Abstract:
By using the method and equipment according to this invention it is possible to analyse rapidly a large number of microbiological culture samples, or alternatively of liquid phase samples, based on the gases or gaseous compounds released by them. This invention exploits generally a sample line, along which the samples move, and it can be used for the microbial control tasks in hospitals, industry, hygiene and environmental fields. In this system gas is led into the culture vessels during the growth of the microbe, and gases released by the culture or liquids derived from them are collected into the chambers, capsules or equivalents.

Description:
BACKGROUND OF THE INVENTION 
       [0001]    For the use of microbiological analyses and studies carried out in hospitals and also more broadly in the field of health care, as well as in the field of food industry, industrial hygiene and environmental monitoring, there is a need for: 
         [0002]    1. handling the samples as fresh and as unchanged as possible (transport, preservation and storage should be minimized); 
         [0003]    2. getting the results rapidly, sensitively and reliably; 
         [0004]    3. detecting as many microbes present in the samples as possible (inter alia recovery of the cells); 
         [0005]    4. the use of enrichment culture or other culture method, which representatively reveals the microbiological characteristics of the sample; 
         [0006]    5. the efficient handling of large number of samples. 
         [0007]    By using the PMEU equipment (Portable Microbe Enrichment Unit), many of the needs mentioned above in steps 1-4 could be fulfilled in clinical microbiology, as well as e.g. in monitoring tasks of food industry and environmental fields. However, the need of step 5 can be satisfied especially only in large central laboratories, but then usually other objectives, like the quality and rapidity of the microbiological analyses, have to be compromised. 
         [0008]    The PMEU equipment has been suggested for use in the hygiene culture methods in hospitals (Hakalehto, 2006), for detecting aerobic and anaerobic pathogenic bacteria (Hakalehto et al., 2007), for the research of the function and development of the intestinal microbial flora (Hakalehto et al., 2008), as well as for the detection of bacteria, present e.g. in blood or urine, at record speed based on the gases formed by them (Hakalehto et al., 2009). In the latter study the growth of  Escherichia coli  has been characterized. Also in the same studies  Staphylococcus aureus  and other  Staphylococcus, Streptococcus  and  Klebsiella  species have been detected by using the PMEU equipment together with a gas sensor. In that case microbes have been detected even from low concentrations in less than 5 hours, which is unprecedented. However, these studies have been carried out in conditions, which include a limited number of samples, but not with a large number of samples arriving continuously. This is however often the situation in hospitals, large laboratories or in other control tasks in food industry or environmental or other industrial fields. For example, in large Finnish hospitals approximately 50% of the microbiological studies could be related to the analysis of urine samples, and the large number of these samples exposes the laboratory system, even though it is a conventional automatic or semi-automatic system, to a severe stress, whereby the functional capacity and performance of the system could turn out to be limited and inadequate. As another type of samples, in which the large-scale and sufficiently sensitive and efficient analysis automatically meets practical problems, samples from blood cultures could be mentioned. For example, during generalized infection the amount of bacteria in the system of the patient could anyhow be moderately low; however, they should still be analysed as soon as possible. Prolonged analysis delays the commencement or confirmation of the appropriate treatment, and also consumes resources and produce costs. Guidelines for how to analyse gaseous emittable compounds from blood cultures have been reported (Hakalehto et al., 2009). However, this system is not automatic and does not enable the analysis of a very large number of samples at a time. 
         [0009]    If in these above mentioned studies a detection of the gases released by the microbial culture is exploited as a basis of the measurement, an efficient and practical automated sample analysis and corresponding sensor equipment is needed. The sample collection is often decentralized, whereby means and equipment are needed for the data transfer, e.g. with respect to the changes in the cultures and gas analysis results. Recording of this information is also often useful for the purpose of later comparative analyses. In practice it is possible to analyse the function of bacteria and other microbes in the samples not only by analysing the emitted gases, but also by measuring the transmittance of infra-red radiation or light or UV radiation, or by measuring the fluorescence caused by them from the liquid growth medium (Hakalehto, 2010). 
         [0010]    The automated microbiological analysers can of course be studied, developed and used besides in the health care and associated medical research sector and in the patient studies, also in all other fields, where there is a need to analyse accurately, rapidly and reliably large numbers of microbiological samples. These fields could include the monitoring of the equipment, processes and, hygiene in food industry, pharmaceutical and drug industry, cosmetic and process industry, the monitoring of microbiota in environmental and primary production, veterinary therapy and different ecological studies of microbes. Essential for the success of the studies and analyses is, that the capacity of the system is sufficient with respect to the number of the samples to be analysed and the rapidity of the analyses, whereby it becomes preferred to move the samples along sample lines; these type of approaches have been introduced e.g. in clinical chemistry applications. Corresponding applications in microbiological cases require the use of liquid cultures. This causes problems, if one uses conventional means to quantify microbes based on their colony growth seen on solid growth media. However, in recent studies it has been shown, that liquid cultures in the PMEU equipment could give better estimates, when the growth is monitored as described above, compared to the calculation of colony numbers on Petri dishes or on other equivalent flat-type growth media (Pesola et al., 2009). 
         [0011]    In the PMEU equipment the beginning of the growth could reflect the original concentration of bacteria in the sample (Hakalehto 2010, Wirtanen &amp; Salo 2010). However, the reliability of this “inverse correlation” suffers from the fact, that one does not exactly know the length of the period before the growth starts (“lag period”). For this reason it is preferred to study the growth in compartments, which locate in a chamber around the culture syringe, which compartments contain samples collected from different time points, and/or on different growth media for the subculturing and for their monitoring. At the same time one can also define more closely the quantification results of the original bacterial concentration by comparing the results obtained from different subcultures. In this case it can be assumed, that the inoculum made from the fresh culture in the syringe starts to grow without a lag period. Thus, by measuring the time needed for the appearance of the growth in the time series of the inoculated culture chambers, one can deduce and calculate the original microbe concentration from the sample taken from the culture syringe. The said time depends of course e.g. on the detection limit of the sensor used. 
         [0012]    In fact the quantification can be done with sufficiently sensitive optical or equivalent measuring methods by calculating the number of microcolonies formed in liquid growth medium. This becomes possible, if the sensors or equivalents can be prepared sensitive enough to register microscopical optical phenomena associated with the growth of microbial particle sizes. 
     
    
     DESCRIPTION OF THE INVENTION 
       [0013]    By using the method and equipment according to this invention several samples and corresponding microbial cultures could be analysed in a continuous mode. An example of one embodiment of the equipment according to the invention is shown in  FIG. 1 . This invention is characterized in that the cultures (A) are moving along the sample line (B) so, that the culture vessels are placed inside the capsules (C), which collect the gases formed and released by the microbes present in them. In this application the gases released, from the microbial cultures can also mean compounds vaporized or volatilized from the cultures, like VOC components (Volatile Organic Compounds). In gas analysis points or gas analysis level (D) these gases are measured e.g. by the sensor system according to the reference Hakalehto et al., 2009. In this case the gas to be analysed is discharged from the capsule or chamber, when the orifice present in the chamber or capsule becomes confronted with the orifice of the analysis point. Then the gas is carried to the sensor. This sensor is coupled to the automated control unit of the sample line so, that the measuring time of the gas carried to the sensor or equivalent will be appropriate. 
         [0014]    By using the method and equipment according to this invention microbial samples can be processed in different ways and conveniently transferred forward in analysis series. The object is to seamlessly combine microbiological culturing techniques on the one hand to molecular biology methods needed and on the other hand to different sensors, which can give real-time information concerning the status of the microbial culture. Essential part of the equipment includes a culture vessel for the microbes, a sample cylinder, one preferred embodiment of which is an injection syringe, which serves as said cylinder or culture vessel. 
         [0015]    In the culture vessel, which preferably is, as said, cylindrical and injection syringe-like, the amount of the liquid and the volume of the gas space can be adjusted by moving the piston present in the cylinder. In this way the liquid or gas can be led out from the cylinder through the syringe-like orifice located on the tip of it, or through the orifices made in its flanks. This makes it possible to construct around the syringe or equivalent cylinder chambers, cuvettes and measuring spaces, to which the gas, liquid or suspension to be analysed can be taken from the culture. These separate spaces or compartments can be prepared inside the capsule, which surrounds the syringe moving along the sample line. 
         [0016]    The preferred gas needed for the bubbling of the culture can be conveyed into the cylinder through the syringe-like tip, like in one embodiment of the PMEU equipment (Hakalehto, 2010), or by the piston or through the walls of the cylinder. Correspondingly, the partial (sampling) or total emptying of the cylinder can be carried out, besides through the tip, alternatively by using e.g. the outlets present in its flanks, which can be prepared so, that they will be opened or closed, when the piston is moved back and forth. In this way different studies related to the characteristics of the culture cultivated or incubated in the growth syringe (culture syringe) can be carried out, also during its movement along the sample lines. Measurement or study devices needed can be placed in the capsule, or assemblies can be connected to them via the capsule, and in that way samples and subsamples can be delivered, if necessary, for additional analyses. This principle allows the collection of samples to different tests during the cultivation, and the handling of a large number of samples is enabled due to the fact, that the cylinders and capsules surrounding them move along the sample lines, if necessary, to separate measuring points, which at the same time reflect the time taken by the growth process and other transformations happened in the population. 
         [0017]    The sampling channels can be reclosed by moving the piston so, that the orifices or assemblies or channels to the capsule or through it will be closed. Then both these sample transfer channels and the compartments or equivalents needed for their analysis can be rinsed and/or washed, if necessary, for the new run. For this purpose the capsules and/or sample line can be equipped with accessories needed for this purification process. When the capsules and cylinders located in them contain several sampling points, many different variables could be analysed from the cultures at the same time. Correspondingly, phenomena and changes at different time points, which are preferably physically separated to different sites in the sample line, can be studied. 
         [0018]    The syringe containing the sample can be disposable, but the capsule needed for its transport, and for sampling and for analysing, can be reusable. Part of the capsule functions can be placed into the piston part or equivalent part of the syringe. This location can contain sensors e.g. for the temperature or pH of the growth medium or equivalent. By using different more specific measurement modes placed in the equipment according to the invention, several microbes and subpopulations of different types could be studied from the same culture. For this purpose, growth media of different types can be added in the chambers or compartments or equivalents placed around the cylinder, which media could be solid ones, semi-solid ones, gels or liquids. Samples for subculturing can be taken into these compartments or chambers or equivalents at different sites in the sample line, by the aid of which one can follow the development of the microbiota in the sample. The chambers meant for the subculturing can be placed e.g. annularly, whereby subcultures can be prepared on different media at the same time through several orifices, or alternatively sampling can be done as a function of time. These sampling strategies can naturally be combined in many ways so, that the samples are preferably moving along the sample line and through different measuring points. For the purpose of sampling and different measurements the syringes can also be rotated, besides getting assemblies, orifices or channels opened for the sampling and analysis purposes by moving the piston. 
         [0019]    The capsules or chambers or equivalents can be moved along the sample line mechanically, by electrical control, magnetically, with the aid of pressurized air, or by other practical means. When they and the cultures in culture vessels included by them, move forward, places for new samples will be released. During the samples move forward, they will, like in the PMEU equipment, go through the microbial growth and/or enrichment by the aid of appropriate gas stream led into the liquid. This gas could be aerobic, microaerobic or anaerobic (free from oxygen). It spreads into the culture from the wall of the vessel at its attachment site to the sample line, and it causes bubbling, whereby the diffusion of the compounds and gases in the culture is enhanced. At the same time gases formed by the microbes will be collected into the gas stream, which is accumulated into the capsule or chamber, when it moves forward along the sample line, and is released at appropriate sites for measurement. Alternatively, the capsules and chambers, microbial cultures to be analysed located in or associated with them, can also be totally or partially stationary. Essential is, that the gas led into the microbial culture takes along volatile organic compounds (VOC) necessary for the detection of microbes, which are released from them or which are formed as a result of their function. The gas released from the culture vessels can also be collected into the chamber or capsule or equivalent, while it is moving to the next measuring point. 
         [0020]    Microbiological samples can be clinical samples, which have been collected into test tube, sample vial or sampling syringe. The samples can be surface samples, blood, urine or fecal samples, or many other types of clinical microbial samples. The microbes present in them can be e.g. facultative anaerobes, like coliforms,  Streptococcus, Staphylococcus, Salmonella, Campylobacterium, Clostridium, Bacillus  species or any of the several other clinically important bacteria. In the method according to this invention it is essential, that gas, which is appropriate for culturing of the microbe (or bacterium) to be studied, is preferably led into the culture vessel, which is in motion. The culture vessels and equivalent chambers or capsules of different samples will move to the measurement points. This movement happens preferably in a tube, the temperature of which is set appropriate for the microbe. Said temperature, as well as the temperature, composition and pressure of the gas led into the culture, can be changed, if necessary. In the said tubular structure, where the samples move attached to the framework of the sample line, the gas can be led into the culture vessels e.g. by using overpressure. Then, after this gas has bubbled, the growth medium in the culture vessel, it will be collected into the chamber or capsule. Inside this chamber or capsule or associated with it, there could be a baggy structure, which fills up with the gas and thus collects it. This baggy structure can be emptied at the measuring point and/or at the time of measurement. 
         [0021]    Besides in clinical analytic field, the analysis of large number of samples is also important in food industry, pharmaceutical and chemical industry, forest industry, environmental and safety oversight. Emergency cases, in which the method according to the present invention is also needed, are e.g. crises, epidemics, wars, natural catastrophes and equivalent situations. In all situations rapid and efficient microbiological analysis increases safety and lowers the costs. If the microbes to be studied are dangerous ones, the gas transferred to the sensor at the measuring point can be sterilized by filtering. When analyses from the chamber or capsule are finished, they can be purified and sterilized, if necessary. 
         [0022]    The gas in the chambers or capsules moving along the sample line can be measured also so, that they include per se the sensors needed for the measurements, from which the measured data can be wirelessly transferred forward. At separate measuring points or levels the gas released from the chambers or capsules can be led into different analytical devices, like GC-MS apparatus (gas chromatography-mass spectometer). Correspondingly, also liquid samples can be transferred to different measuring equipments for analysis. The equipments needed for the measurement can be located also inside the capsules. To obtain appropriate culturing temperatures in the culture vessels moving along the sample line, they or the capsules containing them can be placed in a tubular structure, the temperature of which can be adjusted appropriately. When desired, filtersterilized gas can be led into the culture vessels through this tubular structure by using overpressure. The temperature and other conditions of the equipment according to the present invention can be adjusted via the control unit, which also enables the recording of the measured data or their transfer forward either with wired or wireless mode. 
         [0023]    For the collection of the liquid or gas, the chambers/capsules constructed around or in association with the culture vessels, can be disposable or reusable. The gas led into them can be filtersterilized, if necessary. If the capsules/chambers do not surround the culture vessel, in one embodiment of the present invention one can alternatively use the method and equipment according to this invention in such way, that these chambers or capsules are moving parts, which the sample line brings to the culture vessels, from which the needed samples are collected to them for analyses. All functions of the sample line can be automatized by the control unit in all embodiments. 
       REFERENCES 
       [0024]    E. Hakalehto. Semmelweis&#39; present day follow-up: Updating bacterial sampling and enrichment in clinical hygiene,  Pathophysiology  13 (2006) 257-267. 
         [0025]    E. Hakalehto. Hygiene monitoring with the Portable Microbe Enrichment Unit (PMEU). 41 st  R3—Nordic Symposium. Cleanroom technology, contamination control and cleaning. Espoo, Finland, May 2010. VTT (State Research Centre of Finland), Publications 266. 
         [0026]    E. Hakalehto, J. Pesola, L. Heitto, A. Närvänen, A. Heitto. Aerobic and anaerobic growth modes and expression of type 1 fimbriae in  Salmonella, Pathophysiology  14 (2007): 61-69. 
         [0027]    E. Hakalehto, T. Humppi, H. Paakkanen. Dualistic acidic and neutral glucose fermentation balance in small intestine: simulation in vitro,  Pathophysiology  15 (2008): 211-220. 
         [0028]    E. Hakalehto, J. Pesola, A. Heitto, B. B. Deo, K. Rissanen, U. Sankilampi, T. Humppi, H. Paakkanen. Fast detection of bacterial growth by using Portable Microbe Enrichment Unit (PMEU) and ion mobility gas sensor,  Pathophysiology  16 (2009): 57-62. 
         [0029]    J. Pesola, O. Vaarala, A. Heitto, E. Hakalehto. Enrichment in Portable Enrichment Unit in rapid characterization of infant intestinal enterobacterial microbiota,  Microbial Ecology in Health and Disease  21 (2009): 203-210. 
         [0030]    G. Wirtanen, S. Salo. PMEU-laitteen validointi koliformeilla (Validation of PMEU equipment with coliforms). Report VTT-S-01705-10 (2010), VTT Expert Services Oy, Espoo, Finland.