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  1. Article ; Online: Point-of-Care Testing for the Diagnosis of Fungal Infections: Current Testing Applications and Potential for the Future.

    Luethy, Paul M

    Clinics in laboratory medicine

    2023  Volume 43, Issue 2, Page(s) 209–220

    Abstract: Invasive fungal infections are increasing worldwide due to factors such as climate change and immunomodulating therapies. Unfortunately, the detection of these infections is limited due to the low sensitivity and long periods required for laboratory ... ...

    Abstract Invasive fungal infections are increasing worldwide due to factors such as climate change and immunomodulating therapies. Unfortunately, the detection of these infections is limited due to the low sensitivity and long periods required for laboratory testing. Point-of-care testing could lead to more rapid diagnosis of these often devasting infections. However, there are currently no true point-of-care tests on the market for the detection of fungi. In this article, the current state of fungal antigen and molecular testing is reviewed, with commentary on the potential for development and use in the point-of-care setting.
    MeSH term(s) Humans ; Mycoses/diagnosis ; Point-of-Care Testing ; Antigens, Fungal ; Point-of-Care Systems ; Molecular Diagnostic Techniques ; Sensitivity and Specificity ; Mannans
    Chemical Substances Antigens, Fungal ; Mannans
    Language English
    Publishing date 2023-03-15
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 604580-7
    ISSN 1557-9832 ; 0272-2712
    ISSN (online) 1557-9832
    ISSN 0272-2712
    DOI 10.1016/j.cll.2023.02.005
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  2. Article: Overprediction of Carbapenemase-Containing Isolates by an Automated AST Instrument's Computer Algorithm.

    Rice, Kathryn S / Luethy, Paul M

    The journal of applied laboratory medicine

    2022  Volume 7, Issue 6, Page(s) 1283–1289

    Abstract: Background: The VITEK® 2 is generally accepted as a reliable method for predicting antibiotic resistance mechanisms including aminoglycoside phenotypes, beta lactam phenotypes, impermeability, and penicillinases. However, when it comes to predicting ... ...

    Abstract Background: The VITEK® 2 is generally accepted as a reliable method for predicting antibiotic resistance mechanisms including aminoglycoside phenotypes, beta lactam phenotypes, impermeability, and penicillinases. However, when it comes to predicting carbapenemases, the research that has been done is inconsistent in both methods and results.
    Methods: We compared the predictions of the VITEK 2 and Advanced Expert System™ (AES) with the results of the modified carbapenemase inactivation method in an academic medical center lab to evaluate the clinical reliability of the VITEK 2 and AES in routine workflow for the detection of carbapenemases.
    Results: Our findings show that the positive predictive value of carbapenemase detection on the VITEK2 and AES is 30.3% (91/300) in our patient population.
    Conclusions: In light of these results, we propose that the VITEK 2 and AES be used as a screening tool for carbapenemase-containing organisms rather than as a definitive test.
    MeSH term(s) Humans ; Reproducibility of Results ; Microbial Sensitivity Tests ; beta-Lactamases/genetics ; Computers
    Chemical Substances carbapenemase (EC 3.5.2.6) ; beta-Lactamases (EC 3.5.2.6)
    Language English
    Publishing date 2022-10-07
    Publishing country England
    Document type Journal Article
    ISSN 2576-9456
    ISSN 2576-9456
    DOI 10.1093/jalm/jfac077
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  3. Article ; Online: Estimating the Burden of COVID-19 Symptoms Among Participants at the 2020 USA Curling Club Nationals Tournament

    Luethy, Paul M

    medRxiv

    Abstract: The COVID-19 pandemic has been a significant cause of global morbidity and mortality, with evidence suggesting that activities involving heavier breathing, such as singing and exercise, can result in increased risk for disease transmission. The USA ... ...

    Abstract The COVID-19 pandemic has been a significant cause of global morbidity and mortality, with evidence suggesting that activities involving heavier breathing, such as singing and exercise, can result in increased risk for disease transmission. The USA Curling Club Nationals is a week-long curling tournament to determine the men9s and women9s club-level champions. The 2020 tournament took place March 7-14 at the Potomac Curling Club in Laurel, MD, and featured teams from across the United States. Preventative measures, such as increased cleaning and disinfection of surfaces, single use and disposable food containers, and canceling traditional event banquets were implemented. Despite these measures, players, coaches, officials, volunteers, and spectators contracted the virus as a result of participation in the event. We surveyed participants to assess total positivity, potential days of transmission, and the burden of symptoms experienced among the participants. We found that 55.6% of all participants reported experiencing symptoms consistent with COVID-19, with nearly all experiencing more than one symptom. Although most participants9 symptoms resolved quickly, 9.6% of all participants experienced symptoms for at least one month and 12.6% of all participants reported taking at least 30 days before they felt they had returned to normal. As a result of this study, we believe curling tournaments have the potential to be high-risk events for the transmission of COVID-19. Further infection prevention measures that were not yet publicly implemented at the time of this tournament may be an effective method of lowering transmission risk, although further research is required.
    Keywords covid19
    Language English
    Publishing date 2020-10-13
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2020.10.08.20209437
    Database COVID19

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  4. Article ; Online: Estimating the Burden of COVID-19 Symptoms Among Participants at the 2020 USA Curling Club Nationals Tournament

    Luethy, Paul M

    Abstract: The COVID-19 pandemic has been a significant cause of global morbidity and mortality, with evidence suggesting that activities involving heavier breathing, such as singing and exercise, can result in increased risk for disease transmission. The USA ... ...

    Abstract The COVID-19 pandemic has been a significant cause of global morbidity and mortality, with evidence suggesting that activities involving heavier breathing, such as singing and exercise, can result in increased risk for disease transmission. The USA Curling Club Nationals is a week-long curling tournament to determine the mens and womens club-level champions. The 2020 tournament took place March 7-14 at the Potomac Curling Club in Laurel, MD, and featured teams from across the United States. Preventative measures, such as increased cleaning and disinfection of surfaces, single use and disposable food containers, and canceling traditional event banquets were implemented. Despite these measures, players, coaches, officials, volunteers, and spectators contracted the virus as a result of participation in the event. We surveyed participants to assess total positivity, potential days of transmission, and the burden of symptoms experienced among the participants. We found that 55.6% of all participants reported experiencing symptoms consistent with COVID-19, with nearly all experiencing more than one symptom. Although most participants symptoms resolved quickly, 9.6% of all participants experienced symptoms for at least one month and 12.6% of all participants reported taking at least 30 days before they felt they had returned to normal. As a result of this study, we believe curling tournaments have the potential to be high-risk events for the transmission of COVID-19. Further infection prevention measures that were not yet publicly implemented at the time of this tournament may be an effective method of lowering transmission risk, although further research is required.
    Keywords covid19
    Publisher MedRxiv; WHO
    Document type Article ; Online
    Note WHO #Covidence: #20209437
    DOI 10.1101/2020.10.08.20209437
    Database COVID19

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  5. Article: Evaluation of Inappropriate COVID-19 RT-PCR Test Utilization at an Academic Medical Center.

    Hardy, Naomi L / Luethy, Paul M

    The journal of applied laboratory medicine

    2021  Volume 6, Issue 6, Page(s) 1484–1491

    Abstract: Background: An evolving COVID-19 testing landscape and issues with test supply allocation, especially in the current pandemic, has made it challenging for ordering providers. We audited orders of the Xpert® Xpress SARS-CoV-2 PCR with reverse ... ...

    Abstract Background: An evolving COVID-19 testing landscape and issues with test supply allocation, especially in the current pandemic, has made it challenging for ordering providers. We audited orders of the Xpert® Xpress SARS-CoV-2 PCR with reverse transcription (RT-PCR) platform-the fastest of several other testing modalities available-to illuminate these challenges utilizing a multidisciplinary laboratory professional team consisting of a pathology resident and microbiology laboratory director.
    Methods: Retrospective review of the first 5 hundred Xpert Xpress SARS-CoV-2 RT-PCR test orders from a 2-week period to determine test appropriateness based on the following indications: emergency surgery, emergent obstetric procedures, initial behavioral health admission, and later including discharge to skilled care facilities and pediatric admissions. Our hypothesis was that a significant proportion of orders for this testing platform were inappropriate.
    Results: On review, a significant proportion of orders were incorrect, with 69.8% (n = 349, P < 0.0001) not meeting indications for rapid testing. Of all orders, 249 designated as emergency surgery were inappropriate, with 49.0% of those orders never proceeding with any surgical intervention; most of these were trauma related (64.6% were orders associated with a trauma unit).
    Conclusions: Significant, pervasive inappropriate ordering practices were identified at this center. A laboratory professional team can be key to identifying problems in testing and play a significant role in combating inappropriate test utilization.
    MeSH term(s) Academic Medical Centers ; COVID-19 ; COVID-19 Testing ; Child ; Female ; Humans ; Pregnancy ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; SARS-CoV-2
    Language English
    Publishing date 2021-06-29
    Publishing country England
    Document type Journal Article
    ISSN 2576-9456
    ISSN 2576-9456
    DOI 10.1093/jalm/jfab081
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Comparison of Three Sample-to-Answer RT-PCR Testing Platforms for the Detection of SARS-CoV-2 RNA in Positive Nasopharyngeal and Nasal Swabs.

    Luethy, Paul M / Johnson, J Kristie

    The journal of applied laboratory medicine

    2021  Volume 6, Issue 6, Page(s) 1635–1639

    Abstract: Background: The COVID-19 pandemic has strained clinical microbiology laboratories due to testing supply allocations. As a result, laboratories have had to invest in multiple COVID-19 assays performed on different testing instruments. Comparing the ... ...

    Abstract Background: The COVID-19 pandemic has strained clinical microbiology laboratories due to testing supply allocations. As a result, laboratories have had to invest in multiple COVID-19 assays performed on different testing instruments. Comparing the results achieved by testing positive samples between in-use assays can provide insights into which platforms may be interchangeable for testing in times of supply chain emergencies.
    Methods: Nasopharyngeal and nasal swab specimens collected in viral transport media that tested positive on the Xpert® Xpress SARS-CoV-2 assay were tested on the ePlex® SARS-CoV-2 and BD SARS-CoV-2 Reagents for BD Max™ assays. Positive percent agreement was calculated using the Xpert Xpress SARS-CoV-2 assay as the reference method.
    Results: We tested 78 positive swabs, resulting in a positive percentage agreement (PPA) of 92% (CI 84-97%) for the BD SARS-CoV-2 assay and 58% (CI 47-70%) for the ePlex assay. Following development of a new workflow for the ePlex, we detected SARS-CoV-2 in 7 additional samples, resulting in a new PPA of 68% (CI 56-78).
    Conclusions: During times of supply allocation and shortage of the Xpert Xpress SARS-CoV-2 assay, the BD SARS-CoV-2 assay is well suited to test substitutions due to its high PPA.
    MeSH term(s) COVID-19 ; Humans ; Pandemics ; RNA, Viral/genetics ; Reverse Transcriptase Polymerase Chain Reaction ; SARS-CoV-2 ; Sensitivity and Specificity
    Chemical Substances RNA, Viral
    Language English
    Publishing date 2021-06-21
    Publishing country England
    Document type Journal Article
    ISSN 2576-9456
    ISSN 2576-9456
    DOI 10.1093/jalm/jfab066
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  7. Article: The Use of Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) for the Identification of Pathogens Causing Sepsis.

    Luethy, Paul M / Johnson, J Kristie

    The journal of applied laboratory medicine

    2018  Volume 3, Issue 4, Page(s) 675–685

    Abstract: Background: Sepsis is a life-threatening condition with high rates of morbidity and mortality; effective and appropriate antibiotic therapy is essential for ensuring patient improvement. To aid in the diagnosis of sepsis, blood cultures are drawn and ... ...

    Abstract Background: Sepsis is a life-threatening condition with high rates of morbidity and mortality; effective and appropriate antibiotic therapy is essential for ensuring patient improvement. To aid in the diagnosis of sepsis, blood cultures are drawn and sent to the microbiology laboratory for pathogen growth, identification, and susceptibility testing. The clinical microbiology laboratory can assist the medical team by providing timely identification of the pathogen(s) causing the bloodstream infection through the use of rapid diagnostic technology. One of these rapid diagnostic technologies, MALDI-TOF MS, has been proven to reduce the time required for appropriate antibiotic therapy when used to identify pathogens grown in culture. This technology has also been used to identify pathogens directly from the positive blood cultures with great success.
    Content: In this minireview, we summarize the different methods that have been developed to directly identify pathogens from positive blood cultures by use of MALDI-TOF MS and the effect of this technology on patient outcomes. Additionally, we touch on current research in the field, including the identification of antimicrobial resistance directly from positive blood cultures by MALDI-TOF MS.
    Summary: Rapid identification of pathogens is important in the survival of patients undergoing a septic event. MALDI-TOF MS technology has played an important role in rapid identification, which has led to a reduction in the time to appropriate antibiotic therapy and contributed to the improvement of patient outcomes. The high sensitivity and specificity of MALDI-TOF MS identification, in combination with MALDI-TOF's rapid function and reduced labor costs, make this technology an attractive choice for clinical laboratories.
    MeSH term(s) Anti-Infective Agents/pharmacology ; Anti-Infective Agents/therapeutic use ; Bacteremia/diagnosis ; Bacteremia/drug therapy ; Bacteremia/microbiology ; Bacteria/isolation & purification ; Blood Culture ; Drug Resistance, Microbial ; Fungemia/diagnosis ; Fungemia/drug therapy ; Fungemia/microbiology ; Fungi/isolation & purification ; Humans ; Microbial Sensitivity Tests/methods ; Sensitivity and Specificity ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Time Factors ; Time-to-Treatment
    Chemical Substances Anti-Infective Agents
    Language English
    Publishing date 2018-09-13
    Publishing country England
    Document type Journal Article ; Review
    ISSN 2576-9456
    ISSN 2576-9456
    DOI 10.1373/jalm.2018.027318
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  8. Article ; Online: Rapid one-step extraction method for the identification of molds using MALDI-TOF MS.

    Luethy, Paul M / Zelazny, Adrian M

    Diagnostic microbiology and infectious disease

    2018  Volume 91, Issue 2, Page(s) 130–135

    Abstract: Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) has revolutionized fungal identification. Previously, we developed a MALDI-TOF MS mold extraction procedure and comprehensive database. While MALDI-TOF MS has ... ...

    Abstract Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) has revolutionized fungal identification. Previously, we developed a MALDI-TOF MS mold extraction procedure and comprehensive database. While MALDI-TOF MS has become routine in a few laboratories, it has not yet become widespread. A major obstacle is the lack of a simple, reproducible and uniform protein extraction procedure. In this study, we developed and validated a rapid one-step protein extraction protocol for filamentous fungi. Excised molds were placed into tubes containing zirconia-silica beads and extraction solution without washing or ethanol inactivation steps. Extraction solutions containing different ratios of acetonitrile and formic acid were evaluated. Samples were then processed using a PowerLyzer high power bead based homogenizer and supernatants spotted for MALDI-TOF MS. The rapid method was evaluated prospectively and in parallel to our current mold extraction protocol for 3 months. Analysis of 106 clinical mold isolates resulted in an improved performance and a decrease in extraction time by 30 minutes to a total of 5 minutes of hands-on time. Acceptable identification scores (≥ 2.00) were achieved for up to 63.0% of mold isolates by the rapid method compared with 52.8% of isolates by the current routine protocol. Score comparisons between duplicate spots showed higher reproducibility of the rapid method as compared to the routine method. The rapid extraction method allows efficient analysis of clinical mold isolates both in scheduled batch runs and on an in-demand basis while providing a simple starting platform for laboratories adopting MALDI-TOF MS for mold identification.
    MeSH term(s) Fungi/chemistry ; Fungi/classification ; Fungi/isolation & purification ; Humans ; Mycological Typing Techniques/methods ; Mycoses/microbiology ; Prospective Studies ; Reproducibility of Results ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization/methods
    Language English
    Publishing date 2018-02-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604920-5
    ISSN 1879-0070 ; 0732-8893
    ISSN (online) 1879-0070
    ISSN 0732-8893
    DOI 10.1016/j.diagmicrobio.2018.01.015
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    Zs.A 1845: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
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  9. Article ; Online: Listeria Meningitis: An Inconsistent Organism Causing an Inconsistent Disease.

    Hauser, Naomi / Luethy, Paul M / Stamatos, Nicholas

    The American journal of medicine

    2020  Volume 134, Issue 1, Page(s) e64–e65

    MeSH term(s) Blood Culture/methods ; Emergency Service, Hospital/organization & administration ; Female ; Humans ; Listeria monocytogenes/drug effects ; Listeria monocytogenes/pathogenicity ; Meningitis, Listeria/complications ; Middle Aged ; Multiple Myeloma/complications ; Multiple Myeloma/physiopathology ; Muscle Weakness/etiology
    Language English
    Publishing date 2020-07-24
    Publishing country United States
    Document type Case Reports
    ZDB-ID 80015-6
    ISSN 1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
    ISSN (online) 1555-7162 ; 1873-2178
    ISSN 0002-9343 ; 1548-2766
    DOI 10.1016/j.amjmed.2020.06.028
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    Ua VI Zs.289: Show issues Location:
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  10. Article ; Online: An Immunocompromised Woman with a Brain Lesion.

    Hauser, Naomi / Luethy, Paul M / Rapaka, Rekha R

    The American journal of medicine

    2020  Volume 133, Issue 9, Page(s) e516–e517

    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Brain Abscess/microbiology ; Female ; Humans ; Immunocompromised Host ; Immunosuppressive Agents/pharmacology ; Middle Aged ; Mycophenolic Acid/pharmacology ; Nocardia ; Nocardia Infections/diagnosis ; Nocardia Infections/microbiology ; Nocardia Infections/pathology ; Nocardia Infections/therapy ; Prednisone/pharmacology
    Chemical Substances Anti-Bacterial Agents ; Immunosuppressive Agents ; Mycophenolic Acid (HU9DX48N0T) ; Prednisone (VB0R961HZT)
    Language English
    Publishing date 2020-03-19
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 80015-6
    ISSN 1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
    ISSN (online) 1555-7162 ; 1873-2178
    ISSN 0002-9343 ; 1548-2766
    DOI 10.1016/j.amjmed.2020.02.021
    Database MEDical Literature Analysis and Retrieval System OnLINE

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