Paired nasal swab specimens were collected from patients who were undergoing routine methicillin-resistant Staphylococcus aureus (MRSA) screening prior to elective cardiac or orthopedic procedures. Each patient was swabbed using a traditional wound fiber liquid Stuart swab and an ESwab device, a flocked swab with a modified liquid Amies microbiology transport medium. The two specimens were tested using the Cepheid Xpert SA Nasal Complete assay. Results demonstrated a 95.5% agreement between the ESwab and the FDA-cleared wound fiber swab collection device.

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IN continuation of our earlier investigations on Clostridium welchiitoxin (Walbum and Reymann, 1933) and on Vibrion septique toxin (Walbum and Reymann, 1936) we report below our investigation concerning the toxin of Cl. edematiens. The technique adopted was similar to that described in our previous communications. Weinberg and SBguin (1915) were the first to show the production of a specific, thermo-labile toxin in cultures of Cl. odematiens. They used 0.2 per cent. glucose broth with an incubation period of 1 t o 6 days a t 37" C.The same year Sacquhphe (1915) recorded similar observations. These first toxins were, however, fairly weak since the minimal Iethal dose for guineapigs was between 0.25 and 2 C.C.Later Weinberg and SBguin (1917) succeeded in preparing toxins which were considerably stronger (m.1.d. for a guinea-pig about 0.01 c.c.), and in the course of time reports from other quarters on more successful experiments were received. According to a report of the Medical Research Committee (1919, p. 105) stronger toxin could be obtained in a glucose broth (0.2 glucose and 1 per cent. peptone) to which large quantities of sterile rabbit muscle had been added ; similarly, by using boiled meat in place of sterile rabbit muscle excellent results were obtained (m.Z.d. for mice about 0.0001 c.c.). Sordelli, Ferrari and Meyer (1928) also used broth containing meat a t the bottom of the incubation vessel, but they recommend an addition of 5 per cent. gelatin in order to stimulate toxin production. Kawamura (1931) considered liver-broth to be the most suitable medium, and Celarek and Stetkiewicz (1936) confirm the earlier observation that ordinary byoth containing cooked meat a t the bottom (pH = 7.6) and with its surface covered by a layer of liquid paraffin constitutes an excellent medium for the production of the toxin. Barg (1933) obtained the strongest toxin by using fermented broth and by strictly anaerobic conditions of growth.it can be entirely destroyed by heating to 50" C. for 30 minutes, and by precipitation with alcohol or ammonium sulphate ; it is also highly sensitive to acids. (Edematiems toxin is highly labile;The production of toxin under varying conditions. Cl. edematiens is generally considered to be the most exacting of the gas-gangrene bacteria its regards anaerobic conditions. Nevertheless, it grows as a rule luxuriantly in the ordinary " meat broth " covered with liquid paraffin, when the medium has been 378

The iC-GPC assay (iCubate, Huntsville, AL) provides a molecular option for the rapid, on-demand analysis of positive blood cultures. A preliminary evaluation of the iC-GPC assay using 203 clinical or seeded specimens demonstrated a sensitivity of 93.8% to 100% and a specificity of 98.0% to 100% for the identification of five Gram-positive bacterial species (Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Enterococcus faecalis, and Enterococcus faecium) and three associated genetic resistance determinants (mecA, vanA, and vanB) in positive blood culture broths.T he rapid identification of bacterial and fungal pathogens in positive blood culture broths by use of a variety of methods has been described. These methods include peptide nucleic acid fluorescence in situ hybridization (PNA-FISH), matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), and real-time PCR (RT-PCR) or microarray-based molecular tests (1-10). The ability to reliably identify a specific bacterium or yeast present in a positive blood culture within 1 to 3 h of culture positivity using these methods has resulted in significant reductions in time to effective antimicrobial therapy, length of hospital/intensive care unit (ICU) stay, 30-day mortality, and cost of care (6,7,(11)(12)(13). Importantly, while organism identification alone can provide some benefit, the most significant benefits are achieved when the presence of resistance markers, such as mecA, vanA, or carbapenemases, is identified concomitantly (11,12,(14)(15)(16).The research-use-only (RUO) iC-GPC assay (iCubate, Huntsville, AL) is a molecular target amplification assay capable of detecting and identifying Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Enterococcus faecalis, and Enterococcus faecium as well as the genetic resistance determinants mecA, vanA, and vanB directly from positive blood culture broths. The system consists of an automated processor (iC-Processor), a reader (iC-Reader), and single-use, closed-system test cassettes. Each test cassette contains all reagents necessary for cell lysis, nucleic acid extraction, target amplification, and amplicon hybridization to an array of immobilized capture probes. Each immobilized capture probe has a unique nucleic acid sequence, which can hybridize to the target. A second fluorescence-labeled gene-specific detection probe contained within the closed cassette was used to detect the target after capture.(A portion of the data collected in this study was presented at the 115th General Meeting of the American Society for Microbiology, New Orleans, LA, 30 May to 2 June 2015.)We conducted a preliminary evaluation of the iC-GPC assay using a total of 215 positive blood culture broths containing Gram-positive cocci (GPC). Positive broths were enrolled and tested at three clinical laboratories. The cohort included 107 prospectively collected blood cultures and was augmented with 108 simulated blood cultures seeded with organisms less frequent...

IN continuation of a series of papers published during the last few years on conditions which influence the production of gas-gangrene toxins (Walbum and Reymann, 1933, 1934, 1936, 1937 and 1938 we communicate below the result of our investigations into toxin production in cultures of Bacillus sordellii. The present report concludes-at least for the time being--our communications on this subject. The technique of the experiments was on the whole very similar to that outlined in previous papers. Sordelli (1922) was the first to show the production of specific thermolabile toxin in cultures of those organisms which he had described as B. cedemtis sporogenes and which Hall and Scott (1927) renamed B. sordellii. The medium used by Sordelli was ordinary broth with the addition of 2 per cent. Park Davis peptone ( p H 8.0) ; the incubation period was 2-6 days. Sordelli states that the toxin of this organism is a typical exotoxin which is not neutralised by the other gas-gangrene sera. This author was the &st to produce a specific antitoxin by irnmunising horses. Weinberg, Davesne and Lefranc (1931) isolated two French strains with similar characteristics. Hall and Scott showed that B. sordellii grows at p H 5-5-8-0, that it ferments glucose, lavulose and maltose, and that the lesions in animals strongly resemble those caused by B. nowyi (Cl. cedematiens). Meleney, Humphreys and Carp (1926-27) showed that toxin production is satisfactory both in plain broth and in cooked meat medium to which 0.2 per cent. glucose has been added, and furthermore that the culture filtrates possess slightly proteolytic properties. Humphreys and Meleney (1927-28) obtained the best results with cooked meat broth to which 1 per cent. Witte peptone and 0.2 per cent. glucose had been added, and by incubating for 40 hours at 37" C. Hall, Rymer and Jungherr (1929) reported that no rapidly lethal toxin is formed in the cultures, although very large doses, injected intravenously, kill mice within 4-5 hours. These authors corroborate the statement by Meleney, Humphreys and Carp that the toxin weakens rapidly a t ordinary temperatures but more slowly in the cold room. At 56" C. it is totally destroyed within one hour. For immunisation 0.3 per cent. tricresol was added and the toxin kept a t 3" C.Production of toxin under varying conditions. B. sordellii is not exacting in its anaerobic demands. It grows luxuriantly in ordinary peptone broth, with or without meat a t the bottom of the culture, boiled in the customary manner and 185