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Biomedical subjects

B M Andersen

Publications and source records attributed to B M Andersen.

At least 19 recordsLinked to original sources
PubMed2006

Comparison of UV C light and chemicals for disinfection of surfaces in hospital isolation units.

OBJECTIVE: To determine the bactericidal effect on surfaces of ceiling- and wall-mounted UV C (UVC) light (wavelength, 254 nm) in isolation units, compared with standard hospital environmental cleaning and chemical disinfection during final disinfection after patients are treated for infections. DESIGN: Microbial samples were obtained from surfaces in isolation units (patient room, anteroom, and bathroom) before and after irradiation with UVC, chloramine disinfection, and standard hospital environmental cleaning. Samples were tested using standard contact plates. SETTING: Four identical, negative air-pressure isolation units (patient room, anteroom, and bathroom) with a defined number of ceiling- and wall-mounted UVC light units. The UVC distribution was monitored in one isolation unit after irradiation for approximately 40 minutes, corresponding to doses ranging from 160 J/m2 in a shadowed area to 19,230 J/m2 at the mostly highly exposed site (which is high enough to inactivate most bacterial organisms, including spores). RESULTS: UVC disinfection significantly reduced the number of bacteria on surfaces directly or indirectly exposed to UVC to a very low number, as did 5% chloramine disinfection alone (P<.001 for both). Completely shadowed areas in the isolation unit (eg, the bed rail, lockers, and mattresses) still required disinfection by chemicals. CONCLUSION: Disinfection with UVC light may significantly reduce environmental bacterial contamination and thereby protect the next patient housed in an isolation room. UVC disinfection may not be used alone but is a good addition to chemical disinfection.

Bacteria↗
PubMed2005

Decontamination of rooms, medical equipment and ambulances using an aerosol of hydrogen peroxide disinfectant.

A programmable device (Sterinis, Gloster Sante Europe) providing a dry fume of 5% hydrogen peroxide (H(2)O(2)) disinfectant was tested for decontamination of rooms, ambulances and different types of medical equipment. Pre-set concentrations were used according to the volumes of the rooms and garages. Three cycles were performed with increasing contact times. Repetitive experiments were performed using Bacillus atrophaeus (formerly Bacillus subtilis) Raven 1162282 spores to control the effect of decontamination; after a sampling plan, spore strips were placed in various positions in rooms, ambulances, and inside and outside the items of medical equipment. Decontamination was effective in 87% of 146 spore tests in closed test rooms and in 100% of 48 tests in a surgical department when using three cycles. One or two cycles had no effect. The sporicidal effect on internal parts of the medical equipment was only 62.3% (220 tests). When the devices were run and ventilated during decontamination, 100% (57/57) of spore strips placed inside were decontaminated. In the ambulances, the penetration of H(2)O(2) into equipment, devices, glove boxes, under mattresses, and the drivers' cabins was 100% (60/60 tests) when using three cycles, but was less effective when using one or two cycles. In conclusion, an H(2)O(2) dry fumigation system, run in three cycles, seemed to have a good sporicidal effect when used in rooms, ambulances, and external and internal parts of ventilated equipment. Further studies need to be performed concerning concentration, contact time and the number of cycles of H(2)O(2). This is especially important for inner parts of medical equipment that cannot be ventilated during the decontamination process.

Aerosols↗
PubMed2002

Spread of methicillin-resistant Staphylococcus aureus in a neonatal intensive unit associated with understaffing, overcrowding and mixing of patients.

Over the period May-June 1999, an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) was registered in eight newborns in a neonatal intensive care unit (NICU) at the Department of Pediatrics, Ullevål University Hospital (UUH) in Oslo. Seven were infected or colonized with an indistinguishable strain, detected at the NICU, and one patient with a slightly different PFGE type (i.e. a subtype) was registered at the outpatient clinic. The MRSA strains resembled the sensitive, inbred 'Norwegian type' described four years earlier at UUH, showing a relatively low and heterogenic methicillin resistance (MIC 12-96 mg/L), and susceptibility to most other anti-staphylococcal agents. Before and during the outbreak, there was high activity, understaffing, overcrowding and a mix of patients; 42% of the staff were relatively untrained, and up to 62% (during weekends) were extra nursing staff, partly from other Scandinavian countries. All cases were isolated (air and contact isolation), and all other patients and personnel were treated as being exposed to MRSA (isolated from other departments) until the last patient had been identified, disinfection of all rooms was complete, and all screening samples from staff and other patients were negative. The NICU and the delivery suite were closed for one week for disinfection and screening. The outbreak ended after 34 days. Since then, two years later, no further cases have been detected in the NICU or the delivery suite.

Cross Infection↗
PubMed2000

Outbreak of Campylobacter infection in a subartic community.

A presumably waterborne outbreak of Campylobacter jejuni/coli infection in a subarctic community is described. Drinking water supplied to residents was delivered unchlorinated during a 4-week period. No Campylobacter sp. was recovered from the water supply. Three hundred thirty individuals (15% of the 2,200 exposed) became ill. Diarrhoea, abdominal pain, fever, nausea and joint pain occurred in 81%, 30%, 29%, 43% and 21%, respectively. Nine percent reported swelling of joints, and two cases of reactive arthritis occurred. A Campylobacter sp. was isolated from 9 of 33 individuals who became ill and from 1 of 33 healthy controls. All culture-positive individuals, 46% of culture-negative ill persons and 27% of healthy controls were seropositive. All strains recovered had an identical DNA profile.

Adult↗
PubMed2000

A three-year survey of nosocomial and community-acquired infections, antibiotic treatment and re-hospitalization in a Norwegian health region.

In Norway, hospital-acquired infections (HAI) were analysed by repeated point prevalence studies (four each year) performed simultaneously at 14 hospitals in a health region (860,000 inhabitants) during the period 1996-1998. The study included 3200 beds and 121,000 discharged patients each year, and was initiated by and co-ordinated from the regional university hospital; Ullevål University Hospital (UHH). An overall prevalence rate of HAI of 6.5% (interhospital variation 1.4-11.7%) was found for the 32,248 patients studied. The rate of HAI was reduced from 7.7% in 1996 to 5. 9% in 1998. Smaller hospitals (<200 beds) generally had lower rates of HAI, community acquired infections (CAI), postoperative infections and use of antibacterial agents, than the large regional hospital (1200 beds). HAI was reduced in non-operated patients from 5.8% in 1996 to 4.4% in 1998 and in operated patients from 13.2% in 1996 to 10.5% in 1998. The risk of developing HAI was twice as high after surgery. From 1996 to 1998 there was a reduction in: urinary tract infections from 2.4% to 1.7%, lower respiratory tract infections from 1.5% to 0.8% and postoperative wound infections from 5.7% to 4.3%, while septicaemia (from 0.5% to 0.4%) remained unchanged. Re-hospitalization because of HAI was registered in 0.6% (interhospital variation 0.3-1.1%) of patients. The CAI rate in hospitals increased from 8.3% in 1996 to 10.8% in 1998. Approximately 16% (variation:14.4-20.6%) of the patients had an infection. The total use of antibacterial agents was 19.2% in 1996, 16.6% in 1997 and 17.8% in 1998 (variation: 14.9-23%).

Anti-Bacterial Agents↗
PubMed2000

Outbreak of scabies in Norwegian nursing homes and home care patients: control and prevention.

Over a period of five months (October 1998-February 1999), an outbreak of scabies affected 19 persons associated with a nursing home in Oslo, Norway. Scabies was diagnosed in 13 patients; six long-term patients, five short-term patients also cared for at home, and two home care patients associated with the same institution. Six healthcare workers who had assisted with infected patients in their own homes were also diagnosed with scabies. Two separate index cases were found. Both had had pruritus for several months, diagnosed as eczema, and were repeatedly treated at dermatology outpatient clinics before the diagnosis was made. Both index cases were cared for at home and in the nursing home (short-term). Repeated treatments with permethrin were tried before effective treatment with benzyl benzoate. Altogether 370 persons (patients, staff, relatives) were treated. In June-July 1999, scabies was diagnosed in two other nursing homes; six patients or staff, and 156 persons were treated. Patients with scabies were contact isolated and disinfection and cleaning was performed. Simultaneous treatment and washing or disinfection of clothing, bedding and environment of all potentially affected individuals is imperative to control an outbreak of scabies.

Adult↗
PubMed2000

Hospital-acquired infections in Norwegian long-term-care institutions. A three-year survey of hospital-acquired infections and antibiotic treatment in nursing/residential homes, including 4500 residents in Oslo.

Point prevalence studies of hospital-acquired infections among the elderly in 65-70 long-term care facilities (LTCF) were carried out once a year over a three-year period in Oslo city, Norway. They showed an overall rate of 6.5% of hospital-acquired infections among 13 762 residents. The infection rate was approximately the same as in hospitals and twice as high as among hospitalized long-term psychiatric patients. Residents who had received surgical treatment within the previous three months had a high rate of postoperative infections, especially wound infections (14.8%). During the study period, the LTCFs were found to be understaffed and overcrowded. They had few private rooms, a lack of bathrooms and toilets, no isolation facilities and deficient ventilation systems. The economic consequences of hospital-acquired infections in these LTCFs were extra costs in medical and nursing care and antibacterial treatment of 157 500 Nkr/day (22500 USD). There would be a substantial cost-benefit in effective preventive measures against hospital-acquired infections in long-term care institutions.

Anti-Bacterial Agents↗
PubMed1999

A Norwegian nosocomial outbreak of methicillin-resistant Staphylococcus aureus resistant to fusidic acid and susceptible to other antistaphylococcal agents.

In Norway, infections caused by methicillin resistant Staphylococcus aureus (MRSA) are still uncommon. From December 1993 to January 1997, MRSA was isolated from 22 people in Oslo county; 17 patients and five carriers (healthcare workers). A cluster of ten people (five patients and five healthcare workers) were associated with an outbreak at two hospitals in Oslo. The five patients were all admitted to the same intensive care unit (ICU) at Ullevål University Hospital between May-July 1995 (they were not transferred from abroad) and treated for acute neurological lesions. After surgery, four of them (one died) were transferred to another hospital for rehabilitation and training. The presence of MRSA was discovered in the patients and the five healthcare workers during the 10 months June 1995-March 1996. All cluster strains showed an unusual antibiotic resistance pattern in vitro, with a relatively low degree of methicillin resistance, resistance to fusidic acid, but sensitivity to all other anti-staphylococcal agents. A clonal spread of this fusidic acid resistant MRSA was supported by strain typing using pulsed-field gel electrophoresis (PFGE), which showed that all ten cluster strains belonged to one type or its subtype.

Adolescent↗
PubMed1998

[Air quality and microbiologic contamination in operating theatres].

The present study concerns the air quality and microbiological contamination in two newly built operating theatres; one with laminar air flow (LAF) equipment for cardio-thoracic operations, and one with conventional ventilation for urological operations. Both theatres had an identical number of air exchanges (17/h), identical microclimatic conditions and they employed the same cleaning procedures. In the LAF-ventilated operating theatre bacterial contamination of the air was effectively reduced to less than 10 colony-forming units (CFU)/m3 in all 125 samples (1 m3 per sample) tested. In most samples, 118/125, the bacterial count was less than 5 CFU/m3, despite the presence of ten persons. The conventionally ventilated theatre reached values up to 120 CFU/m3 during the most active period of the day when approximately seven persons were present. The LAF ventilation reduced both the content of particles in the air and contamination by bacteria on the floor. In both theatres cleaning procedures had only a low impact on CFU in the air and on the floor. The use of diathermia markedly increased the level of small particles in the air, and this may influence the air quality in the operating theatres.

Air Conditioning↗
PubMed1998

[Methicillin resistant yellow staphylococci].

The incidence of methicillin-resistant Staphylococcus aureus in Norway is extremely low. Isolation of such strains is nearly always associated with import. From December 1993 to January 1997 at the Ullevål University Hospital Department of Medical Microbiology, methicillin-resistant Staphylococcus aureus was isolated from 22 persons in Oslo (17 patients and five healthy carriers). A cluster of ten infected persons was detected (five patients and five carriers (nurses)) who were infected with strains showing an unusual antibiotic resistance pattern. All of the cluster strains except for beta-lactams were resistant to fucidic acid and sensitive to other antistaphylococcal agents. The cluster was associated with two hospitals. The five patients were all admitted to the same intensive care unit during the period May to July 1995. Four of the five patients (one died) were referred to the same department in a long-term care hospital for rehabilitation and training. Problems concerning epidemiological investigation and control are discussed.

Adolescent↗
PubMed1998

[Prevention of infections among surgeons].

Accidental exposure to blood may represent a frightening experience for health care workers because of the risk of developing infectious diseases, such as hepatitis B and C virus and HIV infection. Recommendations for follow-up after occupational exposure to HIV- and hepatitis infected blood are presented. Post-exposure chemoprophylaxis decreases the risk of occupational HIV infection after percutaneous exposure and should be administered within two hours. Studies have shown that most accidents could have been avoided with better working routines during operations.

Blood-Borne Pathogens↗
PubMed1998

Low faecal carrier rate of vancomycin resistant enterococci in Norwegian hospital patients.

The faecal carrier rate of vancomycin resistant enterococci (VRE) was surveyed among 616 patients in selected departments of 7 Norwegian hospitals. One Enterococcus gallinarum isolate harbouring a vanB2 element was recovered from a child with malignant disease treated with vancomycin and ceftazidime. No vancomycin resistant Enterococcus faecalis or Enterococcus faecium were detected and no VRE isolates of the VanA type were identified. The low level of VRE carriage corresponds to the limited use of glycopeptide antibiotics for human therapeutic purposes in Norway. It indicates a low risk of acquiring VRE infections in Norwegian hospitals.

Anti-Bacterial Agents↗