Den största akuta risken inom dricksvattenförsörjningen är vattenburen smittspridning. Dricksvattenrelaterad smittspridning förekommer i störst utsträckning i utvecklingsländer med dåliga sanitära förhållanden. Under 2000-talet har de nordiska länderna drabbats av flertalet dricksvattenburna sjukdomsutbrott vilket har lett till att mikrobiella föroreningar uppmärksammats som ett problem även i Norden. För att säkerställa att det dricksvatten som distribueras är av god mikrobiologisk kvalitet krävs att säkerhetsbarriärerna i vattenverket är tillräckligt effektiva för alla typer av mikrobiella föroreningar. Vissa mikroorganismer har uppmärksammats som mer tåliga mot olika desinfektionsmetoder, till exempel klorering, än vad som tidigare varit känt. För ett säkrare dricksvatten är det därför viktigt att öka kunskapen om mikroorganismers varierande motståndskraft mot olika desinfektionsmedel samt undersöka alternativ till de avskiljnings- och inaktiveringsmetoder som traditionellt används idag. Examensarbetets syfte var att studera de bakterier och virus som har störst relevans för dricksvattenkvaliteten och som tros kunna utgöra ett hot mot nordiskt dricksvatten, att undersöka orsakerna bakom dricksvattenburna utbrott samt att undersöka effektiviteten hos olika avskiljnings- och inaktiveringsmetoder för bakterier och virus. Detta gjordes genom en utförlig litteraturstudie samt en fallstudie. Fallstudiens syfte var att belysa problematiken inom dricksvattenberedning samt distribution i Norden genom verkliga exempel.  Studien visade att vattenburna sjukdomsutbrott normalt orsakas av kontaminering från avloppsvatten till dricksvatten. Detta sker antingen direkt till råvattnet, ofta till följd av kraftig nederbörd, eller under distributionen på grund av driftstörningar. Att kontamineringen tillåts nå konsumenten är ett resultat av inadekvata reningsmetoder i vattenverken. Problematiken inom dricksvattenområdet beror bland annat på användandet av bristfälliga indikatororganismer vilka är mindre tåliga och har sämre överlevnadsförmåga än många sjukdomsalstrande mikroorganismer. Tidskrävande och osäkra analysmetoder utgör också ett stort problem. Svårigheter i att identifiera den orsakande mikroorganismen samt att bekräfta utbrottet som dricksvattenrelaterat har lett till att mörkertalet gällande antalet vattenburna sjukdomsfall är stort. Det finns ett stort behov av ökad kunskap gällande olika mikroorganismers tålighet mot desinfektion samt ett behov av reglering för kontroll av råvattenkvaliteten och den mikrobiologiska säkerheten. Utifrån studien kunde även konstateras att antalet vattenburna utbrott tros öka med kraftigare nederbörd och extremväder till följd av klimatförändringarna. / Waterborne diseases are considered a major problem in the water supply. Spreading of infection through drinking water occurs predominantly in developing countries with poor sanitation. During the 21th century the Nordic countries have been affected by several waterborne outbreaks associated with drinking water. As a result, microbial contamination of drinking water has been recognized as a problem in the Nordic countries as well. To ensure high quality drinking water it is required that the hygienic barriers used in the water treatment plant are efficient in reducing all types of microbial contaminants. Some microorganisms have shown a greater resistance against commonly used disinfectants then previously known. To secure the distribution of safe drinking water it is essential to increase the knowledge regarding the varying resistance of microorganisms and to investigate alternative water treatment processes to those traditionally used in drinking water treatment today.  The objective to this master thesis was to study the bacteria and viruses that are most relevant for drinking water quality and may compose a threat to the drinking water quality in the Nordic countries, to investigate the cause of waterborne outbreaks and to study the effectiveness in reducing bacteria and viruses for various water treatment processes. The study was performed through a thorough literature review and a case study. The purpose of the case study was to illustrate the issues in drinking water treatment and distribution in the Nordic region. The study showed that the majority of the outbreaks are caused by contamination from sewage water to drinking water. The contamination is allowed to reach the consumer as a result of inadequate treatment in the water works. Usage of inappropriate indicator organisms that are less resistant to disinfectants than a lot of pathogens are a big problem in drinking water treatment. Time-consuming and uncertain analytical methods also compose a great issue. Due to difficulties in identifying the causative microorganism and verify the outbreak as drinking water related it is believed that there is a large number of unrecorded cases of illness. There is a great need of increased understanding of the varying resistance of microorganisms to disinfectants and a need for regulation for monitoring raw water quality and microbiological safety. Based on the study it was also found that waterborne outbreaks are believed to increase as a result of extreme weather caused by climate change.

It is well established that water quality is directly linked to health. In-line chlorination is one technology that can be used in the developing world to potentially inactivate pathogens and improve water quality. The purpose of this study was to determine the effectiveness of the Panamanian Ministry of Health's in-line PVC chlorinator under three different operating conditions in a rural water supply system. Free and total chlorine were measured entering the storage tank, leaving the storage tank, and at three households along the transmission line of the water system in the two rural indigenous communities of Calabazal and Quebrada Mina in western Panama during April-August 2011. The Ct method for disinfection was used to compare the measured free chlorine concentration to the concentration required to inactivate common pathogens found in gravity flow water systems in Panama, such as E. coli, Salmonella typhi, Hepatitis A, Giardia lamblia, and E. histolytica, as well as other pathogens of interest to the global health community, such as Vibrio cholerae and Rotavirus. When the chlorine tablet was sealed in a plastic wrapper prior to use to prevent contact with humid surroundings, the chlorine was able to dissolve in seven days instead of three hours into the transmission line. The use of one tablet, sealed in a plastic wrapper before use, was able to obtain the required free chlorine concentration estimated to disinfect E. coli, Vibrio cholerae, Rotavirus, Salmonella typhi, and Hepatitis A. However, it did not achieve a free chlorine concentration above 0.27 mg/L needed to inactivate Giardia lamblia nor above 0.35 mg/L needed to inactivate E. histolytica. The use of three properly stored tablets in the chlorinator was able to provide a free chlorine concentration above 0.35 mg/L for only one day, reaching 0.37 mg/L, before falling below 0.35 mg/L to a level of 0.26 mg/L the next day. The study suggests that with three tablets the in-line PVC chlorinator can be an effective technology if slightly more free chlorine concentration can enter the system. The cost of this technology could be allocated to every owner with a house connection in the communities of Calabazal and Quebrada Mina by increasing their monthly tariff by $1 each month.

Access to safe drinking water has a direct effect on improving human health and their quality of life. One country still struggling with providing access to safe drinking water to all of its population is Panama. Panama's largest indigenous group, the Ngöbe people, is disproportionately affected by lack of access to safe drinking water. One way Panama's Ministry of Health (MINSA) is attempting to increase access to safe drinking water to the Ngöbe people is by disinfecting the water already captured by rural gravity fed water systems constructed within in the Ngöbe-Bugle reservation. This is accomplished using an in-line chlorinator specifically designed to accommodate locally manufactured calcium hypochlorite tablets as a source of chlorine. However, in this study it was hypothesized that the current way MINSA is implementing the in-line chlorinator was ineffective both at educating communities on knowledge of chlorination and in chlorinating water in their water distribution systems. This study investigated MINSA's implementation method and then compared it to a new method of implementation that was based on a newly developed disinfection field guide created by the author of this thesis. The motivation of this study was to improve this process of implementation which could lead to more effective chlorination thereby decreasing illness caused by waterborne pathogens. Each implementation method investigated attempted to disseminate knowledge of chlorination to community members through a seminar. The MINSA seminar was presented by a MINSA health practitioner and a newly developed seminar was presented by this thesis's author. A survey was developed to assess the knowledge of chlorination of community members after they attended a seminar. Results showed that community members who attended the new seminar on average answered 20 of the 22 questions of the administered survey more correctly than community members attending the MINSA seminar. Additionally, based on the average correct response of community members to survey questions, participants in the new seminar answered more questions correctly compared to participants in the MINSA seminar in all sections of the survey, 32% greater in the "General Knowledge" section; 43% greater in the "MINSA Specific" section; and 36% greater over the total survey. This higher score by new seminar participants suggests that the new seminar is better at educating community members on knowledge of chlorination. An assessment of each implementation method to effectively chlorinate the studied community's water distribution systems was also completed. This was done by measuring the free chlorine residual of water leaving the studied community's storage tank and entering the distribution system over one week. These concentration values were multiplied by a calculated chlorine contact time of the studied system's distribution system to determine Ct values. Measured Ct values were compared to literature guidelines that provide information on what Ct values will kill commonly found waterborne pathogens in the region. Calculated Ct values above a critical literature value of 40.0 min-mg/L Cl2 were determined to be effectively chlorinating a system's water. Results showed that when using the MINSA implementation method the required Ct level of 40.0 min-mg/L Cl2 was never met at any time during the week. However when using the new implementation method, the required Ct level of 40.0 min-mg/L Cl2 was met at all points during the week except one when tested on the last day where the Ct value was found to be 35.9 min-mg/L Cl2. These results suggest the new implementation method is more effective at chlorinating rural gravity fed water systems in the region compared to the previous implementation method.

This thesis is an investigation on water reuse in the fresh-cut fruits and vegetable industry. Fresh water is used intensively in washing, cutting/peeling processes and disinfecting fruits and vegetables, as a result washwater with heavy solids is generated. Effective removal of solids is needed to allow for water reuse. Thus dissolved air flotation (DAF) and centrifuge with coagulation and flocculation process were explored for solid removal capabilities; some settling analysis was also conducted. Bench scale studies show DAF and centrifuge produce waters of similar quality (Turbidity). DAF is able to produce waters with higher UV transmittance and can work better with membrane filtration and UV disinfection. While centrifuge showed higher reduction in pathogen levels, it can be cost effective and compact in design. Membrane filtration feasibility showed that high quality waters (low turbidity) can be produced, but were unable to remove pathogens. Collimated beam results show UV disinfection can further be used to completely eliminate pathogens and allow for water reuse. This allows the processors to reduce their water foot-print, increase sustainability of their operations, and meet the increasing demand for fresh-cut fruits and vegetables.

Made available in DSpace on 2014-06-11T19:28:38Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-03-26Bitstream added on 2014-06-13T19:16:49Z : No. of bitstreams: 1 sanita_pv_me_arafo.pdf: 1236296 bytes, checksum: 793fd4710489b2253297ebbc15835736 (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A estomatite protética associada à Candida é a forma mais comum de candidíase oral e também uma das infecções oportunistas mais encontradas em pacientes infectados por HIV. Atualmente, a desinfecção de próteses totais através da irradiação por microondas tem sido recomendada para tratamento e prevenção da estomatite protética, tanto em indivíduos saudáveis, quanto em pacientes imunocomprometidos. O presente estudo avaliou a efetividade da irradiação por microondas na desinfecção de próteses totais simuladas contaminadas com 5 diferentes espécies do microorganismo Candida (C. albicans, C. glabrata, C. dubliniensis, C. tropicalis e C. krusei) isoladas de culturas padrão e de pacientes HIV positivo. Para isso, próteses totais simuladas foram confeccionadas, esterilizadas por meio de óxido de etileno e individualmente inoculadas com os microorganismos avaliados. Após o período de incubação (48 horas a 37°C), as próteses foram submetidas à irradiação por microondas a 650W durante 3 minutos. Próteses totais não irradiadas foram utilizadas como controle positivo. A seguir, uma alíquota de 25 æL da solução resultante das diluições seriadas de 10-1 a 10-4 foi semeada em placas de Petri em duplicata e todas as placas foram incubadas por 48 horas a 37°C. As colônias foram quantificadas em ufc/mL. Para verificar a efetividade da desinfecção por microondas a longo prazo, as próteses totais irradiadas foram incubadas a 37°C por 7 dias. Os resultados obtidos foram analisados estatisticamente pelos testes de ANOVA e de Tukey (a=0.05). As próteses totais contaminadas com todas as espécies de Candida avaliadas demonstraram esterilização após irradiação por microondas durante 3 minutos a 650W. Todas as próteses do grupo controle positivo demonstraram crescimento microbiológico após incubação nas placas de Petri. / The most common form of oral candidiasis is Candida-associated denture stomatitis. Oral candidiasis is also a frequent manifestation of HIV infection. Microwave disinfection of complete dentures has been recommended to treat and prevent denture stomatitis in non-immune compromised patients. The present study evaluated the effectiveness of microwave irradiation on the disinfection of simulated complete dentures inoculated with ATCC and HIV isolates of 5 species of Candida (C. albicans, C. glabrata, C. dubliniensis, C. tropicalis and C. krusei). Simulated complete dentures were made, sterilized and individually inoculated with the tested microorganisms. After incubation for 48 hours at 37°C, dentures were submitted to microwave irradiation (650W for 3 minutes). Non-irradiated dentures were used as positive controls. Replicate aliquots of suspensions were plated at dilutions 10-1-10-4 and incubated for 48 hours at 37°C. Colonies counts (cfu/mL) of each plate were quantified. To verify the long-term effectiveness of microwave disinfection, dentures were incubated at 37°C for 7 days. Data were analyzed with two-way ANOVA and Tukey HSD tests (a=0.05). The results indicated that complete dentures contaminated with all Candida yeasts showed sterilization after microwave irradiation for 3 minutes at 650W. All control dentures showed microbial growth on the plates. The cfu/mL for C. glabrata was significantly higher than those of C. albicans, C. dubliniensis and C. tropicalis whereas the cfu/mL for C. krusei was significantly lower. The cfu/mL for clinical isolates was significantly higher than those of ATCC yeasts. Microwave irradiation for 3 minutes at 650W resulted in sterilization of complete dentures contaminated with the 5 species of Candida isolated from HIV-infected patients.

Made available in DSpace on 2014-06-11T19:28:38Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-03-28Bitstream added on 2014-06-13T20:18:32Z : No. of bitstreams: 1 altieri_kt_me_arafo.pdf: 598917 bytes, checksum: 3b01564a77c1be4471454056881b7028 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Infecções causadas por bactérias resistentes a antibióticos são consideradas causa principal de mortalidade entre indivíduos imunocomprometidos e aproximadamente 50 % destas infecções tem sido relacionadas ao Staphylococcus aureus resistente à meticilina (MRSA). Estes microrganismos, quando presentes no biofilme das próteses dentarias, podem se dispersar nas secreções salivares e se disseminar pelo trato respiratório, causando pneumonia aspirativa. Assim, o presente estudo comparou a efetividade do hipoclorito de sódio a 1 %, digluconato de clorexidina a 2 % e irradiação por micro-ondas na desinfecção de próteses totais e corpos-de-prova circulares de resina acrílica para base de prótese (10 x 2 mm) contaminados com MRSA. Para isso, 36 próteses totais simuladas e 36 corpos-de-prova circulares foram confeccionados, esterilizados, inoculados com MRSA (107 ufc/mL) e incubados a 37 °C (por 24 e 48 h, respectivamente). Após incubação, próteses totais e corpos-de-prova foram distribuídos em 4 grupos de estudo (n=9): GC - não foi realizado nenhum método de desinfecção; GH - foi realizada a imersão em solução de hipoclorito de sódio a 1 % por 10 min; GCl -foi realizada a imersão em solução de digluconato de clorexidina a 2 % por 10 min; GM - foi realizada a desinfecção por irradiação em forno de micro-ondas a 650 W por 3 min. A efetividade dos procedimentos de desinfecção foi avaliada por meio de quantificação de colônias viáveis e da viabilidade celular. Para a quantificação de colônias viáveis, alíquotas de 25 μL da solução resultante das diluições seriadas (10-3 a 10-6 para GC e 100 a 10-3 para os grupos experimentais) foram semeadas em placas de Petri em duplicata e todas as placas foram incubadas por 48 h a 37 °C. As colônias foram quantificadas em ufc/mL. Para verificar a efetividade da desinfecção por micro-ondas em longo prazo... / Infections caused by antibiotic-resistant bacteria have been recognized as a predominant risk factor for mortality in elderly patients and approximately 50 % of these infections have been related to methicillin-resistant Staphylococcus aureus (MRSA). This microorganism, when present in the denture biofilm, can be released into the oral fluids and aspirated into the lower respiratory tract, thus causing infections such as aspiration pneumonia. The present study compared the efficacy of 1 % sodium hypochlorite, 2 % chlorhexidine gluconate, and microwave irradiation in disinfecting simulated complete dentures and circular specimens of acrylic resin denture base material (10 x 2 mm) contaminated with MRSA. Thirty-six dentures and 36 specimens were made, sterilized, inoculated with MRSA (107 cfu/mL), and incubated at 37 °C (for 24 and 48 h, respectively). After incubation, dentures and specimens were divided into 4 groups of study (n=9): PC - positive control, consisting of dentures and specimens not disinfected; HY - soaking in 1 % sodium hypochlorite solution for 10 min; CHL - soaking in 2 % chlorhexidine gluconate solution for 10 min; and MW - irradiating by microwave for 3 min at 650W. The effectiveness of the disinfection procedures was assessed cell viability (quantification of viable cells and XTT reduction method). For quantification procedures, aliquots of suspensions were plated at dilutions (10-3 to 10-6 for PC and 100 to 10-3 for experimental groups) and incubated (37 °C/48 h). Colonies counts (cfu/mL) were quantified. Dentures disinfected were also incubated at 37 °C for 7 days to verify the long-term effectiveness of disinfection. The viability of cells in each group of specimens was evaluated by XTT reduction method. The results showed that all dentures and specimens from the PC groups showed substantial microbial growth. No evidence of microbial growth was observed... (Complete abstract click electronic access below)

Made available in DSpace on 2014-06-11T19:28:58Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-04-13Bitstream added on 2014-06-13T20:58:51Z : No. of bitstreams: 1 pesqueira_aa_me_araca.pdf: 540641 bytes, checksum: 5dfe2f80d73fb4a9cb52016d432619cf (MD5) / Este estudo teve como objetivo avaliar a estabilidade dimensional, reprodução e manutenção de detalhes, dureza “Shore A”, deterioração e estabilidade de cor, de um silicone facial, com distintas pigmentações, sob a influência da desinfecção e do envelhecimento acelerado. Para isso foram obtidos 60 corpos-de-prova, utilizando o silicone Silastic MDX 4- 4210, divididos em 3 grupos: sem pigmentação, pigmentado com pó de maquiagem e pigmentado com cerâmica. Metade dos corpos-de-prova de cada grupo foram submetidas à desinfecção com Efferdent e a outra metade com sabão neutro por 60 dias. Após esse período todos os corpos-de-prova (n=10) foram levados a uma câmara de envelhecimento acelerado para corpos não metálicos. Os ensaios de deterioração, estabilidade dimensional, reprodução e manutenção de detalhes, dureza Shore A e estabilidade de cor foram realizados após sua confecção, desinfecção e nos intervalos de cada ciclo de envelhecimento acelerado (252, 504 e 1008 horas). Os corpos-de-prova foram analisados, em computador pelo sistema AutoCAD para verificação da alteração dimensional linear e observados, em lupa estereoscópica para a análise da reprodução de detalhes. A dureza dos materiais foi analisada em durômetro Shore A e pesados em balança digital de precisão para análise da deterioração. A estabilidade de cor foi analisada por meio de espectrofotometria. Os valores encontrados dos testes de estabilidade dimensional, reprodução e manutenção de detalhes, dureza “Shore a“ e estabilidade de cor foram submetidos à análise de variância e teste de Tukey em nível de 1% de probabilidade. Para a análise da reprodução e manutenção de detalhes foi utilizado escore. Pôde-se observar que os fatores desinfecção química e o envelhecimento acelerado influenciaram estatisticamente na deterioração, estabilidade dimensional, dureza... / The aim of this study was to evaluate the dimensional stability, reproduction and maintenance of details, Shore A hardness, deterioration and color stability of facial silicone, with different pigmentation, on the influence of the disinfection and accelerated wheatering. 60 samples were obtained, using silicone Silastic MDX 4-4210, divided in 3 groups: nonpigmented, pigmented with make-up powder and pigmented with ceramics. The half of the samples of each group was submitted to the disinfection with Efferdent and another one with neutral soap per 60 days. After this period all the samples were taken to a chamber of accelerated wheatering for not metallic bodies (n=10). The tests of deterioration, dimensional stability, maintenance of the details, Shore A hardness and color stability were realized after the confection, disinfection and in the intervals of each cycle of accelerated wheatering (252, 504 e 1008 horas). Samples were weighty in digital balance for analysis of deterioration. Analyzed, in computer by the AutoCAD system to verification of the linear dimensional alteration and observed, in stereoscopic magnifying glass for analysis of the reproduction of details. Materials hardness was analyzed in Shore A durometer and the color stability by means of spectrophotometer. The values had been submitted to the analysis of variance and Tukey test (1%). It can be observed that the factors: chemical disinfection and the accelerated wheatering had influenced statistically in deterioration, dimensional stability, Shore A hardness and color stability of the materials independently of the pigmented. With relation to the reproduction and maintenance of details, the values did not change independently of the pigmented, disinfection and accelerated wheatering.

Orientador: Carlos Eduardo Vergani / Banca: Ana Cláudia Pavarina / Banca: Elaine Maria Sgavioli Massucato / Banca: Helena de Freitas Oliveira Paranhos / Banca: Karin Hermana Neppelenbroek / Resumo: A estomatite protética é uma infecção fúngica que acomete entre 60% e 72% dos indivíduos portadores de próteses removíveis, sobretudo idosos do gênero feminino. Atualmente, a desinfecção de próteses totais por meio da irradiação por micro-ondas tem sido recomendada para tratamento e prevenção da estomatite protética. Considerando esses aspectos, esse estudo in vivo avaliou a efetividade da frequência da desinfecção de próteses totais por micro-ondas (3 min/650 W) em relação à terapia antifúngica tópica para o tratamento da estomatite protética, além de verificar a prevalência de Candida nos pacientes avaliados. Para isso, foram selecionados 60 indivíduos, portadores de próteses totais superiores e com diagnóstico clínico de estomatite protética. Esses pacientes foram aleatoriamente distribuídos em 3 grupos (n=20), de acordo com o tratamento instituído: Terapia Antifúngica Tópica (Grupo I) - utilização de nistatina (suspensão oral, 100.000 UI/mL), 4 vezes ao dia durante 15 dias; Irradiação por Micro-ondas - imersão das próteses totais em água e irradiação das próteses por micro-ondas durante 3 minutos a 650 W, 1 ou 3 vezes por semana (Grupos II e III, respectivamente) por um período de 15 dias. Para avaliação da efetividade dos tratamentos instituídos, foram realizadas culturas micológicas quantitativas e identificação das espécies de Candida, utilizando-se o meio CHROMagar Candida, análise de microcultivo, teste de triagem em caldo hipertônico e o sistema bioquímico de identificação ID 32C. Coletas de biofilme das superfícies internas das próteses totais superiores e das mucosas palatinas de todos os pacientes, foram realizadas previamente ao tratamento (dia 0) e após 15 dias do seu início. Com o objetivo de avaliar a efetividade dos tratamentos em longo prazo, a quantificação de colônias viáveis de Candiada spp... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Denture stomatitis is a fungal infection that affects 60% to 72% of individuals who use removable dentures, primarily elderly women. Currently, the disinfection of complete dentures using microwave irradiation has been recommended to treat and prevent denture stomatitis. Considering these aspects, this in vivo study evaluated the effectiveness of the frequency of complete denture disinfection using microwaves (3 min/650 W) compared to antifungal therapy for the treatment of denture stomatitis. It also verified the prevalence of Candida spp. in the evaluated patients. This study used a sample of 60 healthy individuals who use complete upper dentures and have received a clinical diagnosis of denture stomatitis. Patients were randomly distributed into three groups (n=20), based on the treatment used: Topical Antifungal Therapy (Group I) - use of nystatin (oral suspension, 100.000 UI/mL), four times a day for 15 days; Irradiation with Microwaves - irradiation of the dentures by microwaves for three minutes at 650 W, one time or three times per week (Groups II and III, respectively) for a period of 15 days. In order to evaluate the effectiveness of the treatments used, quantitative mycological cultures were collected and the Candida species were identified using the CHROMagar Candida method, microculture analysis, screening test in hypertonic broth and the ID 32C biochemical identification system. Biofilm samples were collected from the inner surfaces of the complete upper dentures and from the palatal mucosa of all patients before (day 0) and after 15 days of treatment. In order to evaluate the effectiveness of the treatments over the long term, the quantification of the viable Candiada spp. colonies was repeated 30, 60 and 90 days after starting the treatment. For each consultation (days 0, 15, 30, 60 and 90), a clinical evaluation was also performed through intra-oral photography... (Complete abstract click electronic access below) / Doutor

Escherichia coli O157:H7 é um dos patógenos alimentares mais importantes da atualidade, e, recentemente, diversas cepas desse microrganismo foram isoladas no sul do Brasil. O objetivo deste trabalho foi caracterizar duas cepas de E. coli O157:H7, através da avaliação de sua resistência térmica, ácida e comportamento frente a diferentes desinfetantes e procedimentos de higienização de vegetais folhosos. Resultados demonstraram a redução significativa das contagens bacterianas, após 3 minutos a 60ºC, 2 minutos a 65º, 1 minuto a 70, 72º C e 75ºC. Contudo, após adaptação ácida, nenhuma das cepas foi inativada a 60ºC, por até 3 minutos. A 70ºC foi observado aumento significativo da resistência térmica apenas para a CC. Em relação à resistência ácida, ambas as cepas sobreviveram quando expostas ao meio TSBm a diferentes pH entre 2,0 a 9,5 ajustados com ácido clorídrico e ácido propiônico (AP). Apenas, o meio com pH 2,0, ajustado com AP, foi capaz de reduzir significativamente às contagens de ambas as cepas. Na avaliação da resistência aos desinfetantes, álcool etílico (96ºGl e 70%) e quaternário de amônio foram capazes de inativar ambas as cepas, mesmo na presença de matéria orgânica. O ácido orgânico, na concentração recomendada pelo fabricante e o dobro dessa concentração, reduziu cerca de 90% das contagens, após 5 minutos de exposição. O dicloroisocianurato de sódio só apresentou reduções significativas quando foram utilizadas duas vezes a concentração recomendada pelo fabricante. Todos os procedimentos de lavagem e desinfecção de alfaces, artificialmente contaminadas com E. coli O157:H7, reduziram as contagens em 2,97±1,21logUFC/g, apenas o tratamento conduzido a 10ºC, diferiu significativamente dos demais, apresentando maior redução 6,27±0,50logUFC/g. Esses resultados demonstram que as cepas de E. coli O157:H7 foram resistentes a diferentes situações de estresse, sendo portanto importantes do ponto de vista epidemiológico, visto que estão presentes no sul do Brasil e podem se tornar agentes etiológicos de surtos alimentares. / Escherichia coli O157:H7 is a major food pathogens today, and recently, several strains of this organism were isolated in southern Brazil. The objective of this study was to characterize two strains of E. coli O157: H7, by evaluating its thermal and acid resistance and behavior among different disinfectants and cleaning procedures on leafy vegetables. The results showed a significant reduction in bacterial counts after 3 minutes at 60 ° C, 2 min at 65 ° and 1 min at 70, 72 º C and 75 º C. However, after acid adaptation, none of the strains was inactivated at 60 ° C among 3 minutes. At 70 ° C significant increase in heat resistance was observed only for CC. Regarding acid resistance, both strains survived when exposed to TSBm medium at different pH adjusted from 2.0 to 9.5 with hydrochloric acid and propionic acid (PA). Only when the medium was adjusted with AP at pH 2.0 it was able to significantly reduce the counts of both strains. Evaluating the resistance to disinfectants, Ethyl Alcohol Free (96ºGl and 70 %) and quaternary ammonium were able to inactivate both strains, even in the presence of organic matter. For the orgnic acid in the concentration recommended by the manufacturer and at the double concentration there was reduced around 90 % of the counts after 5 minutes of exposure. The sodium dichloroisocyanurate only showed significant reductions when used in the double concentration recommended by the manufacturer. All procedures for cleaning and disinfecting the lettuces artificially contaminated with E. coli O157 : H7 counts decreased by 2.97 ± 1.21 log CFU / g , only the treatment conducted at 10 ° C reduced significantly from the others (6 , 27 ± 0.50 log CFU / g). The results demonstrate that the strains of E. coli O157 : H7 were resistant to different stress situations and therefore are important as an epidemiological point of view, as it is present in southern Brazil and can become etiologic agents of food borne outbreaks.

Nosocomial infections, which do not often relate to the diseases are increasing nowadays. Clostridium difficile belongs to the frequent nosocomial infections and it is known as post-antibiotic colitis. The main reason of colitis is the usage of antibiotics, especially broad-spectrum antibiotics. The thesis is divided into the theoretical part and practical, as well. Theoretical part describes the division of the nosocomial infections, infection of the intestinal tract, anatomy, physiology of the intestines and infectious diarrhoeal diseases. The thesis is subsequently aimed to the clostridial infections and precautions against the spread of the disease. Practical part is aimed to the knowledge of the nurses, skills and attitude towards this issue.The thesis uses quantitative investigation and technique of the questionnaires, hidden observation of the nurses working on the selected wards and additional interviews with head nurses. The research was conducted in hospital in Tábor, a.s. The questionnaires were distributed on the surgery, orthopaedics, surgical JIP, ARO, ONP, infective ward, rehabilitative ward, TRN, cardio JIP, internal ward-cardio, internal ward-gastro. The thesis was formed from 143 questionnaires and 171 questionnaires were distributed. Hidden observation was made by head nurses from individual wards and it was logged to the relevant observation sheets.From existing findings we can say that there exist specifics of nursing care at the patient with the clostridium difficile. Among to these specifics we can cite the barrier nursing care where we can include the isolation of the patient, disinfection and hygiene of hands,using protectors, appropriate usage of laundries and infectious waste, location of the patient according to the epidemiological perpective and individualization of the tools for the patients. From another investigation ensue that the nurses keep barrier nursing care, superficial disinfecion, decontamination of the tools. From the results is evident that the nurses do not know the methods of the transmission of the clostridial infection. On the base of another investigations we have found out that the nurses do not know principles of the barrier nursing care. In conclusion is it possible to say that the nurses do not have so extensive information, that are essential for care for the patiens with clotridium difficile. In order to care for these patients in right way is neccessary to know principles of the barrier nursing care and keep them all. Keeping the principles of the barrier nursing care is crucial step in preventing the transmission nosocomial infections. The results will be provided to the officials of the individual hospital´s wards as an option of improvement in caring for the patiens with clostridial infection. The results were partially presented at a conference in Tabor´s hospital in May 2014. We recommend to re-train the staff of the hospital, which would be specifically aimed towards the principles of the barrier nursing care and towards the disinfection and decontamination in related to the nosocomial infections. On the base of these findings was made a proposal of the nursing care standard, which would specify and unite the care for the patiens with clostride infection. Subsequently, it would be apropriate to repeat the research in 1 2 years and than both researches compare together.