THE isolation rate of anaerobic bacteria from clinical specimens increased manyfold in our laboratory when the techniques for anaerobic bacteriology were revised. We present here an account of our findings with these methods applied as a routine to clinical specimens, and make recommendations concerning the techniques of incubation, media and the use of certain identification tests. The isolation of anaerobic species from different anatomical sites is described, and special attention is given to the yield of organisms from empyema fluid, the peritoneal cavity, surface lesions and blood. MATERIALS AND METHODSWith the general exception of urines, faeces, respiratory specimens and cerebrospinal fluid (CSF), specimens of exudates received between 1 Dec. 1974 and 31 Jan. 1976 were cultured for anaerobic bacteria as described below. Transport of specimens. Samples of pus were transported to the laboratory in sterileMcCartney bottles. Swabs of purulent material were sometimes transported deep in a tube of Cary and Blair transport medium (Cary and Blair, 1964), but many swabs were received in the ordinary dry state.Macroscopic examination. Specimens were examined for colour, odour, consistency and the presence of sulphur granules. Liquid pus samples were examined for brick-red fluorescence under an ultraviolet light (Blak-Ray UVL 21, Ultraviolet Products Inc., San Gabriel, California) at a distance of 6-9 in. (15-23 cm) for presumptive evidence of the presence of Bacteriodes melaninogenicus.Microscopic examination. Samples of pus were examined by gram stain to ascertain the number and proportion of morphological forms present.Culture of clinical material. Our complete range of media used for culture in this study were as follows :1. Blood agar: Columbia Agar Base (London Analytical and Bacteriological Media) with 5 % defibrinated horse-blood; this was obtained as poured plates from London Analytical and Bacteriological Media Ltd, Salford, Lancs. (LAB M). 2. Supplemented brucella agar: Brucella Agar (Difco Laboratories Ltd, West Molesey, Surrey) with 5 % defibrinated horse blood and menadione 0.5 pg per ml (Sigma Chemical Co. Ltd, Kingston-upon-Thames, Surrey). 3. Supplemented selective brucella agar: supplemented brucella agar rendered selective by adding kanamycin 75 pg per ml (Kantrex solution, Bristol Laboratories, Langley, Bucks).
SUMMARY A survey of the bacteria found in postoperative wounds was undertaken during a 14-month period. The yields of aerobic and anaerobic bacteria in 65 appendicectomy wounds were compared; 42 wounds yielded aerobes and 51 anaerobes. Seventy-eight other operation wounds yielded anaerobes, and, overall, 33 wounds yielded anaerobes only. Bacteroides sp were the most common anaerobic organisms isolated from all operation sites except the lung.The examination of infected postoperative wounds for bacteria permits rational chemotherapy. Previous reports of bacteria found in postoperative wounds have shown a predominance of aerobes over anaerobes. In two large national surveys (National Academy of Sciences-National Research Council, 1964; Public Health Laboratory Service, 1960) anaerobes were isolated from only 2-3 % of sampled wounds in one, and were not mentioned in the other. More recent surveys (Hoffmann and Gierhake, 1969;Gupta et al., 1972;Peach and Hayek, 1974) Received for publication 17 July 1978 medium. They were sent to the laboratory via the hospital portering system. The survey was limited to the first specimen taken from each wound. MICROSCOPIC EXAMINATIONA Gram film was made from each specimen, and the morphology and number of bacteria present were noted. MEDIA AND CULTUREThe media and conditions of culture have been described in full previously . Swabs and purulent material were plated directly on to Columbia blood agar and MacConkey agar for aerobic culture; and on to Columbia blood agar and selective Brucella agar containing 5 % horse blood, 0 5 )ug/ml menadione, and 75 pg/ml kanamycin for anaerobic culture. Swabs and samples of pus were then inserted into Robertson's cooked meat medium and incubated for 48 hours before subculture on to Columbia blood agar and MacConkey agar aerobically and kanamycin anaerobically.
who, at Maatjesspruit on July 7th, 1901, behaved very gallantly in riding into Boer lines under continuous fire to attend to the wounded ; Lieutenant W. H. Odlum, R.A.M.C., for tending wounded under heavy fire at Draaihoek, Orange River Colony, on July 8th, 1901; Civil Surgeon J. Prentice, for going under very heavy fire to attend to a wounded man lying in the open, and for continuous good work ; Major H. N. Thompson, R.A.M.C., who, near Jamestown, Cape Colony, on June 4th, 1901, went a considerable distance under fire towards the enemy's position to attend to Lieutenant Hogg has been conspicuous for good service throughout. Corporal W. W. Weeden, R. A.M. C., who, at Bersefontein, Orange River Colony, on July 24th, 1901, rode some distance under fire to assist a wounded man lying in the open and stayed with him 20 minutes, being fired at all the time, has been promoted sergeant by the Commander-in-Chief. SOUTH AFRICAN WAR NOTES.
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