Navegando por Palavras-chave "Nosocomial infection"
Agora exibindo 1 - 5 de 5
Resultados por página
Opções de Ordenação
- ItemAcesso aberto (Open Access)Candidúria: uma abordagem clínica e terapêutica(Sociedade Brasileira de Medicina Tropical - SBMT, 2007-06-01) Colombo, Arnaldo Lopes [UNIFESP]; Guimarães, Thaís [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hospital do Servidor Público Estadual de São PauloCandiduria remains a controversial issue for clinicians once that it may represent a broad variety of possibilities including colonization, local or systemic infection. We will discuss the epidemiology, diagnosis and treatment of candiduria in different settings of patients, including renal transplant recipients. Definitions on therapy are mostly based on epidemiological and clinical data. Once antifungal therapy is required the following antifungal treatment may be used: intravenous amphotericin B, bladder irrigation with amphotericin B or fluconazole. Blood cultures may be required in patients with candiduria and high risk for developing hematogenous infection. Removal of the urinary catheter must be considered in order to avoid persistent candiduria and recurrence.
- ItemSomente MetadadadosEmergence of nosocomial Mycobacterium massiliense infection in Goias, Brazil(Elsevier B.V., 2008-11-01) Cardoso, Alessandra Marques; Sousa, Eduardo Martins de; Viana-Niero, Cristina [UNIFESP]; Bortoli, Fernando Bontim de; Pereira das Neves, Zilah Candida; Leao, Sylvia Cardoso [UNIFESP]; Junqueira-Kipnis, Ana Paula; Kipnis, Andre; Universidade Federal de Goiás (UFG); Universidade Federal de São Paulo (UNIFESP); Secretaria Municipal Saude GoianiaA cluster of surgical site infection cases after arthroscopic and laparoscopic procedures occurred between 2005 and 2007 in Goiania, in the central region of Brazil. Nontuberculous mycobacteria (NTM) were isolated from samples (exudates from cutaneous abscesses) from 18 patients of seven private hospitals. There were no reports of post-surgical arthroscopic and laparoscopic mycobacterial infections in Goiania apart from this period. the 18 isolates were identified as Mycobacterium massiliense by PCR-restriction digestion of the hsp65 gene, pulsed-field gel electrophoresis (PFGE) comparisons, and rpoB partial gene sequencing. All isolates were typed as a single clone, indicating that they have the same origin, which suggests a common source of infection for all patients. (C) 2008 Elsevier Masson SAS. All rights reserved.
- ItemSomente MetadadadosImipenem-resistant Pseudomonas aeruginosa infection at a medical-surgical intensive care unit: Risk factors and mortality(Elsevier B.V., 2009-12-01) Furtado, Guilherme H. C. [UNIFESP]; Bergamasco, Maria D. [UNIFESP]; Menezes, Fernando G. [UNIFESP]; Marques, Daniel [UNIFESP]; Silva, Adriana [UNIFESP]; Perdiz, Luciana B. [UNIFESP]; Wey, Sergio B. [UNIFESP]; Medeiros, Eduardo A. S. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objectives: the aim of this study was to evaluate the risk factors and attributable mortality associated with imipenem-resistant Pseudomonas aeruginosa (IRPA) infections in a medical-surgical intensive care unit (ICU).Methods: A retrospective case-control study was carried out at a 16-bed medical-surgical ICU in a 780-bed, university-affiliated hospital. All patients admitted from January 1, 2003, to December 31, 2004, who had nosocomial infection caused by IRPA, were included in the study.Results: Imipenem-resistant P. aeruginosa was recovered from 63 patients during the study period. One hundred eighty-two controls were matched with cases by period of admission, age, and time at risk. Urinary tract (34.9%) and respiratory tract (22.2%) were the main sources of IRPA isolation. in multivariate analysis, a previous stay in the ICU (odds ratio, 3.54; 95% confidence interval [CI], 1.29-9.73; P = .03) was the only independent risk factor for IRPA infection. the in-hospital mortality rate among case patients was 49% (31 of 63) compared with 33% (61 of 182) for control patients (odds ratio, 1.92; 95% CI, 1.07-3.44; P = .02). Thus, we had an attributable mortality of 16% (95% CI, 9.74%-22.3%; P = .03).Conclusions: Our study suggests that IRPA infections are strongly related to previous ICU stay, and that IRPA infections significantly increase mortality in those critical patients. (C) 2009 Elsevier Inc. All rights reserved.
- ItemSomente MetadadadosIncidence and risk factors for surgical site infection after simultaneous pancreas-kidney transplantation(W B Saunders Co Ltd, 2009-08-01) Perdiz, L. B. [UNIFESP]; Furtado, G. H. C. [UNIFESP]; Linhares, M. M. [UNIFESP]; Gonzalez, A. M. [UNIFESP]; Pestana, J. O. M. [UNIFESP]; Medeiros, E. A. S. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)A simultaneous pancreas-kidney transplantation (SPKT) is the best treatment option for type I diabetic patients with advanced chronic renal failure. Infectious complications affect 7-50% of the patients receiving this procedure. We conducted a nested case-control study to assess the risk factors for surgical site infection (SSI) in patients receiving SPKT at our Centre between 2000 and 2006. of the 119 evaluated transplant recipients, 55 (46.2%) developed SSIs and the 30 day mortality was 11.8%. Gram-negative organisms were the predominant organisms isolated from SSIs. After multivariate logistic regression, the variables independently associated with SSI were: acute tubular necrosis, post-transplant fistula and graft rejection. This study demonstrated a high incidence of SSI in this patient cohort and variables related to the surgical procedure were closely associated with the development of SSI. (C) 2009 the Hospital Infection Society. Published by Elsevier B.V. All rights reserved.
- ItemAcesso aberto (Open Access)Perfil de sensibilidade a antimicrobianos de bactérias isoladas do trato respiratório baixo de pacientes com pneumonia internados em hospitais brasileiros: resultados do Programa SENTRY, 1997 e 1998(Sociedade Brasileira de Pneumologia e Tisiologia, 2001-03-01) Sader, Helio Silva [UNIFESP]; Mendes, Rodrigo Elisandro [UNIFESP]; Gales, Ana Cristina [UNIFESP]; Jones, Ronald N.; Pfaller, Michael A.; Zoccoli, Cassia; Sampaio, Jorge; Universidade Federal de São Paulo (UNIFESP); Universidade de Iowa Faculdade de Medicina Departmento de Patologia; Laboratório Santa Luzia; Laboratório LâminaBackground: Nosocomial pneumonia is the most common fatal nosocomial infection with attributable mortality rates ranging from 30 to 60% and a rapid initiation of optimal antimicrobial therapy is important to obtain treatment success. SENTRY is a comprehensive antimicrobial surveillance study involving a great number of medical centers distributed worldwide. Objective: To evaluate the antimicrobial susceptibility of bacterial isolates collected from the lower respiratory tract of inpatients with pneumonia. Material & methods: The authors report the antimicrobial susceptibility of 525 isolates collected in 11 Brazilian hospitals, as part of the SENTRY program. The isolates were tested for susceptibility by broth micro-dilution against a large number of drugs. Results: The five most frequently isolated species were (n/%): Pseudomonas aeruginosa (158/30.1%), Staphylococcus aureus (103/19.6%), Acinetobacter spp. (68/13.0%), Klebsiella spp. (50/9.5%), and Enterobacter spp. (44/8.4%). These five species represented more than 80% of all isolates. P. aeruginosa demonstrated high rates of resistance to most antimicrobial agents tested. The highest susceptibility rates were shown by piperacillin/tazobactam (71.5%) and meropenem (69.0%). Acinetobacter spp. also showed very high rates of resistance. The most active compounds against this species were imipenem and meropenem (80.9% susceptibility) followed by tetracycline (63.2% susceptibility). Cephalosporin susceptibilities among Klebsiella spp were very low and 36.0% of isolates were considered ESBL producers based on increased MICs, > 2 mug/mL) to ceftriaxone or ceftazidime or aztreonam. Ceftriaxone was active against only 56.8% of Enterobacter spp. isolates (MIC50 1 mug/mL), while cefepime was active against 88.6% of these isolates (MIC, < 0.12 mg/mL). Oxacillin-resistance was detected in 43.7% of S. aureus isolates. The most active drugs against this species were vancomycin, teicoplanin, quinupristin/dalfopristin, and linezolid. Conclusion: The results of this study demonstrated a higher prevalence of Acinetobacter spp. and higher resistance rates among Gram-negative rods when compared with results from North American and European studies.