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      How to Handle CT-Guided Abscess Drainages in Microbiological Analyses? Sterile Vials vs. Blood Culture Bottles for Transport and Processing

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          Abstract

          The aim of this investigation was to compare microbiological analyses of 100 computed tomography-guided drainages from infectious foci (thoracic, abdominal, musculoskeletal), transported and analyzed by two widely established techniques, that are (i) sterile vials or (ii) inoculated blood culture bottles. The mean number of detected microorganisms from blood culture (aerobic/anaerobic) or conventional method (sterile vial, solid and broth media) per specimen were comparable with 1.29 and 1.41, respectively ( p = 1.0). The conventional method showed a trend towards shorter time-to-result (median 28.62 h) in comparison to blood culture incubation (median 43.55 h) ( p = 0.0722). Of note, detection of anaerobes (13% vs. 36%) and the number of detected microorganisms in polymicrobial infections (2.76 vs. 3.26) differed significantly with an advantage towards conventional techniques ( p = 0.0015; p = 0.035), especially in abdominal aspirations. Despite substantially overlapping results from both techniques, the conventional approach includes some benefits which justify its role as standard approach.

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          The Measurement of Observer Agreement for Categorical Data

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            16S ribosomal DNA amplification for phylogenetic study.

            A set of oligonucleotide primers capable of initiating enzymatic amplification (polymerase chain reaction) on a phylogenetically and taxonomically wide range of bacteria is described along with methods for their use and examples. One pair of primers is capable of amplifying nearly full-length 16S ribosomal DNA (rDNA) from many bacterial genera; the additional primers are useful for various exceptional sequences. Methods for purification of amplified material, direct sequencing, cloning, sequencing, and transcription are outlined. An obligate intracellular parasite of bovine erythrocytes, Anaplasma marginale, is used as an example; its 16S rDNA was amplified, cloned, sequenced, and phylogenetically placed. Anaplasmas are related to the genera Rickettsia and Ehrlichia. In addition, 16S rDNAs from several species were readily amplified from material found in lyophilized ampoules from the American Type Culture Collection. By use of this method, the phylogenetic study of extremely fastidious or highly pathogenic bacterial species can be carried out without the need to culture them. In theory, any gene segment for which polymerase chain reaction primer design is possible can be derived from a readily obtainable lyophilized bacterial culture.
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              Infectious spondylodiscitis.

              To review the available literature on infectious spondylodiscitis and provide recommendations on management, particularly identification of the causative agent and antimicrobial therapy. The medical literature was searched using PubMed, employing the key words discitis, disc space infection, infectious spondylodiscitis, pyogenic discitis, septic discitis and post-operative discitis. Infectious spondylodiscitis is rising in incidence and diagnosis has been facilitated by the availability of sensitive imaging techniques such as MRI. No randomized controlled studies of antimicrobial therapy were identified in this literature search and there appear to be no UK consensus guidelines on investigation and management. Comprehensive French guidelines have been published and were scrutinized for this review. Unless the patient is severely unwell antimicrobial therapy should be delayed until a microbiological diagnosis is established. If initial blood cultures are negative then a CT-guided biopsy should be conducted. Tentative recommendations for antimicrobial therapy can be made based on theoretical considerations and limited data from uncontrolled studies.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Microorganisms
                Microorganisms
                microorganisms
                Microorganisms
                MDPI
                2076-2607
                14 July 2021
                July 2021
                : 9
                : 7
                : 1510
                Affiliations
                [1 ]Institute of Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, Germany; hahn.andreas@ 123456me.com (A.H.); frickmann@ 123456bnitm.de (H.F.); andreas.podbielski@ 123456med.uni-rostock.de (A.P.); philipp.warnke@ 123456med.uni-rostock.de (P.W.)
                [2 ]Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, Rostock University Medical Center, 18057 Rostock, Germany; christopher.skusa@ 123456med.uni-rostock.de (C.S.); moritz.wohlfarth@ 123456uni-rostock.de (M.W.); Marc-Andre.Weber@ 123456med.uni-rostock.de (M.-A.W.)
                [3 ]Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, 22767 Hamburg, Germany
                Author notes
                [* ]Correspondence: romy.skusa@ 123456med.uni-rostock.de ; Tel.: +49-(0)3-814-945-943
                Author information
                https://orcid.org/0000-0002-0360-8412
                https://orcid.org/0000-0002-5157-8369
                https://orcid.org/0000-0002-8967-9528
                https://orcid.org/0000-0003-3918-8066
                https://orcid.org/0000-0003-1017-439X
                Article
                microorganisms-09-01510
                10.3390/microorganisms9071510
                8306503
                22581f17-71ae-4939-82c2-19a50ee5d6e3
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 04 June 2021
                : 13 July 2021
                Categories
                Article

                drainage,pre-analysis,blood culture incubation,abdominal infections,ct,bactec,microbiology

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