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PubMed1988

Cefotaxime combined with selective decontamination in long term intensive care unit patients. Virtual absence of emergence of resistance.

Emergence of bacterial resistance to antimicrobial agents was studied during a period of 30 months of continuous use of parenteral cefotaxime combined with oral non-absorbable polymyxin E and tobramycin (selective decontamination) in a surgical intensive care unit (ICU). No increase in drug-resistance micro-organisms was found. Colonisation of the oropharyngeal cavity or intestine or both by strains resistant to polymyxin E occurred in 8% of patients (invariably Proteus and Morganella species). Tobramycin-resistant strains (Escherichia coli, Acinetobacter and Pseudomonas species) were found in 4% of patients. Intestinal colonisation with cefotaxime-resistant bacilli (e.g. Enterobacter, Pseudomonas and Acinetobacter species) occurred in 10% of patients, but in most patients these strains were eliminated by therapy with the topical antibiotics within one week. The control of emergence of resistance has major implications for the antibiotic policy in the ICU: firstly, the number of different antimicrobials used is sharply reduced since the switching of antibiotics to treat suprainfections is seldom necessary; secondly, it is possible to use a third generation cephalosporin such as cefotaxime for systemic prophylaxis, without risk of induction of resistance.

Administration, Oral↗
PubMed2001

Cost effectiveness of selective decontamination of the digestive tract in liver transplant patients.

OBJECTIVE: To assess the cost effectiveness of selective decontamination of the digestive tract (SDD) in liver transplant patients. DESIGN: Randomised, placebo-controlled, double-blind trial with an integrated economic evaluation. SETTING: Two university hospitals in The Netherlands. Cost effectiveness was assessed from a societal perspective. PATIENTS AND PARTICIPANTS: 58 patients who underwent liver transplantation and received SDD (n = 29) or placebo (n = 29) pre- and postoperatively. INTERVENTIONS: SDD medication and placebo. MAIN OUTCOME MEASURES: Infection episodes, days of infection, costs of SDD and routine cultures, mean other direct medical costs per patient and additional costs of severe infection. RESULTS: Costs of SDD medicine and routine cultures were on average 3,100 US dollars ($US; 1997 values) per patient who underwent SDD. Both preoperatively and postoperatively, costs other than SDD and cultures did not significantly differ between the SDD and the placebo groups (preoperative, $US2,370 vs $US2,590; postoperative, $US25,455 vs $US24,915). Additional postoperative costs of severe infections were $US250 per day per patient. There were no significant differences in the mean number of infection episodes between groups. CONCLUSIONS: SDD leads to the additional costs of SDD medication and routine cultures, whereas no savings in other costs and no improvement in infection episodes are realised. Consequently, SDD may be considered as a nonefficient approach in patients undergoing liver transplantation. The additional costs of severe infection are considerable.

Adult↗
PubMed1987

Selective intestinal decontamination of the digestive tract for infection prophylaxis in severely burned patients.

An oral prophylactic antibiotic regimen aiming at suppression of the gram-negative rods and yeasts of the bowel flora was utilised in 48 severely burned patients to prevent burn wound colonisation. Only 17% of the patients had an actual or potential infection. Only one Pseudomonas infection occurred. The effect of this selective gastro-intestinal decontamination is discussed.

Adult↗
PubMed1994

Removal of biological stains from aqueous solution using a flow-through decontamination procedure.

Chromatography columns filled with Amberlite XAD-16 were used to decontaminate, using a continuous flow-through procedure, aqueous solutions of the following biological stains: acridine orange, alcian blue 8GX, alizarin red S, azure A, azure B, brilliant blue G, brilliant blue R, Congo red, cresyl violet acetate, crystal violet, eosin B, eosin Y, erythrosin B, ethidium bromide, Giemsa stain, Janus green B, methylene blue, neutral red, nigrosin, orcein, propidium iodide, rose Bengal, safranine O, toluidine blue O, and trypan blue. Adsorption was most efficient for stains of lower molecular weight (< 600). Adsorption of stain increased as the flow rate decreased; column diameter had little effect on adsorption. Adsorption of stain was greatest when finely ground resin was used, but if the resin particles were too small, column clogging occurred. Limited grinding of the resin gave increased adsorption while retaining good flow characteristics. Amberlite XAD-16 saturated with methylene blue was regenerated to its initial adsorption capacity by passing methanol through the column. The technique described provides an economical, rapid means of removing stains from aqueous solution.

Animals↗
PubMed1989

Interaction of microcystin-LR with SuperChar: water decontamination and therapy.

Activated charcoal (SuperChar) has been recommended for therapeutic use against poisoning by several toxic agents, but it has not been tested against microcystin-LR toxicosis. Microcystin-LR, a cyclic heptapeptide isolated from fresh water blue-green algae, has been shown to be a potent hepatotoxin in animals and in man. Studies were performed to determine the degree of in vitro adsorption of microcystin-LR to SuperChar and to assess the efficacy of SuperChar as a therapeutic agent against microcystin-LR in vivo. Scatchard analysis of the in vitro data showed that microcystin-LR bound to SuperChar with a maximum binding capacity of 0.692 mM toxin/g SuperChar with a dissociation constant of 0.016 mM. The adsorption characteristics of microcystin-LR by SuperChar was applied successfully to the decontamination of water samples spiked with microcystin-LR. While an oral (po) dose of toxin mixed with SuperChar (0.31-0.36 g/kg) modulated the toxicity, an oral pretreatment with SuperChar did not prevent lethality induced by an oral or intraperitoneal (ip) dose of microcystin-LR in mice.

Animals↗
PubMed1987

Salmonella decontamination of broiler carcasses with lactic acid, L-cysteine, and hydrogen peroxide.

Experiments on salmonella decontamination of broiler carcasses with lactic acid, L-cysteine, and hydrogen peroxide were performed. Treatment with lactic acid (1%) and hydrogen peroxide (.5%) resulted in a 4-log cycle reduction in colony forming units of Salmonella typhimurium both with pure cultures and with artificially inoculated broiler carcasses. L-cysteine was nonbactericidal in these experiments.

Animals↗
PubMed2000

Efficacy of alkaline washing for the decontamination of orange fruit surfaces inoculated with Escherichia coli.

The effectiveness of washing treatments to decontaminate orange fruit surfaces inoculated with Escherichia coli was evaluated. Washing on roller brushes with fruit cleaners or sanitizers followed by potable water rinse reduced E. coli by 1.9 to 3.5 log cycles. Prewetting fruit for 30 s before washing provided no significant benefit in most cases. Additional sanitizing treatments either with chlorine or acid sanitizers did not enhance the results of alkaline washing. In general, high pH washing solutions (pH 11.8) applied with an adequate spray volume effectively reduced the surface contamination of fruit that lowered the microbial load of fresh juice as well.

Animals↗
PubMed2001

Quantitative investigation of the effects of chemical decontamination procedures on the microbiological status of broiler carcasses during processing.

The effects of elevated chlorine concentrations (25 ppm) added to water in the final carcass washing equipment on total viable counts (TVCs 22 degrees C) and Escherichia coli and Enterobacteriaceae levels on poultry carcasses were investigated. Mean TVC counts on neck skin samples were significantly reduced when pre-evisceration and postwash samples were compared with log10 4.98 to 4.52 CFU/g recovered, respectively (P < or = 0.05). No significant reductions in TVC counts were observed in control samples at corresponding sampling points subjected to wash water containing 1 to 2 ppm chlorine. E. coli and Enterobacteriaceae counts were not significantly altered following final carcass washing in the processing plant. A second trial assessed the microbial decontamination capabilities of sodium triphosphate (TSP) on broiler carcasses. Neck skin samples from carcasses were obtained before final washing (control), following a 15-s dip in potable water and after dipping in a 10% TSP solution (pH 12) for 15 s. Reductions in E. coli and Enterobacteriaceae counts were all statistically significant for both water and TSP-treated samples when compared with corresponding controls (P < or = 0.01). The TSP treatment resulted in higher reductions of log10 1.95 and 1.86/g for E. coli and Enterobacteriaceae, respectively. In contrast, reductions of log10 0.37 and 0.3 l/g were observed for E. coli and Enterobacteriaceae counts when water-dipped carcasses were compared with corresponding controls. Significantly, Salmonella was not detected in any of the TSP-treated carcasses, while log10 1.92 and 1.04/g were found in control and water-dipped samples, respectively. Thermophilic Campylobacter counts were significantly lower in both treatment groups when compared with corresponding controlsresulting in log10 0.55 and 1.71/g reductions for water- and TSP-dipped carcasses, respectively (P < or = 0.01).

Animals↗
PubMed2001

Evaluation of combination treatment processes for the microbial decontamination of pork trim.

Combination treatment processes for the microbial decontamination of pork trim were developed and evaluated. Lean pork trim tissue (LPT) and fat-covered pork trim tissue (FPT) inoculated with swine feces were treated with intervention processes as follows: (i) control (untreated), (ii) water (15 degrees C, 120 s), (iii) water followed by lactic acid wash (15 degrees C, 75 s), (iv) combination 1 (water plus hot water [65.5 degrees C, 15 s] plus hot air [510 degrees C, 60 s] plus lactic acid), (v) combination 2 (water plus hot water [82.2 degrees C, 15 s] plus hot air [510 degrees C, 75 s] plus lactic acid), and (vi) combination 3 (water plus hot water [82.2 degrees C, 45 s] plus hot air [510 degrees C, 90 s] plus lactic acid). Populations of aerobic bacteria, psychrotrophic bacteria, coliforms, Escherichia coli, and lactic acid bacteria were determined before and after treatment and at days 2 and 7 of 4 degrees C storage. Regardless of the intervention treatment, lower microbial populations were observed on FPT than on LPT immediately after treatment and during the 7-day storage period. Both LPT and FPT treated with water plus lactic acid, combination 1, combination 2, and combination 3 had lower remaining populations of all microbial groups immediately after treatment than did water-treated samples. Populations of aerobic bacteria, coliforms, E. coli, and lactic acid bacteria on either LPT or FPT did not statistically increase during the 7-day storage period. On LPT, populations of psychrotrophic bacteria grew during 4 degrees C storage but remained lower at day 7 on LPT treated by combinations 2 and 3 (2.29 and 1.89 log10 CFU/cm2, respectively) than on LPT treated with water (4.07 log10 CFU/cm2) or water plus lactic acid (3.52 log10 CFU/cm2). Populations of psychrotrophic bacteria remained below detectable levels throughout the 7-day storage on FPT treated with water plus lactic acid or any of the three combination treatments. Treatment of pork trim with any of the combination treatments significantly (P < 0.05) affected the color and emulsion stability of the ground pork. Water and water plus lactic acid were the most favorable treatments in reducing microbial populations on pork trim without affecting the quality attributes of the ground pork.

Animals↗
PubMed2001

Direct microscopic observation of lettuce leaf decontamination with a prototype fruit and vegetable washing solution and 1% NaCl-NaHCO3.

Efficacy of a prototype, food-grade alkaline surfactant washing solution and 1% NaCl-NaHCO3 (pH 10.0) against Escherichia coli O157:H7 cells on lettuce leaves was evaluated. Lettuce was inoculated with 10(9) CFU/ml of E. coli O157:H7 for 24 +/- 1 h at 4 degrees C. Samples were rinsed and treated with the prototype washing solution containing lauryl sodium sulfate or NaCl-NaHCO3 for 3 min at 22 degrees C. Viability of E. coli O157:H7 cells was examined by plate counts at the surface and cut edge, and by confocal scanning microscopic (CSLM) observation of samples stained with Sytox green and Alexa 594 conjugated antibody against E. coli O157:H7 at intact leaf surface, stomata, and damaged tissue (0 to 10, 30 to 40, and 0 to 40 microm from the cut surface). Although both treatments caused significant log reductions in CFU at the surface and cut edge, log reductions were greater for the prototype washing solution (0.7 to 1.1 log CFU/cm2) than for NaCl-NaHCO3 (0.2 to 0.4 log CFU/cm2) (P < 0.05). Percentage of viability determined by CSLM for prototype washing solution was significantly greater at 30 to 40 microm from cut surfaces than at 0 to 10 and 0 to 40 microm from cut surfaces and intact surfaces (P < 0.05). Stomata provided moderate protection. NaCl-NaHCO3 was less effective than the prototype washing solution, and high percentages of E. coli O157:H7 cells remained viable at all sites except at the surface. The percent viabilities determined by CSLM were not significantly different from those determined by plate counts for NaCl-NaHCO3 treatment (P > 0.05). However, CSLM indicated significantly greater percent viability than plate counts for lettuce treated with the prototype washing solution (P < 0.05). Surfactant-containing washing solutions warrant additional testing for decontamination of fresh produce.

Colony Count, Microbial↗
PubMed2002

Biofilm formation by acid-adapted and nonadapted Listeria monocytogenes in fresh beef decontamination washings and its subsequent inactivation with sanitizers.

The antimicrobial effects of sodium hypochlorite (SH, 200 ppm, at an adjusted pH of 6.80 +/- 0.20 and at an unadjusted pH of 10.35 +/- 0.25), quaternary ammonium compound (pH 10.20 +/- 0.12, 200 ppm), and peroxyacetic acid (PAA, pH 3.45 +/- 0.20, 150 ppm) on previously acid-adapted or nonadapted Listeria monocytogenes inoculated (10(5) CFU/ml) into beef decontamination water washings were evaluated. The effects of the sanitizers on suspended cells (planktonic or deattached) and on cells attached to stainless steel coupons obtained from inoculated washings stored at 15 degrees C for up to 14 days were studied. Cells were exposed to sanitizers on days 2, 7, and 14. The pathogen had formed a biofilm of 5.3 log CFU/cm2 by day 2 of storage (which was reduced to 4.6 log CFU/cm2 by day 14), while the total microbial populations showed more extensive attachment (6.1 to 6.6 log CFU/cm2). The sanitizers were more effective in reducing populations of cells in suspension than in reducing populations of attached cells. Overall, there were no differences between previously acid-adapted and nonadapted L monocytogenes with regard to sensitivity to sanitizers. The total microbial biofilms were the most sensitive to all of the sanitizers on day 2, but their resistance increased during storage, and they were at their most resistant on day 14. Listeria monocytogenes displayed stronger resistance to the effects of the sanitizers on day 7 than on day 2 but had become sensitized to all sanitizers by day 14. SH at the adjusted pH (6.80) (ASH) was generally more effective in reducing bacterial populations than was SH at the unadjusted pH. PAA generally killed attached cells faster at 30 to 300 s of exposure than did the other sanitizers, except for ASH on day 2. PAA was more effective in killing attached cells than in killing cells treated in suspension, in contrast to the other sanitizers.

Animals↗
PubMed2003

Acid adaptation does not promote survival or growth of Listeria monocytogenes on fresh beef following acid and nonacid decontamination treatments.

The objective of this study was to evaluate the survival and growth of acid-adapted and nonadapted Listeria monocytogenes inoculated onto fresh beef subsequently treated with acid or nonacid solutions. Beef slices (2.5 by 5 by 1 cm) from top rounds were inoculated with acid-adapted or nonadapted L. monocytogenes (4.6 to 5.0 log CFU/cm2) and either left untreated (control) or dipped for 30 s in water at 55 degrees C, water at 75 degrees C, 2% lactic acid at 55 degrees C, or 2% acetic acid at 55 degrees C. The beef slices were vacuum packaged and stored at 4 or 10 degrees C and were analyzed after 0, 7, 14, 21, and 28 days of storage. Dipping in 75 degrees C water, lactic acid, and acetic acid resulted in immediate pathogen reductions of 1.4 to 2.0, 1.8 to 2.6, and 1.4 to 2.4 log CFU/cm2, respectively. After storage at 10 degrees C for 28 days, populations of L. monocytogenes on meat treated with 55 degrees C water increased by ca. 1.6 to 1.8 log CFU/cm2. The pathogen remained at low population levels (1.6 to 2.8 log CFU/cm2) on acid-treated meat, whereas populations on meat treated with 75 degrees C water increased rapidly, reaching levels of 3.6 to 4.6 log CFU/cm2 by day 14. During storage at 4 degrees C, there was no growth of the pathogen for at least 21 days in samples treated with 55 and 75 degrees C water, and periods of no growth were longer for acid-treated samples. There were no differences between acid-adapted and nonadapted organisms across treatments with respect to survival or growth. In conclusion, the dipping of meat inoculated with L. monocytogenes into acid solutions reduced and then inhibited the growth of the pathogen during storage at 4 and 10 degrees C, while dipping in hot water allowed growth despite initial reductions in pathogen contamination. The results of this study indicate a residual activity of acid-based decontamination treatments compared with water-based treatments for refrigerated (4 degrees C) or temperature-abused (10 degrees C) lean beef tissue in vacuum packages, and these results also indicate that this activity may not be counteracted by prior acid adaptation of L. monocytogenes.

Acetic Acid↗
PubMed2004

Decontamination of strawberries using batch and continuous chlorine dioxide gas treatments.

Efficacy of chlorine dioxide (ClO2) gas in reducing Escherichia coli O157:H7 and Listeria monocytogenes on strawberries was determined using batch and continuous flow ClO2 gas treatment systems. Effects of continuous ClO2 gas treatment on total aerobic plate count, color, and residual ClO2 and chlorite on strawberries were also evaluated. Strawberries were spot inoculated with 7 to 8 log CFU per strawberry of each pathogen (E. coli O157:H7 and L. monocytogenes), stored for 1 day at 4 degrees C, and treated at 22 degrees C and 90 to 95% relative humidity with 0.2 to 4.0 mg/liter ClO2 gas for 15 or 30 min using a batch treatment system or with 0.6, 1.8, and 3.0 mg/liter for 10 min using a continuous treatment system. Surviving microbial populations were determined using a membrane-transfer plating recovery method. Increased ClO2 gas concentrations resulted in increased log reductions of each pathogen for both the batch and continuous systems. A batch treatment of strawberries with 4 mg/liter ClO2 for 30 min and continuous treatment with 3 mg/liter ClO2 for 10 min achieved greater than a 5-log reduction for both E. coli O157:H7 and L. monocytogenes. After continuous exposure to 3.0 mg/liter ClO2 gas for 10 min followed by 1 week of storage at 4 degrees C, no aerobic microorganisms were detected and the color of the strawberry surface did not change significantly (P > 0.05). Residues of ClO2 and chlorite on strawberries after the treatment were 0.19 +/- 0.33 mg ClO2 per kg and 1.17 +/- 2.02 mg Cl2 per kg, respectively, whereas after 1 week of storage no ClO2 residues were detected and residual chlorite levels were down to 0.07 +/- 0.12 mg Cl2 per kg. These results suggest that ClO2 gas treatment is an effective decontamination technique for improving the safety of strawberries while extending shelf life.

Chlorine Compounds↗
PubMed2004

Efficiency of pulsed UV light for microbial decontamination of food powders.

The aim of this study was to evaluate the efficiency of pulsed light on the destruction of dried microorganisms on fluidized glass beads and to determine treatment parameters (energy level, water activity, final product quality) for process optimization. The applied drying method allowed microorganisms to remain viable on glass beads or dried powdered products with viability yields approaching 100%. The pulsed UV light system enabled an efficient fluidization of food powders, even for granular products (up to 5 mm diameter) and avoided shadowed areas. For Saccharomyces cerevisiae decontamination, the dose effect of UV rays was preponderant with glass beads and quartz plate, and in this case, 58 J/cm2 were required to decrease the microbial population by 7 log. For colored food powders (black pepper and wheat flour), the thermal effect of pulsed light dominated the UV effect.

Consumer Product Safety↗
PubMed2006

Fate of inoculated Escherichia coli O157:H7, cultured under different conditions, on fresh and decontaminated beef transitioned from vacuum to aerobic packaging.

This study evaluated the behavior of Escherichia coli O157:H7 during aerobic storage, after storage in vacuum packages, on beef inoculated with cultures prepared (35 degrees C, 24 h) in tryptic soy broth without dextrose (TSB), nonacid hot water carcass decontamination runoff fluids (washings; pH 6.0; WASH), cells from biofilms formed on stainless steel coupons in WASH (WETB), or WETB dried (25 degrees C, 12 h) before harvesting of cells (DRYB). These inocula were applied to fresh beef pieces (40 cm2), which were then left untreated or treated by immersion in hot water (75 degrees C) followed by 2% lactic acid (55 degrees C; hot water/lactic acid [HW/LA]), for 30 s each. Inoculated samples were vacuum packaged and stored at 0 (30, 60, or 90 days), 4 (7 or 14 days), or 12 degrees C (4 or 8 days) and subsequently transferred to retail packages for aerobic storage at 7 degrees C for 5 days. Populations of E. coli O157:H117, regardless of inoculum type, remained generally unchanged (P > 0.05) after aerobic storage (7 degrees C, 5 days) of untreated or HW/LA-treated beef samples previously stored in vacuum packages at 0 or 4 degrees C. However, reductions in E. coli O157:H7 levels were generally obtained when vacuum packaged, untreated beef samples previously stored at 12 degrees C were transitioned to aerobic conditions. Additionally, despite similar (P > 0.05) levels of E. coli O157:H7 cells of TSB, WASH, WETB, and DRYB origin on vacuum-packaged, untreated samples after 8 days of storage at 12 degrees C, subsequent aerobic storage resulted in larger (P < 0.05) reductions of cells of WETB and DRYB origin than for cells of TSB and WASH origin. For HW/LA-treated beef previously stored at 12 degrees C in vacuum packages, populations of E. coli O157:H7 remained largely unchanged after aerobic storage in retail packages. Results thus indicated that aerobic storage of beef (7 degees C, 5 days) previously stored in vacuum packages at 0 or 4 degrees C did not lead to E. coli O157:H7 population changes, whereas transition from vacuum packages stored under mildly abusive temperature (12 degrees C) to aerobic storage may have caused injury and death to the pathogen.

Animals↗
PubMedDate not supplied

Decontamination of equipment and the environment.

This article explains the various ways decontamination of equipment and the environment can be carried out and highlights the importance of nurses being familiar with such methods so to reduce the possibility of infection.

Disinfection↗
PubMedDate not supplied

Bacterial infections: antibiotics and decontamination.

Infectious disease is caused by bacteria, viruses, fungi, protozoa and micro-organisms including the mycoplasmas, rickettsiae and chlamydiae. Most of the infections commonly encountered in the UK are caused either by bacteria or viruses. This article describes bacterial structure and function to explain how antibiotics work and the processes of decontamination such as cleaning, disinfection and sterilisation, which are important in infection control.

Anti-Bacterial Agents↗
PubMedDate not supplied

Provision and decontamination of uniforms in the NHS.

AIM: To ascertain the provision and decontamination of uniforms within a cross-section of NHS trusts in the UK and to compare policies regarding their use. METHOD: A questionnaire was circulated to 170 NHS trust infection control teams in the UK. Eighty-six (51 per cent) responses were received, which represented 101 NHS trusts. RESULTS: Less than half of the trusts (47 per cent) provide adequate numbers of uniforms to allow a clean uniform per shift. Only 26 per cent had adequate on-site staff changing facilities and 65 per cent did not launder uniforms. The majority of nursing staff (91 per cent) were compelled, by a combination of these factors, to launder their uniforms at home. Few were provided with any guidance on how to do this safely. CONCLUSION: There is an urgent need for minimum standards to be set for the provision of uniforms, laundering and changing facilities, to minimise the potential for spread of healthcare-associated infections.

Benchmarking↗