[Biosafety and biosecurity in the medical laboratory. Update and trends]. / Biosiguranta si biosecuritatea în laboratorul medical. Actualitati si tendinte.

Biosafety includes the protective measures against the risks of contamination with pathogen germs in the laboratories that handle pathogens, or stock or manipulate potentially contaminated products, or perform microbiological tests for medical or scientific research purposes, as well as the means of protecting the environment and the human collectivities against hazard contaminations that have as starting point these laboratories. Besides, lately, a new notion emerged, that of biosecurity, which refers to the sum of measures designed to protect workers, environment and population against the loss, theft, use and release in the environment of pathogenic biological agents. The work overviews the present concerns for the regulation of these two notions and the way in which a system for the management of the biological risks in a laboratory that handles pathogens should be documented and implemented. The need for the continuous professional training of the staff and for the establishment of individual and collective responsibilities for preventing biosafety incidents and trespassing biosecurity rules are as well emphasized. The main biosafety measures are pointed out and a series of considerations regarding biosafety and bioterrorism in correlation with the medical laboratory are as well mentioned.

[Epidemiology studies regarding anthrax epidemic in Romania]. / Studii epidemiologice în epidemia de antrax din România.

Antrax infection, a major bacterial zoonosis caused by B. anthracis, affects animals, particulary the herbivores. The infection can be accidentally transmitted to man, in whom it has two forms. Cutaneous anthrax, more frequently encountered (95%), the transmission being favoured by the contact with contaminated animal or, after the sacrifice of the animal, with various contaminated products (skin, wool, hair, especially of goat, as well as bones, meat, blood); the evolution is favourable following treatment. Internal (visceral)--pulmonary, gastro-intestinal, meningo-encephalytic--anthrax causes quasi-total mortality, despite treatment. Transmission is conditioned by the presence of sporulated forms. The bacteriological diagnosis is based on the detection of the germ on smears or cultures for various pathological specimens (skin lesions, blood, tissues, exudates, c.s.f., sputum, etc), rapid results being obtained by immunofluorescence. The serological diagnosis is indicated by the elevated titer of antibodies, detectable by immunological methods (ELISA). 81 pathological specimens and 16 soil samples suspected of B. anthracis were received by our laboratory in 2000 and were investigated for their morpho-cultural characteristics, under the microscope and using pathogenecity tests. Of the total number of samples investigated, B. anthracis was confirmed in 12 (12.37%) cases.

Susceptibility to bacteriophages of Staphylococcus aureus strains received at the National Reference Centre for Staphylococci in Romania 1978-1992.

In order to determine the distribution among lytic groups of Staphylococcus aureus strains circulating in Romania 18,539 strains were phage typed in the National Reference Centre for Staphylococci between 1978 and 1992. Strains susceptible to group II phages prevailed, representing 28.28% of all phage typed strains. The distribution on lytic groups differed in terms of the type of the clinical isolate. The results are statistically analysed and compared with those obtained in Romania by Popovici et al. between 1966 and 1978 as well as with those reported for other geographical areas by other authors.

Salmonella serotype typhimurium phage typing. A critical evaluation.

Of 12,930 Salmonella serotype typhimurium strains, phage typed during 1985-1988, 45.68% were "nontypable" by Anderson's set; the percent of typable strains decreased from 54.17 in 1986 to 30.54 in 1988. Of 90 phage patterns of sensitivity, 22 were currently encountered. Phage types 1, 18 and 104 were most frequent to strain of both human and non-human origin. In food generating S. typhimurium outbreaks, phage types 1 and 36 were prevalent. Except lysotypes 198 and 95, isolated from "single cases" in man only, all other phage types were common in man and animals, too. Introducing other typing methods to serotype typhimurium "nontypable" strains (by Anderson's set) was considered necessary for epidemiological purposes.

[An episode of hospital infection due to Klebsiella pneumoniae in a neonatal department]. / Episod de infectie spitaliceasca într-un serviciu de nou-nascuti determinat de Klebsiella pneumoniae.

Enterotoxin-producing Klebsiella pneumoniae was implicated in the induction of intrahospital infections in new-born babies. A total of 46 children and 4 adults (hospital personnel) were involved. Most of the subjects (82.6%) had median and light forms of gastroenterocolitis, and recovered following biological re-equilibration. In 17.39% of the cases the evolution was more severe due to advanced dehydration and secondary dissemination of the infection. Two children (approximately 4%) died. Factors that favored the dissemination of the infection were hygiene deficiencies and ignorance of functioning rules of materno-infantile units, and these included: admission to the hospital of working personnel with acute phenomena of enterocolitis; administration of sweetened solutions that were prepared without control and stored at room temperature; the "critical" point represented by the special room for "the accommodation" of the newborns, a "key-point" where infection was disseminated to other wards following dispersion of "adapted babies".

[The incidence of E. coli O157H7 strains in causing hemorrhagic enterocolitis]. / Incidenta tulpinilor de E. coli O157H7 in producerea enterocolitelor hemoragice.

The authors describe the evidencing of the O157H7 E. coli serotype--an enterohaemorrhagic strain of E. coli--for the first time in our country. This germ is incriminated in haemorrhagic enteritis of children and adults, accompanied or not by an uremic haemolytic syndrome. A total of 717 strains were investigated, obtained from cases of haemorrhagic enteritis (283), nonhemorrhagic enteritis (174), food poisoning (27), and a control lot of subjects without signs of enteritis (233). Identification of the strains was done with a screening method (McConkey) with D-sorbitol in place of lactose, and with anti-O157, and anti-H7 sera. The results obtained have indicated a total of 37 positive strains in haemorrhagic enteritis (69.8%), 12 strains in nonhemorrhagic enteritis (22.65%), and 4 strains in food poisoning (7.55%). No strain was isolated from the control group. The percentage of isolated O157H7 E. coli strains in our county is of 7.55% and this contributes to additional knowledge in the definition of the still unknown etiology of diarrhoeic disease in our country.

An appraisal of a cell culture test for revealing the presence of E. coli thermolabile enterotoxin (L.T.).

Three methods were comparatively used for revealing the presence of thermolabile enterotoxin (L.T.) of E. coli strains causing diarrheal illness of children. From 228 patients 52 L.T.+ strains (22.8%) were identified with the classic rabbit skin test out of which 50 L.T.+ strains (21.9%) also reacted positively in a cell culture test using CHO-KI cells and only 33 L.T.+ strains (14.4%) in the rabbit intestinal loop test. The cell culture test appears to have a constant sensitivity, it is inexpensive, easy to perform and therefore adequate to be carried out in experienced field laboratories.