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Biomedical subjects

R Van Enk

Publications and source records attributed to R Van Enk.

5 recordsLinked to original sources
PubMed1999

Risk of cross-patient infection with clinical use of a needleless injector device.

BACKGROUND: Needleless injection devices use multiple-dose vials for the administration of local anesthetics to patients. There is a theoretic risk of iatrogenic infection associated with use of these devices. METHODS: This study used in vitro models to investigate the potential for transferring microbial pathogens among patients by using the Syrijet (Keystone Industries, Inc, Cherry Hill, NJ). Staphylococcus aureus and coagulase-negative staphylococci were used to determine whether patient skin flora could contaminate the instrument internal canal by postejection reverse flow and whether the staphylococci could survive on the ejection surface, in the internal canal, or in the anesthetic vial. RESULTS: The ejection surface was contaminated by firing the device while it was in contact with a contaminated surface. Postejection reverse flow drew contaminants into the device, and increased with ejection volume. Reverse flow did not reach the multidose vial, and staphylococci did not grow in the commercial anesthetic solution typically administered with the device. Surface, but not internal, contamination could be removed by swabbing with disinfectant. CONCLUSION: Although autoclaving is the only way to ensure sterilization of this device, frequent cleaning of the ejection surface during clinical use minimizes the risk of cross-patient bacterial transfer.

Cross Infection↗
PubMed1994

Use of commercial particle agglutination systems for the rapid identification of methicillin-susceptible and methicillin-resistant Staphylococcus aureus.

The performance of a recently introduced Staphylococcus aureus identification system (Slidex Staph-Kit) was compared with that of currently available systems (Immuno Scan Staphlatex, Staphyloslide, Staphaurex and SeroSTAT II) for the identification of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible Staphylococcus aureus. The new system, which detects a capsular antigen common in MRSA, performed with equal or greater sensitivity than the other systems. None of the commercial systems was adversely affected by the methicillin susceptibility of the staphylococci when isolates were recovered from non-selective media. The greatest advantage of the anti-capsular monoclonal reagent was its improved performance on isolates recovered from selective media.

Humans↗
PubMedDate not supplied

Endoscopy water source: tap or sterile water?

The purpose of this study was to determine whether the endoscopic water source holds potential for transmission of pathogens. Phase I of the study used tap water and clean water bottles; Phase II used sterile water and steam-sterilized water bottles. In both phases, a control bottle filled with water from the appropriate source was set up. Cultures were taken from both the controls and endoscopy water sources before the day's procedures were started and at the end of the day. Each phase contained 100 to 106 sets of samples. Many of the tap water samples were positive for normal flora found in city water sources. No clinically significant complications were identified during either phase of the study. The use of tap water and clean water bottles was found to carry no greater risk than using sterile water and sterile bottles. The practice of using tap water will result in significant cost savings. Further study will be needed to look at the integrity of the endoscope and water bottle design in preventing transmission of pathogens.

Bacterial Infections↗
PubMedDate not supplied

Common bacteria whose susceptibility to antimicrobials is no longer predictable.

The widespread use of antibiotics has been responsible for the development of numerous problems including the emergence of multidrug resistant bacteria, increased number of nosocomial- and community-acquired infections, less than optimal patient outcome, and increased health care costs. Of equal concern is the emergence of resistance in clinical isolates to antibiotics that were once considered "standard" with predictable in vitro susceptibility patterns. Such resistance has been especially notable in organisms that are commonly encountered in a variety of infections including, Streptococcus pneumoniae, Staphylococcus aureus. Enterococci, Klebsiella pneumoniae, and Escherichia coli. It is important for the clinical microbiology laboratory to provide the practicing clinician with accurate and timely antimicrobial susceptibility information which requires the application of standardized and approved in vitro testing methods. The laboratory also serves as a sentinel by maintaining an active monitoring and surveillance program in which current in vitro susceptibility patterns can be compared with local, regional, and national data bases.

Anti-Bacterial Agents↗