Reutilización de barrera de tela de algodón estéril en la práctica clínica: estudio observacional longitudinal / Reusing sterile cotton fabric barriers in the clinical practice: an observational and longitudinal study / Reuso de barreira estéril de tecido de algodão na prática clínica: estudo longitudinal observacional

Objetivo: analizar las características de barrera física y biológica de los campos de algodón utilizados como sistema de barrera estéril después de ser sometidos a múltiples usos y procesos en la práctica clínica. Método: estudio observacional longitudinal de seguimiento y evaluación de tela 100% algodón, utilizada como sistema de barrera estéril en un hospital de mediano porte. Se recolectaron muestras antes del uso (después de tres lavados) y después de tres, seis, nueve, 12 y 15 meses de uso y se evaluaron el número, grosor e integridad de los hilos, peso, absorción de agua y penetración húmeda de microorganismos. Resultados: después de 85 lavados, no cambió el número de hilos, aumentó el número de fibras deshilachadas y el volumen de agua absorbida. La prueba microbiológica mediante la metodología estándar alemana obtuvo un resultado negativo y la de penetración húmeda de microorganismos no mostró cambios significativos con el tiempo, a pesar de que una fracción de células microbianas pasó a través de las muestras de doble capa. Conclusión: las propiedades físicas de la tela 100% algodón utilizada como sistema de barrera estéril cambiaron con el uso/procesamiento; sin embargo, no interfirieron significativamente con los resultados obtenidos en las pruebas realizadas a la barrera microbiológica hasta los 85 lavados.

Objective: to analyze the physical and biological barrier characteristics of cotton fields used as a sterile barrier system after multiple use and processing cycles in the clinical practice. Method: an observational and longitudinal study to monitor and evaluate 100% cotton fabric used as a sterile barrier system in a medium-sized hospital. Samples were collected before use (after three washes) and at three, six, nine, 12 and 15 months of use and evaluated for the number, thickness and integrity of threads, weight, water absorption and wet penetration by microorganisms. Results: after 85 washes, the number of threads remained unchanged, and the shredded fibers and the water volume absorbed were increased. The microbiological test using the German standard methodology obtained a negative result and wet penetration by microorganisms did not show significant changes over time, although a percentage of the microbial cells passed through the double-layer samples. Conclusion: the physical properties of 100% cotton used as a sterile barrier system changed with use/processing cycles; however, these alterations did not significantly interfere with the results obtained by the tests performed on the microbiological barrier up to 85 washes.

Objetivo: analisar as características de barreira física e biológica de campos de algodão, que são utilizados como sistema de barreira estéril, após múltiplos usos e processamentos na prática clínica. Método: estudo longitudinal observacional de acompanhamento e de avaliação de tecido 100% algodão que foi utilizado como sistema de barreira estéril em um hospital de médio porte. Amostras foram coletadas antes do uso (após três lavagens) e com três, seis, nove, 12 e 15 meses de uso e avaliadas quanto ao número, à espessura e à integridade dos fios, peso, absorção de água e penetração úmida de micro-organismos. Resultados: após 85 lavagens, o número de fios permaneceu inalterado, porém aumentaram-se as fibras desfiadas e o volume de água absorvido. O teste microbiológico utilizando metodologia padrão alemão obteve resultado negativo; já o de penetração de úmida de micro-organismos não apresentou mudanças significativas ao longo do tempo, embora uma fração das células microbianas tenham passado pelas amostras de dupla camada. Conclusão: as propriedades físicas do tecido 100% algodão, utilizado como sistema de barreira estéril, alteraram com usos/processamentos; entretanto essas não interferiram significativamente nos resultados obtidos pelos testes realizados na barreira microbiológica até 85 lavagens.

O recém-nascido hospitalizado em unidade de terapia intensiva neonatal e o posicionamento no leito / The newborn hospitalized in a neonatal intensive care unit and bed positioning: systematic review / El recién nacido hospitalizado en la unidad de cuidados intensivos neonatales y el posicionamiento en la cama: revisión sistemática

Objetivo: identificar quais os posicionamentos e produtos auxiliares mais indicados para o recém-nascido hospitalizado em Unidade de Terapia Intensiva Neonatal. Método: caracteriza-se como básica, de caráter exploratório e quanto aos procedimentos técnicos é uma revisão sistemática da literatura. A busca teve como bases a Biblioteca Virtual em Saúde, Plataforma Capes e Unique, limitando as publicações realizadas entre 2011 e 2021. Obteve-se 85 resultados, sendo a análise e discussão dos dados realizada com 7 estudos. Resultados: verificou-se que existem diversos posicionamentos que podem ser utilizados nesses pacientes, como os decúbitos dorsal, ventral e lateral, sendo o ventral o mais indicado. Ademais, identificaram-se diversos produtos que podem ser utilizados para auxiliar no posicionamento dos recém-nascidos e que podem facilitar os cuidados de enfermagem. Considerações finais: observou-se que poucos estudos trouxeram um padrão e/ou um método de posicionamento vinculado com os produtos auxiliares.

Objective: to identify which are the most suitable positioning and auxiliary products for the newborn hospitalized in Neonatal Intensive Care Units. Method: this is characterized as basic, exploratory, and as to the technical procedures, it is a systematic literature review. The search was based on the Biblioteca Virtual em Saúde, Plataforma Capes and Unique, limiting publications between 2011 and 2021. A total of 85 results were obtained, and the analysis and discussion of the data was carried out with 7 studies. Results: it was found that there are several positions that can be used in these patients, such as dorsal, ventral, and lateral decubitus, with the ventral position being the most indicated. Furthermore, several products were identified that can be used to assist in positioning the newborns and that can facilitate nursing care. Final considerations: it was observed that few studies brought a standard and/or a positioning method linked to the auxiliary products.

Objetivo: identificar cuáles son los posicionamientos y productos auxiliares más adecuados para los recién nacidos hospitalizados en una Unidad de Cuidados Intensivos Neonatales. Método: se caracteriza como básico, de carácter exploratorio y en cuanto a los procedimientos técnicos es una revisión sistemática de la literatura. La búsqueda se basó en la Biblioteca Virtual em Saúde, Plataforma Capes y Unique, limitando las publicaciones entre 2011 y 2021. Se obtuvieron 85 resultados, siendo el análisis y la discusión de los datos realizados con 7 estudios. Resultados: Se ha comprobado que hay varias posiciones que pueden utilizarse en estos pacientes, como el decúbito dorsal, ventral y lateral, siendo la ventral la más adecuada. Además, se identificaron varios productos que pueden utilizarse para ayudar a colocar a los recién nacidos y que pueden facilitar los cuidados de enfermería. Consideraciones finales: se observó que pocos estudios trajeron un patrón y/o un método de posicionamiento vinculado a los productos auxiliares.

Guía Técnica: Procedimiento para la determinación de la hemoglobina mediante hemoglobinómetro portátil / Technical Guide: Procedure for determining hemoglobin using a portable hemoglobinometer

Los principales cambios en la presente guía contemplan una mejor distribución en la presentación de los procedimientos priorizando los que involucran a los niños menores de un año, se actualiza los valores de concentración de hemoglobina en cuanto a la severidad. La atención de la salud requiere de una permanente mejora para prestar un servicio de calidad que incluye información confiable a partir de los instrumentos de medición como en este caso la determinación de la hemoglobina, por lo que esperamos esta segunda edición, sea de utilidad

Trends and Challenges in Access to Essential Medicines in Ethiopia and the Contributions of Local Pharmaceutical Production

Decades ago, the United Nations declared that access to essential medicines was a key element of universal human rights. Accordingly, member states have been striving to address this issue through strategic policies and programs. Strengthening local pharmaceutical production has been a pivotal strategy adopted by many developing countries including Ethiopia. The government of Ethiopia identified local pharmaceutical production as a key industrial sector and has been implementing a ten-years strategic plan to improve capabilities and attract investment. Such support is needed because local production could satisfy only 15 to 20% of the national demand, typically from a limited portfolio of medicines in conventional dosage forms. The increasing prevalence of chronic diseases has accentuated the need for a more sustainable supply to reduce reliance on imports and increase access to essential medicines. A full understanding of the structure, constraints and complexities of the Ethiopian pharmaceutical market structure is vital to direct effective policies, target most impactful investments and exploit opportunities for leapfrogging. Hence, the purpose of this review was to assess the trends and challenges in access to essential medicines and local pharmaceutical production in Ethiopia. Literature search through major databases and review of policy documents and performance reports from relevant sector institutions were made to extract information for the review

Research on Maintenance Management of Equipment of Magnetic Resonance Imaging Based on RAM / 中国医疗器械杂志

OBJECTIVE@#To optimize the maintenance quality management of MRI equipment and ensure the quality and safety of its clinical use.@*METHODS@#The data of failure time and repair time of a MRI equipment in three years were collected by magnetic resonance repair report system, and then the reliability, availability and maintainability(RAM) were studied and analyzed.@*RESULTS@#The results of reliability analysis showed that the communication module was the key subsystem of the MRI equipment. The results of usability analysis showed that RF module was a key subsystem of MRI equipment. Maintainability results showed that the proportion of the MRI equipment not fully utilized due to maintenance-related problems was 2.58%. In order to improve the availability of MRI equipment, the maintenance time of MRI equipment should be shortened.@*CONCLUSIONS@#RAM-based analysis of MRI equipment can help hospital equipment managers to carry out the work of operation optimization, maintenance strategy formulation and safety management of MRI equipment.

Large-scale Hospital Material Supply Chain Practice under Closed-loop Management / 中国医疗器械杂志

In the context of public health emergencies, a Hospital used the existing SPD supply chain model as a basis, research and practice proceeded simultaneously and formed a set of "three-group three-port" emergency plan by itself. The program played a positive role and effectiveness in this emergency incident, assisting the hospital to obtain a valuable experience in closed-loop management of emergency supplies. This article elaborated on how the hospital can supply materials in case of emergency medical supplies shortage after emergencies by focusing on the three groups of closed-loop working group, inventory management group, and material procurement group, and the three ports of material storage port, logistics receiving and dispatching port, and closed-loop releasing port. In the case of emergency medical supplies being in short supply after emergencies, how can hospitals ensure adequate and balanced supply of supplies; barrier-free demand information; command and dispatch without chaos and reasonable deployment; materials receiving and dispatching are efficient and distributed in an orderly manner.

Research on the Construction of Hospital Equipment Management Information Platform / 中国医疗器械杂志

With the deepening of China's medical reform, the scale of hospital equipment assets at all levels is also expanding. In the face of large-scale and various equipment assets, the traditional single machine statistical management method not only has a single interface, poor data accuracy and is not compatible with other systems, but also is difficult to achieve "full life cycle" management. In order to solve above problems, the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University of Medicine aims to use the Internet of Things to build a medical equipment management information platform, realize the whole hospital area, whole subject and whole process management of medical materials, and achieve the objectives of business linkage, information connectivity and data sharing between management departments and clinical departments.

Propuesta de sistema innovador de comunicación digital utilizando IoT para equipo biomédico de monitoreo de pacientes: de interés sector salud pública / Innovative digital communication system proposal using IoT in biomedical equipment for patient monitoring: interest in public health sector

La presente propuesta de diseño busca la interoperabilidad de datos en salud por medio de la integración de un sistema de comunicación a equipos especializados, utilizando las TI (Tecnologías de la Información) y el IoT (Internet de las Cosas) en los equipos biomédicos especializados o monitor que está siendo utilizado actualmente en los centros hospitalarios público a nivel nacional para la medición de signos vitales, con el objetivo de poder brindar una atención sanitaria a pacientes con padecimientos médicos y que necesitan de una constante supervisión y vigilancia. En los centros hospitalarios se cuenta con equipo biomédico especializado que carece de dichas funcionalidades. Esto repercute u obliga al responsable especialista a tener que estar frente al monitor y paciente para poder observar las mediciones o lecturas que presenta un paciente.

This design proposal seeks the interoperability of health data through the integration of a communication system to specialized equipment, using IT (Information Technology) and IoT (Internet of Things) in specialized biomedical equipment or monitor that is currently being used in public hospitals nationwide for the measurement of vital signs, in order to provide health care to patients with medical conditions and who need constant surveillance. Hospitals have specialized biomedical equipment that lacks these functionalities. This forces the responsible specialist to have to be in front of the monitor and the patient to be able to observe the measurements or readings that a patient presents.

Elementos de protección y nivel de contagio de Covid 19 en el personal sanitario que labora en un hospital ecuatoriano / Elements of protection and level of Covid 19 in the sanitary personnel working in an Ecuadorian hospital

INTRODUCCIÓN: el COVID-19 es una afección ocasionada por el SARS COV2 que ha tenido grandes repercusiones en la salud de la población a nivel mundial, principalmente en la población vulnerable, entre los cuales se encuentra el personal de salud, ya que están en la primera línea de atención en las unidades de salud, es por ello que se ven en la necesidad del uso del equipo de protección personal para disminuir el nivel de riesgo de contagio. OBJETIVO: identificar los elementos de protección y el nivel de contagio de COVID-19 en el personal de Salud que labor en los Hospitales Ecuatorianos. MATERIAL Y MÉTODOS: el actual estudio es de alcance descriptivo, enfoque cuantitativo, en un periodo de tiempo determinado, con una muestra del estudio de 218 trabajadores entre médicos, enfermeros y auxiliares a los cuales se les aplico la encuesta virtual. RESULTADOS: el 95.9% recibió mascarilla N95,76.6 % overol, 87.2%zapatones, 86.2 % las gafas, 91.7 % gorro, 93,1% guantes y 56,9% protector facial, el 96.3 % menciona que ha recibido capacitación sobre el uso de Equipo de Protección Personal (EPP) por parte de la institución, el 76.6 %del personal refieren haber presentado signos y síntomas de COVID-19, el 63.1 % de los resultados de prueba rápida fue positivos y la prueba de hisopado nasofaríngeo el 32,7 % tuvieron un resultaron positivo y 45,7% aún se encuentran en espera de los resultados. CONCLUSIONES: los elementos de protección que recibieron por parte de la Institución, en la pandemia de COVID-19 fueron: mascarilla N95, overol, zapatones, gafas, protector facial, gorro y guantes para la atención de los pacientes en el área hospitalaria, además de obtener capacitaciones acerca del uso correcto del EPP. Sin embargo, el nivel de contagio es elevado según las pruebas positivas rápidas e hisopado nasofaríngeo.

INTRODUCTION: COVID-19 is a condition caused by SARS COV2 that has had great repercussions on the health of the population worldwide, mainly on the vulnerable population, among which are health personnel, since they are on the front line. Care in health units, that is why they are in need of the use of personal protective equipment to reduce the level of risk of infection. OBJECTIVE: to identify the protection elements and the level of contagion of COVID-19 in the Health personnel who work at the Ecuadorians Hospitals. MATERIAL AND METHODS: the current study is descriptive in scope, quantitative approach, in a given period of time, with a sample of the study of 218 workers including doctors, nurses and assistants to whom the virtual survey was applied. RESULTS: 95.9% received N95 mask, 76.6% overalls, 87.2% sneakers, 86.2% glasses, 91.7% hat, 93.1% gloves and 56.9% face protector, 96.3% mention that they have received training on the use of Personal Protective Equipment (PPE) by the institution, 76.6% of the staff report having presented signs and symptoms of COVID-19, 63.1% of the rapid test results were positive and the nasopharyngeal swab test was 32, 7% had a positive result and 45.7% are still awaiting the results. CONCLUSIONS: the protection elements received by the Institution in the COVID-19 pandemic were: N95 mask, overalls, shoes, glasses, face shield, hat and gloves for patient care in the hospital area, in addition to obtain training on the correct use o PPE. However, the level of infection is high according to rapid positive tests and nasopharyngeal swab.

Recomendaciones ante el COVID-19 para la práctica de otología y audiología / Recomendations for the practice of otology and audiology during COVID-19

Hasta el momento, no se conoce con certeza si el virus SARS-CoV-2 se encuentra en la mucosa que recubre la trompa de Eustaquio, el oído medio o la mastoides, aunque es bastante probable que sí lo esté, dada la relación de vecindad anatómica y fisiológica que existe con la mucosa de la naso y orofaringe, ubicaciones en las que claramente se ha documentado alta carga viral. Actualmente, se encuentra en construcción científica la definición de los aspectos relacionados con la seguridad en la práctica integral otológica en el contexto de la pandemia de la enfermedad por coronavirus 2019 (COVID-19). Este documento pretende recopilar el conocimiento y las experiencias nacionales e internacionales relacionados con la pandemia, para ser aplicados en el día a día en la práctica médica como especialistas. Es pertinente aclarar que el contenido de estos lineamientos deberá ser actualizado a medida que se conozca nueva información o evidencia, puesto que esta se encuentra en constante y rápida evolución.

Until now, it is not known with certainty if the SARS-CoV-2 virus is found in the mucosa that covers the Eustachian tube, the middle ear and the mastoid, but it is quite probable that it is, given the relationship that exists with the mucosa of the nasopharynx and oropharynx, anatomical sites where a high viral load has clearly been documented. The definition of safety-related aspects for the otological practice is currently under construction in the context of the 2019 coronavirus disease pandemic (COVID-19). This document aims to gather the national and international knowledge and experiences related in order to be applied in the day to day of our medical practice as specialists. It is important to mention that the content of these guidelines should be updated as new information or evidence becomes known since it is constantly changing.

Escalas para prevenção de lesão por pressão em unidades de terapia intensiva: revisão integrativa / Pressure injury prevention scales in intensive care units: an integrative review

Objetivo: descrever os elementos constitutivos do cuidado de enfermagem presentes nas escalas de avaliação do risco de lesão por pressão usadas em unidades de terapia intensiva. Métodos: trata-se de uma revisão integrativa da literatura a partir do LILACS, MEDLINE, SCIELO e BDENF. Os descritores utilizados para a busca foram Pressure Ulcer; Decubitus Ulcer; Prevention and Control; Prevention; Intensive Care Units. A amostra final foi constituída por 13 artigos científicos. Resultados: a escala mais utilizada entre os estudos analisados foi Braden. Os elementos constitutivos evidenciados foram avaliação estruturada do risco, avaliação da pele e tecidos, cuidados preventivos com a pele, nutrição, reposicionamento no leito, superfícies de apoio e cuidados com dispositivos médicos. Conclusão: a prevenção de lesões relacionadas às incontinências, avaliação nutricional, intervenções nutricionais com o objetivo de prevenir lesões e os cuidados relacionados a dispositivos médicos são elementos constitutivos do cuidado de enfermagem pouco explorados ou ausentes nas escalas avaliadas

Objective: to describe the constituent elements of nursing care present in the pressure injury risk assessment scales used in intensive care units. Methods: this is an integrative literature review based on LILACS, MEDLINE, SCIELO and BDENF. The descriptors used for the search were Pressure Ulcer; Decubitus Ulcer; Prevention and control; Preven-tion; Intensive Care Units. The final sample consisted of 13 scientific articles. Results: the Braden scale was the most used scale among the analyzed studies. The constituent ele-ments highlighted were structured risk assessment, skin and tissue assessment, preventive skin care, nutrition, re-positioning in bed, support surfaces, and care with medical device. Conclusion: the prevention of incontinence-related injuries, nutritional assessment, nutritional interventions aimed at preventing injuries and care with medical devices are constituent elements of nursing care still poorly explo-red or absent in the evaluated scales

Reliability Analysis of Magnetic Resonance Imaging Equipment Based on Non-homogeneous Poisson Process / 中国医疗器械杂志

In order to evaluate the quality of different brands of magnetic resonance imaging system, optimize the quality of equipment repair and maintenance, and ensure the quality and safety of the equipment in clinical use. Meanwhile build the reliability evaluation model of magnetic resonance imaging equipment based on the large failure data collected by magnetic resonance repair system. In this paper, using the fault data of a certain brand of magnetic resonance in the past two years, applying the statistical judgment criterion, selecting the appropriate statistical distribution model, and finally fitting the equipment reliability evaluation model based on the non-homogeneous Poisson process, and then obtaining the magnetic resonance imaging equipment. Reliability evaluation indicators such as cumulative fault strength function, magnetic resonance imaging equipment fault density function, and mean time between failures. According to the calculated reliability index, on the one hand, it can evaluate the system reliability quality of a certain brand of magnetic resonance imaging equipment, and then evaluate the quality of different brands of magnetic resonance imaging equipment, on the other hand, it can help hospital equipment managers to carry out operational optimization, maintenance strategy development and safety management of magnetic resonance imaging equipment.

Medical Consumable Management System Research under the New Situation / 中国医疗器械杂志

With the continuous improvement of the difficulty of surgery, we need to investigate and analyze the current situation, to understand the structure and related attributes of medical consumables. Rely on the information construction of medical consumables; Improve the supervision method and further improve the refined management effect; Establish multi-modal procurement management; Improve management methods; Maximize the benefits of transformation structure and study the trace management of medical consumables in the key areas of the hospital's full life process at the same time. Provide data decision-making services for hospitals through the early warning management of medical consumables based on clinical quality management, and use tools such as HB-HTA to further construct a reasonable evaluation system for medical consumables.

Construction of Quality Control System for Medical Equipment under the Model of County Medical Service Community / 中国医疗器械杂志

The construction of county and district medical community is an important measure for high-quality medical resources to "double sink and improve". In this study, we have initially constructed a medical equipment quality control system for members of the regional medical community. The current situation of lack of professional medical equipment management personnel and quality control equipment in primary medical institutions has been alleviated, the quality control level of medical equipment in primary medical institutions has been improved, and a new management model for quality control of primary medical equipment has been explored.

Parte I. Requerimientos básicos de infectología para hospitales que atienden pacientes hemato-oncológicos: ambiente hospitalario, protocolos diagnósticos y arsenal terapéutico. Fundamentación / Basic requirements of facilities for hospitals that treat hemato-oncological patients: hospital environment, diagnostic protocols and therapeutic arsenal

Resumen La atención de pacientes con cáncer, incluyendo los receptores de trasplantes de precursores hematopoyéticos, plantea numerosos desafíos para los hospitales que deben proveer ambientes seguros, en que se logre aminorar al máximo posible la exposición a patógenos que generan morbilidad y mortalidad. Al mismo tiempo deben contar con protocolos establecidos que permitan realizar un estudio racional de las posibles etiologías infecciosas que pueden presentar estos pacientes. A su vez, deben asegurar la existencia de un arsenal terapéutico adecuado, junto a algoritmos de tratamiento oportuno, actualizado según guías consensuadas y efectivo según la infección sospechada o confirmada. En este artículo se introducen algunos de los argumentos que sustentan estos requerimientos que luego se desarrollan en tres artículos sucesivos dedicados al ambiente hospitalario, protocolos diagnósticos y arsenal terapéutico.

The care of cancer patients, including recipients of hematopoietic stem cell transplantation, has numerous challenges for hospitals that must provide safe environments in which exposure to pathogens that generate morbidity and mortality is reduced at maximum. At the same time, they must have established protocols that allow a rational study of the possible infectious etiologies and the existence of an adequate therapeutic arsenal together with timely treatment algorithms, updated according to consensus guidelines and effective according to the suspected or confirmed infection. This article introduces some of the arguments that support these requirements, then that are developed in three successive articles dedicated to the hospital environment, diagnostic protocols and therapeutic arsenal.

Parte II. Variables del ambiente hospitalario que inciden en el riesgo de infecciones de pacientes con cáncer y receptores de trasplante de precursores hematopoyéticos: Diseño, procesos asistenciales, calidad microbiológica del aire y agua / Hospital environment variables that affect the risk of infections of cancer patients and recipients of hematopoietic precursor transplants: Design, care processes, microbiological quality of air and water

Resumen El ambiente hospitalario es una fuente potencial de exposición a patógenos como bacterias, hongos y parásitos, que pueden provocar infecciones en pacientes con cáncer incluyendo receptores de trasplante de precursores hematopoyéticos. Para aminorar este riesgo, se deben tener en cuenta los elementos de diseño, construcción y emplazamiento del área de atención de pacientes. Se entregan recomendaciones para proveer ambientes seguros, incluyendo características y uso de ambiente protegido, la definición de procesos críticos, equipos clínicos destinados a la atención de pacientes, sugerencias de ámbitos a supervisar y aspectos relativos a la calidad microbiológica del aire y agua.

The hospital environment is a potential source of exposure to pathogens such as bacteria, fungi and parasites that can cause infections in patients with cancer including transplanted hematopoietic precursors. To mitigate this risk, the design, construction and location elements of the patient care area must be taken into account. Recommendations are given to provide safe environments, including aspects related to characteristics and use of a protected environment, the definition of critical processes, clinical teams dedicated to the care of patients, suggestions of areas to be monitored, the microbiological quality of air and water.

Molecular characteristics of methicillin-resistant Staphylococcus aureus isolates from hospital and community environments in northeastern Brazil

ABSTRACT This study characterized 30 MRSA isolates from intensive care unit (ICU) environment and equipment surfaces and healthy children. The SCCmec types I, IVa and V were detected in HA-MRSA isolates while CA-MRSA showed the SCCmec type IVa and V. Most isolates were classified as agr group II. All isolates presented the sei gene, and only HA-MRSA were positive for etb e tst genes. Three genotypes were related to Pediatric (ST5/SCCmecIV) and Berlin (ST45/SCCmecIV) clones. The present study showed molecular similarity between CA- and HA-MRSA isolates in hospital and community settings in a Brazilian region.

Pacotes molhados: o aumento do tempo de secagem aumenta o consumo de água (recurso natural escasso)? / Paquetes mojados: el aumento del tiempo de secado aumenta el consumo de agua (recurso natural escaso)? / Wet packs: Is extending drying time increasing water (scarce natural resource) consumption?

Resumo Objetivo: Este estudo tem como objetivo comparar o consumo de água e energia em quatro configurações do ciclo (número de pulsos na fase de condicionamento, tempo de secagem e valor de ajuste da profundidade do vácuo) para esterilização a vapor. Métodos: Estudo descritivo de quatro diferentes configurações de ciclo: na configuração A, os pulsos de vácuo da fase de condicionamento foram ajustados no total de três, com a profundidade de vácuo em 90 mbar e o ponto positivo de pressão em 1500 mbar. A fase de secagem foi ajustada em 45 minutos com a profundidade de vácuo em 90 mbar. Os consumos de água e energia foram medidos durante toda a fase de condicionamento e a cada 15 minutos durante a fase de secagem. Na configuração B, a profundidade de vácuo na fase de condicionamento foi de 150 mbar e os outros parâmetros foram idênticos aos da configuração A. Nas configurações C e D, o número de pulsos de vácuo foi ajustado no total de cinco, com o ponto positivo de pressão em 1500 mbar nas duas configurações e a profundidade de vácuo de 90 mbar e 150 mbar, respectivamente. Resultados: A água consumida durante a fase de secagem teve grande impacto sobre o consumo total de água durante todo o ciclo. Conclusão: Este estudo evidenciou que o aumento do tempo de secagem para solucionar pacotes molhados aumenta o consumo de água, um recurso natural escasso, que deve ser utilizado como última opção para obter pacotes secos ao fim do ciclo.

Resumen Objetivo: Este estudio tiene el objetivo de comparar el consumo de agua y energía en cuatro configuraciones del ciclo (número de pulsos en la fase de acondicionamiento, tiempo de secado y valor de ajuste de la profundidad del vacío) para esterilización a vapor. Métodos: Estudio descriptivo de cuatro diferentes configuraciones de ciclo: en la configuración A, los pulsos de vacío de la fase de acondicionamiento se ajustaron en el total de tres, con la profundidad de vacío en 90 mbar y el punto positivo de presión en 1500 mbar. La fase de secado se ajustó en 45 minutos con la profundidad de vacío en 90 mbar. Los consumos de agua y energía fueron medidos durante toda la fase de acondicionamiento y cada 15 minutos durante la fase de secado. En la configuración B, la profundidad de vacío en la fase de acondicionamiento fue de 150 mbar y los otros parámetros fueron idénticos a los de la configuración A. En las configuraciones C y D, el número de pulsos de vacío se ajustó en el total de cinco, con el punto positivo de presión en 1500 mbar en las dos configuraciones y la profundidad de vacío de 90 mbar y 150 mbar, respectivamente. Resultados: El agua consumida durante la fase de secado tuvo un gran impacto en el consumo total de agua durante todo el ciclo. Conclusión: Este estudio evidenció que el aumento del tiempo de secado para solucionar paquetes mojados aumenta el consumo de agua, un recurso natural escaso, que debe ser utilizado como última opción para obtener paquetes secos al final del ciclo.

Abstract Objective: This study aims to compare water and power consumption in four cycle configurations (number of pulses in the conditioning phase, drying time, and vacuum depth set point) for steam sterilization. Methods: A descriptive study of four different cycle configurations: In configuration A, conditioning phase vacuum pulses were set to a total of three, with a lower vacuum set point of 90 mbar and a higher pressure set point of 1500 mbar. The drying phase was set for 45 minutes with a vacuum level of 90 mbar. Water and power consumption were measured during the entire conditioning phase, and every 15 minutes during the drying phase. In configuration B the conditioning phase vacuum set point was adjusted to 150 mbar and the other parameters were identical to configuration A. On configurations C and D, the quantity of vacuum pulses was set to five, with higher pressure adjusted to 1500 mbar in both configurations. The lower vacuum set point was adjusted to 90 mbar in configuration C and to 150 mbar in configuration D. Results: Water consumption at the drying phase had the most impact on the total water consumption for the entire cycle. Conclusion: This study shows that increasing drying time to solve wet packs will increase water consumption, a scarce natural resource, and should be the last option to achieve dry loads at the end of the cycle.