Hospital hydrotherapy pools treated with ultra violet light: bad bacteriological quality and presence of thermophilic Naegleria.

The microbiological quality of eight halogenated and two u.v.-treated hydrotherapy pools in hospitals was investigated. The microbiological quality of halogenated hydrotherapy pools was comparable to halogenated public swimming pools, although in some Pseudomonas aeruginosa and faecal pollution indicators were more frequent due to bad management. On the other hand u.v.-treated hydrotherapy pools had very bad microbiological quality. Apart from faecal pollution indicators, P. aeruginosa was present in very high numbers. Halogenated hydrotherapy pools were not highly contaminated with amoebae, and Naegleria spp. were never detected. On the other hand u.v.-treated pools contained very high numbers of thermophilic Naegleria. The Naegleria isolated were identified as N. lovaniensis, a species commonly found in association with N. fowleri. Isoenzyme analysis showed a different type of N. lovaniensis was present in each of two u.v.-treated pools.     

Incidence of Pseudomonas aeruginosa in recreational and hydrotherapy pools

Pseudomonas aeruginosa remains an important agent of opportunistic infection in patients, particularly those with respiratory complications and burns. One natural niche of this organism is water and water-associated facilities, hence the aim of this study was to examine specimens from recreational and hydrotherapy pools in Northern Ireland over a two-year period. Water specimens (n = 3,510) were obtained from three amenity categories, namely, 13 hydrotherapy pools (specimen number [n] = 323), 51 Jacuzzis/spas (n = 1,397) and 68 swimming pools (n = 1,790). Specimens (100 ml) were filtered through a cellulose acetate (0.45 micron pore size) gridded filter and the membrane was placed on Pseudomonas CFC agar (Oxoid CM559 + SR103) and incubated at 37 degrees C for 48 +/- 2 h. Colonies that clearly showed pyocyanin production or met other identification criteria were considered P. aeruginosa. Of the amenities examined 4/13 hydrotherapy pools (30.8%), 37/51 Jacuzzis/spas (72.5%) and 26/68 swimming pools (38.2%) were positive for P. aeruginosa. The most heavily contaminated amenity category was the Jacuzzi/spa, where 34.7% and 12% of private and public sites respectively were positive for P. aeruginosa at a level of greater than 1,000 cfu 100 ml-1. Approximately twice as many samples were positive in private Jacuzzis/spas compared to publicly operated facilities. There was a similar trend with respect to public and private hydrotherapy pools, though bacterial counts did not exceed 1,000 cfu 100 ml-1. Recreational and therapeutic amenities involving the use of water may be a potential source of P. aeruginosa for susceptible patient groups, including patients with cystic fibrosis and bronchiectasis. This may vary depending on amenity type and public/private ownership of such amenities.     

室内游泳池水中各种病原菌的研究

目的：为全面分析室内游泳池水中存在的病原菌,以掌握游泳池水中微生物的污染情况。方法：采用增菌、平板分离和系统生化的方法分离鉴定病原菌,并对检出的某些病原菌菌株进行毒素分析。结果：333份游泳池水中共检出各种病原菌49株,检出率达14.71%,其中以嗜水气单胞菌检出率最高,检出率为5.7%。其次为金黄色葡萄球菌,检出率为3.9%。嗜水气单胞菌菌株中含H lyA基因的菌株占78.94%,含Aero基因的菌株占73.68%。金黄色葡萄球菌菌株中产肠毒素的占46.15%。结论：室内游泳池水中存在各种病原菌,且许多病原菌含毒力基因。显示目前游泳池的消毒方法不够完善。建议国家标准修订时增加致病菌检测项目,以便更好地对游泳池水的卫生状况进行综合评价。     

Water quality of swimming pools in Athens area

In this work a representative sample of 11 indoor and outdoor swimming pools were investigated with respect to critical physicochemical, health-related, microbiological and technical parameters. These pools were used either as competition (athletic) or as recreation pools. Useful correlations of the above parameters were deduced and properly attributed. Results were checked against well-established standards, such as DIN 19643, showing poor compliance with them in all parameters investigated. Thus, compliance for health-related parameters varied from 0 to 100%, for physical and chemical parameters from 20 to 100%, for microbiological parameters from 45 to 91% and for technical parameters from 27 to 36%. The most critical parameters implicated for poor water quality were Redox potential, turbidity and the appearance of certain opportunistic pathogens ( Staphylococcus aureus and Pseudomonas aeruginosa ). These were attributed to poor process design of pools and lack of sufficient vocational training of the technical personnel operating the water treatment installations.     

Microbiology of postoperative wound infection: a prospective study of 1770 wounds.

A prospective study of postoperative wound infection was carried out over a 12-month period. Intra-operative swabs from the patients' anterior nares, the opened viscus and parietes were cultured using standard bacteriological techniques. Of the 1770 wounds studied, 167 (9.4%) became infected. Wound infection rates, according to clinical wound types, were clean 5.9%, clean-contaminated 10.7%, contaminated 24.3% and dirty 52.9%. The figures according to microbiological wound types were clean 4.7%, and potentially, lightly and heavily contaminated 15.3%, 22.1% and 30.2% respectively. The commonest causative organisms were Staphylococcus aureus 23.7%, Escherichia coli 16.9%, Staphylococcus epidermidis 13.5% and Pseudomonas aeruginosa 13.0%. When isolated intra-operatively, Enterobacter spp., Proteus spp., Klebsiella spp. and P. aeruginosa appeared to have a high probability of causing postoperative wound infection, but the intra-operative isolation of Bacteroides sp. was a poor predictor of subsequent wound infection.     

Mycobacteria in swimming pool water and the meaning of microbiological conventional indicators

Monitoring program of hygienic quality water in twelve public swimming pools was performed. Legally required microbiological indicator parameters of safety for gastrointestinal illness were measured besides the analyses of Pseudomonas spp. and Staphylococcus spp. prevalence, frequency of recovery and number of nontuberculous mycobacteria. We detected positive samples for coliforms at lower rate (29.3%) than Pseudomonas (75.5%), Staphylococcus spp. (46%) and Mycobacteria (59.4%). We pointed out statistically significant correlation (r=0.67 p=0.0001) between Mycobacteria and Pseudomonas so we think that the latter might be a good predictive marker. As 82% of samples had free chlorine residual within the limits stated by Italian Laws, the efficacy of chlorination to prevent risk of infectious diseases transmission by route other than gastroenteric was discussed. A revision of both the sanitary significance of conventional microbial parameters and the related regulations appears necessary.     

Prevalence and antimicrobial-resistance of Pseudomonas aeruginosa in swimming pools and hot tubs

Pseudomonas aeruginosa is an important opportunistic pathogen in recreational waters and the primary cause of hot tub folliculitis and otitis externa. The aim of this surveillance study was to determine the background prevalence and antimicrobial resistance profile of P. aeruginosa in swimming pools and hot tubs. A convenience sample of 108 samples was obtained from three hot tubs and eight indoor swimming pools. Water and swab samples were processed using membrane filtration, followed by confirmation with polymerase chain reaction. Twenty-three samples (21%) were positive for P. aeruginosa, and 23 isolates underwent susceptibility testing using the microdilution method. Resistance was noted to several antibiotic agents, including amikacin (intermediate), aztreonam, ceftriaxone, gentamicin, imipenem, meropenem (intermediate), ticarcillin/clavulanic acid, tobramycin (intermediate), and trimethoprim/sulfamethoxazole. The results of this surveillance study indicate that 96% of P. aeruginosa isolates tested from swimming pools and hot tubs were multidrug resistant. These results may have important implications for cystic fibrosis patients and other immune-suppressed individuals, for whom infection with multidrug-resistant P. aeruginosa would have greater impact. Our results underlie the importance of rigorous facility maintenance, and provide prevalence data on the occurrence of antimicrobial resistant strains of this important recreational water-associated and nosocomial pathogen.     

中山市游泳池水中病原菌的卫生状况调查分析

目的了解中山市游泳场所的泳池水水质卫生状况,以掌握游泳池水中微生物的污染情况。方法在2009年泳季里,依照《公共场所卫生监测技术规范》和《公共场所卫生标准检测方法》对泳池水进行抽样检测并对细菌总数、大肠菌群及游离性余氯等进行测定。对金黄色葡萄球菌、铜绿假单胞菌和大肠埃希菌等病原菌采用增菌、平板分离和系统生化的方式进行检测。结果 467份的泳池水中检出病原菌12株,检出率为2.57%,其中以金黄色葡萄球菌检出率最高,检出率为2.14%;其次为铜绿假单胞菌和大肠埃希菌,检测率各为0.21%。结论该市泳池水中存在着多种病原菌,说明目前游泳池水的消毒方法不够完善,建议加强消毒管理。     

Microbiological quality of fermented cassava flour 'kpor umilin'

A study was conducted on the microbiological quality of traditionally fermented cassava flour 'kpor umilin' and a laboratory modification of the method developed with a view to upgrading the traditional process. Microbial analysis of samples from both processing methods was evaluated using standard microbiological methods. The bacterial count in the traditionally processed flours ranged from 2.7 x 10(3) to 1.2 x 10(7) cfu/g, while the modified sample had a count of 3.5 x 10(2) cfu/g. The predominant flora were Leuconostoc spp., Lactobacillus spp., Staphylococcus spp., Micrococcus spp., Bacillus spp., Streptococcus spp. and coliforms such as Escherichia coli. Other isolates were Enterobacter spp. and proteus spp. The sample from the modified method had a negligible (4 MPN/100 ml) coliform count. The yeast and mould count ranged from 1.9 x 10(3) cfu/g to 3.9 x 10(5) cfu/g in the traditionally processed samples as compared with 1.5 x 10(3) cfu/g in the sample from the modified process. Aspergillus spp., Penicillium spp., Saccharomyces spp. and Geotrichum candidum were the predominant fungi. The poor microbiological quality of 'kpor umilin', processed traditionally, calls for urgency in upgrading the processing and preservation methods as developed in this study as well as proper education of the local processors on good manufacturing practices.     

2008—2010年清远市区游泳池水水质卫生监测分析

目的了解清远市区人工游泳池的水质卫生状况和变化趋势,为进一步加强游泳场所卫生管理提供科学依据。方法对清远市区游泳池水水质按照GB/T 18204.2000《公共场所卫生标准检验方法》、GB/T 5750-2006《生活饮用水标准检验方法》进行细菌总数、大肠菌群、浑浊度、pH值、游离性余氯、尿素等项目进行检验。并对2008—2010年的检测结果进行统计分析。结果共检测水样530份,各项指标全部合格的162份,合格率为29.45%,其中合格率最低的项目主要为尿素(39.82%)、游离性余氯(80.18%),其次为大肠菌群(99.27%)和细菌总数(96.91%);公共泳池水质合格率(55.17%)高于住宅小区(35.07%)和酒店内游泳场所(20.36%),游泳旺季合格率(24.01%)低于游泳淡季(36.18%)。结论近年清远市区游泳池水质卫生状况不佳,市卫生监督部门要重点加强酒店内泳池和住宅小区内泳池的监管,提高水质卫生质量,保障游泳者身体健康。     

2015—2018年住院患者治疗性抗菌药物使用前分离菌株及药敏情况

目的 了解住院患者首次治疗性使用抗菌药物前分离菌株及药敏结果,为医院抗菌药物合理使用提供可靠的微生物依据。方法 基于某院抗菌药物临床决策支持系统后台相关节点数据及医院检验信息系统收集的住院患者分离菌株及药敏结果,收集2015—2018年患者入院后首次治疗性使用抗菌药物前临床分离菌株和住院期间送检标本所有临床分离菌株,比较抗菌药物使用前后菌株分布及其耐药情况。结果 2015—2018年住院患者所有送检标本共检出非重复菌株69 037株（包括细菌及真菌）,其中革兰阳性菌17 900株（占25.93%）,革兰阴性菌44 055株（占63.81%）,真菌7 082株（占10.26%）。住院患者入院后首次治疗性使用抗菌药物前采集标本中检出非重复菌株15 017株,其中革兰阳性菌4 661株（占31.04%）,革兰阴性菌9 451株（占62.93%）,真菌905株（占6.03%）。治疗用药前标本分离菌居前5位的依次是大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌和凝固酶阴性葡萄球菌,所有送检标本分离菌居前5位的分别为肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌、假丝酵母菌属、大肠埃希菌,苛养菌如链球菌属、流感嗜血杆菌、卡他莫拉菌在所有送检标本中占比,较用药前低。临床常见分离菌包括金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌,抗菌治疗后送检标本分离菌株中耐药率更高。结论 研究首次报道大样本治疗性抗菌药物使用前临床送检标本分离的菌株及药敏情况,临床常见分离菌包括金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌,在抗菌治疗后标本中显示更高的耐药性。     

A study of the microbiology of diabetic foot infections in a teaching hospital in Kuwait

The purpose of this study was to determine the microbiological profile of diabetic foot infections (DFIs) and assess the antibiotic susceptibility of the causative agents. Data were obtained from a retrospective analysis of DFI samples collected from June 2007 to July 2008. Specimens were cultured using optimal aerobic and anaerobic microbiological techniques, and antibiotic susceptibility testing was performed according to the methods recommended by the Clinical and Laboratory Standards Institute (CLSI). Extended-spectrum β-lactamase (ESBL) production was measured using the double disk synergy test and the ESBL Etest. A total of 440 patients were diagnosed with DFIs during this period, and a total of 777 pathogens were isolated from these patients with an average of 1.8 pathogens per lesion. We isolated more Gram-negative pathogens (51.2%) than Gram-positive pathogens (32.3%) or anaerobes (15.3%). Polymicrobial infection was identified in 75% of the patients. The predominant organisms isolated were members of the Enterobacteriaceae family (28.5%), Pseudomonas aeruginosa (17.4%), Staphylococcus aureus (11.8%), methicillin-resistant S. aureus (7.7%), anaerobic Gram-negative organisms (10.8%), and Enterococcus spp. (7%). Vancomycin was the most effective treatment for Gram-positive bacteria, and imipenem, piperacillin-tazobactam and amikacin were the most effective treatments for the Gram-negative bacteria. In conclusion, DFI is common among diabetic patients in Kuwait, and most of the cases evaluated in this study displayed polymicrobial etiology. The majority of isolates were multi-drug resistant. The data gathered in this study will be beneficial for future determinations of empirical therapy policies for the management of DFIs.     

新疆不同民族中耳炎病原菌特点分析

目的探讨新疆地区慢性化脓性中耳炎与中耳胆脂瘤分泌物病原菌分布及其与民族、中耳炎分型等的关系。方法选择2006年2月—2008年4月新疆地区151例不同民族的住院及门诊中耳炎患者进行中耳分泌物微生物培养及药物敏感试验,获取细菌分离率的排序、病原菌种类等。结果本组164耳中,中耳胆脂瘤58耳(35.37%),慢性化脓性中耳炎106耳(64.63%);病原菌分布以金黄色葡萄球菌(37.04%)、变形杆菌属(21.30%)、铜绿假单胞菌(17.59%)、凝固酶阴性葡萄球菌(14.81%)为主。不同民族患者病原菌的检出率有所不同,维吾尔族以金黄色葡萄球菌最多见(40.79%),其次是变形杆菌属(25.00%);汉族各类病原菌均有检出;哈萨克族以金黄色葡萄球菌感染最多(35.30%),变形杆菌属很少(5.88%),未发现真菌感染(0.00%)。金黄色葡萄球菌、变形杆菌属、铜绿假单胞菌、凝固酶阴性葡萄球菌株数在中耳炎分型分布间差异无统计学意义(P>0.05);真菌在中耳胆脂瘤患者中的检出率18.96%明显高于慢性化脓性中耳炎者的0.00%(χ2=20.812,P<0.01);其他病原菌在中耳胆脂瘤中的检出率15.52%明显低于慢性化脓性中耳炎的43.40%(χ2=13.072,P<0.01)。结论新疆不同民族中耳炎病原菌的主次顺序与国内外不同;中耳炎分型不同,病原菌的种类与分布也不同。真菌感染常见于胆脂瘤型中耳炎。     

A study of 245 infected surgical wounds in Singapore.

The aims of the study were to correlate the laboratory detection rate of wound infections with the actual wound infection rate, and to analyse the bacteriology of these wounds to provide a rationale for antibiotic usage in prophylaxis and treatment of surgical wound infections. The wound infection rate in a general surgical unit was determined using the most comprehensive surveillance available to us and was correlated with the laboratory detection rate. A correlation coefficient of 0.8 was obtained, allowing a reasonable estimation of the actual wound infection rate from laboratory data. Review of the bacteriology of consecutive infected surgical wounds over a 4 year period in a university hospital, revealed that the commonest organisms cultured were Staphylococcus aureus, Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, enterococci and beta-haemolytic streptococci. Methicillin-resistant S. aureus (MRSA) caused 50% of all staphylococcal wound infections. All MRSA isolates were sensitive to fusidic acid and vancomycin. All the non-MRSA isolates of S. aureus were sensitive to cephalexin. Some 89% of E. coli were sensitive to gentamicin, with 93% and 100% sensitive to cefuroxime and ceftriaxone respectively. Klebsiella isolates have shown an increased resistance to aminoglycosides, with a new strain from one patient, isolated in 1990, resistant to penicillins, aminoglycosides and third generation cephalosporins. Pseudomonas spp., enterococci and beta-haemolytic streptococci did not show a change in resistance patterns over the same time period.     

新生儿感染病原菌变迁

目的 探讨90年代新生儿感染病原菌构成比及变迁。方法 对我院新生儿病房1991年1月至2000年12月间，临床标本分离的660株病原菌进行回顾性分析，并对成立新生儿重症监护室(NICU)前后病原菌构成比进行比较。结果 629份标本中共检出660株细菌，其中革兰阳性菌468株(70．91％)，革兰阴性菌157株(23．79％)。629份标本中62份为复数菌，复数菌感染率9．86％。前7位感染菌依次分别为CNS(占51．82％)、金黄色葡萄球菌、铜绿假单胞菌、真菌、粪肠球菌、大肠埃希菌、克雷伯菌。1994年底组建NICU后，金黄色葡萄球菌、B组链球菌、克雷伯菌、铜绿假单胞菌、嗜麦芽窄食单胞菌所占比例有所上升，粪肠球菌、大肠埃希菌、真菌比例有所下降。结论新生儿感染病原菌以CNS为主，以往少见的一些低毒力菌检出逐年增加，复数菌感染并非少见。     

广州市荔湾区泳池水中铜绿假单胞菌污染状况

目的了解广州市荔湾区游泳场馆泳池水中铜绿假单胞菌的污染状况,为防控游泳池水传播的疾病提供科学依据。方法依据GB9667--1996《游泳场所卫生标准》要求,对2012--2013年广州市荔湾区内游泳场馆游泳池水质进行检测,在国家标准规定的6项指标基础上,增加了对铜绿假单胞菌的检测项目。结果从46家游泳场馆共计285份泳池水中检出铜绿假单胞菌阳性水样27份,阳性率为9．47％。尿素和游离余氯含量与铜绿假单胞菌的检出与否有关系。细菌总数和大肠菌群指标不合格更容易检出铜绿假单胞菌。结论泳池水中铜绿假单胞菌污染状况不容忽视,应加强游泳池水质监测和由游泳池水传播疾病的防控工作。     

Prevalence of Cryptosporidium spp. and Giardia intestinalis in swimming pools, Atlanta, Georgia

Cryptosporidium spp. and Giardia intestinalis have been found in swimming pool filter backwash during outbreaks. To determine baseline prevalence, we sampled pools not associated with outbreaks and found that of 160 sampled pools, 13 (8.1%) were positive for 1 or both parasites; 10 (6.2%) for Giardia sp., 2 (1.2%) for Cryptosporidium spp., and 1 (0.6%) for both.     

2015—2018年住院患者治疗性抗菌药物使用前分离菌株及药敏情况

目的 了解住院患者首次治疗性使用抗菌药物前分离菌株及药敏结果,为医院抗菌药物合理使用提供可靠的微生物依据。方法 基于某院抗菌药物临床决策支持系统后台相关节点数据及医院检验信息系统收集的住院患者分离菌株及药敏结果,收集2015—2018年患者入院后首次治疗性使用抗菌药物前临床分离菌株和住院期间送检标本所有临床分离菌株,比较抗菌药物使用前后菌株分布及其耐药情况。结果 2015—2018年住院患者所有送检标本共检出非重复菌株69 037株（包括细菌及真菌）,其中革兰阳性菌17 900株（占25.93%）,革兰阴性菌44 055株（占63.81%）,真菌7 082株（占10.26%）。住院患者入院后首次治疗性使用抗菌药物前采集标本中检出非重复菌株15 017株,其中革兰阳性菌4 661株（占31.04%）,革兰阴性菌9 451株（占62.93%）,真菌905株（占6.03%）。治疗用药前标本分离菌居前5位的依次是大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌和凝固酶阴性葡萄球菌,所有送检标本分离菌居前5位的分别为肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌、假丝酵母菌属、大肠埃希菌,苛养菌如链球菌属、流感嗜血杆菌、卡他莫拉菌在所有送检标本中占比,较用药前低。临床常见分离菌包括金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌,抗菌治疗后送检标本分离菌株中耐药率更高。结论 研究首次报道大样本治疗性抗菌药物使用前临床送检标本分离的菌株及药敏情况,临床常见分离菌包括金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌,在抗菌治疗后标本中显示更高的耐药性。     

Bacterial pollution of cutting fluids: a risk factor for occupational diseases.

An outbreak of occupational diseases involving 38 metal workers with local infections on the hands and the face (53%), bronchitis (29%), and bronchopneumonia (18%) urged an examination of 150 samples of emulsions which the workers used in processing metals. Among the isolated bacteria, the most frequent was Pseudomonas aeruginosa (48%), followed by Escherichia coli (44%), Proteus spp. (11%), Enterococcus faecalis (9%), Enterobacter aerogenes (7%), Citrobacter spp. (5%), Shigella spp., Staphylococcus aureus (3%), and the sulphite reducing Clostridia (1%). Moulds and yeasts were isolated from all tested samples. Most samples counted about 3 x 10(5)/ml of colony forming units. It was concluded that all emulsions and other substances which come in direct contact with the workers should be regularly monitored. Furthermore, preservatives should be added to prevent microbial infection.     

铜陵地区细菌耐药性监测与分析

目的　研究铜陵地区临床分离菌对抗菌药物的耐药特征。方法　收集 2 0 0 0年 1月 1日至 2 0 0 1年12月 31日在铜陵地区 3所综合性医院临床分离的致病菌。采用Kirby -Bauer法进行药敏试验 ,按照美国临床实验标准委员会 2 0 0 0年判断标准分析结果。结果　 2年共收集致病菌 2 4 5 9株 ,包括革兰阳性球菌 911株(37.0 % ) ,革兰阴性杆菌 14 75株 (6 0 .0 % ) ;致病菌以表皮葡萄球菌、大肠埃希氏菌、铜绿假单胞菌、金黄色葡萄球菌、克雷伯氏菌属多见。有 79.9%的凝固酶阴性葡萄球菌和 5 0 .3%的金黄色葡萄球菌耐苯唑西林 ,对其它药物耐药率亦高。铜绿假单胞菌、克雷伯氏菌属、肠杆菌属、不动杆菌对第三代头孢菌素和氟喹诺酮类的耐药性均有显著增高。结论　合理用药和控制滥用是当务之急