Comparison of Vitek-2 automated identification system and PCR-ITS for species characterization of clinical isolates of Candida spp

Serious infections caused by genus Candida have become a challenge in the diagnostic question, in order to detect and identify the etiologic agent of agile, precise and standardized form in manner clinical laboratories. The prediction of susceptibility to antifungal agents, and the need to generate epidemiological data highlight the importance of routine identification of yeast species involved in infections. Among the 200 Candida species already described, C. albicans, C. parapsilosis, C. tropicalis, C. glabrata, C. guilliermondii, C. krusei and C. lusitaniae are most often related with infections in humans. All of the phenotypic methods of identification of Candida have limitations, especially the characterization of the species not C. albicans, however, the application of molecular methods may reflect the increased cost and spent time for obtain results on laboratory. In order to evaluate the implementation of the automated system Vitek 2 ID - YST (bioMerieux) combined with the use of chromogenic agar in the routine identification of Candida species were tested 44 isolates from invasive infection by inoculation of chromogenic agar and automated panel and realization DNA amplification for the internal transcribed spacer regions of rRNA 1 and 2 (ITS - PCR). Oligonucleotides specific species were used and the size of the amplified product was correlated to other results. The automated system identified 95.4 % of the isolates when in association with colonial features observed in chromogenic medium, however, the use of PCR -ITS or more sensitive methodologies would be needed to solve the other results, ambiguous and erroneous

Impact of the ventilator bundle on ventilator-associated pneumonia (VAP) rates in a pediatric intensive care unit in Londrina-PR

Healthcare-associated infections (HAI) are an important patient safety concern around the globe. Ventilator-associated pneumonia (VAP) is the leading cause of death among HAI, with attributable mortality ranging from 15 to 70% depending on the patient population. The Center for Disease Control and Prevention (CDC) has recommended that all ICUs implement a ventilator bundle to reduce the VAP rate. The purposes of the present study were to examine the effect of the bundle of infection control interventions, education, VAP rates in the Pediatric Intensive Care Unit (PICU) of the Hospital Universitário of Londrina-PR. This study was conducted between January and December 2013 and consisted of three periods: pre-intervention, intervention and post-intervention. An educational intervention was given to 86 healthcare workers (HCWs) about bundles to prevent VAP, and a questionnaire was also performed pre and post-intervention. Overall, 135 opportunities of patient care were evaluated. The compliance with hand hygiene and the use of gloves and gowns did not improve, but orotracheal intubation, maintenance of the patients in a 30-45º head of bed elevation, endotracheal cuff pressure and removal of condensate from ventilator circuts increased significantly when comparing pre- and post-intervention. The VAP rate was 49.6% during the pre-intervention period and 17.5% during the post-intervention period demonstrating a 64.8% reduction in VAP rate. Our results show that implementation of the bundle of infection control interventions was associated with a significant reduction in VAP rate