La implementación de procedimientos estandarizados en la prevención de enfermedades transmitidas por los alimentos. Conteo microbiológico del Staphylococcus aureus en quesos frescos / Implementation of standardized procedures to prevent diseases transmitted by foodstuffs. Microbiological count of Staphylococcus aureus in freshcheese

Introducción: las enfermedades transmitidas por alimentos son una problemática mundial a la que la Organización Mundial de la Salud y los países brindan una atención especial. Dentro de los grupos de alto riesgo se encuentran los productos de origen animal, como la leche y sus derivados. Staphylococcus aureus es un microorganismo causante de brotes de las enfermedades transmitidas por alimentos, lo que genera la necesidad de estudiar la carga microbiana y establecer los controles adecuados. Objetivo: evaluar la calidad microbiológica en el proceso manufacturero en el área de producción de la Cooperativa de Producción Agropecuaria Chone LTDA, con el fin de asegurar la ausencia del Staphylococcus aureus en el queso fresco 100% chonero. Materiales y métodos: Se realizó un estudio de evaluación de la calidad en cuatro fases. Se realizaron exámenes microbiológicos iniciales, se identificaron las causas esenciales de contaminación identificadas por observación directa, revisión de documentos y entrevistas, como base para la elaboración e implementación de POE (Procedimientos Operativos Estandarizados) y POES (Procedimientos Operativos Estandarizados de Saneamiento). Se cumplieron los requerimientos éticos y se realizaron los análisis estadísticos utilizando porcentaje e índices como medida resumen y con el uso de IBM SPSS, versión libre, realizándose regresión logística binaria para determinar la probabilidad de éxito al aplicar dichos procedimientos. Resultados: los análisis microbiológicos iniciales (antes de implementación de POE y POES), dieron como resultado: 98, 116, 79, 120 y 13 UFC/g para las muestras: DiQ1, DiQ2, DiQ3, DiQ4 y DiQ5, respectivamente. Las causas esenciales de contaminación fueron falta de control microbiológico, falta de control del aspecto del personal y falta de control del agua) Una vez implementados los POE y POES, el análisis mostró ausencia en todas las muestras analizadas. Conclusiones: se concluye que la aplicación de POE y POES tiene un efecto significativo sobre la ausencia del Staphylococcus aureus, con probabilidad de éxito del 100% (AU).

Introduction: Diseases transmitted by foodstuffs (DTF) are a worldwide problem that receives special attention by WHO and different countries. High risk groups include foodstuff of animal origin, like milk and its by-products. Staphylococcus aureus is a microorganism responsible for DTF outbreaks which generates the necessity of studying its microbial burden and establishing the adequate controls. Objective: to evaluate the microbiological quality of the manufacturing process in the production area of the Farming and Stockbreeding Cooperative Chone LTDA, to assure the absence of Staphylococcus aureus in the manufacturing process of fresh cheese. Materials and methods: A study to assess the quality in four stages was carried out: initial microbiological tests, identification of the essential contamination causes by direct observation, documental review and inquires. They were used to elaborate and implement the Standardized Operational Procedures (SOP) and the Standardized Operational Procedures of Sanitation (SOPS). The ethical requirements were fulfilled and the statistical tests were performed using percentages and indexes as summary measures through IBM SPSS, free version; binary logistic regression was made to determine the success when applying those procedures. Results: initial microbiological controls (before implementing SOP and SOPS) gave these results 98, 116, 79, 120, and 13 UFC/g for samples DiQ1, DiQ2, DiQ3, DiQ4 and DiQ5 respectively. The main contamination causes were lack of microbiological control, lack of control on the staff's cleanliness and lack of control on the water. After implementing SOP and SOPS microbiological control found particularly clean samples. Conclusions: SOP and SOPS have a significant effect on the amount of Staphylococcus aureus, with 100% success probability (AU).

Por que a ingestão de carambola é proibida para pacientes com doença renal crônica? / Why eating star fruit is prohibited for patients with chronic kidney disease?

Resumo Novos estudos têm mostrado o mecanismo pelo qual a carambola (Averrhoa carambola) torna-se tóxica para indivíduos com doença renal crônica (DRC). O objetivo deste trabalho foi revisar a literatura atual sobre o tema. Trata-se de artigo de revisão, com publicações de 2000 a 2014 disponíveis em bases de dados científicas. Há relatos de que a neurotoxicidade ocorre devido à presença de oxalato na carambola; porém, achados recentes mostram que o efeito neurotóxico se dá pela toxina caramboxina, que parece inibir o sistema GABAérgico, que é o principal sistema inibitório do sistema nervoso central (SNC), envolvendo alterações como soluços e confusão mental, até quadros mais sérios como convulsões e morte. É importante a ação multiprofissional para alertar os pacientes com DRC quanto à proibição do consumo da carambola.

Abstract New studies have shown the mechanism by which the star fruit (Averrhoa carambola) becomes toxic to individuals with chronic kidney disease (CKD). The aim of this study was to review the current literature on the topic. This is a review article, with publications from 2000 to 2014 available in scientific database. There are reports that neurotoxicity is due to the presence of oxalate in star fruit, but recent findings show that the neurotoxic effect of the toxin is by caramboxin, which appears to inhibit the GABAergic system which is the major inhibitory system in the central nervous system (CNS), involving changes as sobs and confusion, to more serious conditions such as seizures and death. It is important to multidisciplinary action to alert patients with CKD as the prohibition of the star fruit consumption.

Reducción de flora contaminante en alimentos mediante tratamiento con microondas / Flora of reduction in food contamination by treatment with microwave

La contaminación bacteriana de alimentos que se consumen en la calle servidas por expendedores ambulantes constituye una alternativa alimentaria para los trabajadores y estudiantes, pero a la vez es fuente de enfermedades trasmitidas por alimentos a los consumidores, para el estudio de la acción de hornos microondas sobre la contaminación de alimentos se tomaron setenta y siete (77) muestras de alimentos de la ciudad de Trujillo-Venezuela, colectadas en expendios (21 perros calientes, 32 empanadas y 24 arepas), tomadas en condiciones de asepsia se trasladaron en cadena de frío hasta el laboratorio para su estudio. De cada muestra se separaron dos partes, una para irradiarla con microondas durante un minuto para luego someterla al estudio bacteriológico y otra control sin el citado tratamiento. Se confirmó contaminación fecal en el 60% de las muestras examinadas, la exposición a microondas durante un minuto redujo en un 85,4% las cargas de bacterias coliformes. Los resultados demuestran la destrucción de bacterias en un 90% de perros calientes, 40% en empanadas y 66,6% de arepas que resultaron positivas. La acción del microondas sobre los alimentos resultó ser una técnica efectiva para reducir las cargas de bacterias contaminantes.

Food that is served by mobile stall and consumed on the street is a nutritional alternative for workers and students but, sometimes, the bacterial contamination of this “fast food” can be a diseasis transmitted by food to consumer. In this study of the effect of microwave ovens on the contamination of food, seventy-seven examples of “fast food” were collected from mobile stalls (twenty-one hot-dogs, thirty-two empanadas and twenty-for arepas). The sample were taken in aseptic conditions and transferred to the laboratory in cold storage. Each sample was divided into two parts. One part was irradiated with microwaves for one minute and the subjected to a bacteriological analysis. The other was not subjected to the radiation treatment. Fecal contamination was confirmed in 60% of the samples examined; the one minute exposure to microwaves reduced the levels of bacterial coliforms by 85.4%. The results revealed the destruction of bacteria in 90% of the hot-dogs, in 40% of the empanadas and in 66.6% of de arepas that were diagno-sed as positive. The effect of microwaves proved to be an effective technique in reducing the levels of bacterial conta-minants in food-stuffs.

Brote por staphylococcus aureus en una guardería infantil en Choluteca, Honduras / Staphylococcus aureus outbreak at a nursery in Choluteca, Honduras

Antecedentes. Aunque con poca frecuencia se investiga en Honduras, la intoxicación aguda por alimentos es relativamente común. El primero de febrero del 2008 el Hospital del Sur en Choluteca informó a la Unidad de Epidemiología de la Región Sanitaria la atención de personas con cuadro gastrointestinal luego de ingerir alimentos en una guardería. Objetivos. Determinar el agente causal, factores asociados, mecanismos de transmisión y las medidas de control y prevención de un brote de enfermedad gastroentérica en una guardería infantil. Pacientes y métodos: Se efectuó un estudio descriptivo, estudio de casos, caso definido como persona que durante la mañana del primero de febrero comió en guardería y presentó uno de los siguientes síntomas: dolor abdominal, nauseas, vómitos y diarrea. Se realizó cultivo bacteriológico en muestras de alimentos y agua. Resultados: Se encontró afectación en 39 de 43 personas expuestas (tasa de ataque en guardería 90,6%). Se aisló Staphylococcus aureus en queso ahumado, frijoles, cuajada y mantequilla consumidos en la merienda de la mañana. No se pudo aislar la bacteria en los pacientes. Discusión: Se confirmó brote de intoxicación por alimentos que afectó principalmente a menores de 10 años. El medio de transmisión fueron los lácteos y el agente infeccioso el Staphylococcus aureus. Se recomienda aplicar el Reglamento Nacional para el Control Sanitario en la Producción y Comercialización de Productos Lácteos...

Acute neuromuscular manifestations in a patient associated with ingesting octopus (Octopus sp)

The authors report neuromuscular manifestations in a 45-year-old woman after consuming octopus meat (Octopus sp.). The patient presented malaise, paresthesias in perioral and extremity areas, intense muscular weakness and arterial hypotension, followed by severe itch and disseminated cutaneous rash. Gastrointestinal manifestations and fever were not observed, reducing the probability of alimentary poisoning. The presence of muscular and neurological symptoms suggests neurotoxin action, which could have been ingested by the victim from the octopus salivary glands or from an accumulation of toxins in the meat, or by an unknown mechanism. There is little known about toxins of the Octopus genus and this communication is important alert to the possibility of poisoning in humans that eat octopus and its differentiation from alimentary poisonings arising from incorrect conservation of seafood.

Os autores relatam um quadro manifestado por sintomas neurológicos e musculares em uma mulher de 45 anos, que surgiu após o consumo da carne de polvo comum (Octopus sp.). A paciente apresentou intenso mal estar, parestesias em extremidades e área perioral, fraqueza muscular intensa e hipotensão arterial, seguidos de prurido importante e uma erupção eritêmato-descamativa disseminada tardia. Não foram observadas manifestações gastrintestinais ou febre, o que reduziu a probabilidade de uma intoxicação alimentar por conservação inadequada do molusco. A presença de sintomas neuro-musculares é sugestiva de ação de neurotoxinas, comprovadamente existentes em muitos gêneros de polvos e que podem ter sido ingeridas através do consumo das glândulas salivares ou acúmulo das toxinas na carne, por algum mecanismo ainda desconhecido. As toxinas dos polvos do gênero Octopus são pouco estudadas e julgamos esta comunicação importante por alertar para a possibilidade do envenenamento nos seres humanos que consomem carne de polvos e ainda sua diferenciação das intoxicações alimentares que ocorrem por conservação inadequada do animal.

Complementary foods associated diarrhea.

The World Health Organization regards illness due to contaminated food as one of the most widespread health problems in the contemporary world. Food safety especially in the weaning groups is one of the major concerns that have posed a threat to health of the children. Millions of children in the world die each year from diarrheal diseases; hundreds of millions suffer from frequent episodes of diarrhea and consequent impairment of nutritional status. Contaminated foods play a major role in the occurrence of diarrheal diseases. Apart from food contamination, transmission of infection occurs by direct contact, highly favored by the habits and customs of the people. Improper storage and handling of cooked food is equally responsible for food-borne illnesses, as during storage especially at ambient temperature (28-38 degrees C) there is the risks of multiplication of pathogenic organisms increase. Food safety education is a critical prerequisite and is an essential element in control and prevention of diarrheal diseases. However, no preventive measures can ever be successful without the acute involvement of the caretakers, other family members and the community. To sensitize the community in a catalytic manner, health workers, community leaders and community volunteers can act as effective change agent, to bring about a behavior that can lead to improvement in their real life practices, thereby reducing the prevalence of diarrheal episodes in young children. Food Safety Education Programs that involve volunteers are cost effective as they can be reached to a maximum number of people through limited health personnels, and by this, the community can be made responsible for its own health problems.

Acute renal failure following consumption of raw fish gall-bladder from Manipur.

Three cases of acute renal failure following consumption of raw grass gall bladder are reported here from NE State, Manipur.

Pelagic paralysis from puffer fish poisoning.

A case of severe puffer fish poisoning was reported. After ingestion of puffer fish, symptoms develop rapidly with paralysis of the whole body, respiratory distress and nonreactive dilated pupils. After ventilatory support, the patient gradually recovered to normal activity within 48 hrs.

Diarreias hospitalares / Nosocomial diarrhea

Os autores revisam o assunto Diarreias Hospitalares e suas duas grandes causas: Clostridium difficile no adulto e rotavirus na crianca. Pesquisa da citotoxina do C. difficile por cultura quantitativa em tecido ainda e a principal maneira do diagnostico. Mais de 80 por cento dos pacientes estavam em uso de antibioticos por tempo prolongado, principalmente cefalosporinas de terceira geracao. De maneira geral, as coproculturas e os parasitologicos raramemte foram positivos e ajudaram no diagnostico das diarreias hospitalares. Salmonella permanece importante agente em surtos relacionados a ingestao de alimentos contaminados. A magnitude e a importancia da diarreia hospitalar esta apenas comecando a ser apreciada: no passado, diarreia era frequentemente despercebida ou mesmo considerada entre as infeccoes hospitalares. Diarreia nosocomial e um importante problema em si mesmo e pode predispor a outras infeccoes hospitalares, como as infeccoes do trato urinario. Welliver e McLaughlin, relataram que num hospital pediatrico...