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1.
Acta Paul. Enferm. (Online) ; 35: eAPE03751, 2022. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1364223

ABSTRACT

Resumo Objetivo Caracterizar os microrganismos e sua suscetibilidade antimicrobiana em uroculturas de idosos residentes de uma instituição de longa permanência. Métodos Estudo observacional transversal com 116 indivíduos de uma Instituição de Longa Permanência para Idosos de um município do sul da Bahia. O estudo foi aprovado por Comitê de Ética em Pesquisa e utilizou-se Termo de Consentimento Livre e Esclarecido. Foram realizadas coleta e análise laboratorial de urina tipo I e urocultura. Realizaram-se testes de sensibilidade a antimicrobianos conforme os critérios do European Committee on Antimicrobial Susceptibility Testing. Para o diagnóstico de infecção do trato urinário, foram utilizados os critérios de McGeer. A análise de dados se deu por estatística descritiva, com frequências absolutas e relativas. Resultados A prevalência de infecção do trato urinário foi de 33,62%, com predominância no sexo feminino e idade acima de 80 anos. Os uropatógenos foram: 69,2% Escherichia coli, 20,6% Klebsiella pneumoniae e 5,1% Providencia stuartii e Acinetobacter baumannii. As cepas de E. coli apresentaram suscetibilidade para a maior parte dos antimicrobianos; já nas de K. pneumoniae, a suscetibilidade foi variável. P. stuartii e A. baumannii não apresentaram resistência a carbapenêmicos e aos betalactâmicos aztreonam e piperacilina associados a tazobactam. Conclusão As cepas mais prevalentes e o perfil de suscetibilidade seguiram padrão próximo ao hospitalar, o que implica a necessidade de a instituição promover melhores estratégias de controle de infecção e envolver a equipe de enfermagem no gerenciamento dos casos e na qualificação da prescrição antimicrobiana, para reduzir a resistência bacteriana e efeitos adversos nos idosos.


Resumen Objetivo Caracterizar los microorganismos y su susceptibilidad antimicrobiana en urocultivos de adultos mayores residentes en una institución de larga estadía. Métodos Estudio observacional transversal con 116 individuos de una institución de larga estadía para adultos mayores de un municipio del sur del estado de Bahia. El estudio fue aprobado por el Comité de Ética de Investigación y se utilizó Consentimiento Informado. Se obtuvieron muestras de orina, con las cuales se realizó análisis de laboratorio tipo I y urocultivo. Se realizaron pruebas de sensibilidad a antimicrobianos según los criterios del European Committee on Antimicrobial Susceptibility Testing. Para el diagnóstico de infección del tracto urinario, se utilizaron los criterios de McGeer. El análisis de datos se obtuvo mediante estadística descriptiva, con frecuencias absolutas y relativas. Resultados La prevalencia de infección del tracto urinario fue del 33,62 %, con predominancia del sexo femenino y edad superior a 80 años. Los uropatógenos fueron: 69,2 % Escherichia coli, 20,6 % Klebsiella pneumoniae y 5,1 % Providencia stuartii y Acinetobacter baumannii. Las cepas de E. coli presentaron susceptibilidad en la mayor parte de los antimicrobianos, en las de K. pneumoniae, la susceptibilidad fue variable. P. stuartii y A. baumannii no presentaron resistencia a carbapenémicos ni a los betalactámicos aztreonam y piperacilina asociados a tazobactam. Conclusión Las cepas más prevalentes y el perfil de susceptibilidad presentaron un patrón parecido al hospitalario, lo que implica la necesidad de que la institución promueva mejores estrategias de control de infecciones e involucre al equipo de enfermería en la gestión de los casos y en la cualificación de la prescripción antimicrobiana para reducir la resistencia bacteriana y los efectos adversos en los adultos mayores.


Resumo Objetivo Caracterizar os microrganismos e sua suscetibilidade antimicrobiana em uroculturas de idosos residentes de uma instituição de longa permanência. Métodos Estudo observacional transversal com 116 indivíduos de uma Instituição de Longa Permanência para Idosos de um município do sul da Bahia. O estudo foi aprovado por Comitê de Ética em Pesquisa e utilizou-se Termo de Consentimento Livre e Esclarecido. Foram realizadas coleta e análise laboratorial de urina tipo I e urocultura. Realizaram-se testes de sensibilidade a antimicrobianos conforme os critérios do European Committee on Antimicrobial Susceptibility Testing. Para o diagnóstico de infecção do trato urinário, foram utilizados os critérios de McGeer. A análise de dados se deu por estatística descritiva, com frequências absolutas e relativas. Resultados A prevalência de infecção do trato urinário foi de 33,62%, com predominância no sexo feminino e idade acima de 80 anos. Os uropatógenos foram: 69,2% Escherichia coli, 20,6% Klebsiella pneumoniae e 5,1% Providencia stuartii e Acinetobacter baumannii. As cepas de E. coli apresentaram suscetibilidade para a maior parte dos antimicrobianos; já nas de K. pneumoniae, a suscetibilidade foi variável. P. stuartii e A. baumannii não apresentaram resistência a carbapenêmicos e aos betalactâmicos aztreonam e piperacilina associados a tazobactam. Conclusão As cepas mais prevalentes e o perfil de suscetibilidade seguiram padrão próximo ao hospitalar, o que implica a necessidade de a instituição promover melhores estratégias de controle de infecção e envolver a equipe de enfermagem no gerenciamento dos casos e na qualificação da prescrição antimicrobiana, para reduzir a resistência bacteriana e efeitos adversos nos idosos.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Urinary Tract Infections/epidemiology , Drug Resistance, Microbial , Drug Resistance, Bacterial , Cross-Sectional Studies , Infection Control , Observational Studies as Topic , Homes for the Aged
2.
Article in Chinese | WPRIM | ID: wpr-878718

ABSTRACT

Objective To verify the relationship between catheter-related urinary tract infection(CAUTI)and stress hyperglycemia during catheter retention in stroke patients. Methods We used nosocomial infection monitoring system to track the status of CAUTI in stroke patients in a hospital.The study cohort was all the patients who received retention catheterization from January 2016 to March 2020.According to the nested case-control design,multivariate logistic regression analysis was performed to explore the relationship between stress hyperglycemia and CAUTI in stroke patients with indwelling catheter. Results A total of 322 cases of CAUTI and 644 cases of non-CAUTI were enrolled in this study.The length of stay in the case group was(20.68 ± 3.73)d,significantly longer than that[(13.00 ± 4.01)d]in the control group(t=29.473,P <0.001).Compared with non-stress hyperglycemia,stress hyperglycemia posed a higher risk of CAUTI in the stroke patients with indwelling catheter(OR=2.020,95% CI=1.447-2.821,P=0.000)and led to the higher incidence of CAUTI in one thousand days(P<0.001). Conclusion Stress hyperglycemia in the stroke patients with indwelling catheter can significantly increase the risk of CAUTI.


Subject(s)
Catheter-Related Infections/epidemiology , Cross Infection/epidemiology , Humans , Hyperglycemia/complications , Stroke/complications , Urinary Catheterization , Urinary Tract Infections/epidemiology
3.
Rev. chil. infectol ; 37(5): 509-514, nov. 2020. tab
Article in Spanish | LILACS | ID: biblio-1144244

ABSTRACT

Resumen La infección del tracto urinario asociada al catéter urinario permanente (ITU/CUP) es un problema relevante en los centros de salud por su alta frecuencia. Objetivo: Identificar factores de riesgo de ITU en pacientes adultos con CUP. Material y Método: Estudio caso control efectuado entre los años 2010-2016 en el Hospital Militar de Santiago. Se realizó un análisis estadístico univariado y multivariado por medio del modelo de regresión logística binaria, con variables como edad, duración e indicación del dispositivo, algunas comorbilidades y la instalación del dispositivo luego de 15 días hospitalización. Resultado: Se obtuvo un total de 63 casos y 123 controles. Fueron variables predictoras de ITU/CUP la duración del CUP desde el séptimo día en adelante (OR 2,6 IC 1,4-4,9, p = 0,004) y la instalación del CUP con una estadía de hospitalización previa de 15 días y más (OR 7,8 IC 2,920,9 p = 0,000). No se encontró asociación con la edad mayor de 80 años, comorbilidades como diabetes y vejiga neurogénica e indicación de instalación. Conclusiones: Los resultados permiten focalizar las intervenciones, evaluando la necesidad real de indicación de CUP en pacientes con estadía hospitalaria previa de dos semanas y fomentar el retiro de CUP antes del séptimo día de uso.


Abstract Catheter-associated urinary tract infection (CAUTI) is a relevant problem in health centers because of its high frequency. Objective: To identify UTI risk factors in adult patients with urinary catheter. Material and Method: Control case study carried out between the years 2010-2016 at the Military Hospital of Santiago, Chile. Univariate and multivariate statistical analysis were performed using the binary logistic regression model, variables such as age, duration and indication of the device, some comorbidities and the installation of the device after 15 days of hospitalization. Result: A total of 63 cases and 123 controls were obtained. Predictive variables of CAUTI for the duration of the urinary catheter from the 7th day onwards (OR 2.6 IC 1.4-4.9, p = 0.004) and the installation of the urinary catheter with a previous hospital stay of 15 days and more (OR 7.8 CI 2.9-20.9 p = 0.000). No association was found in age over 80 years, comorbidities such as diabetes and neurogenic bladder and indication. Conclusions: The results permitted to focus the interventions, evaluating the real need for indication of CUP in patients with previous hospital statistics of 2 weeks and encouraging the withdrawal of CUP before the 7th day of use.


Subject(s)
Humans , Adult , Aged, 80 and over , Urinary Tract Infections/etiology , Urinary Tract Infections/epidemiology , Catheter-Related Infections/epidemiology , Urinary Catheters/adverse effects , Urinary Catheterization/adverse effects , Chile/epidemiology , Cross Infection/epidemiology , Risk Factors
4.
Rev. méd. panacea ; 9(1): 43-49, ene.-abr. 2020.
Article in Spanish | LIPECS, LILACS, LIPECS | ID: biblio-1121544

ABSTRACT

Introducción: La infección urinaria en diabéticos constituye uno de los problemas importantes caracterizado por su unidad clínica y pluralidad etiológica. Objetivo: Generar conocimiento sobre las características, epidemiológicas, clínicas y terapéuticas de infección urinaria en diabéticos.. Materiales y métodos: Es un estudio descriptivo de búsqueda bibliografía y se ha realizado en Pubmed, Medline, Scielo, bibliotecas de universidades nacionales e internacionales. Resultados: El 40.74% de casos fueron varones y 59.26% mujeres. Los malos hábitos de higiene, la presencia de cálculos renales, un tiempo de enfermedad mayor de 10 años, vejiga neurogénica, uso de corticoides, infección urinaria previa están asociadas a infección urinaria en la población de diabéticos. Casi el 30% de los pacientes presentaron bacteriuria asintomática. El síntoma más frecuente fue la fiebre. Los síntomas presentes en el 75,7%. La incontinencia de esfuerzo 45.3%, de urgencia 40.6%, síntomas obstructivos 25%, irritativos 10.1%. Predominó Escherichia coli (57.41%), seguido de Enterobacter (8.33%) y Klebsiella pneumoniae (6.48%). La resistencia de E. coli fue elevada contra clindamicina, ácido nalidíxico, ácido pipemídico (100%) y cefuroxima (90.91%), amoxicilina clavulanato (81.25%), ampicilina (78.57%) y cefalotina (72.22%); buena sensibilidad para imipenem (76.92%), cefepime (72.73%), amikacina (72.41%), nitrofurantoína (70.37%), ceftriaxona (63.79%) y ceftazidima (61.11%). Conclusión: Las infecciones urinarias en los pacientes diabéticos son frecuentes y ocasionadas con más frecuencia por E. coli, con patrones de resistencia y sensibilidad que requieren medidas de intervención. La resistencia a los antibióticos se incrementa por el uso indiscriminado en pacientes con inadecuado control de su enfermedad. (AU)


Introduction: Urinary infection in diabetics is one of the important problems characterized by its clinical unit and etiological plurality. Objective: To generate knowledge about the characteristics, epidemiological, clinical and therapeutic of urinary infection in diabetics. Materials and methods: It is a descriptive study of literature search and has been carried out in Pubmed, Medline, Scielo, libraries of national and international universities. Results: 40.74% of cases were male and 59.26% female. Bad hygiene habits, the presence of kidney stones, a disease time of more than 10 years, neurogenic bladder, corticosteroid use, previous urinary infection is associated with urinary infection in the diabetic population. Almost 30% of the patients presented asymptomatic bacteriuria. The most frequent symptom was fever. The symptoms present in 75.7%. Stress incontinence 45.3%, emergency 40.6%, obstructive symptoms 25%, irritative 10.1%. Escherichia coli (57.41%) predominated, followed by Enterobacter (8.33%) and Klebsiella pneumoniae (6.48%). The resistance of E. coli was high against clindamycin, nalidixic acid, pipemidic acid (100%) and cefuroxime (90.91%), amoxicillin clavulanate (81.25%), ampicillin (78.57%) and cephalothin (72.22%); Good sensitivity for imipenem (76.92%), cefepime (72.73%), amikacin (72.41%), nitrofurantoin (70.37%), ceftriaxone (63.79%) and ceftazidime (61.11%). Conclusions: Urinary infections in diabetic patients are frequent and more frequently caused by E. coli, with resistance and sensitivity patterns that require intervention measures. Antibiotic resistance is increased by indiscriminate use in patients with inadequate control of their disease. (AU)


Subject(s)
Humans , Male , Female , Urinary Tract Infections , Urinary Tract Infections/therapy , Urinary Tract Infections/epidemiology , Diabetes Mellitus , Epidemiology, Descriptive
5.
Clinics ; 75: e1508, 2020. tab, graf
Article in English | LILACS | ID: biblio-1089596

ABSTRACT

OBJECTIVES: Evidence suggests that infection or inflammation is a major contributor to early spontaneous preterm birth (sPTB). Therefore, this study aimed to investigate the development and causes of maternal infection associated with maternal and neonatal outcomes in women with sPTB. METHODS: This was a secondary analysis of a multicenter cross-sectional study with a nested case-control component, the Brazilian Multicentre Study on Preterm Birth (EMIP), conducted from April 2011 to July 2012 in 20 Brazilian referral obstetric hospitals. Women with preterm birth (PTB) and their neonates were enrolled. In this analysis, 2,682 women undergoing spontaneous preterm labor and premature pre-labor rupture of membranes were included. Two groups were identified based on self-reports or prenatal or hospital records: women with at least one infection factor and women without any maternal infection (vulvovaginitis, urinary tract infection, or dental infection). A bivariate analysis was performed to identify potential individual risk factors for PTB. The odds ratios (ORs) with their respective 95% confidence intervals were calculated. RESULTS: The majority of women with sPTB fulfilled at least one criterion for the identification of maternal infection (65.9%), and more than half reported having urinary tract infection during pregnancy. Approximately 9.6% of women with PTB and maternal infection were classified as having periodontal infection only. Apart from the presence of a partner, which was more common among women with infectious diseases (p=0.026; OR, 1.28 [1.03-1.59]), other variables did not show any significant difference between groups. CONCLUSION: Maternal infection was highly prevalent in all cases of sPTBs, although it was not clearly associated with the type of PTB, gestational age, or any adverse neonatal outcomes.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Premature Birth/epidemiology , Infections/epidemiology , Urinary Tract Infections/epidemiology , Brazil/epidemiology , Population Surveillance , Cross-Sectional Studies , Risk Factors , Chorioamnionitis/epidemiology , Vaginosis, Bacterial/epidemiology
6.
Int. braz. j. urol ; 45(2): 347-353, Mar.-Apr. 2019. tab
Article in English | LILACS | ID: biblio-1002202

ABSTRACT

ABSTRACT Study design: Retrospective cohort of patients with traumatic spinal cord injury (SCI) that have been hospitalized for physical-functional rehabilitation purposes. Objectives: To compare the incidence of urinary tract infection (UTI) after urodynamic study (UDS) in three hospitals that adopted different protocols with regard to the preparation of patients. Setting: Sarah Network of Rehabilitation Hospitals, Brazil. Materials and Methods: Between 2014 and 2015, 661 patients from three units of the same hospital network, one of which does not use antimicrobial prophylaxis independently of urine culture results, were evaluated after having undergone UDS. The results were compared in both univariate and multivariate analyses (logistic regression). Results: The global rate of UTI after UDS was that of 3.18% (IC 95% 2.1-4.8), with no differences between the units. In the univariate analysis the only variable that was associated with UTI after UDS was that of T6 injuries or above (P = 0.029). The logistic regression has confirmed this result, with an adjusted odds ratio of 3.06 (IC 95% 1.01 to 9.26; P = 0.0476). The use of antimicrobial prophylaxis did not alter that risk. Conclusions: This study has demonstrated that the use of antimicrobials does not prevent UTI after UDS. Patients with T6 traumatic SCI or above have got three times more chance of developing UTI after UDS if compared to those with a T7 injury or below, independently of the use of antimicrobials. Even in these patients the use of antimicrobials would not be justified.


Subject(s)
Humans , Male , Female , Adult , Spinal Cord Injuries/physiopathology , Urinary Tract Infections/prevention & control , Antibiotic Prophylaxis/methods , Bacteriuria/prevention & control , Bacteriuria/epidemiology , Urinary Tract Infections/epidemiology , Urodynamics , Brazil/epidemiology , Asymptomatic Infections , Middle Aged
7.
Gac. méd. Méx ; 155(2): 143-148, mar.-abr. 2019. tab
Article in English, Spanish | LILACS | ID: biblio-1286475

ABSTRACT

Resumen Introducción: Las sustancias relacionadas con los microorganismos involucrados en la enfermedad periodontal puedan llegar a la interfaz materno-fetal por vía hematógena y estimular la contractilidad uterina. Objetivo: Determinar la asociación entre enfermedad periodontal con nacimiento pretérmino. Método: Estudio de casos y controles de 343 embarazadas pretérmino y 686 de término. Se calculó la edad gestacional por fecha de último periodo menstrual y se confirmó con los métodos de Capurro y Ballard. La enfermedad periodontal se diagnosticó por la profundidad del espacio entre la raíz dental y la encía. La asociación fue medida con regresión logística. Resultados: La edad de las madres en los casos fue de 23.8 ± 6.7 años y en los controles de 23.2 ± 6.7 años. La enfermedad periodontal estuvo presente en 66.8 % de los casos y 40.5 % de los controles. Los factores asociados con nacimiento pretérmino fueron enfermedad periodontal (RM = 2.26), antecedente de nacimiento pretérmino (RM = 4.96), embarazo no planeado (RM = 2.15), control prenatal deficiente (RM = 2.53), infección de vías urinarias (RM = 2.22), preeclampsia (RM = 4.49), ruptura prematura de membranas amnióticas (RM = 2.59) y nacer por cesárea (RM = 9.15). Conclusión: La enfermedad periodontal en el embarazo constituyó un factor de riesgo independiente para nacimiento pretérmino.


Abstract Introduction: Substances related to microorganisms involved in periodontal disease can reach the maternal-fetal interface via the hematogenous route and stimulate uterine contractility. Objective: To determine the association between periodontal disease and preterm birth. Method: Case-control study in 343 preterm and 686 full-term pregnant women. Gestational age was calculated based on the date of the last menstrual period and confirmed with Capurro and Ballard methods. Periodontal disease was diagnosed according to the depth of the space between the tooth root and the gum. The association was measured with logistic regression. Results: Maternal age of the cases was 23.8 ± 6.7 years, and 23.2 ± 6.7 in the controls. Periodontal disease was present in 66.8% of cases and 40.5% of controls. The factors associated with preterm birth were periodontal disease (Odds ratio [OR] = 2.26), history of preterm birth (OR = 4.96), unplanned pregnancy (OR = 2.15) poor prenatal control (OR = 2.53), urinary tract infection (OR = 2.22), preeclampsia (OR = 4.49), premature rupture of membranes (OR = 2.59) and caesarean section delivery (OR = 9.15). Conclusion: Periodontal disease in pregnancy was an independent risk factor for preterm birth.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adolescent , Adult , Young Adult , Periodontal Diseases/complications , Pregnancy Complications/epidemiology , Premature Birth/epidemiology , Periodontal Diseases/epidemiology , Pre-Eclampsia/epidemiology , Urinary Tract Infections/complications , Urinary Tract Infections/epidemiology , Fetal Membranes, Premature Rupture/epidemiology , Case-Control Studies , Cesarean Section/statistics & numerical data , Risk Factors , Mexico
8.
Rev. bras. ter. intensiva ; 31(1): 47-56, jan.-mar. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1003621

ABSTRACT

RESUMEN Objetivo: Determinar en pacientes con sepsis admitidos en el servicio de urgencias la asociación entre el foco infeccioso principal y la mortalidad intrahospitalaria como desenlace principal o requerimiento de ingreso a unidad de cuidados intensivos como desenlace secundario. Métodos: Análisis secundario de cohorte prospectiva multicéntrica. Se incluyeron pacientes mayores de 18 años con diagnóstico de sepsis grave o choque séptico atendidos en las salas de urgencias de 3 hospitales de alta complejidad. De 5022 elegibles, se incluyeron 2510 participantes. Análisis de regresión logística múltiple para mortalidad. Resultados: El sitio de infección más frecuente fue tracto urinario, presente en el 27,8% de los casos, seguido de neumonía en el 27,5% y foco intraabdominal en el 10,8%. En el 5,4% de los casos no se identificó foco claro al ingreso. Mediante regresión logística se encontró asociación significativa entre los siguientes sitios de infección y mortalidad intrahospitalaria al tomar como referencia el grupo de infección urinaria: neumonía (OR 3,4; IC95%, 2,2 - 5,2; p < 0,001), piel y tejidos blandos (OR 2,6; IC95%, 1,4 - 5,0; p = 0,003), torrente sanguíneo (OR 2,0; IC95%, 1,1 - 3,6; p = 0,018), sin foco claro (OR 2,0; IC95%, 1,1 - 3,8; p = 0,028), e intraabdominal (OR 1,9; IC95%, 1,1 - 3,3; p = 0,024). Conclusiones: Existe una asociación significativa entre los diferentes sitios de infección y la mortalidad intrahospitalaria o requerimiento de unidad de cuidados intensivos en pacientes con sepsis o choque séptico, siendo la infección de vías urinarias la que confiere el menor riesgo, lo que se deberá tener en cuenta en los modelos pronósticos de estas condiciones.


ABSTRACT Objective: To determine the association between the primary site of infection and in-hospital mortality as the main outcome, or the need for admission to the intensive care unit as a secondary outcome, in patients with sepsis admitted to the emergency department. Methods: This was a secondary analysis of a multicenter prospective cohort. Patients included in the study were older than 18 years with a diagnosis of severe sepsis or septic shock who were admitted to the emergency departments of three tertiary care hospitals. Of the 5022 eligible participants, 2510 were included. Multiple logistic regression analysis was performed for mortality. Results: The most common site of infection was the urinary tract, present in 27.8% of the cases, followed by pneumonia (27.5%) and intra-abdominal focus (10.8%). In 5.4% of the cases, no definite site of infection was identified on admission. Logistic regression revealed a significant association between the following sites of infection and in-hospital mortality when using the urinary infection group as a reference: pneumonia (OR 3.4; 95%CI, 2.2 - 5.2; p < 0.001), skin and soft tissues (OR 2.6; 95%CI, 1.4 - 5.0; p = 0.003), bloodstream (OR 2.0; 95%CI, 1.1 - 3.6; p = 0.018), without specific focus (OR 2.0; 95%CI, 1.1 - 3.8; p = 0.028), and intra-abdominal focus (OR 1.9; 95%CI, 1.1 - 3.3; p = 0.024). Conclusions: There is a significant association between the different sites of infection and in-hospital mortality or the need for admission to an intensive care unit in patients with sepsis or septic shock. Urinary tract infection shows the lowest risk, which should be considered in prognostic models of these conditions.


Subject(s)
Humans , Male , Female , Adult , Aged , Shock, Septic/epidemiology , Hospital Mortality , Sepsis/epidemiology , Emergency Service, Hospital , Pneumonia/complications , Pneumonia/epidemiology , Prognosis , Shock, Septic/metabolism , Urinary Tract Infections/complications , Urinary Tract Infections/epidemiology , Prospective Studies , Cohort Studies , Colombia , Sepsis/mortality , Tertiary Care Centers , Intensive Care Units , Middle Aged
9.
Mem. Inst. Invest. Cienc. Salud (Impr.) ; 16(3): 44-50, dic. 2018. ilus, tab
Article in Spanish | LILACS, BDNPAR | ID: biblio-1007742

ABSTRACT

Las infecciones del tracto urinario (ITU) en niños con vejiga neurogénica, pueden producir alteraciones tanto morfológicas como funcionales, y desencadenan una respuesta inmune que no siempre es evidente. Las ITU son una de las principales causas de morbilidad y mortalidad. Resulta de suma importancia un correcto diagnóstico de las mismas, para un buen tratamiento y así evitar las complicaciones y secuelas que puedan ocasionar. El objeto del trabajo fue analizar la prevalencia y la etiología de las ITU en pacientes con vejiga neurogénica, y su patrón de resistencia. En un estudio descriptivo, retrospectivo se incluyeron 46 muestras de orina para cultivo de niños de 1 a 18 años, de ambos sexos, con vejiga neurogénica, que fueron procesadas en un laboratorio de microbiología. De 46 urocultivos, 19 correspondieron a varones (19/46) 41% y 27 a niñas (27/46) 59%, los niños tenían una edad promedio de 11(2. De estos 21 resultaron positivos (21/46) 46%, aislando en mayor proporción E. coli. La frecuencia de ITU en niños con vejiga neurogénica fue de 21/46, 46%, siendo el porcentaje en este tipo de pacientes mucho más elevado que en niños que no presentan dicha anomalía. Los uropatógenos aislados con mayor frecuencia fueron E coli y K pneumoniae. El uso de sondas y pañales, así como la mala higiene predisponen a estas infecciones. En este estudio se vio buena sensibilidad a la nitrofurantoina y cefixima(AU)


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Urinary Tract Infections/microbiology , Urinary Bladder, Neurogenic/microbiology , Drug Resistance, Bacterial , Enterobacteriaceae/drug effects , Anti-Bacterial Agents/therapeutic use , Urinary Tract Infections/drug therapy , Urinary Tract Infections/epidemiology , Urinary Bladder, Neurogenic/drug therapy , Microbial Sensitivity Tests , Prevalence , Retrospective Studies , Risk Factors , Disabled Children
11.
Arch. argent. pediatr ; 116(4): 542-547, ago. 2018. ilus, tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-950047

ABSTRACT

Introducción. El objetivo del estudio fue investigar la relación entre reflujo vesicoureteral (RVU) y daño renal en pacientes con infección urinaria (IU) sin fiebre, primera IU febril e IU recurrente. El objetivo secundario, determinar si la proteína C-reactiva (PCR) actuaría como predictor de nefroesclerosis en las IU febriles. Población y métodos. Estudio prospectivo; pacientes pediátricos con IU sin fiebre, primera IU febril e IU recurrente. Los análisis de laboratorio de rutina incluyeron hemograma completo, urea, creatinina, análisis de orina completamente automatizado, urocultivo y PCR. Se realizó ecografía urológica luego del diagnóstico de IU, cistouretrografía miccional tras seis semanas y gammagrafía renal estática con ácido dimercaptosuccínico marcado con 99mTc tras seis meses a todos los participantes. Resultados. Participaron 47 niños con IU sin fiebre, 48 con primera IU febril y 61 con IU recurrente. Hubo una diferencia estadísticamente significativa entre los grupos respecto de RVU y nefroesclerosis (p= 0,001 y p= 0,011, respectivamente). También hubo una diferencia estadísticamente significativa respecto de nefroesclerosis entre los pacientes con y sin RVU (p= 0,001). Además, se estableció una diferencia estadísticamente significativa respecto de nefroesclerosis (p < 0,05) en los pacientes con PCR cinco veces mayor o menor que el valor de corte aceptado (5 mg/dl). Conclusión. La proporción de nefroesclerosis fue paralela a la frecuencia de RVU. Cuanto mayor era el grado de RVU, mayor era el daño renal. Se determinó una correlación positiva entre PCR elevada y nefroesclerosis, lo que señala esclerosis durante el diagnóstico de pielonefritis.


Introduction. The aim was to investigate the relationship between vesicoureteral reflux (VUR) and renal damage in non-febrile, febrile for the first time and recurrent urinary tract infection (UTI) patients. The secondary aim was to determine whether C-reactive protein (CRP) in febrile UTIs could be a predictor of renal scarring. Population and methods. This prospective study included non-febrile, febrile for the first time and recurrent pediatric UTI cases. The routine lab analyses comprised a complete blood count, urea, creatinine, fully automated urinalysis, urine culture and CRP analyses. All the participants were examined using urine ultrasonography subsequent to their UTI diagnosis, voiding cystourethrography (VCUG) after six weeks and Tc-99m dimercaptosuccinic acid (DMSA) static renal scintigraphy after six months. Results. There were included 47 children with non-febrile UTIs, 48 with first febrile UTIs and 61 with recurrent UTIs. A statistically significant difference was found among the groups in terms of VUR and renal scarring (p= 0.001 and p= 0.011, respectively). A statistically significant difference was also found in terms of renal scarring between patients with and without VUR (p= 0.001). Moreover, a statistically significant difference was also present in relation to renal scarring (p <0.05) in patients with five-fold lower or higher CRP values than the accepted cut-off value (5mg/dl). Conclusion. The ratio of renal scars detected was found to be parallel to the VUR frequency. The higher the VUR grade, the more renal damage was found. A positive correlation between elevated CRP and renal scarring was determined, indicating the presence of scarring during the diagnosis of pyelonephritis.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Urinary Tract Infections/complications , Vesico-Ureteral Reflux/epidemiology , Cicatrix/epidemiology , Kidney/pathology , Pyelonephritis/complications , Pyelonephritis/diagnosis , Recurrence , Urinary Tract Infections/epidemiology , Vesico-Ureteral Reflux/etiology , C-Reactive Protein/metabolism , Prospective Studies , Ultrasonography/methods , Cicatrix/etiology , Technetium Tc 99m Dimercaptosuccinic Acid/administration & dosage , Fever/etiology , Fever/epidemiology , Kidney/diagnostic imaging
13.
Arch. argent. pediatr ; 116(2): 126-132, abr. 2018. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-887458

ABSTRACT

Introducción. En los estudios realizados se encontró que la duración de la lactancia tiene un efecto reductor sobre las infecciones frecuentes en los niños durante el período de lactancia. Objetivo. El objetivo de este estudio fue abordar la asociación entre la duración de la lactancia y las enfermedades infecciosas frecuentes en los niños hasta los 5 años de edad para demostrar los efectos protectores de la leche materna. Población y métodos. Se incluyeron 411 lactantes nacidos en Rize, Turquía, entre enero de 2011 y diciembre de 2011. Este estudio de cohorte, prospectivo duró cinco años; en este período, se realizaron 11 entrevistas con cada madre de los lactantes. Se dividió a los lactantes en dos grupos: amamantados durante más y menos de 12 meses, y se estudió la asociación entre la lactancia y las infecciones, como otitis media aguda, gastroenteritis aguda, infección respiratoria aguda e infección urinaria. Resultados. De los 411 nacimientos, se incluyeron 270 lactantes, 193 (71,5%) recibieron lactancia durante más de 12 meses y 77 (28,5%), durante menos de 12 meses. Los lactantes del primer grupo tuvieron menos casos de otitis media aguda y gastroenteritis aguda (n = 77; 28,52%) en comparación con los lactantes amamantados durante menos de 12 meses en el período de cinco años (p < 0,05). Conclusiones. Con este estudio se detectó que la lactancia durante más de 12 meses reduce significativamente las infecciones frecuentes durante la niñez, como la otitis media y la gastroenteritis durante los primeros cinco años de vida.


Introduction.The studies conducted revealed that breastfeeding duration has a reducing effect on common infectious diseases in the children during breastfeeding period. Objective. The aim of the present study was to address the association between breastfeeding duration and common infectious diseases in the children until 5 years of age to show long-term protective effects of the breast milk. Material and methods. The study included 411 infants who were born in Rize (Turkey) between January 2011 and December 2011. The present prospective-cohort study lasted for 5 years and 11 interviews were conducted with each mother of the infants during this period. The infants were divided into two groups as those who were breastfed more and less than 12 months and the association between breastfeeding and infections such as acute otitis media, acute gastroenteritis, acute respiratory tract infections and acute urinary system infections was investigated. Results. Of 270 infants 193 (71.5%) were breastfed longer than 12 months and 77 (28.5%) were breastfed less than 12 months. Infants in the first group had less acute otitis media and acute gastroenteritis (n= 77, 28.52%) when compared with the infants breastfed less than 12 months during 5-year period (p <0.05). Conclusion. The present study detected that breastfeeding duration longer than 12 months significantly reduces the common childhood infections such as otitis media and gastroenteritis during the first 5 years of life.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Otitis Media/prevention & control , Respiratory Tract Infections/prevention & control , Urinary Tract Infections/prevention & control , Breast Feeding , Gastroenteritis/prevention & control , Otitis Media/etiology , Otitis Media/epidemiology , Respiratory Tract Infections/etiology , Respiratory Tract Infections/epidemiology , Time Factors , Turkey , Urinary Tract Infections/etiology , Urinary Tract Infections/epidemiology , Prospective Studies , Follow-Up Studies , Protective Factors , Gastroenteritis/etiology , Gastroenteritis/epidemiology
14.
Coronel Oviedo; s.n; 5 ed; Dic. 2018. 51 p.
Thesis in Spanish | LILACS, BDNPAR | ID: biblio-999854

ABSTRACT

Introducción: Se considera restricción de crecimiento intrauterino al crecimiento fetal menor que el esperado para la edad gestacional. Asociado con un aumento de 6-10 veces de riesgo de muerte perinatal. Cada año nacen en el mundo más de 20 millones de niños con peso inferior a 2.500 gramos; de ellos, más del 96 % en países en desarrollo, lo cual demuestra que esta situación se asocia a condiciones socioeconómicas de pobreza. La prevalencia en Latinoamérica oscila entre el 10 a 17% de los nacidos vivos. Objetivo: Caracterizar a las embarazadas con restricción del crecimiento intrauterino en el Servicio de Ginecología y Obstetricia del Hospital Central del Instituto de Previsión Social, del año 2017. Materiales y métodos: Estudio observacional descriptivo de corte transversal. Fueron incluidas todas las embarazadas con restricción de crecimiento intrauterino que acudieron al Servicio de Ginecología y Obstetricia del Hospital Central de Instituto de Previsión Social del año 2017. Resultados: Fueron 42 embarazadas con restricción de crecimiento intrauterino. Con rango etario de 20 a 42 años, la mediana de 28 años, el 54,76% casadas, el 84,10% proceden del área urbana, y el 52,38% con estudio superior, la mitad eran multigestas, nulíparas sin antecedentes de aborto previo, el 59,62% realizaron más de 5 controles prenatales. El antecedente patológico materno más frecuente fue anemia en el 66,67%. En su mayoría con un índice de masa corporal normal, y moderada ganancia de peso materno durante el embarazo. El 81,25% son de tipo asimétrico, con diámetro biparietal y circunferencia abdominal disminuidos. Conclusión: Este estudio realizado en un centro de referencia nacional de cuarto nivel, similar a resultados de trabajos anteriores, aporta datos actuales sobre las características de las embarazadas con restricción de crecimiento intrauterino.


Subject(s)
Humans , Female , Pregnancy , Adult , Young Adult , Fetal Growth Retardation/epidemiology , Paraguay/epidemiology , Parity , Pre-Eclampsia/epidemiology , Prenatal Care , Socioeconomic Factors , Urinary Tract Infections/epidemiology , Body Weight , Body Mass Index , Nutritional Status , Cross-Sectional Studies , Risk Factors , Ultrasonography, Prenatal , Gestational Age , Diabetes, Gestational/epidemiology , Marital Status , Age Distribution , Substance-Related Disorders/epidemiology , Educational Status , Fetal Growth Retardation/classification , Fetal Growth Retardation/diagnostic imaging , Anemia/epidemiology
15.
Rev. bras. enferm ; 70(4): 838-844, Jul.-Aug. 2017. tab
Article in English | LILACS, BDENF | ID: biblio-898180

ABSTRACT

ABSTRACT Objective: To evaluate epidemiological aspects of urinary tract infection in older patients with urinary incontinence living in long-term care institutions in Belo Horizonte. Method: Concurrent cohort held from April 1st to October 1st, 2015. The study was conducted in two long-term care institutions in the city of Belo Horizonte, Minas Gerais, with 84 incontinent older people. Results: Cumulative incidence of urinary tract infection was 19% (95% CI: 7.83-23.19) and the incidence density was 3.6 cases/100 people-month of follow-up period. The variables Bacteriuria and Institution presented statistical association with the occurrence of urinary tract infection. Conclusion: It is observed that the incidence of urinary tract infection in the study was smaller than in other similar international and national studies, however this is an important world health problem for the older population, with impact on mortality of these individuals.


RESUMEN Objetivo: Analizar los aspectos epidemiológicos de infección del tracto urinario en ancianos con incontinencia urinaria, en residencias para ancianos de Belo Horizonte, Brasil. Método: Se realizó una cohorte del 1º de abril al 1º de octubre de 2015. Se realizó el estudio en dos residencias para ancianos de la ciudad de Belo Horizonte, del cual participaron 84 ancianos con incontinencia urinaria. Resultados: La incidencia acumulada de infección en el tracto urinario fue del 19% (IC 95%: 7,83-23,19) y la densidad de la incidencia fue de 3,6 casos/100 personas-mes por seguimiento. Las variables Bacteriuria y la residencia presentaron asociación estadística en la aparición de este tipo de infección. Conclusión: A pesar de que la incidencia de infección del tracto urinario en este estudio fue menor que en otros estudios nacionales e internacionales de mismo tema, es un grave problema de salud para los ancianos por todo el mundo, puesto que implica la mortalidad de ellos.


RESUMO Objetivo: Avaliar aspectos epidemiológicos da infecção do trato urinário em pacientes idosos com incontinência urinária, residentes em instituições de longa permanência, de Belo Horizonte. Método: Coorte concorrente realizada no período de 01 de abril a 01 de outubro de 2015. O estudo foi realizado em duas instituições de longa permanência, na cidade de Belo Horizonte, MG, com 84 idosos incontinentes. Resultados: A incidência acumulada de infecção do trato urinário foi de 19% (IC 95%: 7,83-23,19) e a densidade de incidência foi de 3,6 casos/100 pessoas-mês de seguimento. As variáveis Bacteriúria e Instituição apresentaram associação estatística com a ocorrência de infecção do trato urinário. Conclusão: Observa-se que a incidência de infecção do trato urinário no estudo foi menor que em outros estudos nacionais e internacionais semelhantes, no entanto trata-se de um importante problema de saúde mundial para os idosos, com impacto na mortalidade desses indivíduos.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Urinary Incontinence/epidemiology , Urinary Tract Infections/epidemiology , Brazil/epidemiology , Comorbidity , Incidence , Cohort Studies , Insurance, Long-Term Care/statistics & numerical data , Middle Aged
16.
Rev. méd. Maule ; 33(1): 14-20, jun. 2017. tab
Article in Spanish | LILACS | ID: biblio-1283792

ABSTRACT

Urinary tract infection associated to permanent catheterization is the most frequent infection associated to health care. Antibiotic resistance is an increasing problem, thus it is important to know the local pathogenic agents, their resistance and sensibility profiles to use an optimal treatment. OBJECTIVES: Describe the resistance and sensibility profiles in the most frequent microorganisms in urinary tract infections associated to permanent catheterization at the Internal Medicine Service of Hospital Regional de Talca. METHODS: We studied the antibiotic resistance and sensitivity of each microorganism isolated from urinary samples from patients with the antecedent of permanent urinary catheterization at the Internal Medicine Service of Hospital Regional de Talca since January 2013 to December 2016, according to the records at the Cross Infection Unit of this center. OUTCOMES: We collected 69 cases, there were 14 of them with two agents. The highest incidence of urinary tract infections associated to permanent urinary catheterization was at 2014, while the lowest at 2015. The most frequent agents detected were K. pneumoniae (34%), E. coli (20%), P. aeruginosa (20%) and A. baumannii (5%), holding a similar tendency in each year. We found 23 strains of Enterobacteriaceae producing Extended-spectrum ß- Lactamases. In general we found that Carbapenems and Amikacin had the best sensitivity while Nitrofurantoin and Ciprofloxacin had the highest resistance


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Bacterial Infections/epidemiology , Urinary Tract Infections/microbiology , Urinary Tract Infections/epidemiology , Community-Acquired Infections/epidemiology , Catheter-Related Infections/microbiology , Catheter-Related Infections/epidemiology , Bacterial Infections/microbiology , Drug Resistance, Microbial , Community-Acquired Infections/microbiology , Methicillin-Resistant Staphylococcus aureus/isolation & purification
17.
Säo Paulo med. j ; 135(3): 270-276, May-June 2017. tab
Article in English | LILACS | ID: biblio-1043426

ABSTRACT

ABSTRACT CONTEXT AND OBJECTIVE: Hospitalizations due to primary care-sensitive conditions constitute an important indicator for monitoring the quality of primary healthcare. This study aimed to describe hospitalizations due to primary care-sensitive conditions found among children under five years of age (according to their age and sex), in two cities in Paraíba, Brazil. DESIGN AND SETTING: Cross-sectional study carried out in the municipalities of Cabedelo and Bayeux, in Paraíba, Brazil. METHODS: Data were collected from four public pediatric hospitals in Paraíba that receive children from these municipalities. Hospital admission authorizations were consulted to gather information on the children's profile and the characteristics of their hospitalizations. Differences in the causes of admissions and the respective lengths of hospital stay length were analyzed according to age group and sex. RESULTS: The proportion of hospital admissions due to primary care-sensitive conditions was 82.4%. The most frequent causes were: bacterial pneumonia (59.38%), infectious gastroenteritis and its complications (23.59%) and kidney and urinary tract infection (9.67%). Boys had higher frequency of hospitalizations due to primary care-sensitive conditions than girls. The median hospitalization due to primary care-sensitive conditions was found to be four days. The duration of hospital stays due to primary care-sensitive conditions was significantly longer than those due to conditions that were not sensitive to primary care. CONCLUSIONS: High rates of hospital admissions due to primary care-sensitive conditions were highlighted, especially among children of male sex, with long periods of hospitalization.


RESUMO CONTEXTO E OBJETIVO: As internações por condições sensíveis à atenção primária constituem importante indicador para o monitoramento da qualidade da atenção primária à saúde. O presente estudo objetivou descrever as internações por condições sensíveis à atenção primária em crianças menores de cinco anos (por idade e sexo) em duas cidades da Paraíba. TIPO DE ESTUDO E LOCAL: Estudo transversal realizado nos municípios de Cabedelo e Bayeux, ­Paraíba, Brasil. MÉTODOS: Coletaram-se os dados nos quatro hospitais públicos pediátricos da Paraíba que internam crianças residentes nos municípios estudados. A partir das autorizações de internação hospitalar, colheram-se informações relativas ao perfil da criança e características das internações. Analisaram-se as diferenças nas causas de internações e respectivos tempos de hospitalização segundo faixa etária e sexo. RESULTADOS: A proporção de internação por condição sensível à atenção primária foi de 82,4%. As causas mais frequentes foram: pneumonias bacterianas (59,38%), gastroenterites infecciosas e suas complicações (23,59%) e infecção do rim e trato urinário (9,67%). Meninos apresentaram maior frequência de internações por condições sensíveis à atenção primária do que meninas. Verificou-se mediana de quatro dias de hospitalização para as condições sensíveis à atenção primária. O tempo de hospitalização por condição sensível à atenção primária foi significantemente maior do que o tempo da condição não sensível à atenção primária. CONCLUSÕES: Ressaltam-se altas taxas de internações por condições sensíveis à atenção primária, principalmente em crianças do sexo masculino, com longos períodos de hospitalização.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Patient Admission/statistics & numerical data , Primary Health Care/statistics & numerical data , Length of Stay/statistics & numerical data , Quality of Health Care , Socioeconomic Factors , Time Factors , Urinary Tract Infections/therapy , Urinary Tract Infections/epidemiology , Brazil/epidemiology , Sex Factors , Cross-Sectional Studies , Age Factors , Sex Distribution , Age Distribution , Statistics, Nonparametric , Pneumonia, Bacterial/therapy , Pneumonia, Bacterial/epidemiology , Gastroenteritis/therapy , Gastroenteritis/epidemiology
18.
J. pediatr. (Rio J.) ; 93(3): 260-266, May.-June 2017. tab, graf
Article in English | LILACS | ID: biblio-841345

ABSTRACT

Abstract Objective: Urinary tract infection (UTI) caused by resistant strains of bacteria is increasingly prevalent in children. The aim of this study was to investigate the clinical characteristics and risk factors for UTI caused by community-acquired extended-spectrum β-lactamase (CA-ESBL)-producing bacteria in infants. Methods: This was a retrospective study performed over 5 years in a single Korean center. Hospitalized infants with febrile UTI were enrolled and divided into two groups (CA-ESBL vs. CA non-ESBL UTI). The yearly prevalence was calculated. Baseline characteristics and clinical course such as fever duration, laboratory and radiological findings were compared between the two groups. Risk factors associated with the CA-ESBL UTI were investigated. Results: Among the enrolled infants (n = 185), 31 (17%) had CA-ESBL UTI. The yearly prevalence of ESBL of CA-ESBL UTI increased during the study (0% in 2010, 22.2% in 2015). Infants with CA-ESBL UTI had a longer duration of fever after initiating antibiotics (2.0 ± 1.1 vs. 1.5 ± 0.6 days, p = 0.020). Cortical defects on renal scan and early treatment failure were more frequent in CA-ESBL (64.5 vs. 42.2%, p = 0.023; 22.6 vs. 4.5%, p = 0.001). A logistic regression analysis revealed that urinary tract abnormalities and previous UTI were independent risk factors for CA-EBSL UTI (odds ratio, 2.7; p = 0.025; 10.3; p = 0.022). Conclusion: The incidence of UTI caused by ESBL-producing bacteria has increased in Korean infants. Recognition of the clinical course and risk factors for ESLB-producing UTI may help to determine appropriate guidelines for its management.


Resumo Objetivo: A infecção do trato urinário (ITU) causada por cepas de bactérias resistentes está cada vez mais prevalente em crianças. O objetivo deste estudo foi investigar as características clínicas e os fatores de risco de ITU causada por bactérias produtoras de β-lactamases de espectro ampliado adquiridas na comunidade (ESBL CA) em neonatos. Métodos: Estudo retrospectivo feito por mais de cinco anos em um único centro sul-coreano. Neonatos internados com ITU febril foram inscritos e divididos em dois grupos (ITU por ESBL CA em comparação com não ESBL CA). A prevalência anual foi calculada. As características básicas e o curso clínico, como duração da febre e achados laboratoriais e radiológicos, foram comparados entre os dois grupos. Os fatores de risco associados à ITU por ESBL CA foram investigados. Resultados: Entre os neonatos inscritos (n = 185), 31 (17%) apresentaram ITU por ESBL CA. A prevalência anual de ESBL em ITU por ESBL CA aumentou durante o estudo (0% em 2010, 22,2% em 2015). Os neonatos com ITU por ESBL CA apresentaram maior duração de febre após o início dos antibióticos (2 ± 1,1 em comparação com 1,5 ± 0,6 dias, p = 0,020). Os defeitos corticais no exame renal e a falha precoce no tratamento foram mais frequentes em ESBL CA (64,5 em comparação com 42,2%, p = 0,023; 22,6 em comparação com 4,5%, p = 0,001). Uma análise de regressão logística revelou que as anomalias do trato urinário e a ITU anterior eram fatores de risco independentes de ITU por ESBL CA (razão de chance: 2,7; p = 0,025; 10,3; p = 0,022). Conclusão: A incidência de ITU causada por bactérias produtoras de ESBL aumentou em neonatos sul-coreanos. O reconhecimento do curso clínico e dos fatores de risco de ITU por ESBL poderá ajudar a determinar as diretrizes adequadas de manejo.


Subject(s)
Humans , Male , Female , Child, Preschool , Urinary Tract Infections/microbiology , Urinary Tract Infections/drug therapy , Urinary Tract Infections/epidemiology , beta-Lactamases/biosynthesis , Drug Resistance , Epidemiologic Methods , Community-Acquired Infections/microbiology , Community-Acquired Infections/epidemiology , Escherichia coli , Republic of Korea/epidemiology , Klebsiella , Anti-Bacterial Agents/classification , Anti-Bacterial Agents/therapeutic use
19.
Egyptian Journal of Hospital Medicine [The]. 2017; 67 (2): 692-696
in English | IMEMR | ID: emr-188457

ABSTRACT

Background: Hyperbilirubinemia is one of the presenting signs of bacterial infection in newborns, and the association of neonatal jaundice with urinary tract infection [UTI] has been particularly emphasized. The aim of this study was to determine the prevalence of UTI in asymptomatic jaundiced neonates younger than 4 weeks old


Method: A cross sectional survey has been conducted at Newborn Unit of Maternity and Pediatrics Hospital - Abha from January 2016 to August 2016. A total of 15 patients have been included in the study, who were diagnosed with hyperbilirubinemia due to urinary tract infection [UTI] after exclusion of unrelated criteria


Conclusion: It could be concluded that UTI should be routinely investigated in early [<10 days] idiopathic neonatal jaundice in which all other etiologic factors of neonatal hyperbilirubinemia are ruled out, and the presence of UTI should be considered in case of a poor phototherapy response in cases receiving phototherapy


Subject(s)
Humans , Female , Male , Infant, Newborn , Urinary Tract Infections/epidemiology , Infant, Newborn , Hyperbilirubinemia , Risk Factors , Phototherapy , Surveys and Questionnaires , Cross-Sectional Studies
20.
Salud pública Méx ; 58(4): 446-452, jul.-ago. 2016. tab, graf
Article in Spanish | LILACS | ID: lil-795411

ABSTRACT

Resumen: Objetivo: Describir los patrones de resistencia bacteriana en cultivos de orina de pacientes de un hospital oncológico en la Ciudad de México, de 2004 a 2013. Material y métodos: Se obtuvo el porcentaje de susceptibilidad para diferentes antibióticos, describiendo por separado las bacterias multidrogorresistentes (MDR). Se analizaron por separado las cepas obtenidas de pacientes hospitalizados de las de la comunidad. Resultados: Se realizaron 51 202 cultivos, de los cuales se identificaron 14 480 bacterias (28.3%). De éstas, se reportaron 11 427 Gram negativos (78.9%); 2 080 Gram positivos (14.4%); y 973 (6.6%) levaduras. Escherichia coli fue el principal microorganismo aislado (56.1%); 24% de las cepas de la comunidad y 66% de las nosocomiales fueron productoras de beta-lactamasas de espectro extendido (BLEE). Klebsiella pneumoniae se identificó en 705 cultivos (4.8%), 115 de los cuales fueron BLEE (16%): 13.1% de la comunidad y 29.8% nosocomiales. Pseudomonas aeruginosa se identificó en 593 cultivos (4.1%): 9% de la comunidad y 51% nosocomiales. Conclusiones: Las cepas MDR son mucho más frecuentes en muestras de origen nosocomial. Es prioritario intensificar el uso racional de antibióticos en la comunidad y el programa de desescalamiento de antimicrobianos en el hospital.


Abstract: Objective: To describe the incidence and patterns of bacterial resistance in urine samples from a tertiary care oncology hospital in Mexico, from 2004 to 2013. Materials and methods: We included the strains obtained from urine cultures, describing separately multidrug-resistant (MDR) bacteria. We analyzed the susceptibility to different antibiotics. Results: 51 202 urine cultures were processed during the study; 14 480 (28.3%) cultures were positive. In 11 427 samples Gram negative (79%) were isolated, 2 080 Gram positive (14.4%), and 973 yeasts (6.6%). Escherichia coli was the most frequent bacteria identified (56.1%); 24% of the community strains and 65.7% of the nosocomial were extended-spectrum beta-lactamase producers (ESBL). Klebsiella pneumoniae was isolated in 705 samples (4.8%); 115 were ESBL (16%), 13.1% from community and 29.8% from nosocomial source. Pseudomonas aeruginosa was identified in 593 cultures (4.1%): 9% from community and 51% nosocomial. Conclusions: MDR bacteria were more frequent in nosocomial isolates. It should be a priority to intensify the rational use of antimicrobials in the community and antibiotic stewardship in the hospital.


Subject(s)
Humans , Adult , Bacteriuria/microbiology , Urinary Tract Infections/microbiology , Urine/microbiology , Drug Resistance, Multiple, Bacterial , Neoplasms/epidemiology , Bacteriuria/epidemiology , Urinary Tract Infections/drug therapy , Urinary Tract Infections/epidemiology , Cancer Care Facilities , Candidiasis/drug therapy , Comorbidity , Cross Infection/drug therapy , Follow-Up Studies , Community-Acquired Infections/microbiology , Community-Acquired Infections/drug therapy , Tertiary Care Centers , Anti-Bacterial Agents/therapeutic use
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