RESUMEN
Isolation of Mycoplasma genitalium from clinical specimens remains difficult. We describe a modified culture system based on Vero cells grown in medium 199 with 2% foetal bovine serum (FBS). The culture system was evaluated using early passage M. genitalium strains M6271 and M6311 with growth monitoring by quantitative TaqMan PCR. Eleven endocervical swabs and one male urethral swab positive by 16S rRNA and MgPa1-3 PCRs were quantified and inoculated into Vero cell suspensions in medium 199 supplemented with 2% FBS and antibiotics. Cultures were incubated for 14 days. Cell passages and growth monitoring by TaqMan PCR were performed until the growth of M. genitalium reached ≥10(6) geq/mL. Confirmation of the new M. genitalium strains was performed by sequencing a 281 bp fragment of mgpB. The growth of Mycoplasma genitalium strains was recorded for all urogenital swab specimens in the modified cell-culture system. Growth of M. genitalium was obtained within 2 months and yielded 12 M. genitalium strains with all 11 isolates from females of an identical, but unique genotype. To our knowledge, this is the first successful isolation of M. genitalium in the Latin-American region. The use of Vero cell culture in 199 medium with 2% FBS is a method comparable to the Ultroser G culture system for isolation of M. genitalium. Genotyping of clinical samples and isolates should be performed to document the absence of cross-contamination.
RESUMEN
The purpose of this study was to examine the outcome of the application of the High Density Polyethylene (HDPE)-Jaipur prosthetic construction in fitting trans-tibial amputees in a number of projects in the developing world. Projects in Honduras, Uganda and India were visited. Three hundred and twenty (320) patients had been provided with a HDPE-Jaipur prosthesis and of these 172 were seen for a technical and clinical follow-up after a median of 35 months. More than half the amputations were due to trauma, the remainder to disease. Fabrication and fitting in the three projects was carried out by individuals who had undertaken a twice week training course provided by Bhagwan Mahaveer Viklang Sahayata Samiti limb centre in Jaipur. The individuals involved had limited background training in prosthetics. Craftsmanship and fit were assessed as being poor in 56% of cases. The technical quality of the Jaipur foot was considered acceptable as its performance was better than previously observed results. Although there was patient satisfaction of 85% and compliance of 94% the HDPE-Jaipur trans-tibial system was not considered acceptable as 49% reported walking distances less than 1km and 36% discomfort. The major inadequacy in outcome relates to the use for fabrication and fitting of individuals with inadequate education and training.