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jueves, 14 de noviembre de 2019

CDC’s Antibiotic Resistance Threats in the United States, 2019


DOWNLOAD REPORT
CDC’s Antibiotic Resistance Threats in the United States, 2019 (2019 AR Threats Report) includes the latest national death and infection estimates that underscore the continued threat of antibiotic resistance in the U.S.
According to the report, more than 2.8 million antibiotic-resistant infections occur in the U.S. each year, and more than 35,000 people die as a result. In addition, 223,900 cases of Clostridioides difficile occurred in 2017 and at least 12,800 people died.
Dedicated prevention and infection control efforts in the U.S. are working to reduce the number of infections and deaths caused by antibiotic-resistant germs, but the number of people facing antibiotic resistance is still too high. More action is needed to fully protect people.
CDC is concerned about rising resistant infections in the community, which can put more people at risk, make spread more difficult to identify and contain, and threaten the progress made to protect patients in healthcare. The emergence and spread of new forms of resistance remains a concern.
The report lists 18 antibiotic-resistant bacteria and fungi into three categories based on level of concern to human health—urgent, serious, and concerning—and highlights:

  • Estimated infections and deaths since the 2013 report
  • Aggressive actions taken
  • Gaps slowing progress

The report also includes a Watch List with three threats that have not spread resistance widely in the U.S. but could become common without a continued aggressive approach.
REFERENCE:
Biggest Threats and Data. CDC 2019. https://www.cdc.gov/drugresistance/biggest-threats.html

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miércoles, 13 de noviembre de 2019

#BOOK: Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases

200 pages | 6 x 9
ISBNs:
Paperback: 978-0-309-16254-8
Ebook: 978-0-309-21429-2
In 2008, the Institute of Medicine (IOM) published the report Preparing for an Influenza Pandemic: Personal Protective Equipment for Healthcare Workers. At the time of that report, the major influenza-related concern was avian influenza (H5N1). As novel H1N1 influenza A became a reality in 2009, the many unknowns about the virulence, spread, and nature of the virus raised to the forefront issues regarding personal protective equipment (PPE) for healthcare personnel. A major issue was the nature of respiratory protection required because much remains to be learned about the mechanisms of influenza transmission. This report comes at a time when controversies continue on issues related to PPE for healthcare personnel, while at the same time, new horizons in PPE research and attention to PPE innovations offer promise of improvements in healthcare worker safety. Keeping the research momentum going is critical, because between pandemics the focus of research efforts often moves to other issues and the nation remains underprepared.
CONTENT:

  1. Introduction
  2. Understanding the Risk to Healthcare Personnel
  3. Designing and Engineering Effective PPE
  4. Using PPE: Individual and Organizational Issues
  5. Policy Research and Implementation: Healthcare Systems, Standards, and Certification

REFERENCE:
Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press.

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martes, 12 de noviembre de 2019

COURSE: Pandemic influenza- Introduction

Overview: Pandemic influenza is an acute viral disease of the respiratory tract. It occurs when an influenza virus that was not previously circulating among people and to which most people have no immunity emerges and transmits among people. This course provides a general introduction to the disease through a short video lecture and quizzes to test your knowledge. It targets personnel preparing to respond to pandemic influenza outbreaks, including medical professionals, public health officials, incident managers and risk communication experts.
Learning objective: By the end of this course, participants should be able to:

  • describe transmission, symptoms and treatment for pandemic influenza;
  • introduce key pharmaceutical and non-pharmaceutical interventions; and
  • understand influenza pandemic phases and key public health challenges.

Course duration: Approximately 1 hour.
Certificates: No certificate available at this time.
Self-paced
Language: English
Basic (Basique)

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lunes, 11 de noviembre de 2019

Correlating Penetration with Biofilm Activity and Viability

Disinfectant biofilm penetration and its effect on biofilm aerobic activity and viability are still unclear. In this study, free chlorine and monochloramine were applied until full biofilm penetration occurred, and their effects on biofilm aerobic activity and viability were investigated in three–dimensions throughout the entire biofilm depth, extending previous work where viability analysis was limited to the upper biofilm (50 μm depth), free chlorine penetration did not reach completion, and only one–dimensional (depth) profiles were obtained. The free chlorine and monochloramine biofilm concentration profiles were correlated spatially and temporally with aerobic microbial activity and cell–membrane integrity based viability using a combination of (1) microelectrode measurements for disinfectant penetration and (2) Live/Dead BacLight staining, cryo–cross–sectioning, and confocal micrographs analysis for viability measurements throughout the entire biofilm depth. Compared to monochloramine, free chlorine penetration (1) was slower, (2) led to a greater decrease in biofilm thickness from sloughing, and (3) corresponded directly with a viability decrease. In addition, biofilm heterogeneity led to minor differences in either disinfectant’s biofilm penetration, and prior biofilm exposure to monochloramine provided little impact to subsequent free chlorine biofilm penetration.
REFERENCE:
Lee WH, Pressman JG, Wahman DG. Three-Dimensional Free Chlorine and Monochloramine Biofilm Penetration: Correlating Penetration with Biofilm Activity and Viability. Environ Sci Technol. 2018;52(4):1889–1898. doi:10.1021/acs.est.7b05215


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jueves, 7 de noviembre de 2019

Surveillance of laboratory exposures to human pathogens and toxins: Canada 2018.

BACKGROUND: The Laboratory Incident Notification Canada (LINC) surveillance system monitors laboratory incidents reported under the Human Pathogens and Toxins Act. The year 2018 marks the third complete year of data.
OBJECTIVE: To describe the laboratory exposure and laboratory-acquired infection incidents that occurred in Canada in 2018 compared to previous years, and then by sector, human pathogens and toxins involved, number of affected persons, incident type and root causes.
METHODS: Laboratory incidents that occurred in 2018 were reported through the LINC system. The number of laboratory incidents, people exposed and laboratory-acquired infections were compared to previous years, then the incidents were analyzed by sector, human pathogen or toxin involved, the type of incident, people exposed, route of exposure and root causes. Microsoft Excel 2016 was used for descriptive analysis.
RESULTS: In 2018, there were 89 exposure incidents to human pathogens and 235 people were exposed. There were five suspected and one confirmed laboratory-acquired infections. This was approximately twice the number of exposure incidents that were reported in 2017 (n=44) and 2016 (n=46). The highest number of exposure incidents occurred in the academic and hospital sectors, and the ratio of incidence to licences was the lowest in the private sector. The majority of incidents (n=50; 56%) involved Risk Group 2 human pathogens that were manipulated in a Containment Level 2 laboratory. Most exposures were related to sharps or procedures and the most common people exposed were laboratory technicians. Human interaction and standard operating procedures were the leading root causes.
CONCLUSION: Although overall the annual incidence of laboratory exposures in Canada remains relatively low, the incidence was higher in 2018 than in previous years. Whether this is a true increase in incidence or an increase in reporting is not known at this time as baseline estimates are still being established.
REFERENCE:
Choucrallah, D et al. Surveillance of laboratory exposures to human pathogens and toxins: Canada 2018. Canada communicable disease report = Releve des maladies transmissibles au Canada vol. 45,9 244-251. 5 Sep. 2019, doi:10.14745/ccdr.v45i09a04

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miércoles, 6 de noviembre de 2019

#BOOK: The Use and Effectiveness of Powered Air Purifying Respirators in Health Care

80 pages | 6 x 9
ISBNs:
Paperback: 978-0-309-31595-1
Ebook: 978-0-309-31598-2
Protecting 18 million United States health care workers from infectious agents - known and unknown - involves a range of occupational safety and health measures that include identifying and using appropriate protective equipment. The 2009 H1N1 influenza pandemic and the 2014 Ebola virus outbreak in West Africa have called raised questions about how best to ensure appropriate and effective use of different kinds of personal protective equipment such as respirators, not only to promote occupational safety but also to reduce disease transmission.
The Use and Effectiveness of Powered Air Purifying Respirators in Health Care is the summary of a workshop convened by the Institute of Medicine Standing Committee on Personal Protective Equipment for Workplace Safety and Health to explore the current state of practices and research related to powered air purifying respirator (PAPRs) and potential updates to performance requirements. Presentations and discussions highlighted current health care practices using PAPRs and outlined the research to date on the use and effectiveness of PAPRs in health care settings with a focus on the performance requirements. The Use and Effectiveness of Powered Air Purifying Respirators in Health Care focuses on efficacy, current training, maintenance, supplies, and possible enhancements and barriers to use in inpatient, clinic, nursing home, and community (home) settings. This report also explores the strengths and weaknesses of using various approaches to health care PAPR standards.
REFERENCE:
Institute of Medicine. 2015. The Use and Effectiveness of Powered Air Purifying Respirators in Health Care: Workshop Summary. Washington, DC: The National Academies Press. https://doi.org/10.17226/18990.

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martes, 5 de noviembre de 2019

Managing epidemics

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This manual provides concise and up-to-date knowledge on 15 infectious diseases that have the potential to become international threats, and tips on how to respond to each of them.
The 21st century has already been marked by major epidemics. Old diseases - cholera, plague and yellow fever - have returned, and new ones have emerged - SARS, pandemic influenza, MERS, Ebola and Zika. These epidemics and their impact on global public health have convinced the world's governments of the need for a collective and coordinated defense against emerging public health threats and accelerated the revision of the International Health Regulations (2005), entered into force in 2007. Another Ebola epidemic, another plague epidemic or a new influenza pandemic are not mere probabilities, the threat is real. Whether transmitted by mosquitoes, other insects, via contact with animals or person-to-person, the only major uncertainty is when and where they, or a new, but equally lethal epidemic, will emerge. These diseases all have the potential to spread internationally highlighting the importance of immediate and coordinated response. The diseases covered are: Ebola virus disease, lassa fever, Crimean-Congo haemorrhagic fever, yellow fever, Zika, chikungunya, avian and other zoonotic influenza, seasonal influenza, pandemic influenza, Middle-East respiratory syndrome (MERS), cholera, monkeypox, plague, leptospirosis and meningococcal meningitis. Although originally developed as guidance for WHO officials, this publication is available to a wide readership including all frontline responders - communities, government officials, non-State actors and public health professionals - who need to respond rapidly and effectively when an outbreak is detected.
REFERENCE:
Managing epidemics: Key facts about major deadly diseasesAuthors: World Health Organization
Number of pages: 255 Publication date: May 2018 Languages: English
ISBN: 978-92-4-156553-0

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lunes, 4 de noviembre de 2019

A cryogel-based bioreactor for water treatment applications


The aim of this study was to develop and test a non-diffusion limited, high cell density bioreactor for biodegradation of various phenol derivatives. The bioreactor was obtained using a straightforward one-step preparation method using cryostructuration and direct cross-linking of bacteria into a 3D structured (sponge-like) macroporous cryogel composite material consisting of 11.6% (by mass) cells and 1.2-1.7% polymer, with approximately 87% water (in the material pores). The macroporous cryogel composite material, composed of live bacteria, has pore sizes in the range of 20-150 μm (confirmed by SEM and Laser Scanning Confocal Microscopy). The enzymatic activity of bacteria within the cryogel structure and the effect of freezing on the viability of the cross-linked cells was estimated by MTT assay. Cryogels based on Pseudomonas mendocina, Rhodococcus koreensis and Acinetobacter radioresistens were exploited for the effective bioremediation of phenol and m-cresol, and to a lesser extent 2-chlorophenol and 4-chlorophenol, utilising these phenolic contaminants in water as their only source of carbon. For evaluation of treatment scalability the bioreactors were prepared in plastic "Kaldnes" carriers to improve their mechanical properties and allow application in batch or fluidised bed water treatment modes.
REFERENCE:
Berillo DA, et al. A cryogel-based bioreactor for water treatment applications. Water Res. 2019 Apr 15;153:324-334. doi: 10.1016/j.watres.2019.01.028. Epub 2019 Jan 31. PubMed PMID: 30739074.

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viernes, 1 de noviembre de 2019

#BOOK: Global Guidelines for the Prevention of Surgical Site Infection

The first ever Global guidelines for the prevention of surgical site infection () were published on 3 November 2016, then updated in some parts and published in a new edition in December 2018. They include a list of 29 concrete recommendations on 23 topics for the prevention of SSI in the pre-, intra and postoperative periods, which are based on 28 systematic reviews of the evidence.
For the 2018 update, the membership of the guidelines development group () was broadened to include an additional eight anaesthesiology experts. The 2018 edition of the guidelines includes the revision of the recommendation regarding the use of 80% fraction of inspired oxygen (high ) in surgical patients under general anaesthesia with tracheal intubation and the update of the section on implementation. Between 2017 and 2018,  re-assessed the evidence on the use of high FiO2 by updating the systematic review related to the effectiveness of this intervention to reduce  and commissioning an independent systematic review on adverse events potentially associated with it. Based on the updated evidence, the GDG decided to revise the strength of the recommendation from strong to conditional.
REFERENCIA:
Global Guidelines for the Prevention of Surgical Site Infection. Geneva: World Health Organization; 2018. ISBN 978-92-4-155047-5. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536404/ 

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jueves, 31 de octubre de 2019

Días de Muertos, Noviembre 1 y 2

En México, la tradición del Día de Muertos surge como parte del sincretismo religioso, en la época colonial. Durante la etapa prehispánica, el culto a la muerte estuvo presente en distintas culturas a lo largo y ancho de México. El día 1° de noviembre, se celebra el Día de Todos los Santos de acuerdo a la tradición católica. En esta fecha se recuerdan a todos aquellos que murieron sin ser beatos y santos, además de quienes fallecieron a temprana edad como los niños. De acuerdo a la religión católica, el Día de los Fieles Difuntos que tiene lugar el 2 de noviembre, se realiza una oración por aquellos que no han accedido al paraíso. En México, las tradiciones de esta celebración incluyen visitar a los seres queridos que ya partieron en los cementerios y preparar altares con alimentos, veladoras, incienso, fotografías y flores para recordarlos. Es solo durante estos días que las almas de los seres queridos pueden volver del más allá para estar cerca de los suyos.
FUENTE

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miércoles, 30 de octubre de 2019

#BOOK: Reusable Elastomeric Respirators in Health Care

226 pages | 6 x 9
ISBNs:
Paperback: 978-0-309-48515-9
Ebook: 978-0-309-48518-0
Protecting the health and safety of health care workers is vital to the health of each of us. Preparing for and responding to a future influenza pandemic or to a sustained outbreak of an airborne transmissible disease requires a high-level commitment to respiratory protection for health care workers across the wide range of settings in which they work and the jobs that they perform. Keeping health care workers healthy is an ethical commitment both in terms of addressing the occupational risks faced by health care workers and of providing for the continuity of patient care and services needed to maintain the health of individuals and communities.
During a public health emergency, challenges will arise concerning the availability of respiratory protective devices (i.e., respirators). Reusable respirators (specifically, reusable half-facepiece elastomeric respirators) are the standard respiratory protection device used in many industries, and they provide an option for use in health care that has to date not been fully explored. The durability and reusability of elastomeric respirators make them desirable for stockpiling for emergencies, where the need for large volumes of respirators can be anticipated. However, they are used infrequently in health care.
Reusable Elastomeric Respirators in Health Care explores the potential for the use of elastomeric respirators in the U.S. health care system with a focus on the economic, policy, and implementation challenges and opportunities. This report examines the practicability of elastomeric use in health care on a routine basis and during an influenza pandemic or other large aerosol-transmissible outbreak, when demand for respiratory protective devices by U.S. health care personnel may be larger than domestic supplies. The report also addresses the issues regarding emergency stockpile management of elastomeric respiratory protective devices.
REFERENCE:
National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. https://doi.org/10.17226/25275.

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martes, 29 de octubre de 2019

Intervención educativa en trabajadores de limpieza en áreas de investigación

Objetivo. Evaluar los resultados de una intervención educativa sobre salud y seguridad laboral bajo principios de bioseguridad en trabajadores y trabajadoras de limpieza de una institución de salud. Material y métodos. Evaluación con métodos mixtos concurrentes sobre conocimientos, actitudes y prácticas en bioseguridad y percepción de riesgos, con medición basal y dos seguimientos, en 31 trabajadores y trabajadoras. Se realizaron modelos fraccionales separados para estimar interacciones de las mediciones. Se hizo análisis cualitativo temático y triangulación metodológica. Resultados. Los conocimientos (+33.3 puntos, escala 0 - 100), actitudes (+10.6) y prácticas (+23.5) incrementaron significativamente en el primer seguimiento; los conocimientos disminuyeron en el segundo seguimiento (p<0.001). Los hallazgos cualitativos revelaron mejora en actitudes y prácticas de prevención frente al riesgo, enmarcados por experiencias de vulnerabilidad, estigma y discriminación. Conclusiones. El estudio aporta elementos clave para la investigación en bioseguridad relacionada con grupos vulnerables y es efectivo para la promoción de la salud de un sector desfavorecido e invisibilizado.
REFERENCIA:
Parra-Tapia E, Perales-Ortiz G, Quezada AD, Torres-Pereda P. Salud y seguridad laboral: intervención educativa en trabajadores de limpieza en áreas de investigación. Salud Publica Mex. 2019;61:657-669. https://doi.org/10.21149/10026

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Reduced Effectiveness of Current Hand Hygiene against mucus with #Influenza Virus

IMPORTANCE: Antiseptic hand rubbing (AHR) and antiseptic hand washing (AHW) are important to prevent the spread of influenza A virus (IAV). This study elucidated the situations/mechanisms underlying the reduced efficacy of AHR against infectious mucus derived from IAV-infected individuals and indicated the weaknesses of the current hand hygiene regimens. Due to the low rate of diffusion/convection because of the physical properties of mucus as a hydrogel, the efficacy of AHR using ethanol-based disinfectant against mucus is greatly reduced until infectious mucus adhering to the hands/fingers has completely dried. If there is insufficient time before treating the next patient (i.e., if the infectious mucus is not completely dry), medical staff should be aware that effectiveness of AHR is reduced. Since AHW is effective against both dry and nondry infectious mucus, AHW should be adopted to compensate for these weaknesses of AHR.
REFERENCE:
Hirose R, et al. Situations Leading to Reduced Effectiveness of Current Hand Hygiene against Infectious Mucus from Influenza Virus-Infected Patients. mSphere. 2019 Sep 18;4(5). pii: e00474-19. doi: 10.1128/mSphere.00474-19. PubMed PMID: 31533996; PubMed Central PMCID: PMC6751490.

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lunes, 28 de octubre de 2019

Tratamiento de una infección por el virus de la Vaccinia de un pinchazo profesional

¿Qué se sabe sobre este tema?
La exposición accidental al virus Vaccinia, un ortopoxvirus utilizado en la investigación biomédica, puede causar lesiones considerables y pérdida de tiempo en el trabajo. Se recomienda la vacunación para los laboratorios que utilizan el virus vaccinia competente en replicación; sin embargo, los laboratorios establecen sus propias políticas.
¿Qué agrega este informe?
El tecovirimat, un nuevo antiviral aprobado para el tratamiento de la viruela, y la inmunoglobulina vaccinia se usaron para tratar de manera segura una exposición ocupacional en un laboratorio no vacunado que fue excluido del trabajo durante 4 meses.
¿Cuáles son las implicaciones para la práctica de la salud pública?
Los laboratorios deben asegurarse de que los trabajadores estén informados sobre los riesgos asociados con la manipulación del virus vaccinia y deben aconsejar a los trabajadores sobre los beneficios potenciales de la vacunación recibida de acuerdo con las pautas actuales.

REFERENCIA:
Whitehouse ER, Rao AK, Yu YC, et al. Novel Treatment of a Vaccinia Virus Infection from an Occupational Needlestick — San Diego, California, 2019. MMWR Morb Mortal Wkly Rep 2019;68:943–946. DOI: http://dx.doi.org/10.15585/mmwr.mm6842a2

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sábado, 26 de octubre de 2019

Survival of Microorganisms on N95 masks

Bioaerosol is a threat at workplaces, therefore the selection and safe use of filtering facepiece respirators (FFRs) is important in preventive activities. The aim of the study was to assess the survival of microorganisms on materials used for FFRs construction. The parameters for microorganism growth under model conditions were described using the Gompertz equation, model verification was also carried out using FFRs at the farmers’ workplaces. We found that the factors determining a high survival of microorganisms were as follows: moisture corresponding to the conditions of use and storage of FFRs at workplaces, the presence of sweat and organic dust; inorganic dust and addition of biocide in nonwovens limited the growth of microorganisms, resulting in a shortening of the stationary growth phase and decreased cell numbers (5–6 log). Dust concentration at workplaces was higher than EU occupational exposure limit values and WHO recommendations for airborne particulate matter. Microbial contaminations of the air (103–104 CFU/m3), settled dust (104–106 CFU/g) and FFRs (105 CFU/4cm2) during the grain harvest were high, the main contamination being bacteria (actinomycetes, Pseudomonas fluorescens) and xerophilic fungi. A high correlation was found between the number of microorganisms and the weight of dust on FFRs (R2 = 0.93–0.96).
REFERENCE:
Jachowicz A, et al. Survival of Microorganisms on Filtering Respiratory Protective Devices Used at Agricultural Facilities. Int J Environ Res Public Health. 2019;16(16):2819. Published 2019 Aug 7. doi:10.3390/ijerph16162819

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