Efectividad de los desinfectantes Lysol® y Amonio Cuaternario durante la evaluación de tres áreas críticas del sillón odontológico / Antimicrobial effectiveness of Lysol® and quaternary ammonium during evaluation of three critical areas of the dental chair

Objetivo. Determinar la eficacia antimicrobiana de Lysol® y amonio cuaternario durante la evaluación de tres áreas críticas de la unidad dental (bandeja / botones de mando, respaldo del sillón odontológico y mango de la jeringa triple). Métodos. A través de un estudio experimental comparativo transversal, se analizó un universo de 8 sillones dentales: tres fueron desinfectadas con Lysol®; tres con amonio cuaternario; dos sillones se seleccionaron como controles (positivo y negativo). Todos los sillones odontológicos se muestrearon dos veces día: antes de comenzar y al finalizar su uso, durante tres días. La toma de muestras fue realizada en las Clínicas de la Universidad Hemisferios antes y después de la colocación del desinfectante; las muestras fueron transportadas en caldo de tioglicolato para ser analizadas. Se sembraron diluciones 1:2 y 1:10 de cada muestra en Agar Plate Count y se incubaron por 24 horas a 37°C. Posteriormente, se realizó un recuento de colonias por duplicado, analizándose un total de 864 muestras. Resultados. Lysol® y amonio cuaternario 5% mostraron igual efectividad antimicrobiana ante las tres áreas analizadas (p>0.05); el área en la que se halló una mayor cantidad de microorganismos fue la bandeja (incluyendo botones de mando). Conclusión. Se determinó que tanto Lysol® como amonio cuaternario 5% son altamente eficaces para eliminar los microorganismos presentes en las superficies críticas de la unidad dental; además, el área más contaminada antes del uso de los tratamientos fue la bandeja, incluyendo los botones de mando.

Objective. Determine the antimicrobial efficacy of Lysol® and quaternary ammonium during the evaluation of three critical areas of the dental unit (control tray/buttons, dental chair back, and triple syringe handle). Methods. Through a cross-sectional comparative experimental study, a total of 8 dental chairs were analyzed: three were disinfected with Lysol®, three with quaternary ammonium, and two armchairs were selected as controls (positive and negative). All dental chairs were sampled twice a day: before use and at the end of use, for three days. Sampling was carried out at the Hemisferios University Clinics before and after the application of the disinfectant. The samples were transported in thioglycollate broth for analysis. 1:2 and 1:10 dilutions of each sample were plated on Plate Count Agar and incubated for 24 hours at 37°C. Subsequently, duplicate colony counts were performed, analyzing a total of 864 samples. Results. Lysol® and 5% quaternary ammonium showed equal antimicrobial effectiveness against the three areas analyzed (p>0.05). The area with the highest number of microorganisms was the tray (including control buttons). Conclusion. It was determined that both Lysol® and 5% quaternary ammonium are highly effective in eliminating microorganisms present on the critical surfaces of the dental unit. Furthermore, the tray, including the control buttons, was found to be the most contaminated area before treatment.

Estrategia de pesquisa sistemática y seguimiento prolongado revela alto número de nuevas infecciones tuberculosas en contactos adultos en la Región Metropolitana, Chile / Systematic screening of adult household contacts of patients with active pulmonary tuberculosis reveals high rates of new infections during follow-up

Background: Contact investigation is cardinal in the control of tuberculosis (TB) since it helps to stop its transmission. In Chile, the National TB Program strategy does not include latent TB infection testing, regular chemoprophylaxis or follow-up in adults. Active TB was found in only 1.2% of contacts at country-level during 2018. Aim: To evaluate the performance of a systematic screening of adult household contacts with targeted chemoprophylaxis and prolonged active follow-up. Material and Methods: Prospective cohort of household contacts in Santiago. Two face-to-face visits (at 0 and 12 weeks) that included QuantiFERON TB-Gold plus tests (QFT), chest radiography (CXR) at 0 and 24 weeks and, periodic text messaging or phone call follow-up for up to 48 weeks were implemented. Contacts with positive QFT were referred for TB chemoprophylaxis. Results: A total of 200 contacts were enrolled, 69% were migrants. At baseline evaluation, 45% had a positive QFT result and 1.6% had co-prevalent active TB. At follow-up, 13% contacts further converted to QFT (+), and 5.1% more were diagnosed with active TB (mean follow-up time 32 weeks). Of these 10 further active TB cases, 6 (60%) had a negative QFT and all (100%) had normal CXR at baseline; while three cases occurred in QFT converters. Conclusions: In this cohort of household contacts, 6.7 % were diagnosed with active TB (more than 2/3 at follow-up) and 13% had a late QFT (+) conversion. Active and prolonged contacts' follow-up are essential to detect new infections and tackle the TB epidemic in Chile.

Evaluación de susceptibilidad y respuesta al tratamiento con piperacilina/tazobactam en pacientes con infecciones por Escherichia coli productoras de β -lactamasas de espectro extendido (BLEE) CTX-M / Evaluation of susceptibility and response to therapy with piperacillin-tazobactam in patients with infections caused by Escherichia coli with extended-spectrum β -lactamase (ESBL) CTX-M

Resumen Introducción: En las infecciones por enterobacterias productoras de β-lactamasas de espectro extendido (BLEE), los β-lactámicos preferidos para tratamiento son los carbapenémicos. Sin embargo, estudios clínicos muestran eficacia de piperacilina/tazobactam en ciertas infecciones por Escherichia coli productoras de BLEE. Objetivo: Determinar la cura clínica y microbiológica con piperacilina/tazobactam en pacientes con infecciones por E. coli productoras de BLEE, tipo CTX-M. Materiales/Métodos: Estudio descriptivo, retrospectivo, con adultos internados en un hospital universitario. Incluimos infecciones del tracto urinario (ITU), intra-abdominales (IIA) e infecciones de tejidos blandos (ITB). Resultados: Estudiamos 40 pacientes, donde 65% correspondían a ITU, 25% IIA y 10 % ITB. La cura clínica global se logró en 89,4%, con mejores resultados en las ITU (100%), seguidas de ITB (80%) e IIA (70%). El 85% de las cepas tenía concentraciones inhibitorias mínimas (CIM) ≤ 8 μg/mL y 70% con CIM ≤ 4 μg/mL. La tasa de fracaso fue mayor en las infecciones con inóculos altos intraabdominales. La BLEE del tipo CTX-M-15 se encontró en 62,5%. Conclusiones: Piperacilina/tazobactam logró cura clínica y microbiológica, en pacientes con infecciones por E. coli productoras de BLEE susceptibles, especialmente en ITU e IPB y en menor medida en IIA.

Background: Carbapenems are the preferred β-lactamics for treatment for infections caused by enterobacteria producing extended-spectrum β-lactamases (ESBL); however, clinical studies show effectiveness of piperacillin/tazobactam in certain infections by Escherichia coli ESBL producers. Aim: To determine the clinical and micro-biological cure with piperacillin/tazobactam in patients with infections caused by E. coli ESBL producers, CTXM type. Methods: Retrospective descriptive study with adults hospitalized in a university hospital. We included urinary tract infections (UTI), intra-abdominal infections (IAI), soft tissue infections (STI) and/or bacteremia. Results: We studied 40 patients, where 65% corresponded to UTI, 25% to IAI and 10% were STI. The overall clinical cure was achieved in 89.4%, with the best results in the ITU (100%), followed by STI (80%) and 70% in IAI. The 85% of the strains had minimum inhibitory concentrations (MIC) ≤8 μg/ml and 70% with MIC ≤4 μg/mL, however the rate of failure were high in intra-abdominal infections with high inocula or not controlled; CTX-M-15 was found in the 62.5%. Conclusions: Piperacillin/tazobactam was efficient to obtain clinical and microbiological cure in patients with infections caused by ESBL producers but susceptible E. coli, especially in UTI and STI and to a lesser extent in IAI.