Jill Clarridge - Academia.edu (original) (raw)

Papers by Jill Clarridge

Journal of medical microbiology, Jan 6, 2016

Clostridium difficile (CD) disease remains a costly and important hospital associated infection. ... more Clostridium difficile (CD) disease remains a costly and important hospital associated infection. Although nontoxigenic CD is detected by some CD testing methods, can interfere with some detection algorithms and has been suggested as a treatment for CD disease, little is known about the relative occurrence of toxigenic and nontoxigenic CD in a single institution. We used both chromogenic and selective agar medium to recover Clostridium difficile (CD) isolates and a molecular method to detect the toxin B gene from over 2400 fresh unformed stool specimens with isolates further tested for the toxin B gene. We recovered 74 nontoxigenic and 306 toxigenic CD isolates for which a collection site could be assigned. The frequency of recovery of toxigenic and nontoxigenic CD for each hospital location and the ratio of toxigenic to nontoxigenic CD were calculated. Although the overall prevalence of toxigenic and nontoxigenic CD was 12.7% and 3.1%, respectively, on some wards 48% of all CD were ...

We determined the frequency distribution of Actinomyces spp. recovered in a routine clinical labo... more We determined the frequency distribution of Actinomyces spp. recovered in a routine clinical laboratory and investigated the clinical significance of accurate identification to the species level. We identified 92 clinical strains of Actinomyces, including 13 strains in the related Arcanobacterium-Actinobaculum taxon, by 16S rRNA gene sequence analysis and recorded their biotypes, sources, and disease associations. The clinical isolates clustered into

Journal of Clinical Microbiology, Nov 1, 2000

Previous studies have demonstrated that the four subspecies of the human pathogen Francisella tul... more Previous studies have demonstrated that the four subspecies of the human pathogen Francisella tularensis, despite showing marked variations in their virulence for mammals and originating from different regions in the Northern Hemisphere, display a very close phylogenetic relationship. This property has hampered the development of generally applicable typing methods. To overcome this problem, we evaluated the use of PCR for discrimination of the subspecies using various forms of long arbitrary primers or primers specific for repetitive extragenic palindromic sequences (REP) or enterobacterial repetitive intragenic consensus (ERIC) sequences. Patterns generated by use of REP, ERIC, or long arbitrary primers allowed differentiation at the species level and of the four subspecies of F. tularensis. With each of these three methods, similar or identical clustering of strains was found, and groups of strains of different geographical origins or differing in virulence showed distinct patterns. The discriminatory indices of the methods varied from 0.57 to 0.65; thus, the patterns were not sufficiently discriminatory to distinguish individual strains. The sequence of a fragment generated by amplification with an arbitrary primer was determined, and a region showing interstrain heterogeneity was identified. Specific primers were designed, and a PCR was developed that distinguished strains of F. tularensis subsp. holarctica from strains of other F. tularensis subspecies, including strains of the highly virulent F. tularensis subsp. tularensis. Notably, one European isolate showed the genetic pattern typical of the highly virulent F. tularensis subsp. tularensis, generally believed to exist only in North America. It is proposed that a combination of the specific PCR together with one method generating subspecies-specific patterns is suitable as a rapid and relatively simple strategy for discrimination of Francisella species and subspecies.

Antimicrobial agents and chemotherapy, Jan 14, 2015

Mupirocin is a topical antimicrobial used to decolonize patients who carry methicillin resistant ... more Mupirocin is a topical antimicrobial used to decolonize patients who carry methicillin resistant Staphylococcus aureus (MRSA), and the topical agent retapamulin may be a potential alternative therapy. The goal of this study was to determine the in vitro activity of retapamulin in a naïve population along with a panel of fifteen antimicrobial agents, including mupirocin, for 403 MRSA isolates collected longitudinally at the Veterans Affairs Puget Sound Health Care System. The minimum inhibitory concentration (MIC) for retapamulin had a unimodal distribution ranging from 0.008-0.5 μg/ml. One isolate had an MIC of >16 μg/ml, was also resistant to clindamycin and erythromycin, and was recovered from the nares of a patient receiving hemodialysis. 24 (6%) and 11 (3%) isolates, respectively, demonstrated low level resistance (8-64 μg/ml) and high level resistance (≥512 μg/ml) to mupirocin. Isolates were recovered from 10 patients both pre- and post- mupirocin therapy. Of those, 2 patien...

Emerging Infectious Diseases, 2015

Molecular Medical Microbiology, 2015

Aerococcus urinae is a rarely reported pathogen, possibly due to difficulties in the identificati... more Aerococcus urinae is a rarely reported pathogen, possibly due to difficulties in the identification of the organism. A. urinae is a gram-positive coccus that grows in pairs and clusters, produces alpha-hemolysis on blood agar, and is negative for catalase and pyrrolidonyl aminopeptidase. Some of these characteristics and its being absent from the databases of most commercial identification systems could allow

Journal of clinical microbiology, 1996

We have isolated two phenotypically distinct nonfastidious Francisella strains (Fx1 and Fx2) from... more We have isolated two phenotypically distinct nonfastidious Francisella strains (Fx1 and Fx2) from the blood of compromised patients with pneumonia and compared them with eight other Francisella strains, including Francisella tularensis biovar tularensis, F. tularensis biovar novicida, and F. philomiragia. Our isolates grew well on sheep blood agar, chocolate agar, modified Thayer-Martin agar, and Trypticase soy agar. Fx1 and Fx2 were determined to be within the Francisella genus by cellular fatty acid analysis and by the utilization of glucose, production of H2S and catalase, and lack of motility, oxidase, nitrate reductase, and gelatinase. They were additionally shown to belong to the species F. tularensis by sequencing of two variable regions comprising approximately 500 nucleotides of the 16S rRNA gene. Also, RNA probe hybridization confirmed their belonging to the species F. tularensis. However, the new strains, which are not identical, are distinguished from other F. tularensis...

Journal of clinical microbiology, 2000

Human Pathology, 2003

Helicobacter pylori infection is the most common cause of gastritis with its associated sequelae.... more Helicobacter pylori infection is the most common cause of gastritis with its associated sequelae. Gastritis secondary to other bacteria is rare. This report describes Enterococcus-associated gastritis in a 59year-old diabetic man. Nine months after receiving treatment for H. pylori-associated gastritis, he underwent endoscopy to confirm H. pylori eradication and to evaluate the status of previously seen ulcers. Mucosal biopsy specimens revealed severe active but focal gastritis adjacent to gram-positive coccobacilli in short to long chains with no H. pylori. Culture grew an Enterococcus similar to E. hirae and E. durans. No treatment was given, and endoscopy done 2 months later showed complete resolution of the gastritis and absence of H. pylori or enterococci. Our patient's gastritis represents a previously undescribed manifestation of Enterococcus infection. It is possible that the presence of NSAID gastric mucosal injury and diabetes predisposed this individual to the development of transient Enterococcus gastritis. HUM PATHOL 34:944-945.

Clinical Microbiology Newsletter, 2014

A 58-year-old man with a history of psoriatic arthritis presented with a post-operative spine inf... more A 58-year-old man with a history of psoriatic arthritis presented with a post-operative spine infection 4 months following an L3-4 spinal fusion and laminectomy. His past medical history included coronary artery disease, hypertension, dyslipidemia, type II diabetes, squamous cell skin cancer, and an initial post-operative course complicated by a surgical site infection due to group B streptococcus approximately 1 month after initial hardware placement, which was managed by irrigation and debridement (I&D), 9 days of parenteral therapy (predominantly cefazolin), and 8 weeks of cephalexin. Several subsequent I&Ds produced no organisms recovered by culture.

Clinical Microbiology Newsletter, 1990

Spinal Cord, 1997

Spinal cord-injured (SCI) patients often suer from symptomatic polymicrobial urinary tract infect... more Spinal cord-injured (SCI) patients often suer from symptomatic polymicrobial urinary tract infection (UTI). The objective of this study was to evaluate the clinical outcome and costsavings associated with antibiotic therapy based on limited vs full microbiological investigation of urine cultures in adult SCI patients with symptomatic polymicrobial UTI (52 organisms growing in urine cultures). In the ®rst part of the study, a total of 40 evaluable patients were prospectively randomized in a single-blinded fashion to receive antibiotic therapy based on either limited (21 patients) or full microbiologic investigation (19 patients) of urine cultures. The practicality of a limited microbiological investigation was further examined in the second part of the study where 12 consecutive patients with symptomatic polymicrobial UTI initially had only limited microbiological investigation of urine cultures and received antibiotic therapy accordingly. When analyzing all patients in the study, the likelihood of adequate clinical response was not signi®cantly dierent between those who received antibiotic therapy based on limited (28/33=85%) vs full (18/19=95%) microbiological investigation of urine cultures (P=0.40). An average of 183 US dollars could be saved per patient by managing symptomatic polymicrobial UTI based on a limited vs a full microbiological investigation. These results suggest that in adult SCI patients with symptomatic polymicrobial UTI antibiotic therapy guided by a limited microbiological investigation may be practical, adequate and cost-saving.

Medicine, 2001

Medicine. Wolters Kluwer Health Logo. All Issues. ...

Journal of Medical Microbiology, 2011

Haemophilus quentini' has been proposed as the name for a distinct and homogeneous Haemophilus ge... more Haemophilus quentini' has been proposed as the name for a distinct and homogeneous Haemophilus genospecies associated with urogenital tract and neonatal-related infections. Reports of 'H. quentini' isolation from adult men are rare and the disease potential in this population is unknown. We report six cases where 'H. quentini' was isolated from the genito-urinary tract in males. The isolation of 'H. quentini' during routine urine and urethral culture in adult men may aid in the determination of unresolved urethritis and possible urinary tract infections.

Journal of Medical Microbiology, 2013

Journal of Medical Microbiology, 2012

Lingual abscesses are rare. We describe a case in a healthy female with no recent history of trau... more Lingual abscesses are rare. We describe a case in a healthy female with no recent history of trauma. The organism recovered by culture of drainage material collected prior to antibiotic treatment was Streptococcus intermedius, an organism recognized as flora of the oropharynx and associated with abscess formation. The isolate was resistant to clindamycin, which was the antibiotic therapy that the patient received.

Journal of Infectious Diseases, 1985

The recent observation that Branhamella catarrhalis may cause a variety of infections in humans h... more The recent observation that Branhamella catarrhalis may cause a variety of infections in humans has stimulated interest in human host defenses against this organism. We encountered 21 patients with B. catarrhalis infection: seven with pneumonia, 13 with a purulent exacerbation of chronic bronchitis, and one with purulent sinusitis. Normal human serum (NHS) demonstrated no bactericidal activity against 20 of the 21 isolates. In contrast, 7 of 19 acute and 18 of 20 convalescent sera demonstrated significant bactericidal effects against the corresponding B. catarrhalis isolate. Heating convalescent sera to 56 C for 30 min abolished bactericidal activity. This activity was restored by NHS but not by complement-rich guinea pig serum. Selective blockage of the classic complement pathway eliminated bactericidal activity, whereas selective blockage of the alternative pathway did not. IgG isolated from convalescent serum plus NHS was bactericidal for the corresponding B. catarrhalis isolate. These results suggest that most patients with pulmonary infections due to B. catarrhalis develop a convalescent IgG antibody response that mediates serum bactericidal activity by the classic complement pathway.

Journal of Clinical Microbiology, 2002

In mid-1999, we noted multiple isolations at the Veterans Affairs Medical Center (VAMC) Houston T... more In mid-1999, we noted multiple isolations at the Veterans Affairs Medical Center (VAMC) Houston Tex. of an unusual nonpigmented Mycobacterium species. Since, on the basis of 16S rRNA gene sequence analysis, the strains were identical to the Mycobacterium szulgai type strain and since M. szulgai has been reported only rarely as a commensal or environmental isolate, we were concerned about laboratory contamination, nosocomial spread, or even the possibility that this could be a novel organism associated with disease. Our investigation found that from 1999 to 2000, 37 strains of M. szulgai were isolated from patients at the VAMC (the base rate for the previous 10 years had been <1 isolation per year). We compared the phenotypic properties and genetic relatedness of these 37 strains (31 of which were nonpigmented) as well as eight stock strains and the M. szulgai type strain. All strains were similar in cellular fatty acid patterns, growth rates, and biochemical characteristics. However, we found three genogroups by gene sequence analysis. Genogroup I comprised the M. szulgai type strain, all the tested nonpigmented strains (27 of the 31 strains were tested), two pigmented strains isolated in 1999 and 2000, and five pigmented stock strains. Genogroup II comprised five pigmented strains: three were isolated from 1999 to 2000 and two were stock strains. The single strain (isolated in 1996) in genogroup III was pigmented and was the only strain associated with disease. Whereas the randomly amplified polymorphic DNA (RAPD) patterns of all nonpigmented strains were identical, indicating that they came from a common source (the pseudoepidemic strain), the RAPD patterns of the other strains were varied. In our investigation for a possible source, we found that there were no common reagents, specimen-processing or patient locations, or procedures linking the 31 pseudoepidemic strains. However, a nonpigmented M. szulgai strain with a gene sequence and RAPD pattern identical to those of the pseudoepidemic strain was recovered from a water storage tank serving the hospital. We concluded that the strains most likely originated from hospital water, which transiently inoculated our patients. Although no disease was associated with this cluster of isolates, the event was costly because identification was problematic and we could not easily discount the isolations, since most of the patients were immunocompromised and were candidates for opportunistic infection.

Journal of Clinical Microbiology, 2003

We describe the first case of continuous ambulatory peritoneal dialysis (CAPD)-related peritoniti... more We describe the first case of continuous ambulatory peritoneal dialysis (CAPD)-related peritonitis due to Lactobacillus paracasei. It occurred in a 65-year-old patient with recurrent episodes of peritonitis while he was receiving a prolonged course of intraperitoneal vancomycin. L. paracasei should be considered in the differential diagnosis of pathogens in CAPD-related peritonitis, especially in patients receiving prolonged vancomycin or glycopeptide treatment.