MWE are looking forward to seeing you at the UK NEQAS Microbiology / Microbiology Scientific
Meeting On 24/11/2022 9:45 am – 3:30 pm @: Holiday Inn Bloomsbury, London
The recent reports of invasive Group A Streptococcal infections in children have drawn attention to this relatively common pathogen. Perhaps best known as a cause of pharyngitis, Streptococcus pyogenes is ubiquitous in the population, with many people being colonized without symptoms. It is, however, an opportunist pathogen, and if untreated can cause more serious, potentially life-threatening illness such as scarlet fever, rheumatic fever, and necrotizing fasciitis.
Streptococcus pyogenes is readily diagnosed by microbiological methods, whether conventional culture, rapid direct tests, or most molecular platforms. Swabs are taken from the patient’s throat or from skin lesions. It is important to use only transport swabs which are M40-A2 compliant1. Streptococcus pyogenes is one of the 10 bacterial species included in the M40-A2 panel of test organisms, against which compliant products have been tested.
MWE’s TRANSWAB® with Plain Amies (MW170), and Charcoal Amies (MW171), and SIGMA-TRANSWAB® with Liquid Amies (MW176S) are routinely tested for the effective recovery of Streptococcus pyogenes. In addition, a recent study demonstrated that the organism is successfully identified when tested on the Cepheid GeneXpert® XVI system utilising Xpert ® Xpress Strep A (XPRSTREPA CE 10).2 Our products meet M40-A2 compliance.
We would be happy to help and support laboratories and kit manufacturers where needed. Our products have been used globally on various platforms and we have the clinical evidence to back that. If you need further information, please get in touch.
Sarenga is a remote rural area 4 – 5 hours drive from Kolkata (Calcutta) and 2 hours from the nearest city with modern facilities. Khristiya Seva Niketan (KSN), a mission hospital in Sarenga, West Bengal, India. The hospital serves a large rural population, of mainly tribal people. Chief Biomedical Scientist Ivor J Mitchelmore and his two colleagues, in early 2020, tired and establish a Microbiology service in the small laboratory at the hospital. They were generously supported by several companies such as MWE. This enabled them to make a tremendous start, but then the pandemic struck and they were unable to support the local staff when problems cropped up.
In January of this year Ivor managed to help local staff overcome a problem they had been having with contaminated media. By the time he left for the UK, the local staff were processing urine samples for culture and sensitivity and they have been able to successfully continue this service to date. In 2023 Ivor is hoping that they will also be able to introduce some wound microbiology.
MWE’s support in this process has been highly appreciated.
At MWE, we are always happy to support as we know, at the end of every swab being used there is a patient. To find out more about this story visit IBMS Journal.
A study done by Cardiff University showed that SIGMA-VCM™ transport medium met and exceeded the basic requirements for transport of bacteria set out by the Clinical and Laboratory Standards Institute Standard M40-A2.
A common sexually transmitted infection, Ureaplasma, can come in two species, Ureaplasma parvum and Ureaplasma urealyticum, as well as multiple serovars. Infection with Ureaplasma can result in premature births, making its effective diagnosis and treatment imperative.
Given the delicate nature of Ureaplasma, the effective transport of clinical samples so that viability of the bacteria is maintained is an essential part of an effective diagnosis. The Clinical and Laboratory Standards Institute Standard M40-A2 gives a minimum basic requirement of 48 hours for bacteria to survive in transport devices at ambient or refrigerated temperatures.
The study evaluated the stability of Ureaplasma in MWE’s SIGMA-VCM™ transport devices with standard Sigma foam swabs or PurFlock swabs at 4 different temperatures over 264 hours, to ensure they meet the basic requirements and to study how Ureaplasma copes with different conditions and freeze-thaw cycles.
Conclusions from this study showed that, SIGMA-VCM™ transport medium met and exceeded the basic requirements for transport of bacteria set out by the Clinical and Laboratory Standards Institute Standard M40-A2.
Viability of Ureaplasma species in SIGMA-VCM™ transport medium was stable for 4 days at room temperature. Viability could be extended to at least 264 hours if kept at 4˚C. Ureaplasma species were more stable at -20˚C with freeze thaw cycles in transport medium, suggesting the physiology of Ureaplasma spp. is more robust than Mycoplasma hominis. The extended viability shown with freeze-thaw cycles is of particular importance as it allows Ureaplasma to be stored for an extended length of time, allowing important specimens to be kept for research purposes and investigated at a later date.
To read the study click here
Moving forward MWE is going to change the way that the products are identified.
All Sigma products with a tube of medium and a packet swab, will have a different lot number for the medium to the lot number of the package and box label. This is a similar method that most other companies in the market use, and we are standardising this process.
This will give MWE better Traceability throughout our manufacturing processes, therefore reducing the time it takes for MWE to react to any potential user/patient risk.
It is usually transmitted by the faecal oral route and in close contact with contaminated surfaces. It can also be transmitted through coughing and sneezing droplets and thus can be transmitted by the airborne route.
It is resistant to many common disinfectants and can remain infectious for long periods. The US EPA gives a list of suitable disinfectants, same as the ones used for Norovirus, which can be used to kill Adenovirus.
Adenovirus is a double stranded non-enveloped DNA virus with over 50 types that infect humans (type B, C, D, E & F). They can also infect a wide range of vertebrate animals.
Symptoms can include mild respiratory conditions with usual viral illness symptoms, and in some cases can cause pneumonia (Group B & C). Groups B & D can also cause painful eye infection and earache in children, while Group F can cause symptoms like Gastroenteritis.
Why are we discussing Adenovirus?
Recently, the World Health Organisation (WHO) released a report on acute hepatitis in children with an unknown origin. Even though Adenovirus is a hypothesis as being one of the strongly associated reasons for Hepatitis in this report, it is still under investigation. United Kingdom is one of the highly affected countries.
The UKHSA is continuing to investigate this sudden onset of Non-A non-B hepatitis in children less that 10 years old. As of 21st June 2022 there have been 288 confirmed cases in the UK with Adenovirus type 41F being isolated in 65% of cases. While no children have died at least 12 have required liver transplants.
SARS-CoV-2 has also been considered as a possible source affecting 15% of the cases in the UK, however this may be incidental and due to the amount of circulating virus in the community. Other viruses including adenovirus-associated virus; human herpes virus 6 are currently being considered, and work to confirm the cause in ongoing. However, the association with Adenovirus type organisms remain the leading hypothesis.
Diagnosis for Hepatitis of all types
PCR analysis has been the first line of diagnosis. Blood sampling, respiratory sampling and stool sampling are being used to collect specimen. Respiratory specimen in a VTM such as the SIGMA VIROCULT® (Viral transport media) and SIGMA MM™ inactivation media can be used to collect samples.
If the samples contain an organism that causes hepatitis, for example Hepatitis A, B, C, SARS-CoV-2 or indeed Adenovirus, they are infectious and can be considered high risk pathogens, a safe way to collect and transport them is crucial. The SIGMA-VIROCULT® media is proven to be a suitable medium to collect and transport these samples to the laboratory.
For a belt and braces approach the sample can be inactivated by the patient bedside and an inactivation media like the SIGMA-MM™ would quickly inactivate these deadly pathogens and preserve the RNA/DNA for future testing.
Another alternative is the FECAL TRANSWAB®, a swab-based system compatible with PCR. It can be used to collect specimen from the rectum or stool. The benefit of a swab-based system is that the amount of sample required is small, and it can negate the need to perform pre-extraction procedures that may be time consuming, costly and involve hazardous chemicals.
MWE’s has 70 years of expertise manufacturing a range of quality specimen collection devices for viruses, bacteria, mycoplasma, and more in industries including Clinical, Food, Pharma, Forensics and Veterinary.
In the UK, we have seen this virus being discussed by UKHSA. The World Health Organisation has now confirmed vaccine-attenuated poliovirus type 2, has been found in environmental samples in the London. This can be excreted as an infectious virus from a child who has been vaccinated, but before the host antibody response matures.
As a result, UKHSA are urging people to get vaccinated if not already. Immunisation is particularly important in young children under 5 as it can, in rare cases, lead to irreversible paralysis which can lead to death from muscle immobilisation effecting breathing muscles.
Poliovirus, a member of the Enterovirus group is contagious and can spread through contact with faeces, especially in areas with low sanitisation and hygiene. Those who are infected can spread disease for up to 6 weeks, including those who are asymptomatic.
The poliovirus enters the body infecting cells in the throat and intestines where it can replicate using the hosts cells mitochondria. It can spread to lymphoid tissue including tonsils where it can multiply further and can be released into the blood stream, where it can be distributed throughout the body and affect any organ.
What could we do to prevent the spread?
Hand hygiene and sanitation is an obvious answer but, in some areas, and cases it is not always possible.
As suggested by UKHSA, immunisation is important for people who are not vaccinated and are at risk, especially children under the age of 5.
Testing and diagnostics using PCR methods that enable rapid processing, gives us the ability to understand the virus but also the level of spread.
Usually, samples for molecular and genomic analysis are collected via a throat swab using a swab and viral transport media such as the SIGMA-VIROCULT®. If an inactivation media is needed then SIGMA-MM™ can be used as it inactivates pathogens in 60 seconds, leaving their RNA/DNA intact for diagnosis. Poliovirus is a single stranded non-enveloped virus from within the Enterovirus family, and both SIGMA-VIROCULT® and SIGMA-MM™ are suitable medium for this virus family group.
Poliovirus can be cultured from faeces which usually goes through a prolonged cell culture process. MWE’s FECAL TRANSWAB® would be a suitable medium to collect and transport the sample to the laboratory if faecal sample was not readily available or desirable.
MWE’s FECAL TRANSWAB® collection and transport medium is also compatible with molecular diagnostic processes using PCR, should the faecal sample require molecular diagnostics for pathogen detection. The FECAL TRANSWAB®, is a swab-based system has been proven to help diagnose viral causes of enteric infections. The benefit of a swab-based system is that the amount of sample required is small, and it can negate the need to perform pre-extraction procedures that may be time consuming, costly and involve hazardous chemicals.
MWE’s products have been preferred products worldwide and have been used by the World Health Organization and UKHSA as quality and reliable specimen collection devices.
Hans Christian Joachim Gram devised this staining technique in 1884, and it is still heavily relied upon in today’s laboratories as it gives a rapid and useful result.
The sample or organism is spread thinly on a microscope slide and heat fixed. This slide is then immersed in a series of stains so that when viewed under the microscope, a technician can decipher the shape and colour of any organisms present. This gives some indication of what the organism might be.
Crystal Violet will stain everything a deep purple, however only the thick peptidoglycan layer in the cell walls of GRAM POSITIVE organisms forms a bond with the stain. Lugol’s Iodine is added next, this strengthens the bond and ensures that the Gram Positive organism holds the stain during the wash step. The slide is next washed with acetone, which strips the stain out of organisms with a thinner layer of peptidoglycan in their cell wall. Finally, a counterstain such as Neutral Red or Fuchsin is added. This adds a pink colour to the cell walls that haven’t held onto the purple Crystal Violet stain.
Organisms that look purple following the staining process are referred to as GRAM POSITIVE. Gram positive bacteria can be rounded, these are known as Gram Positive Cocci (a technical name for a spherical shape) – common examples include Staphylococcus aureus which can be seen in clusters (MRSA is a particularly resistant type of this organism) and Streptococcus pyogenes which can be seen in chains (cause of Strep throat and scarlet fever). Gram positive organisms may also be rod shaped; these are known as Gram Positive Bacilli (a technical term for a rod/sausage shape) – examples include Listeria monocytogenes, Clostridium difficile and Bacillus anthracis.
Yeasts are Gram positive ovals, sometimes with smaller daughter cells budding from them or long hyphae strands stretching out. Yeasts are much bigger than bacteria and can be easily differentiated based on both size and shape.
Organisms that look pink following the staining process are referred to as GRAM NEGATIVE. Gram negative organisms can be rod shaped, these are referred to as Gram Negative Bacilli – examples include Salmonella, E. coli and Acinetobacter. Gram negative organisms may also be rounded, these are known as Gram Negative Cocci– examples include Neisseria meningitidis and Neisseria gonorrhoeae.
Occasionally, organisms will stain poorly with both stains, and these are referred to as GRAM VARIABLE.
Microbiologists can recognise certain groups of organisms just by looking at a Gram stain, and medics/vets can use this information to tailor the antimicrobial treatment a patient/animal receives before the culture plates are even in the incubator! Certain antibiotics will only work against Gram Positive organisms, and some will only work against Gram Negative organisms. And of course, antibacterials have no effect on yeasts, fungus or viruses.
Viruses are much too small to be seen using standard laboratory microscopes and would not take up the stains described, however white blood cells can also be recognised with this staining technique and they can give an indication of whether an infection is bacterial or viral.
MWE products consistently pass every aspect of M40-A2 requirements.
POLYWIPE™ sponges designed for collection of possible contaminants from a wide range of surfaces. These surfaces include production machinery in food factories, and carcasses in the butchering trade.
The wipes are blue because this colour is traditionally used in the food industry for safety non-food items as it is not a naturally occurring food colour and if dropped it will be easily spotted.
Anyone who has watched a baking/cookery programme on TV may well have seen the blue plasters used in kitchens in preference to the skin-coloured ones in most household first aid boxes.
The sponges are premoistened to ensure a good uptake of contaminants from dry surfaces. The moistening liquid varies according to the intended use, with some products being specific to particular industry applications.
Although these products have been traditionally marketed in the food and pharma industry for surface surveillance, they are also ideally suited to infection control screening in hospitals and clinics.
This versatile product can be used on hard surfaces such as bed frames, toilet units, window sills, pens and a wide range of soft furnishings also, such as curtains, bedding and staff lanyards.
The sponge can then be pressed onto media plates to transfer any organisms that may have been picked up on the surfaces, and the plates incubated in laboratories where growth will be measured.
This is a quick and easy method of assessing the cleanliness of a particular area or surface.
Monkeypox is a member of the Orthopoxvirus genus.
Its natural reservoirs are squirrels and monkeys in west and central Africa, but humans can be infected. Symptoms will appear approximately 12 days after infection beginning with fever and headache, followed within the next 3 days by a rash (pustules/blisters) and swollen glands.
While the disease is generally self-limiting, and not life-threatening, serious complications can occur. Vaccines are available for individuals at risk.
Monkeypox is diagnosed by performing a PCR test on a viral swab taken from one or more vesicles or ulcers, or from a dry scraping of the scab.
Swabs should be sent in viral transport media, such as Sigma Virocult® MW951S or Sigma VCM™ MW910S.
Scab scrapings should only be taken if there are no other lesions and sent in a dry sterile tube. Testing of scrapings may take longer than a lesion swab (1).
If specimens require to be inactivated (2,3) Sigma MM™ MWMM or MW0250 can be used.
MWE’s ranges have been the products of choice globally, and are being used as inactivation and liquid transport media for Monkeypox.
We also request that you refer to the guidelines in your country to find out the type of product being recommended (e.g. viral transport media vs dry swab).
Codes for DRYSWAB™ with Dry Sterile Tubes from MWE:
References:
Latex comes from the rubber tree and is widely known to cause allergic reactions. An allergic reaction is when your body overreacts to a particular substance (such as latex, kiwis or pollen).
These reactions can range from sneezing and itchy eyes to itchy, irritated skin or rash to full anaphylaxis (this is an allergic response affecting ability to breathe, including swelling of the throat to the point that it could be life threatening).
People with severe allergy to latex may need to carry an epi-pen or similar branded product, this is essentially a syringe of epinephrine/adrenaline which will counteract the symptoms of anaphylactic shock.
These products have been designed for use by non-professionals, although instructions should always be closely followed when dispensing them.
Latex can be used in everyday and medical products such as rubber plugs, bathmats, binocular/microscope eyepieces, gloves, urinary catheters. Most clinical environments will routinely substitute out latex products as a precautionary measure if possible.
MWE products do not contain latex.
Great efforts are being made by healthcare professionals everywhere to reduce and if possible eliminate the risk of hospital acquired infections such as MRSA and Clostridium difficile. Nowhere is this more important than in the operating theatre, where every possible step is taken to ensure an environment that is as near sterile as possible to prevent surgical site infections.
In addition to environmental considerations, and personnel, controls have to be in place to allow for the safe handling of surgical instruments and consumables. Similar precautions are, of course, also required in pharmaceutical manufacturing facilities.
Medical Wire produces a range of “theatre-packed” specimen collection devices, all triple-wrapped, so that they can be handled in the operating theatre or sterile area without compromising sterility.
Triple-wrapping means that addition to the immediate individual wrapping – normally a peel pouch – there are an additional two outer layers of strong polythene packaging. The product is sterilised complete with the outer layers by irradiation. When required for use, the outer packaging is removed, and the inner packaging is sterile for handling. This can be done a couple of times as items are passed from stores to sterile supplies to theatre or sterile production unit.
The standard ISO 18593:2018 provides important guidance for sampling and testing surfaces in the food chain environment for microbiological safety, and much of this information is relevant for monitoring surfaces in healthcare settings for the purposes of infection control.
Surfaces which require to be sterile are tested for the presence or absence of microbes, while more general food contact surfaces are monitored regularly for numbers of bacteria and so pick up if numbers are increasing.
The standard includes details of sampling using swabs or sponges, including diluents for premoistening, such as buffered peptone water, peptone salt (also called maximum recovery diluent), and peptone solution of 1g/l, with neutralisers if required.
These are already available from MWE as standard diluents for NRS II TRANSWAB® premoistened swabs and POLYWIPE™ premoistened sponge swabs. In addition the neutralisers provided with these products are all among those listed in the standard.
For many years MWE has been a leader for environmental sampling devices, and it is fitting that it is one of the first to be aligned with the new standard.
MWE has been established for 70 years and has always been known for providing pre-analytics to the clinical industry that are compliant, excellent quality and manufactured to international standards. We were the inventors of the first transport swab, now used as the de facto in the industry. Our products are used worldwide in laboratories and in research organisations in genomics, new variant testing, or even testing for new products.
Our products are also used in other industries outside of clinical.
Within Food and Pharma MWE’s swabs, surface wipes, sponges and kits are designed to collect and transport bacterial samples, working across all surfaces, with a variety of sampling applicators. MWE also provides sample collection devices to determine the level of microorganisms on sterile surfaces, especially needed for the pharmaceutical industry.
The collection device is a critical component in any investigation in Forensics, and that careful attention to materials and manufacturing techniques are essential to ensure the integrity of the sample. MWE have dedicated swabs that have special features suitable for scene of crime forensic sampling. Tested with the most stringent standards, MWE swabs are certified DNA free and are produced under dedicated, controlled conditions ensuring complete reliability and integrity of samples.
The quality and dependability of veterinary laboratory consumables underpins the reliability of diagnostic tests, analysis, and research outcomes. MWE range of Veterinary swabs, include several longer swabs particularly suited to large animals. In some, the long shaft is enclosed in a silicone sheath into which the swab head can be withdrawn as the swab is retrieved from the sampling site.
MWE provides products for the Environmental industry for larger surface sampling in critical areas such as manufacturing. MWE’s products enable reliable sampling for monitoring hygiene and sterility of larger surfaces. The choice of formulations meets the requirements of industries or retailers and can provide early detection for key pathogens.
We are more than just Clinical.
A common sexually transmitted infection, Ureaplasma, can come in two species, Ureaplasma parvum and Ureaplasma urealyticum, as well as multiple serovars. Infection with Ureaplasma can result in premature births, making its effective diagnosis and treatment imperative. Given the delicate nature of Ureaplasma, the effective transport of clinical samples so that viability of the bacteria is maintained is an essential part of an effective diagnosis.
The Clinical and Laboratory Standards Institute Standard M40-A2 gives a minimum basic requirement of 48 hours for bacteria to survive in transport devices at ambient or refrigerated temperatures.
A study carried out by Rees and Spiller at 4 different temperatures over 264 hours, to ensure they meet the basic requirements and to study how Ureaplasma copes with different conditions and freeze-thaw cycles.
Similarly, Mycoplasma hominis, a notoriously fastidious organism, is sensitive to environmental factors. Transport medium and conditions are important to successful detection by culture in
clinical assays. Rees and Spiller did another study to evaluate the stability of M. hominis in SIGMA-VCM™ universal transport device, at different storage temperatures over 192 hours.
Both these studies showed that Viability of Ureaplasma species in SIGMA-VCM™ transport medium was stable for 4 days at room temperature. Viability could be extended to at least 264 hours if kept at 4˚C. In one study, despite 8 freeze-thaw cycles from -80oC to RT, 3 of the 4 strains maintained near baseline viability. This feature of SIGMA-VCM™ provides a significant improvement on currents methods of laboratory storage of M. hominis. They also showed that SIGMA-VCM™ transport medium has met and exceeded the basic requirements for transport of bacteria set out by the Clinical and Laboratory Standards Institute Standard M40-A2, and extended viability is possible through freeze-thaw cycles.
SIGMA-GBS™ is a swab based device for the direct collection and rapid processing of screening specimens for Streptococcus agalactiae (commonly known as Group B Streptococcus). Streptococcus agalactiae is a leading cause of illness in newborn babies, and can result in death or serious life changing consequences.
The organism may be carried asymptomatically by the mother, but can then be passed onto the baby during labour. Policies vary, but in some countries there is now a screening programme to identify carriers with a view to offering antibiotics during labour. Other countries may not have universal screening, but there is still increased testing of those deemed to be at most risk of being carriers.
The SIGMA-GBS™ device consists of a vial of Lim broth enrichment medium and a swab which can be snapped into the vial. The swab is used to collect specimen in normal way from vagina or rectum in accordance with local procedures.
After collecting the specimen, the vial is incubated at 37OC before inoculation onto a suitable chromogenic agar medium for the direct detection and identification of Streptococcus agalactiae. Lim Broth medium will promote growth of Streptococcus agalactiae, while inhibiting any growth of other bacteria such as E. coli which would often be present in the same specimens.
The vial is compatible with all current automated processing platforms, while if a more rapid diagnosis is required, the specimen can be tested using molecular methods.
Sputum is an important biological material for the investigation of respiratory disease, but is notoriously difficult to work with. Various reagents have been used over the years to liquefy sputum specimens to make them suitable for inoculation onto agar. Some of these reagents must be prepared in caustic solutions, and can be unsafe and unpleasant to handle, with limited stability. They are normally kept lyophilised and prepared when required.
Modern microbiology laboratories use automated processing platforms for the inoculation of agar plates, but the current methods of preparation of sputum specimens are not well suited to such processing. Specimens are loaded in large numbers onto the equipment, but may wait for several hours before being processed. Reagents such as dithiothreitol are detrimental to the survival of important respiratory pathogens such as Haemophilus influenzae. MWE’s new SIGMA SP™ resolves all of these issues.
SIGMA-SP™ contains a novel reagent which is not only a more powerful mucolytic, but comes in a simple, ready to use liquid format, ready to load onto the automated platforms. It is not directly harmful to any of the target bacteria, so specimens can be safely left in the queue for several hours. The solution has a neutral pH, and can be safely stored prior to use at ambient temperature for many months.
To use, simply add 1ml of sputum directly to the SIGMA-SP™ vial, recap, vortex and allow to stand for about 15 minutes before processing.
Initial studies show that SIGMA-SP™ liquid does not interfere with molecular diagnostic test systems.
It is often necessary to preserve microorganisms for future study. This may be for reasons of research, clinical investigations, epidemiology, education, or commercial use. Effective preservation requires the organisms to remain viable, free of contamination, and without any alteration of genotype or phenotype. Ideally, the organism should be easy to retrieve and restore to its original condition.
MWE’s VIABANK™ is a convenient, easy-to-use cryoprotection system for the storage of microorganisms. The culture to be preserved is added to the cryopreservative solution in a vial of 25 (approximately) coloured ceramic beads. After mixing, the excess fluid is removed, and the vial is stored in a freezer. When the organism is required, individual beads are removed from the vial and used to establish a fresh culture.
VIABANK™ is supplied in convenient stackable freezer grade boxes which can be used for storage. Each box contains 80 VIABANK™ vials with either 4 different coloured caps in each box, or a choice of one colour from the four options. The boxes are divided into individual compartments for the vials, and the lid has a colour coded grid to assist you in keeping track of your valuable isolates. Each vial has a frosted area for writing brief details of the contents.
Microorganisms for storage can be taken from broth cultures, or colonies on a plate. The inocula is added to the vial, allowed to mix with the cryopreservative, and to equilibrate for a short time at room temperature. This allows the organisms to settle onto the ceramic bead surface. Finally the excess liquid is decanted or aspirated, and the vial can be closed and transferred to the freezer.
For real long term storage, temperatures below -130°C are recommended, but for most non-fastidious organisms, -80°C will be satisfactory for up to 5 years. Storage at -20°C is not really recommended because the temperature is not low enough to prevent ice crystal formation. If it has to be done, some organisms can survive for up to 2 years, and we have successfully stored some in VIABANK™ for over 10 years. In this case it is essential to regularly check the stored organisms for viability, and of course with VIABANK™ this can be easily done by simply removing and testing a single bead.
VIABANK™ is suitable for most bacteria, yeasts and moulds, including anaerobes, and the major food and clinical pathogens.
The onset of Covid-19 meant that laboratories had to invest in automated systems for molecular diagnostics. As the world slowly starts going back to the ‘new normal’, these systems need to be utilised in new and novel ways, so that the investment doesn’t go to waste.
MWE’s Fecal transport swab means, you can now use your molecular systems to detect enteric pathogens in faecal specimens.
It is estimated that 685 million individuals worldwide suffer from gastroenteritis, and 17 million annually in the UK alone1. Traditional culture techniques for isolation of enteric pathogens have been used for decades across the world. Culture techniques can take days before results are derived, and sometimes can delay detection if the sample in the stool container wasn’t preserved correctly.
The FECAL TRANSWAB® can change that!
It can help provide results faster, at a lower cost, and in a more efficient manner.
The MWE FECAL TRANSWAB® is a convenient system for transporting faecal samples in small instrument-ready tubes, saving space, and making it easier to transport to laboratories. It enables rectal sampling which has benefits, particularly in paediatric patients. In addition, it simplifies and standardises stool sample collection, transport, and processing by converting solid or semi-solid specimens into liquid phase, in primary tubes, to facilitate automated faecal sample processing.
Diagnostic laboratories who have investigated the use of molecular screening in the routine detection of enteric bacterial pathogens have seen the benefits of its implementation; improved turnaround times on obtaining results, cost efficiency compared to conventional methods and the possibility of expanding the screening panel2. Molecular Enteric screening also reduces the amount of clinical waste generated within the laboratory, therefore making the lab more sustainable.
FECAL TRANSWAB® from MWE has proven to work on PCR systems such as the BD Max and other molecular techniques for the suitable recovery and identification of enteric bacteria. It has also proven to detect pathogens including Salmonella, Shigella, Campylobacter, E.coli 0157, Giardia, Cryptosporidium, and Entamoeba histolytica. A study carried out also shows rectal swabbing with the FECAL TRANSWAB® is as effective as direct collection of stool samples
The diagnostics industry has been forced to move to molecular platforms over the last few years. Where possible the industry should make the most of molecular platforms for efficient handling, transport, and detection of pathogen for faster results. Adopting FECAL TRANSWAB® is just a one way of doing that.
References:
1 https://www.cdc.gov/norovirus/trends-outbreaks/worldwide.html, May 2022.
2De Boer, R. F., Ott, A., Kesztyus, B. and Kooistra-Smid, A. M. D., (2010). Improved Detection of five Major Gastrointestinal Pathogens by Use of a Molecular Screening Approach. Journal of Clinical Microbiology. 48(11), 4140–4146.
MWE has been supporting 3 charities close to our heart. We would like to introduce you to them.
Julia’s House Children’s Hospice: Julia’s House provides clinical, practical and emotional support for families caring for a child with a life-limiting or life-threatening condition, providing frequent and regular support in their own homes, in the community or at their hospices. They are not a typical children’s hospice. The service they provide is totally flexible and bespoke for families – it is also completely free. Life-threatening situations can happen without warning but imagine the reassurance of having access to specialist care, to know your child is in safe, skilled hands. Giving parents the confidence to take a mental and physical break from the exhausting cycle of care is what they do.
The care provided by Julia’s House children’s hospice has been awarded ‘Outstanding’ following a recent inspection (December 2021) by the Care Quality Commission (CQC), the highest rating to be awarded by the independent regulator of care and social care in England.
Group B Step Support: Group B Strep Support (GBSS) is the world’s leading charity working to eradicate group B Strep infection in babies. They educate the public, doctors and midwives about group B Strep and provide information and support to affected families. Group B Strep Support is completely independent, and is mainly supported by the kind donations from people. 800 babies a year suffer group B Strep infection, causing death and disabilities. Most GBS infections are preventable.
Wiltshire Air Ambulance: As the name suggests, WAA save lives. They are an air ambulance service in Wiltshire, Bath and surrounding areas. They are funded by donations made by their sponsors and businesses in the UK. Their helicopter can accommodate a pilot, two paramedics, a patient and a passenger. On board you’ll find all of the equipment you’d find on a land ambulance. They also have specialist kit so their crew can provide the best medical care possible. Their paramedics also use Rapid Response Cars to attend incidents by road when their helicopter is unable to fly or if it is quicker to reach the location using the cars. The cars have the same medical equipment that is onboard in their helicopter.
There have been many clinical studies carried out on SIGMA-MM™ over the years to prove that it not only inactivates infectious pathogens in 60 seconds, but also preserves the DNA and RNA for safe transportation of samples for at least 21 days at room and refrigerated temperatures.
Why choose SIGMA-MM™?
The COVID-19 pandemic has highlighted the need for a safe and stable specimen collection and transportation medium that is regulated and reliable.
There is a range of unregulated and untested products on the market, that state they do the same, with little supporting evidence to back up these claims.
SIGMA-MM™ has been on the market for many years and has consistently proven to inactivate infectious microorganisms from specimens, including mycobacteria, bacteria, and viruses.
Where is SIGMA-MM™ used?
SIGMA-MM™ is being successfully used around the world by various healthcare organisations, World Health Organisation, Public, Private, Independent labs, and governments worldwide.
What recent studies have been done on the SIGMA-MM™?
Luton and Dunstable Hospital NHS Trust
A study carried out by Luton and Dunstable, has proven that not only does SIGMA-MM™ inactivate infectious pathogens like SARS-CoV-2, but also preserves the RNA at room temperature and refrigerated temperatures for at least 21 days. The RNA is stable to use for molecular diagnostic and the medium can be tested through many molecular platforms.
The addition of SIGMA-MM™ has revolutionised their laboratory processes plus they have also incorporated this inactivation media into their POCT where Rapid analysis is being carried out near the patient without the need for sending the specimen to a laboratory. This has proven invaluable within their A&E departments.
In this study, SIGMA-MM™ was tested within their laboratory on a variety of kits. These included CerTest ViaSure SARS-CoV-2 Kit, the Roche Liat using a SARS-CoV-2 Kit and the GeneXpert to detect RNA for SARS-CoV-2, and it worked reliably and safely.
Medical Research Council & University of Glasgow’s Centre
Studies carried out in Glasgow proved that SIGMA-MM™ inactivates infectious SARS-CoV-2 pathogen in 60 seconds.
As per requirement of BS EN 14476, there should be a titre reduction of more than 4 log10 for virucidal suspension tests. SIGMA-MM™ consistently exceeded this requirement for both the time points and concentrations used in the study.
Validation is important!
Throughout the pandemic there have been many unregulated products with claims that cannot be proven. MWE’s products are not only backed-up with clinical data but are also regulated and validated to meet international standards, such as the CLSI-M40-A2.
It is important to understand that the specimen collection device (swab) and the transport medium are both equally important to generate good quality viable results. If the swab doesn’t function well and isn’t good quality, the results will be inaccurate & unreliable. Similarly, if the medium cannot stably store the specimen and has contaminants that affect results, the results may be incorrect.
Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen that causes severe morbidity and mortality worldwide (Cookson et al. 2011). In 2017/2018, a mandatory population-based bacteremia surveillance scheme reported a total of 12,784 MRSA bacteraemia and methicillinsusceptible S. aureus (MSSA) cases in England alone (PHE 2018). MRSA specimens represent a significant proportion of routine microbiological specimens and are very important for the management of critically ill patient. In recent years the introduction of self-contained cartridge systems for the rapid identification of target pathogens using nucleic acid amplification has transformed the ability of clinical microbiology laboratories to provide accurate and timely diagnostic data, allowing correct treatment to be commenced immediately, and also preventing unnecessary treatments.
When culture is not required, it can be convenient and safer to transport the specimen in a medium which effectively inactivates the pathogen without disrupting the DNA or RNA so that analysis is still possible. If such a system is used, however, it is essential to know that the medium will be compatible with such an analysis.
A clinical study at Luton and Dunstable University Hospital investigated the ability of SIGMA-MM™ , a liquid transport medium developed by Medical Wire and Equipment (MWE), to recover analytical quality DNA from specimens spiked with MRSA, while demonstrating that the biological pathogen had been inactivated and lysed. The PCR analysis was performed using Cepheid GeneXpert ® PCR analyser and Cepheid Xpert MRSA. The results for both PCR and culture were compared with those for identical specimens inoculated into SIGMA-TRANSWAB® (MWE), a widely used transport swab device with liquid Amies.
This study has shown that the SIGMA-MM™ devices were compatible with the GeneXpert PCR analyser for MRSA. There was no interference with the chemistry. The SIGMA-MM™ devices were also completely effective at inactivating the MRSA at all concentrations its DNA and RNA, while rendering the specimens non-infective.
SIGMA-MM™ is an inactivation molecular medium described as revolutionary due to its ability to kill bacteria and viruses whilst releasing intact nucleic acids for molecular diagnostics. As sample collection often occurs outside the laboratory and transport of the specimen requires safe and robust handling, ensuring the integrity of the sample is preserved and maintained is of utmost importance.
A study done by University of West of England, evaluated the new molecular transport medium (SIGMA-MM™) for its ability to inactivate microorganisms whilst preserving and maintaining DNA integrity. This study demonstrated that the SIGMA-MM™ molecular medium can rapidly inactivate bacteria and yeast whilst preserving bacterial DNA.
The DNA extraction after incubation of the test organisms (E. coli and S. aureus) in SIGMA-MM™ was successful. The DNA extract was of good quality and high purity.
Following an extended exposure time, Gel electrophoresis was suitable in visualising intact DNA of E. coli.
A clinical study performed by Virology Laboratory, Waikato Hospital, New Zealand evaluated SIGMA VIROCULT® (viral transport media) using the CLSI Quality Control of Microbiological Transport Systems Approved Standard M40–A.
The standard presents a specified culture protocol to assess a viral culture transport device manufactured to facilitate virus preservation.
Viral particles vary widely in composition, structure, morphology size and stability. Viral isolation has been widely accepted as the gold standard for laboratory confirmation of viral infection; however, it requires specimen storage and transport in a viral medium maintained at low temperatures to optimally preserve infectious viral particles. A suitable transport medium for swabs must maintain viability of viruses, prevent overgrowth of bacteria and fungi, and prevent drying of the specimen The SIGMA-VIROCULT® is designed for specimen collection, transport and maintenance of virus viability
The study was carried out using two different temperatures. Herpes simplex virus type 2 and Adenovirus type 3 were inoculated into SIGMA-VIROCULT® swabs at a concentration of 5 x 104 TCID50 and held at 22°C and 4°C. The swabs were sampled every day for four days, then at day seven.
The results showed that the swabs maintain the viability of virus as set out in the standard and that survival is better at 4°C. The SIGMA-VIROCULT® transport swabs may be recommended as a reliable virus transport device.
A clinical study was carried out Andrew Rusdale, Health Protection Agency, to evaluate SIGMA VIROCULT® in accordance to CLSI-M40-A.
In the present study the panel of viruses which were evaluated using Sigma Virocult® were Adenovirus 1, Influenza A, Parainfluenza 3, Rhinovirus, and Herpes Simplex Types 1 and 2. Survival was studied after holding times of up to 7 days, and at holding temperatures of 4°C (refrigeration) and 22°C (representing ambient temperatures).
SIGMA-VIROCULT® was shown to successfully recover all 6 viruses after holding for up to 7 days, and whether held at 4°C or ambient temperature.
The SIGMA-VIROCULT® swab has been around for many years, and there have been many studies in the past showing it to be effective for most of the common respiratory and skin associated viruses. The present study has provided the opportunity to assess the SIGMA-VIROCULT® swab in a new era, using current materials and cell lines.
A clinical study done within Heatherwood and Wexham Park Hospital NHS trusts, was aimed at assessing the compatibility of SIGMA-VIROCULT® viral transport swab (Medical Wire and Equipment) for the detection of HSV–1 and HSV–2 on both the BD Max™ and Smartcycler® automated platforms.
Herpes simplex virus-1, (HSV-) and Herpes simplex virus-2, (HSV-2) cause common, self-resolving infections of the skin or mucosa. Classic HSV-1 and HSV-2 clinical findings are described as painful grouped vesicles on an erythematous base, usually with ulcerated and crusted lesions. Both viruses may subsequently reactivate to cause recurrent disease in the face of existing immunity. Generally, HSV-1 has been associated with oro-labial disease, and HSV-2 with genital disease, however, it is possible for HSV-2 to cause oro-labial herpes and HSV-1 to cause genital herpes.
The results of this evaluation demonstrated 100% sensitivity and specificity between both methods. Within Heatherwood and Wexham Park Hospital NHS Trust they now exclusively use the SIGMA-VIROCULT® viral transport swab with the BD Max™ system. These swabs have proven to be effective and an easy-to-use transport system.
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