SEARCH · PubMed Health

Results for “DECONTAMINATION”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources

PubMed2001

Decontamination of laryngoscopes in The Netherlands.

In this study the decontamination procedures of laryngoscopes in Dutch hospitals are described, based on a structured telephone questionnaire. There were substantial differences between decontamination procedures in Dutch hospitals and the standards of the APIC (Association of Professionals in Infection Control and Epidemiology), CDC (Centers of Disease Control) and ASA (American Society of Anesthesiology) were met in full in 19.4% of the hospitals. The standards of manual decontamination, used in 78% of the 139 hospitals, were particularly disappointing; manual cleaning was considered inadequate in 22.9% of these hospitals and manual disinfection did not meet the standards of the APIC, CDC or ASA in any of these hospitals. Decontamination by instrument cleaning machines as a standard procedure was used in 30 (22%) hospitals. In three of these hospitals the blades were subsequently sterilized. We suggest adherence to the infection control guidelines of the CDC, APIC and ASA, until the safety of less conservative infection control practices are demonstrated.

Disinfection↗

PubMed2003

Decontamination of tried-in orthodontic molar bands.

Molar bands are commonly used to retain orthodontic attachments on posterior teeth and due to the variation in the size of such teeth, it is usually necessary to 'try in' several bands before the correct one is selected. A possible concern with re-using such bands is the lack of cross-infection control, even following autoclaving, due to the presence of one or more small bore lumen (the archwire and headgear tubes). The aim of this experiment was, therefore, to determine whether such bands could be successfully decontaminated so that they could be re-used without a cross-infection risk. Two hundred orthodontic molar bands that had previously been tried in patients' mouths, but not cemented into place, were tested. Each band was decontaminated using an enzymatic cleaner/disinfectant and then sterilized using either a downward displacement (n = 100) or a vacuum cycle autoclave (n = 100). Following autoclaving each band was inoculated into brain heart infusion culture broth and incubated at 37 degrees C for 5 days. None of the decontaminated bands exhibited growth after 5 days. It would appear that, using this methodology, there is little risk of a cross-infection hazard occurring with the re-use of previously tried-in and decontaminated molar bands.

Cross Infection↗

PubMed1994

Selective decontamination of the digestive tract in multiple trauma patients--is there a role? Results of a prospective, double-blind, randomized trial.

OBJECTIVE: To evaluate the efficacy of the technique of selective decontamination of the digestive tract in preventing the development of secondary infection and its influence on morbidity and mortality rates in multiple trauma patients with chest injuries requiring intermittent positive-pressure ventilation. DESIGN: Prospective, double-blind, randomized study. SETTING: A multidisciplinary respiratory intensive care unit (ICU) in a 1,500-bed teaching hospital. PATIENTS: Seventy-two patients (mean Injury Severity Score of 29.5) who were intubated for > 48 hrs and remained in the ICU for > 5 days. INTERVENTIONS: Patients were randomized on admission to receive selective decontamination therapy or placebo. All patients received intravenous cefotaxime for 72 hrs and the treatment group received oral and enteral selective decontamination with amphotericin B, polymyxin E, and tobramycin (n = 39), while the placebo group received a placebo containing oral paste and enteral solution (n = 33). MEASUREMENTS: Secondary infection was determined clinically and microbiologically and surveillance cultures were monitored for gastrointestinal colonization. RESULTS: The patient groups were fully comparable for age, severity of illness, and compromising factors. There was no difference in the number of patients infected (11 treatment group vs. 11 placebo), infections (17 vs. 16) and deaths (5 vs. 3); the duration of ICU (15.5 vs. 14.2 days) and hospital stays (26.3 vs. 25.5) were also similar. Microbiological surveillance cultures confirmed effective elimination of aerobic Gram-negative bacilli, and infections in the treatment group were largely due to Staphylococcus aureus and Staphylococcus epidermidis. CONCLUSION: We have been unable to show any benefit from the use of selective decontamination of the digestive tract in the prevention of secondary infections in multiple trauma patients.

Adult↗

PubMed1996

Does selective decontamination of the digestive tract reduce mortality for severely ill patients?

OBJECTIVE: To investigate the relationship between baseline risk of death and reduced mortality after selective decontamination of the digestive tract in intensive care unit patients. DESIGN: Analysis of data from a meta-analysis of 23 randomized, controlled trials. PATIENTS: A total of 4,142 adult intensive care unit patients from the 23 trials. MEASUREMENTS AND MAIN RESULTS: Mortality for patients receiving selective decontamination of the digestive tract treatment was analyzed as a function of baseline risk of death at study entry, using weighted least squares regression across all 23 trials. In testing whether the slope of the regression is different than 1.0, the observed t value is 3.32 (p < .004), suggesting that the efficacy of selective decontamination of the digestive tract in reducing mortality is significantly better in populations at high mortality risk at study entry. CONCLUSIONS: Mortality reduction from selective decontamination of the digestive tract appears related to the mortality risk of patients at the time of study entry. Future trials should consider using baseline risk assessment as part of trial design and outcome analysis.

Adult↗

PubMed2002

Selective decontamination of the digestive tract.

Ventilator-associated pneumonia usually originates from the patient's oropharyngeal microflora. In selective digestive decontamination, topical antibiotics are applied to the oropharynx and stomach for prevention of pneumonia and other infections, possibly reducing infection-related mortality. Selective digestive decontamination is also used for the prevention of gut-derived infections in acute necrotizing pancreatitis and liver transplantation. Despite numerous clinical trials, selective digestive decontamination remains controversial. Reduction of the incidence of pneumonia is accepted, but the extent of reduction is debated. Mortality was not reduced in most individual trials, but this finding was calculated in meta-analyses, especially for combined use of topical and systemic antibiotics in surgical ICU patients. Some investigators reported increased resistance and a shift to Gram-positive pathogens. Today, it appears that selective means not only selective suppression of pathogenic bacteria but also selection of appropriate groups of patients for underlying diseases and severity of illness, and selection of ICUs, where the endemic resistance patterns might allow the use of selective digestive decontamination at a relatively low risk for increased selection pressure.

Antibiotic Prophylaxis↗

PubMed1999

A comparative study of methods to validate formaldehyde decontamination of biological safety cabinets.

Methods of validation of formaldehyde decontamination of biological safety cabinets were compared. Decontamination of metal strips inoculated with Mycobacterium bovis, poliovirus, or Bacillus spp. spores was compared with the results obtained with three biological indicators. Conditions for successful decontamination, particularly relative humidity, were defined. The Attest 1291 biological indicator was the only biological indicator which was an aid in the detection of gross decontamination failure.

Bacillus↗

PubMed1993

Comparison of four decontamination methods for recovery of Mycobacterium avium complex from stools.

The presence of Mycobacterium avium complex (MAC) in stool specimens may be a predictor of disseminated MAC infection, yet the methods for decontaminating stools have not been evaluated for their usefulness in recovering MAC organisms. In the present study, four decontamination methods commonly used to recover acid-fast bacteria from respiratory specimens were compared for their utility in recovering MAC from stool specimens. Ten strains of MAC were used at a level of 10(4) to 10(6) CFU to seed the stool specimens. Specimens were divided into four portions and were decontaminated by using the following treatments: (i) N-acetyl-L-cysteine-sodium hydroxide (NALC-NaOH), (ii) cetylpyridinium chloride-sodium chloride (CPC-NaCl), (iii) oxalic acid, or (iv) benzalkonium chloride-trisodium phosphate (BC-TSP). The specimens were then plated onto a total of five pieces of selective and nonselective egg- and agar-based media. The oxalic acid method yielded the greatest number of MAC CFU from seeded stool samples; this was followed by NALC-NaOH, BC-TSP, and CPC-NaCl. The difference between the oxalic acid method and each of the other methods was statistically significant (analysis of variance at the 95% significance level). Although more MAC CFU was recovered from seeded stool samples by using oxalic acid than NALC-NaOH, no difference in culture positivity rates was observed when the two methods were used to test 368 clinical stool specimens processed with either oxalic acid (164 specimens) or NALC-NaOH (204 specimens) (P = 0.07) or 67 specimens processed by both methods (P = 0.77). The oxalic acid and NALC-NaOH decontamination methods both appear to be useful for the recovery of MAC organisms from stool specimens.

AIDS-Related Opportunistic Infections↗

PubMed1998

Effects of decontamination methods and culture conditions on viability of Mycobacterium ulcerans in the BACTEC system.

We used the BACTEC system to evaluate the effects of several decontamination methods and the addition of antibiotics on the viability of Mycobacterium ulcerans. The effects of polyoxyethylene stearate or egg yolk as supplements were also evaluated to determine their impact on the growth of M. ulcerans. Strains of different geographic origins were subjected to Petroff, reversed Petroff, oxalic acid, and mild HCI treatments. After treatment, the viability of each strain was assessed in the BACTEC system. All of the decontamination methods tested adversely affected bacterial viability. Treatment with mild HCl gave the best results, allowing better growth rates with some strains and causing a delay in growth with others, depending on the geographic origin of the strain. A mixture of polymyxin B, amphotericin B, nalidixic acid, trimethoprim, and azlocillin did not significantly inhibit growth. Supplementing BACTEC medium with egg yolk markedly improved the recovery of M. ulcerans following the use of each of the decontamination methods. Our findings demonstrate a detrimental impact on the viability of M. ulcerans by all of the decontamination methods currently in common use. This explains, at least in part, the difficulty often experienced in cultivating this organism from clinical specimens. Egg yolk should be added to enhance the rate of successful primary cultivation of M. ulcerans in the BACTEC system.

Amphotericin B↗

PubMed2006

Oral decontamination with chlorhexidine reduces the incidence of ventilator-associated pneumonia.

RATIONALE: Ventilator-associated pneumonia (VAP) is the most frequently occurring nosocomial infection associated with increased morbidity and mortality. Although oral decontamination with antibiotics reduces incidences of VAP, it is not recommended because of potential selection of antibiotic-resistant pathogens. We hypothesized that oral decontamination with either chlorhexidine (CHX, 2%) or CHX/colistin (CHX/COL, 2%/2%) would reduce and postpone development of VAP, and oral and endotracheal colonization. OBJECTIVES: To determine the effect of oral decontamination with CHX or CHX/COL on VAP incidence and time to development of VAP. METHODS: Consecutive patients needing mechanical ventilation for 48 h or more were enrolled in a randomized, double-blind, placebo-controlled trial with three arms: CHX, CHX/COL, and placebo (PLAC). Trial medication was applied every 6 h into the buccal cavity. Oropharyngeal swabs were obtained daily and quantitatively analyzed for gram-positive and gram-negative microorganisms. Endotracheal colonization was monitored twice weekly. RESULTS: Of 385 patients included, 130 received PLAC, 127 CHX and 128 CHX/COL. Baseline characteristics were comparable. The daily risk of VAP was reduced in both treatment groups compared with PLAC: 65% (hazard ratio [HR]=0.352; 95% confidence interval [CI], 0.160, 0. 791; p=0.012) for CHX and 55% (HR=0.454; 95% CI, 0.224, 0. 925; p=0.030) for CHX/COL. CHX/COL provided significant reduction in oropharyngeal colonization with both gram-negative and gram-positive microorganisms, whereas CHX mostly affected gram-positive microorganisms. Endotracheal colonization was reduced for CHX/COL patients and to a lesser extent for CHX patients. No differences in duration of mechanical ventilation, intensive care unit stay, or intensive care unit survival could be demonstrated. CONCLUSIONS: Topical oral decontamination with CHX or CHX/COL reduces the incidence of VAP.

Administration, Topical↗

PubMed2001

Effect of acid resistance of Escherichia coli O157:H7 on efficacy of buffered lactic acid to decontaminate chilled beef tissue and effect of modified atmosphere packaging on survival of Escherichia coli O157:H7 on red meat.

The present study examined the effect of pH-independent acid resistance of Escherichia coli O157:H7 on efficacy of buffered lactic acid to decontaminate chilled beef tissue. A varied level of acid resistance was observed among the 14 strains tested. Eight strains were categorized as acid resistant, four strains as acid sensitive, and two strains demonstrated acid-inducible acid resistance. The survival of an acid-resistant (II/45/4) and acid-sensitive (IX/8/16) E. coli O157:H7 strain on chilled beef tissue treated with 1 and 2% buffered lactic acid, sterile water, or no treatment (control) was followed. A gradual reduction of E. coli O157:H7 was noticed during the 10 days of storage at 4 degrees C for each of the treatments. Decontamination with 1 and 2% buffered lactic acid did not appreciably affect the pathogen. Differences in the pH-independent acid resistance of the strains had no effect on the efficacy of decontamination. The effect of modified atmosphere packaging (MAP) on survival of E. coli O157:H7 in red meat was also studied. MAP (40% CO2/60% N2) or vacuum did not significantly influence survival of E. coli O157:H7 on inoculated sliced beef (retail cuts) meat compared to packing in air. The relative small outgrowth of lactic acid bacteria during storage under vacuum for 28 days did not affect survival of E. coli O157:H7. Neither lactic acid decontamination nor vacuum or MAP packaging could enhance reduction of E. coli O157:H7 on beef, thus underlining the need for preventive measures to control the public health risk of E. coli O157:H7.

Adaptation, Physiological↗

PubMed2004

Effect of single or sequential hot water and lactic acid decontamination treatments on the survival and growth of listeria monocytogenes and spoilage microflora during aerobic storage of fresh beef at 4, 10, and 25 degrees C.

The survival and growth of Listeria monocytogenes and spoilage microflora during storage of fresh beef subjected to different decontamination treatments was studied. Fresh beef inoculated with a five-strain mixture of L. monocytogenes (5.18 log CFU/cm2) was left untreated (control) or was immersed (30 s) in hot water (HW; 75 degrees C), 2% lactic acid (LA; 55 degrees C), hot water followed by lactic acid (HW-LA), or lactic acid followed by hot water (LA-HW) and then stored aerobically at 4, 10, and 25 degrees C for 25, 17, and 5 days, respectively. Initial populations of L. monocytogenes were reduced by 0.82 (HW), 1.43 (LA), 2.73 (HW-LA), and 2.68 (LA-HW) log CFU/cm2. During storage, the pathogen grew at higher rates in HW than in control samples at all storage temperatures. Acid decontamination treatments (LA. HW-LA, and LA-HW) resulted in a weaker inhibition of L. monocytogenes (P < 0.05) at 25 degrees C than at 4 and 10 degrees C. In general, the order of effectiveness of treatments was HW-LA > LA > LA-HW > HW > control at all storage temperatures tested. In untreated samples, the spoilage microflora was dominated by pseudomonads, while lactic acid bacteria, Enterobacteriaceae, and yeasts remained at lower concentrations during storage. Brochothrix thermosphacta was detected periodically in only a limited number of samples. Although decontamination with HW did not affect the above spoilage microbial profile, acid treatments shifted the predominant microflora in the direction of yeasts and gram-positive bacteria (lactic acid bacteria). Overall, the results of the present study indicate that decontamination with LA and combinations of LA and HW could limit growth of L. monocytogenes and inhibit pseudomonads, which are the main spoilage bacteria of fresh beef stored under aerobic conditions. However, to optimize the efficacy of such treatments, they must be applied in the appropriate sequence and followed by effective temperature control.

Animals↗

PubMedDate not supplied

Hand decontamination.

Hand decontamination is the most effective, and certainly the most cost-effective, method of preventing health-related infection (HRI). However, research has shown that health professionals, including nurses, do not decontaminate hands as often as they should. It has become apparent that hand decontamination does not always follow those activities which will probably result in the most heavy soiling, and the technique used to decontaminate hands is often poor.

Anti-Infective Agents, Local↗

PubMed1990

Postirradiation changes in small intestine mucosa of piglets selectively decontaminated by peroral antibiotics.

There was performed light microscopic and morphometric comparison of changes in the intestinal mucosa structure after the irradiation of the lower part of body by radiation 60Co in a dose of 12 Gy, observed the third day after irradiation in piglets kept under conventional conditions and the fifth, the fifteenth and the twentieth days after irradiation in piglets kept under the conditions of selective decontamination by peroral antibiotics. The non-irradiated animals kept conventionally as well as under the conditions of decontamination served as controls. The estimation was performed on transverse slices of the cranial part of jejunum and of the caudal part of ileum. The slices were stained by the method hematoxylin-eosin. The drawings prepared with the help of the projective microscope Pictoval were used for measuring on the apparatus for the quantitative analysis of image MOP AM 03. A markedly lower damage of the intestinal mucosa was evidenced in piglets selectively decontaminated by peroral antibiotics. In the studied time intervals after irradiation in a dose of 12 Gy, the epithelial cover of mucosa, the crypt epithelium and the general outline of mucosa are much better maintained. The favourable effect of the selective decontamination on the maintenance and regeneration of the mucosa of jejunum and ileum is confirmed by a range of morphometric parameters.

Administration, Oral↗

PubMed1990

[Evaluation of decontamination procedures used at digestive endoscopy units in Gironde].

Decontamination procedures used for endoscopes were noted in 23 digestive endoscopy units, public and private, in the department of Gironde and compared to recommended procedures. Serial, bacteriological samples were obtained from one esogastroscope and one colonoscope in each unit, after upper endoscopy and colonoscopy diagnostic procedures at the end of the endoscopy session. Six units of 23 used complete decontamination procedures. In the 17 other units, principal errors of decontamination procedures were: inadequate cleaning of internal channel of scopes (12 units) and lack of utilization of glutaraldehyde between each endoscopy (8 units). Bacteriological samples were negative in 11/12 endoscopes after a complete decontamination procedure and in 8/39 after an inadequate procedure (p less than 0.01). Complete procedures are efficacious but not used often enough. Information and changes in endoscopic practices are necessary in digestive endoscopy units.

Bacterial Infections↗

PubMed1978

Antibiotic decontamination of the dog and its consequences.

An isolation-decontamination regimen was developed which effectively reduced the numbers of resident flora of the dog. Bacterial counts in four dogs before treatment were 3.8 X 10(9) per gram of feces; no organisms were detectable in these same dogs after treatment, however, the intestinal flora had returned to slightly above normal levels 1 week after treatment. Decontamination was accomplished in a laminar air flow system designed to minimize the area that had to be under controlled conditions. By determining the antibiotic sensitivities of 67 isolated organisms representing eight species or groups of bacteria recovered from the four dogs, a standardized antibiotic regimen was developed consisting of bacitracin and neomycin administered as a dry powder in the food. The decontamination treatment apparently did not affect host metabolism because no alterations in serum levels of urea nitrogen, glucose, phosphate, total protein, chloride, sodium, potassium, serum glutamic oxalacetic transaminase, or serum glutamic pyruvic transaminase were found in the antibiotic-treated dogs. The decontamination process did, however, reduce normal granulopoietic stimulation.

Animals↗

PubMed1985

Effect of Pseudomonas contamination or antibiotic decontamination of the GI tract on acute radiation lethality after neutron or gamma irradiation.

The influence of antibiotic decontamination of Pseudomonas contamination of the GI tract prior to whole-body neutron or gamma irradiation was studied. It was observed that for fission neutron doses greater than 5.5 Gy, cyclotron-produced neutron doses greater than 6.7 Gy, and 137Cs gamma-ray doses greater than 14.4 Gy, the median survival time of untreated rats was relatively constant at 4.2 to 4.5 days, indicating death was due to intestinal injury. Within the dose range of 3.5 to 5.5 Gy of fission neutrons, 4.9 to 6.7 Gy of cyclotron-produced neutrons, and 9.6 to 14.4 Gy of gamma rays, median survival time of these animals was inversely related to dose and varied from 12 to 4.6 days. This change in survival time with dose reflects a transition in the mechanisms of acute radiation death from pure hematopoietic, to a combination of intestinal and hematopoietic, to pure intestinal death. Decontamination of the GI tract with antibiotics prior to irradiation increased median survival time 1 to 5 days in this transitional dose range. Contamination of the intestinal flora with Pseudomonas aeruginosa prior to irradiation reduced median survival time 1 to 5 days in the same radiation dose range. Pseudomonas-contaminated animals irradiated within this transitional dose range had maximum concentrations of total bacteria and Pseudomonas in their livers at the time of death. However, liver bacteria concentration was usually higher in gamma-irradiated animals, due to a smaller contribution of hematopoietic injury in neutron-irradiated animals. The effects of both decontamination of the GI tract and Pseudomonas contamination of the GI tract were negligible in the range of doses in which median survival time was dose independent, i.e., in the pure "intestinal death" dose range. Finally, despite the marked changes in survival time produced by decontamination or Pseudomonas contamination in the "transitional dose range," these treatments had little effect on ultimate survival after irradiation as measured by the LD50/5 day and the LD50/30 day end points. The implications of these results with respect to treatment of acute radiation injury after whole-body irradiation are discussed.

Animals↗

PubMed1983

Total intestinal decontamination for prevention of infection in bone marrow transplantation.

In an attempt to prevent infections complicating bone marrow transplantation, 22 patients received oral nonabsorbable antibiotics in protected environments. The standard antibiotic regimen consisted of gentamicin, vancomycin and nystatin. The vast majority of fecal organisms initially cultured were completely suppressed by about one week after initiation of antibiotic prophylaxis. The antibiotics had to be taken regularly to keep the gastrointestinal tract decontaminated. However, Candida was often cultured despite prophylaxis. The best method for continuously suppressing Candida was considered to be administering an adequate antifungal drug before intestinal decontamination. The throat, however, was far more difficult to decontaminate than the stool. Lincomycin inhalation was most effective in suppressing anaerobic bacteria. Some of the organisms cultured persistently or intermittently from the throat tended to appear sooner or later in the stool during prophylaxis, although they were not always resistant. The pattern of reappearance of the fecal flora after intestinal decontamination was similar to that observed in newborn infants. However, none of the Enterobacteriaceae strains which reappeared in the stool were identical to those cultured initially. Absorption of gentamicin and vancomycin from the gastrointestinal tract was negligible. A gentamicin-induced small-colony variant of Klebsiella pneumoniae was isolated from one patient. Amphotericin B was more tolerable than nystatin, which often produced nausea and vomiting in association with the preparative radio-chemotherapy for marrow transplantation. Hypoprothrombinemia and hypocholesterolemia were noted during prophylaxis. Three episodes of exogenous bacterial infection occurred despite strict isolation procedures.

Adolescent↗

PubMed1993

The value of surveillance cultures in neutropenic patients receiving selective intestinal decontamination.

230 neutropenic episodes in 84 patients with acute myeloid leukemia receiving selective intestinal decontamination were studied to evaluate the ability of surveillance cultures to monitor the efficacy of microbial suppression, to identify causative organisms in case of fever, and to predict infection due to potential pathogens (i.e. Staphylococcus aureus and aerobic Gram-negative bacteria). Most cultures became negative soon after the administration of prophylactic antibiotics and there were only few persistent colonizations. 14 potential pathogens resistant to the intestinal decontamination regimen were isolated in surveillance cultures, none of which caused infection. Of the 212 febrile episodes, only 22 were caused by a microbiologically documented infection with potential pathogens. Most microbiologically documented infections were caused by organisms not routinely identified by surveillance cultures, indicating efficient selective intestinal decontamination. Only 9 (41%) of the 22 infections with potential pathogens were predicted by surveillance cultures. We conclude that surveillance cultures are of limited use in predicting infection or identifying causative organisms of fever in neutropenic patients receiving selective intestinal decontamination. However, they are useful in monitoring the efficacy of microbial suppression. One set of surveillance cultures each week after the disappearance of potential pathogens would be sufficient.

Adult↗