Coagulase-negative staphylococci strains resistant to oxacillin isolated from neonatal blood cultures

Coagulase-negative staphylococci (CoNS) are the microorganisms most frequently isolated from clinical samples and are commonly found in neonatal blood cultures. Oxacillin is an alternative treatment of choice for CoNS infections; however, resistance to oxacillin can have a substantial impact on healthcare by adversely affecting morbidity and mortality. The objective of this study was to detect and characterise oxacillin-resistant CoNS strains in blood cultures of newborns hospitalised at the neonatal ward of the University Hospital of the Faculty of Medicine of Botucatu. One hundred CoNS strains were isolated and the mecA gene was detected in 69 of the CoNS strains, including 73.2% of Staphylococcus epidermidis strains, 85.7% of Staphylococcus haemolyticus strains, 28.6% of Staphylococcus hominis strains and 50% of Staphylococcus lugdunensis strains. Among these oxacillin-resistant CoNS strains, staphylococcal cassette chromosome mec (SCCmec) type I was identified in 24.6%, type II in 4.3%, type III in 56.5% and type IV in 14.5% of the strains. The data revealed an increase in the percentage of CoNS strains isolated from blood cultures from 1991-2009. Furthermore, a predominant SCCmec profile of the oxacillin-resistant CoNS strains isolated from neonatal intensive care units was identified with a prevalence of SCCmec types found in hospital-acquired strains.

Avaliação dos padrões de vitalidade neonatal, hemogasometria e eletrocardiografia em equinos da raça Paint Horse

Pós-graduação em Medicina Veterinária - FMVZ

Hypothermia and Early Neonatal Mortality in Preterm Infants

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Physiological Parameters in Neonatal Lambs of the Bergamasca Breed

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

Effects of therapeutic approach on the neonatal evolution of very low birth weight infants with patent ductus arteriosus

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

Profissionais de UTI neonatal e alimentação de recém-nascidos com uso de copo

Purpose: Cup feeding is an alternative technique of infant feeding when the infant is not being breastfed. Healthcare providers should have experience with the cup feeding technique in order to feed safely an infant. Objectives: The aim of this study is to identify the practices and the feeding cup techniques currently being used by healthcare NICU professionals, and to explore the opinions and beliefs of health professionals regarding to feeding cup. Methods: Twelve NICU nursing assistant were interviewed. Results: Most of the professionals interviewed were able to properly execute the feeding cup technique. The main problem observed was the improper positioning of the cup while using the technique. Most of them were ‘pouring’ the milk into the infant’s mouth. Thus, the participants interviewed expressed doubts about the technique and denied having been trained for this procedure in routine work at NICU. Nevertheless, all the participants were interested to learn more about the technique. Conclusion: In general,, all the professionals interviewed were able to properly execute the feeding cup technique. The questions and concerns presented by the professionals reassure the need for research and educational activities in order to educate health professionals about the correct use of feeding cup technique to assure a safe alternative feeding for infants.

Exposição neonatal a drogas ototóxicas e possíveis alterações auditivas

Introduction: Scientific evidence indicates that neonatal exposure to ototoxic drugs cause hearing loss in newborns. Objective: To characterize the use of ototoxic antibiotics in newborns (NB), treated in the Neonatal Intensive Care Unit (NICU) and evaluate possible hearing modifications. Methods: A descriptive cross-sectional quantitative approach, using data from medical records of infants who were at some time in the NICU and used antibiotics, including ototoxic, from January to June 2004 as much as 2010, and the data were compared and analyzed. Parents/guardians of infants born in 2004 were contacted and applied a questionnaire containing questions about the children’s hearing. These children were submitted to audiological evaluation. Results: There was significant reduction in the time of use, the amount of antibiotics prescribed to newborns and Vancomycin prescription in 2010 compared to 2004. The hearing tests of 13 born in 2004 showed: sensorineural hearing loss in only 2 (one with moderate hearing loss and descending configuration in pure tone audiometry and the other with bilateral cochlear impairment); audiometric thresholds within the normal range in 11 patients, and the presence of otoacoustic emissions in 9. In Evoked Auditory Brainstem Response (ABR) no changes were observed. Conclusion: The reduction in the time of use, the amount and types of antibiotics observed may be related to the adoption of a Protocol in 2008, by the service. In contrast, auditory alterations may be related to a neonatal exposure to antibiotics in 2004.

Late-Onset Sepsis in very Low Birth Weight Infants: A Brazilian Neonatal Research Network Study

Background: Late-onset sepsis (LOS) is an important cause of morbidity and mortality in very low birth weight (VLBW) infants.Aim: To determine the incidence, risk factors and etiology of LOS.Methods: LOS was investigated in a multicenter prospective cohort of infants at eight public university neonatal intensive care units (NICUs). Inclusion criteria included inborn, 23-33 weeks of gestational age, 400-1499 g birth weight, who survived >3 days.Results: Of 1507 infants, 357 (24%) had proven LOS and 345 (23%) had clinical LOS. Infants with LOS were more likely to die. The majority of infections (76%) were caused by Gram-positive organisms. Independent risk factors for proven LOS were use of central venous catheter and mechanical ventilation, age at the first feeding and number of days on parenteral nutrition and on mechanical ventilation.Conclusion: LOS incidence and mortality are high in Brazilian VLBW infants. Most risk factors are associated with routine practices at NICU.

Characterization of the clonal profile of MRSA isolated in neonatal and pediatric intensive care units of a University Hospital

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

Cord blood cytokine levels in focal early-onset neonatal infection after preterm premature rupture of membranes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise das centrais de triagem do programa de coleta seletiva da cidade de São Paulo - SP

Among numerous studies about the selective collection of solid waste and cooperatives of recyclable materials, this research aims to contribute with the study of these problems from the geographic space. As the world population increases, the issue of solid waste becomes increasingly worrying, due to new consumption patterns that create larger amounts of waste, especially in the urban centers. The recycling appears to be the best solution for this problem since most materials that are currently sent to landfills would become raw material for new products. The Triage Centers performs an important role in this process because they are responsible for sorting, packing and selling the materials arising from the selective collect, so it is necessary to analyze the places where these steps are performed. This study intend to examine the location and distribution of these enterprises in the city of São Paulo in order to provide support for the mitigation of impacts, both environmental and social, from their location, as well as provide support for the expansion of selective collection program in the city. The choice for studying this area was due to the curiosity of investigating the inefficiency of the recycling program in the city of São Paulo, which currently recycles about 1% of all household solid waste collected. Therefore, from a historical survey of the city's recycling programs, technical visits, interviews with responsible agencies and also analysis of the Triage Center's frameworks based on the guidelines from the municipal legislation, it will be evaluated the problems faced by the program for its expansion

Caracterização da fauna recebida e avaliação dos procedimentos em Centros de Triagem de Animais Silvestres (CETAS)

Estima-se que anualmente, em função do tráfico de animais silvestres, cerca de 12 milhões de espécimes sejam retirados de nossas florestas, sendo que apenas uma ínfima porcentagem de indivíduos é recuperada e destinada à soltura com o devido rigor técnico. O tráfico de animais silvestres constitui um dos fatores mais relevantes da destruição da fauna, acarretando em um desequilíbrio na estruturação e manutenção dos ecossistemas. Este comércio ilegal constituise o terceiro maior do mundo, perdendo apenas para o tráfico de narcóticos e armas. Assim, para otimizar o processo de soltura da fauna como estratégia para conservação de espécies torna-se necessário uma análise quantitativa e qualitativa da fauna atendida e dos procedimentos realizados nos Centros de Triagem de Animais Silvestres (CETAS). Nesse sentido, o presente trabalho teve como objetivo fazer uma caracterização da fauna recebida e uma avaliação dos procedimentos realizados em dois CETAS, além de discutir sobre a importância desse órgão na triagem, reabilitação e conservação de animais silvestres. O presente estudo é justificado pela escassez de informações sobre a fauna retirada da natureza. Estas são necessárias para servir de base científica para a adoção de políticas públicas para o combate ao tráfico de animais silvestres; elaborar um programa de fauna que contemple a triagem e destinação adequada e contribuir para o desenvolvimento de trabalhos educativos com o fim de esclarecimento da sociedade. Foram analisados o “Livro de Registro” do CETAS da Fundação Animália e o “Livro de Plantão” do CETAS DEPAVE – 3, bem como os “Relatórios CETAS” que esses dois Centros enviaram ao IBAMA. O período escolhido foi do ano de 2003 a 2008. Os dados foram compilados e organizados em planilhas do Microsoft Office Excel e foram elaborados tabelas e gráficos para análise dos resultados.

Avaliação de métodos de triagem e de detecção fenotípica de ß-lactamase de espectro ampliado (ESBL)

The catalytic function of extended-spectrum β-lactamases can result in high degrees of bacterial resistance to β-lactamic antimicrobials and in the emergence of ESBL among the members of Enterobacteriaceae family, especially Klebsiella pneumoniae and Escherichia coli. This occurs due to the dissemination and emergence of new variants of these enzymes caused by the high utilization of antibiotics like broad-spectrum cephalosporins. The ESBL are β-lactamases capable of conferring bacterial resistance to the penicillins, 1st, 2nd and 3rd generation cephalosporins, and aztreonam (but not cephamycins and carbapenems) through the hydrolysis of these antibiotics. In view of this phenomenon, the exact screening and detection of the producers of ESBL are essential for the appropriate selection of the antimicrobial therapy. The purposes of this study were to evaluate the best antimicrobial for the selection of ESBL producers and to determine the best method for the detection of such microorganisms. We evaluated 200 sequential bacterial samples including the species Klebsiella pneumoniae (56.5%), Escherichia coli (34%), Proteus mirabilis (8.5%) and Klebsiella oxytoca (1%), previously characterized as ESBL producers between February and September 2008 in the Laboratory of Microbiology, Botucatu Medical School - UNESP, Botucatu, São Paulo State, Brazil. To select the ESBL-producer bacteria, we used the disks recommended by CLSI 2008, aztreonam (ATM), cefpodoxime (CPD), ceftriaxone (CRO), cefotaxime (CTX) and ceftazidime (CAZ), besides cefepime (FEP). ESBL production was confirmed by three methods: double disk screening, ESBL Etest®, and Vitek® automated system. The disks employed in the double disk screening were: penicillin associated with β-lactamase inhibitor, amoxicillin-clavulanic acid, and two β-lactamic antibiotics, ceftazidime and cefotaxime...(Complete abstract click electronic access below)