a microbiology newsletter - june, 2022
A newsletter of, by, and for microbiologists. Copyright 2022, rights reserved
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A bacterium that caused a nationwide crisis...
What's Behind the Baby Formula Shortage?
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Many parents in the United States are reeling from the effects of an outbreak of Cronobacter sakazakii in powdered infant formula. Between September 2021 and January 2022, four cases of Cronobacter infections in infants were reported to the FDA. In each case, the infants were fed powdered formula from Abbott Nutrition.(1)
Cronobacter sakazakii (formerly genus: Enterobacter) is an opportunistic Gram-negative, rod-shaped pathogen that can tolerate a wide range of temperatures and persist in dry environments, known as xerotolerance.(4) Symptoms of infection include irritability, poor feeding, temperature changes, abnormal body movements, grunting breaths, and jaundice. Severe infections can lead to sepsis and meningitis.(3) The chance of developing meningitis is highest in infants that are two months old or younger.(2) The bacterium is ubiquitous, being isolated from a range of environments and foods; the majority of Cronobacter cases occur in the adult population. However it is the association with intrinsically or extrinsically contaminated powdered formula which has attracted the main attention.
After two infant deaths, Abbott voluntarily recalled multiple lots of powered formula produced in their Sturgis, Michigan plant. Similac Sensitive, Similac Pro-total Comfort, Similac Advance, and Similac PM 60/40 were all implicated.(2) Using whole genome sequencing, an initial comparison of patient and environmental samples from the Michigan plant revealed that the identified strains of Cronobacter were not closely related. Additional sample analysis is still ongoing.(2)
Abbott is the largest manufacturer of infant formula in the United States. In addition to disruptions in the supply chain and limited formula suppliers, the temporary closure of Abbott’s Michigan plant, which is also their largest, has exacerbated the formula shortage. Many parents have been met with empty shelves or tight limits on purchases.(5) On May 18th, President Biden invoked the Defense Production Act to increase the domestic production of infant formula. Biden also authorized the Defense Department to import thousands of pounds of formula from overseas.(6)
The FDA recently reached an agreement with Abbott to reopen the Michigan plant in the first week of June. Abbott estimates an eight to ten week lead time for new formula to be produced.(6) Infant formula should not be diluted and caretakers should never attempt to make their own formula. Do not purchase imported formula online due to the risk of counterfeit products.(3) ) If your regular formula is unavailable, contact your baby’s healthcare provider for assistance or visit healthychildren.org for more information.(7) The CDC encourages individuals to report any diagnosed Cronobacter infections to local or state health departments.(2)
Early identification of Cronobacter sakazakii is important to avoid additional infant infections from powdered formula. Hardy Diagnostic offers HardyCHROM™ sakazakii for the selective isolation and differentiation of Cronobacter sakazakii. This chromogenic medium provides easy identification of colonies of Cronobacter sakazakii, which appear smooth and blue-green as seen in the photo below.
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Watch a very funny and entertaining video on Antibiotic Stewardship.
It sums up why antibiotic choices must be made carefully!
By Dr. Glaucomflecken
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What is Hardy Diagnostics all about?
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Read a short article in Company Week that explains what makes Hardy Diagnostics different...
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Did you know that Hardy Diagnostics was the first to introduce Chromogenic Media to America in 1996?
Chromogenic media allows the microbiologist to make identifications based on colony color. The principle involves a carbohydrate molecule in the media that is bound to a colorless chromogen. When a specific bacterial enzyme cleaves the bond, the chromogen turns color, thus creating color throughout the bacterial colony.
Want to see the complete list? Just type "HardyCHROM" in the search bar here.
Interested in trying out any of our HardyCHROM plates? Contact your account rep here for free evaluation samples. |
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HardyCHROM Plates...
Make Micro Easy!
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Who developed over 40 different vaccines and forever improved healthcare throughout the world?
Another little known unsung hero in the field of microbiology.
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Above: Nine yards of ammo from a waist gunner of a WWII B-17 "Flying Fortress." Below: A Hollywood movie by the same name from the year 2000. |
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Phraseology
"The Whole 9 Yards"
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This phrase means "to the fullest extent" or "giving it all you've got." There are many theories as to where this phrase comes.
One of the most popular tales is that “9 yards” was the length of the ammo belts from machine gun magazines (especially 50 caliber) during World War II. The gunners in the Army Air Corps were encouraged to use “the whole nine yards” against the enemy.
This saying is relatively new and can be traced back to the 1960's. Other less plausible theories are 9 yards of cement in a cement truck, 9 yards of material for dress or kilt making, and 9 yards of sail in a square rigger sailing ship.
The true origin of this popular phrase in America remains obscure and numerous theories abound.
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As a free service to all microbiologists, Hardy has produced a series of instructional videos to help you train new technologists. Here is our list...
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A spirochete that evades detection and resists antibiotics
Lyme Disease:
Why it's so difficult to treat
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Lyme disease is one of the most common types of tick-borne diseases (TBDs), yet many questions remain surrounding long-term treatment of this disease. Borrelia burgdorferi, the spirochete causing the disease, is transmitted to humans through the bite of an infected Ixodes tick. (1) The first symptoms will often include a bullseye rash forming around the tick bite, as seen in the photo to the left. Approximately 35,000 cases are reported to the CDC annually, however, the CDC believes this number is severely underreported and estimates the actual number of cases to be closer to 476,000. (2)
Early detection can be difficult because of the low concentrations of bacteria present in a patient’s blood sample, frequently yielding false negatives. (3) Additionally, TBD testing is pathogen-specific, meaning a specific test must be ordered by a clinician who suspects a TBD. This makes the diagnosis heavily reliant on the clinical picture. (3) The gold standard for testing has been a two-tiered system including an ELISA test followed by a Western blot test, as recommended by the CDC. (3) However, this testing method is very time consuming and is more accurate the longer the patient has had the disease.(3)
Lyme disease initially causes symptoms that mimic common illnesses such as the flu, making it difficult to diagnose, especially in regions where TBDs are uncommon. (3) Initial symptoms are treated with a cocktail of oral antibiotics including doxycycline, amoxicillin, or cefuroxime. (4) Patients left untreated may experience persistent symptoms such as facial palsy, joint and muscle pain, and cognitive impairment. (5) The puzzling question researchers face is what causes these persistent symptoms in many Lyme disease patients?
B. burgdorferi has evolved many adaptations that have allowed it to persist within its host’s tissues, whether it be animal, tick, or human host. These adaptations have also allowed it to survive harsh antibiotic treatments as well. In vitro studies have demonstrated that when treated with antibiotics, a small number of B. burgdorferi survive but are non-cultivable.(4) The spirochete alters its gene expression, allowing it to transform into a variety of shapes and remain dormant during an attack by antibiotics. (4) While researchers have yet to demonstrate this in vivo, these studies may suggest why many patients’ symptoms resurge and persist after initial diagnosis and seemingly successful treatment. (4)
Research progression has been slow, mostly attributed to the lack of public awareness and concerns surrounding Lyme disease and other TBDs. The number of cases also falsely appears to be relatively small, which translates to less funding and investments for new technologies and detection methods.(3) It is also a difficult bacterium to study, since it requires a complex growth medium and takes two to four weeks of incubation.(8) A critical advancement would be a readily available detection method that tests for multiple TBDs simultaneously. (3) The Far Clinic has produced an excellent video that explains how B. burgdorferi can evade detection by the immune system and develop resistance to antibiotics.(9)
Understanding long-term treatment is essential due to the growing concern of the geographical expansion of ticks as well as the increased prevalence of TBDs such as Powassan virus.(6) According to the CDC, the Powassan virus is very rare, but the reported number of cases has increased in recent years from only six cases reported in 2015 to 39 cases reported in 2019. (7) Time-consuming test methods that yield false negatives at early stages of disease beg for more specific and sensitive technologies. As warmer temperatures have allowed ticks to survive in areas they previously could not, public education is key to preventing misdiagnosis and treating TBDs in their early stages.
By Allie Malmberg
Technical Support Microbiologist
HARDY DIAGNOSTICS
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Covid Supplies and Test Kits |
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Rapid Covid Antibody Test Kit
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Hardy announces a rapid test kit for the detection of Covid antibodies (both IgM for current infection and IgG for long term immunity) from any blood specimen. Read out in only 10 minutes. No equipment required. |
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AloeSafe, a better way
Hardy's hand sanitizing gel guards against drying of your skin with Vitamin E, soothes with Aloe Vera, and has a pleasant scent with lavender oil. No harmful ingredients (such as parabens and propylene glycol) as with the cheap drug store variety! Don't your hands deserve the very best?
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DisCide Wipes
With Hardy's DisCide Ultra you get 160 towelettes that are soaked with two powerful killing agents, isopropyl alcohol and quaternary ammonium. Effective against bacteria and viruses.
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Hardy's viral specimen transport is ideal for COVID-19 antigen testing. The shelf life has been increased to 365 days at room temperature. Swabs are sold separately. |
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Face Masks
With adjustable metal nose band.
Now available for immediate shipping!
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Double Action Sanitizer
Hardy's custom produced sanitizer pump bottle gives you double protection...both isopropyl alcohol and hydrogen peroxide. Bugs don't stand a chance!
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Comfy Lab Coats
For added protection on the job, Hardy offers disposable lab coats, featuring three pockets, and comfortable knit cuffs and collars.
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Specimen Collection Swabs
Hardy offers swabs in the flocked, foam, and spun polyester formats.
Choose from nasopharyngeal, oropharyngeal, standard, or urethral.
Available for immediate shipping!
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"I used to run an online dating service for chickens...
but I had to give it up since I couldn't make hens meet."
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I recorded all my corny jokes into a Dad-a-base.
Poultry owners make great chicken tenders.
I just got promoted by Old MacDonald to run his farm. I guess that makes me the C-I-E-I-O.
There once was a king who was only 12 inches tall. He was a terrible king but an amazing ruler!
I saw someone stealing from an Apple store. I guess that makes me an iWitness.
"I only know 25 letters of the alphabet. I don't know y."
I don't trust trees...all of them seem shady to me.
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Ever wish for an instrument that will quickly identify all the major pathogens in respiratory and stool specimens?
Now it's here!
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HardyCHROM Strep A
Are you ready for Strep Season? Hardy's chromogenic medium detects Group A Strep. Colored colonies are easy to see on a white background.
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HardyCHROM Candida+auris
Hardy's new chromogenic plate for the detection of Candida spp, now includes C. auris! It creates both a colored and fluorescent colony. Vivid colors stand out against a white background. Ask us for samples!
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Rapid Test Methods
Check out our mini catalog on rapid test kits that includes reagents and test cards. You'll see many "hard to find" products that will save you time and money!
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Loops of all kinds!
When it comes to loops, Hardy has it all. Nichrome, platinum, disposable, calibrated, needles, or spreaders. See our mini-catalog below or click here to learn about the convenient Loop Caddy.
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QC Organisms
Hundreds of species are available from Hardy Diagnostics, your Microbiologics distributor. Available in the pellet or stick format. Quantitative or qualitative.
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Carba 5 for CRE Detection
With Carba 5 you can test for the 5 major enzymes of carbapenem resistance. Tests for gene expression not just gene presence. Read out in only 15 minutes. No equipment needed! See the video!
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Rapid Bacterial Pneumonia
Detection
Hardy offers a rapid kit that will detect bacterial antigens in the urine in only 15 minutes. Watch a short video here.
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Fast Strep Grouping
Strep season is in full swing! Hardy's StrepPRO will rapidly identify your streps into the proper Lancefield grouping. Takes only minutes!
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AnaeroGRO
Pre-reduced anaerobic culture media, ready-to-use for your set-ups. Pouches are gassed out with nitrogen for superior growth. Click here for a short video. See our complete anaerobic catalog below...
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Dehydrated Media
Hardy manufactures a complete line of powdered media. It is conveniently packaged in five different configurations ready for export. Click here to watch a short video explaining the advantages of CRITERION.
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Which is darker? A or B?
Actually they are exactly the same. Context is everything!
"Believe nothing of what your hear and half of what you see."
Edgar Allan Poe, 1845
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Pharmaceutical Microbiology |
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DuraRack for all Petri Plates
Hardy now offers an indestructible rack for 100mm standard and 60mm contact plates. Click here to find out why this will be the last rack you will ever have to buy! |
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Impact Air Samplers
Hardy offers a complete line of air samplers for your clean room monitoring program. Click here for a short instructional video. Check out our complete catalog!
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HardyCHROM Campy
Hardy announces a new chromogenic media for Campylobacter. Easily identify colonies based on their red color.
Ask us for samples to evaluate.
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The smartest ATP Monitors!
Hardy is your authorized dealer for the Hygiena ATP monitoring system, Ensure Touch. Get results in 10 seconds!
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Zinc, zinc ionophores, and Vitamin D are recommended for a robust immune system.
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Early Treatment of COVID-19
What are the recent recommendations regarding "home based" treatment of the virus?
More outpatient recommendations as published in the American Journal of Medicine...
1) Reduction of re-inoculation - To prevent further spread of the virus, room ventilation measures can be taken.
2) Combination antiviral therapy - Zinc lozenges, zinc ionophores (hydroxychloroquin (HCG)), azithromycin, doxycycline, Favipiravir.
3) Immunomodulation - Corticosteroids to prevent a possible cytokine storm.
4) Antiplatelet/antithrombotic therapy - Low dose aspirin or heparin to prevent blood clots.
5) Administration of oxygen - Blood oxygen can be monitored with a fingertip pulse oximeter, utilizing supervised supplemental oxygen, and self-proning.
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Abigail Adams
1744 ~ 1818
The wife of John Adams, the second president of the United States and mother of John Quincy Adams, the sixth president. She was invaluable as a consultant to the president and an avid and articulate writer.
"If particular care and attention is not paid to the ladies, we are determined to foment a rebellion, and will not hold ourselves bound by any laws in which we have no voice, or representation."
"Learning is not attained by chance, it must be sought for with ardor and diligence."
"Great learning and superior abilities...will be of little value and small estimation unless virtue, honor, truth, and integrity are added to them."
"I've always felt that a person's intelligence is directly reflected by the number of conflicting points of view he can entertain simultaneously on the same topic."
"Many of our disappointments and much of our unhappiness arise from our forming false notions of things and persons."
"We have too many high-sounding words, and too few actions that correspond with them."
"To be good, and do good, is the whole duty of man comprised in a few words."
"It’s never too late to get back on your feet though we won’t live forever, make sure you accomplish what you were put here for."
"My bursting heart must find vent at my pen."
"What is the history of mighty kingdoms and nations, but a detail of the ravages and cruelties of the powerful over the weak?"
"Do not put such unlimited power into the hands of husbands. Remember all men would be tyrants if they could."
"I am more and more convinced that man is a dangerous creature."
"Posterity who are to reap the blessings will scarcely be able to conceive the hardships and sufferings of their ancestors."
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Vintage public health poster |
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Brainteasers
Need to exercise
the gray matter?
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During our 42 years of serving the microbiology community, we have continually aimed to provide the utmost in "a culture of service" for our valued customers. As a 100% employee owned company, we have even more incentive to please our customers as best we possibly can every day. Do you have a suggestion, comment, or question? Please contact me here.
Jay Hardy, CLS, SM (NRCM)
CEO of Hardy Diagnostics
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