Preoperative whole body disinfection--a controlled clinical study.

Preoperative whole body washing with chlorhexidine scrub was compared with soap for its effect on prevention of wound infection in clean surgery. Two thousand and fifteen patients were studied using chlorhexidine scrub, placebo or plain soap. The overall infection rate in the control and placebo groups was 12.8% (p less than 0.05) and 11.7% as opposed to 9% (p less than 0.05) in the treated group. Three per cent fewer infections were found in treated 'clean surgery' patients, and the incidence of Staphylococcus aureus infections was reduced from 6% (bar soap) to 3% (chlorhexidine). The saving in bed occupancy from prevention of infection is a significant cost-saving.

A placebo-controlled trial of the effect of two preoperative baths or showers with chlorhexidine detergent on postoperative wound infection rates.

The effect of preoperative whole-body washing with chlorhexidine detergent on the incidence of postoperative wound infection was assessed in a placebo-controlled trial of 1989 patients. Patients bathed or showered with chlorhexidine, placebo, or conventional bar soap, on two occasions in the 24 h before operation. The overall infection rate for patients treated with chlorhexidine was 9%, against 12.8% in the bar soap and 11.7% in the placebo groups; in the 'clean' surgery group infections were 7.2% against 10.2% and 10%, respectively. The Staphylococcus aureus infection rate in the 'clean' group was 3% for chlorhexidine against 6% for bar soap.

Identification of the Enterobacteriaceae: a comparison of the Enterotube II with the API 20E.

Two commercial methods for the identification of the Enterobacteriaceae, API 20E and Enterotube II, were compared using the results obtained with 235 cultures of fresh clinical isolates. Enterotube II was an improvement on the original Enterotube, but the availability of two differing indices, one using the Voges-Proskauer (VP) test result and one without, is criticised.

An evaluation of the Modified R/B Enteric Differential System for the identification of the Enterobacteriaceae.

Two hundred and twenty-two organisms were identified by conventional methods and by the Modified R/B Enteric Differential System. Two hundred and eighteeen (98-2%) of these organisms were correctly identified by the R/B system. The results of individual tests were also compared. The convenience and general ease of handling of the R/B system are discussed.

A comparison of two commerical methods for the identification of the Enterobacteriaceae--API 20E and the Enterotube--with conventional methods.

The API 20E, the Enterotube, and routine methods of Cowan and Steel were used in parallel to identify 245 members of the Enterobacteriaceae. The API 20E and conventional methods gave the same identification in all but 2 (0-8%) of the 245 organisms tested. The Enterotube correctly identified 85% of these organisms on the first testing. On re-testing those organisms incorrectly identified the Enterotube results agreed with the conventional ones in a further 20 (8%). There was no change in the identification obtained by the API or conventional methods. Further conventional sugar tests were necessary before final identification was available by the API system in 7 (3%) against 106 (47%) of the 226 organisms correctly identified by the Enterotube. The Enterotube relied on serological testing alone to distinguish between alternatives in 17 (7%) isolates. Other advantages and disadvantages of these systems are discussed.