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PubMed1994

Special considerations in gastrointestinal decontamination.

Many considerations factor into selecting the most appropriate method of gastrointestinal decontamination used in the poisoned patient. A thorough knowledge of the indications and efficacy as well as contraindications and complications of each modality is critical to the clinician's assessment. This article examines the current utility of syrup of ipecac-induced emesis, orogastric lavage, activated charcoal, cathartics, and whole bowel irrigation. In addition, the role of multiple dose activated charcoal and the controversial issue of the N-acetylcysteine and activated charcoal interaction are discussed.

Acetylcysteine↗
PubMedDate not supplied

[Effect of algisorb on decontamination of milk contaminated with 90Sr].

The possibility of algisorb application for decontamination of milk contaminated with 90Sr has been investigated. Added to milk algisorb efficiently fixes radionuclide, giving an insoluble complex alginate-Sr. Administration of this milk has prevented 90Sr absorbtion and accumulation in the skeleton to the extend depending on the sorbent dose.

Alginates↗
PubMed1993

The efficacy of different formulations of protective-decontaminating ointments based on polyethylene glycol in rats percutaneously poisoned with highly toxic organophosphates.

Protective-decontaminating ointments based on polyethylene glycols (PEG) of different molecular weights were tested alone or with oxime N-octylpyridinium-4-aldoxime bromide, against percutaneous poisoning by the nerve gases 0-ethyl S-2-diisopropyl methylphosphorothiolate and soman in rats after 60 min exposure. PEG-based ointments consisting of higher PEG combined with the oxime proved the most efficient for both poisons. The combination of lower and medium PEG was somewhat less efficient, while the formulation consisting of mostly lower PEG exerted protective effects only in soman poisoning.

Administration, Cutaneous↗
PubMed1993

[The effect of Mycoplasma contamination and decontamination with ciprofloxacin on the karyotypic structure of the Chinese hamster V-79 lung cell line].

Karyotypic variability was investigated for the Chinese hamster lung cell line V-79, infected (contaminated) with a mycoplasma Acholeplasma laidlawii A. The mycoplasmal contamination did not affect cell distribution for the chromosome number. However, 30-70 days following cell culture contamination the increase in chromosomal aberrations was observed in the contaminated cell line primarily at the expense of chromosomal breaks. The following cyprofloxacin treatment of the culture resulted in mycoplasmal elimination and decrease in the frequency of chromosomal aberrations up to the control level. The analysis of G-banded chromosomes showed no significant differences in karyotypes of originally non-infected cells and cells after decontamination. The karyotypic variability, induced by mycoplasmal infection in V-79 cell line, differed from that in the muntjac skin fibroblast cell line, the latter being described elsewhere. A predominant type of chromosomal variability in V-79 cell line are chromosomal breaks, whereas in the muntjac fibroblast cell line dicentrics (telomeric fusions) were primarily observed, possible explanations of these differences being discussed. This may be presumably due to differences in karyotypic structure of these two cell lines, and to their different adaptation to culture conditions.

Acholeplasma laidlawii↗
PubMed1977

[Comparative study between the surface-active substances präwozell NBX (Nekal BX) and Ditalan WO hc for homogenization and decontamination of specimens for the cultivation of mycobacteria (author's transl)].

In cooperation of eight laboratories the new surface-active substance Ditalan WO hc was compared with Präwozell NBX (Nekal BX) used for homogenization and decontamination of the specimens for culture investigations of mycobacteria in routine. Under routine conditions Ditalan showed a slight, but statistically not significant advantage. Out of 1672 specimens pretreated with both detergents 482 cultures were positive in all, 429 (89,0%) after homogenization with Ditalan and 413 (85,7%) after pretreatment with Präwozell. The rate of contamination of the cultures was low in both cases (about 0,5%). Ditalan had a better mucolytic effect than Präwozell. In quantitative investigations the number of positive cultures was equal with both methods, but the number of colonies was somewhat higher and the time of growth was a little shorter after using Ditalan. In the third part the influence of both detergent-reagent-solutions on mycobacteria of different species was compared to that of physiological sodium chloride solution. The rate of growth was decreased by both the detergents in nearly the same degree. But the damaging effect is caused less by the detergent itself than by the sodium hydroxide contained in the solution used for pretreatment of the specimens.

Bronchi↗
PubMed1977

[Change in the normal microflora of the intestinal tract of rats in the process of their decontamination].

The authors studied a possibility of decontamination of animals by using antibiotics and a sterile diet, and also a combination of both methods. A reduction of the species composition of the intestinal microbial flora was noted in rats on sterile diet kept under conditions limiting the penetration of microbes into the organism from the external environment. Its greatest rarefaction -- practically to individual species -- was observed when the antibiotics were used in combination with a partial gnotobiotic isolation. In studying the action of antibiotics on the bacterial flora it is recommended to use the gnotobiotic isolation chamber to prevent the entrance of vulgar microbial flora from the surrounding environment.

Animal Feed↗
PubMed1996

Selective intestinal decontamination with norfloxacin reduces bacterial translocation in ascitic cirrhotic rats exposed to hemorrhagic shock.

Bacterial translocation (BT) can be involved in the pathogenesis of severe infections due to bacteria of enteric origin that complicates bleeding cirrhotic patients. To assess the effect of hemorrhagic shock (HS) on the incidence of BT and if selective intestinal decontamination (SID) reduces this incidence, we studied six groups of Sprague-Dawley rats: ascitic rats, ascitic rats exposed to HS with and without previous norfloxacin prophylaxis, healthy rats, and healthy shocked rats with and without previous norfloxacin prophylaxis. BT tended to be higher in ascitic rats with shock than without shock (69% vs. 41%, P = .15) and was significantly higher in healthy rats with than without shock (50 percent vs. 0 percent, P = .01). Norfloxacin significantly reduced translocation in ascitic shocked rats in comparison with nondecontaminated ascitic shocked rats (31 percent vs. 69 percent, P = .038). This effect was due mainly to a reduction of gram-negative BT (O percent vs. 37 percent, P = .008). In addition, norfloxacin prevented translocation in healthy shocked rats. Accordingly, aerobic gram-negative bacteria disappeared from fecal flora in all rats administered norfloxacin, except for Klebsiella species in one control rat. Cecal severe submucosal edema, chronic inflammatory infiltrate, and intestinal lymphangiectasia were significantly more frequent in ascitic rats than in control rats. Intestinal mucosal injury related with HS, particularly subepithelial cecal edema, was observed only in ascitic shocked rats. In conclusion, HS increases the incidence of BT both in ascitic cirrhotic and healthy rats. Norfloxacin reduces significantly the incidence of translocation after shock, especially in those cases caused by aerobic gram-negative bacilli.

Animals↗
PubMed1998

Selective bowel decontamination of recipients for prevention against liver injury following orthotopic liver transplantation: evaluation with rat models.

Gut-derived substances can activate Kupffer cells to provoke hepatic necrosis after partial hepatectomy in rats. A similar situation may occur during orthotopic liver transplantation (OLT), as congestion in the intestinal wall, caused by portal vein occlusion, is inevitable during the operation. The contribution of such substances to liver injury following OLT was investigated in rats. Oral administration of polymyxin B sulfate for 7 days significantly altered intestinal bacterial flora in rats; Enterobacteriaceae diminished and anaerobes such as Bifidobacterium , Lactobacillus, Bacteroides, and Eubacterium increased in number, compared with the control rats. Also, this treatment significantly reduced endotoxin concentration in the portal blood 30 minutes after blood reflow following portal vein occlusion. When OLT was performed in rats using the liver preserved in cold University of Wisconsin solution for 18 hours, tissue factor activity in Kupffer cells (KC) isolated from the transplanted liver 1 hour after the operation was significantly higher than in that of normal rats. This increase was significantly reduced by pretreatment of the recipients with polymyxin B sulfate. In these recipients, serum alanine aminotransferase activity, tumor necrosis factor alpha (TNF alpha) concentration, and histological extent of liver necrosis were significantly attenuated at 24 hours after the operation compared with those of control rats. We conclude that the substances derived from bacilli sensitive to polymyxin B sulfate in the gut may be a contributing factor to liver injury following OLT in rats; we feel that this probably occurs by entering of the substances into the portal blood during the ahepatic phase of the operation to activate KC. Selective bowel decontamination of recipients with polymyxin B sulfate would be a candidate for protection against early graft failure following OLT.

Animals↗
PubMed1994

Photolytic destruction and polymeric resin decontamination of aqueous solutions of pharmaceuticals.

Amoxicillin, ampicillin, bleomycin, carmustine, cephalothin, dacarbazine, lomustine, metronidazole, norethindrone, streptozocin, sulfamethoxazole, and verapamil were completely degraded in solution, without the production of mutagenic residues, by photolysis using a medium-pressure mercury lamp in an all-quartz apparatus. A stream of air was passed through the solution and for amoxicillin, ampicillin, bleomycin, lomustine, metronidazole, and norethindrone it was necessary to add hydrogen peroxide. Dilute aqueous solutions of ampicillin, bleomycin, carmustine, cephalothin, lomustine, norethindrone, streptozocin, trimethoprim, and verapamil can be decontaminated using polymeric Amberlite resins.

Animals↗
PubMed2002

Solid-phase extraction for the decontamination of alkali metal, alkaline Earth metal, and ammonium salts from heavy metal ions.

Salicylaldoxime-immobilized silica gel was characterized and used as a potential sorbent for heavy metal ions, viz. Cu(II), Ni(II), Co(II), and Zn(II). The experimental conditions were optimized both in batch and column processes to achieve the maximum efficiency. Kinetic and thermodynamic parameters as well as isotherm constants were evaluated to test the feasibility of the process. The role of various metal ions and different anions were tested in order to monitor the process in case of real samples. The alkali metal, alkaline earth metal, and ammonium salts do not have any effect on the said process. This differential behavior can be effectively used for the decontamination of alkali metal, alkaline earth metal, and ammonium salts from Cu(II), Ni(II), Co(II), and Zn(II) ions via solid phase extraction following AAS measurement. The purification of the salts was confirmed by voltammetric experiment.

Journal Article↗
PubMed1995

Postoperative selective bowel decontamination prevents gram-negative bacterial translocation in small-bowel graft recipients.

Gram-negative septic episodes are a potential risk of small-bowel transplantation; bacterial translocation through the graft is considered the mechanism. As a measure to prevent this complication, we evaluated postoperative selective bowel decontamination (SBD) in the rat model of orthotopic small-bowel transplantation [Lewis (LEW) and Brown-Norway (BN) rats as donors and recipients]. For 4 days after transplantation we gave FK 506, 2 mg/kg, which prevents rejection and results in indefinite recipient survival. For SBD, 24 mg/kg/day polymyxin E and 20 mg/kg/day tobramycin were administered via orogastric gavage to allograft recipients, both with and without FK 506 therapy. On Day 9, all rats were sacrificed, the peritoneal cavity was swabbed, and mesenteric lymph nodes (MLN), spleen, liver, and ileum were harvested for microbial qualitative and quantitative analysis. Animals with positive peritoneal swab cultures were excluded. SBD resulted in a significant reduction of the quantitative gram-negative bacterial flora in the ileum and cecum and of bacterial translocation to the MLN [0% versus 50% (no FK 506 therapy) and 8% versus 50% (FK 506 treated)]. In the allograft groups not treated with FK 506, SBD failed to significantly prolong survival, suggesting that acute rejection is not hastened by infection (bacterial translocation). We conclude that SBD in small-bowel-graft recipients prevents bacterial translocation by reducing intestinal gram-negative bacterial flora; this may reduce local and systemic infections by gut-derived organisms.

Animals↗
PubMed1988

Effect of selective decontamination of the digestive tract of donor and recipient on the occurrence of murine delayed-type graft-versus-host disease.

In the present study we investigated the occurrence of delayed-type graft-versus-host disease (DT-GvHD) after allogeneic bone marrow transplantation (BMT) between two H-2 incompatible mouse strains. BMT was performed on mice with a conventional intestinal microflora as well as on mice in which the Enterobacteriaceae were selectively eliminated from the intestinal microflora by oral antibiotic treatment. None of the conventional or the selectively decontaminated (SD) chimaeric mice suffering from DT-GvHD died of bacteraemia. While DT-GvHD was mitigated when C3H/He recipient mice were SD-treated, this was not the case when C57B1/6J recipient mice were SD-treated. SD-treatment of the digestive tract of donor mice only mitigated DT-GvHD when the recipients were also SD-treated. We conclude that Enterobacteriaceae in the digestive tract may only play a minor role, if any, in the occurrence of DT-GvHD. Instead, we postulate that in this study DT-GvHD was determined by differences in the composition of the resident intestinal microflora (IM) of both mouse strains together with the cellular composition of the bone marrow graft. The interaction between antigenic components of the recipient's IM and the developing donor immune system in the recipient as a possible cause for DT-GvHD is discussed.

Animals↗
PubMed1988

Selective decontamination of the digestive tract improves survival in patients receiving differential lung ventilation.

In a review of the literature on differential lung ventilation (DLV) the average mortality was found to be 47%. The major cause of death (66%) was infection. The effect of a novel infection prevention regimen on the colonisation and infection rate of the respiratory tract and on outcome was studied in polytrauma patients. Nineteen patients who presented with asymmetric pulmonary contusion were treated with DLV (103 +/- 72 h) and conventional mechanical ventilation (CMV) (16 +/- 10 days). They were treated with selective decontamination of the digestive tract with topical non-absorbable antibiotics in combination with systemic antibiotic prophylaxis starting immediately after admission. In one patient colonisation of the respiratory tract was found with Staphylococcus aureus. This disappeared after continued systemic antibiotic prophylaxis. Colonisation with hospital-acquired Gram-negative bacteria or yeasts was not observed. No patient developed pneumonia throughout the period on conventional mechanical ventilation or on DLV. One patient died from cerebral injury. It is concluded that prolonged endobronchial intubation for DLV can be used without increased risk for pneumonia with this antibiotic regimen and that the very low mortality in this study may be attributed to the prevention of infectious complications.

Adolescent↗
PubMed1994

Bacterial and fungal colonization and infections using oral selective bowel decontamination in orthotopic liver transplantations.

Bacterial and fungal infections are a major cause of morbidity and mortality after orthotopic liver transplantation. In the immunocompromised host, infections are thought to arise from the gut, which is almost always colonized with potential pathogens. Using oral selective bowel decontamination (SBD), potential pathogens can be eradicated from the gut and infections prevented. In this catamnestic study we have reviewed gastrointestinal colonization, bacterial and fungal infections, and bacterial resistance to standard antibiotics in our first 206 liver transplant patients while under SBD. With few exceptions, gram-negatives were eradicated from the gastrointestinal tract and secondary colonization was inhibited. In spite of unsatisfactory elimination of Candida, probably because nystatin doses were too low, Candida infections were rare (n = 4) and none was fatal. One and two-year survival rates were 93% and 92%, respectively. The bacterial and fungal infection rate was 27.8% with an infection-related mortality of 1.95%. Infections with aerobic gram-positive bacteria prevailed and only 11 gram-negative and 11 fungal infections occurred; among the latter, Aspergillus and Mucor were the most serious and responsible for three of the six deaths in this series. With regard to the development of resistance, we found an increasing number of enterococci and coagulase-negative staphylococci resistant to ciprofloxacin and imipenem, respectively, but unlikely as a consequence of SBD.

Administration, Oral↗
PubMed1983

Binding to faeces and influence on human anaerobes of antimicrobial agents used for selective decontamination.

The degree of binding of ampicillin, cephradine, co-trimoxazole, gentamicin, nalidixic acid, neomycin, polymyxin B and tobramycin by faecal substance as well as the influence of these antibiotics on human intestinal obligate anaerobes was investigated. In contrast to ampicillin, cephradine, co-trimoxazole and nalidixic acid, the nonabsorbable antibiotics polymyxin B and neomycin were bound to a considerable degree by human faeces. The binding of tobramycin and gentamicin to the solid part of faeces was less effective. The inhibitory effect of co-trimoxazole, gentamicin, nalidixic acid, neomycin, polymyxin B and tobramycin on the human obligate anaerobes was weak as compared with ampicillin and cephradine. Drugs which effectively eliminate Enterobacteriaceae from the gastrointestinal tract and which have a moderate effect on obligate anaerobes, like polymyxin B, are particularly suitable for selective decontamination of the gastrointestinal tract. The strong inactivating binding of aminoglycosides and polymyxin B to faeces accounts for the relatively high oral dose needed for a suitable faecal concentration.

Ampicillin↗
PubMed1996

Selective decontamination of the digestive tract: effect of cessation of routine application at an ICU.

BACKGROUND: Selective decontamination of the digestive tract (SDD) with non-absorbable antibiotics was extensively used at intensive care units (ICU) in Europe to prevent nosocomial infections in critically ill patients. After three recent meta-analyses in which it was demonstrated that SDD did not influence hospital stay and mortality in these patients several ICU's decided to stop the routine use of SDD. OBJECTIVE: To examine the effects of the cessation of SDD on nosocomial infections, mortality and hospital stay at an ICU in post-operative patients. DESIGN: Retro- and prospective follow-up. PATIENTS: Post-operative patients with mechanical ventilation (MV) for > or = 5 days at an ICU were included. The retrospective group (SDD group) comprised of 138 patients (mean age 66, range 10-91; 78% male) and the prospective group (non-SDD group) of 142 patients (mean age 67 range 18-85; 65% male). The SDD regime consisted of colistin, tobramycin and amphotericin B. Cessation of the SDD was accompanied by a shortening of the routine intravenous cefuroxime prophylaxis. RESULTS: There was a nonsignificant increase from an average 21 to 23 days ICU stay in the non-SDD group when compared with the SDD group (p > 0.05). Of the 280 patients 97 (35%) died on the ICU. The risk of death was lower in the non-SDD group (adjusted hazard ratio 0.7 with 95% Cl 0.5-1.1). There was a trend towards an increase in infections as a cause of death in the non-SDD group (38% of the ceased patients versus 20% in the SDD group) (p > 0.05). The incidence of respiratory tract infection (per 1000 person days) was 80 (95% Cl 48-113) in the non-SDD group versus 19 (95% Cl 8-22) in the SDD group (adjusted hazard ratio 4.5 (95% Cl 2.9-7.1)). CONCLUSION: The cessation of the routine application of SDD in post-operative patients mechanically ventilated for 5 days or more did nod adversely affect survival nor increased length of stay at the ICU. There may have been a shift to infections as a cause of death after cessation of SDD.

Adolescent↗
PubMed1990

The Inventory of College Students' Recent Life Experiences: a decontaminated hassles scale for a special population.

The development and validation of a new decontaminated hassles measure, the Inventory of College Students' Recent Life Experiences, are described. An initial pool of 85 items was administered to 100 undergraduates along with the Perceived Stress Scale. Forty-nine items were selected based on significant correlations against the Perceived Stress Scale. The alpha reliability of the resultant final form of the Inventory of College Students' Recent Life Experiences and its correlation against the Perceived Stress Scale were both high. In a separate cross-replication sample of 108 undergraduates, the alpha reliability of the Inventory and its correlation against the Perceived Stress Scale showed little shrinkage. Furthermore, separate analyses for male and female subjects supported the reliability and validity of the Inventory of College Students' Recent Life Experiences across gender. Factor analysis of the Inventory yielded seven interpretable factors. Intercorrelations among sub-scales based on these factors were generally modest, though in all cases significant, suggesting that the Inventory is relatively free of contamination by psychological distress.

Adult↗