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Sample records for nosocomial ii resistencia

  1. Etiología bacteriana de la neumonía nosocomial y resistencia a los antimicrobianos en pacientes con y sin tratamiento antimicrobiano previo Bacterial etiology of nosocomial pneumonia and antimicrobial resistance in patients with and without antimicrobial treatment

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    Beatriz Weyland

    2011-03-01

    Full Text Available La neumonía nosocomial (NN se asocia a una elevada morbimortalidad y es la segunda causa de infección intrahospitalaria después de la infección urinaria. El objetivo de este trabajo fue conocer la etiología de la NN en adultos y evaluar el perfil de resistencia a los antimicrobianos de los microorganismos aislados teniendo en cuenta si los pacientes recibieron o no tratamiento antimicrobiano previo. Desde el año 2000 hasta el 2005 se analizaron 430 lavados broncoalveolares provenientes de 430 pacientes adultos con diagnóstico de neumonía internados en la unidad de cuidados intensivos del Hospital de Clínicas "José de San Martín". El 74% (199/ 269 de los pacientes con tratamiento previo tuvieron cultivos positivos, mientras que en el grupo sin tratamiento previo esta proporción fue del 83% (134/161 (p = 0,03. Los microorganismos prevalentes fueron Acinetobacter spp., Staphylococcus aureus y Pseudomonas aeruginosa (37,9% ; 21,3% y 20,9% vs. 36,1%; 26,6% y 17,7% en los pacientes con tratamiento previo o sin él, respectivamente; p > 0,05. La resistencia a los antimicrobianos de los citados microorganismos cuando los aislamientos provinieron de pacientes que recibieron antes tratamiento antibiótico fue superior a la encontrada en el grupo de pacientes que no recibió tratamiento previo (p Nosocomial pneumonia (NP is associated with high morbimortality, representing the second cause of nosocomial infection after urinary tract infection. The objective of this work was to become acquainted with the etiology of NP and to evaluate the antimicrobial resistance profile of the isolated microorganisms from adult patients with and without previous antimicrobial treatment admitted in the intensive care unit (ICU. From 2000 to 2005, 430 bronchoalveolar lavages from 430 adult patients diagnosed with pneumonia admitted in the ICU were analyzed. Seventy-four percent (199/ 269 of the patients with previous treatment had positive cultures, whereas in

  2. Klebsiella pneumoniae as a nosocomial pathogen: epidemiology and drug resistance Klebsiella pneumoniae como patógeno intrahospitalario: epidemiología y resistencia

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    Juan Carlos Cataño Correa

    2010-08-01

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    Worldwide, bacterial resistance is an increasingly serious problem, especially in hospital environments. Staphylococcus aureus and Escherichia coli are the most frequently isolated microorganisms in patients with nosocomial infections. In Medellín, Colombia, however, Klebsiella pneumoniae has become increasingly important in this kind of infection, for which reason this review was carried out.

    It includes the following aspects: microbiology, epidemiology, dissemination, resistance to betalactamic antibiotics and its mechanisms, clinical impact and importance of the problem in this city.

     

    La resistencia bacteriana es un problema serio, de magnitud creciente y presentación universal, que reviste gran importancia, especialmente en los ambientes hospitalarios; los microorganismos más frecuentemente aislados de pacientes con infecciones intrahospitalarias son Staphylococcus aureus y Escherichia coli. En Medellín, sin embargo, Klebsiella pneumoniae ha cobrado gran importancia en años recientes debido a su gran incremento como agente causal de ese tipo de infecciones, lo que motiva esta revisión. Se incluyen los siguientes aspectos: microbiología, epidemiología, diseminación, resistencia a los beta-lactámicos y sus mecanismos, impacto clínico e importancia del problema

  3. Methicillin-resistant Staphylococcus aureus carrying SCCmec type II was more frequent than the Brazilian endemic clone as a cause of nosocomial bacteremia.

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    Caiaffa-Filho, Helio Hehl; Trindade, Priscila A; Gabriela da Cunha, Paula; Alencar, Cecilia Salete; Prado, Gladys V B; Rossi, Flavia; Levin, Anna S

    2013-08-01

    Fifty consecutive MRSA blood isolates were evaluated: 30(60%) carried SCCmec type II (single PFGE clone; sequence type 5 or ST105); 12 (26%), IV; 5 (10%), III; 3 (6%), I. Brazilian endemic clone, carrying SCCmec type III, has been the main nosocomial clone in Brazil; however, this study showed that a clone carrying type II predominated. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Iniciación educativa a la resistencia aeróbica. (II Actividades asociadas: el canto en carrera

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    Antonio D. Galera

    2013-12-01

    Full Text Available El autor presenta un conjunto de factores didácticos sistemáticos para la iniciación educativa a la resistencia aeróbica, centrándose en métodos aplicables a la realidad escolar desde una perspectiva sostenible. La doctrina en que se sustenta fue desarrollada como resultado de su experiencia con un grupo de niños y niñas que participaron en un programa escolar de educación física cooperativa, uno de cuyos contenidos maestros era el desarrollo de la resistencia aeróbica. Los criterios de aplicación didáctica están contemplados desde el ámbito escolar, de primaria o de secundaria, si bien pueden adaptarse a otros ámbitos, como el entrenamiento a cualquier edad, actividades de tiempo libre, etc. En esta entrega se aborda el papel de las actividades asociadas a su práctica, con especial énfasis en el canto en carrera.

  5. Resistencia a herbicidas. Glifosato

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    Andrea Villalba

    2009-01-01

    Full Text Available Se presenta una revisión actualizada de los mecanismos generadores de resistencia a herbicidas, en plantas, y los factores que favorecen su desarrollo. Se reúnen las especies que actualmente han sido denunciadas como resistentes a glifosato, en Argentina y el mundo. Se explica el mecanismo de acción y de desarrollo de resistencia de este xenobiótico, poniendo énfasis en las conductas preventivas.

  6. Descifrando las bases moleculares de la resistencia cuantitativa

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    Camilo Lopez

    2011-05-01

    Full Text Available Uno de los factores mas importantes que afectan los cultivos son las enfermedades ocasionadas por los patógenos. La resistencia vegetal ha sido clásicamente dividida en dos tipos: i competa, vertical o cualitativa que es gobernada por un solo gen y ii incompleta, horizontal o cuantitativa la cual es gobernada por varios genes. Aunque la resistencia cuantitativa provee resistencia de amplio espectro y es durable, los mecanismo moleculares subyacentes no han sido estudiados en detalle. En esta revisión se propone un modelo basado en la co-localización de genes similares a los clásicos genes de resistencia cualitativa con QTLs (Quantitative Trait Loci para explicar el mecanismo involucrado en el reconocimiento del patógeno durante la resistencia cuantitativa. Además se presenta información acerca del progreso obtenido en los últimos tres años para entender este tipo de resistencia, que culminó con la clonación de varios genes asociados a la resistencia cuantitativa. En conjunto, estos datos proveen nuevas luces sobre la naturaleza genética de este tipo de resistencia y de cómo puede ser empleada en programas de mejoramiento genético.

  7. Alelos del complejo mayor de histocompatibilidad BoLA clase II asociados a la resistencia y susceptibilidad a Boophilus microplus en ganado bovino, Junín–Perú

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    M. Custodio Villanueva

    2011-01-01

    Full Text Available El objetivo del presente estudio fue identificar mediante la amplificación de microsatélites, los alelos del Complejo Mayor de Histocompatibilidad (CMH BoLA Clase II aso ciados a la resistencia y susceptibilidad a Boophilus microplus en ganado bovino, Junín – Perú. S e recolectaron muestra s de sangre de 47 bovinos , a sí como, ejemplares de B. microplus durante los meses de marzo, abril y mayo del 2009, en horas de la mañana, del lado derecho de cada animal. La extracción del ADN genómico se realizó por el método de Phil Summers (1995 y la amplificación de los microsatélites DRB3.2, DRB31 y BM1815 fue por PCR en un secuenciador automático. Los datos fueron evaluados mediante e l programa POPGEN 32. Se identificaron los alelos A, B y C relacionados con la resistencia y susceptibilidad a B. microplus en ganado bovino tanto en el locus BoLA DRB3.2 como en BoLA BM1815. Las frecuencias alélicas estimadas fueron: en el locus DRB3.2 la frecuencia del alelo A fue de 0 . 2742, del alelo B fue de 0.5000 y del alelo C fue de 0.2258; en el locus DRB31 la frecuencia del alelo A fue de 1.0000 y, en el locus BM1815 la frecuencia del alelo A fue de 0.3295, del alelo B fue de 0.5909y del alelo C fu e de 0.0795. Se concluye que los alelos A, B y C de los loci DRB3.2 y BM1815 del Complejo Mayor de Histocompatibilidad BoLA Clase II están relacionados con la resistencia a B. microplus en ganado bovino y el alelo A del locus DRB31 está relacionado con la susceptibilidad.

  8. [Invasive nosocomial pulmonary aspergillosis].

    Science.gov (United States)

    Germaud, P; Haloun, A

    2001-04-01

    Immunodepressed patients, particularly those with neutropenia or bone marrow or organ grafts, are at risk of developing nosocomial invasive pulmonary aspergilosis. The favoring factors, early diagnostic criteria and curative treatment protocols are well known. Prognosis remains however quite severe with a death rate above 50%. Preventive measures are required for the treatment of these high-risk patients and epidemiology surveillance is needed in case of aspergillosis acquired in the hospital.

  9. [Nosocomial rotavirus gastroenteritis].

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    Marinosci, A; Doit, C; Koehl, B; Belhacel, K; Mariani Kurkdjian, P; Melki, I; Renaud, A; Lemaitre, C; Ammar Khodja, N; Blachier, A; Bonacorsi, S; Faye, A; Lorrot, M

    2016-11-01

    Rotavirus is the most common cause of gastroenteritis in children requiring hospitalization. It is a very resistant and contagious virus causing nosocomial gastroenteritis. In France, the vaccine against rotavirus has been available since 2006, but the vaccine is not recommended for infant vaccination. The aim of this retrospective study was to describe nosocomial rotavirus gastroenteritis (NRGE) and to assess its impact on children hospitalized in the General Pediatrics Department of Robert-Debré Hospital (Paris) between 1 January 2009 and 31 December 2013. We analyzed the demographic characteristics of children (age, term birth, underlying diseases) and the severity of the NRGE (oral or intravenous hydration), and assessed whether these children could benefit from vaccination against rotavirus. One hundred thirty-six children presented nosocomial rotavirus infection, with an incidence of 2.5 NRGE per 1000 days of hospitalization. The incidence of NRGE was stable between 2009 and 2013 despite the introduction of specific hygiene measures. The average age of the children was 7 months (range: 0.5-111 months). Most often NRGE occurred in children hospitalized for respiratory diseases (65% of cases) and requiring prolonged hospitalization (median: 18 days). One-third of children were born premature (25%). Hydration was oral in 80 patients (59%), by intravenous infusion in 18 patients (13%), and intraosseous in one patient. Half of the patients were aged less than 5 months and could benefit from the protection afforded by vaccination. NRGE are common. Rotavirus mass vaccination should have a positive impact on the incidence of NRGE by reducing the number of children hospitalized for gastroenteritis, therefore indirectly reducing the number of hospital cross-infections of hospitalized children who are too young to be vaccinated. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  10. Nosocomial infections and staff hygiene.

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    Petroudi, Dimitra

    2009-03-01

    Nosocomial infections are a major source of morbidity and mortality in hospital settings. The most important defences against nosocomial transmission of viral, bacterial, and other infections are detailed and continuing education of staff and strict adherence to infection control policies. The issue is no longer whether hand hygiene is effective, but how to produce a sustained improvement in health workers' compliance.

  11. Resistencia antimicrobiana e implicancias para el manejo de infecciones del tracto urinario

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    Luisa Durán, MD, DTMH

    2018-03-01

    Full Text Available Resumen: La resistencia antimicrobiana es un problema global creciente, que también afecta a los agentes etiológicos comunes de las infecciones del tracto urinario (ITU y puede implicar mayor morbimortalidad sin un tratamiento adecuado. Existen diferencias regionales en la resistencia y a nivel ambulatorio versus nosocomial que deben considerarse. Todo uso de antibióticos causa presión selectiva sobre el microbioma por eliminación de bacterias susceptibles y aumenta el riesgo de infecciones por bacterias resistentes. Se discuten los principales mecanismos de resistencia y los antimicrobianos afectados, además de sus implicancias terapéuticas en los distintos cuadros de ITU. Es fundamental evitar la exposición innecesaria a antibióticos, realizar un correcto diagnóstico, elegir y ajustar un adecuado tratamiento, entre otras medidas para enfrentar la resistencia antimicrobiana. Summary: Antimicrobial resistance is a growing global problem, which also affects the common etiological agents of urinary tract infections (UTI and may involve increased morbidity and mortality without adequate treatment. There are regional differences in resistance and at the ambulatory versus nosocomial level that should be considered. Any use of antibiotics causes selective pressure on the microbiome by eliminating susceptible bacteria and increases the risk of infections by resistant bacteria. The main mechanisms of resistance and the affected antimicrobials are discussed, as well as their therapeutic implications in the different UTI cases. It is essential to avoid unnecessary exposure to antibiotics, make a correct diagnosis, choose and adjust an appropriate treatment, among other measures to face antimicrobial resistance. Palabras clave: Infecciones del tracto urinario, resistencia a antimicrobianos, tratamiento, Key words: Urinary tract infections, drug resistance, therapeutics

  12. [INHALED ANTIBIOTICS IN TREATMENT OF NOSOCOMIAL PNEUMONIA].

    Science.gov (United States)

    Kuzovlev, A N; Moroz, V V; Golubev, A M

    2015-01-01

    Nosocomial pneumonia is the most common infection in intensive care units. Currently the problem of resistance of noso-comial pathogens to miost of antibiotics is crucial. Using of inhaled antibiotics in combination with intravenous drugs is eff ective and safe method for treatment of nosocomial pneumonia. The literature review describes current opportunities of ihhaled antibiotic therapy of nosocomial pneumonia, descriptions of drugs, the advantages and disadvantages of this treatment. Special attention is paid for using inhaled aminoglycosides for nosocomial pneumonia.

  13. [Nosocomial virus infections].

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    Eggers, H J

    1986-12-01

    Enveloped viruses, e.g. influenza- or varicella viruses may cause highly contagious airborne infections. Their spread is difficult to control, also in hospitals. In the case of influenza and varicella immune prophylaxis and chemotherapy/chemoprophylaxis are possible. This is of particular significance, since varicella and zoster are of increasing importance for immunocompromized patients. Diarrhea is caused to a large extent by viruses. Rotavirus infections play an important role in infancy, and are frequently acquired in the hospital. In a study on infectious gastroenteritis of infants in a hospital we were able to show that 30 percent of all rotavirus infections were of nosocomial origin. Admission of a rotavirus-excreting patient (or personnel) may start a long chain of rotavirus infections on pediatric wards. Even careful hygienic measures in the hospital can hardly prevent the spread of enterovirus infections. Such infections may be severe and lethal for newborns, as shown by us in a study on an outbreak of echovirus 11 disease on a maternity ward. We have recently obtained data on the "stickiness" of enteroviruses on human skin. This could explain essential features of the spread of enteroviruses in the population.

  14. CURRENT ASPECTS OF NOSOCOMIAL LEGIONELLOSIS PROFILAXIS

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    I. S. Tartakovsky

    2010-01-01

    Full Text Available The nosocomial or hospital acquired infections is one of the most important medical and social problem. Mo- dern strategy of nosocomial infections prevention include prevention of nosocomial legionellosis. Epidemic outbreaks of nosocomial legionellosis with high mortality rate (20–40% were recognized last years in different countries. The contaminated by Legionella hospital hot water supply system is a source of Legionella infection outbreaks. A risk reduction strategy of waterborne pathogens in hospital water system is important part of mo- dern conception of nosocomial infection prevention, especially among immune compromised patient including transplant patients. In revue discussed different aspects of epidemiology, laboratory diagnostic and prevention of nosocomial legionellosis. 

  15. Pediatric mortality due to nosocomial infection: a critical approach

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    Julia Marcia Maluf Lopes

    Full Text Available Nosocomial infection is a frequent event with potentially lethal consequences. We reviewed the literature on the predictive factors for mortality related to nosocomial infection in pediatric medicine. Electronic searches in English, Spanish and Portuguese of the PubMed/MEDLINE, LILACS and Cochrane Collaboration Databases was performed, focusing on studies that had been published from 1996 to 2006. The key words were: nosocomial infection and mortality and pediatrics/neonate/ newborn/child/infant/adolescent. The risk factors found to be associated with mortality were: nosocomial infection itself, leukemia, lymphopenia, neutropenia, corticosteroid therapy, multiple organ failure, previous antimicrobial therapy, catheter use duration, candidemia, cancer, bacteremia, age over 60, invasive procedures, mechanical ventilation, transport out of the pediatric intensive care unit, methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and Burkholderia cepacia infections, acute physiology and chronic health evaluation (APACHE II scores over 15. Among these factors, the only one that can be minimized is inadequate antimicrobial treatment, which has proven to be an important contributor to hospital mortality in critically-ill patients. There is room for further prognosis research on this matter to determine local differences. Such research requires appropriate epidemiological design and statistical analysis so that pediatric death due to nosocomial infection can be reduced and health care quality improved in pediatric hospitals.

  16. Diabetes mellitus tipo 2 y resistencia a la insulina

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    Enrique Cipriani-Thorne

    2010-07-01

    Full Text Available Se analizó la literatura de los últimos 15 años para poder objetivar los temas que son materia de esta comunicación. En primer lugar se analiza en qué consiste el llamado Síndrome Metabólico, sus características; a continuación se resume la historia natural de la Diabetes Mellitus tipo II y su patogenia. Se revisa la importancia de la resistencia a la insulina en el músculo estriado principal órgano de combustión de la glucosa y el factor mitocondrial de la resistencia a la insulina. Se analiza además la importancia de resistencia a la insulina con respecto al metabolismo del hígado y en particular a las alteraciones del metabolismo del colesterol y de los triglicéridos. Se hace un comentario extenso de cómo así la Diabetes Mellitus Tipo II es considerada en la actualidad como una enfermedad de origen inflamatorio y por último se discuten las consecuencias de la hiperinsulinemia, dado que el exceso de insulina es producido por el bloqueo en la línea metabólica de su acción más no en su línea de producir proliferación tisular.(Rev Med Hered 2010;21:160-170.

  17. Update on bacterial nosocomial infections.

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    Bereket, W; Hemalatha, K; Getenet, B; Wondwossen, T; Solomon, A; Zeynudin, A; Kannan, S

    2012-08-01

    With increasing use of antimicrobial agents and advance in lifesaving medical practices which expose the patients for invasive procedures, are associated with the ever increasing of nosocomial infections. Despite an effort in hospital infection control measures, health care associated infections are associated with significant morbidity and mortality adding additional health care expenditure which may leads to an economic crisis. The problem is further complicated with the emergence of difficult to treat multidrug resistant (MDR) microorganism in the hospital environment. Virtually every pathogen has the potential to cause infection in hospitalized patients but only limited number of both gram positive and gram negative bacteria are responsible for the majority of nosocomial infection. Among them Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Enterococci takes the leading. Many intrinsic and extrinsic factors predispose hospitalized patients for these pathogens. Following simple hospital hygienic practices and strictly following standard medical procedures greatly reduces infection to a significant level although not all nosocomial infections are avoidable. The clinical spectrum caused by nosocomial pathogens depend on body site of infection, the involving pathogen and the patient's underlying condition. Structural and non structural virulence factors associated with the bacteria are responsible for the observed clinical manifestation. Bacteria isolation and characterization from appropriate clinical materials with antimicrobial susceptibility testing is the standard of laboratory diagnosis.

  18. Prevention of Nosocomial Respiratory Infections

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    N. A. Karpun

    2007-01-01

    Full Text Available Objective: to evaluate the efficiency of an extended package of preventive measures on the incidence of nosocomial respiratory infections in surgical patients at an intensive care unit (ICU. Subjects and methods. The study included 809 patients aged 35 to 80 years. A study group comprised 494 patients in whom an extended package of preventive measures was implemented during 7 months (March-September. A control group consisted of 315 patients treated in 2004 in the same period of time (March-September. The groups were stratified by age, gender, underlying diseases, and APACHE-2 and SOFA scores. The extended package of anti-infectious measures involved a high air purification in ICUs («Flow-M» technology, routine use of ventilatory filters, closed aspiration systems with a built-in antibacterial filter under artificial ventilation for over 2 days. Results. The proposed technologies could reduce the frequency of tracheobronchitis and ventilator-associated pneumonias in the groups of patients at high risk for nosocomial infections substantially (by more than twice. Conclusion. The findings have led to the conclusion that the extended package of preventive measures is effective in preventing respiratory infections in ICU patients. Of special note is the proper prevention of upper airway contamination with pathogenic microorganisms, by employing the closed aspiration systems with a built-in antibacterial filter. The routine use of high-tech consumables in the intensive care of surgical patients causes a considerable decrease in the incidence of nosocomial pneumonia, ventilator-associated pneumonia, and purulent tracheobronchitis and a reduction in the number of microbiological studies. Key words: ventilator-associated pneumonia, prevention of nosocomial infections, closed aspiration system.

  19. Antibióticos vs. resistencia bacteriana

    OpenAIRE

    Elso Manuel Cruz Cruz

    2015-01-01

    La resistencia bacteriana a los antibióticos es un problema de salud mundial que se encuentra en constante evolución. De manera frecuente se reportan nuevos mecanismos de resistencia bacteriana a los antibióticos, tanto en bacterias gram negativas como en gram positivas. La presencia de resistencia en una bacteria causante de infección disminuye las posibilidades de obtener la curación clínica y la erradicación bacteriológica e incrementa los costos del tratamiento, la morbilidad y la mortali...

  20. Poder y resistencia en Michel Foucault

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    Reinaldo Giraldo Díaz

    2006-01-01

    Full Text Available En este artículo se analizan los conceptos de poder y resistencia en las obras del período genealógico de Michel Foucault, es decir, después de El orden del discurso, texto programático y hasta el primer volumen de Historia de la Sexualidad. La voluntad de saber. El artículo realiza sobre todo una elaboración de las concepciones de Foucault sobre el poder y la resistencia en las sociedades disciplinarias y en las sociedades de control. Contrario a lo que sostienen los críticos de Foucault, en este artículo se considera que la resistencia no es negativa, ni reactiva. Nuestra hipótesis de trabajo es que para el pensador francés la resistencia es creativa, productiva y anterior al poder.

  1. Relationship between climate conditions and nosocomial infection ...

    African Journals Online (AJOL)

    Background: Nosocomial infections constitute a global health problem. Objective: To explore the relationship between nosocomial infection rates (NIRs) and climatic factors including temperature and relative humidity in Guangzhou area of China. Methods: 30892 patients in our hospital in 2009 were investigated for ...

  2. Nosocomial infections and their control strategies

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    Hassan Ahmed Khan

    2015-07-01

    Full Text Available Nosocomial infections are also known as hospital-acquired/associated infections. National Healthcare Safety Network along with Centers for Disease Control for surveillance has classified nosocomial infection sites into 13 types with 50 infection sites, which are specific on the basis of biological and clinical criteria. The agents that are usually involved in hospital-acquired infections include Streptococcus spp., Acinetobacter spp., enterococci, Pseudomonas aeruginosa, coagulase-negative staphylococci, Staphylococcus aureus, Bacillus cereus, Legionella and Enterobacteriaceae family members, namely, Proteus mirablis, Klebsiella pneumonia, Escherichia coli, Serratia marcescens. Nosocomial pathogens can be transmitted through person to person, environment or contaminated water and food, infected individuals, contaminated healthcare personnel's skin or contact via shared items and surfaces. Mainly, multi-drug-resistant nosocomial organisms include methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Pseudomonas aeruginosa and Klebsiella pneumonia, whereas Clostridium difficile shows natural resistance. Excessive and improper use of broad-spectrum antibiotics, especially in healthcare settings, is elevating nosocomial infections, which not only becomes a big health care problem but also causes great economic and production loss in the community. Nosocomial infections can be controlled by measuring and comparing the infection rates within healthcare settings and sticking to the best healthcare practices. Centers for Disease Control and Prevention provides the methodology for surveillance of nosocomial infections along with investigation of major outbreaks. By means of this surveillance, hospitals can devise a strategy comprising of infection control practices.

  3. Comparison of the Nosocomial Pneumonia Mortality Prediction (NPMP) model with standard mortality prediction tools.

    Science.gov (United States)

    Srinivasan, M; Shetty, N; Gadekari, S; Thunga, G; Rao, K; Kunhikatta, V

    2017-07-01

    Severity or mortality prediction of nosocomial pneumonia could aid in the effective triage of patients and assisting physicians. To compare various severity assessment scoring systems for predicting intensive care unit (ICU) mortality in nosocomial pneumonia patients. A prospective cohort study was conducted in a tertiary care university-affiliated hospital in Manipal, India. One hundred patients with nosocomial pneumonia, admitted in the ICUs who developed pneumonia after >48h of admission, were included. The Nosocomial Pneumonia Mortality Prediction (NPMP) model, developed in our hospital, was compared with Acute Physiology and Chronic Health Evaluation II (APACHE II), Mortality Probability Model II (MPM 72  II), Simplified Acute Physiology Score II (SAPS II), Multiple Organ Dysfunction Score (MODS), Sequential Organ Failure Assessment (SOFA), Clinical Pulmonary Infection Score (CPIS), Ventilator-Associated Pneumonia Predisposition, Insult, Response, Organ dysfunction (VAP-PIRO). Data and clinical variables were collected on the day of pneumonia diagnosis. The outcome for the study was ICU mortality. The sensitivity and specificity of the various scoring systems was analysed by plotting receiver operating characteristic (ROC) curves and computing the area under the curve for each of the mortality predicting tools. NPMP, APACHE II, SAPS II, MPM 72  II, SOFA, and VAP-PIRO were found to have similar and acceptable discrimination power as assessed by the area under the ROC curve. The AUC values for the above scores ranged from 0.735 to 0.762. CPIS and MODS showed least discrimination. NPMP is a specific tool to predict mortality in nosocomial pneumonia and is comparable to other standard scores. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  4. Resistencia a heladas en plantas frutales

    OpenAIRE

    J. E. Chaar

    2013-01-01

    El daño por congelación en los tejidos vegetales es considerado un estrés abiótico principal en los cultivos frutales. Sin embargo, las plantas han desarrollado mecanismos de resistencia al frío. Para una especie y órgano en particular, dicha resistencia es variable a lo largo del año, en función (principalmente) de la temperatura ambiental. Las temperaturas bajas, sin llegar a ser de congelación, también afectan las etapas reproductivas mediante la disminución de la actividad de los agentes ...

  5. Inhaled Antibiotics in the Treatment of Nosocomial Pneumonia

    OpenAIRE

    A. N. Kuzovlev; V. V. Moroz; A. M. Golubev; S. G. Polovnikov

    2013-01-01

    Nosocomial pneumonia is the most common nosocomial infection in intensive care units. Rational antibiotic therapy is the basis for the treatment of nosocomial pneumonia. There is currently a challenge of the pathogens of nosocomial pneumonia being resistant to most of the antibiotics recommended for its treatment. Inhaled antibiotics used in combination with systemic drugs are an effective and safe treatment for nosocomial pneumonia. This review of literature characterizes the current possibi...

  6. [Epidemiology of nosocomial infections in neonates].

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    Lachassinne, E; Letamendia-Richard, E; Gaudelus, J

    2004-03-01

    Epidemiology of nosocomial infections in neonates has to be described according to our definitions (early onset GBS diseases excluded) and according to levels of care. Nosocomial risk exists in maternity departments (3% in postnatal beds), incidence rates are 7.5-12.7% or 1.3-8.5 per 1000 days in neonatal care units and 14.2% or 11.7 per 1000 days in neonatal intensive care units (NICU). Gram-positive cocci bloodstream infections are the most common nosocomial infections in NICU but viral gastroenteritis are more frequent in neonatal care units. Risk factors are low birthweight, small gestational age and intravascular catheter in NICU, and for viral nosocomial infections, visits and winter outbreaks.

  7. Postoperative Nosocomial Infections and Antimicrobial Resistance ...

    African Journals Online (AJOL)

    Postoperative Nosocomial Infections and Antimicrobial Resistance Pattern of Bacteria Isolates among Patients Admitted at Felege Hiwot Referral Hospital, Bahirdar, ... Wound swab and venous blood samples were collected and processed for bacterial isolation and antimicrobial susceptibility testing following standard ...

  8. Resistencia al esfuerzo cortante en rellenos sanitarios

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    Eimar Andrés Sandoval-Vallejo

    2015-01-01

    Full Text Available Los rellenos sanitarios son obras ingenieriles conformadas con un material específico, cuyas propiedades de resistencia al cor te pueden determinarse de manera similar a la de un material geotécnico. Este artículo presenta resultado s de un programa experimental r ealizado con el fin de obtener los paráme tros de resistencia al corte de l relleno sanitario Presidente en el Valle del Cauca (Colombia . El programa experimental involucró ensayos d e corte directo no consolidado no drenado (UU sobre muestras reconstituidas en laboratorio. L a variación del ángulo de fricción interna y de la cohesión, como una funci ón del peso específico, profundidad, y tiempo de descomposición del relleno fue evaluada. También se compararon los resu ltados con valores internacionales usados para diseñ o. Los resultados mostraron un a marcada influencia del tiempo de descom posición en la resistencia al co rte. También se encontró ciert a dependencia con la profundidad. Los parámetros de resistencia obtenidos se encuentran dentro de ran gos internacionales recomendados para diseño.

  9. Fibras de alta resistencia: Kevlar

    OpenAIRE

    CSIC-UZA - Instituto de Ciencia de Materiales de Aragón (ICMA)

    2010-01-01

    Trabajo presentado como material divulgativo a la II Escuela de Materiales: "Aplicaciones de los Cristales Líquidos", en el marco del XI Congreso Nacional de Materiales, organizado por la Sociedad Española de Materiales y el ICMA.

  10. Nosocomial pneumonia in critically ill patients

    Directory of Open Access Journals (Sweden)

    Dandagi Girish

    2010-01-01

    Full Text Available The care of critically ill patients in the intensive care unit (ICU is a primary component of modern medicine. ICUs create potential for recovery in patients who otherwise may not have survived. However, they may suffer from problems associated with of nosocomial infections. Nosocomial infections are those which manifest in patients 48 hours after admission to hospital. Nosocomial infections are directly related to diagnostic, interventional or therapeutic procedures a patient undergoes in hospital, and are also influenced by the bacteriological flora prevailing within a particular unit or hospital. Urinary tract infections are the most frequent nosocomial infection, accounting for more than 40% of all nosocomial infections. Critical care units increasingly use high technology medicine for patient care, hemodynamic monitoring, ventilator support, hemodialysis, parenteral nutrition, and a large battery of powerful drugs, particularly antibiotics to counter infection. It is indeed a paradox that the use of high-tech medicine has brought in its wake the dangerous and all too frequent complication of nosocomial infections

  11. Streptococcus pneumoniae, mecanismos de resistencia antimicrobiana

    Directory of Open Access Journals (Sweden)

    Amauri Noda Albelo

    2011-09-01

    Full Text Available El Streptococcus pneumoniae, principal agente causal de la neumonía comunitaria, líder en la etiología de la otitis media y la meningitis, en las últimas 3 décadas ha incrementado, de manera importante, su resistencia a los agentes terapéuticos más utilizados, como los betalactámicos, macrólidos, azálidos y fluroquinolonas. La versatilidad adaptativa del microorganismo le ha permitido crear mecanismos capaces de sobreponerse a cualquiera de estas agresiones terapéuticas con un grado variable de eficacia. Se realiza una revisión de los mecanismos más importantes implicados en la adquisición de resistencia antimicrobiana por S. pneumoniae, y se precisan algunos de los factores de riesgo implicados en infección por S. pneumoniae resistente.

  12. Antibióticos vs. resistencia bacteriana

    Directory of Open Access Journals (Sweden)

    Elso Manuel Cruz Cruz

    2015-02-01

    Full Text Available La resistencia bacteriana a los antibióticos es un problema de salud mundial que se encuentra en constante evolución. De manera frecuente se reportan nuevos mecanismos de resistencia bacteriana a los antibióticos, tanto en bacterias gram negativas como en gram positivas. La presencia de resistencia en una bacteria causante de infección disminuye las posibilidades de obtener la curación clínica y la erradicación bacteriológica e incrementa los costos del tratamiento, la morbilidad y la mortalidad; por lo que es importante seleccionar el tratamiento adecuado. Uno de los aspectos que más preocupa a los médicos en el diagnóstico y tratamiento de una infección es la llamada resistencia adquirida, la cual ocurre en una bacteria inicialmente sensible a los antibióticos, por cambios, mutaciones o la adquisición de genes de resistencia durante el fenómeno de transferencia genética lateral, proceso por medio del cual un organismo transfiere material genético a otra célula que no es descendiente. La resistencia bacteriana adquirida a los antibióticos puede ser de distintos tipos, dependiendo de la presión selectiva, las mutaciones o la transferencia de genes de resistencia. Las definiciones de resistencia se clasifican según el número y clase de antibióticos afectados. La multirresistencia (Multiple Drug Resistance, MDR se define como la ausencia de sensibilidad a, por lo menos, un fármaco en tres o más de las categorías de antibióticos; la resistencia extrema (Extensively Drug-Resistant, XDR se refiere a la ausencia de sensibilidad a, por lo menos, un agente en todas las categorías de antimicrobianos, excepto en dos de ellas o menos, y la resistencia a todos los antimicrobianos se define como resistencia a todas las categorías de antibióticos. (1 Los mecanismos de resistencia dependen del tipo de bacteria que los desarrollen. Las bacterias gram positivas que producen con más frecuencias infecciones en humanos y que por

  13. Distribution of potential nosocomial pathogens in a hospital ...

    African Journals Online (AJOL)

    STORAGESEVER

    2008-10-20

    Oct 20, 2008 ... associated/acquired infections) are those infections that develop in a patient during ... nosocomial pathogens that cause infections can come either from ... aeruginosa is a regular cause of nosocomial pneumonia, urinary tract ...

  14. Inhaled Antibiotics in the Treatment of Nosocomial Pneumonia

    Directory of Open Access Journals (Sweden)

    A. N. Kuzovlev

    2013-01-01

    Full Text Available Nosocomial pneumonia is the most common nosocomial infection in intensive care units. Rational antibiotic therapy is the basis for the treatment of nosocomial pneumonia. There is currently a challenge of the pathogens of nosocomial pneumonia being resistant to most of the antibiotics recommended for its treatment. Inhaled antibiotics used in combination with systemic drugs are an effective and safe treatment for nosocomial pneumonia. This review of literature characterizes the current possibilities of inhaled antibiotic therapy for nosocomial pneumonia in detail and describes medicaments and the advantages and disadvantages of this treatment option. Despite insufficient evidence in circumstances where the microorganisms are polyresistant and where the design of novel antibiotics shows no promise, the use of inhaled antibiotics is an important alternative in the treatment of severe nosocomial pneumonia caused by polyresistant gram-negative bacteria. Key words: nosocomial pneumonia, antibiotic therapy, inhaled antibiotics, resistance.

  15. Estudio clínico y epidemiológico de un brote nosocomial producido por klebsiella oxytoca productora de IMP-8

    OpenAIRE

    Vergara López, Salvador

    2015-01-01

    Falta resumen Klebsiella oxytoca, al igual que K. pneumoniae, son dos patógenos humanos asociados a múltiples cuadros clínicos, pero fundamentalmente importantes como patógenos oportunistas. El progresivo aumento de las enfermedades crónicas, la inmunodepresión y los procedimientos agresivos, la capacidad de este género de bacterias para adaptarse al ambiente nosocomial, adquirir determinantes de resistencia frente a distintos antimicrobianos y diseminarse explican esta situación. Específi...

  16. Patrones de resistencia bacteriana en urocultivos en un hospital oncológico Antimicrobial resistance patterns of isolates from urine cultures at an oncological center

    Directory of Open Access Journals (Sweden)

    Patricia Cornejo-Juárez

    2007-10-01

    Full Text Available OBJETIVOS: Describir los patrones de resistencia bacteriana en cultivos de orina en un hospital oncológico. MATERIAL Y MÉTODOS: Se incluyeron las cepas obtenidas de cultivos de orina de 1998 a 2005. Se obtuvo el porcentaje de sensibilidad para diferentes antibióticos, tras analizar por separado cepas nosocomiales y compararlas con las de la comunidad. RESULTADOS: Se detectaron 9 232 cultivos positivos (20.7% de 44 447 muestras: gramnegativos, 78.8%; grampositivos, 13.8%; y levaduras, 7.4 por ciento. Escherichia coli fue el principal microorganismo identificado (41.3%; la resistencia en aislados nosocomiales fue mayor que en la comunidad para amikacina (92.4 y 97%, ceftazidima (83.1 y 95.1% y ciprofloxacina (46.2 y 58.6%. De igual manera, Pseudomonas aeruginosa presentó mayor resistencia para amikacina y ceftazidima en las cepas nosocomiales (55.7 y 66.6%; y 65.5 y 84.8%, respectivamente. Enterococcus resistente a vancomicina se encontró sólo en 2.5% (3/119 aislados de E. faecium. CONCLUSIONES: Existe una mayor resistencia bacteriana en las cepas de origen nosocomial en comparación con las cepas comunitarias. Se encontró un incremento progresivo de la resistencia para E. coli, el patógeno aislado con más frecuencia de infecciones nosocomiales y comunitarias. Es prioritario intensificar una campaña educativa para el control y uso racional de los antibióticos.OBJECTIVE: To describe the patterns of antimicrobial resistance of organisms isolated from urine cultures at a teaching oncological hospital for adult patients. MATERIAL AND METHODS: All strains obtained from urine cultures from 1998 to 2005 were included. Mean susceptibilities were obtained for each antimicrobial tested; nosocomial and community-acquired isolates were analyzed separately. RESULTS: A total of 9 232 positive urine cultures were obtained (20.7% from 44 447 samples taken. Gram negative bacteria were reported in 78.8%, Gram-positive in 13.8% and yeasts in 7

  17. Antibiogram of nosocomial urinary tract infections in Felege Hiwot ...

    African Journals Online (AJOL)

    Background: Nosocomial infections increase the cost of medical care, extend hospital stay and reflect on the morbidity and mortality of the admitted patients. Urinary tract infections (UTIs) are one of the most common nosocomial infections in humans. Objectives: To determine the prevalence and antibiogram of nosocomial ...

  18. Major Trends in the Microbial Etiiology of Nosocomial Infection

    NARCIS (Netherlands)

    D.R. Schaberg; D.H. Culver; R.P. Gaynes

    1991-01-01

    textabstractTo determine trends in the microbial etiology of nosocomial infections in the 1980s, surveillance data on the microbiology of documented nosocomial infection reported to the National Nosocomial Infections Surveillance System and from the University of Michigan Hospital were analyzed.

  19. Nosocomial infections due to Acinetobacter calcoaceticus.

    Directory of Open Access Journals (Sweden)

    Zaer F

    1989-01-01

    Full Text Available Fifty four isolates of Acinetobacter calcoaceticus were studied in a period of 6 months. Maximum isolates were from burns cases and environmental sampling from burns ward also grew the same organism, indicating their role as nosocomial pathogen. Acinetobacter may initially be mistaken for Neisseria species. As the organisms show multidrug resistance to commonly used antibiotics their correct identification is important.

  20. Nosocomial infections due to Acinetobacter calcoaceticus.

    Science.gov (United States)

    Zaer, F; Deodhar, L

    1989-01-01

    Fifty four isolates of Acinetobacter calcoaceticus were studied in a period of 6 months. Maximum isolates were from burns cases and environmental sampling from burns ward also grew the same organism, indicating their role as nosocomial pathogen. Acinetobacter may initially be mistaken for Neisseria species. As the organisms show multidrug resistance to commonly used antibiotics their correct identification is important.

  1. Nosocomial imipenem-resistant Acinetobacter baumannii infections ...

    African Journals Online (AJOL)

    Imipenem-resistant Acinetobacter baumannii (A. baumannii) (IRAB) has emerged as a challenging nosocomial pathogen particularly in intensive care units (ICUs). Studying the risk factors associated with IRAB infection is of paramount importance for appropriate control of IRAB spread. The aim of this study was to assess ...

  2. [Hospital hygiene - outbreak management of nosocomial infections].

    Science.gov (United States)

    Kerwat, Klaus; Wulf, Hinnerk

    2012-04-01

    According to §6, section 3 of the German Protection against Infections Act [Infektionsschutzgesetz (IfSG)] an outbreak is defined as the occurrence in large numbers of nosocomial infections for which an epidemiological relationship is probable or can be assumed. About 2-10% of nosocomial infections in hospitals (about 5% in intensive care wards) occur within the framework of an outbreak. The heaped occurrence of nosocomial infections can be declared according to the prescribed surveillance of nosocomial infections (§23 IfSG) when, in the course of this assessment, a statistically significant increase in the rate of infections becomes apparent. On the other hand, the occurrence of an outbreak can also be recognized through the vigilance of all involved personnel and a general sensibilization towards this subject. The names of patients involved in outbreaks need not be reported to the responsible health authorities. As a consequence of the report the health authorities become involved in the investigation to determine the cause and its elimination, and to provide support and advice. The outbreak management should be oriented on the respective recommendations of the Robert Koch Institute. © Georg Thieme Verlag Stuttgart · New York.

  3. Resistencia a antibióticos no betalactámicos de aislamientos invasores de Streptococcus pneumoniae en niños latinoamericanos: SIREVA II, 2000-2005 Resistance to non-beta-lactam antibiotics in the clinical isolates of Streptococcus pneumoniae of children in Latin America: SIREVA II, 2000-2005

    Directory of Open Access Journals (Sweden)

    Clara Inés Agudelo

    2009-04-01

    Full Text Available OBJETIVO:Determinar la evolución de la resistencia a la eritromicina, el cloranfenicol, el trimetoprim-sulfametozaxol (SXT y la vancomicina de aislamientos invasores de Streptococcus pneumoniae obtenidos de niños de 10 países de América Latina y del Caribe en seis años de vigilancia. MÉTODOS: Se analizaron 8 993 aislamientos de S. pneumoniae recuperados entre 2000 y 2005 de niños menores de 6 años con infecciones invasoras, procedentes de Argentina, Brasil, Chile, Colombia, Cuba, México, Paraguay, República Dominicana, Uruguay y Venezuela. La sensibilidad a los antibióticos se determinó mediante los métodos establecidos y estandarizados en el proyecto SIREVA. La resistencia a múltiples antibióticos se definió como la resistencia a tres o más familias de antibióticos, de los no betalactámicos analizados en este estudio o de los betalactámicos evaluados en un estudio previo en el que 37,8% de estos aislamientos presentaron sensibilidad disminuida a la penicilina. RESULTADOS: Se encontró algún grado de resistencia al SXT y la eritromicina (56,4% y 15,4% de los aislamientos estudiados, respectivamente y 4,6% presentó alta resistencia al cloranfenicol. Todos los aislamientos fueron sensibles a la vancomicina. Se observó la mayor frecuencia de resistencia al SXT en los aislamientos de neumonía y a la eritromicina en los casos de sepsis (61,6% y 25,5%, respectivamente; P OBJECTIVE: To examine the development of resistance to erythromycin, chloramphenicol, trimethoprim-sulfamethoxazole (TMP-SMZ, and vancomycin of the invasive isolates of Streptococcus pneumoniae obtained from children in 10 Latin American/Caribbean countries during six years of surveillance. METHODS: Analysis of 8 993 isolates of S. pneumoniae recovered in 2000-2005 from children with invasive infections, who were less than 6 years of age, and from Argentina, Brazil, Chile, Colombia, Cuba, Dominican Republic, Mexico, Paraguay, Uruguay, or Venezuela. Antibiotic

  4. Resistencia a heladas en plantas frutales

    Directory of Open Access Journals (Sweden)

    J. E. Chaar

    2013-01-01

    Full Text Available El daño por congelación en los tejidos vegetales es considerado un estrés abiótico principal en los cultivos frutales. Sin embargo, las plantas han desarrollado mecanismos de resistencia al frío. Para una especie y órgano en particular, dicha resistencia es variable a lo largo del año, en función (principalmente de la temperatura ambiental. Las temperaturas bajas, sin llegar a ser de congelación, también afectan las etapas reproductivas mediante la disminución de la actividad de los agentes polinizadores y la alteración del proceso de fecundación. Las reservas nutricionales influyen en la resistencia a heladas mediante la degradación del almidón en compuestos osmóticamente activos, que aumentan la capacidad de sobreenfriamiento del tejido vegetal. La elección del sitio de cultivo, los cultivares más resistentes a heladas y la implementación de prácticas de manejo, permitirían la disminución en la aplicación del control activo contra heladas, volviendo eficiente el uso de los recursos y disminuyendo el daño ambiental. La existencia de modelos predictivos permite adelantarse a los posibles efectos perjudiciales del calentamiento global y, por lo tanto, seleccionar con anticipación los materiales vegetales adecuados para el nuevo escenario.

  5. INSULINO RESISTENCIA EN MUJERES INFÉRTILES

    OpenAIRE

    Urdaneta Machado,José  ; Vera Cabana,Jimys; García Ildefonso,José  ; Babel Zambrano,Nasser  ; Contreras Benítez,Alfi  

    2010-01-01

    Antecedentes: La insulino resistencia (IR) es una compleja alteración fisiopatológica, presente en los órganos terminales, de alta prevalencia en mujeres en edad fértil y etapa prepuberal, con reconocida asociación a riesgo cardiovascular e infertilidad. Objetivo: Determinar la frecuencia de IR en mujeres infértiles y los factores de riesgos asociados en mujeres que acuden a la consulta de ginecología de la Maternidad "Dr. Armando Castillo Plaza". Método: Investigación de tipo aplicada y desc...

  6. Adiposidad, resistencia a la insulina y dislipidemia

    Directory of Open Access Journals (Sweden)

    Angélica María Serrano Cruz

    2011-12-01

    Full Text Available Tomando como punto de partida la discusión de un artículo publicado por la propia revista Finlay en su número anterior, esta carta se refiere específicamente a la relación entre la adiposidad visceral, la resistencia a la insulina y la dislipidemia.Adiposity, Insulin Resistance and Dyslipidemia Considering as a start point the discussion of an article published by this same journal (Finlay in its previous issue, this letter deals specifically with the relationship between visceral adiposity, insulin resistance and dyslipidemia.

  7. Resistencia bacteriana Bacterial resistance to antimicrobial agents

    Directory of Open Access Journals (Sweden)

    Jesualdo Fuentes

    1993-01-01

    Full Text Available

    Se presenta un panorama de la resistencia bacteriana incluyendo su fisiopatogenia y formas de presentación y se establecen algunas consideraciones generales de tipo clínico como auxiliares para racionalizar el uso de los antimicrobianos y evitar o retardar el problema de la resistencia; éste plantea la necesidad de un reordenamiento definitivo en la prescripción de antimicrobianos. No será tanto la creación o descubrimiento de nuevos antibióticos sino la racionalización del manejo de los existentes lo que permitirá alcanzar victorias sobre estos microorganismos. Es Importante mantener educación continua sobre el uso adecuado de los antimicrobianos desde los puntos de vista epidemiológico, farmacocinético y fisiopatogénico.

    An overview on bacterial resistance to antimicrobial agents is presented. It includes the different genetic mechanisms for Its development and the biochemical phenomena that explain It. Some clinical considerations are proposed in order to rationalize the use of these drugs and to avoid or delay the appearance of resistance.

  8. RESISTENCIAS A LA LECTURA Y RESISTENCIAS A LA TEORÍA. ALGUNOS EPISODIOS EN LA CRÍTICA LITERARIA LATINOAMERICANA

    Directory of Open Access Journals (Sweden)

    Miguel Dalmaroni

    2015-01-01

    Full Text Available La resistencia a la teoría de la lectura ―resistencia a la necesidad de un pensamiento sobre la literatura como acontecimiento y experiencia― sería una variante de la «resistencia a la teoría» (de Man; desde 1990 y hasta la actualidad tal resistencia tiene particulares manifestaciones en la crítica latinoamericana y argentina y en las «historias de la lectura»; en tales ámbitos es posible advertir el recurso a cierta idea de «historización» como vía facticista, posteórica o antiteórica para suprimir como problema crítico la resistencia de la literatura a su reducción cultural.

  9. Reducing nosocomial infections in neonatal intensive care.

    Science.gov (United States)

    Rogers, Eileen; Alderdice, Fiona; McCall, Emma; Jenkins, John; Craig, Stanley

    2010-09-01

    Nosocomial infection is a common problem in neonatal intensive care. A pilot quality improvement initiative focussing on hand hygiene and aimed at reducing nosocomial infection in very low birth weight (VLBW) infants was introduced in five Neonatal Intensive Care Units. Line associated laboratory confirmed bloodstream infection (LCBSI) and ventilator associated pneumonia (VAP) were chosen as main outcome measures. In VLBW infants, the rate of line associated LCBSI per 1000 central venous catheter days fell by 24%. The rate of VAP per 1000 ventilator days in VLBW infants fell by 38%. Pre- and post-intervention questionnaires showed a statistically significant increase in use of alcohol-based gels and increased knowledge of hand hygiene.

  10. Nosocomial outbreak of Pseudomonas aeruginosa endophthalmitis.

    Science.gov (United States)

    Mateos, I; Valencia, R; Torres, M J; Cantos, A; Conde, M; Aznar, J

    2006-11-01

    We describe an outbreak of nosocomial endophthalmitis due to a common source, which was determined to be trypan blue solution prepared in the hospital's pharmacy service. We assume that viable bacteria probably gained access to the trypan blue stock solution during cooling after autoclaving. The temporal cluster of Pseudomonas aeruginosa endophthalmitis was readily perceived on the basis of clinical and microbiological findings, and an exogenous source of contamination was unequivocally identified by means of DNA fingerprinting.

  11. [Antibibiotic resistance by nosocomial infections' causal agents].

    Science.gov (United States)

    Salazar-Holguín, Héctor Daniel; Cisneros-Robledo, María Elena

    2016-01-01

    The antibibiotic resistance by nosocomial infections (NI) causal agents constitutes a seriously global problematic that involves the Mexican Institute of Social Security's Regional General Hospital 1 in Chihuahua, Mexico; although with special features that required to be specified and evaluated, in order to concrete an effective therapy. Observational, descriptive and prospective study; by means of active vigilance all along 2014 in order to detect the nosocomial infections, for epidemiologic study, culture and antibiogram to identify its causal agents and antibiotics resistance and sensitivity. Among 13527 hospital discharges, 1079 displayed NI (8 %), standed out: the related on vascular lines, of surgical site, pneumonia and urinal track; they added up two thirds of the total. We carried out culture and antibiogram about 300 of them (27.8 %); identifying 31 bacterian species, mainly seven of those (77.9 %): Escherichia coli, Staphylococcus aureus and epidermidis, Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae and Enterobacter cloacae; showing multiresistance to 34 tested antibiotics, except in seven with low or without resistance at all: vancomycin, teicoplanin, linezolid, quinupristin-dalfopristin, piperacilin-tazobactam, amikacin and carbapenems. When we contrasted those results with the recommendations in the clinical practice guides, it aroused several contradictions; so they must be taken with reserves and has to be tested in each hospital, by means of cultures and antibiograms in practically every case of nosocomial infection.

  12. Nosocomial Legionnaires’ Disease: Clinical and Radiographic Patterns

    Directory of Open Access Journals (Sweden)

    Thomas J Marrie

    1992-01-01

    Full Text Available From 1981 to 1991, 55 patients (33 males, 22 females, mean age 58.6 years with nosocomial Legionnaires’ disease were studied. The mortality rate was 64%. One-half of the patients developed nosocomial Legionnaires’ disease within three weeks of admission. A surprising clinical feature was the low rate of findings of consolidation on physical examination, despite the fact that 52% of patients had this finding on chest radiograph. More than one-half of patients had pre-existing lung disease, rendering a radiographic diagnosis of pneumonia due to Legionella pneumophila impossible in 16% of cases despite microbiological confirmation. Nineteen per cent of patients who had blood cultures done had a pathogen other than L pneumophila isolated, suggesting dual infection in at least some of the patients. When the clinical and radiographic findings were combined it was noted that 40% of patients had one of three patterns suggestive of nosocomial Legionnaires’ disease: rapidly progressive pneumonia, lobar opacity and multiple peripheral opacities. However, in 60% of patients there were no distinctive features.

  13. Procesos metalúrgicos de aceros microaleados de alta resistencia 450 EMZ tipo II en la zona afectada térmicamente debido al efecto multipasada en soldaduras por arco sumergido

    Directory of Open Access Journals (Sweden)

    González-Palma, R.

    2006-08-01

    Full Text Available A considerable number of crack tip opening displacement tests in the heat affected zone (HAZ of multipass welds, performed in accordance with standards BS 5762 and EEMUA, are rejected since the crack is not inside the coarse grain region at 0.5 mm from the fusion border, as well as the quantity of the crack length in percentage, that the crack goes through the intercritical region instead of in the grain coarse region as it would correspond. This circumstance make advisable to carry out a metallographic study of the intercritical zone in the HAZ as well as the corresponding tests, in order analyze the intercritical region brittleness reasons. The study is performed on a HSLA 75 mm thick panel 450 EMZ type II, welded under a SAW process with heat input and welded parameters controlled, without any post weld heat treatment

    La falta de cumplimiento de las normas BS 5762 y EEMUA, en considerables casos, invalida los ensayos de mecánica de la fractura, al no encontrarse la grieta en la región de grano grueso a 0,5 mm de la línea de fusión, así como en la cantidad expresada en porcentaje de longitud de grieta que atraviesa la región intercrítica, en lugar de hacerlo en la región de grano grueso. Esta circunstancia, conduce a realizar un estudio metalográfico de dicha región intercrítica de la zona afectada térmicamente así como los correspondientes ensayos, con objeto de analizar las causas de su fragilidad. Este estudio se realiza sobre un panel de chapa de acero microaleado de alto límite elástico, calidad EMZ 450 tipo II, de 75 mm de espesor, soldado bajo un proceso por arco sumergido, con energía calorífica aportada y parámetros de soldadura controlados, sin tratamiento térmico post-soldeo.

  14. Resistencia antimicrobiana en Hospitales nor-occidentales de Nicaragua

    OpenAIRE

    Herrera, Karen; Espinoza, Meylin; Mejía, Yaoli; Zambrana, Luis Enrrique; Silva, Erasmo; Rojas, Jency; Gadea, Walter; Chavarria, Sergio; Hernandez, Mario; Ramirez, María Mercedes; Membreño, Juana María; Lara, María Eugenia; Saenz, J. E.; Valle, S.; Torrez, A.

    2007-01-01

    En los últimos años se ha observado un incremento de la incidencia de la Resistencia Antimicrobiana entre patógenos que causan infecciones intra-hospitalarias principalmente y también en la comunidad. La Resistencia antimicrobiana es un problema global de salud pública, promovido básicamente por el uso y abuso de los antibióticos. El fenómeno de la Resistencia antimicrobiana es un área prioritaria de investigación del Centro de investigación de enfermedades infecciosas y como parte de sus act...

  15. RESISTENCIA A LA INSULINA: VERDADES Y CONTROVERSIAS

    Directory of Open Access Journals (Sweden)

    DR. Felipe Pollak C.

    2016-03-01

    Full Text Available La resistencia a la insulina es una condición prevalente generalmente asociada a un estilo de vida no saludable. Se expresa en diferentes vías metabólicas y aumenta el riesgo de patologías de diferentes órganos y sistemas. Las manifestaciones clínicas son esenciales para el diagnóstico de la condición, no siendo necesario los test específicos de laboratorio. La reducción del sobrepeso y el estilo de vida saludable son las medidas terapéuticas más importantes, reservándose el uso de metformina a los casos con alto riesgo de desenlaces clínicos.

  16. Resistencia a la insulina y altura

    Directory of Open Access Journals (Sweden)

    Oscar Castillo Sayán

    2015-04-01

    Full Text Available En el presente artículo se describe las características iniciales que permitieron conocer la resistencia a la insulina. Así mismo, se muestra los estudios realizados en sujetos nativos de altura, o sea sometidos a hipoxia crónica, quienes presentan menor glicemia basal y posprandial, sin diferencias en la insulinemia en comparación con nativos de nivel del mar. Esta misma diferencia se aprecia en la menor incidencia de diabetes mellitus en la altura. Finalmente se presenta estudios realizados en sujetos nativos de nivel del mar sometidos a hipoxia aguda natural y en hipoxia intermitente en cámara hipobárica.

  17. Nosocomial Infections Transmitted Via Computers : A Literature Review

    OpenAIRE

    Atanda, Angela Achieng; Nwaoha, Nkechi Naomi

    2010-01-01

    The purpose of this review was to discuss how current literature described nosocomial infections transmitted via computers in hospitals. It also described the various methods used to disinfect computers. The research questions in this study were; What are nosocomial infections? How do contaminated computer devices transmit nosocomial infections? and What infection control methods are applied to decontaminate computers within hospitals? The aim of conducting this study was to create an aw...

  18. Resistencia bacteriana a los antimicrobianos ocasionada por bombas de eflujo

    OpenAIRE

    Marchetti, María Laura; Errecalde, Jorge Oscar; Mestorino, Olga Nora

    2011-01-01

    La resistencia a los antimicrobianos representa un severo problema a nivel mundial. Se han descripto variados mecanismos de resistencia, entre los cuales se encuentran las bombas de eflujo. Estas son proteínas transportadoras de membrana, organizadas en superfamilias y distribuidas ubicuamente entre organismos procariotas y eucariotas. Los genes que codifican para las bombas de eflujo pueden estar localizados en el cromosoma bacteriano o bien en elementos genéticos transmisibles como los plás...

  19. Dental hygiene intervention to prevent nosocomial pneumonias.

    Science.gov (United States)

    Barnes, Caren M

    2014-06-01

    Nosocomial and ventilator associated pneumonias that plague critically ill, elderly and long-term care residents could be reduced with effective oral hygiene practices facilitated collaboratively between nurses and dental hygienists. Nosocomial pneumonias, specifically aspiration pneumonias and ventilator-associated pneumonias in the elderly and infirm have become a major health care issue, The provision of oral care in hospital and hospital-like facilities presents challenges that can prevent patients from receiving optimal oral care One sequela can be aspiration pneumonia which ranks first in mortality and second in morbidity among all nosocomial infections. Since aspiration pneumonia is linked to the colonization of oral bacteria in dental plaque and biofilm, it is time to look for creative solutions to integrating the expertise of dental hygienists into health care teams in these institutional settings. A comprehensive review of the literature was conducted regarding the etiology and prevalence of health care related pneumonias. Evidence describing the challenges and barriers that the nurses, nursing staff, and dental hygienists face in the provision of oral care in hospitals and long-term care facilities is provided. Intercollaborative solutions to providing optimal oral care in hospitals and long-term care facilities are suggested. Dental hygienists have the expertise and practice experience to provide oral care in hospitals, long-term care and residential facilities. They can contribute to solving oral care challenges through intercollaboration with other health care team members. Yet, there are long-standing systemic barriers that must be addressed in order to provide this optimal care. Dental hygienists becoming better assimilated within the total health care team in hospital and residential facilities can positively impact the suffering, morbidity and mortality associated with aspiration pneumonias. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Nosocomial infections and related factors in southern khorasan hospitals

    Directory of Open Access Journals (Sweden)

    Bita Bijari

    2014-12-01

    Full Text Available Background and Aim: Nosocomial infections are defined as infections occurring during a patient's stay at hospital (48-72h after admission.Nosocomial infections are one of the important problems of health. This study aimed was determine the prevalence of nosocomial infections, and related factors in hospitals with more than 100 beds in south Khorasan Province. Materials and Methods: In this crass-sectional study, an investigator-administered questionnaire was completed for each patient with nosocomial infections diagnosis in hospitals with more than 100 beds in South Khorasan. This questionnaire conation demographic characteristic of patients, department, duration of admission, kind of pathogen and risk factors that was designed according to standard questionnaire of Iranian Nasocomial infections surveillance system (INIS of Center for communicable Disease Control, Ministry of Health. Data were analyzed with SPSS 16 software. Results and discussion: Number of patients with nosocomial infection was 358. The incidence of nosocomial infection was 0.9%. ICU had the highest incidence rate (17.3%. The most common nosocomial infection was pneumonia (43%, and urinary tract infection (UTI (15.1%. In 33.5% culture result were negative. In other cases, culture results showed klebsiella spp. (12.8% and Pseudomonas aeruginosa (9.8% were the most prevalent bacteria. Most factors associated with nosocomial infection in patients were urinary catheters (70.4%, suction (66.8% and tracheal tube (54.2%. 24% of patients expired. The results showed lower ratio of nosocomial infection, that the main reason is failure to detection and reporting of actual cases of nosocomial infection. Promoting detection and reporting system for Prevention and control of nosocomial infection was recommended

  1. Resistencia a insulina en adolescentes obesos

    Directory of Open Access Journals (Sweden)

    Maria Isabel Rojas-Gabulli

    2010-03-01

    Full Text Available Introducción: La obesidad en niños y adolescentes es un problema de salud pública que se encuentra en incremento a nivel mundial, siendo conocida su relación con el desarrollo de alteraciones metabólicas como la diabetes mellitus tipo 2. Objetivos: Determinar la presencia de resistencia a la insulina en adolescentes obesos y no obesos según sexo, edad, estadio puberal y antecedentes familiares de alteración metabólica o enfermedad cardiovascular (ECV explorando asociación y riesgo. Diseño: Estudio transversal, observacional y analítico. Lugar: Tres centros educativos de la zona urbana de Lima. Participantes: Adolescentes entre 10 y 17 años de edad. Intervenciones: Se estudió 69 adolescentes entre 10 y 17 años de edad, agrupados de acuerdo a la presencia de obesidad. El diagnóstico de obesidad fue definido por un índice de masa corporal (IMC >95 percentil; 55,1% varones y 44,9% mujeres. Se empleó el modelo de evaluación homeostática para determinar la resistencia a insulina (HOMA-IR y la función de la célula beta (HOMA-%B en ambos grupos. También se realizó determinaciones de lípidos mediante método enzimático y se aplicó una encuesta para buscar antecedentes familiares de obesidad, diabetes mellitus y enfermedad cardiovascular (ECV. El análisis estadístico se hizo mediante pruebas de correlación de Spearman y de comparación de medias con la prueba U de Mann- Whitney. Principales medidas de resultados: Insulina basal, colesterol total, triglicéridos, colesterol-VLDL, HOMA IR y HOMA%B en adolescentes obesos y no obesos. Resultados: Se encontró que la insulina basal, el colesterol total, triglicéridos, colesterol-VLDL, HOMA IR y HOMA%B fueron significativamente mayores (p<0,05 en el grupo de obesos. El HOMA-IR presentó una correlación inversa, débil, con el desarrollo puberal, particularmente en el sexo femenino (r=-0,486, p<0,05. Predominaron los antecedentes familiares de obesidad y ECV en el grupo de obesos

  2. Escherichia coli con resistencia a múltiples antimicrobianos en granjas de producción porcina de la República Argentina

    OpenAIRE

    Moredo, Fabiana Alicia; Colello, Rocío; Sanz, Marcelo Eduardo; Cappuccio, Javier Alejandro; Carriquiriborde, Martin; Etcheverría, Analía Inés; Perfumo, Carlos Juan; Padola, Nora Lía; Leotta, Gerardo Anibal

    2016-01-01

    Los objetivos del presente trabajo fueron: i) monitorear la resistencia de E. coli frente a diversos antimicrobianos frecuentemente utilizados con fines terapéuticos y profilácticos en explotaciones porcinas; ii) aislar y caracterizar fenotípica y genotípicamente E. coli toxigénicos provenientes de cerdos con diarrea pre y posdestete; iii) determinar la presencia de integrones clase 1 y 2 como posible mecanismo de diseminación de resistencia. Se procesaron 216 hisopados rectales de cerdos clí...

  3. Evolución de la resistencia antimicrobiana de bacilos Gram negativos en unidades de cuidados intensivos en Colombia

    Directory of Open Access Journals (Sweden)

    Cristhian Hernández-Gómez

    2014-04-01

    Full Text Available Introducción. La evolución de la resistencia bacteriana constituye una amenaza para la salud pública mundial. Los sistemas de vigilancia epidemiológica han integrado técnicas de biología molecular para mejorar las estrategias de control. Objetivo. Describir los perfiles moleculares y fenotípicos de los bacilos Gram negativos en unidades de cuidados intensivos de 23 hospitales de Colombia entre 2009 y 2012. Materiales y métodos. Se diseñó un estudio descriptivo en 23 hospitales del Grupo para el Estudio de la Resistencia Nosocomial (sic. en Colombia. Se analizaron 38.048 aislamientos usando WHONET durante el periodo descrito. Se describieron perfiles de resistencia para Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa y Acinetobacter baumannii. En 1.248 cepas se realizó reacción en cadena de la polimerasa (PCR para detectar las carbapenemasas clínicamente más relevantes. Resultados. Escherichia coli fue el microorganismo más frecuente (promedio=14,8 %; la frecuencia de aislamientos de K. pneumoniae aumentó de 11 % en 2009 a 15 % en 2012 (p<0,001. La tendencia de los perfiles de multirresistencia aumentó en todas las especies estudiadas. De los aislamientos de K. pneumoniae evaluados, 68,4 % fue positivo para KPC (Klebsiella pneumoniae Carbapenemase, mientras que la VIM (Verona Integron-encoded Metallo-betalactamase en P. aeruginosa se observó en 46,5 %. Conclusiones. Se observó un incremento en la tendencia de los microorganismos hacia la multirresistencia y una amplia distribución de las carbapenemasas. La articulación de la biología molecular con los sistemas de vigilancia permitió integrar el análisis del fenotipo con los mecanismos de resistencia involucrados en las bacterias estudiadas. Este análisis permitirá la elaboración de guías para el uso adecuado de antimicrobianos y contribuirá a la contención de estas bacterias multirresistentes en Colombia.

  4. Acinetobacter spp. as nosocomial pathogens: Epidemiology and resistance features

    Directory of Open Access Journals (Sweden)

    Saad B. Almasaudi

    2018-03-01

    Full Text Available The genus Acinetobacter is a major cause of nosocomial infections; it is increasingly being associated with various epidemics and has become a widespread concern in a variety of hospitals worldwide. Multi-antibiotic resistant Acinetobacter baumannii, is now recognized to be of great clinical significance. Numerous reports relay to the spread of A. baumannii in the hospital settings which leads to enhanced nosocomial outbreaks associated with high death rates. However, many other Acinetobacter spp. also can cause nosocomial infections. This review focused on the role of Acinetobacter spp. as nosocomial pathogens in addition to their persistence, antimicrobial resistance patterns and epidemiology. Keywords: Acinetobacter, Nosocomial infections, Multi-drug resistance, Epidemiology, Characteristics

  5. Nosocomial outbreak of cryptosporidiosis in AIDS patients

    DEFF Research Database (Denmark)

    Ravn, Pernille; Lundgren, Jens Dilling; Kjaeldgaard, P

    1991-01-01

    OBJECTIVE--To describe a nosocomial outbreak of cryptosporidiosis during four months after June 1989. SETTING--A department of infectious diseases in Copenhagen, seeing about half the patients with AIDS in Denmark. SUBJECTS--73 HIV antibody negative subjects and 60 antibody positive subjects...... admitted as inpatients during the transmission period of the outbreak (20 June-14 August), of whom 18 (17 with AIDS, one with AIDS related complex), developed cryptosporidiosis. Two further HIV negative subjects (one departmental secretary, one visiting relative) developed cryptosporidiosis. MAIN OUTCOME...... out ice for cold drinks. The mean incubation time was at least 13 days-that is, twice that in HIV-negative patients. Of the 18 patients with AIDS who developed cryptosporidiosis, five recovered, two were symptomless carriers, three died of unrelated causes, and eight died after prolonged diarrhoea...

  6. Nosocomial infections by respiratory syncytial virus in children

    Directory of Open Access Journals (Sweden)

    Maren Karina Machado Echeverría

    2017-01-01

    Full Text Available Introduction: Acute lower respiratory infections cause high morbidity and mortality in children. Respiratory syncytial virus (RSV is the most prevalent agent. Some viruses cause serious nosocomial infections. In Uruguay, there is no knowledge about the morbidity and mortality of nosocomial infections by RSV. Objective: To determine the prevalence and characteristics of RSV nosocomial infections. Methodology: A descriptive study of acute lower respiratory infections caused by RSV in patients younger than two years, between 1/1/2005 and 31/12/2008 at the Hospital Pediátrico del Centro Hospitalario Pereira Rossell, was made. Results: Were identified 59 patients who represented an annual rate lower than 2/1000 discharges. The monthly distribution of cases was similar to the respiratory infections. No outbreaks were reported. The age of the patients had an average of 8.9 months, 39 were younger than one year, 23 had one or more risk factors for severe disease. Six patients required admission to intensive care unit, all required invasive ventilation, 3 died, none had chronic respiratory failure following the RSV nosocomial infection. Conclusions: During the study period, the RSV nosocomial infections showed a low prevalence, despite it highly contagiousness. They mainly affected young children, carriers of risk factors for severe ALRI. Their evolution was similar to that reported for RSV respiratory infections community acquired. It is important to maintain standards for the control of nosocomial infections, to prevent nosocomial transmission of RSV and prevent the onset of severe disease in hospitalized patients.

  7. Electronic monitoring and voice prompts improve hand hygiene and decrease nosocomial infections in an intermediate care unit.

    Science.gov (United States)

    Swoboda, Sandra M; Earsing, Karen; Strauss, Kevin; Lane, Stephen; Lipsett, Pamela A

    2004-02-01

    To determine whether electronic monitoring of hand hygiene and voice prompts can improve hand hygiene and decrease nosocomial infection rates in a surgical intermediate care unit. Three-phase quasi-experimental design. Phase I was electronic monitoring and direct observation; phase II was electronic monitoring and computerized voice prompts for failure to perform hand hygiene on room exit; and phase III was electronic monitoring only. Nine-room, 14-bed intermediate care unit in a university, tertiary-care institution. All patient rooms, utility room, and staff lavatory were monitored electronically. All healthcare personnel including physicians, nurses, nursing support personnel, ancillary staff, all visitors and family members, and any other personnel interacting with patients on the intermediate care unit. All patients with an intermediate care unit length of stay >48 hrs were followed for nosocomial infection. Electronic monitoring during all phases, computerized voice prompts during phase II only. We evaluated a total of 283,488 electronically monitored entries into a patient room with 251,526 exits for 420 days (10,080 hrs and 3,549 patient days). Compared with phase I, hand hygiene compliance in patient rooms improved 37% during phase II (odds ratio, 1.38; 95% confidence interval, 1.04-1.83) and 41% in phase III (odds ratio, 1.41; 95% confidence interval, 1.07-1.84). When adjusting for patient admissions during each phase, point estimates of nosocomial infections decreased by 22% during phase II and 48% during phase III; when adjusting for patient days, the number of infections decreased by 10% during phase II and 40% during phase III. Although the overall rate of nosocomial infections significantly decreased when combining phases II and III, the association between nosocomial infection and individual phase was not significant. Electronic monitoring provided effective ongoing feedback about hand hygiene compliance. During both the voice prompt phase and post

  8. RESISTENCIA AL CORTE EN DISCONTINUIDADES CON DIFERENTES GRADOS DE RUGOSIDAD

    Directory of Open Access Journals (Sweden)

    Javier Fernando Camacho Tauta

    2009-01-01

    Full Text Available En esta investigación se realizaron ensayos triaxiales sobre rocas artifi ciales elaboradascon un mortero (arena, cemento y agua de diferente resistencia. Se incluyeron cilindros sin y con una discontinuidad orientada a 60° con respecto al eje horizontal y tres diferentes grados de rugosidad, (pulida plana, pulida ondulada y ondulada. Se determinaron los parámetros de resistencia de las probetas de mortero y se analizó la infl uencia de los diferentes grados de rugosidad utilizando el criterio de Barton, obteniendo el coefi ciente de rugosidad de la discontinuidad.

  9. 102 nosocomial infections and the challenges of control

    African Journals Online (AJOL)

    Dr Oboro VO

    AFRICAN JOURNAL OF CLINICAL AND EXPERIMENTAL MICROBIOLOGY MAY 2010 .... international organizations including accreditation and governmental agencies, national associations and organizations, World ... coupled with research to keep nosocomial ..... medical/dental students, student nurses and other.

  10. Modelling the contact propagation of nosocomial infection in emergency departments

    OpenAIRE

    Jaramillo, Cecilia; Taboada, Manel; Epelde, Francisco; Rexachs, Dolores; Luque Amat, Emilio

    2015-01-01

    The nosocomial infection is a special kind of infection that is caused by microorganisms acquired inside a hospital. In the daily care process of an emergency department, the interactions between patients and sanitary staff create the environment for the transmission of such microorganisms. Rates of morbility and mortality due to nosocomial infections areimportant indicators of the quality of hospital work. In this research, we use Agent Based Modeling and Simulation tech...

  11. Pneumonia nosocomial: Actualização terapêutica

    Directory of Open Access Journals (Sweden)

    João Pedro Falcão Baptista

    2005-08-01

    Full Text Available Resumo: A pneumonia nosocomial é uma doença frequente, potencialmente fatal, e que apresenta elevada mortalidade. Neste artigo, após revisão crítica dos consensos e protocolos actuais para o tratamento da pneumonia nosocomial, são actualizadas as bases racionais da antibioterapia, revendo os aspectos epidemiológicos, microbiológicos e farmacológicos. No final faz-se referência ao posicionamento dos mais recentes antibióticos disponíveis para o seu tratamento. Abstract: Nosocomial pneumonia is a common disease with high mortality rate. In this article we review the antibiotic therapy fundamentals highlighting epidemiological, microbiological and pharmacological aspects, based on the actual consensus and protocols for the management of nosocomial pneumonia. In the end we make a short review of the current antibiotherapy practiced in this clinical situation. Palavras-chave: Pneumonia nosocomial, pneumonia associada ao ventilador, tratamento empírico, descalonamento terapêutico, antibioterapia, farmacodinâmica, farmacocinética, Key words: Nosocomial pneumonia, ventilator associated pneumonia, empirical therapy, de-escalation, antibiotherapy, pharmacodynamics, pharmacokinetics

  12. NOSOCOMIAL INFECTIONS IN PATIENTS WITH UROLITHIASIS IN THE POSTOPERATIVE PERIOD

    Directory of Open Access Journals (Sweden)

    F. S. Sadulloev

    2015-01-01

    Full Text Available Abstract:Objective: To determine the most frequent causative agents of nosocomial infection in patients with urolithiasis in the postoperative period.Material and Methods. The study is based on the results of comprehensive studies conducted in 122 patients with nosocomial urinary tract infection, detected in 823 patients with urolithiasis treated by various methods. A cohort of 823 patients is isolated from 2688 patients treated without at admission signs of infections in the urinary tract for the period 2011–2014. All patients were treated at the Urological department of Avicenna Tajik State Medical University in the Republican Clinical Center of Urology. Main results. By the method of randomly selected 823 medical records of patients with urolithiasis various operations we carried out with 122 patients revealed cases of nosocomial infections. The diagnosis of nosocomial infections on the basis of established symptomatic urinary tract infection, asymptomatic bacteriuria or the presence of wound infection, use during the hospital stay for treatment of antibiotics, antiseptics, physiotherapy and other therapies. The incidence of nosocomial infections was studied in dependence with the severity of the underlying disease, the volume of surgical, invasive, endoscopic and other urological procedures, the timing and frequency of tests, the proportion of individual clinical manifestations in the overall structure of urinary tract infections, sex and age of patients.Conclusions. The leading microflora causing nosocomial infection in patients with urolithiasis in all treatments are gram-negative microorganisms, including prevailing E.coli (24,0%.

  13. [Prevalence of nosocomial infections in two hospitals in Conakry (Guinea)].

    Science.gov (United States)

    Keita, Alpha Kabinet; Doumbouya, Naman; Sow, Mamadou Saliou; Konaté, Bintou; Dabo, Yacouba; Panzo, Daniel Agbo; Keita, Mamady

    2016-01-01

    Nosocomial infections can be prevented by applying simple hygiene rules. However, they have not been sufficiently studied in the Republic of Guinea. For this purpose, we conducted a one-day study in the Conakry University Hospital surgery wards and intensive care units. Fourteen units (12 surgical wards and 2 intensive care units) participated in the study. A total of 310 patients were included. A nosocomial infection was observed in 62 patients, [20%, 95%CI 15.9-24.8%]. Surgical site infections were significantly more frequent with 42/62 cases [67.7%, 95%CI 55.3-78.1%, p = 0.0001] than other types of infections (urinary tract, skin and digestive) with 20/62 cases [32.3% 95%CI 21.9-44.6%]. The average hospital stay of 29.1 ± 23.4 days [95%CI, 23.2 ± 35.04] for patients with nosocomial infection was significantly different (p = 0.0001) from that observed in patients without nosocomial infection: 15.9 ± 16.3 days [95%CI, 13.8 ± 17.9]. Staphylococcus aureus was the pathogen most commonly isolated: 32/62 (51.6%; 95%CI 39.5-63.6%). Escherichia coli infection was identified in the bladder catheters of 13 patients [20.9%, 95%CI 12.7-32.6%]. Finally, five deaths were observed among the 62 patients with nosocomial infection. This study shows that nosocomial infections are common in Conakry University Hospital. Further studies must be conducted to identify the risk factors for nosocomial infections and to propose solutions.

  14. Vigilancia de los niveles de uso de antibióticos y perfiles de resistencia bacteriana en hospitales de tercer nivel de la Ciudad de México Surveillance of antibiotic utilization and bacterial resistance profiles in tertiary level hospitals in Mexico City

    Directory of Open Access Journals (Sweden)

    Lilia Benavides-Plascencia

    2005-06-01

    Full Text Available OBJETIVO: Determinar los niveles de uso de antibióticos y el perfil de resistencia de las bacterias nosocomiales, e identificar y proponer estrategias para disminuir la resistencia a los antibióticos. MATERIAL Y MÉTODOS: Estudio descriptivo, retrolectivo (1994-1995, hecho en seis hospitales de tercer nivel de la Ciudad de México. RESULTADOS: La resistencia del grupo hospitalario fue de 86%, mientras que el consumo total de antibióticos por institución varió entre 44 y 195 dosis diarias definidas/100 camas-día. CONCLUSIONES: Se identificaron los elementos para instrumentar un sistema de vigilancia integral que mejore el uso de antibióticos y la valoración de la resistencia bacteriana.OBJECTIVE: To identify the levels of antibiotic utilization and the resistance profiles of nosocomial bacteria, as well as the strategies to diminish resistance to antibiotics. MATERIAL AND METHODS: A descriptive, retrospective (1994-1995 study was conducted in six tertiary level hospitals in Mexico City. RESULTS: A total of 86% antibiotic resistance was observed in these hospitals. The overall consumption of antibiotics per hospital ranged between 44 and 195 Defined Daily Doses/100 day-beds. CONCLUSIONS: We identified the components to frame an integral surveillance system aimed at improving the use of antibiotics and the quality of the bacterial resistance assessment in these hospitals.

  15. De la resistencia gaitanista a la resistencia liberal; Villavicencio 1948- 1950

    Directory of Open Access Journals (Sweden)

    Andrés Gómez Barrera

    2011-01-01

    Full Text Available A través de fuentes escritas y orales en el presente artículo se identifican: primero, las relaciones políticas entre la élite y los sectores populares en Villavicencio durante los años de 1948 a 1950; segundo, la existencia e influencia del movimiento gaitanista en Villavicencio; y tercero, movimientos insurgentes nacidos en la capital del Meta como forma de resistencia a la represión que ejerció el gobierno conservador contra el liberalismo entre los años de 1948 a 1953. A través de la historia de Villavicencio se obtiene una amplia visión de la Violencia y del sistema socio-político, tanto de la élite regional como de los sectores populares colombianos de mediados del siglo XX. De tal manera, que al unir la violencia de Villavicencio con el todo (Colombia, no sólo se logra la construcción del conocimiento histórico, sino el entendimiento y comprensión del proceso conocido en Colombia como la Violencia.

  16. Frequency of nosocomial pneumonia in ICU Qazvin Razi hospital (2013

    Directory of Open Access Journals (Sweden)

    S. Makhlogi

    2016-12-01

    Full Text Available Background: Nosocomial pneumonia is the most prevalent cause of hospital-acquired infection in intensive care units (ICU. The aim of this research was to detect the frequency and predisposing factors of nosocomial Ventilator Associated Pneumonia, by cross sectional study on 188 patients that were hospitalized in ICU Qazvin Razi Hospital. Using questionnaire based on the national nosocomial infection surveillance system (NNIS data collected and analyzed. The average age of patients was 51±24 years old, 37 hospitalized patients (19/6% in the fourth day of admission were affected Ventilator Associated Pneumonia. The most common pathogenesis of causing nosocomial pneumonia were klebsiella in 13 patients (35/1%, staph in 8 patients (21/6%, sodomona in 8 patients (21/6%, ecoli in 3 patients (8/1%, cetrobacter in 2 patients (5/4%, antrococus and Proteus each of them in 1 patient (each 2/7%. Considering (19/6% frequency of nosocomial pneumonia in this study, it’s necessary to act standard protocols in nursing care and medication process.

  17. Nosocomial Infections in Nuclear Medicine Departments: some considerations

    International Nuclear Information System (INIS)

    Metello, L.F.; Cunha, L.; Martins, M.; Isabel, O.; Ribeiro, G.

    2002-01-01

    Aim: Surveillance for Nosocomial Infection has become an integral part of hospital practice. Studies conducted more than 30 years ago by the Centers for Disease Control and Prevention (CDC) documented the efficacy of these surveillance activities in reducing Nosocomial Infection occurrence. It is clear that surveillance for Nosocomial Infection involves more than just documenting infection rates. However, many times the professionals involved have tended to stop at the point where rates are reported and fail to complete the task of implementing changes based on the analysis of rates or disseminating information. Moreover specific documentation regarding Nuclear Medicine Departments is not available. We therefore decided to produce this work based in the recognition of this specific need. Methods and Conclusions: Having previously defined the 'state-of-the-art' from science and technology concerning Nosocomial Infection Control and after particular study regarding technical/clinical reality of Nuclear Medicine Departments, namely introducing the radioactivity as a factor that must be taken into account with all its implications and interactions, we have obtained a group of considerations and/or recommendations to be considered in order to accomplish the maximum Quality and Efficiency regarding the Control of Nosocomial Infection in Nuclear Medicine Departments

  18. Prevention of nosocomial infections in developing countries, a systematic review.

    Science.gov (United States)

    Murni, Indah; Duke, Trevor; Triasih, Rina; Kinney, Sharon; Daley, Andrew J; Soenarto, Yati

    2013-05-01

    Prevention of nosocomial infection is key to providing good quality, safe healthcare. Infection control programmes (hand-hygiene campaigns and antibiotic stewardship) are effective in reducing nosocomial infections in developed countries. However, the effectiveness of these programmes in developing countries is uncertain. To evaluate the effectiveness of interventions for preventing nosocomial infections in developing countries. A systematic search for studies which evaluated interventions to prevent nosocomial infection in both adults and children in developing countries was undertaken using PubMed. Only intervention trials with a randomized controlled, quasi-experimental or sequential design were included. Where there was adequate homogeneity, a meta-analysis of specific interventions was performed using the Mantel-Haenzel fixed effects method to estimate the pooled risk difference. Thirty-four studies were found. Most studies were from South America and Asia. Most were before-and-after intervention studies from tertiary urban hospitals. Hand-hygiene campaigns that were a major component of multifaceted interventions (18 studies) showed the strongest effectiveness for reducing nosocomial infection rates (median effect 49%, effect range 12.7-100%). Hand-hygiene campaigns alone and studies of antibiotic stewardship to improve rational antibiotic use reduced nosocomial infection rates in three studies [risk difference (RD) of -0.09 (95%CI -0.12 to -0.07) and RD of -0.02 (95% CI -0.02 to -0.01), respectively]. Multifaceted interventions including hand-hygiene campaigns, antibiotic stewardship and other elementary infection control practices are effective in developing countries. The modest effect size of hand-hygiene campaigns alone and negligible effect size of antibiotic stewardship reflect the limited number of studies with sufficient homogeneity to conduct meta-analyses.

  19. Mupirocin prophylaxis against nosocomial Staphylococcus aureus infections in nonsurgical patients: a randomized study

    NARCIS (Netherlands)

    M.C. Vos (Margreet); A. Ott (Alewijn); A. Voss (Andreas); J.A.J.W. Kluytmans (Jan); C.M.J.E. Vandenbroucke-Grauls (Christina); M.H.M. Meester (Marlene); P.H.J. van Keulen (Peter); H.A. Verbrugh (Henri); H.F.L. Wertheim (Heiman)

    2004-01-01

    textabstractBACKGROUND: Staphylococcus aureus nasal carriage is a major risk factor for nosocomial S. aureus infection. Studies show that intranasal mupirocin can prevent nosocomial surgical site infections. No data are available on the efficacy of mupirocin in nonsurgical

  20. [Listeria monocytogenes nosocomial infection in the maternity ward].

    Science.gov (United States)

    Jean, D; Croize, J; Hirtz, P; Legeais, C; Pelloux, I; Favier, M; Mallaret, M R; Le Noc, P; Rambaud, P

    1991-01-01

    Nosocomial infection with Listeria monocytogenes 4b occurred in January 1990 in a maternity hospital in Grenoble. The 3 patients involved were born within a 24 hour-interval. The premature newborn responsible for contamination was asymptomatic. Two other newborns without any perinatal infectious risk presented with meningitis, one on the 5th day of life in the maternity hospital, the other one on the 11th day while already at home. The 3 strains of Listeria had the same serovar and lysovar. Epidemiologic investigations led to suspect a contamination in the delivery room and during the care of the children. Strict respect of hygiene orders is imperative to avoid nosocomial infections.

  1. Nosocomial transmission of Cupriavidus pauculus during extracorporeal membrane oxygenation.

    Science.gov (United States)

    Stovall, S H; Wisdom, C; McKamie, W; Ware, W; Dedman, H; Fiser, R T

    2010-01-01

    Patients undergoing extracorporeal membrane oxygenation (ECMO) are at increased risk of infection. We present the first known report of nosocomial infection with Cupriavidus pauculus attributable to contamination from ECMO equipment and describe the measures taken to halt subsequent infections. A cluster of infections in ECMO patients should prompt team members to consider contamination of equipment with environmental pathogens as a possible cause.

  2. Comparison of two nosocomial infection surveillance in a neonatal ward

    Directory of Open Access Journals (Sweden)

    Masomeh Abedini

    2014-01-01

    Conclusion: It seems that a large part of this considerable differences between the results of this study compared to NNIS based study, is this fact that, for nosocomial infection surveillance in the neonatal field, the presence of a specialist as a performer and leader of the team, is necessary.

  3. Drug-resistant post-neurosurgical nosocomial Acinetobacter ...

    African Journals Online (AJOL)

    Drug-resistant post-neurosurgical nosocomial Acinetobacter baumannii meningitis in two Iranian hospitals. ... Vol 11, No 17 (2012) >. Log in or Register to get access to full text downloads. ... Acinetobacter baumannii may cause meningitis and ventriculitis, particularly after head trauma and/or neurosurgery. The rate of ...

  4. Neonatal intensive care unit: Reservoirs of Nosocomial pathogens ...

    African Journals Online (AJOL)

    Improvement in the care and treatment of neonates had contributed to their increased survival. Nosocomial infection remains an important problem in intensive care units. Hospital wards had been shown to act as reservoirs of pathogenic microorganisms associated with infection. To assess the prevalence of pathogenic ...

  5. Risk factors for postoperative nosocomial infections among patients ...

    African Journals Online (AJOL)

    Objectives: The aim of this study was to identify possible risk factors for post operative nosocomial infections among operated patients at Felege Hiwot Referral ... Bacterial culture confirmation was done for all patients who developed clinical signs and symptoms of surgical site and/or bloodstream infection starting from the ...

  6. Monitoring of nosocomial infections as an element of prevention

    Directory of Open Access Journals (Sweden)

    Izabela Gąska

    2017-10-01

    Full Text Available Introduction. Hospital infections are one of the most serious threats to the hospitalised patient and their monitoring is recognised as one of the most important criteria of care quality for modern hospitals. The aim of the work was to present the problem of nosocomial infections and desired behaviours and activities in the field of infection prophylaxis. Material and method. The analysis of the current scientific literature was carried out with particular attention to the prevention of infections in treatment wards and the need to monitor the patient's condition and the environment in the case of an infection. Results. The lack of developed and implemented programmes for the control of nosocomial infections is a fundamental element that increases the risk of nosocomial infections. This disrupts the proper functioning of the hospital and causes additional health problems for the patient and the ward staff. In addition, the hospital suffers losses instead of savings, which is a priority aim in the current funding system. Conclusions. The basis for eliminating or minimising the incidence of nosocomial infections is a well-developed and implemented programme of hospital infection control based on the education of medical personnel in the field of infection prevention. Constant, comprehensive assessment of the procedures used and the standards of conduct, epidemiological data as well as microbiological data can ensure quick identification and elimination of the threat.

  7. Nosocomial infections at Clinical Centre in Kragujevac: Prevalence study

    Directory of Open Access Journals (Sweden)

    Ilić Milena

    2010-01-01

    Full Text Available Introduction Nosocomial infections (NIs are a serious health problem in hospitals worldwide and are followed by a series of consequences, medical, judicial, ethical and economic. Objective The main aim of this study was to assess the magnitude of NIs at the Clinical Centre in Kragujevac. Methods A prevalence study of nosocomial infections was conducted from 16th till 20th May, 2005, within Second National Prevalence Study of Niš in the Republic of Serbia. Results The study included 866 patients. 40 patients had a NI, thus the prevalence of patients with NIs and prevalence of NIs was the same, 4.6%. Among NIs, the most frequent were urinary infections (45.0% followed by surgical-site infections (17.5%, skin and soft tissue infections (15% and pneumonia (12.5%. The rate of NIs was highest at departments of orthopaedics and traumatological surgery (12.0%, followed by intensive care units (8.0%. Overall, 67.5% (27/40 NIs were culture-proved; the leading pathogens were Escherichia coli (40.0%, followed by gram-negative bacteria (Pseudomonas species, Proteus mirabilis, Enterobacteriaceae with equal frequency of 8.0%. Nosocomial infections were significantly more frequent in patients aged ≥65 years (p<0.05, with longer hospitalization ≥8 days (p<0.00, in intensive care patients (p<0.05, patients with an intravenous catheter (p<0.00, urinary catheter (p<0.00, and those under antibiotic therapy (p<0.00. Conclusion This study showed that the prevalence of nosocomial infections in our hospital is similar to the prevalence in the developed countries. The study of prevalence provides a prompt insight into basic epidemiological and ethiological characteristics of nosocomial infections, hence identification of hospital priorities and the need to undertake appropriate prevention measures. .

  8. [Estimation of economic costs for the care of patients with nosocomial pneumonia in a regional peruvian hospital, 2009-2011].

    Science.gov (United States)

    Dámaso-Mata, Bernardo; Chirinos-Cáceres, Jesús; Menacho-Villafuerte, Luz

    2016-06-01

    To estimate and compare the economic costs for the care of patients with and without nosocomial pneumonia at Hospital II Huánuco EsSalud during 2009-2011, in Peru. This was a partial economic evaluation of paired cases and controls. A collection sheet was used. nosocomial pneumonia. direct health costs, direct non-health costs, indirect costs, occupation, age, comorbidities, sex, origin, and education level. A bivariate analysis was performed. Forty pairs of cases and controls were identified. These patients were hospitalized for >2 weeks and prescribed more than two antibiotics. The associated direct health costs included those for hospitalization, antibiotics, auxiliary examinations, specialized assessments, and other medications. The direct non-health costs and associated indirect costs included those for transportation, food, housing, foregone payroll revenue, foregone professional fee revenue, extra-institutional expenses, and payment to caregivers during hospitalization and by telephone. The direct health costs for nosocomial pneumonia patients were more than three times and the indirect costs were more than two times higher than those for the controls. Variables with the greatest impact on costs were identified.

  9. Resistencia a los repilos de distintas variedades de olivo

    OpenAIRE

    Trapero Casas, Antonio; López Doncel, Luis Miguel; Oliveira, R.; Gutiérrez, F.; Navarro, N.; Alsalimiya, Mohammed; Benali, A.; Ávila de La Calle, A.; Bouhmidi, K.; Moral, J.; Roca, L.F.

    2005-01-01

    El repilo, la antracnosis y el emplomado son tres enfermedades conocidas comúnmente con el término repilos. Actualmente estos repilos causan en España más del 10% de las pérdidas de la cosecha y un deterioro notable de la calidad del aceite. Por ello, el estudio de las distintas variedades de olivo presentes en el mundo en cuanto a resistencia/susceptibilidad a estas enfermedades y la obtención de nuevas variedades resistentes sigue siendo un objetivo prioritario entre los investigadores en e...

  10. Propuestas para el entrenamiento combinado de fuerza y resistencia

    OpenAIRE

    López de Viñaspre, Pablo; Comellas, Josep

    2000-01-01

    Muchas especialidades deportivas requieren de un buen nivel de entrenamiento tanto en la capacidad de fuerza como en la de resistencia. Por este motivo, se incluye el entrenamiento combinado de estas dos cualidades en el programa de entrenamiento de muchos deportistas. Por otro lado, en el deporte recreativo, el concepto del Fitness es ya común entre la mayoría de la población y va tomando cada vez más importancia. Actualmente se busca el bienestar global (tendencia del Wellness) a través de ...

  11. Ensayos acelerados de resistencia del hormigón

    Directory of Open Access Journals (Sweden)

    Krishna Iyer, R.

    1979-09-01

    Full Text Available Not avaible

    Las normas para proyectar las estructuras de hormigón se basan, en cuanto a calidad se refiere, en los resultados del ensayo de la compresión de probetas preparadas y curadas en condiciones normalizadas, rotas a 28 días de edad. Este largo plazo causa dificultades pues sus indicaciones se conocen cuando ya han sido colocadas grandes cantidades de hormigón; esto es trágico si el resultado acusa una calidad defectuosa. Se impone utilizar métodos acelerados que permitan aplicar inmediatos correctivos en casos necesarios. Los métodos acelerados permiten, además, conocer rápidamente si la proporción proyectada alcanza las resistencias requeridas. Los autores estudian tres modos de operar, limitándose principalmente al estudio de la relación entre los resultados obtenidos para la resistencia a la compresión alcanzada por el método normalizado a 28 días y la que arrojan los ensayos acelerados, por el hormigón preparado con cemento portland ordinario.

  12. Exploring 5-nitrofuran derivatives against nosocomial pathogens: synthesis, antimicrobial activity and chemometric analysis.

    Science.gov (United States)

    Zorzi, Rodrigo Rocha; Jorge, Salomão Dória; Palace-Berl, Fanny; Pasqualoto, Kerly Fernanda Mesquita; Bortolozzo, Leandro de Sá; de Castro Siqueira, André Murillo; Tavares, Leoberto Costa

    2014-05-15

    The burden of nosocomial or health care-associated infection (HCAI) is increasing worldwide. According to the World Health Organization (WHO), it is several fold higher in low- and middle-income countries. Considering the multidrug-resistant infections, the development of new and more effective drugs is crucial. Herein, two series (I and II) of 5-nitrofuran derivatives were designed, synthesized and assayed against microorganisms, including Gram-positive and -negative bacteria, and fungi. The pathogens screened was directly related to either the most currently relevant HCAI, or to multidrug-resistant infection caused by MRSA/VRSA strains, for instance. The sets I and II were composed by substituted-[N'-(5-nitrofuran-2-yl)methylene]benzhydrazide and 3-acetyl-5-(substituted-phenyl)-2-(5-nitro-furan-2-yl)-2,3-dihydro-1,3,4-oxadiazole compounds, respectively. The selection of the substituent groups was based upon physicochemical properties, such as hydrophobicity and electronic effect. The compounds have showed better activity against Staphylococcus aureus, Escherichia coli, and Enterococcus faecalis. The findings from S. aureus strain, which was more susceptible, were used to investigate the intersamples and intervariables relationships by applying chemometric methods. It is noteworthy that the compound 4-butyl-[N'-(5-nitrofuran-2-yl)methylene]benzhydrazide has showed similar MIC value to vancomycin, which is the reference drug for multidrug-resistant S. aureus infections. Taken the findings together, the 5-nitrofuran derivatives might be indeed considered as promising hits to develop novel antimicrobial drugs to fight against nosocomial infection. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Hand hygiene for the prevention of nosocomial infections.

    Science.gov (United States)

    Kampf, Günter; Löffler, Harald; Gastmeier, Petra

    2009-10-01

    The WHO regards hand hygiene as an essential tool for the prevention of nosocomial infection, but compliance in clinical practice is often low. The relevant scientific literature and national and international evidence-based recommendations (Robert Koch Institute [Germany], WHO) were evaluated. Hygienic hand disinfection has better antimicrobial efficacy than hand-washing and is the procedure of choice to be performed before and after manual contact with patients. The hands should be washed, rather than disinfected, only when they are visibly soiled. Skin irritation is quite common among healthcare workers and is mainly caused by water, soap, and prolonged wearing of gloves. Compliance can be improved by training, by placing hand-rub dispensers at the sites where they are needed, and by physicians setting a good example for others. Improved compliance in hand hygiene, with proper use of alcohol-based hand rubs, can reduce the nosocomial infection rate by as much as 40%.

  14. Asymptomatic carriers contribute to nosocomial Clostridium difficile infection

    DEFF Research Database (Denmark)

    Blixt, Thomas; Gradel, Kim Oren; Homann, Christian

    2017-01-01

    BACKGROUND & AIMS: Nosocomial infection with Clostridium difficile pose a considerable problem despite numerous attempts by health care workers to reduce risk of transmission. Asymptomatic carriers of C difficile might spread their infection to other patients. We investigated the effects...... of of asymptomatic carriers on nosocomial C difficile infections. METHODS: We performed a population-based prospective cohort study at 2 university hospitals in Denmark, screening all patients for toxigenic C difficile in the intestine upon admittance, from October 1, 2012, to January 31, 2013. Screening results...... were blinded to patients, staff, and researchers. Patients were followed during their hospital stay by daily registration of wards and patient rooms. The primary outcomes were rate of C difficile infection in exposed and unexposed patients and factors associated with transmission. RESULTS: C difficile...

  15. Surveillance of nosocomial infections in Dr. Cipto Mangunkusumo National General Hospital, Jakarta, 1999-2002

    Directory of Open Access Journals (Sweden)

    Djoko Widodo

    2004-06-01

    Full Text Available Nosocomial infection are one of the main problem in hospital which are associated with significant morbidity, mortality and increased economic cost. Surveillance should be attempted regularly to obtain local data of incidence of nosocomial infections, types of infection, pathogen and resistance pattern. We reported the results of nosocomial surveillance in Dr. Cipto Mangunkusumo National General Hospital, Jakarta, in year 1999 to 2002. The data were obtained from surveillance, conducted by Nosocomial Infection Control Committee. Surveillance were performed to patient in risk of nosocomial infections such as underwent surgical procedure, urinary catheter, peripheral or central venous catheter, ventilator and other invasive procedure. Criteria for nosocomial infection which were used, based on technical guidelines of nosocomial infection in Dr. Cipto Mangunkusumo National General Hospital, year 1999; which referred to CDC definition of nosocomial infections. Incidence rate of nosocomial infections in year 1999, 2000, 2001 and 2002 were 1.1, 0.9, 0.6 and 0.4 % respectively. Type of nosocomial infection include catheter related, surgical wound, urinary tract and respiratory tract infections, ranged between 0 to 5.6 %. Gram negative bacteria consist of Pseudomonas sp, Enterobacter aerogenes, Escherichia coli, Proteus mirabilis were the most common nosocomial pathogen. Gram positive bacteria consist of Staphylococcus epidermidis, Staphylococcus aureus and Streptococcus anhemolyticus. Trend of increasing incidence of Gram positive nosocomial infection also showed in our surveillance. Mostly Gram negative bacteria had been resistant to penicillin, co amoxicillin-clavulanic acid and 3rd generation cephalosporin, but still sensitive to 4th generation cephalosporin and aminoglycoside. The Gram positive bacteria were still sensitive to penicillin, co amoxicillin-clavulanic acid, 4th generation cephalosporin and aminoglycoside. (Med J Indones 2004; 13: 107

  16. Resistencia bacteriana de cultivos de orina en un hospital oncológico:seguimiento a diez años

    Directory of Open Access Journals (Sweden)

    Consuelo Velázquez-Acosta

    2016-07-01

    Full Text Available Objetivo. Describir los patrones de resistencia bacteriana en cultivos de orina de pacientes de un hospital oncológico en la Ciudad de México, de 2004 a 2013. Material y métodos. Se obtuvo el porcentaje de susceptibilidad para diferentes antibióticos, describiendo por separado las bacterias multidrogorresistentes (MDR. Se analizaron por separado las cepas obtenidas de pacientes hospitalizados de las de la comunidad. Resultados. Se realizaron 51 202 cultivos, de los cuales se identificaron 14 480 bacterias (28.3%. De éstas, se reportaron 11 427 Gram negativos (78.9%; 2 080 Gram positivos (14.4%; y 973 (6.6% levaduras. Escherichia coli fue el principal microorganismo aislado (56.1%; 24% de las cepas de la comunidad y 66% de las nosocomiales fueron productoras de beta-lactamasas de espectro extendido (BLEE. Klebsiella pneumoniae se identificó en 705 cultivos (4.8%, 115 de los cuales fueron BLEE (16%: 13.1% de la comunidad y 29.8% nosocomiales. Pseudomonas aeruginosa se identificó en 593 cultivos (4.1%: 9% de la comunidad y 51% nosocomiales. Conclusiones. Las cepas MDR son mucho más frecuentes en muestras de origen nosocomial. Es prioritario intensificar el uso racional de antibióticos en la comunidad y el programa de desescalamiento de antimicrobianos en el hospital.   DOI: http://dx.doi.org/10.21149/spm.v58i4.8025

  17. Emerging Trend of Acinetobacter Nosocomial Infection in Northeast of Iran

    Directory of Open Access Journals (Sweden)

    Samaneh Saed

    2015-10-01

    Full Text Available Background: Acinetobacter spp. emerged as an opportunistic pathogen for hospital-acquired infections. Recently, increasing antibiotic resistance among Acinetobacter spp. has worsened the problem. The aim of this study was to investigate  the  emerging  trend  of  infection  due  to Acinetobacter  in Ghaem University Hospital, Mashhad during 2006-2012.Methods: The demographic data and information about redisposing factors was collected. Appropriate bacteriological samples were collected and Acinetobacter spp. was isolated. Antibiotics susceptibility pattern of these isolates againstdifferent antimicrobials agents was determined.Results: Results confirmed that Acinetobacter spp. cause 20.9% of nosocomial infection during this period. The trend of Acinetobacter nosocomial infection was increasing and patients with risk factors such as COPD, bronchectasia, diabetes   mellitus   were   more   prone   to   infection.  There   was   significant association   between   these   infections   and   invasive   procedures   such   as catheterization, mechanical ventilation and broad-spectrum antibiotics usage. Conclusion:  Understanding  trends  in  causative  organisms  of  nosocomial infection can help us to better define our infection control policy.

  18. Nosocomial pneumonia in the ICU--year 2000 and beyond.

    Science.gov (United States)

    Bowton, D L

    1999-03-01

    Diagnostic and treatment strategies in ICU patients with ventilator-associated pneumonia (VAP) remain controversial, largely because of the paucity of well-controlled comparison trials using clinically important end points. Recent studies indicating that early appropriate antibiotic therapy significantly lowers mortality underscore the urgent need for well-designed comparative trials. When quantitatively cultured, bronchial specimens obtained by noninvasive techniques may provide clinically useful information and avoid the higher costs and risks of invasive bronchoscopic diagnostic techniques. Previous antibiotic use before onset of nosocomial pneumonia raises the likelihood of infection with highly virulent organisms, such as Pseudomonas aeruginosa and Acinetobacter sp. Thus, the empiric antibiotic regimen should be active against these Gram-negative pathogens as well as other common Gram-negative and Gram-positive causative organisms. Promising preventive modalities for nosocomial VAP include use of a semirecumbent position, endotracheal tubes that allow continuous aspiration of secretions, and heat and moisture exchangers. Rotating their standard empiric antibiotic regimens and restricting the use of third-generation cephalosporins as empiric therapy may help hospitals reduce the incidence of nosocomial pneumonia caused by resistant Gram-negative pathogens.

  19. [Orion (Outbreak Reports and Intervention studies of Nosocomial Infection) used for evaluating interventions and investigations of nosocomial infection outbreaks].

    Science.gov (United States)

    Pires-Cronenberger, S; Nicolle, M-C; Voirin, N; Giard, M; Luxemburger, C; Vanhems, P

    2009-04-01

    British colleagues have developed the Outbreak Reports and Intervention studies of Nosocomial Infection (Orion) guidelines with the aim to promote transparency of publications in the field of health-care associated infections and particularly for reports of outbreak investigation or intervention studies. The aim of this study was to translate the Orion criteria and to promote their use in France. The Orion guidelines include a checklist of 22 commented items related to the title, abstract, introduction, methods, results, and discussion sections of a scientific article. Specific points for each item are developed to enhance its relevance. The use of Orion guidelines by authors and editors should be encouraged and should improve the quality of standards in research, intervention studies, and publications on nosocomial infections and health-care associated infections.

  20. La evolución de la resistencia bacteriana en México, 1973-2013

    Directory of Open Access Journals (Sweden)

    Eduardo Rodríguez-Noriega

    2014-04-01

    Full Text Available Introducción. La resistencia bacteriana a los antibióticos es un problema de salud mundial. Las investigaciones relacionadas con este problema emergente son indispensables para reconocer y desarrollar programas para su vigilancia y control. Objetivo. Revisar y comentar las contribuciones de los investigadores mexicanos en el área de la resistencia bacteriana a los antibióticos. Materiales y métodos. Se realizó una búsqueda de la literatura científica relacionada con la resistencia bacteriana a los antibióticos producida por investigadores mexicanos y registrada en Medline-PubMed entre 1973 y julio de 2013. Resultados. En 66 publicaciones, las contribuciones de investigadores mexicanos incluyeron datos sobre la resistencia de agentes patógenos entéricos como Salmonella Typhi, múltiples contribuciones sobre la producción de betalactamasas de espectro extendido, de metalobetalactamasas y de carbapenemasas, los mecanismos de resistencia en Pseudomonas aeruginosa y la evolución de la resistencia en cocos Gram positivos como Streptococcus pneumoniae, Staphylococcus aureus y Enterococcus spp., entre otros. Conclusiones. Los datos publicados en los últimos 40 años son fuente adecuada para entender la evolución de la resistencia bacteriana a los antibióticos y desarrollar programas para su control.

  1. Una Mirada Probabilística al Concreto de Alta Resistencia

    OpenAIRE

    Zaira A. Cerón S.; Juan Ruge; Álvaro Rodríguez

    2015-01-01

    Este artículo presenta el análisis probabilístico realizado a dos diseños de mezcla para concreto de alta resistencia como primer paso para obtener un modelo estadístico que logre expresar los resultados de una forma más útil y permita determinar la resistencia y la calidad potencial del concreto. El análisis de resultados del ensayo de resistencia a compresión del concreto se llevó a cabo mediante el uso de un software estadístico llamado SPSS, que a partir de las diferentes variables estadí...

  2. Prácticas de Física: Resistencia de un voltímetro

    OpenAIRE

    Beléndez, Augusto; Bernabeu, Guillermo; Vera Guarinos, Jenaro; Pastor Antón, Carlos; Martín García, Agapito

    1988-01-01

    El objetivo de esta práctica es determinar la resistencia interna de un voltímetro. Para ello se utilizan varias resistencias de valor conocido. El voltímetro es un aparato que sirve para medir la diferencia de potencial entre dos puntos de un circuito. Los voltímetros de aguja se basan en el mismo principio que el amperímetro de aguja, pues ambos se pueden construir mediante un galvanómetro de cuadro móvil, pero en el caso del voltímetro se monta en serie con el galvanómetro una resistencia ...

  3. Resistencia a fármacos en pacientes en tratamiento antirretroviral, Cali, Colombia, 2008-2010

    OpenAIRE

    Jorge L. Martínez-Cajas; Héctor F. Mueses-Marín; Pablo Galindo-Orrego; Juan F. Agudelo; Jaime Galindo-Quintero

    2013-01-01

    Introducción. En Colombia se ha publicado poco sobre farmacorresistencia del VIH en pacientes que toman tratamiento antirretroviral (TAR). Las guías de VIH de Colombia de 2006 no recomiendan el uso de los estudios genotípicos de resistencia (EGR) en pacientes nunca expuestos a medicamentos antirretrovirales ni después del primer fracaso terapéutico. Objetivo. Determinar la frecuencia de mutaciones de resistencia y el grado de susceptibilidad/resistencia del VIH a los antirretrovirales en...

  4. Normas para la determinación de las resistencias del cemento

    Directory of Open Access Journals (Sweden)

    Meyer, A.

    1964-09-01

    Full Text Available Not availableTodas las normas de cemento contienen disposiciones sobre el ensayo de resistencia, ya que la resistencia constituye, generalmente, la base de la que se parte para determinar la calidad del cemento. Como las normas de los distintos países no suelen ser iguales, el ensayo de un mismo cemento, hecho según cada una de ellas, da unas cifras muy diferentes, lo cual dificulta considerablemente la comparación de la resistencia de un cemento entre los distintos métodos de ensayo.

  5. POÉTICA DE RESISTENCIA EN ITXARO BORDA

    Directory of Open Access Journals (Sweden)

    Tina Escaja

    2014-10-01

    Full Text Available La actitud reivindicativa y visionaria de la pluralidad (del cuerpo, el lenguaje, la sexualidad, la cultura y la geografía en la obra poética de Itxaro Borda es signo de celebración alternativa y de resistencia hacia los valores que impone una nacionalidad vasca unívoca, hipermasculina y fija que con frecuencia la autora vascofrancesa explícitamente denuncia. Su crítica al lenguaje/nación desde el lenguaje/nación que incorpora las diferencias, logra desarticular el discurso unívoco del poder, resistiendo esencialismos y jerarquías desde una «centralidad móvil» o movilidad periférica en la estética de alternancias que plantea su obra poética.

  6. Resistencia bacteriana a los antimicrobianos: Una terrible amenaza

    Directory of Open Access Journals (Sweden)

    Gustavo Malagón Londoño

    2014-09-01

    Full Text Available La resistencia microbiana a la acción de los antibióticos se cierne a pasos agigantados, algo que embarga la atención del mundo médico y preocupa hondamente al sector hospitalario. Crece el desconcierto y a veces la sensación de impotencia del profesional, con la natural desazón, angustia y desconfianza de las familias. Lo más selecto del mundo científico y de los organismos nacionales é internacionales (con la Organización Mundial de la Salud a la cabeza, adelantan grandes esfuerzos ante la arremetida de esos minúsculos organismos que propician uno de los más serios problemas de salud pública.

  7. Métodos de molienda, granulometría y resistencia desarrollada por los diferentes cementos

    Directory of Open Access Journals (Sweden)

    Beke, B.

    1961-12-01

    Full Text Available Not availableSe han realizado dos series de ensayos para determinar la influencia de las varias fracciones granulométricas en el endurecimiento o desarrollo de resistencias de diferentes cementos.

  8. Impact of inappropriate antimicrobial therapy on patients with bacteremia in intensive care units and resistance patterns in Latin America Impacto de la terapia antimicrobiana inapropiada en pacientes con bacteriemia en unidades de cuidado intensivo y patrones de resistencia en América Latina

    Directory of Open Access Journals (Sweden)

    J. A. Cortés

    2010-09-01

    Full Text Available Patient care in an intensive care unit (ICU is associated with an increased risk of developing nosocomial infections. Bacteremia is responsible for a great number of cases, 23% of which have attributable mortality in developed countries and can affect up to 52% of ICU patients. The main cause of mortality is inadequate and inappropriate antimicrobial empirical therapy. The incorrect use of antimicrobials is a major risk for identifying multidrug resistant microorganisms, thereby involving increased morbidity, mortality and costs. Implementing several surveillance systems and becoming acquainted with resistance patterns represent a valuable tool for identifying, preventing and treating this infectious complication. There is paucity of data regarding antimicrobial resistance in bacteremic patients in Latin America, and the available data reveals a worrying scenario.El manejo médico en la unidad de cuidado intensivo (UCI se asocia con un mayor riesgo de infecciones intrahospitalarias. Las bacteriemias tienen una alta frecuencia en dichas unidades, se presentan hasta en el 52% de los pacientes allí asistidos y en los países desarrollados se les atribuye una mortalidad del 23%, que se debe fundamentalmente al uso de tratamiento empírico inadecuado o inapropiado. El uso incorrecto de los antimicrobianos es uno de los principales factores de riesgo para el desarrollo de la resistencia bacteriana, que conlleva la selección de microorganismos multirresistentes, el aumento de la morbilidad y la mortalidad y el incremento en los días de estancia hospitalaria y del costo por hospitalización. La implementación de diferentes sistemas de vigilancia y el conocimiento de la variabilidad en la resistencia a los antimicrobianos constituyen valiosas herramientas para identificar y prevenir la resistencia a los antibióticos y para orientar la terapéutica. En América Latina disponemos de pocos datos sobre las tasas de resistencia y aquellos disponibles

  9. Vigilancia de la resistencia de Mycobacterium tuberculosis a las drogas antituberculosas en Cuba, 1995-1998.

    Directory of Open Access Journals (Sweden)

    Ernesto Montoro

    2004-06-01

    Full Text Available La vigilancia de la resistencia a fármacos a través del cultivo y de las pruebas de susceptibilidad in vitro permite conocer la magnitud regional y mundial de la resistencia en tuberculosis. En el presente trabajo se determinó la prevalencia de la resistencia a fármacos antituberculosos en Cuba, durante el periodo 1995-1998 en casos nuevos y en aquéllos que han recibido tratamiento previo. Los resultados incluidos en este estudio forman parte de los dos proyectos mundiales organizados por la OMS/UICTER. La resistencia a los medicamentos se evaluó usando el método de las proporciones en 1.379 cepas de Mycobacterium tuberculosis a los fármacos de primera línea (isoniacida, rifampicina, estreptomicina y etambutol. La resistencia en casos nuevos fue del 8,3% y 6,5% y la resistencia múltiple a fármacos (multidrug-resistance, MDR fue del 0,7% y 0% en el primer y segundo estudio, respectivamente. Estos resultados permitieron demostrar la escasa circulación de cepas MDR en Cuba; se reconoció a nivel mundial el buen funcionamiento del Programa Nacional de Control y el éxito de la aplicación en nuestro país de la estrategia del tratamiento estrictamente supervisado desde 1971.

  10. [Bacteriologic and clinical analysis of nosocomial infections in patients from the intensive care unit].

    Science.gov (United States)

    Nikodemski, T

    1999-01-01

    confirmed reduction in Ofloxacin, fluoroquinolones and Colistin consumption over 18 months period (Fig. 2). We observed statistically significant decrease in amount of isolated Proteus spp. strains from 70 in I'95 to 31 in II'95 (p generation cephalosporins and fluoroquinolones (Tab. 3). We have analysed the influence of antibiotic use on the aetiology of nosocomial infection. Table 4 shows statistically significant correlation between Acinetobacter spp., MRSA, MRSE isolates and antibiotics consumption. Crosstabulated variables analyses confirm MRSE outbreaks in periods when excessive amount of Amikacin (p < 0.05 for chi 2 test, D Somer rate 0.59, V Cramer rate 0.67), aminoglicosides (p < 0.05 for chi 2 test, D Somer rate 0.57, V Cramer rate 0.59), imipenem (p < 0.05 for chi 2 test, D Somer rate 0.44, V Cramer rate 0.60) and total antibiotics consumption were high (p < 0.005 for chi 2 test, D Somer rate 0.67, V Cramer rate 0.81) (Fig. 3). This study illustrates the influence of antimicrobial therapy on the species and the resistance of strains isolated in nosocomial infection. Restrictive antibiotics policy does not affect ITU outcome. Better strategies for antibiotic administration in the ITU setting may improve their efficacy and control the spread of nosocomial infection caused by multi-resistant organisms. Therefore, restrictive antibiotic policy would be mandatory in each hospital and department.

  11. Prevention of nosocomial infections in critically ill patients with lactoferrin (PREVAIL study): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Muscedere, John; Maslove, David; Boyd, John Gordon; O'Callaghan, Nicole; Lamontagne, Francois; Reynolds, Steven; Albert, Martin; Hall, Rick; McGolrick, Danielle; Jiang, Xuran; Day, Andrew G

    2016-09-29

    Nosocomial infections remain an important source of morbidity, mortality, and increased health care costs in hospitalized patients. This is particularly problematic in intensive care units (ICUs) because of increased patient vulnerability due to the underlying severity of illness and increased susceptibility from utilization of invasive therapeutic and monitoring devices. Lactoferrin (LF) and the products of its breakdown have multiple biological effects, which make its utilization of interest for the prevention of nosocomial infections in the critically ill. This is a phase II randomized, multicenter, double-blinded trial to determine the effect of LF on antibiotic-free days in mechanically ventilated, critically ill, adult patients in the ICU. Eligible, consenting patients will be randomized to receive either LF or placebo. The treating clinician will remain blinded to allocation during the study; blinding will be maintained by using opaque syringes and containers. The primary outcome will be antibiotic-free days, defined as the number of days alive and free of antibiotics 28 days after randomization. Secondary outcomes will include: antibiotic utilization, adjudicated diagnosis of nosocomial infection (longer than 72 h of admission to ICU), hospital and ICU length of stay, change in organ function after randomization, hospital and 90-day mortality, incidence of tracheal colonization, changes in gastrointestinal permeability, and immune function. Outcomes to inform the conduct of a larger definitive trial will also be evaluated, including feasibility as determined by recruitment rates and protocol adherence. The results from this study are expected to provide insight into a potential novel therapeutic use for LF in critically ill adult patients. Further, analysis of study outcomes will inform a future, large-scale phase III randomized controlled trial powered on clinically important outcomes related to the use of LF. The trial was registered at www

  12. Predicting nosocomial lower respiratory tract infections by a risk index based system

    NARCIS (Netherlands)

    Chen, Yong; Shan, Xue; Zhao, Jingya; Han, Xuelin; Tian, Shuguang; Chen, Fangyan; Su, Xueting; Sun, Yansong; Huang, Liuyu; Grundmann, Hajo; Wang, Hongyuan; Han, Li

    2017-01-01

    Although belonging to one of the most common type of nosocomial infection, there was currently no simple prediction model for lower respiratory tract infections (LRTIs). This study aims to develop a risk index based system for predicting nosocomial LRTIs based on data from a large point-prevalence

  13. Nosocomial Candidiasis: Antifungal Stewardship and the Importance of Rapid Diagnosis.

    Science.gov (United States)

    Pfaller, Michael A; Castanheira, Mariana

    2016-01-01

    Candidemia and other forms of candidiasis are associated with considerable excess mortality and costs. Despite the addition of several new antifungal agents with improved spectrum and potency, the frequency of Candida infection and associated mortality have not decreased in the past two decades. The lack of rapid and sensitive diagnostic tests has led to considerable overuse of antifungal agents resulting in increased costs, selection pressure for resistance, unnecessary drug toxicity, and adverse drug interactions. Both the lack of timely diagnostic tests and emergence of antifungal resistance pose considerable problems for antifungal stewardship. Whereas antifungal stewardship with a focus on nosocomial candidiasis should be able to improve the administration of antifungal therapy in terms of drug selection, proper dose and duration, source control and de-escalation therapy, an important parameter, timeliness of antifungal therapy, remains a victim of slow and insensitive diagnostic tests. Fortunately, new proteomic and molecular diagnostic tools are improving the time to species identification and detection. In this review we will describe the potential impact that rapid diagnostic testing and antifungal stewardship can have on the management of nosocomial candidiasis. © The Author 2015. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Milton Nascimento: El circo como lugar de resistencia cultural

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    Alberto Carlos de Souza

    2013-02-01

    Full Text Available Oficina de cultura de resistencia realizada con 27 niños de 10 años de edad, Estudiantes de una escuela pública municipal de Vitoria – ES, y que tuvo como propósito celebrar El Día Internacional Del Circo, El 27 de marzo. Toda La producción estética de dicha oficina giro en torno de la música “Circo Marimbondo”, de La autoria de Milton Nascimento y Fernando Brant (1978 y consto con la  elaboración de pictografías de artistas circenses (dibujo con masa de modelar, a partir de la pregunta rectora ¿“Quienes son esos marimbondos, de quien tanto habla la música?” Los marimbondos fueron representados por los niños principalmente como figura artistas fantásticos como: payasos, bailarinas, hombres bala, trapecista, y la mujer barbuda o mujer gorila. El taller finalizo con La presentación de toda la producción estética para la familia de aquellos niños. Palabras Clave: Milton Nascimento, Música Popular Brasilera, Cultura de resistencia.__________________Abstract:Workshop by culture of resistance carried out with 27 children from 10 years old, students at a local public school in Vitória - ES, which aimed to celebrate the International Day Circus on March 27. All the aesthetic production of the workshop revolved around the song Circus Wasp, by Milton Nascimento and Fernando Brant (1978 and consisted elaboration of pictography of circus artists (drawing with clay modeling , from question: "Who are these wasps whose music speaks so much?" The wasps were represented mainly by children like it features amazing artists as: clowns, dancers, man bullet, trapeze artists, and bearded woman or female gorilla. The workshop culminated with the presentation of the whole aesthetic production to the family of those children.Keywords: Milton Nascimento, Brazilian Popular Music, Culture of resistance.

  15. Resistencia del hormigón en estructuras terminadas

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    Tobío, J. M.

    1968-09-01

    Full Text Available This paper deals, in a highly practical manner, with the question of determining the true strength of concrete in its final functional state, and it also contains recommendations on safety, and on the dispersal of results. Some testing methods are mentioned and discussed, which are applicable to working site use, and detailed information is given on the precautions that should be taken so that a non destructive auscultation should give reliable data on the actual strength of the concrete.Desde un punto de vista eminentemente práctico, se aborda el problema de la verdadera resistencia del hormigón terminado, con ciertas indicaciones respecto a la seguridad y las dispersiones. Se citan y comentan algunos métodos de ensayo, de especial aplicación en obra, y se muestran, con bastante detalle, las precauciones que es preciso tomar para que una auscultación no destructiva responda fielmente al estado resistente actual del hormigón.

  16. Resistencia a drogas de segunda línea en cepas peruanas de Mycobacterium tuberculosis multidrogorresistentes

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    Francesca Barletta

    Full Text Available Objetivos. Determinar los perfiles de resistencia de las quinolonas; ciprofloxacina (Cpx, ofloxacina (Ofx, gatifloxacina (Gfx y moxifloxacina (Mfx, y de los inyectables; kanamicina (Km, amikacina (Am y capreomicina (Cm en cepas multidrogorresistente (MDR. Se buscó la presencia de mutaciones en los genes rrs,tlyA y gyrA/B, y su posible asociación con la resistencia a inyectables y quinolonas. Materiales y métodos. En este estudio piloto descriptivo se seleccionaron cepas MDR aisladas durante junio a diciembre de 2004, que fueron criopreservadas en el banco de muestras del Instituto de Medicina Tropical "Alexander von Humboldt" en Lima, Perú. Se determinó la concentración mínima inhibitoria (CMI para Cpx, Ofx, Gfx, Mfx, Km, Am y Cm. Se investigó las mutaciones presentes en los genes rrs, tlyA y gyrA/B a través de un PCR convencional y posterior secuenciamiento de los productos obtenidos. Resultados. Cuatro de los once aislados presentaron resistencia contra los inyectables y en todas se observó una alta CMI; >120 μg/mL para Km y >160 μg/mL para Am y Cm. Solo dos aislados presentaron resistencia a Ofx con un CMI = 4 μg/mL. Los resultados de secuenciamiento sugirieron que la mutación A1401T en rrs podría ser la causa molecular de resistencia a los inyectables; mientras que en este estudio no se halló ninguna mutación en tlyA ni en gyrA/B asociada a resistencia. Conclusiones. Este estudio sugiere una posible asociación entre la mutación en A1401G y la resistencia a los antibióticos inyectables.

  17. Resistencia a fármacos en pacientes en tratamiento antirretroviral, Cali, Colombia, 2008-2010

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    Jorge L. Martínez-Cajas

    2013-12-01

    Full Text Available Introducción. En Colombia se ha publicado poco sobre farmacorresistencia del VIH en pacientes que toman tratamiento antirretroviral (TAR. Las guías de VIH de Colombia de 2006 no recomiendan el uso de los estudios genotípicos de resistencia (EGR en pacientes nunca expuestos a medicamentos antirretrovirales ni después del primer fracaso terapéutico. Objetivo. Determinar la frecuencia de mutaciones de resistencia y el grado de susceptibilidad/resistencia del VIH a los antirretrovirales en pacientes expuestos a TAR. Materiales y métodos. Se reclutó una muestra no probabilística de 170 pacientes con infección por VIH que tomaban TAR, experimentaban fracaso virológico y que tenían EGR. Se estudió la farmacorresistencia del VIH en dos grupos: EGR temprano vs. EGR tardío. Resultados. El tipo de resistencia más frecuente en pacientes que toman TAR afectó a los inhibidores no nucleosídicos (76%. El grupo tardío tuvo mayor riesgo de resistencia a inhibidores nucleosídicos y a los inhibidores de proteasa, mayor número de mutaciones de resistencia y mayor complejidad de las resistencias que el grupo temprano. También se encontró un alto grado (30% de resistencia cruzada a los inhibidores nucleosídicos en el grupo tardío. Los medicamentos menos afectados fueron tenofovir y darunavir. Conclusiones. Los resultados de este estudio sugieren que realizar EGR tardíos se asocia a altos niveles de resistencia, lo cual puede restringir el uso de un gran número de ARVs esenciales en regímenes subsiguientes. Es necesario revisar las actuales recomendaciones sobre el uso de EGR en las guías Colombianas de manejo de VIH.    doi: http://dx.doi.org/10.7705/biomedica.v33i4.1462

  18. Resistencia a los antibacterianos en América Latina: consecuencias para la infectología Antibacterial drug resistance in Latin America: consequences for infectious disease control

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    José María Casellas

    2011-12-01

    Full Text Available La resistencia a los fármacos antibacterianos tiene particular importancia en América Latina. En este artículo se analiza la resistencia a los antimicrobianos de tres clases de bacterias de importancia clínica: bacterias grampositivas, enterobacterias y bacilos gramnegativos no fermentadores. Las bacterias grampositivas que producen infecciones humanas frecuentes son, en su mayoría, cocos: estafilococos, estreptococos (incluidos neumococos y enterococos, tanto en el medio comunitario como en el nosocomial. Esta situación no es diferente en la Región de las Américas. Entre las bacterias grampositivas, las que causan bacteriemia con mayor frecuencia corresponden a cepas de estafilococos coagulasa negativos, seguidas de las de enterococos. En este informe se analiza la resistencia de estas especies a distintos antimicrobianos, los mecanismos de resistencia para las cepas de origen hospitalario y comunitario y los nuevos medicamentos para tratar las infecciones por estas bacterias. La resistencia a los antimicrobianos de las cepas de Enterococcus en América Latina todavía es un problema menor en relación con la situación en los Estados Unidos de América. Las cepas del género Streptococcus aisladas de infecciones respiratorias aún son sensibles a penicilina. Por otra parte, la resistencia de las enterobacterias es de gran importancia en la Región, particularmente por la gran difusión de betalactamasas de espectro extendido (BLEE de tipo CTX-M, algunas de las cuales se originaron en América Latina. En el presente artículo se analizan la situación de la resistencia de las cepas de Streptococcus pneumoniae, y de los estreptococos betahemolítico y del grupo viridans. Entre los bacilos gramnegativos no fermentadores, si bien las cepas de Pseudomonas aeruginosa siguen siendo la causa principal de bacteriemias, la proliferación de infecciones por cepas de Acinetobacter spp. tiene en algunas partes gran magnitud. En lo referente a los

  19. Daily antibiotic cost of nosocomial infections in a Turkish university hospital

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    Yalcin Ata

    2005-01-01

    Full Text Available Abstract Background Many studies associated nosocomial infections with increased hospital costs due to extra days in hospital, staff time, extra investigations and drug treatment. The cost of antibiotic treatment for these infections represents a significant part of hospital expenditure. This prospective observational study was designed to determine the daily antibiotic cost of nosocomial infections per infected adult patient in Akdeniz University Hospital. Methods All adult patients admitted to the ICUs between January 1, 2000, and June 30, 2003 who had only one nosocomial infection during their stay were included in the study. Infection sites and pathogens, antimicrobial treatment of patient and it's cost were recorded. Daily antibiotic costs were calculated per infected patient. Results Among the 8460 study patients, 817 (16.6% developed 1407 episodes of nosocomial infection. Two hundred thirty three (2.7% presented with only one nosocomial infection. Mean daily antibiotic cost was $89.64. Daily antibiotic cost was $99.02 for pneumonia, $94.32 for bloodstream infection, $94.31 for surgical site infection, $52.37 for urinary tract infection, and $162.35 for the other infections per patient. The treatment of Pseudomonas aeruginosa infections was the most expensive infection treated. Piperacillin-tazobactam and amikacin were the most prescribed antibiotics, and meropenem was the most expensive drug for treatment of the nosocomial infections in the ICU. Conclusions Daily antibiotic cost of nosocomial infections is an important part of extra costs that should be reduced providing rational antibiotic usage in hospitals.

  20. Una Mirada Probabilística al Concreto de Alta Resistencia

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    Zaira A. Cerón S.

    2015-07-01

    Full Text Available Este artículo presenta el análisis probabilístico realizado a dos diseños de mezcla para concreto de alta resistencia como primer paso para obtener un modelo estadístico que logre expresar los resultados de una forma más útil y permita determinar la resistencia y la calidad potencial del concreto. El análisis de resultados del ensayo de resistencia a compresión del concreto se llevó a cabo mediante el uso de un software estadístico llamado SPSS, que a partir de las diferentes variables estadísticas permitió indagar si la distribución de frecuencias, correspondía a la distribución normal que sigue el concreto convencional. Los resultados obtenidos muestran la distribución o la tendencia de resistencia de cada uno de los diseños. El análisis cuantitativo evidencia que la variación de resistencia del concreto refleja con rigor la importancia que tiene conocer las propiedades de la mezcla de concreto y el proceso en los métodos de ensayo.

  1. Resistencia antimicrobiana de Salmonella, Shigella y Vibrio cholerae: Perú 1997-2002

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    Isabel Arias B

    2004-10-01

    Full Text Available La resistencia a los antimicrobianos es un problema de salud pública, en este caso se presentan los resultados de la resistencia antimicrobiana de Salmonella, Shigella y Vibrio cholerae entre los años 1997 y 2002 de las cepas confirmadas por el Instituto Nacional de Salud, procedentes de los laboratorios referenciales regionales de las diferentes direcciones de salud del Perú. La confirmación se realizó mediante bioquímica y serotipificación; para las pruebas de sensibilidad se utilizó el método de disco difusión. Se evaluaron un total de 542 cepas de Salmonella, 1034 de Shigella y 603 de Vibrio cholerae. La resistencia de Shigella frente a ampicilina muestra un promedio de 74,4% durante los 6 años; cloramfenicol con 65,9 %, cotrimoxazol con 72,2 %. En Salmonella se observa un promedio de 3,46 % para ampicilina; 2,83 % para cloranfenicol; en gentamicina 3,9 % y cotrimoxazol 1,1. V. Cholerae entre 1997 y 1999 mostraron promedios de resistencia de 19 % a cotrimoxazol, 12,1 % a tetraciclina y 10,2 % a ampicilina. A partir del año 2000, no se reportaron casos, por lo que se recibieron pocas cepas de esta especie. Se evidencia el problema de resistencia de Shigella frente a ampicilina, cloramfenicol y cotrimoxazol.

  2. Controlling nosocomial infection based on structure of hospital social networks.

    Science.gov (United States)

    Ueno, Taro; Masuda, Naoki

    2008-10-07

    Nosocomial infection (i.e. infection in healthcare facilities) raises a serious public health problem, as implied by the existence of pathogens characteristic to healthcare facilities such as methicillin-resistant Staphylococcus aureus and hospital-mediated outbreaks of influenza and severe acute respiratory syndrome. For general communities, epidemic modeling based on social networks is being recognized as a useful tool. However, disease propagation may occur in a healthcare facility in a manner different from that in a urban community setting due to different network architecture. We simulate stochastic susceptible-infected-recovered dynamics on social networks, which are based on observations in a hospital in Tokyo, to explore effective containment strategies against nosocomial infection. The observed social networks in the hospital have hierarchical and modular structure in which dense substructure such as departments, wards, and rooms, are globally but only loosely connected, and do not reveal extremely right-skewed distributions of the number of contacts per individual. We show that healthcare workers, particularly medical doctors, are main vectors (i.e. transmitters) of diseases on these networks. Intervention methods that restrict interaction between medical doctors and their visits to different wards shrink the final epidemic size more than intervention methods that directly protect patients, such as isolating patients in single rooms. By the same token, vaccinating doctors with priority rather than patients or nurses is more effective. Finally, vaccinating individuals with large betweenness centrality (frequency of mediating connection between pairs of individuals along the shortest paths) is superior to vaccinating ones with large connectedness to others or randomly chosen individuals, which was suggested by previous model studies.

  3. Nosocomial bloodstream infection in a tertiary care paediatric intensive care unit

    International Nuclear Information System (INIS)

    Hamid, M.H.; Maqbool, S.

    2007-01-01

    To determine the frequency, causative organisms and susceptibility pattern of nosocomial bloodstream infections in children. All children admitted to the unit during the study period were daily evaluated for features suggestive of nosocomial infection. In addition to other investigations, blood cultures were done in all suspected cases for the confirmation of nosocomial bloodstream infection (BSI). Nosocomial infection was defined according to the criteria set by Centre for Disease Control and Prevention. Demographic, microbiological and other variables were carefully studied to analyze frequency, incidence rate, spectrum of isolates and susceptibility pattern. Children with and without nosocomial BSI were compared with regard to age, duration of stay in hospital, need and duration of ventilation and the outcome. Of the total 406 admissions, 134 children were suspected to have nosocomial infection on at least 214 occasions (episodes). Blood cultures yielded growth of pathological organisms in 62 of these episodes, giving the frequency of nosocomial BSI as 15.2 per 100 admissions (62/406 episodes). Children with nosocomial bloodstream infection were found to have younger mean age (2.1 vs. 4.1 years), longer average duration of stay (13.1 vs. 6.6 days), more frequent need for ventilation (64% vs. 34%) and longer duration of ventilation (9.7 vs. 4.8 days). Majority of isolates (77%) were gram-negative bacteria; Klebsiella being the most common isolate (n= 23). Aztreonam, Ceftiazidime, Ceforuxime and Ciprofloxacin showed high resistance pattern (33-50%). Isolates showed good sensitivity to Vancomycin (100%), Imipenem (80%), Meropenem (100%) and Co-amoxiclav (88%). The frequency of nosocomial BSI in the observed setting was quite high, having marked impact on the duration of stay and outcome. Emergence of resistant pathogens is alarming. (author)

  4. Nursing Care Model Based on Knowledge Management in Preventing Nosocomial Infection After Caesarean Section in Hospital

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    Ahsan Ahsan

    2016-09-01

    Full Text Available Introduction: Nosocomial infection is one indicator of the quality of health services in the community, which also determines the image of health care institutions becauseit was a major cause of morbidityand death rate (mortality in hospital. Nursing care based on knowledge management is established from identification knowledge which is required, prevention performance of nosocomial infections post section caesarea. Nosocomial infections component consists of wound culture result. Method: This study was an observational study with a quasi experimental design. The population was all of nursing staff who working in obstetrics installation in hospitals A and B as much as 46 people. Sample was the total population. Data was collected through questionnaire, observation sheets and examination of the wound culture. Data was analyzed using t test B 1.274 dan p=0.028 Result: The result showed that 1 there was difference in knowledge management implementation before and after training; 2 there was difference in nurse’s performance in preventing nosocomial infection before and after training; 3 there is significant relationship between nurse’s performance in preventing nosocomial infection and infection incidence; 4 there is no significant difference of nursing care impementation on nosocomial incidence. Discussion: In conclusion, the development of nursing care based on knowledge management as a synthesis or induction of findings directed at 1 nurses’ knowledge does not affect the performance of the prevention of nosocomial infections; 2 knowledge management has a positive effect on the performance of the prevention of nosocomial infections; 3 implementation of infection prevention is integrated capabilities between knowledge, skills and attitudes of nurses in implementing performance in care. Keywords: model prevention, nosocomial infections, nursing care, knowledge management, sectio Caesarea

  5. RESISTENCIAS FEMENINAS: INVESTIGACIONES ENTRE EL CUERPO Y EL HABLA

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    Thais Oliveira Brandão

    2015-06-01

    Full Text Available Presentamos una propuesta de análisis de lo femenino dentro de algunos conceptos clave de la teoría feminista como son: el género, el sexo y la sexualidad, desde una postura implicada con investigaciones comprometidas, situadas y encarnadas. Analizaremos posibilidades de investigar los lenguajes orales y corporales de las mujeres con el fi n de encontrar la materialidad del cuerpo/habla en una relación sujeto/sujeto en investigación. Resaltamos que estas expresiones (orales y corporales son vividas como una forma de resistencia, de creación y que, por eso mismo, reclaman libertad. El cuerpo y el habla femeninos, interdependientes, se expresan con estrategias propias y constituyen un espacio común de liberación que también está disponible para ser investigado. AbstractAn approach on analyzing some key concepts of feminism theory, such as: gender, sex and sexuality which involves a committed thought with the compromised, embodied and located research we show in this paper. We will analyze the possibilities of looking for female oral and body languages in order to fi nd the materiality of the body/speech in relation with subject/subject in research. We emphasize that these expressions (oral and body languages are lived as a resistance and are constructed. That is why they demand freedom. The female’s body and speech are independent and are expressed with their own strategies and space of freedom which is able to be researched.

  6. RAZONES PARA PARTICIPAR EN CARRERAS DE RESISTENCIA. UN ESTUDIO CON CORREDORES AFICIONADOS

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    David Llopis Goig

    2006-01-01

    Full Text Available En las últimas décadas ha aumentado el número de participantes en carreras populares de resistencia así como el número de pruebas organizadas. En este trabajo se analizan las razones por las que los corredores aficionados participan en carreras de resistencia, y la influencia sobre la participación en las citadas carreras de variables como la edad, el nivel de estudios, la experiencia adquirida, la pertenencia a un club de atletismo y si se cuenta o no con entrenador. Los análisis efectuados indican que la razón principal para participar en carreras populares de resistencia es la satisfacción que produce. Así mismo, se constata la influencia que ejerce sobre las razones para correr la pertenencia a un club de atletismo y estar asesorado por un entrenador.

  7. Subjetividades juveniles: esbozos de resistencia ante la sociedad disciplinaria y la sociedad de control

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    Carolina Roatta Acevedo

    2007-06-01

    Full Text Available El objetivo del presente artículo es desarrollar una reflexión sobre las expresiones de resistencia que se manifiestan mediante una serie de prácticas estéticas y narrativas de un grupo de jóvenespertenecientes al colegio INEM Francisco de Paula Santander, de la localidad Kennedy, que se hacen llamar MAFRA (Movimiento Antifascista Radical Anarco - colectivista. Para ello, se apoya en conceptos como Micropolítica, Biopolítica, Resistencia y Multitud desarrollados por autores como Foucault, Negri, Hardt, Deleuze y Guattari, entre otros. Finalmente, se pregunta por los límites de estas prácticas de resistencia a partir de la figura «la máquina que muta», poniendo como ejemplo el Festival de Rock al Parque.

  8. Effects of a strength endurance training program on endurance levels Efectos de un programa de entrenamiento de la fuerza-resistencia sobre los niveles de resistencia

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    J. C. Redondo

    2010-09-01

    Full Text Available

    The purpose of the current study was to determine whether a strength endurance training program of lower limbs isolate can increase endurance levels, both aerobic capacity and aerobic power, in order to adapt the strength training for endurance races. 20 phisically active men participated in the study. They were divided into two groups: control group (GC (n=10 and experimental group (GE (n=10. GE carried out a strength endurance training program for ten weeks. Results obtained showed that this type of training regime was useful to improve the performance in an aerobic endurance test. This could be due to an improvement in aerobic capacity, maximal dynamic strength, explosive strength and reactive strength. Moreover, there was a decrease in fat mass without increase in muscle mass.
    Key Words:  Training, strength endurance, aerobic capacity, anthropometry.

     

    El presente estudio pretende comprobar que el trabajo aislado de la fuerza resistencia en miembros inferiores produce una mejora de los niveles de resistencia, en términos tanto de potencia como de capacidad aeróbica, optimizando así el entrenamiento de la fuerza para pruebas de resistencia de media y larga duración. Para ello, veinte sujetos participaron en el estudio, dividiéndose de forma aleatoria en dos grupos: grupo control (GC (n=10 y grupo experimental (GE (n=10 el cual llevó a cabo un entrenamiento de fuerza resistencia extensivo por intervalos, de diez semanas de duración. Los resultados obtenidos muestran que este tipo de entrenamiento es efectivo para mejorar el rendimiento en una prueba de resistencia aeróbica para sujetos físicamente activos, gracias a la mejora de la capacidad aeróbica, de la fuerza máxima dinámica, elástico explosiva y elástico explosivo reactiva y a la disminución de los niveles de grasa

  9. Nuevos métodos bacteriológicos para detectar y evitar la resistencia bacteriana

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    Margaret Ordoñez-Smith de Danies

    2003-09-01

    Full Text Available

    DEFINICIÓN DE LA RESISTENCIA

    De acuerdo al COC (Centro de Control de Enfermedades de Estados Unidos, la resistencia se da cuando un medicamento deja de inhibir el crecimiento o matar un microorganismo. 

    Hay dos tipos de resistencia la adquirida y la clínica. La adquirida se realiza en el laboratorio a través de las mutaciones o por transferencia de genes, sistemas de conjugación, transducción y transformación.

    La resistencia clínica es la observada en la práctica médica, donde no todos los organismos son igualmente sensibles o resistentes a cierto antibiótico y que requiere la ayuda de técnicas de laboratorio para medir cuantitativamente o cualitativamente dicho proceso.

    MECANISMOS DE LA RESISTENCIA BACTERIANA

    En la detección de la Resistencia Bacteriana se han identificado diferentes mecanismos utilizados por las bacterias: destrucción o inactivación enzimática, cambios en la permeabilidad de la membrana interna, alteraciones de los precursores de la pared celular, de la membrana y de los ribosomas.

    Para los años 90 se dispuso de una serie de antimicrobianos como betalactámicos, aminoglucósidos, macrólidos, sulfonamidas, trimetoprim, cloranfenicol, glicopéptidos, rifampicina, quinolonas, tetraciclinas....

     

  10. Texto guía de estática y resistencia de materiales

    OpenAIRE

    De la Cruz Morales, Claudia Jenny

    1996-01-01

    El siguiente trabajo consta de la unión de la estática como asignatura con la resistencia de materiales que se dictan en la carrera de ingeniería civil. En su primera etapa se presentan unas generalidades de la estática en cuando al manejo de vectores, cuerpo rígido, equilibrio de cuerpo rígido, etc. y algunos ejemplos. El tema de elementos prismáticos sometidos a fuerza axial ya inicia un acercamiento a la resistencia de materiales, más directo, en forma genérica se plantea el estado ...

  11. Consideraciones para la mejora de la resistencia en el fútbol

    OpenAIRE

    Campos Vázquez, Miguel Ángel

    2012-01-01

    Debido a la duración y los esfuerzos requeridos durante un partido de fútbol, la mejora de la resistencia debe ocupar un lugar importante en las planificaciones que diseñen los entrenadores y preparadores físicos. El desarrollo de dos parámetros fisiológicos parece importante a la hora de conseguir estas mejoras: el consumo máximo de oxígeno y el umbral anaeróbico. El objetivo de este trabajo es el de analizar los diferentes métodos de entrenamiento para la resistencia en el fútbol que han de...

  12. ORGANIZACIÓN INTERNACIONAL DE LA RESISTENCIA CONTRA LA GLOBALIZACIÓN

    Directory of Open Access Journals (Sweden)

    Francisco Domínguez

    2005-01-01

    Full Text Available Parâmetros y dinâmicas de la resistencia al neoliberalismo global. Se examina la estructura del capitalismo mundial y sus tendencias dominantes, para poder asi analisar aspectos centrales de la rivalidad entre la Unión Europea y los Estados Unidos, y discutir los pre-requisitos para Ia manutención de la hegemonia mundial por parte de éstos últimos. Esta contextualización es necesaria para poder entender la resistencia generalizada a la globalización en el mundo entero.

  13. Influencia de la humedad en el ensayo de resistencia de los ladrillos de suelo-cemento

    OpenAIRE

    Lima, José I.; Escobar Martín, Dunia

    1994-01-01

    A través de un diseño experimental adecuado se pretende mostrar la influencia de la humedad en el ensayo a compresión de los ladrillos de suelo-cemento, obteniendo las ecuaciones que muestran esta relación. Su generalización posterior permitió elaborar una matriz de correlación de las resistencias con las diferentes humedades de ensayo, de forma tal que se pueda ensayar con una humedad dada y estimar la resistencia que tendrá esa muestra para diferentes valores de humedad, con un buen nive...

  14. [Changing medical practices and nosocomial infection rates in French maternity units from 1997 to 2000].

    Science.gov (United States)

    Vincent-Boulétreau, A; Caillat-Vallet, E; Dumas, A M; Ayzac, L; Chapuis, C; Emery, M N; Girard, R; Haond, C; Lafarge-Leboucher, J; Tissot-Guerraz, F; Fabry, J

    2005-04-01

    In this study we describe the changes in medical practices and nosocomial infection rates in obstetrics observed through a surveillance network in the South East of France. The maternity units which belong to this network participated in voluntary surveillance using the network's methodology. The criteria for the diagnosis of nosocomial infections were in accordance with the methods described by the Centers for Disease Control and Prevention. 101240 pregnancies including 18503 caesareans (18.3%) were included in the network from 1997 to 2000. During the study period, nosocomial infection rates following caesarean section and vaginal delivery decreased respectively from 7.8% to 4.3% (p infection control programs in maternity units has been confirmed by the results of this surveillance network. During the study period, both obstetrics-related risk factors for nosocomial infection and observed hospital-acquired infection rates were dramatically reduced, what prove an improvement of quality of care in maternity units.

  15. Clinical and antimicrobial profile of Acinetobacter spp.: An emerging nosocomial superbug

    Directory of Open Access Journals (Sweden)

    Purti C Tripathi

    2014-01-01

    Conclusion: Acinetobacter nosocomial infections resistant to most antimicrobials have emerged, especially in ICU. Early identification and continued surveillance of prevalent organism will help prevent the spread of Acinetobacter in hospital environment.

  16. [Role of donor human milk feeding in preventing nosocomial infection in very low birth weight infants].

    Science.gov (United States)

    Bi, Hong-Juan; Xu, Jing; Wei, Qiu-Fen

    2018-02-01

    To investigate the role of donor human milk in the prevention of nosocomial infection in very low birth weight infants. MeETHODS: A total of 105 hospitalized preterm infants with a very low birth weight were enrolled. They were classified into mother's own milk feeding group, donor human milk feeding group, and preterm formula feeding group, with 35 infants in each group. The three groups were compared in terms of incidence rates of nosocomial infection, necrotizing enterocolitis, and feeding intolerance, time to full enteral feeding, and early growth indices. Compared with the preterm formula feeding group, the donor human milk feeding group and the mother's own milk feeding group had significantly lower incidence rates of nosocomial infection and necrotizing enterocolitis and shorter time to full enteral feeding (Pmilk can be used in case of a lack of mother's own milk and may help to reduce nosocomial infection.

  17. Low Compliance to Handwashing Program and High Nosocomial Infection in a Brazilian Hospital

    OpenAIRE

    Borges, Lizandra Ferreira de Almeida e; Rocha, Lilian Alves; Nunes, Maria José; Gontijo Filho, Paulo Pinto

    2012-01-01

    Background. It is a fact that hand hygiene prevents nosocomial infection, but compliance with recommended instructions is commonly poor. The purpose of this study was to implement a hand hygiene program for increase compliance with hand hygiene and its relationship with nosocomial infection (NI) and MRSA infection/colonization rates. Methods. Compliance to hand hygiene was evaluated in a hospital by direct observation and measured of health care-associated infections, including methicillin re...

  18. Bacterial Clearance and Cytokine Profiles in a Murine Model of Postsurgical Nosocomial Pneumonia

    OpenAIRE

    Manderscheid, Patricia A.; Bodkin, Ryan P.; Davidson, Bruce A.; Jensen, Erik; Russo, Thomas A.; Knight, Paul R.

    2004-01-01

    The development of a nosocomial pneumonia is facilitated by alterations in host innate pulmonary antibacterial defenses following surgical trauma, which can result in decreased pulmonary bacterial clearance and increased morbidity and mortality. In a murine model of postoperative nosocomial infection, surgical stress (laparotomy) decreased Escherichia coli clearance from the lungs of animals that underwent surgery. Consistent with previous studies, (i) pulmonary levels of tumor necrosis facto...

  19. Genoma de Candida albicans y resistencia a las drogas

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    Sandra Cruz Quintana

    2017-01-01

    Full Text Available Candida albicans es un importante patógeno fúngico en los humanos tanto por su importan - cia clínica como por su uso como un modelo experimental para la investigación científica. La comprensión de la biología de este patógeno es un requisito importante para la identificación de nuevas dianas de medicamentos para la terapia antifúngica. En esta revisión nos proponemos profundizar en las características del genoma de Candida albicans, su relación con la virulen - cia y cómo influye en la resistencia a las drogas antifùngicas, que nos permita comprender los mecanismos por los cuales ejerce su acción patógena y desarrollar otros enfoques en la búsqueda de nuevos antifúngicos. La revisión se realizó a través de los buscadores y plataformas HINARI , SciELO y MEDLINE . Se revisaron 40 revistas de impacto de la Web of Science relacionadas con el tema. Los descriptores empleados fueron: “genome of Candida albicans”, “drug resistance genes”, “dimorphism”, “virulence” y la combinación entre ellos y sus equivalentes en español. El análisis de los genomas fúngicos hace posible predecir el rol de genes con potencial terapéu - tico, con la secuenciación del genoma de Candida albicans ha aumentado la información sobre la función de los genes, entre los que destacan los posibles objetivos farmacológicos. El estudio del genoma de Candida albicans resulta imprescindible para diseñar en el futuro protocolos diagnósticos seguros, así como hallar nuevas dianas antifúngicas que permitan formular te - rapias más efectivas.

  20. Diagnosis of Acute Respiratory Distress Syndrome in Nosocomial Pneumonia

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    A. N. Kuzovlev

    2009-01-01

    Full Text Available Objective: to define the informative value of the parameters of gas exchange, lung volumetry, and central hemodynamics in the diagnosis of acute respiratory distress syndrome (ARDS in nosocomial pneumonia (NP. Subjects and methods. The study included 38 patients with cancer and severe injury who were divided into 3 groups in accordance with the diagnostic criteria of ARDS and NP: 1 patients with ARDS + NP; 2 those with NP; 3 those with non-ARDS, non-PN. ARDS was diagnosed in 2 steps. At Step 1, the investigators took into account risk factors for ARDS and used the lung injury scale developed by J. Murray et al. and the ARDS diagnostic criteria defined by the American-European Consensus Conference on ARDS. At Step 2, after obtaining the data of lung volume-try (1—2 hours after Step 1, they assessed the compliance of the above criteria for ARDS with those developed by the V. A. Negovsky Research Institute of General Reanimatology, Russian Academy of Medical Sciences, and redistributed the patients between the groups. The stage of ARDS was determined in accordance with the classification of the above Institute. All the patients underwent a comprehensive examination the key element of which was to estimate gas exchange parameters and to monitor lung volumetry and central hemodynamics by the transpulmonary thermodilution methods, by using a Pulsion PiCCO Plus monitor (Pulsion Medical Systems, Germany. The findings were statistically analyzed using a Statistica 7.0 package (arithmetic mean, error of the mean, _ Student’s test, Newman-Keuls test, correlation analysis. The difference was considered to be significant if p-value was Results. The patients with ARDS + NP were observed to have a significantly lower oxygenation index (10 ml/kg and Murray scale scores (>2 than those in patients with NP without ARDS. The reference values of the pulmonary vascular permeability index due to its inadequate informative value call for further investigation. The

  1. NURSING CARE KNOWLEDGE MANAGEMENT BASED TRAINING DECREASE NOSOCOMIAL INFECTION INCIDEN IN POST SECTIO CESAREA PATIENTS

    Directory of Open Access Journals (Sweden)

    Ahsan Ahsan

    2017-04-01

    Full Text Available Introduction: Model of nursing care based on knowledge management can reduce the incidence of nosocomial infections through the performance of nurses in the prevention of infection. Nursing care based on knowledge management is established from identi fi cation knowledge which is required, prevention performance of nosocomial infections post caesarean section. Nosocomial infections component consists of wound culture result. Method: This study was an observational study with a quasy experimental design. The population were all of nursing staff who working in obstetrics installation and a number of patients who is treated in hospitals A and B post sectio caesarea. Sample is comparised a total population all the nursing staff who worked in obstetrics installation according to criteria of the sample, and most of patients were taken care by nursing staff post caesarean section which is taken by random sampling 15 patients. Data was collected through observation sheets and examination of the wound culture. Data analysis which is used the t test. Result: The result was showed that there was signi fi cant difference in the incidence of nosocomial infection in patients with post sesctio caesarea in hospital before and after nursing care training based on knowledge management (tvalue = 2.316 and p = 0.028 < α = 0.05 level, and the incidence of nosocomial infection was lower after training than before training. Discussion: It can be concluded that training knowledge management based on nursing care effectives to reduce Incidence of Nosocomial Infections in Patients after Sectio Caesarea.

  2. Incidence, risk factors and outcome of nosocomial pneumonia in patients with central nervous system infections

    Directory of Open Access Journals (Sweden)

    Gajović Olgica

    2011-01-01

    Full Text Available Introduction. Pneumonia is the most frequent nosocomial infection in intensive care units. The reported frequency varies with definition, the type of hospital or intensive care units and the population of patients. The incidence ranges from 6.8-27%. Objective. The objective of this study was to determine the frequency, risk factors and mortality of nosocomial pneumonia in intensive care patients. Methods. We analyzed retrospectively and prospectively the collected data of 180 patients with central nervous system infections who needed to stay in the intensive care unit for more than 48 hours. This study was conducted from 2003 to 2009 at the Clinical Centre of Kragujevac. Results. During the study period, 54 (30% patients developed nosocomial pneumonia. The time to develop pneumonia was 10±6 days. We found that the following risk factors for the development of nosocomial pneumonia were statistically significant: age, Glasgow Coma Scale (GCS score <9, mechanical ventilation, duration of mechanical ventilation, tracheostomy, presence of nasogastric tube and enteral feeding. The most commonly isolated pathogens were Klebsiella-Enterobacter spp. (33.3%, Pseudomonas aeruginosa (24.1%, Acinetobacter spp. (16.6% and Staphylococcus aureus (25.9%. Conclusion. Nosocomial pneumonia is the major cause of morbidity and mortality of patients with central nervous system infections. Patients on mechanical ventilation are particularly at a high risk. The mortality rate of patients with nosocomial pneumonia was 54.4% and it was five times higher than in patients without pneumonia.

  3. Prevention of nosocomial infections in intensive care unit and nursing practices

    Directory of Open Access Journals (Sweden)

    Sevilay Yüceer

    2009-01-01

    Full Text Available Nosocomial infections which are considered as the primary indicator of the quality of care in hospitals, cause to prolong hospitalization at intensive care unit and hospital, increase morbidity, mortality, and the cost of treatment. Although only 5-10% of the patients are treated in the intensive care units, 20-25% of all nosocomial infections are seen in these units. Preventing nosocomial infections in intensive care units is a process started at the patient acceptance to unit that requires an interdisciplinary team approach of intensive care staffs’ and Infection Control Committee members.Intensive care nurses who are in constant contact with patients have important responsibilities in preventing nosocomial infections. Intensive care nurses should be aware that the nosocomial infections can be prevented. They should have current knowledge about universal precautions related to prevention and control of infections, which are accepted by the entire world and they reinforce this knowledge by practice and should provide the most effective care to patients.In this article, nursing practices for prevention of nosocomial infections in intensive care units are discussed based on universal precautions.

  4. SPHINGOMONAS PAUCIMOBILIS INFECTIONS IN CHILDREN: NOSOCOMIAL VERSUS COMMUNITY ACQUIRED INFECTIONS

    Directory of Open Access Journals (Sweden)

    Nuri Bayram

    2013-06-01

    Full Text Available Sphingomonas paucimobilis is a causative agent of infection in immunocompromised patients, and healthcare-associated infections. Although the infections associated with S.paucimobilis occurs rarely, it has been encountered with increasing frequency in clinical settings. In the current study we noted the risk factors and clinical features of the children with S.paucimobilis infections, and the antimicrobial susceptibilities of the isolated strains among the patients. This study was conducted in Dr. Behçet Uz Children’s Hospital, Turkey, during the period of January 2005 and December 2012. The medical records of pediatric patients with positive cultures for S.paucimobilis were reviewed. Sphingomonas paucimobilis isolates were recovered from 24 pediatric patients. The median age was 4 years (ranging from 3 days infant to 15 years and 58,3% were male. Eight (33,3% of the patients were under 1 months of age. Among the patients; 13 (54,2% infections were community related however 11(45.8% infections were nosocomial infection. The median duration of hospital stay was 7 days (ranging from 4 to 22 days. The most effective antibiotics were fluoroquinolones, carbapenems, and trimethoprim/sulfamethoxazole. This is the first largest study in children to evaluate the clinical features of S. paucimobilis infections. Sphingomonas paucimobilis may cause infections in both previously healthy and immunocompromised children. Although variable antimicrobial regimens were achieved to the patients, there was no attributable fatality due to S.paucimobilis infections due to the low virulence of the bacteria.

  5. [Nosocomial Clostridium difficile diarrhea--adverse effect of antibiotic therapy].

    Science.gov (United States)

    Lemeni, Daniela

    2010-01-01

    C. difficile is recognised as the main cause for colitis in hospitalised patients which are treated with antibiotics, chemotherapics or other drugs that disturb intestinal microbiota. Thus, a rapid and correct diagnostic of Clostridium difficile infections is essential for preventing nosocomial infection spread. Empiric therapy, regardless of the laboratory investigation results, is inadequate, especially in epidemic situations, as not all the cases of diarrhoea are due to C. difficile infection. Other risk factors for CDAD (Clostridiumn difficile Associated Diseases might be: prolonged hospitalization or residency in an asylum, age, existence of a severe chronic disease in the background nasogastric intubation, anti-ulcer drugs, at less extent gastrointestinal surgery, other immunosuppresive compounds etc. In our country, C. difficile infection is rather frequent in adults, though it is not always reported by clinicians. The circulation of endemic rybotype 027 in Romania is not well documented, the rybotype being extremely virulent and spread in other European countries. Hence the importance of extending the diagnostic capacity of C. difficile infection in order to allow detection of this rybotype among the strains isolated in our country.

  6. [Nosocomial sinusitis in an intensive care unit: a microbiological study].

    Science.gov (United States)

    Balsalobre Filho, Leonardo Lopes; Vieira, Fernando Mirage Jardim; Stefanini, Renato; Cavalcante, Ricardo; Santos, Rodrigo de Paula; Gregório, Luis Carlos

    2011-01-01

    Nosocomial sinusitis is a common complication of patients in ICUs. Its diagnosis is important, and early treatment is required to avoid serious complications such as pneumonia, sepsis, meningitis, and intracranial abscesses. To identify the germs causing sinusitis in ICUs by nasal swabs and maxillary sinus puncture, and to correlate these results. ICU patients with a diagnosis (CT confirmed) of maxillary sinusitis underwent nasal swab and puncture of the sinus to collect material for culture and antibiogram. This study evaluated 22 patients. The microbial agent isolated in the swab correlated with the agent in the puncture in 14 of 22 cases (63%). Gram-negative bacteria were the most frequent, as follows: Pseudomonas aeruginosa (29% of punctures), following by Proteus mirabillis (26%) and Acinetobacter baumanni (14%). The resistance index in the antibiogram was high to antibiotics. Maxillary sinus puncture of ICU patients with sinusitis appears to be the best method for identifying bacteria; antibiograms demonstrate resistance to therapy. The swab has little diagnostic value; the correlation was 63%. It may be used when sinus puncture is contraindicated.

  7. [Risk of nosocomial infection in Intertropical Africa. Part 4: prevention].

    Science.gov (United States)

    Rebaudet, S; De Pina, J J; Rapp, C; Kraemer, P; Savini, H; Demortiere, E; Simon, F

    2008-02-01

    Nosocomial infections have long been neglected in Sub-Saharan Africa, even though their prevalence is higher than in developed countries. Recently, however, this major public health problem has been the focus of a growing number of recommendations not only from the World Health Organization but also from some national health ministries. Because of the numerous limitations especially in financial resources in these regions, priority must be given to the implementation of simple and cost-effective measures. Accordingly the greatest efforts must be devoted to educating healthcare workers and patients about the importance of handwashing, eliminating unnecessary injections and transfusions, performing the latter acts in aseptic conditions, isolating patients with communicable diseases, handling waste products safely, and using antimicrobials properly. Amid the daunting health issues facing Sub-Saharan Africa, implementing these inexpensive measures that could save the lives of thousands of patients and healthcare workers appears easy. However it will require a cultural revolution. The keys to success will be changing the organizational culture, developing a commitment to prevention and evaluating performance regularly.

  8. Zonas y métodos de entrenamiento de la resistencia cardiorrespiratoria

    OpenAIRE

    García Pallarés, Jesús

    2015-01-01

    Propuesta metodológica para el desarrollo de los ritmos y zonas de entrenamiento de la resistencia en función de la posición de los hitos fisiológicos de la vía aeróbica y sus factores limitantes.

  9. Los trabajadores de Bavaria:entre la resistencia y la deferencia, 1889-1930

    Directory of Open Access Journals (Sweden)

    Juan Manuel Martínez Fonseca

    2005-01-01

    Full Text Available La resistencia de los trabajadores de Bavaria se manifestó de diversas formas: laprincipal modalidad fue la huelga que sólo logró constituirse en una herramienta depresión a partir de 1925. La solidaridad fue la base de la participación en paros,mítines,

  10. Los trabajadores de bavaria:entre la resistencia y la deferencia, 1889-1930

    OpenAIRE

    Martínez Fonseca, Juan Manuel

    2005-01-01

    La resistencia de los trabajadores de Bavaria se manifestó de diversas formas: laprincipal modalidad fue la huelga que sólo logró constituirse en una herramienta depresión a partir de 1925. La solidaridad fue la base de la participación en paros,mítines,

  11. Cumplimiento de las recomendaciones internacionales en la lucha contra las resistencias bacterianas

    DEFF Research Database (Denmark)

    Malo, Sara; Jose Rabanaque, Mara; Bjerrum, Lars

    2016-01-01

    Introducción: El aumento de la resistencia a antibióticosrepresenta una amenaza para la salud pública al poner en riesgoel tratamiento futuro de las infecciones bacterianas. Este estudiotiene como objetivo describir el cumplimiento de las recomendaciones del Advisory Group on Integrated Surveilla......Introducción: El aumento de la resistencia a antibióticosrepresenta una amenaza para la salud pública al poner en riesgoel tratamiento futuro de las infecciones bacterianas. Este estudiotiene como objetivo describir el cumplimiento de las recomendaciones del Advisory Group on Integrated...... Surveillance of Antimicrobial Resistance (AGISAR) de la Organización Mundial de la Salud (OMS), en España y Dinamarca, en cuanto al uso ambulatoriode Critically Important Antimicrobials (CIA), así como analizarla relación entre éste y las resistencias bacterianas a ellos. Material y métodos: Los sistemas...... resistencias bacterianas, que son másmoderadas en Dinamarca. Introduction: Increasing antibiotic resistance represents a major public health threat that jeopardises the future treatment of bacterial infections. This study aims to describe the adherence to recommendations proposed by the World Health...

  12. Resistencia a la compresión y reología de cementantes ambientalmente amigables

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    Juan Manuel Lizarazo Marriaga

    2009-05-01

    Full Text Available Siendo la producción de cemento responsable de aproximadamente el 9% de la producción industrial de gases de invernadero, y en pro de generar materiales alternativos, en este artículo se presentan los resultados de una investigación encaminada a de- sarrollar cementantes que potencialmente representen una alternativa ambientalmente sostenible en la construcción civil. Com- binaciones de escoria granulada de alto horno, escoria de acería obtenida mediante un proceso de oxígeno básico, polvo de horno de cemento y residuo de demolición de divisiones de yeso fueron usados para optimizar la resistencia a la compresión y obtener cinco mezclas de concreto con cementantes hechos parcial o totalmente con residuos industriales. Los resultados obteni- dos muestran que las resistencias de las mezclas compuestas de cemento Portland y residuos industriales son adecuadas para u- na cantidad importante de aplicaciones en construcción civil, y aunque para las mezclas formadas completamente por residuos industriales se presentó una importante disminución en la resistencia a la compresión, los resultados obtenidos mostraron un gran potencial para determinadas aplicaciones industriales. Adicionalmente a la resistencia a la compresión, a dichas mezclas se les determinaron sus propiedades reológicas definiendo sus características de flujo y trabajabilidad.

  13. Comparison of the systemic inflammatory response syndrome between monomicrobial and polymicrobial Pseudomonas aeruginosa nosocomial bloodstream infections

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    Wenzel Richard P

    2005-10-01

    Full Text Available Abstract Background Some studies of nosocomial bloodstream infection (nBSI have demonstrated a higher mortality for polymicrobial bacteremia when compared to monomicrobial nBSI. The purpose of this study was to compare differences in systemic inflammatory response and mortality between monomicrobial and polymicrobial nBSI with Pseudomonas aeruginosa. Methods We performed a historical cohort study on 98 adults with P. aeruginosa (Pa nBSI. SIRS scores were determined 2 days prior to the first positive blood culture through 14 days afterwards. Monomicrobial (n = 77 and polymicrobial BSIs (n = 21 were compared. Results 78.6% of BSIs were caused by monomicrobial P. aeruginosa infection (MPa and 21.4% by polymicrobial P. aeruginosa infection (PPa. Median APACHE II score on the day of BSI was 22 for MPa and 23 for PPa BSIs. Septic shock occurred in 33.3% of PPa and in 39.0% of MPa (p = 0.64. Progression to septic shock was associated with death more frequently in PPa (OR 38.5, CI95 2.9–508.5 than MPa (OR 4.5, CI95 1.7–12.1. Maximal SIR (severe sepsis, septic shock or death was seen on day 0 for PPa BSI vs. day 1 for MPa. No significant difference was noted in the incidence of organ failure, 7-day or overall mortality between the two groups. Univariate analysis revealed that APACHE II score ≥20 at BSI onset, Charlson weighted comorbidity index ≥3, burn injury and respiratory, cardiovascular, renal and hematologic failure were associated with death, while age, malignant disease, diabetes mellitus, hepatic failure, gastrointestinal complications, inappropriate antimicrobial therapy, infection with imipenem resistant P. aeruginosa and polymicrobial nBSI were not. Multivariate analysis revealed that hematologic failure (p Conclusion In this historical cohort study of nBSI with P. aeruginosa, the incidence of septic shock and organ failure was high in both groups. Additionally, patients with PPa BSI were not more acutely ill, as judged by APACHE II

  14. The incidence of nosocomial infection in the Intensive Care Unit, Hospital Universiti Kebangsaan Malaysia: ICU-acquired nosocomial infection surveillance program 1998-1999.

    Science.gov (United States)

    Rozaidi, S W; Sukro, J; Dan, A

    2001-06-01

    CU-acquired nosocomial infection (NI) remains one of the major causes of ICU mortality. This study presents the incidence of ICU-acquired nosocomial infection in ICU HUKM for the years 1998 and 1999, as part of the ongoing ICU-acquired nosocomial infection surveillance program. The overall incidence was 23%. The main types of NI was lower respiratory tract infection (15.3%), primary bacteraemia (8.1%), ventilator associated pneumonia (5.4%), urinary tract infection (2.0%), skin infection (1.6%) central venous catheter sepsis (1.2%) and surgical skin infection (0.8%). The overall culture positive nosocomial infection rate was only 12.1%, majority from the lungs (12.6%), blood (7.3%), skin swabs (2.0%), and urine (1.6%). The main gram-negative organism cultured was Acinetobacter sp. (19%) and Staph. aureus (8.5%) was the gram-positive organism. The overall ICU mortality rate was 27.5% of which 60.9% of patients who died were attributed directly to sepsis.

  15. Influencia del espesor de adhesivo de poliuretano en la resistencia de uniones sometidas a cortadura

    Directory of Open Access Journals (Sweden)

    García-Ledesma, R.

    2005-02-01

    Full Text Available The thickness of adhesive layers in metallic bonded joints has direct influence in the performance and mechanical behaviour of these joints. The aim of this study was to analyse the strength and strain properties of steel overlap joints bonded with polyurethane adhesive layers with different thickness. The results show that the strength is maximum when the thickness of the adhesive layer is very thin, 0.1 mm. When the thickness growth to 1 mm the strength goes down rapidly. For layers from 1 to 1.5 mm the strength goes down slower and from 1.5 to 4 mm the strength is nearly constant. In other hand, the joint strain increase uniformly with adhesive layer thickness growth.

    El espesor de la capa de adhesivo en las uniones por adhesión de materiales metálicos, tiene una influencia notable en el comportamiento y las propiedades mecánicas de dichas uniones. El objeto de este trabajo fue analizar las propiedades de resistencia y desplazamiento, presentadas por uniones a solape de acero, unidas con capas de diferentes espesores de un adhesivo de poliuretano. Los resultados obtenidos muestran que la resistencia mecánica es máxima para capas de adhesivo de espesor muy delgado: 0,1 mm. Cuando el espesor crece de 0,1 hasta 1 mm la resistencia disminuye rápidamente. Para capas desde 1 hasta 1,5 mm la resistencia disminuye más lentamente y, a partir de 1,5 mm, la resistencia permanece prácticamente constante. Por otro lado, los desplazamientos de la unión aumentan uniformemente a medida que crece el espesor de la capa de adhesivo.

  16. Resistencia de Streptococcus pneumoniae a penicilina en portadores nasofaringeos menores de 2 años

    Directory of Open Access Journals (Sweden)

    Theresa Jean Ochoa Woodell

    1998-04-01

    Full Text Available El neumococo es un agente etiológico importante de infecciones comunes que afectan a todas las edades. En las últimas décadas han aparecido a nivel mundial cepas de neumococo resistentes a la penicilina. A nivel local no se conoce la magnitud de este problema. Objetivo: El objetivo fue determinar el porcentaje de resistencia del neumococo a la penicilina en portadores nasofaríngeos menores de 2 años en el Consultorio de Crecimiento y Desarrollo del Hospital Nacional Cayetano Heredia en Lima. Material y métodos: Se tomaron muestras de hisopeado nasofaríngeo en 170 niños (Setiembre 1996-Marzo 1997, para cultivo de neumococo y determinación de su sensibilidad a la penicilina con el E-test y a otros antibióticos con la sensibilidad en disco. Resultados: Se encontró 44% (75/170 de portadores nasofaríngeos de neumococo en niños de 6 meses a 2 años. La presencia de tres o más niños en la familia estuvo asociado a un mayor porcentaje de portadores. De las 75 cepas aisladas, 4 (5.3% fueron resistentes a la penicilina, incluyendo 3 (4% con resistencia intermedia y 1 (1.3% con alta resistencia (MIC=1.5my g/mL. La resistencia a otros antibióticos fue: trimethoprim/ sulfamethoxazole 39 cepas (52%, cefaclor 18 (24%, cloranfenicol 17 (22.7%, eritromicina 14 (18.6%, clindamicina 9 (12% y rifampicina 8 (10.7%. Conclusión: La resistencia del neumococo a la penicilina continúa baja en el Hospital Cayetano Heredia; sin embargo, es urgente establecer estrategias de prevención y control de la emergencia y diseminación de microorganismos resistentes. ( Rev Med Hered 1998; 9:56-62.

  17. Prevalence of Nosocomial Infection in Different Wards of Ghaem Hospital, Mashhad

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    Jamal Falahi

    2017-04-01

    Full Text Available Background The CDC defines a nosocomial infection as a localized or systemic condition caused by an adverse reaction to the presence of an infectious agent(s or its toxin(s. It is an infection that occurs between 48 to 72 hours after admission of patients in the hospital or as soon after the hospital discharge and on the admission time, patients don't have this infection. Objectives This study aimed to characterize the prevalence of nosocomial infection in Ghaem hospital, Mashhad, Iran. Methods This retrospective study was conducted in all wards of the Ghaem hospital, Mashhad during the 1 year period (2013; the data were collected from the wards records and HIS system and analyzed by the SPSS software (version16. Results In the present study, of total 35979 hospitalized patients in different wards of the Ghaem hospital was reported 1.1% of nosocomial infection. In the meantime, overall, the most prevalent organism was Acinetobacter baumannii with a prevalence of 37.2% and the minimum was linked to the Bacillus species with a prevalence 0.3%. The highest and lowest prevalence of the nosocomial infection was in the ICU and CCU with 49.9% and 0.3%, respectively. In general, among all wards of the mentioned hospital, the most frequent nosocomial infection was pneumonia (47.4% and the lowest belonged to CSF (2.3%. Conclusions In our study, the ICU ward was accounted for the highest rate of nosocomial infection, due to the critical importance of this ward. Preventive measures and survivelance system for reduction of nosocomial infections is needed.

  18. The Study of Nosocomial Infections in Neonatal Intensive Care Unit, A prospective study in Northwest Iran

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    Mohammad Bagher Hosseini

    2014-08-01

    Full Text Available Background: Nosocomial infections are an important cause of mortality in neonatal intensive care units (NICUs. Therefore, in this study, the incidence and prevalence of nosocomial infections were determined in NICUs of the three largest neonatal centers in northwest Iran, and the causative bacteria were identified in order to provide potential solutions to control the infections in these hospitals. Materials and Methods: This is a descriptive-prospective study in which the cases of nosocomial infections were examined in the three largest hospitals in Tabriz in northwest Iran during 1 year (from June 2012 until May 2013 based on clinical findings, medical and nursing reports of patients, and laboratory results. Results: Of the 3129 patients hospitalized in NICUs of the three hospitals, 208 patients were diagnosed with nosocomial infections. The incidence rate of nosocomial infections was 11.34%.per 100 patient days with 52.4% bacteremia, 32.69% pneumonia, 5.77% urinary tract infections, 5.29% wound infections, and 3.85% necrotizing enterocolitis. There was a statistically significant relationship between invasive procedures (such as umbilical catheters, central venous catheters, surgery, and TPN and sepsis (P = 0.001. The relationships between urinary tract infection and urinary catheter (P = 0.000, and aggressive procedures (such as suctioning and intubation and pneumonia (P = 0.001 were also statistically significant. Conclusion: Incidence of nosocomial infections in premature and low birth weight newborns is considered as a health threat. The findings of this research reiterate the importance of giving further attention to prevention and control of nosocomial infections in the NICU.

  19. The Review Systematic and Meta Analysis of Prevalence and Causes of Nosocomial Infection in Iran

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    Pezhman Bagheri

    2014-12-01

    Full Text Available Background and Aim: The variation of reported nosocomial infection is very high respectively. It seems review systematic and Meta analysis of related documents gives precise estimate of this subject for correct politisize. So tha aim of this study the review systematic and meta analysis of prevalence and causes of nosocomial infection in iran. Materials and Methods: For this study all articles published in Iranian journals and international journals, Final Report of Research Projects, related papers presented at congresses and thesis were reviewed with using standard and sensitive keywords. Then, all articles published between 1997-2010 years that had eligibility Inclusion criteria after quality control, using random model, intered to process of meta-analysis. Results: The finding show that the best estimate of total prevalence of nosocomial infection in Iran is 30.43% and the most common infections of nosocomial infection are respiratory infection 39.4%%, urinary infection 23.88%, bacteremia 21.98% and the most common factors of nosocomial infection are Pseudomonas aeroginosa 26.78%, klebsiella 31.42%, Staphylococcus 23.6% and E.coli 30.93%. The research also found a substantial heterogeneity that using meta regression method the main cause of produce of this heterogeneity, participants people, sample size, average age of the samples, time of study and gender were introduced. Conclusions: The simple review of studied documents in this survey show that prevalence rate of different nosocomial infection in Iran is high relatively. Hence make appropriate and evidence-based educational and control programs to reduce nosocomial infections prevalence rate in Iran should be considered by policy makers.

  20. Comportamiento de infecciones nosocomiales en un período de doce años Behavior of nosocomial infections in a 12-year period

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    Mercedes Ravelo González

    2008-06-01

    Full Text Available INTRODUCCIÓN. Son objetivos de esta presentación determinar el comportamiento de las infecciones nosocomiales en el Servicio de Neonatología del Hospital General Provincial Docente de Morón y describir los tipos de infecciones, los factores predisponentes, los microorganismos aislados y la resistencia de dichos gérmenes a los antibióticos de uso habitual en nuestro medio. MÉTODOS. Se realizó un estudio observacional descriptivo en el período de marzo de 1995 a diciembre de 2006. La obtención de los datos fue por revisión documental (historias clínicas y estos se presentan en tablas de distribución de frecuencia. Se realizaron medidas de tendencia central (media aritmética y mediana. RESULTADOS. La tasa de infección observada fue de 12,3. La sepsis generalizada fue el tipo de infección que más se presentó, y sus factores de riesgo más importantes fueron el bajo peso al nacer y la prematuridad. El estafilococo coagulasa-negativo fue el microorganismo más aislado en estudios microbiológicos. En todos los tubos endotraqueales estudiados se obtuvo crecimiento de gérmenes, así como también en catéteres venosos. Los gérmenes grampositivos presentaron elevada resistencia a las penicilinas y cefalosporinas de primera generación. CONCLUSIONES. Las infecciones nosocomiales constituyen un importante problema en nuestro servicio, y se debe trabajar para optimizar la intervención intensiva a nuestros pacientes y actuar sobre sus factores de riesgo.INTRODUCTION. This paper is aimed at determining the behavior of nosocomial infections in the Neonatology Service of the Provincial General Hospital of Morón and at describing the types of infections, the predisposing factors, the isolated microorganisms and the resistance of these germs to the usual antibiotics in our environment. METHODS. An observational descriptive study was carried out from March 1995 to December 2006. Data were obtained by documentary review (medical histories and

  1. Typing of vancomycin-resistant enterococci with MALDI-TOF mass spectrometry in a nosocomial outbreak setting.

    Science.gov (United States)

    Holzknecht, B J; Dargis, R; Pedersen, M; Pinholt, M; Christensen, J J

    2018-03-23

    To investigate the usefulness of matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) typing as a first-line epidemiological tool in a nosocomial outbreak of vancomycin-resistant Enterococcus faecium (VREfm). Fifty-five VREfm isolates, previously characterized by whole-genome sequencing (WGS), were included and analysed by MALDI-TOF MS. To take peak reproducibility into account, ethanol/formic acid extraction and other steps of the protocol were conducted in triplicate. Twenty-seven spectra were generated per isolate, and spectra were visually inspected to determine discriminatory peaks. The presence or absence of these was recorded in a peak scheme. Nine discriminatory peaks were identified. A characteristic pattern of these could distinguish between the three major WGS groups: WGS I, WGS II and WGS III. Only one of 38 isolates belonging to WGS I, WGS II or WGS III was misclassified. However, ten of the 17 isolates not belonging to WGS I, II or III displayed peak patterns indistinguishable from those of the outbreak strain. Using visual inspection of spectra, MALDI-TOF MS typing proved to be useful in differentiating three VREfm outbreak clones from each other. However, as non-outbreak isolates could not be reliably differentiated from outbreak clones, the practical value of this typing method for VREfm outbreak management was limited in our setting. Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  2. Mobile phones: Reservoirs for the transmission of nosocomial pathogens.

    Science.gov (United States)

    Pal, Shekhar; Juyal, Deepak; Adekhandi, Shamanth; Sharma, Munesh; Prakash, Rajat; Sharma, Neelam; Rana, Amit; Parihar, Ashwin

    2015-01-01

    Global burden of hospital-associated infection (HAI) is on the rise and contributes significantly to morbidity and mortality of the patients. Mobile phones are indispensible part of communication among doctors and other health care workers (HCWs) in hospitals. Hands of HCWs play an important role in transmission of HAI and mobile phones which are seldom cleaned and often touched during or after the examination of patients without hand washing can act as a reservoir for transmission of potent pathogens. This study aimed to investigate the rate of bacterial contamination of mobile phones among HCWs in our tertiary care hospital and to compare it with personal mobile phones of non-HCWs (control group). The mobile phones and dominant hands of 386 participants were sampled from four different groups, hospital doctors and staff (132), college faculty and staff (54), medical students (100) and control group (100). Informed consent and questionnaire was duly signed by all the participants. Samples were processed according to standard guidelines. 316 mobile phones (81.8%) and 309 hand swab samples (80%) showed growth of bacterial pathogens. The most predominant isolates were Coagulase-negative Staphylococcus, Staphylococcus aureus, Acinetobacter species, Escherichia coli, Klebsiella pneumoniae, Pseudomonas species and Enterococcus species. Hundred percent contamination was found in mobile phones and hands of HCWs indicating mobile phones can be the potential source of nosocomial pathogens. Our study results suggest that use of mobile phones in health care setup should be restricted only for emergency calls. Strict adherence to infection control policies such as proper hand hygiene practices should be followed.

  3. Hospital ownership: a risk factor for nosocomial infection rates?

    Science.gov (United States)

    Schröder, C; Behnke, M; Geffers, C; Gastmeier, P

    2018-03-26

    In some countries, a relationship between hospital ownership and the occurrence of healthcare-associated infection (HCAI) rates has been described. To investigate the association between hospital ownership and occurrence of HCAI in Germany. Five different components of the German national nosocomial infection surveillance system were analysed with regard to the influence of hospital ownership in the period 2014-2016. Endpoints included ventilator-associated pneumonia, central-venous-catheter-associated bloodstream infections, urinary-catheter-associated urinary tract infections, surgical site infections (SSI) following hip prosthesis and colon surgery, meticillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile infections (CDI) and hand rub consumption per 1000 patient-days. Three hospital ownership types (public, non-profit and private) were analysed using univariate and multi-variate methods. The distribution of hospitals according to the three ownership types was similar in all components. In total, 661 intensive care units (ICUs), 149 departments performing colon procedures, and 349 departments performing hip prosthesis were included. In addition, 568 hospitals provided their MRSA rates and 236 provided their CDI rates, and 1833 ICUs and 12,934 non-ICUs provided their hand rub consumption data. In general, the differences between the hospital types were rather small and not significant for the ICUs. In the multi-variate analysis, public hospitals had a lower SSI rate following hip prosthesis (odds ratio 0.80, 95% confidence interval 0.65-0.99). Hospital ownership was not found to have a major influence on the incidence of HCAI in Germany. Copyright © 2018 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  4. Prevention of nosocomial infection in the ICU setting.

    Science.gov (United States)

    Corona, A; Raimondi, F

    2004-05-01

    The aim of this review is to focus the epidemiology and preventing measures of nosocomial infections that affect the critically ill patients. Most of them (over 80%) are related to the device utilization needed for patient life support but responsible for such complications as ventilator-associated pneumonia (VAP), catheter-related bloodstream infections (CRBSI), surgical site infections (SSI) and urinary tract infections (UTI). General recommendations include staff education and use of a surveillance program with a restrictive antibiotic policy. Adequate time must be allowed for hand washing and barrier precautions must always be used during device manipulation. The routine changing of central catheters is not necessary and increases costs; it is necessary to decrease the handling of administration sets, to use a more careful insertion technique and less frequent set replacement. Specific measures for VAP prevention are: 1). use of multi-use, closed-system suction catheters; 2). no routine change of the breathing circuit; 3). lubrication of the the endotracheal tube cuff with a water-soluble gel; 4). maintenance of patient in semi-recumbent position to improve chest physiotherapy. Specific measures for UTI prevention include: 1). use of a catheter-valve instead of a standard drainage system; 2). use of a silver-alloy, hydro gel-coated latex urinary catheter instead of uncoated catheters. By implementing effective preventive measures and maintaining strict surveillance of ICU infections, we hope to affect the associated morbidity, mortality, and cost that our patients and society bare. More clinical trials are needed to verify the efficacy of prevention measures of ICU infections.

  5. Epidemiología molecular de infección nosocomial por Klebsiella pneumoniae productora de beta-lactamasas de espectro extendido.

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    Paula Andrea Espinal

    2004-09-01

    Full Text Available La epidemiología molecular aplicada al estudio de las infecciones nosocomiales ha sido fundamental para la formulación y la evaluación de las medidas de control; con este fin, se caracterizaron microbiológica y molecularmente aislamientos de Klebsiella pneumoniae productores de beta-lactamasas de espectro extendido (BLEE obtenidos de pacientes en un hospital de tercer nivel de Bogotá, D.C., Colombia. Se tipificaron quince aislamientos por electroforesis en gel de campo pulsado (PFGE y por amplificación de secuencias de ADN repetidas (REP-PCR. La susceptibilidad antimicrobiana y la producción de BLEE se determinaron de acuerdo con las normas de NCCLS. Las beta-lactamasas se evaluaron por isoelectroenfoque y PCR. El 80% de estos aislamientos se asociaron con infección nosocomial y de éstos, el 91,7% provenía de unidades de cuidado intensivo. La susceptibilidad antibiótica mostró 13 patrones de resistencia; 87% de los aislamientos presentó corresistencia a amikacina, 53% a gentamicina, 33,3% a ciprofloxacina, 40% a cefepime, 66,7% a piperacilina/tazobactam, 60% trimetoprim/sulfametoxazol y 46,7% a cloranfenicol. Todos fueron sensibles a imipenem. En la mayoría de los aislamientos se detectó producción simultánea de beta-lactamasas del tipo TEM y SHV y el 93,3% produjo ceftazidimasa de pI 8.2 del tipo SHV-5. Los 15 aislamientos fueron agrupados por PFGE y REP-PCR en 11 y 12 patrones electroforéticos, respectivamente. Esta variabilidad genética está relacionada con infecciones nosocomiales de origen endógeno más que por infecciones cruzadas.

  6. The level of nurses’ knowledge of the prevention of nosocomial infections – a pilot study

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    Izabela Gąska

    2017-08-01

    Full Text Available Introduction. A basic element in preventing and combating nosocomial infections is the medical personnel knowledge. It is up to health care workers to determine whether the hospital environment will be safe for both patients and those employed in this sector. The aim of the study was to present the level of nursing staff knowledge of nosocomial infections. Materials and methods. The research was carried out in the Podkarpackie Center of Cardiovascular Interventions in Sanok. The study group consisted of all nurses working in the Hemodynamic Department - 20 people. The tests were carried out using the diagnostic survey method. The research tool was the author's questionnaire. Results. The nurses were aware that the scale of the problem of nosocomial infections was important. Almost all nurses rated their level of knowledge of hospital-acquired infections very well. However, the full definition of the term "nosocomial infections" was not given by about a quarter of respondents. In hospitals nurses did not always follow the rules of aseptic and antiseptic treatment. In addition, they did not see the need to educate patients and their families about the prevention of infections. Conclusions. Hospitals should carry out monitoring of nurses’ compliance with the procedures that are aimed at the elimination of ward infections and should consistently strive at their best to apply these procedures at their workplace. The ward staff should be involved in the education of patients and their families in the prevention of nosocomial infections.

  7. Pattern of nosocomial infection in two intensive care units of a tertiary care hospital in karachi

    International Nuclear Information System (INIS)

    Rizvi, M.F.; Hassan, Y.; Abdullah, M.; Shakeel, J.; Memon, A.R.; Razvi, M.F.; Saleem, S.; Shakeel, J.

    2007-01-01

    To determine the pattern of nosocomial infections in two ICUs' of a teaching hospital in terms of frequency, common sites of infection, the pathogens involved and the antibiotic sensitivity patterns. It was conducted in two medical ICUs (Neurology and Nephrology) of a public tertiary care hospital. Data was collected prospectively on patients suspected to have developed nosocomial infection after 48 hours of admission to the ICU according to objective. There were 101 cases of suspected nosocomial infection out of a total of 254 patients. The frequency of nosocomial infection was 39.7%. UTI developed in 44.6%, while 27% had blood stream infection, and 21% had pneumonia. Each of the three major sites of infection was strongly associated with the use of invasive devices. Escherichia (E.) coli was the most common organism isolated followed by Pseudomonas aeruginosa and Klebsiella. E. coli and Klebsiella showed a maximum sensitivity to Imipenem followed by Tazocin (pipericillin + tazobactam). Pseudomonas aeruginosa was sensitive to Amikacin and Fosfomycin. The high frequency of nosocomial infection suggests that more strict measures regarding invasive devices should be taken in future to control the infection and limit the emergence of antibiotic resistant organisms. (author)

  8. Nosocomial outbreak of hepatitis B virus infection involving two hospitals in the Republic of Ireland.

    LENUS (Irish Health Repository)

    Burns, K

    2012-02-01

    The routes of nosocomial hepatitis B virus (HBV) transmission have changed over the years. Initiatives to prevent transfusion-associated HBV and healthcare worker-to-patient transmission have had a positive impact on these transmission routes. Recent reports of outbreaks of nosocomial HBV have implicated breaches in standard precautions as important causes of HBV transmission. This report describes a nosocomial outbreak of HBV infection in the Republic of Ireland, which occurred between January 2005 and March 2006. The outbreak was detected following identification of a case of acute HBV infection in a patient whose only risk factor was a recent surgical procedure. The extensive multi-agency investigation that followed revealed that the patient was one of five cases of acute HBV infection and that four separate transmission events between infectious cases had occurred in two different hospitals over a 15-month period. A definitive cause for each transmission event was not identified, although lapses in adherence to standard precautions, safe injection and phlebotomy practices could not be ruled out. Two secondary cases of acute HBV infection in community contacts of two of the nosocomial cases were identified. Phylogenetic analysis proved a useful tool in confirming infection with a pre-core HBV mutant and viral transmission between the seven patients. A patient notification exercise involving 1028 potentially exposed patients found no evidence of additional cases of nosocomial HBV infection. These findings highlight the importance of consistent application of standard precautions.

  9. Vigilancia de la resistencia a los antibacterianos en Argentina. Programa WHONET, 1995-1996

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    Alicia Rossi

    1999-10-01

    Full Text Available La Organización Mundial de la Salud ha puesto en marcha un programa para la vigilancia de la resistencia a los antibacterianos, denominado WHONET, que se desarrolló en Argentina mediante una red de 23 laboratorios de instituciones hospitalarias públicas y privadas sometidos a programas nacionales e internacionales de control de calidad. Entre enero de 1995 y diciembre de 1996 se determinó por el método de difusión en agar la sensibilidad a los antibacterianos de 16 073 aislados clínicos consecutivos, siguiendo las recomendaciones del Comité Nacional de Estándares para Laboratorios Clínicos (National Committee for Clinical Laboratory Standards: NCCLS de los Estados Unidos de América. Más de la mitad de los aislados urinarios de Escherichia coli fueron resistentes a la ampicilina, y más de 30% a la trimetoprima-sulfametoxazol. Cuando se comparó la sensibilidad de los aislados urinarios de pacientes ambulatorios y hospitalizados, se observó una marcada diferencia en los perfiles de actividad (porcentaje de microorganismos resistentes aislados en pacientes hospitalizados frente a pacientes ambulatorios de la gentamicina (8% frente a 2%, la norfloxacina (6% frente a 2% y las cefalosporinas de tercera generación (18% frente a 10%. Los aislados de Klebsiella pneumoniae recuperados de hemocultivos presentaron resistencia a las cefalosporinas de tercera generación y a la gentamicina en 71 y 60% de los casos, respectivamente. La proporción de Staphylococcus aureus resistentes a la oxacilina fue de 39%. Cerca de la mitad de los aislados de Enterococcus spp. presentaron resistencia de alto nivel a los aminoglucósidos, pero no se detectó resistencia a los glicopéptidos. En nuestro medio, la ampicilina y la trimetoprima-sulfametoxazol no fueron apropiadas para el tratamiento de las diarreas; Shigella flexneri presentó mayor porcentaje de aislados resistentes a ambos fármacos (87 y 74%, respectivamente que Shigella sonnei (47 y 71

  10. Prevalencia de la resistencia de Mycobacterium tuberculosis a quinolonas y fármacos inyectables en Colombia, 2012-2013

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    Claudia Llerena

    2017-01-01

    Conclusión. El estudio evidenció la presencia de resistencia a fármacos de segunda línea en personas con tuberculosis farmacorresistente sin tratamiento previo o tratadas previamente con quinolonas o fármacos inyectables, estos últimos con mayor porcentaje de resistencia. En consecuencia, es esencial practicar rutinariamente las pruebas de sensibilidad y el análisis de esta información.

  11. Acciones lipostáticas de la leptina actuando vía sistema nervioso central: mecanismos moleculares en el hígado y en el tejido adiposo blanco. Efecto de la resistencia central a la leptina

    OpenAIRE

    Bonzón Kulichenko, Elena

    2011-01-01

    La leptina actuando vía central o periférica disminuye la ingesta, la adiposidad y aumenta la sensibilidad a insulina del organismo como un todo. La dilucidación de las vías de señalización de la leptina y de los mecanismos que provocan la resistencia a la misma, son factores claves para entender el fenómeno de la obesidad y la diabetes tipo II, así como para permitir el desarrollo de una manera consciente de fármacos que corrijan estas patologías. En la presente tesis se abordan algunos meca...

  12. Epidemiological markers of Serratia marcescens isolates causing nosocomial infections in Spain (1981-1991).

    Science.gov (United States)

    Boquete, T; Vindel, A; Martin-Bourgon, C; Azañedo, L; Sáez-Nieto, J A

    1996-12-01

    The distribution of epidemiological markers (serotyping and phage-typing) of Serratia marcescens isolates from nosocomial episodes (63 nosocomial cutbreaks with 475 isolates, and 1208 sporadic cases) received in our laboratory during the period 1981-1991 was studied. The records for 1683 isolates from Spanish hospitals have been analyzed. In relation with the sporadic cases, the predominant types were serotype O6 (13.4%) and serotype O14 (11.4%); polyagglutinable strains accounted for 15.6%; in outbreaks, type O14 is clearly predominant (27.4%). Phage-typing was a good secondary marker, with a 87.9% of typability; the number of lytic patterns was very high, extended patterns (six or more phages) being the most frequent. We have studied the characteristics of S. marcescens isolates causing infections in the nosocomial environment in Spain.

  13. Knowledge and Prevention of Nosocomial Infection among Ward Nurses at Federal Medical Centre, Umuahia, Nigeria

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    Oti A. Aja

    2017-08-01

    Full Text Available This research was conducted for estimating the knowledge and prevention of nosocomial infection among ward nurses at Federal Medical Centre (FMC, Umuahia Abia state. Four objectives were set, and four questions were formulated. A descriptive survey research method was used for the study. A sample size of one hundred and fifty (150 nurses was drawn from eight wards (medical and surgical, at FMC, Umuahia. A self-developed questionnaire with seventeen (17 structured questions was the instrument of data collection. Data were collected, analyzed, and presented in tables, pie chart, bar chart, histogram, and percentages. The results revealed that the nurses were well knowledgeable about nosocomial infection, although little deficiencies existed in the area of infection control practice and compliance, such as hand washing frequency. This study therefore recommends continuing education/seminar/workshop for all health care givers, to sensitize them with the knowledge and practice of nosocomial infection.

  14. Semmelweis revisited: hand hygiene and nosocomial disease transmission in the anesthesia workstation.

    Science.gov (United States)

    Biddle, Chuck

    2009-06-01

    Hospital-acquired infections occur at an alarmingly high frequency, possibly affecting as many as 1 in 10 patients, resulting in a staggering morbidity and an annual mortality of many tens of thousands of patients. Appropriate hand hygiene is highly effective and represents the simplest approach that we have to preventing nosocomial infections. The Agency for Healthcare Research and Quality has targeted hand-washing compliance as a top research agenda item for patient safety. Recent research has identified inadequate hand washing and contaminated anesthesia workstation issues as likely contributors to nosocomial infections, finding aseptic practices highly variable among providers. It is vital that all healthcare providers, including anesthesia providers, appreciate the role of inadequate hand hygiene in nosocomial infection and meticulously follow the mandates of the American Association of Nurse Anesthetists and other professional healthcare organizations.

  15. Determinantes morfológicos de prognóstico em pneumonia nosocomial: um estudo em autópsias Morphological prognostic factors in nosocomial pneumonia: an autopsy study

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    Luiz Mário Baptista Martinelli

    2010-02-01

    Full Text Available OBJETIVO: Determinar a prevalência de pneumonia nosocomial nas autópsias em um hospital público universitário; identificar os fatores de risco relacionados à pneumonia nosocomial e os potenciais fatores prognósticos relacionados à ocorrência de pneumonia nosocomial fatal; e correlacionar os achados anatomopatológicos com a ocorrência de pneumonia nosocomial e/ou pneumonia aspirativa. MÉTODOS: Estudo retrospectivo de 199 pacientes autopsiados, maiores de 1 ano de idade, internados no Hospital das Clínicas da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista entre 1999 e 2006, cuja causa de morte (causa básica ou associada foi pneumonia nosocomial. Testou-se a associação dos dados demográficos, clínicos e anatomopatológicos com os desfechos pneumonia nosocomial fatal e pneumonia aspirativa fatal. As variáveis significativas entraram na análise multivariada. RESULTADOS: A idade média foi de 59 ± 19 anos. A prevalência de pneumonia nosocomial em autópsias foi 29%, e essa foi a causa mortis de 22,6% dos pacientes autopsiados. A pneumonia nosocomial fatal correlacionou-se com os achados anatomopatológicos de alterações estruturais tabágicas (OR = 3,23; IC95%: 1,26-2,95; p = 0,02 e acometimento pulmonar bilateral (OR = 3,23; IC95%: 1,26-8,30; p = 0,01. Não houve associações significativas entre as variáveis e pneumonia aspirativa fatal. CONCLUSÕES: Em nossa amostra, a pneumonia nosocomial teve prevalência elevada e foi responsável por quase 25% das mortes. A mortalidade é favorecida por alterações estruturais tabágicas e pneumonia bilateral. Esses achados corroboram os resultados de diversos estudos clínicos sobre pneumonia nosocomial.OBJECTIVE: To determine the prevalence of nosocomial pneumonia in autopsies at a public university hospital; to identify the risk factors for nosocomial pneumonia and the potential prognostic factors associated with fatal nosocomial pneumonia and with fatal

  16. Hormigones de alta resistencia con nano-adiciones y fibras de acero

    OpenAIRE

    Alizo Mirabal, Manuel Arturo

    2015-01-01

    El presente Trabajo Fin de Máster consistió en determinar la influencia que pueden poseer las nano-adiciones de Sílice y Alúmina y fibras de acero en un Hormigón de Alta Resistencia. Partiendo de una dosificación de Hormigón de Alta Resistencia conocida, que contenía humo de Sílice (10%) y fibras de poliolefina (3kg/m3), se les procedió a sustituir por la incorporación de nano-adiciones de Sílice y Alúmina (7% y 3% respectivamente) y añadiendo fibras de acero en lugar de poliolefina. En el pr...

  17. Ácidos grasos en la dieta diabetes mellitus e insulino resistencia

    Directory of Open Access Journals (Sweden)

    Clara Eugenia Pérez G.

    2006-04-01

    Full Text Available La resistencia a la insulina es característica de la diabetes mellitus tipo 2. Como parte del tratamiento se recomienda los diabéticos, sustituir en las dietas los ácidos grasos saturados y el colesterol por ácidos grasos monoinsaturados; sin que estén del todo claro los mecanismos bioquímicos que beneficiarían a los pacientes. Es probable, entre otros mecanismos, que los ácidos grasos monoin­saturados aumenten la sensibilidad a la insulina. Esta revisión analiza la relación entre el tipo de ácido graso en la dieta y la resistencia a insulina en la diabetes mellitus tipo 2.

  18. Nosocomial oral myiasis in ICU patients: occurrence of three sequential cases

    Directory of Open Access Journals (Sweden)

    Leylabadlo, Hamed Ebrahimzadeh

    2015-12-01

    Full Text Available Myiasis is the infestation of living vertebrates or humans tissues by dipterous larvae. The oral cavity is rarely affected by this infestation and the circumstances which can lead to oral myiasis include persistent mouth opening together with poor hygiene. Such infestations have been reported mainly in developing countries such as in Asia. Although rare, nosocomial myiasis must be noted carefully, especially in case of hospitalized patients. This report describes three cases of nosocomial oral myiasis in hospitalized patients in ICU (intensive care unit in Tabriz, North West of Iran.

  19. Patrones de resistencia a antibióticos de Acinetobacter baumannii en un hospital de Colombia

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    Mónica Chávez

    2015-01-01

    Full Text Available Objetivo: Identificar patrones de resistencia en los aislamientos de A. baumannii obtenidos en una unidad de cuidados intensivos de Cali, Colombia. Diseño: Estudio descriptivo, prospectivo de corte transversal. Institución: Clínica Universitaria Rafael Uribe Uribe, Cali, Colombia. Materiales: Los aislamientos se obtuvieron de cultivos de muestras de sangre, heridas quirúrgicas, secreción nasal, orina, secreción uretral y puntas de catéter. Intervenciones: Se recolectaron 52 aislamientos durante los años 2009 y 2010. Mediante el análisis del antibiograma se identificaron patrones de resistencia (antibiotipos, se realizó antibiograma cuantitativo y se construyó un cladograma basado en el agrupamiento por el método de promedios aritméticos de grupos apareados no ponderados (conocido en inglés como UPGMA. Principales medidas de resultados: Medida de la concentración mínima inhibitoria (CMI y el coeficiente de similitud generado por las distancias de los diámetros de los halos de inhibición entre dos aislamientos (antibiograma cuantitativo. Resultados: Se identificaron 5 antibiotipos; el 50% de los aislamientos se agruparon en el antibiotipo 1, con resistencia a todos los antibióticos y sensibilidad a tigeciclina y sulperazona; el antibiotipo 4 agrupó los aislamientos con resistencia a todos los antibióticos (19,3%. En el antibiograma cuantitativo se identificaron dos clados con 5 y 47 aislamientos, respectivamente. Conclusiones: Los aislamientos de Acinetobacter baumannii tuvieron pocas diferencias fenotípicas y es probable que presenten alguna de las β-lactamasas tipo OXA.

  20. Influencia de la humedad en el ensayo de resistencia de los ladrillos de suelo-cemento

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    Lima, José I.

    1994-02-01

    Full Text Available The article seeks to show the influence of humidity on the compression test of the soil-cement bricks through an adapted experimental design. The equations showing this relation are obtained. The subsequent generalization provides the possibility of making a pattern of correlation of strengths with different test humidities. Thus, the tests could be performed with a given humidity and the strength of the particular specimen for different humidity values could be estimated with a high degree of certainty. This makes possible the comparison of strength between tested elements in different humidity conditions, verification of fulfillment of recommended strength values and their expressing in terms of a basic humidity value, which is what the currently valid Technical Instructions lack.

    A través de un diseño experimental adecuado se pretende mostrar la influencia de la humedad en el ensayo a compresión de los ladrillos de suelo-cemento, obteniendo las ecuaciones que muestran esta relación. Su generalización posterior permitió elaborar una matriz de correlación de las resistencias con las diferentes humedades de ensayo, de forma tal que se pueda ensayar con una humedad dada y estimar la resistencia que tendrá esa muestra para diferentes valores de humedad, con un buen nivel de confianza. Esto posibilita que se puedan realizar comparaciones de resistencia entre elementos ensayados en condiciones desiguales de humedad, verificar el cumplimiento de los valores recomendados de resistencia y referirlos a un valor de humedad base, defecto actual de las Instrucciones Técnicas vigentes.

  1. El humor político en la Web, un discurso de resistencia

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    LILIANA XIMENA GONZÁLEZ GOYENECHE

    2011-01-01

    Full Text Available Este artículo describe el proceso metodológico desarrollado en la propuesta monográfica titulada El humor. Un discurso de resistencia política: análisis crítico multimodal, tesis de la Maestría en Lingüística de la Universidad Pedagógica y Tecnológica de Colombia. Trabajo que surge del interés por ver cómo, por medio del discurso humorístico, se construye un discurso de resistencia a los discursos hegemónicos, identificando las estrategias discursivas que utiliza el humor para la construcción de un discurso político de resistencia; también, a través del análisis de videos humorísticos de corte político: productos multimodales mediatizados desde la Web en el portal YouTube. El corpus seleccionado fue la serie animada El Pequeño Tirano creada por Santiago Rocha, Simón Wilches y Santiago Rivas en el año 2008, que tematiza alrededor del mandato presidencial de Álvaro Uribe Vélez. Serie animada representativa del fenómeno del humor político en Colombia, de su significado y sus implicaciones en la vida social y cultural del país.

  2. Consideraciones para la mejora de la resistencia en el fútbol

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    Miguel Ángel Campos Vázquez

    2012-12-01

    Full Text Available Debido a la duración y los esfuerzos requeridos durante un partido de fútbol, la mejora de la resistencia debe ocupar un lugar importante en las planificaciones que diseñen los entrenadores y preparadores físicos. El desarrollo de dos parámetros fisiológicos parece importante a la hora de conseguir estas mejoras: el consumo máximo de oxígeno y el umbral anaeróbico. El objetivo de este trabajo es el de analizar los diferentes métodos de entrenamiento para la resistencia en el fútbol que han demostrado su validez, entre los cuales se pueden destacar el entrenamiento interválico de alta intensidad, las situaciones reducidas de juego, el entrenamiento de sprints repetidos y el entrenamiento continuo. La utilización de estos métodos a lo largo de la temporada, se debe basar en la valoración de los niveles de resistencia de los jugadores, lo cual orientará las posibles estrategias en la planificación, con el objetivo de optimizar el rendimiento de los futbolistas.

  3. Búsqueda de genes de resistencia al pasador del fruto en poblaciones segregantes de tomate

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    Diana Milena Rodríguez Mora

    2010-07-01

    Full Text Available Las estrategias de mejoramiento genético para encontrar resistencia al pasador del fruto, Neoleucinodes elegantalis, en tomate, Solanum lycopersicum L. se han basado en métodos tradicionales de introgresión genética por medio de retrocruzamiento. Sin embargo este proceso es largo y dispendioso. Debido a esta problemática, se utilizó la técnica molecular cDNA-AFLP para identificar genes involucrados en la resistencia a esta plaga en poblaciones segregantes de tomate, con el fin de identificar marcadores moleculares que puedan ser utilizados en futuros programas de fitomejoramiento. Los materiales de tomate evaluados fueron Unapal-Maravilla (susceptible, S. habrochaites var. glabratum, accesión PI 134418 (resistente y tres retrocruzamientos obtenidos del cruzamiento interespecífico entre ambas especies. De estos materiales vegetales se extrajo el RNA total y se sintetizó el cDNA, el cual se utilizó como material de inicio de la técnica cDNA-AFLP. A partir del preamplificado de cDNA se evaluaron diferentes combinaciones de primers: +1+1, +3+3 y sus derivados. La combinación que presentó mejores amplificados fue la +1+1, para un total de 37 bandas polimórficas. De estas bandas, 9 fragmentos tipo EST (Expressed Sequence Target fueron recuperados, siendo candidatos a explicar la resistencia al pasador del fruto en tomate.

  4. Resistencia a antimicrobianos de bacilos Gram negativos aislados en unidades de cuidado intensivo en hospitales de Colombia, WHONET 2003, 2004 y 2005

    Directory of Open Access Journals (Sweden)

    María Consuelo Miranda

    2006-09-01

    Resultados. Los altos porcentajes de resistencia reportados en especial para A. baumannii, corroboraron la presencia de bacterias multirresistentes en las UCI en las instituciones participantes durante el periodo de estudio. Conclusiones. Es urgente crear una red nacional de vigilancia de la resistencia a antimicrobianos de los patógenos hospitalarios y de esta manera mejorar nuestra habilidad para detectar, supervisar y manejar la resistencia a antimicrobianos en Colombia.

  5. Vigilancia nacional de la resistencia a medicamentos antituberculosos, Perú 2005-2006

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    Luis Asencios

    2009-07-01

    Full Text Available Objetivo. Determinar la prevalencia de resistencia a medicamentos antituberculosos en el Perú. Materiales y métodos. Se realizó un muestreo por conglomerados en las 33 regiones de salud de Perú. Se utilizó el método de las proporciones de Canetti en medio sólido Lowenstein Jensen para la susceptibilidad de Mycobacterium tuberculosis a medicamentos antituberculosos con isoniacida (INH rifampicina (RMP, estreptomicina (SM y etambutol (EMB. Las cepas con resultado de TB MDR se sometieron a susceptibilidad a medicamentos de segunda línea por el método de las proporciones en agar 7H10, en placas. Resultados. Se analizaron 1809 cultivos de pacientes nuevos y 360 de antes tratados. El 51,6% residía en Lima y el 59,3% fueron varones. La prevalencia nacional de la resistencia primaria fue de 23,2% (IC95%: 21,3 - 25,1 y la resistencia adquirida fue de 41,7% (IC95%: 36,5 - 46,8. Se detectó 180 casos de TB MDR de los cuales la prevalencia de TB MDR primaria fue 5,3% (IC95%: 4,2 - 6,3 y la adquirida fue de 23,6% (IC95%: 19,2 - 28,0. El 20% de aislamientos de pacientes nunca tratados en Lima fueron resistentes a INH o RIF. La resistencia global y la TB MDR primarias fueron más prevalentes en Lima que en el resto del país. La TB XDR estuvo presente en el 5,9% de pacientes con TB MDR y el 36% de las cepas de TB MDR fueron resistentes a por lo menos una droga de segunda línea. Conclusiones. Comparado con los estudios previos, la resistencia a drogas antituberculosas primaria y adquirida se ha incrementado significativamente en los últimos 10 años en Perú.

  6. Impacto de los movimientos migratorios en la resistencia bacteriana a los antibióticos

    Directory of Open Access Journals (Sweden)

    Juan Carlos Galán Montemayor

    2014-01-01

    Full Text Available Fundamentos: España es uno de los principales aceptores mundiales de inmigrantes. Sin embargo existen escasos trabajos sobre la caracterización de bacterias resistentes en la población inmigrante en España. El objetivo es conocer el impacto de la inmigración en la prevalencia de la resistencia antibiótica en España. Métodos: Se realizó una revisión bibliográfica artículos originales publicados entre 1998-2013 realizando la búsqueda con las palabras clave resistencia, inmigrante y España más Mycobacterium tuberculosis, Neisseria gonorrhoeae o Enterobacteriaceae y diarrea del viajero para cada uno de los sub-apartados. Resultados: El porcentaje global de cepas de M. tuberculosis resistentes fue 2,5-4 veces más frecuente en la población inmigrante que en la población nativa. La proporción de cepas multiresistentes fue también mayor en población inmigrante adulta (2,5% e infantil (4,5% respecto apoblación autóctona (0,1-0% respectivamente. El 28% de casos de gonococia en España se detectaron en inmigrantes procedentes de áreas con altos niveles de resistencia a macrólidos (30% y cefalosporinas (20% suponiendo un peligro de diseminación de cepas de N. gonorrhoeae de difícil tratamiento. La detección de entero bacterias multiresistentes en individuos españoles antes y después de realizar viajes a países con alta resistencia se elevó desde 7,9% a 17,9% (a 37,4% en personas procedentes de India. Conclusiones: Las diferentes tasas de resistencia entre población autóctona y población inmigrante en los modelos estudiados en esta revisión revelan que los flujos migratorios no solo afectan a la emergencia o re emergencia de enfermedades infecciosas sino también a la elección de tratamiento efectivo.

  7. Efectos de un entrenamiento concurrente de fuerza y resistencia sobre carreras de media distancia

    Directory of Open Access Journals (Sweden)

    Juan Manuel García-Manso

    2017-01-01

    Full Text Available El objetivo de este estudio fue evaluar los efectos del entrenamiento concurrente (fuerza y resistencia sobre las carreras de media distancia en sujetos jóvenes de moderado nivel de rendimiento. Se aplicó un trabajo organizado en fases de diferente orientación de fuerza, lo que se conoce como periodización por bloques. Quince universitarios sanos y físicamente activos participaron voluntariamente en el estudio. Fueron organizados aleatoriamente en dos grupos: uno que entrenaba solo resistencia (Grupo Resistencia: GR: Edad=21.3±2.3 años; Peso Corporal=66.8±1.9 kg; Estatura=172.0±2.3 cm; Grasa Corporal=10.8±1.1% y otro (Grupo Fuerza-Resistencia: GFR: Edad=20.9±1.2 años; Peso Corporal=69.8±1.3 kg; Estatura=172.8±3.9 cm, Grasa Corporal=11.4±0.6% al que se le añadió un protocolo de entrenamiento de fuerza de 9 semanas (2 días/semana de duración. No se detectaron grandes diferencias en los cambios observados en ambos grupos al final de las nueve semanas. Los dos grupos mejoraron significativamente su rendimiento en las carreras de media y larga duración, la fuerza, la resistencia de fuerza y su capacidad aeróbica (VO2 max. Los cambios fueron poco apreciables en el resto de las pruebas evaluadas (60 y 300 metros. Los mayores beneficios se encontraron en la carrera de 2000 metros. Dichas mejoras se detectaron desde el primer mesociclo de entrenamiento y fueron especialmente evidentes al final de las nueve semanas. No obstante, no se detectaron diferencias relevantes entre ambos grupos (6.5±3.7 vs. 3.7±2.1 ml/kg/min; F=0.534; IC95%= -0.198, 5.932; p=0.65; ES=0.434. En conclusión, podemos afirmar que en esta muestra incorporar un trabajo de fuerza no conlleva mayores beneficios que entrenar solo la carrera.

  8. SAFETY-MODE RESPIRATORY SUPPORT IN NOSOCOMIAL PNEUMONIA

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    V. V. Moroz

    2015-01-01

    Full Text Available Diagnostic criteria for and approaches to differentiated treatment for acute respiratory distress syndrome (ARDS in nosocomial pneumonia (NP have been elaborated, but approaches to preventing this syndrome in the presence of risk factors have not been investigated. Safety-mode mechanical ventilation (MV (protective MV is the most probable way of preventing ARDS in NP. Objective: to evaluate the efficiency of MV with safety parameters in preventing ARDS in NP in patients with surgical abdominal infection. Subjects and methods. This retrospective unicentric study was conducted at the clinical bases of the V. A. Negovsky Research Institute of General Reanimatology in 2013—2014. During a retrospective analysis, the patients were divided into two groups: 1 safe MV — after NP was diagnosed, the patients underwent safetymode MV (tidal volume (TV 6—8 ml/kg; 2 standard MV — after NP was diagnosed, the patients were on MV with traditional parameters (TV 8—10 ml/kg. The incidence of ARDS in the patient groups was taken as a main criterion for the efficiency of safetymode respiratory support. The duration of MV, the length of stay in an intensive care unit, and 30day mortality rates were estimated as secondary criteria for the efficiency of safety-mode respiratory support. The findings were statistically analyzed using a Statistica 7.0 package. The data were expressed as the median (± 25—75 percentiles interquartile range (IQR. The difference at p<0.05 was considered signif icant. >Results. Comparison of oxygenation index (OI and extravascular lung water index (ELWI showed that there were natural significant differences between the safe MV and standard MV groups in these indicators, beginning from day 2 of the investigation. The standard MV group displayed a significant decrease in OI and an increase in ELWI at 7 days versus at day 1 of the investigation. In the safe MV group, TV was naturally lower than that in the standard MV group on days 1

  9. Identificación molecular de mutaciones puntuales relacionadas con resistencia a drogas en VIH-1 de pacientes peruanos

    Directory of Open Access Journals (Sweden)

    Carlos Yabar V

    2006-07-01

    Full Text Available Objetivo: Identificar mutaciones puntuales relacionadas con resistencia a drogas en VIH-1 de pacientes peruanos. Materiales y metodos: Se seleccionaron 11 muestras de VIH provenientes de sangre total de sujetos con tratamiento antirretroviral (ARV. Posteriormente se realizo la optimizacion de la amplificacion de 337 pb del gen de la transcriptasa reversa (tr y 377 pb de todo el gen de la proteasa (prt. Los productos de PCR fueron secuenciados directamente para el analisis de mutaciones de resistencia. Las secuencias finales fueron analizadas en programas de analisis de mutaciones de la HIV Drug Resistance Database de la Universidad de Stanford. mutaciones de la HIV Drug Resistance Database de la Universidad de Stanford. Resultados: La optimizacion de la concentracion de ADN (2,5 ng / µL asi como la concentracion de magnesio (4 mM fueron factores criticos para la amplificacion de la tr y la prt respectivamente. De otro lado, el analisis de secuencia revelo la presencia de las mutaciones T215Y y la M184V en tr, implicadas en conferir resistencia a zidovudina (AZT y estavudina (D4T asi como a lamivudina (3TC y emtricitabina (FTC respectivamente. En prt se observaron las mutaciones D30N y N88D implicadas en conferir resistencia a nelfinavir (NFV. Es importante senalar que solo tres muestras de VIH-1 presentaron mutaciones de resistencia, las demas mostraron mutaciones compensatorias. Conclusiones: Se demuestra la existencia de mutaciones de resistencia a ARV a nivel de tr y prt de VIH-1 en sujetos peruanos que reciben terapia TARGA. Se requieren de mayores estudios para establecer un perfil de resistencia a ARV en la poblacion peruana.

  10. Nosocomial transmission of community-associated methicillin-resistant Staphylococcus aureus in Danish Hospitals

    DEFF Research Database (Denmark)

    Hetem, David J; Westh, Henrik; Boye, Kit

    2012-01-01

    exposure. Despite obvious epidemiological differences, it is unknown whether differences in nosocomial transmissibility exist. We have, therefore, quantified the transmissibility, expressed by the single admission reproduction number (R(A)), of CA-MRSA and HA-MRSA in hospital settings in Denmark....

  11. Endemic nosocomial infections and misuse of antibiotics in a maternity hospital in Saudi Arabia.

    Science.gov (United States)

    Bilal, Naser Eldin; Gedebou, Messele; Al-Ghamdi, Saleh

    2002-02-01

    Patients admitted during a 6-month period to a maternity hospital in Saudi Arabia were studied for nosocomial infections and misuse of antibiotics. Patient history and diagnosis on admission and subsequent clinical and laboratory data were analysed. Infection developing from 72 h after admission was considered nosocomial. Therapeutic and prophylactic data as recorded on the patients' charts were assessed for possible misuse of antibiotics. Of 3439 patients, 136 (4.0%) developed nosocomial infection: 2.0%, 8.9% and 37.7% in obstetric, gynaecologic and nursery patients, respectively. Infections among adults were mostly found in the urinary (44.4%) and lower genital (33.3%) tracts. Among newborns, over 70% of cases were eye and ear (29.8%), skin (26.2%) and blood (19.0%) infections. Gram-negative bacteria caused 65.7% of the infections. Over 90% of the bacterial isolates were multidrug-resistant. About 24% of patients received single or multiple antibiotics; 57.2% were misused. The minimal hospital cost estimate for both nosocomial infections and misused antibiotics was US $318,705. The findings of this study, the first of its type in this region, should prompt improved infection control measures as well as educational and antibiotic restriction interventions.

  12. A NOSOCOMIAL INFECTION MANIFESTED AS ERYSIPELAS IN PEMPHIGUS FOLIACEUS PATIENT UNDER INTRAVENOUS DEXAMETHASONE TREATMENT

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    Achmad Yudha Pranata

    2016-05-01

    Full Text Available Introduction: Puncture wound in diagnostic interventions permits the entry of bacteria into the skin or soft tissue, thus precipitating nosocomial infection, such as erysipelas. There are other risk factors of nosocomial infections including old age, immunosuppressive drugs, and underlying diseases. Pemphigus foliaceus (PF is an autoimmune disease with corticosteroid treatment as the mainstay therapy, which could cause immunosuppression and predispose patients to infection. The objective of this paper was to report erysipelas as one of the manifestations of nosocomial infection in patients under immunosuppressive therapy. Case: A case of erysipelas acquired on the 9th day of hospitalization in a PF patient underwent intravenous dexamethasone injection, with history of puncture wounds on the previous day on the site of erysipelas was reported. The clinical findings of erysipelas were well defined, painful erythema and edema that felt firm and warm on palpation, with blisters and pustules on top. Gram staining from the pustules and blisters fluid revealed Gram (+ cocci. Patient was given 2 grams intravenous ceftriaxone for 7 days and saline wet compress. Improvement on the erysipelas was seen the day after ceftriaxone injection. The patient was discharged after 12 days of hospitalization with improvement both on the PF and the erysipelas. On the next visit 7 days later, the erysipelas lesion disappeared. Conclusion: Puncture wound and immunosuppresive treatment are the factors that could cause erysipelas as a nosocomial infection, and an appropriate treatment of the infection would decrease the functional disability of the patient.

  13. Pattern of nosocomial infections in the special care baby unit of the ...

    African Journals Online (AJOL)

    PROF. EZECHUKWU

    2013-09-27

    Sep 27, 2013 ... -risk infants delivered in the maternity unit of the hospi- tal as well as infants referred ..... In the present study, the risk of nosocomial infection was not significantly higher ... German surveillance system for very low birth weight ...

  14. The impact of nosocomially-acquired resistant Pseudomonas aeruginosa infection in a burn unit.

    Science.gov (United States)

    Armour, Alexis D; Shankowsky, Heather A; Swanson, Todd; Lee, Jonathan; Tredget, Edward E

    2007-07-01

    Nosocomially-acquired Pseudomonas aeruginosa remains a serious cause of infection and septic mortality in burn patients. This study was conducted to quantify the impact of nosocomially-transmitted resistant P. aeruginosa in a burn population. Using a TRACS burn database, 48 patients with P. aeruginosa resistant to gentamicin were identified (Pseudomonas group). Thirty-nine were case-matched to controls without resistant P. aeruginosa cultures (control group) for age, total body surface area, admission year, and presence of inhalation injury. Mortality and various morbidity endpoints were examined, as well as antibiotic costs. There was a significantly higher mortality rate in the Pseudomonas group (33% vs. 8%, p products used (packed cells 51.1 +/- 8.0 vs. 21.1 +/- 3.4, p < 0.01; platelets 11.9 +/- 3.0 vs. 1.4 +/- 0.7, p < 0.01) were all significantly higher in the Pseudomonas group. Cost of antibiotics was also significantly higher ($2,658.52 +/- $647.93 vs. $829.22 +/- $152.82, p < 0.01). Nosocomial colonization or infection, or both, of burn patients with aminoglycoside-resistant P. aeruginosa is associated with significantly higher morbidity, mortality, and cost of care. Increased resource consumption did not prevent significantly higher mortality rates when compared with that of control patients. Thus, prevention, identification, and eradication of nosocomial Pseudomonas contamination are critical for cost-effective, successful burn care.

  15. Nosocomial infections in HIV-infected and HIV-uninfected children ...

    African Journals Online (AJOL)

    One HIV-infected child died of varicella pneumonia. Other common nosocomial infections encountered in HIV-infected and HIV-uninfected children respectively were upper respiratory tract infections (pharyngitis, tonsillitis or rhinitis) affecting 21 and four, otitis media in five and one, oral candidiasis in seven and zero, urinary ...

  16. Norovirus Genotypes in Hospital Settings - Differences between Nosocomial and Community-Acquired Infections

    DEFF Research Database (Denmark)

    Franck, Kristina Træholt; Nielsen, Rikke Thoft; Holzknecht, Barbara Juliane

    2015-01-01

    BACKGROUND:  Norovirus is a major cause of gastroenteritis and hospital outbreaks, leading to substantial morbidity and direct healthcare expenses as well as indirect societal costs. The aim of the study was to estimate the proportion of nosocomial norovirus infections among inpatients tested...

  17. Nosocomial infections in HIV-infected and HIV-uninfected children ...

    African Journals Online (AJOL)

    Twenty-five nosocomial infections (23%) among the HIV-infected children, but only ... candidiasis in seven and zero, urinary tract infection in four and one and .... tant or multidrug-resistant TB received ... bacterial infections, 96 hours in the case.

  18. Cost-analysis of seven nosocomial outbreaks in an academic hospital

    NARCIS (Netherlands)

    Dik, Jan-Willem H.; Dinkelacker, Ariane D.; Vemer, Pepijn; Lo-Ten-Foe, Jerome R.; Lokate, Mariette; Sinha, Bhanu; Friedrich, Alex W.; Postma, Maarten J.

    2016-01-01

    Objectives Nosocomial outbreaks, especially with (multi-)resistant microorganisms, are a major problem for health care institutions. They can cause morbidity and mortality for patients and controlling these costs substantial amounts of funds and resources. However, how much is unclear. This study

  19. Field inversion gel electrophoretic analysis of Legionella pneumophila strains associated with nosocomial legionellosis in children.

    Science.gov (United States)

    Green, M; Wald, E R; Dashefsky, B; Barbadora, K; Wadowsky, R M

    1996-01-01

    Two nosocomial cases of Legionnaires' disease occurred in children. Legionella pneumophila serogroup 1 was isolated from both patients and 30 of 39 plumbing system sites in the hospital. The patient and hospital environmental isolates yielded identical field inversion gel electrophoretic patterns which differed from patterns observed with epidemiologically unrelated strains.

  20. Nosocomial infections after aneurysmal subarachnoid hemorrhage : time course and causative pathogens

    NARCIS (Netherlands)

    Laban, Kamil G.; Rinkel, Gabriel J. E.; Vergouwen, Mervyn D. I.

    BackgroundNosocomial infections after aneurysmal subarachnoid hemorrhage (aSAH) are associated with prolonged length of stay and poor functional outcome. It remains unclear if infections result in prolonged length of stay or, vice versa, if prolonged length of stay results in more infections. Before

  1. Nosocomial infections in HIV-infected and HIV-uninfected children ...

    African Journals Online (AJOL)

    The interaction between tuberculosis and HIV-infected infection is well known and is responsible for the increase in the incidence of tuberculosis ... This retrospective case-control study evaluated the occurrence of nosocomial infections in (HIV)-infected children and age- and time of ... complicated disease, or whose social.

  2. Risk Factors for Nosocomial Bacterremia Due to Methicillin-Resistant Staphylococcus Aureus

    NARCIS (Netherlands)

    M. Pujol (Miquel); C. Pena; R. Pallares (Roman); J. Ayats (Josefina); J. Ariza (Javier); F. Gudiol (Francesc)

    1994-01-01

    textabstractIn a prospective surveillance study (February 1990–December 1991) performed at a 1000-bed teaching hospital to identify risk factors for nosocomial methicillin-resistantStaphylococcus aureus (MRSA) bacteremia, 309 patients were found to be colonized (n=103; 33 %) or infected (n=206; 67

  3. Nosocomial infections: knowledge and source of information among clinical health care students in Ghana

    Directory of Open Access Journals (Sweden)

    Bello AI

    2011-08-01

    Full Text Available Ajediran I Bello1, Eunice N Asiedu1, Babatunde OA Adegoke2, Jonathan NA Quartey1, Kwadwo O Appiah-Kubi1, Bertha Owusu-Ansah11Department of Physiotherapy, School of Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana; 2Department of Physiotherapy, College of Medicine, University of Ibadan, Ibadan, NigeriaBackground: This study determined and compared the knowledge of nosocomial infections among clinical health care students at the College of Health Sciences, University of Ghana.Methods: Two hundred undergraduate health care students from four academic programs participated in the study. The study sample was drawn from each academic program by a simple random sampling technique using the class directory from each course. The Infection Control Standardized Questionnaire (ICSQ was used to assess the knowledge of students about three main domains, ie, hand hygiene, nosocomial infections, and standard precautions. A maximum score of 50 was obtainable, and respondents with scores ≥70% were classified as having a satisfactory knowledge. The response on each item was coded numerically to generate data for statistical analysis. Comparison of knowledge on the domains among categories of students was assessed using the Kruskal–Wallis test, while associations between courses of study and knowledge about nosocomial infections were determined using the Chi-square test. All statistical tests had a significant level of 5% (P < 0.05Results: Overall mean percentage score of the participants on ICSQ was 65.4 ± 2.58, with medical, physiotherapy, radiography, and nursing students recording mean percentage scores of 70.58 ± 0.62, 65.02 ± 2.00, 64.74 ± 1.19, and 61.31 ± 2.35, respectively. The main source of information about the prevention of nosocomial infections as cited by participants was their routine formal training in class. There was no significant association (P > 0.05 between course of study and knowledge of

  4. Antimicrobial resistance among nosocomial isolates in a teaching hospital in Goa

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    Kamat U

    2008-01-01

    Full Text Available Background: Emergence of polyantimicrobial resistant strains of hospital pathogens has presented a challenge in the provision of good quality in-patient care. Inappropriate use of antibiotics in the hospital is largely responsible for this catastrophe. Bacteriological surveillance of the cases of nosocomial infections is crucial for framing an evidence-based antimicrobial policy for a hospital. Materials and Methods: A prospective study was undertaken among 498 patients from medicine and surgery wards in a tertiary teaching hospital in Goa. The patients were followed up clinico-bacteriologically for the occurrence of nosocomial infections (NI. Antibiotic susceptibility testing was done using Kirby-Bauer disc diffusion method. Results: The overall infection rate was 33.93 ± 4.16 infections per 100 patients. Urinary tract infection was the most common NI (26.63%, followed by surgical site infection (23.67%, wound infection (23% and nosocomial pneumonia (18.34%. Ninety-seven percent of the isolates were bacterial, while the others were fungal. More than 80% of the NIs were caused by Gram-negative bacteria, predominantly Pseudomonas aeruginosa, Escherichia coli and Aceinetobacter baumanii . Almost 70% of the isolates were resistant to all the antibiotics for which susceptibility was tested; the rest were sensitive to amikacin, cefoperazone-sulbactam and other antibiotics including methicillin, co-trimoxazole, teicoplenin, vancomycin and rifampicin, either singly or in combination. The proportion of MRSA was 71.4%. Resistance to a particular antibiotic was found to be directly proportional to the antibiotic usage in the study setting. Conclusion: Surveillance of nosocomial infections with emphasis on the microbiologic surveillance and frequent antimicrobial audit are critical towards curbing the evil of polyantimicrobial resistant nosocomial infections in a hospital.

  5. Risk factors and mortality for nosocomial bloodstream infections in elderly patients.

    Science.gov (United States)

    Reunes, S; Rombaut, V; Vogelaers, D; Brusselaers, N; Lizy, C; Cankurtaran, M; Labeau, S; Petrovic, M; Blot, S

    2011-10-01

    To determine risk factors for nosocomial bloodstream infection (BSI) and associated mortality in geriatric patients in geriatric and internal medicine wards at a university hospital. Single-center retrospective (1992-2007), pairwise-matched (1:1-ratio) cohort study. Geriatric patients with nosocomial BSI were matched with controls without BSI on year of admission and length of hospitalization before onset of BSI. Demographic, microbiological, and clinical data are collected. One-hundred forty-two BSI occurred in 129 patients. Predominant microorganisms were Escherichia coli (23.2%), coagulase-negative Staphylococci (19.4%), Pseudomonas aeruginosa (8.4%), Staphylococcus aureus (7.1%), Klebsiella pneumoniae (5.8%) and Candida spp. (5.8%). Matching was successful for 109 cases. Compared to matched control subjects, cases were more frequently female, suffered more frequently from arthrosis, angina pectoris and pressure ulcers, had worse Activities of Daily Living-scores, had more often an intravenous or bladder catheter, and were more often bedridden. Logistic regression demonstrated presence of an intravenous catheter (odds ratio [OR] 7.5, 95% confidence interval [CI] 2.5-22.9) and being bedridden (OR 2.9, 95% CI 1.6-5.3) as independent risk factors for BSI. In univariate analysis nosocomial BSI was associated with increased mortality (22.0% vs. 11.0%; P=0.029). After adjustment for confounding co-variates, however, nosocomial BSI was not associated with mortality (hazard ratio 1.3, 95% CI 0.6-2.6). Being bedridden and increasing age were independent risk factors for death. Intravenous catheters and being bedridden are the main risk factors for nosocomial BSI. Although associated with higher mortality, this infectious complication seems not to be an independent risk factor for death in geriatric patients. Copyright © 2011 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  6. Efficacy of an infection control programme in reducing nosocomial bloodstream infections in a Senegalese neonatal unit.

    Science.gov (United States)

    Landre-Peigne, C; Ka, A S; Peigne, V; Bougere, J; Seye, M N; Imbert, P

    2011-10-01

    Neonatal nosocomial infections are public health threats in the developing world, and successful interventions are rarely reported. A before-and-after study was conducted in the neonatal unit of the Hôpital Principal de Dakar, Senegal to assess the efficacy of a multi-faceted hospital infection control programme implemented from March to May 2005. The interventions included clustering of nursing care, a simple algorithm for empirical therapy of suspected early-onset sepsis, minimal invasive care and promotion of early discharge of neonates. Data on nosocomial bloodstream infections, mortality, bacterial resistance and antibiotic use were collected before and after implementation of the infection control programme. One hundred and twenty-five infants were admitted immediately before the programme (Period 1, January-February 2005) and 148 infants were admitted immediately after the programme (Period 2, June-July 2005). The two groups of infants were comparable in terms of reason for admission and birth weight. After implementation of the infection control programme, the overall rate of nosocomial bloodstream infections decreased from 8.8% to 2.0% (P=0.01), and the rate of nosocomial bloodstream infections/patient-day decreased from 10.9 to 2.9/1000 patient-days (P=0.03). Overall mortality rates did not differ significantly. The proportion of neonates who received antimicrobial therapy for suspected early-onset sepsis decreased significantly from 100% to 51% of at-risk infants (Punit, simple, low-cost and sustainable interventions led to the control of a high incidence of bacterial nosocomial bloodstream infections, and the efficacy of these interventions was long-lasting. Such interventions could be extended to other low-income countries. Copyright © 2011 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  7. Extensive dissemination of methicillin-resistant Staphylococcus aureus (MRSA between the hospital and the community in a country with a high prevalence of nosocomial MRSA.

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    Diana Espadinha

    Full Text Available According to the EARS-Net surveillance data, Portugal has the highest prevalence of nosocomial methicillin-resistant Staphylococcus aureus (MRSA in Europe, but the information on MRSA in the community is very scarce and the links between the hospital and community are not known. In this study we aimed to understand the events associated to the recent sharp increase in MRSA frequency in Portugal and to evaluate how this has shaped MRSA epidemiology in the community. With this purpose, 180 nosocomial MRSA isolates recovered from infection in two time periods and 14 MRSA isolates recovered from 89 samples of skin and soft tissue infections (SSTI were analyzed by pulsed-field gel electrophoresis (PFGE, staphylococcal chromosome cassette mec (SCCmec typing, spa typing and multilocus sequence typing (MLST. All isolates were also screened for the presence of Panton Valentine leukocidin (PVL and arginine catabolic mobile element (ACME by PCR. The results showed that ST22-IVh, accounting for 72% of the nosocomial isolates, was the major clone circulating in the hospital in 2010, having replaced two previous dominant clones in 1993, the Iberian (ST247-I and Portuguese (ST239-III variant clones. Moreover in 2010, three clones belonging to CC5 (ST105-II, ST125-IVc and ST5-IVc accounted for 20% of the isolates and may represent the beginning of new waves of MRSA in this hospital. Interestingly, more than half of the MRSA isolates (8/14 causing SSTI in people attending healthcare centers in Portugal belonged to the most predominant clones found in the hospital, namely ST22-IVh (n = 4, ST5-IVc (n = 2 and ST105-II (n = 1. Other clones found included ST5-V (n = 6 and ST8-VI (n = 1. None of the MRSA isolates carried PVL and only five isolates (ST5-V-t179 carried ACME type II. The emergence and spread of EMRSA-15 may be associated to the observed increase in MRSA frequency in the hospital and the consequent spillover of MRSA into the community.

  8. Herencia de la resistencia al virus del mosaico deformante del pimentón PepDMV en Capsicum

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    Mario Augusto García Dávila

    2009-10-01

    Full Text Available En busca de determinar el modo de herencia de la resistencia en tres materiales resistentes, se hicieron cruzamientos hacia tres líneas susceptibles. Se siguió el método del retrocruzamiento propuesto por Warner (1952 fundamentado en el modelo matemático de Fisher Immer y Tedin (1932 descrito con detalle por Mater (1949 y Jenkins (1982, 1984 en el cual se descompone la varianza genética en tres componentes: aditiva, dominancia y epistática. El modelo del retrocruzamiento incluye los dos parentales, el hibrido de la primera generación y la autofecunfación de la F1 para formar la población F2 y las retrocruzas hacia ambos padres. Las poblaciones fueron evaluadas a resistencia al virus del mosaico del pimentón PepDMV en condiciones de invernadero. Los resultados mostraron que el modelo aditivodominancia explicó la resistencia en los híbridos formados entre materiales resistentes y susceptibles. Los genes con acción heredable transmiten a la descendencia el efecto de resistencia. La ganancia de la resistencia viral se da por la presencia de parentales resistentes.

  9. Inherent Risk Factors for Nosocomial Infection in the Long Stay Critically Ill Child Without Known Baseline Immunocompromise: A Post Hoc Analysis of the CRISIS Trial.

    Science.gov (United States)

    Carcillo, Joseph A; Dean, J Michael; Holubkov, Richard; Berger, John; Meert, Kathleen L; Anand, Kanwaljeet J S; Zimmerman, Jerry; Newth, Christopher J; Harrison, Rick; Burr, Jeri; Willson, Douglas F; Nicholson, Carol; Bell, Michael J; Berg, Robert A; Shanley, Thomas P; Heidemann, Sabrina M; Dalton, Heidi; Jenkins, Tammara L; Doctor, Allan; Webster, Angie

    2016-11-01

    Nosocomial infection remains an important health problem in long stay (>3 days) pediatric intensive care unit (PICU) patients. Admission risk factors related to the development of nosocomial infection in long stay immune competent patients in particular are not known. Post-hoc analysis of the previously published Critical Illness Stress induced Immune Suppression (CRISIS) prevention trial database, to identify baseline risk factors for nosocomial infection. Because there was no difference between treatment arms of that study in nosocomial infection in the population without known baseline immunocompromise, both arms were combined and the cohort that developed nosocomial infection was compared with the cohort that did not. There were 254 long stay PICU patients without known baseline immunocompromise. Ninety (35%) developed nosocomial infection, and 164 (65%) did not. Admission characteristics associated with increased nosocomial infection risk were increased age, higher Pediatric Risk of Mortality version III score, the diagnoses of trauma or cardiac arrest and lymphopenia (P risk of developing nosocomial infection (P risk factors (P < 0.05); whereas trauma tended to be related to nosocomial infection development (P = 0.07). These data suggest that increasing age, cardiac arrest and lymphopenia predispose long stay PICU patients without known baseline immunocompromise to nosocomial infection. These findings may inform pre-hoc stratification randomization strategies for prospective studies designed to prevent nosocomial infection in this population.

  10. [The risk of infection to the mother prior, during and after delivery. A registration of nosocomial infections].

    Science.gov (United States)

    Hirsch, H A; Niehues, U

    1982-09-01

    During 5 1/2 years all infections arising in the hospital (nosocomial infections) were registered prospectively by an infection control nurse. The incidence of all nosocomial infections in 3192 maternity patients was 2.1%. In 10,569 women following vaginal deliveries 2.6% and in 1,353 women following Caesarean section 21.1%. The commonest infections were urinary tract infections, endometritis, infections of the abdominal wound or the episiotomy, and a phlebitis of the intravenous infusion site. Measures to prevent infection resulted in a steadily decreasing incidence of infections during the 6 years of registration of nosocomial infections.

  11. The percentage of nosocomial-related out of total hospitalizations for rotavirus gastroenteritis and its association with hand hygiene compliance.

    Science.gov (United States)

    Waisbourd-Zinman, Orith; Ben-Ziony, Shiri; Solter, Ester; Chodick, Gabriel; Ashkenazi, Shai; Livni, Gilat

    2011-03-01

    Because the absolute numbers of both community-acquired and nosocomial rotavirus gastroenteritis (RVGE) vary, we studied the percentage of hospitalizations for RVGE that were transmitted nosocomially as an indicator of in-hospital acquisition of the infection. In a 4-year prospective study, the percentage of nosocomial RVGE declined steadily, from 20.3% in 2003 to 12.7% in 2006 (P = .001). Concomitantly, the rate of compliance with hand hygiene increased from 33.7% to 49% (P = .012), with a significant (P Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  12. Efectos de la suplementación con testosterona sobre el rendimiento en resistencia

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    P. Fernández-Díaz

    2016-09-01

    Full Text Available El dopaje en el deporte tiene su origen en la Grecia Clásica. Sin embargo, a lo largo del siglo pasado y hasta la actualidad, la utilización de este tipo de prácticas fraudulentas en el deporte ha ido en aumento. Entre las sustancias dopantes más utilizadas destacan la testosterona y sus derivados sintéticos, los anabolizantes sintéticos. A pesar de que estas sustancias prohibidas se han utilizado para la mejora del rendimiento en pruebas de fuerza y potencia, frecuentemente se detectan positivos en deportistas de resistencia. Los objetivos del presente estudio han sido informar acerca de los efectos ergogénicos de la suplementación con testosterona y anabolizantes sintéticos sobre el rendimiento en resistencia, a través de cambios sobre parámetros sanguíneos, así como los efectos secundarios que tienen sobre la salud. Para ello, se ha realizado una revisión en bases de datos como Elsevier, Medline, Pubmed y Web of Science incluyendo términos como testosterone, anemia, doping, endurance, erythropoietin, hepcidin e iron. La hepcidina se ha propuesto la principal reguladora de las reservas corporales de hierro y la suplementación con testosterona puede afectar a la síntesis de dicha hormona. Los efectos de la testosterona sobre la hepcidina podrían hacer mejorar tanto la capacidad de transporte como de difusión de oxígeno. De este modo, el dopaje con testosterona podría tener un potencial efecto ergogénico en modalidades de resistencia. Sin embargo, dichas mejoras pueden tener efectos negativos sobre el estado de salud del deportista, entre los que se encuentran trastornos metabólicos, orgánicos, psicológicos e inmunosupresión.

  13. Caracterización de cultivares de duraznero (Prunus persica (L. Batsch. por resistencia a heladas

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    Javier Emilio Chaar

    2015-07-01

    Full Text Available Las heladas primaverales son una de las principales limitantes de la producción de frutales de clima templado. Dentro de una misma especie existe variabilidad en resistencia frente al daño en órganos florales ocasionado por temperaturas bajo cero durante la salida del reposo invernal. En cinco cultivares de duraznero (Prunus persica (L. Batsch. y uno de nectarino se evaluó el daño ocasionado por heladas y se determinaron la fecha de plena floración y la densidad de floración. Adicionalmente se determinó la temperatura letal media (TL50 de las yemas florales en el estado de flor abierta, mediante descensos térmicos controlados en laboratorio. Los cultivares (cv de duraznero Maria Bianca y Summer Pearl presentaron las mayores densidades de flores sanas por cm de ramo, luego de la ocurrencia de temperaturas bajo cero en campo. La resistencia a heladas en campo se relacionó principalmente con la elevada densidad de floración, en combinación, en algunos casos, con floración tardía. La floración tardía por sí sola no resultó una característica de resistencia; por tanto, para la elección de cultivares de duraznero con menor riesgo de daño por temperaturas bajo cero es importante tener en cuenta más de una variable relacionada con los órganos reproductivos

  14. Resistencia antimicrobiana de Salmonella spp aislada de alimentos de origen animal para consumo humano

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    Adriana Quesada

    2016-01-01

    Full Text Available Objetivos. Analizar la información disponible sobre la resistencia antimicrobiana de aislamientos de Salmonella spp de alimentos de origen animal para consumo humano en América Latina. Materiales y métodos. Se realizó una revisión sistemática de estudios epidemiológicos observacionales realizados en América Latina entre los años 2003 y 2014 en las bases de datos PubMed y LILACS. Se excluyeron estudios realizados como parte de estudio de brotes o casos de infecciones en humanos. Tres revisores de forma independiente participaron en la selección de estudios. Además, se realizó la evaluación de calidad a los estudios incluidos. Resultados. Un total de 25 estudios cumplieron con los criterios de inclusión. Los estudios incluidos fueron realizados en Brasil, México, Colombia, Argentina y Venezuela. Los aislamientos de Salmonella spp se obtuvieron principalmente de alimentos de origen avícola, porcino y vacuno, siendo Salmonella typhimurium y Salmonella enteritidis los serotipos que se aislaron con mayor frecuencia (17 y 11 estudios, respectivamente. En 23 de los estudios, Salmonella spp fue resistente a más de un antibiótico, incluyendo ácido nalidíxico, estreptomicina, tetraciclina, cloranfenicol, ampicilina, trimetoprim/sulfametoxazol, gentamicina, ciprofloxacina y cefalosporinas. Conclusiones. Los aislamientos de Salmonella spp obtenidos de alimentos de origen animal para consumo humano en los países analizados presentan con frecuencia resistencia a múltiples antibióticos. Es importante que más países en América Latina realicen y publiquen estudios sobre la resistencia de Salmonella spp para establecer y monitorear estrategias de control adecuadas.

  15. Búsqueda de genes de resistencia al pasador del fruto en poblaciones segregantes de tomate

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    López-López Karina

    2010-09-01

    Full Text Available

    Las estrategias de mejoramiento genético para encontrar resistencia al pasador del fruto, Neoleucinodes elegantalis, en tomate, Solanum lycopersicum L. se han basado en métodos tradicionales de introgresión genética por medio de retrocruzamiento. Sin embargo este proceso es largo y dispendioso. Debido a esta problemática, se utilizó la técnica molecular cDNA-AFLP para identificar genes involucrados en la resistencia a esta plaga en poblaciones segregantes de tomate, con el fin de identificar marcadores moleculares que puedan ser utilizados en futuros programas de fitomejoramiento. Los materiales de tomate evaluados fueron Unapal-Maravilla (susceptible, S. habrochaites var. glabratum, accesión PI 134418 (resistente y tres retrocruzamientos obtenidos del cruzamiento interespecífico entre ambas especies. De estos materiales vegetales se extrajo el RNA total y se sintetizó el cDNA, el cual se utilizó como material de inicio de la técnica cDNA-AFLP. A partir del preamplificado de cDNA se evaluaron diferentes combinaciones de primers: +1+1, +3+3 y sus derivados. La combinación que presentó mejores amplificados fue la +1+1, para un total de 37 bandas polimórficas. De estas bandas, 9 fragmentos tipo EST (Expressed Sequence Target fueron recuperados, siendo candidatos a explicar la resistencia al pasador del fruto en tomate.

  16. Emergencia de la resistencia antibiótica debida a las β-lactamasas de espectro extendido (BLEE: detección, impacto clínico y epidemiología

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    SALIM< MÁTTAR

    Full Text Available RESUMEN La rápida emergencia de la resistencia antimicrobiana debida a las BLEE tiene un impacto significativo en la salud pública. En los últimos 24 años ha suscitado un gran interés el conocimiento acerca de las BLEE, esta explosión de publicaciones abarca a todos los continentes y más de 30 países, actualmente es motivo de preocupación y se considera un problema de salud pública. Las BLEE son enzimas que producen los gram negativos y confieren resistencia a las penicilinas, a todas las cefalosporinas y al aztreonam, pero no a los carbapenems ni a las cefamicinas y la mayoría son inhibidas por el acido clavulanico. En general las BLEE son derivadas de TEM-1, TEM-2 y SHV-1, difieren entre si de sus progenitoras por unos escasos aminoácidos por lo que su filogenia es cercana. Son comúnmente encontradas en E.coli, Klebsiella sp, y P.mirabilis, no obstante, existen otras BLEE que difieren filogenéticamente de TEM y SHV, como las CTX-M, las carbapenemasas tipo OXA y las metalo-β-lactamasas VIM e IMP, típicamente encontradas en especies de P. aeruginosa, Serratia sp and Enterobacter sp. La producción de BLEE en los patógenos de importancia clínica es un problema serio en los pacientes hospitalizados debido a las implicaciones clínicas, terapéuticas y económicas. Las técnicas para la detección de las BLEE van de lo simple con aspectos fenotipicos hasta las pruebas complejas moleculares de geno-detección específica. El objetivo de esta revisión es discutir el impacto clínico y epidemiológico de las BLEE más prevalentes así como las técnicas para su detección y su seguimiento nosocomial.

  17. Resistencia de levaduras del género Candida al fluconazol

    OpenAIRE

    Gómez Quintero, Carlos Hernando

    2010-01-01

    Las infecciones por levaduras del género Candida sp. son cada vez más prevalentes en pacientes hospitalizados, especialmente en grupos de mayor riesgo como pueden ser pacientes con neoplasia hematológica bajo tratamiento de quimioterapia y en cuidados intensivos. La resistencia de Candida sp. representa un reto terapéutico que deja un menor número de posibilidades para el tratamiento de estas infecciones que se caracterizan, a su vez, por una alta morbimortalidad. Esta revisión describe los m...

  18. Resistencia al cizallamiento de amalgama adherida utilizando dos sistemas adhesivos en dientes temporales in vitro

    OpenAIRE

    Chiappe González, Alezandra; Céspedes Porras, Jacqueline

    2006-01-01

    Objetivo general: determinar in Vitro la resistencia al cizallamiento de dos sistemas adhesivos en restauraciones de amalgama adherida en dientes temporales. Material y Método: se evaluó dos sistemas adhesivos de diferente tipo de curado: Un sistema adhesivo de curado dual (Clearfil Liner Bond 2v) y otro de autocurado (Multilink). Treinta molares libres de caries fueron divididas en dos grupos de 15 cada uno. Se incluyeron las piezas en cilindros de resina acrílica, se desgastó ca...

  19. Resistencia de unión del sistema de postes REBILDA® con la dentina intrarradicular

    OpenAIRE

    Ross, Daphne; Filloy Esna, Carlos E.; Ramírez-Barrantes, Juan Carlos

    2017-01-01

    ResumenActualmente existe controversia en la literatura acerca de la efectividad clínica y adhesiva con respecto a los sistemas adhesivos de refuerzo radicular. Así, el objetivo de este estudio fue evaluar la resistencia de unión mediante la prueba de Push-Out entre el sistema de postes Rebilda® y la dentina intraradicular. Para esto, se utilizaron 28 dientes unirradiculares, que fueron cortados y padronizados en 16 mm. Los segmentos radiculares fueron sometidos a confección de tratamiento en...

  20. Hormigones sustentables: resistencia eléctrica y electroquímica

    OpenAIRE

    Corral Higuera, Ramón; Arredondo Rea, Susana Paola; Gómez Soberón, José Manuel Vicente; Almaral Sánchez, Jorge Luis

    2010-01-01

    Como estrategias para contribuir en la sustentabilidad de la industria del hormigón se está proyectando mejorar la durabilidad de las estructuras de hormigón reforzado y el reemplazo parcial o total de sus ingredientes por materiales reciclables. En este estudio se evaluó la resistividad eléctrica y su relación con la microestructura y resistencia a la corrosión electroquímica de hormigones reforzados fabricados con características de sustentabilidad, es decir, con áridos reciclados y materia...

  1. Arte, política y resistencia en la era postmedia

    OpenAIRE

    Kancler, Tjaša

    2014-01-01

    El inicio de la escritura de la presente tesis doctoral en 2008, titulada Arte, Política y Resistencia en la Era Postmedia, que se inscribe en la línea de investigación en Imagen y Diseño del programa de doctorado Estudios Avanzados en Producciones Artísticas, en la Facultad de Bellas Artes (UB), coincide con el momento del comienzo de la “crisis económica”, en el que surgen una serie de cuestiones en torno a las relaciones que se podrían establecer entre el arte, la política y la resistenci...

  2. EFECTOS DE LA METFORMINA EN EL SINDROME DE OVARIO POLIQUISTICO ASOCIADO A INSULINO RESISTENCIA

    OpenAIRE

    Caro,Claudio; Fuhrer,Juan; Sáez,Rodrigo; Rubio,Víctor; Moreno,Luis; Cumsille,Miguel

    2002-01-01

    Se presenta la experiencia clínica del uso de metformina (1,7 g día), por 4 meses, en 11 pacientes con (SOP) asociado a resistencia insulínica. Se determinaron los efectos clínicos, bioquímicos y hormonales luego de 4 meses de terapia. Cinco de las pacientes que deseaban embarazo, continuaron recibiendo la droga, hasta por un año. Se evaluó durante el tratamiento los síntomas clínicos, historia menstrual, hirsutismo; y los niveles séricos de gonadotrofinas, andrógenos, globulina ligante sexua...

  3. Niveles de resistencia a drogas antituberculosas en pacientes con infección VIH / Tuberculosis, Lima, 1998-2001

    Directory of Open Access Journals (Sweden)

    Luis Asencios S

    2006-04-01

    Full Text Available Objetivos: Determinar los niveles de resistencia a drogas antituberculosas de primera línea en muestras clínicas de pacientes con coinfección por el virus de la inmunodeficiencia humana y tuberculosis (VIH-TB en cinco hospitales de Lima en el periodo 1998-2000. Materiales y métodos: Estudio descriptivo que incluyó las muestras de cultivos de Mycobacterium tuberculosis de pacientes con coinfección VIH-TB, a los que se realizó las pruebas de sensibilidad por el método de las proporciones para isoniacida (H, estreptomicina (S, etambutol (E y rifampicina (R, y el método de Wayne para pirazinamida (H. Resultados: De 523 muestras de pacientes incluidos, 78,2% correspondieron a varones, 72,7% fueron de pacientes sin antecedentes de tratamiento previo. Los valores de resistencia global primaria y multidrogorresistencia (MDR primaria fueron 55,8% y 32,1%, respectivamente; en tanto que los valores de resistencia global adquirida y MDR adquirida fueron 93,0% y 74,8%. La resistencia primaria por drogas fue H (42,1%, R (35,0%, S (35,3%, E (19,0% y Z (24,5% respectivamente; y la resistencia adquirida por drogas fueron H (85,3%, R (78,3%, S (64,4%, E (42,0% y Z (46,2%. Conclusión: Los niveles resistencia a drogas antituberculosas y la MDR en pacientes con coinfección VIH-TB provenientes de hospitales de Lima son elevados.

  4. Extracto acuoso de Lepidium meyenii Walp (maca y su papel como adaptógeno, en un modelo animal de resistencia física

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    Silvia Suárez

    2009-09-01

    Full Text Available Introducción: El Lepidium meyenii Walp (maca es una raíz andina del Perú, utilizada como alimento por su valor nutricional y propiedades etnomedicinales; es parte de la medicina tradicional. Objetivos: Evaluar el papel de adaptógeno del extracto acuoso de maca amarilla sobre las enzimas del tejido muscular en un modelo animal de resistencia física y estrés oxidativo. Diseño: Experimental. Institución: Centro de Investigación de Bioquímica y Nutrición, Facultad de Medicina, UNMSM, Lima, Perú. Material biológico: Extracto acuoso de la maca amarilla y ratas macho recién destetados. Intervenciones: Administración del extracto acuoso de la maca amarilla en ratas macho recién destetados, distribuidos en cuatro grupos: (I, de control, (II 0,4 mg de maca/g de peso (III 0,8 mg de maca/g de peso y (IV, 1,2 mg de maca/g de peso. El extracto acuoso fue administrado por cánula orogástrica. Se realizó un control de los pesos. Se aplicó la prueba de nado forzado después de 30 días de tratamiento. Los animales fueron sacrificados y se preparó homogenizado de músculo al 10%. Principales medidas de resultados: Actividad de las enzimas superóxido dismutasa (SOD, catalasa (CAT y lactato deshidrogenasa (LDH; y, como indicador de proceso oxidativo, se midió la peroxidación lipídica (TBARS. Resultados: El rendimiento en la prueba de resistencia fue la siguiente: (I 7,09 min; (II 11,25 min; (III 11,27 min; (IV 12,71 min, respectivamente. Las actividades enzimáticas de los grupos I, II, III y IV fueron: SOD (U/mL 36,6, 18,2, 17,2 y 18,2; CAT (U/L 18,6, 16,5, 13,4 y 10,3; y LDH (U/mL 11,6, 6,5, 6,0 y 5,8. TBARS (umol/g tejido: 5,82, 7,15, 4,11 y 4,06. Conclusiones: La administración del extracto acuoso de maca amarilla favorece la respuesta del organismo a una situación estresante y físicamente extenuante, lo que correspondería al papel de un adaptógeno.

  5. Nosocomial pneumonia in the ICU: a prospective cohort study.

    Science.gov (United States)

    Hyllienmark, Petra; Gårdlund, Bengt; Persson, Jan-Olov; Ekdahl, Karl

    2007-01-01

    Ventilator-associated pneumonia (VAP) is the most common intensive care unit (ICU)-acquired infection among patients requiring mechanical ventilation. A prospective surveillance programme of all patients has been implemented at the ICU, Karolinska University Hospital, Sweden since 2001. Within this programme, incidence and risk factors for ICU-acquired pneumonia and associated death over a 2-y period have been studied. Of 329 patients enrolled in the study, 221 required mechanical ventilation. 33 of 221 patients (15%) developed VAP, corresponding to a rate of 29 VAP/1000 ventilator d. Risk factors for VAP were aspiration (hazard ratio 3.79; 95% CI 1.48-9.68), recent surgery (HR 3.58; 95% CI 1.15-11.10) and trauma (HR 3.00; 95% CI 1.03-8.71). 11 patients of 33 (33%) with VAP died within 28 d compared to 46 of 288 (16%) without ICU-acquired pneumonia (odds ratio 2.73; 95% CI 0.97-7.63). We conclude that: 1) incidence of VAP was 15% and the most important risk factor was aspiration; 2) APACHE II score > or = 20 is a stronger predictor for poor outcome than VAP; 3) a minority of patients with APACHE II score > or = 20 develop VAP; and 4) continuous surveillance programmes are feasible and provide valuable data for improvement of quality of care.

  6. Análisis estadístico de la resistencia de tendones de puentes atirantados y estructuras similares

    OpenAIRE

    Ascorbe Salcedo, Agustín

    1983-01-01

    RESUMEN: En este trabajo se deduce, mediante un modelo teórico, la resistencia a fatiga de tendones de gran longitud en puentes atirantados a partir de la resistencia a fatiga de probetas de pequeño tamaño. Se introduce la hipótesis de dependencia de los diferentes tramos que componen el tendón mediante un modelo ARMA (p, q) de Box-Jenkins en la simulación. Se analiza la influencia de la ley de tensiones a lo largo del tendón y se estudia la rotura progresiva, tanto estática como a fatiga, pa...

  7. UN PENETRÓMETRO DINÁMICO PARA EVALUAR LA RESISTENCIA MECÁNICA EN SUELOS FORESTALES

    Directory of Open Access Journals (Sweden)

    Irma Vásquez García

    2011-01-01

    matorral. En laboratorio se prepararon muestras de diferente densidad aparente y contenido de humedad para probar la sensibilidad del penetrómetro. El equipo diseñado es sensible a los ambios de resistencia mecánica a densidades bajas (0.6-1.0 Mg·m-3, que son comunes en los suelos forestales y cambios de humedad del suelo (5-25 %. Con la validación del protocolo se encontró que una serie de 10 impactos genera un dato confiable sobre la resistencia mecánica del suelo superficial.

  8. THE “CHALLENGING” MULTIDRUG-RESISTANT PATHOGENS OF NOSOCOMIAL INFECTIONS IN CRITICALLY ILL PATIENTS (A LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    T. V. Chernenkaya

    2015-01-01

    Full Text Available ABSTRACT. Changes in the structure of the main causative agents of nosocomial infections and significant spread of multidrug­resistant strains of bacteria are a natural biological response for antibiotics that selectively inhibit pathogens and contribute to selection, survival and growth of drug resistant strains of bacteria. In this literature review we present the change of structure of the major causative microorganisms of nosocomial septic infections and theirs resistance to antibiotics for the last 70 years. 

  9. Impact of an Infection Control Program on the Prevalence of Nosocomial Infections at a Tertiary Care Center in Switzerland

    OpenAIRE

    Ebnöther, Corina; Tanner, Beate; Schmid, Flavia; Rocca, Vittoria La; Heinzer, Ivo; Bregenzer, Thomas

    2017-01-01

    Objective. To study the impact of a multimodal infection control program on the rate of nosocomial infections at a 550-bed tertiary care center. Methods. Before and after the implementation of an infection control program, the rate of nosocomial infection was recorded in time-interval prevalence studies. Hand hygiene compliance was studied before and after the intervention. As a surrogate marker of compliance, the amount of alcohol-based hand rub consumed before the intervention was compared ...

  10. Case-mix adjustment approach to benchmarking prevalence rates of nosocomial infection in hospitals in Cyprus and Greece.

    Science.gov (United States)

    Kritsotakis, Evangelos I; Dimitriadis, Ioannis; Roumbelaki, Maria; Vounou, Emelia; Kontou, Maria; Papakyriakou, Panikos; Koliou-Mazeri, Maria; Varthalitis, Ioannis; Vrouchos, George; Troulakis, George; Gikas, Achilleas

    2008-08-01

    To examine the effect of heterogeneous case mix for a benchmarking analysis and interhospital comparison of the prevalence rates of nosocomial infection. Cross-sectional survey. Eleven hospitals located in Cyprus and in the region of Crete in Greece. The survey included all inpatients in the medical, surgical, pediatric, and gynecology-obstetrics wards, as well as those in intensive care units. Centers for Disease Control and Prevention criteria were used to define nosocomial infection. The information collected for all patients included demographic characteristics, primary admission diagnosis, Karnofsky functional status index, Charlson comorbidity index, McCabe-Jackson severity of illness classification, use of antibiotics, and prior exposures to medical and surgical risk factors. Outcome data were also recorded for all patients. Case mix-adjusted rates were calculated by using a multivariate logistic regression model for nosocomial infection risk and an indirect standardization method.Results. The overall prevalence rate of nosocomial infection was 7.0% (95% confidence interval, 5.9%-8.3%) among 1,832 screened patients. Significant variation in nosocomial infection rates was observed across hospitals (range, 2.2%-9.6%). Logistic regression analysis indicated that the mean predicted risk of nosocomial infection across hospitals ranged from 3.7% to 10.3%, suggesting considerable variation in patient risk. Case mix-adjusted rates ranged from 2.6% to 12.4%, and the relative ranking of hospitals was affected by case-mix adjustment in 8 cases (72.8%). Nosocomial infection was significantly and independently associated with mortality (adjusted odds ratio, 3.6 [95% confidence interval, 2.1-6.1]). The first attempt to rank the risk of nosocomial infection in these regions demonstrated the importance of accounting for heterogeneous case mix before attempting interhospital comparisons.

  11. Association between Accessory Gene Regulator Polymorphism and Mortality among Critically Ill Patients Receiving Vancomycin for Nosocomial MRSA Bacteremia: A Cohort Study

    Directory of Open Access Journals (Sweden)

    Angélica Cechinel

    2016-01-01

    Full Text Available Background. Polymorphism of the accessory gene regulator group II (agr in methicillin-resistant Staphylococcus aureus (MRSA is predictive of vancomycin failure therapy. Nevertheless, the impact of group II agr expression on mortality of patients with severe MRSA infections is not well established. Objective. The goal of our study was to evaluate the association between agr polymorphism and all-cause in-hospital mortality among critically ill patients receiving vancomycin for nosocomial MRSA bacteremia. Methods. All patients with documented bacteremia by MRSA requiring treatment in the ICU between May 2009 and November 2011 were included in the study. Cox proportional hazards regression was performed to evaluate whether agr polymorphism was associated with all-cause in-hospital mortality. Covariates included age, APACHE II score, initial C-reactive protein plasma levels, initial serum creatinine levels, vancomycin minimum inhibitory concentration, vancomycin serum levels, and time to effective antibiotic administration. Results. The prevalence of group I and group II agr expression was 52.4% and 47.6%, respectively. Bacteremia by MRSA group III or group IV agr was not documented in our patients. The mean APACHE II of the study population was 24.3 (standard deviation 8.5. The overall cohort mortality was 66.6% (14 patients. After multivariate analysis, initial plasma C-reactive protein levels (P=0.01, initial serum creatinine levels (P=0.008, and expression of group II agr (P=0.006 were positively associated with all-cause in-hospital mortality. Patients with bacteremia by MRSA with group II agr expression had their risk of death increased by 12.6 times when compared with those with bacteremia by MRSA with group I agr expression. Conclusion. Group II agr polymorphism is associated with an increase in mortality in critically ill patients with bacteremia by MRSA treated with vancomycin.

  12. Disinfection efficacy of an ultraviolet light on film cassettes for preventive of the nosocomial infection

    International Nuclear Information System (INIS)

    Kweon, Dae Cheol; Jeon, Yong Woong; Cho, Am

    2001-01-01

    The bacterial infection on film cassette contact surface was examined at the diagnostic radiology department of the S. hospital. The objective of this study was to assess the contamination level on film cassette contact surface as a predictor of patient prevention from nosocomial infection and for improvement of the hospital environment. The laboratory result was identified non-pathologic bacterial in the five different cassette size of the contact surface. Film cassettes were exposed to ultraviolet light for 1, 2 and 3 minutes. Ultraviolet light disinfection is proven suitable for bacterial. The study concludes that presence of a bacterial infection will prevent a using antiseptic technique on film cassette contact surface. In addition education of nosocomial infection for radiographers will be required. In conclusion, ultraviolet is considered effective to irradiate bacterial. Additionally, two minutes are required to sterilize film cassettes

  13. Does disinfection of environmental surfaces influence nosocomial infection rates? A systematic review.

    Science.gov (United States)

    Dettenkofer, Markus; Wenzler, Sibylle; Amthor, Susanne; Antes, Gerd; Motschall, Edith; Daschner, Franz D

    2004-04-01

    To review the evidence on the effects of disinfection of environmental surfaces in hospitals (as compared with cleaning without use of disinfectants) on the occurrence of nosocomial infections. Systematic review of experimental and nonexperimental intervention studies dealing with environmental disinfection or cleaning in different health care settings. A total of 236 scientific articles were identified. None described a meta-analysis, systematic review, or randomized controlled trial. Only 4 articles described completed cohort studies matching the inclusion criteria. None of these studies showed lower infection rates associated with routine disinfection of surfaces (mainly floors) versus cleaning with detergent only. Disinfectants may pose a danger to staff, patients, and the environment and require special safety precautions. However, targeted disinfection of certain environmental surfaces is in certain instances an established component of hospital infection control. Given the complex, multifactorial nature of nosocomial infections, well-designed studies that systematically investigate the role of surface disinfection are required.

  14. Nosocomial outbreak of Enterobacter gergoviae bacteraemia in a neonatal intensive care unit.

    Science.gov (United States)

    Ganeswire, R; Thong, K L; Puthucheary, S D

    2003-04-01

    A nosocomial outbreak of bacteraemia, caused by Enterobacter gergoviae infected 11 babies, nine of whom were premature, and was investigated in the neonatal intensive care unit (NICU) of a general hospital in Johor Bahru, Malaysia. The strain that was isolated from the babies was also isolated from the dextrose saline used for the dilution of parenteral antibiotics and from the hands of a healthcare worker on duty in the nursery. Pulsed-field gel electrophoresis (PFGE) of Xba I-digested chromosomal DNA confirmed a possible cross-contamination of parenteral dextrose saline and the healthcare worker. Prompt and effective control measures were initiated within NICU and the nosocomial infection of E. gergoviae was brought to an abrupt end. To the best of our knowledge, this is the first documented outbreak of E. gergoviae in the NICU in a hospital in the state of Johor, Malaysia.

  15. Nosocomial Pandemic (H1N1) 2009, United Kingdom, 2009–2010

    Science.gov (United States)

    Myles, Puja R.; Openshaw, Peter J.M.; Gadd, Elaine M.; Lim, Wei Shen; Semple, Malcolm G.; Read, Robert C.; Taylor, Bruce L.; McMenamin, James; Armstrong, Colin; Bannister, Barbara; Nicholson, Karl G.; Nguyen-Van-Tam, Jonathan S.

    2011-01-01

    To determine clinical characteristics of patients hospitalized in the United Kingdom with pandemic (H1N1) 2009, we studied 1,520 patients in 75 National Health Service hospitals. We characterized patients who acquired influenza nosocomially during the pandemic (H1N1) 2009 outbreak. Of 30 patients, 12 (80%) of 15 adults and 14 (93%) of 15 children had serious underlying illnesses. Only 12 (57%) of 21 patients who received antiviral therapy did so within 48 hours after symptom onset, but 53% needed escalated care or mechanical ventilation; 8 (27%) of 30 died. Despite national guidelines and standardized infection control procedures, nosocomial transmission remains a problem when influenza is prevalent. Health care workers should be routinely offered influenza vaccine, and vaccination should be prioritized for all patients at high risk. Staff should remain alert to the possibility of influenza in patients with complex clinical problems and be ready to institute antiviral therapy while awaiting diagnosis during influenza outbreaks. PMID:21470446

  16. Positive impact of infection prevention on the management of nosocomial outbreaks at an academic hospital.

    Science.gov (United States)

    Dik, Jan-Willem H; Sinha, Bhanu; Lokate, Mariëtte; Lo-Ten-Foe, Jerome R; Dinkelacker, Ariane G; Postma, Maarten J; Friedrich, Alexander W

    2016-10-01

    Infection prevention (IP) measures are vital to prevent (nosocomial) outbreaks. Financial evaluations of these are scarce. An incremental cost analysis for an academic IP unit was performed. On a yearly basis, we evaluated: IP measures; costs thereof; numbers of patients at risk for causing nosocomial outbreaks; predicted outbreak patients; and actual outbreak patients. IP costs rose on average yearly with €150,000; however, more IP actions were undertaken. Numbers of patients colonized with high-risk microorganisms increased. The trend of actual outbreak patients remained stable. Predicted prevented outbreak patients saved costs, leading to a positive return on investment of 1.94. This study shows that investments in IP can prevent outbreak cases, thereby saving enough money to earn back these investments.

  17. Nosocomial infection control in healthcare settings: Protection against emerging infectious diseases.

    Science.gov (United States)

    Fu, Chuanxi; Wang, Shengyong

    2016-04-12

    The Middle East respiratory syndrome (MERS) outbreak in Korea in 2015 may be attributable to poor nosocomial infection control procedures implemented. Strict infection control measures were taken in the hospital where an imported case with MERS was treated in southern China and 53 health care workers were confirmed to be MERS-CoV negative. Infection control in healthcare settings, in which patients with emerging infectious diseases such as MERS, Ebola virus disease, and the severe acute respiratory syndrome (SARS) are diagnosed and treated, are often imperfect. When it comes to emerging or unknown infectious diseases, before the imported case was finally identified or community transmission was reported, cases have often occurred in clusters in healthcare settings. Nosocomial infection control measures should be further strengthened among the workers and inpatients in designated healthcare settings that accommodate suspected cases suffering from emerging or unknown infectious diseases.

  18. Disinfection efficacy of an ultraviolet light on film cassettes for preventive of the nosocomial infection

    Energy Technology Data Exchange (ETDEWEB)

    Kweon, Dae Cheol [Seoul National Univ. Hospital, Seoul (Korea, Republic of); Jeon, Yong Woong; Cho, Am [Dongguk Univ., Seoul (Korea, Republic of)

    2001-06-01

    The bacterial infection on film cassette contact surface was examined at the diagnostic radiology department of the S. hospital. The objective of this study was to assess the contamination level on film cassette contact surface as a predictor of patient prevention from nosocomial infection and for improvement of the hospital environment. The laboratory result was identified non-pathologic bacterial in the five different cassette size of the contact surface. Film cassettes were exposed to ultraviolet light for 1, 2 and 3 minutes. Ultraviolet light disinfection is proven suitable for bacterial. The study concludes that presence of a bacterial infection will prevent a using antiseptic technique on film cassette contact surface. In addition education of nosocomial infection for radiographers will be required. In conclusion, ultraviolet is considered effective to irradiate bacterial. Additionally, two minutes are required to sterilize film cassettes.

  19. [Use of antagonistic Bacillus subtilis bacteria for treatment of nosocomial urinary tract infections].

    Science.gov (United States)

    Pushkarev, A M; Tuĭgunova, V G; Zaĭnullin, R R; Kuznetsova, T N; Gabidullin, Iu Z

    2007-01-01

    Effect of Bactisporin--a probiotic, containing spores of aerobic Bacillus subtilis 3H bacterium--for complex treatment of patients with nosocomial urinary tract infections was studied. 68 Cultures of different species of conditionally pathogenic bacteria were isolated from urine of the patients. Susceptibility of the isolated cultures to antibiotics before and after application of B. subtilis 3H metabolites was determined. The metabolites were accumulated on potato-glucose agar (PGA) while bacterium was cultivated on kapron membranes placed on surface of the medium. Influence of obtained metabolites on isolated strains was assessed by cultivation of each strain in metabolites-rich PGA during 24 h. Metabolites of B. subtilis led to decrease in resistance of isolated uropathogenic microflora to antibiotics. Use of Bactisporin in complex treatment of nosocomial urinary tract infections resulted in accelerated elimination of causative microorganism.

  20. Nosocomial bloodstream infection in a neonatal intensive care unit of a medical center: a three-year review.

    Science.gov (United States)

    Tseng, Ya-Chun; Chiu, Yu-Chiao; Wang, Jen-Hsien; Lin, Hsiao-Chuan; Lin, Hung-Chih; Su, Bai-Horng; Chiu, Hsiu-Hui

    2002-09-01

    Bloodstream infections are the most frequent nosocomial infections in neonatal intensive care units. This retrospective study surveyed the epidemiologic characteristics of nosocomial bloodstream infections which occurred in the neonatal intensive care unit from January 1, 1997 to December 31, 1999. The overall infection patient rate was 5.5% in the 3-year period, and the overall infection patient-day rate was 4.4 per 1000 patient-days. Low birth weight was a risk factor for bloodstream infections. The rate of infection for neonates with birth weight below 1000 g ranged from 36.6% to 45.8% (1997: 36.6%; 1998: 45.8% and 1999: 38.9%). The most common pathogens causing nosocomial bloodstream infection were: Staphylococcus aureus (18.5%) (with 92% oxacillin-resistant), Acinectobacter baumannii (16.3%), Klebsiella pneumoniae (11.9%), Escherichia coli (9.6%), and Pseudomonas aeruginosa (8.1%). The mortality due to nosocomial bloodstream infection was highest among gram-negative bacteria, especially with P. aeruginosa (45.5%). Therefore, surveillance of nosocomial bloodstream infection and successful strategies to decrease nosocomial bloodstream infection, such as infection control and optimal antibiotic use, are warranted.

  1. Reduction in nosocomial infection with improved hand hygiene in intensive care units of a tertiary care hospital in Argentina.

    Science.gov (United States)

    Rosenthal, Victor D; Guzman, Sandra; Safdar, Nasia

    2005-09-01

    Hand hygiene is a fundamental measure for the control of nosocomial infection. However, sustained compliance with hand hygiene in health care workers is poor. We attempted to enhance compliance with hand hygiene by implementing education, training, and performance feedback. We measured nosocomial infections in parallel. We monitored the overall compliance with hand hygiene during routine patient care in intensive care units (ICUs); 1 medical surgical ICU and 1 coronary ICU, of 1 hospital in Buenos Aires, Argentina, before and during implementation of a hand hygiene education, training, and performance feedback program. Observational surveys were done twice a week from September 2000 to May 2002. Nosocomial infections in the ICUs were identified using the National Nosocomial Infections Surveillance (NNIS) criteria, with prospective surveillance. We observed 4347 opportunities for hand hygiene in both ICUs. Compliance improved progressively (handwashing adherence, 23.1% (268/1160) to 64.5% (2056/3187) (RR, 2.79; 95% CI: 2.46-3.17; P nosocomial infection in both ICUs decreased from 47.55 per 1000 patient-days (104/2187) to 27.93 per 1000 patient days (207/7409) RR, 0.59; 95% CI: 0.46-0.74, P hand hygiene, coinciding with a reduction in nosocomial infection rates in the ICUs.

  2. Ongoing large measles outbreak with nosocomial transmission in Milan, northern Italy, March-August 2017.

    Science.gov (United States)

    Amendola, Antonella; Bianchi, Silvia; Frati, Elena R; Ciceri, Giulia; Faccini, Marino; Senatore, Sabrina; Colzani, Daniela; Lamberti, Anna; Baggieri, Melissa; Cereda, Danilo; Gramegna, Maria; Nicoletti, Loredana; Magurano, Fabio; Tanzi, Elisabetta

    2017-08-17

    A large measles outbreak has been ongoing in Milan and surrounding areas. From 1 March to 30 June 2017, 203 measles cases were laboratory-confirmed (108 sporadic cases and 95 related to 47 clusters). Phylogenetic analysis revealed the co-circulation of two different genotypes, D8 and B3. Both genotypes caused nosocomial clusters in two hospitals. The rapid analysis of epidemiological and phylogenetic data allowed effective surveillance and tracking of transmission pathways. This article is copyright of The Authors, 2017.

  3. Does routine gowning reduce nosocomial infection and mortality rates in a neonatal nursery? A Singapore experience.

    Science.gov (United States)

    Tan, S G; Lim, S H; Malathi, I

    1995-11-01

    A 1 year prospective study on routine gowning before entering a neonatal unit was conducted in a maternity hospital in Singapore. This study was done based on previous work by Donowitz, Haque and Chagla and Agbayani et al., as there have been no known studies done in Singapore. The aim of the study was to test the hypothesis that routine gowning before entering a neonatal nursery does not reduce nosocomial infection and mortality rate. A total of 212 neonates from the neonatal intensive care unit (NICU) and 1694 neonates from the neonatal special care unit (NSCU) were studied. Neonates admitted during the 1 year study were assigned to the gowning (control) and no routine gowning (trial) group on every alternate 2 months. The hospital infection control nurse provided data on nosocomial infection. The overall nosocomial infection rate in the NICU was 24% (25 of 104 admissions) during gowning periods compared to 16.6% (18 of 108 admissions) when plastic aprons were not worn before entry. In the NSCU, the overall infection rate was 1.5% (12 of 800 admissions) during gowning periods compared to 2.1% (19 of 894 admissions) when no gown was worn before entry. Results of the study found no significant differences in the incidences of nosocomial infection and mortality in the neonates. The cost of gowns used during the no routine gowning periods was S$2012.8 compared to S$3708 used during the routine gowning procedure. The investigators recommend that routine gowning before entering a neonatal unit is not essential and cost effective for the purpose of reducing infection. Rather the focus should be on adequate handwashing by all hospital personnel and visitors before handling neonates.

  4. Early Prediction and Outcome of Septic Encephalopathy in Acute Stroke Patients With Nosocomial Coma

    OpenAIRE

    Tong, Dao-Ming; Zhou, Ye-Ting; Wang, Guang-Sheng; Chen, Xiao-Dong; Yang, Tong-Hui

    2015-01-01

    Background Septic encephalopathy (SE) is the most common acute encephalopathy in ICU; however, little attention has been focused on risk of SE in the course of acute stroke. Our aim is to investigate the early prediction and outcome of SE in stroke patients with nosocomial coma (NC). Methods A retrospective cohort study was conducted in an ICU of the tertiary teaching hospital in China from January 2006 to December 2009. Ninety-four acute stroke patients with NC were grouped according to with...

  5. The Incidence of Nosocomial Toxigenic Clostridium difficile Associated Diarrhea in Tehran Tertiary Medical Centers

    Directory of Open Access Journals (Sweden)

    Norakhoda Sadeghifard

    2010-09-01

    Full Text Available "nClostridium difficile is the most common cause of nosocomial diarrhea. It is usually a consequence of antibiotic treatment, But sporadic cases can occur. This study was aimed to determine the frequency of the nosocomial Clostridium difficile (C. difficile associated diarrhea in Tehran University of Medical Sciences hospitals and study of antibacterial susceptibility of isolates. In this study a total of 942 stool samples from patients with nosocomial diarrhea that were hospitalized in Imam Khomeini hospital, Shariati hospital and Children clinical center were collected. The samples were cultured on a selective cycloserine cefoxitin fructose agar (CCFA and incubated in anaerobic conditions, at 37°C for 5 days. Isolates were characterized to species level by conventional biochemical tests. Bacterial cytotoxicity was assayed on tissue culture (vero. Antimicrobial sensitivity of isolated toxigenic C. difficile were investigated by kirby Beuer method (disk diffusion. Our findings show that, of the total patients, 57 toxigenic C. difficile (6.1% were isolated. Results of statistical analysis show significant differences between the rate of isolated toxigenic C. difficile and age group of patients (P<0.05. Among the wards of selected hospitals, in gastroenterology of Children clinical center, Toxigenic C. difficile was isolated from patients most frequently. The sensitivity of isolates to vancomycin, Chloramphenicol and ceftriaxone were higher than other antibiotics. Toxigenic C. difficile is a common hospital-acquired infection. The organism was found in 6.1% hospitalized patients. Further studies to evaluate the rate and role of toxigenic C. difficile in nosocomial diarrheal processes, ecological and pathogenic terms are suggested.

  6. El mundo del trabajo entre el disciplinamiento y la resistencia, Chile, 1973-1981

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    Ana Paola López Dietz

    2016-11-01

    Full Text Available El artículo estudia la política laboral de la dictadura y las expresiones de resistencia del movimiento sindical en Chile, entre 1971 y 1981. Durante este período se produjeron cambios importantes en la estructura económica, política y social del país como la reestructuración productiva, la implementación del modelo neoliberal y la represión al movimiento sindical. También se impuso un nuevo plan laboral que atomizó los sindicatos, limitó el derecho a huelga y prohibió las negociaciones colectivas por rama. Aun así, el movimiento sindical se organizó, en condiciones de represión y persecución, para luchar contra la dictadura y sus políticas laborales, llevando adelante una serie de acciones de resistencia como huelgas encubiertas, ausentismo laboral y movilizaciones.

  7. Sobre el concepto de resistencia civil en ciencia política

    Directory of Open Access Journals (Sweden)

    Julio Rafael Quiñones Paez

    2008-07-01

    Full Text Available La resistencia civil es una forma de acción política consistente en la ejecución de estrategias que no conllevan violencia contra el adversario con el que se sostiene un conflicto, sino que se orientan a seducir a la opinión pública amplia para que voluntariamente decida no seguir depositando su obediencia y cooperación respecto del poder controlado por dicho adversario. Además de haber sido puesta en práctica por movimientos sociales y de liberación nacional a lo largo de los últimos dos siglos, una de sus aplicaciones concretas es pasar a constituirse en componente central de una política de defensa. En este caso, la resistencia civil hará referencia a la negativa de los ciudadanos a obedecer o cooperar con las fuerzas de invasión, ocupación, usurpación interna, golpismo de Estado o similares.

  8. Síndrome de resistencia a la insulina. estudio y manejo

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    N. Fernando Carrasco, Dr.

    2013-09-01

    Full Text Available El síndrome de resistencia a la insulina, actualmente más conocido como síndrome metabólico (SM, es una condición clínica de alta prevalencia en Chile. Por el mayor riesgo de enfermedades cardiovasculares y diabetes asociado a esta condición, en la práctica clínica es relevante su detección precoz y manejo. La resistencia a la insulina (RI es una condición metabólica central en la etiopatogenia del SM y su diagnóstico puede efectuarse con mediciones de insulinemia y glicemia en ayuno o con la prueba de tolerancia oral a la glucosa con curva de insulinemia. Existe acuerdo que los mejores resultados del manejo del SM y de la RI se logran con cambios en estilo de vida, incluyendo modificaciones en la dieta y en el patrón de actividad física junto con reducción en el peso y grasa corporal. Algunas terapias farmacológicas orientadas a mejorar la sensibilidad a la insulina han sido recomendadas en consensos internacionales, especialmente en pacientes con elevado riesgo de enfermedad cardiovascular o de diabetes tipo 2, cuando fracasan las terapias no farmacológicas.

  9. AUMENTO EN LA RESISTENCIA A LA CORROSIÓN DE UN ACERO T91 ALUMINIZADO

    Directory of Open Access Journals (Sweden)

    LUZ S. QUINTERO

    2011-01-01

    Full Text Available El acero ferrítico T91 ha sido ampliamente utilizado en plantas de generación de energía eléctrica, calderas y plantas nucleares. Sin embargo, su resistencia a la oxidación se ve gravemente afectada a temperaturas superiores a los 600ºC. En esta investigación se empleó la técnica de cementación empacada para aluminizar un acero T91 y se encontraron las condiciones óptimas para la formación de un recubrimiento libre de porosidad y con espesor uniforme (300 micras. Se evaluó la capa de óxido formada luego de una exposición a 800ºC en atmósfera de aire. La caracterización del recubrimiento y de la capa de óxido (Al2O3 se llevó a cabo empleando un microscopio electrónico de barrido (SEM, Espectroscopia de Rayos X (EDX y mapping. Se comprobó una buena resistencia a la oxidación del acero T91 aluminizado, debido a la formación de una fina capa continua de óxido de aluminio de aproximadamente 6 micras de espesor luego de una exposición de 7 días.

  10. A cluster of cases of nosocomial legionnaires disease linked to a contaminated hospital decorative water fountain.

    Science.gov (United States)

    Palmore, Tara N; Stock, Frida; White, Margaret; Bordner, MaryAnn; Michelin, Angela; Bennett, John E; Murray, Patrick R; Henderson, David K

    2009-08-01

    Nosocomial outbreaks of Legionnaires disease have been linked to contaminated water in hospitals. Immunocompromised patients are particularly vulnerable and, when infected, have a high mortality rate. We report the investigation of a cluster of cases of nosocomial pneumonia attributable to Legionella pneumophila serogroup 1 that occurred among patients on our stem cell transplantation unit. We conducted a record review to identify common points of potential exposure, followed by environmental and water sampling for Legionella species from those sources. We used an air sampler to in an attempt to detect aerosolized Legionella and pulsed-field gel electrophoresis to compare clinical and environmental isolates. The most likely sources identified were the water supply in the patients' rooms and a decorative fountain in the radiation oncology suite. Samples from the patients' rooms did not grow Legionella species. Cultures of the fountain, which had been restarted 4 months earlier after being shut off for 5 months, yielded L. pneumophila serogroup 1. The isolates from both patients and the fountain were identical by pulsed-field gel electrophoresis. Both patients developed pneumonia within 10 days of completing radiation therapy, and each reported having observed the fountain at close range. Both patients' infections were identified early and treated promptly, and both recovered. This cluster was caused by contamination of a decorative fountain despite its being equipped with a filter and ozone generator. Fountains are a potential source of nosocomial Legionnaires disease despite standard maintenance and sanitizing measures. In our opinion, fountains present unacceptable risk in hospitals serving immunocompromised patients.

  11. The Incidence of Nosocomial Toxigenic Clostridium difficile Associated Diarrhea in Tehran Tertiary Medical Centers

    Directory of Open Access Journals (Sweden)

    Norakhoda Sadeghifard

    2010-10-01

    Full Text Available Clostridium difficile is the most common cause of nosocomial diarrhea. It is usually a consequence of antibiotic treatment, But sporadic cases can occur. This study was aimed to determine the frequency of the nosocomial Clostridium difficile (C. difficile associated diarrhea in Tehran University of Medical Sciences hospitals and study of antibacterial susceptibility of isolates. In this study a total of 942 stool samples from patients with nosocomial diarrhea that were hospitalized in Imam Khomeini hospital, Shariati hospital and Children clinical center were collected. The samples were cultured on a selective cycloserine cefoxitin fructose agar (CCFA and incubated in anaerobic conditions, at 37°C for 5 days. Isolates were characterized to species level by conventional biochemical tests. Bacterial cytotoxicity was assayed on tissue culture (vero. Antimicrobial sensitivity of isolated toxigenic C. difficile were investigated by kirby Beuer method (disk diffusion. Our findings show that, of the total patients, 57 toxigenic C. difficile (6.1% were isolated. Results of statistical analysis show significant differences between the rate of isolated toxigenic C. difficile and age group of patients (P

  12. Antibacterial properties of Chinese herbal medicines against nosocomial antibiotic resistant strains of Pseudomonas aeruginosa in Taiwan.

    Science.gov (United States)

    Liu, Ching-Shen; Cham, Thau-Ming; Yang, Cheng-Hong; Chang, Hsueh-Wei; Chen, Chia-Hong; Chuang, Li-Yeh

    2007-01-01

    Pseudomonas aeruginosa is well-recognized as a nosocomial pathogen, which exhibits inherent drug resistance. In this study, the antibacterial activity of ethanol extracts of 58 Chinese herbal medicines used in Taiwan were tested against 89 nosocomial antibiotic resistant strains of Pseudomonas aeruginosa. The results gathered by the disc diffusion method showed that 26 out of the 58 herbal extracts exhibited antibacterial activity. Among the 26 herbal extracts, 10 extracts showed broad-spectrum antibacterial activities and were selected for further antibacterial property assay. The minimum inhibitory concentrations (MIC) of the active partition fractions ranged from 0.25 to 11.0 mg/L. The presence of flavonoid compounds in the active fractions of test herbal extracts was observed by the TLC-bioautography. The results from the time-kill assay revealed that most of the herbal extracts completely killed the test organisms within 4 hours. Exposure of the test strains to a sub-MIC level of the herbal extracts for 10 consecutive subcultures did not induce resistance to the active components. A combination of the active herbal fractions with antibiotics showed that one of the herbal medicines, the hexane fraction of Ramulus Cinnamomi, possessed a synergistic effect with tetracycline, gentamycin, and streptomycin. In conclusion, the tested Chinese medical herbs have the potential to be developed into natural antibiotics. This is the first evaluation for screening large amounts of medical plants against nosocomial antibiotic resistant bacteria in Taiwan.

  13. The Incidence And Risk Factors Nosocomial Pneumonia In A Neuromedical Intensive Care Unit

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    Devragudi TS

    2001-01-01

    Full Text Available This retrospective study examined the incidence and factors influencing the occurrence of nonsocomial pneumonia (NP in a neuromedical intensive care unit (NICU. Of the 57 patients admitted to the NICU over one year, 26% developed nosocomial pneumonia. It was observed that the infected patients were significantly older than the noninfected (43+15 vs 22+18 years; p<0.001, had a longer NICU stay (33+31 vs 18+18 days: p=0.05 and needed longer duration of mechanical ventilation (20+25 vs 9 + 12 days: P<0.05. Patients with neuromuscular diseases had a trend towards higher incidence of NP than those with encephalopathy and therapeutic interventions such as plasmapheresis, blood transfusion and inotropic therapy did not influence the incidence of nosocomial pneumonia. The NICU mortality was not significantly influenced by nosocomial pneumonia. Pseudomonas aerugenosa was the predominant organism responsible for pneumonia. Nine percent of the tracheobronchial isolates were resistant to the routinely-tested antibiotics. In conclusion, nosocornial pneumonia is a common complication in a NICU and while it increases the duration of NICU stay, mortality appears to be uninfluenced.

  14. [Nosocomial infections after cardiac surgery in infants and children with congenital heart disease].

    Science.gov (United States)

    Barriga, José; Cerda, Jaime; Abarca, Katia; Ferrés, Marcela; Fajuri, Paula; Riquelme, María; Carrillo, Diego; Clavería, Cristián

    2014-02-01

    Nosocomial infections generate high morbidity and mortality in children undergoing cardiac surgery. To determine risk factors for nosocomial infections in children after congenital heart surgery. A retrospective case-control study, in patients younger than 15 years undergoing surgery for congenital heart disease from January 2007 to December 2011 admitted to the Pediatric Critical Patient Unit (UPC-P) in a university hospital. For cases, the information was analyzed from the first episode of infection. 39 patients who develop infections and 39 controls who did not develop infection were enrolled. The median age of cases was 2 months. We identified a number of factors associated with the occurrence of infections, highlighting in univariate analysis: age, weight, univentricular heart physiology, complexity of the surgical procedure according to RACHS-1 and cardiopulmonary bypass (CPB) time ≥ 200 minutes. Multivariate analysis identified CPB time ≥ 200 minutes as the major risk factor, with an OR of 11.57 (CI: 1.04 to 128.5). CPB time ≥ 200 minutes was the mayor risk factor associated with the development of nosocomial infections.

  15. Nosocomial infection in a newborn intensive care unit (NICU, South Korea

    Directory of Open Access Journals (Sweden)

    Jeong Jae

    2006-06-01

    Full Text Available Abstract Background This study aimed to determine the occurrence of nosocomial infections (NIs, including infection rates, main infection sites, and common microorganisms. Patients included in the study were taken from a newborn intensive care unit (NICU, in a hospital in South Korea. Methods A retrospective cohort study was performed by reviewing chart. The subjects were 489 neonates who were admitted to the NICU, survived longer than 72 hours, and not transferred to another unit, between Jan. 1. 1995 to Sep. 30, 1999. NIs were identified according to the NNIS definition. Data were analyzed with descriptive statistics. Results Cumulative incidence rate for NIs was 30.3 neonates out of 100 admissions, with a total of 44.6 infections. The incidence density was average 10.2 neonates and 15.1 infections per 1000 patient days. The most common infections were pneumonia (28%, bloodstream infection (26%, and conjunctivitis (22%. Major pathogens were Gram-positives such as Staphylococcus aureus and coagulase-negative staphylococci. The factors associated with NI was less than 1500 g of birth weight, less than 32 weeks of gestational age, and less than 8 of apgar score. There's no statistical difference in discharge status between two groups, but hospital stay was longer in subjects with nosocomial infection than those without infection. Conclusion Although the distribution of pathogens was similar to previous reports, a high rate of nosocomial infection and in particular conjunctivitis was observed in this study that merits further evaluation.

  16. The Evaluation of Nosocomial Infections in Pediatric Patients with Extracorporeal Membrane Oxygenation Support

    Directory of Open Access Journals (Sweden)

    Pelin Ayyıldız

    Full Text Available Abstract Introduction: Extracorporeal membrane oxygenation (ECMO has become a standard technique over the past few decades in intensive care unit (ICU. Objective: A review of pediatric patients who received ECMO support in the pediatric cardiac ICU was conducted to determine the incidence, risk factors and causal organisms related to acquired infections and assess the survival rates of ECMO patients with nosocomial infections. Methods: Sixty-six patients who received ECMO support in the pediatric cardiac ICU between January 2011 and June 2014 were included in the study. Demographic, echocardiographic, hemodynamic features and surgical procedures were reviewed. Results: Sixty-six patients received a total of 292.5 days of venoarterial ECMO support. Sixty were postoperative patients. Forty-five patients were weaned from ECMO support with an ECMO survival rate of 68.2%. The rate of infection was 116.2/1000 ECMO days. Prolonged ICU stay, duration of ventilation and ECMO were found associated with development of nosocomial infection and only the duration of ECMO was an independent risk factor for nosocomial infections in ECMO patients. Conclusion: The correction of the underlying process leading to ECMO support and shortening the length of ECMO duration together with stricter application of ECMO indications would improve the infection incidence and hospital surveillance of the patient group.

  17. Antimicrobial susceptibility pattern in nosocomial infections caused by Acinetobacter species in Asir Region, Saudi Arabia.

    Science.gov (United States)

    Abdalla, Nazar M; Osman, Amani A; Haimour, Waleed O; Sarhan, Mohammed A A; Mohammed, Mohammed N; Zyad, Eyhab M; Al-Ghtani, Abdalla M

    2013-03-15

    This study aimed at evaluating the sensitivity of antibiotics towards nosocomial infections caused by Acinetobacter species. The study took place during the period Dec. 2011- Dec. 2012 at Assir Central Hospital in collaboration with the department of microbiology, college of medicine, King Khalid University, Abha. A prospective study involving 150 patients presented with nosocomial infections due to Acinetobacter species detected by bacteriological tests; direct microscopy, culture in blood agar media, fermentation test in MacConkey media and MIC (minimum inhibitory concentration) for antibiotics sensitivity using Muller Hinton media and Chemical test using API 20. A 150 nosocomial infections in this study showed gram-negative coccobacilli, non motile, glucose-negative fermentor and oxidase negative. All isolates showed 100% sensitivity to: Imipramine, Meropenem, Colistin. From the rest of tested antibiotics the higher resistant ones were; Nitrofurantoin 87% and Cefoxitin 85%. The least resistant antibiotics; Imipenem 3% and Ticarcillin 7%. While variable resistance in the rest of tested antimicrobials. A 47 patients (31.3%) have used antibiotics prior to this study. The high rate of usage occurred in elder patients. The frequency of Acinetobacter calcoaceticus baumannii complex multi-drugs resistance ABCMDR is rising including almost all commonly used antibiotics. Only few antibiotics exert 100% sensitivity towards these bacteria.

  18. Antibacterial Therapy for Nosocomial Pneumonias Caused by Multidrug-Resistant Microorganisms in Critical 1ll Patients

    Directory of Open Access Journals (Sweden)

    V. V. Moroz

    2007-01-01

    Full Text Available The paper presents the results of using the fourth-generation cephalosporin maxicef in the treatment of 20 patients with nosocomial pneumonia and severe concomitant injury. A control group comprised 20 patients receiving a combination of ceftazidime and amikacin. The total efficiency of the antibacterial therapy was 68.5% in the maxicef group and 40.9% in the control group (р<0.05. The therapy had to be modified in 42% of the maxicef group and in 72.7% in the control group (р<0.05. The average treatment cost was US $518 (429—606 and US $482 (368—596 in the maxicef and control groups, respectively. Nephrotoxicity was observed in 9% of the patients receiving a combination of the antibiotics. The activity of maxicef was also analyzed in vitro. Results. Maxicef was demonstrated to be highly active against the majority of gram-negative and gram-positive bacteria in vitro. Its efficacy against the most common bacteria (P.aeruginosa, S.aureus, E.coli, K.pneumonia causing infections in severe injury was in vitro significantly higher than that of ceftazidime. The comparative study indicates that the fourth-generation cephalosporin maxicef may be used as an alternative to the standard combined therapy. Key words: concomitant injury, maxicef, nosocomial pneumonia, a combination of ceftazidime and aminoglycoside, nosocomial infection pathogens.

  19. Procalcitonin is not sufficiently reliable to be the sole marker of neonatal sepsis of nosocomial origin

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    Moro Serrano Manuel

    2006-05-01

    Full Text Available Abstract Background It has recently been suggested that serum procalcitonin (PCT is of value in the diagnosis of neonatal sepsis, with varying results. The aim of this prospective multicenter study was to assess the usefulness of PCT as a marker of neonatal sepsis of nosocomial origin. Methods One hundred infants aged between 4 and 28 days of life admitted to the Neonatology Services of 13 acute-care teaching hospitals in Spain over 1-year with clinical suspicion of neonatal sepsis of nosocomial origin were included in the study. Serum PCT concentrations were determined by a specific immunoluminometric assay. The reliability of PCT for the diagnosis of nosocomial neonatal sepsis at the time of suspicion of infection and at 12–24 h and 36–48 h after the onset of symptoms was calculated by receiver-operating characteristics (ROC curves. The Youden's index (sensitivity + specificity - 1 was used for determination of optimal cutoff values of the diagnostic tests in the different postnatal periods. Sensitivity, specificity, and the likelihood ratio of a positive and negative result with the 95% confidence interval (CI were calculated. Results The diagnosis of nosocomial sepsis was confirmed in 61 neonates. Serum PCT concentrations were significantly higher at initial suspicion and at 12–24 h and 36–48 h after the onset of symptoms in neonates with confirmed sepsis than in neonates with clinically suspected but not confirmed sepsis. Optimal PCT thresholds according to ROC curves were 0.59 ng/mL at the time of suspicion of sepsis (sensitivity 81.4%, specificity 80.6%; 1.34 ng/mL within 12–24 h of birth (sensitivity 73.7%, specificity 80.6%, and 0.69 ng/mL within 36–48 h of birth (sensitivity 86.5%, specificity 72.7%. Conclusion Serum PCT concentrations showed a moderate diagnostic reliability for the detection of nosocomial neonatal sepsis from the time of suspicion of infection. PCT is not sufficiently reliable to be the sole marker of

  20. The effect of antibiotic use on prevalence of nosocomial vancomycin-resistant enterococci- an ecologic study

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    Cornelius Remschmidt

    2017-09-01

    Full Text Available Abstract Background Vancomycin-resistant enterococci (VRE are among the most common antimicrobial-resistant pathogens causing nosocomial infections. Although antibiotic use has been identified as a risk factor for VRE, it remains unclear which antimicrobial agents particularly facilitate VRE selection. Here, we assessed whether use of specific antimicrobial agents is independently associated with healthcare-associated (HA VRE rates in a university hospital setting in Berlin, Germany. Methods We conducted the study between January 2014 and December 2015 at the Charité-university hospital of Berlin, Germany. From the hospital pharmacy, we extracted data for all antibacterials for systemic use (anatomical therapeutic chemical (ATC-classification J01 and calculated ward specific antibiotic consumption in defined daily doses (DDDs per 100 patient-days (PD. We used the microbiology laboratory database to identify all patients with isolation of invasive or non-invasive VRE and calculated HA-VRE incidence as nosocomial VRE-cases per 100 patients and HA-VRE incidence density as nosocomial VRE-cases per 1000 PD. We defined VRE isolates as hospital-acquired if they were identified three days or later after hospital admission and otherwise as community-acquired (CA-VRE. We performed univariable and multivariable regression analyses to estimate the association of the frequency of HA-VRE per month with antibiotic use and other parameters such as length of stay, type of ward or presence of at least one CA-VRE on ward. In a second analysis, we considered only patients with VRE infections. Results We included data from 204,054 patients with 948,380 PD from 61 wards. Overall, 1430 VRE-cases were identified of which 409 (28.6% were considered hospital-acquired (HA. We found that carbapenem use in the current month and prior-month use of glycopeptides increased the risk for HA-VRE by 1% per 1 DDD/100 PD and 3% per 1 DDD/100 PD, respectively. However, when only VRE

  1. BACTERIAL AIR MICROFLORA ISOLATES IN TWO OBSTETRICS AND GYNAECOLOGY UNITS OF A HOSPITAL IN NIGERIA ARE POTENTIAL THREATS OF NOSOCOMIAL INFECTIONS.

    OpenAIRE

    2016-01-01

    Ever since the history of infirmaries, nosocomial infections have been of grave threats to hospital set-ups, the deadliest being nosocomial respiratory tract infection (RTI). Nosocomial RTI was consequently investigated in two units of Obstetrics and Gynaecology department of a hospital in Nigeria using the and ldquo;Settling Plate and rdquo; technique and various culture media for bacteria isolation. Identification of the isolates was done on the basis of each isolate\\'s cultural, morpholog...

  2. Microbial Characteristics of Nosocomial Infections and Their Association with the Utilization of Hand Hygiene Products: A Hospital-Wide Analysis of 78,344 Cases.

    Science.gov (United States)

    Liu, Song; Wang, Meng; Wang, Gefei; Wu, Xiuwen; Guan, Wenxian; Ren, Jianan

    Nosocomial infections are the main adverse events during health care delivery. Hand hygiene is the fundamental strategy for the prevention of nosocomial infections. Microbial characteristics of nosocomial infections in the Asia-Pacific region have not been investigated fully. Correlation between the use of hand hygiene products and the incidence of nosocomial infections is still unknown. This study investigates the microbial characteristics of nosocomial infections in the Asia-Pacific region and analyzes the association between the utilization of hand hygiene products and the incidence of nosocomial infections. A total of 78,344 patients were recruited from a major tertiary hospital in China. Microbial characteristics of major types of nosocomial infections were described. The association between the utilization of hand hygiene products and the incidence of nosocomial infections was analyzed using correlation and regression models. The overall incidence of nosocomial infections was 3.04%, in which the incidence of surgical site infection was 1%. Multi-drug resistance was found in 22.8% of all pathogens, in which multi-drug-resistant Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus were 56.6% and 54.9%, respectively. The utilization of hand hygiene products (including hand sanitizer, soap and paper towel) was associated negatively with the incidence of surgical site infection in surgical departments and the incidence of nosocomial infections in non-intensive care unit (ICU) departments (especially in surgical departments). Regression analysis further identified that higher utilization of hand hygiene products correlated with decreased incidence of major types of nosocomial infections. Multi-drug-resistant organisms are emerging in Asia-Pacific health care facilities. Utilization of hand hygiene products is associated with the incidence of nosocomial infections.

  3. Identificación y mapeo de AFLPs ligados al gen de resistencia al PVX en Solanum commersonii

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    Mónica Blanco

    2005-01-01

    Full Text Available Solanum commersonii es una especie silvestre de papa considerada como una fuente de genes de resistencia al PVX. Para identificar marcadores moleculares relacionados con los genes de resistencia a este virus, se realizó un análisis en el que se combinó la técnica de BSA con el uso de AFLPs. Del cruce de 2 padres heterocigotos y resistentes al PVX, provenientes de una F1, se obtuvo una F2. La población fue inoculada con el PVXMS y 30 días después mediante un ELISA, la progenie fue dividida en individuos infectados y no infectados con el PVXMS; a estos 2 grupos se les realizó un BSA. El ADN de los individuos resistentes fue mezclado aparte del ADN de los individuos susceptibles y con la ayuda de AFLPs se logró identificar 22 combinaciones de imprimadores que produjeron bandas específicas relacionadas con el carácter de resistencia al PVX. Las combinaciones de imprimadores seleccionadas fueron utilizadas para evaluar cada uno de los individuos de la F2 en forma independiente. Producto de este análisis se obtuvo 63 bandas polimórficas relacionadas al carácter de resistencia, cuya información fue introducida en el programa MAPRF6. Como resultado se obtuvo 4 grupos de ligamiento. Se encontró un RGA, obtenido en otro estudio que co-segrega (0 cM con el locus del gen de resistencia extrema (Rx y los AFLPs 42 y 39 que están rodeando el mismo locus a 22,6 cM o más. La información obtenida será básica para implementar programas de selección asistida por marcadores moleculares en el mejoramiento genético.

  4. Genotipicación de la resistencia natural del ganado blanco orejinegro “BON” a la Salmonella dublin SL 2260

    OpenAIRE

    Jorge Eliécer Ossa Londoño; Gary Adams; Gabriel Bedoya Berrío; Jaime I. Velásquez; María Teresa Rugeles López; Ómar A. Saldarriaga

    2000-01-01

    Uno de los factores que controla la resistencia a microorganismos intracelulares como Salmonella y Brucella, es el producto del gen Nramp (proteína del macrófago asociada a resistencia natural); esta proteína, en la fase temprana de la infección, controla la capacidad de replicación de estas bacterias en los macrófagos. Recientemente se identificó asociación entre un alelo de 175 pb de un microsatélite (STR), ligado a Nramp, con la resistencia a microorganismos intracelulares en bovinos; adic...

  5. Frecuencia de aislamientos microbiológicos y perfil de resistencia bacteriana en 13 clínicas y hospitales de alta complejidad en Santiago de Cali - Colombia

    OpenAIRE

    Martínez Buitrago, Ernesto; Hernández, Cristhian; Pallares, Cristhian; Pacheco, Robinson; Hurtado, Kelly; Recalde, Mónica

    2014-01-01

    Introducción: La resistencia bacteriana se consolida como una amenaza para los sistemas de salud en el manejo de las enfermedades infecciosas. La vigilancia epidemiológica de la resistencia bacteriana ha demostrado ser una estrategia efectiva para conocer los patrones de susceptibilidad a los antimicrobianos regionales para el desarrollo de medidas de contención y gestión del uso adecuado de antimicrobianos. Objetivo: Describir los aislamientos microbiológicos y perfiles de resistencia a los ...

  6. [Presence of Legionella spp. in household drinking water reservoirs in Resistencia, Chaco, Argentina. Preliminary report].

    Science.gov (United States)

    Lösch, Liliana S; Merino, Luis A

    Legionella spp. is an environmental bacterium that can survive in a wide range of physicochemical conditions and may colonize distribution systems of drinking water and storage tanks. Legionella pneumophila is the major waterborne pathogen that can cause 90% of Legionnaires' disease cases. The aim of this study was to detect the presence of Legionella spp. in household drinking water tanks in the city of Resistencia, Chaco. The detection of Legionella in water samples was performed by culture methods as set out in ISO 11731:1998. Thirty two water samples were analyzed and Legionella spp. was recovered in 12 (37.5%) of them. The monitoring of this microorganism in drinking water is the first step towards addressing the control of its spread to susceptible hosts. Copyright © 2016 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. RESISTENCIA AL IMPACTO DE LA MADERA DE DIEZ ENCINOS (Quercus MEXICANOS

    Directory of Open Access Journals (Sweden)

    R. Dávalos-Sotelo

    2010-01-01

    Full Text Available Se presentan los valores de resistencia al impacto o tenacidad de la madera de diez especies de encinos mexicanos de los estados de Jalisco, México, Puebla y Veracruz ensayados en condición verde con una máquina tipo FPL. No se detectaron diferencias significativas en los valores entre los individuos de la misma especie que crecen en diferentes estados, por lo que puede establecerse un valor común. Existe un efecto directamente proporcional de la densidad básica sobre la tenacidad, el cual se acentúa al incluir los valores del espesor de la pared celular como una variable independiente adicional en los análisis de regresión múltiple. Finalmente, en este trabajo se incluyen los valores de las características anatómicas, físicas y mecánicas de la madera de Quercus crassipes.

  8. RESISTENCIA SISTÉMICA ADQUIRIDA MEDIADA POR EL ÁCIDO SALICÍLICO

    OpenAIRE

    DIAZ-PUENTES, LUZ NELLY

    2012-01-01

    La Resistencia Sistémica Adquirida (RSA) protege a la planta de una infección secundaria por patógenos biotróficos, necrotróficos y hemibiotróficos. La inducción de RSA ocurre en dos etapas, en una primera la planta reconoce el patógeno e induce las respuestas locales de defensa a través de cascadas de señalización que conllevan a la acumulación intracelular de Ácido Salicílico (AS). Esta acumulación induce el aumento de los niveles de Especies Reactivas del Oxígeno (ERO) y expresión de genes...

  9. Aumento en la resistencia a la corrosión de un acero t91 aluminizado

    OpenAIRE

    QUINTERO, LUZ S.; LAVERDE, DIONISIO; ESCALANTE, HUMBERTO

    2011-01-01

    El acero ferrítico T91 ha sido ampliamente utilizado en plantas de generación de energía eléctrica, calderas y plantas nucleares. Sin embargo, su resistencia a la oxidación se ve gravemente afectada a temperaturas superiores a los 600ºC. En esta investigación se empleó la técnica de cementación empacada para aluminizar un acero T91 y se encontraron las condiciones óptimas para la formación de un recubrimiento libre de porosidad y con espesor uniforme (300 micras). Se evaluó la capa de óxido f...

  10. Representaciones sobre las normas de género: la resistencia al cambio

    Directory of Open Access Journals (Sweden)

    Alejandra Martínez

    2011-10-01

    Full Text Available El presente artículo es producto de un trabajo de investigación realizado entre 2006 y 2009 en la ciudad de Córdoba, Argentina. Uno de los objetivos centrales de dicho estudio fue analizar las representaciones de las normas de género en varones y mujeres, y relacionar dichas representaciones con sus condiciones objetivas de existencia. En este escrito mostramos las articulaciones resultantes entre representaciones y condiciones objetivas -específicamente aquellas relativas a la posesión/carencia de capital económico y cultural-, poniendo en relieve la resistencia de las representaciones más tradicionales asociadas a las normas de género.

  11. Importancia de los ensayos de compactibilidad, resistencia en verde y humedad en mezclas de moldeo

    Directory of Open Access Journals (Sweden)

    Alain Valdés-Crúz

    2000-03-01

    Full Text Available A partir de la teoría del agua rígida y de los trabajos desarrollados por Wenninger se alcanzó una concepción más clara sobre los mecanismos de aglutinación en verde de las mezclas de moldeo. Al mismo tiempo, se presta una particular atención a los ensayos de compactibilidad, resistencia a la compresión en verde y humedad, como índices más representativos de dicho proceso de aglutinación. Se demuestra la relación que existe entre estos ensayos y las consecuencias de los trabajos de Wenninger. Se hace particular énfasis en el ensayo de compactibilidad por considerarlo de aplicación limitada.

  12. El suelo urbano y los asentamientos informales en el gran resistencia. 1. Chaco, Argentina

    Directory of Open Access Journals (Sweden)

    María Cristina Magnano

    2005-01-01

    Full Text Available En el artículo se describe un creciente proceso de ocupaciones ilegales de terrenos por parte de familias sin hogar en Gran Resistencia del Chaco, Argentina. Luego la ocupación es seguida por gestiones legislativas que traspasan al Estado la responsabilidad de expropiar en beneficio de las familias ocupantes. La realidad demuestra que este último no ejecuta sus compromisos legales por carencia de recursos, con el agravante que los precarios presupuestos habitacionales locales no sólo son disminuidos, sino que en los últimos años se han suprimido varios, dejando sin atención necesidades urgentes de las familias sin casa. Los autores concluyen el artículo proponiendo un temario a debatir públicamente en torno las situaciones más críticas, urgentes y de interés local con la participación de todos los sectores vigentes de la institucionalidad.

  13. Nuevas resistencias comunicativas: la rebelión de los ACARP

    Directory of Open Access Journals (Sweden)

    IA Del Amo

    2014-05-01

    Full Text Available Introducción. El trabajo pretende ser una aportación en el debate en torno al papel que los medios de comunicación tienen en el cultivo de asunciones sobre la realidad, especialmente a raíz de la emergencia de las nuevas tecnologías de la información y la comunicación (TICs. Objetivos. Se analizarán dos formas específicas y novedosas de disputa comunicativa por parte de los movimientos sociales: los lip dub reivindicativos y las grabaciones ciudadanas de actuaciones policiales. Englobamos a ambas bajo la categoría de Artefacto Cultural Audiovisual de Reivindicación y Protesta (ACARP. Metodología. Se realiza un análisis teórico acerca de las relaciones entre poder, comunicación y resistencias, proponiendo una lectura acerca de los distintos planos en los que resistencias y disputas se articulan. Para el análisis empírico, atendemos a las reflexiones metodológicas en torno a la sociología visual, aplicándolas a seis de estos artefactos audiovisuales en el contexto vasco. Resultados y conclusiones. Los resultados proporcionan una caracterización general de estos artefactos audiovisuales. El análisis del caso vasco permite situar estas innovaciones tácticas y comunicativas, y discutir acerca de la importancia del contexto, la construcción del discurso, las posibles tendencias a la espectacularización y las posibilidades de contrarrestrar estereotipaciones.

  14. Influencia del filler calizo en las propiedades de los morteros a resistencia constante

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    Hernández, Francisco

    1994-03-01

    Full Text Available This article studies the effects produced by the lime filler on the Portugal cement used with additions in the production of mortars. The starting point is a Portland cement to which different ratios of lime filler, ranging from 0-50%, are added. The next step consists of preparing mortar specimens using standardized sand as aggregate, curing them up to the age of 28 days when they are put to flexo-tensile and compression tests. The mortar strength is fixed at the age of 28 days, making it coincide with the strength of a pattern cement mortar (cement without additions of the same age. Then the effects of the filler on the slump and the water cement relation are observed for fixed strength.

    En este artículo se estudian los efectos producidos por el "filler" calizo en el cemento portland al utilizar este cemento con adiciones, en la fabricación de morteros. Se parte de un cemento portland al que se le añaden proporciones de "filler" calizo desde O hasta el 50%, y se preparan probetas de mortero utilizando como árido arena normalizada, curándose a continuación hasta la edad de 28 días, fecha en la que se someten a rotura por flexotracción y compresión. La resistencia de los morteros se fija a la edad de 28 días, haciéndola coincidir con la de un mortero de cemento patrón (cemento sin adiciones a la misma edad, y se observan, a resistencia fija, los efectos del "filler" sobre el escurrimiento y relación agua/cemento.

  15. RESISTENCIA A ANTIBIOTICOS DE BACTERIAS AISLADAS DE BIOPELÍCULAS EN UNA PLANTA DE ALIMENTOS

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    María Vanegas L

    2009-08-01

    Full Text Available Objetivo. Evaluar la resistencia a antibióticos y la capacidad de formación de biopelículas de bacterias aisladas en una planta de producción de alimentos. Materiales y métodos. Se tomaron muestras de 3 zonas diferentes, en una planta procesadora de alimentos; en la lavadora de canastas, la mesa de producción y en la banda empacadora. Se aislaron e identificaron las bacterias presentes en cada una de las tres zonas y se determinó la capacidad formadora de biopelículas por medio de cuantificación celular. Asimismo se evaluó la resistencia de cada una de las bacterias aisladas frente a ocho diferentes antibióticos. Resultados. Se recuperaron 29 cepas, correspondientes a 13 géneros diferentes, los cuales fueron todos formadores de biopelículas. Se encontró que cerca del 50% de las bacterias aisladas fueron resistentes a antibióticos como la penicilina G y vancomicina. Adicionalmente se evidenció un alto grado de multirresistencia a los diferentes antibióticos. Conclusiones. La alta multirresistencia encontrada a antibióticos entre las bacterias analizadas podría ser un problema para salud pública ya que pueden ser transmitidas por alimentos. De igual manera es de gran importancia la capacidad de producción de biopelículas de la microbiota analizada así como la alta concentración de bacterias entéricas y ambientales, lo que sugiere deficiencia del programa de limpieza y desinfección de la planta.

  16. Influencia de la hipnosis en la resistencia al esfuerzo en ciclistas

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    Rubén Fernández García

    2012-01-01

    Full Text Available En este estudio se evaluó el efecto de aplicar hipnosis para resistir esfuerzos máximos durante el mayor tiempo posible. Participaron en la investigación 24 deportistas juveniles y aficionados practicantes de ciclismo, con una edad media de 17,75 años (Sd 0,97, peso medio de 68 Kg (Sd 3,98, talla media de 178 cm (Sd 15,02 y un promedio de 5,75 años compitiendo (Sd 0,48. Estos se distribuyeron aleatoriamente en dos grupos denominados: hipnosis y control. La intervención con hipnosis consistió en la utilización de una breve técnica de relajación, fase de inducción hipnótica, fase de profundización, introducción de sugestión posthipnótica y fase de salida del estado hipnótico. Los resultados indicaron una relación estadísticamente significativa (p<0.05 en la variable resistencia al esfuerzo, analizada mediante 2 (16,78 y lambda (0.90, respecto al tipo de tratamiento. La resistencia al esfuerzo mejoraba a medida que se incrementaba el número de sesiones de intervención. Podemos concluir que la intervención con hipnosis ayudó a los deportistas a resistir durante más tiempo situaciones de máximo esfuerzo.

  17. Epidemiology of nosocomial colonization/infection caused by Acinetobacter spp. in patients of six surgical clinics in war and peacetime.

    Science.gov (United States)

    Suljagić, Vesna; Jevtić, Miodrag; Djordjević, Boban; Romić, Predrag; Ilić, Radoje; Stanković, Nebojsa; Milović, Novak; Novaković, Marijan; Kozarski, Jefta; Roganović, Zoran; Popović, Zoran; Jovelić, Aleksandra

    2011-08-01

    Acinetobacter spp. has emerged as nosocomial pathogen during the past few decades in hospitals all over the world, but it has increasingly been implicated as a serious nosocomial pathogen in military hospitals. The aim of this study was to analyse and compare the surveillance data on Acinetobacter nosocomial colonization/infection (NCI) collected during the wartime with the data collected in peacetime. We conducted a prospective study of incidence of Acinetobacter spp. colonization/infection. Also, the two nested case-control studies were conducted. The patients with nosocomial infection (cases) were compared with those with nosocomial colonization (controls) during the two different periods, wartime and peacetime. The patients with NCI by Acinetobacter spp. were identified by the case-based surveillance. The surveillance covered all the patients in 6 surgical clinics. During the study periods a total of 166 patients had cultures that grew Acinetobacter spp. and the pooled rates of Acinetobacter spp. colonization and infection were significantly higher in wartime. When patients with NCI in wartime were compared with those with NCI in peacetime significant differences were observed. In the war year, the patients were more significantly males (p war and peace period.

  18. [Perception of nosocomial risk among healthcare workers at "Hopital Principal" in Dakar, Senegal (survey 2004)].

    Science.gov (United States)

    Chevalier, B; Margery, J; Wade, B; Ka, S; Diatta, B; Gueye, M; Mbaye, P S; Debonne, J M

    2008-12-01

    Nosocomial Infection (NI) is also observed in healthcare facilities in non-Western countries. The purpose of this report is to describe the findings of a survey undertaken to evaluate hygiene procedures implemented at the "Hopital Principal" in Dakar, Senegal and to assess perception and awareness of nosocomial risk among the hospital staff. A total of 264 healthcare workers were interviewed. Mean age was 39 years (range, 18-60) and the sex ratio was 1.3 (150 men/114 women). Sixty (22.7%) had university degrees, 106 (40.2%) had secondary school diplomas, 50 (18.9%) had attended middle school, and 13 (4.9%) had no schooling. Analysis of interview data showed that 56.1% (157/264) defined NI as infection acquired at the hospital but that only 9.8% (n=26) knew that a minimum 48-hour delay was necessary to distinguish nosocomial from community acquired infection. While understanding about NI was correlated with education level, data showed that 1 out of 3 physicians (13/39) failed to give the exact definition. Hand contact was cited as the second route of transmission. Isolation precautions were understood by 22.7% of personnel (60/264). Systematic handwashing was reported by 363% (96/264) but observation demonstrated that it was not performed properly regardless of the category of personnel. Care protocols were understood by 54.6% of persons interviewed (144/264). A hygiene-training course had been attended by 52.2% (n=138). Two thirds of the staff (69.7%: 54/264) was able to identify the hygiene nurse. Ninety-eight health care providers (37.1%) were familiar with the CLIN (Comités de Lutte contre les Infections Nosocomiales).

  19. Legionella pneumophila: risk assessment and strategy for the prevention and control of nosocomial infections

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    Salvo Torrisi

    2012-06-01

    Full Text Available The term “Legionellosis” includes all forms of disease caused by microorganisms of the genus Legionella; it may manifest as a flu-like shape (Pontiac fever, or with severe pneumonia with high mortality (Legionnaires Disease. The causative agent was Legionella pneumophila in the literature although other strains of the genus Legionella are classified as pathogens, mode of transmission is through inhalation of aerosol particles produced by hot water or air conditioning systems: for this reason in community settings and nosocomial L. pneumophila represents a serious public health problem. In the light of epidemiological data since the year 2000 the Italian State has issued a series of provisions laws concerning the prevention and control of nosocomial Legionellosis environment and community.The present work aims to evaluate the presence of Legionella species and L. pneumophila comparing the different approaches proposed by the Guidelines of the regions of Lombardy and Piedmont in terms of assessment and prevention of risk “Legionellosis” in the field of nosocomial infection. The analytical methods used are those provided by the Regional Guidelines: the official method in the second CSR April 4 Method 2000 and UNI EN ISO 11731-1: 2008. Checks have been performed on equipment for the comparison of cold water, hot water and air conditioning in nursing homes, retirement homes and hospitals.The results obtained show that the method CSR April 4, 2000 restricts the search to L. pneumophila permitting, than the method EN ISO 11731-1: 2008, to carry out a risk assessment well targeted to the actual pathogen.The culture method for the detection of L. pneumophila allows you to not only prevention, but also to implement a series of targeted interventions following the directions of the legislation.

  20. National Nosocomial Infection Surveillance System–based study in north eastern of Iran

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    Maliheh Ziaee

    2017-09-01

    Full Text Available among about 10% of hospitalized patients. HAIs increase mortality and morbidity and prolonged hospital stay not to mention considerable costs they impose on the health care system. The present study was conducted in order to evaluate the prevalence of HAIs based on National Nosocomial Infection Surveillance System in hospitals of Mashhad, Iran.  Methods: The current prevalence study of HAI was carried out in 26 hospitals using a protocol updated yearly in Mashhad, Iran. The Centers for Disease Control and Prevention–National Nosocomial Infections Surveillance were used to define four HAIs. All patients admitted to the hospitals during a one-year period (March 1, 2015-February 30, 2016 were recruited in the study. Data was extracted using Iranian nosocomial infection surveillance software.  Results: The overall prevalence rate of HAI in our study was 0.8% among the hospitals with the most frequent HAIs found to be pneumonia (25%, followed by urinary tract infections (20%, and blood stream infections (19%. The highest prevalence rate was observed in 15- to 65-year old patients with more than 50% related to surgical site infection. Also, the most frequently isolated micro-organism was acinetobacter. In addition, the highest seasonal prevalence was seen in winter with pneumonia as the most frequent infection. A total of 4988 pathogens were isolated with 30.33% of clinical confirmation and 69.66% of positive culture.  Conclusion: These findings emphasize the need for appropriate measures for prevention, screening, labeling, and isolation precautions for infected patients.

  1. Nosocomial Bloodstream Infections in Brazilian Pediatric Patients: Microbiology, Epidemiology, and Clinical Features

    Science.gov (United States)

    Pereira, Carlos Alberto Pires; Marra, Alexandre R.; Camargo, Luis Fernando Aranha; Pignatari, Antônio Carlos Campos; Sukiennik, Teresa; Behar, Paulo Renato Petersen; Medeiros, Eduardo Alexandrino Servolo; Ribeiro, Julival; Girão, Evelyne; Correa, Luci; Guerra, Carla; Carneiro, Irna; Brites, Carlos; Reis, Marise; de Souza, Marta Antunes; Tranchesi, Regina; Barata, Cristina U.; Edmond, Michael B.

    2013-01-01

    Background Nosocomial bloodstream infections (nBSIs) are an important cause of morbidity and mortality and are the most frequent type of nosocomial infection in pediatric patients. Methods We identified the predominant pathogens and antimicrobial susceptibilities of nosocomial bloodstream isolates in pediatric patients (≤16 years of age) in the Brazilian Prospective Surveillance for nBSIs at 16 hospitals from 12 June 2007 to 31 March 2010 (Br SCOPE project). Results In our study a total of 2,563 cases of nBSI were reported by hospitals participating in the Br SCOPE project. Among these, 342 clinically significant episodes of BSI were identified in pediatric patients (≤16 years of age). Ninety-six percent of BSIs were monomicrobial. Gram-negative organisms caused 49.0% of these BSIs, Gram-positive organisms caused 42.6%, and fungi caused 8.4%. The most common pathogens were Coagulase-negative staphylococci (CoNS) (21.3%), Klebsiella spp. (15.7%), Staphylococcus aureus (10.6%), and Acinetobacter spp. (9.2%). The crude mortality was 21.6% (74 of 342). Forty-five percent of nBSIs occurred in a pediatric or neonatal intensive-care unit (ICU). The most frequent underlying conditions were malignancy, in 95 patients (27.8%). Among the potential factors predisposing patients to BSI, central venous catheters were the most frequent (66.4%). Methicillin resistance was detected in 37 S. aureus isolates (27.1%). Of the Klebsiella spp. isolates, 43.2% were resistant to ceftriaxone. Of the Acinetobacter spp. and Pseudomonas aeruginosa isolates, 42.9% and 21.4%, respectively, were resistant to imipenem. Conclusions In our multicenter study, we found a high mortality and a large proportion of gram-negative bacilli with elevated levels of resistance in pediatric patients. PMID:23861860

  2. Pentaglobin as an adjunct therapy in very low birthweight neonates with nosocomial sepsis

    International Nuclear Information System (INIS)

    Salihoglu, O.; Can, E.; Koc, M.O.; Durmus, E.; Hatipoglu, S.

    2013-01-01

    To evaluate the effect of pentaglobin treatment on clinical and laboratory parametres and the major morbidities in very low birthweight neonates with nosocomial sepsis before and after pentaglobin treatment. Methods: The prospective interventional study was conducted from January 1 to December 31, 2010, at the neonatal intensive care unit (NICU) of the Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey. Pentaglobin was initiated on the day of diagnosis of nosocomial sepsis to 13 pre-term neonates as a support therapy in addition to antibiotics; 5 ml/kg per day of pentaglobin was infused over a 4-hour period on 3 consecutive days. Clinical and laboratory parametres and major morbidities were recorded before and after pentaglobin treatment and compared using NCSS software. Results: Of the total, 8(66%) were females and 5 (40%) males. Following pentaglobin therapy, the immature-to-total neutrophil ratio and C-reactive protein levels were significantly decreased, and the capillary pH and base excess were significantly increased (p 0.05). Coagulase-negative staphylococci (n=3; 23%), Klebsiella pneumoniae (n=2; 15.3%), and Pseudomonas aeruginosa (n=1; 7.7%) were identified in blood cultures. The presence of intraventricular haemorrhages, necrotising enterocolitis, periventricular leukomalacia, and patent ductus arteriosus was not changed following the treatment. Adverse effects and mortality were not observed during or after the therapy. Conclusion: Pentaglobin treatment of nosocomial sepsis could be used as an adjunct therapy without any adverse short-term reactions, even in very low birthweight pre-term infants. (author)

  3. Hospital costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition

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    Morales Eva

    2012-05-01

    Full Text Available Abstract Background We aimed to assess the hospital economic costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition. Methods A retrospective study of all hospital admissions between January 1, 2005, and December 31, 2006 was carried out in a 420-bed, urban, tertiary-care teaching hospital in Barcelona (Spain. All patients with a first positive clinical culture for P. aeruginosa more than 48 h after admission were included. Patient and hospitalization characteristics were collected from hospital and microbiology laboratory computerized records. According to antibiotic susceptibility, isolates were classified as non-resistant, resistant and multi-drug resistant. Cost estimation was based on a full-costing cost accounting system and on the criteria of clinical Activity-Based Costing methods. Multivariate analyses were performed using generalized linear models of log-transformed costs. Results Cost estimations were available for 402 nosocomial incident P. aeruginosa positive cultures. Their distribution by antibiotic susceptibility pattern was 37.1% non-resistant, 29.6% resistant and 33.3% multi-drug resistant. The total mean economic cost per admission of patients with multi-drug resistant P. aeruginosa strains was higher than that for non-resistant strains (15,265 vs. 4,933 Euros. In multivariate analysis, resistant and multi-drug resistant strains were independently predictive of an increased hospital total cost in compared with non-resistant strains (the incremental increase in total hospital cost was more than 1.37-fold and 1.77-fold that for non-resistant strains, respectively. Conclusions P. aeruginosa multi-drug resistance independently predicted higher hospital costs with a more than 70% increase per admission compared with non-resistant strains. Prevention of the nosocomial emergence and spread of antimicrobial resistant microorganisms is essential to limit the strong economic impact.

  4. Hospital costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition.

    Science.gov (United States)

    Morales, Eva; Cots, Francesc; Sala, Maria; Comas, Mercè; Belvis, Francesc; Riu, Marta; Salvadó, Margarita; Grau, Santiago; Horcajada, Juan P; Montero, Maria Milagro; Castells, Xavier

    2012-05-23

    We aimed to assess the hospital economic costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition. A retrospective study of all hospital admissions between January 1, 2005, and December 31, 2006 was carried out in a 420-bed, urban, tertiary-care teaching hospital in Barcelona (Spain). All patients with a first positive clinical culture for P. aeruginosa more than 48 h after admission were included. Patient and hospitalization characteristics were collected from hospital and microbiology laboratory computerized records. According to antibiotic susceptibility, isolates were classified as non-resistant, resistant and multi-drug resistant. Cost estimation was based on a full-costing cost accounting system and on the criteria of clinical Activity-Based Costing methods. Multivariate analyses were performed using generalized linear models of log-transformed costs. Cost estimations were available for 402 nosocomial incident P. aeruginosa positive cultures. Their distribution by antibiotic susceptibility pattern was 37.1% non-resistant, 29.6% resistant and 33.3% multi-drug resistant. The total mean economic cost per admission of patients with multi-drug resistant P. aeruginosa strains was higher than that for non-resistant strains (15,265 vs. 4,933 Euros). In multivariate analysis, resistant and multi-drug resistant strains were independently predictive of an increased hospital total cost in compared with non-resistant strains (the incremental increase in total hospital cost was more than 1.37-fold and 1.77-fold that for non-resistant strains, respectively). P. aeruginosa multi-drug resistance independently predicted higher hospital costs with a more than 70% increase per admission compared with non-resistant strains. Prevention of the nosocomial emergence and spread of antimicrobial resistant microorganisms is essential to limit the strong economic impact.

  5. Multidrug resistance in Pseudomonas aeruginosa isolated from nosocomial respiratory and urinary infections in Aleppo, Syria.

    Science.gov (United States)

    Mahfoud, Maysa; Al Najjar, Mona; Hamzeh, Abdul Rezzak

    2015-02-19

    Pseudomonas aeruginosa represents a serious clinical challenge due to its frequent involvement in nosocomial infections and its tendency towards multidrug resistance. This study uncovered antibiotic susceptibility patterns in 177 isolates from inpatients in three key hospitals in Aleppo, the largest city in Syria. Exceptionally low susceptibility to most routinely used antibiotics was uncovered; resistance to ciprofloxacin and gentamicin was 64.9% and 70.3%, respectively. Contrarily, susceptibility to colistin was the highest (89.1%). Multidrug resistance was rife, found at a rate of 53.67% among studied P. aeruginosa isolates.

  6. [Legal aspects of the health care institution liability for nosocomial infections].

    Science.gov (United States)

    Garus-Pakowska, Anna; Szatko, Franciszek; Pakowski, Maciej

    2009-01-01

    In this paper, the basic concepts concerning the liability of health care institution for nosocomial infections are presented. The principles of ex contracto and ex delicto liabilities, as well as the concept of so-called anonymous guilt are discussed. The range of duties for both the health care institution and the employed medical personnel is indicated, the duties and the consequences of their non-fulfillment are systematized, and the obligatory jurisdiction concerning the functioning of prima facie evidence is considered. The author aimed at explaining the principles governing the civil liability of health care institutions and their employees.

  7. Nosocomial infections of ocular conjunctiva in newborns delivered by cesarian section.

    Science.gov (United States)

    Bezirtzoglou, E; Romond, C

    1991-01-01

    Colonization of the ocular conjunctiva in newborns delivered by cesarian section occurs usually within the first day of life. We have studied the flora of the ocular conjunctiva at birth, from 19 newborns delivered by cesarian section, coming from two different maternity hospitals. Ocular conjunctiva cultures yielded the main predominant flora in both maternity hospitals considered. The most common genus of this flora are: Staphylococcus, Corynebacterium and Propionibacterium acnes. Peptostreptococcus productus, Neisseria, Eubacterium and Clostridium perfringens are isolated occasionally. In newborns delivered by cesarian section, this flora principally acquired may be the consequence of the presence of bacteria in the ambient air, as well as differences in care provided by the nosocomial personnel.

  8. [Risk factors of development of nosocomial pyogenic and septic infections in maternity hospitals].

    Science.gov (United States)

    Zakharova, Iu A; Nikolaeva, A M; Fel'dblium, I V

    2007-01-01

    During prospective epidemiological surveillance cases of pyogenic and septic infections (PSI) in mothers and newborns in two maternity hospitals were studied using standard case definition and leading risk factors of their development were revealed. These factors differed in two hospitals and were connected mainly with high level of patients colonization, contamination of the environment by nosocomial strains of microorganisms, and degree of participation of mother's relatives in delivery. It was shown that permission to relatives for presence on delivery did not influence on the rate of PSI. Specificity of risk factors of PSI in mothers and newborns dictates necessity to determine them in each maternity hospital.

  9. Nosocomial infections—a new approach towards preventive medicine using plasmas

    Science.gov (United States)

    Morfill, G. E.; Shimizu, T.; Steffes, B.; Schmidt, H.-U.

    2009-11-01

    A new, very efficient, large area scalable and robust electrode design for plasma production in air at atmosphere pressures has been developed and tested. This has made the development of a 'plasma dispenser' for hospital disinfection possible, which has certain advantages over current fluid disinfection systems. The properties of this device are presented, in particular the bactericidal and fungicidal efficiency, and the advantages are described. Such plasma dispensers could play an important role in the future fight against the alarming and growing threat posed by nosocomial (=hospital and community associated) bacterial infections.

  10. Nosocomial infections-a new approach towards preventive medicine using plasmas

    International Nuclear Information System (INIS)

    Morfill, G E; Shimizu, T; Steffes, B; Schmidt, H-U

    2009-01-01

    A new, very efficient, large area scalable and robust electrode design for plasma production in air at atmosphere pressures has been developed and tested. This has made the development of a 'plasma dispenser' for hospital disinfection possible, which has certain advantages over current fluid disinfection systems. The properties of this device are presented, in particular the bactericidal and fungicidal efficiency, and the advantages are described. Such plasma dispensers could play an important role in the future fight against the alarming and growing threat posed by nosocomial (=hospital and community associated) bacterial infections.

  11. Analysis on Risk Factors of Nosocomial Infection in Orthopedic Patients and Research on Nursing Strategies

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    Guo Zhitao

    2016-03-01

    Full Text Available Orthopedic patients mostly comprise traumatic patients and elderly or sick individuals. More patients with emergency surgery suffer from open wounds and serious pollution, and operation time is relatively long. Thus, orthopedic patients with surgical incision infection account for a large proportion of incidence of hospital infection. Orthopedic patients are also bedridden for long periods, and they receive poor bone tissue blood supply. In surgical incision infections, mild cases suffer from delayed wound healing, whereas severe cases can form osteomyelitis. This study reviews progress of research on risk factors of nosocomial infection among orthopedic patients in recent years.

  12. Nosocomial infection of CCHF among health care workers in Rajasthan, India.

    Science.gov (United States)

    Yadav, Pragya D; Patil, Deepak Y; Shete, Anita M; Kokate, Prasad; Goyal, Pulkit; Jadhav, Santosh; Sinha, Sanjeev; Zawar, Divya; Sharma, Surendra K; Kapil, Arti; Sharma, D K; Upadhyay, Kamlesh J; Mourya, Devendra T

    2016-11-03

    Ever since Crimean-Congo hemorrhagic fever [CCHF] discovered in India, several outbreaks of this disease have been recorded in Gujarat State, India. During the year 2011 to 2015 several districts of Gujarat and Rajasthan state (Sirohi) found to be affected with CCHF including the positivity among ticks and livestock. During these years many infected individuals succumbed to this disease; which subsequently led to nosocomial infections. Herein, we report CCHF cases recorded from Rajasthan state during January 2015. This has affected four individuals apparently associated with one suspected CCHF case admitted in a private hospital in Jodhpur, Rajasthan. A 30-year-old male was hospitalized in a private hospital in Jodhpur, Rajasthan State, who subsequently had developed thrombocytopenia and showed hemorrhagic manifestations and died in the hospital. Later on, four nursing staff from the same hospital also developed the similar symptoms (Index case and Case A, B, C). Index case succumbed to the disease in the hospital at Jodhpur followed by the death of the case A that was shifted to AIIMS hospital, Delhi due to clinical deterioration. Blood samples of the index case and Case A, B, C were referred to the National institute of Virology, Pune, India for CCHF diagnosis from the different hospitals in Rajasthan, Delhi and Gujarat. However, a sample of deceased suspected CCHF case was not referred. Subsequently, blood samples of 5 nursing staff and 37 contacts (Case D was one of them) from Pokhran area, Jaisalmer district were referred to NIV, Pune. It clearly indicated that nursing staff acquired a nosocomial infection while attending the suspected CCHF case in an Intensive Care Unit of a private hospital in Jodhpur. However, one case was confirmed from the Pokhran area where the suspected CCHF case was residing. This case might have got the infection from suspected CCHF case or through other routes. CCHF strain associated with these nosocomial infections shares the

  13. Perfiles de resistencia a fluoroquinolonas en aislamientos clínicos de cocos Gram positivos provenientes de hospitales colombianos, 1994-2004

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    César A. Arias

    2008-06-01

    Conclusión. Los aislamientos colombianos de S. pneumoniae mantienen susceptibilidad a las fluoroquinolonas de última generación. La resistencia a fluoroquinolonas es alta en S. aureus, especialmente en aislamientos resistentes a la meticilina (cercana al 100%.

  14. Genética de la resistencia de la papa (Solanum tuberosum a patógenos. Estado de arte

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    Mosquera Teresa

    2008-04-01

    Full Text Available

    Este artículo presenta una revisión de la resistencia en papa a patógenos, en cuanto a genes mapeados y clonados, y loci de rasgos cuantitativos (QTL mapeados, en la que se resaltan las relaciones entre resistencia cuantitativa y cualitativa en el caso P. infestans. El conocimiento logrado ha permitido generar un mapa funcional sobre el cual se localizan QTL para resistencia a patógenos. Se han mapeado 20 genes R de resistencia a virus, hongos, nematodos y oomicetos, utilizando marcadores moleculares. La mayoría de estos genes R fueron introducidos de especies silvestres. Catorce de ellos se encuentran en hot spots para resistencia y confieren resistencia a varios patógenos. A la fecha se han identificado cinco clusters de resistencia. La resistencia monogénica envuelve dos procesos básicos: percepción del ataque del patógeno, seguida de una respuesta para limitar la enfermedad. La percepción implica receptores específicos para cepas patogénicas, que son decodificadas por genes de resistencia. En una planta se encuentra un gran repertorio de genes de resistencia R, ubicados en diferentes sitios del genoma. Estos genes expresan diferentes proteínas que pueden ser agrupadas en varias familias. La mayoría de proteínas R contienen repeticiones en grupos, ricas en leucina (LRR. Se plantea la colocalización de genes R y QTL en diferentes cromosomas. Una hipótesis señala que los QTL son variantes alélicas con efecto menos extremo que los genes R y una segunda hipótesis plantea que los QTL de resistencia mapean en regiones del genoma que contienen genes de función conocida involucrados en la respuesta general al ataque de patógenos.

  15. Frecuencia de aislamientos microbiológicos y perfil de resistencia bacteriana en 13 clínicas y hospitales de alta complejidad en Santiago de Cali - Colombia

    Directory of Open Access Journals (Sweden)

    Ernesto Martínez Buitrago

    Full Text Available Introducción: La resistencia bacteriana se consolida como una amenaza para los sistemas de salud en el manejo de las enfermedades infecciosas. La vigilancia epidemiológica de la resistencia bacteriana ha demostrado ser una estrategia efectiva para conocer los patrones de susceptibilidad a los antimicrobianos regionales para el desarrollo de medidas de contención y gestión del uso adecuado de antimicrobianos. Objetivo: Describir los aislamientos microbiológicos y perfiles de resistencia a los antimicrobianos de las principales bacterias gram-negativas y gram-positivas en clínicas y hospitales de alta complejidad de Santiago de Cali, Colombia. Metodología: Estudio descriptivo enmarcado en la estrategia de vigilancia epidemiológica de la resistencia bacteriana desarrollado entre el año 2010 al 2012 en 13 instituciones de alta complejidad. Se recolectaron archivos mensualmente en formato WHONET, se realizaron pruebas de calidad de datos. El análisis fue estratificado por tipos de localización hospitalaria, además de análisis de tendencia a través de los 3 años de seguimiento. Resultados: El 65% de los aislamientos son bacterias de la familia enterobacteriaceae y el 11,4% corresponden a Staphylococcus spp., Escherichia coli presenta hasta un 17% de resistencia a cefalosporinas de 3.ª generación mientras que Klebsiella pneumoniae ha incrementado su perfil de resistencia a carbapenémicos hasta un 2,7% en las UCI; Pseudomonas aeruginosa presenta un perfil MDR de hasta el 21% en UCI y salas de hospitalización general. Conclusiones: Existen altas prevalencias de resistencia a los antimicrobianos en la región; se requiere fortalecer estrategias de vigilancia, prevención y control de la resistencia bacteriana en ambientes hospitalarios y de la comunidad.

  16. Evaluación del grado de sellado marginal y resistencia adhesiva de restauraciones de resina compuesta con adhesivo convencional en dentición primaria y definitiva

    OpenAIRE

    Monsalves Bravo, Silvia Isabel; Terrazas Soto, Pedro; Toro Urbina, Georgina; Bader Mattar, Marcelo

    2014-01-01

    El presente estudio evaluó el grado de sellado marginal y resistencia adhesiva de restauraciones de resinas compuestas confeccionadas con un sistema adhesivo de grabado y lavado en dentición primaria y definitiva. Para realizar ambos test se utilizaron 20 piezas primarias y 20 piezas definitivas. En resistencia al cizallamiento, los dientes fueron seccionados longitudinalmente y se les adhirió un cilindro de resina compuesta, utilizando la técnica adhesiva de grabado y lavado para ambas denti...

  17. Use of proton pump inhibitors is associated with increased mortality due to nosocomial pneumonia in bedridden patients receiving tube feeding.

    Science.gov (United States)

    Hamai, Kosuke; Iwamoto, Hiroshi; Ohshimo, Shinichiro; Wakabayashi, Yu; Ihara, Daisuke; Fujitaka, Kazunori; Hamada, Hironobu; Ono, Koichi; Hattori, Noboru

    2018-05-22

    To investigate the association between the use of proton pump inhibitors (PPI) and nosocomial pneumonia and gastrointestinal bleeding in bedridden patients receiving tube feeding. A total of 116 bedridden hospitalized patients receiving tube feeding, of which 80 were supported by percutaneous endoscopic gastrostomy and 36 by nasogastric tube, were included in the present study. The patients were divided into two groups: 62 patients treated with PPI (PPI group) and 54 patients without PPI (non-PPI group). Mortality due to nosocomial pneumonia was evaluated using the Kaplan-Meier approach and the log-rank test. A total of 36 patients (31%) died of nosocomial pneumonia during the observation period; the mortality rate due to nosocomial pneumonia was significantly higher in the PPI group than in the non-PPI group (P = 0.0395). Cox proportional hazard analysis showed that the use of PPI and lower levels of serum albumin were independent predictors of 2-year mortality due to nosocomial pneumonia. Gastrointestinal bleeding was observed in four patients in the non-PPI group (7.7%) and in one patient in the PPI group (1.6%); there was no significant difference between the two groups. The use of PPI in bedridden tube-fed patients was independently associated with mortality due to nosocomial pneumonia, and the PPI group had a non-significant lower incidence of gastrointestinal bleeding than the non-PPI group. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 The Authors Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

  18. A Descriptive Study of Nosocomial Infections in an Adult Intensive Care Unit in Fiji: 2011-12

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    Keshni Naidu

    2014-01-01

    Full Text Available Nosocomial infections in an intensive care unit (ICU are common and associated with a high mortality but there are no published data from the Oceania region. A retrospective study in Fiji’s largest ICU (2011-12 reported that 114 of a total 663 adult ICU admissions had bacteriological culture-confirmed nosocomial infection. The commonest sites of infection were respiratory and bloodstream. Gram negative bacteria were the commonest pathogens isolated, especially Klebsiella pneumoniae (extended-spectrum β-Lactamase-producing, Acinetobacter, and Pseudomonas species. Mortality for those with a known outcome was 33%. Improved surveillance and implementation of effective preventive interventions are needed.

  19. N-CDAD in Canada: Results of the Canadian Nosocomial Infection Surveillance Program 1997 N-CDAD Prevalence Surveillance Project

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    Meaghen Hyland

    2001-01-01

    Full Text Available BACKGROUND: A 1996 preproject survey among Canadian Hospital Epidemiology Committee (CHEC sites revealed variations in the prevention, detection, management and surveillance of Clostridium difficile-associated diarrhea (CDAD. Facilities wanted to establish national rates of nosocomially acquired CDAD (N-CDAD to understand the impact of control or prevention measures, and the burden of N-CDAD on health care resources. The CHEC, in collaboration with the Laboratory Centre for Disease Control (Health Canada and under the Canadian Nosocomial Infection Surveillance Program, undertook a prevalence surveillance project among selected hospitals throughout Canada.

  20. Quorum sensing molecules production by nosocomial and soil isolates Acinetobacter baumannii.

    Science.gov (United States)

    Erdönmez, Demet; Rad, Abbas Yousefi; Aksöz, Nilüfer

    2017-12-01

    Acinetobacter species remain alive in hospitals on various surfaces, both dry and moist, forming an important source of hospital infections. These bacteria are naturally resistant to many antibiotic classes. Although the role of the quorum sensing system in regulating the virulence factors of Acinetobacter species has not been fully elucidated, it has been reported that they play a role in bacterial biofilm formation. The biofilm formation helps them to survive under unfavorable growth conditions and antimicrobial treatments. It is based on the accumulation of bacterial communication signal molecules in the area. In this study, we compared the bacterial signal molecules of 50 nosocomial Acinetobacter baumannii strain and 20 A. baumannii strain isolated from soil. The signal molecules were detected by the biosensor bacteria (Chromobacterium violaceum 026, Agrobacterium tumefaciens A136, and Agrobacterium tumefaciens NTL1) and their separation was determined by thin-layer chromatography. As a result, it has been found that soil-borne isolates can produce 3-oxo-C8-AHL and C8-AHL, whereas nosocomial-derived isolates can produce long-chain signals such as C10-AHL, C12-AHL, C14-AHL and C16-AHL. According to these results, it is possible to understand that these signal molecules are found in the infection caused by A. baumannii. The inhibition of this signaling molecules in a communication could use to prevent multiple antibiotic resistance of these bacteria.

  1. [Nosocomial infection due to Trichosporon asahii in a critical burned patient].

    Science.gov (United States)

    Tamayo Lomas, Luis; Domínguez-Gil González, Marta; Martín Luengo, Ana Isabel; Eiros Bouza, José María; Piqueras Pérez, José María

    2015-01-01

    Invasive fungal infection is an important cause of morbimortality in patients with severe burns. The advances in burn care therapy have considerably extended the survival of seriously burned patients, exposing them to infectious complications, notably fungal infections, with increased recognition of invasive infections caused by Candida species. However, some opportunistic fungi, like Trichosporon asahii, have emerged as important causes of nosocomial infection. A case of nosocomial infection due to T. asahii in a severely ill burned patient successfully treated with voriconazole is presented. The management of invasive fungal infections in burned patients, from diagnosis to selection of the therapeutic protocol, is often a challenge. Early diagnosis and treatment are associated with a better prognosis. In this case report, current treatment options are discussed, and a review of previously published cases is presented. Due to the difficulty in the diagnosis of invasive mycoses and their high associated mortality rates, it is advisable to keep a high degree of clinical suspicion of trichosporonosis in susceptible patients, including burned patients. The isolation of T. asahii in clinical specimens of this type of host must raise clinical alert, since it may precede an invasive infection. Copyright © 2014 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.

  2. Antimicrobial resistance in community and nosocomial Escherichia coli urinary tract isolates, London 2005 – 2006

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    Wareham David W

    2008-06-01

    Full Text Available Abstract Background Escherichia coli is the commonest cause of community and nosocomial urinary tract infection (UTI. Antibiotic treatment is usually empirical relying on susceptibility data from local surveillance studies. We therefore set out to determine levels of resistance to 8 commonly used antimicrobial agents amongst all urinary isolates obtained over a 12 month period. Methods Antimicrobial susceptibility to ampicillin, amoxicillin/clavulanate, cefalexin, ciprofloxacin, gentamicin, nitrofurantoin, trimethoprim and cefpodoxime was determined for 11,865 E. coli urinary isolates obtained from community and hospitalised patients in East London. Results Nitrofurantoin was the most active agent (94% susceptible, followed by gentamicin and cefpodoxime. High rates of resistance to ampicillin (55% and trimethoprim (40%, often in combination were observed in both sets of isolates. Although isolates exhibiting resistance to multiple drug classes were rare, resistance to cefpodoxime, indicative of Extended spectrum β-lactamase production, was observed in 5.7% of community and 21.6% of nosocomial isolates. Conclusion With the exception of nitrofurantoin, resistance to agents commonly used as empirical oral treatments for UTI was extremely high. Levels of resistance to trimethoprim and ampicillin render them unsuitable for empirical use. Continued surveillance and investigation of other oral agents for treatment of UTI in the community is required.

  3. Emergence of Stenotrophomonas maltophilia nosocomial isolates in a Saudi children's hospital. Risk factors and clinical characteristics.

    Science.gov (United States)

    Alqahtani, Jobran M

    2017-05-01

      To describe the clinical characteristics of pediatric patients colonized or infected by Stenotrophomonas maltophilia (S. maltophilia) at a Saudi children's hospital, to identify risk factors associated with infection, and to investigate the antimicrobial resistance patterns of this emerging pathogen.  Methods: In this cross-sectional observational study, 64 non-duplicating S. maltophilia strains were isolated  in Najran Maternity and Children's Hospital, Najran,  Saudi Arabia between January 2015 to February 2016. Antimicrobial susceptibility testing was performed using the reference broth microdilution method.  Results: In this study, 48 (75%) isolates were identified in true infections and 16 (25%) isolates were considered colonization. The main types of S. maltophilia infection were pneumonia in 22 (45.8%) patients and bloodstream infection in 14 (29.2%) patients. The significant risk factors included exposure to invasive procedure (p=0.02), and presence of acute leukemia as an underlying disease (p=0.02). The most active antimicrobials were trimethoprim/sulfamethoxazole (100% sensitivity) and tigecycline (93.7% sensitivity). Conclusions: Stenotrophomonas maltophilia is an emerging nosocomial pathogen among pediatric patients. Accurate identification and susceptibility testing of this emerging pathogen are crucial for the management of infected patients and prevention of spread of this nosocomial pathogen.

  4. [Preliminary result on the nosocomial infection of severe acute respiratory syndrome in one hospital of Beijing].

    Science.gov (United States)

    He, Yao; Jiang, Yong; Xing, Yu-bin; Zhong, Guang-lin; Wang, Lei; Sun, Zheng-ji; Jia, Hong; Chang, Qing; Wang, Yong; Ni, Bin; Chen, Shi-ping

    2003-07-01

    To study the transmission route of severe acute respiratory syndrome (SARS) nosocomial infection. Ten identified SARS patients were selected from a general hospital in March. Survey was carried out through a standardized questionnaire provided by Chinese Center for Disease Control and Prevention. Contents of the questionnaire would include: history of contact with SARS patient, route of infection, methods used for protection and so on. (1) Distribution os SARS patients were confined to 3 wards: 4, 5, and 6 on the 7, 8, 12, 13 and 14 floors in the west unit of the inpatient building. Most of the inpatients were elderly and having severe original diseases. (2) Index patients were the first generation source of transmission and they infected inpatients and medical staff, making them the second generation. People with latent infection who had close contact with SARS patients might also serve as the possible source of transmission. (3) The major transmission routes were: near distant droplet infection and close contact infection. There was also a clue to the probability of aerosol or droplet nuclei infection through air-conditioning and ventilation system. Nosocomial infection appeared to be the main characteristic of the SARS epidemic in the early stage of this hospital. Other than close contact and near space airborne transmission of SARS virus, the possibility of long-distance aerosol transmission called for further epidemiological and experimental studies in the future.

  5. A case of nosocomial Legionella pneumonia associated with a contaminated hospital cooling tower.

    Science.gov (United States)

    Osawa, Kayo; Shigemura, Katsumi; Abe, Yasuhisa; Jikimoto, Takumi; Yoshida, Hiroyuki; Fujisawa, Masato; Arakawa, Soichi

    2014-01-01

    We report the epidemiological investigation of a nosocomial pneumonia case due to Legionella pneumophila linked to a contaminated hospital cooling tower in an immune-compromised patient. A 73-year-old female patient was diagnosed with nosocomial Legionella pneumonia proven by a culture of L. pneumophila serogroup 1 from bronchoalveolar lavage fluid. Two strains isolated from the patient and two strains isolated from two cooling towers were found to be identical using repetitive-sequence-based-PCR with a 95% probability. This Legionella pneumonia case might be caused by aerosol from cooling towers on the roof of the hospital building which was contaminated by L. pneumophila. We increased up the temperature of hot water supply appropriately for prevention of Legionella breeding in an environment of patients' living. On the other hand, as the maintenance of cooling tower, we increased the frequency of Legionella culture tests from twice a year to three times a year. In addition, we introduced an automated disinfectants insertion machine and added one antiseptic reagent (BALSTER ST-40 N, Tohzai Chemical Industry Co., Ltd., Kawasaki, Japan) after this Legionella disease, and thereafter, we have no additional cases of Legionella disease or detection of Legionella spp. from the cooling tower or hot water supply. This case demonstrates the importance of detecting the infection source and carrying out environmental maintenance in cooperation with the infection control team. Copyright © 2013 Japanese Society of Chemotherapy and the Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  6. Inadequate ventilation for nosocomial tuberculosis prevention in public hospitals in Central Thailand.

    Science.gov (United States)

    Jiamjarasrangsi, W; Bualert, S; Chongthaleong, A; Chaindamporn, A; Udomsantisuk, N; Euasamarnjit, W

    2009-04-01

    Forty-two community and general hospitals in central Thailand. To examine the adequacy of indoor ventilation for nosocomial tuberculosis (TB) prevention in public hospitals in central Thailand. A cross-sectional survey was conducted among 323 patient care and ancillary areas in the target hospitals. Data on indoor ventilation rate were collected by the tracer gas method and reported as air changes per hour (ACH). The adequacy of the measured ventilation rates were then determined by comparison with the international recommended standard values. Indoor ventilation rates were inadequate in almost half of the studied areas (144/323, 44.6%). The inadequacy was particularly serious in the emergency rooms (ERs) and radiological areas, where 73.8% (31/42 each) of the rooms had ACH below the recommended standards. Detailed analysis showed that most of the rooms with natural ventilation had air exchange rates that exceeded the recommended standards, while the opposite was the case for rooms with air-conditioning, particularly the window or wall-mount type. Indoor ventilation in high-risk nosocomial TB areas in public hospitals in Thailand was inadequate due to the installation of air-conditioning systems in modern buildings.

  7. [Incidence and risk factors associated with nosocomial infection in pediatric heart surgery].

    Science.gov (United States)

    Duarte-Raya, Fidencia; Baeza-Zarco, Fabiola Janet

    2016-01-01

    Nosocomial infections are responsible for a high rate of morbidity and mortality in pediatric patients undergoing heart surgery. Our objective was to determine the incidence and associated risk factors to nosocomial infections in this group of patients. A descriptive, prospective, clinical study was conducted in a tertiary hospital for a year. We calculated the rate of incidence, accumulated incidence and devices used. Was Applied the EPIDAT 2004 version 3.1 program OPS for obtaining of Chi-square with Yates correction for p with a confidence of 95 %, alpha of 0.05 with a degree of freedom, we calculated odds ratio, besides of the identification of microorganisms, their sensitivity and resistance to antibiotics. We calculated rates of: 45 % the incidence, 80.6 % cumulative incidence, 7.4 % of mortality, 13.3 % of case-fatality rate of infected and 2.7 % non-infected. The 44.4 % with pneumonia, 74 % associated with mechanical ventilation, 100 % nasogastric tube. The most frequently isolated microorganisms are: Acinetobacter baumanni, Staphylococcus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa with high resistance to antibiotics. Pediatric patients undergoing heart surgery have high risk of infection heart disease, cyanogen's have 5 times more risk. We observed a statistically significant association with infection using nasogastric probe and endotracheal tube, the risk increases to increased hospital stay. Infected patients have 4 times the risk of death.

  8. The gene bap, involved in biofilm production, is present in Staphylococcus spp. strains from nosocomial infections.

    Science.gov (United States)

    Potter, Amina; Ceotto, Hilana; Giambiagi-Demarval, Marcia; dos Santos, Kátia Regina Netto; Nes, Ingolf F; Bastos, Maria do Carmo de Freire

    2009-06-01

    This study analyzed ten strains of coagulase-negative staphylococci (CNS) involved in nosocomial infections in three Brazilian hospitals. Their antibiotic susceptibility profile showed that most strains exhibited multiple antibiotic resistance and possessed the mecA gene. The ability of these strains to adhere to polystyrene microtiter plates was also tested and nine of them proved to be biofilm producers at least in one of the three conditions tested: growth in TSB, in TSB supplemented with NaCl, or in TSB supplemented with glucose. The presence of the bap gene, which codes for the biofilm-associated protein (Bap), was investigated in all ten strains by PCR. AU strains were bop-positive and DNA sequencing experiments confirmed that the fragments amplified were indeed part of a bap gene. The presence of the icaA gene, one of the genes involved in polysaccharide intercellular adhesin (PIA) formation, was also detected by PCR in eight of the ten strains tested. The two icaA-negative strains were either weak biofilm producer or no biofilm producer, although they were bop-positive. To our knowledge, this is the first report demonstrating the presence of the bap gene in nosocomial isolates of CNS, being also the first report on the presence of this gene in Staphylococcus haemolyticus and S. cohnii.

  9. Use of 99mTc-Mononuclear Leukocyte Scintigraphy in Nosocomial Fever

    International Nuclear Information System (INIS)

    Gutfilen, B.; Lopes de Souza, S.A.; Martins, F.P.P.; Cardoso, L.R.; Pinheiro Pessoa, M.C.; Fonseca, L.M.B.

    2006-01-01

    Purpose: To determine the overall diagnostic accuracy of mononuclear leukocyte- 99m Tc scintigraphy in the routine detection of infectious lesions and fever of unknown origin (FUO) in inpatients. Material and Methods: The use of mononuclear leukocyte 99m Tc scintigraphy is presented in 87 patients who fulfilled the Durack and Street diagnostic criteria of nosocomial FUO; 66 patients were suspected of having infectious lesions (myocarditis, endocarditis, infected catheters, diabetic foot, and osteomyelitis) and 21 patients presented with unknown causes of FUO. Scans were carried out 1, 3, and 24 h after injection of labeled leukocytes. Results: In three cases (3/27) where scintigraphs were negative, biopsies were positive. There were two (2/87) false-positive scintigrams. We found a 95.8% sensitivity and 92.3% specificity. PPV was 93.8%, PPN 94.7%, and accuracy 94.2%. Conclusion: Mononuclear leukocyte 99m Tc scintigraphy showed high sensitivity, specificity, positive and negative predictive values in patients with nosocomial FUO. These results suggest an important role for nuclear medicine in the management of patients with infection/inflammation

  10. Handwashing: a simple, economical and effective method for preventing nosocomial infections in intensive care units.

    Science.gov (United States)

    Akyol, A; Ulusoy, H; Ozen, I

    2006-04-01

    As most nosocomial infections are thought to be transmitted by the hands of healthcare workers, handwashing is considered to be the single most important intervention to prevent nosocomial infections. However, studies have shown that handwashing practices are poor, especially among medical personnel. This review gives an overview of handwashing in health care and in the community, including some aspects that have attracted little attention, such as hand drying and cultural issues determining hand hygiene behaviour. Hand hygiene is the most effective measure for interrupting the transmission of micro-organisms which cause infection, both in the community and in the healthcare setting. Using hand hygiene as a sole measure to reduce infection is unlikely to be successful when other factors in infection control, such as environmental hygiene, crowding, staffing levels and education, are inadequate. Hand hygiene must be part of an integrated approach to infection control. Compliance with hand hygiene recommendations is poor worldwide. While the techniques involved in hand hygiene are simple, the complex interdependence of factors that determine hand hygiene behaviour makes the study of hand hygiene complex. It is now recognized that improving compliance with hand hygiene recommendations depends on altering human behaviour. Input from behavioural and social sciences is essential when designing studies to investigate compliance. Interventions to increase compliance with hand hygiene practices must be appropriate for different cultural and social needs.

  11. Low Compliance to Handwashing Program and High Nosocomial Infection in a Brazilian Hospital

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    Lizandra Ferreira de Almeida e Borges

    2012-01-01

    Full Text Available Background. It is a fact that hand hygiene prevents nosocomial infection, but compliance with recommended instructions is commonly poor. The purpose of this study was to implement a hand hygiene program for increase compliance with hand hygiene and its relationship with nosocomial infection (NI and MRSA infection/colonization rates. Methods. Compliance to hand hygiene was evaluated in a hospital by direct observation and measured of health care-associated infections, including methicillin resistant Staphylococcus aureus, before and after an educational intervention, using visual poster, colorful stamps, and feedback of the results. Results. Overall compliance did not increase during intervention, only handwashing before and after patient contact has improved from 40% to 76% (=0.01 for HCWs, but NI and MRSA rates remained high and stable. Conclusion. In a combination of high prevalence of NI and low compliance to hand hygiene, the programme of measure does not motivate the HCW hand hygiene. Future interventions should employ incremental evaluation to develop effective hand hygiene initiatives.

  12. [Primary pneumonic plague with nosocomial transmission in La Libertad, Peru 2010].

    Science.gov (United States)

    Donaires, Luis F; Céspedes, Manuel; Valencia, Pedro; Salas, Juan Carlos; Luna, María E; Castañeda, Alex; Peralta, Víctor; Cabezas, César; Pachas, Paul E

    2010-09-01

    Pneumonic plague is one of the clinical forms of plague, of low frequency and high mortality, transmitted by direct inhalation of Yersinia pestis coming from an animal or from person to person. To describe the clinical and epidemiological characteristics of the cases of primary pneumonic plague in an outbreak in the north of Peru. The clinical records of the confirmed cases of primary pneumonic plague presenting in an outbreak occurring in La Libertad, in July 2010, were reviewed, also the search and contact investigation was performed. The index case was identified, as well as three additional cases, out of these, two were nosocomial infections related to the index case. The initial clinical presentation was characterized by sudden onset of fever, chills, myalgia and chest pain, which in less than 24 hours evolved to hypotension and cyanosis. The initiation of specific treatment varied from 2 to 12 days, and cases with prompt initiation of treatment had a better clinical outcome. The lethality was 50% (2/4). Nosocomial transmission of pneumonic plague in Peru is evidenced, with severe clinical manifestations and high lethality.

  13. Use of {sup 99m}Tc-Mononuclear Leukocyte Scintigraphy in Nosocomial Fever

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    Gutfilen, B.; Lopes de Souza, S.A.; Martins, F.P.P.; Cardoso, L.R.; Pinheiro Pessoa, M.C.; Fonseca, L.M.B. [Univ. Federal do Rio de Janeiro (Brazil). Dept. de Radiologia

    2006-09-15

    Purpose: To determine the overall diagnostic accuracy of mononuclear leukocyte-{sup 99m}Tc scintigraphy in the routine detection of infectious lesions and fever of unknown origin (FUO) in inpatients. Material and Methods: The use of mononuclear leukocyte {sup 99m}Tc scintigraphy is presented in 87 patients who fulfilled the Durack and Street diagnostic criteria of nosocomial FUO; 66 patients were suspected of having infectious lesions (myocarditis, endocarditis, infected catheters, diabetic foot, and osteomyelitis) and 21 patients presented with unknown causes of FUO. Scans were carried out 1, 3, and 24 h after injection of labeled leukocytes. Results: In three cases (3/27) where scintigraphs were negative, biopsies were positive. There were two (2/87) false-positive scintigrams. We found a 95.8% sensitivity and 92.3% specificity. PPV was 93.8%, PPN 94.7%, and accuracy 94.2%. Conclusion: Mononuclear leukocyte {sup 99m}Tc scintigraphy showed high sensitivity, specificity, positive and negative predictive values in patients with nosocomial FUO. These results suggest an important role for nuclear medicine in the management of patients with infection/inflammation.

  14. Resistencia de Plasmodium falciparum a tres fármacos antimaláricos en Turbo (Antioquia, Colombia, 1998

    Directory of Open Access Journals (Sweden)

    Blair Silvia

    2001-01-01

    Full Text Available En 1998, se determinó in vivo e in vitro la frecuencia y el grado de resistencia de Plasmodium falciparum a los tres fármacos antimaláricos (cloroquina, amodiaquina y sulfadoxina/ pirimetamina más utilizados en el municipio de Turbo (zona de Urabá, Antioquia, Colombia en una muestra representativa de la población con malaria. Se realizaron análisis clínicos y parasitológicos durante 14 días según la prueba estándar recomendada por la Organización Mundial de la Salud. In vivo, P. falciparum mostró resistencia a la cloroquina, amodiaquina y sulfadoxina/pirimetamina con una frecuencia de 97, 7 y 13%, respectivamente; in vitro, las cifras correspondientes fueron de 21, 23 y 9%, respectivamente. La concordancia entre los resultados in vivo e in vitro fue de 23% para la cloroquina.

  15. Iniciación educativa a la resistencia aeróbica. (I La carrera económica

    Directory of Open Access Journals (Sweden)

    Antonio D. Galera

    2013-09-01

    Full Text Available El autor presenta un conjunto de factores didácticos sistemáticos para la iniciación educativa a la resistencia aeróbica, centrándose en métodos aplicables a la realidad escolar desde una perspectiva sostenible. La doctrina en que se sustenta fue desarrollada por el autor como resultado de su experiencia con un grupo de niños y niñas que participaron en un programa escolar de educación física cooperativa, uno de cuyos contenidos maestros era el desarrollo de la resistencia aeróbica. Los criterios de aplicación didáctica están contemplados desde el ámbito escolar, de primaria o de secundaria, si bien pueden adaptarse a otros ámbitos, como el entrenamiento a cualquier edad, actividades de tiempo libre, etc.

  16. Resistencia al desgaste de recubrimientos Bi/NbC producidos con el sistema sputtering con magnetrón desbalanceado

    OpenAIRE

    Ardila Rodríguez, Laura Angélica

    2013-01-01

    En este trabajo se produjeron películas nano estructuradas de NbC, Bi y bicapas Bi/NbC sobre acero M2 y 316L mediante la técnica Sputtering con magnetrón desbalanceado, y se evaluó su resistencia frente al desgaste por medio del ensayo pin on disc, la adherencia con una prueba de rayado y la resistencia a la corrosión de las películas depositadas sobre los sustratos 316L mediante técnicas electroquímicas. La microestructura de los recubrimientos se analizó mediante Difracción de rayos X, M...

  17. Emergencia de la resistencia antibiótica debida a las β-lactamasas de espectro extendido (BLEE: detección, impacto clínico y epidemiología Emergence of antimicrobial resistance to extended-spectrum β-lactamases (ESBL: detection, clinic impact and epidemiology

    Directory of Open Access Journals (Sweden)

    SALIM< MÁTTAR

    2007-03-01

    Full Text Available RESUMEN La rápida emergencia de la resistencia antimicrobiana debida a las BLEE tiene un impacto significativo en la salud pública. En los últimos 24 años ha suscitado un gran interés el conocimiento acerca de las BLEE, esta explosión de publicaciones abarca a todos los continentes y más de 30 países, actualmente es motivo de preocupación y se considera un problema de salud pública. Las BLEE son enzimas que producen los gram negativos y confieren resistencia a las penicilinas, a todas las cefalosporinas y al aztreonam, pero no a los carbapenems ni a las cefamicinas y la mayoría son inhibidas por el acido clavulanico. En general las BLEE son derivadas de TEM-1, TEM-2 y SHV-1, difieren entre si de sus progenitoras por unos escasos aminoácidos por lo que su filogenia es cercana. Son comúnmente encontradas en E.coli, Klebsiella sp, y P.mirabilis, no obstante, existen otras BLEE que difieren filogenéticamente de TEM y SHV, como las CTX-M, las carbapenemasas tipo OXA y las metalo-β-lactamasas VIM e IMP, típicamente encontradas en especies de P. aeruginosa, Serratia sp and Enterobacter sp. La producción de BLEE en los patógenos de importancia clínica es un problema serio en los pacientes hospitalizados debido a las implicaciones clínicas, terapéuticas y económicas. Las técnicas para la detección de las BLEE van de lo simple con aspectos fenotipicos hasta las pruebas complejas moleculares de geno-detección específica. El objetivo de esta revisión es discutir el impacto clínico y epidemiológico de las BLEE más prevalentes así como las técnicas para su detección y su seguimiento nosocomial.ABSTRACT The rapid emerge of antimicrobial resistance dueto ESBL has a significant impact in public health. In the last 24 years, the study of extendedspectrumβ-lactamases (ESBL has created great interest. This has been documented by publications from all continents and more than 30 countries, and the extent of this problem is a public

  18. Respuestas y adaptaciones de la funci??n y estructura musculares al entrenamiento oclusivo con resistencias de baja intensidad

    OpenAIRE

    Mart??n Hern??ndez, Juan

    2013-01-01

    137 p. Los objetivos de esta tesis doctoral, que se presenta como compendio de publicaciones, fueron: (1) Estudiar las respuestas de la arquitectura muscular a una sola sesi??n de entrenamiento oclusivo y comparar ??stas con las observadas tras una sesi??n de entrenamiento tradicional con resistencias de alta intensidad; (2) Estudiar las adaptaciones de la fuerza din??mica y el grosor muscular a dos vol??menes diferentes de entrenamiento oclusivo; (3) Comparar estos resultados con los obte...

  19. Selección de materiales para la fabricación de hormigones de alta resistencia

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    Alaejos Gutiérrez, María Pilar

    1994-09-01

    Full Text Available The selection of component materials is the first step in order to reach a good quality concrete. The Spanish Code EH-91 point out the different requisites for the component materials used in a normal concrete. However, these requisites may be not sufficient for a high strength concrete (HSC. In this paper we present the tests carried out in order to establish a system for selecting the component materials for a HSC, such us: cements, aggregates, admixtures. The results of the tests allow by means of normal laboratory tests to know the suitability of these materials used for making HCS. The requirements for these component materials must be higher when higher are the strengths to be reached. The exposed method allow us to save a lot of previous laboratory tests necessary until now, in order to get a high strength concrete.

    La selección previa de materiales constituyentes es el primer paso para conseguir un hormigón de calidad. La normativa española EH-91 establece diferentes requisitos que deben cumplir estos materiales para la fabricación de hormigones normales. Sin embargo, estos requisitos pueden no ser suficientes si se trata de fabricar un hormigón de alta resistencia. En el artículo se muestran ensayos realizados con hormigones de alta resistencia, que han permitido establecer una sistemática de selección de materiales constituyentes para estos hormigones: Cementos, áridos y aditivos. Los resultados permiten, mediante ensayos habituales de Laboratorio, conocer la potencial aptitud de estos materiales para la fabricación de hormigones de alta resistencia. Las exigencias deben ser mayores cuanto mayores sean las resistencias que se quieran alcanzar. La metodología expuesta permite ahorrar muchos ensayos previos de Laboratorio que hasta el momento deben realizarse, cuando se quiere conseguir un hormigón de estas características.

  20. Género, cuerpo, poder y resistencia. Un diálogo crítico con Judith Butler

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    Marya Hinira Sáenz Cabezas

    2017-01-01

    Full Text Available El presente artículo dialoga críticamente con la teoría del género y el poder de Judith Butler, con el fin de indagar por las limitaciones en la comprensión de las prácticas de resistencia que se derivan de ella. Para esto se hace uso, por una parte, de la metodología de historias de vida, la cual permite que la reflexión se alimente de cinco experiencias de personas trans; y por la otra, de los desarrollos de la teoría feminista contemporánea. Se sostiene que Butler no responde satisfactoriamente a la pregunta acerca de cuál es la base material que permite la emergencia de las resistencias a las normas de género, y se propone la noción de cuerpo deseante para dar solución a este vacío y explicar por qué las prácticas de resistencia no deben ser pensadas solamente como posibilitadas por los resquicios que deja el poder.

  1. Criterios para estimar la resistencia en macizos rocosos de la zona oriental del país

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    Roberto Watson-Quesada

    2000-03-01

    Full Text Available En el trabajo se presentan los resultados alcanzados por los autores en el estudio de la resistencia de un grupo de macizos rocosos de diferentes minas y túneles subterráneos de la región oriental del país, los que se caracterizan por el grado de afectación estructural que poseen. Inicialmente se dan criterios sobre los principales métodos que hoy son empleados para valorar las características mecánicas en las discontinuidades, y posteriormente entrar a analizar diferentes vías para la estimación de la resistencia en estos macizos rocosos. Como resultado del trabajo se ofrecen expresiones para la estimación de la resistencia en los macizos rocosos estudiados, que son de gran importancia, ya que permiten enfrentar diferentes tareas de proyecto y construcción en las zonas de estudio con una mayor economía y confiabilidad, pero además son posibles de extrapolar a otros macizos rocosos del país.

  2. Iniciación educativa a la resistencia aeróbica. (III Canto en carrera: funciones y asignaciones

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    Antonio D. Galera

    2014-03-01

    Full Text Available El autor presenta un conjunto de factores didácticos sistemáticos para la iniciación educativa a la resistencia aeróbica, centrándose en métodos aplicables a la realidad escolar desde una perspectiva sostenible. La doctrina en que se sustenta fue desarrollada por el autor como resultado de su experiencia con un grupo de niños y niñas que participaron en un programa escolar de educación física cooperativa, uno de cuyos contenidos maestros era el desarrollo de la resistencia aeróbica. Los criterios de aplicación didáctica están contemplados desde el ámbito escolar, de primaria o de secundaria, si bien pueden adaptarse a otros ámbitos, como el entrenamiento a cualquier edad, actividades de tiempo libre, etc. El autor concluye su exposición doctrinal y presenta repertorios de cantos escolares aplicables a su propuesta de interrelación disciplinar entre educación física y educación musical para la iniciación educativa a la resistencia aeróbica desde una perspectiva sostenible.

  3. Aplicación de un sistema para calcular déficit de fuerza resistencia en atletas de fondo

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    Eduardo Valcarce Merayo

    2012-12-01

    Full Text Available Con este estudio se pretende determinar la evolución en la longitud de zancada en atletas de resistencia que no periodizan el entrenamiento de fuerza. En el estudio participaron 6 sujetos varones atletas de resistencia de 31 años (± 4,6 años, con una experiencia deportiva de 14 años (± 4 años que realizaron un entrenamiento interválico donde se determinó la velocidad, frecuencia y amplitud de zancada media de cada repetición a partir de la zona de grabación. El porcentaje de pérdida de amplitud de zancada, medido a través del índice SLS (stride loss strength comparó dicha pérdida de longitud de zancada (cm/m ∙ s–1 entre grupos de repeticiones: Grupo 1 (repeticiones 1-7, Grupo 2 (repeticiones 8-14, Grupo 3 (repeticiones 15-21 observándose un descenso significativo en el índice SLS entre Grupo 2 y el Grupo 3 (p = 0,05. Concluyendo que este indicador es una herramienta específica para determinar posibles déficits de fuerza en este tipo de deportistas, ayudando a entrenadores y atletas que quieran evaluar los niveles de fuerza resistencia en una medición de campo.

  4. MARCADORES MOLECULARES ASOCIADOS CON RESISTENCIA A LA ENFERMEDAD PUNTA MORADA EN PAPA

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    Ferm\\u00EDn Orona-Castro

    2009-01-01

    Full Text Available El objetivo de este trabajo fue identificar marcadores DNA Polimórfico Amplificado al Azar (RAPDs y Secuencias Simples Repetidas (SSR s también conocidos como Mi crosatélites asocia dos con la resistencia al daño causado por fitoplasmas en papa. Se evaluó la severidad de la punta morada de la papa (PMP y la apa rición de color pardo en el tubérculo, así como también se realizaron análisis moleculares en varie dades y líneas avanzadas de papa . El estudio se realizó en el laboratorio de biotecnología de la Facultad de Cie ncia s Biológicas de la Universidad Autónoma de Nuevo León - Instituto Na cional de Investigaciones Forestales Agrícolas y Pecuarias (INI FAP, México en el 2003 y 2004. Las técnicas utilizadas fueron RAPDs y SSRs también conocido microsatélites. Tres genotip os mostraron resistencia a la apa rición del color pardo deltubérculo, mie ntras que del análisis molecular seis materia les formaron un grupo que incluyó los genotip os con valores de daño mínimos (entre uno y tres de la escala. Los genotip os restantes formaron dos grupos con presencia de color pardo en el tubérculo mayor (entre cinco y siete. Se identificaron marcadores moleculares posiblemente asocia dos con tolerancia a la coloración parda del tubérculo. En el análisis de componentes principa les y el dendograma generado los materia les que presentaron menor severidad de daño, quedaron incluidos en un mismo grupo, mie ntras que materia les con mayor severidad de daño quedaron en un grupo diferente

  5. Aplicación de la resistencia de ruido al estudio de pinturas ricas en zinc

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    Espada Recarey, Luis

    2001-02-01

    Full Text Available Electrochemical Noise has been one of the more useful analysis methods to the study the corrosion processes due to the fact that it is simple and cheap. The objective of this work is to check the efficiency of this technique when it is applied to the study of Rich Zinc Paints and specifically the Noise Resistance parameter which is very efficiency to study metal-electrolyte systems. Then this technique was applied to Rich Zinc Paints systems of which we have already information by means of electrochemical impedance spectroscopy. The outcomes of this paper show the efficiency of applying Noise Resistance technique to explain the behavior of this kind of systems. REVISION 34 Obtención de la tenacidad de fractura dinámica de iniciación de materiales elásticos y lineales Determination of dynamic fracture initiation toughness of linear elastic materials

    La medida e interpretación del ruido electroquímico, REQ se está consolidando como uno de los métodos de análisis más utilizados para la interpretación del fenómeno de la corrosión, por su sencillez y bajo coste frente a otros tipos de metodologías del estudio. El objeto de este trabajo es comprobar la eficacia de la técnica de ruido electroquímico aplicada al estudio de las pinturas ricas en zinc, concretamente, en lo relativo al parámetro "resistencia de ruido" que tan eficaz se ha mostrado en el estudio de sistemas metal desnudoelectrolito. Para ello, se aplicó esta técnica de análisis a muestras de pinturas ricas en zinc, de las que ya se poseía información sobre su comportamiento, a través de la aplicación a las mismas muestras de la impedancia electroquímica, EIE. Los resultados de este articulo muestran la eficacia de la aplicación de la resistencia de ruido, a la hora de explicar el comportamiento de este tipo de sistemas.

  6. Resistencia a antimicrobianos y evaluación del tratamiento combinado en la septicemia neonatal

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    María Espino Hernández

    2003-04-01

    Full Text Available OBJETIVOS: Estudiar la resistencia a los antibióticos de las cepas bacterianas aisladas de pacientes con septicemia neonatal en un hospital ginecobstétrico de La Habana, Cuba, en el período comprendido entre enero de 1994 y diciembre de 1998, y evaluar el valor predictivo del método del "tablero de damas" (checkerboard para seleccionar el tratamiento con combinaciones de antibióticos en pacientes graves. MÉTODOS: Se estudió a 229 neonatos, a quienes se les extrajo sangre para hemocultivo y estudios de sensibilidad a antimicrobianos. El estudio de la susceptibilidad de las cepas se realizó por el método de microdilución en caldo y se utilizó el tablero de damas en bandejas de caldo para evaluar la eficacia del tratamiento antimicrobiano combinado. RESULTADOS: Cincuenta por ciento de las cepas aisladas de Staphylococcus spp. coagulasa-negativas y 37% de las cepas de S. aureus, principales agentes causales de sepsis neonatal, fueron resistentes a la meticilina. De ellas, 94,5% resultaron resistentes a varios antibióticos. Cuatro cepas de Staphylococcus spp. coagulasa-negativas y una de Enterococcus faecium fueron resistentes a la vancomicina (concentración mínima inhibidora = 128 myg/mL. Se observó una alta probabilidad de eficacia clínica (P < 0,01 con combinaciones de antibióticos que mostraron un efecto sinérgico in vitro, mientras que las reacciones antagónicas se correspondieron con la probabilidad altamente significativa de fracaso terapéutico clínico. DISCUSIÓN: La principal causa de septicemia neonatal en la Unidad de Cuidados Intensivos del Hospital "América Arias" en La Habana, Cuba, está constituida por las cepas de estafilococo resistentes a la meticilina y a otros antibióticos. En pacientes graves (atendiendo a lo establecido en el programa de política de este centro, la primera línea de tratamiento la constituye la combinación de un antibiótico aminoglucósido con un betalactámico. Este estudio demostr

  7. Ensayos de resistencia a la compresión de bloques de suelo cemento

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    Mas, J. M.

    2011-12-01

    Full Text Available The purpose of this study is to determine the proper dosage for a particular type of soil, which will be used to make soil-cement blocks to build a home in El Puestito, Burruyacu, Tucumán, Argentina. Two soil samples were extracted from studied area and samples of soil-cement specimens, using a mixture of two samples simultaneously and with each one separately. Another variable introduced was the pressure of production. At 28 days, were tested in two ways: first, subjecting them to compression at break and the second tests was made by submerging them in water and weighing them at certain time intervals. The results showed that: increasing the pressure of production, increases resistance to compression, while the absorption decreases. The results also showed that greater amounts of soil 1, enhances the resistance to breakage.

    El objetivo de este trabajo es determinar la dosificación más adecuada para un determinado tipo de suelo, que se utilizará para fabricar bloques de suelo-cemento, para construir una vivienda en El Puestito, Burruyacu, Tucumán, Argentina. Se extrajeron dos muestras de suelo del área estudiada y se fabricaron probetas de suelo-cemento, utilizando la mezcla de dos muestras a la vez y con cada una por separado. Otra variable introducida fue la presión de fabricación. A los 28 días, fueron ensayadas de dos maneras: la primera, sometiéndolas a la compresión hasta la rotura y la segunda, sumergiéndolas en agua, pesándolas en intervalos de tiempos determinados. Los resultados mostraron que: aumentando la presión de fabricación, se aumenta la resistencia a la compresión, mientras que la absorción disminuye. Las dosificaciones con mayor cantidad de suelo 1 con respecto a la de suelo 2, producen un aumento de la resistencia a la rotura.

  8. Sequence Analysis of the Capsid Gene during a Genotype II.4 Dominated Norovirus Season in One University Hospital

    DEFF Research Database (Denmark)

    Holzknecht, Barbara Juliane; Franck, Kristina Træholt; Nielsen, Rikke Thoft

    2015-01-01

    Norovirus (NoV) is a leading cause of gastroenteritis and genotype II.4 (GII.4) is responsible for the majority of nosocomial NoV infections. Our objective was to examine whether sequencing of the capsid gene might be a useful tool for the hospital outbreak investigation to define possible...

  9. Resistencia y susceptibilidad de microorganismos aislados en pacientes atendidos en una institución hospitalaria de tercer nivel, Villavicencio-Colombia, 2012

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    Oscar Alexander Gutiérrez Lesmes

    2015-05-01

    Full Text Available Introducción: La resistencia bacteriana es problema significativo de salud pública y está asociada al uso indiscriminado e irracional de antibióticos, lo que afecta la eficacia de los tratamientos. Objetivo: Estimar la resistencia antimicrobiana a los antibióticos resultado de las pruebas invitro de susceptibilidad en una institución hospitalaria de tercer nivel de Villavicencio, Colombia. Materiales y Métodos: Se realizó un estudio observacional, descriptivo de tipo retrospectivo, análisis univariado, calculando medias de las variables susceptibilidad, resistencia, antibiótico, microorganismos, y tipo de muestra resultados de las pruebas de susceptibilidad realizadas mediante técnica de Kirby-Bauer de 485 pruebas de susceptibilidad de la institución hospitalaria. Resultados y Discusión: Los microorganismos más frecuentemente aislados, fueron: Escherichia coli, Klebsiella pneumoniae ss. Pneumoniae, Staphylococcus aureus ss. Aureus representando el 49% de total de microorganismos, los mayores reportes de resistencia en la pruebas invitro las presentaron Serratia marcescens, Staphylococcus saprophyticus ss. Saprophytic, Enterobacter cloacae, presentan una resistencia media superior al 50%, y una susceptibilidad inferior 40%, la mayor resistencia media se presentó para los siguientes antibióticos, Cefalotina 72,2%, Cefazolina 59,9%, Nitrofurantoina 54,4%, Ceftriaxona 52,7%. Conclusiones: Antibióticos como la Cefalotina, Nitrofurantoina, Cefazolina y Ceftriaxona  pierden su utilidad terapéutica dada la elevada resistencia demostrada por los microorganismos aislados en las pruebas invitro, es necesario reforzar las medidas de uso adecuado de antibióticos para disminuir la posibilidad de adaptación y resistencia a los mismos,  el fenómeno de resistencia bacteriana ocurre fuera del ámbito hospitalario evidenciando la necesidad de iniciar también control y vigilancia en infecciones ocurridas en la comunidad.Cómo citar este

  10. Resistencia a la insulina y cambios metabólicos en adultos obesos Insulin resistance and metabolic changes in obese adults

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    Raúl Fernández Regalado

    2011-08-01

    Full Text Available Introducción: la relación obesidad-resistencia insulínica-diabetes mellitus-hipertensión arterial adquiere cada día mayor importancia, por el papel cada vez más relevante de la obesidad en el desarrollo de cada una de ellas. Los obesos constituyen alrededor de 20 a 30 % de la población cubana, y esta enfermedad o condición patológica cada día se torna un problema más importante. Objetivo: estudiar la relación entre el grado de obesidad y la resistencia a la insulina en sujetos obesos, así como posibles cambios en el metabolismo lipídico y de compuestos nitrogenados. Métodos: se realizó un estudio observacional con individuos adultos obesos de ambos sexos entre 18 y 60 años de edad, atendidos en el Instituto Nacional de Endocrinología en el período comprendido entre 2006 y 2008. También fueron incluidos sujetos aparentemente sanos, normopesos, seleccionados en instituciones de salud de la atención primaria del municipio Plaza. Todos los sujetos (N=214 fueron clasificados en 4 grupos: normopesos (IMC entre 18,5 y 24,9, preobesos I (IMC entre 25 y 29,9, obeso grado II (IMC de 30 a 34,9, obeso grado III (IMC de 35 a 39,9. Además del examen clínico y mediciones antropométricas se tomó una muestra de sangre en ayunas para determinar en el suero los analitos siguientes: glucemia, insulina, colesterol total, triglicéridos, creatinina y ácido úrico. Se calculó además la resistencia a la insulina a partir de la glucemia y la cifra de insulinemia según el índice HOMA. Resultados: se observó una asociación significativa entre la circunferencia abdominal y el índice de masa corporal con el valor del índice resistencia a la insulina. Además, esta mostró una correlación significativa (pIntroduction: the relation obesity-insulin resistance-diabetes mellitus-high blood pressure is more and more significant due to the more relevant role of obesity in the development of each of them. The obese persons are about the 20 to 30

  11. Mutaciones que seleccionan para resistencia a antirretrovirales y presencia de resistencia en subtipos del VIH-1 diferentes a subtipo B en pacientes con infección crónica sin tratamiento previo

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    Henry Balaguera

    2004-03-01

    Full Text Available

    El desarrollo de la terapia antirretroviral altamente efectiva, la cual inhibe las enzimas virales reversa transcriptasa y proteasa ha transformado dramáticamente la historia natural de la infección por el virus de la inmunodeficiencia humana tipo – 1 (VIH –1 produciendo como resultado una disminución tanto de la morbilidad como de la mortalidad asociada con esta infección (1. La falla para suprimir completamente la replicación viral podría permitir el desarrollo de cambios genotípicos en el VIH-1, los cuales se asocian con la aparicion de la resistencia a cada uno de las tres principales clases de antirretrovirales disponibles (2.

    La prevalencia de resistencia genotípica primaria del VIH-1 subtipo B contra al menos un compuesto antirretroviral es común, entre el 12 % y el 25 % en Estados Unidos (3 y se considera es mayor en pacientes recientemente infectados que en pacientes infectados crónicamente (infección mayor de 6 meses. Sin embargo, existe muy poca información acerca de la prevalencia de resistencia primaria en pacientes con VIH crónicamente infectados y quienes no han estado expuestos a previo tratamiento antirretroviral. Esta resistencia la cual está mediada por mutaciones en el gen de la polimerasa viral (pol, causa disminución de la susceptibilidad de los medicamentos antirretrovirales in vitro y está asociada con falla terapéutica. Una cohorte de pacientes adultos que reciben cuidado médico en un hospital en Boston, fue tamizada para detectar mutaciones en el genoma del VIH-1 y determinar el subtipo de virus circulante de pacientes que nunca habían recibido tratamiento con antirretrovirales (4. Mutaciones asociadas con resistencia a antirretrovirales fue identificada en 18% de 88 pacientes.

    Resistencia

  12. Diarréia nosocomial em unidade de terapia intensiva: incidência e fatores de risco Nosocomial diarrhea in the intensive care unit: incidence and risk factors

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    Sérvulo Luiz Borges

    2008-06-01

    Full Text Available RACIONAL: Diarréia nosocomial parece ser comum em unidades de terapia intensiva, embora sua epidemiologia seja pouco documentada em nosso meio. OBJETIVO: Determinar a incidência e fatores de risco de diarréia entre pacientes adultos internados em unidade de terapia intensiva. MÉTODOS: Foram incluídos prospectivamente 457 pacientes no período entre outubro de 2005 e outubro de 2006. Dados demográficos, clínicos e bioquímicos, bem como aspecto e número de evacuações eram registrados diariamente até a saída do paciente do setor. RESULTADOS: Diarréia ocorreu em 135 (29,5% pacientes, durando em média 5,4 dias. O tempo do seu início em relação à internação foi de 17,8 dias e casos similares de diarréia no mesmo período foram registrados em 113 (83,7% pacientes. A mortalidade hospitalar foi maior nos pacientes com diarréia do que naqueles sem esta intercorrência. Na análise multivariada através de modelo de regressão logística, apenas o número de antibióticos (OR 1,65; IC 95% = 1,39-1,95 e o número de dias de antibioticoterapia (OR 1,16; IC 95% = 1,12-1,20 associaram-se estatisticamente com a ocorrência de diarréia. Cada dia de acréscimo a mais da antibioticoterapia aumentou em 16% o risco de diarréia (IC 12% a 20%, enquanto a adição de um antibiótico a mais ao esquema antimicrobiano aumentou as chances de ocorrência de diarréia em 65% (IC 39% a 95%. CONCLUSÃO: A incidência de diarréia nosocomial na unidade de terapia intensiva é elevada (29,5%. Os principais fatores de risco para sua ocorrência foram número de antibióticos prescritos e duração da antibioticoterapia. Além das precauções entéricas, a prescrição judiciosa e limitada de antimicrobianos, provavelmente reduzirá a ocorrência de diarréia neste setor.BACKGROUND: Nosocomial diarrhea seems to be common at intensive care units, although its epidemiology be poorly documented in Brazil. AIM: To determine the incidence and risk factors of

  13. Application of protein typing in molecular epidemiological investigation of nosocomial infection outbreak of aminoglycoside-resistant Pseudomonas aeruginosa.

    Science.gov (United States)

    Song, Min; Tang, Min; Ding, Yinghuan; Wu, Zecai; Xiang, Chengyu; Yang, Kui; Zhang, Zhang; Li, Baolin; Deng, Zhenghua; Liu, Jinbo

    2017-12-16

    Pseudomonas aeruginosan has emerged as an important pathogen elated to serious infections and nosocomial outbreaks worldwide. This study was conducted to understand the prevalence of aminoglycoside (AMG)-resistant P. aeruginosa in our hospital and to provide a scientific basis for control measures against nosocomial infections. Eighty-two strains of P. aeruginosa were isolated from clinical departments and divided into AMG-resistant strains and AMG-sensitive strains based on susceptibility test results. AMG-resistant strains were typed by drug resistance gene typing (DRGT) and protein typing. Five kinds of aminoglycoside-modifying enzyme (AME) genes were detected in the AMG-resistant group. AMG-resistant P. aeruginosa strains were classified into three types and six subtypes by DRGT. Four protein peaks, namely, 9900.02, 7600.04, 9101.25 and 10,372.87 Da, were significantly and differentially expressed between the two groups. AMG-resistant P. aeruginosa strains were also categorised into three types and six subtypes at the distance level of 10 by protein typing. AMG-resistant P. aeruginosa was cloned spread in our hospital; the timely implementation of nosocomial infection prevention and control strategies were needed in preventing outbreaks and epidemic of AMG-resistant P. aeruginosa. SELDI-TOF MS technology can be used for bacterial typing, which provides a new method of clinical epidemiological survey and nosocomial infection control.

  14. A Model of the Costs of Community and Nosocomial Pediatric Respiratory Syncytial Virus Infections in Canadian Hospitals

    Directory of Open Access Journals (Sweden)

    Philip Jacobs

    2013-01-01

    Full Text Available BACKGROUND: Approximately one in 10 hospitalized patients will acquire a nosocomial infection (NI after admission to hospital, of which 71% are due to respiratory viruses, including the respiratory syncytial virus (RSV. NIs are concerning and lead to prolonged hospitalizations. The economics of NIs are typically described in generalized terms and specific cost data are lacking.

  15. Typing of vancomycin-resistant enterococci with MALDI-TOF mass spectrometry in a nosocomial outbreak setting

    DEFF Research Database (Denmark)

    Holzknecht, B J; Dargis, R; Pedersen, M

    2018-01-01

    OBJECTIVES: To investigate the usefulness of matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) typing as a first-line epidemiological tool in a nosocomial outbreak of vancomycin-resistant Enterococcus faecium (VREfm). METHODS: Fifty-five VREfm isolates...

  16. Caracterización de las infecciones nosocomiales Characterization of nosocomial infections

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    Lucía López Méndez

    2013-04-01

    Full Text Available Introducción: las infecciones nosocomiales constituyen un importante problema de salud relacionado con la calidad de la atención y la eficacia del trabajo. Objetivo: caracterizar las infecciones nosocomiales en el Hospital Pediátrico Provincial Docente "Pepe Portilla" durante el período 2010-2011. Material y método: se realizó una investigación observacional, descriptiva, transversal y aplicada. El universo estuvo conformado por los 22652 egresados y la muestra por los 516 casos. Para la obtención de la información se revisaron los registros del departamento de estadística y las historias clínicas, utilizándose para su análisis las frecuencias absolutas, relativas porcentuales y la prueba de X² al 95 % de certeza. Resultados: el sistema respiratorio es el sitio de mayor localización, donde predominaron los hemocultivos negativos. Los gérmenes más aislados fueron: el Staphylococcus epidermidis, la Pseudomonas sp y el Acinetobacter, entre otros. Conclusiones: las infecciones nosocomiales en pediatría constituyen una problema de salud que requiere el fortalecimiento de las actividades de prevención y control, con especial énfasis en su vigilancia sistemática.Introduction: nosocomial infections constitute an important problem related to the quality and efficiency of the health services. Objective: to characterize nosocomial infections at “Pepe Portilla” Provincial Children Hospital during 2010-2011. Material and method: an observational, descriptive, cross-sectional and applied research was conducted, which target group was comprised of 22652 patients discharged from the hospital and the sample included 516 patients. To collect the information, the records of the statistics department and the clinical histories were reviewed; where absolute frequencies and relative percentages plus chi square test up to 95% of certainty were used to complete its analysis. Results: respiratory tract was the most affected site, where negative

  17. Introgresión de la resistencia al deterioro fisiológico poscosecha en yuca

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    Sánchez Teresa

    2010-06-01

    Full Text Available Se evaluó una población de medios hermanos (B1PD280 proveniente del cruzamiento del parental resistente al deterioro fisiológico poscosecha (DFP CW429-1 (Manihot esculenta x M. walkerae, y ocho genotipos élite utilizados como padres recurrentes susceptibles. Se evaluaron cinco raíces por genotipo, 7 y 14 días después de la cosecha (d.d.c. mediante una escala (0 - 100%. Los resultados mostraron reducción significativa de DFP (entre 10% y 46% en relación con los parentales recurrentes. Cincuenta y un genotipos tuvieron alto y medio nivel de resistencia (0 - 35%, 22% y 20% de ellos correspondieron a individuos sin síntomas 7 o 14 d.d.c., respectivamente. Se estableció una posible correlación entre DFP (14 d.d.c. y escopoletina (0.523, P < 0.001 y materia seca (0.288, P < 0.001.

  18. El Pop como expresión gráfica de la resistencia cultural catalana

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    María Àngels Fortea Castillo

    2017-06-01

    Full Text Available En los años sesenta, en Cataluña (España una de las formas de oposición pacífica contra la dictadura de Franco y sus directrices culturales fue la puesta en marcha de una renovada industria cultural. Como resultado se asistió a la aparición de una importante producción cultural en lengua catalana de gran calidad, al punto que el estilo Pop se convirtió, en el año 1968, en la expresión gráfica de la resistencia cultural. Las discográficas de nuevo cuño, fundadas en el momento en que la canción popular se convirtió en el mejor medio de difusión del catalán, fueron las primeras en aplicar los rasgos del Pop, de clara influencia norteamericana, evolucionando con el tiempo hacia una versión autóctona que recuperó la tradición gráfica de Cataluña.

  19. CASOS SELECTOS DE RESISTENCIA A INSECTICIDAS EN MOSCAS BLANCAS (Hemiptera: Aleyrodidae EN EL MUNDO

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    Macías-flores A

    2013-01-01

    Full Text Available Las moscas blancas (Hemíptera: Aleyrodidae son un problema a escala global. En México, llamó la atención como plaga agrícola en la década de los años 80´s y 90´s del siglo pasado por las pérdidas económicas que ocasionaron en los cultivos agrícolas, debido a los daños directos por la succión de savia y a los daños indirectos por la transmisión de enfermedades de origen viral. El hombre en su intento fallido por erradicarlas ha hecho uso desmedido de insecticidas químicos, quizás por su accesibilidad por costo bajo o por efectos de control inmediatos, por lo cual ha causado daño al medio ambiente y a la salud humana, con la consecuencia de desarrollo de resistencia. En un intento por disminuir los efectos de tales sustancias, muchas investigaciones alrededor del mundo se han conducido para encontrar productos insecticidas más efectivos con el menor impacto ambiental y a la salud humana, y que contribuyan a incrementar las herramientas de control disponibles en los sistemas de producción agrícola.

  20. PROYECTOS, RESISTENCIAS Y ALTERNATIVAS AL NEOLIBERALISMO. EL FORO SOCIAL MUNDIAL DE PORTO ALEGRE

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    Jaime Preciado Coronado

    2003-01-01

    Full Text Available Después de las movilizaciones de Seattle, la integración y la mundialización del comercio y las finanzas se topan con actores que tienen distintos grados de exclusión en esos procesos, lo cual cuestiona las identidades ciudadanas complejas que emergen más allá de lo nacional, obstaculiza las identidades cosmopolitas inclusivas que se plantean como alternativas mundiales a la globalización y acentúa la crisis de gobernabilidad del modelo democrático tradicional. Un conjunto de actores heterogéneos formados por tendencias políticas disímbolas (anarquistas, trotskistas, socialistas, entre las principales, de movimientos identitarios de afirmación ciudadana, defensa del ambiente y de reivindicaciones multiculturales (ecologistas, minorías étnicas y sexuales, etcétera de agrupaciones sindicales del campo y la ciudad, de organismos eclesiales de base territorial, de asociaciones defensoras de los derechos humanos; actores que enfrentan desde dos perspectivas la difusión globalifílica del modelo neoliberal: la negación total y la resistencia contra la globalización (globalifóbicos, o la construcción de alternativas de base frente a los efectos perversos de aquella (globalicríticos, que prefiguran la democracia deliberativa como un sistema de gestión complejo desde abajo.

  1. Kinetic bed therapy to prevent nosocomial pneumonia in mechanically ventilated patients: a systematic review and meta-analysis.

    Science.gov (United States)

    Delaney, Anthony; Gray, Hilary; Laupland, Kevin B; Zuege, Danny J

    2006-01-01

    Nosocomial pneumonia is the most important infectious complication in patients admitted to intensive care units. Kinetic bed therapy may reduce the incidence of nosocomial pneumonia in mechanically ventilated patients. The objective of this study was to investigate whether kinetic bed therapy reduces the incidence of nosocomial pneumonia and improves outcomes in critically ill mechanically ventilated patients. We searched Medline, EMBASE, CINAHL, CENTRAL, and AMED for studies, as well as reviewed abstracts of conference proceedings, bibliographies of included studies and review articles and contacted the manufacturers of medical beds. Studies included were randomized or pseudo-randomized clinical trials of kinetic bed therapy compared to standard manual turning in critically ill mechanically ventilated adult patients. Two reviewers independently applied the study selection criteria and extracted data regarding study validity, type of bed used, intensity of kinetic therapy, and population under investigation. Outcomes assessed included the incidence of nosocomial pneumonia, mortality, duration of ventilation, and intensive care unit and hospital length of stay. Fifteen prospective clinical trials were identified, which included a total of 1,169 participants. No trial met all the validity criteria. There was a significant reduction in the incidence of nosocomial pneumonia (pooled odds ratio (OR) 0.38, 95% confidence interval (CI) 0.28 to 0.53), but no reduction in mortality (pooled OR 0.96, 95%CI 0.66 to 1.14), duration of mechanical ventilation (pooled standardized mean difference (SMD) -0.14 days, 95%CI, -0.29 to 0.02), duration of intensive care unit stay (pooled SMD -0.064 days, 95% CI, -0.21 to 0.086) or duration of hospital stay (pooled SMD 0.05 days, 95% CI -0.18 to 0.27). While kinetic bed therapy has been purported to reduce the incidence of nosocomial pneumonia in mechanically ventilated patients, the overall body of evidence is insufficient to support this

  2. Evaluación de marcadores moleculares asociados con resistencia a gota (Phytophthora infestans L. en papas diploides y tetraploides

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    D. K. Juyó

    2011-07-01

    Full Text Available Título en ingles: Evaluation of molecular markers associated with resistance to late blight (Phytophthora infestans L.  in diploid and tetraploid potatoes Resumen La papa, cultivo de importancia a nivel mundial es gravemente afectado por gota, enfermedad ocasionada por el oomycete Phytophthora infestans. Actualmente la forma más efectiva para combatir la enfermedad es mediante el desarrollo de cultivares resistentes al patógeno. Para esto, una estrategia es identificar genes que confieran resistencia al patógeno, para lo cual se buscan marcadores asociados con el carácter de resistencia. En este estudio se evaluaron marcadores moleculares tipo SCAR (Sequence Characterized Amplified Region: CosA, GP179, BA47f2 y Prp1 asociados con resistencia a P. infestans y el gen de resistencia R1, en 22 cultivares tetraploides pertenecientes a la subespecie andigena y cinco especies silvestres. Se evaluó el polimorfismo y se determinó si los alelos polimórficos permitían diferenciar genotipos resistentes de susceptibles. Se comparó el  tamaño de los fragmentos obtenidos con los fragmentos esperados asociados con resistencia de acuerdo a reportes. El análisis se realizó considerando presencia/ausencia de los fragmentos: CosA210, CosA250, R11400, R11800, BA47f2500, GP179570, Prp1300, Prp1600, y Prp1900. Los resultados indicaron que en los cultivares tetraploides y silvestres, se presentaron polimorfismos en todos los marcadores evaluados, con excepción del marcador GP179. No se encontró correlación entre el rasgo de resistencia y los alelos. Los resultados de este estudio muestran que hay repuesta diferencial a los marcadores entre las subsp. tuberosum y subsp. Andigena.   Palabras clave: Phytophthora infestans, resistencia a gota, marcadores diagnóstico, Solanum tuberosum subsp. Andigena. Abstract Potato is an important worldwide crop seriously affected by late blight disease caused by the oomycete Phytophthora infestans. Currently, the

  3. Nosocomial infections and antibiotic resistance pattern in open-heart surgery patients at Imam Ali Hospital in Kermanshah, Iran.

    Science.gov (United States)

    Heydarpour, Fatemeh; Rahmani, Youssef; Heydarpour, Behzad; Asadmobini, Atefeh

    2017-01-01

    Background: Patients undergoing open heart surgery have a relatively high risk of acquiring nosocomial infections. The development of antibiotic-resistant infections is associated with prolonged hospital stays and mortalities. Objectives: The present study was conducted to investigate nosocomial infections and the antibiotic resistance pattern in bacteria causing these infections in open heart surgery patients at Imam Ali Hospital in Kermanshah in the west of Iran over a 4-year period from March 2011 to March 2014. Materials and methods: The present cross-sectional study was conducted on 135 cases of nosocomial infection among open heart surgery patients. The demographic characteristics and the risk factors of each case of infection were recorded. The antibiotic susceptibility test was carried out using the Minimum Inhibitory Concentration (MIC) method based on the Clinical and Laboratory Standards Institute (CLSI) protocol. The data collected were then analyzed in SPSS-16. Results: Out of the 6,000 patients who underwent open heart surgery during this 4-year period at the selected hospital, nosocomial infections developed in 135 patients (2.25%), 59.3% of whom were female and 40.7% male. Surgery site infection (SSI), pneumonia (PNEU), urinary tract infection (UTI) and blood stream infection (BSI) affected 52.6%, 37%, 9.6% and 0.8% of the cases, respectively. E.coli , Klebsiella spp. and S. aureus were the most common bacteria causing the nosocomial infections. E. coli was most frequently resistant to imipenem (23.3%) Klebsiella spp. to gentamicin (38.5%) S. aureus to co-trimoxazole (54.2%). Conclusion: SSI had a high prevalence in this study. Further studies should therefore be conducted to examine the risk factors associated with SSI in open heart surgery. Various studies have shown that antibiotic resistance patterns are different in different regions. Finding a definitive treatment therefore requires an antibiogram.

  4. La infección nosocomial. Un reto en las unidades de cuidados intensivos

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    Edwin Javier Gordon Zamora

    2018-01-01

    Full Text Available El estudio de la infección nosocomial en las unidades de cuidados intensivos deviene eje central de la asistencia médica y, un pilar del control de su calidad. Estas unidades asumen un elevado número de pacientes críticamente enfermos con comorbilidad, compromiso inmunológico y en contacto con dispositivos invasivos, factores estos que condicionan la diseminación de bacterias multirresistentes, por lo cual se requiere vigilancia e implementación eficiente de las medidas de prevención y control. En este trabajo se intenta abrir el debate en torno a un reto en las unidades de cuidados intensivos: las infecciones nosocomiales.

  5. Recognition and Prevention of Nosocomial Malnutrition: A Review and A Call to Action!

    Science.gov (United States)

    Kirkland, Lisa L; Shaughnessy, Erin

    2017-12-01

    Nosocomial malnutrition in hospitalized adults is a morbid, costly, and potentially preventable and treatable problem. Although recognized as contributing to many serious complications of hospitalization, malnutrition is often missed when present on admission and rarely diagnosed if it occurs during hospital stay. Many routine clinical practices such as holding nutrition for testing or failing to address poor intake, when added to acute inflammatory disease states, cause rapid deterioration in nutritional status in up to 70% of inpatients. Malnutrition during hospitalization is associated with increased mortality for years after discharge. In addition, unrecognized (and under-coded) malnutrition is associated with potential lost revenues for hospital systems. Low-cost interventions of recognizing at-risk patients and providing adequate nutrition have the potential to improve patient outcomes and reduce health care costs. Physicians must champion implementation of these interventions, using guidance from national organizations. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. [Epidemic of Staphylococcus aureus nosocomial infections resistant to methicillin in a maternity ward].

    Science.gov (United States)

    Le Coq, M; Simon, I; Sire, C; Tissot-Guerraz, F; Fournier, L; Aho, S; Noblot, G; Reverdy, M E; Françoise, M

    2001-02-01

    Methicillin-resistant Staphylococcus aureus (MRSA) nosocomial infections frequently occur in the hospital environment, but their incidence is less often observed in neonates. In the present investigation, seventeen cases were recorded over a nine-week period (two cases per week). Pulsed field gradient gel electrophoresis confirmed the clonal character of the strain. The hypothesis of manually-transmitted infection due to contamination from multiple sources was reinforced by the fact the epidemic persisted in spite of the elimination of the main human infectious source and an absence of risk factors determined by the case-control study. The role of environmental factors in the persistence of this outbreak of MRSA infection has been considered.

  7. THE STUDY OF ANTIBIOTIC- AND FAGOSENSITIVITY OF NOSOCOMIAL STRAINS BACTERIA ISOLATED FROM TRANSPLANTED PATIENTS

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    N. I. Gabrielan

    2011-01-01

    Full Text Available Antibiotic and fagosensitivity most etiologically important nosocomial strains of bacteria – Pseudomonas aeru- ginosa, Klebsiella pneumoniae, E. coli, Proteus spp., Staphylococcus spp. were studied. Multiple drug-resistant bacteria as gram-positive and gram-negative, isolated from 8 substrates, had been demonstrated. With regard to the sensitivity of Pseudomonas aeruginosa >40% was observed in 40–50% of the strains to aminoglycosides – aztreonam, amikacin, netilmicin, and only 23–25% of the strains – to gentamicin and levofloxacin (an average of antibiotic susceptibility was 27%. All strains of ESBL Klebsiella drew up and were sensitive only to imipenem, meropenem and aminoglycosides. Specific phages lysed 43–48% of the strains Pseudomonas aeruginosa and Klebsiella pneumoniae, E. coli, Pro- teus spp., multidrug resistant strains of Staphylococcus spp. It is proposed to introduce the use of phages in clinical practice. 

  8. Presencia de B-lactamasas de espectro extendido en enterobacterias aisladas de casos de infección nosocomial

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    Sergio Pavón Romero

    2011-01-01

    Full Text Available Las enterobacterias son los microorganismos etiologicos mas frecuentemente asociados a las infecciones nosocomiales (in, caracterizandose por su alta resistencia a los antibioticos B-lactamicos, mediada por la produccion de B-lactamasas de Espectro Extendido (blee. Su uso excesivo aumenta la seleccion de cepas multirresistentes, favoreciendo su propagacion e incremento de las complicaciones de casos de in. En algunos casos las cepas productoras de blee presentan resistencia adicional a aminoglucosidos, quinolonas, tetraciclinas y trimetoprim-sulfametoxazol, reduciendo las opciones terapeuticas de las in. Con la finalidad de conocer localmente la magnitud de este problema, se estudiaron 87 cepas de enterobacterias aisladas de casos de in, encontrandose que el 26.43% son productoras de blee y en este caso fenotipicamente multirresistentes.

  9. [Analysis of the factors influencing the internal reporting of nosocomial infections. A review of 108 notifications].

    Science.gov (United States)

    Penel, N; Fournier, C; Roussel-Delvallez, M; Deberles, M-F; Buisset, E; Cazin, J-L; Leclercq, B

    2003-11-29

    Since July 26, 2001, the external reporting to the regional office of health and social affairs (Direction départementale des affaires sanitaires et sociales--Ddass) and the coordination centre (Comité de lutte contre les infections nosocomiales--Cclin) for the fight against nosocomial infections (NI) is mandatory. However, the modalities of internal reporting to the Clin are unknown. We performed a retrospective analysis of 108 cases of NI reported over 23 months in 4 medical-surgical departments (MSD) with 14 to 35 NI reported/MSD. The distribution of the bacteria responsible was compared with that of the local epidemiological state (chi2 test). A correlation analysis was performed between the number of NI reported in each MSD and the structural characteristics and activity index of these MSD (Spearmann's correlation test). The NI were predominantly infections related to a catheter (43), lower respiratory tract (25) and infection of the site of surgery (19). Ninety were documented biologically, among which 10 implied multi-resistant bacteria. Ninety-four NI were associated with the prescription of an antibiotic. Compared with the local epidemiological state, the NI reported generally implied multi-resistant bacteria (p=0.009). The other microbiological data had little implication. In each of the MSD, the number of cases reported was independent of: the global activity, the number of interventions, the mean duration of hospitalisation, the number of beds, the number of clinicians, the number of new patients managed and the chemotherapy outpatient activity. Conversely, there was a strong correlation between the global consumption of antibiotics (r=0.78), and the number of the Clin members in each MSD DMC (r=0.82). In each MSD, the internal reporting of NI relies on the discovery of multi-resistant bacteria, but above all on the implication of those involved in the fight against nosocomial infections.

  10. Molecular mechanisms associated with nosocomial carbapenem-resistant Acinetobacter baumannii in Mexico.

    Science.gov (United States)

    Alcántar-Curiel, María Dolores; García-Torres, Luis Francisco; González-Chávez, María Inés; Morfín-Otero, Rayo; Gayosso-Vázquez, Catalina; Jarillo-Quijada, Ma Dolores; Fernández-Vázquez, José Luis; Giono-Cerezo, Silvia; Rodríguez-Noriega, Eduardo; Santos-Preciado, José Ignacio

    2014-10-01

    Acinetobacter baumannii is an emerging pathogen worldwide that is most commonly associated with nosocomial infections and multi-drug resistance. In the present study we determined the mechanisms of carbapenem resistance and clonal diversity of A. baumannii nosocomial isolates in Hospital Civil de Guadalajara, Mexico. A total of 303 clinical isolates of A. baumannii identified during a period expanding from 2004-2011 were analyzed for carbapenem resistance using several microbiological and molecular methods. Clonal relatedness of these isolates was determined using pulsed-field gel electrophoresis. Of the 303 isolates, 84% were resistant to meropenem, 71.3% to imipenem and 78.3% the resistant isolates were positive for metallo-β-lactamases as determined by the phenotypic assay. In addition, 49.6% of carbapenem-intermediate or -resistant isolates carried the blaOXA-72 gene and 1.2% carried the blaVIM-1 gene. Efflux pump phenotype was responsible for reduced susceptibility to meropenem in 14.5% and to imipenem in 31.6% of the resistant isolates, respectively in the presence of the efflux pump inhibitor, carbonyl cyanide 3-chlorophenylhydrazone. Strains representing different carbapenem-resistant patterns exhibited reduced expression of 22, 29, 33, and 43 kDa OMPs. Among the bacterial collection studied, 48 different clones were identified, two of which were predominant and persistently transmitted. Carbapenemase production in combination with efflux pump expression, reduction in OMPs expression and the cross-transmission of clones appear to be major contributors to the high frequency of carbapenem-resistance observed in A. baumannii. To our knowledge, this is the first study to define the molecular mechanisms associated with carbapenem-resistance in A. baumannii in Mexico. Copyright © 2014 IMSS. Published by Elsevier Inc. All rights reserved.

  11. Nutritional status and nosocomial infections among adult elective surgery patients in a Mexican tertiary care hospital.

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    Judith Rodríguez-García

    Full Text Available Controversy exists as to whether obesity constitutes a risk-factor or a protective-factor for the development of nosocomial Infection (NI. According to the obesity-paradox, there is evidence that moderate obesity is a protective-factor. In Mexico few studies have focused on the nutritional status (NS distribution in the hospital setting.The aim of this study was to estimate the distribution of NS and the prevalence of nosocomial infection NI among adult elective surgery (ES patients and to compare the clinical and anthropometric characteristics and length of stays (LOS between obese and non-obese patients and between patients with and without NI.We conducted a cross-sectional study with a sample (n = 82 adult ES patients (21-59 years old who were recruited from a tertiary-care hospital. The prevalences of each NS category and NI were estimated, the assessments were compared between groups (Mann-Whitney, Chi-squared or the Fisher's-exact-test, and the association between preoperative risk-factors and NI was evaluated using odds ratios.The distribution of subjects by NS category was: underweight (3.66%, normal-weight (28.05%, overweight (35.36%, and obese (32.93%. The prevalence of NI was 14.63%. The LOS was longer (p<0.001 for the patients who developed NI. The percentages of NI were: 33.3% in underweight, 18.52% in obese, 17.39% in normal-weight, and 6.90% in overweight patients.The prevalence of overweight and obesity in adult ES patients is high. The highest prevalence of NI occurred in the underweight and obese patients. The presence of NI considerably increased the LOS, resulting in higher medical care costs.

  12. Nosocomial Transmission of C. difficile in English Hospitals from Patients with Symptomatic Infection

    Science.gov (United States)

    van Kleef, Esther; Gasparrini, Antonio; Guy, Rebecca; Cookson, Barry; Hope, Russell; Jit, Mark; Robotham, Julie V.; Deeny, Sarah R.; Edmunds, W. John

    2014-01-01

    Background Recent evidence suggests that less than one-quarter of patients with symptomatic nosocomial Clostridium difficile infections (CDI) are linked to other in-patients. However, this evidence was limited to one geographic area. We aimed to investigate the level of symptomatic CDI transmission in hospitals located across England from 2008 to 2012. Methods A generalized additive mixed-effects Poisson model was fitted to English hospital-surveillance data. After adjusting for seasonal fluctuations and between-hospital variation in reported CDI over time, possible clustering (transmission between symptomatic in-patients) of CDI cases was identified. We hypothesised that a temporal proximity would be reflected in the degree of correlation between in-hospital CDI cases per week. This correlation was modelled through a latent autoregressive structure of order 1 (AR(1)). Findings Forty-six hospitals (33 general, seven specialist, and six teaching hospitals) located in all English regions met our criteria. In total, 12,717 CDI cases were identified; seventy-five per cent of these occurred >48 hours after admission. There were slight increases in reports during winter months. We found a low, but statistically significant, correlation between successive weekly CDI case incidences (phi = 0.029, 95%CI: 0.009–0.049). This correlation was five times stronger in a subgroup analysis restricted to teaching hospitals (phi = 0.104, 95%CI: 0.048–0.159). Conclusions The results suggest that symptomatic patient-to-patient transmission has been a source of CDI-acquisition in English hospitals in recent years, and that this might be a more important transmission route in teaching hospitals. Nonetheless, the weak correlation indicates that, in line with recent evidence, symptomatic cases might not be the primary source of nosocomial CDI in England. PMID:24932484

  13. Organizational culture, team climate, and quality management in an important patient safety issue: nosocomial pressure ulcers.

    Science.gov (United States)

    Bosch, Marije; Halfens, Ruud J G; van der Weijden, Trudy; Wensing, Michel; Akkermans, Reinier; Grol, Richard

    2011-03-01

    Increasingly, policy reform in health care is discussed in terms of changing organizational culture, creating practice teams, and organizational quality management. Yet, the evidence for these suggested determinants of high-quality care is inconsistent. To determine if the type of organizational culture (Competing Values Framework), team climate (Team Climate Inventory), and preventive pressure ulcer quality management at ward level were related to the prevalence of pressure ulcers. Also, we wanted to determine if the type of organizational culture, team climate, or the institutional quality management related to preventive quality management at the ward level. In this cross-sectional observational study multivariate (logistic) regression analyses were performed, adjusting for potential confounders and institution-level clustering. Data from 1274 patients and 460 health care professionals in 37 general hospital wards and 67 nursing home wards in the Netherlands were analyzed. The main outcome measures were nosocomial pressure ulcers in patients at risk for pressure ulcers (Braden score ≤ 18) and preventive quality management at ward level. No associations were found between organizational culture, team climate, or preventive quality management at the ward level and the prevalence of nosocomial pressure ulcers. Institutional quality management was positively correlated with preventive quality management at ward level (adj. β 0.32; p organizational culture, team climate, or preventive quality management at the ward level. These results would therefore not subscribe the widely suggested importance of these factors in improving health care. However, different designs and research methods (that go beyond the cross-sectional design) may be more informative in studying relations between such complex factors and outcomes in a more meaningful way. Copyright ©2010 Sigma Theta Tau International.

  14. Ventilator-associated nosocomial pneumonia in intensive care units in Malaysia.

    Science.gov (United States)

    Gopal Katherason, Supaletchimi; Naing, Lin; Jaalam, Kamarudin; Imran Musa, Kamarul; Nik Mohamad, Nik Abdullah; Aiyar, Subramaniar; Bhojani, Kavita; Harussani, Najah; Abdul Rahman, Aisai; Ismail, Asma

    2009-10-22

    The outcome indicator of nosocomial infection (NI) in the intensive care unit (ICU) is used to benchmark the quality of patient care in Malaysia. We conducted a three-year prospective study on the incidences of ventilator-associated pneumonia (VAP), risk factors, and patterns of the microorganisms isolated in three ICUs. A follow-up in prospective cohort surveillance was conducted on patients admitted to an adult medical-surgical ICU of a university hospital and two governmental hospitals in Malaysia from October 2003 to December 2006. VAP was detected using CDC criteria which included clinical manifestation and confirmed endotracheal secretion culture results. In total, 215 patients (2,306 patient-days) were enrolled into the study. The incidence of ICU-acquired device-related NI was 29.3 % (n = 63). The device-related VAP infection rate was 27.0 % (n = 58), with a mechanical ventilator utilization rate of 88.7%. The death rate due to all ICU-acquired NI including sepsis was 6.5%. The most common causative pathogen was Klebsiella pneumoniae (n = 27). Multivariate analysis using Cox regression showed that the risk factors identified were aspiration pneumonia (HR = 4.09; 95% CI = 1.24, 13.51; P = 0.021), cancer (HR = 2.51; 95% CI = 1.27, 4.97; P = 0.008), leucocytosis (HR=3.43; 95% CI= 1.60, 7.37; P=0.002) and duration of mechanical ventilation (HR=1.04; 95% CI = 1.00, 1.08; P = 0.030). Age, gender and race were not identified as risk factors in the multivariable analysis performed. The incidence of VAP was comparable to that found in the National Nosocomial Infection Surveillance (NNIS) System report of June 1998. The incidence of VAP was considered high for the three hospitals studied.

  15. Nosocomial Infections and Antibiotic Administration in Pediatric Department, Imam Reza Hospital, Mashhad-Iran

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    Abdolkarim Hamedi

    2014-04-01

    Full Text Available Introduction: Nosocomial Infections (NI are a frequent and relevant problem, in other hands; those are responsible of mortality especially in pediatric ICU( Intensive Care Unit and NICUs (Neonatal Intensive Care Unit. Healthcare-associated infections are important in wide-ranging concern in the medical field. The most cause of Nosocomial infection include: bloodstream infection, urinary tract infection, pneumonia, and wound infection. The purpose of this study was to determine the epidemiology of the three most common NI in the Pediatric department.        Materials and Methods: We performed a prospective study in a single Pediatric department during 12 months. Children were assessed for 3 NI: wound infections, pneumonia and urinary tract infections (UTI, as the same method as Center of Disease Control criteria. All patients were followed up and individuals who had have NI and their treatment was entered in this study.          Results: In this study 811 patients were hospitalized that 60% of them were male and were older than 60 months. The main causes of hospitalization include: toxicity, seizure, respiratory infection and fever. Among them 15 cases had NI (1.87%. The most NI occurred in pediatric intensive care unit (PICU and it was followed in aspect of intubation. The most cultured organism was pseudomonas that they suspected to ceftazidime and isolate from blood and endotracheal tube.           Conclusion:  NI presence was associated with increased mortality and length of stay in hospital. This study highlights the importance of NIs in children admitted to a pediatric department especially PICU in a developing country. Clinical monitoring of NIs and bacterial resistance profiles are required in all pediatric units.

  16. Proactive infection control measures to prevent nosocomial transmission of vancomycin-resistant enterococci in Hong Kong.

    Science.gov (United States)

    Cheng, Vincent Chi-Chung; Tai, Josepha Wai-Ming; Chen, Jonathan Hon-Kwan; So, Simon Yung-Chun; Ng, Wing-Chun; Hung, Ivan Fan-Ngan; Leung, Sally Sau-Man; Wong, Sally Cheuk-Ying; Chan, Tuen-Ching; Chan, Felix Hon-Wai; Ho, Pak-Leung; Yuen, Kwok-Yung

    2014-10-01

    The study describes a proactive infection control approach to prevent nosocomial transmission of vancomycin-resistant enterococci (VRE) and tests if this approach is effective for controlling multiple-drug resistant organisms in a nonendemic setting. In response to the increasing prevalence of VRE in Hong Kong since 2011, we adopted a multifaceted assertive approach in our health care network. This included active surveillance culture, extensive contact tracing, directly observed hand hygiene in conscious patients before they received meals and medications, stringent hand hygiene and environmental cleanliness, and an immediate feedback antimicrobial stewardship program. We report the occurrence of VRE outbreaks in our hospital after institution of these measures and compared with the concurrent occurrence in other public hospitals in Hong Kong. Between July 1, 2011 and November 13, 2013, VRE was identified in 0.32% (50/15,851) of admission episodes by active surveillance culture. The risk of VRE carriage was three times higher in patients with a history of hospitalization outside our hospital networks in the past 3 months (0.56% vs. 0.17%; p = 0.001) compared with those who were not. Extensive contact tracing involving 3277 patient episodes was performed in the investigation for the 25 VRE index patients upon whom implementation of contact precautions was delayed (more than 48 hours of hospitalization). One episode of VRE outbreak was identified in our hospital network, compared with the 77 VRE outbreaks reported in the other hospital networks (controls) without these proactive infection control measures. Our multifaceted assertive proactive infection control approach can minimize the nosocomial transmission and outbreak of VRE in a nonendemic area. Copyright © 2014. Published by Elsevier B.V.

  17. CONTROL OF NOSOCOMIAL SPREAD OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA

    Directory of Open Access Journals (Sweden)

    Viktorija Tomič

    2003-12-01

    Full Text Available Background. This prospective cohort study presents the effectiveness and feasibility of a comprehensive control strategy to reduce nosocomial transmission of methicillinresistant Staphylococcus aureus (MRSA in a highly endemic setting.Methods. All patients with MRSA carriage admitted to the University Clinic of Respiratory and Allergic Diseases over a period of 5 years (January 1998 through December 2002 were included and categorized into imported or hospitalacquired cases. In January 1999, an aggressive infection control program was implemented. It was focused on promoting alcohol hand rub, obtaining active surveillance cultures for MRSA, implementing strict barrier precautions and decolonizing MRSA carriers.Results. MRSA was recovered from 223 hospitalized patients; 142 cases were imported and 81 were acquired at our institution. After the introduction of an active surveillance program, the annual incidence of detected MRSA carriage per 1000 admissions first increased from 4.5 in 1998 to 8.0 in 1999 (p = 0.019, but remained stable thereafter. The proportion of patients detected through active surveillance cultures progressively increased from 23% in 1999 to 78% in 2002. Since 1999, the proportion of acquired MRSA cases in our institution has steadily decreased from 50% in 1999 to 6% in 2002 (p < 0.001, whereas the proportion of patients who acquired MRSA in other hospitals (p < 0.001 and nursing homes (p = 0.025 has increased.Conclusions. With a comprehensive infection control program it is possible to substantially reduce nosocomial transmission of MRSA in a highly endemic area. With good hand hygiene, early detection, isolation and decolonization strategy, containment of MRSA is achievable despite a high rate of transferred patients colonized or infected with MRSA from other healthcare facilities.

  18. High Variability in Nosocomial Clostridium difficile Infection Rates Across Hospitals After Colorectal Resection.

    Science.gov (United States)

    Aquina, Christopher T; Probst, Christian P; Becerra, Adan Z; Hensley, Bradley J; Iannuzzi, James C; Noyes, Katia; Monson, John R T; Fleming, Fergal J

    2016-04-01

    Hospital-acquired Clostridium difficile infection is associated with adverse patient outcomes and high medical costs. The incidence and severity of C. difficile has been rising in both medical and surgical patients. Our aim was to assess risk factors and variation associated with the development of nosocomial C. difficile colitis among patients undergoing colorectal resection. This was a retrospective cohort study. The study included segmental colectomy and proctectomy cases in New York State from 2005 to 2013. The study cohort included 150,878 colorectal resections. Patients with a documented previous history of C. difficile infection or residence outside of New York State were excluded. A diagnosis of C. difficile colitis either during the index hospital stay or on readmission within 30 days was the main measure. C. difficile colitis occurred in 3323 patients (2.2%). Unadjusted C. difficile colitis rates ranged from 0% to 11.3% among surgeons and 0% to 6.8% among hospitals. After controlling for patient, surgeon, and hospital characteristics using mixed-effects multivariable analysis, significant unexplained variation in C. difficile rates remained present across hospitals but not surgeons. Patient factors explained only 24% of the total hospital-level variation, and known surgeon and hospital-level characteristics explained an additional 8% of the total hospital-level variation. Therefore, ≈70% of the hospital variation in C. difficile infection rates remained unexplained by captured patient, surgeon, and hospital factors. Furthermore, there was an ≈5-fold difference in adjusted C. difficile rates across hospitals. A limited set of hospital and surgeon characteristics was available. Colorectal surgery patients appear to be at high risk for C. difficile infection, and alarming variation in nosocomial C. difficile infection rates currently exists among hospitals after colorectal resection. Given the high morbidity and cost associated with C. difficile colitis

  19. Rinossinusite nosocomial em unidade de terapia intensiva: estudo microbiológico Nosocomial sinusitis in an intensive care unit: a microbiological study

    Directory of Open Access Journals (Sweden)

    Leonardo Lopes Balsalobre Filho

    2011-02-01

    Full Text Available Rinossinusite Nosocomial é uma complicação frequente de pacientes tratados em UTI. É importante o diagnóstico e tratamento precoce para prevenir complicações graves como pneumonia, sepse, meningite e abscesso intracraniano. OBJETIVO: Identificar os agentes causadores de sinusite em UTI através do swab nasal e da punção de seio maxilar, correlacionando seus resultados. MÉTODO: Pacientes atendidos nas unidades de terapia intensiva com diagnóstico tomográfico de sinusopatia maxilar uni ou bilateral foram submetidos ao swab nasal e punção do seio acometido com material enviado para cultura e antibiograma. RESULTADOS: O presente estudo avaliou 22 pacientes. Houve concordância entre o agente microbiano isolado no swab e na punção em 14 dos 22 casos (63%. A flora aeróbia gram negativa foi a mais encontrada com predomínio da Pseudomonas aeruginosa (29% nas punções, seguido de Proteus mirabillis (26% e Acinetobacter baumanni (14%. Houve alto índice de resistência aos antibióticos usados. CONCLUSÃO: A punção direta do seio maxilar acometido em pacientes em UTI com sinusite parece ser o melhor método para identificar os agentes bacterianos e, através do seu antibiograma, direcionar a conduta terapêutica antimicrobiana. O swab mostrou ter pouco valor diagnóstico, com concordância de 63%, podendo ser reservado para casos onde a punção está contraindicada.Nosocomial sinusitis is a common complication of patients in ICUs. Its diagnosis is important, and early treatment is required to avoid serious complications such as pneumonia, sepsis, meningitis, and intracranial abscesses. AIM: To identify the germs causing sinusitis in ICUs by nasal swabs and maxillary sinus puncture, and to correlate these results. METHODS: ICU patients with a diagnosis (CT confirmed of maxillary sinusitis underwent nasal swab and puncture of the sinus to collect material for culture and antibiogram. RESULTS: This study evaluated 22 patients. The

  20. cobalt (ii), nickel (ii)

    African Journals Online (AJOL)

    DR. AMINU

    Department of Chemistry Bayero University, P. M. B. 3011, Kano, Nigeria. E-mail: hnuhu2000@yahoo.com. ABSTRACT. The manganese (II), cobalt (II), nickel (II) and .... water and common organic solvents, but are readily soluble in acetone. The molar conductance measurement [Table 3] of the complex compounds in.

  1. Corrosión e inhibición en aleaciones de aluminio de media resistencia

    Directory of Open Access Journals (Sweden)

    Davó, B.

    2004-12-01

    Full Text Available The use of chromâtes in aluminum alloys with aeronautical applications has been limited because of the high toxicity of these compounds. This has spurred intensive efforts to develop alternative effective and innocuous inhibitors. In this work, corrosion inhibition of a light and high strength Al-Li-Cu alloy (8090 is studied in NaCl solutions with CeCl3 and LaCl3 lanthanide salts added. The corrosion rate is reduced at least one order of magnitude with concentrations between 100-10,000 ppm. SEM, EDS and XPS techniques are used to characterize the rare earth cations incorporated into the surface as oxides and hydroxides.

    La elevada toxicidad de los cromatos limita cada vez más su uso en los tratamientos superficiales que se aplican a las aleaciones de aluminio en la industria aeronáutica. Por ello, es urgente encontrar inhibidores, no sólo tan eficaces como los cromatos sino, también, inocuos. En este sentido, se ha estudiado la inhibición de la corrosión de una aleación ligera de alta resistencia Al-Li-Cu (8090 en soluciones de NaCl con sales lantánidas de CeCl3 y LaCl3. Se ha comprobado que concentraciones comprendidas entre 100 y 10.000 ppm disminuyen la cinética de corrosión, al menos, un orden de magnitud. La superficie se modifica por la formación de una capa de óxidos e hidróxidos del catión lantánido que se ha caracterizado mediante SEM, EDS y XPS.

  2. Literatura infantil portuguesa en tiempos de la Dictadura: censura y voces de resistencia

    Directory of Open Access Journals (Sweden)

    Angela Balça

    2017-01-01

    Full Text Available Este artículo analiza cómo autores de literatura infantil portuguesa consiguieron eludir la censura en tiempos de la Dictadura (1926-1974 y publicar obras cuyos mensajes, que no podían ser discutidos libremente, fueron transmitidos a los jóvenes lectores del momento. Los objetivos de este estudio son dar a conocer obras de literatura infantil editadas durante la Ditadura y leídas por las jóvenes generaciones de antaño y actuales; establecer qué temas y valores son presentados en estas obras y comprender qué mecanismos fueron usados por los escritores para eludir la censura. Como metodología de estudio, empleamos el análisis hermenéutico a partir de una lectura crítica y reflexiva de los textos. De este análisis concluímos que estas obras abordan cuestiones relacionadas con el racismo y la promoción de la igualdad entre los hombres, la apología de libertad, la resistencia a la opresión y la exhortación a la paz. Los autores aquí estudiados emplean un lenguaje simbólico, cargado de metáforas, ambigüedades, humor e ironía, mecanismos todos ellos retóricos que fueron usados para transmitir su mensaje a los lectores y eludir así la censura del régimen vigente.

  3. Resistencia al choque térmico de Y-TZP con fisuras Palmqvist

    Directory of Open Access Journals (Sweden)

    Fargas Ribas, G.

    2003-02-01

    Full Text Available The thermal shock response of two tetragonal zirconia polycrystals stabilised with 2.5% molar yttria, with two different levels of fracture toughness, has been investigated. Palmqvist cracks are generated by indentation and the crack extension is quantified by assuming that the residual thermal stresses responsible for its extension during thermal shock are smaller than those acting on the crack immediately after indentation. It is proposed to use a thermal shock resistance parameter that only depends on the crack extension induced by thermal stresses generated during the abrupt changes in temperature. The results are applied to the study of thermal shock resistance and they are compared with experimental results.

    Se analiza el comportamiento frente al choque térmico de policristales de circona tetragonal dopados con 2.5% molar de itria (Y-TZP, con dos niveles distintos de tenacidad y con fisuras de indentación del tipo Palmqvist. El proceso de extensión de la fisura se cuantifica suponiendo que las tensiones residuales responsables de su propagación estable durante el choque térmico son inferiores a las presentes en el material inmediatamente después de aplicar la indentación. Se propone la utilización de un parámetro de resistencia al choque térmico que solamente depende de la extensión de las fisuras por efecto de las tensiones térmicas generadas durante el cambio brusco de temperatura. Los resultados del análisis se aplican al estudio del choque térmico y se comparan con los resultados experimentales.

  4. Gubernamentalidad neoliberal, muralismo y resistencia política en el barrio de La Boca

    Directory of Open Access Journals (Sweden)

    Luis María Blasco

    2015-12-01

    Full Text Available Desde la asunción de Mauricio Macri al frente de la gobernación de la Ciudad de Buenos Aires, en el año 2007, el barrio de La Boca es blanco de un proceso de gentrificación. Donde el Estado del GCBA promueve cambiar el perfil de la población del barrio y atraer inversiones privadas en conjunto con una población de un mayor poder adquisitivo. Provocando así la expulsión de los habitantes históricos mediante el encarecimiento de las viviendas, de los servicios públicos, etc. En paralelo a ello ha tenido lugar un proceso de construcción de memoria en el espacio público, una serie de marcas que buscan suscitar una conexión con ciertos acontecimientos: la exclusión y expulsión de quienes pueblan el barrio, los desalojos, incendios, pibes muertos de forma violenta, cierre de programas sociales, falta de espacios de recreación y deportivos. Este trabajo, entonces, reflexiona acerca de las luchas materiales y simbólicas por la construcción de memoria en el espacio público; poniendo el acento en el carácter histórico, dinámico y de lucha que tienen los procesos de construcción de identidad social en los que la memoria se materializa como resultado de las relaciones de poder y de las resistencias al poder. Para ello se retoma el caso del mural realizado en la avenida Don Pedro de Mendoza y Ministro Brin. A partir de este acontecimiento, se intenta ejercer una lectura sobre el terreno de producción de memoria en la Ciudad de Buenos Aires, tomando en cuenta que esta se realiza desde diversos dispositivos que articulan elementos heterogéneos con la finalidad de producir ciertos efectos.

  5. Genes de susceptibilidad/ resistencia a Flavivirus, implicaciones en la severidad de la infección

    Directory of Open Access Journals (Sweden)

    Jeanette Prada-Arismendy

    2006-07-01

    Full Text Available Las infecciones transmitidas por Flavivirus se encuentran entre las enfermedades transmisibles con mayor incidencia en el mundo. La mayoría de ellas se manifiestan clínicamente como un síndrome febril que puede estar o no acompañado de diversos síntomas. La severidad de estas infecciones es variable con casos asintomáticos y otros que pueden llegar a ser letales, La razón de esta variabilidad en la presentación clínica, se desconoce en humanos. En ratones se han identificado cepas susceptibles y cepas resistentes a la infección por algunos Flavivirus. Por clonación posicional se mapeó el gen responsable de la resistencia a virus West Nile en el cromosoma 5 de ratón y se identificó como oligoadenilato sintetasa 1b (Oas1 b. Este gen codifica una proteína que sintetiza oligómeros de adenina que activan la RNasaL, que a su vez degrada los RNAs virales. Células provenientes de ratones resistentes a la infección por Flavivirus producen menor cantidad de virus que su contraparte susceptible, Recientemente en humanos, se identificó un polimorfismo asociado con susceptibilidad a infección por virus West Nile en el gen de OasL. Sin embargo, el mecanismo bioquímico y molecular exacto por el cual se produce la susceptibilidad no ha sido completamente dilucidado, Este conocimiento permitiría aclarar aspectos de la fisiopatología de estas enfermedades y enfocar la terapéutica desde un punto de vista más específico.

  6. Test de campo para valorar la resistencia de los músculos del tronco

    Directory of Open Access Journals (Sweden)

    Casto Juan-Recio

    2014-09-01

    Full Text Available El Biering-Sorensen test (BST, el Side Bridge test (SBT y el Ito test (IT son tres de los test de campo más utilizados para medir la resistencia de los músculos del tronco. El objetivo de este estudio fue analizar la fiabilidad absoluta y relativa de los test referidos, así como valorar el efecto de la antropometría de los participantes en el rendimiento en las pruebas. En el estudio participaron 27 jóvenes varones (23,5 ± 4,0 años y físicamente activos. Los participantes realizaron dos sesiones de registro en las que ejecutaron los tres test (recuperación de 8 min entre pruebas y donde se midieron diversas variables antropométricas. La fiabilidad relativa fue buena, con ICC mayores de 0.80 en todos los test, pero no así la fiabilidad absoluta, con SEM que oscilaron entre el 13,36 % en el BST y el 19,89 % en el IT. El IT mostró una correlación negativa con la masa (r= – ,475; p= ,014 y el diámetro bileocrestal (r = – ,404; p = ,040 y el SBT una correlación negativa con la masa (r = –,610; p = ,001, el diámetro bileocrestal (r = –,546; p = ,004, el diámetro biacromial (r= - ,456; p = ,019 y el índice acromioiliaco (r= –,413; p = ,036. Los datos de fiabilidad ab-soluta cuestionan la utilidad de estas pruebas en programas de entrenamiento donde los participantes tienen poco margen de mejora. Además, si se realizan comparaciones entre sujetos es importante tener en cuenta sus diferencias antropométricas, ya que durante la ejecución de los test el cuerpo se utiliza como instrumento de medida.

  7. EFECTO DE LA TEXTURA DE ELECTRODEPÓSITOS DE ZINC EN ACERO SOBRE SU RESISTENCIA A LA CORROSIÓN

    Directory of Open Access Journals (Sweden)

    Zulema A. Mahmud

    2010-01-01

    Full Text Available En este trabajo, las texturas de depósitos de zinc en acero templado se correlacionan con la resistencia de corrosión del metal base. Se estudian por difracción de rayos X las texturas de electrodepósitos de zinc. Los depósitos de zinc se realizaron simulando las condiciones industriales de temperatura, tiempo y densidad de corriente, utilizando soluciones de electrodeposición de ZnCl2 + NH4Cl en presencia y ausencia de tiourea. Según se ha reportado, los depósitos de Zn con una alta intensidad en la textura de los planos basales (0,0,2 y bajas intensidades en la textura de planos piramidales (del tipo (1,0,3, (1,1,2, (2,0,1 presentan mayor resistencia a la corrosión. Para tiempos de electrodeposición bajos, los cincados obtenidos desarrollan una textura (1,0,3 y las densidades de corriente de corrosión son altas. Mientras que, para tiempos de deposición altos (10 minutos, los cincados tienen una textura (0,0,2 y el valor de la corriente de corrosión disminuye notablemente. La preponderancia de la textura (0,2,2 en los planos basales y la baja intensidad de DRX para la textura (0,0,3 en los planos piramidales, están asociados a los depósitos que presentan una alta resistencia a la corrosión.

  8. Estudio de la resistencia a la abrasión de capas vitrocerámicas depositadas sobre acero

    Directory of Open Access Journals (Sweden)

    Gómez de Salazar, J. M.

    2002-12-01

    Full Text Available Wear test has been completed on two types of layered materials: a non-reinforced enamel plate and a ceramic reinforced enamel plate. The latter has been tested in two forms: with 10 wt. % and 20 wt. % ceramic particles reinforcement. For comparison the same test has also been completed on polished steel. Wear resistance was measure using a tribometer, equipped with a chromium steel sphere of 6 mm diameter. The sphere-plate surface contact area increases with distance covered, which in the polished steel provokes exponential increments in wear values. This exponential behaviour was not observed in the enamel plates due to their greater wear resistance. The reinforcement of the enamel plates with ceramic particles increases the wear resistance. A higher percentage of ceramic reinforcement results in a greater wear resistance of the plates.

    Se han realizado ensayos de desgaste, tanto en placas esmaltadas sin refuerzo como en esmaltes con distinto porcentaje de carga cerámica (10 y 20% en peso, y se han comparado frente al del acero base pulido. Las medidas de resistencia a la abrasión se han obtenido utilizado un tribómetro con bola de acero al cromo de 6 mm de diámetro. El aumento de la superficie de contacto bola-placa a medida que aumenta la distancia recorrida, provoca aumentos exponenciales en los desgastes en el caso del acero pulido. Sin embargo, en el caso de las chapas esmaltadas no se observa este comportamiento, debido a la mayor resistencia al desgaste de las mismas. Cuando las capas esmaltadas están reforzadas con cargas cerámicas, la resistencia al desgaste aumenta con el porcentaje de refuerzo cerámico.

  9. EFECTO DEL PRECALENTAMIENTO Y LA SEVERIDAD DE TEMPLE SOBRE LA RESISTENCIA AL DESGASTE ADHESIVO DEL ACERO AUSTENÍTICO AL MANGANESO

    Directory of Open Access Journals (Sweden)

    OSCAR FABIÁN HIGUERA COBOS

    2010-01-01

    Full Text Available En este trabajo de investigación se estudió el efecto del precalentamiento y la severidad de temple sobre la resistencia al desgaste adhesivo del acero austenítico al manganeso ASTM A 128 grado C. El material se sometió a ciclos térmicos de temple y revenido con y sin precalentamiento con el fin de evaluar su influencia sobre la resistencia al desgaste. Posteriormente el material fue sometido a prueba según norma ASTM G83 y se determinó que el acero Austenítico al manganeso, es un material que presenta una microestructura metaestable en condiciones estables y no debe ser sometido a tratamiento térmico de revenido a altas temperaturas debido que favorece la descomposición de esta a ferrita (fase blanda de los acero y por ende disminuye su resistencia al desgaste.

  10. Influencia de las características del relleno mineral en la resistencia de una mezcla asfáltica

    OpenAIRE

    Reyes-Ortiz, O. J. (Oscar Javier); Rincón, J. F. (John Fredy)

    2009-01-01

    El objetivo principal de esta investigación fue determinar el efecto en la resistencia a tracción indirecta de reemplazar el relleno mineral por cemento, cal y ceniza volante con diferentes porcentajes. El estudio se inició con la caracterización de los materiales (agregados, asfaltos, cal, cemento y ceniza volante), seguido de la determinación del porcentaje óptimo de asfalto mediante el método Marshall. Se seleccionaron para el estudio la granulometría MD10 y el asfalto con penetración 60/7...

  11. Sistemas adhesivos autograbadores, resistencia de unión y nanofiltración: una revisión

    OpenAIRE

    Parra Lozada, Maritza; Garzón Rayo, Herney

    2012-01-01

    Los sistemas adhesivos autograbadores han permitido mejorar los procedimientos clínicos tanto en la evolución de los componentes y su funcionamiento, como en la disminución del tiempo operatorio de aplicación de cada uno de ellos. Estos sistemas han sido sometidos en la última década a constantes pruebas clínicas y de laboratorio, con el objetivo de valorar su desempeño. Sus múltiples ventajas contrastan con su baja efectividad en cuanto resistencia de unión y su permeabilidad que permite for...

  12. Ensayo EBADE: evaluación de la resistencia a la fisuración de las mezclas bituminosas

    OpenAIRE

    Pérez Jiménez, Félix Edmundo; Botella Nieto, Ramón; Miró Recasens, José Rodrigo; Martínez Reguero, Adriana Haydée

    2013-01-01

    La fisuración por fatiga es uno de los procesos de deterioro más frecuentes e importantes que tienen lugar en los firmes flexibles. Para evaluar la resistencia a fatiga que tienen las mezclas bituminosas que componen estos pavimentos se realizan ensayos de larga duración que requieren un equipamiento específico. Por esta razón algunos investigadores están estudiando procedimientos alternativos más sencillos de implementar y que reduzcan el tiempo de ensayo. El ensayo EBADE (Ensayo de BArrido ...

  13. Las TICs como una herramienta de apoyo didáctico en la red de resistencias de antimicrobianos del Ecuador

    OpenAIRE

    Villacís Acuña, José Eduardo

    2015-01-01

    Las Tecnologías de la Información y Comunicación TICs están produciendo un cambio constante en muchos de los ámbitos sociales y se desarrollan a partir de avances científicos en el ámbito de la informática ligado a otras ciencias. Su implementación en la Red Nacional de Resistencias a Antimicrobianos del Instituto Nacional de Investigación en Salud Pública (INSPI), generará varios ambientes de comunicación, información y aprendizaje, promoviendo el trabajo colaborativo y autónomo, que contrib...

  14. Un nuevo caso de resistencia a un bismuto oleo-soluble: curación por una sal insoluble

    Directory of Open Access Journals (Sweden)

    Ch. Petouraud

    1934-07-01

    Full Text Available Acabamos de observar, simple coincidencia o efecto de la casualidad, un nuevo caso de bismuto resistencia que recuerda al que uno de nosotros encontró recientemente con el Profesor Nicolas. S. Joseph, 24 años, es visto por primera vez el 6 de mayo de 1933, en la consulta del servicio hospitalario de Dermato-Syphiligraphie de Antiquille (ficha Nv 5886, Dr. Gaté, para accidentes secundarios típicos; roséola discreta, sifilides papulosas y córneas de las regiones palmares, ganglios supraepitrccleanos y oervicales, reacción de Wassermann muy positiva en la sangre.

  15. Estrategias de resistencia indígena frente al desarrollo minero: La comunidad de Likantatay ante un posible traslado forzoso

    OpenAIRE

    Carrasco, Anita; Fernández, Eduardo

    2009-01-01

    Este artículo revisa el complejo panorama que enfrenta la comunidad indígena atacameña de Likantatay ante las consecuencias de un proyecto de desarrollo minero que implican el traslado forzoso de dicha comunidad si este proyecto se concreta. Se analizan las estrategias de resistencia indígena que presenta y/o puede presentar la comunidad así como los discursos y estrategias ideológicas elaborados por la corporación minera para desarrollar los intereses del capital. El análisis se enmarca dent...

  16. Avances en la selección de fuentes de resistencia a las principales enfermedades del frijol común (Phaseolus vulgaris L. en Costa Rica

    Directory of Open Access Journals (Sweden)

    Carlos M. Araya

    2000-01-01

    Full Text Available En esta investigación se evaluaron diversos genotipos de frijol en la búsqueda de fuentes de resistencia a la antracnosis (Colletotrichum lindemuthianum y a la mancha angular (Phaeoisariopsis griseola. Se evaluó germoplasma del programa nacional de hibridaciones y de tres viveros internacionales distribuidos por el CIAT: VIFURE, VIPADOGEN y CORE COLLECTION. Los ensayos se establecieron en Puriscal (1017 msnm, Alajuela (814 msnm y Fraijanes (1650 msnm, durante los ciclos agrícolas 97-98 y 98-99. Los materiales se sembraron en parcelas de un surco de dos a seis metros de largo con una o dos repeticiones y manejo con mínimos insumos. Se evaluó la reacción a la infección natural por antracnosis y mancha angular a las seis y ocho semanas después de la siembra, con base en la escala de severidad de uno a nueve. Se seleccionaron materiales con reacción de uno hasta grado tres para antracnosis y de uno hasta grado cuatro para mancha angular. Del grupo de materiales provenientes del programa de hibridaciones se seleccionaron nueve líneas por su resistencia a ambos patógenos. Posteriormente, sólo cinco mostraron resistencia específica a antracnosis y dos a mancha angular. De los viveros distribuidos por el CIAT, el VIPADOGEN aportó dos líneas que mostraron resistencia combinada a las dos enfermedades, mientras que 25 fueron resistentes exclusivamente a antracnosis, además de mostrar tolerancia a baja fertilidad o a sequía. Del vivero CORE COLLECTION, sólo 26 líneas mostraron resistencia combinada; 82 líneas fueron resistentes a antracnosis y 12 a mancha angular. Las mejores fuentes de resistencia a antracnosis y mancha angular estarán disponibles en un vivero internacional

  17. Resistencia antibiótica en infecciones urinarias en niños atendidos en una institución privada, periodo 2007 - 2011

    Directory of Open Access Journals (Sweden)

    Fernando Polanco Hinostroza

    2013-07-01

    Full Text Available La resistencia antibiótica es un serio problema de salud, sobre todo en pacientes con recurrencia de episodios y anomalías del sistema urinario. Objetivo: Describir el patrón de resistencia antibiótica de las bacterias causantes de la infección del tracto urinario (ITU como primer episodio, recurrente o complicada en niños menores de 5 años. Material y métodos: Estudio tipo serie de casos observacional, retrospectivo y descriptivo. Se revisaron las historias clínicas de los pacientes con diagnóstico de ITU con cultivo de orina positivo, durante un periodo de 5 años en una institución de salud privada. Resultados: Se incluyeron 111 niños de 1 mes a 5 años; 97 (87,4% fueron mujeres; 68 (61,3% fueron lactantes; hubieron 77 pacientes con ITU, 34 con ITU recurrente o complicada. Escherichia coli (63,1% fue el microorganismo más frecuente en todos los grupos. La resistencia antibiótica fue: ampicilina 80,6%, cefalotina 59%, amoxicilina/clavulánico 55,4%, trimetoprima-sulfametoxazol 51,6%, ácido nalidixico 51%, cefalexina 40%, cefotaxima 31%, cefuroxima 29,8%, ceftriaxona 28,6%, ceftazidima 27,3%, norfloxacino 21,2%, ciprofloxacino 21,1%; y con menos resistencia fueron nitrofurantoína 17%, gentamicina 13,2%, amikacina 1%. Conclusiones: La resistencia antimicrobiana para los antibióticos usados para el tratamiento de ITU es alta para las aminopenicilinas, sulfas, cefalosporinas de primera, segunda y tercera generación así como quinolonas; los aminoglucósidos aún presentan muy baja resistencia porque lo que serían útiles para la terapia de primera elección.

  18. Studies on incidence and prevention of nosocomial infection of urinary tract endoscopies by different antimicrobial agents

    International Nuclear Information System (INIS)

    Hasanien, Y.A.M.

    2010-01-01

    Nosocomial infections occur world wide and affect both developed and resource-poor countries. Infections acquired in health care settings are among the major causes of death and increased morbidity among hospitalized patients. They are a significant burden both for the patient and for public health. A prevalence survey conducted under the auspices of WHO in 55 hospitals of 14 countries representing 4 WHO Regions (Europe, Eastern Mediterranean, South-East Asia and Western Pacific) showed an average of 8.7% of hospital patients had nosocomial infections. At any time, over 1.4 million people worldwide suffer from infectious complications acquired in hospital (Tikhomirov , 1987 ) . In medical practice, an object should be disinfected or sterilized depending on its intended use. Items that come in direct contact with mucous membranes, such as endoscopes, require a high level of disinfection (Ayliffe et al., 2000) . The major problems leading to inadequate decontamination are inappropriate or incomplete decontamination methods, for example, choice of disinfectant and duration of contact, as well as use of water or other fluids of poor microbiological quality for decontamination (Fallis , 1994 ). Endoscopes had been used widely for the diagnosis and therapy of medical disorders and were used increasingly for performing laparoscopic surgery. Currently, greater than 10,000,000 gastrointestinal endoscopic procedures were performed each year. Endoscopes were contaminated routinely by microorganisms during clinical use. Failure to employ appropriate cleaning, disinfection, or sterilization of endoscopes have been responsible for multiple nosocomial outbreaks and serious, sometimes life-threatening infections (Spach et al ., 1993 ). Because the endoscope comes into intimate contact with mucous membranes, high-level disinfection was the current reprocessing standard after each patient use. High level disinfection refered to the use of a chemical sterilant at shorter exposure

  19. Device-associated infection rates and mortality in intensive care units of Peruvian hospitals: findings of the International Nosocomial Infection Control Consortium Tasas de infección asociadas a aparatos y mortalidad en unidades de cuidados intensivos de hospitales peruanos: datos del Consorcio Internacional para el Control de las Infecciones Nosocomiales

    Directory of Open Access Journals (Sweden)

    Luis E. Cuellar

    2008-07-01

    Full Text Available OBJECTIVES: To measure device-associated infection (DAI rates, microbiological profiles, bacterial resistance, and attributable mortality in intensive care units (ICUs in hospitals in Peru that are members of the International Nosocomial Infection Control Consortium (INICC. METHODS: Prospective cohort surveillance of DAIs was conducted in ICUs in four hospitals applying the definitions for nosocomial infections of the U.S. Centers for Disease Control and Prevention National Nosocomial Infections Surveillance System (CDC-NNIS and National Healthcare Safety Network (NHSN. RESULTS: From September 2003 to October 2007 1 920 patients hospitalized in ICUs for an aggregate of 9 997 days acquired 249 DAIs, accounting for a rate of 13.0% and 24.9 DAIs per 1 000 ICU-days. The ventilator-associated pneumonia (VAP rate was 31.3 per 1 000 ventilator-days; the central venous catheter-associated bloodstream infections (CVC-BSI rate was 7.7 cases per 1 000 catheter-days; and the rate for catheter-associated urinary tract infections (CAUTI was 5.1 cases per 1 000 catheter-days. Extra mortality for VAP was 24.5% (RR 2.07, P OBJETIVOS: Determinar las tasas de infecciones asociadas a aparatos (IAA, sus perfiles microbiológicos y la resistencia bacteriana, así como la mortalidad atribuible a estas infecciones en unidades de cuidados intensivos (UCI de hospitales de Perú, miembros del Consorcio Internacional para el Control de las Infecciones Nosocomiales (INICC. MÉTODOS: Se hizo un seguimiento retrospectivo de cohorte de las IAA en las UCI de cuatro hospitales, según las definiciones de infección nosocomial del Sistema Nacional de Vigilancia de Infecciones Nosocomiales de los Centros para el Control y la Prevención de Enfermedades (CDC-NNIS y de la Red Nacional de Seguridad Sanitaria (NHSN, de los Estados Unidos de América. RESULTADOS: De septiembre de 2003 a octubre de 2007, 1 920 pacientes hospitalizados en las UCI, con un total de 9 997 días, adquirieron

  20. Comparación de resultados de resistencias a compresión del hormigón empleando cilindros de dimensiones no estandarizadas

    Directory of Open Access Journals (Sweden)

    Erika A. Barbosa Guzmán

    1997-09-01

    Full Text Available Este trabajo de investigación dirigido por el Ing. J. Gabriel Gómez pretende evaluar la conveniencia de emplear cilindros de 7.5 cm. x 15 cm. y 10 cm. x 20 cm. para resistencias menores a 210 kg/cm2, comparando los resultados de resistencia a la compresión del hormigón de estos tamaños de probetas, con los del cilindro estándar, para lo cual se elaboraron tres diseños de mezcla 140, 170 y 200 kg/cm2

  1. RESISTENCIA A β-LACTÁMICOS Y QUINOLONAS EN AISLAMIENTOS DE Escherichia coli OBTENIDOS DE CANALES DE BOVINOS EN EL ESTADO DE MÉXICO Y JALISCO

    OpenAIRE

    Aguilar Montes de Oca, Saul

    2014-01-01

    Las enfermedades transmitidas por alimentos (ETAs), especialmente por alimentos de origen animal son un problema vigente que afecta a la población humana. Los microorganismos patógenos responsables de estas enfermedades han desarrollado una gran variedad de mecanismos de resistencia a los antibióticos, entre ellos, destacan las β-lactamasas de espectro extendido (ESBLs), las β-lactamasas AmpC plasmídicas (pAmpC) y la resistencia a quinolonas mediada por plásmidos (PMQR), capaces de diseminars...

  2. Aspectos de la resistencia Guaraní : los proyectos de integración en el virreinato del Río de la Plata (1768-1805

    OpenAIRE

    Razzera Dos Santos, Cristina

    2011-01-01

    La investigación analiza las transformaciones de la resistencia de los guaraníes y su proceso de integración en la sociedad colonial tras la expulsión de los jesuitas y en funcion de los "planes de gobierno" elaborados desde la administración colonial y metropolitana para los guaraníes. Con la documentación existente en los archivos españoles y rioplatenses se analiza la evolución de las manifestaciones de resistencia (levantamientos, sublevaciones, proclamas) y las demandas indígenas por la ...

  3. Antividad antibacteriana In vitro de extractos de piper angustifolium (matico) y matricaria chamomilla (manzanilla) en cepas de staphylococcus aureus con resistencia múltiple

    OpenAIRE

    Zuta Arriola, Noemí

    2014-01-01

    El Staphylococcus aureus es el microorganismo más importante causante de infecciones intrahospitalarias y presenta una resistencia múltiple a antibióticos, lo cual conduce a diseñar medidas de prevención dirigidas a controlar y disminuir la resistencia antibiótica. Actualmente se sabe que muchas plantas medicinales tienen actividad antibacteriana, pero su posible efecto frente a bacterias multirresistentes como es el caso de S. aures aislada de muestras clínicas no reúne mayores referencias. ...

  4. Identificación de genes candidatos de resistencia a sigatoka negra en variedades de banano y plátano

    OpenAIRE

    Saavedra, C.; Santos, E.

    2013-01-01

    El control químico y la selección de plantas resistentes continúan siendo las estrategias mayormente usadas para combatir la Sigatoka negra en la producción de banano. La ingeniería genética tiene el potencial para la generación de plantas con cierta resistencia/tolerancia al hongo, por lo que la aplicación de fungicidas sería reducida. Este estudio tiene como objetivo identificar genes candidatos de resistencia a la infección del hongo Mycosphaerella fijiensis Morelet causante de la Sigatoka...

  5. Estudio del comportamiento a fluencia en caliente de un acero avanzado de alta resistencia de bajo contenido en carbono NiCrVCu microaleado con boro

    OpenAIRE

    González Sala, Sara

    2009-01-01

    Una de las líneas de investigación prioritarias en el contexto internacional es el desarrollo de aceros avanzados de alta resistencia (AHSS) con excelentes propiedades de resistencia y tenacidad para aplicaciones en la industria automotriz, naval, aeronáutica y de generación de energía, que permitan disminuir el peso de los componentes y sustituyan aceros tradicionales de contenidos mayores de carbono. Los aceros AHSS microaleados al boro, debido a sus cualidades, tecnología de...

  6. Efectos de diferentes métodos de entramiento de fuerza y resistencia de agarre en escaladores deportivos de distintos niveles

    OpenAIRE

    López Rivera, Eva María

    2016-01-01

    Introducción:Hasta el momento la metodología y planificación de entrenamiento utilizada por los escaladores ha estado basada en la observación, intuición y en el ensayo-error. Numerosos estudios sugieren que la fuerza y resistencia de dedos es un factor de rendimiento en la escalada deportiva. Sin embargo, no hemos encontrado ningún trabajo que haya comparado y valorado los efectos de diferentes métodos de entrenamiento específico de fuerza y resistencia de dedos. El control de la carga es un...

  7. Resistencias sociales y no-violencia: aportes para una interpretación desde la micropolítica del acontecimiento

    Directory of Open Access Journals (Sweden)

    Oscar Useche Aldama

    2013-12-01

    Full Text Available Las luchas de resistencia noviolentas han tomado actualmente nuevas formas y un gran impulso en todo el planeta. Se caracterizan por constituir acontecimientos de alta creatividad que actualizan y abren nuevos espacios de libertad. Estas resistencias toman distancia de los métodos convencionales de la representación política y prefieren centrar sus energías en disputar los campos de relaciones vitales y en desplegar su propia potencia de afirmación de nuevos modos de existencia.

  8. Desarrollo de un modelo de redes neuronales artificiales para predecir la resistencia a la compresión y la resistividad eléctrica del concreto

    OpenAIRE

    Lizarazo Marriaga, Juan Manuel; Gómez Cortés, José Gabriel

    2010-01-01

    En esta investigación se busca obtener un método para predecir la resistencia a la compresión mediante el peso unitario y la velocidad de pulso ultrasónico usando 41 mezclas de concreto diferentes. El estudio ha sido por la necesidad de obtener un método rápido para predecir la resistencia a la compresión del concreto. De la misma manera, la investigación también busca predecir la resistividad eléctrica del concreto mediante el peso unitario, la velocidad de pulso ultrasónico y la resisten...

  9. Resistencia química del hormigón. IX.- Influencia de la adición de escoria a un cemento portland de alta resistencia inicial. Estudio por DRX del sistema cemento 1/escoria-agua potable filtrada

    Directory of Open Access Journals (Sweden)

    Gaspar-Tébar, Demetrio

    1981-03-01

    Full Text Available Not available

    En el presente trabajo [continuación de otro en el que se dio cuenta de las variaciones que experimentan las resistencias mecánicas a flexotracción y de la evolución de los coeficientes de corrosión de probetas de mortero (1:3 sumergidas en agua potable filtrada y en agua de mar artificial ASTM D 1141-75] se estudia por DRX la composición estructural de las nuevas fases sólidas formadas en los medios de curado y conservación (agua potable filtrada en donde han estado sumergidas las distintas series testigo de probetas de ;mortero (1:3 de 1 X 1 X 6 cm hechas con el cemento 1 de alta resistencia inicial, cemento 1 < > P-550-ARI, y con las mezclas cemento 1/escoria granulada (vítrea = 85/ /15-65/35-40/60 y 30/70 (en peso, durante 21 días en el primer período y 56-90-180 y 360 días en el segundo, así como la evolución de las fases cristalinas de la fracción enriquecida (cemento hidratado extraída de uno de Los prismas de cada serie de probetas de mortero.

  10. Validación de un programa de vigilancia de infecciones nosocomiales Validation of a nosocomial infections surveillance program

    Directory of Open Access Journals (Sweden)

    M. Sigfrido Rangel-Frausto

    1999-01-01

    Full Text Available OBJETIVO. Validar el programa de vigilancia de infecciones nosocomiales y conocer la morbilidad y la mortalidad. MATERIAL Y MÉTODOS. Un médico especialmente capacitado, realizó vigilancia intensiva de todos los pacientes admitidos en el hospital. Los casos de infección fueron discutidos con otros dos médicos y el resultado se comparó con la vigilancia rutinaria. Se incluyó a todos los pacientes hospitalizados del 11 de julio al 12 de agosto de 1995, que no tenían un proceso infeccioso activo o que no manifestaban un periodo de incubación a su ingreso. Se siguieron diariamente y se registraron datos de: edad, sexo y padecimiento de ingreso. Se recabó información sobre tratamiento antimicrobiano, microrganismo aislado y susceptibilidad. Se evaluó el estado clínico final y se estimó el tiempo de estancia hospitalaria. RESULTADOS. De 429 pacientes, 45 desarrollaron infección nosocomial (casos y 384 no lo hicieron (controles. La incidencia de infecciones nosocomiales fue de 10.48/100. La sensibilidad y la especificidad del programa fueron de 93.3 y 98.7%, respectivamente. La mortalidad en los infectados fue de 11.11%, y en el grupo de los no infectados, de 2.4%. El promedio de estancia hospitalaria fue de 20 y 11 días, para infectados y no infectados, respectivamente (pOBJECTIVES. To validate the nosocomial infections surveillance system, establish its impact in morbi-mortality. MATERIAL AND METHODS. Surveillance of every single patient admited during a one month period was done by one of us (DMG. Each posibile case was discussed with two other hospital epidemiologists (SPLR, MSRF. This intensive surveillance was compared against the routinely surveillance performed by the nurses. We included all hospitalized patients between 11th July and 12th of August according to CDC (Atlanta, GA nosocomial infections definitions. Patients were followed everyday and information about age, gender, underlying diagnosis, microorganisms responsible

  11. Estrategias para reducir a un mínimo la transmisión nosocomial del sarampión

    Directory of Open Access Journals (Sweden)

    R. J. Biellik

    1998-11-01

    Full Text Available Como resultado de la gran contagiosidad del sarampión antes de salir la erupción, la transmisión nosocomial seguirá siendo un peligro hasta que se erradique la enfermedad. No obstante, varias estrategias pueden reducir a un mínimo la transmisión nosocomial. Es imprescindible, por lo tanto, hacer que el personal de salud cobre mayor conciencia de que un individuo con sarampión puede llegar en cualquier momento a un servicio de salud y de que el peligro de transmisión del sarampión en el medio hospitalario existe de continuo. La presente revisión contiene dos grupos de recomendaciones: las que suelen ser aplicables a todos los países, y ciertas recomendaciones adicionales que pueden ser apropiadas solamente para países industrializados.

  12. The effectiveness of a promotion programme on hand hygiene compliance and nosocomial infections in a neonatal intensive care unit.

    Science.gov (United States)

    Picheansathian, Wilawan; Pearson, Alan; Suchaxaya, Prakin

    2008-08-01

    This quasi-experimental study aimed to identify the impact of a promotion programme on hand hygiene practices and its effect on nosocomial infection rates in a neonatal intensive care unit of a university hospital in Thailand. The study populations were 26 nursing personnel. After implementing a hand hygiene promotion programme, compliance with hand hygiene among nursing personnel improved significantly from 6.3% before the programme to 81.2% 7 months after the programme. Compliance rate did not correlate with the intensity of patient care. Nosocomial infection rate did not decrease after the intervention, probably because of the multifactorial nature of infections. All participants agreed that promotion programme implemented in this project motivated them to practise better hand hygiene. This study indicated that multiple approaches and persistent encouragement are key factors leading to a sustained high level of appropriate hand hygiene practices among nursing personnel.

  13. Study of nosocomial isolates of Staphylococcus aureus with special reference to methicillin resistant S. aureus in a tertiary care hospital in Nepal.

    Science.gov (United States)

    Shrestha, B; Pokhrel, B; Mohapatra, T

    2009-06-01

    To find out the prevalence of Staphylococcus aureus nosocomial infection and methicillin resistant S. aureus (MRSA), clinical samples from nosocomially infected patients were processed by following standard methodology in microbiology laboratory, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Of 149 S. aureus isolates, skin infection isolates contributed a major part 72.5% making nosocomial infection by S. aureus most prevalent in skin infection followed by lower respiratory tract infection 11.41% and urinary tract infection 8.7%. Overall MRSA prevalence was 45.0%. MRSA prevalence was 42.6% in skin infection, 82.3% in lower respiratory tract infection and 30.8% in urinary tract infection. MRSA infection was found associated with lower respiratory tract infection only. Highest occurrence of nosocomial infection was observed in female surgical ward, surgical out patient department, orthopedic ward, male surgical ward and maternity ward. MRSA isolation was high from lower respiratory tract of patients admitted in intensive care unit, coronary care unit, Sub-acute intensive care unit, intermediate coronary care unit, neurology ward and post-operative ward. Whereas methicillin sensitive S. aureus (MSSA) occurrence was higher in patients admitted in orthopedic, Surgical out patient department, and female surgical ward. The occurrence of MRSA did not differ with age but MRSA was found associated with male patients and MSSA was associated with female patients. Since MRSA prevalence was high, regular surveillance of MRSA and nosocomial infections should be done and universal precautions to control nosocomial infections should be followed.

  14. Detection of OXA-Type Carbapenemase Genes in Acinetobacter baumannii Isolates from Nosocomial Infections in Isfahan Hospitals, Iran

    OpenAIRE

    Vajihe Karbasizade; Leila Heidari; Reyhaneh Jafari

    2016-01-01

    "> Background: Acinetobacter baumannii as one of the causes of nosocomial infections has becomeresistant to almost all antimicrobial agents. The emergence of resistance to carbapenems, one ofthe last drugs on the shelf, is the major concern about A. baumannii antimicrobial resistance.Resistance to carbapenems is mediated by production of class B and D carbapenemases. The aimof this study was to detect the resistance genes including blaOXA-23, 24, 51, and 58 in A. baumanniiisolates from nos...

  15. Modeling the economic impact of linezolid versus vancomycin in confirmed nosocomial pneumonia caused by methicillin-resistant Staphylococcus aureus.

    Science.gov (United States)

    Patel, Dipen A; Shorr, Andrew F; Chastre, Jean; Niederman, Michael; Simor, Andrew; Stephens, Jennifer M; Charbonneau, Claudie; Gao, Xin; Nathwani, Dilip

    2014-07-22

    We compared the economic impacts of linezolid and vancomycin for the treatment of hospitalized patients with methicillin-resistant Staphylococcus aureus (MRSA)-confirmed nosocomial pneumonia. We used a 4-week decision tree model incorporating published data and expert opinion on clinical parameters, resource use and costs (in 2012 US dollars), such as efficacy, mortality, serious adverse events, treatment duration and length of hospital stay. The results presented are from a US payer perspective. The base case first-line treatment duration for patients with MRSA-confirmed nosocomial pneumonia was 10 days. Clinical treatment success (used for the cost-effectiveness ratio) and failure due to lack of efficacy, serious adverse events or mortality were possible clinical outcomes that could impact costs. Cost of treatment and incremental cost-effectiveness per successfully treated patient were calculated for linezolid versus vancomycin. Univariate (one-way) and probabilistic sensitivity analyses were conducted. The model allowed us to calculate the total base case inpatient costs as $46,168 (linezolid) and $46,992 (vancomycin). The incremental cost-effectiveness ratio favored linezolid (versus vancomycin), with lower costs ($824 less) and greater efficacy (+2.7% absolute difference in the proportion of patients successfully treated for MRSA nosocomial pneumonia). Approximately 80% of the total treatment costs were attributed to hospital stay (primarily in the intensive care unit). The results of our probabilistic sensitivity analysis indicated that linezolid is the cost-effective alternative under varying willingness to pay thresholds. These model results show that linezolid has a favorable incremental cost-effectiveness ratio compared to vancomycin for MRSA-confirmed nosocomial pneumonia, largely attributable to the higher clinical trial response rate of patients treated with linezolid. The higher drug acquisition cost of linezolid was offset by lower treatment failure

  16. Improving hand hygiene compliance for the reduction of nosocomial infections: recommendations for behaviour change in a health care setting

    OpenAIRE

    Reason, Florence Paige

    2008-01-01

    Nosocomial infection rates are highly dependent on hand hygiene compliance within health care facilities. This paper examines the literature concerning elements of effective hand hygiene interventions and relevant behaviour change theory, in addition to current practice surrounding hand hygiene interventions in leading institutions, in order to inform and propose recommendations for the improvement and success of the University Health Network’s current hand hygiene initiative. The results of ...

  17. Weekly screening supports terminating nosocomial transmissions of vancomycin-resistant enterococci on an oncologic ward – a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Stefanie Kampmeier

    2017-05-01

    Full Text Available Abstract Background To investigate the impact of weekly screening within the bundle of infection control measures to terminate vancomycin-resistant enterococci (VRE transmissions on an oncologic ward. Methods A cluster of 12 VRE colonisation and five infections was detected on an oncologic ward between January and April 2015. Subsequently, the VRE point prevalence was detected and, as part of a the bundle of infection control strategies to terminate the VRE cluster, we isolated affected patients, performed hand hygiene training among staff on ward, increased observations by infection control specialists, intensified surface disinfection, used personal protective equipment and initiated an admission screening in May 2015. After a further nosocomial VRE infection in August 2015, a weekly screening strategy of all oncology patients on the respective ward was established while admission screening was continued. Whole genome sequencing (WGS-based typing was applied to determine the clonal relationship of isolated strains. Results Initially, 12 of 29 patients were VRE colonised; of these 10 were hospital-acquired. During May to August, on average 7 of 40 patients were detected to be VRE colonised per week during the admission screening, showing no significant decline compared to the initial situation. WGS-based typing revealed five different clusters of which three were due to vanB- and two vanA-positive enterococci. After an additional weekly screening was established, the number of colonised patients significantly declined to 1/53 and no further nosocomial cases were detected. Conclusions Weekly screening helped to differentiate between nosocomial and community-acquired VRE cases resulting in earlier infection control strategies on epidemic situations for a successful termination of nosocomial VRE transmissions.

  18. In Vitro Assay of Ethanolic Heat Reflux Extract of Nicotiana tabacum L. var Virginia Against Nosocomial Bacteria Pathogen

    Science.gov (United States)

    Pramono, Andri; Fauzantoro, Ahmad; Rizki Hidayati, Irma; Hygea, Arina; Puspita, Oktaviani Sandra; Muktamiroh, Hikmah; Simanjuntak, Kristina; Gozan, Misri

    2018-03-01

    Tobacco plays an important role in international trade as one of the export commodities. Indonesia is one of the good quality export contributors of tobacco leaves in the world. Nevertheless, tobacco is used only as a raw material for the cigarette industries, and the rise on anti-cigarette regulations prompted the exploration of alternative product from tobacco plants. The content of alkaloids, flavonoids, terpenoids and steroids in tobacco leaves were reported in literatures as antibacterial. Therefore, this study proposed in vitro assay of the ethanolic heat reflux extract (EHRE) of Nicotiana tabacum var. Virginia against nosocomial bacteria pathogen ((Pseudomonas aeruginosa (ATCC 27853), Eschericia coli (ATCC 25922), Staphylococcus aureus (ATCC 25923), Enterococcus faecalis (ATCC 29212)). Kirby-bauer diffusion method was used for this assay. The concentration of the EHRE for Kirby-bauer assay were 20; 40; 60; 80; and 100%. The presence of clear zones on Kirby-bauer test, against the growth of each nosocomial bacteria pathogen show that tobacco extract has antibacterial effect. Statistical analysis result showed that each extract concentration had significant difference value (p steroids) of tobacco leaf extracts (N. tabacum) has potential as antibacterial against nosocomial bacteria pathogen. Nevertheless, optimization of tobacco leaf extract to obtain maximum active ingredient still needs to be done. This study is important for further development of the tobacco leaf extract as antibacterial

  19. Direct costs associated with a nosocomial outbreak of Salmonella infection: an ounce of prevention is worth a pound of cure.

    Science.gov (United States)

    Spearing, N M; Jensen, A; McCall, B J; Neill, A S; McCormack, J G

    2000-02-01

    Nosocomial outbreaks of Salmonella infections in Australia are an infrequent but significant source of morbidity and mortality. Such an outbreak results in direct, measurable expenses for acute care management, as well as numerous indirect (and less quantifiable) costs to those affected, the hospital, and the wider community. This article describes the significant direct costs incurred as a result of a nosocomial outbreak of Salmonella infection involving patients and staff. Information on costs incurred by the hospital was gathered from a number of sources. The data were grouped into 4 sections (medical costs, investigative costs, lost productivity costs, and miscellaneous) with use of an existing tool for calculating the economic impact of foodborne illness. The outbreak cost the hospital more than AU $120, 000. (US $95,000). This amount is independent of more substantial indirect costs. Salmonella infections are preventable. Measures to aid the prevention of costly outbreaks of nosocomial salmonellosis, although available, require an investment of both time and money. We suggest that dedication of limited resources toward such preventive strategies as education is a practical and cost-effective option for health care facilities.

  20. Detection of OXA-Type Carbapenemase Genes in Acinetobacter baumannii Isolates from Nosocomial Infections in Isfahan Hospitals, Iran

    Directory of Open Access Journals (Sweden)

    Vajihe Karbasizade

    2016-02-01

    Full Text Available "> Background: Acinetobacter baumannii as one of the causes of nosocomial infections has becomeresistant to almost all antimicrobial agents. The emergence of resistance to carbapenems, one ofthe last drugs on the shelf, is the major concern about A. baumannii antimicrobial resistance.Resistance to carbapenems is mediated by production of class B and D carbapenemases. The aimof this study was to detect the resistance genes including blaOXA-23, 24, 51, and 58 in A. baumanniiisolates from nosocomial infections in Isfahan hospitals.Methods: A total number of 456 clinical specimens were collected from nosocomial infections andevaluated in order to isolate A. baumannii strains. After identification of the isolates, the antibioticsensitivity to carbapenems was assessed using disk diffusion method. The resistance genes of blaOXA-23, 24, 51, and 58 were detected by multiplex PCR method.Results: Fifty A. baumannii isolates were isolated from clinical specimens. Fifty two percent ofthe isolates showed phenotypic resistance to the carbapenems (imipenem and meropenem.According to PCR results, 88% of resistant isolates had ≥1 blaOXA gene. The frequency of resistantisolates bearing blaOXA-23, blaOXA-24 and blaOXA-58 were 77%, 38% and 15% respectively.Conclusions: This study showed the high frequency of carbapenem resistance genes among A.baumannii isolates. Therefore, adopting an appropriate strategy to confine the spreading of thesestrains and also implementing new treatment regimens are necessary.

  1. Hospital-acquired influenza: a synthesis using the Outbreak Reports and Intervention Studies of Nosocomial Infection (ORION) statement.

    Science.gov (United States)

    Voirin, N; Barret, B; Metzger, M-H; Vanhems, P

    2009-01-01

    Nosocomial influenza outbreaks occur in almost all types of hospital wards, and their consequences for patients and hospitals in terms of morbidity, mortality and costs are considerable. The source of infection is often unknown, since any patient, healthcare worker (HCW) or visitor is capable of transmitting it to susceptible persons within hospitals. Nosocomial influenza outbreak investigations should help to identify the source of infection, prevent additional cases, and increase our knowledge of disease control to face future outbreaks. However, such outbreaks are probably underdetected and underreported, making routes of transmission difficult to track and describe with precision. In addition, the absence of standardised information in the literature limits comparison between studies and better understanding of disease dynamics. In this study, reports of nosocomial influenza outbreaks are synthesised according to the ORION guidelines to highlight existing knowledge in relation to the detection of influenza cases, evidence of transmission between patients and HCWs and measures of disease incidence. Although a body of evidence has confirmed that influenza spreads within hospitals, we should improve clinical and virological confirmation and initiate active surveillance and quantitative studies to determine incidence rates in order to assess the risk to patients.

  2. Fact-finding survey of nosocomial infection control in hospitals in Vietnam and application to training programs.

    Science.gov (United States)

    Ohara, Hiroshi; Hung, Nguyen Viet; Thu, Truong Anh

    2009-12-01

    Nosocomial infection control is crucial for improving the quality of medical care. It is also indispensable for implementing effective control measures for severe acute respiratory syndrome (SARS) and the possible occurrence of a human influenza pandemic. The present authors, in collaboration with Vietnamese hospital staff, performed a fact-finding survey of nosocomial infection control in hospitals in northern Vietnam and compared the results with those of a survey conducted 4 years previously. Remarkable improvement was recognized in this period, although there were considerable differences between the central hospitals in Hanoi and local hospitals. In the local hospitals, basic techniques and the systems for infection control were regarded as insufficient, and it is necessary to improve these techniques and systems under the guidance of hospitals in the central area. Based on the results of the survey, programs were prepared and training courses were organized in local hospitals. Evaluation conducted after the training courses showed a high degree of satisfaction among the trainees. The results of the survey and the training courses conducted during the study period are expected to contribute to the improvement of nosocomial infection control in remote areas of Vietnam.

  3. Activities of doripenem against nosocomial bacteremic drug-resistant Gram-negative bacteria in a medical center in Taiwan.

    Science.gov (United States)

    Dong, Shao-Xing; Wang, Jann-Tay; Chang, Shan-Chwen

    2012-12-01

    The majority of nosocomial infections in Taiwan hospitals are caused by drug-resistant Gram-negative bacteria (GNB), including Pseudomonas aeruginosa, Acinetobacter baumannii, and various species of Enterobacteriaceae. Carbapenems are important agents for treating infections caused by these GNB. Recently, doripenem was approved for use in Taiwan in August 2009. However, data on its in vitro activity against nosocomial GNB isolated from Taiwan remain limited. The study was designed to look into this clinical issue. A total of 400 nonduplicated nosocomial blood isolates isolated in 2009, inclusive of P. aeruginosa (n = 100), A. baumannii (n = 100), and Enterobacteriaceae (n = 200), were randomly selected from the bacterial bank preserved at National Taiwan University Hospital. Susceptibilities of these 400 isolates to various antibiotics, including doripenem, imipenem, meropenem, ceftazidime, amikacin, ciprofloxacin, colistin, and tigecycline were determined by using Etest. Doripenem demonstrated similar in vitro activity to imipenem and meropenem against P. aeruginosa (87%, vs. 85% and 89%), A. baumannii (56%, vs. 60% and 60%), and Enterobacteriaceae (100%, vs. 98.5% and 99.5%). The prevalence of carbapenem-resistant (any one of three tested carbapenems) P. aeruginosa, A. baumannii, and Enterobacteriaceae isolates was 15%, 44%, and 0.5%, respectively. Doripenem was as effective as imipenem and meropenem in our study. However, there was a significant proportion of carbapenem resistance among the tested isolates. Hence, longitudinal surveillance is necessary to monitor the resistance trend. Copyright © 2012. Published by Elsevier B.V.

  4. CARACTERIZACIÓN DE AISLAMIENTOS DE Colletotrichum lindemuthianum DE ECUADOR Y GUATEMALA PARA IDENTIFICAR GENES DE RESISTENCIA

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    Halima Awale

    2008-01-01

    Full Text Available El objetivo de esta investigación fue determinar la variabilidad patogénica de C. lindemuthianum en zonas productoras de frijol común en Ecuador y Guatemala para identificar las combinaciones de genes de resistencia más efectivas para las condiciones locales. Aislamientos de antracnosis recolectados fueron caracterizados para la identifi cación de las razas presentes en estos países empleando el juego estándar de 12 cultivares diferenciales. De acuerdo a la evaluación, solamente dos razas (5, 9 mostraron estar presentes en los dos países. En Guatemala se registró una mayor diversidad patogénica (mayor número de razas que en Ecuador. Basados en esta información y en otros datos de estudios realizados anteriormente, sugerimos como la combinación genética más efectiva la piramidación de los genes Co-12 y Co-42. Esta combinación conferiría resistencia completa a casi todas las razas de C. lindemuthianum identifi cadas hasta el momento en los dos países.

  5. Thomas Hobbes: la resistencia política al Leviatán || Thomas Hobbes: Political Resistance To Leviathan

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    Diego Alejandro Fernández Peychaux

    2013-12-01

    Full Text Available RESUMEN En el presente artículo se presentan cuatro claves de lectura de la obra de Thomas Hobbes desde las que fundamentar una noción de resistencia. Este aporte busca, en otras palabras, crear las condiciones de posibilidad de un debate filosófico ofuscado por el mito recurrente sobre el supuesto monstruo de Malmesbury. Una vez hecho esto, se propone delinear las bases de un enfoque metodológico que parta de dicha noción de resistencia. De ese modo, se fundamentaría el primer paso hacia una apropiación ?o expropiación? contemporánea de la matriz hobbesiana de la relación obediencia-seguridad   ABSTRACT This article presents four key of readings about Thomas Hobbes's work, from which it supports a particular notion of resistance. In others words, this contribution searches to create the conditions of posibility for a philosophical debate obfuscated by the recurrent myth about the monster of Malmesbury. Once done that, I offer setting the bases of a metodological aproach which stars from this notion of resistance. Thus, I would back the first step towards a contemporary appropriation ?or expropriation? of the obedience-security relationship within the Hobbesian matrix.

  6. Resistencia de levaduras del género Candida al fluconazol Candida yeast´s resistance to fluconazol

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    Carlos Hernando Gómez Quintero

    2010-12-01

    Full Text Available Las infecciones por levaduras del género Candida sp. son cada vez más prevalentes en pacientes hospitalizados, especialmente en grupos de mayor riesgo como pueden ser pacientes con neoplasia hematológica bajo tratamiento de quimioterapia y en cuidados intensivos. La resistencia de Candida sp. representa un reto terapéutico que deja un menor número de posibilidades para el tratamiento de estas infecciones que se caracterizan, a su vez, por una alta morbimortalidad. Esta revisión describe los mecanismos de resistencia de Candida sp. a fluconazol y los factores de riesgo para la adquisición de éstos.Yeast infections of the genus Candida sp are becoming more prevalent in hospitalized patients, especially in high risk groups such as patients with hematologic malignancy undergoing chemotherapy and in intensive care units. Candida sp's resistance represents a therapeutic challenge that leaves fewer opportunities for the treatment of these infections which are characterized by high morbidity and mortality. This review describes Candida sp's resistance mechanisms to fluconazole and the risk factors for their acquisition.

  7. EVALUACIÓN DE LA RETRACCIÓN Y FLUENCIA EN EL HORMIGÓN AUTOCOMPACTABLE DE RESISTENCIA MEDIA

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    CLAUDIA JENNY DE LA CRUZ MORALES

    2012-01-01

    Full Text Available La diferencia entre un Hormigón Autocompactable (HAC y un Hormigón Convencional (HC en estado fresco, es la alta fluidez del primero y la necesidad de vibración en el segundo; pero en estado endurecido, ambos hormigones deben cumplir con la resistencia especificada, garantizando además la funcionalidad y seguridad para la que fue diseñado. En este artículo se describen los ensayos y resultados de retracción y fluencia para algunos hormigones autocompactables de resistencia media con adición de arena (HAC-RMCAs y dos tipos de cemento. La investigación se realizó en el Laboratorio de Tecnología de Estructuras (LTE de la Universitat Politècnica de Catalunya (UPC, preparando dosificaciones de 200 Litros; con la idea de evaluar la efectividad de aplicación de estos nuevos hormigones en elementos pensados con hormigones convencionales (HCs.

  8. Cálculo de la resistencia a la penetración en hojas de aloe vera (Barbadenses Miller

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    Giovanni Torres Charry

    2013-12-01

    Full Text Available Para caracterizar la resistencia a la penetración de hojas de aloe vera, variedad Barbadenses Miller, se diseñó una máquina y se establecieron los protocolos de medición para desplazamiento y fuerza necesarios para medir la resistencia a la penetración en tres puntos diferentes de las hojas. Los resultados mostraron que no existe una relación lineal entre el desplazamiento del indentador en la hoja y la fuerza de penetración. Por otro lado, se encontró que no existen diferencias en los valores de la fuerza de penetración al evaluar ésta en distintos puntos para una misma hoja. Se hallaron diferencias en los valores obtenidos entre hojas diferentes, lo que permite suponer que existe influencia de las características dimensionales de las hojas en el valor de la fuerza de penetración. Los valores máximos obtenidos para la fuerza de penetración variaron entre 22 y 27 N, para una velocidad de avance de la herramienta de 2.6 mm/s.

  9. Evaluación formativa de los aprendizajes en el contexto universitario: resistencias y paradojas del profesorado

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    Leonor Margalef García

    2014-01-01

    Full Text Available En este articulo se presentan los resultados de uno de los objetivos de un proyecto de investigación sobre evaluación formativa: analizar las resistencias y paradojas a las que se enfrenta el profesorado universitario para implementar procesos de evaluación orientados a mejorar el aprendizaje de sus estudiantes. La investigación se fundamento en un estudio de casos múltiples conformado por profesorado de las diferentes ramas de conocimiento de la Universidad de Alcalá. Nuestros hallazgos sugieren que estas resistencias y paradojas tienen que ver con las creencias y concepciones del profesorado acerca de la enseñanza, el aprendizaje y la evaluación, la influencia de la cultura organizativa y las condiciones institucionales; a lo que hay que añadir la inseguridad e incertidumbre que provocan los procesos de innovación en las practicas evaluadoras. En el estudio se concluye que esta incertidumbre no solo se debe a una falta de informacion y comprensión de los procesos de cambio evaluativos sino, también, a que el profesorado cuenta con escasos referentes y aprendizajes experienciales en evaluación formativa en los que apoyarse.

  10. Thomas Hobbes: la resistencia política al Leviatán || Thomas Hobbes: Political Resistance To Leviathan

    Directory of Open Access Journals (Sweden)

    Diego Alejandro Fernández Peychaux

    2013-12-01

    Full Text Available RESUMEN En el presente artículo se presentan cuatro claves de lectura de la obra de Thomas Hobbes desde las que fundamentar una noción de resistencia. Este aporte busca, en otras palabras, crear las condiciones de posibilidad de un debate filosófico ofuscado por el mito recurrente sobre el supuesto monstruo de Malmesbury. Una vez hecho esto, se propone delinear las bases de un enfoque metodológico que parta de dicha noción de resistencia. De ese modo, se fundamentaría el primer paso hacia una apropiación ?o expropiación? contemporánea de la matriz hobbesiana de la relación obediencia-seguridad   ABSTRACT This article presents four key of readings about Thomas Hobbes's work, from which it supports a particular notion of resistance. In others words, this contribution searches to create the conditions of posibility for a philosophical debate obfuscated by the recurrent myth about the monster of Malmesbury. Once done that, I offer setting the bases of a metodological aproach which stars from this notion of resistance. Thus, I would back the first step towards a contemporary appropriation ?or expropriation? of the obedience-security relationship within the Hobbesian matrix.  

  11. Resistencia del Plasmodium Falciparum a la combinación de los tres primeros casos en Colombia

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    C. A. Espinal

    1981-12-01

    Full Text Available La combinación sulfadoxina-pirimetamina ha sido uno de los esquemas de tratamiento más utilizados en las infecciones por P. falciparum resistente a la cloroquina. En este artículo describimos los primeros tres casos documentados de resistencia a esta combinación de medicamentos en Colombia. en pacientes procedentes d e San José del Guaviare y el Valle del Ariari, donde también se ha encontrado el P. falciparum resistente a la cloroquina. El empleo de las tetraciclinas, a una dosis de Igr/día por 8 a 12 días, asociadas a un esquizonticida de acción rápida como la quinina o la amodiaquina. es el tratamiento más adecuado para los casos que presentan resistencia múltiple a las drogas antimaláricas. La cloroquina únicamente debe ser utilizada cuando la infección puede ser controlada por este medicamento en su fase aguda y el paciente tenga un bajo recuento de parásitos por microlitro de sangre.

  12. La Resistencia Indígena: Una forma de fortalecer la cultura, la autoridad y los derechos humanos

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    Rubén Darío Guevara Corral

    2010-01-01

    Full Text Available Las expresiones de resistencia indígena, son una de las muestras más significativas de su valoración cultural, que permiten de alguna manera, su reconocimiento como miembros de la sociedad global con derechos y obligaciones por parte del Estado. Los nasa, una etnia del departamento del Cauca, Colombia, han recuperado lo propio de éstas expresiones y a través de la guardia indígena, han inculcado la resistencia, la autoridad y la solidaridad en la disciplina organizativa reflejada en las marchas para reclamar sus derechos.____________ABSTRACT:Expressions of indigenous resistance indicate the most important cultural value of the communities, which in some way, their recognition as members of global society with rights and obligations of the Colombian State. The “Nasa”, ethnic group of the Cauca department, located, south of the country, has regained ownership of these expressions and using the indigenous guard, have instilled the strength, authority and solidarity reflected in the organizational discipline in the marches to demand their rights.

  13. Genotipicación de la resistencia natural del ganado blanco orejinegro “BON” a la Salmonella dublin SL 2260

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    Jorge Eliécer Ossa Londoño

    2000-02-01

    Full Text Available Uno de los factores que controla la resistencia a microorganismos intracelulares como Salmonella y Brucella, es el producto del gen Nramp (proteína del macrófago asociada a resistencia natural; esta proteína, en la fase temprana de la infección, controla la capacidad de replicación de estas bacterias en los macrófagos. Recientemente se identificó asociación entre un alelo de 175 pb de un microsatélite (STR, ligado a Nramp, con la resistencia a microorganismos intracelulares en bovinos; adicionalmente, se han identificado otros tres alelos (177, 179 y 181 pb asociados con susceptibilidad. En la especie bovina, la Salmonella Dublín sirve como modelo para estudiar la resistencia natural a otras bacterias intracelulares como la Brucella abortus, ya que se ha demostrado que macrófagos derivados de bovinos resistentes controlan eficientemente el crecimiento de ambas bacterias. En Colombia, se ha propuesto que el ganado criollo “BON” presenta una marcada resistencia a enfermedades infecciosas, entre ellas la brucellosis. El objetivo de esta investigación fue determinar el genotipo y el fenotipo de la resistencia del ganado BON a la Salmonella Dublín SL 2260, para contribuir a la caracterización inmunogenética de la resistencia natural de este ganado a las infecciones microbianas. En este trabajo sé han analizado 80 bovinos de la raza “BON”, 18 holstein y 4 cebú: se extrajo ADN a partir de sangre periférica, se amplificó el STR ligado al Nramp, a través de la técnica de reacción en cadena de la polimerasa (PCR; el producto fue sometido a un análisis de polimorfismos conformacionales de cadena sencilla (SSCP, utilizando un gel de polyacrilamida al 6% en condiciones no reductoras. De acuerdo a la movilidad electroforética de los amplicones, y comparándola con un patrón ya definido de resistencia, se han tipificado los diferentes animales. De los 80 animales “BON”, 79 (98.75% fueron homocigóticos para el alelo de

  14. Influencia de los tratamientos microabrasivos sobre la resistencia adhesiva en dientes con fluorosis

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    Paola Mena Silva

    2015-12-01

    Full Text Available La búsqueda de tratamientos mínimamente invasivos y altamente estéticos para pacientes con fluorosis, ha llevado a buscar mecanismos para solucionar esta problemática, mediante la utilización de resinas como la primera opción. Sin embargo el principal problema del tratamiento, se centra en la poca adhesión debido a las características estructurales del esmalte fluorótico, en grados de fluorosis TF 1 al 3, el ácido no actúa correctamente, causando ausencia de grabado principalmente entre las estrías de Retzius, en las rugosidades y espacios adamantinos ocupados por detritus de materia orgánica y cúmulos de placa dentobacteriana, siendo necesario efectuar técnicas microabrasivas y desproteinizantes como paso previo a los procesos adhesivos. Así, el presente estudio pretendió determinar la resistencia adhesiva en dientes con fluorosis grados TF 2 y 3, empleando tres diferentes técnicas de abrasión adamantina, se seleccionaron 48 dientes divididos en 3 grupos de 16 muestras cada uno, 8 con grado TF2 y 8 con grado TF3. Las superficies del esmalte fueron preparadas mediante la técnica “microabrasión modificada”, la “técnica de microabrasión” y “Opalustre”, todos los grupos recibieron desproteinización con hipoclorito de sodio al 5% por un minuto. Posterior a lo cual fueron realizados los procesos adhesivos mediante sistema adhesivo y resina compuesta, sometiéndose posteriormente a pruebas de cizallamiento. Los resultados analizados mediante testes de ANOVA y T de Student no determinaron una diferencia estadísticamente significativa entre los grupos, la facilidad en los protocolos de aplicación debe ser considerada en la elección de la técnica, sin embargo resulta importante su ejecución en dientes afectados por fluorosis.

  15. Diagnostic Evasion of Highly-Resistant Microorganisms: A Critical Factor in Nosocomial Outbreaks.

    Science.gov (United States)

    Zhou, Xuewei; Friedrich, Alexander W; Bathoorn, Erik

    2017-01-01

    Highly resistant microorganisms (HRMOs) may evade screening strategies used in routine diagnostics. Bacteria that have evolved to evade diagnostic tests may have a selective advantage in the nosocomial environment. Evasion of resistance detection can result from the following mechanisms: low-level expression of resistance genes not resulting in detectable resistance, slow growing variants, mimicry of wild-type-resistance, and resistance mechanisms that are only detected if induced by antibiotic pressure. We reviewed reports on hospital outbreaks in the Netherlands over the past 5 years. Remarkably, many outbreaks including major nation-wide outbreaks were caused by microorganisms able to evade resistance detection by diagnostic screening tests. We describe various examples of diagnostic evasion by several HRMOs and discuss this in a broad and international perspective. The epidemiology of hospital-associated bacteria may strongly be affected by diagnostic screening strategies. This may result in an increasing reservoir of resistance genes in hospital populations that is unnoticed. The resistance elements may horizontally transfer to hosts with systems for high-level expression, resulting in a clinically significant resistance problem. We advise to communicate the identification of HRMOs that evade diagnostics within national and regional networks. Such signaling networks may prevent inter-hospital outbreaks, and allow collaborative development of adapted diagnostic tests.

  16. The Immune Response against Acinetobacter baumannii, an Emerging Pathogen in Nosocomial Infections

    Science.gov (United States)

    García-Patiño, María Guadalupe; García-Contreras, Rodolfo; Licona-Limón, Paula

    2017-01-01

    Acinetobacter baumannii is the etiologic agent of a wide range of nosocomial infections, including pneumonia, bacteremia, and skin infections. Over the last 45 years, an alarming increase in the antibiotic resistance of this opportunistic microorganism has been reported, a situation that hinders effective treatments. In order to develop effective therapies against A. baumannii it is crucial to understand the basis of host–bacterium interactions, especially those concerning the immune response of the host. Different innate immune cells such as monocytes, macrophages, dendritic cells, and natural killer cells have been identified as important effectors in the defense against A. baumannii; among them, neutrophils represent a key immune cell indispensable for the control of the infection. Several immune strategies to combat A. baumannii have been identified such as recognition of the bacteria by immune cells through pattern recognition receptors, specifically toll-like receptors, which trigger bactericidal mechanisms including oxidative burst and cytokine and chemokine production to amplify the immune response against the pathogen. However, a complete picture of the protective immune strategies activated by this bacteria and its potential therapeutic use remains to be determined and explored. PMID:28446911

  17. Code blue: Acinetobacter baumannii, a nosocomial pathogen with a role in the oral cavity

    Science.gov (United States)

    Richards, A.M.; Kwaik, Y. Abu; Lamont, R.J.

    2015-01-01

    SUMMARY Actinetobacter baumannii is an important nosocomial pathogen that can cause a wide range of serious conditions including pneumonia, meningitis, necrotizing fasciitis and sepsis. It is also a major cause of wound infections in military personnel injured during the conflicts in Afghanistan and Iraq, leading to its popular nickname of ‘Iraqibacter’. Contributing to its success in clinical settings is resistance to environmental stresses such as desiccation and disinfectants. Moreover, in recent years there has been a dramatic increase in the number of A. baumannii strains with resistance to multiple antibiotic classes. Acinetobacter baumannii is an inhabitant of oral biofilms, which can act as a reservoir for pneumonia and chronic obstructive pulmonary disease. Subgingival colonization by A. baumannii increases the risk of refractory periodontitis. Pathogenesis of the organism involves adherence, biofilm formation and iron acquisition. In addition, A. baumannii can induce apoptotic cell death in epithelial cells and kill hyphal forms of Candida albicans. Virulence factors that have been identified include pili, the outer membrane protein OmpA, phospholipases and extracellular polysaccharide. Acinetobacter baumannii can sense blue light through a blue-light sensing using flavin (BLUF) domain protein, BlsA. The resulting conformational change in BlsA leads to changes in gene expression, including virulence genes. PMID:25052812

  18. Nosocomial infections among acute leukemia patients in China: An economic burden analysis.

    Science.gov (United States)

    Wu, Xiaohui; Yan, Tianyuan; Liu, Yunhong; Wang, Jingna; Li, Yingxia; Wang, Shuhui

    2016-10-01

    The economic burden associated nosocomial infections (NIs) in patients with acute leukemia (AL) in China was unclear. A prospective study was conducted to quantify the medical cost burden of NIs among AL patients. Nine hundred ninety-four patients diagnosed with AL between January 2011 and December 2013 were included. Relevant necessary information was extracted from the hospital information system and hospital infection surveillance system. The primary outcome was incidence of NIs and the secondary was economic burden results, including extra medical costs and prolonged length of stay (LOS). We estimated the total incremental cost of NIs by comparing all-cause health care costs in patients with versus without infections. Prolonged duration of stay was compared in patients with different infections. Of 994 patients with AL, 277 (27.9%) experienced NIs. NI was associated with a total incremental cost of $3,092 per patient ($5,227 vs $2,135; P economic burden on patients with AL. The study highlights the influence of NIs on LOS and health care costs and appeal to the establishment of prophylactic measures for NIs to reduce the unnecessary waste of medical resources in the long run. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  19. Decontamination Efficacy of Ultraviolet Radiation against Biofilms of Common Nosocomial Bacteria.

    Science.gov (United States)

    Tingpej, Pholawat; Tiengtip, Rattana; Kondo, Sumalee

    2015-06-01

    Ultraviolet radiation (UV) is commonly used to destroy microorganisms in the health-care environment. However, the efficacy of UV radiation against bacteria growing within biofilms has never been studied. To measure the sterilization effectiveness of UV radiation against common healthcare associated pathogens growing within biofilms. Staphylococcus aureus, Methicillin-resistant S. aureus (MRSA), Streptococcus epidermidis, Escherichia coli, ESBL-producing E. coli, Pseudomonas aeruginosa and Acinetobacter baumannii were cultivated in the Calgary Biofilm Device. Their biofilms were placed 50 cm from the UV lamp within the Biosafety Cabinet. Viability test, crystal violet assay and a scanning electron microscope were used to evaluate the germicidal efficacy. Within 5 minutes, UV radiation could kill S. aureus, MRSA, S. epidermidis, A. baumannii and ESBL-producing E. coli completely while it required 20 minutes and 30 minutes respectively to kill E. coli and P. aeruginosa. However, the amounts of biomass and the ultrastructure between UV-exposed biofilms and controls were not significantly different. UV radiation is effective in inactivating nosocomial pathogens grown within biofilms, but not removing biofilms and EPS. The biofilm of P. aeruginosa was the most durable.

  20. Nosocomial Serratia marcescens infections associated with extrinsic contamination of a liquid nonmedicated soap.

    Science.gov (United States)

    Sartor, C; Jacomo, V; Duvivier, C; Tissot-Dupont, H; Sambuc, R; Drancourt, M

    2000-03-01

    To determine the role of nonmedicated soap as a source of Serratia marcescens nosocomial infections (NIs) in hospital units with endemic S marcescens NI and to examine the mechanisms of soap colonization. University-affiliated tertiary-care hospitals. A prospective case-control study and an environmental investigation were performed to assess the relationship between S marcescens NIs in hospital units and S marcescens-contaminated soap. Soap-bottle use and handwashing practices were reviewed. Cultures of healthcare workers' (HCWs) hands were obtained before and after hand washing with soap. 5 of 7 hospital units with S marcescens NIs had soap bottles contaminated with S marcescens, compared to 1 of 14 other units (P=.006). After hand washing with an S marcescens-contaminated soap pump, HCWs' hands were 54 times more likely to be contaminated with S marcescens (Pliquid soap by S marcescens resulted in handborne transmission of S marcescens NIs by HCWs in our setting. This finding led to the application of strict guidelines for nonmedicated soap use and to the reinforcement of alcoholic hand disinfection.

  1. Nosocomial rapidly growing mycobacterial infections following laparoscopic surgery: CT imaging findings

    International Nuclear Information System (INIS)

    Volpato, Richard; Campi de Castro, Claudio; Hadad, David Jamil; Silva Souza Ribeiro, Flavya da; Filho, Ezequiel Leal; Marcal, Leonardo P.

    2015-01-01

    To identify the distribution and frequency of computed tomography (CT) findings in patients with nosocomial rapidly growing mycobacterial (RGM) infection after laparoscopic surgery. A descriptive retrospective study in patients with RGM infection after laparoscopic surgery who underwent CT imaging prior to initiation of therapy. The images were analyzed by two radiologists in consensus, who evaluated the skin/subcutaneous tissues, the abdominal wall, and intraperitoneal region separately. The patterns of involvement were tabulated as: densification, collections, nodules (≥1.0 cm), small nodules (<1.0 cm), pseudocavitated nodules, and small pseudocavitated nodules. Twenty-six patients met the established criteria. The subcutaneous findings were: densification (88.5 %), small nodules (61.5 %), small pseudocavitated nodules (23.1 %), nodules (38.5 %), pseudocavitated nodules (15.4 %), and collections (26.9 %). The findings in the abdominal wall were: densification (61.5 %), pseudocavitated nodules (3.8 %), and collections (15.4 %). The intraperitoneal findings were: densification (46.1 %), small nodules (42.3 %), nodules (15.4 %), and collections (11.5 %). Subcutaneous CT findings in descending order of frequency were: densification, small nodules, nodules, small pseudocavitated nodules, pseudocavitated nodules, and collections. The musculo-fascial plane CT findings were: densification, collections, and pseudocavitated nodules. The intraperitoneal CT findings were: densification, small nodules, nodules, and collections. (orig.)

  2. The ORION statement: guidelines for transparent reporting of outbreak reports and intervention studies of nosocomial infection.

    Science.gov (United States)

    Stone, Sheldon P; Cooper, Ben S; Kibbler, Chris C; Cookson, Barry D; Roberts, Jenny A; Medley, Graham F; Duckworth, Georgia; Lai, Rosalind; Ebrahim, Shah; Brown, Erwin M; Wiffen, Phil J; Davey, Peter G

    2007-04-01

    The quality of research in hospital epidemiology (infection control) must be improved to be robust enough to influence policy and practice. In order to raise the standards of research and publication, a CONSORT equivalent for these largely quasi-experimental studies has been prepared by the authors of two relevant systematic reviews, following consultation with learned societies, editors of journals, and researchers. The ORION (Outbreak Reports and Intervention Studies Of Nosocomial infection) statement consists of a 22 item checklist, and a summary table. The emphasis is on transparency to improve the quality of reporting and on the use of appropriate statistical techniques. The statement has been endorsed by a number of professional special interest groups and societies. Like CONSORT, ORION should be considered a "work in progress", which requires ongoing dialogue for successful promotion and dissemination. The statement is therefore offered for further public discussion. Journals and research councils are strongly recommended to incorporate it into their submission and reviewing processes. Feedback to the authors is encouraged and the statement will be revised in 2 years.

  3. Nosocomial outbreak of neonatal gastroenteritis caused by a new serotype 4, subtype 4B human rotavirus.

    Science.gov (United States)

    Gerna, G; Forster, J; Parea, M; Sarasini, A; Di Matteo, A; Baldanti, F; Langosch, B; Schmidt, S; Battaglia, M

    1990-07-01

    A nosocomial outbreak of rotavirus gastroenteritis involving 52 newborns occurred between June and September 1988 at the University Children's Hospital of Freiburg, Federal Republic of Germany. Stools from 27 representative patients were examined for rotavirus serotypes, using a monoclonal antibody-based enzyme-linked immunosorbent assay. The electropherotype was also examined by polyacrylamide gel electrophoresis of genomic RNA. As many as 18 patients were found to be infected by serotype 4, subtype 4B strain, and in all of them the same electropherotype was detected. Although rotavirus from the remaining nine patients could not be typed, the electropherotype in four was identical to that of the serotype 4, subtype 4B strain. Thus, most of the patients in the outbreak were infected by the same rotavirus strain. Retrospective epidemiological studies showed that the 4B strain began to circulate at the hospital in January 1988, whereas only rotavirus serotypes 1, 3, and 4A were detected in 1985-1987. The primary case of the outbreak was presumably a newborn with acute gastroenteritis, admitted to the hospital from a small maternity unit in the same urban area. During the outbreak, 12 of 44 healthy newborns in the nurseries of the Children's Hospital and other maternity hospitals were found to be asymptomatic rotavirus carriers, and in three of the newborns the same 4B strain was detected. This is the first reported outbreak caused by a serotype 4, subtype 4B strain.

  4. Nosocomial outbreak of staphyloccocal scalded skin syndrome in neonates in England, December 2012 to March 2013.

    Science.gov (United States)

    Paranthaman, K; Bentley, A; Milne, L M; Kearns, A; Loader, S; Thomas, A; Thompson, F; Logan, M; Newitt, S; Puleston, R

    2014-08-21

    Staphylococcal scalded skin syndrome (SSSS) is a blistering skin condition caused by exfoliative toxin-producing strains of Staphylococcus aureus. Outbreaks of SSSS in maternity settings are rarely reported. We describe an outbreak of SSSS that occurred among neonates born at a maternity unit in England during December 2012 to March 2013. Detailed epidemiological and microbiological investigations were undertaken. Eight neonates were found to be infected with the outbreak strain of S. aureus, of spa type t346, representing a single pulsotype. All eight isolates contained genes encoding exfoliative toxin A (eta) and six of them contained genes encoding toxin B (etb). Nasal swabs taken during targeted staff screening yielded a staphylococcal carriage rate of 21% (17/80), but none contained the outbreak strain. Mass screening involving multi-site swabbing and pooled, enrichment culture identified a healthcare worker (HCW) with the outbreak strain. This HCW was known to have a chronic skin condition and their initial nasal screen was negative. The outbreak ended when they were excluded from work. This outbreak highlights the need for implementing robust swabbing and culture methodswhen conventional techniques are unsuccessful in identifying staff carrier(s). This study adds to the growing body of evidence on the role of HCWs in nosocomial transmission of S. aureus.

  5. Nosocomial infection with Legionella pneumophila serogroup 1 and 8 in a neonate.

    Science.gov (United States)

    Aubert, G; Bornstein, N; Rayet, I; Pozzetto, B; Lenormand, P H

    1990-01-01

    A case of pneumonia related to 2 serogroups (1 and 8) of Legionella pneumophila (Lp) in a 10-day-old boy is described together with the epidemiological survey in the maternity ward which made it possible to establish its nosocomial origin. Rodshaped bacteria reacting with an Lp genus-specific monoclonal antibody and serogroup 1 and 8 polyclonal sera were detected in bronchoalveolar lavages (BAL) collected on day 13. Serogroups 1 and 8 were recovered from cultures of BAL collected on days 12 and 13. Fourfold or more antibody rises to serogroups 1, 5, 8 and 10 of Lp were observed in sequential serum specimens. Water samples collected from the tank and mixer of the maternity ward grew serogroups 1 and 8 of Lp. Serogroup 1 was detected in large amounts in water samples taken at several points of the hot water supply system and from the oxygen nebulizers and the feeding-bottle heater. Analysis of the Lp serogroup 1 strains isolated from the water by subgroup-specific monoclonal antibodies revealed the presence of 4 different subgroups, one of which was identical to the Lp 1 subgroup isolated from the neonate's BAL. This latter subgroup, reactive with McKinney monoclonal antibody Mab 2, has been described as highly virulent. No other case of legionellosis was recorded in the maternity ward.

  6. Nosocomial rapidly growing mycobacterial infections following laparoscopic surgery: CT imaging findings

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    Volpato, Richard [Cassiano Antonio de Moraes University Hospital, Department of Diagnostic Radiology, Vitoria, ES (Brazil); Campi de Castro, Claudio [University of Sao Paulo Medical School, Department of Radiology, Cerqueira Cesar, Sao Paulo (Brazil); Hadad, David Jamil [Cassiano Antonio de Moraes University Hospital, Nucleo de Doencas Infecciosas, Department of Internal Medicine, Vitoria, ES (Brazil); Silva Souza Ribeiro, Flavya da [Laboratorio de Patologia PAT, Department of Diagnostic Radiology, Unit 1473, Vitoria, ES (Brazil); Filho, Ezequiel Leal [UNIMED Diagnostico, Department of Diagnostic Radiology, Unit 1473, Vitoria, ES (Brazil); Marcal, Leonardo P. [The University of Texas M D Anderson Cancer Center, Department of Diagnostic Radiology, Unit 1473, Houston, TX (United States)

    2015-09-15

    To identify the distribution and frequency of computed tomography (CT) findings in patients with nosocomial rapidly growing mycobacterial (RGM) infection after laparoscopic surgery. A descriptive retrospective study in patients with RGM infection after laparoscopic surgery who underwent CT imaging prior to initiation of therapy. The images were analyzed by two radiologists in consensus, who evaluated the skin/subcutaneous tissues, the abdominal wall, and intraperitoneal region separately. The patterns of involvement were tabulated as: densification, collections, nodules (≥1.0 cm), small nodules (<1.0 cm), pseudocavitated nodules, and small pseudocavitated nodules. Twenty-six patients met the established criteria. The subcutaneous findings were: densification (88.5 %), small nodules (61.5 %), small pseudocavitated nodules (23.1 %), nodules (38.5 %), pseudocavitated nodules (15.4 %), and collections (26.9 %). The findings in the abdominal wall were: densification (61.5 %), pseudocavitated nodules (3.8 %), and collections (15.4 %). The intraperitoneal findings were: densification (46.1 %), small nodules (42.3 %), nodules (15.4 %), and collections (11.5 %). Subcutaneous CT findings in descending order of frequency were: densification, small nodules, nodules, small pseudocavitated nodules, pseudocavitated nodules, and collections. The musculo-fascial plane CT findings were: densification, collections, and pseudocavitated nodules. The intraperitoneal CT findings were: densification, small nodules, nodules, and collections. (orig.)

  7. Nosocomial tuberculosis prevention in Portuguese hospitals: a cross-sectional evaluation.

    Science.gov (United States)

    Sousa, M; Gomes, M; Gaio, A R; Duarte, R

    2017-08-01

    Measures to control tuberculous infection are crucial to prevent nosocomial transmission and protect health care workers (HCWs). In Portugal, the extent of implementation of tuberculosis (TB) control measures in hospitals is not known. To determine the current implementation of preventive measures for tuberculous infection at administrative, environmental and personal levels in Portuguese hospitals. A cross-sectional evaluation was performed using two anonymous questionnaires: one sent to all the hospital infection control (IC) committees and the other sent to all pulmonologists and physicians specialising in infectious disease. Fourteen IC committees and 72 physicians responded. According to the IC committees, 92% of hospitals had a written TB control plan, but only 37% of the physicians said there was always/almost always a fast track for diagnosing suspected pulmonary TB cases. The majority of the hospitals had an isolation policy (85%) and these patients were always/almost always admitted in separate rooms, according to 70% of physicians. Both HCWs and TB patients used respiratory protection equipment (92%). These findings indicate that the most basic TB IC measures had been undertaken, but some TB IC measures were not fully implemented at all hospitals. An institutional effort should be made to solve this problem and strengthen TB prevention activities.

  8. CuO nanoparticles and their antimicrobial activity against nosocomial strains

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    Mónica Marcela Gómez León

    2017-09-01

    Full Text Available Using a prototype reactor, CuO nanoparticles (NPs were synthetized through the precipitation method, starting from CuSO2·5H2O and Cu(CH3COO2·H2O. The obtained NPs were characterized by XDR, FT-IR, SEM, and TEM. The antimicrobial activity of the NPs was determined by the plate diffusion method, placing 20 mg of NPs onto four nosocomial strains obtained from north Lima national hospital Intensive-Care Unit (Staphylococcus epidermidis, Aerococcus viridans, Ochrobactrum anthropic, and Micrococcus lylae. NPs characterization revealed that those synthetized from acetate (CuO–Acet shown pure CuO phase, while those synthetized from sulphate CuO–Sulf shown two phases where CuO was the predominant one, having more than 84%. The crystal domains for CuO–Acet and CuO–Sulf were 15 and 19 nm, respectively. The inhibition halos for the studied strains were larger for CuO–Sulf NPs than CuO–Acet NPs, only Ochrobactrum anthropi displayed similar inhibition halos for both types of NPs.

  9. Early prediction and outcome of septic encephalopathy in acute stroke patients with nosocomial coma.

    Science.gov (United States)

    Tong, Dao-Ming; Zhou, Ye-Ting; Wang, Guang-Sheng; Chen, Xiao-Dong; Yang, Tong-Hui

    2015-07-01

    Septic encephalopathy (SE) is the most common acute encephalopathy in ICU; however, little attention has been focused on risk of SE in the course of acute stroke. Our aim is to investigate the early prediction and outcome of SE in stroke patients with nosocomial coma (NC). A retrospective cohort study was conducted in an ICU of the tertiary teaching hospital in China from January 2006 to December 2009. Ninety-four acute stroke patients with NC were grouped according to with or without SE. Risk factors for patients with SE were compared with those without SE by univariate and multivariate analysis. Of 94 stroke patients with NC, 46 (49%) had NC with SE and 48 (51%) had NC without SE. The onset-to-NC time was significant later in stroke patients with SE than those without SE (P stroke patients with SE was higher than those without SE (76.1% vs. 45.8%, P = 0.003). High fever and severe SIRS are two early predictors of stroke patients with SE, and survival rates were worse in stroke patients with SE than those without SE.

  10. Nosocomial pneumonia: Search for an empiric and effective antibiotic regimen in high burden tertiary care centre.

    Science.gov (United States)

    Gupta, Nitin; Soneja, Manish; Ray, Yogiraj; Sahu, Monalisa; Vinod, Kutty Sharada; Kapil, Arti; Biswas, Ashutosh; Wig, Naveet; Sood, Rita

    2018-04-17

    The clinical practice guidelines on nosocomial pneumonia recommends an empirical regimen that would work in 95% of the patients based on the local antibiogram. The aim of the study was development of an antibiogram for guiding empiric therapy in settings with high prevalence of multi-drug resistant organisms. A retrospective review of electronic health records (e-hospital portal) was done to analyze all respiratory isolates from patients admitted in medical wards and intensive care unit between May 2016 and May 2017. The samples included brocho-alveolar lavage (BAL), mini broncho-alveolar lavage (mini-BAL) and endotracheal aspirate. The sensitivity pattern (combined and individual) of all bacterial isolates were analysed for commonly used antibiotics and their combinations. Out of the 269 isolates, the most common organisms were Pseudomonas aeruginosa (125, 46%), Acinetobacter baumanni (74, 27%) and Klebsiella pneumoniae (50, 19%). Cefoperazone-sulbactam (43%) had the best sensitivity pattern overall. Cefoperazone-sulbactam plus amikacin (56%) was the combination with the best combined sensitivity overall. There is a high prevalence of resistance in the commonly implicated organisms to the available antibiotics. There is an urgent need for implementation of effective anti-microbial stewardship programmes and development of newer antimicrobials.

  11. Management of outbreaks of nosocomial pathogens in Neonatal Intensive Care Unit

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    B. Ghirardi

    2013-12-01

    Full Text Available Outbreaks of nosocomial pathogens are one of the most relevant problems in Neonatal Intensive Care Unit (NICU. Many factors contribute to the onset of an epidemic, including virulence of the pathogen and vulnerability of the infants hospitalized in NICU. Outbreaks are often caused by multidrug-resistant organisms (MDROs. MDROs are defined as microorganisms, predominantly bacteria, that are resistant to one or more classes of antimicrobial agents. MDROs, including methicillin-resistant Staphylococcus aureus (MRSA, vancomycin-resistant enterococci (VRE and certain gram-negative bacilli (GNB, have important infection control implications. Once MDROs are introduced into a healthcare setting, transmission and persistence of the resistant strain is determined by the availability of vulnerable patients, selective pressure exerted by antimicrobial use, increased potential for transmission from larger numbers of infected or colonized patients (“colonization pressure”, and the impact of adherence to prevention efforts. Often, routine infection control measures are not enough to contain outbreaks, and additional control measures are needed, including implementation of hand hygiene, cohorting of infected/colonized infants, neonatal surveillance cultures, screening of healthcare workers and decolonization of neonates and/or healthcare workers in selected cases. In this review, we report the practices we developed in our NICU to contain an epidemic. These recommendations reflect the experience of the group, as well as the findings of the current literature.

  12. [Staphylococcus aureus nasal colonization in medical students: importance in nosocomial transmission].

    Science.gov (United States)

    López-Aguilera, Sara; Goñi-Yeste, María Del Mar; Barrado, Laura; González-Rodríguez-Salinas, M Carmen; Otero, Joaquín R; Chaves, Fernando

    2013-10-01

    Staphylococcus aureus is the main pathogen causing nosocomial infections. Health professionals, including medical students, could be a source of transmission. The aims of the study were to determine the rate of nasal carriage of S.aureus susceptible and resistant to methicillin (MRSA) and evaluate the knowledge and adherence that students had about hand hygiene. The study included medical students attached to the Hospital Universitario 12 de Octubre (Madrid, Spain). We collected samples from both nasal vestibules, and the antimicrobial susceptibility was determined on all isolates. Data collection was performed using a self-administered questionnaire that included risk factors for colonization, hygiene habits and knowledge of hand hygiene protocols. Of the 140 students included, 55 (39.3%) were colonized by S.aureus, and 3 (2,1%) by MRSA. The exposure to antibiotics in the last 3 months was lower in colonized students (12.3% vs. 25.9%, P=.03). Self-assessment showed that 56.4% of students almost never washed their hands before to attending to the first patient, and only 38.6% always washed after examining patients. More than a third (35.7%) ignored the hand hygiene protocol, and 38.6% had not received specific formation. Medical students should be included in hospital infection control programs. Hand hygiene training should be given to students before they begin their practices in the hospital. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  13. Integration of microbiological, epidemiological and next generation sequencing technologies data for the managing of nosocomial infections

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    Matteo Brilli

    2018-02-01

    Full Text Available At its core, the work of clinical microbiologists consists in the retrieving of a few bytes of information (species identification; metabolic capacities; staining and antigenic properties; antibiotic resistance profiles, etc. from pathogenic agents. The development of next generation sequencing technologies (NGS, and the possibility to determine the entire genome for bacterial pathogens, fungi and protozoans will likely introduce a breakthrough in the amount of information generated by clinical microbiology laboratories: from bytes to Megabytes of information, for a single isolate. In parallel, the development of novel informatics tools, designed for the management and analysis of the so-called Big Data, offers the possibility to search for patterns in databases collecting genomic and microbiological information on the pathogens, as well as epidemiological data and information on the clinical parameters of the patients. Nosocomial infections and antibiotic resistance will likely represent major challenges for clinical microbiologists, in the next decades. In this paper, we describe how bacterial genomics based on NGS, integrated with novel informatic tools, could contribute to the control of hospital infections and multi-drug resistant pathogens.

  14. A Rare Case of Pediatric Nosocomial Liver Abscess Developing During Dialysis Therapy

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    Mittal

    2015-08-01

    Full Text Available Introduction Liver abscess developing during hospital stay in pediatric patients on dialysis for acute kidney injury has been previously unreported. Impaired immunity, prolonged use of antibiotics, diabetes and malnutrition predispose to liver abscess in chronic hemodialysis patients. Case Presentation We reported a case of liver abscess developing in a 6-year-old boy admitted with sepsis and multiorgan dysfunction syndrome including acute kidney injury. He received peritoneal and subsequently hemodialysis, as he did not improve on peritoneal dialysis. He developed fever while on hemodialysis, which was due to a liver abscess developing during the course of hospital stay. The abscess was in the right lobe of the liver with a volume of 40 mL. Staphylococcus aureus is the leading cause of pyogenic liver abscesses in children and infection acquired from hospital. The patient received vancomycin and responded well with complete resolution and did not require any drainage procedure. He may have acquired bacteremia during dialysis with subsequent hepatic seeding. Conclusions Though rare, liver abscess may develop even in patients undergoing short-term dialysis therapy. Liver abscess is a medical emergency and if not treated promptly may lead to significant mortality. Invasive therapeutic procedures, like drainage is associated with further risk of complications. Therefore, a high index of suspicion should be kept when evaluating a patient who develops unexplained fever while being on hemodialysis. Early medical intervention through appropriate antibiotics can significantly reduce the morbidity and mortality. Strict infection control policies should be followed to prevent such nosocomial infections.

  15. Tendencias de infecciones intrahospitalarias en un centro oncológico, 1986-1996 Trends in nosocomial infections in an oncology center, 1986-1996

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    Patricia Volkow

    2000-06-01

    Full Text Available OBJETIVO: Describir los resultados de diez años de vigilancia de infecciones intrahospitalarias (II en un centro oncológico. MATERIAL Y MÉTODOS: Es un estudio descriptivo, retrospectivo, del programa de vigilancia del Comité de Vigilancia y Control de Infecciones Intrahospitalarias del Instituto Nacional de Cancerología, realizado en 1997. Se utilizaron los criterios de infección intrahospitalaria por sitio propuestos por el Centro para la Prevención y el Control de Enfermedades de Atlanta, Georgia, de Estados Unidos de América, en 1972. De junio de 1986 a diciembre de 1996, se estudiaron 62 733 egresos. La vigilancia se realizó mediante la revisión de los expedientes de pacientes con fiebre, de aquellos que reciben antibióticos y de posoperados en los pisos de hospitalización y revisión de cultivos. Se calcularon las tasas de II por episodios/100 egresos. RESULTADOS: La tasa de infecciones intrahospitalarias por 100 egresos fue de 4.4 en 1986; 7.7, en 1987; 8.1, en 1988; 5.9, en 1989; 4.6, en 1990; 5.1, en 1991; 4.3, en 1992; 5.4, en 1993; 7.6, en 1994; 7.1, en 1995, y 8.5, en 1996. El germen más frecuentemente aislado en las II fue Escherichia coli. Los aislamientos de hongos y los de enterococo se incrementaron en casi siete veces desde 1987. CONCLUSIONES: Se observó un incremento en la tasa de infecciones hospitalarias en los últimos cuatro años. Al menos dos factores contribuyeron a esta tendencia: la aplicación de un sistema de vigilancia más experimentado, el cual hizo que disminuyera el subregistro, y el aumento real en la frecuencia de tales infecciones.OBJECTIVE: To describe the results of ten years of nosocomial infection (NI surveillance in an oncology center. MATERIAL AND METHODS: This is a descriptive study of the Infection Control and Surveillance Program Committee at the Instituto Nacional de Cancerología, conducted in 1997. From June 1986 to December 1996, we surveyed 62 733 hospital discharge records

  16. Frecuencia y resistencia bacteriana de Staphylococcus aureus en infecciones nosocomiales en el Hospital Universitario de Caracas, años 2004 y 2007

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    Guillermo Borga Hernández

    2010-01-01

    Full Text Available Objetivo: Determinar la frecuencia de infecciones nosocomiales y resistencia a meticiclina de S. aureus en el Hospital Universitario de Caracas, primer semestre de años 2004 y 2007. Materiales y Métodos: Estudio descriptivo para determinar frecuencia de infecciones intrahospitalarias (IN y resistencia a meticiclina de S. aureus, se analizaron los informes de los Boletines de la Sub Comisión de Infecciones Hospitalarias del Hospital Universitario de Caracas correspondientes al primer semestre de los años 2004 y 2007 Resultados: En el año 2004 se registraron 1.608 casos de IN, 6,84% ocasionadas por S. aureus y 2.311 en el año 2007, 10,42% causadas por dicho microorganismo. La resistencia a la meticilina en el año 2004 fue 14% de las 110 cepas aisladas y en el 2007 fue de 68% de las 241 cepas aisladas. Conclusiones: Existe diferencia en la frecuencia de infecciones hospitalarias producidas por S. aureus y en la resistencia a meticiclina de las cepas en el HUC, mayor en el 2007 en comparación al 2004.

  17. Relación microestructura resistencia al desgaste de recubrimientos duros ricos en cromo y tungsteno aplicados por soldadura electrica (SMAW

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    Lisys Margarita León Sevilla

    2004-01-01

    Full Text Available Se comparó la microestructura y resistencia a la abrasión de recubrimientos duros depositados por soldadura sobre placas de acero estructural ASTM A36. Se utilizaron cinco electrodos comerciales, dos de bajo cromo, dos de alto cromo aplicados en una y dos capas y uno rico en tungsteno depositado en una capa La resistencia al desgaste fue evaluada en una máquina de rueda de caucho y arena seca construida según la norma ASTM G65-80. Como material abrasivo se utilizaron partículas de sílice con índice de finura AFS 50- 70. La caracterización de las microestructuras se realizó utilizando microscopía óptica y electrónica de barrido. Los resultados mostraron que el parámetro de resistencia a la abrasión no está directamente relacionado con dureza del material pero sí con el tipo, tamaño, forma, composición química y distribución de los carburos presentes en la matriz del recubrimiento. La mejor resistencia a la abrasión se obtuvo en depósitos con microestructura compuesta por carburos primarios (del tipo M7C3 en recubrimientos ricos en Cr o del tipo MC, M6C en recubrimientos ricos en W en una matriz eutéctica.

  18. Clones de Hevea brasiliensis de alta productividad caracterizados por resistencia a Microcyclus ulei en jardin clonal en el magdalena medio colombiano

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    Yeirme Yaneth Jaimes Suarez

    2015-06-01

    Full Text Available Con el objetivo de introducir en la región del magdalena medio de Colombia nuevos clones de caucho (Hevea brasiliensis (Willd. ex A. Juss. Müll. Arg. de alta productividad y con resistencia al Mal de las Hojas, se evaluaron materiales un jardín clonal establecido en Cimitarra, Colombia en la región del magdalena medio. Se evaluó la incidencia y la severidad del ataque de Microcyclus ulei (P. Henn. von Arx. según Garcia et al. (1. Se encontró resistencia completa al mal de las hojas para los clones CDC 312, FDR 4575, FDR 5597, FDR 5788 y MDF 180 y resistencia parcial para los clones FX 3864 y CDC 32. Los clones RRIM 901, PB 235 y PB 260 se mostraron como susceptibles. De acuerdo con los resultados, los clones con resistencia total y parcial se podrán recomendar para zonas preferenciales con restricción para el cultivo, una vez este comportamiento se corroboré en campo clonal. En cuanto a los clones susceptibles se pueden recomendar para zonas de escape al mal de las hojas en el Magdalena Medio Colombiano.

  19. Resistencia de Mycobacterium tuberculosis a los fármacos antituberculosos en menores de 15 años en Colombia

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    Claudia Llerena

    2010-09-01

    Conclusiones. Este análisis demuestra que existen debilidades en el cumplimiento de las normas, lo que dificulta el diagnóstico y la identificación de los patrones de resistencia en menores de 15 años. Éste es un tema en el cual se debe explorar más.

  20. Caracterización fenotípica y genotípica de la resistencia enzimática a las cefalosporinas de tercera generación en Enterobacter spp. Phenotypic and genotypic characterization of resistance to third-generation cephalosporins in Enterobacter spp.

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    E. Bertona

    2005-12-01

    Full Text Available Enterobacter spp. es un patógeno intrahospitalario que presenta múltiples mecanismos de resistencia a los antibióticos b-lactámicos. Se caracterizaron fenotípica y genotípicamente las diferentes b-lactamasas presentes en 27 aislamientos consecutivos e ininterrumpidos de Enterobacter spp. (25 Enterobacter cloacae y 2 Enterobacter aerogenes. También se evaluó la habilidad de diferentes métodos fenotípicos para detectar b-lactamasas de espectro extendido (BLEE en estos microorganismos. En 15/27 aislamientos (63% se observó resistencia a las cefalosporinas de tercera generación. En 12 de los aislamientos resistentes se detectó un alto nivel de producción de cefalosporinasa cromosómica, siendo 6 de ellos también productores de PER-2. Dicha resistencia en los 3 aislamientos restantes se debió exclusivamente a la presencia de BLEE, PER-2 en 2 de ellos y CTX-M-2 en un caso. Sólo CTX-M-2 se detectó con todas las cefalosporinas probadas en los ensayos de sinergia, utilizando el método de difusión, mientras que cefepima mejoró la detección de PER-2 en 7/8 aislamientos productores de esta BLEE, 4/8 utilizando la prueba de doble disco y 7/8 comparando discos de cefepima con y sin el agregado de ácido clavulánico. El método de dilución empleado solo detectó 1/9 BLEE al comparar las cefalosporinas con y sin el agregado de inhibidor.Enterobacter spp. are becoming increasingly frequent nosocomial pathogens with multiple resistance mechanism to b-lactam antibiotics. We carried out the phenotypic and genotypic characterization of beta-lactamases in 27 Enterobacter spp. (25 Enterobacter cloacae y 2 Enterobacter aerogenes, as well as the ability of different extended spectrum b-lactamase (ESBL screening methods. Resistance to third generation cephalosporins was observed in 15/27 (63% isolates. Twelve resistant isolates produced high level chromosomal encoded AmpC b-lactamase; 6 of them were also producers of PER-2. Resistance to third

  1. Impacto de la resistencia a la meticilina sobre la mortalidad y vigilancia de la sensibilidad a la vancomicina en bacteriemias causadas por Staphylococcus aureus Impact of methicillin resistance on mortality and surveillance of vancomycin susceptibility in bacteremias caused by Staphylococcus aureus

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    F. Traverso

    2010-12-01

    Full Text Available Staphylococcus aureus es uno de los principales patógenos nosocomiales y produce una alta morbimortalidad en numerosos hospitales del mundo. Además, la incidencia de bacteriemias por este microorganismo ha aumentado significativamente en las últimas décadas. Los objetivos del presente trabajo fueron identificar los factores de riesgo que favorecen la aparición de resistencia a la meticilina en aislamientos de S. aureus y los factores que afectan la mortalidad por bacteriemias asociadas a este patógeno, así como evaluar la sensibilidad a la vancomicina de las cepas resistentes a la meticilina. Se estudiaron 39 aislamientos de S. aureus provenientes de hemocultivos de pacientes internados con bacteriemia en la Nueva Clínica Chacabuco de Tandil (Pcia. de Buenos Aires, Argentina en el período 01/2006-12/2008. La mortalidad global fue del 51,3% y estuvo significativamente asociada con la resistencia a la meticilina (OR: 4,20; IC95%: 1,08-16,32; p: 0,05; aunque dicho factor no fue un predictor independiente de mortalidad. La cirugía previa (OR: 17,23; IC95%: 1,80-164,60 y la estancia previa en la unidad de cuidados intensivos (OR: 21,12; IC95%: 2,33-191,30 fueron predictores independientes de la resistencia a la meticilina y la asistencia respiratoria mecánica (OR: 15,99; IC: 3,24-78,86 fue un predictor independiente de la mortalidad. No se detectaron cepas con sensibilidad disminuida a la vancomicina. Todos los aislamientos estudiados fueron sensibles in vitro a la vancomicina, con una CIM50 y una CIM90 de 0,5 μg/ml.Staphylococcus aureus is a major nosocomial pathogen that causes severe morbidity and mortality in many hospitals worldwide. Besides, the incidence of S. aureus bacteremia has significantly increased over the past decades. The aims of this study were to detect the risk factors for methicillin resistance and mortality and to evaluate vancomycin susceptibility in methicillin-resistant isolates. Thus, 39 S. aureus isolates from

  2. Herencia de la resistencia al complejo Cercospora spp. en líneas de maíz tropical

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    Narro L. Luis

    2005-09-01

    Full Text Available Se evaluó un diseño dialélico (Griffing Modelo 1 entre 10 líneas endogámicas de maíz tropical contrastantes en su reacción a Cercospora spp. (5 tolerantes y 5 susceptibles, en tres localidades en lotes bajo siembra directa, con presencia natural del patógeno e inoculación artificial, para la variable índice de enfermedad (escala 1 a 5. En el análisis de varianza, por localidad y combinado, los efectos de habilidad combinatoria general (hcg, habilidad combinatoria específica (hce, y recíprocos resultaron altamente significativos; siendo >10 veces mayor los efectos de la hcg que los de hce, indicando predominio de la acción genética aditiva. Resultados también sugieren que la resistencia está controlada por efectos maternos o de citoplasma. La acumulación de genes de resistencia y la conformación de variedades sintéticas tolerantes es una alternativa a implementar en programas del mejoramiento de resistencia a Cercospora de maíces tropicales. ABSTRACT Inheritance of resistance to Cercospora Complex in tropical maize (zea mays inbred lines. Inheritance of resistance to the maize disease complex caused by Cercospora spp on tropical maize was studied by generating and evaluating a diallel mating model (Griffing model I using ten corn inbred lines with contrasting levels of disease reaction (5 tolerant and 5 susceptible. Parental lines and their crosses, both direct and reciprocal, were evaluated in three locations using conservation tillage and inoculated artificially with inoculum prepared using a mixture of foliar maize diseases collected from several farmer’s fields. Analysis of variance for the variable index of disease (scale 1 to 5, both locality and combined, the general combining ability (hcg, specific combining ability (hce, and reciprocal effects were highly significant, with the hcg portion being >10 times greater than the hce component, indicating that the genetic action is predominantly additive. Data

  3. Leishmania: papel de la glicoproteína P en la mediación de resistencia a medicamentos y estrategias de reversión.

    Directory of Open Access Journals (Sweden)

    Edison J. Osorio

    2005-06-01

    Full Text Available Actualmente, los parásitos protozoarios son uno de los principales agentes causantes de morbilidad y mortalidad en el mundo, un problema complicado, además, por la aparición de resistencia a medicamentos en estos organismos. La resistencia a medicamentos observada en parásitos protozoarios se debe a diferentes mecanismos como la disminución de la entrada del medicamento a la célula por cambios en el transportador requerido, la perdida de la activación del medicamento por parte del hospedero, las alteraciones en el blanco del medicamento y la expresi6n exagerada del transportador múltiple de medicamentos o glicoproteína P (Pgp. En esta revisión, nos centramos en: 1 el papel de las glicoproteínas P (Pgp de la familia de proteínas ABC (ATP binding cassette como los transportadores de múltiples medicamentos en la mediaci6n de resistencia en protozoarios, especialmente en Leishmania, y en el desarrollo de resistencia cruzada para medicamentos estructural y funcionalmente no relacionados, y 2 en algunos conceptos relacionados con los mecanismos moduladores que podrían revertir la resistencia a medicamentos por fármacos y productos naturales. Numerosos moduladores o quimio sensibilizadores son conocidos por alterar la capacidad de las glicoproteínas P para mantener concentraciones intracelulares subtóxicas del medicamento; algunos ejemplos incluyen los bloqueadores de los canales de calcio como el verapamilo; sin embargo, se requieren altas concentraciones para una inhibición eficiente y duradera, las cuales producen efectos adversos indeseables. Por tanto, se necesitan mas investigaciones relacionadas con los moduladores naturales para Pgp, los cuales podrían presentar menor toxicidad para el hospedero.

  4. Determinación de la resistencia a insecticidas en Aedes aegypti, Anopheles albimanus y Lutzomyia peruensis procedentes del Norte Peruano

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    Franklin Vargas V

    2006-10-01

    Full Text Available Objetivo: Determinar los niveles de resistencia a temephos y deltametrina en cinco poblaciones naturales de Aedes aegypti del norte de Perú (La Libertad y Piura, dos cepas de Anopheles albimanus (Sullana y Tambogrande y una cepa de Lutzomyía spp (Santiago de Chuco, La Libertad. Materiales y métodos: Se realizaron bioensayos en larvas y adultos siguiendo la metodología de la Organización Mundial de la Salud. La visualización de bandas de B-esterasas se hizo por electroforesis en gel de poliacrilamida en larvas de cuarto estadio. Resultados: Las poblaciones de Ae. aegypti de Sullana y Tambogrande (Piura presentaron factores de resistencia (FR a temephos de 6,84 con un KDT50 = 160,42 minutos y 70% de mortalidad a las 24 horas; en tanto en la población de Tambogrande se observó un FR de 5,60, KDT50 = 107,20 y 80% de mortalidad, a diferencia de las cepas de La Esperanza, El Porvenir y Florencia de Mora (La Libertad que fueron susceptibles. Se identificó resistencia en las poblaciones de Ae. aegypti y A. albimanus procedentes de Piura (Tambogrande y Sullana para deltametrina, a diferencia de las poblaciones de Ae.aegypti y Lutzomyia spp de La Libertad que fueron susceptibles. Se identificó la esterasa B2 con un Rf de 0,23 en la población de Ae. aegypti de Sullana. Conclusiones: Dada la susceptibilidad de la población de La Libertad al insecticida temephos, puede seguir siendo usado en el control vectorial de Aedes aegypti; por lo contrario, dada la resistencia observada en poblaciones de Anopheles en Sullana y Tambogrande se debe evaluar el uso de la deltametrina en estas poblaciones. Finalmente, la población de Lutzomyia spp. no presentó resistencia a deltametrina.

  5. EXPLORACIÓN CON REDES NEURONALES ARTIFICIALES PARA ESTIMAR LA RESISTENCIA A LA COMPRESIÓN, EN CONCRETOS FIBROREFORZADOS CON ACERO

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    Luis Octavio González Salcedo

    2012-01-01

    Full Text Available En diseño y construcción de estructuras de concreto, la resistencia a la compresión a 28 días de curado es la especificación de control de estabilidad de la obra. La inclusión de fibras como reforzamiento de la matriz cementicia permite una ganancia en sus propiedades, además de obtener un material de alto desempeño. En las normativas, se plantean formulaciones predictivas de la resistencia a la compresión basadas en unos pocos parámetros de composición del concreto, tales como la relación agua/cemento y el contenido de cemento Portland. Por otra parte, también se han planteado métodos de diseños de concreto para definir la ponderación de sus materiales componentes, teniendo como referencia la resistencia a la compresión del concreto simple. Además, las redes neuronales artificiales, como un símil de las neuronas biológicas, han sido utilizadas como herramientas de predicción de la resistencia a la compresión en el concreto, también con referencia al concreto simple, sin reforzamiento con fibras. Los antecedentes en este uso muestran que es interesante desarrollar aplicaciones en los concretos reforzados con fibras. En el presente trabajo se elaboraron redes neuronales artificiales para predecir la resistencia a la compresión en concretos reforzados con fibras de acero. Los resultados de los indicadores de desempeño mostraron que las redes neuronales artificiales elaboradas pueden realizar una aproximación adecuada al valor real de la propiedad mecánica.

  6. Control biológico del entrenamiento de resistencia. Biological control of endurance training.

    Directory of Open Access Journals (Sweden)

    González Gross, Marcela

    2006-01-01

    Full Text Available ResumenLa alta exigencia en los deportistas de elite hace cada vez más necesario controlar el proceso de adaptación al entrenamiento. El objetivo de esta revisión es analizar la información biológica de un análisis de sangre, al objeto de obtener información de la carga de entrenamiento en atletas de resistencia. La mayor parte de los parámetros sanguíneos han sido empleados, más que para determinar el proceso del entrenamiento, precisamente, para lo opuesto: el sobreentrenamiento. La concentración en plasma de sustratos metabólicos (glucosa y ácidos grasos no son parámetros que pueda utilizarse para controlar el entrenamiento, debido a las bajas especificidad y sensibilidad. No obstante, la concentración de determinados enzimas que intervienen en la utilización de los sustratos puede ser importante. Valores de creatín kinasa superiores a 200 U/l en una persona sana sugiere claramente que la carga de entrenamiento total de una determinada sesión ha sido elevada. La concentración en plasma de algún producto de degradación del catabolismo también puede señalar la adaptación del organismo al entrenamiento. La concentración de ácido láctico en plasma es la herramienta más común en la valoración de la carga de entrenamiento. La concentración de urea es un buen marcador biológico de la carga de entrenamiento. Valores superiores a 8 mmol/l en varones y de 6,5 mmol/l en mujeres, indican que el entrenamiento ha sido muy intenso. La determinación de otros productos (amonio o sustratos (glutamina se han utilizado para detectar el sobreentrenamiento.AbstractThe high exigency in the elite sportsmen does more necessary to control the process of training adaptation. The purpose of this review is to analyze the biological information of a blood analysis to obtain data of load training in endurance athletes. Most blood parameters has been used to evaluate the overtraining state instead of determining the training process. The

  7. Genetic & virulence profiling of ESBL-positive E. coli from nosocomial & veterinary sources.

    Science.gov (United States)

    Tyrrell, J M; Wootton, M; Toleman, M A; Howe, R A; Woodward, M; Walsh, T R

    2016-04-15

    CTX-M genes are the most prevalent ESBL globally, infiltrating nosocomial, community and environmental settings. Wild and domesticated animals may act as effective vectors for the dissemination of CTX-producing Enterobacteriaceae. This study aimed to contextualise blaCTX-M-14-positive, cephalosporin-resistant Enterobacteriaceae human infections and compared resistance and pathogenicity markers with veterinary isolates. Epidemiologically related human (n=18) and veterinary (n=4) blaCTX-M-14-positive E. coli were fully characterised. All were typed by XbaI pulsed field gel electrophoresis and ST. Chromosomal/plasmidic locations of blaCTX-M-14 were deduced by S1-nuclease digestion, and association with ISEcp1 was investigated by sequencing. Conjugation experiments assessed transmissibility of plasmids carrying blaCTX-M-14. Presence of virulence determinants was screened by PCR assay and pathogenicity potential was determined by in vitro Galleria mellonella infection models. 84% of clinical E. coli originated from community patients. blaCTX-M-14 was found ubiquitously downstream of ISEcp1 upon conjugative plasmids (25-150 kb). blaCTX-M-14 was also found upon the chromosome of eight E. coli isolates. CTX-M-14-producing E. coli were found at multiple hospital sites. Clonal commonality between patient, hospitals and livestock microbial populations was found. In vivo model survival rates from clinical isolates (30%) and veterinary isolates (0%) were significantly different (pE. coli involving community patients and farm livestock. blaCTX-M-14 positive human clinical isolates carry a lower intrinsic pathogenic potential than veterinary E. coli highlighting the need for greater veterinary practices in preventing dissemination of MDR E. coli among livestock. Copyright © 2016. Published by Elsevier B.V.

  8. Investigation of the antibiotic susceptibility patterns of pathogens causing nosocomial infections

    International Nuclear Information System (INIS)

    Yaman, Akgun; Kibar, Filiz; Buyukcelik, Ozlem; Tasova, Yesim; Inal, A.S.; Saltoglu, Nese; Kurtaran, Behice; Dundal, Ismail H.

    2004-01-01

    The aim of this study is to determine the resistance patterns of bacteria causing nosocomial infections. The outcome of this resistance was followed for 3 years. This study was carried out during 2000 to 2002 at a university hospital in Turkey. The resistance patterns of 570 bacteria (390 Gram-negative, 180 Gram-positive) against meropenem, imipenem, ceftazidime, cefotaxime, cefepime, piperacillin/tazobactam, ciprofloxacin and tobramycin were investigated using the E-test. Extended-spectrum beta-lactamase (ESBL) production was determined using ceftazidime and ceftazidime/clavulanic acid E-test strips. Meropenem was the most effective antibiotic against Gram-negative organisms (89.0%); this was followed by imipenem (87.2%) and piperacillin/tazobactam (66.4%). The most active antibiotic against Gram-positive bacteria was imipenem (87.2%) and this was followed by piperacillin/tazobactam (81.7%) and meropenem (77.8%). The rates of production of ESBL by Escherichia coli were 20.9%, Klebsiella pneumoniae 50% and Serratia marcescens were 46.7%. Extended-spectrum beta-lactamase production increased each year (21.7%, 22.1% and 45.5%). All of the ESBL producing isolates were sensitive to meropenem and 98.5% sensitive to imipenem. AmpC beta-lactamase was produced by 20.9% of the Enterobacter species spp, Citrobacter spp. and Serratia marcescens. All of these were sensitive to meropenem and 77.8% to imipenem and ciprofloxacin. Multi-drug resistance rates in Acinetobacter spp were 45.4% and 37.7% in Pseudomonas aeruginosa isolates. As in the entire world, resistance to antibiotics is a serious problem in our country. Solving of this problem depends primarily on prevention of the development of resistance. (author)

  9. Nosocomial rapidly growing mycobacterial infections following laparoscopic surgery: CT imaging findings.

    Science.gov (United States)

    Volpato, Richard; de Castro, Claudio Campi; Hadad, David Jamil; da Silva Souza Ribeiro, Flavya; Filho, Ezequiel Leal; Marcal, Leonardo P

    2015-09-01

    To identify the distribution and frequency of computed tomography (CT) findings in patients with nosocomial rapidly growing mycobacterial (RGM) infection after laparoscopic surgery. A descriptive retrospective study in patients with RGM infection after laparoscopic surgery who underwent CT imaging prior to initiation of therapy. The images were analyzed by two radiologists in consensus, who evaluated the skin/subcutaneous tissues, the abdominal wall, and intraperitoneal region separately. The patterns of involvement were tabulated as: densification, collections, nodules (≥1.0 cm), small nodules (<1.0 cm), pseudocavitated nodules, and small pseudocavitated nodules. Twenty-six patients met the established criteria. The subcutaneous findings were: densification (88.5%), small nodules (61.5%), small pseudocavitated nodules (23.1 %), nodules (38.5%), pseudocavitated nodules (15.4%), and collections (26.9%). The findings in the abdominal wall were: densification (61.5%), pseudocavitated nodules (3.8%), and collections (15.4%). The intraperitoneal findings were: densification (46.1%), small nodules (42.3%), nodules (15.4%), and collections (11.5%). Subcutaneous CT findings in descending order of frequency were: densification, small nodules, nodules, small pseudocavitated nodules, pseudocavitated nodules, and collections. The musculo-fascial plane CT findings were: densification, collections, and pseudocavitated nodules. The intraperitoneal CT findings were: densification, small nodules, nodules, and collections. • Rapidly growing mycobacterial infection may occur following laparoscopy. • Post-laparoscopy mycobacterial infection CT findings are densification, collection, and nodules. • Rapidly growing mycobacterial infection following laparoscopy may involve the peritoneal cavity. • Post-laparoscopy rapidly growing mycobacterial intraperitoneal infection is not associated with ascites or lymphadenopathy.

  10. Investigation of a nosocomial outbreak due to Serratia marcescens in a maternity hospital.

    Science.gov (United States)

    Berthelot, P; Grattard, F; Amerger, C; Frery, M C; Lucht, F; Pozzetto, B; Fargier, P

    1999-04-01

    To investigate an outbreak of Serratia marcescens in a maternity hospital (November 1994 to May 1995). Retrospective analysis of epidemiological data and prospective study of systematic bacteriological samples from patients and environment, with genotyping of strains by arbitrarily primed polymerase chain reaction. A private maternity hospital, Saint-Etienne, France. In the neonatal unit, 1 newborn developed a bacteremia, and 36 were colonized in stools with S marcescens. As the colonization of some newborns was shown to occur only a few hours after delivery, the inquiry was extended to other maternity wards, where 8 babies and 4 mothers were found to be colonized. Environmental sampling led to the isolation of S marcescens from a bottle of enteral feed additive in the neonatal unit and from the transducers of two internal tocographs in the delivery rooms. The genotyping of 27 strains showed two different profiles: a major epidemic profile shared by 22 strains (18 from babies of the neonatal unit, 2 from babies of other units, and 2 from breast milk) and another profile shared by 5 strains (2 from transducers of internal tocographs, 2 from babies, and 1 from a mother). The strain isolated from lipid enteral feeding was not available for typing. Although this source of contamination was removed soon from the neonatal unit, the outbreak stopped only when infection control measures were reinforced in the delivery rooms, including the nonreuse of internal tocographs. In delivery rooms, the quality of hygiene needs to be as high as in surgery rooms to prevent nosocomial colonization or infection of neonates at birth.

  11. Genome evolution and plasticity of Serratia marcescens, an important multidrug-resistant nosocomial pathogen.

    Science.gov (United States)

    Iguchi, Atsushi; Nagaya, Yutaka; Pradel, Elizabeth; Ooka, Tadasuke; Ogura, Yoshitoshi; Katsura, Keisuke; Kurokawa, Ken; Oshima, Kenshiro; Hattori, Masahira; Parkhill, Julian; Sebaihia, Mohamed; Coulthurst, Sarah J; Gotoh, Naomasa; Thomson, Nicholas R; Ewbank, Jonathan J; Hayashi, Tetsuya

    2014-08-01

    Serratia marcescens is an important nosocomial pathogen that can cause an array of infections, most notably of the urinary tract and bloodstream. Naturally, it is found in many environmental niches, and is capable of infecting plants and animals. The emergence and spread of multidrug-resistant strains producing extended-spectrum or metallo beta-lactamases now pose a threat to public health worldwide. Here we report the complete genome sequences of two carefully selected S. marcescens strains, a multidrug-resistant clinical isolate (strain SM39) and an insect isolate (strain Db11). Our comparative analyses reveal the core genome of S. marcescens and define the potential metabolic capacity, virulence, and multidrug resistance of this species. We show a remarkable intraspecies genetic diversity, both at the sequence level and with regards genome flexibility, which may reflect the diversity of niches inhabited by members of this species. A broader analysis with other Serratia species identifies a set of approximately 3,000 genes that characterize the genus. Within this apparent genetic diversity, we identified many genes implicated in the high virulence potential and antibiotic resistance of SM39, including the metallo beta-lactamase and multiple other drug resistance determinants carried on plasmid pSMC1. We further show that pSMC1 is most closely related to plasmids circulating in Pseudomonas species. Our data will provide a valuable basis for future studies on S. marcescens and new insights into the genetic mechanisms that underlie the emergence of pathogens highly resistant to multiple antimicrobial agents. © The Author(s) 2014. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.

  12. Cost-Analysis of Seven Nosocomial Outbreaks in an Academic Hospital.

    Science.gov (United States)

    Dik, Jan-Willem H; Dinkelacker, Ariane G; Vemer, Pepijn; Lo-Ten-Foe, Jerome R; Lokate, Mariëtte; Sinha, Bhanu; Friedrich, Alex W; Postma, Maarten J

    2016-01-01

    Nosocomial outbreaks, especially with (multi-)resistant microorganisms, are a major problem for health care institutions. They can cause morbidity and mortality for patients and controlling these costs substantial amounts of funds and resources. However, how much is unclear. This study sets out to provide a comparable overview of the costs of multiple outbreaks in a single academic hospital in the Netherlands. Based on interviews with the involved staff, multiple databases and stored records from the Infection Prevention Division all actions undertaken, extra staff employment, use of resources, bed-occupancy rates, and other miscellaneous cost drivers during different outbreaks were scored and quantified into Euros. This led to total costs per outbreak and an estimated average cost per positive patient per outbreak day. Seven outbreaks that occurred between 2012 and 2014 in the hospital were evaluated. Total costs for the hospital ranged between €10,778 and €356,754. Costs per positive patient per outbreak day, ranged between €10 and €1,369 (95% CI: €49-€1,042), with a mean of €546 and a median of €519. Majority of the costs (50%) were made because of closed beds. This analysis is the first to give a comparable overview of various outbreaks, caused by different microorganisms, in the same hospital and all analyzed with the same method. It shows a large variation within the average costs due to different factors (e.g. closure of wards, type of ward). All outbreaks however cost considerable amounts of efforts and money (up to €356,754), including missed revenue and control measures.

  13. Cost-Analysis of Seven Nosocomial Outbreaks in an Academic Hospital.

    Directory of Open Access Journals (Sweden)

    Jan-Willem H Dik

    Full Text Available Nosocomial outbreaks, especially with (multi-resistant microorganisms, are a major problem for health care institutions. They can cause morbidity and mortality for patients and controlling these costs substantial amounts of funds and resources. However, how much is unclear. This study sets out to provide a comparable overview of the costs of multiple outbreaks in a single academic hospital in the Netherlands.Based on interviews with the involved staff, multiple databases and stored records from the Infection Prevention Division all actions undertaken, extra staff employment, use of resources, bed-occupancy rates, and other miscellaneous cost drivers during different outbreaks were scored and quantified into Euros. This led to total costs per outbreak and an estimated average cost per positive patient per outbreak day.Seven outbreaks that occurred between 2012 and 2014 in the hospital were evaluated. Total costs for the hospital ranged between €10,778 and €356,754. Costs per positive patient per outbreak day, ranged between €10 and €1,369 (95% CI: €49-€1,042, with a mean of €546 and a median of €519. Majority of the costs (50% were made because of closed beds.This analysis is the first to give a comparable overview of various outbreaks, caused by different microorganisms, in the same hospital and all analyzed with the same method. It shows a large variation within the average costs due to different factors (e.g. closure of wards, type of ward. All outbreaks however cost considerable amounts of efforts and money (up to €356,754, including missed revenue and control measures.

  14. Nosocomial pneumonia in 27 ICUs in Europe: perspectives from the EU-VAP/CAP study.

    Science.gov (United States)

    Koulenti, D; Tsigou, E; Rello, J

    2017-11-01

    We report on intensive care nosocomial pneumonia (NP) in Europe through a review of EU-VAP/CAP manuscripts: a prospective observational study, enrolling patients from 27 ICUs in nine European countries. From 2,436 eligible ICU patients, 827 cases presented NP, with 18.3 episodes of VAP per 1000 ventilator-days. Most common findings were worsening oxygenation, purulent respiratory secretions and temperature increase. At least three criteria from Clinical Pulmonary Infection score (CPIS) were present in 77.9 % of episodes, but only 0.2 % met six CPIS criteria. Diagnosis was confirmed mainly noninvasively (74.8 %), with half qualitative and quantitative cultures. The dominant isolate was S. aureus in Spain, France, Belgium and Ireland, P. aeruginosa in Italy and Portugal, Acinetobacter in Greece and Turkey, but Escherichia coli in Germany. NP resulted in 6 % higher mortality, longer ICU stay and duration of mechanical ventilation (12 and 10 days). COPD and age ≥45 years were not associated with higher VAP incidence but did correlate with increased mortality. Trauma had higher VAP incidence but lower mortality. Bacteremia (led by MRSA and Acinetobacter baumannii) was documented in 14.6 %, being associated with extra ICU stay and mortality. Vasopressors and ICUs with above 25 % prevalence of Potential Resistant Organisms (PRM) were independently associated with PRM, being documented in 50.7 % of patients with early-onset VAP without known risk factors. Most patients initially received combination therapy. Delay in appropriate antimicrobial choice significantly increased mortality, and LOS in survivors was six days longer (p < 0.05). In conclusion, NP management in Europe presents local differences and major shifts when compared to reports from North America, outcomes of randomized trials and general guidelines.

  15. Risk factors for nosocomial infections after cardiac surgery in newborns with congenital heart disease.

    Science.gov (United States)

    García, Heladia; Cervantes-Luna, Beatriz; González-Cabello, Héctor; Miranda-Novales, Guadalupe

    2017-11-23

    Congenital heart diseases are among the most common congenital malformations. Approximately 50% of the patients with congenital heart disease undergo cardiac surgery. Nosocomial infections (NIs) are the main complications and an important cause of increased morbidity and mortality associated with congenital heart diseases. This study's objective was to identify the risk factors associated with the development of NIs after cardiac surgery in newborns with congenital heart disease. This was a nested case-control study that included 112 newborns, including 56 cases (with NI) and 56 controls (without NI). Variables analyzed included perinatal history, associated congenital malformations, Risk-Adjusted Congenital Heart Surgery (RACHS-1) score, perioperative and postoperative factors, transfusions, length of central venous catheter, nutritional support, and mechanical ventilation. Differences were calculated with the Mann-Whitney-U test, Pearson X 2 , or Fisher's exact test. A multivariate logistic regression was used to determine the independent risk factors. Sepsis was the most common NI (37.5%), and the main causative microorganisms were gram-positive cocci. The independent risk factors associated with NI were non-cardiac congenital malformations (OR 6.1, CI 95% 1.3-29.4), central venous catheter indwelling time > 14 days (OR 3.7, CI 95% 1.3-11.0), duration of mechanical ventilation > 7 days (OR 6.6, CI 95% 2.1-20.1), and ≥5 transfusions of blood products (OR 3.1, CI 95% 1.3-8.5). Mortality attributed to NI was 17.8%. Newborns with non-cardiac congenital malformations and with >7 days of mechanical ventilation were at higher risk for a postoperative NI. Efforts must focus on preventable infections, especially in bloodstream catheter-related infections, which account for 20.5% of all NIs. Copyright © 2017. Published by Elsevier B.V.

  16. Influencia del rayado sobre la resistencia electroquímica de les aleaciones de NiTi tratadas por un nuevo tratamiento térmico para aplicaciones biomédicas

    OpenAIRE

    Soualah, Lakhdar

    2005-01-01

    Las aleaciones de níquel-titanio son aleaciones que se utilizan cada vez más en aplicaciones biomédicas, por sus propiedades interesantes de superelasticidad, de memoria de forma, de resistencia a la corrosión y de biocompatibilidad. Sin embargo, los resultados obtenidos de su resistencia a la corrosión son muy variables, dependiendo del estado de superficie. Así, para mejorar, la resistencia a la corrosión de este material, se diseñó en un trabajo anterior un nuevo tratamie...

  17. Infección nosocomial en la terapia intensiva neonatal. Factores de riesgo. Pinar del Río 2001-2003 Nosocomial infection in the neonatal intensive care unit. Risk factors, Pinar del Río

    Directory of Open Access Journals (Sweden)

    Ivón Aimé Sánchez Monterrey

    2007-03-01

    Full Text Available Con el objetivo de evaluar los factores de riesgo de las infecciones nosocomiales en la Unidad de Terapia Intensiva Neonatal del Hospital General Universitario "Abel Santamaría Cuadrado" de Pinar del Río, se realizó una investigación observacional, analítica, de tipo caso-control, para ello se estudiaron 170 niños ingresados en esta unidad en el período comprendido de abril de 2001 a diciembre de 2003. Se recogió en una planilla tipo y momento de adquisición de la infección, abordaje vascular, ventilación mecánica y gérmenes aislados, entre otros. Se elaboró una base de datos en Microsoft Excel-97, se aplicaron los Test de Chi cuadrado y test de Student, ambos con un intervalo de confianza de p With the purpose of evaluating risk factors of nosocomial infections in the Intensive Care Unit of the "Abel Santamaría Cuadrado" General Hospital in Pinar del Río, an observational, analytical and a case-control research was performed in 170 children admitted at this Unit from April 1st., 2001, to December 31st., 2003. The nosocomial infection and time of being infected were recorded in a form, as well as the vascular approach, artificial ventilation and isolated germs, among others. A data base using the Microsoft Excel 97 software was designed, and chi-square test was used, both of them with a confidence interval of p<0,05. It was observed that birth weight, sex, gestational age, stay at ICU, artificial ventilation and deep vascular approach were related significantly with the onset of the nosocomial infection versus a control group showing similar characteristics. E. Coli and negative coagulase were the most frequent isolated germs.

  18. Resistencia química del hormigón. XV-Acción de una disolución saturada de yeso: influencia de la adición de escoria a un cemento portland de alta resistencia inicial. Evolución de las resistencias mecánicas a flexotracción y de los coeficientes de corrosi

    Directory of Open Access Journals (Sweden)

    Sagrera-Moreno, José Luis

    1982-03-01

    Full Text Available In this work, the first of another new series, a study is made on the influence brought by adding different quantities of a groundgranulate slag to a high initial resistance industrial portland cement (cement 1 < > P-550-ARI in its chemical-strength behaviour against the action of a gypsum saturated solution, determining the evolution of the chemical resistance using the Koch-Steinegger method, as well a tensile strengths of mortar test specimens (1:3 of 1 x 1 x 6 cm made with this cement 1 and with mixtures cement 1/slag = 85/15 - 65/35 - 40/60 and 30/70, in weight immersed in drinking water with some series of 12 test speciments filtered and other series that are analogue to the above, in a gypsum saturated solution, for 56-90-180 and 360 days, after curing them in a humidity saturated area at 20 ± 2°C, and later, 21 days under filtered drinking water. The favourabe action exerted by adding slag has been evident, especialy in high amounts (≥ 60 % to cement 1 studied.

    En el presente trabajo, primero de otra nueva serie, se estudia, la influencia que ejerce la adición de distintas cantidades de una escoria granulada molida a un cemento portland industrial de alta resistencia inicial (cemento 1 < > P-550-ARI en su comportamiento químico-resistente frente a la acción de una disolución saturada de yeso, determinando la evolución de la resistencia química por el método de Koch-Steinegger, así como la de las resistencias mecánicas a flexotracción de probetas de mortero (1:3 de 1 x 1 x 6 cm, fabricadas con dicho cemento 1 y con las mezclas cemento 1/escoria = 85/15 - 65/35 - 40/60 y 30/70, en peso, sumergidas en agua potable filtrada unas series de 12 probetas y en una disolución saturada de yeso otras series análogas a las anteriores, durante 56-90-180 y 360 días, después de haberlas curado 24 horas en un recinto saturado de humedad a 20 ± 2°C y, a continuación, 21 días bajo agua potable filtrada. Se ha puesto de

  19. Influencia de la humedad en el comportamiento de la resistencia a la compresión en mezclas de moldeo

    Directory of Open Access Journals (Sweden)

    Hernández, J. E.

    2001-04-01

    Full Text Available The behavior of molding mixtures for foundry cores in high relative humidity outdoors is evaluated. The relationship between the mechanical strength to compression and the relative increment of wet weight in the mixtures was obtained. The functional dependence between both parameters of exponent - type was properly corroborated by statistical stimates.

    Se evalúa el comportamiento de mezclas de moldeo para machos de fundición expuestas a intemperies de altas humedades relativas. En las mezclas analizadas se obtuvo la relación entre la resistencia mecánica a la compresión y el incremento relativo en peso húmedo. La dependencia entre ambos parámetros, de tipo exponencial, fue corroborada por estimaciones estadísticos adecuados.

  20. Publicaciones culturales de resistencia durante la dictadura: estudio de tres casos de representación visual

    Directory of Open Access Journals (Sweden)

    Paulina Francisca González Valenzuela

    2017-06-01

    Full Text Available El presente artículo aborda la resistencia cultural desarrollada durante el período dictatorial en Chile (1973-1989, desde la mirada de tres publicaciones que formaron parte de las redes de expresión artística erigidas al margen del discurso oficial: Palabra Escrita, La Bicicleta y La Castaña. Mediante la revisión de la experiencia productiva de estos medios, se propone ejemplificar las variantes de una disyuntiva estética que definió formas antagónicas de representar la escena cultural post golpe; las cuales encuentran su origen tanto en la influencia de los relatos sociales colindantes a sus espacios de circulación, como en el acceso a determinados medios de producción y manejo técnico.

  1. Prácticas de resistencia y alternativas para el cambio. Una defensa del Trabajo Social con colectivos y comunidades

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    Ariana Sánchez-Cota

    2013-06-01

    Full Text Available En este artículo defiendo una recuperación del Trabajo Comunitario para el contexto actual. En primer lugar propongo una noción de comunidad situada en «lo político» y una propuesta para el Trabajo Social Comunitario centrado en las prácticas creativas y artísticas. En segundo lugar abordo las prácticas de resistencia y las alternativas de cambios, que en cada caso para el Trabajo Comunitario las he centrado en el Artivismo y en el Crowdfunding. Para cada una de ellas presento un caso concreto que de cuenta de su implicancia en la emergente reorganización capitalista y en el lugar que debe ocupar el Trabajo Social sino quiere quedar fuera de la historia y como posibilidad de constituirse como agente de cambio.

  2. Resistencia a antibióticos y epidemiología molecular de Shigella spp. en el nordeste argentino

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    Luis A. Merino

    2004-04-01

    Full Text Available OBJETIVOS: Evaluar la resistencia a antibióticos de cepas de Shigella spp. aisladas de muestras de heces en el nordeste argentino y caracterizarlas desde el punto de vista de su epidemiología molecular. MÉTODOS: Se estudiaron 132 aislamientos de Shigella spp. obtenidos de las heces de igual número de pacientes con diarrea que asistieron a diferentes laboratorios privados y estatales de las provincias del Chaco y Corrientes, Argentina, durante el período de 1998 a 2002. Cada cepa se caracterizó según su serotipo, su resistencia a 13 antibióticos individuales o combinados y su sensibilidad a las piocinas. A 52 cepas seleccionadas en función de sus perfiles de susceptibilidad antimicrobiana se les determinaron la dotación plasmídica mediante lisis alcalina y las secuencias repetitivas palindrómicas extragénicas mediante la amplificación de segmentos repetitivos de ADN con la reacción en cadena de la polimerasa (REP-RCP. Se aplicó la prueba de ji al cuadrado para comparar proporciones. El nivel de significación estadística fue de 0,05. RESULTADOS: Shigella flexneri fue la especie más frecuente (78%, seguida de S. sonnei (22%. En general, la resistencia de S. flexneri a los antibióticos estudiados fue mayor que la de S. sonnei y esta diferencia fue estadísticamente significativa (P <0,001 frente a ampicilina, tetraciclina, cloramfenicol y la combinación de ampicilina con sulbactama. Las cepas de S. flexneri también mostraron mayor multirresistencia que las de S. sonnei (84,5% frente a 31,0%; P <0,001. Las cepas aisladas de S. flexneri pudieron agruparse según 5 piocinotipos, 3 perfiles plasmídicos y 5 patrones de secuencias repetitivas palindrómicas. Por su parte, las cepas de S. sonnei conformaron 3 piocinotipos, 2 perfiles plasmídicos y 3 patrones de secuencias repetitivas palindrómicas. CONCLUSIONES: Las especies de Shigella estudiadas mostraron una elevada resistencia a los antibióticos de uso más frecuente, por lo

  3. RESISTENCIAS DESDE LOS MÁRGENES: LA EXPERIENCIA MIGRATORIA DE LAS MUJERES COMO FORMA DE AGENCIA SOCIAL

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    Vanesa Vázquez Laba

    2014-01-01

    Full Text Available Con el propósito de contribuir a la discusión teórica y política sobre la capacidad agencial de las mujeres en condiciones de subalternidad, el presente artículo se basa en un trabajo de investigación empírica sobre los procesos y experiencias migratorias de mujeres latinoamericanas y africanas residentes en Mallorca, España. Demuestra que a pesar de la condicionalidad de la segmentación por género y raza del mercado laboral y el uso político del velo, las mujeres inmigrantes dan cuenta de acciones concretas de resistencias identitarias y políticas desde los márgenes en una búsqueda por una ciudadanía real.

  4. Historial oral y memoria de los enfermos de Hansen en dos lazaretos de Colombia: trayectorias de vida, conflictos y resistencias

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    Natalia Botero-Jaramillo

    Full Text Available Resumen Investiga la historia oral de la enfermedad de Hansen en dos comunidades de Colombia que fueron hasta 1961 lazaretos. La historia oral en torno de la enfermedad ha permitido conjugar la memoria individual con la memoria colectiva. Esta historia ha quedado en la oralidad y pocos trabajos académicos la han recopilado. Utilizamos la historia oral como método de investigación cualitativo, para analizar cómo enfermos y convivientes se posicionan ante la enfermedad y cómo atraviesa toda su existencia, resignificando los conceptos de salud y enfermedad, de normalidad y anormalidad, y cómo en sus trayectorias de vida emprendieron estrategias de resistencia que les permitiera aproximarse a la normalidad, desde sus propias significaciones socioculturales.

  5. El cuerpo como artefacto: tecnologías médicas, anatomopolítica y resistencia

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    Jorge M. Escobar Ortiz

    2015-06-01

    Full Text Available En este artículo se defiende la tesis de que hay un giro importante en el biopoder anatomopolítico de finales del siglo XX y comienzos del XXI. Este giro consiste en la aparición de diferentes tendencias culturales que comprenden el cuerpo humano como un artefacto que puede usarse para manifestar resistencia al poder. Para ello, estas tendencias se sirven de las tecnologías médicas como un medio para diseñar el cuerpo de acuerdo con una intención particular que permita cumplir cierta función elegida de antemano por quien identifica ese cuerpo como propio.

  6. Importancia de los plásmidos ColE1 en la resistencia a antibióticos

    OpenAIRE

    Santos López, Alfonso

    2016-01-01

    Los antibióticos han salvado millones de vidas desde que en la década de 1940 se introdujeran en la práctica clínica. Desafortunadamente debido a la rápida aparición de resistencias, su fácil diseminación y la dificultad de su eliminación una vez que se han establecido en la población, nos encontramos ante un grave problema tanto para la salud humana como para la sanidad animal. Actualmente, se producen en torno a 700.000 muertes al año por bacterias resistentes a antibióticos, y se calcula q...

  7. Influencia de la transferencia en la resistencia y dureza de las uniones soldadas obtenidas por el proceso de soldadura GMAW

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    Sandra Patricia Romero Nieto

    2013-04-01

    Full Text Available Este trabajo describe el comportamiento del proceso de soldadura GMAW con alambre compuesto de núcleo metálico, en uniones soldadas de acero ASTM A131, grado AH 32, utilizando dos composiciones de gas de protección y las transferencias de arco pulsado y corto circuito. Las propiedades mecánicas y la microestructura se evaluaron y los resultados indican que se logra mayor resistencia a la tensión y, a su vez, un perfil de dureza más homogéneo utilizando la transferencia de arco pulsado. Asimismo, se establece que la porosidad en el pie de soldadura de las uniones en T con depósito en filete se relaciona con la longitud de arco.

  8. UN PENETRÓMETRO DINÁMICO PARA EVALUAR LA RESISTENCIA MECÁNICA EN SUELOS FORESTALES

    OpenAIRE

    Irma Vásquez García; Armando Gómez Guerrero; Alejandro Velázquez Martínez; Arnulfo Aldrete; Aurelio M. Fierros-González

    2011-01-01

    Se diseñó un penetrómetro cónico de impacto para evaluar la resistencia mecánica de los suelos forestales. El equipo diseñado es ligero ya que sólo pesa 4.1 kg, preciso porque se validó en campo y laboratorio, portátil porque desensamblado se puede cargar en el chaleco de un operador de campo, y práctico porque la capacitación para su uso es sencilla y es adecuado para trabajos de inventarios forestales y de suelo. Los resultados mostraron que el uso del prototipo es viable en diferentes ecos...

  9. [Nosocomial urinary tract and surgical site infection rates in the Maternity Ward at the General Referral Hospital in Katuba, Lubumbashi, Democratic Republic of the Congo].

    Science.gov (United States)

    Lukuke, Hendrick Mbutshu; Kasamba, Eric; Mahuridi, Abdulu; Nlandu, Roger Ngatu; Narufumi, Suganuma; Mukengeshayi, Abel Ntambue; Malou, Vicky; Makoutode, Michel; Kaj, Françoise Malonga

    2017-01-01

    In Intertropical Africa hospitalized patients are exposed to a risk of nosocomial infections. The dearth of published data on this subject limits the descriptive analysis of the situation. This study aimed to determine the incidence, the germs responsible for these infections and the risk factors of nosocomial infections in the Maternity Ward at the General Referral Hospital in Katuba, Lubumbashi, Democratic Republic of the Congo. We conducted a descriptive, longitudinal study from 1 October 2014 to 1 January 2015. Our study population consisted of 207 women who had been hospitalized in the Maternity Ward at the General Referral Hospital in Katuba. We carried out a comprehensive data collection. Nosocomial infection rate accounted for 15.5%. Parturient women who had been hospitalized for more than three days were three times more likely to develop a nosocomial infection (p=0.003), while those who had had a complicated delivery were four times more likely to be at risk of developing nosocomial infection (p = 0.000). Escherichia coli was the most isolated causative agent (38.1%), followed by Citrobacter freundi (23.8%), Acinobacter baumani (.18, 2%), Staphylococcus aureus (18.2%), Enterococcus aureus (14.3%) and Pseudomonas aeroginosa (9.1%). Ampicillin was the most prescribed antibiotic, to which isolated microbes were resistant. It is necessary to improve hospital hygiene and to conduct further study to examine the similarity between germs strains in the environment and those in biological fluids.

  10. Resistencia química del hormigón. XXVII. Contribución al estudio del sistema: cemento P-550-ARI hidratado-agua desionizada

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    Bermejo-Muñoz, M. Francisca

    1987-03-01

    Full Text Available In this work, which is the following of others, the performance of a portland cement of a high initial resistance (P-550-ARI —with a calculated content (Bogue of 39,2% of C3S, of 25,7% of C2S, of 9,9% of C3A, of 12,0% of C4AF and of 6,9% of CaSO4 — is studied when it is submitted to the action of deionized water running across the beds of granulated cement, made with this hydrated cement cured during 7 or 28 days, determining: a the evolution of the content on ions Ca (II and SO4 (II on the taken diverse fractions of deionized water which have ran across those beds, so as this of the pH and of the conductivity, b the variation in the amount of these ions that are forming the correspondent compounds, in the hydrated cement from the beds that have been submitted before and after to the action of the deionized water, and c the structural modification undergone by the crystalline compounds of the hydrated cement from the beds submitted to the action of the deionized water.

    En el trabajo presente, continuación de otros, se estudia el comportamiento de un cemento portland de alta resistencia inicial (P-550-ARI —con un contenido calculado (Bogue del 39,2% de C3S, del 25,7% de C2S, del 9,9% de C3A del 12,0 de C4AF y del 6,9 % de CaS04— cuando se somete a la acción del agua desionizada que atraviesa los lechos de cemento granulados, fabricados con dicho cemento hidratado y curado durante 7 y 28 días, determinando: a La evolución del contenido de los iones Ca (II y SO4 (II de las diversas fracciones recogidas de agua desionizada, que han atravesado los lechos mencionados, así como la del pH y de la conductividad, b la variación de las cantidades de dichos iones, que se encuentran formando los compuestos correspondientes en el cemento hidratado de los lechos antes y después de someterlos a la acci

  11. Resistencia al cambio organizacional en una pequeña y mediana empresa (PyME del sector industrial

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    Soraya Zuinaga de Mazzei

    2014-05-01

    Full Text Available El propósito de este artículo es presentar los aspectos más destacados de una investigación que tuvo por objetivo general identificar las variables que inciden en la resistencia al cambio organizacional en pequeña y mediana empresa (PyME, dedicada a la producción de materiales de seguridad e higiene industrial ubicada en el estado Miranda. Se parte de diferentes teorías para su sustentación, como las planteadas por Lewin (1951, Shein (1985, Prochaska y Di Clemente (1992 entre otros; el enfoque del estudio fue positivista con estudio de la realidad objetiva, de naturaleza no experimental descriptiva. La población estuvo integrada por 80 empleados de la empresa Seguntex C.A y la muestra fue de 40 empleados escogidos por género, edad, escolaridad y nivel jerárquico. La técnica de recolección de la información fue el cuestionario estructurado en Escala de Likert bajo 15 items y se utilizó la estadística descriptiva para analizar el resultado de los datos. Se concluye que la falta de canales de comunicación entre la gerencia y los empleados es lo que produce mayor resistencia al cambio frente a las transformaciones que Seguntex C.A comenzó a experimentar desde el 2012 y que afecto de manera negativa el desempeño laboral de los trabajadores en la empresa.

  12. EVALUACIÓN TÉCNICA DE LA RESISTENCIA A COMPRESIÓN EN CONCRETOS ELABORADOS CON CEMENTO TIPO CPCA

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    M. Rincon, H. Bolognini,

    2016-12-01

    Full Text Available En los últimos años en Venezuela se ha presentado una crisis en la demanda, comercialización y producción del cemento, material necesario para la construcción, por lo cual se han venido utilizando cementos adicionados sin ningún tipo de regulación. En este trabajo se presenta la caracterización físico-mecánica de tres mezclas de concreto con relación agua/cemento de 0,45 y relación agua/cemento de 0,60 con diferentes tipos de cemento Portland, Tipo I, Tipo CPCA1, y la tercera mezcla corresponde a Tipo CPCA1 retribuyéndole el 15% de adición en su propio peso, desarrollando una mezcla de mejor calidad. Estos concretos se caracterizaron según: asentamiento, tiempo de fraguado, porcentaje de porosidad total, porcentaje de absorción de agua y resistencia mecánica a la compresión. Los resultados demostraron que la mezcla de concreto elaborada con CPCA1 no cumple con los requisitos mínimos establecidos en la norma venezolana para su uso en la elaboración de concreto estructural, ya que entre otros parámetros su resistencia a la compresión está por debajo del valor de diseño. En cuanto al CPCA1 retribuyéndole el 15% de adición en su propio peso cumple con los requisitos establecidos, y puede ser utilizado en la fabricación de elementos estructurales de concreto.

  13. Estudio de la resistencia a compresión de morteros fabricados con conglomerante compuesto de polvo de vidrio

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    Marco, J.

    2012-12-01

    Full Text Available This research evaluates the resistance of mortars made with mixtures of different compositions, where a part of the traditional binder is replaced by glass power in a simple way to analyze the mechanical properties of the reactive samples obtained in this way. The tests were carried out with mortars. To facilitate the reactions are added to the mixtures being analyzed different reagents, mixing the glass powder with basic reagents, allowing the collection of conditions of pH greater than 12, ins which the soda-lime glass is very reactive. Analyzed the different specimens of mortar, shows, that the glass powder and its fineness, play an important role in the increasing the compressive strength of the mixtures.

    Esta investigación evalúa la resistencia de morteros realizados con mezclas de diferentes composiciones, donde una parte del conglomerante tradicional es sustituido por el polvo de vidrio para analizar de una forma sencilla las características mecánicas de las muestras reactivas obtenidas de esta forma. Los ensayos se han realizado con morteros. Para facilitar las reacciones se añaden a las mezclas objeto del análisis diferentes reactivos: se mezcla el polvo de vidrio con reactivos básicos, lo que permite la obtención de condiciones de pH superiores a 12, en las que el vidrio sodo-cálcico es muy reactivo. Analizadas las diferentes probetas de morteros, se observa que el polvo de vidrio, así como su granulometría, juegan un importante papel en el aumento de las resistencias mecánicas a compresión de las mezclas.

  14. Mecanismos de resistencia a Metales tóxicos (CD bajo variaciones abióticas en Microalgas

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    Alondra A. Cortés Téllez

    2018-01-01

    Full Text Available En los ecosistemas acuáticos, la presencia de ciertos metales (Cu, Zn, Fe a concentraciones traza son esencialespara distintas actividades biológicas. Sin embargo, otros metales como el Cd y Pb son considerados tóxicos aconcentraciones muy bajas y no participan como micronutrientes. Estos metales interactúan con componentesesenciales a través de enlaces iónicos y covalentes induciendoestrés oxidativo, reemplazo de cationes esenciales,etc. Asimismo, presentan la capacidad de acumularse y biomagnificarse a lo largo de la cadena trófica, promoviendoalta sensibilidad en la mayoría de los organismos acuáticos, mientras que otros como las microalgas, han desarrolladouna gran variedad de estrategias de detoxificación para minimizar los efectos tóxicos de losmetales a través de lainducción de mecanismos de adaptación y resistencia que les permiten la supervivencia a esos ambientes extremos.Por ende, es indispensable conocer la gama de mecanismos de resistencia que estos organismos presentan a laexposición de metales tóxicos presentes en el ecosistema acuático. Así, los objetivos de esta revisión son: identificary describir los principales mecanismos moleculares actualmente descritos en microalgas verdes implicados en laresistencia a metales tóxicos en relación específica con el cadmio; dar a conocer la influencia de distintos factoresambientales sobre esta respuesta y los episodios de corresistencia hacia otros metales de carácter tóxico.

  15. Recomendaciones en la prescripción del entrenamiento con pesas (contra resistencia para diabéticos e hipertensos

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    Jessenia Hernández Elizondo

    2004-01-01

    Full Text Available El organismo humano es capaz de mantener un control bastante preciso de los niveles de glucosa sanguínea durante el reposo y en condiciones de ejercicio, sin embargo las concentraciones de insulina en personas con diabetes no responden al ejercicio de manera normal, y el equilibrio entre la utilización de glucosa periférica y hepática se puede alterar. A pesar de lo anterior, se ha considerado que el ejercicio físico es un elemento clave que provee grandes beneficios a la persona diabética. Por otra parte, una de las patologías que está muy asociada con la diabetes es la hipertensión o presión arterial alta (Hipertensión. Cuando queremos prescribir ejercicio en personas hipertensas debemos recordar que el entrenamiento con pesas no mejora la condición cardiovascular, pero sí hace que los músculos y huesos sean más fuertes y se incremente el metabolismo. El presente trabajo se realizó con el propósito de dar a conocer a los profesionales en Educación Física y en Ciencias del Movimiento Humano, los ejercicios de pesas (contra resistencia que no se recomiendan en la prescripción de programas para personas que padecen de diabetes e hipertensión. Además de proveer una herramienta descriptiva y útil para la educación de todas las personas interesadas en la actividad física y especialmente para aquellos que realizan entrenamiento contra resistencia

  16. Resistencia a la corrosión y desgaste de recubrinnientos deTiN obtenidos por PVD

    Directory of Open Access Journals (Sweden)

    Conde, A.

    2005-12-01

    Full Text Available Surface hardening techniques for metallic alloys are widely used to achieve layers of very high hardness and corrosion and wear resistance. In the present paper TiN coatings are obtained by PVD on a tool steel. The films are characterized by SEM, X-ray diffraction and XPS. Corrosion behaviour in NaCl solution showed the importance of the presence of defects on the PVD coating due to the different electrochemical behaviour of the steel base. Pin-on-disk measurements at approximately 40% RH against a corundum (Al2O3 ball showed a significant decrease in the wear rate compared with the results for the standard tool steel.

    Los tratamientos de endurecimiento superficial de aleaciones metálicas se utilizan para lograr capas de muy elevada dureza, resistencia a la corrosión y desgaste. En este trabajo, se estudia el comportamiento de recubrimientos de TiN obtenidos mediante PVD sobre aceros de herramientas. Las capas obtenidas se caracterizan mediante microscopía electrónica de barrido, difracción de rayos X y XPS. Se analiza el comportamiento frente a la corrosión de las capas protectoras, así como la influencia del substrato en su comportamiento en soluciones de NaCl. Finalmente, se realizan ensayos de desgaste por deslizamiento en seco mediante la técnica de pin-on-disk, comprobándose la mayor resistencia de estas capas.

  17. Identificación de un polimorfismo del gen Est9 relacionado con resistencia a piretroides en Rhipicephalus (Boophilus microplus

    Directory of Open Access Journals (Sweden)

    Edgar Diaz R.

    2013-10-01

    Full Text Available Objetivo. Mediante procedimientos de PCR-RFLP, detectar un polimorfismo en el gen Est9 de garrapatas Rhipicephalus (Boophilus microplus resistentes a piretroides en Ibagué, Colombia, determinando el grado de asociación entre los fenotipos y los genotipos resultantes. Materiales y métodos. El ADN de 30 teleoginas R. (Boophilus microplus fenotípicamente susceptibles, resistentes o medianamente resistentes a piretroides en una prueba de Drummond modificada, fue amplificado por PCR con cebadores específicos para obtener un fragmento de 372 pb del gen Est9, que fue sometido a digestión con la enzima EcoRI para estudiar los RFLPs generados y poder diferenciar los respectivos genotipos. El grado de asociación entre los fenotipos y los genotipos resultantes se determinó mediante la prueba exacta de Fisher. Resultados. Luego de digerir el fragmento con la endonucleasa, se generaron dos segmentos en teleoginas con algún nivel de resistencia, mientras en las teleoginas susceptibles no hubo división del fragmento de 372 pb, demostrándose así la presencia de una mutación puntual y los genotipos homocigoto natural, homocigoto mutante y heterocigoto. Las diferencias altamente significativas (p<0.01 entre teleoginas susceptibles y aquellas con algún nivel de resistencia, mostraron una relación directa entre el genotipo y el fenotipo con un nivel de confianza de p=0.0009852. Conclusiones. Se comprobó, por primera vez en Colombia, la presencia de una mutación puntual en el gen Est9 de garrapatas R. (Boophilus microplus resistentes a piretroides, sugiriendo la necesidad de realizar estudios para detectar alteraciones moleculares en otros genes relacionados con quimioresistencia.

  18. Resistencia al cambio organizacionalen una pequeña y mediana empresa (PyMEdel sector industrial

    Directory of Open Access Journals (Sweden)

    Soraya Zuinaga de Mazzei

    2014-01-01

    Full Text Available El propósito de este artículo es presentar los aspectos más destacados de una investigación que tuvo por objetivo general identificar las variables que inciden en la resistencia al cambio organizacional en pequeña y mediana empresa (PyME, dedicada a la producción de materiales de seguridad e higiene industrial ubicada en el estado Miranda. Se parte de diferentes teorías para su sustentación,como las planteadas por Lewin (1951, Shein (1985, Prochaska y Di Clemente (1992 entre otros; el enfoque del estudio fue positivista con estudio de la realidad objetiva, de naturaleza no experimental descriptiva. La población estuvo integrada por 80 empleados de la empresa Seguntex C.A y la muestra fue de 40 empleados escogidos por género, edad, escolaridad y nivel jerárquico. La técnica de recolección de la información fue el cuestionario estructurado en Escala de Likertbajo 15 items y se utilizó la estadística descriptiva para analizar el resultado de los datos. Se concluye que la falta de canales de comunicación entre la gerencia y los empleados es lo que produce mayor resistencia al cambio frente a las transformaciones que Seguntex C.A comenzó a experimentar desde el 2012 y que afecto de manera negativa el desempeño laboral de los trabajadores en la empresa.

  19. Factores de riesgo de neumonía nosocomial en terapia intensiva. Hospital “Dr. Ernesto Guevara”

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    Yadira Santiesteban Escalona

    2015-11-01

    Full Text Available Se realizó un estudio analítico, de tipo caso control pareados 1:2, para determinar los factores de riesgo de neumonía nosocomial en pacientes ingresados en terapia intensiva del Hospital “Dr. Ernesto Guevara de la Serna” de Las Tunas, en el período de enero de 2010 a diciembre de 2011. El universo fue de 1035 pacientes ingresados en terapia intensiva (UCI, en dicho período, de ellos constituyeron la muestra, denominada “casos”, 56 pacientes que desarrollaron Neumonía Nosocomial durante su estadía en UCI. Para el “control” de los factores de confusión, por cada caso, se parearon dos pacientes sin diagnóstico de neumonía. La información se obtuvo de fuentes secundarias (historias clínicas. A los casos y a los controles se les llenó una planilla de vaciamiento de datos con las variables analizadas. Los datos se procesaron utilizando el paquete de programas estadísticos Epinfo, versión 6. Para el estudio de los factores de riesgo se realizaron análisis univariados, evaluándose: ODDS RATIO, intervalo de confianza y probabilidad. Resultaron ser factores de riesgo para presentar neumonía nosocomial: la intubación endotraqueal, los trastornos de conciencia, el aislamiento de bacilos no fermentadores, citrobacter diversus y/o klebsiella ssp., haber requerido neurocirugía, el uso de tratamiento antibiótico previo, antiácidos anti H2, nutrición parenteral y la estadía en UCI mayor de siete días.

  20. A survey of veterinary hospitals in Nigeria for the presence of some bacterial organisms of nosocomial and zoonotic potential

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    Mohammed Lawal

    2009-06-01

    Full Text Available This study was undertaken to determine the type and estimate the prevalence of bacterial organisms on contact surfaces of five close-to-patient facilities in three veterinary health care settings within the Sokoto metropolis of north-western Nigeria. A total of 30 samples (10 from each setting were collected and analysed using culture, microscopy and biochemical testing. Bacterial species isolated from samples in this study included the following: Bacillus sp. (27.3%, Staphylococcus aureus (15.9%, Listeria sp. (13.6%, Streptococcus sp. (11.4%, Salmonella sp. (6.8%, Escherichia coli (4.5%, Staphylococcus epidermidis (4.5%, Citrobacter sp. (2.3%, Klebsiella sp. (2.3%, Lactobacillus sp. (2.3%, Micrococcus sp. (2.3%, Pasteurella sp. (2.3%, Proteus sp. (2.3%, and Yersinia sp. (2.3%. A higher percentage (64.3% of the total bacterial isolates were zoonotic in nature and hence of public health significance. Some pathogens have the potential of nosocomial spread. In this study, we seek to establish the first evidence of bacterial presence in the major veterinary health care settings in the Sokoto region of north-western Nigeria. Of particular interest is the hypothesis, which has not previously been formally tested, that nosocomial infections are especially likely to be implicated in both animals and occupational diseases in Nigeria. It was suggested that some of these isolates were associated with the risk of nosocomial and zoonotic infections and hence draws attention to the need to rigorously employ standard veterinary precautions as part of the hospital’s infection control programme in an attempt to protect both patients and staff from infections.

  1. [In vitro antibacterial activity of Curcuma longa (Zingiberaceae) against nosocomial bacteria in Montería, Colombia].

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    Méndez Álvarez, Nelson; Angulo Ortíz, Alberto; Contreras Martínez, Orfa

    2016-09-01

    Bacterial resistance is a growing health problem worldwide that has serious economic and social impacts, compromising public health, and the therapeutic action of current antibiotics. Therefore, the search for new compounds with antimicrobial properties is relevant in modern studies, particularly against bacteria of clinical interest. In the present study, in vitro antibacterial activity of the ethanol extract and essential oil of Curcuma longa (Zingiberaceae) was evaluated against nosocomial bacteria, using the microdilution method. Escherichia coli strains, Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus sp. were used, Salmonella sp. and Bacillus sp., isolated from nosocomial infections in a hospital in the city of Monteria and reference strains of S. aureus ATCC 43300, S. aureus ATCC 29213, S. aureus ATCC 25923, P. aeruginosa ATCC 27853, E. coli ATCC 25922 and K. pneumonia ATCC 700603. The ethanol extract antibacterial profile was more efficient at higher concentrations (1 000 ppm), obtaining significant percentages of reduction of more than 50 % against K. pneumoniae ATCC 700603 and a clinical isolate of E. coli; while compared to Bacillus clinical isolate, was more active than the essential oil. For the rest of microorganisms, the reduction percentages obtained at a concentration of 1 000 ppm varied between 17 and 42 % with ethanolic extract, and 8 to 43 % with essential oil. At concentrations of 100 and 500 ppm antibacterial activity of the extracts was lower. The results indicated that the ethanolic extract and essential oil of C. longa rhizomes have active compounds with antibacterial properties that could be used in future research as a therapeutic alternative for the treatment of infections caused by nosocomial pathogens.

  2. Prevalence and Antibiogram of Microbial Agents Causing Nosocomial Urinary Tract Infection in Surgical Ward of Dhaka Medical College Hospital

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    Tashmin Afroz Binte Islam

    2016-05-01

    Full Text Available Background: Nosocomial infections pose substantial risk to patients receiving care in hospitals. In Bangladesh, this problem is aggravated by inadequate infection control due to poor hygiene, resource and structural constraints and lack of awareness regarding nosocomial infections. Objective: We carried out this study to determine the prevalence of different microorganisms from urine in surgery ward and antimicrobial susceptibility pattern against various antibiotics. Materials and Methods: This cross sectional study was carried out in Department of Microbiology, Dhaka Medical College, Dhaka over a period of 12 months from July 2011 to June 2012. A total of 52 urine specimens were collected from catheterized patients admitted in general surgery ward of Dhaka Medical College Hospital (DMCH and incubated in blood agar, MacConkey agar media and the isolates were identified by different biochemical tests – oxidase test and reaction in MIU (motility indole urease and Simmon’s citrate and TSI (triple sugar iron media. ESBL producers were detected by double-disk synergy test (DDST. Results: Bacteria were isolated from 35 specimens and Escherichia coli was the commonest isolate (23, 65.71% followed by Pseudomonas aeruginosa 6 (17.14%, Klebsiella pneumoniae 3 (8.57%, Acinetobacter baumannii 2 (5.72% and Proteus vulgaris 1 (2.86% respectively. Among the isolates, 10 (28.57% ESBL producers were detected and the highest ESBL production was observed in Escherichia coli (8, 22.85% followed by Klebsiella pneumoniae 1 (2.86% and Pseudomonas aeruginosa 1 (2.86%. The isolates were resistant to most of the commonly used antimicrobial agents. Conclusion: The emergence of multi-drug resistant (MDR bacteria poses a difficult task for physicians who have limited therapeutic options. However, the high rate of nosocomial infections and multi-resistant pathogens necessitate urgent comprehensive interventions of infection control.

  3. Early Expansion of Circulating Granulocytic Myeloid-derived Suppressor Cells Predicts Development of Nosocomial Infections in Patients with Sepsis.

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    Uhel, Fabrice; Azzaoui, Imane; Grégoire, Murielle; Pangault, Céline; Dulong, Joelle; Tadié, Jean-Marc; Gacouin, Arnaud; Camus, Christophe; Cynober, Luc; Fest, Thierry; Le Tulzo, Yves; Roussel, Mikael; Tarte, Karin

    2017-08-01

    Sepsis induces a sustained immune dysfunction responsible for poor outcome and nosocomial infections. Myeloid-derived suppressor cells (MDSCs) described in cancer and inflammatory processes may be involved in sepsis-induced immune suppression, but their clinical impact remains poorly defined. To clarify phenotype, suppressive activity, origin, and clinical impact of MDSCs in patients with sepsis. Peripheral blood transcriptomic analysis was performed on 29 patients with sepsis and 15 healthy donors. A second cohort of 94 consecutive patients with sepsis, 11 severity-matched intensive care patients, and 67 healthy donors was prospectively enrolled for flow cytometry and functional experiments. Genes involved in MDSC suppressive functions, including S100A12, S100A9, MMP8, and ARG1, were up-regulated in the peripheral blood of patients with sepsis. CD14 pos HLA-DR low/neg monocytic (M)-MDSCs were expanded in intensive care unit patients with and without sepsis and CD14 neg CD15 pos low-density granulocytes/granulocytic (G)-MDSCs were more specifically expanded in patients with sepsis (P sepsis. G-MDSCs, made of immature and mature granulocytes expressing high levels of degranulation markers, were specifically responsible for arginase 1 activity. High initial levels of G-MDSCs, arginase 1, and S100A12 but not M-MDSCs were associated with subsequent occurrence of nosocomial infections. M-MDSCs and G-MDSCs strongly contribute to T-cell dysfunction in patients with sepsis. More specifically, G-MDSCs producing arginase 1 are associated with a higher incidence of nosocomial infections and seem to be major actors of sepsis-induced immune suppression.

  4. Resistencia transmitida del virus de la inmunodeficiencia humana en pacientes sin exposición previa a tratamiento antirretroviral, Cali, Colombia, 2010

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    Pablo Galindo-Orrego

    Full Text Available Introducción: En Colombia, existe poca información publicada sobre farmacorresistencia transmitida en el virus de inmunodeficiencia humana (VIH, y actualmente, las pruebas genotípicas de resistencia no son recomendadas por las guías colombianas para pacientes nunca expuestos ( naïve a terapia antirretroviral (TAR. Se condujo un estudio para determinar la frecuencia de resistencias transmitidas en pacientes naïve a TAR, quienes fueron atendidos en una clínica especializada en VIH/síndrome de inmunodeficiencia adquirida en Cali, Colombia. Metodología: Se realizó un estudio transversal en 152 pacientes adultos elegibles, con infección confirmada por VIH, naïve a TAR, con pruebas genotípicas de resistencia disponibles, y que accedieron a participar. El período de reclutamiento fue de 2008 a 2010. Las mutaciones de resistencias incluidas en el análisis fueron las definidas por la Organización Mundial de la Salud 2009 e International AIDS Society-USA 2010. Adicionalmente, se recolectó información sociodemográfica y condiciones relacionadas con el VIH. Resultados: La edad promedio fue 32 ± 10,2 años, 76% fueron hombres. La frecuencia de resistencia primaria fue de 6,6% (según la lista de Bennett-Organización Mundial de la Salud 2009, pero se encontró algún nivel de resistencia hasta en un 11,8% de los casos (al considerar mutaciones de la lista International AIDS Society-USA 2010. Las mutaciones más comunes fueron K103N/S (2%, F77L (2% y M46L (2%. Mutaciones a los inhibidores no nucleosídicos de transcriptasa reversa fueron encontradas en 5,3%, mutaciones a los inhibidores no nucleosídicos de transcriptasa reversa en 3,9% y mutaciones a inhibidor de proteasa en 2% de las secuencias. El único factor relacionado con la resistencia primaria fue la duración de la infección por VIH. Conclusiones: La frecuencia de resistencia transmitida es similar a la encontrada en estudios previos en Colombia y en otros países con amplio

  5. Rational approaches to the therapy of nosocomial infections caused by gram-positive microorganisms in cancer p

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    V. V. Aginova

    2017-01-01

    Full Text Available Nosocomial infections caused by gram-positive organisms, including Staphylococcus aureus and enterococci (Enterococcus faecium and Enterococcus faecalis are steadily increasing in almost all clinics around the world. Cancer patients have a higher risk of hospital-acquired infections than non-cancer patients. Cancer patients are immunosuppressed due to increased use of broad-spectrum antibiotics and chemotherapy drugs, radiation therapy, surgery and use of steroids. This paper presents an analysis of resistance of gram-positive bacterial pathogens to antimicrobial agents to determine treatment strategy for cancer patients.

  6. Cost Attributable to Nosocomial Bacteremia. Analysis According to Microorganism and Antimicrobial Sensitivity in a University Hospital in Barcelona.

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    Marta Riu

    Full Text Available To calculate the incremental cost of nosocomial bacteremia caused by the most common organisms, classified by their antimicrobial susceptibility.We selected patients who developed nosocomial bacteremia caused by Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, or Pseudomonas aeruginosa. These microorganisms were analyzed because of their high prevalence and they frequently present multidrug resistance. A control group consisted of patients classified within the same all-patient refined-diagnosis related group without bacteremia. Our hospital has an established cost accounting system (full-costing that uses activity-based criteria to analyze cost distribution. A logistic regression model was fitted to estimate the probability of developing bacteremia for each admission (propensity score and was used for propensity score matching adjustment. Subsequently, the propensity score was included in an econometric model to adjust the incremental cost of patients who developed bacteremia, as well as differences in this cost, depending on whether the microorganism was multidrug-resistant or multidrug-sensitive.A total of 571 admissions with bacteremia matched the inclusion criteria and 82,022 were included in the control group. The mean cost was € 25,891 for admissions with bacteremia and € 6,750 for those without bacteremia. The mean incremental cost was estimated at € 15,151 (CI, € 11,570 to € 18,733. Multidrug-resistant P. aeruginosa bacteremia had the highest mean incremental cost, € 44,709 (CI, € 34,559 to € 54,859. Antimicrobial-susceptible E. coli nosocomial bacteremia had the lowest mean incremental cost, € 10,481 (CI, € 8,752 to € 12,210. Despite their lower cost, episodes of antimicrobial-susceptible E. coli nosocomial bacteremia had a major impact due to their high frequency.Adjustment of hospital cost according to the organism causing bacteremia and antibiotic sensitivity could improve prevention strategies

  7. Resistencia antibiótica de streptococcus pneumoniae en portadores nasofaríngeos sanos de siete regiones del Perú

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    Nancy Torres

    Full Text Available Objetivos. Determinar el patrón de susceptibilidad antibiótica de cepas de Streptococcus pneumoniae aisladas de portadores nasofaríngeos sanos menores de 2 años de siete regiones del Perú. Materiales y métodos. Entre el 2007 y 2009 se tomaron muestras de hisopado nasofaríngeo a 2123 niños sanos entre 2 y 24 meses de edad en los consultorios de crecimiento y desarrollo (CRED y vacunación de hospitales y centros de salud de Lima, Piura, Cusco, Abancay, Arequipa, Huancayo, e Iquitos. Se determinó la resistencia a diez antibióticos mediante la prueba de disco-difusión de las cepas de neumococo aisladas. Resultados. Se aislaron 572 cepas. Se encontró altas tasas de resistencia a cotrimoxazol (58%; penicilina (52,2% no-sensibles; tetraciclina (29,1%; azitromicina (28,9%, y eritromicina (26,3%. La resistencia a cloranfenicol fue baja (8,8%. Se encontró 29,5% de multirresistencia. La resistencia a la azitromicina y a la penicilina fue diferente en las siete regiones (p<0,05, hallándose el mayor porcentaje de cepas no-sensibles a penicilina en Arequipa (63,6%, mientras que el menor fue en Cusco (23,4%. Conclusiones. Los elevados niveles de resistencia encontrados para penicilina, cotrimoxazol y macrólidos en cepas de neumococo aisladas de portadores sanos en todas las regiones estudiadas, y su asociación con uso previo de antibióticos, representan un importante problema de salud pública en nuestro país. Esto resalta la necesidad de implementar, a nivel nacional, estrategias para disminuir el uso irracional de antibióticos, sobre todo en la población pediátrica. Es necesario complementar los datos de resistencia a penicilina con la determinación de la concentración mínima inhibitoria para hacer las recomendaciones terapéuticas respectivas

  8. DETERMINACIÓN DE LA RESISTENCIA A LA PENETRACIÓN, AL CORTE TANGENCIAL, DENSIDAD APARENTE Y TEMPERATURA EN UN SUELO CAFETALERO, JUAN VIÑAS, COSTA RICA

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    Carlos Henríquez

    2011-01-01

    Full Text Available En un suelo cultivado con café en Juan Viñas, Costa Rica, se determinó la resistencia a la penetración (con 2 tipos de penetrómetros y al corte tangencial, densidad aparente, humedad gravimétrica y temperatura en la superficie y a 15 cm de profundidad; se eligieron y georeferenciaron 3 puntos dentro de un lote de 0,35 ha en un Dystrudept ubicado en Juan Viñas, Costa Rica. Los valores de resistencia a la penetración en la superficie fueron 1,60 y 0,30 MPa con el tipo de penetrómetro "Chatillón" y "Soil-Test" respectivamente, en tanto que los obtenidos a 15 cm fueron de 0,73 y 0,15 MPa en el mismo orden; asimismo, el contenido de humedad gravimétrica fue de 30,37 y 42,08%, respectivamente. A pesar de que también se encontraron mayores valores en la superficie que a los 15 cm, tanto para la resistencia al corte tangencial (0,028 y 0,025 Mpa como para la densidad aparente(0,98 y 0,93 Mg.m-3 respectivamente, estas diferencias no fueron significativas. Los valores de resistencia a la penetración de ambos tipos de penetrómetros correlacionaron positivamente entre sí (0,65**. La densidad aparente y la resistencia a la penetración medidas con el aparato "Chatillón" guardaron una correlación positiva (0,41+, lo cual concuerda con el hecho de que ambas variables son utilizadas para diagnosticar problemas de compactación. Se encontró además una correlación negativa entre la resistencia a la penetración y el contenido de humedad (-0,68** y una correlación positiva entre esta última variable y la temperatura (0,41+. Con base en los resultados de este estudio, se logró constatar que la superficie del suelo del lote evaluado presentó una mayor compactación que a la profundidad de 15 cm, lo cual se puede relacionar con 2 aspectos: el tránsito humano intenso sobre la plantación, producto de las prácticas agrícolas realizadas en el cultivo, y en cierta forma el menor valor de humedad presentado.

  9. [Phenotypic and genotypic identification of Candida strains isolated as nosocomial pathogens].

    Science.gov (United States)

    Sahiner, Fatih; Ergünay, Koray; Ozyurt, Mustafa; Ardıç, Nurittin; Hoşbul, Tuğrul; Haznedaroğlu, Tunçer

    2011-07-01

    Over the last decade, there have been important changes in the epidemiology of Candida infections and antifungal agents used to treat these infections. In recent years, Candida species have emerged as important causes of invasive infections among patients in intensive care units. One of the main goals of this study was to evaluate the molecular epidemiology of infectious Candida species isolated in our hospital and accordingly supply data for hospital infection (HI) control. The other aim of this study was to evaluate effectiveness and practical applicability of traditional and molecular methods used to identify Candida isolates to the species level. A total of 77 Candida strains that were isolated from various clinical specimens of 60 hospitalized patients (29 male, 24 female; 7 were children) were included in the study. Fifty-seven (74%) of those isolates were defined as HI agents according to Centers for Disease Control and Prevention (CDC) criteria. The most common Candida species identified as agents of HI were C.albicans (22; 38.6%), followed by C.tropicalis (14; 24.6%), C.parapsilosis (13; 22.8%), C.glabrata (7; 12.3%) and Candida spp. (1; 1.75%). It was determined that bloodstream (26; 45.6%) and urinary tract infections (24; 42.1%) were the most frequently encountered nosocomial infections caused by Candida species. In addition it was detected that the most frequent causative agent of bloodstream infections was C.parapsilosis (10; 38.5%) and of urinary tract infections was C.albicans (12; 50%). The evaluation of advantages and disadvantages of traditional phenotypic methods [germ tube formation, chlamydospore formation in corn meal agar, growth at 45°C, colony characteristics on CHROMagar Candida medium, carbohydrate assimilation properties detected by API ID 32C (BioMerieux, France) system] and some molecular techniques [polymerase chain reaction (PCR) by using ITS-1, ITS-3 and ITS 4 primers, PCR-Restriction fragment length polymorphism (RFLP), PCRRFLP

  10. Costos de neumonia nosocomial en una unidad de cuidados intensivos en Cartagena, Colombia

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    Arnaldo Sanmartin-Ávila

    Full Text Available Resumen Objetivo: Estimar el exceso de costos directos de atención atribuible a la neumonía asociada a ventilador mecánico en una unidad de cuidados intensivos de adultos en la ciudad de Cartagena durante los años 2009 al 2014. Material y Método: Se plantea un estudio de evaluación económica parcial centrado en el análisis de costos directos de atención contrastando los escenarios de neumonía asociada a ventilador mecánico versus los escenarios sin neumonía asociada a ventilador mecánico. La población de estudio la constituye 23 pacientes con neumonía asociada a ventilador mecánico. Del mismo modo, se tomaron 46 controles. La información correspondiente a los costos directos se obtuvo a través del departamento de costos de la institución hospitalaria. Se estimó la razón de costos que permite establecer el exceso de costo atribuible a la enfermedad nosocomial. Resultados: La estancia promedio en los casos fue de 47 días mientras que en los controles fue de 9 días. El costo promedio de un caso de neumonía asociada a ventilador mecánico fue de US$ 44.354 mientras que el de un control fue de US$ 5.037. Discusión: El exceso de costo promedio total así como el incurrido en antibióticos y en estancia resultan ser mucho más altos que los encontrados en otros estudios realizados. Conclusiones: Un caso de neumonía asociada a ventilador mecánico cuesta 10 veces más con respecto a los medicamentos y 8 veces más con relación a exámenes de laboratorio se insumos. La estancia resulta ser 6,6 veces más costosa que cuando no se presenta esta patología. El costo que se asume en antibióticos es 7,8 veces más alto. Los casos de neumonía asociada a ventilador mecánico cuestan en promedio 8,8 veces más que los controles.

  11. Assessing the nosocomial infections' rate and the antibiotic resistance pattern among the patient hospitalized in beheshti hospital during 2013

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    Manijeh Kadkhodaei

    2018-01-01

    Full Text Available Aims: Nosocomial infection is associated with increased mortality, morbidity, and length of stay. Detection of infection, identify the etiology of bacterial antibiotic resistance pattern, is necessary given the widespread use of antibiotics and antibiotic-resistant organisms. Materials and Methods: This cross-sectional study was done on 288 patients admitted to the Beheshti Hospitals in Kashan based on NNIS definitions according to the state of Health and Medical education. In this study infections and antibiotic resistance symptoms were found. Data analyses were performed with Chi-square test. Results: Among the 288 patients studied, with mean out of hospital infection was 0.80%. Most cases of infection associated were pneumonia. The highest rates of infection were in the Intensive Care Unit (ICU with 51.7%. Nosocomial infection in ICU wards was associated with increased mortality and morbidity. The most common types were ventilator-associated pneumonia. Among the microorganisms, negative Gram was seen more. The common pathogens were including Acinetobacter, Escherichia coli, and Klebsiella. Antimicrobial resistance was generally increasing and had emerged from selective pressure from antibiotic use and transmission through health staff. Conclusion: This study showed a correlation between antibiotic use and resistance of microorganisms is significant. Hence, it seems that reducing aggressive acts and conduct hygiene education and monitoring act of antibiotics is necessary to prevent antibiotic resistance.

  12. Evaluation of efficacy of skin cleansing with chlorhexidine in prevention of neonatal nosocomial sepsis - a randomized controlled trial.

    Science.gov (United States)

    Gupta, Basudev; Vaswani, Narain Das; Sharma, Deepak; Chaudhary, Uma; Lekhwani, Seema

    2016-01-01

    The aim of this study was to evaluate the efficacy of skin cleansing with chlorhexidine (CHD) in the prevention of neonatal nosocomial sepsis - a randomized controlled trial. This study design was a randomized controlled trial carried out in a tertiary care center of north India. About 140 eligible neonates were randomly allocated to either the subject area group (wiped with CHD solution till day seven of life) or the control group (wiped with lukewarm water). The primary outcome studied was to determine the decrease in the incidence of neonatal nosocomial sepsis (blood culture proven) in the intervention group. Out of 140 enrolled neonates, 70 were allocated to each group. The ratio of positive blood culture among the CHD group was 3.57%, while the ratio of positive blood culture among the control group was 6.85%. There was trending towards a reduction in blood culture proven sepsis in the intervention group, although the remainder was not statistically significant. A similar decreasing trend was observed in rates of skin colonization, duration of hospital stay, and duration of antibiotic treatment. CHD skin cleansing decreases the incidence of blood culture sepsis and could be an easy and cheap intervention for reducing the neonatal sepsis in countries where the neonatal mortality rate is high because of sepsis.

  13. Pulsed-field gel electrophoresis of chromosomal DNA of methicillin-resistant Staphylococcus aureus associated with nosocomial infections.

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    Hanifah, Y A; Hiramatsu, K

    1994-12-01

    Methicillin-resistant Staphylococcus aureus (MRSA) infection has been endemic in the University Hospital, Kuala Lumpur since the late 1970s. Fifty isolates of MRSA obtained from clinical specimens of patients with nosocomial infections associated with this organism have been studied by pulsed-field gel electrophoresis (PFGE) of its chromosomal DNA fragments to discrimate between strains and to identify the predominant strain. Twenty-one chromosomal patterns were observed which could be further grouped into nine types. The predominant strain was Type 9-b (40% of isolates) found mainly in the Orthopaedic and Surgical Units. Outbreak strains found in the Special Care Nursery were of Type 1, entirely different from those of the surgical ward S2, which were of Type 9-b. Type 8 strains were found mainly at one end of the hospital building where the maternity, paediatric and orthopaedic units were situated. Genomic DNA fingerprinting by PFGE is recommended as a useful and effective tool for the purpose of epidemiological studies of MSRA infections, particularly for nosocomial infections.

  14. Emergence of Stenotrophomonas maltophilia nosocomial isolates in a Saudi children’s hospital. Risk factors and clinical characteristics

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    Jobran M. Alqahtani

    2017-05-01

    Full Text Available Objectives: To describe the clinical characteristics of pediatric patients colonized or infected by Stenotrophomonas maltophilia (S. maltophilia at a Saudi children’s hospital, to identify risk factors associated with infection, and to investigate the antimicrobial resistance patterns of this emerging pathogen. Methods: In this cross-sectional observational study, 64 non-duplicating S. maltophilia strains were isolated in Najran Maternity and Children’s Hospital, Najran, Saudi Arabia between January 2015 to February 2016. Antimicrobial susceptibility testing was performed using the reference broth microdilution method. Results: In this study, 48 (75% isolates were identified in true infections and 16 (25% isolates were considered colonization. The main types of S. maltophilia infection were pneumonia in 22 (45.8% patients and bloodstream infection in 14 (29.2% patients. The significant risk factors included exposure to invasive procedure (p=0.02, and presence of acute leukemia as an underlying disease (p=0.02. The most active antimicrobials were trimethoprim/sulfamethoxazole (100% sensitivity and tigecycline (93.7% sensitivity. Conclusions: Stenotrophomonas maltophilia is an emerging nosocomial pathogen among pediatric patients. Accurate identification and susceptibility testing of this emerging pathogen are crucial for the management of infected patients and prevention of spread of this nosocomial pathogen.

  15. Antibacterial and antioxidant activities of Musa sp. leaf extracts against multidrug resistant clinical pathogens causing nosocomial infection.

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    Karuppiah, Ponmurugan; Mustaffa, Muhammed

    2013-09-01

    To investigate different Musa sp. leave extracts of hexane, ethyl acetate and methanol were evaluated for antibacterial activity against multi-drug resistant pathogens causing nosocomial infection by agar well diffusion method and also antioxidant activities. The four different Musa species leaves were extracted with hexane, ethyl acetate and methanol. Antibacterial susceptibility test, minimum inhibitory concentration and minimum inhibitory bacterial concentration were determined by agar well diffusion method. Total phenolic content and in vitro antioxidant activity was determined. All the Musa sp. extracts showed moderate antibacterial activities expect Musa paradisiaca with the inhibition zone ranging from 8.0 to 18.6 mm. Among four species ethyl acetate extracts of Musa paradisiaca showed highest activity against tested pathogens particularly E. coli, P. aeruginosa and Citrobacter sp. The minimum inhibitory concentrations were within the value of 15.63- 250 µg/mL and minimum bactericidal concentrations were ranging from 31.25- 250 µg/mL. Antioxidant activity of Musa acuminate exhibited maximum activity among other three Musa species. The present study concluded that among the different Musa species, Musa paradisiaca displayed efficient antibacterial activity followed by Musa acuminata against multi-drug resistant nosocomial infection causing pathogens. Further, an extensive study is needed to identify the bioactive compounds, mode of action and toxic effect in vivo of Musa sp.

  16. A Culture-Proven Case of Community-Acquired Legionella Pneumonia Apparently Classified as Nosocomial: Diagnostic and Public Health Implications

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    Annalisa Bargellini

    2013-01-01

    Full Text Available We report a case of Legionella pneumonia in a 78-year-old patient affected by cerebellar haemangioblastoma continuously hospitalised for 24 days prior to the onset of overt symptoms. According to the established case definition, this woman should have been definitely classified as a nosocomial case (patient spending all of the ten days in hospital before onset of symptoms. Water samples from the oncology ward were negative, notably the patient’s room and the oxygen bubbler, and the revision of the case history induced us to verify possible contamination in water samples collected at home. We found that the clinical strain had identical rep-PCR fingerprint of L. pneumophila serogroup 1 isolated at home. The description of this culture-proven case of Legionnaires’ disease has major clinical, legal, and public health consequences as the complexity of hospitalised patients poses limitations to the rule-of-thumb surveillance definition of nosocomial pneumonia based on 2–10-day incubation period.

  17. Comparison of Disk Diffusion and E-Test Methods for Doripenem Susceptibility of Nosocomial Acinetobacter Baumannii Strains

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    Yesim Cekin

    2014-03-01

    Full Text Available Aim: Acinetobacter species are amoung the most common two cause of infections isolated from patients of intensive care unit in our hospital. Doripenem which acts by inhibiting cell wall synthesis is resently introduced for use in our country is broad spectrum antibiotic belonging to carbapenems. There are many studies investigating the susceptibility of doripenem of Acinetobacter baumannii which is isolated as a cause of ventilatory associated pneumonia in the literature. We aimed to compare e-test and disc diffusion methods for doripenem susceptibility of acinetobacter baumannii strains as nosocomial infections Acinetobacter baumanni isolates detected as nosocomial infection. Material and Method:. Between January to December, 2009 a total of 94 Acinetobacter baumanni strains isolated from different clinical specimens from intensive care units have been studied for doripenem susceptibility by disc diffusion and E-test methods. Minimal inhibitory consantrations (MIC were accepted as; sensitive %u22641 %u03BCg/ml, intermadiate 2-4 %u03BCg/ml, resistant >4 %u03BCg/ml and diameters of inhibition zone with 10 µg disc; sensitive

  18. Uso controlado de antibióticos ayuda en la disminución de la resistencia bacteriana en una institución de cuarto nivel de complejidad (2004-2012

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    Rubén Darío Camargo Rubio

    2014-09-01

    Full Text Available El uso excesivo o indiscriminado de antibióticos va de la mano con la aparición de resistencia bacteriana. Objetivo: Confirmar si el control de la prescripción diaria de antibióticos contribuye a disminuir la resistencia bacteriana. Métodos: Estudio descriptivo, trasversal, del control de la prescripción diaria de antibióticos. Durante los años 2004 a 2007 (primer periodo y 2008 a 2011 (segundo periodo. Diariamente se evaluó la prescripción de antibióticos de control institucional y se compararon semestralmente cada año sus resultados, con el reporte de resistencia en bacterias bajo vigilancia epidemiológica. Resultados: Los resultados obtenidos con el control diario de las prescripciones de antibióticos durante el estudio evidencian que controlar antibióticos ayuda a disminuir la resistencia bacteriana, en el periodo 2004-2007. La falta de adherencia a las políticas institucionales de control de las prescripciones de antibióticos, evidenció en el estudio aumento de la resistencia bacteriana, en el periodo 2008-2010. Comentario: Controlar institucionalmente antibióticos contribuye a disminuir la resistencia bacteriana o aumentarla sino se controlan.

  19. SENSITIVITY TO ANTIBIOTICS, ANTISEPTICAL NOSOCOMIAL PSEUDOMONAS AERUGINOSA, ISOLATED IN UROLOGICAL PATIENTS

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    Rymsha E.V.

    2015-05-01

    cultures around the disks with antibiotics. To explore sensitivity to antiseptics used commercial samples drug Decesan® (decamethoxin of 0.02% solution ("YURI-PHARM", Ukraine, Miramistin® 0.01% solution (benzyldimethyl-myristoylation- Propylamine chloride monohydrate (ZAO Pharmaceutical firm "Darnitsa" and Chlorhexidine (chlorhexidine digluconate 0.05% solution (PJSC "Monfarm". Comparative evaluation of sensitivity of microorganisms to the test preparations was determined by the minimum bactericidal concentration (MBsC standard method, serial dilutions of the drug in a liquid medium (μg⁄ml. Results and discussion. Just received 20 nosocomially strains of P. аeruginosa. Isolated strains had the typical morphology polymorphic thin sticks, gramnegative on dense nutrient media formed a rounded, translucent colonies with a smooth edge, with a blue-green pigment. The biochemical properties referenceusa gram-negative bacteria were determined using Neverlast-24 (PLIVA – Lachema a. s. Brno, Czech Republic. The results of the determination of antibiotics susceptibility of tested strains P. aeruginosa. The greatest activity against the studied strains of P. аeruginosa had Meropenem, amikacin, ceftazidime and imipenem. Nimensa frequency of resistant strains identified to Meropenem were insensitive to 10% of strains of P. aeruginosa. From resistant to Meropenem 6 strains had perekhresne resistance to imipenem. The second activity with β-lactam antibiotics were identified ceftazidime. Insensitive to it were 5%. Antoniniani penicillins were less active than the carbapenems and ceftazidime.So resistant to Pirillo/tazobactam were 30% of the isolates. The most frequent combinations of stability were gentamicin – piperacillin 55,3%, gentamicin – piperacillin – piperacillin/tazobactam 35%. One strain of P. aeruginosa possessed simultaneously resistant to all antibiotics. Decesan and Miramistin had the same sensitivity P. aeruginosa (62.5± 8.94 μg∕ ml and 62.5±16,04

  20. Neumonía nosocomial asociada a ventilación mecánica

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    Raquel Maciques Rodríguez

    2002-09-01

    Full Text Available Se informa que la neumonía asociada a ventilación mecánica es un tipo particular de infección nosocomial frecuente en los pacientes críticos y se asocia con altas tasas de morbilidad y mortalidad. Su origen es polimicrobiano y depende de múltiples factores de riesgo como: edad, días de ventilación, poca movilización, alcalinización gástrica, trauma, coma y uso de medicamentos como: sedantes y bloqueadores, entre otros. Las estrategias fundamentales para la prevención de esta entidad, tienen como objetivo reducir el impacto de los factores de riesgo ya sean intrínsecos o extrínsecos. Su pronóstico depende del momento de aparición de los síntomas, por lo que se clasifica de inicio temprano, aquella que aparece antes de los 4 días de ventilación, producida por los gérmenes de la orofaringe, se asocia a baja mortalidad y generalmente es de buen pronóstico y la de inicio tardío que aparece después de los 5 días de apoyo ventilatorio, producida por cepas multirresistentes y de muy mal pronóstico. El diagnóstico es difícil por los múltiples criterios propuestos a través de los diferentes estudios realizados. Los emitidos por la Sociedad Americana del Tórax en 1999 son más específicos, pues reúnen las condiciones clínicas, microbiológicas y no microbiológicas, las cuales no son invasivas, resultan fáciles y rápidas de recoger y pueden aplicarse a cualquier grupo de edad, independientemente de la causa que provocó la enfermedad. El análisis microscópico directo y el conocimiento del mapa epidemiológico de cada servicio, permiten el inicio de un tratamiento empírico más efectivo. Aunque la tendencia actual en el tratamiento es la monoterapia, no existe un antibiótico ideal que cubra la totalidad del espectro de los microorganismos responsables de esta entidad.It is reported that pneumonia associated with mechanical ventilation is a particular type of nosocomial infection that is frequently found among critical