RESUMO
OBJECTIVE: To determine the rate of contamination of intravenous solutions and injection ports in pediatric patients. MATERIAL AND METHODS: During non-epidemic periods, eight pediatric wards in Mexican hospitals were studied. Qualitative cultures were performed from the surface of injection ports and from intravenous solutions in use in pediatric patients younger than 2 years, culturing 750 infusion systems from 728 patients. RESULTS: The rate of contamination of intravenous solutions was 2.4% (18/750; CI 95%: 1.3% to 3.5%) and for injection ports it was 3.2% (24/750; CI 95%: 2.1% to 4.3%). Enterobacteriaceae predominated; in four cases the organisms isolated from the port and from the solutions were coincident (Klebsiella spp. and Enterobacter sp.). The rate of contamination for solutions mixed in the wards was 5.1%, against 1.3% of those not mixed (chi2 = 9.19, p < 0.01). DISCUSSION: Contamination of parenteral solutions is not a rare phenomenon and it could be related to inappropriate practices in the preparation of intravenous solutions and medications as well as the contamination of injection ports. In hospitals working with standards similar to those reported here, the monitoring of sterility of intravenous solutions could contribute to reduce the rate of nosocomial bacteremia.
Assuntos
Bactérias/isolamento & purificação , Contaminação de Medicamentos/estatística & dados numéricos , Soluções , Estudos Transversais , Unidades Hospitalares , Humanos , Lactente , Nutrição Parenteral , PediatriaRESUMO
INTRODUCTION: The high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in hospitalized patients is a significant problem due to its associated morbidity and mortality. It is important to know the recent MRSA epidemiology at a General Hospital. OBJECTIVES: To determine the MRSA epidemiology at a Mexican general hospital from 2000 to 2007, in order to know if there is a significant trend in its proportion. MATERIAL AND METHODS: Prevalence survey. The resistance to oxacillin was identified by the Kirby-Bauer's method. The specimens were classified by type and year of isolation. Trend statistics were used for analysis. RESULTS: S. aureus was identified in 1,008 samples, being 301 resistant to oxacillin (30%, 95% Confidence Interval [CI], 25 to 35%). The proportion of MRSA went from 37% (95% CI, 29 to 44%) to 49% (95% CI, 40 to 58%) in the period of study (chi2 for trends = 6.676, p < 0.01). Specimens with the highest proportion of MRSA were blood and sterile liquids with 32% (95% CI, 26 to 39%), secretions with 29% (95% CI, 24 to 33%), and catheters with 21% (95% CI, 16 to 26%). CONCLUSIONS: The proportion of MRSA has increased significantly. This leads to higher costs and morbi-mortality for the hospitalized patients. We require stricter policies to prevent transmission and to control the use of antibiotics.
Assuntos
Hospitais Gerais/estatística & dados numéricos , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Estafilocócicas/epidemiologia , Infecção Hospitalar/epidemiologia , Farmacorresistência Bacteriana Múltipla , Humanos , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , México/epidemiologia , Testes de Sensibilidade Microbiana , Morbidade/tendências , Oxacilina/farmacologia , Prevalência , Estudos Retrospectivos , Infecções Estafilocócicas/microbiologiaRESUMO
Rhabdomyolisis most commonly occurs after muscle injury, alcohol ingestion, drug intake and exhaustive exercise. Prolonged muscle compression at the time of surgery may produce this complication. Obesity has been reported as a risk factor for pressure-induced rhabdomyolysis, but no reports associated with bariatric surgery could be found in the literature. We report 3 superobese patients who developed rhabdomyolysis after bariatric surgery. This complication was attributed to direct and prolonged pressure of the bed against the dorsal and gluteal muscles.