Jill E Clarridge

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

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Publications (46)205.73 Total impact

  • Amanda T. Harrington · Jill E. Clarridge · Steven D. Mahlen

    No preview · Chapter · Dec 2015
  • Amanda T. Harrington · Jennifer A. Black · Jill E. Clarridge
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    ABSTRACT: Mupirocin is a topical antimicrobial used to decolonize patients who carry methicillin resistant Staphylococcus aureus (MRSA), and the topical agent retapamulin may be a potential alternative therapy. The goal of this study was to determine the in vitro activity of retapamulin in a naïve population along with a panel of fifteen antimicrobial agents, including mupirocin, for 403 MRSA isolates collected longitudinally at the Veterans Affairs Puget Sound Health Care System. The minimum inhibitory concentration (MIC) for retapamulin had a unimodal distribution ranging from 0.008-0.5 μg/ml. One isolate had an MIC of >16 μg/ml, was also resistant to clindamycin and erythromycin, and was recovered from the nares of a patient receiving hemodialysis. 24 (6%) and 11 (3%) isolates, respectively, demonstrated low level resistance (8-64 μg/ml) and high level resistance (≥512 μg/ml) to mupirocin. Isolates were recovered from 10 patients both pre- and post- mupirocin therapy. Of those, 2 patients' isolates demonstrated changes in MIC post-mupirocin therapy; however, in both cases, strain typing demonstrated the pre- and post-mupirocin strains were different. 386 (96%) isolates had a vancomycin MIC ≤1.0 μg/ml. 340 (84%) isolates were resistant to levofloxacin, 18 (4.5%) isolates were resistant to TMP/SMZ, and 135 (33%) had an elevated MIC of 4 μg/ml to linezolid. The baseline level of resistance was low for mupirocin (9%) and even lower for retapamulin (0.25%) Although the use of mupirocin is currently the standard therapy for decolonization practices, the activity of retapamulin warrants consideration as an alternative therapy in an MRSA decolonization regimen.
    No preview · Article · Dec 2015 · Antimicrobial Agents and Chemotherapy
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    Siu-Kei Chow · Uyen Bui · Jill E Clarridge

    Preview · Article · Sep 2015 · Emerging Infectious Diseases
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    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.
    Preview · Article · Mar 2014 · Journal of Medical Microbiology
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    Tanis C Dingle · Jill E Clarridge
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    ABSTRACT: The occurrence and significance of Haemophilus spp. isolated from the genitourinary tract are not well known. Herein, we describe the clinical significance and characteristics of Haemophilus influenzae type b genogroup strains isolated from genitourinary tract specimens from an adult male veteran patient population and, in particular, their associations with prostatitis and epididymitis.
    Preview · Article · Mar 2014 · Journal of clinical microbiology
  • Amanda T. Harrington · Sally Mizuki · Uyen Bui · Jill E. Clarridge
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    ABSTRACT: There are over 120 species in the genus Corynebacterium, many of which are generally non-pathogenic. Isolates are frequently recovered from human clinical specimens, but because Corynebacterium spp. are known to be colonizers of human skin and mucosal surfaces, they are often not identified to the species level due to limitations in identification methods and lack of consensus concerning their clinical relevance. In this article, we present a case report demonstrating the difficulty and importance of distinguishing different strains of Corynebacterium isolated from a patient with a post-operative spine infection and review the current literature. This case illustrates not only the role of molecular diagnostics in determining the etiology of infection, but also the diagnostic subtleties that remain for the clinical microbiologist and infectious disease practitioner regarding the genus Corynebacterium.
    No preview · Article · Jan 2014 · Clinical Microbiology Newsletter
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    Siu-Kei Chow · Jill E Clarridge
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    ABSTRACT: Helcococcus spp. are Gram-positive, catalase-negative, facultatively anaerobic cocci that are associated with wound and prosthetic joint infections as well bacteremia and empyema. Five Helcococcus spp. strains were isolated from our patient population, including 2 strains of Helcococcus kunzii from trauma-associated wounds, 2 Helcococcus sueciensis strains from blood and abscess, and a novel Helcococcus spp. strain from blood associated with urosepsis. Based on the phenotypic and phylogenetic evidence, we propose that 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 for leucine aminopeptidase (LAP) and pyrrolidonyl arylamidase (PYR) testing can be cost-effective and efficient for differentiation of Helcococcus spp. from Abiotrophia and Granulicatella species. Using nonstandard methods, we found that all tested Helcococcus spp. had high MICs of >4/76 μg/ml for trimethoprim-sulfamethoxazole, an antibiotic commonly used to treat urinary tract infections. High MICs for erythromycin, azithromycin, and clindamycin, and intermediate to high MICs for moxifloxacin, levofloxacin, and gentamicin were also observed among the Helcococcus strains.
    Preview · Article · Dec 2013 · Journal of clinical microbiology
  • Raquel M Martinez · Kristina G Hulten · Uyen Bui · Jill E Clarridge
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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.
    No preview · Article · Oct 2013 · Journal of clinical microbiology
  • 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.
    No preview · Article · Mar 2013 · Diagnostic microbiology and infectious disease
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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.
    Preview · Article · Jan 2013 · Journal of Medical Microbiology
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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.
    Full-text · Article · Dec 2012 · Journal of Medical Microbiology
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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.
    Full-text · Article · Nov 2012 · Journal of clinical microbiology
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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.
    Preview · Article · Nov 2011 · Journal of Medical Microbiology
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    ABSTRACT: Streptococcus gallolyticus subsp. pasteurianus, previously known as Streptococcus bovis biotype II.2, is known to cause multiple infectious complications, including bacterial meningitis, in adults. Only sporadic individual case reports have identified this pathogen as a cause of meningitis in infants. This study is the first to longitudinally document S. gallolyticus subsp. pasteurianus as a cause of meningitis in four epidemiologically unrelated infants less than 2 weeks of age. The 16S rRNA gene sequences of all 4 isolates were identical, and further were identical to 3 central nervous system (CNS) strains (two adults and one child) reported in existing literature. S. gallolyticus subsp. pasteurianus is an increasingly recognized cause of meningitis and bacteremia in the newborn period, and it merits further study with respect to etiology of infection.
    Preview · Article · Nov 2011 · Journal of clinical microbiology
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    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.
    Preview · Article · Sep 2011 · American Journal of Clinical Pathology
  • Carlos J. Suarez · Jill E. Clarridge

    No preview · Conference Paper · Sep 2011
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    William A Glover · Carlos J Suarez · J E Clarridge
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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.
    Preview · Article · Jul 2011 · Journal of Medical Microbiology
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    Amanda T Harrington · Steven D Mahlen · Jill E Clarridge
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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.
    Preview · Article · Feb 2010 · Journal of clinical microbiology
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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 105 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.
    Preview · Article · Aug 2009 · Journal of clinical microbiology
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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.
    Preview · Article · Aug 2009 · Journal of clinical microbiology

Publication Stats

2k Citations
205.73 Total Impact Points

Institutions

  • 2007-2015
    • VA Puget Sound Health Care System
      Washington, Washington, D.C., United States
  • 2003-2015
    • University of Washington Seattle
      • Department of Laboratory Medicine
      Seattle, Washington, United States
    • Minneapolis Veterans Affairs Hospital
      Minneapolis, Minnesota, United States
  • 1996-2013
    • Baylor College of Medicine
      • • Department of Pediatrics
      • • Veterans Affairs Medical Center
      Houston, Texas, United States
  • 2011
    • San Francisco VA Medical Center
      San Francisco, California, United States
  • 2002
    • Houston Zoo
      Houston, Texas, United States