Comparação da eficácia antimicrobiana na higienização das mãos: óleo essencial de Melaleuca alternifolia versus

OBJETIVOS: este estudio objetivó evaluar la eficacia de la higienización de las manos realizada con dos fórmulas diferentes de jabones: aceite esencial de Melaleuca alternifolia al 0,3% versus triclosan al 0,5%, y compararlas con dos higienizaciones de referencia: procedimiento de la metodología oficial (soft soap) versus procedimiento de la versión draft (soft soap + propan-2-ol). MÉTODO: utilizando la metodología europea EN 1499, fueron determinados factores de reducción logarítmica del número de unidades formadoras de colonia de Escherichia coli K12 antes y después de la higiene de las manos de 15 sujetos voluntarios y comparados por el test de Wilcoxon de una sola cola. RESULTADOS: Tomando como referencia el soft soap, no hubo diferencia entre el desempeño del jabón con Melaleuca alternifolia al 0,3% o jabón conteniendo triclosan al 0,5%. El soft soap + propan-2-ol se demostró más eficaz en relación a los demás procedimientos de higienización de las manos. CONCLUSIÓN: estudios que verifiquen la eficacia terapéutica de aceite esencial en la higienización de las manos pueden mejorar la adhesión a esa práctica.OBJETIVOS: os objetivos deste estudo foram avaliar a eficácia da higienização das mãos, realizada com duas formulações diferentes de sabonetes: óleo essencial de Melaleuca alternifolia a 0,3% versus triclosan a 0,5%, e compará-las com duas higienizações de referência: procedimento da metodologia oficial (soft soap) versus procedimento da versão draft (soft soap+propan-2-ol). MÉTODO: utilizando-se a metodologia europeia EN 1499, foram determinados fatores de redução logarítmica do número de unidades formadoras de colônia de Escherichia coli K12, antes e após a higiene das mãos, de 15 sujeitos voluntários e comparados pelo teste de Wilcoxon unicaudal. RESULTADOS: tomando como referência o soft soap, não houve diferença entre o desempenho do sabonete com M. alternifolia a 0,3% ou sabonete contendo triclosan a 0,5%. O soft soap+propan-2-ol demonstrou ser mais eficaz em relação aos demais procedimentos de higienização das mãos. CONCLUSÃO: estudos que verifiquem a eficácia terapêutica de óleo essencial na higienização das mãos podem melhorar a adesão a essa prática.OBJECTIVE: this study aimed to evaluate the efficacy of hand hygiene performed with two different soap formulations: 0.3% Melaleuca alternifolia essential oil versus 0.5% triclosan, and to compare them with two reference hygiene procedures: the official methodology procedure (soft soap) versus the draft version of the procedure (soft soap + propan-2-ol). METHOD: using the European EN 1499 method, logarithmic reduction factors were determined for the number of colony forming units of Escherichia coli K12 before and after hand hygiene of 15 volunteer subjects, and compared using the one-tailed Wilcoxon test. RESULTS: referring to the soft soap, there was no difference between the performance of soap with 0.3% M. alternifolia and soap containing 0.5% triclosan. The soft soap + propan-2-ol proved to be more effective than the other hand hygiene procedures. CONCLUSION: studies to verify the therapeutic efficacy of essential oil in hand hygiene can improve adherence to this practice

EVALUATION OF MICROBIAL GROWTH ON SINGLE-USE VITRECTOMY PROBES REPROCESSED IN HEALTHCARE PRACTICE

The aim of this study was to evaluate the microbial growth on single-use vitrectomy probes reprocessed in healthcare practice. We investigated nine vitrectomy probes that had been reused and reprocessed using different methods. The samples were sectioned, individually, in portions of 3.5 cm, totaling 979 sampling units (extensions, connectors and vitrectomy cutters), which were inoculated in culture medium and incubated at 37 C for 14 days. The results showed microbial growth on 57 (5.8%) sample units, 25 of which had been sterilized using ethylene oxide, 16 by hydrogen peroxide plasma, and 16 by low-temperature steam and formaldehyde. Seventeen microbial species were identified. The most prevalent were: Micrococcus spp., coagulase-negative Staphylococcus, Pseudomonas spp., and Bacillus subtilis. The reuse of single-use vitrectomy probes was shown to be unsafe, therefore this practice is not recommended

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

The Influence of Environmental Temperature and Air Humidity on the Maintenance of Sterility of Surgical Instruments Sterilized in Different Wraps

State of Sao Paulo Research Foundation (FAPESP), BrazilState of Sao Paulo Research Foundation (FAPESP), Brazi

Avaliação da eficácia da esterilização de furadeiras elétricas domésticas utilizadas em cirurgias ortopédicas

It is estimated that electric drills (ED) have been used in orthopaedic surgeries for bone drilling for more than 50 years in Brazilian hospitals. It is an electric, thermosensitive equipment, not indicated for surgical use, which has not been previously evaluated regarding the sterilization efficacy, being suspect of infection risk. This study evaluated the efficacy of sterilization by ethylene oxide (EtO) of new drills that were intentionally contaminated with Bacillus atrophaeus spores. An experimental, laboratory, randomized applied research was developed, where 16 electric drills were analyzed, in addition to positive and negative controls. All the previously cleaned and sterilized equipment were submitted to contamination by spores. The experimental group was submitted to cleaning and sterilization by EtO and test of sterility by filtration through a 0.45 µm membrane. The membranes were cultivated and Gram and Wirtz-Conklin staining were carried out in positive results for spore visualization. An efficacy of 99.99999881% of the process of sterilization by EtO was confirmed, with a probability of survival of 1.19 x 10-8. Under the development conditions of the experiment, the efficacy of the sterilization of ED by EtO was confirmed.Estima-se que há mais de 50 anos, as furadeiras elétricas têm sido empregadas em cirurgias ortopédicas nos hospitais brasileiros para a perfuração óssea. Trata-se de equipamento elétrico, termossensível, não indicado para uso cirúrgico, não avaliado anteriormente quanto à eficácia da esterilização, suspeitando-se de risco para infecções. Esse estudo avaliou a eficácia da esterilização por óxido de etileno (ETO) de furadeiras novas intencionalmente contaminadas com esporos de Bacillus atrophaeus. Foi desenvolvida pesquisa experimental, laboratorial, randomizada e aplicada onde foram analisadas 16 furadeiras elétricas, além de controle positivo e negativo. Todos os equipamentos previamente limpos e esterilizados foram submetidos à contaminação com esporos. O grupo experimental foi submetido à limpeza e esterilização por ETO e teste de esterilidade por filtração por membrana de 0,45 µm. As membranas foram cultivadas e para resultados positivos foram realizadas coloração de Gram e Wirtz-Conklin para visualização dos esporos. Foi comprovada a eficiência de 99,99999881% do processo de esterilização por ETO, com a probabilidade de sobrevivência de 1,19 x 10-8. Nas condições do desenvolvimento do experimento, a eficácia da esterilização das FE por ETO foi comprovada

Periodic sterility assessment of materials stored for up to 6 months at continuous microbial contamination risk: Laboratory study

An investigation was conducted to test the hypothesis that the storage time of packaging sterility has no effect on contamination susceptibility even under deliberate bacterial exposure (Serratia marcescens). No growth of the test microorganisms was identified in the experimental group in any of the storage intervals (7, 14, 28, 90, and 180 days). Current recommendations/guidelines suggest that contamination of packaging occurs only because of events. This study, done in vitro, supports these recommendations. Copyright (c) 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.13Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data