A comparative investigation of methods for sampling skin flora.
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Biomedical subjects
Publications and source records attributed to A A Hartmann.
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A method for the in vivo investigation of shower-bath supplements and their influences on the human skin flora is presented. The shower-bath supplement is added in a constant dosis directly to the shower-jet to obtain constant conditions of shower-bathing on the human skin. Different concentrations of the shower-bath supplement in neighboured areas of the skin can be avoided and this allows to make comparative investigations of the effect of shower-bath supplements to the normal human skin flora. The reproducibility of the results and the accuracy of the method were investigated in half-side comparisons of the aerobic resident flora of the flexor sides of the forearms in three groups of volunteers, 60 persons in total. A marketable product in two slightly differing modificatons was used as shower-bath supplement. Half-side comparisons between each of the two supplements against water alone and between the shower-bath supplements directly were performed. The detergent washing method was used for sampling the skin flora. Statistically significant changes of the aerobic resident flora in the half-side comparison between the two supplements were obvious only 24 h after a single bath. It could be proved that the results can be reproduced at different times and with different groups of vlunteers. Further more, that a half-side comparison between th two shower-bath supplements detects more sensible differences in the effect on the human skin flora of the two marketable products than the comparison of each supplement with water alone.
The behaviour of the aerobic skin flora of the flexor sides of the forearm, under a daily repeated bath during 21 days, using two marketable bath-supplements, was investigated in 24 volunteers for its quantitative and qualitative aspects. The combined scrubbing-washing-method was used as described by Burtenshaw with Ringer's solution. After the daily baths, using Wilcoxon-test, statistically no significant changes in the total number of microorganizations and in the number of the single groups of bacteria were found in the areas investigated by intermittent samplings of the skin flora. In the analysis of the composition of the normal aerobic skin flora, however, changes were obvious in 4 volunteers. There were no clinical changes of the skin surface in any of the volunteers.
The occurence of Neisseria meningitidis in the urogenital tract is a rarity but nevertheless this may lead to a false diagnosis of gonorrhea, even when the Thayer-Martin-selective-medium is used and oxidase-reaction is performed. This is demonstrated in our case. A complete diagnosis, including sugar-fermentation, is necessary, when gram-negative diplococci are isolated from urogenital swabs. In the case Neisseria meningitidis is isolated, it is not required by law to report it to the public health authorities.
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A severe form of a carpal-tunnel-syndrome with motoric and sensoric deficits and trophic disturbances of the fingers II and III is presented, which reminds also of syringomyelia, erysipeloid or a chronic erysipelas.
The behaviour of the aerobic skin flora of the flexor sides of the forearms, under a three-week restriction of washing, was investigated in twenty-four patients for its quantitative and qualitative aspects. The combined scrabbing-washing method was used as described by Burtenshaw with Ringer's solution. After a three-week restriction of washing, using the Wilcoxon Test, statistically no significant changes in the total number of microorganisms were found in areas investigated in the intermittent sampling of the skin flora. A three-week restriction of washing in the region of the flexor sides of the forearms does not induce significant changes in the composition of the normal aerobic skin flora. The percentage of differences in the total number of bacteria fluctuates up to the mark in wide limits; statements about standard deviations are not permitted because of the technical and experimental conditions. There was no shifting of the Resident flora to other groups of bacteria in the patients under study. Pathogenic microorganisms could not be found in higher numbers after the second sampling.
352 strains of Staphylococci of the normal human skin flora were sampled from one volunteer by single scrabbing in a ca. 3 cm2 measuring area. They were biotyped by the scheme of Pelzer et al.(1973)--a modified Baird-Parker-Scheme (1963)--and the resistance to antibiotics was investigated by the method of Bauer et al. (1966). All the nine biotypes of Staphylococci were found in variable quantities. It seems problematic to call one biotype as the main type. Morphologically identical colonies of Staphylococci from the indigenous flora of the human skin were not identical in their biotypes as previously described by Pelzer (1976). Only the investigation of all Staphylococci colonies from the culture plate can evaluate all biotypes of Staphylococci of the normal human skin flora, and can give the right quantitative correlation. Staphylococci were found to be sensitive and resistant up to four antibiotics, and one biotype did not show one type of antibiogram.
The behaviour of the aerobic skin flora of the flexor sides of the forearms, under a three-week restriction of washing, was investigated in twenty-four patients for its quantitative and qualitative aspects. The combined scrabbing-washing method was used as described by Burtenshaw with Ringer's solution. After a three-week restriction of washing, using the Wilcoxon-Test, statistically no significant changes in the total number of microorganisms were found in areas investigated in the intermittent sampling of the skin flora. A three-week restriction of washing in the region of the flexor sides of the forearms does not induce significant changes in the composition of the normal aerobic skin flora. The percentage of differences in the total number of bacteria fluctuates up to the mark in wide limits; statements about standard deviations are not permitted because of the technical and experimental conditions. There was no shifting of the Resident flora to other groups of bacteria in the patients under study. Pathogenic microorganisms could not be found in higher numbers after the second sampling.
Two cases of malignant melanoma of the penis are reported. A further case report of a naevus caeruleus of the glans penis is presented with regard to the differential diagnosis of malignant melanoma of the penis. A comprehensive review of the literature has revealed 41 case reports of malignant melanoma of the penis. A brief characterisation of malignant melanoma of the penis is given.
We describe a case of Gardnerella vaginalis colonization of the upper genital tract of the male partner of a woman with recurring bacterial vaginosis. G. vaginalis could not be cultured from the urethra but was cultured from semen. After treatment of the male partner with metronidazole, the woman had no more relapses of bacterial vaginosis.
We describe a case of acute urethritis caused by Neisseria meningitidis group B in a heterosexual man. The symptoms started five days after intercourse that included fellatio with a casual female partner. No other urethral pathogens could be isolated. After intramuscular administration of penicillin G, clinical signs and symptoms of urethritis disappeared, and despite repeated attempts, N. meningitidis could no longer be isolated from the urethra. This case illustrates the need for careful diagnostic procedures.
Eleven cases of involvement of the genital tract in paracoccidioidomycosis were collected in a retrospective study of the clinical records of 683 patients seen in Porto Alegre, Rio Grande do Sul, Brazil. These cases are herein summarily reported. Eighteen similar cases were gathered in review of the Brazilian literature. Obtained data are discussed.
Smears were taken from the anterior and posterior vaginal fornices of 232 women who attended prenatal consultations at Würzburg University Gynecological Clinic. The cultures were compared using Sabouraud's Glucose Agar (S.G.A.) and two commercially available rapid testing media--Nickerson Medium (N.M.) and Microstix Candida (M.C.T.) for saccharomycetes. The presence of saccharomycetes was demonstrated by means of S.G.A. in 23% (52) of the women and with N.M. in 10% (23). If only N.M. had been used, colonization by saccharomycetes would have been overlooked in 32 cases. With regard to the reliability of identification of saccharomycetes in the group, there was no significant difference between N.M. and M.C.T. In women without Candidiasis, negative findings with N.M. and M.C.T. were in agreement in 96% of the cases. Reliable identification of saccharomycetes in genital and gastro-intestinal areas is of special importance in prenatal examinations in view of the risk of infection of the newborn. The investigation reported in the present paper indicates that such reliability can only be achieved with the more costly culture method using Sabouraud's Glucose Agar.
In a total of 200 children born at Würzburg University Gynecological Clinic, culture and in some cases microscopic investigations were performed in the first week of life to identify chlamydia trachomatis, ureaplasma urealyticum, mycoplasma species, Lancefield group B streptococci and candida species. Chlamydia trachomatis was isolated in one symptom-free neonate, while ureaplasma urealyticum was found in 31 (15%) of the infants. Statistically, premature rupture was significantly more frequent (29%) in the ureaplasma-urealyticum-positive group than among the ureaplasma-urealyticum-negative infants (11%) (p less than 0.05). Mycoplasma species was detected in one newborn, Lancefield group B in 3 (1.5%). In 7 of the infants (3.5%) Candida species was isolated.