RESUMO
Aim: To investigate whether medical devices coated with a synthesized nanocomposite of poly(methylmethacrylate-co-dimethyl acrylamide) (PMMDMA) and silver nanoparticles (AgNPs) could improve their antibiofilm and antimicrobial activities. We also investigated the nanocomposite's safety. Materials & methods: The nanocomposite was synthesized and characterized using analytical techniques. Medical devices coated with the nanocomposite were evaluated for bacterial adhesion and hemolytic activity in vitro. Results: The nanocomposite formation was demonstrated with the incorporation of AgNPs into the polymer matrix. The nanocomposite proved to be nonhemolytic and significantly inhibited bacterial biofilm formation. Conclusion: The PMMDMA-AgNPs nanocomposite was more effective in preventing biofilm formation than PMMDMA alone and is a promising strategy for coating medical devices and reducing mortality due to hospital-acquired infections.
[Box: see text].
Assuntos
Biofilmes , Nanopartículas Metálicas , Nanocompostos , Prata , Biofilmes/efeitos dos fármacos , Prata/química , Prata/farmacologia , Nanocompostos/química , Nanopartículas Metálicas/química , Humanos , Antibacterianos/farmacologia , Antibacterianos/química , Aderência Bacteriana/efeitos dos fármacos , Equipamentos e Provisões/microbiologia , Hemólise/efeitos dos fármacos , Acrilamidas/química , Acrilamidas/farmacologiaRESUMO
INTRODUCTION: SARS-CoV2 pandemic marks the need to pay attention to bacterial pathogens that can complicate the hospital stay of patients in the intensive care unit (ICU). ESKAPE bacteria which includes Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter cloacae are considered the most important, because of their close relationship with the development of ventilator-associated pneumonia (VAP). The aim of this work was to identify and characterize ESKAPE bacteria and to detect their possible clonal spread in medical devices, patients, and medical personnel of the ICU for COVID-19 patients of the Hospital Juarez de Mexico. METHODOLOGY: Genetic identification of ESKAPE bacteria was performed by analyzing the 16S rRNA gene. Resistance assays were performed according to the CLSI guidelines. Assembly of AdeABCRS operon and inhibition assays of pumps efflux in Acinetobacter baumannii isolates were performed. Associated gene involved in biofilm formation (icaA) was performed in isolates belonging to the Staphylococcus genus. Finally, typing by ERIC-PCR and characterization of mobile genetic element SCCmec were done. RESULTS: Heterogeneous distribution of ESKAPE and non-ESKAPE bacteria was detected in various medical devices, patients, and medical personnel. Acinetobacter baumannii and Staphylococcus aureus were the predominant ESKAPE members. The analysis of intergenic regions revealed an important clonal distribution of A. baumannii (AdeABCRS+). Genotyping of SCCmec mobile genetic elements and the icaA gene showed that there is no clonal distribution of S. aureus. CONCLUSIONS: Clonal spread of A. baumannii (AdeABCRS+) highlights the importance of adopting good practices for equipment disinfection, surfaces and management of COVID-19 patients.
Assuntos
Infecções por Acinetobacter/transmissão , Acinetobacter baumannii/isolamento & purificação , COVID-19/prevenção & controle , Infecção Hospitalar/prevenção & controle , Unidades de Terapia Intensiva , Acinetobacter baumannii/patogenicidade , Antibacterianos/farmacologia , Biofilmes/crescimento & desenvolvimento , Infecção Hospitalar/microbiologia , Farmacorresistência Bacteriana/genética , Equipamentos e Provisões/microbiologia , Genótipo , Humanos , Sequências Repetitivas Dispersas , México , Pneumonia Associada à Ventilação Mecânica/microbiologiaRESUMO
The widespread use of touch-screen mobile devices renders them potential fomites for the transmission of bacterial pathogens among users of different ages. The objectives of the present research were to isolate bacteria from mobile phones, perform molecular and phylogenetic identification, and determine the antibiotic resistance profiles. The surfaces of 50 touch-screen mobile devices owned by bystanders were sampled in the city center of Culiacan, Sinaloa, Mexico. The samples were cultured on nutritive agar; 13 bacterial colonies were isolated and characterized based on their macroscopic and microscopic characteristics and then identified using PCR amplification and sequencing of the 16S rRNA gene V4 and V6 regions. Their taxonomic relationships were determined via a Bayesian inference approach. Antimicrobial resistance was evaluated via disc diffusion and broth microdilution assays. Species of the genera Staphylococcus, Bacillus, and Enterococcus were identified on 84.6, 7.7, and 7.7% of the mobile phones, respectively. A unique subgroup of Staphylococcus epidermidis was identified in strains FBOPL-23, CAEPL-28, and FREPL-28. Staphylococcus hominis novobiosepticus was also identified on mobile phones for the first time. Of the isolated bacteria, 92.3% were resistant to erythromycin, 76.9% to ampicillin and penicillin, 61.5% to dicloxacillin, 38.5% to cephalothin and 7.7% to cefotaxime and ceftriaxone. The presence of antibiotic-resistant bacteria of clinical relevance poses potential risks to users' health and the dissemination of antibiotic resistance mechanisms throughout the community; thus, we recommend regular cleaning to prevent cross-infection by multidrug-resistant bacteria when using touch-screen mobile devices.
Assuntos
Telefone Celular , Farmacorresistência Bacteriana , Bactérias Gram-Positivas , Antibacterianos/farmacologia , Microbiologia Ambiental , Equipamentos e Provisões/microbiologia , Bactérias Gram-Positivas/efeitos dos fármacos , Bactérias Gram-Positivas/genética , Bactérias Gram-Positivas/isolamento & purificação , México , Reação em Cadeia da PolimeraseRESUMO
Human ingestion of antimicrobial residues in dairy products is a problem of public health. In this study we evaluated antibacterial effectiveness of aqueous and ethanolic leaf extracts of Mangifera indica L. as a natural alternative for reduction of Staphylococcus spp. biofilms. Eight Staphylococcus spp. strains from cows with mastitis and the Staphylococcus aureus strain (ATCC 25923) were evaluated. High performance liquid chromatography indicated the presence of phenolic compounds in the aqueous extract. Agilent Technologies gas chromatography revealed the presence of phenolic compounds, carbohydrates, and gallic acid in ethanolic extract. The tannin contents were 2.27 ± 0.01 and 2.67 ± 0.01% for ethanolic extract and aqueous extract, respectively. Extracts were evaluated in agar diffusion test and the size of inhibition zones were compared. The ethanolic extract was the most effective, showing minimum inhibitory concentrations and minimum bactericidal concentrations between 1.8-7.5 and 15.1-45.3 mg/ml, respectively. After tannin removal, the extracts were less effective, indicating these secondary metabolites as one of the main antibacterial compounds. The ethanolic extract at 45.3 mg/ml reduced mature biofilms in teat rubber (average: 3.91 log reduction) and stainless steel (average: 3.87 log reduction) after 5 min of contact. The extracts of M. indica leaves represent natural alternatives against Staphylococcus spp. strains and the ethanolic extract shows potential as a natural sanitizer.
Assuntos
Antibacterianos/farmacologia , Biofilmes/efeitos dos fármacos , Mangifera/química , Extratos Vegetais/farmacologia , Staphylococcus/efeitos dos fármacos , Animais , Bovinos , Equipamentos e Provisões/microbiologia , Feminino , Mastite Bovina/microbiologia , Testes de Sensibilidade Microbiana , Folhas de Planta/química , Borracha , Aço Inoxidável , Infecções Estafilocócicas/microbiologia , Taninos/análiseRESUMO
RESUMEN Introducción: Las infecciones asociadas a la asistencia sanitaria repercuten en la calidad de los servicios de salud, causando prolongación en la estancia hospitalaria, aumento en costos de atención, riesgo para la vida de los pacientes. A pesar de los intentos por mejorar esta situación, la problemática aún persiste. Objetivo: Determinar la carga y tipología microbiana relacionada con las infecciones asociadas a la asistencia sanitaria en servicios clínicos. Métodos: Estudio cuantitativo, descriptivo, correlacional, diseño no experimental, realizado en servicios Quirúrgica y Unidad de Cuidados Intensivos de un Hospital de Santa Marta, Colombia, durante abril a septiembre de 2014. De manera intencional se tomaron muestras de laboratorio a pacientes, trabajadores, espacios físicos y equipos. El análisis de la información se realizó mediante frecuencias absolutas y relativas, así como correlación de Pearson. Resultados: Quirúrgica reportó infección de herida quirúrgica (100 por ciento), aislando Pseudomona aeruginosa en 66,66 por ciento de casos; cinco espacios positivos (60,00 por ciento Staphylococcus albus coagulasa negativo y 40,00 por ciento Streptococcus ssp). Dos equipos resultaron positivos para Staphylococcus albus (coagulasa negativo). Unidad de Cuidados Intensivos reportó infecciones urinarias (40,00 por ciento), neumonía (40,00 por ciento) y de herida quirúrgica (20,00 por ciento), siendo Acinetobacter baumannii (40,00 por ciento) el microorganismo más frecuente. En el 100,00 por ciento espacios positivos se aisló Streptococcus ssp; ningún germen fue aislado en instrumental y equipos. Conclusiones: Quirúrgica tuvo mayor carga microbiana que la Unidad de Cuidados Intensivos. El germen predominante fue Acinetobacter baumanii. La correlación entre germen causal de las Infecciones Asociadas a la Asistencia Sanitaria, espacios físicos y equipos biomédicos resultó débil; entre germen causal e instrumental quirúrgico no existió relación(AU)
ABSTRACT Introduction: Health care-associated infections have an impact on the quality of health care services, thus causing longer stay at hospitals, rise in assistance costs and risks for the patient's life. Despite the attempts at improving this situation, the problem still remains. Objective: To determine the microbial burden and typing related to health care-associated infections in the clinical services. Methods: A quantitative, descriptive, correlative and non-experimental design-type study conducted in the Surgery services and in the Intensive Care Unit of a hospital located in Santa Marta, Colombia, from April to September, 2014. The lab samples were intentionally taken from patients, workers, physical spaces and equipment. The information analysis was based on absolute and relative frequencies as well as Pearson's correlation coefficient. Results: The Surgery Services reported surgical wound infection (100 percent), isolation of Pseudomona aeruginosa in 66.66 percent of cases; five bacteria-positive physical spaces (60 percent to coagulase-negative Staphylococcus albus and 40 percent to Streptococcus spp). Two pieces of equipment were positive to coagulase-negative Staphylococcus albus. The Intensive Care Unit reported urinary infections (40 percent), pneumonia (40 percent) and surgical wound (20 percent), being Acinetobacter baumannii (40 percent) the most frequent. In all the positive physical spaces, Streptococcus spp was isolated, but not a single germ was found in the medical instruments or in the equipment. Conclusions: Surgical Service had higher microbial burden than the Intensive Care Unit. The predominant germ was Acinetobacter baumanni. The correlation among the causative germ of health care-associated infections, the physical spaces and the biomedical equipment was poor whereas the correlation of the causative germ and the surgical instruments was non-existent(AU)
Assuntos
Humanos , Qualidade da Assistência à Saúde , Infecção Hospitalar/epidemiologia , Acinetobacter baumannii/isolamento & purificação , Unidades de Terapia Intensiva , Infecção da Ferida Cirúrgica , Epidemiologia Descritiva , Equipamentos e Provisões/microbiologiaRESUMO
Hemodialysis, which is a kidney failure treatment that uses hemodialysis machine, dialyzer, dialysis solution, catheters, and needles, favors biofilm formation. This study evaluates whether Aspergillus, Candida, and Fusarium can form biofilm in dialysis fluids. Biofilms were grown in 96-well microplates containing solutions (acid and basic) consisting of dialysate, dialysate per se, or dialysate plus glucose as culture medium. The biofilms were incubated at 30⯰C for 72â¯h, quantified by the violet crystal methodology, and visualized by transmission electron microscopy. All the fungi formed biomass in all the tested solutions. However, Bonferroni analysis revealed that the dialysate facilitated Aspergillus biomass development, whereas the dialysate and dialysate with glucose provided similar Fusarium oxysporum biomass development. Candida parapsilosis development was favored in biofilms grown in basic electrolytic solution. Electron micrographs of biofilms that grew on catheters after 72â¯h showed that Aspergillus formed abundant hyphae; the extracellular matrix was visible on the surface of some hyphae when Aspergillus was grown in the dialysate. A multilayered hyphal structure emerged when F. oxysporum biofilms were incubated in the dialysate with glucose. C. parapsilosis biofilm growth in basic solution elicited a dense network of yeasts and pseudohyphae as well as the extracellular matrix; the biofilm was attached across the catheter length. This study may contribute to the formulation of new strategies to monitor biofilm formation and to increase knowledge associated with fungal biofilms in the dialysis environment.
Assuntos
Biofilmes/crescimento & desenvolvimento , Contaminação de Equipamentos , Equipamentos e Provisões/microbiologia , Fungos/metabolismo , Diálise Renal/instrumentação , Aspergillus/isolamento & purificação , Aspergillus/metabolismo , Biomassa , Candida/isolamento & purificação , Candida/metabolismo , Catéteres/microbiologia , Soluções para Diálise , Fusarium/isolamento & purificação , Fusarium/metabolismo , Glucose/metabolismo , Hifas/crescimento & desenvolvimento , Microscopia Eletrônica de VarreduraRESUMO
Purpose. The aim of this work was to investigate the presence of selected potential virulence factors, susceptibility and clonal relatedness among 63 Stenotrophomonas maltophilia isolates recovered from patients exposed to invasive devices in a university hospital in Argentina between January 2004 and August 2012.Methodology. Genetic relatedness was assessed by enterobacterial repetitive intergenic consensus PCR (ERIC-PCR) and pulsed-field gel electrophoresis (PFGE). Isolates were characterized by antimicrobial resistance, the presence and/or expression of potential virulence determinants, and virulence in the Galleria mellonella model.Results/Key findings. ERIC-PCR generated 52 fingerprints, and PFGE added another pattern. Resistance to trimethoprim-sulfamethoxazole (6.35â%), levofloxacin (9.52â%) and ciprofloxacin (23.80â%) was detected. All isolates were susceptible to minocycline. All isolates were lipase, protease and siderophore producers, while all but Sm61 formed biofilms. However, 11/63 isolates did not amplify the major extracellular protease-coding gene (stmPr1). Sm61 is an stmPr1-negative isolate, and showed (as did Sm13 and the reference strain K279a) strong proteolysis and siderophore production, and high resistance to hydrogen peroxide. The three isolates were virulent in the G. mellonella model, while Sm10, a low-resistance hydrogen peroxide stmPr1-negative isolate, and weak proteolysis and siderophore producer, was not virulent.Conclusion. This is the first epidemiological study of the clonal relatedness of S. maltophilia clinical isolates in Argentina. Great genomic diversity was observed, and only two small clusters of related S. maltophilia types were found. Minocycline and trimethoprim-sulfamethoxazole were the most active agents. S. maltophilia virulence in the G. mellonella model is multifactorial, and further studies are needed to elucidate the role of each potential virulence factor.
Assuntos
Stenotrophomonas maltophilia/genética , Fatores de Virulência/genética , Animais , Argentina/epidemiologia , Biofilmes , Ciprofloxacina/farmacologia , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/epidemiologia , Farmacorresistência Bacteriana/genética , Contaminação de Equipamentos , Equipamentos e Provisões/microbiologia , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/epidemiologia , Hospitais Universitários , Humanos , Lepidópteros/microbiologia , Levofloxacino/farmacologia , Minociclina/farmacologia , Modelos Animais , Tipagem Molecular , Stenotrophomonas maltophilia/efeitos dos fármacos , Stenotrophomonas maltophilia/isolamento & purificação , Combinação Trimetoprima e SulfametoxazolRESUMO
INTRODUCTION: With the advancement of medicine and surgery, various types of medical devices have become part of treatment strategies. METHODS: Identification and antimicrobial sensitivity testing were done according to CLSI guidelines following standard microbiological practices. RESULTS: Urinary catheter infections (31%) were most frequent followed by central venous catheter (18%) and orthopedic implants (15%). Methicillin resistant Staphylococcus aureus (MRSA) was a major cause of device-related infection after Escherichia coli (21%); other pathogens were Klebsiella pneumoniae (14%), Pseudomonas spp. (10%), Acinetobacter spp. (8%) and Candida species (7%). None of MRSA was resistant to vancomycin (MIC ≥16µg/mL). Resistance rates were 98% and 97% for ofloxacin and ciprofloxacin, respectively. CONCLUSIONS: Escherichia coli and MRSA are major pathogens of medical device-related infections.
Assuntos
Infecções Relacionadas a Cateter/epidemiologia , Infecções Relacionadas a Cateter/microbiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Relacionadas à Prótese/epidemiologia , Infecções Relacionadas à Prótese/microbiologia , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Candida/isolamento & purificação , Criança , Pré-Escolar , Equipamentos e Provisões/microbiologia , Feminino , Bactérias Gram-Negativas/isolamento & purificação , Humanos , Lactente , Recém-Nascido , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Paquistão/epidemiologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Adulto JovemRESUMO
Abstract INTRODUCTION: With the advancement of medicine and surgery, various types of medical devices have become part of treatment strategies. METHODS: Identification and antimicrobial sensitivity testing were done according to CLSI guidelines following standard microbiological practices. RESULTS: Urinary catheter infections (31%) were most frequent followed by central venous catheter (18%) and orthopedic implants (15%). Methicillin resistant Staphylococcus aureus (MRSA) was a major cause of device-related infection after Escherichia coli (21%); other pathogens were Klebsiella pneumoniae (14%), Pseudomonas spp. (10%), Acinetobacter spp. (8%) and Candida species (7%). None of MRSA was resistant to vancomycin (MIC ≥16µg/mL). Resistance rates were 98% and 97% for ofloxacin and ciprofloxacin, respectively. CONCLUSIONS Escherichia coli and MRSA are major pathogens of medical device-related infections.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/epidemiologia , Infecções Relacionadas à Prótese/microbiologia , Infecções Relacionadas à Prótese/epidemiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Relacionadas a Cateter/microbiologia , Infecções Relacionadas a Cateter/epidemiologia , Paquistão/epidemiologia , Fatores de Tempo , Candida/isolamento & purificação , Testes de Sensibilidade Microbiana , Prevalência , Estudos Retrospectivos , Fatores de Risco , Equipamentos e Provisões/microbiologia , Bactérias Gram-Negativas/isolamento & purificação , Pessoa de Meia-IdadeRESUMO
Adhesion is the first step for Candida species to form biofilms on medical devices implanted in the human host. Both the physicochemical nature of the biomaterial and cell wall proteins (CWP) of the pathogen play a determinant role in the process. While it is true that some CWP have been identified in vitro, little is known about the CWP of pathogenic species of Candida involved in adhesion. On this background, we considered it important to investigate the potential role of CWP of C. albicans, C. glabrata, C. krusei and C. parapsilosis in adhesion to different medical devices. Our results indicate that the four species strongly adher to polyvinyl chloride (PVC) devices, followed by polyurethane and finally by silicone. It was interesting to identify fructose-bisphosphate aldolase (Fba1) and enolase 1 (Eno1) as the CWP involved in adhesion of C. albicans, C. glabrata and C. krusei to PVC devices whereas phosphoglycerate kinase (Pgk) and Eno1 allow C. parapsilosis to adher to silicone-made implants. Results presented here suggest that these CWP participate in the initial event of adhesion and are probably followed by other proteins that covalently bind to the biomaterial thus providing conditions for biofilm formation and eventually the onset of infection.
Assuntos
Candida/fisiologia , Adesão Celular , Parede Celular/química , Equipamentos e Provisões/microbiologia , Proteínas de Membrana/isolamento & purificação , Proteínas de Membrana/fisiologia , Antifúngicos/farmacologia , Materiais Biocompatíveis/química , Biofilmes/crescimento & desenvolvimento , Candida/efeitos dos fármacos , Candida/enzimologia , Candida/metabolismo , Adesão Celular/efeitos dos fármacos , Parede Celular/enzimologia , Parede Celular/metabolismo , Frutose-Bifosfato Aldolase/isolamento & purificação , Frutose-Bifosfato Aldolase/fisiologia , Proteínas Fúngicas/fisiologia , Humanos , Peróxido de Hidrogênio/farmacologia , Fosfoglicerato Quinase , Fosfopiruvato Hidratase/isolamento & purificação , Fosfopiruvato Hidratase/fisiologia , Poliuretanos/química , Cloreto de Polivinila/química , Silicones/químicaRESUMO
To determine the bacterial load on manual resuscitators (MRs), swab samples of MR connectors from a Brazilian intensive care unit were collected at time zero, and after 24 and 48h use in the same patient. From 20 MRs, a total of 54 bacteria were isolated: six at t=0, 17 at t=24, and 31 at t=48. Staphylococcus aureus, Acinetobacter baumannii, Serratia marcescens, and Pseudomonas aeruginosa were the predominant isolates, and multidrug resistance was widespread in all species. Greater awareness of the need to ensure effective decontamination of MRs between patients, as well as more frequent replacement of MRs in individual patients, is recommended to minimize the risk of (re)colonization/infection of the respiratory tract.
Assuntos
Bactérias/isolamento & purificação , Farmacorresistência Bacteriana Múltipla , Equipamentos e Provisões/microbiologia , Ressuscitação/instrumentação , Bactérias/classificação , Bactérias/efeitos dos fármacos , Carga Bacteriana , Brasil , Humanos , Unidades de Terapia Intensiva , Estudos ProspectivosRESUMO
Infections due to microbial biofilm formation on the surface of catheters and other medical devices are constantly reported as a major cause of morbidity and mortality in patients admitted to hospitals. Furthermore, sessile cells are more resistant to phagocytosis and most antimicrobial, which complicates the treatment of such infections. Researches aimed at new antimicrobial originating mainly from plants have increased in recent years and the development of new strategies for their release is critical in combating the formation of biofilms. Geranium oil (GO) has proven antimicrobial activity. Because of this, the aim of this study was to develop nanoemulsions containing this oil (NEG) and evaluate its activity after the biofilm formation of Candida albicans, Candida tropicalis, Candida glabrata, and Candida krusei in hospital medical supplies. For quantification of the biofilm, crystal violet, total protein, and ATP-bioluminescence assays were used. The results revealed that GO and NEG showed lower MIC for C. albicans and C. tropicalis. The biofilms formed by different species of Candida on the surfaces of polyethylene and polyurethane were quantified. GO and NEG significantly inhibited the formation of biofilms in all species tested on the surfaces of polyethylene. However, NEG antibiofilm has had better activity than GO for C. albicans, C. tropicalis and C. glabrata, according to the surface potential analysis by atomic force microscopy (AFM). The analysis of the biofilm formation on the polyethylene surface by ATP-bioluminescence and CFU showed similar results. In both methods the formation of biofilm in the catheter occurred in greater quantity for C. albicans and C. tropicalis. GO did not significantly inhibit the formation of biofilms only in C. krusei, although NEG significantly increased this activity GO in all species tested when compared to the control training biofilm. The following study shows that the development of NEG may become an effective alternative to reduce the adhesion of microorganisms and prevent infections resulting from the use of some hospital medical materials.
Assuntos
Antifúngicos/farmacologia , Biofilmes/efeitos dos fármacos , Candida/efeitos dos fármacos , Equipamentos e Provisões/microbiologia , Pelargonium/química , Extratos Vegetais/farmacologia , Antifúngicos/isolamento & purificação , Candida/fisiologia , Emulsões/farmacologia , Hospitais , Testes de Sensibilidade Microbiana , Extratos Vegetais/isolamento & purificaçãoRESUMO
ABSTRACT Objective To compare sterility and microbial (bacteria and fungi) load in the outer part of hyperbaric bupivacaine (Neocaína®) in ampoule and bupivacaine in vial, in conventional and sterile pack formulations. Methods The sterile packs were divided into two groups: G1 (n=16) with ampoules and G2 (n=16) with vials. Conventional formulations were divided into two groups, being G3 (n=16) with ampoules and G4 (n=16) with vials. The ampoules and vials were opened and had their content drawn. The empty bottles were then placed in sterile plastic bags and sent for analysis of microbial load (bacteria and fungi) and sterility testing. Data were analyzed using the χ2 test with Yates correction, and 95% confidence interval. Results G1 and G2 showed no bacterial growth when compared to conventional groups (p<0.001). The most common agent in conventional microbiological samples was Staphylococcus aureus. There was no fungal growth in both groups. Conclusion The use of (sterile pack) reduces the microbial load of bottles, and would decrease the chance of exposure to potential contamination of the anesthetic solution.
RESUMO Objetivo Comparar a esterilidade e a carga microbiana (bactérias e fungos) da parte externa dos frascos de envasamento de bupivacaína hiperbárica (Neocaína®) em ampola e bupivacaína em frasco-ampola das apresentações convencional e estéril (sterile pack). Métodos As apresentações estéreis (sterile pack) foram distribuídas em dois grupos, sendo que o G1 (n=16) continha as ampolas e o G2 (n=16), os frascos-ampola. As apresentações convencionais foram distribuídas em dois grupos, a saber G3 (n=16) com as ampolas e G4 (n=16) com os frascos-ampola. As ampolas e os frascos-ampolas eram abertos e tinham seu conteúdo aspirado. Os frascos vazios eram, então, acondicionados em sacos plásticos estéreis e enviados para análise quanto à carga microbiana (bactérias e fungos), bem como para o teste de esterilidade. Os dados foram analisados por meio do teste χ2 com correção Yates com intervalo de confiança de 95%. Resultados Os grupos G1 e G2 não apresentaram crescimento bacteriano quando comparado aos grupos convencionais (p<0,001). O microbiano mais comum nas amostras convencionais foi o Staphylococcus aureus. Não houve crescimento de fungos em nenhum dos grupos. Conclusão O uso de embalagens estéreis (sterile pack) diminui a carga microbiana dos frascos de envasamentos, o que diminuiria a chance de exposição a uma potencial contaminação da solução anestésica.
Assuntos
Bupivacaína , Esterilização/métodos , Contaminação de Medicamentos/prevenção & controle , Contaminação de Equipamentos/prevenção & controle , Embalagem de Medicamentos/métodos , Anestésicos Locais , Staphylococcus aureus/crescimento & desenvolvimento , Bacillus/crescimento & desenvolvimento , Fatores de Tempo , Contagem de Colônia Microbiana , Reprodutibilidade dos Testes , Fatores de Risco , Equipamentos e Provisões/microbiologia , Micrococcus/crescimento & desenvolvimentoRESUMO
OBJECTIVE: To compare sterility and microbial (bacteria and fungi) load in the outer part of hyperbaric bupivacaine (Neocaína®) in ampoule and bupivacaine in vial, in conventional and sterile pack formulations. METHODS: The sterile packs were divided into two groups: G1 (n=16) with ampoules and G2 (n=16) with vials. Conventional formulations were divided into two groups, being G3 (n=16) with ampoules and G4 (n=16) with vials. The ampoules and vials were opened and had their content drawn. The empty bottles were then placed in sterile plastic bags and sent for analysis of microbial load (bacteria and fungi) and sterility testing. Data were analyzed using the χ2 test with Yates correction, and 95% confidence interval. RESULTS: G1 and G2 showed no bacterial growth when compared to conventional groups (p<0.001). The most common agent in conventional microbiological samples was Staphylococcus aureus. There was no fungal growth in both groups. CONCLUSION: The use of (sterile pack) reduces the microbial load of bottles, and would decrease the chance of exposure to potential contamination of the anesthetic solution. OBJETIVO: Comparar a esterilidade e a carga microbiana (bactérias e fungos) da parte externa dos frascos de envasamento de bupivacaína hiperbárica (Neocaína®) em ampola e bupivacaína em frasco-ampola das apresentações convencional e estéril (sterile pack). MÉTODOS: As apresentações estéreis (sterile pack) foram distribuídas em dois grupos, sendo que o G1 (n=16) continha as ampolas e o G2 (n=16), os frascos-ampola. As apresentações convencionais foram distribuídas em dois grupos, a saber G3 (n=16) com as ampolas e G4 (n=16) com os frascos-ampola. As ampolas e os frascos-ampolas eram abertos e tinham seu conteúdo aspirado. Os frascos vazios eram, então, acondicionados em sacos plásticos estéreis e enviados para análise quanto à carga microbiana (bactérias e fungos), bem como para o teste de esterilidade. Os dados foram analisados por meio do teste χ2 com correção Yates com intervalo de confiança de 95%. RESULTADOS: Os grupos G1 e G2 não apresentaram crescimento bacteriano quando comparado aos grupos convencionais (p<0,001). O microbiano mais comum nas amostras convencionais foi o Staphylococcus aureus. Não houve crescimento de fungos em nenhum dos grupos. CONCLUSÃO: O uso de embalagens estéreis (sterile pack) diminui a carga microbiana dos frascos de envasamentos, o que diminuiria a chance de exposição a uma potencial contaminação da solução anestésica.
Assuntos
Anestésicos Locais , Bupivacaína , Contaminação de Medicamentos/prevenção & controle , Embalagem de Medicamentos/métodos , Contaminação de Equipamentos/prevenção & controle , Esterilização/métodos , Bacillus/crescimento & desenvolvimento , Contagem de Colônia Microbiana , Equipamentos e Provisões/microbiologia , Micrococcus/crescimento & desenvolvimento , Reprodutibilidade dos Testes , Fatores de Risco , Staphylococcus aureus/crescimento & desenvolvimento , Fatores de TempoRESUMO
Healthcare-associated infections (HAI) are described in diverse settings. The main etiologic agents of HAI are bacteria (85%) and fungi (13%). Some factors increase the risk for HAI, particularly the use of medical devices; patients with severe cuts, wounds, and burns; stays in the intensive care unit, surgery, and hospital reconstruction works. Several fungal HAI are caused by Candida spp., usually from an endogenous source; however, cross-transmission via the hands of healthcare workers or contaminated devices can occur. Although other medically important fungi, such as Blastomyces dermatitidis, Paracoccidioides brasiliensis, and Histoplasma capsulatum, have never been considered nosocomial pathogens, there are some factors that point out the pros and cons for this possibility. Among these fungi, H. capsulatum infection has been linked to different medical devices and surgery implants. The filamentous form of H. capsulatum may be present in hospital settings, as this fungus adapts to different types of climates and has great dispersion ability. Although conventional pathogen identification techniques have never identified H. capsulatum in the hospital environment, molecular biology procedures could be useful in this setting. More research on H. capsulatum as a HAI etiologic agent is needed, since it causes a severe and often fatal disease in immunocompromised patients.
Assuntos
Infecção Hospitalar/etiologia , Infecção Hospitalar/microbiologia , Equipamentos e Provisões/microbiologia , Histoplasma/patogenicidade , Blastomyces/patogenicidade , Candida/patogenicidade , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/patologia , Humanos , Paracoccidioides/patogenicidadeRESUMO
The instruments and materials used in health establishments are frequently exposed to microorganism contamination, and chemical products are used before sterilization to reduce occupational infection. We evaluated the antimicrobial effectiveness, physical stability, and corrosiveness of two commercial formulations of peracetic acid on experimentally contaminated specimens. Stainless steel specimens were contaminated with Staphylococcus aureus, Escherichia coli, Candida albicans, blood, and saliva and then immersed in a ready peracetic acid solution: 2% Sekusept Aktiv (SA) or 0.25% Proxitane Alpha (PA), for different times. Then, washes of these instruments were plated in culture medium and colony-forming units counted. This procedure was repeated six times per day over 24 non-consecutive days. The corrosion capacity was assessed with the mass loss test, and the concentration of peracetic acid and pH of the solutions were measured with indicator tapes. Both SA and PA significantly eliminated microorganisms; however, the SA solution was stable for only 4 days, whereas PA remained stable throughout the experiment. The concentration of peracetic acid in the SA solutions decreased over time until the chemical was undetectable, although the pH remained at 5. The PA solution had a concentration of 500-400 mg/L and a pH of 2-3. Neither formulation induced corrosion and both reduced the number of microorganisms (p = 0.0001). However, the differences observed in the performance of each product highlight the necessity of establishing a protocol for optimizing the use of each one.
Assuntos
Desinfetantes/farmacologia , Desinfecção/métodos , Ácido Peracético/farmacologia , Aço Inoxidável/química , Candida albicans/efeitos dos fármacos , Contagem de Colônia Microbiana , Corrosão , Desinfetantes/química , Estabilidade de Medicamentos , Equipamentos e Provisões/microbiologia , Escherichia coli/efeitos dos fármacos , Humanos , Ácido Peracético/química , Reprodutibilidade dos Testes , Saliva/microbiologia , Staphylococcus aureus/efeitos dos fármacos , Estatísticas não Paramétricas , Fatores de TempoRESUMO
The instruments and materials used in health establishments are frequently exposed to microorganism contamination, and chemical products are used before sterilization to reduce occupational infection. We evaluated the antimicrobial effectiveness, physical stability, and corrosiveness of two commercial formulations of peracetic acid on experimentally contaminated specimens. Stainless steel specimens were contaminated with Staphylococcus aureus, Escherichia coli, Candida albicans, blood, and saliva and then immersed in a ready peracetic acid solution: 2% Sekusept Aktiv (SA) or 0.25% Proxitane Alpha (PA), for different times. Then, washes of these instruments were plated in culture medium and colony-forming units counted. This procedure was repeated six times per day over 24 non-consecutive days. The corrosion capacity was assessed with the mass loss test, and the concentration of peracetic acid and pH of the solutions were measured with indicator tapes. Both SA and PA significantly eliminated microorganisms; however, the SA solution was stable for only 4 days, whereas PA remained stable throughout the experiment. The concentration of peracetic acid in the SA solutions decreased over time until the chemical was undetectable, although the pH remained at 5. The PA solution had a concentration of 500-400 mg/L and a pH of 2-3. Neither formulation induced corrosion and both reduced the number of microorganisms (p = 0.0001). However, the differences observed in the performance of each product highlight the necessity of establishing a protocol for optimizing the use of each one.
Assuntos
Humanos , Desinfetantes/farmacologia , Desinfecção/métodos , Ácido Peracético/farmacologia , Aço Inoxidável/química , Contagem de Colônia Microbiana , Corrosão , Candida albicans/efeitos dos fármacos , Estabilidade de Medicamentos , Desinfetantes/química , Equipamentos e Provisões/microbiologia , Escherichia coli/efeitos dos fármacos , Ácido Peracético/química , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Saliva/microbiologia , Staphylococcus aureus/efeitos dos fármacos , Fatores de TempoRESUMO
Postoperative endophthalmitis often progresses to significant visual impairment. This paper describes an outbreak of Ochrobactrum anthropi endophthalmitis following cataract surgery, and propose a new sterilization protocol to minimize the risk of further cases. Medical records of patients with O. anthropi endophthalmitis or with suggestive clinical findings during the outbreak were reviewed. Seven cases of O. anthropi pseudophakic endophthalmitis were confirmed between 24 July and 10 November 2010. The most probable cause of the outbreak of Ochrobactrum anthropi endophthalmitis was contamination of the tubing of the phaco-emulsification machine. Following introduction of a new sterilization protocol, no further cases occurred in over 1000 subsequent procedures.