Transcript Materials avalaible Perfusion liquid

Determination of the
origin of the
contamination of the
patient
Context
The patient victim of the infection was hospitalized
following a surgery. During hospitalization he
received each day different care and treatment :
Liquid perfusion
with analgesic
Perfusion
Catheter
liquid
contaminated
contaminated
?
?
Cleaning of
the scar
Physiological
cleaning
water
contamined
?
Compresses
contamined
?
1. Detection of bacterial
contaminants on
compresses
Materials avalaible
Compress bag to test
Special
agar
contact
dish
1.1. Open a bag of
compresse.
1.2. Apply on the
compresse, the “agar
contact dish”. Press
lightly and maintain
contact approximately
10 seconds.
WARNING! The sample is realized in asepsis
around the Bunsen burner.
1.3. Use eventually a forceps to peel off the
compresse and after close the box
1.4. Write on the bottom of the box “Box 1”
and the number of your table. Incubate 24
hours at 37°C
2. Detection of bacterial
contaminants in
physiological cleaning
water
Materials avalaible
Physiological water (PW) to test
Agar
Petri
dish
Sterile
pipette
Sterile
spread
rake
2.1. Open the
“PW” bottle, and
with a sterile
pipette, sample
0,5 mL around
2.2. Put down 2 or 3
drops on the surface
of the agar Petri dish
WARNING! The sample is realized in asepsis
around the Bunsen burner.
Agar Spread
rack
2.3. With a sterile rack,
spread the drops on the
surface of the agar
Spread through the entire surface of the agar.
Do not press too hard to avoid damaging the agar
2.4. Close the box. Write on the bottom of
the box “Box 2”, and the number of your
table. Incubate 24 hours at 37°C
3. Detection of bacterial
contaminants in a
catheter
Materials avalaible
Swab
Agar Petri dish
Catheter to test
3.1. Take the catheter
with a forceps, in
approximately 1 cm
of the extremity
3.2. With the swab,
rub inside the
catheter next to this
extremity
WARNING! The sample is realized in asepsis
around the Bunsen burner.
3.3. With the swab,
realize a spreading
on the surface of the
agar plate dish.
Realize tight
streaks.
Spread through the entire surface of the agar.
Do not press too hard to avoid damaging the agar
3.4. Close the box. Write on the bottom of
the box “Box 3”, and the number of your
table. Incubate 24 hours at 37°C
4. Detection of bacterial
contaminants in
perfusion liquid
Materials avalaible
Filtering
system
under
pressio
n
Bacteria filter
(preinstalled on
filtering system)
Small agar
Petri dish
Perfusion
liquid (PL)
to test
Principle of membrane filtration for
bacterial detection
Bacteria filter :
view of the
upper face
4.1. On the pre-installed
filtering system, check
presence of a bacteria
filter
4.2. Pour the content of
the perfusion liquid (PL)
on the center of the
filter.
Not to put drops on the
walls of the filtering
system
WARNING! The sample is realized in asepsis
around the Bunsen burner.
4.3. Run the pression on the filtering system (by
opening water tap) to triger vacuum, until filter
all the liquid.
After filtration, close the water tap to
stop vacuum
4.4. Take off the upper
part of filtering system
(removing before the big
black clamp), so as to
access to the filter.
4.5. With a forceps,
recover the filter and
deposit it immediately on
a small agar Petri dish
After deposit, apply a light pression
with the forceps to allow a good
adhesion of the filter on the agar
4.6. Close the box. Write on the bottom of
the box “Box 4”, and the number of your
table. Incubate 24 hours at 37°C
5. Results
The second day, after incubation, observe
the surface of different agar Petri dish to
look for bacterial colonies
What is the probable origin of the
contamination ?