ABSTRACT
BACKGROUND: RGM medium is an agar-based, selective culture medium designed for the isolation of nontuberculous mycobacteria (NTM) from the sputum of patients with cystic fibrosis (CF). We evaluated RGM medium for the detection of NTM in patients with CF (405 samples), bronchiectasis (323 samples) and other lung diseases necessitating lung transplantation (274 samples). METHODS: In total, 1002 respiratory samples from 676 patients were included in the study. Direct culture on RGM medium, with incubation at two temperatures (30 °C and 37 °C), was compared with conventional culture of decontaminated samples for acid-fast bacilli (AFB) using both a solid medium (Löwenstein-Jensen medium) and a liquid medium (the Mycobacterial Growth Indicator Tube; MGIT). RESULTS: For all three patient groups, significantly more isolates of NTM were recovered using RGM medium incubated at 30 °C than by any other method (sensitivity: 94.6% vs. 22.4% for conventional AFB culture; P < 0.0001). Significantly more isolates of Mycobacterium abscessus complex were isolated on RGM at 30 °C than by AFB culture (sensitivity: 96.1% vs. 58.8%; P < 0.0001). The recovery of Mycobacterium avium complex was also greater using RGM medium at 30 °C compared to AFB culture (sensitivity: 83% vs. 70.2%), although this difference was not statistically significant and a combination of methods was necessary for optimal recovery (P = 0.21). CONCLUSIONS: In the largest study of RGM medium to date, we reaffirm its utility for isolation of NTM from patients with CF. Furthermore; we show that it also provides an effective tool for culture of respiratory samples from patients with bronchiectasis and other lung diseases.
Subject(s)
Bronchiectasis/microbiology , Cystic Fibrosis/microbiology , Lung Diseases, Interstitial/microbiology , Mycobacterium Infections, Nontuberculous/diagnosis , Nontuberculous Mycobacteria/isolation & purification , Pulmonary Disease, Chronic Obstructive/microbiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Culture Media , Culture Techniques , Female , Humans , Lung Diseases/microbiology , Lung Transplantation , Male , Middle Aged , Mycobacterium abscessus/isolation & purification , Mycobacterium avium Complex/isolation & purification , Mycobacterium avium-intracellulare Infection/diagnosis , Sensitivity and Specificity , Sputum , Young AdultSubject(s)
Carbon Dioxide/metabolism , Cross Infection/epidemiology , Disease Outbreaks , Methicillin-Resistant Staphylococcus aureus/metabolism , Staphylococcal Infections/epidemiology , Bacterial Typing Techniques , Cluster Analysis , Cross Infection/microbiology , Genotype , Hospitals , Humans , Liver Transplantation , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Molecular Epidemiology , Multilocus Sequence Typing , Staphylococcal Infections/microbiology , Transplantation , United Kingdom/epidemiologyABSTRACT
All medical doctors have an important role to play in the diagnosis, management and prevention of healthcare-associated infection (HCAI). Strengthening the contribution of medical doctors and medical students to HCAI prevention programmes should include measures that enhance knowledge, improve practice and develop appropriate attitudes to the safety and quality of patient care. The Hospital Infection Society (HIS) funded a review of medical education on HCAI throughout medical schools in the UK and the Republic of Ireland. A questionnaire was drafted and circulated to all medical schools and 31 of 38 (82%) responded. The prevalence and transmission of HCAI were taught by 97% and 100% of medical schools, respectively, but the importance of HCAI as a quality and safety issue was covered in only 60% of medical schools. Multiple choice questions (MCQs) and objective structure clinical examinations (OSCEs) were the most popular methods of assessment. Lectures, discussion of cases and practical demonstrations were considered useful by >90% of respondents and online material and log books by 67% and 60%, respectively. More than 80% were willing to share a common pool of educational resources. An agreed curriculum should be developed for educating medical students in HCAI prevention and control, to outline optimum methods for assessment and develop a shared pool of educational resources.
Subject(s)
Cross Infection , Data Collection , Education, Medical, Undergraduate/methods , Educational Measurement/methods , Schools, Medical , Teaching/methods , Cross Infection/epidemiology , Cross Infection/prevention & control , Cross Infection/transmission , Curriculum , Humans , Ireland , Surveys and Questionnaires , United KingdomABSTRACT
Two dimensional gel electrophoresis has been used to measure the degree of genetic polymorphism among the proteins of normal human fibroblasts. Autoradiographic analysis of the gel protein profiles from radioactively labeled cells allowed comparison of as many as 300 discrete polypeptides at a time. In addition, a newly developed technique for double label autoradiography was used to increase the sensitivity of the system for detection of small differences in the protein profiles of different cell lines. Only about 1.2% of the proteins of different cell lines were found to differ in their electrophoretic mobility. This corresponds to an average heterozygosity of approximately 0.6%. Previous studies of genetic polymorphism using different methods of one-dimensional electrophoretic analysis have estimated the average heterozygosity of the human population at about 6.7%. Detailed mathematical analysis shows the variation of the observed from the expected number of differences to be statistically highly significant. While the reasons for this difference are not clear, the observation of low levels of genetic polymorphism on two-dimensional gels should enhance the usefulness of this technique for detection of altered proteins in inherited disease.
