Our data show a high rate of rectal chlamydia infection, in the majority of cases it was asymptomatic. We recommend routine screening for rectal chlamydia in men at risk, as this may represent an important reservoir for the onward transmission of infection.
Doripenem showed excellent activity against Gram-negative isolates; generally it was more active than imipenem and at least as good as meropenem. Against Pseudomonas species, doripenem was more active than both imipenem and meropenem, with doripenem susceptibility observed for some imipenem- and/or meropenem-resistant isolates.
SummaryThe ability of face masks to prevent forward dispersal of bacteria is offset by the possibility that they may increase vertical shedding of bacteria from the face during facial movement. To investigate this, a blood agar plate was placed 30 cm directly below the lips of 20 volunteers who were encouraged to talk for 20 min while moving their heads from side to side, without a face mask for the first 5 min and then with a standard, soft pleated face mask for the subsequent 15 min. The agar plates were changed at 5-min intervals. Analysis of the number of bacterial colonies grown on each agar plate showed a statistically significant reduction in the median number of colonies cultured per plate when the mask was worn. Our results suggest that for procedures lasting less than 15 min, the operator should wear a face mask, particularly when the face is in close proximity to the operative field and the need for speaking is anticipated.
Summary
We have investigated the incidence of contamination of the contents of glass ampoules used for neuraxial injections, and whether this was reduced by wiping the outsides of the ampoules with isopropyl alcohol or using a filter straw. One hundred fentanyl and diamorphine ampoules used for routine regional anaesthesia were either wiped or not wiped with alcohol before their contents were aspirated, and the residual contents were swabbed and incubated. None of the swabs from the wiped ampoules grew organisms compared with nine (18%) from non‐wiped ampoules (p = 0.004). In a second, laboratory study, 100 glass ampoules of saline were coated with Staphylococcus aureus and divided into four groups: wiped/not wiped with alcohol and with/without a filter straw. The contents of the ampoules were aspirated; the remnants and the aspirate were swabbed and incubated as before. Most contamination occurred in the unwiped groups and although numbers were small, filtering appeared to reduce contamination further. As filter straws also reduce the risk of injecting glass particles (even if not contaminated), our results suggest that wiping glass ampoules with isopropyl alcohol and using a filter straw should be part of routine practice when performing regional anaesthesia.
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