RESUMO
We report 3 cases of successful treatment of Microascus spp. bronchopulmonary infection in a multiple-traumatized patient and 2 lung transplant recipients in France. We emphasize the promising use of olorofim antifungal therapy in a rising context of intrinsically less-susceptible respiratory infections caused by mold.
Assuntos
Ascomicetos , Humanos , Piperazinas , Pirimidinas , Acetamidas , Antifúngicos/uso terapêuticoAssuntos
Doença Enxerto-Hospedeiro/tratamento farmacológico , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Infecções por Mycobacterium não Tuberculosas/induzido quimicamente , Proteinose Alveolar Pulmonar/induzido quimicamente , Pirazóis/efeitos adversos , Idoso , Feminino , Doença Enxerto-Hospedeiro/etiologia , Humanos , Mycobacterium abscessus/isolamento & purificação , Síndromes Mielodisplásicas/cirurgia , Nitrilas , Proteinose Alveolar Pulmonar/patologia , PirimidinasRESUMO
CHROMmagar Orientation media (Becton Dickinson) was developed and validated for the culture of urinary samples. It allows a direct identification of E. coli colonies without additional tests. As CHROMmagar Orientation media is superior to non-chromogenic media for the distinction of enterobacterial colonies, it is used for the inoculation of a large variety of samples in clinical laboratories. Direct identification of E. coli colonies cultured from these samples is not validated by the manufacturer. The difference in microbial ecology and the nature of the sample may impact CHROMagar Orientation performances for this use. We evaluated these media for the direct identification of E. coli colonies from 410 samples (excluding urine). Its sensitivity of 99% allows a direct identification of E. coli colonies cultured from a wide variety of samples. On-site testing using a large number of representative samples, allows laboratories to assess agar media performance and adapt their uses. Suppliers who are aware of frequent and non-recommended use of their culture media should perform tests and if conclusive, adapt their technical instructions.
Assuntos
Técnicas Bacteriológicas/métodos , Compostos Cromogênicos/química , Meios de Cultura/química , Escherichia coli/isolamento & purificação , Hemocultura/métodos , Humanos , Testes de Sensibilidade Microbiana , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
In order to perform biological analysis, clinical laboratories apply the instructions of reagent suppliers. For culture media these instructions are often incomplete and poorly adapted to the variety of clinical samples and micro-organisms. The REMIC can help to overcome these shortcomings. Required time of incubation for culture media are proposed based on the nature of the sample and the type of micro-organism suspected. Nevertheless, they are most often expressed in multiple of 24 hours and they are often considered as minimal by the laboratories. As the samples are inoculated "continuously", while the readings are most often done at a single definite time of the day, we propose a strategy to optimize incubation duration of cultures medium. A time of incubation in the day so-called "limit" is defined. From this, the incubations are stopped or prolonged according to the results of the culture and the direct examination. As the instructions of suppliers of culture media are not adapted, it appears necessary that these suppliers relies on the repositories of professional societies as this is the case for agars medias used for antibiotic susceptibility testing.
Assuntos
Serviços de Laboratório Clínico/normas , Meios de Cultura/normas , Técnicas Microbiológicas , Técnicas Bacteriológicas/métodos , Técnicas Bacteriológicas/normas , Calibragem , Humanos , Incubadoras/normas , Técnicas Microbiológicas/métodos , Técnicas Microbiológicas/normas , Fatores de TempoRESUMO
The culture of micro-organisms exposes to the risk of microbiological contamination at all stages of the analysis: inoculation on culture media, incubation, and observation of cultures. During our accreditation renewal audit, a surveillance point was notified, regarding the lack of consideration of the risk of microbiological contamination. Its mastery mainly relies on cleaning/disinfection operations and their traceability. In addition, several strategies based on environmental sampling or indicators can be performed. We propose a risk analysis in order to present these strategies.