Ants associated with pathogenic microorganisms in brazilian hospitals: attention to a silent vector/Formigas associadas a microorganismos patogenicos em hospitais brasileiros: a atencao para um vetor.
Ants are social insects found almost everywhere and have higher diversity in tropical regions. These insects cause problems in hospitals worldwide (BEATSON, 1972), was the first reporting the occurrence of ants in nine hospitals in the United Kingdom, then in England (EDWARD; BACKER, 1981), Chile (IPINZA-REGLA et al., 1981); Germany (EICHELER; 1990) and Trinidad (CHADEE; MAITRE, 1990), Colombia (OLAYA-MASMELA et al., 2005), Spain (ESPALDER; ESPEJO, 2002), United States (KLOTZ et al., 1995; NELDER et al., 2006), Malaysia (NA; LEE, 2001), and Korea (KIM et al., 2005).
In Brazil, studies have initiated in the 90's with the identification of 14 ant species (FOWLER et al., 1993), Bueno and Fowler (1994) investigated 20 hospitals in Brazil, and the ant fauna in each hospital consisted of between 10 and 23 species.
Among the factors affecting the presence of ants in hospitals, highlights the architectural structure, proximity to residences, weather interferences, temperature variations that stimulate the migration of these insects to electronic devices searching for thermal stability and/or packages of drugs that provide suitable conditions for nesting, besides foodstuffs that function as extra attractive (BEATSON, 1972; ZARZUELA et al., 2002).
With the growing concern about the occurrence of ants in these environments, several studies have been undertaken in Brazil aiming to verify the potential of these organisms to carry pathogenic microorganisms, and the results have indicated their role as mechanical vector, contaminating the environment and collaborating to nosocomial infections (BUENO; FOWLER, 1994; FOWLER et al., 1993, MOREIRA et al., 2005). This discussion is justified because it is essential that health professionals to know and be aware of the need to control and monitor the presence of these insects, since currently hospital infections are a serious public health problem in the country.
Although ants are not considered the major source of hospital infections, are viewed as any other vehicle of transmission (FOWLER et al., 1993). For immunosuppressed patients, susceptible to develop infections, this exposure may change the prognosis, increasing the length and cost of hospitalization (IPINZA-REGLA et al., 1981).
This study examined the occurrence of ants in Brazilian hospital environments over the last decade, by means of a literature review, focusing on the distribution and potential of ants to carry pathogenic microorganisms, once ants in hospital settings may transport diverse bacterial species (gram-positive and gram-negative), considering that some strains may be multidrug-resistant. The Table 1 lists results from 13 studies performed in Brazil, with the species of ants collected in hospitals, microorganisms carried by them, and hospital wards in which they were collected.
Material and methods
For this study we used the systematic review using meta-analysis to integrate the results, allowing to describe current knowledge, indicating those aspects that are science-based and those that do not have a solid base of support and require further investigation.
The criteria for selection and inclusion of articles has occurred as the objectives of this study to maintain the rigor and uniformity in the choice of these were complied with some criteria: articles that address the topic, articles indexed in databases LILACS (Latin American Literature in Health Sciences) and MEDLINE (Medical Literature Analysis and Retrieval Sistem online); articles published in national journals within the defined time period from 2001 to 2011.
The key words used for this literature in LILACS and MEDLINE were ants, hospital and vectors.
Results and discussion
The ant diversity registered in Brazil with potential to act as mechanical vector of pathogenic microorganisms in hospital environments is significantly higher than in European countries. M. pharaonis is the species found in European hospitals (BEATSON, 1972; EICHLER, 1990; ULLOA, 2003). Fowler et al. (1993) considered that the ant species predominant in Brazil are the exotic M. pharaonis and T. melanocephalum.
Surveys in five Brazilian states indicated that some species are predominant in hospitals, and the occurrence of T. melanocephalum was predominant (TANAKA et al., 2007; TEIXEIRA et al., 2009), followed by P. longicornis. These and other species listed in Table 1 are mechanical vectors for nosocomial infections, since were identified pathogens such as Staphylococcus, Enterococcus, Klebsiela, Escherichia coli, Pseudomonas and Streptococcus carried by them in different hospital wards (BELEI et al., 2006; COSTA et al., 2006; FOWLER et al., 1993; GARCIA et al., 2011; LISE et al., 2006; MOREIRA et al., 2005; PESQUERO et al., 2008; RANDO et al., 2009; SANTOS et al., 2009; TANAKA et al., 2007; TEIXEIRA et al., 2009).
The identification of pathogenic microorganisms in the ants analyzed, along with biological traits, can define ants as potential carriers of pathogens and the infestation in hospitals is a risk to public health (BEATSON, 1972). The association between enterobacteria and ants has been observed in some Brazilian hospitals, which always represents a risk to hospitalized patients. Enterobacteria are common among insects, and horizontally transmitted from one to another individual, but can be acquired from the environment, showing thus capacity of propagation and maintenance of the microorganism in the environment (MOREIRA et al., 2005, PEREIRA; UENO, 2008, PESQUERO et al., 2008).
Ants can move upon human material such as urine, feces, sputum, and carry the microorganisms to the utensils and surfaces in general. Among the microorganisms identified in the ants is the group of fecal coliforms, including Escherichia, Enterobacter and Klebsiella, present in human feces by being part of the intestinal flora; and Staphylococcus aureus, on the human skin and nasopharynx, is the responsible for the most of nosocomial infections (TRABULSI, 1991).
Regarding the Escherichia coli, even being part of the gastrointestinal tract of humans it has been reported as one of the most important agents for extraintestinal infections, such as diarrhea in adults and children, and experimental keratoconjunctivitis, an infection similar to shigellosis (JAWETZ et al., 1998). Thus, the problem becomes relevant in the studied hospitals, once this bacterium was identified in ants Odontomachus sp and Pheidole sp1 and sp2 found in areas with the presence of children, such as nursery and maternity (SANTOS et al., 2009).
Ants have great capacity to maintain the association between bacteria and fungi, including some antibiotic-resistant pathogenic species, characterizing a condition of risk of nosocomial infection (PANTOJA et al., 2009; PEREIRA; UENO, 2008). Among the multiresistant strains, stand out the genera Acinetobacter, Streptococcus, Gemella, Enterococcus faecalis and Klebsiella (MOREIRA et al., 2005; TRABULSI, 1991) and K Pneumomiae (TANAKA et al., 2007). Thus, it is evident the importance of the problem in the public health area, once these bacteria are becoming increasingly resistant to a higher number of antibiotics.
The inpatient units for adults and children, Intensive Care Units (ICU) for adults and children, as well as nursery, surgical centers, nursing stations, sterilizing rooms, kitchens and laboratories are among the wards with high infestation of ants (COSTA et al., 2006; LISE et al., 2006; MOREIRA Ants in brazilian hospitals: atention to a silent vector et al., 2005; PESQUERO et al., 2008; RANDO et al., 2009; SANTOS et al., 2009; TANAKA et al., 2007; TEIXEIRA et al., 2009). Among them, some units with critically ill patients such as ICU, surgical centers and nurseries, receive a lower flow of people and materials, and have a higher frequency of environmental hygiene, then it was expected a lower index of infestation of ants than observed (BRAGANCA; LIMA, 2010). However, their presence was not related to the lack of cleaning, some species are attracted to sterilized materials, serum and medications used.
Multiresistant bacterial strains isolated from ants in places such as nurseries indicate a direct effect on disease transmission and consequently on increased rates of infection and severity of nosocomial infections. Undoubtedly, this needs to be discussed with sectors related to prevention of hospital infection (TANAKA et al., 2007).
According to these studies, ants in hospitals should be considered a threat to human health, because they are vectors of pathogenic bacteria, but not associate the presence of ants with indices of nosocomial infections, nor neglect their presence, without controlling or monitoring their presence in these environments (CINTRA-SOCOLOWSKI, 2007).
The presence of ants in hospitals should receive attention since they can carry diverse bacterial species, including multiresistant strains. In this way, ants in this environment should warn the CCIH and all multidisciplinary team for the effective control of nosocomial infections, because only with the participation of the entire hospital community it will be possible to develop from basic measures, such as hand washing, and the maintenance of a clean working environment, to the control of ants, but the professional awareness comes to the fore as prevention.
This problem can be minimized by adopting some measures to control ants in hospitals, such as the ban on entry of food and flowers, cover small cracks on the walls, removal of tree branches close to the windows and outside walls, removal of debris in the outer area. Because several factors favor the occurrence of ants in hospitals, including the deficient structure, even with efforts of a committee on hospital infection control, given the circulation of a large amount of people (patients, relatives, employees, suppliers) and goods (clothes, foodstuffs, flowers, and other objects) that favor the entry of these insects, in addition to the drugs that attract them.
BARROS, R. A. M.; CAMPOS-FARINHA, A. E.; PREZOTO, F. Ocorrencia, comportamento e vetoracao de fungos por formigas no Hospital. Revista Brasileira de Zoociencias, v. 8, n. 2, p. 217-220, 2006.
BEATSON, S. H. Pharaoh's ants as pathogens vectores in hospitals. The Lancet, v. 1, n.1, p. 425-427, 1972.
BELEI, R. A.; GUARIENTE, M. H. D. M.; CAVASSIN, E. D.; RIBEIRO, P. H. V. Formigas: analise dos microorganismos carreados no ambiente hospitalar Nursing, v. 9, n. 95, p. 777-781, 2006.
BRAGANCA, M. A. L.; LIMA, J. D. Composicao, abundancia e indice de infestacao de especies de formigas em um hospital materno-infantil de Palmas, TO. Revista Neotropical Entomology, v. 39, n. 1, p. 124-130, 2010.
BUENO, O. C.; FOWLER, H. G. Exotic ants and native ant fauna of Brazilian hospitals. In: WILLIAMS. D. F. (Ed.). Exotic ants: biology, impact and control of introduced species. Boulder: Westview Press, 1994. p. 191-198.
CHADE, D.; MAITRE, A. Ants: potential mechanical vectors of hospital infections in Trinidad. Transactions of the Royal Society of Tropical Medicine and Hygiene, v. 84, n. 2, p. 297-297, 1990.
CINTRA-SOCOLOWSKI, P. Historico sobre as pesquisas com formigas em ambientes hospitalares no Brasil. Biologico, v. 69, p. 35-38, 2007. (Supl. 2). COSTA, S. B.; PELLI, G. P.; CARVALHO, P.; OLIVEIRA, A. G.; SILVA, P. R.; TEIXEIRA, M. M.; MARTINS, E.; TERRA, A. P. S.; RESENDE, E. M.; OLIVEIRA, C. C. H. B.; MORAIS, C. A. Formigas como vetores mecanicos de microorganismos no hospital escola da universidade federal do triangulo mineiro. Revista Sociedade Brasileira de Medicina Tropical, v. 39 n. 6, p. 527-529, 2006.
EDWARD, J. P.; BAKER, L. F. Distribuition and importance of Tha Pharaoh's Monomorium pharaonis (L) in national Health Service Hospitals in England. Journal of Hospital Infection, v. 2, n. 2, p. 245-254, 1981.
EICHELER, W. Health aspects and control of Monomorium pharaonis. In: MEER, R. K. V.; JAFE, K.; CEDENO, A. (Ed.). Applied Mirmecology: a world pesperctive. Boulder: Westview Press, 1990. p. 671-675.
ESPALDER, X.; ESPEJO, F. Tapinoma melanochephalum (Fabricius, 1793) a new exotic ant in Spain (Hymenoptera, Formicidae). Orsis, v. 17, n. 4, p. 101-104, 2002.
FOWLER, H. G.; BUENO, O. C.; SADASTSUNE, T.; MONTELLI, A. Ants as potential vectors of pathogens in hospitals in the state of Sao Paulo, Brazil. Insect Science and its Applications, v. 14, n. 3, p. 367-370, 1993.
GARCIA, F. R. M.; AHLERT, C. C.; FREITAS, B. R.; TRAUTMANN, M. M.; TANCREDO, S. P.; LUTINSKI, J. A. Ants (Hymenoptera: Formicidae) in five hospitals of Porto Alegre, Rio Grande do Sul State, Brazil. Acta Scientiarum. Health Sciences, v. 33, n. 2, p. 203-209, 2011.
GONCALVES, M. G.; LOECK, A. E.; SILVA, W. P.; ROSADO, J. L. O.; BASTOS, C. P.; BASSANI, M. T. Associacao entre formigas (Hymenoptera: Formicidae) e bacterias patogenicas em cinco hospitais do municipio de Pelotas, RS. Arquivos do Instituto Biologico, v. 78, n. 2, p. 287-295, 2011.
IPINZA-REGLA, J.; FIGUEROA, G.; OSORIO, J. Iriaomyrmex humilis 'hormiga argentina como vector de infecciones intrahospitalarias: I Estudio bacteriologico. Folia Entomologica Mexicana, v. 50, n. 1, p. 81-96, 1981.
JAWETZ, E.; MELNICK, J.; ADELBERG, E. A. Microbiologia medica. Rio de Janeiro: Guanabara Koogan, 1998.
KIM, C. W.; KIM, D. I.; CHOI, S. Y.; PARK, J. W.; HONG, C. S. Pharaoh ant (Monomorium pharaonis); Newly identified important inhalant allergens in bronchial asthma. Journal Korean of Medical Science, v. 20, n. 2, p. 390-396, 2005.
KLOTZ, J. K.; MANGOLD, J. R.; VAIL, K. M.; DAVIS JUNIOR, L. R.; PATTERSON, R. S. A survey of urban pests ants (Hymenoptera: Formicidae) of Peninsular Florida. Florida Entomologist, v. 78, n. 1, p. 109-118, 1995.
LISE, F.; GARCIA, F. R. M.; LUTINSKI, J. A. Association of ants (Hymenoptera: Formicidae) with bacteria in hospitals in State of Santa Catarina. Revista da Sociedade Brasileira de Medicina Tropical, v. 39, n. 6, p. 523-526, 2006.
MOREIRA, D. D. O.; MORAES, V.; MOTTA, O. V.; CAMPOS, A. E. C.; TONHASCA JUNIOR, R. A. Ants as potential bacteria carriers in three hospitals in Campos dos Goytacazes, Rio de Janeiro State, Brazil. Neotropical Entomology, v. 34, n. 6, p. 999-1006, 2005.
NA, J. P. S.; LEE, C. Y. Identification key to commonurban pest ants in Malysia. Tropical Biomedicine, v. 18, n. 1, p. 1-17, 2001.
NELDER, M. P.; PAYSEN, E. S.; ZUNGOLI, P. A.; BENSON, E. P. Emergence of the introduced ant Pachycondyla chinensis (Formicidae: Ponerinae) as a public health threat in the southeastern United States. Journal of Medical Entomology, v. 43, n. 5, p. 1094-1098, 2006.
OLAYA-MASMELA, L. A.; ULLOA, P. C.; PAYAN, A. Ants (Hymenoptera: Formicidae) in hospital centers of Valle del Cauca as vectors of nosocomial pathogens. Revista Colombiana de Entomologia, v. 31, n. 2, p. 183-187, 2005.
PANTOJA, L. D. M.; MOREIRA FILHO, R. E.; BRITO, E. H. S.; ARAGAO, T. B.; BRILHANTE, R. S. N.; CORDEIRO, R. A.; ROCHA, M. F. G.; MONTEIRO, A. J.; QUINET, Y. P.; SIDRIM, J. J. C. Formigas (Hymenoptera: Formicidae) como portadoras de fungos no Hospital Ambientes: enfase sobre os generos Tapinoma e Pheidole. Journal of Medical Entomology, v. 46, n. 4, p. 895-899, 2009.
PEREIRA, R. S; UENO, M. Formigas como veiculadoras de microrganismos em ambiente hospitalar. Revista da Sociedade Brasileira de Medicina Tropical, v. 41, n. 5, p. 492-495, 2008.
PESQUERO, M. A.; FILHO, J. E.; CARNEIRO, L. C.; FEITOSA, S. B.; OLIVEIRA, M. A. C.; QUINTANA, R. C. Formigas em ambiente hospitalar e seu potencial como transmissoras de bacterias. Neotropical Entomology, v. 37, n. 4, p. 472-477, 2008.
RANDO, J. S. S.; MATSUMOTO, L. S.; SILVA, G. V.; QUIRINO, A. F. A.; HADDAD, R. E. Caracterizacao da mirmecofauna em estabelecimentos ligados a area da Saude no Municipio de Bandeirantes, PR. Arquivos do Instituto Biologico, v. 76, n. 4, p. 665-671, 2009.
RODOVALHO, C. M.; SANTOS, A. L.; MARCOLINO, M. T.; BONETTI, A. M.; BRANDEBURGO, M. A. M. Urban ants and transportation of nosocomial bacteria. Neotropical Entomology, v. 36, n. 3, p. 454-458, 2007.
SANTOS, P. F.; FONSECA, A. R.; SANCHES, N. M. Formigas (Hymenoptera: Formicidae) como vetores de bacterias em dois hospitais do municipio de Divinopolis, Estado de Minas Gerais. Revista da Sociedade Brasileira de Medicina Tropical, v. 42, n. 5, p. 565-569, 2009.
TANAKA, I. I.; VIGGIANI, A. M. F. S.; PERSON, O. C. Bacterias veiculadas por formigas em ambiente hospitalar. Arquivos Medicos do ABC, v. 32, n. 2, p. 60-63, 2007.
TEIXEIRA, M. M.; PELLI, A.; SANTOS, V. M.; REIS, M. G. Microbiota associated with tramp ants in a Brazilian University Hospital. Neotropical Entomology, v. 38, n. 4, p. 537-541, 2009.
TRABULSI, L. R. Microbiologia. Rio de Janeiro: Atheneu, 1991.
ULLOA, P. C. Hormigas urbanas. In: FERNANDEZ, F. (Ed.). Introduccion a las hormigas de la region neotropical. Bogota: Instituto de Investigacion de Recursos Biologicos Alexander von Humboldt, 2003. p. 337-349.
ZARZUELA, M. F. M.; RIBEIRO, M. C. C; CAMPOSFARINHA, A. E. C. Distribuicao de formigas urbanas em um hospital da regiao sudeste do Brasil. Arquivos do Instituto Biologico, v. 69, n. 1, p. 85-87, 2002.
Received on Junee 22, 2010.
Accepted on August 16, 2011.
Flavio Roberto Mello Garcia * and Fernanda Lise
Laboratorio de Ecologia de Insetos, Departamento de Zoologia e Genetica, Instituto de Biologia, Universidade Federal de Pelotas, Cx. Postal 354, 96010-900, Pelotas, Rio Grande do Sul, Brazil. * Author for correspondence. E-mail: firstname.lastname@example.org
Table 1. Species of ants, microorganisms carried by them, and hospital units examined by the 14 Brazilian studies. Title Authors Ant species Ants as carriers of Moreira et al. Tapinoma resistant bacteria (2005) melanocephalum; in hospitals Paratrechina longicornis; Monomorium pharaonis; Solenopsis saevissima; Occurrence, Barros et al. (2006) Camponotus sp., behavior, and Camponotus crassus; vectoring of fungi C. atriceps; C. by ants in the renggeri; Wasmannia hospital of the auropuntata; Federal University Paratrechina of Juiz de Fora, longicornis; M. Minas Gerais State floricola; Pheidole sp., Tapinoma melanocephalum; Odontomachus sp. Ants: analysis on Belei et al. (2006) Not specified microorganisms carried in the hospital environment Ants as mechanical Costa et al. (2006) Tapinoma vectors of melanocephalum; microorganisms in Pheidole sp. and the school hospital Paratrechina of the Federal Longicornis. University of triangulo mineiro Association between Lise et al. (2006) Monomorium ants (Hymenoptera: pharaonis; Formicidae) and Solenopsis bacteria in saevissima; hospitals of Santa Paratrechina Catarina State longicornis; Brachymyrmex sp.; Solenopsis sp.; Camponotus sp.; Tapinoma melanocephalu. Urban ants and the Rodovalho et al. Tapinoma transport of (2007) melanocephalum and nosocomial bacteria C. vittatus Bacteria carried by Tanaka et al. (2007) Monomorium pharaonis ants in hospital and Tapinoma environment melanocephalum. Ants as Pereira e Ueno 125 ants of the same microorganism (2008) not- specified carriers in species hospitals Ants in hospital Pesquero et al. Pheidole sp1; environment and (2008) Hipoponera sp1; their potential to Dorymyrmex transmit bacteria pyramicus; Linepitthema humile; Camponotus sp1; Brachymyrmex sp1; Brachymyrmex sp2; Paratrechina fulva; Cardiocondyla sp1; Ants (Hymenoptera: Santos et al. (2009) Pheidole sp1 and Formicidae) as sp2; Linepithema bacterial vectors in humile; Wasmannia two hospitals of the auropunctata; municipality of Camponotus sp.; Divinopolis, Minas Odontomachus sp; Gerais State Solenopsis sp.; Acromyrmex sp. and Tapinoma melenocephalum. Characterization of Rando et al. (2009) Tapinoma ant fauna in melanocephalu; establishments of Paratrechinafulva; health area in the Monomorium municipality of pharaonis; C. Bandeirantes, Parana atriceps; State. Brachymyrmex sp.; Pheidole sp.4; Pheidole sp.3; Pheidole sp.2; Pheidole sp.1; Dorymyrmex sp. Microbiota Teixeira et al. Tapinoma associated with (2009) melanocephalum. urban ants in a Brazilian university hospital. Ants (Hymenoptera: Pantoja et al. Tapinoma Formicidae) as (2009) melanocephalum; carriers of fungi in Paratrechina hospitals: emphasis longicornis; on genera Tapinoma Camponotusand Pheidole Solenopsis; Pheidole. Association between Goncalves et al. Cardiocondyla emeryi ants G (Hymenoptera: (2011) Pheidole nubila, Formicidae) and Pheidole spininodis, pathogenic bacteria Pheidole sp.1, S. in five hospitals in saevissima, the city of Pelotas Tetramorium bicarinatum, Title Microorganisms Hospital unit Ants as carriers of Bacillus spp.; Adult and pediatric resistant bacteria Enterobacter wards, Cardiology, in hospitals amnigenus; gynecology, trauma, Enterobacter postopoerative; cloacae; Adult and pediatric Enterococcus ICU. faecalis; Klebsiella pneumoniae; Staphylococcus saprophyticus; Acinetobacter baumanni; Gemella morbillorum; Staphylococcus epidermidis; Staphylococcus equorum; Klebsiella oxytoca; Staphylococcus aureus; Staphylococcus simulans; Staphylococcus warneri; Serratia rubidae Staphylococcus cohnii Bacillus spp. Enterobacter agglomerans; Gemellaha emolysans; Enterococcus faecium; Gemellaha emolysans; Streptococcus acidominimus; Staphylococcus lugdunensis. Occurrence, Aspergillus sp.; Not specified behavior, and Cladosporium sp.; vectoring of fungi Penicillium sp.; by ants in the Candida sp. and hospital of the Aspergillus niger. Federal University of Juiz de Fora, Minas Gerais State Ants: analysis on Filamentous fungi, NICU and other microorganisms Coagulase negative hospital units. carried in the staphylococci, hospital environment acinetobacter sp.; micrococcus sp.; and bacillus sp.. Ants as mechanical Staphylococcus sp.; Wards, service of vectors of Gram-positive nutrition and microorganisms in bacilli, Pseudomonas dietetics, and the school hospital sp.; and Micrococcus pediatric ICU of the Federal sp.. University of triangulo mineiro Association between Acinetobacter sp.; Adult inpatient ants (Hymenoptera: Acinetobacter unit, surgical, Formicidae) and haemolyticu; oncology and bacteria in Oerskovia sp.; pediatrics. hospitals of Santa Corynebacterium sp.; Catarina State Corynebacterium diphtheriae; Corynebacterium jeikeium; Enterococcus sp.; Listeria monocytogenes; Neisseria sp.; Planococcus sp.; Pseudomonas luteola; Sphingobacterium sp.; Sphingomonas paucimobilis; Staphylococcus sp.; Staphylococcus intermedius; Staphylococcus saprophyticus; Stenotrophomonas maltophilia; Streptococcus agalactiae; Streptococcus bovis;. Neisseria sp.; Planococcus sp. and S. agalactiae. Urban ants and the Coagulase positive Unit of infectious transport of staphylococci, diseases, emergency nosocomial bacteria Coagulase negative room, and burn unit staphylococci and Gram-negative bacilli. Bacteria carried by Corinebacterium sp.; Nursery, surgical ants in hospital Klebsiella center, nursing environment pneumoniae; K. station, sterilizing ozaenae; Escherichia room, blood donation coli. room, and ICU Ants as Hafnia alvei; Medical clinic, microorganism Klebsiella p neu blood unit, laundry, carriers in moniae; Enterobacter and orthopedics. hospitals aglomerans; Enterobacter cloacae; Enterobacter sakazakii; Serratia liquefaciens; Serratia marcescens. Epidermopgyton floccosum; Trichophyton rubrum; Trichophyton verrucosun; Clodosparium carruoni; Aurobasidium pullulans; Wangiella dermatitidis; Conidiobolus coronalus; Fonsecaea pedrosoi; Aspergillus niger; Aspergillus jlavus; Aspergillus fumigatus; Monilia sitophita. Ants in hospital Escherichia coli; Restrooms, nursery, environment and Staphylococcus sp.; medical offices, their potential to Enterococcus sp.; kitchen, sterilizing transmit bacteria Klebsiella sp.; room, hematology, Salmonella sp. and laboratory, milk Aeromonas sp. kitchen unit, nursing station, suture room, plaster room, Adult and pediatric ICU Ants (Hymenoptera: Escherichia coli; Warehouse, nursery, Formicidae) as Pseudomonas chapel, sterilizing bacterial vectors in aeruginosa'; room, surgical two hospitals of the pathogenic and non- center, medical municipality of pathogenic clinic, drugstore, Divinopolis, Minas Staphylococcus spp; kitchen, bedrooms, Gerais State Streptococcus laboratory, faecalis and other maternity, ICU, Enterococcus sp. radiology. Characterization of Staphylococcus sp.; Surgical center, ant fauna in Serratia sp.; hallways, drugstore, establishments of Klebsiella sp.; laundry, nursing health area in the Escherichia coli; stations, reception, municipality of Salmonella sp.; and adult and pediatric Bandeirantes, Parana Pseudomonas sp.. inpatient units, and State. ICU Microbiota Gram-positive Surgical center, and associated with bacilli, Gram- ICU. urban ants in a negative bacilli, Brazilian university Gram-positive cocci, hospital. Filamentousfungi, Pseudomonas; Staphylococcus; and Streptococcus. Ants (Hymenoptera: Absidia sp.; NICU, adult ICU, Formicidae) as Acremonium sp.; surgical center, carriers of fungi in Acremonium transplant units, hospitals: emphasis hyalinulum; pediatrics, on genera Tapinoma AspergiHusflavus; hematology, surgery, and Pheidole Aspergillus niger; gynecology. Aspergilluso chraceus; Aspergillus oryzae; Aspergillus sydowii; Aspergillus versicolor; Chrysosporium inops; Cladosporium Sphaerospermum; Cokeromyces sp.; Cunninghamella Bertholletiae; Cyphellophora sp.; Fusarium sp.; Fusarium proliferatum; Fusarium solani; Mortierella; polycephala; Mucor sp.; Mycocentrospora; acerina; Ochroconis gallopava; Paecilomyces marquandii; Paealomyces variotii; Penicillium sp. Rhinocladiella aquaspersa; Scopulariopsis koningii; Scytalidium sp.; Tritirachium oryzae; Candida albicans; Candida glabrata; Candida guilliermondii; Candida Association between Enterobacteria, Surgical center, ants G (Hymenoptera: Pseudomonas hallways, drugstore, Formicidae) and aeruginosa, laundry, nursing pathogenic bacteria Pseudomonasfluorescens, stations, reception, in five hospitals in Pseudomonas putida, adult and pediatric the city of Pelotas Staphylococcus inpatient units, and epidermidis and ICU Staphylococcus saprophyticus