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1.
J Hosp Infect ; 119: 9-15, 2022 Jan.
Article in English | MEDLINE | ID: mdl-34619268

ABSTRACT

BACKGROUND: Surgical site infections after total hip and knee replacement are linked to the quality of the operating room (OR) air. Applying tight occlusive clothing, effective ventilation and correct working methods are key concepts to obtain low bacterial concentrations in the OR air. The dry penetration test referred to in European standard EN 13795-2:2019 is a screening method for materials used in surgical clothing. Source strength, defined as the dispersal of bacteria-carrying particles from persons during activity, is a functional test of clothing systems and has been calculated in a dispersal chamber and in ORs. Results from both tests can be used when comparing surgical clothing systems. AIM: This study relates results of dry penetration tests to source strength values for five surgical clothing systems available on the Swedish market. METHODS: Experimental data are reported on the function of these products, expressed as source strength calculated from results in a dispersal chamber and in ORs during orthopaedic operations. FINDINGS: All materials tested with dry penetration ≤50 colony-forming units (cfu) had source strength values <3 cfu/s for one person in the dispersal chamber, whereas the material of one product when laundered >50 times had source strength in the dispersal chamber of up to 8 cfu/s. CONCLUSION: The dry penetration test could predict the performance of clean air suits of the same design, but more studies are needed to obtain a more valid correlation. Requirements of source strength should be included in standards.


Subject(s)
Air Microbiology , Operating Rooms , Bacteria , Drug Contamination , Humans , Surgical Wound Infection , Ventilation
2.
J Hosp Infect ; 91(2): 166-70, 2015 Oct.
Article in English | MEDLINE | ID: mdl-26213368

ABSTRACT

BACKGROUND: The adenosine triphosphate (ATP) method is widely accepted as a quality control method to complement visual assessment, in the specifications of requirements, when purchasing cleaning contractors in Swedish hospitals. AIM: To examine whether the amount of biological load, as measured by ATP on frequently touched near-patient surfaces, had been reduced after an intervention; to evaluate the correlation between visual assessment and ATP levels on the same surfaces; to identify aspects of the performance of the ATP method as a tool in evaluating hospital cleanliness. METHODS: A prospective intervention study in three phases was carried out in a medical ward and an intensive care unit (ICU) at a regional hospital in mid-Sweden between 2012 and 2013. Existing cleaning procedures were defined and baseline tests were sampled by visual inspection and ATP measurements of ten frequently touched surfaces in patients' rooms before and after intervention. The intervention consisted of educating nursing staff about the importance of hospital cleaning and direct feedback of ATP levels before and after cleaning. FINDINGS: The mixed model showed a significant decrease in ATP levels after the intervention (P < 0.001). Relative light unit values were lower in the ICU. Cleanliness as judged by visual assessments improved. In the logistic regression analysis, there was a significant association between visual assessments and ATP levels. CONCLUSION: Direct feedback of ATP levels, together with education and introduction of written cleaning protocols, were effective tools to improve cleanliness. Visual assessment correlated with the level of ATP but the correlation was not absolute. The ATP method could serve as an educational tool for staff, but is not enough to assess hospital cleanliness in general as only a limited part of a large area is covered.


Subject(s)
Adenosine Triphosphate/analysis , Environmental Microbiology , Housekeeping, Hospital/methods , Housekeeping, Hospital/standards , Infection Control/methods , Infection Control/standards , Microbiological Techniques/methods , Hospitals , Humans , Prospective Studies , Quality Control , Sweden
3.
J Hosp Infect ; 76(1): 26-31, 2010 Sep.
Article in English | MEDLINE | ID: mdl-20359768

ABSTRACT

An outbreak of multidrug-resistant Klebsiella pneumoniae producing the extended-spectrum beta-lactamase CTX-M15 affected 247 mainly elderly patients in more than 30 wards in a 1000-bedded swedish teaching hospital between May 2005 and August 2007. A manual search of the hospital administrative records for possible contacts between cases in wards and outpatient settings revealed a complex chain of transmission. Faecal screening identified twice as many cases as cultures from clinical samples. Transmission occurred by direct and indirect patient-to-patient contact, facilitated by patient overcrowding. Interventions included formation of a steering group with economic power, increased bed numbers, better compliance with alcohol hand disinfection and hospital dress code, better hand hygiene for patients and improved cleaning. The cost of the interventions was estimated to be euro3 million. Special infection control policies were not necessary, but resources were needed to make existing policies possible to follow, and for educational efforts to improve compliance.


Subject(s)
Cross Infection/epidemiology , Infection Control/methods , Klebsiella Infections/epidemiology , Adolescent , Aged , Aged, 80 and over , Bacterial Proteins/biosynthesis , Child , Child, Preschool , Cross Infection/microbiology , Cross Infection/prevention & control , Female , Hospitals, Teaching , Humans , Infection Control/economics , Klebsiella Infections/microbiology , Klebsiella Infections/prevention & control , Klebsiella pneumoniae/enzymology , Klebsiella pneumoniae/isolation & purification , Male , Middle Aged , Sweden/epidemiology , Young Adult , beta-Lactamases/biosynthesis
4.
J Hosp Infect ; 64(3): 217-23, 2006 Nov.
Article in English | MEDLINE | ID: mdl-16979262

ABSTRACT

All healthcare settings around the world face the problem of healthcare-associated infections (HCAIs). Rates of infection vary between countries and within the same country depending on resources, interest of caregivers and healthcare staff, and patients' socio-economic situation. According to recent publications, 10-70% of HCAIs are preventable. Failure to comply with guidelines on hand hygiene, glove and gown use, and barrier nursing is a problem and unnecessary infection control measures are costly. National legislations and regional, national and international standards and guidelines associated with infection control also have an impact for countries that are not directly involved. They should be based on the assessment of infection risk, and should not increase costs unnecessarily. The International Federation of Infection Control and national infection control societies play an important role in continuing the education of infection control specialists.


Subject(s)
Cross Infection/prevention & control , Hand Disinfection/standards , Infection Control/standards , Protective Clothing/standards , Global Health , Guidelines as Topic , Hand Disinfection/methods , Health Policy , Humans , Infection Control/trends , Internationality , Patient Isolation/methods , Patient Isolation/standards , Protective Clothing/statistics & numerical data
5.
Infect Control Hosp Epidemiol ; 22(6): 338-46, 2001 Jun.
Article in English | MEDLINE | ID: mdl-11519910

ABSTRACT

OBJECTIVES: To trace the routes of transmission and sources of Staphylococcus aureus found in the surgical wound during cardiothoracic surgery and to investigate the possibility of reducing wound contamination, with regard to total counts of bacteria and S. aureus, by wearing special scrub suits. METHODS: A total of 65 elective operations for coronary artery bypass graft with or without concomitant valve replacement were investigated. All staff present in the operating room wore conventional scrub suits during 33 operations and special scrub suits during 32 operations. Bacteriological samples were taken from the hands of the scrubbed team after surgical scrub but before putting on sterile gowns and gloves and from the patients' skin (incisional area of sternum and vein harvesting area of legs) after preoperative skin preparation with chlorhexidine gluconate. Air samples were taken during operations. Bacteriological samples also were taken from the subcutaneous walls of the surgical wound just before closing the wound. Total counts of bacteria on sternal skin and wound walls (colony-forming units [CFUs]/cm2) were calculated, as well as total counts of bacteria in the air (CFUs/m3). Strains of S. aureus recovered from the different sampling sites were compared by pulsed-field gel electrophoresis (PFGE). RESULTS: Special scrub suits significantly reduced total counts of bacteria in air compared to conventional scrub suits (P=.002). The number of air samples in which S. aureus was found was significantly reduced by special scrub suits compared with conventional scrub suits (P=.016; relative risk, 4.4; 95% confidence interval [CI95], 1.3-14.91). By use of PFGE, it was possible to identify two cases of possible airborne transmission of S. aureus when wearing conventional scrub suits, whereas no case was found when wearing special scrub suits. When exposed to airborne S. aureus, the concomitant sternal carriage of S. aureus was a risk factor for having S. aureus in the wound. CONCLUSIONS: Use of tightly woven special scrub suits reduces the dispersal of total counts of bacteria and of S. aureus from staff in the operating room, thus possibly reducing the risk of airborne contamination of surgical wounds. The importance of careful preoperative disinfection of the patient's skin should be stressed.


Subject(s)
Protective Clothing , Staphylococcal Infections/prevention & control , Surgical Wound Infection/microbiology , Surgical Wound Infection/prevention & control , Thoracic Surgical Procedures/methods , Adolescent , Adult , Aged , Aged, 80 and over , Air Microbiology , Colony Count, Microbial , Female , Humans , Male , Risk Factors , Staphylococcal Infections/transmission , Staphylococcus aureus/isolation & purification , Sweden , Thoracic Surgical Procedures/adverse effects
6.
J Hosp Infect ; 47(4): 266-76, 2001 Apr.
Article in English | MEDLINE | ID: mdl-11289769

ABSTRACT

The objective of this study was to trace the source and route of transmission of methicillin-resistant Staphylococcus epidermidis (MRSE) in the surgical wound during cardio-thoracic surgery, and to investigate the possibility of reducing wound contamination by wearing special scrub suits. In total 65 elective operations for coronary artery bypass grafting (CABG) with or without concomitant valve replacement were investigated. All staff present in the operating room wore conventional scrub suits during 33 operations and special scrub suits during 32 operations. Samples were taken from the hands of the scrubbed team after surgical scrub but before putting on sterile gowns and gloves, and from patients' skin (incisional area of sternum and vein harvesting area of legs) after preoperative skin preparation with chlorhexidine gluconate. Air samples were taken during operations. Samples were also taken from the wound just before closure. Total counts of bacteria on sternal skin and from the wound (cfu/cm2) were calculated as well as total counts of bacteria in the air (cfu/m3). Strains of MRSE recovered from the different sampling sites were compared by pulsed field gel electrophoresis (PFGE). It was found that wearing special scrub suits did not reduce the number of air-samples where MRSE was found compared with conventional scrub suits. The risk factor most strongly associated with MRSE in the wound at the end of the operation was preoperative carriage of MRSE on sternal skin; RR 2.42 [95% CI 1.43-4.10], P= 0.021. By use of PFGE, it was possible to identify the probable source for four MRSE isolates recovered from the wound. In three cases the source was the patients own skin. Finding MRSE in air-samples, or on the hands of the scrubbed team, were not risk factors for the recovery of MRSE in the wound at the end of operation. In conclusion, with a total bacterial air count around 20 cfu/m3 and a low proportion of MRSE, the reduction of total air counts by use of tightly woven special scrub suits did not reduce air counts of MRSE or wound contamination with MRSE. The patients' sternal skin was the main source for wound contamination with MRSE


Subject(s)
Infection Control , Protective Clothing , Staphylococcal Infections/etiology , Staphylococcal Infections/prevention & control , Staphylococcus epidermidis , Surgical Wound Infection/etiology , Surgical Wound Infection/prevention & control , Thoracic Surgical Procedures , Adult , Aged , Air Microbiology , Electrophoresis, Gel, Pulsed-Field , Female , Humans , Male , Methicillin Resistance , Middle Aged , Staphylococcus epidermidis/drug effects , Staphylococcus epidermidis/genetics
7.
Scand J Infect Dis ; 33(3): 182-7, 2001.
Article in English | MEDLINE | ID: mdl-11303807

ABSTRACT

Ampicillin-resistant enterococci (ARE) have recently emerged as clinical pathogens in Sweden. Between 1991 and 1995 the incidence of ARE among enterococcal isolates at Uppsala University Hospital increased from 0.5% to 8.1%. Shedding of ARE from infected cases and risk factors for infection with ARE were studied during a period of 7 months for 38 ARE cases and 38 controls with ampicillin-susceptible enterococci. ARE cases had longer mean duration of hospitalization than controls (29 d vs. 15 d; p = 0.002). In univariate analysis other risk factors for infection with ARE were found to be prior therapy with > 2 antimicrobials (odds ratio [OR] 3.3; 95% confidence interval [CI] 1.2-9.5), > 4 weeks of antimicrobial therapy (OR 6.9; CI 1.8-28.3) and cephalosporin therapy (OR 9.1; CI 2.6-33.7). Fourteen of 26 skin carriers of ARE were found to be shedding ARE to the environment, compared to 2 of 12 non-skin carriers (p = 0.03). Pulsed-field gel electrophoresis suggested multifocal origin of the majority of the infecting ARE strains. Non-recognized fecal colonization and silent spread of ARE among many patients and over a prolonged time period is suggested to be the main explanation for the increase of ARE infections in our hospital. Infection control measures focusing on protecting patients at high risk for ARE infections and further efforts to optimize antimicrobial use are proposed.


Subject(s)
Ampicillin Resistance , Cross Infection/transmission , Enterococcus/drug effects , Gram-Positive Bacterial Infections/transmission , Anti-Bacterial Agents/therapeutic use , Carrier State/epidemiology , Carrier State/microbiology , Carrier State/transmission , Case-Control Studies , Cross Infection/epidemiology , Cross Infection/microbiology , Drug Resistance, Microbial , Electrophoresis, Gel, Pulsed-Field , Enterococcus/classification , Enterococcus/isolation & purification , Feces/microbiology , Female , Gram-Positive Bacterial Infections/epidemiology , Gram-Positive Bacterial Infections/microbiology , Humans , Incidence , Infection Control , Longevity , Male , Odds Ratio , Risk Factors , Sweden/epidemiology , Time Factors
8.
J Hosp Infect ; 44(2): 119-26, 2000 Feb.
Article in English | MEDLINE | ID: mdl-10662562

ABSTRACT

Methicillin-resistant Staphylococcus epidermidis (MRSE) is a common cause of deep sternal infections. The aim of the present investigation was to evaluate staff in an operating suite for thoracic and cardiovascular surgery as a possible source of MRSE and the possibility of reducing the amount of MRSE shed into the air by wearing tightly woven scrub suits. A second aim was to compare the results of dispersal obtained in a test chamber with those from an operating room. We studied carriage of MRSE in the nose and on different skin sites and made an experimental study of dispersal of MRSE during exercise in a test chamber and during operations, using two different types of scrub suits. Dispersal of MRSE [defined as > 1% of the total count of colony forming units (CFU) shed into the air] occurred in 25% of women and 43% of men. Nasal carriage was found among 28% in women and 33% in men. Among five skin-sampling sites, carriage of MRSE was most frequent on the cheek (50%) and in the axilla (24%) and least frequent in the perineum (5%). Dispersal of MRSE was however more strongly associated with carriage in the perineum (P = 0.097) than on the cheek (P = 0.5) and in the axilla (P = 0.21). With regard to shedding of bacteria into the air, there was a significant difference in favour of the tightly woven clothes regarding total counts of CFU both in the test chamber (P = 0.02) and the operating theatre (P = 0.002). Regarding MRSE, no such difference was found. We found there were too many dispersers of MRSE among operating department staff to exclude them from work. Although tightly woven scrub suits significantly reduced the amount of bacteria shed into the air, the amount of MRSE was not significantly reduced. Full-scale experiments in operating rooms are not needed when evaluating the protective capacity of different scrub suits as results from a test chamber give conclusive information.


Subject(s)
Infectious Disease Transmission, Professional-to-Patient , Methicillin Resistance , Operating Rooms , Staphylococcal Infections/transmission , Staphylococcus epidermidis , Air Microbiology , Colony Count, Microbial , Female , Humans , Male , Nose/microbiology , Protective Clothing , Skin/microbiology , Sweden , Thoracic Surgical Procedures/adverse effects
9.
Scand J Infect Dis ; 31(1): 87-91, 1999.
Article in English | MEDLINE | ID: mdl-10381225

ABSTRACT

A total of 154 episodes of infective endocarditis (IE) in 149 patients were studied retrospectively with special regard to the major aetiological groups and the surgical evaluation. There were 136 episodes of native valve endocarditis (NVE) (88%) and 18 episodes of prosthetic valve endocarditis (PVE) (12%). Three major groups of NVE crystallized: Streptococcus viridans in 37 (27%), Staphylococcus aureus in 39 (29%) and culture negative IE in 28 (21%) episodes. In these groups surgery during the active phase was required in 41, 28 and 18%, respectively. At the operation myocardial abscess was found in as many as 7/15 cases with S. viridans, but in only in 3/11 cases with S. aureus and 1/5 cases with culture negative IE. The mean duration of preoperative antibiotic treatment was 34 d. This long period of unsuccessful pharmacotherapy, preceded by a mean of 47 d from start of symptoms to admission to hospital, has probably resulted in the high frequency of myocardial abscess in S. viridans NVE. Surgical evaluation should be considered when fever persists beyond 10 d of adequate treatment, even in the absence of clinically apparent complications. Among the PVE episodes, 11/18 were managed with pharmacological treatment alone. Uncomplicated PVE may thus often be successfully treated with antibiotics alone.


Subject(s)
Endocarditis, Bacterial/microbiology , Endocarditis, Bacterial/surgery , Abscess/microbiology , Adolescent , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/epidemiology , Female , Heart Valve Prosthesis/microbiology , Humans , Male , Middle Aged , Retrospective Studies , Staphylococcus aureus/isolation & purification , Streptococcus/isolation & purification , Time Factors
10.
Lakartidningen ; 95(47): 5338-40, 1998 Nov 18.
Article in Swedish | MEDLINE | ID: mdl-9855734

ABSTRACT

In Sweden, the provision of health care (i.e. non-physician care) of elderly residents in community housing and care facilities has been the statutory responsibility of local authorities since 1992. The Health and Medical Services Act stipulates that such care should be of good quality, As infection control is one aspect of good quality, in 1997 the Dept. of Infection Control at University Hospital, Uppsala, and the six municipalities of the County of Uppsala that are responsible for the care of a total of 4,400 elderly people, launched a joint enterprise to provide the care required by the Act. The program includes the education of staff in the basic concepts of infection control/recruitment of link surses and surveillance of risk factors, in order to minimise nosocomial infections in nursing homes for the elderly.


Subject(s)
Community Health Services , Cross Infection/prevention & control , Homes for the Aged , Infection Control , Nursing Homes , Aged , Community Health Services/standards , Health Services for the Aged/standards , Homes for the Aged/standards , Humans , Nursing Homes/standards , Risk Factors , Sweden
11.
J Wound Care ; 7(9): 435-7, 1998 Oct.
Article in English | MEDLINE | ID: mdl-9887733

ABSTRACT

This study analysed 656 wound samples from patients with chronic wounds in order to determine the bacterial flora and patterns of antibiotic use and resistance. Almost all wounds (95.1%) were colonised with at least one bacterial species; 26% of all patients were on antibiotic treatment. The total number of bacterial isolates resistant to antibiotics was low.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Bacterial Infections/drug therapy , Skin Ulcer/complications , Wound Infection/drug therapy , Adolescent , Adult , Aged , Aged, 80 and over , Bacterial Infections/etiology , Child , Child, Preschool , Chronic Disease , Female , Humans , Male , Middle Aged , Retrospective Studies , Surveys and Questionnaires , Sweden , Treatment Outcome , Wound Infection/etiology
13.
Transfusion ; 35(10): 871-3, 1995 Oct.
Article in English | MEDLINE | ID: mdl-7570920

ABSTRACT

BACKGROUND: When bacteria are found, after a platelet transfusion, in the recipient's blood as well as in the platelet concentrate (PC), a causal relationship is normally suspected, with the PC as the causative agent. The other alternative, that the patient has bacteremia and contaminated the PC, is less well documented in the literature. CASE REPORT: Arbitrarily primed polymerase chain reaction (AP-PCR) was used for testing strains of Proteus mirabilis isolated from a patient's blood before and after a platelet transfusion and from the PC. Because of a febrile reaction after a platelet transfusion, bacterial culture was performed on the PC used, showing growth of P. mirabilis. The same species was found in the patient's blood after the transfusion. Posttransfusion sepsis caused by a contaminated PC was suspected, and anti-sepsis treatment was given to the recipient. Later, it became apparent that the patient had had bacteremia before the transfusion and that P. mirabilis was one of the species in the isolate. With AP-PCR, the identity of the three P. mirabilis isolates could be distinguished. CONCLUSION: AP-PCR is a useful technique for distinguishing the identity of bacterial isolates from patients and blood components. A patient with bacteremia can contaminate a PC in conjunction with a platelet transfusion. With AP-PCR, the PC could be ruled out as the cause of the posttransfusion sepsis.


Subject(s)
DNA, Bacterial/analysis , Platelet Transfusion/adverse effects , Polymerase Chain Reaction , Proteus Infections/transmission , Proteus mirabilis/genetics , Base Sequence , Blood Platelets/microbiology , Escherichia coli/isolation & purification , Feces/microbiology , Female , Humans , Middle Aged , Molecular Sequence Data , Proteus mirabilis/isolation & purification
14.
J Hosp Infect ; 30 Suppl: 232-40, 1995 Jun.
Article in English | MEDLINE | ID: mdl-7560955

ABSTRACT

In studies from the USA it has been shown that infection control can lower infection rates by 30%. To achieve this an infection control programme has to be given a firm structure. Judging from the opinions presented by an educational workshop within the International Federation of Infection Control (IFIC) and from the literature there is an international consensus on the basic components of hospital infection control. An infection control team, with the task of identifying areas of concern, providing or initiating work on written policies, educating and advising not only medical staff but also hospital administrators, constructors etc., constitutes the backbone of infection control. However, in most countries the infection control team, should it exist, is usually understaffed. This is false economy, a qualified medical input is a proven investment.


Subject(s)
Infection Control/organization & administration , Forecasting , Humans , Infection Control/standards , Infection Control/trends , Infection Control Practitioners/education , Patient Care Team , Professional Staff Committees
17.
J Hosp Infect ; 25(4): 251-64, 1993 Dec.
Article in English | MEDLINE | ID: mdl-7907622

ABSTRACT

Experimental skin colonization was attempted on healthy volunteers using one epidemic and two non-epidemic strains of Staphylococcus epidermidis isolated from a bone marrow transplant unit. Although the three strains had similar biochemical reactions, they had different antibiograms and plasmid patterns, and the epidemic strain grew rather more slowly when in a mixture in broth. Two experiments involving sets of 5 volunteers were performed. The epidemic strain was mixed with one non-epidemic strain for experiment 1, and with the other for experiment 2. Each volunteer had an inoculum of a mixture of 10(7) cfu of each strain inoculated onto the antecubital fossae of both arms; one of the arms had had a prior treatment with chlorhexidine to see if this would prevent colonization. Quantitative skin cultures were continued until the test strains could no longer be isolated. Colonization occurred in all but one volunteer, and lasted from a few weeks to 17 months. Maximal counts of the epidemic strain were significantly higher than the maximal counts of the non-epidemic strains. Chlorhexidine had no effect in experiment 1, and caused a reduction in intensity and duration of colonization in experiment 2, although this did not achieve statistical significance. Plasmid patterns were unchanged throughout, but in two instances a variant of the epidemic strain that had lost resistance to methicillin and tobramycin was isolated together with the parent strain. The enhanced ability of the epidemic strain to colonize skin may be an important factor in allowing cross-infection.


Subject(s)
Cross Infection/microbiology , Skin/microbiology , Staphylococcal Infections/microbiology , Staphylococcus epidermidis/pathogenicity , Chlorhexidine/therapeutic use , Humans , Staphylococcal Infections/prevention & control
18.
Transfusion ; 33(10): 802-8, 1993 Oct.
Article in English | MEDLINE | ID: mdl-8236420

ABSTRACT

The growth of two strains of Serratia marcescens in blood components was tested in this study. One of the strains had been implicated in the epidemic of transfusion-associated sepsis experienced in Denmark and Sweden in 1991. In whole blood with a final concentration of 100 colony-forming units per mL of S. marcescens, there was an immediate reduction of more than 95 percent of colony-forming units, but no reduction of the bacterial concentration if the blood had been white cell-reduced before inoculation. This is interpreted as an effect due to phagocytosis by white cells and as a lack of bactericidal effect of the plasma. A reduction to 10 percent of the original concentration, observed if the blood had a nominal content of white cells, was most likely due to phagocytosis. White cell reduction by filtration after inoculation further reduced the bacterial concentration of one of the strains tested, but, after a 1-week lag phase, growth accelerated to high concentrations by 6 weeks. In platelet-rich plasma prepared from S. marcescens-inoculated units, abundant growth was found after 24 hours, increasing to very high concentrations (10(12) colony-forming units/mL) during 10-day storage at 22 +/- 2 degrees C. Keeping the whole blood at ambient temperature for 20 hours before preparation of platelet-rich plasma caused only temporary reduction of bacterial concentration in the S. marcescens experiments, but resulted in a complete absence of bacteria in the platelet-rich plasma for 10 days in control experiments performed with Staphylococcus epidermidis.(ABSTRACT TRUNCATED AT 250 WORDS)


Subject(s)
Serratia Infections/etiology , Serratia marcescens , Transfusion Reaction , Blood Platelets/microbiology , Erythrocytes/microbiology , Humans , Serratia marcescens/growth & development , Staphylococcus aureus/growth & development , Staphylococcus epidermidis/growth & development
19.
J Hosp Infect ; 24(1): 47-61, 1993 May.
Article in English | MEDLINE | ID: mdl-8101202

ABSTRACT

The aim of this study was to establish whether long-term use of chlorhexidine would prevent skin colonization by antibiotic-resistant Staphylococcus epidermidis. Ten nurses, working on a ward for haematological disorders, volunteered to participate in the test. They washed one arm every morning for three weeks with chlorhexidine gluconate, ('Hibiscrub' ICI Pharmaceuticals). The other arm served as a negative control. Samples from the antecubital fossa of both arms were taken two to three times a week during the wash period and two weeks thereafter, giving a total of 216 samples. The appearance of resistant S. epidermidis with different antibiograms was analysed. During the wash period the total bacterial counts and the counts of the resistant S. epidermidis strains on the test arm were both about one-tenth of those on the control arm, a significant difference (P < 0.05). Moreover, there were significantly fewer resistant S. epidermidis on the test arm, 1.3 per sample, than on the control arm, 2.5 per sample (P < 0.01). Most of the resistant S. epidermidis were only found once or a few times on the same site, after which they disappeared, though a few persisted on the skin even during 'Hibiscrub' washing. In an agar dilution test, chlorhexidine minimum inhibitory concentrations (MICs) of persisting strains were the same as for strains disappearing from the skin following 'Hibiscrub' washing, 1.0 or 2.0 mg l-1, but somewhat higher than MICs of strains isolated from healthy carriers outside the hospital whose MICs were 0.5 mg l-1. The relative contribution to the skin counts by those S. epidermidis strains found only occasionally were compared with those found repeatedly but no difference in reduction was found between these categories during 'Hibiscrub' washing.


Subject(s)
Chlorhexidine/analogs & derivatives , Hand Disinfection , Skin/microbiology , Staphylococcus epidermidis/drug effects , Adult , Aerosols , Chlorhexidine/pharmacology , Colony Count, Microbial , Drug Resistance, Microbial , Female , Hospitals, University , Humans , Male , Middle Aged , Staphylococcus epidermidis/growth & development , Sweden , Time Factors
20.
Vox Sang ; 65(1): 42-6, 1993.
Article in English | MEDLINE | ID: mdl-8362513

ABSTRACT

In a previous study, removal of white blood cells (WBC), by filtration 5 h after deliberate contamination of whole blood with a type 0:3 strain of Yersinia enterocolitica, was shown to be an effective way of avoiding bacterial growth in red blood cells (RBC) during storage. In the present study the Opti-System technique was used to remove the buffy coat from whole blood, leaving 10-20% of the original number of WBC in the RBC preparation. In one series of experiments, all of 4 units of RBC suspension, from which buffy coats were removed 2 h after inoculation of 112 colony-forming units (cfu) per ml of Y. enterocolitica, became Yersinia-free, while abundant bacterial growth occurred in all of 4 units where RBC suspension and buffy coat had been recombined. In a second series of 10 experiments, with an inoculum of 80 cfu/ml, no growth was found in platelet-poor plasma stored for 42 days at 4 degrees C. Five out of 10 RBC suspensions in SAGM additive solution remained Yersinia-free throughout a 6-week storage period; 4 of these 10 units showing growth of Yersinia after 4 weeks and 5 after 6 weeks. In the buffy coats bacterial growth was found in 1 out of 10 units after 1 week, 4 after 2 weeks, and in all of 10 units after 4 weeks. In 2 control experiments with WBC-reduced RBC inoculated with the same bacterial dose, growth started within 24 h and was abundant after 1 week.(ABSTRACT TRUNCATED AT 250 WORDS)


Subject(s)
Transfusion Reaction , Yersinia Infections/transmission , Yersinia enterocolitica/growth & development , Humans , Leukocyte Count , Platelet Count , Yersinia Infections/prevention & control
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