RESUMO
Introducción: La otitis externa infecciosa es una consulta otorrinolaringológica frecuente en usuarios de audífonos. Las propiedades antibacterianas descritas del cobre, han motivado el desarrollo de aplicaciones clínicas de este metal. Objetivo: Evaluar la capacidad antibacteriana de moldes de audífonos manufacturados con polímeros sensible a luz UV, silicona y acrílico que incorporan cobre metálico, en un sistema experimental in vitro. Material y método: Se diseñaron moldes de audífonos con y sin cobre, que fueron inoculados con distintas concentraciones de microorganismos (S aureus y P aeruginosa), para luego determinar el porcentaje de adherencia bacteriana a distintos tiempos de contacto (4, 8 y12 horas). Resultados: Existió reducción significativa en la adhesión bacteriana a los moldes con cobre respecto a aquellos sin cobre, independiente del material, del tipo de microorganismo y del inóculo bacteriano. Discusión: La disminución en la adherencia bacteriana en los prototipos con cobre, puede atribuirse a su actividad inhibitoria sobre los microorganismos en función de su concentración y el tiempo de contacto, ejerciendo su efecto por difusión a través de los distintos materiales. Conclusión: Con estos resultados, se hace necesario el desarrollo de estudios clínicos enfocados en comprobar si el uso de audífonos con cobre disminuyen las otitis externas de origen infeccioso.
Introduction: External otitis of infectious etiology among hearing aid users is a common motive of otolaryngology consultation. Antibacterial properties described copper, they have motivated the development of clinical applications of this metal. Aim: Evaluate the antibacterial capacity of copper-based ear molds manufactured with different materials such UV sensitive polymers, silicone and acrylic incorporating metallic copper, in an experimental system in vitro. Material and method: Ear molds with and without copper, were inoculated with different concentrations of microorganisms (S aureus and P aeruginosa) and determine the percentage of bacterial adherence to different contact times (4-8 and 12 hours). Results: There was significant reduction in bacterial adhesion to copper molds than those without copper, independent of the material, the type of microorganism and the bacterial inoculum. Discussion: The decrease in bacterial adherence on prototypes with copper, can be attributed to inhibitory activity on microorganisms depending on their concentration and contact time, exerting its effect by diffusion through the various materials. Conclusion: With these results, is necessary the development of clinical studies focused on checking whether the use of hearing aids with copper decreases external otitis of infectious origin.
Assuntos
Humanos , Antibacterianos/farmacologia , Cobre/química , Auxiliares de Audição/microbiologia , Pseudomonas aeruginosa/efeitos dos fármacos , Staphylococcus aureus/efeitos dos fármacos , Aderência Bacteriana/efeitos dos fármacos , Otite Externa/prevenção & controleRESUMO
BACKGROUND: Copper has a bactericidal activity against a series of bacterial strains. AIM: To measure resistance to bacterial adherence of copper (Cu) and stainless steel (SS) metal coupons. MATERIAL AND METHODS: Bacterial strains causing nosocomial infections in Chile were analyzed. Bacterial adherence was studied using a previously described method based on a system of metal coupons that are immersed in culture media containing the bacteria of interest at room temperature. RESULTS: Adherence to Cu and SS coupons was different for Methicillin-resistant Staphylococcus aureus (MRSA), Klebsiella pneumoniae and Acinetobacter baumannii strains. For these strains, no adherence to Cu coupons occurred during the 48 h observation period compared to a rapidly increasing adherence to SS coupons, with a final colony count of 1.00 E + 07 cfu/mL. For two different Pseudomonas aeruginosa clinical strains, inhibition of adherence was not observed on Cu coupons, and colony counts were similar for Cu and SS using the standard inoculum (2-3 x lO7 cfu).A partial decrease in adherence was observed for Cu but not for SS coupons, when a lower inoculum was used. CONCLUSIONS: Copper surfaces represent an interesting option to reduce bacterial contamination in the hospital environment due to its resistance to bacterial adhesión of most of the common nosocomial bacterial strains.
Assuntos
Aderência Bacteriana/fisiologia , Cobre , Infecção Hospitalar/microbiologia , Aço Inoxidável , Acinetobacter baumannii/fisiologia , Adulto , Contagem de Colônia Microbiana , Humanos , Klebsiella pneumoniae/fisiologia , Staphylococcus aureus Resistente à Meticilina/fisiologia , Pseudomonas aeruginosa/fisiologiaRESUMO
Background: Copper has a bactericidal activity against a series of bacterial strains. Aim: To measure resistance to bacterial adherence of copper (Cu) and stainless steel (SS) metal coupons. Material and Methods: Bacterial strains causing nosocomial infections in Chile were analyzed. Bacterial adherence was studied using apreviously described method based on a system of metal coupons that are immersed in culture media containing the bacteria ofinterest at room temperature. Results: Adherence to Cu and SS coupons was differentfor Methicillin-resistant Staphylococcus aureus (MRSA), Klebsiella pneumoniae and Acinetobacter baumannii strains. For these strains, no adherence to Cu coupons occurred during the 48 h observation period compared to a rapidly increasing adherence to SS coupons, with a final colony count of 1.00E + 07 cfu/mL. For two different Pseudomonas aeruginosa clinical strains, inhibition of adherence was not observed on Cu coupons, and colony counts were similar for Cu and SS using the standard inoculum (2-3 xlO7 cfu).Apartial decrease in adherence was observed for Cu but not for SS coupons, when a lower inoculum was used. Conclusions: Copper surfaces represent an interesting option to reduce bacterial contamination in the hospital environment due to its resistance to bacterial adhesión ofmost ofthe common nosocomial bacterial strains.
Assuntos
Adulto , Humanos , Aderência Bacteriana/fisiologia , Cobre , Infecção Hospitalar/microbiologia , Aço Inoxidável , Acinetobacter baumannii/fisiologia , Contagem de Colônia Microbiana , Klebsiella pneumoniae/fisiologia , Staphylococcus aureus Resistente à Meticilina/fisiologia , Pseudomonas aeruginosa/fisiologiaRESUMO
Background: Copper is essential for cell metabolism in animals and plants and thus for life. Along centuries, copper has been identified as a metal containing antimicrobial properties. In recent years, laboratory assays and clinical studies have revealed that surfaces of metallic copper or its alloys, containing at least 70% copper, eliminate in a few hours several pathogenic organisms including bacterial strains associated with nosocomial infections, influenza virus, HIV, and fungi such as Candida albicans. In March 2008, the American Environmental Protection Agency (EPA), supported by scientific evidence gathered to date, registered copper as the first and only metal with antimicrobial properties. We herein review certain mechanisms proposed for the antibacterial, antiviral and antifungal activity of copper. We also discuss in vitro and clinical efficacy studies developed world wide and in Chile, focusing on bactericidal activity of copper surface areas in comparison to materials typically used in hospital environments such as stainless steel and polymers. Scientific evidence gathered to date, consistently shows that the use of copper surface areas in high contact critical points in hospitals, significantly reduces environmental bacterial load. This is associated with a decreased risk of pathogen transmission to patients and represents therefore an interesting complement to infection control programs.
Assuntos
Humanos , Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Cobre/farmacologia , Infecção Hospitalar/prevenção & controle , Chile , Contagem de Colônia Microbiana , Desinfecção/métodos , Microbiologia Ambiental , Escherichia coli/efeitos dos fármacos , Prática Clínica Baseada em Evidências , Staphylococcus aureus/efeitos dos fármacosRESUMO
BACKGROUND: Copper is essential for cell metabolism in animals and plants and thus for life. Along centuries, copper has been identified as a metal containing antimicrobial properties. In recent years, laboratory assays and clinical studies have revealed that surfaces of metallic copper or its alloys, containing at least 70% copper, eliminate in a few hours several pathogenic organisms including bacterial strains associated with nosocomial infections, influenza virus, HIV, and fungi such as Candida albicans. In March 2008, the American Environmental Protection Agency (EPA), supported by scientific evidence gathered to date, registered copper as the first and only metal with antimicrobial properties. We herein review certain mechanisms proposed for the antibacterial, antiviral and antifungal activity of copper. We also discuss in vitro and clinical efficacy studies developed world wide and in Chile, focusing on bactericidal activity of copper surface areas in comparison to materials typically used in hospital environments such as stainless steel and polymers. Scientific evidence gathered to date, consistently shows that the use of copper surface areas in high contact critical points in hospitals, significantly reduces environmental bacterial load. This is associated with a decreased risk of pathogen transmission to patients and represents therefore an interesting complement to infection control programs.
Assuntos
Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Cobre/farmacologia , Infecção Hospitalar/prevenção & controle , Chile , Contagem de Colônia Microbiana , Desinfecção/métodos , Microbiologia Ambiental , Escherichia coli/efeitos dos fármacos , Prática Clínica Baseada em Evidências , Humanos , Staphylococcus aureus/efeitos dos fármacosRESUMO
Clinical and epidemiological aspects of shigatoxin producing E. coli (STEC) infections and hemolytic uremic syndrome (HUS) are reviewed. Surveillance results from 14 sentinel centers during 2000-2002 showed a mean incidence rate of 3.4 HUS cases per 100.000 children, with the highest incidence in the 6 to 28 month age group. Disease is endemic with summer peaks. Between 1988 and 2002 we obtained the clinical characteristics of a group of 119 HUS children with the following results: mean age 16 months, bloody diarrhea 57.8 percent, no previous diarrhea 9 percent, 60 percent received antibiotics, 72 percent had oligoanuria, 53 percent required dialysis, 15 percent had seizures and 31 percent had dizziness; mortality was 3 percent. Four foodborne outbreaks have been detected in Santiago, two outbreaks occurred in household settings, one in a Day Care Center and one in a Neonatal Unit. Recommendations for diagnosis, treatment and prevention of STEC infections, including potential vaccines are discussed.
Se revisan y actualizan aspectos clínicos y epidemiológicos de las infecciones por Escherichia coli productora de shigatoxina (STEC), y el síndrome hemolítico urémico (SHU). Se incluyen resultados de una vigilancia de SHU en 14 centros centinelas (2000-2002), que mostró una incidencia promedio de 3,4 casos por 100.000 niños, 78 por ciento) en el grupo de 6 a 48 meses. Esta vigilancia reflejó una situación endémica, con aumento en verano. Se analiza la observación clínica protocolizada de 119 pacientes con SHU hospitalizados en la Región Metropolitana (RM) (1988 y 2002). Edad promedio: 16 meses. El 578 por ciento> tenía diarrea con sangre, 9 por ciento> no tenía diarrea previa, 60 por ciento> recibió antibacterianos, 72 por ciento> presentó oligoanuria y 53 por ciento> necesitó diálisis. El 31 por cientoo tuvo compromiso de conciencia y 15 por cientoo presentó convulsiones. Letalidad 3 por ciento. Se analizan brotes de STEC asociados a alimentos ocurridos en la RM en el hogar (2), un jardín infantil (1) y en un servicio de neonatología (1). Finalmente, se entregar recomendaciones para el manejo clínico y prevención, se revisan los criterios diagnósticos, nuevas estrategias terapéuticas y progresos en el desarrollo de vacunas.
Assuntos
Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Infecções por Escherichia coli/microbiologia , Síndrome Hemolítico-Urêmica/microbiologia , Escherichia coli Shiga Toxigênica/isolamento & purificação , Chile/epidemiologia , Infecções por Escherichia coli/diagnóstico , Infecções por Escherichia coli/epidemiologia , Síndrome Hemolítico-Urêmica/diagnóstico , Síndrome Hemolítico-Urêmica/epidemiologia , Incidência , Vigilância da PopulaçãoRESUMO
BACKGROUND: Acute bacterial meningitis (ABM) is a serious disease that needs rapid diagnosis for an accurate treatment. The most important etiological agents are: Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type b. Overall pathogen detection rate in patients with ABM in Chile is 83%. AIM: To evaluate a Polymerase Chain Reaction (PCR) protocol for simultaneous detection of several pathogens in patients with ABM. MATERIAL AND METHODS: We designed and evaluated a multiplex PCR protocol for simultaneous specific genes identifications of S pneumoniae ( inverted exclamation markytA and ply genes), N meningitidis (ctrA, crgA) and H influenzae (bexA) in cerebrospinal fluid (CSF) samples from pediatric patients with suspected diagnosis of ABM. Sensitivity, specificity and minimum detection levels of DNA were determined. Amplifications ofrDNA 16S gene was done to confirm extraction of bacterial DNA. RESULTS: Ninety nine CSF samples were studied, 90 from children with fever and negative CSF culture, and 9 from ABM and positive culture patients. The PCR protocol had a sensitivity of 89%, specificity of 100%, positive predictive value 100% and negative predictive value 99%. CONCLUSIONS: We observed a high concordance (89%) between bacteriological cultures and the PCR protocol results. This diagnostic tool could increase identification of agents in specific settings such as patients previously treated with antibiotics.
Assuntos
Meningites Bacterianas/líquido cefalorraquidiano , Reação em Cadeia da Polimerase/métodos , Doença Aguda , Criança , Chile , DNA Bacteriano/líquido cefalorraquidiano , DNA Bacteriano/genética , Haemophilus influenzae tipo b/genética , Haemophilus influenzae tipo b/isolamento & purificação , Humanos , Meningites Bacterianas/microbiologia , Meningite por Haemophilus/líquido cefalorraquidiano , Meningite por Haemophilus/microbiologia , Meningite Meningocócica/líquido cefalorraquidiano , Meningite Meningocócica/microbiologia , Neisseria meningitidis/genética , Neisseria meningitidis/isolamento & purificação , Infecções Pneumocócicas/líquido cefalorraquidiano , Infecções Pneumocócicas/microbiologia , Sensibilidade e Especificidade , Streptococcus pneumoniae/genética , Streptococcus pneumoniae/isolamento & purificaçãoRESUMO
Background: Acute bacterial meningitis (ABM) is a serious disease that needs rapid diagnosis for an accurate treatment. The most important etiological agents are: Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type b. Overall pathogen detection rate in patients with ABM in Chile is 83 percent. Aim: To evaluate a Polymerase Chain Reaction (PCR) protocol for simultaneous detection of several pathogens in patients with ABM. Material and methods: We designed and evaluated a multiplex PCR protocol for simultaneous specific genes identifications of S pneumoniae (¡ytA and ply genes), N meningitidis (ctrA, crgA) and H influenzae (bexA) in cerebrospinal fluid (CSF) samples from pediatric patients with suspected diagnosis of ABM. Sensitivity, specificity and minimum detection levels of DNA were determined. Amplifications ofrDNA 16S gene was done to confirm extraction of bacterial DNA. Results: Ninety nine CSF samples were studied, 90 from children with fever and negative CSF culture, and 9 from ABM and positive culture patients. The PCR protocol had a sensitivity of 89 percent, specificity of 100 percent, positive predictive value 100 percent and negative predictive value 99 percent. Conclusions: We observed a high concordance (89 percent) between bacteriological cultures and the PCR protocol results. This diagnostic tool could increase identification of agents in specific settings such as patients previously treated with antibiotics.
Assuntos
Criança , Humanos , Meningites Bacterianas/líquido cefalorraquidiano , Reação em Cadeia da Polimerase/métodos , Doença Aguda , Chile , DNA Bacteriano/líquido cefalorraquidiano , DNA Bacteriano/genética , Haemophilus influenzae tipo b/genética , Haemophilus influenzae tipo b/isolamento & purificação , Meningites Bacterianas/microbiologia , Meningite por Haemophilus/líquido cefalorraquidiano , Meningite por Haemophilus/microbiologia , Meningite Meningocócica/líquido cefalorraquidiano , Meningite Meningocócica/microbiologia , Neisseria meningitidis/genética , Neisseria meningitidis/isolamento & purificação , Infecções Pneumocócicas/líquido cefalorraquidiano , Infecções Pneumocócicas/microbiologia , Sensibilidade e Especificidade , Streptococcus pneumoniae/genética , Streptococcus pneumoniae/isolamento & purificaçãoRESUMO
Clinical and epidemiological aspects of shigatoxin producing E. coli (STEC) infections and hemolytic uremic syndrome (HUS) are reviewed. Surveillance results from 14 sentinel centers during 2000-2002 showed a mean incidence rate of 3.4 HUS cases per 100,000 children, with the highest incidence in the 6 to 28 month age group. Disease is endemic with summer peaks. Between 1988 and 2002 we obtained the clinical characteristics of a group of 119 HUS children with the following results: mean age 16 months, bloody diarrhea 57.8%, no previous diarrhea 9%, 60% received antibiotics, 72% had oligoanuria, 53% required dialysis, 15% had seizures and 31% had dizziness; mortality was 3%. Four foodborne outbreaks have been detected in Santiago, two outbreaks occurred in household settings, one in a Day Care Center and one in a Neonatal Unit. Recommendations for diagnosis, treatment and prevention of STEC infections, including potential vaccines are discussed.
Assuntos
Infecções por Escherichia coli/microbiologia , Síndrome Hemolítico-Urêmica/microbiologia , Escherichia coli Shiga Toxigênica/isolamento & purificação , Pré-Escolar , Chile/epidemiologia , Infecções por Escherichia coli/diagnóstico , Infecções por Escherichia coli/epidemiologia , Feminino , Síndrome Hemolítico-Urêmica/diagnóstico , Síndrome Hemolítico-Urêmica/epidemiologia , Humanos , Incidência , Lactente , Masculino , Vigilância da PopulaçãoRESUMO
Background: Shigella spp is a frequent cause of diarrhea in children. Antimicrobials decrease the duration of diarrhea and pathogen excretion. However, the increasing resistance limits their therapeutic value. Aim: To study Shigella serotype distribution in the Metropolitan Region in Chile, and its relationship with severity of disease, antimicrobial resistance pattern and clonality. Material and methods: During summer 2004-2005, stool samples from children with diarrhea were collected in Cary Blair transpon medium and cultured. Shigella isolates were serotyped using monoclonal and polyclonal commercial antibodies. In vitro activity of ampicillin, amoxicillin/clavulanic acid, chloramphenicol, cotrimoxazol, nalidixic acid, ciprofloxacin, ceftriaxone and azythromycin was determined by minimal inhibitory concentration (MIC). Clonality was studied by pulsed-field gel electrophoresis (PFGE) using Xbal as restriction enzyme. Results: One hundred thirty nine Shigella strains were isolated (77 S sonnei and 62 S flexneri). S sonnei and S flexneri 2a serotypes were responsible for 95 percent of episodes. Children aged 2-4 years, showed a greater incidence of Shigella infections and 77 percent of episodes were treated on an ambulatory basis. High resistance levels were observed for ampicillin, cotrimoxazole, amoxicillin-clavulanic acid and chloramphenicol (67 percent, 60 percent, 56 percent and 45 percent, respectively). We found 11 resistance patterns and 61,2 percent of strains were multiresistant. There were multiple clones without a strict relationship with resistance patterns. Conclusions: Shigella infections in Metropolitan Region in Chile are associated to a restricted number of serotypes, representing a clonal expansion associated to different antimicrobial resistant patterns.