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Lillis RA, Parker RL, Ackerman R, Ackerman J, Young S, Weissfeld A, Trevino E, Nachamkin I, Crane L, Brown J, Huang C, Liu X, Van Der Pol B. Clinical Evaluation of a New Molecular Test for the Detection of Organisms Causing Vaginitis and Vaginosis. J Clin Microbiol 2023; 61:e0174822. [PMID: 36853028 PMCID: PMC10035313 DOI: 10.1128/jcm.01748-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
In this prospective, observational, method comparison clinical study, the Xpert Xpress MVP test (MVP) was evaluated using both clinician-collected (CVS) and self-collected vaginal swabs (SVS) collected in a clinical setting. The study was conducted at 12 sites, including point-of-care (POC) settings, from geographically diverse locations in the United States. Participants were biologically female patients ≥ 14 years old with signs and/or symptoms of vaginitis/vaginosis. MVP test results for BV were compared to the BD MAX Vaginal Panel (BDVP). Results for Candida group and Candida glabrata and Candida krusei targets (species not differentiated) were assessed relative to yeast culture followed by mass spectrometry for species identification. Trichomonas vaginalis (TV) results were compared relative to a composite method that included results from the BDVP and InPouch TV culture. The investigational test demonstrated high positive percent agreement ranging from 93.6 to 99.0%, and negative percent agreement ranging from 92.1% to 99.8% for both CVS and SVS specimens, indicating it may be a valuable tool for the diagnosis of vaginitis/vaginosis in laboratory and POC settings.
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Affiliation(s)
- Rebecca A Lillis
- Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - R Lamar Parker
- Unified Women's Clinical Research, Raleigh, North Carolina, USA
| | - Ronald Ackerman
- Comprehensive Clinical Research, West Palm Beach, Florida, USA
| | - Jamie Ackerman
- Comprehensive Clinical Research, West Palm Beach, Florida, USA
| | - Stephen Young
- TriCore Reference Laboratories, University of New Mexico HSC, Albuquerque, New Mexico
| | | | | | - Irving Nachamkin
- Perlman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | | | | | - Barbara Van Der Pol
- Heersink School of Medicine, University of Alabama Birmingham, Birmingham, Alabama, USA
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Janku F, Zhang HH, Pezeshki A, Goel S, Murthy R, Wang-Gillam A, Shepard DR, Helgason T, Masters T, Hong DS, Piha-Paul SA, Karp DD, Klang M, Huang SY, Sakamuri D, Raina A, Torrisi J, Solomon SB, Weissfeld A, Trevino E, DeCrescenzo G, Collins A, Miller M, Salstrom JL, Korn RL, Zhang L, Saha S, Leontovich AA, Tung D, Kreider B, Varterasian M, Khazaie K, Gounder MM. Intratumoral Injection of Clostridium novyi-NT Spores in Patients with Treatment-refractory Advanced Solid Tumors. Clin Cancer Res 2020; 27:96-106. [PMID: 33046513 DOI: 10.1158/1078-0432.ccr-20-2065] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/24/2020] [Accepted: 10/07/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Intratumorally injected Clostridium novyi-NT (nontoxic; lacking the alpha toxin), an attenuated strain of C. novyi, replicates within hypoxic tumor regions resulting in tumor-confined cell lysis and inflammatory response in animals, which warrants clinical investigation. PATIENTS AND METHODS This first-in-human study (NCT01924689) enrolled patients with injectable, treatment-refractory solid tumors to receive a single intratumoral injection of C. novyi-NT across 6 dose cohorts (1 × 104 to 3 × 106 spores, 3+3 dose-escalation design) to determine dose-limiting toxicities (DLT), and the maximum tolerated dose. RESULTS Among 24 patients, a single intratumoral injection of C. novyi-NT led to bacterial spores germination and the resultant lysis of injected tumor masses in 10 patients (42%) across all doses. The cohort 5 dose (1 × 106 spores) was defined as the maximum tolerated dose; DLTs were grade 4 sepsis (n = 2) and grade 4 gas gangrene (n = 1), all occurring in three patients with injected tumors >8 cm. Other treatment-related grade ≥3 toxicities included pathologic fracture (n = 1), limb abscess (n = 1), soft-tissue infection (n = 1), respiratory insufficiency (n = 1), and rash (n = 1), which occurred across four patients. Of 22 evaluable patients, nine (41%) had a decrease in size of the injected tumor and 19 (86%) had stable disease as the best overall response in injected and noninjected lesions combined. C. novyi-NT injection elicited a transient systemic cytokine response and enhanced systemic tumor-specific T-cell responses. CONCLUSIONS Single intratumoral injection of C. novyi-NT is feasible. Toxicities can be significant but manageable. Signals of antitumor activity and the host immune response support additional studies of C. novyi-NT in humans.
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Affiliation(s)
- Filip Janku
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, Texas.
| | | | | | - Sanjay Goel
- Montefiore/Albert Einstein Cancer Center, Bronx, New York
| | - Ravi Murthy
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | | | - Thorunn Helgason
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Tyler Masters
- Early Drug Development Service, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, New York, New York
| | - David S Hong
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sarina A Piha-Paul
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Daniel D Karp
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mark Klang
- Early Drug Development Service, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, New York, New York
| | - Steven Y Huang
- Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Divya Sakamuri
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Anjali Raina
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jean Torrisi
- Early Drug Development Service, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, New York, New York
| | - Stephen B Solomon
- Early Drug Development Service, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, New York, New York
| | | | | | | | | | - Maria Miller
- BioMed Valley Discoveries Inc., Kansas City, Missouri
| | | | | | - Linping Zhang
- BioMed Valley Discoveries Inc., Kansas City, Missouri
| | - Saurabh Saha
- BioMed Valley Discoveries Inc., Kansas City, Missouri.,Atlas Venture, Boston, Massachusetts
| | | | - David Tung
- BioMed Valley Discoveries Inc., Kansas City, Missouri
| | - Brent Kreider
- BioMed Valley Discoveries Inc., Kansas City, Missouri
| | | | | | - Mrinal M Gounder
- Early Drug Development Service, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, New York, New York.
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Nichols K, Trevino E, Ikeda N, Philo D, Garcia A, Bowman D. Interdependency amongst earthquake magnitudes in Southern California. J Appl Stat 2018. [DOI: 10.1080/02664763.2017.1313965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- K. Nichols
- Department of Mathematics, California State University, Fullerton, CA, USA
| | - E. Trevino
- Department of Mathematics, California State University, Fullerton, CA, USA
| | - N. Ikeda
- Division of Mathematics and Computer Science, Fullerton College, CA, USA
| | - D. Philo
- Department of Geology, California State University, Fullerton, CA, USA
| | - A. Garcia
- Department of Physics, California State University, Fullerton, CA, USA
| | - D. Bowman
- Department of Geology, California State University, Fullerton, CA, USA
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Abstract
In July 1976, the American Legion held a conference at the Bellevue Stratford Hotel in Philadelphia, PA, to celebrate the nation's bicentennial. This convention resulted in transmission of a gram-negative bacterium to over 200 attendees, who developed a respiratory illness; 34 deaths were attributed to the infections. An investigation of the illness revealed a bacterium that had not been documented before. The disease became known as Legionnaires' disease, and the etiological agent was subsequently named Legionella pneumophila. This is the story of Legionella, with special emphasis on its ecological niche, the diagnosis of human infection, and its isolation from the environment. There are only a handful of diseases that debuted in the 20th or 21st century. They include Legionnaires' disease (the subject of this review), Lyme disease, AIDS, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and West Nile virus.
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Affiliation(s)
- Paula H Vance
- Microbiology Specialists Incorporated, Houston, Texas
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Abstract
Case report on a premature male infant, born in the 34th week of pregnancy with bronchopulmonary dysplasia, bronchitis, hepatitis, marked cortical and subcortical atrophy of the brain with enlargement of the inner and outer subarachnoid space, with severe cerebral motility disorders and convulsions. Blood serology showed rapidly increasing cytomegaly titers, which were also elevated in the serum of the mother. The ophthalmological examination revealed a hypoplastic, white papilla in both eyes. Neither retinal arteries nor veins were seen. The macula and retinal periphery were normal. There were no signs of acute or passed retinochorioiditis. Temporary opacification of the cornea was observed. In connection with the pediatric findings the authors interpret the aplasia of the retinal vessels and the hypoplasia of the optic nerve as a result of a cytomegaly infection prior to the 4th month of pregnancy, which prevented normal development of the vessels. The temporary opacity of the cornea could be a reaction of the corneal endothelium against the virus.
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