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The effect of jewellery on surface bacterial counts
FE 2001 Abstracts
129
P77
P78
ANAL HPV DISEASE AND PREVENTION OF ANAL
THE EFFECT OF JEWELLERY ON SURFACE BACTERIAL COUNTS. GE. Bartlett, TCB. Pollard, KE. Bowker, GC. Bannister. Department Orthopaedics Avon Orthopaedic Centre, Southmead Hospital, Bristol, UK. Objectives: To measure the effect on local surface bacterial counts of, retaining or removing jewellery worn outside theatre clothing. Methods: Finger rings, nose and ear piercings were assessed, twenty items tested in each group. Samples were taken using sterilised skin swabs, three for each item of jewellery; one from an adjacent area of skin as a control, a second from the jewellery surface and a third from the skin immediately behind the jewellery. Each swab was plated out onto a preincubated horse blood agar plate and incubated for 24 hours
CANCER. M. Nathan, Department of Sexual Health, Homerton Hospital, London, U.K. BACKGROUND Anal warts caused by human papillomavirus (HPV) are common in selected population groups. HPV is associated with anal cancer. There is increasing evidence that anal warts is a risk factor for anal cancer. We looked at the feasibility of treatment of anal warts as a means of prevention of anal cancer. METHODS A retrospective case-controlled study of patients with anal warts attending the East London Anoscopy Clinic. RESULTS Thirty-three of 37 patients had demonstrable anal warts. In 17 of these cases (45.9%) anal intraepithelial
cancer, as is the case for CIN with cervical cancer.
at 37OC. The number of colony forming units was used as a measure of bacterial counts present. Results: The lower bacterial counts were found on the control areas of skin, rising on the jewellery surfaces, with the highest counts being on the skin tested under the jewellery, p<0.0001. Conclusion: Finger rings, nose and ear piercings increase local surface bacterial counts when in situ and especially after removal. Piercings should not be removed but covered by masks and hats respectively. Current guidelines for theatre staff should be updated to reflect this.
P79
P80
DIFFERENTIATION OF MEMBERS OF THE
An unusual case of Group A Streptococcal infection S. Hegde, J. Clark, M. Ward Platt
neoplasia (AIN) was identified. Seven patients (18.9%) had high-grade disease (AIN 213). HPV detection was positive in 27 cases (72.9%). Fourteen patients (37.8%) had high-risk HPV types. Twenty-five patients had laser ablative treatment. Sixteen patients (64%) had remained disease-free during a follow-up period of 3 to 47 months. INTERPRETATION AIN frequently co-exists with exophytic warts. Successful treatment of anal warts and AIN is feasible. Treatment of AIN may form a basis for prevention of anal
A4YCOBACTERIUhf TUBERCULOSIS COMPLEX USrNG GYM-BASED POLYMORPHISM ANALYSIS. AM Kearns, J Heatherington, D Burdess, R Freeman and JG Magee, Public Health Laboratory, General Hospital, Westgate Road, Newcastle upon Tyne, NE4 6BE, UK. The Mycobacterium tuberculosis complex (MTBC) comprises a group of c!osely-related species which cause tuberculosis in humans and animals: A4. tuberculosis, M. bovis, M. africanum and M. microti. These organisms differ in their host range and pathogenicity, hence their differentiation is desirable for epidemiological purposes. However, conventional methods for characterisation of members of the MTBC can be difficult, labour intensive and the results may be equivocal. We have evaluated gyrB sequence polymorphism for the identification and differentiation of clinical isolates of MTBC using a PCR-RFLP approach. Polymorphisms in the PCR amplicon were analysed by restriction with each of 3 enzymes: RsaI, Sac11 and TaqI. Data will be presented showing that this technique allowed precise and accurate discrimination of species within the MTBC, is easy to perform and can be completed within a working day. Preliminary work suggests the assay may be applicable not only to cultures, but also to the timely (<24h) detection, identification and differentiation of these organisms in clinical material.
Department of infectious disease and immunology, Newcastle General Hospital, Newcastle upon Tyne Case: 2 1 -month-old boy presented with a short history of pyrexia and a painful erysipelas like lesion on anterior abdominal wall just to right of umbilicus with surrounding extensive erythema. He continued to be pyrexial and the lesion was still spreading (fig 1) despite intravenous therapy with benzyl penicillin and flucloxacillin for 36 hours. With the possibility of necrotising fasciitis in mind he was changed over to meropenem and clindamycin. CT scan of abdomen did not show any involvcmcnt of dccpcr structures. Blood culture and ASOT were negative. The lesion resolved into an abscess in 48 hours (fig 2) needing surgical drainage. There was no evidence of fasciitis and the pus grew heavy growth of Group A Beta haemolytic streptococci. Learning points: This case illustrates one of a wide range of the diverse manifestation of group A Streptococcal infections with unusual progress. Erysipelas like presentation in an unusual site with some suggestion of possible necrotising fasciitis gave grave concern and prompted detailed imaging and aggressive antimicrobial therapy. Blood culture and ASOT were negative illustrating the point that ASOT is an antibody test, which may take several weeks to rise.
129
P77
P78
ANAL HPV DISEASE AND PREVENTION OF ANAL
THE EFFECT OF JEWELLERY ON SURFACE BACTERIAL COUNTS. GE. Bartlett, TCB. Pollard, KE. Bowker, GC. Bannister. Department Orthopaedics Avon Orthopaedic Centre, Southmead Hospital, Bristol, UK. Objectives: To measure the effect on local surface bacterial counts of, retaining or removing jewellery worn outside theatre clothing. Methods: Finger rings, nose and ear piercings were assessed, twenty items tested in each group. Samples were taken using sterilised skin swabs, three for each item of jewellery; one from an adjacent area of skin as a control, a second from the jewellery surface and a third from the skin immediately behind the jewellery. Each swab was plated out onto a preincubated horse blood agar plate and incubated for 24 hours
CANCER. M. Nathan, Department of Sexual Health, Homerton Hospital, London, U.K. BACKGROUND Anal warts caused by human papillomavirus (HPV) are common in selected population groups. HPV is associated with anal cancer. There is increasing evidence that anal warts is a risk factor for anal cancer. We looked at the feasibility of treatment of anal warts as a means of prevention of anal cancer. METHODS A retrospective case-controlled study of patients with anal warts attending the East London Anoscopy Clinic. RESULTS Thirty-three of 37 patients had demonstrable anal warts. In 17 of these cases (45.9%) anal intraepithelial
cancer, as is the case for CIN with cervical cancer.
at 37OC. The number of colony forming units was used as a measure of bacterial counts present. Results: The lower bacterial counts were found on the control areas of skin, rising on the jewellery surfaces, with the highest counts being on the skin tested under the jewellery, p<0.0001. Conclusion: Finger rings, nose and ear piercings increase local surface bacterial counts when in situ and especially after removal. Piercings should not be removed but covered by masks and hats respectively. Current guidelines for theatre staff should be updated to reflect this.
P79
P80
DIFFERENTIATION OF MEMBERS OF THE
An unusual case of Group A Streptococcal infection S. Hegde, J. Clark, M. Ward Platt
neoplasia (AIN) was identified. Seven patients (18.9%) had high-grade disease (AIN 213). HPV detection was positive in 27 cases (72.9%). Fourteen patients (37.8%) had high-risk HPV types. Twenty-five patients had laser ablative treatment. Sixteen patients (64%) had remained disease-free during a follow-up period of 3 to 47 months. INTERPRETATION AIN frequently co-exists with exophytic warts. Successful treatment of anal warts and AIN is feasible. Treatment of AIN may form a basis for prevention of anal
A4YCOBACTERIUhf TUBERCULOSIS COMPLEX USrNG GYM-BASED POLYMORPHISM ANALYSIS. AM Kearns, J Heatherington, D Burdess, R Freeman and JG Magee, Public Health Laboratory, General Hospital, Westgate Road, Newcastle upon Tyne, NE4 6BE, UK. The Mycobacterium tuberculosis complex (MTBC) comprises a group of c!osely-related species which cause tuberculosis in humans and animals: A4. tuberculosis, M. bovis, M. africanum and M. microti. These organisms differ in their host range and pathogenicity, hence their differentiation is desirable for epidemiological purposes. However, conventional methods for characterisation of members of the MTBC can be difficult, labour intensive and the results may be equivocal. We have evaluated gyrB sequence polymorphism for the identification and differentiation of clinical isolates of MTBC using a PCR-RFLP approach. Polymorphisms in the PCR amplicon were analysed by restriction with each of 3 enzymes: RsaI, Sac11 and TaqI. Data will be presented showing that this technique allowed precise and accurate discrimination of species within the MTBC, is easy to perform and can be completed within a working day. Preliminary work suggests the assay may be applicable not only to cultures, but also to the timely (<24h) detection, identification and differentiation of these organisms in clinical material.
Department of infectious disease and immunology, Newcastle General Hospital, Newcastle upon Tyne Case: 2 1 -month-old boy presented with a short history of pyrexia and a painful erysipelas like lesion on anterior abdominal wall just to right of umbilicus with surrounding extensive erythema. He continued to be pyrexial and the lesion was still spreading (fig 1) despite intravenous therapy with benzyl penicillin and flucloxacillin for 36 hours. With the possibility of necrotising fasciitis in mind he was changed over to meropenem and clindamycin. CT scan of abdomen did not show any involvcmcnt of dccpcr structures. Blood culture and ASOT were negative. The lesion resolved into an abscess in 48 hours (fig 2) needing surgical drainage. There was no evidence of fasciitis and the pus grew heavy growth of Group A Beta haemolytic streptococci. Learning points: This case illustrates one of a wide range of the diverse manifestation of group A Streptococcal infections with unusual progress. Erysipelas like presentation in an unusual site with some suggestion of possible necrotising fasciitis gave grave concern and prompted detailed imaging and aggressive antimicrobial therapy. Blood culture and ASOT were negative illustrating the point that ASOT is an antibody test, which may take several weeks to rise.