Antimicrobial use and incidence of multidrug-resistant Pseudomonas aeruginosa in a teaching hospital: an ecological approach

Introduction: Multidrug-resistant Pseudomonas aeruginosa is a major threat in healthcare settings. The use of antimicrobials can influence the incidence of resistant strains by direct and indirect mechanisms. The latter can be addressed by ecological studies. Methods: Our group attempted to analyze the relation between the use of antipseudomonal drugs and the incidence of MDR-PA among 18 units from a 400-bed teaching hospital. The study had a retrospective, ecological design, comprising data from 2004 and 2005. Data on the use of four antimicrobials (amikacin, ciprofloxacin, ceftazidime and imipenem) were tested for correlation with the incidence of MDR-PA (defined as isolates resistant to the four antimicrobials of interest) in clinical cultures. Univariate and multivariate linear regression analyses were performed. Results: Significant correlations were determined between use and resistance for all antimicrobials in the univariate analysis: amikacin (standardized correlation coefficient = 0.73, p = 0.001); ciprofloxacin (0.71, p = 0.001); ceftazidime (0.61, p = 0.007) and imipenem (0.87, p < 0.001). In multivariate analysis, only imipenem (0.67, p = 0.01) was independently related to the incidence of multidrug-resistant strains. Conclusions: These findings share similarities with those reported in individual-based observational studies, with possible implications for infection control.

Nothing too much: reflecting about the role of contextualization in science teaching

The contextualization and discussion about the science role in the social and economical development are unquestionably important for the science teaching process. It doesn't mean, however, that the scientific-theoretic knowledge and the strategies involved in its construction and application might be neglected. In this way, a dangerous situation is created when the contextualization is assumed as a unique and primordial target in science education. This paper presents a research carried out with 15 future chemistry teachers and the results show a worrying "supervalorization", of the contextualization beside other equally important aspects of the chemical knowledge.

Horizontal co-operation on environmental issues in Latin America and the Caribbean: the challenges of an idea in time of crisis

Includes bibliography

The major unresolved issues in the negotiations on the UNCTAD Code of Conduct for the transfer of technology

Includes bibliography

Regional level issues in Latin America and the Caribbean on coordination of integrated youth policies and programmes

Trata sobre los problemas y logros de la CEPAL en sus tareas relacionadas con el Año Internacional de la Juventud y presenta sugerencias para la acción en la coordinación interinstitucional de las actividades relacionadas con la juventud en la región.

Proceedings of the Workshop on Issues in the Privatization of Water Utilities in the Americas

Includes bibliography

Proceedings of the Workshop on Issues in the Privatization of Water Utilities in the Americas: contributions

Includes bibliography

Current trends and issues in Caribbean migration

Includes bibliography

Major issues in the management of enclosed or semi-enclosed seas, with particular reference to the Caribbean Sea

Includes bibliography

Issues in the development of a regional mechanism

Includes bibliography