Introduction: Monitoring water quality in mobile dialysis (MD) services, assessing critical points and characterizing the risks inherent in the process, is essential to avoid risks to the patient's health. This study evaluated the microbiological quality of water in the MD of 36 hospitals with intensive treatment in the city of Rio de Janeiro. Methods: 204 water samples were collected from the points of entry to the network (NET), post-osmosis (PO) and dialysis solution (DS). The samples were evaluated for heterotrophic bacteria count, pathogen search, presence of endotoxins and aluminum content. Results: Bacterial contamination at 3 collection points in 36 hospitals was 30% (32/108); 42% from DS, 31% from PO and 17% from NET, with the presence of Pseudomonas aeruginosa, Stenotrophomonas maltophilia , Burkholderia cepacia and Ralstonia pickettii in the 3 points. Endotoxin concentrations above 0.25 EU/mL occurred in 77% of the samples (17/22) analyzed in the PO. In the aluminum content, values above 0.01 mg/L were presented in 47% (7/15) of PO samples and 27% (4/15) of NET samples. There is no specific legislation for water used in the MD; therefore, the limits of the RDC of the National Health Surveillance Agency (Anvisa) 11/2014 were used; which regulates conventional hemodialysis services. Conclusion: The results highlight the importance of evaluating water quality in MD services to ensure patient safety and support the sanitary monitoring of this process as a healthcare promoter.
Atividade antimicrobiana in vitro de produtos antissépticos por meio de técnica time killAnalysis of in vitro antimicrobial activity of antiseptics products by means of time kill assay RESUMOInúmeros agentes químicos (álcoois, iodóforos, clorexidina, etc.) são utilizados em laboratórios e indústrias. Ao contrário dos desinfetantes, não há padrões e critérios específicos para avaliar a atividade de antissépticos. Neste trabalho foi estudada a atividade antimicrobiana de antissépticos, utilizando-se o ensaio Time Kill (Hobson & Bolsen), que avalia a população de micro-organismos aeróbios em período de tempo específico, diante de agentes antimicrobianos. Foram avaliadas duas metodologias de recuperação dos microorganismos: filtração por membrana e semeadura em profundidade. A filtração por membrana foi menos sensível. A semeadura em profundidade demonstrou maior sensibilidade com maior contagem de colônias. De 25 amostras de produtos, os antissépticos à base de digluconato de clorexidina foram insatisfatórios e ineficazes para todas as cepas de micro-organismos de referência, correspondendo a 20 % das amostras analisadas. Estes produtos apresentaram-se satisfatórios frente às cepas de origem clínica. Portanto, estes produtos devem ser utilizados com cautela e estudos adicionais são necessários, pois são escassas as informações sobre sua eficácia. Os dados deste estudo poderão auxiliar as ações de vigilância sanitária e de saúde pública na elaboração de futuras legislações, pois estes produtos são encontrados no comércio, mas sem seguir nenhuma legislação específica. Palavras-chave. atividade antimicrobiana, antisséptico, tempo de morte, neutralização. ABSTRACTMany chemicals (alcohol, iodophor, chlorhexidine, etc) are used in laboratories and industries. Unlike disinfectants, no specific norms and criteria have been standardized for evaluating the antiseptics activity. This study analyzed the antimicrobial activity of antiseptics using Time Kill Test (Hobson & Bolsen). This assay assessed the evolution of a population of aerobic microorganisms in a specific period of time when tested against antimicrobial agents. Two different recovery methodologies were evaluated: membrane filtration and pour plate technique The membrane filtration assay was less sensitive. Pour plate technique showed high sensitivity with high colonies counts. Of 25 samples of products analyzed, only the chlorhexidine digluconate-based antiseptics were unsatisfactory, showing no efficacy on all reference micro-organisms strains, and corresponded to 20 % of analyzed samples. However, they were efficacious against clinical strains. Therefore, these products should be used with caution and further studies are needed, as data on its efficacy have still been scarce. These findings might give support to the health surveillance and public health in establishing the future legislation, as these products have been available on the market, but without following any specific legislation.
and two pitanga (Eugenia uniflora L.) were analyzed from two different cultivation sites. 75% of the samples studied were satisfactory for counting aerobic bacteria, 100% satisfactory for mold and yeast counts, and 83% satisfactory for bile tolerant bacteria. Samples of liquid soaps with extracts of medicinal plants grown in Pau da Fome showed 100% approval. Although unsatisfactory, all soaps were fit for use. After diagnosis, a training course was held on good manufacturing practices, focused on personal care and hygiene of the materials and workplace.
ABSTRACT. Hemodialysis water and dialysates are fundamental in the treatment of kidney disease. During just one hemodialysis session, 120 liters of dialysate are consumed. Thus, it is essential that the parameters of chemical and microbiological quality of the fluids used in dialysis systems are carefully observed. In this study, water samples were collected at 12 hospitals in the state of Rio de Janeiro. The samples were obtained at three points of fluid reservoirs: pre-, post-osmosis and dialysis solution. After collection, colony forming units (CFU), total coliforms and Escherichia coli 100 mL -1 were quantified. Later, isolated colonies and endotoxin content were identified by biochemical assays. Data about total aluminum levels per sample (mg L -1 ) were also obtained. Samples of all mobile dialysis services and points of collection were contaminated above the levels set out by national laws, in particular by Pseudomonas aeruginosa. Endotoxin levels were also above the recommended by current legislation (> 0.25 EU mL -1 ). Only three samples contained detectable levels of aluminum, which were found to be above the recommended values for the corresponding resolution (0.01 mg L -1 ). Finally, there were no observable amounts of total coliforms and E. coli 100 mL -1 sample. The data from this study are an important step forward in the standardization and control of chemical/microbiological quality of mobile dialysis services.Keywords: dialysis, hemodialysis units, dialysis solutions.Detecção de microrganismos, endotoxinas e alumínio em serviços de diálise móvel RESUMO. Águas de hemodiálise e dialisatos são peças fundamentais na terapêutica da doença renal. Durante apenas uma sessão de hemodiálise, são consumidos aproximadamente 120 litros de dialisato. Desta forma, é essencial que os parâmetros de qualidade microbiológica e química dos fluidos utilizados em sistemas de diálise sejam cuidadosamente observados. Neste trabalho, foram coletadas amostras de água em 12 hospitais do Estado do Rio de Janeiro. Amostras foram obtidas em pontos pré-osmose, pós-osmose e solução de diálise. Após coleção, quantificaram-se unidades formadoras de colônias (UFC), coliformes totais e Escherichia coli 100 mL ). Por fim, não foram encontradas quantidades observáveis de coliformes totais e E. coli 100 mL -1 de amostra. Dados de nosso estudo são importante avanço na padronização e controle de qualidade química/microbiológica em serviços de diálise móvel.Palavras-chave: diálise, unidades hospitalares de hemodiálise, soluções para diálise.
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