Correlation between serology and nucleic acid amplification test in blood donors who are reactive for hepatitis B virus, hepatitis C and human immunodeficiency virus and evaluation of the epidemiological profile of infected people in blood centers in the State of Paraná.

OBJECTIVES: To compare the results of conventional serological tests and molecular technology (NAT, Nucleic Acid Amplification Test), identify donors in the diagnostic window period, and determine the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) among the samples of blood donors blocked by serological screening. METHODS: A retrospective cross-sectional study was carried out by analyzing blood donor information contained in the database of 20 blood centers in Paraná, from January 2018 to December 2019. RESULTS: A total of 1,496 blood bags were reactive for HBV, HCV, or HIV in serological and/or NAT tests. The 20th Regional Health (RH) Unit had the greatest number of unfit individuals with altered screening for the three infections, with a prevalence of 0.70%. The lowest number of blocked blood donors occurred in the 15th RH, with a prevalence of 0.08%. The highest prevalence of HBV occurred in the 8th RH, with a reagent serology of 0.34% and a positive NAT of 0.17%. For HCV, the prevalence for reagent serology was 0.28%, while that for NAT was 0.02%, which occurred in the 20th RH. For HIV and for NAT, the prevalence of blood donors with positive serology occurred in the 20th RH, at 0.25% and 0.04%, retrospectively. The 13th RH had the highest prevalence of HIV in relation to NAT, that is, conventional serology in concomitance with NAT technology, at 0.07%. During the 2-year period, only 1 reactive donor in the 9th was found for NAT (HBV), in a diagnostic window. CONCLUSION: In Paraná's blood centers, the inability to donate due to HBV, HCV, and HIV, occurred mainly in initial donors, men, those with >8 years of education, aged 16-45 years, married, and O positive. The most affected regions were located in the west and northwest of Paraná. Most of the results showed a discrepancy between the methodologies used.

Prevalence of Sexually Transmitted Infections and Risk Factors Among Young People in a Public Health Center in Brazil: A Cross-Sectional Study.

INTRODUCTION: Sexually transmitted infections (STI) significantly affect the health of sexually active people, especially young people, and can cause low sexual dysfunction, low self-esteem, infertility, increased transmission of HIV, and death. METHODS: We reviewed the medical records of a cross-section of users of a public health services center and verified the prevalence of STI and its associated predictors for male and female individuals 13-24 years of age in an interior county of southern Brazil. RESULTS: The records of 1703 adolescents and young adults, stratified by age (13-18 and 19-24 years, respectively) and sex, admitted between April 1, 2012, and March 31, 2017, were reviewed in this retrospective study. Epidemiological, clinical, and laboratory data of medical records were analyzed using the chi-square test and odds ratio, with confidence interval of 95% by the Stata® 9.0 program. During the study period, a total of 3448 patients were attended to; of these, 1703 (49.39%) were 13-24 years of age, with 86.56% of those 19-24 years having at least 1 STI. The prevalence of STI among men and women, respectively, was 35.40% and 47.67% for condylomata, 8.46% and 7.00% for herpes, 26.35% and 18.80% for syphilis, and 20.06% and 6.27% for urethral discharge syndrome. The risk for STI acquisition was the highest in young adults (odds ratio [OR] 1.55, 95% confidence interval [CI] 1.17-2.06, P = .002), female individuals (OR 1.51, 95% CI 1.14-2.00, P = .004), those with multiple sexual partners (OR 1.62, 95% CI 1.22-2.16, P < .001), and those not using or irregularly using prophylactics (OR 1.62, 95% CI 1.22-2.16, P < .001). CONCLUSIONS: The findings revealed a significant prevalence of STI among young people in public health service. The predictors associated with STI in these patients were being female, having multiple partners in the last year, and not using or irregularly using prophylactics. These predictors confirm the necessity to implement more aggressive strategies to prevent the occurrence of STI in specific populations with higher disease risk, thereby minimizing costs and damage caused by the infections.

Prevalência de infecções urinárias e do trato genital em gestantes atendidas em Unidades Básicas de Saúde / Urinary tract infections prevalence and genital tract infections in pregnant women assisted in Basic Health Units

Objetivo Esta pesquisa teve por objetivo determinar a prevalência de fatores associados às infecções do trato urinário e genital em mulheres em período gestacional. Métodos Trata-se de pesquisa epidemiológica de caráter descritivo com abordagem quantitativa, realizada por meio da coleta de dados em prontuários de gestantes atendidas em nove Unidades Básicas de Saúde distribuídas em Cascavel, Paraná, entre janeiro e dezembro de 2015. Foram consideradas as gestantes com diagnóstico positivo para qualquer doença que acometa os tratos genital e urinário. Foram coletadas dos prontuários informações sociodemográficas, comportamentais, clínicas e resultados laboratoriais. Para as análises estatísticas foi utilizado o método de Qui-Quadrado. Resultados Foram analisados 798 prontuários, observando-se uma positividade de 33,08% (264 casos) com infecções do trato urinário, genital ou ambos. Destas pacientes, 125 (15,66%) apresentaram episódios de infecções do trato urinário, 115 (14,41%) foram acometidas por algum tipo de infecção genital e 24 (3,01%) estavam coinfectadas. Verificou-se diferença estatística em relação ao número de pacientes que apresentaram sinais e sintomas característicos para infecções do trato urinário (<0,001), infecção genital (<0,001) e para casos anteriores de infecções do trato urinário (<0,001). A maioria das infecções do trato genital deu-se por Gardnerella vaginalis (43/37,39%) e Candida sp. (34/29,57%). Conclusão Os resultados indicam altas prevalências de infecções do trato urinário e infecção genital, considerando que, em gestantes, as consequências para o bebê podem ser graves, o que torna o diagnóstico dessas doenças de suma importância na determinação de medidas preventivas. Sendo assim, a investigação, o diagnóstico precoce e o tratamento adequado auxiliam no controle de infecções e problemas congênitos.

Objective To determine the prevalence of factors associated with urinary tract infections, infections of the genital tract in gestational women. Methods A descriptive epidemiological research with a quantitative approach was carried out by means of the collection of data in records of pregnant women attended at nine Basic Health Units distributed in Cascavel, Paraná, between January and December 2015. Pregnant women were considered with positive diagnosis for any disease that affects the genital and urinary tracts. Sociodemographic, behavioral, clinical and laboratory results were collected from the medical records. Statistical analyses were performed using the Chi-square method. Results A total of 798 records were analyzed, with a positive (urinary tract infections or genital infection or urinary tract infections and genital infection) of 33.08% (264 cases). Of these, 125 (15.66%) presented urinary tract infections episodes, 115 (14.41%) were affected by some type of genital infection and 24 (3.01%) were co-infected. There was a statistically significant difference in the number of patients presenting characteristic signs and symptoms for urinary tract infections (<0.001), genital infection (<0.001) and previous cases of urinary tract infections (<0.001). The majority of infections of the genital tract were Gardnerella vaginalis (43/37.39%) and Candida sp. (34/29.57%). Conclusion The prevalence of urinary tract infections and genital infection has been high considering that in pregnant women the consequences for the baby may be serious, which makes the diagnosis of these diseases of paramount importance in determining preventive measures. Therefore, research, early diagnosis and appropriate treatment help control infections and congenital problems.

Prevalência e perfil de suscetibilidade a antimicrobianos de microrganismos isolados em culturas de cateter / Prevalence and antimicrobial susceptibility profile of isolated microorganisms in catheter cultures

Introdução: os cateteres intravenosos são de uso amplamente difundido em hospitais e por estarem em contato direto com a circulação sanguínea, tornam­se um potencial risco para a ocorrência de contaminação e infecção local e sistêmica, aumentando a mortalidade, o tempo de internação e consequentemente custos hospitalares. Objetivo: o presente estudo teve como objetivo realizar levantamento epidemiológico da prevalência de bactérias e fungos em pontas de cateteres provenientes de sete hospitais do município de Cascavel ­ Paraná. Metodologia: foi realizado um estudo transversal por meio da coleta de dados em laudos emitidos por um laboratório clínico privado do mesmo município, entre os anos de 2011 a 2014. Resultados: verificou­se positividade em 21,7% dos laudos analisados (248). O grupo dos bacilos Gram negativos fermentadores (BGN) foi o mais prevalente, sendo as principais bactérias encontradas Escherichia coli e Klebsiella pneumoniae (84 laudos), seguidos de BGN não­fermentadores (79 laudos) e cocos Gram positivos (67 laudos). Leveduras foram encontradas em 18 laudos. Staphylococcus aureus apresentaram uma resistência de 31,8% para oxacilina, sendo para Staphylococcus coagulase­negativa resistência de 86,9%. Klebsiella pnemoniae apresentou discreta resistência para ertapenem (9,5%), imipenem (7,1%) e meropenem (7,1%), sugerindo presença de carbapenemase. Espécies de Enterobacter foram resistentes a diversos antimicrobianos, não constatado resistência aos carbapenêmicos ertapenem, imipenem e meropenem. Acinetobacter baumanii e Pseudomonas aeruginosa apresentaram elevada resistência para imipenem e meropenem (77,1% e 45,2%; 80% e 51,6%, respectivamente). Candida albicans apresentou 100% de suscetibilidade aos antifúngicos utilizados. Conclusão: esses resultados demonstram a grande importância no manejo eficiente do controle de infecção hospitalar e uso responsável de antimicrobianos por hospitais.

Introduction: intravenous catheters are widely used in hospitals, and they become a potential risk for local and systemic contamination due to direct contact with blood circulation, increasing mortality, length of hospital stay and consequently hospital costs. Objectives: the present study aimed to conduct an epidemiological survey of bacteria and fungi prevalence in catheter tips from seven hospitals in Cascavel county ­ Paraná. Methodology: a cross­sectional study was performed by data collection in reports issued by a private clinical laboratory in the same municipality from 2011 to 2014. Results: positive results were found in 21.7% of analyzed reports (248). The Gram negative bacilli fermenting (BGN) group was the most prevalent, being main bacterias Escherichia coli and Klebsiella pneumoniae (84 reports), followed by non­fermenting BGN (79 reports) and Gram positive cocci (67 reports). Yeasts were found in 18 reports. Staphylococcus aureus showed a resistance of 31.8% for oxacillin, and resistance for Staphylococcus coagulase­negative of 86.9%. Klebsiella penmoniae presented a mild resistance to ertapenem (9.5%), imipenem (7.1%) and meropenem (7.1%), suggesting presence of carbapenemase. Enterobacter species were resistant to several antimicrobials, no resistance to carbapenems ertapenem, imipenem and meropenem. Acinetobacter baumanii and Pseudomonas aeruginosa presented high resistance to imipenem and meropenem (77.1% and 45.2%, 80% and 51.6%, respectively). Candida albicans showed 100% susceptibility to antifungals used. Conclusion: these results demonstrate great importance in the efficient management of hospital infection control and responsible use of antimicrobials by hospitals

Infecções genitais e fatores de risco em gestantes atendidas em um serviço de saúde pública / Genital infections and risk factors in pregnant women attended at a public health service

As infecções sexualmente Transmissíveis (IST) atingem um importante espaço no avanço de patologias no ciclo grávido-puerperal, ocasionando sérios danos à gestante e feto. O objetivo deste estudo foi definir a prevalência de infecções genitais e determinar as características epidemiológicas relacionadas às gestantes. Estudo transversal e descritivo, realizado com prontuários de 2795 pacientes atendidos entre 2012-2017. A prevalência de infecção foi 10,4% em 113 gestantes. As infecções mais comuns foram condiloma (%1,32%), seguida por sífilis (8,85%). As coinfecções mais comuns foram condiloma/ outras infecções em 30,09% dos casos. As principais características das gestantes afetadas foram idade entre 20-39 anos (62/54,87%) e casadas (72/63,72%). Verificou-se alta prevalência de infecção nas gestantes em estudo (10,04%). Considerando as graves consequências que as infecções podem trazer à gestante e bebê, é de grande importância o conhecimento das características da população afetada para utilização de medidas preventivas o que pode reduzir o número de casos.