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PubMed2005

Presence of Campylobacter jejuni in various organs one hour, one day, and one week following oral or intracloacal inoculations of broiler chicks.

Day-old broiler chicks (n=30) were obtained from a commercial hatchery and inoculated, either orally or intracloacally, with a characterized strain of Campylobacter jejuni. At 1 hr, 1 day, and 1 wk after inoculation, broilers (n = 5) from the orally and intracloacally inoculated groups along with control birds (n=4) were humanely killed by cervical dislocation. The broilers from the control and treatment groups were aseptically opened, and the thymus, spleen, liver/gallbladder, bursa of Fabricius, and ceca were aseptically removed and individually analyzed for C. jejuni. Overall, C. jejuni was isolated after oral inoculation from 13% (10/ 75), 17% (13/75), and 28% (14/50) of the 1-hr, 1-day, and 1-wk samples, respectively. Campylobacter jejuni was isolated from 10% (4/ 40), 8% (3/40), 10% (4/40), 25% (10/40), and 40% (16/40) of the thymus, spleen, liver/gallbladder, bursa of Fabricius, and ceca samples, respectively. Following the intracloacal route of inoculation, C. jejuni was recovered from 32% (24/75), 8% (6/75), and 16% (8/50) of the 1-hr, 1-day, and 1-wk samples, respectively. Campylobacter jejuni was isolated from 5% (2/40), 5% (2/40), 5% (2/40), 45% (18/40), and 40% (16/40) of the thymus, spleen, liver/gallbladder, bursa of Fabricius, and ceca samples, respectively, for all sampling periods. Campylobacter spp. were not recovered from sample sites examined from the control broilers from trial one, trial two, or trial three samples examined after 1 hr and 1 day. However, one control sample was positive from the 1-wk sampling from repetition three; therefore, those data were omitted. The rapid movement of Campylobacter to internal organs following both oral and intracloacal inoculation may be significant, particularly if it persists in these organs as reservoirs throughout the 65-wk life cycle of breeding birds.

Animals↗
PubMed2002

Correlation of MR imaging and histopathology after partial resection of normal rabbit brain.

OBJECTIVES: To investigate the findings of magnetic resonance (MR) imaging and histopathology in early postoperative normal brain, and to define the correlation between MR images and histopathology. METHODS: Thirty-six New Zealand rabbits weighing 2.0 to 3.0 kg were divided into 10 groups according to different postoperative days: 1 to 10 days. A partial resection of the parietooccipital region was performed under usual aseptic conditions after the animals were anesthetized intravenously with 3% pentobarbital (30 mg/kg). MR imaging procedures consisted of pre- and postcontrast scanning and were carried out on postoperative days 1 to 10. Brain tissue samples were prepared for examination immediately after MR scanning. Histopathological examination was done under light both and electron microscopes. The findings of MR imaging were compared with histopathologic findings. RESULTS: Surgical margin contrast enhancement on MR images could be seen 24 hours after surgery. The degree of contrast enhancement increased gradually up to 5 days postoperation, and no remarkable changes were present from days 5 to 10. Disruption of the blood brain barrier (BBB) was the main cause of contrast enhancement during the first 3 postoperative days. After that period, the mechanism responsible for contrast enhancement was the formation of neovascularity and a broken BBB. An increase in the amount of neovascularity played a predominant role in contrast enhancement in normal postoperative brain tissue. CONCLUSIONS: The features of enhanced MR images present at the surgical margin followed a typical time course during the early postoperative period. The role of neovascularity and BBB disruption in the formation of contrast enhancement at the surgical margin varies with time. Knowledge of the features of contrast enhancement in postoperative MR images of normal brain can help in differentiating benign changes from residual malignant glioma.

Animals↗
PubMed2002

[Bloodstream infection].

Bloodstream infection is the most serious disease and the third mortality rate among nosocomial infections. Recently, catheter-related bloodstream infection(CRBSI) is the major cause of the bloodstream infection, related to serious complication, leading to increase in morbidity and mortality. Coagulase-negative staphylococci, Staphylococcus aureus, enterococci and Candida spp. are most commonly causes of CRBSI. A variety of methods such as aseptic insertion techniques and appropriate catheter care have proved effective, which are also preferable to prevent CRBSI. If CRBSI occurs, empirical antimicrobial therapy should be immediately started after appropriate cultures of blood and catheter sample are performed.

Anti-Bacterial Agents↗
PubMed2000

[SAPHO syndrome: clinico-rheumatologic and radiologic differentiation and classification of a patient sample of 86 cases].

Synovitis (inflammatory arthritis), acne (pustulosa), pustulosis (psoriasis, palmoplantar pustulosis), hyperostosis (acquired), and ostitis (bland osteomyelitis) are symptoms forming the acronym SAPHO, which is a syndrome of nosologic heterogeneity. All entities forming the SAPHO syndrome are connected by a non-obligate dermatoskeletal association with an aseptic pustulous character. 86 cases were analyzed clinically, radiologically and by histology/histopathology. 31 adult patients showed the typical triad of pustulosis palmo-plantaris (psoriatica, PPP), sterno-costo-clavicular hyperostosis (SCCH), and "productive" spondylopathy, which we define as entity I. spondarthritis hyperostotica pustulopsoriatica (Spond.hyp.pp). Twelve adolescent and 13 adult patients showed entity no. II: chronic recurrent multifocal osteomyelitis (CRMO), being characterized by non-purulent osteomyelitis of plasma-cell sclerotic type, potentially being a reactive inflammatory process. 50% of the adult patients with CRMO showed PPP. Differentiation between these two entities is possible by detection of ossifying enthesiopathy in cases of Spond. hyp.pp and primarily chronic osteomyelitis in cases of CRMO. Two more entities or abortive forms of group I and II are III: the inflammatory syndrome of the anterior chest-wall (ACW syndrome) and IV: the more productive form of isolated sterno-costoclavicular hyperostosis (SCCH). Both are connected quite frequently to HLA-B-27-independent forms of spondarthritis and to pustulous dermatosis. More rarely we find osteo-articular symptoms in cases of acne pustulosa, which form group V: acne-associated spondarthritis and CRMO in the case of acne. Adult forms of CRMO with different forms of appearance (lumosacro-iliac hyperostosis with retroperitobeal fibrosis, pelvic type with affection of the hip-joint) are described. The immunologic theory of a "reactive osteomyelitis" potentially triggered by saprophytes is described. The inverse acne triad is brought in a context of skin symptoms. A case of intercurrent postpartum symptoms together with ulcerative colitis is described. Three cases of patients with Crohn's disease are described. Clinical features, radiological findings, and histopathological elements are brought together to determine the connections between the different entities and the possibilities of differentiation. With these elements together with bone-scan, it is often not necessary to obtain a bone specimen. Therapeutical possibilities, especially concerning CRMO, are discussed. "SAPHO syndrome" is more a sign-post on the way to a more subtle diagnosis when it comes to hyperostotic, skin-associated diseases, and it needs interdisciplinary work to clear the situation.

Acquired Hyperostosis Syndrome↗
PubMed1995

A persistent biochemical marker for partially treated meningitis/ventriculitis.

Regulation of circulating iron is important in bacterial, yeast, and fungal infections. In the present study, cerebrospinal fluid levels of ferritin, an iron-binding protein, were determined in controls and in patients with central nervous system pyogenic and viral infections. Among 441 controls, cerebrospinal fluid ferritin level was higher than 18 ng/mL in two relapsed patients with central nervous system leukemia, 12 with bacteremia or pneumonia, and one with hemorrhagic herpes simplex encephalitis. Cerebrospinal fluid ferritin levels were more than 18 ng/mL in 13 of 63 patients diagnosed with nonhemorrhagic aseptic meningitis/ventriculitis, when defined solely by negative cerebrospinal fluid culture. Conversely, cerebrospinal fluid ferritin exceeded 18 ng/mL in culture-proven meningitis (46 of 47 cases) and ventriculitis (five of five cases). Cases of indolent cryptococcus and tuberculous meningitis showed modest increases despite traditional cerebrospinal fluid markers, at times, being normal. Cerebrospinal fluid ferritin levels did not correlate with cerebrospinal fluid neutrophil count, cerebrospinal fluid protein concentration, serum ferritin level, or patient age. In 16 of 19 cases monitored sequentially during ongoing antibiotic treatment, levels remained over 18 ng/mL (average, 15.0 days; range, 1 to 54 days). This observation suggests that obtaining cerebrospinal fluid ferritin levels is helpful whenever traditional laboratory benchmarks normalize, as during acute or chronic antibiotic therapy, or create confusion with positive cultures stemming from sample contamination.

AIDS-Related Opportunistic Infections↗
PubMed1985

Viral meningitis.

Viral meningitis is part of the aseptic meningitis syndrome but must be distinguished from bacterial meningitis on the basis of a careful examination of the CSF and sound clinical judgment. Enteroviruses probably account for the bulk of cases of aseptic meningitis that occur in the United States and which are reported to the Centers for Disease Control each year. The seasonal pattern in the incidence of aseptic meningitis is largely due to the seasonal variation of enteroviral infections. Early on, the CSF in patients with viral meningitis frequently contains a predominance of polymorphonuclear leukocytes and may even have a low glucose level. The presence of neutrophils in the initial CSF sample is especially common in patients with enteroviral infections. A CSF glucose level lower than 50 per cent of a simultaneously drawn blood glucose determination is not uncommon in patients with viral meningitis due to mumps, LCM, and herpes simplex. In a patient with a predominance of polymorphonuclear leukocytes in the initial CSF specimen and in whom a viral infection is suspected, antibiotics may be withheld if a spinal tap is repeated within 12 hours. A shift from polymorphonuclear leukocytes to mononuclear cells makes viral meningitis the likely diagnosis. Both herpes simplex and varicella-zoster may infect the meninges by means of spread from cervical and dorsal root ganglia in a retrograde fashion much the way they spread in an antegrade fashion to the skin. HSV-2 is more likely to cause the clinical syndrome of viral meningitis, while HSV-1 is more likely to cause a meningoencephalitis with serious brain dysfunction. The identification of a specific viral agent in body fluids, especially the CSF, in a patient with aseptic meningitis is of more than academic interest, since it can shorten duration of hospital stay and eliminate unnecessary antimicrobial therapy. The diagnosis of enteroviral infections depends upon the isolation of a virus from CSF, stool, or throat plus a fourfold antibody response in the serum to the viral isolate. The 60-odd serotypes of enterovirus, each with different antigenic determinants, preclude serologic testing alone as a useful diagnostic test to identify the patient infected with coxsackievirus or echovirus. For infections, due to herpes simplex, varicella-zoster, LCM, and arboviruses, a serologic test alone can be useful.(ABSTRACT TRUNCATED AT 400 WORDS)

Bacterial Infections↗
PubMed2004

A cluster of nosocomial Klebsiella oxytoca bloodstream infections in a university hospital.

BACKGROUND: On February 19, 2003, four patients (patients 1-4) in the neurology ward underwent cranial magnetic resonance angiography (MRA) and developed fever within 1 hour afterward. Klebsiella oxytoca was isolated from blood cultures of patients 1 through 3. OBJECTIVE: To identify the source of this cluster of nosocomial K. oxytoca bloodstream infections. DESIGN: Outbreak investigation. SETTING: A 1,000-bed university hospital. METHODS: The infection control team reviewed patient charts and interviewed nursing staff about the preparation and administration of parenteral fluids. The procedure of cranial MRA was observed. Arbitrarily primed polymerase chain reaction (AP-PCR) was performed to show the clonal relationship among these three strains. RESULTS: AP-PCR revealed that three K. oxytoca isolates had the same molecular profile. Cranial MRA was found to be the only common source among these patients. During MRA, before injection of the contrast medium, normal saline solution was infused to check the functioning of the intravenous catheter. Use of the solution for multiple patients was routine, but the access diaphragm of the bottle was not cleansed. The bottle of normal saline solution used on February 19 had already been discarded and the culture sample taken from the solution on the day of observation was sterile. CONCLUSIONS: We speculate that normal saline solution became contaminated during manipulation and that successive uses might have been responsible for this cluster. Poor aseptic techniques employed during successive uses appear to be the most likely route of contamination. Use of parenteral solutions for multiple patients was discontinued.

Aged↗
PubMed2004

Prevention of infections associated with permanent cardiac antiarrhythmic devices by implementation of a comprehensive infection control program.

OBJECTIVE: To implement a comprehensive infection control (IC) program for prevention of cardiac device-associated infections (CDIs). DESIGN: Prospective before-after trial with 2 years of follow-up. SETTING: A tertiary-care, university-affiliated medical center. PATIENTS: A consecutive sample of all adults undergoing cardiac device implantation between 1997 and 2002. INTERVENTION: An IC program was implemented during late 2001 and included staff education, preoperative modification of patient risk factors, intraoperative control of strict aseptic technique, surgical scrubbing and attire, control of environmental risk factors, optimization of antibiotic prophylaxis, postoperative wound care, and active surveillance. The clinical endpoint was CDI rates. RESULTS: Between 1997 and 2000, there were 7 CDIs among 725 procedures (mean annual CDI incidence, 1%). During the first 9 months of 2001, there were 7 CDIs among 167 procedures (4.2%; P = .007): CDIs increased from 7 among 576 to 3 among 124 following pacemaker implantation (P = .39) and from 0 among 149 to 4 among 43 following cardioverter-defibrillator implantation (P = .002). Of the 14 CDIs, 5 involved superficial wounds, 7 involved deep wounds, and 2 involved endocarditis. Following intervention, there were no cases of CDI among 316 procedures during 24 months of follow-up (4.2% reduction; P = .0005). CONCLUSIONS: We observed a high CDI rate associated with substantial morbidity. IC measures had an impact on CDI. Although the relative weight of each measure in the prevention of CDI remains unknown, our results suggest that implementation of a comprehensive IC program is feasible and efficacious in this setting.

Adult↗
PubMed1980

Relation of culture site to the recovery of nonpolio enteroviruses.

The relative utilities of rectal swab, throat swab, stool, and cerebrospinal fluid cultures for the recovery of nonpolio enteroviruses were retrospectively evaluated for 81 patients who had one or more positive cultures. Of 33 stool cultures submitted, 32 (97%) were positive; of 52 throat swabs submitted, 35 (67%) were positive; of 29 rectal swabs, 20 (69%) were positive. Of 16 patients for whom both sites were simultaneously sampled, stool cultures were positive for 15, but throat cultures were positive for only six. Seven other patients who had positive throat cultures had simultaneous rectal swab cultures that were negative. For patients who had aseptic meningitis, cerebrospinal fluid was positive in only nine of 21 cultures, whereas stool was positive in all of 12 cultures. Stool should be cultured for all patients suspected of having nonpolio enterovirus infections; rectal swabs are inadequate substitutes for stool cultures.

Adult↗
PubMed1989

[Mycoplasma as a contaminant of cell cultures maintained in laboratories of private and official institutions].

Mycoplasma is one of the most serious contaminants of cell cultures. Its detection is very important in virology, as well as its eradication. The aim of this study was to verify the incidence of mycoplasma in cell lines maintained in seven laboratories of private, government and college institutions of the State of São Paulo, Brazil, for the purposes of research, production of reagents for diagnosis and production of biologicals for human and animal use. Of the 29 cell lines, eight were derived from human tissues and 21 from other animal species (dog, rabbit, mouse, hamster, monkey, pig, chicken and ox). Using the direct method with specific liquid and solid media for detection of mycoplasma, 48 out of the 106 cell samples tested were positive, corresponding to a contamination index of 45.28%. The incidence of contamination among the 35 cell samples of human origin was 51.43% (18 positive). Of the 71 samples originated from other species, 30 were positive (42.25%). The high incidence of contamination found calls for the adoption of measures for the prevention of this hazard: the elimination of mouth pipetting, the use of aseptic techniques and a rigid control of trypsin, serum and other components of cell culture media. The substitution of mycoplasma-free cultures for all contaminated ones and the performance of periodical tests for mycoplasma detection must also be carried out to prevent and avoid the dissemination of these organisms. Data obtained showed that contamination appeared in the 2nd (72.92%), in the 3rd (20.83%) and in the 4th passage (6.25%).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

[The hygiene of refrigerated and frozen foods].

Health and spoilage hazards arising from refrigerated and deep frozen foods may be due to - raw materials, e.g. pathogenic microorganisms which come from infected living animals or contaminate raw foods during handling. Psychrotrophic organisms have particular significance as pathogens or spoilage organisms as they can multiply also during refrigeration; - improper processing. Temperature abuse and incorrect time/temperature relations are main causes for microorganisms being not destroyed at the expected rate or even getting a chance of multiplying. Proper handling after refrigeration or frozen storage of foods ("hygiene of thawing") deserves also particular attention. - contamination, i.e. initial contamination of raw products which are ready for consumption without further processing (fruits, raw salads). Recontamination which follows a heat process is much more important and occurs before, during and after application of cold. In those cases, again, one has to distinguish between products which (a) are ready for consumption without a process (bakery and confectionary goods, ice cream, drinking milk) and (b) have to pass a process which reduces the bacterial load before consuming the food (ready to eat dishes or other foods ready for reheating in the home). Sites of increased hygienic hazard are a) lack of partitioning "clean" and "unclean" areas and processes, b) defects of sanitation and hygiene of personnel, c) defects of packaging, d) leakage during aseptic filling. Hazards are controlled through product and plant specific analysis of the process flow followed by continuous monitoring the "Critical Control Points". As an example, a report is given on a study on random samples taken from 180.000 prepackaged deep frozen menus which had been produced for a mass meeting. Microbiological monitoring of the process revealed time/temperature relations as critical control points of primary importance. Particular problems arose from any stoppage at the production line. Reliable means to assure food safety and protect consumer's health are HACCP concept based in plant control programs rather than sporadic microbiological monitoring of end products.

Animals↗
PubMedDate not supplied

High resolution protein electrophoresis of 100 paired canine cerebrospinal fluid and serum.

This study was performed to investigate the diagnostic relevance of cerebrospinal fluid (CSF) high resolution electrophoresis. The laboratory technique was applied to 100 paired samples of canine CSF and serum, with paired samples tested during the same analytical run, as recommended in human medicine. Ninety four of the dogs had a neurological disease and 6 healthy dogs served as a control group. A strong linear correlation between CSF total protein concentration and the albumin quota (AQ) was found in the control group and in the inflammatory (infectious or noninfectious), neoplastic, and miscellaneous groups: AQ = 0.015 CSF total protein--0.102, r = 0.990. This correlation suggests that an increased CSF total protein concentration can be an indicator of blood brain barrier dysfunction. The highest median AQ value was found in the aseptic suppurative meningitis group, but no statistical differences were found between this and the other groups. The AQ, calculated with this technique, did not provide any additional information. Moreover, although unexpected, the electrophoretic profiles were not characteristic of any particular disease. In conclusion, this study did not confirm high resolution electrophoresis of paired CSF and serum samples to be a valuable ancillary diagnostic tool for canine neurological diseases.

Animals↗
PubMed1995

An unseasonable winter outbreak of echovirus type 30 meningitis.

During the winter of late October, 1990 to March, 1991, echovirus type 30 meningitis affected 10 children aged 3-9 years of age in Mikuni, Japan. Five patients presented with constipation, four had diarrhoea, while five complained of severe abdominal pain, in addition to typical symptoms and signs compatible with aseptic meningitis. Echovirus type 30 was isolated from the CSF of nine, from the faeces of 10, and from the throats of eight children. All showed a significant antibody response to echovirus type 30 in paired samples of serum. Antigenic variation and thermostability of a representative isolate indicated some changes in virus structural proteins, possibly reflecting an altered tropism for tissues in the gastrointestinal tract.

Abdominal Pain↗
PubMed2000

A five year outbreak of methicillin-susceptible Staphylococcus aureus phage type 53,85 in a regional neonatal unit.

We identified a 5-year outbreak of a methicillin-susceptible Staphylococcus aureus (MSSA) strain, affecting 202 babies on a neonatal unit, by routine weekly phage typing all S. aureus isolates. Multiple staged control measures including strict emphasis on hand hygiene, environmental and staff surveillance sampling, and application of topical hexachlorophane powder failed to end the outbreak. S. aureus PT 53,85 (SA5385) was found on opened packs of Stomahesive, used as a neonatal skin protectant. Only following the implementation of aseptic handling of Stomahesive, and the use of topical mupirocin for staff nasal carriers of SA5385, and for babies colonized or infected with S. aureus, did the isolation rate of SA5385 decline. DNA fingerprinting indicated that > or =, 95% of SA5385 isolates were clonal. In vitro death rates of SA5385 on Stomahesive with human serum were significantly lower than on Stomahesive alone (P = 0.04), and on cotton sheet with serum (P = 0.04), highlighting the potential of this material as a survival niche. Phage typing remains a valuable, inexpensive and simple method for monitoring nosocomial MSSA infection.

Bacteriophage Typing↗
PubMedDate not supplied

Assessment of the risk of fetal loss after the coelocentesis procedure using a baboon model.

OBJECTIVES: The aims of this study were to gain some insight with regard to the safety of the coelocentesis procedure and, to determine pH, pCO2, and base excess status of the extracoelomic fluid 40 days after fertilization. METHODS: Twenty-eight timed-mated baboons from the breeding colony of the Biological Resource Laboratory at the University of Illinois at Chicago were studied. The initial 19 animals were used to determine the ultrasonographic relations between the different compartments of the gestational sac from 38 to 62 days of pregnancy. Under aseptic conditions, in 9 animals coelocenteses were then performed, under continuous transvaginal ultrasound guidance to avoid the amniotic or yolk sacs. Extracoelomic fluid (1-5 ml) was aspirated using 10-ml syringes. Only one attempt of sampling was performed in each of the 9 animals. Extracoelomic fluid pH, pCO2, and base excess were compared with maternal femoral venous blood. Pregnancies were followed by transabdominal ultrasound evaluations on day 3 after the procedure and weekly until day 140 after fertilization. RESULTS: Extracoelomic fluid could be aspirated easily using a 20-gauge needle. Only one pregnancy loss was detected within 3 days after the procedure. No complications occurred in the remaining 8 pregnancies. Extracoelomic fluid pH (7.45 +/- 0.01) and pCO2 (39.9 +/- 2.4 mm Hg) were significantly different from maternal femoral venous blood pH (7.41 +/- 0.01) and pCO2 (47.1 +/- 1.4 mm Hg; p < 0.02), while base excess values were similar. CONCLUSIONS: This preliminary study performed at 40 days after fertilization in the baboon model suggests that the coelocentesis procedure is technically simple and presents a relatively low risk to mother and fetus if a 20-gauge needle is used and the amount of aspirated extracoelomic fluid is <3 cm3. At this gestational age, the extracoelomic fluid is more alkalotic than maternal femoral venous blood.

Animals↗
PubMed1990

[Measurement of gamma-interferon in sera and CSF in patients with multiple sclerosis and inflammatory neurological diseases].

We examined whether gamma-interferon (gamma-IFN) can be detected in serum and CSF of patients with multiple sclerosis and other inflammatory neurological diseases. Gamma-IFN was assayed by solid phase radioimmunoassay on the forward sandwich principle. In 7 serum samples in acute stage of multiple sclerosis without corticosteroid, in 2 CSF samples in acute stage, gamma-IFN was not detected. In stable stage there was no case with positive gamma-IFN. The patient with tuberculous meningitis showed high titer in CSF but not in serum. One case with herpes zoster meningitis, one case out of 2 aseptic encephalitis showed positive gamma-IFN in CSF. In one case with Vogt-Koyanagi-Harada disease, gamma-IFN was detected both in serum and CSF. One case with Neuro-Behçet syndrome showed positive gamma-IFN in CSF. No gamma-IFN was detected in 2 cases with Guillain-Barré syndrome, one case with Crow-Fukase syndrome, Fisher syndrome, 2 cases with polymyosits. gamma-IFN in CSF was detected in meningitis and encephalitis, but not in serum. This suggests that the locally infiltrating cells produce gamma-IFN. However, we could not detect gamma-IFN in either CSF or serum of patients with multiple sclerosis. Negative results of gamma-IFN in patients with multiple sclerosis can be interpreted in 2 ways. 1. The half life of gamma-IFN is very short in vivo, and the level of gamma-IFN may not be detected at the time of sampling. 2. Generalized augmentation of gamma-IFN production may not be observed but locally infiltrating cells or astrocytes might produce gamma-IFN.(ABSTRACT TRUNCATED AT 250 WORDS)

Behcet Syndrome↗
PubMed1978

Evaluation of compounding accuracy and aseptic techniques for intravenous admixtures.

Intravenous admixtures containing potassium collected from three hospital pharmacies were analyzed for compounding accuracy, sterility and pyrogenicity. The study was performed in two stages. During stage I, pharmacists and technicians were not informed of the study, but during stage II they were informed. In each stage 10 samples were collected from each person in the two personnel groups, analyzed and the results compared between the two personnel groups and the two stages. Results of the study showed that without monitoring (stage I) pharmacists had a higher mean percent error and contamination level than technicians. With monitoring, however, pharmacists showed a lower mean percent error and contamination level than technicians. Both personnel groups showed a decline in their mean percent error in the second stage, but there were still 83 (39.5%) errors in compounding accuracy greater than +/- 6%. No positive results with the Limulus test for pyrogens were obtained. It is recommended that a planned program of quality control be instituted for the preparation of i.v. admixtures by both pharmacists and technicians.

Antisepsis↗
PubMed1981

Effect of laminar air flow and clean-room dress on contamination rates of intravenous admixtures.

The effect of laminar air flow conditions and clean-room dress on the microbial contamination rates of intravenous admixtures was investigated. Intravenous admixtures were prepared by one investigator using aseptic technique under four environmental conditions: laminar air flow conditions with clean-room dress; laminar air flow without clean-room dress; clean table top with clean-room dress; and clean table top without clean-room dress. In each environmental condition, 350 admixtures were compounded. Negative-control samples (n = 150) were also tested, as were 10 positive-control samples. Samples were tested in each of two growth media and incubated at 35 degrees C for 14 days or until growth occurred. The incidence of contamination of admixtures compounded in laminar air flow conditions was significantly less than the contamination of those compounded on a clean table top (p less than 0.05) regardless of the operator's dress. The incidence of contamination of admixtures compounded while wearing clean-room dress was not significantly different from those prepared while not wearing clean-room dress regardless of the environment in which the admixture was prepared. The overall low level of contamination [0.79% (11/1400)] was inconclusive regarding the effect of dress on the incidence of contamination when admixtures were prepared under LAF conditions. It is concluded that, when one adheres to aseptic technique, the environment in which admixtures are compounded is the most important variable affecting the microbial contamination rate.

Drug Compounding↗