Antimicrobial Activity of Glucoprotamin: A Clinical Study of a New Disinfectant for Instruments

Abstract Objective: To determine the in vitro efficacy of glucoprotamin for the disinfection of instruments. Design: Prospective observational study. Setting: University women's hospital. Methods: Instruments were immersed in saline solution after use, and glucoprotamin was added to a concentration of 1.5% before soaking for 60 minutes. Biocidal activity was determined by the difference in colony-forming units (CFU) on instruments before and after disinfection. Results: One hundred thirty-seven instruments were collected during 10 days and exposed to a 1.5% dilution of glucoprotamin without prior washing. Bioburden before disinfection ranged from 2 × 105 to 7.1 × 107 CFU per instrument. Average bacterial killing was 5.98 log10 CFU ± 0.48 under aerobic conditions and 6.75 log10 CFU ± 0.54 under anaerobic conditions, despite the presence of large amounts of proteins on instruments that were frequently bloody. No vegetative bacteria were isolated in any sample after disinfection. Conclusion: This clinical study confirmed excellent in vitro efficacy of glucoprotamin without prior removal of proteins and debri

Microbiological tests to predict treatment outcome in experimental device-related infections due to Staphylococcus aureus

Treatment outcome of experimental device-related infections cannot be predicted by the results of standard susceptibility tests such as MIC. Microorganisms involved in such infections have a slow growth rate and adhere to surfaces. Therefore, laboratory tests were developed taking into account these properties and compared with the treatment outcome in an animal model. Vancomycin, teicoplanin, ciprofloxacin and fleroxacin were tested alone, or in combination with rifampicin for their ability to cure experimental device-related infections in guinea pigs due to Staphylococcus aureus ATCC 29213. Rifampicin alone or in combination was significantly more effective than the other four drugs (P < 0·001). Combined treatment with rifampicin had a higher cure rate than rifampicin alone. Treatment success was not predicted by an antibiotic trough level exceeding the MIC at site of infection. In contrast, drug efficacy was predicted if the stationary-phase MBC was in the sensitive range, and if glass-adherent S. aureus was killed by low drug concentration

Equal Efficacy of Glucoprotamin and an Aldehyde Product for Environmental Disinfection in a Hematologic Transplant Unit: A Prospective Crossover Trial

Background. The inanimate hospital environment has emerged as an important reservoir of nosocomial pathogens. In particular, multidrug-resistant pathogens, such as methicillin-resistant Staphylococcus aureus, Acinetobacter species, and Clostridium difficile, play a major role in the transmission of hospital-acquired infections. In Europe, aldehydes, chlorine, and quaternary ammonium compounds have been commonly used for environmental disinfection. Glucoprotamin, a newer active compound for disinfectants, has been clinically tested for disinfection of instruments but not for environmental disinfection. Objective. This study evaluated the antimicrobial effectiveness of a glucoprotamin-containing product (Incidin) compared with that of an aldehyde-containing product (Deconex), the current standard at our institution. Methods. This prospective crossover study was conducted in our access-restricted hematologic transplant unit. A total of 3,086 samples from the environment were processed and examined for overall bacterial burden as well as selectively for S. aureus, C. difficile, and gram-negative bacteria. Results. There was no significant difference in residual bacteria after disinfection between the 2 products in terms of overall burden and selected pathogens. Enterococci were the predominant pathogens recovered from surfaces, but no vancomycin-resistant enterococci were recovered. Similarly, C. difficile could not be found in the patients' environment, even in rooms, despite the use of selective media. Conclusion. The aldehyde-containing product (Deconex) and the glucoprotamin-containing product (Incidin) demonstrated similar efficacy against environmental contamination in a hematologic transplant unit with the application of selective media for C. difficile, S. aureus, and gram-negative bacteria in addition to standard mediu

Methicillin-resistant Staphylococcus aureus (MRSA) among dental patients: a problem for infection control in dentistry?

We assessed the frequency of carriers of methicillin-resistant Staphylococcus aureus (MRSA) among 500 dental patients of a university clinic. From each participant, two specimens were taken from the anterior nares and the pharynx and analysed by culture. The participants completed a questionnaire on possible risk factors of MRSA infection. Two hundred ten individuals carried S. aureus, 90 in the nares only, 51 in the throat only and 69 in nares and throat. Isolates of 208 patients were methicillin-sensitive; two isolates were methicillin-resistant, both carried in the throat exclusively. In conclusion, the frequency of nasal and/or throat carriers of MRSA among dental patients was low and suggests few opportunities of exposure in the dental clinic assesse

Rate of Transmission of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae Without Contact Isolation

The estimated rate of spread of extended-spectrum beta-lactamaseproducing Enterobacteriaceae was low in a tertiary care university-affiliated hospital with high levels of standard hygiene precautions, challenging the routine use of contact isolation in a non-epidemic settin