Antimicrobial resistance.
نویسنده
چکیده
434 more orders of magnitude (8,10). In spite of this concentration method, the success rate in EM diagnostics using swab specimens has declined to <10%, while viral agents continue to be identified in >60% of lesions in submitted aspirates. Because concentration methods are not always available, and in view of the sample problems identified by Marshall (3), we reviewed , in Winnipeg, whether collection of lesion fluids directly onto EM sample grids (5) improved sensitivity over aspiration into 26-gauge needles on tuberculin syringes (4). While neither method increased the number of cases identified in matched samples, the yield of virus seen in samples taken by touching the EM sample grid directly to the base of the lesion did increase, making it easier to identify viral agents in the samples (Hazelton and Louie, unpub. data). In Berlin, we also routinely find higher particle numbers on grids that have been prepared by the direct touch method. Sample preparation on EM grids is conducive to prolonged storage and transport of samples over long distances (5) and removes the risk of needle-stick accidents. We continue to recommend examining grids touched directly to the lesion or vesicle aspirates. Where possible, infectious diseases and infection control staff contact the EM unit when a sample needs to be collected to receive instructions about methods and ensure that staff are available to conduct the examination. When the specimen needs to be transported some distance, such as between cities, smears on individually packaged glass slides or on sample grids are an alternative method for submitting vesicle aspirates. Glass slides allow the collection of samples for both polymerase chain reaction and EM examination (Charles Humphrey, personal communication). An additional advantage of smears is that interfering background proteins can be removed by drying the sample on the slide and then resus-pending the viral agent. Proteins such as mucus, which interfere with staining and visualization, remain insoluble. We understand that other major viral EM diagnostic units also prefer aspirates, smears on glass slides, or lesion exudate on the final sample grid as preferred methods of submission of suspected blister material because of ease in handling and higher efficiency in examination.
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عنوان ژورنال:
- Emerging Infectious Diseases
دوره 6 شماره
صفحات -
تاریخ انتشار 2000