used in the early diagnosis of invasive candida infections. The same type of procedure is also extremely promising for detecting other pathogens such as viruses. 14 Enzyme immunoassay will probably find a place in the early diagnosis of invasive aspergillosis, which is currently being investigated.
IT is surprising that so little attention has been paid to the incidence and prevention of urinary infection following colporrhaphy. In the multiplicity of operations described for the cure of urinary symptoms in the female those writers who mention the problem comment briefly that the patient should be dismissed with a sterile urine.Our interest in this subject was stimulated by an increasing awareness of the part played by urinary infection in the residual symptomatology after colporrhaphy. When we investigated what was, at that time, our standard post-operative practice we were appalled by the incidence of urinary infection revealed. Alteration of our post-operative technique produced some diminution in the incidence of urinary infection but significant improvement did not occur until the introduction of our present combined aseptic and antiseptic technique. We present the results of 176 cases, divided into three series according to the clinical methods employed. MATERIAL AND METHODSGram-stained film and by culturing on bloodagar and MacConkey plates for eighteen hours. Strains of Staphylococcus aureus, Streptococcus faecalis and Proteus spp. were identified in the usual way. Most strains of Staph. aureus were phage-typed. Gram-negative bacilli which fermented lactose were grouped as coliform bacilli. Evans' "Sentest" tablets were employed to assess the antibiotic sensitivities. A specimen of urine was considered to be infected when pus cells and organisms were present on the direct film and a positive culture was obtained. A light growth of organisms in the absence of pus cells was disregarded.When an in-dwelling catheter was employed, this was inserted in the theatre at the end of the operation. Intermittent catheterization was at first done as follows. A boiled glass catheter was introduced after the urethral meatus had been swabbed with 1 / 1,000 solution of chlorhexidine.The hands were scrubbed but not dried. The instillation of chlorhexidine was carried out through a small glass funnel attached to the end of the catheter by means of a short piece of rubber tubing. The funnel and tubing were Catheter specimens of urine were collected at separately boiled. We have discarded the-use of carefully specified times which will be separately a soft rubber catheter as it cannot be introduced detailed for each of the three series and these without considerable handling by the attendant specimens were examined within two hours of who in a busy ward cannot find the time to collection. The centrifuged deposit of each decontaminate his hands effectively between specimen was examined by microscopy of a each patient. 394
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