Assessment of antimicrobial resistance, biofilm formation, and surface modification potential in hospital strains of Pseudomonas aeruginosa and Klebsiella pneumoniae.

The occurrence of healthcare-associated infections is a multifactorial phenomenon related to hospital space contamination by bacteria. The ESKAPE group, specifically Pseudomonas aeruginosa and Klebsiella pneumoniae, play a relevant role in the occurrence of these infections. Therefore, comprehensive research is needed to identify characteristics that justify the prevalence of these species in the healthcare environment. In this line, the study aimed to determine the antimicrobial resistance, biofilm formation, and the potential for polymer degradation in a collection of 33 P. aeruginosa strains and 2 K. pneumoniae strains sampled from various equipment and non-critical surfaces in a Portuguese hospital. Antimicrobial susceptibility tests revealed that none of the strains was categorized as multidrug-resistant (non-MDR). An assessment of their biofilm-forming capabilities indicated that 97 % of the strains exhibited biofilm-producing characteristics. Notably, within this group, the majority of P. aeruginosa and half of K. pneumoniae strains were classified as strong biofilm producers. Furthermore, the strains were evaluated for their potential to cause damage or change medical devices, namely infusion sets, nasal cannula, and urinary catheters. Three P. aeruginosa strains, two strong and one moderate biofilm producers, showed the highest ability to modify surfaces of the nasal cannula and infusion sets. Additionally, the Chi-square test revealed a statistically significant relationship between the presence of P. aeruginosa strains and the water accession spots. In conclusion, this work suggests that bacteria from this group hold a significant ability to grow in the healthcare environment through the degradation of non-critical materials. This suggests a potential concern for the persistence and proliferation of these organisms in hospital environments, emphasizing the importance of robust infection control measures to mitigate the risks associated with bacterial growth on such surfaces.

Evaluation of the Microbiological Effectiveness of Three Accessible Mask Decontamination Methods and Their Impact on Filtration, Air Permeability and Physicochemical Properties.

The need to secure public health and mitigate the environmental impact associated with the massified use of respiratory protective devices (RPD) has been raising awareness for the safe reuse of decontaminated masks by individuals and organizations. Among the decontamination treatments proposed, in this work, three methods with the potential to be adopted by households and organizations of different sizes were analysed: contact with nebulized hydrogen peroxide (H2O2); immersion in commercial bleach (NaClO) (sodium hypochlorite, 0.1% p/v); and contact with steam in microwave steam-sanitizing bags (steam bag). Their decontamination effectiveness was assessed using reference microorganisms following international standards (issued by ISO and FDA). Furthermore, the impact on filtration efficiency, air permeability and several physicochemical and structural characteristics of the masks, were evaluated for untreated masks and after 1, 5 and 10 cycles of treatment. Three types of RPD were analysed: surgical, KN95, and cloth masks. Results demonstrated that the H2O2 protocol sterilized KN95 and surgical masks (reduction of >6 log10 CFUs) and disinfected cloth masks (reduction of >3 log10 CFUs). The NaClO protocol sterilized surgical masks, and disinfected KN95 and cloth masks. Steam bags sterilized KN95 and disinfected surgical and cloth masks. No relevant impact was observed on filtration efficiency.

Implementation of a systematic approach to diabetes in primary care in Bahia, Brazil improves metabolic outcomes: PRODIBA-Programa de Interiorização da Assistência ao Diabetes na Bahia (Project for Dissemination of Diabetes Care in the State of Bahia).

BACKGROUND: Staged Diabetes Management (SDM) improves glycaemic control and reduces diabetes-related complications in primary care. METHODS: An 18-month randomized controlled cohort study was conducted in two municipalities in the state of Bahia, Brazil, involving 100 patients with Type 2 diabetes in each municipality. In one municipality, healthcare professionals were trained to use SDM customized protocols for clinical decisions and, in the other municipality, no protocols for diabetes care were implemented. We hypothesized that, in the municipality with SDM trained professionals, patients would have better outcomes, including a fall in glycated haemoglobin (HbA(1c)). RESULTS: Improvements in some metabolic parameters were observed in the SDM group, including a 22% decrease in mean random glucose, a significant 15% decrease in mean HbA(1c), a 6% decrease in systolic blood pressure and an 11% decrease in diastolic blood pressure. There were no differences in body mass index and lipid profile. CONCLUSIONS: SDM customized algorithms are effective, practical and easy to use in primary healthcare teams with very limited resources.

[Hormonal axes in obesity: cause or effect?]. / Eixos hormonais na obesidade: causa ou efeito?

Several endocrine changes have been described in the obesity state. The corticotropic axis is hyperresponsive and there is enhancement of hormonal clearance, but cortisol levels are within the normal range. It is important to characterize a pseudo-Cushing in obesity. Leptin seems to be a permissive hormone for the beginning of puberty. In adults, gonadotropines are normal, and hyperandrogenism and hyperestrogenism are found. In women, insulin resistance has a central role in polycystic ovarian syndrome (POS), which is associated to ovarian hyperandrogenemia. In obese subjects, growth hormone (GH) is generally low and IGF1 is normal. Thyroid function is commonly normal in obese subjects.

Eixos hormonais na obesidade: causa ou efeito? / Hormonal axes in obesity: cause or effect?

Diversas alterações endócrinas são descritas na obesidade. O eixo corticotrófico encontra-se hiper-responsivo, com maior depuração dos hormônios e nível de cortisol normal. A caracterização do pseudo-Cushing é importante. A leptina parece ser um hormônio permissivo para o desencadeamento da puberdade. Em adultos, as gonadotrofinas são normais, hiperandrogenismo e hiperestrogenismo são encontrados. Nas mulheres, a resistência insulínica é central no desenvolvimento da síndrome dos ovários policísticos (SOP), associada a hiperandrogenemia ovariana. Nos obesos, GH geralmente é baixo e IGF1 normal. A função tireoidiana é habitualmente normal nos obesos.

Several endocrine changes have been described in the obesity state. The corticotropic axis is hyperresponsive and there is enhancement of hormonal clearance, but cortisol levels are within the normal range. It is important to characterize a pseudo-Cushing in obesity. Leptin seems to be a permissive hormone for the beginning of puberty. In adults, gonadotropines are normal, and hyperandrogenism and hyperestrogenism are found. In women, insulin resistance has a central role in polycystic ovarian syndrome (POS), which is associated to ovarian hyperandrogenemia. In obese subjects, growth hormone (GH) is generally low and IGF1 is normal. Thyroid function is commonly normal in obese subjects.