Caracterización clínica y microbiológica de niños y adolescentes con infecciones asociadas a la atención sanitaria / Clinical and microbiological characterization of children and adolescents with infections associated with health care

Se realizó un estudio descriptivo y transversal de 54 pacientes con infecciones asociadas a la asistencia sanitaria en el Hospital Infantil Sur Docente Dr Antonio María Béguez César de Santiago de Cuba, que abarcó desde enero de 2015 hasta diciembre de 2016. Las variables analizadas incluyeron edad, sexo, tipo de infección, resultado de los cultivos, microorganismo aislado y servicio de procedencia. Todas las muestras de los cultivos efectuados fueron procesadas en el Departamento de Microbiología de la mencionada institución. En la casuística predominaron el grupo etario de 5-17 años, el sexo masculino, la infección en la herida quirúrgica, la positividad de los cultivos, el aislamiento de la Escherichia coli y la Unidad de Cuidados Intensivos. Solo fallecieron 2 de los lactantes de 0-11 meses, para 3,7 por ciento.

A descriptive and cross-sectional study of 54 patients with infections associated with the health care in Dr Antonio María Béguez César Southern Teaching Pediatric Hospital was carried out in Santiago from Cuba, from January, 2015 to December, 2016. The analyzed variables included age, sex, infection type, result of the cultures, isolated organism and origin service. All the culture samples were processed in the Microbiology Department of the institution. The age group 5-17 years, male sex, infection in the surgical wound, the positivity of the cultures, isolation of Escherichia coli and the Intensive Care Unit prevailed in the case material. Only 2 of the infants with 0-11 months died, for 3,7 percent.

Evaluación de la incorporación de un sistema automatizado de cultivo microbiológico en un hospital público de Nuquén / Assessment of the incorporation of an automated microbiological culture system in a public hospital of Neuquén

En este artículo se presenta un informe rápido de evaluación de tecnología sanitaria sobre la incorporación de un sistema de cultivo microbiano automatizado para la realización de pruebas de identificación y sensibilidad antibiótica de gérmenes en el laboratorio de microbiología de un hospital público de alta complejidad de la provincia del Neuquén.(AU)

"The Chennai declaration" Recommendations of "A roadmap- to tackle the challenge of antimicrobial resistance" - A join meeting of medical societies of India.

"A Roadmap to Tackle the Challenge of Antimicrobial Resistance - A Joint meeting of Medical Societies in India" was organized as a pre-conference symposium of the 2 nd annual conference of the Clinical Infectious Disease Society (CIDSCON 2012) at Chennai on 24 th August. This was the first ever meeting of medical societies in India on issue of tackling resistance, with a plan to formulate a road map to tackle the global challenge of antimicrobial resistance from the Indian perspective. We had representatives from most medical societies in India, eminent policy makers from both central and state governments, representatives of World Health Organization, National Accreditation Board of Hospitals, Medical Council of India, Drug Controller General of India, and Indian Council of Medical Research along with well-known dignitaries in the Indian medical field. The meeting was attended by a large gathering of health care professionals. The meeting consisted of plenary and interactive discussion sessions designed to seek experience and views from a large range of health care professionals and included six international experts who shared action plans in their respective regions. The intention was to gain a broad consensus and range of opinions to guide formation of the road map. The ethos of the meeting was very much not to look back but rather to look forward and make joint efforts to tackle the menace of antibiotic resistance. The Chennai Declaration will be submitted to all stake holders.

[Application of satellite remote sensing for tracking of arthropod vectors of diseases]

Arthropod-borne diseases are one of the major causes of human mortality. Since launch of the first meteorological satellites in 1960s, remote sensing has been increasingly implicated in the field of human health research and the data from satellites and their sensors with different spatial and temporal resolutions opened a new field of research in human health for scientists. Search engines and national/international scientific databanks were used to search keywords of remote sensing, satellite, tick, mosquito and sand fly and obtained articles were analyzed. Some ecological indices were used more in remote sensing of arthropod-borne diseases, including NDVI, SST, LST and CCD. Data of environmental factors such as temperature, relative humidity, land use/ land cover help us to detect the habitats of vectors of diseases regard to their ecology. However, the scope of applications, beyond theoretical large potentialities, appears limited both by their technical nature and the related models developed. The main problem for application of remote sensing in health science and epidemiology of diseases, is the costs of satellite images as well as the availability in the studied times to monitor a specific subject like vector or agent of the disease. Although the majority of health studies and diseases monitoring need to application of high spatial resolution images

Avaliação da eficácia de quatro protocolos de higienização das mãos, utilizados em servicos de saúde / Effectiveness comparison of four handwashing protocols, used in health services

Este estudo teve como objetivo avaliar a eficácia de quatro protocolos de higienização das mãos utilizados por profissionais da área da saúde durante suas rotinas profissionais. Amostras da microbiota das mãos de 120 acadêmicos de Odontologia foram coletadas antes e após antissepsia. Os voluntários foram divididos em quatro grupos para testar a eficácia de um sabonete líquido contendo triclosan 1%, do álcool etílico em solução a 70%, utilizado sobre a forma de imersão e fricção após o sabonete antisséptico, e o álcool etílico gel a 77% sem lavagem prévia das mãos. A coleta das amostras foi realizada utilizando o método "modified glove juice" O total de bactérias presentes nas situações testadas foi determinado a partir da contagem das unidades formadoras de colônias que cresceram após semeadura das amostras em Tryptic Soy Agar. O sabonete líquido contendo 1% de triclosan reduziu significativamente a microbiota das mãos (p<0,051. o mesmo acontecendo com o álcool em solução a 70% utilizado nas duas formas (p0,05). A variação do desempenho dos três antissépticos que se mostraram eficazes foi estimada pelo teste ANOVA, verificando-se não haver diferença significativa entre eles (p= 0,59). O estudo demonstrou que o sabonete líquido degermante a base de 1% de triclosan sozinho el ou associado ao álcool etílico a 70% utilizado após a lavagem das mãos pode ser usado com segurança nas rotinas dos consultórios odontológicos e demais serviços de saúde.

This study aimed to evaluate and compare the effectiveness of four protocols for handwashing used by dental health professionals during their routines. Samples of the microflora from the hands of 120 dental students were collected before and after antisepsis. The volunteers were divided into four groups to test the effectiveness of a liquid soap containing 1% triclosan and 70% ethanol solution. It was used in the form of immersion and friction after soaking and washing hands with antiseptic soap and 77% alcohol gel without prior handwashing. The collection of samples was performed using a modified glove juice method. The total number of bacteria present in the tested situations was determined by counting the colony forming units that grew after sowing of the samples in Tryptic Soy Agar. The liquid soap containing 1% tri- closan significantly reduced hand microflora (p<0.0051. as did the 70% alcohol solution used in both tested ways (p0.05). Performance variation of the three antiseptics revealed effective when estimated by ANOVA, which showed no significant difference between them (p=O.59). The study showed that the 1% triclosan antibacterialliquid soap alone and/or associated with 70% ethanol used after handwashing can be used safely in dental routines and other health services.

Condições gengivais de crianças com idade entre 6 e 12 anos: aspectos clínicos e microbiológicos / Gingival conditions of children aged 6 to 12 years: clinical and microbiological aspects

Objetivo: Avaliar as condições gengivais e a ocorrência de diferentes periodontopatógenos em 93 crianças com idade de 6 a 12 anos, em Araçatuba, SP, Brasil. Método: O exame clínico foi realizado de acordo com os critérios de Shour e Massler (1947), enquanto as amostras de placa bacteriana subgengival foram obtidas através de cones de papel absorvente esterilizados que eram introduzidos no interior dos sulcos gengivais sadios ou inflamados dos dentes 54 ou 14, 61 ou 11, 26, 75 ou 35, 82 ou 42 e 46, onde foram mantidos por 1 minuto e transferidos para tubos contento 5ml de caldo de tioglicolato. Os microrganismos foram isolados em ágar sangue e ágar CVE, e, incubados em anaerobiose a 37ºC por 10 dias. A identificação dos isolados foi realizada de acordo com suas características morfocoloniais, morfocelulares e bioquímicas. Resultados: 91,40% das crianças apresentaram gengivite, sendo que 70,97% gengivite leve. Apenas 8,6 % evidenciaram ausência de gengivite. Verificou-se que a grande maioria das crianças apresentava gengivite leve e mostrava-se portadora de algum periodontopatógeno. Conclusão: A gengivite parece se elevar com a idade e apenas o F. nucleatum mostrou correlação com a elevação da gengivite.

Purpose: To evaluate the gingival conditions and the occurrence of different periodontal pathogens in 93 children aged 6 to 12 years in the city of Ara‡atuba, SP, Brazil.Method: The clinical examination was performed according to the criteria proposed by Shour and Massler (1947), while the subgingival bacterial plaque samples were obtained using sterile absorbent paper points that were introduced into the healthy or inflamed gingivalsulci of teeth 54 or 14, 61 or 11, 26, 75 or 35, 82 or 42 and 46. The paper points were maintained inside the sulci during 1 minute and transferred to tubes containing 5 mL of thioglycollate broth. The microorganisms were isolated in blood agar and agar CVE, andincubated in anaerobiosis at 37§C for 10 days. The identification of the isolates was performed according to their morphocolonial,morphocellular and biochemical characteristics.Results: 91.40% of the children presented gingivitis, 70.97% of them with mild gingivitis. Only 8.6% showed absence of gingivitis.The majority of the children presented with mild gingivitis and exhibited some periodontal pathogen.Conclusions: Gingivitis seems to accentuate with age and only F.nucleatum showed a correlation with the increase of gingivitis incidence.

Bactérias com potencial patogênico nos rins e lesöes externas de jundiás (Rhamdia quelen) cultivados em sistema semi-intensivo / Pathogenic bacterials in kidney and external lesions of jundiá (Rhamdia quelen) in semi-intensive fish culture

Os objetivos do presente trabalho foram o de realizar o levantamento e a identificaçäo dos gêneros bacterianos presentes nos rins e lesöes externas de jundiás (Rhandia quelen) criados em tanques, e investigar a existência de correlaçäo entre comprimento, peso e sexo dos peixes e temperatura da água, em relaçäo às bactérias isoladas. Para tanto, foram necropsiados 100 jundiás colhidos durante o período de dezembro de 1995 a outubro de 1996. Para exame bacteriológico, foram utilizadas amostras dos rins de todos os peixes e amostras de lesöes externas, quando presentes. Em 35 dos 100 peixes necropsiados, foram isolados e identificados 11 diferentes gêneros bacterianos descritos como patogênicos para peixes: Plesiomonas shigelloides (15 por cento). Aeromonas sp. (6 por cento), Flavobacterium sp. (5 por cento), Acinetobacter sp. (4 por cento), Vibrio sp. (4 por cento), Pseudomonas sp. (4 por cento), Micrococcus sp. (3 por cento), Staphylococcus sp. (3 por cento), Edwardsiella tarda (3 por cento), Yersinia ruckeri (2 por cento) e Pasteurella sp. (1 por cento). Näo foi evidenciada correlaçäo entre as características dos animais amostrados e temperatura da água em relaçäo ao índice de isolados bacterianos. A bactéria Yersinia ruckeri é pela primeira vez encontrada em peixes no Brasil.

Infección por virus de inmunodeficiencia humana en la mujer / HIV infection in the women

La mujer constituye uno de los puntos más vulnerables en la cadena epidemiológica en la Infección por Virus de Inmunodeficiencia Humana (HIV). Dicha vulnerabilidad está determinada por factores sociopolíticos, económicos y culturales de cada país en particular, lo cual se traduce en un incremento cada vez mayor del número de casos de Infección por VIH en este sexo. Los aspectos más dramáticos de la Infección por VIH en este segmento tan especial de la población susceptible, corresponden a: 1. el mayor número de casos se observa en mujeres jóvenes con vida sexual activa. 2. el Síndrome de Inmunodeficiencia Adquirida (SIDA) es la tercera causa de muerte en mujeres con edad comprendida entre 25 y 44 años, lo cual coloca en situación de orfandad a miles de niños a nivel mundial, con un total actual de 8.2 millones de niños huérfanos por esta causa. 3. aún cuando el porcentaje de mujeres con Infección por VIH que consultan por sintomatología primaria de enfermedad ginecológica es relativamente bajo (aproximadamente 9 por ciento), una evaluación ginecológica exhaustiva, puede demostrar patología ginecológica hasta en un 83 por ciento de los casos. 4. en relación a la transmisión vertical, en algunas regiones del mundo, el hecho de saberse infectada con el HIV no cambia en la mujer la conducta ante la concepción, por lo tanto considerando que más del 86 por ciento de la Infección por VIH en niños es adquirida de madre a hijo, es la mujer uno de los elementos claves de la cadena epidemiológica donde se deben fundamentar programas integrales de prevención y tratamiento antiretroviral efectivo para garantizar de esta forma no solo una mejor calidad de vida a la mujer infectada, sino la posibilidad de disminuir la incidencia de Infección por VIH en los niños

Evolutionary control of infectious disease: prospects for vectorborne and waterborne pathogens

Evolutionary theory may contribute to practical solutions for control of disease by identifying interventions that may cause pathogens to evolve to reduce virulence. Theory predicts, for example, that pathogens transmitted by water or arthropod vectors should evolve to relatively high levels of virulence because such pathogens can gain the evolutionary benefits of relatively high levels of host exploitation while paying little price from host illness. The entrance of Vibrio cholerae into South America in 1991 has generated a natural experiment that allows testing of this idea by determining whether geographic and temporal variations in toxigenicity correspond to variation in the potencial for waterborne transmission. Preliminary studies show such correspondences: toxigenicity is negatively associated with access to uncontaminated water in Brazil; and in Chile, where the potential for waterborne transmission is particularly low, toxigenicity of strains declined between 1991 and 1998. In theory vector-proofing of houses should be similarly associated with benignity of vectorborne pathogens, such as the agents of dengue, malaria, and Chagas'disease. These preliminary studies draw attention to the need for definitive prospective experiments to determine whether interventions such as provisioning of uncontaminated water and vector -proofing of houses cause evolutionary reductions in virulence.

El riesgo de transmisión de enfermedades infecciosas por vía de la transfusión / The risk of transmision of infectious diseases via transfusion

La transfusión es una práctica frecuente en las pacientes obstétricas; el empleo de la sangre puede salvar la vida de una paciente, pero no está exento de riesgos, de los cuales la transmisión de infecciones es uno de los más importantes. A partir de la identificación de la transmisión del virus de la inmunodeficiencia humana (VIH) por vía de la transfusión, a nivel mundial se ha incrementado el número de medidas preventivas para eliminar el riesgo de transmisión de enfermedades infecciosas por esta vía. Los microorganismos que se pueden transmitir por enfermedades infecciosas por esta vía. Los microorganismos que se pueden transmitir por enfermedades infecciosas por esta vía. Los microorganismos que se pueden transmitir por transfusión incluyen: virus linfotrópicos humanos de células T (HTLV) y II, VIH, virus de hepatitis B, virus de hepatitis C; virus de hepatitis D, virus de hepatitis G, citomegalovirus, Treponema pallidum, Brucella sp, Plasmodium sp, Toxoplasma gondii y Trypanosoma cruzi. La medida más importante para reducir los riesgos que conlleva la transfusión es el uso adecuado y cauteloso de la misma. El presente artículo revisa las indicaciones de la transfusión, describe las infecciones más comunes asociadas a este procedimiento y analiza las medidas de prevención a poner en práctica