RESUMO
The majority of paediatric Clostridioides difficile infections (CDI) are community-associated (CA), but few data exist regarding associated risk factors. We conducted a case-control study to evaluate CA-CDI risk factors in young children. Participants were enrolled from eight US sites during October 2014-February 2016. Case-patients were defined as children aged 1-5 years with a positive C. difficile specimen collected as an outpatient or ⩽3 days of hospital admission, who had no healthcare facility admission in the prior 12 weeks and no history of CDI. Each case-patient was matched to one control. Caregivers were interviewed regarding relevant exposures. Multivariable conditional logistic regression was performed. Of 68 pairs, 44.1% were female. More case-patients than controls had a comorbidity (33.3% vs. 12.1%; P = 0.01); recent higher-risk outpatient exposures (34.9% vs. 17.7%; P = 0.03); recent antibiotic use (54.4% vs. 19.4%; P < 0.0001); or recent exposure to a household member with diarrhoea (41.3% vs. 21.5%; P = 0.04). In multivariable analysis, antibiotic exposure in the preceding 12 weeks was significantly associated with CA-CDI (adjusted matched odds ratio, 6.25; 95% CI 2.18-17.96). Improved antibiotic prescribing might reduce CA-CDI in this population. Further evaluation of the potential role of outpatient healthcare and household exposures in C. difficile transmission is needed.
Assuntos
Creches/estatística & dados numéricos , Clostridioides difficile/fisiologia , Infecções por Clostridium/epidemiologia , Microbiologia de Alimentos/estatística & dados numéricos , Pacientes Ambulatoriais/estatística & dados numéricos , Estudos de Casos e Controles , Pré-Escolar , Infecções por Clostridium/microbiologia , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Feminino , Humanos , Incidência , Lactente , Masculino , Fatores de Risco , Estados Unidos/epidemiologiaRESUMO
The wildlife of the Brazilian Pampa is threatened by large-scale habitat loss, due in particular to the expansion of soybean cultivation and the conversion of grasslands areas into extensive areas of silviculture. It is essential to study how the mammal fauna copes with the highly fragmented, human-influenced, non-protected landscape. Our study presents the results of a survey of the large- and medium-sized mammals of a typical human-influenced steppic savanna area of the Pampa biome. The survey was conducted exclusively with the use of camera traps over a period of 16 months. The relative frequencies of species in the area were evaluated. We recorded 18 species, some of them locally threatened (Tamandua tetradactyla, Alouatta caraya, Leopardus colocolo, Leopardus geoffroyi, Leopardus wiedii, Puma yagouaroundi, Mazama gouazoubira and Cuniculus paca). Several species were found to thrive in the area; however, many species were considered rare, and undoubtedly new species could be recorded if we continued the sampling. Our results contribute to the knowledge of faunal diversity in the Pampa biome and associated habitats, warn about threats and provide support for conservation measures.
Assuntos
Biodiversidade , Conservação dos Recursos Naturais , Mamíferos/fisiologia , Animais , Brasil , PradariaRESUMO
Abstract The wildlife of the Brazilian Pampa is threatened by large-scale habitat loss, due in particular to the expansion of soybean cultivation and the conversion of grasslands areas into extensive areas of silviculture. It is essential to study how the mammal fauna copes with the highly fragmented, human-influenced, non-protected landscape. Our study presents the results of a survey of the large- and medium-sized mammals of a typical human-influenced steppic savanna area of the Pampa biome. The survey was conducted exclusively with the use of camera traps over a period of 16 months. The relative frequencies of species in the area were evaluated. We recorded 18 species, some of them locally threatened (Tamandua tetradactyla, Alouatta caraya, Leopardus colocolo, Leopardus geoffroyi, Leopardus wiedii, Puma yagouaroundi, Mazama gouazoubira and Cuniculus paca). Several species were found to thrive in the area; however, many species were considered rare, and undoubtedly new species could be recorded if we continued the sampling. Our results contribute to the knowledge of faunal diversity in the Pampa biome and associated habitats, warn about threats and provide support for conservation measures.
Resumo A fauna do Pampa brasileiro está sendo ameaçada pela grande perda de habitat que vem sofrendo, em especial, devido à expansão do cultivo da soja e da conversão de áreas de pastagens em extensas áreas de silvicultura. É essencial estudar como a fauna de mamíferos lida com a paisagem altamente fragmenta e não protegida, pela influencia humana. Nosso estudo apresenta os resultados de um levantamento dos mamíferos de médio e grande porte em uma área típica do bioma Pampa com influência humana. O levantamento foi realizado exclusivamente com o uso de armadilhas fotográficas ao longo de um período de 16 meses. Foram avaliadas as frequências relativas das espécies na área. Foram registradas 18 espécies, algumas delas ameaçadas localmente (Tamandua tetradactyla, Alouatta caraya, Leopardus colocolo, Leopardus geoffroyi, Leopardus wiedii, Puma yagouaroundi, Mazama gouazoubira e Cuniculus paca). Várias espécies foram encontradas de forma abundante, no entanto, muitas espécies foram consideradas raras, sendo que novas espécies poderiam ser registradas se continuássemos a amostragem. Nossos resultados contribuem para o conhecimento da diversidade de mamíferos do bioma Pampa e habitats associados, alertam sobre ameaças e fornecem suporte para medidas de conservação.