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PubMed1992

[The sterility of blood products manufactured in Ukraine].

The author reports results of examination for sterility of 3100 series (7343 samples) of hemocorrectors that were received for State control from zonal blood transfusion stations in the Ukraine from 1987 through 1990. Four of them proved non-sterile. Strict surveillance for aseptics and antiseptics at all stages of the technological process will ensure sterility of all hemotransfusion media obtained from the blood transfusion services.

Bacteria↗
PubMed1987

HLA-DR antigen expression on T cells from cerebrospinal fluid in multiple sclerosis and aseptic meningo-encephalitis.

HLA-DR expression on T lymphocytes in cerebrospinal fluid (CSF) from patients with multiple sclerosis (MS) and acute aseptic meningo-encephalitis (AM), and from blood only from healthy controls was examined by a new double-immunofluorescence labelling assay using species-specific second layers on prefixed cell samples. Thirteen of 16 patients with AM (81%) had an elevated percentage of DR positive T cells in CSF against only two of 20 patients with MS (10%). Our data indicate that AM, an acute infection of the central nervous system (CNS), is accompanied by accumulation in CSF of activated, DR positive T cells as a reflection of actively involved cellular immunity within the CNS, while this accumulation of DR positive T cells is not seen in MS, a chronic inflammatory CNS disease, despite some of the patients being examined during clinical exacerbations.

Acute Disease↗
PubMed1986

Sampling for airborne fluorouracil in a hospital drug preparation area.

Fluorouracil content was studied in air samples from a hospital pharmacy work area where a vertical laminar-airflow biological safety cabinet (BSC) vented into the work area was used for the preparation of antineoplastic drugs. The BSC was run 24 hours per day and used approximately 6 hours per day. During one 56-hour period and one 95-hour period, a portable pump delivering room air at 2 L/min was positioned 12 inches outside the BSC. Fluorouracil content in extracts from 0.5-micron Teflon filters housed in the pump was assayed by high-performance liquid chromatography. The assay's lower limit of fluorouracil detection was 0.2 ng/cu m air. In the 56-hour sampling period and the 96-hour sampling periods, 25.4 g and 25 g, respectively, of fluorouracil were prepared. No fluorouracil was detectable in the filter extracts. Use of an appropriate biological safety cabinet in conjunction with good aseptic technique and the recommended procedures for safe handling of antineoplastic drugs may reduce the potential for dispersal of drug into the pharmacy workroom environment.

Air Pollutants, Occupational↗
PubMedDate not supplied

The EmulSiv filter removes microbial contamination from propofol but is not a substitute for aseptic technique.

PURPOSE: To evaluate the ability of the EmulSiv filter (EF) to remove extrinsic microbial contaminants from propofol. METHODS: Aliquots of Staphylococcus aureus (S. aureus), Candida albicans (C. albicans), Klebsiella pneumoniae (K. pneumoniae), Moraxella osloensis (M. osloensis), Enterobacter agglomerans (E. agglomerans), Escherichia coli (E. coli), Serratia marcescens (S. marcescens), Moraxella catarrhalis (M. catarrhalis), Haemophilus influenzae (H. influenzae) and Campylobacter jejuni (C. jejuni) were inoculated into vials containing 20 mL of sterile propofol. The unfiltered inoculated propofol solutions served as controls. Ten millilitres and 20 mL samples of the inoculated propofol were filtered through the EF. All solutions were then subplated onto three culture plates using a precision 1 micro L calibrated platinum loop and incubated. The number of colony forming units (CFU) were counted. Data were analyzed using a one-sample t test, and a P value of less than 0.05 was selected as the level of statistical significance. RESULTS: The EF was able to completely remove CFU of S. aureus, C. albicans, K. pneumoniae, M. osloensis, E. agglomerans, E. coli, S. marcescens, and M. catarrhalis (P < 0.05). A small number of H. influenzae CFU were able to evade filtration in both the 10 mL and 20 mL samples. C. jejuni CFU were able to evade filtration in only the 10 mL sample. CONCLUSIONS: The EF removes the majority of microbial contaminates from propofol with the exception of H. influenzae and C. jejuni. Although the EF is capable of removing most of the microbial contamination produced by H. influenzae and C. jejuni, a few CFU are capable of evading filtration. Consequently, even the use of a filter capable of removing microbial contaminants is not a substitute for meticulous aseptic technique and prompt administration when propofol is used.

Bacteria↗
PubMed2000

Penetration of rufloxacin into the cerebrospinal fluid in patients with inflamed and uninflamed meninges.

Forty-four patients scheduled for lumbar puncture (LP) were recruited to determine the level of penetration of orally administered rufloxacin into cerebrospinal fluid (CSF). The patients were divided into three clinical groups: those with normal CSF (groups A(1d) and A(7d)), those with aseptic meningitis (group B), and those with bacterial meningitis (group C). Members of group A(1d) received a single 400-mg rufloxacin dose, while group A(7d), B, and C constituents had a multiple-dose regimen (one 400-mg dose, followed by one 200-mg dose daily for 6 days). LP was performed on group A(1d) members 5 h after they had received treatment, while for group A(7d) it was undertaken 5 h after administration of the last dose. For group B, LP was performed 5 h after the first and the last doses, whereas for group C it was undertaken after the first, fourth, and last doses. Concentrations of rufloxacin in simultaneously collected CSF and plasma samples were determined. Mean CSF/plasma rufloxacin concentration ratios ranged from 0.57 to 0.84, depending on the study group. A higher, but not statistically significant, degree of penetration into CSF was observed in patients with bacterial meningitis than in those with normal CSF or aseptic meningitis. These data indicate that rufloxacin diffuses efficiently into the CSF of patients with either inflamed or uninflamed meninges.

Adult↗
PubMed2006

Sterile and disposable fluidic subsystem suitable for clinical high speed fluorescence-activated cell sorting.

BACKGROUND: Applications of fluorescence-activated cell sorting (FACS) are ideally performed under aseptic conditions so that isolated cells can be successfully cultured, transplanted, or processed for the isolation of protein and nucleic acids. However, modern "off-the shelf" flow cytometers are suboptimally designed for these purposes because nonsterile instrument hardware components directly contact sample-harboring fluids, compromising their sterility. METHODS: We have described the design and modular modification of a cytometer with a sterile and disposable FACS fluid handling system that meets requirements of high-speed FACS and good manufacturing practice. This system was tested for functionality and its ability to maintain a clean and sterile fluid environment. RESULTS: Our data have shown that this new fluidic subsystem completely replicated the intended function of the manufacturer's standard fluid handling system, and isolates the fluid from contaminants such as bacteria and fungus, endotoxins, mycoplasma, and helicobacter. CONCLUSIONS: FACS has emerged as a powerful tool used to study and manipulate stem cells. However, if stem cell discoveries are to be fully utilized in clinical transplant medicine, aseptic instrument configurations must be developed. For this purpose, we have designed a disposable sterile fluid handling system.

Endotoxins↗
PubMed2000

Diagnosis and surveillance of herpes simplex virus infection of the central nervous system.

Herpes simplex viruses (HSV) are responsible for neurological disorders that require rapid diagnostic methods and specific antiviral therapy. During 1997, 1431 cerebrospinal fluid samples (CSF) collected from 1339 patients with neurological disorder presentations were processed for HSV detection. Eleven patients were positive for HSV, seven presenting with encephalitis (6/7 due to HSV1) and 4 with aseptic meningitis (4/4 due to HSV2). The incidence of HSV encephalitis was 2.33 cases / 10(6) inhabitants/year. Among encephalitis (HSV encephalitis) cases, 1 patient died due to the late implementation of antiviral therapy, and sequelae were observed in 4 cases. No sequelae were observed in aseptic meningitis cases. Four HSV encephalitis cases were monitored by PCR detection in CSF. Despite acyclovir therapy, PCR remained positive in CSF up to 20 days in 2 cases. This result suggest that the antiviral treatment for HSV encephalitis should be monitored by PCR detection of HSV in CSF.

Acyclovir↗
PubMed1994

An outbreak of Ochrobactrum anthropi bacteraemia in five organ transplant patients.

Nosocomial bacteraemia caused by Ochrobactrum anthropi occurred over a 1-month period in five organ transplant recipients, four of whom were in the same renal and pancreatic transplant unit. Bacteraemia occurred with cyclosporin A, azathioprine and steroids, and with a rabbit anti-thymocyte globulin (RATG) during the induction phase. RATG appeared to be the only common factor among the five cases. Over the period described, 71.4% of all patients receiving RATG developed O. anthropi bacteraemia. Three patients presented with fever and chills during or shortly after RATG infusion. Analysis of residues of the infusion, and the used vials of RATG, showed the presence of O. anthropi in concentrations of between 20 and 1000 cfu ml-1 in 5.3% of samples. Unused vials were found to be heavily contaminated with either O. anthropi or Microbacterium spp. in 23.5% of samples. All positive vials were of one particular lot number suggesting a malfunction in the manufacturing process. Many parenteral drugs such as the RATG used here do not contain preservatives and, although aseptically prepared, will not withstand thermal sterilization. Bacterial contamination of these small volume medications is not always easily detectable by conventional methods. This outbreak highlights the need for accurate quality control testing to detect small inocula that may occur during or after the manufacturing process.

Adult↗
PubMed1989

Perioperative antibiotic prophylaxis for transurethral resection of the prostate: is it justifiable?

The role of perioperative antimicrobial prophylaxis in transurethral resection of the prostate remains controversial. A total of 110 patients with preoperative sterile urine undergoing transurethral resection of the prostate was included in this open, prospective and randomized study to compare the prophylactic role of cefoperazone to no antibiotic prophylaxis. Patients were well matched between the 2 groups on all essential characteristics and risk factors at baseline. Owing to the strict selection criteria and aseptic measures used, the low incidence of postoperative urinary tract infections in the control group (1.8 per cent) compared to none in the cefoperazone group made conclusions and generalization limited due to sample size. In view of the extremely low infection rate it is doubtful that antibiotic prophylaxis had any beneficial role in this selected population.

Aged↗
PubMed2002

Alumina-alumina artificial hip joints. Part I: a histological analysis and characterisation of wear debris by laser capture microdissection of tissues retrieved at revision.

The aims of this study were to investigate the tissues from uncemented Mittelmeier alumina ceramic-on-ceramic total hip replacements using histological methods and to isolate and characterise the ceramic wear debris using laser capture microdissection and electron microscopy. Tissues from around 10 non-cemented Mittelmeier alumina ceramic on ceramic THRs were obtained from patients undergoing revision surgery. Tissues were also obtained from six patients who were undergoing revisions for aseptic loosening of Charnley, metal-on-polyethylene prostheses. Tissue sections were analysed using light microscopy to determine histological reactions and also the location and content of alumina ceramic wear debris. Tissue samples were extracted from sections using laser capture microdissection and the characteristics of the particles subsequently analysed by TEM and SEM. The tissues from around the ceramic-on-ceramic prostheses all demonstrated the presence of particles, which could be seen as agglomerates inside cells or in distinct channels in the tissues. The tissues from the ceramic-on-ceramic retrievals had a mixed pathology with areas that had no obvious pathology, areas that were relatively rich in macrophages and over half of the tissues had in the region of 60% necrosis/necrobiosis. In comparison, the Charnley tissues showed a granulomatous cellular reaction involving a dense macrophage infiltrate and the presence of giant cells and < 30% necrosis/necrobiosis. The tissues from the ceramic prostheses also showed the presence of neutrophils and lymphocytes, which were not evident in the tissues from the Charnley retrievals. There were significantly more macrophages (p < 0.05), and giant cells (p < 0.01) in the Charnley tissues and significantly more neutrophils (p < 0.01) in the ceramic-on-ceramic tissues. TEM of the laser captured tissue revealed the presence of very small alumina wear debris in the size range 5-90 nm, mean size + SD of 24 +/- 19nm whereas SEM (lower resolution) revealed particles in the 0.05-3.2 microm size range. This is the first description of nanometre sized ceramic wear particles in retrieval tissues. The bi-modal size range of alumina ceramic wear debris overlapped with the size ranges commonly observed with metal particles (10-30 nm) and particles of ultra-high molecular weight polyethylene (0.1-1,000 microm). It is possible that the two size ranges of contributed to the mixed tissue pathology observed. It is speculated that the two types of ceramic wear debris are generated by two different wear mechanisms in vivo, under normal articulating conditions, relief polishing wear and very small wear debris is produced. while under conditions of microseparation of the head and cup and rim contact, intergranular and intragranular fracture and larger wear particles are generated.

Aluminum Oxide↗
PubMed1998

Incidence of Campylobacter in crops of preharvest market-age broiler chickens.

Previous research has identified cecal and intestinal contents as sources for Campylobacter contamination of broiler carcasses in the processing plant. During the present study, we evaluated the crop contents of preharvest market-age broilers as a potential reservoir of field-derived Campylobacter in the processing plant. Crops were collected aseptically from 40 randomly selected market-age broilers in each of nine commercial broiler flocks. Ceca were collected from broilers in six of the same flocks for comparison with the crop samples. The presence of Campylobacter in the crops and ceca was determined by enrichment culture in Bolton broth followed by culture on Campy-Ceflex plates. Campylobacter was isolated from the crop contents of broilers in seven of the nine flocks and from the cecal contents in three of six flocks. The incidence of Campylobacter-positive crop samples among all birds evaluated (224/359; 62%) was significantly higher (P < 0.001) than the number of positive cecal samples (9/240; 4%). The results indicate that the incidence of Campylobacter contamination of crop contents may exceed that of the cecal contents by as much as 37-fold in some broiler flocks, and may represent a critical preprocessing control point in reducing Campylobacter entry into the processing plant.

Animals↗
PubMed1997

Granulocyte elastase activity measurement in the cerebrospinal fluid of patients with purulent meningitis.

Measurements were made of the granulocyte elastase activity and the concentration of granulocyte elastase alpha 1-proteinase inhibitor complex (E-alpha 1 PI) in the cerebrospinal fluid (CSF) of patients with purulent meningitis and aseptic meningitis. Granulocyte elastase activity was determined by the cleavage of methoxysuccinyl-L-(alanyl)2-prolyl-valyl-p-nitroanilide peptide substrate. The E-alpha 1 PI concentration was assayed with an enzyme immunoassay technique. Granulocyte elastase activity in the CSF on admission was significantly higher in patients with purulent meningitis (800 +/- 539 micrograms/L; mean +/- SD) than in patients with aseptic meningitis (< 10 micrograms/L). Granulocyte elastase activity in the CSF of patients with purulent meningitis decreased rapidly except for two patients who subsequently developed hydrocephalus. There was a weak correlation between granulocyte elastase activity and the concentration of E-alpha 1 PI in the CSF with purulent meningitis (n = 67, r = 0.48, P < 0.01). However, some samples of CSF showed a marked discrepancy between granulocyte elastase activity and E-alpha 1 PI concentration, indicating the importance of measuring granulocyte elastase activity in the CSF to estimate tissue injury.

Biomarkers↗
PubMed1978

Tissue sterility in uneviscerated carcasses.

Sheep muscle tissue removed aseptically from control carcasses, from uneviscerated carcasses held at 20 degrees C for 24 h, and from carcasses of sheep subjected to stress before slaughter was examined for the presence of bacteria. All samples from a total of 68 carcasses were sterile. Whole-body autoradiography of mouse carcasses showed that 14C-labeled fixed bacteria injected after death remained in the lumen of the intestine. Live bacteria did not penetrate the mucosal surface until the tissue structure had been disrupted by proteolytic enzymes. Bacteria were unable to penetrate sections of intestine longitudinally until considerable structural breakdown had occurred, indicating that blood and lymph vessels do not normally offer a pathway for microbial invasion from the intestine. Clostridia, which have been reported to be responsible for deep spoilage of meat, reached maximum numbers 24 to 28 h after death in the intestines of guinea pig carcasses stored at 20 degrees C, but did not invade carcass tissues until the stomach ruptured as a result of proteolysis between 2 and 3 days after death.

Animals↗
PubMed2001

Geo-helminth infections in a rural area of Sri Lanka.

School children carry the heaviest burden of morbidity due to intestinal helminth infection. The objective of this investigation was to study geo-helminth infections in 349 school children aged 6 to 13 years living in a rural area of Sri Lanka. Stool samples were examined by direct saline smear in an initial survey to determine the prevalence of intestinal parasitic infections and thereafter the children were followed up over a two year period with cross sectional surveys of stool samples being carried out at yearly intervals. Following collection of a stool sample, all the subjects were treated with mebendazole 500 mg as a single dose. Weights and heights were measured using standardized procedures. 2 ml of venous blood were collected from each subject under aseptic conditions to determine hematological indices. The prevalence of geo-helminth infections was low, and the prevalence declined during the two-year period from 5.4% in 1997 to 2.2% in 1998 and 2.0% in 1999 following yearly mass anti-helminth treatment. The incidence density was 0.021 cases per child year. The reduction in the prevalence from the baseline to the second survey is probably due to the reduction of the reservoir of infection among children as a result of mass treatment at baseline. The prevalence of infection during the second and third surveys were almost the same probably due to infections originating from other segments of the untreated population.

Adolescent↗
PubMed1978

The organization of a human milk bank in a North Q ueensland hospital.

The development of a human milk bank with nursing mothers as donors of human milk is described. Breast milk is collected manually, and as aseptically as possible, by the mother in the privacy of her home, and the milk is transported frozen to the milk bank by a member of the Nursing Mothers' Association of Australia. A sample of expressed milk is also collected and sent to the Microbiology Department of the Australian Government Health Laboratory for bacteriological examination. The milk bank is suitably located in the paediatric ward of the Townsville General Hospital. Human milk which has been classed as bacteriologically safe is given untreated to hospitalized infants in preference to formula milk. The result is a human milk bank which is administered under medical and microbiological control.

Australia↗
PubMed1993

Stability of octreotide acetate in polypropylene syringes.

The stability of octreotide acetate in polypropylene syringes was studied. Polypropylene syringes were aseptically filled with 1 mL of octreotide acetate 0.2 mg/mL and stored at 3 or 23 degrees C under light protection or light exposure. Three syringes were prepared for each condition and each sampling time. Unopened 5-mL glass vials of the drug served as controls. Samples were removed immediately and at 8, 15, 22, and 29 days and analyzed by high-performance liquid chromatography. At 3 degrees C, octreotide stored in light-protected syringes maintained more than 90% of its initial concentration for up to 29 days. However, at 22 days the concentration in the syringes stored at that temperature and exposed to light was less than 90% when the standard deviation is considered. At 23 degrees C, the drug was stable for only up to 15 days (light protection) and 22 days (light exposure) when the standard deviation is considered. Octreotide acetate in polypropylene syringes was stable for up to 29 days when stored at 3 degrees C and protected from light and for up to 22 days when stored at 23 degrees C and exposed to light.

Chemistry, Pharmaceutical↗
PubMed2001

Non-polio enteroviruses in acute flaccid paralysis.

OBJECTIVE: Human enteroviruses are the major cause of aseptic meningitis and also cause a wide range of other acute illnesses, including neonatal sepsis like disease, meningitis, acute flaccid paralysis and acute hemorrhagic conjunctivitis. Infection in neonates is particularly life threatening. METHODS: Stool samples of 523 children (age < 4 years) showing symptoms of acute flaccid paralysis (AFP) were studied. National Polio Surveillance Project workers from different parts of Uttar Pradesh and Bihar collected the samples during June to October 1998. Non-polio enteroviruses (NPEV) were isolated in 191 cases only, by cell culture based neutralization assay. These NPEV isolates were further studied to find the frequent enterovirus serotype detected in stool of children having AFP. RESULTS: Data generated will help future studies on NPEV serotypes circulating in this area. CONCLUSION: In addition it may reduce unnecessary hospitalization, allow immune globulin batches of high titres to frequently circulating serotypes, to be reserved for intravenous therapy of neonates and guide the formulation of antigens for rapid and less expensive diagnosis.

Child, Preschool↗
PubMed2000

Cystatin C and cathepsin B in CSF from patients with inflammatory neurologic diseases.

BACKGROUND: In CSF, proteolytic enzymes are believed to have crucial roles in the initiation and progression of inflammatory neurologic diseases (IND). Cystatin C, a major cysteine protease inhibitor in CSF, is tightly bound to cathepsin B and H. OBJECTIVE: To determine if cystatin C is involved in the disease process of IND, the authors measured the cystatin C concentration by ELISA method and cathepsin B and H activities in the CSF of patients with acute IND. METHODS: Cystatin C concentration and cathepsin B and H activities were measured in CSF samples taken from patients during the acute phase of their disease. Subjects studied were 8 patients with Guillain-Barré syndrome (GBS), 5 with chronic inflammatory demyelinating polyneuropathy (CIDP), 12 with MS, 16 with aseptic meningitis, 15 with neurodegenerative diseases as disease controls, and 35 healthy controls. RESULTS: A significant decrease in CSF cystatin C level was seen in the patients with GBS, CIDP, and MS compared to the control subjects. High cathepsin B activity, but not cathepsin H activity, was also observed in the patients with GBS, CIDP, and MS. CONCLUSION: Cystatin C levels in CSF measured by ELISA may help the physician recognize GBS, CIDP, and MS. Decreased levels of cystatin C may be related to the high levels of cathepsin B activity seen in the CSF of patients with GBS, CIDP, and MS.

Adult↗