The diagnostics and treatment of tropical diseasesStitt, E. R. (Edward Rhodes)
Science
The diagnostics and treatment of tropical diseases
Stitt, E. R. (Edward Rhodes)
Tropical medicine
Smear the three-hour surface growth of a peptone culture on a
dry agar surface in a Petri dish. From colonies developing make
agglutination and, if desired, cultural tests. It is by immunity
reactions and not by cultural ones that we identify cholera
spirilla. The surface moisture of plates is best dried by the
filter-paper top.
The cholera colony is easily distinguished from the ordinary faecal
bacterial colonies by its transparent, bluish gray, delicate
character.
A practical quick method is to make smears from suspicious
colonies, stain for one minute with dilute carbol fuchsin and if
vibrios are present to make 2 vaseline rings on a single slide
allowing ample space at one end for handling the preparation
safely. Inside of one ring deposit with a platinum loop a drop of
salt solution and inside the ring nearest the end which is to be
held by fingers or forceps deposit a loopful of 1 to 500 or 1 to
1000 dilution of cholera serum. The emulsion in the salt solution
remains uniformly turbid and under a low power of the microscope
(⅔-inch) shows a scintillating motility. The emulsion made into
the drop of serum quickly shows a curdy agglutination and upon
examination with the ⅔-inch objective shows clumping and absence of
motility. Cover-glasses placed over the two vaseline rings assist
in the study of the preparation.
The best-known selective medium for plating out cholera material is
that of Dieudonne which is referred to under etiology. Apparently
a more satisfactory medium is that proposed by Goldberger, this
medium being transparent.
First prepare a 100% meat infusion by treating 500 grams of finely
chopped lean beef with 500 cc. water and after three hours strain
the infusion, adjust reaction to neutral with 5.3% anhydrous sodium
carbonate, then add to each 100 cc. 2½ cc. of the 5.3% anhydrous
sodium carbonate, sterilize in Arnold for one-half hour and filter.
Next prepare a 3% meat extract agar and mix one volume of the
alkaline meat infusion with 3 volumes of the hot melted 3% meat
extract agar. Pour plates and cover with a piece of filter-paper
and place in incubator for one-half hour until they are quite dry.
The necessity for a surface without moisture applies to Dieudonne’s
and Krumwiede’s alkaline egg media as well as this one. On this
medium cholera grows well while faecal bacteria are restrained.
The cholera colony is clear, round and shows a brownish center but
is without that striking bluish opalescence shown on ordinary agar
plates.
While peptone solution is a more favorable enrichment medium and
answers perfectly when cholera organisms are fairly abundant yet,
when scarce, selective enrichment media may be desirable. Of these
the best known is Ottolenghi’s alkaline bile. Goldberger prefers an
alkaline egg peptone solution made as follows:
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