Microbiological surveillance of flexible bronchoscopes after a high-level disinfection with peracetic acid: preliminary results from an Italian teaching hospital.

BACKGROUND: Flexible bronchoscopes are heat labile, complex and difficult to clean, and some nosocomial outbreaks related to bronchoscopy have been reported in literature. The aim of our study was to determine, through a systematic monitoring, whether bronchoscopes' cleaning and disinfection procedures have been correctly adopted by health operators. METHODS: We conducted a 19 months-long prospective study in the Unit of Pulmonology at Careggi Teaching Hospital (Florence, Italy), analyzing endoscopes that were reprocessed through a high-level disinfection procedure. Samples collection was performed weekly by two trained operators. Results were organized in a database and then exported for descriptive and inferential statistical analysis. RESULTS: From February 2016 to September 2017 we collected 218 samples from bronchoscopes' valves (N=109) and from their inner channels (N=109). Staphylococci were found in 34 samples (15.69% of all samples). Pseudomonas was found in 11 samples (5.04% of all samples). Pseudomonas aeruginosa wasn't found in any sample. CONCLUSIONS: Our results came out to be better than similar studies in literature and demonstrated that a correct endoscopes' hygiene should be part of a more complex strategy of surveillance and control of healthcare-associated infections. However, a continuous monitoring of endoscopes could provide a wider view about this problem, and more reliable results.

Mycotic and aflatoxin contamination in Myristica fragrans seeds (nutmeg) and Capsicum annum (chilli), packaged in Italy and commercialized worldwide.

Aflatoxins are secondary metabolites of moulds known to be carcinogenic for humans, and therefore should not be ingested in high doses. This study aimed to determine the level of mould and aflatoxin contamination in dehydrated chilli and nutmeg imported from India and Indonesia, respectively, packaged in Italy, and commercialized worldwide. We tested 63 samples of chilli (22 sanitized through heat treatment and 41 not heat-treated) and 52 samples of nutmeg (22 heat-treated and 30 not heat-treated) for aflatoxin, moulds and moisture content. Heat-treated samples were less contaminated than untreated samples. Spices in powder form (both chilli and nutmeg) were more contaminated than whole ones. In untreated spices, we observed a positive correlation between mould and moisture content. Of the powdered nutmeg and chilli samples, 72.5% and 50% tested positive for aflatoxin contamination, with a range of 0-17.2 µg kg(-1) and 0-10.3 µg kg(-1), respectively. The steam treatment of spices would be useful in reducing the initial amount of moulds. Although the risk from the consumption of spices contaminated with aflatoxins is minimal, owing to the small amount used in food, preventive screening of the whole food chain is very important, especially because the most frequently identified toxin was B1, which is the most dangerous of the four toxins (B1, B2, G1, G2).

Prevalence and antibiotic resistance of Enterococcus spp. isolated from retail cheese, ready-to-eat salads, ham, and raw meat.

Food specimens were analyzed in order to research Enterococcus spp.: 636 samples of raw meat (227 beef, 238 poultry, and 171 pork), 278 samples of cheese (110 fresh soft cheese and 168 mozzarella cheese), 214 samples of ready-to-eat salads, and 187 samples of ham. 312 strains of Enterococcus spp samples were isolated, then identified and submitted to susceptibility tests against 11 antimicrobial agents. The predominant species were Enterococcus faecalis in raw meat and Enterococcus faecium in retail products. Low percentages of microorganisms were resistant to vancomycin (3.53%), teicoplanin (2.24%), linezolid (0.32%), and amoxicillin in combination with clavulanic acid (0.32%). A high percentage of resistance was noted in E. faecalis at high level gentamicin (21.9%) and tetracycline (60.6%). In general, strains of E. faecalis were more resistant than E. faecium. Enterococci should be considered not only potential pathogens, but also a reservoir of genes encoding antibiotic resistance which can be transferred to other microorganisms. Continuous monitoring of their incidence and emerging resistance is important in order to identify foods which potentially represent a real risk to the population, and to ensure effective treatment of human enterococcal infections.