Aislamiento microbiológico en trabajadores de salud posterior a la higiene de manos

Introducción: La higiene de manos es un paso fundamental para prevenir la transmisión y diseminación de infecciones asociadas a la atención en salud (IAAS), por esto, es de vital importancia su correcta ejecución según los 5 momentos sugeridos por la Organización Mundial de la Salud (OMS). Objetivo: Aislar bacterias y hongos posterior a la higiene de las manos en el personal de salud. Métodos: Estudio descriptivo, experimental, transversal, con una muestra de 16 individuos que laboraban en el Servicio de Enfermedades Infecciosas del Adulto del Hospital Universitario de Caracas, divididos en dos grupos de 8 participantes, quienes realizaron la higiene de manos de acuerdo a las técnicas descritas por la Organización Mundial de la Salud con agua y jabón (grupo A) y con gel antibacterial a base de alcohol al 70 % (grupo B). Consecutivamente, se tomó muestra de las manos mediante aposición en placas de Petri, en Agar Endo (HiMedia™) y Agar Sabouraud (Oxoid™). Los crecimientos positivos fueron repicados a otros agares y se realizaron pruebas bioquímicas para su identificación. Resultados: En 56,25 % (9/16) de las muestras hubo crecimiento de levaduras, a partir de las cuales se identificaron C. parapsilosis (77,7 %), C. tropicalis (11,3 %) y C. kefyr (11,3 %). Por su parte, 50 % (8/16) tuvieron crecimiento positivo para bacilos Gram negativos fermentadores y no fermentadores. Conclusiones: En las manos de los trabajadores de salud se aislaron bacilos Gram negativos fermentadores y no fermentadores, así como especies de Candida. Se observó una mayor eficacia antimicrobiana con el uso de agua y jabón líquido con respecto a la eliminación de Candida spp.

Introduction: Hand washing is a key tool to prevent transmission and dissemination of hospital associated infections; thus it is a very important to elaborate the proper technique to achieve hand antisepsis, throughout several methods including the 5 times to hand washing proposed by World Health Organization (WHO). Aim: To isolate bacteria and fungi after handwashing in a group of healthcare personnel. Methods: This was an experimental, descriptive and cross-sectional study carried out with 16 healthcare personnel from the Adult Infectious Disease Department at the Hospital Universitario de Caracas, divided in 2 groups (A and B) of 8 participants who was asked and instructed to performed the handwashing technique stablished by the WHO. Group A used conventional soap and water, while group B used 70 % alcohol-based hand sanitizer. After hand sanitization with any of both substances, sample collection was performed throughout hand apposition in Petri dishes with Endo agar (HiMedia™) and Sabouraud dextrose agar with chloramphenicol (Oxoid™) and incubated during 36h in an aerobic 37 °C atmosphere. Positive growth in each case was replied and biochemical tests were performed to each isolation to confirm its identification. Results: 56.25 % (9/16) of the growth was represented by Candida sp: C. parapsilosis (77.7 %), C. tropicalis (11.33 %) and C. kefyr (11.3 %). About bacteria, 50 % (8/16) of the samples collected had growth for gram negative fermenting and nonfermenting bacilli. Conclusions: There were presence of gram-negative bacilli and fungi after handwashing in the hands of the healthcare personnel studied. It was observed that water and soap had a better antimicrobial outcome in comparison with alcohol-based sanitizer to eliminate Candida sp.

An in Vitro Effectiveness Evaluation of Chemical Agents for Toothbrushes Disinfection

Objective: To evaluate in the vitro effectiveness of three chemical agents for toothbrush disinfection. Material and Methods: Sixteen new toothbrushes were evaluated, previously sterilized and classified in five experimental groups (n=3) and one item as control. Three chemical agents were assessed: 0.12% Chlorhexidine gluconate (CHX), essential oil mouth rinse (Listerine) and 3.5% Sodium hypochlorite (NaOCl). The five selected strains were inoculated on toothbrushes and incubated for a 24 hours period and 37°C temperature in aerobic conditions. The incubated toothbrushes were immersed for a 15 min period into selected chemical agents and after drying in a controlled air stream, again re-cultured into enriched broth. A comparison was made between the initial and final microorganisms density recovered after chemical disinfection based on Mc Farland scale. The data obtained was compared by descriptive analysis and ANOVA methodology. Results: 3.5% NaOCl was the most effective chemical agent for toothbrush disinfection followed by CHX; Listerine was not effective to eliminate the inoculated bacteria in toothbrushes. Conclusion: 3.5% NaOCl and 0.12% CHX are the most effective chemical agents for toothbrush disinfection and Listerine was only effective against C. albicans.

Isolation of Fungi and Gram Negative Bacteria from Toothbrushes and Bathroom Bioaerosols

Objective: To identify, using phenotypic methods, FGNB, NFGNB and Candida sp. in toothbrushes, and environmental samples of bathroom air in a group of students from the Dentistry School of the Universidad Central de Venezuela. Material and Methods: Thirty-four toothbrushes were supplied to the cohort during a 60-day period; environmental samples were collected in the rooms where toothbrushes were kept during this period. All samples were processed by traditional methods of microbiological counting isolation and phenotypic identification using selective and differential agar based on the international guidelines of the United States Pharmacopeia (USP) 38. Results: 82.36% of the toothbrush samples were positive to bacteria and fungi and 91.17% of the environmental samples were positive to enterobacteria. Conclusion: It is necessary to establish antiseptic protocols for the management, storage and disinfection of toothbrushes. The high rate of contamination may represent an opportunity for enterobacteria colonization of oral biofilms, reservoir to infection foci and metastatic infections in certain populations.

Oral Manifestations Associated to Paracoccidioidomicosis and Histoplasmosis

Objective: To determine the frequency and clinical forms of oral manifestations associated to Paracoccidioidomycosis (PCM) and Histoplasmosis. Material and Methods: 481 medical records of outpatients referred to the Medical Mycology Department were reviewed since 2009 to 2016. Data were analyzed using descriptive statistical methods. Results: 47 (9.77%) cases had oral manifestations, 29 (61.70%) were associated to PCM and 18 (38.29%) to histoplasmosis. For PCM, male-female ratio was 8:1 and 1:1 for histoplasmosis. The average age for PCM was 48 years old and 53 for histoplasmosis. All the PCM patients had more than 1 oral structure affected: 44.82% were gingival lesions and 27.58% palate. In patients with histoplasmosis, 6 (33.33%) were lesions affecting palate and 6 (33.33%) involving tongue. For both entities, painful ulcers and granulomatous-like lesions were the most prevalent clinical forms; however, we observed a wide range of other oral manifestations. Regarding PCM patient's comorbidities, 3 (10.34%) cases had HIV/AIDS, 8 (27.58%) histoplasmosis and 2 (6.89%) carcinomas. Whereas the comorbidities of patients with histoplasmosis, 2 (11.11%) had HIV/AIDS and 1 (5.55%) had carcinoma. Conclusion: In endemic countries for both mycoses, dentists must be aware of patients with mouth lesions, take advantage of epidemiologic clues that suggest risk factors and be acquainted with all the current diagnostic tests in order to make a quick diagnosis and treatment in highly suspicious cases.