Search

Alginate films containing natamycin as the antimicrobial agent were developed and its release from the films to liquid and semi-solid media with different water activities was evaluated. In samples immersed in liquid media, the release rate of natamycin increased with an increase in the water activity of the solutions. Effective diffusivities were estimated by fitting Fick’s second law to the data, obtaining values ranging from 0.52 × 10–12 to 5.30 × 10–12 cm2/s. The amount of natamycin that migrated to the semi-solid media indicated incomplete release, with 85% of the initial mass released in gels and only 33% released in cheese samples. This highlights the importance of evaluating the release behavior in real systems. The films were applied to slices of semi-hard cheese, previously inoculated with Aspergillus niger and Penicillium roqueforti. Colony counts on the surface of cheese samples sandwiched between active films were one log cycle lower than that in uncovered slices. Cheese samples covered with control films (without natamycin) also yielded fewer colonies but were not as effective.

Background The objective of this study was to determine the correlation between adenosine triphosphate (ATP) measurements and microbial contamination using a standardized method. Secondarily, analyzing reproducibility of ATP measurements and aerobic colony counts (ACC’s) on the same surface. Methods ATP measurements and ACC’s were conducted on 10 pre-defined fomites in a hospital and nursing home setting. Per fomite two ATP measurements and two agar plate measurements were conducted, each measurement was conducted on a 25 cm2 surface. Both measurements were compared and analyzed for correlation. Results In total 200 paired measurements were conducted, 200 ATP measurements and 200 ACC’s. The mean of all ATP measurements tested on the same surface was calculated, as was for all 200 ACC’s. There was a strong correlation between the mean of two ATP measurements on two different sites on the same fomite (R = 0.800, p Conclusions Reproducibility of ATP measurements and ACC’s on the same fomite was good. However, the correlation between RLU values and ACC’s on hospital surfaces was much lower. This may be explained by the wide variety of biological material that is measured with ATP, of which the bacterial load is only one of many components. ATP measurement can be used to give a quantifiable outcome for the rating of cleanliness in health care facilities, however the results cannot be translated into the level of microbial contamination.

Background: As Mobile Phones (MPs) aren’t cleaned routinely and have been touched during patient’s examination, they may become contaminated with hospital pathogens. Objectives: Screen MPs of Health care workers (HCWs) for pathogens and verify the effect of disinfectants in their decontamination. Methods: A questionnaire was submitted by 160 HCWs in Tanta University Hospitals. Samples were taken from their MPs and subjected to pour plate counting before and after disinfection. Standard identification and antibiotic susceptibility of isolates were done. Results: Colony count was greater in MPs used while caring for patients or inside restroom, and was less in regularly cleaned MPs. All tested disinfectants reduced the colony count significantly. Pathogens were isolated from 84.38% of samples and 36.25% of them were Multi-Drug Resistant Organisms (MDROs). Conclusion: Using MPs at critical care areas and restroom may contribute to their contamination with pathogens. Regular disinfection of MPs can reduce this contamination.

Wound healing and wound management are among challenging clinical problems, despite the advancement in medical technology and research. Honey is one of the natural products, synthesized by honey bees that exhibits great antibacterial and medicinal properties. Incorporation of honey into modern dressing materials such as cellulose hydrogel is beneficial to anticipate cell proliferation while preventing infection in a wound region. This study reports the fabrication of honey cellulose hydrogels for reliable alternative treatment of wound infection. The cellulose hydrogels were incorporated with three types of mainland Southeast Asia honeys of stingless bee, giant bee and Asian bee, independently. Each hydrogel was subjected to ATR-FTIR analysis for the determination of chemical composition. The antibacterial properties of honey hydrogels were evaluated through zone inhibition and colony count tests against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). The cytocompatibility of the honey hydrogels was then evaluated through MTT assay and cell scratch assay with human skin fibroblast cells. The composition of honey and cellulose hydrogel were verified with the appearances of fingerprint bandwidth and identical peaks of both compounds, respectively. The giant bee honey hydrogels produced the highest bacterial retardation through both antibacterial tests. The stingless bee honey hydrogels projected susceptibility towards E. coli while the Asian bee honey hydrogels projected susceptibility towards S. aureus. Among these three variations of honey hydrogels, the in-vitro cytocompatibility analyses testified the greatest cell viability and cell migration on the stingless bee honey hydrogels compared to the Asian bee honey hydrogels, giant bee honey hydrogels and control hydrogels. The findings support the potential of honey hydrogels as a reliable alternative treatment for wound infection.

The current study designed to obtain, execute and test a freeze-drying protocol for the preparation and a better storage conservation of the live attenuate Mycobacterium bovis BCG-Moreau-Finlay, fundamental element for the immunotherapy against bladder carcinoma, passed successfully all trials. The new lyophilized formulation also reduces the in vivo toxicity compared to present BCG liquid preparation by means of lowering dose needed for the treatment. The second re-seeding of the Moreau Rio de Janeiro sub-strain of Mycobacterium bovis BCG (pBCG Moreau); was sub-cultured in the Sauton Synthetic Medium (SSMII), previously maintained in Seed Lot Systems and harvested during the logarithmic growth phase. Basic Bacterial Suspension (BBS) was then prepared, homogenized and stabilized by freeze-drying in vehicle A, compare to vehicle B. By means of Thin Layer Chromatography (TLC) was realized the comparative quality control of the (BBS) preparation before and after lyophilisation procedure of the final product. A high (%) colony count measure in Ogawa medium and average survival of 50.4% (Heat stability over the time). Additional values as (0.75 – 0.95 %) were obtained for the ranks of dispersion using Zieln Nielsen and the Dubos Methods. The integrity/vitality oscillated from 67.8 to 68.5 (%) measured by oxygen consumption, the residual humidity indicators from 73 to 74 (%)[BBS] and the accepts organoleptic properties designed all aftermaths concern the in vitro assays required by World Health Organization (WHO) standards for BCG intra-Vesical final product. A freeze-dried “Onco BCG Moreau - Finlay” formulation was successfully produced and has many “in vitro and in vivo test” practical and theoretical advantages when it compared to the current liquid preparation, such as the best preserving BCG biological properties and reducing the dose of product required for treatment.

Staphylococcus aureus colonizes patients with atopic dermatitis (AD) and exacerbates disease by promoting inflammation. The present study investigated the safety and mechanisms of action of Staphylococcus hominis A9 (ShA9), a bacterium isolated from healthy human skin, as a topical therapy for AD. ShA9 killed S. aureus on the skin of mice and inhibited expression of a toxin from S. aureus (psmα) that promotes inflammation. A first-in-human, phase 1, double-blinded, randomized 1-week trial of topical ShA9 or vehicle on the forearm skin of 54 adults with S. aureus-positive AD (NCT03151148) met its primary endpoint of safety, and participants receiving ShA9 had fewer adverse events associated with AD. Eczema severity was not significantly different when evaluated in all participants treated with ShA9 but a significant decrease in S. aureus and increased ShA9 DNA were seen and met secondary endpoints. Some S. aureus strains on participants were not directly killed by ShA9, but expression of mRNA for psmα was inhibited in all strains. Improvement in local eczema severity was suggested by post-hoc analysis of participants with S. aureus directly killed by ShA9. These observations demonstrate the safety and potential benefits of bacteriotherapy for AD.

Objective To evaluate whether Clostridioides (formerly Clostridium) difficile–contaminated stethoscope diaphragms remained aseptic by the placement of an aseptic diaphragm barrier. Methods On November 1, 2019, fresh cultures of C difficile were diluted to 107 colony-forming units (CFU)/mL and used to inoculate 16 stethoscope diaphragms; 8 had an aseptic diaphragm barrier applied and 8 served as nonbarrier controls. Contaminated stethoscopes were anaerobically incubated, then swabbed at 15 and 30 minutes, 2 and 4 hours, and 1, 2, 3, and 7 days after inoculation and subsequently plated onto blood, chocolate, and cycloserine-cefoxitin fructose agar. Plates were incubated for 48 hours and on November 9, 2019, the resulting colonies were manually counted. Statistical analyses (RStudio, version 1.0.153) used analysis of variance with post hoc Tukey honestly significant difference. Results Overall, mean colony count was 33 CFU on stethoscopes without barriers vs zero on those with barriers (P≤.05). Growth was greatest at 48 hours, with colony counts as high as 160 CFU. The presence of the barrier resulted in no growth in 100% of stethoscope diaphragms for up to 1 week. Conclusion We found that stethoscope diaphragm barriers provide an aseptic patient contact point, thus reducing the potential for transmission of C difficile during the physical examination. In critical care environments, in which many hospitals use acoustically inferior disposable stethoscopes, the option of a disposable aseptic stethoscope barrier may allow high-quality auscultation while reducing the potential for pathogen transmission.

Introduction: This research was carried out to compare the effects of 0.525% and 5.25% NaOCl, 2% H2O2, and 16-mg/mL propolis on additional silicone impression materials contaminated with Candida albicans at 5- and 10-minute exposure times, to evaluate the hypotheses of this study that propolis can be used for disinfecting of dental impressions. Materials and methods: A total of 122 silicone impressions were prepared. Two samples were considered the negative controls, and the rest were contaminated with C. albicans fungal species and disinfected with 0.525% NaOCl, 5.25% NaOCl, 2% H2O2, 16-mg/mL propolis, and 96% ethyl alcohol for 5 and 10 minutes (10 samples for each interval in each group). The data were analyzed with Kruskal–Wallis and Mann–Whitney U tests in all the groups at 5- and 10-minute intervals. Results: All the disinfecting agents significantly decreased C. albicans colony counts at both intervals compared to the control groups (P = 0.00). The differences in the disinfecting effects were significant between the four study groups (P = 0.00). The most significant effects were related to NaOCl at both intervals and concentrations and 2% H2O2 at the 10-minute interval (P = 0.001), followed by 2% H2O2 at the 5-minute interval and propolis (P = 0.001). Concerning propolis (P = 0.001) and 2% H2O2 (P = 0.004), the effect of exposure time was significant. Conclusion: All the disinfecting agents in the present study can be used to disinfect impressions contaminated with C. albicans; however, concerning propolis, although it resulted in significant decreases in C. albicans colony counts, the elimination of the remaining colonies was ineffective.

Background Portable electronic devices are used regularly within the veterinary and medical environments. Use of these in clinical areas may predispose them to bacterial contamination and they could act as fomites, transmitting infection between clinicians and patients. Aim To determine the prevalence, origin and nature of Staphylococcal bacterial contamination on the surface of portable electronic devices used in a large small animal hospital. Materials and methods Staff were surveyed on the frequency of portable electronic device use and device-cleaning routines. Portable electronic devices were swabbed for staphylococcus species. Cultured cocci were tested for antimicrobial resistance and identified at the species level to help determine the likely source (human or animal). Findings Forty one of 48 (85%) of staff used a portable electronic device every day within the hospital. Useable swabs were obtained from 47 portable electronic devices. Staphylococci were found on 68% of portable electronic devices. Vancomycin and Oxacillin resistance were seen in 17 of 46 (37%) and 1 of 46 (2%) isolated colonies respectively, including four vancomycin resistant, coagulase-positive staphylococci. 44% of staff never cleaned their device. Clinical significance Portable electronic devices are commonly used in veterinary hospitals, but few staff routinely disinfect them. The use of disinfectant to reduce colony counts should be implemented when forming protocols for these devices in the hospital. The majority of staphylococci found were of likely human origin. It is suggested that contamination is therefore more likely to be originating from staff rather than patients.

Single‐cell sorting of Escherichia coli was conducted to analyze the effect of osmotic stress–induced injury on the colony‐forming rate (CFR). Injury caused a time delay in the start of colony formation and a decrease in the final level of CFR. Surprisingly, dead cells also inhibited cell growth possibly due to the release of insoluble factors., Osmotic stress‐induced injured cells of Escherichia coli were prepared by sorting live cells onto tryptic soy agar (TSA) containing 10–50% sucrose. The time course of colony‐forming rate (CFR%) was analyzed. A time delay in colony formation indicated a sublethal effect. The final CFR level at 24 h indicated the relative number of culturable cells irrespective of injury. A value of (100‐CFR)% at 24 h indicated a lethal effect. When cells were grown on TSA containing 10% sucrose, the time delay was 4 h and the lethal effect was 4%. However, dead cells inhibited the growth of live cells. Physical contact with insoluble matter derived from dead cells or dead cells themselves might have caused growth inhibition. These findings highlight a novel perspective on colony count methods in practical situations, such as when sampling foods containing a high concentration of sucrose.

Background: The degree of tissue damage caused by related inflammatory and immunological sequelae poses a major therapeutic treatment problem in burn wounds. Chronic wounds frequently have a significant bioburden and pathogens that are resistant to antibiotics. This review article discusses present research on phototherapy, which is believed to be useful in managing wound bioburden and promoting healing. Objective: To evaluate the wound healing efficacy of polarized light therapy (BLT) against low-level laser therapy (Ga-As laser) in order to determine which is more efficient and successful at speeding burn healing. Subject and methods: The current study enrolled thirty patients having partial thickness thermal burn on the forearm (dermal burn). They were selected from Burn Unit at Legislation Association Hospital for Burns & Oncology. They were randomly assigned into two equal groups: Group (A) that included fifteen patients who received the BLT with mean age of 28.8 ± 2.51 years old and group (B) that enrolled fifteen patients who received LLLT with mean age of 29.6 ± 2.79 years old. Both groups also received traditional physical therapy and conservative treatment for the burn site three times weekly for four weeks. Results: Group A and B showed a significant reduction in colony count and wound surface area after treatment in comparison to that before treatment (p > 0.001). In group A, the colony count and wound surface area decreased by 38.63% and 55.1% respectively, but in group B, by 15.6% and 37.92% respectively. Conclusion: Both polarized light therapy and low-level laser therapy had a therapeutic efficiency on wound healing, but BLT is more efficient and more successful in the acceleration of the burned wounds healing.

The objective of this study was to determine the prevalence of Shiga toxin-producing Escherichia coli (STEC) O157:H7 in colon contents and on carcasses from pigs slaughtered at provincially licensed abattoirs (PLAs) in Alberta, Canada. In 2017, carcass sponge samples and colon content samples were collected from 504 healthy market hogs at 39 PLAs and analyzed for E. coli O157:H7. Carcass samples were also analyzed for E. coli and aerobic colony count (ACC). Nine (1.8%) of 504 carcass samples were confirmed positive for E. coli O157:H7. Seven (1.4%) of 504 colon content samples were confirmed positive for E. coli O157:H7. These positives were found in 5 (12.8%) of 39 PLAs from hogs originating from eight farms. The E. coli O157:H7 isolates recovered from the positive samples (n = 1 isolate per sample) were clonal, as determined by pulsed-field gel electrophoresis. Six E. coli O157:H7 isolates obtained over 8 months from one PLA that only processed hogs and sourced hogs from one farm had indistinguishable pulsed-field gel electrophoresis patterns. All 16 E. coli O157:H7 isolates harbored eae and ehxA and were of stx2a subtype, suggesting that swine can carry E. coli O157:H7 of importance to human health. All carcass sponge swabs (100%) were positive for ACC. E. coli was present in 72% of carcass swabs. Carcasses from PLAs slaughtering both beef and hogs had a numerically higher ACC mean value but not statistically different compared with the carcasses from PLAs slaughtering only swine (2,799 and 610 CFU/cm2, respectively). E. coli showed a similar trend with a mean value of 0.88 CFU/cm2 in PLAs slaughtering both species and 0.26 CFU/cm2 in PLAs slaughtering only swine (P ≤ 0.05). This study provides evidence that healthy market hogs from different producers and farms in Alberta can carry E. coli O157:H7, and some strains of the organism may be able to establish persistence on some swine farms. HIGHLIGHTS

The transient contamination of medical professional’s attires including white coats is one of the major vehicles for the horizontal transmission of microorganisms in the hospital environment. This study was carried out to determine the degree of contamination by bacterial agents on the white coats in a tertiary care hospital in Nepal. Sterilized uniforms with fabric patches of 10 cm × 15 cm size attached to the right and left pockets were distributed to 12 nurses of six different wards of a teaching hospital at the beginning of their work shift. Worn coats were collected at the end of the shifts and the patches were subjected for total bacterial count and identification of selected bacterial pathogens, as prioritized by the World Health Organization (WHO). Fifty percent of the sampled swatches were found to be contaminated by pathogenic bacteria. The average colony growth per square inch of the patch was 524 and 857 during first and second workdays, respectively, indicating an increase of 63.6% in colony counts. The pathogens detected on patches were Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter sp. Additional bacteria identified included Bacillus sp., Micrococcus sp., and coagulase-negative staphylococci (CoNS). The nurses working in the maternity department had their white coats highly contaminated with bacteria. On the other hand, the least bacterial contamination was recorded from the nurses of the surgery ward. One S. aureus isolate from the maternity ward was resistant to methicillin. This study showed that pathogens belonging to the WHO list of critical priority and high priority have been isolated from white coats of nurses, thus posing the risk of transmission to patients. White coats must be worn, maintained, and washed properly to reduce bacterial contamination load and to prevent cross-contamination of potential superbugs. The practice of wearing white coats outside the healthcare zone should be strictly discouraged.

Background: Escherichia coli (E. coli) is the major cause of community-based Urinary tract infections (UTI). Products from nature have been used in traditional medicine practice although with limited scientific validity. In this study garlic and cranberry extracts was assessed for its efficacy to inhibit E. coli growth. Materials and Methods: Crude garlic and cranberry extracts were obtained and E. coli was isolated from an infected urine sample. Two-fold serial dilution was carried out on the E. coli and crude extract inoculations. Incubation and plating was carried out for 24 hr at 30°C. Colony count was done using a digital Quebec Colony Counter. Results: A general trend of reducing number of average CFU with increasing concentration of both extracts was observed. Garlic was observed to be more potent than the cranberry extract even at the lowest concentration. Conclusion: This study establishes the merit of using garlic and cranberry extract as a household remedy for UTI caused by E. coli.

Objective: To investigate the effect of two methods of propolis administration on plaque accumulation and microbial count as well as patient acceptance of each vehicle. Study design: A randomized clinical trial with two parallel arms was used with a sample of 60 high caries risk children 6–8 years old. Children were divided randomly into two groups. Group I: Children who received propolis chewing gum and instructed to chew it twice daily for at least twenty minutes, for two weeks. Group II: children who received propolis mouthwash and instructed to rinse twice daily for one minute. A plaque index was recorded and a plaque sample was collected from all participants at base line and after two weeks of treatment. All participants were asked to rate the preparation they received during treatment period on a Visual Analogue Scale chart. Results: Data showed that propolis had a significant effect on reducing plaque scores and colony counts in both vehicles. There was no significant difference between both vehicles neither on plaque reduction nor on microbial count. However children preferred the gum formula. Conclusion: Propolis in both vehicles reduced plaque accumulation and microbial count which recommends its use as an antimicrobial agent in different vehicles.

Background: The significant increase in the use of implantable cardiac devices (ICDs) has been accompanied by biofilm formation and increase rate of infection on the devices. The purpose of our study is to describe the clinical and microbiological findings of infection of ICDs in the cardiology units of western Algeria hospitals. Methodology: All patients with clinical diagnosis of ICD infections or infective endocarditis upon removal of their ICDs from December 2012 to August 2014 in cardiology units of 4 Algerian hospitals were included in the study. Each element of the ICD pocket and lead was separately sonicated in sterile saline, inoculated onto Chapman and MacConkey agar plates and incubated aerobically at 37oC for colony count after 24 hours. Biochemical identification of the bacteria isolates was made by API 20E, API 20 NE and API Staph, and confirmed by Siemens Healthcare Diagnostics WalkAway® 96 Plus System. Antibiotic susceptibility testing on each isolate was performed by the disk diffusion method on Mueller Hinton agar. Biofilm formation was detected by Congo Red Agar (CRA) and Tissue Culture Plate (TCP) methods, and hydrophobicity of the bacterial cell was determined by the MATH protocol. Results: Over a period of twenty-one months, 17 ICDs were removed from patients with post-operative infections; 6 (35.3%) had early infection of ICD and 11 (64.7%) had late ICD infection. Fifty-four bacterial strains were isolated and identified, with coagulase-negative staphylococci being the predominant bacteria with 46.3% (25/54). There was no significant association between hydrophobicity and antimicrobial resistance in the 54 isolates but there is positive correlation between biofilm production and antimicrobial resistance, with the strongest biofilm producers resistant to more than one antibiotic. Four independent predictors of infection of resynchronization devices were reported; reoperation, multi-morbidity, long procedure, and ICD implantation. Conclusion: Our study is the first in Algeria to describe microbiological characteristics of ICD infection. The bacteria in the biofilm were protected, more resistant and tolerated high concentrations of antibiotics and thus played a major role in the development of ICD infections. Despite the improvements in ICD design and implantation techniques, ICD infection remains a serious challenge. Keywords: implantable cardiac devices, staphylococci, resistance, biofilm, hydrophobicity French title: Infections des dispositifs cardiaques implantables par des bactéries formant un biofilm dans les hôpitaux de l'ouest Algérien Contexte: L'augmentation significative de l'utilisation des dispositifs cardiaques implantables est un risque majeur d'augmentation du taux d'infection et donc du risque de formation d'un biofilm sur ce genre de dispositifs. L'objectif de notre étude est de décrire les résultats cliniques et microbiologiques de l'infection sur les dispositifs cardiaques implantables (DCI) dans les unités de cardiologie des hôpitaux de l'ouest Algérien. Méthodologie: Tous les patients cliniquement diagnostiqués avec une infection sur DCI, ou une endocardite infectieuse et ayant subit un retrait de leur dispositif cardiaque sont inclus dans cette étude et cela sur une période entre décembre 2012 et aout 2014 dans 4 unités de cardiologie. Chaque élément du DCI (boitier et sonde) est trempé séparément dans une solution saline stérile, ensemencé sur deux milieux de culture, un milieu de Chapman et un milieu MacConkey et incubé en aérobiose à 37°C pour la numération des colonies après 24 heures. L'identification biochimique des isolats de bactéries est effectuée par le API 20E, API 20 NE et API Staph, et confirmée par le système WalkAway® 96 Plus de Siemens Healthcare Diagnostics. Les tests de sensibilité aux antibiotiques de chaque isolat sont effectués par la méthode de diffusion des disques sur gélose de Mueller Hinton. La formation d'un biofilm est détectée par les méthodes de la gélose rouge du Congo (CRA) et de la plaque de culture tissulaire (TCP), et l'hydrophobicité de la cellule bactérienne est déterminée par le protocole MATH. Résultats: Sur une période de 21 mois, 17 DCI sont retirés de patients atteints d'infections postopératoires; 6 patients (35,3%) sont identifiés comme ayant une infection précoce sur leurs DCI et 11 patients (64,7%) ayant une infection tardive. Cinquante-quatre souches bactériennes sont isolées et identifiées, les staphylocoques à coagulase négative étant les bactéries prédominantes avec 46,3% (25/54). Il n'y a pas d'association significative entre l'hydrophobicité et la résistance aux antimicrobiens dans les 54 isolats, mais il existe une corrélation positive entre la production de biofilm et la résistance aux antimicrobiens, les plus puissants en biofilm sont résistant à plus d'un antibiotique. Quatre facteurs prédictifs indépendants d’infection des dispositifs cardiaques implantable sont retrouvés dans ce travail: ré-intervention, longue procédure, sujets multi-tarés, et implantation d’un DCI Conclusion: Notre étude est la première en Algérie à décrire les caractéristiques microbiologiques de l'infection des DCI. Les bactéries présentes dans le biofilm sont protégées, plus résistantes et tolèrent de fortes concentrations d'antibiotiques et jouent ainsi un rôle majeur dans le développement des infections par DCI. Malgré des améliorations dans les techniques de conception et d'implantation de DCI, l'infection des dispositifs cardiaques implantables reste un problème grave et très couteux. Mots-clés: dispositifs cardiaques implantables; staphylocoque; résistance; biofilm; hydrophobicité

Background Acquisition of pathogens into health care settings from prior room occupants has been documented. Hospital room privacy curtains are at high risk for pathogenic bacterial contamination. Antimicrobial impregnated curtains could be effective in reducing contamination. Methods Rooms within an intensive care unit at The University of Iowa Hospitals and Clinics were randomized to 3 arms. The 2 intervention arms: (1) halamine antimicrobial curtains (BioSmart curtain [BSC]) and (2) halamine antimicrobial curtains sprayed twice weekly with a sodium hypochlorite-based disinfecting spray (BSC-pre and BSC-post) and a third control arm (standard curtain [SC]). Samples were collected twice weekly for 3 weeks to assess pathogenic bacterial contamination. Results The likelihood of remaining uncontaminated was 38% for SC, 37% for BSC, and 60% for the BSC-pre group. Time to event (contamination) analysis found no statistically significant difference between pathogenic contamination between the SC, BSC, and BSC-pre groups (P value = .1921). There was a decrease in average colony count for BSC curtains compared with control, however, this difference was not statistically significant. Hypochlorite spray was found to transiently decontaminate curtains, but effects dissipated after 72 hours. Conclusions BSC did not show a significant reduction in pathogenic contamination compared with control. Antimicrobial curtains could have a role in reducing environmental contamination in the health care setting. Future studies should be done to determine the long-term effects of using antimicrobial curtains in health care.

Purpose : To determine the effect of Inherited Cleft Lip and Palate Management on microbial migration in forked lip and palate (CLP) children. Material and methods: Fifteen forked lip and palate children and fifteen standard children (the control group), aged 3 months to 36 months were selected from the out clinic of Faculty of Dental Medicine, Al-Azhar University for Girls. Dribble samples were collected after the breakfast by inserting sterile cotton gauze in the entry from the jaws before and after construction of obturator. Results: The highest (mean±SD) value of log bacterial count (CFU/μl) was found in the cleft patients pre-operatively (5.64±1.06), while post-operatively there was a significant reduction in value (0.60±0.06) (P

Acrylic resin processed by compression molded technique had been used to manufacture the removable complete dentures bases for many years. However there are many disadvantages connected to the use of this material with the ordinary compression molding as a denture base, the reason that made the researches try to find a better alternatives whether by changing the processing technique: like in the case of using acrylic resins processed by injection molded technique which proved to be a better choice in many aspects, on the other hand some researchers preferred to use another material so they used metal bases as replacement for the ordinary acrylic denture base. There are many ways to make patterns for metal bases casting in partial and complete dentures. Recently many researchers and practitioners used CAD-CAM technologies to make patterns for metal casting and facilitate the work, and save time. This study compares the candida albicans colony formation on the two materials mentioned above as an advantage to the material studied.Purpose: The purpose of this study is to compare the growth of candida albicans on removable complete dentures bases manufactured using CAD/CAM designed metal (Co-Cr casted from milled wax patterns) and injection molded acrylic resin. Materials and Methods: Split-palate maxillary complete dentures were fabricated for 10 edentulous patients. one-half of the palate was made in acrylic resin and the other half in Co-Cr metal palate that was casted from CAD-CAM milled patterns for each patient in this study. specimens were collected at 1, 3, and 5 months using a modified imprint culture method. Speciation of Candida albicans was performed using a chromogenic culture medium. Two-sample t-test was employed to determine effects and significant interactions between the acrylic and the metal groups. Results: Significant differences were observed in the candida albicans colony counts between both materials during the first, the third, and the fifth month. The Colony forming unit(CFU)/cm2 means were significantly less on the Co-Cr casted metal denture bases than CFU/cm2 means on the injection molded acrylic resin. Conclusions: The metal base proved to be effective in decreasing the candida albicans growth typically present in complete dentures. Colony counts of Candida albicans were higher in the injection molded acrylic resin part of denture bases of the patients in this study.

Inconsistencies persist regarding the efficacy of treating asymptomatic group B Streptococcus bacteriuria in pregnant individuals with colony counts below 10(5) (100,000) CFU/mL. Despite these discrepancies, treatment still occurs. This article examines the role of screening and treatment, evidence-based guidelines, and practice patterns to provide clarification and resolve local practice disparities.

Background: Plaque retention during fixed orthodontic therapy is an important cause of developing enamel demineralization. The purpose of this study was to evaluate the effect of different brackets types on the count of Streptococcus Mutans in orthodontic patients using conventional fluoridated toothpaste. Materials and Methods: Plaque samples were collected from maxillary 1st premolar teeth of twenty right handed patients (using split mouth technique) before bonding, after 48 hrs of bonding using tooth brush only, and after 2 weeks of using fluoridated toothpaste. Stainless steel bracket was bonded on right first premolar while the left one was bonded with sapphire bracket. The calculation of the Streptococcus Mutans count was done using the plate counting method utilizing colony counter. The differences between the two types of brackets were determined using the Wilcoxon signed ranks test. Results: The median bacterial count on the right side was insignificantly higher than the left side; streptococcus mutans in the plaque sample around the sapphire brackets showed insignificantly less counts than around the stainless steel one, when the patients used tooth brush only or fluoridated toothpastes. Fluoridated toothpastes reduced streptococcus mutans insignificantly around both types of brackets. Conclusion: Fluoridated toothpaste acts effectively in reducing streptococcus mutans colony counts around sapphire and stainless steel brackets. Keywords: Streptococcus mutans, Stainless steel brackets, Sapphire brackets.

Many factors can influence the microbiological quality of raw cow’s milk. In this study, our aim was to determine whether there was any difference between the microbiological statuses of milk produced in different seasons. Samples were collected and analysed from five dairy farms in Hajdú-Bihar County, from February to November in 2019. During our studies, total plate count (TPC), coliform count and Staphylococcus aureus count of raw cow’s milk samples were determined. There was no significant difference (P>0.05) between the mean TPC values detected in the milk collected in winter and autumn, but that values were significantly (P

This study aimed to evaluate the antibacterial efficacy of 810-nm diode laser on the root canals infected with Enterococcus faecalis biofilm-like structure by using comparable and safe parameters. The root canals of 52 extracted human single-rooted teeth were prepared, 4 teeth allocated as negative control and 48 teeth inoculated with E. faecalis for 3 weeks. The teeth were then randomly divided into the following 4 experimental groups: Group NaOCl (n = 12), 17% EDTA + 5.25% NaOCl + saline; Group DL1 (n = 12), 17% EDTA + 1 W diode laser + saline; Group DL2 (n = 12), 17% EDTA + 1.5 W diode laser + saline; Group S (n = 12), Saline. Samples were obtained from dentin chips before and after the interventions. A reduction in colony count was assessed by counting the colony-forming units. Compared to the control group, significant reductions were noted in E. faecalis colony counts in all groups (p .05). The greatest reduction in colony count (98.9%) was noted in the Group NaOCl. The difference in this respect between the Group DL2 and Group S (p .05). Our results demonstrated two different parameters of 810-nm diode laser showing the significant antibacterial effect on E. faecalis biofilm but it was not as effective as NaOCl irrigation.

Objectives Isolation gowns are used as a barrier to bacterial transmission from patient to provider and vice versa. If an isolation gown is ineffective, the patient and provider have a potential breach of safety and increased infection risk. This study compared the bacterial permeability of differently rated, commonly uses isolation gowns to assess their effectiveness in preventing simulated bacterial transmittance, and thus contamination, from patient to provider. Methods Serial dilutions of Staphylococcus epidermidis in sterile saline were applied to a simulated skin surface. Unrated and Levels 1 through 4 non-sterile isolation gowns contacted the solution, simulating patient contact. Both sides of the contaminated gowns were then cultured on blood agar by rolling a sterile swab across the gown and evenly inoculating the culture plate. Colony counts from inside and outside of the gowns were compared. Separately, S. epidermidis was placed on a sample of each gown and scanning electron microscopy was used to visualize the contaminated gowns’ physical structure. Results Mean bacterial transmittance from outside of the gown (i.e. patient contact side) to inside of the gowns (i.e. provider clothing or skin side) based on gown rating was as follows: unrated: 50.4% (SD 9.0%); Level 1: 39.7% (SD 11.2%); Level 2: 16.3% (SD 10.3%); Level 3: 0.3% (SD 0.8%); Level 4: 0.0% (SD 0.0%). Scanning electron microscope imaging of unrated, Level 1, and Level 2 gowns revealed gown pore sizes much larger than the bacteria. The Welch one-way analysis of variance statistic showed significant difference dependent on gown-level rating. Conclusions Unrated, Level 1, and Level 2 isolation gowns do not provide effective bacterial isolation barriers when bacteria like S. epidermidis make contact with one side of the gown material. Not studied, but implied, is that unrated and lower rated isolation gowns would be as or even more physically permeable to virus particles, which are much smaller than bacteria.

Background and aim: The prevalence of typhoid fever is reportedly high, especially in Asia. When a pathogen enters the human body, there are markers in the form of molecules that will be known by the innate immune system. Specific molecular markers of gram negative bacteria, which are Lipopolysaccharides (LPS) and Toll-Like receptors-4 will interact with LPS. The binding between LPS and TLR-4 will give rise to activation signals that will activate innate immune cells. Immune cells will release a number of proinflammatory cytokines, such as TNF-α, IL-1, and IL-6. While Vitamin D Receptors (VDR) are expressed in large amounts in tumor tissue and infected cells. This study aimed to prove the role of IL-6, TNF-α, and VDR in inhibiting bacterial growth in mice that have been induced by S.Typhi. Methods: This research was a real experimental pre-post test design to investigate the level of IL-6, TNF-α and VDR in suppressing the growth of bacteria in the peritoneal fluid of S. Typhi, male, mice BALB/c. Mice were divided into three groups comprised of 10 mice each. All mice in groups A and B were intraperitoneally inoculated with S. Typhi strain Thy1 in study day 0. Group A was treated with antibiotic Levofloxacine, on study day 4th. Another study group, group B, was used as a placebo and received aquades on study day 4th. While group C as a control was not inoculated with S. Typhi. Blood samples from three groups for the calculation of serum Il-6, TNF-α, and VDR were collected. This examination was taken four times; at baseline, 4th day, 10th day, and 30th day. For the calculation of bacterial colony, peritoneal fluid retrieval was collected three times, which is on 4th day, 10th day, and 30th day. Results: A repeated measure ANOVA in group A (antibiotic) and group B (placebo) group showed that mean IL-6, TNF-α, and VDR level differed statistically significant between times (p-value 0.000). There was a strong negative correlation between bacterial colony count and VDR level, which was statistically significant in both groups (group A; r = -0.875, p-value = 0.000 vs group B; r = -0.470, p-value = 0.002). IL-6 and TNF-α didn't give significant statistical correlation with bacterial colony count. Conclusion: VDR, IL-6, and TNF-α play an important role in killing bacteria. From the results of this study, IL-6 level is related to the number of bacterial colonies, the lower the IL-6 level, the less the number of bacterial colonies. Similarly, TNF-α levels have a positive correlation with the number of bacterial colonies. While VDR levels are also related to the number of bacterial colonies, the higher the VDR level, the lower the number of bacterial colonies.

The aim of the present study was to evaluate the microbial contamination of domestic swine carcasses over an 8-year period in a slaughterhouse located in the Marche region, Central Italy. The hygiene of the slaughter process was assessed by microbiological criteria involving aerobic colony count (ACC), Enterobacteriaceae and Salmonella spp. [Regulation (EC) No 2073/2005 and amendments]. Five carcasses were tested during five sampling sessions each year (four different sites from each carcass were pooled before the analysis) for a total of 200 samples. The results of the study showed low levels of ACC and Enterobacteriaceae and the absence of Salmonella spp., except for one sample. The values of ACC were consistently satisfactory (

Summary Background Cleaning high-touch surfaces serves as a crucial step towards controlling the transmission of multidrug-resistant pathogens in hospital environments. The process can be made most effective if scientifically monitored using a simple, feasible and reliable technique, especially in resource-poor settings. Aim To identify a novel florescent marker (FM) comparable to the already existing commercial FM systems and to assess its efficacy in evaluating cleaning of high-touch surfaces in a hospital environment. Methods A liquid detergent used for washing purposes was identified as a novel FM. Pre- and post-cleaning sampling were performed from 250 high-touch surfaces in different patient-care areas using this marker and aerobic colony counts. Concordance between the two methods was assessed and compared by Cohen's kappa coefficient. The sensitivity, specificity, positive predictive and negative predictive values for the new FM method were calculated against the microbiological method. Findings A good correlation (κ = 0.60) with overall concordance of 79.6% was observed between the two methods. The sensitivity, specificity, positive predictive value and negative predictive value of the FM were 79.58% (95% confidence interval (CI): 72–85.85%), 79.63% (95% CI: 70.79–86.78), 83.70% (95% CI: 76.38–89.50) and 74.78% (95% CI: 65.83–82.38), respectively. Conclusions The FM used in the present study proved to be a simple and cost-effective alternative to commercially available FMs for assessing environmental cleaning practices on a daily basis in resource-poor settings. Additional studies making direct comparisons of the FM used here with the established FMs are warranted before it can be generalized for use.

INTRODUCTION Infections of cardiac implantable electronic devices remain a prevalent health concern necessitating the advent of novel preventative strategies. Based on the observation that bacterial infections of the Micra transcatheter pacemaker device are extremely rare, we examine the effect of parylene coating on bacterial adhesion and growth. METHODS Bacterial growth was compared on polyurethane coated, bare, or parylene coated titanium surfaces. Eight test samples per bacterial species and material combination were incubated with Staphylococcus Aureus or Pseudomonas aeruginosa for 24 hours and then assayed for bacterial growth. The surface contact angle was also characterized by measuring the angle between the tangent to the surface of a liquid droplet made with the surface of the solid sample. RESULTS The mean bacterial colony counts were significantly reduced for both parylene coated titanium versus bare samples (3.69 ± 0.27 and 4.80 ± 0.48 log[CFU/mL] respectively for S. aureus [P

Background: Dental caries is one of the commonest oral diseases that require early stages of prevention and intervention. The primary organisms related to dental caries are streptococcus mutans and lactobacilli. In the past decades, some of the non-pathogenic bacteria called probiotics have been added to the food products for the beneficial effect of human health. Intake of probiotic food products has been shown to have beneficial effects on the oral tissues. Hence the present study aimed to compare the levels of salivary pH, S. mutans, B. dentium counts in children consuming probiotic and non-probiotic curd. Methods and Material: 40 healthy caries free children were randomly allocated into two groups. First baseline salivary samples were collected from all the participants and tested for salivary pH, salivary B. dentium and S. mutans count. After collecting the baseline values test group of children were provided with probiotic curd whereas the control group were provided with non probiotic curd for 15 days. After 15 days of consumption of these dairy products, salivary samples were collected again and tested for salivary pH, salivary B. dentium and S. mutans count. Results: Probiotic curd was found to be more effective in reducing the colony counts of B.dentium and S.mutans .There was a marginal decrease in pH in both the groups but was well above the critical pH. Conclusions: Probiotic curd showed considerable level of decrease in colony counts of B.dentium, S.mutans and salivary pH when compared to normal curd.

Background: Sodium hypochlorite (5.25% NaOCl) is the gold standard among irrigation solutions, but it is toxic to periapical tissue, decreases the micromechanical characteristics of dentin, has no effect on smear layer removal, and may not completely eradicate biofilms. Therefore, many new irrigation solutions, such as mixtures of tetracycline, citric acid, and detergent (MTAD) and a mixture of chlorhexidine (CHX) and ethylenediaminetetraacetic acid (EDTA) have been introduced as the alternatives to NaOCl. Objectives: The objectives of this study are to analyze the differences in the effects of MTAD and mixtures of CHX and EDTA on the growth of Enterococcus faecalis ex vivo.Methods: This study used 28 lower premolars, divided into seven groups. Group I received MTAD. Group II received MTAD with CHX. Group III received a mixture of CHX and EDTA. Group IV received a 2% CHX solution. Group V received 17% EDTA. Group VI received a 5.25% NaOCl solution, which served as the positive control, and Group VII received sterile distilled water, which was the negative control. The effectiveness of various irrigation solutions in preventing the growth of E. faecalis was measured by the zone of growth inhibition and colony counts. Results: A one-way analysis of variance revealed a significant difference among the tested irrigation solutions, both in terms of zone inhibition of E. faecalis and E. faecalis colonies counting (P < 0.05). Conclusion: There was a different antibacterial effect between MTAD and the mixture of CHX and EDTA. MTAD were more effective as irrigation solution compared to the mixture of CHX and EDTA. However, as irrigation solutions, both were less effective than 5.25% NaOCl.

Background Inadequate hospital cleaning may contribute to cross-transmission of pathogens. It is important to implement effective cleaning for the safe hospital environment. We conducted a three-phase study using human factors engineering (HFE) approach to enhance environmental cleanliness. Methods This study was conducted using a prospective interventional trial, and 28 (33.3%) of 84 wards in a medical center were sampled. The three-phases included pre-intervention analysis (Phase 1), implementing interventions by HFE principles (Phase 2), and programmatic analysis (Phase 3). The evaluations of terminal cleaning and disinfection were performed using the fluorescent marker, the adenosine triphosphate bioluminescence assay, and the aerobic colony count method simultaneously in all phases. Effective terminal cleaning and disinfection was qualified with the aggregate outcome of the same 10 high-touch surfaces per room. A score for each high-touch surface was recorded, with 0 denoting a fail and 10 denoting a pass by the benchmark of the evaluation method, and the total terminal cleaning and disinfection score (TCD score) was a score out of 100. Results In each phase, 840 high-touch surfaces were collected from 84 rooms after terminal cleaning and disinfection. After the interventions, the TCD score by the three evaluation methods all showed significant improved. The carriage incidence of multidrug-resistant organism (MDRO) decreased significantly from 4.1 per 1000 patient-days to 3.6 per 1000 patient-days (P = .03). Conclusion The HFE approach can improve the thoroughness and the effectiveness of terminal cleaning and disinfection, and resulted in a reduction of patient carriage of MDRO at hospitals. Larger studies are necessary to establish whether such efforts of cleanliness can reduce the incidence of healthcare-associated infection.

Background: The appropriateness of the wound bed for autograft transplantation is routinely evaluated based on the surgeon's judgment, which might not be reliable in some situations. Therefore, this study was designed to evaluate the association between wound pH, wound temperature, and wound culture results with autograft taking. Materials and Methods: In this prospective, cross-sectional study, the body core temperature, wound pH, and local wound temperature at the beginning of operation and after burn wound excision were measured in 50 patients with burn wounds. Swab culture specimen was obtained from the burn wound after dressing removal and after the completion of wound excision. Autograft taking was evaluated on days 3 and 7 postoperative. Results: There was a statistically significant reverse association between autograft taking on day 3 and wound pH at the beginning of operation (P = 0.016). Besides, there was a statistically significant association between core body temperature and autograft taking on days 3 (P = 0.035) and 7 (P = 0.002). However, there was no significant association between local wound temperature and autograft taking. A positive result for wound culture after excision, even when the colony count was

Background/Aim. Establishing a food safety control sys-tem is extremely important in preventing diseases associated with foodborne pathogens. The aim of this study was to ex-amine the hygiene status of food contact surfaces and the ap-plication of good hygiene practices by food handlers in school canteens. Methods. A total of 10,366 swabs were tak-en from food contact surfaces, including food handler's hands from public school canteens in Novi Sad, Serbia, over ten years (2008-2017), covering voluntary good hygiene prac-tices and obligatory Hazard Analysis Critical Control Points (HACCP) implementation periods. Results. Statistically sig-nificant differences (p < 0.05) in aerobic colony counts (ACCs) on surfaces between two examined periods were found. A general positive trend regarding the reduction of microbial contamination of food contact surfaces was ob-served. The percentage of surfaces swabs with ACCs above 2.48 log CFU/cm2 significantly decreased (R2 = 0.453) during the study period, and the percentage of coagulase-positive Staphylococcus in the swabs also decreased, but not significantly (R2 = 0.264), and average annual Enterobacteriaceae counts above the established limit values on surfaces significantly de-creased (R2 = 0.442) over the years. A significantly higher (p < 0.05) percentage of workers' hands harbored ACCs, coagu-lase-positive Staphylococcus, and Enterobacteriaceae above the es-tablished limits than the equipment or work surfaces. Con-clusion. The results obtained showed the proper implemen-tation of good hygiene practices concerning food contact sur-faces, but the implementation of good personal hygiene prac-tices needs enhanced supervision. Uvod/Cilj. Uspostavljanje sistema kontrole bezbednosti je izuzetno važno u prevenciji bolesti povezanih sa patogenima koje se prenose hranom. Cilj ovog istraživanja bio je da se utvrdi higijenski status kontaktnih površina i primena dobre higijenske prakse pri rukovanju hranom u školskim kantinama. Metode. Ukupno 10 366 briseva uzeto je sa površina koje dolaze u kontakt s hranom i ruku osoblja zaposlenog u školskim kantinama u Novom Sadu u desetogodišnjem periodu (2008–2017). Istraživanje je uključivalo dva perioda: a) dobrovoljnu primenu dobre higijenske prakse i b) obaveznu implementaciju sistema Hazard Analysis Critical Control Points (HACCP). Rezultati. Statistički značajna razlika (p < 0,05) utvrđena je u ukupnom broju aerobnih bakterija (aerobic colony counts -ACCs) na površinama. Primećen je opšti pozitivni trend u pogledu smanjenja mikrobiološke kontaminacije površina koje dolaze u kontakt s namirnicama. Učestalost nalaza briseva sa utvrđenim ukupnim ACCs iznad 2,48 log CFU/cm2 smanjivala se statistički značajno (R2 = 0,453) tokom perioda ispitivanja; učestalost prisustva koagulaza pozitivnih stafilokoka se takođe smanjivala, ali ne statistički značajno (R2 = 0,264), dok se prosečan broj enterobakterija iznad utvrđenih graničnih vrednosti na površinama statistički značajno smanjio tokom godina (R2 = 0,442). Na brisevima ruku ispitanog osoblja utvrđena je statistički značajno viša (p < 0,05) učestalost prisustva ukupnog ACCs, koagulaza pozitivnih stafilokoka i enterobakterija iznad utvrđenih granica u odnosu na briseve uzete sa opreme ili radnih površina. Zaključak. Dobijeni rezultati pokazuju pravilnu primenu dobre higijenske prakse kada su u pitanju površine koje dolaze u kontakt s hranom, dok implementacija prakse dobre lične higijene zaposlenih zahteva pojačan nadzor

Objective. Compare the effects of three sampling methods on the microbiological monitoring results after reprocessing of gastrointestinal endoscopes, providing scientific basis for improving the monitoring quality of gastrointestinal endoscope cleaning and disinfection. Method. Gastrointestinal endoscopes after reprocessing were selected randomly at the gastrointestinal endoscopy center of a tertiary hospital in Shanghai from October 2018 to February 2019. The endoscopes selected were all sampled in three different methods under continuous sampling and intermittent sampling respectively. Methods used includes, the biopsy channel group (Group A), the entire channel group (Group B), and the disc brush group (Group C). Then the colony forming units (CFU/piece) were counted in the laboratory. Results. A total of 12 endoscopes were sampled by using continuous sampling approach, in which the detection rate of bacteria in disc brush group (33.3%) and entire channel group (33.3%) was higher than biopsy channel group (8.3%). Among the 12 endoscopes sampled with intermittent approach, the detection rate of bacteria from high to low was the disc brush group (50%), the entire channel group (41.7%), and the biopsy channel group (8.3%). Conclusion. Different sampling methods will lead to the difference of microbiological culture results after reprocessing of gastrointestinal endoscope, indicating that the improved sampling method is beneficial to objectively reflect the endoscope cleaning and disinfection effect, and improve the monitoring quality of endoscope disinfection.

Understanding the molecular determinants underlying the interaction between the leaf and human pathogenic bacteria is key to provide the foundation to develop science-based strategies to prevent or decrease the pathogen contamination of leafy greens. In this study, we conducted a dual RNA-sequencing analysis to simultaneously define changes in the transcriptomic profiles of the plant and the bacterium when they come in contact. We used an economically relevant vegetable crop, lettuce (Lactuca sativa L. cultivar Salinas), and a model plant, Arabidopsis thaliana Col-0, as well as two pathogenic bacterial strains that cause disease outbreaks associated with fresh produce, Escherichia coli O157:H7 and Salmonella enterica serovar Typhimurium 14028s (STm 14028s). We observed commonalities and specificities in the modulation of biological processes between Arabidopsis and lettuce and between O157:H7 and STm 14028s during early stages of the interaction. We detected a larger alteration of gene expression at the whole transcriptome level in lettuce and Arabidopsis at 24 h post inoculation with STm 14028s compared to that with O157:H7. In addition, bacterial transcriptomic adjustments were substantially larger in Arabidopsis than in lettuce. Bacterial transcriptome was affected at a larger extent in the first 4 h compared to the subsequent 20 h after inoculation. Overall, we gained valuable knowledge about the responses and counter-responses of both bacterial pathogen and plant host when these bacteria are residing in the leaf intercellular space. These findings and the public genomic resources generated in this study are valuable for additional data mining.

Background In resource-limited settings, sputum smear conversion is used to document treatment response. Many People living with HIV (PLHIV) are smear-negative at baseline. The Xpert MTB/RIF test can indirectly measure bacterial load through cycle threshold (ct) values. This study aimed to determine if baseline Xpert MTB/RIF could predict time to culture negativity in PLHIV with newly diagnosed TB. Methods A subset of 138 PLHIV from the ‘SOUTH’ study on outcomes related to TB and antiretroviral drug concentrations were included. Bacterial load was estimated by Mycobacterium Growth Indicator Tubes (MGIT) culture time-to-positivity (TTP) and Lowenstein Jensen (LJ) colony counts. Changes in TTP and colony counts were analyzed with Poisson Generalised Estimating Equations (GEE) and multilevel ordered logistic regression models, respectively, while time to culture negativity analysed with Cox proportional hazard models. ROC curves were used to explore the accuracy of the ct value in predicting culture negativity. Results A total of 81 patients (58.7%) were males, median age 34 (IQR 29 ̶ 40) years, median CD4 cell count of 180 (IQR 68 ̶ 345) cells/μL and 77.5% were ART naive. The median baseline ct value was 25.1 (IQR 21.0 ̶ 30.1). A unit Increase in the ct value was associated with a 5% (IRR = 1.05 95% CI 1.04 ̶ 1.06) and 3% (IRR = 1.03 95% CI 1.03 ̶ 1.04) increase in TTP at week 2 and 4 respectively. With LJ culture, a patient’s colony grade was reduced by 0.86 times (0R = 0.86 95% CI 0.74 ̶ 0.97) at week 2 and 0.84 times (OR = 0.84 95% CI 0.79 ̶ 0.95 P = 0.002) at week 4 for every unit increase in the baseline ct value. There was a 3% higher likelihood of earlier conversion to negativity for every unit increase in the ct value. A ct cut point ≥28 best predicted culture negativity at week 4 with a sensitivity of 91. 7% & specificity 53.7% while a cut point ≥23 best predicted culture negativity at week 8. Conclusion Baseline Xpert MTB/RIF ct values predict sputum conversion in PLHIV on anti-TB treatment. Surrogate biomarkers for sputum conversion in PLHIV are still a research priority.

Phenolic extracts of coconut oil meal (CME) and sesame oil meal (SME) were compared with synthetic antioxidants for the potential of improving shelf life of vanilla cake. CME maintained hexanal (product of chemical spoilage) levels below 0.3 mg/kg in cake up to 14 days. BHT- and SME-added cakes maintained hexanal levels below 2 mg/kg, while control cake with no added antioxidants exceeded this level by day 14. Both CME and SME extended the microbial shelf life up to 13 days, while control and BHT-added cake exceeded the maximum allowed colony count by day 7 and day 11, respectively. The results indicate that the onset of microbial spoilage of vanilla cake is faster than the chemical spoilage, and addition of CME and SME extends both microbiological and chemical stability of cakes beyond day 7 during storage. Over 90% of the antioxidant activity of CME and SME retained after heating at 180°C for 2 h. CME and SME are ideal thermally stable natural alternatives for synthetic antioxidants in vanilla cake.

[Purpose] The aim of this study was to evaluate the effect of pulsed high intensity neodymium-doped yttrium aluminum garnet (Nd: YAG) laser on staphylococcus aureus (S. aureus) and pseudomonas aeruginosa (P. aeruginosa) bacterial growth, which cause many health problems and establish which doses are effective in bacterial inhibition. [Materials and Methods] Five samples of S. aureus and five samples of P. aeruginosa were prepared in the microbiology lab, one used as control sample and the other 4 samples acted as experimental samples. The experimental samples received pulsed high intensity Nd: YAG laser with a total dose of 500, 600, 700 and 800 joules. The primary measures are colony count and the percentage decrease in colony count, the colony count was assessed at baseline and after 24 h of laser application. [Result] There was significant decrease in colony count and the percentage decrease in colony count after pulsed high intensity Nd: YAG laser application in all experimental samples of S. aureus and P. aeruginosa after 24 h of application for all doses (500, 600, 700 and 800 j) as compared with the control sample, with the most effect in higher doses of pulsed high intensity Nd: YAG laser than lower doses in both types of bacteria. [Conclusion] pulsed high intensity Nd: YAG laser was found to be an effective modality for inhibition of S. aureus and P. aeruginosa growth after a single application.

Introduction Some countries have implemented reuse of laparoscopic instruments for cost-effective purposes. An accurate cleaning as the first step of reprocessing would lead to the effective sterilization. The purpose was to evaluate the effect of cleaning guidelines implementation on microbial load of laparoscopic instruments which were used in laparoscopic cholecystectomy surgery. Methods This experimental study was done in an educational hospital, in 2017 and included a total of 128 laparoscopic instruments randomly selected from cholecystectomy surgeries and divided into two cleaning groups. The instruments were checked out in terms of number (colony-forming units [CFU]/mL) and type of microorganisms in two groups of routine cleaning and according to guideline cleaning. This guideline was indigenous and taken from successful instruction in this context that was presented by the Association for the Advancement of Medical Instrumentation (AAMI). The appropriate statistical analysis was conducted by SPSS version 19. Results The average microbial load was 2.4 × 106 CFU/100 mL after clinical use. It was reduced to 7.2 × 105 CFU/100 mL in the control group and 3.4 × 104 CFU/100 mL in the intervention group, after the cleaning process. The most common microorganisms that were isolated immediately after clinical use were Escherichia coli 81.2%, Pseudomonas 68.8%, Klebsiella 57.8%, and spp., and so on. Conclusion The AAMI cleaning method is recommended to be utilized by operating room nurses for laparoscopic instruments.

In view of the increasing interest in the occurrence and spread of antibiotic-resistant bacteria due to wastewater treatment systems into the environment, total colony counts and antibiotic-resista...

Pathologic halitosis has been classified into 5 types: oral, airway, gastroesophageal, blood-borne and subjective, respectively. Type 1 (oral) halitosis mostly takes origin from anaerobic bacterial activities on oral surfaces. The role of anaerobic bacterial activities is clearly demonstrated, but despite the large number of anectodal claims, the role of Candida in patients with halitosis has not been adequately investigated. The aim of this study was to confirm the relationship between Candida and halitosis. A total of 136 subjects were enrolled and divided into two groups. The study group comprised of 69 patients with halitosis who had over 0.7 ppm H2S concentration in their oral cavity and the control group comprised of 67 healthly subjects. Self assesment scores for halitosis, Candida colony counts in saliva samples, oral NH3, SO2, H2S, H2 and volatile organic gas concentrations were recorded. H2S producing capacity of subjects was quantified by applying cysteine challenge test. Candida samples were taken from the mouths of the patients with and without halitosis, and Candida albicans isolates were inoculated into broth medium. After 3 days of incubation at 37oC, gas concentrations of the headspace of the flasks were read by a portable multigas detector. The rate of Candida positivity was 44.9% in the study group while it was 46.3% in the control group. There was no statistical significant difference between the groups according to the Candida growth (p= 0.561). The oral gas concentrations were comparable in both groups (p< 0.05). Oral H2S concentration increased 9.65 fold with 20 mM cysteine rinse in patients with halitosis while it was increased 5.8 fold in controls. Self assesment for halitosis were well correlated with clinical signs (p= 0.001, r= 0.8). Concentrations of hidrogen and organic gases were found to be increased in all Candida culture media. In this study, no relationship between the presence of Candida and oral halitosis was detected. As a result, there is no need for diets similar to Candida diet in the treatment of halitosis. On the other hand, cysteine challenge can be a useful diagnostic tool. In addition, portable gas detectors can be used as a convenient and practical halitometer to quantify halitosis.

Objective: To compare the efficacy of negative pressure wound therapy (NPWT) with that of microcurrent electrical stimulation (MES) on wound surface area, length of stay (LoS) and colony count of wounds in patients with burns. Method: Patients with thermal dermal burn injuries covering 25–40% of total body surface area were enrolled in this clinical trial. Participants were randomly allocated into three, equal-sized groups: patients receiving NPWT, patients receiving MES and a control group which received standard wound care. All groups received the same traditional physical therapy programme in addition to the same nursing and medical care. In all groups, wound surface area, colony count and LoS were measured 72 hours after thermal burn injury (pre), after 10 days and again at 21 days from the beginning of the study. Results: A total of 45 patients took part in the study. There were statistically significant decreases in wound surface area observed in all groups (pConclusion: From the findings of this study, MES was more effective in decreasing wound surface area in burn wounds while NPWT was more effective in reducing bacterial growth.

Nonuniversal use of facial protection during endoscopy may place endoscopists at risk of exposure to blood and body fluids; however, the frequency of exposure is unknown.A prospective 6-month study of 4 gastroenterologists using a face shield during endoscopy was undertaken. The face shield was swabbed in a standardized fashion before and at the end of the session. Controls included pre- and post-swabs of face shields placed on the (1) endoscopy suite wall, (2) remote patient intake bay wall, and (3) after deliberate contamination with a colonoscope immediately after colonoscopy. The swabs were cultured for 48 hours, and growth was reported as no growth or by number of colony-forming units (CFUs). The groups were compared for +CFU rate and CFU number.A total of 1100 procedures were performed in 239 endoscopy sessions. The +CFU rate in the pre-endoscopy groups (2%-4.8%, not significant) was significantly lower than the postendoscopist face shield (45.8%, P .001) and endoscopy suite wall groups (21.4%, P .001), respectively. Using a cut-off of15 CFUs as an indicator of definite exposure, the occurrence rate was 5.6 per 100 half days of endoscopy to the endoscopist's face and 3.4 per 100 half days of endoscopy 6 feet away.This is the first study to quantify the rate of unrecognized exposure to the endoscopist's face to potentially infectious biologic samples during endoscopy (5.6/100 days of endoscopy). This exposure may result in transmission of infectious diseases. As such, we recommend the use of universal facial protection during GI endoscopy.

The microbial quality of food contact surfaces in the food preparation facilities is an indication of their hygiene status. The objective of this study was to assess the hygiene status and the incidence of pathogens of food contact surfaces in the food preparation facilities of schools offering school feeding programs in the Mpumalanga Province, South Africa. 192 swab samples were collected by swabbing 100 cm2 areas of food contact surfaces in the food preparation facilities of randomly selected schools. Only 16.2% of the food contact surfaces had satisfactory hygiene status in which the surface aerobic colony counts were less than 2 log cfu/cm2. Only 3% and 6% of the benchtop and dry storage surfaces respectively had a satisfactory hygiene status. Listeria monocytogenes and Staphylococcus aureus were the most detected pathogen on food contact surfaces with 53.1% and 25.5% incidences. There was a strong significant positive correlation between the occurrence of L. monocytogenes on dry storage surfaces and benchtop (rho = 0.539**, p = 0.01), cutting board (rho = 0.541**, p = 0.01), refrigerator handle (rho = 0.420*, p = 0.05), and sink faucet (rho = 0.498**, p = 0.01) surfaces. The Bacillus species was generally detected the most from aerobic growth isolates of food contact sources, among which Bacillus subtilis was the most abundant species identified. Most of the food contact surfaces in the food preparation facilities of schools offering school feeding programs were of unsatisfactory hygiene status and constituted a food safety risk to schoolchildren consuming meals at school.

Summary Background Infection occurs in 2–4% of arthroplasty cases, and identifying potential sources of infection can help to reduce infection rates. The aim of this study was to identify the impact and potential for the contamination of hands and gowns whilst scrubbing using sterile surgical helmet systems (SSHSs). Methods A colony-forming unit (cfu) is a pathogenic particle of 0.5–5 μm. Standard arthroplasty hoods and SSHSs, with and without the fan switched on, were tested for a 3-min exposure (to represent scrubbing time) on three subjects and a mannequin with concurrent particle counts and culture plates. Results All SSHSs were positive for Gram-positive cocci, with a mean colony count of 410 cfu/m2. Background counts were lower for laminar flow areas [mean 0.7 particles/m3; 95% confidence interval (CI) 0–1.4] than scrub areas (mean 131.5 particles/m3; 95% CI 123.5–137.9; P=0.0003). However, neither grew any bacteria with a 2-min exposure. The background count increased 3.7 times with the fan switched on (total P=0.004, cfu P=0.047), and all helmets had positive cultures (mean 36 cfu/m2). There were no positive cultures with the standard arthroplasty hood or the SSHS with the fan switched off. In laminar flow areas, all cultures were negative and particle counts were low. Conclusions Sterile gloves and gowns can be contaminated when scrubbing with the SSHS fan switched on. It is recommended that the fan should remain switched off when scrubbing until the hood and gown are in place, ideally in a laminar flow environment.