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      Staphylococcus aureus y la detección de portadores entre el personal que labora en la producción de parenterales: detection of carriers among the staff working in parenteral production Translated title: Staphylococcus aureus

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          Abstract

          En la producción de medicamentos estériles el personal se considera la principal fuente de contaminación, teniendo en cuenta los microorganismos y las partículas no vivientes que esparcen. El objetivo de nuestro trabajo es la detección de portadores de Staphylococcus aureus entre el personal que labora en la producción de parenterales, a quienes se les realizaron exudados nasofaríngeos. Se aislaron 50 cepas, de las cuales 6 fueron identificadas como este microorganismo, lo que representa el 12 %. Se aislaron además otros microorganismos a los que se les considera gérmenes patógenos por alojarse en esa zona. Los resultados obtenidos corroboran que es de suma importancia realizar este tipo de muestreo como parte del monitoreo del personal que labora en las áreas clasificadas de producción de formulaciones inyectables.

          Translated abstract

          Staff is the main cause of contamination in aseptic drug production process, due to microorganism and non viable particles. The goal of this paper is to isolate staphylococcus aureus strain from the staff working in clean rooms. Nasopharyngeal swabs were performed on this staff. 50 strains were isolated. Six were sthaphylococcus aureus, (12 %). Other microorganisms were isolated which are considered pathogen germens since they are located in the area. Results express how important personnel monitoring is as parts of the Environmental Monitoring Program in the Pharmaceutical Industry, mainly in aseptic process.

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          Methicillin-resistant Staphylococcus aureus disease in three communities.

          Methicillin-resistant Staphylococcus aureus (MRSA) infection has emerged in patients who do not have the established risk factors. The national burden and clinical effect of this novel presentation of MRSA disease are unclear. We evaluated MRSA infections in patients identified from population-based surveillance in Baltimore and Atlanta and from hospital-laboratory-based sentinel surveillance of 12 hospitals in Minnesota. Information was obtained by interviewing patients and by reviewing their medical records. Infections were classified as community-associated [correction] MRSA disease if no established risk factors were identified. From 2001 through 2002, 1647 cases of community-associated [correction] MRSA infection were reported, representing between 8 and 20 percent of all MRSA isolates. The annual disease incidence varied according to site (25.7 cases per 100,000 population in Atlanta vs. 18.0 per 100,000 in Baltimore) and was significantly higher among persons less than two years old than among those who were two years of age or older (relative risk, 1.51; 95 percent confidence interval, 1.19 to 1.92) and among blacks than among whites in Atlanta (age-adjusted relative risk, 2.74; 95 percent confidence interval, 2.44 to 3.07). Six percent of cases were invasive, and 77 percent involved skin and soft tissue. The infecting strain of MRSA was often (73 percent) resistant to prescribed antimicrobial agents. Among patients with skin or soft-tissue infections, therapy to which the infecting strain was resistant did not appear to be associated with adverse patient-reported outcomes. Overall, 23 percent of patients were hospitalized for the MRSA infection. Community-associated MRSA infections are now a common and serious problem. These infections usually involve the skin, especially among children, and hospitalization is common. Copyright 2005 Massachusetts Medical Society.
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            Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk.

            Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections in children have occurred primarily in individuals with recognized predisposing risks. Community-acquired MRSA infections in the absence of identified risk factors have been reported infrequently. To determine whether community-acquired MRSA infections in children with no identified predisposing risks are increasing and to define the spectrum of disease associated with MRSA isolation. Retrospective review of medical records. Hospitalized children with S aureus isolated between August 1988 and July 1990 (1988-1990) and between August 1993 and July 1995 (1993-1995). The University of Chicago Children's Hospital. Prevalence of community-acquired MRSA over time, infecting vs colonizing isolates, and risk factors for disease. The number of children hospitalized with community-acquired MRSA disease increased from 8 in 1988-1990 to 35 in 1993-1995. Moreover, the prevalence of community-acquired MRSA without identified risk increased from 10 per 100000 admissions in 1988-1990 to 259 per 100000 admissions in 1993-1995 (P<.001), and a greater proportion of isolates produced clinical infection. The clinical syndromes associated with MRSA in children without identified risk were similar to those associated with community-acquired methicillin-susceptible S aureus. Notably, 7 (70%) of 10 community-acquired MRSA isolates obtained from children with an identified risk were nonsusceptible to at least 2 drugs, compared with only 6 (24%) of 25 isolates obtained from children without an identified risk (P=.02). These findings demonstrate that the prevalence of community-acquired MRSA among children without identified risk factors is increasing.
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              Community-acquired, methicillin-resistant and methicillin-susceptible Staphylococcus aureus musculoskeletal infections in children.

              The clinical characteristics and virulence factors related to musculoskeletal infections caused by community-acquired, methicillin-resistant Staphylococcus aureus (MRSA) in children are not well-defined. In this retrospective study, the demographics, hospital course and outcome of children with musculoskeletal infections were reviewed from medical records and by contacting patients or their physicians. Antimicrobial susceptibilities were determined by disk diffusion. Polymerase chain reaction was performed to detect genes encoding for virulence factors. Mann-Whitney, chi2 and Kaplan-Meier tests were used for statistical analysis. Community-acquired MRSA and community-acquired methicillin-susceptible S. aureus (MSSA) caused musculoskeletal infections in 31 and 28 children, respectively. The median numbers of febrile days after start of therapy were 4 and 1 for MRSA and MSSA patients, respectively (P = 0.001). The median numbers of hospital days were 13 and 8 for the MRSA and MSSA groups, respectively (P = 0.014). At follow-up, 2 patients in the MRSA and 1 in the MSSA group had developed chronic osteomyelitis. pvl and fnbB genes were found in 87 and 90% versus 24 and 64% in the MRSA versus MSSA groups, respectively. (P = 0.00001 and 0.017). Ten patients with pvl-positive strains had complications versus no patients with pvl-negative isolates (P = 0.002). Febrile days and hospital days were greater in children with musculoskeletal infection caused by MRSA than in those affected by MSSA, but no significant differences were found in the final outcome. pvl and fnbB genes were more frequent in the MRSA than in the MSSA strains. The presence of the pvl gene may be related to an increased likelihood of complications in children with S. aureus musculoskeletal infections.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                hie
                Revista Cubana de Higiene y Epidemiología
                Rev Cubana Hig Epidemiol
                Editorial Ciencias Médicas (Ciudad de la Habana )
                1561-3003
                December 2012
                : 50
                : 3
                : 278-285
                Affiliations
                [1 ] Laboratorios Liorad Cuba
                [2 ] Laboratorio de Control Microbiológico Cuba
                Article
                S1561-30032012000300003
                a3ff8310-cd87-4561-a8dc-bd6b8e32ec46

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Cuba

                Self URI (journal page): http://scielo.sld.cu/scielo.php?script=sci_serial&pid=1561-3003&lng=en
                Categories
                HEALTH CARE SCIENCES & SERVICES
                HEALTH POLICY & SERVICES

                Health & Social care,Public health
                Staphylococcus aureus,nasopharyngeal swabs,pathogen germens,exudados nasofaríngeos,gérmenes patógenos

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