Thesis (Ph. D.)--Michigan State University. Dept. of Microbiology, 1997. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (Ph. D.)--Michigan State University. Dept. of Microbiology, 1997. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

CONTEXT: Nowadays, cellphones are susceptible to bacterial contamination and, therefore, they are potential reservoirs for disease transmission. The main aim of this study is to evaluate the efficacy of the use of alcoholic agents, in different presentations, for the decontamination of the hands and/or cell phones, therefore, to prevent the contamination of mobile devices. OBJECTIVES: To evaluate the efficacy of the anti-bacterial hand gel versus antibacterial wipes in the decontamination of the hands, to reduce the bacterial contamination of the cellphones of med students. PARTICIPANTS: 60 cellphones of med students in their 6th year at a Peruvian university, 2019 INTERVENTION: An experimental study and cultures of gram-negatives and positive bacteria were carried out before and after a 48-hour intervention. The participants were told to use two different agents with alcohol as they were divided in four groups (n=15 each group). The sample was taken with swabs and enriched transport tubes. The analysis was made by intention to treat. RESULTS: Basal contamination of 53.33%. Bacteria isolated in basal culture: Staphylococcus coagulase negative (36%), Staphylococcus aureus (5%), Pseudomonas stutzeri (3.33%), Bacillus spp (3.33%), Candida sp, Pseudomonas aeruginosa, Bordetella hinzii, Acinetobacter baumanii and Klebsiella Pneumoniae (1.67%). Lower final contamination proportion was found in the phones of the groups that were told to use an alcoholic agent (27-53%), compared to the control group (67%), however p value was not significant. No difference was reported when we compared specific bacteria, except for Enterobacter cloacae (p=0,05) CONCLUSIONS: In the present exploratory study, there was no difference found between the intervention groups, except for Enterobacter cloacae. More studies are required. / INTRODUCCIÓN: Los dispositivos móviles son objetos susceptibles a la contaminación bacteriana y, por lo tanto, potenciales reservorios para la transmisión de enfermedades. El objetivo de este estudio fue evaluar la eficacia del uso de agentes alcohólicos en diferentes presentaciones para demostrar si al utilizarlos en las manos y/o celular, disminuye la contaminación en los celulares. OBJETIVO: Se evaluó la eficacia del alcohol gel versus paños desinfectantes para desinfectar las manos/celular con el fin de reducir la contaminación bacteriana de los dispositivos móviles de los estudiantes de medicina de una universidad privada peruana, 2019. PARTICIPANTES: 60 estudiantes de medicina de sexto año de carrera en una universidad privada peruana, 2019 INTERVENCIÓN: Se realizó un estudio experimental y cultivo de bacterias gramnegativas y positivas antes y después de una intervención de 48 horas basada en el uso de agentes desinfectantes alcohólicos en celulares de 60 estudiantes de medicina de una universidad peruana divididos en cuatro grupos aleatoriamente (n=15 en cada grupo). RESULTADOS: Contaminación basal de 53.33%. Bacterias aisladas en cultivo basal: Staphylococcus coagulasa negativo (36%), Staphylococcus aureus (5%), Pseudomona stutzeri (3.33%), Bacillus spp (3.33%), Candida sp, Pseudomona aeruginosa, Bordetella hinzii, Acinetobacter baumanii y Klebsiella Pneumoniae (1.67%). Se halló menor contaminación final en los participantes de los grupos de intervención (27-53%), en comparación con el control (67%) sin embargo, no fue significativo. Además, no se reportó diferencia alguna cuando se comparó por bacterias específicas, excepto para Enterobacter cloacae (p=0,05) CONCLUSIÓN: En el presente estudio, no hubo diferencias entre los grupos de intervención excepto para Enterobacter cloacae. Se requiere realizar más estudios. / Tesis

Submitted by JÚLIO HEBER SILVA (julioheber@yahoo.com.br) on 2016-11-09T14:03:31Z No. of bitstreams: 2 Tese - Giselle Pinheiro Lima Aires Gomes - 2016.pdf: 3158182 bytes, checksum: ba9d36d200045df31c0cbd0972cc94a2 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Jaqueline Silva (jtas29@gmail.com) on 2016-11-10T17:49:41Z (GMT) No. of bitstreams: 2 Tese - Giselle Pinheiro Lima Aires Gomes - 2016.pdf: 3158182 bytes, checksum: ba9d36d200045df31c0cbd0972cc94a2 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2016-11-10T17:49:41Z (GMT). No. of bitstreams: 2 Tese - Giselle Pinheiro Lima Aires Gomes - 2016.pdf: 3158182 bytes, checksum: ba9d36d200045df31c0cbd0972cc94a2 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-03-31 / Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEG / INTRODUCTION: The manual resuscitator is a widely used respiratory assist device that has been reported to be a reservoir and a source of contamination from various microorganisms. At present, there is no criteria to replacement of manual resuscitator when it is in successive use in the same patient. AIM: To evaluate the safest amount of time the manual resuscitator can be successively used in the same patient. METHODS: An open, prospective cohort study was conducted from October to November, 2014 using 30 patient connector valves from manual resuscitator devices obtained from Intensive Care Units of a general hospital located in a region north of Brazil. The samples were collected through swab friction on the manual resuscitator that was used by the same patient, at zero (ready use), 24 and 48 hours. Bacterial identification and antibiotic susceptibility were performed automatically (Vitek 2 Compact®). RESULTS: Of the 30 resuscitators evaluated, 20 (66.6%) were found to be contaminated. There was a significant difference between the microbial load on the manual resuscitators in use at zero and 24 hours (p = 0.03). Associated risk factors for the contamination of manual resuscitators identified were frequency and time of use. The presence of visible soil was not detected on 19 manual resuscitators in use, however, 95.0% were contaminated. The number of microorganisms isolated at zero, 24 and 48 hours were five, 11 and 24, respectively. Thirteen devices were contaminated with two or more bacterial species. Of the Gram-positive cocci, 38.9% (n = 18) were methicillin-resistant Staphylococcus aureus and 11.1% were methicillin-resistant coagulase-negative Staphylococcus, all were constitutive MLSB resistant. Of the Gram-negative rods (n = 36), Acinetobacter baumannii (36.1%), Pseudomonas aeruginosa (19.4%), Serratia marcescens (22.2%) and Proteus spp. (8.3%) dominated. Over 50% of these were resistant to carbapenems, second, third and fourth cephalosporins generations, and ampicillin/sulbactam. CONCLUSION: Manual resuscitators in successive use in the same patient were contaminated even in the absence of visible dirt. Multi- and extensively-resistant bacteria of clinical importance were also detected. Frequency and time of use were identified as risk factors in the contamination of manual resuscitators. The longer the time of use, the greater the number of contaminated resuscitators and bacterial species isolated. These results point to failures in reprocessing, and therefore highlights the importance of having thorough discussions among regulators about the recommendations for the reprocessing of semi-critical medical devices, especially, those for ventilatory assistance. Furthermore, the results highlight the need to replace manual resuscitators every 24 hours after use as a strategy for infection control and to minimize the risk of re-colonization or -infection of the respiratory tract. / INTRODUÇÃO: O reanimador manual é um dispositivo de assistência respiratória amplamente utilizado que tem sido reportado como reservatório e fonte de contaminação por diversos micro-organismos, e ainda não apresenta critérios definidos para a troca quando em uso sucessivo no mesmo paciente. OBJETIVO: Avaliar o tempo de uso seguro do reanimador manual em uso sucessivo no mesmo paciente. MÉTODO: Trata-se de uma coorte aberta prospectiva, realizada de outubro a novembro de 2014 em 30 válvulas do reanimador manual (conector do paciente) em Unidades de Tratamento Intensivo de um hospital geral da região Norte do Brasil. As amostras foram coletadas por meio de fricção de swab em reanimador manual em uso no mesmo paciente nos tempos zero (pronto uso), 24 e 48 horas. A identificação bacteriana e o antibiograma foram automatizados (Vitek 2 Compact®). RESULTADOS: Dos 30 reanimadores avaliados, 20 (66,6%) estavam contaminados. A carga microbiana entre os tempos zero e 24h de uso dos reanimadores manuais apresentou diferença estatística significativa (p=0,03). A frequência e o tempo de uso foram identificados como fatores de risco associados para a contaminação de reanimadores manuais em uso. Dos 19 reanimadores manuais avaliados como visivelmente limpos, 95,0% apresentaram contaminados. Foram isolados cinco, 11 e 24 tipos de micro-organismos nos tempos zero, 24 e 48 horas respectivamente. Treze dispositivos estavam contaminados por duas ou mais espécies bacterianas. Dentre os cocos gram-positivos (n=18), 38,9% eram Staphylococcus aureus resistentes à meticilina e 11,1% Staphylococcus coagulase negativos resistentes à meticilina, todos com resistência constitutiva ao grupo MLSB. Dentre os bastonetes gram-negativos (n=36), predominaram Acinetobacter baumannii (36,1%), Pseudomonas aeruginosa (19,4%), Serratia marcescens (22,2%) e Proteus spp. (8,3%). Mais de 50% destes apresentaram resistência aos carbapenens, cefalosporinas de segunda, terceira e quarta gerações, e ampicilina/sulbactam. CONCLUSÃO: Os reanimadores manuais em uso sucessivo no mesmo paciente estavam contaminados, mesmo na ausência de sujidade visível, sendo o tempo e a frequência de uso do dispositivo fatores de risco identificados. Bactérias multirresistentes e extensivamente resistentes de importância clínica foram detectadas. Quanto maior o tempo de uso, maior o número de reanimadores contaminados e de espécies bacterianas isoladas. Os resultados apontam para falhas no processamento, e indicam necessidade de discussão entre os órgãos regulamentadores sobre a recomendação para o processamento de produtos para a saúde semicríticos, em especial, os de assistência ventilatória e demonstram ainda a necessidade de troca do reanimador manual a cada 24 horas de uso, como estratégia primária para minimizar o risco de (re)colonização que poderá resultar em infecção do trato respiratório.