Infeção por staphylococcus aureus meticilina-resistente da comunidade em Portugal

Nazareth, Raquel; Gonçalves-Pereira, João; Tavares, Ana; Miragaia, Maria; Lencastre, Hermı́nia de; Silvestre, J.F.; Freitas, Priscilla Ramos; Gonçalves, Eva; Martins, Fátima; Mendes, Vitor; Tapadinhas, Camila; Póvoa, Pedro

doi:10.1016/j.rppneu.2011.05.007

Cited by 15 publications

(7 citation statements)

References 33 publications

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“… 16 There is evidence that mothers of preterm infants have lower success rates in breastfeeding, and thus the adoption of practices that aim to establish and maintain the supply of breast milk as first choice for feeding preterm infants, considered a vulnerable population, must be continually supported and reviewed. 1 , 5 - 7 , 17 …”

Section: Discussionmentioning

confidence: 99%

Duration of breastfeeding in preterm infants followed at a secondary referral service

Freitas

Lima

Carlos³

et al. 2016

Revista Paulista de Pediatria (English Edition)

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Objective:Identify and analyze variables associated with shorter duration of breastfeeding in preterm infants.Methods:Retrospective cohort of premature infants followed up at secondary referral service in the period of 2010-2015. Inclusion: first appointment in the first month of corrected age and have undergone three or more consultations. Exclusion: diseases that impaired oral feeding. Outcome: duration of breastfeeding. A total of 103 preterm infants were evaluated, accounting for 28.8% of the preterm infants born in the municipality in that period, with a power of study of 80%. Descriptive analysis, t-test, chi-square test, Kaplan-Meier curves and Cox regression were used. p-values <0.05 were considered significant.Results:The median duration of breastfeeding among preterm infants was 5.0 months. The risk of breastfeeding discontinuation among preterm infants with gestational age <32 weeks was 2.6-fold higher than for those born at 32 weeks or more and the risk of breastfeeding interruption in preterm infants who were receiving breastfeeding supplementation in the first outpatient visit was 3-fold higher when compared to those who were exclusively breastfed in the first consultation.Conclusions:The median duration of breastfeeding in preterm infants was below the recommended one and discontinuation was associated with gestational <32 weeks and the fact that the infant was no longer receiving exclusive breastfeeding in the first outpatient visit. When these two variables were associated, their negative effect on the median duration of breastfeeding was potentiated.

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Section: Discussionmentioning

confidence: 99%

Duration of breastfeeding in preterm infants followed at a secondary referral service

Freitas

Lima

Carlos³

et al. 2016

Revista Paulista de Pediatria (English Edition)

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“…Studies including isolates from nasal swabs of young healthy individuals, nasopharyngeal swabs of children attending day care centers and isolates from soft tissues infections (SSTI) in children attending a pediatric emergency department, reported a prevalence of MRSA lower than 0.9% [12]–[14]. Typically CA-MRSA clonal lineages, as the European clone (ST80-IVc) or the USA300 clone (ST8-IVa) producing PVL, were sporadically reported in Portugal only in cases where the existence of hospital risk factors could not be eliminated [12], [15], [16].…”

Section: Introductionmentioning

confidence: 99%

Contamination of Public Buses with MRSA in Lisbon, Portugal: A Possible Transmission Route of Major MRSA Clones within the Community

et al. 2013

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In a previous study we have shown that public buses in Oporto, the second largest city in Portugal, were highly contaminated with MRSA. Here we describe the results of a similar study performed in another urban area of Portugal–Lisbon, the capital. Between May 2011 and May 2012, hand touched surfaces of 199 public buses in Lisbon were screened for MRSA contamination. Subsequently, the hands of 575 passengers who frequently use these bus lines were also screened. All hand carriers of MRSA were further screened for nasal carriage. The isolates were characterized by PFGE, staphylococcal cassette chromosome (SCC) mec typing, spa typing, MLST and were tested for the presence of mecA, Panton-Valentine leukocidin and arginine catabolic mobile element genes. MRSA contamination was shown in 72 buses (36.2%). The majority of the isolates belonged to three major clones: Clone A was identified as EMRSA-15 defined by pattern PFGE A, spa types t2357/t747/t025/t379/t910, ST22, and SCCmec IVh (n = 21; 29%). Clone B was the New York/Japan clone characterized by PFGE B-t002/t10682-ST5-II (n = 15; 21%). Clone C included isolates with characteristics of the international community-acquired USA300 or related clones, PFGE C-t008-ST8-IVa/IVc/IVg/IVnt/VI (n = 19; 26%). The first two clones are currently the two major lineages circulating in Portuguese hospitals. The hands of 15 individuals were contaminated with MRSA belonging to the nosocomial clones A or B. Eleven of these individuals were not nasal carriers of MRSA and all but one had travelled by public transportation, namely by bus, prior to sampling. In conclusion, public buses in two major cities in Portugal are often contaminated with MRSA representing clones dominant in hospitals in the particular geographic area. MRSA contamination of public transport and the transfer of the bacteria to the hands of passengers may represent a route through which hospital-acquired MRSA clones may spread to the community.

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“…22 Some studies have reported high rates of MRSA in SSSI or similar infections, both CA-MRSA and HA-MRSA, ranging from 22.4% to 74.8%, 1,12 but with important geographic variations. 23 In Portugal CA-MRSA has already been reported, 24 but HA-MRSA clearly predominates.…”

Section: Discussionmentioning

confidence: 99%

Evidence Associated with the Use of Oxazolidinones for the Treatment of Skin and Skin Structure Infections: A Retrospective Study

et al. 2019

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Introduction: Skin and skin structure infections are an increasing cause of hospitalization. Although mortality is relatively low, skin and skin structure infections are associated with prolonged hospital length of stay and high costs. Oxazolidinones have been suggested as a tool to treat infected patients in the ambulatory setting in order to decrease hospital length of stay. We wanted to address the evidence associated with the use of oxazolidinones in the treatment of skin and skin structure infections.Material and Methods: In this observational retrospective study we analyzed the anonymized diagnosis related group coded information from the Portuguese database for hospital admissions, that included all adult patients with a diagnosis of oxazolidinone use and a SSSI, discharged between 2010 and 2015.Results: During the study period, a total of 5518 patients had a diagnosis of oxazolidinone treatment. We selected 483 of those who were also diagnosed with a skin and skin structure infections. Their mean age was 64.9 years and 62.7% were male. The median hospital length of stay was 27 days (Inter quartile range 13 – 56) and the mortality rate was 12.6%. The prevalence of secondary anemia and of thrombocytopenia in the whole group treated with oxazolidinones was 2.5% and 3%, respectively.Discussion: Despite the high bioavailability of oxazolidinones, we were not able to find evidence that its use was associated with a decrease of mortality or hospital length of stay (due to early discharge) of patients with skin and skin structure infections.Conclusion: In this study we were not able to find evidence that oxazolidinones had any clinically significant benefit. A structured approach, including antibiotics with favorable pharmacokinetic and safety profile as well as a carefully planned ambulatory follow up may be needed.

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Infeção por staphylococcus aureus meticilina-resistente da comunidade em Portugal

Cited by 15 publications

References 33 publications

Duration of breastfeeding in preterm infants followed at a secondary referral service

Duration of breastfeeding in preterm infants followed at a secondary referral service

Contamination of Public Buses with MRSA in Lisbon, Portugal: A Possible Transmission Route of Major MRSA Clones within the Community

Evidence Associated with the Use of Oxazolidinones for the Treatment of Skin and Skin Structure Infections: A Retrospective Study

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