Evaluation of the microbicidal efficacy of Steris System I for digestive endoscopes using GERMANDE and ASTM validation protocols.

In the light of more and more invasive procedures being carried out in digestive endoscopy using sterile devices, it appears necessary to put in place a process of endoscope reprocessing capable of ensuring the complete elimination of micro-organisms contaminating the device. We undertook a study of the microbial efficacy of STERIS SYSTEM 1 (SS1) which purports to achieve this objective. The channels of a gastroscope and a colonoscope were contaminated with suspensions of Pseudomonas aeruginosa, Aspergillus niger and Bacillus subtilis spores.

[Evaluation of 7 endoscope washer-disinfectors: bactericidal activity of the disinfectants, antibacterial efficacity of paired washer-disinfector products].

The authors studied seven automatic washer disinfectors for flexible endoscopes with two methods. The first method, a microdilution method, studied the bactericidal activity of the seven disinfectants against 21 strains: four reference strains, 14 hospital strains reported in the literature as nosocomial strains responsible for infections transmitted by flexible endoscopes and three vancomycin-resistant Enterococci. The ability of the seven automatic washer disinfectors to decontaminate flexible endoscopes following inoculation with four reference strains was studied with the second method.

[Validation of a sampling method for the channels of a flexible endoscope which is experimentally contaminated].

The increase of endoscopic actions and infectious risks explains of interest in endoscopic material maintenance processing. This purpose study was to set to the point and validate a microbiological flexibles endoscopes channels (suction, biopsy, air/water) sample method. An inoculum made of faeces contents material and microorganisms suspension (Pseudomonas aeruginosa or Candida albicans), at low or high concentration, was injected into digestive endoscope's channels.

Unusual cause of lethal pulmonary aspergillosis in patients with chronic obstructive pulmonary disease.

Two patients admitted to two different medical wards of our institution following respiratory decompensation of chronic obstructive pulmonary disease (COPD) were subsequently transferred to the same room of the medical intensive care unit (ICU) and intubated. Both patients developed invasive pulmonary aspergillosis and died soon after. Because COPD itself is rarely associated with lethal pulmonary aspergillosis, both cases were reviewed, and a retrospective investigation was conducted.

Infectious risk factors related to operating rooms.

Risk factors related to operating rooms include patient-associated risks, the operating room environment, ventilation systems, cleansing and sterilization, and operating room personnel. Although constantly debated, surgical wound infection surveillance with appropriate feedback to surgeons is one of the few effective measures that helps reduce surgical infection rates, and we strongly recommend its use. We also recommend the further study of other potential components of effective infection control programs for surgical patients.

[Biocontamination, European standardization and pharmaceutical industry].

The coming to light of new concepts in environmental microbiology, particularly the notions of bacterial adhesion and of biofilm or of cells in starvation, conducted to an evolution of the standardization of the controlled contamination area. It is necessary to match to the biocontamination of hazard area the principles governing the quality insurance used in alimentary industry named HACCP (hazard analysis of control critical point). This method will have to be applied wilfully to all the fields where a patient or a product risk a biocontamination.

[Verification of bacteriological safety of PCM 40 air conditioner].

This study assessed the bacteriological safety of the bedside air conditioner PCM 40 (Howorth Airtech), used for prevention of intraoperative hypothermia, by blowing filtered warm air through a special mattress. The 3 microns bacterial filter of the device released 2,968 +/- 5,618 particles of diameter less than 3 microns per m3 of room air, containing 78,798 +/- 37,243 of such particles per m3. The amount of bacteries in the air pulsed from the mattress was 30 +/- 41 cfu/m3 vs 120 cfu/m3 in the ambient air and in the hot air supply tubing it reached 6 +/- 5 cfu/m3 vs 175 +/- 77 cfu/m3.

[A pilot test of the efficacy of a povidone-iodine-based surgical soap].

A PVP-iodine containing surgical soap (low-iodine) was tested by 20 volunteers (14 women and 6 men) under conditions usually present in surgical clinics. The results proved the efficacy of this soap, as its usage entails a significant decrease in the number of germs. Two of the volunteers presented diverging results.

[Efficacy of 2 antiseptics intended for the disinfection of normal skin].

In Switzerland, antiseptics must be checked for their "in use" efficacy before being admitted by the Federal Office of Public Health (FOPH). Betadine solution standardized and Merfen tincture widely used in Swiss hospitals for skin disinfection, were compared following federal prescriptions. Tests were performed by the technique of Williamson and Kligman modified by Fleurette and Transy.

[Antibiotic sensitivity of strains of Klebsiella isolated in Geneva and Algiers].

573 strains of Klebsiella were isolated in Geneva (239 strains) and in Algiers (334 strains). The complete work with bacteriologic features (culture, biochemistry and antigenicity) will be published later. Two investigations took place in surgical cardio-vascular service in Geneva cantonal hospital and in Algiers hospitals: Pediatric (Beni-Messous) and intensive care service (Mustapha).

An international survey of the prevalence of hospital-acquired infection.

The prevalence of hospital-acquired infection was measured in 47 hospitals in 14 countries in four continents. The aim was to establish the evidence that hospital infection is a common and serious problem throughout the world. Using a standard protocol, 28,861 patients were observed by local teams of doctors and nurses in their own hospitals.

[Nosocomial infections in the intensive care unit].

The conflict between hosts and microorganisms evidences the breakdown in the hosts' defence system or the acquisition of characters new to the infectious agents; it occurs constantly in the hospital environment and particularly in surgical intensive care units, due to the weakened defence system in the patient, contact with infected material, contamination of the environment, and resistance of microorganisms to antibiotics. The sources of infectious agents are the patient himself, other patients, hospital personnel, visitors, inanimate surroundings, the air, materials used and/or nutrition, liquids, drugs, dressings, drainage, etc. These microorganisms cause postoperative infections, urinary tract and respiratory tract infections, and systemic infections.

[Bacteriological safety of enteral nutrition with continuous delivery].

Enteral nutrition can be administered as bolus feedings or by pump-assisted continuous drip. We have compared these two techniques in regard to bacterial contamination of nutritional solutions for given periods of administration set utilisation. A total of 103 patients were treated for 3 months.

Nosocomial infections due to Pseudomonas aeruginosa: review of recent trends.

The role of Pseudomonas aeruginosa in nosocomial infections occurring since 1975 is reviewed. Data from the National Nosocomial Infections Study conducted by the Centers for Disease Control, from individual medical centers, and from the literature were used to compare the relative frequency of occurrence of nosocomial infection caused by P. aeruginosa with that of infection caused by other gram-negative bacilli.

[Influence of cimetidine on bacterial growth in gastric fluid (author's transl)].

Samples of gastric fluid were tested for pH and number of bacteria in 20 patients who received cimetidine 400 mg prior to selective gastric surgery. The results were compared with those obtained in a group of surgical patients who did not receive the drug. The cimetidine-treated patients had alkaline gastric fluid with pronounced bacterial growth (4.

[Evolution of the intestinal flora in patients under preventive treatment with cephalosporins].

The evolution of the intestinal flora has been studied in 20 patients undergoing chemoprophylaxis with cephalosporins. The patients, admitted to the Cantonal Hospital of Geneva for heart surgery, all received intravenous treatment initiated on the day of admission. Subsequently, one group continued to receive a cephalosporin orally while prophylaxis was discontinued in a second group.