PubMed Health⌕ Search

Biomedical subjects

G Kampf

Publications and source records attributed to G Kampf.

At least 37 records · Page 2Linked to original sources
PubMed2003

Dermal tolerance of Sterillium, a propanol-based hand rub.

Alcohol-based hand rubs have been used for hygienic hand disinfection in hospitals for decades. In order to achieve good compliance with hand hygiene practices in the healthcare setting, dermal tolerance of a hand rub product is crucial. Sterillium, which is used in many European countries for hygienic hand disinfection, is based on iso-propanol, n-propanol and mecetronium etilsulphate. The potential for dermal irritation and sensitization of commercially available propanol-based hand rubs containing emollients has not been studied systematically. We therefore studied the dermal tolerance of Sterillium in a repetitive occlusive patch test on 55 subjects. Sterillium was applied to one site on the back under an occlusive patch during an induction phase (total of nine applications over a three-week period) and two weeks later to a virgin site on the back during a challenge phase (one application). Twenty-four hours after removal of the patches (induction phase and challenge phase), and in addition, after 48 and 72 h (challenge phase), the sites were graded for skin reactions using a standardized scoring scale. In the induction phase, two of the 55 subjects had a barely perceptible minimal erythema at one of nine time points. The remaining 53 subjects had no skin reaction at any time. In the challenge phase, all 55 subjects had no skin reaction at all. The absence of significant reactions with respect to severity and frequency demonstrates the favourable dermal tolerance of the hand rub product. The lack of irritation or sensitization potential could enhance compliance with hand hygiene among healthcare workers.

1-Propanol↗
PubMed2003

Evaluation of the bactericidal effect of five products for surgical hand disinfection according to prEN 12054 and prEN 12791.

Surgical hand disinfection (with an alcohol-based hand rub) and surgical handwash (with an antiseptic-based liquid soap) are accepted measures to reduce the risk for surgical site infections. The new European Standards allow a comparison of their antimicrobial efficacy. The bactericidal activity of surgical hand rubs [Sterillium and Softaman, (active ingredient=alcohols)] and handwashes [Derman plus (triclosan), Hibiscrub (chlorhexidine) and Betadine (PVP-iodine)] was tested according to the prEN 12054 suspension test using Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Enterococcus hirae, and to prEN 12791 for the effect on resident skin flora in comparison with 1-propanol, 60% (v/v). All five products achieved a reduction of test bacteria within 3 min of >10(5)-fold so fulfilling prEN 12054. However, only Hibiscrub, Sterillium and Softa Man met the requirements of prEN 12791, giving a mean reduction of resident micro-organisms (immediate and sustained effect) which was not significantly lower than the reference alcohol (P>0.1; Wilcoxon matched-pairs signed-rank test). Sterillium was significantly more effective than the reference alcohol (immediate and sustained affect). Products for surgical hand disinfection may have equal antimicrobial activity in suspension tests but show large differences under practical conditions. Healthcare workers should not rely on results from suspension tests when deciding on a product for surgical hand disinfection.

1-Propanol↗
PubMed2003

Suitability of Sterillium Gel for surgical hand disinfection.

In some countries, alcohol-based hand gels are used for hygienic hand disinfection but their efficacy and suitability for surgical hand disinfection has never been investigated. The efficacy of Sterillium Gel was investigated according to prEN 12791 in two separate experiments. Finger tips of 20 volunteers per experiment were sampled for resident skin bacteria before surgical hand disinfection. In a cross-over design, each volunteer carried out a surgical hand disinfection with the reference alcohol [n-propanol 60%, (v/v)] or Sterillium Gel [ethanol 85% (v/v)] for 3 min. After the product application, one hand was sampled for the immediate effect, the other hand was gloved for 3 h and then sampled for the sustained effect. Samples were analysed for remaining resident bacteria. The mean of the pre-value, the 0 h and 3 h values of the reference disinfection and the test product were calculated. With the reference alcohol, respective mean immediate log10-reduction factors of 2.06+/-0.76 and 2.23+/-1.13 were found in both experiments. The mean sustained effects with the reference alcohol were 2.03+/-1.14 and 1.44+/-0.81. Sterillium Gel achieved respective mean immediate effects of 2.48+/-1.06 and 2.13+/-0.81, the mean sustained effects were 2.77+/-0.95 and 2.18+/-0.72. They proved significantly larger than those obtained with the reference alcohol (P<0.05; pair-wise Wilcoxon test). Sterillium Gel, therefore, more than fulfils the efficacy requirements for surgical hand disinfection of prEN 12791. In addition, 25 of 26 operating theatre healthcare workers in an orthopaedic hospital found it suitable for surgical hand disinfection after a single use, which included putting on a pair of surgical gloves. Although none of them had ever used an alcohol-based gel before, they had rather been accustomed to alcohol-based liquid products for years. The main reasons given for the positive assessment were better skin feeling after use, smell and easier donning of the surgical gloves. No significant correlation was found between overall or dermal acceptance and years of professional experience, profession or number of gel portions used for surgical hand disinfection (Pearson's correlation; P>0.05).

1-Propanol↗
PubMed2003

Inducibility and potential role of MecA-gene-positive oxacillin-susceptible Staphylococcus aureus from colonized healthcare workers as a source for nosocomial infections.

To determine the carrier rate of methicillin-susceptible mecA-positive Staphylococcus aureus (dormant MRSA) among healthcare workers (HCWs), 447 nurses and physicians from 13 general wards and intensive care units were investigated for nasal or oropharyngeal S. aureus carriage during one year whenever an MRSA patient was treated. Induction of phenotypic resistance in all mecA-positive oxacillin-susceptible aureus was attempted by 24 h exposure to oxacillin and cefotaxime. Organisms from the broth tube with the highest antibiotic concentration and visible growth after incubation were re-exposed for a total of seven repetitive exposures. Two mecA-negative oxacillin-susceptible S. aureus served as negative control. A population analysis before and after antibiotic exposure was performed. A third of the HCWs were found to be S. aureus carriers. Only three nurses were MRSA positive (0.7%). Seven isolates of dormant MRSA were isolated in six nurses and one doctor (1.6%). After four days of repetitive antibiotic exposure six of seven dormant MRSA were highly resistant to oxacillin. Resistance of the two control S. aureus without the mecA gene was not changed by repetitive antibiotic exposure. Two of the seven dormant MRSA were clonally related as shown by pulsed-field gel electrophoresis (PFGE). The PFGE pattern of one dormant MRSA (HCW) was identical to an MRSA (HCW). The pattern of another dormant MRSA was indistinguishable from an MRSA isolated from a patient who was treated at the same time on the same ward suggesting transmission from the HCW to the patient. Dormant MRSA may be isolated twice as often as MRSA from HCWs. Transmission to patients is possible, which may lead to clinical infections. It might be useful to screen methicillin-susceptible S. aureus isolates from HCWs for the mecA gene when recurrent infections with MRSA occur on a ward and a source cannot be found.

Bacterial Proteins↗
PubMed2003

Dermatological aspects of a successful introduction and continuation of alcohol-based hand rubs for hygienic hand disinfection.

With the new Centers for Disease Control and Prevention (CDC) guideline on hand hygiene, hospitals often introduce alcohol-based hand rubs for hand disinfection. Healthcare workers, however, may reject the new products because of skin irritation or other skin-related problems, which they experience after years of handwashing. In order to facilitate a successful introduction and continued use of alcohol-based hand rubs in hospitals, we have reviewed and summarized the major studies on the topic. Occupational hand dermatitis may occur in up to 30% of healthcare workers. It is mainly described as an irritant contact dermatitis caused by detergents. The diagnosis is usually clinical. Allergic reactions are very rare. After using an alcohol-based hand rub for the first time, healthcare workers may have a burning skin sensation that can be explained by pre-irritated skin. In this case the skin barrier has usually been impaired by frequent handwashing or occlusive gloves. This may result in a vicious circle whereby the healthcare worker increases the frequency of handwashing and reduces the frequency of hand disinfection. Prevention of irritant contact dermatitis is possible by selection of a low-irritating hand rub, which contains emollients, the correct use of the hand rub and a clear guideline when to disinfect and wash hands in the clinical setting. Common mistakes in the use of alcohol-based hand rubs are application to pre-irritated skin and washing hands before hand disinfection, which is, in general, not necessary, or after hand disinfection, which results in washing off the emollients. Clear preparation and guidance of healthcare workers before the introduction of alcohol-based hand rubs can help to enhance compliance in hand hygiene. The switch from handwash to alcohol-based hand rub will improve healthcare workers skin if mistakes are avoided and hand rinses are used correctly.

Alcohols↗
PubMed2003

Comparison of two test methods for the determination of sufficient antimicrobial activity of three commonly used alcohol-based hand rubs for hygienic hand disinfection.

In Europe, the antimicrobial efficacy of alcohol-based hand rubs is determined with a quantitative suspension test (prEN 12054) and a test under practical conditions (EN 1500). Another test method has recently been published by the German Society for Hygiene and Microbiology (DGHM) with four differences to the European system in the in vitro tests: additional qualitative suspension tests with product dilutions to the ineffective range; a selection of the most resistant Gram-negative test strains in the qualitative suspension test, which should be used adjacent to Pseudomonas aeruginosa in the quantitative suspension test; a high organic load in the quantitative suspension tests (0.3% albumin and 0.3% sheep erythrocytes); and an aqueous control in the quantitative suspension test. According to DGHM, the in vitro tests should be followed by EN 1500. We have determined the antimicrobial efficacy of three commonly used alcohol-based hand rubs according to both methods. prEN 12054 was carried out without organic load. The qualitative suspension tests (DGHM) were carried out with P. aeruginosa, Escherichia coli, Proteus mirabilis, Staphylococcus aureus, Enterococcus hirae and Candida albicans. The quantitative suspension test (DGHM) was carried out with product dilutions of 75%, 50% and 25%, and a high organic load using the following test organisms: P. aeruginosa, P. mirabilis (one product only), S. aureus, E. hirae and C. albicans. All these suspension tests were carried out in quadruplicate with each product and exposure time. EN 1500 was carried out with 3 mL of each product and an application time of 30 s. All three products achieved the required bactericidal activity of prEN 12054 and the new DGHM method within 30 s, and were equally effective with the reference hand disinfection of EN 1500 within 30 s. In our study, the DGHM test method did not provide additional information for hand rubs which exhibit their bactericidal efficacy with 3 mL within 30 s (EN 1500).

Alcohols↗
PubMed2003

Validity of the four European test strains of prEN 12054 for the determination of comprehensive bactericidal activity of an alcohol-based hand rub.

A comprehensive bactericidal activity of an alcohol-based hand rub is essential for prevention of cross-transmission by the hands of healthcare workers. In Europe, however, only four test organisms are used to determine bactericidal activity according to prEN 12054. The susceptibility of the various bacterial species against the commonly used alcohols is thought to be similar, but so far this has never been studied. We therefore evaluated the bactericidal activity of an alcohol-based hand rub (Sterillium) within 30 s in compliance with prEN 12054 and in a time kill test against 13 Gram-positive, 18 Gram-negative bacteria and 14 antibiotic-resistant bacterial pathogens. Each strain was evaluated in quadruplicate. Counts of the four test bacteria of prEN 12054 were reduced by factors exceeding 10(5) within 30 s. In the time kill test, all 13 Gram-positive and all 18 Gram-negative bacteria were reduced more than 10(5)-fold within 30 s, not only against the ATCC test strains but also against corresponding clinical isolates. Comparable reductions were also observed against all 14 emerging bacterial pathogens. The four European test bacteria were found to be sufficient to determine a comprehensive bactericidal activity of a propanol-based hand rub.

Bacteria↗
PubMed2003

Inter-laboratory reproducibility of the hand disinfection reference procedure of EN 1500.

Recent tests carried out using EN 1500 have suggested that most alcohol-based hand gels are significantly less effective than the reference alcohol [2-propanol, 60% (v/v)] whereas liquid alcohol-based hand rubs are not. However concerns about the accuracy and reproducibility of the test have been raised. We therefore analysed 41 experiments performed in four different laboratories using EN 1500 hand disinfection procedures with the reference alcohol, to analyse inter-laboratory reproducibility of the test. The mean reduction factors (difference of the log(10) of the pre-value and the post-value) from the four laboratories did not reveal a significant difference (P=0.059; analysis of variance), although the difference of the mean pre and post-values was highly significant (P<0.001). EN 1500 is a reproducible test method which leads to valid data.

Analysis of Variance↗
PubMed2002

Clinical double-blind trial on the dermal tolerance and user acceptability of six alcohol-based hand disinfectants for hygienic hand disinfection.

Six commercially available alcohol-based hand rubs [AHD 2000, Desderman, Mucasept A, Manorapid (Poly-Alkohol, Spitacid, and Sterillium] were investigated in a clinical double-blind trial involving 10 participants who had no previous experience of using hand rubs (Group 1), and seven who had substantial professional experience of using hand rubs (Group 2; virology laboratory staff). Group 1 was studied for one week with 20 applications on day 1 and then five applications per day for six days. Transepidermal water loss, dermal water content and superficial sebum content of the skin were measured before and after the seven-day application of the products, as well as user acceptability (self-assessment of smell, speed of drying, emolliant effect, skin dryness). Group 2 used each preparation twice for two weeks in a random sequence, and carried out self assessment at the end of each fortnight. Transepidermal water loss (mean baseline: 18.7 g/m(2)h), dermal water content (mean baseline dorsum: 75.6) and superficial sebum content (mean baseline dorsum: 4.8 microg/cm(2)) did not change significantly. In both groups assessments of the smell and the speed of drying did not reveal any significant differences between the six products. Sterillium had the best emollient effect of all products (P<0.05; Wilcoxon test and Mann-Whitney-U test) and was significantly better than Desderman, AHD 2000, and Mucasept A, causing less skin dryness after seven days use in Group 1 (P<0.05; Mann-Whitney-U test). Manorapid caused significantly less dryness than Spitacid, AHD 2000, and Mucasept A in Group 2 after the first use, but no significant difference was observed after the second use. Thus alcohol-based hand rubs that contain emolliants, irrespective of the type of alcohol (n-propanol, iso-propanol or ethanol), are well tolerated and do not dry out or irritate the skin. Personal assessments showed significant differences for the emolliant effect and the extent of dryness. Both factors are very important, as user acceptability has an impact on compliance. Sterillium is the only hand disinfectant containing mecetronium etilsulphate which has been shown to have an emolliant effect. Future research should focus on user acceptability in order to improve compliance.

Adult↗
PubMed2002

Spectrum of antimicrobial activity and user acceptability of the hand disinfectant agent Sterillium Gel.

The antimicrobial efficacy of alcohol-based hand gels has been shown to be significantly less than liquid hand rubs probably because of a lower concentration of alcohol. Sterillium Gel is the first hand gel with 85% ethanol. Its antimicrobial efficacy and user acceptability was studied. Bactericidal activity was tested according to prEN 12054 against Staphylococcus aureus, Enterococcus hirae, Pseudomonas aeruginosa and Escherichia coli (suspension test) and EN 1500 (15 volunteers; four replicates), fungicidal activity according to EN 1275 against Candida albicans and spores of Aspergillus niger (suspension test) and tuberculocidal activity against Mycobacterium terrae using the DGHM suspension test. Virucidal activity was determined in suspension tests based on reduction of infectivity with and without interfering substances (10% fetal calf serum; 0.3% erythrocytes and 0.3% bovine serum albumin). Ninety-six healthcare workers in hospitals in France and the UK used the gel for four weeks and assessed it by filling out a questionnaire. The gel was bactericidal (a reduction factor of > 10(5)-fold), tuberculocidal (reduction factor > 10(5)) and fungicidal (reduction factor > 10(4)) in 30 s. Irrespective of interfering substances the gel inactivated orthopoxvirus and herpes simplex virus type 1 and 2 in 15 s, adenovirus in 2 min, poliovirus in 3 min and papovavirus in 15 min by a factor of > 10(4)-fold. Rotavirus and human immunodeficiency virus were inactivated in 30 s (without interfering substances). Under practical use conditions it was as effective in 30 s as the reference alcohol in 60 s. Most users described the tackiness, aggregation, skin feeling after use and smell as positive or acceptable. A total of 65.6% assessed the new gel to be better than a comparator irrespective of its type (gel or liquid). Overall Sterillium Gel had a unique spectrum of antimicrobial activity. It is probably the first alcohol-based hand gel to pass EN 1500 in 30 s. Due to the excellent acceptance by healthcare workers it may significantly improve compliance for hand hygiene and thereby help to reduce the incidence of nosocomial infection.

Attitude of Health Personnel↗
PubMed2002

Intra-laboratory reproducibility of the hand hygiene reference procedures of EN 1499 (hygienic handwash) and EN 1500 (hygienic hand disinfection).

The bactericidal efficacy of hand antiseptic products is determined in Europe using two norms--EN1499 (hygienic handwash), and EN 1500 (hygienic hand disinfection) based on reducing the counts of bacteria on artificially contaminated hands. Each requires 12-15 data sets per test and comparison with a reference procedure. Recent research using EN 1500 suggested that most alcohol-based hand gels are significantly less effective than the reference alcohol (2-propanol 60%), whereas liquid alcohol-based rubs are not. However concerns about the accuracy and reproducibility of the norm reference procedures have been raised. We therefore analysed 23 experiments carried out using EN 1500 representing 342 hand disinfection procedures, and 12 experiments using EN 1499 representing 178 handwashes, all performed in the same laboratory for reproducibility of the reference procedures. The reference alcohol gave a mean log(10) reduction factor (RF) of 4.64 +/- 0.93; only one data set gave a significantly higher result (5.14, P = 0.034), and one significantly lower (4.05; P = 0.034). Analysis of all 23 means revealed no significant difference (P = 0.188; ANOVA model). The reference soap gave a mean reduction of 2.82 +/- 0.49. Two data sets were significantly higher than this (3.35,P < 0.001; 3.12, P < 0.001) and two significantly lower (2.55, P = 0.031; 2.47,P = 0.004). Analysis of all the means did reveal a significant difference (P < 0.001, ANOVA model), which is probably explained by the smaller standard deviations of these results. Pre-values (bacteria recovered from fingers before a reference procedure) correlated significantly with RFs for both hand disinfection (correlation coefficient: 0.291;P = 0.01) and handwash (correlation coefficient: 0.372, P = 0.01). Overall both procedures gave accurate and reproducible results.

Analysis of Variance↗
PubMed2002

Dermal tolerance and effect on skin hydration of a new ethanol-based hand gel.

We studied the dermal tolerance (repetitive occlusive patch test; ROPT) and the skin hydrating properties of a new ethanol-based gel [85% (w/w)], Sterillium Gel. For the ROPT, 53 participants were studied. Gel was applied to one site on the back under an occlusive patch during an induction phase (nine applications over three weeks) and two weeks later to a virgin site on the back during a challenge phase (one application). Twenty-four hours after the removal of the patches (induction phase and challenge phase), then 48 and 72 h later (challenge phase) sites were graded for skin reactions using a standardized scale. In the induction phase none of the 53 participants had a skin reaction. In the challenge phase one participant had a barely perceptible skin reaction, and one had mild erythema at one time point. To evaluate skin hydrating properties of the gel, treated skin of 21 participants was compared to untreated skin. The gel was applied twice a day to the forearm for 14 days. Control corneometer values were taken before application of the gel (mean: 32.7 +/- 5.0) and after one (36.3 +/- 4.4) and two weeks (36.1 +/- 5.4). Relative skin hydration on treated skin in comparison with an untreated control field was significantly higher after one week by 6.85% (P = 0.0031; paired t -test for dependent samples) and after two weeks by 4.47% (P = 0.0153). Sterillium Gel did not demonstrate a clinically relevant potential for dermal irritation or sensitization, and significantly increased skin hydration after repetitive use, and so could enhance compliance with hand hygiene among healthcare workers.

Adolescent↗
PubMed2001

Formation of ternary complexes by coordination of (diethylenetriamine)-platinum(II) to N1 or N7 of the adenine moiety of the antiviral nucleotide analogue 9.

The synthesis of (Dien)Pt(PMEA-N1), where Dien = diethylenetriamine and PMEA2- = dianion of 9-[2-(phosphonomethoxy)ethyl]adenine, is described. The acidity constants of the threefold protonated H3[(Dien)Pt(PMEA-N1)]3+ complex were determined and in part estimated (UV spectrophotometry and potentiometric pH titration): The release of the proton from the (N7)H+ site in H4[(Dien)Pt(PMEA-N1)]3+ occurs with a rather low pKa (= 0.52+/-0.10). The release of the proton from the -P(O)2(OH) group (pKa = 6.69+/-0.03) in H[(Dien)Pt(PMEA-N1)]+ is only slightly affected by the N1-coordinated (Dien)Pt2+ unit. Comparison with the acidic properties of the H[(Dien)Pt(PMEA-N7)]+ species provides evidence that in the (Dien)Pt(PMEA-N7) complex in aqueous solution an intramolecular, outer-sphere macrochelate is formed through hydrogen bonds between the -PO3(2-) residue of PMEA2- and a PtII-coordinated (Dien)NH2 group; its formation degree amounts to about 40%. The stability constants of the M[(Dien)Pt(PMEA-N1)]2+ complexes with M2+ = Mg2+, Ca2+, Ni2+, Cu2+ and Zn2+ were measured by potentiometric pH titrations in aqueous solution at 25 degrees C and I = 0.1 M (NaNO3). Application of previously determined straight-line plots of log K(M(R-PO3))M versus pK(H(R-PO3)H for simple phosph(on)ate ligands. R-PO3(2-), where R represents a non-inhibiting residue without an affinity for metal ions, proves that the primary binding site of (Dien)Pt(PMEA-N1) is the phosphonate group with all metal ions studied; in fact, Mg2+, Ca2+ and Ni2+ coordinate (within the error limits) only to this site. For the Cu[(Dien)Pt(PMEA-N1)]2+ and Zn[(Dien)Pt(PMEA-N1)]2- systems also the formation of five-membered chelates involving the ether oxygen of the -CH2-O-CH2-PO3(2-) residue could be detected; the formation degrees are about 60% and 30%, respectively. The metal-ion-binding properties of the isomeric (Dien)Pt(PMEA-N7) species studied previously differ in so far that the resulting M[(Dien)Pt(PMEA-N7)]2+ complexes are somewhat less stable, but again Cu2+ and Zn2+ also form with this ligand comparable amounts of the mentioned five-membered chelates. In contrast, both M[(Dien)Pt(PMEA-N1/N7)]2+ complexes differ from the parent M(PMEA) complexes considerably; in the latter instance the formation of the five-membered chelates is of significance for all divalent metal ions studied. The observation that divalent metal-ion binding to the phosphonate group of (Dien)Pt(PMEA-N1) and (Dien)Pt(PMEA-N7) is only moderately inhibited (about 0.2-0.4 log units) by the twofold positively charged (Dien)Pt2+ unit at the adenine residue allows the general conclusion, considering that PMEA is a nucleotide analogue, that this is also true for nucleotides and that consequently participation of, for example, two metal ions in an enzymatic process involving nucleotides is not seriously hampered by charge repulsion.

Adenine↗
PubMed2001

Bacterial diversity in soil samples from two uranium waste piles as determined by rep-APD, RISA and 16S rDNA retrieval.

The bacterial diversity in two uranium waste piles was studied. Total DNA was recovered from a large number of soil samples collected from different sites and depths in the piles using two procedures for direct lysis. Significant differences in the bacterial composition of the samples were revealed by the use of rep-APD, RISA and 16S ARDREA. The 16S rDNA analyses showed that the uranium wastes were dominated by Acidithiobacillusferrooxidans and by several Pseudomonas species classified in the gamma-subdivision of the Proteobacteria. The three kinds of A. ferrooxidans 16S and IGS rDNA specific fragments that were found corresponded to the three phylogenetic groups recognised in this species. This microdiversity probably reflects the genetic adaptation of the uranium waste strains to different concentrations of heavy metals.

Base Sequence↗
PubMed1999

Efficacy of hand disinfectants against vancomycin-resistant enterococci in vitro.

Vancomycin-resistant enterococci (VRE) may be spread within a hospital via the contaminated hands of the healthcare worker. Effective hand disinfectants are necessary to break chains of transmission. We determined the bactericidal activity of 1-propanol, chlorhexidine digluconate (0.5 and 4%). Sterillium (45% 2-propanol, 30% 1-propanol and 0.2% mecetronium etilsulphate), Skinsept F (70% 2-propanol, 0.5% chlorhexidine digluconate and 0.45% hydrogen peroxide) and Hibisol (70% 2-propanol and 0.5% chlorhexidine gluconate) against 11 clonally distinct enterococcal isolates in a quantitative suspension test. Four isolates were vancomycin susceptible, four were vanA and the remainder vanB positive. Eight isolates were identified as Enterococcus faecium, two as Enterococcus faecalis and one as Enterococcus gallinarum. The investigator was blinded to the species and the genotype. Four parallel experiments were carried out for each isolate, each preparation, each dilution and each reaction time. 1-Propanol (60%), Sterillium, Skinsept F and Hibisol were all highly bactericidal after 15 and 30 s against VRE and vancomycin-susceptible enterococci (VSE) with reduction factors (RF) > 6.4, even in dilution of 50% (v/v). No significant difference was observed between vanA isolates, vanB isolates and VSE. Chlorhexidine digluconate (0.5% and 4%) was found to be less bactericidal after 30, 60 and 300 sec (RF < or = 2.5). The vanB genotype isolates were found to be significantly more susceptible to chlorhexidine (0.5%) than the vanA isolates (60 sec; one-way ANOVA model; P = 0.05). After 300 sec the vanB genotype isolates were found to be significantly more susceptible to chlorhexidine (0.5%) than the other two genotype isolates (P = 0.016). The vanA isolates were found to be significantly more susceptible to chlorhexidine (4%) than the vanB isolates (300 s; P = 0.024). E. faecium was found to be less susceptible to chlorhexidine than E. faecalis at all concentrations and reaction times, but significant differences between RF were only observed at 60 sec for both chlorhexidine concentrations (P < 0.05; t-test for independent samples). Propanol is much more effective against enterococci than chlorhexidine and combination of the two may be useful in providing an immediate and long lasting effect.

Analysis of Variance↗
PubMed1999

Evaluation of the BBL Crystal MRSA ID System for detection of oxacillin resistance in Staphylococcus aureus.

AIMS: To evaluate the BBL Crystal MRSA ID System for detection of oxacillin resistance in Staphylococcus aureus. METHODS: 52 methicillin resistant S aureus (MRSA) from five different countries and 85 methicillin susceptible S aureus (MSSA) were included. The species was confirmed by tube coagulation and detection of the clumping factor using the Staphaurex Plus. Clonal non-identity of the MRSA isolates was shown by pulsed field gel electrophoresis. MIC values (oxacillin) were determined using the Etest. Polymerase chain reaction was carried out to detect the mecA gene. The BBL Crystal MRSA ID System was carried out according to the manufacturer's instructions. RESULTS: The BBL Crystal MRSA ID System showed fluorescence in 45 of 52 MRSA (sensitivity 86.5%; negative predicitive value 92.2%), and the specificity was 97.6% (positive predicitive value 95.7%). Two of seven MRSA that failed to show fluorescence had MIC values (oxacillin) of 4 mg/litre. CONCLUSIONS: The BBL Crystal MRSA ID System is a valuable test for detecting oxacillin resistance in S aureus. Its major advantage is the short time (4-5 hours) required to perform the test when organisms are grown on tryptic soy agar or sheep blood agar. Difficulties may arise in borderline resistant isolates.

Evaluation Studies as Topic↗