ABSTRACT
OBJECTIVE: To evaluate Candida parapsilosis candidaemia in a neonatal unit over 7 years. DESIGN: Case series study. SETTING: A 2000-bed tertiary-care university hospital at São Paulo, Brazil. PARTICIPANTS: Neonates hospitalised in a 63-bed neonatal unit. PRIMARY AND SECONDARY OUTCOME MEASURES: We evaluated the incidence of C parapsilosis fungemia in a neonatal unit from 2002 through 2008 and the main microbiological, clinical and epidemiological aspects of this disease in neonates. During the study period an outbreak occurred, an infection control programme was implemented, and isolates from blood and hand healthcare workers (HCWs) were submitted to molecular typing. RESULTS: During 7 years, there were 36 cases of C parapsilosis fungaemia and annual incidence varied from 0 to 19.7 per 1000 admissions. Evaluating 31 neonates with fungemia, the mean age at diagnosis was 19 days. All children except for one were premature; all had received total parenteral nutrition and all but one had used central venous catheter. Three neonates had received antifungal treatment previously to the diagnosis. Thirty-day mortality was 45%. Only lower birthweight was associated with mortality. C parapsilosis species complex was isolated from hand cultures in eight (11%) of the HCWs (one isolate was identified as C orthopsilosis). By molecular typing no HCW isolate was similar to any of the blood isolates. CONCLUSIONS: The incidence of C parapsilosis fungemia in a neonatal unit varied widely over 7 years. We observed in our series a higher death rate than that reported in European countries and the USA.
ABSTRACT
A higienização das mãos é a medida mais simples, com menor custo e mais efetiva na prevenção das infecções hospitalares. Considerando a baixa adesão ao procedimento, optamos por avaliar o impacto de soluções alcoólicas na higienização das mãos. Avaliar a adesão dos profissionais de saúde à higiene das mãos com o uso de soluções alcoólicas. Observação direta para coleta de dados de prática de higiene das mãos. Uso do software Epi-Info 6.0 para análise dos resultados. Foram realizadas 603 observações de oportunidades/indicações de higienização. Ocorreu um aumento na adesão à higienização das mãos com o uso de soluções alcoólicas (17 por cento versus 28 por cento, p< 0,05). Houve um aumento significativo na adesão à higiene das mãos após a introdução de soluções alcoólicas.
Subject(s)
Humans , Cross Infection/prevention & control , Hand Disinfection , Intensive Care UnitsABSTRACT
Os autores apresentam relato de três casos de linfadenite inguinal ulcerada tuberculosa. A escassez de casos na literatura motivou-nos esta apresentaçäo
