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PubMed2004

In vitro modeling of dental water line contamination and decontamination.

The contamination of dental unit water lines (DUWL) is an emerging concern in dentistry. The aim of this study was to use an in vitro DUWL to model microbial contamination and evaluate the decontamination efficacy of tetraacetylethylenediamine (TAED) solutions. A DUWL biofilm model used to simulate clinical conditions was used to generate a range of biofilms in DUWL. Three distinct biofilms were generated: (1) biofilm from water, (2) biofilm from a mix of water + contaminating human commensal bacteria, (3) biofilm from water with contaminating oral bacteria added after biofilm formed. The contaminating oral species used were Streptococcus oralis, Enterococcus faecalis and Staphylococcus aureus. Decontamination by simple water flushing or flushing with TAED was evaluated (2, 5 and 10 min intervals). The DUWL tubes were split and samples were plated onto a range of media, incubated and bacteria enumerated. Water flushing did not reduce the number of microorganisms detected. Bacteria were not detected from any of the TAED sampling points for any of the biofilm types tested. Interestingly, if contamination was introduced to new DUWL along with the waterborne species a biofilm was formed containing only the waterborne species. If however, an existing biofilm was present before the introduction of "contaminating" bacteria then these could be detected in the biofilm. This implies that if the DUWL are new or satisfactorily cleaned on a regular basis then the associated cross-contamination aspects are reduced. In conclusion, TAED provides effective control for DUWL biofilms.

Biofilms↗

PubMed2005

Combined decontamination processes for wastes containing PCBs.

This project has focused on the development of a complex assembly of mutually corresponding technological units: a low temperature thermal process for the desorption of PCBs and other organics from soils and other contaminated solid wastes; the extraction of PCBs from soils by an ecological friendly aqueous solution of selected surfactants; the chemical decontamination of PCBs in oils and in-oil-in-water emulsions by metallic sodium and potassium in polyethylene glycols in the presence of aluminum powder; the modified alkaline catalyzed chemical decontamination of PCBs in oil-in-water dispersions in a solid-state reactor (in a film of reacting emulsion on solid carriers); and the breakdown of PCBs in aqueous emulsions with activated hydroxyl radicals enhanced by UV radiation. The processes operate in a closed loop configuration with effluents circulating among the process unit. These technologies have been verified at laboratory and pilot-plant scales.

Decontamination↗

PubMed2004

Problems with the decontamination of dental handpieces and other intra-oral dental equipment in hospitals.

Dental departments within district general hospitals contain items of equipment that require decontamination between patients. Some of these items are complex and expensive, and in busy clinics, may be required in large numbers if a sterile services department (SSD) were to be used. This may result in local manual cleaning of these instruments and sterilization in non-vacuum downward displacement autoclaves within dental departments, despite some items having narrow lumens, deep recesses and cavities, which will not adequately sterilize these instruments. Infection control teams should be aware of these difficulties particularly when arranging satisfactory infection control and decontamination procedures in hospital dental departments.

Decontamination↗

PubMed2004

Cefuroxime, rifampicin and pulse lavage in decontamination of allograft bone.

The risk of bacterial infection through allogenic bone transplantation is one of the major problems facing tissue banks. Different screening methods and decontamination procedures are being used to achieve a safe surgical result. The purpose of this study was to investigate the contamination rate in fresh frozen bone allografts after treating them with different decontamination methods. The allografts were contaminated by rubbing on the operating theatre floor for 60 min, after which they were rinsed either with sterile physiological saline, cefuroxime or rifampicin solution or they were washed with low-pressure pulse lavage of sterile physiological saline. Our findings show that low-pressure pulse lavage with sterile saline solution is very effective in removing bacteria from bone allograft, when compared with the antibiotic solutions tested.

Anti-Bacterial Agents↗

PubMed2004

Is biofilm accumulation on endoscope tubing a contributor to the failure of cleaning and decontamination?

We predicted that biofilm would form on surfaces of endoscope tubing in contact with fluids, and may be difficult to remove by current washing procedures. Its presence may protect micro-organisms from disinfectant action and contribute to failure of decontamination prior to re-use. Tubing samples removed from 13 endoscopes that had been sent to an endoscope-servicing centre were examined for the presence of biofilm and bacteria by scanning electron microscopy. Biological deposits were present on all samples tested. Biofilm (bacteria plus exopolysaccharides matrix) was present on the suction/biopsy channels of five of 13 instruments, and was very extensive on one of these. Bacteria and microcolonies were often but not necessarily associated with surface defects on the tubing. All 12 air/water channels examined showed biofilm, and this was extensive on nine samples. Routine cleaning procedures do not remove biofilm reliably from endoscope channels, and this may explain the unexpected failure of decontamination encountered in practice despite good adherence to infection control guidelines.

Bacteria↗

PubMed2005

Evaluation of virus decontamination techniques for porcine embryos produced in vitro.

The objective of this study was to explore approaches to decontaminate embryos either contaminated naturally or under experimental conditions with different viruses. Embryos were obtained from in vitro maturation and fertilisation of porcine oocytes. After 7 days of development, morula and blastocyst stages were exposed for 1 h to the following viruses: encephalomyocarditis virus (EMCV), porcine circovirus type 2 (PCV2), porcine parvovirus (PPV), porcine reproductive and respiratory syndrome virus (PRRSV), and bovine viral diarrhea virus (BVDV) at an infectivity of 100 TCID50/mL. Embryos samples were treated with different washing procedures, which all included the following standard washing solutions: PBS+0.4% BSA (five times for 10 s), Hank's+0.25% trypsin (two times for 60-90 or 120-150 s, or one time of 5 min), Hank's+0.1 mg/mL DNase 1+20 U/mL RNase One (one time of 30 min) and PBS+0.4% BSA again (five times for 10s). Two new approaches were used to improve trypsin treatment, 0.1% hyaluronidase (one time for 5 min) instead of trypsin and a pre-incubation with oviductal cells. Therefore, in the first experiment, oocytes received standard maturation treatments and in the second, they were also co-incubated with oviductal cells for the last 3 h of maturation. The effectiveness of the different washing techniques in removing viruses was evaluated by polymerase chain reaction (PCR) analysis. In the first experiment, trypsin treatment did not eliminate PRRSV, PPV, PCV, and EMCV from contaminated embryos. Surprisingly, treatment with hyaluronidase eliminated all tested viruses. In the second experiment, all viruses tested were removed from the oocytes following the different enzymatic treatments. In conclusion, in vitro embryo decontamination was more effective following exposure to oviductal secretions and hyaluronidase eliminated more virions than trypsin in washing techniques.

Animals↗

PubMed1999

Alteromonas prolidase for organophosphorus G-agent decontamination.

Enzymes catalyzing the hydrolysis of highly toxic organophosphorus compounds (OPs) are classified as organophosphorus acid anhydrolases (OPAA; EC 3.1.8.2). Recently, the genes encoding OPAA from two species of Alteromonas were cloned and sequenced. Sequence and biochemical analyses of the cloned genes and enzymes have established Alteromonas OPAAs to be prolidases (E.C. 3.4.13.9), a type of dipeptidase hydrolyzing dipeptides with a prolyl residue in the carboxyl-terminal position (X-Pro). Alteromonas prolidases hydrolyze a broad range of G-type chemical warfare (CW) nerve agents. Efforts to over-produce a prolidase from A. sp.JD6.5 with the goal of developing strategies for long-term storage and decontamination have been successfully achieved. Large-scale production of this G-agent degrading enzyme is now feasible with the availability of an over-producing recombinant cell line. Use of this enzyme for development of a safe and non-corrosive decontamination system is discussed.

Aryldialkylphosphatase↗

PubMed1999

Organophosphate skin decontamination using immobilized enzymes.

We previously demonstrated that a combination of cholinesterase (ChE) pre-treatment with an oxime is an effective measure against soman and sarin. We describe here a novel approach for the preparation of covalently linked ChEs which are immobilized to a polyurethane matrix. Such preparation of ChE-sponges enhances the stability and usefulness of the enzymes in non-physiological environments. The ChE-sponges, which can be molded to any form, can effectively be used to remove and decontaminate organophosphates (OPs) from surfaces, biological (skin or wounds) or otherwise (clothing or sensitive medical equipment), or the environment. The ChE-sponges retained their catalytic activity under conditions of temperature, time, and drying where the native soluble enzyme would rapidly denature, and can be reused in conjunction with oximes many times. The ChE-sponge in the presence of oxime repeatedly detoxified OPs such as DFP or MEPQ. These developments in ChE technology have extended the applicability of OP scavengers from in vivo protection, to a variety of external detoxification and decontamination schemes. In addition to treatment of OP-contaminated soldiers, the ChE-sponge could protect medical personnel from secondary contamination while attending chemical casualties, and civilians exposed to pesticides or highly toxic nerve agents such as sarin.

Cholinesterase Inhibitors↗

PubMed1990

Penetration of [3H]T-2 mycotoxin through abraded and intact skin and methods to decontaminate [3H]T-2 mycotoxin from abrasions.

Penetration of 50 muCi of [3H]T-2 mycotoxin through abraded and intact skin was studied in anesthetized rats sacrificed at 5, 15, 30, 45, 60 and 90 min post-exposure. The greatest penetration was through abraded skin (49 +/- 7%) at 90 min post-exposure, whereas penetration through intact skin (2 +/- 3%) was substantially less (P less than 0.0015). Methods to decontaminate [3H]T-2 mycotoxin from abraded skin over time were studied. Treatment of [3H]T-2 contaminated abrasions by applying Trau + Medic dressing, applying Charcoal Cloth-Anti-bacterial Field Dressing (Charcoal Dressing), or swabbing with povidone-iodine 30 min post-exposure removed 17-32% of the applied [3H]T-2. Immediate blotting with immediate removal of the dressings absorbed 103 +/- 4% (Trau + Medic) and 87 +/- 4% (Charcoal Dressing) of the applied [3H]T-2, while immediate blotting and leaving the dressing in place for 30 min removed 91 +/- 5% (Trau + Medic) and 76 +/- 3% (Charcoal Dressing). It appears that immediate blotting with either dressing followed by immediate removal before application of a clean dressing is an effective method for decontaminating [3H]T-2 from abrasions.

Adsorption↗

PubMed2003

Establishing and training health care facility decontamination teams.

Recent terrorist events, changes in Joint Commission on Accreditation of Healthcare Organizations requirements, and availability of grant funding have focused health care facility attention on emergency preparedness. Health care facilities have historically been underprepared for contaminated patients presenting to their facilities. These incidents must be properly managed to reduce the health risks to the victims, providers, and facility. A properly equipped and well-trained health care facility team is a prerequisite for rapid and effective decontamination response. This article reviews Occupational Safety and Health Administration (OSHA) training requirements for personnel involved with decontamination responses, as well as issues of team selection and training. Sample OSHA operations-level training curricula tailored to the health care environment are outlined. Initial and ongoing didactic and practical training can be implemented by the health care facility to ensure effective response when contaminated patients arrive seeking emergency medical care.

Decontamination↗

PubMed2001

Sedimentation field-flow fractionation device cleaning, decontamination and sterilization procedures for cellular analysis.

In Sedimentation FFF (SdFFF) practice, it is known that a large number of cell elutions create aging phenomena of the separator, thereby reducing recovery and modifying elution characteristics. Systematic cleaning procedures are developed to enhance channel lifetime, together with microbial decontamination processes. Cells can be therefore reproducibly eluted for a large number of analyses and collected under sterile conditions, if needed. This is one of the most valuable aspect if further culture or transplantation is required. Decontamination was performed using, as contaminant probe, Staphylococcus aureus, highly adherent pathogenic bacteria that eluted from SdFFF as aggregates.

Bacterial Adhesion↗

PubMed1994

[Selective digestive decontamination in patients under reanimation].

Nosocomial infections increase morbidity and mortality in hospitalized patients. ICU patients are at high risk of sustaining them, due to the high rate of invasive procedures and their poor health state. Conventional methods for decreasing the incidence of infection in ICU patients include handwashing, catheter care, strict antibiotic policy, and reduction of environmental sources of infection. Despite these measures, the colonization in these patients is always high, because of the presence of pathogens in the own patients' flora. Nosocomial pneumonia which is a major cause of mortality in ICU patients arises from retrograde colonization of the lung by pathogens originating from oro-pharyngeal and gastric secretions. Since 1984, selective decontamination of the digestive tract (SDD) has been advocated in ICUs to prevent from bacterial and fungal gastrointestinal/oropharyngreal colonization, nosocomial infection, subsequent multiple organ failure (MOF) and death. The SDD regimen is usually an extemporaneously prepared suspension of antimicrobial agents. Appropriate antibiotics for this regimen should ideally be nonabsorbable, to prevent from the development of resistant pathogens and avoid systemic toxicity. They should also be able to selectively eliminate enterobacteriaceae and yeasts, without decreasing the protective anaerobic flora. The most used combination is a suspension of colistin, amphotericin B and aminoglycoside, administered four times day through the nasogastric tube, in association with a paste consisting of 2 p. 100 colistin/amphotericin B/aminoglycoside, applied to the oropharynx. A parenteral antibiotic is also often co-administered during the first four days to prevent from early infections until the SDD regimen reaches its full effect; cefotaxime is usually used for this. SDD significantly decreases colonization rates in the oropharynx, gastrointestinal (GI) tract and trachea. This effects is primarily attributable to a decrease of Gram-negative bacilli (GNB) and yeasts, although several studies also reported decreased isolates of Gram-positive cocci (GPC). Oropharyngeal and GI colonization significantly decrease after four days of such a regimen, but tracheal decontamination in uncertain. Several studies recognized an emergence of GPC during or after SDD and resistance occurrence in GNB (especially against aminoglycosides). Recolonization occurs rapidly, about 4 to 8 days after the discontinuation of SDD. SDD decreases significantly the nosocomial infections, especially Gram-negative pneumonia. This benefit is most obvious in trauma patients, severely burned patients and after orthopic liver transplantation. Several studies reported a significant decrease in the overall rate of infections, especially extrapulmonary infections, including blood, urinary tract, wounds, abdominal, and catheter related infections. Despite a major decrease in infection rates with SDD, most studies did not show lowered mortality rates.(ABSTRACT TRUNCATED AT 400 WORDS)

Anti-Bacterial Agents↗

PubMed2004

Responding to and managing casualties: detection, personal protection, and decontamination.

Unfortunately, a mass casualty caused by chemical or biologic terrorism has become a real threat to the United States. A well-considered preparedness plan is needed to minimize tOe impact of a chemical or biologic attack on civilians and responders. This article describes some of the key elements in a preparedness plan, specifically issues regarding early detection, decontamination. and personal protection. Although chemical and biologic terrorism is often considered as a single entity, there are important distinctions in detection, decontamination, and personal protection procedures that effect preparedness planning. Therefore, any preparedness plan needs to be flexible enough to deal with both biologic and chemical terrorism. Preparedness plans also need to be thorough enough to deal with the differences in response to a variety of specific chemical or biologic agents.

Bioterrorism↗

PubMed2003

Influence of intestinal decontamination using metronidazole on the detection of methanogenic Archaea in bone marrow transplant recipients.

Methane-forming microbes of the phylogenetic domain Archaea are part of the strictly anaerobic microflora of the human intestine. In bone marrow transplant (BMT) recipients, the regimen of intestinal decontamination with metronidazole is targeted to anaerobic bacteria. The effect on the anaerobic methanoarchaea, however, is unknown. Therefore, the faeces of patients undergoing BMT were investigated for methane production. The anoxic Hungate technique and an archaeal growth medium were used to culture faecal specimens. Methane production was measured in the head space of the culture bottles by gas chromatography using a thermal conductivity detector. In a testing serial specimen of 100 patients, 13 patients were found to bear methanogens, and 11 of these patients received metronidazole. The methane-producing faecal specimens occurred before metronidazole use in three patients, during the first week in five patients, and after cessation in three patients. No specimen of the 11 patients that was obtained during the 2nd-5th week of gut decontamination showed methane production. It is concluded that use of metronidazole directed against faecal anaerobic bacteria also suppresses or eliminates faecal methanogenic Archaea.

Adult↗

PubMed2000

Decontamination of minimally invasive surgical endoscopes and accessories.

(1) Infections following invasive endoscopy are rare and are usually of endogenous origin. Nevertheless, infections do occur due to inadequate cleaning and disinfection and the use of contaminated rinse water and processing equipment. (2) Rigid and flexible operative endoscopes and accessories should be thoroughly cleaned and preferably sterilized using properly validated processes. (3) Heat tolerant operative endoscopes and accessories should be sterilized using a vacuum assisted steam sterilizer. Use autoclavable instrument trays or containers to protect equipment during transit and processing. Small bench top sterilizers without vacuum assisted air removal are unsuitable for packaged and lumened devices. (4) Heat sensitive rigid and flexible endoscopes and accessories should preferably be sterilized using ethylene oxide, low temperature steam and formaldehyde (rigid only) or gas plasma (if appropriate). (5) If there are insufficient instruments or time to sterilize invasive endoscopes, or if no suitable method is available locally, they may be disinfected by immersion in 2% glutaraldehyde or a suitable alternative. An immersion time of at least 10 min should be adopted for glutaraldehyde. This is sufficient to inactivate most vegetative bacteria and viruses including HIV and hepatitis B virus (HBV). Longer contact times of 20 min or more may be necessary if a mycobacterial infection is known or suspected. At least 3 h immersion in glutaraldehyde is required to kill spores. (6) Glutaraldehyde is irritant and sensitizing to the skin, eyes and respiratory tract. Measures must be taken to ensure glutaraldehyde is used in a safe manner, i.e., total containment and/or extraction of harmful vapour and the provision of suitable personal protective equipment, i.e., gloves, apron and eye protection if splashing could occur. Health surveillance of staff is recommended and should include a pre-employment enquiry regarding asthma, skin and mucosal sensitivity problems and lung function testing by spirometry. (7) Possible alternative disinfectants to glutaraldehyde include peracetic acid (0.2-0.35%), chlorine dioxide (700-1100 ppm) and superoxidized water. These are very effective, killing vegetative bacteria, including mycobacteria, and viruses in 5 min and bacterial spores in 10 min. An endorsement of compatibility with endoscopes, accessories and processing equipment is required from both the solution/device manufacturer and the endoscope manufacturer. Other important considerations are stability, cost and safety from the user and environmental standpoints. (8) Cleaning and disinfection or sterilization should be undertaken by trained staff in a dedicated area, e.g., SSD or TSSU. A suitable training programme is described. (9) If endoscopes are processed by immersion in disinfectants, harmful residues must be removed by thorough rinsing. Sterile or bacteria free water is essential for rinsing all invasive endoscopes and accessories to prevent recontamination. (10) If an automated washer disinfector is used it must be effective, non-damaging, reliable, easy to use and its performance regularly monitored. (11) If used, washer disinfectors and other processing equipment should be disinfected on a regular basis, i.e., between patients or at the start of each session. This will prevent biofilm formation and recontamination of instruments during rinsing. Disinfection should include the water treatment system, if present. (12) To comply with the Medical Devices Directive, manufacturers are obliged to provide full details on how to decontaminate the reusable devices they supply. This should include details of compatibility with heat, pressure, moisture, processing chemicals and ultrasonics. (13) The Infection Control Team should always be involved in the formulation and implementation of decontamination policies. Wherever possible, the national good practice guidelines produced by the Medical Devices Agency and/or professional societies shoul

Cross Infection↗

PubMed2006

Selective decontamination of the digestive tract: cumulating evidence, at last?

Selective decontamination of the digestive tract (SDD), an infection-control strategy designed to prevent nosocomial pneumonia in mechanically ventilated patients, has been implemented in numerous studies for more than 2 decades, but its role remains controversial. Sentinel studies in the 1960s and 1970s identified a link between colonization of the upper respiratory tract and subsequent increased risk of developing nosocomial pneumonia in critically ill patients. Studies in the 1980s found that prophylaxis with topical and systemic antibiotics to decontamination of the upper respiratory tract and gastrointestinal tract (particularly depleting gram-negative aerobic bacteria) was associated with lower rates of infections. However, impact on survival was not substantiated. However, several recent studies (including randomized trials and meta-analyses) suggest that SDD may improve survival in selected cohorts of critically ill patients in intensive care units (ICUs). Because liberal use of SDD (or any antimicrobial prophylactic strategy) may lead to escalating antimicrobial resistance, the risk of resistance varies according to local pathogens and resistance patterns. This review describes the development of the SDD concept, discusses recently published trials, and develops points for discussion and research. Additional studies are required to further define appropriate indications and limitations of this preventative strategy.

Anti-Bacterial Agents↗

PubMed1975

Decontamination procedures for skin exposed to phenolic substances.

Spraying or swabbing with a mixture of polyethylene glycol 300/industrial methylated spirits (PEG-300/IMS) (2:1 by volume) has been shown to substantially reduce mortality, systemic effects, and skin burns resulting from skin contamination by phenol, cumene hydroperoxide, or phenol/acetone cleavage product. The skin-damaging potentials of sodium hydroxide and sulfuric acid have also been investigated. PEG-300/IMS(2:1 by volume) mixture was found, in rats, to be slightly less effective than water as means of decontamination. The PEG-300/IMS mixture has been shown not to cause eye irritation, and so should not present a hazard where this mixture is used as a decontaminant spray.

Acetone↗

PubMed2004

Comparative study of different surface decontaminants on chicken quality.

(1) A comparative study on the effect of different surface decontaminants: hot water at 70 degrees C for one minute; 2% lactic acid for 30 s; 1200 p.p.m. acidified sodium chlorite (ASC) solution for 5 s and 50 p.p.m. chlorine solution for 5 min in the form of dips and sprays on the surface of dressed broilers for 0, 24 and 48 h of storage was conducted. (2) The variables studied were, total plate count (TPC), presumptive coliform count (PCC), pH and extract release volume (ERV). All treatments reduced TPC and PCC. (3) Lactic acid dip and hot water dip were the most effective for reducing TPC (1.36 and 1.28 log/cm2, respectively) with no significant difference between them. (4) ASC and hot water in dip could diminish PCC (1.37 and 1.34 log/cm2, respectively) and did not vary significantly. (5) No treatment affected muscle pH, water holding capacity (WHC), ERV, appearance, smell, tenderness and overall acceptability of treated broilers significantly. (6) Hot water treatment is the cheapest, most convenient and simplest decontamination technique for hygienic and wholesome poultry production.

Animals↗