Department of Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness-Ziona, Israel.
Plague Unit, Central Laboratory for Plague, Institut Pasteur de Madagascar, Antananarivo, Madagascar.
J Clin Microbiol. 2021 Jul 19;59(8):e0056421. doi: 10.1128/JCM.00564-21.
According to the WHO, 75% of the world's plague cases are found in Madagascar, with an average of 200 to 700 cases suspected annually (mainly bubonic plague). In 2017, a pneumonic plague epidemic of unusual proportions occurred, which raised several challenges for laboratory confirmation of cases, pointing to the need for the development of Yersinia pestis isolation procedures, especially those that can be performed in remote areas. As the WHO gold standard for plague diagnosis is bacterial culture, we sought to develop a simple method to prepare a highly selective medium, fit for use in remote areas where plague is endemic. The performance of the new medium, named improved BIN, was examined in terms of growth support and selectivity with spiked samples as well in isolating Y. pestis from clinical specimens, and it was compared to the results obtained with commercially available selective media. The preparation of the new medium is less complex and its performance was found to be superior to that of first-generation BIN medium. The growth support of the medium is higher, there is no batch diversity, and it maintains high selectivity properties. In 55 clinical specimens obtained from patients suspected to be infected with Y. pestis, approximately 20% more Y. pestis-positive isolates were identified by the improved BIN medium than were identified by commercially available selective media. The improved BIN medium is notably advantageous for the isolation of Y. pestis from clinical specimens obtained from plague patients, thus offering better surveillance tools and proper promotion of medical treatment to more patients suspected of being infected with Y. pestis.
根据世界卫生组织的数据，全球 75%的鼠疫病例发生在马达加斯加，每年平均有 200 至 700 例疑似病例（主要为腺鼠疫）。2017 年，发生了一起非典型性肺鼠疫疫情，这对鼠疫病例的实验室确诊提出了一些挑战，表明需要开发鼠疫耶尔森菌的分离程序，特别是那些可以在偏远地区进行的程序。由于细菌培养是世界卫生组织鼠疫诊断的金标准，我们试图开发一种简单的方法来制备一种高度选择性的培养基，适合在鼠疫流行的偏远地区使用。新培养基，命名为改良 BIN，在添加样本的生长支持和选择性方面的性能以及从临床标本中分离鼠疫耶尔森菌方面进行了评估，并与市售选择性培养基的结果进行了比较。新培养基的制备过程不那么复杂，其性能优于第一代 BIN 培养基。该培养基的生长支持能力更高，没有批次差异，并且保持着较高的选择性。在从疑似感染鼠疫耶尔森菌的患者中获得的 55 份临床标本中，改良 BIN 培养基鉴定出的鼠疫耶尔森菌阳性分离株比市售选择性培养基多约 20%。改良 BIN 培养基在从鼠疫患者获得的临床标本中分离鼠疫耶尔森菌方面具有显著优势，从而提供了更好的监测工具，并为更多疑似感染鼠疫耶尔森菌的患者提供了适当的治疗。
