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PubMed2004

An improved method for emergent decontamination of ocular and dermal hydrofluoric acid splashes.

Accidental hydrofluoric acid (HF) splashes often occur in industrial settings. HF easily penetrates into tissues by initial acid action allowing fluoride ions to penetrate deeply, chelating calcium and magnesium. Resultant hypocalcemia and hypomagnesemia can be fatal. This report describes the utilization of Hexafluorine--a hypertonic, amphoteric, chelating decontamination solution--in workplaces where water decontamination followed by calcium gluconate inunction failed to prevent HF burns and systemic toxicity. Between 1998 and 1999, 16 cases of ocular and dermal HF splashes with either 70% HF or 6% HF/15% nitric acid (HNO3) were decontaminated with Hexafluorine at the worksite. HF burns did not develop and medical treatment other than initial decontamination was not reQuired in 12/16 (75%). In 7/16 (44%) cases, lost work time corresponded to duration of hospital observation (mean < 1 d).

Adult↗

PubMedDate not supplied

Hand decontamination: nurses' opinions and practices.

Infection is spread in hospital mainly by hands, making hand decontamination the most important means of preventing dissemination. There is some evidence to suggest that when access to hand-decontaminating agents is poor or the agents available are disliked, hands are washed too seldom, increasing risks of cross-infection. However, little attention has been paid to the use of towels and factors which promote their use, although it is known that damp hands transfer bacteria more readily than dry ones and that hands which become sore through poor drying have higher bacterial counts, contributing to the risk of cross-infection. This paper reports the results of the Nursing Times Hand Drying survey designed to assess nurses' access to hand decontamination agents and towels. The results suggest that the 112 nurses who participated were aware of the need for attention to hand hygiene but that access to both hand-decontaminating agents and paper towels was variable. Forty-one per cent complained of a shortage of soap and although nearly all used paper towels, these were in many cases of poor quality. Such towels were perceived as damaging to hands, leaving them feeling damp and sore. Good-quality, soft, paper towels were much appreciated by respondents in this sample. It is concluded that the quality of paper towels contributes to good infection control practice.

Cross Infection↗

PubMed1991

Does selective decontamination of the gastrointestinal tract prevent multiple organ failure? An experimental study.

Gut bacteria have been incriminated as causing or contributing to generalized sepsis with multiple organ failure in severely ill patients, and selective decontamination of the gastrointestinal tract of Enterobacteriaceae has been claimed to decrease septic complications in these patients. We studied the effects of selective decontamination of the gastrointestinal tract on survival and organ function in an experimental model of sepsis with multiple organ failure. Wistar rats were inoculated intraperitoneally with zymosan and randomized into control or treatment groups (trimethoprim or streptomycin sulfate). Selective decontamination effectively prevented bacterial translocation of Enterobacteriaceae. However, only early mortality was decreased, and only so in the streptomycin-treated rats. Selective decontamination did not result in a significantly better condition of the surviving animals on day 12.

Animals↗

PubMed2000

Assessment of decontamination methods as pretreatment of silanization of composite glass fillers.

In terms of mechanical properties and durability, the surface of glass fillers should be decontaminated in order to optimize the silanization process for the production of resin composites. The objective of this study was to evaluate the decontamination efficiency of 18 cleaning methods on glass fillers as pretreatment of silane coupling. X-ray photoelectron spectroscopy revealed that SiO(2) boiled with a 5% sodium peroxodisulfate aqueous solution for 15 min, followed by ultrasonic rinsing with acetone for 30 min was most effective among all the decontamination methods investigated. In addition, nano-indentation measurements on SiO(2) treated by the above-mentioned method revealed that the surface was not significantly weakened as compared to untreated SiO(2). The results of this study should lead to an improved filler-matrix coupling and thus contribute to the development of better wear and fatigue-resistant composites. Therefore, sodium peroxodisulfate is proposed as a presilanization filler decontamination step in the production process of resin composites.

Bisphenol A-Glycidyl Methacrylate↗

PubMed1992

Role of selective decontamination in surgery.

Aspects of selective decontamination as an antibiotic prophylaxis in general surgery are discussed with respect to the respiratory tract and wound infection. The high rate of nosocomial infection encountered in surgical patients, who experience up to 71 per cent of all such infection, is considered. The infection rate increases to 70-80 per cent after 1 week in the surgical intensive care unit, while the infection-related mortality rate rises to up to 60 per cent. The endogenous origin of nosocomial infection suggests the importance of maintaining colonization resistance to prevent colonization with Gram-negative micro-organisms, especially using selective decontamination which eliminates potentially pathogenic micro-organisms while leaving colonization resistance intact. Selective decontamination has proved effective in decreasing infection rates by 50-80 per cent, and is especially successful in respiratory tract infection. Possible adverse effects and future indications for selective decontamination are discussed.

Anti-Bacterial Agents↗

PubMed1993

Pediatric gastrointestinal decontamination in acute toxin ingestion.

The appropriate implementation of the various modalities of gastrointestinal (GI) decontamination is critical in the management of the pediatric patient who is examined in the emergency department or private office after an acute ingestion. Gastrointestinal decontamination includes gastric lavage, syrup of ipecac, activated charcoal, and whole bowel irrigation. Clinical studies have delineated the role and efficacy of these procedures. Trends in GI decontamination place less emphasis on ipecac and gastric lavage and more emphasis on activated charcoal alone in the patient with a mild overdose. Gastric lavage is indicated in serious ingestion and is most effective if done soon after the exposure. Whole bowel irrigation is the newest addition and has important clinical use in the treatment of serious iron ingestions as well as in older adolescent cocaine body suffers and packers. Indications and contraindications of the various forms of GI decontamination are discussed and relevant clinical studies are reviewed.

Charcoal↗

PubMed1984

Influence of decontamination of the digestive tract on the urinary excretion of histamine and some of its metabolites.

Urinary excretions of histamine, N tau-methylhistamine and N tau-methylimidazoleacetic acid have been determined for 8 healthy volunteers during 14 consecutive days. Selective decontamination of the digestive tract was performed from day 3 to day 6, followed by total decontamination from day 7 to day 10. Urinary excretions of N tau-methylhistamine and N tau-methylimidazoleacetic acid decreased to a small though significant degree (about 15-20%) after total decontamination, suggesting a histamine production by anaerobic bacteria. Cadaverine decreased for about 70% under both selective and total decontamination, suggesting that this amine in human urine mainly originates from aerobic bacteria in the intestinal tract.

Adult↗

PubMed2000

Effects of dental plaque antiseptic decontamination on bacterial colonization and nosocomial infections in critically ill patients.

OBJECTIVES: To document in intensive care unit (ICU) patients the effect of dental plaque antiseptic decontamination on the occurrence of plaque colonization by aerobic nosocomial pathogens and nosocomial infections. DESIGN: Single-blind randomized comparative study. SETTING: A 16-bed adult intensive care unit in a university hospital. PATIENTS: Patients consecutively admitted in the ICU with a medical condition suggesting an ICU stay of 5 days and requiring mechanical ventilation. INTERVENTIONS: After randomization, the treated group received dental plaque decontamination with 0.2% chlorhexidine gel, three times a day during the ICU stay. The control group received standard oral care. SPECIFIC MEASUREMENTS: Dental status was assessed by the Caries-Absent-Occluded index; the amount of dental plaque was assessed by a semi-quantitative plaque index. Bacterial sampling of dental plaque, nasal and tracheal aspirate, blood, and urine cultures were done on days 0, 5, 10, and every week. MAIN RESULTS: Sixty patients were included; 30 in the treated group and 30 in the control one (mean age: 51 +/- 16 years; mean Simplified Acute Physiological Score II: 35 +/- 14 points). On admission, no significant differences were found between both groups for all clinical and dental data. Compared with the control group, the nosocomial infection rate and the incidence densities related to risk exposition were significantly lower in the treated group (18 vs 33% days in the ICU and 10.7 vs 32.3% days of mechanical ventilation; P < 0.05). These results were consistent with a significant preventive effect of the antiseptic decontamination (Odds Ratio: 0.27; 95% CI: 0.09; 0.80) with a 53% relative risk reduction. There was a trend to a reduction of mortality, length of stay, and duration of mechanical ventilation. CONCLUSIONS: An antiseptic decontamination of dental plaque with a 0.2% chlorhexidine gel decreases dental bacterial colonization, and may reduce the incidence of nosocomial infections in ICU patients submitted to mechanical ventilation.

Adult↗

PubMed1997

Endogenous endotoxemia of intestinal origin during cardiopulmonary bypass. Role of type of flow and protective effect of selective digestive decontamination.

OBJECTIVE: To evaluate the possible related factors to endotoxemia and cytokine activation during the ischemic phase of extracorporeal surgery, and the effect of selective digestive decontamination (SDD) as a preventive measure. DESIGN: Prospective, open, randomized trial. SETTING: Two multidisciplinary ICUs (tertiary care hospitals). PATIENTS: One hundred consecutive patients undergoing cardiopulmonary bypass (CPB), randomly allocated to two groups; gut decontamination (group I = 50 cases) and controls (group II = 50 cases). INTERVENTIONS: Preoperative administration of oral non-absorbable antibiotics (polymyxin E, tobramycin and amphotericin B) versus no administration. MEASUREMENTS AND RESULTS: The assessment of decontamination by means of the bacteriologic control of rectal swabs. Determinations of gastric intramucosal pH (gastric pHi) and plasma endotoxin, tumor necrosis factor (TNF) aNd interleukin-6 (IL-6) before surgery and during the ischemic and reperfusion phases of bypass. Rectal aerobic Gram-negative bacilli (AGNB) were significantly reduced in the treated patients and in 56% total eradication was achieved. Endotoxin, TNF and IL-6 plasma levels were significantly lower in this group. By contrast, both endotoxin and TNF/IL-6 levels and gastric pHi correlated with the type of surgical flow (pulsatile versus non-pulsatile). CONCLUSIONS: SDD reduces the gut content of enterobacteria. This may explain the lower endotoxin and cytokine levels detected in decontaminated patients. In addition to SDD, the type of flow employed during bypass seems to influence endotoxemia and cytokine levels.

Amphotericin B↗

PubMed2000

Bacterial resistance and overgrowth due to selective decontamination of the digestive tract.

Infection of the lower airways is a major problem in ventilated patients and contributes substantially to morbidity and mortality in the intensive care unit. The selective decontamination of the digestive tract and its effect on the reduction of the gram-negative colonisation rate in patients has been studied widely. However, the findings are inconsistent. Most studies describe an increase in resistant gram-negative bacterial strains and/or an increase in the occurrence of gram-positive strains following selective decontamination of the digestive tract. In light of the unresolved questions concerning the efficacy of selective decontamination of the digestive tract, it would seem that the resultant effect of this treatment on the bacterial flora should be an important consideration when assessing the value of such treatment. To date, none of the studies available for examination have been designed to adequately assess the effect of selective decontamination of the digestive tract on the bacterial flora.

Anti-Bacterial Agents↗

PubMed1975

Chairside decontamination of endodontic files.

Chairside decontamination. of files and reamers is attempted during root canal treatment. The purpose of this study was to evaluate some techniques for reducing the number of microorganisms of artificially contaminated endodontic files. Endodontic files were artificially contaminated with about 10,000 colony-forming units of either B. subtilis spores or S. mitis. The files containing the bacteria were then subjected to various decontamination procedures. Although sterilization was not achieved with any procedure, the bead sterilizer was found to be the most effective decontamination method tested. All gauze wipings showed reductions greater than 90 per cent. It was concluded that wiping with 2 by 2 inch gauze is a highly efficient and practical method of chairside decontamination

1-Propanol↗

PubMed1991

Effect of selective decontamination of the digestive tract on respiratory tract infections and mortality in the intensive care unit.

To assess the effect of selective decontamination of the digestive tract on respiratory tract infections and survival of patients treated in an intensive care unit, we carried out a meta-analysis of clinical studies comparing patients treated with selective decontamination with untreated controls. From eleven trials (1489 patients), differences between observed and expected respiratory tract infections and mortality were compared, and odds ratios (ORs) calculated. Analysis was done according to study design. With respect to the risk for respiratory tract infections, the studies with historical controls and the randomised trials showed a protective effect of selective decontamination. Historical control studies yielded an OR of 0.21 (95% confidence limits [CL] 0.15 to 0.29, p less than 0.05) and randomised trials an OR of 0.12 (95% CL 0.08 to 0.19, p less than 0.05). By contrast, the mortality benefit was less clear. Studies with historical controls and randomised trials showed that mortality was not significantly different between treatment and control patients. The evidence from these studies is at best consistent with a very limited effect of selective decontamination of the digestive tract on survival of patients in the intensive care unit, despite a clear preventive effect on the occurrence of respiratory tract infections.

Anti-Bacterial Agents↗

PubMed1994

Nurses' hand decontamination practice: results of a local study.

Cross-infection in hospital occurs mainly via hands. Hand washing is the most effective means of prevention, yet it has been reported that hands are washed too seldom, often inappropriately and that technique is poor. However, these claims are often made without explaining precisely how data were collected. This study employed more rigorous criteria than earlier research to judge the appropriateness and technique of nurses' hand contamination. During the 2 h that they were observed nurses decontaminated hands after 28.7% patient contacts. The data were then reanalysed so that only those activities likely to result in heavy contamination were examined. This revealed that such 'essential' decontaminations were performed on 49.8% occasions. Differences were found between hospitals related to the availability of hand decontaminating agents, particularly when nursing workload became high. A scoring system to assess technique was developed for the study. Mean score was 8.6 out of 12. Technique was superior for nurses employed in intensive care units regardless of the hospital in which data were collected (P < 0.0001). Nurses' knowledge of infection control was poor, but those with more knowledge decontaminated hands more appropriately (P < 0.004), although they did not have a better technique. It is recommended that future research move beyond mere description, with its inevitable conclusion that clinical staff should improve performance, turning toward the identification of local barriers to effective practice. This could be followed by improvement in resources and educational intervention should these emerge as problematic.

Cross Infection↗

PubMed1984

A toxicology program for evaluating the safety of a chemical warfare decontaminant.

An ideal topical decontaminant for chemical warfare agents should be highly efficacious, easy to use, and have low toxicity. For toxicity assessment, a stepwise approach linking type of toxicity study to stage of decontaminant development is both efficient and economical. In the initial exploratory phase, range-finding acute toxicity studies using a few animals will suffice to screen out highly toxic decontaminants . More definitive acute toxicity studies and a short term mutagenic test are sufficient during the live agent efficacy testing phase. When an efficacious decontaminant is found and is ready to be formulated into a product, a more extensive toxicologic program including a 2-week dermal toxicity study, a skin sensitization study, and an inhalation study (for aerosol or powder formulations) should be implemented before clinical trials.

Animals↗

PubMed1998

Nonacid meat decontamination technologies: model studies and commercial applications.

Increased consumer awareness and concern about microbial foodborne diseases has resulted in intensified efforts to reduce contamination of raw meat, as evidenced by new meat and poultry inspection regulations being implemented in the United States. In addition to requiring operation of meat and poultry slaughtering and processing plants under the principles of the hazard analysis critical control point (HACCP) system, the new regulations have established microbiological testing criteria for Escherichia coli and Salmonella, as a means of evaluating plant performance. These developments have renewed and intensified interest in the development and commercial application of meat and poultry decontamination procedures. Technologies developed and evaluated for decontamination include live animal cleaning/washing, chemical dehairing, carcass knife-trimming to remove physical contaminants, steam/hot water-vacuuming for spot-cleaning/decontamination of carcasses, spray washing/rinsing of carcasses with water of low or high pressures and temperatures or chemical solutions, and exposure of carcass sides to pressurized steam. Under appropriate conditions, the technologies applied to carcasses may reduce mean microbiological counts by approximately one-three log colony forming units (cfu)/cm2, and some of them have been approved and are employed in commercial applications (i.e., steam-vacuuming; carcass spray-washing with water, chlorine, organic acid or trisodium phosphate solutions; hot water deluging/spraying/rinsing, and pressurized steam). The contribution of these decontamination technologies to the enhancement of food safety will be determined over the long term, as surveillance data on microbial foodborne illness are collected. This review examines carcass decontamination technologies, other than organic acids, with emphasis placed on recent advances and commercial applications.

Animals↗

PubMed2002

Nondestructive decontamination of mortar and concrete by electro-kinetic methods: application to the extraction of radioactive heavy metals.

Because the service lives of nuclear power plants are limited to a certain number of years, the need for the management of quite a large volume of radioactive contaminated concrete arises, which, in most cases, was not taken into account when the capacities of the low and medium activity repositories were designed. Therefore, the decontamination of these structures would be of great interest in order to declassify the wastes as radioactive and manage them as conventional ones. This research studies the reliability of the application of electrical fields to decontaminate radioactive contaminated concrete. Three series of decontamination experiments have been carried out, using Cs+, Sr2-, Co2+, and Fe3+ ions added during casting and that have penetrated from the outside, testing carbonated and uncarbonated matrixes, and using laboratory devices as well as the homemade device for in situ application named "honeycomb device". As a result, the application of electrical fields to concrete-contaminated structures has been developed as a new technique to extract radioactive ionic species from concrete. This method of decontamination has been patented by ENRESA (Spanish Company for the Management of Radioactive Wastes) in association with the IETcc.

Electricity↗

PubMed2000

Fungal colonization and invasive fungal infections following allogeneic BMT using metronidazole, ciprofloxacin and fluconazole or ciprofloxacin and fluconazole as intestinal decontamination.

Invasive fungal infections (IFI) are increasingly diagnosed in patients undergoing allogeneic BMT. We have previously shown that the addition of metronidazole to ciprofloxacin for gastrointestinal bacterial decontamination significantly reduces the incidence of grades II-IV aGVHD by reduction of the anaerobic intestinal bacterial flora. Here, we found that the combined use of ciprofloxacin, metronidazole and fluconazole as antifungal prophylaxis increased intestinal yeast colonization when compared to ciprofloxacin and fluconazole alone (P < 0.01). Based on the EORTC criteria, a total of 18 out of 134 study patients developed IFI: seven of 68 (10%) patients who received metronidazole compared to 11 of the 66 (17%) patients decontaminated without metronidazole developed IFI (log-rank P = 0.36). Lethal IFI occurred in two of seven patients receiving metronidazole and in four of 11 patients without anaerobic decontamination. In conclusion, bacterial intestinal decontamination using metronidazole as an antibiotic with activity against most anaerobic intestinal bacteria significantly increases the intestinal yeast burden without influencing the incidence of IFI in patients undergoing allogeneic BMT.

Adolescent↗

PubMed2004

Final decontamination of the filtrates obtained after interaction of two ligand-containing Cu2+ and Zn2+ electroplating solutions.

A cheap and simple way to decontaminate two ligand-containing rinsing waters of metal finishing has been previously suggested. Both the copper diphosphate-containing rinsing wastewater and acidic zinc ammonium-containing rinsing wastewater may be decontaminated by mixing them which results in precipitation of solid solutions of copper-zinc-potassium-ammonium diphosphates. This way of decontamination requires no expensive reagents since only a small amount of H2SO4, is needed for pH adjustment. 80-99.5 % of environmentally dangerous substances, viz. zinc, copper and diphosphate, are removed from the mixture. However, Cu2+ and Zn2+ amounts in filtrates significantly exceed the discharge consent level (DCL). Besides, high concentrations of undesirable diphosphate and ammonium ions, which cause the eutrophication of natural water reservoirs, are present in the filtrates. There are relatively small concentrations of heavy metals: Cu2+ (approximately 0.4 mM dm-3) and Zn2+ (approximately 1 mM dm-3), and relatively large quantities of ligands: P2O7(4-) (approximately 20 mM dm-3) and NH4+/NH3 (approximately 500 mM dm-3) in these filtrates. Our investigation has shown, that decontamination may be easily achieved in industry by using cheap materials or industrial by-products: lime, MgO, phosphogypsum, extractive phosphoric acid and spent steel etching solution. Using lime, Cu2+ and Zn2+ ions may be removed below their DCL. After that, diphosphate ion concentration may be reduced approximately 1000 fold by addition of spent steel etching solution or continuous mixing with phosphogypsum. The amount of NH4+/NH3 may be reduced 20 to 30 fold, the concentration of soluble phosphates -- 5 to 40 fold and both c Cu2+ and c Zn2+ -- lower than their DCL by precipitating barely soluble fine crystalline MgNH4PO46H2O (struvite).

Copper↗