Rapid tests for the detection of the Mycobacterium abscessus subsp. bolletii strain responsible for an epidemic of surgical-site infections in Brazil

A single strain of Mycobacterium abscessus subsp. bolletii, characterised by a particular rpoB sequevar and two highly related pulsed field gel electrophoresis patterns has been responsible for a nationwide outbreak of surgical infections in Brazil since 2004. In this study, we developed molecular tests based on polymerase chain reaction restriction-enzyme analysis (PRA) and sequencing for the rapid identification of this strain. Sequences of 15 DNA regions conserved in mycobacteria were retrieved from GenBank or sequenced and analysed in silico. Single nucleotide polymorphisms specific to the epidemic strain and located in enzyme recognition sites were detected in rpoB, the 3' region of the 16S rDNA and gyrB. The three tests that were developed, i.e., PRA-rpoB, PRA-16S and gyrB sequence analysis, showed 100%, 100% and 92.31% sensitivity and 93.06%, 90.28% and 100% specificity, respectively, for the discrimination of the surgical strain from other M. abscessus subsp. bolletii isolates, including 116 isolates from 95 patients, one environmental isolate and two type strains. The results of the three tests were stable, as shown by results obtained for different isolates from the same patient. In conclusion, due to the clinical and epidemiological importance of this strain, these tests could be implemented in reference laboratories for the rapid preliminary diagnosis and epidemiological surveillance of this epidemic strain.

Tecnologia educacional: avaliação de um web site sobre Escala de Pessoal de Enfermagem

O uso da tecnologia de informática é uma realidade em todas as áreas do conhecimento humano, nos dias atuais. A incorporação tecnológica se faz nos serviços e no ensino, nos diferentes processos de trabalho do enfermeiro. Este estudo teve como objetivo avaliar um site desenvolvido sobre o tema Escala de Pessoal de Enfermagem, relevante na gestão de recursos humanos em saúde. A metodologia envolveu pesquisa quantitativa com docentes da área de administração em enfermagem, e alunos das oito Universidades Públicas do estado de São Paulo que formam enfermeiros. Entre os principais resultados, apontamos que 85% dos avaliadores consideraram o site excelente ou satisfatório. Além disso, foram analisados os comentários enviados por e-mail e as autoras fazem uma auto-avaliação. O site foi considerado de utilidade tanto para a prática profissional (81,7% entre excelente e satisfatório) como para o ensino (84,6% entre excelente e satisfatório).

Evaluation of adherence to measures for the prevention of surgical site infections by the surgical team

AbstractOBJECTIVEEvaluate pre- and intraoperative practices adopted by medical and nursing teams for the prevention of surgical infections.METHODA prospective study carried out in the period of April to May 2013, in a surgical center of a university hospital in Belo Horizonte, Minas Gerais.RESULTS18 surgeries were followed and 214 surgical gloves were analyzed, of which 23 (10.7%) had postoperative glove perforation detected, with 52.2% being perceived by users. Hair removal was performed on 27.7% of patients in the operating room, with the use of blades in 80% of the cases. Antibiotic prophylaxis was administered to 81.8% of patients up to 60 minutes prior to surgical incision. An average of nine professionals were present during surgery and the surgery room door remained open in 94.4% of the procedures.CONCLUSIONPartial adhesion to the recommended measures was identified, reaffirming a need for greater attention to these critical steps/actions in order to prevent surgical site infection.

Readmission from orthopedic surgical site infections: an integrative review

Abstract OBJECTIVE Characterizing readmissions from orthopedic surgical site infections. METHOD An integrative review of literature in the LILACS, IBECS, MEDLINE, Cochrane, SciELO and PUBMED databases, using the descriptors Patient readmission, Wound infection, Cross infection, Orthopedic procedures, Orthopedics. RESULTS 78 studies were identified and 10 publications were selected. Surgical site infections are the most common cause of unplanned orthopedic readmissions, representing long periods of hospitalization, new surgical procedures and high costs, and greater possibility of subsequent hospitalizations. Most significant predictors have indicated average length of hospitalization, need for intensive care, emergency status at admission, risk of death, age > 65 years, males and higher body mass index. CONCLUSION Readmission rates have increasingly become measures of quality and concerns about costs. New studies could involve issues related to indirect costs, specifically social and psychological costs.

Surgical site infection and its risk factors in colon surgeries

Abstract OBJECTIVE To identify the occurrence of surgical site infection (SSI) and its risk factors in patients undergoing colon surgery in a tertiary hospital located in the countryside of the state of São Paulo. METHOD Retrospective cohort study, with collection of information contained in the medical records of patients undergoing colon surgery in the period between January 2010 and December 2013. The studied variables were the possible risk factors related to the patient, to demographic characteristics and the surgical procedure. RESULTS In total, were evaluated 155 patients with an overall SSI incidence of 16.7%. A statistically significant association was found both in the univariate as in the multivariate analysis between the SSI and the following variables: male gender, Charlson index and mechanical bowel preparation. CONCLUSION The understanding of health professionals about the factors that influence the incidence of SSI in colon surgery may contribute to the quality of care provided to surgical patients, from effective actions to minimize the risk of infections.

Nest distribution and nesting habits of Xylocopa ordinaria Smith (Hymenoptera, Apidae) in a restinga area in the northern Rio de Janeiro State, Brazil

This paper aims to study the distribution of natural nests of Xylocopa ordinaria and characterize its nesting habits in the restinga of Grussai/Iquipari (RJ), supporting future studies on the pollinators management in the northern Rio de Janeiro state. The data obtained from Aug/2003 to Dec/2004, in an area of 11.6ha, were related to the nest distribution, substrate identification and dimensions, emergence, sex ratio, nest structure (n= 23 nests) and pollen content analysis of provisioning masses and feces. X. ordinaria nests were abundant and presented a clustered distribution. These bees do not present taxonomical affinity for nesting substrates, but preferences for wood availability and characteristics, being Pera glabrata the main substrate. X. ordinaria is a multivoltine species that tolerates co-specifics in their nests. These bees were generalist on their nectar and pollen consumption, but presented floral constancy while provisioning brood cells. These behaviors, activity along the year, flights throughout the day, and legitimate visits to flowers indicate the importance of X. ordinaria on the pollination of plants in the restinga.

Nest descriptions of Megalopta aegis (Vachal) and M. guimaraesi Santos & Silveira (Hymenoptera, Halictidae) from the Brazilian Cerrado

We present the first data on the nesting biology of Megalopta aegis and M. guimaraesi from southeastern Brazil. Nests were collected in the Área de Proteção Ambiental Água Limpa, Bauru, São Paulo state. Our data suggest that nest architecture is conserved throughout all species of Megalopta. Two nests of M. guimaraesi consisted of a single female with brood. Of three M. aegis nests, two contained single females with brood and the third nest contained three adult females, with three times more brood than any single female nest. This observation suggests that social behavior in M. aegis is facultative, as known for other Megalopta species.

Nest structure and occurrence of three species of Azteca (Hymenoptera, Formicidae) in Cecropia pachystachya (Urticaceae) in non-floodable and floodable pantanal areas

Thirty Cecropia pachystachya trees were examined in non-floodable and floodable areas to investigate the association between C. pachystachya and Azteca ants in the Pantanal of Mato Grosso do Sul, Brazil. The species Azteca ovaticeps, Azteca isthmica, and Azteca alfari were found nesting inside domatia of C. pachystachya. A. ovaticeps was the most frequent species in the trees in the floodable area, while A. isthmica and A. alfari, in the non-floodable area. A. ovaticeps and A. isthmica maintained more entrance/exit holes in comparison to A. alfari. All Azteca species maintained entrance/exit holes in the closest domatia to the apical area of the branch, due to proximity to Müllerian and pearl bodies, suggesting that these species of Azteca were influenced by their environment during evolution and became specialized. All internodal septa of each examined branch were perforated by ants, indicating the branches were inhabited by a single colony.

Entering behavior of Gasteruption brachychaetum Schrottky (Hymenoptera, Gasteruptiidae) into a nest of Hylaeus Fabricius (Hymenoptera, Colletidae)

Nests of Hylaeus aff. guaraniticus (Schrottky, 1906) were parasited by females of Gasteruption brachychaetum Schrottky, 1906 in trap nests in São Paulo (Brazil). This is thefirst host record of a Gasteruptiidae in the Neotropical Region. The behavior of a G.brachychaetum female entering a host's nest is described as follows: an inquiline female hovered near the host's nest, landed and detected that a female of H. aff. guaraniticus was inside the nest, waited for the host female to fly out, entered backwards into the nest, remained there for almost six minutes, and then went out the nest. The development time of immature stages of G.brachychaetum varied between 16 and 299 days.

Energy substrate used by workers of leaf-cutting ants during nest excavation

Energy substrate used by workers of leaf-cutting ants during nest excavation. In this study we aimed to ascertain whether leaf-cutting ant workers lose body reserves (fat or sugars) as a function of nest excavation. For each treatment, we isolated 10 workers of Atta sexdens into two experimental groups, Control (C- without excavation) and Soil (S- with excavation), which were kept for different time intervals (0, 24, 48 or 72 hours), totaling 700 tested workers. We then determined the concentration of soluble carbohydrates and total lipid content in them. The total carbohydrates were determined colorimetrically, based on the reaction between carbohydrates and sulfuric acid-phenol. For determination of lipids, the insects were immersed in organic solvent until they reached a constant weight. Our results showed that carbohydrates are consumed during nest excavation activities. In the experimental groups S24, S48 and S72, there was an average reduction of 5.82 (20.42%), 14.31 (44.96%) and 13.27 (43.96%) µ.mg-1 in soluble sugar when compared with the experimental groups that did not excavate. Furthermore, the lipids were not used during this activity. With respect to dry mass of the workers, their values were C0 = 8%, C24 = 10.4%, C48 = 9.2%, C72 = 10%, S24 = 9.2%, S48 = 8.7% and S72 = 8.5%. Our results show experimentally that the source of energy for nest excavation is carbohydrates, whereas lipids are conserved for other activities.

Nest plasticity of Cornitermes silvestrii (Isoptera, Termitidae, Syntermitinae) in response to flood pulse in the Pantanal, Mato Grosso, Brazil

Nest plasticity of Cornitermes silvestrii (Isoptera, Termitidae, Syntermitinae) in response to flood pulse in the Pantanal, Mato Grosso, Brazil. The Pantanal is one of the largest wetlands in the world. Since many areas in Pantanal are flooded during part of the year, it is expected that plants and animals would have mechanisms for their survival during the flooded period. This study investigated the existence of differences in nest shape and inquilines of Cornitermes silvestrii in areas influenced by the flood pulse. We measured the volume, height, width, and height/width ratio of 32 nests in flooded areas and 27 in dry areas, and performed an one-way-Anova with the quasi-Poisson distribution to determine if there were differences in the nest measurements between the points. To analyze the relationship of nest inquilines to flood pulse and nest shape, we performed a regression with a Poisson distribution with the inquiline richness and flood pulse, and the above measurements. The nests of C. silvestrii in flooded areas were significantly higher than nests in dry areas, and had a larger height/width ratio. Colonies in periodically flooded areas would probably make a larger effort to extend their nests vertically, to maintain at least some portion of the structure out of the water and prevent the entire colony from being submerged. Neither the size of the nest nor the flood pulses influenced the assemblage of 11 species found in nests of C. silvestrii.

Egg laying site selection by a host plant specialist leaf miner moth at two intra-plant levels in the northern Chilean Atacama Desert

Egg laying site selection by a host plant specialist leaf miner moth at two intra-plant levels in the northern Chilean Atacama Desert. The spatial distribution of the immature stages of the leaf miner Angelabella tecomae Vargas & Parra, 2005 was determined at two intra-plant levels (shoot and leaflet) on the shrub Tecoma fulva fulva (Cav.) D. Don (Bignoniaceae) in the Azapa valley, northern Chilean Atacama Desert. An aggregated spatial pattern was detected for all the immature stages along the shoot, with an age dependent relative position: eggs and first instar larvae were clumped at apex; second, third and fourth instar larvae were mostly found at intermediate positions; meanwhile the spinning larva and pupa were clumped at basis. This pattern suggests that the females select new, actively growing leaflets for egg laying. At the leaflet level, the immature stages were found more frequently at underside. Furthermore, survivorship was higher for larvae from underside mines. All these results highlight the importance of an accurate selection of egg laying site in the life history of this highly specialized leaf miner. By contrast, eventual wrong choices in the egg laying site selection may be associated with diminished larval survivorship. The importance of the continuous availability of new plant tissue in this highly human modified arid environment is discussed in relation with the observed patterns.

Análise de dinâmica de uso e de desempenho: o caso do web site da Embrapa Monitoramento por Satélite

A Embrapa Monitoramento por Satélite, há mais de uma década, utiliza a Internet como meio de difusão de resultados de pesquisa e de interação com clientes, parceiros e usuários. Com intuito de avaliar o uso do web site por esse público e o desempenho do sistema de comunicação eletrônica envolvido, tem-se utilizado o programa Webalizer, que monitora e elabora estatísticas de entradas e saídas do sistema, com base na análise de arquivos de log. Com os indicadores contabilizados pelo programa foi possível avaliar aspectos sobre a origem dos acessos, as ações executadas pelos usuários e sobre aspectos do desempenho do sistema em termos de respostas enviadas às solicitações dos usuários. Os resultados podem possibilitar a remodelagem do web site, de modo a melhorar a dinâmica de interação instituição-usuário e promover o desenvolvimento de uma abordagem própria de análise de logs.

Fatores motivadores de uso de site web: um estudo de caso

A partir da adaptação de um conjunto de critérios de avaliação de sites web centrados no usuário, foram identificados fatores motivadores de uso de site de governo eletrônico. O site web selecionado para análise foi o Comprasnet. O objetivo geral da pesquisa foi identificar os critérios determinantes na tomada de decisão pela opção de uso do Comprasnet. Para tanto, foram realizadas entrevistas por telefone, em âmbito nacional, com os usuários do Comprasnet. Concluiu-se com a apresentação e discussão dos fatores motivadores de uso do Comprasnet, e foram apresentadas as limitações e recomendações para estudos posteriores.