Direct Swab Research Articles

Epidemiology of oral HPV in the oral mucosa in women without signs of oral disease from Yucatan, Mexico.

High-risk human papillomaviruses (HR-HPV) are considered necessary for the development of cervical cancer. Furthermore, there is no doubt that some types of oral squamous cell carcinoma are associated with HR-HPV. The epidemiology of oral HPV infections in healthy subjects remains unclear due to a lack of knowledge. The objective of this study was to investigate the epidemiology of human papillomavirus infections of the oral mucosa without pathology. A cross-sectional study was performed; samples from 390 women seeking prenatal care, Pap smears, family planning or gynecological diseases were studied. Oral cells were collected by direct swab sampling. Information regarding sociodemographic status, sexual behavior, infectious diseases, contraceptive history and tobacco and alcohol consumption were obtained through direct interviews. HPV and genotypes were detected by type-specific polymerase chain reaction. Our results revealed that 14% of the women studied had an oral HPV infection. Women ≤ 20 years of age had the highest HPV prevalence (24.5%). In total, seven genotypes were identified, including the high-risk genotypes 16, 18, 58 and 59 and the low-risk genotypes 6, 81 and 13, the latter of which is a type exclusive to oral mucosa. Sexual behavior was not associated with the presence of genital HPV types in the oral mucosa. Genital HPV types were present in the oral mucosa of women without associated clinical manifestations; however, sexual behavior was not associated with infection, and therefore others routes of transmission should be explored.

Identification of avian coronavirus in wild aquatic birds of the central and eastern USA.

Coronaviruses (CoVs) are worldwide in distribution, highly infectious, and difficult to control because of their extensive genetic diversity, short generation time, and high mutation rates. Genetically diverse CoVs have been reported from wild aquatic birds that may represent a potential reservoir for avian CoVs as well as hosts for mutations and recombination events leading to new serotypes or genera. We tested 133 pooled samples representing 700 first-passage (in eggs) and 303 direct cloacal swab transport media samples from wild aquatic birds in the US that were avian influenza-negative. We isolated RNA from frozen samples and performed reverse transcriptase-PCR using a published universal CoV primer set. Of the samples tested, one from a Ruddy Turnstone (Arenaria interpres) was positive for CoV, showing nucleotide sequence similarity to a duck coronavirus (DK/CH/HN/ZZ2004). These data indicate a possible low prevalence of CoVs circulating in wild aquatic birds in the eastern half of the US.

Fabrication of SERS swab for direct detection of trace explosives in fingerprints.

Swab sampling is of great importance in surface contamination analysis. A cotton swab (cotton Q-tip) was successfully transformed into surface-enhanced Raman scattering (SERS) substrate (SERS Q-tip) through a bottom-up strategy, where Ag NPs were first self-assembled onto the Q-tip followed by in situ growing. The capability for direct swab detection of Raman probe Nile Blue A (NBA) and a primary explosive marker 2,4-dinitrotoluene (2,4-DNT) using the SERS Q-tip was explored. It was found that at optimum conditions, a femotogram of NBA on glass surface could be swab-detected. The lowest detectable amount for 2,4-DNT is only ∼1.2 ng/cm(2) (total amount of 5 ng) on glass surface, 2 orders of magnitude more sensitive than similar surface analysis achieved with infrared technique, and comparable even with that obtained by ion mobility spectrometry-mass spectrometry. Finally, 2,4-DNT left on fingerprints was also analyzed. It was found that SERS signal of 2,4-DNT from 27th fingerprint after touching 2,4-DNT powder can still be clearly identified by swabbing with the SERS Q-tip. We believe this is the first direct SERS swabbing test of explosives on fingerprint on glass. Considering its relative long shelf life (>30 d), the SERS Q-tip may find great potential in future homeland security applications when combined with portable Raman spectrometers.

Gelenkinfekt – eine Entität für die spezielle septische Chirurgie

BackgroundJoint infections can cause severe complications that result in irreversible joint destruction when treated inadequately.PathogenesisReasons for joint infections consist of endogenous hematological and exogenous factors. Patients acquire empyema almost solely through iatrogenic measures (e.g. arthroscopic operations, punctures and intra-articular infections) or as a result of near joint fractures and penetrating injuries.DiagnosisTo make a correct diagnose, a joint puncture with a direct swab test is necessary in addition to laboratory examinations, x-ray and magnetic resonance imaging (MRI) examinations. The leucocyte count must be determined (threshold value 25,000/μl) as well as a gram stain to microscopically identify possible bacteria present.TherapyAcute joint infections are considered to be orthopedic emergencies necessitating immediate surgical treatment as irreversible cartilage damage can rapidly result due to the pathophysiological process. Acute joint empyema should be treated arthroscopically. Clinical symptoms lasting more than 7 days emanate in chronic empyema and should be treated by arthrotomy, synovialectomy and removal of extraneous material including a possible cruciate ligament replacement. Postoperatively, an immediate intensive physiotherapy is necessary, even under the use of pain catheters. The transfer to a centre for septic surgery is recommended.

Development of loop-mediated isothermal amplification (LAMP) assay for rapid and sensitive identification of ostrich meat.

Animal species identification is one of the primary duties of official food control. Since ostrich meat is difficult to be differentiated macroscopically from beef, therefore new analytical methods are needed. To enforce labeling regulations for the authentication of ostrich meat, it might be of importance to develop and evaluate a rapid and reliable assay. In the present study, a loop-mediated isothermal amplification (LAMP) assay based on the cytochrome b gene of the mitochondrial DNA of the species Struthio camelus was developed. The LAMP assay was used in combination with a real-time fluorometer. The developed system allowed the detection of 0.01% ostrich meat products. In parallel, a direct swab method without nucleic acid extraction using the HYPLEX LPTV buffer was also evaluated. This rapid processing method allowed detection of ostrich meat without major incubation steps. In summary, the LAMP assay had excellent sensitivity and specificity for detecting ostrich meat and could provide a sampling-to-result identification-time of 15 to 20 minutes.

Chlamydia Infections in Children and Adolescents

1. Lorena M. Siqueira, MD, MSPH* 1. *Division of Adolescent Medicine, Miami Children’s Hospital, Miami, FL. * Abbreviations: CDC: : Centers for Disease Control and Prevention FDA: : Food and Drug Administration HIV: : human immunodeficiency virus LGV: : lymphogranuloma venereum MIF: : microimmunofluorescent MSM: : men who have sex with men NAAT: : nucleic acid amplification tests PID: : pelvic inflammatory disease STI: : sexually transmitted infection 1. The need for annual screening for chlamydia in sexually active adolescents and young adults is underrecognized because this infection is asymptomatic in most females (75%) and males (50%). 2. Difficulty in diagnosis arises from the range of possible symptoms at presentation of symptomatic infections and the type of testing that can be used in each situation. After completing this article the reader should be able to: 1. Recognize the spectrum of clinical manifestations of chlamydia infection in neonates, children, and adolescents. 2. Discuss the appropriate use of culture and nonculture diagnostic tests for chlamydia infections in various age groups. 3. List the current recommendations for screening and treatment of chlamydia infections. A 17-year-old girl presents with prolonged menstrual bleeding associated with severe menstrual cramping pain. Her menarche was at age 13 years. Subsequent menstrual cycles were monthly, lasting 5 days, with average flow associated with mild to moderate pain relieved by over-the-counter pain medications. The current cycle began a month ago and is associated with severe lower abdominal pain. She admits to sexual activity with one partner and uses condoms intermittently. On examination she is afebrile and in discomfort, with a heart rate of 120 beats per minute. She does not appear anemic and has good capillary refill. She has diffuse abdominal pain with significant tenderness in both the right lower and upper quadrants. Chlamydiae are small obligate, gram-negative, intracellular bacteria that contain both DNA and RNA and were formerly considered to be viruses. There are 3 species that are pathogenic to humans: Chlamydia trachomatis , Chlamydophilia pneumoniae, and Chlamydophilia psittaci . They fall within 2 genera in the family Chlamydiaceae . C trachomatis is in …

Influence of denture plaque biofilm on oral mucosal membrane in patients with chronic obstructive pulmonary disease.

Patients with chronic obstructive pulmonary disease (COPD) have the lower airways colonized with pathogenic bacteria in a stable period of the disease and during exacerbations. The etiology of bacterial exacerbations of COPD depends on the underlying disease, the frequency of exacerbations and antibiotic therapy. Microorganisms can be aspirated off the denture plaque biofilm into the lower respiratory tract and could reduce the patient's immunity and cause pneumonia. COPD patients, who are using acrylic dentures in oral cavity, are exposed to denture stomatitis and oral candidiasis. The aim of this study was to establish the composition of denture plaque biofilm and its impact on the oral mucosa in COPD patients. The study included patients in a stable phase of COPD using removable denture and the control group included healthy wearer's appliances. Examinations concerned the oral mucosal membrane and the hygienic condition of prosthetic restorations. Microbiological examinations were performed by taking a direct swab from the surface of acrylic dentures. Seventeen bacterial and fungal strains were isolated from denture plaque of COPD patients, which could be a reservoir of pathogens in the upper and lower airways. The results showed a greater frequency of prosthetic stomatitis complicated by mucosal infections among COPD patients compared to healthy subjects.

Contribution of the Ogawa-Kudoh swab culture method to the diagnosis of pulmonary tuberculosis in Brazil

To analyse the contribution of the Ogawa-Kudoh (O-K) swab culture method to the diagnosis of pulmonary tuberculosis (PTB) in four different regions of Brazil. This study was carried out in two phases. Phase 1 was designed to compare the direct swab culture method (O-K) with the culture concentrated method (N-acetyl-L-cysteine-sodium hydroxide [NALC-NaOH]); for this purpose, 569 sputum samples were cultured by both methods. Phase 2 was carried out to assess the contribution of the O-K method to the diagnosis of PTB in four different regions in Brazil, based on the evaluation of 19,163 sputum samples. In the first phase of the study, O-K culture had a sensitivity of 94.8% and specificity of 99.8% in cases confirmed by NALC-NaOH/Löwenstein-Jensen (LJ) culture. In the second phase of the study, the overall contribution of O-K culture compared to acid-fast bacilli (AFB) examination (AFB-/culture+) to the diagnosis of PTB was 29.8%. O-K culture contributes significantly to the diagnosis of smear-negative PTB. Importantly, this method allows the recovery of clinical isolates in areas where use of the standard culture centrifuge is impossible, indicating that the O-K swab culture method should become a standard method for TB diagnosis in these regions.

Sperm Hy-Liter™: An effective tool for the detection of spermatozoa in sexual assault exhibits

A fluorescence-based assay specifically targeting human spermatozoa was tested and optimized for best staining results using a variety of mock sexual assault samples. Swab clippings versus whole swabs were evaluated for best sample preparation and to simplify workflow (direct application versus swab extraction). The practicality and sensitivity of Sperm Hy-Liter™ was compared to our current phase contrast microscopy protocol for searching for the presence of spermatozoa. Sperm Hy-Liter™ was more sensitive than phase contrast microscopy and was able to detect spermatozoa more effectively in actual sexual assault samples (recent [N=240] or 24 years old [N=4]) containing few spermatozoa. Correlations were drawn between the Sperm Hy-Liter™ spermatozoa counts and the AmpFlSTR(®) Profiler(®) Plus male profiles generated from the sperm cell DNA fractions of semen containing swabs and swab clippings. In addition, recovered spermatozoa from Sperm Hy-Liter™-stained slides with greater than 40 spermatozoa produced full STR male profiles in 20.3% of slides tested and partial STR male profiles in 52.8% of slides tested. The adoption of Sperm Hy-Liter™ offers a means to standardize and improve the efficiency of the microscopic screening of sexual assault evidence.

Bacteriological and Molecular Detection of Streptococcus equi subsp. equi and Streptococcus equi subsp. zooepidemicus in Equines of Northern India.

Present study was undertaken to study the prevalence of β-haemolytic streptococci in equine of northern temperate region of Jammu and Kashmir, India. One hundred and forty one samples were collected in duplicate from nasopharyngeal tract of diseased (53) and apparently healthy equine (88) for isolation and direct PCR. A total of 77 isolates of streptococci were recovered from 141 samples with an overall prevalence rate of 54.60%. Out of these 77 isolates, 52 were from diseased and 25 from apparently healthy animals. Of the 77 isolates, 4 were identified as Streptococcus equi subsp. equi, 56 as S. equi subsp. zooepidemicus and 17 as S. dysgalactiae subsp. equisimilis. Thus the overall prevalence of S. equi subsp. equi, S. equi subsp. zooepidemicus and S. dysgalactiae subsp. equisimilis was 2.83, 39.71 and 12.05% respectively. The sensitivity of the PCR for the detection of S. equi species was found higher when attempted from direct swab samples.

A retrospective evaluation of microbiology of acute otitis media complicated by spontaneous otorrhea in children living in Milan, Italy

To evaluate the microbiology of acute otitis media (AOM) with otorrhea due to spontaneous tympanic membrane perforation (STMP) in children living in Milan, Italy. We evaluated middle ear fluid (MEF) specimens taken from children affected by AOM associated with STMP and otorrhea between January 2001 and December 2011. The fluid was collected by means of direct swab sampling, sent for culture, and processed within 4 h. A total of 705 specimens were obtained from 458 children (233 boys; mean age ± SD 28.3 ± 19.9 months), and were positive for bacteria in 487 cases (69.1 %). The most frequently cultured infectious agent in single-pathogen cultures was Haemophilus. influenzae (51.0 %), followed by Streptococcus pneumoniae (19.4 %), Streptococcus pyogenes (17.4 %), and Staphylococcus aureus (10.7 %). After adjusting for the sub-period of data collection, age, gender, and previous full heptavalent pneumococcal conjugate vaccine (PCV-7) schedule, it was found that the prevalence of H. influenzae slightly increased in 2008-2010, and the prevalence of S. pneumoniae significantly decreased over time (p = 0.02). AOM with STMP is a particular form of AOM in which S. pyogenes plays a significant causative role although, as in uncomplicated cases, H. influenzae and S. pneumoniae retain their etiological importance. The frequency of the detection of S. aureus in MEF deserves further study because this pathogen can give rise to severe clinical problems. Finally, although the use of PCV-7 was relatively efficacious, the benefit of pneumococcal vaccination would be increased by vaccines including a larger number of serotypes.

Prevalence, molecular diagnosis and treatment of Mycoplasma conjunctivae isolated from infectious keratoconjunctivitis affected Lohi sheep maintained at Livestock Experiment Station, Bahadurnagar, Okara, Pakistan

Mycoplasma conjunctivae are etiological agents of infectious keratoconjunctivitis (IKC), commonly known as pink-eye in domestic sheep, goats and other wild animals in many parts of the world. A few young Lohi lambs maintained at Livestock Experiment Station (LES), Bahadurnagar, Okara, Pakistan showed clinical signs and symptoms of conjunctivitis, keratitis, severe lacrimation and varying degree of blindness. During January to March, 2011, a total of 36 ocular swabs were collected from IKC affected animals and were processed for isolation, identification, and characterization of M. conjunctivae. Sixteen (44.44%) out of 36 samples showed turbidity in PPLO broth. Twelve (75%) out of 16 broth samples showed colony growth on PPLO agar. All 16 (44.44%) out of 36 turbid broth samples, 12 (75%) out of 16 cultured on agar plate samples, and 21 (59%) out of 36 sheep ocular direct swab samples were found positive for M. conjunctivae through polymerase chain reaction test by using M. conjunctivae-specific primer pair McoF1 and McoR1 and detecting a 750 base pair fragment on agarose gel. Topical application of 0.5% sterile solution of gentamycin (100mg/ml) (Gentafar 10%, FARVET, Netherlands) proved suitable for the treatment of IKC in Lohi lambs as all clinical signs of IKC disappeared after 5days of treatment with this antibiotic. This is the first report about the prevalence, molecular diagnosis, and treatment of M. conjunctivae in Lohi sheep affected with infectious keratoconjunctivitis at LES, Bahadurnagar, Okara, Pakistan.

Evaluating a direct swabbing method for screening pesticides on fruit and vegetable surfaces using direct analysis in real time (DART) coupled to an Exactive benchtop orbitrap mass spectrometer

Rapid screening of pesticides present on the surfaces of fruits and vegetables has been facilitated by using a Direct Analysis in Real Time (DART(®)) open air surface desorption ionization source coupled to an Exactive(®) high-resolution accurate mass benchtop orbitrap mass spectrometer. The use of cotton and polyester cleaning swabs to collect and retain pesticides for subsequent open air desorption ionization is demonstrated by sampling the surface of various produce to which solutions of pesticides have been applied at levels 10 and 100 times below the tolerance levels established by the United States Environmental Protection Agency (US EPA). Samples analyzed include cherry tomatoes, oranges, peaches and carrots each chosen for their surface characteristics which include: smooth, pitted, fuzzy, and rough respectively. Results from the direct analysis of fungicides on store-bought oranges are also described. In all cases, the swabs were introduced directly into the heated ionizing gas of the DART source resulting in production of protonated pesticide molecules within seconds of sampling. Operation of the orbitrap mass spectrometer at 25,000 full-width half maximum resolution was sufficient to generate high-quality accurate mass data. Stable external mass calibration eliminated the need for addition of standards typically required for mass calibration, thus allowing multiple analyses to be completed without instrument recalibration.

Bacterial contamination of blood products

Safety is always at the top priority in transfusion medicine. With improvement of viral testing, although the risk of transfusion-transmitted viral infection is now at its very low level, bacterial sepsis has been reported repeatedly. Not only they can result in serious clinical consequence but can also lead to potential medicolegal problems. Therefore, transfusion experts have looked into the prevalence, pathogenesis, detection and risk minimization of transfusiontransmitted bacterial sepsis over the past years. Below is a short update of the subject.

Detection of single and mixed colonization of Candida species in patients with denture stomatitis

Aim: To evaluate the profile of the colonization by Candida spp. using presumptive identification to classify the patients with denture stomatitis as having single or mixed colonization, correlating with oral and systemic status. Methods: The CHROMagar Candida™ Medium (CC) for yeast culture and exfoliative cytology was used to identify colonization by Candida spp. and distinguish the different species of the Candida genus from patients with denture stomatitis (DS) and denture wearers without DS (control group). In addition, colonization was correlated with specific habits, such as tobacco and alcohol use, as well as with the use of systemic drugs. Results: Direct swabbing of whole unstimulated saliva (WUS) and palatal mucosa revealed colonization in 97.3% of the patients with DS. In the control group, 55.0% patients presented colonization. The presumptive identification found C. albicans as the most prevalent between both groups, respectively in 89.4% of the DS group and 40.0% from the control group. Regarding the nonalbicans species in the DS group, the most frequent were C. krusei (31.5%), C. glabrata (21.0%) C. tropicalis (15.7%) and Candida spp (2.6%). Smokers presented 90% of mixed isolates, and no C.albicans single colonization in the DS group, with statistically significant difference between smokers and non-smokers (p=0.0051). In the control group, the non-albicans species were C.glabrata (23.0%) and C.tropicalis (23.0%). The results of cytology from the DS group showed positive results in 22.2% of the cases. Conclusions: The use of CC was effective as a complementary method for the diagnosis of colonization by Candida spp. and DS, with the additional advantage of enabling a rapid presumptive identification of the specie. Smoking seemed to play a role in the colonization of oral mucosa by mixed albicans and non-albicans species. Mixed colonization seems to be more prevalent between patients with DS.

<i>Toxocara cati</i> infections in domestic cats from two communities in south-western Nigeria

An epidemiological survey was undertaken to study the prevalence and intensity of infection with Toxocara cati in some selected domestic cats from two communities in south-western Nigeria. Faecal samples of 200 cats were collected through a direct rectal swab using a long forceps from households with cat from Ode Irele and Oyo communities between April and September 2008 and examined for eggs of T. cati using a modified Kato-katz technique. An overall prevalence of 48.5% was recorded for T. cati infection. The overall mean intensity of T. cati infection as determined by eggs per gram of faeces (epg) was 387.20 ± 101.20. The highest prevalence of infection was recorded in cats above 48 months (> 48 months old). There was no significant difference in prevalence and intensity of infections between male and female cats (p>0.05). The prevalence of T. cati was significantly higher (p

Influence of hormone supplementation therapy on the incidence of denture stomatitis and on chemiluminescent activity of polymorphonuclear granulocytes in blood of menopausal-aged women

BackgroundMenopause is a health and social problem that affects a large number of women. Inadequate quantity of steroid hormones also impacts quality of the mucous membrane of the oral cavity. During menopausal age, many women wear removable prosthetic restorations in order to replace missing teeth. Such restorations may facilitate the development of inflammations in the surface of the oral cavity, referred to as denture stomatitis.ObjectiveThe aim of the study was to evaluate the influence of hormone supplementation therapy on the incidence of Candida-associated denture stomatitis and on the metabolic activity of polymorphonuclear granulocytes in peripheral blood of female patients.Materials and methodsThe study was conducted on a group of women in menopausal age, users of hormone replacement therapy and of removable prosthetic restorations. Female patients were subjected to a clinical study that included interviews and physical examinations. Laboratory microbiological examinations were completed on the basis of direct swabs collected from the mucous membrane of the oral cavity and from the surface of dentures. Metabolic activity of polymorphonuclear granulocytes in peripheral blood of female patients was evaluated by means of a chemiluminescence test.ResultsCandida-associated denture stomatitis observed was characterized by a strong growth of fungi and a lower chemiluminescent activity of neutrophils in blood of female patients undergoing hormone supplementation therapy.ConclusionsPatients using hormone supplementation therapy and removable prosthetic restorations constitute a high-risk group for Candida infections and inflammations of the mucous membrane of the oral cavity; thus they should remain under constant dental control.

Prospective, Multicenter Evaluation of the BD GeneOhm VanR Assay for Direct, Rapid Detection of Vancomycin-Resistant Enterococcus Species in Perianal and Rectal Specimens

The BD GeneOhm VanR assay (BD Diagnostics, San Diego, CA), a qualitative test for the rapid detection of vancomycin-resistant enterococci (VRE) from rectal and/or perianal swabs, combines integrated nucleic acid extraction and automated polymerase chain reaction for the detection of vanA and/or vanB gene sequences. We studied 1,027 perianal and rectal swab specimens from 3 geographically distinct US sites (prevalence rates, 13.1%-25.8%). Direct swab specimens were tested by the assay and compared with direct culture. The sensitivity, specificity, and positive and negative predictive values of the assay were 93.2%, 81.9%, 54.4%, and 98.1%, respectively. The specificity was limited largely due to false-positives in the vanB portion of the assay. Specificity with perianal swabs was significantly greater than with rectal swabs, 87.1% vs 74.7%, respectively (P < .0001). When used only to detect resistance conferred by vanA, the assay was 88.3% (158/179) sensitive and 95.8% (802/837) specific, with positive and negative predictive values of 81.9% and 97.4%, respectively. The assay is a simple, rapid, and acceptable method for screening for VRE in a variety of populations in which vanA is the predominant genotype. Samples positive for the vanB genotype should be confirmed by culture owing to the apparent high number of false-positive results.

Acute Herpes Zoster Infection

ImageAcute herpes zoster infection is a painful dermatomal lesion that can masquerade as a wide array of dermatologic conditions. While visiting the United States, this 26-year-old Malaysian man developed a fever and vesicular rash that extended from the right perianal region along the right intergluteal cleft and right gluteus maximus. Despite reporting a noncontributory sexual history, the patient expressed concern about having a sexually transmitted disease, and worried about the transmissibility of the rash to future sexual partners. Sacral herpes zoster infection was confirmed by direct fluorescent antigen swab obtained from the base of one of the vesicular lesions. The patient was lost to follow-up and unavailable for further HIV testing. Sacral herpes zoster infection should be considered in the differential diagnosis of new onset unilateral anal rash. When it presents in a young individual, it may suggest undiagnosed HIV infection. Return to EM-News.com

A novel rapid and effective donor arm disinfection method

The aim of the study was to derive a donor arm disinfection technique that was rapid, but with a disinfection efficacy equivalent to a previous "best-practice" technique. This method consisted of a two-stage procedure with an initial application of 70% isopropyl alcohol and then 2% tincture of iodine (IATI). The total time for the IATI method was 2 minutes in duration. A rapid technique (1 min in duration) was needed to obviate potential problems due to increased donor waiting time, had the IATI method been implemented at blood donation sessions. A direct swabbing and plating technique was used to enumerate bacteria present before and after disinfection. In total, seven methods were evaluated. The chlorhexidine/alcohol applicator (CAA) disinfection device containing 1.5 mL of 2% chlorhexidine gluconate and 70% isopropyl alcohol (99.91% reduction; confidence limits, 99.55%, 99.98%) was shown to have equivalent disinfection efficacy as the IATI method (99.89% reduction; confidence limits, 99.36%, 99.98%; p = 0.86). Procedural time for the 1.5-mL CAA method was 1 minute thereby avoiding potential problems of increased donor waiting time, inherent in the IATI 2-minute procedure at blood donation sessions. The 1.5-mL CAA disinfection method offers blood services a rapid and effective donor arm disinfection procedure. In 2006, the 1.5-mL CAA procedure was implemented throughout the entire English blood service for all donations.