PCR-based national bacterial meningitis surveillance in Turkey: years 2006 to 2009.

Polymerase chain reaction-based surveillance for bacterial meningitis including 841 children revealed 246 with bacterial DNA in cerebrospinal fluid samples of which 53% were Streptococcus pneumoniae, 19% Neisseria meningitidis, and 16% Haemophilus influenzae type b. The most common S. pneumoniae serotypes/serogroups were 1, 19F, 6A/6B, 23F, 5, 14, 18 and 19A. Among 47 meningococci, 86% were serogroup B, 6% serogroup C, 3% serogroup A, 3% serogroup X and 3% serogroup W.

Biofilms of black tooth stains: PCR analysis reveals presence of Streptococcus mutans

This study investigated the presence of the black-pigmented bacteria Prevotella nigrescens and Prevotella intermedia, the non-black-pigmented bacteria Actinomyces spp and particularly the cariogenic pathogen Streptococcus mutans in the dental biofilms of patients with or without black extrinsic tooth stains, using the multiplex polymerase chain reaction (PCR) technique. Analysis of the dental biofilms of patients with (n=26) or without (n=26) black tooth stains was performed using duplex PCR for the 16S ribosomal RNA gene (P. nigrescens, P. intermedia, Actinomyces spp) and glucosyltransferase-I gene for S. mutans. P. nigrescens and S. mutans were the most frequent bacteria detected in both groups. The least frequently detected were P. intermedia and Actinomyces spp. The similar bacterial composition of dental biofilms of black tooth stains and healthy tooth surfaces indicates that black tooth stains are not free of cariogenic bacteria.

O objetivo deste estudo foi investigar a presença das bactérias pigmentadoras de negro Prevotella nigrescens e Prevotella intermedia, da não pigmentadora de negro Actinomyces spp e particularmente a bactéria cariogênica Streptococcus mutans, no biofilme dentário de pacientes com ou sem manchas dentárias extrínsecas negras, utilizando a técnica multiplex PCR (reação em cadeia da polimerase). Análises do biofilme dentário de pacientes com manchas (n=26) e sem manchas (n=26) foram realizadas utilizando a multiplex PCR para o gene 16S RNA ribosomal (P. nigrescens, P. intermedia, Actinomyces spp) e o gene glucosiltransferase-I para S. mutans. P. nigrescens e S. mutans foram as bactérias mais frequentemente detectadas em ambos os grupos. As menos frequentemente detectadas foram P. intermedia e Actinomyces spp. A similaridade entre a composição bacteriana dos biofilmes dentários das manchas dentárias extrínsecas negras e das superfícies dentárias sem manchas indicam que as manchas dentárias extrínsecas negras não estão livres de bactérias cariogênicas.

Molecular epidemiological investigation to determine the source of a fatal case of serotype 22F pneumococcal meningitis.

A child's death due to pneumococcal meningitis after contracting the disease in an after-school programme prompted an investigation to assess nasopharyngeal (NP) carriage among her contacts. The serotype of the meningitis case isolate was determined, together with the serotypes of the NP specimens of contacts, comprising the case patient's brother, the case patient's after-school programme contacts and the brother's day-care centre (DCC) contacts. NP swabs from 155 children and 69 adults were obtained. Real-time PCR and conventional multiplex PCR (CM-PCR) assays were used to detect pneumococcal carriage and determine serotypes. Broth-enriched culture of NP specimens followed by pneumococcal isolation and Quellung-based serotyping were also performed. DNA extracts prepared from cerebrospinal fluid of the index case and from the NP strain isolated from the brother and from one attendee of the brother's DCC were subjected to genotyping. Pneumococcal carriage assessed by real-time PCR and culture was 49.6 and 36.6%, respectively (P<0.05). Twenty-three serotypes were detected using CM-PCR, with serotypes 6A/6B, 14, 19F, 6C/6D, 22F/22A, 23F and 11A/11D being the most frequent. All eight serotype 22F/22A NP specimens recovered were from children attending the brother's DCC. The meningitis case isolate and the NP carriage isolate from the patient's brother were both serotype 22F and shared the same new multilocus sequence type (ST6403) with the attendee of the brother's DCC. CM-PCR proved to be useful for assessing carriage serotype distribution in a setting of high-risk pneumococcal transmission. The causal serotype appeared to be linked to the brother of the case patient and attendees of his DCC.

Biofilms of black tooth stains: PCR analysis reveals presence of Streptococcus mutans.

This study investigated the presence of the black-pigmented bacteria Prevotella nigrescens and Prevotella intermedia, the non-black-pigmented bacteria Actinomyces spp and particularly the cariogenic pathogen Streptococcus mutans in the dental biofilms of patients with or without black extrinsic tooth stains, using the multiplex polymerase chain reaction (PCR) technique. Analysis of the dental biofilms of patients with (n=26) or without (n=26) black tooth stains was performed using duplex PCR for the 16S ribosomal RNA gene (P. nigrescens, P. intermedia, Actinomyces spp) and glucosyltransferase-I gene for S. mutans. P. nigrescens and S. mutans were the most frequent bacteria detected in both groups. The least frequently detected were P. intermedia and Actinomyces spp. The similar bacterial composition of dental biofilms of black tooth stains and healthy tooth surfaces indicates that black tooth stains are not free of cariogenic bacteria.

Prevalência de bastonetes gram-negativos isolados da saliva de trabalhadores da saúde / Prevalence of gram-negative bacilli isolated from saliva of health workers / Prevalencia de las bacterias gram-negativas aisladas en la saliva de los trabajadores de la salud

O estudo objetivou determinar a prevalência de bastonetes Gram-negativos (BGN) isolados da saliva de trabalhadores de saúde de um hospital universitário em Goiânia-Goiás e caracterizar o perfil dos colonizados. De agosto⁄2005 a julho⁄2006, participaram do estudo 278 trabalhadores de saúde responsáveis pelos cuidados assistenciais aos clientes atendidos na instituição. A taxa de portadores foi de 69,4%, destes 44% foram considerados portadores persistentes e 49,2% multicolonizados. Foram isolados 319 BGN, sendo 208 (65,2%) enterobactérias e 111 (34,8%) não-fermentadores. As principais espécies identificadas foram: Enterobacter aerogenes (17,9%), Klebsiella pneumoniae (16,3%), Enterobacter agglomerans (8,8%). No grupo dos BGN não-fermentadores, foram isoladas 25 (7,8%) Pseudomonas aeruginosa. Elevada prevalência de trabalhadores colonizados por BGN foi observada. Os resultados obtidos neste estudo são de grande relevância, pois BGN assumem fundamental importância na etiologia e patogênese de infecções relacionadas à assistência à saúde de pacientes críticos, submetidos a procedimentos invasivos e com permanência prolongada no ambiente nosocomial.

The aim of this study was to determine the prevalence of Gram-negative (GNB) isolated from the saliva of health workers in a school hospital in Goiânia-Goiás, and to characterize the profile of the colonized individuals. From August/2005 to July/2006, 278 health care workers participated of the study. The GNB carrier rate was 69.4%, being 44% of them persistent carriers, and 49.2% multicolonized carriers. 319 BGN were isolated, of which 208 (65.2%) were Enterobacteriaceae and 111 (34.8%) non-fermenters. The main species identified were Enterobacter aerogenes (17.9%), Klebsiella pneumoniae (16.3%), and Enterobacter agglomerans (8.8%). In the group of non-fermenting GNB were isolated 25 (7.8%) Pseudomonas aeruginosa. High prevalence of colonization by GNB was observed. The results of this study are of great importance because BGN are important in the etiology and pathogenesis of infections associated with health care of critically ill patients, undergoing invasive procedures and prolonged stay in the nosocomial environment.

El objetivo del estudio fue determinar la prevalencia de bacterias Gram-negativas (BGN) aislado de la saliva de trabajadores de salud en un hospital universitario en Goiânia-Goiás y caracterizar el perfil de los colonizados. Participaron del estudio realizado entre Agosto/2005 a Julio/2006, 278 profesionales 278 responsables por asistencia sanitaria a los clientes. La tasa de portadores fue 69,4%, siendo de estos 44% persistente y 49,2% multicolónias. 319 BGN fueron aislados, 208 (65,2%) enterobacterias y 111 (34,8%) no fermentadores. Principales especies identificadas fueron Enterobacter aerogenes (17,9%), Klebsiella pneumoniae (16,3%), Enterobacter agglomerans (8,8%). En el grupo de los no fermentadores fueron aisladas 25 (7,8%) Pseudomonas aeruginosa. Alta prevalencia de colonización por los trabajadores GNB se observó. Los resultados de este estudio son de gran pertinencia, porque BGN son de fundamental importancia en la etiología y patogénesis de las infecciones relacionadas con el cuidado de salud de los pacientes enfermos, sometidos a procedimientos invasivos y estancia prolongada en ambiente hospitalario.

Influir la limpieza y la esterilidad de tubos de silicona: estudio casi-experimental / Influência da limpeza na esterilidade de tubos de silicone: estudo quase-experimental / Influence of Cleaning in Sterility of Silicone Tubes: a Quasi-Experimental Study

Objective: Evaluate the sterility of silicone tubes after sterilization in autoclave of saturated vapor under pressure before and after intervention in the cleaning stage. Method: It is a quasi-experimental study performed in a College hospital, in the municipality of Goiania, Brazil. 120 segments were analyzed: 60 in the extremity (E) and 60 in the middle (M). Group (1): 30 tubes, before the cleaning stage and group (2): 30 tubes after this intervention. Samples were inoculated, peaked in nutrient agar and the colonies were isolated and identified. Results: in group (1), 23 (76,67%) were contaminated and in the group (2) eight (26,67%). There was a significant statistical difference between the groups (X2 = 25699, p = 0,0001) and not between the segments. Prevailing microorganisms were: Staphylococcus coagulase-negative. Discussion: the significant statistical difference between the groups related to microbial development, reveals interference in the cleaning stage of reprocessing. Conclusion: the cleaning stage is fundamental for the success of reprocessing.

Objetivo: avaliar la esterilidad de tubos de silicona después de la esterilización en autoclave a vapor saturado sobre presión antes y después de la intervención en la etapa de la limpieza.Metodo: estudio casi-experimental realizado en un hospital universitario,Goiânia-GO. Fueron analizados 120 segmentos: 60 de la exremidad ( E) y 60 del medio (M). Grupo (1): 30 tubos. antes de la intervención en la limpieza y grupo (2): 30 tubos después de la intervención.Las muestras fueron inoculadas,transplantadas en agar nutriente y las colonias aisladas e identificadas. Resultados: en el grupo (1),23 (76,67%) estaban contaminados y en el (2) ocho (26,67%). Hubo diferencia estadísticamente significativa entre los grupos (X2=25699,P=0,0001) y no entre los segmentos. Los microrganismos frecuentes fueron: Estafilococos coagulasa-negativa. Discusión: la diferencia estsdísticamente significante entre los grupos, cuanto al crecimiento microbiano, revela la interferencia de la etapa de la limpieza en la calidad de reprocesamiento. Conclusión: la etapa de la limpieza es fundamental para el suceso del reprocesamiento.

Objetivo: avaliar a esterilidade de tubos de silicone após esterilização em autoclave a vapor saturado sob pressão antes e após intervenção na etapa da limpeza. Método: estudo quase-experimental realizado em um hospital universitário, Goiânia-GO. Foram analisados 120 segmentos: 60 da extremidade (E) e 60 do meio (M). Grupo (1): 30 tubos, antes da intervenção na limpeza e grupo (2): 30 tubos após a intervenção. As amostras foram inoculadas, repicadas em ágar nutriente e as colônias isoladas e identificadas. Resultados: no grupo (1), 23 (76,67%) estavam contaminados e no (2) oito (26,67%). Houve diferença estatisticamente significativa entre os grupos (X2 = 25699, p = 0,0001) e não entre os segmentos. Os microrganismos prevalentes foram: estafilococos coagulase-negativa. Discussão: a diferença estatisticamente significante entre os grupos, quanto ao crescimento microbiano, revela a interferência da etapa da limpeza na qualidade do reprocessamento. Conclusão: a etapa da limpeza é fundamental para o sucesso do reprocessamento.

Lessons to learn with the methicillin-resistant Staphylococcus aureus control in Norway

The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in Norway is low, compared to other European and American countries. The health system includes mandatory case reporting and has written guidelines for prevention and control. This communication describes the national public policies related to MRSA obtained from documents and academic experience gained during a doctoral fellowship in Oslo, Norway. The painstaking procedures used for investigating suspected cases, including health professionals, decolonization and case monitoring, could be important tools to be used by countries with a high prevalence of MRSA.

Prevalência de Staphylococcus aureus na saliva de trabalhadores de saúde / Prevalence of Staphylococcus aureus in saliva of healthcare workers

Introdução: O estado de portador de Staphylococcus aureus resistente à meticilina é apontado como preditor de infecção e fator para a disseminação ambiental e de pessoa a pessoa, incluindo trabalhadores de serviço de saúde. Estes quando colonizados são freqüentemente associados a surtos. Objetivo: Analisar a prevalência de Staphylococcus aureus na saliva de trabalhadores de hospital universitário. Metodologia: Estudo epidemiológico longitudinal realizado em Curitiba, Paraná, Brasil, com 486 trabalhadores no período de abril de 2006 a junho de 2008 compreendeu a coleta de três amostras de saliva e aplicação de instrumento de coletade dados. Staphylococcus aureus foram isolados dos espécimes clínicos e caracterizados fenotipicamente. Os dados foram organizados e processados no Programa EPI-Info e analisados por meio de estatística descritiva. Resultados: Entre os trabalhadores investigados, 60,9 por cento estavam colonizados por Staphylococcus aureus na saliva,sendo 67.9 por cento carreadores transitórios e 32.1 por cento carreadores persistentes; a prevalência de Staphylococcus aureus resistenteà meticilina (MRSA) entre os isolados foi de 15.7 por cento. A prevalência média de MRSA foi de 12.7 por cento sendo maior entre técnicos em enfermagem (21.4 por cento) e auxiliares de limpeza (20.6 por cento) e menor entre enfermeiros (4.5 por cento) e médicos (5.9 por cento). Conclusões: Os trabalhadores apresentaram alta prevalência de Staphylococcus aureus na saliva, indicando a boca como importante sítio corporal para a investigação da colonização por MRSA e potencial fonte para sua disseminação.

Background: The carrier state of methicillin-resistant Staphylococcus aureus is pointed as an infection predictor and a factor for environmental and person-to-person dissemination, including health service workers. These, when colonized are commonly associated to outbreaks. Objective: Analyze the prevalence of Staphylococcus aureus in saliva of workers at a university hospital.Methodology: Epidemiologic longitudinal study carried out in Curitiba, Paraná, Brazil, with 486 workers between April2006 and June 2008. Three saliva samples were collected and a data collection instrument was applied. Staphylococcus aureus were isolated from the clinical specimen and characterized by phenotypes. The data from the instrument and the laboratory results were organized and processed with EPIInfo software and analyzed via descriptive statistics. Results: Among the healthcare workers studied, 60.9%were colonized by Staphylococcus aureus in saliva; of those, 67.9% were transitory carriers and 32.1% were persistent carriers; the prevalence of meticillin-resistant Staphylococcusaureus (MRSA) among the isolated cases was 15.7%. The average prevalence of MRSA was 12.7% and higher among nurses’ aides (21.4%) and cleaning aides (20.6%) and loweramong nurses (4.5%) and doctors (5.9%). Conclusions: Healthcare workers presented high prevalence of Staphylococcus aureus in saliva, indicating the mouth as an important body site to investigate colonizationby MRSA and a potential source to its dissemination.

[Associated antimicrobial resistance in Enterococcus spp. clinical isolates]. / Resistência antimicrobiana associada em isolados clínicos de Enterococcus spp.

INTRODUCTION: The increasing prevalence of enterococci strains in hospitals, particularly among isolates of vancomycin-resistant enterococci (VRE), poses important problems because of the limited effect of antimicrobial therapy for enterococcal infections. METHODS: This work presents a retrospective investigation of quantitative in vitro susceptibility data for the range of antimicrobials against Enterococcus spp. isolates and evaluation of the association of resistance between antimicrobial agents recommended as the treatment of choice for infections caused by VRE through calculation of the relative risk. RESULTS: Of the 156 enterococci isolates, 40 (25.6%) were resistant to 3 or more antimicrobials, including 7.7% (n = 12/156) vancomycin resistant. The association of elevated resistance was more pronounced among VRE isolates against alternative and primary antimicrobials for the treatment of infections caused by these pathogens, including ampicillin (100%, RR = 7.2), streptomycin (90.9%, RR = 4.9), rifampin (91.7%, RR = 3.1) and linezolid (50%, RR = 11.5), despite high susceptibility to this drug (94.9%). CONCLUSIONS: The significant associated resistance to alternative and first choice antimicrobials used in the treatment of serious infections of strains with the VRE phenotype and that require a combined therapeutic regime, revealed even more limited therapeutic alternatives in the institution analyzed.

Resistência antimicrobiana associada em isolados clínicos de Enterococcus spp / Associated antimicrobial resistance in Enterococcus spp. clinical isolates

INTRODUÇÃO: O aumento da prevalência de isolados de enterococos em hospitais, particularmente Enterococcus resistente à vancomicina (VRE), é importante por causa da limitada terapia antimicrobiana efetiva para o tratamento de infecções enterocócicas. MÉTODOS: O presente trabalho apresentou uma investigação retrospectiva de dados de suscetibilidade in vitro quantitativa para uma variedade de antimicrobianos frente aos isolados de Enterococcus spp. e avaliação da associação de resistência entre os agentes antimicrobianos apontados como escolha para o tratamento de infecções causadas por VRE, através do cálculo do risco relativo. RESULTADOS: Dos 156 isolados de enterococos, 40 (25,6 por cento) foram resistentes a três ou mais antimicrobianos, incluindo 7,7 por cento (n = 12/156) resistentes à vancomicina. A associação de resistência elevada foi mais pronunciada entre os isolados de VREs com antimicrobianos alternativos e primários para o tratamento de infecções causadas por estes patógenos, incluindo ampicilina (100 por cento, RR = 7,2), estreptomicina (90,9 por cento, RR = 4,9), rifampicina (91,7 por cento, RR = 3,1) e linezolida (50 por cento, RR = 11,5), apesar da alta taxa de suscetibilidade a esta droga (94,9 por cento). CONCLUSÕES: A resistência associada significativa aos antimicrobianos de primeira escolha e alternativos, usados no tratamento de infecções graves por cepas com o fenótipo VRE e que requerem um regime terapêutico combinado, evidencia alternativas terapêuticas ainda mais limitadas na instituição analisada.

INTRODUCTION: The increasing prevalence of enterococci strains in hospitals, particularly among isolates of vancomycin-resistant enterococci (VRE), poses important problems because of the limited effect of antimicrobial therapy for enterococcal infections. METHODS: This work presents a retrospective investigation of quantitative in vitro susceptibility data for the range of antimicrobials against Enterococcus spp. isolates and evaluation of the association of resistance between antimicrobial agents recommended as the treatment of choice for infections caused by VRE through calculation of the relative risk. RESULTS: Of the 156 enterococci isolates, 40 (25.6 percent) were resistant to 3 or more antimicrobials, including 7.7 percent (n = 12/156) vancomycin resistant. The association of elevated resistance was more pronounced among VRE isolates against alternative and primary antimicrobials for the treatment of infections caused by these pathogens, including ampicillin (100 percent, RR = 7.2), streptomycin (90.9 percent, RR = 4.9), rifampin (91.7 percent, RR = 3.1) and linezolid (50 percent, RR = 11.5), despite high susceptibility to this drug (94.9 percent). CONCLUSIONS: The significant associated resistance to alternative and first choice antimicrobials used in the treatment of serious infections of strains with the VRE phenotype and that require a combined therapeutic regime, revealed even more limited therapeutic alternatives in the institution analyzed.

Colonization of nursing professionals by Staphylococcus aureus.

This cross-sectional study aimed to investigate the presence of Staphylococcus aureus in the saliva of the nursing team of a teaching hospital in the interior of São Paulo State. Three saliva samples were collected from 351 individuals with an interval of two months between each collection. All ethical aspects were considered. In 867 (82.3%) cultures there was no identification of Staphylococcus aureus in the saliva, in 88 (17.7%) cultures Staphylococcus aureus was isolated, 26 (2.5%) of which were resistant to methicillin. The prevalence of professionals colonized by Staphylococcus aureus was 41.0% (144/351), of which 7.1% (25/351) were characterized as methicillin-resistant Staphylococcus aureus. Transient carriers represented 81.2% and persistent carriers 18.8%. Resistance to mupirocin was 73.1% of MRSA and 9.3% of MSSA. The results demonstrate that it is the nurse and nursing technician that are the professional categories most susceptible to MRSA. Broader discussion on the thematic and interventions are needed.

Prevalence of mutans streptococci isolated from complete dentures and their susceptibility to mouthrinses.

The aims of this study were to evaluate the incidence of mutans streptococci (MS - sessile form) on complete maxillary dentures after use of a specific denture paste, and to determine the minimum inhibitory concentration (MIC) and maximum inhibitory dilution (MID) of 3 oral mouthrinses: Cepacol, Plax and Periogard. Seventy-seven complete denture wearers were randomly assigned into 2 groups, according to the product used for denture cleaning: Control group - conventional dentifrice (Kolynos-Super White); and Test group: experimental denture cleaning paste. Denture biofilm was collected at baseline and after 90 and 180 days after treatment by brushing the dentures with saline solution. After decimal serial dilution, samples were seeded onto agar sucrose bacitracin to count colonies with morphological characteristics of MS. MS identification was performed by the sugar fermentation tests. After this procedure, brain heart infusion broth (BHI) was added to oral mouthrinses (Plax, Cepacol e Periogard) and seeded on Petri dishes. The colonies were seeded using the Steers multiplier and, after the incubation, the MIC and MID of the mouthrinses were calculated. The results showed an incidence of 74.0% (n=57) of MS in the 77 complete dentures examined in the study, being 76.3% (n=29) of the Control group (conventional dentifrice) and 71.8% (28) of the Test group (experimental denture cleaning paste). In both groups, the number of positive cases for MS decreased from day 0 to day 180. In the Test group there was a slight decrease in the incidence of Streptococcus mutans 90 days after use of the experimental denture cleaning paste, which was not observed in the Control group. As regards to mouthrinses, for both groups, Periogard showed antimicrobial action with the highest dilution, followed by Cepacol and Plax. In conclusion, the incidence of MS in complete dentures was high and Periogard was the mouthrinse with the strongest antimicrobial action against MS. The experimental denture cleaning paste showed a slight action against S. mutans after 90 days of treatment.

Colonization of nursing professionals by Staphylococcus aureus / A colonização dos profissionais de enfermagem por Staphylococcus aureus / La colonización de los profesionales de enfermería por Staphylococcus aureus

This cross-sectional study aimed to investigate the presence of Staphylococcus aureus in the saliva of the nursing team of a teaching hospital in the interior of São Paulo State. Three saliva samples were collected from 351 individuals with an interval of two months between each collection. All ethical aspects were considered. In 867 (82.3 percent) cultures there was no identification of Staphylococcus aureus in the saliva, in 88 (17.7 percent) cultures Staphylococcus aureus was isolated, 26 (2.5 percent) of which were resistant to methicillin. The prevalence of professionals colonized by Staphylococcus aureus was 41.0 percent (144/351), of which 7.1 percent (25/351) were characterized as methicillin-resistant Staphylococcus aureus. Transient carriers represented 81.2 percent and persistent carriers 18.8 percent. Resistance to mupirocin was 73.1 percent of MRSA and 9.3 percent of MSSA. The results demonstrate that it is the nurse and nursing technician that are the professional categories most susceptible to MRSA. Broader discussion on the thematic and interventions are needed.

Este é um estudo transversal e teve como objetivo investigar a presença de Staphylococcus aureus na saliva da equipe de enfermagem de um hospital escola, do interior paulista. Foram coletadas três amostras da saliva de 351 indivíduos, com intervalo de dois meses. Todos os aspectos éticos foram contemplados. Em 867 (82,3 por cento) culturas não houve identificação de Staphylococcus aureus na saliva, em 88 (17,7 por cento) culturas foi isolado Staphylococcus aureus, sendo 26 (2,5 por cento) resistentes à meticilina. A prevalência de profissionais colonizados por Staphylococcus aureus foi de 41,0 por cento (144/351), dos quais 7,1 por cento (25/351) foram caracterizados como Staphylococcus aureus resistentes à meticilina. Os carreadores transitórios representaram 81,2 por cento e os persistentes 18,8 por cento. A resistência à mupirocina foi de 73,1 por cento entre os resistentes à meticilina e 9,3 por cento nos sensíveis à meticilina. Os resultados evidenciaram que enfermeiras e os técnicos de enfermagem representam as categorias profissionais mais suscetíveis ao MRSA. Discussão mais ampla sobre a temática e intervenções se fazem necessárias.

Se trata de un estudio transversal que tuvo como objetivo investigar la presencia de Staphylococcus aureus en la saliva del equipo de enfermería de un hospital escuela del interior del estado de Sao Paulo. Fueron recolectadas tres muestras de saliva de 351 individuos con intervalo de dos meses. Todos los aspectos éticos fueron contemplados. En 867 (82,3 por ciento) culturas no hubo identificación de Staphylococcus aureus en la saliva, en 88 (17,7 por ciento) culturas fue aislado Staphylococcus aureus, siendo 26 (2,5 por ciento) resistentes a la meticilina. La prevalencia de profesionales colonizados por Staphylococcus aureus fue de 41,0 por ciento (144/351), de los cuales 7,1 por ciento (25/351) fueron caracterizados como Staphylococcus aureus resistentes a la meticilina. Los portadores transitorios representaron 81,2 por ciento y los persistentes 18,8 por ciento. La resistencia a la mupirocina fue de 73,1 por ciento entre los resistentes a la meticilina y 9,3 por ciento en los sensibles a la meticilina. Los resultados evidenciaron que son las enfermeras y los técnicos de enfermería las categorías profesionales más susceptibles al MRSA. Es necesario realizar una discusión más amplia sobre la temática e las intervenciones.

Staphylococcus aureus detection in the mouth of housekeepers.

This study assessed the prevalence of colonization by Staphylococcus aureus in hospital housekeepers, and their knowledge and beliefs regarding this problem. Three saliva samples were collected and a questionnaire regarding knowledge and beliefs was applied. Of the 92 workers, 63 (68.5%) participated in the study; 20 were not and 43 were colonized; 13 by methicillin resistant Staphylococcus aureus and 30 by methicillin sensitive Staphylococcus aureus. Persistent carrier status of methicillin resistant Staphylococcus aureus was detected in 15.4% of cases. Low knowledge and perception of occupational risk were observed. The mouth was identified as an important reservoir of methicillin resistant Staphylococcus aureus. Analyzing knowledge and beliefs, as well as the state of carrier, is an important strategy to be added to educational actions for the prevention of workers' colonization.

BEAUVERIA BASSIANA: quercetinase production and genetic diversity

Beauveria bassiana genetic diversity and ability to synthesize quercetin 2,3-dioxygenase (quercetinase) were analyzed. B. bassiana isolates, obtained from Brazilian soil samples, produced quercetinase after induction using 0.5 g/L quercetin. B. bassiana ATCC 7159 (29.6 nmol/mL/min) and isolate IP 11 (27.5 nmol/ml/min) showed the best performances and IP 3a (9.5 nmol/mL/min) presented the lowest level of quercetinase activity in the culture supernatant. A high level of polymorphism was detected by random amplified polymorphic DNA (RAPD) analysis. The use of internal-transcribed-spacer ribosomal region restriction fragment length polymorphism (ITS-RFLP) did not reveal characteristic markers to differentiate isolates. However, the ITS1-5.8S-ITS2 region sequence analysis provided more information on polymorphism among the isolates, allowing them to be clustered by relative similarity into three large groups. Correlation was tested according to the Person's correlation. Data of our studies showed, that lower associations among groups, level of quercetinase production, or geographical origin could be observed. This study presents the production of a novel biocatalyst by B. bassiana and suggests the possible industrial application of this fungal species in large-scale biotechnological manufacture of quercetinase.

Staphylococcus aureus detection in the mouth of housekeepers / Detecção de staphylococcus aureus na boca de trabalhadores da limpeza hospitalar / Detección de staphylococcus aureus en la boca de trabajadores de la limpieza hospitalaria

This study assessed the prevalence of colonization by Staphylococcus aureus in hospital housekeepers, and their knowledge and beliefs regarding this problem. Three saliva samples were collected and a questionnaire regarding knowledge and beliefs was applied. Of the 92 workers, 63 (68.5 percent) participated in the study; 20 were not and 43 were colonized; 13 by methicillin resistant Staphylococcus aureus and 30 by methicillin sensitive Staphylococcus aureus. Persistent carrier status of methicillin resistant Staphylococcus aureus was detected in 15.4 percent of cases. Low knowledge and perception of occupational risk were observed. The mouth was identified as an important reservoir of methicillin resistant Staphylococcus aureus. Analyzing knowledge and beliefs, as well as the state of carrier, is an important strategy to be added to educational actions for the prevention of workers' colonization.

Este estudio evaluó la prevalencia de la colonización por Staphylococcus aureus en trabajadores de limpieza hospitalaria, y su conocimiento y creencias acerca de la problemática. Fueron recolectadas tres muestras de saliva y aplicado un cuestionario referente al conocimiento y creencias. De 92 trabajadores, 63 (68,5 por ciento) participaron del estudio; 20 se presentaron no colonizados y 43 colonizados; 13 para Staphylococcus aureus resistente a la meticilina y 30 para Staphylococcus aureus sensibles a la meticilina. El estado de portador persistente por Staphylococcus aureus resistente a la meticilina fue detectado en 15,4 por ciento de los casos. Bajo conocimiento y percepción del riesgo ocupacional fueron observados. La boca fue identificada como importante reservatorio de Staphylococcus aureus resistente a la meticilina. Analizar el conocimiento y creencias juntamente con la investigación del estado de portador es una importante estrategia a ser agregada a las acciones educativas para la prevención de la colonización de trabajadores.

Este estudo avaliou a prevalência da colonização por Staphylococcus aureus em trabalhadores de limpeza hospitalar, e seu conhecimento e crenças acerca da problemática. Foram coletadas três amostras de saliva e aplicado questionário referente ao conhecimento e crenças. De 92 trabalhadores, 63 (68,5 por cento) participaram do estudo; 20 apresentaram-se não colonizados e 43 colonizados; 13 para Staphylococcus aureus resistente à meticilina e 30 para Staphylococcus aureus sensível à meticilina. O estado de carreador persistente por Staphylococcus aureus, resistente à meticilina, foi detectado em 15,4 por cento dos casos. Baixo conhecimento e percepção do risco ocupacional foram observados. A boca foi identificada como importante reservatório de Staphylococcus aureus resistente à meticilina. Analisar o conhecimento e crenças, juntamente à investigação do estado de carreador, é importante estratégia a ser agregada às ações educativas para a prevenção da colonização de trabalhadores.

Lessons to learn with the methicillin-resistant Staphylococcus aureus control in Norway.

The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in Norway is low, compared to other European and American countries. The health system includes mandatory case reporting and has written guidelines for prevention and control. This communication describes the national public policies related to MRSA obtained from documents and academic experience gained during a doctoral fellowship in Oslo, Norway. The painstaking procedures used for investigating suspected cases, including health professionals, decolonization and case monitoring, could be important tools to be used by countries with a high prevalence of MRSA.

Candida albicans de cavidade oral de crianças com Síndrome de Down: prevalência e suscetibilidade in vitro a drogas antifúngicas pelo método de fitas de E-test® / Buccal Candida albicans in children with Down's syndrome: prevalence and in vitro susceptibility to antifungal drugsby E-test® ribbons method

The anatomo-physiological alterations of the mouth of children with Down's syndrome favor the proliferation of adiversified microbiota. This study aimed to verify the occurrence of Candida in buccal mucosa of children with Down's syndrome, from April/2006 to July/2007, and to detect the in vitro susceptibility to antifungal drugs by E-test® ribbons method. C. albicans wasthe only species of Candida identified in thirty five children with Down's syndrome (87.5%) and in 10 children of the control group (12.5%). All C. albicans have shown in vitro sensitive to the antifungals employed, especially the polyene drugs with the smallestminimum inhibitory concentrations.

As alterações anatomofisiológicas da cavidade oral de crianças com Síndrome de Down favorecem a proliferação de uma diversificada microbiota. Este estudo objetivou verificar a ocorrência de Candida na mucosa bucal de crianças com Síndrome de Down, no período de abril/2006 a julho/2007, e detectar a suscetibilidade in vitro a drogas antifúngicas pelo método de fitas de E-test. C. albicans foi a única espécie de Candida identificada em trinta e cinco (87,5%) crianças com Síndrome de Down e em 10 (12,5%) crianças do grupo controle. Todas as C. albicans mostraram-se sensíveis in vitro aos antifúngicos empregados, especialmente as drogas poliênicas com as menores concentrações inibitórias mínimas .

Prevalence of mutans streptococci isolated from complete dentures and their susceptibility to mouthrinses

The aims of this study were to evaluate the incidence of mutans streptococci (MS - sessile form) on complete maxillary dentures after use of a specific denture paste, and to determine the minimum inhibitory concentration (MIC) and maximum inhibitory dilution (MID) of 3 oral mouthrinses: Cepacol, Plax and Periogard. Seventy-seven complete denture wearers were randomly assigned into 2 groups, according to the product used for denture cleaning: Control group - conventional dentifrice (Kolynos-Super White); and Test group: experimental denture cleaning paste. Denture biofilm was collected at baseline and after 90 and 180 days after treatment by brushing the dentures with saline solution. After decimal serial dilution, samples were seeded onto agar sucrose bacitracin to count colonies with morphological characteristics of MS. MS identification was performed by the sugar fermentation tests. After this procedure, brain heart infusion broth (BHI) was added to oral mouthrinses (Plax, Cepacol e Periogard) and seeded on Petri dishes. The colonies were seeded using the Steers multiplier and, after the incubation, the MIC and MID of the mouthrinses were calculated. The results showed an incidence of 74.0 percent (n=57) of MS in the 77 complete dentures examined in the study, being 76.3 percent (n=29) of the Control group (conventional dentifrice) and 71.8 percent (28) of the Test group (experimental denture cleaning paste). In both groups, the number of positive cases for MS decreased from day 0 to day 180. In the Test group there was a slight decrease in the incidence of Streptococcus mutans 90 days after use of the experimental denture cleaning paste, which was not observed in the Control group. As regards to mouthrinses, for both groups, Periogard showed antimicrobial action with the highest dilution, followed by Cepacol and Plax. In conclusion, the incidence of MS in complete dentures was high and Periogard was the mouthrinse with the strongest antimicrobial action against MS. The experimental denture cleaning paste showed a slight action against S. mutans after 90 days of treatment.

O objetivo deste estudo foi avaliar a incidência de estreptococos do grupo mutans (forma séssil) de próteses totais superiores após o uso de uma pasta específica para higienização de próteses totais, bem como determinar a concentração inibitória mínima (CIM) e diluição inibitória máxima (DIM) de 3 enxaguatórios bucais: Cepacol, Plax e Periogard. Setenta e sete usuários de próteses totais foram distribuídos em 2 grupos: (A) grupo Controle: dentifrício convencional (Kolynos Super Branco) e (B) grupo Teste: pasta experimental para higiene de próteses (1). O biofilme das próteses foi coletado no início e após 90 e 180 dias dos tratamentos, por meio de escovação das próteses com solução salina. Após a diluição decimal seriada, as amostras foram semeadas em agar sacarose bacitracina para a contagem de colônias características de estreptococos do grupo mutans. A identificação dos estreptococos do grupo mutans foi realizada por meio de testes de fermentação de açúcares. Após este procedimento, o caldo de infusão de cérebro e coração (BHI) foi adicionado aos antissépticos (Plax, Cepacol e Periogard) e semeado em placas de Petri. As colônias foram semeadas usando o mutiplicador de Steers e após a incubação, a concentração inibitória mínima e a concentração inibitória máxima dos enxaguatórios foram calculadas. Os resultados mostraram que a incidência de estreptococos do grupo mutans nas 77 próteses totais examinadas foi de 74,0 por cento (n=57), sendo 76,3 por cento (n=29) do grupo Controle (pasta convencional) e 71,8 por cento (n=28) do grupo Teste (pasta experimental). Em ambos os grupos, o número de casos positivos para estreptococos do grupo mutans diminuiu, do início (0 dias) para 180 dias. Houve uma pequena diminuição da incidência de Streptococcus mutans após 90 dias do uso da pasta experimental, o que não foi observado no grupo controle. Com relação aos enxaguatórios, para ambos os grupos, o Periogard apresentou atividade antimicrobiana com diluições maiores, seguido do Cepacol e Plax. Pôde-se concluir que a incidência de estreptococos do grupo mutans em próteses totais foi elevada e que o Periogard foi o enxaguatório com melhor ação antimicrobiana contra os estreptococos do grupo mutans. A pasta experimental mostrou uma pequena ação contra S. mutans após 90 dias de tratamento.

Endoscope reprocessing using glutaraldehyde in endoscopy services of Goiânia, Brazil: a realidade em serviços de endoscopia de Goiânia, GO.

CONTEXT: The endoscopic procedure safety depends on the use of an adequately reprocessed device which quality is related to each of its operational steps. OBJECTIVE: To characterize the reprocessing of endoscopes using glutaraldehyde in endoscopy services METHODS: Study was conducted by observing the reprocessing of 60 endoscopes from 20 medical practices of the municipality of Goiânia, GO, central area of Brazil. RESULTS: This study showed failure in all reprocessing steps. The pre-washing was performed in 24 (40.0%) of the endoscope. In the cleaning steps, was identify the improper use of enzymatic detergent, and in 27 (45.0%) cases, the brushing of internal channels was not performed. All 60 endoscopes were submitted to this disinfectant. However, for 33 (55.0%) of the cases the internal channels was not filled. The total immersion of endoscope in the glutaraldehyde was not performed in 39 (65.0%) cases. The recommended minimum total immersion time for exposure to 2% glutaraldehyde solution was followed only for 12 (20.0%) endoscopes. There was no filter for water treatment used in the rinse of most endoscopes 54 (90.0%) and to dry the internal channels only 6 (10.0%) of them used compressed air. Adequate storing conditions were identified. CONCLUSION: Considering the particularities of the endoscope and its reprocessing, it is imperative to establish protocols to ensure the quality of the disinfection and the prevention of cross-contamination.