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Isolation of anaerobic bacteria from human gingiva and mouse cecum by means of a simplified glove box procedure.

An anaerobic glove box constructed of clear flexible vinyl plastic is described. It is sufficiently inexpensive and simple in operation to be used not only in research but also in a clinical laboratory by technicians without special training. Conventional bacteriological techniques may be used inside the glove box for culturing and transferring anaerobic bacteria. The box may be heated to 37 C and thus serve as an anaerobic incubator as well, permitting inspection of cultures at any time. Media may be prepared and agar plates may be poured on the laboratory bench in the conventional manner. An overlay of trace amounts of palladium black catalyst over plated agar media reduces the medium to an oxidation-reduction (O-R) potential of - 300 mv within 2 days after introduction into the glove box. In spite of its greater simplicity, the system matched or excelled the roll tube method with respect to all parameters tested, including O-R potential obtainable in the media, O(2) concentration in the gas phase, and efficiency in isolating anaerobic bacteria from the mouse cecum. Comparative studies indicate that the conventional anaerobic jar method was inadequate for the isolation of strict anaerobes from human gingival specimens and from the mouse cecum. This was due to the exposure of specimens and media to air during plating on the open laboratory bench. Anaerobic jars were adequate for maintaining the proper conditions for growth of anaerobic bacteria once these had been established in the glove box.

Animals↗

Acute musculoskeletal infection: comparison of different methods for intraoperative bacterial identification.

PURPOSE OF THE STUDY: Various techniques are used for detection of pathogens in musculoskeletal infection. These methods differ with respect to reliability and ease of handling. A prospective study was performed to evaluate the efficacy of three intraoperative techniques. MATERIAL AND METHODS: In 20 cases (18 patients) with clinically confirmed acute musculoskeletal infections, intraoperative collected swab samples, tissue samples and fluid samples injected into standard blood culture vials were used for microbiological diagnosis. Identification of bacteria, time necessary for detection and ease of handling during surgery was evaluated. RESULTS: In 19 cases bacterial growth was demonstrated using either intraoperative swabs or blood culture technique (95% sensitivity), whereas 18 tissue biopsies were positive (90% sensitivity. 27 bacterial species were isolated. In 18 instances for the swab technique, 14 instances for the tissue biopsy and 4 operations for the blood culture vials, ease of handling was rated as excellent. DISCUSSION: The study demonstrated differences between the three tested methods with respect to ease of handling. With respect to the number of detected organisms and time for their detection there are no significant differences. These last findings are in contrast to of the results of other authors. The reason for this could be that during operative dissection an accurate and specific collection of specimens from the acute deep infected soft tissues and bones independent from the type of surgical procedure is possible. Therefore, even with the swab method a high amount of microorganisms can be recovered. Especially for intraarticular infections, fluid samples injected into standard blood vials is a practical method for the surgeon. In acute musculoskeletal infections other than joint infections, there is less benefit for the blood culture vials. CONCLUSION: Intraoperative swab technique yields valid results comparable to other techniques and is an accurate technique for detection of pathogens from acute musculoskeletal infections. Key words: implant, infections, bacteriological techniques, comparative study.

Acute Disease↗

Modern approach to the diagnosis of anaerobic surgical sepsis.

Oxygen-sensitive anaerobic bacteria comprise the largest group of organisms among the human endogenous microflora. The oral cavity, the vagina, and the colon are the areas of the human body where the obligate anaerobes are predominant and can be isolated in very high numbers. Sepsis following surgery of any of these organs is frequently due to the escape of these endogenous bacteria during the course of the operative procedure. To enable the isolation and successful identification of most of these anaerobic microorganisms from clinical exudate, special collection and bacteriologic techniques are necessary. The acceptable anaerobic collection techniques have been reviewed in this paper. All of these techniques minimize the exposure of the clinical specimen to atmospheric oxygen during collection and transfer. The modern equipment used in sophisticated anaerobic bacteriologic workup has been discussed. Clinical clues that indicate anaerobic sepsis include a putrid odor of the exudate and evidence of abscess, necrosis, or associated gas formation. The importance and value of the gram-stain in the early identification of surgical sepsis has been stressed.

Anaerobiosis↗

Bacteriology of the chronically discharging middle ear.

Suitable bacteriological techniques revealed anaerobic bacteria in 38 (33%) of 114 chronically discharging middle ears. The genus Bacteroides was cultured from 25 ears. Aerobic bacteriology showed the predominance of staphylococci, facultative enteric gramnegative rods, diphtheroid bacilli and Pseudomonas species. Anaerobic bacterial cultures were always mixed with aerobic bacteria. 12 ears were culture-negative, and 9 of the 108 Gram-stained smers revealed no bacteria. No significant difference in bacteriology was noted between ears with or without local antimicrobial treatment, or between profusely draining or only moist ears. The ears with postoperative recurrent infection or with clinical suspicion of cholesteatoma grew anaerobes significantly more often, and were seldom sterile. Because anaerobic bacteria are frequently associated with chronic otitis media, their characteristics with regard to susceptibility to antimicrobials and to air must be remembered in the choice of therapy.

Bacteria↗

Membrane filtration media for the enumeration of coliform organisms and Escherichia coli in water: comparison of Tergitol 7 and lauryl sulphate with Teepol 610.

In a multi-laboratory trial with the membrane filtration technique, three surfactants--Teepol 610 (T610), Tergitol 7 (T7) and sodium lauryl sulphate (LS)--were compared in media for the enumeration of coliform organisms and Escherichia coli in water. A total of 179 samples of water (87 raw and 92 marginally chlorinated) were examined for colony counts of coliform organisms, and 185 water samples (94 raw and 91 marginally chlorinated) for E. coli. Slight differences in the confirmed colony counts between the three media were noted, but few of these were observed consistently in every laboratory. In most laboratories, T7 gave slightly higher counts of E. coli than LS with chlorinated waters; a higher incidence of false-positive results for E. coli at 44 degrees C was also noted with T7. As there were no outstanding differences in the trial, sodium lauryl sulphate, which is chemically defined, cheap and readily available, is therefore recommended for use at a concentration of 0 . 1% instead of Teepol 610 in the standard medium for the enumeration of coliform organisms and E. coli in water by the membrane filtration technique.

Bacteriological Techniques↗

Isolation of Mycoplasma hominis from blood cultures in patients with postpartum fever.

Eight women with postpartum fever are presented in whom Mycoplasma hominis was isolated from cultures of their blood. Clinical disease consisted of a mild although often prolonged febrile illness, and all but one recovered without appropriate antimicrobial therapy. Five patients demonstrated elevated convalescent titers of mycoplasmacidal antibodies. The isolates of M. hominis were recovered from routine blood cultures in the diagnostic bacteriology laboratory using blind subcultures to blood agar plates. These cases lend support to the concept that endometritis with M. hominis is a cause of postpartum fever and suggest that these organisms may be recovered with increased frequency if minor changes in standard bacteriologic technique are introduced.

Bacteriological Techniques↗

Wound infections and systemic antibiotic prophylaxis in gynecologic surgery. A review.

The gynecologic literature was reviewed and yielded 11 well-designed and well-conducted studies since 1960 involving the use of systemic prophylactic antibiotics. Five had significant results that support using prophylactic antibiotics in vaginal hysterectomy while three supported prophylaxis in cesarean sections. A cephalosporin agent is effective as a prophylactic agent and should be administered 2 hours before surgery by the intravenous route and discontinued 24-72 hours after surgery. A change in the bacteriologic flora of the cervical cuff occurs after surgery with an increase in E. coli and enterococci and a decrease in coagulose negative staphylococci and steptococci. Future studies should be randomized, prospective, and performed in a double-blind manner with antibiotics begun preoperatively. Special attention should be given to bacteriologic techniques, especially the search for anaerobic pathogens.

Anti-Bacterial Agents↗

[Process control in large-scale technical meat production--poultry].

1. The technical process of poultry meat production influences the quantitative and qualitative bacteriological status of the food broiler-meat in a characteristic and especially explicable manner. 2. Successful provisions to improve the bacteriological status of deep-frozen broiler-meat have to be enforced in the earlier stages of poultry meat production. 3. Controlling the bacteriological status of a product by recourse to the gaining technology is a bearing concept as for self-control-aspects as for official supervision. 4. Nevertheless, to guarantee the comparison of data, a reproducible and as simple as possible bacteriological technique is necessary, which can be commonly accepted and which covers a broad spectrum of bacteria.

Animals↗

Bacteriological analysis of pyogenic infections of the brain.

Pyogenic infections of the brain are divided according to the anatomic structures they involve. Brain abscess and subdural empyema are the main phenomena. This retrospective study analyses case records of the Neurosurgical University Teaching Hospital at Münster from a bacteriological standpoint and compares them with other reports in the literature. Various kinds of bacteria depending on etiology and pathogenesis are described. It is found that with improved bacteriological techniques the number of anaerobic infections increases and, at the same time, the number of sterile empyema decreases. A significantly higher mortality of patients with sterile suppuration is also found. It must be assumed that insufficient bacteriological evaluation leads to faulty diagnoses and ineffective antibiotic therapy and that genuine sterile empyema is rare.

Bacteria, Anaerobic↗

[Bacteriologic monitoring of 1,000 units of human packed red blood cells for Yersinia enterocolitica].

Several reports of Yersinia enterocolitica (Ye) post-transfusion septicaemia have been recently published. In order to study the prevalence of Ye contamination of packed red blood cells (PRBC) we performed a post-transfusion control on 1,000 PRBC units. We did not find any Ye contamination. This is in accordance with the rarity of the reported cases. However as they are very serious, a prevention is necessary. As classical bacteriological techniques are not feasible, the only possibility is to decrease the PRBC conservation time and to select blood donors by a careful questioning about recent GI tract disturbances.

Bacteriological Techniques↗

Automated radiometric detection of bacteria in 2,967 blood cultures.

A new radiometric method for the automatic detection of bacterial growth in blood cultures has been compared with conventional methods. A total of 2,967 cultures from 1,280 patients suspected of having bacteremia were studied. A 2-ml amount of blood was inoculated into culture media in which the glucose was labeled with carbon-14. The release of (14)CO(2) by bacterial metabolism was checked hourly for 18 to 24 hr, daily for the next 2 days, and, on the 12th day, with an automated instrument. A 10-ml amount of blood was studied by conventional bacteriological techniques. In 125 cultures from 50 patients, there was bacterial growth in at least one of the routine media. Of these, the radiometric method detected 102 cultures from 40 patients. In 111 cultures from 48 patients, there was radiometric detection of bacterial growth. In all of these cultures, there was detection of bacterial growth in subcultures from the radioactive medium. Of these, the routine laboratory detected 98 cultures from 40 patients. Neither method detected all patients with bacteremia. Among the 57 patients positive by one or both methods, routine techniques detected bacteria in 87% and the radiometric method detected bacteria in 85%. Seventy per cent of the cultures were detected first by the radiometric method, 65% on the day of inoculation. Our results suggest that the radiometric method is faster than conventional techniques and comparable in accuracy. Its great advantage is that it is simple, automatic, and can be extended to automatic detection of bacterial sensitivity to antibiotics.

Bacteria↗

Office bacteriology.

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Bacteriological Techniques↗

Culture-negative infective endocarditis.

Culture-negative endocarditis is not uncommon; the most frequent causes of the culture negative state are prior antibiotic therapy and problems with or inadequacies in bacteriologic technique. In addition to blood culture, studies that can aid in substantiating a presumptive diagnosis of infective endocarditis include echocardiography. Immunologic tests, and cardiac catheterization. Empiric antibiotic therapy often is necessary and should not be delayed to await positive blood cultures and results of antimicrobial sensitivity studies.

Anemia↗