Assessing the Hawthorne effect on hand hygiene compliance in an intensive care unit.

Background: The influence of the Hawthorne effect on hand hygiene compliance in an intensive care unit was assessed using covert and overt direct observation.

Methods: The observational study was conducted from February to November 2018 in a 24-bed adult intensive care unit in a 243-bed tertiary care hospital, in four periods (P): P-1, February 5-March 3, 29 h (covert) and P-2, March 15-April 16, 33 h (overt), prior to an educational campaign on hand hygiene; and P-3, August 27-September 28, 33 h (covert) and P-4, October 3-November 6, 35 h (overt), after the campaign. Three 20-min observation sessions were performed daily, randomly distributed in the morning, afternoon and evening shifts, including holidays and weekends.

Synergistic activity of polymyxin B combined with vancomycin against carbapenem-resistant and polymyxin-resistant Acinetobacter baumannii: first in vitro study.

Purpose: The effect of a combination of polymyxin B (PMB) and vancomycin (VAN) was assessed against six Acinetobacter baumannii clinical isolates belonging to six different clusters (three PMB-susceptible and three PMB-resistant).

Methodology: The synergistic effect of the PMB-VAN combination was determined with the checkerboard, time-kill, disk-diffusion and M.I.

What does the susceptible-dose dependent interpretive category for cefepime in ESBL-producing bacteria?

In this study, we investigated the frequency of isolates included in the susceptible-dose dependent (SDD) category, according to the Clinical and Laboratory Standards Institute guidelines, carrying bla, bla and bla genes among 92 Klebsiella pneumoniae and 80 Enterobacter cloacae clinical isolates. The presence of one or more extended-spectrum β-lactamases (ESBLs) genes was observed in 64% K. pneumoniae and 69% E.

Strategies for the treatment of polymyxin B-resistant Acinetobacter baumannii infections.

In this study, the activity of meropenem (MEM), fosfomycin (FOF) and polymyxin B (PMB), alone and in combination, was analysed. In addition, optimisation of the pharmacodynamic index of MEM and FOF against six isolates of OXA-23-producing Acinetobacter baumannii (including three resistant to PMB) that were not clonally related was assessed. Antimicrobial combinations were evaluated by chequerboard analysis and were considered synergistic when the fractional inhibitory concentration index (FICI) was ≤0.

ISAba1/blaOXA-23: A serious obstacle to controlling the spread and treatment of Acinetobacter baumannii strains.

This study demonstrated a direct correlation between Acinetobacter baumannii clusters carrying the ISAba1/blaOXA-23 gene and increased minimal inhibitory concentrations for carbapenems and greater clonal diversity. Our findings showed that clusters carrying ISAba1 are widely distributed in our hospital, further complicating the treatment and control of infections caused by A baumannii.

A rapid and simple method to detect ESBL in Enterobacter cloacae based on MIC of cefepime.

Introduction: The aim of this study was to identify a rapid and simple phenotypic method for extended-spectrum β-lactamase (ESBL) detection in Enterobacter cloacae.

Methods: A total of 79 consecutive, non-repeated samples of E. cloacae were evaluated.

Can ampicillin/sulbactam resistance in Acinetobacter baumannii be predicted accurately by disk diffusion?

The objective of this study was to compare the performance of disk diffusion and agar dilution for the determination of susceptibility to ampicillin/sulbactam (SAM), ceftazidime, cefepime, imipenem, meropenem, polymyxin B and tigecycline of 121 Acinetobacter baumannii clinical isolates. The antimicrobial susceptibility testing methods were performed as recommended by the Clinical and Laboratory Standards Institute (CLSI). For SAM, in addition the Etest method was performed according to the manufacturer's instructions.

In vitro activity of polymyxins in combination with β-lactams against clinical strains of Pseudomonas aeruginosa.

The emergence of multidrug-resistant (MDR) strains has made it difficult to treat infections caused by Pseudomonas aeruginosa. In order to develop new alternative therapies for the treatment of MDR P. aeruginosa infections, the antimicrobial activities of different antibiotic combinations have been studied in vitro and in vivo.

Nasal carriage of methicillin-resistant Staphylococcus aureus in university students.

In a study of university students, the percentage nasal carriage of Staphylococcus aureus was 40.8% (102/250). Of the isolates, MIC(50) of methicillin was 0.

High prevalence of children colonized with penicillin-resistant Streptococcus pneumoniae in public day-care centers.

Objectives: To investigate the prevalence of Streptococcus pneumoniae (pneumococci) in the nasopharynx of healthy children enrolled in public day-care centers of the municipality of Umuarama, state of Paraná, Brazil. The susceptibility of the pneumococcal strains to antimicrobial agents was also studied.

Methods: Nasopharyngeal specimens from 212 children were collected from April to October 2008.

Comparison of 3 alcohol gels and 70% ethyl alcohol for hand hygiene.

In a laboratory study, we demonstrated that 3 alcohol-based hand gels, commercially available in Brazil, were as effective as the traditional 70% ethyl alcohol (by weight) in removing clinical isolates of methicillin-resistant Staphylococcus aureus, Serratia marcescens, and Candida albicans from heavily contaminated hands of human volunteers.

Preliminary evaluation of adherence on abiotic and cellular surfaces of Acinetobacter baumannii strains isolated from catheter tips.

The cell surface hydrophobicity and adhesion to abiotic and cellular surfaces was tested in five clinical strains of Acinetobacter baumannii isolated from catheter tips. Biochemical and molecular characteristics of these strains were also studied. Hydrophobicity was characterized by a test for affinity to xylene.

Improved laboratory safety by decontamination of unstained sputum smears for acid-fast microscopy.

Tubercle bacilli may survive in unstained heat-fixed sputum smears and may be an infection risk to laboratory staff. We compared the effectiveness of 1% and 5% sodium hypochlorite, 5% phenol, 2% glutaraldehyde, and 3.7% formalin in killing Mycobacterium tuberculosis present in smears prepared from 51 sputum samples.

Effect of plaque accumulation and salivary factors on enamel demineralization and plaque composition in situ.

This study evaluated the effect of some plaque and salivary factors on caries progression in situ. The salivary secretion rate, buffering capacity and mutans streptococci counts from 13 volunteers were determined. For three distinct periods of time, 4, 7 and 10 days, each of them wore a palatal appliance containing 4 bovine enamel blocks.