APPLICATION OF GENOMIC DNA SUBTYPING BY PULSED-FIELD GEL-ELECTROPHORESIS AND RESTRICTION ENZYME ANALYSIS OF PLASMID DNA TO CHARACTERIZE METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS FROM 2 NOSOCOMIAL OUTBREAKS

Pulsed-field gel electrophoresis (PFGE) and restriction enzyme analysis of plasmid DNA (REAP) were applied to study the epidemiologic relationship among methicillin-resistant Staphylococcus aureus (MRSA) isolates from outbreaks in two hospitals in Sao Paulo, Brazil: 82 MRSA isolates, 73 from a university hospital and nine from a general adult intensive care unit of a private hospital, were collected from 62 patients: 95% of the MRSAs were also resistant to gentamicin and ciprofloxacin. REAP subtyping of both collections identified six different subtypes: 55 (72.6%) MRSAs from the university hospital and nine isolates from the private hospital shared the same epidemic REAP subtype. Discrimination by restriction of genomic DNA with Sma I followed by PFGE enabled the identification of 14 DNA subtypes. Based an the combined REAP-genomic DNA subtype, the predominant subtype in the university hospital was AIA (44 isolates) whereas the epidemic subtype in the private hospital was AIM (seven isolates). The application of two typing methods showed better discrimination among MRSAs than did either method alone.17427528

Avaliação dos cuidados de saúde: percepções de mulheres imigrantes em Portugal Health care assessment: the perceptions of female immigrants in Portugal

OBJETIVOS: descrever práticas relacionadas com a procura de cuidados de saúde e percepções relativamente a aspectos da utilização dos serviços de saúde por parte de uma população de mulheres imigrantes a residir em Portugal. MÉTODOS: em 2009 foi realizado um estudo transversal na área metropolitana de Lisboa onde foi aplicado um inquérito por questionário a uma amostra de 703 mulheres imigrantes. O questionário incluiu itens para caracterização sóciodemográfica e sobre práticas relacionadas com a procura de cuidados de saúde e percepções das participantes quanto à utilização dos serviços. Realizou-se uma análise descritiva das variáveis em estudo. RESULTADOS: a grande maioria das participantes (82.4%) reporta já ter utilizado o Serviço Nacional de Saúde (SNS), mais frequentemente as africanas (94,5%) e do Leste Europeu (87,2%) do que as brasileiras (66.8%). Cerca de 60% das inquiridas revela estar satisfeita ou muito satisfeita com os serviços, mais frequentemente as africanas (77%) do que as brasileiras (49,7%) e do Leste Europeu (43,4%). Os grupos de participantes apontam diferentes obstáculos para a utilização dos serviços de saúde, entre os quais aspectos relacionados com a condição de ser imigrante, a interação com os profissionais de saúde e os serviços. CONCLUSÕES: as diferenças nas percepções dos grupos de imigrantes sobre os serviços e profissionais refletem a importância de desenvolver práticas avaliativas que identifiquem necessidades de intervenção. Tal conhecimento pode contribuir para melhor adequar a prestação de cuidados de saúde às especificidades dos grupos de imigrantes.<br>OBJECTIVES: to describe the health care seeking behavior and perceptions relating to the use of health services of women immigrants residing in Portugal. METHODS: in 2009 a cross-sectional study was carried out in the metropolitan area of Lisbon, in which a questionnaire was applied to a sample of 703 women immigrants. The questionnaire included items relating to social and demographic characteristics and the health care seeking behavior and perceptions of the participants regarding the use of services. A descriptive analysis of the variables under study was carried out. RESULTS: most participants (82.4%) reported that they had already used the National Health Service (SNS), although this response was more frequent among Africans (94.5%) and East Europeans (87.2%) than among Brazilians (66.8%). Around 60% of respondents reported that they were satisfied or highly satisfied with the service, with the Africans responding in this manner more frequently (77%) than the Brazilians (49.7%) and East Europeans (43.4%). The groups of participants point to various obstacles to the use of health services, including issues related their status as immigrants, interaction with health professionals and the services provided. CONCLUSIONS: differences in the perceptions of immigrant groups regarding health services and professionals reflect the importance of developing evaluative practices that identify where intervention is needed. Knowing this would make it possible to better adapt the health care provided to specific immigrant groups