Predictors of incorrectness in antimicrobial prescription in the Bauru State Hospital (Bauru city, São Paulo State, Brazil)

The inappropriate use of antimicrobials in hospitals presents a negative impact on patient outcome and is associated with the emergence and spread of multidrug-resistant microorganisms. Antimicrobial stewardship programs (ASPs) have been instituted in order to improve the quality of prescriptions in hospitals. In this setting, the identification of patterns of inappropriate antimicrobial prescription is a valuable tool that allows ASPs to identify priorities for directing educative/restrictive policies. With this purpose, a study was conducted in the Bauru State Hospital, a teaching hospital with 285 beds affiliated to the Botucatu Medical School, São Paulo State University. The hospital maintains an active ASP since it was opened, in 2002. We selected 25% of the requests for parenteral antimicrobials (RPAs) from 2005 for analysis. Prescriptions for prophylactic purposes were excluded. All other RPAs were classified according to a modified Kunin and Jones categories. Univariate and multivariable analyses were performed to identify predictors of general inappropriateness and of specific prescription errors. Prescriptions classified as "appropriate'' or "probably appropriate" were selected as controls in all stages of the study. Among 963 RPAs included in our study, 34.6% were inappropriate. General predictors of inappropriateness were: prescription on weekends/holidays (OR = 1.67, 95% CI = 1.20-2.28, p = 0.002), patient from intensive care unit (OR = 1.57, 95% CI = 1.11-2.23, p = 0.01), peritoneal (OR = 2.15, 95% CI = 1.27-3.65, p = 0.004) or urinary tract infection (OR = 1.89, 95% CI = 1.25-2.87, p = 0.002), combined therapy with two or more antimicrobials (OR = 1.72, 95% CI = 1.15-2.57, p = 0.008) and prescriptions including penicillin (OR = 2.12, 95% CI = 1.39-3.25, p = 0.001) or first-generation cephalosporins (OR = 1.74, 95% CI = 1.01-3.00, p = 0.048). Previous consultation with an infectious diseases (ID) specialist had a protective effect against inappropriate prescription (OR = 0.34, 95% CI = 0.24-0.50, p < 0.001). Factors independently associated with specific prescription errors varied. However, consultation with an ID specialist was protective against both unnecessary antimicrobial use (OR = 0.04, 95% CI = 0.01-0.26, p = 0.001) and requests for agents with insufficient spectrum (OR = 0.14, 95% CI = 0.03-0.30, p = 0.01). In conclusion, the analysis of factors predictive of inappropriateness in antimicrobial prescription allowed us to identify issues requiring intervention. Also, it provided a positive feedback of the ASP efficacy, demonstrating the importance of previous consultation with an ID specialist to assure the quality of antimicrobial prescriptions.

Packaging to Preserve 'Aurora-1' Peaches from Two Maturity Stages

The main objective of this research was to evaluate chemical and physical changes in 'Aurora-1' peach harvested at two maturity stages, packed in different types of packaging and kept under refrigeration. Fruit were harvested at the mature green and ripe stages, packed in four different types of packaging (control, PD-900 (TM), PVC and PET) and stored at 6 degrees C. The following variables were evaluated every eight days: coloration, accumulated fresh mass loss, firmness, appearance, acidity, total soluble solids contents, soluble sugars, and percentage of pectin solubilization. We observed that the postharvest life was influenced by packaging and the mature green fruits showed lower disease occurrence. Fresh mass loss was lower in packed fruits. The peel of mature green fruits developed a characteristic ripe peach color at the end of storage, but PD-900 (TM) provided a delay in color change. Packaging also influenced the firmness, allowing for more firmness retention than for the control fruits at both harvest stages. The organic acid content decreased in the packaged fruits and increased in the control fruits. In the packaged fruit, the amount of sugar increased until the eighth day and then decreased until the end of the storage period. The 'Aurora-1' peaches did not show compromised quality by packaging use and exhibited an increase in harvest life to 24 days (compared to 16 days for the control).

Pt(II) and Ag(I) complexes with acesulfame: Crystal structure and a study of their antitumoral, antimicrobial and antiviral activities

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Beef Carcass Contamination by Shiga Toxin-Producing Escherichia coli Strains in an Abattoir in Brazil: Characterization and Resistance to Antimicrobial Drugs

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Antimicrobial photodynamic action on dentin using a light-emitting diode light source

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

In vivo antimicrobial activity of 2% chlorhexidine used as a root canal irrigating solution

The aim of the present study was to evaluate the in vivo antimicrobial activity of 2% chlorhexidine gluconate (FCFRP-USP) used as a root canal irrigating solution in teeth with pulp necrosis and radiographically visible chronic periapical reactions. Culture techniques and measurement of the inhibition zone were used. Twenty-two root canals of incisors and molars of 12 patients were used. After accessing the canal, the first root canal sample was collected with two sterile paper points that were transferred to a tube containing reduced transport fluid. The root canal was instrumented using chlorhexidine solution. A small sterile cotton pellet was placed at the root canal entrance, and the cavity was sealed with zinc oxide-eugenol cement. The canals were maintained empty for 48 h. Three sterile paper points were then introduced to absorb the root canal fluid (second sample). One paper point was placed on an agar plate inoculated with Micrococcus luteus ATCC 9341 and incubated for 24 h at 37°C, and the other two were submitted to microbiological evaluation. Present in 10 cases at baseline, mutans streptococci was reduced by 100% at the second assessment. Treatment showed an efficiency of 77.78% for anaerobic microorganisms at the second assessment. These data suggest that chlorhexidine prevents microbial activity in vivo with residual effects in the root canal system up to 48 h. Copyright © 1999 by The American Association of Endodontists.

Antimicrobial activity of essential oils from plants used in Brazilian popular medicine

Essential oils from, Salvia officinalis L. (SO), Mentha sylvestris L. (MS), Casearia sylvestris Sw. (CS), Mentha piperita L. (MP), Ocimum micrantum Willd. (OM) and Mentha arvensis L. (MA), plants used in Brazilian popular medicine were extracted using method I, as described in the Brazilian Pharmacopoeia, in order to obtain the phytochemical profile and to evaluate their antimicrobial activity against the following microorganisms: Bacillus subtilis, Staphylococcus aureus, Micrococcus luteus, Escherichia coli, Serratia marcescens, Candida albicans and Aspergilus oryzae. Test was made by means of the disk-plaque diffusion test in liquid medium using 1% essential oil. In the disk-plaque diffusion test, all the essential oils exhibited activity against B. subtilis, but OM showed the greatest inhibition zone and was the only one to show activity against S. aureus. Samples of SO, MS, MP, OM and MA were active against M. luteus, E. coli and S. marcescens, while A. oryzae was sensitive to MS, MP, OM and MA. No sample, however, was active against C. albicans. In the liquid medium test, significant results were observed for OM and MA, which inhibited the growth of all microorganisms for 24 hours, and OM continued active against E. coli and A. oryzae until the last reading.

Influence of antimicrobial subinhibitory concentrations on hemolytic activity and bacteriocin-like substances in oral: Fusobacterium nucleatum

Fusobacterium nucleatum is considered for its role in colonization of initial and late microorganisms in dental plaque and for its coaggregation with other bacterial species. It is known that action of different antimicrobial substances may interfere with either virulence factors or with host-bacteria interaction. The goal of this study was to examine the influence of subinhibitory concentrations of chlorhexidine, triclosan , penicillin G and metronidazole on hemolytic activity and bacteriocin-like substance production of oral F. nucleatum. A high resistance to penicillin G was observed and 63% of the isolates were β-lactamase positive. All the tested isolates were susceptible to metronidazole. F. nucleatum isolates grown with or without antimicrobials were alpha-hemolytics. Bacteriocin-like substance production was increased in isolates grown with penicillin G. Impaired production of hemolytic or antagonic substances can suggest a role in the regulation of oral microbiota.

In vitro evaluation of antimicrobial activity of sealers and pastes used in endodontics

The antimicrobial activity of four root canal sealers (AH Plus, Sealapex, Ketac Endo, and Fill Canal), two calcium hydroxide pastes (Calen and Calasept), and a zinc oxide paste was evaluated. Seven bacterial strains were used, six of them standard; Micrococcus luteus ATCC 9341, Staphylococcus aureus ATCC 25923, Pseudomonas aeruginosa ATCC 27853, Staphylococcus epidermidis ATCC 12228, Escherichia coli ATCC 25922, and Enterococcus faecalis ATCC 10541. There was a wild strain of Streptococcus mutans isolated from saliva obtained in an adult dental clinic. Activity was evaluated using the agar diffusion method with Brain Heart Infusion agar and Müller Hinton medium seeded by pour plate. Calcium hydroxide-based sealers and pastes were either placed directly into 4.0 × 4.0 mm wells or by using absorbent paper points. The plates were kept at room temperature for 2 hr for diffusion. After incubation at 37°C for 24 hr, the medium was optimized with 0.05 g% TTC gel and inhibition haloes were measured. All bacterial strains were inhibited by all materials using the well method. However, when the materials were applied with absorbent paper points, Enterococcus faecalis was not inhibited by zinc oxide, and Pseudomonas aeruginosa was not inhibited by AH Plus, Fill Canal, and the zinc oxide-based paste. We conclude that sealers and pastes presented antimicrobial activity in vitro and culture medium optimization with 0.05 g% TTC gel facilitated observation of the inhibition haloes. Copyright © 2000 by The American Association of Endodontists.

In vitro evaluation of the antimicrobial activity of a castor oil-based irrigant

The antimicrobial activity of irrigating solutions - Endoquil (castor oil detergent), 2% chlorhexidine gluconate solution, and 0.5% NaOCI solution - was evaluated against Gram-positive cocci (Micrococcus luteus, Staphylococcus aureus, Enterococcus faecalis, Staphylococcus epidermidis, Streptococcus mutans, and Streptococcus sobrinus), Gramnegative rods (Escherichia coli and Pseudomonas aeruginosa), and the yeast Candida albicans. Activity was evaluated using the two-layer agar diffusion technique. The base layer was obtained by pouring 10.0 ml of Muller Hinton Medium or 10.0 ml of Brain Heart Infusion agar in a Petri dish. After solidification a 5.0 ml seed layer of Muller Hinton Medium or Brain Heart Infusion agar with inoculum (106/ml) was added. Absorbent paper disks (6.0 mm in diameter) immersed in the solutions were placed at equidistant points. Plates were maintained at room temperature for 2 h for prediffusion of the solutions and incubated at 37°C for 24 h. The candle jar system was used for the Brain Heart Infusion agar plates. All tests were performed in duplicate. After incubation the medium was optimized with 0.05 g% triphenyltetrazolium chlorate gel and inhibition halos were measured. All bacterial strains were inhibited by 2.0% chlorhexidine gluconate. Endoquil was effective against Grampositive microorganisms, and 0.5% NaOCI was effective only against S. aureus. Copyright © 2001 by The American Association of Endodontists.

Evaluation of antimicrobial activity of extracts of medicinal plants on three tomato phytopathogens

Antimicrobial activity of 45 extracts of medicinal plants were tested on Xanthomonas campestris pv. vesicatoria, Ralstonia solanacearum and Clavibacter michiganense subsp. michiganense. Some assays were done to verify the capability of these plants extrats to show an antibiosis. Five extracts (EAFQ, SM1, SM12, SM16, SA1) shown positive activity. The extract EAFQ expressed bactericide activity on C. michiganense. It suggests the possibility of using these actives substances in natura or as a model to synthesize industrialized products, intendind field utilization.