1022. Evaluating the Impact of GenMark Dx ePlex® Blood Culture Identification (BCID) on Gram-negative Bloodstream Infections

Background The GenMark Dx ePlex BCID Gram-Negative (GN) panel utilizes electrowetting technology to detect the most common causes of GN bacteremia (21 targets) and 6 antimicrobial resistance (AMR) genes from positive blood culture (BC) bottles. Rapid detection of extended spectrum β-lactamases (ESBL: CTX-M & carbapenemases: KPC, NDM, IMP, VIM, OXA 23/48), and highly resistant bacteria such as S. maltophilia should enable early optimization of antimicrobial therapy. Methods In this prospective study, aliquots of positive BC bottles with GN bacteria detected on Gram stain (GS) (n=108) received standard of care (SOC) culture and antimicrobial susceptibility testing (AST). Additionally, samples were evaluated with the BCID-GN panel but only SOC results were reported in the EMR and available to inform clinical decisions. Chart reviews were performed to evaluate the impact of the BCID-GN panel on the time to organism identification, AST results, and optimization of antimicrobial therapy. Results A total of 108 patients are included in the analysis (Table 1). Escherichia coli was the most common bacteria identified followed by Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterobacter species (Table 2). There were 11 (10.2%) polymicrobial bacteremias. Repeat BCs were obtained in 68 (63%) patients of which 13 (19%) were persistently positive. Eight (7%) patients had evidence of additional gram-positive (GP) pathogens. Organism identification occurred 26.7 hours faster than culture. In conjunction with GS, negative pan-GP marker data could have helped providers make the decision to remove GP antibiotic coverage in 63 (58%) patients. Narrowing from empiric meropenem could have occurred in 5 patients. Of 10 individuals infected with resistant isolates (1 S. maltophilia, 1 OXA 23/48, and 8 CTX-M) empiric therapy was ineffective in 4 (40%) cases. Optimization of antimicrobial therapy for 9 (8.3%) patients could have occurred an average of 52.4 hours earlier than standard methods. Table 1. Patient demographics and co-morbidities. Table 2. Gram-negative bacteria frequency. Conclusion The BCID-GN panel enabled earlier time to optimal treatment of highly resistant bacteria as well as multiple opportunities for narrowing gram negative spectrum and a higher degree of certainty in cessation of broad-spectrum gram-positive antibiotics Disclosures Todd P. McCarty, MD, Cidara (Grant/Research Support)GenMark (Grant/Research Support, Other Financial or Material Support, Honoraria for Research Presentation)T2 Biosystems (Consultant) Sixto M. Leal, Jr., MD, PhD, Abnova (Grant/Research Support)AltImmune (Grant/Research Support)Amplyx Pharmaceuticals (Grant/Research Support)Astellas Pharmaceuticals (Grant/Research Support)CNINE Dx (Grant/Research Support)GenMark Diagnostics (Grant/Research Support, Other Financial or Material Support, Honoraria- Research Presentation)IHMA (Grant/Research Support)IMMY Dx (Grant/Research Support)JMI/Sentry (Grant/Research Support)mFluiDx Dx (Grant/Research Support)SpeeDx Dx (Grant/Research Support)Tetraphase Pharmaceuticals (Grant/Research Support)

Time-of-flight secondary ion mass spectrometry fragment regularity in gallium-doped zinc oxide thin films

Time-of-flight secondary ion mass spectrometry fragment analysis remains a challenging task. The fragment appearance regularity (FAR) rule is particularly useful for two-element compounds such as ZnO. Ion fragments appearing in the form of ZnxOy obey the rule $$2x \ge 2y + 1$$ 2 x ≥ 2 y + 1 in the positive secondary ion spectrum and $$2x \le 2y + 1$$ 2 x ≤ 2 y + 1 in the negative spectrum where the valence of Zn is + 2 and that of O is − 2. Fragment analysis in gallium-doped ZnO (GZO) films can give insights into the bonding of the elements in this important semiconductor. Fragment analysis of 1 and 7 wt% GZO films shows that only the negative ion fragments obey the FAR rule where ZnO‒, 66ZnO‒, 68ZnO‒ and ZnO2‒ ion fragments appear. In the positive polarity, subdued peaks from out-of-the-rule ZnO+, 66ZnO+ and 68ZnO+ ion fragments are observed. The Ga ion peaks are present in both the positive and negative spectra. The secondary ion spectra of undoped ZnO also shows consistency with the FAR rule. This implies that Ga doping even in amounts that exceed the ZnO lattice limit of solubility does not affect the compliance with the FAR rule.

Interactions of polymyxin B with lipopolysaccharide-containing membranes

Bacterial resistance to antibiotics constantly remodels the battlefront between infections and antibiotic therapy. Polymyxin B, a cationic peptide with anti-Gram-negative spectrum of activity is re-entering use as a last resort...

Computing Nearest Correlation Matrix via Low-Rank ODE’s Based Technique

For n-dimensional real-valued matrix A, the computation of nearest correlation matrix; that is, a symmetric, positive semi-definite, unit diagonal and off-diagonal entries between −1 and 1 is a problem that arises in the finance industry where the correlations exist between the stocks. The proposed methodology presented in this article computes the admissible perturbation matrix and a perturbation level to shift the negative spectrum of perturbed matrix to become non-negative or strictly positive. The solution to optimization problems constructs a gradient system of ordinary differential equations that turn over the desired perturbation matrix. Numerical testing provides enough evidence for the shifting of the negative spectrum and the computation of nearest correlation matrix.

On the N-spectrum of oriented graphs

Given any digraph D, its non-negative spectrum (or N-spectrum, shortly) consists of the eigenvalues of the matrix AA T , where A is the adjacency matrix of D. In this study, we relate the classical spectrum of undirected graphs to the N-spectrum of their oriented counterparts, permitting us to derive spectral bounds. Moreover, we study the spectral effects caused by certain modifications of a given digraph.

Ring chains with vertex coupling of a preferred orientation

We consider a family of Schrödinger operators supported by a periodic chain of loops connected either tightly or loosely through connecting links of the length [Formula: see text] with the vertex coupling which is non-invariant with respect to the time reversal. The spectral behavior of the model illustrates that the high-energy behavior of such vertices is determined by the vertex parity. The positive spectrum of the tightly connected chain covers the entire halfline while the one of the loose chain is dominated by gaps. In addition, there is a negative spectrum consisting of an infinitely degenerate eigenvalue in the former case, and of one or two absolutely continuous bands in the latter. Furthermore, we discuss the limit [Formula: see text] and show that while the spectrum converges as a set to that of the tight chain, as it should in view of a result by Berkolaiko, Latushkin, and Sukhtaiev, this limit is rather non-uniform.

The non-negative spectrum of a digraph

Given the adjacency matrix A of a digraph, the eigenvalues of the matrix AAT constitute the so-called non-negative spectrum of this digraph. We investigate the relation between the structure of digraphs and their non-negative spectra and associated eigenvectors. In particular, it turns out that the non-negative spectrum of a digraph can be derived from the traditional (adjacency) spectrum of certain undirected bipartite graphs.

THE STATE OF THE PSYCHO-EMOTIONAL SPHERE IN PATIENTS WITH CHRONIC PROSTATITIS WITH DIFFERENT STATUS OF MARRIAGE SATISFACTION

109 men with CP and their wives were examined. According to the criterion of presence/absence of marital satisfaction, the surveyed couples were divided into two groups. The first group (group 1) included 73 (67.0 %) couples with low or low levels of marital satisfaction. The second (group 2) included 36 (33.0 %) married couples who were satisfied with their own relationship. The comprehensive examination included, in addition to standard clinical methods, a clinical-psychological and psychodiagnostic study. As a result of the study, it was found that men with CP were found to have manifestations of anxiety and depression, much more pronounced among people dissatisfied with marital relations. They were also characterized by a predominance of negative spectrum emotions in the palette of emotional response, while in patients experiencing marital satisfaction, the emotional spectrum was dominated by positive emotional coloration. Among the wives of patients, there was a similar trend of greater prevalence and severity of symptoms of pathological anxiety and depression among women who experienced marital dissatisfaction. Thus, despite the presence of CP in all surveyed men, which became a provoking factor in the formation of a negative emotional background and reactions of the anxiety-depressive spectrum, patients who were satisfied with the marital relationship showed significantly better psychoemotional performance than patients, dissatisfied with marital relations. The success of marital relations in this case became a shock absorber of the negative psychogenic effects of the disease, which provided a significant difference in the psycho-emotional state of men with CP.

Inter-individual differences in human brain structure and morphology link to variation in demographics and behavior

We perform a comprehensive integrative analysis of multiple structural MR-based brain features and find for the first-time strong evidence relating inter-individual brain structural variations to a wide range of demographic and behavioral variates across a large cohort of young healthy human volunteers. Our analyses reveal that a robust ‘positive-negative’ spectrum of behavioral and demographic variates, recently associated to covariation in brain function, can already be identified using only structural features, highlighting the importance of careful integration of structural features in any analysis of inter-individual differences in functional connectivity and downstream associations with behavioral/demographic variates.