424 JOURNAL OF THE SOCIETY OF COSMETIC CHEMISTS Skin-care preparations These substances fall into an important 'grey area' between the pharma- ceutical and cosmetic fields, and have hitherto been somewhat neglected. The two main areas of danger are the fluids and creams applied to the hands of staff during and after washing, and those used for the skin care of newborn infants. Hand creams from non-pharmaceutical sources may be used in hospitals. In the U.S.A., frequent and heavy contamination was found in previously unopened containers of four of 26 brands sampled (46). Ayliffe, Barrowcliff and Lowbury (47) found that 22 of 67 communal jars of hand cream in use in British hospital wards were contaminated, seven with Ps. aeruginosa and six with Klebsiella. Many of the fluids and creams used on the skin in hospitals contain antibacterial substances, such as hexachlorophane and chloroxylenols, which have poor activity against Gram-negative bacilli, with which they often become contaminated either in bulk or during use in the wards (47-49). Disinfectants A revolution in the handling of disinfectants has taken place in recent years, and it is now common practice for them to be issued at use dilution from the pharmacy. Several instances of the mass contamination of hospital supplies of disinfectants with Gram-negative rods have been recorded (3, 42, 50). For a summary of outbreaks of sepsis spread by disinfectant solutions see Bassett (51). CONCLUSION The most urgent clinical problems arising from the contamination of pharmaceutical products, and of cosmetic products used in the medical field, are caused by the multiplication of 'free-living' types of Gram- negative bacteria. That this happens so often is attributable to failure to recognize the ability of the organisms to multiply in fluids apparently devoid of nutrient, and the remarkable ability of some of them to resist the activity of commonly used bacteriostatic and disinfectant substances. Some of this contamination may occur in the pharmacy, and un- doubtedly much more is added in the course of re-use of preparations in the

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