A Silicone Ventricular Catheter Coated with a Combination of Rifampin and Trimethoprim for the Prevention of Catheter-related Infections

So-called antiinfective catheters which are generated by incorporation of antimicrobial substances into polymers appear to be effectful devices in the prevention of catheter related infections. Such devices mainly act by prevention of bacterial colonization of the catheter surface rather than by inhibition of adherence. In a preceding study, we developed a rifampin-containing silicone catheter for the prevention of ventricular shunt infection. In the present study, this work was continued with a combination of antimicrobials incorporated in silicone ventricular catheters to reduce the risk of rifampin resistance and to expand the antimicrobial spectrum. We found that the drug release kineti…

Development of a long-lasting ventricular catheter impregnated with a combination of antibiotics.

A ventricular silicone catheter impregnated with a combination of rifampin and a quinolone was developed in order to prevent ventricular shunt related infections. As model substance for the quinolones we used sparfloxacin, because of its specific physicochemical properties resulting in a quantitative detection also in the presence of a second antibiotic. In our study we focused especially on an optimization of the antibiotic release out of the impregnated catheters in order to develop long lasting devices with a broad antimicrobial spectrum. A release-optimized catheter was tested with an in vitro colonization test and additionally with a method developed to examine the spread of bacteria o…

Occurence of vancomycin-resistant Enterococcus faecium in patient isolates and aquatic environment during a period between 2004 and 2010

Comparative evaluation of three different genotyping methods for investigation of nosocomial outbreaks of Legionnaires' disease in hospitals.

ABSTRACT The increased incidence of nosocomial Legionnaires' disease in two hospitals prompted investigation of possible environmental sources. In the search for an effective DNA-typing technique for use in hospital epidemiology, the performance and convenience of three methods— Sfi I macrorestriction analysis (MRA), amplified fragment length polymorphism (AFLP), and arbitrarily primed PCR (AP-PCR)—were compared. Twenty-nine outbreak-associated and eight nonassociated strains of Legionella pneumophila with 13 MRA types and subtypes were investigated. These strains comprised isolates from bronchoalveolar lavages, from environmental, patient-related sources, and type strains. All three typing…

The “Mainzer EMF-Wachhund”: results from a watchdog project on self-reported health complaints attributed to exposure to electromagnetic fields

The "Mainzer EMF-Wachhund," a watchdog project, offered a system of self-notification of health complaints attributed to exposures to electromagnetic fields (EMFs) to a population of a part of Germany with about 4 million inhabitants. By using a self-administered questionnaire, which was provided online and for download from the Internet, 192 persons reported such health complaints in the period from October 2003 to March 2005. Of these, 56% classified themselves as electromagnetic hypersensitive (EH). Predictors of this self classification were being affected by all kinds of EMF rather than single EMF sources and being female. On average, EH subjects reported a high degree of suffering, 77…

Evaluation of microbiological screening in a neonatal intensive care unit to optimize empiric antibiotic use.

Self-reporting hydrogels rapidly differentiate among enterohemorrhagic Escherichia coli (EHEC) and non-virulent Escherichia coli (K12)

Abstract We report on the development of an autonomously reporting indicator hydrogel for the rapid and selective detection of enzymes secreted by the food-borne biosafety level 3 pathogen enterohemorrhagic Escherichia coli (E. coli) O157:H7 (EHEC) and the differentiation of this pathogen from the non-virulent E. coli strain K12. To introduce the sensing functionality, chitosan hydrogel films were equipped with fluorogenic substrates for the detection of α-galactosidase (α-Gal) and β-galactosidase (β-Gal), which are secreted by E. coli O157:H7, and β-glucuronidase (β-GUS), which is produced by the non-virulent E. coli K12 strain, but not by E. coli O157:H7, respectively. In the presence of …

In vitro evaluation of the biocompatibility of contaminated implant surfaces treated with an Er : YAG laser and an air powder system

Abstract: Titanium platelets with a sand-blasted and acid-etched surface were coated with bovine serum albumin and incubated with a suspension of Porphyromonas gingivalis (ATCC 33277). Four groups with a total of 48 specimens were formed. Laser irradiation of the specimens (n=12) was performed on a computer-controlled XY translation stage at pulse energy 60 mJ and frequency 10 pps. Twelve specimens were treated with an air powder system. After the respective treatment, human gingival fibroblasts were incubated on the specimens. The proliferation rate was determined by means of fluorescence activity of a redox indicator (Alamar Blue® Assay) which is reduced by metabolic activity related to c…

Aktuelle Empfehlungen zur Pneumokokken-Impfung

Real-time PCR detection of Pseudomonas aeruginosa in clinical and municipal wastewater and genotyping of the ciprofloxacin-resistant isolates

Real-time quantification of Pseudomonas aeruginosa was performed in various wastewater systems including clinical, municipal wastewaters and inflow from a wastewater treatment plant. The highest concentrations of P. aeruginosa-specific targets were detected in clinical wastewaters. Limitations of the detection system resulting from inhibition or cross-reaction were identified. Ciprofloxacin-resistant P. aeruginosa strains were isolated after specific enrichment from clinical and municipal wastewaters. In some cases they were also cultivated from effluent of a wastewater treatment plant, and from its downstream river water. A total of 119 isolates were phenotypically characterized as ciprofl…

Efficacy of NaOCl/H2O2irrigation and GaAlAs laser in decontamination of root canals in vitro

Background and Objectives To investigate the bactericidal effect of an 809 nm semiconductor laser alone, and in combination with NaOCl/H2O2 irrigation in root canals in vitro. Study Design/Materials and Methods A total of 72 human single-rooted teeth extracted for periodontal reasons were included. The crowns were removed, the roots shortened to a length of 12 mm, and the canals enlarged up to an apical size of #50 file. The specimens were autoclaved and incubated with a suspension of Streptococcus sanguinis (ATCC 10556). Laser irradiation was performed on a PC-controlled XY translation stage. A 200 micron optic fiber was used. Twelve specimens were irradiated at a power output of 1.5, 3.0,…

Early Cessation of a Vancomycin-Resistant Enterococci (VRE) Outbreak in a Hematology-Oncology Department after Implementation of an Enhanced Infection Control Intervention. A Single Center Experience.

Abstract Introduction: Worldwide, the incidence of nosocomial outbreaks of VRE has increased especially in high-risk patients such as hematology-oncology patients. Outbreaks reported so far, required a minimum of three months to be controlled. Such outbreaks have a serious impact on daily care and treatment of the patients and hospital economics. Patients and Methods: We describe the outcome of a VRE-outbreak in a department with 48 beds (fourteen 2-patient rooms, and 20 single-patient rooms) including allogeneic BMT. Epidemiological evaluation was initiated after two patients in the department for the first time had a blood stream infection (BSI) with VRE within one week. Two goals had to …

Infections associated with medical devices: pathogenesis, management and prophylaxis.

The insertion or implantation of foreign bodies has become an indispensable part in almost all fields of medicine. However, medical devices are associated with a definitive risk of bacterial and fungal infections. Foreign body-related infections (FBRIs), particularly catheter-related infections, significantly contribute to the increasing problem of nosocomial infections. While a variety of micro-organisms may be involved as pathogens, staphylococci account for the majority of FBRIs. Their ability to adhere to materials and to promote formation of a biofilm is the most important feature of their pathogenicity. This biofilm on the surface of colonised foreign bodies is regarded as the biologi…

Outbreak of Salmonella Enteritidis gastrointestinal infections among medical staff due to contaminated food prepared outside the hospital

Microbiological quality of carbonated drinking water produced with in-home carbonation systems.

The microbiological quality of carbonated water produced with tap water in commercial in-home carbonation systems was determined, the results being discussed in the context of the microbiological quality of the tap water used, the properties of the drink makers, and the procedures of preparation and washing of various parts of the appliance. The last-mentioned data were received from each participant of the study by questionnaire. Escherichia coli, coliforms, fecal streptococci and spore-forming sulphite-reducing anaerobes were used as indicators for the hygienic quality of the water. Tap-water samples were collected according to the usual procedure when filling the carbonating bottle, i.e.…

Increased Risk of Catheter Colonization and Catheter-Related Infections in Severe Immunocompromized Patients with Multiple Myeloma Undergoing High-dose Glucocorticoid Treatment

Catheter-related infections (CRI) are an important problem in medicine because of major consequences for treatment, prolongation of hospitalization and increasing therapy costs. Malignancies, immunodeficiency, severe burns and malnutrition compromise host defense. Studies to quantify the increased risk of CRI in immunocompromised patients are required. We analyzed the influence of immunoglobulin deficiency and high-dose glucocorticoid treatment in patients with multiple myeloma with regard to catheter colonization and CRI. In patients with multiple myeloma, central venous catheters (CVC) were significantly more frequently colonized (> 15 CFU) as compared to patients with other malignancies …

In vitro efficacy of a Hydrophilic Central Venous Catheter Loaded with Silver to Prevent Microbial Colonization

A method was developed to load the surface of a central venous catheter with silver to prevent bacterial colonization. Silver confers a broad antimicrobial activity with a relatively low risk of resistance. Catheters were incubated with a silver nitrate solution in different concentrations. The solvent, incubation temperature and incubation period were varied to examine the influence on the catheter loading. With increasing incubation temperature, time and concentration of silver nitrate, higher rates of silver elution were observed by atomic absorption spectroscopy. Furthermore, by using ethanol-water as a solvent instead of pure water, the amount of silver bound to the catheter surface wa…

Modern Strategies in the Prevention of Implant-Associated Infections

The application of medical devices either for temporary or permanent use has become an indispensible part of almost all fields of medicine. However, foreign bodies are associated with a substantial risk of bacterial and fungal infections. Implant-associated infections significantly contribute to the still increasing problem of nosocomial infections. To reduce the incidence of such infections, specific guidelines providing evidence-based recommendations and comprising both technological and nontechnological strategies for prevention have been established. Strict adherence to hygienic rules during insertion or implantation of the device are aspects of particular importance. Besides such basi…

Detection of antibiotic-resistant bacteria and their resistance genes in wastewater, surface water, and drinking water biofilms.

Abstract In view of the increasing interest in the possible role played by hospital and municipal wastewater systems in the selection of antibiotic-resistant bacteria, biofilms were investigated using enterococci, staphylococci, Enterobacteriaceae, and heterotrophic bacteria as indicator organisms. In addition to wastewater, biofilms were also investigated in drinking water from river bank filtrate to estimate the occurrence of resistant bacteria and their resistance genes, thus indicating possible transfer from wastewater and surface water to the drinking water distribution network. Vancomycin-resistant enterococci were characterized by antibiograms, and the vanA resistance gene was detect…

Prophylaxe gegen Infektionen durch Streptococcus pneumoniae

Streptococcus pneumoniae steht als Erreger ambulant erworbener Pneumonien an erster Stelle. Vor allem bei Patienten mit verminderter Immunantwort werden invasive Pneumokokkeninfektionen als besonders risikoreich eingestuft und gehen mit einer hohen Mortalitat einher. Weltweit wird eine zunehmende Antibiotikaresistenz von Streptococcus pneumoniaebeobachtet. Daher hat die Standige Impfkommission (STIKO) die Impfung fur Risikogruppen in ihre aktuellen offiziellen Empfehlungen vom Marz 1998 aufgenommen. Der bereits seit langerem kommerziell verfugbare 23-valente Polysaccharidimpfstoff vermittelt bei Kindern ab dem zweiten Lebensjahr und Erwachsenen eine gute Immunantwort zur Abwehr von Pneumoko…

Bactericidal Effect of the Er:YAG Laser on Dental Implant Surfaces: An In Vitro Study

The aim of the in vitro study was to examine the bactericidal effect of an Er:YAG laser on common dental implant surfaces.Seventy-two titanium platelets with 3 different surfaces--sandblasted and acid-etched (SA), titanium plasma-sprayed (TPS), and hydroxyapatite-coated (HA)--were incubated with a suspension of Streptococcus sanguinis (ATCC 10556). Irradiation at pulse energies of 60 and 120 mJ and a frequency of 10 pps was performed on a computer-controlled XY translation stage. After laser treatment the specimens were sonicated and the bacterial growth examined by counting colony forming units on blood agar plates. Temperature elevations during irradiation were investigated using K-type t…