El presente trabajo tuvo como finalidad evaluar en las fórmulas de nutrición enteral, distribuidas en dos hospitales de la ciudad de Lima, el nivel de contaminación microbiana, a través de la presencia de bacterias indicadoras de contaminación fecal y malas condiciones de higiene (aerobios mesofilos, coliformes, coliformes fecales y Staphylococcus aureus). El análisis de las muestras de las fórmulas enterales se realizó en el Centro Latinoamericano de Enseñanza e Investigación de Bacteriología Alimentaria (CLEIBA). Se evaluaron 72 muestras de fórmulas enterales, 42 de las cuales, fueron fórmulas comerciales (ADN) y 30 fórmulas artesanales. El 54% de las muestras analizadas excedieron los niveles permisibles para aerobios (104 ufc/mL), el 49% de las muestras excedieron los niveles permisibles para coliformes (10 ufc/mL), y el 22% de las muestras mostraron un recuento superior a 10 ufc/mL para coliformes fecales cuando estos deberían estar ausente. No se aisló Staphylococcus aureus, lo que demuestra una mejora en la higiene y control de temperatura, de los servicios nutricionales y al preparar los alimentos enterales. Las fórmulas de nutrición enteral artesanal mostraron un mayor nivel de contaminación que las fórmulas comerciales. Los resultados obtenidos reflejan inadecuadas condiciones en la preparación de los alimentos enterales en los servicios nutricionales, por lo tanto es urgente asegurar una higiene estricta durante la preparación y la manipulación de la alimentación enteral de manera que se controle el crecimiento bacteriano. / The purpose of the present investigation was to evaluate the microbiological level of enteral nutrition formulae distributed in two hospitals of Lima through the microbe contamination level to indicate fecal contamination and bad hygienic conditions (coliforms, fecal coliforms, aerobic and Staphylococcus aureus). The enteral sampling analysis of enteral formulae was realized in Centro Latinoamericano de Enseñanza e Investigación de Bacteriología Alimentaria (CLEIBA). A total of 72 enteral formulae solutions were evaluated, 42 samples were commercial (AND) formulae and 30 samples were handicraft formulae. Just 54% of the evaluated samples exceeded the permissible levels for aerobic bacteria (104 cfu/mL), 49% of the evaluated samples exceeded the permissible recount for coliforms (10 cfu/mL) and 22% of evaluated samples showed levels over 10 cfu/mL for fecal coliforms when they must have been absent. Staphylococcus aureus wasn’t isolated, it shows on improvement in hygiene and temperature control the nutritional services. The handicraft enteral feeding formulae showed more contamination levels than the commercial formulae. The obtained results reflex inadequated preparation conditions of the enteral feeding in the nutritional services, therefore, it is urgent to assure a strict hygiene during the preparation and handling of all enteral feeding solutions in order to.

Thèse d'exercice : Médecine. Santé publique et médecine sociale : Université de Nantes : 2003. / Bibliogr. f. 118-124 [93 réf.].

Zugl.: Giessen, Universiẗat, Diss., 2009.

Reproduction de : Thèse doctorat : Médecine. Biologie cellulaire : Reims : 2006. / Titre provenant de l'écran-titre. Bibliogr. p.140-158.

Reproduction de : Thèse d'exercice : Médecine vétérinaire : Toulouse 3 : 2007. / Titre provenant de l'écran titre. Bibliogr. p. 130-137.

Thesis (M.S.)--University of Hawaii at Manoa, 2005. / Includes bibliographical references (leaves 160-171). Also available via World Wide Web.

Thesis (M.S.)--Ball State University, 2009. / Title from PDF t.p. (viewed on Nov. 30, 2009). Includes bibliographical references (p. 61-67).

published_or_final_version / Microbiology / Master / Master of Philosophy

published_or_final_version / Microbiology / Master / Master of Medical Sciences

Background Methicillin resistant Staphylococcus aureus (MRSA) is endemic in healthcare settings in many countries of the world. Patients who have acquired MRSA serve as a source of transmission by contamination of their surrounding environments. Numerous studies illustrate that many different inanimate surfaces in hospitals can become a reservoir for MRSA. Objectives The objective of this study is to examine the presence of MRSA on environmental surfaces and its relationship between patients’ acquisition of MRSA by studying their molecular characteristics. Methodology The near-patient surfaces of 30 MRSA positive patients, 30 control patients and the ward environments were sampled from June 2011 to September 2011. The swabs were enriched and cultured for the presence of MRSA. The MRSA isolates obtained from environmental samples and from the clinical samples of the patients were then characterized by Spa typing. Results The MRSA found in case patients and control patients’ environmental surfaces was 97% (29/30) and 40% (12/30) respectively. Environmental surfaces that were highly contaminated by MRSA positive patients were bed sheets (70%), followed by pillows (55%), patient bed frames (52%) and patient lockers (52%). On the environmental surfaces other than the near-patient areas, ambulatory chair armrests had the highest amount of MRSA (21%), followed by fax machines which accounted for 14%. Among the 216 MRSA isolates (30 clinical isolates and 151 environmental isolates), eight spa types were found and the most predominant spa type was t1081 (63.3%) followed by t032 (17.6%) and t037 (7.4%). 27 patients were found to have the MRSA isolates with same spa type in the clinical samples and their surrounding environments. The agreement between the MRSA isolated from the clinical sample of patients and their surrounding environment was 93.1%. Conclusion Identical isolates were recovered from the patient and their environment (93.1%) which suggests possible environmental contamination of the ward cubicles, possibly contributing to endemic MRSA. More effective and rigorous use of current approaches to cleaning and decontamination is required and consideration of newer technologies to eradicate MRSA. / published_or_final_version / Microbiology / Master / Master of Medical Sciences