Prótesis mitral mecánica disfuncionante: cuando el trombo sobre pannus dificulta el diagnóstico / Dysfunctioning mechanical mitral valve prosthesis: When thrombus over pannus makes hinders diagnosis

La obstrucción de una válvula protésica es una complicación rara pero que puede ser letal. Las causas más frecuentes son la formación de trombos y pannus, en ausencia de datos infecciosos. El diagnóstico no siempre es sencillo recurriendo a la realización de tomografía computarizada (TC) cardiaca, y en el 46-85% de los casos coexisten trombo y pannus, por lo que el diagnóstico se complica. Un diagnóstico rápido es esencial para evitar un desenlace fatal de esta patología, cuya mortalidad, a pesar de un tratamiento correcto, es elevada.(AU)

Prosthetic valve obstruction is a rare but potentially lethal complication. The most frequent causes are thrombus and pannus formation, in the absence of infectious data. Diagnosis is not always easy using cardiac CT scanning and in 46-85% of cases thrombus and pannus coexist, complicating the diagnosis. A rapid diagnosis is essential to avoid a fatal outcome of this pathology whose mortality, despite correct treatment, is high.(AU)

Dysfunctioning mechanical mitral valve prosthesis: When thrombus over pannus makes hinders diagnosis.

Prosthetic valve obstruction is a rare but potentially lethal complication. The most frequent causes are thrombus and pannus formation, in the absence of infectious data. Diagnosis is not always easy using cardiac CT scanning and in 46%-85% of cases thrombus and pannus coexist, complicating the diagnosis. A rapid diagnosis is essential to avoid a fatal outcome of this pathology whose mortality, despite correct treatment, is high.

Concordance of in vivo reflectance confocal microscopy and horizontal-sectioning histology in skin tumours.

BACKGROUND: In vivo reflectance confocal microscopy (RCM) enables the study of architectural and cytological aspects in horizontal sections, which closely correlate with histologic features. However, traditional histopathological vertical sections cannot totally reproduce the image of the in vivo RCM horizontal section. OBJECTIVE: To evaluate the concordance between in vivo RCM and histopathologic transverse sections for melanocytic lesions, basal cell carcinoma and seborrheic keratoses. METHODS: Prospectively collected benign melanocytic and non-melanocytic tumours diagnosed by dermoscopy were evaluated for common RCM features and compared to histopathology in horizontal sections with haematoxylin and eosin staining. RESULTS: A total of 44 skin tumours including 19 melanocytic lesions (nine compound, five junctional and five intradermal nevi), 12 basal cell carcinomas and 13 seborrheic keratoses were collected in the Department of Dermatology of Hospital Clinic of Barcelona. The RCM features that had statistically significant agreement with the histopathological horizontal sections were the preserved and visible honeycomb pattern, well defined DEJ, small bright particles, dermal nests, tumour islands and dark silhouettes, clefting, collagen bundles, thickened collagen bundles and cytologic atypia. CONCLUSIONS: Histopathology evaluation of horizontal sections of skin tumours can be correlated with main RCM findings. The results of this study have improved the understanding and interpretation of RCM features in relation to skin tumours, thus reinforcing the utility of RCM as a diagnostic tool.

Air change rates and infection risk in school environments: Monitoring naturally ventilated classrooms in a northern Italian urban context.

The importance of building ventilation in avoiding long-distance airborne transmission has been highlighted with the advent of the COVID-19 pandemics. Among others, school environments, in particular classrooms, present criticalities in the implementation of ventilation strategies and their impact on indoor air quality and risk of contagion. In this work, three naturally ventilated school buildings located in northern Italy have undergone monitoring at the end of the heating season. Environmental parameters, such as CO2 concentration and indoor/outdoor air temperature, have been recorded together with the window opening configurations to develop a two-fold analysis: i) the estimation of real air change rates through the transient mass balance equation method, and ii) the individual infection risk via the Wells-Riley equation. A strong statistical correlation has been found between the air change rates and the windows opening configuration by means of a window-to-volume ratio between the total opening area and the volume of the classroom, which has been used to estimate the individual infection risk. Results show that the European Standard recommendation for air renewal could be achieved by a window opening area of at least 1.5 m2, in the most prevailing Italian classrooms. Furthermore, scenarios in which the infector agent is a teacher show higher individual infection risk than those in which the infector is a student. In addition, the outcomes serve school staff as a reference to ensure adequate ventilation in classrooms and keep the risk of infection under control based on the number of the students and the volume of the classroom.

Anisakidosis en peces frescos comercializados en tres ciudades de la Región del Bío Bío, Chile

Introducción: La anisakidosis humana es una zoonosis transmitida por alimentos, causada por la ingestión de carne de pescado parasitada por nematodos anisákidos. Investigaciones sobre la presencia de anisákidos en pescados comercializados, sin cocción o congelación previa, en la región centro sur de Chile son escasas. Objetivo: Identificar nematodos anisákidos en catorce especies de peces marinos, obtenidos por pesca artesanal y comercializados en Concepción, Talcahuano y Lebu, ciudades de la Región del Bío Bío, Chile. Métodos: Entre los años 2018 y 2020, se examinó en busca de anisákidos a 334 pescados marinos frescos. Resultados: Se identificó larvas de Anisakis spp. y Pseudoterranova sp. en ejemplares de siete y cuatro especies de peces, respectivamente. La mayoría de las larvas se encontraron vivas y ubicadas a nivel visceral. Conclusión: La mayoría de las especies de peces que resultaron positivas son reconocidos hospederos intermediarios de estos parásitos. La presencia de anisákidos en la musculatura de estas especies indica que su preparación, en forma ahumada o cruda, es un riesgo para salud pública, recomendándose comprar estos productos en forma eviscerada y/o congelada, junto a promover su cocción.

Background: Human anisakidosis is a food-borne zoonosis, caused by the intake of fish meat parasitized by anisakid nematodes. Research of anisakids parasites in commercialized fish, without previous cooking or freezing, in the south central region of Chile is scarce. Aim: To identify anisakid nematodes in fourteen species of marine fish, obtained by artisanal fishing and commercialized in Concepción, Talcahuano and Lebu, cities from Bío Bío Region, Chile. Methods: During 2018 to 2020, we examinated for anisakids to 334 fresh marine fishes. Results: Larvae of Anisakis spp. and Pseudoterranova sp. were identified in specimens of seven and four fish species, respectively. Most of the larvae were found alive and located at the visceral level. Conclusion: Most of the positive fish species are recognized intermediate hosts for these parasites. The presence of anisakids in the musculatura of these species indicates that their preparation, in smoked or raw form, is a risk to public health, and it is recommended to buy these products in gutted and / or frozen form, together with promoting their cooking.

Gender differences in adaptation to heat in Spain (1983-2018).

In Spain the average temperature has increased by 1.7 °C since pre-industrial times. There has been an increase in heat waves both in terms of frequency and intensity, with a clear impact in terms of population health. The effect of heat waves on daily mortality presents important territorial differences. Gender also affects these impacts, as a determinant that conditions social inequalities in health. There is evidence that women may be more susceptible to extreme heat than men, although there are relatively few studies that analyze differences in the vulnerability and adaptation to heat by sex. This could be related to physiological causes. On the other hand, one of the indicators used to measure vulnerability to heat in a population and its adaptation is the minimum mortality temperature (MMT) and its temporal evolution. The aim of this study was to analyze the values of MMT in men and women and its temporal evolution during the 1983-2018 period in Spain's provinces. An ecological, longitudinal retrospective study was carried out of time series data, based on maximum daily temperature and daily mortality data corresponding to the study period. Using cubic and quadratic fits between daily mortality rates and the temperature, the minimum values of these functions were determined, which allowed for determining MMT values. Furthermore, we used an improved methodology that provided for the estimation of missing MMT values when polynomial fits were inexistent. This analysis was carried out for each year. Later, based on the annual values of MMT, a linear fit was carried out to determine the rate of evolution of MMT for men and for women at the province level. Average MMT for all of Spain's provinces was 29.4 °C in the case of men and 28.7 °C in the case of women. The MMT for men was greater than that of women in 86 percent of the total provinces analyzed, which indicates greater vulnerability among women. In terms of the rate of variation in MMT during the period analyzed, that of men was 0.39 °C/decade, compared to 0.53 °C/decade for women, indicating greater adaptation to heat among women, compared to men. The differences found between men and women were statistically significant. At the province level, the results show great heterogeneity. Studies carried out at the local level are needed to provide knowledge about those factors that can explain these differences at the province level, and to allow for incorporating a gender perspective in the implementation of measures for adaptation to high temperatures.

Ceftazidime-avibactam treatment in bacteremia caused by OXA-48 carbapenemase-producing Klebsiella pneumoniae.

Therapeutic options for bacteremia caused by carbapenem-resistant Enterobacterales (CRE) OXA-48-type are limited. The objective of this study was to analyze clinical success of CAZ-AVI compared with best available therapy (BAT) in patients with Klebsiella pneumoniae carbapenemase-producing OXA-48-type bacteremia (CRKp-OXA-48). We conducted a retrospective, single-center observational study in adult patients with CRKp-OXA-48 between December 2015 and May 2019. We collected the patients' clinical and epidemiological characteristics, antibiotic treatment (CAZ-AVI vs. BAT), and evolution. Factors associated with clinical success were analyzed using binary logistic regression. The study included 76 patients with CRKp-OXA-48-type bacteremia 33 received CAZ-AVI and 43 BAT. CAZ-AVI was mainly used in monotherapy (91%). Clinical success was more common in patients < 70-year-old (OR 4.79, 95% CI [1.435-16.002], p = 0.011) and CAZ-AVI treatment (OR 6.69, 95% CI [1.68-26.604], p = 0.007). Kaplan-Meier survival curve of 14-day mortality showed a lower mortality in patients who received CAZ-AVI (log rank 0.013). However, CAZ-AVI did not achieve statistical difference in IPTW for 14- and 30-day mortality (aOR 0.1, 95% CI [0.02-1.22], p = 0.076 and aOR 1.7, 95% CI [0.48-5.98], p = 0.413, respectively). CAZ-AVI treatment might be associated with a greater clinical success in CRKp-OXA-48 bacteremia.

Ventilation strategies to reduce airborne transmission of viruses in classrooms: A systematic review of scientific literature.

The recent pandemic due to SARS-CoV-2 has brought to light the need for strategies to mitigate contagion between human beings. Apart from hygiene measures and social distancing, air ventilation highly prevents airborne transmission within enclosed spaces. Among others, educational environments become critical in strategic planning to control the spread of pathogens and viruses amongst the population, mainly in cold conditions. In the event of a virus outbreak - such as COVID or influenza - many school classrooms still lack the means to guarantee secure and healthy environments. The present review examines school contexts that implement air ventilation strategies to reduce the risk of contagion between students. The analysed articles present past experiences that use either natural or mechanical systems assessed through mathematical models, numerical models, or full-scale experiments. For naturally ventilated classrooms, the studies highlight the importance of the architectural design of educational spaces and propose strategies for aeration control such as CO2-based control and risk-infection control. When it comes to implementing mechanical ventilation in classrooms, different systems with different airflow patterns are assessed based on their ability to remove airborne pathogens considering parameters like the age of air and the generation of airflow streamlines. Moreover, studies report that programmed mechanical ventilation systems can reduce risk-infection during pandemic events. In addition to providing a systematic picture of scientific studies in the field, the findings of this review can be a valuable reference for school administrators and policymakers to implement the best strategies in their classroom settings towards reducing infection risks.

Multisystemic inflammatory syndrome related to COVID-19, with latent tuberculosis in bone marrow, and satisfactory response to tocilizumab, in a 7-year-old boy.

Paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS) or multisystem inflammatory syndrome in children (MIS-C) is a new acute-onset systemic inflammatory disease, which mainly affects children. Latent tuberculosis infection (LTBI) is characterized by the presence of immune sensitization to Mycobacterium tuberculosis (MTB) in the absence of any clinical or radiological evidence of active disease. We present a child with MIS-C related to COVID-19, with latent TB in the bone marrow, and satisfactory response to tocilizumab. It is important to pay attention in the investigation of TB cases in countries with a high prevalence of tuberculosis, especially when opting for immunusuppression.

Analytical solutions for the magnon frequencies at high-symmetry points of the Brillouin zone in anisotropic kagome antiferromagnets.

The knowledge of the magnon dispersion relations in antiferromagnetic materials with nontrivial spin textures has considerable interest to the understanding of magnonic and spintronic phenomena involving these materials. One particularly interesting nontrivial spin texture existing in several antiferromagnets has spins at an angle of 120° with the in-plane neighbors and arranged in kagome lattices. Here we present a spin-wave calculation for antiferromagnets with kagome spin lattices considering exchange and single-ion anisotropy interactions between the spins. The theory yields exact analytical expressions for the frequencies of magnons at high-symmetry points of the Brillouin zone, that can be readily use to obtain the interaction parameters from experimental data with one-and two-magnon inelastic light scattering. The analytical expressions are used to obtain the field parameters for the kagome lattice antiferromagnet L12-IrMn3from four experimentally measured frequencies. Both exchange field parameters are in reasonable agreement with the values obtained withab initiocalculations, while the anisotropy field is in very good agreement with the one calculated with atomistic spin models and Monte Carlo simulations.

Prototype of the National Dose Register (NDR) for Latin America: main experiences in design and implementation.

Several national regulations and good international practices promote the existence of a central register with the results of individual radiological monitoring. In the majority of countries (in the Latin American region), dosimetry data were neither harmonised nor managed by a unique database, and therefore the possibility of using such data for proper characterisation of the radiological conditions, integrally at national level, in a territory or sector, and by practice or occupational category, was very limited. All these considerations justified the need for developing a prototype of a National Dose Register (NDR) for Latin America. The main objectives were the strengthening of safety supervision in nuclear applications and the provision of a surveillance system for occupational exposure as well as the centralisation of personal dosimetry data, compiling all doses evaluated by the different dosimetric service providers. The experience of Cuba and Brazil in the implementation of their national registers was well known, and was accordingly used as the basis for designing this software. The first version of the NDR prototype, developed in the Spanish language, has been designed, developed and validated. So far, 16 countries have started to implement the NDR. The present work describes aspects such as the technical bases of the NDR design, its characteristics and its functionalities. Experience gained during implementation in Latin America is also addressed. Having a common system of dosimetric information management in the region has opened an important space for scientific exchanges between the countries and their competent authorities. The NDR implementation has provided regulatory authorities with a tool that permits the verification of the level of compliance with dose limits and restrictions, as well as allowing them to carry out statistical assessments of the results of individual radiological surveillance that may permit evaluation of the appropriateness and effectiveness of workplace radiation protection programmes, contributing to their optimisation.

Mortality-related factors in patients with OXA-48 carbapenemase-producing Klebsiella pneumoniae bacteremia.

ABSTRACT: Carbapenemase-producing Enterobacterales constitute a serious public health threat; however, information on the oxacilinasa (OXA-48)-type is limited. The objective of the study was to evaluate the risk factors associated with 14-day mortality for patients with bacteremia due to OXA-48 carbapenemase-producing Klebsiella pneumoniae.We conducted a retrospective, single-center observational study of adult patients with K. pneumoniae bacteremia, classifying the strains as carbapenem-susceptible K. pneumoniae (CSKp) and carbapenem-resistant K. pneumoniae (CRKp). All of the CRKp strains were the OXA-48-type.The study included 202 cases of bacteremia: 114 due to CSKp and 88 due to CRKp. The clinical cure rate was higher for the patients with CSKp (85% vs 69% for CSKp and CRKp, respectively; P = .010), while the 14-day mortality rate was lower (13% vs 30%, P = .005). An INCREMENT-CPE score ≥7 (HR 3.05, 95% CI 1.50-6.25, P = .002) was the only independent factor associated with 14-day mortality for the patients with Klebsiella spp. bacteremia. Other factors related to 14-day mortality were a rapidly fatal prognosis (McCabe) (HR 7.1, 95% CI 2.75-18.37, P < .001), dementia (HR 5.9, 95% CI 2.0-7.43, P = .001), and a high-risk source of infection (HR 2.7, 95% CI 1.06-6.82, P = .038).The most important factors associated with 14-day mortality for the patients with K. pneumoniae bacteremia was an INCREMENT-CPE score ≥7, dementia, a McCabe score indicating a rapidly fatal prognosis and a high-risk source of infection. We found no relationship between a poorer outcome and CRKp isolation or inadequate antibiotic therapy.

[Detection of Cryptosporidium parvum (Apicomplexan: Cryptosporidiidae) oocyst in Aulacomya ater specimen, extracted from to the coast Bio Bio Region, Chile]. / Detección de ooquistes de Cryptosporidium parvum (Apicomplexa: Cryptosporidiidae) en ejemplares de cholga Aulacomya ater, extraídas desde la costa de la Región del Bío Bío, Chile.

BACKGROUND: The bivalve Aulacomya ater (cholga), is one of the most consumed mollusks by the population. However, there is evidence of fecal water contamination caused by causes that affect the sea, increasing the probability of contamination by the Cryptosporidium parvum, which generates cryptosporidiosis in people. AIM: To determine the presence of C. parvum in cholga extracted from the Bio Bio Region (Chile). METHODS: Fifty-five cholgas were selected from a cultivation center and a natural extraction bank. These samples were processed in the laboratory and the presence of acid-alcohol resistant elements was evaluated. Positive samples were analyzed by direct immunofluorescence with anti-C. parvum antibody. RESULTS: 16.4% of the total samples were affected by the oocysts of C.parvum. CONCLUSIONS: For the first time we described C. parvum in A. ater from the Chilean coast, being this mollusk a possible vehicle for transmission of cryptosporidiosis to the population and their predatory animals. Furthermore, the presence of C. parvum reflects fecal water contamination on the evaluated coasts. We are currently monitoring other extraction areas for this mollusk.

Detección de ooquistes de Cryptosporidium parvum (Apicomplexa: Cryptosporidiidae) en ejemplares de cholga Aulacomya ater, extraídas desde la costa de la Región del Bío Bío, Chile / Detection of Cryptosporidium parvum (Apicomplexan: Cryptosporidiidae) oocyst in Aulacomya ater specimen, extracted from to the coast Bio Bio Region, Chile

Resumen Introducción: El bivalvo Aulacomya ater (cholga), es uno de los moluscos de mayor consumo en la población chilena. Sin embargo, existe evidencia de contaminación fecal hídrica provocada por los cauces que llegan al mar, aumentando la probabilidad de contaminación por Cryptosporidium parvum, el que genera criptosporidiosis en el ser humano. Objetivo: Determinar la presencia de C. parvum en cholgas extraídas desde la Región del Bío Bío (Chile). Material y Métodos: Se seleccionaron 55 cholgas provenientes de un centro de cultivo y de un banco natural de extracción. Estas muestras, fueron procesadas en el laboratorio y se evaluó la presencia de elementos ácido-alcohol resistentes. Las muestras positivas, se analizaron por inmunofluorescencia directa, con anticuerpo específicos contra C. parvum. Resultados: 16,4% del total de las muestras tenían ooquistes de C. parvum. Conclusiones: Por primera vez se describe C. parvum en A. ater provenientes de las costas chilenas, siendo este molusco un posible vehículo de transmisión de criptosporidiosis a la población y a sus animales depredadores. Además, la presencia de C. parvum refleja la contaminación fecal hídrica en las costas evaluadas. Actualmente estamos monitoreando otras zonas de extracción de este molusco.

Abstract Background: The bivalve Aulacomya ater (cholga), is one of the most consumed mollusks by the population. However, there is evidence of fecal water contamination caused by causes that affect the sea, increasing the probability of contamination by the Cryptosporidium parvum, which generates cryptosporidiosis in people. Aim: To determine the presence of C. parvum in cholga extracted from the Bio Bio Region (Chile). Methods: Fifty-five cholgas were selected from a cultivation center and a natural extraction bank. These samples were processed in the laboratory and the presence of acid-alcohol resistant elements was evaluated. Positive samples were analyzed by direct immunofluorescence with anti-C. parvum antibody. Results: 16.4% of the total samples were affected by the oocysts of C.parvum. Conclusions: For the first time we described C. parvum in A. ater from the Chilean coast, being this mollusk a possible vehicle for transmission of cryptosporidiosis to the population and their predatory animals. Furthermore, the presence of C. parvum reflects fecal water contamination on the evaluated coasts. We are currently monitoring other extraction areas for this mollusk.

COVID-19: Initial experience of an international group of hand surgeons.

The emergence of the COVID-19 pandemic has severely affected medical treatment protocols throughout the world. While the pandemic does not affect hand surgeons at first glance, they have a role to play. The purpose of this study was to describe the different measures that have been put in place in response to the COVID-19 pandemic by hand surgeons throughout the world. The survey comprised 47 surgeons working in 34 countries who responded to an online questionnaire. We found that the protocols varied in terms of visitors, health professionals in the operating room, patient waiting areas, wards and emergency rooms. Based on these preliminary findings, an international consensus on hand surgery practices for the current viral pandemic, and future ones, needs to be built rapidly.

Migration of noble gas tracers at the site of an underground nuclear explosion at the Nevada National Security Site.

As part of an underground gas migration study, two radioactive noble gases (37Ar and 127Xe) and two stable tracer gases (SF6 and PFDMCH) were injected into a historic nuclear explosion test chimney and allowed to migrate naturally. The purpose of this experiment was to provide a bounding case (natural transport) for the flow of radioactive noble gases following an underground nuclear explosion. To accomplish this, soil gas samples were collected from a series of boreholes and a range of depths from the shallow subsurface (3 m) to deeper levels (~160 m) over a period of eleven months. These samples have provided insights into the development and evolution of the subsurface plume and constrained the relative migration rates of the radioactive and stable gas species in the case when the driving pressure from the cavity is low. Analysis of the samples concluded that the stable tracer SF6 was consistently enriched in the subsurface samples relative to the radiotracer 127Xe, but the ratios of SF6 and 37Ar remained similar throughout the samples.

Control de la infección cruzada en los laboratorios de prótesis dental de Galicia / Control of cross-contamination in dental prostheses laboratories in Galicia

Fundamento: El laboratorio dental es una fuente potencial de contaminación cruzada. Este trabajo busca evaluar su control en Galicia. Material y métodos: Entrevistas telefónicas aleatorias y voluntarias hasta completar 149 cuestionarios. Las variables se describen mediante porcentajes o medias y desviaciones típicas. Se realiza análisis bivariante empleando ji cuadrado. Resultados: Participaron mayoritariamente varones (68,5%), de mediana edad (media=45,7; DE=9,8) con 20,8 (DE=10,5) años de ejercicio en laboratorios urbanos medianos (58,4%), que cuentan mayoritariamente con protocolo escrito (57,7%) y que identifican mayor riesgo al recibir trabajos (80,6%). El 55,0% (significativamente hombres de mayor edad) no asegura la desinfección de los trabajos. La mayoría usa guantes (62,4%), sobre todo jóvenes en laboratorios grandes. Un 55,7% está vacunado frente a hepatitis B. Una minoría (22,0%) ha recibido formación en control de contaminación cruzada. Conclusiones: Las prácticas de control de contaminación cruzada se encuentran por debajo de los estándares recomendados, con un importante déficit de formación y protocolos

Background: Dental laboratories are a potential source of cross-contamination. This study aims to assess its control in Galicia. Methods: Voluntary random telephone interviews resulted in 149 completed questionnaires. The variables are described by percentages or means and standar deviations. A bivariate analysis was undertaken using the Chi square test. Results: Participants were mostly middle-age (mean=45.7, SD=9.8) males (68.5%) with 20.8 (SD=10.5) years of professional experience in middle-size urban (58.4%) laboratories, who identified a higher risk when receiving items from the clinic (80.6%). Most technicians (57.7%) have a written protocol. Many (55.0%), significantly older males, do not check for item disinfection. Most technicians use gloves (62.4%) particularly younger staff at larger laboratories. Fifty-five point seven percent had been vaccinated against hepatitis B. Only 22.0% of technicians reported receiving training in cross-contamination control. Conclusions: Identified cross-infection control practices are below standards, and lack of training and protocols are a matter for concern

[Control of cross-contamination in dental prostheses laboratories in Galicia]. / Control de la infección cruzada en los laboratorios de prótesis dental de Galicia.

BACKGROUND: Dental laboratories are a potential source of cross-contamination. This study aims to assess its control in Galicia. METHODS: Voluntary random telephone interviews resulted in 149 completed questionnaires. The variables are described by percentages or means and standard deviations. A bivariate analysis was undertaken using the Chi square test. RESULTS: Participants were mostly middle-age (mean=45.7, SD=9.8) males (68.5%) with 20.8 (SD=10.5) years of professional experience in middle-size urban (58.4%) laboratories, who identified a higher risk when receiving items from the clinic (80.6%). Most technicians (57.7%) have a written protocol. Many (55.0%), significantly older males, do not check for item disinfection. Most technicians use gloves (62.4%) particularly younger staff at larger laboratories. Fifty-five point seven percent had been vaccinated against hepatitis B. Only 22.0% of technicians reported receiving training in cross-contamination control. CONCLUSIONS: Identified cross-infection control practices are below standards, and lack of training and protocols are a matter for concern.