Antimicrobials and resistant bacteria in global fish farming and the possible risk for public health / Antimicrobianos e bactérias resistentes na piscicultura global e o possível risco para a saúde pública

The use of antimicrobials in fish farming is a reflection of the fast aquaculture development worldwide. The intensification of aquaculture to achieve market demands could lead to an increase in infectious diseases by pathogenic bacteria. Consequently, antimicrobials act as controls for emerging infectious diseases, but their use must follow the rules and regulations of the country where the activity is performed. Although the regulations impose limits to the use of antimicrobials in fish farming, many studies show that resistant bacteria are isolated from this system. The selection of resistant bacteria is not limited only to the use of antimicrobials, but also to co-selection of resistance genes or even with cross-resistance processes. Resistant bacteria from fish farming are a serious concern because they can be acquired by humans with handling or food chain, which may represent a public health problem. In the present review, we present an overview of antimicrobials use in aquaculture, the antimicrobial resistance and the impact of antimicrobial and bacterial resistance from a public health perspective.(AU)

O uso de antimicrobianos na piscicultura é um reflexo do rápido desenvolvimento da aquicultura em todo o mundo. A intensificação da aquicultura para suprir as demandas do mercado pode levar ao aumento de doenças infecciosas por bactérias patogênicas. Consequentemente, os antimicrobianos atuam no controle de doenças infecciosas emergentes, mas seu uso deve seguir as regras e regulamentos do país onde a atividade é realizada. Embora os regulamentos imponham limites ao uso de antimicrobianos na piscicultura, muitos estudos mostram que bactérias resistentes são isoladas desse sistema. A seleção de bactérias resistentes não se limita apenas ao uso de antimicrobianos, mas também à cosseleção de genes de resistência ou mesmo por meio do processo de resistência cruzada. As bactérias resistentes da piscicultura são uma preocupação séria, uma vez que tais bactérias podem ser adquiridas pelos seres humanos no manuseio ou na cadeia alimentar, o que pode representar um problema de saúde pública. Nesta revisão, apresentamos uma visão geral do uso de antimicrobianos na aquicultura, a resistência antimicrobiana e o impacto da resistência antimicrobiana e bacteriana do ponto de vista da saúde pública.(AU)

Knowledge about bacterial and viral pathogens present in wild mammals in Chile: a systematic review

This study organizes all available information about viral and bacterial pathogens of wild mammals in Chile. This was done in order to identify pathogens that have been well-documented and recognize those that have not been properly studied, determine the number of articles that have been published annually about this topic and identify regions in Chile that concentrate the highest and lowest number of studies concerning viral and bacterial pathogens. A total of 67 scientific articles published in peer-reviewed journals from 1951 to 2018 were selected for revision. Results indicate that the number of publications has increased per decade but there are years in which no articles were published. Most studies addressed Leptospira, rabies, hantavirus, Mycobacterium avium paratuberculosis (MAP) and distemper. Rodentia, Carnivora, Chiroptera and Cetartiodactyla were the most studied mammal orders. Information about presence/absence of pathogens was found for 44 wild mammal species. Research was mainly carried out in central and southern Chile and the most commonly employed methods for pathogen diagnosis were serology and molecular techniques. Overall, research in wild mammals has been directed towards the evaluation of zoonotic diseases, while vector-borne and non-zoonotic diseases have been mostly neglected by the scientific community over the years.

Conocimiento acerca de los patógenos virales y bacterianos presentes en mamíferos silvestres en Chile: una revisión sistemática / Knowledge about viral and bacterial pathogens present in wild mammals in Chile: a systematic review

Resumen Este estudio organiza toda la información disponible acerca de los patógenos virales y bacterianos de mamíferos silvestres en Chile. Esto fue realizado con el objetivo de identificar patógenos que han sido bien documentados y reconocer aquellos que no han sido apropiadamente estudiados, determinar el número de artículos que han sido publicados anualmente acerca de este tópico e identificar las regiones en Chile que han concentrado el mayor y menor número de estudios relacionados con patógenos virales y bacterianos. Para lograr esto, se seleccionó para revisión un total de 67 artículos científicos publicados en revistas evaluadas por pares desde 1951 al 2018. Los resultados indican que el número de publicaciones ha incrementado por década y hay años en los cuales no se publicaron artículos. La mayoría de los estudios se relacionan con Leptospira, rabia, hantavirus, Mycobacterium avium paratuberculosis (MAP) y distémper. Rodentia, Carnivora, Chiroptera y Cetartiodactyla fueron los órdenes de mamíferos más estudiados. Información acerca de la presencia/ausencia de patógenos fue encontrada en 44 especies de mamíferos silvestres. La mayor parte de las investigaciones buscaron patógenos en Chile sur y central y los métodos de diagnóstico más empleados para el diagnóstico de patógenos fueron serología y técnicas moleculares. En general, la investigación en mamíferos silvestres ha sido dirigida a la evaluación de enfermedades zoonóticas, mientras que aquellas enfermedades transmitidas por vectores y enfermedades no zoonóticas han sido mayormente ignoradas por la comunidad científica.

This study organizes all available information about viral and bacterial pathogens of wild mammals in Chile. This was done in order to identify pathogens that have been well-documented and recognize those that have not been properly studied, determine the number of articles that have been published annually about this topic and identify regions in Chile that concentrate the highest and lowest number of studies concerning viral and bacterial pathogens. A total of 67 scientific articles published in peer-reviewed journals from 1951 to 2018 were selected for revision. Results indicate that the number of publications has increased per decade but there are years in which no articles were published. Most studies addressed Leptospira, rabies, hantavirus, Mycobacterium avium paratuberculosis (MAP) and distemper. Rodentia, Carnivora, Chiroptera and Cetartiodactyla were the most studied mammal orders. Information about presence/absence of pathogens was found for 44 wild mammal species. Research was mainly carried out in central and southern Chile and the most commonly employed methods for pathogen diagnosis were serology and molecular techniques. Overall, research in Chilean wild mammals has been directed towards the evaluation of zoonotic diseases, while vector-borne and non-zoonotic diseases have been mostly neglected by the scientific community.

Situación epidemiológica de las meningoencefalitis bacterianas / Epidemiological situation of bacterial meningoencephalitis

Se describen los casos de meningoencefalitis bacterianas exponiendo el análisis histórico de algunas variables y a continuación la información desde la Semana epidemiológica (SE) 1 a la 25 del año 2017 que provienen de la notificación por canales oficiales: SNVS (módulos C2/SIVILA) y SIC (Sistema de Información epidemiológica de CABA). El análisis de las infecciones invasivas no meníngeas será realizado en próximas actualizaciones. Los casos fueron notificados a través de estos sistemas por los efectores públicos y privados de la Ciudad. El análisis de los mismos se realizó de manera individual a fin de evitar duplicaciones, excluyendo los casos descartados e integrando la información en una base unificada. Se incluyeron como residentes de CABA a todos aquellos que se domicilian en la Ciudad y aquellos casos atendidos en efectores de la CABA cuyo domicilio es desconocido al momento del análisis. La construcción de las tasas, se realizó en base a las proyecciones poblacionales aportadas por la Dirección de Estadística y Censos (DGEyC) de la Ciudad Autónoma de Buenos Aires. (AU)

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)

Morbidity and mortality associated with arterial surgery site infections by resistant microorganisms / Morbimortalidade relacionada às infecções de ferida operatória ocasionadas por micro-organismos resistentes em cirurgias arteriais

Background: Surgical site infection is a severe complication of peripheral vascular surgery with high morbidity and mortality rates. Objective: To evaluate the morbidity and mortality of infections of peripheral artery surgery sites caused by resistant microorganisms. Methods: This was a prospective study of a cohort of patients who underwent peripheral artery revascularization procedures and developed surgical site infections between March 2007 and March 2011. Results: Mean age was 63.7 years; males accounted for 64.3% of all cases. The overall prevalence of bacterial resistance to antimicrobials was 65.7%. The most common microorganism identified was Staphylococcus aureus (30%). Comparison of the demographic and surgical characteristics of both subsets (resistant versus non-resistant) detected a significant difference in length of preoperative hospital stay (9.3 days vs. 3.7 days). The subset of patients with infections by resistant microorganisms had higher rates of reoperation, lower numbers of limb amputations and lower mortality, but the differences compared to the subset without resistant infections were not significant. Long-term survival was similar. Conclusions: This study detected no statistically significant differences in morbidity or mortality between subsets with surgical wound infections caused by resistant and not-resistant microorganisms...

Contexto: A infecção de ferida operatória é uma complicação grave da cirurgia vascular periférica e está associada a elevadas taxas de morbidade e mortalidade. Objetivo: Avaliar a morbidade e a mortalidade relacionadas às infecções de ferida operatória causadas por micro-organismos resistentes em cirurgias arteriais periféricas. Métodos: Coorte prospectiva envolvendo pacientes submetidos a procedimentos de revascularização arterial periférica que desenvolveram infecção de sítio cirúrgico, entre março de 2007 e março de 2011. Resultados: A média de idade desses pacientes foi de 63,7 anos; homens representaram 64,3% de todos os casos. A prevalência total de resistência bacteriana foi de 65,7%. O micro-organismo mais isolado foi o Staphylococcus aureus (30%). Comparando-se as características demográficas e cirúrgicas das duas amostras (com e sem resistência), foi demonstrado que o tempo de permanência hospitalar apresentou diferença significativa (9,3 dias × 3,7 dias). O grupo de pacientes portadores de infecção por micro-organismo resistente apresentou elevadas taxas de reoperação, amputação de membro inferior e mortalidade, porém sem diferença estatística quando comparado ao grupo sem resistência. No longo prazo, a sobrevida foi similar. Conclusão: este estudo não demonstrou diferença estatística quanto a morbidade e mortalidade entre os grupos com infecção de ferida operatória ocasionada por micro-organismos resistentes e não resistentes...

Molecular detection of enteropathogenic Escherichia coli in asymptomatic captive psittacines / Detecção molecular de Escherichia coli enteropatogênica em psitacídeos assintomáticos em cativeiro

Psittaciformes are one of the most endangered groups of birds, and several Brazilian species are classified between vulnerable and critically endangered. It is thus necessary to identify agents that cause infections in captive wild animals and to assess the risks posed thereof and to design interventions to minimize the possibility of disease outbreaks, leading to the conservation of endangered species. The purpose of this study was to identify enteropathogenic Escherichia coli (EPEC) cloacal isolates from asymptomatic psittacines in captivity and evaluate the distribution of the EPEC pathotype. Cloacal swabs were obtained from 46 asymptomatic birds, and resulting isolates were tested by polymerase chain reaction (PCR) for the presence of the attaching and effacing gene (eae) and bundle-forming pilus structural gene (bfpA) of EPEC. Samples from several species were tested, and three samples were found to be positive for the eae and bfpA genes and characterized as typical EPEC. This is the first report of this pathotype in asymptomatic psittacines. Although certain E. coli strains are more pathogenic than others, various factors should be considered when determining the potential of E. coli isolates to cause disease in captive psittacines. Birds that are positive for the EPEC (typical) strain could be zoonotic sources of infection, and may have acquired these strains through contact with humans or domestic animals. These findings may also be valuable for the long-term management of endangered species ex situ as one EPEC sample was isolated from a Red-tailed Amazon (Amazona brasiliensis).

Os psitacídeos são um dos grupos de aves mais ameaçadas no mundo e diversas espécies brasileiras são classificadas desde vulneráveis à criticamente ameaçadas de extinção. Torna-se, portanto, necessário identificar os agentes que causam infecções em animais selvagens em cativeiro e determinar os riscos relacionados de modo a intervir sobre os fatores envolvidos para diminuir a possibilidade de surtos de doenças e promover a conservação de espécies ameaçadas. O objetivo deste estudo foi identificar Escherichia coli Enteropatogência (EPEC) de isolados cloacais de psitacídeos assintomáticos em cativeiro e avaliar a distribuição do patotipo EPEC. Suabes cloacais foram coletados de 46 psitacídeos assintomáticos e os isolados foram testados pela reação em cadeia pela polimerase (PCR) para a presença do gene attaching and effacing (eae) e bundle forming pilus (bfpA) de EPEC. Amostras oriundas de diversas espécies foram testadas e três amostras resultaram positivas para os genes eae e bfp e caracterizadas como EPEC típicas. Esse é o primeiro relato em psitacídeos assintomáticos para esse patotipo. Apesar de que algumas cepas de E.coli serem mais patogênicas do que outras, diversos fatores devem ser considerados para determinar o potencial de isolados de E.coli de causar doença em psitacídeos em cativeiro. Aves positivas para cepas de EPEC (típicas) poderiam ser fontes de infecção zoonóticas e adquirir essas cepas através do contato com humanos e animais domésticos. Esses achados também podem ser valiosos para o manejo a longo prazo de espécies ameaçadas ex situ já que uma amostra de EPEC foi isolada de um Papagaio-de-cara-roxa (Amazona brasiliensis).

Wolbachia screening in spiders and assessment of horizontal transmission between predator and prey

Recent studies have revealed that the prevalence of Wolbachia in arthropods is attributable not only to its vertical transmission, but also to its horizontal transfer. In order to assess the horizontal transmission of Wolbachia between predator and prey, arthropods belonging to 11 spider families and six insect families were collected in the same field of rice. The distribution of Wolbachia in these arthropods was detected by diagnostic PCR amplification of the wsp (Wolbachia outer surface protein gene) and 16S rDNA genes. Nurscia albofasciata Strand (Araneae: Titanoecidae), Propylea japonica Thunberg (Coleoptera: Coccinellidae), Paederus fuscipes Curtis (Coleoptera: Staphylinidae), and Nilaparvata lugens Stal (Homoptera: Delphacidae) were infected with Wolbachia. This is the first report of infection of N. albofasciata and P. fuscipes by Wolbachia. No direct evidence indicated the existence of horizontal transmission of Wolbachia between predator and prey.

Colonización nasal bacteriana en población sana de la ciudad de Santiago de Chile: ¿existe portación de Staphylococcus aureus meticilino resistente comunitario? / Nasal bacterial colonization in healthy people of the city of Santiago of Chile: is there nasal carriage of community methicillin resistant Staphylococcus aureus?

Introducción: No existe consenso en cuanto a qué se considera flora nasal normal. Recientemente, ha emergido Staphylococcus aureus meticilino resistente comunitario (MRSA-com) en personas sin factores de riesgo conocido, produciendo una alarma sanitaria a nivel mundial. Objetivo: Determinar la colonización nasal bacteriana y evaluar la presencia de MRSA-com. Material y método: Estudio prospectivo descriptivo, entre octubre de 2007 y octubre de 2008, en población sana. Se realizó toma de muestra de secreción nasal, incubación e identificación bacteriana por métodos convencionales. Resultados: Población estudiada con promedio de edad 37,6 +/-15,8 años, 55 por ciento de sexo femenino, y 37,1 por ciento tabaquismo activo. Se obtuvo 73 por ciento de cultivos positivos. Se identificaron 18 especies bacterianas, siendo las más frecuentes Staphylococcus coagulasa negativo (53 por ciento) y Staphylococcus aureus (22,7 por ciento). Se detectó sólo un caso de MRSA, cuyo análisis genético fue negativo para demostrar su origen comunitario. Discusión: Existe una alta tasa de portación nasal de S coagulasa negativo y S aureus, similar a lo reportado por la literatura internacional. Pese a que la prevalencia encontrada para S aureus es la habitual, no se encontraron muestras positivas a MRSA-com. Lo anterior indica que aún no existe en Chile la diseminación de clones de MRSA-com.

Introduction: Doesn't exists agreement about normal nasal flora. Recently it has emerged community-associated methicillin-resistant Staphylococcus aureus in people without known rísk factors, producing a global health scare. Aim: Look for normal nasal flora and test the presence oí MRSA-com. Material ana method: Descriptive and prospective study, between October 2007 and October 2008, in healthy people. Was taken a sampling from nasal secretion, incubation and bacterial identification by conventional methods. Results: Studied population, average age 37.6 +/-15.8years, 55 percent témale and 37.1 percent active smoking. We obtained 73 percent of positive cultures. We identified 18 bacterial species, the most common was Staphylococcus coagulase-negative (53 percent) and Staphylococcus aureus (22.7 percent). Was detected only one case ofMRSA, and his genetic test was negative to prove community origin. Discusión: There is a high rate of nasal carriage of Staphylococcus coagulase-negative, like to that reponed by international literature. Although the prevalence found for S aureus is the usual, there were no MRSA-com positive samples. This indicates that in Chile there is still no spread of clones of MRSA-com.

Anaplasma marginale infection in cattle from south-western Amazonia / Infecção por Anaplasma marginale em bovinos na Amazônia Sul Ocidental, Brasil

The present study provides the first epidemiological data regarding infection by Anaplasma marginale in cattle reared in south-western Brazilian Amazonia. One simple procedure was adapted for the extraction of DNA from blood clots collected in seven microregions of Rondônia State and two mesoregions of Acre State. PCR method was used to asses the frequency of A. marginale infections in 4 to12-month-old cattle. The cattle infection was investigated by polymerase chain reaction (PCR) using the specific primer "msp5" for A. marginale. The DNA amplifications revealed that the mean frequency of A. marginale infection was 98.6 percent (1,627/1,650) in samples from Rondonia, and 92.87 percent (208/225) in samples from Acre. The high frequency of A. marginale infections in 4 to 12-month-old cattle indicate a situation of enzootic stability in the studied areas and are comparable to those detected by immunodiagnosis in different endemic regions in Brazil. The DNA extraction of clotted blood method described here can be used for epidemiological studies on anaplasmosis and other bovine hemoparasites.

O presente estudo fornece os primeiros dados epidemiológicos relativos a infecção por Anaplasma marginale em bovinos criados na Amazônia Sul Ocidental brasileira. Foi adaptado um procedimento simples para a extração de DNA a partir de coágulos sanguíneos coletados em sete microrregiões do estado de Rondônia e duas mesoregiões do estado do Acre. A técnica da reação em cadeia da polimerase (PCR) foi aplicada para avaliar a freqüência da infecção por A. marginale em bovinos com idade entre 4 e 12 meses. Após a extração do DNA de cada amostra, a infecção nos bovinos foi investigada pela amplificação do gene "msp5" de A. marginale. As técnicas de amplificação do DNA revelaram que a freqüência de infecção por A. marginale foi de 98,6 por cento (1.627/1.650) nas amostras provenientes de Rondônia e de 92,87 por cento (208/225) nas amostras do Acre. A alta freqüência da infecção por A. marginale nos animais com idade entre 4 e 12 meses indica uma situação de estabilidade enzoótica nas regiões estudadas, as quais são comparáveis às detectadas por técnicas de imunodiagnóstico em outras regiões endêmicas no Brasil. A extração do DNA através do método aqui descrito pode ser utilizado em estudos epidemiológicos sobre a anaplasmose bovina e outros hemoparasitas.

[Evaluation of bacterial infection of external surface and digestive system of cockroach species]

The presence of cockroaches has health implications, such as nosocomial infection, as the insects move freely from areas within and around hospitals that may harbor pathogenic organisms. The aims of the present study were to detect cockroach species and bacterial infection transmitted by their surface and their digestive system. In this study we caught 250 cockroach from hospital of Hamedan. We hunt them with hand, glass trap and sticky trap. Then they have been carried to bacteriology lab. After anesthesia and washing in 2cc physiology serum, their gut have been expelled from oral to anal and cultured. In this study we used E.M.B, T.S.I, DNAase, B.A, SF, SS, ONPG, MR, SIM, Mnitol sult agar, Lysin, Simmon citrate and Urea as bacterial culture methods. In this study we recognized 4 species of cockroaches from hospitals of Hamedan: Periplaneta americana, Periplaneta australasiae, Blatta orientalis Blatella germanica. The most frequent one was Periplaneta americana, [88%] and just 0.8% were Blatta orientalis [the least frequency]. 23 species of bacteria recognized from surface and digestive system or cockroaches. In surface of them, Escherichia coli had 26.5%[the most frequency] and Edward siella had 0.4% [the least frequency]. In digestive system E.coli had 30.8% [the most frequency] and Morganella morgani had 0.8% [the least percent]. Tour study determined that cockroaches play as potential vectors of medically important microorganisms such as pathogenic bacteria in hospital environments. Integrated management of cockroach populations should be carried out into the disease prevention and control programs in hospitals

[Density of airborne bacteria in a children's hospital in Tehran]

Atmospheric transport is a key mode of microbial dispersal and the transmission of airborne microbe can have significant impacts on human health. The main objective of this study was to determine the concentrations of airborne bacteria in a children's hospital. Three sampling points were selected. Airborne bacteria were collected with 6 days interval at each location using Quick take 30 sampler at an sampling rate of 28.3 l min-1 from November 2007 to March 2008. The results showed that the highest indoor density of bacteria was 429 CFU/m3 that founded in oncology ward. Bacteria identified were representative of normal flora of the skin, respiratory and gastrointestinal tracts. Our analysis revealed that colony of bacteria in 14% in patient room exceeded available guideline value for indoor air quality. That 11% cases was found in the oncology ward

Transmisión de infecciones bacterianas y parasitarias por transfusiones de sangre y sus componentes / Transmission of bacterial and parasitic infections by blood transfusions and their components

Aunque las infecciones causadas por agentes virales tienen una gran significación entre las infecciones transmitidas por transfusión (ITT), no se puede desconocer el peligro que representan las bacterias y algunos protozoos. Se ofrecen datos sobre la trascendencia de la transmisión por Treponema pallidum, causante de la sífilis y sobre otras bacterias que pueden contaminar las bolsas de sangre o de componentes, en particular los concentrados de plaquetas, y se hace hincapié en la importancia de las medidas higiénico-sanitarias en los centros de colecta de sangre, sean fijos o móviles. Además, se mencionan los principales parásitos, como el Trypanosomas cruzi, causante de la tripanosomiasis americana o enfermedad de Chagas, y el género Plasmodium causantes de la malaria, responsables del mayor número de ITT en la América Latina, y que se consideran enfermedades infecciosas exóticas para Cuba, lo que nos obliga a adoptar medidas epidemiológicas para mantener la seguridad de la sangre que se transfunde en el país.

Although the infections caused by viral agents are very important among the transfusion-borne diseases, the danger represented by bacteria and some protozoa cannot be ignored. Data on the transcendence of the transmission by Treponema pallidum, causative of syphilis, and on some other bacteria that may contaminate the blood bags or their components, particularly the platelet concentrates, are given. Emphasis is made on the importance of the hygienic and sanitary measures that should be taken in the fixed or mobile blood collection centres. Moreover, the main parasites such as Tripanosomas cruzi, causing American tripasonomiasis or Chagas' disease, and the genus Plasmodium producing malaria, which are responsible for the highest number of transfusion-borne infections in Latin America, are mentioned. These infectious diseases that are exotic for Cuba make us adopt epidemiological measures to maintain the safety of the blood that is transfused in the country.

Influência de fluídos biológicos na sobrevivência de Staphylococcus aureus sobre diferentes superfícies secas / Influence of biological fluids on survival of Staphylococcus aureus on various dried surfaces

Sabe-se que a transmissão de infecções hospitalares, via cruzada ou ambiental, é facilitada pela sobrevivência de microrganismos em superfícies secas que pode ser favorecida pela presença de fluídos biológicos. Visando demonstrar o cuidado com substâncias corporais narotina de limpeza, esse estudo avaliou a influência de alguns fluídos biológicos (sangue, urina e saliva artificial) na sobrevivência de Staphylococcus aureus (ATCC 25923), depositados de modo similar, sobre diferentes superfícies após secagem. O sangue foi capaz de preservar a viabilidade bacteriana por até 72 diasquando depositado sobre piso cerâmico. O tecido em fibra de algodão permitiu maior tempo de sobrevivência em comparação ao tecido sintético. Esses resultados demonstram que a composição do fluído biológico e o tipo de suporte altera o tempo da sobrevivência bacteriana em condições ambientais.

[ prevalence of bacterial and red blood cell contamination of multiple dose vials used in ICU, NICU and the operation room]

Transmission of infection via multiple dose vials has been well documented. Thus, the probability of contamination in these vials, no matter how little, is very important because they are supposed to be a potential source of nosocomial infection in patients. Therefore, a prevalence study on the contamination of multiple dose vials [MDV] seams to be necessary. The purpose of this study was to identify bacterial contamination and red blood cell [RBC] contamination in multiple dose vials used in Bahman 22 [nd] Hospital. In a cohort study, different types of MDVs used in different sections of Bahman 22[nd] Hospital were periodically collected during one year. Information about the medication, wards, labeling of vials, the date and time of opening and storing temperature was recorded. Then, 0.5 ml of each vial was cultured in Blood Agar media at 37[degree sign] c for 48 hours. Also, the samples were tested for Red Blood Cell contamination after they were centrifuged. Totally, 300 MDV's were collected and studied. No bacterial contamination was found in the cultures. Of the 300 vials available, 2 vials were contaminated with RBC [2 RBC in one vial and 3 RBC in another] at a contamination rate of 0.67%. Although the results of bacterial culture of multiple dose vials used in different wards of the hospital were negative, the contamination of two vials with Red Blood Cells is still very important. The findings should raise concerns about the potential risk of transmission of blood borne pathogens through such vials

Nursing staff knowledge of multi-resistant bacterial infections

OBJECTIVE: To assess professional nurses', associate degree prepared nurses', licensed practical nurses', and nursing assistants' knowledge of the causes of multi-resistant bacterial infections, the risks theses infections pose to health care providers, the chain of transmission of these infections, and patients' susceptibility to colonization of these multi-resistant bacterial infections. METHODS: This descriptive study was conducted in a major general hospital in Minas Gerais, Brazil. The sample consisted of 42 nursing staff from a medical clinical unit. Descriptive statistics were used to analyze and present the data. RESULTS: Nursing staff had unsatisfactory knowledge of the causes of multi-resistant bacterial infections, the chain of transmission of multi-resistant bacterial infections, and patients' susceptibility to colonization of multi-resistant bacterial infections. However, the majority of participants had some knowledge about the risks that multi-resistant bacterial infections posed to health care providers. CONCLUSION: Lack of knowledge among nursing staff compromise adherence to preventive measures and nursing management of multi-resistant bacterial infections.

OBJETIVO: Avaliar o conhecimento dos enfermeiros, técnicos e auxiliares de enfermagem de hospital geral de Minas Gerais, quanto às causas da multirresistência bacteriana, os riscos para a equipe de saúde, o modo de transmissão e susceptibilidade dos pacientes à colonização por bactérias resistentes a múltiplas drogas. MÉTODOS: Realizado na clínica médica, foram entrevistados 42 profissionais de enfermagem lotados na unidade. Este estudo do tipo quantitativo teve uma análise descritiva de seus dados, para a qual utilizamos estatística descritiva com base no cálculo de porcentagem, sendo os mesmos apresentados em tabelas. RESULTADOS: Os profissionais demonstraram conhecimento restrito e limitado sobre a temática, restringindo as causas da resistência à utilização indiscriminada de antibióticos. A maioria estava ciente dos riscos que o portador da bactéria oferecia à equipe de saúde. Evidenciamos falta de informação quanto aos mecanismos de transmissão, principais reservatórios e os mais susceptíveis à colonização. CONCLUSÕES: A lacuna no conhecimento implica diretamente na percepção de susceptibilidade à contaminação, comprometendo a adesão às medidas preventivas.

OBJETIVO: Evaluar el conocimiento de los enfermeros, técnicos y auxiliares de enfermería de un hospital general de Minas Gerais, en cuanto a las causas da multirresistencia bacteriana, los riesgos para el equipo de salud, el modo de transmisión y susceptibilidad de los pacientes a la colonización por bacterias resistentes a múltiples drogas. MÉTODOS: Realizado en la clínica médica, fueron entrevistados 42 profesionales de enfermería encontrados en la unidad. En este estudio de tipo cuantitativo se realizó un análisis descriptivo de sus datos, utilizándose la estadística descriptiva con base en el cálculo de porcentaje, los cuales fueron presentados en tablas. RESULTADOS: Los profesionales demostraron conocimiento restricto y limitado sobre la temática, restringiendo las causas de la resistencia a la utilización indiscriminada de antibióticos. La mayoría estaba conciente de los riesgos que el portador de la bacteria ofrecía al equipo de salud. Evidenciamos falta de información en cuanto a los mecanismos de transmisión, principales reservorios y los más susceptibles a la colonización. CONCLUSIONES: La laguna en el conocimiento implica directamente en la percepción de susceptibilidad a la contaminación, comprometiendo la adhesión a las medidas preventivas.

Flora vaginal en adolescentes con embarazo a término y su relación con rotura prematura de membranas / Vaginal flora in pregnant adolescents with membrane premature failure

El objetivo de este trabajo fue determinar la relación existente entre flora vaginal y rotura prematura de membranas, en adolescentes embarazadas que acudieron a la consulta prenatal de la Maternidad “Dr. Armando Castillo Plaza” (MACP), perteneciente al Servicio Autónomo Hospital Universitario de Maracaibo. El diseño de este estudio fue explicativo, cuasi experimental. La población y muestra estuvo representada por 80 adolescentes embarazadas, en el último trimestre de gestación. El método de recolección de datos estuvo constituido por una entrevista personalizada y los datos fueron recogidos en un formulario conformado por preguntas abiertas. A todas las pacientes se les tomó muestra para cultivo de secreción vaginal identificándose la flora vaginal presente. Como resultados obtenidos se tuvo que la población mayormente afectada fueron las adolescentes mayores de 17 años; iniciando su actividad sexual entre los 15 y 17 años, las cuales viven en concubinato y pertenecen al Nivel V según Graffar. El diagnóstico de RPM se realizó a través de la maniobra de Tarnier y el Test de Nitrazina, con un periodo de latencia de 6-12 horas, la edad gestacional estuvo entre las 37-38 semanas. Los microorganismos reportados fueron bacilos Gram positivos en un 46%, combinación de bacilos Gram positivos y Gram negativos en el 16%, levaduras en el 15%, bacilos Gram negativos 8% y virus de papiloma humano (VPH) 3%. El cultivo de secreción vaginal fue positivo en el 57% de los casos, siendo Candida albicans el microorganismo predominante (25%). Se concluye que existe relación entre la flora vaginal patógena y RPM en las adolescentes con embarazo a término.

The objective of this work was to determine the existing relation between vaginal flora and membrane premature failure, in pregnant adolescents who went to the consultation of Maternity “Dr. Armando Castillo Plaza” (MACP), pertaining to the Independent Service University Hospital of Maracaibo. The design of this study was explanatory, cuasi experimental. The population was represented by 80 pregnant adolescents, in the last trimester of gestation. The method of data collection was constituted by a customized interview and the data were gathered in a form conformed by open questions. All the patients were taken vaginal secretion culture identifying the vaginal flora present. As obtained results it were had population mainly affected was the greater adolescents of 17 years; initiating its sexual activity between the 15 and 17 years, which live in concubines and belong at Level V according to Graffar. The diagnose of MPF was made through the maneuver of Tanier and Test of Nitrazina with a period of 6-12 latency hours; the gestacional age was between the 37-38 weeks. The reported microorganisms were Gram positive bacilli in a 46%, combination of Gram positive and Gram negative bacilli in 16%, yeast in 15%, bacilli Gram negative 8% and human papiloma virus (HPV) 3%. Vaginal secretion culture was positive in 57% of the cases, being Candida albicans predominant microorganism (25%). One concludes that relation between the pathogenic vaginal flora exists and MPF in the adolescents with pregnancy upon maturity.

Canales Endémicos y Marcadores de Resistencia Bacteriana, en Instituciones de Tercer nivel de Bogota, Colombia / Endemic channels and bacterial resistance markers in third-level hospitals in Bogotá, Colombia

Objetivo: Determinar los perfiles de resistencia bacteriana y los canales endémicos en 14 instituciones de tercer nivel. Métodos: Población. Bogotá-Colombia, 14 hospitales pertenecientes al Grupo para el Control de la Resistencia Bacteriana de Bogotá (GREBO). A partir de la información obtenida de los laboratorios de microbiología de los centros participantes (métodos automatizados y manuales), se creó una base de datos usando los programas BacLink 2.0 y Whonet 5.3, durante los años 2001, 2002 y 2003. Los perfiles de susceptibilidad fueron hallados acordes a las normas de la nCCLS (2003). Se realizó un análisis descriptivo de los diferentes marcadores de resistencia y se determinó el canal endémico de la resistencia para los hospitales, utilizando los puntos entre los percentiles 25 y 75 por ciento, para cada mes durante el periodo de estudio. Resultados: Se analizaron 84664 aislamientos. Los más frecuentes fueron Escherichia coli, Staphylococcus aureus, Staphylococcus coagulasa negativo, Klebsiella pneumoniae y Pseudomonas aeruginosa. La resistencia para los años 2001, 2002 y 2003 fue respectivamente: S. aureus meticilino resistente: 41 por ciento, 48 por ciento, 48 por ciento; Staphylococcus coagulasa negativo resistente a oxacilina: 75 por ciento, 73 por ciento, 72 por ciento; E. faecium vancomicina resistente: 14 por ciento, 9 por ciento, 3 por ciento; K. pneumoniae resistente a cefalosporinas de tercera generación: 37 por ciento, 25 por ciento, 23 por ciento; P. aeruginosa resistente a imipenem: 24 por ciento, 22 por ciento, 17 por ciento; P. aeruginosa resistente a ciprofloxacina: 46 por ciento, 46 por ciento, 35 por ciento, A. baumannii resistente a imipenem: 11 por ciento, 29 por ciento, 39 por ciento. Los canales endémicos evidenciaron la problemática de la resistencia bacteriana, esta se centró en la presencia de S. aureus meticilino resistente y en el marcado incremento de la resistencia de A. baumanni a imipenem. Conclusiones: Se destacan los altos porcentajes de resistencia para todos los marcadores de impacto epidemiológico a nivel hospitalario especialmente en Unidades de Cuidado Intensivo.

Patógenos hospitalares resistentes em teclados de computadores / Hospitalar pathogens resistant in computers keyboards

Os computadores hospitalares são fômites novos e desconhecidos e sua introdução nos quartos dos pacientes já é uma realidade em alguns hospitais modernos. Cinqüenta amostras de teclados de computadores desktop hospitalares foram examinadas no período de agosto a outubro de 2005. Microrganismos mesófilos aeróbios foram detectados em 82 por cento (41/50) dos teclados examinados; fungos em 84 por cento (42/50); enterococos em 24 por cento (12/50) e estafilococos em 28 por cento (14/50) dos teclados. O nível de contaminação nos teclados foi compatível com o encontrado em diversas superfícies. Porém, Staphylococcus sp. coagulase-positivos (8 por cento) e Enterococcus sp. (25 por cento), com perfis de resistência monitorados pelos sistemas internacionais de vigilância, foram encontrados, caracterizando-os como fontes potenciais na disseminação de patógenos hospitalares. O uso de uma cobertura protetora, a desinfecção periódica e uma política de uso que dificulte a disseminação de patógenos são recomendados.