Com o objetivo de determinar a prevalência de Staphylococcus spp resistentes à meticilina isolados na Maternidade Escola Januário Cicco, Natal, RN, no período de 2002 a 2003, analisou-se 1.576 materiais clínicos de pacientes hospitalizados. As amostras foram coletadas, processadas e identificadas conforme procedimento padrão para cada espécime clínico. O perfil de susceptibilidade in vitro foi realizado pelo método de Kirby-Bauer. Isolou-se 188 cepas de Staphylococcus spp, das quais 105 foram identificadas como Staphylococcus aureus e 83 como Staphylococcus coagulase negativos. Staphylococcus aureus foi isolado com mais freqüência em secreções enquanto Staphylococcus coagulase negativos foram mais prevalentes em hemoculturas. A elevada (41,5%) prevalência dos Staphylococcus spp resistentes à meticilina demonstra a necessidade de medidas profiláticas imediatas com o objetivo de impedir a disseminação desse fenômeno.

Analyses on 1,576 clinical specimens from hospitalized patients were performed with the aim of determining the prevalence of methicillin-resistant Staphylococcus spp isolated in the Januário Cicco Teaching Maternity Hospital in Natal, Rio Grande do Norte, in 2002 and 2003. The samples were collected, processed and identified according to standard procedures, for each clinical specimen. In vitro susceptibility profiles were obtained using the Kirby-Bauer method. 188 strains of Staphylococcus spp were isolated: 105 were identified as Staphylococcus aureus and 83 as coagulase-negative Staphylococcus. Staphylococcus aureus was isolated most often in secretions, whereas coagulase-negative Staphylococcus was most prevalent in blood cultures. The high (41.5%) prevalence of methicillin-resistant Staphylococcus spp shows the need for immediate prophylactic measures aimed at impeding the dissemination of this phenomenon.

Foram estudados, entre janeiro de 2003 a dezembro de 2004, todos os recém-nascidos internados na UTI neonatal da Maternidade Escola Januário Cicco, portadores de cateter venoso umbilical. Avaliou-se a prevalência de espécies de Candida nas pontas de cateteres intra-venosos dos neonatos, e os fatores associados a que os pacientes estavam submetidos. As pontas de cateter foram cultivadas em ágar sangue, e, quando houve crescimento de colônia leveduriforme, esta foi subcultivada para a realização de provas morfológicas e bioquímicas para identificar a espécie. Do total de 240 cateteres analisados, 41 apresentaram crescimento de leveduras, sendo 34 encaminhados para identificação, observando-se os seguintes agentes: 13 C. albicans (38%), 10 Candida parapsilosis (29%), 8 C. tropicalis (20%), 1 C. guilliermondii (3%), 1 C. famata (3%) e 1 Trichosporon spp. (3%). Dos pacientes que apresentaram cultura de ponta de cateter positiva para fungos, três tiveram hemocultura positiva com a mesma espécie em ambos os sítios. Entre os fatores de risco destaca-se que todos os pacientes faziam uso de antibioticoterapia de amplo espectro, portavam sonda nasogástrica, além de outros procedimentos invasivos, como ventilação mecânica e cateter umbilical.

All the newborns with umbilical venous catheters, hospitalized in the neonatal intensive care unit at Januário Cicco Maternity Hospital in Natal, Brazil, between January, 2003 and December, 2004 were studied. The prevalence of Candida species in the tips of intra-venous catheters was assessed, as well as the coexisting exposures that the patients were subjected to. Catheter tips were cultivated in blood agar and when yeast culture occurred, the colony was subcultivated for species identification through morphologic and biochemical assays. From a total of 240 catheters, 41 were positive for yeasts, and 34 were submitted to identification. The following agents were isolated: 13 C. albicans (38%), 10 Candida parapsilosis (29%), 8 C. tropicalis (20%), one C. guilliermondii (3%), one C. famata (3%) and one Trichosporon spp. (3%). Three patients among those with positive catheter tip fungal cultures were also hemoculture positive, with the same fungal species at both sites. Among the coexisting exposures, it should be pointed out that all the patients underwent broad spectrum antibiotic therapy, used a nasogastric probe, in addition to undergoing other invasive procedures such as mechanical ventilation and umbilical catheter implantation.

Several strategies aim at characterizing the AIDS epidemic in different parts of the world. Among these, the identification of recent HIV-1 infections using the recently described serologic testing algorithm for recent human immunodeficiency virus (HIV) seroconversion (STARHS) strategy was employed in four testing sites of the City of São Paulo Public Health Department (CSPPHD). Those identified as recently infected were invited to participate in a prospective clinical and laboratory evaluation study. We describe the establishment of the patient identification network and the success in enrolling the participants, as well as their clinical and laboratory characteristics. From May to December 2002, 6,443 persons were tested for HIV in the four participating sites, of whom 384 (5.96%) tested HIV-1 positive; 43 (11.2%) of them were identified as recently infected. Twenty-two were successfully enrolled in the follow-up study, but three of them did not meet clinical and/or laboratory criteria for recent HIV-1 infection. After these exclusions, the laboratory findings revealed a median CD4+ T lymphocyte count of 585 cells/muL (inter-quartile range 25-75% [IQR], 372-754), a CD8+ T lymphocyte count of 886 cells/muL (IQR, 553-1098), a viral load of 11,000 HIV-RNA copies/mL (IQR, 3,650-78,150), log10 of 4.04 (IQR 3.56-4.88). The identification of recent HIV infections is an extremely valuable way to evaluate the spread of the virus in a given population, especially when cohort studies, considered the gold standard method to evaluate incidence, are not available. This work demonstrated that establishing a network to identify such patients is a feasible task, even considering the difficulties in a large, resource-limited country or city.

Centros de Testagem e Aconselhamento em DST/HIV (CTA) oferecem, entre outras atividades, a realização de testes sorológicos anti-HIV e VDRL. Estes serviços dispõem de coleta sistemática de dados permitindo conhecer o perfil epidemiológico dos indivíduos infectados. O presente estudo descreve o perfil epidemiológico das pessoas com sorologia positiva que utilizaram um dos maiores CTA do país, durante os anos de 2001 e 2002. Foram utilizados dados de sorologia positiva e das entrevistas (pré e pós teste) realizadas de rotina. Obsevou-se 470 (4%) resultados positivos entre 10657 testes sorológicos realizados, sendo que grande parte (81,4%) dos usuários com sorologia positiva são do sexo masculino. A idade média dos indivíduos estudados foi 32,3 anos, sem diferencial para sexo (p=0,968); 75% trabalham; 41% dos usuários do sexo feminino e 77% do sexo masculino são solteiros (p<0,001); 43% possuem segundo grau (completo e incompleto). Quanto à categoria de exposição, 36% são homossexuais, 34% são heterossexuais e 27% bissexuais. Alto percentual refere ter parceiros múltiplos (82%); 32% referem utilizar preservativo sempre.

STD/HIV Counseling and Testing Centers (CTA) provide serological testing for HIV and syphilis, among other activities. These centers collect and register data systematically, and thus allow profiling of HIV-positive individuals. The present study presents the epidemiological profile of HIV-positive individuals who attended a high-demand center from January 2001 to December 2002. Data from serological tests with positive results and information recorded during the interviews (pre- and post-testing) were used as sources. During the period, there were 470 (4%) positive results, out of 10,657 tests performed. Most HIV-positive individuals were male (81.4%); the average age among all positive individuals was 32.3 years; 75% were employed; 41% of HIV-positive females and 77% males were single (p<0.001). Regarding exposure category, 36% of individuals classified themselves as homosexuals, 34% as heterosexuals and 27% as bisexuals. A very large percentage reported having multiple partners (82%) and 32% claimed to always use condoms.

Centros de Testagem e Aconselhamento em DST/HIV (CTA) oferecem, entre outras atividades, a realização de testes sorológicos anti-HIV e VDRL. Estes serviços dispõem de coleta sistemática de dados permitindo conhecer o perfil epidemiológico dos indivíduos infectados. O presente estudo descreve o perfil epidemiológico das pessoas com sorologia positiva que utilizaram um dos maiores CTA do país, durante os anos de 2001 e 2002. Foram utilizados dados de sorologia positiva e das entrevistas (pré e pós teste) realizadas de rotina. Obsevou-se 470 (4%) resultados positivos entre 10657 testes sorológicos realizados, sendo que grande parte (81,4%) dos usuários com sorologia positiva são do sexo masculino. A idade média dos indivíduos estudados foi 32,3 anos, sem diferencial para sexo (p=0,968); 75% trabalham; 41% dos usuários do sexo feminino e 77% do sexo masculino são solteiros (p<0,001); 43% possuem segundo grau (completo e incompleto). Quanto à categoria de exposição, 36% são homossexuais, 34% são heterossexuais e 27% bissexuais. Alto percentual refere ter parceiros múltiplos (82%); 32% referem utilizar preservativo sempre.

STD/HIV Counseling and Testing Centers (CTA) provide serological testing for HIV and syphilis, among other activities. These centers collect and register data systematically, and thus allow profiling of HIV-positive individuals. The present study presents the epidemiological profile of HIV-positive individuals who attended a high-demand center from January 2001 to December 2002. Data from serological tests with positive results and information recorded during the interviews (pre- and post-testing) were used as sources. During the period, there were 470 (4%) positive results, out of 10,657 tests performed. Most HIV-positive individuals were male (81.4%); the average age among all positive individuals was 32.3 years; 75% were employed; 41% of HIV-positive females and 77% males were single (p<0.001). Regarding exposure category, 36% of individuals classified themselves as homosexuals, 34% as heterosexuals and 27% as bisexuals. A very large percentage reported having multiple partners (82%) and 32% claimed to always use condoms.