The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases
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Strongyloides stercoralis (S. S.) is a human intestinal parasite, which may lead to complicated strongyloidiasis. We report a case of disseminated strongyloidiasis following the treatment of myeloma. ⋯ The diagnosis of strongyloidiasis was established through endotracheal tube secretions. Despite the treatment with Ivermectin and Albendazole, the outcome was fatal. The value of screening for strongyloidiasis is unclear but may be of benefit in patients with hematological malignancies from high endemic areas.
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Comparative Study
Evaluation of procalcitonin and neopterin level in serum of patients with acute bacterial infection.
Fever as a common presenting complaint in pediatric patients can be due to various causes. Differentiating bacterial infection from other causes is important because the prompt use of antibiotics is critical in bacterial infection. Traditional markers of infection such as BT and WBC count may be unspecific and culture may be late or absent. CRP and Procalcitonin (PCT) have been considered to evaluate the evolution of infections and sepsis in patients presenting with SIRS. Neopterin has also been proposed to aid in the diagnosis of bacterial infection. In this study, we compared the value of the serum PCT, neopterin level, and WBC count for predicting bacterial infection and outcome in children with fever. ⋯ Rapid PCT test is superior to neopterin and WBC count for anticipating bacterial infection, especially in ED where prompt decision making is critical.
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The objective of this study was to estimate disease incidence and mortality rate of sepsis in a tertiary public hospital. ⋯ The data from our study revealed a high incidence of sepsis among hospitalized patients. Moreover, sepsis patients had a high rate of mortality.
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We observed the clinical and microbiological characteristics of several stages of bloodstream infections (BSI), as well as the mortality attributed to it in a tertiary hospital in the northeast of Brazil (in the city of Maceió, Alagoas). A prospective cohort of 143 patients who had at least one positive blood culture was enrolled in the study. Their clinical evolution was followed up for 30 days from October 2005 to December 2006. ⋯ Chronic renal failure, diabetes mellitus, and neuropathy were present in 21.7%, 26.6%, and 29.4% of the cases, respectively. Coagulase-negative Staphylococcus (25.9%), Staphylococcus aureus (21%), and Klebsiella pneumoniae (14%) were the most present microorganism in the sample. The high morbidity and mortality rates in this study are attributed to the lack of knowledge on BSI characteristics and on instituted protocols for detection and treatment in early stages.
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Comparative Study
Low compliance with alcohol gel compared with chlorhexidine for hand hygiene in ICU patients: results of an alcohol gel implementation program.
Although the introduction of alcohol based products have increased compliance with hand hygiene in intensive care units (ICU), no comparative studies with other products in the same unit and in the same period have been conducted. We performed a two-month-observational prospective study comparing three units in an adult ICU, according to hand hygiene practices (chlorhexidine alone-unit A, both chlorhexidine and alcohol gel-unit B, and alcohol gel alone-unit C, respectively). Opportunities for hand hygiene were considered according to an institutional guideline. ⋯ Higher compliance rates were observed for general opportunities for hand hygiene (patient bathing, vital sign controls, etc), while very low compliance rates were observed for opportunities related to skin and gastroenteral care. One of the reasons for not using alcohol gel according to health care workers was the necessity for water contact (35.3%, 12/20). Although the use of alcohol based products is now the standard practice for hand hygiene the abrupt abolition of hand hygiene with traditional products may not be recommended for specific services.