Sex-dependent vulnerability for Wistar rats model following intranasal instillation with Klebsiella pneumoniae ATCC 43816 causing lobar pneumonia.

BACKGROUND: Klebsiella pneumoniae has become one of the major threats to public health as it causes nosocomial and community-acquired infections like lobar pneumonia. This infection causes acute inflammation in the lung, characterized by the recruitment of polymorphonuclear cells, generating free radicals, and decreasing the endogenous antioxidant balance system. Many experimental studies have focused on the induction, progression and resolution of infection up to its peak, but these documented processes remain highly random and their sex dependence un-elicited. These fluctuations of physiopathological parameters would impact disease progression depending on the animal's model and bacterial strain used. The present study investigated the sex-dependent vulnerability of Wistar rats to K. pneumoniae ATCC 43816 lobar pneumonia induced by the intranasal instillation method. METHODS: Experimental pneumonia was induced by K. pneumoniae ATCC 43816 in male and female Wistar rats following intranasal instillation. The physiopathogenesis of the disease was studied by bacteriological and histopathological exams, histomorphometric analysis of the blood and/or lung tissue, and body weight loss in infected animals. In addition, the overall severity of lesions was determined by the total score obtained by averaging the individual scores from the same group of animals. RESULTS: The K. pneumoniae ATCC 43816 strain showed inoculation dose-, incubation time of the disease- and sex-dependent- differences in its ability to induce lobar pneumonia. Evaluation of different parameters showed that the disease peaked on day 15 post-inoculation, with more pathogenic effects on female rats. This observed sex-dependence difference in Wistar rats was mainly highlighted by the determined lethal dose 50 (LD50), bacterial load count in whole blood and lung tissues, body weight loss, inflammatory granulomas forming and diffuse alveolar damages. The pathogenicity was confirmed by scoring the severity of pathologic lesions of lung tissues. CONCLUSIONS: The results obtained highlighted the gender-dependency in the physiopathogenesis processes of K. pneumoniae ATCC 43816 induced-lobar pneumonia, in Wistar rats. Female Wistar rats' susceptibility is useful in studying pathology and in preclinical trial investigations of new treatments for infectious pneumonia.

Antioxidant and anti-inflammatory effects of Boswellia dalzielii and Hibiscus sabdariffa extracts in alloxan-induced diabetic rats.

Diabetes mellitus (DM) is one of the leading worldwide public health problems. It is characterized by hyperglycemia which induces oxidative stress and inflammation, both involved in the pathogenesis of diabetes. We previously showed that Boswellia dalzielii (BD) and Hibiscus sabdariffa (HS) extracts reduced hyperglycemia and hyperlipidemia in alloxan-induced diabetic rats. In the present study, we evaluated the antioxidant and anti-inflammatory activities of both plants in alloxan-induced diabetic rats. Two sets of experiments were conducted in male Wistar rats subjected to a single intraperitoneal injection of alloxan monohydrate (150 mg/kg, b. w.). Then, diabetic rats were daily administered with either BD (1st set of experiments) or HS (2nd set of experiments) at 100, 200, and 400 mg/kg orally for 21 consecutive days. Glibenclamide (10 mg/kg) was also administered as a reference drug. At the end of the study, the animals were anesthetized, and blood samples were collected from each animal. Then, oxidative stress and inflammatory biomarkers in the serum were determined. We found that treatment with BD and HS significantly reduced malondialdehyde (MDA) and enhanced the levels of reduced glutathione (GSH), superoxide dismutase (SOD), and catalase (CAT). These extracts also significantly decreased the inflammatory markers tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-1 beta (IL-1ß). From the results obtained, it can therefore be concluded that BD and HS have the potential to being developed as natural sources of antioxidant and anti-inflammatory agents that can be used for the prevention or treatment of DM.

In-Field Implementation of Near-Infrared Quantitative Methods for Analysis of Medicines in Tropical Environments.

Near-infrared (NIR) spectroscopy is actually a well-established technique that demonstrates its performance in the frame of detection of poor-quality medicines. The use of low-cost handheld NIR spectrophotometers in low-resource contexts can allow an inexpensive and more rapid detection compared to laboratory methods. Considering these points, it was decided to develop, validate, and transfer methods for the quantification of ciprofloxacin and metronidazole tablet samples using a NIR handheld spectrophotometer in transmission mode (NIR-M-T1) coupled to chemometrics such as partial least squares regression (PLSR) algorithm. All of the models were validated with the total error approach using an accuracy profile as a decision tool, with ±10% specifications and a risk α set at 5%. Quantitative PLSR models were first validated in Belgium, which is a temperate oceanic climate zone. Second, they were transferred to Cameroon, a tropical climate zone, where issues regarding the prediction of new validation series with the initial models were highlighted. Two augmentation strategies were then envisaged to make the predictive models robust to environmental conditions, incorporating the potential variability linked to environmental effects in the initial calibration sets. The resulting models were then used for in-field analysis of ciprofloxacin and metronidazole tablet samples collected in three cities in Cameroon. The contents results obtained for each sample with the two strategies were close and not statistically different. Nevertheless, the first one is easier to implement and the second is the best regarding model diagnostic measures and accuracy profiles. Two samples were found to be noncompliant in terms of content, and these results were confirmed using high-performance liquid chromatography taken as the reference method.

Evaluation of the Antimicrobial Resistance Surveillance System in Sentinel Sites in Cameroon.

Background The purpose of antimicrobial resistance (AMR) surveillance is to guide clinical decision-making, characterize trends in resistance infections, and provide epidemiological data to study the impact of AMR on health and the effectiveness of control measures in health facilities and the community. To do this, regular and relevant assessments of standardized AMR surveillance systems are essential to prioritize threats and improve their performance and cost-effectiveness. The scarcity of data and the absence of a local and national strategy on the surveillance of antibiotic resistance in Sub-Saharan Africa and even more so in Cameroon do not allow an effective response to be carried out against the scourge. This gap led us to conduct a study on the evaluation of the attributes of the antibiotic resistance surveillance system in Cameroon. Methodology We conducted a descriptive, cross-sectional study over a period of one year from January to December 2021. The study was conducted in the sentinel sites of surveillance in Cameroon, namely, those of the Centre, South-West, Littoral, and North regions. Using structured questionnaires and a pre-established and pre-tested interview guide, we collected data that allowed us to assess a surveillance system's quantitative and qualitative attributes according to the CDC guidelines. Scores were assigned based on the different questionnaires to assess the attributes of the AMR surveillance system. Results Of the evaluated attributes, it appears that although the system is useful (88.9%, i.e., a score of 2), and has good completeness of data transmission (98.9%, i.e., a score of 3), it is not simple (64.3%, i.e., a score of 1), not stable (58.6%, i.e., a score of 1), not acceptable (58.6%, i.e., a score of 1), and presents poor data quality (11.05%, a score of 1). Conclusions The AMR surveillance system in Cameroon is useful with good completeness. However, many other attributes have poor performance, indicating the importance of improving the antimicrobial surveillance system.

Antibiotic consumption history of patients in a referred laboratory in Yaounde.

Background: Regulation of antibiotic prescription and consumption remains a major public health burden in low- and middle- income countries. Objective: This study aimed to describe the antibiotic consumption of patients who had a positive antibiotic culture in a reference laboratory. Methods: A retrospective descriptive study was conducted among 113 participants with positive antibiograms with a documented history of antibiotics intake at the Yaoundé University Teaching Hospital in Cameroon between January 2016 and June 2021. Data were stored and analyzed using the Census and Survey Processing System version 7.3 and Statistical Package for Social Science version 25.0. Descriptive statistics were used to estimate the indicators. Results: Of the 113 patients enrolled, 105 had a history of drug use; 56 participants (53.3%) had taken at least 2 antibiotics prior to sampling. Cephalosporins were the most consumed antibiotics (41%), followed by nitroimidazols (28.6%) and penicillins (28.6%). According to the World Health Organization classification, 55 (52.4%) took major priority antibiotics. Conclusion: We are on the alert and there is an urgent need to raise awareness among clinicians and patients alike by providing them with good clinical practice guidelines.

Antibiotic consumption history of patients in a referred laboratory in Yaounde

Background. Regulation of antibiotic prescription and consumption remain a major public health burden in low- and middle-income country. This study aimed to describe the antibiotic consumption of patients who had a positive antibiotic culture in a reference laboratory. Methods. A retrospective descriptive study was conducted among 113 participants with positive antibiogram with a documented history of antibiotics intake at the Yaoundé University Teaching Hospital (YUTH) in Cameroon between January 2016 to June 2021. Data were stored and analyzed using the Census and Survey Processing System (CSPro) version 7.3 and Statistical Package for Social Science (SPSS) version 25.0. Descriptive statistic was used to estimate the indicators. Results. Of the 113 patients enrolled, 105 had a history of drug use; 56 participants (53, 3%) had taken at least 2 antibiotics prior to sampling. Cephalosporins were the most consumed antibiotics (41, 0%), followed by nitroimidazols (28, 6%) and penicillins (28,6%). According to the WHO classification, 55 (52, 4%) took the major priority antibiotics. Conclusion. We are on the alert and there is an urging need to raise awareness among clinicians and patients alike by providing them with good clinical practice guidelines.

Problématique duDiagnostic du VIH en Afrique Subsaharienne: Résultats Erronés dans une Etude Pilote (NAMSAL) au Cameroun

Introduction.The NAMSAL therapeutic trial evaluated the non-inferiority of a first line treatment comprising Dolutegravir to another line comprising Efavirenz 400. The criteria for not taking part to the trial included infection with non-M HIV-1, untreated patients with HIV viral load <1000 copies/mL. The objective of this study was to explain why some treatment naïve patients had undetectable viral loads. Materials and methods. Out of 817 patients pre-included with HIV-1 infection and untreated, 204 were not included and the present study focused on 114 of these 204 patients not included in NAMSAL. HIV plasma viral load, serological status and the serotype were confirmed by RT-qPCR (Abbott), INNOLIA HIVI/II Score (Fujirebio), and by ELISA with synthetic peptides of thedifferent HIV-1&2 groups. Universal or specific PCR (M and O) were performed on the samples for molecular confirmation and characterization. Results. Amongthe 114 patients studied, 49 (43%) had a viral load < 1000 copies/mL and 65 (57%) had a viral load > 1000 copies/mL. When reported to the whole cohort of pre-included patients (n=817), 4/817 (0.5%) were group-O confirmed by molecular biology. Based on the PCR results, 14 out of 817 patients (1.7%) deemed to be HIV-1 positive were most likely uninfected. Conclusion. 1.7% of HIV-1 patients referred for inclusion in NAMSAL were not actually infected. Ongoing staff training and quality control of laboratories must be strengthened in Cameroon in view of the social and economic consequences of misdiagnosis.

Poor-Quality Medicines in Cameroon: A Critical Review.

Poor-quality medicines are the cause of many public health and socioeconomic problems. We conducted a review to acquire an overview of the situation concerning such medicines in Cameroon. Different searches were performed on databases from several websites of the WHO, the Ministry of Public Health of Cameroon, the Anti-Counterfeit Medicine Research Institute, the Global Pharma Health Fund, and the Infectious Disease Data Observatory. We identified 92 publications comprised of 19 peer-reviewed studies and 73 alerts. Based on studies completed, 1,664 samples were analyzed, and the prevalence of substandard and falsified (SF) medicines could be estimated for 1,440 samples. A total of 67.5% of these samples were collected from the informal sector, 20.9% from the formal sector, and 11.6% from both sectors. We found a prevalence of SF medicines across the peer-reviewed studies of 26.9%, whereas most of the SF medicines belonged to the anti-infective class. The problem of SF medicines is not studied sufficiently in Cameroon; therefore, efforts should be made to conduct adequate studies in terms of representativity and methodology.

Knowledge, practices and attitudes on antibiotics use in Cameroon: Self-medication and prescription survey among children, adolescents and adults in private pharmacies.

Benefits of antibiotics are threatened by the self-medication, people's lack of knowledge and inappropriate use of antibiotics, especially in developing countries. This study was designed to determine knowledge; attitudes and practices toward antibiotics use in an urban community, and evaluate the factors that are associated with antibiotic use. Between January and March 2015, a cross sectional and prospective study was conducted in all pharmacies within the Douala IV health district, Cameroon. Anonymous interviews including both open and closed ended questions were conducted in participants selected by convenience sampling Descriptive and logistic regression analysis were performed using StataSE11 software (version 11 SE) and R software (version 3.1.1) in data analysis. Overall 402 (33.7%) of 1,192 customers purchased antibiotics and of these, 47% bought antibiotics without a prescription. 60.7% of purchased antibiotics was for adult 'patients and around 60% of parents carried out self-medication on their children. The vast majority reported that all microbes can be treated with antibiotics (88.3%). The belief that antibiotics are appropriate for bacterial infections was more common among those with a higher level education (OR = 4.03, 95%CI:1.89-8.57, p<0.0001) and among public/private servants (OR = 2.47, 95%CI:1.21-5.08, p = 0.013). Physicians provide less explanations about antibiotics are and their potential side effects than the pharmacy auxiliaries (OR = 0.205, 95%CI = 0.09-0.46, p<0.0001), but more than pharmacists (OR = 3.692, 95%CI:1.44-9.25, p = 0.005). Indications on antibiotics use were 7 times more given to customers with a prescription compared to those without a prescription (OR = 7.37, 95% CI = 2.13-25.43, p = 0.002). Adult male (OR = 2.32, 95%CI:1.24-4.34, p = 0.009) and higher education (OR = 2.05, 95%CI:1.08-3.89, p = 0.027) were significantly associated with self-medication. Misuse, little "practical knowledge" and high self-medication confirm the unsatisfactory prescription and dispensing practices of the antibiotics in our country. These results highlight the important of the development and implementation appropriate guidelines for the responsible use of antibiotics for health care providers and health education targeting community members themselves.

Évaluation de la stabilité du cotrimoxazole 240 mg / 5 ml suspension commercialisé dans les circuits formel et informel de la ville de Douala

Introduction. Le marché parallèle de la vente des médicaments s'est développé au cours des dernières décennies dans les pays en voie d'émergence et il a été établi que la commercialisation de médicaments hors du circuit officiel est une source potentielle de risques pour la santé publique. Notre étude avait pour objectif d'étudier la stabilité du Cotrimoxazole 240 mg / 5 ml suspension stocké dans les circuits formel et informel. Méthodologie : De septembre 2015 à Mai 2016, une étude expérimentale a été conduite dans la ville de Douala. Un total de 81 échantillons de Cotrimoxazole 240 mg/5 mL suspension ont été prélevés dans neuf sites. Tous les échantillons ont subi un contrôle qualité sur la base des évaluations technico-règlementaire, organoleptique, physico-chimique et microbiologique. De plus, des analyses qualitative et quantitative des composés actifs du cotrimoxazole (sulfaméthoxazole et triméthoprime) ont été réalisées. Résultats. Le Ghana et l'Inde sont apparus comme les plus grands fournisseurs du Cotrimoxazole. Les numéros de lot, la notice, les dates de fabrication et de péremption, la présentation et la forme, la classe thérapeutique, les indications, et la posologie étaient présents sur tous les échantillons (100%). Par ailleurs, 41,99% et 55,55% des échantillons étaient de couleur ponceau et avaient un goût aromatisé à la fraise respectivement (p-value < 0,0001). Le pH moyen des suspensions de Cotrimoxazole dans le secteur informel s'est révélé significativement faible par rapport à celui des suspensions du secteur formel (p-value = 0,0054). Tous les échantillons étaient exempts de microorganismes pathogènes. L'analyse spectrophotométrique UV-Vis a montré que la teneur en substances actives était en moyenne significativement plus élevée dans le secteur formel (80,16% contre 73,16%; p-value = 0,001). Conclusion. Cette étude souligne le besoin urgent de lutter activement contre la vente illicite des médicaments ainsi que la nécessité de renforcer les systèmes de contrôle qualité des médicaments dans la ville de Douala

New Approach for the Development of Improved Traditional Medicine: Case of a Preparation of an Oral Hypoglycemic Medicine from Laportea ovalifolia (Schumach. & Thonn.) Chew. (Urticaceae).

A majority of Africans rely on traditional medicine as the primary form of health care. Yet most traditional medicine products have a short shelf life, especially for water-based formulations such as macerations, infusions and decoctions. Indeed, many of these water extracts become unfit for human consumption after five to seven days of conservation either because of the degradation or toxicity of active components, and/or the growth of pathogenic organisms. The purpose of this study was to describe and apply a new approach for the development of an improved traditional medicine (ITM) that is cheap, very efficient, not toxic, and easy to produce, and that can be conserved for a longer time without a significant loss of activity. Hence, Laportea ovalifolia was selected from an ethnobotanical prospection in all regions of Cameroon, and was used to prepare an oral hypoglycemic product. This preparation required 9 steps focused on the characterization of the plant species, and the standardization of the ethnopharmacological preparation by a multidisciplinary team of scientists with expertise in botany, ecology, pharmacognosy and pharmacology. Resultantly, four galenic formulations of hypoglycemic medications were produced. A relationship between these four formulations was described as follow: One spoon of oral suspension (10 ml)=one sachet of powder=2 tablets=3 capsules. Hence, our research provides new insight into a drug discovery approach that could alleviate the major problems affecting traditional medicine and enhance its effectiveness in addressing health care in developing and undeveloped countries.

Relation entre pollution des eaux de sources; forages et maladies hydriques enregistrees au Centre Hospitalier Dominicain Saint Martin de Porres (CHDSMP) du quartier Mvog-Betsi a Yaounde

OBJECTIFS : Mesurer les indices de contamination bacteriologique de l'eau des sources et forages de Mvog-Betsi; et rechercher une relation entre ces indices et le nombre de maladies hydriques enregistrees au Centre Hospitalier Dominicain Saint Martin de Porres (CHDSMP) de ce quartier de Yaounde. MeTHODES Il s'agit d'une etude retrospective et prospective; basee d'une part sur les statistiques des maladies hydriques enregistrees au CHDSMP; et d'autre part sur l'analyse bacteriologique de l'eau des sources et forages consommees par la population. Nous avons utilise la technique de Presence-Absence puis le denombrement apres inondation sur gelose specifique pour la culture des bacteries. L'identification bacterienne a ete faite par la galerie RapIDTM ONE. ReSULTATS Nous avons constate que presque tous les habitants de Mvog Betsi buvaient de l'eau issue des puits ou des sources ou des forages. D'autre part; les eaux de sources et de forages de Mvog-Betsi etaient toutes polluees. En effet; le denombrement des Escherichia coli; indice de pollution fecale dans toutes les eaux; a ete anormal; ce qui revele un probable danger pour la sante. Les statistiques des maladies hydriques enregistrees en 2012 au CHDSMP montrent que 1752 habitants de Mvog Betsi ont souffert de ces maladies contre 2576 qui avaient d'autres pathologies. Au premier trimestre 2013; il ya eu 272 cas de maladies hydriques sur un total de 766 habitants de Mvog-Betsi venues consulter. CONCLUSION Il y a une relation claire entre la pollution des eaux de source; forages et les maladies hydriques enregistrees au CHDSMP du quartier Mvog-Betsi

Formulation d'un medicament traditionnel ameliore a base d'extraits hydro-ethanoliques des feuilles de Senna alata. (Cesalpinaceae)

L'objectif de ce travail est de formuler un medicament traditionnel ameliore dont les extraits hydro-ethanoliques sont efficaces sur les levures et champignons testes; non toxiques sur les souris swiss. Pour ce faire; nous avons realise des etudes pharmacologiques su la toxicite puis l'activite sur les levures et certains champignons filamenteux et enfin formuler un medicament traditionnel ameliore a base d'extraits a froid d'un melange ethanol/eau (70/30) de feuilles de Senna alata linn (Cesalpinacee). Precedemment appele Cassia alata; est une herbe qui pousse dans les zones humides des regions tropicales du monde. Ses feuilles contiennent de l'adenine; du kaempferol-3-O-gentiobioside; de l'acide chrisophanique; du rhein; de l'emodine; du kaepferol; de l'?-sitosterol; des sennosides; de la deoxycoeluatine et des huiles essentielles riches en terpenes et en composes phenoliques. L'utilisation de S-alata est sans danger per os aux dosages controles car la DL50 des extraits de ces feuilles est superieure a 5g/kg . Les extraits des feuilles de cette plante ont montres de fortes activites antifongiques; notamment contre Trichophyton rubrum; Trichophyton mentagrophytes; Epidermophyton floccosum; Bassidiobolus haptosporus; Aspergillus niger; Rhodotorula japonicus; Candida albicans; Candida tropicalis; pityriasis versicolore et Rhodotorula glutinis. Les extraits des feuilles ont egalement monte des activites hypoglycemiantes; anti-inflammatoire; antihepatite; antimutagenique et tonifiante. Nous avons formule une pommade a3dont la stabilite; l'efficacite et l'innocuite sont garanties par le respect des normes de preparation; des formulations magistrales; officinales; phytotherapeutiques et homeopathique

Water treatment in domiciliary hemodialysis equipment: ultraviolet irradiation and Sartobind membrane.

Water is a fundamental element in any hemodialysis device. It must be safe, free not only of micro-organisms but also of any organic or inorganic chemical contaminant. Up to now ion exchanger, reverse osmosis, activate carbon and chlorine are generally used for this purpose. The results are not satisfactory. Microbial contaminants survive and at some points multiply. Pyrogens and endotoxins are not completely eliminated. Chlorine itself adds more risk factors because of the compounds deriving from its interaction with organic molecules. A system to obtain safe water in hemodialysis equipment is described. It is based on the use of ultraviolet irradiation to eliminate any microbial contaminant and on Sartobind membranes to eliminate pyrogens, endotoxins, proteins and other unwanted molecules. Mobile domiciliary hemodialysis equipment was used. Ultraviolet lamps (30 mW/cm2) were applied at two points: after the ion exchange and after the reverse osmosis. Three Q100 Sartobind membranes were positioned immediately before the monitor. The values of cfu/mL counted in the water after the ion exchange ranged from 450 to 1,990, whereas before the monitor they dropped from 0.01 to 0.09 cfu/mL. The LAL test, positive before the Sartobind membrane, was negative thereafter. The system proposed has shown to be effective in guaranteeing safe water free of micro-organisms and endotoxins.

Clonal spread of Acinetobacter baumannii in a general intensive care unit.

The epidemiological characterization of multiply resistant Acinetobacter baumannii isolates from a six-bed Intensive Care Unit (ICU) is described. Investigations for A. baumannii were performed in three subsequent surveillance studies. In the first study, surveillance cultures were taken from patients, health care personnel and the environment; in the second study surveillance cultures were taken at 0, 4, and 7 days from all patients admitted consecutively to the ward; and in the third study surveillance cultures were taken from patients, health care personnel and the environment. During the first study all four hospitalized patients were found to harbour A. baumannii. Hand cultures did not grow any A. baumannii when staff entered the ward from home, but 7 positive health care workers were identified out of 25 samples taken during work, and two cultures of environmental specimens grew A. baumannii. During the second study, 4 of 86 (4.6%) patients resulted colonized with A. baumannii. In the third epidemiological study, no A. baumannii was cultured from either patients, health care personnel or the environment. All isolates recovered from various patients or sources produced conserved macrorestriction Pulsed-Field Gel Electrophoresis (PFGE) patterns and showed the same antibiotic resistance; therefore, they can be considered indistinguishable. The same antibiotic resistance and macrorestriction patterns were observed in previously isolated A. baumannii strains in the ward during May 1997, suggesting the persistence of a single A. baumannii in the ICU. The present study confirms that molecular typing is an essential tool in the epidemiology and control of nosocomial infections, showing here the persistence of a single A. baumannii clone in the ICU. The origin of this strain remains unknown but, when basic infection control measures were reinforced, emphasizing the importance of hand antisepsis and judicious use of gloves, control of A. baumannii spread in the ward was achieved.

[Microbial air monitoring in operating theatre: active and passive samplings]. / Confronto tra due metodi di campionamento nel monitoraggio microbiologico in sala operatoria: campionamento attivo e passivo.

Microbial air contamination was evaluated in 11 operating theatres using active and passive samplings. SAS (Surface Air System) air sampling was used to evaluate cfu/m3 and settle plates were used to measure the index of microbial air contamination (IMA). Samplings were performed at the same time on three different days, at three different times (before, during and after the surgical activity). Two points were monitored (patient area and perimeter of the operating theatre). Moreover, the cfu/m3 were evaluated at the air inlet of the conditioner system. 74.7% of samplings performed at the air inlet and 66.7% of the samplings performed at the patient area before the beginning of the surgical activity (at rest) exceeded the 35 cfu/m3 used as threshold value. 100% of IMA values exceeded the threshold value of 5. Using both active and passive sampling, the microbial contamination was shown to increase significantly during activity. The cfu values were higher at the patient area than at the perimeter of the operating theatre. Mean values of the cfu/m3 during activity at the patient area ranged from a minimum of 61+/-41 cfu/m3 to a maximum of 242+/-136 cfu/m3; IMA values ranged from a minimum of 19+/-10 to a maximum of 129+/-60. 15.2% of samplings performed at the patient area using SAS and 75.8% of samplings performed using settle plates exceeded the threshold values of 180 cfu/m3 and 25 respectively, with a significant difference of the percentages. The highest values were found in the operating theatre with inadequate structural and managerial conditions. These findings confirm that the microbiological quality of air may be considered a mirror of the hygienic conditions of the operating theatre. Settle plates proved to be more sensitive in detecting the increase of microbial air contamination related to conditions that could compromise the quality of the air in operating theatres.