ABSTRACT
Enterococcus spp. resistentes à vancomicina (ERV) têm emergido como um patógeno multirresistente relevante e de etiologia potencialmente letal nas infecções associadas à assistência em saúde ao redor do mundo. Este estudo pretende mostrar epidemiologia e características clínicas de pacientes com ERV em um hospital do sul do Brasil. Um estudo retrospectivo foi conduzido no período de janeiro de 2005 a novembro de 2007 no Hospital Universitário de Londrina. Todos os pacientes com cultura clínica com ERV foram identificados e seu prontuário médico revisado. A presença de colonização foi avaliada através de culturas de swab retal e a identificação das amostras clínicas foi realizada pelo método automatizado MicroScan®. A média de idade dos pacientes foi de 54 anos. Trato urinário (68,0%) e corrente sanguínea (23,8%) foram os sítios mais frequentes, e a UTI apresentou se como setor de maior ocorrência (49,2%) das culturas positivas. E. faecium foi a espécie predominante, em 82,8% dos casos. Os fatores de risco observados foram a duração da internação (média de 58,2 dias), uso de antimicrobianos prévios e realização de procedimento invasivos, como o uso de cateter venoso central, sonda vesical e ventilação mecânica. Medidas de controle e culturas de vigilância são imprescindíveis no controle da disseminação do ERV. Os resultados obtidos no presente trabalho contribuem para uma melhor compreensão da dinâmica epidemiológica das infecções e da disseminação do ERV no Hospital Universitário de Londrina.
Vancomycin-resistant Enterococci (VRE) have emerged as a relevant multidrug-resistant pathogen and potencially lethal etiology of healthcare associated infections worldwide. This study intends to show the epidemiology and clinical characteristics of patients with VRE in a Hospital in South Brazil. A retrospective study was conducted from January 2005 to November 2007. A total of 122 VRE were identified in this period at the University Hospital of Londrina. All patients with VRE clinical culture have identified and their medical records have reviewed. The presence of colonization was evaluated through rectal swab cultures, and the species identification of clinical samples was performed by automated method MicroScan®. The mean age of patients was 54 years. Urinary tract (68.0%) and blood (23.8%) were the most frequent sites, and ICU was the largest sector of occurrence (49.2%). E. faecium was the predominant species, in 82.8% of cases.The risk factors presents were length of hospitalization (mean 58.2 days), previous use of antimicrobials and invasive procedure, such as use of central venous catheter, urinary catheter and mechanical ventilation. Control barriers and surveillance cultures are essential to prevent the VRE spread. The results obtained in this study contribute to a better understanding of the epidemiological dynamics of infections and the spread of VRE in University Hospital of Londrina.
Subject(s)
Vancomycin-Resistant Enterococci , Risk Factors , Cross InfectionABSTRACT
Extracellular lipase from Beauveria bassiana strain CG481 was immobilized by using thirteen different immobilization protocols. Silica gel was chosen as the most suitable adsorbent with 94.8% of activity yield. The adsorption on silica gel did not change the optimum pH (8.5) and temperature (45ºC) values of the free lipase (FL) for lipolytic activity, and it showed higher activities in extreme conditions (pH 9.0 to 10.5, 60ºC). The lipase immobilized on silica gel (ILS) showed enhanced stability at pH 7.0 after 120 h incubation (69.0%) when compared to FL (33.3%). The thermal stability was also enhanced by immobilization at 60ºC in aqueous (64.6%) and organic medium (95.1%), while FL showed only 40.6% of residual activity in aqueous medium and exhibited no activity for esterification reaction in n-heptane. The treatment of ILS with 0.8 M NaCl prevented lipase desorption while Triton X-100 (0.1%) resulted the enzyme leakage. The ILS was reused for four times for esterification reaction with 80.8% of initial activity.