The Italian experience of quality control in microbiology.
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Biomedical subjects
Publications and source records attributed to A Orsi.
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Activity of rifampicin and of a new rifamycin, rifaximin, was tested in strains of anaerobic bacteria belonging to the Bacteroides genus (75 B. fragilis group and 17 Bacteroides non-fragilis group) and in Clostridium perfringens (15 strains). It turned out that the bactericidal activity of both rifamycins could be overlapped and that it equalled 100% in the case of the non-fragilis Bacteroides and Clostridium species.
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The sensitivity of 200 bacterial strains, recently isolated from pathological products, has been determined in relation to 16 antibiotics both with the ABAC system and the agar diffusion method (Barry). Furthermore, the interference of the variation of inoculum in the ABAC system (controlled by numbering in Petri dishes) has been evaluated. This study presented a good general agreement of the results between both methods. Results of studies on the variation of inoculum (10(6)--10(7) CFU/ml) performance with the ABAC system, gave a very weak interference in the accuracy of the results (with the exception of a few bacterial species in relation to some antibiotics).
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A comparison between direct and standardized disk diffusion tests was made on a total of 116 urine specimens containing greater than or equal to 10(5) organism/ml and on a total of 229 clinical specimens others than urine. The number of major discrepancies per organism tested in pure culture was 31 (39.7%) for urine and 102 (59.6%) for other specimens. Although this procedure may be of value in selected cases with pure cultures of organism, its use on a routine basis is not recommended.
A quality control study in clinical microbiology was instituted by A.M.O.I. (Associazione Microbiologi Ospedalieri Italiani) since 1974. Preliminary results are reported on sensitivity tests quality control made by a group of laboratories in various parts of Italy. Our data show the great variety of methods used for antibiotic sensitivity disk determination and therefore the opportunity to standardize this procedure.
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The validity of the direct antimicrobial disc susceptibility test has been compared with the same test carried out on bacterial strains isolated from clinical materials obtained from the respiratory tract. The experimental evidence so far obtained raises some doubts concerning the reiliability of the direct test. The use of the latter seems to be reccomended in urgent cases only considering that either with multimicrobic or monomicrobic material the results obtained are partial and slightly reproducible. The conclusion is that, in order to obtain an accurate picture of the sensitivity to the various antibiotics, the direct test should be followed always with the antimicrobial disc susceptibility test carried out with isolated strains.
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An imported case of intestinal schistosomiasis in AIDS is analysed by the relationships between immune response, diagnostic methods, pathogenetic mechanisms. The inconclusiveness of negative results from both serology and stool parasitology is remarked whereas the efficacy of associated histological, histochemical and immunohistochemical methods is emphasized in order to get better data on aetiological diagnosis and on cell types and size of reactive granulomas. In the case studied, negative serology, absent fecal egg excretion and uneffective granulomatous response with scarcity of T and B lymphocytes have been documented by means of the above methods.
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The blood culture results of patients of S. M. Nuova Hospital of Florence (Italy) have been examined in a period of nine years (1967-1976). We can attest from this results that in the last years of this period we have had an increase of the number of Enterobacteriaceae from blood culture. In the meanwhile we have had a decrease of positive results that is not due to an increase of the number of blood culture; in fact it has been doubled, but this decrease is mostly due to a larger number of examinated patients that to an increase of blood culture for each patient. Introduction in the routine of a diphasic culture system (Castañeda) commercially available has allowed contaminants' decrease. Antibiotic resistance of most important bacteria isolated in the last three years (1974-1976) were carry out.
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This research was done to describe the nature and degree of psychological distress persons experience after receiving a diagnosis of colorectal cancer and to describe the effect on functional dependency of that distress during the first 3 months of treatment. The sample consisted of 66 persons who completed interviews before surgery and 1 and 3 months after surgery. Depressive symptoms changed substantially over time in relation to the events of diagnosis and treatment. Having an ostomy, additional treatment, and depressive symptoms were predictors of functional dependency after surgery. The findings suggest that depressive symptoms, even at low levels, are important to address because they may reduce patients' ability to function in their usual roles and activities for considerable periods after colorectal cancer surgery.