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Fulltext Bacterial contamination of a closed enteral feeding system: difference between laboratory evaluation and clinical experience

Ngeow YF, Chan L, Yasmin AH, Ong GS

Med J Malaysia, 1994 Dec;49(4):427.
PMID: 7674983
Matched MeSH terms: Equipment Contamination*
Fulltext Microbial contamination of orthodontic buccal tubes from manufacturers

Purmal K, Chin S, Pinto J, Yin WF, Chan KG

Int J Mol Sci, 2010 Sep 16;11(9):3349-56.
PMID: 20957099 DOI: 10.3390/ijms11093349

This study aimed to test the sterility of new unused orthodontic buccal tubes received from manufacturers. Four different types of buccal tubes were used straight from the manufactures package without any additional sterilizing step. Of these buccal tubes tested, three genera of bacteria, implicated as opportunistic pathogens, namely Micrococcus luteus, Staphylococcus haemolyticus and Acinetobacter calcoaceticus were recovered from these buccal tubes. Our data showing microbial contamination on buccal tubes highlights the need of sterilization before clinical use. We also suggest that manufacturers should list the sterility state of orthodontic buccal tubes on their packaging or instructions stating the need for sterilization.

Matched MeSH terms: Equipment Contamination*
Physical methods of reducing the transmission of nosocomial infections via ultrasound and probe

Abdullah BJ, Mohd Yusof MY, Khoo BH

Clin Radiol, 1998 Mar;53(3):212-4.
PMID: 9528873

Nosocomial infections are posing an increasingly serious problem in the hospital setting. With the increasing use of ultrasound in medical diagnosis, there is the potential for transmission of nosocomial infections via the ultrasound transducer and coupling gel. We evaluated the use of different membranes (three types of commercially available household cling film, condom, surgical glove and Opsite) applied over the ultrasound probe to determine if these were safe, convenient, cost-effective and did not impair the performance parameters of the ultrasound probe. None of the membranes impaired the physical scanning parameters using a Multi-Purpose Tissue/Cyst Phantom. The cling film was ideal for general use in terms of cost and convenience as well as safety. For sterile use the Opsite was better overall compared to the surgical glove, though it costs significantly more. The condom and surgical glove, though safe, were not very convenient to use for scanning.

Matched MeSH terms: Equipment Contamination*
Fulltext The stethoscope and the transfer of bacteria in the neonatal nursery

Boo NY, Wong YH, Khoo AK

Med J Malaysia, 1989 Mar;44(1):87-8.
PMID: 2696869
Matched MeSH terms: Equipment Contamination/prevention & control*
Fulltext Evaluation of the bacteriological contamination of a closed feeding system for enteral nutrition

Chan L, Yasmin AH, Ngeow YF, Ong GS

Med J Malaysia, 1994 Mar;49(1):62-7.
PMID: 8057993

A closed enteral delivery system consisting of a cardboard tetrapack containing the sterile ready-to-use liquid feed and an independent sterile administration set, has been devised. We found bacterial contamination within 24 hours in this system in patients on ventilatory support in intensive care. This emphasises the need for meticulous care in handling enteral feeding systems to prevent environmental contamination.

Matched MeSH terms: Equipment Contamination/prevention & control; Equipment Contamination/statistics & numerical data*
Free-living ciliates in CSF of a patient with meningoencephalitis: a contaminant?

Isa NH, Sulaiman S, Shahid MS, Rose IM, Eugene CB

Southeast Asian J. Trop. Med. Public Health, 1994 Mar;25(1):212-4.
PMID: 7825018
Matched MeSH terms: Equipment Contamination*
The Potential Source of B. licheniformis Contamination During Whey Protein Concentrate 80 Manufacture

Md Zain SN, Bennett R, Flint S

J Food Sci, 2017 Mar;82(3):751-756.
PMID: 28135405 DOI: 10.1111/1750-3841.13633

The objective of this study was to determine the possible source of predominant Bacillus licheniformis contamination in a whey protein concentrate (WPC) 80 manufacturing plant. Traditionally, microbial contaminants of WPC were believed to grow on the membrane surfaces of the ultrafiltration plant as this represents the largest surface area in the plant. Changes from hot to cold ultrafiltration have reduced the growth potential for bacteria on the membrane surfaces. Our recent studies of WPCs have shown the predominant microflora B. licheniformis would not grow in the membrane plant because of the low temperature (10 °C) and must be growing elsewhere. Contamination of dairy products is mostly due to bacteria being released from biofilm in the processing plant rather from the farm itself. Three different reconstituted WPC media at 1%, 5%, and 20% were used for biofilm growth and our results showed that B. licheniformis formed the best biofilm at 1% (low solids). Further investigations were done using 3 different media; tryptic soy broth, 1% reconstituted WPC80, and 1% reconstituted WPC80 enriched with lactose and minerals to examine biofilm growth of B. licheniformis on stainless steel. Thirty-three B. licheniformis isolates varied in their ability to form biofilm on stainless steel with stronger biofilm in the presence of minerals. The source of biofilms of thermo-resistant bacteria such as B. licheniformis is believed to be before the ultrafiltration zone represented by the 1% WPC with lactose and minerals where the whey protein concentration is about 0.6%.

Matched MeSH terms: Equipment Contamination*
Fulltext High Occurrence of Staphylococcus aureus Isolated from Fitness Equipment from Selected Gymnasiums

Maurice Bilung L, Tahar AS, Kira R, Mohd Rozali AA, Apun K

J Environ Public Health, 2018;2018:4592830.
PMID: 30245728 DOI: 10.1155/2018/4592830

Introduction: Staphylococcus aureus is a leading cause of cutaneous bacterial infection involving community.
Methods: In this study, a total of 42 swab samples were collected from the surface of various fitness equipment such as back machines, exercise mats, dip stations, dumbbells, and treadmills. Identification of the bacterial isolates was conducted using biochemical tests and further analysed molecularly using the PCR method targeting nuc gene (270 bp). The nuc gene encodes for the thermonuclease enzyme, a virulent factor of S. aureus.
Results: The findings showed 31 out of 42 swab samples (73.81%) were positive with S. aureus.
Conclusion: This study showed that gymnasium equipment is a potential reservoir for S. aureus and might play an important role in transmitting the pathogen to humans.
Objective: This study was undertaken to assess the presence of S. aureus on the surface of fitness equipment from selected gymnasiums in Kuching and Kota Samarahan, Sarawak (Malaysia).

Matched MeSH terms: Equipment Contamination/statistics & numerical data*
Incidence of meticillin-resistant Staphylococcus aureus contamination on mobile phones of medical students

Goh ZNL, Chung PY

J Hosp Infect, 2019 Apr;101(4):482-483.
PMID: 30711530 DOI: 10.1016/j.jhin.2019.01.022
Matched MeSH terms: Equipment Contamination/statistics & numerical data*
Norovirus cross-contamination during food handling and interruption of virus transfer by hand antisepsis: experiments with feline calicivirus as a surrogate

Bidawid S, Malik N, Adegbunrin O, Sattar SA, Farber JM

J Food Prot, 2004 Jan;67(1):103-9.
PMID: 14717359

While there is good epidemiological evidence for foods as vehicles for norovirus transmission, the precise means of spread and its control remain unknown. The feline calicivirus was used as a surrogate for noroviruses to study infectious virus transfer between hands and selected types of foods and environmental surfaces. Assessment of the potential of selected topicals in interrupting such virus transfer was also made. Ten microliters of inoculum of feline calicivirus deposited onto each fingerpad of adult subjects was allowed to air dry and the contaminated area on individual fingerpads was pressed (10 s at a pressure of 0.2 to 0.4 kg/cm2) onto 1-cm-diameter disks of ham, lettuce, or brushed stainless steel. The virus remaining on the donor and that transferred to the recipient surfaces was eluted and plaque assayed. Virus transfer to clean hands from experimentally contaminated disks of ham, lettuce, and stainless steel was also tested. Nearly 46 +/- 20.3, 18 +/- 5.7, and 13 +/- 3.6% of infectious virus was transferred from contaminated fingerpads to ham, lettuce, and metal disks, respectively. In contrast, approximately 6 +/- 1.8, 14 +/- 3.5, and 7 +/- 1.9% virus transfer occurred, respectively, from ham, lettuce, and metal disks to hands. One-way analysis of variance test showed that pretreatment (washing) of the fingerpads either with water or with both topical agent and water significantly (P < 0.05) reduced virus transfer to < or = 0.9%, as compared with < or = 2.3 and < or = 3.4% transfer following treatments with either 75% (vol/vol) ethanol or a commercial hand gel containing 62% ethanol, respectively. Despite wide variations in virus transfer among the targeted items used, intervention agents tested reduced virus transfer significantly (P < 0.05) when compared with that without such treatments (71 +/- 8.9%). These findings should help in a better assessment of the potential for cross-contamination of foods during handling and also assist in developing more effective approaches to foodborne spread of norovirus infections.

Matched MeSH terms: Equipment Contamination*
Campylobacter in chicken carcasses and slaughterhouses in Malaysia

Rejab SB, Zessin KH, Fries R, Patchanee P

Southeast Asian J. Trop. Med. Public Health, 2012 Jan;43(1):96-104.
PMID: 23082559

This study was conducted to determine the Campylobacter contamination rate of chicken carcasses and the processing lines of modern processing plants in Malaysia. Three hundred sixty samples were collected from 24 flocks of broiler chickens at 12 modern poultry processing plants in 6 states of Malaysia. Fresh fecal droppings were collected from crates in the arrival area. Neck skin samples were taken from processed chicken carcasses at 3 different processing stages: before inside-outside washing, after inside-outside washing and post chilling. Swab samples from the scalding tank, chilling tank and conveyer belt before chilling were also collected to determine contamination with Campylobacter in the slaughter house environment prior to slaughter. Isolation for Campylobacter was performed following ISO 10272-1:2006(E). The overall of contamination rate with Campylobacter at the 12 plants was 61.0% (220/360). Eighty point six percent of the samples from before the inside-outside wishing step were contaminated with Campylobacter, as were 62.5% of the samples after the inside washing and 38.9% after the post-chilling step. This study shows extensive contamination of chicken carcasses and slaughtering houses in Malaysia with Campylobacter.

Matched MeSH terms: Equipment Contamination
Fulltext Practice of endoscopy during COVID-19 pandemic: position statements of the Asian Pacific Society for Digestive Endoscopy (APSDE-COVID statements)

Chiu PWY, Ng SC, Inoue H, Reddy DN, Ling Hu E, Cho JY, et al.

Gut, 2020 Jun;69(6):991-996.
PMID: 32241897 DOI: 10.1136/gutjnl-2020-321185

Coronavirus-19 (COVID-19) caused by SARS-CoV-2 has become a global pandemic. Risk of transmission may occur during endoscopy and the goal is to prevent infection among healthcare professionals while providing essential services to patients. Asia was the first continent to have a COVID-19 outbreak, and this position statement of the Asian Pacific Society for Digestive Endoscopy shares our successful experience in maintaining safe and high-quality endoscopy practice at a time when resources are limited. Sixteen experts from key societies of digestive endoscopy in Asia were invited to develop position statements, including patient triage and risk assessment before endoscopy, resource prioritisation and allocation, regular monitoring of personal protective equipment, infection control measures, protective device training and implementation of a strategy for stepwise resumption of endoscopy services after control of the COVID-19 outbreak.

Matched MeSH terms: Equipment Contamination
Fulltext Can the use of 70% isopropyl alcohol swab or aspiration using 5 microm Filter Straw reduce bacterial contamination of fentanyl solution used for regional anaesthesia?

Roshaliza HM, Liu CY, Joanna OSM

Med J Malaysia, 2011 Jun;66(2):92-4.
PMID: 22106684

This prospective study aimed to determine the extent of contamination of fentanyl solutions used for central neuraxial injection by wiping the neck of the ampoules with 70% isopropyl alcohol swabs (Kendall) before breaking open the ampoules and aspiration of fentanyl solutions using a 5 microm Filter Straw (B. Braun). In Group A, fifty fentanyl ampoules were wiped with 70% isopropyl alcohol swab prior to opening and the contents were aspirated immediately using a 21G needle and a 5 microm filter straw for culture. The same steps were repeated on the remaining solutions after two hours. In Group B, all the above steps were repeated but without wiping the ampoules with 70% isopropyl alcohol swabs. None of the samples from the wiped ampoules or aspiration using filter straw grew microorganisms. Six percent of the samples from unwiped group grew microorganisms when fentanyl were aspirated using a 21G needle and the contamination increased to 16% when repeated after two hours. Wiping the outsides of the fentanyl ampoules with 70% isopropyl alcohol swabs before opening or aspirating the contents using a 5 pm filter straw has been shown to be equally effective in avoiding bacterial contamination and should be practiced routinely when performing regional anaesthesia.
KEY WORDS: Fentanyl solution, Isopropyl alcohol swab, Filter straw, Contamination, Regional anaesthesia, Hospital Kuala Lumpur, Malaysia

Matched MeSH terms: Equipment Contamination/prevention & control
Fulltext Potential of Superhydrophobic Surface for Blood-Contacting Medical Devices

Wu XH, Liew YK, Mai CW, Then YY

Int J Mol Sci, 2021 Mar 24;22(7).
PMID: 33805207 DOI: 10.3390/ijms22073341

Medical devices are indispensable in the healthcare setting, ranging from diagnostic tools to therapeutic instruments, and even supporting equipment. However, these medical devices may be associated with life-threatening complications when exposed to blood. To date, medical device-related infections have been a major drawback causing high mortality. Device-induced hemolysis, albeit often neglected, results in negative impacts, including thrombotic events. Various strategies have been approached to overcome these issues, but the outcomes are yet to be considered as successful. Recently, superhydrophobic materials or coatings have been brought to attention in various fields. Superhydrophobic surfaces are proposed to be ideal blood-compatible biomaterials attributed to their beneficial characteristics. Reports have substantiated the blood repellence of a superhydrophobic surface, which helps to prevent damage on blood cells upon cell-surface interaction, thereby alleviating subsequent complications. The anti-biofouling effect of superhydrophobic surfaces is also desired in medical devices as it resists the adhesion of organic substances, such as blood cells and microorganisms. In this review, we will focus on the discussion about the potential contribution of superhydrophobic surfaces on enhancing the hemocompatibility of blood-contacting medical devices.

Matched MeSH terms: Equipment Contamination/prevention & control*
Targeting cyst wall is an effective strategy in improving the efficacy of marketed contact lens disinfecting solutions against Acanthamoeba castellanii cysts

Abjani F, Khan NA, Yousuf FA, Siddiqui R

Cont Lens Anterior Eye, 2016 Jun;39(3):239-43.
PMID: 26675112 DOI: 10.1016/j.clae.2015.11.004

Acanthamoeba cysts are highly resistant to contact lens disinfecting solutions. Acanthamoeba cyst wall is partially made of 1,4 β-glucan (i.e., cellulose) and other complex polysaccharides making it a hardy shell that protects the resident amoeba. Here, we hypothesize that targeting the cyst wall structure in addition to antiamoebic compound would improve the efficacy of marketed contact lens disinfecting solutions. Using chlorhexidine as an antiamoebic compound and cellulase enzyme to disrupt cyst wall structure, the findings revealed that combination of both agents abolished viability of Acanthamoeba castellanii cysts and trophozoites. When tested alone, none of the agents nor contact lens disinfecting solutions completely destroyed A. castellanii cysts and trophozoites. The absence of cyst wall-degrading enzymes in marketed contact lens disinfecting solutions render them ineffective against Acanthamoeba cysts. It is concluded that the addition of cyst wall degrading molecules in contact lens disinfecting solutions will enhance their efficacy in decreasing the incidence of Acanthamoeba effectively.

Matched MeSH terms: Equipment Contamination/prevention & control*
Bacterial adherence and biofilm formation on medical implants: a review

Veerachamy S, Yarlagadda T, Manivasagam G, Yarlagadda PK

Proc Inst Mech Eng H, 2014 Oct;228(10):1083-99.
PMID: 25406229 DOI: 10.1177/0954411914556137

Biofilms are a complex group of microbial cells that adhere to the exopolysaccharide matrix present on the surface of medical devices. Biofilm-associated infections in the medical devices pose a serious problem to the public health and adversely affect the function of the device. Medical implants used in oral and orthopedic surgery are fabricated using alloys such as stainless steel and titanium. The biological behavior, such as osseointegration and its antibacterial activity, essentially depends on both the chemical composition and the morphology of the surface of the device. Surface treatment of medical implants by various physical and chemical techniques are attempted in order to improve their surface properties so as to facilitate bio-integration and prevent bacterial adhesion. The potential source of infection of the surrounding tissue and antimicrobial strategies are from bacteria adherent to or in a biofilm on the implant which should prevent both biofilm formation and tissue colonization. This article provides an overview of bacterial biofilm formation and methods adopted for the inhibition of bacterial adhesion on medical implants.

Matched MeSH terms: Equipment Contamination/prevention & control*
Environmental contamination in the hospital as a possible source for nosocomial infection with methicillin-resistant Staphylococcus aureus

Ghaznavi-Rad E, Ghasemzadeh-Moghaddam H, Shamsudin MN, Hamat RA, Sekawi Z, Aziz MN, et al.

Infect Control Hosp Epidemiol, 2010 Dec;31(12):1302-3.
PMID: 21028965 DOI: 10.1086/657587
Matched MeSH terms: Equipment Contamination*
The use of dimethyl sulfoxide in contact lens disinfectants is a potential preventative strategy against contracting Acanthamoeba keratitis

Siddiqui R, Aqeel Y, Khan NA

Cont Lens Anterior Eye, 2016 Oct;39(5):389-93.
PMID: 27133448 DOI: 10.1016/j.clae.2016.04.004

Acanthamoeba castellanii is the causative agent of blinding keratitis. Though reported in non-contact lens wearers, it is most frequently associated with improper use of contact lens. For contact lens wearers, amoebae attachment to the lens is a critical first step, followed by amoebae binding to the corneal epithelial cells during extended lens wear. Acanthamoeba attachment to surfaces (biological or inert) and migration is an active process and occurs during the trophozoite stage. Thus retaining amoebae in the cyst stage (dormant form) offers an added preventative measure in impeding parasite traversal from the contact lens onto the cornea. Here, we showed that as low as 3% DMSO, abolished A. castellanii excystation. Based on the findings, it is proposed that DMSO should be included in the contact lens disinfectants as an added preventative strategy against contracting Acanthamoeba keratitis.

Matched MeSH terms: Equipment Contamination/prevention & control
Effect of infusion set replacement intervals on catheter-related bloodstream infections (RSVP): a randomised, controlled, equivalence (central venous access device)-non-inferiority (peripheral arterial catheter) trial

Rickard CM, Marsh NM, Larsen EN, McGrail MR, Graves N, Runnegar N, et al.

Lancet, 2021 04 17;397(10283):1447-1458.
PMID: 33865494 DOI: 10.1016/S0140-6736(21)00351-2

BACKGROUND: The optimal duration of infusion set use to prevent life-threatening catheter-related bloodstream infection (CRBSI) is unclear. We aimed to compare the effectiveness and costs of 7-day (intervention) versus 4-day (control) infusion set replacement to prevent CRBSI in patients with central venous access devices (tunnelled cuffed, non-tunnelled, peripherally inserted, and totally implanted) and peripheral arterial catheters.
METHODS: We did a randomised, controlled, assessor-masked trial at ten Australian hospitals. Our hypothesis was CRBSI equivalence for central venous access devices and non-inferiority for peripheral arterial catheters (both 2% margin). Adults and children with expected greater than 24 h central venous access device-peripheral arterial catheter use were randomly assigned (1:1; stratified by hospital, catheter type, and intensive care unit or ward) by a centralised, web-based service (concealed before allocation) to infusion set replacement every 7 days, or 4 days. This included crystalloids, non-lipid parenteral nutrition, and medication infusions. Patients and clinicians were not masked, but the primary outcome (CRBSI) was adjudicated by masked infectious diseases physicians. The analysis was modified intention to treat (mITT). This study is registered with the Australian New Zealand Clinical Trials Registry ACTRN12610000505000 and is complete.
FINDINGS: Between May 30, 2011, and Dec, 9, 2016, from 6007 patients assessed, we assigned 2944 patients to 7-day (n=1463) or 4-day (n=1481) infusion set replacement, with 2941 in the mITT analysis. For central venous access devices, 20 (1·78%) of 1124 patients (7-day group) and 16 (1·46%) of 1097 patients (4-day group) had CRBSI (absolute risk difference [ARD] 0·32%, 95% CI -0·73 to 1·37). For peripheral arterial catheters, one (0·28%) of 357 patients in the 7-day group and none of 363 patients in the 4-day group had CRBSI (ARD 0·28%, -0·27% to 0·83%). There were no treatment-related adverse events.
INTERPRETATION: Infusion set use can be safely extended to 7 days with resultant cost and workload reductions.
FUNDING: Australian National Health and Medical Research Council.

Matched MeSH terms: Equipment Contamination/statistics & numerical data
Methicillin-resistant Staphylococcus aureus bacteraemia at a tertiary teaching hospital

Cheong I, Samsudin LM, Law GH

Br J Clin Pract, 1996 Jul-Aug;50(5):237-9.
PMID: 8794598

Between July and December 1994, 25 patients with MRSA bacteraemia were treated at the Hospital Kuala Lumpur, a tertiary hospital in Malaysia with 3000 beds. The patients included 15 males and 10 females whose mean age was 46.7 years (range 13-75). The sources of their MRSA were: Urology/Nephrology, 11; General ICU, six; Orthopaedic, four; Medicine, three; Surgery, one. Their underlying diseases were: end-stage and chronic renal failure, 11; burns, three; acute necrotising pancreatitis, two; haematological malignancies, two; and one each of fracture of the neck of the femur, pustular psoriasis, alcoholic cirrhosis, liver abscess, peptic ulcer (antrectomy), choledochol cyst, and abdominal aneurysm with gangrene of the legs. Six patients were also diabetic. A total of 19 infections were considered nosocomial. The duration of hospital stay ranged from one to 60 days, mean 16 days. On the day of blood culture, 20 patients (80%) were febrile and 15(60%) had leucocytosis. A total of 14 patients were considered to have received prolonged broad-spectrum antibiotics before the bacteraemia; of these, 11 had had either a third-generation cephalosporin and/or a quinolone. The primary foci of infection were: vascular access dialysis catheters, six; infected AV fistulae, three; non-surgical wounds, five; orthopaedic pin, one; multiple venous lines and catheters, nine; unknown, one. The sensitivities to anti-MRSA antibiotics were: vancomycin, 100%; fusidic acid, 96%; rifampicin, 96%; ciprofloxacin and perfloxacin 28% each. In all, 13 patients (52%) eventually died; nine of these deaths were directly attributed to MRSA bacteraemia. The microbiological eradication rate was 88%. Mortality was significantly associated with duration of hospital stay and failure to remove the infected catheters/peripheral lines after the development of MRSA bacteraemia.

Matched MeSH terms: Equipment Contamination

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