Current bacteriological techniques of enteric bacteria.
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Human immunodeficiency virus (HIV) and M. tuberculosis are two intracellular pathogens that interact with each other at both clinical and cellular levels. A known HIV positive case, presentingwith vague pulmonary symptoms followed by bilateral cervical lymphadenopathy, is reported here. The condition was treated as asthma, based on lung symptoms. Cytology revealed acute purulent lymphadenitis. Only Z. N. staining and culture of sputum and lymphnode aspirate could diagnose tuberculosis. Patient responded well to the standard anti tuberculosis treatment.
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We used a membrane filter contact technique to pick up and grow bacteria from artificially contaminated surfaces. We were able to recover individual colony-forming units (CFU) of Staphylococcus aureus from a moist agar surface more efficiently with 3- and 5- micron membrane filters than with Rodac plates, velvet pads, velveteen pads, or smaller-pore membrane filters. The effective transfer of bacteria with the 3- and 5-micron membrane filters was 0.96 +/- 0.04 (standard error of the mean) and 0.99 +/- 0.04, respectively, as compared to 0.49 +/- 0.03 for Rodac plates, 0.09 +/- 0.01 velvet pad imprints, 0.05 +/- 0.01 for velveteen pad imprints, 0.27 +/- 0.02 for velvet pad rinses, 0.005 +/- 0.001 for velveteen pad rinses, 0.39 +/- 0.02 for 0.45-micron filters, and 0.85 +/-0.05 for 1.2 micron filters. In addition, the recovery of S. aureus from contaminated bovine muscle surfaces with the 5-microns membrane filter was similar to that of quantitative dilutions of biopsy material and was significantly higher than the recovery from Rodac plates. The 5-microns membrane filters on a paddle recovered 52 +/- 5 CFU/cm2 from artificially contaminated bovine skeletal muscle, the quantitative dilutions of biopsy recovered 69 +/- 5 CFU/cm2, and the Rodac plate recovered 5 +/- 3 CFU/cm2. Sampling of moist surfaces by the membrane filter contact technique is easy to perform and highly efficient; our data suggest that it could be employed for cultures of clinical surfaces such as surgical wounds or burns.
In the introductory part a new classification of joint drug actions is submitted, according which three fundamental types are distincted, named respectively interference, cooperation and true interaction. In its turn, interaction is subdivided in three classes (uni-effectual, bis-ineffectual, bis-effectual) in the last of which is placed the most relevant of the interactions, that is synergism, subclassified, at its turn, as additive, super and infra-additive. The second part is devoted to the classification of the bacteriological techniques hitherto proposed in order to evaluate in vitro and in vivo the antibacterial interaction of chemoantibiotics. The third part is devoted to the classification and critical analysis of biometrical techniques hitherto applied to above quoted bacteriological techniques in order to obtain a quantitative evaluation of interaction. Criticism versus isobolic model is pointed out. In the final part a new procedure, named isoeffectual, is proposed. According to such a procedure a close grid of single and joint concentrations of a couple of chemoantibiotics, broad enough in order to cover the whole of the effects to be explored, is tested in vitro adopting the one-center agar diffusion test or a liquid medium. The experimental data so obtained are related in a planar diagram to the log of the sum obtained by adding to the concentrations of the first the concentrations of the second agent, converted into equi-effectual concentrations of the first. By this way a series of curvilinear regressions is obtained, which may be all explained by a mathematical formula according which the data may be submitted to statistical analysis and elaborated in order to draw the parameters able to define quantitatively the interaction. The model so applied is discussed as a general model for joint drug action.
The etiological role of non-sporulating anaerobic bacteria as causative agents of suppurative-inflammatory diseases (SID) of the maxillo-mandibulo-facial region and the E. N. T. organs as studied. Express diagnosis of anaerobic infection was carried out by means of gas-liquid chromatography. The species-specific composition of the microflora of the suppurative focus was investigated. It was established that only obligate anaerobes in monoculture or in association were isolated from patients with so-called "sterile" inoculations when strictly anaerobic bacteriological technique was used. The use of anaerobic bacteriological technique of investigation enlarged the spectrum of the microflora isolated from the suppurative focus from 5 to 26 species. Results of chromatographic and bacteriological examinations were compared; the main causes of obtaining false-positive and false-negative results of chromatography were analysed. Statistical processing using factor analysis has shown that the information power of chromatographic examination of the metabolites of anaerobic bacteria is higher in comparison with the main clinical-laboratory indices, but statistical processing using cluster analysis and correlation analysis has revealed that an index like metabolic activity reflects the degree of real participation of anaerobic microflora in the development of the pathological process, and can be used in the clinic for the evaluation of the degree of severity of the course of the SID and of the effectiveness of treatment.
An experimental study was carried out to evaluate and compare various noncommercial methods of blood culture for the isolation of Salmonella typhi and Brucella abortus from fresh human blood samples that had been artificially inoculated with 1 to 50 microorganisms per ml of blood. The methods compared included the Ruiz-Castañeda blood culture, broth blood culture, leukocyte lysis and direct plating on agar (WBL-P), leukocyte lysis and filtration, Ficoll-Hypaque centrifugation and filtration, Ficoll-Hypaque centrifugation, and Ficoll-Hypaque centrifugation and leukocyte lysis methods. Results with the WBL-P technique showed that S. typhi was isolated in 18 h, and its recovery rate was 36.6% (calculated from the number of CFU recovered per milliliter versus the number inoculated). B. abortus was isolated in 48 h by the same technique, and its recovery rate was 48.8%. The isolation times for the other blood culture techniques were between 36 and 44 h for S. typhi and 66 h for B. abortus. The techniques which relied on filtering systems for the recovery of S. typhi and B. abortus performed poorly. The WBL-P technique for the isolation of S. typhi and B. abortus is faster than the other methods tested.
Twenty cases of culture negative infective endocarditis admitted to the Cardiology Department of Green Lane Hospital from 1959 to 1980 out of a total of 265 cases (7.5%), were analysed retrospectively. Cases were included only when adequate proof of endocarditis was available at surgery or postmortem. Indiscriminate use of antibiotics before taking blood cultures was the most common association with failure to obtain positive cultures, seen in 16 of the 20 patients described. Failure to obtain positive cultures in four cases was attributed to inadequate bacteriologic techniques before 1967. Where no antibiotics were given prior to collecting blood cultures and bacteriologic techniques were adequate, proven culture negative endocarditis was virtually unknown. When antibiotics have been given, repeated blood cultures are recommended following withdrawal of antibiotic for at least four days.
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A rapid technique for confirmation of the diagnosis and the orientation of medical treatment of urinary infection. Performance of direct antibiotic sensitivities on urine is a rapid (14 to 18 hours) procedure for determining the presence of organisms in the urine and seeking the antibiotic most active against them. In order to assess the value of the procedure, it was compared with classical bacteriological techniques. The correlation was found to be satisfactory. This procedure of direct sensitivity studies on urine is not in to way in competition with classical bacteriological techniques but is of great value in rapidly confirming the diagnosis of urinary infection and in the orientation of therapy. It eliminates a number of the justifications of blind treatment.
The isolation of Chlamydia psittaci and serological detection of Chlamydia-specific antibodies in racing pigeons and pigeons from public parks is described. Several serological methods (complement fixation test, indirect microimmunofluorescence test, and enzyme-linked immunosorbent assay) were compared with bacteriological techniques (isolation both in embryonated eggs and McCoy cell monolayers). Tests confirmed that 28.6%, 33.5%, and 35.9% of the pigeons, respectively, were seropositive by the tests mentioned above. Chlamydiae were isolated from 13% of the fecal specimens in ovocultures and from 18% of the fecal specimens in cell cultures. No significant differences between the two groups of pigeons were found (at a 95% confidence level, alpha = 0.05) using the hypothesis test of the difference between proportions of two populations. The serological and bacteriological techniques used are compared and discussed.
Eighty-eight Nigerian children with untreated, severe, acute pneumonia were investigated by standard bacteriological techniques (blood culture and culture of pharyngeal secretions) and by needle aspiration of the consolidated lung. Countercurrent immunoelectrophoresis (CIE) against grouped pneumococcal and Haemophilus influenzae type b antisera was carried out on serum samples from 45 patients. The aetiology of pneumonia was shown by examination of the needle aspirate in 70/88 patients (79%), by CIE in 9/45 patients (20%), and by blood culture in 4/36 patients (11%). Overall, a bacterial cause for pneumonia was shown in 73/88 patients (83%). The results of pharyngeal culture were misleading when compared with cultures of needle aspirates. The prediction of aetiology from the radiological appearance was alos inaccurate, even for labor pneumonia. Needle aspiration of the lung, with a low (5%) and minor complication rate, merits wider application in the diagnosis of acute pulmonary infections in children. Tradiational bacteriological techniques (blood culture and pharyngeal culture) are of very limited value. The place of CIE in the investigation of childhood pneumonia still needs thorough evaluation.
The value of pernasal swabs and direct adenoid swabs in chronic adenoid and adenotonsillar disease was assessed in 175 patients. Prior to adenoidectomy (53 patients) or adenotonsillectomy (122 patients), pernasal and direct adenoid swabs were taken. Adenoid currettings and tonsil tissue were cultured. Haemophilus influenzae was the bacterium most frequently isolated from adenoid currettings and from the centre (core) of the resected tonsil. There was a close relationship between the bacteriology of the pernasal swab and the adenoid tissue and tonsil core in 72 and 71% of patients, respectively. There was an identical profile of pathogens in 52 and 49%, respectively. We suggest that in children with adenoiditis or adenotonsillitis and hypertrophy of the adenoid, a pernasal swab should be used in preference to a throat swab in selecting appropriate antimicrobial therapy. Penicillin and ampicillin are not appropriate blind therapy in chronic adenoid and adenotonsillar infections because of the prevalence of beta-lactamase-producing aerobes (40%) in adenoid and tonsil core in these conditions.
The cerebrospinal fluid of 120 subjects, 80 of whom were suffering from a purulent meningitis, were examined comparatively by classical bacteriological techniques (direct examination and culture) and by electro-immunodiffusion. This procedure makes it possible to detect not only viable bacteria, but also capsular polysaccharide antigens. It revealed the diagnosis in 96.9% of cases of meningococcal, pneumococcal and Haemophilus meningitis, as against 80.3% positive results using classical bacteriological techniques, for the same organisms. Electro-immunodiffusion provides a rapid answer (20 minutes) and, amongst other things, makes it possible: - to confirm the serotype or capsular type within the species, - to determine the aetiological diagnosis in certain types of meningitis where diagnosis is rendered difficult by blind antibiotic therapy, - to quantify and follow over a period of time the levels of polysaccharide antigens in the cerebrospinal fluid and serum of the patients. The sensitivity and specificity of electro-immunodiffusion render it a technique of the future in the diagnosis of purulent meningitis. By virtue of its simplicity, it should become a routine examination.
Countercurrent immunoelectrophoresis (CIE) with H. influenzal type b(Hib) and Pneumococci Omni antisera was performed on serum and concentrated urine and pleural fluid samples from 100 patients with acute pneumonia in Beijing Children's Hospital. Thirty-one patients were investigated by bacteriologic techniques (blood culture and pleural fluid culture). CIE was positive in 29/100 (29%) of cases of Hib, 13/100 (13%) of cases for pneumococci. Overall, bacterial causes of pneumonia were diagnosed by CIE in 41/100 (41%) cases. Antigens were detected in 5/90 (5.6%) serum samples, in 36/87 (41.5%) concentrated urine samples, and in 1/2 (50%) samples of pleural fluid. Only one Hib strain was found by pleural fluid culture. The contamination rate of bacterial culture in this group was high (5/31 cases, 16.1%). Therefore, traditional bacteriologic techniques are of very limited value for diagnosing pneumonia in Chinese children. The results showed that bacterial pathogen, especially Hib and Pneumococci, are very common and important causes of pediatric pneumonia in China.
One hundred ninety-six Mycobacterium avium isolates from blood samples recovered from 93 AIDS patients for several months were typed by serotyping, by IS1245 restriction fragment length polymorphism (RFLP) analysis and in some cases RFLP analysis with plasmids pVT2 and pLR7 as probes, and by pulsed-field gel electrophoresis (PFGE). PCR typing of single colonies was also used to detect polyclonal infections. Strains belonged mainly to serotypes 1, 4, and 8. pVT2- and pLR7-related plasmids were detected in strains from 49% of the patients. The IS1245 RFLP and PFGE analyses showed a 96.8% diversity of the M. avium strains from the 93 patients. The vast majority (95.2%) of infections were monoclonal, indicating that recent infection is unlikely, even at an advanced stage of AIDS. For one patient, sequential isolates gave divergent patterns of sensitivity and resistance to clarithromycin, but all were identified as the initial clone. RFLP analysis and PCR typing of single colonies allowed for the detection of three polyclonal infections during the bacteriological follow-up. Among strains from patients whose samples were positive by culture after treatment for 2 to 15 months, 97.4% were the same as the initial strain. In conclusion, relapses and failures were mostly due to the initial strain. These relapses and failures resulted either from the selection of resistant mutants or the reappearance of sensitive strains, suggesting the persistence of nonsterilized tissue reservoirs.