RESUMO
We describe a nosocomial outbreak of diarrheal disease caused by extended-spectrum ß-lactamase-producing multidrug-resistant Salmonella enterica serovar Typhimurium, focused on a pediatric ward in South Africa. The outbreak peaked between May 2012 and July 2012. Person-to-person transmission was the most likely mechanism of spread of the infection, expedited due to a breakdown in hand-washing and hygiene, suboptimal infection control practices, overcrowding of hospital wards, and an undesirable nurse-to-patient ratio.
Assuntos
Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Surtos de Doenças , Infecções por Salmonella/epidemiologia , Infecções por Salmonella/microbiologia , Salmonella typhimurium/isolamento & purificação , Adulto , Infecção Hospitalar/transmissão , Diarreia/epidemiologia , Diarreia/microbiologia , Hospitais , Humanos , Lactente , Infecções por Salmonella/transmissão , Salmonella typhimurium/enzimologia , África do Sul , beta-Lactamases/metabolismoRESUMO
Isoniazid preventive therapy (IPT) prevents tuberculosis (TB) in immunocompetent children <5 years of age after exposure to an infectious TB source case. Routine IPT has been advocated in all HIV-infected children without TB, but has been controversial. Antiretroviral therapy markedly reduces the risk for TB in HIV-infected children, especially when started early in infancy. In HIV-infected children, as in HIV- uninfected children, we recommend post-exposure IPT after each TB exposure episode; but in HIV-infected children, this should be given irrespective of age or antiretroviral therapy. However, evidence for routine IPT without known exposure to TB in HIV-infected children is not convincing and is therefore not recommended.