Test 367Â Â SSTI Panel Antibiotic Resistance by Real-Time PCR
[Enterococcus faecalis, Escherichia coli, Group A Streptococcus, Group B
Streptococcus, Klebsiella species, Proteus mirabilis, Pseudomonas aeruginosa,
Community Associated MRSA (CA-MRSA)]
Skin and Soft Tissue
â€¢ Real-Time PCR
â€¢ Simple and convenient sample collection
â€¢ No refrigeration is required before or after collection
â€¢ Specimen stable for up to five days
â€¢ Test additions are available up to 30 days after receipt of the specimen
â€¢ 24 – 48 hour turnaround time. Up to 72 hours with resistance testing
â€¢ High diagnostic specificity and sensitivity
â€¢ One vial, multiple pathogens
Test 366Â Â Skin & Soft Tissue Infections (SSTI) Panel by Real-Time PCR
â€¢Â Â Â Bacteroides fragilis
â€¢Â Â Â Enterococcus faecalis
â€¢Â Â Â Escherichia coli
â€¢Â Â Â Group A Streptococcus
â€¢Â Â Â Group B Streptococcus
â€¢Â Â Â Klebsiella species
â€¢Â Â Â Prevotella Groups 1 & 2
â€¢Â Â Â Proteus mirabilis
â€¢Â Â Â Pseudomonas aeruginosa
â€¢Â Â Â Staphylococcus aureus
â€¢Â Â Â Methicillin resistant Staphylococcus aureus(MRSA)
â€¢Â Â Â Community Associated MRSA (CA-MRSA)
â€¢Â Â Â Amoxicillin-clavulanic acid
â€¢Â Â Â Ampicillin (for E. faecalis)
â€¢Â Â Â Cephalothin (cephalexin)
â€¢Â Â Â Clindamycin
â€¢Â Â Â Doxycycline
â€¢Â Â Â Trimethoprim-sulfamethoxazole
â€¢Â Â Â Ciprofloxacin
â€¢Â Â Â Cefepime
â€¢Â Â Â Piperacillin-tazobactam
â€¢Â Â Â Imipenem
â€¢Â Â Â Gentamicin
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125Â Â Â BacteroidesÂ Â Â fragilisÂ Â Â by Real-Time PCR
Clinical significance:Â Â Â Bacteroides are Gram-negative, anaerobic bacilli associated with a number of different types of infections that are typically polymicrobial in nature. Anatomic sites affected include the central nervous system, head, neck, chest, abdomen, pelvis, skin and soft tissue. Due to their fastidious growth requirements, Bacteroides species are extremely hard to identify by culturing methodologies and, as a result, are believed to be under reported pathogenic agents. B. fragilis is considered normal flora of the gastrointestinal tract and is commonly associated with SSI of the abdomen and abscesses.
141Â Â Â EscherichiaÂ Â Â coliby Real-Time PCR
Clinical significance:Â Â Â E. coli are Gram-negative, facultative, rod-shaped bacteria that naturally inhabit the gastrointestinal tract. Outside their normal environment, E. coli can cause infection, particularly within the urinary tract. They are also associated with skin infections in regions in close proximity to the rectum, particularly with incontinent individuals. Individuals undergoing surgical procedures associated with the gastrointestinal tract and lower regions of the spine are also at risk of contracting infection.
172Â Â Â KlebsiellaÂ Â Â species by Real-Time PCR (Reflex to Speciation by Pyrosequencing) ClinicalÂ significance:
Klebsiella speciesÂ areÂ Gram-negative,Â facultativeÂ rodsÂ thatÂ colonizeÂ theÂ skinÂ andÂ gastrointestinalÂ tract.Â These opportunistic pathogens are a leading cause of nosocomial infections second only to E. coli, and account for 8% of all hospital-acquired infections. Such infections typically arise within the respiratory, biliary and urinary tracts as well as surgical sites. The ubiquitous nature of these bacteria, in combination with increased treatment with broad-spectrum antibiotics, has led to the development of resistant strains. Two species, K. pneumoniae and K. oxytoca, account for the majority of infections with K. pneumoniae serving as an important cause of community-acquired pneumonia in the elderly and K. oxytoca more commonly associated with UTIs.
362Â Prevotella species Group 1Â Â Â (P.Â Â Â bivia,Â Â Â P.Â Â Â disiens,Â Â Â P.Â Â Â intermedia,Â Â Â P.Â Â Â melaninogenica)by Real-Time PCR
363Â Â Prevotella species Group 2 (P.Â Â Â corporis,Â Â Â P.Â Â Â albensis)by Real-Time PCR
Clinical significance:Â Â Â Prevotella species are Gram-negative, anaerobic bacilli that colonize the vaginal and oral cavities. Depending on their anatomic location, these bacteria cause a wide-range of infections. Oral cavity colonization is associated with sinus and periodontal infections peritonsillar abscess and pneumonia, while those colonizing the GI tract have been isolated from cases of peritonitis, intraabdominal abscess, postoperative wound infections, pelvic inflammatory disease, vulvovaginal and perianal infections. Infections of the soft tissue include gangrene and necrotizing fasciitis.
146Â Â Â ProteusÂ Â Â mirabilisÂ Â Â by Real-Time PCR
Clinical significance:Â Â Â Proteus species are a Gram-negative, facultative bacilli that colonize the gastrointestinal tract and are a source of nosocomial infection within hospitals and long-term care facilities. Usually associated with UTIs, Proteus mirabilis has also been isolated from abscesses, SSI, decubitus ulcers and burns.
174Â PseudomonasÂ Â Â aeruginosaby Real-Time PCR
Clinical significance:Â Â Â Pseudomonas aeruginosa is a Gram-negative bacillus associated with a number of different opportunistic infections and is particularly problematic for ventilated patients, burn patients and those with chronic debilities. Infections of the skin include those affecting the feet and toenails (tinea), hot tub/swimming pool infections (folliculitis) and burn wound sepsis. Recently, the ability of P. aeruginosa to form bio-films has been postulated as a mechanism for long standing wounds that will not heal.
1112Â Â Â StreptococcusÂ Â Â pyogenesÂ Â Â (GAS) by Real-Time PCR
Clinical significance:Â Â Â GAS is a Gram-negative, coccus that resides harmlessly on the skin as a commensal until the protective skin barrier is breeched and it becomes pathogenic. GAS is a causative factor, along with Staphylococcus aureus, for impetigo. While impetigo itself is not life-threatening, it can lead to more serious complictions, including cellulitis and MRSA affecting the skin and poststreptococcal glomurelonephritis affecting the kidney.
127Â Â Â Group BÂ Â Â Strep (GBS)Â Â Â by Real-Time PCR
ClinicalÂ significance:Â Â Â GBS, StreptococcusÂ agalactiae, isÂ aÂ Gram-positiveÂ coccusÂ thatÂ causesÂ aÂ numberÂ ofÂ seriousÂ infectionsÂ inÂ both pregnant women and adults with underlying health issues, like diabetes mellitus, heart disease and malignancy. Aside from its role in neonatal sepsis, GBS has been associated with infections within the over-seventy years of age group, particularly the bedridden and those afflicted with congestive heart failure, where UTI, pneumonia and soft tissue infections are the most frequent manifestations. Streptococci, along with Staphylococci, are the leading causative agents associated with the potentially life-threatening skin infection, cellulitis.
1118Â StaphylococcusÂ Â Â aureusÂ Â Â with methicillin resistance (MRSA) by Conventional PCR Clinical significance:
Staphylococcus aureusis a Gram-positive coccus that is largely considered to be normal flora of the skin. However, upon breach of this protective barrier, Staph can become highly pathogenic, particularly within individuals having chronic disorders such as diabetes, cancer, vascular and lung disease, eczema and individuals with weakened immune systems. Infections of the skin often go untreated as initial infections resemble pimples or spider bites, allowing the infection to progress to greater degrees of severity. Infections are further complicated by the emergence and circulation of methicillin-resistant strains.