Contamination of Cetrimide and Other Fluids with Pseudomonas pyocyanea

Lowbury, E. J. L.

doi:10.1136/oem.8.1.22

Cited by 33 publications

(18 citation statements)

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“…pyocyanea have been found to die during the evaporation of their suspending fluid on skin (Ricketts, Squire & Topley, 1951) and on glass (Lowbury & Fox, 1953), enough of them continue to survive on a dried surface to allow a moderate contamination of the air during the removal of dressings, and of the ward dust. Such contamination of the environment is likely to persist for some time and may constitute a minor reservoir of infection, even when the ward is free from infected burns, and when the floor is swept daily (Lowbury, 1950). Burns treated by the exposed method are particularly liable to contamination from this source if effective dust-laying is not practised.…”

Section: A Note On the Protection Of Exposed Burns Against Pseudomonamentioning

confidence: 99%

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The epidemiology of infection withPseudomonas pyocyaneain a burns unit

Lowbury

Fox

1954

J. Hyg.

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A bacteriological study of burned patients and of the staff and environment in a burns unit was made with the purpose of discovering the principal reservoirs and routes of transfer ofPs. pyocyanea.Infected burns appeared to be the most important reservoirs. About 3 % of the stools of normal subjects and of patients with intestinal symptoms carried the organism, which was also isolated from the nose, throat, nasopharynx, skin and ear of a small proportion of patients and staff in the burns wards.The hands of nurses in the wards were often contaminated withPs. pyocyanea, and presented a likely vector in the transfer of the organism by contact—e.g. from the bandages of infected patients, and from furniture and other objects near to their beds.It was shown by slide agglutination that a new type ofPs. pyocyaneaadmitted to one of the wards spread freely in that ward but hardly at all to the other ward. Since patients from both wards used the same dressing station and operating theatres, it seemed from this finding that a large proportion of the cross-infection occurred in the wards.Polymyxin dusting powder was shown in a controlled trial to protect exposed burns against contamination byPs. pyocyanea.These results are discussed in relation to the mechanism of transfer of the organism and the methods of preventing cross-infection. The need to use several methods concurrently is emphasized, since none of those which have been investigated contributes more than a partial effect. Cubicle wards are advocated, since much cross-infection is shown to occur in open wards.We are much indebted to Dr G. T. Cook for kindly letting us use results obtained by him at the Oxford Public Health Laboratory. We also wish to thank Prof. J. F. D. Shrewsbury of Birmingham University and our colleagues at the Birmingham Accident Hospital for their valuable co-operation, and Dr A. C. Cunliffe of King's College Hospital for information on the typing ofProteusfrom patients in our wards.

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Section: A Note On the Protection Of Exposed Burns Against Pseudomonamentioning

confidence: 99%

“…pyocyanea, and the routine hospital supply of sterile fluids in screw-cap bottles was followed by a fall in the incidence of Ps. pyocyanea in open wounds (Lowbury, 1951a). Ps.…”

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The epidemiology of infection withPseudomonas pyocyaneain a burns unit

Lowbury

Fox

1954

J. Hyg.

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“…The results in vitro have confirmed that a use-dilution of 1/160 is reliably bactericidal in 'clean' situations, although where marked organic contamination is known or suspected the disinfectant should be employed at a dilution of 1/80. Disinfectant solutions themselves are not immune from bacterial contamination (Lowbury, 1951;Anderson and Keynes, 1958;Kelsey and Maurer, 1966;Burdon and Whitby, 1967), and clinical outbreaks of infection, especially of the urinary tract, have been attributed to this cause (Mitchell and Hayward, 1966;Dulake and Kidd, 1966;Moore and Forman, 1966). Burdon and Whitby (1967) have reported the contamination of aqueous solutions of chlorhexidine and of cetrimide-chlorhexidine with species of Pseudomonas, and regular tests for bacterial pollution of pharmaceutical products have been urged, (Brit.…”

Section: Discussionmentioning

confidence: 99%

“…These are picloxydine digluconate, a broad-spectrum antibacterial compound possessing a biguanide structure: octylphenoxy-polyethoxyethanol, a nonionic detergent: and the quaternary ammonium compound, benzalkonium chloride. (Lowbury, 1951;Burdon and Whitby, 1967;Brit. med.…”

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Observations on a new disinfectant

Gordon

1969

J Clin Pathol

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SYNOPSIS A disinfectant formula (Resiguard) containing picloxydine digluconate, benzalkonium chloride, and a detergent was examined for antibacterial activity.Studies in vitro with simulated organic contamination were followed by realistic in-use tests employing items of anaesthetic and urological equipment heavily infected with Pseudomonas aeruginosa and contaminated with blood. These showed that a dilution of 1/80 was reliably bactericidal to this resistant organism.It is concluded that Resiguard is a valuable disinfectant which may reliably be employed in the cleaning and disinfection of items of delicate, non-autoclavable, hospital equipment.Hospital-acquired infections present a continuing challenge to clinical and laboratory personnel. There is evidence that the patterns of such infections have been undergoing important changes within recent years, infections by the Gram-negative organisms having become more frequent (Finland, Jones, and Barnes, 1959;William, Williams, and Hyams, 1960;Barber, 1961;Selwyn, MacCabe, and Gould, 1964; Williams, Blowers, Garrod, and Shooter, 1966). This is especially relevant to Pseudomonas aeruginosa, a notoriously 'opportunistic' pathogen for debilitated patients in hospital, which possesses a high intrinsic resistance to many currently available antibiotics, and to the majority of traditional hospital disinfectants. Furthermore, recent developments in medical technology have been associated with the introduction of highly intricate equipment many components of which, being non-autoclavable, must be cleaned and disinfected by chemical methods.Despite the magnitude of these problems, it is apparent that chemical disinfection is a somewhat neglected subject. Previous authoritative reports (Public Health Laboratory Service Committee, 1965; Kelsey and Maurer, 1967) active principles. These are picloxydine digluconate, a broad-spectrum antibacterial compound possessing a biguanide structure: octylphenoxy-polyethoxyethanol, a nonionic detergent: and the quaternary ammonium compound, benzalkonium chloride. (Lowbury, 1951;Burdon and Whitby, 1967; Brit. med. J., 1967) that bacteria, especially pseudomonas, may proliferate in solutions of some disinfectants, preliminary experiments in vitro were undertaken to establish whether resistant Gram-negative bacilli would survive and multiply in dilutions of Resiguard stored over prolonged periods. The organisms chosen were Pseudomonas aeruginosa NCTC 6749 and Klebsiella aerogenes NCTC 8172, and the method employed was similar to that of Burdon and Whitby (1967). METHODS INVESTIGATIONS IN VITRO In view of previous reportsDuplicate doubling dilutions of a stock concentrate of the disinfectant were made, in 10 ml aliquots, with distilled water in laboratory glassware, and these were inoculated with a straight wire from single colonies of the two strains grown overnight on nutrient agar at 37°C. Dilutions ranging from 1/10 to 1/2,560 were tested. At intervals of 48 hours, 0-2 ml amounts of each disinfectant dilution were subcultured to 5 ...

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“…The occasional reports in the literature indicating that ophthalmic solutions have been found contaminated with Pseudomonas and Proteus organisms, even though a preservative is present in the solution (19,20). is sufficient cause for some consideration of a routine practice to be followed in hospitals and pharmacies in the formulation of such solutions with a minimal number or complete absence of viable microorganisms.…”

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confidence: 99%

An Evaluation of Chemical Preservatives for Ophthalmic Solutions*

Lawrence

1955

Journal of the American Pharmaceutical Association (Scientific

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Contamination of Cetrimide and Other Fluids with Pseudomonas pyocyanea

Cited by 33 publications

References 5 publications

The epidemiology of infection withPseudomonas pyocyaneain a burns unit

The epidemiology of infection withPseudomonas pyocyaneain a burns unit

Observations on a new disinfectant

An Evaluation of Chemical Preservatives for Ophthalmic Solutions*

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