Contamination of drinking water by microorganisms and arsenic represents a major human health hazard in many parts of the world. An estimated 3.4 million deaths a year are attributable to waterborne diseases. Arsenic poisoning from contaminated water sources is causing a major health emergency in some countries such as Bangladesh where 35 to 77 million people are at risk. The World Health Organization (WHO) has recently recognized point-of-use water treatment as an effective means of reducing illness in developing country households. A new point-of-use water treatment system that is based on flocculation, sedimentation and disinfection was evaluated for the removal of bacterial, viral and parasitic pathogens as well as arsenic from drinking water to estimate its potential for use in developing countries. Tests were conducted with United States Environmental Protection Agency (EPA)-model and field- sample waters from developing countries. Samples were seeded with known numbers of organisms, treated with the combined flocculation/disinfection product, and assayed for survivors using standard assay techniques appropriate for the organism. Results indicated that this treatment system reduced the levels from 10(8)/l to undetectable (<1) of 14 types of representative waterborne bacterial pathogens including Salmonella typhi and Vibrio cholerae. No Escherichia coli were detected post-treatment in 320 field water samples collected from five developing countries. In addition, the water treatment system reduced polio and rotavirus titres by greater than 4-log values. Cyrptosporidium parvum and Giardia lamblia inocula were reduced by greater than 3-log values following use of this water treatment system. Arsenic, added to laboratory test waters, was reduced by 99.8%, and naturally occurring arsenic in field samples from highly contaminated Bangladeshi wells was reduced by 99.5% to mean levels of 1.2 microg/l. This water treatment system has demonstrated the potential to provide improved drinking water to households in developing countries by removing microbial and arsenic contaminants.
ltrasound equipment comes into direct contact with patients and practitioners during scanning procedures, enabling it to be a potential vehicle for the spread of nosocomial infections. A study was undertaken to determine the extent of contamination on this equipment and therefore the efficacy of the present decontamination guidelines. Five ultrasound machines were sampled over a period of three months. Three used for non-invasive procedures and two for invasive procedures. The equipment was sampled from the probe, probe holder, keyboard and gel. The results revealed that 64.5% of the total samples were contaminated with environmental organisms, 7.7% with potential pathogens and 27.8% were no growth. The most significant contamination was found on the non-invasive equipment, probably due to the lower level of decontamination practices designated for this equipment. Following the study, comprehensive decontamination guidelines for all ultrasound equipment were devised and distributed to all ultrasound departments, and staff were educated on the need for improved decontamination regimes.
BackgroundRGM 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).MethodsIn 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).ResultsFor 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).ConclusionsIn 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.
Aims: To compare the performance of a new chromogenic medium, Uriselect 4, with cystine lactose electrolyte deficient (CLED) agar and an established chromogenic agar, CPS ID 2 medium, for detection of urinary tract pathogens. Methods: Using a semiquantitative culture method, 777 samples were inoculated on to the three test media in duplicate. All bacterial strains that yielded a potentially significant growth were observed for colony colour and identified using standard methods. Results: Of the 777 samples tested, 589 urine samples yielded potentially significant growth of at least one strain. A total of 811 strains were isolated on at least one of the three media. A total of 168 urine samples yielded a mixture of at least two strains. Uriselect 4 medium showed the best sensitivity of the three media and only failed to recover 14 strains (1.7%). CPS ID 2 medium failed to recover 22 strains (2.7%). CLED medium showed the worst recovery and failed to recover 74 strains (9.1%). Both chromogenic media allowed for identification of Escherichia coli with a high degree of specificity (98% for Uriselect 4, 99.7% for CPS ID 2). Inclusion of a spot indole test increased the specificity of both chromogenic media to 100% for E coli. Conclusions: Uriselect 4 and CPS ID 2 were superior to CLED medium for the isolation of urinary tract pathogens mainly because of their ability to discriminate mixed cultures. Both chromogenic media were also useful for the preliminary identification of the most common urinary tract pathogens.
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