O complexo Atuba: um cinturão paleoproterozóico intensamente retrabalhado no Neoproterozóico

Studies of terranes between the northern Ribeira and southern Dom Feliciano Belts allow the characterization of three geotectonic domains with different evolutions: the Luís Alves, Curitiba and Paranaguá terranes. The Atuba Complex occurs in the Curitiba Domain, which has a northwestern limit with metassediments of the Açungui and Setuva Groups and a southwestern limit with the granulitic gneisses of the Luis Alves domains. The contacts are expressive shear zones. The predominant rocks of the Curitiba Domain are banded, migmatitic gneisses in amphibolite grade with biotite-amphibole gneissic mesosomes and tonalitic/granodioritic to granitic leucosomes, here called the Atuba Complex. The migmatites are Paleoproterozoic (2.000 ± 200 Ma) and remigmatized in Neoproterozoic (600 ± 20 Ma). During the latter period temperatures reached more than 500º C. The structural pattem indicated shear-controlled tectonics with an important lateral component, and low-angle, south-southeastwards transport direction. The terranes of the Atuba Complex appear to represent deep-level rocks which were migmatized, granitized and then added to the border of the Luis Alves Microplate during the Neoproterozoic. This late Neoproterozoic tectonic scheme which continued to the Cambro-Ordoviciano seems to be the result of larger-scale processes of continental agglutination which ended with the formation of western Gondwanaland.Os estudos realizados nos terrenos localizados entre os Cinturões Ribeira (N) e Dom Feliciano (S) permitiram caracterizar a existência de três domínios geotectônicos com evoluções próprias e distintas: Domínios Luis Alves, Curitiba e Paranaguá. O Complexo Atuba se insere no âmbito do Domínio Curitiba, que se limita a noroeste com as seqüências metassedimentares dos Grupos Açungui e Setuva, e a sudeste com os gnaisses granulíticos do Domínio Luis Alves, contatos esses que se fazem por importantes zonas de cisalhamento. Predominam no Domínio Curitiba rochas gnáissicas bandadas, migmatíticas, do fácies anfibolito, representadas principalmente por biotita-anfibólio-gnaisses contendo leucossomas de composições tonalitogranodioríticas além de graníticas, que compõem o aqui denominado Complexo Atuba. Caracteriza-se por migmatitos formados no Paleoproterozóico (2.000 ± 200 Ma), remigmatizados no Neoproterozóico (600± 20 Ma), período esse em que as isotermas atingiram temperaturas superiores a 500 ºC. O padrão estrutural observado é indicativo de uma tectônica controlada em grande parte por cisalhamento, com importante componente lateral, e transporte relativo em direção a sul-sudeste. As rochas pertencentes ao Complexo Atuba representam terrenos relativamente profundos, do fácies anfibolito, migmatizados, granitizados acrescidos à borda do Domínio Luis Alves (Microplaca Luis Alves) durante o Neoproterozóico. Este quadro tectônico definido no final do Neoproterozóico com continuidade até o Cambro-Ordoviciano, parece ser o resultado de processos maiores, envolvendo aglutinações de massas continentais, que culminaram com a formação do Gondwana Ocidental

Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study

Purpose In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. Methods We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. Results 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28. Conclusions HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes