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group G streptococci after ingestion of contaminated food have been reported. It is the practice in our laboratory to serogroup these organisms when they
are present in large numbers from throat cultures. Feedback from physicians usually indicates the patients have acute pharyngitis.
Eileen L. Randall, Ph.D. Chief, Microbiology Division Evanston Hospital Evanston, Illinois 60201
T o the Editors: A case study published in a recent issue of the Journal of the American Medical Association (1) confirms my previous impression of the potential hazards intrinsic in enzyme-linked immunosorbent assay (ELISA) technology as performed in many medical laboratories today. The authors describe a bacteriology technologist who developed acute polymicrobial, polyarticular arthritis after performing ELISA tests. Culture of right-knee aspirate revealed Sabnonella enteritidis; aspirate from other involved, joints, which differed clinically from the right-knee arthritis, were culture negative. Subsequently, ELISA tests of fluid from her right elbow revealed Neisseria
meningitidis group C antigen, corroborating the finding of gram-negative intraceUular diplococci in Gram stained smears of fluid from her right elbow and left wrist. In addition, her throat culture was positive for group C meningococci. Although the authors admit to uncertainty about the origin of the infection, substantial evidence links it to the patient's occupation: ELISA work with group C meningococcus was in progress at the time of the patient's illness. The evidence for a laboratoryacquired Sahnonella infection is not as strong, but the authors suggest that although S. enteritidis had not been isolated in the laboratory during the three months before the patient's illness, it is possible that she was exposed to Salmonella aerosols while performing ELISA tests for enterovirus on stool
samples not previously cultured for Salmonella. The inherent potential for transmitting microorganisms by aerosols is obvious when observing the washing techniques used with ELISA tests. Since this experience, the authors require that all ELISA tests in their laboratory be performed in a biological safety cabinet. All laboratories performing ELISA tests would do well to follow in their footsteps.
Regional Society Contacts
Editor's r e p l y :
Microbiology P.O. Box 1151 Norman, OK 73070
Letters to the Editors
ELISA Infection Hazard
To the Editors: The January 15, 1984, 6 (2) issue of the Clinical Microbiology Newsletter, page 13, provides a useful service in reviewing the Regional Clinical Microbiological Associations SEACM, SCACM, and SWACM. However, the article would have been more helpful if it had included suggested contacts in the organizations for individuals who might be interested in them. I would personally be interested in that information, if available. Jacob C. Holper, Ph.D. Director, Scientific & Clinical Affairs Litton Bionetics Charleston, South Carolina 29405
60
0196-4399/84/$0.00 + 02.00
The following is a list of the current or past Presidents of the Regional Microbiology Associations and their addresses: Ms. Patty Brunson Southeastern Association for Clinical Microbiology South Carolina Department of Health and Environmental Control P.O. Box 2202 Columbia, SC 29202 Richard R. Clark Northeast Association for Clinical Microbiology and Infectious Disease P.O. Box 1588 Cambridge, MA 02238 Dr. Howard W. Larsh Southwestern Association for Clinical
Anthony D'Auria, M.S. Chief Microbiologist St. Peter's Medical Center New Brunswick, New Jersey 08903
References 1. Petty, B. G., D. T. Sowa, and P. Charache. 1983. Polymicrobial polyarticular septic arthritis. J. Am. Med. Assoc, 249:2069-2072.
Dr. David L. Smalley Tennessee Society for Clinical Microbiology P.O. Box 40787 Memphis, TN 38174-0787 Dr. Malcolm Slifkin Western Pennsylvania Society for Clinical Microbiology Section of Microbiology Allegheny General Hospital 320 East North Avenue Pittsburgh, PA 15212-9986 Ms. Patricia P. Tumminello South Central Association for Clinical Microbiology 3901 North Meridian, Suite 235 Indianapolis, Indiana 46208
Clinical Microbiology Newsletter
are present in large numbers from throat cultures. Feedback from physicians usually indicates the patients have acute pharyngitis.
Eileen L. Randall, Ph.D. Chief, Microbiology Division Evanston Hospital Evanston, Illinois 60201
T o the Editors: A case study published in a recent issue of the Journal of the American Medical Association (1) confirms my previous impression of the potential hazards intrinsic in enzyme-linked immunosorbent assay (ELISA) technology as performed in many medical laboratories today. The authors describe a bacteriology technologist who developed acute polymicrobial, polyarticular arthritis after performing ELISA tests. Culture of right-knee aspirate revealed Sabnonella enteritidis; aspirate from other involved, joints, which differed clinically from the right-knee arthritis, were culture negative. Subsequently, ELISA tests of fluid from her right elbow revealed Neisseria
meningitidis group C antigen, corroborating the finding of gram-negative intraceUular diplococci in Gram stained smears of fluid from her right elbow and left wrist. In addition, her throat culture was positive for group C meningococci. Although the authors admit to uncertainty about the origin of the infection, substantial evidence links it to the patient's occupation: ELISA work with group C meningococcus was in progress at the time of the patient's illness. The evidence for a laboratoryacquired Sahnonella infection is not as strong, but the authors suggest that although S. enteritidis had not been isolated in the laboratory during the three months before the patient's illness, it is possible that she was exposed to Salmonella aerosols while performing ELISA tests for enterovirus on stool
samples not previously cultured for Salmonella. The inherent potential for transmitting microorganisms by aerosols is obvious when observing the washing techniques used with ELISA tests. Since this experience, the authors require that all ELISA tests in their laboratory be performed in a biological safety cabinet. All laboratories performing ELISA tests would do well to follow in their footsteps.
Regional Society Contacts
Editor's r e p l y :
Microbiology P.O. Box 1151 Norman, OK 73070
Letters to the Editors
ELISA Infection Hazard
To the Editors: The January 15, 1984, 6 (2) issue of the Clinical Microbiology Newsletter, page 13, provides a useful service in reviewing the Regional Clinical Microbiological Associations SEACM, SCACM, and SWACM. However, the article would have been more helpful if it had included suggested contacts in the organizations for individuals who might be interested in them. I would personally be interested in that information, if available. Jacob C. Holper, Ph.D. Director, Scientific & Clinical Affairs Litton Bionetics Charleston, South Carolina 29405
60
0196-4399/84/$0.00 + 02.00
The following is a list of the current or past Presidents of the Regional Microbiology Associations and their addresses: Ms. Patty Brunson Southeastern Association for Clinical Microbiology South Carolina Department of Health and Environmental Control P.O. Box 2202 Columbia, SC 29202 Richard R. Clark Northeast Association for Clinical Microbiology and Infectious Disease P.O. Box 1588 Cambridge, MA 02238 Dr. Howard W. Larsh Southwestern Association for Clinical
Anthony D'Auria, M.S. Chief Microbiologist St. Peter's Medical Center New Brunswick, New Jersey 08903
References 1. Petty, B. G., D. T. Sowa, and P. Charache. 1983. Polymicrobial polyarticular septic arthritis. J. Am. Med. Assoc, 249:2069-2072.
Dr. David L. Smalley Tennessee Society for Clinical Microbiology P.O. Box 40787 Memphis, TN 38174-0787 Dr. Malcolm Slifkin Western Pennsylvania Society for Clinical Microbiology Section of Microbiology Allegheny General Hospital 320 East North Avenue Pittsburgh, PA 15212-9986 Ms. Patricia P. Tumminello South Central Association for Clinical Microbiology 3901 North Meridian, Suite 235 Indianapolis, Indiana 46208
Clinical Microbiology Newsletter