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West Indian med. j ; 51(1): 21-4, Mar. 2002. tab
Artigo em Inglês | MedCarib | ID: med-102


The nosocomial infection rate in an Intensive care unit (ICU) of a private hospital was assessed during an 18-month survey. From 629 admissions to the ICU, 139 hospital-acquired infections were identified. The rate was 22.1 percent compared to the overall nosocomial infection rate of 15.3 percent for the entire hospital. In the ICU, the main infections occurred in the respiratory tract, 41 (29.5 percent), followed by surgical wounds, 35 (25.2 percent), urinary tract, 28 (20.1 percent) and the blood stream, 24 (17.3 percent). From 165 bacterial isolates, 80 percent of isolates were gram-negative rods, with P aeruginosa, 48 (36.6 percent), being the predominant gram-negative isolate followed by Klebsiella pneumoniae, 27 (20.6 percent), and Enterobacter sp, 22 (16.8 percent). The main gram-positive isolates were S aureus, 23 (41.8 percent), coagulase-negative Staphylococci, 17 (30.9 percent), and Enterococci, 11 (20.0 percent). Of the 23 S aureus strains, 15 (65.2 percent) were methicillin-resistant (MRSA), (8 MRSA were from surgical wounds, 5 from the respiratory tract and 2 from infected urine). Only 2 of the 17 (11.8 percent) coagulase-negative staphylococci were methicillin-resistant, and both were isolated from wounds. Resistance to ampicillin and augmentin (amoxicillin-clavulanic acid) was high, 81.9 percent and 55.4 percent, respectively. Gentamicin, azteronam, piperacillin-tazobactam showed resistance rates of less than 15 percent. Infection control measures aimed at reducing nosocomial infections at the hospital are often frustrated by apathy of hospital administrators who apparently are insensitive to the high nosocomial infection rate. Effort by the infection control team through seminars, lectures and newsletters have begun to show improvements in attitude and awareness of staff to infection control and preventative measures within the institution. (AU)

Humanos , Infecção Hospitalar/epidemiologia , Unidades de Terapia Intensiva/estatística & dados numéricos , Hospitais Privados/estatística & dados numéricos , Trinidad e Tobago/epidemiologia , Coleta de Dados , Infecções Respiratórias/epidemiologia , Infecção da Ferida Cirúrgica/epidemiologia , Infecções Urinárias/epidemiologia , Pseudomonas aeruginosa/isolamento & purificação , Bacilos e Cocos Aeróbios Gram-Negativos/isolamento & purificação , Klebsiella pneumoniae/isolamento & purificação , Enterobacter/isolamento & purificação , Bactérias Gram-Positivas/isolamento & purificação , Infecção Hospitalar/prevenção & controle , Staphylococcus aureus/isolamento & purificação , Gentamicinas/uso terapêutico , Aztreonam/uso terapêutico , Piperacilina/uso terapêutico
West Indian med. j ; 50(Suppl 5): 29, Nov. 2001.
Artigo em Inglês | MedCarib | ID: med-146


OBJECTIVE: The objective was to investigate the antibacterial activity of the crude Carica papaya preparations as used by nurses, on gram negative and gram positive organisms; to determine which part and stage of maturity of the fruit yielded the best antibacterial activity, and determine the effects of storage conditions on the observed activity. METHODS: The pathogens commonly found in human wounds were obtained from the Microbiology Department, University of the West Indies, Biochemistry Section, The University of the West Indies and the Jamaican Bureau of Standards. Cultures were routinely maintained in nutrient agar slants at 4§c. Extracts were obtained by separately grinding fractions of the epicarp, endocarp and seeds of the immature, mature and ripe Carica papaya fruit and filtering them through guaze. Sensitivity tests were conducted by adding 0.06 ml. of agar wells (6 mm diameter) prepared from 20 ml agar seeded with 10 cells/ml suspension of one of the eight organisms per plate. The inoculated plates were allowed to equilibrate at 4§c for one hour then incubated at 37§c for 24 hours, after which zones of inhibition were measured in millimeters. Antibacterial activity was expressed in terms of the radius of the zone of inhibition calculated as the difference in radius of the observed zones and the edge of the agar wells. Daily sensitivity tests were carried out on extracts stored at 5§c, 25§c and 35§c for 7 days. RESULTS: The seed extracts from all three stages of the fruit showed an average order of inhibition in the following order: B cereus> E coli> S faecalis> S aureus> P vulgaris> and X flexneri. There was no significant difference in bacterial sensitivity between the immature, mature and ripe fruits tested. The epicarp and endocarp did not produce any inhibition zone in any of the three stages of the fruit tested. There was a gradual reduction in antibiotic activity with increasing storage item. Also, a fall-off of activity was found to be more drastic at higher temperatures. CONCLUSION: The findings show that crude extracts of Carica papaya seed have antibacterial activity that inhibits the growth of both gram positive (B cereus, S aureus and S faecalis) and gram negative (E coli, P vulgaris and S flexneri) organisms. Observed activity was dependent on stage of maturity but tended to decrease with duration and conditions of storage. No antibacterial activity was observed from the epicarp and the endocarp of the fruit. (AU)

Humanos , Asimina triloba/uso terapêutico , Ferimentos e Lesões/terapia , Anticorpos Antibacterianos/uso terapêutico , Bactérias Gram-Negativas/crescimento & desenvolvimento , Bactérias Gram-Positivas/crescimento & desenvolvimento , Medicina Tradicional
West Indian med. j ; 42(2): 72-6, June 1993.
Artigo em Inglês | MedCarib | ID: med-9598


The isolation of pathogens from urine specimens was surveyed during a six-month period when 1611 urine specimens were examined in the Public Health Laboratory, and 8769 were examined in the Microbiology Laboratory of the Queen Elizabeth Hospital. Significant growth (defined as >10 organisms/ml urine) was detected in 393 (24,4 percent) of the urine cultured in the Public Health Laboratory and in 1218 (13.9 percent) of urines cultured in the Queen Elizabeth Hospital. The overall isolation rate 15.5 percent; Gram-negative bacilli were more commonly isolated from hospital patients, whereas Gram-positive cocci were relatively more common in community patients. The most common pathogens detected were coliforms (1233 isolates), streptococci (197) and coagulase-negative straphylococci (182); 50 percent of all isolates were sensitive to amoxycillin, 68 percent to cephradine, 61 percent to co-trimoxazole, 62 percent: to nalidixic acid and 79 percent to nitrofurantoin. Anti-bacterial activity was detected in 130 (8 percent) of the urine specimens received in the Public Health Laboratory. (AU)

Humanos , Adulto , Pessoa de Meia-Idade , Urina/microbiologia , Infecções Urinárias/microbiologia , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Positivas/isolamento & purificação , Barbados , Infecções Urinárias/tratamento farmacológico , Testes de Sensibilidade Microbiana
In. Levett, Paul N; Fraser, Henry S; Hoyos, Michael D. Medicine and therapeutics update 1990: proceedings of Continuing Medical Education symposia in Barbados, November 1988 & June 1989. St. Michael, University of the West Indies, (Cave Hill). Faculty of Medical Sciences, 1990. p.115-9, tab.
Monografia em Inglês | MedCarib | ID: med-15001


The importance of blood cultures in the early detection of organisms is examined with the following conclusions. The isolation of of gram-positive and gram negative organisms are isolated from blood cultures with equal frequency. K. pneumoniae and E. coli are the most frequently isolated gram gram-negataive organisms. Staph, epidermis is isolated more frequently than Stap. aureus. Gentamcin was found to be the most effective antibiotic against Gram-negative blood culture isolates. Clindamycin and cloxacillin were found to be the most effective antibiotics against the gram-positive isolates. Chloramphenicol was found to be the most effective agent against the anaerobes as a group

Sepse/diagnóstico , Bactérias Gram-Negativas , Bactérias Gram-Positivas , Testes de Sensibilidade Microbiana , Antibacterianos , Cefradina , Gentamicinas , Barbados