Report of two events of nosocomial outbreak and pseudo-outbreak due to contamination with Achromobacter spp / Comunicación de 2 eventos de brote y seudobrote nosocomial debido a contaminación con Achromobacter spp

Abstract Achromobacter spp. are increasingly recognized as emerging pathogens in immunocompromised patients or suffering cystic fibrosis, but unusual in immunocompetent hosts or individuals that underwent surgery. In this study we describe two simultaneous events attributable to two different Achromobacter spp. contaminated sources. One event was related to an episode of pseudo-bacteremia due to sodium citrate blood collection tubes contaminated with Achromobacter insuavis and the other to Achromobacter genogroup 20 infection and colonization caused by an intrinsically contaminated chlorhexidine soap solution. Both threatened the appropriate use of antimicrobials. Molecular approaches were critical to achieving the accurate species identification and to assess the clonal relationship, strengthening the need for dedicated, multidisciplinary and collaborative work of microbiologists, specialists in infectious diseases, epidemiologists and nurses in the control of infections to clarify these epidemiological situations.

Resumen Achromobacter spp. son reconocidas con mayor frecuencia como patógenos emergentes en pacientes con fibrosis quística e inmunodeprimidos, pero son inusuales en hospedadores inmunocompetentes o quirúrgicos. En este estudio describimos 2 eventos simultáneos atribuibles a 2 fuentes contaminadas con Achromobacter spp. Uno correspondió a un episodio de seudobacteriemia por tubos de citrato de sodio contaminados con Achromobacter insuavis y el otro a infecciones y colonizaciones debidas al uso de solución jabonosa de clorhexidina intrínsecamente contaminada con Achromobacter genogrupo 20. Ambos episodios pusieron en peligro el uso apropiado de antimicrobianos. Los enfoques moleculares fueron fundamentales para lograr la identificación precisa de las especies y evaluar la relación clonal de los aislamientos, lo que refuerza la necesidad del trabajo perseverante y multidisciplinario de microbiólogos, especialistas en enfermedades infecciosas, epidemiólogos y enfermeras en el control de infecciones para el esclarecimiento de estas situaciones epidemiológicas.

Eefectividad de los colutorios de clorhexidina más flúor en niños de 6 años con alto riesgo de caries / Effectiveness of the clorhexidine plus fluoride collutoriums in 6 year-old children with high risk of dental caries

Se efectuó un estudio cuasiexperimental en 27 escolares de 6 años con alto riesgo de caries, pertenecientes a la Escuela Primaria "Miguel Ángel Oramas Alfonso" de Santiago de Cuba, desde octubre del 2009 hasta mayo del 2012, con vistas a determinar la efectividad de los colutorios de clorhexidina más flúor en estos niños. La casuística quedó distribuida en 2 grupos: estudio (A) y control (B), seleccionados a través de un muestreo aleatorio simple; los primeros tratados con clorhexidina más flúor, durante 15 días continuos, por 4 meses y los segundos con flúor solamente, por igual periodo. Se demostró la efectividad de los citados colutorios con resultados significativos, puesto que en el grupo A existió una disminución proporcional de las caries (66,6 %), no aparecieron nuevas y 76,9 % de sus integrantes lograron una higiene bucal eficiente.

A quasi-experimental study was carried out in 27 school children who were 6 years-old with high cavity risk, belonging to "Miguel Ángel Oramas Alfonso" Primary School in Santiago de Cuba, from October, 2009 to May, 2012, aimed at determining the effectiveness of clorhexidine plus fluoride collutoriums in these children. The case material was distributed in 2 groups: study group (A) and control group (B), selected through a simple random sampling; the first group was treated with clorhexidine plus fluorine, during 15 continuous days, for 4 months and the second one with fluoride only, during an equal period. The effectiveness of the mentioned collutoriums was demonstrated with significant results, since in group A proportional decrease of the caries existed (66.6%), there were no new ones and 76.9 % of its members achieved an efficient oral hygiene.

Comparação da atividade antimicrobiana entre os sabonetes contendo digluconato de clorexidine, triclosan e óleo essencial de achillea milefollium L (asteraceae) / Comparision of the antimicrobial activity of soap containing clorhexidine digluconate, triclosan, and the essential oil of the achillea millefolium achillea millefolium L (asteraceae)

Amostras de sabonete contendo, como agentes antissépticos, triclosan, na concentração de 1,0%; digluconato de clorexidine a 2,0%; óleo essencial de Achillea millefolium nas concentrações de 1,0% e 2,0%, foram avaliadas quanto à atividade antimicrobiana frente aos microorganismos S. aureaus, E. coli, P. aeruginosa e C. albicans pela técnica de Pour Plate. Os resultados demonstraram um poder inibitório total do triclosan frente aos microorganismos testados e observou-se poder inibitório superior do óleo essencial de achillea millefolium na concentração de 2,0% em relação ao sabonete de digluconato de clorexidine, muito utilizado em ambientes hospitalares.

Soap samples containing antiseptics agents such as 1%-triclosan, 2%-clorexidine digluconato, and 1-2% essential oil of Achillea millefolium was assessed according to its antimicrobial activity against Sthaphylococus aureus, E. coli, P. aeruginosa, and C.albicans by the Pour Plate technique. The results demonstrated a total inhibition of the triclosan to the tested microorganisms and a superiorinhibition of the essential oil of Achillea millefolium was observed at the concentration of 2% in relation to the clorhexidine digluconate soap, very used in hospital atmospheres.