Search

We report in this publication the use of two educational tools, a questionnaire of satisfaction and a training book, to improve the training of students during their internship in clinical laboratory at the "Pôle de biologie des Hôpitaux universitaires de Strasbourg" in France. First, the ongoing training was assessed by the interns with a questionnaire measuring satisfaction. The analysis of this questionnaire identified four key points to improve: 1) define the teaching objectives, 2) organize the training with a schedule, 3) revise certain teaching methods and 4) ensure better integration of the students in the team of medical biologists. After this assessment, we implemented a training book to answer these four points. Indeed, the training book presents the objectives, the schedule of training, and how to validate the educational objectives. A new assessment was performed again using the same methodology. Results showed an improvement in student satisfaction from 74 to 88 %. The questionnaire of satisfaction and the training book are presented in this article. The aim of the assessment of training combined with the training book is to incite the actors of the training (students and teachers) to continually improve the training. The objectives of the Pôle de Biologie are to obtain an 80 % satisfaction rate during the 6 months trainings and to reduce or eliminate dissatisfaction, and finally to ensure the validation by students of 80 to 100 % of their predetermined objectives.

Escherichia coli is the most common bacterial cause of urinary tract infections. Its rapid and specific identification in urine samples represents a major challenge within the rendering results and optimizing the management of the patient. We aimed to compare the sensitivity and specificity of two commercially available chromogenic media for E. coli: ChromID CPS (Biomérieux) and UriSelect4 (Bio(-)Rad), without carrying out further tests. 99 consecutive and non-redundant urine samples considered to be infected were simultaneously plated onto blood agar and the two chromogenic media. Colony color and bacterial growth quantification were compared 18 and 48 hours after incubation. Bacteria were identified with mass spectrometry. A complementary analysis on 80 bacterial strains known to pose potential identification problems was performed. 43 urines samples grew E. coli, and 42 of them were pink-colored on the two chromogenic mediums, as expected (sensibility=97.7%). Growth quantification was significantly greater on blood agar than on chromogenic media (p<0.001).We noted specificity issues at the complementary analysis with the UriSelect4 medium: Citrobacter freundii and some strains of Citrobacter brakii, Enterobacter cloacae and Hafnia alvei were pink-colored, and could be misidentified as E. coli. ChromID CPS medium did not show such misidentification. In conclusion, the agar ChromID CPS proved to be greater than the UriSelect4 agar in our work in terms of specificity of direct identification of E. Coli, without the use of additional test.

Lyme disease is endemic in Europe. The strains of the causative agent, Borrelia burgdorferi, seem to be antigenically more heterogeneous than the North American isolates. The only documented vector for this bacterium in Europe is ixodes ricinus, but other vectors might be involved as observed in the United States. The tick hosts are not yet well documented in Europe. Human infection occurs principally during summer months. The clinical aspect of the disease has particular features in Europe: at the early stage of the disease, a single and large erythema chronicum migrans is observed on the skin; complications often include meningoradiculonevritis (Bannwarth's syndrome) and later, acrodermatitis chronica atrophians; arthritis is less frequent in Europe than in the USA. The culture of B. burgdorferi from the lesions is difficult. The diagnosis of the disease is performed on the basis of serological tests: immunofluorescence assay where the important thing is to define a cutoff titer; ELISA tests using either whole cells or supernatant of sonicated cells or flagellar antigen; passive haemagglutination for IgG; IgM solid phase haemadsorption; Western blot (immunoblot) seems interesting to perform on a research basis to determine to which protein antigens patients are responding with antibody. Once antibody production begins, it is usually in the form of IgM antibody to flagellin protein (41 kD), with time, both IgM and IgG antibodies to a variety of other antigens appear. Prophylaxis is based on health services and public education because a prompt removal of the tick diminishes risk of infection with B. burgdorferi (4 p. cent of cases after tick bite). The treatment includes aminopenicillins or tetracyclines at the early stage. The second and third stages of borreliosis are treated by high doses aminopenicillins or cetriaxone.