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PubMed2001

[The relationship between postburn enterogenic hypermetabolism and decontamination of intestine].

OBJECTIVE: To explore whether postburn enterogenic hypermetabolism exists. METHODS: Eighty -- eight Wistar rats inflicted by 30% TBSA III degree burns were randomly divided into two groups, i,e. burn (B) and burn with gut decontamination (D) groups. The change in resting energy expenditure (REE) was observed during 0 to 10 postburn day (PBDs) in rats. The plasma contents of lipopolysaccharide (LPS), tumor necrosis factor (TNF) and interleukin-1 (IL-1) were determined on 1, 3, 5, 7 and 10 PBDs and their correlations were analyzed. RESULTS: The postburn REE and plasma contents of TNF, LPS and IL-1 were much higher in both groups than those before injury. When compared between the two groups, the above data in D group were lower in varying degrees than those in B group. It was shown by correlation analysis that REE was postively correlated to LPS, TNF and IL-1, respectively (gamma = 0.77 similar 0.9, P < 0.05 similar 0.01). CONCLUSION: Postburn hypermetabolism in rats could be ameliorated by gut decontamination, and the postburn plasma inflammatory mediators in rats could also be lowered by gut decontmination. This suggests that enterogenic hypermetabolism does exist after burn injury.

Animals↗

PubMed1999

[Aflatoxins in food: tests of decontamination of peanut cakes by ionizing treatment].

The efficacy of ionising treatment for decontaminating peanut cakes was tested. The influence of cakes water content and the effect of ionisation dose rate were studied. The results obtained after a reverse phase liquid chromatographic determination of B1, B2, G1 and G2 aflatoxins have revealed an important contamination of the peanut cakes (up to 1000 ppb of total aflatoxin's contents). After ionising treatment at 25 kGy, the aflatoxins degradation in peanut cake's was less important in dried samples (about 5-10% at 0.55 water activity: aw) than in the humid ones (40-60% degradation at 0.95 water activity). At this dose, any indicative difference of the degradation rate of aflatoxins, with regard to the ionising process was observed. The efficacy of ionising treatment for decontaminating peanut cakes could probably be improved, however the economic interest of such process as alternative of the treatment with ammonia is questionable.

Aflatoxin B1↗

PubMedDate not supplied

Temperature changes at the implant-bone interface during simulated surface decontamination with an Er:YAG laser.

PURPOSE: This study investigated temperature changes at the implant-bone interface during simulated implant surface decontamination with an Er:YAG laser. MATERIALS AND METHODS: Stepped cylinder implants with three different surfaces (titanium plasma sprayed, sandblasted and acid etched, and hydroxyapatite coated) were placed in bone blocks cut from freshly resected pig femurs. An artificial periimplant bone defect with a size of 6 mm2 provided access for laser irradiation in the coronal third of the implant. A 540-pm periimplantitis application tip was used at a distance of 0.5 mm from the implant surface. Pulse energy was varied between 60 and 120 mJ at 10 pps. The bone block was placed into a 37 degrees C water bath to simulate in vivo thermal conductivity and diffusitivity of heat. K-type thermocouples connected to a digital meter were used to register temperature changes at three levels of the periimplant bone. RESULTS: The temperature at the implant-bone interface did not exceed 47 degrees C after 120 seconds of continuing laser irradiation. Temperature elevations were significantly higher at the hydroxyapatite-coated implants than in the two titanium surface groups (P < .001). CONCLUSION: Decontamination of implant surfaces by means of the Er:YAG laser did not excessively heat the periimplant bone within the energy range investigated. This technique therefore seems clinically safe, at least when used with the surfaces studied.

Acid Etching, Dental↗

PubMed1999

Quality control of decontaminating agents.

The present study evaluates the efficiency of the following decontaminating agents for the multiresistant, locally circulating bacterium Pseudomonas aeruginosa: glutaraldehyde 2%--makes A and B-, glutaraldehyde-formaldehyde; povidone-iodine-makes A, B and C-; sodium hypochloride; chloroxylenol--makes A and B-; and lapire chloride. The 9027 ATCC strain was used as a standard. A modification of the method of Kelsey and Sykes (1) was used to evaluate decontaminating efficiency. Highly satisfactory results were obtained with glutaraldehide 2% A and B, glutaraldehyde-formaldehyde and sodium hypochlorite. The results for povidone-iodine A, B and C were satisfactory but were unsatisfactory for chloroxylenol and lapirium chloride.

Dental Disinfectants↗

PubMed1992

UV absorption complicates PCR decontamination.

UV irradiation is widely used to inactivate contaminating DNA in PCR. Highly UV-absorbent deoxyribonucleoside triphosphates in PCR mixtures reduce the efficiency of UV decontamination. Optimal decontamination may be achieved by irradiating the PCR mixture without the deoxyribonucleoside triphosphates.

Artifacts↗

PubMed2003

CJD decontamination of surgical instruments.

Following the CJD protocol and decontamination processes (Table 1) as recommended in the Health Canada CJD Guideline will serve to prevent transmission of CJD via surgical instruments, "Preparation of the work area" and "safe handling of strong chemicals used for decontamination" are other topics that must be addressed by staff in the OR and SPD. The appendix offers a quick reference that summarizes many of the important points which staff in the OR caring for patients, and staff in SPD caring for instruments, need to be aware of.

Canada↗

PubMed2003

[Efficacy of treatment of chronic destructive forms of apical periodontitis using oral decontamination antibiotic therapy].

The efficiency of preventive oral antibiotic therapy before the root channel filling was evaluated in 78 patients with granulating and granulomatous chronic periodontitis. Positive clinical changes were observed after lincomycin or rondomycin therapy (p = 0.017). The number of complaints was also less in the latter group (p > 0.05). The incidence of x-ray restoration of periapical foci of bone tissue destruction during 6 and 12 months was significantly higher (p < 0.05 and p < 0.01) after preventive treatment with lincomycin or rondomycin, characterized by potent osteotropic effects (decontamination with rondomycin 81.8%, with lincomycin 70.3% vs. 31.0% without decontamination therapy).

Administration, Oral↗

PubMed2003

Decontamination of Bacillus thuringiensis spores on selected surfaces by chlorine dioxide gas.

This work examined the efficacy of chlorine dioxide (ClO2) gas for the decontamination of Bacillus thuringiensis spores on paper, wood, epoxy, and plastic surfaces. Spores representing an inoculation level of approximately 6 log colony-forming units (CFU) per surface were treated with 5, 10, 15, 20, 25, or 30 milligrams per liter (mg/L) ClO2 gas for 12 hours under 85-92 percent relative humidity and at 22 +/- 1 degrees C. Under the tested treatment conditions, the highest population of surviving spores was found on the paper surface and the lowest was found on the plastic surface (p < .05). The 5 mg/L ClO2 gas treatment inactivated 2.5, 3.6, 4.0, and 4.9 log spores per surface on paper, wood, epoxy, and plastic surfaces, respectively. A greater than 5-log reduction of spores was achieved on each surface after the 15 mg/L ClO2 gas treatment. The minimum ClO2 gas concentration needed to completely inactivate the inoculated spores was 30 mg/L for paper and wood surfaces, 25 mg/L for epoxy surfaces, and 20 mg/L for plastic surfaces. The results of this study may provide insight into the parameters of effective decontamination procedures for Bacillus spores.

Bacillus thuringiensis↗

PubMed1992

Selective decontamination of the digestive tract as an infection-control measure in intensive care unit patients.

Infection is responsible for a large percentage of morbidity and mortality in intensive care unit (ICU) patients. Conventional infection-control measures are directed at decreasing infection by exogenous sources and have had variable success in significantly reducing nosocomial infection rates. Selective gastrointestinal decontamination with topical nonabsorbable antibiotics attempts to reduce infection by eliminating intestinal mucosal colonization by pathogenic microorganisms. These antibiotics are selectively bactericidal against gram-negative organisms and yeasts, thereby leaving the normal flora (mainly anaerobes) unharmed. In the majority of clinical trials, selective decontamination effectively reduced colonization and infection among ICU patients, with the most significant reductions observed in gram-negative respiratory infections. Resistance to the antimicrobials was not documented in the majority of trials; however, follow-up periods were minimal and may not have been adequate to detect selection of resistant strains. Reductions in infection do not alter mortality; however, patients without significant underlying disease appear to be the subgroup that will most likely benefit.

Anti-Infective Agents↗

PubMed1992

Selective bowel decontamination does not alter hepatic regeneration in rats.

The purpose of the present study was to determine whether changes to the gut flora that occur following norfloxacin-induced selective bowel decontamination alter hepatic regenerative activity. Adult rats (n = 6 per group) were treated with norfloxacin (10 mg/day) or vehicle for 10 days before 70% partial hepatectomy. Hepatic regenerative activity was determined 24 hours after surgery by documenting restitution of liver mass, [3H]thymidine incorporation into DNA, and ornithine decarboxylase activity in the liver. The results of the study revealed that hepatic regeneration was unaffected by norfloxacin therapy. Thus, selective bowel decontamination with norfloxacin does not alter hepatic regenerative activity following partial hepatectomy in the rat.

Animals↗

PubMed2005

[The effect of selective bowel decontamination and mechanical bowel preparation on bacterial translocation due to intraabdominal hypertension].

BACKGROUND: The objective of our study is to evaluate the preventive effects of selective digestive decontamination (SDD) and mechanical bowel preparation in rats with experimentally induced bacterial translocation. METHODS: Fourty adult male Sprague Dowley rats weighing 250-300 g. were divided equally into four groups as Group 1 (sham [control]), Group 2 (experimentally induced IAH at 19 mmHg), Group 3 ( SDD group) and Group 4 (SDD and mechanical bowel preparation with 19 mmHg intraabdominal pressure). Group 3 and 4 were treated at 12 hours intervals with oral gentamycine 5 mg/kg and IM sefotaxime 100mg/kg Mechanical bowel preparation was performed by oral administration of sodium phosphate. After 24 hours all rats were sacrified; mesenteric lymph nodes, spleen and liver biopsy specimens were harvested aseptically. Specimens were diluted and cultured in McConkey medium and the colony-forming units (CFU/gr ) were calculated. RESULTS: In Kruskal Wallis tests there were no significant differences between Group 1 and 3 or 4, and also Group 3 and 4 (p>0.05, p=0.872 respectively), while differences between Group 1 and 2, and also Group 3 and 4 were statistically significant (p<0.001) with respect to CFU/g estimates. CONCLUSION: These data indicate that selective intestinal decontamination and mechanical bowel preparation prevent bacterial translocation due to intraabdominal hypertension.

Acinetobacter↗

PubMed2004

Effect of bowel decontamination with metronidazole and vancomycin on gastroduodenal myoelectric activity.

UNLABELLED: It is well recognized that prolonged antibiotic therapy leading to gut decontamination often results in side effects and may lead to colonization of gut with pathologic bacteria. Changes of a gut microflora could play a role in dysmotility of gastrointestinal tract. The aim of the study was to evaluate influence of intraluminal colon anaerobic and aerobic bacterial flora on myoelectric activity of duodenum and stomach. A myoelectric activity recordings using electrodes implanted on small bowel of the conscious rats were performed. Group I was scheduled for control recording, group II for recordings in 4th day after metronidazole (M) administration (30 mg/kg) and group III for recordings after vancomycin (V) administration (15 mg/kg) respectively. Rat's stools were cultured for confirmation of changes in colon flora composition. Recordings were previously filtered digitally with bandwidth filter 0.01-0.1 Hz and 0.1-1.0 Hz to extract gastric and duodenal slow wave respectively and than analyzed with Fast Fourier Transformation. Baseline duodenal slow wave frequency in control group revealed 0.60 +/- 0.05 Hz. M increased slow waves frequency to 0.64 +/- 0.13 Hz and V did not 0.58 +/- 0.09 Hz (p > 0.05). Slow wave dominant frequency of the stomach showed decrease of frequency from control 0.035 +/- 0.04 to 0.025 +/- 0.06 Hz after M (p < 0.05). Pretreatment with V also did not influence slow wave dominant frequency in comparison to control group (0.036 +/- 0.07 Hz, p > 0.05). CONCLUSION: Only pretreatment with M significantly decreased gastric slow wave frequency. One can speculate that M effects are related not only to gut decontamination but also directly affects ENS. We propose hypothesis that M influence on slow wave frequency may be related not only to its antimicrobial activity but to its potential neurotoxic action on intramural ENS neurons.

Animals↗

PubMed1992

Systemic prostacyclin in cirrhotic patients. Relationship with portal hypertension and changes after intestinal decontamination.

The total body production of prostacyclin was shown to be increased in cirrhotic patients, suggesting that its synthesis by blood vessels of the systemic circulation is enhanced. However, the mechanism by which the synthesis of systemic prostacyclin is stimulated is not known. The present study investigated the urinary excretion of 2,3-dinor-6-keto-PGF1 alpha, an index of total body prostacyclin synthesis, first, in cirrhotics with portal hypertension (n = 19) as compared with cirrhotics with reduced portal pressure after portacaval shunt surgery (n = 18) and with control noncirrhotic subjects (n = 11), and; second, in cirrhotics before and after intestinal decontamination by oral nonabsorbable antibiotics (n = 9 antibiotic treated patients, n = 10 control nontreated cirrhotics). Control noncirrhotic subjects showed lower urinary excretion of 2,3-dinor-6-keto-PGF1 alpha than both groups of cirrhotics (P less than 0.001). Interestingly, urinary excretion of 2,3-dinor-6-keto-PGF1 alpha was significantly higher in cirrhotics with portacaval shunt than in those with portal hypertension (P less than 0.01). The urinary excretion of 2,3-dinor-6-keto-PGF1 alpha decreased significantly after intestinal decontamination in the antibiotic-treated group (580.1 +/- 232.4 vs. 431.2 +/- 219.2 pg/mg creatinine; P less than 0.05) but not in nontreated patients (543.9 +/- 214.4 vs. 581.2 +/- 281.4 pg/mg creatinine; P = NS). These data suggest that the increased urinary excretion of 2,3-dinor-6-keto-PGF1 alpha observed in cirrhotics is not directly related to portal hypertension itself but to portal blood factors that bypass the liver. Some such factors may be of intestinal bacterial origin.

6-Ketoprostaglandin F1 alpha↗

PubMedDate not supplied

[Kinetics of setting up of a human fecal flora in germ free mice and trial of decontamination of antibiotherapy (author's transl)].

We have tried in this study to reproduce in germfree mice a bacterial equilibrium observed previously in the gastrointestinal tract of child "L.N.", reared in a plastic isolator. Eight bacterial strains were studied. Seven had been fortuitously introduced: Acinetobacter lwoffi LN1, Staphylococcus epidermidis LN2, Clostridium perfringens LN3, Plectridium anatum LN4, Streptococcus bovis LN5, Enterobacter cloacae LN6, Corynebacterium sp LN7. The eighth strain was purposely administered to the child in order to take advantage of an antagonism between this strain and spontaneously acquired flora. This strain is Bacillus licheniformis FD1. The gnotoxenic mice proved to be a good experimental model because we found their bacterial equilibrium comparable to that observed in child L.N. In addition, we studied the decontamination procedures of the gastrointestinal tract of mice by observing both the antagonism of B. licheniformis with bacitracin, and the action of a suitable mixture of antibiotics. Conditions for the realization of this decontamination are discussed in this study.

Acinetobacter↗

PubMed1991

[Selective intestinal decontamination--yes or no?].

Various studies have shown that as a result of selective decontamination of the digestive tract, the incidence of pneumonia in artificial ventilation caused by gram-negative bacteria is reduced; however, a few studies have pointed out that, at the same time, the rate of pneumonia caused by gram-positive bacteria is increased. Most investigators agree that mortality cannot be reduced. A few studies have demonstrated that simultaneous administration of cefotaxime is not necessary. Various recent reports indicate that under certain conditions selective decontamination of the digestive tract undoubtedly leads to the development of resistance to gram-negative bacteria and in particular, to oxacillin-resistant staphylococci, S. epidermidis, and enterococci. Multicenter, randomized, and prospective double-blind studies will have to investigate and establish definitively which antibiotics have to be applied in which patients in order to reduce the rate of pneumonia as well as mortality. In addition, these studies will have to determine the microbiological and hospital hygiene measures necessary to avoid the risk of resistance or colonization developing by certain agents. As long as this is not the case, broad, non-selective use of SDD is not justified, especially in intensive care units.

Anti-Bacterial Agents↗

PubMed1989

Changes of immunological parameters in immunocompromised patients under selective decontamination of the digestive tract. Second Part: Investigations on the influence of drugs on zymosan-induced and luminol-enhanced chemiluminescence of peripheral leucocytes.

The influence of drugs used for selective decontamination, given in therapeutically effective concentrations, was examined in healthy controls and immunocompromised patients with hematologic systemic diseases by measuring the zymosan-induced and luminol-enhanced chemiluminescence of peripheral leucocytes. Drug-induced repression of phagocytic activity could usually be found both in healthy controls and in patients with hematologic systemic diseases. The combination of trimethoprim and sulfamerazine had a pronounced repressive effect. Such indications should be taken as a basis for further investigations in order to avoid additional iatrogenic restriction of defence. If possible, drugs with effects leading to repression of phagocytosis should not be used for selective decontamination.

Anti-Infective Agents↗

PubMed1989

Dual enzymatic detergents: a safer way to decontaminate.

1. Although the technology of mechanical equipment has advanced, manual cleaning of contaminated items has not been eliminated in the initial decontamination phase. 2. Proteolytic enzymes dissolve and lift the protein contaminate while detergents remove the dissolved organic particulate from the surface of the item. 3. A dual proteolytic enzyme detergent can be used over a wide range of pH levels and temperatures. 4. Dual enzymatic detergents reduce employee exposure through manual cleaning and assure the complete removal of gross organic debris during the initial decontamination phase.

Detergents↗

PubMed1989

[Frequency of colonization and pneumonia and development of resistance in long-term ventilated intensive-care patients subjected to selective decontamination of the digestive tract].

Colonization of the oropharynx with potentially pathogenic microorganisms (PPM) is a highly significant factor in the pathogenesis of bacterial pneumonia in intensive care patients. Via colonization of the oropharynx, bacteria pass into the tracheobronchial tree, where they can give rise to pneumonia after overcoming pulmonary resistance mechanisms. By a new, prophylactic antibiotic treatment schedule consisting in selective decontamination of the digestive tract (SDD) with locally applied nonabsorbable antibiotics, Stoutenbeek achieved drastic lowering of the colonization and infection rate in trauma patients. In the present study, we wanted to check whether this new prophylactic antibiotic schedule can be applied on a surgical intensive care ward in all patients with long-term ventilation, irrespective of the diagnosis, and whether it affords advantages over a conventional antibiotic schedule. MATERIALS AND METHODS. All patients on a surgical intensive care ward in whom it was expected that mechanical ventilation would be necessary for more than 4 days were included in the study. During the first 6 months 83 patients were investigated, in whom antibiotics were only administered when the presence of infection had been confirmed, in accordance with generally accepted guidelines (control group). In the second 6-month period, 82 patients were selectively decontaminated with 4 x 100 mg polymyxin E, 4 x 80 mg tobramycin and 4 x 500 mg amphotericin B, administered through the gastric tube and in an antimicrobial paste in the oropharynx (SDD group). The SDD schedule entailed systemic administration of cefotaxime in the first 3-4 days. RESULTS. In the control group, enterobacteria/Pseudomonas spp. were isolated significantly more frequently than in the SDD group (P less than 0.001): in the pharyngeal smear in up to 53%, in the tracheal secretion up to 36%, and in the rectal smear in up to 93% of the patients In the SDD group in the 1 week the frequency of gram-negative aerobic bacteria in the pharynx decreased from 33% to 5%, in the tracheal secretion from 23% to 14% and in the rectum from 86% to 52% (24% in the second week). However, the decrease in gram-negative microorganisms was accompanied by significant increase in the frequency of Staphylococcus epidermidis and enterococci. The SDD schedule proved to be effective with regard to the rate of infection. In the control group, 35 patients developed pneumonia (42%) as against 5 patients receiving SDD prophylaxis (6%). The duration of mechanical ventilation in the patients with pneumonia was 5 days longer than in patients without pneumonia.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗