A freqüência de infecções hematogênicas por Candida (candidemia) tem aumentado consideravelmente, especialmente em unidades de terapia intensiva e ou de assistência a pacientes críticos 2 3 4 7 8 14 15 17 20 24 . O aumento na freqüência de candidemia tem sido observado particularmente entre pacientes em uso de antibióticos, terapia imunossupressora, nutrição parenteral, e em pacientes expostos a múltiplos procedimentos invasivos 11 24 .Espécies do gênero Candida, em particular Candida albicans, têm emergido como importantes patógenos nosocomiais, estando associadas a quase 80% de todas as infecções fúngicas nosocomiais, representando a maior causa de fungemia 2 24 . Candidemia é a quarta causa mais comum de infecção na corrente sangüínea em hospitais terciários, e sua ocorrência tem sido associada à longa permanência hospitalar e alta mortalidade 5 10 18 21 . ABSTRACTWe conducted a prospective, observational, laboratory-based study on candidemia to investigate the incidence of candidemia, species distribution and clinical conditions between September 2003 and March 2004 in a private tertiary hospital in Recife, northeastern Brazil. Cases of candidemia were defined as occurrences of isolation of Candida spp from blood cultures. The incidence rate was calculated per 1,000 admissions. A total of 5,532 patients were admitted to the hospital during the study period, and 1,745 blood cultures were processed. Twenty-one episodes of candidemia were observed in 18 patients. The incidence rate of candidemia was 3.9 episodes per 1,000 admissions. Non-albicans species accounted for more than 50% of the cases, and Candida parapsilosis (33%) and Candida tropicalis (24%) predominated. Eleven (61%) patients died. The incidence of candidemia was higher than that observed in a Brazilian multicenter study. Candidemia was caused predominantly by non-albicans species.

Candida is an opportunistic pathogen that affects high-risk patients who are either immunocompromised or critically ill and is associated with almost 80% of all nosocomial fungal infections, representing the major cause of fungemia with high mortality rates (40%). Candida albicans is the main cause of candidemia and among the non-albicans species C. parapsilosis, C. glabrata and C. tropicalis are the most frequent agents.

We observed a higher prevalence of serological markers for HBV and a lower prevalence of anti-HCV. Our results indicate that females and patients of an advanced age are the most affected categories and that patients that received multiple transfusions are at a higher probability of HCV infection.

The objective of this study was to determine the prevalence of serological markers of hepatitis B and risk factors in health care workers of dialysis units. An analytical descriptive transversal study was performed with 138 health professionals from six dialysis units of Recife city, Brazil. Blood samples were collected between March and July, 2007 and tested for the HBsAg markers (HBsAg, anti-HBs and total anti-HBc) using ELISA method of third generation. Two softwares were used for statistical analysis: the Epi Info (v. 6.04) for the univariate analysis and the Statistical Package for the Social Sciences-SPSS (v. 8.0) for multiple logistical regression. The prevalence of hepatitis B infections, determined by presence of the HBsAg and/or total anti-HBc markers in dialysis staff was 13%. Positivity rate for anti-HBs was 75.4%.However, 11.6% of them were susceptible to infection. In the univariate analysis the variables: length of employment in hemodialysis, quantity of individual protective equipment (IPEs), surgery and/or dentary-surgery antecedents and incomplete vaccination against HBV presented statistically significant association with HBV seropositivity. But, according the multivariate analysis, only length of employment in hemodialysis, quantity of individual protective equipment (IPEs) used and incomplete vaccination against HBV presented statistically significant association with HBV seropositivity. These results showed that dialysis units have been focused on reducing the occurrence of exposure to blood and body fluids. These strategies include reevaluating the kind of material used, demanding strict compliance for protection in risky occupational procedures, the use of gloves and other barriers and a follow-up with serological tests whenever there is a case of work-related injury with biological material, as well as mandatory vaccination after exposure.