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Journal of clinical microbiology 43건

  1. [해외논문]   Serotype Distribution, Population Structure, and Antimicrobial Resistance of Group B Streptococcus Strains Recovered from Colonized Pregnant Women   SCI SCIE

    Teatero, Sarah (Public Health Ontario Laboratory, Toronto, Ontario, Canada ) , Ferrieri, Patricia (Departments of Laboratory Medicine and Pathology and Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA ) , Martin, Irene (National Microbiology Laboratory, Winnipeg, Manitoba, Canada ) , Demczuk, Walter (National Microbiology Laboratory, Winnipeg, Manitoba, Canada ) , McGeer, Allison (Mount Sinai Hospital, Toronto, Ontario, Canada ) , Fittipaldi, Nahuel (Public Health Ontario Laboratory, Toronto, Ontario, Canada)
    Journal of clinical microbiology v.55 no.2 ,pp. 412 - 422 , 2017 , 0095-1137 ,

    초록

    Using serotyping, multilocus sequence typing, and whole-genome sequencing (WGS) of selected strains, we studied the population structure of 102 group B Streptococcus (GBS) isolates prospectively sampled in 2014 from vaginal/rectal swabs of healthy pregnant women in metropolitan Toronto, Canada. We also determined the susceptibilities of each of the colonizing isolates to penicillin, erythromycin, clindamycin, tetracycline, and other antimicrobial agents. Overall, we observed a high rate of tetracycline resistance (89%) among colonizing GBS isolates. We found resistance to erythromycin in 36% of the strains, and 33% were constitutively or inducibly resistant to clindamycin. The most frequently identified serotypes were III (25%), Ia (23%), and V (19%). Serotype IV accounted for 6% of the colonizing isolates, a rate consistent with that observed among patients with invasive GBS infections in metropolitan Toronto. The majority of serotype IV isolates belonged to sequence type (ST)459, a tetracycline-, erythromycin-, and clindamycin-resistant ST first identified in Minnesota, which is considered to be the main driver of serotype IV GBS expansion in North America. WGS revealed that ST459 isolates from Canada are clonally related to colonizing and invasive ST459 organisms circulating in regions of the United States. We also used WGS to study recombination in selected colonizing strains from metropolitan Toronto, which revealed multiple episodes of capsular switching. Present and future circulating GBS organisms and their genetic diversity may influence GBS vaccine development.

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  2. [해외논문]   Progress in Quantitative Viral Load Testing: Variability and Impact of the WHO Quantitative International Standards   SCI SCIE

    Hayden, R. T. (Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA ) , Sun, Y. (Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA ) , Tang, L. (Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA ) , Procop, G. W. (Department of Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio, USA ) , Hillyard, D. R. (Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, USA ) , Pinsky, B. A. (Departments of Pathology and Medicine, Stanford University School of Medicine, Stanford, California, USA ) , Young, S. A. (Department of Pathology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA ) , Caliendo, A. M. (Department of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, USA)
    Journal of clinical microbiology v.55 no.2 ,pp. 423 - 430 , 2017 , 0095-1137 ,

    초록

    It has been hoped that the recent availability of WHO quantitative standards would improve interlaboratory agreement for viral load testing; however, insufficient data are available to evaluate whether this has been the case. Results from 554 laboratories participating in proficiency testing surveys for quantitative PCR assays of cytomegalovirus (CMV), Epstein-Barr virus (EBV), BK virus (BKV), adenovirus (ADV), and human herpesvirus 6 (HHV6) were evaluated to determine overall result variability and then were stratified by assay manufacturer. The impact of calibration to international units/ml (CMV and EBV) on variability was also determined. Viral loads showed a high degree of interlaboratory variability for all tested viruses, with interquartile ranges as high as 1.46 log 10 copies/ml and the overall range for a given sample up to 5.66 log 10 copies/ml. Some improvement in result variability was seen when international units were adopted. This was particularly the case for EBV viral load results. Variability in viral load results remains a challenge across all viruses tested here; introduction of international quantitative standards may help reduce variability and does so more or less markedly for certain viruses.

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  3. [해외논문]   Performance Characteristics of a New Consensus Commercial Kit for Hepatitis D Virus RNA Viral Load Quantification   SCI SCIE

    Le Gal, Fré (Laboratoire de Bactéééèériologie, Virologie, Hygiéééèéène des Héééèéèôpitaux Universitaires de Paris Seine-Saint-Denis, Universitéééèéèôé) , dé (Sorbonne Paris Citéééèéèôéé, Bobigny, France ) , é (Laboratoire de Bactéééèériologie, Virologie, Hygiéééèéène des Héééèéèôpitaux Universitaires de Paris Seine-Saint-Denis, Universitéééèéèôé) , ric (Sorbonne Paris Citéééèéèôéé, Bobigny, France ) , Dziri, Samira (Laboratoire de Bactéééèériologie, Virologie, Hygiéééèéène des H) , Gerber, Athenais , Alloui, Chakib , Ben Abdesselam, Zahia , Roulot, Dominique , Brichler, Sé , é , é , golé , é , é , è , ne , Gordien, Emmanuel
    Journal of clinical microbiology v.55 no.2 ,pp. 431 - 441 , 2017 , 0095-1137 ,

    초록

    Hepatitis D virus (HDV) is responsible for fulminant hepatitis and liver failure and accelerates evolution toward cirrhosis and hepatocellular carcinoma in hepatitis B virus (HBV)-infected patients. To date, treatment relies upon long-term administration of pegylated alpha-interferon with a sustained virological response in 30% of the patients. Very recently, new, promising anti-HDV therapies have been developed and are already being used in clinical trials. HDV RNA viral load (HDVL) monitoring must be an integral part of the management of the infected patients. However, HDV genus is characterized by a high genetic variability into eight genotypes (HDV-1 to -8), and most available in-house or commercial assays are useful for only a limited subset of genotypes. Results of a comparison of the performance of a new kit for HDVL quantification with the consensus in-house assay of the French National Reference Laboratory for HDV developed in 2005 are reported here. A total of 611 clinical samples of all HDV genotypes with various HDVL values, including several consecutive samples over several years from 36 patients, were studied. A specificity, sensitivity, and reproducibility evaluation was conducted using HDV-positive clinical samples, hepatitis A, B, C and E (HAV, HBV, HCV, and HEV, respectively) and HIV mono-infected samples, and the WHO HDV RNA international standard. Overall results were strictly comparable between the two assays (median difference, 0.07 log IU/ml), with high diagnosis precision and capacity. In summary, this new kit showed high performance in detection/quantification of HDVL, regardless of the genotype of the infecting strain used, and seems to be a suitable tool for patient management.

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  4. [해외논문]   Superiority of Digital Reverse Transcription-PCR (RT-PCR) over Real-Time RT-PCR for Quantitation of Highly Divergent Human Rhinoviruses   SCI SCIE

    Sedlak, Ruth Hall (Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA ) , Nguyen, Thuy (Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA ) , Palileo, Isabel (Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA ) , Jerome, Keith R. (Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA ) , Kuypers, Jane (Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA)
    Journal of clinical microbiology v.55 no.2 ,pp. 442 - 449 , 2017 , 0095-1137 ,

    초록

    Human rhinoviruses (HRV) comprise 3 species representing more than 150 genotypes. As an important human respiratory pathogen, molecular detection is an indispensable tool for diagnosis and surveillance. However, the sequence diversity of HRV genotypes poses challenges for developing robust molecular methods that detect all genotypes with equal efficiencies. This study compares the accuracies of reverse transcription-quantitative PCR (RT-qPCR) and reverse transcription-digital PCR (RT-dPCR) for quantifying HRV RNA using genotype-specific primers and probes and a consensus primer/probe set targeting the 5′ noncoding region of HRV. When using consensus primers and probes for the quantification of HRV, RT-dPCR outperformed RT-qPCR by consistently and accurately quantifying HRV RNAs across more genotype groups, despite the presence of up to 2 target-sequence mismatches within the primer or probe binding region. Because it does not rely on amplification efficiency, which can be affected by sequence mismatches in primer/probe binding regions, RT-dPCR may be the optimal molecular method for future HRV quantification studies and for quantitating other viruses with high sequence diversity.

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  5. [해외논문]   Performance of Vitek 2 for Antimicrobial Susceptibility Testing of Acinetobacter baumannii, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia with Vitek 2 (2009 FDA) and CLSI M100S 26th Edition Breakpoints   SCI SCIE

    Bobenchik, April M. (Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA ) , Deak, Eszter (Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA ) , Hindler, Janet A. (UCLA Health System, Los Angeles, California, USA ) , Charlton, Carmen L. (Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA ) , Humphries, Romney M. (Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA)
    Journal of clinical microbiology v.55 no.2 ,pp. 450 - 456 , 2017 , 0095-1137 ,

    초록

    The performances of Vitek 2 AST-GN69 and AST-XN06 cards were compared to Clinical and Laboratory Standards Institute (CLSI) reference broth microdilution (BMD) for 99 isolates of Pseudomonas aeruginosa , 26 Acinetobacter baumannii isolates, and 11 Stenotrophomonas maltophilia isolates. In total, 15 antimicrobials were evaluated, with 11 for P. aeruginosa , 14 for A. baumannii , and 2 for S. maltophilia . Categorical agreement (CA) was assessed using both Vitek 2 breakpoints and 2016 CLSI M100S 26th edition breakpoints. The essential agreement values for P. aeruginosa , A. baumannii , and S. maltophilia were 99.5%, 99.2%, and 100%, respectively. The CA values for P. aeruginosa , A. baumannii , and S. maltophilia were 94.1%, 92.7%, and 95.5%, respectively, by the Vitek 2 breakpoints, and 93.4%, 92.3%, and 95.5%, respectively, by the CLSI breakpoints. Overall, the Vitek 2 performance was comparable to that of BMD using both Vitek 2 breakpoints and 2016 CLSI M100S 26th edition breakpoints. Improved performance was noted for the reformulated piperacillin-tazobactam and imipenem found on the AST-GN69 card, with no very major or major errors noted when using the CLSI breakpoints.

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  6. [해외논문]   Whole-Genome Sequencing of Mycobacterium tuberculosis Provides Insight into the Evolution and Genetic Composition of Drug-Resistant Tuberculosis in Belarus   SCI SCIE

    Wollenberg, Kurt R. (Office of Cyber Infrastructure & Computational Biology, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, Maryland, USA ) , Desjardins, Christopher A. (The Broad Institute of MIT & Harvard, Cambridge, Massachusetts, USA ) , Zalutskaya, Aksana (Republican Scientific and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus ) , Slodovnikova, Vervara (Republican Scientific and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus ) , Oler, Andrew J. (Office of Cyber Infrastructure & Computational Biology, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, Maryland, USA ) , Quiñ (Office of Cyber Infrastructure & Computational Biology, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, Maryland, USA ) , ones, Mariam (The Broad Institute of MIT & Harvard, Cambridge, Massachusetts, USA ) , Abeel, Thomas (The Broad Institute of MIT & Harvard, Cambridge, Massachusetts, USA ) , Chapman, Sinead B. (Office of Cyber Infrastructure & Computational Biology, National Institute of Allergy and Infectious) , Tartakovsky, Michael , Gabrielian, Andrei , Hoffner, Sven , Skrahin, Aliaksandr , Birren, Bruce W. , Rosenthal, Alexander , Skrahina, Alena , Earl, Ashlee M.
    Journal of clinical microbiology v.55 no.2 ,pp. 457 - 469 , 2017 , 0095-1137 ,

    초록

    The emergence and spread of drug-resistant Mycobacterium tuberculosis (DR-TB) are critical global health issues. Eastern Europe has some of the highest incidences of DR-TB, particularly multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB. To better understand the genetic composition and evolution of MDR- and XDR-TB in the region, we sequenced and analyzed the genomes of 138 M. tuberculosis isolates from 97 patients sampled between 2010 and 2013 in Minsk, Belarus. MDR and XDR-TB isolates were significantly more likely to belong to the Beijing lineage than to the Euro-American lineage, and known resistance-conferring loci accounted for the majority of phenotypic resistance to first- and second-line drugs in MDR and XDR-TB. Using a phylogenomic approach, we estimated that the majority of MDR-TB was due to the recent transmission of already-resistant M. tuberculosis strains rather than repeated de novo evolution of resistance within patients, while XDR-TB was acquired through both routes. Longitudinal sampling of M. tuberculosis from 34 patients with treatment failure showed that most strains persisted genetically unchanged during treatment or acquired resistance to fluoroquinolones. HIV+ patients were significantly more likely to have multiple infections over time than HIV− patients, highlighting a specific need for careful infection control in these patients. These data provide a better understanding of the genomic composition, transmission, and evolution of MDR- and XDR-TB in Belarus and will enable improved diagnostics, treatment protocols, and prognostic decision-making.

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  7. [해외논문]   Improved Accuracy of Cefepime Susceptibility Testing for Extended-Spectrum-Beta-Lactamase-Producing Enterobacteriaceae with an On-Demand Digital Dispensing Method   SCI SCIE

    Smith, Kenneth P. (Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA ) , Brennan-Krohn, Thea (Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA ) , Weir, Susan (Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA ) , Kirby, James E. (Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA)
    Journal of clinical microbiology v.55 no.2 ,pp. 470 - 478 , 2017 , 0095-1137 ,

    초록

    Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae generally cannot be treated with penicillins and cephalosporins. However, some later-generation cephalosporins, including cefepime, are poorly hydrolyzed by specific ESBL enzymes, and certain strains demonstrate in vitro susceptibility to these agents, potentially affording additional treatment opportunities. Moreover, the ability to adjust both the dose and dosing interval of beta-lactam agents allows the treatment of strains with elevated MICs that were formerly classified in the intermediate range. The ability to treat strains with elevated cefepime MICs is codified in new susceptible dose-dependent (SDD) breakpoints promulgated by the Clinical and Laboratory Standards Institute. In the interest of validating and implementing new cefepime SDD criteria, we evaluated the performances of Vitek 2, disk diffusion, and a MicroScan panel compared to that of reference broth microdilution (BMD) during the testing of 64 strains enriched for presumptive ESBL phenotype (based on nonsusceptibility to ceftriaxone). Surprisingly, categorical agreement with BMD was only 47.6%, 57.1%, and 44.6% for the three methods, respectively. Given these findings, we tested the performance of the HP D300 inkjet-assisted broth microdilution digital dispensing method (DDM), which was previously described by our group as an at-will testing alternative. In contrast to commercial methods, DDM results correlated well with the reference method, with 86% categorical agreement, 91.1% evaluable essential agreement, and no major or very major errors. The reproducibility and accuracy of MIC determinations were statistically equivalent to BMD. Our results provide support for the use of the DDM as a BMD equivalent methodology that will enable hospital-based clinical laboratories to support cefepime MIC-based dosing strategies.

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  8. [해외논문]   Performance Evaluation of Allplex Respiratory Panels 1, 2, and 3 for Detection of Respiratory Viruses and Influenza A Virus Subtypes   SCI SCIE

    Huh, Hee Jae (Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea ) , Kim, Ji-Youn (Center for Clinical Medicine, Samsung Biomedical Research Institute, Samsung Medical Center, Seoul, Republic of Korea ) , Kwon, Hyeon Jeong (Center for Clinical Medicine, Samsung Biomedical Research Institute, Samsung Medical Center, Seoul, Republic of Korea ) , Yun, Sun Ae (Center for Clinical Medicine, Samsung Biomedical Research Institute, Samsung Medical Center, Seoul, Republic of Korea ) , Lee, Myoung-Keun (Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea ) , Lee, Nam Yong (Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea ) , Kim, Jong-Won (Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea ) , Ki, Chang-Seok (Department of Laboratory Medicine and Genetics, Samsung Medical Cent)
    Journal of clinical microbiology v.55 no.2 ,pp. 479 - 484 , 2017 , 0095-1137 ,

    초록

    The Allplex respiratory panels 1, 2, and 3 (Allplex) comprise a one-step real-time reverse transcription-PCR assay for the detection of respiratory viruses (RVs) and influenza A subtypes based on multiple detection temperature (MuDT) technology. The performance of the Allplex assay was compared with those of the Advan-Sure RV real-time PCR kit (AdvanSure) and the PowerChek pandemic H1N1/H3N2/H5N1 real-time PCR kit (PowerChek) using 417 clinical respiratory specimens. In comparison with the AdvanSure assay for RV detection by each virus, the ranges of positive percent agreement, negative percent agreement, and kappa values with the Allplex assay were 82.8 to 100%, 95.5 to 100%, and 0.85 to 1.00, respectively. For influenza A virus (INF A) subtyping, the kappa values between the Allplex and PowerChek assays were 0.67 and 1.00 for the INF A H1N1-pdm09 and H3 subtypes, respectively. Uniplex PCR and sequencing for samples with discrepant results demonstrated that the majority of results were concordant with those from the Allplex assay. When testing 24 samples, the turnaround and hands-on time required to perform the Allplex assay were 4 h 15 min and 15 min, respectively. In conclusion, the Allplex assay produced results comparable to those from the AdvanSure and PowerChek assays.

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  9. [해외논문]   Multicenter Evaluation of a Modified Cefoxitin Disk Diffusion Method and PBP2a Testing To Predict mecA-Mediated Oxacillin Resistance in Atypical Staphylococcus aureus   SCI SCIE

    Miller, Shelley A. (Department of Pathology and Laboratory Medicine, University of California—Los Angeles, Los Angeles, California, USA ) , Karichu, James (Department of Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio, USA ) , Kohner, Peggy (Division of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota, USA ) , Cole, Nicolynn (Division of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota, USA ) , Hindler, Janet A. (Department of Pathology and Laboratory Medicine, University of California—Los Angeles, Los Angeles, California, USA ) , Patel, Robin (Division of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota, USA ) , Richter, Sandra (Department of Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio, USA ) , Humphries, Romney M. (Department of Pathology and Laboratory Medicine, University of California—Los Angeles, Los Angeles, California, USA)
    Journal of clinical microbiology v.55 no.2 ,pp. 485 - 494 , 2017 , 0095-1137 ,

    초록

    Phenotypic variants of Staphylococcus aureus that display small colonies, reduced pigmentation, and decreased hemolysis and/or coagulase activity are periodically isolated by the clinical laboratory. Antimicrobial susceptibility testing (AST) of these isolates is complicated, because many do not grow on routine AST media, including Mueller-Hinton agar (MHA) and cation-adjusted Mueller-Hinton broth. This multicenter study evaluated cefoxitin disk diffusion for 37 atypical S. aureus isolates (156 readings) with MHA supplemented with 5% sheep's blood (BMHA), using mecA PCR as the reference standard. The correlation of two commercial PBP2a assays with mecA PCR was also assessed. Ten isolates were negative and 27 positive for mecA . No major errors for cefoxitin were observed, but 19.5% very major errors (VMEs) were observed at 24 h of incubation, and 17.2% VMEs were observed at 48 h. The proportions of VMEs ranged from 14.7 to 23.0% at 24 h, and from 13.3 to 17.6% at 48 h, across three testing laboratories. PBP2a tests were performed from growth on BMHA and blood agar plates (BAP), with and without cefoxitin disk induction. The Alere PBP2a SA culture colony test sensitivities for mecA were 90.0% with uninduced growth and 97.4% with induced growth from BMHA. On BAP, sensitivity was 96.0% with induced growth. The sensitivities of the Oxoid PBP2′ latex agglutination test were 85.7% with uninduced growth and 93.9% with induced growth from BMHA and 95.9% with induced growth on BAP. On the basis of these data, we recommend that laboratories perform only mecA PCR and/or PBP2a tests when requested to perform AST on atypical isolates of S. aureus .

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  10. [해외논문]   Use of Recombinant Antigens for Sensitive Serodiagnosis of American Tegumentary Leishmaniasis Caused by Different Leishmania Species   SCI SCIE

    Sato, Camila Massae (Instituto de Medicina Tropical de Sãão Paulo, Universidade de Sããão Paulo, Sãããão Paulo, Brazil ) , Sanchez, Maria Carmen Arroyo (Instituto de Medicina Tropical de Sãão Paulo, Universidade de Sããão Paulo, Sãããão Paulo, Brazil ) , Celeste, Beatriz Julieta (Instituto de Medicina Tropical de Sãão Paulo, Universidade de Sããão Paulo, Sãããão Paulo, Brazil ) , Duthie, Malcolm S. (Infectious Disease Research Institute, Seattle, Washington, USA ) , Guderian, Jeffrey (Infectious Disease Research Institute, Seattle, Washington, USA ) , Reed, Steven G. (Infectious Disease Research Institute, Seattle, Washington, USA ) , de Brito, Maria Edileuza Felinto (Department of Immunology, Aggeu Magalhããããães Research Center-Oswaldo Cruz Foundation (FIOCRUZ), Recife, Pernambuco, Brazil ) , Campos, Marliane Batista (Instituto Evandro Chagas, Belãããããém, Parãããããéá, Brazil ) , de Souza Encarnacã (Fundaca&) , o, Helia Valeria , Guerra, Jorge , de Mesquita, Tirza Gabrielle Ramos , Pinheiro, Suzana Kanawati , Ramasawmy, Rajendranath , Silveira, Fernando Tobias , de Assis Souza, Marina , Goto, Hiro
    Journal of clinical microbiology v.55 no.2 ,pp. 495 - 503 , 2017 , 0095-1137 ,

    초록

    American tegumentary leishmaniasis (ATL) (also known as cutaneous leishmaniasis [CL]) is caused by various species of protozoa of the genus Leishmania . The diagnosis is achieved on a clinical, epidemiological, and pathological basis, supported by positive parasitological exams and demonstration of leishmanin delayed-type hypersensitivity. Serological assays are not routinely used in the diagnosis because many are considered to have low sensitivity and the particular Leishmania species causing the disease can lead to variable performance. In the present study, we generated recombinant versions of two highly conserved Leishmania proteins, Leishmania ( Viannia ) braziliensis -derived Lb8E and Lb6H, and evaluated both in enzyme-linked immunosorbent assays (ELISA). Recombinant Lb6H (rLb6H) had better performance and reacted with 100.0% of the ATL and 89.4% of the VL samples. These reactions with rLb6H were highly specific (98.5%) when compared against those for samples from healthy control individuals. We then assessed rLb6H against sera from ATL patients infected with different species of Leishmania prevalent in Brazil [ Leishmania ( Leishmania ) amazonensis , L . ( Viannia ) braziliensis , and L . ( V .) guyanensis ] and samples from patients with other infectious diseases. In analyses of 500 sera, ELISA using rLb6H detected all 219 ATL samples (sensitivity of 100.0%) with an overall specificity of 93.9% (considering healthy individuals and other infectious diseases patients). Only a minority of samples from Chagas disease patients possessed antibodies against rLb6H, and all of these responses were low (with a highest reactivity index of 2.2). Taken together, our data support further evaluation of rLb6H and the potential for its routine use in the serological diagnosis of ATL.

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