Calidad del aire en dos centros hospitalarios y ocho clínicas veterinarias en Costa Rica / Air quality in two hospitals and eight veterinary clinics in Costa Rica

La calidad del aire en espacios cerrados o intradomiciliarios, es uno de los factores más importantes en la calidad de vida de los individuos puesto que pasamos del 80 a 90 por ciento de nuestro tiempo en espacios cerrados, 1. En Latinoamérica poco se ha estudiado de este tema y Costa Rica no es la excepción. No hay estudios exhaustivos sobre la calidad del aire en diferentes centros humanos, hospitales, escuelas, supermercados, oficinas, fábricas, etc., y tampoco en centros veterinarios, hospitales, clínicas, consultorios, que permitan identificar cuál es la situación sobre el tema. En este artículo evaluamos la calidad del aire en ocho clínicas y consultorios veterinarios y en dos hospitales públicos en Costa Rica. Los estudios fueron llevados a cabo en el año 2003 y 2004. Planteamos como la calidad del aire interno puede incidir en la salud de los ocupantes, tanto pacientes como de los trabajadores del lugar. Este estudio ha permitido un primer tratamiento del tema e identificación de los niveles de contaminación interna para contaminantes del aire tales como monóxido de carbono, dióxido de carbono, sistemas de ventilación, concentración de bacterias y hongos de una manera sencilla, permitiendo con el conocimiento de la situación ofrecer medidas correctivas a los problemas detectados. Se encontró que en general la contaminación microbiana del ambiente es aceptable, no así para material particulado, estos datos se dan tanto en los centros hospitalarios humanos como en los centros veterinarios. En ambos sitios, centros hospitalarios como clínicas veterinarias, las prácticas ocupacionales por lo general provocan un aumento en la concentración de vectores contaminantes.

Given that 80% to 90% of our time is spent indoors (1), air quality in closed or intradomiciliar spaces is one of the most important factors in our quality of life. In Latin America, this topic has not been very well studied and Costa Rica is not the exception. Thus, there are nopublications which allow the study of indoor air quality in different either human (hospitals, schools, supermarkets, offices, factories and the like) or veterinary centers (hospitals, clinics, offices). In this article we evaluate indoor air quality in eight veterinary clinics and in two public hospitals in Costa Rica; these studies were carried out in 2003 and 2004. We postulate a mechanism wherebyindoor air quality can affect the health of the dwellers of these spaces, be they patients or workers. This study has allowed an initial discussion of thistopic and identified internal contamination levels for substances such as carbon monoxide, carbon dioxide, ventilation systems and bacterial as wells as fungalconcentrations. Hopefully, this knowledge will permit corrective measures to be offered to the problemsdetected. It was found that, in general, microbial contamination of the environment is acceptable exceptfor particulate material. Data are offered for both human hospitals as well as veterinary centers. In general, in both sites, occupational practices cause an increase in the concentration of contaminating vectors.

New approaches for education and training in veterinary public health: the SAPUVET projects.

Continued contact between humans and animals, in combination with the ever-increasing movement of human and animal populations that is one effect of globalization, contributes to the spread of diseases, often with detrimental effects on public health. This has led professionals involved in both animal health and public health to recognize veterinary public health (VPH) as a key area for their activities to address the human-animal interface. Veterinarians, a profession with major involvement in this field, are in need of specific knowledge and skills to prevent and control public-health problems. As a result, VPH must be directly integrated into veterinary educational programs. At present, only few veterinary schools have specific VPH programs; in most institutions, VPH does not feature as a specific subject in either undergraduate or post-graduate curricula. SAPUVET and SAPUVETNET II are network projects supported by the ALFA program of the European Union (EU). Their main objectives are to reach a common understanding between European and Latin American universities in the definition of the areas in which VPH is important in their respective countries, and to design a harmonized training program for veterinarians in VPH, by making use of new technological applications and innovative teaching methodologies. The elaboration of educational material in combination with case studies presenting real-life problems provides a basis to apply the knowledge acquired on VPH. It is envisaged that the material and modules developed during the two projects will be integrated into the veterinary curricula of the participating universities, as well as in other partner organizations.

Aerobic bacterial flora of nesting green turtles (Chelonia mydas) from Tortuguero National Park, Costa Rica.

Bacteriological examination of 70 nesting green turtles (Chelonia mydas) from Tortuguero National Park, Costa Rica was performed to investigate nasal and cloacal aerobic bacteria. A total of 325 bacterial isolates were obtained, including 10 Gram-negative and three Gram-positive genera. Two hundred thirty-nine were Gram-negative and 86 were Gram-positive isolates. Klebsiella pneumoniae was the most common microbe identified in turtle samples: 27/70 (38.5%) in cloacal, and 33/70 (47.1%) in nasal samples. The Enterobacteriaceae family, including Enterobacter agglomerans, E. cloacae, Escherichia coli, Klebsiella oxytoca, K. pneumoniae, and Serratia marcescens, was the largest Gram-negative group of bacteria recovered and comprised 127 of 239 (53.1%) of the Gram-negative isolates. Staphylococcus species was the largest Gram-positive bacteria group, including S. aureus, S. cromogenes, S. epidermis, and S. intermedius, and made up 63 of 86 (73.2%) of the Gram-positive isolates recovered. The results of this study demonstrate that the aerobic bacterial flora of nesting green turtles at Tortuguero National Park is composed of a very wide spectrum of bacteria, including several potential pathogens.

Predominance of vanA genotype among vancomycin-resistant Enterococcus isolates from poultry and swine in Costa Rica.

The use of avoparcin as a growth promoter is considered to have selected for vancomycin-resistant enterococci (VRE). In Costa Rica, the use of avoparcin for poultry and swine was intensive until the product was withdrawn from the market in 2000. We evaluated the presence of VRE in poultry, swine, and cattle fecal samples obtained during 1998 and 1999. A total of 185 VRE isolates were recovered from 116 out of 893 samples. Enterococcus faecium was the most frequently isolated species (50.8%), being predominant among poultry (71.6%) and swine (37.7%) isolates, but it was not recovered from the bovine samples. The second-most-frequently-isolated species from poultry and swine, respectively, were E. durans (23.2%) and E. faecalis (21.7%). E. casseliflavus was the only species obtained from bovine samples, but it was not found among the avian isolates. An evident predominance of the vanA determinant among vancomycin-resistant enterococcal species from poultry and swine, but not from cattle, was observed and was similar to the situation in European countries before avoparcin was forbidden. The diversity of the vanA determinant in the isolates was assessed by detection of the IS1251 insertion in the vanSH intergenic region and of the IS1476 insertion in the vanXY intergenic region. However, in none of the 154 vanA+ isolates recovered in this study were those insertions detected.

Residuos de antibióticos en leche pasteurizada distribuida en servicios de nutrición hospitalarios de Costa Rica / Presence of antibiotic residues in pasteurized milk distributed to hospital's nutrition services in Costa Rica

Se evaluó la presencia de residuos de antibióticos en 200 muestras de leche pasteurizada recolectadas en diez hospitales costaricenses. La detección de antibióticos se efectuó mediante las pruebas de inhibición del crecimiento del Bacillus stearothermophilus var. calidolactis (Delvo test P) y del Streptococcus thermophilus (T-101): (Valiotest 101). Los resultados señalan que el 13 por ciento (N=200) de las muestras presentaron residuos de antibióticos; no obstante, los porcentajes de positividad de las muestras variaron significativamente entre los hospitales evaluados, oscilando entre cero y 35 por ciento (N=20). El mayor número de muestras positivas correspondió a las industrias lácteas que suministran el 70 por ciento de la leche requerida en los centros hospitalarios incluídos en el estudio