Avaliação da colonização por bactérias multirresistentes em pacientes admitidos via central de regulação do estado em um hospital filantrópico em Salvador, Bahia

Background and objectives: Health Care Related Infections (IRAS) are considered a public health problem whose control can minimize patients' morbidity and mortality. The early institution of contact isolation for patients possibly colonized by multiresistant (MR) microorganisms can reduce their spread in cases of IRAS and hospital costs. This study aimed to evaluate the frequency and impact of positive surveillance cultures with multiresistant (MR) microorganisms following an outbreak of vancomycin resistant Enterococcus spp. (VRE). Methods: Surveillance cultures collection routines were implemented since April / 14 for patients referred from other health to a philanthropic hospital in Salvador – Bahia via state and municipal referral center. Results: A total of 663 patients were evaluated in the period from December / 14 to December / 15, and 42 of them had a positive surveillance culture for gram positive and negative MR microorganisms. After the routine implementation of surveillance cultures, no outbreaks were detected in our unit. Conclusion: Despite the high cost, the study showed that routine surveillance cultures are an important tool in preventing MR dissemination.Justificación y objetivos: Infecciones Relacionadas a la Asistencia sanitaria (IRAS) se consideran un problema de salud pública cuyo control puede minimizar la morbimortalidad de los pacientes. La institución precoz de aislamiento de contacto para pacientes posiblemente colonizados por microrganismos multirresistentes (MR), puede reducir su diseminación de los casos de IRAS y costos hospitalarios. El objetivo del estudio fue evaluar la frecuencia e impacto de cultivos de vigilancia positivos con microrganismos multirresistentes (MR) después de un brote de Enterococcus spp. resistentes a la vancomicina (VRE). Métodos: Se implementaron rutinas de recolección de cultivos de vigilancia a partir de abril / 14 para pacientes procedentes de otras unidades de salud vía Central de Regulación del Estado y Municipio en un hospital filantrópico en Salvador - BA. Resultados: Se evaluaron 663 pacientes en el período de diciembre / 14 a diciembre / 15, siendo que 42 de ellos presentaron un cultivo de vigilancia positiva para microrganismos gram positivos y negativos MR. Después de la implementación de la rutina de realización de cultivos de vigilancia, ya no se detectaron brotes en nuestra unidad. Conclusiones: La rutina de cultivos de vigilancia puede ser un importante instrumento en la prevención de la diseminación de MR.Justificativa e objetivos: Infecções Relacionadas à Assistência à Saúde (IRAS) são consideradas um problema de saúde pública cujo controle pode minimizar a morbimortalidade dos pacientes. A instituição precoce de isolamento de contato para pacientes possivelmente colonizados por microrganismos multirresistentes (MR), pode reduzir sua disseminação os casos de IRAS e custos hospitalares. O objetivo deste estudo foi avaliar a frequência e impacto de culturas de vigilância positivas com microrganismos multirresistentes (MR) após um surto de Enterococcus spp. resistentes à vancomicina (VRE). Métodos: Foram implementadas rotinas de coleta de culturas de vigilância a partir de abril de 2014 para pacientes procedentes de outras unidades de saúde via Central de Regulação do Estado e Município em um hospital filantrópico em Salvador – BA. Resultados: Foram avaliados 663 pacientes no período de dezembro de 2014 a dezembro de 2015, sendo que 42 destes apresentaram cultura de vigilância positiva para microrganismos gram positivos e negativos MR. Após a implementação da rotina de realização de culturas de vigilância, não foram mais detectados surtos na nossa unidade. Conclusão: A rotina de culturas de vigilância pode funcionar como um importante instrumento na prevenção da disseminação de MR. Descritores: Isolamento de Pacientes. Resistência Microbiana a Medicamentos; Monitoramento Epidemiológico

COLISTIN INDUCED NEUROTOXITY: A CASE REPORT AND REVIEW OF LITERATURE

To describe a case of neurotoxity associated to Colistin. Case description: A 29-year-old black male under treatment for urinary tract infection with identification of Klebsiella pneumoniae in urine culture resistant to all carbapenem antibiotics, presented visual turbidity, paresthesia on the face and upper left limb, slowed and discordant speech in the fourth day of Colistin use. Symptoms improved after reduction of the dose of colistin with adjustment for renal function, with complete reversion after discontinuation of the drug. Conclusions: Colistin-mediated neurotoxicity must be suspected in patients with altered mental status of unknown etiology and therapy promptly interrupted

Comparative Study of rK39 Leishmania Antigen for Serodiagnosis of Visceral Leishmaniasis: Systematic Review with Meta-Analysis

Visceral Leishmaniasis (VL) is a neglected tropical disease for which serodiagnostic tests are available, but not yet widely implemented in rural areas. The rK39 recombinant protein is derived from a kinesin-like protein of parasites belonging to the Leishmania donovani complex, and has been used in the last two decades for the serodiagnosis of VL. We present here a systematic review and meta-analysis of studies evaluating serologic assays (rK39 strip-test, rK39 ELISA, Direct Agglutination Test [DAT], Indirect Immunofluorescence test [IFAT] and ELISA with a promastigote antigen preparation [p-ELISA]) to diagnose VL to determine the accuracy of rK39 antigen in comparison to the use of other antigen preparations. Fourteen papers fulfilled the inclusion and exclusion selection criteria. The summarized sensitivity for the rK39-ELISA was 92% followed by IFAT 88% and p-ELISA 87%. The summarized specificity for the three diagnostic tests was 81%, 90%, and 77%. Studies comparing the rK39 strip test with DAT found a similar sensitivity (94%) and specificity (89%). However, the rK39 strip test was more specific than the IFAT and p-ELISA. In conclusion, we found the rK39 protein used either in a strip test or in an ELISA is a good choice for the serodiagnosis of VL

Completeness of tuberculosis reporting forms for disease control in individuals with HIV/AIDS in priority cities of Bahia state

The control of HIV / Tuberculosis (TB) co -infection remains a challenge for public health. Notification is mandatory for both diseases and the National Case Registry Database (Sinan) is responsible for the collection and processing of individual forms of reporting and monitoring. The adequate fulfillment of these fields chips (completeness) is essential to follow the dynamics of the disease and set priorities for intervention. The aim of this study was to evaluate the completeness of the notification forms of tuberculosis in the priority municipalities of Bahia (Camaçari , Feira de Santana , Ilhéus , Itabuna, Jequié, Lauro de Freitas , Porto Seguro , Teixeira de Freitas , Paulo Afonso, Barreiras and Salvador) to control the disease in individuals with HIV/AIDS using tabulations obtained from the Sinan in the period from 2001 to 2010. The results showed that despite the completeness of the field HIV be above 50 %, more than half the cases were met as "undone" or "being processed" in all municipalities assessed in the period. The low completeness of reporting forms may compromise the quality of surveillance of TB cases. The results suggest the need for greater availability of HIV testing in these individuals

Completeness of tuberculosis reporting forms for disease control in individuals with HIV/AIDS in priority cities of Bahia state

Castro Filho, Bernardo Galvão; Grassi, Maria Fernanda Rios “Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta à informação no documento”.Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2017-06-29T19:10:10Z No. of bitstreams: 1 Lírio, Monique Completeness of tuberculosis.....pdf: 69540 bytes, checksum: ef57aefb06cb9df3c47953e2f6e6aad0 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2017-06-29T19:27:38Z (GMT) No. of bitstreams: 1 Lírio, Monique Completeness of tuberculosis.....pdf: 69540 bytes, checksum: ef57aefb06cb9df3c47953e2f6e6aad0 (MD5)Made available in DSpace on 2017-06-29T19:27:38Z (GMT). No. of bitstreams: 1 Lírio, Monique Completeness of tuberculosis.....pdf: 69540 bytes, checksum: ef57aefb06cb9df3c47953e2f6e6aad0 (MD5) Previous issue date: 2015Universidade Federal da Bahia. Complexo Hospital Professor Edgard Santos. Salvador, BA, BrasilEscola Bahiana de Medicina e Saúde Pública. Salvador, BA, BrasilEscola Bahiana de Medicina e Saúde Pública. Salvador, BA, BrasilUniversidade Federal do Rio de Janeiro. Faculdade de Medicina. Rio de Janeiro, RJ, BrasilEscola Bahiana de Medicina e Saúde Pública. Salvador, BA, BrasilEscola Bahiana de Medicina e Saúde Pública. Salvador, BA, BrasilThe control of HIV / Tuberculosis (TB) co -infection remains a challenge for public health. Notification is mandatory for both diseases and the National Case Registry Database (Sinan) is responsible for the collection and processing of individual forms of reporting and monitoring. The adequate fulfillment of these fields chips (completeness) is essential to follow the dynamics of the disease and set priorities for intervention. The aim of this study was to evaluate the completeness of the notification forms of tuberculosis in the priority municipalities of Bahia (Camaçari , Feira de Santana , Ilhéus , Itabuna, Jequié, Lauro de Freitas , Porto Seguro , Teixeira de Freitas , Paulo Afonso, Barreiras and Salvador) to control the disease in individuals with HIV/AIDS using tabulations obtained from the Sinan in the period from 2001 to 2010. The results showed that despite the completeness of the field HIV be above 50 %, more than half the cases were met as "undone" or "being processed" in all municipalities assessed in the period. The low completeness of reporting forms may compromise the quality of surveillance of TB cases. The results suggest the need for greater availability of HIV testing in these individuals

HTLV-1 and tuberculosis association a review of the literature

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2014-09-26T13:36:12Z No. of bitstreams: 1 Santos N P HTLV-1 and....pdf: 99416 bytes, checksum: 218b7f5651fba8f422a7e7ac0d855186 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2014-09-26T13:36:31Z (GMT) No. of bitstreams: 1 Santos N P HTLV-1 and....pdf: 99416 bytes, checksum: 218b7f5651fba8f422a7e7ac0d855186 (MD5)Made available in DSpace on 2014-09-26T13:45:47Z (GMT). No. of bitstreams: 1 Santos N P HTLV-1 and....pdf: 99416 bytes, checksum: 218b7f5651fba8f422a7e7ac0d855186 (MD5) Previous issue date: 2014Bahiana School of Medicine and Human Health. Salvador, BA, BrasilUniversidade Federal da Bahia. Salvador, BA, BrasilBahiana School of Medicine and Human Health. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, BrasilBahiana School of Medicine and Human Health. Salvador, BA, BrasilBahiana School of Medicine and Human Health. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, BrasilBahiana School of Medicine and Human Health. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, BrasilObjective: To review and evaluate the scientific evidences on the relationship between tuberculosis (TB) and HTLV-1 infection. Methods: Searches on MEDLINE, LILACS/SciELO and Cochrane Library databases were performed using the following keywords: HTLV-1 Infection, Human T-lymphotropic virus type 1; Paraparesis Tropical Spastic; Tuberculosis. The following data were evaluated: Study design, sample size, number of controls, frequency of HTLV-1 infection in patients with TB and uninfected controls, mortality in HTLV-1/TB coinfected individuals compared with controls group, response in vivo and in vitro to PPD, frequency of individuals with tuberculin skin test (TST) positive or negative. Results: Nineteen articles were selected: twelve investigated prevalence, four mortality, three evaluated both prevalence and mortality and six described immunological findings. The majority of the studies was conducted in South America (Brazil and Peru), and Japan. Seven out of 12 studies found an increased risk of HTLV-1 in patients with TB diagnosis. The prevalence of HTLV-1/TB co-infection ranged from 1.49 % in Brazil to 11.4 % in patients in Peru. Two out of five studies found a higher mortality of patients with HTLV-1/TB co-infection compared to patients with TB alone. Three studies conducted in Africa (Guinea Bissau and Senegal) found no increase in the mortality of patients co-infected with TB and HTLV-1. A decreased response to PPD in vitro or in vivo was observed in co-infected individuals compared with patients with TB alone. Conclusion: Patients with TB diagnosis have a higher prevalence of HTLV-1, compared with uninfected controls. Co-infection HTLV-1/TB increases the mortality of T

Algorithm for selection of studies.

<p>Algorithm for selection of studies.</p