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Alves Villa P.E.,Orthopedics and Traumatology | Nunes T.R.,Orthopedics and Traumatology | Goncalves F.P.,Orthopedics and Traumatology | Martins J.S.,Orthopedics and Traumatology | And 2 more authors.
Revista Brasileira de Ortopedia | Year: 2013

Objective: To evaluate clinically patients with chronic osteomyelitis after open fractures, treated in the Hospital of urgencies in Goiania. Methods: A cross-sectional study, with data collection through questionnaire, from a review of medical records. We collected data on the type of trauma and the clinical characteristics of the patient. The hour of attendance and the injuries on the patients were collected, and then classified according to Gustilo and Anderson (1976). Samples of the lesion during the surgical procedure were collected for culture of pathogenic microorganisms. The analyzes were performed using STATA/SE version 8.0. Descriptive analysis was performed (absolute and relative frequencies) and to verify existence of association between variables was performed using thur-square or Fisher's Exact Test. This study was approved by the Research Ethics Committee of the Hospital and Emergency in Goiania. Results: There was predominance of male adult, presenting open fractures with increased involvement of the leg bones or in two or more bones (polytrauma). The majority of patients presented with a lesion type III (high-energy trauma). There was loss of excessive time since the time of the accident until the initial surgical care. We detected the presence of gram-positive cultures of material obtained after the diagnosis of osteomyelitis. Conclusions: The control of factors such as antibiotics, exposure time, bacterial resistance to the antimicrobial used, extensive tissue damage and location of the fracture are extremely important to the predictive effect of infection in open fractures. © 2013 Sociedade Brasileira de Ortopedia e Traumatologia. Published by Elsevier Editora Ltda. Source

Rubio F.G.,Parasitary and Dermatology Diseases | Rangel R.M.C.,Hospital Infection Control Committee | Nogueira M.C.L.,Parasitary and Dermatology Diseases | Nogueira M.C.L.,Microbiology Laboratory | And 2 more authors.
Brazilian Journal of Infectious Diseases | Year: 2013

The objective of this study was to investigate bacterial resistance trends, infection sites and the relationship between resistance and admittance to the intensive care unit (ICU). A total of 53,316 bacteria identified between 1999 and 2008 were evaluated. Multidrug resistance was characterized when gram-negative bacilli (GNB) presented resistance to two or more classes of antibiotics. Gram-positive cocci (CPC) were assessed for resistance to penicillin, oxacillin and vancomycin. GNB were the most common (66.1%) isolate. There was a 3.7-fold overall increase in multidrug resistant GNB over the study period; Acinetobacter baumanii and Staphylococcus aureus were the most prevalent. Highest increases were recorded for Klebsiella pneumoniae (14.6-fold) and enterococci (73-fold). The resistance rates for GNB and GPC were 36% and 51.7%, respectively. Most multidrug resistant GNB and GPC were recovered from ICU patients (p-value < 0.001). Vancomycin-resistant enterococci were isolated during this decade with an increase of 18.7% by 2008. These data confirm the worldwide trend in multidrug bacterial resistance. © 2013 Elsevier Editora Ltda. Source

Yapicioglu H.,Cukurova University | Ozcan K.,Cukurova University | Mutlu B.,Cukurova University | Satar M.,Cukurova University | And 2 more authors.
Journal of Tropical Pediatrics | Year: 2011

In this study, we have prospectively recorded healthcare-associated infections (HAIs) in NICU and found incidence density as 18 infections per 1000 patient days. Of the infections, 51.3% was bacteriemia (BSI), and 45.1% was ventilator-associated pneumonia (VAP). Gram-negative microorganisms were predominant in VAP and Staphylococcus epidermidis was the leading microorganism (53.0% of BSIs) in BSIs. Multivariate logistic regression analysis showed the importance of hood O2 use in days (RR: 1.3) and total parenteral nutrition use in days (RR: 1.09) for BSIs. Umbilical arterial catheterization in days (RR: 1.94), ventilator use in days (RR: 1.05), chest tube (RR: 12.55), orogastric feeding (RR: 3.32) and total parenteral nutrition in days (RR: 1.05) were found to be significantly associated with VAP. In conclusion, incidence density in our unit is high and Gram-negative rods are predominant similar to developing countries. These results strongly suggest improving measures of prevention and control of HAIs in the unit. © The Author [2010]. Published by Oxford University Press. All rights reserved. Source

Kara A.,Dr Behcet Uz Childrens Hospital | Devrim T.,Dr Behcet Uz Childrens Hospital | Bayram N.,Dr Behcet Uz Childrens Hospital | Katipoglu N.,Dr Behcet Uz Childrens Hospital | And 5 more authors.
Brazilian Journal of Infectious Diseases | Year: 2015

Background: Vancomycin-resistant enterococci colonization has been reported to increase the risk of developing infections, including bloodstream infections. Aim: In this study, we aimed to share our experience with the vancomycin-resistant enterococci bloodstream infections following gastrointestinal vancomycin-resistant enterococci colonization in pediatric population during a period of 18 months. Method: A retrospective cohort of children admitted to a 400-bed tertiary teaching hospital in Izmir, Turkey whose vancomycin-resistant enterococci colonization was newly detected during routine surveillances for gastrointestinal vancomycin-resistant enterococci colonization during the period of January 2009 and December 2012 were included in this study. All vancomycin-resistant enterococci isolates found within 18 months after initial detection were evaluated for evidence of infection. Findings: Two hundred and sixteen patients with vancomycin-resistant enterococci were included in the study. Vancomycin-resistant enterococci colonization was detected in 136 patients (62.3%) while they were hospitalized at intensive care units; while the remaining majority (33.0%) were hospitalized at hematology-oncology department. Vancomycin-resistant enterococci bacteremia was present only in three (1.55%) patients. All these patients were immunosuppressed due to human immunodeficiency virus (one patient) and intensive chemotherapy (two patients). Conclusion: In conclusion, our study found that 1.55% of vancomycin-resistant enterococci-colonized children had developed vancomycin-resistant enterococci bloodstream infection among the pediatric intensive care unit and hematology/oncology patients; according to our findings, we suggest that immunosupression is the key point for developing vancomycin-resistant enterococci bloodstream infections. © 2014 Elsevier Editora Ltda. Source

Jacoby T.S.,Federal University of Rio Grande do Sul | Kuchenbecker R.S.,Hospital Infection Control Committee | dos Santos R.P.,Hospital Infection Control Committee | Magedanz L.,Federal University of Rio Grande do Sul | And 2 more authors.
Journal of Hospital Infection | Year: 2010

We performed a 30-month ecological study to determine the impact of hospital-wide antibiotic consumption, invasive procedure use and hospital-acquired infections (HAIs) on antibiotic resistance in an intensive care unit (ICU). Microbiological isolates from ICU patients with established diagnosis of hospital infection were monitored throughout the study. Overall hospital consumption per 100 patient-days of piperacillin-tazobactam, fluoroquinolones and cephalosporins increased from 1.9 to 2.3 defined daily doses (DDD) (P<0.01), from 4.7 to 10.3 DDD (P<0.01) and from 12.1 to 16.4 DDD (P<0.01), respectively. Bacterial multiresistance in ICU was identified in 31.3% (N=466) of isolates, with increasing resistance demonstrated for meropenem-resistant Klebsiella spp. (P=0.01) and meropenem-resistant Acinetobacter spp. (P=0.02). There was a positive correlation between multiresistance rate and DDD of cephalosporins (P<0.01) and fluoroquinolones (P=0.03). The rate of ceftazidime-resistant Klebsiella spp. correlated with DDD of fluoroquinolones and cephalosporins; the rate of ceftazidime-resistant Pseudomonas spp. correlated with consumption of cephalosporins, and rate of meticillin-resistant Staphylococcus aureus (MRSA) correlated with fluoroquinolone use. During the studied period, 36.9% (P<0.001) and 34.5% (P<0.01) of the changing multiresistance rate in ICU was associated with use of invasive procedures and overall HAI rate, respectively. Multiresistance rates in ICU are influenced by the variation in overall HAI rate, hospital-wide invasive procedures and antibiotic consumption outside the ICU. © 2009 The Hospital Infection Society. Source

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