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  • 1
    Online Resource
    Online Resource
    Aldehyde disinfectants and health in endoscopy unit: The report of a working party of the British Society of Gastroenterology Endoscopy Committee
    BMJ ; 1993
    In:  Gut Vol. 34, No. 11 ( 1993-11-01), p. 1641-1645
    Details
    In: Gut, BMJ, Vol. 34, No. 11 ( 1993-11-01), p. 1641-1645
    Type of Medium: Online Resource
    ISSN: 0017-5749
    URL: Article
    DOI: 10.1136/gut.34.11.1641
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 1993
    detail.hit.zdb_id: 1492637-4
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  • 2
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    Ward floors and other surfaces as reservoirs of hospital infection
    Cambridge University Press (CUP) ; 1967
    In:  Epidemiology and Infection Vol. 65, No. 4 ( 1967-12), p. 515-536
    Details
    In: Epidemiology and Infection, Cambridge University Press (CUP), Vol. 65, No. 4 ( 1967-12), p. 515-536
    Abstract: Impression plates from initially clean horizontal surfaces and floor areas in surgical wards showed a rapid accumulation of bacteria, mainly micrococci, which reached a fluctuating equilibrium after about 24 h. A later increase in bacterial contamination (mainly with aerobic sporing bacilli) to a higher equilibrium level after about 14 days occurred on uncleaned areas. Walls, even if left unwashed, acquired very few bacteria, but many were deposited locally when the wall was touched by a subject whose skin carried large numbers of staphylococci; moist exposed plaster was also heavily contaminated. Regular use of a disinfectant (‘Sudol’ 1 in 100) in cleaning a ward floor did not reduce the equilibrium level of bacteria on the floor. The transfer of staphylococci from contaminated to clean areas on the soles of shoes was demonstrated; the use of tacky and disinfectant mats did not appreciably reduce the transfer of bacteria by this route. Staphylococci deposited on a wall by a disperser were shown to be transferred from the contaminated area of wall to the hands of another subject who did not previously carry the organism; this subject was shown to transfer the staphylo-coccus to a wall which he touched. Attempts to redisperse by air movement Staph. aureus which had been shed by a disperser or by a contaminated blanket on to the floor surfaces had little effect; neither blowing with a hair dryer nor brisk exercise appeared to lift any of the staphylococci from a vinyl surface, and only small numbers were lifted by these measures from a terrazzo surface. The hazards of infection from the inanimate environment are discussed.
    Type of Medium: Online Resource
    ISSN: 0950-2688 , 1469-4409
    URL: Article
    DOI: 10.1017/S0022172400046052
    RVK:
    XA 41125
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 1967
    detail.hit.zdb_id: 1470211-3
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  • 3
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    Online Resource
    Comparison of two methods for assessing the removal of total organisms and pathogens from the skin
    Cambridge University Press (CUP) ; 1975
    In:  Journal of Hygiene Vol. 75, No. 2 ( 1975-10), p. 259-274
    Details
    In: Journal of Hygiene, Cambridge University Press (CUP), Vol. 75, No. 2 ( 1975-10), p. 259-274
    Abstract: A standard hand-wash sampling technique was compared with a simple fingerstreak sampling method in assessing the relative effectiveness of a number of alternative preparations used for disinfecting the surgeon's hands (alcoholic 0-5% chlorhexidine, alcoholic 0-1% tetrabrom- o -methyl phenol, a 4% chlorhexidine detergent solution, aqueous 0-5% chlorhexidine, 2% 'Irgasan' detergent solution and, as control, bar soap). There was a fairly good correlation between the results of assessment by the two methods after a single disinfection and after six disinfections, three on one day and three on the next. Significant differences were shown in 21 comparisons between treatments when the hand-wash sampling test was used, and 16 of these comparisons also showed a significant difference by the finger-streak test. Staphylococcus aureus was found in hand samplings from 5 out of 8 nurses in the Burns Unit of Birmingham Accident Hospital by the hand-wash sampling method and from 2 of the same 8 nurses by the finger-streak method; the numbers were small, and no Staph. aureus were isolated from the same hands after 1 min. wash in 70 % ethyl alcohol. Similar sampling on 29 nurses in other wards showed Staph. aureus on 3 nurses (one in large numbers) by the hand-wash technique and on 1 nurse by the finger-streak test; in only 1 nurse whose hands showed Staph. aureus before disinfection was the organism found, by hand-wash sampling, after disinfection. Parallel sampling of nurses' hands after washing with soap and water and after disinfection with 95 % ethanol showed larger numbers of Staph. aureus in a hospital for skin diseases than in a general hospital, and a lower incidence and somewhat lower density of Staph. aureus after ethanol treatment than after washing with soap and water; Gram-negative bacilli, on the other hand, were commoner on hands in the general than in the skin hospital, and present in much smaller numbers after disinfection with ethanol than after washing with soap and water. Antibiotic sensitivity tests showed the frequent recurrence on the hands of some nurses of multi-resistant Staph. aureus with resistance patterns similar to those found in infective lesions in some of the patients; different sensitivity patterns were usually found in staphylococci isolated from the nose. Even in wards where many patients were infected, carriage by nurses' hands of a particular strain ofStaph. aureus did not seem to last for more than a few days.
    Type of Medium: Online Resource
    ISSN: 0022-1724
    URL: Article
    DOI: 10.1017/S002217240004729X
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 1975
    detail.hit.zdb_id: 1470211-3
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  • 4
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    Surveys of hospital infection in the Birmingham region: I. Effect of age, sex, length of stay and antibiotic use on nasal carriage of tetracycline-resistant Staphyloccus aureus and on post-operative wound infection
    Cambridge University Press (CUP) ; 1977
    In:  Journal of Hygiene Vol. 79, No. 2 ( 1977-10), p. 299-314
    Details
    In: Journal of Hygiene, Cambridge University Press (CUP), Vol. 79, No. 2 ( 1977-10), p. 299-314
    Abstract: Cross-sectional surveys of infection in relation to ward structure and practice were made in 38 hospitals between 1967 and 1973, including repeat surveys in 12 hospitals. The survey team (a research nurse and a senior microbiologist or technician) visited one ward a day and entered data on patients, including appearance of wounds seen at change of dressings, on the structure of the ward, and on ward practices; bacteriological swabs were taken from noses of all patients and staff of wards visited and from infected or open wounds, also from some environmental sites. Effect of age, sex, length of hospital stay and antibiotic use on carriage of tetracycline-resistant Staphylococcus aureus and on post-operative sepsis are considered here. Clinical infection (sepsis), further classified as ‘severe’, ‘moderate’ or ‘mild’ in accordance with a code of physical signs, including inflammation and suppuration, was found in 6·1% of clean undrained operation wounds. Drained wounds and those through hollow, heavily colonized viscera (‘contaminated’ wounds) had higher sepsis rates than undrained and ‘clean’ wounds; there was less sepsis with closed drainage and with small drains. Staph. aureus (24%) was the commonest single bacterial species, but gram-negative bacilli (50%) were found in a much larger proportion of septic wounds. The results showed that the infection rate was lowest among patients between 20 and 40 years old. Infection was significantly more common in male than in female patients. Nasal carriage of tetracycline-resistant Staph. aureus , used as an index of hospital-acquired infection, was commonest in geriatric patients and least common in gynaecological patients. There was correlation between nasal carriage of tetracycline-resistant staphylococci and age of the patient, length of hospital stay, sex, (male greater than female), operative treatment, and treatment with tetracycline, ampicillin and nitrofurantoin, but not with penicillin.
    Type of Medium: Online Resource
    ISSN: 0022-1724
    URL: Article
    DOI: 10.1017/S0022172400053110
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 1977
    detail.hit.zdb_id: 1470211-3
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  • 5
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    Online Resource
    Evaluation of procedures for hygienic hand-disinfection: controlled parallel experiments on the Vienna test model
    Cambridge University Press (CUP) ; 1986
    In:  Journal of Hygiene Vol. 96, No. 1 ( 1986-02), p. 27-37
    Details
    In: Journal of Hygiene, Cambridge University Press (CUP), Vol. 96, No. 1 ( 1986-02), p. 27-37
    Abstract: Controlled parallel experiments were performed on the Vienna test model for the evaluation of procedures for hygienic hand-disinfection in three laboratories (Vienna, Mainz, Birmingham). The degerming activity of four procedures, each taking 1 min, was assessed repeatedly and compared with that of a standard disinfection procedure (ST) using isopropanol 60 % (v/v). The mean log reductions (mean log RF) for each procedure were as follows: n −propanol 50% (v/v) 4·85 and 5·14 in Vienna (V) and Mainz (M) respectively, ethanol 70 % (v/v) + chlorhexidinegluconate 0·5% (w/v), 4·01 (V), 3·76 (M) and 4·00 in Birmingham (B). Washing procedures were less effective, mean log RF 's of 3·19 (V), 3·49 (M) and 3·04 (B) were obtained with povidone-iodine soap, and 2·91 (V), 3·37 (M) and 3·27 (B) with a liquid phenolic soap. Analysis of variance on the data from Vienna and Mainz revealed significant differences of means not only between procedures (‘preparations’) but also on repeat testing. To compensate for the influence of variables such as test subjects, laboratory and day, the Vienna test model provides a method of standardization by testing a ST in parallel with the test procedure (P). Standardization of the results was obtained by pair-wise substraction, log . Analysis of variance on the resulting values demonstrated that comparability of the results between laboratories and on repeat testing was achieved. The relative variation of the measurements within the laboratories ranged from 0·9 to 4·2%. As assessed by power-analysis, a disinfection procedure will be detected as significantly ( P = 0·1) inferior to the standard processes in 95 of 100 experiments if it produces a mean log RF that is at least 0·55–0·65 log units smaller than that of the standard.
    Type of Medium: Online Resource
    ISSN: 0022-1724
    URL: Article
    DOI: 10.1017/S0022172400062501
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 1986
    detail.hit.zdb_id: 1470211-3
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  • 6
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    Online Resource
    Pseudomonas aeruginosa in hospital sinks
    Ovid Technologies (Wolters Kluwer Health) ; 1975
    In:  Plastic and Reconstructive Surgery Vol. 55, No. 2 ( 1975-02), p. 253-
    Details
    In: Plastic and Reconstructive Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 55, No. 2 ( 1975-02), p. 253-
    Type of Medium: Online Resource
    ISSN: 0032-1052
    URL: Article
    DOI: 10.1097/00006534-197502000-00076
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1975
    detail.hit.zdb_id: 2037030-1
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  • 7
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    Online Resource
    Tests of disinfection by heat in a bedpan washing machine
    BMJ ; 1974
    In:  Journal of Clinical Pathology Vol. 27, No. 9 ( 1974-09-01), p. 760-763
    Details
    In: Journal of Clinical Pathology, BMJ, Vol. 27, No. 9 ( 1974-09-01), p. 760-763
    Type of Medium: Online Resource
    ISSN: 0021-9746
    URL: Article
    DOI: 10.1136/jcp.27.9.760
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 1974
    detail.hit.zdb_id: 2028928-5
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  • 8
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    Online Resource
    Preoperative Disinfection of Surgeons' Hands: Use of Alcoholic Solutions and Effects of Gloves on Skin Flora
    BMJ ; 1974
    In:  BMJ Vol. 4, No. 5941 ( 1974-11-16), p. 369-372
    Details
    In: BMJ, BMJ, Vol. 4, No. 5941 ( 1974-11-16), p. 369-372
    Type of Medium: Online Resource
    ISSN: 0959-8138 , 1468-5833
    URL: Article
    DOI: 10.1136/bmj.4.5941.369
    Language: English
    Publisher: BMJ
    Publication Date: 1974
    detail.hit.zdb_id: 1479799-9
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  • 9
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    Online Resource
    Spread of Salmonella typhi in a maternity hospital
    Cambridge University Press (CUP) ; 1979
    In:  Journal of Hygiene Vol. 82, No. 3 ( 1979-06), p. 353-359
    Details
    In: Journal of Hygiene, Cambridge University Press (CUP), Vol. 82, No. 3 ( 1979-06), p. 353-359
    Abstract: An Asian patient with undiagnosed typhoid fever was admitted to a maternity hospital and delivered within 10 mm. Salmonella typhi (phage type D5) was isolated from her blood and from the faeces of her baby. Another woman in a different room of the labour suite at the same time acquired the same organism in her faeces; her brother was admitted to the Infectious Diseases Unit 5 weeks later with typhoid fever. Two babies, born over 60 h after the index case was delivered, became faecal excreters of the same strain and one of them also developed S. typhi osteitis of the hip. These two babies and their mothers were in the same ward as each other, but not that occupied by the infected mother and her baby. Nine other excreters in two of the families involved were identified. The index case and her baby were isolated immediately after delivery, and the relevant rooms in the labour suite were adequately disinfected. No evidence of undisinfected equipment used by the index case and the other infected patients was found, and no spread to staff was detected. The mode of spread remains unknown.
    Type of Medium: Online Resource
    ISSN: 0022-1724
    URL: Article
    DOI: 10.1017/S0022172400053882
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 1979
    detail.hit.zdb_id: 1470211-3
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  • 10
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    Online Resource
    Transfer areas and clean zones in operating suites
    Cambridge University Press (CUP) ; 1969
    In:  Journal of Hygiene Vol. 67, No. 3 ( 1969-09), p. 417-425
    Details
    In: Journal of Hygiene, Cambridge University Press (CUP), Vol. 67, No. 3 ( 1969-09), p. 417-425
    Abstract: The value of clean zones and of transfer areas in operating suites was assessed by comparisons of the amounts of contamination on floors, trolleys and footwear in suites with and without a clean zone and a transfer area; counts of Clostridium welchii were used as an index of bacterial contamination introduced into the aseptic zone from outside. The mean counts of Cl. welchii on contact plates from the wheels of trolleys used to convey patients from wards to the operating suite (67·9 ± 7·68 per plate) were significantly higher than those from theatre trolleys (i.e. those used only inside a theatre suite provided with a transfer area) (3·13 ± 0·47 per plate); mean counts of total bacteria were only slightly lower on the wheels of theatre trolleys than on those of hospital trolleys. Other surfaces of hospital trolleys showed counts similar to those found on theatre trolleys. Contact plates from floors showed significantly lower counts of Cl. welchii in the aseptic zone and the clean zone than in the hospital corridor, the protective zone and (when present) the transfer area. The mean counts per 100 cm 2 of Cl. welchii were approximately the same on the floor of a theatre with a clean zone and a transfer area (0·83) as in one with a clean zone but no transfer area (0·5). Counts of total bacteria were higher in the latter. A suite with no clean zone or transfer area showed a higher mean count of Cl. welchii on contact plates from the aseptic zone (operating theatre) (20·5 ± 12·33 per 100 cm 2 ). These higher levels of contamination were due to sporadic high counts of Cl. welchii found near the door of the theatre with no clean zone; in another theatre with no clean zone the level of Cl. welchii on the floor was not higher than that in the theatres with clean zones. Theatres with plenum ventilation had lower mean counts of airborne Cl. welchii than those ventilated by windows: there was no significant difference in the levels of Cl. welchii on the floors of theatres with the two forms of ventilation. On sampling with contact plates, theatre footwear yielded fewer total organisms, Staphylococcus aureus and Cl. welchii than outdoor shoes removed before entering the clean zone. The hygienic value of transfer areas and clean zones is discussed. Bacteriological support could not be obtained for the former, but the latter appeared to contribute something to the cleanliness of the theatre by preventing heavy sporadic contamination. We wish to thank Mr M. Wilkins for valuable assistance, the staff of the operating theatres for their co-operation and Alne Engineering Limited, 57 High Street, Henley-in-Arden, Solihull, for supplying disposable contact plates.
    Type of Medium: Online Resource
    ISSN: 0022-1724
    URL: Article
    DOI: 10.1017/S0022172400041838
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 1969
    detail.hit.zdb_id: 1470211-3
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