Sterile Storage Research Articles

Sterile Instrument Storage in an Austere Environment: Are Sterile Peel Packaging and Cellulose Wrapping Equivalent?

Recommendations for optimal temperature and humidity for sterile instrument storage vary according to different sources. Furthermore, there are limited data comparing methods of packing smaller, lightweight, low-profile instruments. The purpose of this study was to compare sterile peel packaging and sterile cellulose wrapping for sterile instrument storage in an austere environment characterized by elevated temperature and humidity. Stainless steel screws were sterilized and stored in either sterile peel packaging, sterile cellulose wrapping, or no packaging. Four groups were evaluated. Group 1 consisted of four screws in a sterile peelpack envelope and served as a time-zero control. Group 2 consisted of two groups of five screws, each packaged with blue sterilization cellulose wrap. Group 3 consisted of two groups of five screws, each packaged in sterile peel-pack envelopes. Group 4 consisted of 10 non-sterile unpackaged screws, which served as controls. Screws from groups 2, 3, and 4 were then cultured for 6 and 12 weeks. Temperature and humidity values were recorded in the instrument storage area. Average temperature was 21.3°C (SD 1.2°C; range 18.9°C-27.2°C) and average humidity was 51.7% (SD 3.9%; range 39%- 70%). Groups 1 (time-zero control) and 2 (sterile cellulose wrapping) demonstrated no growth. After 6 and 12 weeks, groups 3 (sterile peel packaging) and 4 (control) demonstrated bacterial growth. The most common culture isolates were gram-positive rods and two common nosocomial Staphylococcius species. Sterile peel packaging was not found to be equivalent to sterile cellulose wrapping in austere environmental conditions.

1419. Evaluation of a vaporized hydrogen peroxide sterilization technology for duodenoscopes

Abstract Background Current methods for reprocessing duodenoscopes, including double high-level disinfection, are not effective in eliminating bacterial contamination. Thus, there is a need to develop effective and safe sterilization technologies for duodenoscopes. Methods We examined the effectiveness of a new hydrogen peroxide gas plasma sterilizer designed for terminal sterilization of flexible endoscopes. The technology directs vaporized hydrogen peroxide into all internal endoscope channels with a short exposure time and includes a sterilization container that facilitates sterile storage after processing. Test organisms included Bacillus atrophaeus and Clostridioides difficile spores, Escherichia coli, Enterococcus faecium, and Candida auris inoculated on steel wires or dispersed throughout the internal channels with 5% fetal calf serum. Results The technology reduced >108 colony-forming units (CFU) of the vegetative organisms to undetectable levels. B. atrophaeus and C. difficile spores on steel wires were eliminated by the technology ( >6 log10 CFU reduction) and spores disperse throughout the channels were reduced by >5 log10 CFU. No damage to the endoscopes was observed. Conclusion The sterilization technology was highly effective in reducing contamination of duodenoscopes in laboratory testing. Our results support further investigation of this technology in reducing contamination of in-use endoscopes. Disclosures William Rutala, MS, MPH, PhD, Ideate Medical: Advisor/Consultant|Ideate Medical: Stocks/Bonds|Kinnos: Advisor/Consultant|Kinnos: Stocks/Bonds|PDI: Advisor/Consultant|PDI: Honoraria

Clinical Issues - August 2023.

Respiratory protection against surgical smoke from liver tissue Key words: surgical N95 respirator, surgical smoke, liver tissue, fine and ultrafine particles, particulate matter concentrations. Local exhaust ventilation and surgical smoke safety Key words: local exhaust ventilation (LEV), surgical smoke evacuation, medical-surgical suction, hierarchy of controls, engineering control. Location of endoscopy storage cabinets Key words: endoscope; sterile storage; contamination; environmental conditions; heating, ventilation, and air-conditioning (HVAC) design parameters. Sterility of ultrasound transmission gel Key words: sterile gel, nonsterile gel, multidose container, ultrasound, outbreaks.

SG-APSIC1043: Creating an urgent operating room alert using Kaizen automation

Objectives: We sought to reduce waiting time for instruments in the operating room, to develop technology for communication between zones, to record data in real time for planning instrument management, and to increase trust and satisfaction of customers. Methods: The central sterile supply department (CSSD) provides sterilization of instruments and medical devices, mostly to the following departments: operating room, dental unit, outpatient otolaryngology, and obstetrics and gynecology. The CSSD processes 557,588 units per month, among which 30.05% are for the operating room. In the normal process when the operating room send instruments for decontamination, the operating room staff places stickers on the item or uses a form to document the request. The normal turnaround time was 3 hours and 9 minutes and urgent turnaround time was 2 hours and 14 minutes. For color control, we used white color for normal requests and pink for urgent requests. We redesigned our record keeping using Google forms and sent data on dashboards with real-time alerts in the CSSD application to notify staff of an urgent request. Results: Staff in the dirty zone placed an urgent tag on the instrument baskets of the auto-washer. After the door was opened in the clean zone, staff noted the urgent tag and marked a validation sheet, then placed a red unilock on the rigid constrainer. Peel pouches were marked “urgent,” advising sterile storage zone staff to separate the basket from normal baskets and to apply the “urgent” paper form and labelling. Conclusions: Turnaround time improved by 15 minutes for urgent instruments. Lead time to export data for analysis increased from 80% to 95.49%. Because of facility design, it was difficult to ensure communication between separate dirty, clean, and sterile storage zones. We redesigned our process using new technology to improve turnaround times, reduce waste, improve communication, and increase productivity.

Study of Colostrum Composition in Lactating Women with Anemia

Background: Colostrum is a pre-milk substance, thick lemon yellow coloured viscous mammary secretion, that is produced immediately after birth, during the first 1-5days of the lactation. Pregnancy induced Anaemia (PIA) is the most common complication of pregnancy in the India. PIA is defined as blood hemoglobin level of less than 11 gm % (WHO). In India, ICMR defines anaemia as hemoglobin less than 10 gm %. it is commonly due to maternal malnutrition resulting in deficiencies of iron, anti anemic factors, folic acid and vitamin B12. Maternal nutritional status has been found to influence the composition of milk, leading to conditions which alters the total proteins, calcium and IgA concentration of the colostrum. Aim and. Objectives: The aim of this study is to compare the composition of following biochemical parameters (total proteins, triglycerides, immunoglobulin A, lactose and calcium) in colostrum of normal pregnancy and pregnancy with anaemia patients, in primigravida, to find out whether there are any significant changes. Materials and Methods: We included a total of 60 lactating women from the postnatal wards of Owaisi hospital /princess Esra hospital, Hyderabad after obtaining their consent. Out of which 30 were Controls (Group A) and 30 lactating anemic women (Group B). Approximately 5ml of colostrum was collected from a single breast within 24 hours of delivery from each subject into sterile storage vials and stored at –20°C and were analyzed within two weeks. The following parameters were analyzed in each sample of colostrum, total proteins, triglycerides, Ig A, lactose and calcium.Statistical Analysis: The data was analysed using SPSS software version 17.0 descriptive results are expressed as mean and SD of various parameters in both the groups. p value less than 0.05 was considered as significant and value above 0.05 was considered as non-significant.Discussion & Conclusion: Colostrum is a dynamic, multi-faceted fluid containing nutrients and bioactive factors needed for infant health and development. Nevertheless, knowledge of human milk composition is increasing, leading to greater understanding of the role of human milk in infant health and development, which can be extremely beneficial for preventive and protective aspects of peadiatrics and neonatology.Human milk also contains many hundreds to thousands of distinct bioactive molecules that protect against infection and inflammation and contribute to immune maturation, organ development, and healthy microbial colonization. Therefore, neonates who are effected and deprived of essential components of colostrum due to anaemia during pregnancy should be provided with the necessary supplements and protection from infections.

Using a stacker crane for sterile storage in the operating theatre: initial environmental microbiological qualification

Adequate storage of sterile surgical devices must prevent contamination and the introduction of microbial contaminants inside the operating room. For functional and economic purposes, stacker cranes (STCs) could replace the traditional sterile storage room (TSSR). STCs are large, multi-stage, computer-assisted systems used to automatically store and retrieve loads from defined locations. However, their microbiological performance has not been evaluated. As part of the opening of a new building that included an operating theatre, we qualified a new STC and compared its microbiological control performance to that of the previous TSSR. From December 2020 to March 2021, 590 environmental specimens (air, N= 56; surfaces, N= 534) were collected and interpreted according to the NF S90-351 French Association for Standardization standards. Thorough surface disinfection was not sufficient for controlling microbial contamination in the STC. Thus, the initial qualification testing was conducted following an aggressive aerial chemical decontamination of the STC. Despite the lack of a HEPA filtered air system, the overall non-conformity rates were lower in the STC than in the TSSR (8.3% vs 21.4%, P=0.33 for air, respectively, and 9.7% vs 41.7% P<0.001 for surfaces). The air-controlled barrier in front of the loading zone appeared to be sufficient to prevent bacterial contamination. The presence of fungi must be carefully monitored. This is the first study supporting the contribution of STCs in saving space and improving the maintenance of sterile surgical device storage and availability under acceptable environmental conditions. Further studies are needed to assess the long-term microbiological contamination inside the STC.

Environmental Impact on Soil and Water Because of Mining Activities in the Eastern Part of Jiu Valley

Abstract Analysing environmental impacts of mining activities involves detailed studies of the interactions between technological activities/operations carried out in a mining operation and environmental components affected by them. In order to carry out a more complex environmental impact assessment caused by mining in the eastern part of Jiu Valley on soil and water 4 mining units have been considered in the study, these being mining unit Lonea, Petrila, and Livezeni with their belonging dumps. Main objective of this research is to analyse the impact caused by mining activities in Eastern part of Jiu Valley by the method of impact networks according to the model “causes - pressures, depreciation of the quality of environmental factors – affected parameters - impact”. Thus, impacts caused by the mining industry were identified based on the top-down typology, being shaped impact networks for underground coal exploitation and sterile material storage on the surface. The metal content of the dumps was also analysed in order to assess the degree of metals soil enrichment compared to the reference concentration of a blank sample. The analysis of the influence of the local rainfall regime aims to highlight the leaching potential of heavy metals in the body of the dump and the possibility of analysing the scenarios of extension of the pollution phenomenon to the saturated area. The study is addressed to researchers, environmental engineers, hydrogeologists and geologists who want to deepen the study of transfer mechanisms of contaminants from dumps to watercourses receiving areas and their dispersion in unsaturated and saturated areas.

Blood Transfusion Notes (UGONSA Model)

Background: Blood transfusion is a crucial life-saving clinical measure. Nurses are at the forefront of bedside blood transfusion in many countries and are responsible for ensuring the safe administration of blood and blood products. Among all the standard practices to ensure safe administration of blood and blood products such as grouping and cross-matching of blood, blood collection from donors with sterile technique, storage, and transport under recommended conditions, the most critical is the one occurring at the bedside. The event at the bedside is a consolidation of other safety practices. Working in pairs, nurses have to verify and certify that the blood or blood product is actually what it was labeled to be, that the right patient is receiving the blood or blood product, and that ideal conditions for handling blood and blood products were followed. The bedside activities of the nurses prior to, during, and after transfusion of blood or blood products is the last lifeline of the healthcare team to arrest any mishap in the entire blood transfusion process. To help clinicians directly involved in administering blood and blood products, the 19th Professional conference of UGONSA held in Kaduna in 2019 constituted a committee of professional nurses to design a simplified tool that will aid clinicians in maintaining a high margin of safety in the administration of blood and blood products. Aim: To produce a standardized blood transfusion note (UGONSA model) to help nurses and physicians carry out the task of clinical blood transfusion effectively and efficiently. Method: A team of professional nurses was drafted into a committee with the mandate of producing a standardized blood transfusion note for nurses and other clinicians involved in the administration of blood and blood products by the congress of the 19th professional conference of UGONSA. Result: A standardized blood transfusion note was produced. The note is simple to use and was designed to ensure high patient safety outcomes while saving much time for clinicians as time is among the most sensitive element during most medical emergencies that necessitate transfusion of blood and blood products. Conclusion: Blood transfusion note (UGONSA) model is a standardized tool that helps bedside clinicians perform the task of blood transfusion effectively, efficiently, timeously, and with a high degree of patient safety.

Ask The Joint Commission.

The sterile supply and equipment spaces in our ambulatory surgery center (ASC) currently are experiencing growing pains due to our success. We do not have enough space for the extra sterile supplies or equipment we acquired in the last two years. Therefore, we are looking into extra space in our office building for storing equipment, extra custom packs, and medical supplies. This space will be dedicated for storage and will not be in the ASC footprint; therefore, it mainly will be a warehouse area. Do any concerns exist for keeping product off site?As long as the organization meets the design requirements of the local authority and maintains the proper ventilation requirements for sterile storage, they will be considered compliant.What is required to be presented regarding X-ray equipment during a TJC survey?Typically, on day one of the survey, the surveyor will provide a list documents for review. Be sure to respond exactly as requested. Your medical equipment management plan, equipment inventory, and maintenance history records should always be ready for review. Because most records are now electronic, be sure that more than one person can run all your management reports. You want to avoid a citation for lack of documentation due to one person being unavailable.For several reasons, alternative equipment maintenance (AEM) is not being accepted at our facility to the extent that it should. For example, legal said “no way” because they are hesitant to depart from manufacturers' recommendations. This is not a valid or quantifiable reason. Some third-party companies see AEM as revenue reduction. What are your suggestions for changing this?A successful AEM program requires acceptance and “buy-in” from your key stakeholders. A data-driven proposal, including a risk assessment based on your historical services records or from another credible source, may help to support your argument. Your AEM strategy must not reduce safety and must be based on accepted practice standards. Your challenge is to prove this to key stakeholders with a defensible program.Why do TJC surveyors not follow the tracer methodology when end users report to a surveyor that “a device is broken and healthcare technology management (HTM) hasn't fixed it”? We have had several surveys where TJC surveyors are told a device is “broken” and that “it has been broken for a long time”; however, no surveyor has taken down the HTM control number for the device and either requested the repair history records or gone to the HTM department to ask questions specific to the repair of that device (e.g., Was a work request submitted? Was a work order created? What was the resolution?). Usually, the report is returned to leadership with a “finding” noted and a description along the lines of “the infusion pump in inpatient was reported as broken and not being repaired,” with no reference as to which one of the hundreds of portable infusion pumps was allegedly at issue. This prohibits HTM staff from appropriately researching and responding to the alleged problems and/or providing documentation regarding the allegation that the device is not being maintained/repaired.The tracer methodology is the process used during the on-site survey to analyze an organization's systems or processes for delivering safe, high-quality care by following an individual patient or resident through the organization's care process in the sequence experienced by each individual. Feedback received from staff is recorded as an observation of finding. Depending on the severity of the comment, the surveyor may or may not choose to investigate further. During the course of a survey, organizations may address the circumstances surrounding the discovery of an item that is out for repair.In this department, The Joint Commission (TJC) answers questions posed by AAMI members. Become part of the discussion by visiting www.aami.org/communities and joining AAMI's Joint Commission Discussion Group, which is open to all AAMI members. Some of the questions and answers may have been edited for space, style, and clarity.

Isolation and Identification of Dominant Spoilage Bacteria in Refrigerated Catfish Fillets

In order to discuss the species of dominant spoilage bacteria in refrigerated 7 d catfish fillets,the squid was taken in a 4℃ sterile cold storage and placed in a vacuum oven at 4℃ for 7 days. Three strains of bacteria,numbered x1-1,y1-1,and y2-1,were isolated from the corrupted fish meat for bacterial morphology observation,physiological and biochemical tests,and 16S rDNA sequence determination.The results showed that all the strains were Gram-negative Brevibacterium spp,and both were facultative anaerobic bacteria. The results of sequencing and phylogenetic tree analysis showed that x1-1 was closely related to Aeromonas hydrophila,reaching 99.9%. The relationship between y1-1 and Aeromonas veronii was up to 99.79%;y2-1 was similar to Aeromonas allosaccharopila,reaching 99.8%.Combined with the above research results,x1-1 is A.hydrophila;y1-1 is A.veronii;y2-1 is A. allosaccharophila.In summary,the dominant spoilage bacteria in refrigerated catfish fillets is Aeromonas.

Investigation of Nosocomial Cluster Infections of Peripheral Venous Catheter-Related Bloodstream Infection

Object: Determine the cause of nosocomial cluster infections of peripheral venous catheter-related bloodstream infection (PIVC-BSI), and provide advice on prevention, control and nursing measures. Method: A retrospective analysis of nosocomial cluster infections that occurred in a tertiary hospital on July 28-30, 2019. Blood samples from patients suspected of PIVC-BSI were retained for bacterial culture. The clinical data of the patients, environmental hygiene indicators were collected. Results: All 8 patients had chills within 0.5 - 3.5 hours after intravenous infusion, and the highest body temperature reached 41°C. The peripheral blood samples of 4 patients were cultured as Burkholderia cepacia infection, and the eluate from the catheter tip of 2 patients cultured the same bacteria as the blood culture. The humidity in the treatment preparation room was 60% - 80%. There was mold in the sterile storage cabinet. Conclusion: The nosocomial cluster infection of PIVC-BSI was caused by Burkholderia cepacia colonizing the tip of the peripheral intravenous catheter, and the high air humidity was the most likely factor. The ability of nurses to identify and respond to PIVC-BSI as well as the infection control management level of each department still needs to be improved.

Clinical Issues-January 2020.

Use of indicator glove systems Key words: perforation indicator system, double gloving, glove perforation, innermost glove. Sharps injury protocols Key words: sharps injury, occupational exposure, risk assessment, bloodborne viruses. Sharps injury reporting Key words: injury reporting, sharps injuries, bloodborne pathogen, hepatitis C virus (HCV). Sterile item storage Key words: sterile storage room, shelving unit, sterile supplies, sterile item, cabinet. Combining storage of sterile and unsterile supplies Key words: sterile supplies, unsterile supplies, sterile storage room, storage rack.

A robust stochastic decision-making model for inventory allocation of surgical supplies to reduce logistics costs in hospitals: A case study

In a hospital, surgical supplies can be stored in multiple locations, each of which has limited space and different associated costs. The locations include central storage, where items are retrieved to build a cart of supplies for each procedure; sterile storage adjacent to the operating rooms; and within the operating rooms themselves. In practice, the decision on allocating items to these locations is often based on the staff’s experience, rather than through optimization methods. In this research, we have identified the costs associated with each location to determine where each item should be stored and in what quantities. These costs include the cost of building the case cart, the cost of returning unused items to storage, the cost of picking items during a procedure, the cost of restocking and the cost of reviewing items to determine what needs to be replenished. Since the number of supplies required to perform a procedure is uncertain, we have developed a robust stochastic mixed-integer programming model to make the inventory allocation decision. The model also enables a hospital to assess the potential cost saving from optimization of the preference cards, which are used by surgeons to specify the requested supplies available on the case carts. The performance of the proposed model is evaluated through a case study. Three alternatives to the current configuration of the system are presented and reduction of inventory expenditure within each alternative is discussed. Finally, sensitivity analyses are performed to determine which cost parameters contribute to the model more significantly and how the model behaves against different levels of risk coefficient.

Prospective study on sterilization of rigid endoscopes in various otolaryngology clinics

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Rigid endoscopes have revolutionized the diagnosis and management of upper aerodigestive pathologies. Inadequate disinfection and sterilization techniques carry increased risk for cross infection. Hence, they require high level disinfection to effectively reduce the bacterial and fungal contamination of rigid endoscopes. The present study analyses the various techniques of sterilization practised in Mangaluru, Karnataka, at different Otorhinolaryngology clinics.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This prospective descriptive study was done on 30 rigid endoscopes. Swabs were taken from the endoscopes and container, and send for detailed microbiological examination. The different methods practised at various centres were documented. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The various sterilization technique practised was predominantly cetrimide and chlorhexidine solution (savlon) wash, ETO and Formaldehyde. However, among all techniques the microbiological studies revealed no growth.&lt;/p&gt;&lt;p class="MsoNoSpacing"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Rigid endoscopes have emerged as the best diagnostic equipment for otorhinolaryngologists. With regard to high level disinfection and sterilization, the endoscope must undergo recommended techniques. In our study the most commonly used techniques was cetrimide and chlorhexidine solution wash and less commonly ETO and Formaldehyde. The use of standard sterilization technique and maintaining the rigid endoscopes in sterile storage container is the key to maintain an organism free environment. The standard technique of prewash with water and soap water, then washing with cetrimide and chlorhexidine solution, then store the endoscope in sterile container is our recommendation. &lt;/p&gt;

Reason behind wet pack after steam sterilization and its consequences: An overview from Central Sterile Supply Department of a cancer center in eastern India

Wet pack after steam sterilization process that means there are surely obtain millions of microorganisms that can breed and multiply rapidly and objects are unsterile and can never be used for further procedure. There are many reasons behind the wet pack occurrences after autoclaving like poor quality of wrapping materials, faulty valves of rigid container, faulty loading and packaging technique, poor steam quality, sterilizer malfunction and may be design related problems in CSSD sterile storage area. Cause of wet pack after steam sterilization processes may occur severe problems because of wasted time and effort, increased work load, increased cost, potentially contaminated instruments, infection risk to the patient, poor patient outcomes and delayed or cancellation of procedures. But such wet pack scenario can be avoided by various methods by using good steam (water) quality, performing periodic maintenance of the Autoclaves, avoidance of sterilizer overloading, allowing adequate post sterilization time to cool down the materials to room temperature, using good quality wrapping materials, properly maintain temperature and humidity of sterile storage area etc.

New methods for cooling and storing oocytes and embryos in a clean environment of −196°C

It is well documented that oocyte vitrification using open systems provides better results than closed systems. However, its use is limited owing to risks of contamination posed by direct exposure to liquid nitrogen and cross-contamination when stored in liquid nitrogen tanks. A device that produces clean liquid air (CLAir) having similar a temperature as liquid nitrogen and a sterile storage canister device (Esther) that keeps samples sealed in their own compartment while in regular liquid nitrogen tanks were developed. The following experiments were performed: temperature measurements, bioburden tests, vitrification and storage experiments with mice embryos and human oocytes. Results showed similar cooling rates for liquid nitrogen and liquid air. Bioburden tests of CLAir and Esther showed no contamination, while massive contamination was found in “commercial” liquid nitrogen and storage canisters. Mice blastocysts had a survival rate of over 90%, with 80% hatching rate after vitirification in CLAir and 1 week storage in Esther, similar to the fresh (control) results. Human oocytes vitrified in CLAir and in liquid nitrogen for three consecutive vitrification/warming cycles showed 100% survival, seen as re-expansion in both groups. These new systems represent a breakthrough for safe vitrification using open systems and a safe storage process generally.

Neuronal and Glial Growth in Organotypic Cultures after Vitrification

Fetal rat dorsal root ganglia (DRG) and spinal cords (SC) slices from rat fetuses were vitrified in a new semiautomatic vitrification system, cooled in sterile slush liquid air (SLA) and stored in a special sterile sealed container in liquid nitrogen (LN). Upon warming organotypic stationary cultures were performed in using NVR-Gel (composed mainly from hyaluronic acid and laminin) and enriched with neuronal factors conjugated to iron oxide nanoparticles. Evaluation of cultures was made by daily phase-contrast microscopy observations and by immune fluorescent staining. Results revealed that SC neurons maintained their multipolar shape and regrew dendrites and axons. The round shape DRG neurons exhibited euchromatic nuclei with prominent nucleoli and an active regeneration of nerve processes. Migration of both neurons and flat cells (fibroblasts and glia Schwann cells) started within 48 hours after seeding and intensified in the upcoming days. In conclusion, it can be said that the using a semi-automatic vitrification, sterile vitrification and sterile storage of neuronal tissues from the CNS and the PNS is a successful advanced technology for the preservation of neurons and glial cells, as shown in the regain of a full regular growth pattern in culture. This may an important step towards clinical use in the reconstruction of severe peripheral nerves and spinal cord injuries.

Ethylene Oxide 가스 멸균물품의 유효기간에 관한 연구 - 보관환경을 중심으로 -

Purpose: This was a study on the expiration date of Ethylene Oxide (EO) gas sterilization and effects of the environmental factors of temperature, humidity and type of cabinet in sterile goods storage area on the expiration date. Methods: Sterile goods storage areas from 13 departments in one hospital were selected and 455 EO gas sterilization samples were prepared and kept in those areas over the 14 months of the study. Each sample was tested with a microbiological culture in the laboratory every week. If the result was positive, the sample was regarded as contaminated. The researcher visited once a month to check the temperature, humidity and type of cabinet. Results: With the exception of 1 sample which was positive at 56th week. 454 samples were confirmed as negative. The environment of the samples storage area was measured monthly. The annual average temperature was <TEX>$24.2{\pm}1.6^{\circ}C$</TEX>, and the mean relative humidity <TEX>$34.7{\pm}15.2%$</TEX>. The types of cabinet were 7 open and 6 closed. Conclusion: The results of the microbiological culture at 13 months showed that none of the samples were contaminated. Therefore the hospital's existing Expiration Date can be extended from 6 months to 13~14 months.

Effects of sterile storage, cation saturation and substrate additions on the degradability and extractability of nonylphenol and phenanthrene in soil

The main objective of this study was to determine the effects of long-term abiotic processes during aging of organic pollutants in soil on their microbial degradability and formation of non-extractable residues. The specific aims of our study were to investigate how the fate of p353-nonylphenol (NP) and phenanthrene (Phe) in soils might be affected by: (i) saturation of soil by cations with different valency (Na+, Ca2+ or Al3+), (ii) addition of organic substrate (wood flour) during incubation period and (iii) different soil moisture levels.This study showed positive effect of long-term aging of sterilized samples on respiration of re-inoculated samples. However, the lack of aging effects on the mineralization of NP and Phe indicates that slow sorption processes by diffusion into less bioaccessible domains were not relevant in studied soils. Similarly, the lower respiration and xenobiotic mineralization rates in the Na+ and Al3+ treated soils indicate that this is due to toxic effects on microbial activity and not due to xenobiotic accessibility. Instead, the formation of non-extractable residues was strongly promoted by biological activity, most likely through formation of more reactive metabolites. The addition of wood flour greatly stimulated microbial respiration and enhanced NP mineralization while inhibiting that of Phe. Along with negligible effect of water addition after 4weeks of incubation on kinetics of soil respiration, the soil moisture effect on xenobiotics mineralization indicates that most probably the bioavailability of NP and Phe increased due to bridging role of water films in soil.

Temperatura e umidade no armazenamento de materiais autoclavados: revisão integrativa

São diversificadas as recomendações referentes à temperatura (T°) e umidade relativa do ar (UR) no armazenamento de materiais esterilizados em Centrais de Material e Esterilização (CME), sem que essas recomendações estejam embasadas em referenciais teóricos ou experimentos. A prática mostra dificuldades em controlar esses parâmetros, suscitando dúvidas quanto ao risco para a manutenção da esterilidade dos materiais. Este artigo propôs, por meio de uma revisão bibliográfica integrativa, identificar e analisar as recomendações referentes à T° e UR indicadas para o setor de guarda dos materiais na CME. Não foi encontrada literatura que justifique tais recomendações. Foram incluídas sete publicações que analisaram as variáveis T° e UR da área de armazenagem como fatores que podem afetar a manutenção do material esterilizado, e apresentaram resultados contraditórios quanto à interferência desses fatores na manutenção da esterilidade dos materiais.