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Controlling bacterial contamination of an enteral formula through the use of a unique closed system: contamination, enteral formulas, closed system.

Contamination of enteral diets may play an essential role in formula tolerance and safety for patients. Contaminated enteral formula commonly support microbiological growth. Commercially sterile liquid formulas received from the manufacturer are required by the Food & Drug Administration (FDA) to be shelf-stable and free from enteric pathogens. This study examined the use of large volume, closed system containers in a typical nursing home. Large volume (1500 mL) containers with unique pierceable caps and piercing spikes were studied to determine their ability to reduce the incidence of microbiological contamination due to their design and ability to decrease handling requirements. This study took place in a room of a typical nursing home. In this clinical setting, 211 containers and administration spike sets were evaluated following a 36-h hangtime. Contamination was virtually nondetectable. Nursing staff in a clinical facility can effectively utilize a large volume, prefilled, ready-to-use feeding system to achieve delivery of noncontaminated product for up to 36 h hangtime.

Colony Count, Microbial↗

Organochlorine residues and elemental contaminants in U.S. freshwater fish, 1976-1986: National Contaminant Biomonitoring Program.

As part of the National Contaminant Biomonitoring Program (NCBP, formerly a component of the National Pesticide Monitoring Program), the U.S. Fish and Wildlife Service periodically determined concentrations of organochlorine chemical residues and elemental contaminants in freshwater fish collected from a nationwide network of stations. In late 1986 and early 1987, the last time the network was sampled, a total of 319 composite fish samples were collected from 97 NCBP stations. The samples were analyzed for residues of organochlorine chemicals and the elements As, Cd, Cu, Hg, Pb, Se, and Zn. The mean concentration of total DDT and its homologs (p,p'-constituents) declined from 1984 to 1986, thus continuing a trend that began in 1970. The most persistent DDT homolog (p,p'-DDE) was detected at all stations sampled in 1986, and averaged 74% of total DDT residues, up from 70% in 1974-1979 but essentially unchanged from 1984. Collectively, these findings indicated a low rate of influx and continued weathering of DDT in the environment; nevertheless, DDT concentrations in fish from some stations in the South remained high enough to constitute a threat to piscivorous wildlife. Residues of polychlorinated biphenyls (PCBs) also remained widespread, but a significant downward trend in total PCB concentrations and incidence was evident, and PCB mixtures containing early eluting components were present at fewer stations than in the past. PCB concentrations were generally highest in fish from the industrialized rivers of the Northeast and Midwest and from the Great Lakes. Concentrations of toxaphene also declined, as did its incidence, from 88% of the stations sampled in 1980-1981 to 64% in 1986; however, analytical problems with the 1986 samples may have contributed to the latter. The risks represented by PCBs and toxaphene could not be evaluated on the basis of our data. Among cyclodiene insecticides, dieldrin and chlordane-related residues were the most widespread. Mean concentrations of dieldrin declined through 1986, but remained consistently highest in the Great Lakes. For chlordane-related residues, mean concentrations were lower that reported previously, and trans-nonachlor continued to replace cis-chlordane as the most abundant component. Collectively, these findings suggested a lower rate of chlordane influx to the aquatic environment; however, a point source of cyclodiene insecticides to the Mississippi R. near Memphis, TN, remained evident. Residues of mirex, PCA, BHC isomers, endrin, heptachlor, and HCB were either found at relatively few (< 25%) of the stations sampled in 1986 or were characterized by relatively low concentrations. Concentrations of the herbicide Dacthal (DCPA) were also low, but incidence increased from 46% of the stations sampled in 1984 to 61% in 1986. In general, organochlorine chemical concentrations were lower in 1986 than at any time reported previously. For elemental contaminants, the geometric mean, maximum, and 85th percentile concentrations (respectively, all in microgram/g wet weight) in 1986 samples were as follows: As, 0.083, 1.53, 0.24; Cd, 0.011, 0.32, 0.04; Cu, 0.794, 11.0, 1.7; Hg, 0.087, 0.44, 0.18; Pb, 0.058, 1.90, 0.21; Se, 0.417, 3.41, 0.66; and Zn, 21.191, 94.5, 31.7. Mean concentrations of Cu increased and concentrations of As decreased relative to the 1984 collection, but these changes may reflect subtle differences in the species composition of the 1986 collection relative to other collections; concentrations of both elements differ greatly among fishes. There were no other statistically significant changes from 1984 to 1986; however, mean concentrations of As, Cd, Pb, and Zn declined from 1976, when elemental contaminants in fish were first measured in the NCBP, and 1986. In contrast, mean concentrations of Hg and Se did not change appreciably. Moreover, and in contrast to the other elements measured in 1986, concentrations of Hg and Se were high enough to constitute a threat to pisc

Animals↗

Kinetics of the alkaline hydrolysis of important nitroaromatic co-contaminants of 2,4,6-trinitrotoluene in highly contaminated soils.

Until this day, large amounts of TNT and related nitroaromatic compounds are found in soils. To obtain basic data for alkaline hydrolysis of these compounds as a novel remediation technology for contaminated soils, we investigated two soils (HTNT2, ELBP2) from two former ammunition plants in Germany. Hydrolysis was performed at pH 11 and pH 12 by addition of Ca(OH)2. During treatment at pH 12 the TNT content dropped to almost zero, and the content of the aminodinitrotoluenes (2A-4,6DNT, 4A-2,6DNT) and the 2,4-dinitrotoluene (2,4-DNT) decreased by about 75% (only HTNT2) and 63%, respectively. The experimental data were described using a pseudo-first-order kinetic. Furthermore, an increase of 2,6-DNT and trinitrobenzene (TNB) as well as in one case also of TNT was initially noted in addition to hydrolysis, leading temporarily to an increase of their total amounts of up to 147%, 986%, and 122%, respectively. The results demonstrate that alkaline hydrolysis is difficult when nitroaromatics except TNT represent the major contaminants. However, regarding 2,6-DNT and TNB higher reduction rates than calculated were actually achieved by alkaline hydrolysis. In the case that TNT is the only contaminant or if it is accompanied by certain lower concentrated nitroaromatics alkaline hydrolysis is a valuable remediation technology, especially for soils that are highly contaminated.

Environmental Monitoring↗

Halogenated organic contaminants in sediments of the Havel and Spree rivers (Germany). Part 5 of organic compounds as contaminants of the Elbe river and its tributaries.

To give a detailed and comprehensive view on the state of pollution of the Havel and Spree rivers nontarget screening as well as quantitative (target) analyses were applied to anoxic sedimentsamples. Based on nontarget GC/MS analysis a significant contribution to the anthropogenic contamination could be attributed to halogenated compounds. Three groups of contaminants corresponding either to diffuse or local contamination could be distinguished. Several commonly observable compounds including pentachloroanisol, polychlorinated biphenyles, 2,4-dichlorobenzoic acid, and chlorinated benzenes were detected with a distribution reflecting the contribution of nonpoint source emissions. A second group of chlorinated as well as brominated compounds was attributed to a strong point source emission at the Teltow Canal. At the sampling locations influenced by this point source the amount of mono- and dibrominated naphthalenes, chlorinated naphthalenes, and hexachlorocyclohexanes as well as DDT- and methoxychlor-related compounds increased significantly as compared to the background concentrations. A third group of halogen compounds emitted at this site consisted of the pesticides bromopropylate, methoxychlor, and chlorfensone as well as specific brominated aromatics including 2,4,6-tribromoaniline, 4,4'-dibromobenzophenone, and brominated benzenes. In addition, tetrabromochlorotoluenes, tribromodichlorotoluenes, dibromotrichlorotoluenes, and 2,2-bis(4-bromophenyl)acetic acid isopropyl ester were identified and are reported for the first time as environmental contaminants. The amounts of brominated compounds detected in Teltow Canal sediments occurred at a similar concentration level as their chlorinated analogues. Therefore, investigations on the occurrence of such a broad spectrum of brominated compounds as established in this work are presumably required more frequently to assess the environmental impact of this type of emissions.

DDT↗

Drinking water contaminants (arsenic, cadmium, lead, benzene, and trichloroethylene). 1. Interaction of contaminants with nutritional status on general performance and immune function in broiler chickens.

The objective of this study was to examine possible interactions between drinking water contaminants and suboptimal nutritional status for performance and immune function in male broiler chickens. Experimental drinking water contained a mixture of arsenic, benzene, cadmium, lead, and trichloroethylene (TCE) at low concentrations (0.80, 1.3, 5.0, 6.7, and 0.65 ppm) and high concentrations (8.6, 13, 50, 67, and 6.5 ppm). These chemicals were selected because they are among the most common contaminants found in ground water near hazardous waste sites. The experimental diets included feed containing 50% added vitamins and minerals (V&M) and feed without added V&M. Increasing levels of drinking water contaminants and decreasing levels of V&M in diet resulted in significantly (P < or = 0.05) decreased water and feed intake, decreased weight gain, and suppression of natural, humoral, and cell-mediated immune response. In a paired-water study, feed consumption, body weight, and immune function were decreased in chickens provided low and high concentrations of the chemical mixture in drinking water compared with chickens given control drinking water equal to the volumes consumed by the chickens given the low and high concentration of mixture, respectively. A deficiency of dietary V&M caused increased sensitivity to adverse effects of drinking water contaminants.

Animals↗

Quantification of campylobacter species cross-contamination during handling of contaminated fresh chicken parts in kitchens.

Numerous outbreak investigations and case-control studies for campylobacteriosis have provided evidence that handling Campylobacter-contaminated chicken products is a risk factor for infection and illness. There is currently extremely limited quantitative data on the levels of Campylobacter cross-contamination in the kitchen, hindering risk assessments for the pathogen commodity combination of Campylobacter and chicken meat. An exposure assessment needs to quantify the transfer of the bacteria from chicken to hands and the kitchen environment and from there onto ready-to-eat foods. We simulated some typical situations in kitchens and quantified the Campylobacter transfer from naturally contaminated chicken parts most commonly used in Germany. One scenario simulated the seasoning of five chicken legs and the reuse of the same plate for cooked meat. In another, five chicken breast filets were cut into small slices on a wooden board where, without intermediate cleaning, a cucumber was sliced. We also investigated the transfer of the pathogen from chicken via hands to a bread roll. The numbers of Campylobacter present on the surfaces of the chicken parts, hands, utensils, and ready-to-eat foods were detected by using Preston enrichment and colony counting after surface plating on Karmali agar. The mean transfer rates from legs and filets to hands were 2.9 and 3.8%. The transfer from legs to the plate (0.3%) was significantly smaller (P < 0.01) than the percentage transferred from filets to the cutting board and knife (1.1%). Average transfer rates from hands or kitchen utensils to ready-to-eat foods ranged from 2.9 to 27.5%.

Animals↗

Accumulation of organic and inorganic contaminants in shellfish collected in estuarine waters near Pensacola, Florida: contamination profiles and risks to human consumers.

We conducted a screening level assessment of contaminants in blue crabs (Callinectes sapidus) and oysters (Crassostrea virginica) from bays and bayous in the Pensacola, FL area. Tissue samples were analyzed for 17 dioxins/furans, 12 dioxin-like PCB (DL-PCBs) congeners, mercury, and various metals. Contaminant levels were compared to screening values (SV) calculated using U.S. EPA recommendations for establishing consumption advisories. All sampling locations exceeded the SV (0.098pgg(-1)) for dioxins/furans/DL-PCBs, based on a Florida-specific consumption rate (46gday(-1)). Arsenic (inorganic), mercury, cadmium, and zinc levels exceeded SVs in samples from select locations, and with the exception of mercury, these locations were generally downstream of known contaminated areas. We also assessed potential human health risks from consumption of these species. Risks to human health were greatest from consumption of crab hepatopancreas, suggesting that consumption of hepatopancreas, whether directly or indirectly, from crabs collected anywhere in the Pensacola Bay region should be avoided.

Animals↗

Use of genomic probes to detect hepatitis A virus and enterovirus RNAs in wild shellfish and relationship of viral contamination to bacterial contamination.

Genomic probes were used to investigate hepatitis A virus (HAV) and enterovirus RNAs in two types of shellfish from natural beds (Atlantic coast, France). After elution concentration, nucleic acid extracted by proteinase K and purified by phenol-chloroform and ethanol precipitation was assayed by dot blot hybridization. The probes used were a specific HAV probe corresponding to the 3' end (3D polymerase coding region) and an enterovirus probe corresponding to the 5' noncoding region. The method was first tested under experimental conditions by using virus-spiked shellfish before being applied under field conditions. Our results show that shellfish were highly contaminated: enterovirus and HAV RNAs were found in 63 and 67%, respectively, of samples examined with the riboprobes. On the same site, viral (HAV and enterovirus) RNAs were found in a larger fraction of cockles than mussels. Statistical tests of dependence showed no relationship between viral contamination and bacterial contamination (evaluated by fecal coliform counts).

Animals↗

Nationwide epidemic of septicemia caused by contaminated intravenous products: mechanisms of intrinsic contamination.

Between 1 July 1970 and April 1971, in many hospitals in this country, there were outbreaks of nosocomial septicemia caused by Enterobacter cloacae of E. agglomerans (formerly Erwinia, herbicola-lathyri). All of these hospitals used infusion products manufactured by one company, Abbott Laboratories, and all affected patients had onset of septicemia while receiving the company's infusion products. Septicemia was epidemiologically and microbiologically traced to intrinsic contamination of the company's screw-cap closure for infusion bottles which was sealed with a newly introduced elastomer liner. Epidemic organisms were isolated from these closures. Investigations both in the laboratory and in the manufacturing plant into the mechanism of contamination of these products revealed the following. (i) Epidemic strains were present in numerous areas throughout the manufacturing plants. (ii) Viable microorganisms gained access to the interior of screw-cap closures after the autoclave step of production. (iii) Cooling closures actively drew moisture through the thread interstices into the inner-most depths of the closure. (iv) Transfer of contaminants from closures to fluid was easily effected by simple manipulations duplicating normal in-hospital use. (v) The red-rubber liner used in the company's screw-cap closures before the introduction of elastomer contained a broad-spectrum antimicrobial inhibitor. The findings from this epidemic and the associated studies show that the screw-cap closure as it is now designed cannot be considered secure for products that must remain sterile.

Cross Infection↗

In vitro contamination of "piggyback/heparin lock" assemblies: prevention of contamination with a closed, positive locking device (Click-Lock).

Direct contact and airborne transmission are established modes of microbial contamination of standard intravenous (iv) assemblies such as piggyback and heparin lock. In this study, 60% of the standard iv assemblies inoculated with Staphylococcus aureus (S. aureus) at the barrel of their exposed needle grew these organisms when cultured in a Soy Casein Digest Broth (SCDB). Also, 40 closed, positive locking iv assemblies (Click-Lock) were inoculated at possible contamination sites, and none of these assemblies grew S. aureus in a SCDB. These in vitro studies suggest that a closed, positive locking iv assembly such as the Click-Lock device may substantially reduce, and potentially prevent contamination of iv systems.

Culture Media↗

[Contamination of flexible fiberoptic bronchoscopes with Mycobacterium chelonae linked to an automated endoscope disinfection machine--on the relationship between the presence of the organism in the intestinal tract and contamination of disinfection machine, and a case of gallbladder and bile duct infection with M. chelonae].

In 1993, thirteen strains (8.7%) of M. chelonae were isolated from bronchoalveolar lavage fluid (BALF) obtained by bronchoscopy of 150 patients in Tachikawa-sogo (T) hospital, where the same automated disinfection machine was commonly used for cleaning, sterilization and disinfection of fiberbronchoscope and fibercolonoscope except 3 bronchoscopes disinfected by gas sterilization. Since January 1994, manual cleaning and sterilization has been applied for bronchoscope, and thereafter no strain of M. chelonae was isolated from BALF of 55 patients in the T hospital. While only one strain (3%) of M. chelonae was isolated from BALF of 33 patients in Ota (O) hospital, but many strains of M. chelonae were isolated from intestinal fluid obtained by fibercolonoscopy of the patients. Manual method of cleaning and disinfection was performed for both bronchoscopes and colonoscopes in the O hospital from the beginning. Based on these results, it was suggested that M. chelonae are commonly present in the colon (intestine) of normal persons. Thus colonoendscope may be often contaminated with the organism and subsequently the automated disinfecting machine may also be contaminated with the organism which is resist and against usual disinfection procedure, and resulted in bronchoscope contamination. If the presence of M. chelonae in intestinal tract is not rare, bile duct may be naturally infected with the organism. A case of cholecystitis and cholangitis caused by M. chelonae, which has not been reported previously, was found in the T hospital.

Aged↗

Sediment core versus grab samples: evaluation of contamination and toxicity at a DDT-contaminated site.

Four sites from a stream system near Huntsville, Alabama, contaminated with DDT and its metabolites, were sampled using a coring device. Grab samples were also collected at these and five other sites. Analytical and toxicological evaluations were made on both sets of samples. Core samples provided vertical delineation of toxicity and contamination in sediments, and documented periods of sedimentation with clean material, which appears to be isolating the contaminated sediments from benthic communities. Grab samples yielded less information about the sites. Relationships between DDT concentration and sediment toxicity to Chironomus tentans were similar regardless of the sampling method. Substantial increases in toxicity occurred in most samples when concentrations exceeded 3000 micrograms of DDT residue/g organic carbon.

Alabama↗

Enhancing pyrene mineralization in contaminated soil by the addition of humic acids or composted contaminated soil.

The addition of composted PAH-contaminated soil to PAH-contaminated soil spiked with 14C-labeled pyrene resulted in rapid mineralization of pyrene (more than 57% after 21 days compared with 3.4% in un-amended soil). The addition of the humic acid fraction of the composted soil also increased the mineralization potential of the soil significantly, but to a lesser extent (37.5% mineralization after 106 days compared with 20.6% in unamended soil). Increasing the humic acid concentration increased mineralization up to a maximum of more than three times the unamended rate, after which the rate of pyrene mineralization decreased, possibly due to inhibitory pH or concentrations of salts. The amendment of PAH-contaminated soil with materials containing humic acids or humic acid extracts is suggested as a method of bioremediation.

Bacteria↗

Effect of arsenic contamination on microbial biomass and its activities in arsenic contaminated soils of Gangetic West Bengal, India.

A study was conducted to see the effect of arsenic contamination on soil quality indicators, viz., microbial biomass, soil respiration, fluorescein diacetate and dehydrogenase (DHG) activity in arsenic contaminated soils of West Bengal. All the parameters were significantly and negatively correlated with all the form of arsenic (bioavailable and total) but the microbial metabolic quotient was significantly and positively correlated with all forms of arsenic, indicating arsenic induced stress to the soil microbial community. This may be due to part of the microbial biomass, which is located in the inner parts of the micro-aggregates of soil, which is affected by arsenic accumulates present in soil particles. Linear regression analysis revealed that the bioavailable arsenic exerted greater inhibitory effect on the soil microbial population than the total arsenic content of soils. Water-soluble arsenic showed more inhibitory effect than NaHCO(3) extractable form, in their association with biological properties of the contaminated soils. Water-soluble form of arsenic was much more toxic than insoluble forms. This signified that with increase in bioavailability, the arsenic exerted more inhibitory effect on these parameters. It is thus suggested that the microbial biomass, fluorescein diacetate and dehydrogenase activity alone and expressed on a soil organic matter basis along with the soil respiration parameters can be helpful in assessing the effects of arsenic on the size and activity of microbial biomass in soils.

Arsenic↗

The use of vegetation to remediate soil freshly contaminated by recalcitrant contaminants.

The use of vegetation to remediate soil contaminated by recalcitrant hydrocarbons was tested under field conditions. Specifically, an evaluation was made of the effectiveness of deep rooting grasses, Johnsongrass and Canadian wild rye in the dissipation of TNT and PBB's in the soils freshly contaminated to an initial concentration of 10.17+/-1.35 for TNT and 9.87+/-1.23 mg/kg for PBB. The experiment used 72 (1.5m long and 0.1m diameter) column lysimeters with four treatments: Johnsongrass; wild rye grass; a rotation of Johnsongrass and wild rye grass; and unplanted fallow conditions. In the laboratory, immunoassay test procedures determined the TNT and PBB concentrations in the soil, leachate, herbage and root samples. The root characteristics such as total root length, rooting density, and root surface area were quantified to a depth of 1.5m. Changes in microbial biomass were assessed for both rhizosphere soil and the bulk soil during the 2-year study. The largest and most rapid loss in soil chemical concentration was for TNT, which decreased to less than 250 microg/kg, the detection limit, by 93 days after germination. The PBB was at or near the detection limit of 500 microg/kg by 185 days after germination. There was no perceptible difference in contaminant concentration in the soil between the vegetation treatments and/or with depth.

Biodegradation, Environmental↗

Organochlorine contaminants in eggs: the influence of contaminated nest material.

Snake eggs were placed in a synthetic nest contaminated with known concentrations of six organochlorines (OCs) to evaluate whether OCs from contaminated nest material accumulate in eggs. It was hypothesized that contaminated nest material may have contributed to OC burdens in eggs observed previously. The six OCs tested included lindane, heptachlor, aldrin, dieldrin, endrin, and DDT. Eggs were removed at 0, 4, and 6 weeks and analyzed using gas chromatography with electron capture detection. Lindane was found at the highest concentration (153 ng/g at 4 weeks and 162 ng/g at 6 weeks). The next highest uptake was for endrin (25 ng/g at 4 weeks and 106 ng/g at 6 weeks). Heptachlor, aldrin, and dieldrin were also taken up into the eggs, but DDT was not detected in any of the eggs at any sampling period. The concentration of OCs increased from week 4 to week 6 for all the OCs except DDT. Structure-activity relationships were examined to determine which physicochemical properties of the OCs tested could be used as predictors of uptake into the eggs. A variety of physicochemical properties were evaluated including vapor pressure and molecular connectivity (a numerical description of topology). Octanol-water partition coefficient (Kow) was a good predictor (r2 = 0.63, p = 0.06) of OC uptake into the eggs using this limited data set.

Adsorption↗

Bacterial contamination in a modern operating suite. 4. Bacterial contamination of clothes worn in the suite.

Clean clothes in the staff dressing rooms were heavily contaminated with bacteria, mainly Bacillus sp., but Staphylococcus aureus were found on 14% and Clostridium sp. on 10% of the garments examined. A comparison of the occurrence of Staph. aureus on shirts worn by staff in wards and operating departments showed ward shirts to be contaminated more heavily and with more strains. Examination of sterile gowns worn by surgeons showed that 70% were contaminated with Staph. aureus after operation. Of the strains isolated 31% were identical with those carried by the surgeon or by the patient operated on, but for the remainder no source could be found.

Bacillus↗