Possible use of frequency-pulse-modulated electron capture gas-liquid chromatography to identify septic and aseptic causes of pleural effusions

Rapid diagnosis of tuberculous meningitis by frequency-pulsed electron-capture gas-liquid chromatography detection of carboxylic acids in cerebrospinal fluid

The frequency-pulsed electron-capture gas-liquid chromatography technique described previously by Brooks et al. was modified and applied to the studies of coded and routine clinical specimens. Uncentrifuged cerebrospinal fluid (2 ml) was extracted under acidic conditions, derivatized, and analyzed by frequency-pulsed electron-capture gas-liquid chromatography on large-bore fused silica polar and nonpolar capillary columns. The frequency-pulsed electron-capture gas-liquid chromatography profile of carboxylic acids (C2 through C22) along with identification of tuberculostearic acid, established by retention time comparison of derivatized tuberculostearic acid and derivatized sample extract, strongly suggests the presence of Mycobacterium tuberculosis in patients with lymphocytic meningitis. Results from 41 coded cases and 75 clinical cases showed that the frequency-pulsed electron-capture gas-liquid chromatography test had a specificity of 91% and a sensitivity of 95%.

Rapid diagnostic methods for aspergillosis

Conventional laboratory methods are always unsatisfactory for the antemortem diagnosis of systemic mycoses, especially aspergillosis, in immunocompromised patients and those with acquired immune deficiency syndrome (AIDS), regardless of their age. There is increasing proof that aspergillosis is not limited to pulmonary, sinus or nasal regions. These facts, plus the high mortality rate, indicate a tremendous need for reliable and rapid methods of diagnosing this infection. Accordingly, refined techniques such as solid-phase radioimmunoassay (SPIRA), crossed-immunoelectrophoresis (CIE), crossed-radioimmunoelectrophoresis (CRIE), radioallergosorbent test (RAST), radioimmunoprecipitation assay (RIPA), paper radioimmunosorbent test (PRIST), computerized enzyme-linked immunosorbent assay (ELISA), biotin avidin enzyme-linked immunosorbent assay and gas-liquid chromatography (GLC) are being considered or used in clinical laboratories for diagnosing aspergillosis. The advantages and limitations of the RIA, ELISA and GLC methods are briefly discussed.

Rapid differentiation of rocky mountain spotted fever from chickenpox, measles, and enterovirus infections and bacterial meningitis by frequency-pulsed electron capture gas-liquid chromatographic analysis of sera

Normal sera and sera from patients with Rocky Mountain spotted fever, chickenpox, enterovirus infections, measles, and Neisseria meningitidis infections were extracted with organic solvents under acidic and basic conditions and then derivatized with trichloroethanol or heptafluorobutyric anhydride-ethanol to form electron-capturing derivatives of organic acids, alcohols, and amines. The derivatives were analyzed by frequency-pulsed electron capture gas-liquid chromatography (FPEC-GLC). There were unique differences in the FPEC-GLC profiles of sera obtained from patients with these respective diseases. With Rocky Mountain spotted fever patients, typical profiles were detected as early as 1 day after onset of disease and before antibody could be detected in the serum. Rapid diagnosis of Rocky Mountain spotted fever by FPEC-GLC could permit early and effective therapy, thus preventing many deaths from this disease.

Gas chromatography in the identification of microorganisms and diagnosis of infectious diseases

Gas-liquid chromatography (GLC) continues to find increasing applications in the characterization of microorganisms and the diseases associated with them. GLC has been used to characterize microorganisms through qualitative and quantitative analyses of cellular structural components and soluble extracts and metabolic by-products. Chromatographic patterns, or fingerprints, can be used to differentiate between very closely related microorganisms, even strain differences, and provides a potentially powerful tool for future taxonomic studies and more precision in definitive microbial classification. However, the most valuable use of GLC is in the identification of disease through patterns obtained by direct analysis of body fluids. Chromatographic fingerprints of microbial metabolites and compounds associated with the host response to infection and even noninfectious disease can be used to develop relatively simple GLC diagnostic methods. These methods are specific, sensitive, and rapid. This review examines the use of GLC for identification of infectious diseases through the analysis of body fluids, spent culture media, and cellular materials and suggest other clinical areas where its diagnostic potential has yet to be developed.

Rapid diagnosis of anaerobic empyema by direct gas-liquid chromatography of pleural fluid

Sixty samples of pleural fluid from 52 patients were subjected to direct gas-liquid chromatographic studies, and results were correlated with findings from microbiologic cultures. Fourteen patients had anaerobic empyema, 22 had aerobic infections, and 16 had sterile pleural effusions. Multiple volatile fatty acids or succinic acid or both were found as markers of anaerobic infection in all but one instance. Aerobic infections and sterile pleural fluids were characterized by the absence of multiple volatile fatty acids or succinic acid. Infection with Bacteroides, when present, was characterized by a major product of succinic acid. One patient infected with Peptococcus magnus (which does not produce fatty acids or succinic acid) could not be diagnosed by gas-liquid chromatograms. Two patients without anaerobic bacteria in the pleural effusions but who had infections associated with Bacteroides fragilis outside the pleural space demonstrated succinic acid in the pleural fluid. With these exceptions, the presence of volatile fatty acids or succinic acid in pleural fluid was considered characteristic of anaerobic empyema. Direct gas-liquid chromatographic study of pleural fluids is, therefore, recommended as a routine procedure for rapid diagnosis of anaerobic empyema.

Rapid differentiation of the major causative agents of bacterial meningitis by use of frequency-pulsed electron capture gas-liquid chromatograph: analysis of acids

The major causative agents of bacterial meningitis, Haemophilus influenzae serogroup B, Neisseria meningitidis serogroups B and C, Klebsiella pneumoniae, Streptococcus pneumoniae, and two types of Escherichia coli, were cultured in a modified chemically defined Catlin medium and in a commercial version of the unmodified Catlin medium. The spent media were extracted under acidic conditions, and electron-capturing derivatives were prepared by derivatization with trichloroethanol or haptafluorobutyric anhydride. The derivatives were analyzed on a gas chromatograph equipped with a frequency-pulsed electron capture detector and a PEP-2 computer. The data obtained from the study show that these organisms can be easily distinguished from each other on the basis of metabolic products detected in either type of medium. Three different metabolic groups were detected within two serogroups of N. meningitidis. The methods are practical, and the new technique should offer clinical laboratories and hospitals a better method for rapid identification of this important group of pathogens.

Rapid differentiation of the major causative agents of bacterial meningitis by use of frequency-pulsed electron capture gas-liquid chromatography: analysis of amines

The major causative agents of bacterial meningitis (Haemophilus influenzae serogroup B, Neisseria meningitidis serogroups B and C, Klebsiella pneumoniae, Steptococcus pneumoniae, and two types of Escherichia coli) were cultured in a chemically defined medium, and selected strains were further studied in Todd-Hewitt medium. After acidic extraction of the spent media with chloroform, a basic extraction was made with chloroform to obtain amines. A third extraction was performed on re-acidified Todd-Hewitt medium with ethyl ether to obtain hydroxyacids. The extracts were derivatized with heptafluorobutyric anhydride-ethanol to form electron-capturing derivatives, and the derivatives were analyzed on a frequency-pulsed electron capture gas-liquid chromatograph (FPEC-GLC) equipped with a PEP-2 computer. The data obtained from the study showed that amines were produced by these organisms that formed characteristic patterns. Different serotypes of K. pneumoniae and the two serogroups of N. meningitidis produced different types of FPEC-GLC profiles within serotypes. E. coli produced several hydroxy acids on Todd-Hewitt medium that made it unique among the organisms studied. The methods used are practical and the techniques have potential for use in clinical laboratories and hospitals as a valuable aid for the rapid identification of the major causative agents of bacterial meningitis.

Electron capture gas-liquid chromatographic study of metabolites produced by some arthritic transudate-associated organisms in vitro and in vivo in rabbit models

Computerized, frequency-pulsed, modulated electron capture gas-liquid chromatography was used to study the acid metabolites produced in vitro in fetal calf serum and in vivo in an animal chamber model. Several strains of Diplostreptococcus agalactiae, Propionibacterium acnes, Staphylococcus aureus, and Streptococcus serogroups A, B, and G were studied. All of these organisms have been reported to be associated with arthritic transudates in humans. Metabolites were detected by this method from derivatized extracts of both spent fetal calf serum and chamber fluids. Since there was little host response to the organisms cultured in the chambers, it is highly probable that the products detected represent metabolites produced in an in vivo type of environment. The metabolic patterns were reproducible and exhibited many similarities in vitro and in vivo. Production of the acids detected was reproducible, and these acids were useful identification markers. The data support published reports (J. B. Brooks, C. C. Alley, and J. A. Liddle, Anal. Chem. 46: 1930-1934, 1974; J. B. Brooks, G. Choudhary, R. B. Craven, D. Edman, C. C. Alley, and J. A. Liddle, J. Clin. Microbiol. 5:625-628, 1977; J. B. Brooks, R. B. Craven, A. R. Melton, and C. C. Alley, in H. H. Johnson and W. B. Newson, ed., Second International Symposium on Rapid Methods and Automation on Microbiology, 1976; J. B. Brooks, R. B. Craven, D. Schlossberg, C. C. Alley, and F. M. Pitts, J. Clin. Microbiol. 8:203-208, 1978; J. B. Brooks, D. S. Kellogg, C. C. Alley, H. B. Short, and H. H. Handsfield, J. Infect. Dis. 129:660-668, 1974) that bacterial metabolites might be detectable in diseased body fluids. The growth characteristics of the organisms in the animal model and fetal calf serum are discussed, and a moderately priced computer for performing data manipulations is evaluated.