Adenosine Triphosphate Quantification Correlates Poorly with Microbial Contamination of Duodenoscopes

2017 ◽  
Vol 38 (06) ◽  
pp. 678-684 ◽  
Author(s):  
Lovisa B. Olafsdottir ◽  
Sharon B. Wright ◽  
Anne Smithey ◽  
Riley Heroux ◽  
Elizabeth B. Hirsch ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Adenosine Triphosphate ◽  
Bacterial Contamination ◽  
Care Facility ◽  
High Volume ◽  
Relative Light Unit ◽  
Spearman Correlation ◽  
Endoscopic Retrograde ◽  
Colony Forming Units ◽  
High Level

OBJECTIVE The aim of this study was to quantify the correlation between adenosine triphosphate (ATP) measurements and bacterial cultures from duodenoscopes for evaluation of contamination following high-level disinfection. DESIGN Duodenoscopes used for any intended endoscopic retrograde cholangiopancreatography (ERCP) procedure were included. Microbiologic and ATP data were collected concomitantly and in the same manner from ERCP duodenoscopes. SETTING A high-volume endoscopy unit at a tertiary referral acute-care facility. METHODS Duodenoscopes were sampled for ATP and bacterial contamination in a contemporaneous and highly standardized fashion using a “flush-brush-flush” method for the working channel (WC) and a dry flocked swab for the elevator mechanism (EM). Specimens were processed for any aerobic bacterial growth (colony-forming units, CFU). Growth of CFU>0 and ATP relative light unit (RLU)>0 was considered a contaminated result. Frequency of discord between among WC and EM measurements were calculated using 2×2 contingency tables. The Spearman correlation coefficient was used to calculate the relatedness of bacterial contamination and ATP as continuous measurements. RESULTS The Spearman correlation coefficient did not demonstrate significant relatedness between ATP and CFU for either a WC or EM site. Among 390 duodenoscope sampling events, ATP and CFU assessments of contamination were discordant in 82 of 390 WC measurements (21%) and 331 of 390 of EM measurements (84.9%). The EM was frequently and markedly positive by ATP measurement. CONCLUSION ATP measurements correlate poorly with a microbiologic standard assessing duodenoscope contamination, particularly for EM sampling. ATP may reflect biological material other than nonviable aerobic bacteria and may not serve as an adequate marker of bacterial contamination. Infect Control Hosp Epidemiol 2017;38:678–684

scholarly journals High prevalence rate of digestive tract bacteria in duodenoscopes: a nationwide study

Gut ◽  
2018 ◽  
Vol 67 (9) ◽  
pp. 1637-1645 ◽  
Author(s):  
Arjan W Rauwers ◽  
Anne F Voor in ’t holt ◽  
Jolanda G Buijs ◽  
Woutrinus de Groot ◽  
Bettina E Hansen ◽  
...  
Keyword(s):  
Bacterial Contamination ◽  
Sampling Methods ◽  
Cross Sectional Study ◽  
Klebsiella Pneumonia ◽  
Endoscopic Retrograde ◽  
Cross Sectional ◽  
Uniform Sampling ◽  
Colony Forming Units ◽  
High Prevalence ◽  
Control Procedures

ObjectiveIncreasing numbers of outbreaks caused by contaminated duodenoscopes used for Endoscopic Retrograde Cholangiopancreatography (ERCP) procedures have been reported, some with fatal outcomes. We conducted a nationwide cross-sectional study to determine the prevalence of bacterial contamination of reprocessed duodenoscopes in The Netherlands.DesignAll 73 Dutch ERCP centres were invited to sample ≥2 duodenoscopes using centrally distributed kits according to uniform sampling methods, explained by video instructions. Depending on duodenoscope type, four to six sites were sampled and centrally cultured. Contamination was defined as (1) any microorganism with ≥20 colony forming units (CFU)/20 mL (AM20) and (2) presence of microorganisms with gastrointestinal or oral origin, independent of CFU count (MGO).ResultsSixty-seven out of 73 centres (92%) sampled 745 sites of 155 duodenoscopes. Ten different duodenoscope types from three distinct manufacturers were sampled including 69 (46%) Olympus TJF-Q180V, 43 (29%) Olympus TJF-160VR, 11 (7%) Pentax ED34-i10T, 8 (5%) Pentax ED-3490TK and 5 (3%) Fujifilm ED-530XT8. Thirty-three (22%) duodenoscopes from 26 (39%) centres were contaminated (AM20). On 23 (15%) duodenoscopes MGO were detected, including Enterobacter cloacae, Escherichia coli, Klebsiella pneumonia and yeasts. For both definitions, contamination was not duodenoscope type dependent (p values: 0.20 and higher).ConclusionIn 39% of all Dutch ERCP centres, at least one AM20-contaminated patient-ready duodenoscope was identified. Fifteen per cent of the duodenoscopes harboured MGO, indicating residual organic material of previous patients, that is, failing of disinfection. These results suggest that the present reprocessing and process control procedures are not adequate and safe.

scholarly journals Characteristics of Critically Ill Patients with COVID-19 Compared to Patients with Influenza—A Single Center Experience

2021 ◽  
Vol 10 (10) ◽  
pp. 2056
Author(s):  
Frank Herbstreit ◽  
Marvin Overbeck ◽  
Marc Moritz Berger ◽  
Annabell Skarabis ◽  
Thorsten Brenner ◽  
...  
Keyword(s):  
Influenza A ◽  
Health Care Systems ◽  
Severe Disease ◽  
Tertiary Care ◽  
Care Facility ◽  
High Volume ◽  
Single Center Experience ◽  
Severe Influenza ◽  
Tertiary Care Facility ◽  
Care Systems

Infections with SARS-CoV-2 spread worldwide early in 2020. In previous winters, we had been treating patients with seasonal influenza. While creating a larger impact on the health care systems, comparisons regarding the intensive care unit (ICU) courses of both diseases are lacking. We compared patients with influenza and SARS-CoV-2 infections treated at a tertiary care facility offering treatment for acute respiratory distress syndrome (ARDS) and being a high-volume facility for extracorporeal membrane oxygenation (ECMO). Patients with COVID-19 during the first wave of the pandemic (n = 64) were compared to 64 patients with severe influenza from 2016 to 2020 at our ICU. All patients were treated using a standardized protocol. ECMO was used in cases of severe ARDS. Both groups had similar comorbidities. Time in ICU and mortality were not significantly different, yet mortality with ECMO was high amongst COVID-19 patients with approximately two-thirds not surviving. This is in contrast to a mortality of less than 40% in influenza patients with ECMO. Mortality was higher than estimated by SAPSII score on admission in both groups. Patients with COVID-19 were more likely to be male and non-smokers than those with influenza. The outcomes for patients with severe disease were similar. The study helps to understand similarities and differences between patients treated for severe influenza infections and COVID-19.

scholarly journals Understanding Suicide in Our Community through the Lens of the Pediatric ICU: An Epidemiological Review (2011–2017) of One Midwestern City in the US

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 59
Author(s):  
Andrew Kampfschulte ◽  
Matthew Oram ◽  
Alejandra M. Escobar Vasco ◽  
Brittany Essenmacher ◽  
Amy Herbig ◽  
...  
Keyword(s):  
Local Community ◽  
Hospital Admissions ◽  
Age Groups ◽  
Care Facility ◽  
Pediatric Intensive Care ◽  
High Volume ◽  
Temporal Variables ◽  
Geographical Regions ◽  
Icd 10 ◽  
Pediatric Icu

Suicide frequency has tripled for some pediatric age groups over the last decade, of which, serious attempts result in pediatric intensive care unit (PICU) admissions. We paired clinical, aggregate geospatial, and temporal demographics to understand local community variables to determine if epidemiological patterns emerge that associate with risk for PICU admission. Data were extracted at an urban, high-volume, quaternary care facility from January 2011 to December 2017 via ICD 10 codes associated with suicide. Clinical, socioeconomic, geographical, and temporal variables were reviewed. In total, 1036 patients over the age of 9 were included, of which n = 161 were PICU admissions. Females represented higher proportions of all suicide-related hospital admissions (67.9%). Looking at race/ethnicity, PICU admissions were largely Caucasian (83.2%); Blacks and Hispanics had lower odds of PICU admissions (OR: 0.49; 0.17, respectively). PICU-admitted patients were older (16.0 vs. 15.5; p = 0.0001), with lower basal metabolic index (23.0 vs. 22.0; p = 0.0013), and presented in summer months (OR: 1.51, p = 0.044). Time-series decomposition showed seasonal peaks in June and August. Local regions outside the city limits identified higher numbers of PICU admissions. PICUs serve discrete geographical regions and are a source of information, when paired with clinical geospatial/seasonal analyses, highlighting clinical and societal risk factors associated with PICU admissions.

Glucose and Adenosine Triphosphate Level in Normal Subjects

1974 ◽  
Vol 125 (588) ◽  
pp. 459-460 ◽  
Author(s):  
J. Damas Mora ◽  
D. Vlissides ◽  
F. A. Jenner
Keyword(s):  
Blood Glucose ◽  
Correlation Coefficient ◽  
Adenosine Triphosphate ◽  
Whole Blood ◽  
Normal Subjects ◽  
Red Cell ◽  
Linus Pauling

In Orthomolecular Psychiatry; Treatment of Schizophrenia, edited by David Hawkins and Linus Pauling (1973), Beebe and Wendel (pp. 278–302) report a high correlation coefficient of r = 0.99 (which we calculate gives N = 42, p very much lower than 0.001) between whole blood glucose and adenosine triphosphate (ATP). This relationship they claim is no longer maintained in schizophrenics with anxiety, r = 0.16 (N = 62, p > 0.1). Erban and Hanzlicek (1966), Hansen (1972) and Hansen and Dimitrakoudi (1974) have suggested a possible significance of whole blood ATP in psychoses, and Naylor, Dick, Dick, Le Poidevin and Whyte (1973) have implicated red cell Na/K ATPases. The mechanisms involved in controlling blood ATP seemed therefore worthy of study especially if they are so dependent on glucose.

Prediction of distance running performances of female runners using nomograms

2021 ◽  
Author(s):  
Lucie Lerebourg ◽  
Brice Guignard ◽  
Ghazi Racil ◽  
Mohamed Chedly Jlid ◽  
Eric Held ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Training Programs ◽  
Distance Running ◽  
Limits Of Agreement ◽  
Running Performance ◽  
Precision And Accuracy ◽  
High Level ◽  
Very High

This study examined the validity, precision and accuracy of the predictions of distance running performances in female runners from three nomograms. Official rankings of French women for the 3000-m, 5000-m, and 10,000-m track-running events from 2005 to 2019 were examined. Only female runners who performed in the three distance events within the same year were included (n=158). Each performance over any distance was predicted using the three nomograms from the two other performances. The 3000-m, 5000-m and 10,000-m performances were 11min17 s± 1min20 s, 19min29 s ± 2min20 s, 41min18 s ± 5min7 s, respectively. No difference was found between the actual and predicted running performances regardless of the nomogram (p>0.05). All predicted running performances were significantly correlated with the actual ones, with a very high correlation coefficient (p<0.001; r>0.90). Bias and 95% limits of agreement were acceptable because, whatever the nomogram, they were less than or equal to -0.0±6.2% on the 3000-m, 0.0±3.7% on the 5000-m, and 0.1±9.3% on the 10,000-m. The study confirms the validity of the three nomograms to predict track-running performance with a high level of accuracy. The predictions from these nomograms are similar and may be used in training programs and competitions.

A Survey of Coliforms and Staphylococcus aureus in Cheese Using Impedimetric and Plate Count Methods1

1988 ◽  
Vol 51 (1) ◽  
pp. 53-55 ◽  
Author(s):  
F. A. KHAYAT ◽  
J. C. BRUHN ◽  
G. H. RICHARDSON
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Correlation Coefficient ◽  
Cheddar Cheese ◽  
Plate Count ◽  
Impedance Method ◽  
Colony Forming Units ◽  
Fresh Cheese ◽  
Cheese Products ◽  
And Staphylococcus Aureus

A total of 256 cheese samples were analyzed for coliform plate count using violet red bile agar and for an impedance count using BactometerR Coliform Medium with a correlation coefficient between methods of R=−.91. Fifty-four percent of the samples contained 102 to 107 colony forming units/gram (CFU/g). The highest counts were in cream and fresh cheese products. When 27 Cheddar cheese samples were inoculated with from 102 to 107 CFU of Escherichia coli/g a correlation of R=−.97 was found between methods. Two hundred of the cheese samples were analyzed for Staphylococcus aureus using Baird-Parker medium and impedance count using BactometerR S.aureus Medium. Five samples (2%) contained over 103 CFU/g. The strains isolated were coagulase-positive. When 34 samples of cheese were inoculated with 102 to 107 CFU of staphylococci/g, the correlation between the plate and impedance method was R=0.98.

Effectiveness of antimicrobial hospital curtains on reducing bacterial contamination—A multicenter study

2018 ◽  
Vol 40 (2) ◽  
pp. 164-170 ◽  
Author(s):  
Shik Luk ◽  
Viola Chi Ying Chow ◽  
Kelvin Chung Ho Yu ◽  
Enoch Know Hsu ◽  
Ngai Chong Tsang ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Bacterial Contamination ◽  
Indirect Costs ◽  
Multidrug Resistant ◽  
Clinical Settings ◽  
Carbapenem Resistant ◽  
Colony Forming Units ◽  
Multidrug Resistant Organisms ◽  
Bed Days

AbstractObjectiveTo determine the efficacy of 2 types of antimicrobial privacy curtains in clinical settings and the costs involved in replacing standard curtains with antimicrobial curtains.DesignA prospective, open-labeled, multicenter study with a follow-up duration of 6 months.SettingThis study included 12 rooms of patients with multidrug-resistant organisms (MDROs) (668 patient bed days) and 10 cubicles (8,839 patient bed days) in the medical, surgical, neurosurgical, orthopedics, and rehabilitation units of 10 hospitals.MethodCulture samples were collected from curtain surfaces twice a week for 2 weeks, followed by weekly intervals.ResultsWith a median hanging time of 173 days, antimicrobial curtain B (quaternary ammonium chlorides [QAC] plus polyorganosiloxane) was highly effective in reducing the bioburden (colony-forming units/100 cm2, 1 vs 57; P < .001) compared with the standard curtain. The percentages of MDRO contamination were also significantly lower on antimicrobial curtain B than the standard curtain: methicillin-resistant Staphylococcus aureus, 0.5% vs 24% (P < .001); carbapenem-resistant Acinetobacter spp, 0.2% vs 22.1% (P < .001); multidrug-resistant Acinetobacter spp, 0% vs 13.2% (P < .001). Notably, the median time to first contamination by MDROs was 27.6 times longer for antimicrobial curtain B than for the standard curtain (138 days vs 5 days; P = .001).ConclusionsAntimicrobial curtain B (QAC plus polyorganosiloxane) but not antimicrobial curtain A (built-in silver) effectively reduced the microbial burden and MDRO contamination compared with the standard curtain, even after extended use in an active clinical setting. The antimicrobial curtain provided an opportunity to avert indirect costs related to curtain changing and laundering in addition to improving patient safety.

Sign in / Sign up

Export Citation Format

Share Document