Methicillin-resistant Staphylococcus aureus in HIV patients: Risk factors associated with colonization and/or infection and methods for characterization of isolates - a systematic review

Staphylococcus aureus is an important cause of infections and HIV-infected individuals are frequently susceptible to this pathogen. The aim of this study was to perform a systematic review to identify both the risk factors associated with colonization/infection by methicillin-resistant S. aureus in HIV patients and the methods used for characterization of isolates. An electronic search of articles published between January 2001 and December 2013 was first conducted. Among 116 studies categorized as being at a quality level of A, B or C, only 9 studies were considered to have high methodological quality (level A). The majority of these studies were retrospective (4/9 studies). The risk factors associated with colonization/infection by S. aureus were use of antimicrobials (4/9 studies), previous hospitalization (4/9 studies) and low CD4+ T lymphocyte counts (<200 cells/μl) (3/9 studies). Culture in mannitol salt agar (3/9 studies) and the latex agglutination test (5/9 studies) were the main methods used for bacterial phenotypic identification. Genotypic profiles were accessed by pulsed-field gel electrophoresis (6/9 studies) and USA300 was the most prevalent lineage (5/9 studies). Most isolates were resistant to erythromycin (3/9 studies) and susceptible to vancomycin (4/9 studies). Ultimately, use of antimicrobials and previous hospitalization were the main risk factors for colonization/infection by methicillin-resistant S. aureus in HIV-infected individuals. However, the numbers of evaluated patients, the exclusion and inclusion criteria and the characterization of the S. aureus isolates were not uniform, which made it difficult to establish the characteristics associated with HIV patients who are colonized/infected by S. aureus.

A promoção do brincar no contexto da hospitalização infantil como ação de enfermagem: relato de experiência / Promoting games and playing in child hospitalization as a nursing action: experience account

Trata-se de um relato de experiência de atividade realizada com alunos de graduação em Enfermagem, no período de setembro a dezembro de 2006, durante o estágiocurricular. O objetivo foi discorrer sobre mudanças implantadas em uma unidade de cirurgia pediátrica de um hospital universitário. Percebeu-se a necessidade de realizar algumas modificações no ambiente físico, afim de que as crianças pudessem passar pela internação com menos sofrimento, diminuindo os riscos de traumas decorrentes da hospitalização. Para isso dez salas da unidade foram remodeladas. Figuras adesivas e laváveis foram afixadas em vários locais, caixas foram encapadas, um painel colorido foi elaborado na parede de uma sala de procedimentos. No refeitório, estabeleceu-se a brinquedoteca. Nos intervalos das refeições, a sala transforma-se em uma brinquedoteca capaz de atender as crianças da unidade. O ambiente ficou mais colorido e alegre, colocando vida em paredes e objetos que fazem parte da rotina diária da criança hospitalizada