Extensively drug-resistant tuberculosis (XDR-TB) is an emerging health problem that threatens tuberculosis (TB) control worldwide, since suitable treatment for this disease has not yet been found. We report a case of secondary pulmonary XDR-TB in a 54-year-old, HIV-negative male from Goiânia, Brazil. The patient had long-standing pulmonary tuberculosis (nine years) with extensive bilateral lung damage and had been treated with multiple antituberculosis drugs (self-administered) before XDR-TB diagnosis. The strain of Mycobacterium tuberculosis was resistant to R- rifampicin, H-isoniazid, E-ethambutol, Eto-ethionamide, Ofx-ofloxacin, and Am-amikacin. This patient died with multiple organ failure due to sepsis secondary to bacterial pneumonia.

Multidrug-resistant tuberculosis (MDR-TB) is an emerging and worrisome health problem that threatens tuberculosis (TB) control worldwide. The clinical management of MDR-TB is a complex issue associated with the use of multiple drugs for a long period, usually accompanied by side effects and high costs. The objective of this work was to relate cases of MDR-TB occurring in Goiás, a central state of Brazil. We related five cases of MDR-TB, three women and two men. All were pulmonary cases. Three were in their second treatment and two in their first treatment. Surgical pulmonary resection was performed in one case. One death occurred. Lack of adherence, gastric intolerance to anti-TB drugs and poor clinical management were the main aspects related to the emergent resistance. A revision of the main clinical aspects of this disease was performed.

The reprocessing of objects from hospitals and dentistry is strongly associated with biological risk to the workers for the inherent exposition to the organic matter, and to the patients in which these objects are used. This descriptive study was accomplished at 12 hospitals in Goiânia-GO from July 2004 to July 2005 with the purpose of: identify the adoption of Equipments of Protection for the workers of Material and Sterilization Centers (MSC); to identify the availability of these Equipments in the services and to establish the facilitative and difficulty factors on its adoption. Participated in the study 64 volunteer workers. Data was obtained through observation and interview and was processed by the program Epi Info. There was no coherence between availability and use of the Equipments of Protection, as well as the workers' understanding regarding its importance. The intervening factors for non adhesion were: of personal reasons, lack of physical structure and material resources, and related to the organizational structure. These factors acted in a synergic way on what was considered “situation of risk” at the MSC work, for the workers as well for the customers.

El reprocesamiento de artículos odontomédico hospitalarios tiene relación con el riesgo biológico, tanto para los trabajadores, por la inherente exposición a la materia orgánica, como para los pacientes en los cuales los artículos son usados. Este estudio descriptivo se realizó en 12 hospitales en Goiânia-GO de julio/2004 a julio/2005 y sus objetivos fueron: identificar la adopción de equipamientos de protección por los trabajadores de centrales de material y esterilización; identificar la disponibilidad de estos equipamientos en los servicios y establecer los factores facilitadores y dificultadores de su adopción. Participaron voluntariamente 64 trabajadores. Los datos fueron obtenidos a través de la observación y entrevista, y fueron procesados por el programa Epi Info. No hubo coherencia entre disponibilidad y uso de los equipamientos de protección, así como con la comprensión de los trabajadores con relación a su importancia. Los factores de la no adhesión fueron: de cuño individual, falta de estructura física y recursos materiales, y relacionados a la estructura organizacional. Estos factores actuaron de manera sinérgica para lo que fue considerado “situación de riesgo” del trabajo en el CME, tanto para trabajadores como a los clientes.

O reprocessamento de artigos odontomédico-hospitalares tem relação com o risco biológico, tanto para os trabalhadores, pela inerente exposição à matéria orgânica, quanto para os pacientes nos quais estes artigos são utilizados. Este estudo descritivo foi realizado em 12 hospitais de Goiânia, GO de julho/2004 a julho/2005 e seus objetivos foram: identificar a adoção de equipamentos de proteção pelos trabalhadores de centros de material e esterilização; identificar a disponibilidade destes equipamentos nos serviços e estabelecer os fatores facilitadores e dificultadores de sua adoção. Participaram voluntariamente 64 trabalhadores. Os dados foram obtidos por meio de observação e entrevista e foram processados pelo programa Epi Info. Não houve coerência entre disponibilidade e uso dos equipamentos de proteção, bem como com a compreensão dos trabalhadores quanto à sua importância. Os fatores da não-adesão foram: de cunho individual, falta de estrutura física e recursos materiais, e relacionados à estrutura organizacional. Estes fatores atuaram de maneira sinérgica para o que foi considerado “situação de risco” do trabalho em Central de Material de Esterilização (CME), tanto para trabalhadores quanto para os clientes.