Perfil microbiológico de la peritonitis bacteriana espontánea en una ciudad del sur de Brasil / Microbiological profile of spontaneous bacterial peritonitis in a Southern

Introducción: La peritonitis bacteriana espontánea (PBE) es una de las complicaciones infecciosas másfrecuentes que afectan a los pacientes con cirrosis y ascitis descompensadas, la cual presenta un alto índicede mortalidad. Objetivo: Identifi car los principales agentes causantes de la PBE en un Hospital Universitarioentre los años 2008 y 2011. Métodos: Se llevó a cabo un estudio transversal de resultados positivos decultivos de líquido ascítico. Se obtuvieron variables clínicas y de laboratorio de los registros médicos.Resultados: Se incluyeron 47 pacientes de 55,7 ± 15,5 años de edad con cultivos positivos de líquidoascítico, de los cuales 70,2% eran hombres y 53,6% presentaba cirrosis. Todos los pacientes cirróticos presentaronGASA ≥ 1,1 y conteo promedio de neutrófi los en el líquido ascítico de 3.260,8 ± 5.122,9 células. Elmicrobio encontrado más frecuentemente fue el Escherichia coli (25,5%), seguido por el Klebsiella (14,9%), elEnterococcus (8,5%) y el Streptococcus (8,5%). No se observaron diferencias signifi cativas cuando se compararonlos pacientes cirróticos con los no cirróticos respecto a la prevalencia del E. coli (19,2% vs. 33,3%;p= 0,270), Klebsiella (19,2% vs. 9,5%; p= 0,436), Enterococcus (7,7% vs. 9,5%; p= 1,000) y Streptococcus(15,4% vs. 0,0%; p= 0,117). La presencia de infección causada por dos o más microbios es más común entrelas personas sin cirrosis (11,5% vs. 38,1%; p= 0,047).Conclusión: El perfi l microbiológico de los cultivos de líquido ascítico de este hospital es similar al de otrosestudios relacionados con el PBE, con prevalencia de bacterias Gram negativas

experienced by patients with decompensated cirrhosis and ascites, has a high mortality rate. Objective:Our objective was to identify the main agents causing SBP at a University Hospital between 2008 and 2011.Methods: A cross-sectional study of positive results from ascitic fl uid cultures was carried out. Clinical andlaboratory variables were extracted from the medical records.Results: 47 patients with positive ascitic fl uid cultures were included. Average age was 55.7 years ± 15.5years, 70.2% were men, and 53.6% of patients presented cirrhosis. All cirrhotic patients presented GASA≥ 1.1 and mean neutrophil count in the ascitic fl uid of 3,260.8 ± 5,122.9 cells. The most frequent germsfound were Escherichia coli (25.5%), Klebsiella (14.9%), Enterococcus (8.5%) and Streptococcus (8.5%). Nosignifi cant differences were observed between cirrhotic and non-cirrhotic patients regarding the prevalenceof E.coli (19.2% vs. 33.3%; P=0.270), Klebsiella (19.2% vs. 9.5%; P=0,436), Enterococcus (7.7% vs. 9.5%;P=1.000) or Streptococcus (15.4% vs. 0.0%; P=0.117). The presence of infection by two or more germs wasmore common among individuals without cirrhosis (11.5% vs. 38.1%; P=0.047).Conclusion: The microbiological profi le of ascitic fl uid cultures showed a prevalence of gram-negativebacteria similar to other studies related to spontaneous bacterial peritonitis

Positive serology for viral hepatitis and donor self-exclusion in Southern Brazil

Introduction Despite the great advances in serological testing for transfusion-transmitted infections, the selection of blood donors by blood bank operators remains the only way to avoid transmission within the testing window period. Part of this selection is the self-exclusion form, on which the donors can exclude their blood from donation without any explanation. This study assessed the clinical and epidemiological characteristics related to positivity for viral hepatitis and to the use of the confidential self-exclusion (CSE) form. Methods This transversal study analyzed the data collected from blood donors' files in a hospital in Southern Brazil. Univariate and multivariate analyses identified the clinical and epidemiological variables related to positive serologies of viral hepatitis and to whether the donor was self-excluded. Results Of the 3,180 donors included in this study, 0.1% tested positive for HBsAg, 2.1% for anti-HBc, and 0.9% for anti-HCV. When the 93 donors with positive serologies for viral hepatitis were compared with those who were negative, a greater proportion of the positive serology group was found to have had a history of blood transfusions (OR=4.908; 95%CI=1.628 - 14.799; p<0.01), had repeatedly donated (OR=2.147; 95%CI=1.236 - 3.729; p<0.01), and used the CSE form for self-exclusion (OR=7.139; 95%CI=2.045 - 24.923; p<0.01). No variables were independently associated with self-exclusion. Conclusions A history of blood transfusion, repeated donations, and self-exclusion are factors that should be considered during viral hepatitis screenings in blood banks. .