Navegando por Palavras-chave "respiratory tract infections"
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- ItemSomente MetadadadosAntimicrobial susceptibility of Streptococcus pneumoniae in Latin America: results from five years of the SENTRY Antimicrobial Surveillance Program(Blackwell Publishing Ltd, 2004-07-01) Castanheira, Mariana [UNIFESP]; Gales, Ana Cristina [UNIFESP]; Mendes, Rodrigo Elisandro [UNIFESP]; Jones, R. N.; Sader, Helio Silva [UNIFESP]; Jones Grp; Universidade Federal de São Paulo (UNIFESP)A total of 1561 pneumococcal isolates were collected in 1997-2001, mainly from patients with community-acquired respiratory tract infections, and susceptibilities were tested by reference broth microdilution against 29 antimicrobial agents. in general, 69.3% of strains were considered susceptible (MIC less than or equal to 0.06 mg/L) to penicillin. Resistance to penicillin (MIC greater than or equal to 2 mg/L) and cefotaxime (MIC greater than or equal to 4 mg/L) was found in 11.9% and 0.4% of isolates, respectively. the fluoroquinolones gatifloxacin (MIC90, 0.5 mg/L) and levofloxacin (MIC90, 1 mg/L) were active against > 99% of the isolates tested. Among the other non-beta-lactam drugs tested, the rank order of susceptibility was chloramphenicol (95.6%) > clindamycin (94.5%) > azithromycin (88.5%) > clarithromycin (87.5%) >tetracycline (79.5%) > trimethoprim + sulphamethoxazole (60.5%). the penicillin-non-susceptible isolates presented higher rates of resistance to other antimicrobial agents. the rank order of penicillin resistance rates among the seven participating countries was Mexico (25.0%) > Uruguay (19.2%) > Chile (18.3%) > Colombia = Argentina (9.9%) > Brazil (3.9%) > Venezuela (2.8%). the regional rate of penicillin resistance did not vary significantly over the years studied (p 0.339). Screening for the ermB and mefA genes by multiplex rapid cycle PCR on 23 erythromycin-resistant isolates collected during the year 2001 showed that 43.5% and 56.5%, respectively, were positive for ermB and mefA. Overall, the results indicated that antimicrobial susceptibilities of Streptococcus pneumoniae vary significantly among Latin American countries. Regional and local surveillance programmes are necessary to guide empirical therapy of pneumococcal infection in Latin American countries.
- ItemSomente MetadadadosCefdinir: an oral cephalosporin for the treatment of respiratory tract infections and skin and skin structure infections(Expert Reviews, 2007-02-01) Sader, Helio S. [UNIFESP]; Jones, Ronald N.; JMI Labs; Universidade Federal de São Paulo (UNIFESP); Tufts UnivCefdinir is an oral third-generation cephalosporin (also known as an advanced-spectrum or generation cephem) with good in vitro activity against the pathogens responsible for community-acquired respiratory tract infections and uncomplicated skin and skin structure infections. the drug distributes very well in respiratory tract tissues and fluids, as well as skin blisters and ear fluids; its pharmacokinetic profile allows once- or twice-daily administration. Oral cefdinir 300 mg twice daily or 600 mg once daily in adults and adolescents, or 14 mg/kg/day in one or two daily doses in pediatric patients, administered for 5 or 10 days, has shown good clinical and bacteriological efficacy, at least equivalent to that of other oral agents in randomized controlled trials conducted in patients with community-acquired pneumonia, acute bacterial exacerbation of chronic bronchitis, sinusitis, acute otitis media, pharyngitis and uncomplicated skin and skin structure infections. Cefdinir is well tolerated and the oral suspension has shown superior taste or palatability over other comparator oral antimicrobial agents. Thus, cefdinir continues to represent an important cephalosporin option for the treatment of adult, adolescent and pediatric patients with mild or moderate respiratory tract or cutaneous infections, especially in areas with elevated rates of beta-lactamase production in Haemophilus influenzae and where resistance to other commonly used agents has emerged (e.g., macrolides, penicillins, tetracyclines, fluoroquinolones and trimethoprim-sulfamethoxazole).
- ItemSomente MetadadadosEfeito da vacina contra papilomavírus humano (tipos 6, 11, 16 e 18) no tratamento de crianças com papilomatose respiratória recorrente(Universidade Federal de São Paulo (UNIFESP), 2015-12-16) Hermann, Juliana Sato [UNIFESP]; Pignatari, Shirley Shizue Nagata Pignatari [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Purpose: To evaluate whether the tetravalent vaccine against human papilomavírus (HPV) (types 6, 11, 16 and 18), when administered in a group of patients with juvenile-onset recurrent respiratory papillomatosis (RRP), influences the clinical course of the disease. Method: Uncontrolled intervention study of patients with juvenile-onset RRP of the Clinic of Pediatric Otorhinolaryngology, Federal University of São Paulo, where nine patients aged between 9-17 years received three doses of prophylactic quadrivalent vaccine against HVP (Gardasil®) and were followed for one year. The staging of disease, the intervals between relapses, the intervals between surgeries and their number during the year prior to vaccination and the first year of follow-up after vaccination were compared. Results: Eight patients had disease due to HPV-6 and one per HPV-11. There was no statistically significant change between the previous and subsequent years of vaccination in relation to clinical score (p = 0,083), anatomical score (p = 0,257), interval between relapses (p = 0,062), interval between surgery (p = 0,357) and the number of surgeries (p = 0,180). All patients had relapsed following vaccination. Conclusion: Vaccination with Gardasil® did not affect the clinical course of patients with juvenile-onset RRP during the study period.
- ItemAcesso aberto (Open Access)Infections with human coronaviruses NL63 and OC43 among hospitalised and outpatient individuals in São Paulo, Brazil(Instituto Oswaldo Cruz, Ministério da Saúde, 2012-08-01) Cabeça, Tatiane Karen [UNIFESP]; Carraro, Emerson [UNIFESP]; Watanabe, Aripuanã Sakurada Aranha [UNIFESP]; Granato, Celso Francisco Hernandes [UNIFESP]; Bellei, Nancy Cristina Junqueira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The incidence and clinical features of human coronaviruses (HCoVs) among Brazilian patients with respiratory illness are not well known. We investigated the prevalence of HCoVs among Brazilian outpatients and hospitalised patients with respiratory illnesses during 2009 and 2010. To identify the HCoVs, pancoronavirus and species-specific reverse-transcriptase polymerase chain reaction assays were performed. Five of 394 samples were positive for HCoVs (1.2%): 1/182 (0.5%) outpatients and 4/212 (1.8%) hospitalised patients. The OC43 and NL63 HCoVs were identified. Two patients were admitted to the intensive care unit. Underlying chronic disease was reported in cases and one diabetic adult died. HCoVs can cause lower respiratory infections and hospitalisation. Patients with pre-existing conditions and respiratory infections should be evaluated for HCoV infections.
- ItemAcesso aberto (Open Access)Manifestações clínicas e evolução da infecção pelo vírus da influenza A (H1N1) em receptores de transplante renal(Sociedade Brasileira de Nefrologia, 2011-06-01) Freitas, Tainá Veras de Sandes [UNIFESP]; Ono, Gislaine [UNIFESP]; Corrêa, Luci [UNIFESP]; Gomes, Pollyane Sousa [UNIFESP]; Galante, Nelson Zocoler [UNIFESP]; Tedesco-Silva Junior, Hélio [UNIFESP]; Camargo, Luís Fernando Aranha [UNIFESP]; Pestana, Jose Osmar Medina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)INTRODUCTION: The emergence of the pan>demic outbreak of influenza A (H1N1) in April, 2009, represented a logistic challenge for public health. Although most infected patients presented clinical and evolutionary manifestations which were very similar to seasonal influenza, a significant number of individuals developed pneumonia and severe acute respiratory failure. The impact of influenza A (H1N1) in immunocompromised patients is not well established yet. METHODS: This study aimed to analyze the clinical presentations and evolution of influenza A (H1N1) in 19 kidney transplant recipients. Influenza A (H1N1) infection was confirmed by RT-PCR in all patients. Treatment included antiviral therapy with oseltamivir phosphate and antibiotics. RESULTS: The studied population was compounded mostly of white people (63%), males (79%), at a mean age of 38.6 ± 17 years and patients with at least one comorbidity (53%). Influenza A (H1N1) infection was identified 41.6 ± 49.6 months after transplantation. Common symptoms included cough (100%), fever (84%), dyspnea (79%), and myalgia (42%). Acute allograft dysfunction was observed in 42% of the patients. Five patients (26%) were admitted to the Intensive Care Unit, two (10%) required invasive ventilation support, and two (10%) required vasoactive drugs. Mortality rate was 10%. CONCLUSIONS: Acute renal allograft dysfunction was a common finding. Clinical, laboratory, and evolutionary characteristics were comparable to those in the general population.
- ItemAcesso aberto (Open Access)Papel da punção do seio maxilar no diagnóstico e no tratamento de pacientes com rinossinusite hospitalar(Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2012-08-01) Mendes Neto, José Arruda [UNIFESP]; Guerreiro, Viviane Maria [UNIFESP]; Hirai, Elcio Roldan; Kosugi, Eduardo Macoto [UNIFESP]; Santos, Rodrigo de Paula [UNIFESP]; Gregório, Luiz Carlos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Rhinosinusitis is one of the most commom causes of fever of unknown origin in critically ill patients and should be systematically searched. OBJECTIVE: This study aims to evaluate the diagnostic and therapeutic effect of maxillary sinus puncture performed at the bedside in patients with infective rhinosinusitis hospitalized in an Intensive Care Unit of a high complexity care hospital. MATERIALS AND METHODS: This retrospective study looks into patients on mechanical ventilation with fever of unknown origin and signs of rhinosinusitis on CT images who were submitted to inferior meatus maxillary sinus puncture. RESULTS: The total study sample consisted of 27 patients (70.3% male; mean age 45.3 years). The most common Intensive Care Unit admission diagnoses were head trauma and stroke. CT scans revealed the maxillary (85.2%) and sphenoid (74.1%) sinuses were the most involved paranasal sinuses. Middle meatus purulent drainage was seen in 30.7% of the nasal cavities. Fever was reduced in 70.4% of the patients after puncture (p < 0.001). The most commonly found organisms in sinus aspirates were Pseudomonas aeruginosa and Acinetobacter baumannii. CONCLUSION: Maxillary sinus puncture performed at the bedside of the patients is an important diagnostic and theraupetic tool for critically ill patients.