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At least 595 records · Page 33Linked to original sources
PubMed2006

Real-time PCR detection of Pseudomonas aeruginosa in clinical and municipal wastewater and genotyping of the ciprofloxacin-resistant isolates.

Real-time quantification of Pseudomonas aeruginosa was performed in various wastewater systems including clinical, municipal wastewaters and inflow from a wastewater treatment plant. The highest concentrations of P. aeruginosa-specific targets were detected in clinical wastewaters. Limitations of the detection system resulting from inhibition or cross-reaction were identified. Ciprofloxacin-resistant P. aeruginosa strains were isolated after specific enrichment from clinical and municipal wastewaters. In some cases they were also cultivated from effluent of a wastewater treatment plant, and from its downstream river water. A total of 119 isolates were phenotypically characterized as ciprofloxacin-resistant via antibiogram testing. Subsequently, the fluoroquinolone-resistance-mediating mutations in the genes gyrA codon positions 83 and 87, gyrB codon position 466 and parC codon positions 87 and 91 were determined by mini-sequencing. Ciprofloxacin resistance was mainly associated with mutations in gyrA codon position 83 and parC mutation in codon positions 87 or 91 of the bacterial gyrase and topoisomerase II genes. All ciprofloxacin-resistant P. aeruginosa strains were compared with genotypes from clinical data of fluoroquinolone-resistant P. aeruginosa infections. The results were in agreement with data from clinical analyses, with the exception that no gyrA 87 and no gyrB mutations were found in ciprofloxacin-resistant P. aeruginosa wastewater isolates.

Ciprofloxacin↗
PubMed2002

Law and regulation of retained organs: the ethical issues.

Organ retention has been with us for millennia. Walk into virtually any cathedral and many a church in Europe and you will find an array of retained organs or tissue, allegedly originally the property of assorted saints, or even of God, and almost certainly collected without proper informed consent and retained in less than secure conditions. In our own time the complexities of organ collection, retention and use have proliferated. The events at Alder Hey Children's Hospital and the debates about the ethics of biobanking all over the world have dramatically highlighted the complexity, the difficulty and the moral importance of these issues. Some of these issues have to do with the question of who can give permission for or consent to such removal and retention. Other issues involve consideration of whose rights or interests are engaged when cadaver organs and tissue are removed and retained, just what in particular is the nature, extent and force of those rights or interests, and how they are to be balanced against other moral considerations. These questions are the subject of this paper. We will not, however, here be concerned with the issues of genetic privacy, the security of genetic information.

Advance Directives↗
PubMedDate not supplied

Containers for waste causing peritonitis in CAPD patients.

Fungal infection is a rare cause of peritonitis in patients on chronic peritoneal dialysis. In this population, fungi are found in less than 2 percent of all cases of primary episodes of peritonitis (1). More often, a primary bacterial peritonitis treated with antibiotic therapy leads to secondary fungal infection (2). Candida species cause 74.5% of the episodes of fungal peritonitis (2). The fungi invade the peritoneal cavity from the skin peri- or intraluminally through the catheter (3). Filamentous fungi are rare (4,5). Treatment of fungal peritonitis commonly consists of removal of catheter and antifungal drugs (3). Here we describe two cases of fungal peritonitis caused by mycelial fungi, where the source of the microorganism could be special containers used for biological waste, which are popular in Germany

Adult↗
PubMed2000

The environmental effects of dental amalgam.

Dental amalgam is one of the most commonly used materials in restorative dentistry. However, one of its major components, mercury, is of particular concern due to its potential adverse effects on humans and the environment. In this review, the environmental impact of dental amalgam will be discussed, with particular reference to the effects attributed to its mercury component. Mercury commonly occurs in nature as sulfides and in a number of minerals. Globally, between 20,000-30,000 tons of mercury are discharged into the environment each year as a result of human activities. According to a recent German report, approximately 46 per cent of the freshly triturated amalgam is inserted as new amalgam restorations and the rest is waste. Depending on the presence of an amalgam separating unit, some of the generated amalgam-contaminated sludge is discharged into the sewage system. Lost or extracted teeth with amalgam fillings and amalgam-contaminated waste, such as trituration capsules and cotton rolls are discharged with the solid waste and, in most instances, are incinerated. Use of disinfectants containing oxidizing substances in dental aspirator kits may contribute to remobilization of mercury and its subsequent release into the environment. Nevertheless, dental mercury contamination is only a small proportion of terrestrial mercury (3-4 per cent), which is quite insignificant compared with industrial pollution and combustion of fossil fuels by vehicles. The environmental impact of dental mercury is mainly due to the poor management of dental amalgam waste. Proper collection of mercury-contaminated solid waste prevents the release of mercury vapour during combustion. In addition, the use of amalgam separating devices reduces the amount of amalgam-contaminated water released from dental clinics.

Dental Amalgam↗
PubMed1998

Dental practice and the environment.

This paper summarises issues pertaining to the environmental effects of clinical practice. Using examples of environmental awareness, the concept of environmental auditing is introduced by way of a pointer to actions to limit the environmental impact of dentistry. It is concluded that environmental management and auditing would be advantageous to dentistry.

Dental Waste↗
PubMed2003

Infection control for SARS in a tertiary neonatal centre.

The Severe Acute Respiratory Syndrome (SARS) is a newly discovered infectious disease caused by a novel coronavirus, which can readily spread in the healthcare setting. A recent community outbreak in Hong Kong infected a significant number of pregnant women who subsequently required emergency caesarean section for deteriorating maternal condition and respiratory failure. As no neonatal clinician has any experience in looking after these high risk infants, stringent infection control measures for prevention of cross infection between patients and staff are important to safeguard the wellbeing of the work force and to avoid nosocomial spread of SARS within the neonatal unit. This article describes the infection control and patient triage policy of the neonatal unit at the Prince of Wales Hospital, Hong Kong. We hope this information is useful in helping other units to formulate their own infection control plans according to their own unit configuration and clinical needs.

Cross Infection↗
PubMed2004

Wastewater-grown duckweed may be safely used as fish feed.

Duckweed has been used for the treatment of wastewater and as fish feed. A comparative study was carried out to determine (i) the efficacy of duckweed in treating hospital-based wastewater and (ii) the level of the microbial contamination of fish fed on wastewater-grown duckweed. There were two groups of ponds where fish farming was done. In one group of ponds (control ponds), duckweed that was grown using artificial fertilizer was used as fish feed; in another group (study ponds), wastewater-grown duckweed was used as fish feed. The faecal contamination of water, duckweed, and fish from study and control ponds were monitored by faecal coliform estimation. The presence of enteric pathogens among handlers, water, duckweed, and fish samples was also examined. It was observed that the faecal coliform counts of raw wastewater were 4.7 Log10 CFU/mL, which was reduced to <1 Log10 CFU/mL after treating with duckweed. There was no significant difference (P > 0.05) in faecal coliform counts in water collected from duckweed ponds and fish ponds of study and control areas. The wastewater-grown duckweed did not pose any health hazard to the handlers. These results demonstrated that the wastewater-treated duckweed may be safely used as fish feed.

Animal Feed↗
PubMed1998

A cluster of bloodstream infections and pyrogenic reactions among hemodialysis patients traced to dialysis machine waste-handling option units.

From June 17 through November 15, 1995, ten episodes of Enterobacter cloacae bloodstream infection and three pyrogenic reactions occurred in patients at a hospital-based hemodialysis center. In a case-control study limited to events occurring during October 1-31, 1995, seven dialysis sessions resulting in E. cloacae bacteremia or pyrogenic reaction without bacteremia were compared with 241 randomly selected control sessions. Dialysis machines were examined, dialysis fluid and equipment were cultured, and E. cloacae isolates were genotyped by pulsed-field gel electrophoresis. Each dialysis machine had a waste-handling option (WHO) through which dialyzer-priming fluid was discarded before each dialysis session; in 7 of 11 machines, one-way check valves designed to prevent backflow from the WHO into patient bloodlines were dysfunctional. In the case-control study, case sessions were more frequent when machines with >/=1 dysfunctional check valves were used. E. cloacae with identical pulsed-field gel electrophoresis patterns were isolated from case patients, dialysis fluid, station drains, and WHO units. Our investigation shows that bloodstream infections and pyrogenic reactions were caused by backflow from contaminated dialysis machine WHO units into patient bloodlines. The outbreak was terminated when WHO use was discontinued, check valves were replaced, and dialysis machine disinfection was enhanced.

Adult↗
PubMedDate not supplied

The role of flushing dental water lines for the removal of microbial contaminants.

OBJECTIVES: This study was designed to determine the role of flushing dental water lines for the removal of heterotrophic plate count bacteria, Legionella spp., and free-living protozoa. METHODS: Forty dental offices were surveyed in the study. An initial sample and a sample taken after three minutes of flushing were obtained from the air/water syringe at each location. All samples were quantitatively analyzed for heterotrophic bacteria using three bacteriological procedures. The samples were analyzed for the presence of Legionella spp. using cultural, immunological, and molecular procedures and for the occurrence of free-living protozoa using a killed bacteria plate procedure. RESULTS: The flushing process reduced the level of heterotrophic plate count bacteria by 1.1 to 1.5 log10 CFU/ml. Compliance with recommendations for bacterial levels varied depending on the methodology employed in the analysis. The flushing process did not reduce the occurrence of Legionella spp. or free-living protozoa. CONCLUSION: The results support recent U.S. Centers for Disease Control and Prevention recommendations that the process of flushing dental water lines cannot be relied upon as a sole means of reliably improving the quality of water used in dental treatment.

Bacteriological Techniques↗
PubMed2001

Hospital waste management in Brazil: a case study.

The evaluation of the current definition, classification and quantification of hospital waste being carried out by hospitals in different countries is extremely important to avoid improper waste management practices. In this work, the waste management from a 400-bed Brazilian hospital which generates about 386 kg per day of hospital waste was studied. The generation rate of just over one kg per bed per day was considered small, although more than 50% of the waste from non-isolation wards consisted of food waste. It was also interesting to note that the highest generation rate per patient per day was found in private rooms and the lowest rate in the public ones. The waste practices used in this hospital are discussed in terms of current Brazilian legislation.

Brazil↗
PubMed2004

Tradable permits without legislative targets: a review of the potential for a permit scheme for sterilized clinical waste in the UK.

Tradable-permit schemes are becoming an increasingly popular technique for encouraging materials recovery and the diversion of waste from landfill. Such schemes operate using various forms of market-based trading of waste permits between polluters but usually rely on mandatory recycling targets to provide an incentive for trading. Using the UK's Packaging Recovery Note (PRN) scheme as a template, this paper examines the potential for permit trading where mandatory targets are absent and schemes must be driven solely by the financial benefits of reduced landfill costs and permit/material sales. The case examined is sterilized clinical waste, which has considerable recycling potential but suffers from health concerns and a poor public image. Interviews with healthcare and waste-management representatives indicate that although elements of the PRN scheme might prove appropriate for encouraging materials recovery, the absence of government targets and uncertain end markets for sterilized clinical waste present major obstacles to trading. Alternative incentives would therefore be required to catalyse schemes and develop recycling infrastructure. In the final analysis, thermal processing may be a more practical alternative to landfill than materials recovery for this particular waste stream.

Commerce↗
PubMed2005

Health-care waste management in Lao PDR: a case study.

This study investigated the health-care waste (HCW) management at each health-care facility level at two selected sites in the Lao People's Democratic Republic (Lao PDR): Vientiane Municipality; and Bolikhamxay province. It focused on the amount of HCW, its segregation and the factors influencing HCW management, particularly segregation procedures. A high proportion of incorrectly segregated medical waste was found at each level of health-care facility. Re-segregation revealed 39, 62, 57 and 37% at national hospital, provincial hospital, district hospital and health centre level, respectively, was poorly segregated. The mean of generated HCW was 0.62 kg/bed per day (Vientiane Municipality) and 0.38 kg/bed per day (Bolikhamxay) at two study sites. A higher proportion of medical waste (MW) from the inpatient department at the primary health-care level was found. Thus, HCW management at primary health-care facilities needs more attention and should be better understood.

Community Health Centers↗
PubMed2006

Assessing workplace compliance with handling of antineoplastic agents.

Oncology nurses and ancillary support personnel who work in oncology settings are at risk for exposure to antineoplastic drugs in their workplaces. A review of the literature reveals issues of environmental contamination and personal exposure. Although the United States has no formal regulations regarding hazardous drugs, including cytotoxic agents, guidelines have been published and are readily available to improve workplace safety. Oncology healthcare workers must be aware of the serious nature of antineoplastic drug exposure and the avenues available to initiate a simple, highly effective, problem-solving process called SOLVE to make medical workplaces safer.

Antineoplastic Agents↗