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      Evaluation of an autoclave resistant anatomic nose model for the testing of nasal swabs

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          Abstract

          A nose model that allows for the comparison of different modes of sample acquisition as well as of nasal swab systems concerning their suitability to detect defined quantities of intranasal microorganisms, and further for training procedures of medical staff, was evaluated.

          Based on an imprint of a human nose, a model made of a silicone elastomer was formed. Autoclave stability was assessed. Using an inoculation suspension containing Staphylococcus aureus and Staphylococcus epidermidis, the model was compared with standardized glass plate inoculations. Effects of inoculation time, mode of sampling, and sample storage time were assessed.

          The model was stable to 20 autoclaving cycles. There were no differences regarding the optimum coverage from the nose and from glass plates. Optimum sampling time was 1 h after inoculation. Storage time after sampling was of minor relevance for the recovery. Rotating the swab around its own axis while circling the nasal cavity resulted in best sampling results.

          The suitability of the assessed nose model for the comparison of sampling strategies and systems was confirmed. Without disadvantages in comparison with sampling from standardized glass plates, the model allows for the assessment of a correct sampling technique due to its anatomically correct shape.

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          Evaluation of the Xpert methicillin-resistant Staphylococcus aureus (MRSA) assay using the GeneXpert real-time PCR platform for rapid detection of MRSA from screening specimens.

          The need for rapid methods to accurately detect methicillin-resistant Staphylococcus aureus (MRSA) is widely acknowledged, and a number of molecular assays are commercially available. This study evaluated the Xpert MRSA assay, which is run on the GeneXpert real-time PCR platform (Cepheid) for use in a clinical laboratory. The following parameters were investigated: (i) the limits of detection (LoDs) for four MRSA strains; (ii) the ability to detect isolates of MRSA from a collection representative of MRSA in Ireland since 1974 (n = 114) and the ability to detect control strains with staphylococcal cassette chromosome mec types IVa (IV.1.1.1), IVb (IV.2.1.1), IVc (IV.3.1.1), IVd (IV.4.1.1), V (V.1.1.1), V(T), and VI; and (iii) performance in a clinical trial with swabs from nose, throat, and groin/perineum sites from 204 patients, where results were compared with those obtained by direct and enrichment cultures. The average LoD of the four test strains was 610 CFU/ml (equivalent to 58 CFU/swab). All 114 MRSA isolates and 7 control strains tested were detected. Sensitivity, specificity, and positive and negative predictive values for clinical specimens from all sites investigated were 90%, 97%, 86%, and 98%, respectively, but throat specimens yielded poor sensitivity (75%). Sensitivity, specificity, and positive and negative predictive values for nasal specimens were 95%, 98%, 90%, and 99%, respectively. Overall, the assay was rapid and easy to perform, but performance might be enhanced by the inclusion of an equivocal interpretive category based on analysis of all available amplification data.
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            Methicillin-resistant Staphylococcus aureus survival on hospital fomites.

            We examined the duration of survival of 2 strains of methicillin-resistant Staphylococcus aureus (MRSA) on 3 types of hospital fomites. MRSA survived for 11 days on a plastic patient chart, more than 12 days on a laminated tabletop, and 9 days on a cloth curtain. Irregular surfaces may help harbor organisms in the environment. In addition to contact precautions, MRSA containment during an outbreak should include concurrent environmental decontamination.
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              An evaluation of methicillin-resistant Staphylococcus aureus survival on five environmental surfaces.

              This study evaluated methicillin-resistant Staphylococcus aureus (MRSA) survival on environmental surfaces: glass, wood, vinyl, plastic, and cloth. Effects of relative humidity (RH) and bovine serum albumin (BSA) were examined. Surfaces were inoculated with 10(7)-10(8) colony forming units per milliliter (CFU/ml)of MRSA with and without 1% BSA and incubated at 35°C at 45%-55% and 16% RH. Surfaces were sampled, and each collected sample was re-suspended in phosphate buffer, spread plated, and incubated at 35°C for 24 hrs; resulting colonies were enumerated. Samples were collected immediately on drying, and at 3 hrs, 24 hrs, 2 days, 3 days, 4 days, and 5 days. Results demonstrated that MRSA survived the longest on plastic and vinyl and for the least amount of time on wood (p < 0.001). BSA enabled MRSA to survive for significantly longer duration (p < 0.001). The number of CFU/ml was significantly lesser on surfaces stored in 45%-55% RH versus 16% RH. This study demonstrates that viable MRSA bacteria can remain on surfaces for days, which may impact the public health of occupants in workplace and residential settings.
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                Author and article information

                Journal
                1886
                122234
                European Journal of Microbiology and Immunology
                EuJMI
                Akadémiai Kiadó, co-published with Springer Science+Business Media B.V., Formerly Kluwer Academic Publishers B.V.
                2062-509X
                2062-8633
                1 September 2014
                : 4
                : 3
                : 159-165
                Affiliations
                [ 1 ] Institute for Microbiology, Virology and Hygiene, University Hospital Rostock, Rostock, Germany
                [ 2 ] Department of Tropical Medicine at the Bernhard Nocht Institute, German Armed Forces Hospital Hamburg, Bernhard Nocht street 74, D-20359, Hamburg, Germany
                [ 3 ] Department of Prosthodontics and Material Science, University Hospital Rostock, Rostock, Germany
                Author notes

                Lennart Bartolitius and Hagen Frickmann equally contributed to this work.

                [* ] 0049-40/6947-28743, 0049-40/6947-28709, Frickmann@ 123456bni-hamburg.de
                Article
                3
                10.1556/EUJMI-D-14-00020
                c2c11256-4986-4f80-8b51-e5ef75858c60
                History
                : 9 June 2014
                : 24 June 2014
                Categories
                Original Paper

                Medicine,Immunology,Health & Social care,Microbiology & Virology,Infectious disease & Microbiology
                swab,autoclave resistant,hygiene testing,nose model, Staphylococcus aureus

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