Polymerase chain reaction detection of enterotoxins genes in coagulase-negative staphylococci isolated from Brazilian Minas cheese.

For a long time, Staphylococcus aureus has been always thought to be the only pathogenic species among Staphylococcus, while coagulase-negative staphylococci (CNS) were classified as contaminant agents. However, molecular techniques have shown that these microorganisms also possess enterotoxin-encoding genes. The aim of this study was to analyze the frequency of genes for staphylococcal enterotoxins SEA, SEB, SEC, and SED in CNS strains isolated from Minas soft cheese and to assess the in vitro production of toxins. CNS were found in 65 (72.2%) samples of cheese: 23 were Staphylococcus saprophyticus, 16 Staphylococcus warneri, 10 Staphylococcus epidermidis, 9 Staphylococcus xylosus, 3 Staphylococcus haemolyticus, 2 Staphylococcus schleiferi subsp. schleiferi, and 1 each Staphylococcus capitis subsp. urealyticus and Staphylococcus caprae. Seventeen (26.2%) CNS strains had genes for enterotoxins, and sea was more frequently found (18.5%), followed by sec in three and seb in two strains, whereas the sed gene was not found. S. saprophyticus showed enterotoxin genes in 6 of 23 isolates, but only sea was observed. On the other hand, five strains of S. warneri showed the sea, seb, or sec gene. In spite of the presence of these enterotoxin genes, these strains did not produce enterotoxins in vitro. It is essential to understand the real role of CNS in food, and based on the presence of enterotoxin genes, CNS should not be ignored in epidemiological investigations of foodborne outbreaks.

Elaboração e implantação de protocolo de infiltração e extravasamento de antineoplásicos em acesso venoso central / Elaboración e implementación de un protocolo para la infiltración y extravación de antineoplásicos en el acceso venoso central / Elaboration and implementation of a protocol for infiltration and extravassion of antineoplastics in central venous access

Objetivo: Relatar a experiência na elaboração e implantação do protocolo de extravasamento e infiltração de antineoplásicos em acesso venoso central. Método: estudo descritivo, tipo relato de experiência realizado de fevereiro a maio de 2021. Resultados: Após a busca de evidências na literatura, foi elaborado um fluxograma referente aos cuidados de enfermagem realizados durante e após o extravasamento/infiltração. Além das medidas iniciais padronizou-se o uso da hialuronidase tópica e da fotobiomodulação (1 a 3 joules, com potência de 100 miliwats). A área deveria ser demarcada e se possível fotografada. Após a validação do protocolo por um grupo de enfermeiros especialistas e pelo escritório de qualidade, foi implantado em um Ambulatório de Oncologia de Hospital Público do interior do Estado de São Paulo. Conclusão: Apesar de raro, o extravasamento em acesso central pode acontecer e a equipe precisa de um protocolo assistencial para padronizar a conduta e garantir o sucesso da terapêutica.(AU)

Objective: To report the experience in the elaboration and implementation of the protocol for extravasation and infiltration of anticancer drugs in central venous access. Method: descriptive study, experience report type carried out from February to May 2021. Results: After searching for evidence in the literature, a flowchart was created referring to the nursing care performed during and after the extravasation/infiltration. In addition to the initial measurements, the use of topical hyaluronidase and photobiomodulation (1 to 3 joules, with a potency of 100 milliwatts) was standardized. The area should be demarcated and, if possible, photographed. After validation of the protocol by a group of specialist nurses and by the quality office, it was implemented in an Oncology Outpatient Clinic of a Public Hospital in the interior of the State of São Paulo. Conclusion: Although rare, extravasation in central access can happen and the team needs a care protocol to standardize the conduct and ensure the success of the therapy.(AU)

Objetivo: Informar la experiencia en la elaboración e implementación del protocolo de extravasación e infiltración de fármacos antineoplásicos en acceso venoso central. Método: estudio descriptivo, tipo relato de experiencia realizado de febrero a mayo de 2021. Resultados: Después de la búsqueda de evidencias en la literatura, se elaboró un diagrama de flujo sobre los cuidados de enfermería realizados durante y después de la extravasación/infiltración. Además de las mediciones iniciales, se estandarizó el uso de hialuronidasa tópica y fotobiomodulación (1 a 3 julios, con una potencia de 100 milivatios). El área debe ser delimitada y, si es posible, fotografiada. Después de la validación del protocolo por un grupo de enfermeros especialistas y por la oficina de calidad, fue implantado en un Ambulatorio de Oncología de un Hospital Público del interior del Estado de São Paulo. Conclusión: aunque rara, la extravasación en el acceso central puede ocurrir y el equipo necesita un protocolo de atención para estandarizar la conducta y garantizar el éxito de la terapia.(AU)