A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiologya

Miller, J. M.; Binnicker, Matthew J.; Campbell, Sheldon; Carroll, Karen C.; Chapin, Kimberle; Gilligan, Peter H.; Gonzalez, Mark D.; Jerris, Robert C.; Kehl, Sue C.; Patel, Robin; Pritt, Bobbi S.; Richter, Sandra; Robinson-Dunn, Barbara; Schwartzman, Joseph D.; Snyder, James W.; Telford, Sam R.; Theel, Elitza S.; Thomson, Richard B.; Weinstein, Melvin P.; Yao, Joseph D.

doi:10.1093/cid/ciy584

Cited by 275 publications

(173 citation statements)

References 268 publications

(259 reference statements)

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“…Guidelines for diagnosis of pneumonia by other groups can also be informative though do not always specifically apply to the SOT recipient. [75][76][77][78] A tiered approach to the diagnostic evaluation of pneumonia encompasses an initial approach, followed by a more extensive evaluation if the diagnosis remains unclear or if the patient is deteriorating. If the clinical situation is critical or if a more specific diagnosis is initially suspected, respective tests are applied and the order of diagnostic tests modified.…”

Section: Iag Nos Ti C Te S Tingmentioning

confidence: 99%

Pneumonia in solid organ transplantation: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice

Dulek

Mueller

2019

Clinical Transplantation

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Pneumonia is a frequent infectious complication of solid organ transplantation (SOT). The occurrence of post-transplant pneumonia adversely impacts both graft and recipient survival, as well as the cost of care for SOT recipients. 1 Numerous micro-organisms can cause pneumonia in the SOT recipient with some etiologies resulting in self-limited infection and others causing significant morbidity and mortality. As a result of the varied clinical presentations and etiologies of pneumonia in SOT recipients, arriving at a specific microbiologic diagnosis can be challenging but is important for optimal care, especially with complicated or refractory pneumonias. In this section, the clinical presentation, differential diagnosis, diagnostic testing, and empiric antimicrobial treatment of pneumonia in SOT recipients are reviewed. Pathogen-specific sections within the AST ID Guidelines are referenced for further information regarding the diagnosis and treatment of specific pathogens that cause pneumonia in this vulnerable population. AbstractThese guidelines from the AST Infectious Diseases Community of Practice review the diagnosis and management of pneumonia in the post-transplant period. Clinical presentations and differential diagnosis for pneumonia in the solid organ transplant recipient are reviewed. A two-tier approach is proposed based on the net state of immunosuppression and the severity of presentation. With a lower risk of opportunistic, hospital-acquired, or exposure-specific pathogens and a non-severe presentation, empirical therapy may be initiated under close clinical observation. In all other patients, or those not responding to the initial therapy, a more aggressive diagnostic approach including sampling of tissue for microbiological and pathological testing is warranted. Given the broad range of potential pathogens, a microbiological diagnosis is often key for optimal care. Given the limited literature comparatively evaluating diagnostic approaches to pneumonia in the solid organ transplant recipient, much of the proposed diagnostic algorithm reflects clinical experience rather than evidencebased data. It should serve as a template which may be modified according to local needs. The same holds true for the suggested empiric therapies, which need to be adapted to the local resistance patterns. Further study is needed to comparatively evaluate diagnostic and empiric treatment strategies in SOT recipients. K E Y W O R D Sdiagnosis, pneumonia, transplantation

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Section: Iag Nos Ti C Te S Tingmentioning

confidence: 99%

Pneumonia in solid organ transplantation: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice

Dulek

Mueller

2019

Clinical Transplantation

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“…Furthermore, by implementing electric field assisted binding of bacteria, the detection speed decreased to 5 minutes from 45 minutes, and the detection limit reduced by 3 orders of magnitude down to 10 4 cells/ml, which is the threshold at which urinary tract infections 43,44 or bronchoalveolar lavage fluid are indicated to be disease causing. 45,46 Further reduction in detection limit below 10 3 cells/ml to meet point of care and clinical requirements 47 is desired and could be obtained by optimizing the device design, PDMS well size as well as the electric field application process. Though, increasing the device size could increase the attachment of bacteria at lower concentrations, it may also reduce the sensitivity of the devices due to non-uniformity (e.g.…”

Section: Resultsmentioning

confidence: 99%

Dielectrophoresis assisted rapid, selective and single cell detection of antibiotic resistant bacteria with G-FETs

Kumar

Wang

Ortiz‐Marquez

et al. 2019

Preprint

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Time-consuming, expensive and low sensitivity diagnostic methods used for monitoring bacterial infections lead to unnecessary or delays in prescription of the right antibiotic treatment.Determining an optimal clinical treatment requires rapid detection and identification of pathogenic bacteria and their sensitivity to specific antimicrobials. However, diagnostic devices that meet all of these criteria have proven elusive thus far. Graphene field effect transistors (G-FET) are a promising solution, since they are highly sensitive to chemical/biological modification, can have fast detection times and can be placed on different substrates. Here, by integrating specific peptide probes over G-FETs, we present a proof-of-concept study for species and strain specific label-free detection of clinical strains of pathogenic bacteria with high specificity and sensitivity. We found that pyrene-conjugated peptides immobilized on G-FETs were capable of detecting pathogenic Staphylococcus aureus at the single-cell level and discriminate against other gram-positive and gram-negative bacterial pathogens. A similar device was able to discriminate between antibiotic resistant and sensitive strains of Acinetobacter baumannii, suggesting that these devices can also be used for detecting antibiotic resistive pathogens. Furthermore, a new means of enhancing attachment, electric-field assisted binding, reduced the detection limit to 10 4 cells/ml and the detection time to below 5 minutes. The combination of single step attachment, inexpensive production, rapid, selective and sensitive detection suggest G-FETs plus pyrene-conjugated peptides are a new platform for solving major challenges faced in point of care diagnostics to fight infectious diseases and antimicrobial resistance.Bacterial infections cause a wide range of diseases and significant mortality 1 . While antibiotics are key in controlling disease severity and reducing mortality, their over prescription and misuse are some of the most important factors in the surge of antibiotic resistant cases around the world. [2][3][4] In order to solve this crisis, diagnostic methods are needed that can rapidly and accurately identify the bacterium causing the infection and determine its associated antibiotic resistance profile. Antibiotic susceptibility testing (AST) is mostly carried out by phenotypic methods that require prior identification of bacterial pathogens from patients (at the species and/or strain level) and incubation under antibiotic conditions, 5, 6 a lengthy process that can take up to 24 hours to a month depending on the species. 7 Moreover, both species/strain identification and AST require trained specialists, specific laboratory environments and often expensive instrumentation. 5, 6, 8 Since these conditions limit widespread application and implementation into actual treatment strategies at most points of care, there is much room for improvement to develop new diagnostic devices that have the potential for adoption across a large variety of use cases. Ideally these dev...

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“…The recommended blood volume of blood sampled for blood culture at different ages are, for newborns 0.5-1ml, for infants1-2ml, for 1-12 years 2-5ml and >13years 10 to 20ml. 22 In study by Hanan Ramzy Ahmed Atalla And Warda Mohamed Henedy, regarding effectiveness of structured teaching program on knowledge and practice regarding blood specimen collection among nurses, revealed that obvious improvement in parameters of strategies after blood collection to avoid complications (57.4%) followed by safety aspects during blood collection parameter (46.5%) and there is little improvement in measures to improve prominence of vein parameter (45.1%) and inspection of vein parameter (30%). 23 Thus 18(60%) participants accepted that they have collected blood culture not maintaining complete asepsis at some time in past.…”

Section: Discussionmentioning

confidence: 99%

Knowledge and practice among the pediatric post graduate residents regarding the technique of blood culture sampling

2019

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Background: Errors in sampling during blood culture, may lead to contaminants or poor yield which result in faulty reports increasing patient's suffering, endanger patient safety and increasing cost of health care. Optimal knowledge about the sampling method for important microbiological test like blood culture translates into appropriate practices. Authors objectives was to assess the knowledge and practice of the Pediatric resident doctors, regarding sterile technique during blood culture collection. The change in the knowledge of the residents during blood culture sampling with regards to maintaining asepsis after watching educational video was evaluated. Methods: A quasi experimental, questionnaire based study with pre-post intervention, involved post graduate resident's knowledge and practice regarding the sterile technique during blood culture collection. The data analyzed using paired t test and Chi-square Test. Results: 18(60%) participants accepted that they have collected blood culture not maintaining complete asepsis at some time in past. The reasons for the same were lack of knowledge 14 (46.66%), no assistance from staff for the procedure 14 (46.66%), non-availability of sterile gloves 4 (13.33%), non-availability of antiseptic solution 4(13.33%), time consuming 8 (26.66%). Conclusions: Ultimately, blood culture contamination is a complex, challenging problem that requires a multidisciplinary approach. Regular teaching modules for the health personnel and ensuring environment conducive to correct practises would definitely help in improving the sampling practises for aseptic procedures.

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A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiologya

Cited by 275 publications

References 268 publications

Pneumonia in solid organ transplantation: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice

Pneumonia in solid organ transplantation: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice

Dielectrophoresis assisted rapid, selective and single cell detection of antibiotic resistant bacteria with G-FETs

Knowledge and practice among the pediatric post graduate residents regarding the technique of blood culture sampling

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