Inflammatory markers in saliva for diagnosis of sepsis of hospitalizes patients.

BACKGROUND: Inflammatory/immunological serum markers are useful for the early detection of organ dysfunction, helping the diagnosis of sepsis. Although the detection of blood biomarkers is a standard practice, the use of noninvasive samples (eg saliva) would be beneficial. AIM: To investigate the saliva of hospitalized patients with and without sepsis and identify the levels of inflammatory markers such as C-reactive protein (CRP), procalcitonin (PCT), interleukin 6 (IL-6) and nitric oxide (NO). METHODS: Saliva samples were collected from 26 patients in intensive care unit with diagnosis of sepsis and from 26 without sepsis (control). The levels of CRP were determined by using latex agglutination test, whereas those of procalcitonin and IL-6 by ELISA and NO by the Griess reaction. RESULTS: Of 26 patients with sepsis, 14 were males (54%) with a mean age of 63.81 ± 3.48 years. The control group had the same distribution for gender, with mean age 65.04 ± 4.07 years. Sepsis group showed higher salivary concentrations of CRP, PCT, IL-6 and NO, with only levels of IL-6 being statistically different (P = .0001). CONCLUSIONS: Patients with sepsis had significantly higher levels of IL-6 in their saliva, suggesting that this biological sample could be useful in the diagnosis of this condition.

IgA antibodies against Streptococcus mutans in breast milk and saliva: Passive Immunity against caries / Anticorpos IgA contra Streptococcus mutans no leite materno e na saliva: Imunidade passiva contra cáries

Objective: The present work aimed to correlate the levels of IgA antibodies reactive with Streptococcus mutans antigens in the saliva and/or in the breast milk and the oral health of lactating. Material and Methods: Breast milk and whole saliva samples were collected from 29 lactating. The oral health was verified using Decayed, Missing, Filled (DMF) scores and the volunteers were separated in three groups: 1) low DMF score; 2) high DMF score with active caries and 3) high DMF score without active caries. The IgA antibodies anti-Streptococcus mutans were analyzed in the samples using ELISA technique. Results: The results showed similar levels of IgA antibodies in all groups, both in milk and saliva. No correlation could be confirmed between the levels of IgA in the saliva and in the breast milk with the oral health of lactating studied. Conclusion: The results suggest that, independently of mother's oral health, the newborn receive the same amounts of anti-Streptococcus mutans IgA by breastfeeding. (AU)

Objetivo: O presente trabalho objetivou correlacionar os níveis de anticorpos IgA reativos com antígenos de Streptococcus mutans na saliva e / ou no leite materno com a saúde bucal de mulheres em lactação. Material e Métodos: Amostras de leite materno e saliva total foram coletadas de 29 lactantes. A saúde bucal foi analisada utilizando os índices de CPO e os voluntários foram separados em três grupos: 1) baixo escore de CPO; 2) alto escore de CPO com cárie ativa e 3) alto escore de CPO sem cárie ativa. Os anticorpos IgA anti-Streptococcus mutans foram analisados pela técnica de ELISA. Resultados: Os resultados mostraram níveis semelhantes de anticorpos IgA em todos os grupos, tanto no leite como na saliva. Nenhuma correlação pôde ser confirmada entre os níveis de IgA na saliva e no leite materno com a saúde bucal das mulheres estudadas. Conclusão: Os resultados sugerem que, independentemente da saúde bucal da mãe, o recém-nascido recebe as mesmas quantidades de IgA anti-Streptococcus mutans pela amamentação. (AU)

Matricaria Recutita Extract (Chamomile) to reduce Candida Albicans and Entrobacter Cloacae biofilms: in vitro study / Extrato de Matricaria recutita (camomila) para redução do biofilme de Candida albicans e Entrobacter cloacae: estudo in vitro

ABSTRACT Objective: This research study aimed at evaluating the inhibitory activity of Matricaria recutira (chamomile) hydroalcoholic extract on Candida albicans and Enterobacter cloacae biofilms. Methods: C. albicans and E. cloacae biofilms with thirty-hour formation were submitted, for five minutes, to 100, 200 and 300 mg / mL of M. recutita hydroalcoholic extract, chlorhexidine digluconate 0.12% (Periogard® - inhibition control) or sterile distilled water (growth control). Subsequently, they were washed and divided into two groups to determine the microbial viability: G/UFC - counting of colony forming units (cfu) in agar and G/DNA - quantification of viable DNA with violet crystal dye by spectrophotometry. Results: M. recutita extract at 300 mg/mL reduced significantly (p <0.01) the E. cloacae cfu/mL number in biofilm with results similar to chlorhexidine 0.12%, while extracts at 100 and 200 mg/mL did not have the same effectiveness. The amount of E. cloacae viable DNA was reduced (p <0.05) in all the M. recutita extract concentrations and chlorhexidine. There was no significant difference (p = 0.565) in the cfu/mL number or in the amount of viable DNA (p = 0.8094) in C. albicans biofilm when compared to untreated biofilm (control) or, even, between the extracts when compared to each other or to chlorhexidine 0.12%. Conclusion: 300 mg/mL M. recutita extract reduced significantly the E. cloacae biofilm but not the C. albicans, both with a similar result to chlorhexidine 0.12% (Periogar®).

RESUMO Objetivo: Avaliar a atividade inibitória do extrato hidroalcoólico de Matricaria recutira (camomila) sobre biofilme de Candida albicans e Enterobacter cloacae. Métodos: Biofilmes de C. albicans e E. cloacae com trinta horas de formação foram submetidos por cinco minutos a 100, 200 e 300 mg/mL de extrato hidroalcoólico de M. recutita, digluconato de clorexidina 0,12% (Periogard® - controle de inibição) ou água destilada esterilizada (controle do crescimento). Depois foram lavados e divididos em dois grupos para determinação da viabilidade microbiana: G1 - contagem de unidades formadoras de colônia (ufc) em ágar e G2 - quantificação de DNA viável com corante cristal violeta por espectrofotometria. Resultados: O extrato de M. recutita a 300 mg/mL reduziu significativamente (p < 0,01) o número de ufc/mL de E. cloacae em biofilme com resultados semelhantes a clorexidina 0,12%, enquanto os extratos a 100 e 200 mg/mL não tiveram a mesma efetividade. Já a quantidade de DNA viável de E. cloacae foi reduzida (p < 0,05) em todas as concentrações do extrato de M. recutita testadas e clorexidina. Não houve diferença significativa (p=0,565) no número de ufc/mL ou na quantidade de DNA viável (p=0,8094) no biofilme de C. albicans quando comparado ao biofilme sem tratamento (controle) ou mesmo entre as concentrações do extrato quando comparados entre si ou com a clorexidina 0,12%. Conclusão: O extrato de M. recutita 300 mg/mL reduziu significativamente o biofilme de E. cloacae mas não de C. albicans, ambos com resultado semelhante à clorexidina 0,12% (Periogar®).

Lactobacillus rhamnosus intake can prevent the development of Candidiasis.

OBJECTIVE: This study aimed to investigate the influence of Lactobacillus rhamnosus intake on the development of candidiasis and cytokines release. MATERIAL AND METHODS: Candida suspensions were inoculated into the oral cavity of experimentally immunosuppressed mice for candidiasis induction. The animals were divided into experimental groups: candidiasis with no probiotic intake (F), candidiasis with probiotic intake during Candida inoculation (FP), and candidiasis with probiotic intake 14 days before inoculation with Candida (FPP); and control groups: (C), (CP), and (CPP) without inducing candidiasis with probiotic intake in the same manner as groups F, FP, and FPP, respectively. After these periods, samples were collected from the oral cavity for yeast counts and, after euthanasia, the tongues of the animals were removed for histological analysis. Sera samples were also collected for analysis of IL-1 beta, TNF-alpha, INF-gamma, IL-12, IL-4, and IL-10. RESULTS: FP group showed lower Candida counts in the oral cavity, and the presence of Candida was almost not detected in FPP group. In tissues, the counts of fungi were significantly lower in FPP group, followed by FP. Groups that consumed probiotics also had lower histological and inflammatory infiltrates compared to F. Cytokines analysis demonstrated low concentrations of TNF-α, IL-12, IL-4, and IL-10 in all the groups, and no statistical difference between them. The production of IL-6 could be better detected, and the experimental groups that consumed the probiotic showed significant lower levels of this cytokine. CONCLUSIONS: The results suggest that L. rhamnosus intake, especially preventively, may avoid or decrease the development of candidiasis in immunosuppressed mice. CLINICAL RELEVANCE: This work adds scientific evidences that probiotics intake can avoid the development of candidiasis.

Effect of Lactobacillus rhamnosus on the response of Galleria mellonella against Staphylococcus aureus and Escherichia coli infections.

This study evaluated the prophylactic effects of the live or heat-killed probiotic strain Lactobacillus rhamnosus ATCC 7469 in Galleria mellonella, inoculated with Staphylococcus aureus or Escherichia coli. L. rhamnosus suspension was prepared and a part of it was autoclaved to obtain heat-killed lactobacilli. The larvae were inoculated of these suspensions and pathogenic. The survival of the larvae was observed during 7 days and after 24 h of inoculation haemocytes counted, melanization and nitric oxide production were analyzed. Larvae survival rate increased in the group inoculated with heat-killed L. rhamnosus, however, with no statistical difference. There was a significant increase in total haemocyte counts in all test groups. Haemolymph melanization and nitric oxide production were higher in the group inoculated with L. rhamnosus and infected with S. aureus. It was concluded that, in this model of infection, heat-killed L. rhamnosus ATCC 7469 promoted greater protection in Galleria mellonella infected with S. aureus or E. coli.

Prevalence and Sensitivity of Bacilli and Pseudomonas in the Newborn's Oral Cavity.

The aim of this study was to isolate Enterobacteria and Pseudomonas from the oral cavity of hospitalized newborns (NB) and determine their prevalence and the sensitivity profile to most commonly used antibiotics for this age group. Samples from the oral cavity of NB from 24 to 48 h age were collected using swabs. The samples were inoculated on MacConkey agar, incubated and the colonies counted and identified. For each strain, the minimum inhibitory concentration (MIC) was determined using agar dilution test. Tests for enterobacteria producing extended spectrumß-lactamases (ESBL) were performed using agar diffusion. Descriptive statistics was used for data analysis. Two of the isolated strains were submitted to the susceptibility test in biofilm. Of the collected samples, 8% presented Enterobacteria (mean of 6,141 CFU/mL) and no Pseudomona species was isolated. Positive samples were from NB in accommodation set or in the NB nursery. Enterobacter was the most prevalent genus and some strains were resistant to ampicillin, gentamicin and cephalothin. No ESBL strain was detected. Microorganisms in biofilms were resistant to all antibiotics, with concentrations four times higher than MIC. The presence of enterobacteria in the oral cavity of newborns, especially some strains resistant to normally used antibiotics, warns to the need for care to avoid the early colonization of this niche and the occurrence of a possible hospital infection in this age group.

Immunomodulatory effects and anti-Candida activity of lactobacilli in macrophages and in invertebrate model of Galleria mellonella.

Due to the growing number of multi-resistant Candida spp., adjuvant treatments that may help combat these fungal pathogens are relevant and useful. This study evaluated the immunomodulation and anti-Candida activity of Lactobacillus rhamnosus (LR), Lactobacillus acidophilus and Lactobacillus paracasei suspensions, either single- or multiple-strain, in mouse macrophages (RAW 264.7) and Galleria mellonella (GM). Mouse macrophages were activated by different lactobacilli suspensions and challenged with C. albicans (CA). Tumor necrosis factor (TNF)-α, interleukin IL-1ß, IL-6 and IL-17 production and cell viability were investigated. LR was the best suspension for stimulating all evaluated cytokines and thus was used in subsequent in vivo assays. Two C. albicans clinical strains, CA21 and CA60, were then added to the GM assays to further confirm the results. LR suspension was injected into the larvae 24 h before challenging with CA. Survival curve, CFU per larva and hemocytes were counted. In the GM, the LR suspension increased the survival rate and hemocyte counts and decreased the CFU per larva counts for all groups. Lactobacilli suspensions presented strain-dependent immunomodulation; however, single suspensions showed better results. Anti-Candida activity was demonstrated by decreased Candida counts in the GM with the use of LR.

Prevalence and Sensitivity of Bacilli and Pseudomonas in the Newborn's Oral Cavity

Abstract The aim of this study was to isolate Enterobacteria and Pseudomonas from the oral cavity of hospitalized newborns (NB) and determine their prevalence and the sensitivity profile to most commonly used antibiotics for this age group. Samples from the oral cavity of NB from 24 to 48 h age were collected using swabs. The samples were inoculated on MacConkey agar, incubated and the colonies counted and identified. For each strain, the minimum inhibitory concentration (MIC) was determined using agar dilution test. Tests for enterobacteria producing extended spectrumβ-lactamases (ESBL) were performed using agar diffusion. Descriptive statistics was used for data analysis. Two of the isolated strains were submitted to the susceptibility test in biofilm. Of the collected samples, 8% presented Enterobacteria (mean of 6,141 CFU/mL) and no Pseudomona species was isolated. Positive samples were from NB in accommodation set or in the NB nursery. Enterobacter was the most prevalent genus and some strains were resistant to ampicillin, gentamicin and cephalothin. No ESBL strain was detected. Microorganisms in biofilms were resistant to all antibiotics, with concentrations four times higher than MIC. The presence of enterobacteria in the oral cavity of newborns, especially some strains resistant to normally used antibiotics, warns to the need for care to avoid the early colonization of this niche and the occurrence of a possible hospital infection in this age group.

Resumo O objetivo foi isolar enterobactérias e Pseudomonas da cavidade oral de recém-nascidos hospitalizados (RN) e determinar a prevalência e o perfil de sensibilidade aos antibióticos mais comumente utilizados para este grupo etário. Foram coletadas amostras da cavidade oral de NB com idade de 24-48 horas, usando swab. As amostras foram inoculadas em ágar MacConkey, incubadas e, as colônias contadas e identificadas. Para cada cepa, a concentração inibitória mínima (CIM) foi determinada utilizando teste de ágar diluição. Testes para enterobactérias produtoras de b-lactamases de espectro estendido (ESBL) foram realizados utilizando difusão em ágar. Estatística descritiva foi utilizada para análise dos resultados. Duas das cepas isoladas foram submetidas ao teste de susceptibilidade em biofilme. Das amostras coletadas, 8% apresentaram enterobactérias (média de 6,141 UFC / ml) e nenhuma espécie de Pseudomonas foi isolada. As amostras positivas foram de RN de alojamento conjunto ou RN de berçário. Enterobacter foi o gênero mais prevalente e algumas cepas foram resistentes à ampicilina gentamicina e cefalotina. Não foi detectada cepa ESBL. Micro-organismos em biofilme foram resistentes a todos os antibióticos, em concentrações quatro vezes superiores ao MIC. A presença de enterobactérias em cavidade oral de recém-nascidos, especialmente algumas cepas resistentes aos antibióticos normalmente utilizados, alerta para a necessidade de cuidados, evitando a colonização precoce deste nicho e a ocorrência de possível infecção nosocomial neste grupo etário.

Influência da ciclosporina a nos tecidos periodontais e na osseointegração de implantes: revisão de literatura / Influence of cyclosporine a on periodontal tissue and osseointegration of implants: review of literature

A Ciclosporina A é um potente imunossupressor utilizado no tratamento de diversas patologias mediada imunologicamente. É indicado principalmente no tratamento preventivo da rejeição de órgãos em indivíduos transplantados. Efeitos adversos relacionados com o uso do fármaco como a indução de osteopenia, desequilíbrio no processo de remodelação óssea, desenvolvimento de osteoporose e o aumento gengival são descritos na literatura. O objetivo do presente estudo foi revisar através da literatura os efeitos da ciclosporina A no metabolismo do tecido gengival, ósseo e sua influência como possível fator de risco na osseointegração de implantes. Empregando-se os termos cyclosporine AND dental implants; cyclosporine AND osseointegration; e cyclosporine AND gingival overgrowth como palavras chave, foram levantados artigos na base de dados Pubmed, publicados entre os anos de 2000 a 2016, na língua inglesa e portuguesa. Conclui-se que os efeitos adversos causados pela ciclosporina A podem interferir na saúde bucal dos indivíduos e no sucesso do tratamento odontológico. É fundamental que o cirurgião dentista conheça os mecanismos de ação do medicamento, seus efeitos adversos e interações medicamentosas, a fim de desenvolver estratégias de prevenção e tratamento para usuários do medicamento (AU)

Cyclosporine A is a potent immunosuppressive drug used in the treatment of various immunologically mediated pathologies. It is mainly indicated in the preventive treatment of organ rejection in transplant recipients. Adverse effects associated with using the drug such as the induction of osteopenia, imbalance in bone remodeling, development of osteoporosis and gingival enlargement are described in literature. The aim of this study was to review, through literature, the effects of cyclosporine A in the metabolism of gingival tissue, bone and its influence as a possible risk factor in osseointegration of implants. Using the terms cyclosporine AND dental implants; cyclosporine AND osseointegration; and cyclosporine AND gingival overgrowth as keywords, a search was conducted for articles published in the Pubmed database between the years 2000-2016, in English and Portuguese. It was concluded that the adverse effects caused by cyclosporine A may interfere in the oral health of individuals and the success of the dental treatment. It is essential that the dentist is aware of the action mechanisms of the drug, its side effects and medicinal interactions in order to develop prevention and treatment strategies for users of the drug (AU)

Live and Heat-Killed Lactobacillus rhamnosus ATCC 7469 May Induce Modulatory Cytokines Profiles on Macrophages RAW 264.7.

This study aimed to evaluate the capacity of Lactobacillus rhamnosus and/or its products to induce the synthesis of cytokines (TNF-α, IL-1ß, IL-4, IL-6, IL-10, and IL-12) by mouse macrophages (RAW 264.7). Three microorganism preparations were used: live L. rhamnosus (LLR) suspension, heat-killed L. rhamnosus (HKLR) suspension, and the supernatant of a heat-killed L. rhamnosus (SHKLR) suspension, which were cultured with macrophages (37°C, 5% CO2) for 2 h and 30 min. After that, cells were cultured for 16 h. The supernatants were used for the quantitation of cytokines, by ELISA. The results were compared with the synthesis induced by lipopolysaccharide (LPS) and analysed, using ANOVA and Tukey test, 5%. LLR and HKLR groups were able to significantly increase the production of TNF-α, IL-6, and IL-10 (P < 0.05). SHKLR also significantly increased the production of TNF-α and IL-10 (P < 0.05) but not IL-6 (P > 0.05). All the L. rhamnosus suspensions were not able to produce detectable levels of IL-1ß or significant levels of IL-4 and IL-12 (P > 0.05). In conclusion, live and heat-killed L. rhamnosus suspensions were able to induce the synthesis of different cytokines with proinflammatory (TNF-α and IL-6) or regulatory (IL-10) functions, suggesting the role of strain L. rhamnosus ATCC 7469 in the modulation or in the stimulation of immune responses.

Lactobacillus rhamnosus pode alterar a virulência de Candida albicans / Lactobacillus rhamnosus may change the virulence of Candida albicans

OBJETIVO: Avaliar a influência de Lactobacillus rhamnosusna expressão dos fatores de virulência de Candida albicans in vitro.MÉTODOS: Uma suspensão de L. rhamnosusfoi inicialmente cultivada em ágar MRS. No dia seguinte, foi adicionado ágar Sabouraud dextrose sobre o crescimento dos lactobacilos e C. albicansfoi cultivada, por 24, 48 e 72 horas. As cepas de Candidaforam então isoladas para investigação da capacidade de formação de biofilme, por meio do cultivo em placas de 96 poços e leitufra das densidades ópticas e contagem de unidades formadoras de colônia por mL (UFC/mL). Também se investigou a capacidade de formação de tubo germinativo, após incubação em soro de cavalo e contagem em 200 células. Os resultados foram comparados aos observados nas cepas de Candidacultivadas na ausência de L. rhamnosus, utilizando o teste tde Student para análise estatística.RESULTADOS: Observou-se uma redução significativa no crescimento de C. albicans na presença de lactobacilos após 24, 48 ou 72 horas. Também foi observada redução significativa na formação de tubo germinativo após a interação por 48 ou 72 horas. Quanto à formação de biofilme, não foi observada diferença significante entre as cepas de Candidacultivadas na presença ou na ausência de lactobacilos.CONCLUSÃO: Os resultados sugerem que L. rhamnosusé capaz de influenciar significativamente o crescimento e a expressão de fatores de virulência de C. albicans in vitro, podendo interferir na patogenicidade desses micro-organismos.

PURPOSE: To investigate the influence of Lactobacillus rhamnosus in the expression of virulence factors of Candida albicans in vitro.METHODS: A suspension of L. rhamnosus was initially grown in MRS agar. The other day, Sabouraud dextrose agar was added on the growth of lactobacilli and C. albicans was seeded for 24, 48 and 72 hours. Candida strains were then isolated for investigation of the ability of biofilm formation, by means of cultivation into 96 wells plaque, and reading the optical densities and counting colony forming units per mL. Also the ability of germ tube formation was investigated, after incubation in horse serum and counting of 200 cells. The results were compared to Candida strains grown in the absence of L. rhamnosus, using Student's t test for statistical analysis.RESULTS: there was a significant reduction in the growth of C. albicans in the presence of lactobacilli after 24, 48 or 72 hours. Significant reduction was also observed in germ tube formation after interaction for 48 or 72 hours. For biofilm formation, no statistically significant difference was observed between the Candida strains grown in the presence or absence of lactobacilli.CONCLUSION: The results suggest that L. rhamnosus is able to influence significantly the growth and expression of virulence factors of C. albicans in vitro, and may interfere with pathogenicity of these micro-organisms.

[Lactobacillus rhamnosus may change the virulence of Candida albicans]. / Lactobacillus rhamnosus pode alterar a virulência de Candida albicans.

PURPOSE: To investigate the influence of Lactobacillus rhamnosus in the expression of virulence factors of Candida albicans in vitro. METHODS: A suspension of L. rhamnosus was initially grown in MRS agar. The other day, Sabouraud dextrose agar was added on the growth of lactobacilli and C. albicans was seeded for 24, 48 and 72 hours. Candida strains were then isolated for investigation of the ability of biofilm formation, by means of cultivation into 96 wells plaque, and reading the optical densities and counting colony forming units per mL. Also the ability of germ tube formation was investigated, after incubation in horse serum and counting of 200 cells. The results were compared to Candida strains grown in the absence of L. rhamnosus, using Student's t test for statistical analysis. RESULTS: there was a significant reduction in the growth of C. albicans in the presence of lactobacilli after 24, 48 or 72 hours. Significant reduction was also observed in germ tube formation after interaction for 48 or 72 hours. For biofilm formation, no statistically significant difference was observed between the Candida strains grown in the presence or absence of lactobacilli. CONCLUSION: The results suggest that L. rhamnosus is able to influence significantly the growth and expression of virulence factors of C. albicans in vitro, and may interfere with pathogenicity of these micro-organisms.

In vitro effect of caffeic acid phenethyl ester on matrix metalloproteinases (MMP-1 and MMP-9) and their inhibitor (TIMP-1) in lipopolysaccharide-activated human monocytes.

OBJECTIVE: The role of matrix metalloproteinases (MMPs) in tissue degradation has become evident in many diseases and great interest therefore exists in the pharmacological control of the activity of these enzymes. This study evaluated the effect of caffeic acid phenethyl ester (CAPE) on the production of MMPs and their inhibitor (TIMP) in monocytes activated by lipopolysaccharide (LPS). DESIGN: The human monocytic cell line (THP-1) was treated with non-cytotoxic concentrations of CAPE (10 and 60µM) combined with 1µg/mL of LPS. The gene expression of MMP-1, MMP-9 and TIMP-1 was evaluated by quantitative real-time polymerase chain reaction. The protein secretion into the culture medium was assessed via enzyme-linked immunosorbent assay and the gelatinolytic activity of MMP-9 by zymography. RESULTS: CAPE, especially at the highest concentration, down-regulated MMP-1 and MMP-9 gene expression but up-regulated the gene expression of TIMP-1. Furthermore, CAPE reduced the secreted protein level of MMP-1 and MMP-9 as well as the gelatinolytic activity of MMP-9. CONCLUSION: CAPE was able to inhibit the gene expression, production and the activity of MMPs induced by LPS and also increased the gene expression of TIMP-1. The present observations suggest that CAPE exerted a positive effect on the regulatory mechanism between MMPs and TIMP, which is important for the control of different diseases.

Stability of antimicrobial activity of peracetic acid solutions used in the final disinfection process.

The instruments and materials used in health establishments are frequently exposed to microorganism contamination, and chemical products are used before sterilization to reduce occupational infection. We evaluated the antimicrobial effectiveness, physical stability, and corrosiveness of two commercial formulations of peracetic acid on experimentally contaminated specimens. Stainless steel specimens were contaminated with Staphylococcus aureus, Escherichia coli, Candida albicans, blood, and saliva and then immersed in a ready peracetic acid solution: 2% Sekusept Aktiv (SA) or 0.25% Proxitane Alpha (PA), for different times. Then, washes of these instruments were plated in culture medium and colony-forming units counted. This procedure was repeated six times per day over 24 non-consecutive days. The corrosion capacity was assessed with the mass loss test, and the concentration of peracetic acid and pH of the solutions were measured with indicator tapes. Both SA and PA significantly eliminated microorganisms; however, the SA solution was stable for only 4 days, whereas PA remained stable throughout the experiment. The concentration of peracetic acid in the SA solutions decreased over time until the chemical was undetectable, although the pH remained at 5. The PA solution had a concentration of 500-400 mg/L and a pH of 2-3. Neither formulation induced corrosion and both reduced the number of microorganisms (p = 0.0001). However, the differences observed in the performance of each product highlight the necessity of establishing a protocol for optimizing the use of each one.

Stability of antimicrobial activity of peracetic acid solutions used in the final disinfection process

The instruments and materials used in health establishments are frequently exposed to microorganism contamination, and chemical products are used before sterilization to reduce occupational infection. We evaluated the antimicrobial effectiveness, physical stability, and corrosiveness of two commercial formulations of peracetic acid on experimentally contaminated specimens. Stainless steel specimens were contaminated with Staphylococcus aureus, Escherichia coli, Candida albicans, blood, and saliva and then immersed in a ready peracetic acid solution: 2% Sekusept Aktiv (SA) or 0.25% Proxitane Alpha (PA), for different times. Then, washes of these instruments were plated in culture medium and colony-forming units counted. This procedure was repeated six times per day over 24 non-consecutive days. The corrosion capacity was assessed with the mass loss test, and the concentration of peracetic acid and pH of the solutions were measured with indicator tapes. Both SA and PA significantly eliminated microorganisms; however, the SA solution was stable for only 4 days, whereas PA remained stable throughout the experiment. The concentration of peracetic acid in the SA solutions decreased over time until the chemical was undetectable, although the pH remained at 5. The PA solution had a concentration of 500-400 mg/L and a pH of 2-3. Neither formulation induced corrosion and both reduced the number of microorganisms (p = 0.0001). However, the differences observed in the performance of each product highlight the necessity of establishing a protocol for optimizing the use of each one.

[Sensitivity profile of Staphylococcus spp. and Streptococcus spp. isolated from toys used in a teaching hospital playroom]. / Perfil de sensibilidade de Staphylococcus spp. e Streptococcus spp. isolados de brinquedos de brinquedoteca de um hospital de ensino.

OBJECTIVE: To evaluate the presence of microorganisms of the genus Staphylococcus and Streptococcus on toys in the playroom of a teaching hospital, as well to as analyze the antimicrobial from the isolated strains. METHODS: Samples were collected from 60 toys, using wet swabs, soon after being used by the children. The samples were inoculated in enriched and selective agar for isolation and later identification of the microorganisms. Antibiogram testing was performed by agar diffusion technique. RESULTS: The genus Staphylococcus was present in 87.0% (52/60) of the toys. Seventythree strains were isolated, with 29.0% (21/73) coagulase-positive and 71.0% (52/73) coagulase-negative. Among the coagulase-negative strains, 90.4% were resistant to penicillin, 65.4% to oxacillin, 28.8% to clarithromycin, 61.5% to clindamycin, and none to vancomycin. Among the coagulase-positive strains, 76.2% were resistant to penicillin, 23.8% to oxacillin, 23.8% to clarithromycin, 47.6% to clindamycin, and none to vancomycin. The genus Streptococcus was not detected in any of the evaluated toys. CONCLUSIONS: Toys can be contaminated with potentially pathogenic bacteria with antimicrobial resistance, representing a possible source of nosocomial infection for patients who are already debilitated.

Perfil de sensibilidade de Staphylococcus spp. e Streptococcus spp. isolados de brinquedos de brinquedoteca de um hospital de ensino / Sensitivity profile of Staphylococcus spp. and Streptococcus spp. isolated from toys used in a teaching hospital playroom

Objetivo: Observar a presença de microrganismos dos gêneros Staphylococcus e Streptococcus em brinquedos de uma brinquedoteca de unidade pediátrica hospitalar, bem como analisar o perfil de resistência aos antimicrobianos das cepas isoladas. Métodos: Foram realizadas coletas de 60 brinquedos, utilizando swab umedecido em solução fisiológica, logo após a utilização pelas crianças. As amostras coletadas foram semeadas em meios de cultura para proporcionar o isolamento dos microrganismos e posterior identificação. Foi realizado o antibiograma para todas as bactérias identificadas, com a técnica de difusão em agar. Resultados: O gênero Staphylococcus estava presente em 87% (52/60) dos brinquedos analisados. Foram isoladas 73 cepas, sendo 29% (21/73) de Staphylococcus coagulasepositiva e 71% (52/73) de Staphylococcus coagulase-negativa. Neste estudo, 90,4% das cepas coagulase-negativas apresentaram resistência à penicilina, 65,4% à oxacilina, 28,8% à claritromicina, 61,5% à clindamicina e nenhuma à vancomicina. Das cepas coagulase-positivas, 76,2% apresentaram resistência à penicilina, 23,8% à oxacilina, 23,8% à claritromicina, 47,6% à clindamicina e nenhuma à vancomicina. Não foram detectadas bactérias do gênero Streptoccocus nos brinquedos estudados. Conclusões: Os resultados obtidos demonstraram que os brinquedos podem apresentar contaminação por bactérias potencialmente patogênicas com resistência aos antimicrobianos, representando uma possível fonte de infecção nosocomial para pacientes que normalmente já se encontram debilitados...

Objective: To evaluate the presence of microorganisms of the genus Staphylococcus and Streptococcus on toys in the playroom of a teaching hospital, as well to as analyze the antimicrobial resistance from isolated strains. Methods: Samples were collected from 60 toys, using wet swabs, soon after being used by the children. The samples were inoculated in enriched and selective agar for isolation and later identification of the microorganisms. Antibiogram testing was performed by agar diffusion technique. Results: The genus Staphylococcus was present in 87.0% (52/60) of the toys. Seventy-three strains were isolated, with 29.0% (21/73) coagulase-positive and 71.0% (52/73) coagulasenegative. Among the coagulase-negative strains, 90.4% were resistant to penicillin, 65.4% to oxacillin, 28.8% to clarithromycin, 61.5% to clindamycin, and none to vancomycin. Among the coagulase-positive strains, 76.2% were resistant to penicillin, 23.8% to oxacillin, 23.8% to clarithromycin, 47.6% to clindamycin, and none to vancomycin. The genus Streptococcus was not detected in any of the evaluated toys. Conclusions: Toys can be contaminated with potentially pathogenic bacteria with antimicrobial resistance, representing a possible source of nosocomial infection for patients who are already debilitated...

Candida spp. adherence to oral epithelial cells and levels of IgA in children with orthodontic appliances.

Adhesion and colonization of the oral cavity by Candida albicans is an initial step in candidosis. Orthodontic and other oral appliances seem to favor candidal presence. The aim of this work was to compare the presence of Candida species in saliva, their adherence to oral epithelial cells, and the levels of anti­C. albicans IgA in children with or without orthodontic appliances. This study included 30 children 5 to 12 years old (9.1 ± 1.7 years old) who were users of removable orthodontic devices for at least 6 months and 30 control children of similar ages (7.7 ± 1.5 years old). The presence of yeast species in the saliva was evaluated by microbiological methods. Candida species were identified using phenotypic methods. Anti­C. albicans IgA levels in saliva were analyzed by ELISA. The yeasts adhering to oral epithelial cells were assessed by exfoliative cytology. No statistically significant differences were observed for saliva yeast counts and anti­C. albicans IgA levels between the studied groups. Children with orthodontic devices exhibited more yeast cells adhering to oral epithelial cells and a higher percentage of non-albicans species relative to the control group. In conclusion, orthodontic appliances may favor the adherence of Candida to epithelial cells but do not influence the presence of these yeasts in saliva, and the levels of anti­C. albicans IgA do not correlate with yeast adherence or presence of Candida in the oral cavity

Candida spp. adherence to oral epithelial cells and levels of IgA in children with orthodontic appliances

Adhesion and colonization of the oral cavity by Candida albicans is an initial step in candidosis. Orthodontic and other oral appliances seem to favor candidal presence. The aim of this work was to compare the presence of Candida species in saliva, their adherence to oral epithelial cells, and the levels of anti-C. albicans IgA in children with or without orthodontic appliances. This study included 30 children 5 to 12 years old (9.1 ± 1.7 years old) who were users of removable orthodontic devices for at least 6 months and 30 control children of similar ages (7.7 ± 1.5 years old). The presence of yeast species in the saliva was evaluated by microbiological methods. Candida species were identified using phenotypic methods. Anti-C. albicans IgA levels in saliva were analyzed by ELISA. The yeasts adhering to oral epithelial cells were assessed by exfoliative cytology. No statistically significant differences were observed for saliva yeast counts and anti-C. albicans IgA levels between the studied groups. Children with orthodontic devices exhibited more yeast cells adhering to oral epithelial cells and a higher percentage of non-albicans species relative to the control group. In conclusion, orthodontic appliances may favor the adherence of Candida to epithelial cells but do not influence the presence of these yeasts in saliva, and the levels of anti-C. albicans IgA do not correlate with yeast adherence or presence of Candida in the oral cavity.