Efficacy of five alcohol-based skin antiseptics on sebaceous skin used at shorter application times than the current recommendation of 10 minutes.

Alcohol-based skin antiseptics are recommended with a minimum application time of 10 min on skin containing high numbers of sebaceous glands. In clinical practice, a 10-min application time is often too long. Therefore, we determined the efficacy of skin antiseptics on the forehead and lower back using shorter application times. Five alcoholic solutions were tested in a double-blind trial for their colony-forming units (cfu) reduction after 3, 4, 5 and 10 min on the forehead of 20 healthy volunteers and the lower back of 10 healthy volunteers and 10 patients against the reference alcohol 70% propan-2-ol, 10 min. After an application time of 3 min, 3/5 (forehead) and 5/5 (lower back) preparations were at least equally as effective compared to the reference alcohol and an application time of 10 min. Alcohol-based skin antiseptics do not require a 10-min application time. For all of the tested antiseptics, a minimum application time of 3 min on sebaceous skin can be recommended.

Re-evaluation of current A0 value recommendations for thermal disinfection of reusable human waste containers based on new experimental data.

Issues over the correct cleaning and disinfection of reusable medical devices are of great concern for local infection control teams. We investigated the heat resistance of two important micro-organisms implicated in nosocomial infections, Enterococcus spp. and spores of Bacillus subtilis (a surrogate for Clostridium difficile). Disinfection with moist heat, based on the A(0) concept (EN ISO 15883-1), is the most common method for disinfection of human waste containers in the hospital setting. The aim of this study was to scrutinise the A(0) concept regarding the inactivation of the above-mentioned micro-organisms and to look for possible interferences. Experiments were carried out in phosphate-buffered saline, artificial soil in suspension (ASS) and dried artificial soil (AS). Artificial soil was used to simulate insufficient cleaning of bedpans. Micro-organisms were treated at different temperatures and time periods. It was shown that soil protected the micro-organisms against heat and that dried soil enhanced this effect, probably as a result of thermal insulation. The results of the current study do not support the general recommendation to use an A(0) of 60 for the disinfection of bedpans but warrant differential strategies depending on the expected microbial load. We generally recommend for disinfection processes aimed at vegetative bacteria an A(0) of >or=180. Furthermore we want to emphasise the utmost importance of not allowing freshly contaminated bedpans to dry for longer time periods, as the significance of thorough cleaning of contaminated human waste containers before being exposed to heat treatment for their disinfection was clearly demonstrated.

Prevalence of Panton-Valentine leukocidin genes in methicillin-resistant Staphylococcus aureus isolates phenotypically consistent with community-acquired MRSA, 1999-2007, Vienna General Hospital.

The purpose of this study was to investigate methicillin-resistant Staphylococcus aureus (MRSA) isolates with antibiotic resistance restricted to beta-lactam antibiotics and variable resistance to fusidic acid for the presence of Panton-Valentine leukocidin (PVL) genes. Our data show that the selected resistance pattern is found rarely among MRSA isolates in our hospital, but it appears that this phenotype consistent with typical community-acquired (ca) MRSA is indicative of PVL-positive MRSA.