PubMed · 9915351
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J S Welch. 1999. Bottle contamination.. https://doi.org/10.1097/00000542-199901000-00056
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The phototransformation of the widely used biocide triclosan (5-chloro-2-(2,4-dichlorophenoxy)phenol) was quantified for surface waters using artificial UV light and sunlight irradiation. The pH of surface waters, commonly ranging from 7 to 9, determines the speciation of triclosan (pKa = 8.1) and therefore its absorption of sunlight. Direct phototransformation of the anionic form with a quantum yield of 0.31 (laboratory conditions at 313 nm) was identified as the dominant photochemical degradation pathway of triclosan. Combining the photochemical parameters with actual meteorological data and field measurements allowed us to validate a model describing the behavior of triclosan in the water column of a Swiss lake (Lake Greifensee). From August to October 1999, direct phototransformation accounted for 80% of the observed total elimination of triclosan from the lake. The remaining major sink for triclosan was the loss in the outflow. Thus, during the summer season, direct phototransformation appears to be a major elimination pathway of triclosan in this lake. Based on absorption spectra and quantum yield data, the phototransformation half-lives of triclosan were calculated under various environmental conditions typical for surface waters. Daily averaged half-lives were found to vary from about 2 to 2000 days, depending on latitude and time of year.
CONTEXT: Surgical site infections prolong hospital stays, are among the leading nosocomial causes of morbidity, and a source of excess medical costs. Clinical studies comparing the risk of nosocomial infection after different hand antisepsis protocols are scarce. OBJECTIVE: To compare the effectiveness of hand-cleansing protocols in preventing surgical site infections during routine surgical practice. DESIGN: Randomized equivalence trial. SETTING: Six surgical services from teaching and nonteaching hospitals in France. PATIENTS: A total of 4387 consecutive patients who underwent clean and clean-contaminated surgery between January 1, 2000, and May 1, 2001. INTERVENTIONS: Surgical services used 2 hand-cleansing methods alternately every other month: a hand-rubbing protocol with 75% aqueous alcoholic solution containing propanol-1, propanol-2, and mecetronium etilsulfate; and a hand-scrubbing protocol with antiseptic preparation containing 4% povidone iodine or 4% chlorhexidine gluconate. MAIN OUTCOME MEASURES: Thirty-day surgical site infection rates were the primary end point; operating department teams' tolerance of and compliance with hand antisepsis were secondary end points. RESULTS: The 2 protocols were comparable in regard to surgical site infection risk factors. Surgical site infection rates were 55 of 2252 (2.44%) in the hand-rubbing protocol and 53 of 2135 (2.48%) in the hand-scrubbing protocol, for a difference of 0.04% (95% confidence interval, -0.88% to 0.96%). Based on subsets of personnel, compliance with the recommended duration of hand antisepsis was better in the hand-rubbing protocol of the study compared with the hand-scrubbing protocol (44% vs 28%, respectively; P =.008), as was tolerance, with less skin dryness and less skin irritation after aqueous solution use. CONCLUSIONS: Hand-rubbing with aqueous alcoholic solution, preceded by a 1-minute nonantiseptic hand wash before each surgeon's first procedure of the day and before any other procedure if the hands were soiled, was as effective as traditional hand-scrubbing with antiseptic soap in preventing surgical site infections. The hand-rubbing protocol was better tolerated by the surgical teams and improved compliance with hygiene guidelines. Hand-rubbing with liquid aqueous alcoholic solution can thus be safely used as an alternative to traditional surgical hand-scrubbing.
The in vitro activities of povidone iodine, potassium peroxymonosulfate, and dimethyldidecylammonium chloride were investigated against 379 nosocomial isolates of Staphylococcus aureus and Pseudomonas aeruginosa responsible for surgical wound infections in patients operated on between July 1995 and June 2001. Overall, the isolates were inhibited by the antiseptics at concentrations below those used routinely. In spite of increasing resistance to the various antibiotics used to treat surgical wound infections, no significant variation in the susceptibility to antiseptics was demonstrated during this 6-year study.