Background: The environment has increasingly been shown to be involved in transmission of healthcare-associated infections, but data on environmental cleanliness assessment are relatively sparse. ...Method: Environmental samples were collected from 18 high touch surfaces in 10 different acute care hospital rooms before cleaning to provide data on the rank order of cleanliness by site using both adenosine triphosphate (ATP) detection and quantitative microbiology. In addition, pre- and post-cleaning pooled samples of surfaces from 10 rooms were analysed by culture and sensitivity analysis to detect organisms of concern in the hospital. Results: Four surfaces were ranked in the top six for contamination by both ATP and culture detection (bedrail control panel, nurse call light, patient phone, and bedrail). Additionally, the top three areas for cleanliness were identical between the two methods (main light switch, mattress, and bathroom interior door handle). Overall, quantitative microbiology and ATP analysis showed directional agreement in assessment of environmental cleanliness with higher ATP readings found on surfaces designated as 'dirty' by quantitative microbiology. Several organisms of concern for hospital infection control were seldom detected in the pre-cleaning environmental samples, and not at all in the post-cleaning samples. Conclusions: In this study environmental bioburden decreased after cleaning, and few hazardous nosocomial organisms were noted. Although quantitative microbiology and ATP detection measure somewhat different aspects of environmental contamination, they both generally agree in distinguishing clean from dirty surfaces.
The ability to decontaminate a room potentially containing the Ebola virus is important to healthcare facilities in the United States. The Ebola virus remains viable in body fluids, a room that has ...housed a patient with Ebola virus disease must have all surfaces manually wiped with an approved disinfectant, which increases occupational exposure risk. This study evaluated the efficacy of gaseous chlorine dioxide inactivation of bacterial organisms in blood as the Ebola virus surrogates and as the organisms used by the Nebraska Biocontainment Unit to provide the margin of safety for decontamination. Bacillus anthracis, Escherichia coli, Enterococcus faecalis, and Mycobacterium smegmatis blood suspensions that were exposed to ClO
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gas concentrations and exposure limits. The log reduction in Colony Forming Units (CFU) was determined for each bacterial blood suspension. Exposure parameters approximating industry practices for ClO
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environmental decontamination (360 ppm concentration to 780 ppm-hr exposure, 65% relative humidity) as well as parameters exceeding current practice (1116 ppm concentration to 1400 ppm-hr exposure; 1342 ppm concentration to 1487 ppm-hr exposure) were evaluated. Complete inactivation was not achieved for any of the bacterial blood suspensions tested. Reductions were observed in concentrations of B. anthracis spores (1.3-3.76 log) and E. faecalis vegetative cells (1.3 log) whereas significant reductions in vegetative cell concentrations for E. coli and M. smegmatis blood suspensions were not achieved. Our results showed that bacteria in the presence of blood were not inactivated using gaseous ClO
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decontamination. ClO
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decontamination alone should not be used for the Ebola virus, but decontamination processes should first include manual wiping of potentially contaminated blood; especially for microorganisms as infectious as the Ebola virus.
The lack of rapid diagnostic procedures is a major obstacle in the successful management of fungal disease. Most of the methods now used in the microbiology laboratory include growth-based phenotypic ...testing. However, polymerase chain reaction (PCR) has allowed for rapid identification of organism without the need for a growing culture. An ion-paired reverse phase chromatography (IP-RP)-based assay using high performance liquid chromatography (HPLC) was developed with commercially available IP-RP-HPLC system called the WAVE to differentiate medically important fungi. Universal fungus-specific primers and restriction fragment length polymorphism (RFLP) of PCR amplicon were done prior to WAVE analysis. The assay was enhanced when combined with a searchable relational database of retention time. Discrimination among closely related fungal species was possible by evaluation of distinct-retention time patterns. This assay is simple, rapid, and allows for the identification of medically important fungi by searching the database with the information obtained from PCR-WAVE analysis
Roentgenographic complete gastric emptying times using dilute barium were measured in 31 conditioned mongrel dogs (1) under normal or basal conditions, (2) after subdiaphragmatic complete truncal ...vagotomy, and (3) after four different methods of gastric drainage. The drainage procedures in 24 dogs were divided into four groups of six dogs each: (1) Heineke-Mikulicz two-layer (HM1) pyloroplasty; (3) Finney pyloroplasty (FP); and (4) the Ramstedt pyloromyotomy (RP). Using the same protocol for measuring complete gastric emptying, a fifth group of seven dogs underwent two gastric drainage procedures each: RP followed by subsequent conversion to the HM1. The statistical comparison to these procedures for adequacy of gastric drainage demonstrated no significant differences or superiority of any procedure in the groups of animals tested.
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