RESUMEN
OBJECTIVE: In 30 to 50% of cases, the route of transmission of virus C remains unknown. The aim of this study was to investigate the effectiveness of manual cleaning and disinfection procedures after endoscopic examinations in highly infected patients. METHODS: In 39 patients with chronic hepatitis C and a high level of replication, a gastroscopy with biopsy was performed with a fully submersible endoscope. Cleaning and disinfection were carried out with the following protocol: cleaning with detergent solution (Sekulyse), rinsing, 3 to 5 min immersion into a glutaraldehyde disinfectant solution (Sekucid) and final rinsing. One hundred mL of sterile water was flushed through the biopsy channel immediately after removal of the endoscope (T1), after cleaning (T2), and after final disinfection (T3). These 100 mL were collected in aliquots for viral and bacterial screening. Virus C particles were searched for in the effluent of the biopsy channel using two methods of polymerase chain reaction. RESULTS: Virus C particles were found in 2 of 39 patients in T1 aliquots collected before washing. Routine cleaning with a detergent eliminated all viral particles, as tests were negative at T2 and T3. The usual bacteria (Pseudomonas, Streptococcus, Neisseria...) were detected at T1 and had disappeared after total disinfection at T3. CONCLUSION: Virus C hepatitis could be transmitted during endoscopic examination, but cleaning and disinfection procedures effectively eliminated all viral particles.
Asunto(s)
Endoscopía del Sistema Digestivo/efectos adversos , Hepatitis C/etiología , Desinfección/métodos , Hepacivirus/genética , Hepatitis C/genética , Hepatitis C/transmisión , Humanos , ARN Viral/análisis , Factores de RiesgoRESUMEN
Bacterial adhesion is a crucial factor in the pathogenicity of numerous bacterial species. This property plays such a great role in infections of foreign material that removal of the material is the only effective therapy. The electron microscopy studies performed by Christensen have demonstrated that infected foreign material harbors bacteria which are often coated with slime and therefore escape detection by conventional microbiological methods. in view of these properties, enzymatic or physical detachment of adherent bacteria was attempted. 231 specimens from a variety of materials (catheters, heart valves, drains, bone biopsies) which yielded negative results after 15 days culture in Schaedler medium were either exposed to trypsin or sonicated. Among catheter specimens, 44.7% yielded positive bacteriologic results; pathogens recovered included 8.3% micrococci, 5.1% nongroupable streptococci, 1.7% group D streptococci, 2.9% Enterobacteria, and 23.3% coagulase-negative staphylococci. Among the bone specimens, the improvement in yield was 64.7%; except in one case, the pathogens recovered were consistent with previously initiated treatments. This bacterial detachment method should be studied in a larger number of specimens to determine its diagnostic value as compared with conventional techniques.
Asunto(s)
Adhesión Bacteriana/efectos de los fármacos , Osteomielitis/diagnóstico , Sonicación , Infecciones Estafilocócicas/diagnóstico , Tripsina/farmacología , Bioprótesis , Catéteres de Permanencia/efectos adversos , Enfermedad Crónica , Infecciones por Bacterias Grampositivas/diagnóstico , Infecciones por Bacterias Grampositivas/microbiología , Prótesis Valvulares Cardíacas/efectos adversos , Humanos , Técnicas In Vitro , Osteomielitis/etiología , Osteomielitis/microbiología , Estudios Retrospectivos , Infecciones Estafilocócicas/etiología , Infecciones Estafilocócicas/microbiología , Staphylococcus epidermidis/aislamiento & purificaciónRESUMEN
Among the S. aureus 25/39 are non producing slime and non adherent isolates. These results did not allow a correlation between these properties and pathogenesis. Several different phenotyping systems (biotyping, phage typing, serotyping, antibiotic susceptibility profiling, and plasmid pattern analysis) have been used in an attempt to identify strains of CNS. There is still a need however, for a simple, rapid, and cost effective method of distinguishing true pathogens from simple contaminants. Our results suggest that testing isolates for slime positivity and for adherence property may fulfill this task.
Asunto(s)
Adhesión Bacteriana/efectos de los fármacos , Polisacáridos Bacterianos/farmacología , Staphylococcus aureus/patogenicidad , Staphylococcus epidermidis/patogenicidad , Humanos , Polisacáridos Bacterianos/biosíntesis , Staphylococcus aureus/análisis , Staphylococcus aureus/fisiología , Staphylococcus epidermidis/análisis , Staphylococcus epidermidis/fisiologíaRESUMEN
The authors describe a method for the determination of the plasma and/or serum haemoglobin, based on the peroxidase properties of the Haemoglobin-Haptoglobin complex, following the action of a solution of ABTS and hydrogen peroxide. The colour observed after a defined period of time is measured by spectrophotometry at 402 nm and is proportional to the haemoglobin concentration of the sample. A statistical study of the plasma haemoglobin concentration performed in male and female blood donors aged between 18 and 60 years is also presented.