Evaluation of liquid media for growth of Helicobacter pylori.

Helicobacter pylori has routinely been isolated and grown on solid media. Recently, we have succeeded in obtaining growth of this organism in several liquid media in large volumes, including tryptic soy broth, Mueller-Hinton broth, brucella broth, brain heart infusion broth, and Columbia broth. Growth was tested in the media with and without supplementation. Growth was obtained after incubation under microaerobic conditions and with CO2 enrichment. Growth in a stationary system versus that in an agitated system was evaluated. Results from these experiments show that H. pylori can be grown in any of the liquid media tested except buffered yeast extract-alpha-ketoglutarate if serum is added. No growth was observed on buffered yeast extract-alpha-ketoglutarate even with serum and other supplementation. Growth of H. pylori in most of the liquid media with supplements was improved if the culture was incubated in a CO2 atmosphere. The findings reported here may be useful in clinical, industrial, and research laboratories that require harvests of large quantities of H. pylori cells

Indication and Prognostication

The decision to admit or not admit a patient to the intensive care unit (ICU), thus increasing the intensity of care, should be the result of medical expertise regarding the reversibility of the acute condition that led to the failure of vital organ systems, in accordance with the will of the patient. Since all required information may not be available in the acute situation, nor the certainty of the effectiveness of intensified treatment in the ICU, admission of the patient for a predetermined time period to see any improvement and reversibility may be advisable. This holds especially true for the unknown patient with limited available documentation, seen in an emergency department. Ideally, different scenarios were discussed previously and electively with physicians involved, the patient, and the family. Taking time is important and can be used to collect all required information while also observing the effect of the implemented therapies in the ICU since a patient can die only once. The use of scoring systems for the individual patient to determine indication and prognostication for treatment in an ICU is of limited value