Understanding the significance of microbiota recovered from health care surfaces

BACKGROUND

Microbial contamination of hospital surfaces remains despite adherence to routine disinfection. Our study demonstrates bioburden from various types of hospital high-touch surfaces and the pathogenicity of all bacteria recovered.

METHODS

Several high-touch hospital surfaces from a single medical-surgical unit were sampled and cultured using replicate organism detection and counting (RODAC) Tryptic Soy agar plates. Colonies were then subcultured to blood agar plates and speciated using MALDI-TOF. The local microbiology laboratory database was queried for any clinical isolate match with the environmental samples recovered.

RESULTS

Manikins, bed rails, and workstations-on-wheels were the most contaminated surfaces with the largest variety of bacteria isolated from manikins and bed rails. A total of 60 different types of pathogens were isolated, 18 of which were well-known pathogens, and 7 were classified as important in the health care setting by CDC. Our clinical microbiology laboratory identified 29 of 60 hospital surface bacteria in clinical isolates. Urine, soft tissue, and blood were the most common sources of clinical isolates.

CONCLUSIONS

Surfaces in the health care environment harbor both well-known and not-so-well-known human pathogens. Several not-so-well-known pathogens are skin flora or environmental bacteria, which in the right setting, can become pathogenic and cause diseases including meningitis, brain abscess, endocarditis, and bacteremia.

Campylobacter coli bacteremia associated with diarrhea

Campylobacter coli (C. coli) is a gram negative, non-spore forming, mobile, curved, or spiral-shaped rod organisms and one of the most common gastrointestinal human pathogens. Campylobacter very rarely causes bacteremia. However, there are reports of bloodstream infection of C. coli and most of the Campylobacterbacteremia have been found among immunocompromised patients. In this study, a case of C. coli blood stream infection that was associated with diarrhea in an immunocompetent patient.

[Functional study in children with repaired esophageal atresia]

Esophageal atresia Type III was repaired in 8 children 5-11 y/o. All had stenosis in the esophagus diagnosed by radiology and endoscopy after surgical correction. Dilation was performed until normal lumen was obtained. Motor disfunction in upper and middle part of the esophagus was evidenced in six by manometry. Our findings are suggestive that Esophageal manometry is indicated in the evaluation of repaired esophageal atresia.

[Measurement of cardia and pylorus distance by endoscopy in children]

We performed upper gastrointestinal endoscopy in 258 children. We measured the distance from the teeth to cardias and pylorus and found, that height correlated with distance from then teeth to cardias.

[Measurement of esophageal pH during 24 hours in children. Preliminary report]

A preliminary report is presented regarding the 24 hours continuous pH monitoring of 40 patients from 1 month to 19 years of age with clinical features of gastro-esophageal reflux confirmed by at least one of the diagnostic methods utilized (radiology, endoscopy, esophageal biopsy). The equipment used was a MIC GASTROGRAPH with 1.2 and 3 mm catheters according to age and using the methodology suggested by ESPGAN. Patients with reflux index of more than 10% had all other pH indexes and other diagnostic methods abnormal. The area of the curve below pH 4 correlated directly with the presence of esophagitis. Patients with post history of esophageal atresia and caustic esophagitis had marked alterations of pH. PH monitoring with the modern methodology currently available is of great help to quantify severity of acid reflux, to distinguish between physiologic pathologic reflux and to decide treatment.

[Chronic caustic esophagitis in childhood. A functional study]

The purpose of this study was to investigate the motor function of the esophagus in patients with chronic caustic esophagitis. We evaluated 7 patients between 2 and 10 years of age, who had ingested caustics between 15 months and 3 years of age. The method we used was radiology with fluoroscopy vision and manometry. There was no correlation between radiologic and manometric findings. Esophageal transit was normal in all patients, even in those that had small stenosis while manometry showed motor disfunction in patients with severe esophageal damage.

[The usefulness of biofeedback in children with encopresis. A preliminary report]

Children with encopresis (costiveness) have a social problem, and (BFB) offers them a valid therapeutic alternative. The present prospective study compares the advantages of this technique with conventional treatment in 21 patients, with average ages of 10.13 and 8.54 years in each group. The patients were studied by clinical, manometric and electromyographic parameters. Those treated with BFB showed clinical improvement, with manometric significant enhancement (p < 0.001) of the percentage of internal anal sphincter (IAE) relaxation, relaxation interval of the IAE and rectal sensation threshold (RST), on the other hand, patients treated by conventional therapy only improved the RST (p < 0.01). Biofeedback seems useful in the treatment of the child with encopresis.

[The Alagille syndrome. Apropos 3 cases]

The clinical, biochemical, and histopathological characteristics of three patients who had jaundice and other findings suggestive of the syndrome are reported. Studies showed the presence of hypoplasia of the intrahepatic biliary ducts associated with facial, vertebral, cardiovascular, and eye abnormalities and a delay in the weight-height development. This group of abnormalities establish the Alagille syndrome, an entity which has not, until now, been extensively studied in our country.