Rapdi Diagnosis of Anaerobic Infections by Direct Gas-Liquid Chromatography of Clinical Specimens

Gorbach, Sherwood L.; Mayhew, James F.; Bartlett, John G.; Thadepalli, Haracopal; Onderdonk, Andrew B.

doi:10.1097/00006254-197608000-00003

Cited by 40 publications

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“…Suc has also been described as a marker for anaerobic infections in clinical pus samples on gas-liquid chromatography. 27 Nonvisibility of the resonance of Ac with or without Suc on in vivo 1 H-MR spectroscopy in 41% of anaerobic culture-positive brain abscesses in our study could be explained by the relatively low concentration of these metabolites, which might be below the sensitivity of the current scanner. 28 Suc and Ac are usually not observed in brain abscesses secondary to aerobic (Fig 4) and facultative anaerobic microorganisms because the pyruvate formed during glycolysis enters the tricarboxylic acid cycle in these bacteria in the presence of oxygen.…”

Section: Discussionmentioning

confidence: 58%

In Vivo Proton MR Spectroscopy Evaluation of Pyogenic Brain Abscesses: A Report of 194 Cases

Pal¹,

Bhattacharyya²,

Husain³

et al. 2009

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:The combination of nonspecific clinical findings and similarities in morphologic appearances on imaging often makes it difficult to distinguish abscesses from other brain lesions. We present a retrospective analysis of in vivo 1 H-MR spectroscopy data for characterization of the etiology of the brain abscess based on the established criteria and demonstrate the sensitivity and specificity of metabolite markers assigned to specific bacterial groups defined by the microbial culture in 194 patients.

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Section: Discussionmentioning

confidence: 58%

In Vivo Proton MR Spectroscopy Evaluation of Pyogenic Brain Abscesses: A Report of 194 Cases

Pal¹,

Bhattacharyya²,

Husain³

et al. 2009

AJNR Am J Neuroradiol

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“…Before the use of molecular methods, D. pneumosintes was suspected to be associated with brain infections alone or in association with S. anginosus (10). This assumption was never firmly established because of the poor results of both the phenotypic characterization and analysis of the short-chain fatty acids by direct gas-liquid chromatography (8,10). Our two cases firmly establish for the first time that D. pneumosintes may be associated with cerebral abscesses.…”

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confidence: 99%

Dialister pneumosintes Associated with Human Brain Abscesses

et al. 2002

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In this report, we review two cases of brain infection due to Dialister pneumosintes in previously healthy patients. The bacterium was isolated from the first patient by blood culture and directly from a brain abscess in the second patient. In both cases, the infection was suspected to be of nasopharyngeal or dental origin. The patients had favorable outcomes following surgical debridement and antibiotic treatment. After in vitro amplification and partial sequencing of the 16S rRNA gene, two strains were classified as D. pneumosintes. However, traditional biochemical tests were not sufficient to identify the bacteria. In addition to causing periodontal and opportunistic infections, D. pneumosintes, contained in mixed flora, may behave as a clinically important pathogen, especially in the brain. In addition to phenotypic characterization, 16S rRNA partial sequencing was used to identify D. pneumosintes definitively. CASE REPORTSCase 1. A 17-year-old man was admitted to Strasbourg University Hospital for fever and dysphagia that had evolved over 1 week. Prior to admission, he had received amoxicillin and then clarithromycin. On physical examination, he presented with a high fever (40°C), right temporal headache, paralysis of the left arm, and swelling of the submandibular lymph nodes. Laboratory investigations revealed an inflammatory syndrome with a C-reactive protein level measuring 118 mg/liter and a leukocyte count of 13.3 ϫ 10 9 cells/liter. Standard cerebrospinal fluid analysis as well as aerobic and anaerobic cultures did not reveal any abnormalities. Two aerobic and anaerobic blood cultures (BACTEC Plus Aerobic/F and BACTEC Plus Anaerobic/F; BD, Pont-de-Claix, France) were performed upon admission.A brain computerized tomography (CT) scan revealed a subdural empyema compressing the right frontal lobe. Arteriography of the cerebral vessels revealed possible thrombophlebitis of the longitudinal median sinus. Antimicrobial treatment with cefotaxime at 12 g/day, metronidazole at 1.5 g/day, and acyclovir at 2.4 g/day was started. The general condition of the patient rapidly worsened, leading to sepsis and aggravation of his neurologic symptoms. On the second day after admission, a right frontal craniotomy was performed. A subdural empyema was evacuated and the frontal sinuses were drained. Thiamphenicol (750 mg) was injected into the operative cavity. Postsurgical treatment consisted of metronidazole, cefotaxime, ofloxacin, carbamazepine, and heparin.Gram staining of the empyema revealed numerous polymorphonuclear cells and small gram-negative rods. Rare colonies of Streptococcus anginosus grew on chocolate agar under aerobic conditions and also on blood agar supplemented with hemin and vitamin K 1 under anaerobic conditions. Rare colonies of S. anginosus and coagulase-negative Staphylococcus were isolated from the frontal sinus sample. On the fourth day of hospitalization, Dialister pneumosintes (IBS 708/99) was obtained from one of the blood cultures done on the day of admission. All other blood cultures done...

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“…Both patients showed amino-acid signals at 0.9 ppm, seen in many brain abscesses and assigned to valine, leucine, and isoleucine, considered representing accumulated end-products of proteolysis caused by proteolytic enzymes secreted by microorganisms or polymorphonuclear leukocytes in pus, or both [16][17][18][19][20][21][22] . Patient 2, infected by an anaerobe facultative bacteria, presented acetate and succinate, considered being the end products of homolactic and heterolactic fermentation and key markers of bacterial infection [23][24][25] . Other infectious diseases as cysticercosis may also display succinate elevation 26 .…”

Section: Discussionmentioning

confidence: 99%

“…Although succinate is one of the intermediate metabolites of the tricarboxylic acid cycle it does not accumulate during its formation and immediately 29 . Succinate was also earlier described as a marker for anaerobic infections in clinical samples at gas liquid chromatography 25 .…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance spectroscopy in the diagnosis and etiological definition of brain bacterial abscesses

Morais

Zanardi

Faria

2007

Arq. Neuro-Psiquiatr.

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-We report two patients with bacterial brain abscesses whose etiological diagnosis was correctly proposed by association of diffusion weighted images (DWI) and magnetic resonance spectroscopy (MRS) with conventional MRI. Both patients presented ring enhancing lesions with evidences of restricted diffusion. On MRS, the abscess caused by aerobic bacteria presented lactate and aminoacids peaks and the abscess caused by anaerobic facultative bacteria showed also acetate and succinate peaks. These results are in agreement with an unique previous study that related MRS pattern with bacterial etiology. Conventional MRI, associated with DWI and MRS is effective in diagnosing bacterial abscess and promising in exploring its etiology.KEY WORDS: pyogenic bacterial abscess, spectroscopy, diffusion, magnetic resonance. Espectroscopia por ressonância magnética no diagnóstico e definição etiológica dos abscessos bacterianos cerebraisRESUMO -Apresentamos dois pacientes com abscessos bacterianos cerebrais cujos diagnósticos etiológicos foram corretamente auxiliados pela associação de difusão e espectroscopia à ressonância magnética convencional. Ambos apresentavam lesões com captação anelar de contraste e evidências de restrição à difusão de moléculas de água. Na espectroscopia, o abscesso causado por bactéria aeróbia apresentou picos de lactato e aminoácidos, enquanto o abscesso causado por bactéria anaeróbia facultativa mostrou, além destes, picos de acetato e succinato. Tais resultados concordam com um único estudo prévio que relacionou o padrão de espectroscopia nos abscessos com sua etiologia bacteriana. A ressonância magnética convencional, associada à difusão e à espectroscopia é uma técnica eficiente no diagnóstico de abscessos bacterianos e promissora em explorar suas etiologias. PALAVRAS-CHAVE: abscesso cerebral piogênico, espectroscopia, difusão, ressonância magnética.

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Rapdi Diagnosis of Anaerobic Infections by Direct Gas-Liquid Chromatography of Clinical Specimens

Cited by 40 publications

References 0 publications

In Vivo Proton MR Spectroscopy Evaluation of Pyogenic Brain Abscesses: A Report of 194 Cases

In Vivo Proton MR Spectroscopy Evaluation of Pyogenic Brain Abscesses: A Report of 194 Cases

Dialister pneumosintes Associated with Human Brain Abscesses

Magnetic resonance spectroscopy in the diagnosis and etiological definition of brain bacterial abscesses

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