The antimicrobial susceptibility, biofilm formation and genotypic profiles of Staphylococcus haemolyticus from bloodstream infections.

We analysed the antimicrobial susceptibility, biofilm formation and genotypic profiles of 27 isolates of Staphylococcus haemolyticus obtained from the blood of 19 patients admitted to a hospital in Rio de Janeiro, Brazil. Our analysis revealed a clinical significance of 36.8% and a multi-resistance rate of 92.6% among these isolates. All but one isolate carried the mecA gene. The staphylococcal cassette chromosome mec type I was the most prevalent mec element detected (67%). Nevertheless, the isolates showed clonal diversity based on pulsed-field gel electrophoresis analysis. The ability to form biofilms was detected in 66% of the isolates studied. Surprisingly, no icaAD genes were found among the biofilm-producing isolates.

Influence of vaccine-preventable diseases and HIV infection on demand for an infectious diseases service in Rio de Janeiro State, Brazil, over 22 years - Part II (1995-2016).

Patients' data during daily clinical care are extremely important for improving the allocation of healthcare resources and for assessing healthcare demands. The prospective gathering of these data over decades allowed us to describe the trends of infectious diseases in a tertiary hospital. The results concerning the period between 1965 and 1994 described the exponential increase in the incidence of HIV infection and its important effects on our institutional mortality. The present study describes the demand for the same hospital between 1995 and 2016. There were 4,691 admissions and the main causes of admissions were, in descending order, HIV infection (1,312, 28.0%), noninfectious diseases (447, 9.5%), meningoencephalitis (432, 9.2%), soft tissue infections (427; 9.1%), tuberculosis (272, 5.8%), pneumonias (212, 4.5%) and leptospirosis (212, 4.5%). There were 864 readmissions; most due to HIV infections (65.2%). The institutional mortality fell from 16.9% in the first two years to 5.0% in the last two years of the study. The case-fatality rates among the HIV patients decreased from more than 40% to approximately 5% over the study period. In the last two decades, the hospital experienced a decrease in demand due to vaccine-preventable diseases. The demand for children has fallen and the demand for patients over the age of 50 has increased. These results reflect the improvement in public health standards over more than half a century and the positive effects of the National Immunization Program. They also illustrate the sharp decline in the HIV case-fatality rate after the introduction of combined antiretroviral therapy.

Freqüência e mortalidade das infecçöes hospitalares em neonatologia e pediatria / Nosocromial infections and mortality in hight risk nursery and pediatrics

Com o objetivo de contribuir para a determinaçäo de parâmetros para avaliaçäo da freqüência das infecçöes hospitalares no Brasil, e da mortalidade a elas associada, foram estudados 213 pacientes de Neonatologia, internados em quato hospitais, e 1.643 de Pediatria admitidos em nove hospitais, localizados em oito cidades brasileiras. O risco médio de contrair infecçäo hospitalar, expresso em taxas por mil pacientes saídos foi de 324 em Neonatologia e 85 em Pediatria. Os episódios mais freqüêntes em Neonatologia foram: septicemia 136, infecçöes urinárias nove e outras 113, na Pediatria os mais freqüentes foram infecçöes respiratórias 32; gastroenterites 18; septicemias 10, infecçöes urinárias de catéter vascular quatro, infecçöes em úlcera de decúbito uma, impetigo uma, e outras 30 por mil pacientes. A mortalidade associada a estas infecçöes, por mil pacientes saídos, foi de 42 em Neonatologia e nove em Pediatria