scholarly journals Culturing Periprosthetic Tissues in BacT/Alert® Virtuo Blood Culture Bottles for a Short Duration of Post-operative Empirical Antibiotic Therapy

2020 ◽  
Vol 5 (3) ◽  
pp. 145-150
Author(s):  
Claire Duployez ◽  
Frédéric Wallet ◽  
Henri Migaud ◽  
Eric Senneville ◽  
Caroline Loiez
Keyword(s):  
Blood Culture ◽  
Antibiotic Therapy ◽  
Joint Infection ◽  
Length Of Hospital Stay ◽  
Empirical Antibiotic Therapy ◽  
Gram Positive ◽  
Gram Negative ◽  
Surgical Interventions ◽  
Joint Infections ◽  
Gram Positive Cocci

Abstract. Introduction: A post-operative empirical antibiotic therapy (PEAT) is required in periprosthetic joint infections. It commonly uses broad-spectrum antibiotics to cover most Gram-positive cocci and Gram-negative bacilli. It is currently continued until first microbiological results are available, no less than five days later.Methods: We performed a retrospective study in order to evaluate duration of incubation required for surgical samples using the BacT/Alert® Virtuo blood culture bottles system.Results: Among 216 surgical interventions and 199 clinical strains (53.8% staphylococci, 22,1% streptococci and enterococci, 14,6% Gram-negative bacilli, 5,5% anaerobes), 90.5% of the strains were detected between day 0 and day 2; 15 infective strains are cultured from day 3 including 8 Cutibacterium sp., 4 staphylococci, 2 streptococci and 1 Enterococcus.Conclusions: We suggest that the duration of PEAT in patients operated for a periprosthetic joint infection may be shortened to three days as Gram-negative rods are unlikely to grow after three days of culture by using BacT/Alert® Virtuo blood culture bottles. This is likely to shorten the overall length of hospital stay, to diminish the occurrence of adverse side effects, and the emergence of antimicrobial resistance. However, coverage of Gram-positive cocci should be maintained for 14 days until the definite culture results are available.

scholarly journals Clinical Presentation and Bacterial Etiology of Adult Community Acquired Pneumonia

2017 ◽  
Vol 34 (3) ◽  
pp. 128-134
Author(s):  
Md Abdus Salam ◽  
Md Robed Amin ◽  
Quazi Tarikul Islam
Keyword(s):  
Streptococcus Pneumoniae ◽  
Blood Culture ◽  
Mycoplasma Pneumoniae ◽  
Chlamydia Pneumoniae ◽  
Community Acquired Pneumonia ◽  
Sputum Culture ◽  
Gram Positive ◽  
Gram Negative ◽  
The Mean ◽  
Gram Positive Cocci

Introduction: Pneumonia is a worldwide, serious threat to health and an enormous socio-economic burden for health care system. According to recent WHO data, each year 3-4 million patients die from pneumonia. The clinical presentations and bacterial agents responsible for community acquired pneumonia (CAP) varies according to geography and culture.Methods: A cross sectional observational study conducted among the 53 consecutive patients with a clinical diagnosis of CAP in admitted patient in the department of Medicine, DMCH, during January 2010 to December 2010. Hematological measurements (TC of WBC, Hb%, ESR, platelet count), blood culture, chest X-ray P/A view, sputum for Gram staining and culture sensitivity, sputum for AFB, blood urea and random blood sugar were done in all cases. ELISA for IgM antibody of Mycoplasma pneumoniae and Chlamydia pneumoniae were done in sputum culture negative cases.Results: The mean (±SD) age was 38.9±17.3 years and Male female ratio was 3:1. Fever, chest pain and productive cough were the most common clinical features. The mean (±SD) respiratory rate was 23.0±2.8 /minute . COPD and DM were found in 17.0% and 5.7% of patients respectively . Blood culture was found positive in only 1.9% of the study patients. Gram positive Cocci 62.26%, Gram negative Bacilli 9.43%, mixed Gram positive cocci and Gram negative bacilli 11.32% and Gram negative Cocco Bacilli 1.9% were observed and in 15.03 % cases, no bacteria could be seen. Sputum culture revealed 53.8% streptococcus pneumoniae, 26.9% Klebsiella pneumonia as predominant organism. Mycoplasma pneumoniae and Chlamydia pneumoniae were found in 7.4% and 3.7% respectively by serological test. For Streptococcus pneumoniae, sensitive antibiotics were Amoxyclav and Levofloxacin. For Gram negative bacilli and coccobacilli, more sensitive antibiotics were Meropenem, Ceftriaxone, and Clarithromycin. The best sensitive drug were found meropenem. The mean (±SD) duration of hospital stay was 5.0±1.7 days with ranging from 3 to 10 days.Conclusion: Region based bacteroiological diagnosis of Cap is important for selecting the best and sensitive drugs for complete cure.J Bangladesh Coll Phys Surg 2016; 34(3): 128-134

scholarly journals Automated Interpretation of Blood Culture Gram Stains by Use of a Deep Convolutional Neural Network

2017 ◽  
Vol 56 (3) ◽  
Author(s):  
Kenneth P. Smith ◽  
Anthony D. Kang ◽  
James E. Kirby
Keyword(s):  
Neural Network ◽  
Blood Culture ◽  
Convolutional Neural Network ◽  
Clinical Laboratory ◽  
Clinical Microbiology Laboratory ◽  
Proof Of Concept ◽  
Gram Stain ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Cocci

ABSTRACTMicroscopic interpretation of stained smears is one of the most operator-dependent and time-intensive activities in the clinical microbiology laboratory. Here, we investigated application of an automated image acquisition and convolutional neural network (CNN)-based approach for automated Gram stain classification. Using an automated microscopy platform, uncoverslipped slides were scanned with a 40× dry objective, generating images of sufficient resolution for interpretation. We collected 25,488 images from positive blood culture Gram stains prepared during routine clinical workup. These images were used to generate 100,213 crops containing Gram-positive cocci in clusters, Gram-positive cocci in chains/pairs, Gram-negative rods, or background (no cells). These categories were targeted for proof-of-concept development as they are associated with the majority of bloodstream infections. Our CNN model achieved a classification accuracy of 94.9% on a test set of image crops. Receiver operating characteristic (ROC) curve analysis indicated a robust ability to differentiate between categories with an area under the curve of >0.98 for each. After training and validation, we applied the classification algorithm to new images collected from 189 whole slides without human intervention. Sensitivity and specificity were 98.4% and 75.0% for Gram-positive cocci in chains and pairs, 93.2% and 97.2% for Gram-positive cocci in clusters, and 96.3% and 98.1% for Gram-negative rods. Taken together, our data support a proof of concept for a fully automated classification methodology for blood-culture Gram stains. Importantly, the algorithm was highly adept at identifying image crops with organisms and could be used to present prescreened, classified crops to technologists to accelerate smear review. This concept could potentially be extended to all Gram stain interpretive activities in the clinical laboratory.

scholarly journals 285. Evaluation of the ePlex® Blood Culture Identification (BCID) Panels for Gram-positive/Gram-negative bacteria and yeasts

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S143-S143
Author(s):  
Kimberle Chapin ◽  
Giannoula Tansarli
Keyword(s):  
Blood Culture ◽  
Gram Positive ◽  
Gram Negative ◽  
Soc Testing ◽  
Percent Agreement ◽  
Culture Identification ◽  
Reduced Time ◽  
Gram Positive Cocci ◽  
Pna Fish ◽  
Vitek Ms

Abstract Background Multiple methods used for blood culture identification create inconsistent to reporting of critical results. Study aim was to evaluate performance characteristics of the ePlex BCID panels compared to current standard of care (SOC) methods used in our lab. Methods Identification sensitivity and specificity were assessed across all targets detected by the ePlex as well as time to final identification (from time of bottle positive Gram stain) between ePlex and SOC testing. SOC included Xpert MRSA/SA or latex agglutination for Gram-positive cocci in clusters (GPCC), Vitek MS + Accelerate Pheno for Gram-negative rods (GNRs), serotyping or optochin disk ± Vitek MS for Gram-positive cocci in chains (GPC chains), Vitek MS or Vitek-2 for Gram-positive rods (GPR), and PNA-FISH or Vitek MS for yeasts. Results 313 unique prospective blood culture specimens were tested with ePlex BCID panels during a 3-month period (January-March 2020). The positive percent agreement was 100% for GNR (n= 98), S. aureus (n= 42), coagulase-negative staphylococci (n= 38), Group A Streptococcus (n= 3), Group B Streptococcus (n= 5), S. pneumoniae (n= 10), GPR (n= 21), and yeasts (n= 20). There was 1 false negative, (S.mutans) which should have been detected. The negative percent agreement was 100% across all targets except for 1 false positive Corynebacterium spp. In total, 6.7% of blood cultures had an off-panel organism which ePlex did not detect. The median time to final identification was 3 (2 – 4) hrs. for ePlex and calculated for all other SOC methods. Compared to SOC molecular methods, the ePlex reduced time to identification 0.5 h compared to Xpert MRSA/SA, 6.7 h compared to Accelerate Pheno for GNR (but Accelerate Pheno provides susceptibilities), and 3 h compared to PNA-FISH for yeasts (p< 0.05). ePlex compared to non-molecular techniques (MALDI-TOF), SOC for Streptococcus spp. and Enteroococcus spp., the time to final identification was reduced by 24 – 30 hours (p< 0.05). Workflow chart comparison eplex to SOC Time to results eplex vs SOC Conclusion The ePlex BCID system provided highly accurate identification results for GP and GN bacteria as well as for yeasts. Our evaluation showed that this system significantly reduced time to final identification compared to SOC testing methods. Disclosures Kimberle Chapin, MD, genmark (Scientific Research Study Investigator) Giannoula Tansarli, MD, GenMark (Grant/Research Support)

scholarly journals FREQUENCY AND ANTIMICROBIAL RESISTANCE PATTERNS OF BACTERIA ISOLATED FROM ASPIRATION SPECIMENS OF PATIENTS WITH HIP AND KNEE INFECTIONS AT A HOSPITAL IN BAGHDAD

2020 ◽  
Vol 5 (12) ◽  
pp. 10-16
Author(s):  
Hadi Abdulah Abd Ali Al-Zuhairi ◽  
Nadheema Hammood Hussein ◽  
Khetam Habeeb Rasool
Keyword(s):  
Knee Joint ◽  
Joint Infection ◽  
Resistance Pattern ◽  
P Value ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Gram Negative ◽  
Joint Infections ◽  
Resistance Patterns ◽  
Knee Joint Infection

The present study was carried out to determine the frequency of bacteria responsible for hip and knee infections at a hospital in Baghdad/Iraq and to get an updated knowledge about their antibiotic resistance pattern during a period of study which extended from 1 October, 2016 till 1 October, 2017. Identification of bacteria at species level was done by using Analytic Profile Index (API) system (Bio-Merieux, France). The antimicrobial susceptibility test was performed according to Kirby-Bauer (disk diffusion) technique. The frequency of positive aspiration of hip and knee joint infections cultures was 25(65.79%) cases out of 38 hip and knee joint aspiration. Out of 25 positive aspirations of hip and knee joint infections cultures, 3(12%) cultures gave mix growth of bacteria. Frequency of positive hip and knee joint infections cultures was higher in male than female patients, 19(76%) vs. 6(24%) (P-value ≤ 0.05). Out of 28 isolated bacteria, Gram positive was the most frequently isolated bacteria in hip and knee joint infection cultures, 22(78.6%) vs. 6(21.4%) (P-value < 0.05). Staphylococcus epidermidis was the most frequently isolated 13(46.5%) isolates followed by Staphylococcus aureus isolates 7(25%). On other hand Pseudomonas aeruginosa was the most frequently isolated Gram negative bacteria 3(10.7 %%) in hip and knee joint infection cultures. The most effective antibiotic on Gram-positive isolates was Vancomycin which showed 95.5%. In Gram negative bacteria the most effective antibiotics were Imipenem (100%) followed by Amikacin which showed sensitivity rate 83.33.

scholarly journals An AI-based auxiliary empirical antibiotic therapy model for children with bacterial pneumonia using low-dose chest CT images

2021 ◽  
Author(s):  
Mudan Zhang ◽  
Siwei Yu ◽  
Xuntao Yin ◽  
Xianchun Zeng ◽  
Xinfeng Liu ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Bacterial Pneumonia ◽  
Low Dose ◽  
Ct Images ◽  
Chest Ct ◽  
Classification Model ◽  
Empirical Antibiotic Therapy ◽  
Gram Positive ◽  
Gram Negative ◽  
Multi Class Classification

Abstract Purpose To construct an auxiliary empirical antibiotic therapy (EAT) multi-class classification model for children with bacterial pneumonia using radiomics features based on artificial intelligence and low-dose chest CT images. Materials and methods Data were retrospectively collected from children with pathogen-confirmed bacterial pneumonia including Gram-positive bacterial pneumonia (122/389, 31%), Gram-negative bacterial pneumonia (159/389, 41%) and atypical bacterial pneumonia (108/389, 28%) from January 1 to June 30, 2019. Nine machine-learning models were separately evaluated based on radiomics features extracted from CT images; three optimal submodels were constructed and integrated to form a multi-class classification model. Results We selected five features to develop three radiomics submodels: a Gram-positive model, a Gram-negative model and an atypical model. The comprehensive radiomics model using support vector machine method yielded an average area under the curve (AUC) of 0.75 [95% confidence interval (CI), 0.65–0.83] and accuracy (ACC) of 0.58 [sensitivity (SEN), 0.57; specificity (SPE), 0.78] in the training set, and an average AUC of 0.73 (95% CI 0.61–0.79) and ACC of 0.54 (SEN, 0.52; SPE, 0.75) in the test set. Conclusion This auxiliary EAT radiomics multi-class classification model was deserved to be researched in differential diagnosing bacterial pneumonias in children.

scholarly journals Performance and impact of a multiplex PCR in ICU patients with ventilator-associated pneumonia or ventilated hospital-acquired pneumonia

2020 ◽  
Author(s):  
Nathan Peiffer-Smadja ◽  
Lila BOUADMA ◽  
Vincent MATHY ◽  
Kahina ALLOUCHE ◽  
Juliette PATRIER ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Multiplex Pcr ◽  
Antimicrobial Therapy ◽  
Bacterial Resistance ◽  
Clinical Samples ◽  
Gram Positive ◽  
Icu Patients ◽  
Gram Negative ◽  
Surgical Icu ◽  
Gram Positive Cocci

Abstract Background: Early appropriate antibiotic therapy reduces morbidity and mortality of severe pneumonia. However, the emergence of bacterial resistance requires the earliest use of antibiotics with the narrowest possible spectrum. The Unyvero Hospitalized Pneumonia (HPN, Curetis) test is a multiplex PCR (M-PCR) system detecting 21 bacteria and 19 resistance genes on respiratory samples within 5 hours. We assessed the performance and the potential impact of the M-PCR on the antibiotic therapy of ICU patients. Methods: In this prospective study we performed a M-PCR on bronchoalveolar lavage (BAL) or plugged telescoping catheters (PTC) samples of patients with ventilated HAP or VAP with Gram-negative bacilli or clustered Gram-positive cocci. This study was conducted in 3 ICUs in a French academic hospital; the medical and infectious diseases ICU, the surgical ICU and the cardio-surgical ICU. A multidisciplinary expert panel simulated the antibiotics changes they would have made if the M-PCR results had been available. Results We analyzed 95 clinical samples of ventilated HAP or VAP (72 BAL and 23 PTC) from 85 patients (62 males, median age 64 years). The median turnaround time of the M-PCR was 4.6 hours (IQR 4.4-5). A total of 90/112 bacteria were detected by the M-PCR system with a global sensitivity of 80% (95%CI, 73-88%) and specificity of 99% (95%CI 99-100). The sensitivity was better for Gram-negative bacteria (90%) than for Gram-positive cocci (62%) (p=0.005). Moreover, 5/8 extended-spectrum beta-lactamases (CTX-M gene) and 4/4 carbapenemases genes (3 NDM, one oxa-48) were detected. The M-PCR could have led to the earlier initiation of an effective antibiotic in 20/95 patients (21%) and to early de-escalation in 37 patients (39%) but could also have led to one (1%) inadequate antimicrobial therapy. Among 17 empiric antibiotic treatments with carbapenems, 10 could have been de-escalated in the following hours according to the M-PCR results. The M-PCR also led to 2 unexpected diagnosis of severe legionellosis confirmed by culture methods. Conclusions: Our results suggest that the use of a M-PCR system for respiratory samples of patients with VAP and ventilated HAP could improve empirical antimicrobial therapy and reduce the use of broad-spectrum antibiotics.

scholarly journals Performance and impact of a multiplex PCR in ICU patients with ventilator-associated pneumonia or ventilated hospital-acquired pneumonia

2020 ◽  
Author(s):  
Nathan Peiffer-Smadja ◽  
Lila BOUADMA ◽  
Vincent MATHY ◽  
Kahina ALLOUCHE ◽  
Juliette PATRIER ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Multiplex Pcr ◽  
Antimicrobial Therapy ◽  
Bacterial Resistance ◽  
Clinical Samples ◽  
Gram Positive ◽  
Icu Patients ◽  
Gram Negative ◽  
Surgical Icu ◽  
Gram Positive Cocci

Abstract Background: Early appropriate antibiotic therapy reduces morbidity and mortality of severe pneumonia. However, the emergence of bacterial resistance requires the earliest use of antibiotics with the narrowest possible spectrum. The Unyvero Hospitalized Pneumonia (HPN, Curetis) test is a multiplex PCR (M-PCR) system detecting 21 bacteria and 19 resistance genes on respiratory samples within 5 hours. We assessed the performance and the potential impact of the M-PCR on the antibiotic therapy of ICU patients. Methods: In this prospective study we performed a M-PCR on bronchoalveolar lavage (BAL) or plugged telescoping catheters (PTC) samples of patients with ventilated HAP or VAP with Gram-negative bacilli or clustered Gram-positive cocci. This study was conducted in 3 ICUs in a French academic hospital; the medical and infectious diseases ICU, the surgical ICU and the cardio-surgical ICU. A multidisciplinary expert panel simulated the antibiotics changes they would have made if the M-PCR results had been available. Results We analyzed 95 clinical samples of ventilated HAP or VAP (72 BAL and 23 PTC) from 85 patients (62 males, median age 64 years). The median turnaround time of the M-PCR was 4.6 hours (IQR 4.4-5). A total of 90/112 bacteria were detected by the M-PCR system with a global sensitivity of 80% (95%CI, 73-88%) and specificity of 99% (95%CI 99-100). The sensitivity was better for Gram-negative bacteria (90%) than for Gram-positive cocci (62%) (p=0.005). Moreover, 5/8 extended-spectrum beta-lactamases (CTX-M gene) and 4/4 carbapenemases genes (3 NDM, one oxa-48) were detected. The M-PCR could have led to the earlier initiation of an effective antibiotic in 20/95 patients (21%) and to early de-escalation in 37 patients (39%) but could also have led to one (1%) inadequate antimicrobial therapy. Among 17 empiric antibiotic treatments with carbapenems, 10 could have been de-escalated in the following hours according to the M-PCR results. The M-PCR also led to 2 unexpected diagnosis of severe legionellosis confirmed by culture methods. Conclusions: Our results suggest that the use of a M-PCR system for respiratory samples of patients with VAP and ventilated HAP could improve empirical antimicrobial therapy and reduce the use of broad-spectrum antibiotics.

scholarly journals MICROBIAL PATTERN AND ANTIBIOTIC SENSITIVITY TEST OF HOSPITALIZED CHILDREN

2016 ◽  
Vol 51 (3) ◽  
pp. 190
Author(s):  
John Wiwin ◽  
IGAA Putri Sri Rejeki
Keyword(s):  
Blood Culture ◽  
Rectal Swab ◽  
Antibiotic Sensitivity ◽  
Sensitivity Test ◽  
Sensitivity Testing ◽  
Gram Positive ◽  
Gram Negative ◽  
E Coli ◽  
Oncology Ward ◽  
Gram Positive Cocci

Infection often occurs in children with malignant hematology and causes morbidity and mortality in the children. Antibiotics given must be based on culture results and antibiotic sensitivity testing. This study was aimed to obtain the microbial pattern and sensitivity test in children hospitalized in the Hemato-Oncology Ward,  dr. Soetomo Hospital from September 2012 - February 2013. This was a descriptive study. Data were obtained from the  patients’ medical records  in Dr. Soetomo Hospital. There were 341 culture examinations (blood, urine, rectum swab, faecal, and others) from 88 patients (44 males and 44 females). Most of patients´ age was < 5 years (58%) and suffered from ALL (50%).There were microbial (83 of culture) and yeast (15 of culture) growth out of 98 cultures. Escherichia coli, Burkholderia cefacea, and Klebsiella oxytoca (Gram negative) dan CONS, Stapyloccocus aureus, and Stapylococcus sapropyticus (gram positive) were found in blood culture. S. aureus (gram positive) and E. coli, Klebsiella pneumoniae, and B. cefacea (gram negative) were found in urine culture. Only E. coli was found in rectal swab culture. CONS of gram positive cocci were mostly found in blood culture of children hospitalized in Hemato-Oncology Ward, Dr. Soetomo Hospital. E. coli was the mostly found gram negative rods. Gram positive cocci showed a high resistant to penicillin and co-trimoxazole. E. coli, mostly found in rectal swab and urine, has a high sensitivity to amikacin and meropenem, but highly resistant to  ampicillin and ampicillin sulbactam.

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