ABSTRACT
SETTING: Specialised tuberculosis out-patient clinic covering a population of 350 885. OBJECTIVES: To compare two techniques, ultrasonic nebuliser (UN) and Venturi-type face mask nebuliser (VFMN), for obtaining sputum in patients suspected of having active pulmonary tuberculosis (PTB) and who cannot expectorate, and to analyse the usefulness and cost of sputum induction with UN in a specialised medical practice. DESIGN: Prospective study from October 1997 until March 2000. RESULTS: Of 94 subjects who completed all tests, at least one sample of sputum was obtained from 89 (95.6%). UN provided adequate samples in 86 (93.4%) and VFMN in 66 (71%), a significant difference (P < 0.001). Among 43 patients diagnosed with active PTB, the diagnosis was confirmed in 39 with the samples obtained by sputum induction. Direct acid-fast bacilli smear was positive in 8 (19%). Direct costs were low and the technique can be performed on the day the patient attends the outpatient clinic. CONCLUSION: Sputum induction with an ultrasonic nebuliser was well-tolerated, of low cost, allows adequate samples to be obtained in the majority of patients who cannot produce sputum, and was more effective than the Venturi-type face mask.
Subject(s)
Sputum/microbiology , Tuberculosis, Pulmonary/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Nebulizers and Vaporizers , Prospective Studies , Specimen Handling , UltrasonicsABSTRACT
INTRODUCTION: An atypical mycobacterium, Mycobacterium chelonae is a saprophyte germ in the environment, but rarely pathogenic. A few disseminated infections can be noted in immunodepressed patients. OBSERVATION: A 30 year-old man infected by HIV was hospitalised for deterioration in his general status of health with, on clinical examination, pallor, several superficial lymph nodes and hepatosplenomegaly. A biopsy of an axillary node and the liver revealed numerous granulomas with many atypical M. chelonae-like mycobacteria. Adapted treatment led to complete remission. DISCUSSION: Immunodepression facilitates the occurrence of M. chelonae infections, often of severe evolution and leading to dissemination. This mycobacterium is resistant to many antibiotics.
Subject(s)
HIV Seropositivity/complications , Mycobacterium Infections/complications , Mycobacterium chelonae/isolation & purification , Adult , Biopsy , CD4 Antigens/immunology , HIV Seropositivity/drug therapy , HIV Seropositivity/immunology , Health Status , Hepatomegaly/complications , Humans , Liver/pathology , Lymph Nodes/pathology , Male , Mycobacterium Infections/drug therapy , Severity of Illness Index , Splenomegaly/complicationsSubject(s)
Fungemia/microbiology , Leukemia, Myeloid/complications , Neutropenia/complications , Opportunistic Infections/microbiology , Pharyngitis/microbiology , Yeasts/isolation & purification , Acute Disease , Adult , Antifungal Agents/therapeutic use , Fungemia/drug therapy , Fungemia/etiology , Humans , Immunocompromised Host , Male , Opportunistic Infections/drug therapy , Opportunistic Infections/etiology , Pharyngitis/drug therapy , Pharyngitis/etiologyABSTRACT
This study was performed to compare the MicroScan WalkAway automated identification system in conjunction with the new MicroScan Combo Negative type 1S panels with conventional biochemical methods for identifying 85 environmental, clinical, and reference strains of eight Aeromonas species.
Subject(s)
Aeromonas/classification , Bacterial Typing Techniques , Aeromonas/isolation & purification , Animals , Environmental Microbiology , Evaluation Studies as Topic , Gram-Negative Bacterial Infections/microbiology , Humans , Reagent Kits, Diagnostic , Reference StandardsABSTRACT
Automated systems are required when numerous samples need to be processed, offering both high through put and test of a multiple simultaneously. This study was performed to compare the MicroScan WalkAway automated identification system in conjunction with the new MicroScan Combo Neg Panels Type 1S with conventional biochemical methods for identifying ten environmental Serratia plymuthica strains. High correlation between both methods were observed for all the 21 tests evaluated, and the MicroScan system was found capable of correctly identifying all S. plymuthica strains tested. In all tests, the percentage of correlation was 100%, except in raffinose test (91%).
Subject(s)
Bacterial Typing Techniques/instrumentation , Serratia/classification , Evaluation Studies as Topic , Water MicrobiologyABSTRACT
El sistema automático estudiado, contiene unos paneles (MIC PANELS) que son utilizados para medir cualitativamente la sensibilidad de los microorganismos frente a una batería de agentes antimicrobianos. Se determinó la sensibilidad a los agentes antimicrobianos utilizando antibiogramas en laboratorio, en especies del género Staphylococcus aisladas de muestras medioambientales. El porcentaje de correlación entre ambos métodos resultó ser un 73.98 por ciento. Los resultados muestran que es un sistema poco fiable en la determinación de un perfil de antibiograma para las muestras evaluadas. Una de las posibles causas de este bajo porcentaje de correlación puede ser debido a la incompleta solubilización de algunos sustratos. Además de un posible almacenamiento de los paneles en condiciones diferentes a las recomendadas, pueden producir la pérdida de potencia de los agentes antimicrobianos. Seria necesario realizar controles de calidad más exhaustivos, y controlar en todo momento las condiciones de almacenado de los paneles (AU)
Subject(s)
Humans , Staphylococcus aureus , Staphylococcal Infections/drug therapy , Staphylococcus aureus/pathogenicity , Staphylococcus epidermidis , Staphylococcus epidermidis/pathogenicity , Drug Resistance, Microbial , Ampicillin/pharmacology , Gentamicins/pharmacology , Vancomycin/pharmacology , Methicillin/pharmacology , Microbial Sensitivity Tests/methodsABSTRACT
Hafnia alvei is a gram-negative facultatively anaerobic bacillus that belongs to the family Enterobacteriaceae. This organism is a causative agent of intestinal disorders and is found in different environments. H. alvei has received increased clinical attention as a cause of different infections in humans. This study was performed to compare the MicroScan WalkAway automated identification system in conjunction with the new MicroScan Combo Negative type 1S panels with conventional biochemical methods for identification of 21 H. alvei strains. The MicroScan WalkAway system was found capable of correctly identifying 20 of the 21 strains tested.
Subject(s)
Bacterial Typing Techniques , Enterobacteriaceae Infections/diagnosis , Hafnia alvei/classification , Enterobacteriaceae Infections/microbiology , Hafnia alvei/isolation & purification , Humans , Reagent Kits, Diagnostic , Reproducibility of ResultsABSTRACT
Conventional biochemical tests were compared with reactions in a multiple test system, MicroScan Walkaway (Dade Diagnostic Inc. MicroScan Divison, West Sacramento, California) in conjugation with the Combo Pos ID Panels (Dade Diagnostic Inc. MicroScan Divison, West Sacramento, California), in order to evaluate the accuracy for the identification of 99 clinical isolates of Staphylococcus spp. and five reference strains. False-negative or positive reactions were detected from Voges-Proskauer, urease and mannose tests. A good correlation was found among the two identification systems for the fermentation of trehalose, lactose, raffinose, as well as for arginine dyhydrolase, esculin hydrolisis and nitrate reduction. From the results of the present study, it is concluded that the MicroScan Walkaway system is a reliable method for identification of staphylococci (94.23%), although 8.2% could be identified to the species level only after use of additional test.
