A narrative review on current duodenoscope reprocessing techniques and novel developments

Duodenoscopy-associated infections occur worldwide despite strict adherence to reprocessing standards. The exact scope of the problem remains unknown because a standardized sampling protocol and uniform sampling techniques are lacking. The currently available multi-society protocol for microbial culturing by the Centers for Disease Control and Prevention, the United States Food and Drug Administration (FDA) and the American Society for Microbiology, published in 2018 is too laborious for broad clinical implementation. A more practical sampling protocol would result in increased accessibility and widespread implementation. This will aid to reduce the prevalence of duodenoscope contamination. To reduce the risk of duodenoscopy-associated pathogen transmission the FDA advised four supplemental reprocessing measures. These measures include double high-level disinfection, microbiological culturing and quarantine, ethylene oxide gas sterilization and liquid chemical sterilization. When the supplemental measures were advised in 2015 data evaluating their efficacy were sparse. Over the past five years data regarding the supplemental measures have become available that place the efficacy of the supplemental measures into context. As expected the advised supplemental measures have resulted in increased costs and reprocessing time. Unfortunately, it has also become clear that the efficacy of the supplemental measures falls short and that duodenoscope contamination remains a problem. There is a lot of research into new reprocessing methods and technical applications trying to solve the problem of duodenoscope contamination. Several promising developments such as single-use duodenoscopes, electrolyzed acidic water, and vaporized hydrogen peroxide plasma are already applied in a clinical setting.

Inquiry-Driven Bioinformatics Laboratory Research Module: Metagenomic Study of Student Oral Microbes

American Society for Microbiology Curriculum Guidelines highlight the importance of enabling students to think critically and learn by doing research. Moreover, information in biology, especially genetics and biotechnology, increases too rapidly for instructors to teach everything.

Real-World Ethical Dilemmas in Laboratory Safety for Microbiology Under-Resourced and Outreach Teaching

With modernization of safety standards for microbiology outreach teaching laboratories, ethical challenges arise in teaching microbiology for the public good without short-changing students in under-resourced situations, or when institutional support is subpar. Still, educators want students to engage using applied skills for inquiry, research-based microbial learning activities – safely. Following several United States microbial outbreaks, federal investigation traced sources back to teaching laboratories. Policy discussions ensued. The American Society for Microbiology (ASM) Task Force provides recommended but not mandated guidelines; however, guidelines are not amenable by all. Here, a real-world, ethical scenario of a university-level outreach microbiology laboratory course hosted at several locations provides context for under-resourced challenges in safety compliance. In this example of biomedical and public health ethical considerations, upper administration puts the onus on instructors to assure safe labs for their students and the general public. Temporarily hired instructors without curriculum or sufficient institutional support are put in precarious positions with often egregious practices to get the job done. This scenario is examined with different public health ethical frameworks and principles: non-maleficence, beneficence, health maximization, efficiency of policy regulations, respect for institutional and instructor autonomy, justice, and proportionality balancing stakeholder concerns. Sample curricular strategies are employed to mitigate these challenges. Taking a utilitarianism framework of the greatest good for the most benefit, this paper advocates for social justice supporting access to education as a moral duty. Administrations should ensure instructors are supported sufficiently to provide safe, authentic learning experiences. Solutions for under-resourced outreach teaching are needed for public trust.

All You Need to Know and More about the Diagnosis and Management of Rare Mold Infections

ABSTRACT Invasive mold infections caused by molds other than Aspergillus spp. or Mucorales are emerging. The reported prevalences of infection due to these rare fungal pathogens vary among geographic regions, driven by differences in climatic conditions, susceptible hosts, and diagnostic capabilities. These rare molds—Fusarium, Lomentospora, and Scedosporium species and others—are difficult to detect and often show intrinsic antifungal resistance. Now, international societies of medical mycology and microbiology have joined forces and created the “Global guideline for the diagnosis and management of rare mould infections: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology and the American Society for Microbiology” (published in Lancet Infect Dis, https://doi.org/10.1016/S1473-3099(20)30784-2), with the goal of improving the diagnosis, treatment, prevention, and survival of persons with rare mold infections. The guideline provides cutting-edge guidance for the correct utilization and application of established and new diagnostic and therapeutic options.

Hábitos nutricionales y estados emocionales en tiempos de COVID-19

El estilo de vida saludable reduce las posibilidades de contraer enfermedades degenerativas, sin embargo; durante la pandemia COVID-19 se presentaron dificultades para su constancia. El sobrepeso y la obesidad se asocian a conductas de alimentación que afectan la salud, y en consecuencia alteran las respuestas inmunitarias que debilitan las defensas, aumentando la probabilidad a contraer esta enfermedad. El objetivo del presente artículo fue determinar las consecuencias nutricionales y alteraciones emocionales ocasionadas por el sedentarismo provocado por el SARS-CoV-2. Se realizó una búsqueda sistemática de publicaciones en las bases de datos de SciELO, Dialnet, Science Direct, Pub Med, la Organización Mundial de la Salud (OMS), Association of Obesity, British Medical Journal, American Society for Microbiology y Infectious Diseases Society of America, sobre consecuencias y causas de la obesidad y sus agravantes. Paralelamente, se realizó una encuesta a 51 personas para identificar las condiciones a las que se enfrentaron durante el confinamiento. Los encuestados declaran haber experimentado cambios significativos en su día a día, principalmente al momento de adquirir alimentos, es decir, por la disposición de alimentos saludables, asimismo, la inactividad física debido al aislamiento y un deterioro en su estado físico. El tener un estilo de vida saludable es una prioridad, para prevenir enfermedades futuras. Este trabajo puede servir como un referente para futuras investigaciones que intenten identificar aquellos factores que repercuten los estilos de vida a causa del confinamiento provocado por la COVID-19.