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Barrier isolators as an alternative to a cleanroom.

The use of barrier isolators as an alternative to a cleanroom for the preparation of sterile products at ASHP-defined risk levels 2 and 3 and cytotoxic and hazardous drugs is described. The two isolators selected provide enclosed microenvironments. The isolator used for preparing products of risk level 2 has white acrylic and polycarbonate rigid walls that isolate the sterile product from the operator. The isolator used for preparing level 3 products and cytotoxic and hazardous drugs has epoxy-painted steel walls, a front window, and a pair of glove ports; its design theoretically prevents cross contamination between the operator and the product under preparation and between the product and the external environment. An independent contractor familiar with barrier isolators certifies the equipment every six months. A random microbiological sampling is periodically compared with a control. The isolators have been in operation since July 1998 without microbial growth in any sample tested. The barrier isolators cost more than traditional laminar-airflow hoods, but the hospital considers the barrier isolators to be more cost-effective than a cleanroom. A cost saving in supplies for cytotoxic and hazardous drug preparation as a result of a reduction in overall gown and glove use was observed. Barrier isolators offer an alternative to a cleanroom for the preparation of products at risk levels 2 and 3 and offer an aseptic, safe environment for preparing cytotoxic and hazardous agents.

Antineoplastic Agents↗

Serum folates in man.

In an aseptic microbiological assay of folate compounds and their breakdown compounds, using Lactobacillus casei, Streptococcus faecalis, and Pediococcus cerevisiae, 4a-hydroxy-5methyl-4,5,6,7-tetrahydrofolate and 5-methyl-5,8-dihydrofolate were inactive under all conditions to all three organisms and 5-methyl-5,6-dihydrofolate was inactive unless ascorbate was present in the incubation medium, and then only to L. casei. 5-Methyltetrahydrofolate was active only for L. casei, and activity in purified samples to S. faecalis was due to trace amounts of folic acid. Analysis of S. faecalis values in the serum in normal subjects and in patients with various disorders showed that levels of 10-formyltetrahydrofolate are raised in coeliac disease, leukaemia, rheumatoid arthritis, and schizophrenia. 5-Methyltetrahydrofolate is readily absorbed by normal human subjects and by patients with pernicious anaemia but poorly absorbed by patients with coeliac disease or leukaemia. 5-Methyl-5,6-dihydrofolate was quickly absorbed by normal human subjects, being reflected by a considerably raised level of 5-methyltetrahydrofolate in serum when sodium bicarbonate was given by mouth before the 5-methyl-5,6-dihydrofolate. These higher levels were comparable to those in patients with pernicious anaemia after oral administration of 5-methyl-5,6-dihydrofolate. Oral 5-methyl-5,8-dihydrofolate and 4a-hydroxy-5-methyl-tetrahydrofolate did not appear as microbiologically active folates in the serum. The findings of this study suggest that the availability for biological utilisation of the major dietary folate compounds will depend on the amount of gastric acidity and of ascorbate in the intestinal chyme. Many may be unavailable for metabolic utilization in the body.

Anemia, Pernicious↗

[The study of tarnish induced by Actinobacillus actinomycetemcomitans serotype b (Aay4) on titanium and Ti-75 alloys].

OBJECTIVE: To study the tarnish induced by Aay4 on titanium and Ti-75 alloys. METHODS: Pure titanium and Ti-75 alloys were machined into size of 10 mm x 10 mm x 1 mm in tablets(30 of pure titanium; 60 of Ti-75 alloys). Thirty specimens sampled randomly from Ti-75 alloy together with 30 specimens of titanium were subjected to chemical passivation treatment. 30 specimens of the pure titanium, depassivation Ti-75 alloy and passivation Ti-75 alloy were randomly divided into three groups (blank control group, media control group and inoculated media group) respectively, every group contains 10 specimens. Under the anaerobic conditions, the surfaces of the modified GAM media were inoculated with Aay4. The labeled specimens surfaces were then aseptically placed on top of the media surface for 10 weeks with one generation time per week. The specimens were removed after 10 weeks of incubation, immersed in 0.05% glutaradehyde solution to eliminate Aay4, rinsed with distilled water. After 2 weeks, the specimens were removed and observed visually or examined by MINOLTA CR-100 color apparatus. RESULTS: Visual evaluation: Aay4 caused significant tarnish on specimens exposed to inoculated media, all the specimens surface changed into yellow color. Color apparatus evaluation: this result showed that comparing with the blank control, media control has no influence on all the specimens L*a*b* values (P > 0.05). Aay4 caused significant tarnish on specimens exposed to inoculated media, the result showed that there was significant difference between media control group and blank control group with inoculated media group on all the specimens L*a*b* values (P < 0.05). CONCLUSION: Aay4 caused significant tarnish on pure titanium, depassivation Ti-75 alloys and passivation Ti-75 alloys by naked eyes and color apparatus, according CIE1976L*a*b* color system reading, the color of titanium and Ti-75 alloys changed from the yellow-green ranges to red-yellow ranges.

Aggregatibacter actinomycetemcomitans↗

Effects of intrauterine infection on the function of the corpora lutea formed after first postpartum ovulations in dairy cows.

This study was carried out to determine the relationship between postpartum intrauterine infections, endocrine patterns and the function of corpora lutea formed following the first postpartum ovulations in dairy cows. Blood samples were collected daily starting from the day of parturition until 30 d after parturition or until the second postpartum estrus, whichever occurred first. Sera were assayed for progesterone (P4), prostaglandin F2alpha metabolite (PGFM), and luteinizing hormone (LH) concentrations. Palpations per rectum and real-time ultrasound scanning of the reproductive tracts were carried out in all cows once every 4 d for 1 mo, starting from Day 4 after parturition. In addition, endometrial swabs were collected aseptically from each cow once every 4 d during the first month postpartum. The swabs were cultured for aerobic and anaerobic bacteria. Twelve cows (60%) exhibited short estrous cycles (SC; 6 to 14 d long) following first postpartum ovulations. The mean preovulatory LH surges and LH patterns during the first postpartum cycles were similar in both groups, leading us to believe that lack of luteotrophic stimulation was not a factor in the occurrence of SC. Bacterial isolations were frequent in SC cows. The occurrence of moderate to heavy bacterial growth patterns and the repeated isolations of the similar organisms during postpartum suggests the persistence of uterine infections in SC cows. Increases in PGFM concentrations prior to luteolysis in SC cows were associated with moderate to heavy infection. Thus, postpartum uterine infections do not appear to affect ovulations, but prostaglandin (PGF2alpha) released in response to uterine infection may contribute to early demise of the corpus luteum formed after the first postpartum ovulation.

Journal Article↗

Intravenous feeding in a gastroenterological unit: a prospective study of infective complications.

We have assessed the bacteriological safety of a system of intravenous feeding by culturing catheters on removal, swabs taken from the catheter's skin entry sites, and samples of infusion fluid. Among 38 treatment periods using 51 catheters over 1551 patient days, septicaemia due to Staphylococcus aureus was observed in one treatment period and bacteraemias due to Staphylococcus albus and Diphtheroid species in two others. The Staph. aureus and the diphtheroids probably gained access via the skin entry site along the outside of the catheter. The origin of the Staph. albus was uncertain. Parenteral nutrition over extended periods can be a safe procedure if aseptic precautions are taken. The importance of the catheter's skin entry site as a source of contaiminating organisms is emphasised.

Adult↗

Rapid identification of Toscana virus by nested PCR during an outbreak in the Siena area of Italy.

The sand fly-transmitted Toscana virus is recognized as an etiologic agent of an aseptic meningitis with a long convalescence. This infection has been reported overall in many tourists or in a seronegative population circulating in endemic Mediterranean areas (Italy, Portugal, Egypt, and Cyprus). We report a cluster of acute Toscana virus infections in the local population during the summer of 1995. Twenty-one clinical cases of meningitis were investigated for the presence of Toscana virus by nested PCR performed on the S segment of the virus RNA extracted from cerebrospinal fluid samples.

Adolescent↗

Increased expression of a novel osteoclast-stimulating factor, ADAM8, in interface tissue around loosened hip prostheses.

OBJECTIVE: ADAM8 is a protein of a disintegrin and a metalloproteinase family that can induce osteoclast fusion and activity, perhaps via interactions involving integrin receptors and their cysteine-rich/disintegrin domains. Because loosening of hip replacement implants is characterized by foreign body giant cells and peri-implant osteoclasts, it was speculated that this molecule might be (over)expressed in the synovial membrane-like interface tissues. METHODS: In situ hybridization; immunohistochemical staining with or without tartrate-resistant acid phosphatase (TRAP) staining; image analysis/morphometry; isolation, amplification, and cloning of ADAM8; nucleotide sequencing; quantitative reverse transcriptase-polymerase chain reaction (RT-PCR); and Western blot. RESULTS: In situ hybridization disclosed ADAM8 mRNA in mono- and multinuclear cells in both interface and control synovial samples. Quantitative RT-PCR revealed high ADAM8 mRNA copy numbers in interface tissue (p < 0.01). Accordingly, extensive ADAM8 immunoreactivity was observed in the lining-like layers and sublining areas of interface tissue (p < 0.001). A 65 kDa ADAM8 band in Western blot of tissue extracts confirmed these findings. ADAM8/TRAP double staining showed close spatial relationships of ADAM8 positive precursor cells with other precursors and/or TRAP-positive multinuclear cells. CONCLUSION: ADAM8 is (over)expressed in tissues around aseptically loosened total hip implants, which are characterized by chronic foreign body inflammation and peri-implant bone loss. This is compatible with a role for ADAM8 in the formation of foreign body giant cells and osteoclasts.

Aged↗

Hygiene of infant-feeding utensils. Practices and standards in the home.

Of 758 infants' feeding-bottles and teats collected aseptically by health visitors in four areas of Great Britain and examined in public health laboratories, less than two-thirds of the bottles and just over half of the teats produced results within an arbitrary "satisfactory" level. The mothers who said they used the hypochlorite method of sterilization and of storage of bottles and teats produced significantly better results. More of the mothers with satisfactory results had attended mothercraft classes. Twenty-two per cent. of babies in the sample were said to have suffered from diarrhoea, or vomiting, or both.The standards of home sterilization of bottles and teats could be improved, and straightforward and effective health education is required, together with professional backing, so that mothers would put into practice what they had been taught.

Adolescent↗

Evaluation of diagnostic fetoscopy.

The authors evaluate the efficacy and safety of fetoscopy on a series of 510 patients in which the procedure was carried out between the 18th and 20th week of gestation in order to obtain a suitable fetal blood sample for prenatal genetic diagnosis; the whole pregnancy could be completely followed up in them. The complication rate was low (1.7%) when the first attempt of fetoscopy was successful, but rose dramatically up to 17.9% on repeated attempts: however, they only amounted to 7.8% of all cases. The results of their study lead the authors to propose fetoscopy as a powerful, accurate and safe addition to the presently available diagnostic methods, provided it is performed by well trained fetoscopists, under aseptic conditions and local anaesthesia.

Abortion, Therapeutic↗

On the chemical characterization of colloid cyst contents.

Colloid cysts of the third ventricle have been investigated by chemical characterization of the cyst contents using ELISA with monoclonal antibodies for certain carbohydrate epitopes as well as a polyclonal antiserum against peptide domains, and immunohistochemistry on the cyst wall using the same antibodies. Furthermore, the carbohydrate composition of one sample has been determined after gel filtration. The cyst contents reacted strongly with the monoclonal antibody for the sulfo-Lewis epitope, and with the antimucin polyclonal antiserum. In one case the cyst fluid exhibited a blood group A antigen. A sample of cyst wall obtained by biopsy showed strong immunoreactivity against sulfo-Lewis antigen, and the sialo-Lewis antigen. The presence of the S atom with its high atomic number relative to that of C, H, and O atoms, may contribute to the high density appearance of colloid cysts on CT-scans. The sulfo-Lewis and sialo-Lewis carbohydrate epitopes are known as ligands for selectins, involved in inflammatory processes, and may well account for the aseptic meningeal reaction that may follow spilling of cyst contents during operative evacuation. The carbohydrate epitopes exhibited by colloid cysts and their contents, have also been reported for the mucins of salivary glands, uterine cervix, gall bladder and colon, and therefore, are not inconsistent with the assumption of an endodermal origin of colloid cysts.

Biopsy↗

Prospective investigation of a large outbreak of meningitis due to echovirus 30 during summer 2000 in marseilles, france.

Enteroviruses (EVs) are responsible for an array of clinical diseases affecting different systems of the organism. Many cases are asymptomatic; the most severe clinical syndromes caused by EVs are due to infection of the central nervous system and present as aseptic meningitis or encephalitis. We report here a large outbreak of enteroviral meningitis that spread in Marseilles, France, during the year 2000. The dominant strain of the outbreak was genetically identified as a human echovirus 30. The study was conducted prospectively from May to December 2000, with an investigative protocol recording epidemiologic, clinical, and laboratory data. A total of 250 patients with febrile neurologic manifestations were included between May 15 and December 30, 2000. A total of 195 cerebrospinal fluid (CSF) samples, 114 throat swabs, and 85 stool specimens were processed through viral culture and resulted in respectively 117 (60%), 61 (54%), and 58 (68%) cultures positive for EV; 69/106 (65%) CSF samples tested positive for the presence of EV RNA. None of the throat swab cultures but 5 of the stool cultures in control patients were positive. One hundred thirty-nine (55.6%) patients were considered confirmed cases because they had positive culture or reverse transcription polymerase chain reaction (RT-PCR) in CSF, and 38 (15.2%) patients were considered probable cases because they had a positive throat and/or stool culture and a negative (or not performed) procedure in CSF. The 177 confirmed and probable cases were not significantly different from the remaining 73 patients in terms of age distribution and epidemiologic, clinical, and biologic characteristics. The median age was 18.4 years (range, 15 d to 84 yr), and 92% of patients were younger than 40 years old. The male:female sex ratio was 1.8:1. We found no evidence of cases spread in nosocomial, household, or institutional settings, or limited community spread. All patients were immunocompetent except 4 adults. Meningoencephalitis represented 5.6% of cases. All but 3 of the 177 patients had a good outcome without sequelae. Two immunocompetent adults with meningoencephalitis had neurologic sequelae and an immunosuppressed adult had a fatal outcome. Upper respiratory symptoms were noted in 18.5% of patients, diarrhea in 11.5%, various types of rash in 4.5%, and myalgia in 3.8%. In CSF, white cell count was elevated in 90% of cases, with a percentage of neutrophils >50% in 55% of cases. Protein level was increased in 43% of cases. In blood, C-reactive protein was elevated in 67% of cases. Other blood parameters were unremarkable. Clinical and laboratory features did not differ from those related to other pathogens that caused meningitis and meningoencephalitis. Hence, unnecessary treatment for other infections is frequently instituted during EV infections. Virologic diagnosis is important to distinguish between EV and other treatable bacterial and viral diseases.

Adolescent↗

[What effect does of obesity have on the outcome of total hip and knee arthroplasty. Review of the literature].

As the prevalence of obesity worldwide continues to rise, defining the relationship between obesity and arthroplasty outcomes becomes increasingly important. The effect of obesity on the outcome of total hip or knee arthroplasty has been reported to be variable. Some authors believe that a high body weight will lead to less than optimal arthroplasty outcomes, because increased body weight leads to increased stress across the components and an increased load on the surrounding bone. Although this should, in turn, lead to a higher incidence of aseptic loosening or prosthetic failure in obese patients, studies have suggested that the effect of increased body weight and arthroplasty outcome are not so straightforward. The lower activity level typically observed in obese patients may partially counter the negative effects of increased weight on the bone-prosthesis interface. Although results do not show significant differences in all studies, it appears that obesity has negative impact on the results of total hip and knee arthroplasty. Therefore, long-term studies using large sample sizes should be conducted. If significant differences are demonstrated, an altered course of treatment, such as having a patient lose weight before considering a total hip or knee arthroplasty, might be advocated.

Arthroplasty, Replacement, Hip↗

Rapid diagnosis of meningitis using reagent strips.

OBJECTIVES: Identification of causative agent with estimation of cerebrospinal fluid (CSF) glucose, protein, cells is necessary for accurate diagnosis of meningitis. Unfortunately, even these facilities are not available in many areas. Reagent strips that measure glucose and protein in blood and urine can serve this task but have been used with varying results in the past. This study was carried out to evaluate the utility and efficacy of Combur 10 strips in the diagnosis of meningitis. DESIGN, SETTINGS AND METHODS: A prospective clinical single blinded study of 63 children suspected to have meningitis undergoing CSF analysis. Each CSF sample was divided in to two and was utilised for reagent strip analysis in addition to standard laboratory evaluation and a correlation analysis were made. STATISTICAL METHOD USED: Results were analysed using standard statistical tests. Accuracy of the reagent strips as a screening tool was established using Godyn's test. RESULTS: The sensitivity, specificity of the reagent strips for the diagnosis of meningitis was 97.14%, 96.42%. The sensitivity, specificity for tuberculous meningitis and bacterial meningitis were 100%, and 96.55%. That for the aseptic meningitis was 70% and 96.55%. Accuracy for the diagnosis of meningitis as a whole, bacterial meningitis, tuberculous meningitis, and aseptic meningitis were 96.78%, 98.2%, 98.27% and 83.0% respectively. CONCLUSION: Combur10 strips thus can be used for the rapid CSF analysis and screening with good accuracy. In situations where facilities of routine laboratory testing are not available this can be of an immense help.

Child, Preschool↗

Proteins bound to polyethylene components in patients who have aseptic loosening after total joint arthroplasty. A preliminary report.

BACKGROUND: Immunological responses to proteins that adhere to ultra-high molecular weight polyethylene have not, to our knowledge, been examined previously in patients who have aseptic loosening. In the current study, polyethylene components from forty-nine failed prostheses recovered during revision procedures were examined for the presence of antibodies that were bound to the polyethylene surface or that were reactive with other proteins that were bound to the polyethylene surface. METHODS: The polyethylene components consisted of thirty acetabular cups recovered during revision total hip arthroplasties and nineteen tibial components recovered during revision total knee arthroplasties. After extensive washing, bound proteins were extracted from the polyethylene components with use of 0.1-molar glycine-hydrogen chloride solution followed by four-molar guanidine hydrochloride solution. RESULTS: Sufficient protein for analysis was recovered from forty-two polyethylene components. Polyacrylamide gel electrophoresis demonstrated a minimum of one and a maximum of twelve protein bands, with molecular weights ranging from thirteen to 231 kilodaltons. Immunoblotting revealed the presence of type-I collagen in most (thirty-four) of the forty-two explants, whereas aggrecan proteoglycans were detected in eight samples. Immunoglobulin also was detected in most (thirty-three) extracts, whereas type-II collagen was consistently absent. The presence of autologous antibodies directed against polyethylene-bound proteins in sera drawn at the time of the revision was investigated. Antibodies that were reactive against the ultra-high molecular weight polyethylene-bound proteins were detected in twenty-six of the forty-two patients with use of the Western blot technique. The number of reactive bands ranged from one to six, and the strongest binding was directed against a 103-kilodalton protein. Assays for specificity revealed that these sera autologous antibodies were reactive against the type-I collagen that was present in the explant solutions. CONCLUSIONS: We hypothesize that immunoglobulin complexed with polyethylene may fix complement and that the complement cascade may in turn attract inflammatory cells to the polyethylene surface. Our data support the hypothesis that an immunological response to antigens bound to the polyethylene surface may contribute to aseptic loosening. CLINICAL RELEVANCE: Despite improvements in materials and designs of prostheses, aseptic loosening is the most common complication of total joint replacement, frequently leading to revision operations. We examined the immunological response to proteins that bind to ultra-high molecular weight polyethylene in patients who had aseptic loosening and discovered a high prevalence of antibodies to polyethylene-bound proteins. This immunological response may contribute to an inflammatory reaction in the periprosthetic tissue, ultimately leading to increased bone resorption around the prosthesis.

Antigen-Antibody Complex↗

Herpes simplex virus infection limited to the brainstem.

Focal meningoencephalitis is commonly caused by Herpes simplex virus infection, which typically affects temporal or frontal lobes, and carries a mortality rate of 70% if untreated. On rare occasions, however, the infection is restricted to the brain stem. Polymerase chain reaction analysis of cerebrospinal fluid is the gold standard for the diagnosis of herpes simplex encephalitis. A 46-year-old male was admitted to the hospital with a three-day history of headache and fever up to 39 degrees C. Cerebrospinal fluid findings were in accordance with aseptic meningitis. On the third hospital day, the patient presented with double vision followed by confusion, and gaze paresis developed. The condition rapidly progressed from stupor to coma. A second examination of cerebrospinal fluid revealed a low glucose level (1.2 mmol/l) and cefotaxime with ampicillin were started empirically. All cerebrospinal fluid specimens were negative for bacteria and fungi. Serum IgG antibodies for herpes simplex virus type 1 were found with no intrathecal specific antibody synthesis. A polymerase chain reaction analysis of cerebrospinal fluid sample performed on the seventh day of his illness was negative for herpes simplex virus 1 and 2. A computer tomography scan of the brain did not show any abnormality. Despite antimicrobial and supportive intensive care, the condition of the patient progressively deteriorated and he died on the 11th day after admission. An autopsy revealed hemorrhagic and necrotic brainstem meningoencephalitis, and herpes simplex virus type 1 infection was confirmed by hybridization in situ. Herpes simplex virus encephalitis carries a mortality rate of 70% if untreated. The atypical location of the infection, as well as an atypical clinical manifestation with negative radiological and microbiological tests, could be the reasons for false diagnoses and mistreatment. Many authors advocate the use of empiric acyclovir in any patients with unexplained encephalopathy, since delay in treatment may greatly affect outcome. We describe a patient who died due to a herpes simplex virus 1 encephalitis affecting the brainstem, where nucleic acids were found post mortem by in situ hybridization. On rare occasions, the herpes simplex viral infection, as well as clinical manifestations and pathological changes, is restricted solely to the brainstem.

Brain Stem↗

The effect of injectable barium selenate on the selenium status of horses on pasture.

AIM: To examine the effect of intramuscular barium selenate on the blood selenium concentration of horses with marginal selenium status. METHODS: Eighteen mares were assigned to one of six groups. The mares in groups 1-4 received barium selenate at 0.5, 0.75, 1.0 and 1.5 mg Se/kg, respectively, injected into the right pectoral muscle mass. The mares in group 5 received sodium selenate at 0.05 mg Se/kg orally at 8-week intervals. The mares in group 6 were left untreated. Blood samples were collected at 0, 1, 2, 5, 10, 30, 60, 90, 120, 180, 240, 300 and 360 days after the initial treatment for assay of whole blood and plasma selenium. Injection site reactions were recorded on each sampling date. RESULTS: Treatment with barium selenate at each dose rate significantly increased whole blood, plasma and blood cell selenium concentrations when compared to no treatment or oral treatment with sodium selenate, and maintained group mean whole blood selenium concentrations in the adequate range (>1600 nmol/l) until the end of the experimental period of 1 year. The severity of injection site reactions increased with dose rate but was considered acceptable alt the lower dose rates used. CONCLUSION: The injection of barium selenate placed aseptically at a deep intramuscular site was efficacious in correcting the selenium status of mares grazing pasture with a selenium content of 0.01-0.07 mg/kg DM. However, some swelling and fibrosis at the injection site was apparent at all dose rates used. CLINICAL RELEVANCE: There is currently no long-acting selenium supplementation product licensed in New Zealand for use in horses. Barium selenate promises to provide a useful method for selenium supplementation for horses, with an effective duration of at least 1 year following a single injection.

Journal Article↗

Aseptic addition method for Lactobacillus casei assay of folate activity in human serum.

An ;aseptic addition' method is described for microbiological assay with Lactobacillis casei of folate activity in human serum. It has the following advantages over the previously reported ;standard' method. 1 The manipulations involved in the assay are halved, by deleting autoclaving of serum in buffers. 2 The use of 1 g.% ascorbate better preserves serum folates than the lower amounts of ascorbate which are the maximum quantities usable in the standard methods. 3 Only 0.3 ml. of serum is required (0.1 ml. for one sample; 0.2 ml. for its duplicate).

Biological Assay↗

Bacterial contamination of suction tips used during surgical procedures performed on dogs and cats.

OBJECTIVE: To determine prevalence of bacterial contamination of surgical suction tips. SAMPLE POPULATION: Surgical tips used during 44 surgical procedures performed on 42 dogs and 2 cats. PROCEDURE: Surgical procedures were classified into 1 of 3 categories according to degree of bacterial contamination of the surgical site (clean, clean-contaminated, contaminated). Two sets of suction apparatuses were used for test and control suction tips. Test tips were used normally to suction blood and fluid, whereas control tips were placed on the surgical drapes but not in the surgical wound. Suction tips were collected aseptically and placed into thioglycolate broth tubes for qualitative aerobic and anaerobic bacterial culture at the end of each procedure. RESULTS: Test and control suction tips were contaminated with bacteria during 30 of 44 (68%) procedures. Staphylococcus spp were the predominant bacteria in tips used during clean and clean-contaminated surgeries. When surgery was performed on clean-contaminated or contaminated wounds, prevalence of isolation of other bacteria such as Pseudomonas spp, Streptococcus spp, and Escherichia coli from both test and control suction tips was higher than for clean wounds. Mean time of procedures during which both test and control suction tips became contaminated was not significantly different from time of procedures during which neither tip became contaminated. CONCLUSION AND CLINICAL RELEVANCE: Surgical suction tips often become contaminated during standard veterinary surgical procedures. The risk of wound infection after surgery may be influenced by bacterial contamination of surgical suction tips.

Animals↗