Project 5.1.1B Evidence Report #2 Culture Results Patients present with elevated white blood cell count (left shift) and persistent fever, suggesting infection. Both blood and urine culture samples were collected from each patient and were sent to the lab for analysis. Blood culture is used to detect the presence of bacteria or yeast in the blood and to identify any microorganisms that may be present. A blood sample is cultured on nutrient media and monitored for growth of microorganisms. Urine culture tests for the presence of microorganisms in the urine. A small sample of the urine is placed on an agar plate and incubated at body temperature. A microorganism that is present should grow in isolated colonies after 24-48 hours. A colony is then smeared on a clean slide and subjected to Gram-staining and further identification tests. Results The blood culture results for Patients 1, 3, 4, and 5 come back negative. The sample from Patient 2 was inconclusive and will be redrawn. Doctors begin to rule out PCP pneumonia, Cryptococcus or other infection by yeast, and aspergillus contaminated food products. Urine culture samples from Patients 1, 3, 4, and 5 showed no growth. The urine culture results for Patient 2 reveal greater than 100,000 organisms/ml. Pink, Gram-negative rods are detected under a microscope. Environmental Testing Report All five patients now present with respiratory symptoms. The differential diagnosis is consistent with poisoning. Suspected agents include phosphine, a fast-acting poison © 2011 Project Lead The Way, Inc. Biomedical Innovation Project 5.1.1B Evidence Report #2 – Page 1
used to kill outdoor pests. Therefore, an environmental testing team was sent to search the residence of each patient. Various pest traps were found at more than one home, but there was no evidence of phosphine poison at any patient residence. Two of the more rural residences were located next to farms. When interviewed, both farm owners mentioned spraying with both herbicides and pesticides; however, no evidence of either chemical was found on the property of a patient. The environmental team determined that two of the homes are supplied by public water and two rely on wells. Water samples were taken from each well, as well as from the lake where Patient 3 had been camping. PCR-based testing was run to determine the presence or absence of coliform bacteria in each source. Samples were run on a gel and analyzed. Lane 1: 200bp ladder Lane 2: Positive control Lane 3: Negative control Lane 4: Well sample – Patient 1 and 2 Lane 5: Well sample – Patient 5 Lane 6: Lake sample Chemical assays from each source were all within normal limits for lead, nitrates, chloride, copper, pH, and sulphate.