Comparison of a Waterless, Brushless Chlorhexidine/Ethanol Emollient with Povidone-Iodine Surgical Scrubs / 병원감염관리

BACKGROUND: The purpose of this study was to compare a 1% chlorhexidine gluconate/6l% ethanol (CHG/Ethanol) emollient and 7.5% povidone-iodine (PVI) scrub for antibacterial efficacy and effect on skin condition. METHODS: Twelve healthy newly employed nurses were recruited for this clinical study to evaluate the two hand cleansing agents. The CHG/Ethanol emollient hand preparation was applied without scrubbing and 7.5% PVI was applied using a scrub brush in 5-minute surgical scrubbing. Subjects used one method for 5 days and switched to the other method for another 5 days. Samples were taken for bacterial counts using the glove juice technique before and one minute after hand cleansing and again at the end of surgical operation on Day 1, 2, and 5. The VSS (Visual Scoring of Skin condition) scores and HSA (Hand Subject Assessment) scales were used to evaluate skin condition. RESULTS: Log reduction in bacterial counts by CHG/Ethanol emollient was greater than by PVI immediately after hand cleasing (log3.73 vs log1.66) and at the end of surgical operation (log3.49 vs log1.93) on Day 1. But there were no significant difference on Day 2 and 5. CHG/Ethanol emollient caused fewer skin problems than PVI; the VSS scores of the CHG/Ethanol emollient were better than those of PVI on Day 2, 3, 4, and 5 (P24.5 vs 23.0-->19.3). CONCLUSION: Compared to PVI, the CHG/Ethanol emollient hand preparation was shown to be more antibacterial and less irritation to skin. The results showed the possibility of using the waterless, scrubless agent for surgical hand scrub in Korea.

Three Cases of Bacteremia by Capnocytophaga spp / 대한임상병리학회지

Capnocytophaga spp. are thin, spindle-shaped, gram-negative bacilli, similar to fusobacteria. We isolated Capnocytophaga from the blood of three patients with fever: two acute myelogenous leukemia patients and one chronic osteomyelitis patient. The patients showed mild course of disease without hypotension or the change of mental status. As Capnocytophaga spp. are slow growing bacteria, there were difficulties in the isolation and susceptibility test of bacteria. More concerns should be given to the uncommonly isolated bacteria such as Capnocytophaga.

A Case of Bacteremia by Plesiomonas shigelloides / 대한임상미생물학회지

Plesiomonas shigelloides was isolated from blood culture of a 53-year-old man with fever, who had treatment history of gastrointestinal malignancy. The patient showed neither clinical features nor hematological finding which suggest bacteremia. Identification of the isolate was delayed because of its similar characteristics with Aeromonas spp. and other gram-negative bacilli. The isolate was misinterpreted as susceptible to ampicillin by the first disk diffusion test. It may not always easy to identify P. shigelloides by conventional tests and to determine its antimicrobial susceptibility accurately, as laboratorians rarely have experience with the organism and as the organism may show unusual inhibition pattern when tested by disk diffusion method or Etest.

A Case of Bacteremia by Plesiomonas shigelloides / 대한임상미생물학회지

Plesiomonas shigelloides was isolated from blood culture of a 53-year-old man with fever, who had treatment history of gastrointestinal malignancy. The patient showed neither clinical features nor hematological finding which suggest bacteremia. Identification of the isolate was delayed because of its similar characteristics with Aeromonas spp. and other gram-negative bacilli. The isolate was misinterpreted as susceptible to ampicillin by the first disk diffusion test. It may not always easy to identify P. shigelloides by conventional tests and to determine its antimicrobial susceptibility accurately, as laboratorians rarely have experience with the organism and as the organism may show unusual inhibition pattern when tested by disk diffusion method or Etest.