Molecular analysis of the prevalence of Acinetobacter baumannii in hospitals and the surrounding environments: a cross-sectional study

Acinetobacter baumannii is widely recognized in clinical environments due to its infectious capacity, antimicrobial adaptability, and lethality. Analyzing the prevalence of this agent in intra- and extra-hospital environments may reveal target indicators for appropriate management interventions. In this observational cross-sectional study, we evaluated the prevalence of A. baumannii within hospitals with intensive care units and in their external surroundings in a macro-health region of Brazil. Samples of Columba livia (pigeon) droppings from the external environment of four hospitals (n = 40), from floor surfaces (n = 20), and door handles (n = 20) of different hospital wards were collected based on random sampling, all of which were evaluated for the presence of A. baumannii using polymerase chain reactions (PCR). The sensitivity and specificity of the technique was verified after the collected samples were contaminated with clinical samples positive for A. baumannii. We detected a significantly higher A. baumannii prevalence (87.50%, CI = 71.29­100.00) in samples collected within the hospital environment compared with those obtained from the external environment (12.50%, CI = 0.00­28. 71) (p = 0.003). In addition, samples collected from floor surfaces contained bacterial densities (181.3 ± 11.58) that exceeded those in environmental (93.32 ± 1.56) and door handle (142.70 ± 17.14) samples by 94% and 78.71%, respectively. The findings of this study will enhance our understanding of the spatial distribution of A. baumannii and additionally, validate the efficiency of PCR for diagnosis of this infectious agent.

Staphylococcus aureus and Enterococcus faecium isolated from pigeon droppings (Columba livia) in the external environment close to hospitals

ABSTRACT Background: Domestic pigeons carry pathogens in their droppings, posing a potential public health problem. Methods: The phenotypic and genotypic antimicrobial resistances of Staphylococcus aureus and Enterococcus faecium in the feces of urban pigeons near hospitals with intensive care units were measured. Results: Twenty-nine samples showed Enterococcus growth, whereas one was positive for S. aureus. The S. aureus isolate was sensitive to the antibiotics tested via antibiogram, however resistance genes were identified. E. faecium isolates showed phenotypic resistance to gentamicin, erythromycin, and ciprofloxacin. Conclusions: Antimicrobial profiles harmful to health were demonstrated in bacterial pathogens isolated from the external environment of hospitals.

Infecção e fatores preditivos de óbito em pacientes queimados atendidos em um hospital universitário na cidade de Uberaba/MG / Infection and predicting factors of death in burnt patients attended in a university hospital in the city of Uberaba/MG

OBJETIVO: Avaliar a ocorrência de infecções e as variáveis associadas a óbito entre pacientes queimados atendidos em um hospital universitário na cidade de Uberaba/MG. MÉTODO: Estudo retrospectivo realizado por análise dos prontuários de pacientes queimados (2° e/ou 3° graus) internados entre janeiro de 2013 e janeiro de 2019. Foram avaliados tempo de internação, internação em unidade de terapia intensiva (UTI), uso de antibióticos, superfície corporal queimada (SCQ), infecções, vias de acesso e comorbidades anteriores. Os dados foram tabulados no Microsoft® Excel e analisados por IBM SPSS statistics 21 e GraphPad Prism 7.0 (p<0.05). RESULTADOS: Foram avaliados 168 prontuários de pacientes com idades entre 0,12 e 84 anos (p=0,58). A ocorrência de infecção foi correlacionada a um risco relativo (RR) de quase seis vezes maior de óbito (RR=5,96; p=0,003). Pacientes com SCQ superior a 50% apresentaram RR cerca de 18 vezes maior de óbito (RR=18,33; p<0,0001). Demonstrou-se também aumento do número de óbitos em pacientes com mais de três acessos (RR=35,53; p <0,0001) e associação de óbitos com os custos hospitalares de internação (p=0,0018). Raça, sexo, tempo de hospitalização, hospitalização em UTI, comorbidades, uso de antibiótico e grau de queimadura não interferiram na sobrevida dos pacientes avaliados. CONCLUSÕES: A incidência de infecções entre os pacientes queimados avaliados apresentou relação positiva com óbito, bem como a SCQ, o número de acessos utilizados e os gastos hospitalares. Atenção especial deve ser dada ao controle de infecções, visto ser esta uma variável possível de alteração mediante esforços e cuidados da equipe multiprofissional responsável por esses pacientes.

OBJECTIVE: To evaluate the occurrence of infections and the variables associated with death among burn patients treated at a university hospital in the city of Uberaba/MG. METHODS: Retrospective study performed by analyzing the medical records of burned patients (2nd and/or 3rd degrees) hospitalized between January 2013 and January 2019. Length of stay, intensive care unit (ICU) stay, use of antibiotics, burned body surface (BBS), infections, access routes and previous comorbidities were evaluated. The data were tabulated in Microsoft® Excel and analyzed by IBM SPSS statistics 21 and GraphPad Prism 7.0 (p<0.05). RESULTS: 168 medical records of patients aged 0.12 to 84 years (p=0.58) were evaluated. The occurrence of infection was correlated with a relative risk (RR) of almost six times higher of death (RR=5.96; p=0.003). Patients with BBS greater than 50% had about 18 times higher risk of death (RR=18.33; p <0.0001). There was also an increase in the number of deaths in patients with more than three accesses (RR=35.53; p <0.0001) and an association of deaths with hospitalization costs (p=0.0018). Race, sex, length of hospital stay, ICU, stay comorbidities, use of antibiotics and degree of burn did not interfere with the survival of the evaluated patients. CONCLUSIONS: The incidence of infections among the burn patients evaluated showed a positive relationship with death, as well as BBS, the number of accesses used and hospital expenses. Special attention should be given to infection control, as this is a variable that can be controlled through the efforts and care of the multidisciplinary team responsible for these patients.

Prevalência e suscetibilidade bacteriana em infecções do trato urinário de pacientes atendidos no Hospital Universitário de Uberaba / Prevalence and bacterial susceptibility in urinary tract infection in the University Hospital of Uberaba

Em função da alta incidência das infecções urinárias tanto na comunidade como em hospitais, este trabalho teve como objetivo identificar os agentes etiológicos mais frequentes nestas infecções e relatar o perfil de sensibilidade antimicrobiana da Escherichia coli isolada no Hospital das Clínicas da Universidade Federal do Triângulo Mineiro de Uberaba. Durante o período de estudo (Janeiro a Dezembro de 2007) foram analisadas todas as uroculturas positivas perfazendo um total de 938 amostras. A Escherichia coli foi a bactéria mais isolada (60,4%) seguida de Klebisiella pneumoniae (12,0%) e Pseudomonas aeruginosa (7,4%) A Escherichia coli apresentou mais de 90% sensibilidade para ceftazidina, amicacina, aztreonam, cefepime, ceftriaxona, cefoxitina, nitrofurantoína e gentamicina, enquanto que 51,45% apresentaram resistência a sulfametoxazol-trimetroprim.