Comparative evaluation of practical functionality of rapid test format kits for detection of Escherichia coli O157:H7 on lettuce and leafy greens.

Multistate outbreaks of Escherichia coli O157:H7 infection in 2005 and 2006 associated with fresh and especially minimally processed produce greatly escalated the application of rapid pathogen detection systems to safety management in this food category. Pathogen testing was rapidly integrated into preharvest qualification for field lots, incoming raw produce, or final product. The raw produce and final product were incorporated into test-and-hold programs, typically within a 10-h time frame. To enhance consumer safety and provide guidance for the industry, an assessment of selected kits in comparison to a culture-based method was undertaken. Four primary kits were compared: the Neogen Reveal, SDI RapidChek, BioControl GDS O157, and Qualicon BAX O157 MP. Nine different leafy greens were freshly harvested and inoculated with a five-isolate mixture of E. coli O157:H7 at 10 CFU/25 g of sample, and cultures were enriched following the specified protocol. The PCR method was most consistent for identifying the presence of the inoculated pathogen in the shortest period of time. For the red-pigmented leafy vegetables red butter lettuce, curly endive, red lettuce, and lollo rosa, 13, 38, 88, and 100% false-negative results, respectively, were obtained with the immunoassays, but PCR detection was minimally affected. Immunoassays were negatively affected by delays in achieving critical threshold populations during the allowed enrichment period. Leafy green type, temperature abuse, and preharvest environment were unlikely to affect the results of PCR-based kits. Findings strongly suggest that product testing systems using 8-h detection cutoffs may give false-negative results. These issues become very important in high-throughput testing and retest protocols for presumptive pathogen-positive lots of produce.

Clonal population structure and specific genotypes of multidrug-resistant Campylobacter coli from Turkeys.

Commercial turkey flocks in North Carolina have been found to be colonized frequently with Campylobacter coli strains that are resistant to several antimicrobials (tetracycline, streptomycin, erythromycin, kanamycin, and ciprofloxacin/nalidixic acid). Such strains have been designated multidrug resistant (MDR). However, the population structure of MDR C. coli from turkeys remains poorly characterized. In this study, an analysis of multilocus sequence typing (MLST)-based sequence types (STs) of 59 MDR strains from turkeys revealed that the majority of these strains corresponded to one of 14 different STs, with three STs accounting for 41 (69%) of the strains. The major STs were turkey specific, and most (87%) of the strains with these STs were resistant to the entire panel of antibiotics mentioned above. Some (13%) of the strains with these STs were susceptible to just one or two of the antibiotics in this panel. Further subtyping using fla typing and pulsed-field gel electrophoresis with SmaI and KpnI revealed that the major MDR STs corresponded to strains of related but distinct subtypes, providing evidence for genomic diversification within these STs. These findings suggest that MDR strains of C. coli from turkeys have a clonal population structure characterized by the presence of a relatively small number of clonal groups that appear to be disseminated in the turkey production system. In addition, the observed correlation between STs and the MDR profiles of the microbes indicates that MLST-based typing holds potential for source-tracking applications specific to the animal source (turkeys) and the antimicrobial resistance profile (MDR status) of C. coli.

The use of irradiated allograft in a paediatric population: an Indian experience.

Lyophilised, irradiated bone allografts available for the first time in the country from the Tata Memorial Hospital Tissue Bank were used in 30 paediatric patients from January 2001 to August 2004. They included 20 patients of scoliosis of various origin and ten with assorted orthopaedic conditions including one congenital kyphosis, two Pott's spine, one Perthes disease, one developmental dysplasia of the hip (DDH), one infective non-union, one fibrous dysplasia and three with bone defects either due to trauma, a cyst or removal of hardware. Morsellised allograft was used in 28 patients. In those cases of scoliosis in which ribs were resected out during costectomy, the morsellised allograft was mixed with morsellised rib autograft. Non-morsellised femoral head grafts were used in two patients, one a case of varus open derotation osteotomy in Perthes disease and the other an acetabuloplasty in DDH. Patients were followed at intervals of 8-12 weeks and radiological evaluation was done periodically. The follow up period ranged from 1 to 4 years post surgery. All patients with scoliosis showed excellent union at the grafting site with non-progression of curve and no signs of loosening at implant site. The two patients, in whom non-morsellised femoral head grafts were used, both showed incorporation of the graft with good fusion within a 4 month period. None of the patient had infection, non-union, pseudoarthrosis, fracture at the graft site, or any other complication.

Reconstructing tumour defects: lyophilised, irradiated bone allografts.

Tumour excision leaves behind large defects. Allografts provide an excellent alternative to autografts without donor site morbidity and are especially useful in large defects or in children where the quantity of available autograft is limited. In this paper we discuss our experience with indigenously procured and processed lyophilised, irradiated bone allografts. Bone allografts were used in 41 patients. They were used morsellised and used in 32 cases. Of these, 25 cases were available for follow-up. These included 21 patients in whom the allograft was used in contained cavities. Complete incorporation of the graft was seen between 6 and 9 months in all these 21 patients. In 4 patients the allograft was layered onto autograft. In only one of these the allograft incorporated with the host bone. Struts were used in 9 cases (3 cases complete intercalary segmental defect, 3 cases of hemicortical defects, 2 cases of allograft-prosthesis composite around the hip, in 1 case an iliac-crest block was used to stop bleeding from an anterior sacral defect). Of these, 2 full segment struts showed no incorporation. Both these patients were on chemotherapy and radiotherapy. There was no follow-up in sacral defect case. All the other struts incorporated with the host bone within 6-9 months.In 5 cases there was sterile postoperative drainage. All these cases went on to uneventful. Deep infection was observed in 4 patients (10%). In one, the graft was removed, another settled uneventfully with subsequent incorporation of graft, and two have a persisting sinus but good incorporation.To restore part of the strength of the struts it was necessary to hydrate them for 30 min prior to use. Autogenous marrow or autograft was used to provide osteoinductive properties.Conclusion. In selected cases the lyophilised, irradiated bone allografts proved to be very useful in reconstruction of large tumour defects.

The use of irradiated allografts in reconstruction of tumor defects - the tata memorial hospital experience.

A Tissue Bank is a valuable adjunct to tumour management. In bone tumours, the defects produced by ablative surgery can be reconstructed using banked tissue, thereby obviating the donor site morbidity associated with autografts. Allografts are especially useful in large defects or in children where the quantity of available autograft is limited. The use of bone allografts in India has been limited by the availability of good quality, affordable grafts. In this article we share our experience with the use of indigenously produced allografts in limb salvage, as bone graft expanders and as struts. Lyophilised, irradiated bone allografts were morcellised and used in 32 patients. In 21 of these patients the allograft was used in contained cavities. Complete incorporation of the graft was seen between 6-9 months in all the 25 cases available for follow-up. In 4 patients the allograft was layered onto autograft. The allograft incorporated with the host bone in only one of these patients.Struts were used in 9 cases (3 cases complete intercalary segmental defect, 3 cases of hemicortical defects, 2 cases of allograft-prosthesis composite around the hip, 1 case an iliac-crest block was used to stop bleeding from an anterior sacral defect). Of these, no incorporation of the full segment struts was observed in 2 patients who were on chemotherapy and radiotherapy. The sacral defect case was lost to follow-up. All the other struts incorporated with the host bone within 6-9 months. In 5 cases there was sterile postoperative drainage. Overall infection was observed in 4 patients (10%). In one the graft was removed, another settled uneventfully with subsequent incorporation of graft, and two have a persisting sinus but good incorporation. Since radiation and lyophilisation are known to affect the material properties of bone, the grafts were rehydrated in saline for 30 minutes prior to transplantation. Autogenous marrow or autograft was used to provide osteoinductive properties. In selected cases the lyophilised, irradiated bone allografts proved to be clinically useful in the reconstruction of large tumour defects.