Nosocomial infections constitute an important problem in hospitals, intensive care units (ICU) having the highest incidence of this type of infection. Staphylococci, especially Staphylococcus epidermidis and Staphylococcus aureus, are among the most important microorganisms associated with nosocomial infections. S. epidermidis is a common skin resident, and can be introduced into the clinical environment by patients and hospital staff. The situation in hospitals is aggravated by the emergence of multiresistant strains. We evaluated 98 hospital S. epidermidis isolates collected at neonatal, pediatric and adult ICUs and 20 S. epidermidis control skin resident isolates from healthy volunteers, for resistance to ten antibiotics and chemotherapeutic agents, and other pathogenicity factors. A high frequency (76.5%) of multiresistance was detected in clinical isolates, whereas community isolates were resistant to penicillin and ampicillin only. The frequency of multiresistant strains was 67.7% in the neonatal ICU, 66.6% in the pediatric ICU and 60.8% in the adult ICU, the lower frequency of multiresistant isolates in the adult ICU indicates a higher incidence of community strains in this unit. There were significantly higher frequencies of hemolytic, proteolytic and biofilm-forming isolates in the clinical isolates than the community isolates, indicating a higher incidence of strains with pathogenic potential in the hospital environment. Except for slight correlation with hemolytic activity there was no correlation between antibiotic multiresistance and pathogenicity factors.

Introduction: Group B Streptococcus (GBS), a source of neonatal infection, colonizes the gastrointestinal and genitourinary tracts of pregnant women. Routine screening for maternal GBS in late pregnancy and consequent intrapartum antibiotic prophylaxis have reduced the incidence of early-onset GBS neonatal infection. The aim of this study was to evaluate the performance of PCR, compared to culture (gold standard), in GBS colonization screening of pregnant women, and to establish the prevalence of GBS colonization among this population. Methods: Vaginal introitus and perianal samples were collected from 204 pregnant women, between the 35 th and 37 th weeks of pregnancy, at the Obstetrics and Gynecology Unit of the University of Caxias do Sul General Hospital between June 2008 and September 2009. All samples were cultured after enrichment in a selective medium and then assayed by culture and PCR methods. Results: The culture and PCR methods yielded detection rates of vaginal/perianal GBS colonization of 22.5% and 26%, respectively (sensitivity 100%; specificity 95.6%; positive and negative predictive values 86.8% and 100%, respectively). A higher prevalence of GBS colonization was detected in the combined vaginal and perianal samples by both culture and PCR assay analyses. Conclusions: PCR is a faster and more efficient method for GBS screening, allowing for optimal identification of women who should receive intrapartum antibiotic prophylaxis to prevent newborn infection.

Background The Americas are home to biologically and clinically diverse endemic fungi, including Blastomyces, Coccidioides, Emergomyces, Histoplasma, Paracoccidioides and Sporothrix. In endemic areas with high risk of infection, these fungal pathogens represent an important public health problem. Objectives This report aims to summarise the main findings of the regional analysis carried out on the status of the endemic mycoses of the Americas, done at the first International Meeting on Endemic Mycoses of the Americas (IMEMA). Methods A regional analysis for the Americas was done, the 27 territories were grouped into nine regions. A SWOT analysis was done. Results All territories reported availability of microscopy. Seventy percent of territories reported antibody testing, 67% of territories reported availability of Histoplasma antigen testing. None of the territories reported the use of (1–3)‐β‐d‐glucan. Fifty two percent of territories reported the availability of PCR testing in reference centres (mostly for histoplasmosis). Most of the territories reported access to medications such as trimethoprim‐sulfamethoxazole, itraconazole, voriconazole and amphotericin B (AMB) deoxycholate. Many countries had limited access to liposomal formulation of AMB and newer azoles, such as posaconazole and isavuconazole. Surveillance of these fungal diseases was minimal. Conclusions A consensus emerged among meeting participants, this group concluded that endemic mycoses are neglected diseases, and due to their severity and lack of resources, the improvement of diagnosis, treatment and surveillance is needed.

No abstract

No abstract

Objetivo. Reportar las especies identificadas en candidemias aisladas en hospitales del país, su distribución según los grupos etarios y determinar la sensibilidad a fluconazol, voriconazol y anfotericina B. Métodos. Estudio retrospectivo de candidemias reportados por siete hospitales al Laboratorio Central de Salud Pública en el período 2010 - 2018. La identificación y el antifungigrama fueron realizados en el sistema automatizado Vitek®2. Resultados. Se informaron 520 casos de candidemias. Las especies prevalentes fueron Candida albicans (34,4%), C. parapsilosis (30,4%), C. tropicalis (25,4%), C. glabrata (4,8%), C. krusei (2,1%). Otras menos frecuentes fueron: C. lusitaniae (1,2%), C. guilliermondii (1%), C. famata (0,3%), C. rugosa (0,2%) y C. kefyr (0,2%). Las candidemias en ancianos (48,5%) y adultos (29,9%) fueron las más prevalentes. C. parapsilosis fue más frecuente en recién nacidos y lactantes y C. tropicalis en pacientes pediátricos. El 2,8 % y 0,6% de C. albicans y el 4,4% y 2,5% de C. parapsilosis fueron resistentes a fluconazol y voriconazol, respectivamente. El 8% de C. glabrata fue resistente a fluconazol y dos aislamientos presentaron una concentración inhibitoria mínima para voriconazol mayor que 0,25 mg/L. Conclusiones. Este es el primer reporte de candidemias en hospitales de Paraguay que, junto a otros estudios, permitirá un mejor conocimiento de esta infección en el país.

Introducción: las mascotas generalmente son reservorios y diseminadores de hongos causantes de tiñas en humanos. Objetivo: aislar e identificar hongos dermatofitos en el pelaje de gatos asintomáticos del área metropolitana de Asunción. Materiales y métodos: se incluyeron 68 gatos asintomáticos del área metropolitana de Asunción, cuyas edades estaban entre 1 mes y 14 años. Las muestras de pelos fueron obtenidas por el método del tapete de Mariat y Tapia, se cultivaron en Agar Sabouraud con cloramfenicol y cicloheximida (agar Mycosel) y se incubaron 21 días a 28 ºC. La identificación se basó en las características macroscópicas y microscópicas de las colonias. Resultados: se aislaron hongos dermatofitos en 13 gatos: 10 (14,7%) tenían Microsporum canis y 3 (4,4%) Microsporum gypseum. No se encontró diferencias significativas en cuanto a la presencia del hongo y las variables sexo, edad, hábitat y contacto con otros animales. Conclusión: en gatos de Asunción se aislaron Microsporun canis (14,7%) y Microscporum gypseum (4,4%).

RESUMOOs objetivos do presente estudo foram avaliar o tratamento com tuberculostáticos para verificar o índice de abandono nos esquemas terapêuticos (2RHZ/4RH e 2RHZE/4RH), e identificar fatores preditivos ao abandono do tratamento.