[Infusion technique as a significant aspect of public health monitoring of hospitals--a case report]. / Infusionstechnik als bedeutsamer Aspekt bei der amtsärztlichen Uberwachung von Krankenhäusern--ein kasuistischer Beitrag.

An outbreak of septicaemia caused by Acinetobacter involved eight patients of an ICU within a period of 6 days. All patients were treated with heparin infusions. We isolated Acinetobacter from the blood of all these patients and from a mixture of heparin and isotonic saline solution. As underlying causal event a combination of risk factors and mistakes is suggested. These may include the multiple reuse of infusion bottles by different users, the reuse of perfusor injectors, and underscores the necessity of strict hygienic precautions. This event points to a disseminated risk factor that should be considered within the frame of control systems for hospitals.

Elevated endogenous nitrate synthesis associated with giardiasis.

Mean nitrate content in the morning urine of 117 patients with giardiasis comprises 155.3 mg/l, which exceeds about 4 fold the normal value. Maximum concentrations of 1000 mg/l were observed. Under treatment with metronidazol (Vagimid) nitrate content at first increased and then restored to normal. Endogenously synthesized nitrate with giardiasis 3-4 fold exceeds the daily nitrate intake by food and, therefore, plays an important role in total nitrate load of the patients.

[Contributions of experimental and clinical medicine to environmental medicine]. / Beiträge der experimentellen und klinischen Medizin zur Umweltmedizin.

Contributions towards the system of risk assessment and risk management are the most important topical tasks to be solved by environmental medicine. This covers the whole range of hazard evaluation for chemicals, assessment of exposure (biomonitoring), systematic development of biological markers for effects and the detection of damages on the organism-, organ-, cellular and subcellular level, the epidemiology of environmentally related diseases, and the elaboration of computer-assisted models for the conception of risk assessment and risk management in terms of a better preventive efficiency in the field of environmental medicine.

A study of Campylobacter jejuni and Campylobacter coli in a river system.

Campylobacter isolates were detected in 82.1% of river water samples moderately polluted with organic wastes. In the majority of the samples less than 10 Campylobacter cfu/100 ml were detectable. The presence of waterfowl and the faecal contamination from a poultry-farm resulted in considerable higher Campylobacter contents (greater than 240/100 ml). Correlation studies showed a high correlation coefficient (P less than 0.05) between the number of campylobacters and that of total coliforms. Campylobacter isolates were never found in river water samples of 100 ml of volume with total coliform contents less than 10/ml. Campylobacter contents and the spectrum of serotypes isolated indicate hygienic precautions for drinking water supply from oligotrophic surface waters if the water is distributed without chlorination.

[Immunoassays. Performance efficient methods of analysis for environmental toxicologic research and practice]. / Immunoassays. Leistungsfähige Analysenmethoden für die umwelttoxikologische Forschung und Praxis.

A review is presented which summarizes the development and application of immunoassays for pesticides and other environmental pollutants. Especially, in the last ten years an increased activity in that field can be noted. With the production of monoclonal antibodies an essential prerequisite is realized for standardization and commercialization of that methods. Potential application fields are routine measurements of environmental probes, biomonitoring in occupational hygiene and in epidemiological studies, determination of compounds difficult to analyze by classical analytical methods, application in chemical damages, control of hazardous waste deposits as well as for quality control of biotechnological products. Related research should be forced also in the GDR.

Characterization of Campylobacter jejuni and Campylobacter coli isolated from waste water.

The raw sewage samples of the investigated municipal sewage plant (sewage flow of about 30,000 m3/d) contained about 10(3) campylobacters/100 ml. The sewage plant reduced 80.8% of organic wastes (COD), 85.0% of colony counts (20 degrees C), 92.5% of total coliforms and 88.0% of campylobacters. The sewage plant effluent contained an average of 1.3 X 10(2) campylobacters/100 ml. About 10(10) campylobacters are discharged with the effluent of the high-output sewage plant into the receiving water every day. No reduction of the indicator bacteria was found in the activated sludge tank, there was, however, a significant reduction (94.5%) of campylobacters. In total, 94 strains were differentiated by biotyping and serotyping. 59.6% were found to be Campylobacter jejuni and 40.4% were Campylobacter coli. 8 Serotypes were found among the C. jejuni strains and 12 among C. coli. The raw sewage of the investigated oxidation pond treatment plant contained an average of 51 campylobacters/100 ml. The sewage plant effluent did not show campylobacters in any case.

Radioimmunoassay for 2,4-dichlorophenoxyacetic acid.

Antisera to 2,4-dichlorophenoxyacetic acid (2,4-D), a widely used herbicide, have been obtained from rabbits following immunization with various 2,4-D-protein conjugates. Employing [125I] 2,4-D-tyramine as the radioligand for the antisera, very poor assay sensitivity was achieved because of a much higher affinity of the antibodies to the tracer. When using [6-3H] 2,4-D(specific radioactivity 465 GBq/mmol) a sensitive and specific radioimmunoassay (RIA) for 2,4-D could be developed, which allows determination directly in water, plasma and urine samples. Levels as low as approximately 100 pg (450 femtomoles) of 2,4-D can be detected. The antiserum is fairly specific for 2,4-D. Other related phenoxycarboxylic acids and dichlorophenol showed a cross-reactivity smaller than 10%. After a single administration of 2,4-D (0.91 mg/100 g body weight, orally) to rats, plasma and urine levels were determined at different times. Results correspond to those found in the literature, thus indicating the utility of the RIA. Further applications and limitations are discussed.

[Use of paraformaldehyde tablets for bacterial count reduction, disinfection, cold sterilization, and sterile preservation of medical instruments. 3: On the use of paraformaldehyde tablets in medical institutions]. / Untersuchungen über den einsatz von paraformaldehydtabletten zur Keimzahlverminderung, Desinfektion, Kaltsterilisation und Sterilaufbewahrung von ärztlichem Instrumentarium.

Paraformaldehyde tablets are very effective against a wide spectrum of organisms. They may be recommended for targeted degerming measures in medical practice. Their utilization requires the observance of the conditions necessary for their efficient use. The tablets should be employed only in containers which are as tight-fitting as possible (preferentially instrument cabinets, Heynemann cabinets, catheter boxes and plastic bags). Paraformaldehyde tablets are well suited for the reduction of the bacterial population and the storage of nonwrapped sterilized instruments. For this purpose, 1 tablet/dm3 is needed. The exposure time required for bacterial count reduction is no less than 3 h. Despite certain limitations, paraformaldehyde tablets may be used for disinfecting. The objects to be disinfected should be neither too contaminated nor too soiled. The minimum period of exposure is 5 h, and 10 tablets/dm3 are necessary. Cold sterilization requires 10 tablets/dm3, too; but the exposure time ranges from 15 to 24 h. This method (which must be considered an expedient) should be employed only if the respective device or instrument cannot be sterilized by other sterilizing techniques. In any case, 80% relative air humidity is a must in the devices in which paraformaldehyde tablets are used.

Long-term study of virus contamination of surface water in the German Democratic Republic.

Between 1 January 1970 and 31 December 1979, a study of the concentration of viruses in surface water was carried out by 4 virological laboratories in different regions of the German Democratic Republic. All these laboratories used the same methods for virus detection.Altogether 1908 samples from 30 sampling points were evaluated. The rate of virus isolation ranged from 8% to 92% with a mean of 20%. There were considerable differences in isolation rate among the sampling points, and the rate for any particular point varied from year to year.The mean value of virus concentration, determined by the most probable number technique, was 2.7 cytopathogenic units (CU) per litre, while the maximum was 22.1 CU/litre. Viruses seen throughout the 10-year investigation included poliovirus, types 1, 2, and 3, echovirus types 6, 11, and 30, and coxsackievirus B 3 and B 5; echovirus 7 and 24, coxsackievirus B 1, and adenovirus 5 were seen occasionally. The results of the study reflected the high level of use of surface waters in the German Democratic Republic.Where water is intended for human use, e.g., as drinking-water or for recreation, reasonable safety measures, such as water treatment and disinfection, should be taken, in order to ensure that the level of viral contamination is within the permissible limits.