Colostrum oropharyngeal immunotherapy for very low birth weight preterm infants: protocol of an intervention study.

BACKGROUND: The oropharyngeal colostrum administration protocol to treat premature newborns is a possible and plausible strategy in neonatal health services, since the immunoprotective components of colostrum can be absorbed by the lymphoid tissues of the oropharynx. In this context, this study aims to describe the implementation of oropharyngeal colostrum immunotherapy in very low birth weight preterm newborns in a neonatal unit, as well as to test an algorithm in a public hospital. METHODS: The protocol is applied in a non-randomized, superiority clinical trial with historical control. In the treatment group, 0.2 mL of raw colostrum is dripped into the right and left oropharyngeal mucosa, totaling 8 administrations every 24 h until the 7th complete day of life interruptedly. The control group consists of very low birth weight preterm newborns born in the same hospital in previous years (historical control). The clinical progression of 60 newborns until hospital discharge is recorded on standardized forms. A total of 350 participants are estimated to complete the survey in 4 years. The occurrence of continuous outcomes between the groups are compared through the paired t-test or Wilcoxon's two-sample test. The chi-square test or Fisher's exact test, and survival analysis are used for binary outcomes. The nutritional status is assessed through Intergrowth-21st growth curves for preterm newborns. DISCUSSION: The flows of the protocol's actions is sorted by an algorithm, compatible with the Brazilian reality of a public hospital. This measure facilitates and systematizes clinical care, organizes the team's work process, speeds up the intervention steps, standardizes decision-making and unifies the quality of care, besides showing the feasibility of oropharyngeal colostrum immunotherapy. TRIAL REGISTRATION: ReBEC, U1111-1222-0598 , Registered 09 October 2018, http://www.ensaiosclinicos.gov.br/rg/RBR-2cyp7c/ .

Methicillin-resistant Staphylococcus aureus (MRSA) in foods of animal origin: A systematic review / Staphylococcus aureus resistente à meticilina (MRSA) em alimentos de origem animal: uma revisão sistemática

Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of infections in humans and onset of this bacterium in hospitalized individuals has been well documented. However, a report on MRSA colonization and infection of individuals in the community, without prior contact with hospital environment, suggests the occurrence of other sources of contamination, such as the use of drugs in livestock, causing colonization of production animals with MRSA, and resulting in contamination of meat products. This study aimed at compiling and analyzing the scientific publications on the occurrence of MRSA in foods. A systematic review of the literature was performed in Lilacs, Medline and Pubmed databases, and the articles published from 2000 to 2013 were selected. A significant number of studies involving different samples was observed. Wide variations on the MRSA prevalence were found, and also on the methodologies used for the analyses. The MLST strain ST398 is commonly detected in pigs, and it was the most isolated bacterium from samples analyzed in different studies. ST8 and ST5 strains, belonging to human biovar, have also been frfrequently isolated, suggesting that food handlers have been a source for meat contamination with MRSA.

Staphylococcus aureus resistente à meticilina (MRSA) é uma das principais causas de infecção em humanos, e está bem documentado o acometimento desta bactéria em indivíduos hospitalizados. Contudo, o relato de colonização e infecção de indivíduos na comunidade, sem contato prévio com o ambiente hospitalar, sugere outras fontes de contaminação, como o emprego de fármacos na pecuária, o que induz a colonização por MRSA em animais de produção e consequente contaminação de produtos cárneos. O objetivo do presente estudo foi de compilar e analisar as publicações científicas sobre a ocorrência de MRSA em alimentos. Neste contexto, foi realizada uma revisão de literatura sistemática nas bases de dados Lilacs, Medline e Pubmed, e selecionados os artigos publicados no período de 2000 a 2013. Observou-se número significativo de estudos em que foram analisadas diversas amostras. Foi encontrada grande variação nas prevalências de MRSA, bem como nas metodologias utilizadas para análise. O MLST tipo ST398, comumente encontrado em suínos, foi o mais isolado nas amostras analisadas nos diferentes estudos. No entanto, as linhagens ST8 e ST5, pertencentes à biovariedade humana, foram também frequentemente detectados, o que sugere que os manipuladores de alimentos têm também sido a fonte de contaminação da carne por MRSA.