Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-8 (of 8 Records) |
Query Trace: Yakrus M[original query] |
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Trends in testing for Mycobacterium tuberculosis complex from US Public Health Laboratories, 2009-2013
Tyrrell F , Stafford C , Yakrus M , Youngblood M , Hill A , Johnston S . Public Health Rep 2017 132 (1) 56-64 OBJECTIVE: We investigated data from US public health laboratories funded through the Centers for Disease Control and Prevention's Tuberculosis Elimination and Laboratory Cooperative Agreement to document trends and challenges in meeting national objectives in tuberculosis (TB) laboratory diagnoses. METHODS: We examined data on workload and turnaround time from public health laboratories' progress reports during 2009-2013. We reviewed methodologies, laboratory roles, and progress toward rapid detection of Mycobacterium tuberculosis complex through nucleic acid amplification (NAA) testing. We compared selected data with TB surveillance reports to estimate public health laboratories' contribution to national diagnostic services. RESULTS: During the study period, culture and drug susceptibility tests decreased, but NAA testing increased. Public health laboratories achieved turnaround time benchmarks for drug susceptibility tests at lower levels than for acid-fast bacilli smear and identification from culture. NAA positivity in laboratories among surveillance-reported culture-positive TB cases increased from 26.6% (2355 of 8876) in 2009 to 40.0% (2948 of 7358) in 2013. Public health laboratories provided an estimated 50.9% (4285 of 8413 in 2010) to 57.2% (4210 of 7358 in 2013) of culture testing and 88.3% (6822 of 7727 in 2011) to 94.4% (6845 of 7250 in 2012) of drug susceptibility tests for all US TB cases. CONCLUSIONS: Public health laboratories contribute substantially to TB diagnoses in the United States. Although testing volumes mostly decreased, the increase in NAA testing indicates continued progress in rapid M tuberculosis complex detection. |
Molecular and Growth-Based Drug Susceptibility Testing of Mycobacterium tuberculosis Complex for Ethambutol Resistance in the United States.
Yakrus MA , Driscoll J , McAlister A , Sikes D , Hartline D , Metchock B , Starks AM . Tuberc Res Treat 2016 2016 3404860 Ethambutol (EMB) is used as a part of drug regimens for treatment of tuberculosis (TB). Susceptibility of Mycobacterium tuberculosis complex (MTBC) isolates to EMB can be discerned by DNA sequencing to detect mutations in the embB gene associated with resistance. US Public Health Laboratories (PHL) primarily use growth-based drug susceptibility test (DST) methods to determine EMB resistance. The Centers for Disease Control and Prevention (CDC) provides a service for molecular detection of drug resistance (MDDR) by DNA sequencing and concurrent growth-based DST using agar proportion. PHL and CDC test results were compared for 211 MTBC samples submitted to CDC from September 2009 through February 2011. Concordance between growth-based DST results from PHL and CDC was 88.2%. A growth-based comparison of 39 samples, where an embB mutation associated with EMB resistance was detected, revealed a higher percentage of EMB resistance by CDC (84.6%) than by PHL (59.0%) which was significant (P value = 0.002). Discordance between all growth-based test results from PHL and CDC was also significant (P value = 0.003). Most discordance was linked to false susceptibility using the BACTEC MGIT 960 (MGIT) growth-based system. Our analysis supports coalescing growth-based and molecular results for an informed interpretation of potential EMB resistance. |
Evaluation of a u.s. Public health laboratory service for the molecular detection of drug resistant tuberculosis.
Yakrus MA , Metchock B , Starks AM . Tuberc Res Treat 2015 2015 701786 Crucial to interrupting the spread of tuberculosis (TB) is prompt implementation of effective treatment regimens. We evaluated satisfaction, comfort with interpretation, and use of molecular results from a public health service provided by the Centers for Disease Control and Prevention (CDC) for the molecular detection of drug resistant Mycobacterium tuberculosis complex (MTBC). An electronic survey instrument was used to collect information anonymously from U.S. Public Health Laboratories (PHL) that submitted at least one isolate of MTBC to CDC from September 2009 through February 2011. Over 97% of those responding expressed satisfaction with the turnaround time for receiving results. Twenty-six PHL (74%) reported molecular results to healthcare providers in less than two business days. When comparing the molecular results from CDC with their own phenotypic drug susceptibility testing, 50% of PHL observed discordance. No respondents found the molecular results difficult to interpret and 82% were comfortably discussing them with TB program officials and healthcare providers. Survey results indicate PHL were satisfied with CDC's ability to rapidly provide interpretable molecular results for isolates of MTBC submitted for determination of drug resistance. To develop educational materials and strategies for service improvement, reasons for discordant results and areas of confusion need to be identified. |
Concordance between molecular and phenotypic testing of Mycobacterium tuberculosis complex isolates for resistance to rifampin and isoniazid in the United States.
Yakrus MA , Driscoll J , Lentz AJ , Sikes D , Hartline D , Metchock B , Starks AM . J Clin Microbiol 2014 52 (6) 1932-7 Multidrug-resistant (MDR) isolates of Mycobacterium tuberculosis complex (MTBC) are defined by resistance to at least rifampin (RMP) and isoniazid (INH). Rapid and accurate detection of multidrug resistance is essential for effective treatment and interruption of disease transmission of tuberculosis (TB). Over-diagnosis of MDR TB may result in treatment with second-line drugs that are more costly, less effective, and more poorly tolerated than first-line drugs. CDC offers rapid confirmation of MDR TB by molecular detection of mutations associated with resistance (MDDR) to RMP and INH along with analysis for resistance to other first-line and second-line drugs. Simultaneously, CDC does growth-based phenotypic drug susceptibility testing (DST) by the indirect agar proportion method for a panel of first-line and second-line antituberculous drugs. We reviewed discordance between molecular and phenotypic DST for INH and RMP for 285 isolates submitted as MTBC to CDC September 2009-February 2011. We compared CDC's results with those from the submitting public health laboratories (PHL). Concordance between molecular and phenotypic testing at CDC was 97.4% for RMP and 92.5% for INH resistance. Concordance between CDC's molecular testing and PHL DST results was 93.9% for RMP and 90.0% for INH. Overall concordance between CDC molecular and PHL DST results was 91.7% for RMP and INH collectively. Discordance was primarily attributable to absence of known INH-resistance mutations in isolates INH resistant by DST and detection of mutations associated with low-level RMP resistance in isolates that were RMP susceptible by phenotypic DST. Both molecular and phenotypic test results should be considered for diagnosis of MDR TB. |
Shared Mycobacterium avium genotypes observed among unlinked clinical and environmental isolates.
Dirac MA , Weigel KM , Yakrus MA , Becker AL , Chen HL , Fridley G , Sikora A , Speake C , Hilborn ED , Pfaller S , Cangelosi GA . Appl Environ Microbiol 2013 79 (18) 5601-7 Our understanding of the sources of Mycobacterium avium infection is partially based on genotypic matching of pathogen isolates from cases and environmental sources. These approaches assume that genotypic identity is rare in isolates from unlinked cases or sources. To test this assumption, a high-resolution PCR-based genotyping approach, LSP-MVR, was selected and used to analyze clinical and environmental isolates of M. avium from geographically diverse sources. Among 127 clinical isolates from seven locations in North America, South America, and Europe, 42 genotypes were observed. Among twelve of these genotypes, matches were seen in isolates from apparently unlinked patients in two or more geographic locations. Six of the twelve were also observed in environmental isolates. A subset of these isolates was further analyzed by alternative strain genotyping methods, PFGE and MIRU-VNTR, which confirmed the existence of geographically dispersed strain genotypes. These results suggest that caution should be exercised in interpreting high-resolution genotypic matches as evidence for an acquisition event. |
Revival and emended description of 'Mycobacterium paraffinicum' (Davis, Chase and Raymond 1956) as Mycobacterium paraffinicum (ex Davis, Chase and Raymond 1956) sp. nov., nom. rev
Toney NC , Adekambi T , Toney S , Yakrus M , Butler WR . Int J Syst Evol Microbiol 2009 60 (10) 2307-2313 The omission of the name 'Mycobacterium paraffinicum' from the 1980 Approved List of Bacterial Names was due to phenotypic confusion surrounding a close relationship with Mycobacterium scrofulaceum. Correspondingly 'M. paraffinicum' strains grew slowly in >7 days, stained acid-alcohol fast, produced yellow-pigmented smooth waxy colonies in the dark at an optimal temperature of 35 degrees C. However 'M. paraffinicum' strains demonstrated no activity for urease, nicotinamidase or pyrazinamidase, and lacked growth at 42 degrees C as compared to M. scrofulaceum. The mycolic acid pattern as determined by high performance liquid chromatography (HPLC) clustered 'M. paraffinicum' with M. scrofulaceum, Mycobacterium avium, and Mycobacterium parascrofulaceum. Strains were fully susceptible to linezolid, rifabutin, clarithromycin and amikacin. Examination of the historical reference strain of 'M. paraffinicum' ATCC 12670 and five additional isolates using comparative gene studies with 16S rRNA, hsp65, rpoB and concatenated sequences demonstrated separate, monophyletic tree branching that was distinct from similar nontuberculous mycobacteria and formed a tight taxonomical group with the classical reference strain of 'M. paraffinicum'. Multilocus enzyme electrophoresis (MEE) analysis confirmed a close association of the five additional isolates with the reference strain of 'M. paraffinicum' with a genetic distance of 0.12 and was distinct from other closely related species. These genetic results provided unambiguous evidence of the uniqueness of the slow-growing, scotochromogenic species and supported the revival of the name as Mycobacterium paraffinicum (ex Davis, Chase and Raymond 1956) sp. nov., nom. rev. We propose the previously deposited reference strain located in the worldwide collections as the type strain ATCC 12670T =DSM 44181T =NCIMB10420T. |
Pseudo-outbreak of "Mycobacterium paraffinicum" infection and/or colonization in a tertiary care medical center
Wang SH , Pancholi P , Stevenson K , Yakrus MA , Butler WR , Schlesinger LS , Mangino JE . Infect Control Hosp Epidemiol 2009 30 (9) 848-53 OBJECTIVE: To investigate a pseudo-outbreak of "Mycobacterium paraffinicum" (unofficial taxon) infection and/or colonization, using isolates recovered from clinical and environmental specimens. DESIGN: Outbreak investigation. SETTING: University-affiliated, tertiary-care hospital. METHODS: M. paraffinicum, a slow-growing, nontuberculous species of mycobacteria, was recovered from 21 patients and an ice machine on a single patient care unit over a 2.5-year period. The clinical, epidemiological, and environmental investigation of this pseudo-outbreak is described. RESULTS: Twenty-one patients with pulmonary symptoms and possible risk factors for tuberculosis were admitted to inpatient rooms that provided airborne isolation conditions in 2 adjacent hospital buildings. In addition, 1 outpatient had induced sputum cultured for mycobacteria in the pulmonary function laboratory. Of the samples obtained from these 21 patients, 26 isolates from respiratory samples and 1 isolate from a stool sample were identified as M. paraffinicum. Environmental isolates obtained from an ice machine in the patient care unit where the majority of the patients were admitted were also identified as M. paraffinicum. CONCLUSIONS: An epidemiological investigation that used molecular tools confirmed the suspicion of a pseudo-outbreak of M. paraffinicum infection and/or colonization. The hospital water system was identified as the source of contamination. |
Nontuberculous mycobacteria infections in immunocompromised patients: single institution experience
Wei MC , Banaei N , Yakrus MA , Stoll T , Gutierrez KM , Agarwal R . J Pediatr Hematol Oncol 2009 31 (8) 556-60 Disseminated infection due to nontuberculous Mycobacterium (NTM) species is rare in pediatrics. Here we report 6 infections affecting 5 patients at a single institution in an immunocompromised population of pediatric oncology and stem cell transplant recipients. The patients presented within a 1-year period with catheter-associated bacteremia. New pulmonary nodules were noted in 4 of the 5 patients. All of the infections were due to rapidly growing NTM. Patients were successfully treated with removal of the infected catheter and combination antibiotic therapy. There are currently no consensus guidelines for treatment of NTM infections in this population, and a therapeutic approach is presented here. |
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