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PubMed1992

[The role of the bacteriological laboratory in the criteria for choosing and monitoring antibiotic treatment].

The constant development of clinical bacteriology and the consequence this has on the way an infected patient is approached and treated require that be examined a bacteriology laboratory's contribution in choosing and monitoring an antibiotic treatment. In the economic context of hospitals, one of the aims is to rationalize the prescription of biological investigations, as well as that of antibiotic treatments. The patient's history, his clinical state as well as the place where he has been admitted must be taken into account to establish, together with microbiologists, a hierarchy of the biological investigations required and to adapt the antibiotic treatment. In the laboratory, both the bacteriostatic and bactericidal sensitivity to antibiotics may be assessed in vitro. The best therapeutic antibiotic concentrations may be obtained by monitoring the pharmacokinetics of antibiotics.

Anti-Bacterial Agents↗
PubMed1991

[Verification of bacteriological safety of PCM 40 air conditioner].

This study assessed the bacteriological safety of the bedside air conditioner PCM 40 (Howorth Airtech), used for prevention of intraoperative hypothermia, by blowing filtered warm air through a special mattress. The 3 microns bacterial filter of the device released 2,968 +/- 5,618 particles of diameter less than 3 microns per m3 of room air, containing 78,798 +/- 37,243 of such particles per m3. The amount of bacteries in the air pulsed from the mattress was 30 +/- 41 cfu/m3 vs 120 cfu/m3 in the ambient air and in the hot air supply tubing it reached 6 +/- 5 cfu/m3 vs 175 +/- 77 cfu/m3. It is concluded that bacteriological data do not contra-indicate the use of this air conditioner in the operating theater. The only limitations for use are the position (prone or lateral position) and type of surgery (neurosurgery).

Air Conditioning↗
PubMed1985

[Lack of specificity of protected distal bronchial samples in the bacteriological diagnosis of nosocomial pneumonia caused by gram negative bacilli].

Lower respiratory tract secretions (LRS) were sampled during a two year period in patients undergoing mechanical ventilation using a method previously described by Matthew et al. Only those LRS positive for gram-negative bacilli were reported in this study. The patients were separated in two groups: those with nosocomial pneumonia due to gram-negative bacilli (NP+ group) and those without (NP- group). The species most often isolated from LRS were: Pseudomonas aeruginosa (25%), Proteus (20%), Escherichia coli (18%), Klebsiella pneumoniae (10%), Acinetobacter calcoaceticus (8%) and Haemophilus influenzae (7%). The spectrum of gram-negative species was not statistically different in either group of patients. The numbers of gram-negative bacilli isolated from each LRS were more important in the NP+ group (p less than 0.001), but so was the duration of mechanical ventilation before each LRS (p less than 0.01). In this group also, a specific bacteriological diagnosis with only one species was possible in 3 out of the 13 cases; a tentative diagnosis only was possible in 10 cases: in 6 cases, the responsibility of two (or more) species was suggested. The susceptibility to antibiotics of gram-negative bacilli isolated from LRS was moderate. A third generation cephalosporin together with amikacin seemed to be the best choice of antibiotics when no specific bacteriological diagnosis could be made with the LRS.

Anti-Bacterial Agents↗
PubMed1974

The bacteriological examination of urine: a computer-aided study.

For 6 months details of every patient who had his or her urine sent to a laboratory for bacteriological examination and the result of such examination were entered on a computer-card. A total of 15,606 cards were completed with information in code recording the sex and age of a patient, the origin of the request, the presence or absence in the urine of an excess of protein or cells, the culture result and the name of any significant organism isolated together with its sensitivity to various antimicrobial drugs. This information was interrelated in a computer, and in some cases the resulting numerical details were expressed as rates so as to eliminate the effect of uneven sex and age distribution. In this way the occurrence of urinary tract infection and the type of infecting organism in persons of either sex at various ages was examined according to whether the patient was in hospital or general practice. The sensitivity pattern of each type of significant organism isolated was established according to its source. The association between patients of either sex and various ages who had, or did not have, bacteriologically evident infections and the presence in their urine of an inflammatory exudate was investigated. Finally, the capacity of each type of infecting organism to produce such an exudate was estimated.It was shown that hospital and general practice experience of urinary tract infections differed widely, with regard both to the age and sex distribution of those suffering from it, and to the causative organisms concerned and their sensitivities to antimicrobial drugs. It is suggested that these differences were so great that conclusions drawn from any study of this subject conducted in one of the two areas cannot be applied to the other, and that those derived from a mixture of the two will vary according to the relative sizes of each of the components.

Age Factors↗
PubMed1974

The bacteriological status of a specific-pathogen-free animal production building and of its staff and the microbiological integrity of the animals one year after the building was commissioned.

Bacteriological contamination of a specific-pathogen-free (SPF) animal production building was more extensive after one year of operation than at the time of commissioning. Throat and nose swabs taken from the staff yielded a number of undesirable organisms, in particular, on one occasion, a Group A streptococcus. It is recommended that a closer bacteriological scrutiny of the staff of SPF production buildings ought perhaps to be made in the light of these findings.

Animals↗
PubMedDate not supplied

Effect of bacteriologic monitoring of urinary catheters on recognition and treatment of hospital-acquired urinary tract infections.

Catheter-associated urinary tract infections remain the most common hospital-acquired infection. Regular bacteriologic monitoring of urine from catheterized patients has been advocated as a measure for reducing the morbidity associated with this infection. To assess the effectiveness of this measure we reviewed the records of 100 catheterized patients hospitalized before implementation of a monitoring program and 200 such patients admitted after a daily monitoring program was operational. We found that culturing urine from catheterized patients was infrequent prior to monitoring but, when done, patients usually were febrile, cultures usually were positive, and patients were treated. Monitoring identified more cases of bacteriuria, but less than half of the patients so identified were treated. Being febrile was associated with receiving antibiotics. Infection rates increased with duration of catheterization; long periods of catheterization typically occurred on the neurosurgical, orthopedic, and medical services. Daily bacteriologic monitoring of all catheterized patients is relatively inefficient and does not predictably lead to therapeutic intervention in infected patients. The cost:benefit ratio of this measure might be decreased by applying it to selected patients chosen on the basis of risk factors, including hospital service assignment.

Anti-Bacterial Agents↗
PubMedDate not supplied

Ignaz Philipp Semmelweis, the prophet of bacteriology.

Although by 1931 I. Ph. Semmelweis' achievements and the tragedy of his life had been given their due place in the history of mankind, Alexander Fränkel, formerly Theodor Billroth's assistant and later his biographer, critically stated that the discoverer of the causes of puerperal fever should have defended his discovery with facts rather than with fanaticism. It was only a few years after Semmelweis' death, for instance, that Billroth made laborious experiments. Billroth's work on Coccobacteria had important implications and even influenced Robert Koch, although his hypotheses did not really predict the pathogenic and specific nature of microbes. In 1847 Semmelweis postulated his theory; ie, that the pathological-anatomical changes which he observed in the bodies of the women who died in childbed, in their newborn infants, and in the autopsy findings on his friend Jakob Kolletschka were an entity, morphologically and clinically. He summed them up under the concept of pyemia. Even though Semmelweis was continually abhorred by the evident statistics and would have been able to prove his discovery through animal experiments, he primarily took to the pen to defend his opinion vehemently. Only the clinical facts proved him right during his lifetime; the triumph of bacteriology which began after his death made him not only the "savior of mothers" but also a genial ancestor of bacteriology.

Austria↗
PubMed1985

Experiences with bacteriological monitoring of pool water.

A bacteriological study was completed on pools and whirlpools operated by hotels and private health clubs in the metropolitan area of Toronto, Ontario, Canada. Coliform bacteria, fecal coliform bacteria, and fecal streptococci were found only when other indices showed a drastic deterioration in water quality. Aerobic plate counts were higher, and staphylococci and Pseudomonas aeruginosa occurred more often in whirlpools than in swimming pools. There was a correlation between aerobic plate counts and the presence of staphylococci and P. aeruginosa. P. aeruginosa was rare in swimming pools in the absence of staphylococci; however, in whirlpools the organism was often found in the absence of staphylococci, and when aerobic plate counts were low. P. aeruginosa and plate counts in excess of 3,000 per ml occurred more frequently in whirlpools when the free chlorine residual was less than one part per million. The surface film showed concentrations of staphylococci far greater than the pool water. Whirlpools appear to present a different ecosystem that favors the establishment of P. aeruginosa. Staphylococci, but not Staphylococcus aureus, are useful in indicators of pool water quality but better laboratory methodology is required. Additional attention should be directed to the bacteriology of the water surface film, which presents a more direct hazard to bathers.

Bacteriological Techniques↗
PubMed1991

[Bacteriologic findings before and in transcervical chorionic villi biopsy and their clinical relevance].

Between August 1987 and May 1989, bacteriological examinations of smears from the cervical canal was performed in 358 pregnant women, who underwent transcervical sampling of chorionic villi. The outcome of 349 of these pregnancies is documented. 12 of these patients (3.5%) had an artificial abortion for genetic reasons. In 12 other patients, the pregnancy ended before 28 weeks (one child surviving). Microbiological examinations showed that in 187 women (52%), it was possible to culture one or more microorganisms from the cervical canal. The most frequently detected pathogen was Chlamydia trachomatis (111 women, 31%). In pregnancies, where more than one microorganism could be cultured, the risk of following abortion was 8.9 times higher than in those, where no pathogens could be found. In only two of the 12 women with a subsequent spontaneous abortion (16.6%), no microorganism could be found. The bacterial contamination of the cervical canal during TC-CVS seems to be a risk factor for subsequent abortion. Therefore, a bacteriological examination of cervical flora should be performed before as well as during TC-CVS, and antibiotic therapy should be initiated in case of positive results.

Abortion, Septic↗
PubMedDate not supplied

[Protracted croup syndrome. Bacteriologic findings and therapeutic consequences].

BACKGROUND: Croup normally is characterized by acute onset and a self limited course of only few days. In 1990 and 1991 at the University Children's Hospital Freiburg an unexpected high number of patients were hospitalized for prolonged Croup syndrome. Expanded microbiological investigations were used to uncover etiologic factors. METHODS: Of a total of 138 inpatients with Croup 60 (17 in their first year of life, 21 in the second year of life and 22 infants older than 2 years) had bacteriological (37 nasopharyngeal-, 4 tracheal-aspirates or 19 throat swabs), and virological (antigen detection in nasopharyngeal aspirates, n = 28) tests. Of these patients 48% were hospitalized longer than 3 days (mean 4,7; range 1-18 days). RESULTS: Bacteria found: B. catarrhalis 24/11 (total/pure-culture), S. pneumoniae 15/6, H. influenzae 10/3, S. group A 5/4 and S. aureus 4/1. Sixteen specimen yielded more than one pathogen, one specimen was sterile. Nasopharyngeal secretions had the most reliable results: Pure cultures (72%) and associations of two pathogens (87%) were found in these aspirates, and only 26% of the unspecific mixed findings (p < 0.005; chi 2-Test). Of the patients hospitalized longer than 3 days 27.6% had positive cultures for H. influenzae, whereas only 6.5% of those hospitalized shorter (p < 0.05; chi 2-Test). The only microorganism with an age-bound distribution was B. catarrhalis found predominantly (54.2%) in the 2nd year of life, with 62% of patients positive (p < 0.05; chi 2-Test). Virus found: RSV (n = 3), Parainfluenza 2 (1) and Parainfluenza 3 (1). CONCLUSIONS: Nasopharyngeal aspirate is the most reliable specimen for a bacteriologic diagnosis in Croup. In the second year of life B. catarrhalis is present in most Croup cases, and H. influenzae was associated with a prolonged course of the disease. An appropriate antibiotic therapy therefore must cover these two pathogens.

Antibodies, Viral↗
PubMed1986

[Bacteriologic findings and therapeutic consequences in adnexitis].

After laparoscopic confirmation of adnexitis, a bacteriological examination was made of specimens taken from the small pelvis of 63 patients, with an average age of 26.4 years, at the Rheinischen Landesfrauenklinik (Gynecological Hospital) in Wuppertal. To this end, various aerobic and anaerobic optimal and selective culture media were used. The cultured germs were identified with API systems, other conventional methods, and by using gas chromatography. All bacilli were tested for their sensitivity to mezlocillin and metronidazole. In 40 cases (63.5%), it was possible to determine 1-10 bacilli from the inner genital tract. In most cases there was an aerobic/anaerobic mixed infection, with participation of streptococci, staphylococci, enteric bacteria, as well as peptococci, peptostreptococci and bacteroid types. Neisseria gonorrhoeae was only identified three times. In 23 cases (36.5%), it was not possible to determine bacilli in spite of definite inflammatory symptoms. Since, according to international literature, Chlamydia trachomatis was to be found on the inflamed tubes of roughly one third of cases of adnexitis, the presence of this bacillus is suspected even in the many bacteriologically negative cases in the author's own study. Only in one case of a monoinfection by Staphylococcus aureus did the combination of mezlocillin and metronidazole prove to be unsuitable. In 25% of the cases where the presence of bacilli was proved, metronidazole was even necessary, since bacilli of the Bacteroides fragilis and Bacteroides bivius and disiens groups were involved, all of which are capable of inactivating penicillins and cephalosporins by formation of a beta-lactamase.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1982

Cost effectiveness of quality control in bacteriology.

The cost effectiveness of quality control in bacteriology stipulated by regulators is not established. The authors evaluated 111 surveillance procedures applied to 54 different operations; 100 had been performed in the authors' lab between 1965 and 1980, 91 of which had been performed 50 times. Forty-six conformed to CLIA requirements (CLIA-P). Thirty-seven others were CLIA-P, which had been modified (CLIA-PM) by reducing frequency and extent because few or no deficiencies had been observed. Eight others were devised by the authors (HH-P). The number detecting deficiencies, the per cent, and the mean per cent of deficiencies detected were: CLIA-P, 31, 67%, 3.5%; CLIA-PM, 8, 22%, 2.1%; HH-P, 8, 100%, 8.8%. Compliance with CLIA would cost HH $20,700/year (3.4% of total bacteriology laboratory cost). HH-P would cost an additional $9000/year. Discontinuation of CLIA-P not detecting deficiencies would reduce HH costs by $2900/year. Application of other low yield CLIA-P only to new lots of selected dehydrated media and fresh batches of selected reagents would reduce cost further by $2000/year.

Bacteriology↗
PubMed2003

Scientific triumphalism and learning from facts: bacteriology and the "Spanish flu" challenge of 1918.

The devastating influenza pandemic known as 'Spanish flu', which killed at least 20 million people all over the world in 1918, was responsible for the first bitter blow inflicted on triumphant bacteriology, fortified by the series of resounding successes achieved in identifying the pathogenic agents of terrible diseases such as anthrax, cholera, tuberculosis, plague, and syphilis. Over-confidence and the idea, born of the Pasteur revolution, that every infectious disease was caused by a bacterium, had led the scientific community to accept the theory put forward by the German bacteriologist, Richard Pfeiffer, who, in 1892, believed he had identified the pathogenic influenza agent in a bacterium, Haemophilus influenzae. But, while the most appalling epidemic ever to sweep through the world since the 'Black Death' of the 1300s was still raging, the scientific community had to admit that influenza originated not from a microbe, but from a virus. This article aims to reconstruct the enlightening and little-known cultured/scientific events and issues of the dramatic crisis that bacteriology experienced in the autumn of 1918, with the consequent simultaneous collapse of both the 'Pfeiffer doctrine' on the microbial origin of influenza and the illusion of a world free of infectious diseases. This was an illusion destined to surface again at the end of the century and collapse with the advent of AIDS.

Bacteriology↗
PubMed2002

Use of bacteriologic studies in the outpatient management of peritonsillar abscess.

OBJECTIVE: To examine whether obtaining bacterial Gram stain and aerobic/anaerobic cultures alters management of patients with peritonsillar abscess. STUDY DESIGN: Retrospective study. MATERIALS AND METHODS: A total of 221 cases of suspected peritonsillar abscess from July 1990 to February 1999 were analyzed with regard to outcomes and management patterns of those who had bacteriologic studies performed and those who did not. RESULTS: Pus was aspirated in 153 (69%). Eighty-two had bacterial studies performed whereas 71 did not. Of patients that followed up, all patients had complete resolution in the first group based on initial management. Three patients of the latter group had a complicated course secondary to dehydration and antibiotic noncompliance (P =.24). Of the 82 cultures sent, sensitivities were conducted on only 17 (21%). Nine of 17 grew organisms that were penicillin-resistant. No patient in the study had any treatment decisions based on microbiologic studies. CONCLUSION: In the routine management of peritonsillar abscess, bacteriologic studies are unnecessary on initial presentation. They should be reserved for patients with a high likelihood of infection by resistant organisms, i.e., diabetics, immunocompromised patients, and patients with recurrent peritonsillar abscess.

Adolescent↗
PubMed1996

Evaluation of nasopharyngeal cultures for bacteriologic assessment of acute otitis media in children.

BACKGROUND: The recent emergence of penicillin-resistant Streptococcus pneumoniae, particularly in acute otitis media (AOM), has increased interest in the development of noninvasive procedures that might help to predict the bacterial etiology of this condition. We conducted an open multicenter study to evaluate the predictive value of the nasopharyngeal (NP) sampling in children with AOM by comparing the bacteriologic results of NP cultures with those of pus collected by myringotomy in the same patients. METHODS: The NP secretions and the pus obtained by myringotomy were collected concomitantly in 354 children younger than 6 years of age with clinical signs of AOM. The clinical usefulness of NP culture was determined by calculating its sensitivity and specificity, and especially its positive and negative predictive values for the three main pathogens responsible for AOM, Haemophilus influenzae, S. pneumoniae and Moraxella catarrhalis. RESULTS: A positive NP culture was found to have little predictive value for H. influenzae (52%), S. pneumoniae (43%) and M. catarrhalis (19%). In contrast the negative predictive value of NP cultures was much greater and was accompanied by negative middle ear fluid cultures in more than 95% of children, especially for S. pneumoniae. Furthermore the incidence of beta-lactamase-producing strains of H. influenzae at both sampling sites was similar (30 and 35%, respectively), as was the incidence of penicillin-resistant S. pneumoniae (50 and 54%). CONCLUSION: It appears that the correlation between results of NP and middle ear fluid cultures in children with AOM is too weak to allow NP culture to be recommended for the bacteriologic documentation of this disease. However, these results should not overshadow the considerable epidemiologic value of NP cultures, particularly with reference to the monitoring of pneumonococcal susceptibility in children. The collection of NP cultures should therefore be promoted for their collective epidemiologic value.

Bacterial Infections↗
PubMed1980

A scheme for the identification of clinical isolates of Gram-negative anaerobic bacilli by conventional bacteriological tests.

More than 1000 strains of gram-negative anaerobic bacilli, including reference strains, clinical isolates, and members of the normal flora of the mouth, lower gastro-intestinal tract and vagina of healthy human subjects, were studied by conventional bacteriological methods and by gas-liquid chromatographic analysis of metabolic products in a series of investigations. A short combined set of tests with particular discriminant value was selected, and a scheme for the identification of the species and subspecies encountered in the diagnostic bacteriological laboratory was based upon our composite results. The tests are: antibiotic-disk resistance tests with neomycin 1000 micrograms, kanamycin 1000 micrograms, penicillin 2 units and rifampicin 15 micrograms per disk; tolerance tests with sodium taurocholate, Victoria blue 4R and gentian violet; and tests for pigment production, indole production, aesculin hydrolysis and the fermentation of glucose, lactose, sucrose, rhamnose, trehalose, mannitol and xylose. Gram-negative anaerobic bacilli are divided into four groups: (1) the fragilis group with nine species, which include the five subgroups previously classified as subspecies of B. fragilis; (2) the melaninogenicus-oralis group, which includes the three saccharolytic subspecies (ss.) of B. melaninogenicus--ss. melaninogenicus, ss. intermedius and ss. levii--and four non-pigmented species; (3) the asaccharolytic group, which comprises B. asaccharolyticus (formerly B. melaninogenicus ss. asaccharolyticus), B. corrodens and other non-pigmented non-saccharolytic strains, and (4) the fusobacteria.

Anti-Bacterial Agents↗
PubMed1991

The assessment of faecal flora in patients with inflammatory bowel disease by a simplified bacteriological technique.

A semi-quantitative bacteriological method was used to study faecal flora in 42 patients with Crohn's disease, 37 with ulcerative colitis and 21 healthy controls. Faecal homogenates were plated on primary isolation plates by a technique that allowed the growth of various microbial isolates to be assessed on a visual 1(+)-5+ score. This method was first calibrated against a standard quantitative bacteriological technique, which confirmed the reliability and reproducibility of the results obtained by the simpler method. Patients with clinically active Crohn's disease (22) had significantly higher total aerobe scores than patients with quiescent disease (20) (p less than or equal to 0.006) or ulcerative colitis (p less than or equal to 0.04) or normal controls (p less than or equal to 0.02). The scores of Escherichia coli were parallel to those of total aerobes. Lactobacillus and bifidobacteria scores were significantly reduced in patients with Crohn's disease compared to those with ulcerative colitis and controls. The anaerobic flora in both Crohn's disease and ulcerative colitis was indistinguishable from that of controls. Bacteroides vulgatus and B. fragilis were the predominant bacteroides in all groups. Patients with ulcerative colitis, regardless of disease activity, harboured faecal flora that did not differ from that of normal controls. The abnormal faecal flora in Crohn's disease did not correlate with established clinical and laboratory indicators of disease activity.

Adult↗
PubMed1994

Comparison of multiplex PCR and standard bacteriological methods of detecting Salmonella on chicken skin.

A multiplex PCR technique was compared with standard bacteriological techniques for the detection of Salmonella, and Salm. enteritidis in particular, in samples of chicken skin obtained from retail outlets. Five of 68 samples were positive by both systems (7.4%), 58 of 68 were negative by both systems (85%), five were positive by PCR only (7.4%) but none were positive by culture only. The PCR was quicker and more sensitive than the bacteriological methods, finding 15% of samples positive for Salmonella compared to 7.4%, and taking less than 24 h to reach a result as opposed to 2-3 d.

Animals↗