scholarly journals Information system on tuberculosis: data completeness spatial analysis in the state of Paraná, Brazil

Author(s):  
Marcelle Saldanha da Silva ◽  
Marcos Augusto Moraes Arcoverde ◽  
Rubia Laine de Paula Andrade ◽  
Adriana Zilly ◽  
Tereza Cristina Scatena Villa ◽  
...  

ABSTRACT Objective: To analyze the spatiality of completeness of the Information System on Diseases of Compulsory Declaration of tuberculosis in Paraná state, focusing on the border region. Method: A study composed by the notified cases of the disease treated in Paraná between 2008 and 2017. The variable completeness was classified as excellent (<5% of incompleteness), good (5 to <10%), regular (10 to <20%), poor (20% to 50%), and very poor (>50%). Moran global was used for the spatial correlation and local association was analyzed. Logistic regression was employed to assess the spatial association of the variables with the border and, for the significant variables, multiple logistic regression was used. The study abides by the resolution 510/2016 of the National Health Council. Results: There was a “high-high” correlation for education level, 2- and 6-month sputum smear in the Eastern health macroregional and “high-high” correlation in the Northwestern macroregional for 2-month sputum smear and antibiotic sensitivity testing. There was no spatial association with the border. Conclusion: Unsatisfactory completeness was identified in the database and conglomerates, indicating spatial association of incompleteness of some variables, but with no relation with the border. There was no worsening of completeness nor of the case outcomes related to these regions.

2019 ◽  
Vol 31 (1) ◽  
pp. 44-51

Objectives of study are (1) to reinforce the national capacity for diagnosis and antibiogram of some infectious diseases causing severe acute respiratory infection (SARI) and (2) to build a network between hospital and laboratory for the diagnosis and surveillance of SARI in Yangon. This study is a crosssectional hospital- and laboratory-based descriptive study. A total of 825 samples including respiratory samples and blood samples from 511 children attending Yangon Children’s Hospital and Yankin Children’s Hospital from December 2014 to April 2016 for treatment of SARI were included. Identification and antibiotic sensitivity testing were done using Vitek 2. Out of 129 gram-negative bacilli (GNB), K. pneumoniae 32%, P. aeruginosa 18%, A. baumannii 13%, E. coli 9% were mostly isolated. Among 35 gram-positive cocci (GPC), S. aureus 42% and S. pneumoniae 6% were mostly isolated. Multidrug resistance rates were E. coli 100%, K. pneumoniae 95%, A. baumanii 82% and P. aeruginosa 17%. Extended-spectrum beta-latamase (ESBL)-producing K. pneumoniae and E. coli was 6 out of 10 tested organisms. Carbarpenemase-producing GNB and methicillin-resistant Staphylococcus aureus (MRSA) were 21% and 33%, respectively. Virology section tested 529 samples of 490 patients using the FTD33 Multiplex PCR method which can detect 33 pathogens including 20 viruses, 12 bacteria and 1 fungus. Out of 490 patients, 374 were PCR positive. Different types of samples including nasopharyngeal, throat, endotracheal and laryngeal swab, tracheal secretion and bronchoalveolar lavage, were tested. Out of 566 viruses, respiratory syncytial virus (RSV) (19.3%), rhinovirus (17.0%), parechovirus (14.3%), bocavirus (11.1%), adenovirus (10.2%), metapneumo-virus A and B (10.2%), parainfluenza virus (5.7%), enterovirus (3.0%), influenza A virus (2.8%), coronavirus (4%), parainfluenza virus (0.9%) and influenza C virus (0.4%) were detected. This study highlighted the etiological agents of bacteria, viruses and drug-resistant bacterial pathogens in SARI.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Charlie A. Sewalt ◽  
Benjamin Y. Gravesteijn ◽  
Daan Nieboer ◽  
Ewout W. Steyerberg ◽  
Dennis Den Hartog ◽  
...  

Abstract Background Prehospital triage protocols typically try to select patients with Injury Severity Score (ISS) above 15 for direct transportation to a Level-1 trauma center. However, ISS does not necessarily discriminate between patients who benefit from immediate care at Level-1 trauma centers. The aim of this study was to assess which patients benefit from direct transportation to Level-1 trauma centers. Methods We used the American National Trauma Data Bank (NTDB), a retrospective observational cohort. All adult patients (ISS > 3) between 2015 and 2016 were included. Patients who were self-presenting or had isolated limb injury were excluded. We used logistic regression to assess the association of direct transportation to Level-1 trauma centers with in-hospital mortality adjusted for clinically relevant confounders. We used this model to define benefit as predicted probability of mortality associated with transportation to a non-Level-1 trauma center minus predicted probability associated with transportation to a Level-1 trauma center. We used a threshold of 1% as absolute benefit. Potential interaction terms with transportation to Level-1 trauma centers were included in a penalized logistic regression model to study which patients benefit. Results We included 388,845 trauma patients from 232 Level-1 centers and 429 Level-2/3 centers. A small beneficial effect was found for direct transportation to Level-1 trauma centers (adjusted Odds Ratio: 0.96, 95% Confidence Interval: 0.92–0.99) which disappeared when comparing Level-1 and 2 versus Level-3 trauma centers. In the risk approach, predicted benefit ranged between 0 and 1%. When allowing for interactions, 7% of the patients (n = 27,753) had more than 1% absolute benefit from direct transportation to Level-1 trauma centers. These patients had higher AIS Head and Thorax scores, lower GCS and lower SBP. A quarter of the patients with ISS > 15 were predicted to benefit from transportation to Level-1 centers (n = 26,522, 22%). Conclusions Benefit of transportation to a Level-1 trauma centers is quite heterogeneous across patients and the difference between Level-1 and Level-2 trauma centers is small. In particular, patients with head injury and signs of shock may benefit from care in a Level-1 trauma center. Future prehospital triage models should incorporate more complete risk profiles.


2020 ◽  
Vol 221 (Supplement_2) ◽  
pp. S164-S173
Author(s):  
Li Tong ◽  
Xiao-Guang Hu ◽  
Fa Huang ◽  
Shun-Wei Huang ◽  
Li-Fen Li ◽  
...  

Abstract Background Information on possible donor-derived transmission events in China is limited. We evaluated the impacts of liver transplantation from infected deceased-donors, analyzed possible donor-derived bacterial or fungal infection events in recipients, and evaluated the etiologic agents’ characteristics and cases outcomes. Methods A single-center observational study was performed from January 2015 to March 2017 to retrospectively collect data from deceased-donors diagnosed with infection. Clinical data were recorded for each culture-positive donor and the matched liver recipient. The microorganisms were isolated and identified, and antibiotic sensitivity testing was performed. The pathogens distribution and incidence of possible donor-derived infection (P-DDI) events were analyzed and evaluated. Results Information from 211 donors was collected. Of these, 82 donors were infected and classified as the donation after brain death category. Overall, 149 and 138 pathogens were isolated from 82 infected donors and 82 matched liver recipients, respectively. Gram-positive bacteria, Gram-negative bacteria, and fungi accounted for 42.3% (63 of 149), 46.3% (69 of 149), and 11.4% (17 of 149) of pathogens in infected donors. The incidence of multidrug-resistant bacteria was high and Acinetobacter baumannii was the most concerning species. Infections occurred within the first 2 weeks after liver transplantation with an organ from an infected donor. Compared with the noninfection recipient group, the infection recipient group experienced a longer mechanical ventilation time (P = .004) and intensive care unit stay (P = .003), a higher incidence of renal dysfunction (P = .026) and renal replacement therapy (P = .001), and higher hospital mortality (P = .015). Possible donor-derived infection was observed in 14.6% of cases. Recipients with acute-on-chronic liver failure were more prone to have P-DDI than recipients with other diseases (P = .007; odds ratio = 0.114; 95% confidence interval, .025–.529). Conclusions When a liver recipient receives a graft from an infected deceased-donor, the postoperative incidence of infection is high and the infection interval is short. In addition, when a possible donor-derived, drug-resistant bacterial infection occurs, recipients may have serious complications and poor outcomes.


2021 ◽  
Vol 26 (2) ◽  
pp. 105-113
Author(s):  
L. Yu. Orekhova ◽  
V. G. Atrushkevitch ◽  
E. S. Loboda ◽  
V. Yu. Vashneva ◽  
A. A. Petrov

Relevance. Successful treatment of endo-perio lesions depends on the thorough clinical assessment, accurate diagnosis and structural approach to the planning of periodontal and endodontic treatment. Aim – to provide clinical and laboratory evidence about the effectiveness of ciprofloxacin-and-tinidazole-containing antibiotic in the comprehensive treatment of endo-perio lesions with a primary periodontal disease which secondarily affects the pulp.Materials and methods. We examined 29 patients aged from 35 to 50 (mean age 42.3±3.21) with class II endo-perio lesions according to P. Eickholz classification. The patients were randomly divided into 2 groups. All patients had comprehensive periodontal and endodontic treatment with (Group 2) and without (Group 1) antibiotic therapy. The clinical and paraclinical examination included determination of such indices as OHI-s, SL, PMA, SBI, as well as Doppler ultrasound, EPT, CBCT, microbiological test of the discharge from periodontal pockets and root canal system. We selected the systemic antibiotic after the antibiotic sensitivity testing.Results. Comprehensive treatment of endo-perio lesions, which included systemic antibiotic therapy with ciprofloxacin and tinidazole, effectively arrested the inflammation in the periodontium and pulp beginning from the 7th day of use.Conclusion. Cifran ST, a combination broad-spectrum antibiotic, helps reduce periodontal inflammation by effectively eliminating microbiota in the root canals and periodontal pockets in patients with moderate or severe chronic generalized periodontitis. 


Author(s):  
Jayaprada Rao Chunduri ◽  
Hetwi R. Shah

Objective: phytochemical screening and antioxidant activity analyses of selected indoor plants and to evaluate commercial applications.Methods: Qualitative and quantitative phytochemical analyses of alcoholic and aquatic crude extracts of leaves of selected non-flowering indoor plants were assessed using standard protocols and later compared with FTIR analyses. Antioxidant and antibacterial activities of the extracts were studiedResults: Phytochemical analysis of polar solvent extractions of the four selected plants Pedilanthus tithymaloides, Cordyline terminalis, Tradescantia zebrine and Rhoeo discolou. Indicated the presence of tannins in all four varieties terpenoids in 3, flavonols, phytosterols and phenols in two plants, followed by alkaloids. The phytochemical analyses were supported by FTIR reports. Quantitative studies indicated variations in flavonol, tannin and phenols concentrations among the four species. High concentrations of Total flavonols (P. tithymaloides) and Tannins (C. terminalis) were observed. C. terminalis extract showed comparatively highest reducing power followed by R. discolour and P. tithymaloides extracts. Antibiotic Sensitivity Testing indicated P. tithymaloides showed a maximum zone of inhibition compared to R. discolor. C. terminalis plant leaf extract showed a faint zone of inhibition against E. fecalis while others couldnot. Intense colors of C. terminalis and T. zebrine plants could be used as a natural dye as well as pH indicator. Conclusion: The rich concentrations of the tannins from non-flowering indoor plants could be the future option of dyes and dyeing industry as natural colorants as well as pH indicators. These plants were rich sources of phytochemicals (phenols, flavonols, tannins, and phytosterols), with antioxidant and antibacterial activity.


Author(s):  
Anania Arjuna ◽  
Dinobandhu Nandi

ABSTRACTObjective: Nosocomial infections or Hospital acquired infection (HAI) are one of the major threats to hospitalized patients as well as for the hospitalassociated personnel. In last few years there is a gross change in causative agents, new organisms have come out with great threat to hospitals as theypossess antibiotic resistance property e.g. production of biofilm, production of enzymes such as β- lactamases. Among many organisms, Acinetobacterbaumannii has emerged as a potent nosocomial pathogen. Our objective of this study was to find the burden of Acinetobacter baumannii infectionswhich are associated as nosocomial infections and to determine the drug of choice for an effective treatment.Methods: Clinical specimens were collected from patients of different unit of the hospital by maintaining universal precautions and standardmicrobiological protocols. All the respective specimens were cultured in respective culture medium i.e. MacConkey agar, blood agar, chocolate agar,cysteine lactose electrolyte deficient (CLED) agar and, fluid thioglycolate (TG) medium at 37˚C for 24-48 hours. After incubation of 24-48 hours cultureplates were examined for bacterial growth and identification and antibiotic sensitivity test was made by Vitek2 compact.Result: The study was conducted at the department of microbiology from January 2016 to April 2016. A total of 2582 specimens were collected andprocessed for identification and sensitivity testing. Specimens of all age group (2 days- 93 years) and both sexes were processed for identificationof A. baumannii and antibiotic sensitivity testing. A total of 119 isolates (4.60%) of A. baumannii were obtained from 2582 clinical specimens. Themost common infection A. baumannii was found as lower respiratory tract infection (89.07%) followed by abscess (6.72%), septicaemia (2.52%),urinary tract infections (0.84%), and soft tissue infections (0.84%). The maximum sensitivity of A. baumannii isolates were seen to Colistin (CL) (119,100%), followed by Tigecycline (TGC) (63, 52.94%) and Minocycline (MIN) (27, 22.69%). The maximum resistant was observed for Imipenem (IMI),Aztreonam (AZT) and Ticarcillin- clavulanic acid (TIC) (119, 100%).Conclusion: The Gram- negative coccobacillus, Acinetobacter baumannii poses a formidable threat to patients. It has emerged as a superbug inhospital environment particularly in ICU units. The chances of A. baumannii infections increase in the presence of iatrogenic factors like inadequatelong- term antibiotic therapy and new interventions in a medical facility. To control the burden of Acinetobacter infections new therapies suchas combine therapy must be obtained and followed with proper dose as recommend by physicians; along with awareness of the importance ofthis infection should be implicated. Proper sanitation, good housekeeping, sterilization of equipment, hand hygiene, water purification, isolationprocedures and maintaining of the hospital environment, use of infection control practices are some of the measures to control the transmission ofAcinetobacter spp. among hospital personnel.Keywords: Acinetobacter baumannii, Biofilm, β-lactamases, Hospital acquired infection.


Author(s):  
Abdulrahman Y. Al-Haifi ◽  
Abdul Salam Mohamed Al Makdad ◽  
Mohammed Kassim Salah ◽  
Hassan A. Al-Shamahy ◽  
Wadee Abdullah Abdulwahid Al Shehari

Objectives:  Lower respiratory infections (LRTIs) are the leading reason of death infectious diseases in the world and the fifth leading cause of death in general. The study aimed to identify the general characteristics of LRTI, the causative bacteria and the results of sensitivity to antibiotics. Subjects and methods:  A multicentre prospective study was performed at 3 University hospitals. The study included 555 clinical diagnostic cases as LRTI cases, 328 male and 227 female, aged 3 to 69 years. Clinical and demographic data were collected in the standard questionnaire, and samples included sputum or bronchial lavage (BAL) staining and culture. Samples were cultured in 3 different bacterial media, blood agar and LJ slope, chocolate agar with Co2; cultures were then examined for possible bacterial pathogens of LRTI. Possible bacterial pathogens were isolated and identified by standard laboratory techniques, and microbial sensitivity testing was carried out by disc diffusion method. Results:  LRTI was recorded among all age groups and with less frequency in children less than 16 years of age. A large number of LRTI (36.2%) was not diagnosed, most in CAP (52.4%), followed by HAP (33.9%) while unidentified cases were lower in AECOPD (22.8%). CAP isolates are K. pneumoniae (26.2%), S. pyogens (12.3%), and S. pneumoniae (9%); in HAP are MSSA (24%), E. Coli (12.9%), MRAS (11.1%), K. pneumoniae (10.5%) and P. aeruginosa (7%); and in AECOPD are M. catarrhalis (47.2%), K. pneumoniae (17.2%), H. influnzae (10.7%) and P. aeruginosa (2%). In Gram-positive bacteria, high resistance to ampicillin/sulbactam (100%) and amoxicillin/clavulanate (100%) was recorded, while moderate resistance to amikacin, vancomycin, cefepime and moxifloxacin was recorded. In Gram-negative bacteria, a high resistance to 3rd g Cephalosporin’s  (68.5%) was recorded, while a moderate sensitivity to the other antibiotics tested was recorded. Conclusion:  There is a high rate of undiagnosed LRTI in Yemen and this highlights the need for health authorities to develop strategies to diagnose most of the causes of LRTI, including Mycoplasma, Chlamydia, and viral causes. No antibiotics are completely effective in treating LRTI in our area and antibiotic sensitivity should be performed in all cases. Peer Review History: Received 22 April 2019; Revised 4 May; Accepted 9 May, Available online 15 May 2020 UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 8.0/10 Reviewer(s) detail: Name: Dr. Michael Otakhor Erhunmwunse Affiliation: St. Philomena Catholic Hospital, Nigeria E-mail: [email protected]   Name: Dr. Amany Mohamed Alboghdadly Affiliation: Princess Nourah bint abdulrahman university, Riyadh E-mail: [email protected] Comments of reviewer(s): Similar Articles: BIOFILM FORMATION AND ANTIBIOTIC SUSCEPTIBILITY OF UROPATHOGENS IN PATIENTS WITH CATHETER ASSOCIATED URINARY TRACT INFECTIONS IN IBB CITY -YEMEN PREVALENCE, ANTIMICROBIAL SUSCEPTIBILITY PATTERN AND RISK FACTORS OF MRSA ISOLATED FROM CLINICAL SPECIMENS AMONG MILITARY PATIENTS AT 48 MEDICAL COMPOUND IN SANA'A CITY-YEMEN


2021 ◽  
Vol 8 ◽  
Author(s):  
Nurul Asyiqin Haulisah ◽  
Latiffah Hassan ◽  
Siti Khairani Bejo ◽  
Saleh Mohammed Jajere ◽  
Nur Indah Ahmad

Overuse of antimicrobials in livestock health and production beyond therapeutic needs has been highlighted in recent years as one of the major risk factors for the acceleration of antimicrobial resistance (AMR) of bacteria in both humans and animals. While there is an abundance of reports on AMR in clinical isolates from humans, information regarding the patterns of resistance in clinical isolates from animals is scarce. Hence, a situational analysis of AMR based on clinical isolates from a veterinary diagnostic laboratory was performed to examine the extent and patterns of resistance demonstrated by isolates from diseased food animals. Between 2015 and 2017, 241 cases of diseased livestock were received. Clinical specimens from ruminants (cattle, goats and sheep), and non-ruminants (pigs and chicken) were received for culture and sensitivity testing. A total of 701 isolates were recovered from these specimens. From ruminants, Escherichia coli (n = 77, 19.3%) predominated, followed by Staphylococcus aureus (n = 73, 18.3%). Antibiotic sensitivity testing (AST) revealed that E. coli resistance was highest for penicillin, streptomycin, and neomycin (77–93%). In addition, S. aureus was highly resistant to neomycin, followed by streptomycin and ampicillin (68–82%). More than 67% of E. coli isolates were multi-drug resistant (MDR) and only 2.6% were susceptible to all the tested antibiotics. Similarly, 65.6% of S. aureus isolates were MDR and only 5.5% were susceptible to all tested antibiotics. From non-ruminants, a total of 301 isolates were recovered. Escherichia coli (n = 108, 35.9%) and Staphylococcus spp. (n = 27, 9%) were the most frequent isolates obtained. For E. coli, the highest resistance was against amoxicillin, erythromycin, tetracycline, and neomycin (95–100%). Staphylococcus spp. had a high level of resistance to streptomycin, trimethoprim/sulfamethoxazole, tetracycline and gentamicin (80–100%). The MDR levels of E. coli and Staphylococcus spp. isolates from non-ruminants were 72.2 and 74.1%, respectively. Significantly higher resistance level were observed among isolates from non-ruminants compared to ruminants for tetracycline, amoxicillin, enrofloxacin, and trimethoprim/sulfamethoxazole.


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