Abstract
The contamination of semiclosed disposable circuits of Healthdyne and Bourns ventilators was studied in a newborn intensive care unit over a 2-year period. A total of 379 fluid samples was obtained from inspiratory and expiratory tubing condensates and traps and from thermal humidifier columns fed with prefilled containers of sterile water. In addition, 100 tryptic soy agar plates were exposed to the exhalation mist of the circuits sampled. With 24-h changes of circuits a 2.5% contamination rate was observed (phase I). In an effort to contain costs, circuits were changed every 48 h (phase II); the concentration of potential pathogens increased to greater than 10(5) CFU/ml with this extension of changing time. Two long-term (15- and 9-month) infants were colonized and intermittently infected, one with Klebsiella pneumoniae and Staphylococcus aureus and the other with Pseudomonas aeruginosa. When the protocol was readjusted from 48- to 24-h circuit changes (phase II), the contamination rate decreased; for the two colonized infants (35 circuits, 123 samples) the contamination rate decreased from 19 to 6% (P less than 0.01; chi-square test), and for seven noncolonized infants (59 circuits, 217 samples) the contamination rate decreased from 5 to 0.5% P less than 0.001; (chi-square test). These data suggest that frequent changing of the circuits reduces colonization and cross-infection.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Carson L. A., Favero M. S., Bond W. W., Petersen N. J. Morphological, biochemical, and growth characteristics of pseudomonas cepacia from distilled water. Appl Microbiol. 1973 Mar;25(3):476–483. doi: 10.1128/am.25.3.476-483.1973. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Favero M. S., Carson L. A., Bond W. W., Petersen N. J. Pseudomonas aeruginosa: growth in distilled water from hospitals. Science. 1971 Aug 27;173(3999):836–838. doi: 10.1126/science.173.3999.836. [DOI] [PubMed] [Google Scholar]
- Favero M. S., Petersen N. J., Carson L. A., Bond W. W., Hindman S. H. Gram-negative water bacteria in hemodialysis systems. Health Lab Sci. 1975 Oct;12(4):321–334. [PubMed] [Google Scholar]
- Goldmann D. A., Freeman J., Durbin W. A., Jr Nosocomial infection and death in a neonatal intensive care unit. J Infect Dis. 1983 Apr;147(4):635–641. doi: 10.1093/infdis/147.4.635. [DOI] [PubMed] [Google Scholar]
- Hemming V. G., Overall J. C., Jr, Britt M. R. Nosocomial infections in a newborn intensive-care unit. Results of forty-one months of surveillance. N Engl J Med. 1976 Jun 10;294(24):1310–1316. doi: 10.1056/NEJM197606102942403. [DOI] [PubMed] [Google Scholar]
- Kessel S. S., Villar J., Berendes H. W., Nugent R. P. The changing pattern of low birth weight in the United States--1970 to 1980. JAMA. 1984 Apr 20;251(15):1978–1982. [PubMed] [Google Scholar]
- MacGregor R. R. Nosocomial infection control problems in neonates and infants. J Med. 1980;11(4):229–237. [PubMed] [Google Scholar]
- Malecka-Griggs B., Reinhardt D. J. Direct dilution sampling, quantitation, and microbial assessment of open-system ventilation circuits in intensive care units. J Clin Microbiol. 1983 May;17(5):870–877. doi: 10.1128/jcm.17.5.870-877.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Marshall T. A. The outlook for the high-risk infant-1981. J S C Med Assoc. 1981 Aug;77(8):373–376. [PubMed] [Google Scholar]
- McCormick M. C. The contribution of low birth weight to infant mortality and childhood morbidity. N Engl J Med. 1985 Jan 10;312(2):82–90. doi: 10.1056/NEJM198501103120204. [DOI] [PubMed] [Google Scholar]
- Paneth N., Kiely J. L., Wallenstein S., Marcus M., Pakter J., Susser M. Newborn intensive care and neonatal mortality in low-birth-weight infants: a population study. N Engl J Med. 1982 Jul 15;307(3):149–155. doi: 10.1056/NEJM198207153070303. [DOI] [PubMed] [Google Scholar]
- Philip A. G. Detection of neonatal sepsis of late onset. JAMA. 1982 Jan 22;247(4):489–492. [PubMed] [Google Scholar]
- Simmons B. P., Wong E. S. Guideline for prevention of nosocomial pneumonia. Infect Control. 1982 Jul-Aug;3(4):327–333. doi: 10.1017/s0195941700056423. [DOI] [PubMed] [Google Scholar]
- Tyson J. E., Clarkson J. E., Sinclair J. C., Leitch R. Analysis of newborn intensive care by time-lapse photography. Crit Care Med. 1981 Nov;9(11):780–784. doi: 10.1097/00003246-198111000-00006. [DOI] [PubMed] [Google Scholar]