Objectives: To evaluate the Neisseria gonorrhoeae Becton Dickinson (BD) ProbeTec strand displacement assay (SDA) on female endocervical swab and male first void urine against culture for Neisseria gonorrhoeae on female endocervical and urethral swab for the diagnosis of N gonorrhoeae infection in genitourinary medicine (GUM) attendees. To determine an algorithm for implementation of N gonorrhoeae infection screening by SDA in these patients taking account of the desirability of having a N gonorrhoeae isolate in people with N gonorrhoeae infection. Methods: Initially, 1582 patients attending the GUM clinic were tested for N gonorrhoeae infection by SDA and routine microscopy, and culture. On the basis of the results, a protocol for diagnosis of N gonorrhoeae infection by SDA, with culture specimens only from patients with a listed risk factor for acquiring N gonorrhoeae infection, was devised and implemented. A post implementation audit was done to assess the effectiveness of this protocol for routine service use. Results: There was good concurrence between the N gonorrhoeae SDA and culture results with a N gonorrhoeae infection prevalence rate of 3.4% by both methods. All men and 85% of women with N gonorrhoeae infection had an identifiable risk factor for acquiring infection. Overall, 38% men and 60% women attending the GUM clinic had this listed risk factor for acquiring N gonorrhoeae. Post implementation audit confirmed the initial findings. Conclusion: Nucleic acid amplification techniques like the SDA are sensitive and specific for diagnosis of N gonorrhoeae. We were able to list certain risk factors, which were predictive of those patients most likely to have N gonorrhoeae infection. To obtain timely sensitivity data, a culture specimen should also be submitted at the same time from patients deemed to have a listed risk factor for acquiring Neisseria gonorrhoeae infection.
Methicillin-resistant Staphylococcus aureus (MRSA) continues to cause major problems, both in hospitals and the community. Microbiology departments need to review their methodology regularly to ensure that they are contributing in the most appropriate manner to the battle against MRSA. Media employing chromogenic enzymes to aid the isolation and identification of MRSA is a relatively new approach. In this study, 192 swabs from 112 different patients were inoculated on two chromogen-containing media and four other commonly used solid MRSA media to determine which gave the appropriate combination of sensititivity, specificity and speed of result. Methicillin-resistant S. aureus was isolated on at least one of the six media from 102 of the 192 swabs. Both chromogenic media proved to be statistically significantly more sensitive than the other media after overnight incubation and had a sensitivity of 96% after 48 hours' incubation. The recent introduction of chromogen-containing MRSA media offers microbiology laboratories the opportunity to isolate and confirm the majority of MRSA infections/colonisations in 24 hours, which should result in better patient care. The possible slight increase in costs should not provide a valid excuse for using inferior methodologies.
This study compares a recently introduced latex agglutination test for the serogrouping of beta-haemolytic streptococci against four internationally used commercial kits. The new kit is Prolex-Blue (Pro-Lab Diagnostics) and the comparators are Streptex (Murex), PathoDx (DPC), Streptococcus Grouping kit (Oxoid) and Prolex-White (Pro-Lab Diagnostics). A total of 302 consecutive clinical isolates are tested against all five kits, following the individual manufacturer's protocol, for both accuracy and speed. In addition, the data produced permits determination of the strengths or weaknesses of the kits against individual serotypes. Prolex-Blue proved to be both accurate and rapid, with a sensitivity of 99% and a specificity of 100%. Furthermore, average time to agglutination was substantially less than achieved by three of the other four kits evaluated.
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