consistent in all twin pairs, although slight differences in contractures and thresholds were seen. In this material the reproducibility of the IVCT was found to be satisfactory.

  1. Dynamic Biomechanical Examination of the Lumbar Spine with Implanted Total Disc Replacement (TDR) Utilizing a Pendulum Testing System

    PubMed Central

    Daniels, Alan H; Paller, David J; Koruprolu, Sarath; McDonnell, Matthew; Palumbo, Mark A; Crisco, Joseph J

    2013-01-01

    Study Design Biomechanical cadaver investigation Objective To examine dynamic bending stiffness and energy absorption of the lumbar spine with and without implanted Total Disc Replacement (TDR) under simulated physiologic motion. Summary of background data The pendulum testing system is capable of applying physiologic compressive loads without constraining motion of functional spinal units (FSUs). The number of cycles to equilibrium observed under pendulum testing is a measure of the energy absorbed by the FSU. Methods Five unembalmed, frozen human lumbar FSUs were tested on the pendulum system with axial compressive loads of 181N, 282N, 385N, and 488N before and after Synthes ProDisc-L TDR implantation. Testing in flexion, extension, and lateral bending began by rotating the pendulum to 5° resulting in unconstrained oscillatory motion. The number of rotations to equilibrium was recorded and bending stiffness (N-m/°) was calculated and compared for each testing mode. Results In flexion/extension, the TDR constructs reached equilibrium with significantly (p<0.05) fewer cycles than the intact FSU with compressive loads of 282N, 385N and 488N. Mean dynamic bending stiffness in flexion, extension, and lateral bending increased significantly with increasing load for both the intact FSU and TDR constructs (p<0.001). In flexion, with increasing compressive loading from 181N to 488N, the bending stiffness of the intact FSUs increased from 4.0N-m/° to 5.5N-m/°, compared to 2.1N-m/° to 3.6N-m/° after TDR implantation. At each compressive load, the intact FSU was significantly more stiff than the TDR (p<0.05). Conclusion Lumbar FSUs with implanted TDR were found to be less stiff, but also absorbed more energy during cyclic loading with an unconstrained pendulum system. Although the effects on clinical performance of motion preserving devices are not fully known, these results provide further insight into the biomechanical behavior of this device under approximated

  2. Test-Retest Reliability of the Chinese Version of the Diagnostic Interview Schedule for Children-Version 4 (DISC-IV)

    ERIC Educational Resources Information Center

    Ho, Ting-Pong; Leung, Patrick Wing-leung; Lee, Chi-chiu; Tang, Chun-pan; Hung, Se-fong; Kwong, Shi-leung; Lucas, Christopher P.; Lieh-Mak, Felice; Shaffer, David

    2005-01-01

    Background: Despite the huge youth population, there is a lack of psychiatric diagnostic instruments with reported psychometric properties in Chinese. This study reports the development of the Chinese version of DISC-IV and examines its test-retest reliability. Method: Seventy-eight parents and 79 youths (mean age 13.1 years) attending child…

  3. Antimicrobial Susceptibility Testing of Helicobacter pylori in a Large Multicenter Trial: the MACH 2 Study

    PubMed Central

    Mégraud, Francis; Lehn, Norbert; Lind, Tore; Bayerdörffer, Ekkehard; O’Morain, Colm; Spiller, Robin; Unge, Peter; van Zanten, Sander Veldhuyzen; Wrangstadh, Michael; Burman, Carl Fredrik

    1999-01-01

    Culture and susceptibility testing of Helicobacter pylori strains was performed in a large multinational, multicenter randomized clinical trial. Culture was carried out on gastric biopsy samples obtained from 516 patients at entry and had a sensitivity of 99% when the [13C]urea breath test was used as a reference. Susceptibility testing was performed for clarithromycin and metronidazole on 485 strains by an agar dilution method and the epsilometer test (Etest) and for amoxicillin by an agar dilution method only. Resistance to clarithromycin (>1 μg/ml) was found in 3% of the H. pylori strains, with a perfect correlation between Etest and agar dilution methods. Resistance to metronidazole (>8 μl/ml) was found in 27% of the strains by agar dilution, but there were important discrepancies between it and the Etest method. No resistance to amoxicillin was found. The logarithms of the MICs of the three antibiotics against susceptible strains had a distribution close to normal. The impact of resistance was tested in the four arms of the trial. There were not enough clarithromycin-resistant strains to evaluate the impact of resistance on the cure rate of clarithromycin-based regimens. For metronidazole-resistant strains, the impact noted in the clarithromycin-metronidazole arm was partially overcome when omeprazole was added (76% eradication for resistant strains versus 95% for susceptible strains). Secondary resistance to clarithromycin occurred in strains from 12 of 105 patients (11.4%) after the failure of a clarithromycin-based regimen to effect eradication. The detection of point mutations in clarithromycin-resistant strains was performed by a combination of PCR and restriction fragment length polymorphism. Mutations (A2142G and 2143G) were found in all strains tested except one. This study stresses the importance of performing susceptibility tests in clinical trials in order to explain the results of different treatments. PMID:10543758

  4. Recommendation for a Standardised Method of Broth Microdilution Susceptibility Testing for Porcine Bordetella bronchiseptica

    PubMed Central

    Prüller, Sandra; Frömke, Cornelia; Kaspar, Heike; Klein, Günter; Kreienbrock, Lothar; Kehrenberg, Corinna

    2015-01-01

    The objective was to establish and standardise a broth microdilution susceptibility testing method for porcine Bordetella (B.) bronchiseptica. B. bronchiseptica isolates from different geographical regions and farms were genotyped by macrorestriction analysis and subsequent pulsed-field gel electrophoresis. One reference and one type strain plus two field isolates of B. bronchiseptica were chosen to analyse growth curves in four different media: cation-adjusted Mueller-Hinton broth (CAMHB) with and without 2% lysed horse blood, Brain-Heart-Infusion (BHI), and Caso broth. The growth rate of each test strain in each medium was determined by culture enumeration and the suitability of CAMHB was confirmed by comparative statistical analysis. Thereafter, reference and type strain and eight epidemiologically unrelated field isolates of B. bronchiseptica were used to test the suitability of a broth microdilution susceptibility testing method following CLSI-approved performance standards given in document VET01-A4. Susceptibility tests, using 20 antimicrobial agents, were performed in five replicates, and data were collected after 20 and 24 hours incubation and statistically analysed. Due to the low growth rate of B. bronchiseptica, an incubation time of 24 hours resulted in significantly more homogeneous minimum inhibitory concentrations after five replications compared to a 20-hour incubation. An interlaboratory comparison trial including susceptibility testing of 24 antimicrobial agents revealed a high mean level of reproducibility (97.9%) of the modified method. Hence, in a harmonization for broth microdilution susceptibility testing of B. bronchiseptica, an incubation time of 24 hours in CAMHB medium with an incubation temperature of 35°C and an inoculum concentration of approximately 5 x 105 cfu/ml was proposed. PMID:25910232

  5. Negative temperament as a moderator of intervention effects in infancy: testing a differential susceptibility model.

    PubMed

    Anzman-Frasca, Stephanie; Stifter, Cynthia A; Paul, Ian M; Birch, Leann L

    2014-10-01

    A consideration of potential moderators can highlight intervention effects that are attenuated when investigating aggregate results. Differential susceptibility is one type of interaction, where susceptible individuals have poorer outcomes in negative environments and better outcomes in positive environments, compared to less susceptible individuals, who have moderate outcomes regardless of environment. In the current study, we provide rationale for investigating this type of interaction in the context of a behavioral childhood obesity preventive intervention and test whether infant negativity moderated intervention effects on infant self-regulation and weight gain and on two aspects of mothers' parenting competence: parenting self-efficacy and parenting satisfaction. Results showed that infants' negative temperament at 3 weeks moderated intervention effects on some, but not all, outcomes. The intervention led to greater parenting satisfaction in mothers with highly negative infants but did not affect parenting satisfaction in mothers with less negative infants, consistent with a model of differential susceptibility. There was also a trend toward less weight gain in highly negative intervention group infants. In contrast, there was a main effect of the intervention on infant self-regulation at 1 year, such that the intervention group had higher observed self-regulation, across levels of infant negativity. Results support the importance of incorporating tests of moderation into evaluations of obesity interventions and also illustrate that individuals may be differentially susceptible to environmental effects on some outcomes but not others.

  6. Mode-Stirred Method Implementation for HIRF Susceptibility Testing and Results Comparison with Anechoic Method

    NASA Technical Reports Server (NTRS)

    Nguyen, Truong X.; Ely, Jay J.; Koppen, Sandra V.

    2001-01-01

    This paper describes the implementation of mode-stirred method for susceptibility testing according to the current DO-160D standard. Test results on an Engine Data Processor using the implemented procedure and the comparisons with the standard anechoic test results are presented. The comparison experimentally shows that the susceptibility thresholds found in mode-stirred method are consistently higher than anechoic. This is consistent with the recent statistical analysis finding by NIST that the current calibration procedure overstates field strength by a fixed amount. Once the test results are adjusted for this value, the comparisons with the anechoic results are excellent. The results also show that test method has excellent chamber to chamber repeatability. Several areas for improvements to the current procedure are also identified and implemented.

  7. Rapid, modified Kirby-Bauer susceptibility test with single, high-concentration antimicrobial disks.

    PubMed

    Boyle, V J; Fancher, M E; Ross, R W

    1973-03-01

    A rapid (6-7 hr), modified Kirby-Bauer disk-susceptibility method, by which derivatives of tetrazolium dyes are used to enhance delineation between areas of growth and zones of inhibition, has been developed. Inoculated petri plates, prepared by the Kirby-Bauer method, were sprayed, after 6 to 7 hr of incubation (37 C), with aqueous solutions of MTT-tetrazolium or INT-tetrazolium resulting in readily detectable zones of inhibition. Excellent correlation was obtained between the modified test and the standard Kirby-Bauer test when challenged with a variety of gram-negative bacteria and Staphylococcus aureus strains. Additionally, the modified test has demonstrated reproducibility comparable to the standard Kirby-Bauer test. It is demonstrated that the modified test is applicable to susceptibility determinations with representative, commercially available antimicrobial disks. This applicability indicates that the modified method could provide rapid in vitro guidelines for in vivo therapy.

  8. Accuracy of in vitro susceptibility tests for carbapenemase-producing Gram-negative bacteria.

    PubMed

    Sun, Jingyong; Xu, Yingchun; Yu, Yunsong; Ni, Yuxing

    2015-06-01

    Accurate susceptibility results on antibiotic-resistant bacteria are essential for proper treatment of infections. In this study, 100 metallo-β-lactamase (MBL)-producing strains and 95 isolates with Klebsiella pneumoniae carbapenemase (KPC) were tested for carbapenem susceptibility using two automated platforms, the Phoenix and Vitek-2 systems, and a manual Etest. Phoenix showed higher categorical agreements (97% for imipenem and 94% for meropenem) compared with those from Vitek-2 (92 and 74%) and Etest (89 and 96%), respectively, when testing MBL strains. Categorical agreement for imipenem tests with KPC-producing strains was 88.4% with the Phoenix system, 83.2% with the Vitek 2 system and 90.5% with the Etest. Categorical agreement was 100% for all tests with ertapenem. In conclusion, the Phoenix system demonstrated a higher accuracy than Vitek-2 in testing carbapenemase-producing strains, particularly in MBL strains.

  9. Comparative study of agar diffusion test and the NCCLS macrobroth method for in vitro susceptibility testing of Candida spp.

    PubMed

    Soni, L M; Burattini, M N; Pignatari, A C; Gompertz, O F; Colombo, A L

    1999-01-01

    We performed a prospective double-blind study to evaluate the correlation between inhibition zones obtained by a disk-diffusion test, using Neo-sensitabs of fluconazole (Rosco Diagnostica), and the MICs generated by the NCCLS macrobroth dilution assay. Eighty clinical isolates, representing 5 of the clinically relevant species of Candida, were tested simultaneously by both methods. A clear inverse correlation was found between the results obtained by both tests (r = -0.69). In addition, there was high degree of agreement between methods in the identification of susceptible isolates. However, the resistance definition by disk-diffusion test had a positive predictive value of only 17%. Our data support the hypothesis that Rosco Fluconazole Neo-sensitabs have potential as a screening test for the identification of Candida isolates susceptible to fluconazole. Resistant isolates should be further investigated by standardized broth procedures.

  10. Dobutamine "stress" test and latent cardiac susceptibility to inhaled diesel exhaust in normal and hypertensive rats**

    EPA Science Inventory

    Background -Exercise "stress" testing is a screening tool used to determine the amount of stress for which the heart can compensate before developing abnormal rhythm or ischemia, particularly in susceptible people. Although this approach has been used to assess risk in humans exp...

  11. Antimicrobials, susceptibility testing, and minimum inhibitory concentrations (MIC) in veterinary infection treatment.

    PubMed

    Papich, Mark G

    2013-09-01

    Veterinarians are quick to attribute an unsuccessful antimicrobial treatment to a failure of the culture and susceptibility test. There are many reasons why antimicrobial treatment fails. When evaluating a patient that has failed to respond to therapy, one must consider any of the many factors that contribute to antibiotic failure.

  12. Dobutamine "stress" test and latent cardiac susceptibility to inhaled diesel exhaust in normal and hypertensive rats**

    EPA Science Inventory

    Background -Exercise "stress" testing is a screening tool used to determine the amount of stress for which the heart can compensate before developing abnormal rhythm or ischemia, particularly in susceptible people. Although this approach has been used to assess risk in humans exp...

  13. Blood Agar Validation for Susceptibility Testing of Isoniazid, Rifampicin, Ethambutol, and Streptomycin to Mycobacterium tuberculosis Isolates

    PubMed Central

    Coban, Ahmet Yilmaz

    2013-01-01

    In recent studies, it was shown that blood agar can be used at least as effectively as Löwenstein-Jensen medium for growing Mycobacterium tuberculosis. It was also shown that susceptibility testing can be performed on blood agar. Additional validation of blood agar was performed on regional M. tuberculosis isolates from Turkey to determine critical concentrations of isoniazid (INH), rifampicin (RIF), ethambutol (ETM), and streptomycin (STR). In the current study, 40 M. tuberculosis clinical isolates were tested. H37Rv, which is susceptible to all antituberculosis agents, ATCC 35822 (INH-resistant), ATCC 35838 (RIF-resistant), ATCC 35837 (ETM-resistant), and ATCC 35820 (STR-resistant) quality control strains were used as control strains. Proportion method on 7H11 agar was considered as gold standard in the study. MIC values of the control strains and clinical isolates were detected on blood and 7H11 agar. Categorical agreements were 100% for each antibiotic, and essential agreements were 100%, 97.5%, 82.5%, and 95% for INH, RIF, ETM, and STR, respectively. According to the data, 0.2 µg/mL for INH, 1 µg/mL for RIF, 4 µg/mL for ETM, and 2 µg/mL for STR were appropriate breakpoint values for susceptibility testing on blood agar. Blood agar may be recommended for use in both developed and developing countries for the susceptibility testing of M. tuberculosis isolates to primary antituberculosis drugs. PMID:23405140

  14. 21 CFR 866.1700 - Culture medium for antimicrobial susceptibility tests.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Culture medium for antimicrobial susceptibility tests. 866.1700 Section 866.1700 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Diagnostic Devices § 866...

  15. 21 CFR 866.1700 - Culture medium for antimicrobial susceptibility tests.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Culture medium for antimicrobial susceptibility tests. 866.1700 Section 866.1700 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Diagnostic Devices § 866...

  16. Contemporary tetracycline susceptibility testing: doxycycline MIC methods and interpretive criteria (CLSI and EUCAST) performance when testing Gram-positive pathogens.

    PubMed

    Jones, Ronald N; Stilwell, Matthew G; Wilson, Michael L; Mendes, Rodrigo E

    2013-05-01

    International susceptibility testing breakpoint organizations and regulatory agencies have markedly differing interpretive criteria for the tetracycline class. Here we examined the magnitude of these differences for doxycycline and tetracycline hydrochloride (HCL) when tested against a collection of 13,176 Gram-positive cocci from a worldwide surveillance network (SENTRY Antimicrobial Surveillance Program, 2010). Clinical and Laboratory Standards Institute (CLSI) breakpoints are routinely higher, usually 4-fold, compared to those of the European Committee on Antimicrobial Susceptibility Testing (EUCAST); however, CLSI recently (2013) modified Streptococcus pneumoniae breakpoints (≤ 2 μg/mL in 2012) to ≤ 0.25 and ≤ 1 μg/mL for doxycycline and tetracycline HCL, respectively. We report that these changes are a promising step toward international breakpoint harmonization, but lack a comprehensive approach needed for testing tetracyclines against all Gram-positive cocci. Generally, EUCAST breakpoint criteria showed i) lower spectrums (reduced susceptibility rates) for the tetracyclines, but highest for doxycycline versus all species examined; ii) greater test accuracy (lower predictive categorical errors), especially for tetracycline to predict doxycycline susceptibility (99.91%); and iii) zone diameter correlate breakpoints which are generally available online. Molecular tests for tet resistance genes demonstrate that tet (K) and tet (M) containing strains can occur in the susceptible population of MIC results by both CLSI and EUCAST breakpoint criteria. In summary, doxycycline continues to show greater comparative potency versus tetracycline HCL against all monitored Gram-positive species and the international harmonization of tetracycline breakpoints should be a priority, as the most recent CLSI update only addressed 1 streptococcal species and 2 tetracycline agents.

  17. Multilaboratory Evaluation of In Vitro Antifungal Susceptibility Testing of Dermatophytes for ME1111

    PubMed Central

    Chaturvedi, V.; Diekema, D.; Ostrosky-Zeichner, L.; Rennie, R.; Walsh, T.; Wengenack, N.; Fothergill, A.; Wiederhold, N.

    2015-01-01

    ME1111 is a novel small molecule antifungal agent under development for the topical treatment of onychomycosis. Standardization of the susceptibility testing method for this candidate antifungal is needed. Toward this end, 8 independent laboratories determined the interlaboratory reproducibility of ME1111 susceptibility testing. In addition, we subsequently identified 2 strains as quality control (QC) isolates for the method. In the reproducibility study, 5 blinded clinical strains each of Trichophyton rubrum, Trichophyton mentagrophytes, and Epidermophyton floccosum were tested, while the QC study tested 6 blinded T. rubrum or T. mentagrophytes ATCC strains. Testing was performed in frozen microtiter panels according to the Clinical and Laboratory Standards Institute (CLSI) M38-A2 methodology. In the reproducibility study, 9 of 15 clinical strains showed interlaboratory agreement of >90% at the 80% inhibition endpoint, with a range of agreement of 76.2% to 100%. In the QC study, 4 of the 6 ATCC strains showed interlaboratory agreement of >90%. ME1111 demonstrated excellent interlaboratory agreement when tested against dermatophytes. Based on this data, the CLSI Subcommittee on Antifungal Susceptibility Tests approved the susceptibility testing of ME1111 against dermatophytes according to M38-A2 methodology, which stipulates RPMI 1640 as the test medium, an inoculum size of 1 to 3 × 103 CFU/ml, and an incubation time and temperature of 96 h at 35°C. The MIC endpoint should be 80% inhibition compared with the growth control. T. rubrum ATCC MYA-4438 and T. mentagrophytes ATCC 28185 were selected as QC isolates, with an acceptable range of 0.12 to 1 μg/ml for the two strains. PMID:26719434

  18. Antimicrobial Susceptibility Testing, Drug Resistance Mechanisms, and Therapy of Infections with Nontuberculous Mycobacteria

    PubMed Central

    Nash, Kevin A.; Wallace, Richard J.

    2012-01-01

    Summary: Within the past 10 years, treatment and diagnostic guidelines for nontuberculous mycobacteria have been recommended by the American Thoracic Society (ATS) and the Infectious Diseases Society of America (IDSA). Moreover, the Clinical and Laboratory Standards Institute (CLSI) has published and recently (in 2011) updated recommendations including suggested antimicrobial and susceptibility breakpoints. The CLSI has also recommended the broth microdilution method as the gold standard for laboratories performing antimicrobial susceptibility testing of nontuberculous mycobacteria. This article reviews the laboratory, diagnostic, and treatment guidelines together with established and probable drug resistance mechanisms of the nontuberculous mycobacteria. PMID:22763637

  19. Diagnosis of coccidioidomycosis by culture: safety considerations, traditional methods, and susceptibility testing.

    PubMed

    Sutton, Deanna A

    2007-09-01

    The recovery of Coccidioides spp. by culture and confirmation utilizing the AccuProbe nucleic acid hybridization method by GenProbe remain the definitive diagnostic method. Biosafety considerations from specimen collection through culture confirmation in the mycology laboratory are critical, as acquisition of coccidioidomycosis by laboratory workers is well documented. The designation of Coccidioides spp. as select agents of potential bioterrorism has mandated strict regulation of their transport and inventory. The genus appears generally susceptible, in vitro, although no defined breakpoints exist. Susceptibility testing may assist in documenting treatment failures.

  20. Characterization of biofilm growth and biocide susceptibility testing of Mycobacterium phlei using the MBEC assay system.

    PubMed

    Bardouniotis, E; Huddleston, W; Ceri, H; Olson, M E

    2001-09-25

    The importance of non-tuberculosis mycobacterial biofilm species in medicine, industry and the environment has recently gained attention. Our objectives were to characterize biofilm growth of Mycobacterium phlei M4, as a model of rapidly growing mycobacteria using the minimal biofilm eradication concentration (MBEC) and to compare biocide susceptibility of planktonic and biofilm organisms. Scanning electron microscopy was also carried out to observe biofilm morphology. With the exception of Sporicidin and Virkon the minimum bactericidal concentration values for all biocides tested were lower than the MBEC values. The MBEC assay system was seen to produce multiple and reproducible biofilms of M. phlei and to be a useful tool for susceptibility studies.

  1. Computerised emission and susceptibility MIL.STD testing with automated NB/BB detection

    NASA Astrophysics Data System (ADS)

    Vanessen, J. C.

    1990-09-01

    Automation of Electromagnetic Compatibility (EMC) testing is becoming common at many EMC test facilities. Commercial automated systems have become available in the past few years. The test and operations section has developed its own EMC automation to enhance and aid in testing. A complete overview of the automated EMC test facility in operation for emission and susceptibility measurements is presented. It includes a hardware description, the program structure and some of the methods required to complete such a program on the equipment chosen, including the Narrow Band (NB) and Broad Band (BB).

  2. Proficiency of drug susceptibility testing of Mycobacterium tuberculosis against pyrazinamide: the Swedish experience.

    PubMed

    Hoffner, S; Angeby, K; Sturegård, E; Jönsson, B; Johansson, A; Sellin, M; Werngren, J

    2013-11-01

    Pyrazinamide (PZA) is a key drug in the treatment of tuberculosis (TB), including multidrug-resistant TB. Drug susceptibility testing (DST) of Mycobacterium tuberculosis against PZA is not included in the World Health Organization's yearly proficiency testing. There is an increasing need to establish quality control of PZA DST. To evaluate the performance of PZA DST and to introduce a quality assurance system for the test in Sweden. Panels with PZA-susceptible and -resistant isolates were used in three rounds of proficiency testing in all five Swedish clinical TB laboratories and our reference laboratory. All laboratories used the MGIT 960 system. Minimum inhibitory concentrations (MICs) were determined and the pncA gene was sequenced to further characterise the 52 panel strains. Good agreement was seen between the phenotypic PZA DST and pncA sequence data, and MIC determination confirmed high levels of resistance. However, in contrast to other drugs, for which correct proficiency test results were observed, specificity problems occurred for PZA DST in some laboratories. In Sweden, using panel testing, differences were seen in the proficiency of TB laboratories in correctly identifying PZA susceptibility. Improved results were noted in the third round; PZA has therefore been included in yearly proficiency testing.

  3. Simultaneous titration and phenotypic antiviral drug susceptibility testing for herpes simplex virus 1 and 2.

    PubMed

    Tardif, Keith D; Jorgensen, Shane; Langer, Janine; Prichard, Mark; Schlaberg, Robert

    2014-11-01

    Most herpes simplex virus (HSV) isolates from treatment-naïve patients are susceptible to antivirals. However, prolonged antiviral therapy can select for drug-resistant strains, especially in immunocompromised patients. Standard phenotypic methods for antiviral resistance testing are labor and time-intense and molecular resistance determinants are insufficiently understood for routine diagnostic use of genotypic resistance testing. To enable rapid, scalable antiviral susceptibility testing and minimize viral passage, we developed a 7-day, 96-well assay for simultaneous HSV 1/2 titration and phenotypic resistance testing for acyclovir and foscarnet. The assay was optimized and validated by testing clinical isolates and laboratory strains (n=39) with known IC50 for acyclovir (23 resistant) and foscarnet (1 resistant) based on plaque reduction or dye-uptake assays. A chemiluminescent detection reagent is used for quantification of cytopathic effect instead of plaque counting or measuring dye-uptake. Drug concentrations inhibiting 50% of chemiluminescent signal reduction (IC50) were determined concurrently at each of three virus dilutions. Results agree for 92.3% (acyclovir) and 100% (foscarnet) of isolates. For all three discordant samples, results of reference testing by plaque reduction agreed with the chemiluminescent assay. Reproducibility studies showed 100% qualitative agreement and 3-37% coefficient of variation based on IC50. Chemiluminescence detection as a surrogate for cellular viability with an automated plate reader provides improved throughput and workflow, as well as high accuracy and reproducibility for antiviral drug susceptibility testing. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. "All-in-one-plate" E-test and disk diffusion susceptibility co-testing for multiresistant Acinetobacter baumannii.

    PubMed

    Gilad, J; Giladi, M; Poch, F; Aharoni, Y; Schwartz, D

    2006-12-01

    Multiresistant Acinetobacter baumannii requires ancillary manual susceptibility testing with the E-test and disk diffusion when tested with the VITEK-2 system (bioMérieux, Marcy l'Etoile, France). In the study presented here, the E-test and disk diffusion were combined in a single plate, and the method was verified by comparing categorical agreement of combined and control plates. There were no very major, major or minor errors, and similar results were obtained for all ten representative bacterial strains used as controls. Co-testing is thus feasible, accurate and reproducible, and it merits evaluation with other bacterial species.

  5. New concepts in antimicrobial susceptibility testing: the mutant prevention concentration and mutant selection window approach.

    PubMed

    Blondeau, Joseph M

    2009-10-01

    Current measurements of antimicrobial susceptibility or resistance utilize a standardized bacterial inoculum (10(5) cfu/mL) exposed to varying drug concentrations in a test tube. Following incubation under ideal conditions, the lowest drug concentration inhibiting growth is the minimum inhibitory concentration (MIC). When the MIC exceeds the amount of drug that can be safely achieved in the body, we call these microorganisms resistant; established breakpoints for various 'bug-drug' combinations are used to categorize microorganisms as susceptible, intermediate or resistant. MIC testing has been used for decades to guide antimicrobial therapy and remains an important measurement for infectious diseases. More recently, the mutant prevention concentration (MPC) has been described as a novel measurement of in vitro susceptibility or resistance and is based on the testing of larger bacterial inocula, i.e. > or =10(9) cfu/mL - such as those associated with some infections in humans and animals. MPC defines the lowest drug concentration required to block the growth of the least susceptible cell present in high density bacterial populations. MPC testing applies to microorganisms considered susceptible to the drug by MIC testing. The mutant selection window (MSW) defines the 'danger zone' for therapeutic drug concentrations. Minimizing the length of time the drug concentration remains in the MSW may reduce the likelihood for resistance selection during therapy. The MSW is bordered by the MIC and MPC values and the drug concentration range between the measured MIC and MPC values defines the MSW. MPC values, when considered with drug pharmacology, may allow prediction on the probability of resistance selection when bacteria are exposed to antimicrobial agents during therapy for infectious diseases. In today's environment, resistance prevention should be a goal of antimicrobial therapy.

  6. [Performance evaluation of VITEK 2 system in meropenem susceptibility testing of clinical Pseudomonas aeruginosa isolates].

    PubMed

    Acuner, Ibrahim Cağatay; Bayramoğlu, Gülçin; Birinci, Asuman; Cekiç Cihan, Ciğdem; Bek, Yüksel; Durupınar, Belma

    2011-07-01

    Pseudomonas aeruginosa is an important opportunistic pathogen associated with various community-acquired or nosocomial infections. Multi-drug resistant P.aeruginosa strains increasingly cause epidemics and spread in various hospital wards and geographic regions. Carbapenems are among the most effective antimicrobials in the treatment of multi-drug resistant P.aeruginosa infections, and meropenem is the most successful among alternatives in initial therapy. Particularly in severe infections, inappropriate or inadequate initial antimicrobial therapy is independently associated with adverse clinical and economic outcomes. Availability of accurate and rapid susceptibility testing is a priority. Most of the automated microbiology systems can provide rapid results within 8 to 12 hours. In comparison to standard methods, problems in the antimicrobial susceptibility testing of particular microorganisms and antimicrobial agents have been reported for automated microbiology systems. Failures have been reported previously especially in the susceptibility testing of P.aeruginosa versus carbapenem. Most of these studies are designed according to the Food and Drug Administration (FDA, USA) performance analysis scheme (Class II Special Controls Guidance Document: Antimicrobial Susceptibility Test Systems) in a simplified form. However, there are many lacking issues in the design of most of these studies. Among these, insufficient sample size, use of inappropriate reference method, lack of reproducibility testing, and inadequate distribution of study isolates in interpretative categories are of notice. There are only few studies in the literature that evaluate the performance of automated systems in antimicrobial susceptibility testing of carbapenems in clinical P.aeruginosa isolates with a sufficient sample size (n ? 100). However, most of these studies still have one or more major deficiencies in the study design. Furthermore, none of these studies evaluate the performance of

  7. Women's receptivity to testing for a genetic susceptibility to breast cancer.

    PubMed

    Chaliki, H; Loader, S; Levenkron, J C; Logan-Young, W; Hall, W J; Rowley, P T

    1995-08-01

    Four hundred eighty-four patients undergoing mammography and 498 patients visiting their obstetrician-gynecologist were asked whether they would take a breast cancer 1 (BRCA1) test to detect a genetic susceptibility to breast cancer. More than 90% in both groups said they would take the test. Women were more likely to accept if they were regularly having breast examinations by a physician, believed that mammography effectively detects early breast cancer, and believed that early breast cancer is curable. If shown to have inherited a susceptibility, many reported that they would be very anxious, would want the test repeated, would examine their breasts more often than monthly, and would want mammography more often than yearly. Many also reported that they would recommend testing to relatives.

  8. Women's receptivity to testing for a genetic susceptibility to breast cancer.

    PubMed Central

    Chaliki, H; Loader, S; Levenkron, J C; Logan-Young, W; Hall, W J; Rowley, P T

    1995-01-01

    Four hundred eighty-four patients undergoing mammography and 498 patients visiting their obstetrician-gynecologist were asked whether they would take a breast cancer 1 (BRCA1) test to detect a genetic susceptibility to breast cancer. More than 90% in both groups said they would take the test. Women were more likely to accept if they were regularly having breast examinations by a physician, believed that mammography effectively detects early breast cancer, and believed that early breast cancer is curable. If shown to have inherited a susceptibility, many reported that they would be very anxious, would want the test repeated, would examine their breasts more often than monthly, and would want mammography more often than yearly. Many also reported that they would recommend testing to relatives. PMID:7625512

  9. Comparison between E-test and CLSI broth microdilution method for antifungal susceptibility testing of Candida albicans oral isolates.

    PubMed

    Koga-Ito, Cristiane Yumi; Lyon, Juliana Pereira; Resende, Maria Aparecida de

    2008-01-01

    Thirty Candida albicans isolated from oral candidosis patients and 30 C. albicans isolated from control individuals were studied. In vitro susceptibility tests were performed for amphotericin B, fluconazole, 5-flucytosine and itraconazole through the Clinical and Laboratorial Standards Institute (CLSI) reference method and E test system. The results obtained were analyzed and compared. MIC values were similar for the strains isolated from oral candidosis patients and control individuals. The agreement rate for the two methods was 66.67% for amphotericin B, 53.33% for fluconazole, 65% for flucytosine and 45% for itraconazole. According to our data, E test method could be an alternative to trial routine susceptibility testing due to its simplicity. However, it can not be considered a substitute for the CLSI reference method.

  10. Rapid bacterial antibiotic susceptibility test based on simple surface-enhanced Raman spectroscopic biomarkers.

    PubMed

    Liu, Chia-Ying; Han, Yin-Yi; Shih, Po-Han; Lian, Wei-Nan; Wang, Huai-Hsien; Lin, Chi-Hung; Hsueh, Po-Ren; Wang, Juen-Kai; Wang, Yuh-Lin

    2016-03-21

    Rapid bacterial antibiotic susceptibility test (AST) and minimum inhibitory concentration (MIC) measurement are important to help reduce the widespread misuse of antibiotics and alleviate the growing drug-resistance problem. We discovered that, when a susceptible strain of Staphylococcus aureus or Escherichia coli is exposed to an antibiotic, the intensity of specific biomarkers in its surface-enhanced Raman scattering (SERS) spectra drops evidently in two hours. The discovery has been exploited for rapid AST and MIC determination of methicillin-susceptible S. aureus and wild-type E. coli as well as clinical isolates. The results obtained by this SERS-AST method were consistent with that by the standard incubation-based method, indicating its high potential to supplement or replace existing time-consuming methods and help mitigate the challenge of drug resistance in clinical microbiology.

  11. Rapid bacterial antibiotic susceptibility test based on simple surface-enhanced Raman spectroscopic biomarkers

    PubMed Central

    Liu, Chia-Ying; Han, Yin-Yi; Shih, Po-Han; Lian, Wei-Nan; Wang, Huai-Hsien; Lin, Chi-Hung; Hsueh, Po-Ren; Wang, Juen-Kai; Wang, Yuh-Lin

    2016-01-01

    Rapid bacterial antibiotic susceptibility test (AST) and minimum inhibitory concentration (MIC) measurement are important to help reduce the widespread misuse of antibiotics and alleviate the growing drug-resistance problem. We discovered that, when a susceptible strain of Staphylococcus aureus or Escherichia coli is exposed to an antibiotic, the intensity of specific biomarkers in its surface-enhanced Raman scattering (SERS) spectra drops evidently in two hours. The discovery has been exploited for rapid AST and MIC determination of methicillin-susceptible S. aureus and wild-type E. coli as well as clinical isolates. The results obtained by this SERS-AST method were consistent with that by the standard incubation-based method, indicating its high potential to supplement or replace existing time-consuming methods and help mitigate the challenge of drug resistance in clinical microbiology. PMID:26997474

  12. Rapid bacterial antibiotic susceptibility test based on simple surface-enhanced Raman spectroscopic biomarkers

    NASA Astrophysics Data System (ADS)

    Liu, Chia-Ying; Han, Yin-Yi; Shih, Po-Han; Lian, Wei-Nan; Wang, Huai-Hsien; Lin, Chi-Hung; Hsueh, Po-Ren; Wang, Juen-Kai; Wang, Yuh-Lin

    2016-03-01

    Rapid bacterial antibiotic susceptibility test (AST) and minimum inhibitory concentration (MIC) measurement are important to help reduce the widespread misuse of antibiotics and alleviate the growing drug-resistance problem. We discovered that, when a susceptible strain of Staphylococcus aureus or Escherichia coli is exposed to an antibiotic, the intensity of specific biomarkers in its surface-enhanced Raman scattering (SERS) spectra drops evidently in two hours. The discovery has been exploited for rapid AST and MIC determination of methicillin-susceptible S. aureus and wild-type E. coli as well as clinical isolates. The results obtained by this SERS-AST method were consistent with that by the standard incubation-based method, indicating its high potential to supplement or replace existing time-consuming methods and help mitigate the challenge of drug resistance in clinical microbiology.

  13. A review of the current state of antimicrobial susceptibility test methods for Brachyspira.

    PubMed

    Kulathunga, Dharmasiri G R S; Rubin, Joseph E

    2017-03-21

    The re-emergence of swine dysentery (Brachyspira-associated muco-haemorrhagic colitis) since the late 2000's has illuminated diagnostic challenges associated with this genus. The methods used to detect, identify and characterize Brachyspira from clinical samples have not been standardized and laboratories frequently rely heavily on in-house techniques. Particularly concerning is the lack of standardized methods for determining and interpreting the antimicrobial susceptibility of Brachyspira spp. The integration of laboratory data into a treatment plan is a critical component of prudent antimicrobial usage, the lack of standardized methods is therefore an important limitation to the evidence based use of antimicrobials. This review will focus on describing the methodological limitations and inconsistencies between current susceptibility testing schemes employed for Brachyspira, provide an overview of what we do know about the susceptibility of these organisms and suggest future directions to improve and standardize diagnostic strategies.

  14. SUSCEPTIBILITY TEST FOR FUNGI: CLINICAL AND LABORATORIAL CORRELATIONS IN MEDICAL MYCOLOGY

    PubMed Central

    ALASTRUEY-IZQUIERDO, Ana; MELHEM, Marcia S.C.; BONFIETTI, Lucas X.; RODRIGUEZ-TUDELA, Juan L.

    2015-01-01

    SUMMARY During recent decades, antifungal susceptibility testing has become standardized and nowadays has the same role of the antibacterial susceptibility testing in microbiology laboratories. American and European standards have been developed, as well as equivalent commercial systems which are more appropriate for clinical laboratories. The detection of resistant strains by means of these systems has allowed the study and understanding of the molecular basis and the mechanisms of resistance of fungal species to antifungal agents. In addition, many studies on the correlation of in vitro results with the outcome of patients have been performed, reaching the conclusion that infections caused by resistant strains have worse outcome than those caused by susceptible fungal isolates. These studies have allowed the development of interpretative breakpoints for Candida spp. and Aspergillus spp., the most frequent agents of fungal infections in the world. In summary, antifungal susceptibility tests have become essential tools to guide the treatment of fungal diseases, to know the local and global disease epidemiology, and to identify resistance to antifungals. PMID:26465371

  15. Comparison of the CLSI guideline and ISO/IDF standard for antimicrobial susceptibility testing of Lactobacilli.

    PubMed

    Mayrhofer, Sigrid; Zitz, Ulrike; Birru, Firew H; Gollan, Dagmar; Gołoś, Aleksandra K; Kneifel, Wolfgang; Domig, Konrad J

    2014-12-01

    Lactobacilli play a crucial role as probiotics and as starter cultures in the production of fermented foods. Although lactobacilli are a technologically useful and beneficial group of bacteria, a few members of them have been rarely correlated with bacterial infections. Correspondingly, clinicians are interested in the antimicrobial susceptibility of lactobacilli. In addition, antimicrobial susceptibility testing (AST) is also relevant for commercially applied lactobacilli as bacterial strains harboring transferable antibiotic resistance genes should not be used in fermented and probiotic foods. Therefore, two methods were developed by different organizations, which were compared within this study. For this purpose, 22 Lactobacillus-type strains were tested for their antimicrobial susceptibility to 16 antibiotics following the procedures of the Clinical and Laboratory Standards Institute (CLSI) and the International Organization of Standardization (ISO)/International Dairy Federation (IDF). Crucial discrepancies between both procedures were detected mainly due to the different AST media. Hence, half of the strains tested did not consistently grow in the CLSI medium, whereas all showed evaluable growth in the ISO/IDF medium. However, some antibiotics were influenced by the latter medium. In particular, low levels of essential agreement between both methods were obtained with seven antibiotics. Accordingly, different interpretative criteria are needed for both procedures to distinguish resistant from susceptible strains.

  16. Auditory Tests for the Early Detection of Noise-Susceptible Individuals - A Literature Study

    DTIC Science & Technology

    2005-04-01

    continues to be a high incidence of noise-induced hearing loss ( NIHL ) among military personnel. One of the ways to reduce the adverse effects of...to NIHL . In the literature various auditory tests are proposed that measure items such as loudness discrimination, octave masking, frequency...of the individual susceptibility to NIHL can only be determined in longitudinal studies. In such studies, the promising auditory tests have to be

  17. Lumbar disc herniations: the predictive value of the Health Attribution Test (HAT) and the Minnesota Multiphasic Personality Inventory (MMPI).

    PubMed

    Herron, L D; Turner, J A; Weiner, P

    1988-01-01

    Ninety-one patients who were treated for lumbar disc herniation with chymopapain chemonucleolysis were evaluated preoperatively by means of the Health Attribution Test (HAT) and the Minnesota Multiphasic Personality Inventory (MMPI). There were 54 good, 10 fair, and 27 poor results after chemo-nucleolysis. Nineteen patients subsequently underwent lumbar laminectomy and discectomy and the ultimate outcome for the entire series including these laminectomy patients was 66 good, 10 fair, and 15 poor results. The fair/poor chemonucleolysis outcome patients scored significantly lower than did the good outcome patients on the HAT Powerful Others and significantly higher on the Chance scale. Patients with fair or poor outcomes after chemonucleolysis only scored significantly higher on the Hypochondriasis, Hysteria, Psychopathic Deviate, Paranoia, and Hypomania scales in preoperative MMPI testing. Good versus fair/poor ultimate outcome patients differed significantly on preoperative MMPI Hypochondriasis, Hysteria, Psychopathic Deviate, Paranoia, Psychasthenia, Schizophrenia, Hypomania, and Social Introversion scales. These groups also differed significantly on preoperative HAT Internal and Chance scales. Further analyses found the MMPI to be a slightly better predictor of chemonucleolysis outcome and much better predictor of ultimate outcome than the HAT.

  18. A Reference Broth Microdilution Method for Dalbavancin In Vitro Susceptibility Testing of Bacteria that Grow Aerobically.

    PubMed

    Koeth, Laura M; DiFranco-Fisher, Jeanna M; McCurdy, Sandra

    2015-09-09

    Antimicrobial susceptibility testing (AST) is performed to assess the in vitro activity of antimicrobial agents against various bacteria. The AST results, which are expressed as minimum inhibitory concentrations (MICs) are used in research for antimicrobial development and monitoring of resistance development and in the clinical setting for antimicrobial therapy guidance. Dalbavancin is a semi-synthetic lipoglycopeptide antimicrobial agent that was approved in May 2014 by the Food and Drug Administration (FDA) for the treatment of acute bacterial skin and skin structure infections caused by Gram-positive organisms. The advantage of dalbavancin over current anti-staphylococcal therapies is its long half-life, which allows for once-weekly dosing. Dalbavancin has activity against Staphylococcus aureus (including both methicillin-susceptible S. aureus [MSSA] and methicillin-resistant S. aureus [MRSA]), coagulase-negative staphylococci, Streptococcus pneumoniae, Streptococcus anginosus group, β-hemolytic streptococci and vancomycin susceptible enterococci. Similar to other recent lipoglycopeptide agents, optimization of CLSI and ISO broth susceptibility test methods includes the use of dimethyl sulfoxide (DMSO) as a solvent when preparing stock solutions and polysorbate 80 (P80) to alleviate adherence of the agent to plastic. Prior to the clinical studies and during the initial development of dalbavancin, susceptibility studies were not performed with the use of P-80 and MIC results tended to be 2-4 fold higher and similarly higher MIC results were obtained with the agar dilution susceptibility method. Dalbavancin was first included in CLSI broth microdilution methodology tables in 2005 and amended in 2006 to clarify use of DMSO and P-80. The broth microdilution (BMD) procedure shown here is specific to dalbavancin and is in accordance with the CLSI and ISO methods, with step-by-step detail and focus on the critical steps added for clarity.

  19. Experimental Study of the Rolling-Sliding Contact Conditions in a PA66/STEEL Gear Using Twin-Disc Test Rig: Friction and Wear Analysis

    NASA Astrophysics Data System (ADS)

    Mbarek, Meftah; Rhaiem, Sadok; Kharrat, Mohamed; Dammak, Maher

    2015-09-01

    This study investigates the effects of sliding ratio on the tribological response of the contact between the teeth of a metal/polymer gear in the regions close to the pitch point. For this purpose, a new twin-disc test rig was developed on the basis of two discs of different diameters rotating one above the other at the same angular speed. Two different materials were used: non-alloyed structural steel (C45) and polyamide (PA66). The effect of the slip ratio (4%, 12%, 20% and 28%) was studied at a constant pressure of 34 MPa and a constant angular speed of 300 rpm. In addition, the contact conditions were controlled with measurements of the two discs surface temperatures. The results indicate that the wear and the friction are closely related to the contact temperature generated by the sliding phenomenon. At low slip ratio (4% and 12%), the coefficient of friction and the temperature are characterized by a quasi-linear increase with time, and the wear increases slowly. At higher slip ratio (20% and 28%), the coefficient of friction and the temperature presents a steady state, and the wear increases dramatically. During the test, a film of transferred PA66 is formed on the steel surface causing the development of adhesive interactions between the contacting discs which increase the friction coefficient and the contact temperature. The high thermal conductivity of steel as compared to that of the polymer can reduce enormously the contact temperature generated by the sliding process.

  20. Combination antimicrobial susceptibility testing for acute exacerbations in chronic infection of Pseudomonas aeruginosa in cystic fibrosis.

    PubMed

    Waters, Valerie; Ratjen, Felix

    2017-06-19

    Antibiotic therapy for acute pulmonary exacerbations in people with cystic fibrosis is usually chosen based on the results of antimicrobial susceptibility testing of individual drugs. Combination antimicrobial susceptibility testing assesses the efficacy of drug combinations including two or three antibiotics in vitro and can often demonstrate antimicrobial efficacy against bacterial isolates even when individual antibiotics have little or no effect. Therefore, choosing antibiotics based on combination antimicrobial susceptibility testing could potentially improve response to treatment in people with cystic fibrosis with acute exacerbations. This is an updated version of a previously published review. To compare antibiotic therapy based on conventional antimicrobial susceptibility testing to antibiotic therapy based on combination antimicrobial susceptibility testing in the treatment of acute pulmonary exacerbations in people with cystic fibrosis and chronic infection with Pseudomonas aeruginosa. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Cystic Fibrosis Trials Register which comprises of references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. Date of latest search: 19 December 2016.We also searched ongoing trials registries. Date of latest search: 08 March 2017. Randomised and quasi-randomised controlled studies of antibiotic therapy based on conventional antimicrobial susceptibility testing compared to antibiotic therapy based on combination antimicrobial susceptibility testing in the treatment of acute pulmonary exacerbations in cystic fibrosis due to chronic infection with Pseudomonas aeruginosa. Both authors independently selected studies, assessed their quality and extracted data from eligible studies. Additionally, the authors contacted the study investigators to obtain further information. The search identified one multicentre study

  1. Genetic Testing for the Susceptibility to Alcohol Dependence: Interest and Concerns in an African American Population

    PubMed Central

    Nwulia, Evaristus; Kwagyan, John; Cain, Gloria; Marshall, Vanessa J.; Kalu, Nnenna; Ewing, Altovise; Taylor, Robert E.

    2014-01-01

    Background: The search to identify genes for the susceptibility to alcohol dependence (AD) is generating interest for genetic risk assessment. The purpose of this study is to examine the level of interest and concerns for genetic testing for susceptibility to AD. Methods: Three hundred four African American adults were recruited through public advertisement. All participants were administered the Genetic Psycho-Social Implication (GPSI) questionnaire, which surveyed their interests in hypothetical genetic testing for AD, as well as their perception of ethical and legal concerns. Results: Over 85% of participants were interested in susceptibility genetic testing; however, persons with higher education (p=0.002) and income (p=0.008) were less willing to receive testing. Perception of AD as a deadly disease (48.60%) and wanting to know for their children (47.90%) were the strongest reasons for interest in testing. Among those not interested in testing, the belief that they were currently acting to lower their risk was the most prevalent. The most widely expressed concern in the entire sample was the accuracy of testing (35.50%). Other notable concerns, such as issues with the method of testing, side effects of venipuncture, falsely reassuring results, and lack of guidelines on “what to do next” following test results, were significantly associated with willingness to receive testing. Conclusion: Although an overwhelming majority of participants expressed an interest in genetic testing for AD, there is an understandable high level of methodological and ethical concerns. Such information should form the basis of policies to guide future genetic testing of AD. PMID:24926856

  2. Comparison of Animal Discs Used in Disc Research to Human Lumbar Disc: Torsion Mechanics and Collagen Content

    PubMed Central

    Showalter, Brent L.; Beckstein, Jesse C.; Martin, John T.; Beattie, Elizabeth E.; Orías, Alejandro A. Espinoza; Schaer, Thomas P.; Vresilovic, Edward J.; Elliott, Dawn M.

    2012-01-01

    Study Design Experimental measurement and normalization of in vitro disc torsion mechanics and collagen content for several animal species used in intervertebral disc research and comparing these to the human disc. Objective To aid in the selection of appropriate animal models for disc research by measuring torsional mechanical properties and collagen content. Summary of Background Data There is lack of data and variability in testing protocols for comparing animal and human disc torsion mechanics and collagen content. Methods Intervertebral disc torsion mechanics were measured and normalized by disc height and polar moment of inertia for 11 disc types in 8 mammalian species: the calf, pig, baboon, goat, sheep, rabbit, rat, and mouse lumbar, and cow, rat, and mouse caudal. Collagen content was measured and normalized by dry weight for the same discs except the rat and mouse. Collagen fiber stretch in torsion was calculated using an analytical model. Results Measured torsion parameters varied by several orders of magnitude across the different species. After geometric normalization, only the sheep and pig discs were statistically different from human. Fiber stretch was found to be highly dependent on the assumed initial fiber angle. The collagen content of the discs was similar, especially in the outer annulus where only the calf and goat discs were statistically different from human. Disc collagen content did not correlate with torsion mechanics. Conclusion Disc torsion mechanics are comparable to human lumbar discs in 9 of 11 disc types after normalization by geometry. The normalized torsion mechanics and collagen content of the multiple animal discs presented is useful for selecting and interpreting results for animal models of the disc. Structural composition of the disc, such as initial fiber angle, may explain the differences that were noted between species after geometric normalization. PMID:22333953

  3. Multilaboratory Comparison of Proficiencies in Susceptibility Testing of Helicobacter pylori and Correlation between Agar Dilution and E Test Methods

    PubMed Central

    Best, L. M.; Haldane, D. J. M.; Keelan, M.; Taylor, D. E.; Thomson, A. B. R.; Loo, V.; Fallone, C. A.; Lyn, P.; Smaill, F. M.; Hunt, R.; Gaudreau, C.; Kennedy, J.; Alfa, M.; Pelletier, R.; Veldhuyzen van Zanten, S. J. O.

    2003-01-01

    Susceptibility testing was performed at seven Canadian microbiology laboratories and the Helicobacter Reference Laboratory, Halifax, Nova Scotia, Canada, to assess susceptibility testing proficiency and the reproducibility of the results for clarithromycin and metronidazole and to compare the Epsilometer test (E test) method to the agar dilution reference method. Control strain Helicobacter pylori ATCC 43504 (American Type Culture Collection) and 13 clinical isolates (plus duplicates of four of these strains including ATCC 43504) were tested blindly. The National Committee for Clinical Laboratory Standards (NCCLS) guidelines for agar dilution testing were followed, and the same suspension of organisms was used for agar dilution and E test. Antimicrobials and E test strips were provided to the investigators. Methods were provided on a website (www.Helicobactercanada.org). Each center reported MICs within the stated range for strain ATCC 43504. Compared to the average MICs, interlaboratory agreements within 2 log2 dilutions were 90% (range, 69 to 100%) for clarithromycin by agar dilution, with seven very major errors [VMEs], and 85% (range, 65 to 100%) by E test, with three VMEs. Interlaboratory agreements within 2 log2 dilutions were 83% (range, 50 to 100%) for metronidazole by agar dilution, with six VMEs and eight major errors (MEs), and 75% (range, 50 to 94%) by E test, with four VMEs and four MEs. At lower and higher concentrations of antibiotic, E test MICs were slightly different from agar dilution MICs, but these differences did not result in errors. When a standardized protocol based on NCCLS guidelines was used, most participants in this study correctly identified clarithromycin- and metronidazole-susceptible and -resistant strains of H. pylori 93% of the time by either the agar dilution or E test method, and the numbers of errors were relatively equivalent by both methods. PMID:14506021

  4. Multilaboratory comparison of proficiencies in susceptibility testing of Helicobacter pylori and correlation between agar dilution and E test methods.

    PubMed

    Best, L M; Haldane, D J M; Keelan, M; Taylor, D E; Thomson, A B R; Loo, V; Fallone, C A; Lyn, P; Smaill, F M; Hunt, R; Gaudreau, C; Kennedy, J; Alfa, M; Pelletier, R; Veldhuyzen Van Zanten, S J O

    2003-10-01

    Susceptibility testing was performed at seven Canadian microbiology laboratories and the Helicobacter Reference Laboratory, Halifax, Nova Scotia, Canada, to assess susceptibility testing proficiency and the reproducibility of the results for clarithromycin and metronidazole and to compare the Epsilometer test (E test) method to the agar dilution reference method. Control strain Helicobacter pylori ATCC 43504 (American Type Culture Collection) and 13 clinical isolates (plus duplicates of four of these strains including ATCC 43504) were tested blindly. The National Committee for Clinical Laboratory Standards (NCCLS) guidelines for agar dilution testing were followed, and the same suspension of organisms was used for agar dilution and E test. Antimicrobials and E test strips were provided to the investigators. Methods were provided on a website (www.Helicobactercanada.org). Each center reported MICs within the stated range for strain ATCC 43504. Compared to the average MICs, interlaboratory agreements within 2 log(2) dilutions were 90% (range, 69 to 100%) for clarithromycin by agar dilution, with seven very major errors [VMEs], and 85% (range, 65 to 100%) by E test, with three VMEs. Interlaboratory agreements within 2 log(2) dilutions were 83% (range, 50 to 100%) for metronidazole by agar dilution, with six VMEs and eight major errors (MEs), and 75% (range, 50 to 94%) by E test, with four VMEs and four MEs. At lower and higher concentrations of antibiotic, E test MICs were slightly different from agar dilution MICs, but these differences did not result in errors. When a standardized protocol based on NCCLS guidelines was used, most participants in this study correctly identified clarithromycin- and metronidazole-susceptible and -resistant strains of H. pylori 93% of the time by either the agar dilution or E test method, and the numbers of errors were relatively equivalent by both methods.

  5. Canadian Multicenter Laboratory Study for Standardized Second-Line Antimicrobial Susceptibility Testing of Mycobacterium tuberculosis ▿

    PubMed Central

    Sharma, Meenu; Thibert, Louise; Chedore, Pamela; Shandro, Cary; Jamieson, Frances; Tyrrell, Gregory; Christianson, Sara; Soualhine, Hafid; Wolfe, Joyce

    2011-01-01

    The purpose of this study was to establish a standardized protocol for second-line antimicrobial susceptibility testing of Mycobacterium tuberculosis using the Bactec MGIT 960 system in Canadian laboratories. Four Canadian public health laboratories compared the susceptibility testing results of 9 second-line antimicrobials between the Bactec 460 and Bactec MGIT 960 systems. Based on the data generated, we have established that the Bactec MGIT 960 system provides results comparable to those obtained with the previous Bactec 460 method. The critical concentrations established for the testing of the antimicrobials used are as follows: amikacin, 1 μg/ml; capreomycin, 2.5 μg/ml; ethionamide, 5 μg/ml; kanamycin, 2.5 μg/ml; linezolid, 1 μg/ml; moxifloxacin, 0.25 μg/ml; ofloxacin, 2 μg/ml; p-aminosalicylic acid, 4 μg/ml; rifabutin, 0.5 μg/ml. PMID:21998413

  6. Canadian multicenter laboratory study for standardized second-line antimicrobial susceptibility testing of Mycobacterium tuberculosis.

    PubMed

    Sharma, Meenu; Thibert, Louise; Chedore, Pamela; Shandro, Cary; Jamieson, Frances; Tyrrell, Gregory; Christianson, Sara; Soualhine, Hafid; Wolfe, Joyce

    2011-12-01

    The purpose of this study was to establish a standardized protocol for second-line antimicrobial susceptibility testing of Mycobacterium tuberculosis using the Bactec MGIT 960 system in Canadian laboratories. Four Canadian public health laboratories compared the susceptibility testing results of 9 second-line antimicrobials between the Bactec 460 and Bactec MGIT 960 systems. Based on the data generated, we have established that the Bactec MGIT 960 system provides results comparable to those obtained with the previous Bactec 460 method. The critical concentrations established for the testing of the antimicrobials used are as follows: amikacin, 1 μg/ml; capreomycin, 2.5 μg/ml; ethionamide, 5 μg/ml; kanamycin, 2.5 μg/ml; linezolid, 1 μg/ml; moxifloxacin, 0.25 μg/ml; ofloxacin, 2 μg/ml; p-aminosalicylic acid, 4 μg/ml; rifabutin, 0.5 μg/ml.

  7. Direct antimicrobial drug susceptibility testing of Mycobacterium tuberculosis by the radiometric method

    SciTech Connect

    Libonati, J.P.; Stager, C.E.; Davis, J.R.; Siddiqi, S.H.

    1988-05-01

    Direct-drug-susceptibility tests were performed on clinical specimens positive for acid-fast bacilli by either Ziehl-Neelsen or fluorochrome staining. The results of conventional agar dilution and a modified radiometric (BACTEC) method were compared. A total of 580 smear-positive specimens were tested by the BACTEC method at three separate sites. Three hundred and seventy-seven of these were culture positive for M. tuberculosis, and 343 (91%) yielded acceptable direct-susceptibility-test results. We used the conventional method to determine that 343 of 519 smear-positive specimens were culture positive for M. tuberculosis, and 212 (62%) produced acceptable results within 3 wks. Conventional results were reported in 3-4 wks, while the time required to obtain results with the BACTEC method ranged from 5 to 21 days (average 11.5 days). Results indicate that the radiometric method provides reportable results more frequently with time savings as compared to the conventional method.

  8. A microfluidic platform for rapid, stress-induced antibiotic susceptibility testing of Staphylococcus aureus.

    PubMed

    Kalashnikov, Maxim; Lee, Jean C; Campbell, Jennifer; Sharon, Andre; Sauer-Budge, Alexis F

    2012-11-07

    The emergence and spread of bacterial resistance to ever increasing classes of antibiotics intensifies the need for fast phenotype-based clinical tests for determining antibiotic susceptibility. Standard susceptibility testing relies on the passive observation of bacterial growth inhibition in the presence of antibiotics. In this paper, we present a novel microfluidic platform for antibiotic susceptibility testing based on stress-activation of biosynthetic pathways that are the primary targets of antibiotics. We chose Staphylococcus aureus (S. aureus) as a model system due to its clinical importance, and we selected bacterial cell wall biosynthesis as the primary target of both stress and antibiotic. Enzymatic and mechanical stresses were used to damage the bacterial cell wall, and a β-lactam antibiotic interfered with the repair process, resulting in rapid cell death of strains that harbor no resistance mechanism. In contrast, resistant bacteria remained viable under the assay conditions. Bacteria, covalently-bound to the bottom of the microfluidic channel, were subjected to mechanical shear stress created by flowing culture media through the microfluidic channel and to enzymatic stress with sub-inhibitory concentrations of the bactericidal agent lysostaphin. Bacterial cell death was monitored via fluorescence using the Sytox Green dead cell stain, and rates of killing were measured for the bacterial samples in the presence and absence of oxacillin. Using model susceptible (Sanger 476) and resistant (MW2) S. aureus strains, a metric was established to separate susceptible and resistant staphylococci based on normalized fluorescence values after 60 min of exposure to stress and antibiotic. Because this ground-breaking approach is not based on standard methodology, it circumvents the need for minimum inhibitory concentration (MIC) measurements and long wait times. We demonstrate the successful development of a rapid microfluidic-based and stress

  9. Towards a Standardized Method for Broth Microdilution Susceptibility Testing of Haemophilus parasuis.

    PubMed

    Prüller, Sandra; Turni, Conny; Blackall, Patrick J; Beyerbach, Martin; Klein, Günter; Kreienbrock, Lothar; Strutzberg-Minder, Katrin; Kaspar, Heike; Meemken, Diana; Kehrenberg, Corinna

    2017-01-01

    Currently, there is no agreed method available for broth microdilution susceptibility testing of Haemophilus parasuis, one of the most important bacterial pathogens in pig production. Therefore, the aim of this study was to develop a method that could be easily performed by diagnostic laboratories and that appears suitable for a harmonized susceptibility testing. Growth determinations using one type strain and three field isolates revealed no visible growth of H. parasuis in media which have proven to be suitable for susceptibility testing of fastidious organisms. Therefore, a new medium, cation-adjusted Mueller-Hinton broth (CAMHB) plus NADH and sterile filtered heat-inactivated chicken serum, was developed. The reproducibility of MICs obtained in this medium was evaluated and statistically analyzed, considering a model with two different variables (precondition of five identical MICs and MIC mode accepting a deviation of ±1 dilution step, respectively). No significant differences for both variables were seen between two time points investigated and between results obtained with the recently proposed test medium broth (TMB). Nearly all MICs of quality control strains were in the acceptable range. Subsequently, 47 H. parasuis isolates representing 13 serovars were tested with the newly developed medium and TMB. Statistical analysis of all isolates and 15 antimicrobial agents and antimicrobial combinations showed no significant difference between MICs obtained in supplemented CAMHB and TMB. Because of a simplified implementation in routine diagnostic and a lower chance of interference between medium components and antimicrobial agents, supplemented CAMHB is recommended with an incubation time of 24 h.

  10. [Evaluation of an automated system in bacteriology. Application to bacteriological susceptibility tests].

    PubMed

    Philippin, J L; Pitton, J S; Fournier, P

    1991-05-01

    Susceptibility tests have been compared between a new automated system and the reference method by agar diffusion. The COBAS-Micro apparatus for bacterial susceptibility tests is intended for rapid determinations with, normally, an incubation time of 5 h at 37 degrees C. Its is compatible with strains requiring greater than 18 h incubation. With this technique a large range of antibacterial substances (greater than 60) can be studied, in groups of fifteen. With the help of a computerized soft-ware, one growth-index:EPR (End Point Ratio) is calculated, in comparison with a standard, for each antibacterial agent tested and expressed in three categories: SIR. The findings are optimized according to the limits prescribed by the NCCLS. The reference method, by agar-diffusion, is as described by the Comité de l'Antibiogramme de la Société Française de Microbiologie (CA-SFM). A total of 1,048 strains were tested by the two techniques: 518 Gram negative rods, 530 Gram positive cocci, with four common antibiotics. The percentages of agreement between the two groups were: 96% full agreement and minor discrepancy, 4% major and very major discrepancy. This automated system seems to be perfectly suitable for susceptibility testing in a routine laboratory, especially with strains isolated from ambulatory patients.

  11. Antibiotic susceptibility testing in less than 30 min using direct single-cell imaging.

    PubMed

    Baltekin, Özden; Boucharin, Alexis; Tano, Eva; Andersson, Dan I; Elf, Johan

    2017-08-22

    The emergence and spread of antibiotic-resistant bacteria are aggravated by incorrect prescription and use of antibiotics. A core problem is that there is no sufficiently fast diagnostic test to guide correct antibiotic prescription at the point of care. Here, we investigate if it is possible to develop a point-of-care susceptibility test for urinary tract infection, a disease that 100 million women suffer from annually and that exhibits widespread antibiotic resistance. We capture bacterial cells directly from samples with low bacterial counts (10(4) cfu/mL) using a custom-designed microfluidic chip and monitor their individual growth rates using microscopy. By averaging the growth rate response to an antibiotic over many individual cells, we can push the detection time to the biological response time of the bacteria. We find that it is possible to detect changes in growth rate in response to each of nine antibiotics that are used to treat urinary tract infections in minutes. In a test of 49 clinical uropathogenic Escherichia coli (UPEC) isolates, all were correctly classified as susceptible or resistant to ciprofloxacin in less than 10 min. The total time for antibiotic susceptibility testing, from loading of sample to diagnostic readout, is less than 30 min, which allows the development of a point-of-care test that can guide correct treatment of urinary tract infection.

  12. [Identification and antimicrobial susceptibility testing of positive blood culture isolates from briefly incubated solid medium cultures].

    PubMed

    Ballestero-Téllez, Mónica; Recacha, Esther; de Cueto, Marina; Pascual, Álvaro

    2016-02-16

    Mass spectrometry Matrix-Assisted Laser Desorption-Ionization Time-of-Flight (MALDI-TOF) helps in the rapid identification of microorganisms causing blood stream infection. Rapid and reliable methods are required to decrease the turnaround time for reporting antimicrobial susceptibility results from blood culture isolates. An evaluation was performed on the reliability of a method for antimicrobial susceptibility testing of positive blood culture isolates from briefly incubated solid medium cultures. The agreement between the evaluated and standard methods was 99.3%. The major and minor error rates were 0.4% and 0.3%, respectively, and no very major errors were observed. The inoculation of briefly incubated solid medium cultures into antimicrobial susceptibility testing panels is an easy and reliable technique, and helps to decrease the turnaround time for reporting antimicrobial susceptibility results of positive blood cultures. Copyright © 2016 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  13. Evaluation of rapid phenotypic identification and antimicrobial susceptibility testing in a pediatric oncology center.

    PubMed

    Brazelton de Cárdenas, J N; Su, Y; Rodriguez, A; Hewitt, C; Tang, L; Garner, C D; Hayden, R T

    2017-09-01

    Identification (ID) and antimicrobial susceptibility testing (AST) remain rate limiting steps in producing actionable data for clinical care of bloodstream infections. Rapid, automated phenotypic ID and AST by fluorescent in situ hybridization and automated microscopy were used to characterize blood stream infections in a predominantly pediatric oncology patient population. Results were compared to standard of care (SOC) phenotypic methods. The Accelerate Pheno System (AXDX) had a sensitivity of 91.2% and an accuracy of 100% to the genus level for identification, and an overall categorical agreement 91.2-91.8% for susceptibility, depending on the breakpoints used. The AXDX required a mean time of 1.4hours for identification and 6.6hours for susceptibility testing compared to SOC, requiring 32.5 and 46.7hours, respectively. Identification and susceptibility by rapid phenotypic methods shows a high degree of accuracy; the marked reduction in time to results may have significant implications for patient care. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Interpretation of the Disk Diffusion Susceptibility Test for Amikacin: Report of a Collaborative Study

    PubMed Central

    Washington, John A.; Yu, Pauline K. W.; Gavan, Thomas L.; Schoenknecht, Fritz D.; Thornsberry, Clyde

    1979-01-01

    Because excessively high rates of false resistance have been encountered with the 10-μg amikacin disk in diffusion susceptibility tests, a study was performed to examine existing zone diameter interpretative criteria and to compare the accuracy of 10- and 30-μg amikacin disks by the error rate-bounded classification scheme. Although current zone diameter interpretative criteria eliminate false susceptibles, there is an unacceptably high rate of false resistants. This problem can be resolved in most instances by revising the zone diameter interpretative criteria for the 10-μg disk (resistant, ≤9 mm; indeterminate, 10 to 11 mm; susceptible, ≥12 mm) or, preferably, by replacing the 10-μg disk with a 30-μg disk and adopting new interpretative criteria (resistant, ≤14 mm; indeterminate, 15 to 16 mm; susceptible, ≥17 mm). Because of significant differences in performance among media, it is necessary to include Pseudomonas aeruginosa ATCC 27853 among controls routinely tested and to exclude from use lots of Mueller-Hinton agar yielding results outside the 75% tolerance (90% confidence) limits for amikacin. PMID:464567

  15. Evaluation of a biphasic media assay for pyrazinamide drug susceptibility testing of Mycobacterium tuberculosis.

    PubMed

    Gonzalo, X; Drobniewski, F; Hoffner, S; Werngren, J

    2014-11-01

    Pyrazinamide is a key first-line tuberculosis drug. Reliable drug susceptibility testing (DST) data are of clinical importance, but in vitro testing is challenging since the activity of pyrazinamide is pH sensitive. The BACTEC MGIT 960 is considered the principal reference technique, but Wayne's test is an alternative, although it may be difficult to interpret. A further alternative is the use of a biphasic media assay (BMA). The objective of this work was to evaluate the BMA against the MGIT method and with screening of pncA gene mutations. Twenty strains were inoculated in tubes containing 2 mL of Löwenstein-Jensen (LJ) medium and 2 mL of semi-solid Kirchner medium with a critical concentration of 66 mg/L pyrazinamide at a pH of 5.2 or 5.5, incubated for 2 weeks and visually read. The results obtained were compared with MGIT 960 and DNA sequencing. Results were obtained in duplicate for 19 strains. One strain failed to grow on two occasions and only one result was available. Reproducibility was 95%. Eleven of the 19 strains were susceptible to pyrazinamide, whereas 7 were resistant. One strain was susceptible initially and pyrazinamide resistant on repeat testing. At pH 5.5, two strains reported as susceptible at pH 5.2 gave resistant results. The BMA might serve as a reliable low-cost DST alternative for pyrazinamide, particularly in laboratories using locally made solid media for DST. Its major drawback is the time to result. A reliable and affordable test method for the detection of pyrazinamide resistance is needed, especially in settings where multidrug-resistant tuberculosis is increasing. Proficiency testing should be routinely introduced wherever pyrazinamide DST is performed. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  16. In-vitro contracture testing for susceptibility to malignant hyperthermia: can halothane be replaced?

    PubMed

    Metterlein, Thomas; Schuster, Frank; Kranke, Peter; Roewer, Norbert; Anetseder, Martin

    2011-04-01

    Malignant hyperthermia is a potentially lethal inherited hypermetabolic syndrome that develops in susceptible individuals following administration of depolarising neuromuscular relaxants or volatile anaesthetics. Genetic analysis can only confirm a diagnosis of malignant hyperthermia in about 70%, and in the remainder an in-vitro contracture test, with halothane and caffeine, on muscle obtained from open muscle biopsy is required to establish the diagnosis. As the licence for clinical use of halothane expired in 2005, its continuing availability is in doubt. More modern volatile anaesthetics such as enflurane, isoflurane, desflurane and sevoflurane are less potent triggers of malignant hyperthermia in humans and pigs. The aim of this study was to investigate whether these agents can be considered possible substitutes for halothane in a modified in-vitro contracture test. With institutional review board approval and prior written consent, muscle bundles of 30 patients with a personal or family history of malignant hyperthermia were investigated. Of these, 13 were diagnosed malignant hyperthermia susceptible and 17 nonsusceptible. Surplus muscle was tested with increasing concentrations of enflurane, isoflurane, desflurane and sevoflurane. There were no differences in weight, length or predrug tension of the muscle bundles. At increasing concentration, all volatile anaesthetics except sevoflurane induced significantly greater contractures in malignant hyperthermia susceptible compared to malignant hyperthermia nonsusceptible muscle. In malignant hyperthermia susceptible muscle bundles, halothane led to significantly higher contractures compared to the other investigated substances. Halothane was the strongest discriminator for malignant hyperthermia in the in-vitro contracture tests. It remains the ideal substance for diagnostic testing and cannot simply be replaced by other agents in this test.

  17. Luciferase Reporter Mycobacteriophages for Detection, Identification, and Antibiotic Susceptibility Testing of Mycobacterium tuberculosis in Mexico

    PubMed Central

    Banaiee, N.; Bobadilla-del-Valle, M.; Bardarov, S.; Riska, P. F.; Small, P. M.; Ponce-de-Leon, A.; Jacobs, W. R.; Hatfull, G. F.; Sifuentes-Osornio, J.

    2001-01-01

    The utility of luciferase reporter mycobacteriophages (LRPs) for detection, identification, and antibiotic susceptibility testing of Mycobacterium tuberculosis was prospectively evaluated in a clinical microbiology laboratory in Mexico City, Mexico. Five hundred twenty-three consecutive sputum samples submitted to the laboratory during a 5-month period were included in this study. These specimens were cultivated in Middlebrook 7H9 (MADC), MGIT, and Löwenstein-Jensen (LJ) media. Of the 71 mycobacterial isolates recovered with any of the three media, 76% were detected with the LRPs, 97% were detected with the MGIT 960 method, and 90% were detected with LJ medium. When contaminated specimens were excluded from the analysis, the LRPs detected 92% (54 of 59) of the cultures. The median time to detection of bacteria was 7 days with both the LRPs and the MGIT 960 method. LRP detection of growth in the presence of p-nitro-α-acetylamino-β-hydroxypropiophenone (NAP) was used for selective identification of M. tuberculosis complex (MTC) and compared to identification with BACTEC 460. Using the LRP NAP test, 47 (94%) out of 50 isolates were correctly identified as tuberculosis complex. The accuracy and speed of LRP antibiotic susceptibility testing with rifampin, streptomycin, isoniazid, and ethambutol were compared to those of the BACTEC 460 method, and discrepant results were checked by the conventional proportion method. In total, 50 MTC isolates were tested. The overall agreement between the LRP and BACTEC 460 results was 98.5%. The median LRP-based susceptibility turnaround time was 2 days (range, 2 to 4 days) compared to 10.5 days (range, 7 to 16 days) by the BACTEC 460 method. Phage resistance was not detected in any of the 243 MTC isolates tested. Mycobacteriophage-based approaches to tuberculosis diagnostics can be implemented in clinical laboratories with sensitivity, specificity, and rapidity that compare favorably with those of the MGIT 960 and BACTEC 460

  18. Genetic Testing for TMEM154 Mutations Associated with Lentivirus Susceptibility in Sheep

    PubMed Central

    Petrik, Dustin T.; Simpson, Barry; Kijas, James W.; Clawson, Michael L.; Chitko-McKown, Carol G.; Harhay, Gregory P.; Leymaster, Kreg A.

    2013-01-01

    In sheep, small ruminant lentiviruses cause an incurable, progressive, lymphoproliferative disease that affects millions of animals worldwide. Known as ovine progressive pneumonia virus (OPPV) in the U.S., and Visna/Maedi virus (VMV) elsewhere, these viruses reduce an animal’s health, productivity, and lifespan. Genetic variation in the ovine transmembrane protein 154 gene (TMEM154) has been previously associated with OPPV infection in U.S. sheep. Sheep with the ancestral TMEM154 haplotype encoding glutamate (E) at position 35, and either form of an N70I variant, were highly-susceptible compared to sheep homozygous for the K35 missense mutation. Our current overall aim was to characterize TMEM154 in sheep from around the world to develop an efficient genetic test for reduced susceptibility. The average frequency of TMEM154 E35 among 74 breeds was 0.51 and indicated that highly-susceptible alleles were present in most breeds around the world. Analysis of whole genome sequences from an international panel of 75 sheep revealed more than 1,300 previously unreported polymorphisms in a 62 kb region containing TMEM154 and confirmed that the most susceptible haplotypes were distributed worldwide. Novel missense mutations were discovered in the signal peptide (A13V) and the extracellular domains (E31Q, I74F, and I102T) of TMEM154. A matrix-assisted laser desorption/ionization–time-of flight mass spectrometry (MALDI-TOF MS) assay was developed to detect these and six previously reported missense and two deletion mutations in TMEM154. In blinded trials, the call rate for the eight most common coding polymorphisms was 99.4% for 499 sheep tested and 96.0% of the animals were assigned paired TMEM154 haplotypes (i.e., diplotypes). The widespread distribution of highly-susceptible TMEM154 alleles suggests that genetic testing and selection may improve the health and productivity of infected flocks. PMID:23408992

  19. Automated interpretation of disk diffusion antibiotic susceptibility tests with the radial profile analysis algorithm.

    PubMed Central

    Hejblum, G; Jarlier, V; Grosset, J; Aurengo, A

    1993-01-01

    An original algorithm referred to as the radial profile analysis algorithm was implemented on a Macintosh Quadra 700 computer to provide an automatic determination of the inhibition zone diameters of antibiotic susceptibility tests performed with the disk diffusion method. After digitization of the petri plate image, each antibiotic disk is recognized and labeled. Pixels of the local zone around each disk are then used for generating a profile pattern that is subjected to decision rules. The resulting estimate of the inhibition zone diameter is then automatically compared with conventional breakpoints for classifying the tested strain in one of the clinical categories of antibiotic susceptibility. The program is also able to request a human reading for some rare plates difficult to interpret. The algorithm accuracy was tested by comparing the results with a combination of independent human measurements performed on the tested plates. The test sample was composed of 98 strains, and 2,552 tests of 40 distinct antibiotics were subjected to the analysis. The difference between the automatic and human diameter estimates was less than 4 mm in 90% of the tests. The agreement between the automatic and human clinical categorizations amounted to 95.5%, and severe (major and very major) disagreements were found in 5.6% of the tests performed with staphylococci but only 0.3% of the tests with gram-negative rods. We conclude that the radial profile analysis algorithm is a solid backbone for an automatic system dedicated to the clinical interpretation of disk diffusion antibiotic susceptibility tests. Images PMID:8408562

  20. Comparison of Susceptibility Testing of Mycobacterium tuberculosis Using the ESP Culture System II with That Using the BACTEC Method

    PubMed Central

    Ruiz, P.; Zerolo, F. J.; Casal, M. J.

    2000-01-01

    The ESP Culture System II was evaluated for its capacity to test the susceptibility of 389 cultures of Mycobacterium tuberculosis to streptomycin, rifampin, ethambutol, and isoniazid. Good agreement with results with the BACTEC TB 460 was found. ESP II is a reliable, rapid, and automated method for performing susceptibility testing. PMID:11101619

  1. Multicenter evaluation of the MB/BACT system for susceptibility testing of Mycobacterium tuberculosis.

    PubMed

    Bemer, Pascale; Bodmer, Thomas; Munzinger, Juerg; Perrin, Monique; Vincent, Véronique; Drugeon, Henri

    2004-03-01

    The reliability of the MB/BACT system for susceptibility testing of Mycobacterium tuberculosis to pyrazinamide, rifampin, isoniazid, streptomycin, and ethambutol was compared to the BACTEC 460TB system. The proportion method was used to resolve discrepant results by an independent arbiter. Two interpretative methods were used, with an undiluted control (direct control) and a diluted control (10(-1) control). As no significant difference was observed between the two controls, the method with the direct control was adopted as the most accurate one. One hundred sixty-six strains were tested, with an overall agreement of 98.3%. After resolution of the 18 discrepant results by the proportion method, the sensitivity and specificity of the MB/BACT system were 100% for rifampin, isoniazid, and pyrazinamide. For ethambutol, sensitivity was 92.3% at the critical concentration and 33% at the high concentration, and specificity was 100% at both concentrations. For streptomycin, sensitivity was 100% at the critical concentration and 80% at the high concentration, and specificity was 98.6% at the critical concentration and 100% at the high concentration. The rifampin, isoniazid, streptomycin, and ethambutol susceptibility test results were obtained in 6.6 days with the MB/BACT versus 5 days with the BACTEC 460TB. The pyrazinamide susceptibility test results were obtained in 7.8 days with the MB/BACT, versus 6.7 days with the BACTEC 460TB. These data demonstrate that the fully automated MB/BACT system is a very reliable method for rapid susceptibility testing of M. tuberculosis against rifampin, isoniazid, and pyrazinamide. Sensitivity results have to be improved for ethambutol and streptomycin, especially at the high concentration.

  2. Multicenter Evaluation of the MB/BACT System for Susceptibility Testing of Mycobacterium tuberculosis

    PubMed Central

    Bemer, Pascale; Bodmer, Thomas; Munzinger, Juerg; Perrin, Monique; Vincent, Véronique; Drugeon, Henri

    2004-01-01

    The reliability of the MB/BACT system for susceptibility testing of Mycobacterium tuberculosis to pyrazinamide, rifampin, isoniazid, streptomycin, and ethambutol was compared to the BACTEC 460TB system. The proportion method was used to resolve discrepant results by an independent arbiter. Two interpretative methods were used, with an undiluted control (direct control) and a diluted control (10−1 control). As no significant difference was observed between the two controls, the method with the direct control was adopted as the most accurate one. One hundred sixty-six strains were tested, with an overall agreement of 98.3%. After resolution of the 18 discrepant results by the proportion method, the sensitivity and specificity of the MB/BACT system were 100% for rifampin, isoniazid, and pyrazinamide. For ethambutol, sensitivity was 92.3% at the critical concentration and 33% at the high concentration, and specificity was 100% at both concentrations. For streptomycin, sensitivity was 100% at the critical concentration and 80% at the high concentration, and specificity was 98.6% at the critical concentration and 100% at the high concentration. The rifampin, isoniazid, streptomycin, and ethambutol susceptibility test results were obtained in 6.6 days with the MB/BACT versus 5 days with the BACTEC 460TB. The pyrazinamide susceptibility test results were obtained in 7.8 days with the MB/BACT, versus 6.7 days with the BACTEC 460TB. These data demonstrate that the fully automated MB/BACT system is a very reliable method for rapid susceptibility testing of M. tuberculosis against rifampin, isoniazid, and pyrazinamide. Sensitivity results have to be improved for ethambutol and streptomycin, especially at the high concentration. PMID:15004049

  3. Electromagnetic Compatibility Testing for Conducted Susceptibility Along Interconnecting Signal Lines. Final report

    SciTech Connect

    Ewing, P. D.; Wood, R. T.; Korsah, K.; Shourbaji, A. A.; Wilson, T. L.; Beets, B. M.

    2002-07-31

    This document presents recommendations and the associated technical basis for addressing the effects of conducted electromagnetic interference (EMI) and radio-frequency interference (RFI) along interconnecting signal lines in safety-related instrumentation and control (I&C) systems. Oak Ridge National Laboratory has been engaged in assisting the U.S. Nuclear Regulatory Commission Office of Nuclear Regulatory Research in developing the technical basis for regulatory guidance on EMIIRFI immunity and power surge withstand capability (SWC). Previous research efforts have provided recommendations on (1) electromagnetic compatibility design and installation practices, (2) the endorsement of EMI/RFI and SWC test criteria and test methods, (3) the determination of ambient electromagnetic conditions at nuclear power plants, and (4) the development of recommended electromagnetic operating envelopes applicable to locations where safety-related I&C systems will be installed. The current research focuses on the susceptibility of l&C systems to conducted EMIIRFI along interconnecting signal lines. Coverage of signal line susceptibility was identified as an open issue in previous research on establishing the technical basis for EMIIRFI and SWC in safety-related I&C systems. Research results provided in this report will be used to establish the technical basis for endorsing U.S. Department of Defense and European Committee for Electrotechnical Standardization test criteria and test methods that address signal-line susceptibility. In addition, recommendations on operating envelopes are presented based on available technical information.

  4. Comparative erythromycin and tylosin susceptibility testing of streptococci from bovine mastitis.

    PubMed

    Entorf, Monika; Feßler, Andrea T; Kaspar, Heike; Kadlec, Kristina; Peters, Thomas; Schwarz, Stefan

    2016-10-15

    Tylosin, a 16-membered macrolide, is - besides other indications - used for the treatment of bovine mastitis. So far, there is only limited information available on the tylosin susceptibility of streptococci isolated from mastitis. The aim of the present study was to comparatively investigate 303 streptococci from bovine mastitis, including 101 Streptococcus agalactiae, 100 Streptococcus dysgalactiae and 102 Streptococcus uberis, for their tylosin and erythromycin susceptibility by broth microdilution and agar disk diffusion. Both tests followed the recommendations of the Clinical and Laboratory Standards Institute (CLSI). For erythromycin, the results were interpreted using the CLSI-approved clinical breakpoints. Moreover, erythromycin-resistant isolates were tested for the presence of macrolide resistance genes and for inducible macrolide resistance. In general, both testing methods showed a good correlation for the three streptococcal species, although for the erythromycin susceptibility testing 11 S. uberis isolates fell into the very major error category. All but one of the erythromycin-resistant isolates harbored at least one macrolide resistance gene, with the erm(B) gene being most common. Moreover, single isolates of S. agalactiae and S. dysgalactiae proved to be inducibly macrolide-resistant. Since inducible macrolide resistance can easily switch to constitutive resistance, tylosin should not be used for the treatment of infections caused by inducibly resistant streptococci. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Identification and antimicrobial susceptibility testing of Staphylococcus vitulinus by the BD phoenix automated microbiology system.

    PubMed

    Cirković, Ivana; Hauschild, Tomasz; Jezek, Petr; Dimitrijević, Vladimir; Vuković, Dragana; Stepanović, Srdjan

    2008-08-01

    This study evaluated the performance of the BD Phoenix system for the identification (ID) and antimicrobial susceptibility testing (AST) of Staphylococcus vitulinus. Of the 10 S. vitulinus isolates included in the study, 2 were obtained from the Czech Collection of Microorganisms, 5 from the environment, 2 from human clinical samples, and 1 from an animal source. The results of conventional biochemical and molecular tests were used for the reference method for ID, while antimicrobial susceptibility testing performed in accordance with Clinical and Laboratory Standards Institute recommendations and PCR for the mecA gene were the reference for AST. Three isolates were incorrectly identified by the BD Phoenix system; one of these was incorrectly identified to the genus level, and two to the species level. The results of AST by the BD Phoenix system were in agreement with those by the reference method used. While the results of susceptibility testing compared favorably, the 70% accuracy of the Phoenix system for identification of this unusual staphylococcal species was not fully satisfactory.

  6. Development of MAST: A Microscopy-Based Antimicrobial Susceptibility Testing Platform.

    PubMed

    Smith, Kenneth P; Richmond, David L; Brennan-Krohn, Thea; Elliott, Hunter L; Kirby, James E

    2017-08-01

    Antibiotic resistance is compromising our ability to treat bacterial infections. Clinical microbiology laboratories guide appropriate treatment through antimicrobial susceptibility testing (AST) of patient bacterial isolates. However, increasingly, pathogens are developing resistance to a broad range of antimicrobials, requiring AST of alternative agents for which no commercially available testing methods are available. Therefore, there exists a significant AST testing gap in which current methodologies cannot adequately address the need for rapid results in the face of unpredictable susceptibility profiles. To address this gap, we developed a multicomponent, microscopy-based AST (MAST) platform capable of AST determinations after only a 2 h incubation. MAST consists of a solid-phase microwell growth surface in a 384-well plate format, inkjet printing-based application of both antimicrobials and bacteria at any desired concentrations, automated microscopic imaging of bacterial replication, and a deep learning approach for automated image classification and determination of antimicrobial minimal inhibitory concentrations (MICs). In evaluating a susceptible strain set, 95.8% were within ±1 and 99.4% were within ±2, twofold dilutions, respectively, of reference broth microdilution MIC values. Most (98.3%) of the results were in categorical agreement. We conclude that MAST offers promise for rapid, accurate, and flexible AST to help address the antimicrobial testing gap.

  7. American Society of Clinical Oncology Policy Statement Update: Genetic and Genomic Testing for Cancer Susceptibility.

    PubMed

    Robson, Mark E; Bradbury, Angela R; Arun, Banu; Domchek, Susan M; Ford, James M; Hampel, Heather L; Lipkin, Stephen M; Syngal, Sapna; Wollins, Dana S; Lindor, Noralane M

    2015-11-01

    The American Society of Clinical Oncology (ASCO) has long affirmed that the recognition and management of individuals with an inherited susceptibility to cancer are core elements of oncology care. ASCO released its first statement on genetic testing in 1996 and updated that statement in 2003 and 2010 in response to developments in the field. In 2014, the Cancer Prevention and Ethics Committees of ASCO commissioned another update to reflect the impact of advances in this area on oncology practice. In particular, there was an interest in addressing the opportunities and challenges arising from the application of massively parallel sequencing-also known as next-generation sequencing-to cancer susceptibility testing. This technology introduces a new level of complexity into the practice of cancer risk assessment and management, requiring renewed effort on the part of ASCO to ensure that those providing care to patients with cancer receive the necessary education to use this new technology in the most effective, beneficial manner. The purpose of this statement is to explore the challenges of new and emerging technologies in cancer genetics and provide recommendations to ensure their optimal deployment in oncology practice. Specifically, the statement makes recommendations in the following areas: germline implications of somatic mutation profiling, multigene panel testing for cancer susceptibility, quality assurance in genetic testing, education of oncology professionals, and access to cancer genetic services.

  8. A rapid antimicrobial susceptibility test based on single-cell morphological analysis.

    PubMed

    Choi, Jungil; Yoo, Jungheon; Lee, Mincheol; Kim, Eun-Geun; Lee, Ji Soo; Lee, Seungok; Joo, Seik; Song, Sang Hoon; Kim, Eui-Chong; Lee, Jung Chan; Kim, Hee Chan; Jung, Yong-Gyun; Kwon, Sunghoon

    2014-12-17

    A rapid antibiotic susceptibility test (AST) is desperately needed in clinical settings for fast and appropriate antibiotic administration. Traditional ASTs, which rely on cell culture, are not suitable for urgent cases of bacterial infection and antibiotic resistance owing to their relatively long test times. We describe a novel AST called single-cell morphological analysis (SCMA) that can determine antimicrobial susceptibility by automatically analyzing and categorizing morphological changes in single bacterial cells under various antimicrobial conditions. The SCMA was tested with four Clinical and Laboratory Standards Institute standard bacterial strains and 189 clinical samples, including extended-spectrum β-lactamase-positive Escherichia coli and Klebsiella pneumoniae, imipenem-resistant Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, and vancomycin-resistant Enterococci from hospitals. The results were compared with the gold standard broth microdilution test. The SCMA results were obtained in less than 4 hours, with 91.5% categorical agreement and 6.51% minor, 2.56% major, and 1.49% very major discrepancies. Thus, SCMA provides rapid and accurate antimicrobial susceptibility data that satisfy the recommended performance of the U.S. Food and Drug Administration. Copyright © 2014, American Association for the Advancement of Science.

  9. Testing of susceptibility of Mycobacterium tuberculosis to isoniazid and rifampin by mycobacterium growth indicator tube method.

    PubMed Central

    Walters, S B; Hanna, B A

    1996-01-01

    We tested isolates of Mycobacterium tuberculosis recovered from 117 patients for their susceptibilities to isoniazid (INH) and rifampin (RIF) by the Centers for Disease Control and Prevention's disk modification of the indirect method of proportions (MOP) test and a three-tube mycobacteria growth indicator tube (MGIT; BBL) antimycobacterial susceptibility test (AST). Sixty-seven of the M. tuberculosis isolates were recovered from Lowenstein-Jensen (BBL) subcultures, and 50 of the isolates were recovered from MGIT cultures of samples from various body sites. For the MGIT AST method, 0.5 ml of test organism suspension was inoculated into an MGIT with 0.1 micrograms of INH per ml, an MGIT with 1.0 micrograms of RIF per ml, and growth control MGIT. The tubes were incubated at 37 degrees C and were examined daily. The MGIT AST results were interpreted as follows: susceptible if the tubes containing INH or RIF did not fluoresce within 2 days of the time that the positive growth control fluoresced and resistant if the tubes containing INH or RIF did fluoresce within 2 days of the time that the positive growth control fluoresced. The mean time fluorescence for the positive growth control was 5.5 days. The two methods were in agreement for 114 of the 117 isolates from patients, while for 3 isolates there were minor discordant results. PMID:8735121

  10. Cost of genetic counseling and testing for BRCA1 and BRCA2 breast cancer susceptibility mutations.

    PubMed

    Lawrence, W F; Peshkin, B N; Liang, W; Isaacs, C; Lerman, C; Mandelblatt, J S

    2001-05-01

    Counseling and predictive testing are now available for the recently isolated BRCA1 and BRCA2 breast cancer susceptibility genes. We examined the societal costs of providing this counseling and testing to women at risk of having a breast cancer susceptibility mutation. Genetic counselors in a research program prospectively monitored the time necessary to provide counseling and results disclosure. A time-motion study was used to determine time spent on phone calls, preparation, and documentation for counseling. Study participants were surveyed to determine travel time and need for dependent care during counseling. The test cost was calculated using the charge for full BRCA1/2 gene sequencing (Myriad Genetics, Inc.) multiplied by a Medicare-based cost-to-charge ratio. Counselors spent an average of 4.2 h providing genetic counseling for women at risk of having a susceptibility mutation. Genetic counseling without testing cost on average $213, whereas counseling, testing, and disclosure of results totaled $2057. A brief physician-based counseling instead of genetic counselor-based counseling would produce only small reductions in total costs. Providing counseling and testing to the study population averaged $8034 per mutation found. The cost of testing and counseling exceeded $2000. The counseling portion of the cost comprised only 16% of the total cost, with the remainder representing costs associated with testing; thus, alternatives to full genetic counseling that shorten counseling time are unlikely to have a large impact on the overall cost of counseling and testing. The cost of detecting a mutation within a population of women is highly dependent on the prevalence of the mutation in the population.

  11. Herniated Cervical Disc

    MedlinePlus

    ... center of the disc may start to lose water content, making the disc less effective as a cushion. As a disc deteriorates, the outer layer can also tear. This can allow displacement of the disc's center (called a herniated or ...

  12. Optimized In Vitro Antibiotic Susceptibility Testing Method for Small-Colony Variant Staphylococcus aureus

    PubMed Central

    Precit, Mimi R.; Wolter, Daniel J.; Griffith, Adam; Emerson, Julia; Burns, Jane L.

    2016-01-01

    Staphylococcus aureus small-colony variants (SCVs) emerge frequently during chronic infections and are often associated with worse disease outcomes. There are no standardized methods for SCV antibiotic susceptibility testing (AST) due to poor growth and reversion to normal-colony (NC) phenotypes on standard media. We sought to identify reproducible methods for AST of S. aureus SCVs and to determine whether SCV susceptibilities can be predicted on the basis of treatment history, SCV biochemical type (auxotrophy), or the susceptibilities of isogenic NC coisolates. We tested the growth and stability of SCV isolates on 11 agar media, selecting for AST 2 media that yielded optimal SCV growth and the lowest rates of reversion to NC phenotypes. We then performed disk diffusion AST on 86 S. aureus SCVs and 28 isogenic NCs and Etest for a subset of 26 SCVs and 24 isogenic NCs. Growth and reversion were optimal on brain heart infusion agar and Mueller-Hinton agar supplemented with compounds for which most clinical SCVs are auxotrophic: hemin, menadione, and thymidine. SCVs were typically nonsusceptible to either trimethoprim-sulfamethoxazole or aminoglycosides, in accordance with the auxotrophy type. In contrast, SCVs were variably nonsusceptible to fluoroquinolones, macrolides, lincosamides, fusidic acid, and rifampin; mecA-positive SCVs were invariably resistant to cefoxitin. All isolates (both SCVs and NCs) were susceptible to quinupristin-dalfopristin, vancomycin, minocycline, linezolid, chloramphenicol, and tigecycline. Analysis of SCV auxotrophy type, isogenic NC antibiograms, and antibiotic treatment history had limited utility in predicting SCV susceptibilities. With clinical correlation, this AST method and these results may prove useful in directing treatment for SCV infections. PMID:26729501

  13. [Comparison of microdilution method and Phoenix automated system for testing antimicrobial susceptibilities of Enterococcus strains].

    PubMed

    Gülmez, Dolunay; Hasçelik, Gülşen

    2011-01-01

    Enterococcus spp. are important pathogens which are intrinsically resistant to most of the commonly used antimicrobial agents such as aminoglycosides and cephalosporins. Accurate determination of resistance is important to ensure appropriate antimicrobial therapy. This study was undertaken to compare the susceptibility results obtained by Phoenix system (Becton Dickinson, USA) with reference microdilution method. We included 1248 Enterococcus spp. (903 Enterococcus faecalis, 345 Enterococcus faecium) strains isolated from clinical samples between 2005-2007 in routine microbiology laboratory of Hacettepe University Hospital. The strains were identified and the antimicrobial susceptibilities were determined by the Phoenix system. Antimicrobial susceptibilities to ampicillin, teicoplanin, vancomycin, gentamicin and streptomycin were also studied by microdilution method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Evaluation revealed excellent agreement for all of the antibiotics with category agreement rates of > 97%. Among 1248 strains, 76 revealed discordant results. Very major error rates were 1.5% for ampicillin, 1.3% for gentamicin, and 0.9% for streptomycin. Major error rates were 1.4% for streptomycin, 0.6% for ampicillin and vancomycin and 0.3% for gentamicin. Minor error rates were found as 0.2% for vancomycin, and 0.1% for teicoplanin. Resistance rates obtained by microdilution were as follows; high level streptomycin 44%, high level gentamicin 29.7%, ampicillin 25.6%, vancomycin 2.2% and teicoplanin 2.2%. Resistance rates were higher in E.faecium than E.faecalis and 96.4% of the vancomycin resistant enterococcus isolates were identified as E.faecium. In conclusion, based on the data obtained, Phoenix system is reliable for testing susceptibilities of Enterococcus spp. to these antimicrobials. Since isolation of vancomycin resistant enterococci has an important impact in terms of hospital infection control, vancomycin

  14. In Vitro Susceptibilities of Mycoplasma hominis to Six Fluoroquinolones as Determined by E Test

    PubMed Central

    Waites, Ken B.; Canupp, Kay C.; Kenny, George E.

    1999-01-01

    Twenty isolates of Mycoplasma hominis were tested for their susceptibility to six fluoroquinolones by the E test. The MICs at which 90% of the isolates were inhibited (in micrograms per milliliter) were as follows: sparfloxacin, 0.031; clinafloxacin, moxifloxacin, and trovafloxacin, 0.063; levofloxacin, 0.25; and ciprofloxacin, 0.5. Increasing the amount of inoculum or incubation in CO2 elevated MICs by ≤1 dilution. E tests produce fluoroquinolone MICs comparable to those obtained by agar and microbroth dilution for M. hominis. PMID:10508049

  15. The effect of age on result of straight leg raising test in patients suffering lumbar disc herniation and sciatica.

    PubMed

    Tabesh, Homayoun; Tabesh, Ariyan; Fakharian, Esmaeil; Fazel, Mohammadreza; Abrishamkar, Saeid

    2015-02-01

    Ninety percent of all people sometimes during their lives experience low back pain, and 30-40% develops radicular leg pain with the sciatica characteristics. Although for clinical diagnosis of lumbar disc herniation (LDH) straight leg raising (SLR) test in 85-90% of cases indicates LDH, but in our practice with LDH patients this test is frequently negative despite radicular leg pain due to LDH. Hence, we decided to evaluate this test in LDH in different age groups. All patients with leg pain referring to neurosurgery clinic were enrolled. Those with a history of pain other than sciatica excluded and SLR test and magnetic resonance imaging (MRI) of the lumbosacral spine performed. The patients with negative MRI findings excluded and finally 269 patients with true sciatica and positive MRI were included. SLR tests were performed for different age groups. Of 269 patients, 167 were male. The age range was 16-80 years. The most involved levels were L5-S1 (47%) and L4-L5 (42%), respectively. The rate of positive SLR result, which was 100%, 87% and 82% for 10-19, 20-29 and 30-39 years age group respectively. With an increment of age, the rate of positive test regularly declined. The chance of positive SLR in men is 1.3 times the women (odds ratio [OR] 2.4; 95% confidence interval [CI] = 1.265-4.557; P = 0.007). Increasing the age has suppression effect in positivity of SLR so that for each 1-year the chance of SLR become 0.27 times less to become positive and this is also statically meaningful (OR = 0.271;95% CI = 0.188-0.391; P,0.001). The chance of positive SLR for patients under 60 is 5.4 folds more than patients above 60 years old (OR = 5.4; 95% CI = 4-8.3; P, 0.001). Age, sex (male), and disk level had statistically the effect on SLR positive test.

  16. What's in a Name? The Impact of Accurate Staphylococcus pseudintermedius Identification on Appropriate Antimicrobial Susceptibility Testing

    PubMed Central

    2016-01-01

    Bacteria in the Staphylococcus intermedius group, including Staphylococcus pseudintermedius, often encode mecA-mediated methicillin resistance. Reliable detection of this phenotype for proper treatment and infection control decisions requires that these coagulase-positive staphylococci are accurately identified and specifically that they are not misidentified as S. aureus. As correct species level bacterial identification becomes more commonplace in clinical laboratories, one can expect to see changes in guidance for antimicrobial susceptibility testing and interpretation. The study by Wu et al. in this issue (M. T. Wu, C.-A. D. Burnham, L. F. Westblade, J. Dien Bard, S. D. Lawhon, M. A. Wallace, T. Stanley, E. Burd, J. Hindler, R. M. Humphries, J Clin Microbiol 54:535–542, 2016, http://dx.doi.org/10.1128/JCM.02864-15) highlights the impact of robust identification of S. intermedius group organisms on the selection of appropriate antimicrobial susceptibility testing methods and interpretation. PMID:26763965

  17. Effect of Susceptibility Testing Conditions on the In Vitro Antibacterial Activity of ETX0914.

    PubMed

    Giacobbe, Robert A; Huband, Michael D; deJonge, Boudewijn L M; Bradford, Patricia A

    2017-02-01

    The effect of various conditions including pH, inoculum, temperature, atmosphere, divalent cations, and several body fluids on the in vitro activity of the novel antibacterial spiropyrimidinetrione ETX0914 in standard susceptibility tests was investigated against several species. None of the parameters investigated affected the activity of ETX0914, with the exception of pH. Whereas the MIC values for ETX0914 with S. aureus, E. faecalis, and E. coli did not change when the pH of the growth medium was varied from 5 to 8, they did increase at least 8-fold at pH values above 8. This loss of activity can be attributed to the deprotonation of the molecule at elevated pH. The data suggest that routine susceptibility testing with ETX0914 should result in reproducible MIC values.

  18. Proposed interpretive criteria and quality control parameters for ofloxacin susceptibility testing of Neisseria gonorrhoeae.

    PubMed Central

    Fuchs, P C; Barry, A L; Baker, C; Murray, P R; Washington, J A

    1992-01-01

    A multilaboratory study designed to determine the in vitro susceptibility criteria and quality control parameters for ofloxacin against Neisseria gonorrhoeae was conducted according to the guidelines of the National Committee for Clinical Laboratory Standards. Proposed susceptibility breakpoints are MICs of less than or equal to 0.25 microgram/ml for the agar dilution test and greater than or equal to 31 mm for the disk diffusion test. A category for resistance could not be defined. Proposed acceptable quality control MICs for N. gonorrhoeae ATCC 49226 and Staphylococcus aureus ATCC 29213 range from 0.004 to 0.03 microgram/ml and 0.25 to 1.0 microgram/ml, respectively. With 5-micrograms ofloxacin disks, acceptable inhibitory zone diameters for S. aureus ATCC 25923 and the N. gonorrhoeae control strains range from 22 to 27 mm and 43 to 51 mm, respectively. PMID:1572960

  19. Development of an Accelerated Test Method for the Determination of Susceptibility to Atmospheric Corrosion

    NASA Technical Reports Server (NTRS)

    Ambrose, John R.

    1991-01-01

    The theoretical rationale is presented for use of a repetitive cyclic current reversal voltammetric technique for characterization of localized corrosion processes, including atmospheric corrosion. Applicability of this proposed experimental protocol is applied to characterization of susceptibility to crevice and pitting corrosion, atmospheric corrosion and stress corrosion cracking. Criteria upon which relative susceptibility is based were determined and tested using two iron based alloys commonly in use at NASA-Kennedy; A36 (a low carbon steel) and 4130 (a low alloy steel). Practicality of the procedure was demonstrated by measuring changes in anodic polarization behavior during high frequency current reversal cycles of 25 cycles per second with 1 mA/sq cm current density amplitude in solutions containing Cl anions. The results demonstrated that, due to excessive polarization which affects conductivity of barrier corrosion product layers, A36 was less resistant to atmospheric corrosion than its 4130 counterpart; behavior which was also demonstrated during exposure tests.

  20. Novel Antibiotic Susceptibility Tests by the ATP-Bioluminescence Method Using Filamentous Cell Treatment

    PubMed Central

    Hattori, Noriaki; Nakajima, Moto-O; O’Hara, Koji; Sawai, Tetsuo

    1998-01-01

    Antimicrobial susceptibility testing by the ATP-bioluminescence method has been noted for its speed; it provides susceptibility results within 2 to 5 h. However, several disagreements between the ATP method and standard methodology have been reported. The present paper describes a novel ATP method in a 3.5-h test which overcomes these deficiencies through the elimination of false-resistance discrepancies in tests on gram-negative bacteria with β-lactam agents. In our test model using Pseudomonas aeruginosa and piperacillin, it was shown that ATP in filamentous cells accounted for the false resistance. We found that 0.5% 2-amino-2-methyl-1,3-propanediol (AMPD) extracted ATP from the filamentous cells without affecting normal cells and that 0.3 U of adenosine phosphate deaminase (APDase)/ml simultaneously digested the extracted ATP. We used the mixture of these reagents for the pretreatment of cells in a procedure we named filamentous cell treatment, prior to ATP measurements. This novel ATP method with the filamentous cell treatment eliminated false-resistance discrepancies in tests on P. aeruginosa with β-lactam agents, including piperacillin, cefoperazone, aztreonam, imipenem-cilastatin, ceftazidime, and cefsulodin. Furthermore, this novel methodology produced results which agreed with those of the standard microdilution method in other tests on gram-negative and gram-positive bacteria, including P. aeruginosa, Escherichia coli, Staphylococcus aureus, and Enterococcus faecalis, for non-β-lactam agents, such as fosfomycin, ofloxacin, minocycline, and aminoglycosides. MICs obtained by the novel ATP method were also in agreement with those obtained by the agar dilution method of susceptibility testing. From these results, it was shown that the novel ATP method could be used successfully to test the activities of antimicrobial agents with the elimination of the previously reported discrepancies. PMID:9624485

  1. Correlation of different phenotypic drug susceptibility testing methods for four fluoroquinolones in Mycobacterium tuberculosis.

    PubMed

    Coeck, Nele; de Jong, Bouke C; Diels, Maren; de Rijk, Pim; Ardizzoni, Elisa; Van Deun, Armand; Rigouts, Leen

    2016-05-01

    Molecular resistance testing fails to explain all fluoroquinolone resistance, with a continued need for a suitable rapid phenotypic drug susceptibility testing method. To evaluate the optimal method for phenotypic fluoroquinolone susceptibility testing. Using Löwenstein-Jensen medium, Middlebrook 7H11 agar, BACTEC-MGIT 960 and the resazurin microtitre plate assay, we determined susceptibility to fluoroquinolones in Mycobacterium tuberculosis and investigated cross-resistance between ofloxacin, levofloxacin, moxifloxacin and gatifloxacin. We compared MICs of all four fluoroquinolones for 91 strains on Löwenstein-Jensen (as the gold standard) with their MICs in resazurin plates, and with ofloxacin susceptibility at a single concentration in MGIT and on 7H11 agar, in addition to sequencing of the gyrAB genes. Applying a cut-off of 2 mg/L ofloxacin, 1 mg/L levofloxacin and 0.5 mg/L moxifloxacin and gatifloxacin in all methods, some discordance between solid medium and MGIT methods was observed, yet this tended to be explained by MICs around the cut-off. The high discordance between Löwenstein-Jensen (LJ) and resazurin plates suggests that the currently applied cut-offs for all fluoroquinolones in the resazurin method should decrease and minor changes in colour (from blue to purple) be considered as meaningful. High-level resistance in all assays to all drugs correlated well with the presence of gyrA mutations, in support of recent findings that fluoroquinolone resistance should be tested at different concentrations, as patients with lower levels of resistance may continue to benefit from high-dose fluoroquinolone-based therapy. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.

  2. Automated reading of a microtitre plate: preliminary evaluation in antimicrobial susceptibility tests and Enterobacteriaceae identification.

    PubMed Central

    Courcol, R J; Deleersnyder, H; Roussel-Delvallez, M; Martin, G R

    1983-01-01

    An automated microELISA Reader was evaluated for its ability to read and interpret microtitre plates. A total of 309 microtitre plates were investigated by automated and visual methods. There was disagreement between the methods in one hundred and twelve (0.6%) wells. However agreements between the two methods for susceptibility tests and Enterobacteriaceae identification were respectively 98.8% and 89.3%. PMID:6338058

  3. Evaluation of a New System, VITEK 2, for Identification and Antimicrobial Susceptibility Testing of Enterococci

    PubMed Central

    Garcia-Garrote, Fernando; Cercenado, Emilia; Bouza, Emilio

    2000-01-01

    We evaluated the new automated VITEK 2 system (bioMérieux) for the identification and antimicrobial susceptibility testing of enterococci. The results obtained with the VITEK 2 system were compared to those obtained by reference methods: standard identification by the scheme of Facklam and Sahm [R. R. Facklam and D. F. Sahm, p. 308–314, in P. R. Murray et al., ed., Manual of Clinical Microbiology, 6th ed., 1995] and with the API 20 STREP system and, for antimicrobial susceptibility testing, broth microdilution and agar dilution methods by the procedures of the National Committee for Clinical Laboratory Standards. The presence of vanA and vanB genes was determined by PCR. A total of 150 clinical isolates were studied, corresponding to 60 Enterococcus faecalis, 55 Enterococcus faecium, 26 Enterococcus gallinarum, 5 Enterococcus avium, 2 Enterococcus durans, and 2 Enterococcus raffinosus isolates. Among those isolates, 131 (87%) were correctly identified to the species level with the VITEK 2 system. Approximately half of the misidentifications were for E. faecium with low-level resistance to vancomycin, identified as E. gallinarum or E. casseliflavus; however, a motility test solved the discrepancies and increased the agreement to 94%. Among the strains studied, 66% were vancomycin resistant (57 VanA, 16 VanB, and 26 VanC strains), 23% were ampicillin resistant (MICs, ≥16 μg/ml), 31% were high-level gentamicin resistant, and 45% were high-level streptomycin resistant. Percentages of agreement for susceptibility and resistance to ampicillin, vancomycin, and teicoplanin and for high-level gentamicin resistance and high-level streptomycin resistance were 93, 95, 97, 97, and 96%, respectively. The accuracy of identification and antimicrobial susceptibility testing of enterococci with the VITEK 2 system, together with the significant reduction in handling time, will have a positive impact on the work flow of the clinical microbiology laboratory. PMID:10834961

  4. Direct Antimicrobial Susceptibility Testing of Gram-Negative Bacilli in Blood Cultures by an Electrochemical Method

    PubMed Central

    Huang, Ay Huey; Wu, Jiunn Jong; Weng, Yu Mei; Ding, Hwia Cheng; Chang, Tsung Chain

    1998-01-01

    Nonfastidious aerobic gram-negative bacilli (GNB) are commonly isolated from blood cultures. The feasibility of using an electrochemical method for direct antimicrobial susceptibility testing of GNB in positive blood cultures was evaluated. An aliquot (10 μl) of 1:10-diluted positive blood cultures containing GNB was inoculated into the Bactometer module well (bioMérieux Vitek, Hazelwood, Mo.) containing 1 ml of Mueller-Hinton broth supplemented with an antibiotic. Susceptibility tests were performed in a breakpoint broth dilution format, with the results being categorized as resistant, intermediate, or susceptible. Seven antibiotics (ampicillin, cephalothin, gentamicin, amikacin, cefamandole, cefotaxime, and ciprofloxacin) were used in this study, with each agent being tested at the two interpretive breakpoint concentrations. The inoculated modules were incubated at 35°C, and the change in impedance in each well was continuously monitored for 24 h by the Bactometer. The MICs of the seven antibiotics for each blood isolate were also determined by the standardized broth microdilution method. Of 146 positive blood cultures (1,022 microorganism-antibiotic combinations) containing GNB tested by the direct method, the rates of very major, major, and minor errors were 0, 1.1, and 2.5%, respectively. The impedance method was simple; no centrifugation, preincubation, or standardization of the inocula was required, and the susceptibility results were normally available within 3 to 6 h after inoculation. The rapid method may allow proper antimicrobial treatment almost 30 to 40 h before the results of the standard methods are available. PMID:9738038

  5. Evaluation of a new system, VITEK 2, for identification and antimicrobial susceptibility testing of enterococci.

    PubMed

    Garcia-Garrote, F; Cercenado, E; Bouza, E

    2000-06-01

    We evaluated the new automated VITEK 2 system (bioMérieux) for the identification and antimicrobial susceptibility testing of enterococci. The results obtained with the VITEK 2 system were compared to those obtained by reference methods: standard identification by the scheme of Facklam and Sahm [R. R. Facklam and D. F. Sahm, p. 308-314, in P. R. Murray et al., ed., Manual of Clinical Microbiology, 6th ed., 1995] and with the API 20 STREP system and, for antimicrobial susceptibility testing, broth microdilution and agar dilution methods by the procedures of the National Committee for Clinical Laboratory Standards. The presence of vanA and vanB genes was determined by PCR. A total of 150 clinical isolates were studied, corresponding to 60 Enterococcus faecalis, 55 Enterococcus faecium, 26 Enterococcus gallinarum, 5 Enterococcus avium, 2 Enterococcus durans, and 2 Enterococcus raffinosus isolates. Among those isolates, 131 (87%) were correctly identified to the species level with the VITEK 2 system. Approximately half of the misidentifications were for E. faecium with low-level resistance to vancomycin, identified as E. gallinarum or E. casseliflavus; however, a motility test solved the discrepancies and increased the agreement to 94%. Among the strains studied, 66% were vancomycin resistant (57 VanA, 16 VanB, and 26 VanC strains), 23% were ampicillin resistant (MICs, >/=16 microgram/ml), 31% were high-level gentamicin resistant, and 45% were high-level streptomycin resistant. Percentages of agreement for susceptibility and resistance to ampicillin, vancomycin, and teicoplanin and for high-level gentamicin resistance and high-level streptomycin resistance were 93, 95, 97, 97, and 96%, respectively. The accuracy of identification and antimicrobial susceptibility testing of enterococci with the VITEK 2 system, together with the significant reduction in handling time, will have a positive impact on the work flow of the clinical microbiology laboratory.

  6. In Vitro Susceptibility Testing of Eravacycline Is Unaffected by Medium Age and Nonstandard Assay Parameters

    PubMed Central

    Pillar, Chris M.; Sahm, Daniel F.; Sutcliffe, Joyce A.

    2015-01-01

    Eravacycline is a fluorocycline antibiotic in phase 3 clinical development for complicated intra-abdominal and urinary tract infections. To support its clinical development, a study was conducted to evaluate the effects of various susceptibility test parameters on the MIC values for aerobic bacteria. The results showed that eravacycline appears to be largely unaffected by medium age, medium additives, and other nonstandard assay conditions. PMID:25605350

  7. Antimicrobial susceptibility of anaerobic bacteria in Belgium as determined by E-test methodology.

    PubMed

    Glupczynski, Y; Berhin, C; Nizet, H

    2009-03-01

    The objective was to collect recent data on the antibiotic susceptibility of clinically significant anaerobes in Belgium. A total of 333 anaerobic clinical isolates from various body sites were prospectively collected between 2005 and 2007 at two tertiary care hospitals in Belgium. The minimal inhibitory concentrations (MICs) were determined using the E-test method for nine anti-anaerobic antibiotics. Sixty-one percent of the isolates were beta-lactamase producers, which explains the poor activity of penicillin. Amoxicillin/clavulanic acid, piperacillin/tazobactam, metronidazole and meropenem were very active against most anaerobes, but around 10% of the Bacteroides fragilis group strains were non-susceptible to the two beta-lactam/beta-lactamase inhibitors. No resistance was observed to metronidazole, while 3% of the Bacteroides spp. had decreased susceptibility to meropenem (MIC > or = 4 mg/L). Cefoxitin, clindamycin and moxifloxacin were less active, with 33%, 52% and 57% of the B. fragilis group being non-susceptible respectively. Tigecycline showed consistently good activity against most anaerobes with MIC(50) and MIC(90) of 0.25 and 2 mg/L. Metronidazole, amoxicillin/clavulanate, piperacillin/tazobactam and meropenem remain good empirical choices when anaerobes are expected in our setting. Because of the occurrence of resistance to most classes of current anti-anaerobic antibiotics, it is recommended that the antimicrobial resistance patterns be monitored regularly in order to guide empirical therapy.

  8. In vitro antifungal susceptibility testing of Candida blood isolates and evaluation of the E-test method.

    PubMed

    Lu, Jang-Jih; Lee, Shih-Yi; Chiueh, Tzong-Shi

    2004-12-01

    Fungal infections have dramatically increased in recent years, along with the increase of drug-resistant isolates in immunocompromised patients. Ninety eight Candida species obtained from blood cultures at the Tri-Service General Hospital, Taiwan, from 1998 to 2000 were studied. These included 50 Candida albicans, 13 Candida glabrata, 24 Candida tropicalis and 11 Candida parapsilosis isolates. To investigate their susceptibility to commonly used antifungal drugs, minimum inhibitory concentrations (MIC) of amphotericin B, fluconazole, flucytosine, and ketoconazole were determined. Both the National Committee for Clinical Laboratory Standards reference broth macrodilution method and E-test were used in parallel. Ninety five isolates (95/98, 96.94%) were susceptible to amphotericin B at a concentration < or = 1 microg/mL. All isolates (100%, 98/98) were susceptible to flucytosine. Approximately 30% of these Candida isolates were resistant to fluconazole. The MIC for 90% of isolates (MIC90) values for both methods for these isolates were 0.5 microg/mL for amphotericin B, 32 microg/mL for fluconazole, 0.25 microg/mL for flucytosine (0.125 microg/mL by E-test method), and 4 microg/mL for ketoconazole. MIC for 50% of isolates (MIC50) values for these agents were 0.25, 2, 0.06, and 0.06 microg/mL, respectively. The essential agreement of MIC values within 2 dilutions for the 2 methods was 99.0% for amphotericin B, 90.8% for ketoconazole, 92.9% for fluconazole, and 91.8% for flucytosine. This study showed that E-test has equivalent performance to the broth macrodilution method and can be used as an alternative MIC technique for antifungal susceptibility testing.

  9. Levofloxacin susceptibility testing against Helicobacter pylori: evaluation of a modified disk diffusion method compared to E test.

    PubMed

    Boyanova, Lyudmila; Ilieva, Juliana; Gergova, Galina; Mitov, Ivan

    2016-01-01

    We compared levofloxacin (1 μg/disk) disk diffusion method to E test against 212 Helicobacter pylori strains. Using diameter breakpoints for susceptibility (≥15 mm) and resistance (≤9 mm), very major error, major error rate, and categoric agreement were 0.0%, 0.6%, and 93.9%, respectively. The method may be useful in low-resource laboratories. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Antifungal Susceptibility Testing of Fluconazole by Flow Cytometry Correlates with Clinical Outcome

    PubMed Central

    Wenisch, Christoph; Moore, Caroline B.; Krause, Robert; Presterl, Elisabeth; Pichna, Peter; Denning, David W.

    2001-01-01

    Susceptibility testing of fungi by flow cytometry (also called fluorescence-activated cell sorting [FACS]) using vital staining with FUN-1 showed a good correlation with the standard M27-A procedure for assessing MICs. In this study we determined MICs for blood culture isolates from patients with candidemia by NCCLS M27-A and FACS methods and correlated the clinical outcome of these patients with in vitro antifungal resistance test results. A total of 24 patients with candidemia for whom one or more blood cultures were positive for a Candida sp. were included. Susceptibility testing was performed by NCCLS M27-A and FACS methods. The correlation of MICs (NCCLS M27-A and FACS) and clinical outcome was calculated. In 83% of the cases, the MICs of fluconazole determined by FACS were within 1 dilution of the MICs determined by the NCCLS M27-A method. For proposed susceptibility breakpoints, there was 100% agreement between the M27-A and FACS methods. In the FACS assay, a fluconazole MIC of <1 μg/ml was associated with cure (P < 0.001) whereas an MIC of ≥1 μg/ml was associated with death (P < 0.001). The M27-A-derived fluconazole MICs did not correlate with outcome (P = 1 and P = 0.133). PMID:11427554

  11. A microfluidic device for antimicrobial susceptibility testing based on a broth dilution method.

    PubMed

    Lee, Wen-Bin; Fu, Chien-Yu; Chang, Wen-Hsin; You, Huey-Ling; Wang, Chih-Hung; Lee, Mel S; Lee, Gwo-Bin

    2017-01-15

    Bacterial resistance to antimicrobial compounds is increasing at a faster rate than the development of new antibiotics; this represents a critical challenge for clinicians worldwide. Normally, the minimum inhibitory concentration of an antibiotic, the dosage at which bacterial growth is thwarted, provides an effective quantitative measure for antimicrobial susceptibility testing, and determination of minimum inhibitory concentration is conventionally performed by either a serial broth dilution method or with the commercially available Etest(®) (Biomerieux, France) kit. However, these techniques are relatively labor-intensive and require a significant amount of training. In order to reduce human error and increase operation simplicity, a simple microfluidic device that can perform antimicrobial susceptibility testing automatically via a broth dilution method to accurately determine the minimum inhibitory concentration was developed herein. As a proof of concept, wild-type (ATCC 29212) and vancomycin-resistant Enterococcus cells were incubated at five different vancomycin concentrations on-chip, and the sample injection, transport, and mixing processes occurred within five reaction chambers and three reagent chambers via the chip's automatic dispensation and dilution functions within nine minutes. The minimum inhibitory concentration values measured after 24h of antibiotic incubation were similar to those calculated using Etest(®). With its high flexibility, reliability, and portability, the developed microfluidic device provides a simple method for antimicrobial susceptibility testing in an automated format that could be implemented for clinical and point-of-care applications.

  12. 3D Elastic Solutions for Laterally Loaded Discs: Generalised Brazilian and Point Load Tests

    NASA Astrophysics Data System (ADS)

    Serati, Mehdi; Alehossein, Habib; Williams, David J.

    2014-07-01

    This paper investigates the application of a double Fourier series technique to the construction of an elastic stress field in a cylindrical bar subject to lateral boundary loads. The lateral loads, including the constant load boundary conditions, are represented by two Fourier series: one on the perimeter of the circular section ( r 0, θ) and the other on the longitudinal curved surface parallel to the bar axis ( z). The technique invokes acceptable potential functions of the Papkovich-Neuber displacement field, satisfying the governing partial differential equations, to assign appropriate odd and even trigonometric Fourier terms in cylindrical coordinates ( r, θ, z). The generic solution decomposes the problem of interest to a state of stress caused by two independent boundary conditions along the z axis and θ-polar angle, both superimposed on a solution for which these potentials are the product of the trigonometric terms of the independent variables ( θ, z). Constants appearing in the resultant second-order partial differential equations are determined from the generally mixed (tractions and/or displacements) boundary conditions. While the solutions are satisfied exactly at the ends of an infinite bar, they are satisfied weakly on average, in the light of Saint Venant's approximation at the two ends of a finite bar. The application of the proposed analysis is verified against available elastic solutions for axisymmetric and non-axisymmetric engineering problems such as the indirect Brazilian Tensile Strength and Point Load Strength tests.

  13. Multilaboratory evaluation of disk diffusion antimicrobial susceptibility testing of Neisseria meningitidis isolates.

    PubMed

    Jorgensen, James H; Crawford, Sharon A; Fulcher, Letitia C; Glennen, Anita; Harrington, Susan M; Swenson, Jana; Lynfield, Ruth; Murray, Patrick R; Tenover, Fred C

    2006-05-01

    In 2005, the Clinical and Laboratory Standards Institute published MIC interpretive criteria for 13 antimicrobial agents used for either therapy or prophylaxis of Neisseria meningitidis infections. The MIC method includes the use of lysed horse blood-supplemented Mueller-Hinton broth with incubation in 5% CO2 for 20 to 24 h. Since some clinical laboratories might prefer the option of disk diffusion testing for infrequently encountered isolates a multicenter collaborative study was conducted to evaluate the reproducibility of a disk diffusion method for testing isolates of N. meningitidis. Interpretive criteria were developed for 12 antimicrobial agents. Four laboratories tested a common collection of 50 meningococcal strains and then tested 25 unique isolates per laboratory. Isolates were tested using Mueller-Hinton sheep blood agar plates incubated for 20 to 24 h in 5% CO2; they were also tested by the reference broth microdilution method in parallel. Pooling of the MIC and disk diffusion data from the common and unique isolates provided a sufficient sample size to develop susceptible, intermediate, and resistant zone diameter interpretive criteria using the error rate-bounded method for the following agents: chloramphenicol, trimethoprim-sulfamethoxazole, ciprofloxacin, and rifampin. Due to the lack of resistant strains at the present time, "susceptible only" interpretive criteria were proposed for cefotaxime, ceftriaxone, meropenem, azithromycin, and minocycline. The numbers of minor interpretive errors with penicillin and ampicillin disk tests were unacceptably high and precluded recommended testing of those agents by the disk method. However, amdinocillin, an agent that preferentially binds to the altered penicillin binding protein responsible for diminished penicillin susceptibility, has potential utility as a surrogate screening reagent for ampicillin resistance. A disk diffusion breakpoint was derived for nalidixic acid to serve as a surrogate marker for

  14. Comparison of European Committee on Antimicrobial Susceptibility Testing (EUCAST) and Etest Methods with the CLSI Broth Microdilution Method for Echinocandin Susceptibility Testing of Candida Species▿

    PubMed Central

    Pfaller, M. A.; Castanheira, M.; Diekema, D. J.; Messer, S. A.; Moet, G. J.; Jones, R. N.

    2010-01-01

    The antifungal broth microdilution (BMD) method of the European Committee on Antibiotic Susceptibility Testing (EUCAST) and the Etest agar diffusion method were compared with the Clinical and Laboratory Standards Institute (CLSI) BMD method M27-A3 for anidulafungin, caspofungin, and micafungin susceptibility testing of 133 clinical isolates of Candida species. The isolates were characterized for the presence or absence of fks1 and/or fks2 gene mutations and included 34 isolates of C. glabrata (4 mutant strains), 32 of C. albicans (1 mutant strain), 25 of C. parapsilosis, 19 of C. guilliermondii, 12 of C. tropicalis (2 mutant strains), and 11 of C. krusei. Excellent essential agreement (EA; within 2 dilutions) between the CLSI and EUCAST and CLSI and Etest MIC results was observed. The overall EA between the EUCAST and CLSI results ranged from 89.5% (caspofungin) to 99.2% (micafungin), whereas the EA between the Etest and CLSI results ranged from 90.2% (caspofungin) to 93.2% (anidulafungin). The categorical agreement (CA) between methods for each antifungal agent was assessed using previously determined epidemiological cutoff values (ECVs). Excellent CA (>90%) was observed for all comparisons between the EUCAST and CLSI results with the exceptions of C. glabrata and caspofungin (85.3%) and C. krusei and caspofungin (54.5%). The CA between the Etest and CLSI results was also excellent for all comparisons, with the exception of C. krusei and caspofungin (81.8%). All three methods were able to differentiate wild-type (WT) strains from those with fks mutations. With anidulafungin as the test reagent, the CLSI method identified 5 of 7 mutant strains, whereas the EUCAST method and the Etest identified 6 of 7 mutant strains. With either caspofungin or micafungin as the test reagent, the CLSI method identified all 7 mutant strains and the EUCAST method identified 6 of 7 mutant strains. The Etest identified all 7 mutant strains using caspofungin as the reagent. All three

  15. Comparison of European Committee on Antimicrobial Susceptibility Testing (EUCAST) and Etest methods with the CLSI broth microdilution method for echinocandin susceptibility testing of Candida species.

    PubMed

    Pfaller, M A; Castanheira, M; Diekema, D J; Messer, S A; Moet, G J; Jones, R N

    2010-05-01

    The antifungal broth microdilution (BMD) method of the European Committee on Antibiotic Susceptibility Testing (EUCAST) and the Etest agar diffusion method were compared with the Clinical and Laboratory Standards Institute (CLSI) BMD method M27-A3 for anidulafungin, caspofungin, and micafungin susceptibility testing of 133 clinical isolates of Candida species. The isolates were characterized for the presence or absence of fks1 and/or fks2 gene mutations and included 34 isolates of C. glabrata (4 mutant strains), 32 of C. albicans (1 mutant strain), 25 of C. parapsilosis, 19 of C. guilliermondii, 12 of C. tropicalis (2 mutant strains), and 11 of C. krusei. Excellent essential agreement (EA; within 2 dilutions) between the CLSI and EUCAST and CLSI and Etest MIC results was observed. The overall EA between the EUCAST and CLSI results ranged from 89.5% (caspofungin) to 99.2% (micafungin), whereas the EA between the Etest and CLSI results ranged from 90.2% (caspofungin) to 93.2% (anidulafungin). The categorical agreement (CA) between methods for each antifungal agent was assessed using previously determined epidemiological cutoff values (ECVs). Excellent CA (>90%) was observed for all comparisons between the EUCAST and CLSI results with the exceptions of C. glabrata and caspofungin (85.3%) and C. krusei and caspofungin (54.5%). The CA between the Etest and CLSI results was also excellent for all comparisons, with the exception of C. krusei and caspofungin (81.8%). All three methods were able to differentiate wild-type (WT) strains from those with fks mutations. With anidulafungin as the test reagent, the CLSI method identified 5 of 7 mutant strains, whereas the EUCAST method and the Etest identified 6 of 7 mutant strains. With either caspofungin or micafungin as the test reagent, the CLSI method identified all 7 mutant strains and the EUCAST method identified 6 of 7 mutant strains. The Etest identified all 7 mutant strains using caspofungin as the reagent. All three

  16. Process analysis of variables for standardization of antifungal susceptibility testing of nonfermentative yeasts.

    PubMed

    Zaragoza, Oscar; Mesa-Arango, Ana C; Gómez-López, Alicia; Bernal-Martínez, Leticia; Rodríguez-Tudela, Juan Luis; Cuenca-Estrella, Manuel

    2011-04-01

    Nonfermentative yeasts, such as Cryptococcus spp., have emerged as fungal pathogens during the last few years. However, standard methods to measure their antifungal susceptibility (antifungal susceptibility testing [AST]) are not completely reliable due to the impaired growth of these yeasts in standard media. In this work, we have compared the growth kinetics and the antifungal susceptibilities of representative species of nonfermentative yeasts such as Cryptococcus neoformans, Cryptococcus gattii, Cryptococcus albidus, Rhodotorula spp., Yarrowia lipolytica, Geotrichum spp., and Trichosporon spp. The effect of the growth medium (RPMI medium versus yeast nitrogen base [YNB]), glucose concentration (0.2% versus 2%), nitrogen source (ammonium sulfate), temperature (30°C versus 35°C), shaking, and inoculum size (10(3), 10(4), and 10(5) cells) were analyzed. The growth rate, lag phase, and maximum optical density were obtained from each growth experiment, and after multivariate analysis, YNB-based media demonstrated a significant improvement in the growth of yeasts. Shaking, an inoculum size of 10(5) CFU/ml, and incubation at 30°C also improved the growth kinetics of organisms. Supplementation with ammonium sulfate and with 2% glucose did not have any effect on growth. We also tested the antifungal susceptibilities of all the isolates by the reference methods of the CLSI and EUCAST, the EUCAST method with shaking, YNB under static conditions, and YNB with shaking. MIC values obtained under different conditions showed high percentages of agreement and significant correlation coefficient values between them. MIC value determinations according to CLSI and EUCAST standards were rather complicated, since more than half of isolates tested showed a limited growth index, hampering endpoint determinations. We conclude that AST conditions including YNB as an assay medium, agitation of the plates, reading after 48 h of incubation, an inoculum size of 10(5) CFU/ml, and

  17. An in-vivo metabolic test for detecting malignant hyperthermia susceptibility in humans: a pilot study.

    PubMed

    Schuster, Frank; Metterlein, Thomas; Negele, Sabrina; Kranke, Peter; Muellenbach, Ralf M; Schwemmer, Ulrich; Roewer, Norbert; Anetseder, Martin

    2008-09-01

    In vitro contracture testing to diagnose malignant hyperthermia (MH) susceptibility requires a muscle biopsy, which may be associated with severe side effects for the patient. After investigation of several different protocols, we present a less invasive metabolic test that involves IM injection of caffeine and halothane, and subsequent measurement of interstitial lactate to differentiate between MH susceptible (MHS) and MH non-susceptible (MHN) individuals. Two microdialysis probes with attached microtubing for trigger injection were inserted into the lateral vastus muscle of eight previously diagnosed MHS patients (representing three genetic variants Gly2434Arg, Thr2206Met, and Arg614Cys), seven MHN patients, and seven control individuals. After equilibration and lactate baseline recording, a single bolus of 200 muL caffeine 80 mM and a suspension of 200 muL halothane 4%V/V in soy bean oil (triggers) were injected locally. Lactate was measured spectrophotometrically. Data are presented as medians and interquartile ranges. Although baseline lactate values were similar in the investigated groups before trigger injection, caffeine increased local lactate in MHS patients significantly more (2.0 [1.8-2.6] mM) than in MHN (0.8 [0.6-1.1] mM) or in control individuals (0.8 [0.6-0.8 mM]). Similarly, halothane lead to a significant lactate increase in MHS compared to MHN and control individuals (8.6 [3.7-8.9] mM vs 0.9 [0.5-1.1] mM and 1.7 [0.9-2.3] mM, respectively). However, a relevant increase of lactate was observed in one MHN and in two control individuals. Systemic hemodynamic and metabolic variables did not differ between the investigated groups. Metabolic monitoring of IM lactate after local caffeine and halothane injection may allow less invasive testing to detect MH susceptibility, without systemic side effects.

  18. Experimental approach for bacteriophage susceptibility testing of planktonic and sessile bacterial populations – Study protocol

    PubMed Central

    Neguţ, Alina Cristina; Săndulescu, Oana; Popa, Marcela; Streinu-Cercel, Anca; Alavidze, Zemphira; Berciu, Ioana; Bleotu, Coralia; Popa, Mircea Ioan; Chifiriuc, Mariana Carmen; Streinu-Cercel, Adrian

    2014-01-01

    Introduction Antimicrobial resistance is a growing threat for all clinical branches. This phenomenon poses important challenges in controlling infectious diseases. However, multidrug resistance is not the only issue, as bacteria that are otherwise susceptible to common antibiotics express other patterns for evading antibiotherapy, for example they can aggregate within a self-produced matrix to form biofilm. Methods We intend to perform a prospective laboratory study of the germs isolated from different samples collected from patients admitted with infectious pathology in reference hospitals in Romania. We will perform antibiotic resistance testing as well as phage testing, both on solid and liquid growth medium, for Staphylococcus spp., Enterococcus spp., and Pseudomonas spp. We intend to collect data for 150 patients with different infections with these identified pathogens. Phage susceptibility testing will be performed using 5 types of strain-specific bacteriophage mixtures: PYO, INTESTI, STAPHYLOCOCCAL (Eliava BioPreparations, Tbilisi, Georgia), PHAGYO, PHAGESTI (JSC “Biochimpharm”, Tbilisi, Georgia). For phage-susceptible strains, we will evaluate biofilm formation in the presence of phages, as well as phage effect on already formed biofilm. Expected results Through this study, we intend to provide the first set of results on bacteriophage-susceptibility of bacteria isolated from patients with hard to treat infections, from reference hospitals in Romania. By evaluating a large number of bacterial strains we aim to predict and project biofilm kinetics, while adding binary phage dilutions at key timepoints during biofilm formation. Acknowledgments POSDRU/159/1.5/S/141531; Carol Davila University of Medicine and Pharmacy, Young Researchers Grant no. 28341/2013. PMID:25505742

  19. Process Analysis of Variables for Standardization of Antifungal Susceptibility Testing of Nonfermentative Yeasts ▿

    PubMed Central

    Zaragoza, Oscar; Mesa-Arango, Ana C.; Gómez-López, Alicia; Bernal-Martínez, Leticia; Rodríguez-Tudela, Juan Luis; Cuenca-Estrella, Manuel

    2011-01-01

    Nonfermentative yeasts, such as Cryptococcus spp., have emerged as fungal pathogens during the last few years. However, standard methods to measure their antifungal susceptibility (antifungal susceptibility testing [AST]) are not completely reliable due to the impaired growth of these yeasts in standard media. In this work, we have compared the growth kinetics and the antifungal susceptibilities of representative species of nonfermentative yeasts such as Cryptococcus neoformans, Cryptococcus gattii, Cryptococcus albidus, Rhodotorula spp., Yarrowia lipolytica, Geotrichum spp., and Trichosporon spp. The effect of the growth medium (RPMI medium versus yeast nitrogen base [YNB]), glucose concentration (0.2% versus 2%), nitrogen source (ammonium sulfate), temperature (30°C versus 35°C), shaking, and inoculum size (103, 104, and 105 cells) were analyzed. The growth rate, lag phase, and maximum optical density were obtained from each growth experiment, and after multivariate analysis, YNB-based media demonstrated a significant improvement in the growth of yeasts. Shaking, an inoculum size of 105 CFU/ml, and incubation at 30°C also improved the growth kinetics of organisms. Supplementation with ammonium sulfate and with 2% glucose did not have any effect on growth. We also tested the antifungal susceptibilities of all the isolates by the reference methods of the CLSI and EUCAST, the EUCAST method with shaking, YNB under static conditions, and YNB with shaking. MIC values obtained under different conditions showed high percentages of agreement and significant correlation coefficient values between them. MIC value determinations according to CLSI and EUCAST standards were rather complicated, since more than half of isolates tested showed a limited growth index, hampering endpoint determinations. We conclude that AST conditions including YNB as an assay medium, agitation of the plates, reading after 48 h of incubation, an inoculum size of 105 CFU/ml, and incubation at 30

  20. Evaluation of Carbon Nanotube Thin Films for Optically Transparent Microwave Applications Using On-Wafer Probing of Corbino Disc Test Structures

    DTIC Science & Technology

    2013-03-01

    Structures by Ryan C. Toonen, Julia B. Doggett, S. Gary Hirsch, Mathew P . Ivill, Eric H. Ngo, Clifford W. Hubbard, Henning Richter, and Ramesh Sivarajan...Corbino Disc Test Structures Ryan C. Toonen, S. Gary Hirsch, Mathew P . Ivill, Eric H. Ngo, and Clifford W. Hubbard Weapons and Materials Research...5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Ryan C. Toonen, Julia B. Doggett,* S. Gary Hirsch, Mathew P . Ivill, Eric H. Ngo, Clifford

  1. Correlation between microdilution, E-test, and disk diffusion methods for antifungal susceptibility testing of posaconazole against Candida spp.

    PubMed

    Sims, Charles R; Paetznick, Victor L; Rodriguez, Jose R; Chen, Enuo; Ostrosky-Zeichner, Luis

    2006-06-01

    Agar-based antifungal susceptibility testing is an attractive alternative to the microdilution method. We examined the correlation between the microdilution, E-test, and disk diffusion methods for posaconazole against Candida spp. A total of 270 bloodstream isolates of Candida spp. with a broad range of posaconazole MICs were tested using the CLSI M27-A2 method for microdilution, as well as the M-44A method and E-test methods for agar-based testing on Mueller-Hinton agar supplemented with 2% glucose and 0.5 microg of methylene blue. MICs and inhibitory zone diameters at the prominent growth reduction endpoint were recorded at 24 and 48 h. The Candida isolates included Candida albicans (n = 124), C. parapsilosis (n = 44), C. tropicalis (n = 41), C. glabrata (n = 36), C. krusei (n = 20), C. lusitaniae (n = 3), and C. dubliniensis (n = 2). The overall concordance (i.e., the percentage of isolates within two dilutions) between the E-test and microdilution was 64.8% at 24 h and 82.6% at 48 h. When we considered an arbitrary breakpoint of < or = 1 microg/ml, the agreement between the E-test and microdilution methods was 87.8% at 24 h and 93.0% at 48 h. The correlation of MICs with disk diffusion zone diameters was better for the E-test than the microdilution method. Zone correlation for diameters produced by the disks of two manufacturers was high, with a Pearson test value of 0.941 at 24 h. The E-test and microdilution MICs show good concordance and interpretative agreement. The disk diffusion zone diameters are highly reproducible and correlate well with both the E-test and the microdilution method, making agar-based methods a viable alternative to microdilution for posaconazole susceptibility testing.

  2. Attitudes of obstetrician-gynecologists toward DNA testing for a genetic susceptibility to breast cancer.

    PubMed

    Rowley, P T; Loader, S

    1996-10-01

    To assess knowledge and attitudes of area obstetrician-gynecologists toward DNA testing for genetic susceptibility to breast cancer. At a staff meeting of each of the Rochester area's hospitals that had an obstetric service, we assessed knowledge of inherited predisposition to breast cancer, presented the current status of testing for genetic susceptibility, and assessed attitudes toward such testing. The majority of the physicians surveyed believed that current BRCA1 testing can detect a genetic predisposition to breast cancer accurately enough to be clinically useful (81%) and that a young woman with a family history of breast cancer not currently having regular mammography is likely to benefit from DNA testing because a positive result may motivate her to start mammography earlier (88%). However, most respondents thought that women who test positive are likely to be excessively anxious (87%) and may be discriminated against for insurance purposes (75%). In response to an invitation to participate in a clinical trial of free BRCA1 screening, 74 (70%) desired to participate. Obstetrician-gynecologists expect women detected to have a BRCA1 mutation to be motivated to conduct surveillance, but also to experience anxiety and possible discrimination.

  3. Public interest in predictive genetic testing, including direct-to-consumer testing, for susceptibility to major depression: preliminary findings.

    PubMed

    Wilde, Alex; Meiser, Bettina; Mitchell, Philip B; Schofield, Peter R

    2010-01-01

    The past decade has seen rapid advances in the identification of associations between candidate genes and a range of common multifactorial disorders. This paper evaluates public attitudes towards the complexity of genetic risk prediction in psychiatry involving susceptibility genes, uncertain penetrance and gene-environment interactions on which successful molecular-based mental health interventions will depend. A qualitative approach was taken to enable the exploration of the views of the public. Four structured focus groups were conducted with a total of 36 participants. The majority of participants indicated interest in having a genetic test for susceptibility to major depression, if it was available. Having a family history of mental illness was cited as a major reason. After discussion of perceived positive and negative implications of predictive genetic testing, nine of 24 participants initially interested in having such a test changed their mind. Fear of genetic discrimination and privacy issues predominantly influenced change of attitude. All participants still interested in having a predictive genetic test for risk for depression reported they would only do so through trusted medical professionals. Participants were unanimously against direct-to-consumer genetic testing marketed through the Internet, although some would consider it if there was suitable protection against discrimination. The study highlights the importance of general practitioner and public education about psychiatric genetics, and the availability of appropriate treatment and support services prior to implementation of future predictive genetic testing services.

  4. The use of E-test for the drug susceptibility testing of Mycobacterium tuberculosis - a solution or an illusion?

    PubMed

    Verma, J S; Rawat, D; Hasan, A; Capoor, M R; Gupta, K; Deb, M; Aggarwal, P; Nair, D

    2010-01-01

    To evaluate E-test as a tool for rapid determination of drug susceptibility against the conventional LJ method focusing on reliability, expense, ease of standardization and performance of the technique in low resource settings. A total of 74 clinical isolates (2004-2005) of Mycobacterium tuberculosis were tested using E-test for susceptibility to streptomycin (STM), isoniazid (INH), rifampicin (RIF) and ethambutol (EMB) by E-strip and LJ (LJPM) proportion methods. The LJPM method, the gold standard, detected resistance against STM in 16.2%, INH in 40.5%, RIF in 18.9% and EMB in 27% cases. In comparison, the resistance values showed by E-test was 66.67% for STM, 57.14% for INH 71.43% for RIF and 80% for EMB. The susceptible correlation was 90.32% for STM, 73.91% for INH, 93.33% for RIF and 59.26% for EMB. E-test correctly identified only eight of the 12 (66.6%) MDR isolates and wrongly identified four isolates which were not MDR. The overall agreement between the two methods was only 48.6%. Resistant isolates showed false positive resistance observed while using E-strip towards all the drugs. E-strips are not quite feasible as a replacement for LJ-proportion method on a large scale due to high risk of cross contamination, laboratory infection, expense associated with it and high false positive resistance observed to all first line drugs. However, the good correlation observed for RIF between the two methods indicates that E-test could contribute to the role in rapid screening of MDR TB isolates as rifampicin mutations are invariably observed in MDR TB isolates.

  5. Self-assembled magnetic bead biosensor for measuring bacterial growth and antimicrobial susceptibility testing.

    PubMed

    Kinnunen, Paivo; McNaughton, Brandon H; Albertson, Theodore; Sinn, Irene; Mofakham, Sima; Elbez, Remy; Newton, Duane W; Hunt, Alan; Kopelman, Raoul

    2012-08-20

    Bacterial antibiotic resistance is one of the major concerns of modern healthcare worldwide, and the development of rapid, growth-based, antimicrobial susceptibility tests is key for addressing it. The cover image shows a self-assembled asynchronous magnetic bead rotation (AMBR) biosensor developed for rapid detection of bacterial growth. Using the biosensors, the minimum inhibitory concentration of a clinical E. coli isolate can be measured within two hours, where currently tests take 6-24 hours. A 16-well prototype is also constructed for simple and robust observation of the self-assembled AMBR biosensors.

  6. Antimicrobial activity of fusidic acid and disk diffusion susceptibility testing criteria for gram-positive cocci.

    PubMed

    Toma, E; Barriault, D

    1995-07-01

    The in vitro activity of fusidic acid was assessed and was compared with those of cloxacillin, cefamandole, vancomycin, teicoplanin, ofloxacin, ciprofloxacin, pefloxacin, and fleroxacin against 500 gram-positive cocci: 151 Staphylococcus aureus, 197 coagulase-negative staphylococci, and 152 Enterococcus faecalis strains. All clinical isolates were concomitantly tested by disk diffusion and agar dilution procedures as outlined by the National Committee for Clinical Laboratory Standards. The results with fusidic acid were further analyzed by regression line and error rate-bounded methods. With control American Type Culture Collection organisms, the values were within the limits of the National Committee for Clinical Laboratory Standards or published limits. The incidence of resistance to fusidic acid was 0.7% for S. aureus, 2.5% for coagulase-negative staphylococci, and 99.3% for E. faecalis. The correlation coefficient between the results of disk diffusion and agar dilution tests with fusidic acid was 0.90. Current interpretive criteria for susceptibility to fusidic acid (i.e., MIC of < 2 micrograms/ml and inhibitory zone of 20 mm) gave 1% false susceptibility (all strains being E. faecalis). This error rate is practically eliminated if a zone diameter of 21 mm is considered the breakpoint for susceptibility.

  7. Combination antimicrobial susceptibility testing of Burkholderia cepacia complex: significance of species.

    PubMed

    Abbott, Felicity K; Milne, Kathleen E N; Stead, David A; Gould, Ian M

    2016-11-01

    The Burkholderia cepacia complex (Bcc) is notorious for the life-threatening pulmonary infections it causes in patients with cystic fibrosis. The multidrug-resistant nature of Bcc and differing infective Bcc species make the design of appropriate treatment regimens challenging. Previous synergy studies have failed to take account of the species of Bcc isolates. Etest methodology was used to facilitate minimum inhibitory concentration (MIC) and antimicrobial combination testing on 258 isolates of Bcc, identified to species level by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF/MS). The most active antimicrobials were trimethoprim/sulphamethoxazole, doxycycline and minocycline (52.5%, 46.4% and 45.9% of isolates susceptible, respectively). Synergy was observed in 9.2% of the 1799 combinations tested; the most common synergistic combinations were tobramycin + ceftazidime, meropenem + tobramycin and levofloxacin + piperacillin/tazobactam (35.4%, 32.3% and 22.2% synergy, respectively). Antimicrobial susceptibility analysis revealed differences between Burkholderia cenocepacia and Burkholderia multivorans. Disparity in clinical outcome during infection with these two micro-organisms necessitates further investigation into the clinical outcomes of treatment regimens in light of species identification and in vitro antimicrobial susceptibility studies.

  8. EUCAST recommendations for antimicrobial susceptibility testing applied to the three main Campylobacter species isolated in humans.

    PubMed

    Sifré, Elodie; Salha, Ben Amor; Ducournau, Astrid; Floch, Pauline; Chardon, Hubert; Mégraud, Francis; Lehours, Philippe

    2015-12-01

    Antimicrobial susceptibility testing of Campylobacter isolates is of great importance for treatment options especially in systemic diseases. The European Committee for Antimicrobial Susceptibility Testing (EUCAST) recently proposed epidemiological cut-offs (ECOFFs) for a limited number of antimicrobial compounds and for Campylobacter jejuni and Campylobacter coli only. In the present study, the EUCAST method was used after minor modifications to define antimicrobial susceptibility patterns for, 1997 C. jejuni, 419 C. coli and 100 Campylobacter fetus strains received at the French National Reference Center for Campylobacters and Helicobacters. Our results show that the ECOFFs defined by EUCAST for tetracycline and ciprofloxacin can be used for C. jejuni and C. coli. The same ECOFF can be used for erythromycin for the three species. The C. jejuni and C. coli ECOFFs for ciprofloxacin however cannot be applied to C. fetus. We also provide data to categorise two 2 β-lactams of interest for systemic diseases, ampicillin and amoxicillin+clavulanate, for the three species. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Rapid antimicrobial susceptibility testing with electrokinetics enhanced biosensors for diagnosis of acute bacterial infections.

    PubMed

    Liu, Tingting; Lu, Yi; Gau, Vincent; Liao, Joseph C; Wong, Pak Kin

    2014-11-01

    Rapid pathogen detection and antimicrobial susceptibility testing (AST) are required in diagnosis of acute bacterial infections to determine the appropriate antibiotic treatment. Molecular approaches for AST are often based on the detection of known antibiotic resistance genes. Phenotypic culture analysis requires several days from sample collection to result reporting. Toward rapid diagnosis of bacterial infection in non-traditional healthcare settings, we have developed a rapid AST approach that combines phenotypic culture of bacterial pathogens in physiological samples and electrochemical sensing of bacterial 16S rRNA. The assay determines the susceptibility of pathogens by detecting bacterial growth under various antibiotic conditions. AC electrokinetic fluid motion and Joule heating induced temperature elevation are optimized to enhance the sensor signal and minimize the matrix effect, which improve the overall sensitivity of the assay. The electrokinetics enhanced biosensor directly detects the bacterial pathogens in blood culture without prior purification. Rapid determination of the antibiotic resistance profile of Escherichia coli clinical isolates is demonstrated.

  10. An investigation of tests of susceptibility to noise-induced hearing loss

    NASA Astrophysics Data System (ADS)

    Lawton, B. W.; Robinson, D. W.

    1986-08-01

    Susceptibility to hearing damage was studied by testing 81 males aged 16 to 27 yr, and 50 males aged 45 to 65 yr. The older men were then screened for better than average hearing in an attempt to identify an innate factor protecting them from noise damage. Results suggest that there is no interaction between the psychoacoustical and neuromechanical properties of the ear. Cochlear function seems to be independent from the reflex self-protection of the ear. However, outliers of the variate distributions, i.e., robust or susceptible ears, were further analyzed. Correlations of rank, free from artefacts imposed by the physical scales of measurement, identified a small number of consistent outliers, and demonstrate the statistical independence of three properties of human hearing: conductive efficiency, cochlear function, and reflex function.

  11. In vitro susceptibility testing of fluoroquinolone activity against Salmonella: recent changes to CLSI standards.

    PubMed

    Humphries, Romney M; Fang, Ferric C; Aarestrup, Frank M; Hindler, Janet A

    2012-10-01

    Fluoroquinolone (FQ) resistance in Salmonella enterica is a significant clinical concern. Recognition of resistance by the clinical laboratory is complicated by the multiple FQ resistance mechanisms found in Salmonella. The Clinical Laboratory Standards Institute (CLSI) recently addressed this issue by revising the ciprofloxacin break points for Salmonella species. It is critical for clinicians and laboratory workers to be aware of the multiple technical issues surrounding these revised break points. In this article, we review FQ resistance mechanisms in Salmonella, their clinical significance, and data supporting the revised ciprofloxacin break points. We encourage clinical laboratories to adopt the revised CLSI ciprofloxacin break points for all Salmonella isolates in which susceptibility testing is indicated and discuss the technical issues for laboratories using commercial antimicrobial susceptibility systems.

  12. Preparation of ormetoprim-sulfadimethoxine-medicated discs for disc diffusion assay

    USDA-ARS?s Scientific Manuscript database

    Romet ( a blend of ormetoprim and sulfadimethoxine) is a type A medicated article for the manufacture of medicated feed in the catfish industry. Recently, the commercial manufacture of ormetoprim-sulfadimethoxine susceptibility discs was discontinued. Ormetoprim-sulfadimethoxine discs were prepare...

  13. New insights into the mechanism of action of pyrazinamide, implications for susceptibility testing, and future regimens.

    PubMed

    Anthony, Richard M; den Hertog, Alice; Mansjö, Mikael; Werngren, Jim

    2016-12-01

    Pyrazinamide (PZA) is included in the 2016 World Health Organization multidrug-resistant tuberculosis treatment guidelines and is a key component of most ongoing clinical trials investigating novel antibiotic combinations. PZA resistance is associated with worse tuberculosis treatment outcomes. Unfortunately, for such an important drug, phenotypic susceptibility testing is extremely challenging. The exacting bacterial growth conditions required to induce susceptibility to the drug reduce the accuracy of the susceptibility assay, even in experienced laboratories, and widespread testing is not performed. This situation is unacceptable for such a valuable and important drug. A more complete understanding of the mechanism of action of PZA would be expected to lead to improvements in this situation. Although the exact mechanism of action of PZA is not known yet, it is widely accepted that PZA is a prodrug requiring transformation to pyrazinoic acid, the active form, by the mycobacterial enzyme encoded by the pncA gene. Most clinical resistance indeed appears to be a result of a diverse range of mutations in this gene and sequencing of the pncA gene has been shown to have excellent predictive power for PZA resistance. The wider availably of pncA sequencing in combination with databases of the phenotypic implications of these mutations has helped make genetic testing for PZA resistance a practical proposition. For the past decades, it has been generally accepted that an extracellular low pH is required for PZA activity but work in our laboratory [1] and others [2] has recently challenged this assumption. Alternative bacterial stresses, apart from a reduced pH of the growth media (such as reduced temperature), can also induce a PZA-susceptible phenotype. The characterization of spontaneous in vitro-resistant pyrazinoic acid mutants selected under neutral pH conditions suggests a key role for the pantothenate/coenzyme A biosynthetic pathway. This has profound implications

  14. Comparison of microdilution method and E-test procedure in susceptibility testing of caspofungin against Candida non-albicans species.

    PubMed

    Serefko, Anna; Los, Renata; Biernasiuk, Anna; Malm, Anna

    2008-04-01

    It is widely known that systemic and mucosal candidiasis caused by Candida non-albicans strains endangers the lives of hospitalised patients since these pathogens are extremely difficult to defeat by commonly used antifungal agents. The present study determined the in vitro activities of a novel antimicotic drug - caspofungin - against 76 Candida non-albicans isolates by means of the CLSI reference method for broth dilution antifungal susceptibility testing of yeasts and the E-test procedure for comparison. Caspofungin was efficacious against the majority of strains tested, with the average MICs90 evaluated by the microdilution method and E-tests amounting to 1 mg/l and 0.5 mg/l, respectively. Since the agreement between MICs within +/-2 dilutions obtained by these two techniques was 92% (Kappa coefficient of 0.92), the E-test procedure seems to be a reliable alternative to the broth microdilution method and may provide another choice for clinical laboratories.

  15. Multicenter Evaluation of the Mycobacteria Growth Indicator Tube for Testing Susceptibility of Mycobacterium tuberculosis to First-Line Drugs

    PubMed Central

    Rüsch-Gerdes, Sabine; Domehl, Cornelia; Nardi, Giampietro; Gismondo, Maria Rita; Welscher, Hans-Martin; Pfyffer, Gaby E.

    1999-01-01

    In a multicenter study involving three reference centers for mycobacteria, the reliability of the Mycobacteria Growth Indicator Tube (MGIT) for rapid antimicrobial susceptibility testing (AST) of Mycobacterium tuberculosis was evaluated and compared to the radiometric method (BACTEC 460TB). Test cultures for which the results of the MGIT and BACTEC 460TB tests were discordant were checked by the conventional proportion method on solid medium. Four hundred forty-one isolates have been tested for susceptibility to isoniazid (INH), rifampin (RMP), ethambutol (EMB), and streptomycin (SM). Discrepant results were obtained for three isolates (0.7%) with INH (susceptible by MGIT, resistant by BACTEC 460TB), for four isolates (0.9%) with RMP (susceptible by MGIT, resistant by BACTEC 460TB), for six isolates (1.9%) with EMB (four susceptible by MGIT, resistant by BACTEC 460TB; two resistant by MGIT, susceptible by BACTEC 460TB), and for four isolates (0.9%) with SM (two susceptible by MGIT, resistant by BACTEC 460TB; two resistant by MGIT, susceptible by BACTEC 460TB). When cultures with discordant results were tested by the conventional proportion method, about half of the cultures yielded results similar to the BACTEC 460TB results, while the other half yielded results similar to the MGIT results. Turnaround times were 3 to 14 days (median, 8.8 days) for MGIT and 3 to 15 days (median, 7.8 days) for BACTEC 460TB. There was no statistically significant difference between the susceptibility testing results of the two methods (P > 0.05). These data demonstrate that the MGIT system is an accurate, nonradiometric alternative to the BACTEC 460TB method for rapid susceptibility testing of M. tuberculosis. PMID:9854062

  16. Patients' understanding of genetic susceptibility testing in mainstream medicine: qualitative study on thrombophilia

    PubMed Central

    Saukko, Paula M; Ellard, Sian; Richards, Suzanne H; Shepherd, Maggie H; Campbell, John L

    2007-01-01

    Background UK and US policy initiatives have suggested that, in the future, patients and clinicians in mainstream medicine could use genetic information to prevent common illnesses. There are no studies on patients' experience and understanding of the process of testing for common genetic susceptibilities in mainstream medicine. Methods Qualitative interviews with 42 individuals who had undergone testing for a genetic susceptibility for deep vein thrombosis in primary and secondary care in the UK. Results Some participants, often from higher social classes, had a good understanding of the test and its implications. They had often sought additional information on thrombophilia from relatives and from the Internet. Others, often from less privileged backgrounds, had a poorer understanding of the test – seven individuals were unaware of having had the genetic test. Features of genetic information led to misunderstandings: (i) at referral, (ii) when communicating results, and (iii) when making sense of the implications of testing. Participants' accounts indicated that non-specialist doctors may feel obliged to refer a patient for a genetic test they know little about, because a patient requests it after a relative had tested positive. Sometimes a referral for a genetic test was lost under information overload when multiple tests and issues were considered. The inconsistent and informal ways of communicating test results – for example by phone – in mainstream medicine also led to confusion. Participants did not generally overestimate their risk, but some were uncertain about whether they were taking the right preventive actions and/or whether their children were at risk. Information about genetic susceptibilities was difficult to make sense of, as it related to ambiguous risks for participants and family members, complicated and unfamiliar terminology and multiple genes and preventive strategies. Conclusion Policy visions of clinicians and patients in mainstream

  17. Sizes of protoplanetary discs after star-disc encounters

    NASA Astrophysics Data System (ADS)

    Breslau, Andreas; Steinhausen, Manuel; Vincke, Kirsten; Pfalzner, Susanne

    2014-05-01

    Most stars do not form in isolation, but as part of a star cluster or association. These young stars are initially surrounded by protoplanetary discs. In these cluster environments tidal interactions with other cluster members can alter the disc properties. Besides the disc frequency, its mass, angular momentum, and energy, the disc's size is particularly prone to being changed by a passing star. So far the change in disc size has only been investigated for a small number of very specific encounters. Several studies investigated the effect of the cluster environment on the sizes of planetary systems like our own solar system, based on a generalisation of information from this limited sample. We performed numerical simulations covering the wide parameter space typical of young star clusters, to test the validity of this approach. Here the sizes of discs after encounters are presented, based on a size definition that is comparable to the one used in observational studies. We find that, except for encounters between equal-mass stars, the usually applied estimates are insufficient. They tend to severely overestimate the remaining disc size. We show that the disc size after an encounter can be described by a relatively simple dependence on the periastron distance and the mass ratio of the encounter partners. This knowledge allows us, for example, to pin down the types of encounter possibly responsible for the structure of today's solar system. Appendix A is available in electronic form at http://www.aanda.org

  18. Performance of Vitek 2 for Antimicrobial Susceptibility Testing of Staphylococcus spp. and Enterococcus spp.

    PubMed Central

    Bobenchik, April M.; Hindler, Janet A.; Giltner, Carmen L.; Saeki, Sandra

    2014-01-01

    Vitek 2 (bioMérieux, Inc., Durham, NC) is a widely used commercial antimicrobial susceptibility testing system. We compared MIC results obtained by Vitek 2 to those obtained by the Clinical and Laboratory Standards Institute (CLSI) broth microdilution (BMD) reference method for 134 staphylococcal and 84 enterococcal clinical isolates. Nineteen agents were evaluated, including all those available on Vitek 2 for testing staphylococci and enterococci. The resistance phenotypes tested included methicillin-resistant Staphylococcus aureus (MRSA) (n = 58), S. aureus with inducible clindamycin resistance (ICR) (n = 30), trimethoprim-sulfamethoxazole-resistant MRSA (n = 10), vancomycin-resistant Enterococcus (n = 37), high-level gentamicin-resistant Enterococcus (n = 15), linezolid-resistant Enterococcus (n = 5), and daptomycin-nonsusceptible Enterococcus faecalis (n = 6). For the staphylococci, there was 98.9% categorical agreement (CA). There was one very major error (VME) for gentamicin in a Staphylococcus hominis isolate, six VMEs for inducible clindamycin in S. aureus isolates, and two major errors (ME) for daptomycin in an S. aureus and a Staphylococcus epidermidis isolate. For enterococci, there was 97.3% CA. Two VMEs were observed for daptomycin in isolates of E. faecalis and 2 ME, 1 for high-level gentamicin resistance and 1 for nitrofurantoin, in E. faecium isolates. Overall, there was 98.3% CA and 99% essential agreement for the testing of staphylococci and enterococci by the Vitek 2. With the exception of detecting ICR in S. aureus, Vitek 2 performed reliably for antimicrobial susceptibility testing of staphylococci and enterococci. PMID:24478467

  19. Classical against molecular-genetic methods for susceptibility testing of antituberculotics.

    PubMed

    Porvaznik, I; Mokry, J; Solovic, I

    2015-01-01

    Tuberculosis currently belongs to rare respiratory diseases in Slovakia. However, the emergence and spread of multi-drug resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) are major challenges for global tuberculosis control, since the treatment of resistant forms creates both medical and financial problems. Cultivation methods of diagnosis are time-consuming, many times exceeding the time of the initial phase of tuberculosis treatment. Therefore, in the presented study we compared the standard procedures, based on the cultivation of mycobacteria and subsequent drug susceptibility testing to antituberculotics, with molecular-genetic methods using PCR diagnostic kits. The molecular-genetic testing enables to obtain direct and fast evidence of Mycobacterium tuberculosis, with genomic verification of resistance to the most important anti-tuberculosis drugs - isoniazid and rifampicin in MDR-TB, and ethambutol, aminoglycosides, and fluoroquinolones in XDR-TB. In 2012-2013, we confirmed 19 cases of drug-resistant tuberculosis in Slovakia. The resistance to rifampicin was confirmed in all strains with both methods. In two cases, the molecular-genetic testing did not show resistance to isoniazid, as confirmed by conventional cultivation. Furthermore, two strains demonstrating susceptibility in conventional microbiological testing to ethambutol and five strains to fluoroquinolones were verified as actually being resistant using a PCR method. Rapid diagnosis and identification of MDR-TB or XDR-TB strains using molecular-genetic testing is an essential tool for the timely and appropriate drug treatment and prevention of spread of drug resistant strains.

  20. Performance of Vitek 2 for antimicrobial susceptibility testing of Staphylococcus spp. and Enterococcus spp.

    PubMed

    Bobenchik, April M; Hindler, Janet A; Giltner, Carmen L; Saeki, Sandra; Humphries, Romney M

    2014-02-01

    Vitek 2 (bioMérieux, Inc., Durham, NC) is a widely used commercial antimicrobial susceptibility testing system. We compared MIC results obtained by Vitek 2 to those obtained by the Clinical and Laboratory Standards Institute (CLSI) broth microdilution (BMD) reference method for 134 staphylococcal and 84 enterococcal clinical isolates. Nineteen agents were evaluated, including all those available on Vitek 2 for testing staphylococci and enterococci. The resistance phenotypes tested included methicillin-resistant Staphylococcus aureus (MRSA) (n = 58), S. aureus with inducible clindamycin resistance (ICR) (n = 30), trimethoprim-sulfamethoxazole-resistant MRSA (n = 10), vancomycin-resistant Enterococcus (n = 37), high-level gentamicin-resistant Enterococcus (n = 15), linezolid-resistant Enterococcus (n = 5), and daptomycin-nonsusceptible Enterococcus faecalis (n = 6). For the staphylococci, there was 98.9% categorical agreement (CA). There was one very major error (VME) for gentamicin in a Staphylococcus hominis isolate, six VMEs for inducible clindamycin in S. aureus isolates, and two major errors (ME) for daptomycin in an S. aureus and a Staphylococcus epidermidis isolate. For enterococci, there was 97.3% CA. Two VMEs were observed for daptomycin in isolates of E. faecalis and 2 ME, 1 for high-level gentamicin resistance and 1 for nitrofurantoin, in E. faecium isolates. Overall, there was 98.3% CA and 99% essential agreement for the testing of staphylococci and enterococci by the Vitek 2. With the exception of detecting ICR in S. aureus, Vitek 2 performed reliably for antimicrobial susceptibility testing of staphylococci and enterococci.

  1. Disc cell therapies: critical issues.

    PubMed

    Tibiletti, Marta; Kregar Velikonja, Nevenka; Urban, Jill P G; Fairbank, Jeremy C T

    2014-06-01

    patient selection and the feasibility of achieving the desired repair in an acceptable time frame. Few diagnostic tests that examine whether cell therapies are likely to succeed are available at present, but definite exclusion criteria would be evidence of major disc fissures, or disturbance of nutrient pathways as measured by post-contrast MRI.

  2. Genetic testing for heart disease susceptibility: potential impact on motivation to quit smoking.

    PubMed

    Sanderson, S C; Michie, S

    2007-06-01

    As genetic tests for common gene variants and multifactorial, lifestyle-related conditions become available, it will be increasingly important to determine the psychological and behavioral impact of this emerging class of genetic tests. Our aim was to examine the potential impact of genetic testing for heart disease susceptibility on psychological predictors of smoking cessation. Two hundred and sixty-one smokers were asked to imagine that they had undergone a test for heart disease risk. They were randomly assigned to a genetic test scenario (low- or high-risk result) or an oxidative test scenario (high-risk result). Smokers in the genetic test-high risk group reported greater intention to quit smoking than smokers in the oxidative test-high risk group (p = 0.009); 30% of this was mediated by their holding stronger beliefs that quitting would reduce their heart disease risk (outcome expectations) (p = 0.011). The effect of genetic test-high risk feedback on outcome expectations was greatest amongst smokers with no heart disease family history (p = 0.038). The results suggest that genetic testing for heart disease risk may enhance interventions designed to improve health via increasing smoking cessation rates. Whether the findings hold true in studies that use real rather than hypothetical genetic tests remains to be seen.

  3. Assessment of Etest as an alternative to agar dilution for antimicrobial susceptibility testing of Neisseria gonorrhoeae.

    PubMed

    Liu, Hsi; Taylor, Thomas H; Pettus, Kevin; Trees, David

    2014-05-01

    We studied whether the Etest can be used as an alternative to agar dilution to determine antimicrobial susceptibilities of ceftriaxone, cefixime, and cefpodoxime in Neisseria gonorrhoeae surveillance. One hundred fifteen clinical and laboratory isolates of N. gonorrhoeae were tested following the Clinical Laboratory Improvement Amendments (CLIA)-approved CLSI standard agar dilution method and, separately, by the Etest according to the manufacturer's recommendations. The MICs were determined and compared. Ten laboratory-generated mutants were used to simulate substantially nonsusceptible specimens. The Etest and agar dilution methods were well correlated. Statistical tests produced regression R2 values of 88%, 82%, and 85% and Pearson correlation coefficients of 92%, 91%, and 92% for ceftriaxone, cefixime, and cefpodoxime, respectively. When paired comparisons were made, the two tests were 88.7%, 80%, and 87% within 1 log2 dilution from each other for ceftriaxone, cefixime, and cefpodoxime, respectively. The within-2-log2 agreements were 99.1%, 98.3%, and 94.8% for ceftriaxone, cefixime, and cefpodoxime, respectively. Notwithstanding the good correlations and the within-2-log2 general agreement, the Etest results produced slightly lower MICs than the agar dilution results. In conclusion, we found that the Etest can be effectively used as an alternative to agar dilution testing to determine the susceptibility of N. gonorrhoeae to ceftriaxone, cefixime, and cefpodoxime, although we recommend further research into extremely resistant isolates. For isolates within the typical range of clinical MICs, reexamination of the Etest interpretation of susceptible and nonsusceptible categories would likely allow for successful transition from agar dilution to the Etest.

  4. Use of Positive Blood Cultures for Direct Identification and Susceptibility Testing with the Vitek 2 System

    PubMed Central

    de Cueto, Marina; Ceballos, Esther; Martinez-Martinez, Luis; Perea, Evelio J.; Pascual, Alvaro

    2004-01-01

    In order to further decrease the time lapse between initial inoculation of blood culture media and the reporting of results of identification and antimicrobial susceptibility tests for microorganisms causing bacteremia, we performed a prospective study in which specially processed fluid from positive blood culture bottles from Bactec 9240 (Becton Dickinson, Cockeysville, Md.) containing aerobic media were directly inoculated into Vitek 2 system cards (bio-Mérieux, France). Organism identification and susceptibility results were compared with those obtained from cards inoculated with a standardized bacterial suspension obtained following subculture to agar; 100 consecutive positive monomicrobic blood cultures, consisting of 50 gram-negative rods and 50 gram-positive cocci, were included in the study. For gram-negative organisms, 31 of the 50 (62%) showed complete agreement with the standard method for species identification, while none of the 50 gram-positive cocci were correctly identified by the direct method. For gram-negative rods, there were 50% categorical agreements between the direct and standard methods for all drugs tested. The very major error rate was 2.4%, and the major error rate was 0.6%. The overall error rate for gram-negatives was 6.6%. Complete agreement in clinical categories of all antimicrobial agents evaluated was obtained for 19 of 50 (38%) gram-positive cocci evaluated; the overall error rate was 8.4%, with 2.8% minor errors, 2.4% major errors, and 3.2% very major errors. These findings suggest that the Vitek 2 cards inoculated directly from positive Bactec 9240 bottles do not provide acceptable bacterial identification or susceptibility testing in comparison with corresponding cards tested by a standard method. PMID:15297523

  5. Neuraminidase Inhibitor Susceptibility Testing in Human Influenza Viruses: A Laboratory Surveillance Perspective

    PubMed Central

    Okomo-Adhiambo, Margaret; Sleeman, Katrina; Ballenger, Kristina; Nguyen, Ha T.; Mishin, Vasiliy P.; Sheu, Tiffany G.; Smagala, James; Li, Yan; Klimov, Alexander I.; Gubareva, Larisa V.

    2010-01-01

    Neuraminidase inhibitors (NAIs) are vital in managing seasonal and pandemic influenza infections. NAI susceptibilities of virus isolates (n = 5540) collected during the 2008–2009 influenza season were assessed in the chemiluminescent neuraminidase inhibition (NI) assay. Box-and-whisker plot analyses of log-transformed IC50s were performed for each virus type/subtype and NAI to identify outliers which were characterized based on a statistical cutoff of IC50 >3 interquartile ranges (IQR) from the 75th percentile. Among 1533 seasonal H1N1 viruses tested, 1431 (93.3%) were outliers for oseltamivir; they all harbored the H275Y mutation in the neuraminidase (NA) and were reported as oseltamivir-resistant. Only 15 (0.7%) of pandemic 2009 H1N1 viruses tested (n = 2259) were resistant to oseltamivir. All influenza A(H3N2) (n = 834) and B (n = 914) viruses were sensitive to oseltamivir, except for one A(H3N2) and one B virus, with D151V and D197E (D198E in N2 numbering) mutations in the NA, respectively. All viruses tested were sensitive to zanamivir, except for six seasonal A(H1N1) and several A(H3N2) outliers (n = 22) which exhibited cell culture induced mutations at residue D151 of the NA. A subset of viruses (n = 1058) tested for peramivir were sensitive to the drug, with exception of H275Y variants that exhibited reduced susceptibility to this NAI. This study summarizes baseline susceptibility patterns of seasonal and pandemic influenza viruses, and seeks to contribute towards criteria for defining NAI resistance. PMID:21994620

  6. Assessment of Etest as an Alternative to Agar Dilution for Antimicrobial Susceptibility Testing of Neisseria gonorrhoeae

    PubMed Central

    Taylor, Thomas H.; Pettus, Kevin; Trees, David

    2014-01-01

    We studied whether the Etest can be used as an alternative to agar dilution to determine antimicrobial susceptibilities of ceftriaxone, cefixime, and cefpodoxime in Neisseria gonorrhoeae surveillance. One hundred fifteen clinical and laboratory isolates of N. gonorrhoeae were tested following the Clinical Laboratory Improvement Amendments (CLIA)-approved CLSI standard agar dilution method and, separately, by the Etest according to the manufacturer's recommendations. The MICs were determined and compared. Ten laboratory-generated mutants were used to simulate substantially nonsusceptible specimens. The Etest and agar dilution methods were well correlated. Statistical tests produced regression R2 values of 88%, 82%, and 85% and Pearson correlation coefficients of 92%, 91%, and 92% for ceftriaxone, cefixime, and cefpodoxime, respectively. When paired comparisons were made, the two tests were 88.7%, 80%, and 87% within 1 log2 dilution from each other for ceftriaxone, cefixime, and cefpodoxime, respectively. The within-2-log2 agreements were 99.1%, 98.3%, and 94.8% for ceftriaxone, cefixime, and cefpodoxime, respectively. Notwithstanding the good correlations and the within-2-log2 general agreement, the Etest results produced slightly lower MICs than the agar dilution results. In conclusion, we found that the Etest can be effectively used as an alternative to agar dilution testing to determine the susceptibility of N. gonorrhoeae to ceftriaxone, cefixime, and cefpodoxime, although we recommend further research into extremely resistant isolates. For isolates within the typical range of clinical MICs, reexamination of the Etest interpretation of susceptible and nonsusceptible categories would likely allow for successful transition from agar dilution to the Etest. PMID:24554750

  7. A Rapid Molecular Test for Determining Yersinia pestis Susceptibility to Ciprofloxacin by the Quantification of Differentially Expressed Marker Genes

    PubMed Central

    Steinberger-Levy, Ida; Shifman, Ohad; Zvi, Anat; Ariel, Naomi; Beth-Din, Adi; Israeli, Ofir; Gur, David; Aftalion, Moshe; Maoz, Sharon; Ber, Raphael

    2016-01-01

    Standard antimicrobial susceptibility tests used to determine bacterial susceptibility to antibiotics are growth dependent and time consuming. The long incubation time required for standard tests may render susceptibility results irrelevant, particularly for patients infected with lethal bacteria that are slow growing on agar but progress rapidly in vivo, such as Yersinia pestis. Here, we present an alternative approach for the rapid determination of antimicrobial susceptibility, based on the quantification of the changes in the expression levels of specific marker genes following exposure to growth-inhibiting concentrations of the antibiotic, using Y. pestis and ciprofloxacin as a model. The marker genes were identified by transcriptomic DNA microarray analysis of the virulent Y. pestis Kimberley53 strain after exposure to specific concentrations of ciprofloxacin for various time periods. We identified several marker genes that were induced following exposure to growth-inhibitory concentrations of ciprofloxacin, and we confirmed the marker expression profiles at additional ciprofloxacin concentrations using quantitative RT-PCR. Eleven candidate marker transcripts were identified, of which four mRNA markers were selected for a rapid quantitative RT-PCR susceptibility test that correctly determined the Minimal Inhibitory Concentration (MIC) values and the categories of susceptibility of several Y. pestis strains and isolates harboring various ciprofloxacin MIC values. The novel molecular susceptibility test requires just 2 h of antibiotic exposure in a 7-h overall test time, in contrast to the 24 h of antibiotic exposure required for a standard microdilution test. PMID:27242774

  8. Termite-Susceptible Species of Wood for Inclusion as a Reference in Indonesian Standardized Laboratory Testing.

    PubMed

    Arinana; Tsunoda, Kunio; Herliyana, Elis N; Hadi, Yusuf S

    2012-03-28

    Standardized laboratory testing of wood and wood-based products against subterranean termites in Indonesia (SNI 01.7207-2006) (SNI) has no requirement for the inclusion of a comparative reference species of wood (reference control). This is considered a weakness of the Indonesian standard. Consequently, a study was undertaken to identify a suitable Indonesian species of community wood that could be used as a reference control. Four candidate species of community woods: Acacia mangium, Hevea brasiliensis, Paraserianthes falcataria and Pinus merkusii were selected for testing their susceptibility to feeding by Coptotermes formosanus. Two testing methods (SNI and the Japanese standard method JIS K 1571-2004) were used to compare the susceptibility of each species of wood. Included in the study was Cryptomeria japonica, the reference control specified in the Japanese standard. The results of the study indicated that P. merkusii is a suitable reference species of wood for inclusion in laboratory tests against subterranean termites, conducted in accordance with the Indonesian standard (SNI 01.7207-2006).

  9. Drug-resistant tuberculosis in Central Mozambique: the role of a rapid genotypic susceptibility testing.

    PubMed

    Namburete, Evangelina Inácio; Tivane, Inês; Lisboa, Miguelhete; Passeri, Margarida; Pocente, Renata; Ferro, Josefo Joao; Harrison, Lee H; Bollela, Valdes Roberto

    2016-08-17

    Genotypic molecular testing may be very helpful for tuberculosis (TB) drug-resistance surveillance and for treatment guidance in low resource settings. Descriptive analysis of M. tuberculosis isolates from Beira Central Hospital, Mozambique, during 2014-2015. Genotype MTBDRplus and MTBDRsl were used and patient medical records reviewed. To explore genotypic susceptibility profile of Mycobacterium tuberculosis, to first and second line drugs (SLD) in Beira Mozambique. Of 155 isolates, 16.1 % (25) were multidrug resistant (MDR), 8.4 % (13) isoniazid-monoresistant and 1.3 % (2) rifampicin-monoresistant. Among MDR-TB, 22.2 % showed primary and 77.8 % represented acquired resistance. The majority of patients with drug resistance had a history of previous TB treatment. Among 125 isolates tested for ethambutol and SLD, 7.2 % (9) were resistant to ethambutol, 4.8 % (6) to fluoroquinolones and 0.8 % (1) to ethambutol and fluoroquinolones. Resistance to injectable SLD was not detected. As far as we know this is the first report of a genotypic testing used to provide information about SLD resistance in Mozambique, where phenotypic susceptibility testing is usually unavailable. Extensively drug resistant TB was not detected in this isolates from Beira Mozambique.

  10. Rapid inoculum standardization system: a novel device for standardization of inocula in antimicrobial susceptibility testing.

    PubMed Central

    Wicks, J H; Nelson, R L; Krejcarek, G E

    1983-01-01

    A rapid inoculum standardization system for antimicrobial susceptibility testing without incubation or the conventional turbidity adjustment has been developed. The rapid inoculum standardization system consists of a plastic rod with cross-hatched grooves on one end and a specific nutrient medium in a vial. The crosshatched grooves are designed to pick up and release a known number of viable microorganisms. In use, the end of the rod is touched to five colonies 1 to 2 mm in diameter from a primary agar plate, thus filling the grooves with bacteria. The rod is placed into the vial, and the bacteria are suspended in the medium by agitation with a Vortex Genie Mixer. The resulting suspension contains 5 X 10(7) to 5 X 10(8) CFU/ml for most gram-negative bacilli and gram-positive cocci. Microorganisms such as streptococci that have colonies less than 1 mm in diameter require as many as 10 colonies for an adequate inoculum suspension. Ninety-five commonly encountered bacterial isolates were tested in triplicate by agar plate counts. The resulting overall geometric mean of the agar plate counts was 1.52 X 10(8) CFU/ml for the species tested. We have found that the rapid inoculum standardization system provides a consistent and reproducible method for the standardization of inoculum for antimicrobial susceptibility testing without the incubation period and turbidity adjustment. Images PMID:6874902

  11. Direct Susceptibility Testing of Mycobacterium tuberculosis for Pyrazinamide by Use of the Bactec MGIT 960 System

    PubMed Central

    Demers, Anne-Marie; Venter, Amour; Friedrich, Sven O.; Rojas-Ponce, Gabriel; Mapamba, Daniel; Jugheli, Levan; Sasamalo, Mohammed; Almeida, Deepak; Dorasamy, Afton; Jentsch, Ute; Gibson, Mara; Everitt, Daniel; Diacon, Andreas H.

    2016-01-01

    Pyrazinamide (PZA) is a key antituberculosis drug, yet no rapid susceptibility test is commercially available. PZA drug susceptibility testing (DST) was performed directly on sputum samples from 327 patients and compared with the indirect method by using the Bactec MGIT 960 system in the context of patient screening for participation in a drug trial. Compared to standard indirect PZA DST, direct DST was successful in only 59% of cases, but results obtained were highly accurate and available faster. Agreement between the direct and indirect methods varied from 90 to 100% in each laboratory. The median times for obtaining PZA results from the time when the specimen was collected ranged from 11 to 16 days for the direct test and 18 to 95 days for the indirect test across laboratories. The direct method is accurate and reproducible across laboratories. It can be expected to accelerate results in >50% of cases, but it cannot replace indirect DST for PZA. Phenotypic methods remain the gold standard for DST in drug trials. If future studies can optimize the method to decrease the number of uninterpretable results, direct MGIT DST could be the new phenotypic DST standard for clinical trials, providing more rapid detection of resistance to new drugs in experimental regimens. PMID:26912751

  12. Direct Susceptibility Testing of Mycobacterium tuberculosis for Pyrazinamide by Use of the Bactec MGIT 960 System.

    PubMed

    Demers, Anne-Marie; Venter, Amour; Friedrich, Sven O; Rojas-Ponce, Gabriel; Mapamba, Daniel; Jugheli, Levan; Sasamalo, Mohammed; Almeida, Deepak; Dorasamy, Afton; Jentsch, Ute; Gibson, Mara; Everitt, Daniel; Eisenach, Kathleen D; Diacon, Andreas H

    2016-05-01

    Pyrazinamide (PZA) is a key antituberculosis drug, yet no rapid susceptibility test is commercially available. PZA drug susceptibility testing (DST) was performed directly on sputum samples from 327 patients and compared with the indirect method by using the Bactec MGIT 960 system in the context of patient screening for participation in a drug trial. Compared to standard indirect PZA DST, direct DST was successful in only 59% of cases, but results obtained were highly accurate and available faster. Agreement between the direct and indirect methods varied from 90 to 100% in each laboratory. The median times for obtaining PZA results from the time when the specimen was collected ranged from 11 to 16 days for the direct test and 18 to 95 days for the indirect test across laboratories. The direct method is accurate and reproducible across laboratories. It can be expected to accelerate results in >50% of cases, but it cannot replace indirect DST for PZA. Phenotypic methods remain the gold standard for DST in drug trials. If future studies can optimize the method to decrease the number of uninterpretable results, direct MGIT DST could be the new phenotypic DST standard for clinical trials, providing more rapid detection of resistance to new drugs in experimental regimens.

  13. Reverberation Chamber Uniformity Validation and Radiated Susceptibility Test Procedures for the NASA High Intensity Radiated Fields Laboratory

    NASA Technical Reports Server (NTRS)

    Koppen, Sandra V.; Nguyen, Truong X.; Mielnik, John J.

    2010-01-01

    The NASA Langley Research Center's High Intensity Radiated Fields Laboratory has developed a capability based on the RTCA/DO-160F Section 20 guidelines for radiated electromagnetic susceptibility testing in reverberation chambers. Phase 1 of the test procedure utilizes mode-tuned stirrer techniques and E-field probe measurements to validate chamber uniformity, determines chamber loading effects, and defines a radiated susceptibility test process. The test procedure is segmented into numbered operations that are largely software controlled. This document is intended as a laboratory test reference and includes diagrams of test setups, equipment lists, as well as test results and analysis. Phase 2 of development is discussed.

  14. Antimicrobial susceptibility testing of Brachyspira intermedia and Brachyspira pilosicoli isolates from Australian chickens.

    PubMed

    Hampson, D J; Stephens, C P; Oxberry, S L

    2006-02-01

    Susceptibilities of predominantly Australian isolates of the pathogenic intestinal spirochaetes Brachyspira intermedia (n = 25) and Brachyspira pilosicoli (n = 17) from chickens were tested in agar dilution against four concentrations each of the antimicrobials tiamulin, lincomycin, tylosin, metronidazole, tetracycline and ampicillin. Based on available minimum inhibitory concentration (MIC) breakpoint values for Brachyspira hyodysenteriae or other Gram-negative enteric veterinary pathogens, isolates of both species generally were susceptible to tiamulin, lincomycin, metronidazole and tetracycline. Although not classed as resistant, four isolates of B. intermedia had an elevated MIC range for tiamulin (1 to 4 mg/l), 11 isolates of B. intermedia and five of B. pilosicoli had an elevated MIC range for lincomycin (10 to 50 mg/l), one isolate of B. pilosicoli had an elevated MIC range for tetracycline (10 to 20 mg/l), and one isolate of B. intermedia and five of B. pilosicoli had an elevated MIC range for ampicillin (10 to 50 mg/l). A clear lack of susceptibility to tylosin (MIC > 4 mg/l) was seen in 11 isolates each of B. intermedia and B. pilosicoli, and to ampicillin (MIC > 32 mg/l) in two isolates of B. pilosicoli. These data suggest that some resistance to common antimicrobials exists among intestinal spirochetes obtained from laying hens and supports the need of MIC data for clinical isolates before any treatment is considered.

  15. Rapid susceptibility testing of Mycobacterium tuberculosis by bioluminescence assay of mycobacterial ATP

    SciTech Connect

    Nilsson, L.E.; Hoffner, S.E.; Ansehn, S.

    1988-08-01

    Mycobacterial growth was monitored by bioluminescence assay of mycobacterial ATP. Cultures of Mycobacterium tuberculosis H37Rv and of 25 clinical isolates of the same species were exposed to serial dilutions of ethambutol, isoniazid, rifampin, and streptomycin. A suppression of ATP, indicating growth inhibition, occurred for susceptible but not resistant strains within 5 to 7 days of incubation. Breakpoint concentrations between susceptibility and resistance were determined by comparing these results with those obtained by reference techniques. Full agreement was found in 99% of the assays with the resistance ratio method on Lowenstein-Jensen medium, and 98% of the assays were in full agreement with the radiometric system (BACTEC). A main advantage of the bioluminescence method is its rapidity, with results available as fast as with the radiometric system but at a lower cost and without the need for radioactive culture medium. The method provides kinetic data concerning drug effects within available in vivo drug concentrations and has great potential for both rapid routine susceptibility testing and research applications in studies of drug effects on mycobacteria.

  16. Susceptibility testing of fungi: current status of correlation of in vitro data with clinical outcome.

    PubMed Central

    Ghannoum, M A; Rex, J H; Galgiani, J N

    1996-01-01

    In summary, it is clear that in vitro susceptibility testing can predict outcome in selected clinical situations. The clearest data are from the fluconazole-treated AIDS patients with oropharyngeal candidiasis. In this setting, the homogeneity of the underlying immune defect, combined with the ease of identification and monitoring of the infection, creates a near-perfect test situation. In more complex scenarios, such as the heterogeneous population of patients enrolled in a recent study of candidemia, no such clear-cut correlation was present. The importance of host factors in the correlation of the MIC with outcome cannot be overemphasized. Examples of these parameters include patient status (underlying disease, the presence of intravascular catheters, and CD4+ T-cell number), drug pharmacokinetics (absorption and distribution), patient compliance, and drug-drug interactions. Identification of relevant factors can substantially improve the degree of the MIC-outcome correlation and thus improve the clinical utility of in vitro testing. An important feature in this entire process is the role of standardized susceptibility testing procedures. While not without flaws, the proposed NCCLS reference method has been invaluable in allowing multiple investigators to contribute data that can be used to clarify the correlation between the fluconazole MIC and outcome. While the development of simplified second-generation methods is eagerly anticipated, the role of the reference method as a common touchstone is critical. Only by use of either the reference method itself or methods with a known relationship to the reference method can this broad collaborative process really proceed. Current work is focusing on defining interpretive breakpoints for fluconazole and Candida species, refinement of the in vitro procedures used to measure susceptibility to amphotericin B, ketoconazole, and itraconazole, and the acquisition of a broad base of data on the relationship between the MIC

  17. Genetic antimicrobial susceptibility testing in Gram-negative sepsis - impact on time to results in a routine laboratory.

    PubMed

    Kommedal, Øyvind; Aasen, Johanne Lind; Lindemann, Paul Christoffer

    2016-07-01

    Diagnostic testing of positive blood cultures is among the most critical tasks performed by clinical microbiology laboratories, and the total analysis time from sampling to results should be kept as short as possible. By providing identification of pelleted bacteria directly from positive blood-cultures, MALDI-TOF MS opens for relatively low-complex species-adjusted genetic susceptibility testing from the same bacterial pellet. In our lab routine, we prospectively evaluated a rapid in-house real-time PCR targeting the most common aminoglycoside and cephalosporin resistance genes in Escherichia coli and Klebsiella pneumoniae and measured time to preliminary susceptibility reporting for 138 samples. The results were compared to direct phenotypic susceptibility testing with interpretation after 6 h and overnight incubation respectively. Results from the genetic susceptibility testing were available for 69.5% (96/138) of the positive blood cultures within 24 h after sample collection. No phenotypic susceptibility results were available at this time. Compared to overnight direct susceptibility testing, the average time from sample collection to preliminary susceptibility reporting was reduced with 43%, from 45 h and 5 min to 25 h and 44 min, providing an earlier adjustment of antimicrobial therapy for 12 patients. Minor logistic adjustments have the potential to save yet another 4 h.

  18. Comparative analysis of the Vitek 2 antifungal susceptibility system and E-test with the CLSI M27-A3 broth microdilution method for susceptibility testing of Indian clinical isolates of Cryptococcus neoformans.

    PubMed

    Tewari, Aarti; Behera, Bijayani; Mathur, Purva; Xess, Immaculata

    2012-06-01

    The emergence of antifungal resistance among Cryptococcus neoformans isolates is a matter of great concern. The Clinical and Laboratory Standards Institute (CLSI) broth microdilution reference method (BMD) for antifungal susceptibility testing of C. neoformans is tedious and time-consuming. Consequently, there is a greater need for a reproducible in vitro susceptibility testing method for use in clinical microbiology laboratories. By random amplified polymorphic DNA analysis, the 62 Indian clinical isolates were characterized as Cryptococcus neoformans var. grubii. We evaluated the susceptibilities of these isolates for amphotericin B (AMB) and fluconazole (FLC) by two commercial techniques, i.e., Vitek 2 and E-test against the CLSI M27-A3 BMD. The essential agreement (EA) between the Vitek 2 and E-test with the reference procedure for FLC was similar (82.2%). For AMB, EA of 92 and 76% was obtained with E-test and Vitek 2. Excellent categorical agreement (CA) (98.3% and 100% by Vitek 2 and E-test, respectively) was obtained for AMB. The CA for FLC was 81 and 77.4% by Vitek 2 and E-test. We conclude that both E-test and Vitek 2 system have acceptable levels of accuracy for susceptibility testing of both the drugs. Both of them could identify fluconazole-resistant strains. Vitek 2 could be used for testing susceptibility of voriconazole and 5-flucytosine also at the same time.

  19. [Detection of the expression of extended-spectrum beta-lactamases (ESBL) in clinical strains of Klebsiella pneumoniae and Escherichia coli: comparison of E-test and two-disc methods].

    PubMed

    Andrzejewska, Ewa; Szkaradkiewicz, Andrzej

    2004-01-01

    The aim of this study was to compare the effectiveness of E-test and two disc methods applied for the detection of extended spectrum beta-lactamases. All strains were tested by E-test, by double-disc synergy test (DDST) according to Jarlier (cefotaxim, ceftazidim, aztreonam and clavulanic acid) and also by disc test according to Appleton (cefpodoxime and cefpodoxime with clavulanic acid, CPD and CD01 disc). We tested 148 clinical strains of E. coli and 78 strains of K. Pneumoniae. In case of K. pneumoniae, the activity of the ESBLs was detected among 30 strains--both in E-test, Jarlier test and Appleton test. Among E. coli, four strains were found ESBL-positive in the test according to Jarlier but only three strain of these when E-test and Appleton test was used. The results of investigations performed suggest, that E-test and disc methods according both Jarlier and Appleton have the same effectiveness in detection ESBLs among K. pneumoniae strains. However, in case of E. coli, interpretation of results may present a problem.

  20. A cost-effective smartphone-based antimicrobial susceptibility test reader for drug resistance testing (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Feng, Steve W.; Tseng, Derek; Di Carlo, Dino; Garner, Omai B.; Ozcan, Aydogan

    2017-03-01

    Antimicrobial susceptibility testing (AST) is commonly used for determining microbial drug resistance, but routine testing, which can significantly reduce the spread of multi-drug resistant organisms, is not regularly performed in resource-limited and field-settings due to technological challenges and lack of trained diagnosticians. We developed a portable cost-effective smartphone-based colorimetric 96-well microtiter plate (MTP) reader capable of automated AST without the need for a trained diagnostician. This system is composed of a smartphone used in conjunction with a 3D-printed opto-mechanical attachment, which holds a set of inexpensive light-emitting-diodes and fiber-optic cables coupled to the 96-well MTP for enabling the capture of the transmitted light through each well by the smartphone camera. Images of the MTP plate are captured at multiple exposures and uploaded to a local or remote server (e.g., a laptop) for automated processing/analysis of the results using a custom-designed smartphone application. Each set of images are combined to generate a high dynamic-range image and analyzed for well turbidity (indicative of bacterial growth), followed by interpretative analysis per plate to determine minimum inhibitory concentration (MIC) and drug susceptibility for the specific bacterium. Results are returned to the originating device within 1 minute and shown to the user in tabular form. We demonstrated the capability of this platform using MTPs prepared with 17 antibiotic drugs targeting Gram-negative bacteria and tested 82 patient isolate MTPs of Klebsiella pneumoniae, achieving well turbidity accuracy of 98.19%, MIC accuracy of 95.15%, and drug susceptibility interpretation accuracy of 99.06%, meeting the FDA defined criteria for AST.

  1. Risk perceptions, worry, and attitudes about genetic testing for breast cancer susceptibility.

    PubMed

    Cameron, Linda D; Reeve, Jeanne

    2006-01-01

    This study assessed the unique associations of risk perceptions and worry with attitudes about genetic testing for breast cancer susceptibility. Women (general practitioner clinic attenders, university students, and first-degree relatives of breast cancer survivors; N = 303) read information about genetic testing and completed measures assessing perceived cancer risk, cancer worry, and genetic testing attitudes and beliefs. Worry was associated with greater interest in genetic testing, stronger beliefs that testing has detrimental emotional consequences, and positive beliefs about benefits of testing and risk-reducing surgeries. Perceived risk was unrelated to interest and associated with more skeptical beliefs about emotional consequences and benefits of testing and risk-reducing surgeries. At low worry levels, testing interest increased with more positive beliefs about testing benefits; at high worry levels, interest was high regardless of benefits beliefs. The findings support Leventhal's Common-Sense Model of self-regulation delineating interactive influences of risk-related cognitions and emotions on information processing and behavior.

  2. [Drug sensitivity analysis of Mycobacterium chelonae and Mycobacterium abscessus and evaluation of Etest for susceptibility testing].

    PubMed

    Gui, Jing; Wang, Feng; Hong, Chuang-yue; Li, Jin-li; Liang, Jing

    2013-08-01

    To study the drug resistance profile of Mycobacterium(M.) chelonae and M.abscessus and to evaluate the clinical application of Etest(epsilometer test) for susceptibility testing. Twenty clinical isolates of M.abscessus and 16 clinical isolates of M.chelonae from clinical specimens were collected.Strain identification was carried out by GenoType Mycobacterium CM assay(Hain Lifescience, Germany). The accuracy was evaluated by comparing Etest results to those obtained by broth microdilution. Thirty-six isolates were tested against amikacin, cefoxitin, ciprofloxacin, clarithromycin, doxycycline, imipenem, linezolid, sulfamethoxazole and tobramycin. The agreement among MICs and interpretive category was evaluated. Chi-squared test was used to compare observed frequency of each of the 2 examples. All of the isolates(36/36) were sensitive to amikacin and cefoxitin, and only 1 isolate(1/36) was resistant to clarithromycin, but more isolates(29/36) were resistant to ciprofloxacin, doxycycline, imipenem and sulfamethoxazole.For M.chelonae, only 2/16 were resistant to linezolid, and 7/16 resistant to tobramycin.For M.abscessus, more than 12/20 were resistant to linezolid and 16/20 resistant to tobramycin. The agreement between broth microdilution MICs and Etest MICs for 9 drugs was 149/324.With amikacin, clarithromycin, doxycycline and imipenem, the agreement for interpretive category was excellent(35/36), followed by sulfamethoxazole(34/36), which corresponded to rarely very major error of 2/36.With ciprofloxacin and tobramycin, agreement for interpretive category was 31/36 and 26/36.With cefoxitin and linezolid, the agreement of Etest MICs was the lowest(14/36), resulting in the resistant category. Isolates of M.chelonae and M.abscessus exhibit far more susceptibility to amikacin, cefoxitin and clarithromycin than any other antimicrobial agents.Linezolid and tobramycin showed sensitivity to some isolates of M.chelonae.It is suitable for the Etest method as a simple reliable

  3. [Antifungal susceptibility of Acremonium species using E-test and Sensititre].

    PubMed

    Saldarreaga, A; Garcia Martos, P; Ruiz Aragón, J; García Agudo, L; Montes de Oca, M; Puerto, J L; Marín, P

    2004-03-01

    Filamentous fungi have become a common cause of severe infections, especially in immunocompromised patients. In recent years, the number and diversity of the infections caused by Acremonium species have increased and numerous species have been implicated. As is the case for most emerging pathogens, the optimal therapeutic approach to Acremonium species remains to be determined. We used two methods to determine the in vitro susceptibility to amphotericin B, itraconazole and fluconazole for 15 clinical isolates of eight different species of Acremonium. The MICs were determined according to protocol M38-A of the National Committee for Clinical Laboratory Standards (NCCLS) document, using the Sensititre and E-test microdilution methods. Amphotericin B was effective in vitro for few species using the Sensititre method. However, high MICs were obtained with E-test. Fluconazole and itraconazole were ineffective according to both methods. Acremonium species are generally resistant to the most commonly used antifungal agents. Consequently, Acremonium susceptibility testing is recommended to assist in choosing adequate treatment of infections caused by this filamentous fungus.

  4. Antimicrobial susceptibility testing for Helicobacter pylori in times of increasing antibiotic resistance.

    PubMed

    Smith, Sinéad M; O'Morain, Colm; McNamara, Deirdre

    2014-08-07

    The gram-negative bacterium Helicobacter pylori (H. pylori) causes chronic gastritis, gastric and duodenal ulcers, gastric cancer and mucosa-associated lymphoid tissue lymphoma. Treatment is recommended in all symptomatic patients. The current treatment options for H. pylori infection are outlined in this review in light of the recent challenges in eradication success, largely due to the rapid emergence of antibiotic resistant strains of H. pylori. Antibiotic resistance is a constantly evolving process and numerous studies have shown that the prevalence of H. pylori antibiotic resistance varies significantly from country to country, and even between regions within the same country. In addition, recent data has shown that previous antibiotic use is associated with harbouring antibiotic resistant H. pylori. Local surveillance of antibiotic resistance is warranted to guide clinicians in their choice of therapy. Antimicrobial resistance is assessed by H. pylori culture and antimicrobial susceptibility testing. Recently developed molecular tests offer an attractive alternative to culture and allow for the rapid molecular genetic identification of H. pylori and resistance-associated mutations directly from biopsy samples or bacterial culture material. Accumulating evidence indicates that surveillance of antimicrobial resistance by susceptibility testing is feasible and necessary to inform clinicians in their choice of therapy for management of H. pylori infection.

  5. Rapid Real-Time Antimicrobial Susceptibility Testing with Electrical Sensing on Plastic Microchips with Printed Electrodes.

    PubMed

    Safavieh, Mohammadali; Pandya, Hardik J; Venkataraman, Maanasa; Thirumalaraju, Prudhvi; Kanakasabapathy, Manoj Kumar; Singh, Anupriya; Prabhakar, Devbalaji; Chug, Manjyot Kaur; Shafiee, Hadi

    2017-03-30

    Rapid antimicrobial susceptibility testing is important for efficient and timely therapeutic decision making. Due to globally spread bacterial resistance, the efficacy of antibiotics is increasingly being impeded. Conventional antibiotic tests rely on bacterial culture, which is time-consuming and can lead to potentially inappropriate antibiotic prescription and up-front broad range of antibiotic use. There is an urgent need to develop point-of-care platform technologies to rapidly detect pathogens, identify the right antibiotics, and monitor mutations to help adjust therapy. Here, we report a biosensor for rapid (<90 min), real time, and label-free bacteria isolation from whole blood and antibiotic susceptibility testing. Target bacteria are captured on flexible plastic-based microchips with printed electrodes using antibodies (30 min), and its electrical response is monitored in the presence and absence of antibiotics over an hour of incubation time. We evaluated the microchip with Escherichia coli and methicillin-resistant Staphylococcus aureus (MRSA) as clinical models with ampicillin, ciprofloxacin, erythromycin, daptomycin, gentamicin, and methicillin antibiotics. The results are compared with the current standard methods, i.e. bacteria viability and conventional antibiogram assays. The technology presented here has the potential to provide precise and rapid bacteria screening and guidance in clinical therapies by identifying the correct antibiotics for pathogens.

  6. Radiometric method for testing susceptibility of mycobacteria to pyrazinamide in 7H12 broth.

    PubMed Central

    Heifets, L B; Iseman, M D

    1985-01-01

    The test of susceptibility to pyrazinamide requires an acid environment (pH less than or equal to 5.5). This, however, is not favorable to the growth of Mycobacterium tuberculosis, especially in solid agar media. To obviate this difficulty, we developed a testing method with 7H12 broth medium and based on radiometric readings of the growth. The radiometric method employed in this study (BACTEC system) provides an opportunity to detect the dynamics of growth by daily recording of the growth index, which reflects the metabolic activity of the multiplying bacteria. In our technique, M. tuberculosis isolates were initially cultivated at pH 6.8. After logarithmic growth had begun, phosphoric acid solution was added to obtain pH 5.5. When pyrazinamide was added simultaneously with the acid, the growth index of susceptible cultures decreased, whereas it continued to increase in pH 5.5 control vials and in tests with pyrazinamide-resistant strains. PMID:3972987

  7. Disk diffusion test and E-test with enriched Mueller-Hinton agar for determining susceptibility of Candida species to voriconazole and fluconazole.

    PubMed

    Lee, Sai-Cheong; Lo, Hsiu-Jung; Fung, Chang-Phone; Lee, Ning; See, Lai-Chu

    2009-04-01

    A simplified antifungal disk diffusion test using Mueller-Hinton agar containing 2% glucose and methylene blue 5 microg/mL (GM-MH, Clinical and Laboratory Standards Institute [CLSI] M44-A) has proved to correlate well with the standard reference test. A new azole, voriconazole, has recently been approved for clinical therapy in Taiwan. This study investigated the reliability of the disk diffusion test with GM-MH agar and compared the results with those of the E-test using GM-MH agar to determine the voriconazole and fluconazole susceptibility of Candida isolates. The antimicrobial susceptibility of Candida isolates were evaluated by E-test and disk diffusion test in accordance with the guidelines of the CLSI, and compared with the reference antifungal macrodilution susceptibility test (CLSI M27-A). The antifungal disk diffusion test and the E-test using GM-MH agar plate provided a sufficiently accurate, time-efficient, and cost-effective way to determine the susceptibility of 182 Candida spp. to voriconazole and fluconazole. There was a high correlation between the test results of the E-test using the GM-MH agar plate and those obtained by the reference antifungal macrodilution susceptibility test (CLSI M27-A). The results of the E-test and those of the 1-microg voriconazole disk diffusion test on the GM-MH agar plate at 24 h had a high correlation. All the minimal inhibitory concentrations of voriconazole for all Candida spp. were <8 microg/mL. The positive predictive value of the susceptible disk test of voriconazole on the GM-MH agar plate was 100% at 24 h for C. albicans and other Candida spp. The disk diffusion test and the E-test using the GM-MH agar plate can be performed quickly, simply, and cost-effectively, and are practicable methods for the initial testing of the susceptibility of Candida spp. to voriconazole and fluconazole.

  8. Rapid detection and E-test antimicrobial susceptibility testing of Vibrio parahaemolyticus isolated from seafood and environmental sources in Malaysia.

    PubMed

    Al-Othrubi, Saleh M; Hanafiah, Alfizah; Radu, Son; Neoh, Humin; Jamal, Rahaman

    2011-04-01

    To find out the prevalence and antimicrobial susceptibility of Vibrio parahaemolyticus in seafoods and environmental sources. The study was carried out at the Center of Excellence for Food Safety Research, University Putra Malaysia; Universiti Kebangsaan Malaysia; Medical Molecular Biology Institute; and University Kebansaan Malaysia Hospital, Malaysia between January 2006 and August 2008. One hundred and forty-four isolates from 400 samples of seafood (122 isolates) and seawater sources (22 isolates) were investigated for the presence of thermostable direct hemolysin (tdh+) and TDH-related hemolysin (trh+) genes using the standard methods. The E-test method was used to test the antimicrobial susceptibility. The study indicates low occurrence of tdh+ (0.69%) and trh+ isolates (8.3%). None of the isolates tested posses both virulence genes. High sensitivity was observed against tetracycline (98%). The mean minimum inhibitory concentration (MIC) of the isolates toward ampicillin increased from 4 ug/ml in 2004 to 24 ug/ml in 2007. The current study demonstrates a low occurrence of pathogenic Vibrio parahaemolyticus in the marine environment and seafood. Nonetheless, the potential risk of vibrio infection due to consumption of Vibrio parahaemolyticus contaminated seafood in Malaysia should not be neglected.

  9. CLSI performance standards for antimicrobial susceptibility testing of bacteria isoloated from aquatic animals; second information supplement. CLSI document VET03/VET04-S2

    USDA-ARS?s Scientific Manuscript database

    The supplemental information presented in this document is intended for use with the antimicrobial susceptibility testing procedures published in the following Clinical and Laboratory Standards Institute (CLSI) approved documents VET03-A Methods for Antimicrobial Disk Susceptibility Testing of Bacte...

  10. A novel microbead-based microfluidic device for rapid bacterial identification and antibiotic susceptibility testing.

    PubMed

    He, J; Mu, X; Guo, Z; Hao, H; Zhang, C; Zhao, Z; Wang, Q

    2014-12-01

    Effective treatment of infectious diseases depends on the ability to rapidly identify the infecting bacteria and the use of sensitive antibiotics. The currently used identification assays usually take more than 72 h to perform and have a low sensitivity. Herein, we present a microbead-based microfluidic platform that is highly sensitive and rapid for bacterial detection and antibiotic sensitivity testing. The platform includes four units, one of which is used for bacterial identification and the other three are used for susceptibility testing. Our results showed that Escherichia coli O157 at a cell density range of 10(1)-10(5) CFU/μL could be detected within 30 min. Additionally, the effects of three antibiotics on E. coli O157 were evaluated within 4-8 h. Overall, this integrated microbead-based microdevice provides a sensitive, rapid, reliable, and highly effective platform for the identification of bacteria, as well as antibiotic sensitivity testing.

  11. Determination of disk diffusion susceptibility testing interpretive criteria using model-based analysis: development and implementation.

    PubMed

    DePalma, Glen; Turnidge, John; Craig, Bruce A

    2017-02-01

    The determination of diffusion test breakpoints has become a challenging issue due to the increasing resistance of microorganisms to antibiotics. Currently, the most commonly-used method for determining these breakpoints is the modified error-rate bounded method. Its use has remained widespread despite the introduction of several model-based methods that have been shown superior in terms of precision and accuracy. However, the computational complexities associated with these new approaches has been a significant barrier for clinicians. To remedy this, we developed and examine the utility of a free online software package designed for the determination of diffusion test breakpoints: dBETS (diffusion Breakpoint Estimation Testing Software). This software package allows clinicians to easily analyze data from susceptibility experiments through visualization, error-rate bounded, and model-based approaches. We analyze four publicly available data sets from the Clinical and Laboratory Standards Institute using dBETS.

  12. Validity and Reliability of a Measurement of Objective Functional Impairment in Lumbar Degenerative Disc Disease: The Timed Up and Go (TUG) Test.

    PubMed

    Gautschi, Oliver P; Smoll, Nicolas R; Corniola, Marco V; Joswig, Holger; Chau, Ivan; Hildebrandt, Gerhard; Schaller, Karl; Stienen, Martin N

    2016-08-01

    There are few objective measures of functional impairment to support clinical decision making in lumbar degenerative disc disease (DDD). We present the validation (and reliability measures) of the Timed Up and Go (TUG) test. In a prospective, 2-center study, 253 consecutive patients were assessed using the TUG test. A representative cohort of 110 volunteers served as control subjects. The TUG test values were assessed for validity and reliability. The TUG test had excellent intra- (intraclass correlation coefficient: 0.97) and interrater reliability (intraclass correlation coefficient: 0.99), with a standard error of measurement of 0.21 and 0.23 seconds, respectively. The validity of the TUG test was demonstrated by a good correlation with the Visual Analog Scale (VAS) back (Pearson's correlation coefficient [PCC]: 0.25) and VAS (PCC: 0.29) leg pain, functional impairment (Roland-Morris Disability Index [PCC: 0.38] and Oswestry Disability Index [PCC: 0.34]), as well as with health-related quality of life (Short Form-12 Mental Component Summary score [PCC: -0.25], Short Form-12 Physical Component Summary score [PCC: -0.32], and EQ-5D [PCC: -0.28]). The upper limit of "normal" was 11.52 seconds. Mild (lower than the 33rd percentile), moderate (33rd to 66th percentiles), and severe objective functional impairment (higher than the 66th percentile) as determined by the TUG test was <13.4 seconds, 13.4 to 18.4 seconds, and >18.4 seconds, respectively. The TUG test is a quick, easy-to-use, valid, and reliable tool to evaluate objective functional impairment in patients with lumbar degenerative disc disease. In the clinical setting, patients scoring a TUG test time of over 12 seconds can be considered to have functional impairment. BMI, body mass indexDDD, degenerative disc diseaseHRQOL, health-related quality of lifeICC, intraclass correlationLDH, lumbar disc herniationLSS, lumbar spinal stenosisODI, Oswestry Disability IndexOFI, objective functional impairment

  13. Evaluating Constraints on Heavy-Ion SEE Susceptibility Imposed by Proton SEE Testing and Other Mixed Environments

    NASA Technical Reports Server (NTRS)

    Ladbury, R. L.; Lauenstein, J.-M.

    2016-01-01

    We develop metrics for assessing the effectiveness of proton SEE data for bounding heavy-ion SEE susceptibility. The metrics range from simple geometric criteria requiring no knowledge of the test articles to bounds of SEE rates.

  14. Correlation between bactericidal activity of fosfomycin trometamol in an in vitro model of the urinary bladder and susceptibility testing.

    PubMed

    Pinasi, C; Albini, E; Marca, G

    1987-01-01

    The present study was undertaken to define an interpretative guideline for disk diffusion susceptibility testing with fosfomycin trometamol, a new antimicrobial agent which has been developed for the treatment of urinary tract infections. Two potencies of fosfomycin disk were used: 50 and 200 micrograms, prepared in the presence and absence of glucose-6-phosphate. To verify the reliability of the results obtained in susceptibility testing, we have also evaluated the bactericidal activity of fosfomycin trometamol versus sensitive and resistant strains in an 'in vitro' model simulating the hydrokinetic aspects involved in the treatment of bacterial cystitis. The data obtained evidenced the role of glucose-6-phosphate in antimicrobial susceptibility tests as well as the importance of the urinary antibiotic concentrations to define sensitive and resistant bacteria. On the basis of our results, we recommend that a 200-microgram disk of fosfomycin containing 50 micrograms of glucose-6-phosphate should be used in antimicrobial susceptibility testing with fosfomycin trometamol.

  15. Methods for broth dilution susceptibility testing of bacteria isolated from aquatic animals; approved guideline-second edition

    USDA-ARS?s Scientific Manuscript database

    Antimicrobial susceptibility testing is recommended to determine which antimicrobial agents should be considered for treating a bacterial pathogen. Many bacteria that cause disease in aquatic animals require growth conditions that vary substantially from routine terrestrial pathogens. It has thus ...

  16. Physically-based landslide susceptibility modelling: geotechnical testing and model evaluation issues

    NASA Astrophysics Data System (ADS)

    Marchesini, Ivan; Mergili, Martin; Schneider-Muntau, Barbara; Alvioli, Massimiliano; Rossi, Mauro; Guzzetti, Fausto

    2015-04-01

    We used the software r.slope.stability for physically-based landslide susceptibility modelling in the 90 km² Collazzone area, Central Italy, exploiting a comprehensive set of lithological, geotechnical, and landslide inventory data. The model results were evaluated against the inventory. r.slope.stability is a GIS-supported tool for modelling shallow and deep-seated slope stability and slope failure probability at comparatively broad scales. Developed as a raster module of the GRASS GIS software, r.slope.stability evaluates the slope stability for a large number of randomly selected ellipsoidal potential sliding surfaces. The bottom of the soil (for shallow slope stability) or the bedding planes of lithological layers (for deep-seated slope stability) are taken as potential sliding surfaces by truncating the ellipsoids, allowing for the analysis of relatively complex geological structures. To take account for the uncertain geotechnical and geometric parameters, r.slope.stability computes the slope failure probability by testing multiple parameter combinations sampled deterministically or stochastically, and evaluating the ratio between the number of parameter combinations yielding a factor of safety below 1 and the total number of tested combinations. Any single raster cell may be intersected by multiple sliding surfaces, each associated with a slope failure probability. The most critical sliding surface is relevant for each pixel. Intensive use of r.slope.stability in the Collazzone Area has opened up two questions elaborated in the present work: (i) To what extent does a larger number of geotechnical tests help to better constrain the geotechnical characteristics of the study area and, consequently, to improve the model results? The ranges of values of cohesion and angle of internal friction obtained through 13 direct shear tests corresponds remarkably well to the range of values suggested by a geotechnical textbook. We elaborate how far an increased number of

  17. Posaconazole susceptibility testing against Candida species: comparison of broth microdilution and E-test methods.

    PubMed

    Sóczó, G; Kardos, G; McNicholas, P M; Falusi, E; Gergely, L; Majoros, L

    2007-05-01

    Posaconazole (POS) is a newer triazole with activity against yeasts and moulds. POS and fluconazole were tested in vitro against 32 Candida albicans, 30 C. glabrata, 21 C. tropicalis, 29 C. krusei, 28 C. parapsilosis, 50 C. inconspicua, 13 C. kefyr and 5 C. famata isolates using CLSI broth microdilution method (BMD). We compared E-test and a modified BMD using polyethylene-glycol (PEG) as solvent to the CLSI method. BMDs and E-test were performed according to CLSI and the manufacturer's instructions respectively. Geometric means of POS MICs using BMD were 0.71, 0.22 and 0.21 microg ml(-1) against C. glabrata, C. krusei and C. inconspicua, respectively, and remained below 0.1 microg ml(-1) against all other species tested. One of two C. albicans and two of three C. glabrata isolates resistant to fluconazole showed MICs above 8 microg ml(-1) to POS. The impact of using PEG instead of DMSO had only a minor effect (agreements above 95% with the exception of C. parapsilosis). E-tests read after 24 h showed good agreement with the BMD. POS exhibited excellent in vitro activity against Hungarian Candida strains. E-test showed good correlation with the CLSI method, but to facilitate the comparability of results we believe that DMSO should be used as solvent in the BMD.

  18. Interlaboratory Comparison of Results of Susceptibility Testing with Caspofungin against Candida and Aspergillus Species

    PubMed Central

    Odds, Frank C.; Motyl, Mary; Andrade, Roberto; Bille, Jacques; Cantón, Emilia; Cuenca-Estrella, Manuel; Davidson, Amanda; Durussel, Christian; Ellis, David; Foraker, Elyse; Fothergill, Annette W.; Ghannoum, Mahmoud A.; Giacobbe, Robert A.; Gobernado, Miguel; Handke, Rosemary; Laverdière, Michel; Lee-Yang, Wendy; Merz, William G.; Ostrosky-Zeichner, Luis; Pemán, Javier; Perea, Sophia; Perfect, John R.; Pfaller, Michael A.; Proia, Laurie; Rex, John H.; Rinaldi, Michael G.; Rodriguez-Tudela, Juan-Luis; Schell, Wiley A.; Shields, Christine; Sutton, Deanna A.; Verweij, Paul E.; Warnock, David W.

    2004-01-01

    Seventeen laboratories participated in a study of interlaboratory reproducibility with caspofungin microdilution susceptibility testing against panels comprising 30 isolates of Candida spp. and 20 isolates of Aspergillus spp. The laboratories used materials supplied from a single source to determine the influence of growth medium (RPMI 1640 with or without glucose additions and antibiotic medium 3 [AM3]), the same incubation times (24 h and 48 h), and the same end point definition (partial or complete inhibition of growth) for the MIC of caspofungin. All tests were run in duplicate, and end points were determined both spectrophotometrically and visually. The results from almost all of the laboratories for quality control and reference Candida and Aspergillus isolates tested with fluconazole and itraconazole matched the NCCLS published values. However, considerable interlaboratory variability was seen in the results of the caspofungin tests. For Candida spp. the most consistent MIC data were generated with visual “prominent growth reduction” (MIC2) end points measured at 24 h in RPMI 1640, where 73.3% of results for the 30 isolates tested fell within a mode ± one dilution range across all 17 laboratories. MIC2 at 24 h in RPMI 1640 or AM3 also gave the best interlaboratory separation of Candida isolates of known high and low susceptibility to caspofungin. Reproducibility of MIC data was problematic for caspofungin tests with Aspergillus spp. under all conditions, but the minimal effective concentration end point, defined as the lowest caspofungin concentration yielding conspicuously aberrant hyphal growth, gave excellent reproducibility for data from 14 of the 17 participating laboratories. PMID:15297486

  19. A novel approach to antibiofilm susceptibility testing using a thermo-reversible matrix.

    PubMed

    Taylor, B J; Marsh, L L; Nosworthy, J O; Williams, D W

    2016-02-01

    Biofilm microorganisms are known to have a much higher tolerance to antimicrobials compared to their planktonic equivalents. Therefore, traditional antimicrobial susceptibility testing may not extrapolate to clinical treatment of infections of biofilm origin, and as a result, there is a need to not only develop antimicrobials with antibiofilm activity, but also suitable in vitro testing methods for their evaluation. In this study, we report on a novel method of antibiofilm testing using a thermo-reversible matrix (poloxamer 407), coupled with live/dead staining of bacteria cultured from the matrix. Pseudomonas aeruginosa (NCIMB 8626) was cultured in medium containing poloxamer 407 at 37°C for 24 hours to generate biofilms. The preparation was cooled to liquefy the poloxamer and allow recovery of the biofilm cells, which were then stained with SYTO9 to determine viability following exposure to four antimicrobials: polyhexanide, octenadine dihydrochloride, povidone-iodine and silver carbonate. Over an 8-minute time period, fluorescence levels were spectrophotometrically measured and compared with bacterial controls, cultured in the absence of poloxamer and without antimicrobial. Untreated cells showed no reduction in viability over this period. Importantly, planktonic cells were more susceptible to test agents compared with those of a 'biofilm' phenotype cultured in poloxamer. Antibiofilm activity was evident for all of the test agents, with highest relative activity seen with octenadine dihydrochloride. In summary, a novel and relatively rapid approach to screen compounds for antibiofilm activity has been described. The method uses standard laboratory equipment and can be readily adapted to test a wide range of microorganisms and other antibiofilm compounds. This research was, in part, supported by Advanced Medical Solutions in the form of a Knowledge Transfer Project. Mr J. Nosworthy was employed by Advanced Medical Solutions. There are no other conflicts of

  20. American Society of Clinical Oncology policy statement update: genetic testing for cancer susceptibility.

    PubMed

    2003-06-15

    As the leading organization representing cancer specialists involved in patient care and clinical research, the American Society of Clinical Oncology (ASCO) reaffirms its commitment to integrating cancer risk assessment and management, including molecular analysis of cancer predisposition genes, into the practice of oncology and preventive medicine. The primary goal of this effort is to foster expanded access to, and continued advances in, medical care provided to patients and families affected by hereditary cancer syndromes. The 1996 ASCO Statement on Genetic Testing for Cancer Susceptibility set forth specific recommendations relating to clinical practice, research needs, educational opportunities, requirement for informed consent, indications for genetic testing, regulation of laboratories, and protection from discrimination, as well as access to and reimbursement for cancer genetics services. In updating this Statement, ASCO endorses the following principles: Indications for Genetic Testing: ASCO recommends that genetic testing be offered when 1) the individual has personal or family history features suggestive of a genetic cancer susceptibility condition, 2) the test can be adequately interpreted, and 3) the results will aid in diagnosis or influence the medical or surgical management of the patient or family members at hereditary risk of cancer. ASCO recommends that genetic testing only be done in the setting of pre- and post-test counseling, which should include discussion of possible risks and benefits of cancer early detection and prevention modalities. Special Issues in Testing Children for Cancer Susceptibility: ASCO recommends that the decision to offer testing to potentially affected children should take into account the availability of evidence-based risk-reduction strategies and the probability of developing a malignancy during childhood. Where risk-reduction strategies are available or cancer predominantly develops in childhood, ASCO believes that

  1. Clinical findings and electrodiagnostic testing in 108 consecutive cases of lumbosacral radiculopathy due to herniated disc.

    PubMed

    Mondelli, M; Aretini, A; Arrigucci, U; Ginanneschi, F; Greco, G; Sicurelli, F

    2013-10-01

    This prospective study aim to examine whether clinical findings and electrodiagnostic testing (EDX) in patients with lumbosacral monoradiculopathy due to herniated disc (HD) differ as a function of root involvement level (L5 vs. S1) and HD zone (paramedian vs. intraforaminal). All patients with L4, L5 or S1 monoradiculopathy were prospectively enrolled at four electromyography (EMG) labs over a 2-year period. The diagnosis was based on a congruence between patient history and MRI evidence of HD. We compared the sensitivities of clinical findings and EDX with respect to both root involvement level and HD zone. Multivariate logistic regression was performed in order to verify the association between abnormal EMG, clinical, and neuroradiological findings. One hundred and eight patients (mean age 47.7 years, 55% men) were consecutively enrolled. Sensory loss in the painful dermatome was the most frequent finding at physical examination (56% of cases). EMG was abnormal in at least one muscle supplied by femoral and sciatic nerves in 45 cases (42%). Inclusion of paraspinal muscles increased sensitivity to only 49% and that of proximal muscles was useless. Motor and sensory neurography was seldom abnormal. The most frequent motor neurographic abnormalities were a delay of F-wave minimum latency and decrease in the compound muscle action potential amplitude from extensor digitorum brevis and abductor hallucis in L5 and S1 radiculopathies, respectively. Sensory neurography was usually normal, the amplitude of sensory nerve action potential was seldom reduced when HD injured dorsal root ganglion or postganglionic root fibres. Multivariate logistic regression analysis showed that EMG abnormalities could be predicted by myotomal muscular weakness, abnormal deep reflexes, and paraesthesiae. The only clinical and electrophysiological differences with respect to root involvement level concerned deep reflexes and motor neurography of deep peroneal and tibial nerves. Only some EDX

  2. Single-disk diffusion testing (Kirby-Bauer) of susceptibility of Proteus mirabilis to chloramphenicol: significance of the intermediate category.

    PubMed

    Furtado, G L; Medeiros, A A

    1980-10-01

    The significance of the intermediate category of the single-disk diffusion test (Kirby-Bauer) of antibiotic susceptibility has never been clearly defined. Thirty-two percent of 756 clinical isolates of Proteus mirabilis were of intermediate susceptibility to chloramphenicol, a higher percentage than for any other species. The breakpoint separating susceptible and intermediate isolates nearly bisected the frequency distribution of zone diameters of P. mirabilis but not that of the other species. The breakpoint separating susceptible and intermediate isolates nearly bisected the frequency distribution of zone diameters of P. mirabillis but not that of the other species tested. By serial broth dilution testing, the minimal inhibitory concentrations (MICs) of chloramphenicol of 50 individual isolates of P. mirabilis were 3.9 to 22.1 micrograms/ml (geometric mean, 8.0), whereas the MICs of susceptible Escherichia coli, Klebsiella, and Enterobacter strains were 2.0 to 3.9 micrograms/ml (geometric mean, 2.9). Seventy percent of isolates of P. mirabilis with MICs of 7.8 to 15.6 micrograms/ml were classified as susceptible by disk testing. We conclude that existing Kirby-Bauer breakpoints do not accurately discriminate P. mirabilis isolates that are marginally susceptible to chloramphenicol. These data underscore the difficulty of applying a single set of breakpoints to all species and suggest that species-specific breakpoints would more accurately predict the MIC equivalent of given zone diameters.

  3. Psychological impact of genetic testing for cancer susceptibility: an update of the literature.

    PubMed

    Meiser, Bettina

    2005-12-01

    This article presents an overview of the rapidly evolving body of literature on the psychological impact of genetic testing for hereditary breast/ovarian cancer susceptibility, hereditary non-polyposis colorectal cancer (HNPCC) and familial adenomatous polyposis (FAP). Uptake of genetic testing for BRCA1/2 and HNPCC-related mutations is more consistently related to psychological factors, rather than sociodemographic variables. Most studies on the psychological impact of genetic testing amongst individuals who have never been affected by cancer demonstrate that non-carriers derive significant psychological benefits from genetic testing, while no adverse effects have been observed amongst carriers. These benefits are more clear-cut for HNPCC, compared to hereditary breast/ovarian cancer, reflecting differences in risk management options. The few studies available on individuals affected with cancer indicate that the impact of genetic testing is mediated and amplified by their former experience of cancer. Future directions and challenges of research in this area are reviewed. In particular, more empirical data are needed on the broader impact of genetic testing on those with inconclusive results or results of uncertain significance. As genetic testing is becoming available for other types of familial cancer, additional investigations will be needed as there is evidence to suggest that the impact of genetic testing may be unique to each type of familial cancer.

  4. Intra- and Interlaboratory Study of a Method for Testing the Antifungal Susceptibilities of Dermatophytes

    PubMed Central

    Ghannoum, M. A.; Chaturvedi, V.; Espinel-Ingroff, A.; Pfaller, M. A.; Rinaldi, M. G.; Lee-Yang, W.; Warnock, D. W.

    2004-01-01

    The National Committee for Clinical Laboratory Standards (NCCLS) M38-A standard for the susceptibility testing of conidium-forming filamentous fungi does not explicitly address the testing of dermatophytes. This multicenter study, involving six laboratories, investigated the MIC reproducibility of seven antifungal agents tested against 25 dermatophyte isolates (5 blinded pairs of five dermatophyte species per site for a total of 300 tests), using the method of dermatophyte testing developed at the Center for Medical Mycology, Cleveland, Ohio. The dermatophytes tested included Trichophyton rubrum, Trichophyton mentagrophytes, Trichophyton tonsurans, Epidermophyton floccosum, and Microsporum canis. Seven antifungals with activity against dermatophytes were tested, including ciclopirox, fluconazole, griseofulvin, itraconazole, posaconazole, terbinafine, and voriconazole. Interlaboratory MICs for all isolates were in 92 to 100% agreement at a visual endpoint reading of 50% inhibition as compared to the growth control and 88 to 99% agreement at a visual endpoint reading of 80% inhibition as compared to the growth control. Intralaboratory MICs between blinded pairs were in 97% agreement at a visual endpoint reading of 50% inhibition as compared to the growth control and 96% agreement at a visual endpoint reading of 80% inhibition as compared to the growth control. Data from this study support consideration of this method as an amendment to the NCCLS M38-A standard for the testing of dermatophytes. PMID:15243047

  5. ESBL Detection: Comparison of a Commercially Available Chromogenic Test for Third Generation Cephalosporine Resistance and Automated Susceptibility Testing in Enterobactericeae.

    PubMed

    El-Jade, Mohamed Ramadan; Parcina, Marijo; Schmithausen, Ricarda Maria; Stein, Christoph; Meilaender, Alina; Hoerauf, Achim; Molitor, Ernst; Bekeredjian-Ding, Isabelle

    2016-01-01

    Rapid detection and reporting of third generation cephalosporine resistance (3GC-R) and of extended spectrum betalactamases in Enterobacteriaceae (ESBL-E) is a diagnostic and therapeutic priority to avoid inefficacy of the initial antibiotic regimen. In this study we evaluated a commercially available chromogenic screen for 3GC-R as a predictive and/or confirmatory test for ESBL and AmpC activity in clinical and veterinary Enterobacteriaceae isolates. The test was highly reliable in the prediction of cefotaxime and cefpodoxime resistance, but there was no correlation with ceftazidime and piperacillin/tazobactam minimal inhibitory concentrations. All human and porcine ESBL-E tested were detected with exception of one genetically positive but phenotypically negative isolate. By contrast, AmpC detection rates lay below 30%. Notably, exclusion of piperacillin/tazobactam resistant, 3GC susceptible K1+ Klebsiella isolates increased the sensitivity and specificity of the test for ESBL detection. Our data further imply that in regions with low prevalence of AmpC and K1 positive E. coli strains chromogenic testing for 3GC-R can substitute for more time consuming ESBL confirmative testing in E. coli isolates tested positive by Phoenix or VITEK2 ESBL screen. We, therefore, suggest a diagnostic algorithm that distinguishes 3GC-R screening from primary culture and species-dependent confirmatory ESBL testing by βLACTATM and discuss the implications of MIC distribution results on the choice of antibiotic regimen.

  6. ESBL Detection: Comparison of a Commercially Available Chromogenic Test for Third Generation Cephalosporine Resistance and Automated Susceptibility Testing in Enterobactericeae

    PubMed Central

    El-Jade, Mohamed Ramadan; Parcina, Marijo; Schmithausen, Ricarda Maria; Stein, Christoph; Meilaender, Alina; Hoerauf, Achim; Molitor, Ernst

    2016-01-01

    Rapid detection and reporting of third generation cephalosporine resistance (3GC-R) and of extended spectrum betalactamases in Enterobacteriaceae (ESBL-E) is a diagnostic and therapeutic priority to avoid inefficacy of the initial antibiotic regimen. In this study we evaluated a commercially available chromogenic screen for 3GC-R as a predictive and/or confirmatory test for ESBL and AmpC activity in clinical and veterinary Enterobacteriaceae isolates. The test was highly reliable in the prediction of cefotaxime and cefpodoxime resistance, but there was no correlation with ceftazidime and piperacillin/tazobactam minimal inhibitory concentrations. All human and porcine ESBL-E tested were detected with exception of one genetically positive but phenotypically negative isolate. By contrast, AmpC detection rates lay below 30%. Notably, exclusion of piperacillin/tazobactam resistant, 3GC susceptible K1+ Klebsiella isolates increased the sensitivity and specificity of the test for ESBL detection. Our data further imply that in regions with low prevalence of AmpC and K1 positive E. coli strains chromogenic testing for 3GC-R can substitute for more time consuming ESBL confirmative testing in E. coli isolates tested positive by Phoenix or VITEK2 ESBL screen. We, therefore, suggest a diagnostic algorithm that distinguishes 3GC-R screening from primary culture and species-dependent confirmatory ESBL testing by βLACTATM and discuss the implications of MIC distribution results on the choice of antibiotic regimen. PMID:27494134

  7. Detection of relatively penicillin G-resistant Neisseria meningitidis by disk susceptibility testing.

    PubMed Central

    Campos, J; Mendelman, P M; Sako, M U; Chaffin, D O; Smith, A L; Sáez-Nieto, J A

    1987-01-01

    Beginning in 1985, relatively penicillin G-resistant (Penr) meningococci which did not produce beta-lactamase were isolated from the blood and cerebrospinal fluid of patients in Spain. We identified 16 Penr (mean MIC, 0.3 microgram/ml; range, 0.1 to 0.7 microgram/ml) and 12 penicillin-susceptible (Pens; mean MIC, less than or equal to 0.06 microgram/ml) strains of Neisseria meningitidis by the agar dilution technique using an inoculum of 10(4) CFU and questioned which disk susceptibility test would best differentiate these two populations. We compared the disk susceptibility of these strains using disks containing 2 (P2) and 10 (P10) U of penicillin G, 2 (Am2) and 10 (Am10) micrograms of ampicillin, and 1 microgram of oxacillin (OX1). We also investigated susceptibility with disks containing 30 micrograms of each of cephalothin (CF30), cefoxitin (FOX30), cefuroxime (CXM30), and cefotaxime (CTX30) and 75 micrograms of cefoperazone (CFP75) and determined by cluster analysis any correlation with the zone diameters obtained with P2 disks. Using the P2 and AM2 disks (in contrast to the P10 and AM10 disks), we correctly differentiated all the Penr from Pens isolates. In addition, the zone diameters with the P2 disk gave the best correlation with the penicillin G MIC determinations. All 16 Penr strains and 3 of 12 Pens strains showed zone diameters of 6 mm around OX1 disks, limiting the usefulness of OX1 disks. The zone diameters obtained with CF30, CXM30, and OX1 disks correlated with those obtained with the P2 disk, which suggests that these antibiotics have similar effects on these strains. In contrast, the data obtained with FOX30, CTX30, and CFP75 disks did not cluster with those obtained with the P2 disk, which suggests that there was a difference in the bacterial target or reflects their greater activity. We conclude that the P2 disk tests more readily identify Penr meningococci than do the standard P10 disk tests. PMID:3124729

  8. Rapid method for testing susceptibility of Mycobacterium tuberculosis by using DNA probes.

    PubMed Central

    Martin-Casabona, N; Xairó Mimó, D; González, T; Rossello, J; Arcalis, L

    1997-01-01

    The increasing number of multidrug-resistant Mycobacterium tuberculosis strains has stimulated the interest of investigators in finding a rapid method for susceptibility testing. We used commercially available rRNA DNA-bioluminescence-labelled probes (Accu-Probe, Gen Probe, Inc. San Diego, Calif.) for this purpose. The study was performed in three chronological steps. (i) We studied the correlation between the photometric light units (PLUs) given by the hybridization method, the numbers of CFU per milliliter, and turbidity as nephelometric units for six different inocula of an M. tuberculosis strain over 14 days. A good correlation (c > 0.9; P < 0.05) was found from the third day for all concentrations used. (ii) Over a period of 14 days we studied the evolution of the PLUs for 20 strains growing in medium with 0.2 microl of isoniazid (H) per ml and 18 strains in medium with 1 microl of rifampin (R) per ml to standardize the method. Susceptible and resistant strains were used according to the reference proportions method in Middlebrook 7H10, and the MICs were determined in solid and liquid media. The final inoculum of a 10(-2) dilution from a McFarland no. 1 standard and reading at 3 and 5 days provided the best results. A quotient was established to find a cutoff point between resistant and susceptible strains. (iii) We used the standardized parameters in 117 tests with H and R. On day 3, the sensitivity, specificity, positive predictive value, and negative predictive value for detecting resistant strains were 86.8, 100, 100, and 90.1%, respectively, and on day 5 they were 96.2, 100, 100, and 94%, respectively. We concluded that the method is readily available, is easy to perform, and could be useful for screening resistant M. tuberculosis strains. PMID:9316900

  9. Reliability of Disk Diffusion Test Results for the Antimicrobial Susceptibility Testing of Nosocomial Gram-positive Microorganisms: Is E-test Method Better?

    PubMed Central

    Khalili, Hossein; Soltani, Rasool; Negahban, Sorrosh; Abdollahi, Alireza; Gholami, Keirollah

    2012-01-01

    Disk diffusion test is the usual applicable method for assessing the antimicrobial susceptibility pattern in most institutions and hospitals. The aim of this study was to determine the reliability of resistant-reported results of disk diffusion test for 6 routinely used antibiotics against Gram-positive microorganisms of nosocomial origin, using E-test method. Over a 1-year period, clinical specimens (e.g. blood, tracheal secretions, wound secretions, urine, etc.) were obtained from hospitalized patients with defined nosocomial infection and were cultured. Isolated Gram-positive bacteria underwent disk diffusion test for cephalothin, oxacillin, clindamycin, ciprofloxacin, vancomycin, teicoplanin (only for Enterococci), and meropenem antibiotics. E-test method was performed for all isolates resistant or intermediately sensitive to the disks of any mentioned antibiotics. Data showed compatible results of disk diffusion test with the results of E-test method for cephalothin, oxacillin, ciprofloxacin, vancomycin, and teicoplanin. None of ciprofloxacin- and vancomycin-resistant isolates in disk diffusion test showed sensitivity in E-test method. Significant differences between the results of disk diffusion and E-test methods were observed for clindamycin and meropenem against S.aureus (p = 0.01 and 0.04, respectively) and Enterococcus spp (p = 0.03 and 0.02, respectively). In order to increase the reliability of antimicrobial susceptibility results, it is recommended to perform E-test for nosocomial Gram-positive microorganisms that show antibiotic resistance by disk diffusion test and it is more important for clindamycin and meropenem. PMID:24250479

  10. Reliability of Disk Diffusion Test Results for the Antimicrobial Susceptibility Testing of Nosocomial Gram-positive Microorganisms: Is E-test Method Better?

    PubMed

    Khalili, Hossein; Soltani, Rasool; Negahban, Sorrosh; Abdollahi, Alireza; Gholami, Keirollah

    2012-01-01

    Disk diffusion test is the usual applicable method for assessing the antimicrobial susceptibility pattern in most institutions and hospitals. The aim of this study was to determine the reliability of resistant-reported results of disk diffusion test for 6 routinely used antibiotics against Gram-positive microorganisms of nosocomial origin, using E-test method. Over a 1-year period, clinical specimens (e.g. blood, tracheal secretions, wound secretions, urine, etc.) were obtained from hospitalized patients with defined nosocomial infection and were cultured. Isolated Gram-positive bacteria underwent disk diffusion test for cephalothin, oxacillin, clindamycin, ciprofloxacin, vancomycin, teicoplanin (only for Enterococci), and meropenem antibiotics. E-test method was performed for all isolates resistant or intermediately sensitive to the disks of any mentioned antibiotics. Data showed compatible results of disk diffusion test with the results of E-test method for cephalothin, oxacillin, ciprofloxacin, vancomycin, and teicoplanin. None of ciprofloxacin- and vancomycin-resistant isolates in disk diffusion test showed sensitivity in E-test method. Significant differences between the results of disk diffusion and E-test methods were observed for clindamycin and meropenem against S.aureus (p = 0.01 and 0.04, respectively) and Enterococcus spp (p = 0.03 and 0.02, respectively). In order to increase the reliability of antimicrobial susceptibility results, it is recommended to perform E-test for nosocomial Gram-positive microorganisms that show antibiotic resistance by disk diffusion test and it is more important for clindamycin and meropenem.

  11. A Cell Phone-Based Microphotometric System for Rapid Antimicrobial Susceptibility Testing.

    PubMed

    Kadlec, Meichei Wang; You, David; Liao, Joseph C; Wong, Pak Kin

    2014-06-01

    This study demonstrates a low-cost, portable diagnostic system for rapid antimicrobial susceptibility testing in resource-limited settings. To determine the antimicrobial resistance phenotypically, the growth of pathogens in microwell arrays is detected under different antibiotic conditions. The use of a colorimetric cell viability reagent is shown to significantly improve the sensitivity of the assay compared with standard absorbance spectroscopy. Gas-permeable microwell arrays are incorporated for facilitating rapid bacterial growth and eliminating the requirement of bulky supporting equipment. Antibiotics can also be precoated in the microwell array to simplify the assay protocol toward point-of-care applications. Furthermore, a low-cost cell phone-based microphotometric system is developed for detecting the bacterial growth in the microwell array. By optimizing the operating conditions, the system allows antimicrobial susceptibility testing for samples with initial concentrations from 10(1) to 10(6) cfu/mL. Using urinary tract infection as the model system, we demonstrate rapid antimicrobial resistance profiling for uropathogens in both culture media and urine. With its simplicity and cost-effectiveness, the cell phone-based microphotometric system is anticipated to have broad applicability in resource-limited settings toward the management of infectious diseases caused by multidrug-resistant pathogens. © 2013 Society for Laboratory Automation and Screening.

  12. Evaluation of direct E-test on lower respiratory tract samples: a rapid and accurate procedure for antimicrobial susceptibility testing.

    PubMed

    Cercenado, Emilia; Cercenado, Sonia; Marín, Mercedes; Rico, María-Victoria; Vicente, Teresa; Bouza, Emilio

    2007-06-01

    We compared the direct E-test susceptibility testing (DET) on respiratory samples with a standard microbroth dilution method (MBD) after quantitative cultures. A total of 152 samples from intensive care unit patients were processed by DET onto Mueller-Hinton agar. Oxacillin, piperacillin/tazobactam, cefepime, imipenem, ciprofloxacin, and amikacin were the antimicrobials evaluated. Cultures were 102 monomicrobials and 50 polymicrobials. Overall, 93.8% of the isolates were recovered by the DET. Among the 772 microorganism-antibiotic combinations evaluated, there was a total agreement with the MBD in 96.1%. There were 8 very major errors (1.03%), 15 major (1.94%), and 7 minor (0.91%). All discrepancies but one corresponded to polymicrobial cultures, and most occurred with cefepime (8 cases, 7.07%) and imipenem (7 cases, 6.18%). Readings of DET were easy to interpret and improved with transmitted light. DET on respiratory samples is a rapid technique that provides susceptibility results in 18 to 24 h comparable with these obtained by MBD.

  13. Development of an antimicrobial susceptibility testing method suitable for performance during space flight.

    PubMed Central

    Jorgensen, J H; Skweres, J A; Mishra, S K; McElmeel, M L; Maher, L A; Mulder, R; Lancaster, M V; Pierson, D L

    1997-01-01

    Very little is known regarding the effects of the microgravity environment of space flight upon the action of antimicrobial agents on bacterial pathogens. This study was undertaken to develop a simple method for conducting antibacterial susceptibility tests during a space shuttle mission. Specially prepared susceptibility test research cards (bioMérieux Vitek, Hazelwood, Mo.) were designed to include 6 to 11 serial twofold dilutions of 14 antimicrobial agents, including penicillins, cephalosporins, a beta-lactamase inhibitor, vancomycin, erythromycin, tetracycline, gentamicin, ciprofloxacin, and trimethoprim-sulfamethoxazole. MICs of the drugs were determined by visual reading of color end points in the Vitek research cards made possible by incorporation of a colorimetric growth indicator (alamarBlue; Accumed International, Westlake, Ohio). This study has demonstrated reproducible susceptibility results in the testing of isolates of Staphylococcus aureus, group A Streptococcus species, Enterococcus faecalis, Escherichia coli (beta-lactamase-positive and -negative strains), Klebsiella pneumoniae, Enterobacter cloacae, and Pseudomonas aeruginosa. In some instances, the MICs were comparable to those determined by a standard broth microdilution method, while in some cases the unique test media and format yielded slightly different values that were themselves reproducible. The proposed in-flight experiment will include inoculation of the Vitek cards on the ground prior to launch of the space shuttle, storage of inoculated cards at refrigeration temperature aboard the space shuttle until experiment initiation, and then incubation of the cards for 18 to 48 h prior to visual interpretation of MICs by the mission's astronauts. Ground-based studies have shown reproducible MICs following storage of inoculated cards for 7 days at 4 to 8 degrees C to accommodate the mission's time schedule and the astronaut's activities. For comparison, ground-based control (normal gravity

  14. Development of an Antimicrobial Susceptibility Testing Method Suitable for Performing During Space Flight

    NASA Technical Reports Server (NTRS)

    Jorgensen, James H.; Skweres, Joyce A.; Mishra S. K.; McElmeel, M. Letticia; Maher, Louise A.; Mulder, Ross; Lancaster, Michael V.; Pierson, Duane L.

    1997-01-01

    Very little is known regarding the affects of the microgravity environment of space flight upon the action of antimicrobial agents on bacterial pathogens. This study was undertaken to develop a simple method for conducting antibacterial susceptibility tests during a Space Shuttle mission. Specially prepared susceptibility test research cards (bioMerieux Vitek, Hazelwood, MO) were designed to include 6-11 serial two-fold dilutions of 14 antimicrobial agents, including penicillins, cephalosporins, a Beta-lactamase inhibitor, vancomycin, erythromycin, tetracycline, gentamicin, ciprofloxacin, and trimethoprim/sulfamethoxazole. Minimal inhibitory concentrations (MICS) of the drugs were determined by visual reading of color endpoints in the Vitek research cards made possible by incorporation of a colorimetric growth indicator (alamarBlue(Trademark), Accumed International, Westlake, OH). This study has demonstrated reproducible susceptibility results when testing isolates of Staphylococcus aurezis, Group A Streptococcus, Enterococcusfaecalis, Escherichia coli (beta-lactamase positive and negative strains), Klebsiella pneumoniae, Enterobacter cloacae, and Pseudomoiias aeruginosa. In some instances, the MICs were comparable to those determined using a standard broth microdilution method, while in some cases the unique test media and format yielded slightly different values, that were themselves reproducible. The proposed in-flight experiment will include inoculation of the Vitek cards on the ground prior to launch of the Space Shuttle, storage of inoculated cards at refrigeration temperature aboard the Space Shuttle until experiment initiation, then incubation of the cards for 18-48 h prior to visual interpretation of MICs by the mission's astronauts. Ground-based studies have shown reproducible MICs following storage of inoculated cards for 7 days at 4-8 C to accommodate the mission's time schedule and the astronauts' activities. For comparison, ground-based control

  15. Methicillin Resistant Staphylococcus aureus: Inconsistencies in Vancomycin Susceptibility Testing Methods, Limitations and Advantages of each Method

    PubMed Central

    Himani; Madan, Molly; Pandey, Anita; Thakuria, Bhaskar

    2015-01-01

    Background Vancomycin may be ineffective against an increasing proportion of methicillin resistant Staphylococcus aureus (MRSA) with minimum inhibitory concentrations (MICs) well within the susceptible range. On the other hand it is common knowledge that determination of vancomycin MICs is method dependent. Therefore, given the apparent variability in vancomycin MIC results obtained with the different methods, the use of the vancomycin MIC to predict the outcome of serious S. aureus infections needs to take into account the method used and the results of studies using that particular method. Aim Comparative study was carried out to evaluate the MICs obtained by BMD method, E-test, and Vitek 2 method and to detect inconsistencies in these vancomycin for 66 MRSA isolates obtained from various samples of patients attending the OPDs & IPDs within a period of one year. Materials and Methods A comparative study was carried out to evaluate the MICs obtained by BMD method, E-test, and Vitek 2 method to detect vancomycin susceptibility in 66 clinical isolates of MRSA obtained from various samples of patients attending the OPDs & IPDs within a period of one year. The study was conducted in Department of Microbiology, Subharti Medical College, Meerut from January to December 2012. Results On determination of MICs for vancomycin for the MRSA isolates, all were identified as VSSA by BMD, E-Test & Vitek 2 methods. However, the vancomycin MIC values obtained by E-test correlated better with BMD method (correlation factor= 0.6727) than Vitek 2 (correlation factor=0.5316), indicating E-Test to be a better method for determination of vancomycin MICs as compared to Vitek 2. Conclusion MRSA isolates with higher vancomycin MICs, even within the susceptibility range, are being observed more frequently which result in treatment failures with vancomycin. Because of the discrepancy that exists in vancomycin MIC results from different methods, the prediction of outcome of serious S

  16. Artificial Disc Replacement

    MedlinePlus

    ... treat this condition, alternatives to disc replacement include fusion, nonoperative care or no treatment. Typically, surgery is ... operative treatment for disc pain has been spinal fusion. This is a surgical procedure in which disc ...

  17. Cancer therapy. Ex vivo culture of circulating breast tumor cells for individualized testing of drug susceptibility.

    PubMed

    Yu, Min; Bardia, Aditya; Aceto, Nicola; Bersani, Francesca; Madden, Marissa W; Donaldson, Maria C; Desai, Rushil; Zhu, Huili; Comaills, Valentine; Zheng, Zongli; Wittner, Ben S; Stojanov, Petar; Brachtel, Elena; Sgroi, Dennis; Kapur, Ravi; Shioda, Toshihiro; Ting, David T; Ramaswamy, Sridhar; Getz, Gad; Iafrate, A John; Benes, Cyril; Toner, Mehmet; Maheswaran, Shyamala; Haber, Daniel A

    2014-07-11

    Circulating tumor cells (CTCs) are present at low concentrations in the peripheral blood of patients with solid tumors. It has been proposed that the isolation, ex vivo culture, and characterization of CTCs may provide an opportunity to noninvasively monitor the changing patterns of drug susceptibility in individual patients as their tumors acquire new mutations. In a proof-of-concept study, we established CTC cultures from six patients with estrogen receptor-positive breast cancer. Three of five CTC lines tested were tumorigenic in mice. Genome sequencing of the CTC lines revealed preexisting mutations in the PIK3CA gene and newly acquired mutations in the estrogen receptor gene (ESR1), PIK3CA gene, and fibroblast growth factor receptor gene (FGFR2), among others. Drug sensitivity testing of CTC lines with multiple mutations revealed potential new therapeutic targets. With optimization of CTC culture conditions, this strategy may help identify the best therapies for individual cancer patients over the course of their disease.

  18. Direct disk diffusion susceptibility testing from respiratory tract specimens: focus on Pseudomonas aeruginosa.

    PubMed

    Perez, Leandro Reus Rodrigues; Freitas, Ana Lúcia Peixoto de; Barth, Afonso Luís; Dias, Cícero Armídio Gomes

    2014-09-01

    The aim of this study was to evaluate the application of direct disk diffusion (DDD) testing to respiratory tract specimens for the prediction of the antimicrobial susceptibility profile. DDD was performed on 144 specimens containing P. aeruginosa and the disk diffusion test was used as reference method. Agreement with the reference method was 77.8% for amikacin, 69.4% for cefepime, 86.1% for levofloxacin, 87.5% for meropenem, and 62.5% for piperacillin/tazobactam. Very major errors were observed for all agents, except levofloxacin. Our study showed that DDD results are inaccurate and may lead to errors in early decision-making regarding antibiotic therapy for lower respiratory tract infections.

  19. An in situ antimicrobial susceptibility testing method based on in vivo measurements of chlorophyll α fluorescence.

    PubMed

    Heliopoulos, Nikolaos S; Galeou, Angeliki; Papageorgiou, Sergios K; Favvas, Evangelos P; Katsaros, Fotios K; Stamatakis, Kostas

    2015-05-01

    Up to now antimicrobial susceptibility testing (AST) methods are indirect and generally involve the manual counting of bacterial colonies following the extraction of microorganisms from the surface under study and their inoculation in a separate procedure. In this work, an in situ, direct and instrumental method for the evaluation and assessment of antibacterial properties of materials and surfaces is proposed. Instead of indirectly determining antibacterial activity using the typical gram(-) test organisms with the subsequent manual colony count or inhibition zone measurement, the proposed procedure, employs photosynthetic gram(-) cyanobacteria deposited directly onto the surface under study and assesses cell proliferation and viability by a quick, accurate and reproducible instrumental chlorophyll fluorescence spectrophotometric technique. In contrast with existing methods of determination of antibacterial properties, it produces high resolution and quantitative results and is so versatile that it could be used to evaluate the antibacterial properties of any compound (organic, inorganic, natural or man-made) under any experimental conditions, depending on the targeted application.

  20. Radiorespirometric testing of antibiotic sensitivity in urinary tract infections: concise communication

    SciTech Connect

    Singh, K.T.; Ganatra, R.D.; Shah, D.H.; Shanta, M.; Nimbkar, Y.S.; Gaitonde, B.B.; Dudani, R.A.; Jadav, S.K.; Acharya, V.N.

    1980-02-01

    A radiometric method, based on inhibition of /sup 14/CO/sub 2/ release from bacterial metabolism of C-14-labeled glucose, was applied to test the susceptibility of urinary organisms to antibiotics. The testing was also carried out by the routine disc diffusion method after isolation of the organisms. Results of susceptibility to antibiotics could be obtained within 2 to 4 hr by the radiometric technique, compared with the 48 hr required for the disc method.

  1. Target product profile of a molecular drug-susceptibility test for use in microscopy centers.

    PubMed

    Denkinger, Claudia M; Dolinger, David; Schito, Marco; Wells, William; Cobelens, Frank; Pai, Madhukar; Zignol, Matteo; Cirillo, Daniela Maria; Alland, David; Casenghi, Martina; Gallarda, Jim; Boehme, Catharina C; Perkins, Mark D

    2015-04-01

    Current phenotypic testing for drug resistance in patients with tuberculosis is inadequate primarily with respect to turnaround time. Molecular tests hold the promise of an improved time to diagnosis. A target product profile for a molecular drug-susceptibility test (DST) was developed on the basis of a collaborative effort that included opinions gathered from researchers, clinicians, policy makers, and test developers on optimal clinical and operational characteristics in settings of intended use. In addition, the current diagnostic ecosystem and the diagnostic development landscape were mapped. Molecular DSTs for detecting tuberculosis in microscopy centers should ideally evaluate for resistance to rifampin, fluoroquinolones, isoniazid, and pyrazinamide and enable the selection of the most appropriate treatment regimen. Performance characteristics of DSTs need to be optimized, but compromises can be made that depend on the trade-off between a false-positive result and a false-negative result. The operational requirements of a test will vary depending on the site of implementation. However, the most-important considerations pertain to quality control, maintenance and calibration, and the ability to export data. This target product profile defines the needs as perceived by the tuberculosis stakeholder community and attempts to provide a means of communication with test developers to ensure that fit-for-purpose DSTs are being developed. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  2. Slow Strain Rate Testing for Hydrogen Embrittlement Susceptibility of Alloy 718 in Substitute Ocean Water

    NASA Astrophysics Data System (ADS)

    LaCoursiere, M. P.; Aidun, D. K.; Morrison, D. J.

    2017-05-01

    The hydrogen embrittlement susceptibility of near-peak-aged UNS N07718 (Alloy 718) was evaluated by performing slow strain rate tests at room temperature in air and substitute ocean water. Tests in substitute ocean water were accomplished in an environmental cell that enabled in situ cathodic charging under an applied potential of -1.1 V versus SCE. Some specimens were cathodically precharged for 4 or 16 weeks at the same potential in a 3.5 wt.% NaCl-distilled water solution at 50 °C. Unprecharged specimens tested in substitute ocean water exhibited only moderate embrittlement with plastic strain to failure decreasing by about 20% compared to unprecharged specimens tested in air. However, precharged specimens exhibited significant embrittlement with plastic strain to failure decreasing by about 70%. Test environment (air or substitute ocean water with in situ charging) and precharge time (4 or 16 weeks) had little effect on the results of the precharged specimens. Fracture surfaces of precharged specimens were typical of hydrogen embrittlement and consisted of an outer brittle ring related to the region in which hydrogen infused during precharging, a finely dimpled transition zone probably related to the region where hydrogen was drawn in by dislocation transport, and a central highly dimpled ductile region. Fracture surfaces of unprecharged specimens tested in substitute ocean water consisted of a finely dimpled outer ring and heavily dimpled central region typical of ductile fracture.

  3. Target Product Profile of a Molecular Drug-Susceptibility Test for Use in Microscopy Centers

    PubMed Central

    Denkinger, Claudia M.; Dolinger, David; Schito, Marco; Wells, William; Cobelens, Frank; Pai, Madhukar; Zignol, Matteo; Cirillo, Daniela Maria; Alland, David; Casenghi, Martina; Gallarda, Jim; Boehme, Catharina C.; Perkins, Mark D.

    2015-01-01

    Background. Current phenotypic testing for drug resistance in patients with tuberculosis is inadequate primarily with respect to turnaround time. Molecular tests hold the promise of an improved time to diagnosis. Methods. A target product profile for a molecular drug-susceptibility test (DST) was developed on the basis of a collaborative effort that included opinions gathered from researchers, clinicians, policy makers, and test developers on optimal clinical and operational characteristics in settings of intended use. In addition, the current diagnostic ecosystem and the diagnostic development landscape were mapped. Results. Molecular DSTs for detecting tuberculosis in microscopy centers should ideally evaluate for resistance to rifampin, fluoroquinolones, isoniazid, and pyrazinamide and enable the selection of the most appropriate treatment regimen. Performance characteristics of DSTs need to be optimized, but compromises can be made that depend on the trade-off between a false-positive result and a false-negative result. The operational requirements of a test will vary depending on the site of implementation. However, the most-important considerations pertain to quality control, maintenance and calibration, and the ability to export data. Conclusion. This target product profile defines the needs as perceived by the tuberculosis stakeholder community and attempts to provide a means of communication with test developers to ensure that fit-for-purpose DSTs are being developed. PMID:25765105

  4. CHROMagar Candida Medium for Direct Susceptibility Testing of Yeast from Blood Cultures

    PubMed Central

    Tan, Grace L.; Peterson, Ellena M.

    2005-01-01

    An evaluation was performed on 95 blood cultures positive for Candida spp. to determine the correlation of direct susceptibility testing of fluconazole versus both standardized disk diffusion and MIC methods. For direct testing, an aliquot taken from BD BACTEC Plus and/or BD BACTEC Lytic/10 bottles (Becton Dickinson [BD], Sparks, MD) positive by gram stain for yeast was subcultured to CHROMagar Candida (BD), and a 25-μg fluconazole disk (BD) was placed on the plate. The area of growth inhibition surrounding the disk was measured at 24 and 48 h. In addition, a subculture of the isolate was tested by a microdilution MIC using YeastOne (TREK Diagnostics Systems Inc., OH) and disk diffusion (NCCLS M44-A) using a standardized inoculum plated onto CHROMagar Candida as well as Mueller-Hinton agar to which 2% glucose and 0.5 μg/ml methylene blue dye was added (MH-GMB). The categorical interpretation derived from the MIC was used as the reference to which the disk diffusion results were compared. There were a total of 41 Candida albicans, 23 Candida glabrata, 20 Candida parapsilosis, 9 Candida tropicalis, and 1 each of Candida krusei and Candida lusitaniae tested. At 24 h there was full agreement among the methods for all C. albicans, C. tropicalis, C. lusitaniae, and C. krusei isolates. For the C. parapsilosis isolates at 24 h there was one very major discrepancy using the direct CHROMagar and one major error with the standardized MH-GMB. The majority of the errors were seen at 24 h with the C. glabrata isolates. Of the 23 C. glabrata isolates at 24 h by direct CHROMagar, there were 10 minor and 1 very major error; by MH-GMB there were 12 minor and 2 very major errors; and by standardized CHROMagar Candida there were 13 minor and 2 major errors. There were no very major errors with C. glabrata when all plates were read at 48 h. At 24 h by the direct and standardized CHROMagar the majority of C. glabrata isolates were more resistant, whereas by MH-GMB they were more

  5. CHROMagar Candida medium for direct susceptibility testing of yeast from blood cultures.

    PubMed

    Tan, Grace L; Peterson, Ellena M

    2005-04-01

    An evaluation was performed on 95 blood cultures positive for Candida spp. to determine the correlation of direct susceptibility testing of fluconazole versus both standardized disk diffusion and MIC methods. For direct testing, an aliquot taken from BD BACTEC Plus and/or BD BACTEC Lytic/10 bottles (Becton Dickinson [BD], Sparks, MD) positive by gram stain for yeast was subcultured to CHROMagar Candida (BD), and a 25-microg fluconazole disk (BD) was placed on the plate. The area of growth inhibition surrounding the disk was measured at 24 and 48 h. In addition, a subculture of the isolate was tested by a microdilution MIC using YeastOne (TREK Diagnostics Systems Inc., OH) and disk diffusion (NCCLS M44-A) using a standardized inoculum plated onto CHROMagar Candida as well as Mueller-Hinton agar to which 2% glucose and 0.5 microg/ml methylene blue dye was added (MH-GMB). The categorical interpretation derived from the MIC was used as the reference to which the disk diffusion results were compared. There were a total of 41 Candida albicans, 23 Candida glabrata, 20 Candida parapsilosis, 9 Candida tropicalis, and 1 each of Candida krusei and Candida lusitaniae tested. At 24 h there was full agreement among the methods for all C. albicans, C. tropicalis, C. lusitaniae, and C. krusei isolates. For the C. parapsilosis isolates at 24 h there was one very major discrepancy using the direct CHROMagar and one major error with the standardized MH-GMB. The majority of the errors were seen at 24 h with the C. glabrata isolates. Of the 23 C. glabrata isolates at 24 h by direct CHROMagar, there were 10 minor and 1 very major error; by MH-GMB there were 12 minor and 2 very major errors; and by standardized CHROMagar Candida there were 13 minor and 2 major errors. There were no very major errors with C. glabrata when all plates were read at 48 h. At 24 h by the direct and standardized CHROMagar the majority of C. glabrata isolates were more resistant, whereas by MH-GMB they were more

  6. Antimicrobial potentials of Mentha longifolia by disc diffusion method.

    PubMed

    Bakht, Jehan; Shaheen, Salma; Shafi, Mohammad

    2014-07-01

    This study was conducted for the assessment of the antimicrobial activities of different solvents extracted samples from the aerial parts of Mentha longifolia against ten microbial species through the disc diffusion assay using two different concentrations of 1 and 2 mg disc1. All extracts from Mentha longifolia showed different ranges of antimicrobial activities. Butanol and ethyl acetate fractions showed inhibitory activities against all microbial species. Methanol fraction showed inhibitory effects against all the tested microbial species except Salmonella typhi. Salmonella typhi was also not controlled by methanol, petroleum ether and dichloromethane extracted samples. The most susceptible gram positive bacteria was Bacillus atropheus and Bacillus subtilis and were inhibited by all extracts and Staphylococus aureus was least susceptible among gram positive bacteria. Klebsiella pneumoniae was the most susceptible gram negative bacterium and Salmonella typhi was highly resistant among the gram negative bacteria. Erwinia carotovora and Agrobacterium tumefaciene were susceptible to all fractions. All fractions showed antifungal activities against Candida albicans except water extracted samples.

  7. The relationship between quantitative measures of disc height and disc signal intensity with Pfirrmann score of disc degeneration.

    PubMed

    Salamat, Sara; Hutchings, John; Kwong, Clemens; Magnussen, John; Hancock, Mark J

    2016-01-01

    To assess the relationship between quantitative measures of disc height and signal intensity with the Pfirrmann disc degeneration scoring system and to test the inter-rater reliability of the quantitative measures. Participants were 76 people who had recently recovered from their last episode of acute low back pain and underwent MRI scan on a single 3T machine. At all 380 lumbar discs, quantitative measures of disc height and signal intensity were made by 2 independent raters and compared to Pfirrmann scores from a single radiologist. For quantitative measures of disc height and signal intensity a "raw" score and 2 adjusted ratios were calculated and the relationship with Pfirrmann scores was assessed. The inter-tester reliability of quantitative measures was also investigated. There was a strong linear relationship between quantitative disc signal intensity and Pfirrmann scores for grades 1-4, but not for grades 4 and 5. For disc height only, Pfirrmann grade 5 had significantly reduced disc height compared to all other grades. Results were similar regardless of whether raw or adjusted scores were used. Inter-rater reliability for the quantitative measures was excellent (ICC > 0.97). Quantitative measures of disc signal intensity were strongly related to Pfirrmann scores from grade 1 to 4; however disc height only differentiated between grade 4 and 5 Pfirrmann scores. Using adjusted ratios for quantitative measures of disc height or signal intensity did not significantly alter the relationship with Pfirrmann scores.

  8. Testing the indicative value of magnetic susceptibility measurements for concluding on site potentials and risks provoked by fly ash deposition.

    PubMed

    Fürst, C; Lorz, C; Zirlewagen, D; Makeschin, F

    2010-12-01

    The article presents results of testing the indicative value of magnetic susceptibility for fly ash deposition and its effects on forest site properties. Base saturation and concentrations of Ca and Mg were used as indicators for nutrient pools resulting from fly ash deposition. Concentrations of Fe, Al, Mn, Cd and Black Carbon were used as indicators for risks of leaching. The correlation of magnetic susceptibility with concentrations of nutrient, acidic cations, heavy metals, base saturation and Black Carbon was calculated. Additionally, we tested the suitability of magnetic susceptibility as a parameter in a linear regression based model to predict the concentrations of Ca, Mg, Fe, Al, Mn, Cd and Black Carbon. We were able to show a positive correlation between magnetic susceptibility and the selected indicators. In contrast to previous studies, we were also able to demonstrate the suitability of magnetic susceptibility to predict the size of fly ash deposition influenced nutrient pools mainly for humus layers, especially for Oa horizons. The spatial distribution of magnetic susceptibility showed also a positive correlation with regionalized base saturation. However, because of the data base and other factors impacting the measurement and modeling results, some shortcomings of using a linear regression model must be noted. From these results, we concluded that magnetic susceptibility might be a valuable parameter in a multiple regression based approach, but should not be used alone for predicting effects of fly ash deposition.

  9. Cephalothin is not a reliable surrogate marker for oral cephalosporins in susceptibility testing of Enterobacteriaceae causing urinary tract infection.

    PubMed

    López, Itziar Angulo; Montes, Jorge Calvo; Álvarez, Mar Justel; Mazarrasa, Carlos Fernández; Martínez-Martínez, Luis

    2016-12-01

    Vitek® 2 (bioMérieux) is a widely used commercial antimicrobial susceptibility test (AST) system. AST-N244 card includes cephalothin as first-generation cephalosporin. We compared the cephalothin susceptibility results obtained with Vitek® 2 AST-N244 to those obtained by broth microdilution (BMD) and disk diffusion (DD) for 212 urinary Enterobacteriaceae. We also evaluated the differences between cefazolin and cephalothin susceptibility results. The overall performance of Vitek® 2 for cephalothin testing was 74.5% and 76.4% category agreement compared to BMD and DD, respectively; 84.4% essential agreement; very major errors 15.2% and 11.1% compared to BMD and DD; major errors 0% compared to both methods; and minor errors 22.2% and 21.7% compared to BMD and DD. Regarding correlation between cephalothin and cefazolin, the differences observed were statistically significant (P<0.0001) for the 167 Escherichia coli included (39.5% cephalothin susceptible versus 92.2% cefazolin susceptible by BMD; 41.9% cephalothin susceptible versus 93.4% cefazolin susceptible by DD). Vitek® 2 should provide cefazolin instead of cephalothin as a surrogate marker for oral cephalosporins on the urinary AST-244 cards in order to follow the CLSI (2016) recommendations.

  10. Genetic diversity and antifungal susceptibility testing of Trichosporon asahii isolated of Intensive Care Units patients

    PubMed Central

    de Oliveira Silva, Rosana Bellan; Fusco-Almeida, Ana Marisa; Matsumoto, Marcelo Teruyuki; Baeza, Lilian Cristiane; Benaducci, Tatiane; Mendes-Giannini, Maria José Soares

    2008-01-01

    Trichosporon asahii is an opportunistic pathogen, associated with a high mortality rate in immunocompromised patients. In this study, ten isolates, recovered from oral cavity and urine of patients in Intensive Care Units (ICU) over six months, were identified by classical and molecular methods, typed by RAPD and tested in vitro for susceptibility to fluconazole, itraconazole, 5-flucytosine and amphotericin B. A total agreement between the identification of Trichosporon sp by PCR based on sequences of the Internal Transcribed Spacer Regions (ITS) and on the sequences of small-subunit (SSU) ribosomal DNA (rDNA) was found. Randomly amplified of polymorphic DNA (RAPD), with primers P6 and M13, was used to determine the genomic profiles. The dendogram analysis indicated that almost all strains showed similarity >0.9 among them and all strains were multidrug-resistant. This study brings new results on the identification and genotyping of T. asahii isolated from Brazilian ICU patients and information about their antifungal drugs susceptibility. PMID:24031270

  11. The power of DNA double-strand break (DSB) repair testing to predict breast cancer susceptibility.

    PubMed

    Keimling, Marlen; Deniz, Miriam; Varga, Dominic; Stahl, Andreea; Schrezenmeier, Hubert; Kreienberg, Rolf; Hoffmann, Isabell; König, Jochem; Wiesmüller, Lisa

    2012-05-01

    Most presently known breast cancer susceptibility genes have been linked to DSB repair. To identify novel markers that may serve as indicators for breast cancer risk, we performed DSB repair analyses using a case-control design. Thus, we examined 35 women with defined familial history of breast and/or ovarian cancer (first case group), 175 patients with breast cancer (second case group), and 245 healthy women without previous cancer or family history of breast cancer (control group). We analyzed DSB repair in peripheral blood lymphocytes (PBLs) by a GFP-based test system using 3 pathway-specific substrates. We found increases of microhomology-mediated nonhomologous end joining (mmNHEJ) and nonconservative single-strand annealing (SSA) in women with familial risk vs. controls (P=0.0001-0.0022) and patients with breast cancer vs. controls (P=0.0004-0.0042). Young age (<50) at initial diagnosis of breast cancer, which could be indicative of genetic predisposition, was associated with elevated SSA using two different substrates, amounting to similar odds ratios (ORs=2.54-4.46, P=0.0059-0.0095) as for familial risk (ORs=2.61-4.05, P=0.0007-0.0045). These findings and supporting validation data underscore the great potential of detecting distinct DSB repair activities in PBLs as method to estimate breast cancer susceptibility beyond limitations of genotyping and to predict responsiveness to therapeutics targeting DSB repair-dysfunctional tumors.

  12. Evaluation of Vitek system for susceptibility testing of Enterococcus faecium isolates.

    PubMed

    Lee, Hae Kyung; Park, Yeon-Joon; Kwon, Hi Jeong; Lee, Eun Jung; Kim, Byung Kee; Kang, Chang Suk

    2004-01-01

    Although imipenem is not a first-line drug for treating enterococcal infection, it could well become a useful drug for treating mixed infections that include enterococci. However, there is no NCCLS guideline for susceptibility testing of imipenem versus enterococci. Moreover, there are no statements to indicate that in vitro susceptibility results for other antimicrobial agents can be used to predict the in vitro activity of imipenem against enterococci. In this study, 52 Enterococcus faecium isolates were collected from patients hospitalized at Kangnam St. Mary's Hospital between March 2002 and December 2002. The sources of the isolates were mainly urine specimens and wounds. For ampicillin, the "major" and "very major" error rates observed with the Vitek system were 0% and 2.0%, respectively. For penicillin, the major and very major error rates observed with the Vitek system were both 0%. For imipenem, the major and very major error rates observed with the Vitek system were 0% and 36.5%, respectively. The MICs of ampicillin and penicillin obtained using the Vitek system were reliable, but that of imipenem was unreliable. In the 52 E. faecium isolates, the in vitro activity of penicillin and ampicillin versus enterococci accurately predicted that of imipenem. Therefore, the MIC of imipenem obtained with the Vitek system must be retested by the agar dilution method, when it disagrees with those of penicillin and ampicillin.

  13. Evaluation of Etest for Susceptibility Testing of Multidrug-Resistant Isolates of Mycobacterium tuberculosis†

    PubMed Central

    Hazbón, Manzour Hernando; del Socorro Orozco, Maria; Labrada, Luz Angela; Tovar, Rafael; Weigle, Kristen A.; Wanger, Audrey

    2000-01-01

    To prescribe effective treatment schemes for patients with tuberculosis, more-efficient susceptibility testing techniques for Mycobacterium tuberculosis are needed, especially in regions with multidrug resistance. Etest (AB BIODISK, Solna, Sweden) is a simple technique that provides quantitative drug susceptibility results for M. tuberculosis in 5 to 10 days from a culture grown at low cost. The performance of Etest was compared to that of the reference proportion method, using 95 M. tuberculosis clinical isolates of which 42.1% (40 of 95) were resistant to at least one antibiotic by the reference method. Overall agreement between Etest and the reference method was 98.9% (94 of 95) for detection of multidrug resistance; for resistance to individual drugs, agreement was 97.9% (93 of 95) for rifampin, 96.0% (92 of 95) for ethambutol, 94.7% (90 of 95) for isoniazid, and 85.3% (81 of 95) for streptomycin. This study supports the utility of Etest for timely detection of drug resistance in M. tuberculosis and for use in tuberculosis control programs. PMID:11101602

  14. [Confirming the Utility of RAISUS Antifungal Susceptibility Testing by New-Software].

    PubMed

    Ono, Tomoko; Suematsu, Hiroyuki; Sawamura, Haruki; Yamagishi, Yuka; Mikamo, Hiroshige

    2017-08-15

    Clinical and Laboratory Standards Institute (CLSI) methods for susceptibility tests of yeast are used in Japan. On the other hand, the methods have some disadvantage; 1) reading at 24 and 48 h, 2) using unclear scale, approximately 50% inhibition, to determine MICs, 3) calculating trailing growth and paradoxical effects. These makes it difficult to test the susuceptibility for yeasts. Old software of RAISUS, Ver. 6.0 series, resolved problem 1) and 2) but did not resolve problem 3). Recently, new software of RAISUS, Ver. 7.0 series, resolved problem 3). We confirmed that using the new software made it clear whether all these issue were settled or not. Eighty-four Candida isolated from Aichi Medical University was used in this study. We compared the MICs obtained by using RAISUS antifungal susceptibility testing of yeasts RSMY1, RSMY1, with those obtained by using ASTY. The concordance rates (±four-fold of MICs) between the MICs obtained by using ASTY and RSMY1 with the new software were more than 90%, except for miconazole (MCZ). The rate of MCZ was low, but MICs obtained by using CLSI methods and Yeast-like Fungus DP 'EIKEN' methods, E-DP, showed equivalent MICs of RSMY1 using the new software. The frequency of skip effects on RSMY1 using the new software markedly decreased relative to RSMY1 using the old software. In case of showing trailing growth, the new software of RAISUS made it possible to choice the correct MICs and to put up the sign of trailing growth on the result screen. New software of RAISUS enhances its usability and the accuracy of MICs. Using automatic instrument to determine MICs is useful to obtain objective results easily.