The microbiological contamination of the environment in independent healthcare facilities such as dental and general practitioner offices was poorly studied. The aims of this study were to describe qualitatively and quantitatively the bacterial and fungal contamination in these healthcare facilities and to analyze the antibiotic resistance of bacterial pathogens identified. Microbiological samples were taken from the surfaces of waiting, consulting, and sterilization rooms and from the air of waiting room of ten dental and general practitioner offices. Six surface samples were collected in each sampled room using agar contact plates and swabs. Indoor air samples were collected in waiting rooms using a single-stage impactor. Bacteria and fungi were cultured, then counted and identified. Antibiograms were performed to test the antibiotic susceptibility of bacterial pathogens. On the surfaces, median concentrations of bacteria and fungi were 126 (range: 0–1280) and 26 (range: 0–188) CFU/100 cm2, respectively. In indoor air, those concentrations were 403 (range: 118–732) and 327 (range: 32–806) CFU/m3, respectively. The main micro-organisms identified were Gram-positive cocci and filamentous fungi, including six ubiquitous genera: Micrococcus, Staphylococcus, Cladosporium, Penicillium, Aspergillus, and Alternaria. Some antibiotic-resistant bacteria were identified in general practitioner offices (penicillin- and erythromycin-resistant Staphylococcus aureus), but none in dental offices. The dental and general practitioner offices present a poor microbiological contamination with rare pathogenic micro-organisms.

Introduction Surgical tracheostomy (ST) and Percutaneous dilatational tracheostomy (PDT) are classified as high-risk aerosol-generating procedures and might lead to healthcare workers (HCW) infection. Albeit the COVID-19 strain slightly released since the vaccination era, preventing HCW from infection remains a major economical and medical concern. To date, there is no study monitoring particle emissions during ST and PDT in a clinical setting. The aim of this study was to monitor particle emissions during ST and PDT in a swine model. Methods A randomized animal study on swine model with induced acute respiratory distress syndrome (ARDS) was conducted. A dedicated room with controlled airflow was used to standardize the measurements obtained using an airborne optical particle counter. 6 ST and 6 PDT were performed in 12 pigs. Airborne particles (diameter of 0.5 to 3 μm) were continuously measured; video and audio data were recorded. The emission of particles was considered as significant if the number of particles increased beyond the normal variations of baseline particle contamination determinations in the room. These significant emissions were interpreted in the light of video and audio recordings. Duration of procedures, number of expiratory pauses, technical errors and adverse events were also analyzed. Results 10 procedures (5 ST and 5 PDT) were fully analyzable. There was no systematic aerosolization during procedures. However, in 1/5 ST and 4/5 PDT, minor leaks and some adverse events (cuff perforation in 1 ST and 1 PDT) occurred. Human factors were responsible for 1 aerosolization during 1 PDT procedure. ST duration was significantly shorter than PDT (8.6 ± 1.3 vs 15.6 ± 1.9 minutes) and required less expiratory pauses (1 vs 6.8 ± 1.2). Conclusions COVID-19 adaptations allow preventing for major aerosol leaks for both ST and PDT, contributing to preserving healthcare workers during COVID-19 outbreak, but failed to achieve a perfectly airtight procedure. However, with COVID-19 adaptations, PDT required more expiratory pauses and more time than ST. Human factors and adverse events may lead to aerosolization and might be more frequent in PDT.

We read with interest the commentary by Cantarella and Mazzolla to our article ''Augmentation of Scarred Vocal Folds With Centrifuged and Emulsified Autologous Fat Grafts.'' 1 First of all, we would like to thank the authors for thoroughly reviewing our work and for their pioneering work in the field of fat grafting. The fact that the article by Cantarella and Mazzola entitled ''Management of Vocal Fold Scars by Concurrent Nanofat and Microfat Grafting'' was not cited is due to the fact that our article was already finished by the time that theirs was published. 2 Therefore, although it was not mentioned in our article because their work had not been published yet, we absolutely recognize that the first published article to describe the use of centrifuged and emulsified fat for vocal fold augmentation belongs to them.Also, in our reference review, we unfortunately missed the article ''Vocal Fold Augmentation by Autologous Fat Injection With Lipostructure Procedure,'' published in 2005 by Cantarella et al, in which the use of centrifuged fat is described. 3 So, the sentence that mentions that it was not described until 2016 should be replaced by the citation of that article.Finally, the cited reference of 1983 is another erratum, as the reference that we intended to include was the article by Dedo and Rowe entitled ''Laryngeal Reconstruction in Acute and Chronic Injuries. '' 4 We strongly apologize for the inaccuracy of these details in our reference review; however, we are still proud to contribute to the knowledge of these techniques for the good of all patients suffering from this condition.