Mucosal Brushings

Mucosal brushings may be used to sample bacteria from the intestinal mucosa. The cytology brush, protected by a sheath, is passed through the instrument channel of the endoscope. After the endoscope is placed at the location of interest, the brush is advanced from its sleeve within sight of the mucosal surface, and rubbed and rolled across the surface. Thereafter, the brush is pulled back into the sleeve. Normally, cytology brushes are only covered with a plastic sleeve to protect the specimen during withdrawal. This sleeve, however, does not protect against contamination; the use of suction of saliva and gastric fluid during endoscopy contaminates the suction channel of the endoscope, and the subsequent passage of the brush without a sheath through the suction channel causes loss of sterility of the brush (27). These brushes cannot be used for sampling bacteria in the lumen of the gastrointestinal tract. Avoidance of any suction during endoscopy is extremely difficult. To obtain small bowel samples without contamination one could utilize a catheter with a specimen brush plugged with sterile Vaseline. Brushes cannot be protected from contact with air, so it is not useful for the isolation of anaerobes for culture. To determine the concentration of bacteria obtained by the brush present per milliliter, one has to standardize the loading capacity of the brush used. Brushing is a highly reproducible technique (92%) (60).

Pregnancy And Childbirth

Pregnancy And Childbirth

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