Crib Mattress Investigation: A quality improvement study to assess mattress cover permeability and bacterial growth in crib mattresses.

PURPOSE: Any opening in a medical bed mattress cover may allow bodily fluids to enter the mattress, leading to contamination and potential nosocomial infection. This study's purpose was to assess permeability of crib mattress covers and measure bacterial growth within and on crib mattress surfaces. METHOD: Mattresses were selected randomly from hospital inventory. Bonney's blue dye was applied over mattress covers to assess permeability. Mattress cover surface swabs were acquired from standardized locations. Samples of mattress foam were acquired under sterile conditions. All samples were collected with the Eswab and eMRSA systems (Copan Diagnostics Inc, Brescia, Italy). Total aerobic bacteria count and colony types were assessed. Results are presented as mean ± standard error of the mean, independent t tests and analysis of variance were used to analyze data, and significance was achieved with P < .05. RESULTS: All mattresses (n = 7) had Bonney's blue dye visible on underlying mattress foam. There were 77 samples and 44 had bacterial growth. Total bacterial count ranged from 0.2-11.6 CFU/cm(2) with mean of 1.7 ± 0.38 CFU/cm(2). There was no relative differences between mattress sample location and colony type. All samples were negative for Staphylococcus aureus, including methicillin-resistant S aureus. CONCLUSIONS: Any crack in a mattress cover renders it permeable to fluid entering the mattress. Bacterial growth was present on mattress covers and within mattress foam. Mattresses support microbial viability from which nosocomial infection may occur.

Baby bottle steam sterilizers disinfect home nebulizers inoculated with bacterial respiratory pathogens.

BACKGROUND: Contaminated nebulizers are a potential source of bacterial infection but no single method is universally accepted for disinfection. We hypothesized that baby-bottle steam sterilizers effectively disinfect home nebulizers. METHODS: Home nebulizers were inoculated with the common CF respiratory pathogens methicillin resistant Staphylococcus aureus, Burkholderia cepacia, Haemophilus influenzae, mucoid and non mucoid Pseudomonas aeruginosa, and Stenotrophomonas maltophilia. The nebulizers were swabbed for bacterial growth, treated with either the AVENT (Philips), the NUK Quick & Ready (Gerber) or DRY-POD (Camera Baby) baby bottle steam sterilizer and reswabbed for bacterial growth. RESULTS: All steam sterilizers were effective at disinfecting all home nebulizers. Viable bacteria were not recovered from any inoculated site after steam treatment, under any conditions tested. CONCLUSIONS: Steam treatment is an effective disinfection method. Additional studies are needed to confirm whether these results are applicable to the clinical setting.

Disinfection alternatives for contact surfaces and toys at child care centers.

Child care surfaces are vehicles for disease-causing organisms. Disinfectant procedures prevent microbial dispersion. This study reports the effectiveness of CITRUS Farm Edition® (CFE), Clorox® GreenWorks™ (CGW) and Clorox® Anywhere® (CA) against Salmonella Typhimurium and Staphylococcus aureus inoculated (1 ml of 9Log(10) CFU/ml) on a high chair and ball toy. Disinfectants were sprayed and bacteria recovered from surfaces by sponge method. Exposing an inoculated high chair to CA resulted in the highest reduction of S. aureus (3.92 Log(10)) and S. Typhimurium (3.22 Log(10)). CGW reduced S. aureus and S. Typhimurium by 2.84 and 2.12 Log(10) from the inoculated high chair, while the inoculated ball toy showed a 2.50 and 1.80 Log(10) reduction, respectively. CFE showed the lowest reduction with 1.42 and 1.53 Log(10) of S. aureus and S. Typhimurium from the inoculated ball toy. CA was the best disinfectant no matter which bacteria or surface was analyzed. Emphasis on the effectiveness of disinfectant products is needed to be included in child care center infection control programs.

Used cot mattresses as potential reservoirs of bacterial infection: nutrient availability within polyurethane foam.

AIM: To evaluate possible source of nutrients for bacterial growth within polyurethane (PU) foam of used cot mattresses as determinants of bacterial population density. METHODS AND RESULTS: Used infant mattresses (n = 30) were analysed for bacteria capable of degrading colloidal PU and for aqueous soluble chemical components (aromatic amines, ammonium ions, phosphates and protein). Mattress type (waterproof cover vs exposed PU foam at the infant-head region), mattress age and previous use by another child were evaluated as factors that could influence the measured parameters. The levels of protein extracted from PU foam were (i) significantly (P = 0.0019) higher for mattresses lacking a waterproof cover at the infant-head region and (ii) positively correlated with both culturable bacterial population densities of the PU foams and extent of growth of Staphylococcus aureus on aqueous leachates. No statistically significant (P > 0.05) associations between other measured parameters and mattress type/use factors were identified. CONCLUSIONS: Infant use of cot mattresses with exposed PU foam leads to accumulation of proteins within the PU, which can promote bacterial growth. SIGNIFICANCE AND IMPACT OF THE STUDY: The study provides a mechanistic explanation for increased levels of bacteria associated with exposed PU of cot mattresses. In the context of the common bacterial toxins hypothesis for the sudden infant death syndrome (SIDS), this could explain the lowered risk of SIDS associated with use of a waterproof cover above the mattress.

Mites in dust samples from mattress surfaces from single beds or cribs in the south Brazilian city of Londrina.

The aim of this study was to investigate the mite fauna in mattresses dust samples from cribs or beds in the south Brazilian city of Londrina, State of Parana. A total of 133 dust samples from upper and lower mattress surfaces, and bed frames were aspirated once from 38 dwellings (18 cribs and 21 beds), and one day nursery (six cribs). A total of 758 mite bodies were counted in slides: 233 (30.7%) from cribs and 525 (69.3%) from beds (p<0.001). House dust mites--mainly Dermatophagoides pteronyssinus, represented 72% and 84% of total mite count in crib and bed dust samples, respectively. The mean HDM body concentration in crib or bed slides were, respectively, 289.9+/-136.7 and 875.0+/-183.6 mites/g. Statistical analysis showed a significantly higher mite bodies count on lower mattress surface compared with upper surface in bed samples only (p=0.025). Data herein show that cribs like mattress have sufficient mite bodies to cause sensitization to humans. The use of mattress covers for cribs and beds should be encouraged in order to avoid allergens exposure.

Bacterial colonization of toys in neonatal intensive care cots.

OBJECTIVES: To investigate the bacteria and fungi contaminating toys in neonatal intensive care unit (NICU) cots, the colonization rates, and factors that influence them. METHODS: A cross-sectional, longitudinal bacteriologic survey of all toys in the cots of infants in an NICU. All the toys in an infant's cot were cultured weekly for 4 weeks. Data were collected on the infant's postnatal age, the type of cot, whether humidity was added, characteristics of the toy, and any infant infections. RESULTS: Over the 4-week period, there were 86 cultures from 34 toys of 19 infants. Bacteria were grown from 84/86 (98%): 84 of the cultures grew coagulase-negative Staphylococcus, 50 Micrococcus sp, 21 Bacillus sp, 13 methicillin-resistant Staphylococcus aureus, 12 diphtheroids, 4 group B streptococcus, 3 S aureus, 3 nonhemolytic streptococci, 3 group D streptococci, 4 alpha-hemolytic streptococci, and 2 coliforms. None grew fungi. The colonization rate did not differ with cot type, presence of humidity, size of the toy, toy fiber length, or the fluffiness score. Eight (42%) of the infants had positive blood culture results and 5/8 of the isolates (63%) were of the same type as that colonizing their corresponding toy. IMPLICATIONS: With time, all the toys in NICU cots became colonized with bacteria. Many were potentially pathogenic. Toys may be reservoirs for potential infantile nosocomial sepsis. infant, newborn, toys, infection, neonatal intensive care.

Biovolatilization of antimony and sudden infant death syndrome (SIDS).

1. The aerobic filamentous fungus S. brevicaulis IMI 17297 methylated antimony from Sb2O3 substrate, with the formation of gaseous trimethylantimony (TMA). No evidence was found for the generation of other gaseous antimony compounds by this organism. 2. Biovolatilization of inorganic antimony was greatest during cultivation of the fungus on solid media at 25 degrees C, and occurred more readily from antimony (III) substrates than from antimony (V) substrates. 3. Under simulated cot environment conditions (CO2 enriched atmosphere, 33 degrees C) the fungus exhibited an altered morphology and a reduced capability to volatilize inorganic antimony from the pure compound. 4. No evidence of antimony biovolatilization from cot mattress PVC was found, unless antimony was released from PVC by heat treatment (at 80 or 100 degrees C). 5. These data suggest that normal cot environment conditions are non-optimal for volatilization of antimony by S. brevicaulis, and that Sb2O3 in cot mattress PVC is not bioavailable. 6. Cot mattress isolates of S. brevicaulis also volatilized antimony (not encapsulated by PVC), whereas those of other filamentous fungi (Penicillium spp., Aspergillus niger, Aspergillus fumigatus, Alternaria sp.) and of bacteria (Bacillus spp.) did not. 7. The oxidation products of TMA may be the true determinants of toxicity for biogenic antimony gases produced in an aerobic environment.

Lack of inhibition of human plasma cholinesterase and red cell acetylcholinesterase by antimony compounds including stibine.

1. The toxic gas hypothesis proposes exposure to stibine (antimony trihydride) generated from microbial contamination of cot mattress materials as a possible cause of unexplained death in infancy (SIDS) as a consequence of cholinesterase inhibition. We have measured the direct effects of antimony compounds including stibine on the activity of plasma cholinesterase, red blood cell acetylcholinesterase (AChE) and mouse neuronal AChE in vitro. 2. Colorimetric assays for the different esterases with potassium antimonyl tartrate or antimony trichloride at concentrations up to 10(-3) M in the presence of substrate concentrations sufficient to produce 80% of the maximum reaction rate produced no inhibition of enzyme activity. Exposure of enzyme preparations to stibine gas at concentrations sufficient to cause denaturation of red cell haemogloblin caused no measurable inhibition of esterase activity. 3. We conclude that stibine gas or soluble antimony compounds are not capable of inhibiting cholinesterase activity at toxicologically relevant concentrations.