Use of nonsterile gloves for routine noninvasive procedures in thermally injured patients.

A total of 26 boxes of gloves were analyzed to determine if using nonsterile gloves for routine noninvasive procedures was sufficient for thermally injured patients and if the risk of infection increased. All of the study boxes had some organism present on or in the used box; the most common type found was Staphylococcus aureus. Eleven of the 13 subjects (85%) had specific antibiotic-resistant strains of S. aureus present on cultures obtained from open wounds. Seven (64%) of these corresponded to the glove boxes assigned to that patient. The remaining four boxes of gloves had no S. aureus present. In all of the boxes of gloves that had positive S. aureus cultures, 100% of the resistant strains occurred after it was first cultured from the patient. As a result, nonsterile gloves can be used safely for routine non-invasive procedures in the thermally injured patient. It is imperative to avoid using a common box of gloves for two or more patients to prevent the transfer of organisms between patients.

The value of culturing central-line catheter tips in burn patients.

Fifty burn patients who had central venous cannulations performed were randomly assigned to one of two groups. In group 1, the skin around the catheter insertion site was cleaned with 70% isopropyl alcohol prior to catheter removal. In group 2, the skin around the catheter insertion site was not cleaned prior to catheter removal. Twenty (40%) of the patients had negative cultures. The remaining 30 patients had positive cultures, 11 (37%) of which were positive for both skin and catheter tip specimens. All 11 of these cultures matched for the same organism. Six (55%) were from group 1 and five (45%) from group 2. Of the 14 patients with cultures positive for the catheter tips but not the skin, eight (57%) did not have the skin cleaned prior to catheter removal. Five skin cultures were positive, with no organism growth on the corresponding catheter tip; four (80%) of these were from group 2. Data from blood and intravenous (IV) catheter tip cultures performed from November 1982 through December 1985 demonstrated that of the 441 blood cultures obtained, 91 (21%) were positive. Twenty-seven (6%) were positive blood and IV catheter tip cultures; only ten (37%) of these matched for the same organism, accounting for only 2% of the total number of cultures obtained.