The use of laboratory animals as experimental models of disease has been a critical tool for biomedical researchers for decades. Animal studies allow scientists to discover and understand the mechanism of infection and ultimately to develop effective treatment and prevention modalities. Workers who directly handle infectious microbes or infected laboratory animals are at risk of exposure while performing their assigned duties. A comprehensive biosafety program, led by a biosafety professional, is critical to properly protect workers and the surrounding community. Such a program includes a thorough understanding of the biohazard through formal risk assessment, implementation of effective biohazard controls, and extensive training of all personnel who are at risk of exposure.
The environmental mold Aspergillus fumigatus is the primary cause of invasive aspergillosis. In patients with high-risk conditions, including stem cell and organ transplant recipients, mortality exceeds 50%. Triazole antifungals have greatly improved survival (1); however, triazole-resistant A. fumigatus infections are increasingly reported worldwide and are associated with increased treatment failure and mortality (2). Of particular concern are resistant A. fumigatus isolates carrying either TR34/L98H or TR46/Y121F/T289A genetic resistance markers, which have been associated with environmental triazole fungicide use rather than previous patient exposure to antifungals (3,4). Reports of these triazole-resistant A. fumigatus strains have become common in Europe (2,3), but U.S. reports are limited (5). Because of the risk posed to immunocompromised patients, understanding the prevalence of such isolates in patients is important to guide clinical and public health decision-making. In 2011, CDC initiated passive laboratory monitoring for U.S. triazole-resistant A. fumigatus isolates through outreach to clinical laboratories. This system identified five TR34/L98H isolates collected from 2016 to 2017 (6), in addition to two other U.S. isolates collected in 2010 and 2014 and reported in 2015 (5). Four of these seven isolates were reported from Pennsylvania, two from Virginia, and one from California. Three isolates were collected from patients with invasive pulmonary aspergillosis, and four patients had no known previous triazole exposure. A. fumigatus resistant to all triazole medications is emerging in the United States, and clinicians and public health personnel need to be aware that resistant infections are possible even in patients not previously exposed to these medications.
OBJECTIVE: This cross-sectional observational study was designed to assess the biosafety conducts adopted by orthodontists, and possible differences regarding training time. METHODS: Both the application of methods for sterilization/disinfection of instruments and materials, and the use of personal protective equipment (PPE) were collected through questionnaires via e-mail. RESULTS: The questionnaires were answered by 90 orthodontists with a mean age of 37.19 ± 9.08 years and mean training time of 13.52 ± 6.84 years. Regarding orthodontic pliers, 63.23% use an autoclave, except 1 who does not perform any procedure. All participants use autoclave to sterilize instruments, and 95.6% of respondents perform cleaning with chemicals prior to sterilization. Most of them (65.56%) use an autoclave to sterilize orthodontic bands, with some still associating disinfection methods, while few (18.89%) do nothing at all. There was a high incidence of the answer "nothing" for the methods used for elastic, accessories, bandages, metal springs, and arches. All respondents use mask and gloves in attendance, 78.92% use aprons, 58.92% use protective goggles, and 50.01% use cap. Training time significantly influenced (p = 0.003) only the use of glutaraldehyde for sterilization/disinfection of pliers. CONCLUSIONS: The sterilization and cleaning of pliers, instruments, and bands, besides the use of PPE, received more uniform and positive responses, while other items suggest disagreements and possible failures. Only orthodontists trained for more than 13 years choose using glutaraldehyde for pliers sterilization/disinfection, the only adopted method with a significant difference in relation to training time.
| Vacuna | Enfermerdad que previene | A quién se aplica |
| Sabin | Poliomielitis | Niños y niñas menores de 5 años |
| Antihepatitis B | Hepatitis B | Niños y niñas menores de 5 años y adolescentes |
| Pentavalente acelular | Difteria, Tosferina, Tétanos, Poliomelitis y H. Influenzae | Niños y niñas menores 5 años |
| DPT | Difteria, Tosferina y Tétanos | Niños y niñas de 4 años |
| Rotavirus | Gastroenteritis causada por rotavirus | Niños y niñas menores de 1 año |
| Neumococica conjugada | Infecciones por neumococo | Niños y niñas de 2, 4 y 12 meses |
| Triple Viral SRP | Sarampión, Rubéola y Parotiditis | Niños y niñas de 1 y 6 años |
| TD | Tétanos y Difteria | Embarazadas, hombres y mujeres mayores de 12 años |
| SR | Sarampión, rubéola | Hombres y mujeres de 1 a 4 años |
