Acetic Acid Versus Chlorine Tablet Solution as Disinfectant of Non-Critical Environmental Surfaces

Objectives@#This study aims to determine the bactericidal activity of 4% acetic acid versus chlorine tablets against gram negative and gram-positive microorganisms based on percentage reduction of microorganisms in hospital surfaces and suggest that it may be an effective alternative disinfectant.@*Methodology@#This was an experimental study where microbiological sampling of hospital surfaces was used to determine bacterial growth. The study was conducted from November to December 2020 at National Children’s Hospital, a 200 bed capacity tertiary government hospital catering to children 0 to less than 19 years old. Non-critical hospital surfaces such as beds, bed rails and bedside tables were swabbed before and after intervention cleaning with chlorine tablets or 4% acetic acid solution. @*Result@#Pre-swabbing, hospital surfaces showed the presence of Bacillus sp., Klebsiella pneumoniae and Coagulase Negative Staphylococcus (CONS). Post-application of 4% acetic acid solution resulted to 100% reduction of Bacillus sp., 70.8% reduction of CONS, and 19.5% reduction of Klebsiella pneumoniae while post-application of chlorine tablet solution showed 100% reduction of Klebsiella pneumoniae and CONS and 95.2% reduction of Bacillus species. @*Conclusion@#The use of 4% acetic acid solution significantly reduced more gram-positive than gram-negative organisms and is a highly effective disinfectant against Bacillus sp. but is not effective against gram-negative organisms as it does not fulfil the criteria of at least 90 percent reduction in bacterial growth. Chlorine tablet solution is a more effective disinfectant against gram-negative organisms than gram-positive organisms. Acetic acid 4% solution is not an effective alternative disinfectant to chlorine tablet solution, the currently used hospital disinfectant, but maybe used as an adjunct for better reduction of hospital environmental pathogens.

Mycotic abdominal aortic aneurysm in a patient with rheumatic heart disease: A case report

@#Rheumatic heart disease is one of the most common acquired heart diseases with valvular heart damage as its hallmark. It is preventable, and the prognosis is good when caught early on. However, serious complications could arise if early detection and prompt intervention are not done. One of its dreaded complication is mycotic abdominal aortic aneurysm, an uncommon sequela that could arise from infective endocarditis. In such cases, surgical intervention is warranted due to its high risk of rupture. The case presented is a 9-year-old female with rheumatic heart disease and infective endocarditis who later developed mycotic abdominal aortic aneurysm. Manifestations were fever, joint pains, left-sided body weakness and abdominal mass. Echocardiography revealed mild aortic insufficiency with vegetations. Abdominal CT scan and CT angiogram showed a mass in the left para-aortic region and a saccular abdominal aneurysm, respectively, which confirmed the diagnosis. Antibiotics and cardiac support were given, and eventually underwent repair of aneurysm with mitral valve replacement. The aim of presenting this report is to highlight one of the rarest complications of rheumatic heart disease and infective endocarditis - mycotic abdominal aortic aneurysm.