Avaliação da qualidade na gestão de estoque em laboratório clínico no município de Fortaleza, Ceará / Quality assessment in stock management in a clinical laboratory in Fortaleza Municipality, Ceará

Objetivo: Este trabalho visa discutir sobre a correta gestão de insumos em um laboratório de análises clínicas. Nesse tipo de atividade, o Sistema de Gestão da Qualidade embasa uma série de processos visando garantir a fidedignidade dos resultados, pautados em processos bem estabelecidos. A gestão de insumos e estoque é uma atividade integrada entre os diversos setores existentes na empresa, fundamental para a garantia da qualidade do exame. Dessa forma, falhas na política de qualidade podem desencadear prejuízos materiais, institucionais e humanos. Métodos: Para tanto, realizou-se análise em um laboratório clínico privado de Fortaleza, Ceará, de modo observacional, prospectivo e descritivo, desenvolvido como estudo de caso. Resultados: Verificou-se que, apesar de sistemas de gestão de estoque serem adotados, não há treinamento efetivo e documentação detalhada que norteie todos os processos do setor. Conclusão: A ausência de processos bem definidos de gestão de estoque pode ser interferente importante na correta liberação dos laudos de exames, gerando prejuízos importantes à organização e ao cliente.

Objective: This paper aims to discuss the correct management of inputs in a clinical analysis laboratory. In this type of activity, the Quality Management System is based on a series of processes aimed at guaranteeing the reliability of results, based on well-established processes. The management of inputs and stock is an integrated activity among the various sectors existing in the company, essential for ensuring the quality of the exam. Thus, failures in quality policy can trigger material, institutional and human losses. Methods: For this purpose, an analysis was carried out in a private clinical laboratory in Fortaleza, Ceará, in an observational, prospective and descriptive manner, developed as a case study. Results: It was found that, although inventory management systems are adopted, there is no effective training and detailed documentation to guide all processes in the sector. Conclusion: The absence of well-defined inventory management processes can be an important interferer in the correct release of examination reports, generating significant losses to the organization and the customer.

Fungal biodiversity of air in hospitals in the city of Fortaleza, Ceará, Brazil / Biodiversidade fúngica do ar de hospitais da cidade de Fortaleza, Ceará, Brasil

Objectives: To monitor the environment in specific areas of three tertiary hospitals in Fortaleza - CE, seeking to report the presence of potentially pathogenic fungi for patients and staff, contributing to a better risk assessment in these hospitals. Methods: In the period from December, 2005 to November, 2006, air samples from three public hospitals were collected monthly, which resulted in 180 air samples originated in 15 hospitals. The biological specimens were collected using the passive method of sedimentation, with exposure of Petri dishes containing Sabouraud agar supplemented with antibiotic. The dishes were incubated for 10 days (28°C) and all fungal colonies developed were subsequently identified. Results: 10,608 colonies were isolated, belonging to 16 genera, the most common being Aspergillus, Penicillium, Candida, Curvularia and Trichoderma. There were no statistically significant relationships between the total number of colonies and the characteristics of each environment studied, except for three of those. Conclusion: The difference in fungal concentrations in the air of these hospitals is possibly more related to instability of human activities, such as overpopulated settings and construction works, than to climatic variations observed in the period.

Objetivos: Monitorar o ambiente em áreas específicas de três hospitais terciários da cidade de Fortaleza ? CE, buscando relatar a presença de fungos potencialmente patogênicos para pacientes e funcionários, contribuindo para uma melhor avaliação de riscos nesses hospitais. Métodos: No período de dezembro/2005 a novembro/2006, foram realizadas coletas mensais de amostras do ar de três hospitais públicos, que resultaram em 180 amostras de ar oriundas de 15 ambientes hospitalares. Os espécimes biológicos foram coletados através do método da sedimentação passiva, com exposições de placas de Petri, contendo ágar Sabouraud, suplementado com antibiótico. As placas foram incubadas por 10 dias (28°C), com a posterior identificação de todas as colônias fúngicas desenvolvidas. Resultados: Isolaram-se 10.608 colônias, pertencentes a 16 gêneros, sendo os mais frequentes Aspergillus, Penicillium, Candida, Curvularia e Trichoderma. Não se observaram relações estatisticamente significativas entre o número total de colônias e as características de cada ambiente analisado, com exceção de três ambientes. Conclusão: A diferença na concentração fúngica do ar desses hospitais possivelmente está mais relacionada com desequilíbrios das atividades humanas, tais como ambientes superpovoados e obras de construção, do que com as variações climáticas observadas no período em análise.

Farnesol inhibits in vitro growth of the Cryptococcus neoformans species complex with no significant changes in virulence-related exoenzymes.

Farnesol is a sesquiterpene alcohol that modulates cell-to-cell communication in Candida albicans. In recent years, several studies have shown that this molecule presents inhibitory effects against non-albicans Candida species, Paracoccidioides brasiliensis and bacteria. The present study aimed at determining the effect of farnesol on the growth of strains of the Cryptococcus neoformans species complex, through microdilution assays. In addition, the effect of farnesol on the synthesis of phospholipase and protease - important virulence-associated enzymes - by C. neoformans and Cryptococcus gattii was also investigated. A total of 36 strains were studied, out of which 20 were from veterinary sources, 8 were from human cases and 8 were from a reference collection. The minimum inhibitory concentrations (MICs) were determined in accordance with the M27-A3 protocol as described by the CLSI and farnesol was tested at a concentration range of 0.29-150 µM. Phospholipase and protease activities were evaluated through growth on egg yolk agar and spectrophotometry, respectively, after pre-incubating the strains at different farnesol concentrations (MIC/4, MIC/2 and MIC). It was observed that farnesol presents an inhibitory activity against C. neoformans and C. gattii (MIC range: 0.29-75.0 µM). Although farnesol did not significantly alter phospholipase activity, a tendency to decrease this activity was observed. Concerning protease, no statistically significant differences were observed when comparing the production before and after pre-incubation at different farnesol concentrations. Based on these findings, it can be concluded that farnesol has in vitro inhibitory activity against C. neoformans and C. gattii, but has little impact on the production of the analyzed virulence factors.

Synergistic effect of antituberculosis drugs and azoles in vitro against Histoplasma capsulatum var. capsulatum.

This study evaluated in vitro interactions of antituberculosis drugs and triazoles against Histoplasma capsulatum. Nine drug combinations, each including an antituberculosis drug (isoniazid, pyrazinamide, or ethambutol) plus a triazole (itraconazole, fluconazole, or voriconazole), were tested against both growth forms of H. capsulatum. Stronger synergistic interactions were seen in isoniazid or pyrazinamide plus triazoles for the mold form and ethambutol plus voriconazole for the yeast-like form. Further studies should evaluate these combinations in vivo.