Análise da susceptibilidade e patogenicidade dos fômites de Sars-Cov-2 no Brasil: revisão da literatura / Analysis of the susceptibility and pathogenicity of the Sars-cov-2 fomites in Brazil: literature review

Objetivo ­ Verificar a suscetibilidade de criação de fômites de Sars-Cov-2 de acordo com temperatura, umidade e período de exposição. Métodos ­ Foi realizada uma revisão sistemática da literatura, entre março de 2021 e junho de 2022, utilizando-se a Biblioteca Virtual em Saúde (BVS), PubMed e Medline, através do cruzamento dos termos SARS-COV-2 AND desinfecção AND higienização AND fômites AND superfícies. Resultados ­ Dos 295 artigos encontrados, 24 foram selecionados e divididos em 3 categorias temáticas, "A influência das condições ambientais", "detecção por período de exposição" e "amostragens não experimental". Conclusões ­ Foi observado que existe a possibilidade da formação de fômites de Sars-Cov-2 e as condições ambientais influenciam diretamente, exigindo assim cuidado com superfícies possivelmente contaminadas. Descritores: Sars-Cov2; Desinfecção; Fômites; Superfícies

Stability of enteroviruses on toys commonly found in kindergarten

@#Hand, foot, and mouth disease (HFMD) is a contagious childhood disease caused by enteroviruses including enterovirus A71 (EV-A71), coxsackievirus A6 (CV-A6) and CV-A16 transmitted via direct and indirect contact. Different types of toy surfaces can affect the stability of viruses. Understanding the stability of enteroviruses on toys provides insightful data for effective disinfection in kindergartens or homes. Porous (ethylene-vinyl acetate mat foam, paper, pinewood, polyester fabric, and squishy polyurethane foam) and non-porous (acrylonitrile butadiene styrene plastic and stainless-steel coin) surfaces were inoculated with EV-A71 at 4, 24, and 35°C, and coxsackieviruses at 24°C. Infectious enteroviruses were recovered and titred in median tissue culture infectious dose assay (TCID50). Atomic force microscopy (AFM) images were taken from surfaces to examine association of surface roughness with virus stability. Overall, infectious enteroviruses were persistent on all non-porous and porous surfaces. Virus persistence was longest at 4°C followed by 24°C and 35°C. EV-A71 half-lives ranged between 6.4-12.8 hours at 4°C, 2.4-6.7 hours at 24°C, and 0.13-2.7 hours at 35°C. At lower virus titres exposed to 24°C, half-lives of enteroviruses ranged from 0.1-1.4 hours. Surface roughness values from AFM suggested smooth surfaces of non-porous surfaces were associated with better virus stability. Temperature, enterovirus concentration, and type of surface affected persistence and stability of enteroviruses. Our findings suggest both porous and non-porous surfaces in kindergartens allow enterovirus persistence and should be frequently disinfected to curb HFMD outbreaks in kindergartens.

Estudio piloto de caracterización microbiológica de los billetes que circulan en la ciudad de Bucaramanga, Colombia / Pilot Study of Microbiological Characterization of Banknotes Circulating in the City of Bucaramanga, Colombia / Estudo piloto de caracterização microbiológica das notas em circulação na cidade de Bucaramanga, Colômbia

Introducción. Los billetes son un potencial medio de transmisión de microorganismos capaces de producir enfermedades. Es el caso del Staphylococcus aureus, una bacteria distribuida por toda América Latina, causante de infecciones y resistente a antibióticos de uso común. El objetivo del estudio es realizar una caracterización bacteriana y fúngica de billetes circulantes en la ciudad de Bucaramanga, y en especial identificar algunos que puedan relacionarse con problemas de salud pública. Metodología. Estudio observacional y cuantitativo, con una muestra de 50 billetes (5 diferentes denominaciones de 2 fechas de emisión). Se identificaron y cuantificaron los microorganismos mediante siembra en caldo peptona, posteriormente en agar Reasoner´s 2A (R2A), nutritivos y selectivos, además del uso de técnicas de índice analítico de perfil (API) y microscopia óptica. Se realizó un análisis estadístico de correlación de variables mediante el software Statistical Package for the Social Sciences (SPSS). Resultados. Se identificaron 21 géneros y 12 especies de bacterias, así como 3 géneros y 2 especies de hongos filamentosos, entre ellos algunos que pueden ocasionar infecciones como Klesiella, Enterobacter, Listeria, Staphylococcus, Cryptococcus y Aspergillus. Discusión. En relación con estudios internacionales, en este trabajo se identificaron menos tipologías de microorganismos, lo cual se explica en razón a las limitaciones propias de las técn icas utilizadas y del nivel de contaminación local. Conclusión. Se pudo establecer que el grado de contaminación microbiana no depende significativa o consistentemente de la fecha de emisión ni de la denominación; pero la identificación de patógenos sugiere plantear medidas para limitar su transmisión por esta vía.

Introduction. Banknotes are a potential means of transmission of microorganisms capable of producing diseases. This is the case of Staphylococcus aureus, a bacterium distributed throughout Latin America, which causes infections and is resistant to commonly used antibiotics. The objective of the study is to perform a bacterial and fungal characterization of banknotes circulating in the city of Bucaramanga, and especially to identify some that may be related to public health problems. Methodology. Observational and quantitative study, with a sample of 50 banknotes (5 different denominations of 2 issue dates). Microorganisms were identified and quantified by seeding in peptone broth, then on Reasoner's 2A agar (R2A), nutrient and selective, in addition to the use of analytical profile index (API) and light microscopy techniques. A statistical analysis of correlation of variables was performed using the Statistical Package for the Social Sciences (SPSS) software. Results. Twenty-one genera and 12 species of bacteria were identified, as well as 3 genera and 2 species of filamentous fungi, including some that can cause infections such as Klesiella, Enterobacter, Listeria, Staphylococcus, Cryptococcus, and Aspergillus. Discussion. In comparison with international studies, this study identified fewer types of microorganisms, which is explained by the limitations of the techniques used and the level of local contamination. Conclusion. It was possible to establish that the degree of microbial contamination does not depend significantly or consistently on the date of issue or the denomination; but the identification of pathogens suggests that measures should be taken to limit their transmission by this ro ute.

Introdução. As notas são um meio potencial de transmissão de microrganismos capazes de produzir doenças. É o caso do Staphylococcus aureus, bactéria distribuída por toda a América Latina, causadora de infecções e resistente aos antibióticos comumente utilizados. O objetivo do estudo é realizar uma caracterização bacteriana e fúngica das notas em circulação na cidade de Bucaramanga e, principalmente, identificar algumas que possam estar relacionadas a problemas de saúde pública. Metodologia. Estudo observacional e quantitativo, com uma amostra de 50 notas (5 denominações diferentes de 2 datas de emissão). Os microrganismos foram identificados e quantificados por meio de semeadura em caldo peptonado, depois em ágar Reasoner 2A (R2A), nutritivo e seletivo, além da utilização de índice de perfil analítico (API) e técnicas de microscopia óptica. Foi realizada uma análise estatística de correlação das variáveis por meio do software Statistical Package for the Social Sciences (SPSS). Resultados. Foram identificados 21 gêneros e 12 espécies de bactérias, além de 3 gêneros e 2 espécies de fungos filamentosos, incluido alguns que podem causar infecções como Klesiella, Enterobacter, Listeria, Staphylococcus, Cryptococcus e Aspergillus. Discussão. Em relação aos estudos internacionais, neste trabalho foram identificados menos tipos de microrganismos, o que se explica pelas limitações das técnicas utilizadas e pelo nível de contaminação local. Conclusão. Foi possível estabelecer que o grau de contaminação microbiana não depende de forma significativa ou consistente da data de emissão ou da denominação; mas a identificação de patógenos sugere considerar medidas para limitar sua transmissão por essa via.

Antibiogram Profile of Enteric Pathogens Isolated from Fomites in Cross River University of Technology Medical Centre, Calabar, Nigeria

Background: Healthcare environments are considered as potential reservoirs for pathogenic microorganisms especially those responsible for nosocomial infections. Such microorganisms often present with varying degrees of drugs resistance. This study was aimed at evaluating the Cross River University of Technology (CRUTECH) Medical Center Environment for the presence of pathogenic bacterial contaminants and antibiotics susceptibility profile of such isolates. Materials and Methodology: A total of 72 swab samples were collected from nineteen frequently touched hospital surfaces and processed using the standard bacteriological procedures. The emergent bacterial colonies were identified using phenotypic and biochemical tests. Antibiotic susceptibility testing of the presumptively identified isolates was carried out using Kirby-Bauer抯 method. Results: Out of 72 swab samples collected, 44 (61.1%) were positive for Enteric bacterial pathogens. The mean viable count ranged from 1.8 x 106 Cfu/cm2 (weighing scales) to 2.41 x 107 Cfu/cm2 (wash sinks). The most prevalent isolate was E. coli (48 of 127, 37.8%) followed by Klebseilla sp (27 of 127, 21.3%), Salmonella sp (19 of 127, 14.9%), Proteus sp (12 of 127, 9.4%), Citrobacter sp (11 of 127, 8.7%), Enterobacter sp (7 of 127, 5.5%) while Shigella sp (3 of 127, 2.4%) was least isolated. Isolates demonstrated high level of susceptibility to Norfloxacin 124 (97.6%), Imipenem 116 (91.3%) and Chloramphenicol 105 (82.7%). Resistance to Erythromycin was 95 (74.8%), Gentamycin 84 (66.1%) and Amikacin 82 (64.6%). Conclusion: Contamination of healthcare surfaces by multi-drugs resistant pathogens is a potential risk, especially to hospitalized patients and health care workers. Thus, it is therefore imperative that appropriate hygienic measures be implemented to suppress any potential microbial cross-contamination.

Rapid determination of 30 volatile organic compounds in workplace air by gas chromatography / 中华劳动卫生职业病杂志

Objective: To establish a method for rapid detection of DB-WAX capillary column and determination of the workplace air in 30 kinds of volatile organic pollutants. Methods: In August 2020, N-pentane, n-hexane, methylcyclohexane, octane, Acetone, ethyl acetate, butanone, benzene, 3-pentanone, trichloroethylene, tetrachloroethylene, toluene, butyl acetate, 2-hexanone, Isoamyl acetate, ethylbenzene, p-xylene, m-xylene, amyl acetate, o-xylene, chlorobenzene, styrene, cyclohexanone, P-chlorotoluene, bromobenzene, M-dichlorobenzene, p-dichlorobenzene, O-dichlorobenzene, o-Chlorotoluene, 1, 2 , 4-trichlorobenzene of 30 kinds of substances in air were collected by activated carbon tube. After analysis by carbon disulfide, the analytical solution was analyzed by DB-WAX column and determined by FID detector. Results: The above 30 kinds of volatile organic pollutants had good separation effect, the correlation coefficient of the standard curve was above 0.999, the relative standard deviation was 0.1%-3.2%, the desorption efficiency was 77.0%-117.1% , the lower limit of quantitation was 0.33-5.33 μg/ml, and the lowest quantitation concentration was 0.22-3.55 mg/m(3), the recoveries ranged was 95.4%-104.9%. Conclusion: The method can effectively separate and accurately determine 30 volatile organic compounds in these workplaces, and the method is simple and quick.

Antibiotic susceptibility of bacteria recovered from university libraries in Jordan

Aims@#Due to the growing number of media reports claiming that books contain germs, it is crucial to look into the possibility that contagious diseases could spread through libraries. The aim of the study was to identify bacteria from various fomites in four Jordanian university libraries and to assess the antibacterial resistance pattern of isolates.@*Methodology and results@#In this study, swab samples were taken from different fomites of four Jordanian university libraries. Samples were then cultivated on nutrient agar and incubated aerobically at 37 °C for 48 h. To identify different types of isolated bacteria, biochemical and conventional biochemical tests were applied using the qualitative RapIDTM One System with the help of ERICTM software to identify the bacterial isolates at the species level. Identified bacterial species, including Escherichia coli, Shigella sonnei, Pseudomonas aeruginosa, Klebsiella pneumonia, Staphylococcus epidermis, S. aureus, Salmonella choleraesuis, Bacillus subtilis and Citrobacter freundii were isolated from different library fomites. Seventy-one bacterial isolates from University A were observed to be multidrug-resistant (MDR) (S. sonnei and S. choleraesuis). This MDR pattern is alarming as those isolates were found in a public environment and that imposes a direct threat on library users, staff and visitors.@*Conclusion, significance and impact of study@#University libraries' fomites carry live bacterial pathogens, which can contaminate users' hands and serve as an indirect route for spreading antibiotic resistance and microbial illnesses. While more research is required, considering hand hygiene improvement would be the simplest infection control technique at libraries. Additionally, proactive measures should be taken to track the prevalence of harmful microorganisms in these settings and their effects on employees' and the public's health.

Perfil de resistencia genotípica y fenotípica presente en bacterias aisladas a partir de fómites en Armenia, Quindío-Colombia período junio-julio 2019 / Genotypic and phenotypic resistance profile present in bacteria isolated from fomites in Armenia, Quindío-Colombia period June-July 2019

Resumen Introducción: La antibiótico-resistencia es un fenómeno por el cual las bacterias logran sobrevivir al tratamiento con antimicrobianos; con incidencia en ambientes intra y extrahospitalarios como: fuentes hídricas, sector agrario/ganadero y fómites. Objetivo: Describir bacterias presentes en fómites de alta circulación en una región centro-occidental de Colombia junto a su perfil de sensibilidad fenotípica y presencia de genes para betalactamasas tipo TEM-full, OXA-3 y SHV-full. Metodología: Se aislaron cepas bacterianas de billetes, pasamanos de escaleras eléctricas y botones de cajeros automáticos; se evaluó su perfil de sensibilidad fenotípica por medio de concentración mínima inhibitoria-técnica automatizada/Vitek2® y genes para betalactamasas tipo TEM-full, OXA-3 y SHV-full mediante PCR convencional. Resultados: Se obtuvo 30 aislados; Acinetobacter baumannii complex, fue la más común; el fómite con mayor aislados y resistencia fueron los billetes; el 53% portó al menos uno de los genes estudiados. Se identificaron bacterias gramnegativas con resistencia frente a: Imipinem, Piperacilina/Tazobactam, Colistina, Ceftazidima, Tigeciclina y Ceftriaxona; bacterias grampositivas con resistencia frente a: Quinupristina/Dalfopristina, Minociclina, Tetraciclina, Teicoplanina, Nitrofuratoina, Oxacilina, Clindamicina, Trimetropina-sulfametoxazol, y Minociclina. Conclusión: Teniendo en cuenta la circulación de cepas con estas resistencias, es importante la educación en la comunidad para evitar la adquisición o propagación de infecciones por manipulación inadecuada de fómites.

Abstract Introduction: Antibiotic-resistance is a phenomenon by which bacteria manage to survive antimicrobial treatment; with incidence in intra and extra hospital environments such as: water sources, agricultural / livestock sector and fomites. Aim: To describe bacteria present in high circulation fomites in a central-western region of Colombia, with their phenotypic sensitivity profile and presence of genes beta-lactamases (TEM, OXA3 and SHV). Methodology: We isolate bacterial strains from banknotes, escalator handrails and ATM buttons. We evaluated its phenotypic sensitivity profile by minimal inhibitory concentration automated technique using Vitek 2® and presence of genes for beta-lactamases type TEM-full, OXA-3 and SHV-full by conventional PCR. Results: A total of 30 isolates were obtained; Acinetobacter baumannii complex, was the most common; banknotes were the form with the highest number of isolates and resistance. Of the total isolates, 53% carried at least one of the genes studied. Phenotypically, gram-negative bacteria were identified with resistance against: Imipinem, Piperacillin / Tazobactam, Colistin, Ceftazidime, Tigecycline and Ceftriaxone; Gram-positive bacteria with resistance to: Quinupristin / Dalfopristin, Minocycline, Tetracycline, Teicoplanin, Nitrofuratoin, Oxacillin, Clindamycin, Trimethropine-sulfamethoxazole, and Minocycline. Conclusion: Taking into account the circulation of strains with these resistances, it is important to educate the community to avoid the acquisition or spread of infections due to the inappropriate handling of this type of inanimate elements.

Contaminación microbiana en estetoscopios utilizados por proveedores de salud / Microbial contamination in stethoscopes used by health care providers

Introducción: El estetoscopio se ha descrito como un fómite capaz de transmitir patemas de tipo infeccioso a los trabajadores de la salud Objetivo: Caracterizar la presencia de contaminación microbiana en estetoscopios utilizados por proveedores de salud. Métodos: Estudio transversal en 50 muestras microbiológicas obtenidas de estetoscopios pertenecientes a proveedores de salud que laboran en el Hospital Pediátrico Cerro, de junio-octubre de 2019. Se aplicó una encuesta para evaluar variables demográficas y epidemiológicas de sus titulares relacionadas con la aplicación de medidas descontaminantes. Se examinaron los resultados mediante el análisis porcentual y prueba de Ji-cuadrada para buscar asociación significativa (p≤0,05) con los hábitos higiénicos. Resultados: El 100 por ciento de los estetoscopios están contaminados. Los aislamientos más frecuentes fueron: Staphylococcus alba 40,3 por ciento, Staphylococcus aureus 32,6 por ciento y Klebsiella pneumoniae 3,8 por ciento. Las áreas de mayor contagio fueron las de misceláneas (44,2 por ciento) y de respiratorio (36,5 por ciento). El personal con notable contaminación en sus equipos fueron los alumnos (81,4 por ciento) y los especialistas (14,8 por ciento). Las causas que determinaron no practicar la desinfección en los alumnos fue la falta de enseñanza (45,4 por ciento); en los especialistas, la carencia de hábitos (33,3 por ciento) y la falta de desinfectante (66,3 por ciento). Las bacterias gramnegativas fueron sensibles en su mayoría a los aminoglucósidos y Staphylococcus aureus a la clindamicina, vancomicina, ciprofloxacino y cloranfenicol. Conclusiones: Existe alta frecuencia de contaminación en los estetoscopios utilizados por los proveedores de salud motivado por la falta de hábito de desinfección en médicos y su desconocimiento en alumnos(AU)

Introduction: Stethoscopes has been described as a fomite which is able to transmit infectious agents to health care workers. Objective: To describe the presence of microbial contamination in stethoscopes used by health care providers. Methods: Cross-sectional study in 50 microbiological samples obtained from stethoscopes belonging to health care providers whom worked in Cerro Pediatric Hospital from June to October, 2019. It was applied a survey to evaluate demographic and epidemiologic variables of the owners related with the implementation of disinfection measures. The results were examined through percentage analysis and the Ji-square test to look for significative relation (p≤0,05) with hygene habits. Results: 100 percent of the stethoscopes were contamined. The most frequent isolated agents were: Staphylococcus alba 40.3 percent, Staphylococcus aureus 32.6 percent and Klebsiella pneumoniae 3.8 percent. The hospital areas with more contagion were: Miscellany (44.2 percent) and Respiratory (36.5 percent). The personnel with more contamination in their equipments were: students (81.4 percent) and specialists (14.8 percent). The cause of not doing the disinfection processes in the students was the lack of knowledge (45.4 percent); and in the specialists was the lack of hygene habits and the lack of disinfectant solutions (66.3 percent). Negative Gran bacteria were mostly sensitive to aminoglycosides and Staphylococcus aureus to clindamycin, vancomycin, ciprofloxacin and cloramphenicol. Conclusions: There is high frequency of contamination in the stethoscopes used by health care providers, mainly motived by the lack of disinfection habits in physicians and lack of knowledge on it in the students(AU)

Tiempo de vida del SARS-CoV-2 en el medio ambiente: potencial de transmisión por gotículas, aerosoles y fómites / Life time of SARS-CoV-2 in the environment: transmission potential by droplets, aerosols and fomites

La COVID-19 se ha extendido rápidamente en todos los países del mundo. Según los datos globales obtenidos hasta la fecha, el curso de la pandemia ha dejado un estimado de 44 871 314 casos y 1 178 751 de fallecidos a nivel mundial1. Muchos países han reportado una disminución de casos, lo que ha permitido una reapertura gradual de las actividades, estableciendo medidas de prevención para evitar la transmisión del virus entre la población. A pesar de esto, algunos países que experimentaron disminución de casos, ahora registran un segundo aumento. Este fenómeno ha formado parte de la discusión científica mundial, generando así la necesidad de estudiar con más detalle la forma de trasmisión del virus, describir su comportamiento en ambiente y determinar el tiempo en que permanece viable en superficies inertes. Se ha llegado al conceso que el virus SARS-CoV-2, que causa la COVID-19, se transmite a través de secreciones o gotículas respiratorias2. Se pude transmitir a través del contacto directo o indirecto entre las personas y por medio de superficies inertes contaminadas con el virus2. El potencial de transmisión por aerosol era poco conocido al inicio de la pandemia, sin embargo, la evidencia científica sobre la transmisión aérea del virus por aerosoles está aumentando y hay muchos estudios que sugieren, se considere como una importante vía de trasmisión. A continuación, se presenta una reseña científica sobre la transmisión del SARS-CoV-2 por medio del aire, superficies inertes y el agua, considerando algunos factores ambientales y la viabilidad que tiene en ciertas condiciones. Esta reseña científica no es una revisión sistemática, sin embargo, es un análisis rápido realizado a partir de publicaciones en revistas arbitradas y documentos de entidades de salud como la Organización Mundial de la Salud (OMS), entre otras.

COVID-19 has spread rapidly in all countries of the world. According to global data obtained to date, the course of the pandemic has left an estimated 44,871,314 cases and 1,178,751 deaths worldwide1. Many countries have reported a decrease in cases, which has allowed a gradual reopening of activities, establishing prevention measures to avoid the transmission of the virus among the population. Despite this, some countries that experienced declines in cases now register a second increase. This phenomenon has been part of the global scientific discussion, thus generating the need to study in more detail the way the virus is transmitted, describe its behavior in the environment and determine the time it remains viable on inert surfaces. It has been agreed that the SARS-CoV-2 virus, which causes COVID-19, is transmitted through respiratory secretions or droplets2. It can be transmitted through direct or indirect contact between people and through inert surfaces contaminated with the virus2. The potential for transmission by aerosol was little known at the beginning of the pandemic, however, scientific evidence on the airborne transmission of the virus by aerosols is increasing and there are many studies that suggest it is considered an important route of transmission. Next, a scientific review on the transmission of SARS-CoV-2 through the air, inert surfaces and water is presented, considering some environmental factors and its viability under certain conditions. This scientific review is not a systematic review, however, it is a quick analysis based on publications in peer-reviewed journals and documents from health entities such as the World Health Organization (WHO), among others.

Frecuencia de contaminación por enteroparásitos en pasamanos de autobuses de Barquisimeto, Venezuela / Enteric Parasite Contamination Frequency on Bus Handrails in Barquisimeto, Venezuela / Frequência da contaminação por enteroparasitos em corrimãos de ônibus em Barquisimeto, Venezuela

Introducción. La contaminación enteroparasitaria en autobuses por parte de usuarios infectados con malas conductas sanitarias potencia el riesgo de infección del resto de los pasajeros con el subsecuente peligro del desarrollo de patologías gastrointestinales. Por esto se evaluó la frecuencia de contaminación de autobuses con el fin de aportar datos que son desconocidos en Venezuela e inexistentes en Latinoamérica. Metodología. El trabajo fue descriptivo, transversal, con muestra no probabilística y accidental, donde la obtención de la muestra consistió en frotar el pasamanos de cada autobús (100 vehículos examinados) tres veces con un hisopo impregnado en solución salina isotónica 0.85%, resuspendiendolo en un tubo de ensayo con 10 ml de solución salina. La muestra se centrifugó a 3000 rpm por diez minutos para luego observar el sedimento al microscopio. Resultados. El 16% de las muestras presentaron contaminación, encontrándose solo dos especies de enteroparásitos, Blastocystis spp. (14% del total de muestras examinadas) y Endolimax nana (5%). Discusión. La abundancia del potencial patógeno Blastocystis sp., se relaciona con lo descrito en exámenes de heces de habitantes de Barquisimeto y del estado Lara, demostrando que los usuarios enfermos con malas conductas higiénicas convierten a los autobuses en un foco de infección que debe ser controlado. Conclusión. La falta de aseo constante en unidades de transporte público y la ausencia de conciencia sanitaria de algunos pasajeros infectados facilitan la transmisión de enteroparásitos endémicos potencialmente productores de enfermedades gastrointestinales. Cómo citar: Traviezo, L. Frecuencia de contaminación por enteroparásitos en pasamanos de autobuses de Barquisimeto, Venezuela. MedUNAB. 2020;23(3):434-440 doi: doi.org/10.29375/01237047.3913

Introduction. Enteroparasite contamination by infected users with poor sanitary habits in buses increases other passengers' risk of infection, with the subsequent danger of developing gastrointestinal pathologies. For this reason, bus contamination frequency was evaluated in order to provide data that is unknown in Venezuela and non-existent in Latin America. Methodology. The work was descriptive and cross-sectional, with non-probability and accidental sampling. The sample was obtained by rubbing each bus' handrail (100 examined vehicles) three times with a swab permeated with a 0.85% isotonic saline solution, resuspending it in a test tube with 10 ml of saline solution. The sample was centrifuged at 3,000 rpm for ten minutes to then observe the sediment under a microscope. Results. Sixteen percent of samples were contaminated, observing only two species of enteroparasites, Blastocystis sp. (14% of total examined samples) and Endolimax nana (5%). Discussion. The abundance of the potential pathogen, Blastocystis sp. is related to what has been described in feces exams on the inhabitants of Barquisimeto and the state of Lara, demonstrating that sick users with poor hygiene habits make buses a point of infection that must be controlled. Conclusion. The lack of constant cleaning in public transportation units and the absence of some infected passengers' sanitary awareness facilitates transmitting endemic enteroparasites that could potentially produce gastrointestinal diseases. Cómo citar: Traviezo, L. Frecuencia de contaminación por enteroparásitos en pasamanos de autobuses de Barquisimeto, Venezuela. MedUNAB. 2020;23(3):434-440 doi: doi.org/10.29375/01237047.3913

Introdução. A contaminação enteroparasitária em ônibus por usuários infectados com comportamentos sanitários inadequados aumenta o risco de infecção do resto dos passageiros com o consequente perigo de desenvolvimento de patologias gastrointestinais. Por isso, avaliou-se a frequência de contaminação de ônibus, a fim de fornecer dados até agora desconhecidos na Venezuela e inexistentes na América Latina. Metodologia. O trabalho foi descritivo, transversal, com amostra não-probabilística e acidental, em que a obtenção da amostra consistiu em esfregar o corrimão de cada ônibus (100 veículos examinados) três vezes com um cotonete impregnado em solução salina isotônica 0.85%, ressuspendendo-o em um tubo de ensaio com 10 ml de solução salina. A amostra foi centrifugada a 3,000 rpm por dez minutos para posteriormente observar o sedimento ao microscópio. Resultados. 16% das amostras apresentaram contaminação, sendo encontradas apenas duas espécies de enteroparasitas, Blastocystis sp. (14% do total das amostras examinadas) e Endolimax nana (5%). Discussão. A abundância do potencial patógeno Blastocystis sp., está relacionada ao que foi descrito em exames de fezes de moradores dos estados de Barquisimeto e Lara, mostrando que usuários doentes e com comportamentos sanitários inadequados fazem do ônibus um foco de infecção que deve ser controlado. Conclusão. A falta de limpeza constante nas unidades de transporte público e a falta de conscientização sobre a saúde de alguns passageiros infectados facilitam a transmissão de enteroparasitos endêmicos potencialmente produtoras de doenças gastrointestinais. Cómo citar: Traviezo, L. Frecuencia de contaminación por enteroparásitos en pasamanos de autobuses de Barquisimeto, Venezuela. MedUNAB. 2020;23(3):434-440 doi: doi.org/10.29375/01237047.3913

Contaminación enteroparasitaria de intercomunicadores en edificios de Barquisimeto y Cabudare, Venezuela / Enteroparites contamination of intercoms in buildings of Barquisimeto and Cabudare, Venezuela

Resumen Introducción. La falta de estudios en intercomunicadores como medios de propagación de enteroparásitos en Venezuela, motivó el presente estudio. Metodología. Se frotó el intercomunicador tres veces con un hisopo impregnado con solución salina 0,85% (SSI), resuspendiéndolo en un tubo con 10 ml de SSI, el cual se centrifugó a 3000 rpm por 10 minutos para luego observar el sedimente al microscopio. Resultados. El 65% de las muestras estuvieron contaminadas, encontrando 10 taxones de enteroparásitos, a saber: Blastocystis sp (49% del total de muestras examinadas), Endolimax nana (36%), lodamoeba butschlii (8%), Giardia lamblia (7%), Entamoeba coli (4%), Chilomastix mesnili (2%), Entamoeba hartmanni (2%), Trichuris trichiura (2%), Hymenolepis nana (2%) y Taenia sp (1%). Discusión. La diversidad de parásitos encontrados y su abundancia, se corresponden con lo reportado en poblaciones de la misma zona. Conclusión. La falta de higiene en la mayoría de los intercomunicadores facilitan el potencial de estos para transmitir los parásitos endémicos del estado Lara.

Abstract Introduction. The lack of studies in intercoms as means of propagation of enteroparasites in Venezuela, motivated the present study. Methodology. The intercom was rubbed three times with a swab impregnated with 0.85% saline solution (SSI), resuspending it in a tube with 10 ml of SSI, which was centrifuged at 3000 rpm for 10 minutes to then observe the pellet under a microscope. Results. 65% of the samples were contaminated, finding 10 taxa of enteroparasites, namely: Blastocystis sp (49% of the samples examined), Endolimax nana (36%), Iodamoeba butschlii (8%), Giardia lamblia (7%), Entamoeba coli (4%), Chilomastix mesnili (2%), Entamoeba hartmanni (2%), Trichuris trichiura (2%), Hymenolepis nana (2%) and Taenia sp (1%). Discussion. The diversity of parasites found and their abundance correspond to that reported in populations of the same area. Conclusion. The lack of hygiene of most of the intercoms facilitates the potential of these to transmit the endemic parasites of the Lara State.

Investigating a Possible Linkage of Working with Migrant Workers and New Leprosy Cases among Indigenous Populations of Shimla, Himachal Pradesh, India

This study was initiated in 2015, when an association of occurrence of leprosy in a rich apple orchard owner and his working with migrant workers from leprosy endemic state was observed. Further 21/27 (more than 70%) cases in Shimla districts were contributed by migrant workers during 2016-17 indicating the potential risk of spread to local population. We started an investigation of all new indigenous cases for the year 2015 of district Shimla and tracked their history of contact with any migrant labourers. Indirect correlation was found in overall decrease in leprosy cases among migrants associated with decrease in indigenous leprosy cases as well. The migrants carrying leprosy infection may be spreading it as infected droplets into the air and into the orchard soil and other fomites through exhalation of bacilli and also while blowing their noses in open air and in temporary sheds/rooms where migrant workers/ labourers and owners work together for apple grading. Sharing of temporary airspaces and fomites need to be investigated by classical epidemiological approaches as well as newer molecular technologies for studying such transmission and evidence based effective measures should be considered and taken to protect the population in leprosy free or low endemic settings such as in Himachal Pradesh. There is need to educate locals regarding hidden nature of leprosy infection that can spread from unsuspecting carrier migrants from leprosy endemic states of India and Nepal which is still an leprosy endemic country. Migrants from leprosy endemic districts need to be screened by an appropriate strategy and treated with MDT to effectively control leprosy spread. For that purpose innovative methods of screening, diagnosis and treatment of leprosy among migrant population, understanding the dynamics of such possible mode of transmission by molecular technology as well as awareness generation in the local population should be given due importance for effective control of leprosy in India.

Sphygmomanometers and thermometers as potential fomites of Staphylococcus haemolyticus: biofilm formation in the presence of antibiotics

BACKGROUND The association between Staphylococcus haemolyticus and severe nosocomial infections is increasing. However, the extent to which fomites contribute to the dissemination of this pathogen through patients and hospital wards remains unknown. OBJECTIVES In the present study, sphygmomanometers and thermometers were evaluated as potential fomites of oxacillin-resistant S. haemolyticus (ORSH). The influence of oxacillin and vancomycin on biofilm formation by ORSH strains isolated from fomites was also investigated. METHODS The presence of ORSH on swabs taken from fomite surfaces in a Brazilian hospital was assessed using standard microbiological procedures. Antibiotic susceptibility profiles were determined by the disk diffusion method, and clonal distribution was assessed in pulsed-field gel electrophoresis (PFGE) assays. Minimum inhibitory concentrations (MICs) of oxacillin and vancomycin were evaluated via the broth microdilution method. Polymerase chain reaction (PCR) assays were performed to detect the mecA and icaAD genes. ORSH strains grown in media containing 1/4 MIC of vancomycin or oxacillin were investigated for slime production and biofilm formation on glass, polystyrene and polyurethane catheter surfaces. FINDINGS ORSH strains comprising five distinct PFGE types were isolated from sphygmomanometers (n = 5) and a thermometer (n = 1) used in intensive care units and surgical wards. ORSH strains isolated from fomites showed susceptibility to only linezolid and vancomycin and were characterised as multi-drug resistant (MDR). Slime production, biofilm formation and the survival of sessile bacteria differed and were independent of the presence of the icaAD and mecA genes, PFGE type and subtype. Vancomycin and oxacillin did not inhibit biofilm formation by vancomycin-susceptible ORSH strains on abiotic surfaces, including on the catheter surface. Enhanced biofilm formation was observed in some situations. Moreover, a sub-lethal dose of vancomycin induced biofilm formation by an ORSH strain on polystyrene. MAIN CONCLUSIONS Sphygmomanometers and thermometers are fomites for the transmission of ORSH. A sub-lethal dose of vancomycin may favor biofilm formation by ORSH on fomites and catheter surfaces.

Analysis of the presence of organic matter (ATP) in mobile devices of healthcare workers in hospitals

We report the result of an awareness campaign about the importance of hand hygiene after using different devices used in assistance to patients, such as tablets, notebooks, mobile phones, identification cards, watches, cameras, showing the level of contamination found after detection of adenosine triphosphate (ATP) via bioluminescence, which enables a quantitative assessment ready and easy to implement. ATP molecules found in all living cells react with the enzyme complex to generate light and represent the presence of organic matter in such objects(AU)

Conductas de higiene en el uso de estetoscopios de estudiantes de un programa de medicina de la ciudad de Tunja, Colombia / Hygiene behaviors in the use of stethoscopes of students of a medicine program of the city of Tunja, Colombia

Introducción: múltiples investigaciones han demostrado que los estetoscopios se encuentran colonizados por bacterias causantes de infecciones humanas. A pesar de ello, no se han definido las causas por las que estos instrumentos se contaminan. Objetivo: determinar las conductas de higiene que tienen los estudiantes de un programa de medicina de la ciudad de Tunja, Colombia, en el uso de los estetoscopios. Materiales y métodos: se seleccionaron 50 estudiantes de medicina quienes diligenciaron un cuestionario con preguntas cerradas, construido con base en grupos focales que permitieron caracterizar las conductas de uso intra y extrahospitalarias del estetoscopio. Además, a cada estudiante participante se le solicitó su estetoscopio para tomar muestras de cuatro partes del mismo, que posteriormente fueron cultivadas en agar nutritivo y caracterizadas macroscópica y microscópicamente por medio de la coloración de Gram. Resultados: de los 50 estudiantes que diligenciaron el cuestionario se evidenció que el 48% nunca había limpiado el estetoscopio, el 24% lo limpiaba con alcohol antiséptico y el 2% realizaba limpieza antes de la valoración del paciente. En el 100% de los estetoscopios se aislaron colonias bacterianas, principalmente cocos Gram positivos, siendo el diafragma la parte más contaminada de este instrumento. Conclusiones: se determinaron conductas inadecuadas en el uso del estetoscopio a nivel intra y extrahospitalario, así como la falta de información para su adecuada desinfección. (AU)

Introduction: multiple investigations have shown that bacteria causing human infections colonize stethoscopes. However, the reasons why these instruments are contaminated have not been defined. Objective: To determine the hygiene behaviors that medicine students have in the use of stethoscopes. Materials and methods: 50 medicine students were selected to complete a questionnaire with closed questions, based on focus groups that allowed characterizing the intra and extrahospital behavior of the stethoscope use. In addition, each participant student was asked for his stethoscope in order to take samples of four parts of it, which were later culture on nutritive agar and characterized macroscopically and microscopically by Gram staining. Results: Of the 50 students, who completed the questionnaire, 48% have never cleaned the stethoscope, 24% cleaned it with antiseptic alcohol, and 2% cleaned before the patient's evaluation. In 100% of the stethoscopes bacterial colonies were isolated, mainly Gram-positive cocci, been diaphragm the most contaminated part of this instrument. Conclusions: inadequate behaviors were determined in the intra- and extra-hospital stethoscope use, as well as lack of information for it adequate disinfection. (AU)

Contaminación con bacterias patógenas de estetoscopios del personal médico en un hospital de nivel III en Lima, Perú / Contamination of medical stethoscopes with pathogenic bacteria in a level III hospital in Lima, Peru

Objetivos: Determinar el grado de contaminación bacteriana con bacterias patógenas de los estetoscopios del personal médico en un hospital general de Lima, Perú. Material y métodos: Estudio de tipo observacional,descriptivo y transversal, realizado en el Hospital Nacional Arzobispo Loayza, entre los meses de enero y juniodel 2013. Se estudiaron 124 muestras de estetoscopios del personal médico en las siguientes áreas: UCI 20; neonatología 13; quemados 3; medicina 52; emergencia 36. Se recolectaron las muestras con hisopos humedecidos,en condiciones estériles (En presencia de un mechero de vidrio para alcohol) y luego fueron introducidos en tuboscon preparado de caldo BHI (Infusión cerebro corazón) para ser incubados por 24 horas a 37°C; se cultivó en Agarsangre, Agar MacConkey, Agar manitol y Agar cetrimidepara su posterior determinación de bacterias patógenaspor procedimientos bioquímicos ,luego se identificó la susceptibilidad bacteriana con la técnica de Kirby- Bauer...

Objectives: To determine the degree of contamination with pathogenic bacteria by stethoscopes used for medical personnel in a general hospital in Lima, Peru. Methods: Cross sectional study carried-out at Hospital Nacional Arzobispo Loaya between January and June 2013. A total of 124 samples were evaluated from the following areas: 20 from the ICU, 13 from the neonatology service, 3 from the burn unit; 52 from medicine wards, and 36 from the emergency room. The samples were collected using a moist cotton swab in sterile conditions (using a alcohol bunser burner) and introduced in tubes containing brain-heart infusion to be incubated at 37C for 24 hours. The determination of pathogenic bacteria used MacConkey and manitol agar with specific biochemical methods. The Kirby-Bauer method was used to determine the antibiotic susceptibility pattern...

Contaminación de billetes con enteroparásitos en Coro, estado Falcón, Venezuela / Contamination of banknotes with enteric parasites in Coro, Falcon state, Venezuela

El papel moneda es uno de los objetos que mayormente manipulan e intercambian los humanos, pudiendo representar un vehículo potencial en la transmisión de los parásitos intestinales. Entre mayo y julio de 2013, se evaluaron 185 muestras de billetes (Bs.F) de todas las denominaciones, los cuales se obtuvieron al azar en bancos y comercios de Coro, estado Falcón, Venezuela. Todas las muestras se lavaron con agua destilada estéril + Tween® 20 al 20%, y se sometieron a sedimentación espontánea por 2-3 horas, centrifugación y observación microscópica por métodos parasitológicos directo y tinción de Kinyoun. Se detectó que el 42,16% (78/185) de los billetes presentaron contaminación por uno o más taxones parasitarios/comensales, siendo los más frecuentemente observados: Blastocystis sp. (30,27%), Endolimax sp. (8,65%), Cyclospora sp. (8,11%) y Giardia sp. (7,57%). Los billetes sucios/mutilados (50,75%) presentaron porcentajes de contaminación parasitaria significativamente mayores que los nuevos (0%) y limpios (50%) (χ²= 26,11; P= 0,00001). No se encontró una relación estadísticamente significativa entre la denominación, la fecha de emisión de los billetes y los porcentajes de contaminación (P > 0,05). Se concluye que los billetes circulantes en la ciudad de Coro pueden potencialmente jugar un papel significativo en la diseminación de enfermedades parasitarias vía fómite. Por lo tanto, se recomienda programas de educación para la salud para el manejo y uso del papel moneda.

Banknotes are some of the objects most handled and exchanged by people, thus representing a potential vehicle for the transmission of intestinal parasites. Between May and July 2013, a total of 185 banknotes (Bs.F) from all denominations were randomly selected from trade centers and banks in Coro, Falcon state, Venezuela. The notes were washed with sterile distilled water + Tween® 20 (20 %) and then left at room temperature for 2-3 h for sedimentation to occur. Five mL of sediment were then centrifuged for 3-5min and the sediment was then examined with the aid of a light microscopy using direct parasitological methods and Kinyoun stained slides. A total of 42.16% (78/185) of the examined notes were contaminated by one or more parasitic/commensal taxa, with Blastocystis sp. (30.27%), Endolimax sp. (8.65%), Cyclospora sp. (8.11%) and Giardia sp. (7.57%) the most commonly isolated species. Dirty and damaged notes (50.75%) showed significantly higher percentages of contamination compared to mint (0%) and apparently clean (50%) ones (χ2= 26.11; P=0.0000). No statistically significant associations between the value of the notes, their date of emission and contamination frequencies were found (P > 0.05). We conclude that banknotes (Bs.F) circulating in Coro, Falcon state, Venezuela, could serve as a potential fomite for the spread of intestinal parasites. Sanitation awareness campaigns for the proper use and management of banknotes are therefore recommended.

Frecuencia de aislamientos ambientales de Staphylococcus aureus y su actividadbeta-lactamasa en un hospital de Cajamarca, Perú / Frequency of Staphylococcus aureus environmental isolations and beta-lactamase activity at a hospital of Cajamarca, Perú

Objetivo. Determinar la frecuencia de aislamientos de Staphylococcus aureus y su capacidad para producir beta-lactamasas clásicas, en reservorios ambientales de las salas de operaciones del Servicio de Cirugía y de las salas de partos del Servicio de Obstetricia del Hospital Regional de Cajamarca, Perú. Metodología. Las muestras analizadas para el presente estudio fueron obtenidas mediante hisopados de las superficies del mobiliario y de otros objetos inanimados que se encontraban en las salas. Para el aislamiento e identificación se empleó agar selectivo manitol salado, coloración Gram y las pruebas de catalasa y coagulasa. Para la determinación de beta-lactamasas clásicas, se empleó el método yodométrico. Resultados. De 64 muestras, se obtuvieron 17 aislamientos identificados como S. aureus, de los cuales, 3 fueron productores de betalactamasas clásicas y fueron hallados en reservorios tipo camillas y mesas. Conclusiones. La investigación demuestra una moderada frecuencia de S. aureus con capacidad de producir beta-lactamasa y, por lo tanto, potencialmente multirresistente, en reservorios ambientales hospitalarios.

Objetive: To determine the frequency of Staphylococcus aureus isolates, and its capacity to produce classic beta-lactamases, in environmental fomites in operations rooms and delivery rooms at the Hospital Regional de Cajamarca, Perú. Methods: Analyzed samples for the present study were obtained by cottons swabs from furniture surfaces and other inanimate objects that were in the rooms. Mannitol salt agar, Gram coloration, catalase and coagulase tests were used for starin isolation and identification. The iodometric method was used for the determination of classic beta-lactamases. Results: Out of 64 samples, 17 isolates were obtained and identified as S. aureus, 3 of which were producing classic beta-lactamases and were found in fomites from stretchers and tables. Conclusions: This study showed a moderate frequency of S. aureus with capacity to produce beta-lactamases, potentially multiresistant, in environmental fomites at the hospital.

Aspectos médico legales de la infección por gonococo: gonorrea / Medical legal aspects of the gonococcal infection: gonorrhea

El diagnóstico de una enfermedad de transmisión sexual en una víctima de abuso sexual debe ser adecuadamente interpretado a la luz de la historia médico legal, los hallazgos físicos, el laboratorio y la investigación sobre otras posibles formas de contagio. El objetivo de esta revisión bibliográfica, es actualizar los conocimientos sobre la Gonorrea, enfermedad que afecta pricipalmente la mucosa de los genitales masculinos y femeninos, la conjuntiva del ojo, la región anorectal y la faringe. En el niño menor de un año, la forma más frecuente de contagio es a través del canal de parto o por contacto accidental, sin embargo, la evidencia sugiere fuertemente que la gonorrea en niños mayores de un año y preadolescentes, al igual que en el adulto, es transmitida sexualmente. La transmisión vía fomites no ha sido comprobada, a pesar de que se ha aislado el microorganismo en objetos inanimados. Debido a las implicaciones legales del diagnóstico de gonorrea en niños, sólo se debe usar el procedimiento de cultivo estándar para aislar el germen.

The diagnose of a sexual transmission disease in a sexually abused victim must be adequately interpreted under the knowledge of its medical?-legal history, physical findings, lab results and the research of different ways of contagious. The goal of this bibliographic revisit is to update the knowledge about Gonorrhea, disease that affects mainly male and female genital mucosa, the eyes conjuntive, annal rectal area and the faringe. Under one year-old children means of transmission are usually ? by birth process or accidental contact, but evidence strongly suggest that gonorrea on children older than one year, pre-adolescents and adults, is sexually transmitted. The transmission via fomites (via fomites transmission?) has not been confirmed even though the micro-organism has been isolated in unanimated objects. Due to legal implications of gonorrhea diagnose on children, it should only be used the standard culture procedure in order to isolate the germ.