Infecção urinária em recém-nascido de termo: análise de fatores de risco

OBJETIVOS: Analisar a contribuição dos fatores de risco para a ocorrência de infecção urinária em recém-nascidos de termo. CASUÍSTICA E METODOLOGIA: Estudo retrospectivo (1997), incluindo recém-nascidos de termo com urocultura positiva por saco coletor. A indicação desta coleta foi baseada em: hipertermia (T>;37,8ºC), perda de peso>;10% do peso de nascimento, alterações do estado geral (recusa alimentar, ganho insuficiente de peso e hipoatividade) ou presença de malformações nefro-urológicas. Nesses recém-nascidos foi realizada punção suprapúbica para confirmação diagnóstica. Os recém-nascidos foram divididos em dois grupos, segundo o resultado das uroculturas: Grupo I (diagnóstico presuntivo de infecção urinária) e Grupo II (diagnóstico confirmado de infecção urinária), para avaliação dos fatores de risco pela análise do risco relativo. RESULTADOS: Foram estudadas 61 crianças (5,1% dos recém-nascidos de termo) - Grupo I n=42 (68,9%) e Grupo II n=19 (31,1%). Os fatores de risco avaliados (patologias infecciosas associadas, uso prévio de antibióticos, malformações nefro-urológicas, ventilação mecânica, nutrição parenteral e o uso de cateteres) foram mais freqüentes no Grupo II (pOBJECTIVE: To analyze the correlation of risk factors to the occurrence of urinary tract infection in full-term newborn infants. PATIENTS AND METHODS: Retrospective study (1997) including full-term infants having a positive urine culture by bag specimen. Urine collection was based on: fever, weight loss >; 10% of birth weight, nonspecific symptoms (feeding intolerance, failure to thrive, hypoactivity, debilitate suction, irritability), or renal and urinary tract malformations. In these cases, another urine culture by suprapubic bladder aspiration was collected to confirm the diagnosis. To compare and validate the risk factors in each group, the selected cases were divided into two groups: Group I - positive urine culture by bag specimen collection and negative urine culture by suprapubic aspiration, and Group II - positive urine culture by bag specimen collection and positive urine culture by suprapubic aspiration . RESULTS: Sixty one infants were studied, Group I, n = 42 (68.9%) and Group II, n = 19 (31.1%). The selected risk factors (associated infectious diseases, use of broad-spectrum antibiotics, renal and urinary tract malformations, mechanical ventilation, parenteral nutrition and intravascular catheter) were more frequent in Group II (

Infecção urinária em recém-nascido de termo: valor da cultura de urina obtida através de saco coletor

OBJETIVE: to evaluate the efficacy of urine culture by bag specimen for the detection of neonatal urinary tract infection in full-term newborn infants. Retrospective study (1997) including full-term newborn infants having a positive urine culture (>100,000 CFU/ml) by bag specimen collection. The urinary tract infection diagnosis was confirmed by positive urine culture (suprapubic bladder aspiration method). The select cases were divided into three groups, according to newborn infant age at the bag specimen collection: GI (< 48 h, n = 17), GII (48 h to 7 d, n = 35) and GIII (> 7 d, n = 9). Sixty one full-term newborn infants were studied (5.1 % of total infants). The diagnosis was confirmed on 19/61 (31.1 %) of full-term infants born alive. Distribution among the groups was: GI = 2/17 (11.8 %), GII = 10//35 (28.6 %), and GIII = 7/9 (77.7 %). The most relevant clinical symptoms were: fever (GI - 100 %, GII - 91.4 %) and weight loss (GI - 35.3 %, GII - 45.7 %). Urine culture results for specimens collected by suprapubic aspiration were: E. coli GI (100 %), GII (40 %) and GIII (28.6 %), E. faecalis GI (30%), Staphylococcus coagulase-negative GII (20 %) and GIII (42.8 %), and Staphylococcus aureus GII (10 %). Correlation between positive urine culture collection (bag specimen method) and urinary tract infection diagnosis, using relative risk analysis, produced the following results: GI=0.30 (CI95% 0.08-1.15), GII=0.51 (CI 95% 0.25-1.06) and GIII=3.31 (CI95% 1.8-6.06) The most frequent urinary tract infection clinical signs in the first week were fever and weight loss, while non-specific symptomatology occurred later. E. coli was most frequent infectious agent, although from the 7th day of life, staphylococcus was noted. The urine culture (bag specimen method) was effective in detecting urinary tract infection only after the 7th day of life.OBJETIVO: avaliar a eficácia da cultura de urina obtida através de saco coletor na detecção de infecção do trato urinário no período neonatal. Estudo retrospectivo (1997), englobando recém-nascidos de termo com urocultura positiva (>100000UFC/ml) colhida em saco coletor. Nesses recém-nascidos foi realizada punção suprapúbica, coletando-se urina para cultura, para confirmação diagnóstica. Os recém-nascidos foram divididos em três grupos, de acordo com a idade do recém-nascido na ocasião da coleta: GI-n=17 (< 48h de vida), GII-n=35 (entre 48h e 7dias) e GIII-n=9 (> 7dias). Foram estudadas 61 crianças (5,1% dos recém-nascidos de termo). A confirmação diagnóstica pela punção suprapúbica mostrou: GI=2/17 (11,8%), GII=10/35 (28,6%) e GIII=7/9 (77,7%). Quanto ao quadro clínico, nos GI e II a febre (100 e 91,4%) e a perda de peso (35,3 e 45,7%) foram os sinais clínicos mais freqüentes. No GIII as alterações do estado geral (66,6%) e a febre (44,4%) destacaram-se. Dentre os agentes etiológicos, obteve-se: E coli GI (100%), GII (40%) e GIII (28,6%), E faecalis GI (30%), S coagulase-negativa GII (20%) e GIII (42,8%) e S aureus GII (10%) e GIII(14,3%). A análise do risco relativo da positividade da cultura de urina obtida por saco coletor corresponder à infecção urinária foi de: GI=0,3 (IC95% 0,08-1,15), GII=0,51 (IC95% 0,25-1,06) e GIII=3,31 (IC95% 1,8-6,06). Os resultados sugerem que os sinais clínicos mais importantes da infecção do trato urinário na primeira semana de vida foram a febre e a perda de peso, enquanto as alterações do estado geral ocorreram mais tardiamente; a E coli foi o agente mais freqüente e, a partir do sétimo dia, houve o aparecimento de S aureus e S coagulase negativa. A cultura de urina através de saco coletor teve maior capacidade de detecção de infecção urinária a partir do setimo dia

Eighty Years of Mycopathologia: A Retrospective Analysis of Progress Made in Understanding Human and Animal Fungal Pathogens

Mycopathologia was founded in 1938 to ‘diffuse the understanding of fungal diseases in man and animals among mycologists.’ This was an important mission considering that pathogenic fungi for humans and animals represent a tiny minority of the estimated 1.5–5 million fungal inhabitants on Earth. These pathogens have diverged from the usual saprotrophic lifestyles of most fungi to colonize and infect humans and animals. Medical and veterinary mycology is the subdiscipline of microbiology that dwells into the mysteries of parasitic, fungal lifestyles. Among the oldest continuing scientific publications on the subject, Mycopathologia had its share of ‘classic papers’ since the first issue was published in 1938. An analysis of the eight decades of notable contributions reveals many facets of host–pathogen interactions among 183 volumes comprising about 6885 articles. We have analyzed the impact and relevance of this body of work using a combination of citation tools (Google Scholar and Scopus) since no single citation metric gives an inclusive perspective. Among the highly cited Mycopathologia publications, those on experimental mycology accounted for the major part of the articles (36%), followed by diagnostic mycology (16%), ecology and epidemiology (15%), clinical mycology (14%), taxonomy and classification (10%), and veterinary mycology (9%). The first classic publication, collecting nearly 200 citations, appeared in 1957, while two articles published in 2010 received nearly 150 citations each, which is notable for a journal covering a highly specialized field of study. An empirical analysis of the publication trends suggests continuing interests in novel diagnostics, fungal pathogenesis, review of clinical diseases especially with relevance to the laboratory scientists, taxonomy and classification of fungal pathogens, fungal infections and carriage in pets and wildlife, and changing ecology and epidemiology of fungal diseases around the globe. We anticipate that emerging and re-emerging fungal pathogens will continue to cause significant health burden in the coming decades. It remains vital that scientists and physicians continue to collaborate by learning each other’s language for the study of fungal diseases, and Mycopathologia will strive to be their partner in this increasingly important endeavor to its 100th anniversary in 2038 and beyond