Oral moxifloxacin in the outpatient treatment of low-risk children with fever and neutropenia

Universidade Federal de São Paulo, Pediat Oncol Inst, Dept Pediat, São Paulo, BrazilUniversidade Federal de São Paulo, Pediat Oncol Inst, Dept Infect Dis, São Paulo, BrazilUniversidade Federal de São Paulo, Pediat Oncol Inst, Dept Pediat, São Paulo, BrazilUniversidade Federal de São Paulo, Pediat Oncol Inst, Dept Infect Dis, São Paulo, BrazilWeb of Scienc

Pandemic H1N1 illness prognosis: evidence from clinical and epidemiological data from the first pandemic wave in São Paulo, Brazil

OBJECTIVES: The pandemic of 2009 H1N1 influenza A emerged in February 2009, with high morbidity and mortality, and rapidly spread globally. São Paulo was among the most affected areas in Brazil. This study compares the clinical and epidemiological characteristics of influenza-like illness between outpatients and hospitalized patients and evaluates the impact of oseltamivir therapy on the outcome of 2009 H1N1 influenza A patients. METHODS: This is a case series study comparing the clinical and epidemiological characteristics of influenza-like illness between outpatients attended at Hospital São Paulo in August 2009 (the peak of the first pandemic wave) and those patients hospitalized between May and September 2009 (the entire first pandemic wave). RESULTS: The 1651 patients evaluated were predominantly female (927×686, p<0.001) and aged 31.71±16.42 years, with 148 reporting chronic pulmonary disease. Dyspnea was presented by 381 (23.4%) patients and was more frequent among those aged 30 years or more (p<0.001). Hospitalization occurred at 3.73±2.85 days, and antiviral treatment started 2.27±2.97 days after the onset of first symptoms. A delay of more than 5 days in starting oseltamivir therapy was independently associated with hospitalization (p<0.001), a stay in the ICU (p<0.001) and a higher risk of dying (OR = 28.1, 95% CI 2.81-280.2, p = 0.007). CONCLUSION: The 2009 pandemic of H1N1 influenza A affected young adults, presented a significant disease burden and produced severe cases with a significant fatality rate. However, promptly starting specific therapy improved the outcome.Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Laboratório de Virologia ClínicaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de MedicinaHospital São Paulo Unidade de Doenças InfecciosasUniversidade de São Paulo Faculdade de MedicinaUNIFESP, EPM, Laboratório de Virologia ClínicaUNIFESP, EPM, Depto. de MedicinaHospital São Paulo Unidade de Doenças InfecciosasSciEL

Epidemiology and mortality of the multidrug resistant gram-negative bloodstream infection in acute myeloid leukemia

Universidade Federal de São Paulo, Escola Paulista Med, Infectol Dept, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Hematol, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Infectol Dept, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Hematol, São Paulo, BrazilWeb of Scienc

Bloodstream infections in febrile neutropenic children with cancer

Universidade Federal de São Paulo, Pediat Oncol Inst, Dept Pediat, São Paulo, BrazilUniversidade Federal de São Paulo, Pediat Oncol Inst, Dept Infect Dis, São Paulo, BrazilUniversidade Federal de São Paulo, Pediat Oncol Inst, Dept Pediat, São Paulo, BrazilUniversidade Federal de São Paulo, Pediat Oncol Inst, Dept Infect Dis, São Paulo, BrazilWeb of Scienc

Perceptions and attitudes of the professional staff concerning infection surveillance and control programs in Brazilian hospitals

Background: Several countries have conducted studies to assess the status of their infection control programs (ICP) with the objective of improving quality of infection control practices.Methods: To assess the perceptions and attitudes of the health care workers (HCW) concerning ICP in Brazilian hospitals, we conducted a cross-sectional survey using a self-administered online questionnaire during a Web-based course (WBC) on infection control (IC) and antimicrobial resistance (AR).Results: of 6256 Brazilian HCW registered for the WBC, 1998 were members of infection control committees (ICC) and answered the survey. Eight hundred six (40.4%) respondents said that an ICP was established for more than 10 years in their institutions. Most professionals reported that their hospitals perform microbiologic surveillance targeted at epidemiologically important multidrug-resistant organisms, but the majority underestimated the prevalence of AR.Conclusion: Our survey highlights important information about the perceptions and attitudes of ICC members that may be used to tailor key interventions for implementing effective ICP. It suggests, additionally, that, to achieve countrywide standardized IC mechanisms in a developing country, authorities should consider the social, cultural, and economical disparities between regions and identify specific regional needs to make available the resources required to minimize such disparities.Universidade Federal de São Paulo, São Paulo, BrazilNatl Hlth Surveillance Agcy ANVISA, Brasilia, DF, BrazilPAHO, Brasilia, DF, BrazilMinist Hlth Brazil MS, Brasilia, DF, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc

How to educate health care professionals in developing countries? A Brazilian experience

E-learning is an important tool to bring health care professionals updated information, especially in a large, developing country like Brazil, where teaching resources are limited. It allows the exchange of experiences between professionals, promotes simultaneous knowledge acquisition by a large number of participants, and reaches some remote areas.Universidade Federal de São Paulo, Dept Med, Div Infect Dis, BR-04024002 São Paulo, BrazilNatl Hlth Surveillance Agcy, Brasilia, DF, BrazilPan Amer Hlth Org, Brasilia, DF, BrazilMinist Hlth Brazil, Brasilia, DF, BrazilUniversidade Federal de São Paulo, Dept Med, Div Infect Dis, BR-04024002 São Paulo, BrazilWeb of Scienc