Bacteremia possibly caused by Curtobacterium spp found in a blood culture from a central venous line of a pediatric leukemia patient who underwent bone marrow transplantation: [letter to editor] / Bacteremia possivelmente causada por Curtobacterium spp encontrado na cultura do sangue de um cateter venoso num paciente pediátrico submetido a transplante de medula óssea: [carta ao editor]

Microbiologistas clínicos devem estar atentos à possibilidade debacteremia relacionada com cateter causada por infecçãodifteróide, como possivelmente foi o caso neste relato, no qual um menino de dois anos, portador de um cateter venoso central paratratamento de leucemia, apresentou pneumonia. A cultura dosangue obtido no cateter revelou Curtobacterium spp.

Avaliação de quatro kits comerciais para detecção rápida de antígenos de Rotavírus em amostras de fezes / Four kits evaluation for Rotavirus rapid antigen detection in stool samples

O Rotavírus é um dos principais agentes causadores de diarréia, sendo desejável o diagnóstico laboratorial de maior rapidez e acurácia para evitar a complicação por essa infecção. Nesse estudo, foram comparados os resultados obtidos por 4 diferentes kits comerciais para pesquisa de antígenos de rotavírus em 42 amostras de fezes: dois kits com metodologia de aglutinação em látexe dois kits de detecção combinada de Rotavírus e Adenovírus por imunocromatografia. A concordância entre os kits testados foi de 88%, sendo 16 amostras positivas e 21 negativas em todos os testes. Nas cinco amostras com resultados discordantes apenas um kit obteve resultado diferente dos demais, sendo estes, repetidos por outro executor. Essa repetição demonstrou interpretação diferenteem duas amostras por um dos testes de aglutinação de látex. As taxas de detecção pelos kits imunocormatográficos foi de 66% (18/42) e para os kits de aglutinação de látex foi de 38-40% (16 e 17/42). Os kits imunocromatográficos demonstraram total concordância coma maioria dos demais kits testados. Conclui-se que, apesar da boa concordância entre os kits avaliados, algumas metodologias podem apresentar problemas na aplicação prática, principalmente com a interpretação da aglutinação de látex.

A total of 42 stool specimens were tested for the presence of antigen rotavirus by two distinct enzyme immunoassays (EIA) and two latex agglutination tests (LAT). Overall concordance was 88%, with 16 positive and 21 negative results by all tests. Discordant results occurred when one test differed from the others and was repeated by other technician. These procedures change the interpretation of latex agglutination. Detection rate for two immunocromatographic tests were 66% (18/42) and two latex agglutination tests were 40% and 38% (17 and 16/42). The results show that each of the commercial assays evaluated could accurately detect rotavirus in the stools specimens. Comparative results demonstrate that sensitivity of latex agglutination tests was lower than immunocromatographic tests. In conclusion, those rapid tests could be detect differently antigen rotavirus, the latex agglutination methodology could be difficult interpretation and immunochromatographic technique do not require specialized equipment, showed higher sensitivity and was rapid and easy to perform in the routine clinical laboratory.

Risk factors for nosocomial bloodstream infection caused by multidrug resistant gram-negative bacilli in pediatrics

The aim of this study was to identify the risk factors for nosocomial bloodstream infections by multidrug resistant Gram-negative bacilli. From November 2001 to December 2003, in the Pediatric Department of the Santa Casa de São Paulo, a retrospective case-control study was developed concerning patients who had nosocomial bloodstream infection caused by Gram-negative bacilli. Patients with multidrug resistant infections were designated as case patients, and control patients were those with an infection that did not meet the criteria for multidrug resistance. Previous use of central venous catheter and previous use of vancomycin plus third generation cephalosporins were associated to a higher chance of infections by multidrug resistant Gram-negative bacilli (Odds ratio - 5.8 and 5.2, respectively). Regarding sensitivity of the isolated agents, 47.8 percent were multidrug resistant, 54.2 percent were Klebsiella spp. ESBL producers and 36.4 percent were imipenem resistant Pseudomonas aeruginosa. The lethality rate was 36.9 percent in the studied cases and this rate was significantly higher in the group of patients with multidrug resistant infections (p=0.013). Risk factor identification as well as the knowledge of the susceptibility of the nosocomial infectious agents gave us the possibility to perform preventive and control strategies to reduce the costs and mortality related to these infections.

Métodos bacteriológicos de triagem em infecçöes do trato urinário na infäncia e adolescência / Bacteriological methods for screening urinary tract infections during chilhood and adolescence

A cultura quantitativa da urina é considerada o exame laboratorial "padräo-ouro" para o diagnóstico da infecçäo no trato urinário (ITU). O objetivo deste trabalho foi avaliar: a correlaçäo da urocultura quantitativa realizada por métodos clássicos com o uso do laminocultivo; o desempenho dos métodos de triagem em relaçäo à cultura; e a evidência de indicaçäo de algum dos métodos de triagem citados anteriormente, para diagnóstico de ITU.(au)

High frequency of colonization and absence of identifiable risk factors for methicillin-resistant Staphylococcus aures (MRSA) in Intensive Care Units in Brazil

Colonization of hospitalized patients with methicillin-resistant Staphylococcus aureus (MRSA) is of increasing concern. To evaluate this problem in Intensive Care Units (ICUs) in Brazil, we studied 100 patients admitted to two ICUs from april to june, 1997. Of the 100 patients, 70 were male, 53 were age 60 years or older, 55 were previously hospitalized, 78 were transferred to the ICU from other hospital units, 49 had received antibiotic therapy, and 66 had undergone recent surgery. Nasal and axillary swab cultures were obtained on admission and every 48 hours thereafter until discharge. MRSA were identified by plating any cultured S. aureus on Mueller-Hinton agar containing 6µg/ml of oxacillin. At the time of admission, 46 (46 percent) of the patients were colonized with MRSA. No associated risk factors for acquiring MRSA (age, previous hospitalization, prior surgery) could be identified. Of the 54 patients negative for MRSA on admission, 28 (52 percent) became colonized while in the ICU. Sixteen (22 percent) of the 74 colonized patients (colonized either on admission or during ICU stay) had associated respiratory or urinary tract infections due to MRSA, and 9 (56 percent) died. No correlation with special risk factors (invasive procedures, antibiotic use, age, chronic disease) was identified. MRSA occurred frequently, but there was minimal evidence of associated risk factors. Thus, control of MRSA cannot be accomlished by targeting special factors alone, but requires attention to preventing microbial spread in all areas. Of special concern is the high frequency of acquiring the organism in the ICU (52 percent). Education concerning the importance of hand washing, environmental surface cleaning, and barrier protection from infected patients is needed.

Estudo bacteriológico da secreçäo de orelha média em crianças com otite média secretora crônica / Bacteriological study of middle ear secretion in children with cronical otitis media

Foram submetidos a exame bacteriológico 51 aspirados de secreçäo de orelha média obtidos de 29 crianças com idade entre 1 ano e 8 meses e 12 anos, com diagnóstico de otite média secretora crônica rebelde ao tratamento clínico. Obteve-se crescimento bacteriano em 23,5 por cento das culturas, com predominância do Staphilococcus aureus (41,7 por cento), seguido pelo Streptococcus pneumoniae (16,7 por cento), Haemophilus influenzae (8,3 por cento) e Pseudomonas aeruginosa (8,3 por cento). Näo houve crescimento de bactérias anaeróbias