OBJECTIVE: To study the characteristics of infections associated with peripheral venous indwelling needles and to explore the best indwelling position in patients with cardiovascular diseases from the perspective of bacteriology. METHODS: A total of 240 hospitalized patients from the Department of Cardiovascular Diseases, Xiangya Hospital, Central South University between November 2009 to July 2010 were randomly selected, and were divided into 3 groups according to the indwelling position and the indwelling time: a back of hand group (n=80), a forearm group (n=80) and a foot group (n=80). The above 3 groups were also divided into 4 subgroups according to the indwelling time (T1: 48 h ≤ t < 72 h; T2: 72 h ≤ t ≤ 96 h; T3: 96 h < t ≤ 120 h; and T4: 120 h < t ≤ 168 h) (20 patients in each subgroup). The bacteria of samples from puncture position of the skin were respectively cultured and identified after skin disinfection, needle pulling out and sample puncture from the indwelling needle catheters, respectively. RESULTS: 1) After the skin disinfection, there was no bacterium in the skin samples of puncture position. 2) When the needles were pulled out, there was bacterial growth in the skin samples of puncture position in 41 patients in the 3 groups, and the bacterium was not detected in samples of the 3 groups at T1 and T2 period. There was no significant difference in the positive rate of bacterial culture in the 3 groups at T3 and T4 period (P<0.05). 3) When the needles were pulled out. There was bacterial growth in the samples of indwelling needle catheters in 10 patients in the 3 groups; no bacterium was detected in the back of hand group and the forearm group at T1, T2, T3 and T4 period. In the foot group, there was no bacterium growth in the samples of indwelling needle catheters at T1 and T2 period, but there was bacterial growth in 4 patients at T3 period and in 6 patients at T4 period. There was significant difference in the positive rate of bacterial culture in the samples of indwelling needle catheters in the 3 groups (P<0.05). CONCLUSION The best indwelling position for peripheral venous indwelling needles is the forearm in patients with cardiovascular diseases.
Bacteria ; isolation & purification ; Cardiovascular Diseases ; complications ; Catheters, Indwelling ; Equipment Contamination ; Foot ; microbiology ; Forearm ; microbiology ; Hand ; microbiology ; Humans ; Needles ; Skin ; microbiology ; Veins ; microbiology

AIMIt is our opinion that the CDC and the WHO have underestimated cross-contamination under examination gloves in dental clinics while wearing jewelry, such as finger rings. These agencies only "recommend" removing jewelry, and only washing hands for 15 seconds with soap and warm water before donning gloves. This study examined several washing procedures and finger rings using simulated microbes.

METHODOLOGYA gloved rubber hand manikin was made and fitted with a fresh disposable vinyl glove. Four fingers were fitted with rings or no ring, dusted with simulated microbes, and washed with a scrub brush for 5, 15, and 25 seconds under 20 degrees C and 40 degrees C water alone, or with liquid hand soap. Light levels (in lux) of fluorescent powder before and after washing were measured and delta scores calculated for changes in light levels, equivalent to effectiveness of hand washing procedures. A full-factorial, 3-factor analysis of variance (ANOVA) was used to test for differences among levels of the three study factors-time, temperature, and soap use. Tukey's post hoc honestly significant difference (HSD) test was applied to significant factors to examine pair-wise differences between factor levels.

RESULTSIt was found that the longer the hands with rings were washed with a scrub brush under flowing water, the more simulated microbes were removed. By 25 seconds, all methods were essentially the same. Simulated microbes were more difficult to remove from the palm compared to the back of the hand. The liquid hand soap used in this study was more effective with warm water than cold. When given a choice of washing with cold water up to 15 seconds, it would be preferable not to use soap to remove simulated microbes. Qualitatively, the outer surface of finger rings were more effectively cleaned than the crevice below the ring, and the ring with a stone setting appeared to accumulate and retain simulated microbes more than other rings.

CONCLUSIONThe most effective treatment was washing with warm water and liquid soap. Longer times were more effective. Rings should not be worn under examination gloves due to difficulty cleaning in the crevice under the ring, and the well-known consequences of cross-contamination between the patient and the health care worker.

Colony Count, Microbial ; Fingers ; microbiology ; Fluorescent Dyes ; Hand ; anatomy & histology ; microbiology ; Hand Disinfection ; methods ; Humans ; Jewelry ; microbiology ; Manikins ; Soaps ; therapeutic use ; Temperature ; Time Factors ; Water

Bite wounds are often mistakenly considered innocuous. However, they are frequently complicated by infection which may be serious. We describe a case of Pasteurella multocida septicaemia with myopericarditis following a dog bite. Treatment of the infection as well as active support of myocardial function led to a successful outcome.
Adult ; Animals ; Bites and Stings ; microbiology ; Dogs ; Hand Injuries ; microbiology ; Humans ; Male ; Pasteurella Infections ; pathology ; Pasteurella multocida ; Pericardial Effusion ; microbiology ; Pericarditis ; microbiology ; Sepsis ; pathology ; Wound Infection ; pathology

Adult ; Aged ; Female ; Foot Injuries ; microbiology ; Hand Injuries ; microbiology ; Humans ; Male ; Middle Aged ; Surgical Wound Infection ; epidemiology ; etiology ; microbiology ; Suture Techniques ; adverse effects ; Wound Healing ; physiology

OBJECTIVEThis study aims to investigate the bacteria contamination on hands of funeral staffs in different positions.

METHODSBacterial samples were collected from the hands of 105 funeral staffs in different positions (including 90 frontline staffs and 15 administrative workers) from 13 funeral parlors nationwide, and were subsequently tested by bacterium inspection.

RESULTSIn total, 1783 strains of bacteria were isolated, including 1027 Gram-positive bacteria, most of which were Staphylococcus; and 756 Gram-negative bacteria, most of which were Pseudomonas. Out of the 1783 strains of bacteria, 570 pathogens and opportunistic pathogens were isolated, accounted to 31.96%. The isolated ratio of pathogens and conditional pathogens in embalmed/cosmetologist of cadavers was 35.67% (370/1037), which was higher than those in the funeral workers in other positions, such as cremators, pick-up and administrative workers, whose ratios were 24.42% (95/389), 22.41% (52/232) and 10.40% (12/125), respectively (χ(2) were 13.682, 10.967 and 32.263, respectively; P values were all < 0.05). And the isolated ratios of pathogens and conditional pathogens in cremators and pick-up workers were significantly higher than that in administrative workers (χ(2) were 11.206 and 7.873, respectively; P values were all < 0.05).

CONCLUSIONLots of bacteria were found in the samples from hands of funeral staffs. The isolated ratio of pathogens and conditional pathogens was different between the funeral staffs in different positions; while the highest was from embalmed/cosmetologist of cadavers and the lowest was from administrators.

Bacteria ; isolation & purification ; Hand ; microbiology ; Humans ; Microbial Sensitivity Tests ; Mortuary Practice ; Occupational Exposure

INTRODUCTIONNecrotising fasciitis is a disease associated with high morbidity and mortality, and multi-focal necrotising fasciitis is uncommon. We present 2 cases of concurrent necrotising fasciitis of contralateral upper and lower limbs.

CLINICAL PICTUREBoth presented with pain, swelling, bruising or necrosis of the affected extremities. Traditional medical therapy was sought prior to their presentation.

TREATMENTAfter initial debridement, one patient subsequently underwent amputation of the contralateral forearm and leg. The other underwent a forearm amputation, but refused a below-knee amputation.

OUTCOMEThe first patient survived, while the second died.

CONCLUSIONTraditional medical therapy can cause bacterial inoculation, leading to necrotising fasciitis, and also leads to delay in appropriate treatment. Radical surgery is needed to optimise patient survival.

Aged ; Amputation ; Debridement ; Fasciitis, Necrotizing ; diagnosis ; drug therapy ; surgery ; Fatal Outcome ; Female ; Hand ; microbiology ; surgery ; Humans ; Leg ; microbiology ; surgery ; Male ; Medicine, East Asian Traditional ; Middle Aged ; Risk Factors

OBJECTIVETo monitor and analyze the arthroplasty related infection situations of Drum Tower Hospital, so as to provide evidences for the prevention of infection after arthroplasty.

METHODSMonitoring of infection situations of nine arthroplasty operations were carried out from July to August in 2008. Five sampling methods were used to monitor the air of the 30 m2 surgery for 4 times. Through the cotton swab sampling, hands of 14 surgeons and 76 samples of surgical instruments (forceps, surgical scissors, retractors) were collected and then for bacterial culture.

RESULTSThe average amount of the total number of free-floating bacteria in our surgery was 88.2 cfu/m3. For the germiculture, 8 samples of hand detections were positive; 11 samples of surgical instruments including those used and unused and exposed at different times were positive.

CONCLUSIONIn the surgery of arthroplasty, all operation personnels should protect the air cleanliness degree, obey the surgical hand-washing rules and diminish the exposed time of aseptic table.

Aged ; Air Microbiology ; Arthroplasty, Replacement ; adverse effects ; Bacterial Infections ; diagnosis ; prevention & control ; Equipment Contamination ; Female ; Hand Disinfection ; Humans ; Male ; Middle Aged

INTRODUCTIONThe surgeon uses different methods of surgical hand antisepsis with the aim of reducing surgical site infections. To date, there are no local studies comparing the efficacy of iodine hand scrub against newer alcohol-based hand rubs with active ingredients. Our pilot study compares a traditional aqueous hand scrub using 7.5% Povidone iodine (PVP-I) against a hand rub using Avagard: 61% ethyl alcohol, 1% chlorhexidine gluconate. The outcome measure is the number of Colony Forming Units (CFU) cultured from 10-digit fingertip imprints on agar plates.

MATERIALS AND METHODSTen volunteers underwent 2 hand preparation protocols, with a 30-minute interval in between-Protocol A (3-minute of aqueous scrub using PVP-I) and Protocol B (3-minute of hand rub, until dry, using Avagard). In each protocol, fingertip imprints were obtained immediately after hand preparation (t(0)). The volunteers proceeded to don sterile gloves and performed specific tasks (suturing). At one hour, the gloves were removed and a second set of imprints was obtained (t(1)).

RESULTSFour sets of fingertip imprints were obtained. All 10 participants complied with the supervised hand preparation procedures for each protocol. CFUs of initial fingertip imprints (t(0)): The median CFU counts for initial imprint was significantly higher in the PVP-I treatment (median = 6, Inter Quartile Range (IQR) = 33) compared to the Avagard treatment (median = 0, IQR = 0, P <0.001). CFUs of fingertip imprint at 1 hour (t(1)): The median CFU counts for second imprint (t(1)) was significantly higher in the PVP-I treatment (median = 0.5, IQR = 11) compared to the Avagard treatment (median = 0, IQR = 0, P = 0.009). Our results suggest that the Avagard was more efficacious than aqueous PVP-I scrub at reducing baseline colony counts and sustaining this antisepsis effect.

CONCLUSIONAlcohol hand rub with an active compound, demonstrated superior efficacy in CFU reduction. Based on our results, and those pooled from other authors, we suggest that alcohol-based hand rubs could be included in the operating theatre as an alternative to traditional surgical scrub for surgical hand antisepsis.

Alcohols ; administration & dosage ; Anti-Infective Agents, Local ; administration & dosage ; Antisepsis ; methods ; Chlorhexidine ; administration & dosage ; analogs & derivatives ; Cohort Studies ; Hand ; microbiology ; Hand Disinfection ; methods ; Humans ; Pilot Projects ; Povidone-Iodine ; administration & dosage ; Singapore

OBJECTIVETo explore the causative pathogens in littoral hand infections which exhibited chronic granulomatous inflammation, the relationship between chronic granulomatous inflammation and mycobacteria and to discuss the prospects of PCR in clinical application for diagnosis of granulomatous inflammation.

METHODWith 16S-rDNA as the target sequence, Nest-PCR was used to detect mycobacteria directly from 37 cases of chronic granulomatous inflammations, and identified them by gene sequencing.

RESULTSTwenty-four of 37 cases were positive for mycobacteria by Nest-PCR, in which 17 were M.marinum, 1 M.chelonae, 2 M.avium, 2 M.kansasii, and 2 M.tubercular through gene sequencing.

CONCLUSIONSNest-PCR combining gene sequencing proved to be a liable and sensitive method to detect Non-tubercular mycobacteria (NTM) in fresh tissue. NTM is the major factor of hand specific chronic infections other than tubercular. Pathological changes are difficult to differentiate TB from NTM and bacterial evidence was necessary.

Chronic Disease ; DNA, Bacterial ; chemistry ; genetics ; Granuloma ; diagnosis ; microbiology ; Hand ; Humans ; Inflammation ; diagnosis ; microbiology ; Molecular Diagnostic Techniques ; Mycobacterium Infections, Nontuberculous ; diagnosis ; microbiology ; Mycobacterium marinum ; genetics ; isolation & purification ; Mycobacterium tuberculosis ; genetics ; isolation & purification ; Nontuberculous Mycobacteria ; genetics ; isolation & purification ; Polymerase Chain Reaction ; RNA, Ribosomal, 16S ; genetics ; Sequence Analysis, DNA

PURPOSE: This study was conducted to develop a health education program for preschoolers who have defected from North Korea with their mothers, and to evaluate the effects on health knowledge and behavior. METHODS: A non-equivalent control group pre-post test design was used with 58 preschoolers who were assigned to either the experimental or control group (29 for each group). The program was composed of five sessions in health education and contracts. To test the effectiveness of the intervention, health knowledge and behaviors, and total bacterial colony counts on hands were measured at one pretest and two post tests (1 week and 4 weeks after the intervention ended). Data were analyzed using the SAS program. RESULTS: Health knowledge and behavior in the experimental group increased significantly compared to the control group. The effects of the intervention were evident even at 4 weeks after the intervention ended. Total bacterial colony counts in the experimental group decreased significantly at the 1 and 4 week posttest intervention compared to the control group. CONCLUSION: Results indicate that this program is effective in improving health knowledge and behavior in these children and therefore can be utilized to ensure efficient management their health care.
Bacteria/isolation & purification ; Child ; Child, Preschool ; Democratic People's Republic of Korea ; Female ; Hand/microbiology ; Health Behavior ; *Health Education ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; *Program Development ; *Program Evaluation ; Refugees/*psychology