Objective: To evaluate the use of diagnostic Leptospira laboratory testing within the Midlands region of New Zealand and identify the most sensitive testing strategy.
Method: Leptospira serology and ...polymerase chain reaction (PCR) testing performed within the Pathlab remit in 2013-2022 were reviewed by comparing methodologies and request origins to identify trends over time and evaluate the relative performance of serology and PCR testing.
Results: 81% of the cases tested by both serology and PCR that were confirmed infections were detected by either blood PCR, urine PCR, or serology alone. No significant difference was observed between the detection rates of blood PCR and urine PCR. Serology was the most frequently requested methodology, though PCR testing quadrupled in 2017 and uptake has continued to increase since then, becoming the favoured methodology amongst hospital-based requestors in 2022. Appropriately timed paired serological testing was rarely performed.
Conclusions: No single methodology can be relied on to consistently detect leptospirosis infections. Follow-up serology was under- utilised. A combination of PCR and serology testing was the most effective testing strategy.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
4.
Lemierre Syndrome: Two Cases and a Review Syed, Mohammed Iqbal; Baring, David; Addidle, Michael ...
The Laryngoscope,
September 2007, Volume:
117, Issue:
9
Journal Article
Peer reviewed
Objectives: Lemierre syndrome is usually caused by an acute oropharyngeal infection in previously healthy young adults, resulting in thrombophlebitis of the internal jugular vein, leading to ...metastatic septic embolization and bacteraemia. The usual organism is Fusobacterium necrophorum. Lemierre syndrome, not so long ago labeled as the “forgotten disease,” is on the rise. Today with increasing antibiotic‐resistant organisms, and decreasing awareness of the syndrome, subsequent re‐emergence of this “forgotten disease” is becoming more common in clinical settings. Lemierre syndrome has significant morbidity. Cranial nerve complications associated with the condition have been increasingly diagnosed in the last few years. Looking back at literature on Lemierre syndrome, there have been review articles in medical and microbiology journals but rarely in otolaryngology journals. By presenting our cases we demonstrate the diverse presentations and severity of the illness.
Methods: A review of the literature and a case report on two cases seen in our institution in the last year are presented. Each of these had varied presentations and neurologic complications—one developed 9th to 12th cranial nerve palsies and Horner syndrome, which have not been described in previous literature, and the other developed polyneuropathy and a frontal lobe infarct among other multisystem complications.
Conclusions: Diagnosis of Lemierre syndrome is not always straightforward as clinical features are variable and blood cultures are often negative. Awareness of the syndrome and a high degree of suspicion are needed.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Assesses the impact that the universal hepatitis B vaccination which has been in place in NZ for the past 22 years is beginning to have on the prevalence of hepatitis B in the antenatal population. ...Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.
'Kingella kingae', a Gram negative bacillus normally found in the oropharynx of infants, is a well recognised cause of invasive bone and joint infections in paediatric patients. Osteoarticular ...infections due to K. kingae in adults are much less common. We report an interesting case of 'K. kingae' septic arthritis of the ankle in a 68 year old woman with rheumatoid arthritis, followed by a brief literature review.
Audits key quality indicators for blood culture practices across microbiology laboratories around Aotearoa New Zealand to facilitate national blood culture practice peer review and promote blood ...culture quality improvement interventions. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.
Abstract
Objectives
There is clinical uncertainty over the optimal treatment for penicillin-susceptible Staphylococcus aureus (PSSA) infections. Furthermore, there is concern that phenotypic ...penicillin susceptibility testing methods are not reliably able to detect some blaZ-positive S. aureus.
Methods
Nine S. aureus isolates, including six genetically diverse strains harbouring blaZ, were sent in triplicate to 34 participating laboratories from Australia (n = 14), New Zealand (n = 6), Canada (n = 12), Singapore (n = 1) and Israel (n = 1). We used blaZ PCR as the gold standard to assess susceptibility testing performance of CLSI (P10 disc) and EUCAST (P1 disc) methods. Very major errors (VMEs), major error (MEs) and categorical agreement were calculated.
Results
Twenty-two laboratories reported 593 results according to CLSI methodology (P10 disc). Nineteen laboratories reported 513 results according to the EUCAST (P1 disc) method. For CLSI laboratories, the categorical agreement and calculated VME and ME rates were 85% (508/593), 21% (84/396) and 1.5% (3/198), respectively. For EUCAST laboratories, the categorical agreement and calculated VME and ME rates were 93% (475/513), 11% (84/396) and 1% (3/198), respectively. Seven laboratories reported results for both methods, with VME rates of 24% for CLSI and 12% for EUCAST.
Conclusions
The EUCAST method with a P1 disc resulted in a lower VME rate compared with the CLSI methods with a P10 disc. These results should be considered in the context that among collections of PSSA isolates, as determined by automated MIC testing, less than 10% harbour blaZ. Furthermore, the clinical relevance of phenotypically susceptible, but blaZ-positive S. aureus, remains unclear.
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