scholarly journals In VitroMicrobiology Studies on a New Peritoneal Dialysis Connector

2012 ◽  
Vol 32 (5) ◽  
pp. 552-557
Author(s):  
Giovanni Di Bonaventura ◽  
Paolo Cerasoli ◽  
Arianna Pompilio ◽  
Fabio Arrizza ◽  
Lorenzo Di Liberato ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Peritoneal Dialysis ◽  
Bacterial Infection ◽  
Flow Control ◽  
Clinical Setting ◽  
Staphylococcus Epidermidis ◽  
Colony Forming Units ◽  
Airborne Contamination

ObjectiveWe evaluated the ability of a recently developed peritoneal dialysis (PD) connector to prevent the risk of bacterial transfer to the fluid path after simulated touch and airborne contamination.MethodsStaphylococcus epidermidis ATCC1228 and Pseudomonas aeruginosa ATCC27853 strains were used. For touch contamination, 2 μL of a standardized inoculum [1x108colony-forming units (CFU) per milliliter] were deposited on top of the pin closing the fluid path of the patient connector. For airborne contamination, the patient connector was exposed for 15 seconds to a nebulized standardized inoculum. To simulate the patient peritoneum and effluent, the patient connector was pre-attached to a 2-L bag of sterile PD solution. After contamination, the patient connector was attached to the transfer set, the pin was captured, flow control was turned to simulate “patient drain” into the empty bag, and then “patient fill” using the bag pre-attached to the connector. Finally, a new pin was recaptured. The PD solution collected in the bag pre-attached to the connector was run through a 0.20-μm filter for colony counts.ResultsNo infected connector transferred bacteria to the fluid path, regardless of the challenge procedure or the strain used.ConclusionsOur results show that the new PD connector may fully obviate the risk of bacterial infection, even in the presence of heavy contamination. Further studies are in progress to test our PD connector in a clinical setting.

Bacterial survival and biofilm formation on conventional and antibacterial toothbrushes

Biofilms ◽  
2004 ◽  
Vol 1 (2) ◽  
pp. 123-130 ◽  
Author(s):  
R. L. Sammons ◽  
D. Kaur ◽  
P. Neal
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Staphylococcus Epidermidis ◽  
Biofilm Formation ◽  
Bacterial Survival ◽  
Opportunistic Pathogens ◽  
Mechanical Agitation ◽  
Gram Staining ◽  
Colony Forming Units ◽  
Significant Difference ◽  
Number Of Bacteria

The aim of this study was to investigate bacterial survival and biofilm formation on toothbrushes. Fifteen healthy volunteers each used a normal toothbrush and an antibacterial toothbrush of the same design for two separate 5 week periods. Bacteria were removed from the brush head by swabbing and mechanical agitation in 10ml of tryptone soya broth, cultured aerobically on selective and non-selective media, and classified by Gram staining, catalase and oxidase tests. Survival of Staphylococcus epidermidis and Pseudomonas aeruginosa was monitored in the laboratory on both types of brush over 8 days. Scanning electron microscopy was used to observe biofilm formation on antibacterial and conventional brushes used for various times. Numbers of bacteria isolated from conventional and antibacterial brushes from different individuals ranged from 8.3×103 to 4.7×106 and from 1×102 to 1.2×106 colony-forming units/ml, respectively. A larger number of bacteria were isolated from conventional brushes than from antibacterial brushes used by the same individuals but no statistically significant difference was demonstrated. No differences in the relative proportions of Gram-negative and Gram-positive rods or cocci were seen. Staphylococci, presumptive coliforms and pseudomonads were isolated from 48%, 28% and 16% of brushes, respectively. Pseudomonas aeruginosa was viable for at least 4 days on conventional, and 2–3 days on antibacterial, brushes, whilst S. epidermidis survived for 6–8 days on antibacterial and more than 8 days on conventional brushes. Biofilms formed on the heads and bristles of both conventional and antibacterial brushes. Extensive, mixed community biofilms developed after several months of use. We conclude that toothbrushes may be a reservoir of opportunistic pathogens including staphylococci and pseudomonad-like organisms and must be considered as a potential source of haematogenous infections and cross-infection.

Adequate Disinfection of a Split-Septum Needleless Intravascular Connector with a 5-Second Alcohol Scrub

2012 ◽  
Vol 33 (7) ◽  
pp. 661-665 ◽  
Author(s):  
Mark E. Rupp ◽  
Stephanie Yu ◽  
Tomas Huerta ◽  
R. Jennifer Cavalieri ◽  
Roxanne Alter ◽  
...  
Keyword(s):  
Clinical Setting ◽  
Staphylococcus Epidermidis ◽  
Isopropyl Alcohol ◽  
Agar Plate ◽  
Laboratory Assessment ◽  
Minimal Growth ◽  
Colony Forming Units ◽  
Clinical Survey ◽  
Clinical Conditions

Objective.Define optimum vascular catheter connector valve disinfection practices under laboratory and clinical conditions.Design.Prospective observational clinical survey and laboratory assessment of disinfection procedures.Setting.All adult inpatients at an academic healthcare center.Methods.In the clinical setting, contamination of needleless connectors was assessed in 6 weekly prevalence surveys in which the connector valves from central venous catheters (CVCs) in situ were cultured by pressing the connector diaphragm to an agar plate. Before culture, valves were disinfected by scrubbing the diaphragm with a 70% isopropyl alcohol pledget for 0, 5, 10, 15, or 30 seconds. In the laboratory, the diaphragms on 150 unused sterile connector valves were inoculated with 103, 105, or 108colony-forming units ofStaphylococcus epidermidisand allowed to dry. After disinfection of the diaphragms by scrubbing with a 70% isopropyl alcohol pledget for 0, 5, 10, 15, or 30 seconds, the valves were sampled by pressing the diaphragm to an agar plate.Results.In the clinical setting, 363 connector valves from patients with CVCs were sampled, and 66.7% of nondisinfected valves revealed bacterial contamination. After 5-second disinfection with an alcohol pledget, only 1 (1.4%) of 71 yielded microbial growth (P< .005). In the laboratory, at the 103and 105inoculum, all connector valves yielded sterile cultures when scrubbed for 5 or more seconds (P< .001). At the 108inoculum, 2 (20%) of 10 connector valves yielded minimal growth ofS. epidermidis.Conclusions.A 5-second scrub with a 70% isopropyl alcohol pledget yields adequate disinfection of a split-septum intravascular catheter connector valve under clinical and laboratory conditions.

Establishing an Experimental Infection Model for Peritoneal Dialysis: Effect of Inoculum and Volume

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 79-81 ◽  
Author(s):  
Wim Calame ◽  
Charles Afram ◽  
Nico Blijleven ◽  
Roeland J.B.M. Hendrickx ◽  
Ferry Namavar ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Peritoneal Dialysis ◽  
Peritoneal Cavity ◽  
Experimental Infection ◽  
Staphylococcus Epidermidis ◽  
Infection Model ◽  
Bacterial Number ◽  
Colony Forming Units ◽  
Number Of Bacteria ◽  
Experimental Infection Model

The effect of the number of bacteria and the volume of the inoculum was studied in an experimental infection model to establish a peritoneal dialysis model in the rat. Staphylococcus aureus was used in all experiments, and Staphylococcus epidermidis only in the volume experiments. A bacterial number between 108 and 109 colony forming units (cfu) resulted in a time-dependent decrease of bacteria collected from the peritoneal cavity. Higher concentrations resulted in the death of animals, while lower concentrations were rapidly cleared. There was a positive correlation between the volume in which 3 x 108 cfu were dissolved and the number of bacteria isolated from the peritoneal cavity 24 hours after infection. The results of this study led to an experimental dialysis model using 10 mL of dialysis fluid and 0.5 mL of a suspension containing 3 x 108 cfu of Staphylococcus aureus.

Colonization-Resistant Antimicrobial-Coated Peritoneal Dialysis Catheters: Evaluation in a Newly Developed Rat Model of Persistent Pseudomonas Aeruginosa Peritonitis

2002 ◽  
Vol 22 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Anthony Finelli ◽  
Lori L. Burrows ◽  
Frank A. DiCosmo ◽  
Valerio DiTizio ◽  
Selva Sinnadurai ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Peritoneal Dialysis ◽  
Rat Model ◽  
Bacterial Colonization ◽  
Blood Cultures ◽  
Sprague Dawley ◽  
Sprague Dawley Rats ◽  
Colony Forming Units ◽  
Peritoneal Washings ◽  
Culture Positive

Objective Development of a rat model of persistent peritonitis and evaluation of the ability of liposomal ciprofloxacin hydrogel-coated silicone to resist colonization. Design A newly developed model of persistent Pseudomonas aeruginosa peritonitis to compare the ability of liposomal ciprofloxacin hydrogel (LCH)-coated silicone versus plain silicone for resistance to bacterial colonization. Animals Male Sprague–Dawley rats. Results Inoculating the peritoneum of rats with 1 mL 0.5% agar containing 106 colony-forming units (cfu)/mL P. aeruginosa in the presence of a plain silicone coupon resulted in persistent peritonitis for at least 7 days. Plain silicone coupons in all 40 rats were colonized (median 2.54 × 103 cfu/cm2; range 5.0 × 101 – 1.0 × 106 cfu/cm2) and peritoneal washings were consistently culture-positive. In contrast, the LCH coupons removed after 7 days from the 40 test rats were sterile, as were the peritoneal washings, and there was no evidence of peritonitis. Blood cultures were negative in both groups. Conclusions Liposomal ciprofloxacin hydrogel-coated silicone resists colonization in this rat model of persistent P. aeruginosa peritonitis.

scholarly journals Design and proof-of-concept evaluation of a touchless connector system for preventing peritoneal dialysis-associated peritonitis.

2021 ◽  
Author(s):  
Ibrahim O. Yekinni ◽  
Thomas Viker ◽  
Ryan Hunter ◽  
Aaron Tucker ◽  
Sarah Elfering ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Staphylococcus Epidermidis ◽  
Standard Of Care ◽  
Luria Bertani ◽  
Worst Case ◽  
Colony Forming Units ◽  
Concept Evaluation ◽  
Peritoneal Dialysis Fluid ◽  
Test Organisms ◽  
Further Development

In this paper, we describe the design of a touchless peritoneal dialysis connector system and how we evaluated its potential for preventing peritoneal dialysis-associated peritonitis, in comparison to the standard of care. The unique feature of this system is an enclosure within which patients can connect and disconnect for therapy, protecting their peritoneal catheters from touch or aerosols. We simulated a worst-case contamination scenario by spraying 40mL of a standardized inoculum [1x107 colony-forming units (CFU) per milliliter] of test organisms, Staphylococcus epidermidis ATCC1228 and Pseudomonas aeruginosa ATCC39327, while test participants made mock connections for therapy. We then compared the incidence of fluid path contamination by test organisms in the touchless connector system and the standard of care. 4 participants were recruited to perform a total of 56 tests, divided in a 1:1 ratio between both systems. Peritoneal dialysis fluid sample from each test was collected and maintained at body temperature (37 C) for 16 hours before being plated on Luria Bertani agar, Mannitol Salts Agar and Pseudomonas isolation agar for enumeration. No contamination was observed in the test samples from the touchless connector system, compared to 65%, 75% and 70% incidence contamination for the standard of care on Luria Bertani agar, Mannitol Salts Agar and Pseudomonas isolation agar respectively. In conclusion, the results show that the touchless connector system can prevent fluid path contamination even in heavy bacterial exposures and may help reduce peritoneal dialysis-associated peritonitis risks from inadvertent contamination with further development.

Scanning Electron Microscopy of Staphylococcus Epidermidis Adherence to Continuous Ambulatory Peritoneal Dialysis Catheters

1985 ◽  
Vol 43 ◽  
pp. 520-521
Author(s):  
William J. Lamoreaux ◽  
David L. Smalley ◽  
Larry M. Baddour ◽  
Alfred P. Kraus
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Staphylococcus Epidermidis ◽  
Sterile Saline ◽  
Intravascular Devices ◽  
Capd Patient ◽  
Scanning Electron

Infections associated with the use of intravascular devices have been documented and have been reported to be related to duration of catheter usage. Recently, Eaton et al. reported that Staphylococcus epidermidis may attach to silastic catheters used in continuous ambulatory peritoneal dialysis (CAPD) treatment. The following study presents findings using scanning electron microscopy (SEM) of S. epidermidis adherence to silastic catheters in an in vitro model. In addition, sections of polyvinyl chloride (PVC) dialysis bags were also evaluated by SEM.The S. epidermidis strain RP62A which had been obtained in a previous outbreak of coagulase-negative staphylococcal sepsis at local hospitals was used in these experiments. The strain produced surface slime on exposure to glucose, whereas a nonadherent variant RP62A-NA, which was also used in these studies, failed to produce slime. Strains were grown overnight on blood agar plates at 37°C, harvested from the surface and resuspended in sterile saline (0.85%), centrifuged (3,000 rpm for 10 minutes) and then washed twice in 0.1 M phosphate-buffered saline at pH 7.0. Organisms were resuspended at a concentration of ca. 106 CFU/ml in: a) sterile unused dianeal at 4.25% dextrose, b) sterile unused dianeal at 1.5% dextrose, c) sterile used dialysate previously containing 4.25% dextrose taken from a CAPD patient, and d) sterile used dialysate previously containing 1.5% dextrose taken from a CAPD patient.

Антимікробна резистентність провідних збудників інфекцій сечових шляхів у Києві (Україна)

2017 ◽  
Vol 1 (2) ◽  
pp. 48-60
Author(s):  
A.G. Salmanov ◽  
A.V. Rudenko
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Klebsiella Pneumoniae ◽  
Staphylococcus Epidermidis ◽  
Klebsiella Oxytoca ◽  
Enterobacter Aerogenes ◽  
Enterobacter Cloacae ◽  
Proteus Vulgaris ◽  
Providencia Rettgeri ◽  
E Coli

Мета роботи — вивчити резистентність до антибіотиків бактеріальних збудників інфекцій сечових шляхів (ІСШ), виділених у пацієнтів урологічного стаціонару в м. Києві. Матеріали і методи. Досліджено 1612 штамів бактерій, виділених із сечі хворих з ІСШ (цистит, уретрит, пієлонефрит), госпіталізованих в урологічне відділення ДУ «Інститут урології НАМН України» у м. Києві протягом 2016 р. Серед пацієнтів переважали жінки — 1201 (74,5 %). Вік хворих становив від 17 до 74 років. Для збору даних використано медичну документацію лікарні. Мікробіологічні дослідження виконано у лабораторії мікробіології ДУ «Інститут урології НАМН України». Аналізували результати культурального дослідження зразків сечі, зібраних за наявності клінічних ознак ІСШ. Дослідження клінічного матеріалу та інтерпретацію отриманих результатів проводили загальноприйнятими методами. Вивчено чутливість уропатогенів до 31 антибіотика дискодифузійним методом відповідно до рекомендацій Інституту клінічних та лабораторних стандартів США (Clinical and Laboratory Standards Institute (CLSI)). Результати та обговорення. Аналіз мікробного спектра сечі виявив домінування серед уропатогенів штамів Escherichia coli (32,0 %), Enterococcus faecalis (19,5 %), Klebsiella pneumoniae (10,9 %), Staphylococcus epidermidis (8,9 %), S. haemolyticus (6,5 %) та Pseudomonas aeruginosa (6,4 %). Частка Enterococcus faecium, Enterobacter aerogenes і Streptococcus viridans становила відповідно 2,5, 2,2 і 1,6 %, Enterobacter cloacae, Klebsiella oxytoca, Acinetobacter baumannii, Proteus vulgaris та Providencia rettgeri — менше 1,0 %. У більшості випадків (69,7 %) мікроорганізми виділено у монокультурі, у решті випадків — у мікробних асоціа- ціях. Високу резистентність до тестованих антибіотиків виявили штами E. aerogenes (45,1 %), E. cloacae (45,7 %), E. faecium (40,9 %), E. faecalis (40,7 %), E. coli (39,9 %), P. aeruginosa (34,0 %), K. pneumoniae (28,6 %). Найбільш активними до уропатогенів були іміпенем (E. coli — 87,6 %, P. aeruginosa — 75,7 %, E. cloacae — 67,3 %, E. aerogenes — 72,6 %, K. pneumoniae — 93,2 %), меропенем (E. coli — 89,1 %, P. aeruginosa — 76,7 %, K. pneumoniae — 82,6 %), лефлоцин (E. coli — 74,5 %, ентерококи — 78,7 %, P. aeruginosa — 76,7 %, E. cloacae — 73,9 %, E. aerogenes — 80,4 %, K. pneumoniae — 83,5 %), амоксицилін/клавуланат (ентерококи — 84,6 %), фурагін (ентерококи — 82,6 %), цефоперазон (K. pneumoniae — 89,2 %, P. aeruginosa — 73,8 %), цефтріаксон (K. pneumoniae — 80,1 %). Висновки. Антибіотикорезистентність збудників ІСШ — важлива терапевтична проблема. Найбільшою активністю до уропатогенів характеризуються іміпенем, меропенем, лефлоцин, амоксицилін/ клавуланат, фурагін, цефоперазон, цефтріаксон, які можна розглядати як препарат вибору для призначення стартової терапії ІСШ. Необхідно здійснювати постійний моніторинг за резистентністю до дії антибіотиків. Політику використання антибіотиків у кожному стаціонарі слід визначати залежно від локальних даних щодо резистентності до протимікробних препаратів.

scholarly journals Repeat exit site infection in peritoneal dialysis patient with polycythemia vera – a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Edyta Gołembiewska ◽  
Kazimierz Ciechanowski
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Peritoneal Dialysis ◽  
Case Report ◽  
Polycythemia Vera ◽  
Significant Risk ◽  
Renal Amyloidosis ◽  
Site Infection ◽  
Exit Site ◽  
Exit Site Infection ◽  
First Case

Abstract Background Infectious complications of peritoneal dialysis (PD) remain a common cause of catheter loss and discontinuation of PD. Exit site infection (ESI) constitutes a significant risk factor for PD-related peritonitis and determination of predisposing states is relevant. We here present a case of repeat ESI due to Pseudomonas aeruginosa in a PD patient with skin changes in the course of polycythemia vera (PV). Case presentation A 73-year-old PD patient with chronic kidney disease secondary to renal amyloidosis and ankylosing spondylitis, presented to the nephrology unit with signs of ESI. In 2006 he was diagnosed with PV and since then has was successfully treated with hydroxyurea; however, he reported recurrent episodes of developing skin nodules in the course of the disease. Exit site swab yielded Pseudomonas aeruginosa and the infection developed in the ulcerated PV nodule that appeared in exit site 2 weeks earlier. Patient was treated with intraperitoneal amikacin and oral ciprofloxacin, however, due to neurological complications, the treatment had to be interrupted and finally catheter was removed. Similar episode of ESI with Pseudomonas aeruginosa developed in the patient two years earlier and also required catheter removal. Conclusion This is the first case report demonstrating the development of ESI on the polycythemia vera skin lesion in this area. Skin manifestations of PV might be a predisposing factor to ESI in PD patients.

The Perennial Problem of Variability In Adenosine Triphosphate (ATP) Tests for Hygiene Monitoring Within Healthcare Settings

2015 ◽  
Vol 36 (6) ◽  
pp. 658-663 ◽  
Author(s):  
Greg S. Whiteley ◽  
Chris Derry ◽  
Trevor Glasbey ◽  
Paul Fahey
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Staphylococcus Epidermidis ◽  
Test Point ◽  
Dilution Series ◽  
Healthcare Settings ◽  
Speed Of Response ◽  
Numerical Scale ◽  
Dilution Step ◽  
The Mean ◽  
The Individual

OBJECTIVETo investigate the reliability of commercial ATP bioluminometers and to document precision and variability measurements using known and quantitated standard materials.METHODSFour commercially branded ATP bioluminometers and their consumables were subjected to a series of controlled studies with quantitated materials in multiple repetitions of dilution series. The individual dilutions were applied directly to ATP swabs. To assess precision and reproducibility, each dilution step was tested in triplicate or quadruplicate and the RLU reading from each test point was recorded. Results across the multiple dilution series were normalized using the coefficient of variation.RESULTSThe results for pure ATP and bacterial ATP from suspensions ofStaphylococcus epidermidisandPseudomonas aeruginosaare presented graphically. The data indicate that precision and reproducibility are poor across all brands tested. Standard deviation was as high as 50% of the mean for all brands, and in the field users are not provided any indication of this level of imprecision.CONCLUSIONSThe variability of commercial ATP bioluminometers and their consumables is unacceptably high with the current technical configuration. The advantage of speed of response is undermined by instrument imprecision expressed in the numerical scale of relative light units (RLU).Infect Control Hosp Epidemiol2015;00(0):1–6

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