BACKGROUND: Procedures for rapid identification and susceptibility testing by direct inoculation (DI) from positive blood culture bottles into an automated system have not been standardized. This study was purposed to evaluate DI from BACTEC 9240 blood culture system (BD, USA) into MicroScan (Dade Behring, USA) or Phoenix (BD, USA). METHODS: From May to June 2006, bacterial pellets from positive aerobic bottles showing gram-positive cocci (GPC) or gram-negative rods (GNR) of single morphology were directly inoculated to MicroScan PosCombo1A and NegCombo32 and to Phoenix PMIC/ID-107 and NMIC/ID-53. In addition, the automated instruments were also inoculated from subcultures (standard inoculations, SI). Species identification and susceptibilities were compared between DI and SI and between MicroScan and Phoenix. RESULTS: A total of 108, 104, and 78 specimens were tested with MicroScan, Phoenix, and both, respectively. When DI and SI were matched, 94.8% of GPC were correctly identified with MicroScan, compared to 80.7% with Phoenix, and 93.9% of GNR were correctly identified with MicroScan, compared to 95.7% with Phoenix. DI with MicroScan and Phoenix showed correct susceptibilities in 94.6% of 1,150 and 96.5% of 660 tests (with very major error [VME] of 1.1% and 1.1%), respectively, among GPC and in 94.4% of 942 and 96.3% of 781 tests (with VME of 0.6% and 0%), respectively, of GNR. Correlation of identification/susceptibilities between MicroScan and Phoenix using DI were 81.8%/98.0% for Staphylococcus aureus and 100.0%/95.6% for Escherichia coli. CONCLUSIONS: DI warrants a reliable method for identification and susceptibility testing of both GPC and GNR in MicroScan, and those of only GNR in Phoenix.
Automation ; Bacterial Typing Techniques/instrumentation/*methods ; Culture Media ; Gram-Negative Bacteria/*classification/drug effects/isolation & purification ; Gram-Negative Bacterial Infections/blood/*microbiology ; Gram-Positive Bacterial Infections/blood/*microbiology ; Gram-Positive Cocci/*classification/drug effects/isolation & purification ; Humans ; Microbial Sensitivity Tests/instrumentation/*methods ; Reagent Kits, Diagnostic ; Sensitivity and Specificity

OBJECTIVETo observe the differences in the cytokine levels in the serum and ascites caused by Gram-positive or Gram-negative bacterial infection in patients with multiple organ dysfunction syndrome (MODS).

METHODSThe cytokines in the serum and ascites of the patients were examined by enzyme-linked immunosorbent assay in 27 patients with MODS due to Gram-positive (n=13) or Gram-negative (n=14) bacterial infection at day 1.

RESULTSThe levels of LPS and TNF-a were higher in the patients with Gram-negative bacterial infection than in patients with Gram-positive infection (P<0.05), but the levels of IL-6, IL-8 and IL-10 remained comparable between the two groups (P>0.05).

CONCLUSIONTesting of LPS and TNF-a in the serum and ascites of patients with MODS caused by Gram-positive or -negative bacterial infection may help to identify the pathogens for peritonitis resulting in MODS.

Ascites ; metabolism ; Gram-Negative Bacterial Infections ; blood ; metabolism ; Gram-Positive Bacterial Infections ; blood ; metabolism ; Humans ; Interleukin-10 ; blood ; metabolism ; Interleukin-6 ; blood ; metabolism ; Interleukin-8 ; blood ; metabolism ; Multiple Organ Failure ; blood ; metabolism ; microbiology ; Serum ; metabolism ; Tumor Necrosis Factor-alpha ; blood ; metabolism

No abstract available.
Base Sequence ; Carnobacteriaceae/genetics/*isolation & purification ; Databases, Genetic ; Gram-Positive Bacterial Infections/blood/*microbiology ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; RNA, Ribosomal, 16S/chemistry/genetics ; Sequence Analysis, RNA

Although cervical epidural abscess is rare, it should be strongly suspected in any patient with unexplainable neck pain and fever, especially when the patient has a predisposing factor for this infectious process. The authors report a case of cervical epidural abscess in a 39-yr-old man with an aorto-duodenal fistula, which complicated the interposition of artificial graft for abdominal aortic aneurysm rupture, which had undertaken 40 months before. Timely detection and intervention rendered him a full neurological recovery. This extremely rare case is presented with a literature review.
Adult ; Aneurysm, Dissecting/complications ; Aneurysm, Dissecting/surgery ; Aortic Aneurysm, Abdominal/complications ; Aortic Aneurysm, Abdominal/surgery ; Aortic Diseases/complications* ; Aortic Rupture/complications ; Aortic Rupture/surgery ; Blood Vessel Prosthesis Implantation ; Cervical Vertebrae* ; Duodenal Diseases/complications* ; Duodenal Ulcer/complications ; Enterococcus ; Epidural Abscess/etiology* ; Epidural Abscess/microbiology ; Epidural Abscess/surgery ; Fistula/complications* ; Gram-Positive Bacterial Infections/complications ; Human ; Male ; Peptic Ulcer Perforation/complications ; Salmonella Infections/complications ; Staphylococcal Infections/complications