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Attempts to control clothes-borne infection in a burn unit, 2. Clothing routines in clinical use and the epidemiology of cross-colonization*

Published online by Cambridge University Press:  15 May 2009

Ulrika Ransjö
Affiliation:
The Institute of Clinical Bacteriology, The Department of Plastic Surgery, and the Department of Infectious Diseases, University Hospital, Uppsala, Sweden
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Previous investigations have shown that cross-contamination in a burn unit is mainly clothes-borne. New barrier garments have been designed and tried experimentally. The aim of the present study was to investigate the effects of different clothing routines on cross-contamination. In a long-term study, the rates and routes of colonizations with Staphylococcus aureus, Streptococcus groups A, B, C, F, and G and Pseudomonas aeruginosa were examined. The exogenous colonization rates were, with S. aureus 77%, with Streptococcus species 52% and with Ps. aeruginosa 32%. The colonization rate with Ps. aeruginosa was higher in patients with larger burns. Patients dispersed Streptococcus and Ps. aeruginosa as well as S. aureus into the air of their rooms in considerable amounts, but dispersers were not more important as sources of cross-colonization than non-dispersers. In comparison of clothing routines, there was no difference in overall colonization rates. The newly designed barrier garment that was made from apparently particle-tight material did not reduce the transfer of bacteria from patient to patient. A less rigid routine than that previously used did not increase the risk of cross-contamination. A thorough change of barrier dress after close contact nursing delayed the first exogenous S. aureus colonization from day 6 to day 14 after admission. This routine might be recommended for clinical use. Otherwise, methods must be developed for adequate selection of materials intended for barrier garments.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1979

References

REFERENCES

Alford, D. J., Ritter, M. A., French, M. L. V. & Hart, J. B. (1973). The operating room gown as a barrier to bacterial shedding. American Journal of Surgery 125, 589.CrossRefGoogle ScholarPubMed
Aly, R., Malibach, H. I., Shinefield, H. R., Mandel, A. & Strauss, W. G. (1974). Bacterial interference among strains of Staphylococcus aureus in man. Journal of Infectious Diseases 129, 720.Google Scholar
Barclay, T. L. & Dexter, F. (1968). Infection and cross infection in a new burns centre. British Journal of Surgery 55, 197.CrossRefGoogle Scholar
Bernard, H. R., Speers, R., O'Grady, F. & Shooter, R. A. (1965). Reduction of dissemination of bacteria by modification of operation room clothing. Lancet ii, 458.CrossRefGoogle Scholar
Blair, J. E. & Williams, R. E. (1961). Phage-typing of staphylococci. Bulletin of the World Health Organization 24, 771.Google ScholarPubMed
Burke, J. F. (1972). The management of contamination in burns. A new look at isolation techniques. Journal of Saint Barnabas Medical Centre 9, 11.Google Scholar
Cars, O., Forsum, U. & Hjelm, E. (1975). New immunofluoresence method for the identification of group A, B, C, E, F, and G streptococci. Acta pathologica et microbiologica scandinavica, B 83, 145.Google Scholar
Cason, J. S., Jackson, D. M., Lowbury, E. J. L. & Ricketts, C. R. (1966). Antiseptic and aseptic prophylaxis for burns: Use of silver nitrate and of isolaters. British Medical Journal ii, 1288.CrossRefGoogle Scholar
Charnely, J. (1972). Postoperative infection after total hip replacement with special reference to air contamination in the operating room. Clinical Orthopaedics 87, 167.Google Scholar
Evans, H. E., Akpata, S. O. & Baki, A. (1971). Bacteriologic and clinical evaluation of gowning in a premature nursery. Journal of Pediatrics 78, 883.CrossRefGoogle Scholar
Feller, I. & Jones, C. A. (1973). Nursing the Burned Patient, p. 11. Ann Arbor, Mich.: Braun-Brumfield Inc.Google Scholar
Hambraeus, A. (1973a). Studies on transmission of Staphylococcus aureus in an isolation ward for burned patients. Journal of Hygiene 71, 171.CrossRefGoogle Scholar
Hambraeus, A. (1973b). Dispersal and transfer of Staphylococcus aureus in an isolation ward for burned patients. Journal of Hygiene 71, 787.CrossRefGoogle Scholar
Hambraeus, A. (1973c). Transfer of Staphylococcus aureus via nurses' uniforms. Journal of Hygiene 71, 799.Google ScholarPubMed
Hambraeus, A & Ransjö, U. (1977). Attempts to control clothes-borne infection in a burn unit. 1. Experimental investigations of some clothes for barrier nursing. Journal of Hygiene 79, 193.CrossRefGoogle Scholar
Hambraeus, A. & Sanderson, H. F. (1972). The control by ventilation of air-borne bacteria transfer between hospital patients and its assessment by means of a particle tracer. III. Studies with an airborne particle tracer in an isolation ward for burned patients. Journal of Hygiene 70, 299.CrossRefGoogle Scholar
Hughes, W. H. (1970). The irreducible minimum in cross-infection control and isolation nursing. Journal of Hygiene 68, 379.CrossRefGoogle ScholarPubMed
Kominos, S. D., Copeland, C. E. & Grosiax, B. (1972). Mode of transmission of Pseudomonas aeruginosa in a burn unit and an intensive care unit in a general hospital. Applied Microbiology 23, 309.Google Scholar
Lidwell, O. M., Noble, W. C. & Dolphin, G. W. (1959). The use of radiation to estimate the numbers of micro-organisms in airborne particles. Journal of Hygiene 57, 299.CrossRefGoogle ScholarPubMed
Lidwell, O. M., Brock, B., Shooter, R. A., Cooke, E. M. & Thomas, G. E. (1975). Airborne infection in a fully air-conditioned hospital. IV. Airborne dispersal of Staphylococcus aureus and its nasal aquisition by patients. Journal of Hygiene 75, 445.CrossRefGoogle Scholar
Liljedahl, S. O., Malmborg, A. S., Nyström, B. & Sjöberg, L. (1972). Spread of Pseudomonas aeruginosa in a burns unit. Journal of Medical Microbiology 5, 473.Google Scholar
Lowbury, B. J. L., Babb, J. R. & Ford, P. M. (1971). Protective isolation in a burns unit: the use of plastic isolators and air curtains. Journal of Hygiene 69, 529.Google Scholar
MacMillan, B. G., Edmonds, P., Hummel, R. P. & Maley, M. P. (1973). Epidemiology of Pseudomonas in a burn intensive care unit. Journal of Trauma 13, 627.Google Scholar
Marples, R. R. & Kligman, A. M. (1975). Experimental staphylococcal infections of the skin of man. Zentralblatt für Bakteriologie, Parasitenkunde, Infektionskrankheiten und Hygiene. I. Abteilung, suppl. 5, 755.Google Scholar
Noble, W. C., Lidwell, O. M. & Kingston, D. (1963). The size distribution of airborne particles carrying microorganisms. Journal of Hygiene 61, 507.Google ScholarPubMed
Perry, W. D., Siegel, A. C. & Rammelkamp, C. H. (1957). Transmission of group A streptococci. II. The role of contaminated dust. American Journal of Hygiene 66, 96.Google Scholar
Poplack, D. G., Penland, W. Z. & Levine, A. S. (1974). Bacteriological isolation garment. Lancet i, 1261.CrossRefGoogle Scholar
Ransjö, U., Forsgren, A. & Arturson, G. (1977). Neutrophil leukocyte functions and wound bacteria in burn patients. Burns 3, 171.CrossRefGoogle Scholar
Rubbo, S. D. & Saunders, J. (1963). Liberation of organisms from contaminated textiles. Journal of Hygiene 61, 507.Google Scholar
Sjöberg, L. & Lindberg, A. A. (1968). Phage typing of Pseudomonas aeruginosa. Acta pathologica et microbiologica scandinavica 74, 61.Google Scholar
Thomsen, M. (1970). The burns unit in Copenhagen. VII. Time of onset and duration of infection. Scandinavian Journal of Plastic and Reconstructive Surgery 4, 61.CrossRefGoogle ScholarPubMed
Whyte, W., Vesley, D. & Hodgson, R. (1976). Bacterial dispersal in relation to operating room clothing. Journal of Hygiene 76, 367.Google Scholar
Wickman, K. (1970). Studies on burns, XIV. Bacteriology II. Acta chirurgica scandinavica 408, 1.Google Scholar
Williams, R. E. O., Blowers, R., Garrod, L. P. & Shooter, R. A. (1960). Hospital Infection, p. 292. London: Lloyd-Luke Ltd.Google Scholar
Wormald, P. J. (1970). The effect of a changed environment on bacterial colonization. Journal of Hygiene 68, 633.Google Scholar