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mso-tstyle-border-insideh:cell-none; mso-tstyle-border-insidev:cell-none;} </style> <![endif]--><!--[if gte mso 9]><xml> <o:shapedefaults v:ext="edit" spidmax="2049"/> </xml><![endif]--><!--[if gte mso 9]><xml> <o:shapelayout v:ext="edit"> <o:idmap v:ext="edit" data="1"/> </o:shapelayout></xml><![endif]--> </head> <body lang="ES-VE"> <div class="WordSection1"> <p class="MsoCaption" style="margin: 0cm 0cm 0.0001pt; text-indent: 0cm;"><b><span style="font-size: 14pt;">Artículo Original<o:p></o:p></span></b></p> <p class="AreadePublicacin" style="margin: 0cm 0cm 0.0001pt; background: transparent none repeat scroll 0%; text-indent: 0cm; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial;"><b><span style="font-size: 12pt;">Bacteriología<o:p></o:p></span></b></p> <p class="Datosdeltrabajo" style="margin: 0cm 0cm 0.0001pt; text-indent: 0cm;"><span class="SpellE"><span style="font-size: 9pt;">Kasmera</span></span><span style="font-size: 9pt;"> 47(2):123-130, Julio-<span class="GramE">Diciembre</span>, 2019. P-ISSN 0075-5222<span style=""> </span>E-ISSN 2477-9628<o:p></o:p></span></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-indent: 0cm;"><span style="font-family: Academicons; color: rgb(0, 32, 96);"></span> <a href="https://doi.org/10.5281/zenodo.3406805">https://doi.org/10.5281/zenodo.3406805</a></p> <p class="MsoNormal" style="margin-top: 18pt; text-align: center; text-indent: 0cm;" align="center"><b><span style="font-size: 18pt; color: rgb(0, 32, 96);">Frecuencia y susceptibilidad a penicilina y meticilina de aislamientos ambientales de <i>Staphylococcus aureus</i> en un hospital de Cuenca<o:p></o:p></span></b></p> <p class="MsoNormal" style="margin-bottom: 18pt; text-align: center; text-indent: 0cm;" align="center"><i><span style="font-size: 16pt; color: rgb(0, 32, 96);" lang="EN-US">Frequency and susceptibility to penicillin and methicillin of Staphylococcus aureus environmental isolations at a Cuenca´s hospital<o:p></o:p></span></i></p> <p class="MsoNormal" style="text-indent: 0cm;"><b><span style="color: rgb(0, 32, 96);" lang="EN-US">Andrade T, Carlos</span></b><span class="AutoresCar"><span style="" lang="EN-US"> </span></span><a href="https://orcid.org/0000-0003-3983-1314"><span style="font-family: Academicons; color: rgb(146, 208, 80); text-decoration: none;"></span></a><span class="MsoHyperlink"><span style="font-family: "Cambria",serif; color: windowtext; text-decoration: none;">.</span></span><span style=""> </span><span style="color: rgb(0, 32, 96);">(Autor de Correspondencia)</span><span style="color: windowtext;">.</span><span style=""> </span><span class="AfiliacionesAutoresCar">Unidad Académica de Salud y Bienestar, Carrera de Odontología, Laboratorio de Genética y Biología Molecular del Centro de Investigación, Innovación y Transferencia de Tecnología. Universidad Católica de Cuenca. Dirección Postal: Av. de las Américas y Humboldt (esquina), Cuenca-Ecuador. Código Postal: 010100. Teléfono: +593-992910299. E-mail: <a href="mailto:candradet@ucacue.edu.ec">candradet@ucacue.edu.ec</a></span><span style=""><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent: 0cm;"><span class="AutoresCar"><b><span style="font-size: 10pt; color: rgb(0, 32, 96);">Orellana B Paola</span></b></span><a href="https://orcid.org/0000-0001-6276-0521"><span style="font-size: 10pt; font-family: Academicons; color: rgb(146, 208, 80); text-decoration: none;"></span></a><span style="font-size: 10pt;">. </span><span class="AfiliacionesAutoresCar">Unidad Académica de Salud y Bienestar, Carrera de Odontología, Laboratorio de Genética y Biología Molecular del Centro de Investigación, Innovación y Transferencia de Tecnología. Universidad Católica de Cuenca. Cuenca-Ecuador. E-mail: <a href="mailto:porellana@ucacue.edu.ec">porellana@ucacue.edu.ec</a></span></p> <p class="ResumenTitulo" style="margin-top: 18pt; text-align: center;" align="center"><span style="font-size: 12pt;">Resumen<o:p></o:p></span></p> <p class="ResumenTexto"><i style=""><span style="font-size: 10pt;">Staphylococcus aureus </span></i><span style="font-size: 10pt;">es un patógeno asociado con infecciones intrahospitalarias comúnmente hallado en las fosas nasales y las manos del personal de salud; así como, en superficies ambientales, las cuales se convierten en potenciales reservorios y vehículos de transmisión de infecciones. En este estudio s<span style="">e </span></span><span style="font-size: 10pt;" lang="ES">analizó </span><span style="font-size: 10pt;">la frecuencia y la </span><span style="font-size: 10pt;">susceptibilidad a penicilina y meticilina <span style="">de aislamientos ambientales de <i>S. aureus</i><span style=""> en un</span> hospital de Cuenca. </span><span style="">Se recolectaron 50 muestras </span>(30 de dos quirófanos y 20 de la sala de cuidados intensivos). <i style="">S. aureus</i> se identificó por pruebas fenotípicas y detección molecular del gen <span class="SpellE"><i style="">nuc</i></span>. La susceptibilidad a meticilina y penicilina se determinó por el método de <span style="">difusión del disco en agar </span>y los genes <span class="SpellE"><i style="">blaZ</i></span> y <span class="SpellE"><i style="">mecA</i></span> por reacción en cadena de la polimerasa. La frecuencia de <i style="">S. aureus</i> fue de 6% (3/50 cepas). La resistencia a penicilina y meticilina fue de 66,6% (2/3 cepas). Los genes <span class="SpellE"><i style="">blaZ</i></span> y <span class="SpellE"><i style="">mecA</i></span> se detectaron en las dos cepas resistentes a penicilina y meticilina. </span><span style="font-size: 10pt;">La baja frecuencia de <i>S. aureus</i> puede estar relacionada con los ambientes analizados; ya que, las superficies muestreadas son áreas donde se hace énfasis en la aplicación de protocolos de higiene y desinfección para asegurar una adecuada descontaminación.</span><span style="font-size: 10pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent: 0cm;"><span class="texto"><b style=""><span style="font-size: 10pt; color: rgb(0, 32, 96);">Palabras claves:</span></b></span><span class="texto"><span style="font-size: 10pt; color: rgb(0, 32, 96);"> </span></span><i style=""><span style="font-size: 10pt;">Staphylococcus aureus</span></i><span style="font-size: 10pt;">, quirófano, infección hospitalaria, resistencia a penicilina, resistencia a la meticilina</span><span class="texto"><span style="font-size: 10pt;"><o:p></o:p></span></span></p> <p class="ResumenTitulo" style="margin-top: 18pt; text-align: center;" align="center"><span style="font-size: 12pt;" lang="EN-US">Abstract<o:p></o:p></span></p> <p class="ResumenTexto"><i style=""><span style="font-size: 10pt;" lang="EN-US">Staphylococcus aureus</span></i><span style="font-size: 10pt;" lang="EN"> is a pathogen associated with intrahospital infections commonly found in the nasal cavities and the hands of health personnel, as well as, on environmental surfaces; which become potential reservoirs and transmission vehicles of infections. In this study <span style="">the frequency and </span>susceptibility to penicillin and methicillin <span style="">of environmental isolates of <i>S. aureus</i><span style=""> in a</span> hospital to Cuenca</span> were <span style="">analyzed.</span><span style=""> 50 samples </span>(30 of two operating room and 20 of the intensive care room)<span style=""> were</span><span style=""> collected</span>. <i style="">S. aureus</i> was identified by phenotypic tests and molecular detection of the <span class="SpellE"><i style="">nuc</i></span> gene. The susceptibility to methicillin and penicillin was determined by <span style="">agar disc diffusion </span>method and the <span class="SpellE"><i>blaZ</i></span> and <span class="SpellE"><i>mecA</i></span> genes by polymerase chain reaction. The frequency of <i style="">S. aureus</i> was 6% (3/50 strains). Resistance to penicillin and methicillin was 66.6% (2/3 strains). The <span class="SpellE"><i style="">blaZ</i></span> and <span class="SpellE"><i style="">mecA</i></span> genes were detected in the two <a name="_Hlk9683121">strains resistant to penicillin and methicillin</a>. </span><span style="font-size: 10pt;" lang="EN">The low frequency of <i>S. aureus</i> may be related to the environments analyzed; because the surfaces sampled are areas where emphasis is placed on the application of hygiene and disinfection protocols for ensure adequate decontamination.<o:p></o:p></span></p> <p class="ResumenTexto"><b style=""><span style="font-size: 10pt; color: rgb(0, 32, 96);" lang="EN-US">Keywords:</span></b><b style=""><span style="font-size: 6pt;" lang="EN-US"> </span></b><i style=""><span style="font-size: 10pt;" lang="EN-US">Staphylococcus aureus</span></i><span style="font-size: 10pt;" lang="EN-US">, operating rooms, cross infection, Penicillin Resistance<i style="">,</i> Methicillin Resistance<o:p></o:p></span></p> <p class="ResumenTexto" style="margin-top: 18pt;"><b><span style="font-size: 10pt; color: rgb(0, 32, 96);">Recibido:</span></b><span style="font-size: 10pt;"> 20-07-2019 / </span><b><span style="font-size: 10pt; color: rgb(0, 32, 96);">Aceptado:</span></b><span style="font-size: 10pt;"> 03-09-2019 / </span><b><span style="font-size: 10pt; color: rgb(0, 32, 96);">Publicación en línea:</span></b><span style="font-size: 10pt; color: rgb(0, 32, 96);"> </span><span style="font-size: 10pt;">10-09-2019<o:p></o:p></span></p> <h1 style="margin-top: 18pt;"><span style="font-size: 12pt;">Introducción<o:p></o:p></span></h1> <p class="MsoNormal"><i style=""><span style="font-size: 10pt;">Staphylococcus aureus </span></i><span style="font-size: 10pt;">forma parte <span class="GramE">de la microbiota</span> de la piel y las superficies mucosas de humanos y animales. Este microorganismo es considerado uno de los más frecuentes y de mayor significado clínico, se asocia con una diversidad de enfermedades que incluyen infecciones en piel y tejido blando hasta procesos infecciosos severos, tales como: bacteriemia, endocarditis, neumonía, meningitis, infecciones de heridas quirúrgicas y síndrome de shock tóxico <sup>(</sup><a href="#r1"><sup>1</sup></a><sup>,</sup><a href="#r2"><sup>2</sup></a><sup>)</sup><i style="">. S. aureus</i> produce una serie de factores de virulencia y enzimas extracelulares que se relacionan con la severidad de los cuadros clínicos; además, tiene una alta capacidad para adquirir resistencia a los antibióticos, lo cual puede implicar mayores complicaciones debido a dificultades con el tratamiento antimicrobiano <sup>(</sup><a href="#r1"><sup>1</sup></a><sup>)</sup>.<o:p></o:p></span></p> <p class="MsoNormal"><span style="font-size: 10pt;">A nivel mundial, las infecciones adquiridas en el hospital constituyen un importante problema de salud pública debido a la <span class="SpellE">morbi</span>-mortalidad que ocasionan. Según un estudio auspiciado por la Organización Mundial de la Salud, realizado en 55 hospitales de 14 países de las regiones de Europa, Mediterráneo Este, Sureste Asiático y Pacífico Oeste, </span><span style="font-size: 10pt;">el 8,7% de los pacientes hospitalizados adquieren infecciones relacionadas con los cuidados de salud <sup>(</sup></span><span style="font-size: 10pt;"><a href="#r3"><sup><span style="">3</span></sup></a></span><sup><span style="font-size: 10pt;">)</span></sup><span style="font-size: 10pt;">.<o:p></o:p></span></p> <p class="MsoNormal"><i style=""><span style="font-size: 10pt;">S. aureus</span></i><span style="font-size: 10pt;"> es uno de los principales patógenos asociados con infecciones adquiridas en el hospital. Es un microorganismo altamente invasivo y considerado como el principal responsable de infecciones del tracto respiratorio inferior e infecciones de heridas quirúrgicas y la segunda causa de bacteriemia intrahospitalaria, neumonía e infecciones cardiovasculares <sup>(</sup><a href="#r4"><sup>4</sup></a><sup>-</sup><a href="#r9"><sup>9</sup></a><sup>)</sup>. Por otra parte, la emergencia de cepas resistentes a meticilina, las cuales suelen ser multirresistentes, agrava el problema, puesto que, las infecciones intrahospitalarias producidas por <i style="">S. aureus</i> resistente a meticilina (SARM) incrementan la <span class="SpellE">morbi</span>-mortalidad, prolongan la estancia hospitalaria y aumentan los costos derivados del uso de terapia antimicrobiana. Se estima que, en países en vías de desarrollo más del 30% de las infecciones adquiridas en instituciones hospitalarias son producidas por SARM <sup>(</sup><a href="#r10"><sup>10</sup></a><sup>)</sup>.<o:p></o:p></span></p> <p class="MsoNormal"><i style=""><span style="font-size: 10pt;">S. aureus</span></i><span style="font-size: 10pt;"> es un microrganismo ampliamente distribuido en el ambiente hospitalario y constituye un reto para los programas de control epidemiológico de las infecciones intrahospitalarias. Es comúnmente hallado en las fosas nasales y las manos del personal de salud; así como, en superficies como pisos, paredes, techos, mesas, interruptores eléctricos, manillas de puertas, camas, aparatos electrónicos, equipos de computación, fómites, instrumentos y equipos médicos; los cuales se convierten en potenciales reservorios y vehículos de transmisión de infecciones entre los pacientes <sup>(</sup><a href="#r5"><sup>5</sup></a><sup>,</sup><a href="#r11"><sup>11</sup></a><sup>,</sup><a href="#r12"><sup>12</sup></a><sup>)</sup>.<o:p></o:p></span></p> <p class="MsoNormal"><span style="font-size: 10pt;">La mayoría de las infecciones adquiridas en el hospital son de origen endógeno; siendo <span class="GramE">la microbiota</span> del paciente la principal fuente. Sin embargo, el contacto con otros pacientes infectados o colonizados, el personal de salud y el ambiente hospitalario constituyen fuentes exógenas para la adquisición de patógenos hospitalarios <sup>(</sup><a href="#r13"><sup>13</sup></a><sup>)</sup>. Se estima que, aproximadamente, de 20-40% de las infecciones intrahospitalarias tienen su origen en contaminación cruzada a través de las manos del personal de salud en contacto directo con los pacientes o, indirectamente, por contacto con superficies ambientales contaminadas <sup>(</sup><a href="#r6"><sup>6</sup></a><sup>,</sup><a href="#r14"><sup>14</sup></a><sup>)</sup>.<o:p></o:p></span></p> <p class="MsoNormal"><span style="font-size: 10pt;">La contribución de las superficies ambientales en la transmisión de patógenos intrahospitalarios está relacionada con diversos factores, incluyendo: la habilidad del microorganismo para permanecer viable en superficies inanimadas secas, la frecuencia con la cual los pacientes y el personal de salud entran en contacto con las superficies comúnmente contaminadas y los niveles de contaminación suficientemente altos como para permitir la transmisión a los pacientes <sup>(</sup><a href="#r15"><sup>15</sup></a><sup>)</sup>.<o:p></o:p></span></p> <p class="MsoNormal"><span style="font-size: 10pt;">Si bien está establecido que la diseminación de bacterias intrahospitalarias tiene causas multifactoriales y depende, en gran parte, de la interacción entre el hospedero, el microorganismo y el entorno; los factores considerados más importantes para la diseminación de <i style="">S. aureus</i> en los centros hospitalarios se relacionan con la capacidad de adaptación de la bacteria a diversas condiciones ambientales, la aglomeración de pacientes en espacios físicos reducidos, el incumplimiento de las normas básicas de asepsia y fallas en la identificación temprana de los portadores del microorganismo <sup>(</sup><a href="#r8"><sup>8</sup></a><sup>)</sup>. <o:p></o:p></span></p> <p class="MsoNormal"><span style="font-size: 10pt;">En vista de la importancia de <i>S. aureus</i> como patógeno intrahospitalario, investigar su presencia en los ambientes de instituciones de atención en salud, puede aportar datos para establecer el papel que desempeñan las superficies inertes como reservorios y fuente de transmisión de este microrganismo entre pacientes hospitalizados y personal de salud. Por lo tanto, la presente investigación tiene como objetivo </span><span style="font-size: 10pt;" lang="ES">analizar </span><span style="font-size: 10pt;">la frecuencia y los patrones de susceptibilidad a penicilina y meticilina de <i>S. aureus</i><span style=""> aislados de </span>la unidad de cuidados intensivos (UCI) y las salas de cirugía de un centro hospitalario de Cuenca, Ecuador.</span><span style="font-size: 10pt;"><o:p></o:p></span></p> <h1 style="margin-top: 18pt;"><span style="font-size: 12pt; color: rgb(0, 32, 96);">Métodos<o:p></o:p></span></h1> <p class="MsoNormal" style=""><span class="SubtituloSeccinCar"><span style="font-size: 10pt;">Tipo y diseño de la investigación:</span></span><b style=""><span style="font-size: 10pt; color: windowtext;"> </span></b><a name="_Hlk17374618"><span style="font-size: 10pt; color: windowtext;">El estudio realizado fue de tipo no experimental, descriptivo, ya que, durante el proceso de investigación no se manipularon variables, ni condiciones de experimentación; sólo se observó y describió el comportamiento de las variables.</span></a><span style=""><span style="font-size: 10pt; color: windowtext;"> El diseño de la investigación es transversal, puesto que, los datos se recolectaron y evaluaron durante un tiempo establecido; es decir, se seleccionaron los ambientes hospitalarios, se tomaron las muestras y se analizaron mediante técnicas de laboratorio, con el objetivo de evaluar las variables en estudio<span style="">.<o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoNormal" style=""><a name="_Hlk17379605"><span class="SubtituloSeccinCar"><span style="font-size: 10pt;">Muestra:</span></span></a><span style=""><span style="font-size: 10pt; color: windowtext;"> l</span></span><span style=""><span style="font-size: 10pt; color: windowtext;">os ambientes hospitalarios seleccionados para el estudio fueron los dos quirófanos y la sala de cuidados intensivos con dos camas, existentes en un Hospital de la ciudad de Cuenca. Se<span style=""> recolectaron 50 muestras</span> de materiales instrumentales, equipos médicos y superficies de las áreas mencionadas, distribuidas de la siguiente manera: 15 de cada uno de los dos quirófanos y 10 de cada una de las dos camas ubicadas en la UCI. El muestreo fue aleatorio simple.<o:p></o:p></span></span></p> <p class="MsoNormal"><span style=""><a name="_Hlk17404831"><span style="font-size: 10pt; color: windowtext;">Para su inclusión en este estudio, se seleccionaron los ambientes hospitalarios considerados como áreas críticas para la adquisición de infecciones intrahospitalarias, puesto que, en ellos se aplican procedimientos invasivos, relacionados con los cuidados de salud de los pacientes, los cuales aumentan la posibilidad de contaminación de las superficies ambientales, instrumentos y equipos médicos. Se excluyeron aquellos ambientes que, por la naturaleza de la atención prestada, no representan áreas de riesgo de contaminación microbiana.</span></a></span><span style=""><span style="font-size: 10pt; color: windowtext;"><o:p></o:p></span></span></p> <p class="MsoNormal" style=""><span style=""><span style="font-size: 10pt; color: windowtext;">Las muestras fueron recolectadas por duplicado con la ayuda de un hisopo de algodón estéril humedecido con caldo soya tripticasa (CST), el cual se frotó sobre las superficies de contacto frecuente (manijas de cortinas, interruptores, piso, mesa para materiales, ventanas y lámparas), materiales instrumentales y equipos médicos y se colocó en un tubo conteniendo CST. El procesamiento de las muestras se ejecutó en el laboratorio de Biología Molecular y Genética del Centro de Investigación, Innovación y Transferencia de Tecnología, Universidad Católica de Cuenca.<o:p></o:p></span></span></p> <span style=""></span> <p class="MsoNormal" style=""><span class="SubtituloSeccinCar"><span style="font-size: 10pt;">Metodología:</span></span><span style="font-size: 10pt; color: windowtext;"> </span><span style="font-size: 10pt; color: windowtext;">previo a su análisis bacteriológico, las muestras fueron incubadas en aerobiosis por 4 horas a 35-37°C. Posteriormente, se inocularon en agar manitol salado e incubaron en condiciones de aerobiosis, a una temperatura entre </span><span style="font-size: 10pt; color: windowtext;">35-37°C, durante 24-48 horas. <span style="">Transcurrido el período de incubación, se procedió a la identificación presuntiva mediante la selección de colonias fermentadoras del manitol, con características morfológicas de microorganismos pertenecientes al género <i style="">Staphylococcus. </i>A partir de estas colonias se realizó un extendido coloreado mediante la técnica de Gram. Si se observaban cocos Gram positivos con predominio de racimos, se efectuó la identificación definitiva mediante pruebas fenotípicas y detección genética del gen <span class="SpellE"><i style="">nuc</i></span><i style=""> </i><sup>(</sup></span></span><span style="font-size: 10pt;"><a href="#r16"><sup><span style="">16</span></sup></a></span><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup><span style="font-size: 10pt; color: windowtext;">, que codifica para una nucleasa específica de <i style="">S. aureus.</i><o:p></o:p></span></p> <p class="MsoNormal" style=""><span style="font-size: 10pt; color: windowtext;">La identificación fenotípica de <i style="">S. aureus</i> se realizó mediante la fermentación en agar manitol salado y las reacciones positivas de las pruebas de coagulasa y <span class="SpellE">desoxirribonucleasa</span> (<span class="SpellE">DNAsa</span>). <o:p></o:p></span></p> <p class="MsoNormal" style=""><span class="SubtituloSeccinCar"><span style="font-size: 10pt;">Determinación fenotípica de susceptibilidad a antibióticos beta lactámicos:</span></span><span style="font-size: 10pt; color: windowtext;"> </span><span style="font-size: 10pt; color: windowtext;">l<span style="">a susceptibilidad a penicilina y oxacilina de los aislamientos de S. aureus se determinó mediante el método de difusión del disco en agar, siguiendo los lineamientos del Instituto para la Estandarización de Laboratorios Clínicos (CLSI, por sus siglas en inglés) <sup>(</sup></span></span><span style="font-size: 10pt;"><a href="#r17"><sup><span style="">17</span></sup></a></span><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup><span style="font-size: 10pt; color: windowtext;">. Para tal fin, se preparó con cada una de las cepas de <i style="">S. aureus</i> a analizar, un inóculo bacteriano espectrofotométricamente estandarizado con el patrón 0,5 del nefelómetro de <span class="SpellE">MacFarland</span> (625nm; DO: 0,8-1,0). Con esta suspensión, se inoculó una placa de agar Müeller Hinton sobre la cual se colocaron los discos de antibióticos penicilina G(10U) y oxacilina (1µg). Las placas se incubaron en condiciones de aerobiosis, por 18-24 horas a 35°C. Luego, se procedió a la lectura, midiendo los diámetros de los halos de inhibición y los resultados se interpretaron de acuerdo con los criterios del CLSI como: sensibles, intermedios o resistentes.</span><span style="font-size: 10pt; color: windowtext;"><o:p></o:p></span></p> <p class="MsoNormal"><span class="SubtituloSeccinCar"><span style="font-size: 10pt;">Extracción de ADN:</span></span><i><span style="font-size: 10pt; color: windowtext;"> </span></i><span style="font-size: 10pt; color: windowtext;">para la extracción de ADN de las cepas de <i style="">S. aureus</i> se utilizó el método de lisis alcalina, </span><span style="font-size: 10pt; color: windowtext;">el cual se describe brevemente a continuación: Se suspendieron colonias de <i style="">S. aureus</i> en 1ml de agua destilada, se centrifugó 10 minutos a 3000rpm y se descartó el sobrenadante, se agregaron 50µl de solución de lisis formada por dodecilsulfato sódico al 1% en NaOH 0,25N, se mezcló y se hirvió por 15 minutos, se añadieron 450µl de agua libre de nucleasas y se centrifugó por 20 segundos. El ADN extraído se conservó a -20°C.<o:p></o:p></span></p> <p class="MsoNormal"><span class="SubtituloSeccinCar"><span style="font-size: 10pt;">Identificación genotípica de S. aureus:</span></span><i><span style="font-size: 10pt; color: windowtext;"> </span></i><span style="font-size: 10pt; color: windowtext;">la identificación molecular de las cepas de <i style="">S. aureus </i>se realizó mediante prueba de reacción en cadena de la polimerasa (PCR) utilizando iniciadores específicos para amplificar el gen <span class="SpellE"><i style="">nuc</i></span> que </span><span style="font-size: 10pt; color: windowtext;">codifica para una nucleasa específica de especie <sup>(</sup></span><span style="font-size: 10pt;"><a href="#r16"><sup><span style="">16</span></sup></a></span><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup><span style="font-size: 10pt; color: windowtext;">. El producto amplificado, iniciadores y condiciones de amplificación se muestran en la </span><span style="font-size: 10pt;"><a href="#t1">Tabla 1</a></span><span style="font-size: 10pt; color: windowtext;">. Como controles positivos, se utilizó <i style="">S. aureus</i> ATCC® 11632 y <i style="">S. aureus</i> ATCC® 43300 y como control negativo <i style="">Streptococcus pyogenes (S. pyogenes)</i> ATCC® 12344.<o:p></o:p></span></p> <p class="MsoNormal" style=""><span class="SubtituloSeccinCar"><span style="font-size: 10pt;">Detección genotípica de resistencia a beta-lactámicos:</span></span><i><span style="font-size: 10pt; color: windowtext;"> </span></i><span style="font-size: 10pt; color: windowtext;">la técnica de PCR fue utilizada para la detección molecular de los genes <span class="SpellE"><i style="">blaZ</i></span> y <span class="SpellE"><i style="">mecA</i></span>, que codifican para resistencia a penicilina y meticilina, respectivamente <sup>(</sup></span><span style="font-size: 10pt;"><a href="#r18"><sup><span style="">18</span></sup></a></span><sup><span style="font-size: 10pt; color: windowtext;">-</span></sup><span style="font-size: 10pt;"><a href="#r20"><sup><span style="">20</span></sup></a></span><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup><span style="font-size: 10pt; color: windowtext;">. En la </span><span style="font-size: 10pt;"><a href="#t1"><span style="">Tabla 1</span></a></span><span style="font-size: 10pt; color: windowtext;"> se indican los iniciadores, productos amplificados y condiciones de amplificación. </span><span style="font-size: 10pt; color: windowtext;">Como controles positivos se utilizaron las cepas ATCC® 11632 (<span class="SpellE"><i style="">blaZ</i></span> +) y ATCC® 43300 (<span class="SpellE"><i style="">mecA</i></span> +) y como control negativo, <i style="">S. pyogenes</i> ATCC® 12344.<o:p></o:p></span></p> <p class="MsoNormal" style=""><span style="font-size: 10pt; color: windowtext;">Todas las reacciones de PCR, tanto para la detección del gen <span class="SpellE"><i style="">nuc</i></span> como para los genes <span class="SpellE"><i style="">blaZ</i></span><i style=""> </i>y <span class="SpellE"><i style="">mecA</i></span><i style="">,</i> se llevaron a cabo en un volumen </span><span style="font-size: 10pt; color: windowtext;">total de 20μl conteniendo: 10μl de <span class="SpellE">Mastermix</span> <span class="SpellE">GoTaq</span> Green 2X de Promega con 400μM de cada uno de los <span class="SpellE">dNTP</span> y 3mM MgCl<sub>2</sub>, 1,5μl de cada iniciador, 1,5μl del ADN extraído y 5,5μl de agua pura.<o:p></o:p></span></p> <p class="MsoNormal" style=""><span style="font-size: 10pt; color: windowtext;">Las amplificaciones se realizaron en un termociclador PIKO </span><span style="font-size: 10pt; color: windowtext;">(<span class="SpellE">Finnzymes</span>) </span><span style="font-size: 10pt; color: windowtext;" lang="ES">según los protocolos mencionados en la </span><span style="font-size: 10pt;"><a href="#t1"><span style="" lang="ES">Tabla 1</span></a></span><span style="font-size: 10pt; color: windowtext;" lang="ES">.</span><span style="font-size: 10pt; color: windowtext;"> La separación de los productos de PCR se realizó por electroforesis en geles de agarosa (1,5%p/v) </span><span style="background: white none repeat scroll 0%; font-size: 10pt; color: black; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial;">sobre un cámara horizontal sumergidos en buffer TBE (Tris 90mM-Borato 90mM-EDTA 2mM) con Bromuro de Etidio al 0,5µg/ml, a </span><span style="font-size: 10pt; color: windowtext;">70V, 70A y 50 W por 2 horas. El tamaño de los productos de PCR se calculó de acuerdo con sus migraciones en los geles de agarosa comparándolo con la migración de las bandas de ADN patrón del marcador de peso molecular <span class="SpellE">Trackit</span> de Invitrogen (1 Kb Plus DNA <span class="SpellE">ladder</span>) y</span><span style="background: white none repeat scroll 0%; font-size: 10pt; color: black; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial;"> se fotografiaron sobre un transiluminador con una cámara digital.</span><span style="background: white none repeat scroll 0%; color: windowtext; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial;"><o:p></o:p></span></p> <p class="TablaTitulo"><a name="t1"><b><span style="color: rgb(0, 32, 96);">Tabla 1.</span></b> Iniciadores, producto amplificado y condiciones de amplificación de genes </a><span class="SpellE"><span style=""><i style="">nuc</i></span></span><span style="">, <span class="SpellE"><i style="">blaZ</i></span> y <span class="SpellE"><i style="">mecA</i></span></span></p> <span style=""></span> <div align="center"> <table class="MsoTableGrid" style="border: medium none ; border-collapse: collapse;" border="0" cellpadding="0" cellspacing="0"> <tbody> <tr style="height: 1pt;"> <td style="padding: 0cm 5.4pt; background: rgb(0, 32, 96) none repeat scroll 0%; width: 63.8pt; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial; height: 1pt;" width="85"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><b><span style="font-size: 8pt; color: white;">Producto amplificado (pb)<o:p></o:p></span></b></p> </td> <td style="padding: 0cm 5.4pt; background: rgb(0, 32, 96) none repeat scroll 0%; width: 7cm; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial; height: 1pt;" width="265"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><b><span style="font-size: 8pt; color: white;">Secuencia del iniciador 5’-3’<o:p></o:p></span></b></p> </td> <td style="padding: 0cm 5.4pt; background: rgb(0, 32, 96) none repeat scroll 0%; width: 141.5pt; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial; height: 1pt;" width="189"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><b><span style="font-size: 8pt; color: white;">Condición de amplificación<o:p></o:p></span></b></p> </td> <td style="padding: 0cm 5.4pt; background: rgb(0, 32, 96) none repeat scroll 0%; width: 63.8pt; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial; height: 1pt;" width="85"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><b><span style="font-size: 8pt; color: white;">Referencia<o:p></o:p></span></b></p> </td> </tr> <tr style="height: 1pt;"> <td style="padding: 0cm 5.4pt; width: 63.8pt; height: 1pt;" width="85"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span class="SpellE"><i style=""><span style="font-size: 8pt; color: windowtext;">nuc</span></i></span><i style=""><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></i></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: windowtext;">(218)<o:p></o:p></span></p> </td> <td style="padding: 0cm 5.4pt; width: 7cm; height: 1pt;" width="265"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: windowtext;">Forward: GACTATTATTGGTTGATCCACCTG<o:p></o:p></span></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: windowtext;">Reverse: GCCTTGACGAACTAAAGCTTCG<o:p></o:p></span></p> </td> <td style="padding: 0cm 5.4pt; width: 141.5pt; height: 1pt;" width="189"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: windowtext;">94 °C 5 min<o:p></o:p></span></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: windowtext;">30 ciclos:<o:p></o:p></span></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: windowtext;">94°C 1 min<o:p></o:p></span></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: windowtext;">54°C 1 min<o:p></o:p></span></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: windowtext;">72°C 1 min<o:p></o:p></span></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: windowtext;">72°C 10 min (Elongación final)<o:p></o:p></span></p> </td> <td style="padding: 0cm 5.4pt; width: 63.8pt; height: 1pt;" width="85"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: windowtext;" lang="EN-US">Depardieu y col, 2004</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> </td> </tr> <tr style="height: 1pt;"> <td style="padding: 0cm 5.4pt; background: rgb(242, 247, 252) none repeat scroll 0%; width: 63.8pt; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial; height: 1pt;" width="85"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span class="SpellE"><i style=""><span style="font-size: 8pt; color: black;">blaZ</span></i></span><sup><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></sup></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: black;">(674)</span><i style=""><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></i></p> </td> <td style="padding: 0cm 5.4pt; background: rgb(242, 247, 252) none repeat scroll 0%; width: 7cm; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial; height: 1pt;" width="265"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: black;">Forward: GTTGCGAACTCTTGAATAGG</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: black;">Reverse: GGAGAATAAGCAACTATATCATC</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> </td> <td style="padding: 0cm 5.4pt; background: rgb(242, 247, 252) none repeat scroll 0%; width: 141.5pt; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial; height: 1pt;" width="189"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: black;">94 °C 5 min</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: black;">34 ciclos:</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: black;">94°C 1 min</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: black;">54°C 1 min</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: black;">72°C 1 min</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: black;">72°C 10 min (Elongación final)</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> </td> <td style="padding: 0cm 5.4pt; background: rgb(242, 247, 252) none repeat scroll 0%; width: 63.8pt; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial; height: 1pt;" width="85"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: black;" lang="EN-US">Olsen y col, 2006</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> </td> </tr> <tr style="height: 1pt;"> <td style="border-style: none none solid; border-color: -moz-use-text-color -moz-use-text-color rgb(0, 32, 96); border-width: medium medium 1pt; padding: 0cm 5.4pt; width: 63.8pt; height: 1pt;" width="85"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span class="SpellE"><i style=""><span style="font-size: 8pt; color: windowtext;">mecA</span></i></span><i style=""><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></i></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: windowtext;">(310)<o:p></o:p></span></p> </td> <td style="border-style: none none solid; border-color: -moz-use-text-color -moz-use-text-color rgb(0, 32, 96); border-width: medium medium 1pt; padding: 0cm 5.4pt; width: 7cm; height: 1pt;" width="265"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: windowtext;">Forward: GTAGAAATGACTGAACGTCCGATGA Reverse: CCAATTCCACATTGTTTCGGTCTAA<o:p></o:p></span></p> </td> <td style="border-style: none none solid; border-color: -moz-use-text-color -moz-use-text-color rgb(0, 32, 96); border-width: medium medium 1pt; padding: 0cm 5.4pt; width: 141.5pt; height: 1pt;" width="189"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: windowtext;">94 °C 5 min<o:p></o:p></span></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: windowtext;">30 ciclos:<o:p></o:p></span></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: windowtext;">94°C 1 min<o:p></o:p></span></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: windowtext;">62°C 30 <span class="SpellE">seg</span><o:p></o:p></span></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: windowtext;">72°C 35 <span class="SpellE">seg</span><o:p></o:p></span></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: windowtext;">72°C 10 min (Elongación final)<o:p></o:p></span></p> </td> <td style="border-style: none none solid; border-color: -moz-use-text-color -moz-use-text-color rgb(0, 32, 96); border-width: medium medium 1pt; padding: 0cm 5.4pt; width: 63.8pt; height: 1pt;" width="85"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span class="SpellE"><span style="font-size: 8pt; color: windowtext;">Elhassan</span></span><span style="font-size: 8pt; color: windowtext;"> y col, 2015;<o:p></o:p></span></p> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: windowtext;" lang="EN-US">Harrison y col, 2014</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> </td> </tr> </tbody> </table> </div> <p class="MsoNormal" style="margin-top: 18pt;"><span class="SubtituloSeccinCar"><span style="">Análisis estadístico:</span></span><b style=""><i><span style="color: windowtext;"> </span></i></b><span style="color: windowtext;">los datos obtenidos fueron organizados en tablas y figuras. El análisis estadístico se realizó utilizando el paquete estadístico SPSS</span><span class="A5"><span style="font-family: "Century Gothic",sans-serif; color: windowtext;">TM </span></span><span style="color: windowtext;">versión 19.0 (SPSS, Inc. Chicago, USA) para <span class="SpellE">Windows<span class="A5"><sup><span style="font-family: "Century Gothic",sans-serif; color: windowtext;">TM</span></sup></span></span>. Para establecer si existe alguna relación de asociación entre el ambiente hospitalario y la presencia de <i style="">S. aureus</i> se utilizó el estadístico de contraste <i>X</i></span><span class="A5"><sup><span style="font-family: "Century Gothic",sans-serif; color: windowtext;">2</span></sup></span><span class="A5"><span style="font-family: "Century Gothic",sans-serif; color: windowtext;"> </span></span><span style="color: windowtext;">(Chi-cuadrado), con un nivel de significancia del 95%<i style="">.<o:p></o:p></i></span></p> <h1 style="margin-top: 18pt;"><span style="font-size: 12pt;">Resultados<o:p></o:p></span></h1> <p class="MsoNormal"><span style="font-size: 10pt; color: windowtext;" lang="ES-PE">En este estudio, se demostró una frecuencia de </span><span style="font-size: 10pt; color: windowtext;">6% </span><span style="font-size: 10pt; color: windowtext;" lang="ES-PE">de<i style=""> S. aureus</i> contaminando las superficies de los ambientes hospitalarios analizados. La distribución de las cepas obtenidas fue la siguiente: un aislamiento procedió de una mascarilla utilizada para anestesia general perteneciente al quirófano 1; mientras que, las otras dos cepas se aislaron de muestras obtenidas de un dispositivo de succión y de un equipo de intubación, ambos dispuestos en el perímetro correspondiente a la cama 1 de la UCI. No se recuperó <i style="">S. aureus</i> de los especímenes provenientes del quirófano 2 y de las adyacencias a la cama 2 de la UCI (</span><span style="font-size: 10pt;"><a href="#t2"><span style="" lang="ES-PE">Tabla 2</span></a></span><span style="font-size: 10pt; color: windowtext;" lang="ES-PE">).<o:p></o:p></span></p> <p class="MsoNormal"><span style="font-size: 10pt; color: windowtext;" lang="ES-PE">Las 3 cepas identificadas por pruebas bioquímicas como <i style="">S. aureus</i> amplificaron el fragmento 218pb, correspondiente al gen <span class="SpellE"><i style="">nuc</i></span>, lo cual confirman su identificación genotípica. <o:p></o:p></span></p> <p class="TablaTitulo"><a name="t2"><b><span style="color: rgb(0, 32, 96);">Tabla 2.</span></b></a><span style=""><span style="color: rgb(0, 32, 96);"> </span>Distribución de <i style="">S. aureus</i> en muestras ambientales de un centro hospitalario.</span></p> <span style=""></span> <div align="center"> <table class="MsoNormalTable" style="background: white none repeat scroll 0%; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial; border-collapse: collapse;" border="0" cellpadding="0" cellspacing="0"> <tbody> <tr style="height: 8.5pt;"> <td style="padding: 0cm 5.4pt; background: rgb(0, 32, 96) none repeat scroll 0%; width: 175.5pt; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial; height: 8.5pt;" width="234"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><b><span style="font-size: 8pt; color: white;">Ambiente<o:p></o:p></span></b></p> </td> <td style="padding: 0cm 5.4pt; background: rgb(0, 32, 96) none repeat scroll 0%; width: 100.2pt; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial; height: 8.5pt;" width="134"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><b><span style="font-size: 8pt; color: white;">Positivo N (%)<o:p></o:p></span></b></p> </td> <td style="padding: 0cm 5.4pt; background: rgb(0, 32, 96) none repeat scroll 0%; width: 106.3pt; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial; height: 8.5pt;" width="142"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><b><span style="font-size: 8pt; color: white;">Negativo N (%)<o:p></o:p></span></b></p> </td> </tr> <tr style="height: 8.5pt;"> <td style="padding: 0cm 5.4pt; width: 175.5pt; height: 8.5pt;" width="234"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: left; text-indent: 0cm;" align="left"><span style="font-size: 8pt; color: black;">Quirófano 1</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> </td> <td style="padding: 0cm 5.4pt; width: 100.2pt; height: 8.5pt;" width="134"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: black;">1(6,6)</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> </td> <td style="padding: 0cm 5.4pt; width: 106.3pt; height: 8.5pt;" width="142"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: black;">14(93,4)</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> </td> </tr> <tr style="height: 8.5pt;"> <td style="padding: 0cm 5.4pt; background: rgb(242, 247, 252) none repeat scroll 0%; width: 175.5pt; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial; height: 8.5pt;" width="234"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: left; text-indent: 0cm;" align="left"><span style="font-size: 8pt; color: black;">Quirófano 2</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> </td> <td style="padding: 0cm 5.4pt; background: rgb(242, 247, 252) none repeat scroll 0%; width: 100.2pt; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial; height: 8.5pt;" width="134"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: black;">0</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> </td> <td style="padding: 0cm 5.4pt; background: rgb(242, 247, 252) none repeat scroll 0%; width: 106.3pt; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial; height: 8.5pt;" width="142"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: black;">15(100)</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> </td> </tr> <tr style="height: 8.5pt;"> <td style="padding: 0cm 5.4pt; width: 175.5pt; height: 8.5pt;" width="234"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: left; text-indent: 0cm;" align="left"><span style="font-size: 8pt; color: black;">Sala de cuidados intensivos Cama 1</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> </td> <td style="padding: 0cm 5.4pt; width: 100.2pt; height: 8.5pt;" width="134"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: black;">2(20)</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> </td> <td style="padding: 0cm 5.4pt; width: 106.3pt; height: 8.5pt;" width="142"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: black;">8(80)</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> </td> </tr> <tr style="height: 8.5pt;"> <td style="padding: 0cm 5.4pt; background: rgb(242, 247, 252) none repeat scroll 0%; width: 175.5pt; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial; height: 8.5pt;" width="234"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: left; text-indent: 0cm;" align="left"><span style="font-size: 8pt; color: black;">Sala de cuidados intensivos Cama 2</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> </td> <td style="padding: 0cm 5.4pt; background: rgb(242, 247, 252) none repeat scroll 0%; width: 100.2pt; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial; height: 8.5pt;" width="134"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: black;">0</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> </td> <td style="padding: 0cm 5.4pt; background: rgb(242, 247, 252) none repeat scroll 0%; width: 106.3pt; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial; height: 8.5pt;" width="142"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: black;">10(100)</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> </td> </tr> <tr style="height: 8.5pt;"> <td style="border-style: none none solid; border-color: -moz-use-text-color -moz-use-text-color rgb(0, 32, 96); border-width: medium medium 1pt; padding: 0cm 5.4pt; width: 175.5pt; height: 8.5pt;" width="234"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: left; text-indent: 0cm;" align="left"><span style="font-size: 8pt; color: black;">Total</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> </td> <td style="border-style: none none solid; border-color: -moz-use-text-color -moz-use-text-color rgb(0, 32, 96); border-width: medium medium 1pt; padding: 0cm 5.4pt; width: 100.2pt; height: 8.5pt;" width="134"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: black;">3(6)</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> </td> <td style="border-style: none none solid; border-color: -moz-use-text-color -moz-use-text-color rgb(0, 32, 96); border-width: medium medium 1pt; padding: 0cm 5.4pt; width: 106.3pt; height: 8.5pt;" width="142"> <p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; text-align: center; text-indent: 0cm;" align="center"><span style="font-size: 8pt; color: black;">50(94)</span><span style="font-size: 8pt; color: windowtext;"><o:p></o:p></span></p> </td> </tr> </tbody> </table> </div> <p class="MsoNormal" style="margin-top: 18pt;"><span style="font-size: 10pt; color: windowtext;" lang="ES-PE">De las 3 cepas <i style="">S. aureus</i> aisladas a partir de muestras ambientales, 2 (66,6%) fueron resistentes a penicilina y meticilina, por el método de difusión del disco en agar, mientras que, una cepa resultó sensible a estos dos antimicrobianos.<o:p></o:p></span></p> <p class="MsoNormal"><span style="font-size: 10pt; color: windowtext;" lang="ES-PE">En relación con la detección de los genes de resistencia a beta-lactámicos, las dos cepas resistentes, por el método fenotípico, amplificaron los fragmentos 674pb y </span><span style="font-size: 10pt; color: windowtext;">310pb</span><span style="font-size: 10pt; color: windowtext;" lang="ES-PE">, por lo tanto, poseen los genes <span class="SpellE"><i style="">blaZ</i></span> y <span class="SpellE"><i style="">mecA</i></span>, que codifican para resistencia a penicilina y meticilina, respectivamente (</span><span style="font-size: 10pt;"><a href="#f1"><span style="" lang="ES-PE">Figuras 1</span></a></span><span style="font-size: 10pt; color: windowtext;" lang="ES-PE"> y </span><span style="font-size: 10pt;"><a href="#f2"><span style="" lang="ES-PE">2</span></a></span><span style="font-size: 10pt; color: windowtext;" lang="ES-PE">).<o:p></o:p></span></p> <p class="MsoNormal"><o:p> </o:p></p> <p class="TablaTitulo"><a name="f1"><span style=""><v:shapetype id="_x0000_t75" coordsize="21600,21600" o:spt="75" o:preferrelative="t" path="m@4@5l@4@11@9@11@9@5xe" filled="f" stroked="f"> <v:stroke joinstyle="miter"> <v:formulas> <v:f eqn="if lineDrawn pixelLineWidth 0"> <v:f eqn="sum @0 1 0"> <v:f eqn="sum 0 0 @1"> <v:f eqn="prod @2 1 2"> <v:f eqn="prod @3 21600 pixelWidth"> <v:f eqn="prod @3 21600 pixelHeight"> <v:f eqn="sum @0 0 1"> <v:f eqn="prod @6 1 2"> <v:f eqn="prod @7 21600 pixelWidth"> <v:f eqn="sum @8 21600 0"> <v:f eqn="prod @7 21600 pixelHeight"> <v:f eqn="sum @10 21600 0"> </v:f> <v:path o:extrusionok="f" gradientshapeok="t" o:connecttype="rect"> <o:lock v:ext="edit" aspectratio="t"> </o:lock><v:shape id="Imagen_x0020_11" o:spid="_x0000_i1027" type="#_x0000_t75" style="width: 231pt; height: 155.25pt; visibility: visible;"> <v:imagedata src="20072019_archivos/image004.png" o:title=""> </v:imagedata></v:shape></v:path></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:formulas></v:stroke></v:shapetype></span></a><span style=""><b style=""><span style="color: rgb(0, 32, 96);"><o:p></o:p></span></b></span></p> <p class="TablaTitulo"><span style=""><b style=""><span style="color: rgb(0, 32, 96);">Figura 1.</span></b></span><span style=""><span style="color: rgb(0, 32, 96);"> </span>Productos de PCR para el gen <span class="SpellE"><i>blaZ</i></span> (674pb) en <i>S. aureus</i> aislados de ambientes hospitalarios: carril 1: marcador de PM; carril 2 cepa control positivo; carriles 3 cepa control negativo; carriles 4 cepa negativa: carriles 5 y 6, cepas positivas.</span></p> <span style=""></span> <p class="MsoNormal"><o:p> </o:p></p> <p class="TablaTitulo" style="margin-bottom: 18pt;"><a name="f2"><b><span style=""><v:shape id="Imagen_x0020_12" o:spid="_x0000_i1026" type="#_x0000_t75" style="width: 239.25pt; height: 171.75pt; visibility: visible;"> <v:imagedata src="20072019_archivos/image007.png" o:title=""> </v:imagedata></v:shape></span></b></a><span style=""><b style=""><span style="color: rgb(0, 32, 96);"><o:p></o:p></span></b></span></p> <p class="TablaTitulo" style="margin-bottom: 18pt;"><span style=""><b style=""><span style="color: rgb(0, 32, 96);">Figura 2.</span></b></span><span style=""><span style="color: rgb(0, 32, 96);"> </span>Producto de PCR para el gen <span class="SpellE">mecA</span> (310 pb) en <i>S. aureus</i> aislados de ambientes hospitalarios: Carril 1 marcador de PM, Carril 2 cepa control positivo, Carril 3 cepa control negativo, carril 4 cepa negativa, carriles 5 y 6 cepas positivas.</span></p> <span style=""></span> <h1 style="margin-top: 18pt;"><span style="font-size: 12pt;">Discusión<o:p></o:p></span></h1> <p class="MsoNormal"><a name="_Hlk5410378"><span style="font-size: 10pt; color: windowtext;">Las superficies ambientales, fómites, equipos e instrumentos médicos son reconocidos como importantes reservorios de patógenos intrahospitalarios productores de infecciones asociadas con cuidados de salud. En este estudio, mediante el cual se evaluó la presencia de <i style="">S. aureus</i> en dos quirófanos y una UCI, se recuperó este microorganismo en 6% de las muestras analizadas. Los resultados de esta investigación coinciden con los reportados por Chávez y col <sup>(</sup></span></a><span style=""></span><a href="#r8"><span style=""><sup><span style="font-size: 10pt;">8</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup></span><span style=""><span style="font-size: 10pt; color: windowtext;">, quienes analizaron la frecuencia de <i style="">S. aureus</i></span></span><span style=""><span style="font-size: 10pt; color: windowtext;"> en varios servicios de un hospital de Cali-Colombia y comunicaron 6,1% de aislamiento en la UCI. De igual modo, </span></span><span style=""><span style="font-size: 10pt; color: windowtext;">Al-<span class="SpellE">Abdli</span> y <span class="SpellE">BIau</span> <sup>(</sup></span></span><span style=""></span><a href="#r21"><span style=""><sup><span style="font-size: 10pt;">21</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup></span><span style=""><span style="font-size: 10pt; color: windowtext;">, reportaron 10% de <i style="">S. aureus</i> </span></span><span style=""><span style="font-size: 10pt; color: windowtext;">en la unidad de diálisis de un hospital de Libia; sin embargo, estos autores comunicaron un porcentaje de recuperación de este microrganismo en la UCI de 23,8%, lo cual discrepa de los resultados de este estudio. <o:p></o:p></span></span></p> <p class="MsoNormal"><span style=""><span style="font-size: 10pt; color: windowtext;">Otros autores han hallado porcentajes ligeramente superiores a los encontrados en este estudio. Así, <span class="SpellE">Gharsa</span> y col <sup>(</sup></span></span><span style=""></span><a href="#r1"><span style=""><sup><span style="font-size: 10pt;">1</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup></span><span style=""><span style="font-size: 10pt; color: windowtext;">, en un estudio realizado en diferentes servicios de un hospital de Tunes, reportaron 12% de <i style="">S. aureus;</i> estos aislamientos fueron recuperados en diferentes unidades, mostrando una amplia distribución de este microorganismo en el ambiente hospitalario. Otros autores, <span class="SpellE">Ekrami</span> y col <sup>(</sup></span></span><span style=""></span><a href="#r22"><span style=""><sup><span style="font-size: 10pt;">22</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup></span><span style=""><span style="font-size: 10pt; color: windowtext;">, <span class="SpellE">Mukhiya</span> y col <sup>(</sup></span></span><span style=""></span><a href="#r23"><span style=""><sup><span style="font-size: 10pt;">23</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup></span><span style=""><span style="font-size: 10pt; color: windowtext;">, <span class="SpellE">Tagoe</span> y Desbordes <sup>(</sup></span></span><span style=""></span><a href="#r24"><span style=""><sup><span style="font-size: 10pt;">24</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup></span><span style=""><span style="font-size: 10pt; color: windowtext;">, evaluaron la presencia de esta bacteria en muestras provenientes de diversas superficies hospitalarias y reportaron porcentajes de positividad similares que oscilan entre 13,7-14,42%.<o:p></o:p></span></span></p> <p class="MsoNormal"><span style=""><span style="font-size: 10pt; color: windowtext;">Al contrastar las publicaciones de otros autores con los resultados de la contaminación de los ambientes hospitalarios evaluados en esta investigación, se aprecia una notable discrepancia en la frecuencia de aislamiento de <i style="">S. aureus.</i> En este sentido, Rivera y col <sup>(</sup></span></span><span style=""></span><a href="#r5"><span style=""><sup><span style="font-size: 10pt;">5</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup></span><span style=""><span style="font-size: 10pt; color: windowtext;">, en un estudio realizado en un hospital de Perú, recuperaron 26,6% de <i style="">S. aureus</i> en muestras provenientes de </span></span><span style=""><span style="font-size: 10pt; color: windowtext;">salas de cirugía y salas de parto</span></span><span style=""><span style="font-size: 10pt; color: windowtext;">: mientras que,</span></span><span style=""><span style="font-size: 10pt; color: windowtext;"> <span class="SpellE">Oie</span> y col <sup>(</sup></span></span><span style=""></span><a href="#r25"><span style=""><sup><span style="font-size: 10pt;">25</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup></span><span style=""><span style="font-size: 10pt; color: windowtext;">, </span></span><span style=""><span style="font-size: 10pt; color: windowtext;">en un centro de servicios de salud japonés, comunicaron 27% de aislamiento de este microorganismo en especímenes recolectados de superficies inanimadas. Por otra parte, </span></span><span style=""><span class="SpellE"><span style="font-size: 10pt; color: windowtext;">Odoya</span></span></span><span style=""><span style="font-size: 10pt; color: windowtext;"> y col <sup>(</sup></span></span><span style=""></span><a href="#r4"><span style=""><sup><span style="font-size: 10pt;">4</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup></span><span style=""><span style="font-size: 10pt; color: windowtext;">, en un hospital nigeriano, </span></span><span style=""><span style="font-size: 10pt; color: windowtext;">indican contaminación por este agente microbiano superior al 50% en especímenes ambientales de diversas áreas hospitalarias. <o:p></o:p></span></span></p> <p class="MsoNormal"><span style=""><span style="font-size: 10pt; color: windowtext;">Las variaciones en el aislamiento de patógenos hospitalarios, como <i style="">S. aureus</i>, pueden relacionarse con factores como la técnica de muestreo, los métodos de cultivo y aislamiento bacteriano, la facilidad y grado de contaminación de las superficies y objetos inanimados, la capacidad de la cepa de mantenerse viable por períodos prolongados en ambientes secos, la resistencia bacteriana a los desinfectantes y antisépticos utilizados para la limpieza, la aglomeración de pacientes y personal en las salas de servicios de salud, la falta de protocolos estandarizados para la higiene y desinfección de los ambientes hospitalarios, la frecuencia de brotes epidémicos en el hospital y la rotación de pacientes en las camas hospitalarias <sup>(</sup></span></span><span style=""></span><a href="#r15"><span style=""><sup><span style="font-size: 10pt;">15</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">,</span></sup></span><span style=""></span><a href="#r26"><span style=""><sup><span style="font-size: 10pt;">26</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup></span><span style=""><span style="font-size: 10pt; color: windowtext;">. <o:p></o:p></span></span></p> <p class="MsoNormal"><span style=""><span style="font-size: 10pt; color: windowtext;">Investigaciones a nivel mundial han analizado la distribución de <i style="">S. aureus</i> en ambientes hospitalarios y; en general, existe consenso en cuanto a que estas áreas constituyen reservorios de este patógeno. No obstante, el papel de estas superficies como fuente de infección estafilocócica es controversial. Por una parte, Price y col <sup>(</sup></span></span><span style=""></span><a href="#r27"><span style=""><sup><span style="font-size: 10pt;">27</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup></span><span style=""><span style="font-size: 10pt; color: windowtext;">, en un estudio realizado en un centro de salud, encontraron que, aunque esta bacteria es frecuentemente aislada en la UCI, sólo en dos casos demostraron asociación directa entre el medio ambiente y la adquisición de infección por <i style="">S. aureus</i>. Por otra parte, otros autores <sup>(</sup></span></span><span style=""></span><a href="#r14"><span style=""><sup><span style="font-size: 10pt;">14</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup></span><span style=""><span style="font-size: 10pt; color: windowtext;"> indican que, cuando los pacientes ocupan camas dejadas por otros, quienes han padecido infecciones intrahospitalarias, tienen una mayor probabilidad de infectarse con el mismo patógeno; lo cual evidencia como las camas y las superficies adyacentes representan fuentes de contaminación microbiana.<o:p></o:p></span></span></p> <p class="MsoNormal"><span style=""><span style="font-size: 10pt; color: windowtext;">Otros estudios han asociado la </span></span><span style=""><span style="font-size: 10pt; color: windowtext;">contaminación de las superficies ambientales con la mitad de las epidemias por </span></span><span style=""><span style="font-size: 10pt; color: windowtext;">SARM </span></span><span style=""><span style="font-size: 10pt; color: windowtext;">en diversos hospitales. Además, los datos de un estudio retrospectivo, realizado por Watson y col <sup>(</sup></span></span><span style=""></span><a href="#r28"><span style=""><sup><span style="font-size: 10pt;">28</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup></span><span style=""><span style="font-size: 10pt; color: windowtext;">, entre 2005-2009, en diferentes hospitales de California, Estados Unidos; establecieron una asociación entre la contaminación ambiental y la transmisión de SARM y; además, se demostró que la inclusión de protocolos estrictos de limpieza, favorecen la protección de los pacientes contra infecciones intrahospitalarias. <o:p></o:p></span></span></p> <p class="MsoNormal"><span style=""><span style="font-size: 10pt; color: windowtext;">Desde el descubrimiento de la penicilina, en 1940, el uso de este antibiótico para el tratamiento de infecciones por <i style="">S. aureus</i> y el rápido desarrollo de resistencia antimicrobiana han sido ampliamente documentados. En la actualidad, aproximadamente, el 90% de las cepas aisladas de cuadros clínicos son resistentes a penicilina <sup>(</sup></span></span><span style=""></span><a href="#r18"><span style=""><sup><span style="font-size: 10pt;">18</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup></span><span style=""><span style="font-size: 10pt; color: windowtext;">. Ahora bien, los asilamientos de muestras ambientales obtenidos en esta investigación mostraron una alta resistencia a penicilina, puesto que, de las 3 cepas de <i style="">S. aureus</i> aisladas, 2 (66,6%) presentaron el gen <span class="SpellE"><i style="">blaZ</i></span> y el fenotipo de resistencia a penicilina. <o:p></o:p></span></span></p> <p class="MsoNormal"><span style=""><span style="font-size: 10pt; color: windowtext;">Numerosas investigaciones científicas han evaluado la susceptibilidad a meticilina de <i style="">S. aureus</i> aislados a partir de muestras clínicas y de ambientes hospitalarios. Las cepas resistentes a este antibiótico también lo son a la mayoría de los antimicrobianos beta-lactámicos <sup>(</sup></span></span><span style=""></span><a href="#r1"><span style=""><sup><span style="font-size: 10pt;">1</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup></span><span style=""><span style="font-size: 10pt; color: windowtext;">; además, los aislamientos resistentes a meticilina suelen portar genes de resistencia a múltiples antibióticos, lo cual puede limitar el uso de otros antimicrobianos para el tratamiento de cuadros clínicos provocados por SARM. <o:p></o:p></span></span></p> <p class="MsoNormal"><span style=""><span style="font-size: 10pt; color: windowtext;">El porcentaje de resistencia a meticilina de las cepas ambientales de <i style="">S. aureus</i> aisladas en esta investigación fue de 66,6% (2/3), resultados similares han sido reportados por </span></span><span style=""><span class="SpellE"><span style="font-size: 10pt; color: windowtext;">Wille</span></span></span><span style=""><span style="font-size: 10pt; color: windowtext;"> y col <sup>(</sup></span></span><span style=""></span><a href="#r29"><span style=""><sup><span style="font-size: 10pt;">29</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup></span><span style=""><span style="font-size: 10pt; color: windowtext;">, quienes comunicaron 64% de aislamientos resistentes a meticilina en muestras de superficies inanimadas. De igual modo, <span class="SpellE">Ekrami</span> y col <sup>(</sup></span></span><span style=""></span><a href="#r22"><span style=""><sup><span style="font-size: 10pt;">22</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup></span><span style=""><span style="font-size: 10pt; color: windowtext;">, analizaron el comportamiento frente a este agente antimicrobiano de cepas de <i style="">S. aureus</i> obtenidas de muestras del medio ambiente de siete hospitales iraníes y publicaron 60% de resistencia. <o:p></o:p></span></span></p> <p class="MsoNormal"><span style=""><span style="font-size: 10pt; color: windowtext;">Otros autores </span></span><span style=""><span style="font-size: 10pt; color: windowtext;">Chávez y col, en Colombia <sup>(</sup></span></span><span style=""></span><a href="#r8"><span style=""><sup><span style="font-size: 10pt;">8</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup></span><span style=""><span style="font-size: 10pt; color: windowtext;">; <span class="SpellE">Mukhiya</span> y col <sup>(</sup></span></span><span style=""></span><a href="#r23"><span style=""><sup><span style="font-size: 10pt;">23</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup></span><span style=""><span style="font-size: 10pt; color: windowtext;">, en Nepal y </span></span><span style=""><span style="font-size: 10pt; color: windowtext;">Al-<span class="SpellE">Abdli</span> <sup>(</sup></span></span><span style=""></span><a href="#r21"><span style=""><sup><span style="font-size: 10pt;">21</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup></span><span style=""><span style="font-size: 10pt; color: windowtext;">, en Libia; analizaron los patrones de susceptibilidad a meticilina en aislados de diferentes áreas hospitalarias y encontraron entre 32-45,9% de resistencia a este antimicrobiano. <o:p></o:p></span></span></p> <p class="MsoNormal"><span style=""><span style="font-size: 10pt; color: windowtext;">En contraste con los resultados de este estudio, Price y col <sup>(</sup></span></span><span style=""></span><a href="#r27"><span style=""><sup><span style="font-size: 10pt;">27</span></sup></span></a><span style=""><sup><span style="font-size: 10pt; color: windowtext;">)</span></sup></span><span style=""><span style="font-size: 10pt; color: windowtext;">, evaluaron la transmisión de <i style="">S. aureus</i> entre trabajadores de salud, medio ambiente y pacientes de una UCI. Durante el análisis, los autores obtuvieron 12,92% de resistencia a meticilina en las cepas de <i style="">S. aureus</i> ambientales. <o:p></o:p></span></span></p> <p class="MsoNormal"><span style=""><span style="font-size: 10pt; color: windowtext;">En conclusión, la baja frecuencia de aislamientos de <i>S. aureus</i> en este estudio puede estar relacionada con los ambientes muestreados; ya que, las superficies examinadas están ubicadas en áreas en las cuales se hace énfasis en la aplicación de protocolos de higiene y desinfección para asegurar una adecuada descontaminación. Por otra parte, el volumen de pacientes atendidos en el hospital es relativamente bajo; por lo tanto, no existen condiciones de hacinamiento debidas a la aglomeración de pacientes y personal de salud, que faciliten la transmisión de microorganismos. Además, la media de estancia hospitalaria es baja, lo cual disminuye las posibilidades de transmisión de patógenos entre los pacientes. No obstante, es necesario el análisis de otras salas del hospital, para evaluar su papel como posibles reservorios de <i style="">S. aureus</i> y otros patógenos intrahospitalarios.<b> <o:p></o:p></b></span></span></p> <p class="MsoNormal"><span style=""><span style="font-size: 10pt; color: windowtext;">En vista que, la mayoría de los aislamientos de <i style="">S. aureus</i> obtenidos portaban genes de resistencia a penicilina y meticilina, es recomendable mantener medidas de vigilancia epidemiológica de la resistencia de las cepas aisladas, tanto de pacientes como de superficies ambientales, a fin de controlar la diseminación de cepas multirresistentes, principalmente SARM; importante patógeno intrahospitalario productor de procesos infecciosos graves que pueden prolongar la estancia hospitalaria, generar altos costos y comprometer la vida del paciente. <o:p></o:p></span></span></p> <p class="MsoNormal"><span style=""><span style="font-size: 10pt; color: windowtext;">Esta investigación se vio limitada por la falta de protocolos estandarizados para la evaluación de la contaminación microbiana de los ambientes hospitalarios.<o:p></o:p></span></span></p> <span style=""></span> <h1 style="margin-top: 18pt;"><span style="font-size: 12pt;">Conflicto de Intereses<o:p></o:p></span></h1> <p class="MsoNormal"><span style="font-size: 10pt;">Los autores declaran no presentar conflictos de intereses.<o:p></o:p></span></p> <h1 style="margin-top: 18pt;"><span style="font-size: 12pt;">Referencias Bibliográficas<o:p></o:p></span></h1> <p class="MsoListParagraph" style="text-align: justify;"><a name="r1"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);"><span style="">1.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Gharsa</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> H, <span class="SpellE">Dziri</span> R, <span class="SpellE">Klibi</span> N, <span class="SpellE">Chairat</span> S, Lozano C, Torres C, et al. Environmental <i>Staphylococcus aureus</i> contamination in a Tunisian hospital. </span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;">J <span class="SpellE">Chemother</span> [Internet]. 2016;28(6):506-9. Disponible en: </span></span></span><span style=""></span><a href="https://www.tandfonline.com/doi/full/10.1179/1973947815Y.0000000036"><span style=""><span style="font-size: 10pt;">https://www.tandfonline.com/doi/full/10.1179/1973947815Y.0000000036</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> DOI: </span></span></span><span style=""></span><a href="https://doi.org/10.1179/1973947815Y.0000000036"><span style=""><span style="font-size: 10pt;">10.1179/1973947815Y.0000000036</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> </span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;">PMID:</span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=25968356"><span style=""><span style="font-size: 10pt;">25968356</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=Environmental+Staphylococcus+aureus+contamination+in+a+Tunisian+hospital&btnG="><span style=""><span style="font-size: 10pt;">Google Académico</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r2"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);" lang="EN-US"><span style="">2.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Du J, Chen C, Ding B, Tu J, Qin Z, Parsons C, et al. Molecular characterization and antimicrobial susceptibility of nasal <i>Staphylococcus aureus</i> isolates from a </span></span></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">chinese</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> medical college campus. <span class="SpellE">PLoS</span> One [Internet]. 2011;6(11<span class="GramE">):e</span>27328. Disponible en: </span></span></span><span style=""></span><a href="https://dx.plos.org/10.1371/journal.pone.0027328"><span style=""><span style="font-size: 10pt;" lang="EN-US">https://dx.plos.org/10.1371/journal.pone.0027328</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> DOI: </span></span></span><span style=""></span><a href="https://doi.org/10.1371/journal.pone.0027328"><span style=""><span style="font-size: 10pt;" lang="EN-US">10.1371/journal.pone.0027328</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> </span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">PMID:</span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=22114670"><span style=""><span style="font-size: 10pt;" lang="EN-US">22114670</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> </span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">PMCID:</span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3219665/"><span style=""><span style="font-size: 10pt;" lang="EN-US">3219665</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> <span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=Molecular+characterization+and+antimicrobial+susceptibility+of+nasal+Staphylococcus+aureus+isolates+from+a+chinese+medical+college+campus&btnG="><span style=""><span style="font-size: 10pt;" lang="EN-US">Google <span class="SpellE">Académico</span></span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r3"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);" lang="EN-US"><span style="">3.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Ducel</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> G, Fabry J, Nicolle L. Prevention of hospital acquired infections: a practical guide. [Internet]. 2nd ed. Geneva: World Health Organization; 2002. pp vi+64. Disponible en: </span></span></span><span style=""></span><a href="https://www.cabdirect.org/cabdirect/abstract/20043205361"><span style=""><span style="font-size: 10pt;" lang="EN-US">https://www.cabdirect.org/cabdirect/abstract/20043205361</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=Prevention+of+hospital+acquired+infections%3A+a+practical+guide+World+Health+Organization&btnG="><span style=""><span style="font-size: 10pt;" lang="EN-US">Google <span class="SpellE">Académico</span></span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r4"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);" lang="EN-US"><span style="">4.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Odoya</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> EM, <span class="SpellE">Ohenhen</span> RE, <span class="SpellE">Adias</span> CT, Stanley ON, <span class="SpellE">Ojusin</span> GB. An Overview of the Distribution of <i>Staphylococcus aureus</i> in the hospital Environment. IOSR-J Env Sci <span class="SpellE">Toxicol</span> Food Technol. 2015;9(6):31-3. DOI: </span></span></span><span style=""></span><a href="https://pdfs.semanticscholar.org/9aef/14eda65e6bc0bcd1a87a3393270c38e63f7f.pdf"><span style=""><span style="font-size: 10pt;" lang="EN-US">10.9790/2402-09633133</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> <span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=Odoya+EM%2C+Ohenhen+RE%2C+Adias+CT%2C+Stanley+ON%2C+Ojusin+GB.+An+Overview+of+the+Distribution+of+Staphylococcus+aureus+in+the+hospital+Environment&btnG="><span style=""><span style="font-size: 10pt;" lang="EN-US">Google <span class="SpellE">Académico</span></span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r5"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);"><span style="">5.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;">Rivera-Jacinto M, Rodríguez-Ulloa C, </span></span></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;">Huayán</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;">-Dávila G. Frecuencia de aislamientos ambientales de <i>Staphylococcus aureus</i> y su actividad beta-lactamasa en un hospital de Cajamarca, Perú. <span class="SpellE">Infectio</span> [Internet]. 2009;13(3):192-5. Disponible en: </span></span></span><span style=""></span><a href="http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0123-93922009000300006&nrm=iso"><span style=""><span style="font-size: 10pt;">http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0123-93922009000300006&nrm=iso</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> <span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=Frecuencia+de+aislamientos+ambientales+de+Staphylococcus+aureus+y+su+actividad+beta-lactamasa+en+un+hospital+de+Cajamarca%2C+Per%C3%BA&btnG="><span style=""><span style="font-size: 10pt;">Google Académico</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r6"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);" lang="EN-US"><span style="">6.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Omololu</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> J. <i>Staphylococcus aureus</i> Surface Colonization of Medical Equipment and Environment, Implication in Hospital- Community Epidemiology. J Hosp Med <span class="SpellE">Manag</span> [Internet]. 2017;03(01):1-5. Disponible en: </span></span></span><span style=""></span><a href="http://hospital-medical-management.imedpub.com/staphylococcus-aureus-surfacecolonization-of-medical-equipment-andenvironment-implication-in-hospitalcommunity-epidemiology.php?aid=19547"><span style=""><span style="font-size: 10pt;" lang="EN-US">http://hospital-medical-management.imedpub.com/staphylococcus-aureus-surfacecolonization-of-medical-equipment-andenvironment-implication-in-hospitalcommunity-epidemiology.php?aid=19547</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> DOI: </span></span></span><span style=""></span><a href="http://hospital-medical-management.imedpub.com/staphylococcus-aureus-surfacecolonization-of-medical-equipment-andenvironment-implication-in-hospitalcommunity-epidemiology.pdf"><span style=""><span style="font-size: 10pt;" lang="EN-US">10.4172/2471-9781.100022</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> <span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=Staphylococcus+aureus+Surface+Colonization+of+Medical+Equipment+and+Environment%2C+Implication+in+Hospital-+Community+Epidemiology&btnG="><span style=""><span style="font-size: 10pt;" lang="EN-US">Google <span class="SpellE">Académico</span></span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r7"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);"><span style="">7.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Cespedes C, Miller M, </span></span></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Quagliarello</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> B, <span class="SpellE">Vavagiakis</span> P, Klein RS, Lowy FD. Differences between <i>Staphylococcus aureus</i> isolates from medical and nonmedical hospital personnel. J Clin Microbiol [Internet]. 2002;40(7):2594-7. </span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;">Disponible en: </span></span></span><span style=""></span><a href="http://jcm.asm.org/cgi/doi/10.1128/JCM.40.7.2594-2597.2002"><span style=""><span style="font-size: 10pt;">http://jcm.asm.org/cgi/doi/10.1128/JCM.40.7.2594-2597.2002</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> DOI: </span></span></span><span style=""></span><a href="https://doi.org/10.1128/jcm.40.7.2594-2597.2002"><span style=""><span style="font-size: 10pt;">10.1128/JCM.40.7.2594-2597.2002</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> PMID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=12089282"><span style=""><span style="font-size: 10pt;">12089282</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> PMCID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC120551/"><span style=""><span style="font-size: 10pt;">PMC120551</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=Differences+between+Staphylococcus+aureus+isolates+from+medical+and+nonmedical+hospital+personnel&btnG="><span style=""><span style="font-size: 10pt;">Google Académico</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r8"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);"><span style="">8.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;">Chávez-Vivas M, Martínez A del C, Esparza-Mantilla M. Caracterización de <i>Staphylococcus aureus</i> obtenido del ambiente hospitalario y del personal de salud en un hospital de la ciudad de Cali. </span></span></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;">Biosalud</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> [Internet]. 2017;16(2):22-33. Disponible en: </span></span></span><span style=""></span><a href="http://www.scielo.org.co/scielo.php?pid=S1657-95502017000200022&script=sci_abstract&tlng=en"><span style=""><span style="font-size: 10pt;">http://www.scielo.org.co/scielo.php?pid=S1657-95502017000200022&script=sci_abstract&tlng=en</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> DOI: </span></span></span><span style=""></span><a href="http://www.scielo.org.co/scielo.php?pid=S1657-95502017000200022&script=sci_abstract&tlng=en"><span style=""><span style="font-size: 10pt;">10.17151/biosa.2017.16.2.3</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?q=Caracterizaci%C3%B3n+de+Staphylococcus+aureus+obtenido+del+ambiente+hospitalario+y+del+personal+de+salud+en+un+hospital+de+la+ciudad+de+Cali&hl=es&as_sdt=0,5"><span style=""><span style="font-size: 10pt;">Google Académico</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r9"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);"><span style="">9.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Bereket W, </span></span></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Hemalatha</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> K, <span class="SpellE">Getenet</span> B, <span class="SpellE">Wondwossen</span> T, Solomon A, <span class="SpellE">Zeynudin</span> A, et al. Update on bacterial nosocomial infections. Eur Rev Med <span class="SpellE">Pharmacol</span> Sci [Internet]. </span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;">2012;16(8):1039-44. Disponible en: </span></span></span><span style=""></span><a href="http://www.ncbi.nlm.nih.gov/pubmed/22913154"><span style=""><span style="font-size: 10pt;">http://www.ncbi.nlm.nih.gov/pubmed/22913154</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> PMID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pubmed/22913154"><span style=""><span style="font-size: 10pt;">22913154</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=9.%09Bereket+W%2C+Hemalatha+K%2C+Getenet+B%2C+Wondwossen+T%2C+Solomon+A%2C+Zeynudin+A%2C+et+al.+Update+on+bacterial+nosocomial+infections+&btnG="><span style=""><span style="font-size: 10pt;">Google Académico</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r10"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);"><span style="">10.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Nkuwi</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> EJ, <span class="SpellE">Kabanangi</span> F, Joachim A, <span class="SpellE">Rugarabamu</span> S, <span class="SpellE">Majigo</span> M. Methicillin-resistant <i>Staphylococcus aureus</i> contamination and distribution in patient’s care environment at <span class="SpellE">Muhimbili</span> National Hospital, Dar es Salaam-Tanzania. BMC Res Notes [Internet]. 2018;11(1):484. </span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;">Disponible en: </span></span></span><span style=""></span><a href="https://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-018-3602-4"><span style=""><span style="font-size: 10pt;">https://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-018-3602-4</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> DOI: </span></span></span><span style=""></span><a href="https://doi.org/10.1186/s13104-018-3602-4"><span style=""><span style="font-size: 10pt;">10.1186/s13104-018-3602-4</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> PMID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=30016984"><span style=""><span style="font-size: 10pt;">30016984</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> PMCID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6050707/"><span style=""><span style="font-size: 10pt;">PMC6050707</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=10.%09Nkuwi+EJ%2C+Kabanangi+F%2C+Joachim+A%2C+Rugarabamu+S%2C+Majigo+M.+Methicillin-resistant+Staphylococcus+aureus+contamination+and+distribution+in+patient%E2%80%99s+care+environment+at+Muhimbili+National+Hospital%2C+Dar+es+Salaam-Tanzania&btnG="><span style=""><span style="font-size: 10pt;">Google Académico</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r11"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);"><span style="">11.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;">Villamil AS, Rodríguez C, Badia MB, Moral LSL, </span></span></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;">Zilberman</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> JM, Salinas RL, et al. Los manguitos del esfigmomanómetro son reservorio de bacterias potencialmente patógenas. <span class="SpellE">Rev</span> Argent <span class="SpellE">Cardiol</span> [Internet]. 2004;72(1):9-13. Disponible en: </span></span></span><span style=""></span><a href="https://www.sac.org.ar/wp-content/uploads/2014/07/672.pdf"><span style=""><span style="font-size: 10pt;">https://www.sac.org.ar/wp-content/uploads/2014/07/672.pdf</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> <span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=11.%09Villamil+AS%2C+Rodr%C3%ADguez+C%2C+Badia+MB%2C+Moral+LSL%2C+Zilberman+JM%2C+Salinas+RL%2C+et+al.+Los+manguitos+del+esfigmoman%C3%B3metro+son+reservorio+de+bacterias+potencialmente+pat%C3%B3genas&btnG="><span style=""><span style="font-size: 10pt;">Google Académico</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r12"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);" lang="EN-US"><span style="">12.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Huang R, Mehta S, Weed D, Price CS. Methicillin-Resistant <i>Staphylococcus aureus</i> Survival on Hospital Fomites. Infect Control Hosp Epidemiol [Internet]. 2006;27(11):1267-9. Disponible en: </span></span></a><span style=""></span><a href="http://www.ncbi.nlm.nih.gov/pubmed/17080391"><span style=""><span style="font-size: 10pt;" lang="EN-US">http://www.ncbi.nlm.nih.gov/pubmed/17080391</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> DOI: </span></span></span><span style=""></span><a href="https://doi.org/10.1086/507965"><span style=""><span style="font-size: 10pt;" lang="EN-US">10.1086/507965</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> PMID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=17080391"><span style=""><span style="font-size: 10pt;" lang="EN-US">17080391</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> <span style=""> </span><span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=Methicillin-Resistant+Staphylococcus+aureus+Survival+on+Hospital+Fomites&btnG="><span style=""><span style="font-size: 10pt;" lang="EN-US">Google <span class="SpellE">Académico</span></span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r13"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);"><span style="">13.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;">López-Cerero L. Papel del ambiente hospitalario y los equipamientos en la transmisión de las infecciones nosocomiales. </span></span></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;">Enferm</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> <span class="SpellE">Infecc</span> <span class="SpellE">Microbiol</span> Clin [Internet]. 2014;32(7):459-64. Disponible en: </span></span></span><span style=""></span><a href="http://www.sciencedirect.com/science/article/pii/S0213005X13003108"><span style=""><span style="font-size: 10pt;">http://www.sciencedirect.com/science/article/pii/S0213005X13003108</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> DOI: </span></span></span><span style=""></span><a href="https://doi.org/10.1016/j.eimc.2013.10.004"><span style=""><span style="font-size: 10pt;">https://doi.org/10.1016/j.eimc.2013.10.004</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> PMID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=24315300"><span style=""><span style="font-size: 10pt;">24315300</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> <span style=""> </span><span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=13.%09L%C3%B3pez-Cerero+L.+Papel+del+ambiente+hospitalario+y+los+equipamientos+en+la+transmisi%C3%B3n+de+las+infecciones+nosocomiales&btnG="><span style=""><span style="font-size: 10pt;">Google Académico</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r14"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);" lang="EN-US"><span style="">14.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Russotto V, </span></span></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Cortegiani</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> A, <span class="SpellE">Raineri</span> SM, <span class="SpellE">Giarratano</span> A. Bacterial contamination of inanimate surfaces and equipment in the intensive care unit. J Intensive Care [Internet]. 2015. 3:54. Disponible en: </span></span></span><span style=""></span><a href="http://www.ncbi.nlm.nih.gov/pubmed/26693023"><span style=""><span style="font-size: 10pt;" lang="EN-US">http://www.ncbi.nlm.nih.gov/pubmed/26693023</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> DOI: </span></span></span><span style=""></span><a href="https://dx.doi.org/10.1186%2Fs40560-015-0120-5"><span style=""><span style="font-size: 10pt;" lang="EN-US">10.1186/s40560-015-0120-5</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> PMID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pubmed/26693023"><span style=""><span style="font-size: 10pt;" lang="EN-US">26693023</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> PMCID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676153/"><span style=""><span style="font-size: 10pt;" lang="EN-US">PMC4676153</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><span style=""> </span><span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=14.%09Russotto+V%2C+Cortegiani+A%2C+Raineri+SM%2C+Giarratano+A.+Bacterial+contamination+of+inanimate+surfaces+and+equipment+in+the+intensive+care+unit+&btnG="><span style=""><span style="font-size: 10pt;" lang="EN-US">Google <span class="SpellE">Académico</span></span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r15"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);" lang="EN-US"><span style="">15.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Boyce JM. Environmental contamination makes an important contribution to hospital infection. J Hosp Infect [Internet]. 2007;65(SUPPL. 2):50-4. Disponible en: </span></span></a><span style=""></span><a href="https://linkinghub.elsevier.com/retrieve/pii/S0195670107600152"><span style=""><span style="font-size: 10pt;" lang="EN-US">https://linkinghub.elsevier.com/retrieve/pii/S0195670107600152</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> DOI: </span></span></span><span style=""></span><a href="https://doi.org/10.1016/S0195-6701%2807%2960015-2"><span style=""><span style="font-size: 10pt;" lang="EN-US">10.1016/S0195-6701(07)60015-2</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> PMID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=17540242"><span style=""><span style="font-size: 10pt;" lang="EN-US">17540242</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=15.%09Boyce+JM.+Environmental+contamination+makes+an+important+contribution+to+hospital+infection&btnG="><span style=""><span style="font-size: 10pt;" lang="EN-US">Google <span style=""><span class="SpellE">Académico</span></span></span></span></a><!--[if !supportNestedAnchors]--><a name="_Hlk18966555"></a><!--[endif]--><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r16"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);"><span style="">16.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Depardieu F, </span></span></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Perichon</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> B, <span class="SpellE">Courvalin</span> P. Detection of the van alphabet and identification of enterococci and staphylococci at the species level by multiplex PCR. J Clin Microbiol [Internet]. 2004;42(12):5857-60. </span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;">Disponible en: </span></span></span><span style=""></span><a href="http://jcm.asm.org/cgi/doi/10.1128/JCM.42.12.5857-5860.2004"><span style=""><span style="font-size: 10pt;">http://jcm.asm.org/cgi/doi/10.1128/JCM.42.12.5857-5860.2004</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> DOI: </span></span></span><span style=""></span><a href="https://doi.org/10.1128/JCM.42.12.5857-5860.2004"><span style=""><span style="font-size: 10pt;">10.1128/JCM.42.12.5857-5860.2004</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> PMID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=15583325"><span style=""><span style="font-size: 10pt;">15583325</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> PMCID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC535300/"><span style=""><span style="font-size: 10pt;">PMC535300</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> <span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=16.%09Depardieu+F%2C+Perichon+B%2C+Courvalin+P.+Detection+of+the+van+alphabet+and+identification+of+enterococci+and+staphylococci+at+the+species+level+by+multiplex+PCR&btnG="><span style=""><span style="font-size: 10pt;">Google Académico</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r17"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);" lang="EN-US"><span style="">17.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">CLSI. Performance standards for antimicrobial susceptibility testing. 27th ed. CLSI supplement M100. Wayne, PA: Clinical and Laboratory Standards Institute. 2017. 282 p. </span></span></a><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=Performance+standards+for+antimicrobial+susceptibility+testing.+27th+ed.+CLSI+supplement+M100&btnG="><span style=""><span style="font-size: 10pt;" lang="EN-US">Google <span class="SpellE">Académico</span></span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r18"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);" lang="EN-US"><span style="">18.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Olsen JE, Christensen H, </span></span></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Aarestrup</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> FM. Diversity and evolution of <span class="SpellE"><i>blaZ</i></span> from <i>Staphylococcus aureus</i> and coagulase-negative staphylococci. J <span class="SpellE">Antimicrob</span> Chemother [Internet]. 2006;57(3):450-60. Disponible en: </span></span></span><span style=""></span><a href="http://academic.oup.com/jac/article/57/3/450/738078/Diversity-and-evolution-of-blaZ-from"><span style=""><span style="font-size: 10pt;" lang="EN-US">http://academic.oup.com/jac/article/57/3/450/738078/Diversity-and-evolution-of-blaZ-from</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> DOI: </span></span></span><span style=""></span><a href="https://doi.org/10.1093/jac/dki492"><span style=""><span style="font-size: 10pt;" lang="EN-US">10.1093/<span class="SpellE">jac</span>/dki492</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> PMID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=16449305"><span style=""><span style="font-size: 10pt;" lang="EN-US">16449305</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=18.%09Olsen+JE%2C+Christensen+H%2C+Aarestrup+FM.+Diversity+and+evolution+of+blaZ+from+Staphylococcus+aureus+and+coagulase-negative+staphylococci&btnG="><span style=""><span style="font-size: 10pt;" lang="EN-US">Google <span class="SpellE">Académico</span></span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r19"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);"><span style="">19.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;">Elhassan</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> MM, <span class="SpellE">Ozbak</span> HA, <span class="SpellE">Hemeg</span> HA, <span class="SpellE">Elmekki</span> MA, Ahmed LM. </span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Absence of the <span class="SpellE"><i>mecA</i></span> gene in methicillin resistant <i>Staphylococcus aureus</i> isolated from different clinical specimens in <span class="SpellE">Shendi</span> City, Sudan. Biomed Res Int [Internet]. <span class="GramE">2015;2015:895860</span>. </span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;">Disponible en: </span></span></span><span style=""></span><a href="http://www.hindawi.com/journals/bmri/2015/895860/"><span style=""><span style="font-size: 10pt;">http://www.hindawi.com/journals/bmri/2015/895860/</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> DOI: </span></span></span><span style=""></span><a href="https://doi.org/10.1155/2015/895860"><span style=""><span style="font-size: 10pt;">10.1155/2015/895860</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> PMID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=26290877"><span style=""><span style="font-size: 10pt;">26290877</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> PMCID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4531171/"><span style=""><span style="font-size: 10pt;">PMC4531171</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=19.%09Elhassan+MM%2C+Ozbak+HA%2C+Hemeg+HA%2C+Elmekki+MA%2C+Ahmed+LM.+Absence+of+the+mecA+gene+in+methicillin+resistant+Staphylococcus+aureus+isolated+from+different+clinical+specimens+in+Shendi+City%2C+Sudan&btnG="><span style=""><span style="font-size: 10pt;">Google Académico</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r20"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);"><span style="">20.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Harrison EM, Paterson GK, Holden MTG, Ba X, </span></span></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Rolo</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> J, Morgan FJE, et al. A novel hybrid <span class="SpellE"><i>SCCmec-mecC</i></span> region in <i>Staphylococcus sciuri</i>. J <span class="SpellE">Antimicrob</span> Chemother [Internet]. </span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;">2014;69(4):911-8. Disponible en: </span></span></span><span style=""></span><a href="https://academic.oup.com/jac/article-lookup/doi/10.1093/jac/dkt452"><span style=""><span style="font-size: 10pt;">https://academic.oup.com/jac/article-lookup/doi/10.1093/jac/dkt452</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> DOI: </span></span></span><span style=""></span><a href="https://doi.org/10.1093/jac/dkt452"><span style=""><span style="font-size: 10pt;">10.1093/<span class="SpellE">jac</span>/dkt452</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> PMID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=24302651"><span style=""><span style="font-size: 10pt;">24302651</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> PMCID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3956370/"><span style=""><span style="font-size: 10pt;">PMC3956370</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=A+novel+hybrid+SCCmec-mecC+region+in+Staphylococcus+sciuri&btnG="><span style=""><span style="font-size: 10pt;">Google Académico</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r21"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);" lang="EN-US"><span style="">21.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Al-</span></span></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Abdli</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> NE, <span class="SpellE">Baiu</span> SH. Isolation of MRSA Strains from Hospital Environment in Benghazi City, Libya. Am J Infect Dis Microbiol [Internet]. 2016;4(2):41-3. Disponible en: </span></span></span><span style=""></span><a href="http://pubs.sciepub.com/ajidm/4/2/4"><span style=""><span style="font-size: 10pt;" lang="EN-US">http://pubs.sciepub.com/ajidm/4/2/4</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> DOI: </span></span></span><span style=""></span><a href="http://pubs.sciepub.com/ajidm/4/2/4/"><span style=""><span style="font-size: 10pt;" lang="EN-US">10.12691/ajidm-4-2-4</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> <span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=Al-Abdli+NE%2C+Baiu+SH.+Isolation+of+MRSA+Strains+from+Hospital+Environment+in+Benghazi+City%2C+Libya.+&btnG="><span style=""><span style="font-size: 10pt;" lang="EN-US">Google <span class="SpellE">Académico</span></span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r22"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);"><span style="">22.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Ekrami</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> A, <span class="SpellE">Kayedani</span> A, Jahangir M, <span class="SpellE">Kalantar</span> E, <span class="SpellE">Jalali</span> M. Isolation of common aerobics bacterial pathogens from the environment of seven hospitals, Ahvaz, Iran. </span></span></span><span style=""><span class="SpellE"><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;">Jundishapur</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> J <span class="SpellE">Microbiol</span> [Internet]. 2011;4(2):75-82. Disponible en: </span></span></span><span style=""></span><a href="https://www.sid.ir/en/journal/ViewPaper.aspx?ID=190978"><span style=""><span style="font-size: 10pt;">https://www.sid.ir/en/journal/ViewPaper.aspx?ID=190978</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=A+Ekrami%2C+A+Kayedani%2C+M+Jahangir%2C+E+Kalantar%2C+M+Jalali+-+2011+&btnG="><span style=""><span style="font-size: 10pt;">Google Académico</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r23"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);" lang="EN-US"><span style="">23.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Mukhiya R, Shrestha A, Rai S, </span></span></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Panta</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> K, Singh RN, Rai G, et al. Prevalence of Methicillin-Resistant <i>Staphylococcus aureus</i> in Hospitals of Kathmandu Valley. Nepal J Sci Technol [Internet]. 2013;13(2):185-90. Disponible en: </span></span></span><span style=""></span><a href="https://www.nepjol.info/index.php/NJST/article/view/7734"><span style=""><span style="font-size: 10pt;" lang="EN-US">https://www.nepjol.info/index.php/NJST/article/view/7734</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> DOI: </span></span></span><span style=""></span><a href="https://doi.org/10.3126/njst.v13i2.7734"><span style=""><span style="font-size: 10pt;" lang="EN-US">10.3126/njst.v13i2.7734</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=23.%09Mukhiya+R%2C+Shrestha+A%2C+Rai+S%2C+Panta+K%2C+Singh+RN%2C+Rai+G%2C+et+al.+Prevalence+of+Methicillin-Resistant+Staphylococcus+aureus+in+Hospitals+of+Kathmandu+Valley.+Nepal+J+Sci+Technol+&btnG="><span style=""><span style="font-size: 10pt;" lang="EN-US">Google <span class="SpellE">Académico</span></span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r24"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);" lang="EN-US"><span style="">24.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Tagoe</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> DN, <span class="SpellE">Desbordes</span> KK. Investigating potential sources of transmission of healthcare-associated infections in a regional hospital, Ghana. Int J Appl basic Med Res [Internet]. 2012;2(1):20-4. Disponible en: </span></span></span><span style=""></span><a href="http://www.ijabmr.org/text.asp?2012/2/1/20/96796"><span style=""><span style="font-size: 10pt;" lang="EN-US">http://www.ijabmr.org/text.asp?2012/2/1/20/96796</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> DOI: </span></span></span><span style=""></span><a href="https://doi.org/10.4103/2229-516X.96796"><span style=""><span style="font-size: 10pt;" lang="EN-US">10.4103/2229-516X.96796</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> PMID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=23776803"><span style=""><span style="font-size: 10pt;" lang="EN-US">23776803</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> PMCID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3657994/"><span style=""><span style="font-size: 10pt;" lang="EN-US">PMC3657994</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=Investigating+potential+sources+of+transmission+of+healthcare-associated+infections+in+a+regional+hospital%2C+Ghana&btnG="><span style=""><span style="font-size: 10pt;" lang="EN-US">Google <span class="SpellE">Académico</span></span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r25"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);"><span style="">25.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Oie</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> S, Hosokawa I, <span class="SpellE">Kamiya</span> A. Contamination of room door handles by methicillin-sensitive/methicillin-resistant <i>Staphylococcus aureus</i>. J Hosp Infect [Internet]. 2002;51(2):140-3. </span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;">Disponible en: </span></span></span><span style=""></span><a href="https://linkinghub.elsevier.com/retrieve/pii/S0195670102912211"><span style=""><span style="font-size: 10pt;">https://linkinghub.elsevier.com/retrieve/pii/S0195670102912211</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> DOI: </span></span></span><span style=""></span><a href="https://doi.org/10.4103/2229-516X.96796"><span style=""><span style="font-size: 10pt;">10.1053/jhin.2002.1221</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> PMID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=12090803"><span style=""><span style="font-size: 10pt;">12090803</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> PMCID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3657994/"><span style=""><span style="font-size: 10pt;">PMC3657994</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=Oie+S%2C+Hosokawa+I%2C+Kamiya+A.+Contamination+of+room+door+handles+by+methicillin-sensitive%2Fmethicillin-resistant+Staphylococcus+aureus.+J+Hosp+Infect+&btnG="><span style=""><span style="font-size: 10pt;">Google Académico</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r26"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);" lang="EN-US"><span style="">26.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Otter JA, </span></span></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Yezli</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> S, <span class="SpellE">Salkeld</span> JAG, French GL. Evidence that contaminated surfaces contribute to the transmission of hospital pathogens and an overview of strategies to address contaminated surfaces in hospital settings. Am J Infect Control [Internet]. 2013;41(5 Suppl<span class="GramE">):S</span>6-11. Disponible en: </span></span></span><span style=""></span><a href="https://linkinghub.elsevier.com/retrieve/pii/S0196655313000047"><span style=""><span style="font-size: 10pt;" lang="EN-US">https://linkinghub.elsevier.com/retrieve/pii/S0196655313000047</span></span><span style=""></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> <span lang="EN-US">DOI: </span></span></span></span><span style=""></span><a href="https://doi.org/10.1016/j.ajic.2012.12.004"><span style=""><span style="font-size: 10pt;" lang="EN-US">10.1016/j.ajic.2012.12.004</span></span><span style=""></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> <span lang="EN-US">PMID: </span></span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=23622751"><span style=""><span style="font-size: 10pt;" lang="EN-US">23622751</span></span><span style=""></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=26.%09Otter+JA%2C+Yezli+S%2C+Salkeld+JAG%2C+French+GL.+Evidence+that+contaminated+surfaces+contribute+to+the+transmission+of+hospital+pathogens+and+an+overview+of+strategies+to+address+contaminated+surfaces+in+hospital+settings&btnG="><span style=""><span style="font-size: 10pt;" lang="EN-US">Google <span class="SpellE">Académico</span></span></span><span style=""></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r27"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);" lang="EN-US"><span style="">27.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Price JR, Cole K, </span></span></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Bexley</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> A, <span class="SpellE">Kostiou</span> V, Eyre DW, <span class="SpellE">Golubchik</span> T, et al. Transmission of <i>Staphylococcus aureus</i> between health-care workers, the environment, and patients in an intensive care unit: a longitudinal cohort study based on whole-genome sequencing. Lancet Infect Dis [Internet]. 2017;17(2):207-14. Disponible en: </span></span></span><span style=""></span><a href="https://linkinghub.elsevier.com/retrieve/pii/S1473309916304133"><span style=""><span style="font-size: 10pt;" lang="EN-US">https://linkinghub.elsevier.com/retrieve/pii/S1473309916304133</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> DOI: </span></span></span><span style=""></span><a href="https://doi.org/10.1016/S1473-3099%2816%2930413-3"><span style=""><span style="font-size: 10pt;" lang="EN-US">10.1016/S1473-3099(16)30413-3</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> PMID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=27863959"><span style=""><span style="font-size: 10pt;" lang="EN-US">27863959</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> PMCID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5266793/"><span style=""><span style="font-size: 10pt;" lang="EN-US">PMC5266793</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=27.%09Price+JR%2C+Cole+K%2C+Bexley+A%2C+Kostiou+V%2C+Eyre+DW%2C+Golubchik+T%2C+et+al.+Transmission+of+Staphylococcus+aureus+between+health-care+workers%2C+the+environment%2C+and+patients+in+an+intensive+care+unit%3A+a+longitudinal+cohort+study+based+on+whole-genome+sequencing.+Lancet+Infect+Dis+&btnG="><span style=""><span style="font-size: 10pt;" lang="EN-US">Google <span class="SpellE">Académico</span></span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r28"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);"><span style="">28.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Watson PA, Watson LR, </span></span></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Torress</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">-Cook A. Efficacy of a hospital-wide environmental cleaning protocol on hospital-acquired methicillin-resistant <i>Staphylococcus aureus</i> rates. J Infect <span class="SpellE">Prev</span> [Internet]. 2016;17(4):171-6. </span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;">Disponible en: </span></span></span><span style=""></span><a href="http://journals.sagepub.com/doi/10.1177/1757177416645342"><span style=""><span style="font-size: 10pt;">http://journals.sagepub.com/doi/10.1177/1757177416645342</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> DOI: </span></span></span><span style=""></span><a href="https://doi.org/10.1177/1757177416645342"><span style=""><span style="font-size: 10pt;">10.1177/1757177416645342</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> PMID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=28989476"><span style=""><span style="font-size: 10pt;">28989476</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> PMCID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5074202/"><span style=""><span style="font-size: 10pt;">PMC5074202</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"> <span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=28.%09Watson+PA%2C+Watson+LR%2C+Torress-Cook+A.+Efficacy+of+a+hospital-wide+environmental+cleaning+protocol+on+hospital-acquired+methicillin-resistant+Staphylococcus+aureus+rates.+J+Infect+Prev+&btnG="><span style=""><span style="font-size: 10pt;">Google Académico</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoListParagraph" style="text-align: justify;"><a name="r29"><!--[if !supportLists]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif; color: rgb(0, 32, 96);" lang="EN-US"><span style="">29.<span style="font-family: "Times New Roman"; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> </span></span></span></span><!--[endif]--><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Wille I, Mayr A, </span></span></a><span class="SpellE"><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US">Kreidl</span></span></span></span><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> P, <span class="SpellE">Brühwasser</span> C, <span class="SpellE">Hinterberger</span> G, Fritz A, et al. Cross-sectional point prevalence survey to study the environmental contamination of nosocomial pathogens in intensive care units under real-life conditions. J Hosp Infect [Internet]. 2018;98(1):90-5. Disponible en: </span></span></span><span style=""></span><a href="https://linkinghub.elsevier.com/retrieve/pii/S0195670117305285"><span style=""><span style="font-size: 10pt;" lang="EN-US">https://linkinghub.elsevier.com/retrieve/pii/S0195670117305285</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> DOI: </span></span></span><span style=""></span><a href="https://doi.org/10.1016/j.jhin.2017.09.019"><span style=""><span style="font-size: 10pt;" lang="EN-US">10.1016/j.jhin.2017.09.019</span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"> PMID: </span></span></span><span style=""></span><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=28964884"><span style=""><span style="font-size: 10pt;" lang="EN-US">28964884</span></span></a><span style=""><span class="MsoHyperlink"><span style="font-size: 10pt; color: windowtext; text-decoration: none;" lang="EN-US"><span style=""> </span></span></span></span><span style=""></span><a href="https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=Cross-sectional+point+prevalence+survey+to+study+the+environmental+contamination+of+nosocomial+pathogens+in+intensive+care+units+under+real-life+conditions&btnG="><span style=""><span style="font-size: 10pt;" lang="EN-US">Google <span class="SpellE">Académico</span></span></span></a><span style=""><span class="MsoSubtleReference"><span style="font-size: 10pt; font-family: "Century Gothic",sans-serif;" lang="EN-US"><o:p></o:p></span></span></span></p> <span style=""></span> <p class="MsoNormal" style="margin-top: 18pt; text-align: center; text-indent: 0cm;" align="center"><b><span style="font-size: 12pt; color: rgb(0, 32, 96);">Contribución de los Autores:<o:p></o:p></span></b></p> <p class="MsoNormal" style="text-indent: 0cm;"><b><span style="font-size: 10pt; color: rgb(0, 32, 96);">ATC y OBP:</span></b><span style="font-size: 10pt; color: rgb(0, 32, 96);"> </span><span style="font-size: 10pt;">concepción y diseño del estudio, análisis e interpretación de datos, análisis estadístico, revisión crítica del artículo. Elaboración del manuscrito y aprobación de la versión final a ser publicada.<o:p></o:p></span></p> <p class="MsoNormal"><span style=""><o:p> </o:p></span></p> <p class="MsoNormal" style="background: rgb(213, 220, 228) none repeat scroll 0%; text-indent: 0cm; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial;"><span style="font-size: 8pt;">©2019. Los Autores. </span><span class="SpellE"><span style="font-size: 8pt; font-family: "Gill Sans Ultra Bold",sans-serif;">Kasmera</span></span><span style="font-size: 8pt;">. Publicación del Departamento de <span class="CuadroIdentificacinCar"><span style="">Enfermedades Infecciosas y Tropicales de la Facultad de Medicina. Universidad del Zulia. Maracaibo-Venezuela. 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