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Blondeau LD, Deneer H, Rubin JE, Kanthan R, Sanche SE, Hamula CL, Blondeau JM. Zoonotic Staphylococcus pseudintermedius: an underestimated human pathogen? Future Microbiol 2023; 18:311-315. [PMID: 37158082 DOI: 10.2217/fmb-2023-0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Affiliation(s)
| | - Harry Deneer
- Department of Pathology & Laboratory Medicine, Saskatoon, SK, S7N 0W8, Canada
- University of Saskatchewan, Saskatoon, SK, S7N 5A2, Canada
| | - Joseph E Rubin
- Department of Veterinary Microbiology, Saskatoon, SK, S7N 5A2, Canada
- University of Saskatchewan, Saskatoon, SK, S7N 5A2, Canada
| | - Rani Kanthan
- Department of Pathology & Laboratory Medicine, Saskatoon, SK, S7N 0W8, Canada
- University of Saskatchewan, Saskatoon, SK, S7N 5A2, Canada
| | - Stephen E Sanche
- Division of Clinical Microbiology, Royal University Hospital & Saskatchewan Health Authority, Saskatoon, SK, S7N 0W8, Canada
- Department of Medicine, Saskatoon, SK, S7N 0W8, Canada
- University of Saskatchewan, Saskatoon, SK, S7N 5A2, Canada
| | - Camille L Hamula
- Division of Clinical Microbiology, Royal University Hospital & Saskatchewan Health Authority, Saskatoon, SK, S7N 0W8, Canada
- Department of Pathology & Laboratory Medicine, Saskatoon, SK, S7N 0W8, Canada
- University of Saskatchewan, Saskatoon, SK, S7N 5A2, Canada
| | - Joseph M Blondeau
- Division of Clinical Microbiology, Royal University Hospital & Saskatchewan Health Authority, Saskatoon, SK, S7N 0W8, Canada
- Department of Biochemistry, Microbiology & Immunology, Saskatoon, SK, S7N 0W8, Canada
- Department of Pathology & Laboratory Medicine, Saskatoon, SK, S7N 0W8, Canada
- Department of Ophthalmology, Saskatoon, SK, S7N 0W8, Canada
- University of Saskatchewan, Saskatoon, SK, S7N 5A2, Canada
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Bhavsar SM, Dingle TC, Hamula CL. The impact of blood culture identification by MALDI-TOF MS on the antimicrobial management of pediatric patients. Diagn Microbiol Infect Dis 2018; 92:220-225. [PMID: 29934073 DOI: 10.1016/j.diagmicrobio.2018.05.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/27/2018] [Accepted: 05/24/2018] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To assess the impact of MALDI-TOF MS coupled with antimicrobial stewardship on clinical outcomes for pediatric inpatients with bloodstream infections. METHODS Outcomes of pediatric inpatients were compared before and after MALDI-TOF MS implementation. Outcomes measured included time until organism identification and susceptibility, duration of antibiotics, patient length of stay (LOS), mortality and hospital costs. RESULTS 210 and 135 patient events were compared pre- and post-intervention. Average time to organism identification decreased from 41 to 11 hours (P = <0.0001). Time to i) susceptibilities decreased from 50.8 to 37.7 hours (P = <0.0001), ii) de-escalation of antibiotics decreased from 58 to 23 hours (P = <0.0001), iii) discontinuation of unnecessary antibiotics decreased from 49 to 20 hours (P = <0.0001). Infection-related LOS decreased from 10.5 to 8.37 days (P = 0.006). No significant differences were seen for other outcomes. CONCLUSIONS MALDI-TOF MS identification of bacteria from blood culture broth improves time to appropriate antibiotic treatment for pediatric inpatients.
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Affiliation(s)
- Sejal Makvana Bhavsar
- Division of Pediatric Infectious Disease, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Tanis C Dingle
- Division of Clinical Microbiology, Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Camille L Hamula
- Division of Clinical Microbiology, Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Oydanich M, Dingle TC, Hamula CL, Ghisa C, Asbell P. Retrospective report of antimicrobial susceptibility observed in bacterial pathogens isolated from ocular samples at Mount Sinai Hospital, 2010 to 2015. Antimicrob Resist Infect Control 2017; 6:29. [PMID: 28344783 PMCID: PMC5360068 DOI: 10.1186/s13756-017-0185-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 02/22/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Antimicrobial resistance has emerged as a major threat to global public health. Thus, the surveillance of changes in antimicrobial resistance in local and global settings is a paramount necessity. While many studies have tracked antimicrobial resistance, only a small percentage surveyed ocular isolates. The purpose of this study was to report the in vitro susceptibility of bacterial pathogens isolated from ocular samples in New York, NY from 2010 to 2015. METHODS A retrospective review of ocular isolates was conducted. All organisms were collected by 25 separate inpatient wards and outpatient clinics, and were analyzed by the clinical microbiology laboratory at Mount Sinai Hospital. Clinical Laboratory and Standards Institute (CLSI) guidelines were followed for susceptibility testing and breakpoint interpretations. RESULTS A total of 549 bacterial organisms were isolated from 1664 cultures (33%) during the 6-year study period. Of these, 358 isolates (65.2%) underwent susceptibility testing. 182 (50.8%) isolates were Gram-positive. The most common Gram-positive bacterium was Staphylococcus aureus (62.1%). Methicillin-resistance decreased in S. aureus isolates (31.3% in 2010, 14.1% in 2015) but was without significant change (p = 0.25). When analyzing all S. aureus isolates recovered during the study period, there were significantly more methicillin-resistant S. aureus (MRSA) isolates resistant to fluoroquinolones (p <0.0001), erythromycin (p <0.0001), and trimethoprim/sulfamethoxazole (TMP/SMZ; p <0.05). Overall, Streptococcus pneumoniae isolates showed reduced susceptibility to erythromycin, but were otherwise susceptible to the other antimicrobials tested. Haemophilus influenzae (26.1%) and Pseudomonas aeruginosa (23.9%) were the most common Gram-negative bacteria isolated. Resistance to ampicillin and TMP/SMZ was observed in several of the H. influenzae isolates. P. aeruginosa isolates did not show high resistance overall, however, it was noted that isolates resistant to meropenem were also resistant to other antimicrobials (p < 0.01). CONCLUSION Overall, antimicrobial resistance was infrequent for the Gram-negative and Gram-positive bacteria analyzed. While the MRSA isolates demonstrated increased resistance to multiple antimicrobial classes, this is expected for this pathogen. Due to the continued use of broad-spectrum oral and systemic antimicrobials to treat ocular infections, findings of this study and other surveillance studies specific to ocular isolates should be used as resources in effective decision making in the treatment of ocular disease.
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Affiliation(s)
- Marko Oydanich
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Tanis C Dingle
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA
| | - Camille L Hamula
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA
| | - Claudia Ghisa
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Penny Asbell
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY USA
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Bhavsar SM, Hamula CL, Dingle TC. Report of two paediatric cases of central line infections caused by species of the genus Kocuria. JMM Case Rep 2016; 3:e005040. [PMID: 28348760 PMCID: PMC5330228 DOI: 10.1099/jmmcr.0.005040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 04/22/2016] [Indexed: 11/16/2022] Open
Abstract
Introduction: Species of the genus Kocuria are Gram-positive cocci of the family Micrococcacceae that are ubiquitous in the environment and part of the normal skin and oral flora in humans. A paucity of cases have been reported of Kocuria as human pathogens and there are currently no evidence-based guidelines for managing these uncommon infections. Case presentation: We present two paediatric cases of central line infections with species of the genus Kocuria that required line removal despite antimicrobial therapy. Conclusion: Species of the genus Kocuria are uncommon human pathogens that have rarely been reported to cause opportunistic infections in both adult and paediatric populations. The cases presented here add to the growing body of literature documenting the pathogenicity of these organisms and the possible need for line removal to achieve clinical cure in central line-associated bacteraemia caused by species of the genus Kocuria.
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Affiliation(s)
- Sejal Makvana Bhavsar
- Department of Pediatric Infectious Disease, Mount Sinai Hospital/Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place , New York, NY 10029 , USA
| | - Camille L Hamula
- Department of Pathology, Mount Sinai Hospital/Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place , New York, NY 10029 , USA
| | - Tanis C Dingle
- Department of Pathology, Mount Sinai Hospital/Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place , New York, NY 10029 , USA
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Hamula CL, Hughes K, Fisher BT, Zaoutis TE, Singh IR, Velegraki A. T2Candida Provides Rapid and Accurate Species Identification in Pediatric Cases of Candidemia. Am J Clin Pathol 2016; 145:858-61. [PMID: 27247378 DOI: 10.1093/ajcp/aqw063] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES The goal of this study is to assess the ability of the T2Candida platform (T2 Biosystems, Lexington, MA) to accurately identify Candida species from pediatric blood specimens with low volumes. METHODS Whole blood from 15 children with candidemia was collected immediately following blood culture draw. The amount of blood required by the system was reduced by pipetting whole blood directly onto the T2Candida cartridge. Specimens were subsequently run on the T2Dx Instrument (T2 Biosystems). RESULTS The T2Candida panel provided the appropriate result for each specimen compared with blood culture-based species identification and correctly identified 15 positive and nine negative results in 3 to 5 hours. While the time to species identification for blood culture was not reported, the T2Candida results include species data. CONCLUSIONS T2Candida can be used to efficiently diagnose or rule out candidemia using low-volume blood specimens from pediatric patients. This could result in improved time to appropriate antifungal therapy or reduction in unnecessary empirical antifungal therapy.
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Affiliation(s)
- Camille L Hamula
- From the Division of Clinical Microbiology, Department of Pathology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY
| | - Kenneth Hughes
- From the Division of Clinical Microbiology, Department of Pathology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY
| | - Brian T Fisher
- Division of Infectious Diseases, the Center for Pediatric Clinical Effectiveness, the Children's Hospital of Philadelphia, Pennsylvania, PA Department of Pediatrics; the Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Theoklis E Zaoutis
- Division of Infectious Diseases, the Center for Pediatric Clinical Effectiveness, the Children's Hospital of Philadelphia, Pennsylvania, PA Department of Pediatrics; the Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ila R Singh
- From the Division of Clinical Microbiology, Department of Pathology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY
| | - Aristea Velegraki
- Mycology Research Laboratory, Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Pyne MT, Hamula CL, Tardif K, Law C, Schlaberg R. High-risk HPV detection and genotyping by APTIMA HPV using cervical samples. J Virol Methods 2015; 221:95-9. [DOI: 10.1016/j.jviromet.2015.04.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 03/18/2015] [Accepted: 04/27/2015] [Indexed: 11/25/2022]
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