RESUMO
A cluster of six cases of fungemia among hematology, bone marrow transplant, and oncology patients was investigated in a case-control study (18 controls). The use of implantable and semi-implantable central venous catheters was significantly associated with cases (p = 0.016). The hands of three healthcare workers (HCWs) were positive for Candida parapsilosis. Electrophoretic karyotyping showed two profiles among patients and HCWs, and five among six unrelated strains. The profiles of two HCWs matched the ones of the patients they had handled. The patients' strains were moderate or strong slime producers, whereas none of the HCWs' were strong producers. In conclusion, our results indicated the occurrence of an outbreak C. parapsilosis fungemia related to long-term central venous catheters in which the hands of HCWs were implicated. The amount of slime production might be associated with the pathogenicity of the strains.
Assuntos
Candidíase/etiologia , Cateterismo Venoso Central/efeitos adversos , Infecção Hospitalar/epidemiologia , Fungemia/etiologia , Mãos/microbiologia , Pessoal de Saúde , Adolescente , Adulto , Idoso , Candidíase/tratamento farmacológico , Candidíase/microbiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Feminino , Fungemia/tratamento farmacológico , Fungemia/microbiologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Health professionals (HP) are frequently exposed to accidents with materials contaminated with blood and/or body fluids, thus representing a population at risk for the acquisition of human immunodeficiency virus (HIV) and hepatitis B virus (HBV). PURPOSE--To determine the prevalence of HIV and HBV infection among HP admitted to the University Hospital, Faculty of Medicine, University of São Paulo (UH-FMUSP), and to identify the possible sources of contamination. METHODS--A total of 345 HP who sequentially passed the hiring examination at UH-FMUSP from March 1 to June 23 1993 were evaluated and compared to 2521 blood donors using serologic tests for the detection of AgHBs and total anti-HBc of HBV. The ELISA method was also used for HIV-1, with subsequent confirmation by Western blot. Questionnaires were distributed to the HP for the identification of possible sources of contamination. RESULTS--Positivity to HIV-1 was 0.48% for HP and 0.23% for blood donors, and positivity to HBV was 8.89% and 6.17%, respectively. CONCLUSION--There was no statistically significant difference in the results of the serologic tests for HIV and HBV detection between the two groups, even taking into consideration the different professions of those who work in the health area and their potential exposure to blood and secretion.
Assuntos
Síndrome da Imunodeficiência Adquirida/sangue , Doadores de Sangue , Hepatite B/sangue , Recursos Humanos em Hospital , Síndrome da Imunodeficiência Adquirida/transmissão , Adolescente , Adulto , Idoso , Brasil , Distribuição de Qui-Quadrado , Feminino , Hepatite B/transmissão , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
Os profissionais da área de saúde (PAS) estäo freqüentemente expostos a acidentes com materiais contaminados por sangue e/ou líquidos corporais, constituindo, portanto, populaçäo de risco para aquisiçäo do vírus da imunodeficiência humana (HIV) e vírus da hepatite B (VHB). Objetivos. Determinar a prevalência da infecçäo pelo HIV e VHB em PAS admitidos no Hospital das Clínicas da Faculdade de Medicina da Universidade de Säo Paulo (HC-FMUPS) e identificar os possíveis meios de contaminaçäo. Métodos. Foram avaliados 345 PAS aprovados seqüencialmente em exame admissional pelo HC-FMUSP, de 1§ de março a 23 de junho de 1993, e estes, comparados com 2.521 doadores de sangue para detecçäo do AgHBs e anti-HBc total do VHB, além do método de ELISA para o HIV-1, com a subseqüente confirmaçäo por Western-blot. Procedeu-se a aplicaçäo de questionário nos PAS para identificaçäo das possíveis fontes de contaminaçäo. Resultados. As percentagens de positividades para o HIV foram de 0,48 por cento e 0,23 por cento, enquanto para o VHB constatou-se 9,89 por cento e 6,17 por cento, nos PAS e doadores de sangue, respectivamente. Conclusäo. Näo houve diferença estatisticamente significante entre os resultados sorológicos apra detecçäo do HIV e VHB nos dois grupos estudados, mesmo levando em consideraçäo as diversas profissöes dos que trabalham na área de saúde e seus potenciais de exposiçäo a sangue e secreçöes