Effects of KMnO4 amounts on antibacterial properties of activated carbon for efficient treatment of northern Benin hospital wastewater in a fixed bed column system.

In this study, the wastewater from the Departmental Hospital Center of Atacora in Benin was characterized and then treated with activated carbon/potassium permanganate (AC/KMnO4) composite in a fixed bed column system. The AC/KMnO4 composites with impregnation ratios range 0.025-0.100 were prepared from peanut shell activated carbon and potassium permanganate. The wastewater characteristics revealed that 75% of Escherichia coli strains identified were extended-spectrum lactamases (ESBL) with CTX-M dominance, while 25% of Staphylococcus aureus strains produced Panton and Valentine leucocidin and 77.80% of Salmonella typhi strains were resistant to Trimethoprim/Sulfamethoxazole. The fixed bed column system results showed removal efficiency of 72.18 ± 4.98% turbidity, 63.12 ± 4.11% COD, 0.70 ± 0.04 log10 against E. coli and 3.82 ± 0.01 log10 against S. typhi strains using activated carbon as adsorbent with 0.7 cm bed depth after 3 h of treatment. The composite adsorbent AC/KMnO4 significantly increased the effectiveness of treatment due to the strong oxidant power of KMnO4 in the composite material. The results depicted a removal rate of 83.88 ± 5.00%, 89 ± 1.95%, 90 ± 0.65% turbidity, 66.47 ± 1.62%, 69.82 ± 2.00%, 78.20 ± 2.82% COD, 2.0 ± 0.08 log10, 5.0 ± 0.07 log10 against E. coli and 3.82 ± 0.01 log10 against S. typhi strains using AC/KMnO4 with 0.025, 0.050 and 0.100 ratios respectively at 0.7 cm bed depth. Finally, AC/KMnO4 revealed more adsorption potential and antibacterial property than AC, hence, the composite material could be used as a cost-effective adsorbent for efficient removing of multi-resistant bacteria from hospital wastewater.

Contaminación ambiental por microorganismos multirresistentes y el efecto de la limpieza y desinfección en una unidad de cuidados intensivos / Environmental contamination by multi-resistant microorganisms and the effect of cleaning and disinfection in an intensive care unit / Contaminação ambiental por micro-organismos multirresistentes e o efeito de limpeza e desinfecção em unidade de terapia intensiva

Conocer el rol del medio ambiente es fundamental para evitar las infecciones intra-hospitalarias. Con ese objetivo, se planteó evaluar la prevalencia de contaminación ambiental por microorganismos multirresistentes (MMR) antes y después de la limpieza terminal de habitaciones de pacientes colonizados y establecer si la aparatología de uso común actuaba como reservorio de estos en la unidad de cuidados intensivos (UTI). Se obtuvieron muestras ambientales de las habitaciones, 48 h posteriores a la detección de colonización y luego de las limpiezas. Los resultados mostraron que luego de ambos procedimientos de limpieza se logró reducir de 28,2% a 2,6% la contaminación por Acinetobacter spp. multirresistente (AMR). También, se tomaron muestras de aparatología de uso común encontrándose entre 1,8 y 5,4% de contaminación por MMR. La limpieza y desinfección reducen significativamente la contaminación ambiental. Sin embargo, la colonización de equipos por MMR y el incumplimiento de precauciones universales representan una posibilidad de transmisión cruzada.

It is essential to understand the role of the environment in order to avoid intrahospital infections. To achieve this objective, this research proposes to assess the prevalence of the environmental contamination caused by multi-resistant microorganisms (MRM) before and after terminal disinfection in rooms with colonized patients, but also to establish whether the commonly used device acts as a reservoir of those micro-organisms in an intensive care unit (ICU). Environmental samples were obtained from the rooms, 48 hours after detecting colonization and also after the first and second final cleaning. The results showed that after both procedures, there was a reduction from 28.2% to 2.6% of contamination caused by multi-resistant Acinetobacter spp. (AMR). Samples from appliances and supplies were taken as well, in which case, between 1.8 and 5.4% of contamination levels induced by MMR were found. Cleaning and disinfecting significantly reduce environmental contamination. However, both MMR bacterial colonization and the lack of universal precautions enforcement represent a possibility of cross-transmission.

É essencial conhecer o papel do meio ambiente para evitar as infecções intra-hospitalares. Com esse objetivo, planejou-se avaliar a prevalência de contaminação ambiental por microorganismos multirresistentes (MMR) antes e depois da limpeza final dos quartos de pacientes colonizados e estabelecer se os aparelhos de uso comum atuavam como um reservatório deles na unidade de terapia intensiva (UTI). Obtiveram-se amostras ambientais dos quartos 48 horas após a detecção da colonização e logo após as limpezas finais. Os resultados mostraram que depois dos dois procedimentos de limpeza se obteve uma redução de 28,2% para 2,6% da contaminação por Acinetobacter spp. multirresistente (AMR). Foram obtidas também amostras de aparelhos de uso comum onde se encontraram entre 1,8% e 5,4% de contaminação por MMR. A limpeza e a desinfecção reduzem significativamente a contaminação ambiental. Contudo, a colonização de equipamentos por MMR e o não cumprimento de providências universais representam uma possibilidade de transmissão cruzada.

Hospital environment hygiene nurse: a key player to reduce healthcare associated infections by multi-resistant organisms.

BACKGROUND: Multi-Resistant Organisms (MRO) healthcare-associated infections (HAI) are closely associated with contamination of surfaces. Outsourced companies are usually in charge of both hospital hygiene and environmental hygiene personnel (EHP) supervision, which can result in bias. METHODS: A quasi-experimental study. The intervention was to add the "Hospital Environment Hygiene Nurse" (HEHN). MRO acquired infection rate and MRO acquired colonized rate were calculated, pre and post intervention. Confounding variables: MRO carriage rate upon admission and hospitalisation days median (HDM) were calculated. RESULTS: Median length of stay: 5 days (p=0.85, interquartile range=6 days). Carriage rate upon admission: 4.3% for pre-intervention vs 5.3% post-intervention, dif. (CI 95%): 1% (-1% to 2.9%) p=0.33. MRO acquired infection rate: 4.3% for pre-intervention vs. 2% post-intervention, Standardized Infection Ratio (SIR) (CI 95%): 0.47 (0.25 to 0.87). MRO acquired colonization rate:10.4% for pre-intervention vs. 7.9% post-intervention, SIR (CI 95%): 0.75 (0.53 to 1.07). CONCLUSIONS: As a reinforcement to standard infection control (IC) measures in place, the incorporation of an exclusive, full-time HEHN was significantly useful to reduce MRO HAI.

Saberes e práticas dos profissionais do bloco operatório na prevenção da infeção por microrganismos multirresistentes / Knowledge and practices of operating room professionals in the prevention of infection by multidrug-resistant microorganisms

As infeções associadas aos cuidados de saúde (IACS) representam um dos principais fatores que afetam a qualidade dos cuidados de saúde, sendo crescente a dimensão assumida pelas infeções por microrganismos multirresistentes (MMR), para as quais contribuem, entre outros, o uso inadequado de antibióticos e a transmissão cruzada de microrganismos. Para controlar o agravamento do problema é essencial o conhecimento e a adoção de boas práticas de prevenção e controlo de infeção pelos profissionais. Tendo presente a importância desta problemática, o presente estudo teve como objetivo analisar os conhecimentos e as práticas dos profissionais do Bloco Operatório (BO) na prevenção da infeção por MMR. Trata-se de um estudo descritivo-correlacional, com uma amostra de disponíveis de 144 profissionais e tendo como instrumento de colheita de dados o questionário construído para o estudo. A colheita de dados decorreu entre 1 de maio a 30 de junho de 2016, no BO de um hospital central. A amostra é maioritariamente constituída por enfermeiros (49,3%) e médicos (42,4%). Predominou o sexo feminino (63,9%). A média de idades foi de 36,78±8,66 anos, predominou a licenciatura como habilitação literária (75,0%) e o tempo de serviço no BO com média de 9,57±7,20 anos. Foi realizada formação sobre prevenção e controlo de infeção por MMR por 43,8% dos profissionais, maioritariamente em Serviço (49,2%). Quando se comparam os resultados obtidos entre médicos e enfermeiros, não se observam diferenças estatisticamente significativas quanto aos conhecimentos globais (t=0,799; gl=130; sig=0,426), verificando-se, no entanto, diferenças estatisticamente significativas em domínios heterogéneos. Relativamente às práticas, observa-se que, globalmente, os enfermeiros atribuem mais importância às medidas de prevenção e controlo de infeção e às medidas de isolamento do que os médicos, evidenciando práticas mais favoráveis (t=4,43; gl=109,28; sig=0,00). Da análise de associação, observou-se relação entre os conhecimentos e as opiniões, e os conhecimentos e as atitudes, verificando-se que, mais conhecimentos correspondem a opiniões mais favoráveis e a melhores práticas na prevenção e controlo de infeção por MMR. Como conclusão, maioritariamente os profissionais demostraram um nível de conhecimentos razoável, valorizando as medidas de prevenção e controlo da transmissão cruzada de MMR.

Infections associated to health care (IACS) represent one of the main factors contributing to the health care quality, as the dimension assumed by infections caused by multi-resistant microorganisms (MMR) keep increasing. Infections are caused by the inadequate use of antibiotics and the cross-transmission of microorganisms, among others. In order to control the seriousness of this problem, it is essential for the professionals to acquire the knowledge and adopt good practices to prevent and control infections. Keeping in mind the importance of this issue, the purpose of the current survey was to analyse the professionals' knowledge and practices of the Operating Theatre (BO) to prevent the infection caused by MMR. This is a descriptive-correlational survey, with a sample constituted by 144 professionals using a questionnaire, made on purpose for this study, to collect all data. The survey took place from May 1st to June 30th of 2016, in a central hospital's BO. The sample is constituted mostly by nurses (49,3%) and doctors (42,4%), being the female sex the predominant one (63,9%). The average age was of 36,78±8,66 years, mainly with a university degree (75,0%), and with an average of 9,57±7,20 years working at the BO. The training on prevention and control of the infection by MMR was done by 43,8% of the professionals, most of which on Duty (49,2%). When comparing the results obtained between doctors and nurses, no statistically significant differences are detected concerning general knowledge (t=0,799; gl=130; sig=0,426). However, some statistically major differences are observed in heterogeneous fields. Regarding the practices, it is generally observed that nurses give more importance to the prevention measures and infection control, and to the isolation measures, than the doctors, showing evidence of more favourable practices (t=4,43; gl=109,28; sig=0,0). From the association analysis, it was apparent the connection between knowledge and opinions, and between knowledge and attitudes, showing that an increase in knowledge would lead to more favourable opinions and better practices in the prevention and control of infection by MMR. To sum up, most of the professionals showed a reasonable level of knowledge and became more concerned about the prevention and control measures of the MMR cross-transmission.

Evaluation of antibacterial, antifungal and modulatory activity of methanol and ethanol extracts of Padina sanctae-crucis.

BACKGROUND: Multi-resistantmicroorganisms such as Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Candida tropicalis e Candida krusei are the main causes of microbial infections. Padina sanctae-crucis is a seaweed often used to check the contamination of ecosystems by materials such as heavy metals, but studies of the antimicrobial activity of the same seaweed were not found. METHODS: The tests for the minimum inhibitory concentration and modulation of microbial resistance, with the use of ethanolic and methanolic extracts of Padina Sanctae-cruces combined with drugs of the class of aminoglycosides and antifungal were used to evaluate the activity against the cited microorganisms. RESULTS: Was observed a modulation of antibiotic activity between the natural products and the E. coli and S. aureus strains, indicating a synergism and antagonism respectively. CONCLUSIONS: The results showed a moderate modulatory effect against some microorganisms studied.

Multirresistência microbiana e opções terapêuticas disponíveis / Microbial multi-resistance and available therapeutic options

JUSTIFICATIVA E OBJETIVOS: Devido ao uso irracional de antimicrobianos e a administração empírica, vários problemas de resistência microbiana surgiram como um novo desafio para a terapêutica, causando elevados índices de mortalidade. Dentre os grupos de micro-organismos relacionados a infecções resistentes destacam-se: Staphylococcus aureus resistente à meticilina e Staphylococcus aureus resistente à vancomicina, Enterococcus sp resistentes a diferentes classes de antimicrobianos, Streptococcus pneumoniae resistente à penicilina, Klebsiella pneumoniae carbapenemase, Pseudomonas aeruginosa e Acinetobacter baumanii resistentes aos carbapenêmicos e ainda as enterobactérias produtoras beta-lactamases de espectro ampliado (ESBL). O objetivo deste estudo foi rever na literatura científica a abordagem do surgimento de micro-organismos multirresistentes e as opções terapêuticas disponíveis no Brasil. CONTEÚDO: Novos antimicrobianos são lançados no mercado com o intuito de alcançar tratamento efetivo para infecções causadas por micro-organismos resistentes. Para abordar os mecanismos de resistência mais comuns, das novas opções terapêuticas disponíveis no Brasil e das novas diretrizes de uso desses fármacos. CONCLUSÃO: Enquanto o uso dos medicamentos antimicrobianos continuarem sendo de modo irresponsável e não for cumpridaa legislação para seu uso, os novos fármacos serão eficazes apenas temporariamente, fazendo constante o problema da multirresistência microbiana.

BACKGROUND AND OBJECTIVES: Due to antibiotics irrational use and the empiric administration, many microbial resistance problems become a new therapeutic challenge, causing elevated mortality rates. Among the microorganisms groups related with resistant infections are: methicillin-resistant and vancomycin-resistant Staphylococcus aureus, multi-resistant Enterococcussp, penicillin-resistant Streptococcus pneumoniae, Klebsiella pneumoniae carbapenemase, carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter baumanii and extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL). The aim of this work was carry out a review of scientific literature in order to discuss the emergence of multidrug-resistant microorganism sand the therapeutic options available in Brazil. CONTENTS: New antimicrobials are launched in order to achieve effective treatment for resistant microorganisms infections. To discuss the most common resistance mechanisms, new therapeutic options available in Brazil and new guidelines for the use of these drugs. CONCLUSION: While the use of antimicrobial drugs to keep so irresponsible and the law for its use not met, the new drugs will be effective only temporarily, keeping constant the microbial multi-resistance problem.