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PubMed1989

[Possible decontamination of pancreatin with gamma rays and chemical agents].

Certain pre-conditions given, the microbial contamination of pancreatin in powder form can be reduced below international standard values. However, each of the methods whether physical or chemical, causes a variable loss of activity depending on the methods applied and the concentration of the decontaminating agent used. Therefore during preparation of this complex enzymatic compound, highly aseptic conditions must be kept in all stages of the process to avoid an increase of germal contamination. For a final toxicological assessment of the decontaminated products, further tests are required.

Chromatography, High Pressure Liquid↗
PubMed1989

[Possibility of the survival of free-living amoebae which cause keratitis in decontamination solutions used for the maintenance of contact lenses].

Because Acanthamoeba keratitis associated with contact lenses were described, several solutions used in stationary eye wash stations were contaminated by free-living amoebae. 0.9% sodium chloride rinsing solutions allowed cyst and trophozoite growth and only one solution for decontamination using hydrogen peroxide led to rapid elimination of cysts and trophozoites. Antiseptic solutions containing ammonium derivatives or chlorhexidine killed only trophozoites. Because of the constant contamination of tap water with Acanthamoeba cysts resistant to chlorine, the prevention of amoebic keratitis in wearers of contact lenses needs: use of sterile solutions for decontamination or rinsing, choice, if possible, of oxidizing solutions, suppression of tap water for rinsing.

Acanthamoeba↗
PubMed1985

Influence of faeces on the activity of antimicrobial agents used for decontamination of the alimentary canal.

The influence of faeces on the activity of 9 antibiotics currently used for selective decontamination of the digestive tract was studied. These in vitro findings showed that the antimicrobial activity is differently affected by the presence and concentration of faeces. Great differences in loss of activity were observed on different microorganisms. Decontaminating drugs which were found to be minimally inactivated in vitro by the presence of faeces are proven to be superior in clinical studies too.

Anti-Bacterial Agents↗
PubMed1986

[Decontamination of continual cell lines spontaneously infected with mycoplasmas].

The continual cell lines of bovine kidneys MDBK and AUBEK, and porcine kidneys RPD and IBRS, spontaneously infected with Mycoplasma arginini and Acholeplasma laidlawii, were decontaminated by the method of selective elimination. Two elimination procedures were modified to be used for the decontamination: one based on the reduction of infection by the light treatment of the cultures, the other based on the selection of mycoplasma-free cell population through cell clonation. On the basis of a long-continued control of the cell clones a methodical procedure of the preparation of mycoplasma-free cell lines was worked out.

Acholeplasma laidlawii↗
PubMed1986

[Intestinal decontamination in the neutropenic patient. Apropos of a prospective randomized study].

Sixty-five patients undergoing remission-induction chemotherapy for acute leukemia in a protected environment unit were randomly assigned to selective antimicrobial modulation of the intestinal flora (SAM) with trimethoprim-sulfamethoxazole, or total antibiotic decontamination (TAD) with gentamicin, vancomycin and colimycin. Digestive tract colonization with Streptococcus D was more prevalent in the SAM group (p less than 0.01); colonization with yeasts was more prevalent in the TAD group (p less than 0.001). However, there was no difference between the two groups as regards to clinically and microbiologically documented infections, septicemias and survival. Selective antimicrobial modulation with trimethoprim-sulfamethoxazole is as effective and cheaper than total antibiotic decontamination with gentamicin, vancomycin and colimycin.

Acute Disease↗
PubMed1987

Limiting-dilution analysis for the determination of leukemic cell frequencies after bone marrow decontamination with mafosfamide or merocyanine 540.

To stimulate a leukemia remission marrow, cell suspensions of normal human bone marrow were mixed with human acute lymphoblastic or myelogenous leukemic cells of the CCRF-SF, Nalm-6, and K-562 lines. The cell mixtures were incubated in vitro with mafosfamide (AZ) or with the photoreactive dye merocyanine 540 (MC-540). A quantity of 10(4) cells of the treated suspensions was dispensed into microculture plates, and graded cell numbers of the line used to contaminate the normal marrow were added. Limiting-dilution analysis was used to estimate the frequency of leukemia cells persisting after treatment with the decontaminating agents. Treatment with AZ or MC-540 produced a total elimination (ie, 6 logs or 5.3 logs respectively) of B cell acute leukemia cells (CCRF-SB), whereas nearly 1.7 logs and 2 logs of K-562 acute myelogenous blasts were still present in the cell mixtures after treatment with MC-540 and AZ, respectively. Treatment of the Nalm-6-contaminated cell mixtures with AZ resulted in 100% elimination of clonogenic cells, whereas nearly 80% decontamination was obtained with MC-540. Our results suggest that treatment with AZ could be an effective method of eliminating clonogenic tumor cells from human bone marrow. MC-540, shown by previous studies to spare sufficient pluripotential stem cells to ensure hemopoietic reconstitution in the murine model and in clinical application, has comparable effects and merits trials for possible clinical use in autologous bone marrow transplantation.

Bone Marrow↗
PubMed1987

Whole bowel irrigation as a decontamination procedure after acute drug overdose.

Whole bowel irrigation, routinely used before colonoscopy, is evaluated as a potential gastrointestinal decontamination procedure for acute drug overdose. Nine adult volunteers, who served as their own controls, each ingested 5.0 g of ampicillin trihydrate on two occasions, one week apart. Whole bowel irrigation with polyethylene glycol electrolyte lavage solution was performed one hour after one ingestion. Serial serum ampicillin levels, electrolytes, osmolalities, body weights, and hematocrits were obtained. The areas under the concentration vs time curves for ampicillin were computed for both groups, and their means were compared. Mean duration of the procedure was 234 minutes and mean volume of infused polyethylene glycol electrolyte lavage solution was 7.7 L. Whole bowel irrigation produced a 67% decrease in ampicillin absorption and there were no significant changes in body weight, hematocrit, serum electrolytes, or osmolality. We conclude that whole bowel irrigation is an effective and safe gastrointestinal decontamination procedure for acute drug ingestion.

Adult↗
PubMed1982

Infection prophylaxis in acute leukaemia patients: comparison of selective and total antimicrobial decontamination of the gastrointestinal tract.

In a retrospective study, total antimicrobial decontamination with strict reverse isolation (ITD) and selective decontamination without isolation (SD) were compared as means of preventing infection in patients with acute leukaemia. Thirty patients were treated with ITD and 34 patients with SD. The surveillance cultures indicated that aerobic gram-negative bacilli and yeast could be equally eliminated effectively in both the groups. The anaerobic flora was only minimally influenced by SD. The incidence of acquired infections was 1.17 per patient in group ITD as compared to 0.85 in group SD. In group ITD, acquired bacterial infections were mostly caused by gram-negative bacilli (63%) whereas in the group SD these microorganisms accounted only for 25% of the infections. In group SD the total number of fever days was significantly lower and the mean duration of pyrexial episodes was substantially shorter. The results indicate that SD is an effective and inexpensive method for preventing gram-negative infections and might be at least as effective as ITD.

Acute Disease↗
PubMed1980

[The use of dodecyl-di(beta-oxyethyl) benzylammonium chloride (Bactofen) as a decontaminant in the cultural examination for detection of the Koch bacillus in sputum].

We tried to see whether it was possible to use Bactofen to decontaminate sputum for culture of Mycobacterium tuberculosis. Bactofen showed very little bactericidal action on tubercle bacilli, lower than Desogen, and selectively destroyed many contaminants, more actively than benzalkonium chloride. Digested sputum decontaminated with 0.2% Bactofen and then applied to culture media without centrifugation gave good results in growth of colonies.

Anti-Infective Agents, Local↗
PubMed1980

[Change in the antibiotic sensitivity of the intestinal microbial autoflora of acute leukemia patients in the process of decontamination].

The results of the studies on sensitivity of the intestine microflora to the antibiotics little adsorbed in the intestine are presented with respect to 8 patients with acute leukemia during and after decontamination. In addition to the cytostatic therapy, the patients were treated with gentamicin, ristomycin and nystatin administered orally in doses of 1200, 1500 mg and 6000000 units respectively every day for 2--4 weeks. The antibiotic sensitivity of the intestine microautoflora was determined before, during and after the antibiotic use, by the methods of gradient dishes and paper disks. It was found that during the use of nonadsorbing antibiotics the resistance of E. coli to gentamicin increased and only 3--4 weeks after discontinuation of the antibiotic use it regained the initial level. The shifts in sensitivity of staphylococcus to ristomycin and yeasts to nystatin were of the same character but less pronounced. Sensitivity of the intestine microautoflora to neomycin, monomycin, oxytetracycline and polymyxin decreased during decontamination and remained unchanged for 3--4 weeks after discontinuation of the antibiotic use. Some other characteristic features of the shifts in sensitivity of the intestine microflora to ristomycin, novobiocin and oxacillin were noted. Possible causes of such changes are discussed.

Acute Disease↗
PubMed1994

Gastrointestinal decontamination for acute poisoning by ingestion. Prevention of absorption of toxic compounds.

Gastrointestinal decontamination therapy in the patient with accidental or intentional ingestion of toxic substances has been standard therapy for several decades, although based on theory of presumed action and benefit. As scientific knowledge accumulates in this area of clinical toxicology, old assumptions are being challenged by scientific evidence relating to gastric emptying, efficacy of activated charcoal, and usefulness of whole-bowel irrigation with polyethylene glycol electrolyte lavage solutions. An overview is presented of the scientific data now available. Although realizing the still unresolved controversies, a logical plan is described for gastrointestinal decontamination following acute overdose.

Absorption↗
PubMed1994

[Nosocomial pneumonias. The effect of selective intestinal and ventricular decontamination in respirator-treated intensive care patients].

Nosocomial infections, especially pneumonias, are a common problem in Intensive Care Units (ICU) and are a major cause of morbidity and mortality. During the past ten years a new regime, selective decontamination of the digestive tract (SDD) has been introduced to prevent these infections which are often preceded by colonization with aerobic potentially pathogenic microorganisms. Topical antibiotics are applied both orally and by nasogastric tube to prevent secondary endogeneous infections with Gram-negative enteric rods, Staphylococcus aureus and yeasts, in combination with parenteral antibiotics for the treatment of early primarily exogeneous and endogeneous infections. The effect of SDD on morbidity and mortality has been studied in many papers which are very conflicting and their results are difficult to interpret. This article reviews 11 published randomized trials of SDD in ICU among intubated and artificially ventilated adult patients aged more than 15 years. Of the eleven available controlled studies, eight showed a significant reduction of nosocomial pneumonias among patients who received selective decontamination. Only two studies demonstrated a reduction in infection related mortality rates.

Adult↗
PubMedDate not supplied

Assessing nurses' hand decontamination performance.

There have been numerous attempts to assess the frequency and technique of nurses' hand decontamination, but criteria employed to define acceptable levels of practice are questionable, while comparisons between staff in different clinical settings appear never to have been undertaken. In the study reported here tight criteria were developed to evaluate performance, then used to compare nurses employed in three clinical settings: intensive care, surgical and medical units. Two hospitals were employed, one with an infection control nurse, the other without. Frequency was highest in the ICU of the second hospital, but technique was superior in ICUs regardless of hospital. Half of all opportunities for essential decontamination were, however, omitted. Technique appeared superior to earlier reports. Alcoholic hand-rub was readily available and used more often in the unit where the best practice was witnessed.

Hand Disinfection↗
PubMed1993

[The effect of selective decontamination on malignant hematologic diseases treated with aggressive chemotherapy].

The authors analyzed the course of 100 cycles of chemotherapy administered on account of haematological oncological disease: 66 cycles with administration of selective decontamination and 34 without its administration. Based on an analysis of the gut flora they provided evidence of the necessity of concurrent administration of originally separately administered antibiotics and of the necessity to replace nystatin by amphotericin B. They found a significant reduction of the incidence of infectious complications, the number of days with a body temperature above 38 and reduced consumption of antibiotics. The authors found a different composition of the agents causing infectious complications--a reduction of the ratio of Gram-negative agents and an increase of Gram-positive agents and fungi and also in increased percentage of fever of unknown origin. By analysis of the sensitivity of the detected microbes to antibiotics the authors assessed changes in the resistance caused by administration of selective decontamination and assessed the order of assumed effectiveness of the tested antibiotics.

Adult↗
PubMed1996

[Determination of physicochemical characteristics and evaluation of decontaminating efficacy and in vitro safety of cleaning products for contact lenses].

PURPOSE: This work aims to characterize products designed for cleaning contact lenses and particularly their physicochemical properties, their efficiency and their ocular irritancy potential compared to the main requirements of eye-washes. MATERIAL AND METHODS: The physicochemical controls include pH determination, viscosity and freezing point depression. In addition, we carried out the hydrogen peroxide assay for products containing this active substance. A microbiological control was performed when opening the product and after simulation of a 21-day aging. We determined the decontaminating efficacy of the products on four bacterial strains and a fungal strain. Finally, we tested their ocular allowance by an in vitro test. RESULTS: The pH values obtained ranged from 3.2 (oxygenated water solutions) to 7.6. The viscosity was close to a water solution one (about 1 centipoise). The different assays showed hydrogen peroxide content similar to that stated on the package: rate averaged to 3% and was negligible after neutralization. At opening and after simulation the bacteriological quality was excellent. Finally, decontaminating efficiency against germs was very good for the products tested. The products were classified as non-irritant by the ocular irritancy test. CONCLUSION: The results obtained show that the products tested met the reference criteria, particularly eye-wash criteria.

Bacteria↗
PubMed1997

NMR study of per(3,6-anhydro) alpha cyclodextrin as a potential agent for the biological decontamination of lead.

The ability of per(3,6-anhydro) alpha cyclodextrin(3,6CD) to capture lead from a preformed glutathion (GSH)-lead complex was investigated by NMR spectroscopy. Such a removal strongly depends on the nature and pH of the buffer used in the competition experiments. It was found that an almost complete removal of lead can be achieved at pH 5.5, especially when lead nitrate is used. The capture also strongly depends on the nature of the lead species as well as of the counter ion present in the medium. These observations imply that decontamination of lead by this process should be optimal under acidic conditions, i.e. in the acidic tractus (stomach). Conversely, lead decontamination at neutral pH was of poor efficiency or required a large excess of (3,6CD). This was particularly the case when human plasma was used as solvent.

Chelating Agents↗
PubMed2006

The effect of selective decontamination of the digestive tract on mortality in multiple trauma patients: a multicenter randomized controlled trial.

OBJECTIVE: Evaluation of selective decontamination of the digestive tract (SDD) on late mortality in ventilated trauma patients in an intensive care unit (ICU). METHODS: A multicenter, randomized controlled trial was undertaken in 401 trauma patients with Hospital Trauma Index-Injury Severity Score of 16 or higher. Patients were randomized to control (n=200) or SDD (n=201), using polymyxin E, tobramycin, and amphotericin B in throat and gut throughout ICU treatment combined with cefotaxime for 4 days. Primary endpoint was late mortality excluding early death from hemorrhage or craniocerebral injury. Secondary endpoints were infection and organ dysfunction. RESULTS: Mortality was 20.9% with SDD and 22.0% in controls. Overall late mortality was 15.3% (57/372) as 29 patients died from cerebral injury, 16 SDD and 13 control. The odds ratio (95% confidence intervals) of late mortality for SDD relative to control was 0.75 (0.40-1.37), corresponding to estimates of 13.4% SDD and 17.2% control. The overall infection rate was reduced in the test group (48.8% vs. 61.0%). SDD reduced lower airway infections (30.9% vs. 50.0%) and bloodstream infections due to aerobic Gram-negative bacilli (2.5% vs. 7.5%). No difference in organ dysfunction was found. CONCLUSION: This study demonstrates that SDD significantly reduces infection in multiple trauma, although this RCT in 401 patients was underpowered to detect a mortality benefit.

Adult↗
PubMed1991

An evaluation of saline irrigation and comparison of povidone-iodine and antibiotic in the surface decontamination of donor eyes.

We evaluated the effect of saline irrigation on 38 pairs of donor eyes and determined the relative efficacy of antibiotic rinse/storage (neomycin-polymyxin B-gramicidin) and povidone-iodine immersion. Microbial growth was found in 49 (64.5%) of 76 eyes from which cultures were taken before irrigation, and only four (8.2%) became culture negative after irrigation. Of 27 eyes culture negative before irrigation, 15 (55.6%) became positive after irrigation. One eye of each pair was then assigned randomly to antibiotic rinse/storage and the other eye to 3-minute immersion in 1% povidone-iodine. Both antimicrobial treatments decreased the numbers of positive cultures, with povidone-iodine showing an advantage that did not reach significance. These results demonstrate that saline irrigation of donor eyes in situ does not reduce surface contamination and that povidone-iodine immersion should be considered as an alternative for donor eye decontamination.

Anti-Bacterial Agents↗