Objectives: There are no standard infection control regulations in transvaginal ultrasound probe disinfection followed in the most prominent local public tertiary referral hospital. Likewise, no studies have evaluated the efficacy of the current method that uses an inexpensive multipurpose antiseptic spray solution. This study aims to evaluate the efficacy of the current practice of manual disinfection of TVS probes and compare it with the performance of an acceptable manual reprocessing method. Methods: A prospective, randomized, controlled study was carried out using a crossover, quasi-experimental design, collecting 119 total samples from the ultrasound transducers before (35 samples) and after disinfection with two manual reprocessing methods, either a locally manufactured multipurpose antiseptic spray (A-Septic® Multipurpose Antiseptic Spray) that is currently used for disinfection or Mikrozid Sensitive®, a ready to use impregnated wipes (42 samples each arm). Disinfection efficacy was evaluated based on microbial culture results. Results: Before disinfection, bacterial growth was observed in 77.1% (27/35) of the probes. After disinfection, 80.95% (34/42) remained contaminated with the antiseptic spray and 21.43% (9/42) with the wipes. The cultures revealed many environmental and pathogenic bacterial isolates, including Burkholderia, Staphylococcus, Acinetobacter, Diphtheroids, and Pseudomonas. Conclusions The currently used method for disinfecting transvaginal transducers in the division is not adequate for decontamination and decreasing the risk of cross contamination among patients. The results call for aggressive disinfection measures and highlight the need to update local standards and formulate and institutionalize these recommendations.
2-Propanol

Abstract: Access to handwashing areas is not as convenient as having alcohol in one’s pocket or bedside. Alternatively, cleaning the hands with alcohol can save us a lot of time and effort in disinfecting our hands thus giving us more time for patient care. If alcohol can be proven as effective as soap and water in hand disinfection, then residents and nurses may use this method of hand hygiene instead. Objective: To compare the efficacy of 70% isopropyl alcohol against standard handwashing in hand hygiene among medical residents and nurses at a tertiary hospital. Methods: Seventy-six doctors and nurses were randomly assigned to two groups with 38 subjects each. Group 1 used plain soap and water while group 2 used 70% isopropyl alcohol hand rub. hand swabbing was done before and after hand hygiene. The presence or absence of bacteria was compared for the same subject, before and after hand disinfection. The mean decrease in colony count in group 1 was compared to group 2. Results: Both groups were successful in reducing the mean colony count. Handwashing group had a decrease from 27.34 34 +33.17to 3.58+ 6.63 CFU, while the alcohol group from 21.5 + 31.13 to 0.76 + 1.48 CFU, both with p values <0.05. But in comparison, the mean changes for both groups were not statistically significant, therefore no intervention was superior to the other and both were equally effective. Conclusion Seven percent isopropyl alcohol is as effective as standard handwashing in disinfection. It is recommended to have 70% isopropyl alcohol at bedside/individually carried by doctors/nurses for easy access. Observation of proper hand washing technique should always be emphasized. Bacterial colony identification is ideal for future studies.
Hand Disinfection ; 2-Propanol ; Hand Hygiene

OBJECTIVES: The purpose of this study was to examine the correlation between exposure to acetone and isopropyl alcohol (IPA) and the acquisition dyschromatopsia. METHODS: A study was performed on exposure group of 116 people exposed to and a group of 36 people not exposed to organic solvents were selected and examined. Their smoking and alcohol habits, symptoms, and exposure history were surveyed through questionnaires and interviews. Then dyschromatopsia was evaluated with the Lanthony D-15 d test in a room with standardized intensity of illumination. RESULTS: The statistical prevalence of dyschromatopsia was significantly higher in the exposed group (30.2%) compared to that found in the control group (19.4%). Out of the 116 subjects in the exposed group, 30 people had acquired dyschromatopsia (25.86%). The variables affecting the color confusion index, such as age, exposure, and the duration of exposure, were statistically significant variables. CONCLUSIONS: He prevalence of dyschromatopsia was found to be not significantly higher in the group with exposure to organic solvents compared to that found in the control group. In addition, a statistically significant correlation was found between exposure to organic solvents and the color confusion index.
2-Propanol ; Acetone ; Prevalence ; Questionnaires ; Smoke ; Smoking ; Solvents

For patients with bursitis, the treatment modality of choice was conservative treatment, and those who did not experience symptom relief usually received surgery. However, we have been able to treat a patient with chronic proliferative subdeltoid bursitis through alcohol instillation. The patient complained of aggravating right shoulder area pain particularly on abduction or flexion of his arm. Ultrasonographic examination revealed that there was notable synovial thickening, fluid collection and proliferative pannus in the subdeltoid bursa. Steroid was injected for treatment but after 9 days, synovial proliferation and synovial fluid collection remained unchanged. After additional 7 days, 70% isopropyl alcohol 5 ml was injected into the subdeltoid bursa via ultrasonograph-guided injection, followed by normal saline 10 ml injection to dilute the previously injected alcohol in order to re-aspirate. On the following check-up 3 weeks after, decrease in synovial proliferation along with normal ultrasonographic results other than slightly thickened bursa wall was noted.
2-Propanol ; Arm ; Bursitis ; Humans ; Shoulder ; Synovial Fluid

BACKGROUND: Although many laboratories use automated blood culture systems, adequate skin disinfection and optimal blood volume are still critical for successful culture. The authors undertook a nationwide survey to understand the current situation and problems of blood culture in Korea. METHODS: A survey of blood culture was performed in March and April 2010, including disinfectants, blood collection intervals, and recommended blood volumes. The laboratory physicians described the storage condition of culture bottles before delivery to the equipment. For quality control, the positive rate and skin contamination rate were studied. RESULTS: Replies to the survey were collected from 74 Korean hospitals. Povidone iodine after either isopropyl alcohol or ethanol application was the most common means of skin disinfection. Sampling of a second set of cultures was performed simultaneously in 38% of hospitals and after a 30-min interval in 50%. The recommended blood volume was 10 mL in most cases (69%), but was 20 mL in 24% of cases. The bottles were stored at 37degrees C before installation in 23% of cases and at room temperature in 16%, whereas 57% were placed directly in the equipment during the night shift. Positive rates ranged 8-10% in 32% of hospitals, 5-8% in 23%, and <5% in 12%. Skin contamination rates were 2-3% in 32% of hospitals, 1-2% in 27%, and >3% in 13%. CONCLUSION: Skin disinfection methods were rather variable. Sampling interval, blood volume, and storage of bottles should be standardized. More than 10% of the hospitals require quality improvement in terms of positive rate and skin contamination rates.
2-Propanol ; Bacteremia ; Blood Volume ; Disinfectants ; Disinfection ; Ethanol ; Povidone-Iodine ; Quality Control ; Quality Improvement ; Sepsis ; Skin

BACKGROUND: Recently the tocopherol, which has been proven as an antioxidant, has also been found to possess non-antioxidant roles such as anti-inflammatory and chemopreventive effects, which has heightened the importance of rapid, accurate and reliable testing methods. We evaluated the performance of normal phase high-pressure liquid chromatography (NP-HPLC) for analysis of tocopherol in serum. METHODS: The chromatographic separation parameters, linearity, precision, accuracy and detection limit were evaluated. The analytical column was hypersil silica (4.6 mm*200 mm*5 micrometer, Thermo Electron Corporation, Keystone, PA, USA) and mobile phase comprised 2% (v/v) of isopropanol in n-hexane. Analyses were run at a flow rate of 0.7 mL/min at 295 nm. RESULTS: The run time of separation of tocopherol was completed in less than 15 minutes and its retention factor (0.61-2.13) and resolution including positional isomers ( beta- and gamma-tocopherol) were excellent. Their linearity was good (r>0.999). The coefficient of variation (CV) at medium and high concentrations did not exceed 15% and those at low concentrations did not exceed 20%. The range of its recovery was 91.4-107.8% and bias was within 15%. The detection limits of alpha-, beta-, gamma- and delta-tocopherol were 0.038, 0.064, 0.078 and 0.049, respectively. CONCLUSIONS: NP-HPLC provided a rapid, accurate and reliable performance for the separation of tocopherol and would be helpful as a routine method in the clinical laboratory.
2-Propanol ; Bias (Epidemiology) ; Chromatography, Liquid* ; Limit of Detection ; Silicon Dioxide ; Tocopherols*

BACKGROUND: Optimal use of tricyclic antidepressants (TCAs) requires serum monitoring to determine if the appropriate therapeutic range has been attained and to assess possible side effects. This study was to evaluate the resolution capacity of the following four mobile phases which were previously reported; mobile phase I (methanol, acetonitrile and 5 mmol/L Na2HPO4: 41/15/44 by volume), II (methanol, acetonitrile and 5 mmol/L Na2HPO4,: 15/60/25 by volume), III (acetonitrile and 2-propanol: 95/5 by volume) and IV (methanol and n-butylamine: 99.5/0.5 by volume). METHODS: Amitriptyline (AT), nortriptyline (NT), imipramine (IMI) and doxepin (DOX) were used for the selection of appropriate mobile phase in high performance liquid chromatographic (HPLC) determination. TCAs were extracted from serum with hexane, isoamyl alcohol (99:1). The drug was re-extracted into 0.1 N HCl and an aliquot was injected into the HPLC. The analytical column was C-18 reversed phase column (3.9 mm x 30 cm; Waters, USA) with the flow rate of 1.5 mL/min. The UV detector signal was monitored at 254 nm. RESULTS: Mobile phase I disclosed 9.8-15.8 retention time (min), 5.1-8.8 capacity ratio and 1.0-2.2 resolution factors for the above four TCAs. Precision studies using this mobile phase demonstrated a coefficient variation of 2.4-4.7% in the concentration range of 500-125 ng/mL. Analytical recovery of AT and IMI was 85-90% at a concentration of 125 ng/mL and 250 ng/mL. CONCLUSIONS: Mobile phase I provided a reliable and excellent resolution of TCAs in the use of HPLC with the C-18 reversed phase column and UV absorbance detector.
2-Propanol ; Amitriptyline ; Antidepressive Agents, Tricyclic* ; Chromatography, High Pressure Liquid ; Doxepin ; Imipramine ; Nortriptyline

Pigosept(R) is a prepackaged antiseptic swab for disinfection before blood sampling and intravenous injection. Tego(R) and isopropyl alcohol are the main components of Pigosept(R) swabs. Although Tego(R) has been reported as a common cause of allergic contact dermatitis (ACD), ACD from isopropyl alcohol is rare. We herein report a case of ACD caused by two components of Pigosept(R), Tego(R) and isopropyl alcohol, in a 50-year-old woman. This case demonstrates that dermatologists should be alert to the possibility of ACD due to isopropyl alcohol as well as Tego(R) in some prepackaged disinfectants such as Pigosept(R).
2-Propanol ; Dermatitis, Allergic Contact* ; Disinfectants ; Disinfection ; Female ; Humans ; Injections, Intravenous ; Middle Aged

BACKGROUND: Many disinfectants have been used clinically in both single and combination applications, but there have been few studies on disinfective power according to sterilization sequence when using a combination of disinfectants. The purpose of this study was to evaluate the disinfective power of a combination of 70% isopropyl alcohol and 10% povidone-iodine (PVP-I) according to sterilization sequence. METHODS: Two hundred healthy volunteers were recruited. Subjects were disinfected with a combination of 70% isopropyl alcohol and 10% PVP-I on both forearms, in varying sequence. The AP group included disinfections on the left forearm with isopropyl alcohol first followed by 10% PVP-I, while the PA group included disinfections on the right forearm with same disinfectants in reverse order. Skin cultures were obtained using cotton swabs 3 min after application of each disinfectant, and then were inoculated on blood agar plates for bacterial culture. Cultures were incubated at 37degrees C under aerobic conditions for 48 hours. RESULTS: There was no significant difference in the number of positive cultures after the 1st disinfection (AP, 45; PA, 36, P = 0.262) or the 2nd disinfection (AP, 6; PA, 13, P = 0.157), suggesting that there is no relationship between disinfective power and the sequence of the disinfectants used. The number of positive cultures significantly decreased after the 2nd disinfection (P < 0.01), however. CONCLUSIONS: There was no significant difference in disinfective power according to sterilization sequence with 70% isopropyl alcohol and 10% PVP-I in healthy volunteers. The combination of 70% isopropyl alcohol and 10% PVP-I was more effective than disinfection with a single agent regardless of sterilization sequence.
2-Propanol* ; Agar ; Disinfectants ; Disinfection ; Forearm ; Healthy Volunteers ; Povidone-Iodine* ; Skin ; Sterilization

PURPOSE: Ethanol is the most common toxic substance encountered clinically and is becoming increasingly important in forensic medicine. Generally, pre-treatment with an alcohol disinfectant such as isopropyl alcohol for blood sampling could influence evaluations and affect legal evidence. This study was performed to determine whether isopropyl alcohol affects the serum ethanol level. METHODS: Volunteers were prohibited from drinking alcohol and taking medication for 48 hours prior to participating. Pregnant volunteers and volunteers with abnormal liver enzymes or abnormal kidney function were excluded. Enrolled subjects had their blood collected from each arm to measure the alcohol concentration, one side was disinfected with povidone iodine and the other with isopropyl alcohol. After waiting one hour, they ingested 20g of alcohol and waited. After one hour, the serum ethanol levels were measured using the same method as the first sampling. RESULTS: Ten volunteers enrolled for this study. Without the alcohol intake, all serum ethanol levels were in the nondetectable range(<3 mg/dL) for both samples with either isopropyl alcohol or povidone iodine. After drinking alcohol, the serum ethanol level varied among individuals; the mean value of the serum ethanol levels in the alcohol preparation group was 21.08+/-4.85 mg/dL, which was significantly greater than that of the povidone iodine preparation group (19.71+/-5.47 mg/dL) (p=0.006). However, the Bland-Altman analysis showed that the precision of both groups was 1.230 mg/dL, which was less than the measurement error of the equipment (3.48 mg/dL). Therefore, there was no significant difference between the two groups with regard to the measurement error. CONCLUSION: Before alcohol intake, there was no influence on the blood alcohol concentration from the alcohol disinfection, and the result was reliable. After alcohol intake, the possible influence of pre-treatment alcohol on the serum ethanol level was less than the measurement error of the equipment used.
2-Propanol ; Alcohol Drinking ; Arm ; Disinfection ; Drinking ; Ethanol ; Forensic Medicine ; Kidney ; Liver ; Povidone-Iodine