Detlef Reichenbacher, Marc Thanheiser, Dominique Krüger
Buildings housing biosafety level (BSL) 3 and 4 laboratories and animal facilities according to the German Genetic Engeneering Safety Regulations require special procedures to decontaminate complex indoor surfaces, pass-through boxes and ventilation systems. As a basic principle, fumigation with gaseous formaldehyde or hydrogen peroxide vapour (H2O2) is taken into consideration. For BSL 3 and 4 laboratories as well as for high efficiency particulate air filters of the associated air-conditioning systems, before bringing into service it is necessary to validate the efficiency of decontamination by fumigation with biological indicators. This article provides an overview of literature and gives information on the status quo of application, effectiveness, material compatibility, and limits of gaseous disinfection.
Hyg Med 2010; 35 : 204–208.
Room decontamination Fumigation Hydrogen peroxide
Ottmar Leiß, Eckhart Fröhlich, Reinhold Muller
Flexible endoscopes are complex medical devices and difficult to clean and to disinfect. Following case reports on infection transmission in endoscopy the potential risk of infection transmission was critically discussed in the past questioning the appropriateness of reprocessing practices used at that time. In a historical perspective of the last 20 years different phases were characterized, which retrospectively correspond to the plan-do-check-act-phases of a national quality management program to improve endoscope reprocessing in the physician’s offices. The HYGEA-study reveals questionable results in about 50 % of microbiological surveillance cultures of reprocessed endoscopes. Before introducing a national screening program for colon cancer by colonoscopy in 2002 agreement for a quality assurance assessment was achieved with subsequent establishment of a nationwide quality assurance system. Thereby, the reprocessing quality improved considerably and questionable results of microbiological surveillance cultures drops down nationwide to 5 %. In analogy to the quality assurance assessment for colonoscope reprocessing similar quality assurance assessments for all other endoscopic examinations should be established. The private health assurances should support this quality assurance system.
Hyg Med 2010; 35 : 209–214.
Hygiene in der Endoskopie Koloskop-Aufbereitung Qualitätssicherung Infektionsprävention
Susanne Hellwagner, Susanne Equiluz-Bruck, Marta Fudel, Karljosef Rauchberger
Background: Burkholderia cepacia are gramnegative, obligate aerobic nonfermenters which are ubiquitous in the environment. They can be isolated from plants, soil and water. The facultative pathogen B. cepacia can cause severe symptoms in immunosuppressed patients, such as ICU patients or patients with cystic fibrosis.
Methods and Results: At the Wilhelminenspital in Vienna there were records of 20 patients with B. cepacia (bronchial secretion, central intravenous catheter, anal smear test) in the period from March 2008 to March 2009. Half of them were patients of the neonatal intensive care unit. Nine of these ten patients were premature born infants with low birth weight. All of them had long term ventilation and parenteral and enteral nutrition by tubes. The frequent isolation of this rare pathogen led to an examination of the environment and an evaluation of the course of patient treatment and the work flow on the ward together with the head nurse. The result of the examination showed the pathogen B. cepacia in the water of the feeding bottle warmer unit.
Conclusion: The continuing use of a feeding bottle warmer unit with water over a period of 24 hours made a complete decontamination impossible and led to a switch from feeding bottle warmer units with water to dry warming units of feeding bottles in the whole hospital.
Hyg Med 2010; 35 : 215–217.
Burkholderia cepacia Feeding bottle warmer units