Course of Pharmacy, Laboratory of Toxicology, Department of Biological and Health Sciences, Federal University of Amapa, Juscelino Kubitschek Highway, KM-02, Jardim Marco Zero, Macapa, AP, ZIP code: 68.903-419, Brazil.
Course of Medicine, Department of Biological and Health Sciences, Federal University of Amapa, Juscelino Kubitschek Highway, KM-02, Jardim Marco Zero, Macapa, AP, ZIP code: 68.903-419, Brazil.
BMC Complement Med Ther. 2020 Jan 23;20(1):17. doi: 10.1186/s12906-019-2723-1.
The use of herbal medicine is on the rise worldwide, and safety issues associated with herbal medicines may have an exacerbated impact in elderly because this population has an increased susceptibility and sensitivity to health complications due to the aging process.
This cross-sectional study was carried out at a primary health care unit in the city of Macapa, Brazil. The herbal medicines used and the sociodemographic characteristics of 123 voluntarily consenting participants were collected using a structured questionnaire. A total of 132 herbal medicines with oral or topical administration were donated by the elderly for microbial analysis before consumption, and 18 water samples used in the preparation of homemade herbal medicines were collected. Bacterial and fungal counts and identification of bacterial pathogens (Escherichia coli, Salmonella spp., Pseudomonas aeruginosa and Staphylococcus aureus) were performed according to the regulations of the Brazilian Pharmacopoeia and World Health Organization. Water analysis for the detection of coliforms and E. coli was carried out using Colilert® according to the manufacturer's instructions and the techniques established by Standard Methods.
Of the study participants, 78.8% were women. Bacterial growth was observed in samples from 51.5% of study and 35.6% had fungal growth. A total of 31.8% of the herbal medicine samples exceeded the safety limits (CFU/g ≤ 10), including 16.7% of the homemade herbal medicines and 15.1% of the commercial herbal medicines. It was also found that 31.0% of the samples exceeded the safety limit for fungal growth. The microorganisms most commonly isolated from the herbal medicines were S. aureus (49.2%), followed by Salmonella spp. (34.8%), E. coli (25.8%), and P. aeruginosa (14.4%). Of water samples analyzed, 77.8% were positive for total coliforms (1 ml) and in 66.7% water samples E. coli was detected (1 ml), making them unfit for consumption.
The use of homemade and commercial herbal medicines is a major risk to the health of elderly who use these therapies due to the lack of microbial quality standards. We observed levels of viable bacteria and fungi that were above safety limits; in addition, we were able to isolate pathogenic bacteria from these herbal medicines.
在全球范围内，草药的使用呈上升趋势，与草药相关的安全问题可能在老年人中产生更严重的影响，因为这一人群由于衰老过程而对健康并发症的易感性和敏感性增加。
本横断面研究在巴西马卡帕市的一个初级保健单位进行。使用结构化问卷收集了 123 名自愿同意的参与者使用的草药和社会人口统计学特征。共有 132 种草药经老年人同意在口服或局部使用前进行微生物分析，并采集了 18 种用于制备自制草药的水样本。根据巴西药典和世界卫生组织的规定，对细菌和真菌计数以及细菌病原体（大肠杆菌、沙门氏菌、铜绿假单胞菌和金黄色葡萄球菌）的鉴定进行了检测。按照制造商的说明和标准方法建立的技术，使用 Colilert®进行水分析以检测大肠菌群和大肠杆菌。
在研究参与者中，78.8%为女性。研究中 51.5%的样本有细菌生长，35.6%有真菌生长。共有 31.8%的草药样本超过安全限值（CFU/g≤10），包括 16.7%的自制草药和 15.1%的商业草药。还发现 31.0%的样本真菌生长超过安全限值。从草药中最常分离到的微生物是金黄色葡萄球菌（49.2%），其次是沙门氏菌（34.8%）、大肠杆菌（25.8%）和铜绿假单胞菌（14.4%）。分析的水样中，77.8%的总大肠菌群（1ml）呈阳性，66.7%的水样（1ml）检测到大肠杆菌，表明这些水样不适合饮用。
由于缺乏微生物质量标准，自制和商业草药的使用是使用这些疗法的老年人健康的主要风险。我们观察到的活菌和真菌水平超过了安全限值；此外，我们还能够从这些草药中分离出病原菌。
