Sensitivity of Moore sewer swabs for isolating Salmonella typhi.

Moore swabs (sewer swabs) have been used successfully to culture pathogenic organisms from wastewater. Sensitivity seems to depend on the size of the waterway sampled as well as the number of organisms present. In Santiago, Chile, we placed 24 swabs into the sewers draining the homes of 10 known chronic carriers of typhoid. Swabs were positive for Salmonella typhi in 5 of the 10 households (50%) and 6 of the 24 swabs placed (25%).     

National validation study of a swab protocol for the recovery of Bacillus anthracis spores from surfaces

Twelve Laboratory Response Network (LRN) affiliated laboratories participated in a validation study of a macrofoam swab protocol for the recovery, detection, and quantification of viable B. anthracis (BA) Sterne spores from steel surfaces. CDC personnel inoculated steel coupons (26 cm²) with 1-4 log₁₀ BA spores and recovered them by sampling with pre-moistened macrofoam swabs. Phase 1 (P1) of the study evaluated swabs containing BA only, while dust and background organisms were added to swabs in Phase 2 (P2) to mimic environmental conditions. Laboratories processed swabs and enumerated spores by culturing eluted swab suspensions and counting colonies with morphology consistent with BA. Processed swabs were placed in enrichment broth, incubated 24 h, and cultured by streaking for isolation. Real-time PCR was performed on selected colonies from P2 samples to confirm the identity of BA. Mean percent recovery (%R) of spores from the surface ranged from 15.8 to 31.0% (P1) and from 27.9 to 55.0% (P2). The highest mean percent recovery was 31.0% (sd 10.9%) for P1 (4 log₁₀ inoculum) and 55.0% (sd 27.6%) for P2 (1 log₁₀ inoculum). The overall %R was higher for P2 (44.6%) than P1 (24.1%), but the overall reproducibility (between-lab variability) was lower in P2 than in P1 (25.0 vs 16.5%CV, respectively). The overall precision (within-lab variability) was close to identical for P1 and P2 (44.0 and 44.1, respectively), but varied greatly between inoculum levels. The protocol demonstrated linearity in %R over the three inoculum levels and is able to detect between 26 and 5 × 10⁶ spores/26 cm². Sensitivity as determined by culture was > 98.3% for both phases and all inocula, suggesting that the culture method maintains sensitivity in the presence of contaminants. The enrichment broth method alone was less sensitive for sampled swabs (66.4%) during P2, suggesting that the presence of background organisms inhibited growth or isolation of BA from the broth. The addition of real-time PCR testing to the assay increased specificity from > 85.4% to > 95.0% in P2. Although the precision was low at the 1 log₁₀ inoculum level in both phases (59.0 and 50.2%), this swab processing protocol, was sensitive, specific, precise, and reproducible at 2-4 log₁₀/26 cm² spore concentrations.     

Broth versus solid agar culture of swab samples of cadaveric allograft musculoskeletal tissue

As part of the donor assessment protocol, bioburden assessment must be performed on allograft musculoskeletal tissue samples collected at the time of tissue retrieval. Swab samples of musculoskeletal tissue allografts from cadaveric donors are received at the microbiology department of the South Eastern Area Laboratory Services (Australia) to determine the presence of bacteria and fungi. This study will review the isolation rate of organisms from solid agar and broth culture of swab samples of cadaveric allograft musculoskeletal tissue over a 6-year period, 2006–2011. Swabs were inoculated onto horse blood agar (anaerobic, 35 °C) and chocolate agar (CO₂, 35 °C) and then placed into a cooked meat broth (aerobic, 35 °C). A total of 1,912 swabs from 389 donors were received during the study period. 557 (29.1 %) swabs were culture positive with the isolation of 713 organisms, 249 (34.9 %) from solid agar culture and an additional 464 (65.1 %) from broth culture only. This study has shown that the broth culture of cadaveric allograft musculoskeletal swab samples recovered a greater amount of organisms than solid agar culture. Isolates such as Clostridium species and Staphylococcus aureus would not have been isolated from solid agar culture alone. Broth culture is an essential part of the bioburden assessment protocol of swab samples of cadaveric allograft musculoskeletal tissue in this laboratory.     

The enrichment and early detection of Streptococcus pyogenes in skin lesions, using colistin, oxolinic acid, Todd Hewitt broth and latex agglutination

An improved selective broth, colistin, oxolinic acid, Todd Hewitt broth (COTHB) for the isolation of Streptococcus pyogenes and other streptococci from swabs is described. Staphylococci, coryneforms and Gram negative organisms are inhibited in COTHB inoculated with swabs from skin lesions. Streptococcus pyogenes could be detected by a fluorescent antibody method and by the Streptex and Phadebact streptococcal grouping methods after 6 and 24 h incubation. Other streptococci of groups B, C and G, were also detected. Streptex was the most sensitive and specific method for the detection of streptococci of groups A, B, C, and G in this broth. The method detected 78% of these streptococci in COTHB after 6 h incubation and 93% after 24 h incubation. Of the Strep. pyogenes isolated, 82% were detected in the broth by the Streptex method.     

The enrichment and early detection of Streptococcus pyogenes in skin lesions, using colistin, oxolinic acid, Todd Hewitt broth and latex agglutination

An improved selective broth, colistin, oxolinic acid, Todd Hewitt broth (COTHB) for the isolation of Streptococcus pyogenes and other streptococci from swabs is described. Staphylococci, coryneforms and Gram negative organisms are inhibited in COTHB inoculated with swabs from skin lesions. Streptococcus pyogenes could be detected by a fluorescent antibody method and by the Streptex and Phadebact streptococcal grouping methods after 6 and 24 h incubation. Other streptococci of groups B, C and G, were also detected. Streptex was the most sensitive and specific method for the detection of streptococci of groups A, B, C and G in this broth. The method detected 78% of these streptococci in COTHB after 6 h incubation and 93% after 24 h incubation. Of the Strep. pyogenes isolated, 82% were detected in the broth by the Streptex method.     

Controlling contagious agalactia in artificial insemination centers for goats and detection of Mycoplasma mycoides subspecies capri in semen

Many goat artificial insemination (AI) centers in Spain have adopted new measures to control contagious agalactia (CA). To avoid the introduction of male goats carrying mycoplasma organisms subclinically in their external ear canal (auricular carriers) in these centers, two ear swabs and a blood sample are obtained from all candidate animals for polymerase chain reaction (PCR), culture (swabs) and serologic tests to detect the presence of mycoplasmas. In addition, the semen produced at these centers is routinely cultured and PCR tested also to detect the presence of mycoplasmas. One y after the introduction of this program, we tested 48 ear swabs and 24 blood samples from 24 candidates for admission to these AI Centers. Three of these ear swab samples (3/48, 6.25%) scored positive for the presence of mycoplasmas; Mycoplasma agalactiae (Ma) was detected in two samples and Mycoplasma mycoides subsp. capri (Mmc) in one. All animals were serologically negative for Ma. Also, out of 173 semen samples obtained from 137 admitted animals (2 and 3 samples were obtained in 16 and 10 bucks, respectively), one (1/173, 0.56%) was positive for Mmc. Our findings suggest that ear swab and semen samples are useful tools to control CA at AI Centers. The introduction of this program has also resulted in the first detection of Mmc in semen from a naturally infected goat, confirming the ability of this mycoplasma to colonize the reproductive tract of male goats. These results highlight the need to improve control measures in semen producing centers to minimize the risk of CA transmission.     

Safety studies of the oral rabies vaccine SAD B19 in striped skunk (Mephitis mephitis)

Safety of the modified live rabies virus vaccine, SAD B19, was studied in striped skunks (Mephitis mephitis). Seven skunks received 10(7.9) foci formatting units by direct oral administration. In four cages, a vaccinated animal was placed with a control animal, the other three vaccinated skunks were housed individually. Saliva and nasal swabs were collected 1, 2, 4, 24, 48, and 72 hr post-vaccination. From all vaccinated and control animals (n = 11) blood samples were collected 0, 28, 56, 84, and 296 days post-vaccination. Three of seven vaccinated skunks seroconverted. None of the control animals had detectable levels of rabies virus neutralizing antibodies. Also no vaccine virus was isolated from the nasal and saliva swabs collected from any animal. Thus, SAD B19 was innocuous for skunks in our study after direct oral administration at field concentration.     

Detection of Corynebacterium kutscheri from the oral cavity of rats.

A simple and useful method for the detection of C. kutscheri from the oral cavity of living rats was devised. In 10 sacrificed rats from two naturally and subclinically infected conventional colonies, 10(4.28) or 10(3.84) CFU/ml C. kutscheri were isolated from upper incisor swab extractions, while 10(1.38) or 10(1.58) and < 10 or 10(1.56) CFU/ml from the upper soft palate and pharynx, respectively. In another survey with 26 living animals, which were reared on the same rack, organisms were detected from the upper incisor and gingival swabs in 15 of 26 rats (57.7%). The results were reproducible at a second survey 10 days later. No organisms were isolated from any sites of the orally negative rats. These results indicated that culture of swab specimens from the upper incisors and gingivae of incisors is useful for the detection of C. kutscheri infection in living rats.     

Prevalence of aerobic and anaerobic uterine bacteria during peripartum period in normal and dystocia-affected buffaloes

Parturition complications predispose establishment of uterine infections, which in turn affect subsequent fertility. The aim of present study was to characterize and compare the type of bacterial flora prevalent within the uterine lumen of dystocia-affected buffaloes and compare them with the normally calving buffaloes. The study was conducted on 40 buffaloes; of which 10 calved normally (Group I) and 30 were treated for dystocia (Group II). Bacteriological examination was performed using uterine swabs, which were collected before delivery, immediately after delivery and day's 24-60 postpartum. A total of 30 uterine swabs from Group I and 79 swabs from Group II were collected, of which 19 (63.3%) and 71 (89.9%) yielded significant bacterial growth, respectively. A total of 205 isolates belonging to 10 different genera of bacteria were identified, 8 facultative anaerobes and 2 obligate anaerobes. In Group II, 91.6% of the bacteria positive swabs (n = 71) yielded mixed cultures, whereas the remainder being pure cultures. In contrast, 89.5% of the bacteria positive swabs of Group I (n = 19) yielded pure cultures. Mixed infections comprised mostly Arcanobacter (Actinomyces) pyogenes together with obligate anaerobes, Fusobacterium spp. and Bacteroides spp. In Group II, the frequency of incidental and coliform group bacteria was highest at the time of parturition, i.e., before and immediately after delivery, and decreased to nil during the 24-60-day postpartum period. However, in Group I, the incidental and coliform group of bacteria present at the time of parturition apparently persisted beyond the period when uterine involution is complete. The frequency of obligate anaerobes and A. pyogenes at the time of parturition was nil in the Group I while they predominated in dystocia-affected buffaloes (Group II). During the postpartum period of 24-60 days, the frequency of both obligate anaerobes and A. pyogenes increased significantly in Group II, whereas in Group I, only occasional isolates were obtained. To conclude, at the time of calving the prevalence of obligate anaerobes and A. pyogenes occurring in combination was highest in dystocia-affected buffaloes, and further increased in the postpartum period suggesting that these infections act synergistically.     

Viability of facultative anaerobic bacteria in commercial transport systems

The possibilities of the transport systems manufactured by Copan (Italy) and Deltalab (Spain) were studied on 15 microbial strains: representatives of the family Enterobacteriaceae (enterobacterial swabs with Cary-Blair medium) and the genus Streptococcus, as well as the species Neisseria meningitidis, Haemophilus influenzae (universal swabs with charcoal-enriched Amies medium). Microorganisms were shown to retain their viability (in colony-forming units, %) for 48 hours in the systems of both firms. H. influenzae exhibited greater viability in the system manufactured by Copan than in that manufactured by Deltalab (respectively, 62% and 28% in 24 hours, 19% and 6% in 48 hours).     

The bacteriological culture of equine uterine contents, in-vitro sensitivity of organisms isolated and interpretation.

A total of 19 pathogenic bacterial species was isolated from uterine swabs of 498 out of 1539 mares over 4 years. The swabs were taken by 5 veterinary clinicians using 2 different techniques. Bacterial contamination during swabbing was minimized by scrupulous attention to cleansing of the external genitalia and the perineal area, and in the handling of the culture specimen. The most prevalent organisms isolated were beta-haemolytic streptococcus (39%), Escherichia coli (27%) and Klebsiella pneumoniae (7%). Interpretation of microbiological findings correlated well with clinical findings when number of organisms isolated and endometrial cytology were considered. The use of a bacterial transport medium combined with sophisticated culture methods reflects a more accurate picture of the uterine microflora than can be obtained by previous techniques. Streptococci isolated were uniformly sensitive to penicillins. The sensitivity of E. coli and K. pneumoniae towards chloramphenicol, gentamicin and polymyxin was nearly 100%. The selection of an appropriate antibacterial agent depends upon sensitivity, pharmacological action, genital tract status and cost. This study shows that a Gram stain of uterine cytology can be used to diagnose quickly and select an appropriate antibiotic for treatment prior to culture results if sufficient numbers of organisms are present.     

Evaluation of carriers used in the test methods of the Association of Official Analytical Chemists

Revision of the official test method for the determination of the tuberculocidal activity of disinfectants is being undertaken. The current procedure lacks precision and accuracy and is not quantitative. Variability associated with carriers and the lack of temperature control were evaluated in this paper. The use of porcelain versus stainless steel carriers was also evaluated. When carriers of either type were contaminated with Mycobacterium bovis BCG, the number of organisms on the carriers varied by as much as 1.0 on the log10 scale. The average number of organisms attached to each porcelain carried was 1.10 x 10(5) CFU (range, 2.7 x 10(4) to 2.7 x 10(5) CFU), whereas the average number of organisms attached to each stainless steel carrier was 1.38 x 10(5) CFU (range, 2.9 x 10(4) to 4.0 x 10(5) CFU). The average number of cells attached to the carrier was directly proportional to the number of cells in the contaminating cell suspension. Variations in drying time did not alter the number of cells attached to the carrier. When porcelain carriers were placed in a test solution, the average number of organisms washed from the carriers was 55% of the total, with a range of 19 to 80%, whereas for stainless steel carriers, the average number was 82% of the total, with a range of 52 to 96%. Data for B. subtilis spores were similar to those for M. bovis BCG, suggesting that there may be similar problems with the Association of Official Analytical Chemists sporicidal test, which uses carriers. It was also found that the lack of an exacting temperature control could influence the outcome of the test. Changes in temperature as little as 1 degree C could influence the rate of killing of M. bovis BCG.     

Evaluation of carriers used in the test methods of the Association of Official Analytical Chemists.

Revision of the official test method for the determination of the tuberculocidal activity of disinfectants is being undertaken. The current procedure lacks precision and accuracy and is not quantitative. Variability associated with carriers and the lack of temperature control were evaluated in this paper. The use of porcelain versus stainless steel carriers was also evaluated. When carriers of either type were contaminated with Mycobacterium bovis BCG, the number of organisms on the carriers varied by as much as 1.0 on the log10 scale. The average number of organisms attached to each porcelain carried was 1.10 x 10(5) CFU (range, 2.7 x 10(4) to 2.7 x 10(5) CFU), whereas the average number of organisms attached to each stainless steel carrier was 1.38 x 10(5) CFU (range, 2.9 x 10(4) to 4.0 x 10(5) CFU). The average number of cells attached to the carrier was directly proportional to the number of cells in the contaminating cell suspension. Variations in drying time did not alter the number of cells attached to the carrier. When porcelain carriers were placed in a test solution, the average number of organisms washed from the carriers was 55% of the total, with a range of 19 to 80%, whereas for stainless steel carriers, the average number was 82% of the total, with a range of 52 to 96%. Data for B. subtilis spores were similar to those for M. bovis BCG, suggesting that there may be similar problems with the Association of Official Analytical Chemists sporicidal test, which uses carriers. It was also found that the lack of an exacting temperature control could influence the outcome of the test. Changes in temperature as little as 1 degree C could influence the rate of killing of M. bovis BCG.     

Evaluation of the NucliSens miniMAG RNA extraction and real-time NASBA applications for the detection of Mycoplasma pneumoniae and Chlamydophila pneumoniae in throat swabs

Nucleic acids were extracted from 215 throat swabs from patients with community-acquired pneumonia by the manual Boom extraction, the NucliSens miniMAG and the Qiagen DNA blood kit and amplified respectively by in-house real-time NASBA, NucliSens EasyQ reagents, and real-time PCR for the detection of Mycoplasma pneumoniae and Chlamydophila pneumoniae. Five out of 215 throat swabs were found to be C. pneumoniae positive by all techniques used. A total of 11 out of 215 throat swabs were positive for M. pneumoniae; 10/215 by Qiagen extraction and PCR amplification and 9/215 by NucliSens miniMAG and NucliSens EasyQ amplification. The NucliSens miniMAG and NucliSens EasyQ applications were successfully coupled to detect both organisms in throat swabs.     

Evaluation of the usefulness of selected commercial systems for identification of Streptococcus species

The usefulness was assessed of three commercially available systems for rapid identification of streptococcal strains. The studied material comprised 68 strains of streptococci and enterococci (including 24 standard strains) belonging to serological groups: A (14 strains), B (10), C (11), D (10), F (3) and G (10), as well as 10 S. pneumoniae strains. The strains were isolated from throat, nasal, wound swabs, blood, pus of inpatients and throat and nasal swabs of outpatients. For the identification of streptococci 3 commercially available systems were used: API 20 STREP (bioMerieux, France), rapid ID 32 Strep (bioMerieux, France), Streptoplast PPL 18 (HTL, Poland). The determinations were done according to producer's instructions. The highest percent of correctly identified strains was obtained with the rapid ID 32 Strep--80.9%, with the API 20 STREP--76.4% strains were identified correctly and with the PPL 18--61.8%. The study showed that the API 20 STREP and rapid ID 32 STREP are suitable for the identification of streptococcal strains from groups: A, B, C, D, F and enterococci--group D. The proportions of correctly identified strains from these groups with the Streptoplast PPL 18 were lower than those determined with the bioMerieux systems. Using of three identification systems streptococci from group G and S. pneumoniae strains cannot be identified.     

Tetracycline-resistant Beta-haemolytic Streptococci in South-west Essex: Decline and Fall

The prevalence of tetracycline-resistant beta-haemolytic streptococci in South-west Essex has been recorded over the past 10 years. It has fallen from a peak of 35% in 1965 to a level of 9·2% in 1972. Ear infections no longer provide the highest incidence of these organisms; vaginal, perineal, and skin infections now seem to be of greater relative importance but throat swabs still provide the greatest actual number of isolations. Erythromycin-resistant strains are still rare.     

Cytomegalovirus Survival and Transferability and the Effectiveness of Common Hand-Washing Agents against Cytomegalovirus on Live Human Hands

Congenital cytomegalovirus (CMV) transmission can occur when women acquire CMV while pregnant. Infection control guidelines may reduce risk for transmission. We studied the duration of CMV survival after application of bacteria to the hands and after transfer from the hands to surfaces and the effectiveness of cleansing with water, regular and antibacterial soaps, sanitizer, and diaper wipes. Experiments used CMV AD169 in saliva at initial titers of 1 × 10⁵ infectious particles/ml. Samples from hands or surfaces (points between 0 and 15 min) were placed in culture and observed for at least 2 weeks. Samples were also tested using CMV real-time PCR. After application of bacteria to the hands, viable CMV was recovered from 17/20 swabs at 0 min, 18/20 swabs at 1 min, 5/20 swabs at 5 min, and 4/20 swabs at 15 min. After transfer, duration of survival was at least 15 min on plastic (1/2 swabs), 5 min on crackers and glass (3/4 swabs), and 1 min or less on metal and cloth (3/4 swabs); no viable virus was collected from wood, rubber, or hands. After cleansing, no viable virus was recovered using water (0/22), plain soap (0/20), antibacterial soap (0/20), or sanitizer (0/22). Viable CMV was recovered from 4/20 hands 10 min after diaper wipe cleansing. CMV remains viable on hands for sufficient times to allow transmission. CMV may be transferred to surfaces with reduced viability. Hand-cleansing methods were effective at eliminating viable CMV from hands.     

Association of Chlamydia trachomatis,Neisseria gonorrhoeae,Mycoplasma genitalium and Ureaplasma species infection and organism load with cervicitis in north Indian population

Cervicitis is predominantly caused by Neisseria gonorrhoeae and Chlamydia trachomatis, which accounts for almost half of all the cases of cervicitis. The role of newer organisms like Mycoplasma genitalium and Ureaplasma sp. and association of bacterial load with cervicitis are also not well established. So the study aimed to determine the relative frequency of these organisms and their load in association with cervicitis cases from north India. A case–control study involving 300 women was conducted using quantitative real-time PCR from endocervical swabs for identification of organisms and quantification of bacterial load. Among 150 cervicitis cases, C. trachomatis, N. gonorrhoeae, M. genitalium and Ureaplasma parvum were detected in 5 (3·3%), 10 (6·6%), 37(24·6%) and 47 (31·3%) respectively. Old age (<0·001, chi-squared test) and irregular menstrual cycles (<0·001, chi-squared test) were significantly associated with cervicitis. M genitalium was the only organism to be associated significantly with cervicitis with regard to age (<0·031) and symptoms like discharge (P < 0·033, chi-squared test) and dysuria (P < 0·044, chi-squared test) in multivariate analysis. Our finding suggests that the bacterial load of these organisms is not significantly associated with cervicitis. However, we found significant association of M. genitalium infection with clinical characteristics of cervicitis cases.     

Improved Recovery of Bacillus Spores from Nonporous Surfaces with Cotton Swabs over Foam,Nylon, or Polyester,and the Role of Hydrophilicity of Cotton in Governing the Recovery Efficiency

Evaluating different swabbing materials for spore recovery efficiency (RE) from steel surfaces, we recorded the maximum RE (71%) of 10⁷ Bacillus subtilis spores with Tulips cotton buds, followed by Johnson''s cotton buds and standard Hi-Media cotton, polyester, nylon, and foam (23%) swabs. Among cotton swabs, instant water-absorbing capacity or the hydrophilicity index appeared to be the major indicator of RE, as determined by testing three more brands. Tulips swabs worked efficiently across diverse nonporous surfaces and on different Bacillus spp., registering 65 to 77% RE.     

Development and application of a tool to assess laboratory hygiene in contained-use facilities

To gain information on laboratory hygiene in contained-use laboratories, a method was developed to study the presence of microorganisms on laboratory equipment. Focusing detection on genetically modified organisms (GMOs) containing the universal M13 primer binding sites enabled the detection of a broad range of GMOs using a single PCR. Swabbing surfaces in three different contained-use laboratories led to detection of M13-containing PCR products in 26 out of 34 swabs. Most sequences (up to five per sample) were detected in swabs from the centrifuge and sink, followed by swabs taken from the bin and incubator (up to four sequences per sample). The obtained sequences varied in length from 171 nucleotides (nt) to 878 nt. In most cases, sequences were only partially similar to sequences published in GenBank. The lengths of the regions with high similarity varied from 94 nt to 795 nt, and these similarities ranged from 81% to 100%. Similarities with more than one sequence were commonly found, complicating the identification of detected sequences. Nonetheless, 84% of the detected sequences were actually handled in the laboratory at the time of sampling. This demonstrates that the method may be used as a quality control tool to assess the efficacy of decontamination and cleaning of commonly used surfaces, such as laboratory benches, freezer doors, and centrifuge rotors, without prior knowledge of the identity or characteristics of the GMOs.