Calidad microbiológica del agua para hemodiálisis

RESUMEN Introducción: El elevado costo del tratamiento sustitutivo de la enfermedad renal crónica representa un reto para los sistemas de salud y la exigencia de la calidad del agua de la hemodiálisis aumenta con el transcurso de la historia de la hemodiálisis. Objetivo: identificar los indicadores microbiológicos del agua para hemodiálisis ambulatoria. Métodos: Estudio descriptivo de resultados microbiológicos de 150 muestras de agua de la planta de hemodiálisis ambulatoria del Instituto de Nefrología "Dr. Abelardo Buch López" en el periodo de enero de 2019 a abril de 2020. Las muestras se analizaron en el laboratorio de microbiología de agua del Instituto de Higiene, Epidemiología y Microbiología, La Habana, mediante métodos descritos en el texto. Se utilizó estadística descriptiva. Resultados: De las muestras de agua analizadas 92 % (n=138) fueron microbiológicamente satisfactorias, 8 % (n=12) que no cumplieron los requisitos se registraron en los primeros seis meses del año 2019. En la totalidad de los informes de positividad o alerta, se procedió a la limpieza y desinfección del sistema de tratamiento. No se comprobó presencia de Pseudomonas aeruginosa en las muestras. No hubo incidencia de infecciones asociadas con el tratamiento de hemodiálisis. La determinación de endotoxinas no se realizó en el período. Conclusiones: La mayoría de los informes microbiológicos recibidos en el período de estudio cumplieron las normas establecidas. La vigilancia de la calidad del agua para hemodiálisis permite la ejecución de acciones preventivas, lo cual es determinante en el proceso de diálisis y para la calidad de vida de los pacientes.

ABSTRACT Introduction: The high cost of replacement therapy for chronic kidney disease poses a challenge to the health systems, and a better quality of the water for hemodialysis is required over time. Objective: To identify the microbiological indicators of the water for outpatient hemodialysis Methods: A descriptive study based on the microbiological results of 150 samples of water from the outpatient hemodialysis water station at the Institute of Nephrology "Dr. Abelardo Buch López", from January 2019 to April 2020. Samples were analyzed in the water microbiology laboratory at the Institute of Hygiene, Epidemiology and Microbiology, Havana by methods described in the text. Descriptive statistics was used. Results: Of the water simples analyzed, 92% (n=138) were microbiologically satisfactory, 8% (n=12) did not meet the requirements and were registered in the first half of 2019. In the event of a positivity or alert report, the treatment system was all cleaned and disinfected in each case. Pseudomonas aeruginosa was not identified in the samples. No infection was associated with the hemodialysis treatment. Endotoxin determination was not performed in this period. Conclusions: Most of the microbiological reports received during the study period met the established standards. Monitoring the quality of water for hemodialysis allows the implementation of preventive measures that are critical for the dialysis process and the quality of life of the patients.

Riqueza total de especies de plantas vasculares en un bosque andino de la Cordillera central de Colombia / Total richness of vascular plant species in an Andean forest of the Central Cordillera, Colombia

Resumen Los reportes sobre diversidad de plantas en los bosques tropicales suelen estar restringidos a árboles u otros grupos de plantas leñosas por encima de cierto diámetro del tallo. Sin embargo, otros estudios que incluyen todas las formas de vida sin restricciones de tamaño de los individuos, indican claramente que las plantas no leñosas son igual de importantes. En este estudio se reporta la Riqueza total de especies de plantas vasculares (RTE) en una parcela de una hectárea en un bosque andino del noroccidente de Colombia (6º12'48"N & 75º29'32"O); adicionalmente evaluamos la contribución de los diferentes hábitos de crecimiento a la RTE y el efecto del tamaño de las plantas. Se censaron todos los individuos con diámetro del tronco (D) ≥ 5 cm en 1 ha, y todas las plantas vasculares de todos los tamaños, incluyendo epífitas, en una muestra de 0.25 hectáreas. Se registró un total de 14 545 individuos distribuidos en 318 especies, 72 familias (considerando Pteridophyta como un solo grupo) y 171 géneros. El 99.7 % de las especies son menores de 10 cm de (D) y el 94.4 % son menores a 2.5 cm de (D). Las especies no arbóreas (hierbas terrestres, epífitas y escandentes) representan el 54.3% del total de especies registradas en la parcela, lo que indica que son un componente clave de la estructura, composición y riqueza de este bosque montano neotropical. Estos resultados confirman reportes similares para otros bosques tropicales. Concluimos que para conocer con más detalle la diversidad de florística de un sitio es recomendable: 1) ampliar el rango de tamaño de las plantas considerado comúnmente en los inventarios florísticos y 2) incluir las especies no leñosas; esta información es crucial para tomar mejores decisiones en los esfuerzos de conservación a escala local y global.

Abstract Studies of plant diversity in tropical forests are usually restricted to trees or other groups of woody plants above a certain stem diameter. However, surveys that include all forms of live plants with no restrictions on their sizes, clearly indicate that non-woody plants are equally important. In this study, we reported the total species richness of vascular plants species (TSR) in one hectare plot in an Andean forest in Northwestern Colombia (6º12'48"N & 75º29 32"W). We evaluated the relative contribution of the different growth habits and the effect of the plant size, to TSR. We measured all individuals with diameter (D) ≥ 5 cm in the hectare and all the vascular plants of all sizes, including epiphytes, in a subsample of 0.25 ha. A total of 14 545 individuals distributed in 318 species, 72 families (considering Pteridophyta as one group) and 171 genera were registered. Most of the species showed a (D) < 10 cm (99.7 %) and < 2.5 cm (94.4 %). The no-arboreal species (ground herbs, epiphytes and vines) represented 54.3 % of the total species reported in the plot, indicating that they are important in the structure, composition and species richness of this montane forest. Our results coincide with similar studies in other tropical forests. We concluded that to get a more detailed knowledge of the floristic diversity of a site, it is advisable to: 1) amplify the size range of the plants generally considered in the floristic inventories and 2) to include non-woody species. This information is crucial for making better decisions in local and global conservation efforts. Rev. Biol. Trop. 66(1): 227-236. Epub 2018 March 01.

The single water-surface sweep estimation method accurately estimates very low (n = 4) to low-moderate (n = 25-100) and high (n > 100) Aedes aegypti (Diptera: Culicidae) pupae numbers in large water containers up to 13 times faster than the exhaustive sweep and total count method and without any sediment contamination.

OBJECTIVE: To confirm that a single water-surface sweep-net collection coupled with three calibration factors (2.6, 3.0 and 3.5 for 1/3, 2/3 and 3/3 water levels, respectively) (WSCF) could accurately estimate very low to high Aedes aegypti pupae numbers in water containers more rapidly than the exhaustive 5-sweep and total count (ESTC) method recommended by WHO. METHODS: Both methods were compared in semi-field trials using low (n = 25) to moderate (n = 50-100) pupae numbers in a 250-l drum at 1/3, 2/3 and 3/3 water levels, and by their mean-time determinations using 200 pupae in three 220- to 1024-l water containers at these water levels. Accuracy was further assessed using 69.1% (393/569) of the field-based drums and tanks which contained <100 pupae. RESULTS: The WSCF method accurately estimated total populations in the semi-field trials up to 13.0 times faster than the ESTC method (all P < 0.001); no significant differences (all P-values ≥ 0.05) were obtained between the methods for very low (n = 4) to low-moderate (n = 25-100) and high (n > 100) pupae numbers/container and without sediment disturbance. CONCLUSION: The simple WSCF method sensitively, accurately and robustly estimated total pupae numbers in their principal breeding sites worldwide, containers with >20 l water volumes, significantly (2.7- to 13.0-fold: all P-values <0.001) faster than the ESTC method for very low to high pupae numbers/container without contaminating the clean water by sediment disturbance which is generated using the WHO-recommended ESTC method. The WSCF method seems ideal for global community-based surveillance and control programmes.