RESUMO
OBJECTIVE: Screening for (methicillin-sensitive [MSSA] or -resistant [MRSA]) Staphylococcus aureus (SA) nasal carriage in health care workers in contact with fragile patients is a recurrent question. We wanted to assess carriage among infectious diseases healthcare workers. METHODS: Voluntary health care workers were recruited during the 2010 Yearly French Congress (Journées Nationales d'Infectiologie, JNI). An anonymous double nasal swab was performed followed by PCR examination (GeneXpert MRSA/SA nasal tests) carried out on the Cepheid stand. Health care workers were also asked to fill in a questionnaire. Results were available 1 hour later but kept anonymous. RESULTS: One hundred and fifty-two tests and questionnaires were selected. MRSA was isolated from four health care workers (2.4%). MSSA was isolated from 52 health care workers (34.2%). Sex, clinical activity of health care workers, hospital size, and systematic screening of patients did not affect carriage. CONCLUSIONS: The prevalence of MSSA in nasal carriage in France is similar to the European one but the prevalence of MRSA is higher. This raises the question of a targeted decolonization in health care workers.
Assuntos
Portador Sadio/epidemiologia , Congressos como Assunto , Pessoal de Saúde/estatística & dados numéricos , Cavidade Nasal/microbiologia , Médicos/estatística & dados numéricos , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/isolamento & purificação , Adulto , Pessoal Técnico de Saúde/estatística & dados numéricos , Descontaminação , Feminino , França , Número de Leitos em Hospital/estatística & dados numéricos , Departamentos Hospitalares , Humanos , Infectologia , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Masculino , Pessoal de Laboratório Médico , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Ocupações , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Ertapenem could be used to treat urinary tract infections (UTI) caused by ESBL producing enterobacteriacae (ESBL-E) and administered subcutaneously. METHOD: The authors made a retrospective study on adult patients treated with ertapenem administered intravenously or subcutaneously for UTI caused by ESBL-E, between May 2009 and August 2011 at the Chambery hospital, France. RESULTS: Twenty-five patients were treated (13 cases of prostatitis, ten of pyelonephritis, two of cystitis) mostly caused by Escherichia coli (24 cases). Subcutaneous injections were administered to 20 patients and 23 were treated through outpatient parenteral antibiotic therapy (OPAT). All patients were cured at the end of the ertapenem therapy. Urine samples collected during treatment for 12 patients were sterile. Three months after the end of the treatment, five patients had relapsed, and six had developed a UTI caused by another bacteria. CONCLUSION: Ertapenem administered intravenously or subcutaneously could be an effective treatment for UTI caused by ESBL-E, especially using OPAT.
Assuntos
Cistite/tratamento farmacológico , Infecções por Escherichia coli/tratamento farmacológico , Proteínas de Escherichia coli/análise , Escherichia coli/enzimologia , Prostatite/tratamento farmacológico , Pielonefrite/tratamento farmacológico , Resistência beta-Lactâmica , beta-Lactamases/análise , beta-Lactamas/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Assistência Ambulatorial , Cistite/microbiologia , Avaliação de Medicamentos , Ertapenem , Escherichia coli/efeitos dos fármacos , Infecções por Escherichia coli/microbiologia , Feminino , Humanos , Injeções Intravenosas , Injeções Subcutâneas , Infecções por Klebsiella/tratamento farmacológico , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/enzimologia , Klebsiella pneumoniae/isolamento & purificação , Masculino , Pessoa de Meia-Idade , Prostatite/microbiologia , Pielonefrite/microbiologia , Recidiva , Estudos Retrospectivos , Fatores de Risco , beta-Lactamas/administração & dosagemRESUMO
An open randomized study was done to compare the prophylactic value of single doses of netilmycin-metronidazole versus trimethoprim-sulfamethoxazole in the prevention of postoperative infections associated with transrectal prostatic biopsy. Of 117 patients enrolled in the study 101 were evaluated and of these patients 47 received netilmycin-metronidazole and 54 received trimethoprim-sulfamethoxazole. The bacteremia rate in the netilmycin-metronidazole group was 28% (13 of 47 patients) with a 95% confidence interval of 18 to 42% and in the trimethoprim-sulfamethoxazole group it was 37% (20 of 54) with a confidence interval of 26 to 50% (p = 0.43). None of the patients with bacteremia was symptomatic. Urinary tract infection rates were greater in the netilmycin-metronidazole group: 17% (8 of 47 patients) versus 2% (1 of 54) in the trimethoprim-sulfamethoxazole group, p = 0.01. Trimethoprim-sulfamethoxazole (cotrimoxazole) is a better choice as an antimicrobial prophylaxis for patients undergoing transrectal prostatic biopsy.