ABSTRACT
ABSTRACT Background: Community-genotype methicillin-resistant Staphylococcus aureus (CG-MRSA) emerged in the 1990s as a global community pathogen primarily involved in skin and soft tissue infections (SSTIs) and pneumonia. To date, the CG-MRSA SSTI burden in Latin America (LA) has not been assessed. Objective: The main objective of this study was to report the rate and genotypes of community-genotype methicillin-resistant Staphylococcus aureus (CG-MRSA) causing community-onset skin and soft tissue infections (CO-SSTIs) in LA over the last two decades. In addition, this research determined relevant data related to SSTIs due to CG-MRSA, including risk factors, other invasive diseases, and mortality. Data sources: Relevant literature was searched and extracted from five major databases: Embase, PubMed, LILACS, SciELO, and Web of Science. Methods: A systematic review was performed, and a narrative review was constructed. Results: An analysis of 11 studies identified epidemiological data across LA, with Argentina presenting the highest percentage of SSTIs caused by CG-MRSA (88%). Other countries had rates of CG-MRSA infection ranging from 0 to 51%. Brazil had one of the lowest rates of CG-MRSA SSTI (4.5-25%). In Argentina, being younger than 50 years of age and having purulent lesions were predictive factors for CG-MRSA CO-SSTIs. In addition, the predominant genetic lineages in LA belonged to sequence types 8, 30, and 5 (ST8, ST30, and ST5). Conclusion: There are significant regional differences in the rates of CG-MRSA causing CO-SSTIs. It is not possible to conclude whether or not CG-MRSA CO-SSTIs resulted in more severe SSTI presentations or in a higher mortality rate.
Subject(s)
Humans , Staphylococcal Infections/drug therapy , Staphylococcal Infections/epidemiology , Staphylococcal Skin Infections/drug therapy , Staphylococcal Skin Infections/epidemiology , Community-Acquired Infections/drug therapy , Community-Acquired Infections/epidemiology , Soft Tissue Infections/drug therapy , Soft Tissue Infections/epidemiology , Methicillin-Resistant Staphylococcus aureus/genetics , Argentina , Brazil , Genotype , Latin America/epidemiology , Anti-Bacterial Agents/therapeutic useABSTRACT
OBJETIVO: Avaliar se existe diferença no estadiamento de doentes submetidos à ressecção intestinal por câncer colorretal no sistema previdenciário e na clínica privada. MÉTODO: Foram estudados de forma retrospectiva 41 doentes (16 homens e 25 mulheres) com idade média de 59,4 anos operados no sistema previdenciário (SP) e 33 doentes (18 homens e 15 mulheres) com idade média de 60,8 anos operados na clínica privada (CP). Foram avaliados o estadiamento TNM, a frequência de operações de urgência, de operações paliativas e do uso de colostomia. RESULTADOS: Não se observou diferença entre o estadiamento dos dois grupos. A frequência de operações de urgência foi 26,8 por cento no SP e 12,1 por cento na CP (p=0,100). As operações paliativas ( 19,5 por cento SP x 6,1 por cento CP) e o uso de colostomia ( 26,8 SP X 15,2 CP) foram maiores no sistema previdenciário porém os valores não foram estatisticamente significantes, valores de p=0,087 e p=0,352 respectivamente. CONCLUSÃO: Não há diferença significante entre o estadiamento TNM de doentes operados no sistema previdenciário e privado.
BACKGROUND: To examine whether there is any difference in staging between patients operated on for colorectal cancer in public or private hospital. METHODS: This study included 41 patients (16 men and 25 women, mean age of 59.4 years old) who underwent colorectal resection for adenocarcinoma in public hospital (PU) and 33 patients (18 men and 15 women, mean age 60.8 years old) operated in private hospital (PR). They were evaluated regarding the TNM stage, mode of presentation (elective or emergency), type of resection (curative or palliative) and the use of colostomy. RESULTS: There was no significant difference in the staging among the two groups. Emergency presentation were 26.8 percent in the PU group and 12.1 percent in the PR group (p=0.100). Palliative resection (19.5 percent PU x 6.1 percent PR) and the use of colostomy (26.8 percent PU X 15.2 percent PR) were more frequently in the patients operated in public hospital but differences were not significant, p=0.087 and p=0.352 respectively. CONCLUSION: These findings demonstrate that there was no significant difference in staging between patients operated on for colorectal cancer in public or private hospital.