Prevalencia y factores asociados a la colonización de microorganismos multirresistentes en centros de larga estancia de Gran Canaria / Prevalence and risk factors of multi-drug resistant organism colonization among long-term care facilities in Gran Canaria (Spain)

Introducción. Los microorganismos multirresistentes (MMR) son causa importante de infección nosocomial, su manejo clínico-terapéutico es complicado y producen elevada morbimortalidad, con aumento de costes sanitarios asociados. En centros sanitarios de larga estancia (CSLE), la colonización/infección de sus residentes por MMR es cada vez mayor, pudiendo estos actuar como reservorios y vehículos para brotes de cepas resistentes en los hospitales de agudos. Los objetivos del estudio fueron determinar la prevalencia de portadores de MMR y detectar factores asociados al estado de portador. Material y métodos. Estudio de prevalencia de corte en 235 residentes de 2 CSLE en Las Palmas de Gran Canaria (Islas Canarias, España) entre octubre y noviembre del 2012. Se investigó la presencia de MMR en frotis nasal, faríngeo y rectal utilizando medios de cultivo selectivos. Se estudiaron los factores de riesgo asociados al estado de portador mediante análisis univariante y multivariante. Resultados. El 36,2% de residentes fueron portadores de al menos un MMR. El 26,6% fueron portadores de enterobacterias productoras de betalactamasa de espectro extendido y el 10,2% portadores de SARM. Los factores asociados significativamente con la colonización por MMR fueron: colonización-infección previa por MMR, ingreso hospitalario en los últimos 3 meses, infecciones de repetición del tracto urinario y enfermedad arterial periférica. Conclusiones. La prevalencia de MMR en estos CSLE es mayor que la encontrada en la bibliografía, especialmente la de enterobacterias BLEE. Debido a la alta prevalencia de infección/colonización por MMR y los factores de riesgo asociados al estado de portador, es posible que los CSLE actúen de reservorio de MMR y además su diseminación se facilite con el traslado de estos pacientes a hospitales en episodios agudos (AU)

Introduction. Multidrug resistant organisms (MDRO) are an important cause of nosocomial infections, with complicated clinical-therapeutic management and elevated morbidity-mortality, and an increase in healthcare costs. In long term care facilities (LTCFs) colonization/infection by MDRO among residents is increasing, and they may act as reservoirs and vehicles for the dissemination and production of outbreaks by resistant strains in acute hospitals. This study aimed at determining the prevalence of carriers of some common MDRO, and identifying factors associated with carrier state. Material and methods. A cross-sectional prevalence study was conducted on 235 residents in two LTCFs in the province of Las Palmas de Gran Canaria (Canary Islands, Spain) between October and November of 2012. The presence of MMR was investigated in nasal, pharyngeal and rectal swabs using selective media. Risk factors associated with carrier state were calculated using univariate and multivariate analysis. Results. More than one-third (36.2%) of residents were found to be carriers of ≥ 1 distinct MDROs. More than one-quarter (26.6%) were carriers of ESBL producing Enterobacteriaceae, and 10.2% were MRSA carriers. Factors found to be associated with colonization by any MDRO were: prior colonization or infection by MDRO, hospitalization in the past 3 months, recurrent infections of the urinary tract, and peripheral arterial disease. Conclusions. The prevalence of MDRO in the LTCFs settings studied is greater than that found in the literature, and in particular ESBL producing Enterobacteriaceae. Due to the high prevalence of infection/colonization by MDRO, it is possible that residents of LTCFs could act as important reservoirs of MDRO, and facilitate their spread into the acute care setting (AU)

[Prevalence and risk factors of multi-drug resistant organism colonization among long-term care facilities in Gran Canaria (Spain)]. / Prevalencia y factores asociados a la colonización de microorganismos multirresistentes en centros de larga estancia de Gran Canaria.

INTRODUCTION: Multidrug resistant organisms (MDRO) are an important cause of nosocomial infections, with complicated clinical-therapeutic management and elevated morbidity-mortality, and an increase in healthcare costs. In long term care facilities (LTCFs) colonization/infection by MDRO among residents is increasing, and they may act as reservoirs and vehicles for the dissemination and production of outbreaks by resistant strains in acute hospitals. This study aimed at determining the prevalence of carriers of some common MDRO, and identifying factors associated with carrier state. MATERIAL AND METHODS: A cross-sectional prevalence study was conducted on 235 residents in two LTCFs in the province of Las Palmas de Gran Canaria (Canary Islands, Spain) between October and November of 2012. The presence of MMR was investigated in nasal, pharyngeal and rectal swabs using selective media. Risk factors associated with carrier state were calculated using univariate and multivariate analysis. RESULTS: More than one-third (36.2%) of residents were found to be carriers of ≥ 1 distinct MDROs. More than one-quarter (26.6%) were carriers of ESBL producing Enterobacteriaceae, and 10.2% were MRSA carriers. Factors found to be associated with colonization by any MDRO were: prior colonization or infection by MDRO, hospitalization in the past 3 months, recurrent infections of the urinary tract, and peripheral arterial disease. CONCLUSIONS: The prevalence of MDRO in the LTCFs settings studied is greater than that found in the literature, and in particular ESBL producing Enterobacteriaceae. Due to the high prevalence of infection/colonization by MDRO, it is possible that residents of LTCFs could act as important reservoirs of MDRO, and facilitate their spread into the acute care setting.

O exercício físico para uma vida mais ativa em idosas de uma unidfade básica em saúde em Porto Alegre-RS

O projeto tem por objetivo propor um programa de atividades físicas para um grupo de idosas ligadas à unidade de saúde do bairro Jardim Dona Leopoldina, visando a melhora da qualidade de vida, o bem-estar físico, social e emocional. Pretende propor atividades físicas adaptadas às reais necessidades das idosas, favorecendo desta forma a melhoria de suas autoestimas e capacidades físicas, proporcionando atividades prazerosas em seu cotidiano .