J E Clarridge

VA Puget Sound Health Care System, Washington, Washington, D.C., United States

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Publications (66)308.18 Total impact

  • Siu-Kei Chow, Jill E Clarridge
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    ABSTRACT: The identification of Haemophilus species from urogenital sites can be challenging due to the lack of appropriate media for culturing the organisms and the poor resolution of biochemical methods. By incorporating chocolate agar and 16S rRNA gene sequence in our protocol to identify Haemophilus species from urinary specimens, we isolated and characterized 30 genetically homogeneous strains of a cryptic species that is phylogenetically close to but distinct from H. parainfluenzae. Commercial biochemical kits and Vitek 2 could not distinguish between the two genospecies. Over 90% of the strains were isolated from urine, possible with the inclusion of chocolate agar in our urine culture protocol, and the urogenital area. In contrast, no Haemophilus strains isolated from the respiratory site were identified as the cryptic genospecies. The cryptic genospecies was associated with urinary tract infection in certain patient populations. Distinct from Haemophilus quentinii that also causes urogenital infection, the cryptic genospecies required V factor (nicotinamide adenine dinucleotide) but not X factor (hemin) to grow. The data indicate that 16S rRNA gene sequencing may be necessary in identifying Haemophilus species and that inaccurate categorization of Haemophilus strains isolated from urogenital specimens based on phenotypic characteristics may prevent accurate diagnosis of urinary tract infections.
    Journal of Medical Microbiology 03/2014; · 2.30 Impact Factor
  • Tanis C Dingle, Jill E Clarridge
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    ABSTRACT: The occurrence and significance of Haemophilus spp. isolated from the genitourinary tract is not well known. Herein, we describe the clinical significance and characteristics of H. influenzae type b genogroup isolated from genitourinary tract specimens of an adult male veteran patient population and in particular, its association with prostatitis and epididymitis.
    Journal of clinical microbiology 03/2014; · 4.16 Impact Factor
  • Siu-Kei Chow, Jill E Clarridge
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    ABSTRACT: Helcococcus spp. are Gram positive, catalase-negative, facultatively anaerobic cocci that have been associated with wound and prosthetic joint infections as well bacteremia and empyema. Five Helcococcus strains were isolated from our patient population, including 2 of Helcococcus kunzii from trauma-associated wounds, 2 of Helcococcus sueciensis from blood and abscess, and a novel Helcococcus spp. from blood associated with urosepsis. Based on the phenotypic and phylogenetic evidences, we proposed the unknown bacterium be classified as Helcococcus seattlensis sp. nov. We found that all 5 tested Helcococcus strains grew as satellite colonies around Staphylococcus aureus, and interestingly, both H. kunzii strains were isolated together with S. aureus. In addition to 16S rRNA gene sequencing, conventional methods testing for leucine aminopeptidase (LAP) and pyrrolidonyl arylamidase (PYR) can be cost-effective and efficient to differentiate Helcococcus spp. from Abiotrophia and Granulicatella. Using non-standard methods, we found that all tested Helcococcus spp. had high minimum inhibitory concentration (MIC) of >4/76 μg/ml for trimethoprim-sulfamethoxazole, an antibiotic commonly used to treat urinary tract infections. High MICs for erythromycin, azithromycin, clindamycin, and intermediate to high MICs for moxifloxacin, levofloxacin, gentamicin were also observed among the Helcococcus strains.
    Journal of clinical microbiology 12/2013; · 4.16 Impact Factor
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    ABSTRACT: Lactobacillus spp. are part of the normal human flora and are generally assumed to be non-pathogenic. We determined the genotypic identification of over 100 Lactobacillus isolates from clinical specimens in the context of presumed pathogenic potential (e.g. recovered as the single/predominant isolate from a sterile site, or at ≥10(5) CFU/ml from urine). This study assessed the clinical significance as well as the frequency of occurrence of each Lactobacillus spp. We identified 16 species of Lactobacillus by 16S rRNA gene sequence analysis, ten of which could not be associated with disease. While L. rhamnosus, L. gasseri and L. paracasei were associated with infections, L. gasseri was also a common colonizing/contaminating species. L. casei, L. johnsonii and L. delbruckei were associated with at least one infection. Species commonly used in probiotic products (e.g., L. rhamnosus and L. casei) were identical by 16S rRNA gene sequence to our isolates associated with disease. Human isolates of Lactobacillus spp. have differing site associations and clinical significance. Knowing the niche and pathogenic potential of each Lactobacillus spp. can be of importance to both clinical microbiology and the food and probiotic supplement industry.
    Journal of clinical microbiology 10/2013; · 4.16 Impact Factor
  • Amanda T Harrington, Jill E Clarridge
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    ABSTRACT: Streptococcus dysgalactiae subspecies equisimilis (SDSE) are isolated from the throat of patients with pharyngitis, although the clinical significance remains debated. We sought to determine the incidence and association with pharyngitis of SDSE in an adult veteran population. Organisms were phenotypically identified to subspecies and Lancefield group, with selective 16S rRNA gene sequencing. From 833 throat cultures, the overall frequency of SDSE was 3.4% (64% group C and 36% group G) as compared to 8.6% for S. pyogenes (GAS). SDSE was described as a large colony in only 29% of the original culture evaluations by bench technologists, and clinical symptoms were similar for GAS and SDSE. Laboratory algorithms that are limited to identification of only GAS or are based on Lancefield group or visual identification of "large-colony type" β hemolytic Lancefield group C and G streptococci may be missing or misidentifying SDSE along with Anginosus group streptococci.
    Diagnostic microbiology and infectious disease 03/2013; · 2.45 Impact Factor
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    ABSTRACT: Prior to the advent of the H. influenzae type b vaccine, invasive infections due to H. influenzae type f were rarely described. However, the epidemiology of H. influenzae is changing. While the incidence of invasive infections due to H. influenzae is declining in children, such infections are becoming more common in adults, particularly in the elderly. Here, we report an unusual case of infective aortic aneurysm caused by H. influenzae type f that underscores the emerging clinical relevance and pathogenic capability of this organism.
    Journal of Medical Microbiology 01/2013; · 2.30 Impact Factor
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    ABSTRACT: The incidence of invasive infections due to Haemophilus influenzae has decreased significantly in developed countries with high rates of vaccination against Haemophilus influenzae serotype b (Hib). This vaccine provides no protection against Haemophilus influenzae serotype f (Hif), typically associated with invasive infections in adults with chronic disease and/or immunodeficiency, and rarely in otherwise healthy adults and children. The specific properties of Hif associated with virulence remain largely uncharacterized. A panel of 26 Hif strains consisting of both invasive disease-associated and mucosal surface non-invasive disease-associated isolates was surveyed by DNA fingerprinting, biotyping, PCR detection of hmw1, hmw2, hsf, the hif fimbrial locus, and the lipooligosaccharide (LOS) biosynthetic island, with assessment of β-lactamase expression, and determination of resistance to the bactericidal activity of normal adult human serum. Repetitive sequence based PCR fingerprinting differentiated the 26 strains into three clusters, with the majority of isolates (22 of 26, or 84.6%) clustered into a single indistinguishable group. Most isolates (24 of 26, or 92.3%) were of biotype I, two isolates produced β-lactamase with detection of a conjugative plasmid, and the isolates displayed a range of resistance to the bactericidal activity of human serum. All 26 isolates carried the adhesin hsf, 21 carried a partial hif fimbrial operon, and four had adhesin hmw1/2. A LOS biosynthetic island was detected in 20 isolates consisting of lic2BC. We conclude that serotype f H. influenzae have many recognized virulence properties and comprise a relatively homogenous group independent of the anatomic focus from which they were isolated.
    Journal of Medical Microbiology 12/2012; · 2.30 Impact Factor
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    ABSTRACT: The anterior nares is the site of choice for the Veterans Administration methicillin-resistant Staphylococcus aureus (MRSA) surveillance program; however, correlation between nares colonization and concomitant wound infections has not been well established. The purpose of this study was threefold: to determine the relatedness of MRSA isolates from 40 paired wound and nares specimens by four different strain typing methods, to determine concordance of typing methods, and to establish a baseline of MRSA types at this medical center. Isolates were typed by rep-PCR (DiversiLab System, DL) and SpectraCell Raman analysis (SCRA) (commercially available methods that can be performed within a clinical lab), pulsed-field gel electrophoresis (PFGE) and antibiotic susceptibility profile (AB). Whole genome optical mapping (WGM) (OpGen, Inc.) was performed on selected isolates. All methods agreed that 26 pairs were indistinguishable and four pairs were different. Discrepant results were: SCRA discordant) (4), AB discordant (3), DL and AB discordant (2), and DL and SCRA discordant (1). All WGM agreed with PFGE. After discrepant resolution 80% of the pairs were indistinguishable and 20% were different. 56% of nares results were non-predictive if negative nares and positive wound cultures are included. Methods agreed 85 to 93%; however congruence of isolates to clade was lower. Baseline analysis of types showed 15 pairs were unique to a single patient (30 strains, 38%; 47% of the matching pairs). 25 strains (30%) represented a single clade identical by PFGE, SCRA and DL, decreasing specificity. Typing method and institutional type frequency are important in assessing MRSA strain relatedness.
    Journal of clinical microbiology 11/2012; · 4.16 Impact Factor
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    ABSTRACT: 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 Medical Microbiology 11/2011; 61(Pt 4):590-2. · 2.30 Impact Factor
  • Steven D Mahlen, Jill E Clarridge
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    ABSTRACT: Although 16S ribosomal RNA (rRNA) gene sequencing is well established for correctly identifying bacteria, its most efficient use in a routine clinical laboratory is not clear. We devised and evaluated a strategy to select gram-negative rods and coccobacilli (GNRCB) for which sequencing might be necessary before routine identification methods had been exhausted. The prospectively applied selection criteria were primarily based on the isolate's display of unusual or discordant phenotypic results and/or disease correlation. By using this strategy, we selected a total of 120 GNRCB (representing only ∼2% of all identified). The strategy was demonstrated to be efficient because the preliminary phenotypic identification for 79.2% of those isolates needed revision (18.2% were novel and about a third would have required further extensive testing). The knowledge that 1.6% (ie, 79% of 2%) of isolated GNRCB might benefit from sequence identification could provide guidelines for routine clinical laboratories toward efficient use of sequence analysis.
    American Journal of Clinical Pathology 09/2011; 136(3):381-8. · 2.88 Impact Factor
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    ABSTRACT: '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 07/2011; 60(Pt 11):1689-92. · 2.30 Impact Factor
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    ABSTRACT: Previous studies have validated the properties and documented the utility of chromogenic agar for surveillance of methicillin-resistant Staphylococcus aureus (MRSA). In this study, we used one of the chromagars, MRSASelect (Bio-Rad), as one of the primary isolation media for selected wound and respiratory clinical specimens which, in our institution, were typically polymicrobial. We examined a total of 638 specimens; 142 (22%) MRSA isolates were recovered. Twenty-six of these isolates were recovered only on the MRSASelect plate, representing a 28% (15/54) increase for endotracheal aspirates/sputa and a 15% increase for superficial wounds/ulcers (11/73) compared to the results with conventional culture. One isolate (1 CFU) was recovered by conventional medium alone. MRSASelect has generally been used for surveillance cultures; however, we document that an additional 21% of MRSA isolates would have gone unreported in these selected clinical specimens using only standard culture media. For 40% (6/15) of inpatients, MRSA isolated from the MRSASelect plate was the sole indicator of MRSA. Although these isolates can represent either colonization or infection, they are a potential reservoir of infection and nosocomial transmission. Our data support the focused use of chromogenic selective media for the increased detection of MRSA in polymicrobial wound and respiratory specimens, which could have an impact on both clinical treatment and infection control.
    Journal of clinical microbiology 02/2010; 48(4):1350-3. · 4.16 Impact Factor
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    Steven D Mahlen, Jill E Clarridge
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    ABSTRACT: Streptococcus pseudoporcinus, a recently described organism found in the genitourinary tract of women, was isolated from a thumb wound in a male patient subsequent to trauma. This case describes a rarely reported non-genitourinary tract clinical isolate of S. pseudoporcinus.
    Journal of clinical microbiology 08/2009; 47(9):3041-2. · 4.16 Impact Factor
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    Steven D Mahlen, Jill E Clarridge
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    ABSTRACT: Most of the members of the genus Bifidobacterium, including the related organism Alloscardovia omnicolens, are inhabitants of the gastrointestinal tract and oral cavity of humans and animals and have been considered nonpathogenic for humans. However, the actual site of isolation and the clinical significance of A. omnicolens and of Bifidobacterium species are unclear. This may be due in part to the difficulties in distinguishing these organisms from other genera such as Actinomyces. To determine the potential disease-causing role of these organisms, we analyzed the clinical significance of 15 A. omnicolens and Bifidobacterium isolates identified by 16S rRNA gene sequencing from a clinical laboratory. All of the organisms in this study were isolated from sterile sites or in significant numbers by standard clinical microbiological culture methods. Our 15 clinical strains fit into only four species: A. omnicolens (five isolates), Bifidobacterium scardovii (four isolates), B. longum (two isolates), and B. breve (four isolates). All five A. omnicolens isolates, one of the B. breve isolates, and three of the four B. scardovii isolates were cultured from urine at 10(5) CFU/ml. One B. scardovii isolate was from a patient with a genitourinary tract wound infection, two B. longum isolates were from abdominal wounds, and three B. breve isolates were from blood cultures. This study enlarges the spectrum of diseases and clinical sources associated with A. omnicolens and Bifidobacterium species and addresses identification problems.
    Journal of clinical microbiology 08/2009; 47(10):3289-93. · 4.16 Impact Factor
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    ABSTRACT: Bordetella avium is thought to be strictly an avian pathogen. However, 16S rRNA gene sequencing identified 2 isolates from 2 humans with respiratory disease as B. avium and a novel B. avium-like strain. Thus, B. avium and B. avium-like organisms are rare opportunistic human pathogens.
    Emerging Infectious Diseases 02/2009; 15(1):72-4. · 6.79 Impact Factor
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    Steven D Mahlen, Jill E Clarridge
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    ABSTRACT: Campylobacter rectus was isolated under routine anaerobic conditions (no additional hydrogen gas in the atmosphere) from an oral, nonperiodontal abscess from a patient with gastroesophageal adenocarcinoma. We report the first case of a palate abscess caused by C. rectus and review the literature and atmospheric requirements of this organism.
    Journal of clinical microbiology 01/2009; 47(3):848-51. · 4.16 Impact Factor
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    ABSTRACT: Prompted by the changing profile of Clostridium difficile infection and the impact of formulary policies in hospitals, we performed this study when an increase in the incidence of C. difficile-associated disease was noted at our health care center (Veterans Administration Puget Sound Health Care System, Seattle, Washington). A retrospective, matched case-control study of patients presenting to the Veterans Administration Puget Sound Health Care System, Seattle, Washington during 2004 was performed. Conditional logistic analysis determined risk factors for case patients, defined as individuals with diarrhea and test results (i.e., culture or toxin assay results) positive for C. difficile, and control subjects, defined as individuals with diarrhea and test results negative for C. difficile. C. difficile-associated disease incidence was 29.2 cases per 10,000 inpatient-days. The increase in the incidence of C. difficile-associated diarrhea that paralleled increased gatifloxacin use was not attributable to use of the antimicrobial but was a reflection of seasonal variation in the rate of C. difficile-associated disease. Multivariate analysis controlling for the time at which the assay was performed, the age of the patient, ward, and source of acquisition (community-acquired vs. nosocomial disease) found 6 significant risk factors for C. difficile-associated diarrhea: receipt of clindamycin (adjusted odds ratio [aOR], 29.9; 95% confidence interval [CI], 3.58-249.4), receipt of penicillin (aOR, 4.1; 95% CI, 1.2-13.9), having a lower intestinal condition (aOR, 2.8; 95% CI, 1.3-6.1), total number of antibiotics received (aOR, 1.4; 95% CI, 1.1-1.7), number of prior hospital admissions (aOR, 1.3; 95% CI, 1.1-1.6), and number of comorbid conditions (aOR, 1.3; 95% CI, 1.1-1.5). The increase in the number of cases of C. difficile-associated disease was not attributable to a formulary change of fluoroquinolones; instead, the incidence was within expected seasonal variations for C. difficile-associated disease. Recognition of community-acquired cases and the use of culture may help to identify additional cases of C. difficile-associated disease. Early diagnosis and treatment of C. difficile cases may shorten the duration of hospital stays and reduce the number of outbreaks and readmissions, mortality, and other consequences of C. difficile infection.
    Clinical Infectious Diseases 12/2007; 45(9):1141-51. · 9.37 Impact Factor
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    Maggie M Lam, Jill E Clarridge, E J Young, Sally Mizuki
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    ABSTRACT: beta-Hemolytic Lancefield group G Streptococcus dysgalactiae and Streptococcus canis cannot be distinguished when only Lancefield typing is performed. Phenotypic testing and 16S rRNA gene sequencing identified S. canis associated with ulcer infections in dog owners. Because S. canis may be incorrectly identified (published biochemical descriptions are inconsistent), there may be an underestimation of the true number of infections. Identification of group G streptococci to the species level could have epidemiological and clinical implications.
    Journal of Clinical Microbiology 08/2007; 45(7):2327-9. · 4.07 Impact Factor
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    ABSTRACT: Recent reported outbreaks of Clostridium difficile-associated disease in Canada have changed the profile of C difficile infections. Historically, C difficile disease was thought of mainly as a nosocomial disease associated with broad-spectrum antibiotics, and the disease was usually not life threatening. The emergence of an epidemic strain, BI/NAP1/027, which produces a binary toxin in addition to the 2 classic C difficile toxins A and B and is resistant to some fluoroquinolones, was associated with large numbers of cases with high rates of mortality. Recently, C difficile has been reported more frequently in nonhospital-based settings, such as community-acquired cases. The C difficile disease is also being reported in populations once considered of low risk (children and young healthy women). In addition, poor response to metronidazole treatment is increasing. Faced with an increasing incidence of C difficile infections and the changing profile of patients who become infected, this paper will reexamine the current concepts on the epidemiology and treatment of C difficile-associated disease, present new hypotheses for risk factors, examine the role of spores in the transmission of C difficile, and provide recommendations that may enhance infection control practices.
    American Journal of Infection Control 06/2007; 35(4):237-53. · 2.73 Impact Factor
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    Kim Allison, Jill E Clarridge
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    ABSTRACT: Pasteurella dagmatis and Neisseria canis were repeatedly isolated from the sputum of a poodle-owning patient with chronic bronchiectasis. Commercially available systems failed to identify these unusual organisms: identification was made by 16S rRNA gene sequencing. Difficulties identifying these and five other canine-associated isolates (P. dagmatis [n = 2], Pasteurella canis [n = 2], and N. canis [n = 1]) are discussed.
    Journal of Clinical Microbiology 09/2005; 43(8):4272-4. · 4.07 Impact Factor

Publication Stats

2k Citations
308.18 Total Impact Points

Institutions

  • 2007–2013
    • VA Puget Sound Health Care System
      Washington, Washington, D.C., United States
  • 2004–2011
    • University of Washington Seattle
      • Department of Laboratory Medicine
      Seattle, WA, United States
  • 1996–2002
    • Minneapolis Veterans Affairs Hospital
      Minneapolis, Minnesota, United States
  • 1990–2002
    • Baylor College of Medicine
      • • Veterans Affairs Medical Center
      • • Department of Medicine
      Houston, TX, United States
    • University of Texas Health Science Center at Houston
      • Department of Pathology and Laboratory Medicine
      Houston, TX, United States
  • 1997
    • BC Centre for Disease Control
      Vancouver, British Columbia, Canada