Vancomycin-resistant enterococcus outbreak in a pediatric intensive care unit: report of successful interventions for control and prevention

The objective of this study is to retrospectively report the results of interventions for controlling a vancomycin-resistant enterococcus (VRE) outbreak in a tertiary-care pediatric intensive care unit (PICU) of a University Hospital. After identification of the outbreak, interventions were made at the following levels: patient care, microbiological surveillance, and medical and nursing staff training. Data were collected from computer-based databases and from the electronic prescription system. Vancomycin use progressively increased after March 2008, peaking in August 2009. Five cases of VRE infection were identified, with 3 deaths. After the interventions, we noted a significant reduction in vancomycin prescription and use (75% reduction), and the last case of VRE infection was identified 4 months later. The survivors remained colonized until hospital discharge. After interventions there was a transient increase in PICU length-of-stay and mortality. Since then, the use of vancomycin has remained relatively constant and strict, no other cases of VRE infection or colonization have been identified and length-of-stay and mortality returned to baseline. In conclusion, we showed that a bundle intervention aiming at a strict control of vancomycin use and full compliance with the Hospital Infection Control Practices Advisory Committee guidelines, along with contact precautions and hand-hygiene promotion, can be effective in reducing vancomycin use and the emergence and spread of vancomycin-resistant bacteria in a tertiary-care PICU.

The process of constructing new competencies in the family agricultural production unit

This article discusses the difficulties dairy farmers face when they decide to install a new type of production on their units. We intend to discuss the nature of the new competencies the farmers will construct in order to install new production ateliers, and to show the complexity of the means they used, the difficulties they face in this process, and the strategies farmers develop in consonance with the practical knowledge of their profession. The method used was Ergonomic Work Analysis, together with semi-structured interviews, done after sessions of observation and work analysis. The results show that it is possible to apprehend a part of the complexity of the process of constructing competencies among dairy farmers, the diversity of kinds of resources they mobilize, integrate and transfer in this construction process that materializes through their activities in the work context.

On the relationship between squid and the environment: artisanal jigging for Loligo plei at Sao Sebastiao Island (24 degrees S), southeastern Brazil

The squid Loligo plei concentrates in the southeastern Brazil Bight, where it has traditionally supported small-scale fisheries around Sao Sebastiao Island (SSI). Sea surface temperature (SST), chlorophyll-a (Chl a), windspeed, wave height, rainfall, and lunar phase are related to fishing records and to the results of a survey of local fishers to investigate how they believe environmental variables might affect catches of L. plei. Daily fishery-dependent data over the years 2005-2009 were obtained from a fishing cooperative and were matched with satellite and meteorological forecast data. Generalized linear models were used to explore the significance of environmental variables in relation to variability in catch and catch per unit effort (cpue). Squid are fished with jigs in water shallower than 20 m, generally where SST is warmer and Chl a and windspeed are lower. Cpue and monthly catches decreased from 2005 to 2008, followed by a slight increase in 2009. The correlations between fishery and environmental data relate well to fishers` oceanological knowledge, underscoring the potential of incorporating such knowledge into evaluations of the fishery.

Sensitivity of Eisenia andrei (Annelida, Oligochaeta) to a commercial formulation of abamectin in avoidance tests with artificial substrate and natural soil under tropical conditions

Obtaining ecotoxicological data on pesticides in tropical regions is imperative for performing more realistic risk analysis, and avoidance tests have been proposed as a useful, fast and cost-effective tool. Therefore, the present study aimed to evaluate the avoidance behavior of Eisenia andrei to a formulated product, Vertimec(A (R)) 18 EC (a.i abamectin), in tests performed on a reference tropical artificial soil (TAS), to derive ecotoxicological data on tropical conditions, and a natural soil (NS), simulating crop field conditions. In TAS tests an adaptation of the substrate recommended by OECD and ISO protocols was used, with residues of coconut fiber as a source of organic matter. Concentrations of the pesticide on TAS test ranged from 0 to 7 mg abamectin/kg (dry weight-d.w.). In NS tests, earthworms were exposed to samples of soils sprayed in situ with: 0.9 L of Vertimec(A (R)) 18 EC/ha (RD); twice as much this dosage (2RD); and distilled water (Control), respectively, and to 2RD: control dilutions (12.5, 25, 50, 75%). All tests were performed under 25 +/- A 2A degrees C, to simulate tropical conditions, and a 12hL:12hD photoperiod. The organisms avoided contaminated TAS for an EC50,48h = 3.918 mg/kg soil d.w., LOEC = 1.75 mg/kg soil d.w. and NOEC = 0.85 mg/kg soil d.w. No significant avoidance response occurred for any NS test. Abamectin concentrations in NS were rather lower than EC50, 48h and LOEC determined in TAS tests. The results obtained contribute to overcome a lack of ecotoxicological data on pesticides under tropical conditions, but more tests with different soil invertebrates are needed to improve pesticides risk analysis.

Gradients in N-cycling attributes along forestry and agricultural land-use systems are indicative of soil capacity for N supply

Indicators of soil quality associated with N-cycling were assessed under different land-use systems (native forest NAT, reforestation with Araucaria angustifolia or Pinus taeda and agricultural use AGR) to appraise the effects on the soil potential for N supply. The soil total N ranged from 2 to 4 g/kg (AGR and NAT, respectively), and the microbial biomass N ranged from 80 to 250 mg/kg, being higher in NAT and A. angustifolia, and lower in P. taeda and AGR sites. Activities of asparaginase (ca. 50200 mg NH4+-N/kg per h), glutaminase (ca. 200800 mg NH4+-N/kg per h) and urease (ca. 80200 mg NH4+-N/kg/h) were also more intense in the NAT and A. angustifolia-reforested soils, indicating greater capacity for N mineralization. The NAT and AGR soils showed the highest and the lowest ammonification rate, respectively (ca. 1 and 0.4 mg NH4+-N/kg per day), but the inverse for nitrification rate (ca. 12 and 26%), indicating a low capacity for N supply, in addition to higher risks of N losses in the AGR soil. A multivariate analysis indicated more similarity between NAT and A. angustifolia-reforested sites, whilst the AGR soil was different and associated with a higher nitrification rate. In general, reforestation with the native species A. angustifolia had less impact than reforestation with the exogenous species P. taeda, considering the soil capacity for N supply. However, AGR use caused more changes, generally decrease in indicators of N-cycling, showing a negative soil management effect on the sustainability of this agroecosystem.