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Bacteriological contamination of dialyzers. Clinical, bacteriological and scanning electron-microscopic evaluation of different dialysate mixing systems.

Membranes from Gambro Lundia Nova dialyzers were investigated for presence of bacteria after hemodialysis with centrally and peripherally mixed dialysate. Centrally mixed dialysate was found contaminated with Pseudomonas aeruginosa, and bacterial cultures as well as electron scanning micrographs showed the presence of these bacteria on the dialysate side as well as on the blood side of membranes from dialyzers perfused with this dialysate during hemodialysis. No bacteria were found on membranes used with peripherally mixed dialysate, in which very few bacteria were found. Despite this the frequency of febrile episodes in patients submitted to hemodialysis with the two different dialysate mixing systems showed no significant difference in our material.

Bacteria↗

The bacteriology of acute otitis media in children with special reference to Streptococcus pneumoniae as studied by bacteriological and antigen detection methods.

The middle ear fluid (MEF) was studied during an acute attack of otitis media in 519 children, aged 3 months to 6 years. Streptococcus pneumoniae (Pn) was cultured from 39% of the cases; serotypes 19, 6, 3 and 23 were the most common. Haemophilus influenzae (Hi) was cultured in 12%; only 2/64 strains were of type b. Pn were found equally often in all age groups, but Hi were significantly less often isolated in children older than 3 years. The number of negative cultures increased with the age of the child. Pneumococcal capsular polysaccharide was detected with counterimmunoelectrophoresis and/or latex agglutination in 83% of the MEFs from which Pn were cultured, but also in about one third of the MEFs from which no bacteria could be grown. Altogether, with these methods combined Pn were implicated in nearly 60% of the cases of acute otitis media. Gram staining showed polymorphonuclear leucocytes in 85% of pneumococcal otitis cases that were verified by culture but also in 72% of the cases from which no bacteria could be cultured, supporting the contention that also these latter are usually caused by bacteria.

Acute Disease↗

[Bacteriological study of surgical infected wounds in elective surgery. Bacteriology of surgical wound infection].

OBJECTIVE: To identify the frequency and type of microorganisms isolated from infected surgical wounds at the Instituto Nacional de Perinatología, and identify the association among the microorganisms isolated and the outcome of the infected patients. METHODOLOGY: Observational, descriptive and cross-sectional study carried out between January 1999 and January 2001. Postoperative patients of an obstetric or gynecologic procedure, complicated with a surgical wound infection and with a culture and smear of the wound, were included. RESULTS: During the study period 41 surgical wound infections were identified. The general incidence of surgical infections was 3.9 infections per 1,000 surgical procedures. The incidence of infections after abdominal hysterectomy was 12.4 per 1,000, after vaginal hysterectomy 6.5 per 1,000, postcesarean section 5.3 per 1,000 and after episiotomy 1 per 1,000 procedures. The comparison among bacterial isolates in 1988 with 1999-2000 period showed a high frequency of gram negative bacteria isolation in the second period. CONCLUSIONS: In this study the incidence of surgical infections was less than the incidence reported in the medical literature, but the type of bacteria isolated was similar to other studies.

Adolescent↗

[Evaluation of an automated system in bacteriology. Application to bacteriological susceptibility tests].

Susceptibility tests have been compared between a new automated system and the reference method by agar diffusion. The COBAS-Micro apparatus for bacterial susceptibility tests is intended for rapid determinations with, normally, an incubation time of 5 h at 37 degrees C. Its is compatible with strains requiring greater than 18 h incubation. With this technique a large range of antibacterial substances (greater than 60) can be studied, in groups of fifteen. With the help of a computerized soft-ware, one growth-index:EPR (End Point Ratio) is calculated, in comparison with a standard, for each antibacterial agent tested and expressed in three categories: SIR. The findings are optimized according to the limits prescribed by the NCCLS. The reference method, by agar-diffusion, is as described by the Comité de l'Antibiogramme de la Société Française de Microbiologie (CA-SFM). A total of 1,048 strains were tested by the two techniques: 518 Gram negative rods, 530 Gram positive cocci, with four common antibiotics. The percentages of agreement between the two groups were: 96% full agreement and minor discrepancy, 4% major and very major discrepancy. This automated system seems to be perfectly suitable for susceptibility testing in a routine laboratory, especially with strains isolated from ambulatory patients.

Anti-Bacterial Agents↗