Microbial contamination of disinfectants and antiseptics in four major hospitals in Trinidad

Objective. To assess the microbial contamination of disinfectants and antiseptics in major hospitals on the Caribbean island of Trinidad. Methods. For this cross-sectional study, disinfectants and antiseptics were sampled from the pharmacy departments, the pediatric/neonatal wards, and the surgical wards of four hospitals. The samples were cultured for aerobic bacteria on nutrient agar using the surface plating method. The antibiotic sensitivity of bacterial isolates was determined by the disk diffusion method, using 14 antimicrobial agents. We studied a total of 180 samples: 60 of chlorhexidine gluconate (Habitane), 60 of chlorhexidine gluconate and cetrimonium bromide (Savlon), and 60 of methylated spirit. Results. Of the 180 samples studied, 11 of them (6.1 percent) were contaminated by aerobic bacteria. All bacteria isolated were Pseudomonas spp. Of the 11 contaminated samples, 6 of them (54.5 percent) occurred at the pharmacy level while 5 (45.5 percent) were from diluted pre-use or in-use samples in the pediatric/neonatal wards or the surgical wards. Chlorhexidine gluconate and cetrimonium bromide accounted for 9 of the 11 contaminated disinfectants/antiseptics (81.8 percent), and chlorhexidine gluconate accounted for the remaining 2 (18.2 percent). Only two of the four hospitals had contaminated disinfectant/antiseptic samples. All 24 isolates of Pseudomonas spp. tested were resistant to one or more of the 14 antimicrobial agents tested, with the prevalence of resistance to ciprofloxacin, norfloxacin, tobramycin, and gentamicin being 58.3 percent, 50.0 percent, 45.8 percent, and 41.7 respectively. Conclusions. Our results show that contaminated disinfectants/antiseptics pose a health risk to patients, particularly in the pediatric and surgical wards. The high prevalence of resistance to antimicrobial agents exhibited by the Pseudomonas spp. that were isolated is of special theraputic concern (AU)

Microbial contamination of disinfectants and antiseptics in four major hospitals in Trinidad

OBJECTIVE: To assess the microbial contamination of disinfectants and antiseptics in major hospitals on the Caribbean island of Trinidad. METHODS: For this cross-sectional study, disinfectants and antiseptics were sampled from the pharmacy departments, the pediatric/neonatal wards, and the surgical wards of four hospitals. The samples were cultured for aerobic bacteria on nutrient agar using the surface plating method. The antibiotic sensitivity of bacterial isolates was determined by the disk diffusion method, using 14 antimicrobial agents. We studied a total of 180 disinfectant/antiseptic samples: 60 of chlorhexidine gluconate (Hibitane), 60 of chlorhexidine gluconate and cetrimonium bromide (Savlon), and 60 of methylated spirit. RESULTS: Of the 180 samples studied, 11 of them (6.1 percent) were contaminated by aerobic bacteria. All bacteria isolated were Pseudomonas spp. Of the 11 contaminated samples, 6 of them (54.5 percent) occurred at the pharmacy level while 5 (45.5 percent) were from diluted pre-use or in-use samples in the pediatric/neonatal wards or the surgical wards. Chlorhexidine gluconate and cetrimonium bromide accounted for 9 of the 11 contaminated disinfectants/antiseptics (81.8 percent), and chlorhexidine gluconate accounted for the remaining 2 (18.2 percent). Only two of the four hospitals had contaminated disinfectant/antiseptic samples. All 24 isolates of Pseudomonas spp. tested were resistant to one or more of the 14 antimicrobial agents tested, with the prevalence of resistance to ciprofloxacin, norfloxacin, tobramycin, and gentamicin being 58.3 percent, 50.0 percent, 45.8 percent, and 41.7 percent, respectively. CONCLUSIONS: Our results show that contaminated disinfectants/antiseptics pose a health risk to patients, particularly in the pediatric and surgical wards. The high prevalence of resistance to antimicrobial agents exhibited by the Pseudomonas spp. that were isolated is of special therapeutic concern

Use of disinfectants and antiseptics in Jamaican health care institutions - a knowledge, attitudes, beliefs and practices study - abstract

Little has been published concerning choices and use of disinfectants and antiseptics in Caribbean health care institutions. This paper reports some findings from a cross-sectional study of knowledge, attitudes, beliefs and patterns of use concerning those chemicals. The study was carried out among 176 distributors or users from 12 public health care institutions in the cities and major rural towns of Jamaica. Most respondents acknowledged no distinction between the terms "disinfectant" and "antiseptic". Pharmacies gave the most accurate definitions. Fifteen per cent of all respondents failed to give any definition. In general, female respondents were better informed than males. Bleach, "Savlon" (R) and phenolics were the most commonly used disinfectants, while alcohol was seldom acknowledged for this purpose. Disinfectants were supplied sometimes as concentrates and sometimes in diluted form; they were not always stored appropriately and were often over- or under-diluted. Few respondents knew the recommended strengths for effective disinfection and chemosterilization. Concerning disinfectants, a small number of ancillary workers and registered nurses listed "smell" as their most important characteristic. Some persons believed that all disinfectants are safe and effective for all purposes. When supplies were short, inappropriate substitution occurred in 37 percent of cases. Policy guidelines for cleaning and disinfection are urgently needed in Jamaican health institutions. Education of health workers should stress appropriate selection, storage, and monitoring of the use of disinfectants and antiseptics. Pre-employment and in-service training of workers in infection control, including disinfectant use, is highly recommended (AU)