The importance of environments and surfaces hygienization in pandemic times (Covid-19): a microbiological analysis in places for physical activity practice

The objective of this study was to analyse microbiological organisms in different locations and regions for physical activity in the city of João Pessoa, Brazil. Samples were collected on various objects used, such as: mattresses, drinking fountains, gloves, cell phones and others. The samples were collected in João Pessoa-PB, following the Standard Operating Procedure-SOP/ Microbiology of a specialized laboratory. The collection took place in the five macro-regions: North, South, East, West and Center. Foreach region samples were collected in one public place (square), a private one (gym) and one school (public or private), totaling fifteen collected sites and 450 samples. The following microorganisms were studied in all analyzed surfaces: Bacillus sp, Escherichia Coli, Klebsiella sppor Enterobacter sppand Coag. Neg. Staphylococcus.All regions had a high contamination level by some microorganism. The highest rates were found in the western, central and northern regions -96, 94 and 93% respectively. The Coag. Neg.Staphylococcus presented the highest and lowest incidence rates in the South and East regions, with 43.33 and 6.67%, respectively, as well as Klebsiella sppor Enterobacter spp, which presented high levels. It is concluded that there is a microorganisms' contamination in the most varied places and regions where physical activity practices are developed, with a predominance of Coag. Neg.Staphylococcusand Klebsiella sppor Enterobacter spp. These results lead to a warning about the hygiene importance in places for physical activity practice, especially in pandemic times (COVID-19), since almost all the evaluated surfaces were contaminated.

Klebsiella variicola and Klebsiella quasipneumoniae with capacity to adapt to clinical and plant settings / Klebsiella variicola y Klebsiella quasipneumoniae con capacidad para adaptarse al ambiente clínico y a las plantas

Abstract: Objective: To compare the genetic determinants involved in plant colonization or virulence in the reported genomes of K. variicola, K. quasipneumoniae and K. pneumoniae. Materials and methods: In silico comparisons and Jaccard analysis of genomic data were used. Fimbrial genes were detected by PCR. Biological assays were performed with plant and clinical isolates. Results: Plant colonization genes such as cellulases, catalases and hemagglutinins were mainly present in K. variicola genomes. Chromosomal β-lactamases were characteristic of this species and had been previously misclassified. K. variicola and K. pneumoniae isolates produced plant hormones. Conclusions: A mosaic distribution of different virulence- and plant-associated genes was found in K. variicola and in K. quasipneumoniae genomes. Some plant colonizing genes were found mainly in K. variicola genomes. The term plantanosis is proposed for plant-borne human infections.

Resumen: Objetivo: Comparar genes de colonización de plantas o de virulencia en los genomas reportados de K. variicola, K. quasipneumoniae y K. pneumoniae. Material y métodos: Se utilizaron análisis in silico y de Jaccard. Por PCR se detectaron genes de fimbrias. Se realizaron ensayos biológicos con aislados de plantas y clínicos. Resultados: Los genes de colonización de plantas como celulasas, catalasas y hemaglutininas se encontraron principalmente en genomas de K. variicola. Las β-lactamasas cromosómicas son características de la especie y en algunos casos estaban mal clasificadas. K. variicola y K. pneumoniae producen hormonas vegetales. Conclusiones: Se encontró una distribución en mosaico de los genes de asociación con plantas y de virulencia en K. variicola y K. quasipneumoniae. Principalmente en K. variicola se encontraron algunos genes involucrados en la colonización de plantas. Se propone el término plantanosis para las infecciones humanas de origen vegetal.

Virulence, resistance, and genetic relatedness of Escherichia coli and Klebsiella sp. isolated from mule foals / Virulência, resistência e relação genética de Escherichia coli e Klebsiella sp. isoladas de potros de muar

Respiratory diseases are common in young horses but little is known about such infections in mule foals. This study aimed to characterize Escherichia coli and Klebsiella sp. isolated from tracheal wash (TW) and fecal samples (FS) of mule foals, with or without cytological evidence of respiratory disease. Strains were analyzed against 13 antimicrobials, for presence of Extended spectrum beta-lactamase (ESBL), and virulence genes. Phylogrouping and Randomic (RAPD)-PCR profiles were used to evaluate their genetic relatedness. E. coli strains from TW and FS showed greatest resistance to tetracycline, while Klebsiella strains were mainly resistant to ampicillin; multidrug resistance and ESBL production were also detected. The blaCTX gene prevailed among the E. coli isolates, while the blaSHV gene was more frequently found in K. pneumoniae. The fimH gene was detected in most of the isolates and multiple virulence factors were identified in three E. coli isolates. Most of the E. coli isolates belonged to the B1 phylogroup, but B2 strains displayed more virulence genes. The RAPD assay revealed genetic diversity among strains and was able to distinguish FS isolates from TW isolates. Knowledge of the bacteria associated with the respiratory tract of mule foals is important in the treatment of sick animals.(AU)

Doenças respiratórias são comuns em potros de equinos, porém pouco se sabe sobre tais infecções em potros de muar. Este estudo buscou caracterizar Escherichia coli e Klebsiella sp. isolados de lavados traqueais (TW) e amostras fecais (FS) de potros de muar com e sem evidências citológicas de doença respiratória. As amostras bacterianas foram testadas contra 13 antimicrobianos, para a presença de genes de resistência estendida às betalactamases (ESBL) e de virulência. Filogrupagem e perfis de PCR randômicos (RAPD) foram usados para avaliar sua relação genética. As amostras de E. coli de TW e FS mostraram maior resistência à tetraciclina, enquanto as amostras de Klebsiella foram mais resistentes à ampicilina; multirresistência e produção de ESBL também foram detectadas. O gene blaCTX foi mais frequente entre E. coli, enquanto o gene blaSHV foi mais encontrado entre K. pneumoniae. O gene fimH foi detectado na maioria dos isolados de E. coli, enquanto múltiplos genes de virulência foram identificados em três isolados de E. coli. A maioria dos isolados de E. coli pertenceu ao filogrupo B1, porém somente isolados do filogrupo B2 apresentaram mais genes de virulência. Os ensaios de RAPD demonstraram a diversidade genética entre as amostras e distinguiram amostras TW e FS. O conhecimento de bactérias associadas a infecções de trato respiratório de potros de muar é importante no tratamento de animais doentes.(AU)

Improvement in medication adherence and self-management of diabetes with a clinical pharmacy program: a randomized controlled trial in patients with type 2 diabetes undergoing insulin therapy at a teaching hospital

OBJECTIVE: To evaluate the impact of a clinical pharmacy program on health outcomes in patients with type 2 diabetes undergoing insulin therapy at a teaching hospital in Brazil. METHOD: A randomized controlled trial with a 6-month follow-up period was performed in 70 adults, aged 45 years or older, with type 2 diabetes who were taking insulin and who had an HbA1c level ≥8%. Patients in the control group (CG) (n = 36) received standard care, patients in the intervention group (IG) (n = 34) received an individualized pharmacotherapeutic care plan and diabetes education. The primary outcome measure was change in HbA1c. Secondary outcomes included diabetes and medication knowledge, adherence to medication, insulin injection and home blood glucose monitoring techniques and diabetes-related quality of life. Outcomes were evaluated at baseline and 6 months using questionnaires. RESULTS: Diabetes knowledge, medication knowledge, adherence to medication and correct insulin injection and home blood glucose monitoring techniques significantly improved in the intervention group but remained unchanged in the control group. At the end of the study, mean HbA1c values in the control group remained unchanged but were significantly reduced in the intervention group. Diabetes-related quality of life significantly improved in the intervention group but worsened significantly in the control group. CONCLUSION: The program improved health outcomes and resulted in better glycemic control in patients with type 2 diabetes undergoing insulin therapy. .

Prevalence of two multidrug-resistant Klebsiella species in an Indian teaching hospital and adjoining community

The Gram-negative pathogenic bacteria Klebsiella oxytoca and Klebsiella pneumoniae produce the extended spectrum beta -lactamase [ESBL] and cephalosporinase enzymes and are the major causes of hospital acquired [HA] infections and epidemics in non-hygienic communities in the majority of developing countries. The prevalence of multidrug resistance among 445 strains of K. oxytoca and K. pneumoniae isolated from clinical samples of patients with gastrointestinal infections over a period of 42 months in the hospital was recorded, along with the sensitivity patterns to 23 antibiotics, including third-generation cephalosporin and fluoroquinolone antibiotics, using the disk-diffusion method. Of 175 K. oxytoca isolates, 143 were ESBL positive and 117 were fluoroquinolone resistant. Of 270 K. pneumoniaeisolates, 200 were ESBL positive and 195 were independently fluoroquinolone resistant. The HA samples yielded more isolates than the community acquired [CA] samples for each species. The K. oxytoca strains were resistant to cefepime, gatifloxacin, ciprofloxacin, ceftazidime, levofloxacin and imipenem, whereas the K. pneumoniae strains were highly resistant to ampicillin, norfloxacin, ciprofloxacin, gatifloxacin, ofloxacin, amoxyclav, ceftazidime, cefepime, cefixime, piperacillin and imipenem. The ESBL-producing and fluoroquinolone-resistant K. pneumoniae strains were more prevalent than the K. oxytoca strains in the HA/CA samples. The minimum inhibitory concentration values of the third-generation cephalosporins: cefotaxime and ceftazidime and the fluoroquinolones: ciprofloxacin and levofloxacin against both species of Klebsiella confirmed the resistance in the current/coveted treatment options. Patients with other bacterial infections had a relatively higher probability of infection with ESBL-producing and fluoroquinolone-resistant Klebsiella strains. The data presented here highlight the alarming state of Klebsiellainfection dynamics in the hospital and adjoining communities

Análise do tecido hepático de camundongos alimentados com dieta enteral contendo prebióticos e contaminadas com Klebsiella sp / Analysis of liver tissue of mice fed an enteral diet containing probiotics and infected with Klebsiella sp / Análisis del tejido del hígado de ratones alimentados con una dieta enteral que contiene probióticos e infectados con Klebsiella sp

Objetivo: Avaliou-se, neste trabalho, o efeito da administração de frutoligossacarídeo (FOS) e insulina, adicionados à dieta enteral, na translocação de Klebsiella sp. para o fígado de camundongos. Métodos: Camundongos albinos suiços, com quatro a seis semanas de vida divididos em três grupos. Os animais do grupo I (controle) receberam apenas dieta AIN93-G. No tratamento II, os animais receberam dieta enteral contendo FOS, insulina, antibiótico e corticóide. No tratamento III, os animais receberam antibiótico e corticóide, dieta enteral sem FOS e insulina. No quinto dia após o início de oferecimento das dietas, os animais dos tratamentos II e III foram alimentados com dieta enteral contaminada com, aproximadamente, 10 UFC/g de Klebisella pneumoniae. Dois animais de cada grupo foram eutanasiados 24h após o fornecimento da dieta contaminada. O fígado desses animais foi coletado assepticamente e mantido em solução fixadora para estudos histológicos. Resultados: Análises histológicas demonstraram características mais intensas de inflamação no fígado dos animais que foram imunodeprimidos com corticóide, alimentados com dieta enteral contaminada com K. pneumoniae e sem prebióticos, em relação aos animais imunodeprimidos que receberam dieta enteral com prebióticos contaminada com com K. pneumoniae. Conclusão: Dietas enterais contendo ingredientes prebióticos diminuíram o grau de lesões degenerativas no tecido hepático.

Objective: We evaluated in this study, the effect of a fructoligosaccharides (FOS) and insulin, added to the enteral diet on translocation of Klebsiella sp. to the liver of mice. Methods: Swiss albino mice, with four to six weeks of life divided into three groups. Animals in group I (control) received only diet AIN 93-G. In treatment II, animals received enteral diet containing FOS, insulin, antibiotics and steroids. In treatment III, animals given antibiotics and corticosteroids, enteral nutrition and FOS without insulin. On the fifth day after start offering the diets, the animals in treatments II and III were fed with enteral feeding contaminated with approximately 10 CFU/g Klebisella pneumoniae. Two animals from each group were euthanized 24 hours after the diet contaminated. The liver of these animals were collected aseptically and kept in fixative solution for histological studies. Results: Histological analysis showed features of more intense inflammation in the liver of animals that were immunosuppressed with corticosteroids, enteral feeding on contaminated with K. pneumoniae and without probiotics, for immunosuppressed animals that received enteral feeding with prebiotics-contaminated with K. pneumoniae. Conclusion: Enteral diets containing prebiotic ingredients decreased the degree of degenerative lesions in liver tissue.

Objetivo: Se evaluó en este estudio, el efecto de una fructoligosaccharides (FOS) y la insulina, sumado a la dieta enteral en la translocación de Klebsiella sp. para el hígado de ratones. Métodos: ratones albino suizo, con cuatro a seis semanas de vida dividido en tres grupos. Animales en el grupo I (control) recibió dieta sólo AIN 93-G. En el tratamiento II, los animales recibieron la dieta enteral que contiene FOS, insulina, antibióticos y esteroides. En el tratamiento III, los animales que recibieron antibióticos y corticosteroides, la nutrición enteral y FOS sin insulina. En el quinto día comenzará después de ofrecer las dietas, los animales en los tratamientos II y III fueron alimentados con la alimentación enteral contaminados con aproximadamente 10 UFC/g Klebisella pneumoniae. Dos animales de cada grupo se sacrificaron 24 horas después de la dieta contaminada. El hígado de estos animales fueron recogidos asépticamente y se mantienen en solución fijadora para estudios histológicos. Resultados: El análisis histológico demostró características de más intensa inflamación en el hígado de animales que fueron inmunodeprimidos con corticosteroides, la nutrición enteral en contaminadas con K. pneumoniae y sin probióticos, por inmunodeprimidos animales que recibieron alimentación enteral con prebióticos contaminados con K. pneumoniae. Conclusión: enteral con dietas que contenían ingredientes prebióticos redujo el grado de lesiones degenerativas en el tejido hepático.

Risk factors and microbiologic profile in catheter related urinary tract infection

To describe the consequences of uretheral catheterization in terms of the incidence of catheter related infection, duration of catheterization relation with UTI and changes in microbiologic pathogens. May 2006 to August 2006. Only 214 were included in final analysis, 28 were excluded from the study because these patients expired before the observable endpoint, these were critically ill. Adult patients in whom are indwelling foley's catheter was inserted with past 24 hours at the Emergency Room, Urology Wards, male and female surgical wards, medical wards, orthopedics wards, gynaecology wards, pediatrics wards, neurosurgery wards and ICU of Nishtar Hospital, Multan and Bakhtawar Amin Memorial Trust Hospital, Multan were included in the study. Out of 110 patients who acquired UTI, [83 single bacterial infection, 16 with pure candidal infection, 6 with double bacterial infection and 5 with both bacteria and yeast]. Majority of the isolated organisms were gram negative bacilli [66.9%]. E. coli being the most common [27] followed by Kiebsiella SP [26]. Other gram negative organisms isolated were acinetobactor SP [12], pseudomonas aeruginaosa [8], Enterobactor SP [6] and proteus Sp [2]. Ninteen [15.7%] were gram positive organisms, Enterococcus [9], coagulase negative staphococcus [7] and staphylococcus aureus [3]. Candida spieces were recovered in 17.4% of isolates. Fifty five percent of E. coli were isolated at 2 days post-catheterization while majority of the other organisms were isolated at more than 2 days after catheterization

Bacterial pathogens isolated from patients with bloodstream infections in Latin America, 1997: Frequency of occurrence and antimicrobial susceptibility patterns from the SENTRY antimicrobial surveillance program

We report the antimicrobial susceptibility of 736 organisms isolated from bloodstream infections in 10 Latin American medical centers during the first six months of 1997. The data presented here is from the SENTRY Antimicrobial Surveillance Program, a comprehensive surveillance study involving 72 medical centers worldwide. The isolates were tested for in vitro susceptibility to 35 antimicrobial agents by the broth microdilution method. The five most frequently isolated species were(n/percent): Staphylococcus aureus (165/22.4 percent), Escherichia coli (118/16.0 percent), coagulase-negative staphylococci (CoNS - 115/15.6 percent), Pseudomonas aeruginosa (51/6.9 percent), Klebsiella ssp. (46/6.3 percent). Susceptibility to oxacillin was 70.9 percent for S.aureus and only 33.9 percent for CoNS. Vancomycin was active against all of staphylococci, while teicoplanin was active against 99.4 percent of S.aureus and only 90.4 percent of CoNS. The new fluoroquinolones sparfloxacin, gatifloxacin, and trovafloxacin, and the streptogramin, quinupristin/dalfopristin, were very active against these species. Only one vancomycin-resistant enterococcus was detected; however, high-level aminoglycoside resistance rates were common (66.7 percent). E.coli and Klebsiella spp. showed low susceptibilities for cefotaxime (90.7 percent and 41.3 percent) and for cefoxitin (85.6 percent and 78.3 percent respectively), indicating a high frequency of isolates that produce ESBL and/or stably derepressed ampC enzymes. These strains, phenotypically consistent with extended-spectrum ß-lactamase (ESBL) production, were typed using ribotyping and pulsed-field gel electrophoresis. The most active compounds (MIC90 in µg/mL/ percent susceptibility) against P. aeruginosa were meropenem (2/94.1 percent), followed by amikacin (>32/86.3 percent), and piperacillin alone or with tazobactam (128/84.3 percent). Ceftazidime and cefepime showed similar activity (70.6 percent susceptibility) and levofloxacin was the most active fluoroquinolone (MIC50 menor do que 0.5; 76.5 percent susceptibility) against this gram-negative species. These results show the unique pattern of bloodstream isolates for Latin America and they demonstrate the present utility of several classes of compounds against emerging antimicrobial-resistant species in this region.

Abscesso piogênico do fígado / Pyogenic liver abscess

Os autores chamam a atenção para o abscesso hepático piogênico e a sua alta taxa de morbidade e mortalidade. Discutem os aspectos clínicos e os benefícios da antibioticoterapia. A introdução dos antibióticos e os avanços nas técnicas diagnósticas e bacteriológicas permitem diagnóstico precoce e sucesso terapêutico.

The authors call attention of the pyogenic liver abscess and your high morbidity and mortality rate. They discuss the features clinics of this entity and the benefits of antimicrobial therapy. The introdution of antibiotics and advances in bacteriology and diagnostiques techniques permit a diagnosis precocious and a success therapheutic.

prevalence of bacterial pathogens in throat infections and their susceptibility pattern

Throat swabs from 5083 cases of throat infection belonging to both sexes and all age groups were analysed by standard microbiological techniques. The isolates were identified by conventional methodology. The susceptibility to antimicrobials was determined by disc-diffusion technique [modified Kirby Bauer method]. Three hundred seventy eight cases [7.4%1 revealed significant growth of the pathogenic bacteria. Strep pyogenes was the commonest isolate 287 [75.9%] followed by Staph. aureus 39 [10.3%], Klebsiella spp 29 [7.7%]. Pseudomonas aeruginosa 11[2.9%] and H.influenzae [1.85%]. The miscellaneous group of organisms comprised 5 [1.3%]. Streptococcus pyogenes were 100% susceptible to penicillin, 96.2% to cephalexin, 93.7% to erythromycin and 50% to tetracycline. Ninety seven% of staphylococci were susceptible to cloxacillin, 72% to tetracycline, 67% to cotrimoxazole, 22% to erythromycin and 4% to penicillin. Out of the Klebsiellae 85% isolates were susceptible to cephalexin, 75% to tetracycline and 55% to cotrimoxazole. All pseudomonas were sensitive to amikacin and ciprofloxacin, 90% to aztreonam, 80% to tobramycin and 60% to gentamicin. H. influenzae were 100% sensitive to erythromycin, 83% to tetracycline, 66% to ampicillin, 50% to cephalexin and 28% to cotrimoxazole. It is concluded that only a limited number of cases reveal bacterial pathogen in throat infections

Comportamiento de la infección urinaria en la comuna de Curepto / Behavior of the urinary infection at Curepto community

Debido a la falta de un estudio bacteriológico sobre infecciones urinarias en la comuna de Cvuepto se analizan 191 muestras de orina positivas para dicha patología en el lapso de un año. Se analiza la distribución por sexo, el tipo de cepa más frecuente y la sensibilidad a los distintos medicamentos en uso actualmente en nuestro hospital para su tratainiento. Los resultados muestran que la mujer es afectada 4 veces más que el hombre, la bacteria más frecuente es la E. Coli, y los medicamentos de elección son la iútrofurantoina y la cefradina por vía oral y la gentamicina y la amikacina por vía parenteral

Biliary and pancreatic stent blockage by bacterial biofilm: presentation of two cases

Biliary and pancreatic stents are effective tools in the management of obstructive jaundice (both malignant and benign), pancreatic pseudocyst drainage, and as treatment for biliary and pancreatic fistulae. Unfortunately, stents may become blocked and require replacement in a number of patients. In the present study a blocked stent from a patient with transpapillary drainage of pancreatic pseudocyst and another from a patient with obstructive jaundice resulting from cancer of the head of the pancreas associated with Mirizzi syndrome were characterized by electron microscopy. Stent blockage was diagnosed by a pressure test and stent cultures were performed. Electron microscopy of the blocked stents revealed the sludge to consist of microcolonies of bacteria mixed with amorphous material, and cultures of both stents were positive for Klebsiella sp and E. coli.

Microbiological study of chronic blepharitis

One hundred forty cases of chronic blepharitis were studied, as well as 25 normal controls. They were all evaluated ophthalmologically, microbiologically and dermatologically. It was found that blepharitis can be classified, depending on the cause, into five main groups: seborrheic, ifective, mixed seborrheic-infective, meibomian and unclassified group, A significant role was found for external irritants, prolonged exposure to strong sun, unhygienic surroundings, insufficient sleep and ocular cosmetic. It was also found that bacteria and fungi have no primary role in the pathogenesis of chronic blepharitis

pattern of nosocomial infection: prospective study on a 200 bedded hospital

Nosocomial infection [NCI] was studied prospectively in a 200-bedded hospital, among 10918 total discharges. NCI prevalence rate [attack rate] was found to be 1.44% of the total discharges. According to departments, nursery showed the highest rate [4.66%], followed by ICU [2.32%]. Blood [septicemia] was the commonest site for NCI [43.67% of total NCI], followed by upper respiratory tract [13.39%]. Staphylococcus epidermidis took the upper hand in bacterial etiology of NCI [29.11% of total NCI], followed by Klebsiella [17.72%]. Antibiogram was also studied for the causatives. Policies and procedures for control of infections in hospital were reformulated and stressed in accordance

Vigilancia de la evolución de 6030 heridas quirúrgicas / Vigilance of the evolution of 6030 surgical wounds

Las infecciones de las heridas quirúrgicas representan una complicación que en algunos casos se asocia a muerte, por lo que el control de las mismas debe ser tarea cotidiana en los servicios de cirugía general. El sistema de vigilancia de heridas parece ser un método efectivo para disminuir las infecciones postoperatorias. Por lo anterior en 1983 se implantó el sistema de vigilancia de heridas quirúrgicas, evaluando los resultados cuatro años después. El primer año de vigilancia sirvió de línea base para analizar el conportamiento de la frecuencia de infecciones. Las heridas se catalogaron en cuatro grupos: I. herida limpia; II. herida limpia-contaminada; III. herida contaminada; IV. herida sucia. La frecuencia de infecciones durante el primer año del estudio fue de 6.3, y en el cuarto año de 4.7 por ciento. El tratamiento de las infecciones de cada grupo dio resultados satisfactorios en los grupos II, III, y IV, en que la reducción fue estadísticamente significativa; en el grupo I ayudó a mantener la frecuencia en cifras aceptables. Se recomienda la vigilancia de las heridas como método útil para el control de las infecciones