Bacillus cereus Panophthalmitis: Source of the Organism

Shamsuddin, Daliah; Tuazon, Carmelita U.; Levy, Charles S.; Curtin, James A.

doi:10.1093/clinids/4.1.97

Cited by 58 publications

(46 citation statements)

References 12 publications

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“…from 24%, coagulase-negative staphylococci from 17% and C. perfringens from 10% [22]. Similar results were obtained in the two other studies in the USA [23,25], in which no organisms were recovered from 39% and 69% of samples and bacteria (Bacillus spp. plus a small number of gram-positive cocci) and fungi (Aspergillus and Penicillium spp.)…”

Section: Discussionsupporting

confidence: 87%

“…Tuazon and colleagues [22] examined 100 samples of heroin collected in Washington during 1972, Shamsuddin et al [23] examined 49 samples again from Washington The methods used were direct plating together with adding heroin directly to thioglycolate [22], trypticase soy [23] or chopped meat glucose [25] broths and subculture on to solid selective media after incubation for 4-14 days. Antimicrobial activity of heroin was noted, especially against staphylococci [25,26].…”

Section: Discussionmentioning

confidence: 99%

“…This is despite the fact that the MRD procedure described here used five times more heroin from each sample than the citric acid method. None of the previous studies [22,23,25] used heating as a selective procedure, which also has the effect of heat-shocking (activating) bacterial endospores. The present study demonstrated the usefulness of this technique by the isolation of the small numbers of clostridia, although treatment to higher temperatures (70-808C) has been advocated by others for the isolation of this group of organisms [35].…”

Section: Discussionmentioning

confidence: 99%

“…However, these studies did identify contamination of heroin by B. cereus, C. perfringens and S. aureus, all of which were isolated from clinical samples collected from infected IDUs during the 2000 outbreak [16,17]. B. cereus endocarditis and ophthalmitis from contaminated heroin or injection paraphernalia have been reported elsewhere [23,36]. Staphylococcal endocarditis is a well recognised complication of injecting drug use [37].…”

Section: Discussionmentioning

confidence: 99%

“…Because of the possibility that heroin was the source of infection, especially with C. novyi, investigations were established to develop methods for the analysis of the microbial flora of heroin. There are relatively few data on the microflora of heroin [22][23][24][25] and none available for drugs seized in the UK. During drug injection, heroin is solubilised in acidic solutions.…”

Section: Introductionmentioning

confidence: 99%

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An investigation into the microflora of heroin

McLauchlin¹,

Mithani²,

Bolton³

et al. 2002

Journal of Medical Microbiology

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In 2000, an unusual increase of morbidity and mortality among illegal injecting drug users in the UK and Ireland was reported and Clostridium novyi was identified as the likely source of the serious infection, although infections due to C. botulinum and Bacillus cereus were also reported. Because heroin was a possibile source of infection, this study investigated the microflora of heroin samples seized in England during 2000 and 2002. Two methods were developed for the examination of the microflora of heroin. The first consisted of suspension of the drug in maximum recovery diluent (MRD) which was inoculated directly into Clostridium Botulinum Isolation Cooked Meat Broth (CBI). The second method rendered the heroin soluble in citric acid, concentrated particulate material (and bacterial cells) by filtration and removed heroin residues by washing with citric acid and phosphate-buffered saline before placing the filter in CBI broth. Duplicate CBI broths from both methods were incubated without heating and after heating at 608C for 30 min. Subcultures were made after incubation for 7 and 14 days on to eight different solid media. The methods were evaluated with heroin samples spiked with either C. botulinum or C. novyi spore suspensions; recovery of 10 spores in the original sample was demonstrated. Fifty-eight heroin samples were tested by citric acid solubilisation and 34 by the MRD suspension technique. Fifteen different grampositive species of four genera were recognised. No fungi were isolated. Aerobic endospore-forming bacteria (Bacillus spp. and Paenibacillus macerans) were the predominant microflora isolated and at least one species was isolated from each sample. B. cereus was the most common species and was isolated from 95% of all samples, with B. licheniformis isolated from 40%. Between one and five samples yielded cultures of B. coagulans, B. laterosporus, B. pumilus, B. subtilis and P. macerans. Staphylococcus spp. were isolated from 23 (40%) samples; S. warneri and S. epidermidis were the most common and were cultured from 13 (22%) and 6 (10%) samples respectively. One or two samples yielded cultures of S. aureus, S. capitis and S. haemolyticus. The remainder of the flora detected comprised two samples contaminated with C. perfringens and two samples with either C. sordellii or C. tertium. Multiple bacterial species were isolated from 43 (74%) samples, a single species from the remaining 15. In 13 samples B. cereus alone was isolated, in one B. subtilis alone and in one sample B. pumilus alone. C. botulinum and C. novyi were not isolated from any of the heroin samples. Recommendations for the optimal examination of the microflora of heroin are given.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An investigation into the microflora of heroin

McLauchlin¹,

Mithani²,

Bolton³

et al. 2002

Journal of Medical Microbiology

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Vision Loss Associated With the Opioid Epidemic

et al. 2017

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most commonly selected preferred treatment, many respondents indicated that more evidence was needed to guide treatment choices. 4 The MUTT I result was driven primarily by ulcers caused by Fusarium, which had the worst response to voriconazole. 1 After the results of MUTT I and 2 subsequent trials, 2,3 only a few experts indicated that they would prefer to treat Fusarium keratitis with voriconazole. Limitations of this study include that respondents self-reported practice patterns and it was not possible to validate the survey against actual practice patterns. Respondents may have underreported voriconazole use because of social desirability bias. The decrease in preference for voriconazole over time may indicate that randomized clinical trials led to changes in practice patterns and integration of evidence-based practices into the treatment of fungal keratitis.

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The Genus Bacillus—Medical

Farrar¹,

Reboli²

2006

The Prokaryotes

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Bacillus cereus Panophthalmitis: Source of the Organism

Cited by 58 publications

References 12 publications

An investigation into the microflora of heroin

An investigation into the microflora of heroin

Vision Loss Associated With the Opioid Epidemic

The Genus Bacillus—Medical

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