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Surveillance system for Healthcare-associated endophthalmitis at state level in a middle-income country: preliminary results
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Luz, Reginaldo Adalberto

; Assis, Denise Brandão de

; Madalosso, Geraldine

; Timmons, Stephen

; Padoveze, Maria Clara

Arquivos Brasileiros de Oftalmologia

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2024, Volume 87 Nº 4 elocation e2022-0181

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

ABSTRACT Purpose: To describe the implementation pro cess and the preliminary results of a surveillance system for healthcare-associated endophthalmitis. Methods: This is a case study of the implementation of a surveillance system for healthcare-associated endophthalmitis. The system for healthcare-associated endophthalmitis is a structured system that enables surveillance of cases of healthcare-associated endophthalmitis after intraocular procedures, developed and coordinated by the Division of Hospital Infection at the State Health Department, São Paulo, Brazil. The implementation process included a pilot phase, followed by a scaling-up phase. Data were reported monthly to the Division of Hospital Infection by participating healthcare facilities that performed intraocular procedures in the state of São Paulo, Brazil, from September 2017 to December 2019. Results: Among the 1,483 eligible healthcare facilities, 175 engaged in the study (participation rate of 11.8%), reporting 222,728 intraocular procedures performed, of which 164,207 were cataract surgery and 58,521 were intravitreal injections. The overall incidence rate of endophthalmitis was reported to be 0.05% (n=105; 80 cases after cataract surgery and 25 cases after intravitreal injections). The incidence rates for healthcare facilities ranged from 0.02% to 4.55%. Most cases were caused by gram-positive bacteria, mainly Staphylococcus spp. In 36 (46.2%) of the cases, there was no bacterial growth; no sample was collected in 28 (26.7%) cases. This system for healthcare-associated endophthalmitis enabled the identification of an outbreak of four cases of endophthalmitis after intravitreal injections. Conclusion: The system for healthcare-associated endophthalmitis proved to be operationally viable and efficient for monitoring cases of endophthalmitis at the state level.

RESUMO Objetivo: Descrever o processo de implementação e os resultados preliminares de um sistema de vigilância epidemiológica para endoftalmites associada à assistência à saúde. Métodos: Trata-se de um estudo de caso de implementação de um sistema de vigilância epidemiológica para endoftalmites. O sistema de vigilância epidemiológica para endoftalmites é um sistema estruturado que possibilita a vigilância de casos de endoftalmite associados à assistência à saúde após procedimentos oftalmológicos invasivos, desenvolvido e coordenado pela Divisão de Infecção Hospitalar da Secretaria de Estado da Saúde, São Paulo, Brasil. O processo de implementação incluiu uma fase piloto, seguida pela fase de expansão. Os dados foram enviados mensalmente à Divisão de Infecção Hospitalar pelos estabelecimentos de saúde participantes que realizaram procedimentos oftalmológicos no estado de São Paulo, Brasil no período de setembro de 2017 a dezembro de 2019. Resultados: Entre os 1.483 estabelecimentos de saúde elegíveis, 175 participaram do estudo (taxa de adesão de 11,8%), relatando 222.728 procedimentos oftalmológicos realizados, sendo 164.207 cirurgias de catarata e 58.521 injeções intravítreas. A taxa de incidência global de endoftalmite relatada foi de 0,05% (n=105; 80 casos após cirurgia de catarata e 25 casos após injeção intravítrea). As taxas de incidência entre os estabelecimentos de saúde variaram de 0,02% a 4,55%. A maioria dos casos foi causada por bactérias gram-positivas, principalmente Staphylococcus spp. Em 36 (46,2%) casos não houve crescimento bacteriano; nenhuma amostra foi coletada em 28 (26,7%) casos. O sistema de vigilância epidemiológica para endoftalmites possibilitou a identificação de um surto de quatro casos de endoftalmite após injeção intravítrea. Conclusão: O sistema de vigilância epidemiológica para endoftalmites mostrou-se operacionalmente viável e eficiente para o monitoramento de casos de endoftalmite em nível estadual.

https://doi.org/10.5935/0004-2749.2022-0181

Seroprevalence of SARS-CoV-2 antibodies in schoolchildren in the city of São Paulo, 2020
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Kamioka, Gabriela Akemi

; Madalosso, Geraldine

; Albuquerque, José Olimpio Moura de

; Costa, Selma Anequini

; Ferreira, Paula Bisordi

; Sato, Ana Paula Sayuri

; Glasser, Paula Regina

; Pino, Francisco Alberto

; Burihan, Patrícia Carla Piragibe Ramos

; Carvalho, Ana Carolina Aguiar de

; Amorim, Ana Beatriz Pagliaro

; Cavazzana, Cinthya Luzia

; Aires, Caroline Cotrim

; Kataoka, Ana Paula Arruda Geraldes

; Savani, Elisa San Martin Mouriz

; Bessa, Thirsa Alvares Franco

; Aguiar, Breno Souza de

; Failla, Marcelo Antunes

; Santos, Edson Aparecido dos

; Brito, Edjane Maria Torreão

; Santos, Maria Cristina Honório dos

; Caldeira, Luiz Artur Vieira

; Silva, Solange Maria Saboia e

; Zamarco, Luiz Carlos

; Fonseca, Sandra Maria Sabino

; Lima, Marcia Maria de Cerqueira

; Marques, Ivanilda Argenau

; Mauro, Athenê Maria de Marco França

; Masi, Eduardo de

Revista de Saúde Pública

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2023, Volume 57 Supl. 1 elocation 6s

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO OBJETIVO Estimar a soroprevalência de anticorpos do vírus SARS-CoV-2 em escolares de quatro a 14 anos de idade residentes no município de São Paulo, segundo variáveis clínicas, demográficas, epidemiológicas e sociais, durante o período de fechamento das escolas como medida de controle da covid-19. MÉTODOS Realizou-se um inquérito sorológico em setembro de 2020 com amostra aleatória estratificada por tipo de rede de ensino (pública municipal, pública estadual e privada). Foi coletada amostra de sangue venoso utilizando-se o teste de imunoensaio de fluxo lateral da fabricante Wondfo para detecção de anticorpos totais contra o vírus SARS-CoV-2. Aplicaram-se questionários semiestruturados para o levantamento de dados clínicos, demográficos, sociais e epidemiológicos. RESULTADOS A soroprevalência de anticorpos do vírus SARS-CoV-2 em escolares foi de 16,6% (IC95% 15,4–17,8). O estudo encontrou soroprevalências mais elevadas na rede pública municipal (18,5%; IC95% 16,6–20,6) e estadual (16,2%; IC95% 14,4–18,2) em relação à rede privada (11,7; IC95% 10,0–13,7) e entre escolares da raça/cor preta e parda (18,4%; IC95% 16,8–20,2) e no estrato social mais vulnerável (18,5%; IC95% 16,9–20,2). A pesquisa identificou menores soroprevalências nos escolares que relataram seguir as medidas recomendadas de proteção contra a covid-19. CONCLUSÃO A soroprevalência de anticorpos contra o vírus SARS-CoV-2 atinge principalmente os escolares socialmente mais vulneráveis. Este estudo pode contribuir para embasar políticas públicas que reforcem a importância da suspensão das aulas presenciais e da necessidade de estratégias de medidas de proteção e acompanhamento do status sorológico daqueles que ainda não foram contemplados no calendário vacinal.

ABSTRACT OBJECTIVE To estimate seroprevalence of SARS-CoV-2 antibodies in schoolchildren aged 4 to 14 years living in the city of São Paulo, according to clinical, demographic, epidemiological, and social variables, during the school closure period as a measure against covid-19 spread. METHODS A serological survey was made in September 2020 with a random sample stratified by school system (municipal public, state public and private) type. A venous blood sample was collected using the Wondfo SARS-CoV-2 Antibody Test (lateral flow method) for detection of total SARS-CoV-2 virus antibodies. Semi-structured questionnaires were applied to collect clinical, demographic, social, and epidemiological data. RESULTS Seroprevalence of SARS-CoV-2 antibodies in schoolchildren was of 16.6% (95%CI 15.4–17.8). The study found higher seroprevalence in the municipal (18.5%; 95%CI 16.6–20.6) and state (16.2%; 95%CI 14.4–18.2) public school systems compared to the private school system (11.7; 95%CI 10.0–13.7), among black and brown students (18.4%; 95%CI 16.8–20.2) and in the most vulnerable social stratum (18.5 %;95%CI 16.9–20.2). Lower seroprevalence was identified in schoolchildren who reported following the recommended protective measures against covid-19. CONCLUSION Seroprevalence of SARS-CoV-2 antibodies is found mainly in the most socially vulnerable schoolchildren. This study can contribute to support public policies that reinforce the importance of suspending face-to-face classes and developing strategies aimed at protective measures and monitoring of the serological status of those who have not yet been included in the vaccination schedule.

https://doi.org/10.11606/s1518-8787.2023057004782

Seroprevalence of SARS-CoV-2 antibodies in schoolchildren in the city of São Paulo, 2020
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Kamioka, Gabriela Akemi

; Madalosso, Geraldine

; Albuquerque, José Olimpio Moura de

; Costa, Selma Anequini

; Ferreira, Paula Bisordi

; Sato, Ana Paula Sayuri

; Glasser, Paula Regina

; Pino, Francisco Alberto

; Burihan, Patrícia Carla Piragibe Ramos

; Carvalho, Ana Carolina Aguiar de

; Amorim, Ana Beatriz Pagliaro

; Cavazzana, Cinthya Luzia

; Aires, Caroline Cotrim

; Kataoka, Ana Paula Arruda Geraldes

; Savani, Elisa San Martin Mouriz

; Bessa, Thirsa Alvares Franco

; Aguiar, Breno Souza de

; Failla, Marcelo Antunes

; Santos, Edson Aparecido dos

; Brito, Edjane Maria Torreão

; Santos, Maria Cristina Honório dos

; Caldeira, Luiz Artur Vieira

; Silva, Solange Maria Saboia e

; Zamarco, Luiz Carlos

; Fonseca, Sandra Maria Sabino

; Lima, Marcia Maria de Cerqueira

; Marques, Ivanilda Argenau

; Mauro, Athenê Maria de Marco França

; Masi, Eduardo de

Revista de Saúde Pública

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2023, Volume 57 elocation 6s

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

https://doi.org/10.11606/s1518-8787.2023057004782

Impact of COVID-19 on healthcare-associated infections: Antimicrobial consumption does not follow antimicrobial resistance
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Freire, Maristela Pinheiro

; Assis, Denise Brandão de

; Tavares, Bruno de Melo

; Brito, Valquiria O.C.

; Marinho, Igor

; Lapchik, Milton

; Guedes, Ana Rubia

; Madalosso, Geraldine

; Oliveira, Maura Salaroli

; Lima, Antonio Carlos Pedroso de

; Levin, Anna S.

Clinics

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2023, Volume 78 elocation 100231

Resumo: En | Texto: En | PDF: En

Abstract Background This study aimed to analyze the Healthcare-Associated Infections (HAI) rates and antimicrobial consumption in Intensive Care Units (ICU) in São Paulo city during the COVID-19 pandemic and compare them with the pre-pandemic period. Methods This cohort included all hospitals that reported HAI rates (Central-Line-Associated Bloodstream Infection ‒ CLABSI and Ventilator-Associated Pneumonia ‒ VAP), the proportion of microorganisms that caused CLABSI, the proportion of resistant microorganisms, and antimicrobial consumption from January 2017 ‒ December 2020. Hospitals were stratified by the number of beds, Central Venous Catheter (CVC) utilization rate, Mechanical-Ventilation (MV) utilization rate, and type of funding. Statistical analyses were based on time-series plots and regression models. Results 220 ICUs were included. The authors observed an abrupt increase in CLABSI rates after the pandemic onset. High CLABSI rates during the pandemic were associated with hospital size, funding (public and non-profit private), and low CVC use (≤ 50%). An increase in VAP rates was associated with public hospitals, and high MV use (> 35%). The susceptibility profile of microorganisms did not differ from that of the pre-pandemic period. polymyxin, glycopeptides, and antifungal use increased, especially in COVID-19 ICUs. Conclusions HAI increased during COVID-19. The microorganisms’ susceptibility profile did not change with the pandemic, but the authors observed a disproportionate increase in large-spectrum antimicrobial drug use.

https://doi.org/10.1016/j.clinsp.2023.100231

Surveillance system for Healthcare-associated endophthalmitis at state level in a middle-income country: preliminary results
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Luz, Reginaldo Adalberto

; Assis, Denise Brandão de

; Madalosso, Geraldine

; Timmons, Stephen

; Padoveze, Maria Clara

Arquivos Brasileiros de Oftalmologia

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2022, Nº ahead

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

https://doi.org/10.5935/0004-2749.2022-0181

Prevalence evolution of SARS-CoV-2 infection in the city of São Paulo, 2020–2021
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Albuquerque, José Olimpio Moura de

; Kamioka, Gabriela Akemi

; Madalosso, Geraldine

; Costa, Selma Anequini

; Ferreira, Paula Bisordi

; Pino, Francisco Alberto

; Sato, Ana Paula Sayuri

; Carvalho, Ana Carolina Aguiar de

; Amorim, Ana Beatriz Pagliaro

; Aires, Caroline Cotrim

; Kataoka, Ana Paula Arruda Geraldes

; Savani, Elisa San Martin Mouriz

; Bessa, Thirsa Alvares Franco

; Aguiar, Breno Souza de

; Failla, Marcelo Antunes

; Santos, Edson Aparecido dos

; Brito, Edjane Maria Torreão

; Santos, Maria Cristina Honório dos

; Silva, Solange Maria Saboia e

; Caldeira, Luiz Artur Vieira

; Zamarco, Luiz Carlos

; Fonseca, Sandra Maria Sabino

; Lima, Marcia Maria de Cerqueira

; Marques, Ivanilda Argenau

; Silva, Fabiana Érica Vilanova da

; Glasser, Paula Regina

; Burihan, Patrícia Carla Piragibe Ramos

; Cavazzana, Cinthya Luzia

; Mello, Debora Silva de

; Pellini, Alessandra Cristina Guedes

; Nishio, Fernando Yoshiki

; Kian, Fernanda Miyashiro

; Braga, Elza de Santana

; Bertelli, Nilza Maria Piassi

; Fracini, Wagner

; Gonçalves, Marcelo Dell Áquila

; Zular, Paulete Secco

; Piva, Regiane de Santana

; Masi, Eduardo

Revista de Saúde Pública

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2021, Volume 55 elocation 62

Resumo: En | Texto: En | PDF: En

ABSTRACT OBJECTIVE To estimate the evolution of the prevalence of SARS-CoV-2 virus infection among residents aged 18 years or over in the municipality of São Paulo. METHODS This is a population-based household survey conducted every 15 days, between June and September 2020, and January and February 2021. In total, the study comprised 11 phases. The presence of antibodies against SARS-CoV-2 was identified in venous blood using a lateral flow test, Wondfo Biotech. In the last phase, the researchers combined it with an immunoenzymatic test, Euroimmun. The participants also answered a semi-structured questionnaire on sociodemographic and economic factors, and on social distancing measures. Prevalence estimates and the 95% confidence interval were estimated according to regions, Human Development Index, sex, age group, ethnicity, education, income, and variables associated with risk or prevention of infection. To compare the frequencies among the categories of each variable, the chi-square test with Rao-Scott correction was used, considering a significance level of 5%. RESULTS In total, 23,397 individuals were interviewed and had their samples collected. The estimated prevalence of antibodies against SARS-CoV-2 ranged from 9.7% (95%CI: 7.9–11.8%) to 25.0% (95%CI: 21.7–28.7). The prevalence of individuals with antibodies against the virus was higher among black and brown people, people with lower schooling and income, and among residents of regions with lower Human Development Index. The lowest prevalences were associated with recommended measures of disease protection. The proportion of asymptomatic infection was 45.1%. CONCLUSION The estimated prevalence of the infection was lower than the cumulative incidence variation, except for the last phase of the study. The differences in prevalence estimates observed among subpopulations showed social inequality as a risk of infection. The lower prevalence observed among those who could follow prevention measures reinforce the need to maintain social distancing measures as a way to prevent SARS-CoV-2 infection.

https://doi.org/10.11606/s1518-8787.2021055003970

Prevalence evolution of SARS-CoV-2 infection in the city of São Paulo, 2020–2021
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Albuquerque, José Olimpio Moura de

; Kamioka, Gabriela Akemi

; Madalosso, Geraldine

; Costa, Selma Anequini

; Ferreira, Paula Bisordi

; Pino, Francisco Alberto

; Sato, Ana Paula Sayuri

; Carvalho, Ana Carolina Aguiar de

; Amorim, Ana Beatriz Pagliaro

; Aires, Caroline Cotrim

; Kataoka, Ana Paula Arruda Geraldes

; Savani, Elisa San Martin Mouriz

; Bessa, Thirsa Alvares Franco

; Aguiar, Breno Souza de

; Failla, Marcelo Antunes

; Santos, Edson Aparecido dos

; Brito, Edjane Maria Torreão

; Santos, Maria Cristina Honório dos

; Silva, Solange Maria Saboia e

; Caldeira, Luiz Artur Vieira

; Zamarco, Luiz Carlos

; Fonseca, Sandra Maria Sabino

; Lima, Marcia Maria de Cerqueira

; Marques, Ivanilda Argenau

; Silva, Fabiana Érica Vilanova da

; Glasser, Paula Regina

; Burihan, Patrícia Carla Piragibe Ramos

; Cavazzana, Cinthya Luzia

; Mello, Debora Silva de

; Pellini, Alessandra Cristina Guedes

; Nishio, Fernando Yoshiki

; Kian, Fernanda Miyashiro

; Braga, Elza de Santana

; Bertelli, Nilza Maria Piassi

; Fracini, Wagner

; Gonçalves, Marcelo Dell Áquila

; Zular, Paulete Secco

; Piva, Regiane de Santana

; Masi, Eduardo

Revista de Saúde Pública

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2021, Volume 55 elocation 62

Resumo: En | Texto: En | PDF: En

https://doi.org/10.11606/s1518-8787.2021055003970 43 downloads

Current Status of Antimicrobial Stewardship Programs in São Paulo Hospitals
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Sato, Silvia Akemi

; Brandão, Denise Assis

; Madalosso, Geraldine

; Levin, Anna S.

; Perdigão Neto, Lauro Vieira

; Oliveira, Maura Salaroli

Clinics

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2021, Volume 76 elocation e2882

Resumo: En | Texto: En | PDF: En

OBJECTIVES: Antimicrobial stewardship programs (ASPs) comprise coordinated interventions designed to improve antimicrobial use. Understanding the current structure of ASP hospitals will support interventions for the improvement of these programs. This study aimed to describe the status of ASPs in hospitals in São Paulo, Brazil. METHODS: A cross-sectional survey was conducted on the ASPs of hospitals in the state of São Paulo from March to July 2018. Through interviews by telephone or e-mail, we queried which components of the Infectious Diseases Society of America/Society for Healthcare Epidemiology of America and Centers for Disease Control and Prevention guidelines were implemented. RESULTS: The response rate was 30% (28/93 hospitals), and 26 hospitals (85%) reported having a formal ASP. The most frequently implemented strategies were antimicrobial surgical prophylaxis guidelines (100%), empiric sepsis guidelines (93%), and the presence of ASP team members during bedside rounds (96%). The least commonly implemented strategies included prior authorization for all antimicrobials (11%), pharmacokinetic monitoring, and an adjustment program for patients on IV aminoglycosides (3%). Regarding the metrics of the ASP, the most common indicator was the rate of antimicrobial resistance (77%). Eighteen hospitals evaluated antimicrobial consumption using defined daily dose, and only 29% evaluated the days of therapy; 61% of hospitals reported their results to the hospital administration and 39% to the prescribers. CONCLUSIONS: Most hospitals have a formal and active ASP, but with timely actions. We observed inconsistencies between what program leaders understand as the main objective of ASP and the metrics used to evaluate it. Part of the effort for the next few years should be to improve program evaluation metrics and to provide feedback to physicians and hospital leadership.

https://doi.org/10.6061/clinics/2021/e2882 208 downloads

Statewide evaluation of infection control measures for preventing coronavirus disease 2019 in hemodialysis facilities
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Guedes, Ana Rubia

; Tavares, Bruno de Melo

; Assis, Denise Brandão de

; Freire, Maristela Pinheiro

; Madalosso, Geraldine

; Levin, Anna S.

; Perdigão Neto, Lauro Vieira

; Oliveira, Maura Salaroli de

Clinics

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2021, Volume 76 elocation e3299

Resumo: En | Texto: En | PDF: En

OBJECTIVE: This study aimed to evaluate the occurrence of coronavirus disease 2019 (COVID-19) in hemodialysis facilities and the occurrence of and risk factors for clustering of COVID-19 cases. METHODS: We conducted a cross-sectional online survey between March and July 2020, in all dialysis facilities in São Paulo state, using Google Forms. The online questionnaire contained questions addressing specific components of infection prevention and control practices and the number of cases during the COVID-19 pandemic. RESULTS: A total of 1,093 (5%) COVID-19 cases were reported among 20,984 patients; approximately 56% of the facilities had ≥1 cluster. Most facilities implemented various measures (such as allocation of dedicated COVID-19 areas/shifts, symptom screening, environmental disinfection, and maintenance of adequate ventilation) to prevent the transmission of severe acute respiratory syndrome coronavirus 2. Clustering of COVID-19 cases was suspected in only 7% of dialysis facilities. The only variable associated with this event was the performance of aerosol-generating procedures (odds ratio: 4.74; 95% confidence interval: 1.75-12.86). CONCLUSION: Attention should be paid to avoiding the performance of aerosol-generating procedures in dialysis facilities and monitoring the clustering of cases.

https://doi.org/10.6061/clinics/2021/e3299 102 downloads

10.

Total antibiotic use in a state-wide area and resistance patterns in Brazilian hospitals: an ecologic study
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Boszczowski, Ícaro

; Chiaravalloti Neto, Francisco

; Blangiardo, Marta

; Baquero, Oswaldo Santos

; Madalosso, Geraldine

; Assis, Denise Brandão de

; Olitta, Thais

; Levin, Anna S.

Brazilian Journal of Infectious Diseases

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Dez 2020, Volume 24 Nº 6 Páginas 479 - 488

Resumo: En | Texto: En | PDF: En

ABSTRACT Introduction: Use of antibiotic and bacterial resistance is the result of a complex interaction not completely understood. Objectives: To evaluate the impact of entire antimicrobial use (community plus hospitals) on the incidence of bloodstream infections in intensive care units adjusted by socioeconomic factors, quality of healthcare, and access to the healthcare system. Design: Ecologic study using a hierarchical spatial model. Setting: Data obtained from 309 hospitals located in the state of São Paulo, Brazil from 2008 to 2011. Participants: Intensive care units located at participant hospitals. Outcome: Hospital acquired bloodstream infection caused by MDRO in ICU patients was our primary outcome and data were retrieved from São Paulo Health State Department. Socioeconomic and healthcare indexes data were obtained from IBGE (Brazilian Foundation in charge of national decennial census) and SEADE (São Paulo Planning and Development Department). Information on antimicrobial sales were obtained from IMS Brazil. We divided antibiotics into four different groups (1-4). Results: We observed a direct association between the use of group 1 of antibiotics and the incidences of bloodstream infections caused by MRSA (1.12; 1.04-1.20), and CR-Acinetobacter sp. (1.19; 1.10-1.29). Groups 2 and 4 were directly associated to VRE (1.72; 1.13-2.39 and 2.22; 1.62-2.98, respectively). Group 2 was inversely associated to MRSA (0.87; 0.78-0.96) and CR-Acinetobacter sp. (0.79; 0.62-0.97). Group 3 was inversely associated to Pseudomonas aeruginosa (0.69; 0.45-0.98), MRSA (0.85; 0.72-0.97) and VRE (0.48; 0.21-0.84). No association was observed for third generation cephalosporin-resistant Klebsiella pneumoniae and Escherichia coli. Conclusions: The association between entire antibiotic use and resistance in ICU was poor and not consistent for all combinations of antimicrobial groups and pathogens even after adjusted by socioeconomic indexes. Selective pressure exerted at the community level seemed not to affect the incidences of MDRO infection observed in intensive care setting.

https://doi.org/10.1016/j.bjid.2020.08.012 360 downloads

11.

Norovírus no município de São Paulo, 2010-2016: estudo transversal sobre a principal causa de gastroenterite infantil
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Kamioka, Gabriela Akemi

; Madalosso, Geraldine

; Pavanello, Eliana Izabel

; Sousa, Sonia Cristina Zeferino de

; Bassit, Nídia Pimenta

; Sato, Ana Paula Sayuri

Epidemiologia e Serviços de Saúde

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2019, Volume 28 Nº 2 elocation e2018290

Resumo: Pt En Es | Texto: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Resumo Objetivo: descrever casos de doença diarreica aguda por norovírus em crianças menores de 5 anos do município de São Paulo, Brasil. Métodos: estudo transversal com dados provenientes da Vigilância Epidemiológica das Gastroenterites Causadas por Rotavírus; foi definido como caso o paciente internado em unidade sentinela por doença diarreica aguda e identificação laboratorial do norovírus como agente etiológico, entre os anos de 2010 e 2016. Resultados: durante o período estudado, a proporção de casos de norovírus em menores de 5 anos de idade ultrapassou a proporção de casos de rotavírus, agente considerado predominante na infância; o norovírus foi associado a 28,4% do total de casos notificados, ocorrendo o ano todo, principalmente nos meses mais quentes. Conclusão: norovírus foi o principal agente etiológico identificado em crianças menores de 5 anos com doença diarreica aguda no município de São Paulo.

Abstract Objective: to describe cases of acute diarrheal disease caused by norovirus in children under 5 years old in São Paulo city, Brazil. Methods: this was a cross-sectional study using data from Epidemiological Surveillance of Gastroenteritis due to Rotavirus; cases were defined as patients hospitalized in a sentinel unit because of acute diarrheal disease and laboratory identification of norovirus as the etiological agent between 2010 and 2016. Results: during the study period, the proportion of norovirus cases in children under 5 years old exceeded the proportion of Rotavirus, an agent considered predominant in childhood; norovirus was associated with 28.4% of total reported cases, occurring all year round, especially in warmer months. Conclusion: norovirus was the leading etiological agent identified in children under 5 years old with acute diarrheal disease in São Paulo city.

Resumen Objetivo: describir casos de enfermedad diarreica aguda por Norovirus en niños menores de 5 años provenientes del Municipio de São Paulo, Brasil. Métodos: Estudio transversal con datos de la Vigilancia Epidemiológica de las Gastroenteritis causadas por Rotavirus. Se definió como caso el paciente internado en unidad centinela por enfermedad diarreica aguda e identificación de laboratorio del Norovirus como agente etiológico entre los años de 2010 y 2016. Resultados: Durante el período estudiado, la proporción de casos de Norovirus en menores de 5 años superó la proporción de casos de Rotavirus, agente considerado predominante en la infancia. El Norovirus fue asociado al 28,4% del total de los casos notificados, ocurriendo todo el año, principalmente en los meses más cálidos. Conclusión: el Norovirus fue el principal agente etiológico identificado en niños menores de 5 años con enfermedad diarreica aguda en el Municipio de São Paulo.

https://doi.org/10.5123/s1679-49742019000200016 1854 downloads

12.

Norovírus no município de São Paulo, 2010-2016: estudo transversal sobre a principal causa de gastroenterite infantil
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Kamioka, Gabriela Akemi

; Madalosso, Geraldine

; Pavanello, Eliana Izabel

; Sousa, Sonia Cristina Zeferino de

; Bassit, Nídia Pimenta

; Sato, Ana Paula Sayuri

Epidemiologia e Serviços de Saúde

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2019, Volume 28 Nº 2 elocation e2018290

Resumo: Pt En Es | Texto: Pt En Es | PDF: Pt | PDF: En | PDF: Es

https://doi.org/10.5123/s1679-49742019000200016

13.

Cerebral tuberculomas in AIDS patients: a forgotten diagnosis?
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Vidal, José E.

; Hernández, Adrián V.

; Oliveira, Augusto C. Penalva de

; Souza, Alexandre de Leite

; Madalosso, Geraldine

; Silva, Paula R. Marques da

; Dauar, R.

Arquivos de Neuro-Psiquiatria

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Set 2004, Volume 62 Nº 3b Páginas 793 - 796

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

A epidemia da infecção pelo vírus da imunodeficiência humana (HIV) aumentou a prevalência, multiresistência e formas disseminadas da tuberculose. O acometimento neurológico da tuberculose apresenta elevada morbidade e mortalidade, classificando-se em formas difusas (meningite) e localizadas (tuberculoma e abscesso). Relatamos três casos de tuberculomas cerebrais em pacientes com AIDS: um deles com diagnóstico definitivo, confirmado com histopatologia e dois com diagnóstico provável, baseado em informação clínica, radiológica, isolamento de Mycobaterium tuberculosis fora do sistema nervoso central e adequada resposta ao tratamento tuberculostático. Discutimos também aspectos diagnósticos, terapêuticos e prognósticos dos tuberculomas, enfatizando suas diferenças com os abscesos tuberculosos cerebrais. Apesar de serem relatados de forma infreqüente, os tuberculomas devem sempre ser considerados no diagnóstico diferencial das lesões expansivas cerebrais em pacientes com AIDS.

The human immunodeficiency virus (HIV) infection epidemics increased the prevalence, multi-drug resistance and disseminated forms of tuberculosis. The central nervous system (CNS) tuberculosis has high mortality and morbidity, and it is usually divided into diffuse (meningitis) and localized (tuberculoma and abscess) forms. We report three cases of cerebral tuberculomas in AIDS patients: one with definitive diagnosis, confirmed with histopathology, and two with probable diagnosis, based on clinical information, radiological images, Mycobaterium tuberculosis isolation out of the CNS and adequate response to antituberculous treatment. Further, we discuss diagnostic, therapeutic and prognostic issues of tuberculomas, with emphasis in the distinction from cerebral tuberculous abscesses. Despite of their infrequent presentation, tuberculomas should be considered in the differential diagnosis of cerebral expansive lesions in patients with AIDS.

6002 downloads

14.

Chagasic meningoencephalitis: case report of a recently included AIDS-defining illness in Brazil
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Madalosso, Geraldine

; Pellini, Alessandra C. Guedes

; Vasconcelos, Marileide J.

; Ribeiro, Ana Freitas

; Weissmann, Leonardo

; Oliveira Filho, Gilberto Silva

; Oliveira, Augusto C. Penalva de

; Vidal, Jose E.

Revista do Instituto de Medicina Tropical de São Paulo

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Ago 2004, Volume 46 Nº 4 Páginas 199 - 202

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Recentemente, a reagudização da doença de Chagas (meningoencefalite e/ou miocardite) foi incluída na lista de doenças indicativas de aids no Brasil. Os autores relatam o caso de um paciente de 52 anos de idade, natural de área rural da Bahia e procedente de uma área urbana de São Paulo, sem história de doenças prévias e que apresentou meningoencefalite aguda. As sorologias e pesquisas parasitológicas diretas no sangue e no liquido cefalorraquideano (LCR) demonstraram presença de Trypanosoma cruzi, confirmando-se o diagnóstico mediante cultura do LCR. O teste rápido assim como os ELISA e Western Blot diagnosticaram infecção pelo vírus da imunodeficiência humana (HIV). Apesar do tratamento com benzonidazole e as medidas de suporte, o paciente faleceu 24 horas depois da admissão hospitalar. Em áreas endêmicas, a reagudização da doença de Chagas deve ser sempre considerada no diagnóstico diferencial das meningoencefalites e sua presença em pacientes com infecção pelo HIV é indicativa de aids.

Recently, reactivation of Chagas disease (meningoencephalitis and/or myocarditis) was included in the list of AIDS-defining illnesses in Brazil. We report a case of a 52-year-old patient with no history of previous disease who presented acute meningoencephalitis. Direct examination of blood and cerebrospinal fluid (CSF) showed Trypanosoma cruzi. CSF culture confirmed the diagnosis. Serological assays for T. cruzi and human immunodeficiency virus (HIV) were positive. Despite treatment with benznidazol and supportive measures, the patient died 24 hours after hospital admission. In endemic areas, reactivation of Chagas disease should always be considered in the differential diagnosis of meningoencephalitis among HIV-infected patients, and its presence is indicative of AIDS.

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