RESUMO
Microbiology laboratories continually strive to streamline and improve their urine culture algorithms because of the high volumes of urine specimens they receive and the modest numbers of those specimens that are ultimately considered clinically significant. In the current study, we quantitatively measured the impact of the introduction of CHROMagar Orientation (CO) medium into routine use in two hospital laboratories and compared it to conventional culture on blood and MacConkey agars. Based on data extracted from our Laboratory Information System from 2006 to 2011, the use of CO medium resulted in a 28% reduction in workload for additional procedures such as Gram stains, subcultures, identification panels, agglutination tests, and biochemical tests. The average number of workload units (one workload unit equals 1 min of hands-on labor) per urine specimen was significantly reduced (P < 0.0001; 95% confidence interval [CI], 0.5326 to 1.047) from 2.67 in 2006 (preimplementation of CO medium) to 1.88 in 2011 (postimplementation of CO medium). We conclude that the use of CO medium streamlined the urine culture process and increased bench throughput by reducing both workload and turnaround time in our laboratories.
Assuntos
Bactérias/classificação , Bactérias/isolamento & purificação , Técnicas Bacteriológicas/métodos , Técnicas de Laboratório Clínico/métodos , Meios de Cultura/química , Infecções Urinárias/diagnóstico , Infecções Urinárias/microbiologia , Humanos , Carga de TrabalhoRESUMO
There has been a marked increase in the frequency with which breast prosthesis are being used, both for reconstructive and cosmetic purposes. Although breast implant-related infections are uncommon, they are typically caused by bacterial skin flora, specifically Staphylococcus aureus and the coagulase negative staphylococci. There have been infrequent reports of breast implant infection caused by the atypical mycobacteria. This report summarizes the case of a young female who underwent augmentation mammoplasty who presented shortly thereafter with clinical evidence of an infected breast prosthesis. Despite a protracted course of empiric antibiotic therapy and multiple surgical interventions, she failed to improve. Additional microbiologic investigations allowed for a diagnosis of Mycobacterium fortuitum group breast implant infection to be established. A prolonged course of anti-mycobacterial therapy, based upon susceptibility results, allowed for eradication of the infection and subsequent successful re-implantation of the prosthesis.