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PubMed2005

Development of improved method for isolation of Mycobacterium avium subsp. paratuberculosis from bulk tank milk: effect of age of milk, centrifugation, and decontamination.

Mycobacterium avium subsp. paratuberculosis (MAP) is the causative agent of Johne's disease in cattle and it has been suggested that this organism may be associated with Crohn's disease in humans. Cows at the advanced stage of the disease shed this organism into both their milk and feces. The objective of this study was to develop a more efficient procedure for isolating MAP from bulk tank raw milk. Bulk tank raw milk (50 mL) samples 3 to 13 d old after collection without spiking were investigated to evaluate the effects of milk age on the efficacy of decontamination. Milk samples, 2 to 3 d old, were seeded with MAP at levels of 50 to 200 colony forming units/mL in experiments involving factorial design to evaluate 1) the effects of different decontaminating reagents and decontamination procedures on recovery of MAP, and 2) partition MAP in milk fractions after centrifugation in raw milk. Decontamination in 20 mL of 0.75% hexadecylpyridinium chloride (HPC) at room temperature (22 degrees C) for 2 to 5 h, with shaking, at intervals was found to be the most effective procedure for decontaminating milk 2 to 3 d old. Prolonged exposure to decontaminants, additional incubations in antibiotics, or at higher temperature (37 degrees C) significantly reduced recovery of live MAP. Enhanced growth of microbial contaminants was noticed in samples decontaminated overnight at room temperature compared to those decontaminated for 2 to 5 h. Decontamination of 6 d old milk samples required extra incubation in antibiotic brew. Decontamination of milk samples that are 8 d and older was not effective in removing microbial contaminants. The MAP cells preferentially partitioned into the cream fraction after centrifugation, and combining the milk cream and pellet fractions enhanced recovery of MAP. A recovery rate of 16.6% was estimated with the use of our improved protocol.

Animals↗

PubMed1995

Controlled clinical trial of selective decontamination for the treatment of severe acute pancreatitis.

OBJECTIVE: A randomized, controlled, multicenter trial was undertaken in 102 patients with objective evidence of severe acute pancreatitis to evaluate whether selective decontamination reduces mortality. SUMMARY BACKGROUND DATA: Secondary pancreatic infection is the major cause of death in patients with acute necrotizing pancreatitis. Controlled clinical trials to study the effect of selective decontamination in such patients are not available. METHODS: Between April 22, 1990 and April 19, 1993, 102 patients with severe acute pancreatitis were admitted to 16 participating hospitals. Patients were entered into the study if severe acute pancreatitis was indicated, on admission, by multiple laboratory criteria (Imrie score > or = 3) and/or computed tomography criteria (Balthazar grade D or E). Patients were randomly assigned to receive standard treatment (control group) or standard treatment plus selective decontamination (norfloxacin, colistin, amphotericin; selective decontamination group). All patients received full supportive treatment, and surveillance cultures were taken in both groups. RESULTS: Fifty patients were assigned to the selective decontamination group and 52 were assigned to the control group. There were 18 deaths in the control group (35%), compared with 11 deaths (22%) in the selective decontamination group (adjusted for Imrie score and Balthazar grade: p = 0.048). This difference was mainly caused by a reduction of late mortality (> 2 weeks) due to significant reduction of gram-negative pancreatic infection (p = 0.003). The average number of laparotomies per patient was reduced in patients treated with selective decontamination (p < 0.05). Failure of selective decontamination to prevent secondary gram-negative pancreatic infection with subsequent death was seen in only three patients (6%) and transient gram-negative pancreatic infection was seen in one (2%). In both groups of patients, all gram-negative aerobic pancreatic infection was preceded by colonization of the digestive tract by the same bacteria. CONCLUSION: Reduction of gram-negative colonization of the digestive tract, preventing subsequent pancreatic infection by means of selective decontamination, significantly reduces morbidity and mortality in patients with severe acute necrotizing pancreatitis.

Acute Disease↗

PubMed1992

Selective decontamination of the digestive tract in the intensive care unit: current status and future prospects.

OBJECTIVE: To evaluate the available data on selective decontamination of the digestive tract. This therapy aims to prevent infection in critically ill patients admitted to ICUs. Microbial carriage in the oropharynx, stomach, and gut; infection; mortality rate; and antibiotic resistance are the outcome events that are being reviewed. DATA SOURCES: Published indices, abstract booklets, and conference proceedings up to the end of 1990. STUDY SELECTION: Sixteen controlled trials of selective decontamination were identified. None of these trials was conducted as a randomized, placebo-controlled, double-blind trial. DATA EXTRACTION: Each of the three authors independently conducted a meta-analysis (thorough review) of the data from the 16 studies. DATA SYNTHESIS: Of the 16 trials, 15 show significant reduction of acquired infection among patients who received selective decontamination. Of the 14 studies that consider carriage of disease-causing microorganisms as an outcome event, 13 demonstrate a reduction in carriage of Gram-negative bacilli. Only ten studies consider mortality as an end-point, of which four demonstrate that the administration of selective decontamination is associated with decreased mortality rates in certain subgroups but not in the overall mortality rate. Of 11 studies that provide data about antibiotic resistance during selective decontamination, ten reported no increase in resistant microorganisms. Selective decontamination has been reported to be effective in controlling an outbreak of multi-resistant microorganisms. CONCLUSIONS: There is a general consensus about the efficacy of selective decontamination in diminishing microbial carriage and acquired infection rates, although conclusions about benefits related to mortality rates vary. Differences in mortality rate are found in the selective decontamination studies of patients with curable diseases, including multitrauma and cardiovascular patients. More data on resistance, collected over a longer period of time, are needed. Practical problems of blinding and the major ecological effect of selective decontamination may explain the lack of a randomized, placebo-controlled, double-blind trial.

Anti-Bacterial Agents↗

PubMed1994

Selective decontamination of the digestive tract reduces gram-negative pulmonary colonization but not systemic endotoxemia in patients undergoing elective liver transplantation.

OBJECTIVE: To examine the effect of selective antibiotic decontamination of the digestive tract in patients undergoing elective orthotopic liver transplantation. DESIGN: Prospective, randomized, concurrent allocation to either selective decontamination or standard antibiotic prophylaxis. SETTING: Operating theater and intensive care unit at a tertiary referral, university teaching hospital. PATIENTS: Fifty-nine adult patients were recruited into the study and underwent liver transplantation. INTERVENTIONS: Thirty-two patients were randomized to standard treatment (control group) and 27 patients were randomized to receive selective decontamination. After early deaths and exclusions, 31 controls and 21 decontamination patients were available for analysis. MEASUREMENTS AND MAIN RESULTS: Portal and systemic endotoxemia, colonization and infection rates, severity of illness (organ system failures, Acute Physiology and Chronic Health Evaluation II score, Therapeutic Intervention Scoring System score), antibiotic costs, and hospital survival rates were measured. Selective decontamination significantly reduced pulmonary infections and enteric, aerobic, and Gram-negative bacillary colonization without facilitating the emergence of resistant organisms, but selective decontamination had no effect on endotoxemia or the development of organ system failures. The financial costs of the selective decontamination regimen outweighed the advantages gained from an associated reduction in antibiotic usage. CONCLUSION: The failure of selective decontamination to enhance survival rates in many studies of the regimen in critically ill patients may, in part, be related to the inability of selective decontamination to abolish endotoxemia.

Adult↗

PubMed2001

Genotoxicity testing of extracts from aflatoxin-contaminated peanut meal, following chemical decontamination.

One of the most important concerns in the decontamination of aflatoxin-containing feed commodities is the safety of the products for food-producing animals and for human consumption of products derived from these animals. A new method, based on the use of florisil and C18 solid phase extraction columns, was developed for the preparation of extracts from decontaminated peanut meal, which allowed testing with in vitro genotoxicity assays without interference of the residual aflatoxin B1. Recovery of degradation products in the extracts was evaluated by the use of radiolabelled [14C]-aflatoxin B1 (AFB1) added to naturally-contaminated peanut meal (3.5 mg AFB1/kg). The meal was treated by a small-scale version of an industrial decontamination process based on ammoniation. Following decontamination, more than 90% of the label could not be extracted from the meal. AFB1 accounted for about 10% of the radiolabel present in the extractable fraction, indicating a total AFB1 reduction of more than 99%. Decontamination of the meal by a number of other small- and industrial-scale ammonia-based processes resulted in similar efficiencies. Application of the extraction procedure resulted in AFB1-rich and AFB1-poor fractions, the latter containing half of the extractable decontamination products but less than 1% of the residual AFB1. Testing in the Salmonella/microsome mutagenicity assay (TA 100, with S9-mix) of the original crude extracts and AFB1-rich fractions prepared from non-treated and decontaminated meal, showed the positive results expected from the AFB1 contents as determined by HPLC analysis. Analysis and testing of the AFB1-poor fractions showed that the various decontamination processes not only resulted in a successful degradation of AFB1 but also did not produce other potent mutagenic compounds. Slight positive results obtained with these extracts were similar for the untreated and treated meals and may be due to unknown compounds originally present in the meal. Results obtained with an unscheduled DNA synthesis (UDS) and Comet assay with rat hepatocytes supported this conclusion. Positive results obtained with the micronucleus assay, using immortalized mouse hepatocytes (GKB), did not clearly reflect the mycotoxin levels and require further examination. It is concluded that the newly developed extraction procedure yields highly reproducible fractions and hence is very suitable for examining the possible formation of less potent degradation products of aflatoxins in short-term genotoxicity tests.

Aflatoxins↗

PubMed1989

Decontamination of chemical protective clothing.

This study explored decontamination procedures for removing some organic solvents from protective clothing. The permeation experiments were performed on new and decontaminated specimens in seven polymer/chemical pairs. The decontamination methods investigated were thermal decontamination and air drying at room temperatures followed by detergent washing. Breakthrough time and steady-state permeation rate were determined by two different methods for new and decontaminated materials. The results showed that unless the contamination is limited to the outside surface of an elastomer (a material found in most barrier fabrics used in chemical protective clothing) or the chemical has a very large diffusion coefficient in the material, aeration and washing with detergent may not be an effective decontamination procedure for the type of solvent studied. On the other hand, thermal decontamination was shown to be effective in removing the contaminant from the matrix of the elastomers, and the decontaminated materials had permeation parameters similar to the new materials.

Decontamination↗

PubMed1998

Personal decontamination after exposure to stimulated liquid phase contaminants: functional assessment of a new unit.

OBJECTIVE: To evaluate the efficacy of a decontamination station following exposure of volunteers to liquids with physical characteristics comparable to sarin and mustard gas. DESIGN: Twenty-four volunteers participated in the experiment which was performed with all staff wearing personal protective equipment including respiratory protection. The clothes, skin, and hair of the volunteers were contaminated with the simulated liquid phase contaminants, ethyl lactate and methyl salicylate. Sulphur hexafluoride gas was used to confirm the ventilation efficacy. Decontamination followed guidelines using a two-stage procedure. In the first chamber, all volunteers received a 3-minute shower with water at 30 degrees C, and their clothes but not their respiratory masks were removed. In the second, they were twice washed thoroughly with soap and water. After decontamination, the volunteers entered a third chamber for first aid measures. RESULTS: The air concentration of sulphur hexafluoride was reduced by 1:10,000 between the first and the third chambers. Ethyl lactate and methyl salicylate were measured in low concentrations in the third chamber. The capacity was 16 volunteers per hour with two-thirds on stretchers. After self-decontamination of the staff, the concentration of ethyl lactate increased significantly in the third chamber, consistent with residual ethyl lactate adsorbed by their underwear. This observation revealed a deficiency in the guidelines for self-decontamination. CONCLUSION: The capacity of the decontamination unit was found to be 16 volunteers per hour. The ventilation system and guidelines of the decontamination unit were demonstrated to be effective under the conditions examined. The self-decontamination of the staff was not optimal.

Accidents, Occupational↗

PubMed2004

Cyclodextrines as functional agents for decontamination of the skin contaminated by nerve agents.

Three decontamination solutions of beta-cyclodextrines were prepared. Their abilities to decontamine rat skin contamined with nerve agent soman were tested. Decontamination efficacy of the tested cyclodextrine solutions was compared with the same decontamination means but without the cyclodextrines. The efficacy of tested decontaminants was evaluated by the assessment of the ID50 values. Two decontamination prescriptions with cyclodextrines (tetraborate buffer and tetraborate buffer with acetone) do not show significantly better decontamination efficacies in comparison with prescriptions without cyclodextrines. Only in case of aqueous solution of 2-aminoethanol the addition of beta-cyclodextrine resulted in significant increase (32%) in decontamination efficacy.

Animals↗

PubMed1992

Emergency department external decontamination for hazardous chemical exposure.

Although external decontamination is an integral aspect of the emergency management of hazardous chemicals exposure, no standard protocol or report of human experience is available. We performed a retrospective review of all patients decontaminated in our emergency department over a 6-y period for hazardous chemicals exposure. Patients were treated by a universal substances protocol in a specially designed decontamination area. Ocular irrigation utilizing 1500 ml of normal saline po was employed in 27 patients. Oral mucosal irrigation utilizing 1500 ml water was employed in 2 patients. All 72 patients received skin and hair decontamination. Skin was washed 3 times with detergent and cornmeal mixture, and water irrigation or shower for 3 min. Hair was shampooed 3 times with mild soap for 3 min. A subset of patients (n = 31) received pre-decontamination and post-decontamination skin swabbing. Swabs were analyzed by a certified analytical chemistry laboratory utilizing gas chromatography/mass spectrometry. Positive pre-decontamination swabs were seen for pesticides and PCBs. All post-decontamination swab analyses were negative, indicating that the method utilized was effective.

Clinical Protocols↗

PubMed1984

Evaluation of diethyl malonate as a simulant for 1,2,2-trimethylpropyl methylphosphonofluoridate (soman) in shower decontamination of the skin.

A shower decontamination bench model has been used to assess quantitatively the importance of several variables (water pressure and temperature, surfactant concentration in the decontamination fluid, nozzle type, and shower time) on decontamination of nontoxic chemical warfare-agent simulants diethyl malonate and thickened diethyl malonate from pig skin in vitro. Diethyl malonate was validated as a simulant for 1,2,2-trimethylpropyl methylphosphonofluoridate (soman) by comparison of the skin penetration and decontamination of radiolabeled diethyl malonate to the radiolabeled phosphonofluoridate in shower decontamination trials of pig skin in vitro. Percutaneous penetration of diethyl malonate was significantly greater than that of the phosphonofluoridate during the 15-min period after application. However, both were less than 0.1% of the applied dose. Showering or thickener had no significant effect on the percutaneous penetration of diethyl malonate or the phosphonofluoridate. Most of the phosphonofluoridate removed by showering or scrubbing the skin was inactivated. The quantity of intact 1,2,2-trimethylpropyl methylphosphonofluoridate that penetrated through the skin was below the detection limit of the enzymatic analysis. There was no statistically significant difference between the phosphonofluoridate and diethyl malonate in efficacy of shower decontamination. The presence of thickener did not have a significant effect on decontamination efficacy.

Animals↗

PubMed1976

Bacterial decontamination and antileukemic therapy of AKR mice.

Four nonabsorbable antibiotics (streptomycin, neomycin, bacitracin, and amphotericin B) and a germicidal dip solution (Zephiran chloride/water) were used to eliminate all the detectable bacteria from conventional AKR mice. Control mice were not decontaminated and were used as such. When antibiotic-decontaminated and control mice developed clinical manifestations of spontaneous lymphatic leukemia, each was treated for the disease with an antitumor drug (cyclophosphamide [CP]) at weekly intervals. With the decontamination procedure, mice of each of the two groups became bacteria-free after 16 weeks of continuous oral administration of the antibiotics and two separate germicidal dippings. All decontaminated mice remained free of bacteria throughout the experiment. The bacterial flora of the control mice remained unaltered. With CP therapy, the mean survival time of the female decontaminated mice was 65 days, whereas that of male mice was 218 days. The average survival time of the CP-treated control leukemic mice was 51 days. Untreated decontaminated or control mice usually died of leukemia within 7 days after the onset of symptoms of leukemia. Although CP therapy was not curative, it did prolong the life expectancy of the decontaminated mice significantly.

Amphotericin B↗

PubMedDate not supplied

Gut decontamination prevents bronchoscopy-induced bacterial translocation. An experimental study in rats.

BACKGROUND: Selective gut decontamination is suggested to suppress the gram-negative bacterial overgrowth in the intestine and consequently to reduce bacterial translocation. OBJECTIVE: The purpose of the present study is to examine the effects of gut decontamination on bronchoscopy-induced bacterial translocation, and intestinal mucosal injury. METHODS: Forty-five rats were assigned into three groups. Group 1 served as control (n=15). Group 2 (n=15) and group 3 (n=15) underwent bronchoscopy. In addition, group 3 underwent gut decontamination. Gut decontamination was performed two days prior to bronchoscopy with erythromycin and neomycin. Twenty-four hours after bronchoscopy, blood, mesenteric lymph nodes, spleen, liver, ileum and cecum were harvested for bacterial determination. The ileum was also assessed and graded histologically according to Chiu's injury scale. RESULTS: In the bronchoscopy group, bacterial translocation to the mesenteric lymph nodes was found in 7/15 rats (46.7%), compared to none of the controls (p=0.01). These rats also showed significant evidence of intestinal injury, compared to the controls (mean ranks, 32.7 or 8.5, p<0.0001). On the other hand, gut decontamination prevented bacterial translocation, compared to the bronchoscopy group (p=0.011). However, gut decontamination provided no beneficial effect on the intestinal mucosal injury, compared to the bronchoscopy group. These animals also revealed significant intestinal injury, compared to the controls (mean ranks, 27.8 or 8.5, p<0.0001). CONCLUSIONS: Our data shows that despite no amelioration in bronchoscopy-induced intestinal mucosal injury, gut decontamination has a preventive role for bronchoscopy-induced bacterial translocation.

Animals↗

PubMed1993

[Selective gut decontamination in ventilated intensive therapy patients].

Treatment of long-term artificially ventilated patients is often complicated by nosocomial infections. The infection that occurs with the highest frequency during intensive care treatment is pneumonia (22-63%). Ninety per cent of nosocomial infections of intensive care patients are endogenous infections caused by mainly gram-negative aerobic microorganisms that have colonized in the gastrointestinal tract. Selective decontamination of the intestine provides a method that prevents nosocomial infections. In a prospective study 13 patients whose oropharynx and gastrointestinal tract had been decontaminated (SDD) were compared to 17 patients in a control group. In a third group twelve patients were decontaminated in the gastrointestinal tract (SGD) only, and in a fourth group 16 patients were decontaminated in the oropharynx (SMD) only. Trachea, oropharynx and faeces of the patients belonging to the control group (KG) were colonized to almost 100% with gram-negative bacteria. Only 10% of the patients of the SDD and SMD groups showed gram-negative bacteria located in the trachea and oropharynx after one week of decontamination. No gram-negative aerobic bacteria were present after seven days in the faeces of the patients of the SDD and SGD groups. There was no difference with regard to the trachea and oropharynx between the control group and the SGD group. The gram-negative aerobic intestinal flora was not affected by the selective mouth decontamination. The average rate of pneumonia occurrence within the 15-day observation period was 28.2% for the control group, 14% for the SGD group, and 9.6% for the SDD group, and 4.1% for the SMD group. Decontamination of the oropharynx of patients is essential in order to successfully prevent pneumonia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMedDate not supplied

[Decontamination with clay or alcoholate of pigs percutaneously poisoned with VX and soman].

The efficacy of clay or alcoholate as decontaminants in pigs percutaneously poisoned with 6 LD50 of O-ethyl S-2-diisopropylaminoethyl methylphosphonothioate (VX) and 3 LD50 of 1,2,2-trimethylpropyl methylphosphonofluoridate (soman) nerve gases was tested. It was assessed by the time of onset of the first signs of poisoning and death, as well as by the activity of blood cholinesterase (ChE). No toxic signs or fatalities were observed in decontaminated pigs, regardless of the decontaminant used. In VX poisoning up to 240 min. both decontaminants kept ChE values at normal level. Twenty four hours later, ChE activity in pigs decontaminated with clay was 71%, significantly higher than in pigs decontaminated with alcoholate (49%). In soman poisoning the activity in control group was maintained at almost normal level up to 60 min, followed by rapid fall to 58%. Further readings were impossible due to the death of all animals. No significant difference between decontaminants could be noticed throughout the observation of 24 hr. The values were kept between 80 and 100%, with the trend of rising after 120 min.

Aluminum Silicates↗

PubMed2006

Comparative evaluation of two decontamination methods for the isolation of Mycobacterium avium subspecies paratuberculosis from faecal slurry and sewage.

Faecal slurry of animal origin from sale yards and raw sewage from a sewage treatment plant were sampled for the radiometric culture over 5 months at approximately weekly intervals. Before the radiometric culture, samples were decontaminated using the double incubation method. One set of triplicate samples of slurry and sewage was decontaminated at 37 degrees C and the other set was decontaminated at 42 degrees C. M. a. paratuberculosis or its DNA was detected in seven of 45 cultures (15.6%) of slurry decontaminated at 37 degrees C and in 14 of 39 cultures (35.9%) of slurry decontaminated at 42 degrees C. The contamination rates in cultures of slurry processed at 37 degrees C and 42 degrees C were 82.2% and 69.2%, respectively. M. a. paratuberculosis DNA was also detected in one of 45 cultures (2.2%) of sewage decontaminated at 42 degrees C. The contamination rates in samples of sewage processed at 37 degrees C and 42 degrees C were 84.4% and 4.4%, respectively. Results of this study warrant further investigations to evaluate the suitability of a decontamination method at 42 degrees C for the isolation of M. a. paratuberculosis from faeces, tissues and milk.

Animals↗

PubMed1998

Irradiation as a method for decontaminating food. A review.

Despite substantial efforts in avoidance of contamination, an upward trend in the number of outbreaks of foodborne illnesses caused by nonsporeforming pathogenic bacteria are reported in many countries. Good hygienic practices can reduce the level of contamination but the most important pathogens cannot presently be eliminated from most farms nor is it possible to eliminate them by primary processing, particularly from those foods which are sold raw. Several decontamination methods exist but the most versatile treatment among them is the processing with ionizing radiation. Decontamination of food by ionizing radiation is a safe, efficient, environmentally clean and energy efficient process. Irradiation is particularly valuable as an endproduct decontamination procedure. Radiation treatment at doses of 2-7 kGy--depending on condition of irradiation and the food--can effectively eliminate potentially pathogenic nonsporeforming bacteria including both long-time recognized pathogens such as Salmonella and Staphylococcus aureus as well as emerging or "new" pathogens such as Campylobacter, Listeria monocytogenes or Escherichia coli O157:H7 from suspected food products without affecting sensory, nutritional and technical qualities. Candidates of radiation decontamination are mainly poultry and red meat, egg products, and fishery products. It is a unique feature of radiation decontamination that it can also be performed when the food is in a frozen state. With today's demand for high-quality convenience foods, irradiation in combination with other processes holds a promise for enhancing the safety of many minimally processed foods. Radiation decontamination of dry ingredients, herbs and enzyme preparations with doses of 3-10 kGy proved to be a viable alternative to fumigation with microbicidal gases. Radiation treatment at doses of 0.15-0.7 kGy under specific conditions appears to be feasible also for control of many foodborne parasites, thereby making infested foods safe for human consumption. Microorganisms surviving low- and medium-dose radiation treatment are more sensitive to environmental stresses or subsequent food processing treatments than the microflora of unirradiated products. Radiation treatment is an emerging technology in an increasing number of countries and more-and-more clearances on radiation decontaminated foods are issued or expected to be granted in the near future.

Animals↗

PubMed1990

Pilot trial of selective decontamination for prevention of bacterial infection in an intensive care unit.

Selective decontamination of the oropharynx and gastrointestinal tract with nonabsorbable antimicrobials and sucralfate, a stress ulcer prophylactic that maintains the normal gastric acid bacterial barrier, were compared for prevention of pneumonia in a cardiac surgery intensive care unit. Over 8 months, 51 patients received selective decontamination and 56 received sucralfate. The selective decontamination regimen included polymyxin, gentamicin, and nystatin given as an oral paste and as a solution; patients also received standard antacid or histamine2 blocker stress ulcer prophylaxis. Patients in the selective decontamination group had significantly less colonization of the oropharynx and stomach by gram-negative bacilli (12% vs. 55%, P less than .001), significantly fewer infections due to gram-negative bacilli (6% vs. 20%, P = .02), and fewer infections overall (12% vs. 27%, P = .04). There was one episode of pneumonia in the selective decontamination group and five in the sucralfate group. Mortality and length of stay did not differ between the groups, but those receiving selective decontamination had less than one-third as many days of systemic antibiotic therapy with no increase in colonization or infection with resistant gram-negative bacilli. Thus, selective decontamination appeared to reduce both extrapulmonary and pulmonary infections.

Anti-Bacterial Agents↗

PubMed1998

Antimicrobial effect of ciprofloxacin, povidone-iodine, and gentamicin in the decontamination of human donor globes.

PURPOSE: Clinical research addressing the issue of donor globe decontamination is yet to establish convincing data for the optimal choice of an antimicrobial agent. METHODS: In a donor-globe decontamination study, the antimicrobial effectiveness of a fluoroquinolone antibiotic (ciprofloxacin, 0.3%) was evaluated for the first time and compared with povidone-iodine (P-I, 5%) and gentamicin (0.3%). RESULTS: Ciprofloxacin and gentamicin were found to be less effective than P-I (p < 0.05) in converting culture-positive donor globes to culture negative. In eliminating coagulase-negative staphylococci that predominated the bacterial spectrum, again P-I scored better than ciprofloxacin (p = 0.003) and gentamicin (p = 0.006). Overall, P-I performed better than the other two in the 3-min decontamination procedure. Decontamination was carried out with the same agent for 15 min to assess the effect of duration of decontamination on the antimicrobial activity of P-I. With time, there was no significant increase in the antimicrobial efficacy of the agent except for Corynebacterium species. CONCLUSION: P-I continues to be the preferred agent for decontaminating donor globes. Whereas a contact of 3-min duration between P-I and donor globe remains satisfactory in decontamination procedures, corneal tolerance of this procedure needs investigation.

Anti-Bacterial Agents↗