ABSTRACT
The spread of coronavirus disease 2019 (COVID-19) has promoted the use of hand sanitizers among the general population as recommended by health authorities. Alcohols, which are used in many hand sanitizers, have been shown to promotes the formation of biofilms by certain bacteria and to increase bacterial resistance to disinfection. We investigated the effect of continued use of alcohol-based gel hand sanitizer on biofilm formation by the Staphylococcus epidermidis resident strain isolated from the hands of health science students. Hand microbes were counted before and after handwashing, and the ability to produce biofilms was investigated. We found that 179 (84.8%) strains of S. epidermidis isolated from hands had the ability to form biofilm (biofilm-positive strains) in an alcohol-free culture medium. Furthermore, the presence of alcohol in the culture medium induced biofilm formation in 13 (40.6%) of the biofilm-negative strains and increased biofilm production in 111 (76.6%) strains, which were classified as low-grade biofilm-producing. Based on our findings, there is no clear evidence that the continued use of alcohol-based gels results in the selection of strains with the capacity to form biofilms. However, other disinfectant formulations that are more commonly used in clinical settings, such as alcohol-based hand-rub solutions, should be tested for their long-term effects.
Subject(s)
COVID-19 , Hand Sanitizers , Staphylococcal Infections , Humans , Hand Disinfection , Staphylococcus epidermidis , Hand Sanitizers/pharmacology , Biofilms , Ethanol/pharmacology , Culture Media/pharmacology , Staphylococcal Infections/microbiologyABSTRACT
Travelers with preexisting diseases or chronic conditions may be more susceptible to travel-related health risks. They may, therefore, require more attention from specialist travel medicine providers. Our objective was to examine a group of international travelers in Malaga, Spain, quantify the proportion of travelers suffering from chronic conditions, and understand the characteristics of this group. A representative sample of travelers requesting pretravel medical advice at one travel clinic were asked about their preexisting chronic conditions and any immunosuppression. Additional demographic variables were used in an analysis of bivariate correlations. We used a binary logistic regression analysis to identify relationships between independent variables (age, gender, type of trip, travel duration, and destination) and the presence or absence of chronic conditions in travelers. Of the sample of 1,196 travelers, 258 (21.6%) reported having preexisting chronic conditions and 72 (6%) had two or more chronic conditions. Twenty-four of the travelers with chronic conditions (9%) were immunocompromised because of the disease or treatment. The two most common chronic conditions were cardiovascular disease and chronic respiratory conditions (36.8% and 17.1%, respectively). The chronic condition increased by 6.7% for every year of increased age. Travelers with chronic conditions are older, travel mainly to visit friends and relatives, and take shorter trips. More than half of travelers visiting (55.8%) needed more attention from the travel medicine practitioner because of their preexisting chronic conditions, age, or type of travel. Surveillance data based on the population of people traveling would be helpful to provide better advice to travelers.
Subject(s)
Chronic Disease , Internationality , Travel Medicine , Travel-Related Illness , Travel , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Prospective Studies , Spain , Young AdultABSTRACT
The success of Acinetobacter baumannii as an emerging organism is probably linked to its high resistance to adverse environmental conditions. This study was conducted to analyze the association between some factors that may favor the dissemination of A. baumannii clinical isolates. A total of 47 clinical strains of A. baumannii were evaluated to carbapenem, the ability to produce biofilm, the susceptibility to some antiseptics, and the survival time on cotton fabrics. Most of the isolates were resistant to carbapenem (72.3%), produced biofilm (83%), and survived more than 7 (51%) days on fabrics. A significant association between decreased susceptibility to antiseptics containing chlorhexidine or triclosan and carbapenem resistance and survival on fabrics could be observed. The resistance to carbapenem was significantly associated with survival on fabric, but not with the ability to form biofilm. The survival of the isolates on fabric was not associated with the ability to produce biofilms. Characteristics, such as resistance to antibiotics, ability to form biofilm, and survival on dry surfaces, probably contribute to the proliferation of this organism when selected in the hospital environment and can partly explain its success as responsible for nosocomial infection.
Subject(s)
Acinetobacter baumannii/drug effects , Anti-Infective Agents, Local/pharmacology , Carbapenems/pharmacology , Environmental Microbiology , Microbial Viability , beta-Lactam Resistance , Acinetobacter Infections/microbiology , Acinetobacter baumannii/isolation & purification , Biofilms/growth & development , Hospitals , Humans , SpainABSTRACT
The international maritime traffic of people and goods has often contributed to the spread of pathogens affecting public health. The Maritime Declaration of Health (MDH), according to the International Health Regulations (IHR) (2005), is a document containing data related to the state of health on board a ship during passage and on arrival at port. It is a useful tool for early detection of public health risks. The main objective of our study was to evaluate compliance with the model provided in the IHR, focusing on the format and degree of completion of MDH forms received at Spanish ports. We reviewed the content of 802 MDH forms submitted to nine Spanish ports between October 2014 and March 2015. Study results show that 22% of MDH forms presented did not comply with the recommended model and 39% were incomplete. The proportion of cargo ships with correct and complete MDH forms was lower than passenger ships; thus, the nine health questions were answered less frequently by cargo ships than passenger ships (63% vs 90%, p value <â¯0.001). The appropriate demand and usage of MDH forms by competent authorities should improve the quality of the document as a tool and improve risk assessment.
Subject(s)
Disease Outbreaks/prevention & control , Global Health , Population Surveillance/methods , Public Health/standards , Ships/standards , Travel , Humans , Public Health/legislation & jurisprudence , Risk Assessment , Spain , World Health OrganizationABSTRACT
We developed a fluorescent ß-d-glucuronidase activity (BGA)-based assay for detecting and quantifying Escherichia coli in samples to assess the biocide efficacy of hand antiseptics. The fluorescence level is proportional to the number of viable E. coli organisms present. We compared our assay results to those of the E. coli plate count method specified by the European standard for testing hygienic hand rub disinfectant products (EN1500). The plate count method requires excessive handling and materials and is not valid if the number of organisms per plate is too low or high for counting in many of the samples. We optimized the fluorescent assay based on the cleavage of 4-methylumbelliferyl-ß-d-glucuronide by adding 4-nitrophenyl-ß-d-glucuronide, a nonfluorogenic BGA substrate, to induce glucuronidase activity and reduce assay time. Furthermore, our method can be automated and eliminates the need for multiple dilutions. Fluorescence was temporally monitored, and the time required to reach a specific value of fluorescence was correlated with the initial number of viable E. coli organisms on the samples. There was a positive correlation (P < 0.05) with a high correlation coefficient (R(2) = 0.82) between the E. coli counts by plate count and fluorescence methods. Reported effects in fluorescent BGA were compared to the EN1500 plate count method with five hand disinfectants. We found our method more advantageous, because it was as sensitive as the EN1500 method, requires less time to complete, and is less expensive and less laborious than conventional plating techniques.
Subject(s)
Escherichia coli/drug effects , Fluorometry/methods , Glucuronidase/analysis , Hand Sanitizers/pharmacology , Colony Count, Microbial/methods , Escherichia coli/enzymology , Microbial Sensitivity Tests/methods , Sensitivity and Specificity , Time FactorsABSTRACT
Cholera is a substantial health burden in many countries in Africa and Asia, where it is endemic. It is as well responsible for ongoing epidemics in sub-Saharan Africa which are becoming greater in terms of frequency, extension, and duration. Given the availability of two oral cholera vaccines and the new data on their efficacy, field effectiveness, feasibility, and acceptance in cholera-affected populations and in travelers, these vaccines should be used in endemic areas, in travelers for these areas and should be considered in areas at risk for outbreaks. The two vaccines currently available in worldwide are: (1) The killed oral vaccine (Dukoral, licensed by SBL-Sweden to Crucell-Holland) is recommended since 1999 by WHO and consists of a mixture of four preparations of heat or formalin killed whole cell Vibrio cholera O1 (Inaba and Ogaba serotypes, and classical and El Tor biotypes) that are then added with purified recombinant cholera toxin (CT) B subunit. Because CT cross-reacts with Escherichia coli LT the vaccine also provides short-term protection against ETEC (enterotoxigenic E. coli) which is of added benefit for travelers. It is available in more than 60 countries. (2) A bivalent O1 and O139 whole cell oral vaccine without CT B subunit (Shanchol) has been lately developed in Vietnam (licensed by VaBiotech-Viet Nam to Shantha Biotechnics-India. It is available in India and Indonesia. A structured search of papers in PubMed and reports on cholera vaccines by WHO and CDC, as well as critical reading and synthesis of the information was accomplished. Inclusion criteria were defined according to reports quality and relevance.
ABSTRACT
A new, quick method, using the resazurin dye test as a bacterial respiration indicator, has been developed to assay the antibacterial activity of various substances used as disinfectants against bacterial biofilm growth on clinical devices. Resazurin was used to measure the presence of active biofilm bacteria, after adding disinfectant, in relation to a standard curve generated from inocula in suspension of the same organism used to grow the biofilm. The biofilm was quantified indirectly by measuring the fluorescent, water-soluble resorufin product produced when resazurin is reduced by reactions associated with respiration. Four products used as disinfectants and the biofilm growth of five bacterial species on carriers made of materials commonly found in clinical devices were studied. Under test conditions, chlorhexidine, NaOCl, ethanol, and Perasafe at concentrations of 0.2, 0.01, 350, and 0.16 mg/ml, respectively, all produced 5-log reductions in biofilm cell numbers on the three different carriers. The redox-driven test depends on bacterial catabolism, for which reason resazurin reduction produces an analytic signal of the bacterial activity in whole cells, and therefore could be used for determining disinfectant efficacy in an assay based on the metabolic activity of microorganisms grown as biofilm or in suspension.
Subject(s)
Bacteria/chemistry , Bacterial Physiological Phenomena/drug effects , Biofilms/drug effects , Disinfectants/pharmacology , Oxazines/chemistry , Spectrometry, Fluorescence/methods , Xanthenes/chemistry , Bacteria/metabolism , Oxazines/analysis , Oxazines/metabolism , Oxidation-Reduction , Xanthenes/metabolismABSTRACT
El objetivo del trabajo fue valorar la calidad de los registros incluidos en la historia personal y elaborar un indicador de continuidad interepisodios basado en la información de esos registros. El estudio fue descriptivo. En su diseño y análisis participaron especialistas de salud pública del Departamento de Medicina Preventiva de la Universidad de Granada, España, y en el trabajo de campo, especialistas de medicina familiar y comunitaria del Centro de Salud Zaidín-Sur de Granada, lugar donde se llevó a cabo la investigación entre abril y diciembre de 1989. Para efectuar el estudio, se analizaron 1 581 historias personales. El registro mejor cumplimentado fue el de los antecedentes personales (37 porciento de las historias personales evaluadas) y las historias mejor complimentadas, las pediátricas, las de las mujeres y las de las personas que participaron en programas organizados por el centro de salud. El grado de cumplimentación de los registros fue bajo. Según el indicador elaborado, solo el 16 porciento de las historias del Centro contienen información suficiente que permita la continuidad asistencial. Se recomienda crear sistemas de registros de datos sencillos y educar a los médicos de atención primaria en la recogida de datos esenciales
Subject(s)
Primary Health Care , Medical RecordsABSTRACT
El objetivo del trabajo fue valorar la calidad de los registros incluidos en la historia personal y elaborar un indicador de continuidad interepisodios basado en la informacion de esos registros. El estudio fue descriptivo. En su diseno y analisis participaron especialistas de salud pública del Departamento de Medicina Preventiva de la Universidad de Granada, Espana, y en el trabajo de campo, especialistas de medicina familiar y comunitaria del Centro de Salud Zaidin-Sur de Granada, lugar donde se llevo a cabo la investigación entre abril y diciembre de 1989. Para efectuar el estudio, se analizaron 1 581 historias personales. El registro mejor cumplimentado fue el de los antecedentes personales (37 porciento de las historias personales evaluadas) y las historias mejor complimentadas, las pediatricas, las de las mujeres y las de las personas que participaron en programas organizados por el centro de salud. El grado de cumplimentacion de los registros fue bajo. Segun el indicador elaborado, solo el 16 porciento de las historias del Centro contienen informacion suficiente que permita la continuidad asistencial. Se recomienda crear sistemas de registros de datos sencillos y educar a los medicos de atención primaria en la recogida de datos esenciales
Subject(s)
Medical Records , Primary Health CareABSTRACT
El objetivo del trabajo fue valorar la calidad de los registros incluidos en la historia personal y elaborar un indicador de continuidad interepisodios basado en la información de esos registros. El estudio fue descriptivo. En su diseño y análisis participaron especialistas de salud pública del Departamento de Medicina Preventiva de la Universidad de Granada, España, y en el trabajo de campo, especialistas de medicina familiar y comunitaria del Centro de Salud Zaidín-Sur de Granada, lugar donde se llevó a cabo la investigación entre abril y diciembre de 1989. Para efectuar el estudio, se analizaron 1 581 historias personales. El registro mejor cumplimentado fue el de los antecedentes personales (37 porciento de las historias personales evaluadas) y las historias mejor complimentadas, las pediátricas, las de las mujeres y las de las personas que participaron en programas organizados por el centro de salud. El grado de cumplimentación de los registros fue bajo. Según el indicador elaborado, solo el 16 porciento de las historias del Centro contienen información suficiente que permita la continuidad asistencial. Se recomienda crear sistemas de registros de datos sencillos y educar a los médicos de atención primaria en la recogida de datos esenciales
