Effectiveness of preoperative decolonization with nasal povidone iodine in Chinese patients undergoing elective orthopedic surgery: a prospective cross-sectional study

Staphylococcus aureus colonization in the nares of patients undergoing elective orthopedic surgery increases the potential risk of surgical site infections. Methicillin-resistant S. aureus (MRSA) has gained recognition as a pathogen that is no longer only just a hospital-acquired pathogen. Patients positive for MRSA are associated with higher rates of morbidity and mortality following infection. MRSA is commonly found in the nares, and methicillin-sensitive S. aureus (MSSA) is even more prevalent. Recently, studies have determined that screening for this pathogen prior to surgery and diminishing staphylococcal infections at the surgical site will dramatically reduce surgical site infections. A nasal mupirocin treatment is shown to significantly reduce the colonization of the pathogen. However, this treatment is expensive and is currently not available in China. Thus, in this study, we first sought to determine the prevalence of MSSA/MSRA in patients undergoing elective orthopedic surgery in northern China, and then, we treated the positive patients with a nasal povidone-iodine swab. Here, we demonstrate a successful reduction in the colonization of S. aureus. We propose that this treatment could serve as a cost-effective means of eradicating this pathogen in patients undergoing elective orthopedic surgery, which might reduce the rate of surgical site infections.

Alcoholic povidone-iodine or chlorhexidine-based antiseptic for the prevention of central venous catheter-related infections: In-use comparison

To make a field comparison of the effectiveness, ease of use, and cost of a chlorhexidine antiseptic solution [CBA] and an alcohol-based povidone-iodine solution [PVP-IA] for the prevention of central venous catheter [CVC]-related infections in an intensive care unit, with the aim of identifying the superior antisepsis agent. We measured the CVC colonization and infection incidence for PVP-IA [Betadine alcoolique] and for CBA [Biseptine] during two successive 1-year periods of routine surveillance [REA RAISIN network]. A questionnaire on the ease of CBA use was administered. Consumption data were obtained from the hospital pharmacy. The study included 806 CVC [CBA period: 371]. Upon switching from PVP-IA to CBA, we recorded a significant reduction in colonization incidence/100 catheter days [1.12 vs. 1.55, p = 0.041], nonsignificant differences concerning CVC-related infection incidence/100 catheter days [0.28 vs. 0.26, p = 0.426], and a nonsignificant reduction in CVC-related bacteremia/100 catheter days [0.14 vs. 0.30, p = 0.052]. PVP-IA users were at significantly higher risk of CVC colonization or infection based on a multivariate Cox model analysis [relative risk [95% Cl]: 1.48 [1.01-2.15], p = 0.043]. The main drawbacks of CBA use were its low cleansing activity and its colorless solution. No cost advantage was found. Our field study revealed no major clinical advantage of CBA use in CVC infection and no cost advantage in addition to limited ease of use. 2011 Published by Elsevier Limited on behalf of King Saud Bin Abdulaziz University for Health Sciences. All rights reserved

Effectiveness and microbial contamination of an in-house alcohol-based hand rub.

OBJECTIVES: To evaluate the effectiveness and contamination of an in-house alcohol-based hand rub in a real clinical setting and to compare its effectiveness in bacterial reduction with that of a commercial product. MATERIAL AND METHOD: Effectiveness of the hand rub in bacterial reduction was compared to a commercial product using the modified antiseptic/disinfectant testing method of European Standard (EN 1500) in 12 volunteers. In-house alcohol-based hand rub in 50 clinical wards were serially collected and cultured to determine contamination. RESULTS: The bacterial reduction factor of the hand rub was comparable to that of the commercial product. There was no organisms grown from serial cultures of the in-house alcohol-based hand rub in use for 28 days. CONCLUSION: The in-house alcohol-based hand rub was effective and there was no contamination up to 28 days in use.

Use of antiseptics and disinfectants in Thailand 1990.

A survey by questionnaire was done in March and April 1990 on the use of antiseptics and disinfectants (A/D). Twenty-seven hospitals with 675 wards were enrolled. Results showed that the cost of A/D was 3.3 to 8.1 per cent of the total expenses for drugs. Essential A/D were available and used in most places. Many low level A/D, which have been excluded from modern hospitals, were still employed. Contamination of A/D was a real threat due to improper preparation, unclean containers and refill practices in many wards. Improper applications of A/D, namely: overuse, underuse, and wrong choices were found in many places. Textbooks and written guidelines were available but it is unlikely that they were referred to in practice. A national policy on the use of A/D and proper education to medical personnel are clearly needed.

Estudo prospectivo randomizado do uso de um antisséptico tópico no campo operatório / A prospective study about the use of topical antissepsis the skin surgical area

Os autores apresentam um estudo prospectivo da antissepsia do campo operatório. Foram estudados 188 pacientes, divididos em dois grupos. O grupo A, com 98 pacientes, onde foi utilizado uma soluçäo degermante de iodo-iodeto de K (iodo a 1por cento) e um grupo B, com 90 pacientes em que se realizou a antissepsia do campo operatório com a mesma soluçäo utilizada no grupo A, acrescido com álcool iodado a 1por cento. Os resultados näo demonstraram vantagens na utilizaçäo do álcool iodado em relaçäo a incidência de infecçäo de ferida, queimaduras e dermatites