The Effect of Therapeutic Clowning on Handwashing Technique and Microbial Colonization in Preschool Children.

PURPOSE: This study aimed to determine the effect of therapeutic clowning on handwashing technique and microbial colonization in preschool children. DESIGN: This randomized controlled trial was conducted using pre-test and post-test experimental and control groups. METHODS: The study was conducted between March and June 2016 in two kindergartens in eastern Turkey. The study was completed with a total of 195 students, including 90 students in the experimental group and 105 students in the control group. A questionnaire was used for data collection. This questionnaire included sections about the subjects' descriptive characteristics and the results of the bacterial cultures of their hand swabs. For the collection of these swabs, the subjects were informed in advance, and samples were collected at predetermined times. The swabs were analyzed to determine the bacterial colonization of the subjects' hands. Clowns and video activities were used as intervention tools in the study. FINDINGS: In the post-test, the microbial growth was ≤103 in 68.9% and >103 in 31.1% of the subjects in the experimental group. In contrast, the growth was ≤103 in 34.3% and >103 in 65.7% of the control group subjects. The difference in the post-test microbial growths of the two groups was statistically significant (p < .000). CONCLUSIONS: The hygienic handwashing technique taught in the therapeutic clowning and videos reduced the bacterial colonization on the preschool children's hands by 50%. Moreover, this method was effective in reducing the growth rate of coliform bacteria that indicate undesirable, poor hygiene of the hands. CLINICAL RELEVANCE: Considering these results, we recommend that pediatric healthcare professionals use entertaining methods such as those involving clowns to teach and guide children regarding hygienic handwashing techniques.

Comparison of the mycobacterium growth indicator tube method and the method of proportion for drug susceptibility testing of mycobacterium tuberculosis.

OBJECTIVE: Tuberculosis is an important public health problem in developed and, especially, developing countries. The incidence of multi-drug-resistant Mycobacterium tuberculosis (MDR-TB) has increased in recent years. Mycobacterial culture and susceptibility testing must be rapidly concluded for effective treatment and control of the disease. The present study evaluated the reliability of the Mycobacterium Growth Indicator Tube (MGIT) method for testing the susceptibility of M. tuberculosis to four first-line antimicrobial drugs by comparing MGIT results to those obtained by the method of proportion (MOP), which served as the reference method. MATERIALS AND METHODS: A total of 60 clinical isolates (28 sputum, 7 bronchoalveolar lavage, 7 cerebrospinal fluid, 3 gastric aspirates, 5 urine, 4 pleural fluid and 6 other specimens) of M. tuberculosis were tested for susceptibility to streptomycin (SM), isoniazid (INH), ethambutol (EMB) and rifampin (RIF). MOP was carried out according to National Committe for Clinical Laboratory Standards (NCCLS) on Löwenstein-Jensen medium. MGIT susceptibility testing was performed according to the protocol provided by the manufacturer. RESULTS: Resistance was detected in 18.3% and 16.7% of the isolates for INH, 13.3% and 10.0% for RIF, 16.7% and 11.7% for SM and 6.7% and 8.3% for EMB by MOP and MGIT, respectively. CONCLUSION: MOP remains the method of choice, however, the correlation between MOP and MGIT suggested that MGIT can also be used routinely and that it is a reliable method for testing susceptibility of M. tuberculosis strains to first-line anti-tuberculosis drugs.

Evaluation of quinolone resistance in gram negative bacilli isolated from community- and hospital-acquired infections.

OBJECTIVE: Gram negative bacilli are among the most important microbial agents involved in both hospital- and community-acquired infections. The quinolones are preferred antibacterial agents for the treatment of both community- and hospital-acquired urinary tract infections caused by gram negative bacilli because of their strong antibacterial effects, and because they can be administered both orally and parenterally. In this study, it was aimed to determine the sensitivity of gram negative bacteria isolated from both hospital- and community-acquired infections, to quinolones. MATERIALS AND METHODS: Bacterial strains used in this study were isolated from pathologic samples of patients who were treated in different clinics or who were admitted to the polyclinics of Atatürk University Research Hospitals. Susceptibility to ciprofloxacin, levofloxacin, ofloxacin and norfloxacin was assessed for all strains included in the study via the Kirby-Bauer disk diffusion method according to CLSI criteria. RESULTS: Of the 205 strains tested, 116 (56.5%) were from community-acquired infections, and 89 (43.5%) were from hospital-acquired infections. Resistance rates of community-origin strains against ciprofloxacin, ofloxacin and levofloxacin were 25%, whereas they were 26.7% against norfloxacin. Ciprofloxacin was the most effective quinolone (65.2%) against hospital-origin strains. E. coli was the most commonly isolated etiological agent from both community- and hospital-acquired infections. CONCLUSION: In this study, resistance to quinolones was observed for gram negative bacilli isolated from both hospital- and community-acquired infections, with the exception of community-acquired Salmonella and Shigella. Thus, these drugs should not be used empirically in the treatment of infections caused by gram negative bacilli, and susceptibility test results should be considered when planning therapy.