Rigid bronchoscopy: a consultant survey.

INTRODUCTION: Inhalation of foreign bodies represents a potentially fatal emergency in both adults and children. Chest x-ray, in isolation, is neither sensitive nor specific. Rigid bronchoscopy represents the gold standard to diagnose and retrieve paediatric foreign bodies. Cases are encountered infrequently, creating anxieties about their management. Little is known about the confidence in, and maintenance of, rigid bronchoscopy skills by ear, nose and throat teams. METHODS: A 15-question survey was completed by 50 practising otolaryngology consultants in England. RESULTS: Results show that almost 40% of otolaryngology consultants covering rigid bronchoscopy have not performed bronchoscopy in more than 5 years. Consultants raised concerns about the anaesthetic support and the speed of equipment assembly. Questions on clinical practice showed disparities in practice in the same scenario. CONCLUSIONS: The authors advocate addressing many of the issues raised by the study with a greater availability of simulation courses and regular scheduled intradepartmental teaching days for all professionals involved. National guidelines on criteria for transfer to tertiary centres would improve the consistency of practice.

Microbiological analysis of 'black pudding', a Trinidadian delicacy and health risk to consumers.

The prevalences of Salmonella, Escherichia coli and Staphylococcus aureus in black pudding which originated from local vendors and supermarkets in Trinidad were determined. The enterotoxigenicity of S. aureus strains and occurrence of O157:H7 strains amongst E. coli isolates were also investigated. For the 100 black puddings each sampled from supermarkets and vendors, the mean total aerobic plate count (TAPC) per g was 1.8 x 10(7) +/- 1.5 x 10(7) and 1.5 x 10(8) +/- 2.3 x 10(8), respectively. E. coli was isolated from 56 (56.0%) black pudding samples from supermarkets with a mean count per g of 9.2 x 10(6) +/- 7.9 x 10(6) compared to a prevalence of 79% (79 of 100) and mean count per g of 3.2 x 10(7) +/- 4.7 x 10(7) for samples from local vendors. The difference between prevalences was statistically significant (P < or = 0.001; chi 2). Only 1 (2.2%) of 45 strains of E. coli from supermarket-purchased pudding tested, was an 0157:H7 strain compared to 9 (13.6%) of 66 strains of E. coli from vendor-sold black pudding. The difference was not statistically significant (P > or = 0.05; chi 2). Five (5.0%) of 100 black pudding samples from supermarkets yielded Salmonella, with S. ohio being the predominant serotype. For vendor-sold black pudding however, 11 (11.0%) samples were positive for Salmonella with a new serotype, S. unnamed (4,12:d-) being responsible for 50% (6 of 12) of isolates from this source. Forty samples each of black pudding from supermarkets and vendors were all (100.0%) positive for S. aureus with mean counts per g being 3.1 x 10(5) +/- 8.8 x 10(5) and 3.3 x 10(6) +/- 7.7 x 10(6), respectively. Overall, 27 (33.8%) of 80 strains of S. aureus tested were enterotoxigenic producing staphylococcal enterotoxins A(SEA), SEB, SEC, SED or a combination. It was concluded that black pudding poses a high risk to consumers based on the prevalence, microbial load and toxigenicity of the pathogens detected.

Microbiological analysis of "black pudding", a Trinidadian delicacy and health risk to consumers

The prevalence of Salmonella, Escherichia coli and Staphylococcus aureus in black pudding which originated from local vendors and supermarket in Trinidad were determined. The enterotoxigenicity of S. aureus strains and occurrence of 0157:H7 strains among E. coli isolates were also investigated. For the 100 black puddings each sampled from supermarkets and vendors, the mean total aerobic plate count (TAPC) per g was 1.8 x 10 (7) the mean total aerobic plate count (TAPC) per g was 1.8 x 10 (7) +/- 1.5 x 10 (7) and 1.5 x 10(8) +/- 2.3 x 10 (8), respectively. E. coli was isolated from 56 (56.0 percent) black pudding samples from supermarkets with a mean count per g of 9.2 x 10 (6) +/- 7.9 x 10 (6) compared to the prevalence of 79 percent (79 nof 100) and mean count per g of 3.2 x 10 (7) +/- 4.7 x 10 (7) for samples from local vendors. The differences between the prevalences was statistically significant (P < or = 0.0001; chi 2). Only 1 (2.2 percent) of 45 strains of E. coli from supermarket-purchased pudding tested, was an 0157:H7 strain compared to 9 (13.3 percent) of 66 strains of E. Coli from vendor-sold black puding. The difference was not statistically significant (P) or = 0.05; chi 2). Five (5.0 percent) of 100 black pudding samples from supermarkets utyielded Salmonella. wih S. ohio being the predominant serotype. For vendor-sold black pudding, however, 11 (11.0 percent) samples were positive for Salmonella with a new serotype, S. unmamed (4, 12:d-_ being responsible for 50 percent (6 of 12) of isolates from this source. Forty samples each of black pudding from supermarkets and vendors were all (100.0 percent) positive for S. aureus with mean counts per g being 3.1 x 10 (5) +/- 8.8 x 10(5) and 3.3 x 10 (6) +/- 7.7 x 10 (6), respectively. Overall, 27 (33.8 percent) of 80 strains of S. aureus tested were enterotoxigenic producing staphylococcal enterotoxins A(SEA), SEB, SEC, SED or a combination. It was concluded that black pudding poses a high risk to consumers based on the prevalence, microbial load and toxigenicity of the pathogens detected. (AU)