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Infectio ; 25(4): 262-269, oct.-dic. 2021. tab, graf
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1286720


Abstract Objective: To analyse the clinic characteristics, risk factors and evolution of the first cohort of hospitalised patients with confirmed infection by COVID-19 in 5 Colombian institutions. Materials and methods: Is a retrospective observational study of consecutive hospitalized patients with a diagnosis of COVID-19 confirmed from March 01 to May 30, 2020 in Colombia. Results: A total of 44 patients were included. The median age was 62 years. 43.2% had a history of smoking, while 69.8% were overweight or obese. 88.6% had at least one comorbidity and 52.3% had three or more comorbidities. Hypertension and dyslipidaemia were the most frequent comorbidities (40.9% and 34.1%, respectively). The 30-day mortality rate was 47.7% with a median of 11 days. The composite outcome occurred in the 36.4%. The biomarkers associated with mor tality risk included troponin higher than 14 ng/L (RR: 5.25; 95% CI 1.37-20.1, p = 0.004) and D-dimer higher than 1000 ng/ml (RR: 3.0; 95% CI 1.4-6.3, p = 0.008). Conclusions: The clinical course of SARS-CoV-2 infection in hospitalized Colombian was characterised by a more advanced stage of the infection.

Resumen Objetivo: Analizar las características, clínicas, factores de riesgo, y la evolución de pacientes hospitalizados con infección confirmada por COVID-19 en 5 Institu ciones de Colombia. Material y método: Es un estudio observacional retrospectivo de pacientes consecutivos hospitalizados con diagnóstico de COVID-19 confirmado entre 01 de Febrero de 2020 y 30 de Mayo de 2020 en Colombia. Resultados: Un total de 44 pacientes fueron incluidos. La mediana de edad fue de 62 años y la mayoría del sexo masculino. El 43.2% tenían historia de tabaquismo, mientras que el 69.8% tenían sobrepeso u obesidad. El 88.6% tenían al menos una comorbilidad y el 52.3% tenían tres o más comorbilidades. La hipertensión arterial fue la comorbilidad más frecuente (40.9%), seguido de la dislipidemia (34.1%). La tasa de letalidad a 30 días fue de 47.7% y ocurrió con una mediana de 11 días. El 36.4% presentó el desenlace compuesto. Los biomarcadores asociados con el riesgo de muerte fue troponina > 14 ng/mL (RR:5.25, IC95% 1.37-20.1, p=0.004) y dímero D mayor a 1000 mg/dL (RR: 3.0, IC95% 1.4-6.3, p=0.008). Conclusiones: El curso clínico de la infección por SARS-CoV-2 en colombianos hospitalizados fue un estadio más avanzado de la infección.

Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Biomarcadores , COVID-19 , Pacientes , Tabagismo , Comorbidade , Risco , Fatores de Risco , Mortalidade , Colômbia , Sobrepeso , Cursos , Infecções , Obesidade
Int J Infect Dis ; 2021 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-34022333


INTRODUCTION: Latin America accounts for one-quarter of global COVID-19 cases and one-third of deaths. Inequalities in the region lead to barriers regarding the best use of diagnostic tests during the pandemic. There is a need for a simplified guideline, considering the region's health resources' low availability, international guidelines, medical literature, and local expertise. METHODS: Nine experts from Latin American countries developed a simplified algorithm for COVID-19 diagnosis, using a modified Delphi method. Twenty-four questions related to diagnostic settings were proposed, followed by discussion of the literature and experts' experience. RESULTS: The algorithm considers three timeframes (≤7 days, 8-13 days, and ≥ 14 days) and discusses diagnostic options for each one. SARS-CoV-2 rRT-PCR is the test of choice from day 1 to day 14 after symptom onset or close contact, although antigen testing may be used in particular situations, from days 5 to 7. Antibody assays may be used for confirmation, mainly after day 14. If the clinical suspicion is very high, but other tests are negative, these assays may be used as an adjunct to decision-making from day 8 to day 13. CONCLUSION: The proposed algorithm aims to support COVID-19 diagnosis decision-making in Latin America.

Artigo em Inglês | MEDLINE | ID: mdl-33674459


BACKGROUND: After 8 months of the COVID-19 pandemic, Latin American countries have some of the highest rates in COVID-19 mortality. Despite being one of the most unequal regions of the world, there is a scarce report of the effect of socioeconomic conditions on COVID-19 mortality in their countries. We aimed to identify the effect of some socioeconomic inequality-related factors on COVID-19 mortality in Colombia. METHODS: We conducted a survival analysis in a nation-wide retrospective cohort study of confirmed cases of COVID-19 in Colombia from 2 March 2020 to 26 October 2020. We calculated the time to death or recovery for each confirmed case in the cohort. We used an extended multivariable time-dependent Cox regression model to estimate the HR by age groups, sex, ethnicity, type of health insurance, area of residence and socioeconomic strata. RESULTS: There were 1 033 218 confirmed cases and 30 565 deaths for COVID-19 in Colombia between 2 March and 26 October. The risk of dying for COVID-19 among confirmed cases was higher in males (HR 1.68 95% CI 1.64 to 1.72), in people older than 60 years (HR 296.58 95% CI 199.22 to 441.51), in indigenous people (HR 1.20 95% CI 1.08 to 1.33), in people with subsidised health insurance regime (HR 1.89 95% CI 1.83 to 1.96) and in people living in the very low socioeconomic strata (HR 1.44 95% CI 1.24 to 1.68). CONCLUSION: Our study provides evidence of socioeconomic inequalities in COVID-19 mortality in terms of age groups, sex, ethnicity, type of health insurance regimen and socioeconomic status.

Antibiotics (Basel) ; 10(1)2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33440602


BACKGROUND: To determine the therapeutic effect and tolerability of meropenem in routine clinical practice, in terms of clinical and microbiological response. METHODS: A real-world, observational, descriptive, longitudinal study with daily monitoring of clinical history records was conducted on all patients who were medically prescribed meropenem during a period between October 2015 and March 2016 at a university hospital in Bucaramanga (Colombia). RESULTS: The study evaluated 84 patients with an average age of 63.2 years, mostly older adults with multiple comorbidities, of whom 54.8% were men. A positive clinical or microbiological response was obtained in 98.8% of the patients. At the end of the treatments, significant improvements in dysthermia (0% vs. 29% at the beginning, p = 0.000), tachycardia (13% vs. 47%, p = 0.049), and leukocytosis (39% vs. 15% at the beginning, p = 0.008) were evidenced. The improvement in the indicator that combines all the Systemic Inflammatory Response Syndrome (SIRS) criteria was also significant (p = 0.000). The treatment was well tolerated, although we identified some non-serious and expected adverse reactions. CONCLUSIONS: Generic meropenem proved to be effective and well tolerated for different types of infection in routine clinical practice. The results are consistent with the findings of the clinical studies with the innovator drug.

Infectio ; 23(4): 305-306, Dec. 2019.
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1019860


Clinical practice guidelines (CPGs) are "systematically developed statements to assist practitioner decisions about appropriate health care for specific clinical circumstances"1. Guidelines are designed to support the decision-making processes in patient care and therefore can be used to reduce inappropriate discrepancies in clinical practice and to encourage the delivery of health care of better quality. Although CPGs can be developed either locally or nationally it is essential that guidelines be based on the best available research evidence. Then a detailed literature search should be done to find evidence from research studies about the suitability and effectiveness of different clinical approaches. However, in addition to the scientific evidence, the experience of clinical experts and mainly the expectations of patients must also be considered. At present, the advantage of the development of CPGs for a better clinical outcome is not discussed. But a limitation for their dissemination especially in low- and middle-income countries is time and resource consuming and sometimes the shortage of expert professionals' experts in the methodology. Therefore, strategies like using an alternative methodology such as the adaptation of CPGs is very important because not only decreases times but costs for their development.

Las guías de práctica clínica (GPC) son "declaraciones desarrolladas sistemáticamente para ayudar a los profesionales a tomar decisiones sobre la atención sanitaria adecuada en circunstancias clínicas específicas "1. Las guías están diseñadas para apoyar los procesos de toma de decisiones en la atención al paciente y, por tanto, pueden utilizarse para reducir las discrepancias inapropiadas en la práctica clínica y fomentar la prestación de una atención sanitaria de mayor calidad. Aunque las GPC pueden elaborarse a nivel local o nacional, es esencial que las directrices se basen en las mejores pruebas de investigación disponibles. Para ello, debe realizarse una búsqueda bibliográfica detallada para encontrar pruebas de estudios de investigación sobre la idoneidad y la eficacia de los distintos enfoques clínicos. Sin embargo, además de las pruebas científicas, también hay que tener en cuenta la experiencia de los expertos clínicos y, principalmente, las expectativas de los pacientes. En la actualidad, no se discute la ventaja del desarrollo de las GPC para un mejor resultado clínico. Pero una limitación para su difusión, especialmente en los países de ingresos bajos y medios, es el tiempo y los recursos que consumen y, a veces, la escasez de profesionales expertos en la metodología. Por lo tanto, estrategias como el uso de una metodología alternativa como la adaptación de las GPC es muy importante porque no sólo disminuye los tiempos sino los costes para su desarrollo.

Humanos , Masculino , Feminino , Qualidade da Assistência à Saúde , Guias de Prática Clínica como Assunto , Infecções dos Tecidos Moles , Controle de Infecções , Colômbia , Tomada de Decisões
Infectio ; 23(3): 213-214, July-Sept. 2019.
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1002152


Antimicrobial resistance is a major public health problem and a principal threat to contemporary medicine. A fundamental principle of controlling antimicrobial resistance are antimicrobial drug stewardship programs, which seeks to preserve the future effectiveness of antimicrobials and improve patient outcome; thus, the selection of the optimal antimicrobial drug regimen, dose, route of administration, and duration of therapy are key to limit inappropriate antimicrobial usage and avoiding unnecessary prescribing, including discontinuing antibiotic therapy if it is not required. However, within the context of stewardship programs, insufficient attention has been given to fungal infections. Furthermore, the importance of the accurate and timely diagnosis of fungal infections in overwhelming antimicrobial resistance has been absent from policy discussions. On the other hand, all serious fungal infections need appropriate antifungal therapy for successful patient outcome. Only a few classes of antifungal drugs are available, so the emergence of resistance to single drug classes and now multidrug resistance threatens the appropriate patient management. Azole resistance among Candida and Aspergillus species is one of the greatest challenges to clinical success, followed by echinocandin and multidrug resistance among some Candida species, especially Candida glabrata. Recently, Candida auris, a cryptic species uncommon in most hospitals around the world, including Colombia, has appeared as an emerging species and a global threat capable of developing resistance to multiple antifungals and with great potential for nosocomial transmission.

La resistencia a los antimicrobianos es un importante problema de salud pública y una de las principales amenazas para la medicina contemporánea. Un principio fundamental del control de la resistencia a los antimicrobianos son los programas de administración de medicamentos antimicrobianos, que buscan preservar la eficacia futura de los antimicrobianos y mejorar el resultado de los pacientes; por lo tanto, la selección del régimen óptimo de medicamentos antimicrobianos, la dosis, la vía de administración y la duración de la terapia son clave para limitar el uso inapropiado de antimicrobianos y evitar la prescripción innecesaria, incluyendo la interrupción de la terapia antibiótica si no es necesaria. Sin embargo, en el contexto de los programas de administración, no se ha prestado suficiente atención a las infecciones fúngicas. Además, la importancia del diagnóstico preciso y oportuno de las infecciones fúngicas en la abrumadora resistencia a los antimicrobianos ha estado ausente de los debates políticos. Por otra parte, todas las infecciones fúngicas graves necesitan un tratamiento antifúngico adecuado para que el paciente tenga éxito. Sólo se dispone de unas pocas clases de fármacos antifúngicos, por lo que la aparición de la resistencia a clases de fármacos individuales y ahora la resistencia a múltiples fármacos amenaza el tratamiento adecuado de los pacientes. La resistencia a los azoles entre las especies de Candida y Aspergillus es uno de los mayores retos para el éxito clínico, seguido de la resistencia a las equinocandinas y a los múltiples fármacos entre algunas especies de Candida, especialmente Candida glabrata. Recientemente, Candida auris, una especie críptica poco común en la mayoría de los hospitales del mundo, incluyendo Colombia, ha aparecido como una especie emergente y una amenaza global capaz de desarrollar resistencia a múltiples antifúngicos y con gran potencial de transmisión nosocomial.

Humanos , Terapêutica , Candida , Antifúngicos , Aspergillus , Efetividade , Resistência Microbiana a Medicamentos/efeitos dos fármacos , Equinocandinas
Curr Opin Infect Dis ; 32(4): 322-329, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31157630


PURPOSE OF REVIEW: Fungal outbreaks have been reported in healthcare settings, showing that construction activities are a serious threat to immunocompromised hosts. Preventive measures to control fungal outbreaks (especially Aspergillus spp.) are considered essential during hospital construction. In this article, we update the main advances in each of preventive strategies. RECENT FINDINGS: Anticipation and multidisciplinary teamwork are the keystone for fungal outbreaks prevention. Strategies focused on environmental control measures of airborne dissemination of fungal spores have proven to be successful. It is important to recommend azole-resistant Aspergillus fumigatus active surveillance from both air (outdoors and indoors) and clinical samples during hospital construction works. Apart from genotyping, studies should be further encouraged to understand the environmental dynamics. Risk assessment and implement preventive measures (environment control strategies, air surveillance, inpatients immunocompromised patients in high-efficiency particulate air filters rooms, patient education, antifungal prophylaxis in high-risk patient groups, etc.) have shown that these accomplish to reduce the incidence of invasive fungal infection (IFI). SUMMARY: In general, it is not only a strategy that should be implemented to reduce the risk of IFI but is a bundle of preventive measures, which have proven to be successful in control infection and prevention of airborne transmission of fungi.

Infecção Hospitalar , Arquitetura Hospitalar , Hospedeiro Imunocomprometido , Infecções Fúngicas Invasivas/epidemiologia , Infecções Fúngicas Invasivas/etiologia , Antifúngicos/uso terapêutico , Surtos de Doenças , Suscetibilidade a Doenças , Exposição Ambiental , Humanos , Controle de Infecções , Infecções Fúngicas Invasivas/prevenção & controle , Medição de Risco , Fatores de Risco
J Fungi (Basel) ; 4(2)2018 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-29561795


Data with respect to the epidemiological situation of fungal diseases in Colombia is scarce. Thus, the aim of this study is to estimate the burden of fungal infections. A population projection for 2017 from the Colombian Department for National Statistics was used, as well as official information from the Ministry of Health and National Institute of Health. A bibliographical search for Colombian data on mycotic diseases and population at risk (chronic obstructive pulmonary disease, HIV infection/AIDS, cancer, and transplant patients) was done. The Colombian population for 2017 was estimated at 49,291,609 inhabitants, and the estimated number of fungal infections for Colombia in 2017 was between 753,523 and 757,928, with nearly 600,000 cases of candidiasis, 130,000 cases of aspergillosis, and 16,000 cases of opportunistic infection in HIV, affecting around 1.5% of the population. In conclusion, fungal infections represent an important burden of disease for the Colombian population. Different clinical, epidemiological, and developmental scenarios can be observed in which fungal infections occur in Colombia.

Infectio ; 21(4): 234-242, Oct.-Dec. 2017. tab
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-892737


Resumen Objetivo: evaluar la mejor evidencia actual disponible para generar recomendaciones, con respecto a la efectividad y seguridad del uso de tigeciclina en adultos con infección intraabdominal complicada. Materiales y métodos: se realizó una revisión sistemática de la literatura, seleccionando los metaanálisis y experimentos clínicos controlados, los cuales se valora- ron utilizando la herramienta SIGN, con el fin de generar tablas de evidencia según GRADE de los estudios de tigeciclina en la indicación infección intraabdominal complicada, para posteriormente utilizar un proceso Delphi modificado para calificar las diferentes recomendaciones con el fin de generar un consenso. Resultados: se analizaron los resultados basados en la revisión sistemática de la literatura en la que se incluyeron 5 metaanálisis que cumplieron los criterios de selección comparando tigeciclina con otros tratamientos antibióticos en infección intraabdominal complicada; de los cuales, 2711 pacientes recibieron al menos una dosis del antibiótico (1382 tigeciclina y 1389 el comparador) y en los que no se observaron diferencias estadísticamente significativas en los desenlaces evaluados al comparar tigeciclina con otros antibióticos. Conclusión: en pacientes adultos con infección intraabdominal complicada, se considera que el uso de tigeciclina en monoterapia es equivalente en eficacia y seguridad a otras opciones terapéuticas antimicrobianas y no representa un exceso de mortalidad en comparación a otros antibióticos

Abstract Objective: To assess current best evidence available to generate recommendations regarding the effectiveness and safety of tigecycline use in adults with complicated intra-abdominal infection (cIAIs). Materials and methods: We conducted a systematic review of published meta-analysis that evaluated tigecycline compared to other antimicrobials and included the indication of cIAI. Quality of the evidence was evaluated by using the SIGN tool (Scottish Intercollegiate Guidelines Network) according to GRADE, and final recommendations were assessed by a modified Delphi Method in order to develop a consensus. Results: Five meta-analyzes met the selection criteria comparing tigecycline with other antibiotic treatments in complicated intra-abdominal infection. Five randomized clinical trials comprised in these meta-analysis included 2711 patients that received at least one dose of antibiotic (1382 tigecycline and 1389 the comparator regimen), We found no statistically significant differences in the evaluated outcomes by comparing tigecycline with other antibiotics, including clinical and microbiologic efficacy, safety and drug related mortality Conclusion: In adult patients with cIAIs, the use of tigecycline as monotherapy is equivalent in effectiveness to other antimicrobial therapeutic options and does not represent an increase in mortality compared to other antibiotics.

Humanos , Metanálise , Infecções Intra-Abdominais , Tigeciclina , Ensaios Clínicos Controlados não Aleatórios como Assunto , Abordagem GRADE , Tigeciclina/uso terapêutico
Infectio ; 15(2): 92-97, abr.-jun. 2011. tab
Artigo em Espanhol | LILACS, COLNAL | ID: lil-635679


Objetivos. Identificar las micosis oportunistas que afectan a los pacientes con VIH/sida, y determinar sus características demográficas, socioeconómicas y su relación con el número de células T CD4+. Métodos. Se trata de un estudio descriptivo de serie de casos basado en los participantes de un estudio diseñado para determinar el tipo y la frecuencia de las enfermedades oportunistas en pacientes con VIH/sida. Un caso se definió como un paciente con VIH/sida a quien se le diagnosticó una micosis oportunista, entre octubre de 2007 y mayo de 2010. Los pacientes elegibles estaban siendo tratados en dos instituciones médicas de Bogotá. Se recolectaron muestras respiratorias, de líquido cefalorraquídeo, de sangre y de raspado de lesión orofaríngea, para determinar la presencia de Histoplasma capsulatum, Paracoccidioides brasiliensis, Cryptococcus neoformans o Candida spp. Se utilizaron proporciones para resumir las variables cualitativas y medianas para las cuantitativas. Resultados. En 33 (9,8 %) pacientes con VIH/sida del estudio base (n=336), se diagnosticó una o más de las micosis evaluadas. El 75 % tenía entre 23 y 42 años. La frecuencia de estas infecciones fueron: H. capsulatum (n=1; 3,0 %), P. brasiliensis (n=1; 3,0 %), C. neoformans (n=25; 75,8 %), y Cándida spp. (n=7; 21,2 %). Los valores medianos de células T CD4+ fueron de 176 o menos, independientemente de sus manifestaciones clínicas. Conclusión. Se necesitan estudios adicionales para identificar los factores que podrían estar determinando la presencia de las micosis oportunistas en estos pacientes.

Objectives: To identify the opportunistic fungal infections affecting patients with HIV/AIDS, to determine their demographic and socioeconomic characteristics and the number of CD4+ T cells. Materials and methods: This is a descriptive case series study based on a major study aimed at determining the type and frequency of opportunistic diseases in HIV/AIDS patients. A case was defined as an HIV/AIDS patient who had evidence of fungal infection at baseline. Eligible patients were being treated at two clinical institutions located in Bogotá, Colombia, between October 2007 and May 2010. Respiratory, cerebrospinal fluid and blood samples and scrapping/swabs of oral lesions were collected in order to determine the presence of Histoplasma capsulatum, Paracoccidioides brasiliensis, Cryptococcus neoformans or Candida spp. Proportions were used for qualitative variables and medians for quantitative variables. Results: Overall, 33 (10,2%) patients were diagnosed as having one or more of the evaluated fungal infections , out of 336. Seventy five per cent of them were between the ages of 23 and 42. The frequencies of these fungal infections were: H. capsulatum (n=1; 3.0%), P. brasiliensis (n=1; 3.0%), C. neoformans (n=25; 75.8%), and Candida spp. (n=7; 21.2%). The median values of CD4+ T cells were 176 or less, independently of clinical manifestations. Conclusion: Further studies are required to identify factors contributing to the presence of fungal opportunistic infections in these patients.

Humanos , Masculino , Feminino , Adulto , HIV , Micoses , Síndrome de Imunodeficiência Adquirida , Colômbia , Cryptococcus neoformans , Diagnóstico , Histoplasma
Infectio ; 8(1): 8-49, mar. 2004. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-422712


Definición: la NAC es la infección aguda del parénquima pulmonar que se desarrolla fuera del ambiente hospitalario, se maniefiesta en las primeras 48 horas del ingreso al hospital o después de siete días de haber egresado. Cuadro clínico: Síntomas de una infección aguda del tracto respiratorio inferior: tos y por lo menos uno de los siguientes: expectoración mucopurulenta, dolor torácico de tipo pleurítico, disnea. Por lo menos un síntoma o signo sistémico: sensación de fiebre, suduración, dolores, malestar general y/o temperatura de 38.3°C O más. Infiltrado focal o asimétrico, en la radiografía del tórax, que no se haya observado o descrito previamente y para el cual no se tenga otra explicación. Al examen físico del tórax se puede encontrar o no anormalidades, generalmente localizadas o asimétricas, o signos de consolidación pulmonar. Epidemiología: la NAC es una enfermedad frecuente cuya incidencia varía de acuerdo con la edad, es mayor en los extremos de la vida (mayores de 65 años y menores de cinco) La neumonía es una enfermedad con un alto índice de morbilidad y mortalidad. La mortalidad general producida por la NAC oscila entre 1 por ciento y 25 por ciento, y depende de múltiples factores, entre los que destacan la severidad de la enfermedad y el german causante. Etiología: la posivilidad de identificar el german causante NAC, aun en las mejores condiciones, es relativamente baja (40 por ciento a 60 por ciento). Para el caso colombiano es importante destacar: La causa más frecuente es el S.pneumoniae. M. tuberculosis debe considerarse como causa de NAC en el país, aunque su frecuencia real se desconoce, pero pueden presentarse hasta en 20 por ciento de casos...(AU: Asociación Colombiana de Neumología y Cirugía de Tórax; Asociación Colombiana de Infectología; Asociación Colombiana de Medicina Interna)

Infecções Comunitárias Adquiridas , Pneumonia/diagnóstico , Pneumonia/prevenção & controle , Pneumonia/tratamento farmacológico , Medicina Baseada em Evidências
Infectio ; 6(2): 121-131, jun. 2002. tab
Artigo em Espanhol | LILACS | ID: lil-422667


En los últimos años se publicaron quías de práctica clínica para el manejo de la neumonía adquirida en comunidad en adultos por parte de las sociedades de infectología de los Estados Unidos y Canada, y por parte de las sociedades americana y británica del tórax. Realizamos una discusión acerca de la aplicabilidad de estas guías en las condiciones de salud geográficas de Colombia. contemplando aspectos epidemiológicos, etiológicos, de diagnóstico, de tratamiento y acerca de la decisión del sitio del manejo del paciente. Se resaltan aquellos aspectos en los que las características de nuestro país difieren de aquellos para los que las guías fueron creadas inicialmente

Infecções Comunitárias Adquiridas , Pneumonia , Estágio Clínico
Rev. Fac. Med. (Bogotá) ; 48(3): 152-153, Sept. 2000.
Artigo em Espanhol | LILACS | ID: lil-424632


En un paciente con cáncer se aisló del liquido cefaloraquideo y ascitico un coco gram positivo coagulasa positivo. El germen aislado mostró las características típicas de un Staphylococcus aureus, a excepción de la actividad de la catalasa, la cual no pudo ser encontrada

Meningite , Staphylococcus aureus
Rev. Fed. Odontol. Colomb ; 58(197): 69-77, jul. 1999-feb. 2000. ilus
Artigo em Espanhol | LILACS | ID: lil-270484


La utilidad de los procedimientos de asepsia y antisepsia, desinfección y esterilización, no tienen discusión, más aún en la práctica odontológica, donde está demostrada la posibilidad de contaminación cruzada con organismos altamente patógenos. En esta revisión se describen algunos conceptos nuevos relacionados con métodos de esterilización y mecanismos de acción de las sustancias utilizadas con este fin y se recuerdan los procedimientos a seguir para la obtención de una adecuada bioseguridad

Antissepsia , Assepsia , Controle de Infecções Dentárias/métodos , Esterilização/métodos , Biguanidas/química , Consultórios Odontológicos/normas , Desinfecção/métodos , Formaldeído/química , Glutaral/química , Temperatura Alta , Compostos de Iodo/química , Fenol/química , Compostos de Amônio Quaternário/química , Vapor
Rev. Inst. Med. Trop. Säo Paulo ; 41(4): 229-34, July-Aug. 1999.
Artigo em Inglês | LILACS | ID: lil-246831


This study was carried out in order to obtain base-line data concerning the epidemiology of American Visceral Leishmaniasis and Chagas's Disease in an indigenous population with whom the government is starting a dwelling improvement programme. Information was collected from 242 dwellings (1,440 people), by means of house to house interviews about socio-economic and environmental factors associated with Leishmania chagasi and Trypanosoma cruzi transmission risk. A leishmanin skin test was applied to 385 people and 454 blood samples were collected on filter paper in order to detect L. chagasi antibodies by ELISA and IFAT and T. cruzi antibodies by ELISA. T. cruzi seroprevalence was 8.7 percent by ELISA, L. chagasi was 4.6 percent and 5.1 pecent by IFAT and ELISA, respectively. ELISA sensitivity and specificity for L. chagasi antibodies were 57 percent and 97.5 percent respectively, as compared to the IFAT. Leishmanin skin test positivity was 19 percent. L. chagasi infection prevalence, being defined as a positive result in the three-immunodiagnostic tests, was 17.1 percent. Additionally, 2.7 percent of the population studied was positive to both L. chagasi and T. cruzi, showing a possible cross-reaction. L. chagasi and T. cruzi seropositivity increased with age, while no association with gender was observed. Age (p<0.007), number of inhabitants (p<0.05), floor material (p<0.03) and recognition of vector (p<0.01) were associated with T. cruzi infection, whilst age ( p<0.007) and dwelling improvement (p<0.02) were associated with L. chagasi infection. It is necessary to evaluate the long-term impact of the dwelling improvement programme on these parasitic infections in this community

Humanos , Adulto , Pessoa de Meia-Idade , Cães , Animais , Doença de Chagas/epidemiologia , Leishmania , Leishmaniose Visceral/epidemiologia , Trypanosoma cruzi , Doença de Chagas/transmissão , Colômbia/epidemiologia , Vetores de Doenças , Ensaio de Imunoadsorção Enzimática , Habitação , Leishmaniose Visceral/transmissão , Valor Preditivo dos Testes , Prevalência , Fatores de Risco , Sensibilidade e Especificidade , Estudos Soroepidemiológicos