Streptococcus pneumoniaeSerotype 4 Outbreak in a Home for the Aged: Report and Review of Recent Outbreaks

2000 ◽  
Vol 21 (11) ◽  
pp. 711-717 ◽  
Author(s):  
Sheldon Gleich ◽  
Yosef Morad ◽  
Ramon Echague ◽  
James R. Miller ◽  
John Kornblum ◽  
...  
Keyword(s):  
Gel Electrophoresis ◽  
Pneumococcal Disease ◽  
Serum Antibody ◽  
The United States ◽  
Latex Agglutination ◽  
Pulsed Field Gel Electrophoresis ◽  
Elderly Persons ◽  
Term Care ◽  
Pulsed Field

AbstractObjective:To describe a pneumonia outbreak caused byStreptococcus pneumoniaeamong residents of a home for the aged and to review contemporary pneumococcal outbreaks.Design:Epidemiological investigation.Methods:Spneumoniaeisolates were serotyped and analyzed by pulsed-field gel electrophoresis. Paired sera were tested for antibodies to pneumococcal surface adhesin A protein (PsaA, a 37-kDa cell-wall protein). Pneumococcal outbreaks reported in the last decade in English were reviewed.Results:Pneumonia developed in 18 of 200 residents. In 11 (61%), a pneumococcal etiology was demonstrated.S pneumoniae,serotype 4, was isolated from the blood cultures of 3 patients; all isolates were indistinguishable by pulsed-field gel electrophoresis. Pneumococcal involvement was established in 2 by sputum culture and latex agglutination of parapneumonic fluid and in 6 others by a twofold rise in optical density of serum antibody reactive to PsaA. Pneumococcal immunization had not previously been received by any patient; mortality was 22%. No additional cases were noted following administration of pneumococcal vaccine and antibiotic prophylaxis with penicillin or erythromycin. Twenty-six outbreaks of invasive pneumococcal disease since 1990 were reviewed. Twelve occurred in the United States, and serotypes 23F, 14, and 4 accounted for 8 (67%) of 12 outbreaks. All confirmed serotypes in US outbreaks are included in the 23-valent vaccine. More than one half of pneumococcal outbreaks worldwide involved elderly persons in hospitals or long-term-care facilities.Conclusions:A pneumococcal pneumonia outbreak occurred among unvaccinated residents of a residential facility for the aged. Institutionalized elderly persons are at risk of outbreaks of pneumococcal disease and should be vaccinated.

scholarly journals Genetic Analysis of Multiple Vancomycin-ResistantEnterococcus Isolates Obtained Serially from Two Long-Term-Care Patients

1998 ◽  
Vol 36 (7) ◽  
pp. 2105-2108 ◽  
Author(s):  
Dianna J. Schoonmaker ◽  
Lawrence H. Bopp ◽  
Aldona L. Baltch ◽  
Raymond P. Smith ◽  
Mary Ellen Rafferty ◽  
...  
Keyword(s):  
High Risk ◽  
Genetic Analysis ◽  
Gel Electrophoresis ◽  
Long Term Care ◽  
Pulsed Field Gel Electrophoresis ◽  
Risk Of Infection ◽  
Term Care ◽  
Pulsed Field ◽  
Vancomycin Resistant

Fifty-eight vancomycin-resistant enterococcal isolates were obtained from two patients over 9 weeks. Numerous pulsed-field gel electrophoresis fingerprinting types were isolated from each patient. By PCR, all isolates were vanA +. However, many isolates from patient B were found to lack vanA by hybridization. Our results demonstrate the importance of examining multiple isolates, especially from patients who are at high risk of infection.

Palliative Management of Parkinson Disease: Focus on Nonmotor, Distressing Symptoms

2008 ◽  
Vol 21 (4) ◽  
pp. 262-272 ◽  
Author(s):  
Jack J. Chen ◽  
Dominick P. Trombetta ◽  
Hubert H. Fernandez
Keyword(s):  
Parkinson Disease ◽  
Long Term Care ◽  
Functional Dependence ◽  
Care Facility ◽  
The United States ◽  
Elderly Persons ◽  
Motor Complications ◽  
Term Care ◽  
Increased Risk

Parkinson disease is a progressive neurodegenerative disease that commonly affects elderly persons. In the absence of neuroprotective or curative therapies, currently available therapies only provide symptomatic benefit. Progression to advanced Parkinson disease is often accompanied by functional dependence with increased risk of admission to a long-term care facility. The prevalence of Parkinson disease in long-term care facilities, within the United States, has been estimated to be between 5.2% and 10%. Patients with advanced Parkinson disease also experience other distressing motor and nonmotor conditions, such as motor complications, dementia, depression, gastrointestinal distress, orthostatic hypotension, pain, and psychosis, which can be a challenge for clinicians to manage. The presence of distressing symptoms along with the fact that Parkinson disease remains incurable necessitate discussion on a palliative care approach to this disorder. This article discusses the symptomatic management of distressing symptoms encountered in the long-term care resident with Parkinson disease, including motor complications and nonmotor features.

scholarly journals Comparison of Virulence Gene Identification, Ribosomal Spacer PCR, and Pulsed-Field Gel Electrophoresis for Typing of Staphylococcus aureus Strains Isolated from Cases of Subclinical Bovine Mastitis in the United States

2016 ◽  
Vol 54 (7) ◽  
pp. 1871-1876 ◽  
Author(s):  
Pamela R. F. Adkins ◽  
John R. Middleton ◽  
Lawrence K. Fox
Keyword(s):  
United States ◽  
Staphylococcus Aureus ◽  
Gel Electrophoresis ◽  
Virulence Gene ◽  
The United States ◽  
Pulsed Field Gel Electrophoresis ◽  
Gene Identification ◽  
Content Type ◽  
Pulsed Field

Staphylococcus aureusis one of the most important pathogens causing contagious mastitis in dairy cattle worldwide. The objectives of this study were to determine if recently describedS. aureusgenotype B was present among previously characterized isolates from cases of bovine intramammary infection in the United States and to compare pulsed-field gel electrophoresis (PFGE) to the combination of ribosomal spacer PCR (RS-PCR) and virulence gene identification for typing ofS. aureusstrains. The hypothesis was that isolates that were previously characterized as contagious would be identified as genotype B and that the results of the two strain-typing methods would be comparable. Isolates were selected from a collection ofS. aureusisolates from eight dairy farms. Mammary quarter milk somatic cell count (SCC) andN-acetyl-β-d-gluconaminidase (NAGase) activity data were known and used to evaluate strain pathogenicity. RS-PCR was performed with conventional gel electrophoresis, and PCR was used for toxin gene identification. RS-PCR patterns were associated with a specific virulence gene pattern, as previously reported. Five RS-PCR banding patterns were identified. None of the isolates were characterized as genotype B. No association between RS-PCR types and milk SCC was found; however, NAGase activity was significantly higher in milk from mammary glands infected with RS-PCR banding type 1 (RSP type 1) than in milk from those infected with RSP type 2. The discriminatory power values were 1.0 and 0.46 for PFGE and RS-PCR, respectively. These data suggest that genotype B may have a limited geographic distribution and that PFGE is more discriminatory than RS-PCR performed with conventional gel electrophoresis for typing ofS. aureusisolates of bovine origin.

scholarly journals Long-Term Care Facilities Are Reservoirs for Antimicrobial-Resistant Sequence Type 131 Escherichia coli

2015 ◽  
Vol 2 (1) ◽  
Author(s):  
Mary J. Burgess ◽  
James R. Johnson ◽  
Stephen B. Porter ◽  
Brian Johnston ◽  
Connie Clabots ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Gel Electrophoresis ◽  
Long Term Care ◽  
Pulsed Field Gel Electrophoresis ◽  
Sequence Type ◽  
Term Care ◽  
E Coli ◽  
Care Facilities

Abstract Background.  Emerging data implicate long-term care facilities (LTCFs) as reservoirs of fluoroquinolone-resistant (FQ-R) Escherichia coli of sequence type 131 (ST131). We screened for ST131 among LTCF residents, characterized isolates molecularly, and identified risk factors for colonization. Methods.  We conducted a cross-sectional study using a single perianal swab or stool sample per resident in 2 LTCFs in Olmsted County, Minnesota, from April to July 2013. Confirmed FQ-R E. coli isolates underwent polymerase chain reaction-based phylotyping, detection of ST131 and its H30 and H30-Rx subclones, extended virulence genotyping, and pulsed-field gel electrophoresis (PFGE) analysis. Epidemiological data were collected from medical records. Results.  Of 133 fecal samples, 33 (25%) yielded FQ-R E. coli, 32 (97%) of which were ST131. The overall proportion with ST131 intestinal colonization was 32 of 133 (24%), which differed by facility: 17 of 41 (42%) in facility 1 vs 15 of 92 (16%) in facility 2 (P = .002). All ST131 isolates represented the H30 subclone, with virulence gene and PFGE profiles resembling those of previously described ST131 clinical isolates. By PFGE, certain isolates clustered both within and across LTCFs. Multivariable predictors of ST131 colonization included inability to sign consent (odds ratio [OR], 4.16 [P = .005]), decubitus ulcer (OR, 4.87 [ P = .04]), and fecal incontinence (OR, 2.59 [P = .06]). Conclusions.  Approximately one fourth of LTCF residents carried FQ-R ST131 E. coli resembling ST131 clinical isolates. Pulsed-field gel electrophoresis suggested intra- and interfacility transmission. The identified risk factors suggest that LTCF residents who require increased nursing care are at greatest risk for ST131 colonization, possibly due to healthcare-associated transmission.

Pulsed-field gel electrophoresis applied for comparing Listeria monocytogenes strains involved in outbreaks

1993 ◽  
Vol 39 (4) ◽  
pp. 395-401 ◽  
Author(s):  
C. Buchrieser ◽  
R. Brosch ◽  
B. Catimel ◽  
J. Rocourt
Keyword(s):  
United States ◽  
Listeria Monocytogenes ◽  
Gel Electrophoresis ◽  
The United States ◽  
Pulsed Field Gel Electrophoresis ◽  
Chromosomal Dna ◽  
Restriction Patterns ◽  
Pulsed Field ◽  
Dna Restriction Fragments ◽  
Dna Restriction

Recent food-borne outbreaks of human listeriosis as well as numerous sporadic cases have been mainly caused by Listeria monocytogenes serovar 4b strains. Thus, it was of interest to find out whether a certain clone or a certain few clones were responsible for these cases and especially for outbreaks., We used pulsed-field gel electrophoresis of large chromosomal DNA restriction fragments generated by ApaI, SmaI, or NotI to analyse 75 L. monocytogenes strains isolated during six major and eight smaller recent listeriosis outbreaks. These strains could be divided into 20 different genomic varieties. Thirteen of 14 strains isolated during major epidemics in Switzerland (1983–1987), the United States (California, 1985) and Denmark (1985–1987) demonstrated indistinguishable DNA restriction patterns. In contrast, strains responsible for the outbreaks in Canada (Nova Scotia, 1981), the United States (Massachusetts, 1983), France (Anjou, 1975–1976), New Zealand (1969), and Austria (1986) and some smaller outbreaks in France (1987, 1988, 1989) were each characterized by particular combinations of DNA restriction patterns. Seventy-seven percent of the tested strains could be classified into the previously described ApaI group A (Brosch et al. 1991), demonstrating a very close genomic relatedness. Because 49% of the epidemic strains selected for this study belonged to phagovar 2389/2425/3274/2671/47/108/340 or 2389/47/108/340, fifty-six additional strains of these phagovars, isolated from various origins, were also typed to determine whether differences in DNA restriction profiles between epidemic and randomly selected strains of the same phagovars could be pointed out. Variations in DNA patterns appeared more frequently within randomly selected strains than within epidemic strains.Key words: Listeria monocytogenes, listeriosis, typing, pulsed-field gel electrophoresis, epidemic.

Interinstitutional and Intrainstitutional Transmission of a Strain ofAcinetobacter baumanniiDetected by Molecular Analysis Comparison of Pulsed-Field Gel Electrophoresis and Repetitive Sequence–Based Polymerase Chain Reaction

2006 ◽  
Vol 27 (9) ◽  
pp. 981-983 ◽  
Author(s):  
S. Saeed ◽  
M. G. Fakih ◽  
K. Riederer ◽  
A. R. Shah ◽  
R. Khatib
Keyword(s):  
Polymerase Chain Reaction ◽  
Acute Care ◽  
Repetitive Sequence ◽  
Gel Electrophoresis ◽  
Care Facility ◽  
Pulsed Field Gel Electrophoresis ◽  
Chain Reaction ◽  
Pulsed Field ◽  
Polymerase Chain

Pulsed-field gel electrophoresis and repetitive sequence-based polymerase chain reaction provided comparable strain discrimination with minor discordance in typingAcinetobacter baumanniiclinical isolates from patients at our hospital and affiliated institutions. Typing revealed a cluster strain with intrainstitutional and interinstitutional spread during the study period. A long-term acute care facility may have been the reservoir.

Characterizing Salmonella Contamination in Two Rendering Processing Plants

2017 ◽  
Vol 80 (2) ◽  
pp. 265-270 ◽  
Author(s):  
Chao Gong ◽  
Xiuping Jiang
Keyword(s):  
Gel Electrophoresis ◽  
Raw Materials ◽  
Primary Source ◽  
Latex Agglutination ◽  
Pulsed Field Gel Electrophoresis ◽  
Cross Contamination ◽  
Pulsed Field ◽  
Processing Plants ◽  
Salmonella Serotypes ◽  
Finished Meal

ABSTRACT A microbiological investigation on Salmonella contamination was conducted in two U.S. rendering plants to investigate the potential cross-contamination of Salmonella in the rendering processing environment. Sampling locations were predetermined at the areas where Salmonella contamination may potentially occur, including raw materials receiving, crax (rendered materials before grinding process) grinding, and finished meal loading-out areas. Salmonella was either enumerated directly on xylose lysine Tergitol 4 agar plates or enriched in Rappaport-Vassiliadis and tetrathionate broths. The presumptive Salmonella isolates were confirmed using CHROMagar plating and latex agglutination testing and then characterized using pulsed-field gel electrophoresis, serotyping, and biofilm-forming determination. Among 108 samples analyzed, 79 (73%) samples were Salmonella positive after enrichment. Selected Salmonella isolates (n = 65) were assigned to 31 unique pulsed-field gel electrophoresis patterns, with 16 Salmonella serotypes, including Typhimurium and Mbandaka, identified as predominant serotypes and 10 Salmonella strains determined as strong biofilm formers. Our results indicated that the raw materials receiving area was the primary source of Salmonella and that the surfaces surrounding crax grinding and finished meal loading-out areas harbor Salmonella in biofilms that may recontaminate the finished meals. The same Salmonella serotypes found in both raw materials receiving and the finished meal loading-out areas suggested a potential of cross-contamination between different areas in the rendering processing environment.

Control of Influenza in the Long-Term–Care Facility: A Review of Established Approaches and Newer Options

2000 ◽  
Vol 21 (1) ◽  
pp. 59-64 ◽  
Author(s):  
Nancy H. Arden
Keyword(s):  
Influenza Vaccine ◽  
Long Term Care ◽  
Antiviral Agents ◽  
Care Facility ◽  
The United States ◽  
Elderly Persons ◽  
Term Care ◽  
Long Term Care Facility ◽  
Live Attenuated Influenza Vaccine

AbstractInfluenza infections pose a serious threat to residents of nursing homes and other long-term–care facilities. Annual vaccination of residents and staff with the currently licensed inactivated influenza vaccine continues to be the mainstay of prevention. Live attenuated influenza vaccine, which is expected to be licensed in the United States in the near future, may offer added protection for elderly persons when administered in conjunction with inactivated vaccine. Antiviral agents also can be useful as an adjunct to vaccination, especially for control of institutional outbreaks. Two new antiviral agents that appear to be less toxic than amantadine and rimantadine have recently been approved.

scholarly journals Pulsed-Field Gel Electrophoresis Analysis of Vibrio vulnificus Strains Isolated from Taiwan and the United States

2004 ◽  
Vol 70 (9) ◽  
pp. 5153-5158 ◽  
Author(s):  
Hin-chung Wong ◽  
Shau-Yan Chen ◽  
Meng-Yi Chen ◽  
James D. Oliver ◽  
Lien-I Hor ◽  
...  
Keyword(s):  
United States ◽  
Gel Electrophoresis ◽  
Vibrio Vulnificus ◽  
The United States ◽  
Pulsed Field Gel Electrophoresis ◽  
Intraspecific Diversity ◽  
Pulsed Field ◽  
Clinical Strains ◽  
Discriminative Method ◽  
Geographic Regions

ABSTRACT Vibrio vulnificus is a marine bacterium that causes human wound infections and septicemia with a high mortality rate. V. vulnificus strains from different clinical and environmental sources or geographic regions have been successfully characterized by ribotyping and several other methods. Pulsed-field gel electrophoresis (PFGE) is a highly discriminative method, but previous studies suggested that it was not suitable for examining the correlation of V. vulnificus strains from different origins. We employed PFGE to determine its efficacy for characterizing V. vulnificus strains from different geographic regions, characterizing a total of 153 strains from clinical and environmental origins from the United States and Taiwan after SfiI or NotI digestion. V. vulnificus strains showed a high intraspecific diversity by PFGE after SfiI or NotI digestion, and about 12% of the strains could not be typed by the use of either of these enzymes. For PFGE with SfiI digestion, most of the clinical and environmental strains from the United States were grouped into cluster A, while the strains from Taiwan were grouped into other clusters. Clinical strains from the United States showed a higher level of genetic homogeneity than clinical strains from Taiwan, and environmental strains from both regions showed a similarly high level of heterogeneity. PFGE with NotI digestion was useful for studying the correlation of clinical strains from the United States and Taiwan, but it was not suitable for analyzing environmental strains. The results showed that PFGE with SfiI digestion may be used to characterize V. vulnificus strains from distant geographic regions, with NotI being a recommended alternative enzyme.

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