Epidemic Respiratory Disease: The pneumonias and other infections of the repiratory tract accompanying influenza and measlesOpie, Eugene L. (Eugene Lindsay)
History
Epidemic Respiratory Disease: The pneumonias and other infections of the repiratory tract accompanying influenza and measles
=Methods.=—In an investigation of this nature the culture methods
employed should be suitably directed to determine primarily what
bacteria are present and in what relative proportion they exist. The use
of culture or animal inoculation methods that are highly selective in
character, enhancing the growth of certain bacteria and retarding or
inhibiting the growth of others, are of great additional value, but can
only properly be used secondarily in order to augment the results
obtained by nonselective culture methods. As the most suitable medium
for the purpose in hand plain meat infusion agar, titrating 0.1+ to 0.3+
to phenolphthalein, to which 5 per cent of sterile defibrinated horse
blood was added, was used. Since growth on freshly poured plates is
greatly superior to that on plates that have been stored, the agar was
melted as needed, the blood being added when the medium had cooled to
approximately 45° C. Cultures from the nose and throat were made by
swabbing the mucous membranes with a sterile applicator, touching the
applicator to a small area on the surface of a blood agar plate, and
spreading the inoculum over the surface of the medium with a platinum
needle, insuring as wide a separation as possible. Direct cultures of
selected and washed specimens of sputum were made when possible. In many
instances, of course, it was impossible to get sufficiently satisfactory
specimens to permit of washing, especially when cultures were made very
early in the disease. To supplement direct culture of the sputum the
mouse inoculation method as employed for the determination of
pneumococcus types was used. This is, of course, a highly selective
method, of particular value in the detection of pneumococcus and B.
influenzæ when they are present in relatively small numbers as compared
with other bacteria. Plates were examined after twenty to twenty-four
hours’ incubation and again at the end of thirty-six to forty-eight
hours when necessary.
In the present study, attention has been centered upon B. influenzæ, S.
hemolyticus, and the various immunologic types of pneumococci, other
organisms encountered having played no significant part in the cases
studied except in rare instances. B. influenzæ was identified by its
morphologic, staining and cultural characteristics and conformed to the
classical description given by Pfeiffer. S. hemolyticus was identified
by its morphologic, staining, and cultural characteristics on blood
agar, supplemented by a confirmatory hemolytic test with washed sheep
corpuscles, and bile solubility test. Pneumococci were identified by
morphologic, staining and cultural characteristics, bile solubility
test, and agglutination with specific antipneumococcus immune sera. Note
was made in most instances of the presence of other organisms, such as
members of the Gram-negative diplococcus, staphylococcus, diphtheroid
and streptococcus viridans groups, but no attempt was made further to
isolate or identify them.
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