Se Asian J Trop Med
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Se Asian J Trop Med · Mar 2015
FREQUENCY AND ANTIMICROBIAL SUSCEPTIBILITY OF PATHOGENS AT TERTIARY PUBLIC HOSPITAL, SAO PAULO, BRAZIL.
Nosocomial infections are one of the leading causes of morbidity and mortality. This study determined both prevalence and antimicrobial susceptibility of microorganisms identified during January to December 2012 at a tertiary public hospital, Sao Paulo, Brazil. Data, hospital length of stay, age, identity of microorganisms, and antimicrobial susceptibilities were obtained from patients' records. ⋯ The majority of Escherichia coli isolates were obtained from positive urinary tract cultures (63.4%), with 27.5% resistant against cefepime. Elderly patients, long periods of hospital stay and continuous usage of a single antibiotic should be kept in mind of possible causes for infection of A. baumannii, ESBL and carbapenem-resistant K. pneumoniae and the worrisome E. coli with increased resistance to cefepime. The data allowed us to implement monitoring programs as part of the prevention strategy against pathogens prevalence and antibiotic resistance burden at Ipiranga Hospital, Sao Paulo, Brazil.
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Se Asian J Trop Med · Jul 2014
Occupational risk towards blood-borne infections among ambulance personnel in a provincial hospital network in Thailand.
Health-care personnel working in an ambulance may be at risk for work-related infections, especially blood-borne infections. This cross-sectional study was conducted to assess occupational risks and their preventive practices for blood-borne infections among ambulance personnel working in a provincial hospital network. One hundred sixty-one personnel who voluntarily participated were interviewed using a structured questionnaire. ⋯ The mean score of preventive practices was 7.6±2.2; a score classified at a moderate level. However, data from field observations demonstrated only 30.3% of observed personnel (3/9) used aprons and goggles when contacting a large amount of blood, and only 11.1% (1/9) broke off drug vials with a clean cloths to protect from an injury. Continuous education and training, as well as the improvement of safety equipment are needed to better protect ambulance personnel from occupational risks.
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Se Asian J Trop Med · May 2014
Antimicrobial susceptibility patterns of Burkholderia pseudomallei among melioidosis cases in Kedah, Malaysia.
Burkholderia pseudomallei, the causative agent of melioidosis is an important cause of morbidity and mortality particularly among diabetics. We evaluated 228 isolates of B. pseudomallei for antimicrobial sensitivity during 2005-2010 using the disc diffusion technique, of which 144 were obtained from blood culture. More than 90% of the strains were susceptible to cefoperazone, ceftazidime, chloramphenicol and imipenem. ⋯ The susceptibilities were similar between isolates from females and males, bacteremic and abacteremic cases, diabetics and non-diabetics, pneumonia and non-pneumonia cases and between those who died and those who survived. Our findings show antibiotic susceptibility patterns are not a major factor in determining outcomes of B. pseudomallei infection. Monitoring the drug susceptibilities among B. pseudomallei isolates needs to be conducted regularly to guide empiric therapy for melioidosis, as it causes high mortality, especially among diabetic cases.
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Se Asian J Trop Med · Jan 2014
The determination of carbapenem resistance in Escherichia coli and Pneumoniae isolates related to nosocomial infections and the evaluation of risk factors.
We aimed to investigate carbapenem resistance, resistance mechanisms, risk factors and epidemiological features of Escherichia coli and Klebsiella pneumoniae strains isolated from related infections in intensive care unit (ICU) patients. Carbapenemase activity was determined by MHT, MBL Etest and enzyme extraction methods. Presence of extended-spectrum beta-lactamase (ESBL) and carbapenemase-encoding genes were investigated by PCR and sequencing. ⋯ Fifty-seven percent of K. pneumoniae isolates produced OXA-48 orginating from two clones and remaining isolates originated from different clones. Thus carbapenem resistance was determined as 22% and 3% in K. pneumoniae and E. coli strains, respectively. Invasive devices, duration of total parenteral nutrition, duration of hospitalization, presence of transfusions, ESBL and multiple drug resistance were found to be risk factors for carbapenem resistance.
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Se Asian J Trop Med · Jan 2014
Comparative StudyComparison of clinical and laboratory findings between those with pulmonary tuberculosis and those with nontuberculous mycobacterial lung disease.
In tuberculosis endemic areas, patients with sputum positive for acid-fast bacilli (AFB) are usually diagnosed and treated for pulmonary tuberculosis. The diagnosis of nontuberculous mycobacteria (NTM) lung disease is often ascertained only after lung disease progression occurs, increasing the risk of severe morbidity and mortality. We conducted a matched case-control study among a prospective cohort of 300 patients with newly diagnosed AFB-positive sputum in Thailand during 2010-2012. ⋯ Patients with NTM lung disease had a significantly lower body weight prior to treatment (p = 0.021), a higher body weight change from baseline (p = 0.038), and were more likely to have cavitations on chest radiograph (p = 0.033) than those with NTM colonization. In tuberculosis endemic areas, mycobacterial identification should be performed among patients with impaired immune function. NTM lung disease treatment should be considered in patients with NTM sputum isolates who have a history of significant weight loss or cavitations on chest radiography.