Transcript comparison

Sheldon Manufacturing, Inc.
A Comparison
Anaerobic Jars/Gas Pack Systems
&
Anaerobic/Environmental Chambers
Sheldon Manufacturing, Inc.
The purpose for any laboratory procedure
is to:
•
Effectively and efficiently aid in diagnosis
of patient disease or disorder.
•
Enable the physician to determine and
implement the most effective treatment for
optimal patient outcome.
•
Attain the above objectives in a costeffective manner.
Sheldon Manufacturing, Inc.
The purpose of anaerobic bacteria culture
procedures, therefore, include:
•
Complete, accurate and rapid identification
of all anaerobic bacterial pathogens
contributing to patient infection.
•
Enabling the physician to determine and
implement the most effective treatment in
terms of antibiotic therapy.
•
Attaining the above objectives in a cost
effective manner.
Sheldon Manufacturing, Inc.
Anaerobic Jars:
•
May be “perceived” to be equivalent in
efficacy to anaerobic chambers.
•
May be “perceived” to provide greater user
efficiency & productivity than a chamber.
•
May be “perceived” as less costly than a
chamber.
•
May be “perceived” to provide greater user
convenience than a chamber.
Sheldon Manufacturing, Inc.
Anaerobic Jars:
•
Will anaerobic jars provide complete, accurate
and rapid identification of anaerobic bacterial
pathogens?
•
Will anaerobic jars enable the physician to
develop and implement effective treatment in a
timely manner for optimal patient outcome?
•
Will anaerobic jars accomplish the above as
well or better than an anaerobic chamber?
According to Microbiology experts*, the answer to all
of the above is “Maybe or No”.
(*Dr. Joan Barenfanger, Mike Cox, etc.)
Sheldon Manufacturing, Inc.
Anaerobic Jars vs. Anaerobic Chamber - Efficacy
Oxygen is toxic for most anaerobes and exposure to oxygen inhibits and
can, on occasion, prevent anaerobe growth. Multiple studies have
demonstrated that anaerobic jars are inferior to anaerobic chambers in
terms of anaerobe recovery, rate of growth, and therefore isolation and
identification.
The basic deficiency of an anaerobic jar system is the need to expose
the anaerobes to, what is for those organisms, a“toxic gas”. The toxic
gas is oxygen.
Even if jars don’t leak during incubation the technologist must expose
the anaerobes to oxygen during the plating process and, subsequently,
for isolation, sub culturing and susceptibility testing. Phone calls and
other interruptions to workflow can increase the exposure to oxygen.
This simply does not occur when initial and subsequent culture is
performed in an anaerobic chamber.
Sheldon Manufacturing, Inc.
The apple below was cut in half. The left half was put in an
anaerobic chamber, the right half left in aerobic conditions for thirty
minutes. If you put the apple half on the right in an anaerobic jar or
chamber, the brown color (oxidation) will not be reversed. The
oxidized cells of the apple are dead.
Sheldon Manufacturing, Inc.
The picture below shows an anaerobic organism exhibiting the
effects of exposure to oxygen. Note the serious damage to the cell
membrane. This damage will not be reversed in an anaerobic jar.
Sheldon Manufacturing, Inc.
Anaerobic Jars vs. Anaerobic Chamber - Efficacy
In summary, noted Microbiologists state that initial and subsequent
exposure to oxygen, inherent with anaerobic jar systems, impair growth
and survival of anaerobic pathogens.
At best, using a jar system retards anaerobic bacteria growth and leads to
delays in identification and determination of the most effective treatment
protocol.
At worst, some anaerobic pathogens are not identified or susceptibility
testing is inaccurate. Again patient treatment is negatively affected and
patient outcome may be less than satisfactory.
Using an anaerobic chamber eliminates the unwanted exposure to oxygen
and resulting anaerobe oxidation. An anaerobic chamber promotes rapid
growth of all anaerobes, quicker, more accurate identification and, thus,
more effective treatment and better patient outcome.
Sheldon Manufacturing, Inc.
Anaerobic Jars:
•
Is an anaerobic jar system a more cost
effective system for anaerobic procedures
than an anaerobic chamber?
•
Doesn’t the cost of an anaerobic chamber
mean that a jar system will be much less
costly?
Again, according to Microbiology experts*, the answer
to the above is “No”. (*Dr. Joan Barenfanger, Mike Cox, etc.)
Sheldon Manufacturing, Inc.
Anaerobic Jars versus Anaerobic Chamber Costs:
An independent “cost in use” study compared the long run cost of using
an anaerobic jar system versus an anaerobic chamber (a BACTRON ) for
clinical laboratory anaerobic procedures, initial culture, isolation,
identification and susceptibility testing.
The study considered the costs for both systems, associated disposable
supplies and materials and staff labor costs. Study results projected a
long run, per plate cost with anaerobic jars of $0.96. The long run, per
plate cost for the BACTRON anaerobic chamber was $0.09, less than
10% of that for of the jar system. The chart in the next slide
demonstrates that, even considering the purchase price of a BACTRON
IV, a jar system is more expensive than a chamber after three years.
The study, also noted that patient diagnosis and effective treatment was
prolonged with the anaerobic jar system resulting in increased patient
care days and added cost in that area as compared to an anaerobic
chamber.
Sheldon Manufacturing, Inc.
Anaerobic Jars versus Anaerobic Chamber Costs:
25
Plates/Day
Cost: Jars vs. the BACTRON
Assumes: 250 working days/year.
$0.96/plate for Jars and $0.09/plate for the
BACTRON Anaerobic Chamber.
2005
$6,000
$17,463
Anaerobic Jars
SHEL LAB BACTRON
30
Plates/Day
40
Plates/Day
2006
$7,200
$675.00
Three Year
Cost
$22,800
$19,038
2007
$9,600
$900.00
"Cost in Use" Analysis: Anaerobic Jars versus the BACTRON
$25,000
Purchase BACTRON IV for
$16,900 in 2005.
$20,000
$15,000
Anaerobic Jars
SHEL LAB BACTRON
$10,000
$5,000
$0
2005
2006
2007
Three Year Cost
Sheldon Manufacturing, Inc.
Anaerobic Jars vs. Anaerobic Chamber - Cost
In summary, an Independent Study (Barenfanger et al) concludes that
mid to long run (three to five years) costs for anaerobic jars exceeds that
of an anaerobic chamber.
The “cost-per-plate” for anaerobic jars is estimated to be more than ten
times the “cost-per-plate” for anaerobe chambers. It is true that the
anaerobe chamber certainly involves a significantly high year-one
investment cost in the chamber purchase price. However, the ongoing
cost for anaerobe jar system disposables and replacement items (new
jars, gas packs, indicator strips) begins to equal the investment in the
chamber purchase and chamber gas costs in two to three years. By year
three to five, the cost to use anaerobe jars exceeds that of the chamber
disposables and the original purchase price.
Since durable SHEL LAB BACTRON chambers have a working life of ten to
fifteen years, the savings with an anaerobe chamber become exponential
in ten years.
Sheldon Manufacturing, Inc.
Anaerobic Jars:
Does an anaerobic jar system offer the Microbiologist
a more convenient, comfortable system?
Comfort and convenience are relative, subjective terms.
However, removing numerous anaerobic jars from an
incubator, transferring them to a bench, unsealing all
those jars, and hurriedly trying to complete sub culturing
(to limit oxygen exposure and oxidation) does not seem
convenient. Neither does quickly re-loading, resealing
and returning all the jars to the incubator.
In fact, it seems highly stressful for the Microbiologist
and the anaerobic bacteria.
Sheldon Manufacturing, Inc.
Anaerobic Jars:
Does an anaerobic jar system offer the Microbiologist
a more convenient, comfortable system?
The anaerobic chamber is a fully-functional laboratory
bench and incubator.
All necessary media, equipment and supplies are close at
hand. Specimens and culture plates right where the
Microbiologist needs them. The work area and chamber
incubator are always at ideal anaerobic conditions. The
Microbiologist can work at a reasonable pace, under
comfortable room temperature conditions, without
concern regarding exposure of the anaerobic bacteria to
toxic oxygen.
This seems more convenient and comfortable for the
Microbiologist and less stressful for anaerobic bacteria.
Sheldon Manufacturing, Inc.
A Comparison
Anaerobic Jars/Gas Pack Systems
&
Anaerobic/Environmental Chambers
Thank you for your time.
Questions or comments, please ?????