Identification of bacteriological unknowns: a computer-based teaching program.
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The cerebrospinal fluid of 589 subjects, 78 of whom were suffering from a purulent meningitis were examined. Comparatively by classical bacteriological techniques (direct examination and culture) and by electro-immunodiffusion, latex agglutination, and Limulus endotoxin assay. Soluble bacterial Haemophilus influenzae type B, Neisseria meningitidis group A, C, and Streptococcus pneumoniae antigens, were tested by electro-immunodiffusion and latex agglutination, and soluble bacterial N. meningitidis group B, Listeria monocytogenes and Streptococcus agalactiae antigens by electro-immunodiffusion. Specific antigens and endotoxin were found in 75.8 per cent of the specimens with a rapid answer (120 min). The three tests revealed also only the diagnosis in 29.1 per cent of cases of pneumococcal meningitis, in 33.3 per cent of meningococcal meningitis and in 47 per cent of Gram-negative bacteria meningitis. Only five cerebrospinal fluid from the 589 specimens tested were given a non-specific reaction. These two advantages--sensitivity and specificity--of these three tests render them techniques of the future in the diagnosis of purulent meningitis.
The improvement of bacteriological techniques for isolation and identification of anaerobes has led to an increased interest in anaerobic infections. However, anaerobes have only rarely been found in cases of purulent meningitis, representing less than 1 percent of all isolated pathogens. We observed anaerobic meningitis in a patient suffering from multiple lung abscesses from which anaerobic bacteria spread to the brain, causing formation of anaerobic brain abscesses and consecutive meningitis. Microbiological examinations for anaerobes should be performed in those cases of meningitis in which purulent infections of other organs with known or suspected anaerobic etiology are present or in which a traumatic lesion of the subarachnoid space has preceded the development of meningitis.
Scrotal palpation, microscopical examination of semen smears and the application of bacteriological techniques, revealed the incidence of Actinobacillus seminis and Brucella ovis infection of rams in the central and southern districts of the Orange Free State to be 2,9% and 4,3%, respectively. More Dorper than Merino rams were affected. Although clinically detectable epididymitis was found in 5,9% of rams examined, infection with A. seminis and B. ovis, as measured by the presence of neutrophils in semen and positive semen cultures, could only be demonstrated in a small minority of affected cases. These organisms were found more regularly in clinically negative rams excreting neutrophils in their semen. Possible reasons for the high incidence of sheep brucellosis in rams in the particular area as well as the higher incidence of infection in Dorper rams are discussed.
A streep test has been employed for bacteriuria involving identification of nitrites in the urine and results are compared with those obtained with classical bacteriological techniques. Parallel performance of the nitrite test and urine culture showed that the latter cannot be replaced as far as diagnosis goes but it also proved the usefulness of the nitrite test for mass screening purposes.
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