Potential value of a rapid syndromic multiplex PCR for the diagnosis of native and prosthetic joint infections: a real-world evidence study

Introduction: The BIOFIRE Joint Infection (JI) Panel is a diagnostic tool that uses multiplex-PCR testing to detect microorganisms in synovial fluid specimens from patients suspected of having septic arthritis (SA) on native joints or prosthetic joint infections (PJIs). Methods: A study was conducted across 34 clinical sites in 19 European and Middle Eastern countries from March 2021 to June 2022 to assess the effectiveness of the BIOFIRE JI Panel. Results: A total of 1527 samples were collected from patients suspected of SA or PJI, with an overall agreement of 88.4 % and 85 % respectively between the JI Panel and synovial fluid cultures (SFCs). The JI Panel detected more positive samples and microorganisms than SFC, with a notable difference on Staphylococcus aureus, Streptococcus species, Enterococcus faecalis, Kingella kingae, Neisseria gonorrhoeae, and anaerobic bacteria. The study found that the BIOFIRE JI Panel has a high utility in the real-world clinical setting for suspected SA and PJI, providing diagnostic results in approximately 1 h. The user experience was positive, implying a potential benefit of rapidity of results' turnover in optimising patient management strategies. Conclusion: The study suggests that the BIOFIRE JI Panel could potentially optimise patient management and antimicrobial therapy, thus highlighting its importance in the clinical setting

Antimicrobial Susceptibilities and Molecular Characterization of Toxin-Positive Clostridium difficile Isolates: The First Report on the Presence of Hypervirulent Strains from Turkey

WOS: 000408311400004PubMed ID: 28929960Clostridium difficile infection is one of the most important hospital-acquired infections. Infections caused by hypervirulent C. difficile strains which produce toxins at high levels, have higher morbidity and mortality rates, more complications and relapses. They are characterized by higher sporulation ratios and resistance rates for fluoroquinolones. In order to prevent serious morbidities, mortalities and remarkable increase in health costs, highly pathogenic C. difficile strains must be identified before causing severe outbreaks. The aim of this study was to determine the antimicrobial susceptibilities and molecular characteristics of 61 C. difficile strains isolated by culture from toxin-positive fecal samples of patients who were admitted to three different laboratories in Ankara, between September 2012 and November 2014. Antimicrobial susceptibilities were determined by using gradient test strips and results were interpreted according to the current CLSI and EUCAST criteria. The presence of toxin genes was investigated by polymerase chain reaction (PCR), and mutations in the tcdC gene were determined by sequence analysis following PCR amplification. Genetic characterization of one hypervirulent strain was performed by Public Health Institution of Turkey using the GenoType CDiff (Hain Lifescience, Germany) test. All strains were susceptible to vancomycin and metronidazole. Three (4.9%) isolates were resistant to moxifloxacin with a minimum inhibitory concentration (MIC) of > 8 mu g/ml. The MIC 50 and MIC 90 values for erythromycin and clindamycin were 1.5-3 mu g/ml, and 2-4 mu g/ml, respectively. All strains carried the tcdA and tcdB genes, and 1 (1.6%) was positive for the binary-toxin (cdtA and cdtB) genes. The binary-toxin positive strain carried a 54 bp deletion as well as a single nucleotide change in the tcdC gene. Various single nucleotide changes were found in the tcdC gene of 12 strains (19.6%). Our results have shown that, hypervirulent strains exist in our country, but we have no evidence for the presence of ribotype 027 yet. On the other hand, when the increasing incidence of these strains through out the world is taken into consideration, it would be of great importance to perform surveillance studies and characterize the isolated strains

Guillain-Barré syndrome following influenza immunization: A case report Influenza aşisi sonrasi Guillain-Barré sendromu: Bir vaka takdimi

Guillain-Barré syndrome (GBS) is a peripheral polyneuro radiculopathy with acute onset which is most commonly characterized by rapidly progressive symmetric weakness and areflexia. Infectious agents, surgery or immunizations may trigger the formation of the disease. An 11-year-old boy was admitted to the hospital after presenting weakness and symptoms of walking disabilities three weeks after the influenza vaccination. The neurologic examination revealed a symmetric proximal muscle weakness of upper and lower extremities, Gower's sign and absent deep tendon reflexes. Cerebrospinal fluid analysis revealed an albuminocytologic dissociation. Therefore, a diagnosis of GBS following vaccination was made. While studies have found inconclusive results on the association between influenza vaccine and GBS, all suspected cases should be published for further evaluation and investigated with the aid of literature

PCR investigation of Panton-Valentine leukocidin, enterotoxin, exfoliative toxin, and agr genes in Staphylococcus aureus strains isolated from psoriasis patients

Background/aim: Staphylococcus aureus colonization is a determiner of disease activation in psoriasis patients. Here we evaluate the presence of genes encoding Panton-Valentine leukocidin (PVL), enterotoxins, TSST-1, exfoliative toxins, and the accessory gene regulatory locus by polymerase chain reaction (PCR) in S. aureus isolates obtained from healthy and diseased skin regions and anterior nares of psoriasis patients and healthy controls. Materials and methods: The presence of PVL and toxin genes was investigated, and agr typing was performed by PCR. Results: Eighteen of the isolated strains carried the sei, 1 carried the seb-sec, and 1 carried the seg enterotoxin gene. Eight of the strains carrying enterotoxin genes were isolated from nasal swabs, 6 from diseased skin swabs, and 4 from healthy skin swabs. None of the strains isolated from the control group carried the agr locus. On the other hand, 11 of the S. aureus strains isolated from the patients carried type 1, 7 carried type 1 + 3, 4 carried type 2, 4 carried type 3, and 1 carried type 1 + 2 agr loci. Conclusion: Enterotoxin production and the carried accessory gene regulatory locus may be important in the aggravation of psoriasis

Comparison of polymerase chain reaction and conventional methods in detecting methicillin-resistant Staphylococcus aureus

Background: Accurate and rapid detection of methicillin-resistant Staphylococcus aureus is very important in a clinical laboratory setting to avoid treatment failure. Conventional methods were compared against the gold standard polymerase chain reaction (PCR) technique to determine the best combination of the routine procedures. Methodology: Methicillin resistance was investigated in 416 clinical Staphylococcus aureus isolates by PCR, oxacillin agar screening (OAS), oxacillin disk diffusion (ODD) and cefoxitin disk diffusion (CDD) methods. Results: Two hundred and ten (51%) out of 416 S. aureus strains were found to be mecA-positive by PCR. Sensitivity and specificity of the ODD, CDD and OAS methods were detected as follows: 100% and 89%, 99.50% and 100%, and 99.50% and 100%, respectively . Conclusion: Combining the ODD and CDD methods could be a good choice for detecting methicillin resistance in S. aureus strains where mecA PCR cannot be performed. Key Words : Methicillin-resistant Staphylococcus aureus (MRSA), polymerase chain reaction (PCR), oxacillin disk diffusion, cefoxitin disk diffusion, oxacillin agar screening

Bevacizumab sterility in multiple doses from a single-use vial

TEKELI, ALPER/0000-0001-9950-9613WOS: 000259545900008PubMed: 18765834BACKGROUND: Recent reports have demonstrated that refrigerated bevacizumab can be stored for up to 3 weeks at 4 degrees C without loss of efficacy. There have been no previous reports addressing bevacizumb's sterility when stored and used as multiple doses from a single-use vial. OBJECTIVE: To evaluate the sterility of bevacizumab when used as multiple doses from a single-use vial. METHODS: Four groups of vials were used to simulate the storage and use conditions for bevacizumab. Each group contained 11 doses of 0.2 mL of bevacizumab. One sample from each group was cultured once each day at 37 degrees C for 10 days; one sample from each group was left for 15 days. MacConkey agar, blood agar, thioglycollate broth, and Sabouraud medium were used to assess bacterial and fungal growth. RESULTS: A total of 44 samples of bevacizumab were included in this study. Each sample was placed on 4 growth media for microbial readings. All samples were found to be negative for microbial growth. No significant differences were observed among the groups. Possible limitations of this study included the number of samples for each group and in vitro design of the study, which might have affected the growth of bacterial organisms. CONCLUSIONS: Storage and multiple use of bevacizumab from single-use vials does not seem to result n microbial contamination

Original Article Comparison of polymerase chain reaction and conventional methods in detecting methicillin-resistant Staphylococcus aureus

Background: Accurate and rapid detection of methicillin-resistant Staphylococcus aureus is very important in a clinical laboratory setting to avoid treatment failure. Conventional methods were compared against the gold standard polymerase chain reaction (PCR) technique to determine the best combination of the routine procedures. Methodology: Methicillin resistance was investigated in 416 clinical Staphylococcus aureus isolates by PCR, oxacillin agar screening (OAS), oxacillin disk diffusion (ODD) and cefoxitin disk diffusion (CDD) methods. Results: Two hundred and ten (51%) out of 416 S. aureus strains were found to be mecA-positive by PCR. Sensitivity an