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1.
Emerg Infect Dis ; 26(9): 2064-2068, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32459621

RESUMO

As a result of the coronavirus disease pandemic, commercial hand hygiene products have become scarce and World Health Organization (WHO) alcohol-based hand rub formulations containing ethanol or isopropanol are being produced for hospitals worldwide. Neither WHO formulation meets European Norm 12791, the basis for approval as a surgical hand preparation, nor satisfies European Norm 1500, the basis for approval as a hygienic hand rub. We evaluated the efficacy of modified formulations with alcohol concentrations in mass instead of volume percentage and glycerol concentrations of 0.5% instead of 1.45%. Both modified formulations met standard requirements for a 3-minute surgical hand preparation, the usual duration of surgical hand treatment in most hospitals in Europe. Contrary to the originally proposed WHO hand rub formulations, both modified formulations are appropriate for surgical hand preparation after 3 minutes when alcohol concentrations of 80% wt/wt ethanol or 75% wt/wt isopropanol along with reduced glycerol concentration (0.5%) are used.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Higiene das Mãos/normas , Higienizadores de Mão/normas , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , 2-Propanol/análise , Etanol/análise , Europa (Continente) , Mãos/microbiologia , Higiene das Mãos/métodos , Higienizadores de Mão/análise , Humanos , Organização Mundial da Saúde
2.
Cochrane Database Syst Rev ; 4: CD013597, 2020 04 28.
Artigo em Inglês | MEDLINE | ID: mdl-32343408

RESUMO

BACKGROUND: Handwashing is important to reduce the spread and transmission of infectious disease. Ash, the residue from stoves and fires, is a material used for cleaning hands in settings where soap is not widely available. OBJECTIVES: To assess the benefits and harms of hand cleaning with ash compared with hand cleaning using soap or other materials for reducing the spread of viral and bacterial infections. SEARCH METHODS: On 26 March 2020 we searched CENTRAL, MEDLINE, Embase, WHO Global Index Medicus, and the WHO International Clinical Trials Registry Platform. SELECTION CRITERIA: We included all types of studies, in any population, that examined hand cleaning with ash compared to hand cleaning with any other material. DATA COLLECTION AND ANALYSIS: Two review authors independently screened titles and full texts, and one review author extracted outcome data and assessed risk of bias, which another review author double-checked. We used the ROBINS-I tool for observational studies, we used RoB 2.0 for three interventional studies, and we used GRADE to assess the certainty of the evidence. We planned to synthesise data with random-effects meta-analyses. Our prespecified outcome measures were overall mortality, number of cases of infections (as defined in the individual studies), severity of infectious disease, harms (as reported in the individual studies), and adherence. MAIN RESULTS: We included 14 studies described in 19 records using eight different study designs, but only one randomised trial. The studies were primarily conducted in rural settings in low- and lower-middle-income countries. Six studies reported outcome data relevant to our review. A retrospective case-control study and a cohort study assessed diarrhoea in children under the age of five years and self-reported reproductive tract symptoms in women, respectively. It was very uncertain whether the rate of hospital contacts for moderate-to-severe diarrhoea in children differed between households that cleaned hands using ash compared with households cleaning hands using soap (RR 0.97, 95% CI 0.84 to 1.11; very low-certainty evidence). Similarly, it was very uncertain whether the rate of women experiencing symptoms of reproductive tract infection differed between women cleaning hands with ash compared with cleaning hands using soap (RR 0.48, 95% CI 0.12 to 1.86; very low-certainty evidence) or when compared with handwashing with water only or not washing hands (RR 0.50, 95% CI 0.13 to 1.96; very low-certainty evidence). Four studies reported on bacteriological counts after hand wash. We rated all four studies at high risk of bias, and we did not synthesise data due to methodological heterogeneity and unclear outcome reporting. AUTHORS' CONCLUSIONS: Based on the available evidence, the benefits and harms of hand cleaning with ash compared with soap or other materials for reducing the spread of viral or bacterial infections are uncertain.


Assuntos
Infecções Bacterianas/prevenção & controle , Higiene das Mãos/métodos , Material Particulado/uso terapêutico , Viroses/prevenção & controle , Adolescente , Adulto , Infecções Bacterianas/epidemiologia , Betacoronavirus , Estudos de Casos e Controles , Pré-Escolar , Estudos de Coortes , Culinária , Infecções por Coronavirus/prevenção & controle , Diarreia/epidemiologia , Fezes/microbiologia , Feminino , Fogo , Mãos/microbiologia , Humanos , Masculino , Pandemias/prevenção & controle , Material Particulado/efeitos adversos , Pneumonia Viral/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Infecções do Sistema Genital/epidemiologia , Autorrelato , Sabões , Viroses/epidemiologia
3.
East Mediterr Health J ; 26(2): 198-205, 2020 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-32141598

RESUMO

Background: Adequate hand hygiene is considered the most effective measure to reduce transmission of nosocomial pathogens. Aims: To determine the effectiveness of infection control intervention to improve compliance with hand hygiene in the Emergency Department, Al-Leith General Hospital, Saudi Arabia, and evaluate bacterial load on hands as a possible indicator of improvement. Methods: The study consisted of 3 phases: Phase I, measurement of basal hand hygiene compliance level; Phase II, multimodal hand hygiene educational programme was initiated; and Phase III, hand hygiene compliance level was measured again. Data were collected by direct observation of healthcare workers in the emergency department between October 2016 and March 2017, using the standardized World Health Organization method for direct observation, "Five Moments for Hand Hygiene". The intervention comprised health education sessions using direct personal contact. Hands of healthcare workers were sampled during Phases I and III by sterile bag method, and bacterial load was determined. Results: A total of 1374 opportunities for hand hygiene were observed during the triphase study. Implementation of the interventional hand hygiene educational programme significantly improved compliance with hand hygiene guidelines from 30.7% to 45.5% (P < 0.01). Log10 bacterial load per hand dropped from 4.97 (standard deviation = 0.32) to 4.57 (0.47) (P < 0.05). Conclusions: Hand hygiene educational programmes were effective in improving compliance in the emergency department, and bacterial load on hands of healthcare workers could be used as an indicator of improvement in hand hygiene compliance.


Assuntos
Infecção Hospitalar/prevenção & controle , Higiene das Mãos , Mãos/microbiologia , Pessoal de Saúde , Controle de Infecções/métodos , Educação em Saúde , Hospitais , Humanos , Unidades de Terapia Intensiva/normas , Arábia Saudita
4.
PLoS Negl Trop Dis ; 14(3): e0008120, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32130213

RESUMO

BACKGROUND: Trachoma elimination efforts are hampered by limited understanding of Chlamydia trachomatis (Ct) transmission routes. Here we aimed to detect Ct DNA at non-ocular sites and on eye-seeking flies. METHODS: A population-based household survey was conducted in Oromia Region, Ethiopia. Ocular and non-ocular (faces, hands, clothing, water containers and sleeping surfaces) swabs were collected from all individuals. Flies were caught from faces of children. Flies, ocular swabs and non-ocular swabs were tested for Ct by quantitative PCR. RESULTS: In total, 1220 individuals in 247 households were assessed. Active trachoma (trachomatous inflammation-follicular) and ocular Ct were detected in 10% and 2% of all-ages, and 21% and 3% of 1-9-year-olds, respectively. Ct was detected in 12% (95% CI:8-15%) of tested non-ocular swabs from ocular-positive households, but in none of the non-ocular swabs from ocular-negative households. Ct was detected on 24% (95% CI:18-32%) of flies from ocular-positive households and 3% (95% CI:1-6%) of flies from ocular-negative households. CONCLUSION: Ct DNA was detected on hands, faces and clothing of individuals living in ocular-positive households suggesting that this might be a route of transmission within Ct infected households. In addition, we detected Ct on flies from ocular-positive households and occasionally in ocular-negative households suggesting that flies might be a vector for transmission within and between Ct infected and uninfected households. These potential transmission routes may need to be simultaneously addressed to suppress transmission.


Assuntos
Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/transmissão , Chlamydia trachomatis/isolamento & purificação , Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/transmissão , Transmissão de Doença Infecciosa , Adolescente , Adulto , Animais , Criança , Pré-Escolar , Chlamydia trachomatis/genética , Vestuário , Estudos Transversais , Dípteros/microbiologia , Etiópia , Fezes/microbiologia , Feminino , Fômites/microbiologia , Mãos/microbiologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase em Tempo Real , Adulto Jovem
6.
J Infect Chemother ; 26(1): 110-114, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31266705

RESUMO

Unusual community-acquired invasive Klebsiella pneumoniae infection has been reported worldwide, particularly in Asia. Recently, several virulence-associated genes of the isolates have been investigated. We report a case of multifocal intramuscular and musculoskeletal abscesses caused by K. pneumoniae in a 61-year-old male diabetes patient. A string test of the K. pneumoniae isolate, which was recovered from abscesses obtained by surgical debridement and drainage, was positive. We used whole-genome sequencing to analyze the virulence-associated gene profile of the isolate. The isolate belonged to the K2 genotype with sequence type 375. The isolate harbored rmpA and rmpA2, which induce serum resistance (hypermucoviscosity). The isolate also carried siderophores, i.e., aerobactin and salmochelin, which are associated with enhanced bacterial growth. The isolate did not harbor K1-unique virulence factors, such as colibactin, microcin, and yersiniabactin. Our K2 strain harbored a combination of virulence plasmid-associated genes-rmpA/A2 and siderophores (aerobactin and salmochelin). Hence, we advocate that essential molecular virulence factors of isolates that cannot be identified by a string test and capsular serotyping alone may exist.


Assuntos
Complicações do Diabetes , Infecções por Klebsiella , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/patogenicidade , Infecções dos Tecidos Moles , Fatores de Virulência/genética , DNA Bacteriano/genética , Complicações do Diabetes/diagnóstico , Complicações do Diabetes/microbiologia , Mãos/microbiologia , Mãos/patologia , Humanos , Infecções por Klebsiella/complicações , Infecções por Klebsiella/diagnóstico , Infecções por Klebsiella/microbiologia , Masculino , Pessoa de Meia-Idade , Tipagem Molecular , Infecções dos Tecidos Moles/complicações , Infecções dos Tecidos Moles/diagnóstico , Infecções dos Tecidos Moles/microbiologia , Sequenciamento Completo do Genoma
7.
PLoS Negl Trop Dis ; 13(12): e0007834, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31869324

RESUMO

BACKGROUND: Trachoma, a conjunctivitis caused by repeated infections with Chlamydia trachomatis, remains a significant cause of blindness worldwide. While mass treatments with azithromycin decreases disease and infection, re-emergence occurs, indicating that elimination may require other sustainable interventions. Environmental changes largely focus on facial hygiene and latrines, but further work to identify other possible transmission targets are needed. We sought to determine, in a cross-sectional survey of households of children with active trachoma, if we could detect the presence of Chlamydia trachomatis on household objects and on family members based on sleeping and caretaking patterns. METHODS: In five villages in Kongwa, Tanzania, children

Assuntos
Derrame de Bactérias , Chlamydia trachomatis/isolamento & purificação , Microbiologia Ambiental , Características da Família , Mãos/microbiologia , Tracoma/microbiologia , Pré-Escolar , Estudos Transversais , Transmissão de Doença Infecciosa , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Tanzânia
8.
Ethiop J Health Sci ; 29(5): 605-612, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31666782

RESUMO

Background: Food handlers have been recognized to play a major role in the transmission of food borne diseases, contributing significantly to the global incidence and burden of the diseases. This study, therefore, aimed to assess the nasal and hand carriage of Staphylococcus aureus among food handlers in Jimma Town. Methods: A community based cross sectional study was conducted from February to May 2017. Swab specimens from nasopharyngeal and hands of food handlers working in food establishments were collected for isolation and identification of S. aureus using standard bacteriological methods. Antimicrobial susceptibility test was done using disc diffusion method. Associations of selected variables for S. aureus colonization were determined using SPSS version 20 with p ≤ 0.05 taken as statistically significant. Results: Among the 300 food handlers working in hotels and restaurants in Jimma Town, 86(28.7%) were colonized by S. aureus. The frequency of isolation of S. aureus from nose, hand and both parts (nose and hand) were 27(9%), 34(11.3%) and 25(8.3%), respectively. There was strong association (P=0.00336) between carriage rate of S. aureus and food handlers' job category. The majority (90.7%) of the isolates were resistant to Penicillin and Ampicillin. Increased levels of sensitivity were observed against Ciprofloxacin (96.5%), Cefoxitin (95.3%) and Amoxicillin-Clavulanic Acid (94.2%). Conclusions: This study revealed a high prevalence of S. aureus carriers among food handlers and high antibacterial resistance towards commonly prescribed drugs, justifying the screening of food handlers to detect and treat carriers and protect restaurant customers from staphylococcal food poisoning.


Assuntos
Manipulação de Alimentos , Mãos/microbiologia , Nariz/microbiologia , Staphylococcus aureus/isolamento & purificação , Adulto , Estudos Transversais , Etiópia , Feminino , Humanos , Masculino , Prevalência , Adulto Jovem
9.
BMC Infect Dis ; 19(1): 897, 2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31660887

RESUMO

BACKGROUND: The impact of animals sources of food as a possible reservoir for extended-spectrum ß-lactamase (ESBL) - Producing E. coli, and the dissemination of such strains into the food production chain need to be assessed. This study was aimed to assess the presence and antimicrobial susceptibility patterns of ESBLs - producing E. coli isolates from minced meat and environmental swab samples at meat retailer shops of Jimma town, Southwest Ethiopia. METHODOLOGY: A cross-sectional descriptive study was conducted from March to June, 2016. A total of 168 minced meat and swab samples were first enriched by buffered peptone water (BPW) for overnight and streaked onto MacConkey agar. Double disk synergy (DDS) method was used for detection of ESBL-producing strains. A disk of amoxicillin + clavulanic acid (20/10 µg) was placed in the center of Mueller-Hinton agar plate, and cefotaxime (30 µg) and ceftazidime (30 µg) were placed at a distance of 20 mm from the central disk. Checklist was used to assess hygienic status of butcher shops and practices meat handlers. RESULTS: A total of 35 (20.80%) biochemically confirmed E. coli were obtained from 168 samples. Of these, 21 (23.9%) of them were detected from 88 minced meat and the other 14 (17.5%) from 80 swab samples taken from butcher's hand, knives, chopping board and protective clothing. From 35 E. coli isolates, 7(20%) of them were confirmed as ESBL- producers. Among ESBL- producing strains, 85.7% were resistant for cefotaxime and ceftriaxone and 71.4% for ceftazidime. Among non-ESBLs-producing strains only seven isolates were resistant to third generation cephalosporin. All E. coli isolates were resistant to ampicillin, penicillin and erythromycin, and susceptible to amikacin. Poor hygienic status of butcher shops and unhygienic practice of meat handlers were observed. CONCLUSION: The detections of ESBLs- producing strains could be contributed for the increment of multi drug resistant isolates. This study also concluded that, unhygienic meat handling and processing practice can contribute for contaminations of meat. Thus, strategies should be planned and implemented to improve the knowledge and practice of butchers about handling and processing of meat.


Assuntos
Escherichia coli/enzimologia , Microbiologia de Alimentos/métodos , Carne/microbiologia , Saúde do Trabalhador , beta-Lactamases/análise , Animais , Bovinos , Vestuário , Estudos Transversais , Farmacorresistência Bacteriana Múltipla , Escherichia coli/classificação , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/prevenção & controle , Etiópia , Mãos/microbiologia , Higiene das Mãos , Humanos , Testes de Sensibilidade Microbiana
10.
Infect Genet Evol ; 76: 104068, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31614212

RESUMO

Although the epidemiology of pathogenic Candida species causing invasive human diseases is changing, Candida albicans still remains the most common cause of bloodstream infections worldwide. The propensity of this pathogen to cause infections is undoubtedly the result of its unique genetic plasticity that allow it to adapt and respond quickly to a myriad of changing conditions both in the host and in the environment. For this reason, we decided to investigate the genetic diversity of this important fungal pathogen in a particular category of patients with severe neurological deficits including the hospital environments where they are hospitalized. Genetic diversity of 21 C. albicans isolates recovered from blood, hands of healthcare workers and hospital environments was evaluated by using multilocus sequence typing (MLST) which revealed a high genetic heterogeneity with a set of 18 diploid sequence types (DSTs) recovered among 21 isolates investigated. Interestingly, 13 of these 18 MLST genotypes were completely new and added to the C. albicans MLST central database. Six eBURST clonal complexes (CC-1, CC-2, CC-6, CC-9, CC-27 and CC-42) and three singletons contained all DSTs found in this study. Among all the new DSTs identified, DST3388 was the most intriguing as this genotype was recovered from a typical C. albicans isolate clustering within the MLST-Clade 13, the most divergent evolutionary lineage within C. albicans population containing only isolates with unusual phenotypes originally known as Candida africana. In conclusion, the results of this study expand our understanding of the molecular epidemiology and global population structure of C. albicans suggesting that further studies on different categories of patients and hospital environments are needed to better understand how the population of this species adapts and evolves in heterogeneous hosts and changing environments.


Assuntos
Lesões Encefálicas/microbiologia , Candida albicans/classificação , Candidíase/diagnóstico , Tipagem de Sequências Multilocus/métodos , Candida albicans/genética , Candida albicans/isolamento & purificação , Candidíase/epidemiologia , Microbiologia Ambiental , Evolução Molecular , Feminino , Variação Genética , Mãos/microbiologia , Pessoal de Saúde , Humanos , Masculino , Técnicas de Tipagem Micológica , Filogenia
11.
BMC Public Health ; 19(1): 1324, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640641

RESUMO

BACKGROUND: Several studies have reported an association between improvements in hand hygiene and the reductions in rates of intestinal parasitic diseases. However, only a some have addressed its link to the frequency of influenza-like illness. The current study aimed to find the correlation between personal hygiene habits and the frequency of influenza-like illness. METHODS: A cross-sectional study targeting 3000 participants conducted in Riyadh city, Saudi Arabia. A systematic random sampling methodology was applied for participant from different part of Riyadh city using a computer generating system. The researcher first started by calling each participant. A full explanation was given to each participant in details (from the purpose of the research, consent to answer the questionnaire, to the explanation of the outcome definition). Each point of the questionnaire was explained to them to make sure they had excellent comprehension, and therefore, respond accurately. Descriptive statistics and Odds Ratio and its 95% confidence intervals were used to determine the association between frequency of influenza-like illness and the studied variables. RESULTS: Two thousand eighty-two (69.4%) completed the questionnaire. The participants who spent 5-10 s in handwashing with soap and rubbing were at increased risk of more frequent influenza-like illness (odds ratio = 1.37, 1.08-1.75). Handwashing with soap and rubbing after handshaking is an independent protective habit against frequent influenza-like illness (adjusted OR = 0.59, 0.37-0.94). CONCLUSION: The decrease of the frequency of influenza-like illness could be done through the following: getting the influenza vaccine annually, washing hands with soap and hand rubbing not less than 15 s after getting out of the bathroom, before and after handshaking and before eating. Soap companies should invent soaps that take less rubbing time to kill bacteria, and subsequently may maximize compliance in the community.


Assuntos
Hábitos , Desinfecção das Mãos , Higiene , Influenza Humana/prevenção & controle , Infecções Respiratórias/prevenção & controle , Adulto , Estudos Transversais , Feminino , Mãos/microbiologia , Humanos , Masculino , Arábia Saudita , Sabões , Inquéritos e Questionários
12.
PLoS One ; 14(9): e0221367, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31536497

RESUMO

OBJECTIVE: Mycobacterium marinum causes a rare cutaneous disease known as fish tank granuloma (FTG). The disease manifestations resemble those associated with Cutaneous Leishmaniasis (CL). The aim of this study was to determine whether FTG was the cause of cutaneous lesions in patients who were referred to the Parasitology laboratory of Imam Reza Hospital in Mashhad to be investigated for CL. MATERIALS/METHODS: One hundered patients, clinically diagnosed with CL between April 2014 and March 2015, were included in this study. Ziehl-Neelsen staining was performed to identify acid-fast Mycobacterium in addition to bacterial cultures using Löwenstein-Jensen medium. Skin lesion samples were also collected and kept on DNA banking cards for PCR testing. RESULTS: Twenty-nine of the 100 individuals with skin lesions, and therefore suspected of suffering from CL, tested positive for Mycobacterium marinum by PCR. Of these, 21 (72.4%) were male and 8(27.6%) were female. In 97% of these cases the lesions were located on hands and fingers. These patients had a history of manipulating fish and had been in contact with aquarium water. A sporotrichoid appearance was observed in 58.6% of the patients with mycobacterial lesions; 67% of patients had multiple head appearance. CONCLUSION: Patients suspected to have CL and who test negative for CL could be affected by FTG. Therefore, after obtaining an accurate case history, molecular diagnosis is recommended for cases that give a negative result by conventional methods.


Assuntos
DNA Bacteriano/genética , Leishmaniose Cutânea/diagnóstico , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Mycobacterium marinum/isolamento & purificação , Adolescente , Adulto , Técnicas Bacteriológicas , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Dedos/microbiologia , Mãos/microbiologia , Humanos , Lactente , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Mycobacterium marinum/genética , Adulto Jovem
13.
PLoS One ; 14(9): e0222355, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31504064

RESUMO

BACKGROUND: Hands are a route of transmission for fecal-oral pathogens. This analysis aimed to assess associations between hand E. coli contamination and child age and determine if observed hand cleanliness can serve as a proxy for E. coli contamination on young children's hands. METHODS: Trained field workers collected hand rinse samples from children aged 1-14 months in 584 households in rural Bangladesh and assessed the visual cleanliness of child hands (fingernails, finger pads and palms). Samples were analyzed using the IDEXX most probable number (MPN) methodto enumerate E. coli. We assessed if child age (immobile children aged 1-4 months vs. mobile children aged 5-14 months) is associated with log10 E. coli counts on hands using generalized estimating equations (GEE). We estimated the log10 difference in hand E. coli counts associated with the cleanliness of different hand parts using a multivariable GEE model.We calculated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for dirty fingernails, fingerpads, palms and overall hands (the three observed parts combined) against binary E. coli presence on hands. RESULTS: E. coli was detected on 43% of child hands. Children in the mobile age range had 0.17 log10 MPN higher E. coli on hands than those in the immobile age range (Δlog10 = 0.17, 95% CI = 0.02, 0.32, p = 0.03). Children with visible dirt particles on finger pads had 0.46 log10 MPN higher E. coli on hands than those with clean finger pads (Δlog10 = 0.46, 95% CI = 0.05, 0.87, p = 0.03). Dirty fingernails indicated binary E. coli presence with 81% sensitivity and 26% specificity while dirty fingerpads and palms indicated E. coli presence with 29% sensitivity and 75-77% specificity. The PPV was 45-48% and NPV 59-65% for all three types of observations. CONCLUSION: Hand contamination with E. coli was prevalent among young children in rural Bangladesh, with higher levels of contamination among mobile children. Studies should assess if strategies to remove animal feces from the courtyard, provide designated hygienic play spaces for children and deliver targeted messaging to mothers to wipe or wash children's hands after contact with animals and animal feces reduce child hand contamination. Visible hand cleanliness was a poor predictor of E. coli presence on young children's hands so other low-cost field measurements are needed to accurately detect fecal contamination on hands.


Assuntos
Desinfecção das Mãos , Mãos/microbiologia , Fatores Etários , Escherichia coli/isolamento & purificação , Fezes/microbiologia , Humanos , Lactente
15.
Int J Pharm Compd ; 23(5): 387-391, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31513537

RESUMO

In pharmaceutical compounding, strict adherence to a protocol for hand hygiene and glove sanitizing is essential to ensure the purity, safety, and effectiveness of sterile preparations; reduce patient morbidity and mortality; and decrease the cost of health care. Alcohols and chlorhexidine gluconate are among the most effective bactericides, virucides, and fungicides, and acquired resistance to those agents has not been shown in clinical practice. This article, which is part 1 in a series of 2, pertains primarily to alcohol-based hand rubs that are appropriate for use in sterile compounding (glove sanitizing is discussed as part of the handsanitizing process). In a brief overview of those products, we define pertinent terminology, examine the necessity of and requirements for the use of sanitizers, review their mechanism of action and composition, consider factors pertinent to their selection, and present a protocol for their application. In part 2 of this series, the topics examined include a comparison of various alcohol-based sanitizers and answers to compounders' frequently asked questions about their use.


Assuntos
Desinfecção das Mãos/métodos , Mãos , Mãos/microbiologia , Humanos
16.
PLoS One ; 14(8): e0220555, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31437151

RESUMO

Hand infections are a common presentation at the emergency departments. Without knowing the source of infection clinicians are dependent on systematic reports on the bacterial spectrum and susceptibility tests of the specific infection in their patient community. This study was based on a retrospective chart review of patients presenting to our outpatient clinic with acute hand infections. We documented patient demographics, the etiology, location, culture tests of the infection and analyzed if certain bacteria could be cultured significantly more often in certain etiologies or in specific sites of the hand infection. Susceptibility tests were added. Bacterial swabs of 204 patients were analyzed. Overall S. aureus was found in 53% of all cases, in only one case revealed methicillin-resistant S. aureus (MRSA). There was no significant difference in the bacterial spectrum according to the etiology of the hand infections, except for animal bites where Pasteurella multocida was the dominating bacteria in 63% of all cases. Amoxicillin-clavulanic acid, fluoroquinolones, and piperacillin were effective against the main bacteria. Our study confirms the previously published antibiotic resistance reports and reinforces the current antibiotic treatment guidelines also in this western European population.


Assuntos
Dermatoses da Mão/etiologia , Dermatoses da Mão/microbiologia , Mãos/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/farmacologia , Áustria , Bactérias/efeitos dos fármacos , Infecções Bacterianas/diagnóstico , Infecções Bacterianas/etiologia , Suscetibilidade a Doenças , Feminino , Humanos , Infecções , Masculino , Resistência a Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/patogenicidade , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Estudos Retrospectivos , Infecções dos Tecidos Moles/etiologia , Infecções dos Tecidos Moles/microbiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/patogenicidade
17.
Rev. esp. quimioter ; 32(4): 303-310, ago. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-188824

RESUMO

BACKGROUND: The WHO recognized antimicrobial resistance as a growing global health threat with a wide variability across Europe: in Italy these rates are higher than in other countries. The aim of our study was to detect antimicrobial resistance on the hands of healthcare workers and on surfaces around the patient, to assess the variability between levels of bacterial contamination on these surfaces and to compare the results with those achieved six years ago. MATERIAL AND METHODS: The study was conducted from June 2017 to May 2018 using contact slides for surfaces and active sampling for air. We used automated biochemical methods to identify microorganisms; antibiograms were performed in compliance with the EUCAST expert rules. RESULTS: We analyzed 3,760 samples, 16.17% were found positive and 34 % of these were antimicrobial-resistant. On analyzing the isolated Staphylococci, 39% were multidrug-resistant and 5% extensively drug-resistant. A 30% of the Enterococcus faecalis isolates were resistant to gentamycin and vancomycin. We found Klebsiella pneumoniae isolates resistant to ceftriaxone, cefoxitin, mecillinam and imipenem. A 7% and 8% of the Acinetobacter baumannii and Pseudomonas aeruginosa isolates, respectively, were resistant to gentamicin, imipenem, and ceftazidime. CONCLUSIONS: These findings are in line with the international literature, confirming that antimicrobial resistance is also steadily growing in Italy with rates varied for the different pathogens


INTRODUCCIÓN: La OMS reconoce la resistencia a los antimicrobianos como una creciente amenaza para la salud mundial con una amplia variabilidad en toda Europa: en Italia estas tasas son más altas que en otros países. El objetivo de nuestro estudio fue detectar la resistencia a los antimicrobianos en las manos de trabajadores sanitarios y en las superficies alrededor del paciente así como evaluar la variabilidad entre los niveles de contaminación bacteriana en estas superficies y los resultados obtenidos hace seis años. MATERIAL Y MÉTODOS: El estudio se realizó entre junio de 2017 y mayo de 2018 utilizando dispositivos de contacto para superficies y muestreo activo de aire. Se empleó métodos bioquímicos automatizados para identificar microorganismos y la sensibilidad antimicrobiana fue realizada de acuerdo con las normas del EUCAST. RESULTADOS: Se analizaron 3.760 muestras, de las cuales el 16,17% fueron positivas y el 34% de ellas fueron resistentes a antibióticos. Al analizar los estafilococos, el 39% fueron multirresistentes y el 5% extremadamente resistentes. Un 30% de las cepas de Enterococcus faecalis fueron resistentes a gentamicina y vancomicina. Se aislaron cepas de Klebsiella pneumoniae resistentes a ceftrixona, cefoxitina, mecillinam e imipenem. Un 7% de las cepas de Acinetobacter baumannii y un 8% de las cepas de Pseudomonas aeruginosa fueron resistentes a gentamicina, imipenem y ceftazidima. CONCLUSIONES: Estos hallazgos están en línea con los estudios publicados en otros países, lo que confirma que la resistencia a los antibióticos también está creciendo constantemente en Italia con tasas variadas para los diferentes patógenos


Assuntos
Humanos , Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla , Microbiologia Ambiental , Mãos/microbiologia , Pessoal de Saúde , Unidades Hospitalares , Acinetobacter baumannii/efeitos dos fármacos , Enterococcus faecalis/efeitos dos fármacos , Klebsiella pneumoniae/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Recursos Humanos em Hospital , Pseudomonas aeruginosa/efeitos dos fármacos , Rhizobium/efeitos dos fármacos , Staphylococcus/efeitos dos fármacos , Itália
18.
Am J Trop Med Hyg ; 101(3): 494-497, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31359856

RESUMO

We report a case of a 13-year-old immunocompetent male with multifocal tubercular osteomyelitis involving several spinal segments, small bones of the hands, and the scalp, who started with progressively back pain and enlarging painful swelling on the palms of hands, fatigue, and irregular fever. All the hand lesions were firm, mildly tender, and covered by ulcerated skin with serous discharge from the site. Magnetic resonance showed lesions of the right fifth metacarpal, of the right intermediate phalanx of the fourth finger, of the left second metacarpal, and of most vertebral bodies of the cervical, dorsal, lumbar, and sacral spine. The nucleic acid amplification test and the final culture from the drainage of the hands' lesion were positive for Mycobacterium tuberculosis. The patient received a standard antitubercular treatment for 12 months with clinical improvement.


Assuntos
Osteomielite/diagnóstico por imagem , Tuberculose/complicações , Tuberculose/diagnóstico por imagem , Adolescente , Antituberculosos/uso terapêutico , Mãos/microbiologia , Mãos/patologia , Humanos , Imunocompetência , Masculino , Mycobacterium tuberculosis/genética , Osteomielite/microbiologia , Couro Cabeludo/microbiologia , Couro Cabeludo/patologia , Coluna Vertebral/microbiologia , Coluna Vertebral/patologia , Tuberculose/tratamento farmacológico
19.
Rev Esp Quimioter ; 32(4): 303-310, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31257821

RESUMO

OBJECTIVE: Drug-resistant bacteria on hands of healthcare workers and in the patient area: an environmental survey in Southern Italy's hospital. METHODS: The study was conducted from June 2017 to May 2018 using contact slides for surfaces and active sampling for air. We used automated biochemical methods to identify microorganisms; antibiograms were performed in compliance with the EUCAST expert rules. RESULTS: We analyzed 3,760 samples, 16.17% were found positive and 34 % of these were antimicrobial-resistant. On analyzing the isolated Staphylococci, 39% were multidrug-resistant and 5% extensively drug-resistant. A 30% of the Enterococcus faecalis isolates were resistant to gentamycin and vancomycin. We found Klebsiella pneumoniae isolates resistant to ceftriaxone, cefoxitin, mecillinam and imipenem. A 7% and 8% of the Acinetobacter baumannii and Pseudomonas aeruginosa isolates, respectively, were resistant to gentamicin, imipenem, and ceftazidime. CONCLUSIONS: These findings are in line with the international literature, confirming that antimicrobial resistance is also steadily growing in Italy with rates varied for the different pathogens.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla , Microbiologia Ambiental , Mãos/microbiologia , Pessoal de Saúde , Unidades Hospitalares , Acinetobacter baumannii/efeitos dos fármacos , Enterococcus faecalis/efeitos dos fármacos , Humanos , Itália , Klebsiella pneumoniae/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Recursos Humanos em Hospital , Pseudomonas aeruginosa/efeitos dos fármacos , Rhizobium/efeitos dos fármacos , Staphylococcus/efeitos dos fármacos
20.
J Prev Med Hyg ; 60(2): E103-E108, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31312739

RESUMO

Introduction: Contaminated hands remain the mainstay cause of infection in children. Infections like diarrhoea and pneumonia were found to be common among children who have limited knowledge on the importance of hand wash. The present study was aimed to assess the relationship between the bacterial load sampled from the hands of school children and their routine hand wash practice methods. Methods: Samples were collected from both the hands of 200 rural school children. Bacterial colonies isolated from the swabs were identified by standard microbiological procedures. Questionnaire was provided to gather matrix of routine hand wash practice from the subjects. Proper handwashing technique was demonstrated to children. Results: More than 95% of the children harbored commensal like CoNS and Aerobic spore formers. Other pathogenic bacteria isolated include Acinetobacter species (36.5%), Pseudomonas species 4% (15), Enterococcus species (2%), Klebsiella species (3.5%), Flavobacterium species (1.7%), Escherichia coli (2%), and Enterobacter species (0.75%). It was found that the male children harbored more bacteria in their hands when compared to female population. Bacterial population like Pseudomonas species, Klebsiella species and Enterococcus species were predominant in the hands of children belonging to 7-10 years of age whereas Acinetobacter species, Escherichia coli and Flavobacterium species were slightly higher among 11-15 years of age. This information corresponds to the poor hand washing practices among the children. Conclusions: It can thus be concluded from our study that simple handwashing practices can efficiently reduce the transmission of pathogenic bacteria from our hands and greatly reduce the transmission of infection.


Assuntos
Bactérias , Desinfecção das Mãos , Mãos/microbiologia , Adolescente , Fatores Etários , Criança , Feminino , Humanos , Índia , Masculino , População Rural , Inquéritos e Questionários
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