Genotyping of paired KPC-producing Klebsiella pneumoniae isolates with and without divergent polymyxin B susceptibility profiles.

Polymyxins are still used mainly in treating infections caused by carbapenem-resistant Klebsiella pneumoniae worldwide. The most frequent mechanism of acquired resistance to polymyxins in Gram-negative bacilli is the occurrence of mutations in chromosomal genes regulating operons responsible for lipopolysaccharide modification. As we observed at Santa Casa de São Paulo hospital the occurrence of infections caused by isolates resistant to polymyxins in patients previously treated with this antimicrobial, and new infections caused by the same polymyxin-susceptible species, in this study, we aimed to determine the clonality of consecutive K. pneumoniae isolates from the same patients and characterize the molecular determinants of polymyxin resistance in paired or clonal isolates. A total of 24 pairs and one trio of K. pneumoniae isolates were included in this study. Species identification was achieved by mass spectrometry and multiplex PCR. Polymyxin B minimal inhibitory concentrations were determined by broth microdilution. Clonality was evaluated using pulsed-field gel electrophoresis. The presence of insertions in mgrB gene was tested by PCR, and mutations on pmrA, pmrB, phoP, and phoQ were evaluated by PCR and complete nucleotide sequencing. A fraction of 23.8% of strains resistant to polymyxin B had an insertion in mgrB. Amino acid substitution F204L in PmrB may be implicated in polymyxin resistance. Substitutions T246A and R256G in PmrB were not implicated in polymyxin resistance. In this study, polymyxin resistance after a first susceptible isolate was detected was most frequently due to an infection caused by a distinct clone.

Short-chain cyanoacrylates and long-chain cyanoacrylates (Dermabond) have different antimicrobial effects.

OBJECTIVE: To compare the antimicrobial effect in vitro of a short-chain cyanoacrylate with a long-chain cyanoacrylate (Dermabond, Ethicon, Johnson and Johnson, USA) against bacterial strains. METHODS AND ANALYSIS: The following bacterial strains were analysed: Staphylococcus aureus, Escherichia coli, Klebsiella pneumonia and Pseudomonas aeruginosa. For each microorganism, standardised sterile discs (6 mm) containing 10 µL of ethyl-cyanoacrylate and 2-octyl cyanoacrylate were applied to the plate. All plates received a blank filter-paper disc with no adhesive (control). All plates were incubated for 24 hours, after which the bacterial inhibitory halos, if present, were measured in millimetres in its greater length. RESULTS: Inhibitory halos were observed for both adhesives for S. aureus. Inhibition halos were observed only for ethyl-cyanoacrylate for K. pneumoniae and E. coli. No inhibition halo was observed for P. aeruginosa in any sample. The relationship between the total size of the inhibition halos and the diameter of the paper filter for S. aureus was statistically significant compared with 2-octyl cyanoacrylate. CONCLUSION: Data shown conclude that ethyl-cyanoacrylate showed in vitro bacteriostatic activity for S. aureus, E. coli and K. pneumoniae. 2-Octyl cyanoacrylate showed in vitro lower bacteriostatic activity only against S. aureus when compared with ethyl-cyanoacrylate. No in vitro bactericidal activity of ethyl-cyanoacrylate or 2-octyl cyanoacrylate was observed.

Avaliação da segurança do processamento de fresas intramedulares flexíveis para cirurgia ortopédica / Safety assessment of reprocessing of flexible intramedullary bone reamers for orthopedic surgery / Evaluación de la seguridad del procesamiento de fresas intramedulares flexibles para cirugía ortopédica

Objetivos: Avaliar a eficácia de um procedimento operacional padrão para limpeza de fresas intramedulares flexíveis, bem como o alcance da esterilidade, e evi-denciar a citotoxicidade da sujidade residual de uma fresa flexível utilizada na prática assistencial. Métodos: Fresas intramedulares flexíveis foram pesadas antes do processamento, após contaminação desafio e depois da limpeza. Elas foram contaminadas com Soil Test™, suspensão de Geobacillus stearothermophilus, na concentração de 106 UFC/mL, e farinha de osso bovino. Após processamento, as amostras foram incubadas em meio de cultura por 21 dias. A sujidade residual de uma fresa utilizada na prática foi submetida ao teste de citotoxicidade in vitro. Resultados: As amostras, embora esterilizadas, apontaram acúmulo de sujidade e o processamento foi ineficaz. A sujidade residual apresentou efeito citotóxico. Conclusão: Recomenda-se que o design flexível das fresas seja descontinuado pela insegurança no processamento.

Objectives: To assess the efficacy of a standard operational procedure to clean flexible intramedullary bone reamers, as well as the sterilization level, and to show the cytotoxicity of the residual dirtiness of a flexible reamer used in care practice. Methods: Flexible intramedullary bone reamers were weighed before processing, after challenge contamination and after cleaning. They were contaminated with the Soil Test™, Geobacillus stearothermo-philus suspension, in the concentration of 106 cfu/ml, and bovine bone flour. After processing, the samples were inoculated into a culture medium and incubated for 21 days. Residual dirtiness of a flexible intramedullary bone reamer used in practice was submitted to in vitro cytotoxicity test. Results: Despite being sterilized, the samples indicate to accumulated dirtiness and the processing was inefficient. Residual dirtiness presented a cytotoxic effect. Conclusion: It is recommended that the flexible design of reamers is discontinued by the lack of safety of reprocessing.

Objetivos: Evaluar la eficacia de un procedimiento operacional estándar para limpieza de fresas intramedulares flexibles, así como el alcance de la esterilidad, y evidenciar la citotoxicidad de la suciedad residual de una fresa flexible utilizada en la práctica asistencial. Métodos: Fresas intramedulares flexibles fueron pesadas antes del procesamiento, tras contaminación desafío y después de la limpieza. Fueron contaminadas con Soil Test™, suspensión de Geobacillus stearothermophilus, en la concentración de 106 UFC/mL, y harina de hueso bovino. Tras el procesamiento, las muestras fueron incuba-das en medio de cultura por 21 días. La suciedad residual de una fresa utilizada en la práctica fue sometida al test de citotoxicidad in vitro. Resultados: Las muestras, aunque esterilizadas, apuntaron acumulación de suciedad y el procesamiento fue ineficaz. La suciedad residual presentó efecto citotóxico. Conclusión: Se recomienda que el design flexible de las fresas sea descontinuado por la inseguridad en el procesamiento.

Effect of Spiritist "passe" (Spiritual healing) on growth of bacterial cultures.

BACKGROUND: Biofield therapies are approaches that harness energy fields to influence the human body. These therapies encompass Reiki, Qigong, Therapeutic Touch, Johrei and Spiritist "passe", among others. The aim of this study was to evaluate bacterial growth in two groups of cultures subjected to biofield therapy (Spiritist "passe" and laying on of hands (LOH)) in four situations (no intention, intention to inhibit bacterial growth, intention to promote growth, and influence of a negative factor) and compare them with a "no LOH/no treatment" group. METHODS: Bacterial cultures (Escherichia coli ATCC) were randomized and allocated into three groups: Spiritist "passe", "LOH", and "no LOH". Bacterial growth was assessed using the McFarland Nephelometer Scale. A One-way ANOVA was performed to determine group differences in bacterial growth at 48h, and at 1 week after each situation. RESULTS: A total of 11 Spiritist "passe" healers, 10 LOH laymen and "no LOH" tubes were assessed. Under the intention to inhibit bacterial growth condition, statistically significant differences were found between the Spiritist "passe" and "no LOH" Groups (p=0.002 after 48h, and p=0.008 after one week) and also between the Spiritist "passe" and "LOH" Groups (p=0.005 after 48h, and p=0.009 after one week). No statistically significant difference was detected for the other situations tested (no intention, intention to promote growth and influence of a negative factor). CONCLUSIONS: We concluded that Spiritist "passe" effectively inhibited growth in bacterial cultures compared to LOH with intention or no LOH. Further studies comparing different intentions and types of LOH in cultures of cells and microorganisms are warranted.

Avaliação da atividade antibacteriana in vitro de extratos hidroetanólicos de plantas sobre Staphylococcus aureus MRSA e MSSA / Evaluation of in vitro antibacterial activity of hydro-ethanol from vegetable extracts against MRSA and MSSA Staphylococcus aureus

Este estudo avaliou a atividade antibacteriana de extratos de plantas contra as cepas de Staphylococcus aureus por meio de testes de Disco-Difusão e de Concentração Bactericida Mínima (CBM). Foi testada a susceptibilidade de 52 cepas de S. aureus aos extratos hidroetanólicos das plantas: (1) Psidium guajavavar. pomifera; (2) Hymenaea courbaril var. stilbocarpa; (3) Pothomorphe umbellata; (5) Bidens pilosa, seguindo-se a metodologia baseada nas normas internacionais do CLSI. Na comparação dos resultados da ação dos extratos nas concentrações preparadas neste modelo experimental, foi observado que: B. pilosa apresentou menor ação; P. guajava var. pomifera, P. umbellata, com resultados muito próximos entre si, apresentaram ações medianas; H. courbaril var. stilbocarpa demonstrou ação muito superior aos outros extratos e ao controle com etanol. A ação in vitro dos extratos testados evidenciou a presença de princípios ativos antibacterianos. O estudo tornou evidente que os extratos hidroetanólicos das plantas 1, 2, 3 e 5 possuem ação antibacteriana in vitro contra Staphylococcus aureus MRSA e MSSA.

Evaluation of the in vitro antimicrobial activity of an ethanol extract of Brazilian classified propolis on strains of Staphylococcus aureus

Staphylococcus aureus (S. aureus) is one of the most frequent causes of hospital acquired infections. With the increase in multiple drug resistant strains, natural products such as propolis are a stratagem for new product discovery. The aims of this study were: to determine the in vitro antimicrobial activity of an ethanol extract of propolis; to define the MIC50 and MIC90 (Minimal Inhibitory Concentration - MIC) against 210 strains of S. aureus; to characterize a crude sample of propolis and the respective ethanol extract as to the presence of predetermined chemical markers. The agar dilution method was used to define the MIC and the high performance liquid chromatography (HPLC) method was used to characterize the samples of propolis. MIC results ranged from 710 to 2,850 µg/mL. The MIC50 and MIC90 for the 210 strains as well as the individual analysis of American Type Culture Collection (ATCC) strains of Methicillin-susceptible Staphylococcus aureus (MSSA) and Methicillin-resistant Staphylococcus aureus (MRSA) were both 1,420 µg/mL. Based on the chromatographic analysis of the crude sample and ethanol extracted propolis, it was concluded that propolis was a mixture of the BRP (SP/MG) and BRP (PR) types. The results obtained confirm an antimicrobial activity in relation to the strains of the S. aureus tested.

The use of ozonized oil in the treatment of dermatophitosis caused by Microsporum canis in rabbits

The ozone is effective against most microorganisms due to its high oxidant power. Low concentrations and short-term contact are sufficient to inactivate bacteria, mold, yeast, parasites, seaweeds, protozoa and fungi. Microsporum canis is an important agent of dermatophitosis in human and animal. The aim of the current study was to assess the efficacy of ozonized oil over Microsporum canis in rabbits. Eighteen male New Zealand white rabbits, weight ranging from 2 to 3.2 kg were depilated in the cranial dorso-lateral and right caudal, and cranial and left caudal regions. The regions were inoculated with Microsporum canis, excepting the right caudal region, and were denominated TM, O, OM and M, respectively. After seven days, the treatment of lesions in TM began with 0.12g of terbinaphine 1 percent cream; in OM and O with 0.12g of ozonized oil; all animals were treated once a day for 28 days. Region M was not treated. Material was collected from those regions for cultivation in Sabouraud agar at day 28 of treatment. In the evolution of the treatment with terbinaphine, of 14 contaminated regions with Microsporum canis ten evolved to cure. With the ozonized oil, of 15 contaminations, four were cured. Clinically, that is, the macroscopic evaluation of lesions showed improvement in the TM and OM treated regions. We can conclude that there was statistical evidence of the protection action of the oil against the dermatophyte.

The use of ozonized oil in the treatment of dermatophitosis caused by microsporum canis in rabbits.

The ozone is effective against most microorganisms due to its high oxidant power. Low concentrations and short-term contact are sufficient to inactivate bacteria, mold, yeast, parasites, seaweeds, protozoa and fungi. Microsporum canis is an important agent of dermatophitosis in human and animal. The aim of the current study was to assess the efficacy of ozonized oil over Microsporum canis in rabbits. Eighteen male New Zealand white rabbits, weight ranging from 2 to 3.2 kg were depilated in the cranial dorso-lateral and right caudal, and cranial and left caudal regions. The regions were inoculated with Microsporum canis, excepting the right caudal region, and were denominated TM, O, OM and M, respectively. After seven days, the treatment of lesions in TM began with 0.12g of terbinaphine 1% cream; in OM and O with 0.12g of ozonized oil; all animals were treated once a day for 28 days. Region M was not treated. Material was collected from those regions for cultivation in Sabouraud agar at day 28 of treatment. In the evolution of the treatment with terbinaphine, of 14 contaminated regions with Microsporum canis ten evolved to cure. With the ozonized oil, of 15 contaminations, four were cured. Clinically, that is, the macroscopic evaluation of lesions showed improvement in the TM and OM treated regions. We can conclude that there was statistical evidence of the protection action of the oil against the dermatophyte.

Evaluation of the in vitro antimicrobial activity of an ethanol extract of Brazilian classified propolis on strains of Staphylococcus aureus.

Staphylococcus aureus (S. aureus) is one of the most frequent causes of hospital acquired infections. With the increase in multiple drug resistant strains, natural products such as propolis are a stratagem for new product discovery. The aims of this study were: to determine the in vitro antimicrobial activity of an ethanol extract of propolis; to define the MIC50 and MIC90 (Minimal Inhibitory Concentration - MIC) against 210 strains of S. aureus; to characterize a crude sample of propolis and the respective ethanol extract as to the presence of predetermined chemical markers. The agar dilution method was used to define the MIC and the high performance liquid chromatography (HPLC) method was used to characterize the samples of propolis. MIC results ranged from 710 to 2,850 µg/mL. The MIC50 and MIC90 for the 210 strains as well as the individual analysis of American Type Culture Collection (ATCC) strains of Methicillin-susceptible Staphylococcus aureus (MSSA) and Methicillin-resistant Staphylococcus aureus (MRSA) were both 1,420 µg/mL. Based on the chromatographic analysis of the crude sample and ethanol extracted propolis, it was concluded that propolis was a mixture of the BRP (SP/MG) and BRP (PR) types. The results obtained confirm an antimicrobial activity in relation to the strains of the S. aureus tested.

Analysis of the microbial load in instruments used in orthopedic surgeries.

BACKGROUND: Because of advances in technology, the number of orthopedic surgeries, mainly hip and knee replacement surgeries, has increased, with a total of 150,000 prosthetic surgeries estimated per year in the United States and 400,000 worldwide. METHODS: We used an exploratory cross-sectional study, with a quantitative approach to determine the microbial load in instruments used in orthopedic surgeries, quantifying and identifying the microbial growth genus and species, according to the surgical potential of contamination that characterizes the challenge faced by the Material and Sterilization Center at the Institute of Orthopedics and Traumatology of Hospital das Clinicas of the School of Medicine of the University of Sao Paulo, Brazil.The orthopedic surgical instruments were immersed, after their use, in sterilized distilled water, sonicated in an ultrasonic washer, and posteriorly agitated. Subsequently, the wash was filtrated through a 0.45-mum membrane and incubated in aerobic and anaerobic mediums and in medium for fungi and yeasts. RESULTS: In clean surgeries, 47% of the instruments were contaminated; in contaminated surgeries, 70%; and, in infected surgeries, 80%. Regardless of the contamination potential of the surgeries, the highest quantitative incidence of microorganism recovery was located in the 1 to 100 colony-forming unit range, and 13 samples presented a microbial growth potential >300 colony-forming units. Regardless of the contamination potential of the surgeries, there was a convergence in the incidence of negative-coagulase Staphylococcus growth (28%, clean surgeries; 32%, contaminated surgeries; and 29%, infected surgeries) and Staphylococcus aureus (28%, contaminated surgeries; and 43%, infected surgeries). CONCLUSION: Most of the microorganisms recovered from the analyzed instruments (78%) were vegetative bacteria that presented their death curve at around 80 degrees C, characterizing a low challenge considering the processes of cleaning and sterilization currently employed by the Material and Sterilization Center. Fewer microorganisms were recovered from instruments used in clean surgeries in comparison with those used in contaminated and infected surgeries.

Antimicrobial in vitro evaluation of corneal storage media using a closed chamber study model.

PURPOSE: To evaluate in vitro the antimicrobial influence of the corneal storage media containing antibiotics using a closed chamber study model under the closest simulated environment of corneal preservation process. MATERIALS AND METHODS: Samples of cornea storage media containing streptomycin and gentamicin (Optisol-GS) were analyzed at different moments after its contamination with Staphylococcus aureus (ATCC25923). Samples were analyzed at 1, 2, 3, 4, 5, 6, 24, 48, 72 hours; 7 days; and 14 days after contamination. The samples were analyzed using a new study model system that consists of two closed coupled chambers. The upper chamber contained two culture media (chocolate agar and Sabouraud agar) and CO(2) indicator (indication of bacterial aerobic activity). The inferior chamber contained supplemented solution with an antimicrobial inhibitor. The bacterial growth parameters were analyzed by the presence or absence of bacteria in chocolate agar and by color change of CO(2) indicator when positive. First reading was performed after 24 hours, and, in the absence of bacterial growth, a second reading was carried out after 48 hours. RESULTS: Color change in CO(2) indicator was found in samples contaminated after 1, 2, and 3 hours on the first reading. On the second reading, we observed color change in all remaining samples, except for samples contaminated after 14 days. CONCLUSION: Samples of cornea storage media containing gentamicin sulphate and streptomycin sulphate in vitro showed viable Staphylococcus aureus for up to 7 days of contamination.

Diagnóstico de infecção por Candida: avaliação de testes de identificação de espécies e caracterização do perfil de suscetibilidade / Candida infection diagnosis: evaluation of Candida species identification and characterization of susceptibility profile

INTRODUÇÃO: Infecções invasivas provocadas por Candida são importantes causas de morbidade e mortalidade. O sucesso do tratamento dessas infecções depende da identificação da espécie e do padrão de sensibilidade aos antifúngicos. Portanto, diagnóstico rápido e específico é fundamental para a precoce introdução de terapêutica adequada. OBJETIVOS: Avaliar diferentes métodos diagnósticos de determinação de espécies de Candida e caracterizar, entre as espécies identificadas, o padrão de sensibilidade aos diferentes antifúngicos. MATERIAL E MÉTODOS: A identificação das espécies de Candida presentes em amostras de diferentes materiais biológicos foi realizada pelo cultivo em CHROMagar® Candida e pela técnica de reação em cadeia da polimerase tipo Nested (N-PCR). O padrão de sensibilidade das amostras foi avaliado pela utilização de Etest®. RESULTADO: CHROMagar® caracterizou 50 por cento das amostras como Candida albicans; 20,8 por cento, Candida tropicalis; 2,4 por cento, Candida krusei e 26,9 por cento, outras espécies (não determinadas). As cepas de C. albicans e C. tropicalis foram caracterizadas por CHROMagar® e N-PCR. Porém cepas de outras espécies, indeterminadas em CHROMagar®, caracterizaram-se como C. parapsilosis em N-PCR. Cepas de C. krusei e C. tropicalis apresentaram perfil de resistência a, respectivamente, fluconazol e 5-fluocitosina. Quanto ao itraconazol, observou-se padrão de resistência em cepas de C. albicans e C. tropicalis. DISCUSSÃO: As técnicas metodológicas utilizadas são de fácil reprodutibilidade e alta especificidade, fornecendo diagnóstico complementar, e o emprego do Etest® viabiliza a precoce introdução de tratamento específico. CONCLUSÃO: O crescente aparecimento de espécies de Candida resistentes aos azólicos confirma a importância de monitorar possíveis mudanças na distribuição das espécies patogênicas e dos padrões de sensibilidade.

BACKGROUND: Invasive infections by Candida are an important cause of morbidity and mortality. The successful treatment of these infections depends on the identification of the species and on the sensitivity pattern to antifungal agents. A quick and specific diagnosis is essential to introduce appropriate therapy. OBJECTIVES: Assess different diagnostic methods to determine Candida species and evaluate the sensitivity pattern to different antifungal agents among the identified ones. MATERIAL AND METHODS: The identification of Candida species present in samples of different biological materials was conducted through CHROMagar® Candida culture and Nested-PCR. The sensitivity pattern was assessed using Etest®. RESULTS: The culture of samples on CHROMagar® revealed 50 percent Candida albicans, 20.8 percent Candida tropicalis, 2.4 percent Candida krusei, and 26.9 percent other undetermined species. Samples of Candida albicans and Candida tropicalis were identified through CHROMagar® and N-PCR. Species that were not determined through CHROMagar® were characterized as Candida parapsilosis by N-PCR. Resistance to fluconazole, 5-fluocytosine was detected, respectively, in Candida krusei and Candida tropicalis samples. Both Candida albicans and Candida tropicalis samples showed resistance to itraconazole. DISCUSSION: The methods applied are easily reproducible and highly specific, which allows complementary diagnosis. The determination of the susceptibility profile by Etest® enables the early introduction of specific treatment. CONCLUSION: The growing appearance of Candida species resistant to azole confirms the importance of monitoring possible changes in the distribution of pathogenic species and in the sensitivity pattern.

Microbiota conjuntival em pacientes com alergia ocular / Conjunctival microbiota in patients with ocular allergy

OBJETIVO: Avaliar a presença de microbiota aeróbia da conjuntiva de portadores de alergia ocular e comparar a um grupo controle. MÉTODOS: Foram examinados 133 pacientes no período de abril a junho de 2001 divididos em 2 grupos. O grupo A foi composto de 63 portadores de conjuntivite alérgica (sem uso de medicação) e o grupo B de 70 pacientes do ambulatório geral (controle). Foram coletadas amostras do fundo de saco conjuntival do olho direito de todos os pacientes e o material foi semeado em meios sólidos de cultura (ágar sangue, chocolate e Sabouraud). RESULTADOS: No grupo A, 30 culturas (47,7 por cento) foram positivas e no grupo B, 6 (8,6 por cento). Sete bactérias foram isoladas no grupo A e 4 no B. A análise estatística revelou associação significante entre a positividade dos cultivos e conjuntivite alérgica. CONCLUSÃO: Microbiota bacteriana foi mais freqüentemente encontrada nos pacientes com alergia ocular.

[Conjunctival microbiota in patients with ocular allergy]. / Microbiota conjuntival em pacientes com alergia ocular.

PURPOSE: To evaluate de presence of conjunctival aerobic microbiota in patients with ocular allergy as compared to a control group. METHODS: One hundred and thirty-three patients were evaluated from April to June 2001 and divided into 2 groups. Sixty-three patients with allergic conjunctivitis (without medication) were in group A and 70 patients from the general outpatient clinic were in group B (control group). Samples from the conjunctival sac of the right eye were collected and cultured in solid media (blood, chocolate and Sabouraud agar). RESULTS: In group A, 30 cultures (47.7%) were positive and 6 (8.6%) in group B. Seven bacteria were isolated from group A and 4 from group B. Statistical analysis revealed significant association between positive cultures and allergic conjunctivitis. CONCLUSION: Bacterial microbiota was more frequently found in patients with ocular allergy.

Estudo comparativo in vitro entre a associaçäo de valerato de betametasona, sulfato de gentamicina, tolnaftato e clioquinol versus outros compostos nas cepas bacterianas e fúngicas mais freqüêntes nos meios comunitário e hospitalar / In vitrto comparative study between the association of betamethasone valerato, gentamicin sulfate, tolnaftate and clioquinol versus other medications on frequent bacterials and fungicals samples from communitary and hospitalar environment

A freqüência das infecçöes associadas fúngico-bacterianas cutâneas é um achado muito freqüênte na prática clínica diária. Devido a isso, o encontro de um produto eficiente para resolver essas dermatoses, economicamente viável e com uma comodidade de aplicaçäo é um desafio para os médicos no mundo inteiro. No corrente estudo, verificamos que a eficácia "in vitro" da associaçäo de valerato de betametasona, sulfato de gentamicina, tolnaftato e clioquinol em 20 cepas de Candida spp., Trichophytun spp., Streptococcus pyogenes, Staphylococcus aureus, Acinetobacter sp.,Escherichia coli, Pseudomonas aeruginosa e Pseudomonas aeruginosa resistente variou de 95 a 100 porcento, sendo maior e mais abrangente do que outros produtos antimicrobianos usados freqüêntemente em nosso mercado. Podemos considerar essa associaçäo uma alternativa eficaz no tratamento de infecçöes cutâneas com associaçäo de bactérias e fungos.(au)

Avaliaçäo do Miconazol gel oral** a 2(por cento) no tratamento da monilíase oral em crianças / Evaluation of the Miconazole oral gel in the treatment of the moniliasis in children

Foram estudadas 31 crianças com monilíase oral que receberam um tratamento com miconazol gel a 2 (pôr cento). Uma avaliaçäo clínica e micológica foi feita na inclusäo e sete dias após o início do tratamento que se prolongava por mais sete dias, se necessário, com uma segunda avaliaçäo. A avaliaçäo global do tatamento mostrou que 29 pacientes (94 pôr cento) foram considerados curados clínica e micologicamentE. Destes, 22 (71 pôr cento) já estavam curados no sétimo dia. Três pacientes apresentaram efeitos colaterais relacionados à medicaçäo (vômitos e recusa alimentar). Os resultados confirmam a eficácia do miconazol gel em crianças com monilíase oral

Flora cutânea: fonte de contaminaçäo de cateteres venosos centrais? / Skin flora: contamination sources of central venous cateter?

Os autores avaliam a incidência de infecçäo em 24 cateteres venosos centrais em doentes internados no Departamento de Cirurgia da Faculdade de Ciências Médicas da Santa Casa de Säo Paulo. Foram realizadas culturas da pele e sangue no 1§ e 5§ dias e também das partes do cateter na retirada. Os resultados evidenciaram correlaçäo entre o microorganismo isolado na pele e em partes do cateter em 33 por cento dos casos. Os dados sugerem ser a pele importante foco de infecçäo do cateter, a qual ocorre na inserçäo ou após. Discutem as técnicas de assepsia na instalaçäo e manutençäo dos cateteres.