Glucoprotamin antimicrobial activity against selected standard antibiotic-resistant bacteria and reference strains used in the assessment of disinfection efficacy.

BACKGROUND: The ability of bacteria to develop common mechanisms of resistance to antibiotics and disinfectants raises doubts about the effectiveness of disinfection processes. Glucoprotamin (GP) is an antimicrobial active substance which is widely used to the disinfection in medical area. OBJECTIVE: The aim of study was to compare GP's effectiveness with susceptibility of reference strains used for the evaluation of bactericidal efficacy of disinfectants Staphylococcus aureus (S. aureus); Pseudomonas aeruginosa (P. aeruginosa) and standard antibiotic-resistant strains: meticillin-resistant S. aureus (MRSA) and tetracycline-resistant P. aeruginosa (PAO-LAC). MATERIAL AND METHODS: Minimum inhibitory concentrations (MICs) of GP and minimum bactericidal concentrations (MBCs) against tested strains were evaluated by serial broth dilution technique. GP's efficiency was examined according to qualitative (phenol coefficient GP-PC) and quantitative (EN 1040: 2006) test methods. RESULTS: Gram-negative strains were more tolerant to GP than Gram-positive strains among tested strains. MRSA and S. aureus exhibited similar susceptibility to GP. PAO-LAC had significantly lower susceptibility to GP than P. aeruginosa (P≤0,05). There were no differences in GP efficiency against these strains based on GP-PC. According to PN-EN 1040: 2006 standard average obligatory reduction≥5 log10 was demonstrated in the active concentration of GP (84 mg/l) at obligatory 5 min contact time for PAO-LAC and P. aeruginosa. The differences in basis bactericidal activity between PAO-LAC and P. aeruginosa were obtained in the active concentration at 10 and 15 min contact time (P≤0,05). CONCLUSIONS: Variation in a susceptibility of reference strains and antibiotic-resistant standard strains has no meaning at used clinically GP concentrations, which are higher than concentration causing basis bactericidal activity of GP.

Susceptibility of selected strains used for evaluation of biocidal efficiency of disinfectants and antibiotic-resistant strains to didecyldimethylammonium chloride in 2-propanol.

INTRODUCTION: Didecyldimethylammonium chloride is an active substance which is part of variety of formulations used for the disinfection and antisepsis, both in the medical area as well as in the food, industrial and institutional area. Because of the widespread use of this substance and the development of bacterial resistance to quaternary ammonium compounds (QACs), the aim of this study was determination of the susceptibility of the standard strains used for the evaluation of the effectiveness of disinfectants and standard antibiotic-resistant strains to didecyldimethylammonium chloride in 2-propanol and its bactericidal activity. METHODS: Susceptibility of standard strains used for the evaluation of the effectiveness of disinfectants (Staphylococcus aureus ATCC 6538-SA; Pseudomonas aeruginosa ATCC 15442-PA) and standard antibiotic-resistant strains (Staphylococcus aureus ATCC 43300-MRSA; Pseudomonas aeruginosa ATCC 47085-PAO-LAC) to CMAP was determined by minimum inhibitory concentrations (MICs) and minimum bactericidal concentration (MBCs). The bactericidal efficiency of CMAP against these strains was evaluated by using phenol coefficient (PC). RESULTS: Susceptibility of Gram-positive tested strains SA and MRSA to CMAP was similar (P>0,05). Significant difference in susceptibility of tested Gram-negative strains to CMAP was evaluated between PA and PAO-LAC strains (P<0,05). However,.higher resistance of PAO-LAC to CMAP was not significant when parameters such as concentration and contact time were applied in PC method. CONCLUSIONS: The correct determination and application of "in use" parameters (i.e. concentration, contact time, temperature and interfering substances) in disinfection process prevents the spread of resistant strains in.the environment.

[Significance of efflux pumps in multidrug resistance of Gram-negative bacteria]. / Znaczenie pomp efflux w wielolekowej opornosci Gram-ujemnych bakterii.

The phenomenon of multidrug. resistance of bacteria is a serious problem of modern medicine. This resistance largely is a consequence of abuse and improper use of antibacterial substances, especially antibiotics and chemotherapeutics in hospital settings. Multidrug resistance is caused by a number of interacting mechanisms of resistance. Recent studies have indicated that efflux pumps and systems of efflux pumps are an important determinant of this phenomenon. Contribute to this particular RND efflux systems of Gram-negative bacteria, which possess a wide range of substrates such as antibiotics, dyes, detergents, toxins and active substances of disinfectants and antiseptics. These transporters are usually encoded on bacterial chromosomes. Genes encoding efflux pumps' proteins may also be carried on plasmids and other mobile genetic elements. Such pumps are usually specific to a small group of substrates, but as an additional mechanism of resistance may contribute to the multidrug resistance.

Effect of adaptation process of Pseudomonas aeruginosa to didecyldimethylammonium chloride in 2-propanol on bactericidal efficiency of this active substance.

BACKGROUND: Microorganisms are characterized by two types of resistance innate and acquired. Innate resistance is associated with the construction of the surface structures. Wide use of active substances as antimicrobial compounds, especially in inhibitory concentrations, may promote the acquisition of bacterial resistance to these substances in the process of adaptation. OBJECTIVE: The aim of the study was to determine changes in efficiency of didecyldimethylammonium chloride in 2-propanol (CMAP) against the Pseudomonas aeruginosa strains, which were adapted to this active substance. MATERIALS AND METHODS: Adaptation studies were conducted using two strains: P. aeruginosa ATCC 15442 (PA), which is used in estimation of biocide efficiency and tetracycline-resistant P. aeruginosa ATCC 47085 (PAO-LAC) strain. These strains were adapted to the active substance Bardac22: 50% v/v didecyldimethylammonium chloride in 20% v/v 2-propanol (CMAP) according to the National Institute of Hygiene procedure. After adaptation, obtained isolates were classified to three groups and passaged to solid media: A - strains unadapted passaged onto slant medium without active substance, control group; B - strains with adaptive resistance passaged onto slant medium with 375 mg/l CMAP; C - strains with adaptive resistance passaged onto slant medium without CMAP. Changes in susceptibility of examined strains were determined on the basis of minimum inhibitory concentrations (MICs) by broth dilution method. The minimum bactericidal concentrations (MBCs) were determined by subculture P. aeruginosa strains on solid media without CMAP. The efficiency of CMAP against isolates obtained after adaptation processes was evaluated by using phenol coefficient (PC). RESULTS: There were no differences in the adaptation process between two strains of P. aeruginosa: PA and PAO-LAC. Both isolates obtained after the adaptation process was characterized by approximately 6-8 fold higher MICs compared to the MICs of these strains before the adaptation. Strains passaged to a solid media characterized a variable sensitivity to CMAP. As compared to a control group A, the isolates of PA and PAO-LAC from group B and isolate PA from group C exhibited the highest and stable insensitivity (MIC from > 700 to >1000 mg/l) to 48-49 passages. Isolates from group C of PAO-LAC maintained insusceptibility up to 20th passage (MIC >375 mg/l). There were no statistically significant changes in the CMAP bactericidal efficacy against isolates of reduced sensitivity. CONCLUSIONS: Adaptation of P. aeruginosa strains to didecyldimethylammonium chloride in 2-propanol does not significantly change bactericidal efficacy of this active substance against isolates with reduced sensitivity. Antibiotic-resistant strain PAO-LAC showed a similar adaptability and a similar sensitivity to the CMAP as a strain PA used to assess the effectiveness of disinfectants. KEY WORDS: adaptation process, Pseudomonas aeruginosa, quaternary ammonium compounds, bactericidal efficiency.

Effect of different drying conditions for the viability of Candida albicans present on carriers.

BACKGROUND: Problems in substantial under recovery of Pseudomonas aeruginosa and Candida albicans from carriers have been demonstrated for laboratories performing phase 2, step 2 efficacy tests on disinfectants relative to levels required by the EN 13697 standard. It was thus necessary to determine recoveries of these microorganisms following procedural losses incurred during drying and to optimise drying conditions such that recoveries then complied with the standard. OBJECTIVES: The aim of the study was to establish optimal drying conditions for the recovery of Candida albicans ATCC 10231 from carriers. MATERIALS AND METHODS: The evaluation was performed according to the EN 13697:2001 standard procedure. A test suspension of Candida albicans and interfering substance were inoculated onto the surface of carriers (2 cm diameter stainless steel discs) and then dried under different conditions consisting of: a 37 degrees C incubation with and without an incubator fan as well as at 23 degrees C (room temperature) in a laminar air flow cabinet. Carriers were dried until the surfaces appeared visibly dry and the number of surviving organisms then recovered from the surface were quantified. The following were calculated for colony forming units (cfu); N (log10 cfu in a 0.05 ml test suspension), NC (the control log10 cfu in neutralizing medium), Nts (cfu numbers remaining on the surface) and the N-NC difference which should not exceed 2 log10 when microorganism recoveries are adequate and without any toxicity effects of the neutralising medium. Experiments was conducted using validating procedure (NC) which is performed with distilled water. RESULTS: Drying at 37 degrees C adversely affected the survival of Candida albicans and prevented the levels of microbial recovery from carriers to reach those specified by the EN 13697 standard. However, drying at around room temperatures of 23 degrees C reduced Candida albicans mortality and increased recoveries from the carrier to levels compliant with the standard, where the N-NC differences were not greater than 2 log10. CONCLUSIONS: The viability of Candida albicans ATCC 10231 is sufficiently improved when carriers are dried at 23 degrees C, even if the drying time exceeds 60 minutes. The density of the initial test suspension (N) should also be increased.

Recommendations for thermal disinfection based on the A0 concept according to EN ISO 15883.

The use of aseptic instruments for the care of patients is an essential element in the prevention of nosocomial infections. Significant risks have been associated with inadequate or improper cleaning and disinfection of reusable medical devices. Thermal disinfection with moist heat, based on the A0 concept (EN ISO 15883-1), is the most common method for disinfection of medical devices in the hospital setting. A0 is a physical parameter denoting the inactivation of microorganisms. The concept of A0 is intended to allow equivalent disinfection efficiencies to a reference time/temperature to occur at other disinfection temperatures. This paper focuses on parametric control of thermal disinfection--A0 values as recommended in the standard and their interpretation. The experimental fundamentals regarding of an A0 concept are rare. Data on thermal disinfection are partly contradictory. The washer disinfectors use thermal disinfection programs set in accordance with the parameters: time and temperature, which is proven suitable biocidal activity, not based on the A0 value. Many authorities in the field of disinfection recommends to use higher values of A0 than those specified in the standard EN ISO 15883.

[Significance of the efflux phenomenon as a mechanism of bacterial resistance on active substances of biocide]. / Znaczenie zjawiska efflux jako mechanizmu opornosci bakterii na substancje czynne srodków dezynfekcyjnych.

Efflux phenomenon induced by the presence of efflux pumps is one of the bacterial resistance mechanisms against active substances ofbiocides. Proteins and protein systems create efflux pumps, which are connected with the cell envelope structure ofbacteria. The efflux pump's function is transportation of active substances of disinfectants outside the bacterial cell. The biocides active substances rinsed out of bacterial cell by efflux were described for quaternary ammonium compounds, biguanides, phenols and diamidine. Bacterial resistance induced by efflux was not confirmed in the presence of such active substances like: alcohols, aldehydes, peroxides and chlorine compounds and their derivates. Bacterial resistance to active substance ofbiocides can be caused by two or more resistance mechanisms i.e. efflux mechanisms and reduce diffusion. The cooperation of resistance mechanisms to biocides can result difficulties in pathogenic bacteria eradication. The spread of these bacteria can be an epidemic threat.

[Assessment of decontamination processes: cleaning, disinfection and sterilization in dental practice in Poland in the years 2011-2012]. / Ocena procesów dekontaminacji: mycia, dezynfekcji i sterylizacji w praktyce stomatologicznej w Polsce w latach 2011-2012.

OBJECTIVE: Effective decontamination of instruments is a key element of infection control and the provision of high quality in dental care. The aim of the study was to evaluate the efficiency of decontamination procedures including cleaning, disinfection and sterilization of re-usable instruments in dental practices in Poland. MATERIAL AND METHODS: The efficiency of disinfection and sterilization processes have been evaluated on the results of the questionnaires. The following information were taken into account: setting where disinfection and sterilization had been performed, preparation of dental equipment for sterilization (disinfection, washing and cleaning, packaging), the types of autoclaves and used types of sterilization cycles, routine monitoring and documentation of sterilization processes, treatment of handpieces and the frequency of surface decontamination. RESULTS: Data were collected from 43 dental practices (35 dental offices and 8 clinics). Disinfection and cleaning processes were performed manually in 63% of dental offices and ultrasonic baths were used in 53% of settings. Washer disinfectors were used in 23% of dental practices: in every researched clinic and in a few dental offices. All sterilization processes were performed in steam autoclaves, mainly in small steam sterilizers (81%). Dental handpieces were sterilized in 72% of practices, but only 33% of them performed sterilization in recommended cycle B. Sterilization processes were monitored with chemical indicators in 33% of practices. Biological monitoring of the processes was carried out at different intervals. Incorrect documentation of instruments and surfaces decontamination was recorded in several settings. CONCLUSIONS: There is still a need for improvement of decontamination processes in dental practice in Poland. Areas for improvement include: replacement of manual cleaning and disinfection processes with automatic processes, sterilization of dental handpieces after each patient, monitoring of a sterilization process with chemical and biological indicators. Reported incorrect procedures in decontamination of medical devices performed by questioned dentists and lack or inadequate response to asked questions indicate the lack of adequate knowledge about decontamination. Personnel who performs decontamination processes should be continuously trained.

[Waste generated in Polish hospitals during the years 2005 - 2009]. / Odpady wytwarzane w polskich szpitalach w latach 2005 - 2009.

The medical institutions generate mainly municipal and medical waste. The medical waste includes infectious waste, dangerous but not infectious waste (toxic) and medical not dangerous waste. They have to be correctly identified, properly sorted and suitably neutralized. Questionnaires investigations were conducted on the basis on the forms worked out at National Institute of Public Health - National Institute of Hygiene. Information from above seven hundred seventy hospitals were collected. Inquiries indicated that during the period of years 2005-2009 over two hundred thousand beds per year were available. The degree of the use run from 52% to 100%, in average 72%. The largest fraction of the waste from all institutions were municipal waste run from 80% to 90%. Dangerous waste in following years were between 9.9% and 18.1%. The great part of dangerous waste were infections waste, which content ranged from 8.7 to 17.1%. Very low quantity of medical not dangerous waste was noted (1-1,7%). The majority of infectious medical waste were neutralized outside hospitals by the companies having suitable permissions. The thermal conversions (burning) was the most often used method.

[Microbiological assesssment of efficiency chemothermal disinfection of blood contaminated hospital textiles]. / Ocena mikrobiologiczna skutecznosci dezynfekcji chemiczno-termicznej bielizny szpitalnej zanieczyszczonej krwia.

Thermal disinfection should be applied to laundering procedures of hospital textiles contaminated with blood. Currently, there is an increasing number of hospital textiles composed of cotton-polyester blends that cannot endure high temperatures of thermal disinfection. Besides, decreasing the temperature of chemothermal disinfection enhances the possibility of micro-organisms to survive the laundering procedure. The aim of this study was to prepare a new method for the microbiological evaluation of disinfecting laundering procedures for hospital textiles contaminated with blood. The bactericidal activity of chemical disinfectants for chemothermal disinfection was determined by simulating a laundering procedure for hospital textiles in the laboratory according to procedure of National Institute of Hygiene - DF/05/03. Bioindicators cotton carriers inoculated with Enterococcus faecium were used for determinating the antibacterial effects for hospital textiles contaminated with blood. High concentrations of bovine albumin and/or sheep erythrocytes were used as substrate for simulating human blood. The results showed that the bactericidal activity of chemical disinfectants for chemothermal disinfection hospital textiles in the event of massive organic contamination--heavily soiled with blood, shall be evaluated using carrier test in following conditions: test organism- Enterococcus faecium, interfering substances--6 g/l bovine albumin solution added to preparation.

[The effect of antibacterial substances on spread resistance of bacteria]. / Wplyw substancji antybakteryjnych na rozprzestrzenianie sie opornosci bakterii.

The evaluation of influence biocides on phenomenon of spread resistance bacteria is wide discussed particularly in the medical area. Current issue is examinated mechanisms of spread bacterial resistance in the areas using antibiotics and disinfectants and in natural environment. Selection of resistance bacteria is connected with using biocides against the rules in medical care and disinfection. Biocides using in static concentrations do not act as bacteriocidal substances and contribute to survival rate of resistance bacteria. Disinfectants use correctly to the areas and in right using concentrations prevent spread of resistance bacteria.

[The wastewater treatment significance in the control sanitarian and epidemiological state of environment]. / Znaczenie oczyszczania biologicznego w kontroli stanu sanitarno-epidemiologicznego srodowiska.

The municipal wastewater consist of organic, inorganic and biological contaminations. The most of human and animals pathogens are found in municipal wastewater responsible for water-borne and waterwashed diseases. Wastewater biological treatment is effective methods to reduce the transmission route of this pathogens. Different kind of methods (microfiltration/coagulation) and technology (aerobic/anaerobic stabilization) treated municipal wastewater, secondary effluent, primary and excess sludge are used to inactivation viruses, bacteria and protozoan. Chemical disinfection with CaO significantly affects inactivation of helminthes eggs during the hygienization of sludge. However the efficiency of pathogens disinfection particularly depend on contact time and concentration of disinfectants.

[Assessment of disinfection and sterilization processes in dental practice as an important factors in prevention of infections]. / Ocena prawidlowonci procesów dezynfekcji i sterylizacji w wybranych gabinetach stomatologicznych jako istotnych elementów zapobiegania zakazeniom.

The dental health-care settings is an environment where disease transmission occurs easily. Prevention of cross infection is therefore a crucial aspect of dental practice and dental clinic stuffmust adopt certain basic routines while practicing. Infections may be transmitted in the dental operatory through direct contact with blood, oral fluids or other secretions; via indirect contact with contaminated instruments, equipment or environmental surfaces; or by contact with airborne contaminants present in either droplet splatter or aerosols of oral and respiratory fluids. Strategies to prevent dental patient infections have focused on disinfection and sterilization. This study evaluates basic routines in prevention of cross-infection in the dentistry. The sample comprised 100 dentists, who completed questionnaires. Based on inquires the conditions for disinfection and sterilization of medical devices were assessed. The following issues were taken into consideration: the way of disinfection and preparation of the disinfectants, the localization of disinfection, preparing to disinfection, washing and packing of dental devices, the frequency of disinfection, methods of sterilization and the monitoring system, type of sterilizers and the available cycles. The dental practices are well equiped to proceed the steam sterilization, but 33% of dentists don't know the available cycles in their autoclaves. Only 35% of them made sterilization process protocols. Very common are three failures of instruments disinfections: multiple use of disinfectant, adding of disinfectant, adding new instruments. There is still need for improvement in disinfection and sterilization in dental practice, especially including: monitoring and documentation of sterilization process, proper use of disinfectants according to manufactures instructions, frequent disinfection of surfaces which contact with patients. Dental stuff should take part in advanced training courses about disinfection and sterilization.

Antimicrobial activity of glucoprotamin-containing disinfectants.

Introduction of a new antimicrobial agent as a drug--for treatment of infections or as a disinfectant and antiseptic, may result in the occurrence of resistance mechanisms against this agent among microorganisms. Two disinfectants of different composition--Incidin Plus for surface disinfection and Sekusept Plus for medical devices disinfection, both containing glucoprotamin as the active substance, were investigated in this study in order to analyze their antimicrobial activity. Standard bacterial and fungal strains recommended by European Standards, established by European Standardization Committee for testing bactericidal and fungicidal activity of chemical disinfectants were used in the study. Furthermore, 60 clinical bacterial strains with different susceptibility to antibiotics and chemotherapeutics, mostly multiresistant, isolated from different specimens from hospitalized patients were analyzed. In addition, 184 fungal clinical strains isolated from hospitalized patients and outpatients were also included in this study. Antimicrobial activity was evaluated according to EN 1040:2005 --using bacterial strains and according to EN 1275:2005--using fungal strains. Glucoprotamin proved to be a very effective and rapidly acting bactericidal and fungicidal agent. Low concentration of glucoprotamin--0.5% showed to be very effective (1 min) against clinical bacterial isolates. Incidin Plus was also very effective (5 min) against clinical fungal isolates.

[The principle of registration, evaluation and testing of disinfecting preparations]. / Zasady rejestrowania, opiniowania i badania preparatów dezynfekcyjnych.

Disinfectants are used to produce a state in which the number of living micro-organisms has been reduced to a level which is appropriate to the practical situation. For any products which are included in the Biocidal Directive 98/8/EC, for which specific activity is claimed, test data has to be approved by the regulatory authority and a product license obtained before the product can be offered for sale. Disinfectants can be recorded as biocidal products or medical devices. Presently, it is possible to measure the activity of a product on defined micro-organisms in specified experimental conditions. Efficacy is the result of the use of a product according to a defined application. To allow different requirements in different areas of application, separate tests and pass criteria have been or will be prepared for each of following three areas of application: medical, veterinary and group comprising food, industrial, domestic and institutional areas. The laboratory methods to be used for testing the activity of chemical disinfectants meets the European standards. The tests are categorised on a modular basis as follows: phase 1 tests, phase 2 step 1 tests, phase 2 step 2 tests and phase 3 tests. In order to claim that a product has disinfectant properties, suitable for use in the medical area, the product shall be tested according to European standards: phase 2 step 1 tests, phase 2 step 2 tests. Phase 1 tests are not required to support claims for chemical disinfectants used in human medicine. Only phase 1 tests are required to support claims for active substances for which no particular area of application is specified. Medical devices are subjects to the European Directive 93/42/EEC which requires that a product must carry a CE mark. Disinfectants which are intended specifically by its manufacturer to be used on medical devices are themselves medical devices and so these products, as well as conforming to the instrument disinfection European standards as specified in EN 14885, are also required to carry a CE mark.

[Microbiological assessment of efficiency of antibacterial modified textiles]. / Ocena mikrobiologiczna wlasciwosci materialów wlókienniczych z wykonczeniem antybakteryjnym.

The application of antimicrobial finishes to textiles can prevent bacterial growth and might reduce the risk of infection resulting from textiles that are contaminated with pathogenic microorganisms in hospitals. The main aim of this study was the determination of the antibacterial activities of chemical treatments applied to textiles. Comparison of testing methods assessing antibacterial efficiency was conducted. These studies were performed in order to select the right methods of evaluating the bactericidal and bacteriostatic activity of antibacterial modified textiles. Antibacterial modified polyester fibres and fabrics made from cotton (100%) applied with quaternary ammonium salts were tested. Textiles treated with bacterial agent were compared with reference samples (not treatment with the disinfectant). The Standards ISO/DIS 20645/2002 andAATCC 147/ 1998 suitable for assessment of bacteriostatic activity were applied. For assessment of bactericidal activity ATCC Test Method 100-1998 were applied. The bacterial strains recommended by the above standards such as: Klebsiellapneumoniae (ATCC 4352),Staphylococcus aureus (ATCC 6538), Escherichia coli (ATCC 11229) was tested. Additionally Pseudomonas aeruginosa (ATCC 9027) was examined. Tested fibres did not show antibacterial activity. Samples of antibacterial textiles were washed through laboratory laundering cycles. Residual antimicrobial activity was measured after washes. The fabric showed antibacterial activity against K. pneumonia and S. aureus. The examined specimens showed no bacteriostatic activity against E. coli and P. aeruginosa. The results obtained in two applied quality methods were comparable in assessing antibacterial activity of finishes. Reduction of bacteria in quantitative method was 90%. In quality method ISO/DIS 20645/2002 effectiveness of the treatment against K. pneumonia was retained up to five laundering cycles and against S. aureus--twenty laundering cycles.

[Assessment of the sterilization of medical devices--an important challenge to health care in Poland]. / Ocena procesów sterylizacji wyrobów medycznych jako istotnego elementu higieny szpitalnej w wybranych szpitalach.

The aim of the study was the evaluation of sterilization of medical devices in Polish hospitals. The system that we use to establish which sterilization procedures should be employed to reduce the risk of hospital infections associated with medical devices. Based on inquiries, the conditions for the sterilization of medical devices in 21 Warsaw hospitals were assessed. The following issues were taken into consideration: preparation of medical supplies for sterilization, methods of sterilization and the monitoring system. In order to evaluate hygienic conditions due to sterilization points system was applied. 10% of the hospitals had Central Sterilization Service Department with 3 zones where automatic washing and disinfection, sorting, packaging, sterilization and storage of medical devices had been performed. The other 20% had CSSD without zones. In more than 65% there were common services for sterilization only. Instruments were delivered already prepared for sterilization. In remaining hospitals all steps, including sterilization were performed in words. According preparation of medical devices for sterilization it was established that mainly chemical disinfection just after use and than manual cleaning was used; the automatic cleaning in washer-disinfectors is used mainly in CSSD. Steam was the preferred method of sterilization, but also low temperature methods were used for heat sensitive devices. The monitoring of sterilization processes was satisfactory. There were first trials of the validation of the sterilization processes. There is still a need for improvement in the sterilization of medical devices, especially including: the organisation of CSSD in all Polish hospitals; replacement of manual cleaning processes by automatic cleaning; organisation of advanced training courses for the heads and staff of the CSSD.

[Tests of the microbiologic barrier in sterile packaging]. / Badania szczelnosci mikrobiologicznej opakowan sterylizacyjnych.

After decontamination, cleaning, maintenance and functional testing, sterilised items must be packed suitably. The package must protect sterilised items against microbial contamination during removal from the sterilising chamber, and during storage or transport until use. The ability of any given pack to withstand penetration by bacteria is termed bacterial barrier efficiency. The assurance to keep the contents of the packaging sterile is determined by quality of the materials and the quality of seals. The research was done to proof the microbial barrier, determined by quality of the packaging materials/systems used to sterilization in hospital practice in Poland. 4 packaging materials and 4 types of containers were tested. In all used methods the growth of microorganisms indicated the lack of the bacterial efficiency, the lack of growth--the bacterial barrier efficiency. It was proved that two tested specialistic sterilization papers, non woven material and specialistic containers (metal with a filter or valve, plastic with a filter) are effective microbial barriers because it was no microorganisms growth. It has been determined that sulphite bleachery paper of 60 g/m2 and Schimmelbusch container do not provide the microbial barrier. Based on the performed studies it has been determined that sulphite bleachery paper and Schimmelbusch container can not be used as sterilization packaging system in sterilization practice in hospitals.