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At least 199 records · Page 11Linked to original sources

PubMed2000

Gastrointestinal decontamination for enteric-coated aspirin overdose: what to do depends on who you ask.

CONTEXT: Overdoses with enteric-coated preparation are common. The optimal means by which to limit drug absorption in such cases is controversial. OBJECTIVE: To describe the recommendations for gastrointestinal decontamination issued by North American poison control centers for a hypothetical patient, (an adult male with normal vital signs), presenting 1 hour after ingesting 500 mg/kg of enteric-coated aspirin. DESIGN: Telephone survey of 76 poison control centers in North America. Seven toxicologists who contributed to the American Academy of Clinical Toxicology/European Association of Poison Centres and Clinical Toxicologists position statements on gastrointestinal decontamination were also surveyed for informal comparison. RESULTS: Most poison control centers (99%) and all of the toxicologists (100%) participated in the survey. Four centers (5 %) recommended syrup of ipecac and 38 (51%) recommended gastric lavage, compared with 0% and 0% of toxicologists, respectively. Seventy-three centers (97%) recommended at least one dose of activated charcoal, compared with 6 toxicologists (86%). Twenty-one poison centers (28%) recommended whole-bowel irrigation, compared with 3 toxicologists (43%). A total of 36 different courses of action were suggested by respondents at the poison centers. Some of these recommendations were potentially harmful. CONCLUSIONS: Considerable variability exists in the recommendations of North American poison control centers for the gastrointestinal decontamination of patients with large, acute overdoses of enteric-coated aspirin.

Adult↗

PubMed1987

The effect of oropharyngeal decontamination using topical nonabsorbable antibiotics on the incidence of nosocomial respiratory tract infections in multiple trauma patients.

The incidence of respiratory tract infections was determined in 59 multiple trauma patients requiring prolonged intensive care (greater than 5 days) and receiving no antibiotic prophylaxis. Early pneumonia (less than 48 hr) with S. aureus, S. pneumoniae, and/or H. influenzae was found in 44% of patients. Secondary colonization of the oropharynx and respiratory tract with ICU-associated Gram-negative bacilli followed by pneumonia occurred in 12 patients (20%). The overall incidence of respiratory tract infections was 59%. In a prospective open trial three prophylactic antibiotic regimens were compared: 17 patients were treated with intestinal decontamination using nonabsorbable antibiotics (polymyxin E 400 mg, tobramycin 320 mg, amphotericin B 2,000 mg/day). No difference in infection rate was found. Twenty-five patients were treated with intestinal and oropharyngeal decontamination using an ointment containing 2% of the same antibiotics. Secondary colonization and infection of the respiratory tract with Gram-negative bacilli was significantly reduced (p less than 0.001). The incidence of early (Gram-positive) infections, however, was unchanged. Another group of 63 patients was treated with systemic antibiotic prophylaxis during the first days in combination with oropharyngeal and intestinal decontamination. The incidence of early pneumonia was significantly reduced (p less than 0.001). Five patients (8%) developed an infection. Superinfections were not observed.

Administration, Topical↗

PubMed1995

Advances in decontamination of blood components.

Despite improved pretransfusion donor evaluation and testing, there is still residual risk of transfusion-associated viral infectious disease. Moreover, other important infectious pathogens, including bacteria, protozoa, and nonenveloped viruses, are not detected in current testing programs. Recent investigations from several laboratories have stimulated interest in decontamination of blood products as an additional means to further enhance the safety of blood transfusion. Furthermore, because testing is a retrospective strategy, a robust decontamination process could provide prospective protection against new pathogens that may enter the blood donor population. Recent advances in decontamination of fresh frozen plasma, plasma derivatives, platelet concentrates, and erythrocytes are reviewed. The introduction of solvent-detergent-treated plasma fractions marks an important advance in transfusion safety. Other technologies for cellular components are emerging to address transfusion-associated infectious disease transmission.

Blood↗

PubMed1983

Sodium hypochlorite decontamination of split-thickness cadaveric skin infected with bacteria and yeast with subsequent isolation and growth of basal cells to confluency in tissue culture.

The ability of sodium hypochlorite to decontaminate skin while leaving sufficient epidermal cell viability for growth in tissue culture was investigated with an in vitro system. Split-thickness cadaveric skin was infected with Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans and subsequently treated with various concentrations of sodium hypochlorite for various time intervals. Exposure to a 0.5% solution of sodium hypochlorite for 6 min effectively decontaminated the skin while leaving 66% of the basal cells viable. The basal cells were subsequently grown to confluency in tissue culture. This study demonstrates that microbial colonization of skin can be eliminated by exposure to dilute hypochlorite. This procedure, while decontaminating the skin, leaves sufficient viability of epidermal cells for subsequent growth and expansion in tissue culture, elements essential for grafting over wounds.

Bacteria↗

PubMed2005

Survival or growth of Escherichia coli O157:H7 in a model system of fresh meat decontamination runoff waste fluids and its resistance to subsequent lactic acid stress.

A potential may exist for survival of and resistance development by Escherichia coli O157:H7 in environmental niches of meat plants applying carcass decontamination interventions. This study evaluated (i) survival or growth of acid-adapted and nonadapted E. coli O157:H7 strain ATCC 43895 in acetic acid (pH 3.6 +/- 0.1) or in water (pH 7.2 +/- 0.2) fresh beef decontamination runoff fluids (washings) stored at 4, 10, 15, or 25 degrees C and (ii) resistance of cells recovered from the washings after 2 or 7 days of storage to a subsequent lactic acid (pH 3.5) stress. Corresponding cultures in sterile saline or in heat-sterilized water washings were used as controls. In acetic acid washings, acid-adapted cultures survived better than nonadapted cultures, with survival being greatest at 4 degrees C and lowest at 25 degrees C. The pathogen survived without growth in water washings at 4 and 10 degrees C, while it grew by 0.8 to 2.7 log cycles at 15 and 25 degrees C, and more in the absence of natural flora. E. coli O157:H7 cells habituated without growth in water washings at 4 or 10 degrees C were the most sensitive to pH 3.5, while cells grown in water washings at 15 or 25 degrees C were relatively the most resistant, irrespective of previous acid adaptation. Resistance to pH 3.5 of E. coli O157:H7 cells habituated in acetic acid washings for 7 days increased in the order 15 degrees C > 10 degrees C > 4 degrees C, while at 25 degrees C cells died off. These results indicate that growth inhibition by storage at low temperatures may be more important than competition by natural flora in inducing acid sensitization of E. coli O157:H7 in fresh meat environments. At ambient temperatures in meat plants, E. coli O157:H7 may grow to restore acid resistance, unless acid interventions are applied to inhibit growth and minimize survival of the pathogen. Acid-habituated E. coli O157:H7 at 10 to 15 degrees C may maintain a higher acid resistance than when acid habituated at 4 degrees C. These responses should be evaluated with fresh meat and may be useful for the optimization of decontamination programs and postdecontamination conditions of meat handling.

Acetic Acid↗

PubMed1990

Decontamination of instruments and control of cross infection in general practice.

OBJECTIVE: To assess the effectiveness of decontamination procedures in general practice. DESIGN: Anonymous postal questionnaire survey of 600 general practitioners randomly selected from the national register. SETTING: General practices throughout the United Kingdom. SUBJECTS: 382 General practitioners, a response rate of 65%. RESULTS: 186 General practitioners had autoclaves but 125 used hot water disinfectors or chemical disinfectants to reprocess instruments. 22% (474/2132) Of high risk instruments were inadequately decontaminated. Decontamination was performed by the practice nurse or receptionist in 306 practices. Knowledge of treatment of spillages of blood fluids was uncertain, and only 114 general practitioners used effective methods for dealing with spillages. CONCLUSIONS: A comprehensive central code of practice for control of infection is needed for primary health care staff.

Cross Infection↗

PubMed2003

A comparison of the decontamination efficacy of foam-making blends based on cationic and nonionic tensides against organophosphorus compounds determined in vitro and in vivo.

The ability of foam-making blends to decontaminate the skin exposed to organophosphorus compounds was tested. The appropriate composition and rheological features (stability, grade of foaming) of tested blends were evaluated by in vitro methods and their ability to remove the contaminants from hard surface and to transform the contaminants into nontoxic compounds was evaluated by in vivo methods. The blends containing cationic and nonionic tensides as well as alkalized hydrogen peroxide seem to be the most efficacious to decontaminate the skin exposed to organophosphorus compounds according to the literature data. The composition of tested blends was optimized because particular components often have antagonistic effects. Cationic tensides support the reactivity of the blend and control the grade of foaming. Nonionic tensides control the stability of the foams but also react as retardants of the reactivity of the foams. Hydrogen peroxide is a real reacting component when it is transformed into hydrogen peroxide anion. It also acts as buffer if pH is higher than 11. Our in vivo results confirm that Desam OX (34 and 68%) and the foam-making blend containing benzalkonium chloride--Althosan MB (8%), Slovasol 2510 (2%) and hydrogen peroxide (3%) alkalized at pH 12 seem to be the most efficacious to remove contaminants (soman, VX) from the skin and transform them into nontoxic compounds. Therefore they could be used for primary decontamination of chemical casualties contaminated with nerve agents in the field condition.

Administration, Cutaneous↗

PubMed2006

An approach for decontamination of beta-lactam antibiotic residues or contaminants in the pharmaceutical manufacturing environment.

An effective procedure for decontamination of beta-lactam antibiotic residues or contaminants in the pharmaceutical manufacturing environment was investigated. Decontamination with solutions of hydrochloric acid, sodium hydroxide, hydrogen peroxide and hydroxylamine as agents for degradation was assessed. According to the results, the beta-lactam antibiotics were significantly degraded with sodium hydroxide and hydroxylamine. From the structural analysis of the degradation products of a cephem antibiotic, cefpodoxime proxetil, it was found that hydroxylamine degraded the beta-lactam structure under mild conditions, while sodium hydroxide did not. Therefore, hydroxylamine was considered an appropriate decontamination agent for beta-lactam antibiotics.

Anti-Bacterial Agents↗

PubMed2000

Decontamination of human xenotransplantable tumor with mouse hepatitis virus by implantation in nude rat: a case report.

A human tumor xenograft contaminated with mouse hepatitis virus (MHV) was implanted in a nude rat in order to decontaminate the tumor line. The decontamination failed in the first trial, but succeeded in the second trial. The difference between the two trials was the duration of implantation of the tumor in the nude rat, i.e., 12 days in the first and 24 days in the second trial. Duration of implantation might be a factor in the decontamination of transplantable tumors infected with MHV by passaging in the nude rat.

Animals↗

PubMed2005

[Microbiological evaluation of gastroscope decontamination by electrolysed acid water (Clentop WM-1)].

BACKGROUND: The manual disinfection of endoscopes with glutharaldeyde is widely employed. The great routine in gastroenteroscopy services, low number of equipment and the lack of technical knowledge about the decontamination processes are factors that stimulate the inadequate endoscope disinfection, intensifying the risk of transmission of microorganisms. The electrolysed acid water has been effective in the inactivation and destruction of microorganisms. AIM: The purpose of this investigation was to verify the microbicidal efficiency of electrolyzed acid water (Cleantop WM-1) to decontaminate gastroscopes after their using in patients. MATERIAL AND METHODS: Samples from biopsy channel of flexible endoscopes collected after patient use (n = 20) and after disinfection (n = 20) were cultivated in tryptic soy agar, MacConkey agar and Sabouraud dextrose agar. RESULTS: Seventeen of the 20 samples collected after patients examination yielded gram-negative bacilli, gram-positive coccus and yeast cells in contamination of 3 to 5 log10 ufc/mL. Microbial growth was not verified in samples collected after the decontamination process. Conclusion - In this preliminary study, the mechanical disinfection carried through the Cleantop device with electrolyzed acid water showed satisfactory results for the elimination of microorganisms and time optimization in the reprocessing of gastroscopes.

Decontamination↗

PubMed1999

Application of reuterin produced by Lactobacillus reuteri 12002 for meat decontamination and preservation.

Lactobacillus reuteri strain 12002 was used for reuterin production in the two-step fermentation process. A batch culture fermentation was used to produce a maximum biomass of L. reuteri. Then cells were harvested, resuspended in a glycerol-water solution, and anaerobically incubated to produce reuterin. The lyophilized supernatants (approximately 4000 activity units (AU) of reuterin per ml) were diluted in distilled water for decontamination and preservation trials. The MIC values of reuterin for Escherichia coli O157:H7 and Listeria monocytogenes were 4 and 8 AU/ml, respectively. In meat decontamination experiments, the surface of cooked pork was inoculated with either L. monocytogenes or E. coli O157:H7 at a level of approximately log10 5 CFU/cm2, incubated for 30 min at 7 degrees C, and decontaminated by exposure to reuterin (500 AU/ml). The bactericidal effect of reuterin was analyzed 15 s and 24 h after exposure at 7 degrees C. After 15 s of exposure to reuterin, viable numbers decreased by 0.45 and 0.3 log10 CFU/cm2 for E. coli O157:H7 and L. monocytogenes, respectively. After 24 h the numbers decreased by 2.7 log10 CFU/cm2 for E. coli O157:H7 and by 0.63 log10 CFU/cm2 for L. monocytogenes. In the same experiment, the combined effect of reuterin and lactic acid was also investigated. Adding lactic acid (5%, vol/vol) to reuterin significantly enhanced (P < or = 0.05) the efficacy of reuterin. No additional effect (P < or = 0.05) was found when ethanol (40%) was added to the mixture of reuterin and lactic acid. To evaluate the preservative effect of reuterin during meat storage, reuterin was added to raw ground pork contaminated with E. coli O157:H7 or L. monocytogenes. Reuterin at a concentration of 100 AU/g resulted in a 5.0-log10 reduction of the viability of E. coli O157:H7 after 1 day of storage at 7 degrees C. Reuterin at a concentration of 250 AU/g reduced the number of the viable cells of L. monocytogenes by log10 3.0 cycles after 1 week of storage at 7 degrees C.

Aldehydes↗

PubMed2004

Clinical aspects of percutaneous poisoning by the chemical warfare agent VX: effects of application site and decontamination.

O-ethyl S-(2-diisopropylaminoethyl) methylphosphonothioate (VX) is an extremely toxic organophosphate nerve agent that has been weaponized and stockpiled in a number of different countries, and it has been used in recent terrorist events. It differs from other well-known organophosphate nerve agents in that its primary use is as a contact poison rather than as an inhalation hazard. For this reason, we examined the effects of application site and skin decontamination on VX toxicity in anesthetized domestic swine after topical application. VX applied to the surface of the ear rapidly resulted in signs of toxicity consistent with the development of cholinergic crisis, including apnea and death. VX on the epigastrium resulted in a marked delayed development of toxic signs, reduced toxicity, and reduction in the rate of cholinesterase depression compared with animals exposed on the ear. Skin decontamination (15 minutes post-VX on the ear) arrested the development of clinical signs and prevented further cholinesterase inhibition and death. These results confirm earlier work that demonstrates the importance of exposure site on the resultant toxicity of this agent and they also show that decontamination postexposure has the potential to be an integral and extremely important component of medical countermeasures against this agent.

Administration, Cutaneous↗

PubMedDate not supplied

Infection control. Hygienic hand decontamination.

Hygienic hand decontamination is the single most important technique available to nurses in preventing the spread of infection. The evaluation of hand decontamination is now recognised as a complex task that involves frequency, choice of agent, appropriate timing, duration and quality of technique. This article analyses each of the components of hygienic hand decontamination, and concludes that more research is necessary before evaluation of this vital nursing activity can be undertaken with confidence.

Cross Infection↗

PubMed1989

Decontamination of medical equipment--manufacturer's problems.

1. Small items sent via the post present a much greater hidden hazard and a higher potential for catching people unawares. 2. Large items accompanied by a Decontamination Certificate need to be treated with caution because only those surfaces which are accessible will have been cleaned; as soon as engineers start dismantling equipment, areas which are still soiled become exposed. 3. Total co-operation between hospital staff and service engineers is necessary to resolve these problems-neither can work safely without the assistance of the other. 4. Many products in use in hospitals may be up to 20 years old and clearly were not designed to facilitate decontamination and therefore present far greater risk to all concerned. 5. For the future there a clearly a responsibility with manufacturers to give more thought to the design of their equipment so that decontamination can be achieved more effectively.

Cross Infection↗

PubMed2002

Decontamination upgrading progresses.

Standards of decontamination of surgical instruments in the NHS in England have come under close scrutiny, and some significant improvements have been achieved. Action plans, developed to ensure the rate of improvement is maintained, are described in this article which is derived from the Department of Health/NHS Estate document 'A review of the decontamination of surgical instruments in the NHS in England'. The Institute of Healthcare Engineering and Estate Management is one of the organisations involved in the programme of work on decontamination.

Central Supply, Hospital↗

PubMed2002

Diphoterine for emergent eye/skin chemical splash decontamination: a review.

Eye/skin chemical splashes are a significant problem. Diphoterine is an hypertonic, polyvalent, amphoteric compound developed in France as an eye/skin chemical splash water-based decontamination solution. In vitro and in vivo, it actively decontaminates approximately 600 chemicals, including acids, alkalis, oxidizing and reducing agents, irritants, lacrimators, solvents, alkylating agents, and radionuclides. Its chemical bond energy for such agents is greater than that of tissue receptors. Its hypertonicity impedes chemical tissue penetration and may remove some amount of skin/cornea-absorbed toxicants not already bound to tissue receptors. Diphoterine chemical reactions are not exothermic. Diphoterine and its acid/alkali decontamination residues are not irritating to the eyes or skin; it is essentially nontoxic. Diphoterine can prevent eye/skin burns following chemical splashes and results in nearly immediate pain relief.

Burns, Chemical↗

PubMed2002

Florida ED revamps its decontamination plan.

Your decontamination plans should address both small-scale events and treatment of hundreds or more patients. To protect team members, use rescue signals and medical screenings before staff enter the decontamination unit. Use covered walkways, overhangs, or covered parking garages to decontaminate large numbers of patients. Choose a site at an appropriate distance from the hospital to prevent contaminated patients or staff from entering.

Bioterrorism↗

PubMedDate not supplied

Prions, prion diseases and decontamination.

Prions are extremely resistant to disinfection and sterilization methods used so far. The pathogenic prion protein core (called prion) consists of 142 amino-acids, is resistant to proteolytic enzymes, has a mass of 15 pikograms and is filtrable. Fixed by desiccation or chemicals may retain infectivity for years. It survives dry heat at 200 degrees C for 1-2 hours. Prions are fixed to stainless steel within minutes and remain infectious for long periods. Their pathogenetic properties depend on tertiary spatial structure (conformation) which is specific and transmissible in experiment. The prion decontamination appears by far the most important area of the prion science because very little, or nothing, has been done in the majority of world hospitals to prevent iatrogenic transmission. The number of potentially infectious patients is not known. Therefore, patients undergoing neurosurgery, laryngeal or ophthalmic operations, orthodental treatments and even anaesthetic or endoscopic applications should be classified into risk groups, even if clinically priondisease inapparent. The use (or misuse) of disposable instruments is certainly not the final answer for all cases and classic decontamination procedures, if possible because of the character of medical devices, appear still of greatest importance. We consider the high pathogen safety (HPS) autoclave from FEDEGARI as the best actual equipment for the effective decontamination of prions in the hospital practice. The investment costs are moderate and the handling is simple but must be careful. It appears practicable even in small specialized units.

Decontamination↗