ABSTRACT
We present two patients with colorectal carcinoma who were admitted with fever and diarrhoea during treatment with chemotherapy. Blood cultures taken from both patients revealed an infection with Listeria monocytogenes. A contaminated ice cream was probably the source of infection in one patient. The other patient died of the listeriosis. Patients with diminished cellular immunity are at risk of invasive listeriosis. Listeriosis has a high mortality rate in this group of patients. Intravenous penicillin or ampicillin for 4 to 6 weeks is the first choice of antibiotic treatment. These antibiotics can be combined with an aminoglycoside or trimethoprim-sulfamethoxazole for a synergistic effect. To prevent invasive listeriosis we recommend strict dietary advice to all patients with diminished cellular immunity.
Subject(s)
Diarrhea/diagnosis , Fever/diagnosis , Ice Cream/microbiology , Listeriosis/diagnosis , Anti-Bacterial Agents/therapeutic use , Diarrhea/drug therapy , Diarrhea/microbiology , Fatal Outcome , Fever/drug therapy , Fever/microbiology , Foodborne Diseases/complications , Foodborne Diseases/microbiology , Humans , Immunocompromised Host , Listeria monocytogenes , Listeriosis/complications , Listeriosis/drug therapy , Male , Middle Aged , Risk FactorsABSTRACT
This study was designed to establish a shelf life for processed (peracetic acid) flexible colonoscopes and to demonstrate the adequacy of manual cleaning procedures. The study challenges current practice in Australia where endoscopes are routinely reprocessed prior to use if the endoscope has been sitting at least overnight. The design was a simulated study in the clinical environment and involved artificial contamination of a colonoscope, cleaning validation, and a time series analysis after processing with peracetic acid in a Steris System 1 processor and drying with 100% isopropyl alcohol. The main outcome measure was the presence of bacteria in the internal channels of the colonoscope after cleaning and at 24 and 168 hours after processing with peracetic acid. The findings suggest that colonoscopes may be left for up to 1 week before needing to be reprocessed before use, provided all channels are thoroughly reprocessed and dried, resulting in cost savings and reduced wear and tear on the instruments. The findings also demonstrate the impact of providing feedback to staff on a regular basis about the efficacy of their cleaning techniques.
