Potential virulence of Klebsiella sp. isolates from enteral diets

We aimed to evaluate the potential virulence of Klebsiellaisolates from enteral diets in hospitals, to support nosocomial infection control measures, especially among critical-care patients. Phenotypic determination of virulence factors, such as capsular expression on the external membrane, production of aerobactin siderophore, synthesis of capsular polysaccharide, hemolytic and phospholipase activity, and resistance to antibiotics, which are used therapeutically, were investigated in strains ofKlebsiella pneumoniae and K. oxytoca. Modular industrialized enteral diets (30 samples) as used in two public hospitals were analyzed, and Klebsiella isolates were obtained from six (20%) of them. The hypermucoviscous phenotype was observed in one of the K. pneumoniae isolates (6.7%). Capsular serotypes K1 to K6 were present, namely K5 and K4. Under the conditions of this study, no aerobactin production, hemolytic activity or lecithinase activity was observed in the isolates. All isolates were resistant to amoxicillin and ampicillin and sensitive to cefetamet, imipenem, chloramphenicol, gentamicin and sulfamethoxazole-trimethoprim. Most K. pneumoniae isolates (6/7, 85.7%) from hospital B presented with a higher frequency of resistance to the antibiotics tested in this study, and multiple resistance to at least four antibiotics (3/8; 37.5%) compared with isolates from Hospital A. The variations observed in the antibiotic resistance profiles allowed us to classify theKlebsiella isolates as eight antibiotypes. No production of broad-spectrum β-lactamases was observed among the isolates. Our data favor the hypothesis that Klebsiella isolates from enteral diets are potential pathogens for nosocomial infections.

Avaliação microbiológica de dietas enterais manipuladas em um hospital / Microbiologic evaluation of enteral diets done in hospital

OBJETIVO: Avaliar a qualidade microbiológica de dietas enterais em sistema aberto manipuladas em um hospital especializado em oncologia na cidade de Natal-RN. MÉTODOS: Foram analisadas 20 amostras de dietas enterais industrializadas em sistema aberto. Os microrganismos pesquisados foram: Bacillus cereus, coliformes totais, Escherichia coli, Salmonella sp, Clostridium sulfito redutor, bactérias mesófilas aeróbias e Staphylococcus coagulase positiva. A metodologia empregada para realização das análises microbiológicas foi a preconizada pelo Food and Drug Administration - FDA. RESULTADOS: Foi evidenciada a contaminação por coliformes totais, Escherichia coli e bactérias mesófilas aeróbias em 25 por cento, 10 por cento e 20 por cento das amostras analisadas, respectivamente. Não foi identificada a presença de Bacillus cereus, Salmonella sp, Clostridium sulfito redutor, e Staphylococcus coagulase positiva em nenhuma das amostras analisadas. Conclusão: Os resultados obtidos mostram que as dietas enterais encontram-se em condições higiênico-sanitárias insatisfatórias, evidenciando a necessidade de um maior controle na manipulação das mesmas.

Calidad microbiológica de una fórmula enteral lista para usar / Microbiological quality of an enteral formula ready to use

El objetivo de este estudio fue determinar y comparar en dos periodos de tiempo la calidad microbiológica de una fórmula enteral (FE) lista para usar: ADN lÝquido½. En central de FE, se recolectaron 40 muestras, de 50 ml cada una, al tiempo 0 y 24 horas, a temperatura ambiente, y se realizaron los siguientes estudios en el laboratorio de microbiologÝa del CESMEC: Recuento de bacterias mesófilas (Me), coliformes totales (CT) y coliformes fecales (CF). Los estßndares de calidad microbiológica (ECM) utilizados al tiempo 0 fueron < 102 ufc/ml de Me y, ausencia de CT y CF; y a las 24 horas < 103 ufc/ml de Me; < 10 ufc/ml de CT y ausencia de CF. El anßlisis estadÝstico se realizó en programa Stata. Los resultados fueron analizados mediante prueba Z para proporciones. Se consideró significativo un nivel p < 0,05. Los porcentajes de cumplimiento de ECM al tiempo 0 fueron: 100 por ciento para Me, CT y CF y a las 24 horas: 95 por ciento para Me y 100 por ciento para CT y CF (p = 0,3). Se concluye que las FE de ADN lÝquido½ pueden estar colgadas hasta por 24 horas a temperatura ambiente.

Microbiological contamination of enteral feeding solutions used in Costa Rican hospitals

Enteral feeding is the most common and preferred modality for providing nutritional support to hospital patients with a functional gastrointestinal tract that can not satisfy their nutritional requirements. Nevertheless, enteral feeding may be an important cause of bacterial infection. The aim of this study was to evaluate the microbial contamination level of enteral feedings distributed in Costa Rican hospitals. A total of 124 samples of enteral feeding, coming from five different hospitals from San José, Costa Rica, were evaluated during the second semester of 1997 and first of 1998 for the presence and identification of total and fecal coliforms, Pseudomonas sp. and Listeria sp. A subpopulation of the Pseudomonas isolated was analyzed for their antibiotic susceptibility patterns. The concentration of Gram negative rods in the samples of enteral feeding solutions ranged from 10(3) to 10(7) CFU/mL, markedly exceeding the permissible level (10(2) CFU/mL or less). The coliforms most frequently isolated included Enterobacter cloacae, Escherichia coil, Serratia sp. and Klebsiella pneumoniae. Pseudomonas sp. was isolated in more than 70 per cent of the samples made from commercial based solutions, fruits and vegetables. P. aeruginosa and P. fluorescens were the species most frequently isolated. Listeria sp. was not isolated from enteral solutions samples. The results obtained demonstrate that it is urgent to assure strict hygiene during the preparation and handling of all enteral feed in order to avoid bacterial growth. The implementation of HACCP (Hazard Analysis and Critical Control Points) system will be required in a near future for better quality control of enteral nutrition mixtures.

Produtos de confeitaria salgados: avaliaçäo microbiológica e físico-química / Candy shop salt products: microbiology and physical-chemistry evaluation

Avaliou-se as características físico-químicas e microbiológicas de 208 amostras de produtos de confeitaria salgados, comercializados no Estado de Säo Paulo e colhidos pela vigilância sanitária nos anos de 1993 e 1994. Daquele total, quatorze (6,73 por cento) amostras estavam em desacordo com a legislaçäo vigente, sendo que quatro foram consideradas como produtos potencialmente capazes de causar enfermidades transmitidas por alimentos e 10 apresentaram condiçöes higiênico-sanitárias insatisfatórias. Em três dessas amostras, houve também condenaçäo pelo cheiro alterado, concluindo-se pela sua impropriedade ao consumo