Experimental Biology 2021 Meeting Abstracts.

According to WHO's definition, self-medication is the use of drugs to treat self-diagnosed disorders or symptoms. There is a high risk of self-medication on the general population, mainly in South America. This phenomenon has been increasing with the SARS-CoV-2 outbreak, generating concerns, and anxieties in people, especially during the period of confinement. The present study used an online survey to determine the standard self-medication practices, risk, and medication-severity-index of the Ecuadorian confinement population. This study is a quantitative descriptive analysis survey designed by pharmacists and medical professionals for the self-medication during the confinement. A total of 400 Ecuadorian adults were recruited, and 380 adults accepted the digital informed consent, regardless of whether or not they had had symptoms of COVID19 during the quarantine. The survey platform used was Google Forms, and the digital social networks (WhatsApp, Facebook) were its broadcast medium. The inclusion criteria were adults who respect the confinement conditions. We excluded health professionals or who were already taking long-term medication. The data were analyzed by R, and the Hazard-Risk-Assessment-Score (HRAS) used the analysis of clinically relevant questions. There is a high risk of drug-related problems, despite the high level of education of the surveyed population (63.1% third level and 26.72% 4th level). The 55% of the surveyed Ecuadorian population had an extreme risk of self-medication (HRAS25 points), 35% prefer a drug therapy recommendation of TV, Social networks, and influencer, instead of Health professional (HRAS 20 points, moderate risk), and 39% ends up their medication before recommendations of a health professional (doctor or pharmaceutical), meaning in a moderate risk of self-medication (HRAS 12 points). There is a high risk of the Ecuadorian population to self-medication regardless of the level of education acquired. Even though the majority of the people answered requesting a prescription for the acquisition and consumption of drugs, they presented drug-related problems.

Bla-OXA48 gene microorganisms outbreak, in a tertiary Children's Hospital, Over 3 years (2012-2014): Case Report.

RATIONALE: Carbapenem-resistant Enterobacteriaceae are an emerging problem in children. Nosocomial spread remains the principal risk factor for acquisition of these microorganisms. PATIENTS CONCERNS: We describe an outbreak of Klebsiella pneumoniae OXA48 (KOXA48) in a tertiary children's hospital during the years 2012 to 2014, as well as the preventive measures put in place in colonized and infected cases. DIAGNOSES: We studied, "in vitro," the KOXA48 susceptibility to antiseptics and surface disinfectants. Moreover, an epidemiological surveillance of infection or colonization by these microorganisms, with molecular typing of the KOXA48, was performed, and carbapenemase genes were confirmed by polymerase chain reaction (PCR). INTERVENTIONS: The bundles recommended (early detection, cohorting of children and health care workers [HCW], contact precautions, etc.) to control the KOXA48 outbreak were taken from those described in the centers for disease control (CDC) 2012 guide, and adapted according to our experience in controlling other outbreaks. OUTCOMES: All the KOXA48 microorganisms isolated from children belonged to the same strain (ST11) and were susceptible to alcohol solutions but not the surface disinfectant previously employed in our hospital (tensoactive). We reinforced the surface disinfection using a double application (tensoactive + alcohol). The outbreak of KOXA48 begun in 2012 (16 cases in neonatal intensive care unit [NICU] and 1 in pediatric intensive care unit [PICU]) ended before the end of the same year and was not transmitted to new patients in 2013 to 2014, despite readmission of some colonized cases, in intensive care units (ICUs) and other units, of our children hospital. LESSONS: Infected children are the tip of the iceberg (3/17) of KOXA48 prevalence making it necessary to identify the cases colonized by these bacteria. At the beginning of the outbreak, the susceptibility of the epidemic strain to antiseptics and surface disinfectants should be studied. Moreover, the measures taken (cohorts, contact precautions, etc.) must be thorough in both colonized and infected cases, immediately, after microbiological diagnosis.

Surface Disinfectants for Burn Units Evaluated by a New Double Method, Using Microorganisms Recently Isolated From Patients, on a Surface Germ-Carrier Model.

Assessment methods of surface disinfection based on international standards (Environmental Protection Agency, European Norms, etc) do not correspond to hospital reality. New evaluation methods of surfaces disinfection are proposed to choose the most suitable disinfectant to act against clinically relevant microorganisms detected on the surfaces of burn units. 1) "Immediate effect": 6 products were compared using a glass germ-carrier and 20 recently isolated microorganisms from different patients in the intensive care units. Disinfectants were applied with microfiber cloths. Log10 reductions were calculated for colony forming units produced after 15 minutes of disinfectant application. 2) "Residual effect": the glass germ-carriers were previously impregnated with one of the studied disinfectants. After a 30-minute wait period, they were then contaminated with 1 microorganism (from the 20 above-mentioned). After 15 minutes, the disinfectant was inhibited and the log10 reduction of colony forming units was assessed. The immediate effect (disinfection and microorganism dragging and transferring from the surface to the cloth) produced complete elimination of the inoculums for all products used except one (a diluted quaternary ammonium). The average residual effect found on the 20 microorganisms was moderate: 2 to 3 log10 colony forming unit reduction with chlorine dioxide or 0.5% chlorhexidine (and lower with the other products), obtaining surfaces refractory to recontamination, at least, during 30 minutes. Two tests should be performed before advising surface disinfectant: 1) direct effect and 2) residual efficacy. These characteristics should be considered when a new surface disinfectant is chosen. Chlorine dioxide has a similar or better direct effect than sodium hypochlorite and a similar residual effect than chlorhexidine.

Lasting hand self-disinfection: A backup for hospital hand hygiene?

BACKGROUND: Hand disinfection should be performed on the occasion of 5 separate moments during patient care, but some occasions are skipped. Can using hand antiseptics with residual effect reduce the problem of infection spread? We evaluated a 30-minute residual effect by different antiseptic products on endogenous and acquired microbiota. METHODS: The products tested were 2% and 5% chlorhexidine, 1% and 10% iodine povidone, 60° n-propanol, 0.2% mecetronium + isopropanol, and 0.6% chlorhexidine + isopropanol + 0.1% benzalconium chloride. The microorganisms identified were 3 ATCC and 9 multiresistant strains isolated from intensive care unit patients (used as acquired microbiota). Logarithmic (log10) reductions of the colony forming units obtained with each antiseptic product and for each microorganism were calculated via in vivo (6 volunteers) and in vitro tests. RESULTS: The better in vivo and in vitro products with a residual effect > 2 log10 after 30 minutes on hands were 2%-5% chlorhexidine and 0.6% chlorhexidine + isopropanol + 0.1% benzalconium chloride. This reduction was significantly different (P < .01) from the other 4 antiseptics. This residual effect (> 2 log10) can be considered a self-disinfecting hand status in daily practice. CONCLUSIONS: Hand antiseptics used in hospitals must pass tests of residual efficacy (after 30 minutes on acquired microbiota) showing a reduction > 2 log10 in vivo and in vitro. A good product can be the mixture of chlorhexidine + alcohol + benzalconium chloride.

Disección iatrogénica de aorta por catéter tipo A, sin afectar a la coronaria: estudio pronóstico a largo plazo / Type a iatrogenic aortic dissection following catheterization without coronary involvement: long-term prognosis

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Effectiveness of oxaliplatin desensitization protocols.

INTRODUCTION: Hypersensitivity reaction (HSR) to antineoplastic drugs can force doctors to stop treatment and seek other alternatives. These alternatives may be less effective, not as well tolerated and/or more expensive. Another option is to use desensitization protocols that induce a temporary state of tolerance by gradually administering small quantities of the antineoplastic drug until the therapeutic dosage is reached. The aim of this study is to assess the effectiveness of oxaliplatin desensitization protocols. MATERIALS AND METHODS: A retrospective observational study was carried out between January 2006 and May 2011. The inclusion criteria were patients undergoing chemotherapy treatment with oxaliplatin who had developed an HSR to the drug and who were candidates for continuing the treatment using a desensitization protocol. The patients' clinical records were reviewed and variables were gathered relating to the patient, the treatment, the HSR, and the desensitization protocol administered. The data were analysed using version 18.0 of the statistics program SPSS. RESULTS: A total of 53 desensitization protocols were administered to 21 patients. In 89 % of these cases, no new reactions occurred while the drug was being administered. New reactions of mild severity only occurred in 11 % of cases, and none of these reactions were severe enough for treatment to be stopped. All patients were able to complete the desensitization protocol. CONCLUSION: This study confirms that oxaliplatin desensitization protocols are safe and effective and allow patients to continue with the treatment that initially caused an HSR.

Identificación de levaduras y sensibilidad in vitro a diversos antifúngicos / Identification of yeasts and sensitivity in vitro against different antifungal

Introducción: El aumento en la incidencia de infecciones por hongos levaduriformes del género Candida y su repercusión en el ámbito hospitalario y comunitario (vaginitis recidivante), así como el conocimiento de los nuevos antifúngicos en el arsenal terapéutico, nos han motivado a identificar levaduras de este género de diverso origen y a estudiar su comportamiento frente a los antifúngicos utilizando métodos comerciales de fácil aplicación en el uso clínico. Material y métodos: Se han identificado por métodos comerciales (CHROMagar Candida® y Auxacolor®), un total de 317 levaduras del género Candida: 108 vaginales, 138 de unidades de cuidados intensivos de neonatos y 71 de unidades de cuidados intensivos de adultos, realizándose el antifungigrama a 199 de los aislados utilizando un método comercial (Fungitest®). Resultados y conclusiones: Candida albicans se identifica como el microorganismo más frecuente en ambos tipos de muestras, comunitarias y hospitalarias (el 78,7 y el 45,93 por ciento, respectivamente) seguida de Candida glabrata (el 19,44 y el 28,23 por ciento, respectivamente). La sensibilidad a anfotericina B y 5-fluorocitosina ha sido muy elevada en todos los grupos estudiados, mientras que la sensibilidad a derivados imidazólicos depende de la procedencia de las muestras (menor sensibilidad en los aislados de unidades de cuidados intensivos de neonatos), así como de la especie (C. glabrata es menos sensible que C. albicans) (AU)