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1.
Neurodiagn J ; 60(3): 195-207, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33006508

RESUMO

Since 1995, ASET has periodically published updates to recommendations for best practices in infection prevention for Neurodiagnostic technologists. The latest installment was accepted in December 2019 for publication in Volume 60, Issue 1, before we had much knowledge or understanding about the SARS-CoV-2, the virus that causes COVID-19. This Technical Tips article is presented as an addendum to the 2020 update and includes important information about infection prevention measures specific to procedure protocols when working with patients positive or under investigation for a highly infectious disease, and when working with patients in general during the current pandemic. All Neurodiagnostic technologists who have direct patient care are responsible for ensuring the use of best practices to prevent the spread of infection.


Assuntos
Infecções por Coronavirus/prevenção & controle , Eletroencefalografia/métodos , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Pessoal Técnico de Saúde , Betacoronavirus , Técnicas de Diagnóstico Neurológico/instrumentação , Desinfecção/métodos , Eletroencefalografia/instrumentação , Contaminação de Equipamentos , Humanos , Polissonografia/instrumentação , Polissonografia/métodos
3.
Ann Agric Environ Med ; 27(3): 348-355, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32955213

RESUMO

INTRODUCTION AND OBJECTIVE: Newborn babies staying on hospital wards are likely to be colonized by microorganisms, including potentially pathogenic fungi. The aim of the study was to assess the mycological purity of hospital wards and medical equipment utilized in the treatment and nursing of newborns. MATERIAL AND METHODS: The study was conducted in Neonatal High Dependency Units (NHDU) and Neonatal Intensive Care Units (NICU). 539 samples were collected from 24 different sources, 130 from ward furnishings and 289 from medical equipment. The study was carried out following the microbiology research methods for sample collection. Subsequently, the samples (swabs, water from incubators, washings from respirator tubes and nasal cannulas (nCPAP)) were cultivated on Sabouraud agar plates. The stamps were collected with the application of Count-Tact method. The samples were incubated at the temperature of 25+/-2 o C and the number of fungi assessed (cfu/cm -2 of the surface area). The species were identified based on their morphological and biochemical features. RESULTS: Fungal growth was observed on 60% of samples collected from ward furnishings and 7% of samples collected from medical equipment. The average number of cfu/cm -2 ranged between 0-8.84 in the case of ward furnishings and between 0-1.22 cfu/cm -2 in the case of medical equipment. In 180 samples collected from the material which had direct contact with newborns no fungal growth was observed. CONCLUSIONS: The furnishings of the wards on which newborns were treated and nursed were contaminated with fungi to an extent which did not pose a threat to the life and health of the newborns. Medical equipment (respirators, incubators, nCPAP cannulas and masks) which came into direct contact with newborns was free from fungi.


Assuntos
Contaminação de Equipamentos/estatística & dados numéricos , Fungos/isolamento & purificação , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Decoração de Interiores e Mobiliário/estatística & dados numéricos , Humanos , Recém-Nascido
4.
Gastroenterol. hepatol. (Ed. impr.) ; 43(7): 389-407, ago.-sept. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-188817

RESUMO

INTRODUCCIÓN: La pandemia por COVID-19 ha conllevado la suspensión de la actividad programada en la mayoría de las Unidades de Endoscopia de nuestro medio. El objetivo del presente documento es facilitar el reinicio de la actividad endoscópica electiva de forma eficiente y segura. MATERIAL Y MÉTODOS: Se formularon una serie de preguntas consideradas de relevancia clínica y logística. Para la elaboración de las respuestas, se realizó una búsqueda bibliográfica estructurada en las principales bases de datos y se revisaron las recomendaciones de las principales instituciones de Salud Pública y de endoscopia digestiva. Las recomendaciones finales se consensuaron por vía telemática. RESULTADOS: Se han elaborado un total de 33 recomendaciones. Los principales aspectos que se discuten son: 1) La reevaluación y priorización de la indicación, 2) La restructuración de espacios, agendas y del personal sanitario, 3) El cribado de la infección, 4) Las medidas de higiene y los equipos de protección individual. CONCLUSIÓN: La AEG y la SEED recomiendan reiniciar la actividad endoscópica de forma escalonada, segura, adaptada a los recursos locales y a la situación epidemiológica de la infección por SARS-CoV-2


INTRODUCTION: The COVID-19 pandemic has led to the suspension of programmed activity in most of the Endoscopy Units in our environment. The aim of this document is to facilitate the resumption of elective endoscopic activity in an efficient and safe manner. MATERIAL AND METHODS: A series of questions considered to be of clinical and logistical relevance were formulated. In order to elaborate the answers, a structured bibliographic search was carried out in the main databases and the recommendations of the main Public Health and Digestive Endoscopy institutions were reviewed. The final recommendations were agreed upon through telematic means. RESULTS: A total of 33 recommendations were made. The main aspects discussed are: 1) Reassessment and prioritization of the indication, 2) Restructuring of spaces, schedules and health personnel, 3) Screening for infection, 4) Hygiene measures and personal protective equipment. CONCLUSION: The AEG and SEED recommend restarting endoscopic activity in a phased, safe manner, adapted to local resources and the epidemiological situation of SARS-CoV-2 infection


Assuntos
Humanos , Sociedades Médicas/normas , Endoscopia/normas , Infecções por Coronavirus/epidemiologia , Pandemias/prevenção & controle , Programas de Triagem Diagnóstica/normas , Assistência à Saúde/organização & administração , Sociedades Médicas/organização & administração , Comissão Para Atividades Profissionais e Hospitalares/normas , Contaminação de Equipamentos , Técnicas e Procedimentos Diagnósticos/normas , Endoscopia Gastrointestinal/normas , Gastroscopia/métodos , Colonoscopia , Cápsulas Endoscópicas , Espanha/epidemiologia
5.
J Korean Med Sci ; 35(37): e332, 2020 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-32959546

RESUMO

BACKGROUND: The purpose of this study was to determine the extent of air and surface contamination of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in four health care facilities with hospitalized coronavirus disease 2019 (COVID-19) patients. METHODS: We investigated air and environmental contamination in the rooms of eight COVID-19 patients in four hospitals. Some patients were in negative-pressure rooms, and others were not. None had undergone aerosol-generating procedures. On days 0, 3, 5, and 7 of hospitalization, the surfaces in the rooms and anterooms were swabbed, and air samples were collected 2 m from the patient and from the anterooms. RESULTS: All 52 air samples were negative for SARS-CoV-2 RNA. Widespread surface contamination of SARS-CoV-2 RNA was observed. In total, 89 of 320 (27%) environmental surface samples were positive for SARS-CoV-2 RNA. Surface contamination of SARS-CoV-2 RNA was common in rooms without surface disinfection and in rooms sprayed with disinfectant twice a day. However, SARS-CoV-2 RNA was not detected in a room cleaned with disinfectant wipes on a regular basis. CONCLUSION: Our data suggest that remote (> 2 m) airborne transmission of SARS-CoV-2 from hospitalized COVID-19 patients is uncommon when aerosol-generating procedures have not been performed. Surface contamination was widespread, except in a room routinely cleaned with disinfectant wipes.


Assuntos
Microbiologia do Ar , Infecções por Coronavirus/transmissão , Exposição Ambiental , Contaminação de Equipamentos , Pneumonia Viral/transmissão , Adulto , Aerossóis , Idoso , Idoso de 80 Anos ou mais , Ar , Betacoronavirus , China , Desinfecção , Feminino , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Quartos de Pacientes , Fatores de Tempo , Adulto Jovem
6.
Hu Li Za Zhi ; 67(5): 74-81, 2020 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-32978768

RESUMO

BACKGROUND: Endoscopic evaluation plays an indispensable role in medical treatments designed to prevent, diagnose, and cure gastrointestinal disease. Surveillance culture monitoring may be useful in monitoring the outcome of reprocessing. PURPOSE: In this project, microbiologic surveillance cultures were employed to improve the quality of flexible endoscope disinfection. RESOLUTION: This project, implemented from February 1st, 2018 to February 28th, 2019, used several approaches to improve the positive culture rate. We redesigned and implemented the standard operating procedures for endoscope reprocessing, established an in-service training course, provided education materials on reprocessing, and installed a storage cabinet that custom-built to accommodate the endoscope. RESULTS: The positive culture rate was reduced from 5.8% to 0%. CONCLUSIONS: Endoscopy culturing is a useful method to assess the effectiveness of standard reprocessing procedures. The development of guidelines and skill practices should follow current, evidence-based practice and infection prevention principles, and related documents should be organized. We suggest regularly deploying quality-improvement techniques to improve performance and service delivery.


Assuntos
Desinfecção/normas , Endoscópios Gastrointestinais/microbiologia , Contaminação de Equipamentos/prevenção & controle , Endoscopia Gastrointestinal , Humanos
7.
Int J Pharm Compd ; 24(5): 358-364, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32886632

RESUMO

When using ventilators in the management of the coronavirus disease 2019 patient, dense and abundant mucous secretions are formed, obstructing the endotracheal tube and making its aspiration difficult. This situation is worsened if in order to minimize the risk of infection of the medical personnel, the humidifier is disconnected. This circumstance forces the tube to be removed, cleaned, or changed, increasing the workload of the intensive care unit staff. Other therapies tested until now, like mesna, acetylcysteine, or hypertonic saline solution, are valid alternatives, although they have not shown great efficacy for this specific procedure in the past. The sanitary emergency forced the collaboration between a pharmacist and an otorhinolaryngologist to develop the cocamidopropyl betaine surfactant formula, after several tests with different concentrations of the surfactant. The objective of this compounding formula was to resolve a mechanical problem and avoid reintubation due to obstruction of the ventilator tube. The cocamidopropyl betaine surfactant solution 0.075% in saline 0.9% (physiological serum) solution demonstrated to be a well-tolerated formula, using inexpensive materials, was simple to prepare, and was easy to use in clinical practice.


Assuntos
Betaína/análogos & derivados , Infecções por Coronavirus/terapia , Contaminação de Equipamentos/prevenção & controle , Intubação Intratraqueal , Pneumonia Viral/terapia , Tensoativos/farmacologia , Betacoronavirus , Betaína/farmacologia , Humanos , Higiene , Pandemias , Ventiladores Mecânicos
8.
Eur Rev Med Pharmacol Sci ; 24(17): 9202-9207, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32965015

RESUMO

OBJECTIVE: SARS-CoV-2 can reportedly exist on inanimate surfaces for a long duration, but there is limited data available from Italian COVID-19 hospital wards, especially for non-intensive care units hosting patients that do not require mechanical ventilation. Identification of the extent of environmental contamination can help in understanding possible virus transmission routes, limit hospital infections and protect healthcare workers. Thus, we investigated virus contamination on surfaces of the acute COVID-19 ward of an Italian hospital. MATERIALS AND METHODS: Ward surfaces, including four points inside and six points outside the patients' rooms were sampled by swabs, seven hours after routine sanitation. To minimize the risk of underestimation of virus detection, two different sensitive molecular methods were used comparatively, and specific internal controls were added to enhance the efficiency of all the analysis steps. RESULTS: SARS-CoV-2 contamination was detected in only three out of all the collected samples, i.e., on two floors and one-bathroom sink, likely reflecting aerosol and saliva contamination, respectively. The overall level of contamination was low, and the floors exhibited a very low level of SARS-CoV-2 presence, evidenced by only one of the two methods used. CONCLUSIONS: The existence of SARS-CoV-2 on hospital surfaces may be limited, although it was reported to persist for a longer duration on surfaces under controlled laboratory conditions. Thus, effective transmission of SARS-CoV-2 by surfaces/fomites within the hospital ward may be a rare event. However, the results highlight the importance of assessing method sensitivity and including controls when investigating low-level virus contamination so as to avoid the risk of underestimation of virus presence.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , RNA Viral/metabolismo , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/virologia , Desinfecção , Microbiologia Ambiental , Contaminação de Equipamentos , Hospitais , Humanos , Itália , Pneumonia Viral/virologia , RNA Viral/análise , Reação em Cadeia da Polimerase em Tempo Real , Risco
9.
Ann Agric Environ Med ; 27(3): 319-325, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32955209

RESUMO

INTRODUCTION: Prion diseases are slow-acting, neurodegenerative diseases found in humans and many species of animals. Although they occur very rarely in humans, currently, an increase in this type of disease is being observed, probably as a result of exposure to infectious prions causing BSE disease in cows. OBJECTIVE: The aim of the procedures described in the article is to minimize the risk of human-to-human transfer of all forms of transmissible spongiform encephalopathy, including variant CJD (vCJD) by contaminated medical equipment. BRIEF DESCRIPTION OF THE STATE OF KNOWLEDGE: All diseases caused by prions, referred to as transmissible spongiform encephalopathies, are fatal. They are characterized by a long development period (up to several decades). Enormous problems are connected with the risk of transferring prions from patient to patient on the surface of instruments used in medical procedures. Laboratory tests indicate that standard disinfection and sterilization procedures may be insufficient to completely remove infectious proteins from contaminated instruments. One of the methods of infection prevention involves taking equipment used for surgery within the brain, tonsils or appendix, into quarantine until biopsy results of these organs have been received that exclude, as far as possible, asymptomatic carriage of prions. CONCLUSIONS: Whenever possible and justified, disposable-use instruments should be used for invasive surgery in patients with definite, clinically probable cases of CJD (vCJD). After use, these instruments should be incinerated.


Assuntos
Endoscopia/instrumentação , Contaminação de Equipamentos , Doenças Priônicas/etiologia , Humanos
10.
BMJ Open ; 10(9): e042045, 2020 09 28.
Artigo em Inglês | MEDLINE | ID: mdl-32988954

RESUMO

BACKGROUND: In a previous randomised controlled trial (RCT) in hospital healthcare workers (HCWs), cloth masks resulted in a higher risk of respiratory infections compared with medical masks. This was the only published RCT of cloth masks at the time of the COVID-19 pandemic. OBJECTIVE: To do a post hoc analysis of unpublished data on mask washing and mask contamination from the original RCT to further understand poor performance of the two-layered cotton cloth mask used by HCWs in that RCT. SETTING: 14 secondary-level/tertiary-level hospitals in Hanoi, Vietnam. PARTICIPANTS: A subgroup of 607 HCWs aged ≥18 years working full time in selected high-risk wards, who used a two-layered cloth mask and were part of a randomised controlled clinical trial comparing medical masks and cloth masks. INTERVENTION: Washing method for cloth masks (self-washing or hospital laundry). A substudy of contamination of a sample of 15 cloth and medical masks was also conducted. OUTCOME MEASURE: Infection rate over 4 weeks of follow up and viral contamination of masks tested by multiplex PCR. RESULTS: Viral contamination with rhinovirus was identified on both used medical and cloth masks. Most HCW (77% of daily washing) self-washed their masks by hand. The risk of infection was more than double among HCW self-washing their masks compared with the hospital laundry (HR 2.04 (95% CI 1.03 to 4.00); p=0.04). There was no significant difference in infection between HCW who wore cloth masks washed in the hospital laundry compared with medical masks (p=0.5). CONCLUSIONS: Using self-reported method of washing, we showed double the risk of infection with seasonal respiratory viruses if masks were self-washed by hand by HCWs. The majority of HCWs in the study reported hand-washing their mask themselves. This could explain the poor performance of two layered cloth masks, if the self-washing was inadequate. Cloth masks washed in the hospital laundry were as protective as medical masks. Both cloth and medical masks were contaminated, but only cloth masks were reused in the study, reiterating the importance of daily washing of reusable cloth masks using proper method. A well-washed cloth mask can be as protective as a medical mask. TRIAL RESGISTRATION NUMBER: ACTRN12610000887077.


Assuntos
Infecções por Coronavirus , Desinfecção , Contaminação de Equipamentos , Controle de Infecções , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Máscaras , Pandemias , Recursos Humanos em Hospital/estatística & dados numéricos , Pneumonia Viral , Adulto , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Desinfecção/métodos , Desinfecção/normas , Desinfecção/estatística & dados numéricos , Contaminação de Equipamentos/prevenção & controle , Contaminação de Equipamentos/estatística & dados numéricos , Feminino , Humanos , Controle de Infecções/instrumentação , Controle de Infecções/métodos , Controle de Infecções/normas , Masculino , Máscaras/classificação , Máscaras/normas , Máscaras/provisão & distribução , Exposição Ocupacional/análise , Exposição Ocupacional/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Vietnã/epidemiologia
11.
Curr Opin Gastroenterol ; 36(5): 366-369, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32739998

RESUMO

PURPOSE OF REVIEW: The elevator mechanism of the duodenoscope was the focus of endoscopically transmitted infections prior to the COVID-19 pandemic. Since that time, the 'suspicious suspects' in the endoscopy unit have grown in number in the eyes of both patients and endoscopists. RECENT FINDINGS: This review summarizes the existing guidelines related to infection control in the endoscopy unit and emerging technologies to address gaps, identifies recommendations proposed during the COVID-19 pandemic, and reminds the reader that infection prevention has not changed since the emergence of COVID-19, only the importance of infection prevention has increased in visibility. SUMMARY: Infection prevention has been and will always be necessary in the gastrointestinal endoscopy unit. Although outbreaks of antibiotic-resistant organisms and infectious diseases like COVID-19 raise the profile of infection control, there have been no major changes to infection control practice recommendations because of the global pandemic. The history of lapses in infection control, persistent contamination of reprocessed endoscopes, and failure of many endoscopy units to identify certain endoscopic procedures as aerosol-generating procedures prior to the pandemic emphasize the need for better knowledge and implementation of infection control practices within endoscopy units.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/prevenção & controle , Duodenoscópios/virologia , Endoscopia Gastrointestinal/efeitos adversos , Contaminação de Equipamentos/prevenção & controle , Controle de Infecções/normas , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/virologia , Desinfecção/normas , Humanos , Pneumonia Viral/virologia , Guias de Prática Clínica como Assunto
13.
Sleep Med ; 73: 170-176, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32836085

RESUMO

Since late December 2019, COVID-19, the disease caused by the novel coronavirus, SARS-CoV-2, has spread rapidly around the world, causing unprecedented changes in provided health care services. Patients diagnosed with sleep-disordered breathing (SDB) are subject to a higher risk of worse outcomes from COVID-19, due to the high prevalence of coexistent comorbidities. Additionally, treatment with positive airway treatment devices (PAP) can be challenging because of PAP-induced droplets and aerosol. In this context, sleep medicine practices are entering a new era and need to adapt rapidly to these circumstances, so as to provide the best care for patients with SDB. Novel approaches, such as telemedicine, may play an important role in the management of patients with SDB during the COVID-19 pandemic.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Síndromes da Apneia do Sono/terapia , Telemedicina/métodos , Pressão Positiva Contínua nas Vias Aéreas/métodos , Pressão Positiva Contínua nas Vias Aéreas/tendências , Infecções por Coronavirus/epidemiologia , Contaminação de Equipamentos/prevenção & controle , Humanos , Pneumonia Viral/epidemiologia , Síndromes da Apneia do Sono/diagnóstico , Síndromes da Apneia do Sono/epidemiologia , Telemedicina/tendências
15.
J Am Dent Assoc ; 151(9): 660-667, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32854868

RESUMO

BACKGROUND: The use of dental handpieces produces aerosols containing microbial agents, bacteria, and viruses representing a high-risk situation for airborne cross infections. The aim of this study was to map and quantify the biological contamination of a dental operatory environment using a biological tracer. METHODS: Streptococcus mutans suspension was infused into the mouth of a manikin, and an operator performed standardized dental procedures using an air turbine, a contra-angle handpiece, or an ultrasonic scaler. The presence of the tracer was measured at 90 sites on the dental unit and the surrounding surfaces of the operatory environment. RESULTS: All tested instruments spread the tracer over the entire dental unit and the surrounding environment, including the walls and ceiling. The pattern and degree of contamination were related to the distance from the infection source. The maximum distance of tracer detection was 360 centimeters for air turbine, 300 cm for contra-angle handpiece, and 240 cm for ultrasonic scaler. No surface of the operative environment was free from the tracer after the use of the air turbine. CONCLUSIONS: Attention should be paid to minimize or avoid the use of rotary and ultrasonic instruments when concerns for the airborne spreading of pandemic disease agents are present. PRACTICAL IMPLICATIONS: This study supports the recommendations of dental associations to avoid treatments generating aerosols, especially during pandemic periods. Guidelines for the management of dental procedures involving aerosols, as well as methods for the modification of aerosols aimed to inactivate the infective agent, are urgently needed.


Assuntos
Infecção Hospitalar , Equipamentos Odontológicos de Alta Rotação , Aerossóis , Contaminação de Equipamentos , Humanos
16.
Indian J Dent Res ; 31(3): 465-469, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32769284

RESUMO

Background: Microbial contamination of air in dental operatory is an important source of infection. In this study, passive air sampling using settle plates was used as an effective method to assess the microbial profile and index of microbial air contamination (IMA) in dental operatories. Aim: To assess the microbial profile and index of microbial air contamination (IMA) in dental operatories. Setting and Design: This study design was a experimental cum diagnosis study and was conducted in four outpatient dental operatories in a self-financing dental college using stratified random sampling technique. Materials and Methods: Twenty air samples were collected by leaving blood agar plates open for 1 h, 1 m above the floor and 1 m from the wall. After incubation at 37°C for 48 h, colonies were counted to assess the number of colony-forming units (CFUs) per plate. The number of CFU is the IMA. The evaluation of aerobic bacterial and fungal profiles of representative colonies was done by standard microbiological methods. Results: Independent sample 't' test was applied for this study. All air samples collected near the dental treatment unit showed more contamination than the ambient air. As per the IMA classes, the IMA near the dental treatment unit ranged from fair to poor. IMA of ambient air in all the four operatories was within the acceptable values. The most common microorganism isolated was Staphylococcus species. Conclusion: Passive air sampling is one of the effective ways of quantifying airborne bacteria as used in the present study. Air microbial level evaluation is a step towards cross-infection prevention.


Assuntos
Microbiologia do Ar , Infecção Hospitalar , Bactérias , Contagem de Colônia Microbiana , Contaminação de Equipamentos , Humanos
17.
Acta Odontol Latinoam ; 33(1): 45-49, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32621599

RESUMO

The gutta-percha cones used in endodontic treatment are produced in aseptic conditions and their composition includes zinc oxide, which is responsible for antibacterial activity. However, there is the possibility of microbial contamination by manipulation, aerosol or during storage. Although several chemical agents have been tested for their decontamination, there is no consensus on the best disinfection protocol to be used. The aim of this study was to evaluate the decontamination of gutta-percha cones contaminated with the bacteria Enterococcus faecalis, by using chlorhexidine digluconate (CHX) and sodium hypochlorite (NaClO) at different concentrations for short exposure times. For this purpose, gutta-percha cones (size 40) were selected at random from a sealed box and immersed for 1 min in a microbial suspension. Then they were immersed in specific Petri dishes for different groups containing: CHX 2%, NaClO 1% or NaClO 2.5% for 30 s or 1 min, and subsequently placed in tubes containing BHI broth. After incubating the tubes for 48 h, it was observed that 1% and 2.5% NaClO and 2% CHX were effective for decontaminating the cones at those exposure time intervals. Microbial growth was detected in one of the replicates of the group with CHX applied for 30 s. To prevent the possibility of failures at this stage, the exposure time of gutta-percha cones to the decontaminating agent should not be reduced.


Assuntos
Clorexidina/análogos & derivados , Descontaminação/métodos , Desinfetantes de Equipamento Odontológico/farmacologia , Enterococcus faecalis/efeitos dos fármacos , Guta-Percha , Irrigantes do Canal Radicular/farmacologia , Hipoclorito de Sódio/farmacologia , Esterilização/métodos , Anti-Infecciosos Locais , Clorexidina/farmacologia , Desinfetantes de Equipamento Odontológico/administração & dosagem , Enterococcus faecalis/isolamento & purificação , Contaminação de Equipamentos/prevenção & controle , Humanos , Materiais Restauradores do Canal Radicular , Irrigantes do Canal Radicular/administração & dosagem , Hipoclorito de Sódio/administração & dosagem
19.
Ann Surg ; 272(2): e125-e128, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32675514

RESUMO

BACKGROUND: In the setting of the COVID-19 pandemic, the conduct of elective cancer surgery has become an issue because of the need to balance the requirement to treat patients with the possibility of transmission of the virus by asymptomatic carriers. A particular concern is the potential for viral transmission by way of aerosol which may be generated during perioperative care. There are currently no guidelines for the conduct of elective lung resection surgery in this context. METHODS: A working group composed of 1 thoracic surgeon, 2 anesthesiologists and 1 critical care specialist assessed the risk for aerosol during lung resection surgery and proposed steps for mitigation. After external review, a final draft was approved by the Committee for the Governance of Perioperative and Surgical Activities of the Hôpital Maisonneuve-Rosemont, in Montreal, Canada. RESULTS: The working group divided the risk for aerosol into 6 time-points: (1) intubation and extubation; (2) Lung isolation and patient positioning; (3) access to the chest; (4) conduct of the surgical procedure; (5) procedure termination and lung re-expansion; (6) chest drainage. Mitigating strategies were proposed for each time-point. CONCLUSIONS: The situation with COVID-19 is an opportunity to re-evaluate operating room protocols both for the purposes of this pandemic and similar situations in the future. In the context of lung resection surgery, specific time points during the procedure seem to pose specific risks for the genesis of aerosol and thus should be the focus of attention.


Assuntos
Aerossóis/efeitos adversos , Infecções por Coronavirus/epidemiologia , Contaminação de Equipamentos/prevenção & controle , Controle de Infecções/normas , Neoplasias Pulmonares/cirurgia , Salas Cirúrgicas , Pneumonia Viral/epidemiologia , Procedimentos Cirúrgicos Pulmonares/normas , Betacoronavirus , Procedimentos Cirúrgicos Eletivos , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias , Equipamento de Proteção Individual , Quebeque/epidemiologia
20.
Sci Total Environ ; 742: 140370, 2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-32619841

RESUMO

The rapid development of global COVID-19 pandemic poses an unprecedented challenge to the safety and quality of laboratory diagnostic testing. Little is known about the laboratory surface areas and operation behaviors that may cause potential contamination in SARS-CoV-2 nucleic acid testing. This study aims to provide reference basis for the improvement of laboratory disinfection programs and personal operating protocols. In this study, we compared the qRT-PCR and ddPCR in detecting of residual virus that existed on the object surfaces from sample transportation and reception related facilities, testing related instruments, personal protective equipment and other facilities in nucleic acid testing laboratory. All samples were negative by qRT-PCR, in contrast, 13 of 61 samples were positive for SARS-CoV-2 by ddPCR. The areas with highest density of SARS-CoV-2 nucleic acid were the outer gloves of operator A (37.4 copies/cm2), followed by door handle of 4 °C refrigerator (26.25 copies/cm2), goggles of operator A (22.16 copies/cm2), outer cover of high speed centrifuge (19.95 copies/cm2), inner wall of high speed centrifuge (14.70 copies/cm2) and others. We found that all the positive objects were directly or indirectly contacted by the operator's gloved hands, suggesting that hands contact was the main transmission pathway that led to laboratory environmental contamination. In summary, ddPCR has an advantage over qRT-PCR in tracing laboratory contamination. We evaluated the risk areas and operation behaviors that may easily cause contamination, and provided recommendation for improving the laboratory disinfection programs and personal operating specifications.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Contaminação de Equipamentos , Pandemias , Pneumonia Viral , RNA , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Humanos , Laboratórios , Ácidos Nucleicos/análise , Reação em Cadeia da Polimerase
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