Ocorrência de infecção urinária em pacientes de um hospital universitário

Infection in hospitals is a serious problem for the Public Health System. It is responsible for the increasing number of hospital deaths, as well as the longer time patients may have to stay in hospital, raising the costs of confinement more and more. The most common hospital infection is urinary tract infections (UTI), the use of the urinary catheter being the main risk factor. The aim of this study was to evaluate the profile of UTI among hospitalized patients in a University Hospital in Brazil, from October to December 2003. Out of 271 samples of urine checked, 51 were positive, 27 of these from patients having community-acquired UTI and 24 whose infection originated in the hospital. The community-acquired UTIs were more frequent in female patients (63%). The highest incidence of infection was caused by Escherichia coli (74%), especially in patients aged from 0 to 15 (37%). The episodes of hospital-acquired infection happened, in the main, in male patients aged above 50 (68%) who were using a lasting vesical catheter; in this group of patients the infection was frequently caused by E. coli (29.1%) and Klebsiella spp. (29.1%). E. coli and Klebsiella pneumoniae exhibited strong resistance (62.5%) to trimethoprim-sulfamethoxazole, as well as to ampicillin, showing that these drugs should not be used to cure UTIs in this institution.

Acesso a medicamentos essenciais em farmácias e drogarias do Município de Araraquara

A survey to determine the availability of 20 essential medicines for the diseases with highest prevalence in primary health care was conducted in the city of Araraquara. The presence and the price of these medicines in private sector pharmacies and drugstores of the city were recorded. Two forms, recommended by the WHO, were used in the survey, one for availability and the other for prices. The drugs most commonly available in pharmacies and drugstores were: propranolol (90.5%), captopril (96%) and ranitidine (96%), while the least available were ferrous sulfate (27%), beclomethasone (33.8%) and ibuprofen (41.9%). The drugs that showed the greatest variation among the prices charged were: propranolol (97.1%), hydrochlorothiazide (96.4%) and glibenclamide (95.0%), while the least variable were salbutamol (30.8%) and trimethoprim-sulfamethoxazole (30.2%). Generic drugs, which were half (10) of those assessed, had the lowest prices. The indicators of access, referring to the ability of patients to acquire drugs for the treatment of major diseases at the primary health care level, showed that no establishment stocked all 20 essential drugs and that wide variations existed in their prices, undermining their availability to drug users, whose only sources are pharmacies and drugstores. These data demonstrate the importance of the popular pharmacy to improve the access to medicines, by lowering the cost and increasing the availability of the items selected for the National List of Essential Drugs (RENAME).

Avaliação microbiológica da superfície dos implantes ortopédicos metálicos usados para fixar fraturas ósseas

In the majority of cases of bone fracture requiring surgery, orthopedic implants (screw-plate and screw) are used for osteosynthesis and the infections associated with such implants are due to the growth of microorganisms in biofilms. The objective of this study was to identify microorganisms recovered from osteosynthesis implants used to fix bone fractures, to assess the viability of the cells and the ability of staphylococci to adhere to a substrate and to determine their sensitivity/resistance to antimicrobials. After surgical removal, the metal parts of austenitic stainless steel (ASTM F138/F139 or ISO NBR 5832-1/9) were transported to the Laboratory of Clinical Microbiology, washed in buffer and subjected to ultrasonic bath at 40±2 kHz for 5 minutes. The sonicated fluid was used to seed solid culture media and cell viability was assessed under the microscope by with the aid of a fluorescent marker. The production of extracellular polysaccharide by Staphylococcus spp. was investigated by means of adhesion to a polystyrene plate. The profile of susceptibility to antimicrobials was determined by the disk diffusion assay. The most frequently isolated bacteria included coagulase-negative Staphylococcus resistant to erythromycin, clindamycin and oxacillin. Less frequent were Pseudomonas aeruginosa resistant to trimethoprim/sulfamethoxazole and ampicillin, Acinetobacter baumannii resistant to ceftazidime, Enterobacter cloacae resistant to cephalothin, cefoxitin, cefazolin, levofloxacin and ciprofloxacin, Bacillus spp. and Candida tropicalis. The observation of slides by fluorescence microscope showed clusters of living cells embedded in a transparent matrix. The test for adherence of coagulase-negative Staphylococcus to a polystyrene plate showed that these microorganisms produce extracellular polysaccharide. In conclusion, the metal parts were colonized by bacteria related to orthopedic implant infection, which were resistant to multiple antibiotics.

Etiologia e susceptibilidade à drogas de microrganismos relacionados com a otite média crônica supurativa em pacientes portadores de fissura palatal

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Isolamento e perfil de suscetibilidade a antimicrobianos de cepas de estafilococcus resistentes à meticilina em um hosapital veterinário de ensino no Brasil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Infecção do trato urinário em crianças de um hospital público do Pará-Brasil: perfil clínico-epidemiológico e genotipagem dos uropatógenos

A infecção do trato urinário (ITU) é uma das doenças mais comuns na infância e em 80 a 90% dos casos é causada por bactérias da família Enterobacteriaceae, especialmente Escherichia coli e Klebsiella pneumoniae, as quais no mundo inteiro têm emergido como produtoras de ESBL, um dos principais mecanismos de resistência bacteriana a cefalosporinas de espectro-estendido e monobactans. A prevalência da ITU em crianças, bem como as variáveis, sexo, idade, febre, bactéria mais frequente, presença de refluxo vesico-ureteral (RVU), presença de cicatrizes renais foram avaliadas no período de janeiro de 2006 a março de 2009, em hospital público de belém, região norte do Brasil e no período de abril a agosto de 2009, isolados de cepas de E. coli e K. pneumoniae foram obtidos de urina de crianças menores de 16 anos e avaliados fenotipicamente através do método automatizado de caracterização de ESBL, Vitek2, juntamente com a PCR para determinar se os genes ^blaTEM, ^blaSHV e ^blaCTX-M1 estavam presentes em cada organismo. Foram confirmados 199 casos de ITU no período estudado, 54,2% eram do sexo feminino, 46,2% eram menores de 02 anos de idade, febre ocorreu em 37,3% dos casos, RVU foi identificado em 38,6% das crianças com ITU e cicatriz renal em 38%, a bactéria mais frequente foi a E. coli (60%). Foram isoladas 43 amostras ( E. coli e K. pneumoniae, 74,4% e 25,6%, respectivamente), 95% foi resistente a ampicilina e sulfametoxazol-trimetroprim; 23,2% apresentaram fenótipo ESBL. O gene ^blaCTX-M1 foi o mais prevalente, encontrado em 19 cepas, seguido do gene ^blaTEM (18 cepas) e ^blaSHV (8 cepas). Esse estudo mostrou que bactérias com perfil de resistência ESBLcirculam no ambiente hospitalar em Belém e que os genes ^blaCTX-M1 e ^blaTEM e ^blaSHV estão presentes em cepas de E. coli e K. pneumoniae causadoras de ITU em crianças na região norte do Brasil.

Indicadores de qualidade, pesquisa de marcadores de virulência e multirresistência aos antimicrobianos em estirpes de Staphylococcus spp. em leite de origem bovina produzido no sistema orgânico

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Molecular Identification of Nocardia Isolates from Clinical Samples and an Overview of Human Nocardiosis in Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Prevalence of uropathogens and antimicrobial susceptibility profile in outpatient from Jataí-GO

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Resistência antimicrobiana e prevalência de sorovares de salmonella spp. isolados de fezes e linfonodos de suinos

Pós-graduação em Medicina Veterinária - FMVZ

Trueperella pyogenes multispecies infections in domestic animals: a retrospective study of 144 cases (2002 to 2012)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Perfil molecular e resistência a antimicrobianos de Salmonella isolada em linfonodos mesentéricos de suínos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Epidemiologia da colonização e infecção microbiana em Unidade de Terapia Intensiva Neonatal: abordagem clínica e molecular

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Malakoplakia after renal transplantation in the current era of immunosuppressive therapy: case report and literature review

Malakoplakia is a rare chronic granulomatous disease of unknown cause. It is thought to be caused by an acquired bactericidal defect of macrophages. Malakoplakia is associated with chronic infections and immunosuppression. Although it occurs mainly in the urinary tract, it has already been reported in almost every organ system. The isolation of bacteria, especially Escherichia coli, is common in malakoplakia patients. Here, we present a case of primary cutaneous malakoplakia in a kidney transplant recipient who had been taking prednisone, tacrolimus, and mycophenolate. Culture of a lesion grew Burkholderia cepacia complex. Treatment with high doses of trimethoprim-sulfamethoxazole was successful. We also present a systematic review of the literature, identifying 4 previously reported cases of malakoplakia after renal transplantation under similar immunosuppressive therapy, most occurring in the urinary tract or perineum and following benign courses to cure. Data in the literature suggest that malakoplakia has become even rarer since changes were made in the immunosuppressive therapy employed after kidney transplantation.

Optimización de un método basado en SPE-LC-MS/MS para la determinación de multiresiduos de compuestos farmacéuticos en aguas depuradas

Universidad de Las Palmas de Gran Canaria, Facultad de Ciencias del Mar, Doctorado en Gestión Costera.