Group B Streptococcus in a cohort of HIV-infected pregnant women: prevalence of colonization, identification and antimicrobial susceptibility profile.

Group B Streptococcus (GBS) is a leading cause of infectious morbidity in newborns. We describe the prevalence of GBS colonization and the serotypes and antibiotic susceptibility profiles of isolates obtained from a cohort of human immunodeficiency virus (HIV)-infected pregnant women. This was a cross-sectional study at a centre for the prevention of mother-to-child transmission of HIV. Vaginal and rectal swabs were collected at 35-37 weeks of gestation from 158 eligible women. GBS isolates were serotyped and antimicrobial susceptibility tests performed. Patient sociodemographic characteristics, CD4 counts and viral loads were abstracted from records. The overall anogenital prevalence of GBS colonization was 49/158 (31.0%): 40/158 (25.3%) for vagina, 19/158 (12.0%) for rectum and 10/158 (6.3%) for both. Predominant serotypes were Ib (34.9%) and Ia (25.6%). All were penicillin-susceptible. Two were resistant to erythromycin (4.0%) and one to clindamycin (2.0%). The colonization rate by GBS was high in this cohort. Serotype Ib was the most frequently identified.

Nevirapine toxicity in a cohort of HIV-1-infected pregnant women.

OBJECTIVE: The purpose of this study was to complete an evaluation of nevirapine (NVP) toxicity in a cohort of HIV+ pregnant women. STUDY DESIGN: This was a retrospective study of 611 women followed from January 1996 to December 2003. All women who used NVP for > 7 days were included. Multivariate logistic regression was used to test independent association of CD4 and hepatitis C virus (HCV) infection related to the outcome of toxic effects of NVP. RESULTS: One hundred ninety-seven women were exposed to NVP for > 7 days, and toxicity occurred in 11 (5.6%), leading to drug discontinuation in 7 patients. One case of Stevens-Johnson syndrome occurred. No serious liver toxicity occurred except for 1 grade 4 cholestasis. Median CD4 was 344 in women without toxicities and 298 in women with toxicities. HCV was the only significant factor associated to toxicity by logistic regression (odds ratio [OR] 15.61, P = .001). CONCLUSION: NVP toxicities occurred in a very small fraction of patients and were not associated with fatalities.

Vertical transmission of HIV in Rio de Janeiro, Brazil.

A cohort of 297 HIV-infected pregnant women was followed from January 1996 to December 2001. The overall transmission rate was 3.57% and remained constant over time. Low birth-weight was independently associated with a higher risk of vertical transmission (P=0.0072), whereas a longer duration of antiretroviral drugs during pregnancy was independently associated with a lower risk of transmission (P=0.0084). Further decreases in transmission should be obtained by initiating prophylaxis earlier in pregnancy.

Impact of a single safety-engineered device on the occurrence of percutaneous injuries in a general hospital in Brazil.

BACKGROUND: Health care workers are exposed to bloodborne pathogens through occupational injuries, and the replacement of sharps by safety-engineered devices has been recommended as a key preventive measure. This recommendation has been difficult to implement in Brazil. METHODS: We conducted a retrospective study of selected data from a database of blood and body fluid exposures reported from January 2007 through December 2011 in a public general hospital in Rio de Janeiro where, from the end of 2009, a safety lancet for blood glucose testing (BGT) was introduced. A log-binomial model was used to evaluate the effect of the introduction of the safety lancet on the proportion of percutaneous injuries (PIs) during BGT in the nursing staff. RESULTS: Nursing staff had a significant reduction in rate of PIs per 100 full-time equivalents from 2007 to 2011 (P < .001), and medical residents had the highest rate throughout the same period. A reduction of PIs by small-gauge needles was observed since 2009, and injuries during BGT fell abruptly in 2010 and 2011 paralleling the number of purchased safety lancets (P < .001). CONCLUSION: The adoption of a single safety device, which required no training, significantly reduced PIs among the nursing team.

Papular-purpuric "gloves and socks" syndrome due to parvovirus B19: report of a case with unusual features

We present a case of papular-purpuric "gloves and socks" syndrome (PPGSS) in an adult male with acute parvovirus B19 infection. The patient displayed the classical features of fever, oral lesions, and purpura on hands and feet, but the purpuric lesions on the feet evolved to superficial skin necrosis, a feature not previously described in this syndrome. We believe this is the first reported case of PPGSS occurring in Brazil

Abscesso hepático piogênico, origem provável em foco urinário: relato de um caso / Pyogenic liver abscess of probable urinary origin: report of a case

Relatou-se nesta trabalho o caso de um paciente que desenvolveu múltiplos abscessos piogênicos do fígado por via hematogênica a partir de um provável foco urinário demonstrado laboratoriamente. A mesma bactéria, Klebsiella sp, foi isolada nas hemoculturas, urinocultura e cultura da secreçäo do abscesso. Foi realizada a drenagem percutânea e antibioticoterapia havendo melhora rápida do quadro clínico, laboratorial e radiológico acompanhado pela ultra-sonografia (AU)/