The use of water jackets to provide thermal mass in some incubators delivers limited holding capability, but as the jacketed water undergoes sensible heating (rather than latent heating), it changes temperature rapidly as energy is added to or removed from the system. Additionally, if laboratory climate control is not provided and the ambient temperature rises, cultures may die off, again resulting in false-negative results. Incorrect incubation temperatures will also provide misleading DST results. Without continual power for conventional incubators, cultures held at lower than optimal temperatures may show false-negative results due to slow growth. Temperature control is critical for microbiological culture. The availability of incubators that maintain constant temperatures on poor electrical grids and have low maintenance requirements would partially address this problem and allow health systems to begin developing more comprehensive microbiological diagnostic and surveillance programs. This results partly from the high cost of incubators, the necessity of reliable mains power to maintain culture temperatures, supply of commodities, and availability of technicians trained in microbiological techniques. It remains essential for monitoring and managing the global rise in antimicrobial resistance (AMR).Ĭulture-based diagnostics and screening tools are very poorly accessible at lower levels of the tiered laboratory diagnostic network of most low-resourced health systems. Despite the increasing availability of other detection methods such as immunoassays and nucleic acid amplification technologies, the need for accurate phenotypic drug susceptibility testing (DST) will continue, and microbiological culture is likely to remain the mainstay and gold standard of laboratory diagnosis and DST for the foreseeable future. Microbiological culture remains important for diagnosis and surveillance of certain diseases through controlled growth of pathogens, and for determining antimicrobial drug resistance to inform patient treatment and/or integrated disease surveillance and response. The results indicate that the device will maintain stable culture temperatures across periods of intermittent power supply, while enabling normal workflow of this could greatly increase the availability of microbiological culture for diagnosis and antimicrobial resistance (AMR) monitoring. The prototypes successfully held their temperature to within ☑ ☌ in both laboratory environmental chamber testing as well as during the field test. Five prototypes were tested in a laboratory setting using environmental test chambers and programmable power supplies, and three were field tested in the Lao PDR in situations of intended use. During power outages, stable temperatures are maintained in the device's internal sample compartment by employing phase change material (PCM) as a bi-directional thermal battery to maintain incubation temperature. The device is designed to enable adherence to incubation temperatures recommended for growth detection, identification, and drug susceptibility testing (DST) of human pathogenic bacteria. To help address the limitations of operating conventional microbiological culture incubators in low resource environments, a new incubator design was developed and tested to meet the requirements of operation in laboratories without reliable power (power outages up to 12 contiguous hours) or climate control (ambient indoor temperatures from 5 ☌ to 45 ☌).
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