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Biomedical subjects

R Ostensson

Publications and source records attributed to R Ostensson.

7 recordsLinked to original sources

Surgical area contamination--comparable bacterial counts using disposable head and mask and helmet aspirator system, but dramatic increase upon omission of head-gear: an experimental study in horizontal laminar air-flow.

The effect of different head coverings on air-borne transmission of bacteria and particles in the surgical area was studied during 30 strictly standardized sham operations performed in a horizontal laminar air flow (LAF) unit. The operating team members wore disposable gowns plus either a non-sterile head covering consisting of a squire type disposable hood and triple laminar face mask, a sterilized helmet aspirator system or no head cover at all. In the wound area both types of head cover resulted in low and comparable air (means of 8 and 4cfu/m(3)) and surface contamination (means of 69 and 126cfu/m(2)/h) rates. Omission of head-gear resulted in a three- to five-fold increase (P > or = 0.01- 0.001), depending on site sampled air contamination rate (mean of 22cfu/m(3)) whereas the bacterial sedimentation rate in the wound area increased about 60-fold ( P > or = 0.0001). A proper head cover minimized the emission of apparently heavy particles that were not removed by the horizontal LAF and contained mainly streptococci, presumably of respiratory tract origin. Dust particle counts revealed no differences between the three experimental situations. No correlation between air and surface contamination rates or between air contamination and air particle counts was found. We conclude that, from a bacteriological point of view, disposable hoods of squire type and face masks are equally as efficient as a helmet aspirator system and both will efficiently contain the substantial emission of bacteria-carrying droplets from the respiratory tract occurring when head cover is omitted. Finally, the use of bacterial air counts to assess surgical site surface contamination in horizontal LAF units must be seriously questioned.

Air Microbiology↗

Inefficiency of upward displacement operating theatre ventilation.

A new thermally based ventilation system ('Floormaster') with inlet of cool clean air at floor level, and evacuation at the ceiling of the air warmed by activity in the room (upward displacement ventilation, 17 air changes/h) was compared with a standard positive pressure (plenum) ventilation system with air supply through an inclined perforated screen along one wall at the ceiling and evacuation at floor level (conventional turbulent or mixing system, 16 air changes/h). The study was made during rigidly standardized sham operations (N = 20) performed in the same operating room by a six-member team wearing non-woven disposable or cotton clothing. In general the upward displacement system removed dust particles too small to carry bacteria (0.16-<0.3 microm, 0.001<P<0.01) more efficiently than the conventional system. However, the displacement system also yielded two to threefold higher air and surface bacterial counts in areas important for surgical asepsis (wound area, instrument table) especially with regard to bacterial sedimentation (0.001<P<0.05). The major shortcoming of the displacement system was insufficient elimination of the larger bacteria-carrying particles. The type of clothing worn by the members of the team did not influence the overall results. We conclude that an upward displacement system will lead to increased counts of airborne and sedimenting bacteria and thus increase the risk of postoperative infection in comparison with conventional operating room ventilation systems.

Air Microbiology↗

A 7-year survey of drug resistance in aerobic and anaerobic fecal bacteria of surgical inpatients: clinical relevance and relation to local antibiotic consumption.

One-day studies of bacteriological cultures of fecal specimens obtained from 409 surgical inpatients at 5 occasions enabled rapid assessment of antibiotic resistance in aerobic and anaerobic bacteria, relevant to abdominal infection. This novel approach to surveillance of drug resistance was tested in a 7-year survey at a surgical department. A distinct correlation between local drug consumption and prevalence of resistant fecal bacteria was recorded for ampicillin and doxycycline. 17 other agents studied showed no such obvious correlations. Huge increases of cefuroxime and metronidazole consumption caused no emergence of drug resistant aerobic and anaerobic fecal bacteria. Imipenem was the only agent tested, which inhibited both the aerobic and anaerobic fecal bacteria of nearly all patients.

Abdomen↗

Time- and media-saving testing and identification of microorganisms by multipoint inoculation on undivided agar plates.

Motility and various biochemical activities of isolates of bacteria and yeasts were tested on undivided agar plates by using a simple, manually operated multipoint inoculation apparatus that allowed the analysis of 25 isolates per 9-cm-diameter petri plate. Fermentation of all 17 carbohydrates tested as well as 13 other biochemical activities commonly used for identification of bacteria were readily demonstrated by the multipoint inoculation plate method, and the results agreed very well with those of conventional tube tests. In addition to speedy inoculation and low cost of materials, the multipoint inoculation plate method offers several other advantages when compared with conventional tube tests or with some of the manufactured test kits currently available for recognizing members of the family Enterobacteriaceae.

Agar↗