Semmelweis' sesquicentennial: a little-noted anniversary of handwashing.

This review describes Semmelweis' achievement 150 years ago. User acceptability of hand disinfectants has been improved, but Semmelweis' observation that handwashing, in contrast to hygienic hand disinfection, is not always sufficiently effective, is not yet generally acknowledged, and the compliance of medical personnel to the rules of hand hygiene still remains an educational problem to be solved.

Performance of a new chromogenic oxacillin resistance screen medium (Oxoid) in the detection and presumptive identification of methicillin-resistant Staphylococcus aureus.

A new chromogenic Oxacillin Resistance Screen Agar (ORSA; Oxoid) for the presumptive detection of methicillin-resistant Staphylococcus aureus (MRSA) was compared to a phenyl-mannitol-salt-oxacillin medium (MS-Oxa), blood agar and brain heart-infusion (BHI) on 579 clinical specimens. After 24 h [48h] sensitivity and specificity for ORSA vs. MS-Oxa were 50.

Sensor-operated faucets: a possible source of nosocomial infection?

Recently, contamination of sensor-operated faucets (SOFs) with Pseudomonas aeruginosa was observed. To evaluate odds ratios, we conducted a case-control study in which handle-operated faucets served as controls. No statistically significant difference in P.

Arguments for alcoholic hand disinfection.

The non-aqueous use of ethanol or propanols offers various advantages over washing hands with either unmedicated or medicated soap in both hygienic and surgical hand disinfection. Alcohols exert the strongest and fastest activity against a wide spectrum of bacteria and fungi (but not bacterial spores) as well as enveloped (but less so against non-enveloped) viruses, being little influenced by interfering substances. They are of low toxicity and offer acceptable skin tolerability when made up with suitable emollients.

Performance of candida ID, a new chromogenic medium for presumptive identification of Candida species, in comparison to CHROMagar Candida.

Candida ID agar allows identification of Candida albicans and differentiation of other Candida species. In comparison with CHROMagar Candida, we evaluated the performance of this medium directly from 596 clinical specimens. In particular, detection of C.

Hygiene and health - the need for a holistic approach.

The holistic principles of hygiene and public health have contributed substantially to an increase in life expectancy by more than 30 years and in life quality since the beginning of the 20th century. Frank, Pettenkofer, Nightingale, Pasteur, Lister, and Koch have been pioneering protagonists of the holistic approach to hygiene and public health. Socioeconomic development and related factors such as nutrition status and food hygiene, housing conditions, water supply and sewage systems, and education (including motivation for personal hygiene) have obviously been of more importance for life expectancy and life quality than progress in curative medicine, such as availability of microbial diagnosis, vaccination, and antibiotics.

Urease prevents adherence of Helicobacter pylori to Kato III gastric epithelial cells.

The role of urease in Helicobacter pylori adherence to and internalization by Kato III cells was investigated. Kato III cells were incubated with wild-type strains (N6 or P1), with isogenic mutants lacking urease (N6ureB::TnKm or P1ureA::TnMax5) or producing the inactive apoprotein (N6ureG::TnKm), and with urease-positive clones recovered after complementation of N6ureB::TnKm with ureAB. Bacteria were stained with the green fluorescent dye PKH2, and the bacteria load of cells was analyzed by flow cytometry.

Two enzyme immunoassays and PCR for detection of Helicobacter pylori in stool specimens from pediatric patients before and after eradication therapy.

This study of pediatric patients was intended to determine the suitability of stool PCR and two antigen enzyme immunoassays (EIAs; Premier Platinum HpSA and the novel FemtoLab H. pylori), which detect Helicobacter pylori antigens in feces, as pretreatment diagnostic tools and especially as posttreatment control. Forty-nine H.

In vitro activities of linezolid alone and in combination with amoxicillin, clarithromycin, and metronidazole against Helicobacter pylori.

Linezolid was tested against 70 strains of Helicobacter pylori by the agar dilution method. The MIC range and MICs at which 50 and 90% of strains were inhibited were 8 to 64, 16, and 32 microgram/ml, respectively. With minimum and maximum fractional inhibitory concentration summation values of 0.

Recent advances in cryptococcosis, candidiasis and coccidioidomycosis complicating HIV infection.

Concomitant with the decline in CD4+ T-cells seen as human immunodeficiency virus (HIV) infection progresses, the prevalence of opportunistic mycoses increases dramatically. This article reviews selected recent advances in our understanding of the immunology, molecular epidemiology and treatment of fungal infections in patients infected with HIV. For cryptococcosis, studies are reported on how HIV infection affects the immune response to Cryptococcus neoformans and, conversely, how stimulation with C.

Helicobacter pylori urease significantly reduces opsonization by human complement.

The role of Helicobacter pylori urease in opsonization by human complement was investigated. H. pylori wild type strain N6 and isogenic mutants lacking either the large urease subunit (UreB) or an accessory urease protein (UreG) were incubated with different sera.

Detection of Helicobacter pylori in stool specimens by PCR and antigen enzyme immunoassay.

A highly sensitive seminested PCR assay to detect Helicobacter pylori DNA in feces was developed. PCR with stool specimens and a novel antigen enzyme immunoassay (EIA) for H. pylori detection in feces were evaluated as diagnostic tools and in follow-up with samples from 63 infected and 37 noninfected persons.

Immune response to hepatitis A virus capsid proteins after infection.

This study was undertaken to determine the immune response of humans to viral capsid polypeptides of hepatitis A virus (HAV) after natural infection, which is very important for vaccine development. Antiviral capsids in 73 serum samples from patients with acute and chronic HAV infections were analyzed by immunoblotting against individual HAV capsid polypeptides (VP1, VP2, VP3, and VP4) by using a cell culture-based HAV antigen. For reference, total anti-HAV immunoglobulin G (IgG) and anti-HAV IgM were also determined by radioimmunoassay.

Do 'chlorine covers' exert a sustained bactericidal effect on the bacterial hand flora?

Treatment of skin with chlorine generates 'chlorine covers' which, in a previous study, exerted significant sustained bactericidal effects against transient skin flora on the upper arm and forearm. In this investigation, this effect was studied on both the transient and resident flora of the hands using test models for the evaluation of hand disinfectants as agreed upon in Austria and Germany. Chlorine covers were generated by bathing hands in a solution of 2% sodium tosylchloramide for 1 min.

Test models for hygienic handrub and hygienic handwash: the effects of two different contamination and sampling techniques.

Two methods for artificial contamination of hands and two sampling techniques to recover the test organisms were compared for their effects on the results of two post-contamination hand treatments: a handrub with two portions of 3 ml of 2-propanol 60% v/v for 1 min, and a handwash with liquid soap 20% w/v for 1 min followed by a 15 s rinse. The two contamination methods involved a short immersion of the hands (up to the middle of the mid-hand) in a suspension of the test organism followed by either air-drying (3 min) or drying by rubbing the hands' vigorously against each other (3 min) in a standardized way. The two sampling techniques consisted of rubbing the fingertips in either 10 ml trypticase soy broth (TSB) against the bottom of a Petri dish; or 100 ml TSB against glass beads contained in a bowl.

Surgical hand disinfection: effect of sequential use of two chlorhexidine preparations.

The antimicrobial efficacy of three 'two-phase' surgical hand disinfection procedures was compared, in a volunteer study, to 60% n-propanol, applied for 5 min, which is the reference hand-disinfection procedure used in Austria and West Germany (FRG). The procedures involved sequential use of unmedicated soap or a disinfectant-detergent containing 4% chlorhexidine gluconate (CHX; 'Hibiscrub') followed by a handrub preparation containing 70% w/w isopropanol plus 0.5% CHX ('Hibisol').

Effect of chlorhexidine-containing detergent, non-medicated soap or isopropanol and the influence of neutralizer on bacterial pathogenicity.

In handwashing experiments with Salmonella typhimurium the effect of chlorhexidine (CHX) on the pathogenicity of surviving bacteria was assessed with and without a neutralizer in a mouse model of infection. Without neutralizer the LD50 of CHX handwash fluids was raised. Neutralizer in suspensions of untreated bacteria caused a reduction of LD50 up to 1.

Resistance to antibiotics in humans and animals on the Cape Verde Islands.

From the Cape Verde Islands no studies are known about an efficient treatment with antibiotics and chemotherapeutics. Because of this human samples and samples of domestic animals were collected, the different bacterias were isolated and the antibiograms were analyzed by agar-diffusions-test. The human samples consisted of wound-, eye-, anal-, vaginal- and throat-smears, the animal samples consisted of jaw-, anal- and wound-smears.

Serological investigations for the cause of diarrhoea among patients and personnel in the Minna and Abeokuta Hospitals/Nigeria.

188 blood samples were investigated for antibodies against bacteria causing diarrhoea in two hospitals in Minna and Abeokuta in Nigeria. Antibodies were found against Entamoeba histolytica, Yersinia enterocolitica, Campylobacter jejuni, Salmonella typhi, Salmonella paratyphi C, Shigella dysenteriae, Shigella sonnei, Shigella boydii, Shigella flexneri and Rotavirus.

Serological investigations in Nigeria for anthropozoonoses in human sera: brucellosis, echinococcosis, toxoplasmosis, chlamydial diseases, listeriosis, rickettsiosis (Coxiella burneti and Rickettsia conori).

176 blood sera taken from patients in the hospital of Minna and Abeokuta (Nigeria) were examined for anthropozoonoses. The following positive reactions could be found: Brucella abortus 9%, Brucella melitensis 11.7%, Echinococcosis 0.

Serological testing of human blood samples for infectious diseases in the Abeokuta and the Minna Hospitals/Nigeria.

In serological investigations undertaken in two hospitals in Nigeria a total of 188 blood samples were examined and the following positive reactions for various diseases found: malaria 100%, leishmaniasis 9.5%, biharziasis 2.1%, yersinia 16.

Investigations in the problem of diarrhoea in the Melut district, South Sudan (1981-1982).

Studies of diseases associated with diarrhoea in the Melut district of South Sudan in the years 1981-1982 showed amoebic dysentery and Rota-virus to be predominate, whereby according to our previous results Yersinia, Campylobacter, Shigella and Salmonella infections also play a role. In addition other parasitological bacterial and viral-infections are presumed.

Serological investigations on syphilis in the District of Santa Cruz/Santiago (Cape Verde Islands--West Africa).

In the region of Santa Cruz on the Santiago Island 316 sera samples were examined for syphilis antibodies using the TPHA and VDRL tests. 3.8% of the samples showed positive reactions.

Physiological characterization of heterotrophic bacterial communities from selected aquatic environments.

Three different biotopes, groundwater, surface water, and activated sludge, were examined and the total colony count on nutrient agar determined. The bacteria that could be isolated from the agar plates were identified and their in vitro activities investigated. Three principal approaches were used: (1) isolates were identified and the results used in a numerical analysis to determine their similarity; (2) the different physiological properties of isolates originating from a single biotope were compiled and used to characterize the community (collective total activity); and (3) the diversity of the physiological properties of the isolates of all populations was determined; on the basis of main characters a "heterotrophic" diversity index was calculated.