Bobby Boyanton | Oakland University William Beaumont School of Medicine (original) (raw)

Papers by Bobby Boyanton

Infectious Diseases in Clinical Practice, 2015

Journal of Clinical Microbiology, 2015

The Lyra Direct strep assay was compared to culture for its ability to detect Streptococcus group... more The Lyra Direct strep assay was compared to culture for its ability to detect Streptococcus group A and β-hemolytic groups C/G using rapid antigen-negative pharyngeal specimens (n = 161). The Lyra assay correctly detected all β-hemolytic streptococci (group A, n = 19; group C/G, n = 5). In batch mode, the Lyra assay reduced intralaboratory turnaround time by 60% (18.1 h versus 45.0 h) but increased hands-on time by 96% (3 min 16 s versus 1 min 40 s per specimen).

Journal of Clinical Microbiology, 2015

Pasteurella multocida is a rare cause of neonatal bacterial meningitis. We describe such a case a... more Pasteurella multocida is a rare cause of neonatal bacterial meningitis. We describe such a case and verify two household cats as the source of infection using repetitive element polymerase chain reaction (rep-PCR) molecular fingering.

MMWR. Morbidity and mortality weekly report

Archives of pathology & laboratory medicine, 2006

A 55-year-old man presented to the emergency room after a fall. Chest radiograph showed a fractur... more A 55-year-old man presented to the emergency room after a fall. Chest radiograph showed a fracture of the right 9th rib. This finding was confirmed by computed tomographic scan, which incidentally revealed a large right adrenal mass with the density of fat. Magnetic resonance imaging confirmed fat suppression within the adrenal mass. His medical history was significant for pharmacologically controlled essential hypertension. The physical examination was significant only for tenderness of the right thorax. Initial laboratory findings were within normal limits and the patient was discharged. The results from a 24-hour urine sample (total volume, 3.5 L) were normal for aldosterone, cortisol, 17-ketosteroids, and 17-

Archives of pathology & laboratory medicine, 2004

A 27-year-old man presented to the emergency department with a 3-day history of progressively wor... more A 27-year-old man presented to the emergency department with a 3-day history of progressively worsening abdominal pain, nausea, emesis, and obstipation following a weekend drinking binge. The patient's medical history was significant for smoking and alcohol abuse. Family history was significant for ''intestinal problems'' in 2 uncles. Physical examination revealed an afebrile patient with epigastric pain and high-pitched bowel sounds. Results of laboratory tests were within normal limits, except for an amylase level of 254 U/L (reference range, 25-115 U/L), and a mildly elevated white blood cell count of 13 000/L (reference range, 4000-11 000/L). A computed

Archives of pathology & laboratory medicine, 2007

Intraneural perineurioma may be confused with other "onion bulb" Schwann cell entities ... more Intraneural perineurioma may be confused with other "onion bulb" Schwann cell entities (localized hypertrophic neuropathy, reactive/demyelinating processes, or inherited polyneuropathies of Charcot-Marie-Tooth/Dejerine Sottas) due to similar clinical, radiologic, and histologic features. Perineurial and Schwann cells can only be differentiated by ultrastructure and immunohistochemsitry. To identify and summarize the clinicopathologic features of true cases of intraneural perineurioma from the English language literature. A systematic review was performed on definitive intraneural perineuriomas identified through Medline. Baylor College of Medicine-affiliated hospitals' anatomic pathology databases yielded 2 illustrative intraneural perineurioma cases. Intraneural perineurioma inclusion criteria consisted of characteristic histology and confirmation of perineurial cell lineage by either immunohistochemistry (epithelial membrane antigen positive, S100 protein negative) a...

Archives of pathology & laboratory medicine, 2007

In this article we review the recent literature on Hansen disease (leprosy). We searched publishe... more In this article we review the recent literature on Hansen disease (leprosy). We searched published literature through PubMed (National Library of Medicine) and extracted data through direct review of the literature and pathologic slides. Hansen disease continues to occur in the United States, including among the native-born population. Inclusion of the disease in the differential diagnosis is key to confirmation. Current epidemiology, classification systems, prevention measures, and therapy are reviewed.

Journal of Clinical Microbiology, 2011

Journal of Clinical Microbiology, 2012

Clostridium difficile infection is the primary cause of health care-associated diarrhea. While mo... more Clostridium difficile infection is the primary cause of health care-associated diarrhea. While most laboratories have been using rapid antigen tests for detecting C. difficile toxins, they have poor sensitivity; newer molecular methods offer rapid results with high test sensitivity and specificity. This study was designed to compare the performances of two molecular assays (Meridian illumigene and BD GeneOhm) and two antigen assays (Wampole Quik Chek Complete and TechLab Tox A/B II) to detect toxigenic C. difficile. Fecal specimens from hospitalized patients (n ‫؍‬ 139) suspected of having C. difficile infection were tested by the four assays. Nine specimens were positive and 109 were negative by all four methods. After discrepant analysis by toxigenic culture (n ‫؍‬ 21), the total numbers of stool specimens classified as positive and negative for toxigenic C. difficile were 21 (15%) and 118 (85%), respectively. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were as follows: GeneOhm (95.2%, 100%, 100%, and 99.2%), illumigene (95.2%, 96.6%, 83.3%, and 99.2%), Tox A/B II (52.4%, 97.5%, 78.6%, and 92.4%), and Quik Chek Complete (47.6%, 100%, 100%, and 91.9%). The illumigene assay performed comparably to the GeneOhm assay with a slight decrease in test specificity; the sensitivities of both far exceeded those of the antigen assays. The clinical characteristics of the concordant and discrepant study patients were similar, including stool consistency and frequency. In the era of rapid molecular-based tests for toxigenic C. difficile, toxin enzyme immunoassays (EIAs) should no longer be considered the standard of care.

Infectious Diseases in Clinical Practice, 2010

The management of infective endocarditis (IE) is very challenging in patients with blood cultures... more The management of infective endocarditis (IE) is very challenging in patients with blood cultures negative for a microorganism. Unfortunately, this situation is not uncommon, occurring in up to 30% of cases of IE. Precise microbiological diagnosis, however, is critical to optimize the antibiotic regimen, and thus, nonYculture-based molecular techniques are playing a growing role in the care of these patients. We present a patient with culture-negative IE due to Haemophilus parainfluenzae, with the pathogen identified only via molecular techniques.

Background: : Estimates of Group B Streptococcus (GBS) antibiotic resistance to clindamycin and e... more Background: : Estimates of Group B Streptococcus (GBS) antibiotic resistance to clindamycin and erythromycin range between 12-15% and 25-32%, respectively. In a recent study, an even higher proportion of clindamycin (40.7%) and erythromycin (41.9%) antibiotic resistance in colonizing GBS derived from college students in Southeastern Michigan has been described. Our objective was to retrospectively characterize GBS antibiotic resistance patterns and trends among a collection of non-invasive isolates in three consecutive years (2007-2009) at a large teaching hospital in Southeastern Michigan. Methods: GBS isolates were derived from anogenital sources recovered from women during routine prenatal screens. Each isolate was assayed for susceptibility to clindamycin, erythromycin, penicillin and vancomycin, employing standard microbiological methods. Group comparisons were calculated by Chi square for trends, where appropriate. Results:In total, 3818 anogenital GBS were evaluated. The numb...

The plethora of bacterial pathogens causing infections in children poses multiple challenges for ... more The plethora of bacterial pathogens causing infections in children poses multiple challenges for the pediatrician. Overlapping or similar clinical presentations may result in the simultaneous consideration of established and emerging pathogens. Fortunately for pediatric medicine, the continuous development and refinement of molecular strategies has complemented ongoing improvements in routine approaches for the laboratory diagnosis of bacterial infections. Bacteria are unicellular prokaryotic organisms that may cause infections as single pathogens or disease-causing strains. At the same time, commensal bacteria comprise 90% of the cellular content of human beings with an estimated 1014 bacteria compared to estimates of 1013 human cells.7 The gene content of the intestinal microbiota is estimated to be 100-fold greater in magnitude than the content of the human genome. The challenge for diagnostic microbiology laboratories often becomes a quest to distinguish potential pathogens from...

Background: The stability and stoichiometric changes of analytes in plasma and serum after prolon... more Background: The stability and stoichiometric changes of analytes in plasma and serum after prolonged contact with blood cells in uncentrifuged Vacutainer® tubes were studied. Methods: We simultaneously investigated the stability of 24 analytes (a) after prolonged contact of plasma and serum with blood cells and (b) after immediate separa- tion of plasma and serum (centrifuged twice at 2000g for 5

Kottke-Marchant/Laboratory Hematology Practice, 2012

ABSTRACT Hematology has been and continues to be at the forefront of applying molecular diagnosti... more ABSTRACT Hematology has been and continues to be at the forefront of applying molecular diagnostics and molecular monitoring in the management of patients with hematologic malignancies and inherited disorders. The technology has evolved rapidly over the last decade from hybridization assays and target and signal amplification to gene expression profiling and single nucleotide polymorphism analysis, and more recently to microarray technology and whole genome analysis. All of these advanced methodologies critically depend on the nature of the nucleic acids obtained from patient specimens. Results can not be obtained nor interpreted correctly if the quality and quantity of DNA or RNA is not optimal for the specific molecular application. Multiple issues related to the type of patient specimen, collection and processing, extraction methodologies, stability, and storage for nucleic acids are reviewed.

New England Journal of Medicine, 2014

Journal of Lower Genital Tract Disease, 2014

Health System, Royal Oak, MI h Abstract

Infectious Diseases in Clinical Practice, 2009

California serogroup viral infections are the most common reported etiology of arboviral encephal... more California serogroup viral infections are the most common reported etiology of arboviral encephalitis in the United States. Since 2002, only 29 cases have been reported in Michigan, mostly in children. We report a case of a 27-year-old woman presenting with vertigo and whose cerebrospinal fluid contained 14-3-3 protein. (Infect Dis Clin Pract 2009;17: 127Y129)

Archives of pathology & laboratory medicine, 2008

The incidence of infections due to diverse Candida species is increasing, with correspondingly di... more The incidence of infections due to diverse Candida species is increasing, with correspondingly different antifungal susceptibility patterns. Routine yeast identification methods cause significant delays in appropriate patient management. A DNA pyrosequencing strategy was evaluated for identification of pathogenic Candida species associated with human infections. Clinical (n = 51) and commercial (n = 9) Candida isolates were identified in a blinded, parallel study consisting of routine fungal cultures and biochemical analyses in comparison with DNA pyrosequencing. DNA pyrosequencing yielded species-level identification of all 60 Candida isolates, and sequencing interpretations agreed in all cases with results of biochemical and morphologic testing. Different Candida species were identified, such as C. albicans, C. dubliniensis, C. glabrata, C. guilliermondii, C. krusei, C. lusitaniae, C. parapsilosis, and C. tropicalis. Automated and manual approaches to DNA sequence interpretation, ...

Infectious Diseases in Clinical Practice, 2015

Journal of Clinical Microbiology, 2015

The Lyra Direct strep assay was compared to culture for its ability to detect Streptococcus group... more The Lyra Direct strep assay was compared to culture for its ability to detect Streptococcus group A and β-hemolytic groups C/G using rapid antigen-negative pharyngeal specimens (n = 161). The Lyra assay correctly detected all β-hemolytic streptococci (group A, n = 19; group C/G, n = 5). In batch mode, the Lyra assay reduced intralaboratory turnaround time by 60% (18.1 h versus 45.0 h) but increased hands-on time by 96% (3 min 16 s versus 1 min 40 s per specimen).

Journal of Clinical Microbiology, 2015

Pasteurella multocida is a rare cause of neonatal bacterial meningitis. We describe such a case a... more Pasteurella multocida is a rare cause of neonatal bacterial meningitis. We describe such a case and verify two household cats as the source of infection using repetitive element polymerase chain reaction (rep-PCR) molecular fingering.

MMWR. Morbidity and mortality weekly report

Archives of pathology & laboratory medicine, 2006

A 55-year-old man presented to the emergency room after a fall. Chest radiograph showed a fractur... more A 55-year-old man presented to the emergency room after a fall. Chest radiograph showed a fracture of the right 9th rib. This finding was confirmed by computed tomographic scan, which incidentally revealed a large right adrenal mass with the density of fat. Magnetic resonance imaging confirmed fat suppression within the adrenal mass. His medical history was significant for pharmacologically controlled essential hypertension. The physical examination was significant only for tenderness of the right thorax. Initial laboratory findings were within normal limits and the patient was discharged. The results from a 24-hour urine sample (total volume, 3.5 L) were normal for aldosterone, cortisol, 17-ketosteroids, and 17-

Archives of pathology & laboratory medicine, 2004

A 27-year-old man presented to the emergency department with a 3-day history of progressively wor... more A 27-year-old man presented to the emergency department with a 3-day history of progressively worsening abdominal pain, nausea, emesis, and obstipation following a weekend drinking binge. The patient's medical history was significant for smoking and alcohol abuse. Family history was significant for ''intestinal problems'' in 2 uncles. Physical examination revealed an afebrile patient with epigastric pain and high-pitched bowel sounds. Results of laboratory tests were within normal limits, except for an amylase level of 254 U/L (reference range, 25-115 U/L), and a mildly elevated white blood cell count of 13 000/L (reference range, 4000-11 000/L). A computed

Archives of pathology & laboratory medicine, 2007

Intraneural perineurioma may be confused with other "onion bulb" Schwann cell entities ... more Intraneural perineurioma may be confused with other "onion bulb" Schwann cell entities (localized hypertrophic neuropathy, reactive/demyelinating processes, or inherited polyneuropathies of Charcot-Marie-Tooth/Dejerine Sottas) due to similar clinical, radiologic, and histologic features. Perineurial and Schwann cells can only be differentiated by ultrastructure and immunohistochemsitry. To identify and summarize the clinicopathologic features of true cases of intraneural perineurioma from the English language literature. A systematic review was performed on definitive intraneural perineuriomas identified through Medline. Baylor College of Medicine-affiliated hospitals' anatomic pathology databases yielded 2 illustrative intraneural perineurioma cases. Intraneural perineurioma inclusion criteria consisted of characteristic histology and confirmation of perineurial cell lineage by either immunohistochemistry (epithelial membrane antigen positive, S100 protein negative) a...

Archives of pathology & laboratory medicine, 2007

In this article we review the recent literature on Hansen disease (leprosy). We searched publishe... more In this article we review the recent literature on Hansen disease (leprosy). We searched published literature through PubMed (National Library of Medicine) and extracted data through direct review of the literature and pathologic slides. Hansen disease continues to occur in the United States, including among the native-born population. Inclusion of the disease in the differential diagnosis is key to confirmation. Current epidemiology, classification systems, prevention measures, and therapy are reviewed.

Journal of Clinical Microbiology, 2011

Journal of Clinical Microbiology, 2012

Clostridium difficile infection is the primary cause of health care-associated diarrhea. While mo... more Clostridium difficile infection is the primary cause of health care-associated diarrhea. While most laboratories have been using rapid antigen tests for detecting C. difficile toxins, they have poor sensitivity; newer molecular methods offer rapid results with high test sensitivity and specificity. This study was designed to compare the performances of two molecular assays (Meridian illumigene and BD GeneOhm) and two antigen assays (Wampole Quik Chek Complete and TechLab Tox A/B II) to detect toxigenic C. difficile. Fecal specimens from hospitalized patients (n ‫؍‬ 139) suspected of having C. difficile infection were tested by the four assays. Nine specimens were positive and 109 were negative by all four methods. After discrepant analysis by toxigenic culture (n ‫؍‬ 21), the total numbers of stool specimens classified as positive and negative for toxigenic C. difficile were 21 (15%) and 118 (85%), respectively. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were as follows: GeneOhm (95.2%, 100%, 100%, and 99.2%), illumigene (95.2%, 96.6%, 83.3%, and 99.2%), Tox A/B II (52.4%, 97.5%, 78.6%, and 92.4%), and Quik Chek Complete (47.6%, 100%, 100%, and 91.9%). The illumigene assay performed comparably to the GeneOhm assay with a slight decrease in test specificity; the sensitivities of both far exceeded those of the antigen assays. The clinical characteristics of the concordant and discrepant study patients were similar, including stool consistency and frequency. In the era of rapid molecular-based tests for toxigenic C. difficile, toxin enzyme immunoassays (EIAs) should no longer be considered the standard of care.

Infectious Diseases in Clinical Practice, 2010

The management of infective endocarditis (IE) is very challenging in patients with blood cultures... more The management of infective endocarditis (IE) is very challenging in patients with blood cultures negative for a microorganism. Unfortunately, this situation is not uncommon, occurring in up to 30% of cases of IE. Precise microbiological diagnosis, however, is critical to optimize the antibiotic regimen, and thus, nonYculture-based molecular techniques are playing a growing role in the care of these patients. We present a patient with culture-negative IE due to Haemophilus parainfluenzae, with the pathogen identified only via molecular techniques.

Background: : Estimates of Group B Streptococcus (GBS) antibiotic resistance to clindamycin and e... more Background: : Estimates of Group B Streptococcus (GBS) antibiotic resistance to clindamycin and erythromycin range between 12-15% and 25-32%, respectively. In a recent study, an even higher proportion of clindamycin (40.7%) and erythromycin (41.9%) antibiotic resistance in colonizing GBS derived from college students in Southeastern Michigan has been described. Our objective was to retrospectively characterize GBS antibiotic resistance patterns and trends among a collection of non-invasive isolates in three consecutive years (2007-2009) at a large teaching hospital in Southeastern Michigan. Methods: GBS isolates were derived from anogenital sources recovered from women during routine prenatal screens. Each isolate was assayed for susceptibility to clindamycin, erythromycin, penicillin and vancomycin, employing standard microbiological methods. Group comparisons were calculated by Chi square for trends, where appropriate. Results:In total, 3818 anogenital GBS were evaluated. The numb...

The plethora of bacterial pathogens causing infections in children poses multiple challenges for ... more The plethora of bacterial pathogens causing infections in children poses multiple challenges for the pediatrician. Overlapping or similar clinical presentations may result in the simultaneous consideration of established and emerging pathogens. Fortunately for pediatric medicine, the continuous development and refinement of molecular strategies has complemented ongoing improvements in routine approaches for the laboratory diagnosis of bacterial infections. Bacteria are unicellular prokaryotic organisms that may cause infections as single pathogens or disease-causing strains. At the same time, commensal bacteria comprise 90% of the cellular content of human beings with an estimated 1014 bacteria compared to estimates of 1013 human cells.7 The gene content of the intestinal microbiota is estimated to be 100-fold greater in magnitude than the content of the human genome. The challenge for diagnostic microbiology laboratories often becomes a quest to distinguish potential pathogens from...

Background: The stability and stoichiometric changes of analytes in plasma and serum after prolon... more Background: The stability and stoichiometric changes of analytes in plasma and serum after prolonged contact with blood cells in uncentrifuged Vacutainer® tubes were studied. Methods: We simultaneously investigated the stability of 24 analytes (a) after prolonged contact of plasma and serum with blood cells and (b) after immediate separa- tion of plasma and serum (centrifuged twice at 2000g for 5

Kottke-Marchant/Laboratory Hematology Practice, 2012

ABSTRACT Hematology has been and continues to be at the forefront of applying molecular diagnosti... more ABSTRACT Hematology has been and continues to be at the forefront of applying molecular diagnostics and molecular monitoring in the management of patients with hematologic malignancies and inherited disorders. The technology has evolved rapidly over the last decade from hybridization assays and target and signal amplification to gene expression profiling and single nucleotide polymorphism analysis, and more recently to microarray technology and whole genome analysis. All of these advanced methodologies critically depend on the nature of the nucleic acids obtained from patient specimens. Results can not be obtained nor interpreted correctly if the quality and quantity of DNA or RNA is not optimal for the specific molecular application. Multiple issues related to the type of patient specimen, collection and processing, extraction methodologies, stability, and storage for nucleic acids are reviewed.

New England Journal of Medicine, 2014

Journal of Lower Genital Tract Disease, 2014

Health System, Royal Oak, MI h Abstract

Infectious Diseases in Clinical Practice, 2009

California serogroup viral infections are the most common reported etiology of arboviral encephal... more California serogroup viral infections are the most common reported etiology of arboviral encephalitis in the United States. Since 2002, only 29 cases have been reported in Michigan, mostly in children. We report a case of a 27-year-old woman presenting with vertigo and whose cerebrospinal fluid contained 14-3-3 protein. (Infect Dis Clin Pract 2009;17: 127Y129)

Archives of pathology & laboratory medicine, 2008

The incidence of infections due to diverse Candida species is increasing, with correspondingly di... more The incidence of infections due to diverse Candida species is increasing, with correspondingly different antifungal susceptibility patterns. Routine yeast identification methods cause significant delays in appropriate patient management. A DNA pyrosequencing strategy was evaluated for identification of pathogenic Candida species associated with human infections. Clinical (n = 51) and commercial (n = 9) Candida isolates were identified in a blinded, parallel study consisting of routine fungal cultures and biochemical analyses in comparison with DNA pyrosequencing. DNA pyrosequencing yielded species-level identification of all 60 Candida isolates, and sequencing interpretations agreed in all cases with results of biochemical and morphologic testing. Different Candida species were identified, such as C. albicans, C. dubliniensis, C. glabrata, C. guilliermondii, C. krusei, C. lusitaniae, C. parapsilosis, and C. tropicalis. Automated and manual approaches to DNA sequence interpretation, ...